Anderson, Benjamin O; Yip, Cheng-Har; Smith, Robert A; Shyyan, Roman; Sener, Stephen F; Eniu, Alexandru; Carlson, Robert W; Azavedo, Edward; Harford, Joe
Breast cancer outcomes in low- and middle-income countries (LMCs) correlate with the degree to which 1) cancers are detected at early stages, 2) newly detected cancers can be diagnosed correctly, and 3) appropriately selected multimodality treatment can be provided properly in a timely fashion. The Breast Health Global Initiative (BHGI) invited international experts to review and revise previously developed BHGI resource-stratified guideline tables for early detection, diagnosis, treatment, and healthcare systems. Focus groups addressed specific issues in breast pathology, radiation therapy, and management of locally advanced disease. Process metrics were developed based on the priorities established in the guideline stratification. The groups indicated that cancer prevention through health behavior modification could influence breast cancer incidence in LMCs. Diagnosing breast cancer at earlier stages will reduce breast cancer mortality. Programs to promote breast self-awareness and clinical breast examination and resource-adapted mammographic screening are important early detection steps. Breast imaging, initially with ultrasound and, at higher resource levels with diagnostic mammography, improves preoperative diagnostic assessment and permits image-guided needle sampling. Multimodality therapy includes surgery, radiation, and systemic therapies. Government intervention is needed to address drug-delivery problems relating to high cost and poor access. Guideline dissemination and implementation research plays a crucial role in improving care. Adaptation of technology is needed in LMCs, especially for breast imaging, pathology, radiation therapy, and systemic treatment. Curricula for education and training in LMCs should be developed, applied, and studied in LMC-based learning laboratories to aid information transfer of evidence-based BHGI guidelines. PMID:18816619
Nodora, Jesse N; Carvajal, Scott C; Robles-Garcia, Rebeca; Agraz, Francisco Páez; Daneri-Navarro, Adrian; Meza-Montenegro, Maria Mercedes; Gutierrez-Millan, Luis Enrique; Martinez, Maria Elena
Lacking in the literature are data addressing the extent to which changes in reproductive and lifestyle factors predispose women in developing nations to higher breast cancer rates, and the degree to which these are due to globalization influences. This article describes the development and psychometric assessment of an instrument intended to measure global, predominantly U.S., influences on breast cancer risk profile among women residing in Mexico. Using investigator consensus and a focus group methodology, the Measure of Globalization Influence on Health Risk (MGIHR) was developed and completed by 341 women. Psychometric analysis support the use of an 11-item Consumerism and Modernity scale and 7-item Reproductive Control and Gender Role scale. The MGIHR is a valid and reliable instrument for understanding changing lifestyle and reproductive factors for breast cancer risk and may provide a more complete understanding of breast cancer development and needed interventions. PMID:24859806
Benjamin O. Anderson
Full Text Available The Breast Health Global Initiative (BHGI applied an evidence-based consensus review process to develop guidelines for breast cancer early detection, diagnosis, and treatment in low- and middle-income countries (LMCs including those in Latin America. Breast cancer outcomes correlate with the degree to which 1 cancers are detected early, 2 cancers can be diagnosed correctly, and 3 proper multimodality treatment can be provided in a timely fashion. Cancer prevention through health behavior modification may influence breast cancer incidence in LMCs. Diagnosing breast cancer at earlier stages will reduce breast cancer mortality. Programs to promote breast self-awareness and clinical breast examination and resource-adapted mammographic screening are important early detection steps. Screening mammography has been shown to reduce breast cancer mortality, but is cost prohibitive in some settings. Breast imaging, initially with ultrasound and, at higher resource levels with diagnostic mammography, improves preoperative diagnostic assessment and permits image-guided needle sampling. Multimodality therapy includes surgery, radiation, and systemic therapies.La Iniciativa Global para la Salud de la Mama (BGHI ha aplicado un proceso de revisión de consenso, basado en la evidencia, a fin de desarrollar guías para la detección precoz del cáncer de mama, diagnóstico y tratamiento, en países de bajos y medianos ingresos (PBMI incluyendo aquellos en América latina. La evolución del cáncer de mama se correlaciona con el grado al cual 1 los cánceres son detectados tempranamente 2los cánceres pueden ser diagnosticados correctamente, y 3el adecuado tratamiento multimodal suministrado a tiempo. La prevención del cáncer a través de modificaciones de las conductas de salud puede modificar la incidencia del cáncer de mama en PBMI. El diagnóstico del cáncer de mama en estadios iniciales reduce la mortalidad por cáncer de mama. Los programas que promueven
... Issue Past Issues From the NIH Director: A Global Health System Past Issues / Spring 2008 Table of ... officials the issues of world health and NIH's global outreach. He spoke with MedlinePlus ' Christopher Klose on ...
... 9 12 16 18 20 22 25 4 Global Health and Aging Preface The world is facing ... stages of economic development and with varying resources. Global efforts are required to understand and find cures ...
Arkansas Univ., Fayetteville, Cooperative Extension Service.
This short booklet is designed to be used by health educators when teaching women about breast cancer and its early detection and the procedure for breast self-examination. It includes the following: (1) A one-page teaching plan consisting of objectives, subject matter, methods (including titles of films and printed materials), target audience,…
Greenwood, Brian; Salisbury, David; Hill, Adrian V. S.
Vaccines have made a major contribution to global health in recent decades but they could do much more. In November 2011, a Royal Society discussion meeting, ‘New vaccines for global health’, was held in London to discuss the past contribution of vaccines to global health and to consider what more could be expected in the future. Papers presented at the meeting reviewed recent successes in the deployment of vaccines against major infections of childhood and the challenges faced in developing ...
Beaglehole, Robert; Bonita, Ruth
Global health’ is coming of age, at least as measured by the increasing number of academic centres, especially in North America, which use this title to describe their interests. Most global health centres are in high-income countries although several have strong links with low- and middleincome countries. A task force is establishing a mechanism to coordinate European Academic Global Health initiatives through ASPER. Two recent papers raise important issues about the meaning and scope of glo...
Full Text Available Abstract This debut editorial of Globalization and Health introduces the journal, briefly delineating its goals and objectives and outlines its scope of subject matter. 'Open Access' publishing is expected to become an increasingly important format for peer reviewed academic journals and that Globalization and Health is 'Open Access' is appropriate. The rationale behind starting a journal dedicated to globalization and health is three fold: Firstly: Globalization is reshaping the social geography within which we might strive to create health or prevent disease. The determinants of health – be they a SARS virus or a predilection for fatty foods – have joined us in our global mobility. Driven by economic liberalization and changing technologies, the phenomenon of 'access' is likely to dominate to an increasing extent the unfolding experience of human disease and wellbeing. Secondly: Understanding globalization as a subject matter itself needs certain benchmarks and barometers of its successes and failings. Health is one such barometer. It is a marker of social infrastructure and social welfare and as such can be used to either sound an alarm or give a victory cheer as our interconnectedness hurts and heals the populations we serve. And lastly: In as much as globalization can have an effect on health, it is also true that health and disease has an effect on globalization as exemplified by the existence of quarantine laws and the devastating economic effects of the AIDS pandemic. A balanced view would propose that the effects of globalization on health (and health systems are neither universally good nor bad, but rather context specific. If the dialogue pertaining to globalization is to be directed or biased in any direction, then it must be this: that we consider the poor first.
Full Text Available Objective: to unravel some theoretical and factual elements required to implement more effective health promotion strategies and practices in the field of health services whilst following the great challenges that globalization has imposed on the health systems, which are inevitably expressed in the local context (glocalization. Methodology: a narrative review taking into account the concepts of globalization and health promotion in relation to health determinants. The authors approach some courses of action and strategies for health promotion based on the social principles and universal values that guide health promotion, health service reorientation and primary healthcare, empowerment, social participation, and inter-sectoral and social mobilization. Discussion: the discussion focuses on the redirection of health promotion services in relation to the wave of health reforms that has spread throughout the world under the neoliberal rule. The author also discusses health promotion, its ineffectiveness, and the quest for renewal. Likewise, the author sets priorities for health promotion in relation to social determinants. Conclusion: the current global order, in terms of international relations, is not consistent with the ethical principles of health promotion. In this paper, the author advocates for the implementation of actions to change the social and physical life conditions of people based on changes in the use of power in society and the appropriate practice of politics in the context of globalization in order to achieve the effectiveness of the actions of health promotion.
Margaret A. Winker, MD; Lorraine E. Ferris, PhD, LLM
The Editor-in-Chief of the International Journal of MCH and AIDS (IJMA) is a member of the World Association of Medical Editors (WAME). The Editorial Board of IJMA believes it is important that the statement on promoting global health and this accompanying editorial is brought to the attention of our readers. Medical journal editors have a social responsibility to promote global health by publishing, whenever possible, research that furthers health worldwide.
