scholarly journals 24.H. Round table: AMR and cancer: cross-cutting priorities for an integrated public health and primary care approach

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Health Systems ◽  
Interprofessional Education ◽  
Antimicrobial Agents ◽  
Behavioural Change ◽  
Natural Setting ◽  
Global Public Health ◽  
Populations At Risk ◽  
The Impact

Abstract Antimicrobial Resistance (AMR) is a threat to global public health, development and sustainability necessitating prompt action. Antimicrobial agents are essential to treat humans and animals, but their irrational use has caused rapid AMR growth. Antibiotics are prescribed as 'prevention' for lack of diagnostics (Dx), particularly Point-of-Care Testing tools (PoCTs) for timely and reliable identification of a bacterial versus a viral infection. Given the lack of inexpensive readily available PoCTs, current care remains inefficient, particularly in terms of integrating public health and primary care (PC). PC represents a natural setting for exchanges with PTs, survivors and healthy individuals alike, and an optimal setting to implement interventions such as behavioural change for rational antibiotic use and vaccination. Considering the rise in both cancer incidence and AMR, health systems are seriously threatened, the impact extending well beyond the health sector. Cancer PTs represent the highest burden, with AMR compromising the effectiveness of surgery, radiotherapy and chemotherapy. The most common combination treatments result in immunosuppression exposing PTs to infections. This means PTs often develop infections, frequently recurrent, requiring antibiotic treatment; evidence suggests even key diagnostic procedures, e.g. prostate biopsy, are compromised; the risk of infection necessitates prophylactic treatment and/or resulting iatrogenic infections become difficult to manage. Also, modern oncological therapies rely on immunotherapy to an increasingly more important level. Immunotherapy and AMR interactions and interrelationships ought to be further explored. The effect of AMR on the lives of cancer PTs and carers, along with its impact on health systems is far from being well understood, with commonalities and topic interdependence largely absent from national cancer plans. An in-depth examination of cancer PTs across different settings and countries is needed to better understand which are the most relevant actions and in which settings to implement them. Similarly, the relevance of cancer plans, roadmaps and national efforts, ought to be examined in the context of AMR, incl. the 'One-Health' approach. The panel will discuss all above mentioned issues, but also attempt to highlight other key considerations that ought to be integrated in national cancer plans, incl. R&D incentives, curbing the use of antibiotics in animals and of their presence in the environment through cross-sectoral priority setting. The principal objectives of the workshop are to a. examine AMR implications for cancer PTs in a comprehensive manner encompassing PC, and b. inform on the next steps for interdisciplinary, cross-border and cross-sectoral collaboration. Following five 12-min presentations, the Panel and the Chairs will enter a 30-min discussion. The audience will be able to respond to key propositions and ask questions through an interactive element. Key messages Prioritise the development of Dx/PoTCs, PC and public health integration, and the assessment interventions for populations at risk. Involve PC practitioners and patients to rationalise use and raise awareness, invest in interprofessional education, and engage in interdisciplinary and cross-sectoral dialogue.

scholarly journals Mechanisms of Antimicrobial Resistance in ESKAPE Pathogens

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Sirijan Santajit ◽  
Nitaya Indrawattana
Keyword(s):  
Public Health ◽  
Antimicrobial Resistance ◽  
Antimicrobial Agents ◽  
Multidrug Resistant ◽  
Resistance Mechanisms ◽  
Global Public Health ◽  
Drug Usage ◽  
Inappropriate Use ◽  
Public Health Challenges ◽  
Eskape Pathogens

The ESKAPE pathogens (Enterococcus faecium,Staphylococcus aureus,Klebsiella pneumoniae,Acinetobacter baumannii,Pseudomonas aeruginosa, andEnterobacterspecies) are the leading cause of nosocomial infections throughout the world. Most of them are multidrug resistant isolates, which is one of the greatest challenges in clinical practice. Multidrug resistance is amongst the top three threats to global public health and is usually caused by excessive drug usage or prescription, inappropriate use of antimicrobials, and substandard pharmaceuticals. Understanding the resistance mechanisms of these bacteria is crucial for the development of novel antimicrobial agents or other alternative tools to combat these public health challenges. Greater mechanistic understanding would also aid in the prediction of underlying or even unknown mechanisms of resistance, which could be applied to other emerging multidrug resistant pathogens. In this review, we summarize the known antimicrobial resistance mechanisms of ESKAPE pathogens.

