90 results
Search Results
2. A Landmark Paper in HIV Research?
- Author
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Siegfried, Nandi
- Subjects
Infectious Diseases ,Medicine in Developing Countries ,Clinical trials ,Epidemiology/Public Health ,Health Policy ,Urology ,HIV Infection/AIDS ,HIV/AIDS ,Public Health ,Sexual Health ,Men's Health ,Perspectives - Abstract
Siegfried discusses the first reported randomized controlled trial of whether circumcision protects against HIV, published in PLoS Medicine.
- Published
- 2005
3. A Landmark Paper in HIV Research?
- Author
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Peter Cleaton-Jones
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,Sexual Behavior ,Urology ,Decision Making ,Health Behavior ,education ,Alternative medicine ,Human immunodeficiency virus (HIV) ,lcsh:Medicine ,HIV Infections ,medicine.disease_cause ,Condoms ,South Africa ,medicine ,HIV Infection/AIDS ,Humans ,Ethics, Medical ,Randomized Controlled Trials as Topic ,Gynecology ,Ethics ,Research ethics ,Medicine in Developing Countries ,Ethical issues ,business.industry ,Health Policy ,lcsh:R ,Ethics committee ,General Medicine ,Correspondence and Other Communications ,Bioethics ,Sexually transmitted infections - other than HIV/AIDS ,Infectious Diseases ,Sexual behavior ,Circumcision, Male ,Male circumcision ,Epidemiology/Public Health ,Family medicine ,Personal Autonomy ,HIV/AIDS ,Health behavior ,Sexual Health ,business ,Ethics Committees, Research ,Perspectives - Abstract
Cleaton-Jones, chair of the ethics committee that approved the trial of circumcision for preventing HIV, shares with us the discussions that the committee had ahead of granting approval.
- Published
- 2005
4. Blue marble health: a call for papers.
- Author
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Hotez, Peter J and Peiperl, Larry
- Subjects
- *
COMMUNICABLE disease epidemiology , *HEALTH policy , *RESEARCH , *COMMUNICABLE diseases , *PREVENTION of communicable diseases , *RESEARCH methodology , *WORLD health , *MEDICAL cooperation , *EVALUATION research , *SOCIOECONOMIC factors , *COMPARATIVE studies , *SYMPTOMS , *NEWSLETTERS - Published
- 2014
- Full Text
- View/download PDF
5. malERA: An updated research agenda for health systems and policy research in malaria elimination and eradication.
- Subjects
- Animals, Biomedical Research trends, Delivery of Health Care trends, Disease Eradication trends, Humans, Biomedical Research methods, Delivery of Health Care methods, Disease Eradication methods, Health Policy trends, Malaria epidemiology, Malaria prevention & control
- Abstract
Health systems underpin disease elimination and eradication programmes. In an elimination and eradication context, innovative research approaches are needed across health systems to assess readiness for programme reorientation, mitigate any decreases in effectiveness of interventions ('effectiveness decay'), and respond to dynamic and changing needs. The malaria eradication research agenda (malERA) Refresh consultative process for the Panel on Health Systems and Policy Research identifies opportunities to build health systems evidence and the tools needed to eliminate malaria from different zones, countries, and regions and to eradicate it globally. The research questions are organised as a portfolio that global health practitioners, researchers, and funders can identify with and support. This supports the promotion of an actionable and more cohesive approach to building the evidence base for scaled-up implementation of findings. Gaps and opportunities discussed in the paper include delivery strategies to meet the changing dynamics of needs of individuals, environments, and malaria programme successes; mechanisms and approaches to best support accelerated policy and financial responsiveness at national and global level to ensure timely response to evidence and needs, including in crisis situations; and systems' readiness tools and decision-support systems.
- Published
- 2017
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6. malERA: An updated research agenda for health systems and policy research in malaria elimination and eradication.
- Author
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null, null and malERA Refresh Consultative Panel on Health Systems and Policy Research
- Subjects
MALARIA prevention ,CRISIS management ,DISEASE eradication ,HEALTH policy ,PUBLIC health ,ANIMALS ,MALARIA ,MEDICAL care ,MEDICAL research - Abstract
Health systems underpin disease elimination and eradication programmes. In an elimination and eradication context, innovative research approaches are needed across health systems to assess readiness for programme reorientation, mitigate any decreases in effectiveness of interventions ('effectiveness decay'), and respond to dynamic and changing needs. The malaria eradication research agenda (malERA) Refresh consultative process for the Panel on Health Systems and Policy Research identifies opportunities to build health systems evidence and the tools needed to eliminate malaria from different zones, countries, and regions and to eradicate it globally. The research questions are organised as a portfolio that global health practitioners, researchers, and funders can identify with and support. This supports the promotion of an actionable and more cohesive approach to building the evidence base for scaled-up implementation of findings. Gaps and opportunities discussed in the paper include delivery strategies to meet the changing dynamics of needs of individuals, environments, and malaria programme successes; mechanisms and approaches to best support accelerated policy and financial responsiveness at national and global level to ensure timely response to evidence and needs, including in crisis situations; and systems' readiness tools and decision-support systems. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
7. The Policy Dystopia Model: An Interpretive Analysis of Tobacco Industry Political Activity.
- Author
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Ulucanlar S, Fooks GJ, and Gilmore AB
- Subjects
- Humans, Marketing, Nicotiana, United States, Health Policy, Models, Theoretical, Politics, Public Health, Tobacco Industry economics
- Abstract
Background: Tobacco industry interference has been identified as the greatest obstacle to the implementation of evidence-based measures to reduce tobacco use. Understanding and addressing industry interference in public health policy-making is therefore crucial. Existing conceptualisations of corporate political activity (CPA) are embedded in a business perspective and do not attend to CPA's social and public health costs; most have not drawn on the unique resource represented by internal tobacco industry documents. Building on this literature, including systematic reviews, we develop a critically informed conceptual model of tobacco industry political activity., Methods and Findings: We thematically analysed published papers included in two systematic reviews examining tobacco industry influence on taxation and marketing of tobacco; we included 45 of 46 papers in the former category and 20 of 48 papers in the latter (n = 65). We used a grounded theory approach to build taxonomies of "discursive" (argument-based) and "instrumental" (action-based) industry strategies and from these devised the Policy Dystopia Model, which shows that the industry, working through different constituencies, constructs a metanarrative to argue that proposed policies will lead to a dysfunctional future of policy failure and widely dispersed adverse social and economic consequences. Simultaneously, it uses diverse, interlocking insider and outsider instrumental strategies to disseminate this narrative and enhance its persuasiveness in order to secure its preferred policy outcomes. Limitations are that many papers were historical (some dating back to the 1970s) and focused on high-income regions., Conclusions: The model provides an evidence-based, accessible way of understanding diverse corporate political strategies. It should enable public health actors and officials to preempt these strategies and develop realistic assessments of the industry's claims., Competing Interests: The authors have declared that no competing interests exist.
- Published
- 2016
- Full Text
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8. The influence of health systems on hypertension awareness, treatment, and control: a systematic literature review.
- Author
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Maimaris W, Paty J, Perel P, Legido-Quigley H, Balabanova D, Nieuwlaat R, and McKee M
- Subjects
- Global Health, Health Systems Agencies, Health Systems Plans, Hypertension prevention & control, Health Knowledge, Attitudes, Practice, Health Policy, Hypertension psychology, Hypertension therapy
- Abstract
Background: Hypertension (HT) affects an estimated one billion people worldwide, nearly three-quarters of whom live in low- or middle-income countries (LMICs). In both developed and developing countries, only a minority of individuals with HT are adequately treated. The reasons are many but, as with other chronic diseases, they include weaknesses in health systems. We conducted a systematic review of the influence of national or regional health systems on HT awareness, treatment, and control., Methods and Findings: Eligible studies were those that analyzed the impact of health systems arrangements at the regional or national level on HT awareness, treatment, control, or antihypertensive medication adherence. The following databases were searched on 13th May 2013: Medline, Embase, Global Health, LILACS, Africa-Wide Information, IMSEAR, IMEMR, and WPRIM. There were no date or language restrictions. Two authors independently assessed papers for inclusion, extracted data, and assessed risk of bias. A narrative synthesis of the findings was conducted. Meta-analysis was not conducted due to substantial methodological heterogeneity in included studies. 53 studies were included, 11 of which were carried out in LMICs. Most studies evaluated health system financing and only four evaluated the effect of either human, physical, social, or intellectual resources on HT outcomes. Reduced medication co-payments were associated with improved HT control and treatment adherence, mainly evaluated in US settings. On balance, health insurance coverage was associated with improved outcomes of HT care in US settings. Having a routine place of care or physician was associated with improved HT care., Conclusions: This review supports the minimization of medication co-payments in health insurance plans, and although studies were largely conducted in the US, the principle is likely to apply more generally. Studies that identify and analyze complexities and links between health systems arrangements and their effects on HT management are required, particularly in LMICs. Please see later in the article for the Editors' Summary.
