Using Health Concept Surveying to Elicit Usable Evidence: Case Studies of a Novel Evaluation Methodology

Background Developers, designers, and researchers use rapid prototyping methods to project the adoption and acceptability of their health intervention technology (HIT) before the technology becomes mature enough to be deployed. Although these methods are useful for gathering feedback that advances the development of HITs, they rarely provide usable evidence that can contribute to our broader understanding of HITs. Objective In this research, we aim to develop and demonstrate a variation of vignette testing that supports developers and designers in evaluating early-stage HIT designs while generating usable evidence for the broader research community. Methods We proposed a method called health concept surveying for untangling the causal relationships that people develop around conceptual HITs. In health concept surveying, investigators gather reactions to design concepts through a scenario-based survey instrument. As the investigator manipulates characteristics related to their HIT, the survey instrument also measures proximal cognitive factors according to a health behavior change model to project how HIT design decisions may affect the adoption and acceptability of an HIT. Responses to the survey instrument were analyzed using path analysis to untangle the causal effects of these factors on the outcome variables. Results We demonstrated health concept surveying in 3 case studies of sensor-based health-screening apps. Our first study (N=54) showed that a wait time incentive could influence more people to go see a dermatologist after a positive test for skin cancer. Our second study (N=54), evaluating a similar application design, showed that although visual explanations of algorithmic decisions could increase participant trust in negative test results, the trust would not have been enough to affect people’s decision-making. Our third study (N=263) showed that people might prioritize test specificity or sensitivity depending on the nature of the medical condition. Conclusions Beyond the findings from our 3 case studies, our research uses the framing of the Health Belief Model to elicit and understand the intrinsic and extrinsic factors that may affect the adoption and acceptability of an HIT without having to build a working prototype. We have made our survey instrument publicly available so that others can leverage it for their own investigations.

Mobile Mental Health

Several people with mental health problems do not receive suitable treatment and often avoid or delay seeking help due to concerns about being treated differently and other practical barriers (for example, services costs and unavailability). The mobile health concept has gained more enthusiasts worldwide exactly because it helps mitigate some of these issues. However, despite the emerging scientific evidence in the last decade that proves the efficacy and safety of these interventions, professionals have shown some doubts and worries about their implementation, especially in the mental health field. Thereby, this chapter provides a review on the subject, presenting several mobile applications for mental health problems and also the expectations and needs of health professionals and users for development and implementation of a mobile application.

Saúde vulgar e fabricação do corpo a partir de Georges Canguilhem

O texto parte de uma conferência de Canguilhem sobre o estatuto do conceito de saúde. Trata-se de uma exegese da citação de Epicteto nas Entrevistas (Livro II, 17) que busca explicitar a dupla dimensão da saúde como questão filosófica e como conceito vulgar. Busca-se articular esta formulação tardia e singular da obra de Canguilhem em seu projeto de uma história das ciências da vida compreendida como tarefa filosófica. Neste sentido cabe evocar questões centrais de sua tese Normal e Patológico – especialmente a disjunção entre o par antinômico saúde e doença e a dupla cromática fisiologia-patologia. Enquanto conclusão é oferecida uma articulação do problema com a crisecovid em curso, entendida a partir de impasses do campo biomédico e respostas insatisfatórias das ciências sociais e da filosofia.Palavras-chave: Canguilhem. Corpo. Conceito de saúde. Pandemia. Epicteto. Vulgar health and body fabrication from Georges Canguilhem ABSTRACTThe text is part of a conference by Canguilhem on the status of the concept of health. It is an exegesis of the quote from Epictetus in the Interviews (Book II, 17) that seeks to explain the double dimension of health as a philosophical issue and as a common concept. The aim is to articulate this late and singular formulation of Canguilhem's work in his project for a history of the life sciences understood as a philosophical task. In this sense, central issues of his Normal and Pathological thesis should be evoked – especially the disjunction between the antinomic pair health and disease and the chromatic physiology-pathology pair. As a conclusion, an articulation of the problem with the ongoing crisis is offered, understood from the impasses in the biomedical field and unsatisfactory answers from the social sciences and philosophy.Keywords: Canguilhem. Body. Health concept. Pandemic. Epicteto.

