Implications for health policy, public health, health care, and research

2019 ◽  
pp. 221-246
Author(s):  
Raj S. Bhopal
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Health Care ◽  
Health Policy ◽  
High Risk ◽  
Protective Factors ◽  
Low Cost ◽  
South Asians ◽  
Cost Effective ◽  
Individual Level

Achieving internationally agreed prevention strategies is extremely difficult and doing so for South Asians, specifically, is tougher still. Most guidance is centred on individual level behaviour change. The challenge is to produce focused, low cost, effective actions, underpinned by clear, simple, and accurate explanations of the causes of the phenomenon. The key messages are that the high risk of CVD and DM2 in urbanizing South Asians is not inevitable. It is not innate or genetic. Similarly, the risks are unlikely to be acquired in utero, birth, or infancy, and programmed in a fixed way. Rather, exposure to risk factors in childhood, adolescence, and most particularly in adulthood is the key. In addition to the established causes we need to research additional factors especially those identified as novel in Chapter 9. National legislation and policy that alters environments to reduce exposure to risk factors and increase exposure to protective factors is essential.

scholarly journals Problem-Orientated Antenatal Notekeeping: A Useful Primary Health Care Tool

Curationis ◽  
1978 ◽  
Vol 1 (3) ◽  
Author(s):  
J.V. Larsen
Keyword(s):  
Risk Factors ◽  
South Africa ◽  
Health Care ◽  
Primary Health Care ◽  
High Risk ◽  
Significant Risk ◽  
Obstetric Care ◽  
Antenatal Screening ◽  
Primary Health ◽  
Risk Patients

It has recently been demonstrated that about 56 percent of patients delivering in a rural obstetric unit had significant risk factors, and that 85 percent of these could have been detected by meticulous antenatal screening before the onset of labour. These figures show that the average rural obstetric unit in South Africa is dealing with a large percentage of high risk patients. In this work, it is hampered by: 1. Communications problems: i.e. bad roads, long distances. and unpredictable telephones. 2. A serious shortage of medical staff resulting in primary obstetric care being delivered by midwives with minimal medical supervision.

scholarly journals Harnessing testing strategies and public health measures to avert COVID-19 outbreaks during ocean cruises

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Gerardo Chowell ◽  
Sushma Dahal ◽  
Raquel Bono ◽  
Kenji Mizumoto
Keyword(s):  
Public Health ◽  
Cost Effective ◽  
Contact Network ◽  
Social Distancing ◽  
Individual Level ◽  
Health Measures ◽  
Testing Strategies ◽  
Novel Coronavirus ◽  
The Individual ◽  
The Impact

AbstractTo ensure the safe operation of schools, workplaces, nursing homes, and other businesses during COVID-19 pandemic there is an urgent need to develop cost-effective public health strategies. Here we focus on the cruise industry which was hit early by the COVID-19 pandemic, with more than 40 cruise ships reporting COVID-19 infections. We apply mathematical modeling to assess the impact of testing strategies together with social distancing protocols on the spread of the novel coronavirus during ocean cruises using an individual-level stochastic model of the transmission dynamics of COVID-19. We model the contact network, the potential importation of cases arising during shore excursions, the temporal course of infectivity at the individual level, the effects of social distancing strategies, different testing scenarios characterized by the test’s sensitivity profile, and testing frequency. Our findings indicate that PCR testing at embarkation and daily testing of all individuals aboard, together with increased social distancing and other public health measures, should allow for rapid detection and isolation of COVID-19 infections and dramatically reducing the probability of onboard COVID-19 community spread. In contrast, relying only on PCR testing at embarkation would not be sufficient to avert outbreaks, even when implementing substantial levels of social distancing measures.

scholarly journals Audit of the management of patients at high risk of carbapenemase-producing enterobacteriaceae (CPE): Are we ready?

2017 ◽  
Vol 18 (6) ◽  
pp. 296-300 ◽  
Author(s):  
Lasantha Ratnayake ◽  
Amy Harris ◽  
Doreen Ko ◽  
Linda Hawtin
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
High Risk ◽  
Individual Risk ◽  
Risk Status ◽  
Healthcare Settings ◽  
The Uk ◽  
Individual Risk Factors ◽  
Routine Assessment ◽  
Relevant Section

Background: Incidence of carbapenemase-producing enterobacteriaceae (CPE) in the UK is increasing. In 2013, Public Health England (PHE) published a toolkit to control spread of CPE within healthcare settings. Aim: To assess compliance to hospital CPE policy (adapted from PHE) in the identification, isolation and screening of suspected CPE patients. Methods: Admission booklets of 150 patients were evaluated to see whether the relevant section had been completed to identify high-risk CPE patients. Where necessary, patients were interviewed or their GPs were contacted to assess their CPE risk. Additionally, 28 patients screened for CPE were audited to assess compliance to screening and isolation. Findings: Only 23 patients out of 147 (15.6%) were risk assessed on admission. Risk status of 27 (18.4%) patients could not be assessed due to lack of data. Fifteen patients out of 28 (54%) screened for CPE were identified and isolated on admission. Ten out of 19 patients (53%) had three screens 48 h apart. Discussion: This audit highlights difficulties in screening based on individual risk factors as the majority of patients were not screened on admission and documentation on isolation and screening was poor. More needs to be done to raise awareness of the requirements for routine assessment, isolation and screening.

