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Public health emergency

Abigail R A Aiken, Elisa Padron, Kathleen Broussard, Dana Johnson
BACKGROUND: In Northern Ireland, abortion is illegal except in very limited circumstances to preserve a woman's life or to prevent permanent or long-term injury to her physical or mental health. Abortions conducted outside the law are a criminal offence punishable by imprisonment. We assessed the impacts of Northern Ireland's abortion laws on women's decision-making and experiences in accessing abortion. METHODS: Between April 2017 and February 2018 we interviewed 30 women living in Northern Ireland who had sought abortion by travelling to a clinic in Great Britain or by using online telemedicine to self-manage a medication abortion at home...
October 19, 2018: BMJ sexual & reproductive health
Lauren E Kelly, Michele P Dyson, Nancy J Butcher, Robert Balshaw, Alex John London, Christine J Neilson, Anne Junker, Salaheddin M Mahmud, S Michelle Driedger, Xikui Wang
BACKGROUND: Although children have historically been excluded from clinical trials (CTs), many require medicines tested and approved in CTs, forcing health care providers to treat their pediatric patients based on extrapolated data. Unfortunately, traditional randomized CTs can be slow and resource-intensive, and they often require multi-center collaboration. However, an adaptive design (AD) framework for CTs could be used to increase the efficiency of pediatric CTs by incorporating prospectively planned modifications to CT methods without undermining the integrity or validity of the study...
October 19, 2018: Trials
Hilary M Schwandt, Bethany Sparkle, Moriah Post-Kinney
BACKGROUND: In 2014, the governor of Washington State mandated that all hospitals publically post a reproductive health policy amidst concerns about the lack of clarity among the public how hospitals handled various aspects of reproductive health care. METHODS: The objective of this study is to assess the clarity of abortion and contraception service provision in the hospital reproductive health policies for the public in Washington State. All Washington State hospital reproductive health policies (n = 88) were analyzed in 2016 using content analysis...
October 19, 2018: Reproductive Health
Holly A Taylor, Lainie Rutkow, Daniel J Barnett
As ecologic, social, and economic conditions continue to facilitate the emergence and transmission of infectious diseases, local health department workers' willingness to respond will remain vital to the United States' ability to recognize and respond to new and emerging disease threats. As demonstrated by heavy occupational morbidity and mortality associated with the 2014 Ebola outbreak, infectious disease response can pose serious risks to the health workforce and presents many ethical and logistical challenges...
September 2018: Health Security
Feng-Jen Tsai, Rebecca Katz
In 2016, the World Health Organization moved from using only a self-assessment to monitor national implementation of the International Health Regulations (IHR) to introducing an external evaluation process. In this article, we use preliminary findings from the published Joint External Evaluations to identify if and how the external evaluations differ from IHR self-assessments conducted in the same year. We found that of the 32 countries for which data were available, external assessment scores are consistently 1 to 1...
September 2018: Health Security
Chicora F Oliver, Joseph J Palamar, Alberto Salomone, Steven J Simmons, Helene L Philogene-Khalid, Nick Stokes-McCloskey, Scott M Rawls
RATIONALE: Current prevalence estimates of synthetic cathinone ("bath salt") use may be underestimates given that traditional metrics (e.g., surveys, urinalysis) often fail to capture the emergent issue of synthetic cathinone adulteration of more common illegal drugs, such as ecstasy (3,4-methylenedioxymethamphetamine). OBJECTIVES: This review examines the evolution of synthetic cathinones and prevalence of use over the past decade in the United States...
October 18, 2018: Psychopharmacology
Ahmad Shahzad, Muhammad Masood Ahmad, Ijaz Anwer, Noor Ijaz, Maheen Shahzad, Muhammad Usman
INTRODUCTION: Diabetes mellitus is an emerging public health concern. The aim of this study was to assess the gender-specific knowledge of patients about diabetes mellitus, its complications, and its management. METHODS: A cross-sectional study was conducted in outpatient clinics of Faisalabad, Pakistan, from November 2017 to March 2018. Consecutive patients with diabetes, aged >18 years, were administered a validated questionnaire related to knowledge of diabetes, its complications, and its management...
