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Public health ethics

E J Cooper, S M Driedger
OBJECTIVES: Good knowledge translation efforts can lead to significant changes in health status and service delivery. Although there is growing literature around ways to conduct knowledge translation within policy and health service delivery sectors, literature around how to conduct dissemination within indigenous community-based contexts remains scant. STUDY DESIGN: Using creative, strengths-based approaches to not only return results but also to function as tools to address gaps in health knowledge as identified by participants and community members within intergenerational contexts was a central component applied to dissemination and knowledge translation...
August 8, 2018: Public Health
Raymond G De Vries, Kerry A Ryan, Linda Gordon, Chris D Krenz, Tom Tomlinson, Scott Jewell, Scott Y H Kim
Do members of the public believe that biobanks should accommodate the moral concerns of donors about the types of research done with their biospecimens? The answer to this question is critical to the future of genomic and precision medicine, endeavors that rely on a public willing to share their biospecimens and medical data. To explore public attitudes regarding the requirements of consent for biobank donations, we organized three democratic deliberations involving 180 participants. The deliberative sessions involved small group discussions informed by presentations given by experts in both biobank research and ethics...
August 10, 2018: Qualitative Health Research
James W F Catto, Pramit Khetrapal, Gareth Ambler, Rachael Sarpong, Muhammad Shamim Khan, Melanie Tan, Andrew Feber, Simon Dixon, Louise Goodwin, Norman R Williams, John McGrath, Edward Rowe, Anthony Koupparis, Chris Brew-Graves, John D Kelly
INTRODUCTION: Bladder cancer (BC) is a common malignancy and one of the most expensive to manage. Radical cystectomy (RC) with pelvic lymphadenectomy is a gold standard treatment for high-risk BC. Reductions in morbidity and mortality from RC may be achieved through robot-assisted RC (RARC). Prospective comparisons between open RC (ORC) and RARC have been limited by sample size, use of extracorporeal reconstruction and use of outcomes important for ORC. Conversely, while RARC is gaining in popularity, there is little evidence to suggest it is superior to ORC...
August 8, 2018: BMJ Open
Emma S Walker, Ruth A Roberts
From animal research through adverse events in clinical trials to health scares around food contamination, toxicology has frequently been a focus of scientific and societal concern. As these concerns shift with each new drug, new technology or public health scare, how can toxicology stay current, relevant and ethical? Two of the biggest ethical challenges in pharmaceutical toxicology are the use of animals in testing and the high safety-related attrition rates in new drug development. Both of these require progress in the discipline that will only be driven by research funding...
July 1, 2018: Toxicology Research
Kolitha Wickramage, Jo Vearey, Anthony B Zwi, Courtland Robinson, Michael Knipper
BACKGROUND: With 244 million international migrants, and significantly more people moving within their country of birth, there is an urgent need to engage with migration at all levels in order to support progress towards global health and development targets. In response to this, the 2nd Global Consultation on Migration and Health- held in Colombo, Sri Lanka in February 2017 - facilitated discussions concerning the role of research in supporting evidence-informed health responses that engage with migration...
August 8, 2018: BMC Public Health
Mesafint Abeje Tiruneh, Birhanu Teshome Ayele
INTRODUCTION: In the health sector, questions are being raised about the possible threats to the accepted principles of ethics such as autonomy, beneficence, non malfeasance and justice in the delivery of health care. There is limited information in Ethiopia regarding to practice of code of ethics among medical doctors. Hence, this study aimed to assess practice of code of ethics and associated factors among medical doctors working in governmental and private hospitals in Addis Ababa, Ethiopia...
2018: PloS One
Amy Lauren Fairchild, Ronald Bayer, Sharon H Green, James Colgrove, Elizabeth Kilgore, Monica Sweeney, Jay K Varma
Fear is now commonly used in public health campaigns, yet for years ethical and efficacy-centered concerns provided a challenge to using fear in such efforts. From the 1950s through the 1970s, the field of public health believed that using fear to influence individual behavior would virtually always backfire. Yet faced with the limited effectiveness of informational approaches to cessation, antitobacco campaigns featured fear in the 1960s. These provoked little protest outside the tobacco industry. At the outset of the AIDS epidemic, fear was also employed...
