The impact of COVID-19 on global health and the strategies to control it: The futures Wheel Model

Although the global Covid-19 pandemic is still affecting our lives enormously, we know that a new era of deep reflection about ‘normality’, our planet and our existence on it has also begun. The ‘Education in Europe and the Covid-19 Pandemic’ double Special Issue intends to be part of this reflexive discussion about the post-pandemic European education policy and research space. This is a space shaped continuously by crises and opportunities, by utopias of a shared progressive and liberal education for all, but also the dystopias of nationalism, populism, climate destruction and now a global health emergency. This editorial offers an overview of the current crisis context and of the articles; further, it positions the journal within the post-pandemic research and policy debate about how to understand the impact of the pandemic on the changing forms of education and its enduring inequalities.

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‘Protecting Life in Global Health Assistance’? Towards a framework for assessing the health systems impact of the expanded Global Gag Rule

BMJ Global Health ◽

10.1136/bmjgh-2019-001786 ◽

2019 ◽

Vol 4 (5) ◽

pp. e001786 ◽

Cited By ~ 4

Author(s):

Marta Schaaf ◽

Emily Maistrellis ◽

Hana Thomas ◽

Bergen Cooper

Keyword(s):

Global Health ◽

Mexico City ◽

Health Systems ◽

Grey Literature ◽

Policy Changes ◽

Us Government ◽

Potential Impact ◽

City Policy ◽

The Impact ◽

Initial Research

During his first week in office, US President Donald J Trump issued a presidential memorandum to reinstate and broaden the reach of the Mexico City policy. The Mexico City policy (which was in place from 1985–1993, 1999–2000 and 2001–2009) barred foreign non-governmental organisations (NGOs) that received US government family planning (FP) assistance from using US funds or their own funds for performing, providing counselling, referring or advocating for safe abortions as a method of FP. The renamed policy, Protecting Life in Global Health Assistance (PLGHA), expands the Mexico City policy by applying it to most US global health assistance. Thus, foreign NGOs receiving US global health assistance of nearly any type must agree to the policy, regardless of whether they work in reproductive health. This article summarises academic and grey literature on the impact of previous iterations of the Mexico City policy, and initial research on impacts of the expanded policy. It builds on this analysis to propose a hypothesis regarding the potential impact of PLGHA on health systems. Because PLGHA applies to much more funding than it did in its previous iterations, and because health services have generally become more integrated in the past decade, we hypothesise that the health systems impacts of PLGHA could be significant. We present this hypothesis as a tool that may be useful to others’ and to our own research on the impact of PLGHA and similar exogenous overseas development assistance policy changes.

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CLINICAL AND COST-EFFECTIVENESS OF DONEPEZIL, RIVASTIGMINE, AND GALANTAMINE FOR ALZHEIMER'S DISEASE

International Journal of Technology Assessment in Health Care ◽

10.1017/s026646230200034x ◽

2002 ◽

Vol 18 (3) ◽

pp. 497-507 ◽

Cited By ~ 48

Author(s):

Andrew Clegg ◽

Jackie Bryant ◽

Tricia Nicholson ◽

Linda McIntyre ◽

Sofie De Broe ◽

...

Keyword(s):

Quality Of Life ◽

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cost Effectiveness ◽

Global Health ◽

Cochrane Library ◽

The Impact ◽

Health Cognition ◽

Economic Studies

Objectives: Systematic review of the clinical and cost-effectiveness of donepezil, rivastigmine, and galantamine for people suffering from Alzheimer's disease.Methods: Sixteen electronic databases (including MEDLINE, the Cochrane Library, and Embase) and bibliographies of related papers were searched for published/unpublished English language studies, and experts and pharmaceutical companies were consulted for additional information. Randomized controlled trials (RCTs) and economic studies were selected. Clinical effectiveness was assessed on measurement scales assessing progression of Alzheimer's disease on the person's global health, cognition, functional ability, behavior and mood, and quality of life. Cost-effectiveness was presented as incremental cost per year spent in a nonsevere state (by Mini Mental Health State Examination) or quality-adjusted life-year.Results: Twelve of 15 RCTs included were judged to be of good quality. Although donepezil had beneficial effects in Alzheimer's patients on global health and cognition, rivastigmine on global health, and galantamine on global health, cognition, and functional scales, these improvements were small and may not be clinically significant. Measures of quality of life and behavior and mood were rarely assessed. Adverse effects were usually mild and transient. Cost-effectiveness base case estimates ranged from £2,415 savings to £49,476 additional cost (1997 prices) per unit of effect for donepezil and a small savings for rivastigmine. Estimates were not considered robust or generalizable.Conclusions: Donepezil, rivastigmine, and galantamine appear to have some clinical effect for people with Alzheimer's disease, although the extent to which these translate into real differences in everyday life remains unclear. Due to the nature of current economic studies, cost-effectiveness remains uncertain and the impact on different care sectors has been inadequately investigated. Further research is needed to establish the actual benefits of acetylcholinesterase inhibitors (AChEls) for people with Alzheimer's disease and their caregivers, the relationship of these changes to clinical management, and careful prospective evaluation of resource and budgetary consequences.