August 8, 2018: Curēus
Zoe F Cairncross, Jeremy Herring, Trevor van Ingen, Brendan T Smith, Pamela Leece, Brian Schwartz, Karin Hohenadel
BACKGROUND: Negative health outcomes associated with the use of both prescribed and nonprescribed opioids are increasingly prevalent. We examined long-term trends in opioid-related harms in Ontario across a set of 6 indicators and the relation between harms and neighbourhood income in 2016. METHODS: We examined rates of neonatal abstinence syndrome, opioid poisoning (fatal and nonfatal) and nonpoisoning opioid-related events from 2003 to 2016 in Ontario using population-based health administrative databases...
October 2018: CMAJ Open
Katie Attwell, Mark C Navin, Pier Luigi Lopalco, Christine Jestin, Sabine Reiter, Saad B Omer
BACKGROUND: In response to recent outbreaks of vaccine-preventable diseases and concerns around vaccine refusal, several high-income countries have adopted or reformed vaccine mandate policies. While all make it more difficult for parents to refuse vaccines, the nature and scope of 'mandatory vaccination' is heterogeneous, and there has been no attempt to develop a detailed, comparative systematic account of the possible forms mandates can take. METHODS: We compare the construction, introduction/amendment, and operation of six new high profile vaccine mandates in Australia, France, Germany, Italy, California, and Washington...
October 15, 2018: Vaccine
Neil W Anderson, Phillip I Tarr
Multiplex nucleic acid testing is increasingly used to diagnose childhood gastroenteritis. The advantages of this disruptive technology include rapidity, sensitivity, and ability to detect pathogenic viruses, bacteria, and parasites simultaneously. The drawbacks are its capacity to identify organisms of uncertain clinical significance in North American children, cost, and inability to provide viable bacteria for strain typing by public health authorities. However, this technology will certainly improve our knowledge of the causes of human gut infections...
December 2018: Gastroenterology Clinics of North America
Briana Loomis, Kenneth Epstein, Emily F Dauria, Lynn Dolce
BACKGROUND: Trauma is a ubiquitous and harmful public health concern. Much like individuals, organizations experience trauma and can embed it within their culture. Left unaddressed, trauma inhibits staff from confronting problems, communicating effectively, and generating solutions, factors that undermine organizational functioning. In response to trauma's far-reaching impact, recent efforts have focused on creating "trauma-informed" systems that emphasize safety and avoid retraumatization...
October 18, 2018: Health Education & Behavior: the Official Publication of the Society for Public Health Education
Hailun Liang, Lei Tao, Eric W Ford, May A Beydoun, Shaker M Eid
BACKGROUND: Optimal cancer care entails coordination among multiple providers and continued follow-up and surveillance over time. The patient-centered care brings opportunities to improve the delivery of cancer care. The adoption of patient-centered oncology care (PCOC) is in its infancy. Evidence synthesis on the model's effectiveness is scant. PURPOSES: This is the first systemic review and meta-analysis on associations of PCOC with cancer patients' adverse health care utilization, cost, patient satisfaction, and quality of care...
October 17, 2018: Health Care Management Review
Teresa A Batteiger, Brian E Dixon, Jane Wang, Zuoyi Zhang, Guoyu Tao, Yan Tong, Wanzhu Tu, Sarah A Hoover, Janet N Arno
BACKGROUND: Despite major efforts to control their spread, reported sexually transmitted infections (STI) are increasing. Using data from a mid-sized Midwest metropolitan area, we examined the settings in which individuals are tested for gonorrhea and chlamydia in relation to demographics and test result to determine where interventions may best be focused. METHODS: A de-identified and integrated registry, containing records from all patients tested for an STI from 2003-2014, was created by combining data from a large health information exchange and the reporting district's STI Program located in Indianapolis, IN...
October 16, 2018: Sexually Transmitted Diseases
Peter H Kilmarx, Flora Katz, Myat Htoo Razak, John Palen, Laura W Cheever, Roger I Glass
Faced with a critical shortage of physicians in Africa, which hampered the efforts of the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), the Medical Education Partnership Initiative (MEPI) was established in 2010 to increase the number of medical graduates, the quality of their education, and their retention in Africa. To summarize the accomplishments of the initiative, lessons learned, and remaining challenges, the authors conducted a narrative review of MEPI-from the perspectives of the U.S. government funding agencies and implementing agencies-by reviewing reports from grantee institutions and conducting a search of scientific publications about MEPI...
