Browsing by Subject "Research"

Now showing 1 - 8 of 8
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    Advancing the global physical activity agenda: recommendations for future research by the 2020 WHO physical activity and sedentary behavior guidelines development group
    (2020-11-26) DiPietro, Loretta; Al-Ansari, Salih S; Biddle, Stuart J H; Borodulin, Katja; Bull, Fiona C; Buman, Matthew P; Cardon, Greet; Carty, Catherine; Chaput, Jean-Philippe; Chastin, Sebastien; Chou, Roger; Dempsey, Paddy C; Ekelund, Ulf; Firth, Joseph; Friedenreich, Christine M; Garcia, Leandro; Gichu, Muthoni; Jago, Russell; Katzmarzyk, Peter T; Lambert, Estelle; Leitzmann, Michael; Milton, Karen; Ortega, Francisco B; Ranasinghe, Chathuranga; Stamatakis, Emmanuel; Tiedemann, Anne; Troiano, Richard P; van der Ploeg, Hidde P; Willumsen, Juana F
    Abstract Background In July, 2019, the World Health Organization (WHO) commenced work to update the 2010 Global Recommendations on Physical Activity for Health and established a Guideline Development Group (GDG) comprising expert public health scientists and practitioners to inform the drafting of the 2020 Guidelines on Physical Activity and Sedentary Behavior. The overall task of the GDG was to review the scientific evidence and provide expert advice to the WHO on the amount of physical activity and sedentary behavior associated with optimal health in children and adolescents, adults, older adults (> 64 years), and also specifically in pregnant and postpartum women and people living with chronic conditions or disabilities. Methods The GDG reviewed the available evidence specific to each sub-population using systematic protocols and in doing so, identified a number of gaps in the existing literature. These proposed research gaps were discussed and verified by expert consensus among the entire GDG. Results Evidence gaps across population sub-groups included a lack of information on: 1) the precise shape of the dose-response curve between physical activity and/or sedentary behavior and several of the health outcomes studied; 2) the health benefits of light-intensity physical activity and of breaking up sedentary time with light-intensity activity; 3) differences in the health effects of different types and domains of physical activity (leisure-time; occupational; transportation; household; education) and of sedentary behavior (occupational; screen time; television viewing); and 4) the joint association between physical activity and sedentary time with health outcomes across the life course. In addition, we acknowledge the need to conduct more population-based studies in low- and middle-income countries and in people living with disabilities and/or chronic disease, and to identify how various sociodemographic factors (age, sex, race/ethnicity, socioeconomic status) modify the health effects of physical activity, in order to address global health disparities. Conclusions Although the 2020 WHO Guidelines for Physical Activity and Sedentary Behavior were informed by the most up-to-date research on the health effects of physical activity and sedentary time, there is still substantial work to be done in advancing the global physical activity agenda.
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    An operational model for mainstreaming ecosystem services for implementation
    (2008) Cowling, R M; Egoh, B; Knight, A T; O\'Farrell, PJ; Reyers, B; Rouget, M; Roux, D J; Welz, A; Wilhelm-Rechman, A
    Research on ecosystem services has grown markedly in recent years. However, few studies are embedded in a social process designed to ensure effective management of ecosystem services. Most research has focused only on biophysical and valuation assessments of putative services. As a mission-oriented discipline, ecosystem service research should be user-inspired and user-useful, which will require that researchers respond to stakeholder needs from the outset and collaborate with them in strategy development and implementation. Here we provide a pragmatic operational model for achieving the safeguarding of ecosystem services. The model comprises three phases: assessment, planning, and management. Outcomes of social, biophysical, and valuation assessments are used to identify opportunities and constraints for implementation. The latter then are transformed into user-friendly products to identify, with stakeholders, strategic objectives for implementation (the planning phase). The management phase undertakes and coordinates actions that achieve the protection of ecosystem services and ensure the flow of these services to beneficiaries. This outcome is achieved via mainstreaming, or incorporating the safeguarding of ecosystem services into the policies and practices of sectors that deal with land- and water-use planning. Management needs to be adaptive and should be institutionalized in a suite of learning organizations that are representative of the sectors that are concerned with decision-making and planning. By following the phases of our operational model, projects for safeguarding ecosystem services are likely to empower stakeholders to implement effective on-the-ground management that will achieve resilience of the corresponding social-ecological systems.
