The purpose of this systematic review is to identify, describe and assess the potential effectiveness of strategies to respond to issues of vaccine hesitancy that have been implemented and evaluated across diverse global contexts.
A systematic review of peer reviewed (January 2007–October 2013) and grey literature (up to October 2013) was conducted using a broad search strategy, built to capture multiple dimensions of public trust, confidence and hesitancy concerning vaccines. This search strategy was applied and adapted across several databases and organizational websites. Descriptive analyses were undertaken for 166 (peer reviewed) and 15 (grey literature) evaluation studies. In addition, the quality of evidence relating to a series of PICO (population, intervention, comparison/control, outcomes) questions defined by the SAGE Working Group on Vaccine Hesitancy (WG) was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria; data were analyzed using Review Manager.
Across the literature, few strategies to address vaccine hesitancy were found to have been evaluated for impact on either vaccination uptake and/or changes in knowledge, awareness or attitude (only 14% of peer reviewed and 25% of grey literature). The majority of evaluation studies were based in the Americas and primarily focused on influenza, human papillomavirus (HPV) and childhood vaccines. In low- and middle-income regions, the focus was on diphtheria, tetanus and pertussis, and polio. Across all regions, most interventions were multi-component and the majority of strategies focused on raising knowledge and awareness. Thirteen relevant studies were used for the GRADE assessment that indicated evidence of moderate quality for the use of social mobilization, mass media, communication tool-based training for health-care workers, non-financial incentives and reminder/recall-based interventions.
Overall, our results showed that multicomponent and dialogue-based interventions were most effective. However, given the complexity of vaccine hesitancy and the limited evidence available on how it can be addressed, identified strategies should be carefully tailored according to the target population, their reasons for hesitancy, and the specific context.
Blame your glucose-deprived brain for your rotten mood.
Long-term couples know all too well the perils of the early evening hours: that touchy time after work but before dinner hits the table.
It’s prime time for getting “hangry”, a handy portmanteau for hungry and angry. People commonly feel an uptick in anger or aggression when they’re hungry, says Dr. Brad Bushman, a professor of psychology at Ohio State University. “The brain needs fuel to regulate emotions, and anger is the emotion people have the most difficulty regulating,” he explains.
To understand the growth of income inequality—and the disappointing increases in workers’ wages and compensation as well as middle-class incomes—it is crucial to understand the divergence of pay and productivity.
Productivity growth, which is the growth of the output of goods and services per hour worked, provides the basis for the growth of living standards. Productivity and compensation (wages and benefits) of the typical worker grew in tandem over the early postwar period until the 1970s. In contrast, over the last few decades, productivity has grown substantially, but the hourly compensation of the typical worker has grown much less, especially in the last 10 years or so. In fact, the gap between productivity and compensation growth for the typical worker has been larger since the early 2000s than at any point in the post–World War II period. As such, the last 10 years have been a “lost decade” for American workers. In this light, it is more accurate to say that productivity provides the potential for growing living standards because there is no guarantee that productivity gains will be widely shared.
One key factor in the divergence between pay and productivity is the widespread erosion of collective bargaining that has diminished the wages of both union and nonunion workers. This will be demonstrated below by showing that the productivity–pay gap grew most in those states where collective bargaining coverage declined the most.
Un nouveau rapport publié dans la Revue canadienne de santé publique cerne les coûts annuels de soins de santé par individu qui fume, qui souffre d'obésité ou qui ne fait pas d'exercice.
Robert Strang, médecin en chef de la santé publique de la Nouvelle-Écosse, dit que ces statistiques sont utiles pour prendre des décisions quant au financement des programmes de prévention en santé.
Il n'a pas été surpris de constater qu'un fumeur coûte annuellement 3071 $ à l'État, qu'une personne obèse coûte 1453 $ et qu'une autre inactive coûte 712 $.
Il ne pense cependant pas que cela va changer le comportement de ces personnes.
« Je ne crois pas que les gens vont s'attarder à l'argument comme quoi ces facteurs coûtent cher à l'État. Par contre, les chiffres sont importants pour nous, pour le gouvernement, afin que l'on continue à investir dans la prévention.
Why do doctors get sued? How can malpractice suits be avoided? It turns out, the answer may be simple. Defensive medicine refers to the idea that doctors are forced to order extra tests, perform extra procedures, or push for more office visits because they think that without them, they're at greater risk for being sued. This is in spite of the fact that studies don't support the notion that this extra care actually does reduce their risk.
What might help physicians to get sued less often would be for them to get along better with their patients. Or at least, they could become better communicators. That's the topic of this week's Healthcare Triage. This was based on a piece Aaron wrote for the NYT. Links to further reading can be found there: http://www.nytimes.com/2015/06/02/ups...
