scholarly journals Antidepressants and public health in Iceland

2004 ◽  
Vol 184 (2) ◽  
pp. 157-162 ◽  
Author(s):  
Tómas Helgason ◽  
Helgi Tómasson ◽  
Tómas Zoëga

BackgroundMajor depressive disorder is the second leading cause of disability-adjusted life-years in developed regions of the world and antidepressants are the third-ranking therapy class worldwide.AimsTo test the public health impact of the escalating sales of antidepressants.MethodNationwide data from Iceland are used as an example to study the effect of sales of antidepressants on suicide, disability, hospital admissions and outpatient visits.ResultsSales of antidepressants increased from 8.4 daily defined doses per 1000 inhabitants per day in 1975 to 72.7 in 2000, which is a user prevalence of 8.7% for the adult population. Suicide rates fluctuated during 1950–2000 but did not show any definite trend. Rates for outpatient visits increased slightly over the period 1989–2000 and admission rates increased even more. The prevalence of disability due to depressive and anxiety disorders has not decreased over the past 25 years.ConclusionsThe dramatic increase in the sales of antidepressants has not had any marked impact on the selected public health measures. Obviously, better treatment for depressive disorders is still needed in order to reduce the burden caused by them.

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
E Pallari ◽  
S T Thomsen ◽  
H B M Hilderink

Abstract A key goal of most Burden of Disease (BoD) studies is to support public health policies. However, while the concepts of BoD and Disability Adjusted Life years have been introduced more than 25 years, BoD researchers are still struggling to find better ways to translate their findings and communicate them to the relevant decision makers and other stakeholders. To address this gap, the burden-eu COST Action aims to generate better guidance of the use of BoD metrics in policy-making processes. In collaboration with experts in knowledge translation and risk communication, the Action will compile good practices in knowledge translation and develop a roadmap to integrate knowledge translation in national BOD studies. To support these objectives, collaborations have been established with knowledge translation experts from the European Observatory on Health Systems and Policies, the WHO Regional Office for Europe, and the European Public Health Association. During an initial meeting of the “knowledge translation” working group, 29 participants identified elements in the pathway from evidence generation to practice that need to be addressed. Building on the outcomes of this meeting and the inputs from the knowledge translation experts, this presentation will introduce the knowledge translation framework, and address some of the challenges in identifying best routes to reach out to the public and policy-makers. Specific emphasis will be placed in profiling the context, actors and processes of each country within the policy triangle, and drawing on best and worst example case studies. Additionally, the process will be discussed to co-create a toolkit or guide for using BoD evidence in policy and practice. The session will conclude with an interaction with the audience to learn about the perceived barriers for implementing knowledge translation within the BoD framework.


2016 ◽  
Vol 79 (1) ◽  
pp. 37-42 ◽  
Author(s):  
HONGLIU DING ◽  
TONG-JEN FU

ABSTRACT Sprouts have been a recurring public health challenge due to microbiological contamination, and Salmonella has been the major cause of sprout-associated outbreaks. Although seed treatment and microbiological testing have been applied as risk reduction measures during sprout production, the extent to which their effectiveness in reducing the public health risks associated with sprouts has not been well investigated. We conducted a quantitative risk assessment to measure the risk posed by Salmonella contamination in sprouts and to determine whether and how mitigation strategies can achieve a satisfactory risk reduction based on the assumption that the risk reduction achieved by a microbiological sampling and testing program at a given sensitivity is equivalent to that achieved by direct inactivation of pathogens. Our results indicated that if the sprouts were produced without any risk interventions, the health impact caused by sprouts contaminated with Salmonella would be very high, with a median annual estimated loss of disability-adjusted life years (DALYs) of 691,412. Seed treatment (with 20,000 ppm of calcium hypochlorite) or microbiological sampling and testing of spent irrigation water (SIW) alone could reduce the median annual impact to 734 or 4,856 DALYs, respectively. Combining seed treatment with testing of the SIW would further decrease the risk to 58 DALYs. This number could be dramatically lowered to 3.99 DALYs if sprouts were produced under conditions that included treating seeds with 20,000 ppm of calcium hypochlorite plus microbiological testing of seeds, SIW, and finished products. Our analysis shows that the public health impact due to Salmonella contamination in sprouts could be controlled if seeds are treated to reduce pathogens and microbiological sampling and testing is implemented. Future advances in intervention strategies would be important to improve sprout safety further.


2017 ◽  
Vol 33 (S1) ◽  
pp. 38-39
Author(s):  
Dialina Brilhante ◽  
António Robalo Nunes ◽  
Cândida Fonseca ◽  
João Mairos ◽  
Jorge Félix ◽  
...  

