JoVE Visualize What is visualize?
Stop Reading. Start Watching.
Advanced Search
Stop Reading. Start Watching.
Regular Search
Find video protocols related to scientific articles indexed in Pubmed.
Social protection and tuberculosis control in 21 European countries, 1995-2012: a cross-national statistical modelling analysis.
Lancet Infect Dis
PUBLISHED: 10-12-2014
Show Abstract
Hide Abstract
WHO stresses the need to act on the social determinants of tuberculosis. We tested whether alternative social protection programmes have affected tuberculosis case notifications, prevalence, and mortality, and case detection and treatment success rates in 21 European countries from 1995 to 2012.
Related JoVE Video
Economic shocks, resilience, and male suicides in the Great Recession: cross-national analysis of 20 EU countries.
Eur J Public Health
PUBLISHED: 10-08-2014
Show Abstract
Hide Abstract
During the 2007-11 recessions in Europe, suicide increases were concentrated in men. Substantial differences across countries and over time remain unexplained. We investigated whether increases in unaffordable housing, household indebtedness or job loss can account for these population differences, as well as potential mitigating effects of alternative forms of social protection.
Related JoVE Video
DIALYSIS SERVICES FOR TOURISTS TO THE VENETO REGION: A QUALITATIVE STUDY.
J Ren Care
PUBLISHED: 09-16-2014
Show Abstract
Hide Abstract
The European Union has an established mechanism which enables patients with end-stage kidney disease (ESKD) to receive dialysis abroad, allowing them to benefit from the legal right to freedom of movement. The number of patients seeking dialysis abroad has increased in recent years and the Veneto Region of Italy, a major tourist destination, has made significant investment in providing tourist haemodialysis services.
Related JoVE Video
Foregoing medicines in the former Soviet Union: Changes between 2001 and 2010.
Health Policy
PUBLISHED: 09-03-2014
Show Abstract
Hide Abstract
Pharmaceutical costs dominate out-of-pocket payments in former Soviet countries, posing a severe threat to financial equity and access to health services. Nationally representative household survey data collected in Armenia, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia and Ukraine were analysed to compare the level of population having to forego medicines in 2001 and 2010. Subgroup analysis was conducted to assess differences between populations of different economic status, and rural and urban populations. A substantial proportion of the population did forego medicines in 2010, from 29.2% in Belarus to 72.9% in Georgia. There was a decline in people foregoing medicines between 2001 and 2010; the greatest decline was seen in Moldova [rate ratio (RR)=0.67 (0.63; 0.71)] and Kyrgyzstan [RR=0.63 (0.60; 0.67)], while very little improvement took place in countries with a higher Gross National Income (GNI) per capita and greater GNI growth over the decade such as Armenia [RR=0.92 (0.87; 0.96)] and Georgia [RR=0.95 (0.92; 0.98)]. Wealthier, urban populations have benefited more than poorer, rural households in some countries. Countries experiencing the greatest improvement over the study period were those that have implemented policies such as price controls, expanded benefits packages, and encouragement of rational prescribing. Greater commitment to pharmaceutical reform is needed to ensure that people are not forced to forego medicines.
Related JoVE Video
Towards a comprehensive global approach to prevention and control of NCDs.
Global Health
PUBLISHED: 08-26-2014
Show Abstract
Hide Abstract
BackgroundThe ¿25x25¿ strategy to tackle the global challenge of non-communicable diseases takes a traditional approach, concentrating on a few diseases and their immediate risk factors. Discussion: We propose elements of a comprehensive strategy to address NCDs that takes account of the evolving social, economic, environmental and health care contexts, while developing mechanisms to respond effectively to local patterns of disease. Principles that underpin the comprehensive strategy include: (a) a balance between measures that address health at the individual and population level; (b) the need to identify evidence-based feasible and effective approaches tailored to low and middle income countries rather than exporting questionable strategies developed in high income countries; (c) developing primary health care as a universal framework to support prevention and treatment; (d) ensuring the ability to respond in real time to the complex adaptive behaviours of the global food, tobacco, alcohol and transport industries; (e) integrating evidence-based, cost-effective, and affordable approaches within the post-2015 sustainable development agenda; (f) determination of a set of priorities based on the NCD burden within each country, taking account of what it can afford, including the level of available development assistance; and (g) change from a universal ¿one-size fits all¿ approach of relatively simple prevention oriented approaches to more comprehensive multi-sectoral and development-oriented approaches which address both health systems and the determinants of NCD risk factors.SummaryThe 25x25 is approach is absolutely necessary but insufficient to tackle the the NCD disease burden of mortality and morbidity. A more comprehensive approach is recommended.
Related JoVE Video
Quantifying the influence of the tobacco industry on EU governance: automated content analysis of the EU Tobacco Products Directive.
Tob Control
PUBLISHED: 08-13-2014
Show Abstract
Hide Abstract
The tobacco industry spends large sums lobbying the European Union (EU) institutions, yet whether such lobbying significantly affects tobacco policy is not well understood. We used novel quantitative text mining techniques to evaluate the impact of industry pressure on the contested EU Tobacco Products Directive revision.
Related JoVE Video
Obtaining health care in another European Union Member State: how easy is it to find relevant information?
Eur J Public Health
PUBLISHED: 08-07-2014
Show Abstract
Hide Abstract
The European Union Directive on cross-border health care places an obligation on member states (MSs) to establish one or more national contact points (NCPs). We evaluated whether MSs were meeting their legal obligations. Two researchers created a set of criteria, drawn from the Directive, to evaluate the information that 18 MSs provide on their NCP websites. Some 15 of the 18 MSs evaluated provided >75% of the information sought. This report shows examples of best practices that could be used to encourage other MSs to improve the quality and quantity of information provided.
Related JoVE Video
Patterns of alcohol consumption and myocardial infarction risk: observations from 52 countries in the INTERHEART case-control study.
Circulation
PUBLISHED: 06-13-2014
Show Abstract
Hide Abstract
Although moderate alcohol use is associated with protection against myocardial infarction (MI), it is not known whether this effect is generalizable to populations worldwide. It is also uncertain whether differences in the pattern of alcohol use (and in particular heavy episodic consumption) between different regions negate any beneficial effect.
Related JoVE Video
Economic suicides in the Great Recession in Europe and North America.
Br J Psychiatry
PUBLISHED: 06-12-2014
Show Abstract
Hide Abstract
There has been a substantial rise in 'economic suicides' in the Great Recessions afflicting Europe and North America. We estimate that the Great Recession is associated with at least 10 000 additional economic suicides between 2008 and 2010. A critical question for policy and psychiatric practice is whether these suicide rises are inevitable. Marked cross-national variations in suicides in the recession offer one clue that they are potentially avoidable. Job loss, debt and foreclosure increase risks of suicidal thinking. A range of interventions, from upstream return-to-work programmes through to antidepressant prescriptions may help mitigate suicide risk during economic downturn.
