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Gaffar B, Schroth RJ, Foláyan MO, Ramos-Gomez F, Virtanen JI. A global survey of national oral health policies and its coverage for young children. Front Oral Health 2024; 5:1362647. [PMID: 38645574 PMCID: PMC11026553 DOI: 10.3389/froh.2024.1362647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 03/22/2024] [Indexed: 04/23/2024] Open
Abstract
Background There is no accessible information on countries with oral health policies. The purpose of this study was to identify World Dental Federation (FDI) member countries with oral health policies and their scope and extent of coverage of oral health care for young children. Methods This international survey recruited chief dental officers, oral health advisors to national ministries of health, and other key informants of the 158 FDI member countries between December 2020 and December 2021. The survey tool was administered online to the study participants. Key questions explored the following outcome measures: countries with oral health policies; the thrusts of the oral health policies; policy thrusts targeting young children; and dental care plans as a component of a universal health care plan. Descriptive statistics were conducted to determine the number of countries with any of the study outcome measures and coverage per country. Results Sixty (38%) of the 158 FDI member-countries responded to the survey. Forty-eight (55.2%) of the 60 countries had a national oral health policy document or position statement on oral health; 54 (62.1%) countries had plans on universal health care, and 42 (48.3%) included dental care within their universal health care plan. The most common policy thrusts addressing the oral health needs of children were the promotion of oral hygiene (71.7%), provision of fluoride products for children (53.3%), collaboration with primary care providers (35%), and prenatal oral health education (50%). There were differences in the scope of oral health care coverage and the coverage for young children between continents as well as between countries. Europe had many countries with children-friendly oral health policy coverage. Conclusions About half of the surveyed countries had a national oral health policy. There were variations in the scope of oral health care coverage, particularly for young children, both between continents and among individual countries. These findings underscore the importance of understanding the landscape of oral health policies globally. Such insights can help inform targeted interventions to enhance oral health policies, thereby contributing to improved oral health outcomes on a global level.
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Affiliation(s)
- Balgis Gaffar
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Robert J. Schroth
- Departments of Preventive Dental Science, Dr. Gerald Niznick College of Dentistry and Departments of Pediatrics & Child Health and Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Manitoba, MB, Canada
| | | | - Francisco Ramos-Gomez
- UCLA Center for Children’s Oral Health (UCCOH), University of California, Los Angeles, Los Angeles, CA, United States
| | - Jorma I. Virtanen
- Faculty of Medicine, University of Bergen, Bergen, Norway
- Institute of Dentistry, University of Turku, Turku, Finland
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McNoe BM, Marsh L, Venter N, Morgaine KC, Reeder AI, McLean RM. National Sporting Organisation Policies: A health promotion opportunity? Health Promot J Austr 2022; 34:480-487. [PMID: 35355357 DOI: 10.1002/hpja.601] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 11/12/2021] [Accepted: 03/11/2022] [Indexed: 11/06/2022] Open
Abstract
The objective was to identify whether National Sporting Organisations (NSOs) have policy documentation on healthy behaviours (smokefree, sun-protection, healthy food/beverages, and alcohol) and, for organisations with such documentation, whether this is in-line with current scientific evidence of past best practice in cancer prevention. METHODS This cross-sectional policy analysis study was performed September - December 2018 in New Zealand. A content analysis was undertaken using NSO policy documents matched against a framework of key indicators for best practice within health behaviours of interest. Data analysis of the policy process was undertaken through key informant telephone interviews with NSO staff using semi-structured qualitative interviews. RESULTS Of 96 NSOs, nearly half (49%) mentioned smokefree at least once in one of their policy documents, and 47% had an alcohol policy, although in both instances the policies lacked comprehensiveness. Two NSOs had a reasonably comprehensive sun protection policy. Seventeen had at least one specific nutrition policy/guideline. The contents of the latter were primarily related to short-term athletic performance rather than non-communicable disease prevention, specifically promoting hydration during sports participation, and food and nutrition to support sporting performance. Two NSOs had policies relating to the promotion of health food/nutrition more widely. For some NSOs the lack of health-related policies was not a conscious choice but just not considered previously. Other NSOs reported they lacked resources or had other priorities. CONCLUSIONS Although this study clearly demonstrates that many NSOs lack adequate health-related policies, this is not necessarily a conscious choice, but the result of a lack of resources, other priorities, or just that they had not considered developing policies in these areas. A number expressed support for these types of policies although it was apparent that some, particularly smaller NSOs would require assistance in policy template development. It seems probable that the development of health-related policies will only occur if partner agencies become involved.
