Bmc Public Health
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Good nutrition is important during pregnancy, breastfeeding and early life to optimise the health of women and children. It is difficult for low-income families to prioritise spending on healthy food. Healthy Start is a targeted United Kingdom (UK) food subsidy programme that gives vouchers for fruit, vegetables, milk, and vitamins to low-income families. This paper reports an evaluation of Healthy Start from the perspectives of women and health practitioners. ⋯ Our evaluation of the Healthy Start programme in England suggests that a food subsidy programme can provide an important nutritional safety net and potentially improve nutrition for pregnant women and young children living on low incomes. Factors that could compromise this impact include erosion of voucher value relative to the rising cost of food, lack of access to registered retailers and barriers to registering for the programme. Addressing these issues could inform the design and implementation of food subsidy programmes in high income countries.
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Tobacco use among young Pacific populations continues to undermine efforts to reduce the escalating rates of non-communicable disease in the region. Reducing tobacco use to less than 5 percent by 2025 is now a World Health Organisation (WHO) mandated target for the Pacific region. Yet, little is known about the drivers to uptake of tobacco use among young people in the Pacific. Family and peers are expected to be important in this process, but similarly, tobacco marketing may also play an important role. The tobacco industry has been highly adaptive to the changing media environment across the Pacific Islands. The aim of this study was to develop an understanding of the social cultural and media drivers to tobacco uptake and use among young Samoans to contribute to the design of effective tobacco control intervention. ⋯ In order to develop effective and culturally relevant tobacco control policies, the public health community must consider social norms around tobacco use as well as patterns of media use among young Samoans.
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One approach to preventing opioid overdose, a leading cause of premature, preventable mortality, is to provide overdose education and naloxone distribution (OEND). Two outstanding issues for OEND implementation include 1) the dissemination of OEND training from trained to untrained community members; and 2) the concern that OEND provides active substance users with a false sense of security resulting in increased opioid use. ⋯ Among 4926 substance users who participated in OEND, 373(7.6%) reported administering naloxone during an overdose rescue. We found few differences in behavior between trained and untrained overdose rescuers. Prospective studies will be needed to determine the optimal level of training and whether naloxone rescue kits can meet an over-the-counter standard. With no clear evidence of increased heroin use, this concern should not impede expansion of OEND programs or policies that support them.
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Review
Is planned adaptation to heat reducing heat-related mortality and illness? A systematic review.
Extreme heat is an important public health risk. Climate change will likely increase the temperatures humans are exposed to through exacerbated heat wave intensity and frequency, possibly increasing health risks from heat. To prevent adverse effects on human health, heat prevention plans and climate change adaptation strategies are being implemented. But are these measures effectively reducing heat-related mortality and morbidity? This study assesses the evidence base in 2014. ⋯ Attributing health outcomes to heat adaptation remains a challenge. Recent study designs are less rigorous due to difficulties assigning the counterfactual. While sensitivity to heat is decreasing, the examined studies provide inconclusive evidence on individual planned adaptation measures.
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Randomized Controlled Trial
Evaluating a health care provider delivered intervention to reduce intimate partner violence and mitigate associated health risks: study protocol for a randomized controlled trial in Mexico City.
Intimate partner violence (IPV) victimization is a prevalent issue among women residing in Mexico City. Comprehensive and integrated health care provider (HCP) delivered programs in clinic-settings are needed, yet few have been evaluated in Latin America, including Mexico. In addition, there has been minimal attention to interventions among lower income women presenting at settings outside of antenatal care clinics. The current randomized controlled trial seeks to increase midlevel HCPs' capacity, specifically nurses, who are often the first point of contact in this setting, to identify women presenting at health clinics with experiences of IPV and to assist these women with health risk mitigation. Specific outcomes include changes in past-year IPV (physical and/or sexual), reproductive coercion, safety planning, use of community resources, and quality of life. ⋯ This study will provide important insight into whether a nurse-delivered program can assist women currently experiencing abuse in a Latin American context. Findings can be used to inform IPV programs and policies in Mexico City's public health clinics.