scholarly journals Wider, faster, more: Re-envisioning the treatment and research of depression to address its public health burden in the United States

2022 ◽  
Author(s):  
Lorenzo Lorenzo-Luaces
Keyword(s):  
Public Health ◽  
The United States ◽  
Internalizing Disorders ◽  
Stepped Care ◽  
Public Health Burden ◽  
The Public ◽  
Health Burden ◽  
Effective Interventions ◽  
High Prevalence ◽  
Internalizing Disorder

Depression and other internalizing disorder symptoms are leading causes of disability in theUnited States. Although there are effective interventions, the burden of disability attributableto internalizing disorder symptoms is not decreasing. I review clinical and epidemiological datato identify solutions to the public health burden of internalizing disorder symptoms. Contemporary research efforts have a focus on treatment development and the identification of biomarkers of response. However, these solutions are not scalable because internalizing disorders are much more common than usually appreciated and there are substantial disparities in access to mental health care. Improving the dissemination of individual interventions may also be of limited value given data suggesting that high rates of symptom remission can only be achieved with multiple (e.g., 4-10) treatment steps. The logic of stepped care approaches for internalizing disorders is well-supported by these data, but initial treatments likely should be low-intensity and “stepping up” should occur more quickly than usually done in most trials. Efforts that promise to make an impact in the public health burden of internalizing disorder symptoms need to consider their high prevalence and heterogeneity in the level of care as well as in the mechanisms that treatments may need to engage.

Who, When, and Where?

2020 ◽  
pp. 21-34
Author(s):  
Pamela K. Keel
Keyword(s):  
Public Health ◽  
United States ◽  
Clinical Presentation ◽  
The United States ◽  
Public Health Burden ◽  
The Public ◽  
Purging Disorder ◽  
Cultural Ideals ◽  
Health Burden ◽  
Insight Into

Answering “who, when, and where?” establishes the public health burden associated with purging disorder and gives us insight into why someone develops the illness. Right now, over 2 million girls and women in the United States have purging disorder, and they are joined by another half-million boys and men. Cases of hysterical vomiting from the late 1800s resemble purging disorder in some respects, but vomiting in purging disorder is intentional and directed toward influencing weight or shape, supporting the influence of modern idealization of thinness. Finally, we see the emergence of purging to control weight and purging disorder following the introduction of Western cultural ideals into non-Western contexts. Non-Western cultures further shape the clinical presentation of purging disorder with misuse of traditional herbal emetics to produce purging.

The public health burden of emergency general surgery in the United States

2014 ◽  
Vol 77 (2) ◽  
pp. 202-208 ◽  
Author(s):  
Stephen C. Gale ◽  
Shahid Shafi ◽  
Viktor Y. Dombrovskiy ◽  
Dena Arumugam ◽  
Jessica S. Crystal
Keyword(s):  
Public Health ◽  
United States ◽  
General Surgery ◽  
The United States ◽  
Emergency General Surgery ◽  
Public Health Burden ◽  
The Public ◽  
Health Burden

scholarly journals Research output and the public health burden of cancer: is there any relationship?

2016 ◽  
Vol 23 (2) ◽  
pp. 75 ◽  
Author(s):  
F.M. Patafio ◽  
S.C. Brooks ◽  
X. Wei ◽  
Y. Peng ◽  
J. Biagi ◽  
...  
Keyword(s):  
Public Health ◽  
Clinical Trials ◽  
Cancer Mortality ◽  
Research Funding ◽  
Research Output ◽  
Cancer Site ◽  
Relative Distribution ◽  
Public Health Burden ◽  
The Public ◽  
Health Burden

Purpose The relative distribution of research output across cancer sites is not well described. Here, we evaluate whether the volume of published research is proportional to the public health burden of individual cancers. We also explore whether research output is proportional to research funding.Methods Statistics from the Canadian and American cancer societies were used to identify the top ten causes of cancer death in 2013. All journal articles and clinical trials published in 2013 by Canadian or U.S. authors for those cancers were identified. Total research funding in Canada by cancer site was obtained from the Canadian Cancer Research Alliance. Descriptive statistics and Pearson correlation coefficients were used to describe the relationship between research output, cancer mortality, and research funding.Results We identified 19,361 publications and 2661 clinical trials. The proportion of publications and clinical trials was substantially lower than the proportion of deaths for lung (41% deaths, 15% publications, 16% clinical trials), colorectal (14%, 7%, 6%), pancreatic (10%, 7%, 5%), and gastroesophageal (7%, 5%, 3%) cancers. Conversely, research output was substantially greater than the proportion of deaths for breast cancer (10% deaths, 29% publications, 30% clinical trials) and prostate cancer (8%, 15%, 17%). We observed a stronger correlation between research output and funding (publications r = 0.894, p < 0.001; clinical trials r = 0.923, p < 0.001) than between research output and cancer mortality (r = 0.363, p = 0.303; r = 0.340, p = 0.337).Conclusions Research output is not well correlated with the public health burden of individual cancers, but is correlated with the relative level of research funding.

Fighting the Public Health Burden of AIDS With the Human Pegivirus

2019 ◽  
Vol 188 (9) ◽  
pp. 1586-1594 ◽  
Author(s):  
Scott Greenhalgh ◽  
Rebecca Schmidt ◽  
Troy Day
Keyword(s):  
Public Health ◽  
Highly Active Antiretroviral Therapy ◽  
Health Benefit ◽  
Immune Deficiency Syndrome ◽  
Morbidity And Mortality ◽  
Public Health Burden ◽  
The Public ◽  
Health Burden ◽  
Life Years ◽  
Hiv Aids

Abstract Highly active antiretroviral therapy has revolutionized the battle against human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS). From its current global rollout, HIV/AIDS morbidity and mortality has been greatly reduced, yet there exists substantial interest in the development of new therapies to further mitigate the HIV/AIDS health burden and to inhibit any fallout from the development of antiretroviral drug resistance. One potential intervention is the human pegivirus (HPgV). HPgV is not known to cause disease, and most remarkably it is shown to delay the progression of HIV to AIDS. However, the health benefit of increasing HPgV prevalence in the community of HIV-infected men remains unknown at the public health level. We evaluated the utility of HPgV biovaccination for mitigating the HIV/AIDS health burden using mathematical models. Importantly, our work considers the potential concern that HPgV will, itself, evolve to become disease-causing by permitting mutant disease-causing HPgV strains to potentially arise during treatment. Our findings show that HPgV biovaccination rates of 12.5%–50% annually could prevent 4.2–23.6 AIDS incidences and 3.3–18.8 AIDS deaths, and could save 2.9–18.6 disability-adjusted life years per 1,000 people. Together, these findings indicate that HPgV biovaccination could be an effective therapy for reducing HIV/AIDS morbidity and mortality, and thus warrants further exploration.

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