ORCID Profile
0000-0003-3606-704X
Current Organisations
Organisation
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Johns Hopkins Bloomberg School of Public Health
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University of Oxford
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UNSW Australia
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Imperial College
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Publisher: Royal College of Physicians
Date: 04-2007
DOI: 10.7861/CLINMEDICINE.7-2-119
Abstract: This paper discusses the annual incidence of liver disease and resource costs in providing a hepatology service for all new outpatient referrals to a secondary care setting. In a retrospective study, we found that 200 patients (1 in 1,000 of the West Suffolk population) with a mean age of 52 years were referred per year. One-third of patients had cirrhosis (almost half due to alcohol). Annual incidence (per 100,000 population) were as follows: non-alcoholic fatty liver disease (29: of which 23.5 non-cirrhotic and 5.5 cirrhotic), hepatitis C (25), hepatitis B (3), alcohol-related cirrhosis (12.5), primary biliary cirrhosis (3.5), autoimmune hepatitis (3), primary sclerosing cholangitis (2), haemochromatosis (2), hepatocellular carcinoma (1.5) and oesophageal variceal haemorrhage (6.5). Using national indicative tariffs, the total annual hepatology budget was 130K pounds (58K pounds for resources and 72K pounds for clinic attendances). The greatest resource expenditure was on endoscopy (almost half for oesophageal varices) and radiological imaging (one-third of the total budget). These findings will help inform commissioners in hepatology service funding.
Publisher: BMJ
Date: 10-2012
Publisher: BMJ Publishing Group Ltd
Date: 20-09-2018
Publisher: Informa UK Limited
Date: 07-07-2022
Publisher: BMJ
Date: 10-2012
Publisher: Springer Science and Business Media LLC
Date: 09-03-2011
Publisher: American Public Health Association
Date: 03-2014
Abstract: Objectives. We aimed to analyze the epidemiology of childhood unintentional injuries presenting to hospitals in 5 select sites in low- and middle-income countries (LMICs) (Bangladesh, Colombia, Egypt, Malaysia, and Pakistan). Methods. We collected standardized data from children ages 0 to 12 years at participating emergency departments (EDs) in 2007. Statistical analyses were conducted to compare the characteristics of these injuries and to explore the determinants of injury outcomes. Results. Among 2686 injured children, falls (50.4%) and road traffic injuries (16.4%) were the most common, affecting boys more often (64.7%). Home injuries were more common among younger children (average 5.41 vs 7.06 years) and girls (38.2% vs 31.7%). Following an ED visit, 24% of injured children were admitted to the hospital, and 6 died. Injury outcomes were associated with risk factors, such as age and sex, to varying extents. Conclusions. Standardized ED surveillance revealed unintentional injuries are a threat to child health. The majority of events took place inside the home, challenging traditional concepts of children’s safety and underscoring the need for intensified context-appropriate injury prevention.
Publisher: MDPI AG
Date: 17-03-2020
Abstract: Background: Child road traffic injuries are a major global public health problem and the issue is particularly burdensome in middle-income countries such as South Africa where injury death rates are 41 per 100,000 for under 5′s and 24.5 per 100,000 for 5–14-year-old. Despite their known effectiveness in reducing injuries amongst children, the rates of use of child restraint systems (CRS) remains low in South Africa. Little is known about barriers to child restraint use especially in low- and middle-income countries. Methods: We carried out observation studies and parent/carer surveys in 7 suburbs of Cape Town over a three month period to assess usage rates and explore the knowledge and perceptions of parents towards child restraint legislation, ownership and cost Results: Only 7.8% of child passengers were observed to be properly restrained in a CRS with driver seatbelt use and single child occupancy being associated with higher child restraint use. 92% of survey respondents claimed to have knowledge of current child restraint legislation, however, only 32% of those parents/carers were able to correctly identify the age requirements and penalty. Reasons given for not owning a child seat included high cost and the belief that seatbelts were a suitable alternative. Conclusions: These findings indicate the need for a tighter legislation with an increased fine paired with enhanced enforcement of both adult seatbelt and child restraint use. The provision of low-cost/subsidised CRS or borrowing schemes and targeted social marketing through online fora, well baby clinics, early learning centres would be beneficial in increasing ownership and use of CRS.
