scholarly journals Using informatics to guide public health policy during the COVID-19 pandemic in the USA

2020 ◽  
Vol 42 (4) ◽  
pp. 660-664
Author(s):  
Jay G Ronquillo ◽  
William T Lester ◽  
Diana M Zuckerman
Keyword(s):  
Public Health ◽  
Cross Sectional Study ◽  
Washington Dc ◽  
Cross Sectional ◽  
Public Health Decision ◽  
Health Decision Making ◽  
Health Decision ◽  
The Usa ◽  
The Impact ◽  
At Home

Abstract Background Current and future pandemics will require informatics solutions to assess the risks, resources and policies to guide better public health decision-making. Methods Cross-sectional study of all COVID-19 cases and deaths in the USA on a population- and resource-adjusted basis (as of 24 April 2020) by applying biomedical informatics and data visualization tools to several public and federal government datasets, including analysis of the impact of statewide stay-at-home orders. Results There were 2753.2 cases and 158.0 deaths per million residents, respectively, in the USA with variable distributions throughout divisions, regions and states. Forty-two states and Washington, DC, (84.3%) had statewide stay-at-home orders, with the remaining states having population-adjusted characteristics in the highest risk quartile. Conclusions Effective national preparedness requires clearly understanding states’ ability to predict, manage and balance public health needs through all stages of a pandemic. This will require leveraging data quickly, correctly and responsibly into sound public health policies.

scholarly journals Understanding Spatial Heterogeneity of COVID-19 Pandemic Using Shape Analysis of Growth Rate Curves

2020 ◽  
Author(s):  
Anuj Srivastava ◽  
Gerardo Chowell
Keyword(s):  
Public Health ◽  
Growth Rate ◽  
Shape Analysis ◽  
Spatial Scales ◽  
Transmission Dynamics ◽  
Public Health Decision ◽  
Health Decision Making ◽  
Health Decision ◽  
The Usa ◽  
Level Analysis

AbstractThe growth rates of COVID-19 across different geographical regions (e.g., states in a nation, countries in a continent) follow different shapes and patterns. The overall summaries at coarser spatial scales that are obtained by simply averaging individual curves (across regions) obscure nuanced variability and blurs the spatial heterogeneity at finer spatial scales. We employ statistical methods to analyze shapes of local COVID-19 growth rate curves and statistically group them into distinct clusters, according to their shapes. Using this information, we derive the so-called elastic averages of curves within these clusters, which correspond to the dominant incidence patterns. We apply this methodology to the analysis of the daily incidence trajectory of the COVID-pandemic at two spatial scales: A state-level analysis within the USA and a country-level analysis within Europe during mid-February to mid-May, 2020. Our analyses reveal a few dominant incidence trajectories that characterize transmission dynamics across states in the USA and across countries in Europe. This approach results in broad classifications of spatial areas into different trajectories and adds to the methodological toolkit for guiding public health decision making at different spatial scales.HighlightsCoarsely summarizing epidemic data collected at finer spatial scales can result in a loss of heterogenous spatial patterns that exist at finer scales. For instance, the average curves may give the impression that the epidemic’s trajectory is declining when, in fact, the trajectory of the epidemic is increasing in certain areas.Shape analysis of COVID-19 growth rate curves discovers significant heterogeneity in epidemic spread patterns across spatial areas which can be statistically clustered into distinct groups.At a higher level, clustering spatial patterns into distinct groups helps discern broad trends, such as rapid growth, leveling off, and slow decline in epidemic growth curves resulting from local transmission dynamics. At a finer level, it helps identify temporal patterns of multiple waves that characterize rate curves for different clusters.Quantitative methods for characterizing the spatial-temporal dynamics of evolving epidemic emergencies provide an objective framework to understand transmission dynamics for public health decision making.

