scholarly journals Reimagining What We Measure in Atherosclerosis—a “Phenotype Stack”

2020 ◽  
Vol 126 (9) ◽  
pp. 1146-1158 ◽  
Author(s):  
Calum A. MacRae ◽  
Robert M. Califf
Keyword(s):  
Public Health ◽  
Clinical Care ◽  
Radical Change ◽  
Modern Technology ◽  
General Definition ◽  
Biological Phenomena ◽  
Basic Understanding ◽  
Multiple Levels ◽  
And Behavior ◽  
Unit Of Action

The term phenotype is so commonly used that we often assume that we each mean the same thing. The general definition, the set of observable characteristics of an individual resulting from the interaction of their genotype with the environment, is often left to the eye of the beholder. Whether applied to the multiple levels of biological phenomena or the intact human being, our ability to characterize, classify, and analyze phenotype has been limited by measurement deficits, computing limitations, and a culture that avoids the generalizable. With the advent of modern technology, there is the potential for a revolution in phenotyping, which incorporates old and new in structured ways to dramatically advance basic understanding of biology and behavior and to lead to major improvements in clinical care and public health. This revolution in how we think about phenotypes will require a radical change in the scale at which biomedicine operates with significant changes in the unit of action, which will have far-reaching implications for how care, translation, and discovery are implemented.

Risk Attitudes and Behavior Among Norwegian Adolescents

2005 ◽  
Vol 10 (1) ◽  
pp. 25-38 ◽  
Author(s):  
Hilde Iversen ◽  
Torbjørn Rundmo ◽  
Hroar Klempe
Keyword(s):  
Public Health ◽  
Traffic Safety ◽  
Behavior Modification ◽  
Health Programs ◽  
Risk Attitudes ◽  
Community Based ◽  
Public Health Programs ◽  
The Core ◽  
And Behavior ◽  
Attitudes And Behavior

Abstract. The core aim of the present study is to compare the effects of a safety campaign and a behavior modification program on traffic safety. As is the case in community-based health promotion, the present study's approach of the attitude campaign was based on active participation of the group of recipients. One of the reasons why many attitude campaigns conducted previously have failed may be that they have been society-based public health programs. Both the interventions were carried out simultaneously among students aged 18-19 years in two Norwegian high schools (n = 342). At the first high school the intervention was behavior modification, at the second school a community-based attitude campaign was carried out. Baseline and posttest data on attitudes toward traffic safety and self-reported risk behavior were collected. The results showed that there was a significant total effect of the interventions although the effect depended on the type of intervention. There were significant differences in attitude and behavior only in the sample where the attitude campaign was carried out and no significant changes were found in the group of recipients of behavior modification.

Exploration of Mothers’ Expectations of Care during Childbirth in Public Health Facilities in Kumasi, Ghana

2018 ◽  
Vol 20 (1) ◽  
Author(s):  
Veronica Dzomeku ◽  
Brian Van Wyk ◽  
Lucia Knight ◽  
Jody R. Lori
Keyword(s):  
Public Health ◽  
Clinical Care ◽  
Health Facilities ◽  
Individual Interviews ◽  
Midwifery Education ◽  
Health Centres ◽  
Adequate Communication ◽  
Safe Care ◽  
Respectful Care ◽  
Childbirth Care

It is well established that clients’ past healthcare experiences influence their further use of that particular service, as well as their recommendations of that service. This also applies to the use of facility-based childbirth services which contribute to reducing maternal and infant mortality rates. This paper explores what mothers’ want from care in public health centres during childbirth. Knowing mothers’ expectations will contribute to improving their future childbirth care experiences. In this explorative qualitative study, 56 women were recruited from four public health centres. In-depth individual interviews were digitally recorded and transcribed in full, and subjected to content analysis. Themes emerged, revealing participants’ desire for both “respectful care” and “safe care”. From our findings, we posit that respectful care should be characterised by adequate communication between the healthcare provider and patient, and involvement of the patient in care decisions. Participants expected safe care, which results from health facilities with adequate resources. Health services generally concentrate on clinical care which aligns with mothers’ expectations of respectful and safe care. However, soft skills need much attention in nursing and midwifery education. There is also a need to orient midwives to a patient-centred approach to care that meets mothers’ expectations for childbirth care.