Related JoVE Video
Licensing procedures and registration of medical doctors in the European Union.
Clin Med
PUBLISHED: 06-04-2014
Show Abstract
Hide Abstract
The current proposals to update the European Union (EU) directive on professional qualifications will have potentially important implications for health professions. Yet those discussing it will struggle to find basic information on key issues such as licensing and registration of physicians in different countries. A survey was conducted among national experts in 14 EU member states, supplemented by literature and independent expert review. The questionnaire covered five components of licensing and registration: (1) definitions, (2) regulatory basis, (3) governance, (4) the process of registration and (5) flow and quantity of applications. We identify seven areas of concern: (1) the meaning of terminology, which is inconsistent; (2) the role of language assessments and the responsibility for them; (3) whether approval to practise should be lifelong or time limited, subject to periodic assessment; (4) the need for improved systems to identify those deemed no longer fit to practise in one member state; (5) the complexity of processes for graduates from non-EU/European Economic Area (EAA) countries; (6) public access to registers; and (7) transparency of systems of governance. The systems of licensing and registration of doctors in Europe have developed within specific national contexts and vary widely. This creates inevitable problems in the context of free movement of professionals and increasing mobility.
Related JoVE Video
Mental disorders and their association with disability among internally displaced persons and returnees in georgia.
J Trauma Stress
PUBLISHED: 04-23-2014
Show Abstract
Hide Abstract
There remains limited evidence on comorbidity of mental disorders among conflict-affected civilians, particularly internally displaced persons (IDPs) and former IDPs who have returned to their home areas (returnees). The study aim was to compare patterns of mental disorders and their influence on disability between IDPs and returnees in the Republic of Georgia. A cross-sectional household survey was conducted with adult IDPs from the conflicts in the 1990s, the 2008 conflict, and returnees. Posttraumatic stress disorder (PTSD), depression, anxiety, and disability were measured using cut scores on Trauma Screening Questionnaire, Patient Health Questionnaire 9, Generalised Anxiety Disorder 7, and the WHO Disability Assessment Schedule 2.0. Among the 3,025 respondents, the probable prevalence of PTSD, depression, anxiety, and comorbidity (>1 condition) was 23.3%, 14.0%, 10.4%, 12.4%, respectively. Pearson correlation coefficients (p < .001) were .40 (PTSD with depression), .38 (PTSD with anxiety), and .52 (depression with anxiety). Characteristics associated with mental disorders in regression analyses included displacement (particularly longer-term), cumulative trauma exposure, female gender, older age, poor community conditions, and bad household economic situation; coefficients ranged from 1.50 to 3.79. PTSD, depression, anxiety, and comorbidity were associated with increases in disability of 6.4%, 9.7%, 6.3%, and 15.9%, respectively. A high burden of psychiatric symptoms and disability persist among conflict-affected persons in Georgia.
Related JoVE Video
In search of patient-centred care in middle income countries: The experience of diabetes care in the former Soviet Union.
Health Policy
PUBLISHED: 03-20-2014
Show Abstract
Hide Abstract
In this study we apply the principles of patient-centred care to assess how health systems in middle income countries shape the experiences of patients with a common chronic disease and their care providers. We conducted semi-structured interviews with patients with diabetes, health professionals and key informants. We selected interviewees by purposive and snowball sampling. In total 340 respondents were interviewed in five countries: Armenia, Belarus, Moldova, Russia and Ukraine. Data were analysed according to a coding framework that was developed by three researchers, who then uncovered salient themes, similarities and differences between the five countries. Access to and consistent use of services was hampered by the lack of coordination and the financial weaknesses in the health systems. In many cases, lack of external support for individual patients left friends and family as the main providers of support. Patients were not expected to have a say or challenge the decisions concerning their treatment. Our study suggests the need for a radically different way of delivering care for people with diabetes and, by extension, other chronic diseases. Reforms should focus on improving self-management, the coordination of care, involving patients in decisions about their care, and providing emotional and practical support for patients.
Related JoVE Video
Exploring the scope of practice and training of Obstetricians and Gynaecologists in England, Italy and Belgium: a qualitative study.
Eur. J. Obstet. Gynecol. Reprod. Biol.
PUBLISHED: 03-11-2014
Show Abstract
Hide Abstract
This study explores the scope of practice of Obstetrics and Gynaecology specialists in Italy, Belgium and England, in light of the growth of professional and patient mobility within the EU which has raised concerns about a lack of standardisation of medical speciality practice and training.
Related JoVE Video
Prevalence of alcohol-related pathologies at autopsy: Estonian Forensic Study of Alcohol and Premature Death.
Addiction
PUBLISHED: 03-06-2014
Show Abstract
Hide Abstract
Alcohol can induce diverse serious pathologies, yet this complexity may be obscured when alcohol-related deaths are classified according to a single underlying cause. We sought to quantify this issue and its implications for analysing mortality data.
Related JoVE Video
Exploring the experiences of EU qualified doctors working in the United Kingdom: A qualitative study.
Health Policy
PUBLISHED: 03-04-2014
Show Abstract
Hide Abstract
This qualitative study of 23 doctors from other EU member states working in the UK highlights that, contrary to media reports, doctors from other member states working in the UK were well prepared and their main motivation to migrate was to learn new skills and experience a new health care system. Interviewees highlighted some aspects of their employment that work well and others that need improving. Some interviewees reported initially having language problems, but most noted that this was resolved after a few months. These doctors overwhelmingly reported having very positive experiences with patients, enjoying a NHS structure that was less hierarchical structure than in their home systems, and appreciating the emphasis on evidence-based medicine. Interviewees mostly complained about the lack of cleanliness of hospitals and gave some examples of risk to patient safety. Interviewees did not experience discrimination other than some instances of patronising and snobbish behaviour. However, a few believed that their nationality was a block to achieving senior positions. Overall, interviewees reported having enjoyable experiences with patients and appreciating what the NHS had to offer.
Related JoVE Video
Using multi-level data to estimate the effect of an 'alcogenic' environment on hazardous alcohol consumption in the former Soviet Union.
Health Place
PUBLISHED: 02-18-2014
Show Abstract
Hide Abstract
The purpose of this study was to assess whether alcohol-related community characteristics act collectively to influence individual-level alcohol consumption in the former Soviet Union (fSU).
Related JoVE Video
The timing of introduction of pharmaceutical innovations in seven European countries.
J Eval Clin Pract
PUBLISHED: 02-10-2014
Show Abstract
Hide Abstract
Differences in the performance of medical care may be due to variation in the introduction and diffusion of medical innovations. The objective of this paper is to compare seven European countries (United Kingdom, the Netherlands, West Germany, France, Spain, Estonia and Sweden) with regard to the year of introduction of six specific pharmaceutical innovations (antiretroviral drugs, cimetidine, tamoxifen, cisplatin, oxalaplatin and cyclosporin) that may have had important population health impacts.
