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Neural tube (NT) formation in the spinal region of the mammalian embryo involves a wave of "zippering" that passes down the elongating spinal axis, uniting the neural fold tips in the dorsal midline. Failure of this closure... more
Neural tube (NT) formation in the spinal region of the mammalian embryo involves a wave of "zippering" that passes down the elongating spinal axis, uniting the neural fold tips in the dorsal midline. Failure of this closure process leads to open spina bifida, a common cause of severe neurologic disability in humans. Here, we combined a tissue-level strain-mapping workflow with laser ablation of live-imaged mouse embryos to investigate the biomechanics of mammalian spinal closure. Ablation of the zippering point at the embryonic dorsal midline causes far-reaching, rapid separation of the elevating neural folds. Strain analysis revealed tissue expansion around the zippering point after ablation, but predominant tissue constriction in the caudal and ventral neural plate zone. This zone is biomechanically coupled to the zippering point by a supracellular F-actin network, which includes an actin cable running along the neural fold tips. Pharmacologic inhibition of F-actin or la...
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Tobacco is responsible for the death of 6 million people every year globally, of whom 700 000 are in Europe. Effective policies for tobacco control exist; however, the status of their implementation varies across the World Health... more
Tobacco is responsible for the death of 6 million people every year globally, of whom 700 000 are in Europe. Effective policies for tobacco control exist; however, the status of their implementation varies across the World Health Organization (WHO) European Region. In order to tackle the tobacco epidemic, action has been taken though the implementation of both legally binding and non-legally binding measures. This article aims to present the achievements and challenges of tobacco control in Europe, focussing on the available legally binding instruments such as the WHO Framework Convention on Tobacco Control and the revision of the Tobacco Products Directive at the European Union level. Tobacco still faces heavy lobbying of the tobacco industry, which has systematically contrasted policies to achieve public health objectives. The legal instruments for tobacco control in Europe presented here are not always adequately enforced in all the countries and there is certainly room for impro...
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There is an increasing policy commitment to address the avoidable burdens of unhealthy diet, overweight and obesity. However, to design effective policies, it is important to understand why people make unhealthy dietary choices. Research... more
There is an increasing policy commitment to address the avoidable burdens of unhealthy diet, overweight and obesity. However, to design effective policies, it is important to understand why people make unhealthy dietary choices. Research from behavioural economics suggests a critical role for time discounting, which describes how people's value of a reward, such as better health, decreases with delay to its receipt. We systematically reviewed the literature on the relationship of time discounting with unhealthy diets, overweight and obesity in Web of Science and PubMed. We identified 41 studies that met our inclusion criteria as they examined the association between time discount rates and (i) unhealthy food consumption; (ii) overweight and (iii) response to dietary and weight loss interventions. Nineteen out of 25 cross-sectional studies found time discount rates positively associated with overweight, obesity and unhealthy diets. Experimental studies indicated that lower time d...
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This paper presents a typology of available evidence to inform physical activity policy. It aims to refine the distinction between three types of evidence relating to physical activity and to compare these types for the purpose of... more
This paper presents a typology of available evidence to inform physical activity policy. It aims to refine the distinction between three types of evidence relating to physical activity and to compare these types for the purpose of clarifying potential research gaps. A scoping review explored the extent, range and nature of three types of physical activity-related evidence available in reviews: (I) health outcomes/risk factors, (II) interventions and (III) policy-making. A six-step qualitative, iterative process with expert consultation guided data coding and analysis in EPPI Reviewer 4. 856 Type I reviews, 350 Type II reviews and 40 Type III reviews were identified. Type I reviews heavily focused on obesity issues (18 %). Reviews of a systematic nature were more prominent in the Type II (>50 %). Type III reviews tended to conflate research about policy intervention effectiveness and research about policymaking processes. The majority of reviews came from the United States, United...
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Alcohol is one of the world’s top three priority areas in public health. Even though only half the global population drinks alcohol, it is the world’s third leading cause of ill health and premature death, after low birth weight and... more
Alcohol is one of the world’s top three priority areas in public health. Even though only half the global population drinks alcohol, it is the world’s third leading cause of ill health and premature death, after low birth weight and unsafe sex, and greater than tobacco. In Europe, alcohol is also the third leading risk factor for disease and mortality after tobacco and high blood pressure. This report presents the latest literature overview of effective alcohol policies, and includes data from the European Union, Norway and Switzerland in the areas of alcohol consumption, harm and policy approaches. The data presented were collected from a survey in 2011.
