scholarly journals Adopting State-Level Policy to Support Physical Activity Among School-Aged Children and Adolescents: Georgia’s SHAPE Act

2017 ◽  
Vol 132 (2_suppl) ◽  
pp. 9S-15S ◽  
Author(s):  
Rodney S. Lyn ◽  
Erica R. Sheldon ◽  
Michael P. Eriksen
Keyword(s):  
Public Health ◽  
Physical Activity ◽  
Public Health Problem ◽  
State Level ◽  
Lessons Learned ◽  
Political Climate ◽  
Health And Physical Education ◽  
School Aged Children ◽  
Increased Risk ◽  
Education Act

Physical inactivity among children is a public health problem associated with low levels of fitness, obesity, and increased risk of chronic diseases. Public health experts have identified policies targeting physical activity as a promising strategy to address this challenge. Understanding the process by which such policies are adopted may help to facilitate progress nationally. To examine lessons learned from the passage of the Student Health and Physical Education Act in Georgia, we conducted 15 interviews with people engaged in the adoption of the act. We found that several factors were vital to policy adoption: a shifting social and political climate, the organization and mobilization of diverse partners behind a common agenda, and the development of strategies to overcome impediments to legislative progress. These findings suggest that engagement and cooperation with partners, establishment of mutual interests as a basis for collaboration, and grassroots outreach and advocacy can facilitate adoption of policies that promote physical activity.

scholarly journals Spinal pain increases the risk of becoming overweight in Danish schoolchildren

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Lise Hestbaek ◽  
Ellen Aartun ◽  
Pierre Côté ◽  
Jan Hartvigsen
Keyword(s):  
Public Health ◽  
Physical Activity ◽  
Public Health Problem ◽  
Spinal Pain ◽  
Primary Objective ◽  
Increased Risk ◽  
Children And Adolescence ◽  
Trained Staff ◽  
Relevant Covariates

AbstractSpinal pain is common in adolescence, and overweight in children and adolescence is an increasing public health problem globally. Since musculoskeletal pain is a known barrier for physical activity which potentially can lead to overweight, the primary objective of this study was to determine if self-reported lifetime spinal pain in 2010 was associated with being overweight or obese in 2012 in a cohort of 1080 normal-weighted Danish children, aged 11–13 years at baseline. Overweight was based on body mass index measured by trained staff. Spinal pain was self-reported by questionnaires during school hours. Estimates were adjusted for relevant covariates. The 2-year incidence rate of overweight was 5.3% (95% CI 3.98–7.58) for children with spinal pain at baseline versus 1.6% (95% CI 0.19–5.45) for children without. There was stepwise and statistically significant increased risk of overweight with increasing frequency of pain and for having pain in more than one part of the spine. Despite the short follow-up time where only 40 children developed overweight, these results indicate that spinal pain might increase the risk of subsequent overweight.

scholarly journals Overt acts of perceived discrimination reported by British working-age adults with and without disability

2019 ◽  
Author(s):  
Eric Emerson ◽  
Allison Milner ◽  
Zoe Aitken ◽  
Lauren Krnjacki ◽  
Cathy Vaughan ◽  
...  
Keyword(s):  
Public Health ◽  
Negative Impact ◽  
Policy Research ◽  
Secondary Analysis ◽  
People With Disabilities ◽  
Public Health Problem ◽  
Health Staff ◽  
Cross Sectional ◽  
Increased Risk ◽  
The Uk

Abstract Background Exposure to discrimination can have a negative impact on health. There is little robust evidence on the prevalence of exposure of people with disabilities to discrimination, the sources and nature of discrimination they face, and the personal and contextual factors associated with increased risk of exposure. Methods Secondary analysis of de-identified cross-sectional data from the three waves of the UK’s ‘Life Opportunities Survey’. Results In the UK (i) adults with disabilities were over three times more likely than their peers to be exposed to discrimination, (ii) the two most common sources of discrimination were strangers in the street and health staff and (iii) discrimination was more likely to be reported by participants who were younger, more highly educated, who were unemployed or economically inactive, who reported financial stress or material hardship and who had impairments associated with hearing, memory/speaking, dexterity, behavioural/mental health, intellectual/learning difficulties and breathing. Conclusions Discrimination faced by people with disabilities is an under-recognised public health problem that is likely to contribute to disability-based health inequities. Public health policy, research and practice needs to concentrate efforts on developing programs that reduce discrimination experienced by people with disabilities.

scholarly journals Cox regression survival analysis with compositional covariates: Application to modelling mortality risk from 24-h physical activity patterns

