(An item from the ISHN Member information service) With the global community now debating the purposes and aspects of quality education as part of the 2015-30 Social Development Goals development, an article in Issue #3, 2015 of Comparative Education Review makes a timely point about the lack of a connection between increased student testing and subsequent economic growth. "This article considers the growth of the international testing regime. It discusses sources of growth and empirically examines two related sets of issues: (1) the stability of countries’ achievement scores, and (2) the influence of those national scores on subsequent economic development over different time lags. The article suggests that stability over time and across tests has historically been weak but is increasing in the post-1990 era. In addition, the analysis finds little evidence of macro-level effects of test score performance on subsequent economic growth. Read more>>
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(An item from the ISHN Member information service) An article in the August 2015 Issue of Social Indicators reports on the well-being of children in south-east Asia. We agree with the author's assertion that such reports are too often biased towards western Europe and North America. "Much progress has been made recently in expanding the literature on international comparison of children’s wellbeing. Nevertheless, most studies are skewed toward western or European countries, with the Asian nations rarely included. The purpose of this study is to fill the gap by conducting an exploratory comparison of children’s wellbeing in East and Southeast Asian countries. A multidimensional approach is adopted by analyzing material wellbeing, health, educational wellbeing, behavior, environment, and psychosocial wellbeing, together with their associated components and indicators. All countries are ranked according to their overall child wellbeing indices, including and excluding the dimension of psychosocial wellbeing. The results show that Japan, Korea, and Singapore perform best while Malaysia, Vietnam, Thailand, and Indonesia do less well in terms of children’s wellbeing. Various issues, including the paucity of data, are discussed as items to be considered in the agenda for future research." ISHN also agrees with the suggestion in the article that an agenda for research and knowledge development on child and adolescent health should be developed within the region. Read more>>
(An item from the ISHN Member information service) An article in Issue #4, 2015 of Public Administration Review helps us to understand one aspect of the decision-making processes that occur in professional bureaucracies such as health, education or other ministries/systems. The article examines advice networks and the role that structures, internal competition and Individual attributes play in shaping those networks and the advice. The authors summarize their work: "Interpersonal networks are increasingly important for organizational learning and performance. However, little is known about how these networks emerge. In this article, exponential random graph models are employed to explore the underlying processes of advice network formation in 15 organizations. The author examines the influence of (1) structural effects (reciprocity, transitivity, multiplexity), (2) actor attribute effects (job function, tenure, education, self-efficacy), and (3) peer competition. Results suggest that employees rely more on reciprocity, closure, and similarity in job function than on peer expertise or status when seeking advice. In addition, employees who perceive greater levels of competition with peers are significantly less likely to both seek and provide advice. As public organizations look to private sector strategies that promote internal competition to improve efficiency and accountability, public managers need to be aware of the negative implications those strategies can have on interpersonal networks and organizational learning." In school health promotion and social development we have traditionally ignored the systems above schools, even though we know that eventually and inevitably, educators and nurses in schools will need to report back and ask for resources from these agencies, ministries and systems. Read more>>
(An item from the ISHN Member information service) ISHN has been discussing the limits systematic review in this blog. An article in Issue #3, 2015 of Evidence & Policy extends our skepticism by examining how various "evidence tools (health impact assessments, systematic reviews and cost-benefit studies) are used, misused and misinterpreted in the real world of public decision-making. The authors conclude that "Each has been promoted as a means of synthesising evidence for policy makers but little is known about policy actors' experiences of them. Employing a literature review and 69 interviews, we offer a critical analysis of their role in policy debates, arguing that their utility lies primarily in their symbolic value as markers of good decision making." Not having access to the full text of that article, we did find a very similar version online that includes this statement "‘evidence tools’ can be important means of supporting policy decisions because they appear to be objective and credible (or at least more objective and credible than single studies may be). In addition, the interviewee suggests that ‘evidence tools’ employing quantitative data and providing clear and simple ‘answers’ to policy questions represent ‘gold dust’ to policymakers, who are often desperate for some sense of certainty within complex (and often contested) debates. " They go on to say that " All this leads us to conclude that ‘evidence tools’ represent means of drawing policymakers’ attention to particular kinds of evidence (and, implicitly, away from other kinds). As such, they might best be understood as ‘research-informed advocacy tools’ constructed and employed by actors (researchers using their black magic) working to inform the policy process. Read more>>
