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Revista de Saude Publica Jan 2017To analyze the conceptualization of the term governance on public mental health programs. (Review)
Review
OBJECTIVE
To analyze the conceptualization of the term governance on public mental health programs.
METHODS
In this systematic review, we analyzed the scientific literature published in the international scenario during 15 years (from 2000 to 2015). The databases analyzed were: Medline, CINAHL, PsycINFO and PubMed. Governance and mental health were the descriptors. We included relevant articles according to our subject of study and levels of analysis: (i) the concept of governance in mental health; (ii) process and decision spaces; (iii) strategic and pertinent actors who operate in the functioning of the health system, and (iv) social regulations. We excluded letters to the editor, news articles, comments and case reports, incomplete articles and articles whose approach did not include the object of study of this review.
RESULTS
We have found five conceptualizations of the term governance on mental health in the area of provision policies and service organization. The agents were both those who offer and those who receive the services: we identified several social norms.
CONCLUSIONS
The concept of governance in mental health includes standards of quality and attention centered on the patient, and incorporates the consumers of mental healthcare in the decision-making process.
OBJETIVO
Analizar la conceptualización del término gobernanza en las políticas de salud mental.
MÉTODOS
En esta revisión sistemática se analizó literatura científica publicada en el ámbito internacional durante 15 años (de 2000 hasta 2015). Las bases de datos analizadas fueron: Medline, CINAHL, PsycINFO y PubMed. Los descriptores fueron gobernanza y salud mental. Fueron incluidos artículos relevantes de acuerdo a nuestro objeto de estudio y niveles de análisis: (i) concepto de gobernanza en salud mental; (ii) proceso y espacios de decisión; (iii) actores estratégicos y de interés que intervienen en el funcionamiento del sistema de salud, y (iv) normas sociales. Se excluyeron cartas al editor, noticias, comentarios y reporte de caso, artículos incompletos y artículos que no incluyeran en su abordaje el objeto de estudio de esta revisión.
RESULTADOS
Se reportaron cinco conceptualizaciones del término gobernanza en salud mental en el ámbito de políticas de provisión y organización de servicios. Los actores fueron desde proveedores a usuarios de servicios; se identificaron diversas normas sociales.
CONCLUSIONES
El concepto de gobernanza en salud mental incorpora estándares de calidad y atención centrada en el paciente, e incluye a los usuarios en la toma de decisiones.
Topics: Decision Making; Government Regulation; Health Policy; Humans; Mental Health; Mental Health Services; Quality of Health Care; Social Norms
PubMed: 28146159
DOI: 10.1590/S1518-8787.2017051006991 -
PloS One 2011Immunocompromised patients are vulnerable to severe or complicated influenza infection. Vaccination is widely recommended for this group. This systematic review and... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Immunocompromised patients are vulnerable to severe or complicated influenza infection. Vaccination is widely recommended for this group. This systematic review and meta-analysis assesses influenza vaccination for immunocompromised patients in terms of preventing influenza-like illness and laboratory confirmed influenza, serological response and adverse events.
METHODOLOGY/PRINCIPAL FINDINGS
Electronic databases and grey literature were searched and records were screened against eligibility criteria. Data extraction and risk of bias assessments were performed in duplicate. Results were synthesised narratively and meta-analyses were conducted where feasible. Heterogeneity was assessed using I(2) and publication bias was assessed using Begg's funnel plot and Egger's regression test. Many of the 209 eligible studies included an unclear or high risk of bias. Meta-analyses showed a significant effect of preventing influenza-like illness (odds ratio [OR]=0.23; 95% confidence interval [CI]=0.16-0.34; p<0.001) and laboratory confirmed influenza infection (OR=0.15; 95% CI=0.03-0.63; p=0.01) through vaccinating immunocompromised patie nts compared to placebo or unvaccinated controls. We found no difference in the odds of influenza-like illness compared to vaccinated immunocompetent controls. The pooled odds of seroconversion were lower in vaccinated patients compared to immunocompetent controls for seasonal influenza A(H1N1), A(H3N2) and B. A similar trend was identified for seroprotection. Meta-analyses of seroconversion showed higher odds in vaccinated patients compared to placebo or unvaccinated controls, although this reached significance for influenza B only. Publication bias was not detected and narrative synthesis supported our findings. No consistent evidence of safety concerns was identified.
