scholarly journals Policy Debates Regarding Nicotine Vaping Products in Australia: A Qualitative Analysis of Submissions to a Government Inquiry from Health and Medical Organisations

2019 ◽  
Vol 16 (22) ◽  
pp. 4555 ◽  
Author(s):  
Daniel A Erku ◽  
Kylie Morphett ◽  
Kathryn J Steadman ◽  
Coral E Gartner
Keyword(s):  
Public Health ◽  
Healthcare Professionals ◽  
High Standard ◽  
Unintended Consequences ◽  
Government Agencies ◽  
Policy Debate ◽  
Widening Access ◽  
Health Community ◽  
Regulatory Approach ◽  
Potential Benefits

Australia has maintained a highly restrictive regulatory framework for nicotine vaping products (NVPs) and the regulatory approach differs from most other high income countries. This paper employed a thematic analysis to assess policy consultation submissions made to a government inquiry regarding use and marketing of NVPs. We included in the analysis submissions (n = 40) made by Australian institutions that influence or contribute to health policy-making including government agencies, health bodies and charities (n = 23), and public health academics and healthcare professionals (n = 18). Submissions from commercial entities and consumers were excluded. The majority of submissions from representatives of government agencies, health bodies and charities recommended maintaining current restrictions on NVPs. Arguments against widening access to NVPs included the demand for long-term evidence on safety and efficacy of an unusually high standard. There was widespread support for restrictions on sales, advertising and promotion, with most submissions supporting similar controls as for tobacco products. In contrast, the majority of individual submissions from healthcare professionals and public health academics advocated for widening access to NVPs for smokers and emphasized the potential benefits of smokers switching to vaping and the policy incoherence of regulating less harmful nicotine products more strictly than tobacco cigarettes. Progress in resolving the policy debate concerning NVP regulation in Australia will require policy makers, clinicians and the public health community to engage in a meaningful dialogue which gives due consideration to both intended and unintended consequences of proposed policies.

Navigating the Ethics of Big Data in Public Health

2019 ◽  
pp. 353-367
Author(s):  
Effy Vayena ◽  
Lawrence Madoff
Keyword(s):  
Public Health ◽  
Big Data ◽  
Credit Card ◽  
Health Sector ◽  
Public Health Research ◽  
Ethical Challenges ◽  
The Public ◽  
Health Community ◽  
Digital Disease Detection ◽  
The Public Sphere

“Big data,” which encompasses massive amounts of information from both within the health sector (such as electronic health records) and outside the health sector (social media, search queries, cell phone metadata, credit card expenditures), is increasingly envisioned as a rich source to inform public health research and practice. This chapter examines the enormous range of sources, the highly varied nature of these data, and the differing motivations for their collection, which together challenge the public health community in ethically mining and exploiting big data. Ethical challenges revolve around the blurring of three previously clearer boundaries: between personal health data and nonhealth data; between the private and the public sphere in the online world; and, finally, between the powers and responsibilities of state and nonstate actors in relation to big data. Considerations include the implications for privacy, control and sharing of data, fair distribution of benefits and burdens, civic empowerment, accountability, and digital disease detection.

Voluntary food fortification policy in Australia: did ‘formal’ stakeholder consultation influence the outcome?

2021 ◽  
Author(s):  
Bronwyn Ashton ◽  
Cassandra Star ◽  
Mark Lawrence ◽  
John Coveney
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Policy Process ◽  
Policy Development ◽  
Food Fortification ◽  
Policy Debate ◽  
Stakeholder Consultation ◽  
Regulatory Decision ◽  
Food Regulation ◽  
Ministerial Council