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    Biomedical research, a tool to address the health issues that affect African populations
    (BioMed Central Ltd, 2013) Peprah, Emmanuel; Wonkam, Ambroise
    Traditionally, biomedical research endeavors in low to middle resources countries have focused on communicable diseases. However, data collected over the past 20years by the World Health Organization (WHO) show a significant increase in the number of people suffering from non-communicable diseases (e.g. heart disease, diabetes, cancer and pulmonary diseases). Within the coming years, WHO predicts significant decreases in communicable diseases while non-communicable diseases are expected to double in low and middle income countries in sub-Saharan Africa. The predicted increase in the non-communicable diseases population could be economically burdensome for the basic healthcare infrastructure of countries that lack resources to address this emerging disease burden. Biomedical research could stimulate development of healthcare and biomedical infrastructure. If this development is sustainable, it provides an opportunity to alleviate the burden of both communicable and non-communicable diseases through diagnosis, prevention and treatment. In this paper, we discuss how research using biomedical technology, especially genomics, has produced data that enhances the understanding and treatment of both communicable and non-communicable diseases in sub-Saharan Africa. We further discuss how scientific development can provide opportunities to pursue research areas responsive to the African populations. We limit our discussion to biomedical research in the areas of genomics due to its substantial impact on the scientific community in recent years however, we also recognize that targeted investments in other scientific disciplines could also foster further development in African countries.
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    International collaboration, funding and association with burden of disease in randomized controlled trials in Africa
    (2005) Swingler, George H; Pillay, Victoria; Pienaar, Elizabeth D; Ioannidis, John P A
    OBJECTIVE: This study aimed to assess whether randomized controlled trials conducted in Africa with collaborators from outside Africa were more closely associated with health conditions that have a burden of disease that is of specific importance to Africa than with conditions of more general global importance or with conditions important to developed countries. We also assessed whether the source of funding influenced a study's relevance to Africa. METHODS: We compared randomized controlled trials performed in Africa that looked at diseases specifically relevant to Africa (as determined by burden of disease criteria) with trials classified as looking at diseases of global importance or diseases important to developed countries in order to assess differences in collaboration and funding. FINDINGS: Of 520 trials assessed, 347 studied diseases that are specifically important to Africa; 99 studied globally important diseases and 74 studied diseases that are important to developed countries. The strongest independent predictor of whether a study was of specifically African or global importance was the corresponding author's country of origin: African importance was negatively associated with a corresponding author being from South Africa (odds ratio (OR) = 0.04; 95% confidence interval (CI) = 0.02–0.10) but there was little difference between corresponding authors from other African countries and corresponding authors from countries outside Africa. The importance of a study to Africa was independently associated with having more non-African authors (OR per author = 1.31; 95% CI = 1.08–1.58), fewer trial sites (OR per site = 0.69; 95% CI = 0.50–0.96), and reporting of funding (OR = 2.14; 95% CI = 1.15–4.00). Similar patterns were present in the comparisons of trials studying diseases important to Africa versus those studying diseases important to developed countries with stronger associations overall. When funding was reported, private industry funding was negatively associated with African importance compared with global importance (OR = 0.31, P = 0.008 for African importance and OR = 0.51, P = 0.57 for importance for developed countries). CONCLUSION: The relevance to Africa of trials conducted in Africa was not adversely affected by collaboration with non-African researchers but funding from private industry was associated with a decreased emphasis on diseases relevant to Africa
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    Maternal participant experience in a South African birth cohort study enrolling healthy pregnant women and their infants
    (2016) Barnett, Whitney; Brittain, Kirsty; Sorsdahl, Katherine; Zar, Heather J; Stein, Dan J
    Abstract Background Critical to conducting high quality research is the ability to attract and retain participants, especially for longitudinal studies. Understanding participant experiences and motivators or barriers to participating in clinical research is crucial. There are limited data on healthy participant experiences in longitudinal research, particularly in low- and middle-income countries. This study aims to investigate quantitatively participant experiences in a South African birth cohort study. Methods Maternal participant experience was evaluated by a self-administered survey in the Drakenstein Child Health Study, a longitudinal birth cohort study investigating the early life determinants of child health. Pregnant mothers, enrolled during the second trimester, were followed through childbirth and the early childhood years. Satisfaction scores were derived from the participant experience survey and quantitatively analyzed; associations between satisfaction scores and sociodemographic variables were then investigated using a linear regression model. Results Data were included from 585 pregnant mothers (median age 26.6 years), who had participated in the study for a median time of 16 months. Overall participant satisfaction was high (median score 51/60) and associated with increased attendance of study visits. Reasons for participating were a belief that involvement would improve their health, their child’s health or the health of family and friends. Potential reasons for leaving the study were inconvenience, not receiving clinical or study results, and unexpected changes in study visits or procedures. Variables associated with higher overall satisfaction scores were no prior participation in research, higher socioeconomic status, less intensive follow-up schedules and having experienced stressful life events in the past year. Conclusions Satisfaction scores were high and associated with increased visit attendance. Participants’ perceived benefits of study participation, most notably the potential for an improvement in the health of their child, were a significant motivator to enroll and remain in the study. The consistent theme of perceived health benefits as a motivator to join and remain in the study raises the question of whether participation in research results in actual improvements in health.
