Critical Evaluation of Adler’s Challenge to the cdc’s Male Circumcision Recommendations

2016 ◽  
Vol 24 (2) ◽  
pp. 265-303 ◽  
Author(s):  
Beth E. Rivin ◽  
Douglas S. Diekema ◽  
Anna C. Mastroianni ◽  
John N. Krieger ◽  
Jeffrey D. Klausner ◽  
...  
Keyword(s):  
Public Health ◽  
Male Circumcision ◽  
Scientific Evidence ◽  
Critical Evaluation ◽  
Well Being ◽  
Scientific Data ◽  
Best Interests ◽  
Sexually Transmitted ◽  
Control And Prevention ◽  
Tract Infections

We evaluate Peter Adler’s challenge to the Centers for Disease Control and Prevention (cdc) draft recommendations on male circumcision (this issue, see pp. 237–262). Thecdcadvocates elective male circumcision (mc) to improve public health in theusabased on strong scientific evidence. In marked contrast to thecdc, Adler’s criticisms depend on speculative claims and obfuscation of the scientific data. Adler’s central argument that circumcision in infancy should be delayed to allow a boy to make up his own mind as an adult fails to appreciate that circumcision later in life is a more complex operation, entails higher risk, is more likely to involve general anaesthesia and presents financial, psychological and organisational barriers. These limitations are avoided by circumcision early in infancy, when it is convenient, safe, quick, low risk, usually involves local anaesthesia and provides benefits immediately. Benefits of male circumcision include: protection against: urinary tract infections that are ten times higher in uncircumcised infants; inflammatory skin conditions; other foreskin problems; sexually transmitted infections and genital cancers in the male and his female sexual partners. Circumcision during infancy is also associated with faster healing and improved cosmetic outcomes. Circumcision does not impair sexual function or pleasure. Some authorities regard the failure to offer circumcision as unethical, just as it would be unethical to fail to encourage paediatric vaccination. Since the benefits vastly outweigh the risks, each intervention is in the best interests of the child. In conclusion, Adler’s criticisms of thecdc’s evidence-based male circumcision policy are flawed scientifically, ethically and legally, and should be dismissed as endangering public health and individual well-being.

scholarly journals How effective is dog culling in controlling zoonotic visceral leishmaniasis? a critical evaluation of the science, politics and ethics behind this public health policy

2011 ◽  
Vol 44 (2) ◽  
pp. 232-242 ◽  
Author(s):  
Carlos Henrique Nery Costa
Keyword(s):  
Visceral Leishmaniasis ◽  
Control Measure ◽  
Scientific Evidence ◽  
Critical Evaluation ◽  
Scientific Data ◽  
Ethical Considerations ◽  
Brazilian Government ◽  
Kala Azar ◽  
Scientific Results

INTRODUCTION: Zoonotic kala-azar, a lethal disease caused by protozoa of the genus Leishmania is considered out of control in parts of the world, particularly in Brazil, where transmission has spread to cities throughout most of the territory and mortality presents an increasing trend. Although a highly debatable measure, the Brazilian government regularly culls seropositive dogs to control the disease. Since control is failing, critical analysis concerning the actions focused on the canine reservoir was conducted. METHODS: In a review of the literature, a historical perspective focusing mainly on comparisons between the successful Chinese and Soviet strategies and the Brazilian approach is presented. In addition, analyses of the principal studies regarding the role of dogs as risk factors to humans and of the main intervention studies regarding the efficacy of the dog killing strategy were undertaken. Brazilian political reaction to a recently published systematic review that concluded that the dog culling program lacked efficiency and its effect on public policy were also reviewed. RESULTS: No firm evidence of the risk conferred by the presence of dogs to humans was verified; on the contrary, a lack of scientific support for the policy of killing dogs was confirmed. A bias for distorting scientific data towards maintaining the policy of culling animals was observed. CONCLUSIONS: Since there is no evidence that dog culling diminishes visceral leishmaniasis transmission, it should be abandoned as a control measure. Ethical considerations have been raised regarding distorting scientific results and the killing of animals despite minimal or absent scientific evidence

scholarly journals Deregulation and the Assault on Science and the Environment

2020 ◽  
Vol 41 (1) ◽  
pp. 347-361 ◽  
Author(s):  
Jonathan M. Samet ◽  
Thomas A. Burke
Keyword(s):  
Public Health ◽  
Environmental Pollution ◽  
Reasoned Action ◽  
Scientific Evidence ◽  
Well Being ◽  
The United States ◽  
Research To Policy ◽  
Health And Well Being