2019 ◽  
Vol 29 (5) ◽  
pp. 1447-1465 ◽  
Author(s):  
DE McGregor ◽  
J Palarea-Albaladejo ◽  
PM Dall ◽  
K Hron ◽  
SFM Chastin
Keyword(s):  
Public Health ◽  
Physical Activity ◽  
Survival Analysis ◽  
Regression Model ◽  
Cox Regression ◽  
Public Health Problem ◽  
Sitting Time ◽  
Cox Regression Model ◽  
Log Ratio ◽  
Activity Behaviour

Survival analysis is commonly conducted in medical and public health research to assess the association of an exposure or intervention with a hard end outcome such as mortality. The Cox (proportional hazards) regression model is probably the most popular statistical tool used in this context. However, when the exposure includes compositional covariables (that is, variables representing a relative makeup such as a nutritional or physical activity behaviour composition), some basic assumptions of the Cox regression model and associated significance tests are violated. Compositional variables involve an intrinsic interplay between one another which precludes results and conclusions based on considering them in isolation as is ordinarily done. In this work, we introduce a formulation of the Cox regression model in terms of log-ratio coordinates which suitably deals with the constraints of compositional covariates, facilitates the use of common statistical inference methods, and allows for scientifically meaningful interpretations. We illustrate its practical application to a public health problem: the estimation of the mortality hazard associated with the composition of daily activity behaviour (physical activity, sitting time and sleep) using data from the U.S. National Health and Nutrition Examination Survey (NHANES).

scholarly journals Physical activity in chronic kidney disease and the EXerCise Introduction To Enhance trial

2020 ◽  
Vol 35 (Supplement_2) ◽  
pp. ii18-ii22 ◽  
Author(s):  
Francesca Mallamaci ◽  
Anna Pisano ◽  
Giovanni Tripepi
Keyword(s):  
Physical Activity ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Clinical Outcomes ◽  
Sedentary Lifestyle ◽  
Public Health Problem ◽  
Epidemiological Studies ◽  
Dialysis Patients ◽  
Increased Risk ◽  
Reduced Physical Activity

Abstract It is well known from observational studies that sedentary lifestyle and reduced physical activity are common in dialysis and chronic kidney disease (CKD) patients and associate with an increased risk of morbidity and mortality in this patient population. Epidemiological studies indicate that CKD patients undergo physical activity ~9 days/month and 43.9% of dialysis patients report not exercising at all. On the basis of awareness about the strong link between sedentary lifestyle and adverse clinical outcomes, the National Kidney Foundation and Kidney Disease: Improving Global Outcomes have provided specific recommendations for physical activity in patients with kidney disease. Given the fact that CKD is a public health problem and it is still debated which type of exercise should be prescribed in these patients, this review focuses on the most robust evidence accumulated so far on the beneficial effect of various types of physical exercise on clinical outcomes in CKD and dialysis patients. This review does not treat this very important topic in another CKD category of patients, such as kidney-transplanted patients, for whom a special issue should be dedicated.

scholarly journals Exercise for the Management of Diabetes Mellitus: A Review of the Evidence

2013 ◽  
Vol 3 (2) ◽  
pp. 99-108
Author(s):  
Md. Shahjamal Khan
Keyword(s):  
Public Health ◽  
Physical Activity ◽  
Diabetes Mellitus ◽  
Aerobic Exercise ◽  
Public Health Problem ◽  
Moderate Intensity ◽  
Public Health Approach ◽  
Diabetic Patients ◽  
Published Evidence ◽  
Exercise Programmes

Diabetes mellitus is a public health problem in both developed and developing countries and has increased alarmingly, giving the disease the dimension of an epidemic. The aetiology of diabetes is multifactorial involving genetic, environmental, and behavioural origins. Exercise is an important part for the management of diabetes mellitus. Regularly planned exercise reduces insulin resistance, improves glucose tolerance, improves lipid profile and increases cardiovascular and cardiopulmonary function. This article critically reviews the more relevant evidence on the interrelationships between exercise and diabetes mellitus. This study included bibliography research from both the review and the research literatures on exercise in diabetes mellitus. From this review it appears that the effects of aerobic exercise are well established, and interventions with more vigorous aerobic exercise programmes resulted in greater reductions in HbA1c, greater increase in oxygen consumption and greater increase in insulin sensitivity. Considering the available evidence, it appears that resistance training could be an effective intervention to help glycaemic control, especially considering that the effects of this form of intervention are comparable with what is reported with aerobic exercise. It is well established that physical activity produces general and specific health benefits for diabetic patients. The basic principles of an effective exercise programme are the intensity, duration and frequency of exercise in an appropriate environment. Usually, moderate-intensity and long-duration exercise programmes are considered most suitable for diabetic patients. As it is supported by published evidence, encouragement to adopt increased physical activity and reduction of sedentary behaviour is a successful public health approach for diabetes mellitus prevention and management. Journal of Enam Medical College; Vol 3 No 2 July 2013; Page 99-108 DOI: http://dx.doi.org/10.3329/jemc.v3i2.16133

scholarly journals Obesity and the increased risk for COVID-19: mechanisms and nutritional management