Related JoVE Video
Public-private partnerships with large corporations: setting the ground rules for better health.
Health Policy
PUBLISHED: 02-01-2014
Show Abstract
Hide Abstract
Public-private partnerships with large corporations offer potential benefits to the health sector but many concerns have been raised, highlighting the need for appropriate safeguards. In this paper we propose five tests that public policy makers may wish to apply when considering engaging in such a public-private partnership. First, are the core products and services provided by the corporation health enhancing or health damaging? In some cases, such as tobacco, the answer is obvious but others, such as food and alcohol, are contested. In such cases, the burden of proof is on the potential partners to show that their activities are health enhancing. Second, do potential partners put their policies into practice in the settings where they can do so, their own workplaces? Third, are the corporate social responsibility activities of potential partners independently audited? Fourth, do potential partners make contributions to the commons rather than to narrow programmes of their choosing? Fifth, is the role of the partner confined to policy implementation rather than policy development, which is ultimately the responsibility of government alone?
Related JoVE Video
Do cancer-specific websites meet patient's information needs?
Patient Educ Couns
PUBLISHED: 01-23-2014
Show Abstract
Hide Abstract
To evaluate commonly used cancer websites' information provision, we developed and applied an Information Comprehensiveness Tool to breast and prostate cancer websites.
Related JoVE Video
A Novel Method to Evaluate the Community Built Environment Using Photographs - Environmental Profile of a Community Health (EPOCH) Photo Neighbourhood Evaluation Tool.
PLoS ONE
PUBLISHED: 01-01-2014
Show Abstract
Hide Abstract
Previous research has shown that environments with features that encourage walking are associated with increased physical activity. Existing methods to assess the built environment using geographical information systems (GIS) data, direct audit or large surveys of the residents face constraints, such as data availability and comparability, when used to study communities in countries in diverse parts of the world. The aim of this study was to develop a method to evaluate features of the built environment of communities using a standard set of photos. In this report we describe the method of photo collection, photo analysis instrument development and inter-rater reliability of the instrument.
Related JoVE Video
Individual and community level risk-factors for alcohol use disorder among conflict-affected persons in Georgia.
PLoS ONE
PUBLISHED: 01-01-2014
Show Abstract
Hide Abstract
The evidence on alcohol use disorder among conflict-affected civilian populations remains extremely weak, despite a number of potential risk-factors. The aim of this study is to examine patterns of alcohol use disorder among conflict-affected persons in the Republic of Georgia.
Related JoVE Video
Social-democratic government and health policy in Europe: a quantitative analysis.
Int J Health Serv
PUBLISHED: 09-27-2013
Show Abstract
Hide Abstract
Although health policy ultimately depends on political decision making, empirical evidence of the impact of politics on implementation of health policies and their population health outcomes is scarce. In this study, we assess the effects of social-democratic government participation on indicators of preventive health policy (tobacco, alcohol, food, mother and child health, infectious diseases, hypertension, cancer screening, road traffic safety, air pollution) in Europe. Cumulative years of social-democratic government differed widely between European countries, as did indicators of current health policy performance, but the latter are not associated with recent social-democratic government. However, there is a positive association with social-democratic government cumulated over five decades. Positive effects of social-democratic government are mainly seen on indicators of tobacco and alcohol control. We conclude that long-term social-democratic government participation may have had a positive impact on some areas of preventive health policy, perhaps through the creation of strong public health institutions or a strong public health workforce.
Related JoVE Video
Global health in foreign policy--and foreign policy in health? Evidence from the BRICS.
Health Policy Plan
PUBLISHED: 09-25-2013
Show Abstract
Hide Abstract
Amidst the growing literature on global health, much has been written recently about the Brazil, Russia, India, China, South Africa (BRICS) countries and their involvement and potential impact in global health, particularly in relation to development assistance. Rather less has been said about countries motivations for involvement in global health negotiations, and there is a notable absence of evidence when their motivations are speculated on. This article uses an existing framework linking engagement in global health to foreign policy to explore differing levels of engagement by BRICS countries in the global health arena, with a particular focus on access to medicines. It concludes that countries differing and complex motivations reinforce the need for realistic, pragmatic approaches to global health debates and their analysis. It also underlines that these analyses should be informed by analysis from other areas of foreign policy.
Related JoVE Video
Differential impact of the economic recession on alcohol use among white British adults, 2004-2010.
Eur J Public Health
PUBLISHED: 09-20-2013
Show Abstract
Hide Abstract
Background: Unlike other west European countries, there is a long-term trend of rising alcohol consumption and mortality in England. Whether drinking will rise or fall during the current recession is widely debated. We examined how the recession affected alcohol use in adults in England using individual-level data. Methods: We analysed a nationally representative sample of non-institutionalized white persons aged 20-60 years from seven waves of the Health Survey for England, 2004-2010 (n = 36 525), to assess trends in alcohol use and frequency before, during and after the recession and in association with unemployment, correcting for possible changes in sample composition and socio-demographic confounders. The primary analysis compared 2006/7 with 2008/9, following the official onset of the UK recession in early 2008. Results: During Englands recession, there was a significant decrease in frequent drinking defined as drinking four or more days in the past week (27.1% in 2006 to 23.9% in 2009, P < 0.001), the number of units of alcohol imbibed on the heaviest drinking day (P < 0.01) and the number of days that individuals reported drinking over the past seven days (P < 0.01). However, among current drinkers who were unemployed there was a significantly elevated risk of binge drinking in 2009 and 2010 (odds ratio = 1.64, 95% confidence interval: 1.22-2.19, P = 0.001) that was not previously observed in 2004-2008 (1.03, 0.76-1.41; test for effect heterogeneity: P = 0.036). Conclusions: Englands recession was associated with less hazardous drinking among the population overall, but with rises in binge drinking among a smaller high-risk group of unemployed drinkers.
Related JoVE Video
Health systems performance and cancer outcomes.
J. Natl. Cancer Inst. Monographs
PUBLISHED: 08-22-2013
Show Abstract
Hide Abstract
Do the characteristics of health systems influence cancer outcomes? Although caveats are required when undertaking international comparisons of both health systems and cancer outcomes, observed differences cannot solely be explained by data problems or economic development. Health systems can influence cancer outcomes through three mechanisms: coverage, innovation, and quality of care. First, in countries where population coverage is incomplete, patients may find certain services excluded or face substantial copayments or deductibles. Second, there are variations in the rate at which innovative treatments are introduced, reflecting in particular the need for publicly funded health systems to compare costs and benefits of increasingly expensive treatments given demands for other treatments. Third, systematic differences in quality of care (early diagnosis, timely and equitable access to specialist care, and existence of systematic coordination between these activities) may lead to variations in cancer outcomes.