Ruger, Jennifer Prah
While there is a growing body of work on moral issues and global governance in the fields of global justice and international relations, little work has connected principles of global health justice with those of global health governance for a theory of global health. Such a theory would enable analysis and evaluation of the current global health system and would ethically and empirically ground proposals for reforming it to more closely align with moral values. Global health governance has been framed as an issue of national security, human security, human rights, and global public goods. The global health governance literature is essentially untethered to a theorized framework to illuminate or evaluate governance. This article ties global health justice and ethics to principles for governing the global health realm, developing a theoretical framework for global and domestic institutions and actors. PMID:23215931
Dr. Mike Miller reads an abridged version of the Emerging Infectious Diseasesâ Perspective, The New Global Health. Created: 8/13/2013 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID). Date Released: 8/14/2013.
Abdolreza Jaberi Aghdam
The potentiall to be healthy: physically, mentally and emotionally. The potential to be happy. The potential to live life with purpose. And we believe this journey all begins with good nutrition. Because what you feed your body and your mind, changes the way you feel The purpose of the Global Health is to give us an opportunity to become familiar with the major problems and policy issues in that area. Participating in this issue will be able to understand and discuss the determinants of globa...
Bygbjerg, Ib Christian; Meyrowitsch, Dan W
"Tempora mutantur et nos in illis" King Lothar I remarked by year 900 AD. What exactly changed in us over time, i.e. how patterns of the epidemiological transition in populations locally and globally might appear, was described by Omran in 1971 . The effect of transition on health and diseases in populations was demonstrated by Frenkl et al in 1991 . And which major public health problems following each other, and why, was underscored by LaPorte in 1995 . In 2000, leaders of the world society decided to identify a range of common goals, the Millennium Development Goals (MDG), to be reached by year 2015. Many of the MDG are directly or indirectly related with the major health problems, particularly those hitting the poorest: lack of clean drinking water, unhealthy environment, high maternal mortality due to lack of care for the pregnant, and lack of control of major communicable, often fatal diseases like child diseases, malaria, HIV/AIDS and tuberculosis. It is remarkable that the specific chronic diseases of major public health relevance are in fact not mentioned in the MDG, even if these diseases increasingly are hitting populations in low- and middle-income societies, i.e. developing countries. The world community seems to prioritize the diseases that are most visible, and most often linked with poverty, namely the infectious diseases mentioned above, which together kill about 17 million people annually, often in combination with malnutrition, and the 0.6 million deaths related to birth and pregnancy. With the exception of HIV/AIDS, which also hit richer societies, these diseases of poverty have been under-prioritized regarding research as well. However, at the turn of the Millennium, the burden of "Western" non-communicable diseases was increasing fast in developing countries. And by 2025, the burden of non-communicable diseases is expected to have doubled globally, with half of the burden on developing countries. Therefore it may be rewarding to look
Michaud, Josh; Kates, Jennifer
Attention to global health diplomacy has been rising but the future holds challenges, including a difficult budgetary environment. Going forward, both global health and foreign policy practitioners would benefit from working more closely together to achieve greater mutual understanding and to advance respective mutual goals.
Chronic technology and business process disparities between High Income, Low Middle Income and Low Income (HIC, LMIC, LIC) research collaborators directly prevent the growth of sustainable Global Health innova‐ tion for infectious and rare diseases. There is a need for an Open Source-Open Science Architecture Framework to bridge this divide. We are proposing such a framework for consideration by the Global Health community, by utiliz‐ ing a hybrid approach of integrating agnostic Open Source ...
NIE Jian-gang; LI Juan
@@ Globalization brings about a new era of more integrated human society. However, it is a double-edged sword: while enjoying the benefits of closer economic, trade and more frequent cultural exchanges among countries, we are encountered with a number of problems and risks, such as nuclear weapons proliferation, environmental pollution, natural disasters, spread of infectious diseases, etc. Given this fact, new concepts of global health governance have emerged in the health arena across the globe in recent years.
... Feed Youtube Twitter Facebook Google + iTunes Play Store Global Health Observatory (GHO) data Menu Global Health Observatory ... years on average in 2015 MORE MORTALITY AND GLOBAL HEALTH ESTIMATES DATA PRODUCTS Maps Country profiles About ...
Breast cancer is the most common cancer affecting women globally. This paper discusses the current progress in breast cancer in Western countries and focuses on important differences of this disease in low- and middle-income countries (LMCs). It introduces several arguments for applying caution before globalizing some of the US-adopted practices in the screening and management of the disease. Finally, it suggests that studies of breast cancer in LMCs might offer important insights for a more effective management of the problem both in developing as well as developed countries.high-energy Japanese immigrants female higher proliferative
Bygbjerg, Ib Christian; Meyrowitsch, Dan W
.e. developing countries. The world community seems to prioritize the diseases that are most visible, and most often linked with poverty, namely the infectious diseases mentioned above, which together kill about 17 million people annually, often in combination with malnutrition, and the 0.6 million deaths...... in populations was demonstrated by Frenkl et al in 1991 . And which major public health problems following each other, and why, was underscored by LaPorte in 1995 . In 2000, leaders of the world society decided to identify a range of common goals, the Millennium Development Goals (MDG), to be...... related to birth and pregnancy. With the exception of HIV/AIDS, which also hit richer societies, these diseases of poverty have been under-prioritized regarding research as well. However, at the turn of the Millennium, the burden of "Western" non-communicable diseases was increasing fast in developing...
Min Li; Juan Chen; Zhendong Chen
Breast cancer is defined as a chronic disease.Increasing amounts of attention have been paid to the health management of breast cancer survivors. An important issue is how to find the most appropriate method of follow-up in order to detect long-term complications of treatment, local recurrence and distant metastasis and to administer appropriate treatment to the survivors with recurrence in a timely fashion. Different oncology organizations have published guidelines for following up breast cancer survivors. However, there are few articles on this issue in China. Using the published follow-up guidelines,we analyzed their main limitations and discussed the content,follow-up interval and economic benefits of following up breast cancer survivors in an effort to provide suggestions to physicians.Based on a large number of clinical trials, we discussed the role of physical examination, mammography, liver echograph, chest radiography, bone scan and so on. We evaluated the effects of the above factors on detection of distant disease, survival time,improvement in quality of life and time to diagnosis of recurrence.The results of follow-up carried out by oncologists and primary health care physicians were compared. We also analyzed the correlation factors for the cost of such follow-up. It appears that follow-up for breast cancer survivors can be carried out effectively by trained primary health care physicians. If anything unusual arises, the patients should be transferred to specialists.
Bhoo Pathy, N.
The burden of breast cancer had been increasing in Asia. However, little is known regarding the presentation, management and outcome of breast cancer among multi-ethnic Asian women. Asian ethnicities, lifestyles, health beliefs, and even life expectancies are substantially different from those of we
Full Text Available Although there is a wealth of research on and attention of both the public and the researchers about global health, there is still some controversy and uncertainty about the real meaning of the term "global health". In a multidisciplinary and intersectorial field such as global health, common definition is important for clear and effective communication among all involved in global health.
Yu, Chong; Wang, Jin
Initiation and progression of cancer depend on many factors. Those on the genetic level are often considered crucial. To gain insight into the physical mechanisms of breast cancer, we construct a gene regulatory network (GRN) which reflects both genetic and environmental aspects of breast cancer. The construction of the GRN is based on available experimental data. Three basins of attraction, representing the normal, premalignant and cancer states respectively, were found on the phenotypic landscape. The progression of breast cancer can be seen as switching transitions between different state basins. We quantified the stabilities and kinetic paths of the three state basins to uncover the biological process of breast cancer formation. The gene expression levels at each state were obtained, which can be tested directly in experiments. Furthermore, by performing global sensitivity analysis on the landscape topography, six key genes (HER2, MDM2, TP53, BRCA1, ATM, CDK2) and four regulations (HER2⊣TP53, CDK2⊣BRCA1, ATM→MDM2, TP53→ATM) were identified as being critical for breast cancer. Interestingly, HER2 and MDM2 are the most popular targets for treating breast cancer. BRCA1 and TP53 are the most important oncogene of breast cancer and tumor suppressor gene, respectively. This further validates the feasibility of our model and the reliability of our prediction results. The regulation ATM→MDM2 has been extensive studied on DNA damage but not on breast cancer. We notice the importance of ATM→MDM2 on breast cancer. Previous studies of breast cancer have often focused on individual genes and the anti-cancer drugs are mainly used to target the individual genes. Our results show that the network-based strategy is more effective on treating breast cancer. The landscape approach serves as a new strategy for analyzing breast cancer on both the genetic and epigenetic levels and can help on designing network based medicine for breast cancer. PMID:27410227
Petersen, Poul E; Baehni, Pierre C
Chronic diseases are a growing burden to people, to health-care systems and to societies across the world. The rapid increase in the burden of chronic diseases is particularly prevalent in the developing countries. Periodontal disease is one of the two most important oral diseases contributing...... to the global burden of chronic disease. In addition to social determinants, periodontal health status is related to several proximal factors. Modifiable risk factors, such as tobacco use, excessive alcohol consumption, poor diet and nutrition, obesity, psychological stress and insufficient personal....../oral hygiene, are important and these principal risk factors for periodontal disease are shared by other chronic diseases. The present monograph is devoted to the existing evidence on the practice of public health related to periodontal health. Public health is defined as the process of mobilizing and engaging...
