Social sciences research in neglected tropical diseases 1: the ongoing neglect in the neglected tropical diseases

Centuries of scientific advances and developments in biomedical sciences have brought us a long way to understanding and managing disease processes, by reducing them to simplified cause-effect models. For most of the infectious diseases known today, we have the methods and technology to identify the causative agent, understand the mechanism by which pathology is induced and develop the treatment (drugs, vaccines, medical or surgical procedures) to cure, manage or control

Preventing disease and saving resources:the potential contribution of increasing breastfeeding rates in the UK

Two challenges stand out as we contemplate the future of health services in the United Kingdom. The first is the state of the public finances and therefore the pressure in real terms on health services funding. The second is the recurring and vexing problem of health inequalities. The state of health inequalities in Britain has been commented on by many, but we have seen precious little real change in the disproportionate burden of early death and illness among the most disadvantaged and indeed across the whole health gradient in recent years.This work was funded by UNICEF UK

Behaviour Change in Public Health: Evidence and Implications

Daniel Reidpath - ORCID: 0000-0002-8796-0420 https://orcid.org/0000-0002-8796-0420https://doi.org/10.1155/2015/598672pubpu

Quantifying the contribution of utility cycling to population levels of physical activity: an analysis of the Active People Survey.

Background Population levels of physical activity are far below recommendations limiting its public health benefits. Utility cycling (i.e. cycling for transport purposes) may be a means of increasing this activity. Empirical evidence quantifying the contribution of utility cycling to the population levels of physical activity is sparse. Methods The English Active People Survey (APS) was analysed to assess the likelihood of meeting UK physical activity guidelines in those who reported utility cycling compared with those who did not. Odds ratios were adjusted for important socioeconomic confounders using a logistic regression model. Results In the full sample, unadjusted odds ratio for meeting physical activity guidelines in favour of utility cyclists was 5.21 (95% confidence interval (CI) 4.96–5.47) and adjusted odds ratio was 4.08 (95% CI 3.88–4.29). The odds were even higher for utility cyclists in inner London [adjusted OR: 6.08 (4.07–7.86)]. The pattern was consistent regardless of the number of activities through which people met the physical activity guideline. Conclusion Utility cycling can make a significant contribution to levels of physical activity. As an activity that can easily integrate into everyday life, utility cycling appears to be a pragmatic policy option for public health decision-makers

The selection of an appropriate count data model for modelling health insurance and health care demand: Case of Indonesia

This is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.We apply several estimators to Indonesian household data to estimate the relationship between health insurance and the number of outpatient visits to public and private providers. Once endogeneity of insurance is taken into account, there is a 63 percent increase in the average number of public visits by the beneficiaries of mandatory insurance for civil servants. Individuals' decisions to make first contact with private providers is affected by private insurance membership. However, insurance status does not make any difference for the number of future outpatient visits

Health-care interventions to promote and assist tobacco cessation: a review of efficacy, effectiveness and affordability for use in national guideline development

Aims: This paper provides a concise review of the efficacy, effectiveness and affordability of health-care interventions to promote and assist tobacco cessation, in order to inform national guideline development and assist countries in planning their provision of tobacco cessation support. Methods: Cochrane reviews of randomized controlled trials (RCTs) of major health-care tobacco cessation interventions were used to derive efficacy estimates in terms of percentage-point increases relative to comparison conditions in 6–12-month continuous abstinence rates. This was combined with analysis and evidence from ‘real world’ studies to form a judgement on the probable effectiveness of each intervention in different settings. The affordability of each intervention was assessed for exemplar countries in each World Bank income category (low, lower middle, upper middle, high). Based on World Health Organization (WHO) criteria, an intervention was judged as affordable for a given income category if the estimated extra cost of saving a life-year was less than or equal to the per-capita gross domestic product for that category of country. Results: Brief advice from a health-care worker given opportunistically to smokers attending health-care services can promote smoking cessation, and is affordable for countries in all World Bank income categories (i.e. globally). Proactive telephone support, automated text messaging programmes and printed self-help materials can assist smokers wanting help with a quit attempt and are affordable globally. Multi-session, face-to-face behavioural support can increase quit success for cigarettes and smokeless tobacco and is affordable in middle- and high-income countries. Nicotine replacement therapy, bupropion, nortriptyline, varenicline and cytisine can all aid quitting smoking when given with at least some behavioural support; of these, cytisine and nortriptyline are affordable globally. Conclusions: Brief advice from a health-care worker, telephone helplines, automated text messaging, printed self-help materials, cytisine and nortriptyline are globally affordable health-care interventions to promote and assist smoking cessation. Evidence on smokeless tobacco cessation suggests that face-to-face behavioural support and varenicline can promote cessation

Expect the unexpected? Challenges of prospectively exploring stakeholder engagement in research

Abstract: Stakeholder engagement in research is increasingly viewed as making a major contribution to assisting impact. This paper draws on a longitudinal, prospective impact study exploring stakeholder engagement in a 3-year tobacco control research project which used stakeholder engagement in the development, testing and dissemination of its return on investment tool. The paper presents the challenges of data collection when undertaking prospective research on stakeholder engagement in health-related research. The impact study used mixed methods of data collection to explore stakeholder engagement in the target project, comprising surveys, interviews and observations of meetings and events involving stakeholders. Stakeholder engagement that actually occurred in the target project, and the data collection methods of stakeholder engagement that were actually used in the impact study, varied substantially from those intended in each case. Data collection for the impact study was dependent on the target project’s stakeholder engagement, which became substantially reduced. Modifications to data collection for the impact study were required. One of the reasons for the reduction of stakeholder engagement was linked to constraints on the target project to meet non-negotiable deadlines. Another factor was concerns about overburdening stakeholders. The knock-on effect of reduced stakeholder engagement highlighted the impact study’s lack of control over its data collection, which was related to the prospective nature of the study. The authors acknowledge that an advantage of a retrospective approach over a prospective one is researchers knowing about data availability and accessibility from the outset. However, the prospective approach of the impact study enabled insight into stakeholder engagement in real-time: how and when it occurred, the challenges, and the experiences of stakeholders and the target project researchers. While the quantity of data gathered was considerably less than anticipated, the quality of data was rich and enabled the impact study objectives to be achieved. With increasing emphasis on public engagement in research and calls for engagement to be evaluated for impact, this paper aims—by highlighting the challenges the impact study experienced—to provide some insight to future research that seeks to respond to those calls