INTRODUCTION:Patient Blood Management (PBM) describes a multidisciplinary approach that strives to optimize patients own blood and has been reported to reduce blood components utilization while achieving improved patient outcomes and reduced healthcare costs. The aim of this study was to evaluate the public health and economic impact related to the implementation of a nationwide PBM program in Portugal.METHODS:A decision-model comparing two scenarios (“current clinical practice” and “with PBM implementation”) was used to estimate the PBM impact including hospital-assisted patients from the following therapeutic areas: surgery (orthopaedic, cardiac and urologic), cardiology, oncology, gastrointestinal bleeding, abnormal uterine bleeding, hemodialysis, inflammatory bowel disease and pregnancy. Model inputs were obtained from Portuguese national health databases and literature review. The public health impact was measured in life years (LY) gained, disability-adjusted life years (DALY) reduction, hospital length of stay (LOS) and 30-day readmission rate reduction. The economic value was expressed in total and hospitalization costs savings.RESULTS:A total of 384,704 patients were eligible for PBM strategies. We estimated that a one year nationwide PBM implementation could avoid 594 premature deaths, representing a gain of 1,481 LY and a reduction of 3,660 DALYs relative to the current paradigm. An 8.4 percent and 37.3 percent reduction in length of stay and 30-day readmission rate are expected, respectively. This corresponds to EUR70.4 million savings in hospitalization costs. Although PBM closer monitoring would imply additional physician visits and medicines use, leading to EUR24.1 million in additional expenditure, in this population the overall PBM implementation can generate net savings of more than EUR67.7 million per year (6.3 percent reduction of public expenditure).CONCLUSIONS:The implementation of a nationwide PBM in Portugal may represent a great public health impact, especially in decreased mortality and disability, with substantial public expenditure reduction.


2018 ◽  
Vol 21 ◽  
pp. S238
Author(s):  
B. Bracke ◽  
A. Vidmar ◽  
A. Plevnik Kapun ◽  
C. Marano ◽  
D. Curran

Author(s):  
Jelle Schoemaker ◽  
Simon van Genderen ◽  
Willem I. J. de Boer

Mass participation sporting events (MPSEs) are increasing in popularity. However, little research exists into the potential value of these events for improving public health by enhancing physical activity (PA). The aim of this study is to estimate the health impact of increased physical activity as a result of preparing for an MPSE. Participants of a mass participation women-only running event were asked if they performed additional PA in preparation of the event, including the length (weeks) and intensity (min per week). Additionally, self-reported change in health status was evaluated. Based on these results, we have developed a framework for estimating the cumulatively gained quality adjusted life years (QALYs) and monetary value thereof. Of the respondents (N = 468; mean age 42.3 ± 11.9 years), 32% performed additional vigorous PA in preparation of the event, with an average of 63 min per week over 8.8 weeks. Performing additional vigorous PA significantly improved the odds of self-rated health. The estimated total health impact of participants preparing for the Marikenloop was 6.6 QALYs gained with a corresponding monetary value between EUR 133,000 and EUR 532,000. We believe our health impact framework helps to understand that MPSEs can be a notable part of the public health domain.


2021 ◽  
Author(s):  
Esteban Ortiz-Prado ◽  
Patricio. S Espinosa ◽  
Alfredo Borrero ◽  
Simone P. Cordovez ◽  
Jorge E. Vasconez ◽  
...  

Abstract Background: Globally, more than 5.7% of the population reside above 1,500 m of elevation. It has been hypothesized that acute short-term hypoxia exposure could increase the risk of developing a stroke. Studies assessing the effect of altitude on stroke have provided conflicting results, some analysis suggest that long-term chronic exposure could be associated with reduced mortality and lower stroke incidence rates. Methods:An ecological analysis of all stroke hospital admissions, mortality rates and disability adjusted life years in Ecuador was performed from 2001-2017. The cases and population at risk were categorized in low (<1,500 m), moderate (1,500-2,500 m), high (2,500-3,500 m) and very high altitude (3,500-5,500 m) according to place of residence. The derived crude and direct standardized age-sex adjusted mortality and hospital admission rates were calculated. Results: A total of 38,201 deaths and 75,893 stroke-related hospital admissions were reported. High-altitude populations (HAP) had lower stroke mortality in men (RR: 0.91 [0.88 - 0.95]) and women (RR: 0.83 [0.79 - 0.86]). In addition, HAP had a significant lower risk of getting admitted to the hospital when compared with the low altitude group in men (RR: 0.55 [CI95% 0.54 - 0.56]) and women (RR: 0.65 [CI95% [0.64 - 0.66]). Conclusions: This is the first epidemiological study that aims to elucidate the association between stroke and altitude using four different elevation ranges. Our findings suggest that living at higher elevations offers a reduction or the risk of dying due to stroke as well as a reduction in the probability of being admitted to the hospital. Nevertheless, this protective factor has the stronger effect between 2,000 m to 3,500 m.


