scholarly journals Making sense of the evidence in population health intervention research: building a dry stone wall

2020 ◽  
Vol 5 (12) ◽  
pp. e004017
Author(s):  
David Ogilvie ◽  
Adrian Bauman ◽  
Louise Foley ◽  
Cornelia Guell ◽  
David Humphreys ◽  
...  

To effectively tackle population health challenges, we must address the fundamental determinants of behaviour and health. Among other things, this will entail devoting more attention to the evaluation of upstream intervention strategies. However, merely increasing the supply of such studies is not enough. The pivotal link between research and policy or practice should be the cumulation of insight from multiple studies. If conventional evidence synthesis can be thought of as analogous to building a wall, then we can increase the supply of bricks (the number of studies), their similarity (statistical commensurability) or the strength of the mortar (the statistical methods for holding them together). However, many contemporary public health challenges seem akin to herding sheep in mountainous terrain, where ordinary walls are of limited use and a more flexible way of combining dissimilar stones (pieces of evidence) may be required. This would entail shifting towards generalising the functions of interventions, rather than their effects; towards inference to the best explanation, rather than relying on binary hypothesis-testing; and towards embracing divergent findings, to be resolved by testing theories across a cumulated body of work. In this way we might channel a spirit of pragmatic pluralism into making sense of complex sets of evidence, robust enough to support more plausible causal inference to guide action, while accepting and adapting to the reality of the public health landscape rather than wishing it were otherwise. The traditional art of dry stone walling can serve as a metaphor for the more ‘holistic sense-making’ we propose.

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
T Lang ◽  
C Marquis ◽  
N Haschar-Noé ◽  
M Kelly-Irving ◽  
M Huot-Royer ◽  
...  

Abstract Today, the reduction of social inequalities in health is on the political agenda in public health. The complex reality of the determinants of these health inequalities remains difficult to understand and translate into practical actions. One of the reasons is that the circulation of expertise amongst researchers, actors in the field, and public decision is not systematic and still too rare. In 2013, the Federative Institute of Interdisciplinary Research and Studies Health Society (IFERISS) of Toulouse has an interdisciplinary platform (health, the humanities, and the social sciences) that directly offers expertise to public health actors, institutions, and local communities in order to respond to public health issues. At the request of the actors, AAPRISS can intervene at all stages of a study or an intervention, from conceptual and methodological construction to implementation support, and data analysis and use. In particular, the team has expertise in public policy evaluation, support for transferability according to the key functions/implementation/context (FIC) model, and awareness-raising at the intersection of urban planning and health. The platform is in a multi-year partnership with local authorities, the regional health agency of Occitanie, the primary health insurance funds of Occitanie, and various partners in civil society. Six years after the establishment of the AAPRISS platform, there is a strong demand for support and research from the actors and institutions. However, funding for activities remains uncertain despite the support of the National Cancer League and an increasingly strong network of partners. Mixed structures housing spaces for both research and action, which create a dynamic of Population Health Intervention Research, are showing themselves to be effective and seem to meet a need, but their financial stability is insufficient to sustain their activities and promote sustainable reduction of social inequalities in health. Key messages Mixed structures housing spaces for both research and action, which create a dynamic of Population Health Intervention Research, are showing themselves to be effective and seem to meet a need. But the financial stability of this mixed structures is insufficient to sustain their activities and promote sustainable reduction of social inequalities in health.


2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
C Rinaldi ◽  
M P M Bekker

Abstract Background The political system is an important influencing factor for population health but is often neglected in the public health literature. This scoping review uses insights from political science to explore the possible public health consequences of the rise of populist radical right (PRR) parties in Europe, with welfare state policy as a proxy. The aim is to generate hypotheses about the relationship between the PRR, political systems and public health. Methods A literature search on PubMed, ScienceDirect and Google Scholar resulted in 110 original research articles addressing 1) the relationship between the political system and welfare state policy/population health outcomes or 2) the relationship between PRR parties and welfare state policy/population health outcomes in Europe. Results The influence of political parties on population health seems to be mediated by welfare state policies. Early symptoms point towards possible negative effects of the PRR on public health, by taking a welfare chauvinist position. Despite limited literature, there are preliminary indications that the effect of PRR parties on health and welfare policy depends on vote-seeking or office-seeking strategies and may be mediated by the political system in which they act. Compromises with coalition partners, electoral institutions and the type of healthcare system can either restrain or exacerbate the effects of the PRR policy agenda. EU laws and regulations can to some extent restrict the nativist policy agenda of PRR parties. Conclusions The relationship between the PRR and welfare state policy seems to be mediated by the political system, meaning that the public health consequences will differ by country. Considering the increased popularity of populist parties in Europe and the possibly harmful consequences for public health, there is a need for further research on the link between the PRR and public health.