September 2018: American Journal of Public Health
Xin Zhou, Xiaomei Liao, Lauren M Kunz, Sharon-Lise T Normand, Molin Wang, Donna Spiegelman
In stepped wedge designs (SWD), clusters are randomized to the time period during which new patients will receive the intervention under study in a sequential rollout over time. By the study's end, patients at all clusters receive the intervention, eliminating ethical concerns related to withholding potentially efficacious treatments. This is a practical option in many large-scale public health implementation settings. Little statistical theory for these designs exists for binary outcomes. To address this, we utilized a maximum likelihood approach and developed numerical methods to determine the asymptotic power of the SWD for binary outcomes...
August 1, 2018: Biostatistics
A Bechini, M Chellini, E Pellegrino, E Tiscione, C Lorini, G Bonaccorsi, P Bonanni, S Boccalini
The World Health Organization (WHO) has established specific targets for control, elimination or eradication of some vaccine preventable infectious diseases, which were periodically updated. In Italy, WHO recommendations have been endorsed and implemented over time, through the national and regional health prevention plans. The aim of the study was to assess the impact of the immunization practices against measles, varicella and Neisseria meningitidis type C (Men C) in Italy and in Tuscany Region, during the last decades, by analyzing national and regional surveillance databases...
June 2018: Journal of Preventive Medicine and Hygiene
Belinda J Gabbe, Joanna F Dipnall, John W Lynch, Frederick P Rivara, Ronan A Lyons, Shanthi Ameratunga, Mariana Brussoni, Fiona E Lecky, Clare Bradley, Pam M Simpson, Ben Beck, Joanne C Demmler, Jane Lyons, Amy Schneeberg, James E Harrison
INTRODUCTION: Traumatic injury is a leading contributor to the global disease burden in children and adolescents, but methods used to estimate burden do not account for differences in patterns of injury and recovery between children and adults. A lack of empirical data on postinjury disability in children has limited capacity to derive valid disability weights and describe the long-term individual and societal impacts of injury in the early part of life. The aim of this study is to establish valid estimates of the burden of non-fatal injury in children and adolescents...
August 5, 2018: BMJ Open
Johanna Tomandl, Stephanie Book, Susann Gotthardt, Stefan Heinmueller, Elmar Graessel, Ellen Freiberger, Thomas Kuehlein, Susann Hueber, Stefanie Hoyer
INTRODUCTION: With the medical focus on disease, the problem of overdiagnosis inevitably increases with ageing. Considering the functional health of patients might help to discriminate between necessary and unnecessary medicine. The International Classification of Functioning, Disability and Health (ICF) is an internationally recognised tool for describing functional health. However, it is too detailed to be used in primary care practices. Consequently, the aim of this study is to identify relevant codes for an ICF core set for community-dwelling older adults (75 years and above) in primary care...
August 5, 2018: BMJ Open
Essi Heinonen, Barbara Szymanska-von Schultz, Viktor Kaldo, Josefine Nasiell, Ewa Andersson, Mikaela Bergmark, Margareta Blomdahl-Wetterholm, Lisa Forsberg, Erik Forsell, Anna Forsgren, Sandra Frööjd, Amy Goldman, Eva-Mari Nordenadler, Myrto Sklivanioti, Mats Blennow, Katarina Wide, Lars L Gustafsson
INTRODUCTION: Ten per cent of all pregnant women are depressed. Standard therapy of pregnant women with moderate depression is selective serotonin reuptakeinhibitors (SSRI). Observational studies on neurodevelopment after fetal SSRI exposure show conflicting results. Our primary objective is to compare the cognitive development in children exposed to sertraline and maternal depression with those exposed to maternal depression and placebo in utero. We hypothesise that there is a significant neurodevelopmental difference between the groups...
August 5, 2018: BMJ Open
Katherine H A Footer, Emily Clouse, Diana Rayes, Zaher Sahloul, Leonard S Rubenstein
OBJECTIVES: To explore the impact of the conflict, including the use of chemical weapons, in Syria on healthcare through the experiences of health providers using a public health and human rights lens. DESIGN: A qualitative study using semi-structured interviews conducted in-person or over Skype using a thematic analysis approach. SETTING: Interviews were conducted with Syrian health workers operating in opposition-held Syria in cooperation with a medical relief organisation in Gaziantep, Turkey...