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29.E. Workshop: Data analysis, advocacy activities, and actions to counteract the double burden of malnutrition

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.1331 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

◽

Keyword(s):

Risk Factors ◽

Global Health ◽

Chronic Diseases ◽

World Health ◽

Special Focus ◽

Global Level ◽

Double Burden ◽

Related Risk ◽

Double Burden Of Malnutrition ◽

The Impact

Abstract The burden of non-communicable chronic diseases (NCDs) represents a public health issue of gigantic proportion at global level. Among others, diet has been demonstrated to be a key element to maintain health and prevent NCDs. Today's world is facing the so-called “double burden of malnutrition”, characterized by the coexistence of undernutrition along with overweight, obesity or diet-related NCDs due to a substantial shift toward unhealthy diet high in sugars and ultra-processed foods and concomitant inadequate accessibility of nutritious foods. While interventions to improve diet quality and nutrition knowledge are of paramount importance in order to decrease the burden of NCDs over the next decades, the international policy framework should aim to develop evidence-based policy approaches to reduce such burden globally. In this context, the EUPHA Food and nutrition section, the EUPHA Chronic diseases section, the EUPHA Health promotion section, in collaboration with the World Health Organization (WHO), aim to propose a joint workshop to provide the latest updates from leading scientists and experts involved in global health research, with a special focus on NCDs, obesity and nutrition-related risk factors as well as ongoing interventions aimed to reduce the double burden of malnutrition. The objectives of the present workshop are the following: To quantify the global burden and temporal trends of NCDs risk factors; To assess the impact of nutrition-related risk factors on NCDs; To provide examples of advocacy activities and actions at global level to improve nutrition education and dietary behaviors; To promote translatable information at global level and drive implementation of knowledge into policy and practice. Organizing the present workshop would provide an important occasion for gathering experts in the field and sharing opinions with the audience in light of the presented results. Given the many actors involved, the workshop will provide a unique occasion to discuss about potential policy approaches in the context of the conference. Key messages There is science-based evidence demonstrating that healthy nutrition is a key factor to maintain global health and prevent chronic non-communicable diseases. Governmental and non-governmental efforts are currently working to counteract malnutrition worldwide.

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The Impact of the COVID-19 Pandemic on Global Health Dermatology

Dermatologic Clinics ◽

10.1016/j.det.2021.05.005 ◽

2021 ◽

Author(s):

Claire Hannah ◽

Victoria Williams ◽

L. Claire Fuller ◽

Amy Forrestel

Keyword(s):

Global Health ◽

The Impact

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G-8 Geriatric Screening Tool Independently Predicts Progression-Free Survival in Older Ovarian Cancer Patients Irrespective of Maximal Surgical Effort: Results of a Retrospective Cohort Study

Gerontology ◽

10.1159/000520328 ◽

2021 ◽

pp. 1-10

Author(s):

Katharina Anic ◽

Sophie Birkert ◽

Mona Wanda Schmidt ◽

Valerie Catherine Linz ◽

Anne-Sophie Heimes ◽

...

Keyword(s):

Ovarian Cancer ◽

Global Health ◽

Screening Tool ◽

Prognostic Index ◽

Progression Free Survival ◽

Assessment Tools ◽

Prognostic Impact ◽

Free Survival ◽

Geriatric Screening ◽

The Impact

Background: We evaluated the prognostic impact of various global health assessment tools in patients older than 60 years with ovarian cancer (OC). Methods: G-8 geriatric screening tool (G-8 score), Lee Schonberg prognostic index, Eastern Cooperative Oncology Group (ECOG) performance status, and Charlson Comorbidity Index (CCI) were determined retrospectively in a consecutive cohort of elderly patients with OC. Univariate and multivariate Cox regression analyses and Kaplan-Meier method were performed to analyze the impact of the preoperative global health status on survival. Results: 116 patients entered the study. In multivariate analysis adjusted for clinical-pathological factors, only the G-8 score retained significance as a prognostic parameter of progression-free survival (PFS) (hazard ratio [HR]: 1.970; 95% confidence interval [CI] [1.056–3.677]; p = 0.033). Fifty-six patients were classified as G-8-nonfrail with an increased PFS compared to 50 G-8-frail patients (53.4% vs. 16.7%; p = 0.010). A higher CCI was associated with decreased PFS (45.1% vs. 22.2%; p = 0.012), but it did not influence the risk of recurrences or death (p = 0.360; p = 0.111). The Lee Schonberg prognostic index, the ECOG, and age were not associated with survival. Conclusions: The G-8 score independently predicted PFS in elderly OC patients regardless of maximal surgical effort. Thus, it could be useful to assess surgical treatment based on frailty rather than age alone.

