scholarly journals Ranking States on Coverage of Cancer-Preventing Vaccines Among Adolescents: The Influence of Imprecision

2017 ◽  
Vol 132 (6) ◽  
pp. 627-636 ◽  
Author(s):  
Anne R. Waldrop ◽  
Jennifer L. Moss ◽  
Benmei Liu ◽  
Li Zhu
Keyword(s):  
Public Health ◽  
New York ◽  
Rhode Island ◽  
Vaccination Coverage ◽  
Hpv Vaccination ◽  
Washington Dc ◽  
Public Health Decision ◽  
High Performing ◽  
Health Decision ◽  
Promotion Campaigns

Objectives: Identifying the best and worst states for coverage of cancer-preventing vaccines (hepatitis B [HepB] and human papillomavirus [HPV]) may guide public health officials in developing programs, such as promotion campaigns. However, acknowledging the imprecision of coverage and ranks is important for avoiding overinterpretation. The objective of this study was to examine states’ vaccination coverage and ranks, as well as the imprecision of these estimates, to inform public health decision making. Methods: We used data on coverage of HepB and HPV vaccines among adolescents aged 13-17 from the 2011-2015 National Immunization Survey-Teen (n = 103 729 from 50 US states and Washington, DC). We calculated coverage, 95% confidence intervals (CIs), and ranks for vaccination coverage in each state, and we generated simultaneous 95% CIs for ranks using a Monte Carlo method with 100 000 simulations. Results: Across years, HepB vaccination coverage was 92.2% (95% CI, 91.8%-92.5%; states’ range, 84.3% in West Virginia to 97.0% in Connecticut). HPV vaccination coverage was 57.4% (95% CI, 56.6%-58.2%; range, 41.8% in Kansas to 78.0% in Rhode Island) for girls and 31.0% (95% CI, 30.3%-31.8%; range, 19.0% in Utah to 59.3% in Rhode Island) for boys. States with the highest and lowest ranks generally had narrow 95% CIs; for example, Rhode Island was ranked first (95% CI, 1-1) and Kansas was ranked 51st (95% CI, 49-51) for girls’ HPV vaccination. However, states with intermediate ranks had wider and more imprecise 95% CIs; for example, New York was 26th for girls’ HPV vaccination coverage, but its 95% CI included ranks 18-35. Conclusions: States’ ranks of coverage of cancer-preventing vaccines were imprecise, especially for states in the middle of the range; thus, performance rankings presented without measures of imprecision could be overinterpreted. However, ranks can highlight high-performing and low-performing states to target for further research and vaccination promotion programming.

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.

Persons with Disabilities and Public Health Ethics

2019 ◽  
pp. 218-231
Author(s):  
Monika Mitra ◽  
Linda Long-Bellil ◽  
Robyn Powell
Keyword(s):  
Public Health ◽  
Health Policy ◽  
Public Health Policy ◽  
Ethical Issues ◽  
The United States ◽  
Policy And Practice ◽  
Persons With Disabilities ◽  
Public Health Decision ◽  
Health Decision ◽  
Health Policy And Practice

This chapter draws on medical, social, and legal perspectives to identify and highlight ethical issues pertaining to the treatment, representation, and inclusion of persons with disabilities in public health policy and practice. A brief history of disability in the United States is provided as a context for examining the key ethical issues related to public health policy and practice. Conceptual frameworks and approaches to disability are then described and applied. The chapter then discusses the imperativeness of expanding access to public health programs by persons with disabilities, the need to address implicit and structural biases, and the importance of including persons with disabilities in public health decision-making.

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. 

PP130 Nudging In Public Health: Accountability For Practical Wisdom

2017 ◽  
Vol 33 (S1) ◽  
pp. 133-134
Author(s):  
Michal Stanak
Keyword(s):  
Public Health ◽  
Decision Maker ◽  
Narrative Analysis ◽  
Practical Wisdom ◽  
Health Gain ◽  
Cost Effective ◽  
Public Health Decision ◽  
Moral Principles ◽  
Health Decision ◽  
Public Scrutiny

INTRODUCTION:Nudging is the application of behavioural sciences aimed at influencing behaviour in a non-prescriptive way. It is a tool of public health decision makers to produce health gain. Just like decisions in the field of Health Technology Assessment (HTA), nudging decisions are inevitably value laden. The current European Network for HTA (EUnetHTA) approach to evaluate ethical aspects encompasses mainly utilitarian and principlistic approaches. The aim of this project is to incorporate the virtue ethics approach in public health decision-making processes based on the example of nudging.METHODS:The narrative analysis of nudging is based on a systematic literature search conducted from 28 October to 13 November 2015 in the following databases: Medline via Ovid, Embase, and TRIP Database. A total of sixty-two articles were listed as relevant as a result of searches and, in addition, twenty-five more articles were found through hand searching.RESULTS:Regardless of the potential issues related to nudging (manipulation or coercion), nudging is considered cost-effective and inevitable because of the malleability of human psychology for example, alcoholic drinks served in smaller glasses nudge people to drink less alcohol.No policy intervention, nudging or HTA, is value neutral and hence it requires an ethical evaluation. It takes traits of character, virtues, to discern which principle to apply in what circumstances and phronesis, practical wisdom, is the key virtue of a decision maker. Phronesis is not a moral judgement deduced from principles, but it is context specific, bottom-up, action orientated, and framed through dialogues. It focuses on the agent, the decision maker, who, via the use public scrutiny, should be held accountable for phronetic decisions made.CONCLUSIONS:Nudging is a cost-effective tool that can improve the populations health in a non-prescriptive way. Transparent reporting open to public scrutiny is necessary for the sake of evaluating whether the decisions made were phronetic for it takes traits of character, virtues, to decide between competing moral principles.

Chaetomium funicola. [Descriptions of Fungi and Bacteria].

2006 ◽  
Author(s):  
D. W. Minter
Keyword(s):  
New York ◽  
North Carolina ◽  
Sierra Leone ◽  
Rhode Island ◽  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Conservation Status ◽  
Northern Territory ◽  
Washington Dc ◽  
Horticultural Crops

Abstract C. funicola is described and illustrated. Information on host range (mainly field and horticultural crops, trees, wood, dung, man and artefacts), geographical distribution (Democratic Republic of Congo; Ethiopia; Ghana; Kenya; Nigeria; Sierra Leone; South Africa; Tanzania; Togo; Uganda; Zambia; Alberta, British Columbia, Manitoba, Nova Scotia and Ontario, Canada); Mexico; California, Florida, Iowa, Kansas, Maryland, Massachusetts, Michigan, Minnesota, Nebraska, New York, North Carolina, Ohio, Oregon, Pennsylvania, Rhode Island, Tennessee, Texas, Washington DC and West Virginia, USA; Nicaragua; Panama; Brazil; Chile; Uruguay; Venezuela; Fujian and Hongkong, China; India; Indonesia; Japan; Malaysia; Pakistan; Papua New Guinea; Philippines; Sri Lanka; Thailand; Capital Territory, Northern Territory, Queensland and Western Australia; New Zealand; Dominica; Jamaica; Belgium; France; Great Britain; Romania; Sweden; Ukraine; Mauritius; and USSR, and conservation status is presented.

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