- Published
- 2013
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9. Guidance for evidence-informed policies about health systems: rationale for and challenges of guidance development.
- Author
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Bosch-Capblanch X, Lavis JN, Lewin S, Atun R, Røttingen JA, Dröschel D, Beck L, Abalos E, El-Jardali F, Gilson L, Oliver S, Wyss K, Tugwell P, Kulier R, Pang T, and Haines A
- Subjects
- Health Policy
- Abstract
In the first paper in a three-part series on health systems guidance, Xavier Bosch-Capblanch and colleagues examine how guidance is currently formulated in low- and middle-income countries, and the challenges to developing such guidance.
- Published
- 2012
- Full Text
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10. Guidance for evidence-informed policies about health systems: assessing how much confidence to place in the research evidence.
- Author
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Lewin S, Bosch-Capblanch X, Oliver S, Akl EA, Vist GE, Lavis JN, Ghersi D, Røttingen JA, Steinmann P, Gulmezoglu M, Tugwell P, El-Jardali F, and Haines A
- Subjects
- Health Policy
- Abstract
In the third paper in a three-part series on health systems guidance, Simon Lewin and colleagues explore the challenge of assessing how much confidence to place in evidence on health systems interventions.
- Published
- 2012
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11. The Brazil SimSmoke policy simulation model: the effect of strong tobacco control policies on smoking prevalence and smoking-attributable deaths in a middle income nation.
- Author
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Levy D, de Almeida LM, and Szklo A
- Subjects
- Adolescent, Adult, Aged, Brazil epidemiology, Computer Simulation, Female, Government Regulation, Humans, Male, Middle Aged, Models, Theoretical, Prevalence, Seasons, Smoking adverse effects, Smoking trends, Young Adult, Health Policy legislation & jurisprudence, Mortality, Premature, Smoking epidemiology, Smoking legislation & jurisprudence
- Abstract
Background: Brazil has reduced its smoking rate by about 50% in the last 20 y. During that time period, strong tobacco control policies were implemented. This paper estimates the effect of these stricter policies on smoking prevalence and associated premature mortality, and the effect that additional policies may have., Methods and Findings: The model was developed using the SimSmoke tobacco control policy model. Using policy, population, and smoking data for Brazil, the model assesses the effect on premature deaths of cigarette taxes, smoke-free air laws, mass media campaigns, marketing restrictions, packaging requirements, cessation treatment programs, and youth access restrictions. We estimate the effect of past policies relative to a counterfactual of policies kept to 1989 levels, and the effect of stricter future policies. Male and female smoking prevalence in Brazil have fallen by about half since 1989, which represents a 46% (lower and upper bounds: 28%-66%) relative reduction compared to the 2010 prevalence under the counterfactual scenario of policies held to 1989 levels. Almost half of that 46% reduction is explained by price increases, 14% by smoke-free air laws, 14% by marketing restrictions, 8% by health warnings, 6% by mass media campaigns, and 10% by cessation treatment programs. As a result of the past policies, a total of almost 420,000 (260,000-715,000) deaths had been averted by 2010, increasing to almost 7 million (4.5 million-10.3 million) deaths projected by 2050. Comparing future implementation of a set of stricter policies to a scenario with 2010 policies held constant, smoking prevalence by 2050 could be reduced by another 39% (29%-54%), and 1.3 million (0.9 million-2.0 million) out of 9 million future premature deaths could be averted., Conclusions: Brazil provides one of the outstanding public health success stories in reducing deaths due to smoking, and serves as a model for other low and middle income nations. However, a set of stricter policies could further reduce smoking and save many additional lives. Please see later in the article for the Editors' Summary.
- Published
- 2012
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12. Voluntary medical male circumcision: a framework analysis of policy and program implementation in eastern and southern Africa.
- Author
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Dickson KE, Tran NT, Samuelson JL, Njeuhmeli E, Cherutich P, Dick B, Farley T, Ryan C, and Hankins CA
- Subjects
- Africa, Eastern epidemiology, Africa, Southern epidemiology, Circumcision, Male statistics & numerical data, HIV Infections epidemiology, HIV Infections transmission, Humans, International Cooperation legislation & jurisprudence, Male, National Health Programs organization & administration, National Health Programs standards, Circumcision, Male legislation & jurisprudence, HIV Infections prevention & control, Health Policy legislation & jurisprudence, National Health Programs legislation & jurisprudence
- Abstract
Background: Following confirmation of the effectiveness of voluntary medical male circumcision (VMMC) for HIV prevention, the World Health Organization and the Joint United Nations Programme on HIV/AIDS issued recommendations in 2007. Less than 5 y later, priority countries are at different stages of program scale-up. This paper analyzes the progress towards the scale-up of VMMC programs. It analyzes the adoption of VMMC as an additional HIV prevention strategy and explores the factors may have expedited or hindered the adoption of policies and initial program implementation in priority countries to date., Methods and Findings: VMMCs performed in priority countries between 2008 and 2010 were recorded and used to classify countries into five adopter categories according to the Diffusion of Innovations framework. The main predictors of VMMC program adoption were determined and factors influencing subsequent scale-up explored. By the end of 2010, over 550,000 VMMCs had been performed, representing approximately 3% of the target coverage level in priority countries. The "early adopter" countries developed national VMMC policies and initiated VMMC program implementation soon after the release of the WHO recommendations. However, based on modeling using the Decision Makers' Program Planning Tool (DMPPT), only Kenya appears to be on track towards achievement of the DMPPT-estimated 80% coverage goal by 2015, having already achieved 61.5% of the DMPPT target. None of the other countries appear to be on track to achieve their targets. Potential predicators of early adoption of male circumcision programs include having a VMMC focal person, establishing a national policy, having an operational strategy, and the establishment of a pilot program., Conclusions: Early adoption of VMMC policies did not necessarily result in rapid program scale-up. A key lesson is the importance of not only being ready to adopt a new intervention but also ensuring that factors critical to supporting and accelerating scale-up are incorporated into the program. The most successful program had country ownership and sustained leadership to translate research into a national policy and program. Please see later in the article for the Editors' Summary.
- Published
- 2011
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13. Accelerating policy decisions to adopt haemophilus influenzae type B vaccine: a global, multivariable analysis.
- Author
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Shearer JC, Stack ML, Richmond MR, Bear AP, Hajjeh RA, and Bishai DM
- Subjects
- Humans, Immunization, Income, Models, Statistical, Multivariate Analysis, Time Factors, United Nations, Decision Making, Haemophilus Vaccines immunology, Haemophilus influenzae type b immunology, Health Policy
- Abstract
Background: Adoption of new and underutilized vaccines by national immunization programs is an essential step towards reducing child mortality. Policy decisions to adopt new vaccines in high mortality countries often lag behind decisions in high-income countries. Using the case of Haemophilus influenzae type b (Hib) vaccine, this paper endeavors to explain these delays through the analysis of country-level economic, epidemiological, programmatic and policy-related factors, as well as the role of the Global Alliance for Vaccines and Immunisation (GAVI Alliance)., Methods and Findings: Data for 147 countries from 1990 to 2007 were analyzed in accelerated failure time models to identify factors that are associated with the time to decision to adopt Hib vaccine. In multivariable models that control for Gross National Income, region, and burden of Hib disease, the receipt of GAVI support speeded the time to decision by a factor of 0.37 (95% CI 0.18-0.76), or 63%. The presence of two or more neighboring country adopters accelerated decisions to adopt by a factor of 0.50 (95% CI 0.33-0.75). For each 1% increase in vaccine price, decisions to adopt are delayed by a factor of 1.02 (95% CI 1.00-1.04). Global recommendations and local studies were not associated with time to decision., Conclusions: This study substantiates previous findings related to vaccine price and presents new evidence to suggest that GAVI eligibility is associated with accelerated decisions to adopt Hib vaccine. The influence of neighboring country decisions was also highly significant, suggesting that approaches to support the adoption of new vaccines should consider supply- and demand-side factors.
- Published
- 2010
- Full Text
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14. Costs and consequences of the US Centers for Disease Control and Prevention's recommendations for opt-out HIV testing.
