medRxiv - Health Policy最新文献

{"title":"\"WE CAN ALL CONTRIBUTE IN OUR OWN WAY\" : KNOWLEDGE MOBILIZATION TOOLS TO PROMOTE BEST PRACTICES IN UNIVERSAL ACCESSIBILITY","authors":"Maelle Corcuff, Marie-Eve Lamontagne, Francois Routhier","doi":"10.1101/2024.09.17.24313810","DOIUrl":"https://doi.org/10.1101/2024.09.17.24313810","url":null,"abstract":"Background: Cities aim to enhance urban accessibility following the adoption of the United Nations' Convention on the Rights of Persons with Disabilities. However, implementation faces challenges due to complex municipal legislation, lack of awareness, and organizational obstacles. Engaging stakeholders and empowering municipal employees through knowledge mobilization is crucial, as shown in a Quebec City's partnership research process. Methods: The aim of this study is to report the implementation strategy as implemented, explore the perception of the employees about the format and feasibility of the implementation strategy and explore the induced changes of knowledge mobilization tools on the implementation determinants of universal accessibility measures for municipal employees. The study used a multi-method design, involving interviews and a questionnaire with the project steering committee, made up of city employees and the research team. Three 30-minute participatory workshops were conducted for culture, communications, and public consultation administrative units. Results: Participants appreciated the workshop format and video content, suggesting minor improvements for broader implementation. The tools effectively increased engagement in implementing universal accessibility measures, proving valuable for raising awareness. Discussion and Conclusion: The study demonstrates the advantages of a collaborative approach in developing knowledge mobilization tools, enhancing municipal personnel's capacity for universal accessibility measures, and highlighting the need for adaptable strategies.","PeriodicalId":501386,"journal":{"name":"medRxiv - Health Policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142258559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Geospatial Analysis of the Association between Medicaid Ex-pansion, Minimum Wage Policies, and Alzheimer's Disease Dementia Prevalence in the United States","authors":"Abolfazl Mollalo, Sara Knox, Jessica Meng, Andreana Benitez, Leslie A. Lenert, Alexander V. Alekseyenko","doi":"10.1101/2024.09.10.24313418","DOIUrl":"https://doi.org/10.1101/2024.09.10.24313418","url":null,"abstract":"Previous studies indicate that improved healthcare access through Medicaid expansion and alleviation of socioeconomic stressors via higher minimum wages improved health outcomes. This study investigates the spatial relationships between the Medicaid expansion, minimum wage policy, and AD dementia prevalence across the US. We employed the Getis-Ord Gi* statistic to identify hotspots and cold spots of AD dementia prevalence at the county level. We compared these locations with the overall social vulnerability index (SVI) scores and assessed the proportion of hot and cold spots at the state level based on Medicaid expansion and minimum wage status. Most vulnerable SVI quartile (Q4) had the highest number of hotspots (n=311, 64.8%), while the least vulnerable quartile (Q1) had the fewest hotspots (n=22, 4.6%) (Chis-squared=967;R2=307.41, P<0.01). States that adopted Medicaid expansion had a significantly lower proportion of hotspots compared to non-adopting states (P<0.05), and the non-adopting states had significantly higher odds of having hotspots than adopting states (OR=2.58, 95% CI: 2.04-3.26, P<0.001). Conversely, the non-adopting states had significantly lower odds of having cold spots compared to the adopting states (OR=0.24, 95% CI: 0.19-0.32, P<0.01). States with minimum wage levels at or below the federal level showed significantly higher odds of having hotspots than states with a minimum wage above the federal level (OR=1.94, 95% CI: 1.51-2.49, P<0.01). Our findings suggest significant disparities in AD dementia prevalence related to socioeconomic and policy factors and lay the groundwork for future causal analyses.","PeriodicalId":501386,"journal":{"name":"medRxiv - Health Policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142188803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The clinical and cost-effectiveness of interventions for preventing continence issues resulting from birth trauma: a rapid review","authors":"Bethany Fern Anthony, Jacob Davies, Kalpa