scholarly journals Finnish alcohol policy reform: battle over public health objectives

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
P Mäkelä
Keyword(s):  
Public Health ◽  
Price Competition ◽  
Interrupted Time Series ◽  
Alcohol Policy ◽  
First Year ◽  
Grocery Stores ◽  
Interrupted Time Series Analysis ◽  
The One ◽  
Health Objectives ◽  
Physical Availability

Abstract A new Alcohol Act came into force in Finland in 2018. The preparation of a comprehensive reform of the alcohol legislation was started already in 2011. The aim of Finnish alcohol policy has been to reduce alcohol-related harm, and the central means to do that have been by way of high taxation and restrictions in the physical availability of alcohol, in which the state alcohol monopoly has had a central role. The process of reforming the act was a long battle between forces that wished to continue underlining the public health aims and using efficient tools to reach those aims on the one hand, and neoliberal politicians aligned with the strong alcohol industry lobby and enthusiasts in social media who wished to get rid of regulation. The new Act somewhat expanded the rights of grocery stores to sell alcohol and de-regulated the on-premise trade by dismantling regulations in the old legislation. The retail state monopoly was weakened as a result, but it still has an important impact on restricting the physical availability of alcohol. Previously when alcohol has been made more available, consumption has increased, and also this time this was the expected outcome. However, an interrupted time series analysis has shown no statistically significant effect of the law change in the first year. One central explanation seems to be that price competition has been less intense than expected. Nonetheless, despite the fact that alcohol taxes were raised, a 10-year downward trend in alcohol consumption from 2008 to 2017 was halted.

scholarly journals Impact of the COVID-19 Pandemic on the General Mental Health in Sweden: No Observed Changes in the Dispensed Amount of Common Psychotropic Medications in the Region of Scania

2021 ◽  
Vol 12 ◽  
Author(s):  
Mirjam Wolfschlag ◽  
Cécile Grudet ◽  
Anders Håkansson
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Interrupted Time Series ◽  
Psychotropic Medications ◽  
Interrupted Time Series Analysis ◽  
Swedish Population ◽  
General Mental Health ◽  
Before And After ◽  
The One

Some first investigations have focused on the consequences of the COVID-19 pandemic for the general mental health after its outbreak in 2020. According to multiple self-reporting surveys, symptoms of stress, anxiety, and depression have risen worldwide. Even some studies based on health care records start to be published, providing more objective and statistically reliable results. Additionally, concerns have been raised, to what extend the access to mental health care has been compromised by the COVID-19 outbreak. The aim of this study was to detect changes in prescription trends of common psychotropic medications in the Swedish region of Scania. The monthly dispensed amounts of selected pharmaceuticals were compared from January 2018 until January 2021, regarding the prescription trends before and after the outbreak of COVID-19. Using an interrupted time series analysis for each medication, no general trend changes were observed. On the one hand, a possible deterioration of the general mental health could not be confirmed by these results. On the other hand, the access to mental health care did not seem to be impaired by the pandemic. When interpreting findings related to the COVID-19 pandemic, regional differences and country-specific approaches for coping with the pandemic should be considered. The Swedish population, for instance, never experienced a full “lock-down” and within Sweden the time point of the outbreak waves differed regionally. In general, the effects of the COVID-19 outbreak on mental health are still unclear and need to be investigated further in an international comparison.

scholarly journals The impact of city-wide deployment of Wolbachia-carrying mosquitoes on arboviral disease incidence in Medellín and Bello, Colombia: study protocol for an interrupted time-series analysis and a test-negative design study

F1000Research ◽  
2020 ◽  
Vol 8 ◽  
pp. 1327
Author(s):  
Ivan D. Velez ◽  
Eduardo Santacruz ◽  
Simon C. Kutcher ◽  
Sandra L. Duque ◽  
Alexander Uribe ◽  
...  
Keyword(s):  
Public Health ◽  
Time Series ◽  
Time Series Analysis ◽  
Disease Incidence ◽  
Interrupted Time Series ◽  
Case Control ◽  
Interrupted Time Series Analysis ◽  
Series Analysis ◽  
Negative Controls ◽  
Arboviral Disease

Background: Dengue, chikungunya and Zika are viral infections transmitted by Aedes aegypti mosquitoes, and present major public health challenges in tropical regions. Traditional vector control methods have been ineffective at halting disease transmission. The World Mosquito Program has developed a novel approach to arbovirus control using Ae. aegypti stably transfected with the Wolbachia bacterium, which have significantly reduced ability to transmit dengue, Zika and chikungunya in laboratory experiments. Field releases in eight countries have demonstrated Wolbachia establishment in local Ae. aegypti populations. Methods: We describe a pragmatic approach to measuring the epidemiological impact of city-wide Wolbachia deployments in Bello and Medellín, Colombia. First, an interrupted time-series analysis will compare the incidence of dengue, chikungunya and Zika case notifications before and after Wolbachia releases, across the two municipalities. Second, a prospective case-control study using a test-negative design will be conducted in one quadrant of Medellín. Three of the six contiguous release zones in the case-control area were allocated to receive the first Wolbachia deployments in the city and three to be treated last, approximating a parallel two-arm trial for the >12-month period during which Wolbachia exposure remains discordant. Allocation, although non-random, aimed to maximise balance between arms in historical dengue incidence and demographics. Arboviral disease cases and arbovirus-negative controls will be enrolled concurrently from febrile patients presenting to primary care, with case/control status classified retrospectively following laboratory diagnostic testing. Intervention effect is estimated from an aggregate odds ratio comparing Wolbachia-exposure odds among test-positive cases versus test-negative controls. Discussion: The study findings will add to an accumulating body of evidence from global field sites on the efficacy of the Wolbachia method in reducing arboviral disease incidence, and can inform decisions on wider public health implementation of this intervention in the Americas and beyond. Trial registration: ClinicalTrials.gov: NCT03631719. Registered on 15 August 2018.

