Unequal Distribution of Innovation Efforts for Neglected Tropical Diseases: The Role of Funding Evaluation Criteria

Background: International research and innovation efforts for neglected tropical diseases have increased in recent decades due to disparities in overall health research funding in relation to global burden of disease. However, within the field of neglected tropical diseases some seem far more neglected than others. In this research the aim is to investigate the distribution of resources and efforts, as well as the mechanisms that underpin funding allocation for neglected tropical diseases. Methodology: A systematic literature review was conducted to establish a comprehensive overview of known indicators for innovation efforts related to a wide range of neglected tropical diseases. Articles were selected based on a subjective evaluation of their relevance, the presence of original data, and the breadth of their scope. This was followed by thirteen in-depth open-ended interviews with representatives of private, public and philanthropic funding organizations, concerning evaluation criteria for funding research proposals. Results: The findings reveal a large difference in the extent to which the individual diseases are neglected with notable differences between absolute and relative efforts. Criteria used in the evaluation of research proposals relate to potential impact, the probability of success and strategic fit. Private organizations prioritize strategic fit and economic impact;philanthropic organizations prioritize short-term societal impact;and public generally prioritize the probability of success by accounting for follow-up funding and involvement of industry. Funding decisions of different types of organizations are highly interrelated. Conclusions: This study shows that the evaluation of funding proposals introduces and retains unequal funding distribution, reinforcing the relative neglect of diseases. Societal impact is the primary rationale for funding but application of it as a funding criterion is associated with significant challenges. Furthermore, current application of evaluation criteria leads to a primary focus on short-term impact. Through current practice, the relatively most neglected diseases will remain so, and a long-term strategy is needed to resolve this.

Health economic evaluation on population-based Helicobacter pylori eradication and endoscopic screening for gastric cancer prevention

Gastric cancer is a global public health burden, nearly one million new cases are diagnosed per year worldwide, of which 44% of cases occur in China. The prognosis of gastric cancer varies remarkably by the stage of cancer, and most of the patients in China are diagnosed at advanced stages, resulting in poor prognoses. Effective strategies to reduce the burden of gastric cancer include primary prevention through testing and treatment of Helicobacter pylori(H. pylori) and secondary prevention by screening and early detection. Although many countries have issued management guidelines and consensus reports concerning these strategies, the limited availability of healthcare resources often precludes their widespread implementation. Therefore, assessing the costs, benefits, and harms of population-based intervention measures through health economic evaluation is necessary for informed health policy decisions. Accordingly, we synthesize management approaches from different countries on H. pylori eradication and endoscopic screening, and also summarize recent advancements in health economic evaluations on population-based preventive strategies. The goal of the review is to provide empirical evidence supporting optimal resource allocation, maximizing benefits for the population, and ultimately reducing the burden of gastric cancer.

Self-reported physical functioning,cardiometabolic health conditions, and healthcare utilization patterns in Million Veteran Program enrollees with Traumatic Brain Injury Screening and Evaluation Program data

