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Stem Cell Research & Therapy Aug 2023Recent advances in methods to culture pluripotent stem cells to model human development have resulted in entities that increasingly have recapitulated advanced stages of... (Review)
Review
Recent advances in methods to culture pluripotent stem cells to model human development have resulted in entities that increasingly have recapitulated advanced stages of early embryo development. These entities, referred to by numerous terms such as embryoids, are becoming more sophisticated and could resemble human embryos ever more closely as research progresses. This paper reports a systematic review of the ethical, legal, regulatory, and policy questions and concerns found in the literature concerning human embryoid research published from 2016 to 2022. We identified 56 papers that use 53 distinct names or terms to refer to embryoids and four broad categories of ethical, legal, regulatory, or policy considerations in the literature: research justifications/benefits, ethical significance or moral status, permissible use, and regulatory and oversight challenges. Analyzing the full range of issues is a critical step toward fostering more robust ethical, legal, and social implications research in this emerging area and toward developing appropriate oversight.
Topics: Humans; Embryo, Mammalian; Embryonic Development; Pluripotent Stem Cells; Policy
PubMed: 37605210
DOI: 10.1186/s13287-023-03448-8 -
BMC Public Health Aug 2014Intimate partner violence (IPV) is a significant global public health issue. The consistent evidence that alcohol use by one or both partners contributes to the risk and... (Review)
Review
BACKGROUND
Intimate partner violence (IPV) is a significant global public health issue. The consistent evidence that alcohol use by one or both partners contributes to the risk and severity of IPV suggests that interventions that reduce alcohol consumption may also reduce IPV. This study sought to review the evidence for effects on IPV of alcohol interventions at the population, community, relationship and individual levels using the World Health Organization ecological framework for violence.
METHODS
Eleven databases including Medline, PsycINFO, CINAHL and EMBASE were searched for English-language studies and grey literature published 1 January 1992 - 1 March 2013 investigating whether alcohol interventions/policies were associated with IPV reduction within adult (≥ 18) intimate relationships. Eleven studies meeting design criteria for attributing effects to the intervention and ten studies showing mediation of alcohol consumption were included in the review. The heterogeneity of study designs precluded quantitative meta analysis; therefore, a critical narrative approach was used.
RESULTS
Population-level pricing and taxation studies found weak or no evidence for alcohol price changes influencing IPV. Studies of community-level policies or interventions (e.g., hours of sale, alcohol outlet density) showed weak evidence of an association with IPV. Couples-based and individual alcohol treatment studies found a relationship between reductions in alcohol consumption and reductions in IPV but their designs precluded attributing changes to treatment. Randomized controlled trials of combined alcohol and violence treatment programs found some positive effects of brief alcohol intervention as an adjunct to batterer treatment for hazardous drinking IPV perpetrators, and of brief interventions with non-dependent younger populations, but effects were often not sustained.
CONCLUSIONS
Despite evidence associating problematic alcohol use with IPV, the potential for alcohol interventions to reduce IPV has not been adequately tested, possibly because studies have not focused on those most at risk of alcohol-related IPV. Research using rigorous designs should target young adult populations among whom IPV and drinking is highly prevalent. Combining alcohol and IPV intervention/policy approaches at the population, community, relationship and individual-level may provide the best opportunity for effective intervention.
Topics: Adult; Alcohol Drinking; Databases, Factual; Female; Health Policy; Humans; Interpersonal Relations; Male; Spouse Abuse; Young Adult
PubMed: 25160510
DOI: 10.1186/1471-2458-14-881 -
Obesity Reviews : An Official Journal... Nov 2021Weight stigma is an important issue colliding with obesity-related policies; both have population health and social impacts. Our aim was to conduct a systematic review... (Review)
Review
Weight stigma is an important issue colliding with obesity-related policies; both have population health and social impacts. Our aim was to conduct a systematic review of the peer-reviewed literature that combined the concepts of stigma, obesity, and policy. We searched PsycINFO, Medline, Scopus, and Google Scholar for peer-reviewed articles amalgamating terms relevant to stigma, obesity, and policy. Of 3219 records identified, 47 were included in the narrative synthesis. Two key types of studies emerged: studies investigating factors associated with support for obesity-related policies and those exploring policy implementation and evaluation. We found that support for nonstigmatizing obesity-related policies was higher when obesity was attributed as an environmental rather than individual problem. An undercurrent theme suggested that views that blame individuals for their obesity were associated with support for punitive policies for people living in larger bodies. Real-world policies often implicitly condoned stigma through poor language choice and conflicting discourse. Our findings inform recommendations for policy makers that broader socioecological stigma-reduction approaches are needed to fully address the issue of weight stigma in obesity-related policies. Efforts are needed in the research and policy sectors to understand how to improve the design and support of nonstigmatizing obesity-related policies.