Lam, Tai Hing; Chim, David
Alcohol's adverse public health impact includes disease, injury, violence, disability, social problems, psychiatric illness, drunk driving, drug use, unsafe sex, and premature death. Furthermore, alcohol is a confirmed human carcinogen. The International Agency for Research on Cancer concluded that alcohol causes cancer of the oral cavity, pharynx, larynx, esophagus, liver, colon-rectum, and breast. World Cancer Research Fund/American Institute for Cancer Research concluded that the evidence justifies recommending avoidance of consuming any alcohol, even in small quantities. Despite being responsible for 3.8% of global deaths (2,255,000 deaths) and 4.6% of global disability-adjusted life years in 2004, alcohol consumption is increasing rapidly in China and Asia. Contrary to the World Health Assembly's call for global control action, Hong Kong has reduced wine and beer taxes to zero since 2008. An International Framework Convention on Alcohol Control is urgently needed. Increasing alcohol taxation and banning alcohol advertisement and promotion are among the most effective policies. PMID:20566555
Full Text Available Recent fluctuations in economic conditions around the world have triggered an academic interest in the effects of economic conditions on indicators of health. Long-run global health issues are of specific interest considering the fact that the world is at an increasing risk of health threats, such as disease outbreaks, epidemics, industrial accidents, natural disasters, and other health emergencies. This study assesses the role of various macroeconomic determinants and country-level health inputs in affecting health outcomes across countries. Specifically, using data from 1960 to 2010 on 198 countries, this study analyzes the effects of per capita Gross Domestic Product (GDP, foreign direct investment (FDI, population density, food supply, education, health care, and employment on measures of mortality and morbidity. These outcomes include the average death rate, life expectancy, infant mortality, obesity, and cholesterol in a country. Both ordinary least squares and fixed effects methodologies are employed to account for unobserved heterogeneity across countries and capture within-country differences. Estimates provide some evidence that, while per capita GDP is often associated with improved health across countries, it is not obvious that changes in GDP are directly correlated with changes in health within a country. Higher per capita GDP is associated with higher obesity rates, both across and within a country. Population density is generally linked to improved health, and total food supply is associated with higher obesity and cholesterol among females. Vegetable food supply is associated with lower death rates.
Varmus, H.; Klausner, R; Zerhouni, E.; Acharya, T.; Daar, A S; Singer, P A
This week an international panel announces a list of 14 Grand Challenges in Global Health, and scientists throughout the world will be invited to submit grant proposals to pursue them with funds provided by the Bill & Melinda Gates Foundation. We describe the characteristics of these challenges and the process by which they were formulated and selected after receiving over 1000 responses to a "call for ideas" from the scientific community.
Full Text Available Chronic technology and business process disparities between High Income, Low Middle Income and Low Income (HIC, LMIC, LIC research collaborators directly prevent the growth of sustainable Global Health innova‐ tion for infectious and rare diseases. There is a need for an Open Source-Open Science Architecture Framework to bridge this divide. We are proposing such a framework for consideration by the Global Health community, by utiliz‐ ing a hybrid approach of integrating agnostic Open Source technology and healthcare interoperability standards and Total Quality Management principles. We will validate this architecture framework through our programme called Project Orchid. Project Orchid is a conceptual Clinical Intelligence Exchange and Virtual Innovation platform utilizing this approach to support clinical innovation efforts for multi-national collaboration that can be locally sustainable for LIC and LMIC research cohorts. The goal is to enable LIC and LMIC research organizations to acceler‐ ate their clinical trial process maturity in the field of drug discovery, population health innovation initiatives and public domain knowledge networks. When sponsored, this concept will be tested by 12 confirmed clinical research and public health organizations in six countries. The potential impact of this platform is reduced drug discovery and public health innovation lag time and improved clinical trial interventions, due to reliable clinical intelligence and bio-surveillance across all phases of the clinical innovation process.
Mody, Girish M; Brooks, Peter M
Musculoskeletal (MSK) disorders are among the leading reasons why patients consult a family or primary health practitioner, take time off work and become disabled. Many of the MSK disorders are more common in the elderly. Thus, as the proportion of the elderly increases all over the world, MSK disorders will make a greater contribution to the global burden of disease. Epidemiological studies have shown that the spectrum of MSK disorders in developing countries is similar to that seen in industrialised countries, but the burden of disease tends to be higher due to a delay in diagnosis or lack of access to adequate health-care facilities for effective treatment. Musculoskeletal pain is very common in the community while fibromyalgia is being recognised as part of a continuum of chronic widespread pain rather than a narrowly defined entity. This will allow research to improve our understanding of pain in a variety of diffuse pain syndromes. The availability of newer more effective therapies has resulted in efforts to initiate therapy at an earlier stage of diseases. The new criteria for rheumatoid arthritis, and the diagnosis of axial and peripheral involvement in spondyloarthritis, permit an earlier diagnosis without having to wait for radiological changes. One of the major health challenges is the global shortage of health workers, and based on current training of health workers and traditional models of care for service delivery, the global situation is unlikely to change in the near future. Thus, new models of care and strategies to train community health-care workers and primary health-care practitioners to detect and initiate the management of patients with MSK disorders at an earlier stage are required. There is also a need for prevention strategies with campaigns to educate and raise awareness among the entire population. Lifestyle interventions such as maintaining an ideal body weight to prevent obesity, regular exercises, avoidance of smoking and alcohol
Full Text Available In the 21st Century, distinctions and boundaries between global health, international politics, and the broader interests of the global community are harder to define and enforce than ever before. As a result, global health workers, leaders, and institutions face pressing questions around the nature and extent of their involvement with non-health endeavors, including international conflict resolution, counter-terrorism, and peace-keeping, under the global health diplomacy (GHD paradigm.
In this article I argue for the development of a macro perspective within psychology, akin to that found in macroeconomics. Macropsychology is the application of psychology to factors that influence the settings and conditions of our lives. As policy concerns the strategic allocation of resources—who gets what and why?—it should be an area of particular interest for macropsychology. I review ways in which psychology may make a contribution to policy within the field of global health. Global health emphasizes human rights, equity, social inclusion, and empowerment; psychology has much to contribute to these areas, both at the level of policy and practice. I review the sorts of evidence and other factors that influence policymakers, along with the content, process, and context of policymaking, with a particular focus on the rights of people with disabilities in the low- and middle-income countries of Africa and Asia. These insights are drawn from collaborations with a broad range of practitioners, governments, United Nations agencies, civil society organizations, the private sector and researchers. Humanitarian work psychology is highlighted as an example of a new area of psychology that embraces some of the concerns of macropsychology. The advent of "big data" presents psychology with an opportunity to ask new types of questions, and these should include "understanding up," or how psychological factors can contribute to human well-being, nationally and globally. PMID:25486176
Leeder, Stephen R; Raymond, Susan U; Greenberg, Henry M
Globalisation has brought with it many advances in health, but also a new range of challenges. There is a need to move from "nation-focused" (international) public health to global public health--and the terminology we use here matters. Global public health leadership requires that respect be shown to evidence, especially that about the changing nature of disease worldwide. The Australian medical and research communities have a significant opportunity to provide global public health leadership. PMID:17949335
Huckel Schneider, Carmen
This dissertation is concerned with health governance on the global level, where over the past fifteen years a number of new organisations have emerged that address major global public health issues. Three examples are the Global Fund to Fight AIDS, Tuberculosis and Malaria, (GFATM), the Global Alliance for Vaccines and Immunisation (GAVI Alliance), and Joint United Nations Programme on HIV/AIDS (UNAIDS), each of which are examined in depth in the dissertation. These organisations differ ...
Tarrant, R C
Breast-feeding is the superior infant feeding method from birth, with research consistently demonstrating its numerous short- and long-term health benefits for both mother and infant. As a global recommendation the WHO advises that mothers should exclusively breast-feed for the first 6-months of life, thus delaying the introduction of solids during this time. Historically, Irish breast-feeding initiation rates have remained strikingly low in comparison with international data and there has been little improvement in breast-feeding duration rates. There is wide geographical variation in terms of breast-feeding initiation both internationally and in Ireland. Some of these differences in breast-feeding rates may be associated with differing socio-economic characteristics. A recent cross-sectional prospective study of 561 pregnant women attending a Dublin hospital and followed from the antenatal period to 6 months post partum has found that 47% of the Irish-national mothers initiated breast-feeding, while only 24% were still offering \\'any\\' breast milk to their infants at 6 weeks. Mothers\\' positive antenatal feeding intention to breast-feed is indicated as one of the most important independent determinants of initiation and \\'any\\' breast-feeding at 6 weeks, suggesting that the antenatal period should be targeted as an effective time to influence and affect mothers\\' attitudes and beliefs pertaining to breast-feeding. These results suggest that the \\'cultural\\' barrier towards breast-feeding appears to still prevail in Ireland and consequently an environment that enables women to breast-feed is far from being achieved. Undoubtedly, a shift towards a more positive and accepting breast-feeding culture is required if national breast-feeding rates are to improve.