Future Issues in Dissemination and Implementation Research

2017 ◽  
Author(s):  
Ross C. Brownson ◽  
Graham A. Colditz ◽  
Enola K. Proctor
Keyword(s):  
Public Health ◽  
Health Services ◽  
Implementation Research ◽  
Clinical Care ◽  
Dissemination And Implementation ◽  
Public Health Services ◽  
Middle Income ◽  
Middle Income Countries ◽  
Dissemination And Implementation Research ◽  
The Many

This chapter highlights just a sample of the many rich areas for dissemination and implementation research that will assist us in shortening the gap between discovery and practice, thus beginning to realize the benefits of research for patients, families, and communities. Greater emphasis on implementation in challenging settings, including lower and middle-income countries and underresourced communities in higher income countries will add to the lessons we must learn to fully reap the benefit of our advances in dissemination and implementation research methods. Moreover, collaboration and multidisciplinary approaches to dissemination and implementation research will help to make efforts more consistent and more effective moving forward. Thus, we will be better able to identify knowledge gaps that need to be addressed in future dissemination and implementation research, ultimately informing the practice and policies of clinical care and public health services.

scholarly journals Overuse of Health Care in the Emergency Services in Chile

2021 ◽  
Vol 18 (6) ◽  
pp. 3082
Author(s):  
Ximena Alvial ◽  
Alejandra Rojas ◽  
Raúl Carrasco ◽  
Claudia Durán ◽  
Christian Fernández-Campusano
Keyword(s):  
Public Health ◽  
Emergency Services ◽  
Clinical Care ◽  
Tertiary Care ◽  
Public Health Policies ◽  
The Public ◽  
Healthcare Network ◽  
Use Of Emergency Services ◽  
Low Coverage ◽  
Different Levels

The Public Health Service in Chile consists of different levels of complexity and coverage depending on the severity and degree of specialization of the pathology to be treated. From primary to tertiary care, tertiary care is highly complex and has low coverage. This work focuses on an analysis of the public health system with emphasis on the healthcare network and tertiary care, whose objectives are designed to respond to the needs of each patient. A review of the literature and a field study of the problem of studying the perception of internal and external users is presented. This study intends to be a contribution in the detection of opportunities for the relevant actors and the processes involved through the performance of Triage. The main causes and limitations of the excessive use of emergency services in Chile are analyzed and concrete proposals are generated aiming to benefit clinical care in emergency services. Finally, improvements related to management are proposed and the main aspects are determined to improve decision-making in hospitals, which could be a contribution to public health policies.

scholarly journals Consequences of COVID-19 crisis for persons with HIV: the impact of social determinants of health

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kristie C. Waterfield ◽  
Gulzar H. Shah ◽  
Gina D. Etheredge ◽  
Osaremhen Ikhile
Keyword(s):  
Public Health ◽  
Health Care ◽  
Clinical Care ◽  
Hiv Infections ◽  
People Living With Hiv ◽  
Negative Consequences ◽  
Persons Who Inject Drugs ◽  
Persons Living With Hiv ◽  
Living With Hiv ◽  
The Impact

Abstract Background With the indiscriminate spread of COVID-19 globally, many populations are experiencing negative consequences such as job loss, food insecurity, and inability to manage existing medical conditions and maintain preventive measures such as social distancing and personal preventative equipment. Some of the most disadvantaged in the COVID-19 era are people living with HIV/AIDS and other autoimmune diseases. Discussion As the number of new HIV infections decrease globally, many subpopulations remain at high risk of infection due to lack of or limited access to prevention services, as well as clinical care and treatment. For persons living with HIV or at higher risk of contracting HIV, including persons who inject drugs or men that have sex with men, the risk of COVID-19 infection increases if they have certain comorbidities, are older than 60 years of age, and are homeless, orphaned, or vulnerable children. The risk of COVID-19 is also more significant for those that live in Low- and Middle-Income Countries, rural, and/or poverty-stricken areas. An additional concern for those living the HIV is the double stigma that may arise if they also test positive for COVID-19. As public health and health care workers try to tackle the needs of the populations that they serve, they are beginning to realize the need for a change in the infrastructure that will include more efficient partnerships between public health, health care, and HIV programs. Conclusion Persons living with HIV that also have other underlying comorbidities are a great disadvantage from the negative consequences of COVID-19. For those that may test positive for both HIV and COVID-19, the increased psychosocial burdens stemming from stress and isolation, as well as, experiencing additional barriers that inhibit access to care, may cause them to become more disenfranchised. Thus, it becomes very important during the current pandemic for these challenges and barriers to be addressed so that these persons living with HIV can maintain continuity of care, as well as, their social and mental support systems.

scholarly journals Public Health Efforts Can Impact Adoption of Current Susceptibility Breakpoints, but Closer Attention from Regulatory Bodies Is Needed

2018 ◽  
Vol 57 (3) ◽  
Author(s):  
James A. McKinnell ◽  
S. Bhaurla ◽  
P. Marquez-Sung ◽  
A. Pucci ◽  
M. Baron ◽  
...  
Keyword(s):  
Public Health ◽  
Patient Safety ◽  
Los Angeles ◽  
Antimicrobial Susceptibility ◽  
Los Angeles County ◽  
Susceptibility Testing ◽  
Clinical Care ◽  
Public Health Intervention ◽  
Antimicrobial Susceptibility Testing ◽  
Outreach Program