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    Public/community engagement in health research with men who have sex with men in sub-Saharan Africa: challenges and opportunities
    (2016) Molyneux, Sassy; Sariola, Salla; Allman, Dan; Dijkstra, Maartje; Gichuru, Evans; Graham, Susan; Kamuya, Dorcas; Gakii, Gloria; Kayemba, Brian; Kombo, Bernadette; Maleche, Allan; Mbwambo, Jessie; Marsh, Vicki; Micheni, Murugi; Mumba, Noni; Parker, Michael; Shio, Jasmine; Yah, Clarence; van der Elst, Elise; Sanders, Eduard
    Abstract Background Community engagement, incorporating elements of the broader concepts of public and stakeholder engagement, is increasingly promoted globally, including for health research conducted in developing countries. In sub-Saharan Africa, community engagement needs and challenges are arguably intensified for studies involving gay, bisexual and other men who have sex with men, where male same-sex sexual interactions are often highly stigmatised and even illegal. This paper contextualises, describes and interprets the discussions and outcomes of an international meeting held at the Kenya Medical Research Institute-Wellcome Trust in Kilifi, Kenya, in November 2013, to critically examine the experiences with community engagement for studies involving men who have sex with men. Discussion We discuss the ethically charged nature of the language used for men who have sex with men, and of working with ‘representatives’ of these communities, as well as the complementarity and tensions between a broadly public health approach to community engagement, and a more rights based approach. We highlight the importance of researchers carefully considering which communities to engage with, and the goals, activities, and indicators of success and potential challenges for each. We suggest that, given the unintended harms that can emerge from community engagement (including through labelling, breaches in confidentiality, increased visibility and stigma, and threats to safety), representatives of same-sex populations should be consulted from the earliest possible stage, and that engagement activities should be continuously revised in response to unfolding realities. Engagement should also include less vocal and visible men who have sex with men, and members of other communities with influence on the research, and on research participants and their families and friends. Broader ethics support, advice and research into studies involving men who have sex with men is needed to ensure that ethical challenges – including but not limited to those related to community engagement – are identified and addressed. Summary Underlying challenges and dilemmas linked to stigma and discrimination of men who have sex with men in Africa raise special responsibilities for researchers. Community engagement is an important way of identifying responses to these challenges and responsibilities but itself presents important ethical challenges.
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    South African archaeology and palaeontology in legislative quagmire
    (2003) van der Merwe, Nikolaas J
    The malfunctioning or even absence of provincial heritage agencies in various parts of the country, which are now required by the National Heritage Act, is playing havoc with plans to investigate new archaeological and palaeontological sites.
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    Spatial models for the rational allocation of routinely distributed bed nets to public health facilities in Western Kenya
    (2017) Macharia, Peter M; Odera, Patroba A; Snow, Robert W; Noor, Abdisalan M
    BACKGROUND: In high to moderate malaria transmission areas of Kenya, long-lasting insecticidal nets (LLINs) are provided free of charge to pregnant women and infants during routine antenatal care (ANC) and immunization respectively. Quantities of LLINs distributed to clinics are quantified based on a combination of monthly consumption data and population size of target counties. However, this approach has been shown to lead to stock-outs in targeted clinics. In this study, a novel LLINs need quantification approach for clinics in the routine distribution system was developed. The estimated need was then compared to the actual allocation to identify potential areas of LLIN over- or under-allocation in the high malaria transmission areas of Western Kenya. METHODS: A geocoded database of public health facilities was developed and linked to monthly LLIN allocation. A network analysis approach was implemented using the location of all public clinics and topographic layers to model travel time. Estimated travel time, socio-economic and ANC attendance data were used to model clinic catchment areas and the probability of ANC service use within these catchments. These were used to define the number of catchment population who were likely to use these clinics for the year 2015 equivalent to LLIN need. Actual LLIN allocation was compared with the estimated need. Clinics were then classified based on whether allocation matched with the need, and if not, whether they were over or under-allocated. RESULTS: 888 (70%) public health facilities were allocated 591,880 LLINs in 2015. Approximately 682,377 (93%) pregnant women and infants were likely to have attended an LLIN clinic. 36% of the clinics had more LLIN than was needed (over-allocated) while 43% had received less (under-allocated). Increasing efficiency of allocation by diverting over supply of LLIN to clinics with less stock and fully covering 43 clinics that did not receive nets in 2015 would allow for complete matching of need with distribution. CONCLUSION: The proposed spatial modelling framework presents a rationale for equitable allocation of routine LLINs and could be used for quantification of other maternal and child health commodities applicable in different settings. Western Kenya region received adequate LLINs for routine distribution in line with government of Kenya targets, however, the model shows important inefficiencies in the allocation of the LLINs at clinic level.