scholarly journals High-risk human papillomavirus infection and associated factors in the anal canal of HIV-positive patients in Medellín, 2017–2018

2020 ◽  
Vol 54 ◽  
pp. 93
Author(s):  
Daniela Herrera Posada ◽  
Lucia Stella Tamayo Acevedo ◽  
Marleny Valencia Arredondo ◽  
Gloria Inéz Sánchez Vásquez
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Human Papillomavirus ◽  
High Risk ◽  
Elementary Education ◽  
Associated Factors ◽  
Casual Sex ◽  
Hiv Positive ◽  
Factors Associated ◽  
High Risk Hpv

OBJECTIVE: To estimate the prevalence of high-risk human papillomavirus (HR-HPV) anal infection and associated factors in human immunodeficiency virus (HIV) positive patients in Medellín. METHODS: Descriptive cross-sectional study in 300 HIV-positive patients, adults, with history of anal intercourse, treated in two health care services of Medellín 2017–2018. We conducted a structured survey on sociodemographics, sexual behavior and medical history. HPV was detected in anal swabs tested by the COBAS 4800 system. Exploratory data analysis of risk factors associated with HR-HPV was conducted by chi-square test of independence and both raw and adjusted prevalence ratios used the Poisson regression model, at a 95% confidence interval. RESULTS: The high-risk HPV had a prevalence of 82.7%; HPV16 had a prevalence of 32.7%, HPV18 a prevalence of 21.7% and other HPV types scored 78.3%. The high-risk HPV prevalence in women was of 68.2% and 83.8% in men. The risk factors associated with high-risk HPV after adjustment were age under 30 years, elementary education, casual sex partners, and first sexual activity before 18 years old. CONCLUSIONS: The high incidence of high-risk HPV, along with the occurrence of coinfections by multiple types in the study population shows their susceptibility to develop some type of anal intra-epithelial neoplasia. It is important to establish sexual health programs focused on primary health care.

scholarly journals Globalization and Health – A Conceptual Framework

2020 ◽  
Vol 8 (1) ◽  
pp. 13-20
Author(s):  
Anju Gupta
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Health Care ◽  
Economic Globalization ◽  
Conceptual Structure ◽  
Public Health Care ◽  
Health Impacts ◽  
Direct Impact ◽  
Secondary Effects ◽  
Conceptual Frame

Globalization is the key trial for public health care and fundamental health protection, given the links between globalization and health care, which are very complicated today, the stress frequently being on developing countries, in which group is also Croatia. Although there are various papers available on this subject, it is necessary to provide an institutional structure for the assessment of direct and indirect health impacts of several appearances of globalization. Therefore, this paper presents a conceptual frame between health care and globalization based on the movements of David Woodward and Nick Drager, including the mission to serve as a guideline for the construction of existing papers in this field, as well as the search for new cognitions, which can ultimately 6to the growth of national policies on health. When we talk about the conceptual structure, then, by all means, we need to pay consideration to the secondary effects on health, as well as the direct impact on the population on the level of particular risk factors on health and the wellness care system as a whole. The paper will pay appropriate attention to the overall objectives of the activities to optimize the health effects of economic globalization.

scholarly journals The cumulation of ill health and low agency in socially excluded city dwellers in the Netherlands: how to better identify high-risk/high-need population segments with public health survey data

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Addi P. L. van Bergen ◽  
Annelies van Loon ◽  
Stella J. M. Hoff ◽  
Judith R. L. M. Wolf ◽  
Albert M. van Hemert
Keyword(s):  
Public Health ◽  
Health Care ◽  
High Risk ◽  
Social Exclusion ◽  
Social Care ◽  
Health Indicators ◽  
Personal Control ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Labour Market Position

Abstract Background Population segmentation and risk stratification are important strategies for allocating resources in public health, health care and social care. Social exclusion, which is defined as the cumulation of disadvantages in social, economic, cultural and political domains, is associated with an increased risk of health problems, low agency, and as a consequence, a higher need for health and social care. The aim of this study is to test social exclusion against traditional social stratifiers to identify high-risk/high-need population segments. Methods We used data from 33,285 adults from the 2016 Public Health Monitor of four major cities in the Netherlands. To identify at-risk populations for cardiovascular risk, cancer, low self-rated health, anxiety and depression symptoms, and low personal control, we compared relative risks (RR) and population attributable fractions (PAF) for social exclusion, which was measured with the Social Exclusion Index for Health Surveys (SEI-HS), and four traditional social stratifiers, namely, education, income, labour market position and migration background. Results The analyses showed significant associations of social exclusion with all the health indicators and personal control. Particular strong RRs were found for anxiety and depression symptoms (7.95) and low personal control (6.36), with corresponding PAFs of 42 and 35%, respectively. Social exclusion was significantly better at identifying population segments with high anxiety and depression symptoms and low personal control than were the four traditional stratifiers, while the two approaches were similar at identifying other health problems. The combination of social exclusion with a low labour market position (19.5% of the adult population) captured 67% of the prevalence of anxiety and depression symptoms and 60% of the prevalence of low personal control, as well as substantial proportions of the other health indicators. Conclusions This study shows that the SEI-HS is a powerful tool for identifying high-risk/high-need population segments in which not only ill health is concentrated, as is the case with traditional social stratifiers, but also a high prevalence of anxiety and depression symptoms and low personal control are present, in addition to an accumulation of social problems. These findings have implications for health care practice, public health and social interventions in large cities.