Background Examining the health outcomes of veterans who have completed the United States Veterans Health Administration’s(VHA’s)Traumatic Brain Injury(TBI)Screening and Evaluation Program may aid in the refinement and improvement of clinical care initiatives within the VHA.This study compared self-reported physical functioning,cardiometabolic health conditions,and health care utilization patterns in Million Veteran Program enrollees with TBI Screening and Evaluation Program data(collected between 2007 and 2019),with the goal of enhancing understanding of potentially modifiable health conditions in this population.Methods In this observational cohort study,veterans(n=16,452)were grouped based on the diagnostic outcome of the TBI Screening and Evaluation Program:1)negative TBI screen(Screen^(-));2)positive TBI screen but no confirmed TBI diagnosis[Screen^(+)/Comprehensive TBI Evaluation(CTBIE)^(-)];or 3)positive TBI screen and confirmed TBI diagnosis(Screen^(+)/CTBIE^(+)).Chi-square tests and analysis of covariance were used to explore group differences in physical functioning,cardiometabolic health conditions,and health care utilization patterns,and logistic regressions were used to examine predictors of Screen^(+/-)and CTBIE^(+/-)group status.Results The results showed that veterans in the Screen^(+)/CTBIE^(-)and Screen^(+)/CTBIE^(+)groups generally reported poorer levels of physical functioning(P’s<0.001,np2=0.02 to 0.03),higher rates of cardiometabolic health conditions(P’s<0.001,φ=0.14 to 0.52),and increased health care utilization(P’s<0.001,φ=0.14 to>0.5)compared with the Screen-group;however,health outcomes were generally comparable between the Screen^(+)/CTBIE^(-)and Screen^(+)/CTBIE^(+)groups.Follow-up analyses confirmed that while physical functioning,hypertension,stroke,healthcare utilization,and prescription medication use reliably distinguished between the Screen-and Screen^(+)groups(P’s<0.02,OR’s 0.78 to 3.38),only physical functioning distinguished between the Screen^(+)/CTBIE^(-)and Screen^(+)/CTBIE^(+)groups(P<0.001,OR 0.99).Conclusions The findings suggest that veterans who screen positive for TBI,regardless of whether they are ultimately diagnosed with TBI,are at greater risk for negative health outcomes,signifying that these veterans represent a vulnerable group that may benefit from increased clinical care and prevention efforts.

Using the Delphi method to propose foods for special medical purposes health effect evaluation indicators

Objective:The Delphi method was used to propose health effect evaluation indicators to assess foods for special medical purposes(FSMPs).This lays the foundation for the formation of a big data model for human health testing,as well as a big data platform for the health and safety evaluation of special medical foods.Methods:The Delphi method was used to conduct two rounds of expert consultation on the constructed FSMP health effect evaluation indicators.Results:Ten major items were identified after two rounds of expert consultation.Among these,there were 10 primary entries,32 secondary entries,50 tertiary entries,and 28 quaternary entries.Conclusion:The complete list of evaluation indicators contains 10 entries,which can comprehensively and systematically monitor adverse reactions to the use of FSMPs.The present findings lay the foundation for a big data platform to evaluate the health and safety of special foods.

Translation and psychometric evaluation of the Chinese version of the Heart Failure-Specific Health Literacy Scale

Objective:Health literacy is closely associated with self-care behaviors in heart-failure patient.A reliable,valid,and practical measuring tool would evaluated the level of health literacy in Chinese patients with heart failure,and provide evidence for individualized education.Aim of this study was to translate Heart Failure-Specific Health Literacy Scale(HF-Specific HL Scale)into Chinese and test the reliability and validity of the Chinese version.Methods:The original HF-specific HL scale was translated into Chinese and modified for cultural adaption.Totally 164 HF inpatients were investigated with the Chinese version of HF-specific HL scale.To test the reliability and validity of the scale,item analysis,exploratory factor analysis(EFA),confirmatory factor analysis(CFA),and correlation analysis were conducted.Result:Cronbach's a value for the scale is 0.87;the correlation coefficients between each item and the total score ranged from 0.61 to 0.91.Three factors was extracted by EFA,which could explain 64.62%of the total variance.The result of CFA also showed that the scale demonstrated an acceptable model fit.The scale was significantly correlated with the Chinese version of the Heart Failure Knowledge Test(C-HFKT).Conclusion:The Chinese version of HF-specific HL scale is reliable and valid,and is suitable for assessment of HL in Chinese HF patients.

Health evaluation method for degrading systems subject to dependent competing risks

This paper proposes a health evaluation method for degrading systems subject to competing risks of dependent soft and hard failures. To characterize the time-varying degradation rate, the degradation process is determined by a non-stationary Gamma process and the soft failure is encountered when it exceeds a predefined critical level. For the hard failure, a Cox’s proportional hazard model is applied to describe the hazard rate of the time to system failure. The dependent relationship is modeled by incorporating the degradation process as a time-varying covariate into the Cox’s proportional hazard model. To facilitate the health characteristics evaluation, a discretization technique is applied both to the degradation process and the monitoring time.All health characteristics can be obtained in the explicit form using the transition probability matrix, which is computationally attractive for practical applications. Finally, a numerical analysis is carried out to show the effectiveness and the performance of the proposed health evaluation method.