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Research Interests: Health Promotion, Health Behavior, Life Style, Diet, Risk Taking, and 13 moreCapacity Building, Adolescent, Pacific Islands, Health behaviour, Humans, Health Services, Female, Male, Exercise, Public health systems and services research, Curriculum and Pedagogy, Health surveys, and Substance-Related Disorders
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Interventions to prevent morbidity and mortality from chronic diseases need to be cost eff ective and fi nancially feasible in countries of low or middle income before recommendations for their scale-up can be made. We review the cost-eff... more
Interventions to prevent morbidity and mortality from chronic diseases need to be cost eff ective and fi nancially feasible in countries of low or middle income before recommendations for their scale-up can be made. We review the cost-eff ectiveness estimates on policy interventions (both population-based and personal) that are likely to lead to substantial reductions in chronic diseases—in particular, cardiovascular
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As world leaders prepare for the United Nations High Level Meeting on Noncommunicable Diseases, to take place in September 2011, international organizations, nongovernmental organizations, and economic and business fora have created new... more
As world leaders prepare for the United Nations High Level Meeting on Noncommunicable Diseases, to take place in September 2011, international organizations, nongovernmental organizations, and economic and business fora have created new alliances and initiatives to accelerate research, advocacy, and political commitment. This article argues that the time is propitious to reflect on the social nature of the most common behavioral noncommunicable disease determinants, including tobacco and alcohol use, physical inactivity, and unhealthy diet. Evidence is presented related to the fact that these diseases are profoundly rooted in social and community ties and points to the need for a modern communication strategy to serve as a linchpin of any successful action to address these public health threats. Several proposals, aimed at promoting health literacy, strengthening health workforce skills, capturing the power of new media and technologies, and targeting vulnerable groups, are discussed.
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September 2011 will see heads of state and government from around the world gathering at a United Nations high-level meeting to discuss the problem of non-communicable diseases (NCDs) for the first time. The decision to hold such a... more
September 2011 will see heads of state and government from around the world gathering at a United Nations high-level meeting to discuss the problem of non-communicable diseases (NCDs) for the first time. The decision to hold such a meeting demonstrates both that NCDs have finally been recognized as a global health threat and that national leaders are willing to take
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... Negative aspects of the physical environment include indoor and outdoor environmental hazards and pollutants such as lead paint (Barten, 1992), mould, and particulate emissions, and also an overabundance of retail outlets that sell... more
... Negative aspects of the physical environment include indoor and outdoor environmental hazards and pollutants such as lead paint (Barten, 1992), mould, and particulate emissions, and also an overabundance of retail outlets that sell unhealthy food and alcohol (Ashley et al ...
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Public-private partnerships with large corporations offer potential benefits to the health sector but many concerns have been raised, highlighting the need for appropriate safeguards. In this paper we propose five tests that public policy... more
Public-private partnerships with large corporations offer potential benefits to the health sector but many concerns have been raised, highlighting the need for appropriate safeguards. In this paper we propose five tests that public policy makers may wish to apply when considering engaging in such a public-private partnership. First, are the core products and services provided by the corporation health enhancing or health damaging? In some cases, such as tobacco, the answer is obvious but others, such as food and alcohol, are contested. In such cases, the burden of proof is on the potential partners to show that their activities are health enhancing. Second, do potential partners put their policies into practice in the settings where they can do so, their own workplaces? Third, are the corporate social responsibility activities of potential partners independently audited? Fourth, do potential partners make contributions to the commons rather than to narrow programmes of their choosing? Fifth, is the role of the partner confined to policy implementation rather than policy development, which is ultimately the responsibility of government alone?
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This study presents findings on health-related hygiene behaviours of 9,013 adolescents from Vanuatu, Tonga and Pohnpei in the Federal States of Micronesia as part of the Health Behaviour of Pacific Youth Life surveys. We examined the... more
This study presents findings on health-related hygiene behaviours of 9,013 adolescents from Vanuatu, Tonga and Pohnpei in the Federal States of Micronesia as part of the Health Behaviour of Pacific Youth Life surveys. We examined the prevalence of and relationship between tooth brushing, hand washing before eating, hand washing after toileting and a range of psychosocial factors such as sociodemographic charac-teristics, health behaviour and school affiliation. The results showed that patterns of prevalence and relationships were consistent for all countries, with weaker associations observed in Pohnpei. In general, adolescents reported moderate levels of optimal hygiene practice. Girls reported significantly more frequent optimal hygiene practice than boys. Logistic regression analysis confirmed that frequent hygiene behaviours were significantly associated with gender, parental occupations and high levels of school affiliation. These findings suggest the need to consider psycho-social and economic factors when examining potential influences on hygiene behaviour to ensure effective interventions.
