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Ethics infectious disease

Christiana R Dallas, Curtis H Harris, Cham E Dallas
In the U.S., migration has been documented to affect the prevalence of infectious disease. As a mitigation entity, border security has been recorded by numerous scholarly works as being essential to the support of the health of the U.S. POPULATION: Consequently, the lack of current health care monitoring of the permeable U.S. border places the U.S. population at risk in the broad sectors of infectious disease and interpersonal violence. Visualizing border security in the context of public health mitigation has significant potential to protect migrant health as well as that of all populations on both sides of the border...
March 15, 2018: Disaster Medicine and Public Health Preparedness
Jasper Littmann, Alena Buyx
Antibiotics resistance presents one of the major challenges for health care in the twenty-first century. This paper examines the ethical problems that arise as a result of antibiotic resistance. Two main categories of ethical problems in infectious disease control are distinguished: those that are exacerbated by antibiotics resistance, and those that are a direct result of antibiotics resistance. The second category, which is considered in greater detail in this paper, includes, among others, issues of fair distribution of effective antibiotics, if they are considered a scarce resource...
March 13, 2018: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
Sebastian F Winter, Stefan F Winter
BACKGROUND: There is ample evidence that since the turn of the millennium German health policy made a considerable step towards prevention and health promotion, putting the strategies of 'personal empowerment' and 'settings based approach' high on the federal government's agenda. This phenomenon has challenged the role of ethics in health policy. Concurrently, increasing relevance of the Concept of Human Dignity for health and human rights has been discussed. However, a direct relationship between Human Dignity and Public Health Ethics (PHE) has surprisingly not yet been established...
June 10, 2017: International Journal of Health Policy and Management
Dorien T Beeres, Darren Cornish, Machiel Vonk, Sofanne J Ravensbergen, Els L M Maeckelberghe, Pieter Boele Van Hensbroek, Ymkje Stienstra
BACKGROUND: With a large number of forcibly displaced people seeking safety, the EU is facing a challenge in maintaining solidarity. Europe has seen millions of asylum seekers crossing European borders, the largest number of asylum seekers since the second world war. Endemic diseases and often failing health systems in their countries of origin, and arduous conditions during transit, raise questions around how to meet the health needs of this vulnerable population on arrival in terms of screening, vaccination, and access to timely and appropriate statutory health services...
March 2, 2018: BMC Medical Ethics
Bridget Haire, Paul Komesaroff, Rose Leontini, C Raina MacIntyre
Vaccination is a highly effective public health strategy that provides protection to both individuals and communities from a range of infectious diseases. Governments monitor vaccination rates carefully, as widespread use of a vaccine within a population is required to extend protection to the general population through "herd immunity," which is important for protecting infants who are not yet fully vaccinated and others who are unable to undergo vaccination for medical or other reasons. Australia is unique in employing financial incentives to increase vaccination uptake, mainly in the form of various childcare payments and tax benefits linked to timely, age-appropriate vaccination...
March 1, 2018: Journal of Bioethical Inquiry
Robin Christensen, Berit L Heitmann, Karina Winther Andersen, Ole Haagen Nielsen, Signe Bek Sørensen, Mohamad Jawhara, Anette Bygum, Lone Hvid, Jakob Grauslund, Jimmi Wied, Henning Glerup, Ulrich Fredberg, Jan Alexander Villadsen, Søren Geill Kjær, Jan Fallingborg, Seyed A G R Moghadd, Torben Knudsen, Jacob Brodersen, Jesper Frøjk, Jens Frederik Dahlerup, Anders Bo Bojesen, Grith Lykke Sorensen, Steffen Thiel, Nils J Færgeman, Ivan Brandslund, Tue Bjerg Bennike, Allan Stensballe, Erik Berg Schmidt, Andre Franke, David Ellinghaus, Philip Rosenstiel, Jeroen Raes, Mette Boye, Lars Werner, Charlotte Lindgaard Nielsen, Heidi Lausten Munk, Anders Bathum Nexøe, Torkell Ellingsen, Uffe Holmskov, Jens Kjeldsen, Vibeke Andersen
INTRODUCTION: Chronic inflammatory diseases (CIDs) are frequently treated with biological medications, specifically tumour necrosis factor inhibitors (TNFi)). These medications inhibit the pro-inflammatory molecule TNF alpha, which has been strongly implicated in the aetiology of these diseases. Up to one-third of patients do not, however, respond to biologics, and lifestyle factors are assumed to affect treatment outcomes. Little is known about the effects of dietary lifestyle as a prognostic factor that may enable personalised medicine...
