scholarly journals The Role of Public Nutrition Research Organizations in the Construction, Implementation and Evaluation of Evidence-Based Nutrition Policy: Two National Experiences in Mexico

Nutrients ◽  
2019 ◽  
Vol 11 (3) ◽  
pp. 594 ◽  
Author(s):  
Juan Rivera Dommarco ◽  
Teresita González de Cosío ◽  
C. García-Chávez ◽  
M. Colchero
Keyword(s):  
Risk Factors ◽  
Policy Design ◽  
Scientific Evidence ◽  
Nutrition Policy ◽  
Evidence Based ◽  
Relevant Evidence ◽  
Nutrition Research ◽  
Nutrition Policies ◽  
Policies And Programs

Malnutrition and poor diet are the largest risk factors responsible for the global burden of disease. Therefore, ending all forms of malnutrition by 2030 is a global priority. To achieve this goal, a key element is to design and implement nutrition policies based on the best available scientific evidence. The demand for evidence-based nutrition policies may originate directly from policymakers or through social actors. In both cases, the role of research institutions is to generate relevant evidence for public policy. The two key objects of analysis for the design of an effective policy are the nutrition conditions of the population and the policies and programs available, including the identification of delivery platforms and competencies required by personnel in charge of the provision of services (social response). In addition, systematic literature reviews about risk factors of malnutrition, as well as the efficacy and effectiveness of policy actions, lead to evidence-based policy recommendations. Given the multifactorial nature of malnutrition, the drivers and risk factors operate in several sectors (food and agriculture, health, education, and social development) and may be immediate, underlying or basic causes. This multilevel complexity should be considered when developing nutrition policy. In this article, we show two models for the evidence-based design of nutrition policies and programs that may be useful to academia and decision makers demonstrated by two examples of policy design, implementation and evaluation in Mexico.

scholarly journals Stakeholder Perspectives on Barriers and Facilitators on the Implementation of the 1000 Days Plus Nutrition Policy Activities in Ghana

2021 ◽  
Vol 18 (10) ◽  
pp. 5317
Author(s):  
Anne Galaurchi ◽  
Samuel T. Chatio ◽  
Paula Beeri ◽  
Abraham R. Oduro ◽  
Winfred Ofosu ◽  
...  
Keyword(s):  
Well Being ◽  
Nutrition Policy ◽  
Civil Society Organizations ◽  
Barriers And Facilitators ◽  
Policy Framework ◽  
Economic Productivity ◽  
Stakeholder Perspectives ◽  
Nutrition Policies ◽  
Policies And Programs ◽  
Implementation Resources

Optimizing nutrition in the preconception and 1000 days periods have long-term benefits such as higher economic productivity, reduced risk of related non-communicable diseases and increased health and well-being. Despite Ghana’s recent progress in reducing malnutrition, the situation is far from optimal. This qualitative study analyzed the maternal and child health nutrition policy framework in Ghana to identify the current barriers and facilitators to the implementation of nutrition policies and programs relating to the first 1000 days plus. Data analyzed included in-depth interviews and focus group discussions conducted in Ghana between March and April 2019. Participants were composed of experts from government agencies, civil society organizations, community-based organizations and international partners at national and subnational levels. Seven critical areas were identified: planning policy implementation, resources, leadership and stakeholders’ engagement, implementation guidance and ongoing communication, organizational culture, accountability and governance and coverage. The study showed that, to eradicate malnutrition in Ghana, priorities of individual stakeholders have to be merged and aligned into a single 1000 days plus nutrition policy framework. Furthermore, this study may support stakeholders in implementing successfully the 1000 days plus nutrition policy activities in Ghana.

scholarly journals Evidence-Based Management of Gout - A Systematic Search and Review

2020 ◽  
Author(s):  
Md Abu Bakar Siddiq
Keyword(s):  
Risk Factors ◽  
Treatment Options ◽  
Evidence Based ◽  
Level Of Evidence ◽  
Pharmacological Agents ◽  
New Synthesis ◽  
Pubmed Database ◽  
Anti Inflammatory ◽  
Clinical Conditions