Summary This research aimed to understand how the policy was represented as a ‘problem’ in food regulatory decision-making in Australia, and the implications for public health nutrition engagement with policy development processes. Bacchi’s ‘what’s the problem represented to be?’ discourse analysis method was applied to a case study of voluntary food fortification policy (VFP) developed by the then Australia and New Zealand Food Regulation Ministerial Council (ANZFRMC) between 2002 and 2012. As a consultative process is a legislated aspect of food regulatory policy development in Australia, written stakeholder submissions contributed most of the key documents ascertained as relevant to the case. Four major categories of stakeholder were identified in the data; citizen, public health, government and industry. Predictably, citizen, government and public health stakeholders primarily represented voluntary food fortification (VF) as a problem of public health, while industry stakeholders represented it as a problem of commercial benefit. This reflected expected differences regarding decision-making control and power over regulatory activity. However, at both the outset and conclusion of the policy process, the ANZFRMC represented the problem of VF as commercial benefit, suggesting that in this case, a period of ‘formal’ stakeholder consultation did not alter the outcome. This research indicates that in VFP, the policy debate was fought and won at the initial framing of the problem in the earliest stages of the policy process. Consequently, if public health nutritionists leave their participation in the process until formal consultation stages, the opportunity to influence policy may already be lost.

scholarly journals What is common and what is different: recommendations from European scientific societies for triage in the first outbreak of COVID-19

2021 ◽  
pp. medethics-2020-106969
Author(s):  
Joana Teles Sarmento ◽  
Cristina Lírio Pedrosa ◽  
Ana Sofia Carvalho
Keyword(s):  
Public Health ◽  
Healthcare Professionals ◽  
Public Health Emergency ◽  
Fair Allocation ◽  
Ethical Values ◽  
Scientific Societies ◽  
Decision Tools ◽  
Life Saving

A public health emergency, as the COVID-19 pandemic, may lead to shortages of potentially life-saving treatments. In this situation, it is necessary, justifiable and proportionate to have decision tools in place to enable healthcare professionals to triage and prioritise access to those resources. An ethically sound framework should consider the principles of beneficence and fair allocation. Scientific Societies across Europe were concerned with this problem early in the pandemic and published guidelines to support their professionals and institutions. This article aims to compare triage policies from medical bodies across Europe, to characterise the process of triage and the ethical values, principles and theories that were proposed in different countries during the first outbreak of COVID-19.

scholarly journals Obstetric Violence in Spain (Part III): Healthcare Professionals, Times and Areas

2021 ◽  
Vol 18 (7) ◽  
pp. 3359
Author(s):  
Desirée Mena-Tudela ◽  
Susana Iglesias-Casás ◽  
Víctor Manuel González-Chordá ◽  
María Jesús Valero-Chillerón ◽  
Laura Andreu-Pejó ◽  
...  
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Informed Consent ◽  
Healthcare Professionals ◽  
Public Health Problem ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Lack Of Information ◽  
Obstetric Violence

Background: Obstetric violence is a worldwide public health problem, which seems greater in Spain. As no studies were found that identify the most representative healthcare professionals, times, and areas involved in obstetric violence, the objective of this work was to study at what time of maternity, with which professionals, and in what areas women identified obstetric violence. Methods: This descriptive, retrospective, and cross-sectional study was performed from January 2018 to June 2019. The main variables were the area (hospital, primary care, both), the time (pregnancy, birth, puerperium), and the professionals attending to women. Results: Our sample comprised 17,541 participants. The area identified with the most obstetric violence for the different studied variables was hospitals. Women identified more obstetric violence at time of birth. Findings such as lack of information and informed consent (74.2%), and criticism of infantile behavior and treatment (87.6%), stood out. The main identified healthcare professionals were midwives and gynecologists, and “other” professionals repeatedly appeared. Conclusions: Having identified the professionals, times, and areas of most obstetric violence in Spain, it seems necessary to reflect on not only the Spanish National Health System’s structure and management but also on healthcare professionals’ training.

scholarly journals Public health measures to reduce the risk of SARS-CoV-2 transmission in Canada during the early days of the COVID-19 pandemic: a scoping review

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e046177
Author(s):  
Julie Polisena ◽  
Maria Ospina ◽  
Omolara Sanni ◽  
Brittany Matenchuk ◽  
Rachel Livergant ◽  
...  
Keyword(s):  
Public Health ◽  
Scoping Review ◽  
Health Agency ◽  
Unintended Consequences ◽  
Pandemic Preparedness ◽  
School Closures ◽  
Mass Gatherings ◽  
And Migration ◽  
Priority Populations ◽  
New Evidence