Author(s):  
Olukayode James Ayodeji ◽  
Seshadri Ramkumar

The COVID-19 pandemic has been one of the biggest public health challenges of the 21st century. Many prevalent measures have been taken to prevent its spread and protect the public. However, the use of face coverings as an effective preventive measure remains contentious. The goal of the current study is to evaluate the effectiveness of face coverings as a protective measure. We examined the effectiveness of face coverings between 1 April and 31 December 2020. This was accomplished by analyzing trends of daily new COVID-19 cases, cumulative confirmed cases, and cases per 100,000 people in different U.S. states, including the District of Columbia. The results indicated a sharp change in trends after face covering mandates. For the 32 states with face covering mandates, 63% and 66% exhibited a downward trend in confirmed cases within 21 and 28 days of implementation, respectively. We estimated that face covering mandates in the 32 states prevented approximately 78,571 and 109,703 cases within 21- and 28-day periods post face covering mandate, respectively. A statistically significant (p = 0.001) negative correlation (−0.54) was observed between the rate of cases and days since the adoption of a face covering mandate. We concluded that the use of face coverings can provide necessary protection if they are properly used.


2021 ◽  
Vol 16 (2) ◽  
pp. 18-38
Author(s):  
Eva-Maria Knoll

Relations within are quintessential in anthropological fieldwork — and in archipelagos in particular. The domestic sea is incorporated in the national consciousness connecting an archipelagic nation but distinguishing individual islands with a strong emphasis on the centre. The Maldivian archipelago displays this spatial organization of a socio-political and economic centre and a dependent island periphery. In the national consciousness, the capital island, Male', contrasts with “the islands” — a distinction which is particularly evident in the public health sphere, where striving for health equity encounters geographical and socio-political obstacles. Using the topic of the inherited blood disorder thalassaemia as a magnifying lens, this paper asks how different actors are making sense of health inequities between central and outer islands in the Maldivian archipelago. Intra-archipelagic and international mobilities add to the complexities of topological relations, experiences, and representations within this multi-island assemblage. Yet, my study of archipelagic health relations is not confined to a mere outside look at the construction of the ‘island other’ within the archipelagic community. It is a situated investigative gaze on disjunctures, connections, and entanglements, reflecting my methodological-theoretical attempt to unravel my own involvement in island–island relations and representations — my being entangled while investigating entanglements.


2020 ◽  
Vol 7 (2) ◽  
pp. 56
Author(s):  
Hamid Reza Sodagari ◽  
Ihab Habib ◽  
Majedeh Pakzad Shahabi ◽  
Narelle A. Dybing ◽  
Penghao Wang ◽  
...  

Non-typhoidal Salmonella serovars are recognized as zoonotic pathogens. Although human salmonellosis is frequently associated with ingestion of contaminated foods of animal origin, contact with animals may also be a significant source of Salmonella infection, especially contact with turtles, which have shown to be an important reservoir of Salmonella, specifically through their intestinal tracts. Turtles are among the most common reptiles kept as house pets that may pose a public health risk associated with Salmonella exposure, especially among infants and young children. This review discusses the literature reporting the link between turtles and Salmonella as well as turtle-associated human salmonellosis in the last ten years. In most outbreaks, a high proportion of patients are children under five years of age, which indicates that children are at the greatest risk of turtle-associated salmonellosis. Therefore, turtles should not be preferred as recommended pets for children under five years of age. Reducing turtle stress to minimise Salmonella shedding as well as providing client education handouts at the points of sale of these animals may reduce the risk of transmitting such significant pathogen to humans. Further studies are required to investigate the role of both direct contact with turtles as well as indirect contact through cross-contamination in the transmission of turtles-associated Salmonella to humans.


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