scholarly journals The impact of city-wide deployment of Wolbachia-carrying mosquitoes on arboviral disease incidence in Medellín and Bello, Colombia: study protocol for an interrupted time-series analysis and a test-negative design study

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 1327
Author(s):  
Ivan D. Velez ◽  
Eduardo Santacruz ◽  
Simon C. Kutcher ◽  
Sandra L. Duque ◽  
Alexander Uribe ◽  
...  
Keyword(s):  
Public Health ◽  
Time Series ◽  
Time Series Analysis ◽  
Disease Incidence ◽  
Interrupted Time Series ◽  
Case Control ◽  
Interrupted Time Series Analysis ◽  
Series Analysis ◽  
Negative Controls ◽  
Arboviral Disease

Background: Dengue, chikungunya and Zika are viral infections transmitted by Aedes aegypti mosquitoes, and present major public health challenges in tropical regions. Traditional vector control methods have been ineffective at halting disease transmission. The World Mosquito Program has developed a novel approach to arbovirus control using Ae. aegypti stably transfected with the Wolbachia bacterium, which have significantly reduced ability to transmit dengue, Zika and chikungunya in laboratory experiments. Field releases in eight countries have demonstrated Wolbachia establishment in local Ae. aegypti populations. Methods: We describe a pragmatic approach to measuring the epidemiological impact of city-wide Wolbachia deployments in Bello and Medellín, Colombia. First, an interrupted time-series analysis will compare the incidence of dengue, chikungunya and Zika case notifications before and after Wolbachia releases, across the two municipalities. Second, a prospective case-control study using a test-negative design will be conducted in one quadrant of Medellín. Three of the six contiguous release zones in the case-control area were allocated to receive the first Wolbachia deployments in the city and three to be treated last, approximating a parallel two-arm trial for the >12-month period during which Wolbachia exposure remains discordant. Allocation, although non-random, aimed to maximise balance between arms in historical dengue incidence and demographics. Arboviral disease cases and arbovirus-negative controls will be enrolled concurrently from febrile patients presenting to primary care, with case/control status classified retrospectively following laboratory diagnostic testing. Intervention effect is estimated from an aggregate odds ratio comparing Wolbachia-exposure odds among test-positive cases versus test-negative controls. Discussion: The study findings will add to an accumulating body of evidence from global field sites on the efficacy of the Wolbachia method in reducing arboviral disease incidence, and can inform decisions on wider public health implementation of this intervention in the Americas and beyond. Trial registration: ClinicalTrials.gov: NCT03631719. Registered on 15 August 2018.

scholarly journals Impact of a national guideline on use of knee arthroscopy: An interrupted time-series analysis

2019 ◽  
Vol 31 (9) ◽  
pp. G113-G118
Author(s):  
Ali Kiadaliri ◽  
Dan Bergkvist ◽  
Leif E Dahlberg ◽  
Martin Englund
Keyword(s):  
Public Health ◽  
Health Care ◽  
Time Series ◽  
Time Series Analysis ◽  
Knee Arthroscopy ◽  
Interrupted Time Series ◽  
Public Health Care ◽  
Interrupted Time Series Analysis ◽  
Knee Oa ◽  
Series Analysis

Abstract Objective To assess the impact of the Swedish health authority recommendation against the use of knee arthroscopy in patients aged ≥40 years with knee osteoarthritis (OA). Design Interrupted time series analysis. Setting Public health care in Skåne region. Participants Patients aged ≥40 years who underwent knee arthroscopy from January 2010 to December 2015. Intervention(s) National guideline’s recommendation against the use of knee arthroscopy in patients with knee OA. Main Outcome Measure(s) 1) proportion of patients aged ≥40 years with a main diagnosis of Knee OA and/or degenerative meniscal lesions (DML) who underwent knee arthroscopy, and 2) overall knee arthroscopy rate per 100,000 Skåne population aged ≥40 years. Results A total of 6,155 knee arthroscopy were performed among people aged ≥40 years during study period. Of 42,044 patients with Knee OA/DML, 3,728 had knee arthroscopy. The recommendation was associated with reductions in the use of knee arthroscopy and two years after the recommendation, there was a reduction of 28.6% (95% CI: 9.3, 47.8) and 34.7% (23.9, 45.4) in proportion of Knee OA/DML patients with knee arthroscopy and the overall knee arthroscopy rate, respectively, relative to that expected if pre-recommendation trend continued. Our sensitivity analysis showed that the use of total knee replacement was stable over the study period. Conclusion The national recommendation was associated with reduction in use of knee arthroscopy in public health care in southern Sweden. However, still 4.5% of these patients underwent knee arthroscopy in 2015 implying that more efforts are required to achieve the recommended target.

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