Gout is the most common form of inflammatory arthritis. Hyperuricaemia is the pre-requisite for gout and is influenced by variable modifiable and non-modifiable risk factors. Clinical features unique for gout are due to deposition of monosodium urate (MSU) crystal in articular and extra articular tissues. Among various treating agents, anti-inflammatory drugs and urate lowering therapies (ULT) are used widely and successfully, however, non-medicinal means are also effective in the disorder. In their updated guidelines, ACR (2012) and EULAR (2016) recommended both medicinal and non-medicinal approaches that could be used in treating gout, though some of the recommendations are based on lower level of evidence. Moreover, researchers’ continued effort in finding new gout managing agents appear promising, for example, role of Lesinurad in gout management (CLEAR1, CLEAR2). In this new synthesis the author is aimed to provide updated information on gout management based on a systematic review including published work within last ten years between 2008 and 2018 and for this purpose, using ‘clinical trials in gout management’ string, published worked searched in PubMed database from 1st September 2018 to 30 October 2018. Besides the recent ACR and EULAR evidence based management guidelines, the author reviewed another 91 (total 93) articles to make this new draft – 39 articles describe role of pharmacological agents and 54 describe different gout risks, pharmacokinetics/pharmacodynamics of ULT, association between raised sUA level and renal impairment, efficacy of non-pharmacological agents in reducing sUA. According to published work, anti-inflammatory agent is the most appropriate drug group in mitigating inflammatory symptoms of gout, though they often adversely affect over other vital 2 organs with impaired function. Besides ULT, uricase analogues are also found useful in non refractory gout. Since anti-inflammatory agents and ULT contraindicate in some clinical conditions, intra-articular steroid and or adrenocorticotropic hormone (ACTH) are appropriate alternatives instead. However, head-to-head comparison between different NSAIDs, NSAID and prednisolone, NSAID and colchicine are yet to perform. Use of combined anti-inflammatory preparations in gout is also based on lower level of evidence. Regarding effective maximum dose and long-standing impact of ULT on vital organs we are yet to reach a conclusion. Likewise, non-medicinal approaches are widely using in achieving target sUA level, though some of them are based on biased study outcomes and or study with inadequate power, requiring further analysis. Among non-pharmacological approaches, life-style modification, restriction of purine rich diets, avoidance of gout inciting agents are important, but inconclusive. Educating patients’ about diseases, risk factors, available treatment options and side effects from them are also important in terms of achieving sUA level, nevertheless too much counseling sometimes could be worthless.

Prevention of Venous Thromboembolism after Injury: An Evidence-Based Report???Part II: Analysis of Risk Factors and Evaluation of the Role of Vena Caval Filters

2000 ◽  
Vol 49 (1) ◽  
pp. 140-144 ◽  
Author(s):  
George C. Velmahos ◽  
Jack Kern ◽  
Linda S. Chan ◽  
Danila Oder ◽  
James A. Murray ◽  
...  
Keyword(s):  
Risk Factors ◽  
Venous Thromboembolism ◽  
Evidence Based

scholarly journals Evidence-Based Decision Making for Nutrition Policy and Programme Formulation in Ethiopia: A Qualitative Study Exploring Barriers and Facilitators

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1366-1366
Author(s):  
Solomon Eshetu Hailu ◽  
Tesfaye Bekele ◽  
Namukolo Covic ◽  
Desalegn Kuche ◽  
Beza Teshome ◽  
...  
Keyword(s):  
Decision Making ◽  
Nutrition Policy ◽  
Decision Makers ◽  
Evidence Based ◽  
Policy Makers ◽  
Program Coordinators ◽  
Nutrition Research ◽  
Evidence Based Decision Making ◽  
Evidence Dissemination ◽  
Program Decisions

Abstract Objectives Despite much nutrition research conducted in Ethiopia, none has described existing opportunities for synergy or possible missed opportunities to use research to inform policy and program decisions to foster accelerated progress. The study aimed to describe prevailing processes on evidence use in formulating nutrition policy and program decisions and identify potential barriers and opportunities for evidence-based decision-making for nutrition for Ethiopia's context. Methods In 2017, 29 purposively selected key informants (KIs) were interviewed. They were identified using a consultative stakeholder mapping workshop and represented National Nutrition Program coordinators, key actors in government sectors, program coordinators from selected local and international NGOs, local and international universities and research institutes involved in nutrition research and key actors in policy decision-making. A framework analysis including identifying themes, coding, indexing, charting, mapping and interpretation was used. A validation workshop discussed findings and added perspectives to interpretation. Results The KIs perceived that demand for evidence from the Ethiopian government had been increasing over time. Majority referred to poor research quality as a barrier for using research in decision-making processes. Other challenges identified included limited cross-linkage, coordination gaps between researchers and decision makers, and inadequate translation of research evidence into meaningful information for policy makers. Availability of different forums, research dissemination conferences and suitable institutional structures that enable research and evidence dissemination were considered to be opportunities that should be leveraged to inform policy making. Conclusions The quality of research, and of collaborative engagement between those who produce evidence and decision makers who formulate policies need to be strengthened. Regular evidence dissemination events and publication of action oriented easy to read briefs could increase use of evidence among nutrition policy makers. Funding Sources Ethiopian Public Health Institute and Evidence-informed Decision-making in Health and Nutrition Network.