Publisher: SAGE Publications
Date: 21-08-2012
Abstract: In 2006, the Malaysian government began implementing road safety education (RSE) programs in primary schools, involving numerous stakeholders. We interviewed 19 stakeholders. Thematic analysis led to the identification of four themes: road traffic injuries (RTIs) among children in Malaysia, the role of RSE, factors affecting successful implementation, and intersectoral involvement. The latter was identified as a significant strength of the overall approach to implementation, and is one of the first ex les in Malaysia and in the region of such an approach. Lack of official documentation surrounding ownership, funding responsibilities, and roles among the various sectors led to resistance from some groups. Although we know from scientific studies what works in terms of reducing RTIs, the more important question is how such interventions can be successfully and sustainably implemented, particularly in low- and middle-income countries (LMIC). The results of this study permit stronger understanding of issues surrounding the implementation of RTI interventions in LMIC.
Publisher: South African Medical Association NPC
Date: 26-07-2019
Publisher: Springer Science and Business Media LLC
Date: 25-11-2010
DOI: 10.1057/JPHP.2010.40
Abstract: Violence against children has been the least reported, studied, and understood area of child injuries. Initial awareness emerged from international conferences and resolutions, followed by national policies and statements. More effective responses around the world will require action. Although previous calls for action have pointed to important activities (gathering of baseline data, passing of legal reforms, and providing services to those who experience violence), the agenda is limited. Data collection needs to be continuous, systematic, and sustainable, and should enable ongoing evaluation of intervention programs. An inter-sectoral approach to violence against children incorporating public health, criminal justice, social services, education, non-governmental organizations, media, and businesses is imperative if the growing burden is to be mitigated. Thus we offer a framework, building on earlier recommendations, to focus on four domains: national surveillance, intervention research, legislation and policy, and partnerships and collaboration.
Publisher: Elsevier BV
Date: 12-2013
Publisher: BMJ
Date: 09-2010
Publisher: Oxford University Press (OUP)
Date: 30-05-2019
Abstract: Every year more than 1.35 million people lose their lives on the road and tens of millions more are injured, some permanently. Since the early 2000s there has been renewed focus on the issue, with the United Nations, World Health Organization and the World Bank placing the issue higher on their agendas. Guided by the United Nations General Assembly, World Health Assembly resolutions and ministerial-level conferences on the global road safety crisis, multisectoral partnerships have synthesised the evidence, advocated for action (there are two Sustainable Development Goal targets with an ambitious goal of reducing deaths and injuries from road traffic crashes by 50%), raised public awareness, generated funding, piloted interventions and monitored progress. And yet the total number of deaths has plateaued despite some sporadic country-level successes. More needs to be done—more people need to be trained in countries to deliver, monitor and evaluate a systems approach to road safety, more solid evidence of what works in low-resource settings is needed (including sustainable transportation options) and there needs to be a greater focus on optimising care and support for those injured in crashes—if we are to begin to see numbers come down in the next decade.
Publisher: Wiley
Date: 12-12-2010
DOI: 10.1111/J.1447-0594.2010.00662.X
Abstract: The burden of falls amongst the elderly raises important public health concerns. Empirical evidence suggests that macroeconomic growth may not be sufficient to reduce mortality and morbidity from injuries among the elderly. This paper consolidates macro- and microeconomic evidence of the effect of income on elderly falls in Latin America. Using household databases, we estimate an empirical model to assess the relationship between income and falls. The estimations indicate that an increase in personal income reduces the probability of falling yet, the size of the effect is negligible. A 10% increase in income reduces the probability of falling between 0.001 and 0.002% while a 20% increase reduced the probability by up to 1%. These findings are consistent with macroeconomic data where morbidity and mortality among seniors are inelastic to economic growth. Policy implications of cash transfer programs targeting the elderly are discussed.
Publisher: BMJ
Date: 09-2010
Publisher: Elsevier
Date: 2011
Publisher: SAGE Publications
Date: 30-10-2009
Abstract: Aims: The overall goal of this paper is to highlight the epidemiology of injury in Lithuania between 1998 and 2006. Such a situation analysis will inform the important dialogue happening in Lithuania with respect to renewal of the trauma programme and help to profile the burden of injury in the country. Methods: Review of the literature, and secondary analysis of data from the Lithuanian Health Information Center and the European Detailed Mortality database. Results: Sixteen articles were identified as population-based studies only incidence of burn injuries was reported as 240 per 100,000 per year. According to our analysis, the overall incidence of injury increased from 76 cases per 1,000 in iduals in 1998 to 121 cases per 1,000 in iduals in 2006. The total number of deaths from external causes remained similar with an average of 5,301 per year, as did the age-standardized mortality rates of 152 in 1998 and 150 per 100,000 in 2006. The mortality rate in men was four times higher than in women. Suicide was the most frequent cause of death (34% in 2006) while road traffic injuries were the second most frequent accounting for 17—19% of deaths. There were 429 deaths due to exposure to natural cold in 2006, which constituted 8% of all deaths due to injury. Conclusions: Injury incidence and mortality from external causes in Lithuania has not declined over an eight year time frame. New efforts should be launched in the health sector to address this major cause of deaths.