CERN. Geneva; Schwede, Torsten; Moore, Celia; Smith, Thomas E; Williams, Brian; Grey, François
Distributed computing harnesses the power of thousands of computers within organisations or over the Internet. In order to tackle global health problems, several groups of researchers have begun to use this approach to exceed by far the computing power of a single lab. This event illustrates how companies, research institutes and the general public are contributing their computing power to these efforts, and what impact this may have on a range of world health issues. Grids for neglected diseases Vincent Breton, CNRS/EGEE This talk introduces the topic of distributed computing, explaining the similarities and differences between Grid computing, volunteer computing and supercomputing, and outlines the potential of Grid computing for tackling neglected diseases where there is little economic incentive for private R&D efforts. Recent results on malaria drug design using the Grid infrastructure of the EU-funded EGEE project, which is coordinated by CERN and involves 70 partners in Europe, the US and Russi...
The year 2001 and the next millennium will soon be upon us. The major gains in health in the 20th century were primarily the result of improvements in public health including sanitation and immunization. Global health improvements will occur in the 21st century through improvements in information (in particular health training). We will describe a new paradigm for transnational training, the supercourse. In the next century global lecture-shareware training will take place, with Deming based ...
In the second in a series of articles on the changing nature of global health institutions, Julio Frenk offers a framework to better understand national health systems and their role in global health.
Downs, Jennifer A; Reif, Lindsey K; Hokororo, Adolfine; Fitzgerald, Daniel W
Globally, women experience a disproportionate burden of disease and death due to inequities in access to basic health care, nutrition, and education. In the face of this disparity, it is striking that leadership in the field of global health is highly skewed towards men and that global health organizations neglect the issue of gender equality in their own leadership. Randomized trials demonstrate that women in leadership positions in governmental organizations implement different policies than men and that these policies are more supportive of women and children. Other studies show that proactive interventions to increase the proportion of women in leadership positions within businesses or government can be successful. Therefore, the authors assert that increasing female leadership in global health is both feasible and a fundamental step towards addressing the problem of women's health. In this Perspective, the authors contrast the high proportion of young female trainees who are interested in academic global health early in their careers with the low numbers of women successfully rising to global health leadership roles. The authors subsequently explore reasons for female attrition from the field of global health and offer practical strategies for closing the gender gap in global health leadership. The authors propose solutions aimed to promote female leaders from both resource-wealthy and resource-poor countries, including leadership training grants, mentorship from female leaders in global professions, strengthening health education in resource-poor countries, research-enabling grants, and altering institutional policies to support women choosing a global health career path. PMID:24918761
Labonté Ronald; Gagnon Michelle L
Abstract Global health financing has increased dramatically in recent years, indicative of a rise in health as a foreign policy issue. Several governments have issued specific foreign policy statements on global health and a new term, global health diplomacy, has been coined to describe the processes by which state and non-state actors engage to position health issues more prominently in foreign policy decision-making. Their ability to do so is important to advancing international cooperation...
Anderson, Halie; Liebe, Sarah; Bien, Matt
Global health has become an increasingly important part of medical education. This paper outlines the global medicine experiences of two students at Sanford School of Medicine of The University of South Dakota. Their stories highlight the global need for improved health care, the potential impact that such opportunities have on education and future practice, and the many opportunities available in international medicine. PMID:23189410
Mills, Edward; Ernst, Edzard; Singh, Rana; Ross, Cory; Wilson, Kumanan
Background Many breast cancer patients use complementary and alternative medicine (CAM). We aimed to determine what advice health food store employees present to individuals seeking treatment options for breast cancer. Methods Eight data gatherers asked employees of all retail health food stores in a major Canadian city, what they recommended for a patient with breast cancer. The data gatherers inquired about product safety, potential drug interactions, costs and efficacy. They also enquired ...
Downs, Jennifer A.; Reif, Lindsey K.; Hokororo, Adolfine; Fitzgerald, Daniel W.
Globally, women experience a disproportionate burden of disease and death due to inequities in access to basic health care, nutrition, and education. In the face of this disparity, it is striking that leadership in the field of global health is highly skewed towards men and that global health organizations neglect the issue of gender equality in their own leadership. Randomized trials demonstrate that women in leadership positions in governmental organizations implement different policies tha...
Full Text Available Cancer represents a major public health and economical burden in developed countries and has emerged as a major public health problem in developing countries, matching its effect in industrialized nations. Although there have been recent declines in breast cancer mortality rates in some European Union countries, breast cancer remains of key importance to public health in Europe. Now days there is increasing recognition of the causative role of lifestyle factors, as smoking, diet, alcohol consumption, or lake of physical activity. The present study aimed to appreciate the presence and magnitude of modifiable risk factors for breast cancer in a sample of patients diagnosed with the disease, and to outline a risk profile liable to be changed in the intention of reducing the global risk. Risk factors have been investigated in 65 patients diagnosed with breast cancer using a questionnaire for breast cancer risk factors evaluation. The high risk profile was identified as taking shape for urban environment, modulated by the impact of overweight-obesity, smoking, reproductive factors and environmental exposure to different chemical substances. From the public health perspective, the control of overweight and obesity comes out in the foreground of preventive activities. Public health approaches emphasize on inexpensive, practical methods and in this perspective the approach of obesity should focus on the alteration of environmental context, promoting healthy eating and increased physical activity which could have a positive, independent impact on breast cancer risk
In the final decades of the twentieth century world went through a complex process in political, technological, economic, social and health areas. In the process often referred to as globalization, many health problems including global spread have seen and many have still being seen. This situation obliges nurses who are the largest groups of health care providers, to be aware of health problems that result from globalization and to explore solutions these health problems requires them t...
Health has become a policy issue of global concern. Worried that the unstructured, polycentric, and pluralist nature of global health governance is undermining the ability to serve emergent global public health interests, some commentators are calling for a more systematic institutional response to the "global health crisis." Yet global health is a complex and uncertain policy issue. This article uses narrative analysis to explore how actors deal with these complexities and how uncertainties affect global health governance. By comparing three narratives in terms of their basic assumptions, the way they define problems as well as the solutions they propose, the analysis shows how the unstructured pluralism of global health policy making creates a wide scope of policy conflict over the global health crisis. This wide scope of conflict enables effective policy-oriented learning about global health issues. The article also shows how exclusionary patterns of cooperation and competition are emerging in health policy making at the global level. These patterns threaten effective learning by risking both polarization of the policy debate and unanticipated consequences of health policy. Avoiding these pitfalls, the analysis suggests, means creating global health governance regimes that promote openness and responsiveness in deliberation about the global health crisis. PMID:22422655
The first part of this paper reviews the work of the World Health Organization's Regional Office for Europe undertaken to clarify the relevance of health promotion for all member states and regions. This work led to a definition of "health" as the ability to realize aspirations and satisfy needs and to change or cope with the environment. Health promotion was considered to 1) involve the population as a whole in the context of everyday lives, 2) be directed towards action on the determinants of health, 3) combine diverse but complementary methods or approaches, 4) aim for effective and concrete public participation, and 5) involve health professionals. Areas covered by health promotion activities include 1) access to health, 2) development of an environment conductive to health, 3) strengthening of social networks and social supports, 4) promoting positive health behavior and appropriate coping strategies, and 5) increasing knowledge and disseminating information. The next section of the paper traces the development of the concept of health promotion from its roots in health education, and the third section presents a brief history of public health to contextualize this development. The differences between the old and new approaches to public health are presented (the new role of the health sector is to ensure access to health, create advocacy for health, and move beyond health care through intersectoral action and public participation), and the new "forcefield" of public health that emerges from a conceptualization of health promotion is described. This forcefield, illustrated as a triangle linking healthy public policy, health promotion, and community action, works at all levels and is the framework for the development of appropriate strategies. It is concluded that in many cases public health will have to be reorganized as will the health care system as a whole. Health must be viewed as a social project linked to political responsibilities not as a medical
Vermund, Sten H.; Sahasrabuddhe, Vikrant V.; Khedkar, Sheetal; Jia, Yujiang; Etherington, Carol; Vergara, Alfredo
The Institute for Global Health at Vanderbilt enables the expansion and coordination of global health research, service, and training, reflecting the university's commitment to improve health services and outcomes in resource-limited settings. Global health encompasses both prevention via public health and treatment via medical care, all nested within a broader community-development context. This has fostered university-wide collaborations to address education, business/economics, engineering...