August 5, 2018: BMJ Open
Angela Melder, Prue Burns, Ian Mcloughlin, Helena Teede
INTRODUCTION: Healthcare service redesign and improvement has become an important activity that health system leaders and clinicians realise must be nurtured and mastered, if the capacity issues that constrain healthcare delivery are to be solved. However, little is known about the critical success factors that are essential for sustaining and scaling up improvement initiatives. This situation limits the impact of these initiatives and undermines the general standing of redesign and improvement activity within healthcare systems...
August 5, 2018: BMJ Open
Diane Levin-Zamir, Isabella Bertschi
Health literacy describes skills and competencies that enable people to gain access to, understand and apply health information to positively influence their own health and the health of those in their social environments. In an increasingly media saturated and digitized world, these skill sets are necessary for accessing and navigating sources of health information and tools, such as television, the Internet, and mobile apps. The concepts of Media Health Literacy (MHL) and eHealth Literacy (eHL) describe the specific competencies such tasks require...
August 3, 2018: International Journal of Environmental Research and Public Health
Stephen M Modell, Toby Citrin, Sharon L R Kardia
The United States Precision Medicine Initiative (PMI) was announced by then President Barack Obama in January 2015. It is a national effort designed to take into account genetic, environmental, and lifestyle differences in the development of individually tailored forms of treatment and prevention. This goal was implemented in March 2015 with the formation of an advisory committee working group to provide a framework for the proposed national research cohort of one million or more participants. The working group further held a public workshop on participant engagement and health equity, focusing on the design of an inclusive cohort, building public trust, and identifying active participant engagement features for the national cohort...
August 3, 2018: Healthcare (Basel, Switzerland)
James P Collins
Gene drives are systems of biased inheritance that enhance the likelihood a sequence of DNA passes between generations through sexual reproduction and potentially throughout a local population and ultimately all connected populations of a species. Gaps in our knowledge of gene drive systems prompted the US National Institutes of Health (NIH) and the Foundation for the NIH to ask the US National Academies of Sciences, Engineering, and Medicine (NASEM) to convene an expert panel to provide an independent, objective examination of what we know about gene drive systems...
2018: BMC Proceedings
R Montag, W Dietz, S Nietzsche, T Lang, K Weich, B W Sigusch, P Gaengler
Prospective clinical studies of composite restorations revealed their safety and longevity; however, studies did not elucidate the dynamic mechanisms of deterioration caused by fractures and secondary caries. Therefore, the aims of this 29-y controlled study were 1) to follow up on the clinical behavior of posterior composite restorations annually and 2) to compare clinical outcomes with micromorphologic scanning electron microscopy features. After ethical approval, the single-arm study commenced in 1987 with 194 class I or II primary posterior composite restorations with glass ionomer cement providing pulp protection...
August 1, 2018: Journal of Dental Research
Simone Lanini, Raffaella Pisapia, Maria Rosaria Capobianchi, Giuseppe Ippolito
The World Health Organization recognizes that viral hepatitis is not only a massive public health issue but also a huge opportunity to improve quality of life and equity at a global level. Viral hepatitis causes about 1.5 million deaths each year and significantly affects the quality of life of hundreds of millions of people. To date, frail individuals in high-income countries and people living in low-income settings are paying the heaviest tool. Areas covered. Here we present a broad discussion on current knowledge and topical issues about the hepatitis pandemic...
August 2, 2018: Expert Review of Anti-infective Therapy
Sandro Colombo, Francesco Checchi
Accurate, relevant and timely public health information is paramount in a humanitarian crisis: it can help to identify needs and priorities, guide decisions on interventions and resource allocation, monitor trends, evaluate the effectiveness of the response, support advocacy for human rights, and extract lessons that could be relevant in similar contexts. The present review shows, however, that the public health information available in humanitarian crises is, in general, inadequate and that its application is secondary to reasoning and incentives of a political nature, thus contributing to the recurrent failings of humanitarian action...
May 2018: Epidemiologia e Prevenzione
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