- Author
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Holtgrave DR
- Subjects
- Adolescent, Adult, Cost-Benefit Analysis, Disease Transmission, Infectious prevention & control, Early Diagnosis, Female, Guideline Adherence, HIV Infections diagnosis, HIV Infections prevention & control, HIV Infections psychology, HIV Infections transmission, HIV Seropositivity diagnosis, HIV Seropositivity epidemiology, HIV Seroprevalence, Humans, Informed Consent, Male, Middle Aged, Models, Theoretical, Patient Acceptance of Health Care, Public Health economics, Risk, Risk-Taking, United States epidemiology, AIDS Serodiagnosis economics, AIDS Serodiagnosis psychology, AIDS Serodiagnosis statistics & numerical data, Centers for Disease Control and Prevention, U.S., Counseling economics, Diagnostic Tests, Routine economics, Diagnostic Tests, Routine psychology, Diagnostic Tests, Routine statistics & numerical data, Health Care Costs statistics & numerical data, Health Policy economics, Person-Centered Psychotherapy economics, Practice Guidelines as Topic, Risk Assessment economics, Treatment Refusal
- Abstract
Background: The United States Centers for Disease Control and Prevention (CDC) recently recommended opt-out HIV testing (testing without the need for risk assessment and counseling) in all health care encounters in the US for persons 13-64 years old. However, the overall costs and consequences of these recommendations have not been estimated before. In this paper, I estimate the costs and public health impact of opt-out HIV testing relative to testing accompanied by client-centered counseling, and relative to a more targeted counseling and testing strategy., Methods and Findings: Basic methods of scenario and cost-effectiveness analysis were used, from a payer's perspective over a one-year time horizon. I found that for the same programmatic cost of US$864,207,288, targeted counseling and testing services (at a 1% HIV seropositivity rate) would be preferred to opt-out testing: targeted services would newly diagnose more HIV infections (188,170 versus 56,940), prevent more HIV infections (14,553 versus 3,644), and do so at a lower gross cost per infection averted (US$59,383 versus US$237,149). While the study is limited by uncertainty in some input parameter values, the findings were robust across a variety of assumptions about these parameter values (including the estimated HIV seropositivity rate in the targeted counseling and testing scenario)., Conclusions: While opt-out testing may be able to newly diagnose over 56,000 persons living with HIV in one year, abandoning client-centered counseling has real public health consequences in terms of HIV infections that could have been averted. Further, my analyses indicate that even when HIV seropositivity rates are as low as 0.3%, targeted counseling and testing performs better than opt-out testing on several key outcome variables. These analytic findings should be kept in mind as HIV counseling and testing policies are debated in the US.
- Published
- 2007
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15. Projections of Global Mortality and Burden of Disease from 2002 to 2030.
- Author
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Mathers, Colin D. and Loncar, Dejan
- Subjects
MORTALITY ,DEATH ,HIV infections ,AIDS prevention ,HEALTH policy - Abstract
Background Global and regional projections of mortality and burden of disease by cause for the years 2000, 2010, and 2030 were published by Murray and Lopez in 1996 as part of the Global Burden of Disease project. These projections, which are based on 1990 data, continue to be widely quoted, although they are substantially outdated; in particular, they substantially underestimated the spread of HIV/AIDS. To address the widespread demand for information on likely future trends in global health, and thereby to support international health policy and priority setting, we have prepared new projections of mortality and burden of disease to 2030 starting from World Health Organization estimates of mortality and burden of disease for 2002. This paper describes the methods, assumptions, input data, and results. Methods and Findings Relatively simple models were used to project future health trends under three scenarios—baseline, optimistic, and pessimistic—based largely on projections of economic and social development, and using the historically observed relationships of these with cause-specific mortality rates. Data inputs have been updated to take account of the greater availability of death registration data and the latest available projections for HIV/AIDS, income, human capital, tobacco smoking, body mass index, and other inputs. In all three scenarios there is a dramatic shift in the distribution of deaths from younger to older ages and from communicable, maternal, perinatal, and nutritional causes to noncommunicable disease causes. The risk of death for children younger than 5 y is projected to fall by nearly 50% in the baseline scenario between 2002 and 2030. The proportion of deaths due to noncommunicable disease is projected to rise from 59% in 2002 to 69% in 2030. Global HIV/AIDS deaths are projected to rise from 2.8 million in 2002 to 6.5 million in 2030 under the baseline scenario, which assumes coverage with antiretroviral drugs reaches 80% by 2012. Under the optimistic scenario, which also assumes increased prevention activity, HIV/AIDS deaths are projected to drop to 3.7 million in 2030. Total tobacco-attributable deaths are projected to rise from 5.4 million in 2005 to 6.4 million in 2015 and 8.3 million in 2030 under our baseline scenario. Tobacco is projected to kill 50% more people in 2015 than HIV/AIDS, and to be responsible for 10% of all deaths globally. The three leading causes of burden of disease in 2030 are projected to include HIV/AIDS, unipolar depressive disorders, and ischaemic heart disease in the baseline and pessimistic scenarios. Road traffic accidents are the fourth leading cause in the baseline scenario, and the third leading cause ahead of ischaemic heart disease in the optimistic scenario. Under the baseline scenario, HIV/AIDS becomes the leading cause of burden of disease in middle- and low-income countries by 2015. Conclusions These projections represent a set of three visions of the future for population health, based on certain explicit assumptions. Despite the wide uncertainty ranges around future projections, they enable us to appreciate better the implications for health and health policy of currently observed trends, and the likely impact of fairly certain future trends, such as the ageing of the population, the continued spread of HIV/AIDS in many regions, and the continuation of the epidemiological transition in developing countries. The results depend strongly on the assumption that future mortality trends in poor countries will have a relationship to economic and social development similar to those that have occurred in the higher-income countries. [ABSTRACT FROM AUTHOR]
- Published
- 2006
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16. Monitoring and Evaluating Progress towards Universal Health Coverage in China.
- Author
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Meng, Qingyue and Xu, Ling
- Subjects
HEALTH insurance ,PUBLIC health ,MEDICAL care use ,HEALTH policy ,HEALTH funding - Abstract
: This paper is a country case study for the Universal Health Coverage Collection, organized by WHO. Qingyue Meng and colleagues illustrate progress towards UHC and its monitoring and evaluation in China. Please see later in the article for the Editors' Summary [ABSTRACT FROM AUTHOR]
- Published
- 2014
- Full Text
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17. Monitoring and Evaluating Progress towards Universal Health Coverage in Thailand.
- Author
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Tangcharoensathien, Viroj, Limwattananon, Supon, Patcharanarumol, Walaiporn, and Thammatacharee, Jadej
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HEALTH insurance ,MEDICAL care use ,HEALTH policy ,PERIODIC health examinations ,PUBLIC health - Abstract
: This paper is a country case study for the Universal Health Coverage Collection, organized by WHO. Walaiporn Patcharanarumol and colleagues illustrate progress towards UHC and its monitoring and evaluation in Thailand. Please see later in the article for the Editors' Summary [ABSTRACT FROM AUTHOR]
- Published
- 2014
- Full Text
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18. Monitoring and Evaluating Progress towards Universal Health Coverage in Bangladesh.
- Author
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Huda, Tanvir, Khan, Jahangir A. M., Ahsan, Karar Zunaid, Jamil, Kanta, and Arifeen, Shams El
- Subjects
HEALTH insurance ,HEALTH services accessibility ,HEALTH services administration ,HEALTH policy ,PUBLIC health - Abstract
: This paper is a country case study for the Universal Health Coverage Collection, organized by WHO. Tanvir Mahmudul Huda and colleagues illustrate progress towards UHC and its monitoring and evaluation in Bangladesh. Please see later in the article for the Editors' Summary [ABSTRACT FROM AUTHOR]
- Published
- 2014
- Full Text
- View/download PDF
19. Monitoring and Evaluating Progress towards Universal Health Coverage in Estonia.
- Author
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Lai, Taavi, Habicht, Triin, and Jesse, Maris
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HEALTH insurance ,PRIMARY health care ,HEALTH policy ,HEALTH funding ,PUBLIC health - Abstract
This paper is a country case study for the Universal Health Coverage Collection, organized by WHO. Taavi Lai and colleagues illustrate progress towards UHC and its monitoring and evaluation in Estonia. Please see later in the article for the Editors' Summary [ABSTRACT FROM AUTHOR]
- Published
- 2014
- Full Text
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20. Moving from Data on Deaths to Public Health Policy in Agincourt, South Africa: Approaches to Analysing and Understanding Verbal Autopsy Findings.