2020 ◽  
pp. 1-13
Author(s):  
Ana Heloneida de Araújo Morais ◽  
Thais Sousa Passos ◽  
Sancha Helena de Lima Vale ◽  
Juliana Kelly da Silva Maia ◽  
Bruna Leal Lima Maciel
Keyword(s):  
Public Health ◽  
Immune Responses ◽  
Viral Infections ◽  
Public Health Problem ◽  
Complex Problem ◽  
Low Grade ◽  
Adaptive Immune ◽  
Increased Risk ◽  
Nutritional Strategies ◽  
Worse Prognosis

Abstract The global COVID-19 (coronavirus disease 2019) pandemic has become a complex problem that overlaps with a growing public health problem, obesity. Obesity alters different components of the innate and adaptive immune responses, creating a chronic and low-grade state of inflammation. Nutritional status is closely related to a better or worse prognosis of viral infections. Excess weight has been recognised as a risk factor for COVID-19 complications. In addition to the direct risk, obesity triggers other diseases such as diabetes and hypertension, increasing the risk of severe COVID-19. The present review explains the diets that induce obesity and the importance of different foods in this process. We also review tissue disruption in obesity, leading to impaired immune responses and the possible mechanisms by which obesity and its co-morbidities increase COVID-19 morbidity and mortality. Nutritional strategies that support the immune system in patients with obesity and with COVID-19 are also discussed in light of the available data, considering the severity of the infection. The discussions held may contribute to combating this global emergency and planning specific public health policy.

Exploring law enforcement and public health as a collective impact initiative: lessons learned from Tasmania as a case study

2017 ◽  
Vol 3 (2) ◽  
pp. 79-92 ◽  
Author(s):  
Roberta Julian ◽  
Isabelle Bartkowiak-Théron ◽  
Jackie Hallam ◽  
Clarissa Hughes
Keyword(s):  
Public Health ◽  
Law Enforcement ◽  
Significant Proportion ◽  
State Level ◽  
Lessons Learned ◽  
Collective Impact ◽  
Impact Model ◽  
Content Type ◽  
Mapping Process ◽  
Potential Benefits

Purpose The purpose of this paper is to examine the potential benefits as well as some of the practical barriers to the implementation of a collective impact initiative in law enforcement and public health (LEPH) in Tasmania, Australia. Design/methodology/approach The paper is based on a review of programs, agencies and initiatives that are at the intersection of LEPH in Tasmania, through an analysis of the findings in evaluation reports, and the views of practitioners identified at a workshop on LEPH held at a national AOD conference and facilitated by the authors. Findings The strengths of collective impact initiatives, particularly in LEPH, are presented and some weaknesses identified. Some major obstacles to the consolidation of LEPH initiatives include siloed ways of working and budgets, lack of leadership and political will. Some progress has been made in addressing these weaknesses, although addressing complex social problems by moving beyond inter-agency collaboration toward an integrated model of service provision remains challenging. Practical implications The authors argue that there are practical benefits to the adoption of a collective impact model to address problems in Tasmania that lie at the nexus between LEPH. In reviewing existing collaborations, the authors demonstrate the value of a structural mapping process to identify ways forward for government and non-government agencies that are inclined to go further in merging the two disciplinary areas. The authors offer some suggestions with respect to identifying the preconditions for a collective impact model and how to build on these to initiate action. Originality/value A significant proportion of the literature on LEPH remains at a conceptual and theoretical level. This contribution highlights some practical issues while looking at existing examples of collaboration across LEPH at a state level in Australia, and starts mapping a way forward for constructing more integrative LEPH initiatives.

