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Public health ethics

Oriana Ciani, Maria Cucciniello, Francesco Petracca, Giovanni Apolone, Giampaolo Merlini, Silvia Novello, Paolo Pedrazzoli, Nicoletta Zilembo, Chiara Broglia, Enrica Capelletto, Marina Garassino, Elena Nicod, Rosanna Tarricone
INTRODUCTION: Mobile health technologies may enhance patient empowerment and data integration along the whole care continuum. However, these interventions pose relatively new regulatory, organisational and technological challenges that limit appropriate evaluation. Lung Cancer App (LuCApp) is a mobile application developed by researchers and clinicians to promote real-time monitoring and management of patients' symptoms. This protocol illustrates a clinical trial designed to evaluate the usability, effectiveness and cost-effectiveness of LuCApp versus standard of care...
February 15, 2019: BMJ Open
Kristina M Kokorelias, Sarah Munce, Kathy S McGilton, Shawna M Cronin, Chen D Wang, Parvin Eftekhar, Darren K Cheng, Shirin Vellani, Susan Jaglal, Nancy M Salbach, Pia Kontos, Tracey J F Colella, Alisa Grigorovich, Jill I Cameron
INTRODUCTION: Although a growing number of frail adults can benefit from rehabilitation services, few are included in rehabilitation services, and reasons for their exclusion are not well understood. To inform research directions in rehabilitation for all adults (aged 18 years and older), we will conduct a scoping review to describe (1) the characteristics of frail adult individuals included in rehabilitation interventions (eg, age range, inclusion and exclusion criteria that are applied), (2) the type of rehabilitation interventions that are used for individuals who are considered frail and (3) the commonly reported outcome measures used for these rehabilitation interventions...
February 15, 2019: BMJ Open
Karen M Oude Hengel, Pieter Coenen, Suzan J W Robroek, Cecile R L Boot, Allard J van der Beek, Frank J Van Lenthe, Alex Burdorf
INTRODUCTION: Obesity and unhealthy behaviour are more prevalent among workers with a low compared with a high socioeconomic position (SEP), and thus contribute to socioeconomic health inequalities. The occupational setting is considered an important setting to address unhealthy behaviours due to the possibility to efficiently reach a large group of adults through worksite health promotion. This paper describes the rationale and design for an individual participant data (IPD) meta-analysis and a socioeconomic equity-specific reanalysis aiming to: (1) investigate socioeconomic differences in the effectiveness of interventions aimed at promoting healthy behaviour and preventing obesity, (2) examine socioeconomic differences in reach and compliance and (3) to investigate underlying factors affecting possible socioeconomic differences...
February 13, 2019: BMJ Open
Jose Ignacio Melero-Alegria, Manuel Cascon, Alfonso Romero, Pedro Pablo Vara, Manuel Barreiro-Perez, Victor Vicente-Palacios, Fernando Perez-Escanilla, Jesus Hernandez-Hernandez, Beatriz Garde, Sara Cascon, Ana Martin-Garcia, Elena Diaz-Pelaez, Jose Maria de Dios, Aitor Uribarri, Javier Jimenez-Candil, Ignacio Cruz-Gonzalez, Baltasara Blazquez, Jose Manuel Hernandez, Clara Sanchez-Pablo, Inmaculada Santolino, Maria Concepcion Ledesma, Paz Muriel, P Ignacio Dorado-Diaz, Pedro L Sanchez
INTRODUCTION: This study aims to obtain data on the prevalence and incidence of structural heart disease in a population setting and, to analyse and present those data on the application of spatial and machine learning methods that, although known to geography and statistics, need to become used for healthcare research and for political commitment to obtain resources and support effective public health programme implementation. METHODS AND ANALYSIS: We will perform a cross-sectional survey of randomly selected residents of Salamanca (Spain)...
February 13, 2019: BMJ Open
Carolin Winkelmann, Thomas Neumann, Jan Zeidler, Anne Prenzler, Bodo Vogt, Frank K Wacker
BACKGROUND:  Health technology assessments (HTAs) are an interdisciplinary method to support sustainable, evidence-based healthcare decisions. They systematically assess medical products, procedures, and technologies with respect to medical, economic, legal, social, and ethical aspects. METHOD:  This review analyzes the current use of HTAs in radiology in Germany and discusses challenges associated with HTAs. In particular, incentive structures of various players in the healthcare field involved in HTA implementation are considered for both the inpatient and outpatient sectors...
