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Fulltext The use of e-cigarettes among university students in Malaysia

Wan Puteh SE, Manap RA, Hassan TM, Ahmad IS, Idris IB, Sham FM, et al.

Tob Induc Dis, 2018;16:57.
PMID: 31516454 DOI: 10.18332/tid/99539

INTRODUCTION: E-cigarette use is an emerging phenomenon with increasing recognition and acceptance globally. This study aims to create a profile of e-cigarette users among university students in Malaysia.

METHODS: The study was conducted using a cross-sectional research involving six universities in Malaysia. A semi-structured questionnaire was distributed to 1302 randomly selected students, who either smoked cigarettes and/or e-cigarettes. The 2011 version of Global Adult Tobacco Surveys (GATS) tool was used to record the respondents' sociodemographic data.

RESULTS: The study revealed that 74.9% of the respondents smoked e-cigarettes; 40.3% used both cigarettes and e-cigarettes (dual users), and 34.5% were exclusive e-cigarette users. The exclusive use of e-cigarettes was related to gender (OR=0.18, 95% CI: 0.09-0.39). Also, male respondents were the majority users (95%). Of the respondents, 75.2 % were Malays, 98.0% single and most believed they have no health problems (92.1%). Further findings revealed the occurrence of adverse effects, dizziness 14.4%, cough 14.1%, and headaches 12.4%. Overall, 57.8% of the respondents used e-cigarettes as a smoking cessation tool, while others consider e-cigarettes a self-image enhancing tool or as part of social activities.

CONCLUSIONS: Further research on the use of e-cigarettes should be conducted on a large number of respondents in other settings to augment the findings of this study, and also guide policy making on and prevention practice of e-cigarette use, among the general student population in Malaysia.

Matched MeSH terms: Policy Making
Fulltext The values and risks of an Intergovernmental Panel for One Health to strengthen pandemic prevention, preparedness, and response

Hobeika A, Stauffer MHT, Dub T, van Bortel W, Beniston M, Bukachi S, et al.

Lancet Glob Health, 2023 Aug;11(8):e1301-e1307.
PMID: 37474236 DOI: 10.1016/S2214-109X(23)00246-2

The COVID-19 pandemic has shown the need for better global governance of pandemic prevention, preparedness, and response (PPR) and has emphasised the importance of organised knowledge production and uptake. In this Health Policy, we assess the potential values and risks of establishing an Intergovernmental Panel for One Health (IPOH). Similar to the Intergovernmental Panel on Climate Change, an IPOH would facilitate knowledge uptake in policy making via a multisectoral approach, and hence support the addressing of infectious disease emergence and re-emergence at the human-animal-environment interface. The potential benefits to pandemic PPR include a clear, unified, and authoritative voice from the scientific community, support to help donors and institutions to prioritise their investments, evidence-based policies for implementation, and guidance on defragmenting the global health system. Potential risks include a scope not encompassing all pandemic origins, unclear efficacy in fostering knowledge uptake by policy makers, potentially inadequate speed in facilitating response efforts, and coordination challenges among an already dense set of stakeholders. We recommend weighing these factors when designing institutional reforms for a more effective global health system.

Matched MeSH terms: Policy Making
Fulltext Tracking Progress from Policy Development to Implementation: A Case Study on Adoption of Mandatory Regulation for Nutrition Labelling in Malaysia

Ng S, Kelly B, Yeatman H, Swinburn B, Karupaiah T

Nutrients, 2021 Jan 29;13(2).
PMID: 33573100 DOI: 10.3390/nu13020457

Mandatory nutrition labelling, introduced in Malaysia in 2003, received a "medium implementation" rating from public health experts when previously benchmarked against international best practices by our group. The rating prompted this qualitative case study to explore barriers and facilitators during the policy process. Methods incorporated semi-structured interviews supplemented with cited documents and historical mapping of local and international directions up to 2017. Case participants held senior positions in the Federal government (n = 6), food industry (n = 3) and civil society representations (n = 3). Historical mapping revealed that international directions stimulated policy processes in Malaysia but policy inertia caused implementation gaps. Barriers hindering policy processes included lack of resources, governance complexity, lack of monitoring, technical challenges, policy characteristics linked to costing, lack of sustained efforts in policy advocacy, implementer characteristics and/or industry resistance, including corporate political activities (e.g., lobbying, policy substitution). Facilitators to the policy processes were resource maximization, leadership, stakeholder partnerships or support, policy windows and industry engagement or support. Progressing policy implementation required stronger leadership, resources, inter-ministerial coordination, advocacy partnerships and an accountability monitoring system. This study provides insights for national and global policy entrepreneurs when formulating strategies towards fostering healthy food environments.

Matched MeSH terms: Policy Making
Trends in sustainable logistics in major cities in China

Lan S, Tseng ML, Yang C, Huisingh D

Sci Total Environ, 2020 Apr 10;712:136381.
PMID: 31940512 DOI: 10.1016/j.scitotenv.2019.136381

"Smart cities" have become the development direction pursued by city leaders to address challenges related to rapid growth in urban areas. The sustainable development of the logistics sector has important practical significance for the evolution of smart cities. This study assessed the inefficiency rate and total factor productivity (TFP) of logistics in 36 Chinese cities from 2006 to 2015. The directional distance function (DDF) and Luenberger productivity index analytical approaches were used to assess the relevant parameters. The results revealed that the logistics system inefficiency rate of the eastern region was much higher than that of the central and western regions, while that of the western region was slightly higher than that of the central region. This study identified the main constraints of the logistics TFP in different regions in China. This finding is used to promote policy-making and investment planning to improve China's competitive advantage. The results documented that the central region of China needs to accelerate logistics reforms and use its location advantage of its location to form an organic connection with the eastern and western regions. Countries can use such metrics to take actions to improve their logistics performance, as such an improvement has a causal relationship with economic development.