2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
S T Thomsen ◽  
W de Boer ◽  
S M Pires ◽  
B Devleesschauwer ◽  
S Fagt ◽  
...  

Abstract Background Sufficient intake of fish and limited red meat intake is commonly encouraged by national dietary guidelines to prevent various lifestyle diseases. One way to fulfill these guidelines would be to substitute red meat by fish. However, quantitative evidence of the public health gain of such substitution is lacking. Moreover, contaminants in these foods may compromise nutritional benefits. We aimed to estimate the health impact of substituting red meat by fish in the Danish diet in a risk-benefit assessment (RBA). Our study can support policy makers in defining evidence-based public health strategies. Methods We quantified the health impact of substituting red meat by fish among Danish adults in terms of Disability-Adjusted Life Years (DALY) using data from a national dietary survey and food monitoring. We investigated the use of probabilistic methods to model variability in individual substitution behaviors and to assess health impact distributions in RBA of food. Results Health impact of the substitution varied largely by the type of fish consumed and by age and sex of the consumer. We estimated that 134 (95% uncertainty interval: 102; 169) DALYs/100,000 could be averted per year if a mix of lean and fatty fish is consumed in the Danish recommended amounts and intake of red meat decreased among Danish adults. The highest benefit was estimated for women in the childbearing age and for men above 50 years of age. However, a small fraction of women were assigned an overall health loss due to methylmercury exposure during pregnancy and the associated adverse effects in unborn children. Conclusions Our study estimated an overall health gain of substituting red meat by fish in the general Danish adult population, while providing insight in the variability in health impact at the level of individual consumers. Our approach can be applied in other RBAs and the results support the need for targeted public health strategies to ensure consumer health and safety. Key messages The health impact of substituting red meat by fish in Danish adults was quantified in terms of disability-adjusted life years (DALYs), while accounting for variability between individuals. We estimated that young women and men above 50 years of age will experience the largest health gain while a small fraction of the women were assigned a health loss due to chemical exposure.


2021 ◽  
Vol 12 ◽  
Author(s):  
Esteban Ortiz-Prado ◽  
Patricio S. Espinosa ◽  
Alfredo Borrero ◽  
Simone P. Cordovez ◽  
Jorge E. Vasconez ◽  
...  

Introduction: Worldwide, more than 5.7% of the population reside above 1,500 m of elevation. It has been hypothesized that acute short-term hypoxia exposure could increase the risk of developing a stroke. Studies assessing the effect of altitude on stroke have provided conflicting results, some analyses suggest that long-term chronic exposure could be associated with reduced mortality and lower stroke incidence rates.Methods: An ecological analysis of all stroke hospital admissions, mortality rates, and disability-adjusted life years in Ecuador was performed from 2001 to 2017. The cases and population at risk were categorized in low (&lt;1,500 m), moderate (1,500–2,500 m), high (2,500–3,500 m), and very high altitude (3,500–5,500 m) according to the place of residence. The derived crude and direct standardized age-sex adjusted mortality and hospital admission rates were calculated.Results: A total of 38,201 deaths and 75,893 stroke-related hospital admissions were reported. High altitude populations (HAP) had lower stroke mortality in men [OR: 0.91 (0.88–0.95)] and women [OR: 0.83 (0.79–0.86)]. In addition, HAP had a significant lower risk of getting admitted to the hospital when compared with the low altitude group in men [OR: 0.55 (CI 95% 0.54–0.56)] and women [OR: 0.65 (CI 95% 0.64–0.66)].Conclusion: This is the first epidemiological study that aims to elucidate the association between stroke and altitude using four different elevation ranges. Our findings suggest that living at higher elevations offers a reduction or the risk of dying due to stroke as well as a reduction in the probability of being admitted to the hospital. Nevertheless, this protective factor has a stronger effect between 2,000 and 3,500 m.


2020 ◽  
Vol 19 (4) ◽  
pp. 618-632
Author(s):  
A.S. Panchenko

Subject. The article addresses the public health in the Russian Federation and Israel. Objectives. The focus is on researching the state of public health in Russia and Israel, using the Global Burden of Disease (GBD) project methodology, identifying problem areas and searching for possible ways to improve the quality of health of the Russian population based on the experience of Israel. Methods. The study draws on the ideology of the GBD project, which is based on the Disability-Adjusted Life-Year (DALY) metric. Results. The paper reveals the main causes of DALY losses and important risk factors for cancer for Russia and Israel. The findings show that the total DALY losses for Russia exceed Israeli values. The same is true for cancer diseases. Conclusions. Activities in Israel aimed at improving the quality of public health, the effectiveness of which has been proven, can serve as practical recommendations for Russia. The method of analysis, using the ideology of the GBD project, can be used as a tool for quantitative and comparative assessment of the public health.


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