scholarly journals Shedding light on maternal sunlight exposure during pregnancy and considerations for public health policy

2020 ◽  
Vol 11 (1) ◽  
pp. 112-118
Author(s):  
Peter Anto Johnson ◽  
John Christy Johnson
Keyword(s):  
Public Health ◽  
Health Policy ◽  
Health Outcomes ◽  
Birth Outcomes ◽  
Public Health Policy ◽  
Current Knowledge ◽  
Sunlight Exposure ◽  
Adverse Birth Outcomes ◽  
Exposure During Pregnancy

Sunlight exposure during pregnancy could be implicated in the physiological development and growth of the fetus, as well as long-term health after birth. Although several studies suggest the involvement of ultraviolet radiation-mediated vitamin D synthesis, current knowledge regarding the effects of sunlight exposure during pregnancy remains limited. We aimed to (i) summarize the existing body of research studying the influence of sunlight exposure on fetal growth-related birth outcomes and long-term health outcomes and (ii) determine its implications for therapeutics and public health policy. Of the studies identified on birth outcomes, the majority (5/8) demonstrated an association between sunlight exposure and reduced adverse birth outcomes (e.g., low birth weight, preterm births, small for gestational age, etc.), 2/8 studies showed no association, and 1/8 suggested a negative association between sunlight exposure and reduction of these adverse birth outcomes. Of the studies examining long-term health outcomes, sunlight exposure during pregnancy was shown to promote skeletal growth and development (2/6), and reduce the incidence of multiple sclerosis (2/6), asthma (2/6) and pneumonia (1/6). However, several of these studies used different methodologies and populations making it difficult to compare and integrate findings. Based on these results, we examined: the importance of exposure at different stages of pregnancy, proposed mechanisms by which sunlight exposure could lead to optimal outcomes, epidemiological differences influencing the findings, and necessary practical considerations prior to the implementation of public health policy recommendations. While these findings are promising, more rigorous research is warranted to support these recommendations.

Researching Health Service Information Systems Development

2011 ◽  
pp. 598-615
Author(s):  
Said Shahtahmasebi
Keyword(s):  
Public Health ◽  
Health Policy ◽  
Health Outcomes ◽  
Public Health Policy ◽  
Policy Formation ◽  
Human Behaviour ◽  
Service Information ◽  
Current Availability ◽  
Tangible Evidence ◽  
Small Change

Information is considered the currency within health systems. Numerous reorganisations and restructuring, coupled with many buzz words (e.g. evidence-based practice) and the various advancements in ICT (information and communication technology) are apparently designed to improve the utilisation of this currency. However, what constitutes information appears to vary between health professionals. For some, only the data derived from RCTs (randomized control trials) is considered evidence, for others it is the conclusions drawn from focus groups, whilst for others, finding information goes well beyond subjectivity and experimental design and comes from understanding human behaviour and other processes.Although advancements in ICT have greatly improved access to information (currency), the data often disguised as information appears only as small change. Restructuring and reorganizing have been used to inflate the value of this currency (information) leading to the replacement of information departments by the Public Health Intelligence Units or Observatories. However, a change in behaviour is difficult to bring about and manage, while it is easier to change the tools with which the tasks are carried out. It is all too easy to fall into the trap of reproducing what has been produced before by information departments only under a different guise, as well as using different configurations, software or updated hardware and ICT (e.g. the Internet). These units hardly concern themselves with exploring the underlying message of the data. A quick trawl of the web pages of these entities can be testimony to this fact. The process so far has been, in effect, one of test-tubing health outcomes and then extracting the data from the test tubes. Although we have been eager to embrace technological advancements and change, we have failed to monitor the impact and consequences of change on our behaviour and thus on health outcomes. This chapter will delve into the current availability of information for public health policy purposes and will argue its ineffectiveness as information/evidence in the context of human behaviour and social processes. Behaviour and processes are by nature dynamic. Specifically, the feedback effect, a feature of dynamic process, can have a profound attenuating effect on data that was once important, thereby affecting not only the shelf life of a policy but also its intended outcomes. Examples from published reports by public health intelligence units/observatories in New Zealand and the UK, plus references to teenage smoking and suicide, will be used to illustrate these concepts and issues. A conceptual but pragmatic model of data collection based on current health care data management systems will be argued as a way forward for translating data into information and tangible evidence with a view to informing the process of public health policy formation. This chapter discusses a holistic approach to identifying data needed as evidence to inform the process of policy formation/decision making as a conceptual model.

scholarly journals Effectiveness of Technology-Enabled Knowledge Translation Strategies in Improving the Use of Research in Public Health: Systematic Review (Preprint)

