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Khudair M, Marcuzzi A, Ng K, Tempest GD, Bartoš F, Peric R, Maier M, Beccia F, Boccia S, Brandes M, Cardon G, Carlin A, Castagna C, Chaabene H, Chalkley A, Ciaccioni S, Cieślińska-Świder J, Čingienė V, Cortis C, Corvino C, de Geus EJ, Di Baldassarre A, Di Credico A, Drid P, Fernández Tarazaga RM, Gallè F, García Sánchez E, Gebremariam M, Ghinassi B, Goudas M, Hayes G, Honorio S, Izzicupo P, Jahre H, Jelsma J, Juric P, Kolovelonis A, Kongsvold A, Kouidi E, Mansergh F, Masanovic B, Mekonnen T, Mork PJ, Murphy M, O'Hara K, Torun AO, Palumbo F, Popovic S, Prieske O, Puharic Z, Ribeiro JC, Rumbold PLS, Sandu P, Sorić M, Stavnsbo M, Syrmpas I, van der Ploeg HP, Van Hoye A, Vilela S, Woods C, Wunsch K, Caprinica L, MacDonncha C, Ling FCM. DE-PASS Best Evidence Statement (BESt): modifiable determinants of physical activity and sedentary behaviour in children and adolescents aged 5-19 years-a protocol for systematic review and meta-analysis. BMJ Open 2022; 12:e059202. [PMID: 36127107 PMCID: PMC9490573 DOI: 10.1136/bmjopen-2021-059202] [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] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Physical activity among children and adolescents remains insufficient, despite the substantial efforts made by researchers and policymakers. Identifying and furthering our understanding of potential modifiable determinants of physical activity behaviour (PAB) and sedentary behaviour (SB) is crucial for the development of interventions that promote a shift from SB to PAB. The current protocol details the process through which a series of systematic literature reviews and meta-analyses (MAs) will be conducted to produce a best-evidence statement (BESt) and inform policymakers. The overall aim is to identify modifiable determinants that are associated with changes in PAB and SB in children and adolescents (aged 5-19 years) and to quantify their effect on, or association with, PAB/SB. METHODS AND ANALYSIS A search will be performed in MEDLINE, SportDiscus, Web of Science, PsychINFO and Cochrane Central Register of Controlled Trials. Randomised controlled trials (RCTs) and controlled trials (CTs) that investigate the effect of interventions on PAB/SB and longitudinal studies that investigate the associations between modifiable determinants and PAB/SB at multiple time points will be sought. Risk of bias assessments will be performed using adapted versions of Cochrane's RoB V.2.0 and ROBINS-I tools for RCTs and CTs, respectively, and an adapted version of the National Institute of Health's tool for longitudinal studies. Data will be synthesised narratively and, where possible, MAs will be performed using frequentist and Bayesian statistics. Modifiable determinants will be discussed considering the settings in which they were investigated and the PAB/SB measurement methods used. ETHICS AND DISSEMINATION No ethical approval is needed as no primary data will be collected. The findings will be disseminated in peer-reviewed publications and academic conferences where possible. The BESt will also be shared with policy makers within the DE-PASS consortium in the first instance. SYSTEMATIC REVIEW REGISTRATION CRD42021282874.
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Affiliation(s)
- Mohammed Khudair
- Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Anna Marcuzzi
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Kwok Ng
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
| | - Gavin Daniel Tempest
- Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - František Bartoš
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Ratko Peric
- Exercise Physiology Laboratory, OrthoSport Banja Luka, Banja Luka, Bosnia and Herzegovina
| | | | - Flavia Beccia
- Department of Psychology, Università Cattolica del Sacro Cuore, Milano, Italy
| | - Stefania Boccia
- Department of Psychology, Università Cattolica del Sacro Cuore, Milano, Italy
| | - Mirko Brandes
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology, Bremen, Germany
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Angela Carlin
- Centre for Exercise Medicine, Physical Activity and Health, Sport and Exercise Sciences Research Institute, University of Ulster, Jordanstown Campus, UK
| | - Carolina Castagna
- Department of Psychology, Università Cattolica del Sacro Cuore, Milano, Italy
| | - Helmi Chaabene
- Department of Sports and Health Sciences, Faculty of Human Sciences, University of Potsdam, Potsdam, Germany
- High Institute of Sports and Physical Education of Kef, University of Jendouba, Jendouba, Tunisia
| | - Anna Chalkley
- Faculty of Health Studies, University of Bradford, Bradford, UK
- Center for Physically Active Learning, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Norway, Bergen, Norway
| | - Simone Ciaccioni
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Joanna Cieślińska-Świder
- Department of Physiotherapy, The Jerzy Kukuczka Academy of Physical Education in Katowice, Katowice, Poland
| | - Vilma Čingienė
- Institute of Leadership and Strategic Management, Faculty of Public Governance and Business, Mykolas Romeris University, Vilnius, Lithuania
| | - Cristina Cortis
- Department of Human Sciences, Society and Health, University of Cassino and Lazio Meridionale, Cassino, Italy
| | - Chiara Corvino
- Department of Psychology, Università Cattolica del Sacro Cuore, Milano, Italy
| | - Eco Jc de Geus
- Department of Biological Psychology, Vrije Universiteit, Amsterdam, Netherlands
- Department of Public and Occupational Health, Amsterdam Public Health Institute, Amsterdam University Medical Centres, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Angela Di Baldassarre
- Department of Medicine and Aging Sciences, Gabriele d'Annunzio University of Chieti and Pescara, Chieti, Italy
| | - Andrea Di Credico
- Department of Medicine and Aging Sciences, Gabriele d'Annunzio University of Chieti and Pescara, Chieti, Italy
| | - Patrik Drid
- Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
| | | | - Francesca Gallè
- Department of Movement Sciences and Wellbeing, University of Naples-Parthenope, Napoli, Italy
| | - Esther García Sánchez
- Fundación para la Formación e Investigación Sanitarias de la Región de Murcia, Murcia, Spain
| | - Mekdes Gebremariam