VOR and CVOR Index for Health Evaluation of Typical Steppe in Inner Mongolia

[Objective] The aim of this study was to evaluate the effect of livestock exclusion on the health of grassland ecosystem accurately and quantitatively. [Method] One open grazing site and five seasonal exclusion sites, which had the same vegetation composition （taking Leymus chinensis and Stipa krylovii as main species） and soil type, were chosen as research objects for the VOR and CVOR evaluation of the effect of open grazing and livestock exclusion on the health of typical steppes, and for building the calculation model for VOR and CVOR indices to evaluate the health of typical steppes with different exclusion periods. [ Result] The VOR and CVOR composite indices both could accurately evaluate the health of typical steppes, and the evaluation results from the both indices were quite consistent. Although the condition （C）, vigor（V）, organization （O） and resilience（ R ） indices changed differently in different exclusion periods, the VOR and CVOR composite indices increased gradually with the peri- od of exclusion prolonged, and the health condition of typical steppe changed from ＂alert＂ level （in the open grazing and earlier exclusion period） to ＂healthy＂ level （after 13 to 20 years＇exclusion）. [ Conclusion] The application of exclusion was beneficial to the recovery of degraded grassland ecosystem.

An Evaluation on Smoking-induced Health Costs in China (1988-1989)

A study on smoking-attributable health economic costs in China was conducted from 1988-1992, in which three major categories of chronic diseases, diseases of cancer, diseases of circulatory system, and diseases of respiratory system were included. A prevalence-based method which estimated the cumulative effect of cigarette smoking during the past 20-30years was used. The results show that in 1989, the total smoking-attributable economic costs to health sectors in China were about 27.1 billion of Chinese Yuan, including about 7 billion Yuan in direct medical costs and 20 billion Yuan in indirect costs, which include indirect morbidity costs and indirect mortality costs. The relatively low direct costs reflected the low medical costs at hospitals in China at that time. And the high proportion of indirect costs relative to the total costs shows the high potential years of life lost due to clgarette smoking. The results also show the heavier health burden in urban areas than in rural areas, reflecting the worse situation in urban China at nowadays. But if considering that almost 80% of the Chinese are rural farmers with the higher smoking prevalence and relatively shorter history of manufactured cigarette smoking than their urban counterparts,the very frightful situation due to cigarette smoking would be for China in the next century

Evaluation of the forest ecosystem health in Beijing area

The evaluation of ecosystem health has become one of the main research topics of ecosystem science, thus more and more assessment methods and frameworks have been put forward in recent years. However, the attention people pay to ecosystem health is actually more about what the social functions the ecosystem affords, which depend on the integrity and maintenance of the ecosystem structure and function, and the intensity of disturbance from outside. Accordingly, this research commenced from three main aspects, selected the evaluation indices, and then established the Evaluation Index System of Beijing Forest Ecosystem Health （EIS-BFEH）. In the EIS-BFEH, each of the three foundations contained an easily-operated and standard sub-index system, which compounded the specific natural and social conditions of Beijing and was concrete enough to measure and evaluate. Then with the method of the Analytical Hierarchy Process （AHP）, the comprehensive index （CI） could be obtained, which represented the health of the forest ecosystem. As a case study, the forest ecosystems in the Badaling area were sampled, evaluated, compared and ranked by use of the EIS-BFEH. The result show that the health of natural forests is much better than that of plantations in the Badaling forest center： the average comprehensive index of the former is 7.9, while the latter is only 6.6. From the results, it could also be found that there are nine units in the healthy state, two units in the subhealthy state, and only one unit of Robiniapseudoacacia in the morbid state.