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Non-communicable diseases (NCDs) are the biggest cause of death in Europe putting an unsustainable burden on already struggling health systems. Increases in obesity are a major cause of NCDs. This paper projects the future burden of... more
Non-communicable diseases (NCDs) are the biggest cause of death in Europe putting an unsustainable burden on already struggling health systems. Increases in obesity are a major cause of NCDs. This paper projects the future burden of coronary heart disease (CHD), stroke, type 2 diabetes and seven cancers by 2030 in 53 WHO European Region countries based on current and past body mass index (BMI) trends. It also tests the impact of obesity interventions on the future disease burden. Secondary data analysis of country-specific epidemiological data using a microsimulation modelling process. The effect of three hypothetical scenarios on the future burden of disease in 2030 was tested: baseline scenario, BMI trends go unchecked; intervention 1, population BMI decreases by 1%; intervention 2, BMI decreases by 5%. Quantifying the future burden of major NCDs and the impact of interventions on this future disease burden. By 2030 in the whole of the European region, the prevalence of diabetes, ...
Alcohol is one of the world’s top three priority areas in public health. Even though only half the global population drinks alcohol, it is the world’s third leading cause of ill health and premature death, after low birth weight and... more
Alcohol is one of the world’s top three priority areas in public health. Even though only half the global population drinks alcohol, it is the world’s third leading cause of ill health and premature death, after low birth weight and unsafe sex, and greater than tobacco. In Europe, alcohol is also the third leading risk factor for disease and mortality after tobacco and high blood pressure. This report presents the latest literature overview of effective alcohol policies, and includes data from the European Union, Norway and Switzerland in the areas of alcohol consumption, harm and policy approaches. The data presented were collected from a survey in 2011.
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Ageing and urbanization leading to sedentary lifestyles have been the major explanations proposed for a dramatic rise in diabetes worldwide and have been the variables used to predict future diabetes rates. However, a transition to... more
Ageing and urbanization leading to sedentary lifestyles have been the major explanations proposed for a dramatic rise in diabetes worldwide and have been the variables used to predict future diabetes rates. However, a transition to Western diets has been suggested as an alternative driver. We sought to determine what socio-economic and dietary factors are the most significant population-level contributors to diabetes prevalence rates internationally. Multivariate regression models were used to study how market sizes of major food products (sugars, cereals, vegetable oils, meats, total joules) corresponded to diabetes prevalence, incorporating lagged and cumulative effects. The underlying social determinants of food market sizes and diabetes prevalence rates were also studied, including ageing, income, urbanization, overweight prevalence and imports of foodstuffs. Data were obtained from 173 countries. Population-based survey recipients were the basis for diabetes prevalence and food market data. We found that increased income tends to increase overall food market size among low- and middle-income countries, but the level of food importation significantly shifts the content of markets such that a greater proportion of available joules is composed of sugar and related sweeteners. Sugar exposure statistically explained why urbanization and income have been correlated with diabetes rates. Current diabetes projection methods may estimate future diabetes rates poorly if they fail to incorporate the impact of nutritional factors. Imported sugars deserve further investigation as a potential population-level driver of global diabetes.
