Framework, principles and recommendations for utilising participatory methodologies in the co-creation and evaluation of public health interventions

Background: Due to the chronic disease burden on society, there is a need for preventive public health interventions to stimulate society towards a healthier lifestyle. To deal with the complex variability between individual lifestyles and settings, collaborating with end-users to develop interventions tailored to their unique circumstances has been suggested as a potential way to improve effectiveness and adherence. Co-creation of public health interventions using participatory methodologies has shown promise but lacks a framework to make this process systematic. The aim of this paper was to identify and set key principles and recommendations for systematically applying participatory methodologies to co-create and evaluate public health interventions. Methods: These principles and recommendations were derived using an iterative reflection process, combining key learning from published literature in addition to critical reflection on three case studies conducted by research groups in three European institutions, all of whom have expertise in co-creating public health interventions using different participatory methodologies. Results: Key principles and recommendations for using participatory methodologies in public health intervention co-creation are presented for the stages of: Planning (framing the aim of the study and identifying the appropriate sampling strategy); Conducting (defining the procedure, in addition to manifesting ownership); Evaluating (the process and the effectiveness) and Reporting (providing guidelines to report the findings). Three scaling models are proposed to demonstrate how to scale locally developed interventions to a population level. Conclusions: These recommendations aim to facilitate public health intervention co-creation and evaluation utilising participatory methodologies by ensuring the process is systematic and reproducible

Prevalence of neoplasia at colonoscopy among testicular cancer survivors treated with platinum-based chemotherapy

Testicular cancer survivors (TCS) treated with platinum-based chemotherapy have an increased risk of colorectal cancer (CRC). We determined the yield of colonoscopy in TCS to assess its potential in reducing CRC incidence and mortality. We conducted a colonoscopy screening study among TCS in four Dutch hospitals to assess the yield of colorectal neoplasia. Neoplasia was defined as adenomas, serrated polyps (SPs), advanced adenomas (AAs: ≥10 mm diameter, high-grade dysplasia or ≥25% villous component), advanced serrated polyps (ASPs: ≥10 mm diameter or dysplasia) or CRC. Advanced neoplasia (AN) was defined as AA, ASP or CRC. Colonoscopy yield was compared to average-risk American males who underwent screening colonoscopy (n = 24,193) using a propensity score matched analysis, adjusted for age, smoking status, alcohol consumption and body mass index. A total of 137 TCS underwent colonoscopy. Median age was 50 years among TCS (IQR 43–57) vs 55 years (IQR 51–62) among American controls. A total of 126 TCS were matched to 602 controls. The prevalence of AN was higher in TCS than in controls (8.7% vs 1.7%; P =.0002). Nonadvanced adenomas and SPs were detected in 45.2% of TCS vs 5.5% of controls (P &lt;.0001). No lesions were detected in 46.0% of TCS vs 92.9% of controls (P &lt;.0001). TCS treated with platinum-based chemotherapy have a higher prevalence of neoplasia and AN than matched controls. These results support our hypothesis that platinum-based chemotherapy increases the risk of colorectal neoplasia in TCS. Cost-effectiveness studies are warranted to ascertain the threshold of AN prevalence that justifies the recommendation of colonoscopy for TCS.</p

Carbon pulses but not phosphorus pulses are related to decreases in microbial biomass during repeated drying and rewetting of soils

Drying and rewetting cycles are known to be important for the turnover of carbon (C) in soil, but less is known about the turnover of phosphorus (P) and its relation to C cycling. In this study the effects of repeated drying-rewetting (DRW) cycles on phosphorus (P) and carbon (C) pulses and microbial biomass were investigated. Soil (Chromic Luvisol) was amended with different C substrates (glucose, cellulose, starch; 2.5 g C kg-1) to manipulate the size and community composition of the microbial biomass, thereby altering P mineralisation and immobilisation and the forms and availability of P. Subsequently, soils were either subjected to three DRW cycles (1 week dry/1 week moist) or incubated at constant water content (70% water filled pore space). Rewetting dry soil always produced an immediate pulse in respiration, between 2 and 10 times the basal rates of the moist incubated controls, but respiration pulses decreased with consecutive DRW cycles. DRW increased total CO2 production in glucose and starch amended and non-amended soils, but decreased it in cellulose amended soil. Large differences between the soils persisted when respiration was expressed per unit of microbial biomass. In all soils, a large reduction in microbial biomass (C and P) occurred after the first DRW event, and microbial C and P remained lower than in the moist control. Pulses in extractable organic C (EOC) after rewetting were related to changes in microbial C only during the first DRW cycle; EOC concentrations were similar in all soils despite large differences in microbial C and respiration rates. Up to 7 mg kg-1 of resin extractable P (Presin) was released after rewetting, representing a 35-40% increase in P availability. However, the pulse in Presin had disappeared after 7 d of moist incubation. Unlike respiration and reductions in microbial P due to DRW, pulses in Presin increased during subsequent DRW cycles, indicating that the source of the P pulse was probably not the microbial biomass. Microbial community composition as indicated by fatty acid methyl ester (FAME) analysis showed that in amended soils, DRW resulted in a reduction in fungi and an increase in Gram-positive bacteria. In contrast, the microbial community in the non-amended soil was not altered by DRW. The non-selective reduction in the microbial community in the non-amended soil suggests that indigenous microbial communities may be more resilient to DRW. In conclusion, DRW cycles result in C and P pulses and alter the microbial community composition. Carbon pulses but not phosphorus pulses are related to changes in microbial biomass. The transient pulses in available P could be important for P availability in soils under Mediterranean climates.C.R. Butterly, E.K. Bünemann, A.M. McNeill, J.A. Baldock and P. Marschne