Public health
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Despite the widespread use of neonatal screening programmes for sickle cell disease in Western regions, few studies have focused on the special healthcare needs in sub-Saharan African countries. The purpose of this review is to evaluate the need for a neonatal screening programme for sickle cell disease, and if justified, to propose a realistic healthcare programme for sickle cell newborns in those countries based on personal experiences in Kinshasa (Democratic Republic of the Congo) and Ouagadougou (Burkina Faso) as well as from a review of the literature. ⋯ This paper provides an overview of practices employed in neonatal screening and clinical care programmes for sickle cell disease in sub-Saharan African countries. The development of these programmes is pivotal to improving the health care of those affected by haemoglobin disorders. However, such programmes require major economic and organizational resources, which must taken into account and balanced against other local health priorities.
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It has been reported that the incidence of testicular cancer has plateaued in some parts of the USA, especially among non-Hispanic Whites in Los Angeles. Temporal trends analysis was conducted over three decades to assess the evidence for such a plateau, and to examine whether the incidence of testicular cancer remains stable across racial/ethnic groups. This study also investigated the influence of age at diagnosis on the incidence of testicular cancer. ⋯ Overall, the incidence of testicular cancer continues to plateau in the USA, while racial variance persists. Black males demonstrate the greatest increase in annual percentage change. Further studies are needed to examine the recent increase among Black males and the potential determinants.
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To explore the role of evidence in the public health policy-making process, and show how the way in which public health problems are defined and measured influences policy outcomes. ⋯ This case study offers some insight into the ways in which the production and presentation of evidence can influence and shape governmental responses to public health problems. The usefulness of available evidence is dependent upon the type of data that is produced routinely by government, as well as more deliberate decisions concerning public health research funding. Researchers can maximize the influence of research evidence on the policy process by engaging in the policy-making process, presenting research in ways that fit with the political context of the day, and, where necessary, using research evidence in public health advocacy in order to influence political priorities more directly.
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This article reflects on the successful introduction of tobacco control legislation in Scotland. It locates the need for such an approach within the broader context of Scotland's poor smoking-related health record, and traces the development of policy thinking from initial scepticism and caution to later widespread endorsement and effective introduction. The considerable benefits achieved in terms of air quality improvement, avoidance of adverse health outcomes and broader policy empowerment are described. The importance of learning from other administrations, and political and professional leadership are described.