Related JoVE Video
Evidence and ideology as a rationale for light-therapy in Russia: from the Soviet Union to the present day.
JRSM Short Rep
PUBLISHED: 08-01-2013
Show Abstract
Hide Abstract
Light therapy is still used to treat a number of common diseases in Russia. The practice is firmly anchored in history: Soviet clinical practice was divorced from the emerging field of evidence-based medicine. Medical researchers were cut off from international medical research and scientific literature, with much Soviet scientific activity based on a particular socialist ideology. In this study, the use of light therapy serves as a case study to explore tensions between international evidence-based medicine and practices developed in isolation under the Soviet Union, the legacy of which is to the detriment of many patients today. We used four different search methods to uncover scientific and grey literature, both historical and contemporary. We assessed the changing frequency of publications over time and contrasted the volume of literature on light therapy with more orthodox treatments such as statins and painkillers. Our search found an increasing number and comparatively large body of scientific publications on light therapy in the Russian language, and many publications emanating from prestigious Russian institutions. Combined with our analysis of the historical literature and our appraisal of 22 full text articles, this leads us to suggest that light therapy entered mainstream Soviet medical practice before the Stalinist period and still occupies an important position in contemporary Russian clinical practice. We propose that this outdated treatment survives in Russia in part due to the political, economic and social forces that helped to popularize it during Soviet times, and by the seeming justification offered by poorly executed studies.
Related JoVE Video
Recent physician strike in Israel: a health system under stress?
Isr J Health Policy Res
PUBLISHED: 08-01-2013
Show Abstract
Hide Abstract
In 2011, a series of physician strikes in Israel followed eight months of unsuccessful negotiations with the government (Ministry of Health and the Ministry of Finance). Strikes by physicians may be a warning that all is not well in a health system and protestors have claimed that they signify a system failure. In contrast, others argue that strikes have been a feature of the Israeli health system from its inception and should not be a cause for alarm. This paper analyses the Israeli health system from the perspective of the strikers demands using the World Health Organisations six health system building blocks as a framework, including: service delivery; health workforce; information; medical products, vaccines and technologies; leadership and governance; and financing. While we recognise that the immediate causes of the 2011 strikes were concerns about salaries and working conditions, we argue that a complex set of interacting factors underlie the strikers demands, resonating with issues relating to five of the WHO building blocks. We argue that of the five, three are most significant and limit progress with all the others: a disgruntled health workforce, many of whom believe that striking is the only way to be heard; a lack of leadership by the government in understanding and responding to physicians concerns; and a purported information insufficiency, manifest as a lack of critique and analysis that may have prevented those at the top from making a reliable diagnosis of the systems problems. This paper argues that there are cracks within the Israeli health system but that these are not irresolvable. The Israeli health system is a relatively new and popular health system, but there are no grounds for complacency.
Related JoVE Video
The mystery of missing female children in the Caucasus: an analysis of sex ratios by birth order.
Int Perspect Sex Reprod Health
PUBLISHED: 07-31-2013
Show Abstract
Hide Abstract
Official data on sex ratios at birth suggest a rise in sex-selective abortions in some post-Soviet states following the introduction of ultrasonography. However, questions remain about the validity of official data in these nations as well as whether the high sex ratios at birth are a statistical artifact.
Related JoVE Video
The political economy of austerity and healthcare: Cross-national analysis of expenditure changes in 27 European nations 1995-2011.
Health Policy
PUBLISHED: 07-24-2013
Show Abstract
Hide Abstract
Why have patterns of healthcare spending varied during the Great Recession? Using cross-national, harmonised data for 27 EU countries from 1995 to 2011, we evaluated political, economic, and health system determinants of recent changes to healthcare expenditure. Data from EuroStat, the IMF, and World Bank (2013 editions) were evaluated using multivariate random- and fixed-effects models, correcting for pre-existing time-trends. Reductions in government health expenditure were not significantly associated with magnitude of economic recessions (annual change in GDP, p=0.31, or cumulative decline, p=0.40 or debt crises (measured by public debt as a percentage of GDP, p=0.38 or per capita, p=0.83)). Nor did ideology of governing parties have an effect. In contrast, each $100 reduction in tax revenue was associated with a $2.72 drop in health spending (95% CI: $1.03-4.41). IMF borrowers were significantly more likely to reduce healthcare budgets than non-IMF borrowers (OR=3.88, 95% CI: 1.95 -7.74), even after correcting for potential confounding by indication. Exposure to lending from international financial institutions, tax revenue falls, and decisions to implement cuts correlate more closely than underlying economic conditions or orientation of political parties with healthcare expenditure change in EU member states.
Related JoVE Video
The influence of health systems on hypertension awareness, treatment, and control: a systematic literature review.
PLoS Med.
PUBLISHED: 07-01-2013
Show Abstract
Hide Abstract
Hypertension (HT) affects an estimated one billion people worldwide, nearly three-quarters of whom live in low- or middle-income countries (LMICs). In both developed and developing countries, only a minority of individuals with HT are adequately treated. The reasons are many but, as with other chronic diseases, they include weaknesses in health systems. We conducted a systematic review of the influence of national or regional health systems on HT awareness, treatment, and control.
Related JoVE Video
The effect of the late 2000s financial crisis on suicides in Spain: an interrupted time-series analysis.
Eur J Public Health
PUBLISHED: 06-25-2013
Show Abstract
Hide Abstract
The current financial crisis is having a major impact on European economies, especially that of Spain. Past evidence suggests that adverse macro-economic conditions exacerbate mental illness, but evidence from the current crisis is limited. This study analyses the association between the financial crisis and suicide rates in Spain.
Related JoVE Video
An analysis of subject areas and country participation for all health-related projects in the EUs FP5 and FP6 programmes.
Eur J Public Health
PUBLISHED: 06-25-2013
Show Abstract
Hide Abstract
Previous analyses concerning health components of European Union (EU)-funded research have shown low project participation levels of the 12 newest member states (EU-12). Additionally, there has been a lack of subject-area analysis. In the Health Research for Europe project, we screened all projects of the EUs Framework Programmes for research FP5 and FP6 (1998-2006) to identify health research projects and describe participation by country and subject area.
Related JoVE Video
An examination of the association between premature mortality and life expectancy among men in Europe.
Eur J Public Health
PUBLISHED: 06-21-2013
Show Abstract
Hide Abstract
A feature of the health of men across Europe is their higher rates of premature mortality and shorter life expectancy at birth than women. Following the publication of the first State of Mens Health in Europe report, we sought to explore possible reasons.
Related JoVE Video
Does investment in the health sector promote or inhibit economic growth?