Topics: Humans; Obesity; Policy; Social Stigma
PubMed: 34505334
DOI: 10.1111/obr.13333 -
Health Research Policy and Systems May 2021Various interventions have been undertaken in Iran to promote evidence-informed health policy-making (EIHP). Identifying the challenges in EIHP is the first step toward...
BACKGROUND
Various interventions have been undertaken in Iran to promote evidence-informed health policy-making (EIHP). Identifying the challenges in EIHP is the first step toward strengthening EIHP in each country through the design of tailored interventions. Therefore, the current study was conducted to synthesize the results of earlier studies and to finalize the list of barriers to EIHP in Iran.
METHODS
To identify the barriers to EIHP in Iran, two steps were taken: a systematic review and policy dialogue. To conduct the systematic review, three Iranian databases and PubMed, Health Systems Evidence (HSE), Embase, and Scopus were searched. The reference lists of included papers and documentation from some local organizations were hand-searched. Upon conducting the systematic review, given the significance of stakeholders in clarifying the problem of EIHP, policy dialogue was used to complete the list previously extracted and to do advocacy. Selection criteria for the stakeholders included influential and informed individuals from knowledge-producing, knowledge-utilizing, and knowledge-brokering organizations. Semi-structured interviews were held with three important absent stakeholders.
RESULTS
Challenges specific to Iran that were identified included the lack of integration of the health ministry and the medical universities, lack of ties between health knowledge utilization organizations, failure to establish long-term research plans, neglect of national research needs at the time of recruiting human resources in knowledge-producing organizations, and duplication and lack of coordination in routine data obtained from surveillance systems, disease registration systems, and censuses. It seems that some challenges are common across countries, including neglecting the importance of inter- and intra-disciplinary studies, the capacity of policy-makers and managers to utilize evidence, the criteria for evaluating the performance of policy-makers, managers, and academic members, the absence of long-term programmes in knowledge-utilizing organizations, the rapid replacement of policy-makers and managers, and lack of use of evaluation studies.
CONCLUSIONS
In this study, we tried to identify the challenges regarding EIHP in Iran using a systematic review and policy dialogue approach. This is the first step toward determining the best interventions to improve evidence-informed policy-making in each country, because these challenges are contextual and need to be investigated contextually.
Topics: Administrative Personnel; Government Programs; Health Policy; Humans; Iran; Policy Making
PubMed: 33947402
DOI: 10.1186/s12961-021-00717-x -
Sante Publique (Vandoeuvre-les-Nancy,... 2023Transgender and gender diverse people (TGD) represent a large and growing portion of the general population who face individual and systemic barriers in accessing care....
INTRODUCTION
Transgender and gender diverse people (TGD) represent a large and growing portion of the general population who face individual and systemic barriers in accessing care. The socio-cultural context and lack of organization of care place them in a vulnerable situation and there is a need to develop sustainable health promotion strategies.
PURPOSE OF RESEARCH
The aim of this participatory study is to establish an overview of the barriers and opportunities for promoting the health of TGD people. To do so, it relies on the expertise of NGOs and aims to produce a thematic synthesis that will support policy-making.
RESULTS
We centralized the resources of 18 French and European organizations and included 25 eligible documents following a quality analysis. 3047 data were extracted and coded, then developed into 5 themes that allowed us to model the actions, barriers and opportunities to improve care for the TGD population.
CONCLUSIONS
Health promotion of TGD people focuses on discrimination, care pathways, access to care, transmission of knowledge and research. The main obstacles are the role of medical specialists, pathologization, epistemic injustice and the low political priority of their health issues. The main opportunities will rely on ensuring that decision-making allows for the implementation of a pragmatic and collaborative health policy in this context.
Topics: Humans; Transgender Persons; Health Policy; Health Promotion; Policy Making
PubMed: 37336734
DOI: 10.3917/spub.hs2.0197 -
American Journal of Preventive Medicine Apr 2016Policy and environmental changes to support and encourage individual-level nutrition and physical activity behavior are underway in many parts of the U.S. and around the... (Review)
Review
CONTEXT
Policy and environmental changes to support and encourage individual-level nutrition and physical activity behavior are underway in many parts of the U.S. and around the world at national, state, and local levels. Yet, to the authors' knowledge, no summary of the cost-benefit or cost-effectiveness studies of obesity-related policy/environmental interventions exists.
EVIDENCE ACQUISITION
The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement guidelines were followed to identify, screen, and describe the protocols used in this systematic review. In 2014, a unique search was conducted of titles and abstracts in MEDLINE, EconLit, SCOPUS, and Web of Science databases that were published from January 2002 through January 2014 in English-language, peer-reviewed journals. The search terms described obesity, physical activity, and diet in combination with economic evaluation.