CONCLUSIONS/SIGNIFICANCE
Infection prevention and control strategies should recommend vaccinating immunocompromised patients. Potential for bias and confounding and the presence of heterogeneity mean the evidence reviewed is generally weak, although the directions of effects are consistent. Areas for further research are identified.
Topics: Health Policy; Humans; Immunocompromised Host; Influenza Vaccines; Placebos; Public Health
PubMed: 22216224
DOI: 10.1371/journal.pone.0029249 -
Health Policy (Amsterdam, Netherlands) Sep 2021Online alcohol sales are experiencing rapid growth in many places, accelerated by the COVID-19 pandemic, prompting new laws and regulations. There are no comprehensive... (Review)
Review
BACKGROUND
Online alcohol sales are experiencing rapid growth in many places, accelerated by the COVID-19 pandemic, prompting new laws and regulations. There are no comprehensive and systematic analyses of the laws or their effectiveness.
OBJECTIVE
To summarise international policies governing online alcohol sale and delivery, including changes occurring with COVID-19, and examine available evidence of retailer compliance with such policies.
METHOD
A policy review of 77 jurisdictions in six English-speaking OECD countries: United States, Canada, United Kingdom, Ireland, Australia and New Zealand. We synthesised policies according to ten elements identified as potentially relevant for public health regulation. A systematic literature review of compliance evaluations in Medline, Medline Epub, EMBASE, CINAHL, Web of Science and Google Scholar.
RESULTS
72 of 77 jurisdictions permitted online alcohol sales and home delivery. Few jurisdictions require age verification at the time of purchase (n = 7), but most require it at delivery (n = 71). Since the COVID-19 pandemic began, most jurisdictions (69%) have either temporarily or permanently relaxed liquor regulations for alcohol home delivery. Three articles examined retailer compliance with age restrictions and found relatively low compliance (0%-46%).
CONCLUSION
Many jurisdictions permit the online sale and delivery of alcohol, but regulation of these sales varies widely. In most, regulations do not meet the same standard as bricks-and-mortar establishments and may be insufficient to prevent youth access.
Topics: Adolescent; Alcohol Drinking; Alcoholic Beverages; COVID-19; Commerce; Humans; Pandemics; Public Policy; SARS-CoV-2; United States
PubMed: 34311980
DOI: 10.1016/j.healthpol.2021.07.005 -
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 -
Trials Feb 2010The purpose of the study was to evaluate systematic reviews of research into two public health priorities, tobacco consumption and HIV infection, in terms of the... (Review)
Review
BACKGROUND
The purpose of the study was to evaluate systematic reviews of research into two public health priorities, tobacco consumption and HIV infection, in terms of the reporting of data related to the applicability of trial results (i.e., whether the results of a trial can be reasonably applied or generalized to a definable group of patients in a particular setting in routine practice, also called external validity or generalisability).
METHODS
All systematic reviews of interventions aimed at reducing or stopping tobacco use and treating or preventing HIV infection published in the Cochrane database of systematic reviews and in journals indexed in MEDLINE between January 1997 and December 2007 were selected. We used a standardized data abstraction form to extract data related to applicability in terms of the context of the trial, (country, centres, settings), participants (recruitment, inclusion and exclusion criteria, baseline characteristics of participants such as age, sex, ethnicity, coexisting diseases or co-morbidities, and socioeconomic status), treatment (duration, intensity/dose of treatment, timing and delivery format), and the outcomes assessment from selected reviews.