Pisavadia, Sofie Roberts, Llinos Haf Spencer, Elizabeth Gillen, Juliet Hounsome, Jane C Noyes, Dyfrig A Hughes, Deborah Fitzsimmons, Rhiannon Tudor Edwards, Adrian G Edwards, Alison Cooper, Ruth Lewis","doi":"10.1101/2024.09.09.24313310","DOIUrl":"https://doi.org/10.1101/2024.09.09.24313310","url":null,"abstract":"Urinary and faecal incontinence, which are often linked to the stresses and strains of childbirth, particularly perineal trauma, are debilitating conditions that can significantly impact womens quality of life. Approximately 85% of vaginal births in the United Kingdom (UK) are affected by childbirth related perineal trauma, either spontaneously or due to episiotomy. Incontinence also places a significant financial burden on the healthcare system. Previous estimates have shown that stress urinary incontinence alone costs the National Health Service (NHS) 177 million UK pounds per year.\u0000The aim of this rapid review was to identify evidence on the clinical effectiveness and cost-effectiveness of interventions for preventing continence issues resulting from birth trauma. Twenty-three studies, published between 2023 and 2024, were included in this review: 20 systematic reviews of clinical effectiveness and three economic evaluations. A number of key findings, research implications and evidence gaps were identified.\u0000The findings support the use of exercise-based interventions including pelvic floor muscle training for prenatal and postnatal women to prevent urinary incontinence. However, there is limited evidence supporting their long-term effectiveness. Incontinence is a potential long-term burden as pregnancy and childbirth can weaken the pelvic floor, making women more susceptible to incontinence in later life. Menopause often exacerbates these issues due to hormonal changes and by further weakening the pelvic floor muscles. Non exercise-based interventions, such as prenatal perineal massage and vaginal devices were less represented in the available evidence base, especially for faecal incontinence outcomes. There was a paucity of economic evaluations assessing the cost-effectiveness of interventions for incontinence, however, the substantial economic burden of incontinence on the NHS necessitates investment in clinically effective, preventative options. Our findings present the case for investing in exercise-based interventions. Further research is needed to evaluate the maintenance and long-term effects of exercise-based therapy. More research is also needed that focus on alternative type interventions and the prevention of faecal incontinence. Future reviews need to consider qualitative findings of womens experiences and the acceptability and feasibility of rolling out interventions for the prevention of incontinence.","PeriodicalId":501386,"journal":{"name":"medRxiv - Health Policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142188799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supporting women, girls and people who menstruate to participate in physical activity - Rapid evidence summary","authors":"Judit Csontos, Deborah Edwards, Elizabeth Gillen, Juliet Hounsome, Meg Kiseleva, Mala Mann, Amrita Sidhu, Steven Macey, Ruth Lewis, Adrian Edwards, Alison Cooper","doi":"10.1101/2024.09.02.24311982","DOIUrl":"https://doi.org/10.1101/2024.09.02.24311982","url":null,"abstract":"Insufficient physical activity is a leading risk factor for non-communicable diseases and has a negative effect on mental health and quality of life. Women, girls and people who menstruate living in Wales are less likely to engage in regular physical activity than boys and men. The aim of this rapid evidence summary is to identify research focusing on physical activity participation (including exercise and sport) of women, girls and people who menstruate in relation to the menstrual cycle, to inform the Welsh Government Period Proud Action Plan. Results\u000042 reports were identified, including overviews of reviews, systematic reviews, a scoping review, organisational reports, and primary studies. The secondary research evidence was published between 2008 and 2024 with the most recent searches being conducted in September 2023. The primary studies were published between 2020 and 2022. The organisational reports were published between 2018 and 2024. Research Implications and Evidence Gaps\u0000There is a need for interventions that could support physical activity participation (including exercise or sport) of women, girls and people who menstruate in relation to the menstrual