EVIDENCE SYNTHESIS
In 2014 and 2015, the results were analyzed. A total of 27 studies met the inclusion criteria, of which 26 described separate interventions. Of the 27 included studies, eight focused on the community and built environment, seven assessed nutrition-related changes, nine reported on the school environment, and three evaluated social marketing and media interventions. The vast majority of included studies reported beneficial economic outcomes of the interventions.
CONCLUSIONS
Given the large and growing literature on the health and behavioral outcomes of policy and environmental interventions, the relatively low number of located cost-benefit and cost-effectiveness economic assessments appears to indicate a prime opportunity for the research community to address.
Topics: Cost-Benefit Analysis; Environment; Exercise; Health Behavior; Health Policy; Health Promotion; Humans; Nutrition Policy; Obesity; United States
PubMed: 26707464
DOI: 10.1016/j.amepre.2015.10.021 -
Implementation Science : IS Jun 2020Public policy has tremendous impacts on population health. While policy development has been extensively studied, policy implementation research is newer and relies...
BACKGROUND
Public policy has tremendous impacts on population health. While policy development has been extensively studied, policy implementation research is newer and relies largely on qualitative methods. Quantitative measures are needed to disentangle differential impacts of policy implementation determinants (i.e., barriers and facilitators) and outcomes to ensure intended benefits are realized. Implementation outcomes include acceptability, adoption, appropriateness, compliance/fidelity, feasibility, penetration, sustainability, and costs. This systematic review identified quantitative measures that are used to assess health policy implementation determinants and outcomes and evaluated the quality of these measures.
METHODS
Three frameworks guided the review: Implementation Outcomes Framework (Proctor et al.), Consolidated Framework for Implementation Research (Damschroder et al.), and Policy Implementation Determinants Framework (Bullock et al.). Six databases were searched: Medline, CINAHL Plus, PsycInfo, PAIS, ERIC, and Worldwide Political. Searches were limited to English language, peer-reviewed journal articles published January 1995 to April 2019. Search terms addressed four levels: health, public policy, implementation, and measurement. Empirical studies of public policies addressing physical or behavioral health with quantitative self-report or archival measures of policy implementation with at least two items assessing implementation outcomes or determinants were included. Consensus scoring of the Psychometric and Pragmatic Evidence Rating Scale assessed the quality of measures.
RESULTS
Database searches yielded 8417 non-duplicate studies, with 870 (10.3%) undergoing full-text screening, yielding 66 studies. From the included studies, 70 unique measures were identified to quantitatively assess implementation outcomes and/or determinants. Acceptability, feasibility, appropriateness, and compliance were the most commonly measured implementation outcomes. Common determinants in the identified measures were organizational culture, implementation climate, and readiness for implementation, each aspects of the internal setting. Pragmatic quality ranged from adequate to good, with most measures freely available, brief, and at high school reading level. Few psychometric properties were reported.
CONCLUSIONS
Well-tested quantitative measures of implementation internal settings were under-utilized in policy studies. Further development and testing of external context measures are warranted. This review is intended to stimulate measure development and high-quality assessment of health policy implementation outcomes and determinants to help practitioners and researchers spread evidence-informed policies to improve population health.
REGISTRATION
Not registered.
Topics: Attitude of Health Personnel; Guideline Adherence; Health Policy; Humans; Implementation Science; Organizational Culture; Practice Guidelines as Topic; Psychometrics
PubMed: 32560661
DOI: 10.1186/s13012-020-01007-w -
Public Health Nutrition Dec 2023To systematically identify and review food taxation policy changes in Pacific Island Countries and Territories (PICTs).
OBJECTIVE
To systematically identify and review food taxation policy changes in Pacific Island Countries and Territories (PICTs).
DESIGN
Food taxation polices, regarding excise taxes and tariffs applied from 2000 to 2020 in twenty-two PICTs, and their key characteristics were reviewed. The search was conducted using databases, government legal repositories and broad-based search engines. Identified documents for screening included legislation, reports, academic literature, news articles and grey literature. Key informants were contacted from each PICT to retrieve further data and confirm results. Results were analysed by narrative synthesis.
SETTING
Noncommunicable diseases (NCD) are the leading cause of premature death in PICTs and in many jurisdictions globally. An NCD crisis has been declared in the Pacific, and food taxation policy has been recommended to address the dietary risk factors associated with. Progress is unclear.
RESULTS
Of the twenty-two PICTs included in the study, fourteen had food taxation policies and five introduced excise taxes. Processed foods, sugar and salt were the main target of excise taxes. A total of eighty-four food taxation policy changes were identified across all food groups. There was a total of 279 taxes identified by food group, of which 85 % were tariffs and 15 % were excise taxes. Individual tax rates varied substantially. The predominant tax design was ad valorem, and this was followed by volumetric.