RESULTS
A total of 98 systematic reviews were selected (57 Cochrane reviews and 41 non-Cochrane reviews); 49 evaluated interventions aimed at reducing or stopping tobacco use and 49 treating or preventing HIV infection. The setting of the individual studies was reported in 45 (46%) of the systematic reviews, the number of centres in 21 (21%), and the country where the trial took place in 62 (63%). Inclusion and exclusion criteria of the included studies were reported in 16 (16%) and 13 (13%) of the reviews, respectively. Baseline characteristics of participants in the included studies were described in 59 (60%) of the reviews. These characteristics concerned age in about half of the reviews, sex in 46 (47%), and ethnicity in 9 (9%).Applicability of results was discussed in 13 (13%) of the systematic reviews. The reporting was better in systematic reviews by the Cochrane Collaboration than by non-Cochrane groups.
CONCLUSIONS
Our study highlighted the lack of consideration of applicability of results in systematic reviews of research into 2 public health priorities: tobacco consumption and HIV infection.
Topics: Adolescent; Adult; Child; Evidence-Based Medicine; Female; HIV Infections; Health Policy; Health Priorities; Health Services Research; Humans; Male; Middle Aged; Outcome and Process Assessment, Health Care; Public Health Practice; Reproducibility of Results; Review Literature as Topic; Smoking; Smoking Cessation; Smoking Prevention; Treatment Outcome; Young Adult
PubMed: 20187938
DOI: 10.1186/1745-6215-11-20 -
Frontiers in Public Health 2021Black women in the United States experience maternal mortality three to four times more often than white women (1, 2). States vary in degree of disparity, partially due...
Black women in the United States experience maternal mortality three to four times more often than white women (1, 2). States vary in degree of disparity, partially due to programs and policies available to pregnant people. In Massachusetts, Black women were approximately twice as likely as white women to experience pregnancy-associated mortality, with a large percentage of these deaths reported to be preventable (3). Using Massachusetts as a state-level comparison to national policies, we searched the US Congress and Massachusetts legislative databases for maternal health policies from 2010 to 2020. We screened 1,421 national and 360 Massachusetts bills, following set inclusion/exclusion criteria. Data analysis included (1) assessment of bill characteristics, (2) thematic analysis, and a (3) quality appraisal following an adapted model of the analytical framework for evaluating public health policy proposed by the National Collaborating Centre for Healthy Public Policy. Additionally, our data analysis identified the level of racism (internalized, interpersonal or institutional) that each policy addressed. From 2010 to 2020, 31 national and 16 state-level policies were proposed that address maternal health and racial disparities. The majority of policies addressed racism at the institutional level alone (National: = 19, 61.3%, Massachusetts: = 14, 87.5%). Two national and two Massachusetts-level policies became law, while two national policies passed only the House of Representatives. Our critical appraisal revealed that the majority of unintended effects would be neutral or positive, however, some potential negative unintended effects were identified. The appraisal also identified 54.8% ( = 17) of national policies and 68.8% ( = 11) of Massachusetts with positive impact on health equity. There has been an increase in policies proposed addressing racial disparities and health equity in maternal health over the last 10 years. Although half of national policies proposed showed positive impact on health equity, shedding light on the work the U.S. is doing on a federal level to confront the Black maternal health crisis, only two policies made it to law, only one of which addressed racial disparities directly and had a positive impact on health equity.
Topics: Black or African American; Female; Health Policy; Humans; Massachusetts; Maternal Health; Maternal Mortality; Pregnancy; United States
PubMed: 34746071
DOI: 10.3389/fpubh.2021.664659 -
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 -
Health Policy (Amsterdam, Netherlands) Oct 2011To review the evidence on public involvement in the systematic review process in health and social care; to examine the different methods, levels and stages of involving... (Review)
Review
OBJECTIVES
To review the evidence on public involvement in the systematic review process in health and social care; to examine the different methods, levels and stages of involving the public; to synthesise the contributions of the public, as well as the identified tensions, facilitating strategies and recommendations for good practice.
METHOD
Systematic literature search and narrative review.
