PUBLIC HEALTH REVIEWS最新文献

Background: The World Health Organization (WHO) announced the end of the emergency phase of Corona Virus Disease 2019 (COVID-19) in May 2023. Nations across the world address the effects of the pandemic and the need to plan for future pandemics. Ireland heavily focused on isolation and social distancing to curb the infection rate early in the pandemic. These long and extended lockdowns gave Ireland a very unique experience during the COVID-19 pandemic.

Analysis: Ireland's COVID-19 pandemic management was discussed by an expert panel on the strengths in our national pandemic action plans, areas not sufficiently addressed and requirements to ensure future pandemic preparedness plans are robust.

Policy options: Recommendations include having a more strategic plan to protect society's most vulnerable people, a flexible national policy that swiftly implements advances in scientific knowledge and good practices, a robust communication plan including localised information to prevent "pandemic fatigue," and address challenges from restrictions, lockdowns and isolation such as mental health and wellbeing.

Conclusion: Lessons learnt from the Irish COVID-19 pandemic experience can be utilised for pandemic preparedness plans, nationally and internationally.

Background: The unprecedented DANA floods that struck Valencia, Spain on October 29, 2024, caused catastrophic human, economic, and ecological damages, resulting in 223 fatalities, the displacement of 15,000 residents, and long-term health and environmental consequences and incurred financial losses estimated over 50 billion euros. Vulnerabilities in urban planning, ambiguous command and control oversight, delayed warnings, and insufficient preparedness underscored systemic gaps in the flood preparedness and management.

Analysis and policy options: Urgent actions, including stricter urban zoning laws, implementing comprehensive early warning systems, and fostering community-based disaster preparedness are needed to mitigate future risks. A One Health approach that addresses the interconnectedness of human, animal, and environmental health is critical. Investments in resilient infrastructure and communication strategies, including mobile alerts and public education campaigns, can significantly mitigate overall impacts. Moreover, prioritizing mental health interventions and long-term recovery plans are essential for fostering community resilience.

Conclusion: The Valencia floods catastrophe is a painful reminder of the devastating potential of extreme weather and the critical importance of preparedness and clear governance underscore the pressing needs for integrated disaster management frameworks. An effective system of cooperation between local and national governments is essential to avoid the confusion and delays seen during this disaster. Strengthening prevention, preparedness, and response measures, and fostering political and community cohesion, can enable societies to build adaptive capacity to effectively tackle the increasing challenges of climate-driven extreme weather disasters. Future leaders must act with urgency and transparency to build trust and put citizens' safety above all else.

Background: Training scientists in science policy is crucial to enhance scientific advice for decision-making. However, there are limited opportunities for scientists to receive such training.

Analysis: We reflected on our participation in a one-year postgraduate science policy fellowship program in Canada. Although recently discontinued in 2023, this fellowship allowed us to refine practical policy skills, contribute to policy outputs that advanced our office's mandate, and access career pathways beyond academia.

Policy options: Recognizing the value of engaging scientists in policy, we advocate for continued offerings of science policy training, alongside rigorous evaluation to inform program changes. Additionally, we encourage increased financial support early on for graduate students to sustain a talent pool of scientists who will become future science policy leaders. Lastly, we urge more scientists and students to be active in science policy spaces.

Conclusion: By openly sharing our experiences and learnings from the fellowship, we seek to contribute to ongoing discussions on the importance of science policy training and its role in bridging the gap between science and decision-making.

Objectives: West Nile Virus (WNV) infection prevalence is increasing in recent years in Europe, particularly in Italy. Such increase has been related to climate and environmental factors. Our review aims to assess the relation between climate change-related factors and the spread of WNV in Italy.

Methods: We conducted a literature search across four online databases until 22 January 2025, using as search terms WNV, its vectors, and climate change.

Results: Out of 282 unique articles, we included 29 eligible papers published between 2011-2025, most of them assessing distribution of the main WNV vector (Culex pipiens) and epidemiology of the infection in relation to climate/environmental factors. We found a positive strong association of WNV transmission with temperature and agricultural land use. Associations with other environmental variables also emerged, but they were either weak or inconsistent.

Conclusion: Despite some inconsistencies in the results, likely due to heterogeneity in study methodologies and interactions of environmental variables, review findings indicate that some climate change-related factors favor WNV spread through its vectors in Italy, in line with exploratory observations obtained on the entire Europe.

Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD42023430636, identifier CRD42023430636.

Objectives: To identify and synthesize the factors influencing the acceptability and uptake of HIV self-testing (HIVST) among Priority Populations (PPs) in Sub-Saharan Africa (SSA) through a comprehensive scoping review.

Methods: Using Arksey and O'Malley's framework refined by Levac, we systematically reviewed the literature on factors affecting HIVST uptake and acceptability among PPs in SSA. The review included searches in six databases (Embase, Medline (via Ovid), PubMed, PsycINFO, Web of Science, WHO Global Health Library), as well as grey literature, including (Google Scholar and OpenGrey), limiting publications to 2010-2023.