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Affiliation(s)
- B M McNoe
- Department of Preventive and Social Medicine, Social and Behavioural Research Unit, University of Otago, Dunedin, New Zealand
| | - L Marsh
- Department of Preventive and Social Medicine, Social and Behavioural Research Unit, University of Otago, Dunedin, New Zealand
| | - N Venter
- Department of Preventive and Social Medicine, Social and Behavioural Research Unit, University of Otago, Dunedin, New Zealand
| | - K C Morgaine
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - A I Reeder
- Department of Preventive and Social Medicine, Social and Behavioural Research Unit, University of Otago, Dunedin, New Zealand
| | - R M McLean
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
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Weimann A, Shung-King M, McCreedy N, Tatah L, Mapa-Tassou C, Muzenda T, Govia I, Were V, Oni T. Intersectoral Action for Addressing NCDs through the Food Environment: An Analysis of NCD Framing in Global Policies and Its Relevance for the African Context. Int J Environ Res Public Health 2021; 18:ijerph182111246. [PMID: 34769763 PMCID: PMC8582825 DOI: 10.3390/ijerph182111246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/19/2021] [Accepted: 10/20/2021] [Indexed: 11/16/2022]
Abstract
Noncommunicable diseases contribute the greatest to global mortality. Unhealthy diet-a prominent risk factor-is intricately linked to urban built and food environments and requires intersectoral efforts to address. Framings of the noncommunicable disease problem and proposed solutions within global and African regional diet-related policy documents can reveal how amenable the policy landscape is for supporting intersectoral action for health in low-income to middle-income countries. This study applied a document analysis approach to undertake policy analysis on global and African regional policies related to noncommunicable disease and diet. A total of 62 global and 29 African regional policy documents were analysed. Three problem frames relating to noncommunicable disease and diet were identified at the global and regional level, namely evidence-based, development, and socioeconomic frames. Health promotion, intersectoral and multisectoral action, and evidence-based monitoring and assessment underpinned proposed interventions to improve education and awareness, support structural changes, and improve disease surveillance and monitoring. African policies insufficiently considered associations between food security and noncommunicable disease. In order to effectively address the noncommunicable disease burden, a paradigm shift from 'health for development' to 'development for health' is required across non-health sectors. Noncommunicable disease considerations should be included within African food security agendas, using malnutrition as a possible intermediary concept to motivate intersectoral action to improve access to nutritious food in African low-income to middle-income countries.
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Affiliation(s)
- Amy Weimann
- Research Initiative for Cities Health and Equity (RICHE), Division of Public Health Medicine, School of Public Health and Family Medicine, University of Cape Town, Cape Town 7925, South Africa; (T.M.); (T.O.)
- African Centre for Cities, University of Cape Town, Cape Town 7701, South Africa
- Correspondence:
| | - Maylene Shung-King
- School of Public Health and Family Medicine, University of Cape Town, Cape Town 7925, South Africa; (M.S.-K.); (N.M.)
| | - Nicole McCreedy
- School of Public Health and Family Medicine, University of Cape Town, Cape Town 7925, South Africa; (M.S.-K.); (N.M.)
| | - Lambed Tatah
- Health of Populations in Transition Research Group (HoPiT), University of Yaoundé I, Yaoundé 8046, Cameroon; (L.T.); (C.M.-T.)
- Global Diet and Physical Activity Research Group, Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge CB2 0QQ, UK
| | - Clarisse Mapa-Tassou
- Health of Populations in Transition Research Group (HoPiT), University of Yaoundé I, Yaoundé 8046, Cameroon; (L.T.); (C.M.-T.)
| | - Trish Muzenda
- Research Initiative for Cities Health and Equity (RICHE), Division of Public Health Medicine, School of Public Health and Family Medicine, University of Cape Town, Cape Town 7925, South Africa; (T.M.); (T.O.)
| | - Ishtar Govia
- Caribbean Institute for Health Research, The University of the West Indies, Mona Kingston 7, Jamaica;
| | - Vincent Were
- Center for Global Health Research, Kenya Medical Research Institute (KEMRI), P.O. Box 1578, Kisumu 40100, Kenya;
| | - Tolu Oni
- Research Initiative for Cities Health and Equity (RICHE), Division of Public Health Medicine, School of Public Health and Family Medicine, University of Cape Town, Cape Town 7925, South Africa; (T.M.); (T.O.)