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Barbara Ghinassi
- Department of Medicine and Aging Sciences, Gabriele d'Annunzio University of Chieti and Pescara, Chieti, Italy
| | - Marios Goudas
- Department of Physical Education and Sport Science, University of Thessaly, Volos, Greece
| | - Grainne Hayes
- Department of Sport and Early Childhood Studies, Technological University of the Shannon: Midlands Midwest, Moylish Campus, Limerick, Ireland
- Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Samuel Honorio
- Sports, Health and Exercise Research Unit (SHERU), Polytechnic Institute of Castelo Branco, Castelo Branco, Portugal
| | - Pascal Izzicupo
- Department of Medicine and Aging Sciences, Gabriele d'Annunzio University of Chieti and Pescara, Chieti, Italy
| | - Henriette Jahre
- Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
| | - Judith Jelsma
- Department of Public and Occupational Health, Amsterdam Public Health Institute, Amsterdam University Medical Centres, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Petra Juric
- Faculty of Kinesiology, University of Zagreb, Zagreb, Croatia
| | - Athanasios Kolovelonis
- Department of Physical Education and Sport Science, University of Thessaly, Volos, Greece
| | - Atle Kongsvold
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Evangelia Kouidi
- Laboratory of Sports Medicne, Department of Physical 95 Education and Sports Science, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Fiona Mansergh
- Health and Wellbeing Programme, Department of Health, Dublin, Ireland
| | - Bojan Masanovic
- Faculty for Sport and Physical Education, University of Montenegro, Podgorica, Montenegro
- Montenegrin Sports Academy, Podgorica, Montenegro
| | - Teferi Mekonnen
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Paul Jarle Mork
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Marie Murphy
- Doctoral College, Ulster University, Newtownabbey, UK
| | - Kelly O'Hara
- Sport Science Department, University of Beira Interior, Covilha, Portugal
| | - Ayse Ozbil Torun
- Department of Architecture and Built Environment, Northumbria University, Newcastle upon Tyne, UK
| | - Federico Palumbo
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Stevo Popovic
- Faculty for Sport and Physical Education, University of Montenegro, Podgorica, Montenegro
- Western Balkan Sport Innovation Lab, Podgorica, Montenegro
| | - Olaf Prieske
- University of Applied Sciences for Sport and Management Potsdam, Potsdam, Germany
| | - Zrinka Puharic
- University of Applied Sciences Bjelovar, Bjelovar, Croatia
- Faculty of dental medicine and health, Osijek, Croatia
| | | | - Penny Louise Sheena Rumbold
- Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Petru Sandu
- National Institute of Public Health in Romania, Bucharest, Romania
| | - Maroje Sorić
- Faculty of Kinesiology, University of Zagreb, Zagreb, Croatia
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | - Mette Stavnsbo
- Department of Sport Science and Physical Education, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Ioannis Syrmpas
- Department of Physical Education and Sport Science, University of Thessaly, Volos, Greece
| | - Hidde P van der Ploeg
- Department of Public and Occupational Health, Amsterdam Public Health Institute, Amsterdam University Medical Centres, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Aurélie Van Hoye
- Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Sofia Vilela
- EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
| | - Catherine Woods
- Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Kathrin Wunsch
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Laura Caprinica
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Ciaran MacDonncha
- Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Fiona Chun Man Ling
- Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
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Sandu P, Chereches RM, Papiu A, Gelius P, Abu-Omar K, Takeda N, Oida Y, Onatsu T, Tuunanen K. P01-01 Assessment of local governments’ involvement in sport and physical activity policy promotion – LoGoPAS project. Eur J Public Health 2022. [PMCID: PMC9435625 DOI: 10.1093/eurpub/ckac095.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The involvement of local governments in physical activity (PA) promotion represents a key factor to drive change at grassroots level, based on identified specific needs and solutions, tailored to each local context (needs, resources, etc.). The aim of LoGoPAS, Erasmus + Sport co-financed project (2020-2021), is to assess, promote and support local governments' involvement in PA (policy) promotion.
Methods
A mixed methods approach has been put in place (including thematic document analysis of grey literature, semi-structured stakeholder interviews, group consensus methodologies) to explore and analyze the current legally binding and voluntary activities of local goverments in PA (policy) promotion. The study is being conducted at local level in Finland, France, Germany, Japan and Romania. Already validated instruments to evaluate local PA policy, such as L-PAT (Local Policy Audit Tool), Capla SANTE or TEAviisari will be used to harmonize data collected from each partner country, at local level.
Results
Locally collected data from partner countries reveal significant differences in the organization and delivery of PA related policies with more regulations and structures in the western countries (e.g. Germany or Finland) and more opportunistic and mixed approach (related to the purpose of the PA related projects) in Romania. Also, the currently available instruments for evaluation of local PA policies (those used for data harmonization in our project - see methods section) can benefit from additions in order to capture the complexities of the engagement of local governments in PA promotion.
Conclusion
Although the roles of local governments in PA promotion has been widely acknowledged (e.g. by WHO or the European Comission), there are currently few hands-on instruments for policy-makers and other actors at local level to advance PA promotion agenda and activities. Approaches tailored to local contexts may help engage local governments, while international networking may foster the exchange of experiences and help optimize interventions.