- Author
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Byass, Peter, Kahn, Kathleen, Fottrell, Edward, Collinson, Mark A., and Tollman, Stephen M.
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HEALTH policy ,PUBLIC health ,AUTOPSY ,INTERVIEWING - Abstract
Background: Cause of death data are an essential source for public health planning, but their availability and quality are lacking in many parts of the world. Interviewing family and friends after a death has occurred (a procedure known as verbal autopsy) provides a source of data where deaths otherwise go unregistered; but sound methods for interpreting and analysing the ensuing data are essential. Two main approaches are commonly used: either physicians review individual interview material to arrive at probable cause of death, or probabilistic models process the data into likely cause(s). Here we compare and contrast these approaches as applied to a series of 6,153 deaths which occurred in a rural South African population from 1992 to 2005. We do not attempt to validate either approach in absolute terms. Methods and Findings: The InterVA probabilistic model was applied to a series of 6,153 deaths which had previously been reviewed by physicians. Physicians used a total of 250 cause-of-death codes, many of which occurred very rarely, while the model used 33. Cause-specific mortality fractions, overall and for population subgroups, were derived from the model's output, and the physician causes coded into comparable categories. The ten highest-ranking causes accounted for 83% and 88% of all deaths by physician interpretation and probabilistic modelling respectively, and eight of the highest ten causes were common to both approaches. Top-ranking causes of death were classified by population subgroup and period, as done previously for the physician-interpreted material. Uncertainty around the cause(s) of individual deaths was recognised as an important concept that should be reflected in overall analyses. One notably discrepant group involved pulmonary tuberculosis as a cause of death in adults aged over 65, and these cases are discussed in more detail, but the group only accounted for 3.5% of overall deaths. Conclusions: There were no differences between physician interpretation and probabilistic modelling that might have led to substantially different public health policy conclusions at the population level. Physician interpretation was more nuanced than the model, for example in identifying cancers at particular sites, but did not capture the uncertainty associated with individual cases. Probabilistic modelling was substantially cheaper and faster, and completely internally consistent. Both approaches characterised the rise of HIV-related mortality in this population during the period observed, and reached similar findings on other major causes of mortality. For many purposes probabilistic modelling appears to be the best available means of moving from data on deaths to public health actions. [ABSTRACT FROM AUTHOR]
- Published
- 2010
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21. Evidence-Based Priority Setting for Health Care and Research: Tools to Support Policy in Maternal, Neonatal, and Child Health in Africa.
- Author
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Rudan, Igor, Kapiriri, Lydia, Tomlinson, Mark, Balliet, Manuela, Cohen, Barney, and Chopra, Mickey
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ESSAYS ,HEALTH policy ,MATERNAL health services ,CHILD health services - Abstract
An essay is presented on the prioritization tools which can be used for African maternal, neonatal, and child health care policy. It explores health care prioritization tools including Marginal Budgeting for Bottlenecks (MBB), Choosing Interventions that are Cost-Effective (WHO-CHOICE), and Lives Saved Tool (LiST). It tackles research prioritization tools including Council on Health Research for Development (COHRED), Essential National Health Research (ENHR), and Combined Approach Matrix (CAM).
- Published
- 2010
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22. Global Health Actors Claim To Support Health System Strengthening -- Is This Reality or Rhetoric?
- Author
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Marchal, Bruno, Cavalli, Anna, and Kegels, Guy
- Subjects
PUBLIC health in developing countries ,HEALTH care reform ,DISEASE management ,HEALTH policy ,HEALTH services accessibility ,SOCIAL medicine ,DEVELOPING countries ,INTERNATIONAL cooperation - Abstract
The article discusses the effects of the selectivity of health system strengthening (HSS) strategies on the goal high-quality health systems in developing countries. It is stated that global health actors (GHAs) in the domain of HSS often use the terms global health initiative and global health partnership, which are ill defined. It notes that GHAs claim to support health systems but focus on disease-specific interventions. It also mentions the importance of an effective approach to HHS.
- Published
- 2009
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23. Pathways to "Evidence-Informed" Policy and Practice: A Framework for Action.
- Author
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Bowen, Shelley and Zwi, Anthony B.
- Subjects
PUBLIC health ,EVIDENCE-based medicine ,HEALTH policy ,MEDICAL practice ,DECISION making - Abstract
Proposes that an evidence-informed policy and practice pathway can help both public health researchers and policy actors navigate the use of evidence. Stages of progression involved in the pathway to evidence-informed policy and practice; Decision-making factors involved in the pathway; Values that are being underpinned in each stage; Fundamental to the transfer of evidence into policy and practice.
- Published
- 2005
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24. Political rationale, aims, and outcomes of health-related high-level meetings and special sessions at the UN General Assembly: A policy research observational study.
- Author
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Rodi, Paolo, Obermeyer, Werner, Pablos-Mendez, Ariel, Gori, Andrea, and Raviglione, Mario C.
- Subjects
HIV ,IMMUNOLOGICAL deficiency syndromes ,HEALTH policy ,NON-communicable diseases ,HEADS of state ,AIDS - Abstract
Background: Recognising the substantial political weight of the United Nations General Assembly (UNGA), a UN General Assembly special session (UNGASS) and high-level meetings (HLMs) have been pursued and held for 5 health-related topics thus far. They have focused on human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS, 2001), non-communicable diseases (NCDs, 2011), antimicrobial resistance (AMR, 2016), tuberculosis (TB, 2018), and universal health coverage (UHC, 2019). This observational study presents a comprehensive analysis of the political and policy background that prompted the events, as well as an assessment of aims, approaches, and ultimate outcomes.Methods and Findings: We investigated relevant agencies' official documents, performed a literature search, and accessed international institutions' websites for the period 1990-2020. Knowledgeable diplomatic staff and experts provided additional information. Outcomes were evaluated from a United Nations perspective based on national and international commitments, and funding trends. Eliciting an effective governmental response through UNGASSs/HLMs is a challenge. However, increased international commitment was evident after the HIV/AIDS (2001), NCDs (2011), and AMR (2016) meetings. The more recent TB (2018) and UHC (2019) HLMs have received general endorsements internationally, although concrete commitments are not yet documented. Although attribution can only be hypothesized, financial investments for HIV/AIDS following the UNGASS were remarkable, whereas following HLMs for NCDs, AMR, and TB, the financial investments remained insufficient to face the burden of these threats. Thus far, the HIV/AIDS UNGASS was the only one followed by a level of commitment that has likely contributed to the reversal of the previous burden trend. Limitations of this study include its global perspective and aerial view that cannot discern the effects at the country level. Additionally, possible peculiarities that modified the response to the meetings were not looked at in detail. Finally, we assessed a small sample of events; thus, the list of strategic characteristics for success is not exhaustive.Conclusions: Overall, UNGASSs and HLMs have the potential to lay better foundations and boldly address key health challenges. However, to succeed, they need to (i) be backed by large consensus; (ii) engage UN authorities and high-level bodies; (iii) emphasise implications for international security and the world economy; (iv) be supported by the civil society, activists, and champions; and (v) produce a political declaration containing specific, measurable, achievable, relevant, and time-bound (SMART) targets. Therefore, to ensure impact on health challenges, in addition to working with the World Health Assembly and health ministries, engaging the higher political level represented by the UNGA and heads of state and government is critical. [ABSTRACT FROM AUTHOR]- Published
- 2022
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25. Monitoring and Evaluating Progress towards Universal Health Coverage in Tanzania.
- Author
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Mtei, Gemini, Makawia, Suzan, and Masanja, Honorati
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HEALTH insurance ,HEALTH services accessibility ,HEALTH services administration ,HEALTH policy ,HEALTH funding - Abstract
: This paper is a country case study for the Universal Health Coverage Collection, organized by WHO. Gemini Mtei and colleagues illustrate progress towards UHC and its monitoring and evaluation in Tanzania. Please see later in the article for the Editors' Summary [ABSTRACT FROM AUTHOR]
- Published
- 2014
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26. Evaluation of the effectiveness of topical repellent distributed by village health volunteer networks against Plasmodium spp. infection in Myanmar: A stepped-wedge cluster randomised trial.