cycle. These interventions need to consider and address barriers that women, girls and people who menstruate face in relation to their menstrual cycle, and robust evaluations are required to determine effectiveness.","PeriodicalId":501386,"journal":{"name":"medRxiv - Health Policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142188800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance of the Washington Group Questions in Measuring Blindness and Deafness","authors":"Scott D. Landes, Bonnielin K. Swenor, Jean P. Hall","doi":"10.1101/2024.08.27.24312660","DOIUrl":"https://doi.org/10.1101/2024.08.27.24312660","url":null,"abstract":"The Washington Group Short Set (WGSS) questions are intended to measure the severity of disability and disability status in US federal surveys. We used data from the 2010-2018 National Health Interview Survey to examine the performance of the WGSS visual disability and hearing disability questions in capturing blindness and deafness. We found that the WGSS questions failed to capture 35.7% of blind adults and 43.7% of deaf respondents as having a severe disability, or, per their recommended cut point, as being disabled at all. Coupled with prior evidence demonstrating the poor performance of the WGSS questions in estimating the size of the overall disability population, we contend that results from this study necessitate a pause in use of the WGSS questions to measure disability in US federal surveys.","PeriodicalId":501386,"journal":{"name":"medRxiv - Health Policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142188801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of chaos and systems theories to explore health workforce re-organisation following district splitting in Uganda","authors":"Aloysius Mutebi, Moses Mukuru, Suzanne Kiwanuka, Fredrick Makumbi, Elizeus Rutebemberwa","doi":"10.1101/2024.08.29.24312785","DOIUrl":"https://doi.org/10.1101/2024.08.29.24312785","url":null,"abstract":"<strong>Background</strong> District splitting (DS) began in 1962 and intensified in 1997 during implementation of decentralization. This legislative process focuses on geographical demarcation. The health system, organized along local government structures, was re-organized as a result of DS. However, this study explored how the health workforce, as a component of the local government health system, re-organized following district splitting.","PeriodicalId":501386,"journal":{"name":"medRxiv - Health Policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142188804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Questionable practices in data and code sharing policy in high-profile medical journal and research","authors":"Wei Li, Xuerong Liu, Qianyu Zhang, Liping Shi, Jing-Xuan Zhang, Xiaolin Zhang, Jia Luan, Yue Li, Ting Xu, Rong Zhang, Xiaodi Han, Jingyu Lei, Xueqian Wang, Yaozhi Wang, Hai Lan, Xiaohan Chen, Yi Wu, Yan Wu, Lei Xia, Haiping Liao, Chang Shen, Yang Yu, Xinyu Xu, Chao Deng, Pei Liu, Zhengzhi Feng, Chun-Ji Huang, Zhiyi Chen","doi":"10.1101/2024.08.29.24312818","DOIUrl":"https://doi.org/10.1101/2024.08.29.24312818","url":null,"abstract":"<strong>Background</strong> The spurious and unavailable data/code sharing actions are crashing open medical sciences. In this study, we aimed to illustrate how high-profile medical journals are practically carried out their sharing policies and what questionable practices regarding data/code sharing are conducted by authors.","PeriodicalId":501386,"journal":{"name":"medRxiv - Health Policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142188802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overlap between ultra-processed food and food that is high in fat, salt or sugar: analysis of 11 annual waves of the UK National Diet and Nutrition Survey 2008/09-2018/19","authors":"Viktorija Kesaite, Yanaina Chavez-Ugalde, Martin White, Jean Adams","doi":"10.1101/2024.08.27.24312650","DOIUrl":"https://doi.org/10.1101/2024.08.27.24312650","url":null,"abstract":"While many countries use guidance and policies based on nutrients and food groups to support citizens to consume healthy diets, fewer have explicitly adopted the concept of ultra-processed foods (UPF). UPF consumption is associated with many adverse health outcomes in cohort studies. In the UK, a nutrient profiling model (NPM) is used to identify foods high in fat, salt or sugar (HFSS) and several policies target these. It is not known how well the NPM also captures UPF. We aimed to quantify the proportion of food and drink items