Metabolic disturbances in non-alcoholic fatty liver disease

2009 ◽  
Vol 116 (7) ◽  
pp. 539-564 ◽  
Author(s):  
Christopher D. Byrne ◽  
Rasaq Olufadi ◽  
Kimberley D. Bruce ◽  
Felino R. Cagampang ◽  
Mohamed H. Ahmed
Keyword(s):  
Public Health ◽  
Liver Disease ◽  
Fatty Liver ◽  
Health Problem ◽  
Fatty Liver Disease ◽  
Public Health Problem ◽  
Alcoholic Fatty Liver ◽  
Increased Risk ◽  
Alcoholic Fatty Liver Disease ◽  
Over Time

NAFLD (non-alcoholic fatty liver disease) refers to a wide spectrum of liver damage, ranging from simple steatosis to NASH (non-alcoholic steatohepatitis), advanced fibrosis and cirrhosis. NAFLD is strongly associated with insulin resistance and is defined by accumulation of liver fat >5% per liver weight in the presence of <10 g of daily alcohol consumption. The exact prevalence of NAFLD is uncertain because of the absence of simple non-invasive diagnostic tests to facilitate an estimate of prevalence. In certain subgroups of patients, such as those with Type 2 diabetes, the prevalence of NAFLD, defined by ultrasound, may be as high as 70%. NASH is an important subgroup within the spectrum of NAFLD that progresses over time with worsening fibrosis and cirrhosis, and is associated with increased risk for cardiovascular disease. It is, therefore, important to understand the pathogenesis of NASH and, in particular, to develop strategies for interventions to treat this condition. Currently, the ‘gold standard’ for the diagnosis of NASH is liver biopsy, and the need to undertake a biopsy has impeded research in subjects in this field. Limited results suggest that the prevalence of NASH could be as high as 11% in the general population, suggesting there is a worsening future public health problem in this field of medicine. With a burgeoning epidemic of diabetes in an aging population, it is likely that the prevalence of NASH will continue to increase over time as both factors are important risk factors for liver fibrosis. The purpose of this review is to: (i) briefly discuss the epidemiology of NAFLD to describe the magnitude of the future potential public health problem; and (ii) to discuss extra- and intra-hepatic mechanisms contributing to the pathogenesis of NAFLD, a better understanding of which may help in the development of novel treatments for this condition.

scholarly journals Prevalence and Determinants of Falls among Older Adults in Ecuador: An Analysis of the SABE I Survey

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Carlos H. Orces
Keyword(s):  
Public Health ◽  
Older Adults ◽  
Coastal Region ◽  
Public Health Problem ◽  
Linear Increase ◽  
Andes Mountains ◽  
Major Public Health Problem ◽  
Increased Risk ◽  
Risk Of Falls ◽  
Nationally Representative

The present study based on a nationally representative sample of older adults living in the Andes mountains and coastal region of the country indicates that 34.7% of older adults had fallen in the previous year in Ecuador. Among fallers, 30.6% reported a fall-related injury. The prevalence of falls was higher in women and among older adults residing in the rural Andes mountains. In the multivariate model, women, subjects with cognitive impairment, those reporting urinary incontinence, and those being physically active during the previous year were variables found independently associated with increased risk of falling among older adults in Ecuador. Moreover, a gradual and linear increase in the prevalence of falls was seen as the number of risk factors increased. Falls represent a major public health problem among older adults in Ecuador. The present findings may assist public health authorities to implement programs of awareness and fall prevention among older adults at higher risk of falls.

scholarly journals Disruptions to schistosomiasis programmes due to COVID-19: an analysis of potential impact and mitigation strategies

2020 ◽  
Author(s):  
Klodeta Kura ◽  
Diepreye Ayabina ◽  
Jaspreet Toor ◽  
T. Deirdre Hollingsworth ◽  
Roy M. Anderson
Keyword(s):  
Public Health ◽  
Public Health Problem ◽  
Mitigation Strategy ◽  
Mitigation Strategies ◽  
Mass Treatment ◽  
School Aged Children ◽  
High Prevalence ◽  
Potential Impact ◽  
Central Pillar ◽  
The Impact

AbstractBackgroundThe 2030 goal for schistosomiasis is elimination as a public health problem (EPHP), with mass drug administration (MDA) of praziquantel to school-aged children (SAC) a central pillar of the strategy. However, due to COVID-19, many mass treatment campaigns for schistosomiasis have been halted with uncertain implications for the programmes.MethodWe use mathematical modelling to explore how postponement of MDA and various mitigation strategies affect achievement of the EPHP goal for Schistosoma mansoni and S. haematobium.ResultsIn moderate and some high prevalence settings, the disruption may delay the goal by up to two years. In some high prevalence settings EPHP is not achievable with current strategies, and so the disruption will not impact this. Here, increasing SAC coverage and treating adults can achieve the goal.The impact of MDA disruption and the appropriate mitigation strategy varies according to the baseline prevalence prior to treatment, the burden of infection in adults and stage of the programme.ConclusionsSchistosomiasis MDA programmes in medium and high prevalence areas should restart as soon as is feasible, and mitigation strategies may be required in some settings.

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