- Author
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Agius, Paul A., Cutts, Julia C., Han Oo, Win, Thi, Aung, O'Flaherty, Katherine, Zayar Aung, Kyaw, Kyaw Thu, Htin, Poe Aung, Poe, Mon Thein, Myat, Nyi Zaw, Nyi, Yan Min Htay, Wai, Paing Soe, Aung, Razook, Zahra, Barry, Alyssa E., Htike, Win, Devine, Angela, Simpson, Julie A., Crabb, Brendan S., Beeson, James G., and Pasricha, Naanki
- Subjects
INSECT baits & repellents ,REPELLENTS ,HEALTH care networks ,CLINICAL trial registries ,HEALTH policy ,TRYPANOSOMA - Abstract
Background: The World Health Organization has yet to endorse deployment of topical repellents for malaria prevention as part of public health campaigns. We aimed to quantify the effectiveness of repellent distributed by the village health volunteer (VHV) network in the Greater Mekong Subregion (GMS) in reducing malaria in order to advance regional malaria elimination.Methods and Findings: Between April 2015 and June 2016, a 15-month stepped-wedge cluster randomised trial was conducted in 116 villages in Myanmar (stepped monthly in blocks) to test the effectiveness of 12% N,N-diethylbenzamide w/w cream distributed by VHVs, on Plasmodium spp. infection. The median age of participants was 18 years, approximately half were female, and the majority were either village residents (46%) or forest dwellers (40%). No adverse events were reported during the study. Generalised linear mixed modelling estimated the effect of repellent on infection detected by rapid diagnostic test (RDT) (primary outcome) and polymerase chain reaction (PCR) (secondary outcome). Overall Plasmodium infection detected by RDT was low (0.16%; 50/32,194), but infection detected by PCR was higher (3%; 419/13,157). There was no significant protection against RDT-detectable infection (adjusted odds ratio [AOR] = 0.25, 95% CI 0.004-15.2, p = 0.512). In Plasmodium-species-specific analyses, repellent protected against PCR-detectable P. falciparum (adjusted relative risk ratio [ARRR] = 0.67, 95% CI 0.47-0.95, p = 0.026), but not P. vivax infection (ARRR = 1.41, 95% CI 0.80-2.47, p = 0.233). Repellent effects were similar when delayed effects were modelled, across risk groups, and regardless of village-level and temporal heterogeneity in malaria prevalence. The incremental cost-effectiveness ratio was US$256 per PCR-detectable infection averted. Study limitations were a lower than expected Plasmodium spp. infection rate and potential geographic dilution of the intervention.Conclusions: In this study, we observed apparent protection against new infections associated with the large-scale distribution of repellent by VHVs. Incorporation of repellent into national strategies, particularly in areas where bed nets are less effective, may contribute to the interruption of malaria transmission. Further studies are warranted across different transmission settings and populations, from the GMS and beyond, to inform WHO public health policy on the deployment of topical repellents for malaria prevention.Trial Registration: Australian and New Zealand Clinical Trials Registry (ACTRN12616001434482). [ABSTRACT FROM AUTHOR]- Published
- 2020
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27. Understanding how unhealthy food companies influence advertising restrictions.
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Glantz, Stanton A.
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ADVERTISING laws ,CORPORATE political activity ,FOOD advertising ,SEDENTARY behavior ,HEALTH policy - Abstract
As Lauber and colleagues note, the TfL staff members responsible for enforcing the policy and granting exemptions are from TfL's advertising team and also responsible for meeting advertising revenue targets. Except for some smaller businesses, most food and advertising industry respondents opposed the proposed advertising restrictions. [Extracted from the article]
- Published
- 2021
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28. Development of new TB regimens: Harmonizing trial design, product registration requirements, and public health guidance.
- Author
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Lienhardt, Christian, Vernon, Andrew A., Cavaleri, Marco, Nambiar, Sumati, and Nahid, Payam
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PUBLIC health ,HEALTH policy ,BACTERIAL diseases ,SCIENCE & state ,COMMUNICABLE diseases - Abstract
Christian Lienhardt and colleagues discuss the importance of communication and coordination between regulators, researchers, and policy makers to ensure tuberculosis trials provide high-quality evidence for policy decisions. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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- View/download PDF
29. A whole-health-economy approach to antimicrobial stewardship: Analysis of current models and future direction.
- Author
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McLeod, Monsey, Ahmad, Raheelah, Shebl, Nada Atef, Micallef, Christianne, Sim, Fiona, and Holmes, Alison
- Subjects
MEDICAL personnel ,PHYSICIANS ,HEALTH policy ,MEDICAL sciences ,LIFE sciences - Abstract
In a Policy Forum, Alison Holmes and colleagues discuss coordinated approaches to antimicrobial stewardship. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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- View/download PDF
30. Cost-effectiveness of financial incentives and disincentives for improving food purchases and health through the US Supplemental Nutrition Assistance Program (SNAP): A microsimulation study.
- Author
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Mozaffarian, Dariush, Liu, Junxiu, Sy, Stephen, Huang, Yue, Rehm, Colin, Lee, Yujin, Wilde, Parke, Abrahams-Gessel, Shafika, de Souza Veiga Jardim, Thiago, Gaziano, Tom, and Micha, Renata
- Subjects
MONETARY incentives ,CARDIOVASCULAR diseases ,COST effectiveness ,MICROSIMULATION modeling (Statistics) ,CARDIOVASCULAR disease prevention ,FOOD ,GOVERNMENT programs ,MEDICAL care cost statistics ,BEVERAGES ,COMPUTER simulation ,COST control ,DECISION making ,FOOD relief ,HEALTH behavior ,HEALTH policy ,MOTIVATION (Psychology) ,SURVEYS ,QUALITY-adjusted life years ,ECONOMICS - Abstract
Background: The Supplemental Nutrition Assistance Program (SNAP) provides approximately US$70 billion annually to support food purchases by low-income households, supporting approximately 1 in 7 Americans. In the 2018 Farm Bill, potential SNAP revisions to improve diets and health could include financial incentives, disincentives, or restrictions for certain foods. However, the overall and comparative impacts on health outcomes and costs are not established. We aimed to estimate the health impact, program and healthcare costs, and cost-effectiveness of food incentives, disincentives, or restrictions in SNAP.Methods and Findings: We used a validated microsimulation model (CVD-PREDICT), populated with national data on adult SNAP participants from the National Health and Nutrition Examination Survey (NHANES) 2009-2014, policy effects from SNAP pilots and food pricing meta-analyses, diet-disease effects from meta-analyses, and policy, food, and healthcare costs from published literature to estimate the overall and comparative impacts of 3 dietary policy interventions: (1) a 30% incentive for fruits and vegetables (F&V), (2) a 30% F&V incentive with a restriction of sugar-sweetened beverages (SSBs), and (3) a broader incentive/disincentive program for multiple foods that also preserves choice (SNAP-plus), combining 30% incentives for F&V, nuts, whole grains, fish, and plant-based oils and 30% disincentives for SSBs, junk food, and processed meats. Among approximately 14.5 million adults on SNAP at baseline with mean age 52 years, our simulation estimates that the F&V incentive over 5 years would prevent 38,782 cardiovascular disease (CVD) events, gain 18,928 quality-adjusted life years (QALYs), and save $1.21 billion in healthcare costs. Adding SSB restriction increased gains to 93,933 CVD events prevented, 45,864 QALYs gained, and $4.33 billion saved. For SNAP-plus, corresponding gains were 116,875 CVD events prevented, 56,056 QALYs gained, and $5.28 billion saved. Over a lifetime, the F&V incentive would prevent approximately 303,900 CVD events, gain 649,000 QALYs, and save $6.77 billion in healthcare costs. Adding SSB restriction increased gains to approximately 797,900 CVD events prevented, 2.11 million QALYs gained, and $39.16 billion in healthcare costs saved. For SNAP-plus, corresponding gains were approximately 940,000 CVD events prevented, 2.47 million QALYs gained, and $41.93 billion saved. From a societal perspective (including programmatic costs but excluding food subsidy costs as an intra-societal transfer), all 3 scenarios were cost-saving. From a government affordability perspective (i.e., incorporating food subsidy costs, including for children and young adults for whom no health gains were modeled), the F&V incentive was of low cost-effectiveness at 5 years (incremental cost-effectiveness ratio: $548,053/QALY) but achieved cost-effectiveness ($66,525/QALY) over a lifetime. Adding SSB restriction, the intervention was cost-effective at 10 years ($68,857/QALY) and very cost-effective at 20 years ($26,435/QALY) and over a lifetime ($5,216/QALY). The combined incentive/disincentive program produced the largest health gains and reduced both healthcare and food costs, with net cost-savings of $10.16 billion at 5 years and $63.33 billion over a lifetime. Results were consistent in probabilistic sensitivity analyses: for example, from a societal perspective, 1,000 of 1,000 iterations (100%) were cost-saving for all 3 interventions. Due to the nature of simulation studies, the findings cannot prove the health and cost impacts of national SNAP interventions.Conclusions: Leveraging healthier eating through SNAP could generate substantial health benefits and be cost-effective or cost-saving. A combined food incentive/disincentive program appears most effective and may be most attractive to policy-makers. [ABSTRACT FROM AUTHOR]- Published
- 2018
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31. Trade challenges at the World Trade Organization to national noncommunicable disease prevention policies: A thematic document analysis of trade and health policy space.