February 14, 2019: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
Sara L C Mackenzie, Deborah M Hinchey, Kathryn P Cornforth
Undergraduate public health degree programs strive to educate students to improve the health of communities. As such we have an obligation to develop curricula that push students to think critically about their perspectives, examine assumptions, and provide supported opportunities to apply their academic learning. In addition, curricula ideally develop and nurture students' sense of civic responsibility. Community-engaged learning provides opportunities for students to interact with populations with a range of needs and different perspectives...
2019: Frontiers in Public Health
Asta Ratna Prajapati, Alexandra Dima, Allan B Clark, Claire Gant, Chris Gibbons, Richard Gorrod, George Mosa, Sion Scott, Fujian Song, Bonnie Teague, Michael J Twigg, Jon Wilson, Debi Bhattacharya
INTRODUCTION: People with bipolar disorder require long-term treatment but it is estimated that 40% of these people do not adhere to prescribed medication regimens. Non-adherence increases the risk of relapse, hospitalisation and suicide. Some evidence syntheses report barriers to mental health treatment adherence but rarely delineate between modifiable and non-modifiable barriers. They also fail to distinguish between the patients' perspective and that of other stakeholders such as clinicians despite of their different understanding and priorities about adherence...
February 12, 2019: BMJ Open
Mohamed F Jalloh, Mohammad B Jalloh, Alison Albert, Brent Wolff, Amy Callis, Aparna Ramakrishnan, Emily Cramer, Paul Sengeh, Samuel Abu Pratt, Lansana Conteh, Rana Hajjeh, Rebecca Bunnell, John T Redd, Anna Mia Ekström, Helena Nordenstedt
INTRODUCTION: Experimental Ebola vaccines were introduced during the 2014-2015 Ebola outbreak in West Africa. Planning for the Sierra Leone Trial to Introduce a Vaccine against Ebola (STRIVE) was underway in late 2014. We examined hypothetical acceptability and perceptions of experimental Ebola vaccines among health care workers (HCWs), frontline workers, and the general public to guide ethical communication of risks and benefits of any experimental Ebola vaccine. METHODS: Between December 2014 and January 2015, we conducted in-depth interviews with public health leaders (N = 31), focus groups with HCWs and frontline workers (N = 20), and focus groups with members of the general public (N = 15) in Western Area Urban, Western Area Rural, Port Loko, Bombali, and Tonkolili districts...
February 9, 2019: Vaccine
Jennifer Broom, Alex Broom, Phillip Good, Zarnie Lwin
The antibiotic optimisation imperative is now ubiquitous, with national policy frameworks in Organisation for Economic Co-operation and Development (OECD) countries incorporating the requirement for antimicrobial stewardship within healthcare services. Yet in practice, the optimisation agenda often raises complex ethical- and practice-based dilemmas. Antibiotic use at the end of life is multidimensional. It includes balancing complex issues, such as accuracy of prognostic estimates, benevolence to the individual versus the broader public health, personalised value judgement of time and quality of life and the right to treatment versus the right to die...
February 2019: Internal Medicine Journal
Ingrid Miljeteig, Frehiwot Berhane Defaye, Paul Wakim, Dawit Neema Desalegn, Yemane Berhane, Ole Frithjof Norheim, Marion Danis
BACKGROUND: Out-of-pocket health expenditures can pose major financial risks, create access-barriers and drive patients and families into poverty. Little is known about physicians' role in financial protection of patients and families at the bedside in low-income settings and how they perceive their roles and duties when treating patients in a health care system requiring high out-of-pocket costs. OBJECTIVE: Assess physicians' concerns regarding financial welfare of patients and their families and analyze physicians' experiences in reducing catastrophic health expenditures for patients in Ethiopia...
2019: PloS One
Joël Ladner, Ahmed Ben Abdelaziz
In the 21st century, public health is not only about fighting infectious diseases, but also contributing to a "multidimensional" well-being of people (health promotion, non-communicable diseases, the role of citizens and people in the health system etc.). Six themes of public health, issues of the 21st century will be addressed. Climate change is already aggravating already existing health risks, heat waves, natural disasters, recrudescence of infectious diseases. Big data is the collection and management of databases characterized by a large volume, a wide variety of data types from various sources and a high speed of generation...