ABSTRACT Microbiological testing, including interpretation of antimicrobial susceptibility testing results using current breakpoints, is crucial for clinical care and infection control. Continued use of obsolete Enterobacteriaceae carbapenem breakpoints is common in clinical laboratories. The purposes of this study were (i) to determine why laboratories failed to update breakpoints and (ii) to provide support for breakpoint updates. The Los Angeles County Department of Public Health conducted a 1-year outreach program for 41 hospitals in Los Angeles County that had reported, in a prior survey of California laboratories, using obsolete Enterobacteriaceae carbapenem breakpoints. In-person interviews with hospital stakeholders and customized expert guidance and resources were provided to aid laboratories in updating breakpoints, including support from technical representatives from antimicrobial susceptibility testing device manufacturers. Forty-one hospitals were targeted, 7 of which had updated breakpoints since the prior survey. Of the 34 remaining hospitals, 27 (79%) assumed that their instruments applied current breakpoints, 17 (50%) were uncertain how to change breakpoints, and 10 (29%) lacked resources to perform a validation study for off-label use of the breakpoints on their systems. Only 7 hospitals (21%) were familiar with the FDA/CDC Antibiotic Resistance Isolate Bank. All hospitals launched a breakpoint update process; 16 (47%) successfully updated breakpoints, 12 (35%) received isolates from the CDC in order to validate breakpoints on their systems, and 6 (18%) were planning to update within 1 year. The public health intervention was moderately successful in identifying and overcoming barriers to updating Enterobacteriaceae carbapenem breakpoints in Los Angeles hospitals. However, the majority of targeted hospitals continued to use obsolete breakpoints despite 1 year of effort. These findings have important implications for the quality of patient care and patient safety. Other public health jurisdictions may want to utilize similar resources to bridge the patient safety gap, while manufacturers, the FDA, and others determine how best to address this growing public health issue.

scholarly journals Public Health, Systems Change, Justice and the Work of the Kingdom

2019 ◽  
Vol 6 (1) ◽  
pp. 7-19
Author(s):  
Robert E Aronson
Keyword(s):  
Public Health ◽  
Social Change ◽  
Church And State ◽  
Public Health Systems ◽  
New Jerusalem ◽  
Book Of Isaiah ◽  
The Face ◽  
And Behavior ◽  
Personal Decision ◽  
The Church

Disparities in population health statuses are tied to inequities in society, and not just differences in personal decision-making and behavior.  Christians should (and must) play a role in confronting these inequities, based upon three biblical themes: 1) the instructions in the book of Leviticus regarding the Sabbath year and the Year of Jubilee as a way to protect the economic system from producing insurmountable inequities and degrading the environment; 2) the eschatological image of the New Jerusalem in the book of Isaiah, with its focus on Shalom in contrast to a religion focused on personal piety in the face of oppression and social injustice; and 3) Jesus’ teachings about the kingdom, which include its imminence and the counter-cultural nature of its ethic.  The notion of the kingdom can be applied in the lives of Christians (particularly those involved in public health) through individual acts, corporate acts in the context of the church, and state-led actions to bring about social change to achieve social justice. Social change can be described as an act of reconciliation in which systems of society are redeemed by the power of kingdom principles.  

scholarly journals Stillbirth in Canada: anachronistic definition and registration processes impede public health surveillance and clinical care

2021 ◽  
Author(s):  
K.S. Joseph ◽  
Lily Lee ◽  
Laura Arbour ◽  
Nathalie Auger ◽  
Elizabeth K. Darling ◽  
...  
Keyword(s):  
Public Health ◽  
Public Health Surveillance ◽  
Fetal Death ◽  
Clinical Care ◽  
Induced Abortion ◽  
Death Registration ◽  
Starting Point ◽  
Induced Abortions ◽  
History Of ◽  
Definition Of

AbstractThe archaic definition and registration processes for stillbirth currently prevalent in Canada impede both clinical care and public health. The situation is fraught because of definitional problems related to the inclusion of induced abortions at ≥20 weeks’ gestation as stillbirths: widespread uptake of prenatal diagnosis and induced abortion for serious congenital anomalies has resulted in an artefactual temporal increase in stillbirth rates in Canada and placed the country in an unfavourable position in international (stillbirth) rankings. Other problems with the Canadian stillbirth definition and registration processes extend to the inclusion of fetal reductions (for multi-fetal pregnancy) as stillbirths, and the use of inconsistent viability criteria for reporting stillbirth. This paper reviews the history of stillbirth registration in Canada, provides a rationale for updating the definition of fetal death and recommends a new definition and improved processes for fetal death registration. The recommendations proposed are intended to serve as a starting point for reformulating issues related to stillbirth, with the hope that building a consensus regarding a definition and registration procedures will facilitate clinical care and public health.

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