Laaser, Ulrich; Brand, Helmut
Introduction: Since the end of the 1990s, globalization has become a common term, facilitated by the social media of today and the growing public awareness of life-threatening problems common to all people, such as global warming, global security and global divides.Review: For the main parameters of health like the burden of disease, life expectancy and healthy life expectancy, extreme discrepancies are observed across the world. Infant mortality, malnutrition and high fertility go hand in ha...
Amódio, Juliana; Daniela Bazan PALIOTO; Carrara, Helio Humberto Angotti; Tiezzi, Daniel Guimaraes; de Andrade, Jurandyr Moreira; dos Reis, Francisco José Candido
OBJECTIVE: Oral health can affect a patient's general health and quality of life. Given the increase in breast cancer survival rates, investigations of factors influencing the quality of life of survivors have gained importance. Therefore, the objective of our study was to characterize oral health in postmenopausal breast cancer survivors. METHODS: We conducted a matched case-control study. Forty-eight women who survived breast cancer (age 62.1±9.1 years) and 48 healthy controls (age 61.8±8.6...
Juliana Amódio; Daniela Bazan Palioto; Helio Humberto Angotti Carrara; Daniel Guimaraes Tiezzi; Jurandyr Moreira de Andrade; Francisco José Candido dos Reis
OBJECTIVE: Oral health can affect a patient’s general health and quality of life. Given the increase in breast cancer survival rates, investigations of factors influencing the quality of life of survivors have gained importance. Therefore, the objective of our study was to characterize oral health in postmenopausal breast cancer survivors. METHODS: We conducted a matched case-control study. Forty-eight women who survived breast cancer (age 62.1±9.1 years) and 48 healthy controls (age 61.8±8...
Once an orphan field, 'global mental health' now has wide acknowledgement and prominence on the global health agenda. Increased recognition draws needed attention to individual suffering and the population impacts, but medicalizing global mental health produces a narrow view of the problems and solutions. Early framing by advocates of the global mental health problem emphasised biological disease, linked psychiatry with neurology, and reinforced categories of mental health disorders. Universality of biomedical concepts across culture is assumed in the globalisation of mental health but is strongly disputed by transcultural psychiatrists and anthropologists. Global mental health movement priorities take an individualised view, emphasising treatment and scale-up and neglecting social and structural determinants of health. To meet international targets and address the problem's broad social and cultural dimensions, the global mental health movement and advocates must develop more comprehensive strategies and include more diverse perspectives. PMID:24848660
Health literacy, cited as essential to achieving Healthy People 2010's goals to "increase quality and years of healthy life" and to "eliminate health disparities," is defined by Healthy People as "the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions." Accessibility, by definition, the aforementioned "capacity to obtain," thus is health literacy's primary prerequisite. Accessibility's designation as the global gateway to health literacy is predicated also on life's realities: global aging and climate change, war and terrorism, and life-extending medical and technological advances. People with diverse access needs are health professionals' raison d'être. However, accessibility, consummately cross-cultural and universal, is virtually absent as a topic of health promotion and practice research and scholarly discussion of health literacy and equity. A call to action to place accessibility in its rightful premier position on the profession's agenda is issued. PMID:18955546
Full Text Available Once an orphan field, ‘global mental health’ now has wide acknowledgement and prominence on the global health agenda. Increased recognition draws needed attention to individual suffering and the population impacts, but medicalizing global mental health produces a narrow view of the problems and solutions. Early framing by advocates of the global mental health problem emphasised biological disease, linked psychiatry with neurology, and reinforced categories of mental health disorders. Universality of biomedical concepts across culture is assumed in the globalisation of mental health but is strongly disputed by transcultural psychiatrists and anthropologists. Global mental health movement priorities take an individualised view, emphasising treatment and scale-up and neglecting social and structural determinants of health. To meet international targets and address the problem's broad social and cultural dimensions, the global mental health movement and advocates must develop more comprehensive strategies and include more diverse perspectives.
Labonté, Ronald; Gagnon, Michelle L
Global health financing has increased dramatically in recent years, indicative of a rise in health as a foreign policy issue. Several governments have issued specific foreign policy statements on global health and a new term, global health diplomacy, has been coined to describe the processes by which state and non-state actors engage to position health issues more prominently in foreign policy decision-making. Their ability to do so is important to advancing international cooperation in health. In this paper we review the arguments for health in foreign policy that inform global health diplomacy. These are organized into six policy frames: security, development, global public goods, trade, human rights and ethical/moral reasoning. Each of these frames has implications for how global health as a foreign policy issue is conceptualized. Differing arguments within and between these policy frames, while overlapping, can also be contradictory. This raises an important question about which arguments prevail in actual state decision-making. This question is addressed through an analysis of policy or policy-related documents and academic literature pertinent to each policy framing with some assessment of policy practice. The reference point for this analysis is the explicit goal of improving global health equity. This goal has increasing national traction within national public health discourse and decision-making and, through the Millennium Development Goals and other multilateral reports and declarations, is entering global health policy discussion. Initial findings support conventional international relations theory that most states, even when committed to health as a foreign policy goal, still make decisions primarily on the basis of the 'high politics' of national security and economic material interests. Development, human rights and ethical/moral arguments for global health assistance, the traditional 'low politics' of foreign policy, are present in discourse but do
Full Text Available Abstract Global health financing has increased dramatically in recent years, indicative of a rise in health as a foreign policy issue. Several governments have issued specific foreign policy statements on global health and a new term, global health diplomacy, has been coined to describe the processes by which state and non-state actors engage to position health issues more prominently in foreign policy decision-making. Their ability to do so is important to advancing international cooperation in health. In this paper we review the arguments for health in foreign policy that inform global health diplomacy. These are organized into six policy frames: security, development, global public goods, trade, human rights and ethical/moral reasoning. Each of these frames has implications for how global health as a foreign policy issue is conceptualized. Differing arguments within and between these policy frames, while overlapping, can also be contradictory. This raises an important question about which arguments prevail in actual state decision-making. This question is addressed through an analysis of policy or policy-related documents and academic literature pertinent to each policy framing with some assessment of policy practice. The reference point for this analysis is the explicit goal of improving global health equity. This goal has increasing national traction within national public health discourse and decision-making and, through the Millennium Development Goals and other multilateral reports and declarations, is entering global health policy discussion. Initial findings support conventional international relations theory that most states, even when committed to health as a foreign policy goal, still make decisions primarily on the basis of the 'high politics' of national security and economic material interests. Development, human rights and ethical/moral arguments for global health assistance, the traditional 'low politics' of foreign policy, are
The environment continues to be a source of ill-health for many people, particularly in developing countries. International environmental law offers a viable strategy for enhancing public health through the promotion of increased awareness of the linkages between health and environment, mobilization of technical and financial resources, strengthening of research and monitoring, enforcement of health-related standards, and promotion of global cooperation. An enhanced capacity to utilize intern...
This chapter represents a preliminary effort to understand the health implications of transnsational economic integration (globalization) for population health in Canadian metropolitan areas, and to inform the development of policy responses and strategies of resistance. Special emphasis is placed on health equity as it is affected by social determinants of health. I first provide a stylized description of the rationale for concentrating on major metropolitan areas, rather than on...