- Author
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Barlow, Pepita, Labonte, Ronald, McKee, Martin, and Stuckler, David
- Subjects
NON-communicable diseases ,HEALTH policy ,INTERNATIONAL trade disputes ,MEDICAL sciences ,NUTRITION ,PREVENTION ,INTERNATIONAL agencies -- Law & legislation ,MEDICAL policy laws ,ECONOMIC laws ,COMPARATIVE studies ,INTERNATIONAL relations ,RESEARCH methodology ,MEDICAL cooperation ,POLICY sciences ,RESEARCH ,EVALUATION research - Abstract
Background: It has long been contested that trade rules and agreements are used to dispute regulations aimed at preventing noncommunicable diseases (NCDs). Yet most analyses of trade rules and agreements focus on trade disputes, potentially overlooking how a challenge to a regulation's consistency with trade rules may lead to 'policy or regulatory chill' effects whereby countries delay, alter, or repeal regulations in order to avoid the costs of a dispute. Systematic empirical analysis of this pathway to impact was previously prevented by a dearth of systematically coded data.Methods and Findings: Here, we analyse a newly created dataset of trade challenges about food, beverage, and tobacco regulations among 122 World Trade Organization (WTO) members from January 1, 1995 to December 31, 2016. We thematically describe the scope and frequency of trade challenges, analyse economic asymmetries between countries raising and defending them, and summarise 4 cases of their possible influence. Between 1995 and 2016, 93 food, beverage, and tobacco regulations were challenged at the WTO. 'Unnecessary' trade costs were the focus of 16.4% of the challenges. Only one (1.1%) challenge remained unresolved and escalated to a trade dispute. Thirty-nine (41.9%) challenges focussed on labelling regulations, and 18 (19.4%) focussed on quality standards and restrictions on certain products like processed meats and cigarette flavourings. High-income countries raised 77.4% (n = 72) of all challenges raised against low- and lower-middle-income countries. We further identified 4 cases in Indonesia, Chile, Colombia, and Saudi Arabia in which challenges were associated with changes to food and beverage regulations. Data limitations precluded a comprehensive evaluation of policy impact and challenge validity.Conclusions: Policy makers appear to face significant pressure to design food, beverage, and tobacco regulations that other countries will deem consistent with trade rules. Trade-related influence on public health policy is likely to be understated by analyses limited to formal trade disputes. [ABSTRACT FROM AUTHOR]- Published
- 2018
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32. Developing cardiovascular disease risk programs in India-Why location and wealth matter.
- Author
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Peiris, David and Prabhakaran, Dorairaj
- Subjects
CARDIOVASCULAR diseases risk factors ,HEALTH risk assessment ,HEALTH services administration ,DATA visualization ,HEALTH policy ,CARDIOVASCULAR diseases ,DEVELOPING countries ,CROSS-sectional method - Abstract
In a Perspective, David Peiris and Dorairaj Prabhakaran discuss implications and challenges of cardiovascular disease risk assessments in the population of India. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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33. Sexual exploitation of unaccompanied migrant and refugee boys in Greece: Approaches to prevention.
- Author
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Freccero, Julie, Biswas, Dan, Whiting, Audrey, Alrabe, Khaled, and Seelinger, Kim Thuy
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HUMAN trafficking ,HUMAN trafficking victims ,ABUSE of refugees ,HEALTH policy ,MEDICAL care - Abstract
In this essay, Julie Freccero and colleagues discuss resources to prevent the sexual exploitation of unaccompanied and separated refugee boys in Greece. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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34. Human trafficking and exploitation: A global health concern.
- Author
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Zimmerman, Cathy and Kiss, Ligia
- Subjects
HUMAN trafficking ,HUMAN trafficking victims ,HEALTH policy ,SOCIAL mobility ,HUMAN rights violations ,MEDICAL care - Abstract
In this collection review, Cathy Zimmerman and colleague introduce the PLOS Medicine Collection on Human Trafficking, Exploitation and Health, laying out the magnitude of the global trafficking problem and offering a public health policy framework to guide responses to trafficking. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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- View/download PDF
35. Child sex trafficking in the United States: Challenges for the healthcare provider.
- Author
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Greenbaum, V. Jordan
- Subjects
CHILD trafficking ,CHILD trafficking victims ,CHILD psychology ,MENTAL health ,CHILD sexual abuse ,HEALTH policy - Abstract
V. Jordan Greenbaum discusses ways healthcare providers can identify children trafficked for sex to provide for their physical and mental health and their social and educational needs. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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36. Unique Author Identification Number in Scientific Databases: A Suggestion
- Author
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Etienne Joly
- Subjects
media_common.quotation_subject ,Internet privacy ,lcsh:Medicine ,Information Storage and Retrieval ,Bibliometrics ,Bibliographic record ,Clinical trials ,Citation analysis ,Correspondence ,Research Methods ,Medicine ,Humans ,Quality (business) ,Publication ,media_common ,Publishing ,Internet ,Impact factor ,business.industry ,Health Policy ,lcsh:R ,General Medicine ,Databases, Bibliographic ,Authorship ,Variable (computer science) ,Identification (information) ,business ,Medical Informatics - Abstract
I am in complete agreement with the suggestion by Matthew Falagas [1] that a unique author identification number (UAIN) would represent a major improvement for the use of databases of scientific publications. In this regard, I perceive that he has not mentioned several other important advantages that a UAIN system would provide, and that are worth pointing to: 1. When looking up someone's publications, the fact that the last name of a given person can vary from one paper to another can be as much of a problem as that of multiple authors with the same name. For example, these variations include women who change their last name after getting married (or divorced), middle initials that are sometimes included or omitted, translations from non-Roman alphabets that result in variable spellings, and people with last names composed of several terms that can sometimes appear in databases as split or truncated. 2. Contrarily to M. Falagas, I do not see any good reason why a UAIN system could not be retroactive. It is clearly in every scientist's interest to facilitate the job of other people who want to look up their work. I therefore believe that authors could be asked to register for a UAIN, and to validate their list of publications themselves, retroactively. Even for the most productive scientists, this would take only a few minutes, and the fact that they had registered for a UAIN allowing users to trace their whole list of publications could then be indicated in the display of search results from the various bibliographic databases. I also do not see any reason for “hiding” this UAIN. I suggest that it could be designed to be quite simple to remember and to communicate to others, for example: the first four or five letters of the last name followed by the initial of the first name followed by the year of first scientific publication followed by an incremental number depending on order of registration (my UAIN would be JOLY-E-89-01). It would therefore be something quite comparable in length and spirit to a car's licence plate and, like UK licence plates, it would provide an interesting clue regarding the seniority of its bearer. 3. This type of UAIN would therefore provide a very simple way to assess a person's productivity. It would also provide a very useful means to assess the actual impact of their work in terms of citations, by discriminating between self-citation and citations by others. Today, most people are evaluated via the impact factor of the journals in which they have managed to publish their work, and not by the actual impact of the papers themselves. Although most scientists acknowledge that this is an extremely crude and unfair way of assessing the quality of someone's production, the impact factor lives on. By providing the simple means to track someone's bibliographic record and thus facilitate the evaluation of their productivity, I believe that the introduction of a UAIN system will not only help the scientific community to exploit bibliographic databases more efficiently, but also represent a major step towards getting rid of the despotic domination of the dreaded impact factors of journals as a means to evaluate the quality of scientific papers.
- Published
- 2006
37. Global services and support for children with developmental delays and disabilities: Bridging research and policy gaps.