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Affiliation(s)
- Petru Sandu
- Public Health, University Babes-Bolyai , Cluj-Napoca, Romania
- Public Health, University of Medicine and Pharmacy Iuliu Hatieganu , Cluj-Napoca, Romania
| | | | - Antonia Papiu
- Public Health, University Babes-Bolyai , Cluj-Napoca, Romania
| | - Peter Gelius
- Department Sportwissenschaft und Sport, University of Erlangen-Nuremberg (Friedrich-Alexander-Universität Erlangen-Nürnberg) , Erlangen, Germany
| | - Karim Abu-Omar
- Department Sportwissenschaft und Sport, University of Erlangen-Nuremberg (Friedrich-Alexander-Universität Erlangen-Nürnberg) , Erlangen, Germany
| | - Noriko Takeda
- Physical Activity and Health Promotion Studies, Center for Promotion of Higher Education, Kogakuin University , Tokyo, Japan
| | - Yukio Oida
- School of Life Science and Technology, Chukyo University , Nagoya, Japan
| | - Tanja Onatsu
- Fit for life program, LIKES – Research Centre for Physical Activity and Health , Jyväskylä, Finland
| | - Katariina Tuunanen
- Fit for life program, LIKES – Research Centre for Physical Activity and Health , Jyväskylä, Finland
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Sandu P, Chereches RM, Covaliu B, Mocean F. P07-05 Romanian GPs knowledge, attitudes and behavior related to physical activity on prescription. Eur J Public Health 2022. [PMCID: PMC9421841 DOI: 10.1093/eurpub/ckac095.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Background Physical activity on prescription (PAP) - like schemes, have been documented to encourage sustained increases in the levels of physical activity of populations. Although proven effective, these PA promotion schemes have only been implemented high-income countries (eg. Northern/Western Europe). The aim of this study was to explore the opportunity to test PAP (related) schemes in Romania, a developing country. Methods In the timeframe May-June 2018 we conducted a transversal study, using an online questionnaire adressed at general practitioners (GPs) in the county of Cluj. The instrument had 4 sections: 1. attitudes/opinions regarding role of GP in PA promotion; 2. GPs (current) behavior related to PA promotion in their practice; 3. Knowledge regarding the recommended PA levels for children, youth and adults; and 4. Socio-professional information. Results A number of 84 GPs (out of 350) have completed the questionnaire, for a response rate of aproximatelly 25%, the sample being representative of the population - considering gender distribution and workplace location, urban/rural. The majority of the GPs (78%) stated that their role in PA promotion is limited to broadly disscussing this topic with their patients. The more consultations they have (less time available), the more they are prone to promote PA in their practice (contrary to current literature). Only 1 in 5 GPs have reported the correct number of minutes of PA for both adults and children & youth. The lower measured knowledge, the higher were the self-assessed levels of knowledge regarding PA benefits they report. Conclusion Romanian GPs knowledge, attitudes and behavior related to PA prescription/recommendation are strongly influenced by lack of proper information, incentives and/or enforcement. Before attempting to introduce PAP in Romania, more education, awareness and financial/structural resources should be allocated to improve acceptability and feasibility of such PA promotion scheme.
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Affiliation(s)
- Petru Sandu
- Public Health, University Babes-Bolyai , Cluj-Napoca, Romania
- Public Health, University of Medicine and Pharmacy Iuliu Hatieganu , Cluj-Napoca, Romania
| | | | - Bogdan Covaliu
- Public Health, University of Medicine and Pharmacy Iuliu Hatieganu , Cluj-Napoca, Romania
| | - Floarea Mocean
- Public Health, University of Medicine and Pharmacy Iuliu Hatieganu , Cluj-Napoca, Romania
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Sandu P, Rajka D, Pintea A, Moldovan K, Pintea S, L Pop T. FACTORS THAT CAN INFLUENCE IN ROMANIA THE PARENTS’ DECISION REGARDING THE ANTI COVID-19 VACCINATION OF CHILDREN AND ADOLESCENTS AGED 12-15. JSUM 2021. [DOI: 10.51546/jsum.2021.8204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Oltean O, Coman MA, Sandu P, Essafi Kallel K, Ben Rejeb M, Ghorbel F, Eklund Karlsson L, Chereches RM, Zrig A, Plančíková D. Stakeholder analysis in a policy game process in Tunisia. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
This paper discusses the policy game methodology and design that will be used in a simulation that aims to assess and understand the public health policy making in Tunisia. The policy game aims to analyzes the interactions, alliances and networks formed by the institutions and stakeholders during a policy game intervention that will be organized in Tunis, in which policy makers, civil servants, researchers and practitioners will simulate the use of evidence in real life policy making. The simulation has been realized within the Erasmus+ CONFIDE project focused on enhancing transnational partnerships and building capacity to inform evidence-based policies in Tunisia. This capacity building project and policy game is built on the collaboration of four Tunisian universities, from Tunis, Sfax, Sousse and Monastir, and three universities from the European Union, from Romania, Denmark and Slovakia. The policy game will focus on the drafting and implementation of a national strategy for fighting the increase of drug consumption among the Tunisian youth, a phenomenon which is rather new in Tunisia and spreading rapidly. The policy game will be followed by an analysis aiming to explore the impact of the intervention in enhancing cross-sector collaboration and the use of local stakeholder network regarding drug policy making. The preliminary results showed that the stakeholders approached this problem in a collaborative way and were willing to up-take evidence-based measures in the creation of a national strategy to fight drug consumption. This exercise has also shown that the policy game can be an effective tool in enhancing the use of scientific arguments in policy making and encourage stakeholders to approach policy making in a cross-sector way.
Key messages
Policy game can be an effective tool in enhancing the use of scientific arguments in policy making and encourage stakeholders to approach policy making in an interdisciplinary way. Stakeholders approached this problem in a collaborative way and were willing to up-take evidence-based measures in the creation of a national strategy to fight drug consumption.