McMichael, A J; Beaglehole, R
Future health prospects depend increasingly on globalisation processes and on the impact of global environmental change. Economic globalisation--entailng deregulated trade and investment--is a mixed blessing for health. Economic growth and the dissemination of technologies have widely enhanced life expectancy. However, aspects of globalisation are jeopardising health by eroding social and environmental conditions, exacerbating the rich-poor gap, and disseminating consumerism. Global environmental changes reflect the growth of populations and the intensity of economic activity. These changes include altered composition of the atmosphere, land degradation, depletion of terrestrial aquifers and ocean fisheries, and loss of biodiversity. This weakening of life-supporting systems poses health risks. Contemporary public health must therefore encompass the interrelated tasks of reducing social and health inequalities and achieving health-sustaining environments. PMID:10981904
Edgar Barillas discusses the factors contributing to the global transformation of national health systems, the consequences that it may have on the health situation of the population, and the new role that international organizations may have in this scenario. Development (1999) 42, 76–77. doi:10.1057/palgrave.development.1110089
Stein, Dan J; He, Yanling; Phillips, Anthony; Sahakian, Barbara J; Williams, John; Patel, Vikram
Global mental health has emerged as an important specialty. It has drawn attention to the burden of mental illness and to the relative gap in mental health research and services around the world. Global mental health has raised the question of whether this gap is a developmental issue, a health issue, a human rights issue, or a combination of these issues-and it has raised awareness of the need to develop new approaches for building capacity, mobilising resources, and closing the research and treatment gap. Translational neuroscience has also advanced. It comprises an important conceptual approach to understanding the neurocircuitry and molecular basis of mental disorders, to rethinking how best to undertake research on the aetiology, assessment, and treatment of these disorders, with the ultimate aim to develop entirely new approaches to prevention and intervention. Some apparent contrasts exist between these fields; global mental health emphasises knowledge translation, moving away from the bedside to a focus on health systems, whereas translational neuroscience emphasises molecular neuroscience, focusing on transitions between the bench and bedside. Meanwhile, important opportunities exist for synergy between the two paradigms, to ensure that present opportunities in mental health research and services are maximised. Here, we review the approaches of global mental health and clinical neuroscience to diagnosis, pathogenesis, and intervention, and make recommendations for facilitating an integration of these two perspectives. PMID:26359754
Franco-Paredes, Carlos; Zeuli, Julia; Hernández-Ramos, Isabel; Santos-Preciado, Jose I
If the field of global health is to evolve in the second decade of the new millennium, we need to revive the idealistic spirit and by using the lens of health equity work toward improved health status around the world. Morality and empathy are considered by-products of our evolutionary history as a human species. Idealism may be a trait that we may choose to preserve in our modern evolutionary history. PMID:21513081
Wells, J N; Bush, H A; Marshall, D
The purpose of the study was to test the psychometric properties of a culturally sensitive and theory-based instrument: the Breast Health Behavior Questionnaire. This instrument was translated into Spanish and back-translated at a third- to fourth-grade reading level. The pilot group consisted of 70 Hispanic women who attended a class at a local church. Subsequent to pilot testing, another 40 Hispanic women who attended a class at the local health department comprised the study sample. The participants responded to the 15-item questionnaire, which is formatted as a Likert scale. Content validity of the Breast Health Behavior Questionnaire was determined by a panel of experts. A factor analysis of this instrument showed five separate dimensions accounting for 71.82% of the instrument's variance. The three major components of self-regulation theory (schema, coping, and appraisal criteria) were found clustered within the first three dimensions after three items were discarded. The Breast Health Behavior Questionnaire demonstrated an internal consistency reliability coefficient of .7172. The psychometric properties of the Spanish version of this questionnaire warrant further research. The instrument may support a better understanding of the Hispanic woman's practice of breast health behavior. Eventually, the Breast Health Behavior Questionnaire may assist nurses in the formulation of culturally grounded interventions. PMID:11502042
Haines, A. (Univ. College London Medical School, London (United Kingdom). Whittington Hospital); Parry, M. (Univ. of Oxford (United Kingdom). Environmental Change Unit)
Prediction of the impacts of global climate change on health is complicated by a number of factors. These include: the difficulty in predicting regional changes in climate, the capacity for adaptation to climate change, the interactions between the effects of global climate change and a number of other key determinants of health, including population growth and poverty, and the availability of adequate preventive and curative facilities for diseases that may be effected by climate change. Nevertheless, it is of importance to consider the potential health impacts of global climate change for a number of reasons. It is also important to monitor diseases which could be effected by climate change in order to detect changes in incidence as early as possible and study possible interactions with other factors. It seems likely that the possible impacts on health of climate change will be a major determinant of the degree to which policies aimed at reducing global warming are followed, as perceptions of the effect of climate change to human health and well-being are particularly likely to influence public opinion. The potential health impacts of climate change can be divided into direct (primary) and indirect (secondary and tertiary) effects. Primary effects are those related to the effect of temperature on human well-being and disease. Secondary effects include the impacts on health of changes in food production, availability of water and of sea level rise. A tertiary level of impacts can also be hypothesized.
In order to identify perspectives on global health, this essay analyzes different trends from academia that have enriched global health and international health. A database was constructed with information from the world's leading global health centers. The search covered authors on global diplomacy and global health and was performed in PubMed, LILACS, and Google Scholar with the key words "global health" and "international health". Research and training centers in different countries have taken various academic approaches to global health; various interests and ideological orientations have emerged in relation to the global health concept. Based on the mosaic of global health centers and their positions, the review concludes that the new concept reflects the construction of a paradigm of renewal in international health and global health, the pre-paradigmatic stage of which has still not reached a final version. PMID:26578006
LaPorte, R E
Applications of networking to health care have focused on the potential of networking to transmit data and to reduce the cost of health care. In the early 198Os networks began forming among academic institutions; one of them was Bitnet. During the 1980s Internet evolved, which joined diverse networks, including those of governments and industry. The first step is to connect public health organizations such as ministries of health, the World Health Organization, the Pan-American Health Organization, and the United Nations. Computer-based telecommunication will vastly increase effective transmission of information. Networking public health workers in local health departments, academia, governments, industry, and private agencies, will bring great benefits. One is global disease telemonitoring: with new epidemiological techniques such as capture-recapture, accurate estimates of incidences of important communicable and non-communicable diseases can now be obtained. Currently all countries in the Americas except Haiti are connected through Internet. No systematic integration of telecommunication and public health systems across countries has occurred yet. On-line vital statistics could be usable almost instantaneously to facilitate monitoring and forecasting of population growth and the health needs of mothers and children. Linking global disease telemonitoring (morbidity data for non-communicable diseases) with environmental data systems would considerably improve understanding of the environmental determinants of disease. Internet is already linked to the National Library of Medicine through Bitnis. Computer based distance education is rapidly improving through E-mail searches. Reading materials, video, pictures, and sound could be transmitted across huge distances for low costs. Hundreds of schools are already networked together. On-line electronic journals and books have the potential for instantaneous dissemination of free information through gopher servers. Global
Chatwood, Susan; Bjerregaard, Peter; Young, T Kue
in the northern hemisphere have developed different health systems, strategies, and practices, some of which are relevant to middle and lower income countries. As the Arctic gains prominence as a sentinel of global issues such as climate change, the health of circumpolar populations should be part of......Global health should encompass circumpolar health if it is to transcend the traditional approach of the "rich North" assisting the "poor South." Although the eight Arctic states are among the world's most highly developed countries, considerable health disparities exist among regions across the...... Arctic, as well as between northern and southern regions and between indigenous and nonindigenous populations within some of these states. While sharing commonalities such as a sparse population, geographical remoteness, harsh physical environment, and underdeveloped human resources, circumpolar regions...
Evans, Retta R.; Horton, Jacqueline A.; Ahmad, Wajih A.; Davies, Susan L.; Snyder, Scott W.; Macrina, David M.
Purpose: A breast health educational program was administered in two public high school settings in north Alabama to subjects enrolled in health related courses. The purpose of this quasi-experimental study was to determine if teaching breast health with or without interactive learning would affect the breast health knowledge and beliefs of…
Canada's role in the supply of radioisotopes for healthcare applications is unparalleled anywhere else in the world. The NRU reactor, owned and operated by AECL, is the world's major manufacturer of reactor based isotopes. Our cyclotron facilities at the University of British Columbia, TRIUMF facilities, produce unique isotopes for medical research and treatment. CANDU power reactors operated by Hydro Quebec, Bruce Power and Ontario Power Generation are a key source of cobalt-60 production for use in the sterilization of single use medical products. Most of the innovation today is in medical applications of radioisotope technology. Every day, some 34,000 medical procedures take place using medical isotopes supplied by MDS Nordion. Sustaining this daily supply stream of medical isotopes around the world requires a complex combination of production, processing, and timely delivery of high quality isotopes. The NRU reactor, which has played a key role in supplying medical isotopes to date, has been in operation for over 40 years. Replacing this aging reactor has been a priority for MDS Nordion in order to assure the global nuclear medicine community that Canada can continue to be a dependable supplier of medical isotopes. MDS Nordion commissioned AECL to construct two MAPLE reactors dedicated to the production of medical isotopes. The MDS Nordion Medical Isotope Reactor (MMIR) project started in September 1996. This paper provides an update on the MAPLE reactors that AECL has built at its CRL site and will operate for MDS Nordion. (author)
Four points are made about globalization and health. First, economic integration is a powerful force for raising the incomes of poor countries. In the past 20 years several large developing countries have opened up to trade and investment, and they are growing well--faster than the rich countries. Second, there is no tendency for income inequality to increase in countries that open up. The higher growth that accompanies globalization in developing countries generally benefits poor people. Sin...
Full Text Available INTRODUCTION: Breast cancer appears to be a disease of both developing and developed country. Breast cancer is now the most common cancer in most cities in India, and 2nd most common in the rural areas. OBJECTIVES: 1. To assess the knowledge, attitude and practice of self breast examination am ong health care professionals. 2. To assess breast cancer awareness among health care professionals. METHODOLOGY : A questionnaire based cross sectional study in which 133 women belonging to various medical and allied specialties were included. RESULTS: It was found that most (91% respondents were aware of BSE. The electronic media were the major sources of information followed by information from co - health workers. The attitude of health professionals on BSE was positive, with a fairly high degree of accep tability of the idea. Despite the positive attitude to BSE, its practice was low (73.7%. CONCLUSION: BSE is a cost effective screening modality. In view of worldwide rising trends in the incidence of breast cancer rates, importance of BSE should be popula rised through mass media.