Matched MeSH terms: Policy Making
Twenty years and counting: taking the lessons learned from ICPD to move the sexual and reproductive health and rights agenda forward

Thanenthiran S

Glob Public Health, 2014;9(6):669-77.
PMID: 24921436 DOI: 10.1080/17441692.2014.920893

The women's rights movement and the sexual and reproductive health and rights (SRHR) movement have been actively involved in ensuring that the gains (on sexual and reproductive health, reproductive rights and women's sexuality) made during the 1994 International Conference on Population and Development (ICPD) in Cairo and the 1995 fourth World Conference on Women in Beijing are maintained and captured in the new development framework. International processes, especially the United Nations Population Fund's ICPD Beyond 2014 work, have proven essential platforms for this. However, the current geopolitical scenario provides a challenging environment to ensure that the comprehensive Cairo+20 agenda is given the due attention and place it deserves and requires. This article aims to articulate the critical gaps in political discourse and commitment to the ICPD agenda from 1994 to the time of ICPD beyond 2014. Governments' potential lack of commitment to crucial issues of SRHR is also examined and discussed in the first section. In the second section, the article looks at progress and gaps regarding specific and commonly used measures of SRHR as an indicator of where discourse and commitment are required. In the third section, as a follow-up to the previous one, the article discusses the need to and the possibilities of articulating and positioning the rights discourse more clearly within the current complex global discourse as a necessary step in the movement's political discourse. In the last section, some key challenges and opportunities, as well as identified recommendations, are discussed with regard to the way ahead for the SRHR agenda in the 2014 and beyond.

Matched MeSH terms: Policy Making*
Understanding the systemic nature of cities to improve health and climate change mitigation

Chapman R, Howden-Chapman P, Capon A

Environ Int, 2016 Sep;94:380-387.
PMID: 27126780 DOI: 10.1016/j.envint.2016.04.014

Understanding cities comprehensively as systems is a costly challenge and is typically not feasible for policy makers. Nevertheless, focusing on some key systemic characteristics of cities can give useful insights for policy to advance health and well-being outcomes. Moreover, if we take a coevolutionary systems view of cities, some conventional assumptions about the nature of urban development (e.g. the growth in private vehicle use with income) may not stand up. We illustrate this by examining the coevolution of urban transport and land use systems, and institutional change, giving examples of policy implications. At a high level, our concern derives from the need to better understand the dynamics of urban change, and its implications for health and well-being. At a practical level, we see opportunities to use stylised findings about urban systems to underpin policy experiments. While it is now not uncommon to view cities as systems, policy makers appear to have made little use so far of a systems approach to inform choice of policies with consequences for health and well-being. System insights can be applied to intelligently anticipate change - for example, as cities are subjected to increasing natural system reactions to climate change, they must find ways to mitigate and adapt to it. Secondly, systems insights around policy cobenefits are vital for better informing horizontal policy integration. Lastly, an implication of system complexity is that rather than seeking detailed, 'full' knowledge about urban issues and policies, cities would be well advised to engage in policy experimentation to address increasingly urgent health and climate change issues.

Matched MeSH terms: Policy Making
Fulltext What, Where, and How to Collect Real-World Data and Generate Real-World Evidence to Support Drug Reimbursement Decision-Making in Asia: A reflection Into the Past and A Way Forward

Kc S, Lin LW, Bayani DBS, Zemlyanska Y, Adler A, Ahn J, et al.

Int J Health Policy Manag, 2023;12:6858.
PMID: 37579427 DOI: 10.34172/ijhpm.2023.6858

BACKGROUND: Globally, there is increasing interest in the use of real-world data (RWD) and real-world evidence (RWE) to inform health technology assessment (HTA) and reimbursement decision-making. Using current practices and case studies shared by eleven health systems in Asia, a non-binding guidance that seeks to align practices for generating and using RWD/RWE for decision-making in Asia was developed by the REAL World Data In ASia for HEalth Technology Assessment in Reimbursement (REALISE) Working Group, addressing a current gap and needs among HTA users and generators.
METHODS: The guidance document was developed over two face-to-face workshops, in addition to an online survey, a face-to-face interview and pragmatic search of literature. The specific focus was on what, where and how to collect RWD/ RWE.
RESULTS: All 11 REALISE member jurisdictions participated in the online survey and the first in-person workshop, 10 participated in the second in-person workshop, and 8 participated in the in-depth face-to-face interviews. The guidance document was iteratively reviewed by all working group members and the International Advisory Panel. There was substantial variation in: (a) sources and types of RWD being used in HTA, and (b) the relative importance and prioritization of RWE being used for policy-making. A list of national-level databases and other sources of RWD available in each country was compiled. A list of useful guidance on data collection, quality assurance and study design were also compiled.
CONCLUSION: The REALISE guidance document serves to align the collection of better quality RWD and generation of reliable RWE to ultimately inform HTA in Asia.

Matched MeSH terms: Policy Making*