- Global Diet and Physical Activity Research Group, Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge CB2 0QQ, UK
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Windon MJ, Faniriko MBA, Bogale M, Acha E, Koch W. Otolaryngology burden of disease and surgical case triage in resource-limited settings: An example from Cameroon. Laryngoscope Investig Otolaryngol 2021; 6:177-182. [PMID: 33869748 PMCID: PMC8035949 DOI: 10.1002/lio2.522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 12/26/2020] [Accepted: 12/29/2020] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES Otolaryngology services worldwide faced an unprecedented demand for case triage during the SARS-CoV-2 pandemic. We propose and apply a novel case-leveling schema in a resource-limited setting. Describing the surgical burden of otolaryngologic disease in this setting may critically inform resource planning to address global surgical disparities. METHODS This is a retrospective study of otolaryngology cases performed over a 28-month period (1/2016-4/2018) at a hospital in rural Cameroon. Case details were collated and categorized as a surrogate measure of otolaryngologic disease in resource-limited settings. A case-levelling schema based on temporal urgency and anticipated impact on health was proposed and applied. RESULTS 1277 cases took place during the study. The largest proportion of cases were head and neck (517, 40%), followed by pediatrics (316, 25%). A four-tiered leveling system was generated: level 1 cases were immediately life-saving; level 2 cases were expected to result in a significant return to functions of daily living, or would prevent future death from cancer; level 3 cases aimed to significantly improve quality of life; level 4 cases were purely elective. Upon application of the schema, most cases were deemed to be level 2 (661, 52%). CONCLUSION We use our experience in a resource-limited setting to generate and apply a novel schema to be used for otolaryngology case triage in services facing unprecedented states of emergency such as the SARS-CoV-2 pandemic. This is the first study describing the surgical otolaryngologic disease burden in a resource-limited setting, data which may be used for future resource allocation. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- Melina J. Windon
- Department of Otolaryngology‐Head and Neck SurgeryJohns Hopkins UniversityBaltimoreMarylandUSA
| | | | - Mesele Bogale
- Department of SurgeryAdama Hospital Medical CollegeAdamaEthiopia
| | - Everistus Acha
- Department of Ear, Nose, and Throat SurgeryMbingo Baptist HospitalMbingoCameroon
| | - Wayne Koch
- Department of Otolaryngology‐Head and Neck SurgeryJohns Hopkins UniversityBaltimoreMarylandUSA
- Department of Ear, Nose, and Throat SurgeryMbingo Baptist HospitalMbingoCameroon
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Abstract
Advancing evidence-based policy change is a leadership challenge that nurses should embrace. Key tips to ensure that evidence-based policy changes are successful at the individual, community, and population levels are offered to help nurses through the change process. The public trust in the nursing profession is a leverage point that should be used to advance the use of evidence, expedite change, and improve health for students and across communities.
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Affiliation(s)
- Teresa Garrett
- Assistant Professor, University of Utah College of Nursing, Salt Lake City, UT
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Veale EL, Stewart AJ, Mathie A, Lall SK, Rees-Roberts M, Savickas V, Bhamra SK, Corlett SA. Pharmacists detecting atrial fibrillation (PDAF) in primary care during the influenza vaccination season: a multisite, cross-sectional screening protocol. BMJ Open 2018; 8:e021121. [PMID: 29540425 PMCID: PMC5857694 DOI: 10.1136/bmjopen-2017-021121] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Atrial fibrillation (AF) affects >6% of people aged 65 years or older. Left undetected and untreated, patients may develop significant cardiovascular complications and have a fivefold increased risk of suffering a stroke. For 40% of all sufferers, AF can be asymptomatic. Every year in the UK, £2.2 billion is spent on AF-related strokes, so there is an urgent need to improve early detection of AF. This study aims to determine the feasibility of using trained clinical pharmacists based in general practices, to screen for AF, using pulse palpation and a single-lead ECG device on participants aged 65 years or older, attending influenza vaccination clinics. METHODS AND ANALYSIS Seven clinical pharmacists will be trained by a cardiologist to pulse palpate and record single-lead ECGs using the AliveCor Kardia Mobile device. Quantitative analysis will assess the accuracy and ability of the clinical pharmacist to identify pulse irregularities using pulse palpation and to record and interpret a single-lead ECG. The level of agreement of pulse irregularities detected by pulse palpation will be compared with those detected by the single-lead ECG device, as will the level of agreement between the cardiologist and the device's interpretation of the ECG. The proportion of people identified with AF (confirmed by the cardiologist) will be determined. Additional demographic data will be obtained from all participants through a questionnaire. Qualitative data will be captured from the participants, from the clinical pharmacists and from the general practitioners and practice staff to determine their views on this method of AF screening. We aim to recruit 600 participants across general practices within Kent. ETHICS AND DISSEMINATION This protocol was approved by the London-Riverside Research Ethics committee. The findings of this study will be disseminated through forums including, but not limited to, peer-reviewed journals, national and international conferences.