Sophistry in American medicine? Platonic reflections on expertise, influence and the public’s health in the democratic context

2018 ◽  
Vol 45 (1) ◽  
pp. 45-51
Author(s):  
Evan V Goldstein
Keyword(s):  
Public Health ◽  
Decision Making ◽  
American Medical ◽  
Care Quality ◽  
Public Affairs ◽  
Healthcare Sector ◽  
Public Health Decision ◽  
Health Decision Making ◽  
Health Decision ◽  
The Usa

Without question, the American medical craft—the physicians, clinicians and healthcare organisations that comprise the American healthcare sector—provides immense value to patients and contributes expertise on matters relevant to the public’s health. However, several conspicuous realities about healthcare in America should give the reader pause. Most problematic are the comparative measures of access to care, quality of care, life expectancy, racial health disparity and cost, all of which demonstrate how many Americans experience relatively lower value public health than other Western liberal democratic states. Since the early 1900s, American medical craft behaviour contributed to suboptimal social investment in public health, successfully influencing greater medical investment and higher healthcare expenditure relative to social welfare investments. Today, American policymakers seek the ‘holy grail’, a mythical panacea that purports to restrict spending and improve care quality and value, leading the USA to chase ‘technocratic solutions to political problems’. This paper explores the claim that the USA is hampered by suboptimal public health decision making. Public health decision making has been historically impacted by the overextended reach of medical craft expertise—technê in Platonic terms of art—as permitted by the American democratic political system. American policymakers must not forget that the debate over technê, epistêmê, sophistry and who should have authority in public affairs is not new. Rather, it is an ancient debate, and now as then, the ancient arguments remain relevant in a democratic context. For particularly helpful insight, one ought to look no further than the lessons of Plato’s dialogues. Platonic lessons on expertise and decision making can enlighten our understanding of modern public health decision making, specifically regarding the appropriation, allocation and distribution of health-related resources in the state.

scholarly journals Whole-grain dietary recommendations: the need for a unified global approach

2016 ◽  
Vol 115 (11) ◽  
pp. 2031-2038 ◽  
Author(s):  
Chris J. Seal ◽  
Anne P. Nugent ◽  
E-Siong Tee ◽  
Frank Thielecke
Keyword(s):  
Public Health ◽  
Whole Grain ◽  
Dietary Recommendations ◽  
Public Health Decision ◽  
Health Decision Making ◽  
Reduced Body ◽  
Health Decision ◽  
Dietary Fibre Intake ◽  
The Impact

AbstractIncreased whole-grain (WG) consumption reduces the risk of CVD, type 2 diabetes and some cancers, is related to reduced body weight and weight gain and is related to improved intestinal health. Definitions of ‘WG’ and ‘WG food’ are proposed and used in some countries but are not consistent. Many countries promote WG consumption, but the emphasis given and the messages used vary. We surveyed dietary recommendations of fifty-three countries for mentions of WG to assess the extent, rationale and diversity in emphasis and wording of any recommendations. If present, recommendations were classified as either ‘primary’, where the recommendation was specific for WG, or ‘secondary’, where recommendations were made in order to achieve another (primary) target, most often dietary fibre intake. In total, 127 organisations were screened, including government, non-governmental organisations, charities and professional bodies, the WHO and European Food Safety Authority, of which forty-nine including WHO provide a WG intake recommendation. Recommendations ranged from ‘specific’ with specified target amounts (e.g. x g WG/d), ‘semi-quantitative’ where intake was linked to intake of cereal/carbohydrate foods with proportions of WG suggested (e.g. x servings of cereals of which y servings should be WG) to ‘non-specific’ based on ‘eating more’ WG or ‘choosing WG where possible’. This lack of a harmonised message may result in confusion for the consumer, lessen the impact of public health messages and pose barriers to trade in the food industry. A science-based consensus or expert opinion on WG recommendations is needed, with a global reach to guide public health decision making and increase WG consumption globally.

scholarly journals Coronavirus disease (COVID-19) outbreak: can HTA improve preparedness and response in emergencies with a high degree of uncertainty?