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Affiliation(s)
- O Oltean
- School of Public Health, Babes-Bolyai University Cluj-Napoca, Cluj-Napoca, Romania
| | - M A Coman
- School of Public Health, Babes-Bolyai University Cluj-Napoca, Cluj-Napoca, Romania
| | - P Sandu
- School of Public Health, Babes-Bolyai University Cluj-Napoca, Cluj-Napoca, Romania
| | - K Essafi Kallel
- Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia
| | - M Ben Rejeb
- Faculty of Medicine, University of Sousse, Sousse, Tunisia
| | - F Ghorbel
- Department of International Cooperation, University of Sfax, Sfax, Tunisia
| | - L Eklund Karlsson
- Faculty of Health Sciences, University of Southern Denmark, Esbjerg, Denmark
| | - R M Chereches
- School of Public Health, Babes-Bolyai University Cluj-Napoca, Cluj-Napoca, Romania
| | - A Zrig
- Faculty of Medicine, University of Monastir, Monastir, Tunisia
| | - D Plančíková
- Faculty of Health Sciences and Social Work, Trnava University, Trnava, Slovakia
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Kovacs VA, Sarkadi-Nagy E, Sandu P, Duleva V, Spinelli A, Kaposvari C, Hassapidou M, Janssen D, Grochowska-Niedworok E, Messing S, Martos E. Good practice criteria for childhood obesity prevention in kindergartens and schools-elaboration, content and use. Eur J Public Health 2018; 28:1029-1034. [PMID: 29986012 DOI: 10.1093/eurpub/cky129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background In accordance with the policy actions that address childhood overweight and obesity at European level and as a contribution to the EU Action Plan on Childhood Obesity 2014-20, a Joint Action on Nutrition and Physical Activity (JANPA) was established. As part of JANPA work package 6, an evaluation framework to identify good practices, targeting childhood obesity prevention in kindergartens and schools, was developed. This article describes the WP 6 JANPA framework of good practice criteria and its development, compares it to other frameworks and discusses its potential for future use. Methods Based on the analysis of scientific literature, a set of 47 potential good practice criteria was drafted, that was then revised and complemented through a series of online Delphi consultations. Results A final list of 48 good practice criteria (9 of which were rated as core criteria) was developed and grouped into three categories: intervention characteristics (n = 17), implementation (n = 17) and monitoring and evaluation (n = 14). Conclusion The identified JANPA framework of good practice criteria complements the existing frameworks by focussing on kindergarten- and school-based initiatives and provides guidance for evaluators, programme planners and decision makers bearing in mind that a one-size-fits-all approach is inadequate. To ensure the effectiveness of future practices, programme planners should endeavour to meet at least the nine JANPA core criteria.
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Affiliation(s)
| | | | - Petru Sandu
- University Babes-Bolyai, Faculty of Political, Administrative and Communication Sciences, Department of Public Health, Cluj-Napoca, Romania
| | - Vesselka Duleva
- National Centre of Public Health and Analyses, Sofia, Bulgaria
| | | | - Csilla Kaposvari
- National Institute of Pharmacy and Nutrition, Budapest, Hungary.,University of Pécs, Doctoral School, Faculty of Heath Sciences, Pécs, Hungary
| | - Maria Hassapidou
- Alexander Technological Educational Institute of Thessaloniki, Thessaloniki, Greece
| | | | | | - Sven Messing
- Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Eva Martos
- University of Physical Education, Budapest, Hungary
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Tudisca V, Valente A, Castellani T, Stahl T, Sandu P, Dulf D, Spitters H, Van de Goor I, Radl-Karimi C, Syed MA, Loncarevic N, Lau CJ, Roelofs S, Bertram M, Edwards N, Aro AR. Development of measurable indicators to enhance public health evidence-informed policy-making. Health Res Policy Syst 2018; 16:47. [PMID: 29855328 PMCID: PMC5984390 DOI: 10.1186/s12961-018-0323-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [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] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 05/04/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Ensuring health policies are informed by evidence still remains a challenge despite efforts devoted to this aim. Several tools and approaches aimed at fostering evidence-informed policy-making (EIPM) have been developed, yet there is a lack of availability of indicators specifically devoted to assess and support EIPM. The present study aims to overcome this by building a set of measurable indicators for EIPM intended to infer if and to what extent health-related policies are, or are expected to be, evidence-informed for the purposes of policy planning as well as formative and summative evaluations. METHODS The indicators for EIPM were developed and validated at international level by means of a two-round internet-based Delphi study conducted within the European project 'REsearch into POlicy to enhance Physical Activity' (REPOPA). A total of 82 researchers and policy-makers from the six European countries (Denmark, Finland, Italy, the Netherlands, Romania, the United Kingdom) involved in the project and international organisations were asked to evaluate the relevance and feasibility of an initial set of 23 indicators developed by REPOPA researchers on the basis of literature and knowledge gathered from the previous phases of the project, and to propose new indicators. RESULTS The first Delphi round led to the validation of 14 initial indicators and to the development of 8 additional indicators based on panellists' suggestions; the second round led to the validation of a further 11 indicators, including 6 proposed by panellists, and to the rejection of 6 indicators. A total of 25 indicators were validated, covering EIPM issues related to human resources, documentation, participation and monitoring, and stressing different levels of knowledge exchange and involvement of researchers and other stakeholders in policy development and evaluation. CONCLUSION The study overcame the lack of availability of indicators to assess if and to what extent policies are realised in an evidence-informed manner thanks to the active contribution of researchers and policy-makers. These indicators are intended to become a shared resource usable by policy-makers, researchers and other stakeholders, with a crucial impact on fostering the development of policies informed by evidence.