(An item from the ISHN Member information service) A Cochrane Review published in the August 2015 issue of the newsletter reports that there is little evidence that multiple lifestyle interventions can reduce cardiovascular risks in low and middle income countries. The authors report that "Due to the limited evidence currently available, we can draw no conclusions as to the effectiveness of multiple risk factor interventions on combined CVD events and mortality. There is some evidence that multiple risk factor interventions may lower blood pressure levels, body mass index and waist circumference in populations in LMIC settings at high risk of hypertension and diabetes. There was considerable heterogeneity between the trials, the trials were small, and at some risk of bias." Even more startling was the statement in the introduction of the article that suggests there is limited evidence supporting such multiple lifestyle interventions in high income countries as well. Read more>>
(An item from the ISHN Member information service) Several articles in Volume 34, 2015 of Vaccine form a Special Issue that examines the WHO recommendations regarding vaccine hesitancy. The concept is defined and the determinants are described in one article. The results of a systematic review of strategies to address vaccine hesitancy are presented in another article. A guide to tailoring hesitancy prevention programs to specific populations is described in another. Commercial and social marketing principles are also suggested for consideration. Read more>>
(An item from the ISHN Member information service) Last week, we noted several news stories covering the release of an American report (CDC) suggesting that schools adjust their start times for students, especially adolescents, so that they can get more sleep. The CDC noted several health and academic benefits. An article in Volume 81, 2015 of Accident Analysis & Prevention reports on a French study that shows a strong correlation between injuries and sleep problems."The study population included 1559 middle-school adolescents from north-eastern France who completed at the end of school year a self-administered questionnaire to gather school and out-of-school injuries during the school year, and to assess sleep difficulty and previous injury risk factors which were socioeconomic factors, school performance, obesity, alcohol/tobacco/cannabis/hard drugs use, health status, psychological health, and involvement-in-violence. For sleep difficulty and behaviour and health-related difficulties their first occurring over adolescent’s life course was gathered. Multinomial logistic regression models were used retaining only sleep difficulty and other risk factors which had started before the school year (thus before the injuries studied). School and out-of-school injuries and sleep difficulty were frequent. The adolescents with sleep difficulty without medical treatment had a higher risk of single school and out-of-school injuries and a much higher risk of repeated school and out-of-school injuries. The adolescents with persistent sleep difficulty despite a medical treatment also had a higher risk of single school and out-of-school injury, and a much higher risk of repeated school and out-of-school injuries." The authors conclude that "Injury prevention should focus on sleep difficulty, especially among adolescents with socioeconomic difficulties, via physician–parent–school–adolescent collaborations." Read more>>
(An item from the ISHN Member information service) Two news stories identified this week help to explain the potential confusion and debates about e-cigarettes. On August 18th, the US government (National Institutes of Health) released a report noting that e-cigarette use by teens would likely lead to smoking tobacco. On August 19th, the Health Department in England released a research review stating that e-cigarettes were 95% less harmful than tobacco. Both of these studies are likely accurate. What is confusing is the government intentions in both cases and what fact-based health messages are intended by the release of each study. Read more>>
(An item from the ISHN Member information service) A letter/article in Issue #11, 2015 of Public Health Nutrition makes a good point in response to an earlier article suggesting that BMI should be replaced as a measure of obesity by the time it takes a child to run 500 meters. The argument is made well by differentiating "fitness" from "fatness". The physical fitness to run that distance is quite a different construct than a simplistic height/weight ration such as BMI. Further, there are more sophisticated measures of body fat (waist circumference, waist to to height ratio and abdominal fat etc) that can replace BMI if needed. However it is this simple clarification of fitness and fatness that may be even more important to consider, especially in the light of increasing evidence that physical activity alone has little impact on body weight. Increasingly, researchers are turning to diet/healthy eating and accompanying mental states (boredom, loneliness,k stress) as the dominant factors. Read more>>
(An item from the ISHN Member information service) The use of ecological analysis of the over-lapping and inter-acting influences of individual, family, neighbourhood, school and larger community on behaviour and health status is now well-accepted in health promotion research. The ISHN has a version of this thinking that we developed with several researchers. However, it is very difficult to sort out the relative impact of these various layers. Indeed, the more "proximal" and "distal" influences are likely to vary for different individuals, at different times in their lives and events. An article in Issue #11, 2015 of Public Health Nutrition describes the relative contributions of these layers of the Social Ecological Model (SEM) when examining childhood obesity. A randomized telephone survey conducted in 2009–2010 collected information on parental perceptions of their neighbourhoods, and household, parent and child demographic characteristics. Parents provided measured height and weight data for their children. Geocoded data were used to calculate proximity of a child’s residence to food and physical activity outlets. Multiple logistic regression models were estimated to determine the joint contribution of elements within each layer of the SEM as well as the relative contribution of each layer. Layers of the SEM representing parental perceptions of their neighbourhoods, parent demographics and neighbourhood characteristics made the strongest contributions to predicting whether a child was overweight or obese. Layers of the SEM representing food and physical activity environments made smaller, but still significant, contributions to predicting children’s weight status. Read more>>
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