2019 ◽  
Author(s):  
Alison Brown ◽  
Courtney Barnes ◽  
Judith Byaruhanga ◽  
Matthew McLaughlin ◽  
Rebecca K Hodder ◽  
...  
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Health Policy ◽  
Knowledge Translation ◽  
Health Outcomes ◽  
Health Professionals ◽  
Public Health Policy ◽  
Randomized Trials ◽  
Policy Makers ◽  
Or Practice

BACKGROUND Knowledge translation (KT) aims to facilitate the use of research evidence in decision making. Changes in technology have provided considerable opportunities for KT strategies to improve access and use of evidence in decision making by public health policy makers and practitioners. Despite this opportunity, there have been no reviews that have assessed the effects of digital technology-enabled KT (TEKT) in the field of public health. OBJECTIVE This study aims to examine the effectiveness of digital TEKT strategies in (1) improving the capacity for evidence-based decision making by public health policy makers and practitioners, (2) changing public health policy or practice, and (3) changes in individual or population health outcomes. METHODS A search strategy was developed to identify randomized trials assessing the effectiveness of digital TEKT strategies in public health. Any primary research study with a randomized trial design was eligible. Searches for eligible studies were undertaken in multiple electronic bibliographic databases (Medical Literature Analysis and Retrieval System Online [MEDLINE], Excerpta Medica dataBASE [EMBASE], PsycINFO, Cumulative Index to Nursing and Allied Health Literature [CINAHL], and Scopus) and the reference lists of included studies. A hand search of 2 journals (Implementation Science and Journal of Medical Internet Research) and a gray literature search were also conducted. Pairs of independent review authors screened studies, assessed the risk of bias, and extracted data from relevant studies. RESULTS Of the 6819 citations screened, 8 eligible randomized trials were included in the review. The studies examined the impact of digital TEKT strategies on health professionals, including nurses, child care health consultants, physiotherapists, primary health care workers, and public health practitioners. Overall, 5 of the interventions were web-training programs. The remaining 3 interventions included simulation games, access to digital resource materials and the use of tailored messaging, and a web-based registry. The findings suggest that digital TEKT interventions may be effective in improving the knowledge of public health professionals, relative to control, and may be as effective as a face-to-face KT approach. The effectiveness of digital TEKT strategies relative to a control or other digital KT interventions on measures of health professional self-efficacy to use evidence to enhance practice behavior or behavioral intention outcomes was mixed. The evidence regarding the effects on changes to health policy or practice following exposure to digital TEKT was mixed. No trials assessed the effects on individual or population-level health outcomes. CONCLUSIONS This review is the first to synthesize the effectiveness of digital TEKT interventions in a public health setting. Despite its potential, relatively few trials have been undertaken to investigate the impacts of digital TEKT interventions. The findings suggest that although a digital TEKT intervention may improve knowledge, the effects of such interventions on other outcomes are equivocal.

Course of Illness and Predictors of Outcome in Chronic Schizophrenia: Implications for Pathophysiology

1992 ◽  
Vol 161 (S18) ◽  
pp. 38-43 ◽  
Author(s):  
Alan Breier ◽  
Judith L. Schreiber ◽  
Janyce Dyer ◽  
David Pickar
Keyword(s):  
Public Health ◽  
Health Policy ◽  
Public Health Policy ◽  
Disease Process ◽  
Chronic Schizophrenia ◽  
Predictors Of Outcome ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Course Of Illness

Two critically important areas of research are the long-term course of illness and predictors of outcome in chronic schizophrenia. Although these two areas have been actively investigated throughout the 20th century, there is still a lack of agreement about even basic features of the long-term outcome of schizophrenia as well as a lack of validating evidence for putative predictors of outcome. Determining the long-term outcome of schizophrenia has implications for the pathophysiology and public health policy of this illness. For example, a course of illness that is marked by progressive deterioration may suggest a degenerative disease process, whereas a course that remains stable or improves over time may be more consistent with non-degenerative hypotheses such as neurodevelopmental, infectious, or toxic processes. In terms of public health policy, the allocation of resources related to issues such as community-based versus hospital-based care will be heavily influenced by knowledge of the level of chronicity and impairment associated with schizophrenia throughout the lifetime of affected individuals. Validation of predictors of outcome will have immediate clinical relevance, as well as providing support for pathophysiological hypotheses.

scholarly journals Housing and Healthy Child Development: Known and Potential Impacts of Interventions