Involvement and Multi-Sectoral Collaboration: Applying Principles of Health Promotion during the Implementation of Local Policies and Measures—A Case Study

Five principles for health promotion (HP) stand out in various forms, providing guidance for HP measures and policy implementation: (1) a broad and positive health concept, (2) participation and involvement of key stakeholders, (3) build action and action competence by involving and empowering target groups, (4) a setting perspective, and (5) equity in health. The purpose of this study is to describe, and critically discuss, how the five HP principles can be applied to structure collaboration processes for implementing HP measures in local communities. A case study methodology was applied when investigating how the HP principles guided actions and focus-of-attention throughout the process of implementing a local community HP measure. Of special importance was the broad involvement of stakeholders and the anchoring of overarching, as well as specific, HP goals in the municipal strategic documents to ensure political commitment, ownership, and adequate resources. Direction on how to apply or achieve the HP principles should be further explored, described, and brought into systematic day-to-day work for a better society-development.

Health, Hygiene and Diets: Medical Missionaries and the Daily Life of Shanghai Residents (1870-1938)

Throughout the nineteenth and twentieth century, China was the main area of western medical missions. Medical missionaries, one of the largest cross-cultural groups, left a wealth of records in a foreign land. In this article the author explored how the housing, environment, drink and diets habits of British medical missionaries in China spread the western medical knowledge, and how the medical missionaries constantly recognized, interpreted and improved the health concept toward Chinese in their daily life. The intercultural communication of medical knowledge between China and the West enriched the western public health theory on the one hand, and promoted the establishment of modern public health system in China on the other hand.

Biochar and Trichoderma spp. in management of plant diseases caused by soilborne fungal pathogens: a review and perspective

A better understanding of the use of biochar with Trichoderma spp. (TRI), considered the most studied tool for biological control, would increase our ability to set priorities. However, no studies exist using the two inputs on plant disease management. Here, we hypothesized that biochar and TRI would be used for the management of soilborne plant pathogens, mainly due to changes in soil properties and its interactions. To test this hypothesis, this review assesses papers that used biochar and TRI against plant diseases and we summarize the handling mechanisms for each input. Biochar acts by mechanisms: induction to plant resistance, sorption of allelopathic and fungitoxic compounds, increase of beneficial microorganisms, changes the soil properties that promote health and nutrient availability. Trichoderma as biocontrol agents by different mechanisms: mycoparasitism, enzyme and secondary metabolic production, plant promoter agent, natural decomposition agent, and biological agent of bioremediation. Overall, our findings expand our knowledge about the reuse of wastes transformed in biochar combined with Trichoderma has potential perspective to formulate products as alternative management tool of plant disease caused by soilborne fungal pathogen and add important information that can be suitable for development of strategy for use in the global health concept.

Trends, relationships and case attribution of antibiotic resistance between children and environmental sources in rural India

Bacterial antibiotic resistance is an important global health threat and the interfaces of antibiotic resistance between humans, animals and the environment are complex. We aimed to determine the associations and overtime trends of antibiotic resistance between humans, animals and water sources from the same area and time and estimate attribution of the other sources to cases of human antibiotic resistance. A total of 125 children (aged 1–3 years old) had stool samples analysed for antibiotic-resistant bacteria at seven time points over two years, with simultaneous collection of samples of animal stools and water sources in a rural Indian community. Newey–West regression models were used to calculate temporal associations, the source with the most statistically significant relationships was household drinking water. This is supported by use of SourceR attribution modelling, that estimated the mean attribution of cases of antibiotic resistance in the children from animals, household drinking water and wastewater, at each time point and location, to be 12.6% (95% CI 4.4–20.9%), 12.1% (CI 3.4–20.7%) and 10.3% (CI 3.2–17.3%) respectively. This underlines the importance of the ‘one health’ concept and requires further research. Also, most of the significant trends over time were negative, suggesting a possible generalised improvement locally.

Environmental health: The most neglected part of one health

One health concept and perspectives have gained momentum in past few years in global health sector. Keeping in view the increased popularity of “one health” American Veterinary & Medical Association has defined it as the emerging interdisciplinary field that inherently collaborates human, animal and environmental aspects to combat emerging global health problems especially related to zoonotic public health emergencies. According to key findings of “One Health Networks (OHNs)” environmental factor is the most neglected part of one health triad that consists of human-animal-environment interface. Currently, human and animal health has been constantly threatened by rise of novel challenges like antimicrobial resistance, environmental pollution, epizootics, pandemics, development of multifactorial chronic ailments etc which needs an interdisciplinary and intersectoral expertise. Ecosystem heath and its adverse effects on human and animal health have gained greatest attention over recent years as it serves as melting pot for all infectious diseases. Despite of achieving global success in the field of “One health” it is still in embryonic stage in our country. So, the success of one health requires breaking down the shackles that still separate human and veterinary medicine from environmental, evolutionary and ecological sciences that will ultimately lead to desired equilibrium and dynamics in maintaining healthy ecosystems.