Sustainable Development : The 2030 Agenda and its Implications for Global Health Law

This chapter, “Sustainable Development,” examines the rise of global health goals to facilitate sustainable development. It focuses on the 2030 Agenda for Sustainable Development (2030 Agenda), which establishes a comprehensive global policy framework for international development. In advancing sustainable development, the 2030 Agenda was developed as a follow-up to the Millennium Declaration, which had been announced at the turn of the century as a policy foundation to alleviate poverty and address inequalities under 8 Millennium Development Goals (MDGs). The 2030 Agenda builds on the MDGs to establish 17 Sustainable Development Goals (SDGs), including SDG 3, which specifically seeks to promote good health and well-being. SDG 3 brings together thirteen targets aimed at improving health outcomes and strengthening state capacities to promote public health services and ensure universal health coverage. In addition to Goal 3, the SDGs include goals and targets aimed at addressing a wide range of interconnected determinants of health, including climate action, clean water and sanitation, energy access, hunger, and poverty. By shaping global development efforts, the implementation of the 2030 Agenda is establishing global health law norms and shaping global health governance

Through the rule of law looking glass

Transposing rule of law principles from the national to the international level, in particular to international organizations, still raises questions and can be problematic. However, rule of law considerations play an important role when international organizations exercise a substantial amount of public authority and may directly affect states as well as individuals. The World Health Organization (WHO), unlike other international organizations, has a constitutional mandate to prevent and respond to international acute emergencies in the form of disease outbreaks and pandemics. Its main normative tool is the 2005 International Health Regulations (IHR), that represent a breakthrough from past instruments but also raise questions and challenges that can be effectively analyzed from a rule of law perspective. This approach applies in particular to ambiguities in important parts of the IHR affecting their relevance and effectiveness; lack of clarity for processes leading to sensitive executive decisions; the absence of compliance assessment mechanisms resulting in lack of accountability for states parties; and an inadequate inclusion of human rights guarantees. The analysis is extended beyond WHO’s functions, to the impact of COVID-19 on the organization’s governance as well as its internal management

Justiciability of the Right to Health in South Africa and Switzerland through the Lens of its Normative Components

Despite the recent interest in health rights litigation, there has not yet been a study specifically addressing and comparing the justiciability of the right to health in two diverse contexts such as South Africa and Switzerland from the point of view of determining whether the essential components of the right to health under international law have been referred to in the formulation of complaints and in judgments handed down by the courts. The respective constitutional provisions incorporating the right to health as well as pertinent health rights cases were identified before analysing the similarities and differences relating to the essential components of the right to health. The findings support more frequent reference to the normative components of the right to health throughout domestic judicial proceedings in order to further the advancement and effective implementation of the right to health, not only in South Africa and Switzerland but more broadly.</jats:p

Protocol for a systematic review of the factors associated with binge drinking among adolescents and young adults

Alcohol use is the behaviour that has the most significant impact on the mortality and morbidity of young people, and binge drinking is becoming the norm among this population. The burden of disease of binge drinking during adolescence and young adulthood is significant and warrants the development of effective prevention strategies. Although the literature on risk factors for excessive substance use has been increasing, to our knowledge, a systematic review of the factors associated with binge drinking among young people has not yet been conducted. This study aims to identify and organise the factors associated with binge drinking among young people aged 15 to 24 years; and to provide a framework to further understand these factors in order to better target prevention strategies. METHODS/DESIGN: This systematic review of the literature will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. The databases PubMed, Embase, PsycINFO and Social Care will be searched for articles published between 1 January 2006 and 31 December 2015. Our search focuses on studies examining the risk factors for binge drinking among young people (between the ages of 15 and 24). Observational studies (cross-sectional, cohort and case-control studies) will be included, while randomised controlled trials will be excluded. Case series and case reports will also be excluded, while reviews, if relevant, will be included. The primary outcome is binge drinking. Secondary outcomes include indicators of frequency and consequences of binge drinking. Two reviewers will independently screen articles, extract relevant data and assess the quality of the studies. DISCUSSION: This systematic review will add to our knowledge and understanding of binge drinking among young people. It will allow us to identify the main risk and protective factors associated with binge drinking among this population and ultimately help to define the lines for further investigation and research, as an important part of prevention strategies in this area of work

Heterogeneity of definitions and measurements of binge drinking in research on adolescents and young adults