Paternalism, Autonomy, and the Common Good

2021 ◽  
pp. 89-109
Author(s):  
James Wilson
Keyword(s):  
Public Health ◽  
Public Policy ◽  
Health Policy ◽  
Public Health Policy ◽  
Common Good ◽  
Health Policies ◽  
Public Health Policies ◽  
Individual Level ◽  
The Common Good ◽  
The Common

Public health policies are often accused of being paternalistic, or to show the ‘Nanny State’ in action. This chapter argues that complaints about paternalism in public health policy are, for a variety of reasons, much less convincing than is often thought. First, for conceptual reasons, it is difficult to specify what it would be for a policy to be paternalistic. Second, two of the elements that make paternalism problematic at an individual level—interference with liberty and lack of individual consent—are endemic to public policy contexts in general and so cannot be used to support the claim that paternalism in particular is wrong. The chapter concludes that instead of debating whether a given policy is paternalistic, it would be better to ask whether the infringements of liberty it contains are justifiable, without placing any weight on whether or not those infringements of liberty are paternalistic.

EU ‘Public Health’ and ‘Health-care’ Law and Policy

2019 ◽  
pp. 52-91 ◽  
Author(s):  
Anniek de Ruijter
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Policy ◽  
Human Health ◽  
Health Care Policy ◽  
The European Union ◽  
Law And Policy ◽  
Concept Of Health ◽  
Eu Policies ◽  
Health Care Law

Taking into consideration the central health provision in the Treaty, which outlines that health is to be ‘mainstreamed’ in all other EU policies, it could be inferred that EU public health and health-care policy and law is either non-existent as an autonomous policy area, or that it is basically everything, in that all EU public policy is also health policy. This puzzle forms the starting point for this chapter, which describes the nature of EU power in the field of human health currently. The chapter first, as an initial exploration, questions the existence of a European authoritative concept of ‘health’. Second, the chapter takes into consideration the nature of EU policymaking in general and regarding health in particular and develops a concept of EU health law and policy, distinguishing between EU public health and EU health-care law and policy. Last, to draw out the scope of EU health policy more specifically, a historical overview is given of the involvement of the EU in health. The chapter conceptualizes EU power in the field of human health as authoritative allocations of value through the European Union political system with the object of protecting and promoting human health. This conceptualization draws out the scope of policy that will be the central focus for the following chapters.

scholarly journals Smart Sanitation—Biosensors as a Public Health Tool in Sanitation Infrastructure

2020 ◽  
Vol 17 (14) ◽  
pp. 5146 ◽  
Author(s):  
Emma Rary ◽  
Sarah M. Anderson ◽  
Brandon D. Philbrick ◽  
Tanvi Suresh ◽  
Jasmine Burton
Keyword(s):  
Public Health ◽  
Health Monitoring ◽  
Disease Surveillance ◽  
Population Level ◽  
Cost Effective ◽  
Small Scale ◽  
Individual Level ◽  
Emergent Technologies ◽  
The Individual ◽  
Sanitation Infrastructure

The health of individuals and communities is more interconnected than ever, and emergent technologies have the potential to improve public health monitoring at both the community and individual level. A systematic literature review of peer-reviewed and gray literature from 2000-present was conducted on the use of biosensors in sanitation infrastructure (such as toilets, sewage pipes and septic tanks) to assess individual and population health. 21 relevant papers were identified using PubMed, Embase, Global Health, CDC Stacks and NexisUni databases and a reflexive thematic analysis was conducted. Biosensors are being developed for a range of uses including monitoring illicit drug usage in communities, screening for viruses and diagnosing conditions such as diabetes. Most studies were nonrandomized, small-scale pilot or lab studies. Of the sanitation-related biosensors found in the literature, 11 gathered population-level data, seven provided real-time continuous data and 14 were noted to be more cost-effective than traditional surveillance methods. The most commonly discussed strength of these technologies was their ability to conduct rapid, on-site analysis. The findings demonstrate the potential of this emerging technology and the concept of Smart Sanitation to enhance health monitoring at the individual level (for diagnostics) as well as at the community level (for disease surveillance).

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