An Overview of the Ethics of Injury in Public Health

2019 ◽  
pp. 597-603
Author(s):  
Adnan A. Hyder
Keyword(s):  
Public Health ◽  
Injury Prevention ◽  
Prevention And Control ◽  
Public Health Ethics ◽  
Ethical Challenges ◽  
Middle Income ◽  
Middle Income Countries ◽  
Health Ethics ◽  
Prompt Attention ◽  
And Control

This chapter briefly introduces ethics issues in injury prevention and control in low- and middle-income countries (LMICs), using a series of examples that prompt attention to the ethical principles of autonomy and justice. The chapter also introduces the section of The Oxford Handbook of Public Health Ethics dedicated to an examination of injury and public health ethics, with attention given to the complex ethical challenges arising in injury prevention and control in LMICs. The section’s two chapters discuss public health ethics issues arising in the prevention and control of unintentional injuries and intentional injuries, respectively. Those chapters define a set of ethics issues within international injury work and provide an initial analysis of the nature of those ethics issues, their specificity, and potential pathways for addressing them.

Injury prevention and control

2021 ◽  
pp. 361-376
Author(s):  
Corinne Peek-Asa ◽  
Adnan A. Hyder
Keyword(s):  
Injury Prevention ◽  
Low Income ◽  
Prevention And Control ◽  
Low Income Countries ◽  
Middle Income ◽  
Injury Rates ◽  
Middle Income Countries ◽  
Disability Adjusted Life ◽  
Life Years ◽  
And Control

Injuries are among the leading causes of death and disability throughout the world and contribute disproportionately to premature life lost. Injury rates are highest among middle- and low-income countries. According to analyses of the 2016 Global Burden of Disease data, injuries cause over 4.6 million deaths per year, accounting for nearly 8.4% of all deaths and 10.7% of disability-adjusted life years. Many opportunities to implement injury prevention strategies exist, and a systematic approach to injury prevention can help identify the most effective and efficient approaches. Building capacity for injury prevention activities in low- and middle-income countries is an important public health priority.

scholarly journals Informing shigellosis prevention and control through pathogen genomics

2021 ◽  
Author(s):  
Rebecca J Bengtsson ◽  
Adam J Simpkin ◽  
Caisey V Pulford ◽  
Ross Low ◽  
David A Rasko ◽  
...  
Keyword(s):  
Prevention And Control ◽  
Genomic Diversity ◽  
Middle Income ◽  
Middle Income Countries ◽  
Shigella Species ◽  
Genomic Analyses ◽  
Shigella Spp ◽  
Treatment Plans ◽  
Evolution Of Resistance ◽  
And Control

Shigella spp. are the leading bacterial cause of severe childhood diarrhoea in low- and middle- income countries (LMIC), are increasingly antimicrobial resistant and have no licensed vaccine. We performed genomic analyses of 1246 systematically collected shigellae from seven LMIC to inform control and identify factors that could limit the effectiveness of current approaches. We found that S. sonnei contributes ≥20-fold more disease than other Shigella species relative to its genomic diversity and highlight existing diversity and adaptative capacity among S. flexneri that may generate vaccine escape variants in <6 months. Furthermore, we show convergent evolution of resistance against the current recommended antimicrobial among shigellae. This demonstrates the urgent need to integrate existing genomic diversity into vaccine and treatment plans for Shigella, and other pathogens.

scholarly journals Antibiotic Use in Low and Middle-Income Countries and the Challenges of Antimicrobial Resistance in Surgery

Antibiotics ◽  
2020 ◽  
Vol 9 (8) ◽  
pp. 497
Author(s):  
Massimo Sartelli ◽  
Timothy C. Hardcastle ◽  
Fausto Catena ◽  
Alain Chichom-Mefire ◽  
Federico Coccolini ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Infection Prevention And Control ◽  
Antibiotic Prescribing ◽  
Prescribing Practices ◽  
Middle Income ◽  
Middle Income Countries ◽  
And Control ◽  
Low And Middle Income