Introduction: Binge drinking is a widespread health compromising behaviour among adolescents and young adults and is one of the leading causes of mortality and injuries among this population. The definitions and measurement methods of binge drinking are heterogeneous but constitute a crucial component in the literature on associated factors related to binge drinking. This study focused on how binge drinking is defined and measured in the literature exploring its associated risk factors among adolescents and young adults. Methods: The databases PubMed, Embase, PsycINFO and Social Care were searched for articles published between 1 January 2006 and 30 April 2020 using 3 concepts: binge drinking; risk or protective factors; and adolescents/young adults with respective key words. Data were extracted on the main characteristics of studies and the parameters of binge drinking measurements. Results: 173 studies were included, mostly cross-sectional (61 %) and longitudinal (38 %). Only 23 % of the studies explicitly referred to a standardised definition of binge drinking even though 76 % of the studies used a consensual threshold of 5 drinks or more for men. A lower threshold for women was applied in 26 % of the studies. Recall periods ranged between 2 weeks and 1 year in 85 % of the studies and only 16 % presented binge drinking in terms of frequency and/or quantity of drinks. Conclusion: Our results highlight the heterogeneity in the definitions and measurements of binge drinking, raising concerns for meaningful comparisons between studies focused on factors associated with the behaviour. The scientific community needs to be aware of these variations and address the gap of poor stratification and inconsistencies in binge drinking reporting. Keywords: Adolescents and young adults; Binge drinking; Drinking frequency; Drinking intensity; Excessive drinking; Gender threshold; Heavy episodic drinking; Protective factors; Recall period; Risk factors; Risky single occasion drinking (RSOD).</p

Barriers and Facilitators for Implementing Digital Interventions for Anxiety and Depression in Latin America: A Scoping Review

Mental health disorders have a high prevalence in Latin America (LATAM), with an estimated 6.7% of the population suffering from anxiety and 4% from depression. Digital mental health interventions (DMHIs) have been implemented to address these issues. However, there has yet to be a clear picture of these interventions in the region. This scoping review aims to analyze DMHIs&rsquo; characteristics and the barriers and facilitators for their implementation in five LATAM countries (Brazil, Chile, Colombia, Mexico, and Peru). To achieve this goal, four databases (PubMed, APA PsycNet, Scielo, and LILACS) were searched using relevant search terms in English, Spanish, and Portuguese. A total of 484 references were identified and narrowed down to 15 articles included in the final analysis. The studies mostly consisted of RCTs and mixed-methods studies. Most of the DMHIs were designed for individuals, with a focus on targeted communication and personal health tracking. Interventions targeting healthcare professionals were less common, primarily focusing on decisional support. The most prominent barriers to the successful implementation of DMHIs included insufficient healthcare professional training (40%) and resistance from clinicians and organizational culture (40%), while common facilitators included easy access to the interventions (46.7%) and increased training and support for clinical teams (46.7%). Positive outcomes were reported in terms of both effectiveness (33.3%), with many interventions showing results equal to or better than traditional methods (33.3%), and patient satisfaction (33.3%)

Statins for primary prevention in multimorbid patients: to prescribe or not to prescribe? A qualitative analysis of general practitioners’ decision-making processes

Introduction: A better understanding of the determinants involved in general practitioners' (GPs) decision-making processes when it comes to prescribing statins as primary prevention in patients with multimorbidity could provide insights for improving implementation of primary prevention guidelines. Methods: We conducted a qualitative study using a deductive framework-based and inductive analysis of GPs' semi-structured interviews verbatim, from which expertise profiles of prescribers were also drawn. The analytical framework was built from a pragmatic synthesis of the evidence-based medicine, Modelling using Typified Objects (MOT) model of clinical reasoning processes, Theoretical Domains Framework, and shared decision-making frameworks. Results: Fifteen GPs were interviewed between June 2019 and January 2020. Diabetes seemed to represent a specific motivation for deciding about statin prescription for primary prevention purposes; and in situations of multimorbidity, GPs differentiated between cardiovascular and non-cardiovascular multimorbidity. Expert prescribers seemed to have integrated the utilisation of cardiovascular risk calculation scores throughout their practice, whereas non-expert prescribers considered them difficult to interpret and preferred using more of a "rule of thumb" process. One interviewee used the risk calculation score as a support for discussing statin prescription with the patient. Conclusion: Our results shed light on the reasons why statins remain under-prescribed for primary prevention and why non-diabetic multimorbid patients have even lower odds of being prescribed a statin. They call for a change in the use of risk assessment scores, by placing them as decision aids, to support and improve personalised shared decision-making discussions as an efficient approach to improve the implementation of recommendations about statins for primary prevention.</p

Relationships Between Misinformation Variables and Nutritional Health Strategies: A Scoping Review

In an era where information is readily accessible, the dissemination of accurate and reliable health information is crucial for public health promotion. This scoping review explores the impacts of misinformation and disinformation variables on the implementation of nutritional health strategies. It also examines how the design and delivery of these strategies may contribute to the emergence of misinformation. By synthesizing insights from existing literature, this review highlights effective approaches and identifies research limitations to propose actionable recommendations for further investigation. A systematic search on PubMed, Embase, and Web of Science identified fourteen studies published between 2014 and 2024. These fourteen studies focused on various health strategies implemented across different media and in several formats to improve public knowledge and behavior regarding nutrition. Key findings included the role of misinformation variables in shaping public perceptions, the importance of cultural adaptation in health strategies, and the effectiveness of tools, such as e-health communication platforms. This review underscores the necessity for evidence-based, culturally sensitive, and accessible health promotion strategies to counter misinformation and foster informed nutritional practices. Further research is needed to address gaps in demographic representation, user engagement, and the long-term impacts of these strategies