scholarly journals COVID-19 as an “Infodemic” in Public Health: Critical Role of the Social Media

2021 ◽  
Vol 9 ◽  
Author(s):  
Debanjan Banerjee ◽  
K. S. Meena
Keyword(s):  
Public Health ◽  
Social Media ◽  
Critical Role ◽  
Global Public Health ◽  
Sources Of Information ◽  
Multiple Sources ◽  
Health Crisis ◽  
Digital Platforms ◽  
The Impact

The Coronavirus disease 2019 (COVID-19) pandemic has emerged as a significant and global public health crisis. Besides the rising number of cases and fatalities, the outbreak has also affected economies, employment and policies alike. As billions are being isolated at their homes to contain the infection, the uncertainty gives rise to mass hysteria and panic. Amidst this, there has been a hidden epidemic of “information” that makes COVID-19 stand out as a “digital infodemic” from the earlier outbreaks. Repeated and detailed content about the virus, geographical statistics, and multiple sources of information can all lead to chronic stress and confusion at times of crisis. Added to this is the plethora of misinformation, rumor and conspiracy theories circulating every day. With increased digitalization, media penetration has increased with a more significant number of people aiding in the “information pollution.” In this article, we glance at the unique evolution of COVID-19 as an “infodemic” in the hands of social media and the impact it had on its spread and public reaction. We then look at the ways forward in which the role of social media (as well as other digital platforms) can be integrated into social and public health, for a better symbiosis, “digital balance” and pandemic preparedness for the ongoing crisis and the future.

scholarly journals Emphasizing the Role of Neurosurgery Within Global Health and National Health Systems: A Call to Action

2021 ◽  
Vol 8 ◽  
Author(s):  
Jean Wilguens Lartigue ◽  
Olaoluwa Ezekiel Dada ◽  
Makinah Haq ◽  
Sarah Rapaport ◽  
Lorraine Arabang Sebopelo ◽  
...  
Keyword(s):  
Public Health ◽  
Global Health ◽  
Health Systems ◽  
Global Burden ◽  
Global Public Health ◽  
Middle Income ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Development Goals ◽  
Global Burden Of Diseases

Background: Worldwide, neurological disorders are the leading cause of disability-adjusted life years lost and the second leading cause of death. Despite global health capacity-building efforts, each year, 22.6 million individuals worldwide require neurosurgeon's care due to diseases such as traumatic brain injury and hydrocephalus, and 13.8 million of these individuals require surgery. It is clear that neurosurgical care is indispensable in both national and international public health discussions. This study highlights the role neurosurgeons can play in supporting the global health agenda, national surgical plans, and health strengthening systems (HSS) interventions.Methods: Guided by a literature review, the authors discuss key topics such as the global burden of neurosurgical diseases, the current state of neurosurgical care around the world and the inherent benefits of strong neurosurgical capability for health systems.Results: Neurosurgical diseases make up an important part of the global burden of diseases. Many neurosurgeons possess the sustained passion, resilience, and leadership needed to advocate for improved neurosurgical care worldwide. Neurosurgical care has been linked to 14 of the 17 Sustainable Development Goals (SDGs), thus highlighting the tremendous impact neurosurgeons can have upon HSS initiatives.Conclusion: We recommend policymakers and global health actors to: (i) increase the involvement of neurosurgeons within the global health dialogue; (ii) involve neurosurgeons in the national surgical system strengthening process; (iii) integrate neurosurgical care within the global surgery movement; and (iv) promote the training and education of neurosurgeons, especially those residing in Low-and middle-income countries, in the field of global public health.

scholarly journals Using RE-AIM to examine the potential public health impact of an integrated collaborative care intervention for weight and depression management in primary care: Results from the RAINBOW trial