- Author
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Collins, Pamela Y., Pringle, Beverly, Alexander, Charlee, Darmstadt, Gary L., Heymann, Jody, Huebner, Gillian, Kutlesic, Vesna, Polk, Cheryl, Sherr, Lorraine, Shih, Andy, Sretenov, Dragana, and Zindel, Mariana
- Subjects
SERVICES for children with disabilities ,DEVELOPMENTAL delay ,CHILDREN'S health ,CHILDREN'S rights ,CHILD welfare ,RIGHT to education ,TREATMENT of developmental disabilities ,HEALTH services accessibility laws ,DEVELOPMENTAL disabilities ,DISABILITY laws ,HEALTH policy ,PEOPLE with disabilities ,RESEARCH - Abstract
Pamela Collins and colleagues explain the research and policy approaches needed globally to ensure children with developmental delays and disabilities are fully included in health and education services. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
38. Dementia and aging populations-A global priority for contextualized research and health policy.
- Author
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Brayne, Carol and Miller, Bruce
- Subjects
EDITORS ,DEMENTIA research ,AGING ,DEVELOPMENTAL biology ,DEMENTIA ,HEALTH policy ,MEDICAL research - Abstract
In this month's Editorial, Guest Editors Carol Brayne and Bruce Miller discuss research and commentary published in March and future directions for dementia research. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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- View/download PDF
39. Migrants and refugees: Improving health and well-being in a world on the move.
- Author
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Turner, Richard, null, null, and PLOS Medicine editors
- Subjects
WORLD health ,REFUGEES ,IMMIGRANTS ,HEALTH policy ,MEDICAL economics ,EMIGRATION & immigration ,HEALTH services accessibility ,HEALTH status indicators - Abstract
The PLOS Medicine Editors discuss migrant and refugee health, and announce a forthcoming special issue devoted to the topic. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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- View/download PDF
40. Better Reporting, Better Research: Guidelines and Guidance in PLoS Medicine.
- Subjects
REPORTING of medical errors ,MEDICAL research ,BIOTECHNOLOGY ,MEDICAL technology ,HEALTH policy ,PUBLIC health - Abstract
PLoS Medicine announces a new section: Guidelines and Guidance. [ABSTRACT FROM AUTHOR]
- Published
- 2008
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- View/download PDF
41. Who Needs Cause-of-Death Data.
- Author
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Byass, Peter
- Subjects
MEDICAL research ,METHODOLOGY ,CAUSES of death ,HEALTH planning ,HEALTH policy - Abstract
The author discusses two studies that report important methodological advances in determining cause of death, which is crucial for health planning and prioritization. [ABSTRACT FROM AUTHOR]
- Published
- 2007
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- View/download PDF
42. Prioritizing Surgical Care on National Health Agendas: A Qualitative Case Study of Papua New Guinea, Uganda, and Sierra Leone.
- Author
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Dare, Anna J., Lee, Katherine C., Bleicher, Josh, Elobu, Alex E., Kamara, Thaim B., Liko, Osborne, Luboga, Samuel, Danlop, Akule, Kune, Gabriel, Hagander, Lars, Leather, Andrew J. M., and Yamey, Gavin
- Subjects
SURGERY ,CASE studies ,MIDDLE-income countries ,NATIONAL health services ,PUBLIC health ,OPERATIVE surgery ,HEALTH planning ,HEALTH policy ,POLICY sciences ,PRACTICAL politics ,SOCIOECONOMIC factors ,SURGERY laws - Abstract
Background: Little is known about the social and political factors that influence priority setting for different health services in low- and middle-income countries (LMICs), yet these factors are integral to understanding how national health agendas are established. We investigated factors that facilitate or prevent surgical care from being prioritized in LMICs.Methods and Findings: We undertook country case studies in Papua New Guinea, Uganda, and Sierra Leone, using a qualitative process-tracing method. We conducted 74 semi-structured interviews with stakeholders involved in health agenda setting and surgical care in these countries. Interviews were triangulated with published academic literature, country reports, national health plans, and policies. Data were analyzed using a conceptual framework based on four components (actor power, ideas, political contexts, issue characteristics) to assess national factors influencing priority for surgery. Political priority for surgical care in the three countries varies. Priority was highest in Papua New Guinea, where surgical care is firmly embedded within national health plans and receives significant domestic and international resources, and much lower in Uganda and Sierra Leone. Factors influencing whether surgical care was prioritized were the degree of sustained and effective domestic advocacy by the local surgical community, the national political and economic environment in which health policy setting occurs, and the influence of international actors, particularly donors, on national agenda setting. The results from Papua New Guinea show that a strong surgical community can generate priority from the ground up, even where other factors are unfavorable.Conclusions: National health agenda setting is a complex social and political process. To embed surgical care within national health policy, sustained advocacy efforts, effective framing of the problem and solutions, and country-specific data are required. Political, technical, and financial support from regional and international partners is also important. [ABSTRACT FROM AUTHOR]- Published
- 2016
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- View/download PDF
43. Why Are Some Population Interventions for Diet and Obesity More Equitable and Effective Than Others? The Role of Individual Agency.
- Author
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Adams, Jean, Mytton, Oliver, White, Martin, and Monsivais, Pablo
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OBESITY ,PUBLIC health ,OVERWEIGHT persons ,SOCIOECONOMICS ,SOCIAL marketing ,PREVENTION of obesity ,PUBLIC health laws ,PREVENTIVE health service laws ,NATIONAL health service laws ,GOVERNMENT agencies ,BEHAVIOR ,DIET ,HEALTH attitudes ,HEALTH behavior ,HEALTH promotion ,HEALTH services accessibility ,HEALTH status indicators ,HEALTH policy ,MEDICINE information services ,NATIONAL health services ,MOTOR ability ,PREVENTIVE health services ,RESEARCH funding ,RISK assessment ,GOVERNMENT regulation ,LIFESTYLES ,HUMAN services programs ,EVALUATION of human services programs ,HEALTH information services ,DIAGNOSIS - Abstract
Jean Adams and colleagues argue that population interventions that require individuals to use a low level of agency to benefit are likely to be most effective and most equitable. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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- View/download PDF
44. Estimated Effects of Different Alcohol Taxation and Price Policies on Health Inequalities: A Mathematical Modelling Study.
- Author
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Meier, Petra S., Holmes, John, Angus, Colin, Ally, Abdallah K., Meng, Yang, and Brennan, Alan
- Subjects
ALCOHOLIC beverage tax ,ALCOHOLIC beverage sales & prices ,MATHEMATICAL models ,ALCOHOL-induced disorders ,PHYSIOLOGICAL effects of alcohol ,ALCOHOL drinking ,ALCOHOLIC beverages ,BUSINESS & economics ,TAXATION economics ,HEALTH policy ,MEDICAL protocols ,COST analysis ,STATISTICAL models ,ECONOMICS - Abstract
Introduction: While evidence that alcohol pricing policies reduce alcohol-related health harm is robust, and alcohol taxation increases are a WHO "best buy" intervention, there is a lack of research comparing the scale and distribution across society of health impacts arising from alternative tax and price policy options. The aim of this study is to test whether four common alcohol taxation and pricing strategies differ in their impact on health inequalities.Methods and Findings: An econometric epidemiological model was built with England 2014/2015 as the setting. Four pricing strategies implemented on top of the current tax were equalised to give the same 4.3% population-wide reduction in total alcohol-related mortality: current tax increase, a 13.4% all-product duty increase under the current UK system; a value-based tax, a 4.0% ad valorem tax based on product price; a strength-based tax, a volumetric tax of £0.22 per UK alcohol unit (= 8 g of ethanol); and minimum unit pricing, a minimum price threshold of £0.50 per unit, below which alcohol cannot be sold. Model inputs were calculated by combining data from representative household surveys on alcohol purchasing and consumption, administrative and healthcare data on 43 alcohol-attributable diseases, and published price elasticities and relative risk functions. Outcomes were annual per capita consumption, consumer spending, and alcohol-related deaths. Uncertainty was assessed via partial probabilistic sensitivity analysis (PSA) and scenario analysis. The pricing strategies differ as to how effects are distributed across the population, and, from a public health perspective, heavy drinkers in routine/manual occupations are a key group as they are at greatest risk of health harm from their drinking. Strength-based taxation and minimum unit pricing would have greater effects on mortality among drinkers in routine/manual occupations (particularly for heavy drinkers, where the estimated policy effects on mortality rates are as follows: current tax increase, -3.2%; value-based tax, -2.9%; strength-based tax, -6.1%; minimum unit pricing, -7.8%) and lesser impacts among drinkers in professional/managerial occupations (for heavy drinkers: current tax increase, -1.3%; value-based tax, -1.4%; strength-based tax, +0.2%; minimum unit pricing, +0.8%). Results from the PSA give slightly greater mean effects for both the routine/manual (current tax increase, -3.6% [95% uncertainty interval (UI) -6.1%, -0.6%]; value-based tax, -3.3% [UI -5.1%, -1.7%]; strength-based tax, -7.5% [UI -13.7%, -3.9%]; minimum unit pricing, -10.3% [UI -10.3%, -7.0%]) and professional/managerial occupation groups (current tax increase, -1.8% [UI -4.7%, +1.6%]; value-based tax, -1.9% [UI -3.6%, +0.4%]; strength-based tax, -0.8% [UI -6.9%, +4.0%]; minimum unit pricing, -0.7% [UI -5.6%, +3.6%]). Impacts of price changes on moderate drinkers were small regardless of income or socioeconomic group. Analysis of uncertainty shows that the relative effectiveness of the four policies is fairly stable, although uncertainty in the absolute scale of effects exists. Volumetric taxation and minimum unit pricing consistently outperform increasing the current tax or adding an ad valorem tax in terms of reducing mortality among the heaviest drinkers and reducing alcohol-related health inequalities (e.g., in the routine/manual occupation group, volumetric taxation reduces deaths more than increasing the current tax in 26 out of 30 probabilistic runs, minimum unit pricing reduces deaths more than volumetric tax in 21 out of 30 runs, and minimum unit pricing reduces deaths more than increasing the current tax in 30 out of 30 runs). Study limitations include reducing model complexity by not considering a largely ineffective ban on below-tax alcohol sales, special duty rates covering only small shares of the market, and the impact of tax fraud or retailer non-compliance with minimum unit prices.Conclusions: Our model estimates that, compared to tax increases under the current system or introducing taxation based on product value, alcohol-content-based taxation or minimum unit pricing would lead to larger reductions in health inequalities across income groups. We also estimate that alcohol-content-based taxation and minimum unit pricing would have the largest impact on harmful drinking, with minimal effects on those drinking in moderation. [ABSTRACT FROM AUTHOR]- Published
- 2016
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45. Pharmaceutical Industry Off-label Promotion and Self-regulation: A Document Analysis of Off-label Promotion Rulings by the United Kingdom Prescription Medicines Code of Practice Authority 2003-2012.