Robyn Norton is co-founder and Principal Director of The George Institute for Global Health (Australia), a not-for-profit medical research institute that aims to increase the provision of safe, effective and affordable healthcare, especially for disadvantaged populations worldwide. She is Professor of Global Health and James Martin Fellow at the University of Oxford (UK), Professor of Public Health at the University of Sydney (Australia) and Honorary Professor at Peking University (China). Professor Norton is internationally regarded for her research on the causes, prevention and management of injuries and the management of various critical conditions in surgical and intensive care settings. She has had a long-standing commitment to improving women's health, particularly in resource-poor environments. PMID:27189820
Van Der Pol, Barbara
Laboratory generated data are used in support of several types of global health research. Routinely obtained clinical diagnostic data are used for disease surveillance, epidemiologic analysis of frequencies and trends, health outcomes research, and sponsored research projects. Clinical data from research laboratories is also collected in support of sponsored research projects. Whether the initial purpose of the testing is in support of research protocols or the data are retrospectively review...
Su, Xiaoyou; Liang, Xiaohui; Mao, Zongfu; Sun, Jikuan; Jiang, Yu; Liu, Yuanli; Ren, Minghui
Under the background of globalization, public health issues are becoming more and more complicated. In the international arena, global health has gradually replaced international health and "global public health" as one of the dominant terms in the field of public health. However, until now, there is no unified understanding and definition for the concept of global health domestically and internationally. In this article, various foreign experts 'views and domestic experts' opinions about the concept of global health are collected and solicited, in order to generalize appropriate Chinese definition of global health of China. PMID:26268860
Mycotoxins are fungal metabolites produced my micro-fungi (molds and mildews) that have significant impacts on global economics and health. Some of these metabolites are beneficial, but most are harmful and have been associated with well-known epidemics dating back to medieval times. The terms ‘myco...
Brantley-Sieders, Dana M.; Fan, Kang-Hsien; Deming-Halverson, Sandra L.; Shyr, Yu; Cook, Rebecca S.
Despite available demographic data on the factors that contribute to breast cancer mortality in large population datasets, local patterns are often overlooked. Such local information could provide a valuable metric by which regional community health resources can be allocated to reduce breast cancer mortality. We used national and statewide datasets to assess geographical distribution of breast cancer mortality rates and known risk factors influencing breast cancer mortality in middle Tenness...
Paulo M. Buss
Full Text Available More than 2,300 public health professionals from around the world attended the 12th World Public Health Congress, in Istanbul, between April 27th and May 1st, 2009. Participants from 120 countries from all corners of the globe advocated for different disciplines and composed an eclectic and propitious audience for a profound discussion on the part each individual – as well as national associations, at the country level, and the Federation, at the global level – plays in facing the challenges currently posed to the field of Public Health.
Madkhali, Norah Abdullah; Santin, Olinda; Noble, Helen; Reid, Joanne
Aims: To explore breast health awareness and the early diagnosis and detection methods of breast cancer from the perspective of women and primary health care providers in the Jizan region of the Kingdom of Saudi Arabia. Background: While there is a high incidence of advanced breast cancer in young women in the Kingdom of Saudi Arabia, there is no standardised information regarding breast self-examination, nor is there a national screening programme involving clinical breast examination and ma...
Ahdoot, Samantha; Pacheco, Susan E
Rising global temperature is causing major physical, chemical, and ecological changes across the planet. There is wide consensus among scientific organizations and climatologists that these broad effects, known as climate change, are the result of contemporary human activity. Climate change poses threats to human health, safety, and security. Children are uniquely vulnerable to these threats. The effects of climate change on child health include physical and psychological sequelae of weather disasters, increased heat stress, decreased air quality, altered disease patterns of some climate-sensitive infections, and food, water, and nutrient insecurity in vulnerable regions. Prompt implementation of mitigation and adaptation strategies will protect children against worsening of the problem and its associated health effects. This technical report reviews the nature of climate change and its associated child health effects and supports the recommendations in the accompanying policy statement on climate change and children's health. PMID:26504134
Minhas Gunjeet S
Full Text Available Abstract Background Experience with public engagement activities regarding the risks and benefits of science and technology (S&T is growing, especially in the industrialized world. However, public engagement in the developing world regarding S&T risks and benefits to explore health issues has not been widely explored. Methods This paper gives an overview about public engagement and related concepts, with a particular focus on challenges and benefits in the developing world. We then describe an Internet-based platform, which seeks to both inform and engage youth and the broader public on global water issues and their health impacts. Finally, we outline a possible course for future action to scale up this and similar online public engagement platforms. Results The benefits of public engagement include creating an informed citizenry, generating new ideas from the public, increasing the chances of research being adopted, increasing public trust, and answering ethical research questions. Public engagement also fosters global communication, enables shared experiences and methodology, standardizes strategy, and generates global viewpoints. This is especially pertinent to the developing world, as it encourages previously marginalized populations to participate on a global stage. One of the core issues at stake in public engagement is global governance of science and technology. Also, beyond benefiting society at large, public engagement in science offers benefits to the scientific enterprise itself. Conclusion Successful public engagement with developing world stakeholders will be a critical part of implementing new services and technologies. Interactive engagement platforms, such as the Internet, have the potential to unite people globally around relevant health issues.
Barnes, Amy; Brown, Garrett W; Harman, Sophie
Partnership is a key idea in current debates about global health and development assistance, yet little is known about what partnership means to those who are responsible for operationalising it or how it is experienced in practice. This is particularly the case in the context of African health systems. This paper explores how health professionals working in global health hubs and the health systems of South Africa, Tanzania and Zambia understand and experience partnership. Drawing on semi-structured interviews with 101 professionals based in each country, Washington DC and Geneva between October 2012 and June 2013, the paper makes four key arguments. First, partnership has a legitimating function in global health policy processes for international development institutions, government agencies and civil society organisations alike. Second, the practice of partnership generates idiosyncratic and complicated relationships that health professionals have to manage and navigate, often informally. Third, partnership is shaped by historical legacies, critical events, and independent consultants. Fourth, despite being an accepted part of global health policy, there is little shared understanding of what good partnership is meant to include or resemble in practice. Knowing more about the specific socio-cultural and political dynamics of partnership in different health system contexts is critical to equip health professionals with the skills to build the informal relations that are essential to effective partnership engagement. PMID:27155226
The significance of contact with microbes in early life for subsequent health has been the subject of intense research during the last 2 decades. Disturbances in the establishment of the indigenous intestinal microbiome caused by cesarean section delivery or antibiotic exposure in early life have been linked to the risk of immune-mediated and inflammatory conditions such as atopic disorders, inflammatory bowel disease and obesity later in life. Distinct microbial populations have recently been discovered at maternal sites including the amniotic cavity and breast milk, as well as meconium, which have previously been thought to be sterile. Our understanding of the impact of fetal microbial contact on health outcomes is still rudimentary. Breast milk is known to modulate immune and metabolic programming. The breast milk microbiome is hypothesized to guide infant gut colonization and is affected by maternal health status and mode of delivery. Immunomodulatory factors in breast milk interact with the maternal and infant gut microbiome and may mediate some of the health benefits associated with breastfeeding. The intimate connection between the mother and the fetus or the infant is a potential target for microbial therapeutic interventions aiming to support healthy microbial contact and protect against disease. PMID:26051698
Martin, Greg; Grant, Alexandra; D'Agostino, Mark
The impact of increased national wealth, as measured by Gross Domestic Product (GDP), on public health is widely understood, however an equally important but less well-acclaimed relationship exists between improvements in health and the growth of an economy. Communicable diseases such as HIV, TB, Malaria and the Neglected Tropical Diseases (NTDs) are impacting many of the world's poorest and most vulnerable populations, and depressing economic development. Sickness and disease has decreased the size and capabilities of the workforce through impeding access to education and suppressing foreign direct investment (FDI). There is clear evidence that by investing in health improvements a significant increase in GDP per capita can be attained in four ways: Firstly, healthier populations are more economically productive; secondly, proactive healthcare leads to decrease in many of the additive healthcare costs associated with lack of care (treating opportunistic infections in the case of HIV for example); thirdly, improved health represents a real economic and developmental outcome in-and-of itself and finally, healthcare spending capitalises on the Keynesian 'economic multiplier' effect. Continued under-investment in health and health systems represent an important threat to our future global prosperity. This editorial calls for a recognition of health as a major engine of economic growth and for commensurate investment in public health, particularly in poor countries. PMID:22490207
Many breast cancer patients use complementary and alternative medicine (CAM). We aimed to determine what advice health food store employees present to individuals seeking treatment options for breast cancer. Eight data gatherers asked employees of all retail health food stores in a major Canadian city, what they recommended for a patient with breast cancer. The data gatherers inquired about product safety, potential drug interactions, costs and efficacy. They also enquired about employee training related to the products. Thirty-four stores were examined. A total of 33 different products were recommended, none of which are supported by sufficient evidence of efficacy. The average cost of the products they recommended was $58.09 (CAD) (minimum $5.28, median $32.99, maximum $600) per month. Twenty-three employees (68%) did not ask whether the patient took prescription medications. Fifteen employees (44%) recommended visiting a healthcare professional (naturopaths (9), physicians (5), nutritionists (1). Three employees (8.8%) discussed potential adverse effects of the products. Eight employees (23.5%) discussed the potential for drug interactions. Two employees (5.9%) suggested a possible cure with the products and one employee (2.9%) suggested discontinuing Tamoxifen. Four employees (11.8%) recommended lifestyle changes and three employees (8.8%) recommended books for further reading on the products. This study draws attention to the heterogeneity of advice provided by natural health food stores to individuals seeking treatments for breast cancer, and the safety and cost implications of some of the products recommended. Physicians should enquire carefully about the use of natural health food products by patients with breast cancer. Regulators need to consider regulations to protect vulnerable patients from incurring significant costs in their purchasing of natural health food products lacking evidence of benefit and of questionable safety
Consequences to the health of human populations of ignoring various signs that global climate change is a large and qualitatively distinct environmental health hazard are discussed. Evidence is cited to illustrate how even low ambient concentrations of air pollution can have deleterious and harmful impacts on human health, and a warning is issued about the dangers of conducting an unpredictable rather massive experiment with the earth's atmosphere. Opportunities for adaptation such as conservation of freshwater and agricultural land, combined with education, technological development and individual behavioral change, and drastic reduction of anthropogenic sources of greenhouse gases to lessen the effects of impending climatic change have been much talked about, but action has been non-existent, or tentative at best. Part of the reason for the apparent lack of willingness to act is largely economic, aided by the many remaining uncertainties regarding the impact of climate change, especially in so far as human health is concerned. However, this author's view is that our limited understanding of the relationship among the growing list of atmospheric pollutants and their effect on the ecosystems on which we depend, is no reason not to take action until it becomes too late.