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248339
Author(s):  
Megan A. Lewis ◽  
Laura K. Wagner ◽  
Lisa G. Rosas ◽  
Nan Lv ◽  
Elizabeth M. Venditti ◽  
...  
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Collaborative Care ◽  
Health Impact ◽  
Public Health Impact ◽  
Integrative Approach ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Care Intervention ◽  
The Impact

Background An integrated collaborative care intervention was used to treat primary care patients with comorbid obesity and depression in a randomized clinical trial. To increase wider uptake and dissemination, information is needed on translational potential. Methods The trial collected longitudinal, qualitative data at baseline, 6 months (end of intensive treatment), 12 months (end of maintenance treatment), and 24 months (end of follow-up). Semi-structured interviews (n = 142) were conducted with 54 out of 409 randomly selected trial participants and 37 other stakeholders, such as recruitment staff, intervention staff, and clinicians. Using a Framework Analysis approach, we examined themes across time and stakeholder groups according to the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework. Results At baseline, participants and other stakeholders reported being skeptical of the collaborative care approach related to some RE-AIM dimensions. However, over time they indicated greater confidence regarding the potential for future public health impact. They also provided information on barriers and actionable information to enhance program reach, effectiveness, adoption, implementation, and maintenance. Conclusions RE-AIM provided a useful framework for understanding how to increase the impact of a collaborative and integrative approach for treating comorbid obesity and depression. It also demonstrates the utility of using the framework as a planning tool early in the evidence-generation pipeline.

Evidence-Based Global Public Health

2013 ◽  
Author(s):  
Vincanne Adams
Keyword(s):  
Public Health ◽  
Health Care ◽  
Global Health ◽  
Experimental Research ◽  
Evidence Based ◽  
Global Public Health ◽  
The Social ◽  
Research Populations ◽  
Based Medicine ◽  
The Impact

This chapter examines the impact of “evidence-based medicine” (EBM) on global public health. An epistemic transformation in the field of global health is underway, and it argues that the impact of EBM has been twofold: (1) the creation of an experimental metric as a means of providing health care; and (2) a shift in the priorities of caregiving practices in public health such that “people [no longer] come first.” The production of experimental research populations in and through EBM helps constitute larger fiscal transformations in how we do global health. Notably, EBM has created a platform for the buying and selling of truth and reliability, abstracting clinical caregiving from the social relationships on which they depend.

scholarly journals Impact of HIV-1 Diversity on Its Sensitivity to Neutralization

Vaccines ◽  
2019 ◽  
Vol 7 (3) ◽  
pp. 74 ◽  
Author(s):  
Karl Stefic ◽  
Mélanie Bouvin-Pley ◽  
Martine Braibant ◽  
Francis Barin
Keyword(s):  
Public Health ◽  
Envelope Protein ◽  
Neutralizing Antibodies ◽  
Continuous Process ◽  
Population Level ◽  
Global Public Health ◽  
Broadly Neutralizing Antibodies ◽  
The Many ◽  
The Impact ◽  
Hiv 1

The HIV-1 pandemic remains a major burden on global public health and a vaccine to prevent HIV-1 infection is highly desirable but has not yet been developed. Among the many roadblocks to achieve this goal, the high antigenic diversity of the HIV-1 envelope protein (Env) is one of the most important and challenging to overcome. The recent development of broadly neutralizing antibodies has considerably improved our knowledge on Env structure and its interplay with neutralizing antibodies. This review aims at highlighting how the genetic diversity of HIV-1 thwarts current, and possibly future, vaccine developments. We will focus on the impact of HIV-1 Env diversification on the sensitivity to neutralizing antibodies and the repercussions of this continuous process at a population level.

scholarly journals First report of Klebsiella quasipneumoniae harboring blaKPC-2 in Saudi Arabia

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Sharif Hala ◽  
Chakkiath Paul Antony ◽  
Mohammed Alshehri ◽  
Abdulhakeem O. Althaqafi ◽  
Asim Alsaedi ◽  
...  
Keyword(s):  
Public Health ◽  
Saudi Arabia ◽  
Tertiary Hospital ◽  
Whole Genome ◽  
Drug Resistant ◽  
Global Public Health ◽  
Gulf Region ◽  
Carbapenem Resistant ◽  
The Impact ◽  
Klebsiella Spp