Research Interests: Marketing, Nutrition, Public Health Nutrition, Poverty, Global Health, and 18 moreDiet, Developing Countries, Urbanization, Social Class, Multivariate Analysis, Humans, Diabetes mellitus, Food supply, Regression Analysis, Young Adult, Income, Aged, Prevalence, Middle Aged, Food habits, Adult, Internationality, and Energy Intake
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Research Interests: New Media, Health Communication, Health Promotion, Medical Informatics, International organizations, and 22 moreObesity, Health Literacy, Tobacco, Diet, Health, Public Health, Social behavior, Communication Technology, Library and Information Studies, Nongovernmental organizations, Humans, Smoking, Chronic Disease, Alcohol Drinking, Vulnerable Populations, Communication and media Studies, Public health systems and services research, Occupational therapy services in mental health services, Social Behavior, International Organizations, Alcohol Use, and Coomunication and Development
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This paper describes a study undertaken to: (1) determine the prevalence of Ascaris lumbricoides, Trichuris trichiura and hookworm infections and nutritional status among Pacific Island school children; (2) identify factors influencing... more
This paper describes a study undertaken to: (1) determine the prevalence of Ascaris lumbricoides, Trichuris trichiura and hookworm infections and nutritional status among Pacific Island school children; (2) identify factors influencing helminthiasis; (3) identify interventions to improve school health. A total of 3,683 children aged 5-12 years attending 27 primary schools in 13 Pacific Island countries were surveyed along with school environmental data. Stool samples were collected from 1996 children (54.2%) and analysed for ova and helminths. Total prevalence of helminthiasis was 32.8%. Anaemia prevalence was 12.4%. Children with helminthiasis and anaemia were found to be 8.7 times more likely to be stunted and 4.3 times more likely to be underweight than non-anaemic and non-infected children. Four significant environmental influences on helminthiasis were identified: (1) an inadequate water supply; (2); availability of a school canteen; (3) regular water/sanitation maintenance regimes; and (4) overcrowded classrooms. Helminthiasis was found to be strongly associated with anaemia, stunting and underweight and environmental influences identified. Although mass anti-helminthic drug administrations (MDA) have been taking place, reinfection is common as drug therapy alone is not enough. Programme effectiveness depends upon upgrading school environments to include an adequate water supply, controlled food preparation/provision, well-maintained water/sanitation facilities and class sizes of 30 students or less.
Research Interests: Child Welfare, Environmental Health, Biological Sciences, Schools, Pacific Islands, and 19 moreEnvironmental Sciences, Water Supply, Humans, Child, Primary School, Female, Animals, School Health, Male, Anemia, Nutritional Status, Hygiene, Prevalence, School Children, Trichuris, Feces, Drug Therapy, Helminthiasis, and Ascaris Lumbricoides
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We estimated the relationship between soft drink consumption and obesity and diabetes worldwide. We used multivariate linear regression to estimate the association between soft drink consumption and overweight, obesity, and diabetes... more
We estimated the relationship between soft drink consumption and obesity and diabetes worldwide. We used multivariate linear regression to estimate the association between soft drink consumption and overweight, obesity, and diabetes prevalence in 75 countries, controlling for other foods (cereals, meats, fruits and vegetables, oils, and total calories), income, urbanization, and aging. Data were obtained from the Euromonitor Global Market Information Database, the World Health Organization, and the International Diabetes Federation. Bottled water consumption, which increased with per-capita income in parallel to soft drink consumption, served as a natural control group. Soft drink consumption increased globally from 9.5 gallons per person per year in 1997 to 11.4 gallons in 2010. A 1% rise in soft drink consumption was associated with an additional 4.8 overweight adults per 100 (adjusted B; 95% confidence interval [CI] = 3.1, 6.5), 2.3 obese adults per 100 (95% CI = 1.1, 3.5), and 0.3 adults with diabetes per 100 (95% CI = 0.1, 0.8). These findings remained robust in low- and middle-income countries. Soft drink consumption is significantly linked to overweight, obesity, and diabetes worldwide, including in low- and middle-income countries.
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The UN High-Level Meeting on Non-Communicable Diseases (NCDs) in September, 2011, is an unprecedented opportunity to create a sustained global movement against premature death and preventable morbidity and disability from NCDs, mainly... more
The UN High-Level Meeting on Non-Communicable Diseases (NCDs) in September, 2011, is an unprecedented opportunity to create a sustained global movement against premature death and preventable morbidity and disability from NCDs, mainly heart disease, stroke, cancer, diabetes, and chronic respiratory disease. The increasing global crisis in NCDs is a barrier to development goals including poverty reduction, health equity, economic stability, and human security. The Lancet NCD Action Group and the NCD Alliance propose five overarching priority actions for the response to the crisis--leadership, prevention, treatment, international cooperation, and monitoring and accountability--and the delivery of five priority interventions--tobacco control, salt reduction, improved diets and physical activity, reduction in hazardous alcohol intake, and essential drugs and technologies. The priority interventions were chosen for their health effects, cost-effectiveness, low costs of implementation, an...