FINDINGS
Seven case examples were found covering the following review topics: patients' perspectives on electro-convulsive therapy; user involvement in nursing, midwifery and health visiting research; treatments for degenerative ataxias; teaching, learning and assessment of law in social work education; HIV health promotion for men who have sex with men; the conceptualisation, measurement, impact and outcomes of public involvement in health research; methods of consumer involvement in developing healthcare policy and research, clinical practice guidelines and patient information material. The public was found to contribute to systematic reviews by: refining the scope of the review; suggesting and locating relevant literature; appraising the literature; interpreting the review findings; writing up the review. Numerous tensions, facilitating strategies and recommendations were identified.
CONCLUSIONS
The issues raised in this paper should assist researchers in developing and conducting systematic reviews with the involvement of the public.
Topics: Community Participation; Evidence-Based Medicine; Group Processes; Health Policy; Humans; Research; Research Design; Review Literature as Topic
PubMed: 21641075
DOI: 10.1016/j.healthpol.2011.05.002 -
Health Care Analysis : HCA : Journal of... Mar 2021Ethical review and analysis of health policy may help to ensure policies address the needs of society and align with relevant values and principles. Indeed, researchers...
Ethical review and analysis of health policy may help to ensure policies address the needs of society and align with relevant values and principles. Indeed, researchers and bioethicists have recognized the need for ethical frameworks specifically for public health applications. The objective of this research was to compile structured tools for ethical review of (drafted or existing) health policy and to analyze these tools for their scope and philosophical underpinnings. A systematic search and review of academic and grey literature was conducted to compile existing tools designed for health policy ethics review. The search yielded 13 health policy ethical review tools. Qualitative content analysis revealed that all of the tools were influenced by multiple ethical values and that a majority were influenced by more than one ethical theory. The most common values were non-maleficence and beneficence (92.3%). The most common influencing ethical theory was the Principles Approach (92.3%). The structure of the tools demonstrates a heterogeneity of methodology designs to approach policy ethics review. This research offers a unique contribution to the bioethics field that provides a useful resource and understanding of the current ethical review tools for health policy.
Topics: Bioethics; Ethical Theory; Health Policy; Humans; Public Health
PubMed: 33386534
DOI: 10.1007/s10728-020-00422-w -
BMJ Global Health May 2022The infection fatality rate (IFR) of COVID-19 has been carefully measured and analysed in high-income countries, whereas there has been no systematic analysis of... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
The infection fatality rate (IFR) of COVID-19 has been carefully measured and analysed in high-income countries, whereas there has been no systematic analysis of age-specific seroprevalence or IFR for developing countries.
METHODS
We systematically reviewed the literature to identify all COVID-19 serology studies in developing countries that were conducted using representative samples collected by February 2021. For each of the antibody assays used in these serology studies, we identified data on assay characteristics, including the extent of seroreversion over time. We analysed the serology data using a Bayesian model that incorporates conventional sampling uncertainty as well as uncertainties about assay sensitivity and specificity. We then calculated IFRs using individual case reports or aggregated public health updates, including age-specific estimates whenever feasible.
RESULTS
In most locations in developing countries, seroprevalence among older adults was similar to that of younger age cohorts, underscoring the limited capacity that these nations have to protect older age groups.Age-specific IFRs were roughly 2 times higher than in high-income countries. The median value of the population IFR was about 0.5%, similar to that of high-income countries, because disparities in healthcare access were roughly offset by differences in population age structure.
CONCLUSION
The burden of COVID-19 is far higher in developing countries than in high-income countries, reflecting a combination of elevated transmission to middle-aged and older adults as well as limited access to adequate healthcare. These results underscore the critical need to ensure medical equity to populations in developing countries through provision of vaccine doses and effective medications.
Topics: Aged; Bayes Theorem; COVID-19; Developing Countries; Health Services Accessibility; Humans; Middle Aged; Public Policy; Seroepidemiologic Studies
PubMed: 35618305
DOI: 10.1136/bmjgh-2022-008477