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Affiliation(s)
| | | | | | - Timo Stahl
- The National Institute for Health and Welfare (THL), Tampere, Finland
| | - Petru Sandu
- Babeș-Bolyai University (BBU), Cluj-Napoca, Romania
| | - Diana Dulf
- Babeș-Bolyai University (BBU), Cluj-Napoca, Romania
| | | | | | - Christina Radl-Karimi
- Unit for Health Promotion Research, University of Southern Denmark (SDU), Odense, Denmark
| | | | - Natasa Loncarevic
- Unit for Health Promotion Research, University of Southern Denmark (SDU), Odense, Denmark
| | - Cathrine Juel Lau
- Center for Clinical Research and Disease Prevention, previously called Research Centre for Prevention and Health (RCPH), Bispebjerg and Frederiksberg Hospital, The Capital Region, Copenhagen, Denmark
| | | | - Maja Bertram
- Unit for Health Promotion Research, University of Southern Denmark (SDU), Odense, Denmark
| | | | - Arja R. Aro
- Unit for Health Promotion Research, University of Southern Denmark (SDU), Odense, Denmark
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Spitters HPEM, van de Goor LAM, Lau CJ, Sandu P, Eklund Karlsson L, Jansen J, van Oers JAM. Learning from games: stakeholders' experiences involved in local health policy. J Public Health (Oxf) 2018. [PMID: 29538724 DOI: 10.1093/pubmed/fdx149] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Since public health problems are complex and the related policies need to address a wide range of sectors, cross-sectoral collaboration is beneficial. One intervention focusing on stimulating collaboration is a 'policy game'. The focus on specific problems facilitates relationships between the stakeholders and stimulates cross-sectoral policymaking. The present study explores stakeholders' learning experiences with respect to the collaboration process in public health policymaking. This was achieved via their game participation, carried out in real-life stakeholder networks in the Netherlands, Denmark and Romania. The policy game (In2Action) was developed and implemented as a 1-day role-play. The data consisted of: (i) observations and evaluation notes during the game and (ii) participant questionnaire after the game. All three countries showed similar results in learning experience during the collaboration processes in local policymaking. Specific learning experiences were related to: (i) the stakeholder network, (ii) interaction and (iii) relationships. The game also increased participant's understanding of group dynamics and need for a coordinator in policymaking. This exploratory study shows that the game provides participants with learning experiences during the collaboration process in policymaking. Experiencing what is needed to establish cross-sectoral collaboration is a first step towards enhancing knowledge exchange and more effective public health policies.
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Affiliation(s)
- H P E M Spitters
- Department of Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, PO Box 90153, 5000 LE Tilburg, the Netherlands
| | - L A M van de Goor
- Department of Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, PO Box 90153, 5000 LE Tilburg, the Netherlands
| | - C Juel Lau
- Research Centre for Prevention and Health, Capital Region of Denmark, Ndr. Ringvej 57, Building 84/85, 2600 Glostrup, Denmark
| | - P Sandu
- Department of Public Health, Faculty of Political, Administrative and Communication Sciences, University Babes-Bolyai, 7 Pandurilor St. Universitas, Room 910, 400376 Cluj-Napoca, Romania
| | - L Eklund Karlsson
- Unit for Health Promotion Research, Institute of Public Health, University of Southern Denmark, Niels Bohr Vej 9, 6700 Esbjerg, Denmark
| | - J Jansen
- Dutch Institute for Healthcare Improvement (CBO), Churchilllaan 11, 3527 GV Utrecht, the Netherlands
| | - J A M van Oers
- Department of Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, PO Box 90153, 5000 LE Tilburg, the Netherlands.,National Institute of Public Health and the Environment (RIVM), PO Box 1, 3720 BA Bilthoven, the Netherlands
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Spitters HPEM, van Oers JAM, Sandu P, Lau CJ, Quanjel M, Dulf D, Chereches R, van de Goor LAM. Developing a policy game intervention to enhance collaboration in public health policymaking in three European countries. BMC Public Health 2017; 17:961. [PMID: 29258483 PMCID: PMC5735538 DOI: 10.1186/s12889-017-4963-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 11/29/2017] [Indexed: 11/13/2022] Open
Affiliation(s)
- H P E M Spitters
- Department of Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, P.O. Box 90153, 5000, LE, Tilburg, The Netherlands.