Prevention of Venous Thromboembolism after Injury: An Evidence-Based Report???Part I: Analysis of Risk Factors and Evaluation of the Role of Vena Caval Filters

2000 ◽  
Vol 49 (1) ◽  
pp. 132-139 ◽  
Author(s):  
George C. Velmahos ◽  
Jack Kern ◽  
Linda S. Chan ◽  
Danila Oder ◽  
James A. Murray ◽  
...  
Keyword(s):  
Risk Factors ◽  
Venous Thromboembolism ◽  
Evidence Based

scholarly journals Scar Epidemiology and Consequences

2020 ◽  
pp. 45-49
Author(s):  
M. El Kinani ◽  
F. Duteille
Keyword(s):  
Risk Factors ◽  
Functional Impairment ◽  
Evidence Based Medicine ◽  
Genetic Factors ◽  
Evidence Based ◽  
Epidemiological Factors ◽  
Keloid Scars ◽  
Based Medicine

AbstractIn this chapter, after a short reminder of the different scars types, epidemiological factors and risk factors are described. The consequences for the patient of an impairment of healing are multiple: aesthetic discomfort, itching, pain, or even functional impairment, especially in the periarticular area, can lead not only to physical but also to psychological and social repercussions.This chapter focuses on the epidemiology of scars, including hypertrophic and keloid scars. The role of mechanobiology looks major as the pathology may start in specific anatomical locations submitted to excessive tension, and the influence of genetic factors, even if not completely confirmed with evidence-based medicine, is highly suspected.

scholarly journals Technical Packages in Injury and Violence Prevention to Move Evidence Into Practice

2016 ◽  
Vol 41 (1) ◽  
pp. 78-108 ◽  
Author(s):  
Tamara M. Haegerich ◽  
Corinne David-Ferdon ◽  
Rita K. Noonan ◽  
Brian J. Manns ◽  
Holly C. Billie
Keyword(s):  
Violence Prevention ◽  
Federal Government ◽  
Systematic Reviews ◽  
Contextual Information ◽  
Scientific Evidence ◽  
Evidence Based ◽  
Prevention Strategies ◽  
Knowledge Brokers ◽  
And Performance ◽  
Policies And Programs

Injury and violence prevention strategies have greater potential for impact when they are based on scientific evidence. Systematic reviews of the scientific evidence can contribute key information about which policies and programs might have the greatest impact when implemented. However, systematic reviews have limitations, such as lack of implementation guidance and contextual information, that can limit the application of knowledge. “Technical packages,” developed by knowledge brokers such as the federal government, nonprofit agencies, and academic institutions, have the potential to be an efficient mechanism for making information from systematic reviews actionable. Technical packages provide information about specific evidence-based prevention strategies, along with the estimated costs and impacts, and include accompanying implementation and evaluation guidance to facilitate adoption, implementation, and performance measurement. We describe how systematic reviews can inform the development of technical packages for practitioners, provide examples of technical packages in injury and violence prevention, and explain how enhancing review methods and reporting could facilitate the use and applicability of scientific evidence.

The need for evidence-based, non-drug medicine

2012 ◽  
Vol 24 (2) ◽  
Author(s):  
Søren Ventegodt ◽  
Gary Orr ◽  
Joav Merrick
Keyword(s):  
Scientific Evidence ◽  
Number Needed To Treat ◽  
Evidence Based ◽  
Clinical Expertise ◽  
Pharmaceutical Drugs ◽  
Pharmacological Agents ◽  
Relevant Evidence ◽  
Hierarchy Of Evidence ◽  
Patient Values ◽  
Patient At Risk

Abstract Evidence-based medicine (EBM) is defined as “the integration of best research evidence with clinical expertise and patient values.” EBM is based on three equally important key factors: i) the best available scientific evidence; ii) the physician’s experience and intuition; and, iii) the preferences and values of the patient. EBM uses a hierarchy of evidence and critical appraisal of the sources, which makes it possible to balance high quality evidence with documented effectiveness. A treatment that is more safe and effective, but less well documented may very well be the treatment of choice. Ethics (not putting the patient at risk of harm with a treatment if this can be avoided at all) is an important part of EBM. Many pharmaceutical drugs have a number needed to treat (NNT) of approximately 20 [NNT=20, confidence interval CI (5–50)] and the number needed to harm is less well understood and documented. The adverse effect profile of pharmacological agents can be more harmful than non-drug medicine. Most EBM-treatments are likely to be non-drug treatments in the future. There are six steps to the practice of EBM: i) the patients and the physician must work together to define the problem; ii) the patients and the physician must explore the patient’s values and preferences; iii) the information about the possible alternative medical interventions must be discussed and critically appraised; iv) the best, relevant evidence must be applied to the patient as a treatment or cure; v) together, the patient and the physician must evaluate how useful the intervention was; and vi) if the intervention did not help sufficiently, the process must begin again. In this review, we explain, in our opinion, how non-drug EBM should be practiced.

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