2020 ◽  
Vol 41 (1) ◽  
pp. 381-396
Author(s):  
James R. Dunn
Keyword(s):  
Public Health ◽  
Health Policy ◽  
Child Development ◽  
Child Health ◽  
Health Outcomes ◽  
Conceptual Framework ◽  
Healthy Child ◽  
Public Health Policy ◽  
Important Determinant ◽  
Child Health Outcomes

Housing is often described as an important determinant of health, but less commonly of child health. Despite acknowledgment of the importance of housing to health, however, there are relatively few studies of the effects of housing interventions on health, and again even fewer on child health. This article argues that a broad focus on healthy child development—as opposed to just physical health—coupled with a conceptual framework outlining specific attributes of housing with the potential to influence child health, should be adopted to guide a comprehensive approach to public health policy for healthy child development. Most housing interventions address direct pathways linking in-home hazard exposures to child health outcomes, with promising but mixed results. But few housing interventions address the broader aspects of healthy child development. This review addresses potential housing interventions that could impact the broader determinants of healthy child development and accompanying methodological challenges.

scholarly journals High to low, low to high: neighbourhood socioeconomic trajectories and birth outcomes

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L Burgos Ochoa ◽  
L C M Bertens ◽  
E A P Steegers ◽  
J V Been
Keyword(s):  
Socioeconomic Status ◽  
Preterm Birth ◽  
The Netherlands ◽  
Health Outcomes ◽  
Birth Outcomes ◽  
Early Life ◽  
Low Ses ◽  
Adverse Birth Outcomes ◽  
The Relationship

Abstract Background A growing body of literature has consistently linked neighbourhood socioeconomic status (SES) with adverse birth outcomes. However, the available evidence is based on cross-sectional indicators of neighbourhood SES, which fail to reflect neighbourhoods' dynamic nature. The objective of this study was to explore the relationship between temporal trajectories of neighbourhood socioeconomic change and adverse birth outcomes. Methods The study population consisted of registered singleton births occurred in the Netherlands 2003-2017 between 24 and 41 weeks of gestation (N = 2,335,449). Based on neighbourhood socioeconomic data from The Netherlands Institute for Social Research, we categorized neighbourhoods into longitudinal SES trajectories (e.g. stable, declining, ascending). Multilevel logistic regression models were used to estimate the relationship between neighbourhood SES trajectories and birth outcomes, i.e., preterm birth and small-for-gestational-age (SGA). Results Living in a Stable Low SES neighbourhood was associated with higher odds of preterm birth (OR[CI]=1.10[1.06; 1.14]), and SGA (OR[CI]=1.15[1.12; 1.18]), compared to living in Stable High SES areas. Also, women living in a Declining (Middle to Low SES) neighbourhood had higher odds for preterm birth (OR = 1.08[1.03; 1.14]) and SGA (OR = 1.10 [1.06; 1.15]), compared to Stable High SES areas. Conclusions Women from neighbourhoods with long-term low or declining SES were more likely to experience adverse birth outcomes. Policies aimed at mitigating the effect of long-term neighbourhood disadvantage or preventing neighbourhoods' decline have potential to benefit early life health outcomes. Key messages Women living in long-term low or declining socioeconomic status neighbourhoods were more likely to experience adverse birth outcomes. Our results can provide guidance to policies aimed at improving early life health outcomes.

Physical activity: Health outcomes and importance for public health policy

2009 ◽  
Vol 49 (4) ◽  
pp. 280-282 ◽  
Author(s):  
William L. Haskell ◽  
Steven N. Blair ◽  
James O. Hill
Keyword(s):  
Public Health ◽  
Physical Activity ◽  
Health Policy ◽  
Health Outcomes ◽  
Public Health Policy

Researching Health Service Information Systems Development

2011 ◽  
pp. 42-59
Author(s):  
Said Shahtahmasebi
Keyword(s):  
Public Health ◽  
Health Policy ◽  
Health Outcomes ◽  
Public Health Policy ◽  
Policy Formation ◽  
Human Behaviour ◽  
Service Information ◽  
Current Availability ◽  
Tangible Evidence ◽  
Small Change