The quality of the environment is a major determinant of the health and well-being of a population. The role of scientific evidence is central in the network of laws addressing environmental pollution in the United States and has been critical in addressing the myriad sources of environmental pollution and the burden of disease attributable to environmental factors. We address the shift away from reasoned action and science to a reliance on belief and document the efforts to separate regulation from science and to remove science-based regulations and policies intended to protect public health. We outline the general steps for moving from research to policy, show how each has been undermined, offer specific examples, and point to resources that document the enormity of the current efforts to set aside scientific evidence.

scholarly journals Palliative Curriculum Re-imagined: A Critical Evaluation of the UK Palliative Medicine Syllabus

2018 ◽  
Vol 11 ◽  
pp. 117822421878037
Author(s):  
Julian Abel ◽  
Allan Kellehear
Keyword(s):  
Public Health ◽  
Social Support ◽  
Palliative Care ◽  
Palliative Medicine ◽  
Critical Evaluation ◽  
Well Being ◽  
Disease Models ◽  
Care Policy ◽  
The Uk ◽  
Illness And Disease

The UK Palliative Medicine Syllabus is critically evaluated to assess its relationship and relevance to contemporary palliative care policy and direction. Three criteria are employed for this review: (1) relevance to non-cancer dying, ageing, caregivers, and bereaved populations; (2) uptake and adoption of well-being models of public health alongside traditional illness and disease models of clinical understanding; and (3) uptake and integration of public health insights and methodologies for social support. We conclude that the current syllabus falls dramatically short on all 3 criteria. Suggestions are made for future consultation and revision.

scholarly journals Age-Standardized Mortality of Persons on Probation, in Jail, or in State Prison and the General Population, 2001-2012

2019 ◽  
Vol 134 (6) ◽  
pp. 660-666 ◽  
Author(s):  
Christopher Wildeman ◽  
Alyssa W. Goldman ◽  
Emily A. Wang
Keyword(s):  
Public Health ◽  
United States ◽  
Age Distribution ◽  
Correctional Facility ◽  
Well Being ◽  
The United States ◽  
Mortality Rates ◽  
State Prison ◽  
Control And Prevention ◽  
Standardized Mortality Ratios

Objectives: The number of adults in the United States being held on probation—persons convicted of crimes and serving their sentence in the community rather than in a correctional facility—approached 4 million at the end of 2016 and continues to grow, yet little is known about the health and well-being of this population. We compared the standardized mortality ratios of persons on probation in the United States with persons in jail, persons in state prison, and the general US population. Methods: We used administrative data from 2001-2012 from the Bureau of Justice Statistics and the Centers for Disease Control and Prevention WONDER database and indirect standardization techniques to compare the mortality rates of persons on probation in 15 states with the mortality rates of persons in jail, persons in state prison, and the general US population. We applied the age-specific mortality rates of 3 populations (general US population, persons in jail, and persons in state prison) to the age distribution of persons on probation to estimate standardized mortality ratios. Results: Persons on probation died at a rate 3.42 times higher than persons in jail, 2.81 times higher than persons in state prison, and 2.10 times higher than the general US population, after standardizing the age distribution of persons on probation relative to the other 3 groups. Conclusions: Public health interventions should target persons on probation, who have received less attention from the public health community than persons serving sentences in jails and prisons.

scholarly journals Restructuring Institutional Care: Challenges and Coping Measures for Children and Caregivers in Post-COVID-19 Era

2020 ◽  
pp. 234930032097382
Author(s):  
Sudeshna Roy
Keyword(s):  
Global Economy ◽  
Qualitative Content Analysis ◽  
Critical Evaluation ◽  
Institutional Care ◽  
Well Being ◽  
Policy Formulation ◽  
Best Interests ◽  
Financial Barriers ◽  
Safety Issues ◽  
Rights Of The Child

The sudden outbreak of COVID-19 pandemic has rattled the world and has severely compromised not only the public health system but has decelerated the global economy. In this backdrop, the article explores the dynamics of the institutional care of the out-of-home care (OHC) children, adolescents and children who are residing in alternative care homes, childcare institutes (CCIs), foster homes and who are in conflict with law like refugees or in juvenile correctional centres. The article attempts to highlight the risk factors and systematic barriers that CCIs and associated functionaries have been confronting in the aftermath of the COVID-19 pandemic worldwide. It would also catalogue the remedial, preventive and protective initiatives undertaken as best practices. The qualitative content analysis method is used to identify major themes related to the ongoing COVID-19 pandemic and institutional care of children. Critical evaluation of literature reviews, published newspaper reports and articles and documentation of webinar proceedings is performed for theoretical and thematic conceptualisation of this article. The fundamental barriers that surfaced include financial barriers, health and nutrition, social justice, educational barriers, safety issues, administrative barriers, management, rehabilitation and integration of children living in CCIs and the ones who are leaving the CCIs. The unprecedented challenges have exposed the emergency unpreparedness and lacunae in functioning of CCIs in diverse ways. This has necessitated the undeniable need for reframing the regulatory directives for protection of child rights; accounting for the newer structural reforms aiming for standard operating procedures (SOPs); compliance and accountability guidelines; upgrading training and capacity building of the caregivers; addressing issues of psycho-social, mental health and well-being of the children and caregivers; building resilient coping strategies and enhancing the dignity, flexibility, inclusivity and sustainability in the responsive policy formulation regarding overall childcare system. This entails a multi-sectoral, participatory and coordinated approach as envisaged in United Nations Convention on the Rights of the Child (UNCRC) where the concerned stakeholders, including government legislations, non-governmental organisations (NGOs), civil societies, grassroot organisations, individual CCIs and management staff, would ensure non-discriminatory measures protecting the best interests of the children.