Global Health
PUBLISHED: 06-14-2013
Show Abstract
Hide Abstract
Is existing provision of health services in Europe affordable during the recession or could cuts damage economic growth? This debate centres on whether government spending has positive or negative effects on economic growth. In this study, we evaluate the economic effects of alternative types of government spending by estimating "fiscal multipliers" (the return on investment for each $1 dollar of government spending).
Related JoVE Video
Obstacles to the recognition of medical prescriptions issued in one EU country and presented in another.
Eur J Public Health
PUBLISHED: 06-11-2013
Show Abstract
Hide Abstract
A study involving the presentation of 192 Belgian or Finnish prescriptions in pharmacies in five other member states was undertaken to assess whether, as envisaged by European Union law, prescriptions issued in one member state are dispensed by pharmacists in another and to identify factors that influence such decisions. Overall, pharmacists were willing to dispense in 108 cases. Detailed results show important differences depending on the country where prescriptions are presented and whether prescriptions were written by International Nonproprietary Name and in English, as opposed to prescriptions written by brand in a national language.
Related JoVE Video
Changing patterns of fruit and vegetable intake in countries of the former Soviet Union.
Public Health Nutr
PUBLISHED: 05-23-2013
Show Abstract
Hide Abstract
To assess how the frequency of low fruit and vegetable consumption has changed in countries of the former Soviet Union (FSU) between 2001 and 2010 and to identify factors associated with low consumption.
Related JoVE Video
What to do when presented with a prescription from another European country: insight from a qualitative study of pharmacists in England.
Int J Pharm Pract
PUBLISHED: 05-07-2013
Show Abstract
Hide Abstract
Prescriptions for medicines issued by healthcare professionals in other parts of the European Union are legally valid in the UK. However, it is not known whether this is fully understood by British community pharmacists. In this study we aimed to understand the implementation of UK pharmacy policy on dispensing prescriptions from other parts of the European Union and to investigate pharmacists knowledge and interpretation of the relevant provisions in a mystery shopping exercise in English pharmacies.
Related JoVE Video
Prospective Urban Rural Epidemiology (PURE) study: Baseline characteristics of the household sample and comparative analyses with national data in 17 countries.
Am. Heart J.
PUBLISHED: 04-29-2013
Show Abstract
Hide Abstract
The PURE study was established to investigate associations between social, behavioural, genetic, and environmental factors and cardiovascular diseases in 17 countries. In this analysis we compare the age, sex, urban/rural, mortality, and educational profiles of the PURE participants to national statistics.
Related JoVE Video
Estimating the causal effect of alcohol consumption on well-being for a cross-section of 9 former Soviet Union countries.
Soc Sci Med
PUBLISHED: 04-17-2013
Show Abstract
Hide Abstract
While the adverse health and economic consequences attributable to alcohol consumption are widely acknowledged, its impact on psychological wellbeing is less well understood. This is to a large extent due to the challenge of establishing causal effects of alcohol consumption when using standard single-equation econometric analyses. Using a unique dataset collected in 2010/11 of 18,000 individuals and also community characteristics from nine countries of the former Soviet Union, a region with a major burden of alcohol related ill health, we address this problem by employing an instrumental variable approach to identify any causal effects of alcohol consumption on mental well-being. The availability of 24-h alcohol sales outlets in the neighbourhood of the individuals is used as an instrument, based on theoretical reasoning and statistical testing of its validity. We find that increased alcohol consumption decreases well-being and that ignoring endogeneity leads to underestimation of this effect. This finding adds a further and previously under-appreciated dimension to the expected benefits that could be achieved with more effective alcohol policy in this region.
Related JoVE Video
Tobacco use and nicotine dependence among conflict-affected men in the Republic of Georgia.
Int J Environ Res Public Health
PUBLISHED: 04-02-2013
Show Abstract
Hide Abstract
There is very little evidence globally on tobacco use and nicotine dependence among civilian populations affected by armed conflict, despite key vulnerability factors related to elevated mental disorders and socio-economic stressors. The study aim was to describe patterns of smoking and nicotine dependence among conflict-affected civilian men in the Republic of Georgia and associations with mental disorders.
Related JoVE Video
Innovations in health care and mortality trends from five cancers in seven European countries between 1970 and 2005.
Int J Public Health
PUBLISHED: 03-15-2013
Show Abstract
Hide Abstract
Although the contribution of health care to survival from cancer has been studied extensively, much less is known about its contribution to population health. We examine how medical innovations have influenced trends in cause-specific mortality at the national level.
Related JoVE Video
Criminal victimisation and health: examining the relation in nine countries of the former Soviet Union.
Soc Sci Med
PUBLISHED: 02-16-2013
Show Abstract
Hide Abstract
Previous research suggests that criminal victimisation can impact negatively on both physical and psychological health. However, as yet, little is known about crime and its effects on population health in the former Soviet Union (fSU) - despite a sharp growth in crime rates in the countries in this region after the collapse of the communist system. Given this gap in current knowledge, this study examined two forms of crime, theft and violent victimisation, in nine fSU countries - Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia and Ukraine. Using nationally representative data from the Health in Times of Transition (HITT) study collected from 18,000 respondents in 2010/11, the study had two main objectives: (1) to identify which demographic and socioeconomic factors are associated with being a victim of crime; (2) to examine the relation between criminal victimisation and two health outcomes - self-rated health and psychological distress. We found that similar factors were associated with experiencing both forms of crime among respondents. Those who were younger, not married and who consumed alcohol more frequently were at increased risk of victimisation, while greater social capital was associated with lower odds for victimisation. Low education increased the risk of experiencing violence by 1.5 times. Victimisation was strongly associated with poorer health: victims of violence were 2.5 and 2.9 times more likely to report poor self-rated health and psychological distress, respectively, while the corresponding figures for theft victimisation were 1.9 and 1.8. The strong association we observed between criminal victimisation and poorer individual health suggests that, in addition to policies that reduce rates of crime, more research is now urgently needed on victimisation. Specifically, researchers should ascertain whether the association with poor health is causal, determine its potential mechanisms, and evaluate interventions that might mitigate its impact on health that are contextually appropriate in the fSU.
Related JoVE Video
Loneliness: its correlates and association with health behaviours and outcomes in nine countries of the former Soviet Union.
PLoS ONE
PUBLISHED: 01-01-2013
Show Abstract
Hide Abstract
Research suggests that the prevalence of loneliness varies between countries and that feeling lonely may be associated with poorer health behaviours and outcomes. The aim of the current study was to examine the factors associated with loneliness, and the relationship between feeling lonely and health behaviours and outcomes in the countries of the former Soviet Union (FSU)--a region where loneliness has been little studied to date.
Related JoVE Video
Combined effect of ADH1B RS1229984, RS2066702 and ADH1C RS1693482/ RS698 alleles on alcoholism and chronic liver diseases.