Information is considered the currency within health systems. Numerous reorganisations and restructuring, coupled with many buzz words (e.g. evidence-based practice) and the various advancements in ICT (information and communication technology) are apparently designed to improve the utilisation of this currency. However, what constitutes information appears to vary between health professionals. For some, only the data derived from RCTs (randomized control trials) is considered evidence, for others it is the conclusions drawn from focus groups, whilst for others, finding information goes well beyond subjectivity and experimental design and comes from understanding human behaviour and other processes.Although advancements in ICT have greatly improved access to information (currency), the data often disguised as information appears only as small change. Restructuring and reorganizing have been used to inflate the value of this currency (information) leading to the replacement of information departments by the Public Health Intelligence Units or Observatories. However, a change in behaviour is difficult to bring about and manage, while it is easier to change the tools with which the tasks are carried out. It is all too easy to fall into the trap of reproducing what has been produced before by information departments only under a different guise, as well as using different configurations, software or updated hardware and ICT (e.g. the Internet). These units hardly concern themselves with exploring the underlying message of the data. A quick trawl of the web pages of these entities can be testimony to this fact. The process so far has been, in effect, one of test-tubing health outcomes and then extracting the data from the test tubes. Although we have been eager to embrace technological advancements and change, we have failed to monitor the impact and consequences of change on our behaviour and thus on health outcomes. This chapter will delve into the current availability of information for public health policy purposes and will argue its ineffectiveness as information/evidence in the context of human behaviour and social processes. Behaviour and processes are by nature dynamic. Specifically, the feedback effect, a feature of dynamic process, can have a profound attenuating effect on data that was once important, thereby affecting not only the shelf life of a policy but also its intended outcomes. Examples from published reports by public health intelligence units/observatories in New Zealand and the UK, plus references to teenage smoking and suicide, will be used to illustrate these concepts and issues. A conceptual but pragmatic model of data collection based on current health care data management systems will be argued as a way forward for translating data into information and tangible evidence with a view to informing the process of public health policy formation. This chapter discusses a holistic approach to identifying data needed as evidence to inform the process of policy formation/decision making as a conceptual model.

scholarly journals Effectiveness of Technology-Enabled Knowledge Translation Strategies in Improving the Use of Research in Public Health: Systematic Review

10.2196/17274 ◽  
2020 ◽  
Vol 22 (7) ◽  
pp. e17274
Author(s):  
Alison Brown ◽  
Courtney Barnes ◽  
Judith Byaruhanga ◽  
Matthew McLaughlin ◽  
Rebecca K Hodder ◽  
...  
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Health Policy ◽  
Knowledge Translation ◽  
Health Outcomes ◽  
Health Professionals ◽  
Public Health Policy ◽  
Randomized Trials ◽  
Policy Makers ◽  
Or Practice

Background Knowledge translation (KT) aims to facilitate the use of research evidence in decision making. Changes in technology have provided considerable opportunities for KT strategies to improve access and use of evidence in decision making by public health policy makers and practitioners. Despite this opportunity, there have been no reviews that have assessed the effects of digital technology-enabled KT (TEKT) in the field of public health. Objective This study aims to examine the effectiveness of digital TEKT strategies in (1) improving the capacity for evidence-based decision making by public health policy makers and practitioners, (2) changing public health policy or practice, and (3) changes in individual or population health outcomes. Methods A search strategy was developed to identify randomized trials assessing the effectiveness of digital TEKT strategies in public health. Any primary research study with a randomized trial design was eligible. Searches for eligible studies were undertaken in multiple electronic bibliographic databases (Medical Literature Analysis and Retrieval System Online [MEDLINE], Excerpta Medica dataBASE [EMBASE], PsycINFO, Cumulative Index to Nursing and Allied Health Literature [CINAHL], and Scopus) and the reference lists of included studies. A hand search of 2 journals (Implementation Science and Journal of Medical Internet Research) and a gray literature search were also conducted. Pairs of independent review authors screened studies, assessed the risk of bias, and extracted data from relevant studies. Results Of the 6819 citations screened, 8 eligible randomized trials were included in the review. The studies examined the impact of digital TEKT strategies on health professionals, including nurses, child care health consultants, physiotherapists, primary health care workers, and public health practitioners. Overall, 5 of the interventions were web-training programs. The remaining 3 interventions included simulation games, access to digital resource materials and the use of tailored messaging, and a web-based registry. The findings suggest that digital TEKT interventions may be effective in improving the knowledge of public health professionals, relative to control, and may be as effective as a face-to-face KT approach. The effectiveness of digital TEKT strategies relative to a control or other digital KT interventions on measures of health professional self-efficacy to use evidence to enhance practice behavior or behavioral intention outcomes was mixed. The evidence regarding the effects on changes to health policy or practice following exposure to digital TEKT was mixed. No trials assessed the effects on individual or population-level health outcomes. Conclusions This review is the first to synthesize the effectiveness of digital TEKT interventions in a public health setting. Despite its potential, relatively few trials have been undertaken to investigate the impacts of digital TEKT interventions. The findings suggest that although a digital TEKT intervention may improve knowledge, the effects of such interventions on other outcomes are equivocal.

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