| | - J A M van Oers
- Department of Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, P.O. Box 90153, 5000, LE, Tilburg, The Netherlands.,National Institute of Public Health and the Environment (RIVM), P.O. Box 1, 3720, BA, Bilthoven, The Netherlands
| | - P Sandu
- Department of Public Health, Faculty of Political, Administrative and Communication Sciences, University Babes-Bolyai, 7 Pandurilor St. Universitas, Room 910, Zip code 400376, Cluj-Napoca, Romania
| | - C J Lau
- Research Centre for Prevention and Health, Centre of Health, The Capital Region of Denmark, Rigshospitalet - Glostrup, Ndr. Ringvej 57, Building 84/85, -2600, Glostrup, DK, Denmark
| | - M Quanjel
- Entrea, Youth Care, Special Needs Education and Research, P.O. Box 6546, 6503, GA, Nijmegen, The Netherlands
| | - D Dulf
- Department of Public Health, Faculty of Political, Administrative and Communication Sciences, University Babes-Bolyai, 7 Pandurilor St. Universitas, Room 910, Zip code 400376, Cluj-Napoca, Romania
| | - R Chereches
- Department of Public Health, Faculty of Political, Administrative and Communication Sciences, University Babes-Bolyai, 7 Pandurilor St. Universitas, Room 910, Zip code 400376, Cluj-Napoca, Romania
| | - L A M van de Goor
- Department of Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, P.O. Box 90153, 5000, LE, Tilburg, The Netherlands
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van de Goor I, Hämäläinen RM, Syed A, Juel Lau C, Sandu P, Spitters H, Eklund Karlsson L, Dulf D, Valente A, Castellani T, Aro AR. Determinants of evidence use in public health policy making: Results from a study across six EU countries. Health Policy 2017; 121:273-281. [PMID: 28139253 PMCID: PMC5754321 DOI: 10.1016/j.healthpol.2017.01.003] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 01/09/2017] [Accepted: 01/10/2017] [Indexed: 11/26/2022]
Abstract
The knowledge-practice gap in public health is widely known. The importance of using different types of evidence for the development of effective health promotion has also been emphasized. Nevertheless, in practice, intervention decisions are often based on perceived short-term opportunities, lacking the most effective approaches, thus limiting the impact of health promotion strategies. This article focuses on facilitators and barriers in the use of evidence in developing health enhancing physical activity policies. Data was collected in 2012 by interviewing 86 key stakeholders from six EU countries (FI, DK, UK, NL, IT, RO) using a common topic guide. Content analysis and concept mapping was used to construct a map of facilitators and barriers. Barriers and facilitators experienced by most stakeholders and policy context in each country are analysed. A lack of locally useful and concrete evidence, evidence on costs, and a lack of joint understanding were specific hindrances. Also users' characteristics and the role media play were identified as factors of influence. Attention for individual and social factors within the policy context might provide the key to enhance more sustainable evidence use. Developing and evaluating tailored approaches impacting on networking, personal relationships, collaboration and evidence coproduction is recommended.
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Affiliation(s)
- Ien van de Goor
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands.
| | - Riitta-Maija Hämäläinen
- Welfare: Equality and Inclusion, National Institute for Health and Welfare, Helsinki, Finland.
| | - Ahmed Syed
- Specialised Services, NHS England, London, UK.
| | - Cathrine Juel Lau
- Prevention and Health Promotion, Research Centre for Prevention and Health, Capital Region of Denmark, Glostrup, Denmark.
| | - Petru Sandu
- Center for Health Policy and Public Health, Department of Public Health, Babes-Bolyai University, Cluj-Napoca, Romania.
| | - Hilde Spitters
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands.
| | - Leena Eklund Karlsson
- Unit for Health Promotion, Institute of Public Health, University of Southern Denmark, Esbjerg, Denmark.
| | - Diana Dulf
- Center for Health Policy and Public Health, Department of Public Health, Babes-Bolyai University, Cluj-Napoca, Romania.
| | - Adriana Valente
- Institute of Researches on Population and Social Policies, National Research Council, Rome, Italy.
| | - Tommaso Castellani
- Institute of Researches on Population and Social Policies, National Research Council, Rome, Italy.
| | - Arja R Aro
- Unit for Health Promotion, Institute of Public Health, University of Southern Denmark, Esbjerg, Denmark.
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Spitters HPEM, Lau CJ, Sandu P, Quanjel M, Dulf D, Glümer C, van Oers HAM, van de Goor IAM. Unravelling networks in local public health policymaking in three European countries - a systems analysis. Health Res Policy Syst 2017; 15:5. [PMID: 28159008 PMCID: PMC5291943 DOI: 10.1186/s12961-016-0168-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Accepted: 12/30/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Facilitating and enhancing interaction between stakeholders involved in the policymaking process to stimulate collaboration and use of evidence, is important to foster the development of effective Health Enhancing Physical Activity (HEPA) policies. Performing an analysis of real-world policymaking processes will help reveal the complexity of a network of stakeholders. Therefore, the main objectives were to unravel the stakeholder network in the policy process by conducting three systems analyses, and to increase insight into the similarities and differences in the policy processes of these European country cases. METHODS A systems analysis of the local HEPA policymaking process was performed in three European countries involved in the 'REsearch into POlicy to enhance Physical Activity' (REPOPA) project, resulting in three schematic models showing the main stakeholders and their relationships. The models were used to compare the systems, focusing on implications with respect to collaboration and use of evidence in local HEPA policymaking. Policy documents and relevant webpages were examined and main stakeholders were interviewed. RESULTS The systems analysis in each country identified the main stakeholders involved and their position and relations in the policymaking process. The Netherlands and Denmark were the most similar and both differed most from Romania, especially at the level of accountability of the local public authorities for local HEPA policymaking. The categories of driving forces underlying the relations between stakeholders were formal relations, informal interaction and knowledge exchange. CONCLUSIONS A systems analysis providing detailed descriptions of positions and relations in the stakeholder network in local level HEPA policymaking is rather unique in this area. The analyses are useful when a need arises for increased interaction, collaboration and use of knowledge between stakeholders in the local HEPA network, as they provide an overview of the stakeholders involved and their mutual relations. This information can be an important starting point to enhance the uptake of evidence and build more effective public health policies.