February 8, 2018: BMJ Open
Sylvie Delhalle, Sebastian F N Bode, Rudi Balling, Markus Ollert, Feng Q He
Big data generation and computational processing will enable medicine to evolve from a "one-size-fits-all" approach to precise patient stratification and treatment. Significant achievements using "Omics" data have been made especially in personalized oncology. However, immune cells relative to tumor cells show a much higher degree of complexity in heterogeneity, dynamics, memory-capability, plasticity and "social" interactions. There is still a long way ahead on translating our capability to identify potentially targetable personalized biomarkers into effective personalized therapy in immune-centralized diseases...
2018: NPJ Systems Biology and Applications
Roni Bitterman, Noa Eliakim-Raz, Inbal Vinograd, Anca Zalmanovici Trestioreanu, Leonard Leibovici, Mical Paul
BACKGROUND: This is an update of the Cochrane review published in 2013, Issue 10.Immunosuppressed cancer patients are at increased risk of serious influenza-related complications. Guidelines, therefore, recommend influenza vaccination for these patients. However, data on vaccine effectiveness in this population are lacking, and the value of vaccination in this population remains unclear. OBJECTIVES: To assess the effectiveness of influenza vaccine in immunosuppressed adults with malignancies...
February 1, 2018: Cochrane Database of Systematic Reviews
Lawrence O Gostin
BACKGROUND: The detection of wild poliovirus in Israeli sewage in May 2013 led the health authorities to vaccinate children with OPV (Oral Polio Vaccine). Shelly Kamin-Friedman explored the legal and ethical dimensions of this policy. This commentary makes three claims: (1) Mandatory vaccination is a valid exercise of the state's police powers to protect the common good. (2) A disease eradication campaign is a sufficient ground for the exercise of those powers. (3) The state is obliged to use the least restrictive/invasive measure to achieve community-wide vaccine coverage, but need not use less effective measures; further, determining which measure is most effective is a fact-specific determination...
January 3, 2018: Israel Journal of Health Policy Research
Vipin Vashistha
The editorial by Jesani and Johari in this journal raises some contentious yet relevant ethical issues pertaining to vaccination practices in India. Vaccination is one of the most important preventive measures against infectious diseases. The eradication of smallpox in the 70s and near eradication of polio are testimony to this. The Government of India (GoI) has recently added a few new vaccines in its Universal Immunisation Programme (UIP), one of the largest public health programmes across the globe. The number of vaccines delivered through this public health programme has doubled from six in 1985 to twelve in 2017...
December 21, 2017: Indian Journal of Medical Ethics
M Elizabeth Halloran, Kari Auranen, Sarah Baird, Nicole E Basta, Steven E Bellan, Ron Brookmeyer, Ben S Cooper, Victor DeGruttola, James P Hughes, Justin Lessler, Eric T Lofgren, Ira M Longini, Jukka-Pekka Onnela, Berk Özler, George R Seage, Thomas A Smith, Alessandro Vespignani, Emilia Vynnycky, Marc Lipsitch
BACKGROUND: Interventions in infectious diseases can have both direct effects on individuals who receive the intervention as well as indirect effects in the population. In addition, intervention combinations can have complex interactions at the population level, which are often difficult to adequately assess with standard study designs and analytical methods. DISCUSSION: Herein, we urge the adoption of a new paradigm for the design and interpretation of intervention trials in infectious diseases, particularly with regard to emerging infectious diseases, one that more accurately reflects the dynamics of the transmission process...
December 29, 2017: BMC Medicine
Pranab Chatterjee, Soumyadeep Bhaumik, Abhimanyu Singh Chauhan, Manish Kakkar
INTRODUCTION: Zoonotic and emerging infectious diseases (EIDs) represent a public health threat that has been acknowledged only recently although they have been on the rise for the past several decades. On an average, every year since the Second World War, one pathogen has emerged or re-emerged on a global scale. Low/middle-income countries such as India bear a significant burden of zoonotic and EIDs. We propose that the creation of a database of published, peer-reviewed research will open up avenues for evidence-based policymaking for targeted prevention and control of zoonoses...
December 10, 2017: BMJ Open
Claire Lajaunie, Calvin Wai-Loon Ho
Research on emerging infectious diseases calls for a work on collections of pathogens (including hosts or vectors from which the pathogens were isolated), related to human and animal health, to wildlife or on the environmental material. In this respect, the adoption of a One Health perspective is determined by the need for a common approach to consider the collection, storage and use of pathogens coming from human or non-human sources, and particularly when the same pathogen is taken from different environments...
