Urban governance for health and well-being: a step-by-step approach to operational research in cities

It has been estimated that, by 2050, more than two thirds of the world’s population will live in cities (5). It is known, however, that intensive urban growth increases inequity and social exclusion, which are associated with increased social, environmental, economic and health risks (6). Public policies to address social determinants are therefore essential for urban health (7, 8). Urban governance determines how effectively urban inequities and risks are addressed. Bad urban governance may harm societies, as the public policies usually fail to address social and environmental determinants (9, 10), while good urban governance promotes policies to improve health and well-being in the population (11). Cities are complex systems, however, and the same public policies may have different effects in different populations, because, beyond public policies, urban health outcomes also depend on the interactions between governance, stakeholders and the population, requiring participatory governance and consensus in policy-making (12, 13). Each context, indicator of performance and implementation strategy is also different. As the rapid global trend to urbanization continues, participatory urban governance has been a topic of increasing research and interventions to improve health outcomes. Some studies have been conducted to identify and evaluate indicators of participatory urban governance (13–16), and others have analysed the results of policies for addressing health inequity (17–21). Few studies, however, have examined participatory urban governance, public policies and health outcomes together (22)

Good urban governance for health and well-being: a systematic review of barriers, facilitators and indicators

Rapid, unplanned urbanization is one of the major ecological and human challenges of the 21st century. UN Habitat predicts that, by 2050, nearly 70% of the world’s population will be living in cities, with disproportionate urban growth in low- and middle-income countries (10). While cities offer opportunities for employment and access to better public services, they also pose major health risks. Good local governance is critical for achieving the 2030 Agenda, and countries must strive to ensure that their cities are creating and improving their physical and social environments and their community resources to enable people to support each other and to develop to their maximum potential. Building on good practices in the WHO Healthy Cities programme, the World Health Organization (WHO) has identified health promotion in urban and local settings as critical to achieving the Sustainable Development Goals (SDGs) and health equity. The WHO and UN Habitat 2016 Global report on urban health concluded that good urban governance – notably the role of city governments and strong leardership – is key to ensuring health equity and the health and well-being of their citizens (10). WHO contracted the Institute of Social and Preventive Medicine, University of Bern, Switzerland, to review the evidence on two issues that are central to health promotion: achieving good governance for health and well-being, understood as participatory governance built on multisectoral action and civic engagement; and measuring the impact of governance on urban health outcomes. The aim of the systematic review was to identify barriers to and facilitators of multisectoral action and civic engagement and to suggest validated indicators and tools for assessing the processes and outcomes of participatory governance for health, equity and well-being in urban settings from published scientific evidence. Findings from the systemic review informed the development of the Urban governance for health and well-being: a step-by-step approach to conducting operational research in cities

Mesa redonda 1. Los objetivos del desarrollo sostenible: singularización en el Mediterráneo

Taula rodona 1 del III Simposi Mediterrani de Promoció de la Salut, presentada per la Dra. Èlia Díez, de l'Agència de Salut Pública de Barcelona, que compta amb les intervencions següents: "De los objetivos del milenio a los objetivos de desarrollo sostenible ", a càrrec de la Dra. Faten Ben Abdelaziz, coordinadora de promoció de la salut de la OMS, Ginebra; "Los objetivos de desarrollo sostenible desde la perspectiva de los determinantes de la salud", a càrrec de la Dra. Blanca Patricia Mantilla Uribe, de l'Institut Proinapsa, Universidad Industrial de Santander, Colombia; "La agenda 2030 en el contexto de los países mediterráneos", a càrrec de la Dra. Rita Maria Ferrelli, de l'Istituto superiore di sanità, Itàlia; "Los objetivos de desarrollo sostenible i la cooperación", del Consell Català de Cooperació al Desenvolupamen

Complications rénales dans la glycogénose de type 1 : quelles implications pratiques ?

International audienceAim. - To investigate risk factors of renal complications in glycogen storage disease type I, in order to identify practical implications for renal preservation. Methods. - A retrospective study of 38 patients with glycogen storage disease type I. Results. - The patients studied were 8.6 years old in average (1.5 to 22 years) and were followed during 7.4 +/- 4.5 years. Hypercalciuria was detected in 23 patients and was related to acidosis (P = 0.028), higher lactate levels (5.9 +/- 3.5 versus 3.7 +/- 1.7 mmol/L; P = 0.013) and smaller height (-2.1 +/- 1.5 SD versus -0.8 +/- 1.5 SD; P = 0.026). Urolithiasis was diagnosed in 7 cases. Glomerular disease (19/38) was more frequent in cases with severe hypertriglyceridemia (P = 0.042) and occurred at an older age (P = 0.007). Microalbuminuria occurred in 15/31 cases; ACE inhibitors were prescribed in only 8 cases. The frequency of renal complications did not differ according to the diet group (continuous enteral feeding or uncooked starch). Logistic regression concluded as risk factors: lactic acidosis for tubular disease and age > 10 years for glomerular disease. Conclusions. - Renal involvement is common in glycogen storage disease type I patients. Tubular abnormalities are precocious, related to lactic acidosis and may be detected by monitoring of urinary calcium. Glomerular hyperfiltration is the first stage of a progressive glomerular disease and is related to age. Practical implications for renal preservation are discussed based on our results and literature. (C) 2015 Association Societe de nephrologie. Published by Elsevier Masson SAS. All rights reserved

The Geneva Charter—realising the potential of a well‐being society

No abstract available

Characteristics and outcomes of COVID-19 patients admitted to hospital with and without respiratory symptoms

Background: COVID-19 is primarily known as a respiratory illness; however, many patients present to hospital without respiratory symptoms. The association between non-respiratory presentations of COVID-19 and outcomes remains unclear. We investigated risk factors and clinical outcomes in patients with no respiratory symptoms (NRS) and respiratory symptoms (RS) at hospital admission. Methods: This study describes clinical features, physiological parameters, and outcomes of hospitalised COVID-19 patients, stratified by the presence or absence of respiratory symptoms at hospital admission. RS patients had one or more of: cough, shortness of breath, sore throat, runny nose or wheezing; while NRS patients did not. Results: Of 178,640 patients in the study, 86.4 % presented with RS, while 13.6 % had NRS. NRS patients were older (median age: NRS: 74 vs RS: 65) and less likely to be admitted to the ICU (NRS: 36.7 % vs RS: 37.5 %). NRS patients had a higher crude in-hospital case-fatality ratio (NRS 41.1 % vs. RS 32.0 %), but a lower risk of death after adjusting for confounders (HR 0.88 [0.83-0.93]). Conclusion: Approximately one in seven COVID-19 patients presented at hospital admission without respiratory symptoms. These patients were older, had lower ICU admission rates, and had a lower risk of in-hospital mortality after adjusting for confounders