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Antimicrobial Resistance and Social Inequalities in Health: Considerations of Justice

Ethics and Drug Resistance: Collective Responsibility for Global Public Health - Public Health Ethics Analysis ◽

10.1007/978-3-030-27874-8_16 ◽

2020 ◽

pp. 257-278

Author(s):

Lynette Reid

Keyword(s):

Global Health ◽

Health Inequalities ◽

Social Inequalities ◽

Tertiary Care ◽

Practical Importance ◽

Social Inequalities In Health ◽

Inequalities In Health ◽

Catching Up ◽

The Impact

Abstract Within-country social inequalities in health have widened while global health inequalities have (with some exceptions) narrowed since the Second World War. On commonly accepted prioritarian and sufficientist views of justice and health, these two trends together would be acceptable: the wealthiest of the wealthy are pulling ahead, but the worst off are catching up and more are achieving sufficiency. Such commitments to priority or sufficiency are compatible with a common “development” narrative about economic and social changes that accompany changes (“transitions”) in population health. I set out a very simple version of health egalitarianism (without commitment to any particular current theory of justice) and focus on two common objections to egalitarianism. Priority and sufficiency both address the levelling down and formalism objections, but these objections are distinct: giving content to equality (I argue here) places in question the claimed normative superiority of priority and sufficiency. Using examples of the role of antimicrobials in both these trends – and the future role of AMR – I clarify (first) the multiple forms and dimensions of justice at play in health, and (second) the different mechanisms at work in generating the two current patterns (seen in life course narratives and narratives of political economy). The “accelerated transition” that narrowed global health inequalities is fed by anti-microbials (among other technology transfers). It did not accelerate but replaced the causal processes by which current HICs achieved the transition (growing and shared economic prosperity and widening political franchise). The impact of AMR on widening social inequalities in health in HICs will be complex: inequality has been fed in part by tertiary care enabled by antimicrobials; AMR might erode the solidarity underlying universal health systems as the well-off seek to maintain current expectations of curative and rehabilitative surgery and chemotherapy while AMR mounts. In light of both speculations about the impact of AMR on social and global health inequalities, I close with practical and with theoretical reflection. I briefly indicate the practical importance of understanding AMR from the perspective of health justice for policy response. Then, from a broader perspective, I argue that the content by which I meet the formalism objection demonstrates that the two trends (broadening within-country inequality and narrowing global inequality) are selective and biased samples of a centuries-long pattern of widening social inequalities in health. We are not in the midst of a process of “catching up”. In light of the long-term pattern described here, is the pursuit of sufficiency or priority morally superior to the pursuit of equality as a response to concrete suffering – or do they rationalize a process more objectively described as the best-off continuing to take the largest share of one of the most important benefits of economic development?

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Obesity and Stunting in Childhood. Do Grandparents Play A Role? A Systematic Review

Jurnal NERS ◽

10.20473/jn.v14i3.16986 ◽

2019 ◽

Vol 14 (3) ◽

pp. 71

Author(s):

Rizki Agustin Purwaningtyas ◽

Ardila Lailatul Barik ◽

Dwi Astuti

Keyword(s):

Systematic Review ◽

Child Care ◽

Global Health ◽

Full Text ◽

Weight Status ◽

Child Obesity ◽

Primary Caregiver ◽

Inclusion Criteria ◽

Child Weight ◽

The Impact

Introduction: Obesity and stunting in childhood has become one of the greatest global health challenges. The impact of this issue is serious and lasting for individuals, their families, communities and countries. Most of the studies on child weight status have only focused on the mother as the primary caregiver, whereas the role and inﬂuence of the grandparents has received less attention. Grandparent-provided child care has become a trend in many countries, with reported rates of approximately 40% to 58%. The objective of this systematic review was to analyze whether children become stunted or obese when they are cared for by their grandparents.Methods: The methodological search of the literature was conducted using Scopus, Science Direct, PubMed, Pro Quest and ResearchGate, and it was undertaken using PRISMA guidelines. The search identified 1803 papers and 135 full-text articles were screened for eligibility. Finally, 15 met the inclusion criteria. The keyword chain was as follows: ("obesity" OR "stunting") AND (“children”) AND (“grandparents”).Results: As grandparents take on increasingly responsible roles in the lives of their grandchildren, there is an influence on the higher risk of child obesity rather than stunting.Conclusion: In future, nurses should target not only the mother but also the grandparents to control their child’s health, especially when related to their weight status.

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Child development and disability

Oxford Textbook of Global Health of Women, Newborns, Children, and Adolescents ◽

10.1093/med/9780198794684.003.0038 ◽

2018 ◽

pp. 195-199

Author(s):

Richard Rosch ◽

Michelle Heys ◽

Hannah Kuper

Keyword(s):

Sustainable Development ◽

Global Health ◽

Developmental Outcomes ◽

Intervention Strategies ◽

Childhood Development ◽

Developmental Potential ◽

The Sustainable Development ◽

Development Goals ◽

The Impact

Worldwide, many children do not meet their developmental potential. This is particularly the case in LMICs and especially affects children living with disability. Thus, improving developmental attainment and reducing the impact of disability has now become an integral part of many of the sustainable development goals. This chapter introduces several tools currently available to measure both childhood development, and the effects of disability. Using examples from current research in global health this chapter introduces both known effective intervention strategies that improve developmental outcomes, and highlights challenges and future priorities for further research. These points are further illustrated using epilepsy as a case study, highlighting how the interaction of biomedical, psychosocial, and socioeconomic factors impacts on childhood development.

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