ObjectiveThe main objectives of this study were to synthesise and compare pandemic preparedness strategies issued by the federal and provincial/territorial (P/T) governments in Canada and to assess whether COVID-19 public health (PH) measures were tailored towards priority populations, as defined by relevant social determinants of health.MethodsThis scoping review searched federal and P/T websites on daily COVID-19 pandemic preparedness strategies between 30 January and 30 April 2020. The PROGRESS-Plus equity-lens framework was used to define priority populations. All definitions, policies and guidelines of PH strategies implemented by the federal and P/T governments to reduce risk of SARS-CoV-2 transmission were included. PH measures were classified using a modified Public Health Agency of Canada Framework for Canadian Pandemic Influenza Preparedness.ResultsA total of 722 COVID-19 PH measures were issued during the study period. Of these, home quarantine (voluntary) (n=13.0%; 94/722) and retail/commerce restrictions (10.9%; n=79/722) were the most common measures introduced. Many of the PH orders, including physical distancing, cancellation of mass gatherings, school closures or retail/commerce restrictions began to be introduced after 11 March 2020. Lifting of some of the PH orders in phases to reopen the economy began in April 2020 (6.5%; n=47/722). The majority (68%, n=491/722) of COVID-19 PH announcements were deemed mandatory, while 32% (n=231/722) were recommendations. Several PH measures (28.0%, n=202/722) targeted a variety of groups at risk of socially produced health inequalities, such as age, religion, occupation and migration status.ConclusionsMost PH measures centred on limiting contact between people who were not from the same household. PH measures were evolutionary in nature, reflecting new evidence that emerged throughout the pandemic. Although ~30% of all implemented COVID-19 PH measures were tailored towards priority groups, there were still unintended consequences on these populations.

scholarly journals A Holistic Intersection Rating System (HIRS)—A Novel Methodology to Measure the Holistic Operational Performance of Signalized Urban Intersections

Smart Cities ◽  
2021 ◽  
Vol 4 (3) ◽  
pp. 1018-1038
Author(s):  
Wesam Emad Saba ◽  
Salwa M. Beheiry ◽  
Ghassan Abu-Lebdeh ◽  
Mustafa S. AL-Tekreeti
Keyword(s):  
Public Health ◽  
Local Economy ◽  
Rating System ◽  
Operational Performance ◽  
Community Activities ◽  
Community Wellbeing ◽  
Importance Index ◽  
Health Community ◽  
Direct And Indirect Impacts ◽  
Indirect Impacts

Signalized urban intersections are key components of urban transportation networks. They are traditionally viewed and designed as primarily motorized traffic facilities, and thus their physical and operational designs have traditionally aimed at maximizing traffic throughput subject to constraints dictated by vehicular safety requirements and pedestrian crossing needs. Seen from a holistic viewpoint, urban intersections are hubs or effective centers of community activities of which traffic flow is only one. Those hubs have direct and indirect impacts on the overlapping traffic functionalities, the environment, public health, community wellbeing, and the local economy. This study proposes a new rating system, the Holistic Intersection Rating System (HIRS), aimed at appraising signalized intersections from a more inclusive viewpoint. This appraisal covers traffic functionality, sustainability, and public health and community wellbeing. This rating system can be used as a guide to conceive, plan, or design new intersections or revamp existing ones. HIRS rates signalized urban intersections based on the level of use of relevant enabling technologies, and the physical and operational designs that allow those intersections to operate holistically, thus leading to a more human-centric and sustainable operational performance. HIRS was validated using a panel of experts in construction, transportation, and public health. The Relative Importance Index (RII) method was used to weigh the HIRS features. The rating system was piloted on a sample of 20 intersections in different cities in the UAE. The results revealed glaring gaps in services to or the consideration of pedestrians, cyclists, and nearby households. The sample intersections scored a mean of 32% on the public health and community wellbeing section, 37% on the pedestrian subsection, and 15% on the cyclist subsection. Such relatively low scores serve as indicators of areas for improvements, and if mapped to their specific features and their relative weights, specific physical and operations designs and technology integration can be identified as actionable items for inclusion in plans and/or designs.

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