Publisher: WHO Press
Date: 05-2009
Publisher: BMJ
Date: 02-2008
Publisher: Elsevier BV
Date: 07-2012
DOI: 10.1016/J.AAP.2012.01.015
Abstract: The validity of self-reported seatbelt use among low belt use populations in low belt use countries has not been evaluated directly. Nine hundred and ninety drivers were recruited from shopping centers, car parks, and other suitable locations located in Afyon and Ankara cities of Turkey in order to compare the self-reported and observed seatbelt usage rates. Data sets were collected simultaneously from the participants not being aware of having their seatbelt use observed. Participants interviewed in Afyon (n=301) and Ankara (n=658) reported seatbelt usage ("always using a seatbelt") rates of 39% and 45%, respectively. When observed, however, only 47% in Afyon and 70% in Ankara of these drivers actually fasten their seat-belts. It seems that the drivers in both cities exaggerated their use seat belts considerably.
Publisher: Instituto Nacional de Salud Publica
Date: 13-06-2022
DOI: 10.21149/12786
Abstract: The Covid-19 pandemic has brought to the fore many issues that will impact public health for years to come –one such impact is on the nexus between transportation and health. Promoting safe, active transport is an activity that has many physical and mental health benefits. During lockdowns, many cities in Latin America imposed infrastructural and legislative changes in order to abide with public health and social measures to reduce virus spread. These ranged from additional bike lanes to reduced speed limits or incentives to purchase bicycles. These cities showed reduced motorized transport, improved air quality and increased active transport, all of which have multiple health and equity benefits. As countries “build back better”, promoting active transport offers the most value for investment and improves health and well-being while continuing to offer social distancing. Quantified case studies are needed to have a more comprehensive understanding of the impact of active transport in various contexts.
Publisher: Elsevier BV
Date: 03-2010
DOI: 10.1016/J.PUHE.2009.12.006
Abstract: Future Health Systems: Innovations for Equity (FHS) is working in six partner countries in Asia and Africa, focusing on strengthening the research-policy interface in relation to specific health system research projects. These projects present an opportunity to study the influence of stakeholders on research and policy processes. Qualitative stakeholder analysis. Stakeholder analysis was conducted in each FHS country using a structured approach. A cross-country evaluation was performed concentrating on six key areas: chosen research topic type of intervention considered inclusion/exclusion of stakeholder groups general stakeholder considerations power level, power type and agreement level of stakeholders and classification of and approaches to identified stakeholders. All six countries identified a range of stakeholders but each country had a different focus. Four of the six countries identified stakeholders in addition to the guidelines, while some of the stakeholder categories were not identified by countries. The mean power level of identified stakeholders was between 3.4 and 4.5 (1=very low 5=very high). The percentage of classified stakeholders that were either drivers or supporters ranged from 60% to 91%. Three important common areas emerge when examining the execution of the FHS country stakeholder analyses: clarity on the purpose of the analyses value of internal vs external analysts and the role of primary vs secondary analyses. This paper adds to the global body of knowledge on the utilization of stakeholder analysis to strengthen the research-policy interface in the developing world.
Publisher: Elsevier
Date: 2019
Publisher: SAGE Publications
Date: 12-2012
Abstract: Indicators that summarise the health status of a population and that provide comparable measures of a population disease burden are increasingly vital tools for health policy decision making. Decisions concerning health systems across the world are greatly affected by changes in disease profiles and population dynamics, and must develop the capacity to respond to such changes effectively within the resources of each nation. Decisions must be based on evidence of the patterns of diseases, their risk factors and the effectiveness of alternative interventions. This paper focuses on the main approaches used for developing summary measures that include mortality and morbidity occurring in a population. It discusses the rationale for composite measures and reviews the origins of each main approach. The paper also examines methodological differences among these approaches making explicit the value choices that each entails, outlines the advantages and limitations of each measure, and shows how they relate to one another.