consumed in the UK that are HFSS, UPF, both or neither and describe the food groups making the largest contributions to each category. We analysed data from the National Diet and Nutrition Survey (NDNS), between 2008/09 and 2018/19, using descriptive statistics. We used three metrics of food consumption: all foods, % of energy in all foods (reflecting that different foods are consumed in different portion sizes and are of different energy densities), and % of food weight in all foods (reflecting that some UPFs have few calories but are consumed in large volumes). We found that, 33.4% of foods, 47.4% of energy, and 16.0% of food weight were HFSS; 36.2%, 59.8% and 32.9% respectively were UPFs; 20.1%, 35.1% and 12.6% were both; and 50.5%, 27.9% and 63.7% were neither. In total, 55.6% of UPF foods, 58.7% of energy from UPFs and 38.3% of food weight from UPF consumed were also HFSS. The most common food groups contributing to foods that were UPF but not HFSS were low calorie soft drinks and white bread. The UK NPM captures at best just over half of UPFs consumed in the UK. Expanding the NPM to include ingredients common in UPFs would capture a larger percentage of UPFs and could incentivise de-formulation of UPF products.","PeriodicalId":501386,"journal":{"name":"medRxiv - Health Policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142188806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effects of Social Distancing Policy on the Changes of Floating Population in Korea","authors":"Jaehwan Oh, Minsu Choi, Kwang-soo Lee","doi":"10.1101/2024.08.26.24312613","DOIUrl":"https://doi.org/10.1101/2024.08.26.24312613","url":null,"abstract":"<strong>Objectives</strong> In response to the World Health Organization’s declaration of the COVID-19 pandemic in March 2020, nations worldwide, including Korea, implemented social distancing as a critical Non-Pharmaceutical Intervention (NPI) to curb the spread of the disease. Social distancing measures aimed to reduce person-to-person contact through various strategies such as facility restrictions, gathering limitations, travel bans, and lockdowns.","PeriodicalId":501386,"journal":{"name":"medRxiv - Health Policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142188805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A foggy minefield: Experiences of regulation among developers of AI and other medical software in the UK, survey and focus group study","authors":"Henry W W Potts, Paulina Bondaronek, Ana Luisa Neves, Alex Bolotov, Lucie Burgess, Jona Shehu, Gabriella Spinellli, Emanuela Volpi, Austen El-Osta","doi":"10.1101/2024.08.25.24312551","DOIUrl":"https://doi.org/10.1101/2024.08.25.24312551","url":null,"abstract":"Introduction: Regulation is important for medical software, but advances in software, notably developments in artificial intelligence (AI), are developing quickly. There are concerns that regulatory processes are not keeping up and that there is a need for more pro-innovation approaches.\u0000Methods: We conducted a survey (n = 34) and four focus groups to discuss experiences of regulation among UK-based developers.\u0000Results: In the survey, 35% agreed/strongly agreed that they were confident in their knowledge of relevant regulation, while 50% agreed/strongly agreed that poor regulation was allowing bad products to come to market. The focus groups identified 10 themes around challenges with current processes: the process of obtaining regulatory approval is uncertain; lack of knowledge about regulatory approval; difficulties in obtaining reliable advice; complexity and slow pace of approvals; difficult to get NHS clinician involvement; process is costly and difficult to fund; implications for competition; international differences; incentives to develop lower classification products; and lack of harmonisation between NHS and MHRA. Respondents' suggestions for solutions to improve processes fell under four themes: financial and structural support; regulatory collaboration and commissioner involvement; process efficiency and adaptability; and education and guidance.\u0000Discussion: Developers are unhappy with the process of regulation for medical software in the UK, finding it confusing and expensive. They feel systems compare poorly to international comparators. Integration between the MHRA system and NHS commissioning is considered poor.","PeriodicalId":501386,"journal":{"name":"medRxiv - Health Policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142188809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}