- Author
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Vilhelmsson, Andreas, Davis, Courtney, and Mulinari, Shai
- Subjects
DRUG prescribing ,OFF-label use (Drugs) ,DRUG laws ,PHARMACEUTICAL industry ,HEALTH policy ,DRUG standards ,INDUSTRIAL laws & legislation ,MARKETING laws ,INDUSTRIES ,MEDICAL prescriptions ,MARKETING ,WHISTLEBLOWING ,STANDARDS ,MEDICAL laws - Abstract
Background: European Union law prohibits companies from marketing drugs off-label. In the United Kingdom--as in some other European countries, but unlike the United States--industry self-regulatory bodies are tasked with supervising compliance with marketing rules. The objectives of this study were to (1) characterize off-label promotion rulings in the UK compared to the whistleblower-initiated cases in the US and (2) shed light on the UK self-regulatory mechanism for detecting, deterring, and sanctioning off-label promotion.Methods and Findings: We conducted structured reviews of rulings by the UK self-regulatory authority, the Prescription Medicines Code of Practice Authority (PMCPA), between 2003 and 2012. There were 74 off-label promotion rulings involving 43 companies and 65 drugs. Nineteen companies were ruled in breach more than once, and ten companies were ruled in breach three or more times over the 10-y period. Drawing on a typology previously developed to analyse US whistleblower complaints, we coded and analysed the apparent strategic goals of each off-label marketing scheme and the practices consistent with those alleged goals. 50% of rulings cited efforts to expand drug use to unapproved indications, and 39% and 38% cited efforts to expand beyond approved disease entities and dosing strategies, respectively. The most frequently described promotional tactic was attempts to influence prescribers (n = 72, 97%), using print material (70/72, 97%), for example, advertisements (21/70, 30%). Although rulings cited prescribers as the prime target of off-label promotion, competing companies lodged the majority of complaints (prescriber: n = 16, 22%, versus companies: n = 42, 57%). Unlike US whistleblower complaints, few UK rulings described practices targeting consumers (n = 3, 4%), payers (n = 2, 3%), or company staff (n = 2, 3%). Eight UK rulings (11%) pertaining to six drugs described promotion of the same drug for the same off-label use as was alleged by whistleblowers in the US. However, while the UK cases typically related to only one or a few claims made in printed material, several complaints in the US alleged multifaceted and covert marketing activities. Because this study is limited to PMCPA rulings and whistleblower-initiated federal cases, it may offer a partial view of exposed off-label marketing.Conclusion: The UK self-regulatory system for exposing marketing violations relies largely on complaints from company outsiders, which may explain why most off-label promotion rulings relate to plainly visible promotional activities such as advertising. This contrasts with the US, where Department of Justice investigations and whistleblower testimony have alleged complex off-label marketing campaigns that remain concealed to company outsiders. UK authorities should consider introducing increased incentives and protections for whistleblowers combined with US-style governmental investigations and meaningful sanctions. UK prescribers should be attentive to, and increasingly report, off-label promotion. [ABSTRACT FROM AUTHOR]- Published
- 2016
- Full Text
- View/download PDF
46. What about drinking is associated with shorter life in poorer people?
- Author
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Rehm, Jürgen and Probst, Charlotte
- Subjects
ALCOHOL drinking & health ,CARDIOVASCULAR disease related mortality ,ALCOHOLIC cardiomyopathy ,HEALTH policy ,HEART disease risk factors - Abstract
In a Perspective, Jürgen Rehm and Charlotte Probst examine the links between socioeconomic status, alcohol use, and cardiovascular mortality and discuss implications for policy. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
47. Preventing Acute Malnutrition among Young Children in Crises: A Prospective Intervention Study in Niger.
- Author
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Langendorf, Céline, Roederer, Thomas, de Pee, Saskia, Brown, Denise, Doyon, Stéphane, Mamaty, Abdoul-Aziz, Touré, Lynda W.-M., Manzo, Mahamane L., and Grais, Rebecca F.
- Subjects
MALNUTRITION in children ,HUNGER ,HEALTH policy ,HEALTH services administration ,PUBLIC health ,PREVENTION - Abstract
: Céline Langendorf and colleagues conducted a pragmatic intervention study in Niger to assess whether distributions of supplementary foods in addition to household support by cash transfer effectively reduced malnutrition in children aged 6 to 23 months. Please see later in the article for the Editors' Summary [ABSTRACT FROM AUTHOR]
- Published
- 2014
- Full Text
- View/download PDF
48. WHO Essential Medicines Policies and Use in Developing and Transitional Countries: An Analysis of Reported Policy Implementation and Medicines Use Surveys.
- Author
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Holloway, Kathleen Anne and Henry, David
- Subjects
HEALTH policy ,DRUG utilization ,LOW-income countries ,PUBLIC health - Abstract
: Kathleen Holloway and David Henry evaluate whether countries that report having implemented WHO essential medicines policies have higher quality use of medicines. Please see later in the article for the Editors' Summary [ABSTRACT FROM AUTHOR]
- Published
- 2014
- Full Text
- View/download PDF
49. Antiretroviral Therapy for Refugees and Internally Displaced Persons: A Call for Equity.
- Author
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Mendelsohn, Joshua B, Spiegel, Paul, Schilperoord, Marian, Cornier, Nadine, and Ross, David A.
- Subjects
HEALTH policy ,PUBLIC health ,THERAPEUTICS ,HIV infections ,ANTIRETROVIRAL agents ,HEALTH of refugees - Abstract
Joshua Mendelsohn and colleagues discuss the moral, legal, and public health principles and recent evidence that strongly suggest that refugees and internally displaced people should have equal access to HIV treatment and support as host nationals and give detailed recommendations for refugees and internally displaced people accessing antiretroviral therapy in stable settings. Please see later in the article for the Editors' Summary [ABSTRACT FROM AUTHOR]
- Published
- 2014
- Full Text
- View/download PDF
50. Complexity in Mathematical Models of Public Health Policies: A Guide for Consumers of Models.
- Author
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Basu, Sanjay and Andrews, Jason
- Subjects
MATHEMATICAL models ,PUBLIC health ,HEALTH policy ,EPIDEMICS ,PANDEMICS ,INFLUENZA diagnosis ,HIV infections - Abstract
: Sanjay Basu and colleagues explain how models are increasingly used to inform public health policy yet readers may struggle to evaluate the quality of models. All models require simplifying assumptions, and there are tradeoffs between creating models that are more “realistic” versus those that are grounded in more solid data. Indeed, complex models are not necessarily more accurate or reliable simply because they can more easily fit real-world data than simpler models can. Please see later in the article for the Editors' Summary [ABSTRACT FROM AUTHOR]
- Published
- 2013
- Full Text
- View/download PDF
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