Dis. Markers
PUBLISHED: 11-04-2011
Show Abstract
Hide Abstract
The aim of this study was to analyze the combined effect of the most frequent alcohol dehydrogenase polymorphisms (Arg48His and Arg370Cys in ADH1B, Arg272Gln and Ile350Val in ADH1C) on the alcohol use habits, alcohol dependence and chronic liver diseases in Hungary. The study included men, aged 45-64 years. Altogether, 241 cases with chronic liver disease (CLD) and 666 randomly selected controls without CLD were analysed for all four polymorphisms. Associations between the polymorphisms, individually, and in combination, and excessive and problem drinking and CLD, were assessed using logistic regression. In this study we have identified a novel mutation, called ADH1B Arg370His. The ADH1C Arg272Gln and Ile350Val showed almost complete linkage. The 272Gln/35Val allele increased the risk of excessive and problem drinking in homozygous form (OR=1.582, p=0.035, CI=1.034-2.421, OR=1.780, p=0.016, CI=1.113-2.848, respectively). The joint analysis showed that when combined with the wild type ADH1C Arg272/Ile350 allele, the ADH1B 48His is protective against CLD (OR=0.368, p=0.019, CI=0.159-0.851). The results obtained in the study help not only to clarify the effects of different ADH SNPs but to better understand how these polymorphisms modify each others effects in the development of alcoholism and related diseases.
Related JoVE Video
Healthy by law: the missed opportunity to use laws for public health.
Lancet
PUBLISHED: 10-05-2011
Show Abstract
Hide Abstract
Health is the result of biological and social determinants; both are important. Nature dictates the laws for biological determinants; people create the laws for social determinants. Natures laws are hard to discover and are eternal whether or not they suit humanity; peoples laws are easily written and can be changed at anytime to suit humanity better. So why is it that the public health community, which expends much effort and expense probing natural laws, places negligible emphasis on collection, analysis, and making greater use of the worlds public health laws?
Related JoVE Video
Health care reform in the former Soviet Union: beyond the transition.
Health Serv Res
PUBLISHED: 09-23-2011
Show Abstract
Hide Abstract
To assess accessibility and affordability of health care in eight countries of the former Soviet Union.
Related JoVE Video
Inequalities in male mortality by occupational class, perceived status and education in Russia, 1994-2006.
Eur J Public Health
PUBLISHED: 09-21-2011
Show Abstract
Hide Abstract
Russias market reforms in the early 1990s led to marked social inequalities. We analysed inequalities in risks of dying for Russian men by occupational class and perceived social status in the post-transition era.
Related JoVE Video
Patterns of adult tobacco use in Uzbekistan.
Eur J Public Health
PUBLISHED: 09-09-2011
Show Abstract
Hide Abstract
Little is known about the prevalence of tobacco use in Uzbekistan, a country targeted intensively by the international tobacco industry.
Related JoVE Video
Measuring NHS performance 1990-2009 using amenable mortality: interpret with care.
J R Soc Med
PUBLISHED: 09-02-2011
Show Abstract
Hide Abstract
The new performance framework for the NHS in England will assess how well health services are preventing people from dying prematurely, based on the concept of mortality amenable to healthcare. We ask how the different parts of the UK would be assessed had this measure been in use over the past two decades, a period that began with somewhat lower levels of health expenditure in England and Wales than in Scotland and Northern Ireland but which, after 1999, saw the gap closing.
Related JoVE Video
Pharmaceutical lobbying under postcommunism: universal or country-specific methods of securing state drug reimbursement in Poland?
Health Econ Policy Law
PUBLISHED: 08-08-2011
Show Abstract
Hide Abstract
This paper aims to fill in the gap in research on the effect of pharmaceutical lobbying on drug reimbursement policy, particularly in Poland, a post-communist country. To this end, we conducted in-depth, semi-structured, anonymous, elite interviews in Poland, supplemented by a review of legislation, policy documents, official reports and press articles, as well as observations. Overall, 109 representatives of stakeholders involved in reimbursement policy were interviewed. We identified two key lobbying methods: informal persuasion and third-party endorsements. These methods are coupled with two supplementary ones: lobbying through parliament and ministries, as well as diplomatic pressure. Pharmaceutical lobbying methods in Poland clearly resemble those used in other European countries. What is notable about the Polish case is extensive reliance on informal lobbying and diplomatic pressure.
Related JoVE Video
A review of the impacts of tobacco industry privatisation: Implications for policy.
Glob Public Health
PUBLISHED: 07-28-2011
Show Abstract
Hide Abstract
State-owned tobacco companies, which still account for 40% of global cigarette production, face continued pressure from, among others, the International Monetary Fund (IMF), to be privatised. This review of available literature on tobacco industry privatisation suggests that any economic benefits of privatisation may be lower than supposed, because private owners avoid competitive tenders (thus underpaying for assets), negotiate lengthy tax holidays and are complicit in the smuggling of cigarettes to avoid import and excise duties. It outlines how privatisation leads to increased marketing, more effective distribution and lower prices, creating additional demand for cigarettes among new and existing smokers, leading to increased cigarette consumption, higher smoking prevalence and lower age of smoking initiation. Privatisation also weakens tobacco control because private owners, in their drive for profits, lobby aggressively against effective policies and ignore or overturn existing policies. This evidence suggests that further tobacco industry privatisation is likely to increase smoking and that instead of transferring assets from state to private ownership, alternative models of supply should be explored.
Related JoVE Video
Serve the people or close the sale? Profit-driven overuse of injections and infusions in Chinas market-based healthcare system.
Int J Health Plann Manage
PUBLISHED: 07-08-2011
Show Abstract
Hide Abstract
Treatment by injection or infusion is widespread in China. Using the common cold as a tracer condition, we explored the reasons for over-prescription of injections and infusions in Guizhou, China. Interviews with prescribers, patients and key informants were supplemented by focus groups. These revealed how historical ideas encourage unnecessary use of percutaneous treatment: faith in the healing power of needles is locally attributed to association with acupuncture. Many patients and some staff believe that injections per se are therapeutic. However, the structure of health service financing and remuneration now reinforces this irrational faith. Market-based reforms have attempted to control costs and increase productivity with an incentive scheme which rewards prescribers financially for over-prescription in general and for use of injections and infusions in particular. Aggressive marketing has displaced oral treatment from health facilities into independent pharmacies, leaving doctors functioning mainly as injection providers. There is a need for a multi-faceted response encompassing education and reform of financial incentives to reduce the use of unnecessary treatment.
Related JoVE Video
The efficacy of a brief intervention in reducing hazardous drinking in working age men in Russia: the HIM (Health for Izhevsk men) individually randomised parallel group exploratory trial.