An Evaluation of Suicidality and Its Predictors in Police Officers in Lagos, Nigeria

Background: The many dangers and stressors associated with police work often place police officers at a great risk of a variety of mental health morbidity, including suicidality. The causation of suicidality is multi-dimensional, however, there are insufficient studies which have examined the burden and risk factors of suicidality in Nigerian police officers. Objective: To determine the prevalence and predictors of suicidality among police officers in Lagos, Nigeria. Methods: This was a cross-sectional study of 600 police officers who were selected using a non-probability sampling method. Questionnaires used were: Suicide Behaviour Questionnaire-Revised (SBQ-R), State-Trait Anxiety Inventory (STAI), and a Socio-Demographic Questionnaire. Results: Prevalence of suicidality was 14%, and the predictors of suicidality were: state anxiety (p 0.001), trait anxiety (p 0.001), substance use (p = 0.03), being unmarried (p = 0.03), and female gender (p = 0.02). Conclusion: Suicidality is prevalent among Nigerian police officers, with a higher risk in those who are vulnerable. The creation of government policies and infrastructure which promote mental health in police officers is necessary.

Equity Study in Health Workforce on Tuberculosis Control in China: a Nationwide Evaluation

We aimed to describe the distribution of tuberculosis （TB） health workers in China and provide evidences of potential inequity for policy development. We used Lorenz curves and Gini index to characterize the distribution of TB health workers by population size, geographical area and number of annual registered TB cases. An additional stratified analysis was done by three economic regions. The Gini index were 0.33 for population size, 0.62 for geographical area and 0.30 for number of registered tuberculosis cases that indicated an acceptable average, significant inequity and a relative average distribution nationwide respectively.

Development and evaluation of the health belief model scale for exercise

Objectives:This study was aimed to develop a health belief model scale for exercise among Chinese residents to describe the relationships between health beliefs and exercise for promoting residents to adopt or maintain exercise programs.Methods:Participants were from two projects,Project 1 with 3833 participants and Project 2 with 7319 participants.A pool of 21 items was developed based on a small-scale qualitative study about health beliefs of exercise and literature.Internal consistency and construct validity of the scale were evaluated with Cronbach'sαcoefficient,exploratory factor analysis(EFA),confirmatory factor analysis(CFA)and second-order confirmatory factor analysis.Results:A final version of 18 items loaded on six factors which could explain 60.30-%of variance was observed after EFA.The internal consistency of the final version with 18 items performed in Project 1 was acceptable(0.609).The reliability of the six subscales was good with Cronbach'sαcoefficient of 0.628,0.713,0.628,0.801,0.676 and 0.838 for perceived benefits,perceived objective barriers,perceived subjective barriers,self-efficacy,perceived severity and cues to action,respectively.CFA and second-order CFA indicated a good fit to data.Conclusions:The Health Belief Model Scale for Exercise(HBMS-E)is a valid and reliable instrument to assess health beliefs of exercise among residents in China.Understanding the health beliefs of exercise will help health professionals to develop effective interventions for health and evaluate the effectiveness.

Evaluation of the Effectiveness of Workplace Health Promotion Programs from 2000 to 2020: Literature Review

Introduction. Recognition of best practices in workplace health promotion is an important task that significantly affects the expansion of those programs. Once the program has been developed, its effectiveness becomes the most critical point of evaluation to guarantee achievements in the improvement of workers’ health. Objectives. To identify the practices for evaluating the effectiveness of workplace health promotion programs. Material and Methods: A search was performed on MEDLINE through PubMed with the MeSH: “Occupational Health”, “Health Promotion” and “Program Evaluation”, from the year 2000 to the year 2020 for studies with the following designs: Meta-analyses, Systematic reviews, Randomized Clinical Trials and Clinical Trials. Results: The most common topic of workplace health promotion programs (WHP) was increasing physical activity and avoiding a sedentary lifestyle, followed by stress management and finally smoking cessation and musculoskeletal disorders. The post-intervention measurements were most often done at 6 months and 12. The most commonly used indicators were the number of steps, weight, BMI, % body fat, waist circumference, blood pressure, sedentary time, level of physical activity and time of moderate-vigorous physical activity, daily energy output, life purpose, life satisfaction, mood and stress level. Conclusions: Although a great variability was observed in the evaluation of WHP programs, there were also common aspects. These results will help with designing WHP programs and defining evidence-based evaluation of their effectiveness. It is important to remember that WHP programs must be customized, taking into consideration the needs of each organization’s workforce.