Abstract Background Nosocomial infections caused by multi-drug resistant Enterobacteriaceae are a global public health threat that ought to be promptly identified, reported, and addressed accurately. Many carbapenem-resistant Enterobacteriaceae-associated genes have been identified in Saudi Arabia but not the endemic Klebsiella pneumoniae carbapenemases (KPCs), which are encoded by blaKPC-type genes. KPCs are known for their exceptional spreading potential. Methods We collected n = 286 multi-drug resistant (MDR) Klebsiella spp. isolates as part of screening for resistant patterns from a tertiary hospital in Saudi Arabia between 2014 and 2018. Antimicrobial susceptibility testing was carried out using both VITEK II and the broth microdilution of all collected isolates. Detection of resistance-conferring genes was carried out using Illumina whole-genome shotgun sequencing and PacBio SMRT sequencing protocols. Results A Carbapenem-resistant Enterobacteriaceae (CRE) Klebsiella quasipneumoniae subsp. similipneumoniae strain was identified as a novel ST-3510 carrying a blaKPC-2 carbapenemase encoding gene. The isolate, designated as NGKPC-421, was obtained from shotgun Whole Genome Sequencing (WGS) surveillance of 286 MDR Klebsiella spp. clinical isolates. The NGKPC-421 isolate was collected from a septic patient in late 2017 and was initially misidentified as K. pneumoniae. The sequencing and assembly of the NGKPC-421 genome resulted in the identification of a putative ~ 39.4 kb IncX6 plasmid harboring a blaKPC-2 gene, flanked by transposable elements (ISKpn6-blaKPC-2–ISKpn27). Conclusion This is the first identification of a KPC-2-producing CRE in the Gulf region. The impact on this finding is of major concern to the public health in Saudi Arabia, considering that it is the religious epicenter with a continuous mass influx of pilgrims from across the world. Our study strongly highlights the importance of implementing rapid sequencing-based technologies in clinical microbiology for precise taxonomic classification and monitoring of antimicrobial resistance patterns.

scholarly journals How primary care and public health interact in local health contracts in France?

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
M s Kendir ◽  
Mr Le Bodo ◽  
M r Breton ◽  
M r Bourgueil
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Access To Care ◽  
Health Care Services ◽  
Local Level ◽  
Rapid Decline ◽  
Local Health ◽  
Epidemiological Changes ◽  
The Impact ◽  
Primary Care Professionals

Abstract The demographic and epidemiological changes orient health care services towards communities with a focus on prevention and health promotion. Moreover, in France, the rapid decline of General Practitioners affect access to care in certain areas. Thus, it has made a call for interaction of primary care (PC) services and public health which can be strengthened by the actions at the local level. In 2009, the local health contracts (Contract local de santé; CLS) were developed to foster collaborative actions on the social determinants of health and to improve access to care. Considering the critical contribution of PC in these issues, one may ask how CLS mobilized PC and facilitate linkages between actions oriented toward population and primary care. The objective of this ancillary study (part of the CloterreS project), is to explore how often and how CLS involve PC in access to care and public health related actions. A mixed-method study based on document analysis, with a random sample of 17 CLSs (N = 165) from all French regions, was developed. A quantitative analysis of the 440 forms identified in 17 CLS computed frequency of involvement of PC actors and/or PC organizations and a qualitative analysis defined typology of interactions. All CLS and 20.1% (n = 86) of the forms involved PC actors and 43.2% (n = 185) concerned access to care. Of the access to care forms, 35.7% (n = 66) concerned PC. The most common strategies related to actions on the health workforce and on planning of services. The role of primary care professionals was as the target of the action and rarely as leader and partner. PC, mostly GP’s involvement, had a big place and access to care was at the core of local health contracts. The impact of CLS as an instrument to invite interaction public health and healthcare at the local level should be further assessed. Key messages Many of the local access to care actions involved primary care professionals. The local level appears strategic to integrate public health and health services yet more evidence is needed on its role.

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