Trials
PUBLISHED: 07-05-2011
Show Abstract
Hide Abstract
Russia has particularly low life expectancy for an industrialised country, with mortality at working ages having fluctuated dramatically over the past few decades, particularly among men. Alcohol has been identified as the most likely cause of these temporal variations. One approach to reducing the alcohol problem in Russia is brief interventions which seek to change views of the personal acceptability of excessive drinking and to encourage self-directed behaviour change. Very few studies to evaluate the efficacy of brief interventions in Russia have been conducted. Motivational Interviewing (MI) is a person-centred counselling style which can be adapted to brief interventions in which help is offered in thinking through behaviour in the context of values and goals, to decide whether change is needed, and if so, how it may best be achieved.
Related JoVE Video
Socio-demographic predictors of dimensions of the AUDIT score in a population sample of working-age men in Izhevsk, Russia.
Alcohol Alcohol.
PUBLISHED: 07-03-2011
Show Abstract
Hide Abstract
To investigate the relationship between socio-demographic factors and alcohol drinking patterns identified through a formal analysis of the factor structure of the Alcohol Use Disorders Identification Test (AUDIT) score in a population sample of working-age men in Russia.
Related JoVE Video
How market-oriented education policies might influence young peoples health: development of a logic model from qualitative case studies in English secondary schools.
J Epidemiol Community Health
PUBLISHED: 06-28-2011
Show Abstract
Hide Abstract
School systems are increasingly typified by diversity of provision, parental choice and publication of performance data. Schools shape their students lifestyles and health, but the effects of marketisation are under-researched. The authors use qualitative data to develop a logic model regarding such effects.
Related JoVE Video
UN High-Level Meeting on Non-Communicable Diseases: addressing four questions.
Lancet
PUBLISHED: 06-12-2011
Show Abstract
Hide Abstract
Non-communicable diseases (NCDs), principally heart disease, stroke, cancer, diabetes, and chronic respiratory diseases, are a global crisis and require a global response. Despite the threat to human development, and the availability of affordable, cost-effective, and feasible interventions, most countries, development agencies, and foundations neglect the crisis. The UN High-Level Meeting (UN HLM) on NCDs in September, 2011, is an opportunity to stimulate a coordinated global response to NCDs that is commensurate with their health and economic burdens. To achieve the promise of the UN HLM, several questions must be addressed. In this report, we present the realities of the situation by answering four questions: is there really a global crisis of NCDs; how is NCD a development issue; are affordable and cost-effective interventions available; and do we really need high-level leadership and accountability? Action against NCDs will support other global health and development priorities. A successful outcome of the UN HLM depends on the heads of states and governments attending the meeting, and endorsing and implementing the commitments to action. Long-term success requires inspired and committed national and international leadership.
Related JoVE Video
Variations in amenable mortality--trends in 16 high-income nations.
Health Policy
PUBLISHED: 05-30-2011
Show Abstract
Hide Abstract
There has been growing interest in the comparison of health system performance within and between countries, using a range of different indicators. This study examines trends in amenable mortality, as one measure of health system performance, in sixteen high-income countries.
Related JoVE Video
The Soviet legacy in diagnosis and treatment: Implications for population health.
J Public Health Policy
PUBLISHED: 05-12-2011
Show Abstract
Hide Abstract
This article reviews diagnosis and treatment in the Commonwealth of Independent States in three clinical areas: tuberculosis, substance misuse, and neurological disorders in children. While the specific problems in each of these areas differ greatly, commonalities emerge, pointing to the continued influence of the Soviet past. Although progress in developing evidence-based medicine is being made, the isolation of Soviet science from Western developments has resulted in the widespread use of outdated diagnostic procedures and treatment protocols, while finance mechanisms still encourage unnecessary hospitalizations and treatments. A hierarchical medical system, as well as underdeveloped patient rights and medical ethics, mean that patients have little information and ability to participate in decision-making. The continued use of outdated approaches to diagnosis and treatment contributes to poor population health outcomes in the region.
Related JoVE Video
Economic crisis and communicable disease control in Europe: a scoping study among national experts.
Health Policy
PUBLISHED: 05-11-2011
Show Abstract
Hide Abstract
The effects of the current global economic crisis on the spread and control of communicable diseases remain uncertain. This study aimed to explore experts views about the impact of the current crisis and measures that have been undertaken by governments to mitigate an alleged adverse effect of the crisis on communicable diseases.
Related JoVE Video
The impact of economic crises on communicable disease transmission and control: a systematic review of the evidence.
PLoS ONE
PUBLISHED: 05-11-2011
Show Abstract
Hide Abstract
There is concern among public health professionals that the current economic downturn, initiated by the financial crisis that started in 2007, could precipitate the transmission of infectious diseases while also limiting capacity for control. Although studies have reviewed the potential effects of economic downturns on overall health, to our knowledge such an analysis has yet to be done focusing on infectious diseases. We performed a systematic literature review of studies examining changes in infectious disease burden subsequent to periods of crisis. The review identified 230 studies of which 37 met our inclusion criteria. Of these, 30 found evidence of worse infectious disease outcomes during recession, often resulting from higher rates of infectious contact under poorer living circumstances, worsened access to therapy, or poorer retention in treatment. The remaining studies found either reductions in infectious disease or no significant effect. Using the paradigm of the "SIR" (susceptible-infected-recovered) model of infectious disease transmission, we examined the implications of these findings for infectious disease transmission and control. Key susceptible groups include infants and the elderly. We identified certain high-risk groups, including migrants, homeless persons, and prison populations, as particularly vulnerable conduits of epidemics during situations of economic duress. We also observed that the long-term impacts of crises on infectious disease are not inevitable: considerable evidence suggests that the magnitude of effect depends critically on budgetary responses by governments. Like other emergencies and natural disasters, preparedness for financial crises should include consideration of consequences for communicable disease control.
Related JoVE Video
A systematic review of the influence on alcohol use of community level availability and marketing of alcohol.
Health Place
PUBLISHED: 04-27-2011
Show Abstract
Hide Abstract
Exposure to a high number of alcohol outlets and adverts within a community may lead to higher alcohol use by local residents. The aim of this systematic review was to explore evidence on the influence on alcohol use of community level availability and marketing of alcohol.
Related JoVE Video
Democracy and growth in divided societies: A health-inequality trap?