Results: The review found evidence indicating that HIVST is widely accepted and considered convenient among priority groups. Key challenges include limited post-test counseling and linkage to care, which hinder effective implementation. Peer-led and digital distribution strategies show the potential to increase uptake. However, user errors and economic constraints pose significant barriers to scaling HIVST, underscoring the need for targeted interventions to address these implementation challenges for optimal impact.

Conclusion: While HIVST can boost testing rates among PPs in SSA, overcoming access and utilization barriers is crucial. Interventions addressing economic, educational, and systemic challenges are essential for successful HIVST integration into broader HIV prevention and care efforts.

Objectives: Breast cancer (BC) is a leading cause of cancer related disability and mortality. Despite efforts to implement mammography screening programs, uptake rates vary widely due to socioeconomic factors and accessibility challenges. To improve participation, interventions targeting barriers faced by underserved groups are crucial for promoting equitable screening and early detection.

Methods: A systematic search and meta-analysis was performed to identify strategies to reduce disparities and enhance participation in BC screening, with particular attention to underserved groups, including individuals with low SES, underinsured, with immigrant background or part of ethnic minority.

Results: The meta-analysis of 44 randomized studies involving 161,141 individuals (of which 14,720 belonged to underserved groups) showed that, compared to usual care, interventions regarding BC screening were effective in increasing mammography uptake [pooled OR 1.55 (95%CI 1.39-1.73)], particularly, among underserved groups [pooled OR 1.81 (95%CI 1.43-2.28)]. Overall, the most effective were educational interventions. Among underserved groups, reminders, telephonic interventions, navigation services and cultural-sensitive approaches were highly effective.

Conclusion: Combining these strategies can simultaneously address multiple barriers, ensuring comprehensive support throughout the BC screening process and improved access to screening for underserved groups.

Systematic review registration: Identifier CRD42023393352.

Background: Suicide prevention requires evidence-based measures at all prevention levels, embedded in coordinated and sustainable efforts. This policy brief aims to promote the long-term integration of project-based suicide prevention initiatives into the health system. We identify key facilitators and barriers to project sustainability and provide actionable recommendations for advancement.

Analysis: This policy brief integrates evidence from a narrative review, a qualitative study with 36 suicide prevention experts, and ongoing evaluation research on suicide prevention projects to assess sustainability determinants and associated challenges. Key barriers to sustainability include evaluation gaps, insufficient collaboration, limited stakeholder awareness, organizational challenges, and financial constraints.

Policy options: To promote the sustainability of suicide prevention projects in Switzerland, we recommend: 1. Establishing a national suicide prevention website with resources and good practices. 2. Creating a guideline for multi-level collaboration and stakeholder engagement. 3. Involving target groups in project design, implementation, and evaluation. 4. Developing a sustainable financing plan early on.

Conclusion: Implementing these recommendations can enhance access to structured information, foster multi-level collaboration, raise awareness, and optimize resource allocation, thereby strengthening suicide prevention in Switzerland.

Objectives: The aim of this scoping review is to explore the international evidence to identify the potential costs and gains of the development of a career pathway for Health Support Worker's (HSW's), the economic gains and benefits connected with continual professional development (CPD) and value for money.

Methods: Scoping review following JBI methodology was conducted of peer-reviewed international literature using structured searches of electronic databases and grey literature (September 2013-November 2023) applying economic methodological terms to capture economic evidence and perspectives on the issues.

Results: Seventeen papers were critically appraised and during the process of data extraction four key themes emerged: 1) Cost-benefits of employment and training 2) Organisational economic perspectives 3) Service economic perspectives and 4) Sector economic perspectives. This scoping review revealed a scarcity of economic evidence contributing to critical educational approaches, costs and benefits in development of career pathways for HSWs.

Conclusion: Limited evidence was available on benefits of specific training programmes, and considerable gaps in the evidence to inform future investment. Recommendation is that future research should incorporate economic theory within evaluations to inform policy and practice.

Objectives: Socioeconomic status (SES) is in many cases related to air pollution exposure, but less is known about its effects on susceptibility to air pollution. The main aim of this study was to analyse the impact of SES on health effects associated with exposure to fine particles (PM_2.5).

Methods: Firstly, a systematic literature review of studies analysing the impacts of SES on health effects related to air pollution exposure was carried out. Secondly, a meta-analysis was performed by analysing studies on long-term mortality associated with exposure to PM_2.5 divided into different SES groups.

Results: The meta-analysis showed that the relative risk (RR) for all-cause mortality associated with PM_2.5 did not depend on individual education or income. It also revealed that adjustment for individual lifestyle factors (such as smoking, alcohol intake, physical activity, eating behaviours, and body mass index), in addition to adjustment for SES, did not significantly change the RR.

Conclusion: The association between all-cause mortality and PM_2.5 did not depend on education or individual income. Due to the high heterogeneity observed, further studies are required to draw firm conclusions.