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Affiliation(s)
- Emma L Veale
- Medway School of Pharmacy, University of Kent and University of Greenwich, Chatham Maritime, Kent, United Kingdom
| | | | - Alistair Mathie
- Medway School of Pharmacy, University of Kent and University of Greenwich, Chatham Maritime, Kent, United Kingdom
| | | | | | - Vilius Savickas
- Medway School of Pharmacy, University of Kent and University of Greenwich, Chatham Maritime, Kent, United Kingdom
| | - Sukvinder K Bhamra
- Medway School of Pharmacy, University of Kent and University of Greenwich, Chatham Maritime, Kent, United Kingdom
| | - Sarah A Corlett
- Medway School of Pharmacy, University of Kent and University of Greenwich, Chatham Maritime, Kent, United Kingdom
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Frankel BA, Bishop TF. A Cross-Sectional Assessment of the Quality of Physician Quality Reporting System Measures. J Gen Intern Med 2016; 31:840-5. [PMID: 27197975 PMCID: PMC4945566 DOI: 10.1007/s11606-016-3693-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 03/21/2016] [Accepted: 03/22/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Starting in 2015, the Center for Medicare and Medicaid Services (CMS) requires all Medicare providers to report quality measures through Physician Quality Reporting System (PQRS) or incur a 1.5 % financial penalty. Research indicates that physicians believe this reporting does not lead to high quality care; however, little research has examined what PQRS actually measures, which is reflective of the physicians and patient disease populations being assessed. OBJECTIVES (1) Identify the proportion of measures that apply to different medical specialties, types of quality measurement, and National Quality Strategy (NQS) priorities. (2) Identify how different specialties are required to measure quality and NQS priorities. (3) Compare the 2011 and 2015 measures. DESIGN AND MAIN MEASURES This was a categorical qualitative analysis of 2011 and 2015 PQRS measures. One hundred and ninety-eight and 254 individual measures, respectively, were analyzed by three domains: medical specialty measured, type of measure, and NQS priority category. KEY RESULTS Between 2011 and 2015, the type of measures changed significantly, with fewer processes (85.4 % vs. 66.5 %, p < 0.001) and more outcomes (12.6 % vs. 29.1 %, p < 0.001). The measures showed no significant specialty or NQS category differences. For subcategories within each specialty in 2015, differences in measure type were statistically significant: surgery had the highest percentage of outcomes (61.1 %) compared to 21.7 % of internal medicine and 5.9 % of obstetrics/gynecology. For NQS categories, internal medicine had the highest percentage of effective clinical care measures (68.5 %), compared to 22.2 % in surgery. Surgery had the highest percentage of patient safety (31.9 %) and communication and care coordination measures (27.8 %) compared with internal medicine (5.4 % and 6.5 %). CONCLUSIONS Our study shows that PQRS measures include many medical specialties and significantly more outcomes in recent years, particularly for surgery. PQRS still lacks sufficient measures for half of NQS priorities and sufficient outcomes to assess internal medicine and obstetrics/gynecology. CMS must continue to improve PQRS measures to better assess and encourage high-quality care for all Americans.
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Affiliation(s)
- Brittney A Frankel
- Weill Cornell Medicine, 402 E. 67th St., Room LA-215, New York, NY, 10021, USA.
| | - Tara F Bishop
- Division of Health Policy and Economics, Department of Healthcare Policy and Research, Weill Cornell Medicine, New York, NY, USA
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York, NY, USA
- Department of Public Health, Weill Cornell Medicine, 402 E. 67th St., Room LA-215, New York, NY, 10021, USA
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