Publisher: BMJ Publishing Group Ltd
Date: 31-03-2021
Publisher: FapUNIFESP (SciELO)
Date: 2008
Publisher: Informa UK Limited
Date: 03-2012
DOI: 10.1080/15389588.2011.633135
Abstract: Road traffic injuries (RTIs) are one of the leading causes of global deaths, contributing to 1.3 million lives lost each year. Although all regions are affected, low- and middle-income countries share a disproportionate burden. The significance of this public health threat is growing in Turkey, where current estimates show that 2.0 percent of all deaths in the country are due to RTIs. Despite the significance of this growing epidemic, data pertaining to RTIs in Turkey are limited. In order to address the gap in knowledge, this article presents an overview of the epidemiology of RTIs in Turkey through an analysis of available secondary data sets and a comprehensive review of scientifically published studies. A literature review was performed during December 2010 using PubMed, Embase, and ISIS Web of Knowledge databases and Google search engines. Peer-reviewed literature pertaining to Turkey and RTIs were selected for screening. Secondary data were also procured with assistance from Turkish colleagues through an exploration of data sources pertaining to RTIs in Turkey. The literature review yielded a total of 70 studies with publication years ranging from 1988 to 2010. Secondary data sources were procured from the ministries of Health and Interior as well as the Turkish Statistical Institute. These data sources focus primarily on crashes, injuries, and fatalities (crash rate of 1328.5 per 100,000 population injury rate of 257.9 per 100,000 population fatality rate of 5.9 per 100,000). Risk factor data surrounding road safety are limited. The findings reveal the significant burden that RTIs pose on the health of the Turkish population. The introduction of new technologies such as the novel digital recording systems in place to record pre-hospital services and Global Positioning System (GPS) tracking of road traffic crashes by the police have allowed for a more accurate picture of the burden of RTIs in Turkey. There are, however, some considerable gaps and limitations within the data systems. Incorporation of standardized definitions, regular data audits, and timely review of collated data will improve the utility of RTI data and allow it to be used for policy influence.
Publisher: Elsevier BV
Date: 12-2013
Publisher: Informa UK Limited
Date: 03-2012
DOI: 10.1080/15389588.2011.639417
Abstract: Road traffic injuries (RTIs) are a major cause of global mortality and morbidity, killing approximately 1.3 million people and injuring 20 to 50 million each year. The significance of this public health threat is most pronounced in low- and middle-income countries where 90 percent of the world's road traffic-related fatalities take place. Current estimates for Egypt show a road traffic fatality rate of 42 deaths per 100,000 population-one of the highest in the Eastern Mediterranean Region. RTIs are also responsible for 1.8 percent of all deaths and 2.4 percent of all disability-adjusted life years (DALYs) lost in the country. Despite this, studies surrounding this topic are scarce, and reliable data are limited. The overall goal of this article is to define the health impact of RTIs in Egypt and to identify the strengths and weaknesses of each data source for the purpose of improving the current RTI data systems. A 2-pronged approach was undertaken to assess the burden of RTIs in Egypt. First, a thorough literature review was performed using PubMed, Embase, ISIS Web of Knowledge, and Scopus databases. Articles pertaining to Egypt and road traffic injuries were selected for screening. With assistance from Egyptian colleagues, a comprehensive exploration of data sources pertaining to RTIs in Egypt was undertaken and secondary data from these sources were procured for analysis. The literature review yielded a total of 20 studies, of which 6 were multi-country and 5 were hospital-based studies. None examined risk factors such as speeding, alcohol, or seat belt use. Secondary data sources were acquired from national hospital-based injury surveillance a community-based health survey pre-hospital injury surveillance the Ministry of Transport the General Authority for Roads, Bridges and Land Transport death certificates and the central agency for public motorization and statistics. Risk factor data are also limited from these sources. The results of this article clearly highlight the significant burden that road traffic injuries pose on the health of the Egyptian population. The hospital-based injury surveillance system that has been established in the country and the use of International Classification of Diseases (ICD-10) coding brings the system very closely in line with international guidelines. There is, however, some considerable room for improvement, including the need to extend the coverage of the surveillance system, the inclusion of injury severity scores and disability indicators, and standardization of the sometimes rather disparate sources from various sectors in order to maximally capture the true burden of RTIs.
Publisher: BMJ
Date: 09-2010
Publisher: Springer Science and Business Media LLC
Date: 12-2015
Publisher: Springer Science and Business Media LLC
Date: 19-01-2012
Publisher: BMJ
Date: 09-2010
Location: United Kingdom of Great Britain and Northern Ireland
Location: United States of America
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: No location found
No related grants have been discovered for Prasanthi Attwood.