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Timen ◽  
A Miglietta
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Scientific Evidence ◽  
Decision Makers ◽  
Public Health Decision ◽  
Public Health Emergencies ◽  
Health Decision Making ◽  
Health Decision ◽  
High Degree ◽  
The Impact

Abstract Evidence-based decision-making is central to public health. Implementing evidence-informed actions is most challenging during a public health emergency as in an epidemic, when time is limited, scientific uncertainties and political pressures tend to be high, and irrefutable evidence may be lacking. The Coronavirus disease (COVID-19) outbreak is determining a scenario of uncertainty for public health decision-making with fragmented and different responses also within countries (i.e. regional level), which are implemented quickly, sometimes not fully supported by the necessary body of scientific evidence. In such a situation, following a common line and having a shared tool that would allow to include evidence in public health decision-making, would be strategic to strengthen the impact of interventions, enabling stakeholders and decision makers taking actions based on the best available evidence through a process which is systematic and transparent. The objective of this presentation is to use the example of the COVID-19 outbreak, in order to explore how HTA can improve preparedness and response in emergencies with a high degree of uncertainty, representing the mechanisms through which interdisciplinary evidence feeds into decision-making processes during public health emergencies, addressing the link between scientific evidence and decision-making in public health emergencies, overcoming the key challenges faced by public health experts when advising decision makers, including strengthening and accelerating knowledge transfer through rapid HTA, improving networking between actors and disciplines.

scholarly journals 5.I. Skills building seminar: National burden of disease studies: inspirational experiences from across the globe

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Decision Making ◽  
Burden Of Disease ◽  
Public Health Decision ◽  
Health Decision Making ◽  
National Burden ◽  
Health Decision ◽  
Disease Study ◽  
The Impact

Abstract What are the most relevant diseases in a country? Which risk factors are the strongest contributors to disease and death? How is the impact of different diseases evolving over time, and how does it compare to other countries or across sub-national units? With a constantly growing need to rationalize the allocation of available resources, a timely, sound and comprehensive answer to these fundamental questions is more than ever needed to inform public health decision making. Driven by the impact of the Global Burden of Disease study, several countries have decided to establish a national burden of disease study to address these questions. Central to any national burden of disease study is the establishment of a coherent framework for routinely quantifying the impact of diseases and risk factors in terms of Disability-Adjusted Life Years (DALYs). National burden of disease studies further allow to valorise existing health information, foster collaborations with national stakeholders, and support capacity building. Implementing a national burden of disease study is however highly resource demanding, and many researchers struggle to effectively translate their findings to decision makers. This skills building seminar gathers five inspirational examples of national burden of disease studies from across the globe. They reflect the diversity in approaches that currently exist. Indeed, while some countries have implemented their national burden of disease framework themselves, an increasing number of countries is collaborating with the Institute for Health Metrics and Evaluation (IHME) to conduct national and sub-national burden of disease studies. Both approaches have their own specific advantages, which will be outlined during the seminar. The selected examples further document the iterative, step-wise processes behind the implementation of a national burden of disease study, as well as the challenges, but also success stories, in translating data to policies. Overall, the aim is to demonstrate the added value of national burden of disease studies, and to share realistic, hands-on experiences on the steps needed to initiate, implement and maintain a national burden of disease study. Key messages National burden of disease studies are increasingly established across the world to support public health decision making. Different international initiatives are emerging to support countries initiate, implement and maintain a national burden of disease study.

Disposal Practices of Unused Medications Among Patients in Public Health Centers of Dessie Town, Northeast Ethiopia: A Cross-sectional Study

2020 ◽  
Vol 15 (2) ◽  
pp. 105-110
Author(s):  
Haile Kassahun ◽  
Dugessa Tesfaye
Keyword(s):  
Public Health ◽  
Health Care Professionals ◽  
Cross Sectional Study ◽  
Health Centers ◽  
Sectional Study ◽  
Cross Sectional ◽  
Global Challenge ◽  
Northeast Ethiopia ◽  
Unused Medications ◽  
At Home