Antimicrobial resistance (AMR) is a phenomenon resulting from the natural evolution of microbes. Nonetheless, human activities accelerate the pace at which microorganisms develop and spread resistance. AMR is a complex and multidimensional problem, threatening not only human and animal health, but also regional, national, and global security, and the economy. Inappropriate use of antibiotics, and poor infection prevention and control strategies are contributing to the emergence and dissemination of AMR. All healthcare providers play an important role in preventing the occurrence and spread of AMR. The organization of healthcare systems, availability of diagnostic testing and appropriate antibiotics, infection prevention and control practices, along with prescribing practices (such as over-the-counter availability of antibiotics) differs markedly between high-income countries and low and middle-income countries (LMICs). These differences may affect the implementation of antibiotic prescribing practices in these settings. The strategy to reduce the global burden of AMR includes, among other aspects, an in-depth modification of the use of existing and future antibiotics in all aspects of medical practice. The Global Alliance for Infections in Surgery has instituted an interdisciplinary working group including healthcare professionals from different countries with different backgrounds to assess the need for implementing education and increasing awareness about correct antibiotic prescribing practices across the surgical pathways. This article discusses aspects specific to LMICs, where pre-existing factors make surgeons’ compliance with best practices even more important.

scholarly journals Medical student education for injury prevention: closing the gap

2020 ◽  
pp. injuryprev-2020-043759 ◽  
Author(s):  
Amy Zosel ◽  
Sara Kohlbeck ◽  
Christopher S Davis ◽  
Linda Meurer ◽  
Stephen Hargarten
Keyword(s):  
Public Health ◽  
Injury Prevention ◽  
Prevention And Control ◽  
Unintentional Injury ◽  
Medical Student Education ◽  
School Curriculum ◽  
Public Health Issue ◽  
Public Health Approach ◽  
Main Component ◽  
And Control

IntroductionInjury is a major public health issue in the USA. In 2017, unintentional injury was the leading cause of death for ages 1 through 44. Unfortunately, there is evidence that the sciences of injury prevention and control may not fully and widely integrated into medical school curriculum. This paper describes a novel injury prevention and control summer programme that was implemented in 2002 and is ongoing.MethodsThe main component of the Series includes at least seven injury-related lectures and discussions designed to provoke students’ interest and understanding of injury as a biopsychosocial disease. These lectures are organised in a seminar fashion and are 2–4 hours in duration. Kirkpatrick’s four-part model guides evaluation specific to our four programme objectives. Trainee satisfaction with the programme, knowledge and outcome (specific to career goals) is evaluated using several mixed-methods tools.ResultsA total of 318 students have participated in the Series. Evaluation findings show an increase in knowledge of injury-related concepts as well as an increase in interest in pursuing injury-related research topics in the future.ImplicationsThe Series is a novel and innovative programme that provides training in injury and injury prevention and control-related topics to medical students, as well as undergraduate, graduate and pharmacy students. We hope that by increasing students’ knowledge and understanding of injury prevention and control we are contributing to a physician workforce that understands the importance of a public health approach to injury prevention, that implements public health principles in practice and that advocates for policies and practices that positively impact injury prevention and control to help make our communities healthier and safer.

Ethical considerations for the design and implementation of child injury prevention interventions: the example of delivering and installing safety equipment into the home

2017 ◽  
Vol 25 (3) ◽  
pp. 217-221
Author(s):  
Beatrice Scholtes ◽  
Peter Schröder-Bäck
Keyword(s):  
Public Health ◽  
Injury Prevention ◽  
Public Health Ethics ◽  
Local Context ◽  
Child Safety ◽  
Child Injury ◽  
Respect For Autonomy ◽  
Health Ethics ◽  
Child Injury Prevention ◽  
The Impact

IntroductionPublic health ethics is a growing field of academic interest but ethical discussion of injury prevention seems to have received limited attention. Interventions that promise to be effective are not necessarily—without explicit justification—‘good’ and ‘right’ interventions in every sense. This paper explores public health ethics in the context of child injury prevention with the objective to initiate interdisciplinary dialogue on the ethics of child safety interventions.MethodA framework of seven public health ethics principles (non-maleficence, health maximisation, beneficence, respect for autonomy, justice, efficiency and proportionality) were applied to an intervention to promote child safety in the home.ResultsPreventing child injury in the home is ethically challenging due to the requirement for the state to intervene in the private sphere. Non-maleficence and beneficence are difficult to judge within this intervention as these are likely to be highly dependent on the nature of intervention delivery, in particular, the quality of communication. Respect for autonomy is challenged by an intervention occurring in the home. The socioeconomic gradient in child injury risk is an important factor but a nuanced approach could help to avoid exacerbating inequalities or stigmatisation. Equally, a nuanced approach may be necessary to accommodate the principles of proportionality and efficiency within the local context.ConclusionWe conclude that this intervention is justifiable from an ethical perspective but that this type of reflection loop is helpful to identify the impact of interventions beyond effectiveness.

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