Few people seem comfortable with the idea of paying patients to do what we want them to do.
That’s unfortunate, because there’s a significant amount of research that says this works.
I’m not talking about things like wellness programs, which offer reductions in insurance premiums if you do what your employer wants. Those are really a means of cost-sharing in which expenses are shifted onto people who are less healthy. I’m talking about paying incentives directly to people in exchange for changes to their behavior or health.
A recent study published in the New England Journal of Medicine compared various programs that encourage people to quit smoking. The interventions were altered with subtle changes to see what types of programs might achieve better results. In the most successful one, people earned large monetary rewards — with a catch.
Childhood obesity is a major public health concern and is associated with substantial morbidities. Access to less-healthy foods might facilitate dietary behaviors that contribute to obesity. However, less-healthy foods are usually available in school vending machines. This cross-sectional study examined the prevalence of students buying snacks or beverages from school vending machines instead of buying school lunch and predictors of this behavior. Analyses were based on the 2003 Florida Youth Physical Activity and Nutrition Survey using a representative sample of 4,322 students in grades six through eight in 73 Florida public middle schools. Analyses included χ2 tests and logistic regression. The outcome measure was buying a snack or beverage from vending machines 2 or more days during the previous 5 days instead of buying lunch. The survey response rate was 72%. Eighteen percent of respondents reported purchasing a snack or beverage from a vending machine 2 or more days during the previous 5 school days instead of buying school lunch. Although healthier options were available, the most commonly purchased vending machine items were chips, pretzels/crackers, candy bars, soda, and sport drinks. More students chose snacks or beverages instead of lunch in schools where beverage vending machines were also available than did students in schools where beverage vending machines were unavailable: 19% and 7%, respectively (P≤0.05). The strongest risk factor for buying snacks or beverages from vending machines instead of buying school lunch was availability of beverage vending machines in schools (adjusted odds ratio=3.5; 95% confidence interval, 2.2 to 5.7). Other statistically significant risk factors were smoking, non-Hispanic black race/ethnicity, Hispanic ethnicity, and older age. Although healthier choices were available, the most common choices were the less-healthy foods. Schools should consider developing policies to reduce the availability of less-healthy choices in vending machines and to reduce access to beverage vending machines.
OBJECTIVES: The purpose of this article is to review all randomized control trials (RCTs) that have looked at the health effects of yoga on pregnancy, and to present their evidence on the specific ways in which pregnant women, and their infants can benefit from yoga intervention. The purpose is also to determine whether yoga intervention during pregnancy is more beneficial than other physical exercises. METHODS: Four databases were searched using the terms yoga and (pregnancy or pregnant or prenatal or postnatal or postpartum). Databases were searched from January 2004 to February 2014. RESULTS: Ten randomized controlled trials were evaluated. The findings consistently indicate that yoga intervention presented with lower incidences of prenatal disorders (p<0.05), and small gestational age (p<0.05), lower levels of pain and stress (p<0.05), and higher score of relationship (p<0.05). In addition, yoga can be safely used for pregnant women who are depressed, at high-risk, or experience lumbopelvic pain. Moreover, yoga is a more effective exercise than walking or standard prenatal exercises. CONCLUSIONS: The findings suggest that yoga is a safe and more effective intervention during pregnancy. However, further RCTs are needed to provide firmer evidence regarding the utility and validity of yoga intervention.
Research into the effectiveness of comic books as health education tools overwhelmingly consists of studies evaluating the information learnt as a result of reading the comic, for example using preintervention and postintervention questionnaires. In essence, these studies evaluate comics in the same way in which a patient information leaflet might be evaluated, but they fail to evaluate the narrative element of comics. Health information comics have the potential to do much more than simply convey facts about an illness; they can also support patients in dealing with the social and psychological aspects of a condition. This article discusses how some common elements of educational comics are handled in a selection of comics about diabetes, focusing on the more personal or social aspects of the condition as well as the presentation of factual information. The elements examined include: fears and anxieties; reactions of friends and family; interactions with medical professionals; self-management; and prevention. In conclusion, the article argues that comics, potentially, have many advantages over patient information leaflets, particularly in the way in which they can offer ‘companionship’, helping patients to address fears and negative feelings. However, empirical studies are required to evaluate educational comics in a way which takes account of their potential role in supporting patients in coming to terms with their condition, as well as becoming better informed.