Real-time Health Condition Evaluation on Wind Turbines Based on Operational Condition Recognition

针对大型风电机组运行工况和状态信息复杂，健康状态难以准确评价的问题，提出基于工况辨识的健康状态实时评价方法。该方法充分考虑机组运行工况的复杂性和多变性，采用工况辨识实现运行工况空间的划分。在各运行工况子空间，建立基于高斯混合模型（gaussianmixturemodel，GMM）多状态特征融合的健康状态评价模型。采用健康衰退指数（healthdegradationindex，HDI）作为机组健康状态评价指标，并给出健康衰退报警限的确定方法。该方法用于某1．5MW风电机组传动系统故障前的健康状态评价。结果表明，该方法提前监测到机组健康状态的衰退趋势，可实现故障的早期预报，避免严重故障发生，并为合理调整运行和安排维修提供依据。

Ecosystem Health and Its Evaluation

Firstly, the connotations and influencing factors of ecosystem health are discussed, and then the assessment principle, evaluation stand- ard and evaluation method of ecosystem health and the establishment and measurement of ecosystem health indicators are studied. Through the study of its connotation and evaluation, feasible measures to effectively promote the development of ecosystem health are put forward finally.

Erratum to “Recovery Approaches in Mental Health: A Qualitative Evaluation of the Whole Life Therapy Programme for Persons with Schizophrenia” [Health 5 (2013) 582-587]

The original online version of this article (Littlechild, B., Smith, A. H., Meredith-Windle, G., Gale, T., Lloyd, M. and Hawley, C. (2013) Recovery Approaches in Mental Health: A Qualitative Evaluation of the Whole Life Therapy Programme for Persons with Schizophrenia. Health, 5, 582-587. http://dx.doi.org/10.4236/health.2013.53A077) was published mistakenly with a co-author (who also developed the Whole Life Programme) missing. To reflect the contribution and responsibility of the co-author as well as the affiliations of the authors at the time of the study, we revised authorship and author affiliations of the article.

Recovery approaches in mental health: A qualitative evaluation of the Whole Life Therapy programme for persons with schizophrenia

The recovery approach within mental health services has in recent years been influential in promoting more active participation from service users concerning their treatment and progress, within a move towards models of interventions based on social models and ideas of service user empowerment. Although mental health recovery models are often heralded as ideological goals, comparatively little has been documented about the means of achieving these. This article sets out the nature and content of the Whole Life Programme, used within the Hertfordshire NHS Partnership Foundation Trust, and the results of qualitative research into the programme that set out to analyse the impact of its delivery from the perspectives of service users. The research examined the experiences and views of participants receiving treatment several months after the completion of the programme, and also of those who withdrew prematurely, in order to learn from these experiences, adding to our understanding of how one recovery based approach, the Whole Life Manual, can be applied in practice.