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Affiliation(s)
- Hilde P. E. M. Spitters
- Department of Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, P.O. Box 90153, 5000 LE, Tilburg, The Netherlands
| | - Cathrine J. Lau
- Research Centre for Prevention and Health, Capital Region of Denmark, Ndr, Ringvej 57, Afsnit 84/85, 2600 Glostrup, Denmark
| | - Petru Sandu
- Department of Public Health, College of Political, Administrative and Communication Sciences, Babes-Bolyai University, 7 Pandurilor St. Universitas, Room 910, 400376 Cluj-Napoca, Romania
| | - Marcel Quanjel
- Youth Care, Special Needs Education and Research, P.O. Box 6546, 6503 GA, Nijmegen, The Netherlands
| | - Diana Dulf
- Department of Public Health, College of Political, Administrative and Communication Sciences, Babes-Bolyai University, 7 Pandurilor St. Universitas, Room 910, 400376 Cluj-Napoca, Romania
| | - Charlotte Glümer
- Research Centre for Prevention and Health, Capital Region of Denmark, Ndr, Ringvej 57, Afsnit 84/85, 2600 Glostrup, Denmark
- Department of Health Sciences and Technology, Aalborg University, Frederik Bayers vej 7D2, DK-9220 Aalborg, Denmark
| | - Hans A. M. van Oers
- Department of Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, P.O. Box 90153, 5000 LE, Tilburg, The Netherlands
- National Institute of Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA Bilthoven, The Netherlands
| | - Ien A. M. van de Goor
- Department of Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, P.O. Box 90153, 5000 LE, Tilburg, The Netherlands
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Daniel P, Ashton D, Sheppard C, Eletu S, Sandu P, Litt D, Fry N, Lim WS. S105 Pneumococcal serotypes implicated in adult pneumococcal pneumonia, 9 years following the introduction of the infant vaccine programme in the uk. Thorax 2016. [DOI: 10.1136/thoraxjnl-2016-209333.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Hämäläinen RM, Sandu P, Syed AM, Jakobsen MW. An evaluation of equity and equality in physical activity policies in four European countries. Int J Equity Health 2016; 15:191. [PMID: 27881131 PMCID: PMC5122031 DOI: 10.1186/s12939-016-0481-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 11/15/2016] [Indexed: 11/30/2022] Open
Abstract
Background There is strong research evidence on the importance of health equity and equality for wellbeing in societies. As chronic non-communicable diseases are widespread, the positive impact of physical activity (PA) on health has gained importance. However, PA at the population level is far from optimal. PA depends not only on individual factors, but also on policies for PA in sport, health, transport, education and other sectors, on social and cultural factors, and on the environment. Addressing health inequalities and inequities in PA promotion policies could benefit from policy development processes based on partnership and collaboration between various sectors, researchers, practitioners and policy makers (= cross-sectoral, evidence-informed policy making). The objective of this article is to describe how equity and equality was addressed in PA policies in four EU member states (Denmark, Finland, Romania and England), who were partners in the REPOPA project (www.repopa.eu, EC/FP7/Health Research/GA 281532). Methods Content analysis of 14 PA policies and 61 interviews were undertaken between 2012 and 2013 with stakeholders involved in developing PA policies in partner countries. Results Even though specific population subgroups were mentioned in the policy documents analysed, they were not necessarily defined as vulnerable populations nor was there a mention of additional emphasis to support such groups from being marginalised by the policy due to inequity or inequality. There were no clear objectives and activities in the analysed policies suggesting commitment of additional resources in favour of such groups. Addressing equity and equality were often not included in the core aims of the policies analysed; these aspects were mentioned in the background of the policy documents analysed, without being explicitly stated in the aims or activities of the policies. In order to tackle health inequities and inequalities and their consequences on the health status of different population subgroups, a more instrumental approach to health equality and equity in PA promotion policies is needed. Policies should include aims to address health inequalities and inequities as fundamental objectives and also consider opportunities to allocate resources to reduce them for identified groups in this regard: the socially excluded, the remote, and the poor. Conclusions The inclusion of aspects related to health inequalities and inequities in PA policies needs monitoring, evaluation and transparent accountability if we are to see the best gains in health of socially disadvantaged group. To tackle health inequities and inequalities governance structures need to take into consideration proportionate universalism. Thus, to achieve change in the social determinants of health, policy makers should pay attention to PA and proportionally invest for universal access to PA services. PA promotion advocates should develop a deeper awareness of political and policy structures and require more equity and equality in PA policies from those who they seek to influence, within specific settings for policy making and developing the policy agenda.
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Affiliation(s)
| | - Petru Sandu
- Department of Public Health, Babes-Bolyai University, Pandurilor 7, Cluj-Napoca, Romania
| | - Ahmed M Syed
- National Health Service, 80 London Road, London, SE1 6LH, UK
| | - Mette W Jakobsen
- Unit for Health Promotion Research, Institute of Public Health, University of Southern Denmark, Niels Bohrs Vej 9, 6700, Esbjerg, Denmark
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Sandu P, Rus D, Lau CJ, Spitters HPEM, Chereches RM, van de Goor LAM. What is a policy game about? Insights in components of how to conduct a policy game by experience. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv167.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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15
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Lau CJ, Glümer C, Spitters HPEM, Sandu P, Rus D, Eklund Karlsson L, van de Goor LAM. Impact of policy game on insight and attitude to inter sectoral policy processes - EU country cases. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv175.157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Lau CJ, Glümer C, Spitters HPEM, Sandu P, Rus D, Eklund Karlsson L, van de Goor LAM. Impact of the policy game In2action on insight and attitude towards intersectoral policy processes in real life policy making: questionnaire results from game participants in three EU country cases. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv167.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Spitters HPEM, Lau CJ, Sandu P, Dorgelo A, van de Goor LAM. A policy game intervention to enhance collaboration between stakeholders in local policy development. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv167.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Spitters H, van de Goor LAM, Glümer C, Lau CJ, Sandu P. Policy game development in a local public health setting - process, lessons and reflections. Eur J Public Health 2013. [DOI: 10.1093/eurpub/ckt123.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Cherecheş RM, Rus D, Marton-Vasarhelyi EO, Sandu P, Baba C. The role of evidence in the development of policies that target health enhancing physical activity in Romania. Eur J Public Health 2013. [DOI: 10.1093/eurpub/ckt126.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Cherecheş RM, Ungureanu MI, Sandu P, Rus IA. Defining informal payments in healthcare: a systematic review. Health Policy 2013; 110:105-14. [PMID: 23410757 DOI: 10.1016/j.healthpol.2013.01.010] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2011] [Revised: 01/12/2013] [Accepted: 01/15/2013] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To explore the literature for the definitions of informal payments in healthcare and critically analyze the proposed definitions. This will serve in the process of getting to a coherent definition of informal payments, which will further support acknowledging and addressing them globally. METHODS A search strategy was developed to identify papers addressing informal payments on PubMed, ScienceDirect, Econlit, EconPapers and Google Scholar. RESULTS 2225 papers were identified after a first search. 61 papers were included in the systematic review. Out of all definitions provided, we selected three definitions as being original. All other definitions either cite these definitions or do not provide new insight into the topic of informal payments. Although informal payments have been nominated by various terms over the years, there is a tendency in recent years towards an agreement to use this singular term. Definitions differ in terms of the relation of informal payments with other informal activities, their legality and the motivation behind them. CONCLUSIONS The variety of forms which informal payments may take makes it difficult to define them in a comprehensive manner. However, we identified a definition that could serve as a beginning in this process. More effort is needed to build on it and get to a commonly accepted and shared definition of informal payments.