Background: Disposal of pharmaceutical waste among patients is a global challenge especially in developing countries like Ethiopia. Improper medication disposal can lead to health problems and environmental contaminations. Therefore, the present study aimed to assess disposal practices of unused medications among patients in public health centers of Dessie town, Northeast Ethiopia. Methods: A descriptive cross-sectional study was conducted among 263 patients in four public health centers of Dessie town, Ethiopia from March to June, 2019. Face-to-face interviews using structured questionnaires were used to collect data from each study subject. Results: The majority of the respondents, 224 (85.17%) had unused medications at their home during the study period. The most commonly reported disposal method in the present study was flushing down into a toilet 66 (25.09%). None of the respondents practiced returning unused medications to Pharmacy. Moreover, 85 (32.31%) of the respondents reported never disposing their medications and believed that it is acceptable to store medications at home for future use. Conclusion: In the present study, there was a high practice of keeping medications at home and most of the disposal practices were not recommended methods. In addition, most of the respondents did not get advice from pharmacists and other health care professionals on how to dispose off unused medications. Hence, there is a need for proper education and guidance of patients regarding disposal practices of unused medications.

scholarly journals The NCCMT’s dynamic model for evidence-informed public health

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
E Clark ◽  
S Neil-Sztramko ◽  
M Dobbins
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Research Evidence ◽  
Decision Makers ◽  
Local Data ◽  
Public Health Decision ◽  
Health Decision Making ◽  
Political Preferences ◽  
Health Decision ◽  
Structured Approach

Abstract Issue It is well accepted that public health decision makers should use the best available research evidence in their decision-making process. However, research evidence alone is insufficient to inform public health decision making. Description of the problem As new challenges to public health emerge, there can be a paucity of high quality research evidence to inform decisions on new topics. Public health decision makers must combine various sources of evidence with their public health expertise to make evidence-informed decisions. The National Collaborating Centre for Methods and Tools (NCCMT) has developed a model which combines research evidence with other critical sources of evidence that can help guide decision makers in evidence-informed decision making. Results The NCCMT's model for evidence-informed public health combines findings from research evidence with local data and context, community and political preferences and actions and evidence on available resources. The model has been widely used across Canada and worldwide, and has been integrated into many public health organizations' decision-making processes. The model is also used for teaching an evidence-informed public health approach in Masters of Public Health programs around the globe. The model provides a structured approach to integrating evidence from several critical sources into public health decision making. Use of the model helps ensure that important research, contextual and preference information is sought and incorporated. Lessons Next steps for the model include development of a tool to facilitate synthesis of evidence across all four domains. Although Indigenous knowledges are relevant for public health decision making and should be considered as part of a complete assessment the current model does not capture Indigenous knowledges. Key messages Decision making in public health requires integrating the best available evidence, including research findings, local data and context, community and political preferences and available resources. The NCCMT’s model for evidence-informed public health provides a structured approach to integrating evidence from several critical sources into public health decision making.

scholarly journals Contributions in the field of Public Health for decision-making in health

2017 ◽  
Vol 27 (2) ◽  
pp. 128 ◽  
Author(s):  
Luiz Antônio Tavares Neves
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Motor Development ◽  
Growth And Development ◽  
Human Growth ◽  
Public Health Decision ◽  
Health Decision Making ◽  
Scientific World ◽  
Health Decision ◽  
Human Growth And Development

  Brazil has made a wide development and contribution in the field of Public Health. These contributions have maximized public health decision-making, which is a factor of great importance for the maintenance of health of a given population, either in the prevention of disease, as is the case of immunizations or with actions in Health Promotion, improving the quality of life of the affected population. Thus, the Journal of Human Growth and Development has contributed enormously to the dissemination of knowledge, not only in Brazil but also in the world making a major effort with its publications in English which is the preferred language of the modern scientific world. It was evidenced the importance of research in the investigation of better ways to obtain the public health of a given community, bringing discussion of themes that involve aspects of human growth and development such as nutritional aspects, sexuality, motor development, covering situations and diseases as obesity, cerebral palsy, dyslexia and violence. The Journal of Human Growth and Development has maintained the tradition of approaching the different aspects that involve clinical practice for people and for Public Health. 

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