Babies born too soon or too small face many difficulties, including increased rates of mortality and lifelong disability.1 The 2012 Global Action Report on Preterm Birth ‘Born Too Soon’ presents a sobering picture: 15 million (1 in 10) babies every year are born too soon, with these rates appearing to be rising globally.1 Low levels of maternal education have been clearly associated with adverse birth outcomes such as preterm birth and low birth weight.2–4 While education is only one risk factor—alongside other critical factors such as maternal age, birth order and spacing, multiple pregnancies, body weight, chronic disease, mental health, infectious diseases, health risk behaviours such as smoking, intimate partner violence, and access to screening and health services1,5—it matters, because education enables girls and women to make informed decisions about their reproductive health and interactions with the healthcare system.6 Increasing education levels is a key component of programmes directed at reducing adverse birth outcomes.1
While the prevalence (and burden) of preterm birth is highest in the poorest countries, namely sub-Saharan Africa and southern Asia, it also affects richer countries including those in the Americas and Europe. More country-specific data are needed to assist our understanding of the extent of the problem and the complex interplay of contributory risks. This is why the paper by Ruiz et al7 is a welcome addition to the literature. The authors examine the association between attained educational qualifications of mothers and two adverse birth outcomes (preterm birth, low for gestational age birth weight) in their infants. Conducted as part of the ‘DRIVERS for Health Equity’ research programme, this meta-analysis has systematically analysed data from studies of over 75 000 babies in 12 countries across Europe (France, the Netherlands, the UK, the Czech Republic, Ukraine, Finland, Norway, Sweden, Greece, Italy, Portugal and Spain). Notably, these countries represent the northern, western, southern and central/eastern parts of Europe, thus providing a more complete picture of how maternal education may influence disparities in pregnancy duration and infant birth weight.
Questo è un post sgarbato. Nella passata notte di San Lorenzo di cadente c'era ben altro che le stelle: (s)cadenti il buon senso, la responsabilità per la propria salute, la logica del gruppo (o branco?) e la premura verso i propri figli. Scadente, tutto sommato, l'amore per la vita. Nella sola notte di ieri, il Servizio 118 della mia Asl è stato costretto a intervenire in 11 casi per stato di ebbrezza: 11 potenziali tragedie ma anche 11 ambulanze sottratte a chi poteva seriamente averne bisogno per stati di malattia. Degli 11 ben 6 erano minorenni... I pochi denari che lo Stato mi passa mi servono per curare malati di cancro, persone con disabilità, pazienti cronici e non autosufficienti. Possibilmente non i "bimbominkia" grandi e piccini in cerca del fottutissimo quarto d'ora indimenticabile. Avviso ai naviganti delle terre e dei mari di agosto: chi beve non è FIGO, è un COGLIONE!
Is running really a better form of exercise than walking, given that running can lead to more injuries?At Vox, I sit next to health reporter Sarah Kliff, who trains for half-marathons and triathlons with a casualness most people reserve for grocery shopping. But in the year I’ve known Sarah, she’s suffered plantar fasciitis and a stress fracture. She’s hobbled around in running shoes for months because everything else hurt too much, and she’s currently sporting a big blue brace on her left leg to help cushion the tiny cracks in the bones of her foot brought on from too much wear and tear.
In many ways, Sarah is a perfect case study in how to think about the benefits and risks of running versus walking. Running has greater health benefits than walking (Sarah is super fit), but it also carries a much bigger risk of injury (see Sarah’s foot brace). So which effect dominates? To find out, I first searched for "randomized control trials" and "systematic reviews" on running, walking, and exercise at PubMedhealth (a free search engine for health research) and inGoogle Scholar. I wanted to see what the highest-quality evidence — trials and reviews are thegold standard— said about the relative risks and benefits of these two forms of exercise.
I have had patients try to snapchat their laceration repairs. They have utilized FaceTime for discharge instructions with loved ones. I recently had a patient try to put their phone in selfie mode so they could see how their lumbar puncture was going in their back (my nurse quickly prompted them to get back into position and removed their phone).
Smartphones have changed everything.
By now many physicians know of the Bethesda, Maryland anesthesiologist who wassuccessfully sued for hundreds of thousands of dollars by a patient who “accidentally” recorded conversations she was having while he was sedated.
My social media feeds were in overdrive when the final judgement was announced. Even though every physician I know felt the Anesthesiologist’s behavior was not appropriate, most were shocked at the massive amount of the judgement — $500,000. Most also felt it wasn’t appropriate for the patient to be recording the physician team without their knowledge. What if the team started talking about their next patient at the end of the case, and this patient was privy to all that information?
Researchers from the American Cancer Society have found that women who spend 6 hours or more of free time sitting per day have a 10% greater risk of getting cancer than women who spend less than 3 hours of free time sitting per day.