October 2018: La Tunisie Médicale
Ian Barnett, John Torous
No abstract text is available yet for this article.
February 12, 2019: Annals of Internal Medicine
Raisa B Deber, Jennifer Zwicker
Health policy analysis requires an understanding of a broad range of topics that are often taught in different disciplines spanning economics, political science, ethics, health administration, public health and healthcare. Professor Raisa Deber's Treating Health Care is essential reading for anyone interested in understanding the basic fundamentals of the healthcare system, eloquently weaving together key concepts across disciplines and background information to equip the reader with a "toolkit" for decision making in health policy analysis...
October 2018: Healthcare Quarterly
Shibani Kanungo, Dilip R Patel, Mekala Neelakantan, Brinda Ryali
Newborn screening (NBS) in the United States helps each year diagnose, 1 in every 320 newborns (12,500 of the 4 million births), with a potentially severe or lethal condition prior to clinical symptoms manifestation. 10% of these are inborn errors of metabolism (IEM). Coordinated efforts of NBS program, primary care physicians, and metabolic centers can help with pre-symptomatic identification and interventions for such conditions to ameliorate or resolve associated morbidity and mortality. NBS in the United States is a successful public health program to improve short and long term health outcomes for newborns...
December 2018: Annals of Translational Medicine
Mahboube Shirzad, Elham Shakibazadeh, Ana Pilar Betran, Meghan A Bohren, Mehrandokht Abedini
BACKGROUND: Iran has one of the highest national caesarean section rates worldwide. Few studies explored in-depth the health-facility and health-system level factors that affect women's choices on mode of delivery in Iran. The aim of this study was to explore the health-facility and health-system level factors affecting women's preferences on mode of delivery in Tehran. METHODS: We conducted a qualitative study using in-depth face-to-face interviews with women between October 2017 and May 2018...
February 8, 2019: Reproductive Health
Nahid Bhadelia, Lauren Sauer, Theodore J Cieslak, Richard T Davey, Susan McLellan, Timothy M Uyeki, Mark G Kortepeter
Emerging and re-emerging infectious diseases pose growing global public health threats. However, research on and development of medical countermeasures (MCMs) for such pathogens is limited by the sporadic and unpredictable nature of outbreaks, lack of financial incentive for pharmaceutical companies to develop interventions for many of the diseases, lack of clinical research capacity in areas where these diseases are endemic, and the ethical dilemmas related to conducting scientific research in humanitarian emergencies...
February 6, 2019: Health Security
Nadaby Maria Jesus, Gracielly Ferreira de Souza, Clesnan Mendes-Rodrigues, Omar Pereira de Almeida Neto, Deusdélia Dias Magalhães Rodrigues, Cristiane Martins Cunha
INTRODUCTION: Chronic kidney disease (CKD) negatively affects the physical and biopsychosocial aspects of the lives of individuals with the disease, thereby affecting the quality of life (QOL) of patients and their families. OBJECTIVES: This study aimed to measure the QOL of individuals with CKD and compare the QOL scores of patients with CKD to the scores of disease-free individuals to find factors associated with better QOL. METHOD: The local Ethics Committee approved this cross-sectional study...
January 24, 2019: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
Gianna Milano
The New York Times recently celebrated the 40th anniversary of its historic "Science section" with a special issue. An opportunity to reflect on the state of the art of scientific journalism. After having seen the inserts dedicated to science flourish in the '70s and '80s, in recent times the major Italian weekly and several newspapers have decided - with rare exceptions - to eliminate them. Most health inserts remain. How can we explain the reason for this trend? Science continues to permeate our culture, from cinema, to books, to advertising, to television...
January 2019: Recenti Progressi in Medicina
M Greenberg
No abstract text is available yet for this article.
February 1, 2019: Disease-a-month: DM
Margaret Fry, Kirsten Abrahamse, Steve Kay, Rosalind M Elliott
INTRODUCTION: Suicide in older people is a public health concern. Emergency nurses are ideally placed to identify suicide risk. Therefore, the aim of this research was to explore emergency nurses' knowledge, confidence and attitudes about suicide in older people. METHODS: This descriptive exploratory study was conducted in four emergency departments in Sydney, Australia. Data were collected using a 28-item survey from a convenience sample of emergency nurses. Descriptive quantitative statistics and conventional content analysis were performed...
January 30, 2019: International Emergency Nursing
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