Evaluation of the Functionality of the Networking of Sexual and Reproductive Health Rights Services in the Event of Gender-Based Violence in the Commune of Kpomasse in 2022

Introduction: In developing countries, gender-based violence (GBV) is a real public health problem. In Benin, GBV affects the majority of women and girls (69%). Benin has implemented strategies and set up integrated centers for the management of violence in order to reduce cases of violence and ensure the holistic management of victims. The objective of our study was to assess the functionality of the network of sexual and reproductive health rights (SRHR) in case of GBV in the commune of Kpomasse in 2022. Method: This descriptive and evaluative study was conducted from March 21 to April 11, 2022. The sampling method used was non-probabilistic. Reasoned choice and convenience were the techniques used for the different targets of the study. The functionality of the SRHR service network was assessed first by calculating scores at the structure, process and outcome levels, and then by analysis using the human rights-based approach. Results: Out of the 34 GBV victims identified, only one had received a full response and 54% of the victims had no knowledge of SRHR. The lack of knowledge about health care facilities was 41% for victims and 80% for non-victims in the community who participated in the study. In the case of gender-based violence, the community preferred to settle out of court rather than report it. The functionality of the networking of sexual and reproductive health rights services in the event of the occurrence of gender-based violence in the commune of Kpomassè is insufficient. Lack of knowledge of the roles of rights holders (DD) and duty bearers (DO) explains the insufficient functionality of networking. Conclusion: Training of SRHR service agents and community sensitization are essential to improve the functionality of SRHR service networking in the commune of Kpomasse.

Evaluation Items for Community-Based Health Care Focusing on Social Aspects: A Literature Review

The progressive aging of society has become a global concern, and is expected to lead to the development of effective, sustainable, person-centered, integrated community-based care systems. However, there is insufficient evidence regarding effective integrated community-based care. In particular, few studies have focused on social aspects of the community environment related to elderly health. This study aimed to consider social aspects as evaluation items, focusing particularly on social determinants from the perspective of community-dwelling people, to explore truly effective integrated community-based care to improve elderly health. The definition of social determinants means social cohesion in social and community contexts. A literature review of English articles published in peer-reviewed journals up to October 2019 was conducted using PubMed, MEDLINE, and CINAHL with the following search terms: “social cohesion,” “elderly health,” “mental health” and “community.” Identified articles were screened based on title and abstract, and selected articles were subjected to full-text assessment and critical review. All references cited in the selected articles were also reviewed. The following inclusion criteria were used: 1) studies targeting community-dwelling elderly people or community-dwelling people including elderly people as participants;2) studies with clear descriptions of social factors in the Methods section;and 3) studies with clear descriptions of health-related items in the Methods section. From the 21 articles analyzed, of which 9 articles defined social determinants as social cohesion in social and community context, 37 items were extracted as social aspects at the community level that reflect the perspective of residents. These items can be developed as evaluation items for community-based health care outcomes through consensus among community health care providers and further investigation.

Longitudinal Care Evaluation in Child Healthcare

Objective: To evaluate the essential attribute of Primary Health Care, longitudinal care, care directed at children from birth to two years old. Methods: This is a descriptive and exploratory study of evaluative character and quantitative approach, conducted with parents/caregivers of 186 children, younger than two years old, patients of primary health care services in the city of Santa Cruz/RN, Brazil. For data collection, the instrument Primary Care Assessment Tools (PCA Tools) was used, and the results of the questions dealing with longitudinal attribute were evaluated. The data were stored and processed in Statistical Package for Social Sciences (SPSS). The study was approved by the Research Ethics Committee of the Health Sciences School of Trairí, under number 348896. Results: The mean age of children in months was 8.21;84.4% (n = 157) were assisted by the same doctor/nurse every time;in 81.7% (n = 152) of cases the doctor/nurse know the full medical history of the child;73.7% (n = 137) answered that the professional know their child more as a person than just as someone with a health problem;48.9% (n = 91) stated that the doctor/nurse do not know their family very well;86.6% (n = 161) reported finding the doctor/nurse understands what is saying or questioning;96.2 (n = 179) of respondents said the doctor/nurse answers the questions so that they understand;96.2% (n = 179) of the interviewed said they feel comfortable telling the concerns or problems of their child to the doctor/nurse;66.7% (n = 124) claimed that they would not change the service/doctor/nurse to another health service. Conclusion: It is concluded that the attribute was well rated by the mothers of children seen in primary health care services and that they can establish good communication and relationship with the health professionals who treat their children.