CONCLUSIONS
A quarter of PICTs have introduced food excise taxes from 2000 to 2020. Further excise taxes, specifically tiered or nutrient-specific designs, could be introduced and more systematically applied to a broader range of unhealthy foods.
Topics: Humans; Food; Noncommunicable Diseases; Nutrition Policy; Pacific Islands; Taxes
PubMed: 38126269
DOI: 10.1017/S1368980023002914 -
Current Drug Targets Jul 2007Stroke is a leading cause of disability and death around the world. (Review)
Review
INTRODUCTION
Stroke is a leading cause of disability and death around the world.
METHODS
We conducted a systematic review of peer reviewed articles published since 1999 on the topics of public education and policy for stroke prevention. A research librarian conducted the search using Pubmed and the International Pharmacy Abstracts (IPA). We reviewed the abstracts from the search results to determine if they met the inclusion criteria. Then we abstracted the relevant data from the articles using an evaluation criteria and data abstraction instrument.
RESULTS
The searches of Pubmed and the IPA returned 446 articles, of which 36 were included in the review. Thirty-two were educational programs and four were policies. Twenty-two of the programs were directed at patients, four at providers, and seven at both. Seven of the educational programs were judged successful using the evaluation criteria. They included two large scale programs and five narrowly targeted programs. The policies included two articles presenting guidelines for treatment for stroke prevention in specific patient populations and two articles presenting recommendations for changes in systems of care for stroke prevention and treatment.
CONCLUSIONS
Future efforts to evaluate these programs will require global efforts with a special emphasis on testing and validating with international patient populations. Barriers remain for translating stroke prevention policies into clinical practice. "This material is based upon work supported by the North Florida/South Georgia Veterans Health System, the Office of Research and Development, Rehabilitation R&D Service, and Health Services R&D Service, Department of Veteran Affairs."
Topics: Attitude of Health Personnel; Health Knowledge, Attitudes, Practice; Health Personnel; Health Policy; Humans; Patient Education as Topic; Program Evaluation; Public Health; Research Design; Stroke; United States
PubMed: 17630942
DOI: 10.2174/138945007781077337 -
Implementation Science : IS Jul 2021Involving patients in their healthcare using shared decision-making (SDM) is promoted through policy and research, yet its implementation in routine practice remains... (Review)
Review
BACKGROUND
Involving patients in their healthcare using shared decision-making (SDM) is promoted through policy and research, yet its implementation in routine practice remains slow. Research into SDM has stemmed from primary and secondary care contexts, and research into the implementation of SDM in tertiary care settings has not been systematically reviewed. Furthermore, perspectives on SDM beyond those of patients and their treating clinicians may add insights into the implementation of SDM. This systematic review aimed to review literature exploring barriers and facilitators to implementing SDM in hospital settings from multiple stakeholder perspectives.
METHODS
The search strategy focused on peer-reviewed qualitative studies with the primary aim of identifying barriers and facilitators to implementing SDM in hospital (tertiary care) settings. Studies from the perspective of patients, clinicians, health service administrators, and decision makers, government policy makers, and other stakeholders (for example researchers) were eligible for inclusion. Reported qualitative results were mapped to the Theoretical Domains Framework (TDF) to identify behavioural barriers and facilitators to SDM.
RESULTS
Titles and abstracts of 8724 articles were screened and 520 were reviewed in full text. Fourteen articles met inclusion criteria. Most studies (n = 12) were conducted in the last four years; only four reported perspectives in addition to the patient-clinician dyad. In mapping results to the TDF, the dominant themes were Environmental Context and Resources, Social/Professional Role and Identity, Knowledge and Skills, and Beliefs about Capabilities. A wide range of barriers and facilitators across individual, organisational, and system levels were reported. Barriers specific to the hospital setting included noisy and busy ward environments and a lack of private spaces in which to conduct SDM conversations.
CONCLUSIONS
SDM implementation research in hospital settings appears to be a young field. Future research should build on studies examining perspectives beyond the clinician-patient dyad and further consider the role of organisational- and system-level factors. Organisations wishing to implement SDM in hospital settings should also consider factors specific to tertiary care settings in addition to addressing their organisational and individual SDM needs.
TRIAL REGISTRATION
The protocol for the review is registered on the Open Science Framework and can be found at https://osf.io/da645/ , DOI https://doi.org/10.17605/OSF.IO/DA645 .
Topics: Decision Making, Shared; Delivery of Health Care; Hospitals; Humans; Policy; Qualitative Research
PubMed: 34332601
DOI: 10.1186/s13012-021-01142-y