The nutritional quality of food and beverage products sold in vending machines has been implicated as a contributing factor to the development of an obesogenic food environment. How comprehensive, reliable, and valid are the current assessment tools for vending machines to support or refute these claims? A systematic review was conducted to summarize, compare, and evaluate the current methodologies and available tools for vending machine assessment. A total of 24 relevant research studies published between 1981 and 2013 met inclusion criteria for this review. The methodological variables reviewed in this study include assessment tool type, study location, machine accessibility, product availability, healthfulness criteria, portion size, price, product promotion, and quality of scientific practice. There were wide variations in the depth of the assessment methodologies and product healthfulness criteria utilized among the reviewed studies. Of the reviewed studies, 39% evaluated machine accessibility, 91% evaluated product availability, 96% established healthfulness criteria, 70% evaluated portion size, 48% evaluated price, 52% evaluated product promotion, and 22% evaluated the quality of scientific practice. Of all reviewed articles, 87% reached conclusions that provided insight into the healthfulness of vended products and/or vending environment. Product healthfulness criteria and complexity for snack and beverage products was also found to be variable between the reviewed studies. These findings make it difficult to compare results between studies. A universal, valid, and reliable vending machine assessment tool that is comprehensive yet user-friendly is recommended.
Pregnant women, postpartum women, and infants are at high risk for complications from influenza. From October to November 2012, Text4baby, a free national text service for pregnant women and mothers of infants aged <1 year, implemented a module of interactive messages encouraging maternal influenza vaccination. A program evaluation examined whether a text-based reminder or tailored education improved self-reported influenza vaccination or intent to be vaccinated later in the influenza season among Text4baby participants.
Nearly one third (28,609/89,792) of enrollees responded to a text asking about their vaccination plans. Those planning to receive vaccination were randomly assigned to receive an encouragement message or an encouragement message plus the opportunity to schedule a reminder (n=3,021 at follow-up). Those not planning to be vaccinated were randomly assigned to receive general education or education tailored to their reason for non-vaccination (n=3,820 at follow-up). The effect of the enhanced messages was assessed using multinomial logistic regression in 2013–2014.
A reminder increased the odds of vaccination at follow-up among mothers (AOR=2.0, 95% CI=1.4, 2.9) and of continued intent to be vaccinated later in the season (pregnant, AOR=2.1, 95% CI=1.4, 3.1; mother, AOR=1.7, 95% CI=1.1, 2.5). Among mothers not planning to be vaccinated because of cost, those who received a tailored message about low-cost vaccination had higher odds of vaccination at follow-up (AOR=1.9, 95% CI=1.1, 3.5). Other tailored messages were not effective.
Text reminders and tailored education may encourage influenza vaccination among this vulnerable population; both have now been incorporated into Text4baby.
The Public Health Responsibility Deal in England was launched in 2011 by the Department of Health as a public–private partnership. Together with government, industry and other partners developed a set of commitments or ‘pledges’ including associated targets and actions which business, health, community and public organisations can commit to in order to improve health. The health topics addressed were food, alcohol, physical activity and health at work. The featured article from a university unit funded by the Department of Health to evaluate the Responsibility Deal presents an analysis of the pledges in the alcohol domain.
The Public Health Responsibility Deal for alcohol in England offers a set of pledges which alcohol industry and other bodies can choose to commit to with a view to improving health.
Rather than being prompted by the deal, the actions committed to were usually already done or underway. Even if implemented, acompanion paper has judged the pledges unlikely to significantly improve health.
The pledge on lower strength alcohol products could be effective in certain circumstances, but government calculations that it helped remove 1.3 billion units of alcohol from the UK market have been disputed.
Whatever its effects on consumption, the Responsibility Deal seems to have helped forestall a more effective measure – a minimum per unit price for alcohol.
Although at the time of the featured study there were eight alcohol pledges, it focused on four key pledges: A1 – alcohol labelling (92 signatories); A4 – tackling underage alcohol sales (63 signatories); A6 – advertising and marketing alcohol (92 signatories); and A8 – alcohol unit reduction (32 signatories) panel below. These were selected because they cover much of what is proposed in the remaining pledges.
Sharing your scoops to your social media accounts is a must to distribute your curated content. Not only will it drive traffic and leads through your content, but it will help show your expertise with your followers.
How to integrate my topics' content to my website?
Integrating your curated content to your website or blog will allow you to increase your website visitors’ engagement, boost SEO and acquire new visitors. By redirecting your social media traffic to your website, Scoop.it will also help you generate more qualified traffic and leads from your curation work.
Distributing your curated content through a newsletter is a great way to nurture and engage your email subscribers will developing your traffic and visibility.
Creating engaging newsletters with your curated content is really easy.