scholarly journals Misinformation, chiropractic, and the COVID-19 pandemic

2020 ◽  
Vol 28 (1) ◽  
Author(s):  
Iben Axén ◽  
Cecilia Bergström ◽  
Marc Bronson ◽  
Pierre Côté ◽  
Casper Glissmann Nim ◽  
...  
Keyword(s):  
Public Health ◽  
Social Media ◽  
Scientific Evidence ◽  
Collective Responsibility ◽  
Economic Consequences ◽  
Best Interests ◽  
World Health ◽  
Chiropractic Treatment ◽  
Health Organization ◽  
The Impact

Abstract Background In March 2020, the World Health Organization elevated the coronavirus disease (COVID-19) epidemic to a pandemic and called for urgent and aggressive action worldwide. Public health experts have communicated clear and emphatic strategies to prevent the spread of COVID-19. Hygiene rules and social distancing practices have been implemented by entire populations, including ‘stay-at-home’ orders in many countries. The long-term health and economic consequences of the COVID-19 pandemic are not yet known. Main text During this time of crisis, some chiropractors made claims on social media that chiropractic treatment can prevent or impact COVID-19. The rationale for these claims is that spinal manipulation can impact the nervous system and thus improve immunity. These beliefs often stem from nineteenth-century chiropractic concepts. We are aware of no clinically relevant scientific evidence to support such statements. We explored the internet and social media to collect examples of misinformation from Europe, North America, Australia and New Zealand regarding the impact of chiropractic treatment on immune function. We discuss the potential harm resulting from these claims and explore the role of chiropractors, teaching institutions, accrediting agencies, and legislative bodies. Conclusions Members of the chiropractic profession share a collective responsibility to act in the best interests of patients and public health. We hope that all chiropractic stakeholders will view the COVID-19 pandemic as a call to action to eliminate the unethical and potentially dangerous claims made by chiropractors who practise outside the boundaries of scientific evidence.

scholarly journals Rapid Training and Implementation of the Pollock Technique, a Safe, Effective Newborn Circumcision Procedure, in a Low-Resource Setting

2015 ◽  
Vol 2 ◽  
pp. 2333794X1558911
Author(s):  
Noah Kojima ◽  
Claire C. Bristow ◽  
Neil Pollock ◽  
Pierre Crouse ◽  
Harry Theodore ◽  
...  
Keyword(s):  
Training Program ◽  
Sexually Transmitted Infections ◽  
Male Circumcision ◽  
Adult Health ◽  
Sexually Transmitted ◽  
Urogenital Infections ◽  
Inflammatory Conditions ◽  
Resource Setting ◽  
Low Resource Setting ◽  
Tract Infections

Male circumcision is highly protective against urinary tract infections, inflammatory conditions of the penis, sexually transmitted infections, and urogenital cancers. We aimed to reintroduce newborn male circumcision through the creation of a training program in Port-au-Prince, Haiti—an area with a considerable burden of preventable urogenital infections, sexually transmitted infections, and low circumcision rate—after an earlier study reported that a majority of Haitian medical providers were in need of and wanted newborn circumcision training. The program was conducted at the GHESKIO Health Centers, a large, non-governmental clinic offering comprehensive pediatric and adult health services. Two Haitian obstetricians and seven nurses learned circumcision procedures. On training completion, one of two obstetricians achieved surgical competence. Introduction of a newborn male circumcision training program was feasible, achieving an acceptable rate of procedural competency and high-quality services. Permanent resources now exist in Haiti to train additional providers to perform newborn male circumcisions.

scholarly journals Enhancing Community Engagement by Schools and Programs of Public Health in the United States