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Affiliation(s)
- Răzvan M Cherecheş
- Center for Health Policy and Public Health, Institute for Social Research, Faculty of Political, Administrative and Communication Sciences, Babeş-Bolyai University, 7 Pandurilor Street, 400376 Cluj-Napoca, Romania
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Sandu P, Stefaniu I, Zamfir C, Drăgan I, Ionică N. [Premature elevated intraocular pressure after cataract surgery]. Oftalmologia 2002; 54:61-4. [PMID: 12035605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
We evaluated the frequency of elevated intraocular pressure (IOP) the first 1-3 postoperative days for a group of patients undergoing standard or phacoemulsification extracapsular cataract extraction (ECCE). IOP was measured in the pre and postoperative period using non-contact tonometer. From the 356 operated patients, 21 patients (6%) had early elevated IOP. The frequency of elevated IOP was greater among the patients that received anterior chamber (AC) IOL (25%) as compared to that of patients that received posterior chamber (PC) IOL (5.5%). The viscoelastic substance was responsible for a great percentage of cases (51%). The results show that the majority of elevated IOP is transient, recovered spontaneously or by treatment with carbonic anhydrase inhibitors or beta-adrenergic blockers. Elevated postoperative IOP occurs more frequently in the presence of glaucoma, cataract associated with systemic diseases, in complicated and traumatic cataract.
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Affiliation(s)
- P Sandu
- Spitalul Clinic de Urgenţă Militar Central
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Stefaniu I, Niţă N, Zamfir C, Ionică N, Drăgan I, Sandu P. [Post-traumatic glaucoma]. Oftalmologia 2002; 54:15-9. [PMID: 12035595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
This paper presents theoretical aspects concerning the physiopathological mechanisms involved in producing the glaucoma following trauma, especially the lens related glaucoma, correct identification of the ethiopathogeny of the intraocular pressure elevation in this situation is essential for the appropriate management. These aspects are illustrated by two cases of recent glaucoma following trauma lens related (lens subluxation) treated by medication and surgery. The surgical procedure consisted of intracapsular extraction of the lens, anterior vitrectomy, iridectomy and implantation of sulcus sutured posterior chamber lens. We present the technique, the difficulties met intra- and postoperative, evolution and prognosis.
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Affiliation(s)
- I Stefaniu
- Spitalul Clinic de Urgenţă Militar Central Bucureşti
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Liu H, Sandu P, Yuan Z. [The role of basic fibroblast growth factor on expression of mineralization of periodontal ligament cell population and clones]. Zhonghua Kou Qiang Yi Xue Za Zhi 1998; 33:204-6. [PMID: 11774632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
OBJECTIVE To determine the effect of basic fibroblast growth factor (bFGF) on mineraliztion of PDL cell clone. METHODS The PDL tissue that derived from three human donors was cultured and cells were cloned. The mineralizing ability were detected with or without bFGF treatment in the presence of dexamethasone. Cloned progenitor populations were assayed for their constitutive capacity to bind CAP and express ALP. RESULTS The results show that bFGF increases clone mineralization (11%), but not in PDL cell population. The cell clones that mineralized only in the presence of bFGF have higher CAP binding ability and lower ALP expression compared with other mineralized clone cells. CONCLUSION bFGF enhances mineralizing expression of PDL clone. The clones that mineralized only with bFGF treatment are different cell types from the bFGF-undependent mineralized clones.
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Affiliation(s)
- H Liu
- Department of Stomatology, PLA General Hospital, Beijing 100853
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Dasgupta A, Yeo KT, Malik S, Sandu P, Ahmad S, Kenny M. Two novel endogenous digoxin-like immunoreactive substances isolated from human plasma ultrafiltrate. Biochem Biophys Res Commun 1987; 148:623-8. [PMID: 3689363 DOI: 10.1016/0006-291x(87)90922-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Two digoxin-like immunoreactive substances (DLIS 1 and DLIS-2) were isolated from human plasma by ultrafiltration, alkaline solvent extraction, and HPLC. Both inhibit canine Na, K-ATPase and cross-react with anti-digoxin antibodies. Their UV spectra are similar, with absorption peaks at 190 and 220 nm. FAB mass spectral analysis of both compounds yield a single dominant (M+H)+ component at m/z 532 otherwise, the fragmentation patterns are slightly different. The spectral data are consistent with the postulate that these compounds are related. Their identity as the natriuretic hormone is being investigated.
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Affiliation(s)
- A Dasgupta
- University of Washington, School of Medicine, Seattle 98195
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