October 16, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
Ioannis D Morres, Antonis Hatzigeorgiadis, Afroditi Stathi, Nikos Comoutos, Chantal Arpin-Cribbie, Charalampos Krommidas, Yannis Theodorakis
Although exercise is associated with depression relief, the effects of aerobic exercise (AE) interventions on clinically depressed adult patients have not been clearly supported. The purpose of this meta-analysis was to examine the antidepressant effects of AE versus nonexercise comparators exclusively for depressed adults (18-65 years) recruited through mental health services with a referral or clinical diagnosis of major depression. Eleven e-databases and bibliographies of 19 systematic reviews were searched for relevant randomized controlled clinical trials...
October 18, 2018: Depression and Anxiety
Heejung Son, Wang Jun Lee, Hyun Soo Kim, Kkot Sil Lee, Myoungsoon You
ABSTRACTHospital workers are critical for a successful response to an infectious disease outbreak and for preventing disease transmission to the community. Therefore, hospital crisis management should implement efforts to improve hospital workers' preparedness in responding to public health emergencies caused by infectious diseases. Traditionally, preparedness and skill of hospital workers have been emphasized, but awareness of the importance of the emotional mindset of hospital workers in dealing with disease outbreaks has only recently increased; therefore, empirical approaches to examining emotional responses of hospital workers has been limited...
October 18, 2018: Disaster Medicine and Public Health Preparedness
Anna Maria Geretti, Harrison Austin, Giovanni Villa, Dan Hungerford, Colette Smith, Paula Davies, Jillian Williams, Apostolos Beloukas, Wojciech Sawicki, Mark Hopkins
Eliminating hepatitis C as a public health threat requires an improved understanding of how to increase testing uptake. We piloted point-of-care testing (POCT) for a current HCV infection in an inner-city Emergency Department (ED) and assessed the influence on uptake of offering concomitant screening for HIV. Over four months, all adults attending ED with minor injuries were first invited to complete an anonymous questionnaire then invited to test in alternating cycles offering HCV POCT or HCV+HIV POCT. Viral RNA was detected in finger-prick blood by GeneXpert...
October 17, 2018: Scientific Reports
Xiao Bin Lai, Frances Kam Yuet Wong, Shirley Siu Yin Ching
BACKGROUND: More patients are dying in non-palliative care settings than in palliative care settings. How health care providers care for adult patients at the end-of-life stage in non-palliative care settings has not been adequately explored. The aim of this study was to explore the experiences of health care providers in caring for patients at the end-of-life stage in non-palliative care settings. METHODS: This is a qualitative study. Twenty-six health care providers from eight health care institutions which are based in Shanghai were interviewed individually between August 2016 and February 2017...
October 17, 2018: BMC Palliative Care
Junjie Zou, Juanfang Lin, Chao Li, Ruirui Zhao, Lulu Fan, Jesse Yu, Jingwei Shao
BACKGROUND: Cancer metastasis has emerged as a major public health threat that cause majority of cancer fatalities. Traditional chemotherapeutics have been effective in the past but suffer from low therapeutic efficiency and harmful side-effects. Recently, it has been reported ursolic acid (UA), one of the naturally abundant pentacyclic triterpenes, possesses a wide range of biological activities including anti-inflammatory, anti-atherosclerotic, and anti-cancer properties. More importantly, UA has the features of low toxicity, liver protection and the potential of anti-cancer metastasis...
October 16, 2018: Current Cancer Drug Targets
Mary K Crow, Mikhail Olferiev, Kyriakos A Kirou
Type I interferons, which make up the first cytokine family to be described and are the essential mediators of antivirus host defense, have emerged as central elements in the immunopathology of systemic autoimmune diseases, with systemic lupus erythematosus as the prototype. Lessons from investigation of interferon regulation following virus infection can be applied to lupus, with the conclusion that sustained production of type I interferon shifts nearly all components of the immune system toward pathologic functions that result in tissue damage and disease...
October 17, 2018: Annual Review of Pathology
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