2020 ◽  
Vol 42 (1) ◽  
Author(s):  
Mindi B. Levin ◽  
Janice V. Bowie ◽  
Steven K. Ragsdale ◽  
Amy L. Gawad ◽  
Lisa A. Cooper ◽  
...  
Keyword(s):  
Public Health ◽  
Service Learning ◽  
Community Engagement ◽  
Learning Community ◽  
Community Based Participatory Research ◽  
Well Being ◽  
The United States ◽  
Annual Review ◽  
Publication Date ◽  
Control And Prevention

The US Centers for Disease Control and Prevention define community engagement as “the process of working collaboratively with and through groups of people” in order to improve their health and well-being. Central to the field of public health, community engagement should also be at the core of the work of schools and programs of public health. This article reviews best practices and emerging innovations in community engagement for education, for research, and for practice, including critical service-learning, community-based participatory research, and collective impact. Leadership, infrastructure, and culture are key institutional facilitators of successful academic efforts. Major challenges to overcome include mistrust by community members, imbalance of power, and unequal sharing of credit. Success in this work will advance equity and improve health in communities all around the world. Expected final online publication date for the Annual Review of Public Health, Volume 42 is April 1, 2021. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Preventing Tragedy: Balancing Physicians' Ethical Obligations to Patients and the Public

2007 ◽  
Vol 1 (S1) ◽  
pp. S38-S42 ◽  
Author(s):  
Emily E. Anderson ◽  
Lee J. Black ◽  
Nathan A. Bostick
Keyword(s):  
Public Health ◽  
Violence Prevention ◽  
Public Safety ◽  
Well Being ◽  
Best Interests ◽  
Medical Community ◽  
Minimal Amount ◽  
The Public ◽  
Treatment Measures ◽  
Ethical Obligations

ABSTRACTThe recent shootings at Virginia Polytechnic Institute and State University (Virginia Tech) suggest that an increased reliance upon the medical community to support public health violence prevention efforts may be warranted. As physicians are called upon to support these efforts, they must effectively balance their obligations to promote public safety with their traditional obligations to promote the best interests of their individual patients. To meet these concurrent ethical obligations, physicians' participation in public health violence prevention should seek to improve public safety without compromising the care of patients or exposing individuals to undue harm. Physicians should, therefore, report to the appropriate authorities those patients who are at risk of committing violent acts toward the public, but should only disclose the minimal amount of information that is necessary to protect the public. Moreover, physicians should also recommend the separation of violent individuals from the community at large when necessary to improve public safety while advocating for the provision of appropriate treatment measures to improve the patients' well-being. (Disaster Med Public Health Preparedness. 2007;1(Suppl 1):S38–S42)

scholarly journals Treatment seeking behavior for sexually transmitted infections/reproductive tract infections among married women in urban slums of Mumbai, India

2016 ◽  
Vol 5 (2) ◽  
pp. 65-70
Author(s):  
Poonam P Shingade ◽  
Yasmeen Kazi ◽  
Madhavi LH
Keyword(s):  
Public Health ◽  
Sexually Transmitted Infections ◽  
Reproductive Tract ◽  
Married Women ◽  
Reproductive Age ◽  
Treatment Seeking ◽  
Reproductive Tract Infections ◽  
Sexually Transmitted ◽  
Seeking Behavior ◽  
Tract Infections

Sexually Transmitted Infections/Reproductive Tract Infections (STIs/RTIs) are a major public health problem and a leading cause of morbidity among men and women in developing countries. The aim of the study is to explore treatment seeking behavior among the married women of reproductive age presented with symptoms of STI/RTI. A hospital-based observational study was carried out at the STI/RTI Clinic of Urban Health Centre, Shivaji Nagar, Govandi, Mumbai, India. The study involved a total of 273 married females who attended clinic for their symptoms during January to March 2012. Patients were interviewed using a pretested questionnaire to explore the detail of the treatment seeking behavior regarding STIs/RTIs. Out of total women who participated in the study, only 47.6% of the women with STIs/RTIs symptoms sought health care. Among those who did not seek treatment, 58.65 % females were belonging to 21-25 years of age group. Maximum 65.6% females who were illiterate had not sought any treatment for symptoms of these diseases as compared to 65% who had taken treatment for the presented symptoms who were educated up to higher secondary and above level. 62.5% females belonging to class V had never sought treatment as compared to 100% women who were classified to class I. The poor health seeking behavior was associated with literacy and socioeconomic class of the participants. Private sector was the most favored place for taking treatment by them. Commonest reason for not seeking treatment was no female doctor at clinic. Information, Education and Communication (IEC) sessions, about STI symptoms and the benefits of treat-ment, especially targeted at women and low socioeconomic groups might be an immediately feasible measure that will help to reduce the burden of the disease.South East Asia Journal of Public Health Vol.5(2) 2015: 65-70

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