Soc Sci Med
PUBLISHED: 04-06-2011
Show Abstract
Hide Abstract
Despite a tremendous increase in financial resources, many countries are not on track to achieve the child and maternal mortality targets set out in the Millennium Development Goals 4 and 5. It is commonly argued that two main social factors - improved democratic governance and aggregate income - will ultimately lead to progress in reducing child and maternal mortality. However, these two factors alone may be insufficient to achieve progress in settings where there is a high level of social division. To test the effects of growth and democratisation, and their interaction with social inequalities, we regressed data on child and maternal mortality rates for 192 countries against internationally used indexes of income, democracy, and population inequality (including income, ethnic, linguistic, and religious divisions) covering the period 1970-2007. We found that a higher degree of social division, especially ethnic and linguistic fractionalisation, was significantly associated with greater child and maternal mortality rates. We further found that, even in democratic states, greater social division was associated with lower overall population access to healthcare and lesser expansion of health system infrastructure. Perversely, while greater democratisation and aggregate income were associated with reduced maternal and child mortality overall, in regions with high levels of ethnic fragmentation the health benefits of democratisation and rising income were undermined and, at high levels of inequality reversed, so that democracy and growth were adversely related to child and maternal mortality. These findings are consistent with literature suggesting that high degrees of social division in the context of democratisation can strengthen the power of dominant elite and ethnic groups in political decision-making, resulting in health and welfare policies that deprive minority groups (a health-inequality trap). Thus, we show that improving economic growth and democratic governance are insufficient to achieve child and maternal health targets in communities with high levels of persistent social inequality. To reduce child and maternal mortality in highly divided societies, it will be necessary not only to increase growth and promote democratic elections, but also empower disenfranchised communities.
Related JoVE Video
The governments doctors: the roles and responsibilities of chief medical officers in the European Union.
Clin Med
PUBLISHED: 12-22-2010
Show Abstract
Hide Abstract
The regular meetings of the chief medical officers (CMOs) from the European Unions (EUs) 27 Member States provide an important forum to address issues of common interest affecting Europes populations. Yet there is no universally agreed role for a CMO. This article describes the findings of a study, based on interviews with key informants and documentary analysis that sought to describe their diverse roles. For the purpose of this article, CMOs are defined as those sent by their governments to the regular EU meetings of CMOs. Four broad categories of countries were identified: those whose CMO is the most senior doctor in the health ministry, in some cases with responsibility spanning all of government; where they are head of a division within the health ministry; head of a separate body such as a national board of health; and countries where no single individual can be identified. Although the diversity of health systems means that these roles cannot be harmonised, there is scope to explore what can be learnt from the different approaches.
Related JoVE Video
Raising the priority of preventing chronic diseases: a political process.
Lancet
PUBLISHED: 11-16-2010
Show Abstract
Hide Abstract
Chronic diseases, especially cardiovascular diseases, diabetes, cancer, and chronic obstructive respiratory diseases,are neglected globally despite growing awareness of the serious burden that they cause. Global and national policies have failed to stop, and in many cases have contributed to, the chronic disease pandemic. Low-cost and highly effective solutions for the prevention of chronic diseases are readily available; the failure to respond is now a political, rather than a technical issue. We seek to understand this failure and to position chronic disease centrally on the global health and development agendas. To identify strategies for generation of increased political priority for chronic diseases and to further the involvement of development agencies, we use an adapted political process model. This model has previously been used to assess the success and failure of social movements. On the basis of this analysis,we recommend three strategies: reframe the debate to emphasise the societal determinants of disease and the interrelation between chronic disease, poverty, and development; mobilise resources through a cooperative and inclusive approach to development and by equitably distributing resources on the basis of avoidable mortality; and build one merging strategic and political opportunities, such as the World Health Assembly 2008–13 Action Plan and the high level meeting of the UN General Assembly in 2011 on chronic disease. Until the full set of threats—which include chronic disease—that trap poor households in cycles of debt and illness are addressed, progress towards equitable human development will remain inadequate.
Related JoVE Video
Prevention and management of chronic disease: a litmus test for health-systems strengthening in low-income and middle-income countries.
Lancet
PUBLISHED: 11-10-2010
Show Abstract
Hide Abstract
National health systems need strengthening if they are to meet the growing challenge of chronic diseases in low-income and middle-income countries. By application of an accepted health-systems framework to the evidence, we report that the factors that limit countries capacity to implement proven strategies for chronic diseases relate to the way in which health systems are designed and function. Substantial constraints are apparent across each of the six key health-systems components of health financing, governance, health workforce, health information, medical products and technologies, and health-service delivery. These constraints have become more evident as development partners have accelerated efforts to respond to HIV, tuberculosis, malaria, and vaccine-preventable diseases. A new global agenda for health-systems strengthening is arising from the urgent need to scale up and sustain these priority interventions. Most chronic diseases are neglected in this dialogue about health systems, despite the fact that non-communicable diseases (most of which are chronic) will account for 69% of all global deaths by 2030 with 80% of these deaths in low-income and middle-income countries. At the same time, advocates for action against chronic diseases are not paying enough attention to health systems as part of an effective response. Efforts to scale up interventions for management of common chronic diseases in these countries tend to focus on one disease and its causes, and are often fragmented and vertical. Evidence is emerging that chronic disease interventions could contribute to strengthening the capacity of health systems to deliver a comprehensive range of services-provided that such investments are planned to include these broad objectives. Because effective chronic disease programmes are highly dependent on well-functioning national health systems, chronic diseases should be a litmus test for health-systems strengthening.
Related JoVE Video
Irregular treatment of hypertension in the former Soviet Union.
J Epidemiol Community Health
PUBLISHED: 11-04-2010
Show Abstract
Hide Abstract
The USSR failed to establish a modern pharmaceutical industry and lacked the capacity for reliable distribution of drugs. Patients were required to pay for outpatient drugs and the successor states have inherited this legacy, so that those requiring long-term treatment face considerable barriers in receiving it. It was hypothesised that citizens of former Soviet republics requiring treatment for hypertension may not be receiving regular treatment.
Related JoVE Video
The influence of concern about crime on levels of psychological distress in the former Soviet Union.
J Epidemiol Community Health
PUBLISHED: 10-29-2010
Show Abstract
Hide Abstract
Previous studies suggest that the fear of crime is associated with worse mental health, with social capital potentially having a mediating influence. However, no studies could be identified on this issue in countries of the former Soviet Union, despite them experiencing increasing rates of crime and profound social change. The aim of this study is to explore the relationship between concern about crime and levels of psychological distress in eight countries of the former Soviet Union.
Related JoVE Video

What is Visualize?

JoVE Visualize is a tool created to match the last 5 years of PubMed publications to methods in JoVE's video library.

How does it work?

We use abstracts found on PubMed and match them to JoVE videos to create a list of 10 to 30 related methods videos.

Video X seems to be unrelated to Abstract Y...

In developing our video relationships, we compare around 5 million PubMed articles to our library of over 4,500 methods videos. In some cases the language used in the PubMed abstracts makes matching that content to a JoVE video difficult. In other cases, there happens not to be any content in our video library that is relevant to the topic of a given abstract. In these cases, our algorithms are trying their best to display videos with relevant content, which can sometimes result in matched videos with only a slight relation.