November 29, 2017: Parasitology
Meta Roestenberg, Annie Mo, Peter G Kremsner, Maria Yazdanbakhsh
The principle of deliberately infecting humans with infectious agents in a controlled setting, so-called controlled human infections (CHI), is not novel. Many CHI models have a long history and were established decades ago such as the intentional exposure to yellow fever and dengue performed in the 1900's (Reed, 1902) [2]. In these times bioethics and scientific reasoning were in their infancy. Nowadays, clinical trials are highly regulated and CHI are executed worldwide. Controlled human malaria infections and influenza infections are the two most frequently practiced...
December 18, 2017: Vaccine
Euzebiusz Jamrozik, Michael J Selgelid
Zika virus was recognised in 2016 as an important vector-borne cause of congenital malformations and Guillain-Barré syndrome, during a major epidemic in Latin America, centred in Northeastern Brazil. The WHO and Pan American Health Organisation (PAHO), with partner agencies, initiated a coordinated global response including public health intervention and urgent scientific research, as well as ethical analysis as a vital element of policy design. In this paper, we summarise the major ethical issues raised during the Zika epidemic, highlighting the PAHO ethics guidance and the role of ethics in emergency responses, before turning to ethical issues that are yet to be resolved...
November 16, 2017: Journal of Medical Ethics
Karine Moschetti, Véra Zabrodina, Pierre Stadelmann, Tenzin Wangmo, Alberto Holly, Jean-Blaise Wasserfallen, Bernice S Elger, Bruno Gravier
Prison healthcare is an important public health concern given the increasing healthcare needs of a growing and aging prison population, which accumulates vulnerability factors and suffers from higher disease prevalence than the general population. This study identifies the key factors associated with outpatient general practitioner (GP), nursing or psychiatric healthcare utilization (HCU) within prisons. Cross-sectional data systematically collected by the prison medical staff were obtained for a sample of 1664 adult prisoners of the Canton of Vaud, Switzerland, for the year 2011...
2017: PloS One
Daniel G Bausch
The 2013 outbreak of Ebola virus disease (EVD) in West Africa constituted a major humanitarian crisis. The outbreak numbered over 28,500 cases, more than 10 times the number cumulatively registered from all previous EVD outbreaks combined, with at least 11,000 deaths, and resulted in billions of dollars of lost economic growth to an already impoverished region. The unprecedented scale of West Africa 2013 took the world by surprise and laid bare deficiencies in our response capacity to complex humanitarian disasters of highly infectious and lethal pathogens...
October 26, 2017: Current Topics in Microbiology and Immunology
Nina H Gobat, Micaela Gal, Christopher C Butler, Steve A R Webb, Nicholas A Francis, Helen Stanton, Sibyl Anthierens, Hilde Bastiaens, Maciek Godycki-Ćwirko, Anna Kowalczyk, Mariona Pons-Vigués, Enriqueta Pujol-Ribera, Anna Berenguera, Angela Watkins, Prasanth Sukumar, Ronald G Moore, Kerenza Hood, Alistair Nichol
BACKGROUND: Pandemics of new and emerging infectious diseases are unpredictable, recurrent events that rapidly threaten global health and security. We aimed to identify public views regarding provision of information and consent to participate in primary and critical care clinical research during a future influenza-like illness pandemic. METHODS: Descriptive-interpretive qualitative study, using focus groups (n = 10) and semi-structured interviews (n = 16), with 80 members of the public (>18 years) in Belgium, Spain, Poland and the UK...
September 27, 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
Chris Kaposy, Victor Maddalena, Fern Brunger, Daryl Pullman, Richard Singleton
BACKGROUND: Health care organizations can be very complex, and are often the setting for crisis situations. In recent years, Canadian health care organizations have faced large-scale systemic medical errors, a nation-wide generic injectable drug shortage, iatrogenic infectious disease outbreaks, and myriad other crises. These situations often have an ethical component that ethics consultants may be able to address. Organizational leaders such as health care managers and governing boards have responsibilities to oversee and direct the response to crisis situations...
April 2017: AJOB Empirical Bioethics
Julio Arturo Canario Guzmán, Roberto Espinal, Jeannette Báez, Ricardo Elias Melgen, Patricia Antonia Pérez Rosario, Eddys Rafael Mendoza
BACKGROUND: The establishment of international collaborative research partnerships in times of infectious disease outbreaks of international importance has been considered an ethical imperative. Frail health research systems in low- and middle-income countries can be an obstacle to achieve the goal of knowledge generation and the search for health equity before, during and after infectious disease outbreaks. METHODS: A qualitative case study was conducted to identify the challenges and opportunities facing the Dominican Republic with regards to developing international collaborative research partnerships in the context of the Zika outbreak and its ethical implications...
September 25, 2017: Health Research Policy and Systems
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