Kollar, Eszter; Laukötter, Sebastian; Buyx, Alena
One of the most ambitious and sophisticated recent approaches to provide a theory of global health justice is Sridhar Venkatapuram's recent work. In this commentary, we first outline the core idea of Venkatapuram's approach to global health justice. We then argue that one of the most important elements of the account, Venkatapuram's basis of global health duties, is either too weak or assumed implicitly without a robust justification. The more explicit grounding of the duty to protect and promote health capabilities is based on Martha Nussbaum's version of the capability approach. We argue that this foundation gives rise to humanitarian duties rather than duties of justice proper. Venkatapuram's second argument from the social determinants of health thesis is instead a stronger candidate for grounding duties of justice. However, as a justificatory argument, it is only alluded to and has not yet been spelled out sufficiently. We offer plausible justificatory steps to fill this gap and draw some implications for global health action. We believe this both strengthens Venkatapuram's approach and serves to broaden the basis for future action in the area of global health. PMID:26686330
Laura Hall, Amy
The barrier to global health most often noted in Western discourse is the enduring disparity of access to medical technologies. This assessment of the circumstances in global health fits well within a bioethic centered on the equitable distribution of access to medical goods. Yet through an interrogative consideration of two episodes in the marketing of progress, namely the Century of Progress Exposition in Chicago (1933-1934) and one post-war spin on atomic development in the National Geographic, I suggest that the language of medical advancement continues to trade on a division between civilized, rational, scientifically developed peoples and the atavism of peoples by whom Western science gauges its progress. I recommend unremittingly self-critical attention to the dynamics of language and legitimization used within the Western academy by those who seek ostensibly to be of use in regions (powerfully) labeled as "developing." PMID:16760105
Due to the build up of green house gases in atmosphere, less heat escapes through the atmosphere promoting global warming. This may result in world wide droughts, sea-level rise inundating islands and coastal countries, cataclysmic hurricanes etc. Human health as a result of these changes, will be affected both physiologically and psychologically. Physiological effects may be more pronounced in cases occurring due to changes in rainfall and temperature patterns, food production amounts, water availability, etc. Psychological impact may be more in cases of catastrophes like floods, hurricanes or famine. In this paper, an attempt has been made to highlight the implications of global warming on human health due to temperature change. Food production changes and ultra-violet radiation effects and cataclysmic disaster effects. (author)
This paper identifies potential health problems that may arise from global climates changes caused by increasing green house gases and depletion in the ozone layer. The mankind is responsible for saving or destroying the environment. There are many forms which can pollute the environment like greenhouse activities. The greenhouse gases like carbon dioxide, methane and ozone etc. cause pollutants in the environment. (A.B.)
Lolas Stepke, Fernando
Advancing the opinion that global mental health supersedes public and international levels and deals with an integrative approach, this paper elaborates some of the implications of a differential ethics theory as outlined by H.M. Sass. Rejecting the extremes of moralizing generalizations and narrow scientific stances, it considers the need for cultural competence and praxis-relevant thinking in ethical evaluation. This does not only apply to the relationships between experts and lay people...
Naeemah Abrahams; Shanaaz Mathews; Martin, Lorna J.; Carl Lombard; Nadine Nannan; Rachel Jewkes
Editors' Summary Background Child mortality (death) is a global public health concern. In 2015, 5.9 million children (43 out of every 1,000 children born alive) died before their fifth birthday. Nearly half of these deaths occurred among neonates (babies 28 days old or younger); three-quarters of them occurred among infants (children less than one year old). Most of these deaths happened in resource-limited countries following delivery complications, infections, and other natural causes. Some...
Full Text Available OBJECTIVE: To set investment priorities in global mental health research and to propose a more rational use of funds in this under-resourced and under-investigated area. METHODS: Members of the Lancet Mental Health Group systematically listed and scored research investment options on four broad classes of disorders: schizophrenia and other major psychotic disorders, major depressive disorder and other common mental disorders, alcohol abuse and other substance abuse disorders, and the broad class of child and adolescent mental disorders. Using the priority-setting approach of the Child Health and Nutrition Research Initiative, the group listed various research questions and evaluated them using the criteria of answerability, effectiveness, deliverability, equity and potential impact on persisting burden of mental health disorders. Scores were then weighted according to the system of values expressed by a larger group of stakeholders. FINDINGS: The research questions that scored highest were related to health policy and systems research, where and how to deliver existing cost-effective interventions in a low-resource context, and epidemiological research on the broad categories of child and adolescent mental disorders or those pertaining to alcohol and drug abuse questions. The questions that scored lowest related to the development of new interventions and new drugs or pharmacological agents, vaccines or other technologies. CONCLUSION: In the context of global mental health and with a time frame of the next 10 years, it would be best to fill critical knowledge gaps by investing in research into health policy and systems, epidemiology and improved delivery of cost-effective interventions.
Labonté, Ronald; Schrecker, Ted
This article is the third in a three-part review of research on globalization and the social determinants of health (SDH). In the first article of the series, we identified and defended an economically oriented definition of globalization and addressed a number of important conceptual and metholodogical issues. In the second article, we identified and described seven key clusters of pathways relevant to globalization's influence on SDH. This discussion provided the basis for the premise from which we begin this article: interventions to reduce health inequities by way of SDH are inextricably linked with social protection, economic management and development strategy. Reflecting this insight, and against the background of the Millennium Development Goals (MDGs), we focus on the asymmetrical distribution of gains, losses and power that is characteristic of globalization in its current form and identify a number of areas for innovation on the part of the international community: making more resources available for health systems, as part of the more general task of expanding and improving development assistance; expanding debt relief and taking poverty reduction more seriously; reforming the international trade regime; considering the implications of health as a human right; and protecting the policy space available to national governments to address social determinants of health, notably with respect to the hypermobility of financial capital. We conclude by suggesting that responses to globalization's effects on social determinants of health can be classified with reference to two contrasting visions of the future, reflecting quite distinct values. PMID:17578570
Full Text Available Abstract This article is the third in a three-part review of research on globalization and the social determinants of health (SDH. In the first article of the series, we identified and defended an economically oriented definition of globalization and addressed a number of important conceptual and metholodogical issues. In the second article, we identified and described seven key clusters of pathways relevant to globalization's influence on SDH. This discussion provided the basis for the premise from which we begin this article: interventions to reduce health inequities by way of SDH are inextricably linked with social protection, economic management and development strategy. Reflecting this insight, and against the background of the Millennium Development Goals (MDGs, we focus on the asymmetrical distribution of gains, losses and power that is characteristic of globalization in its current form and identify a number of areas for innovation on the part of the international community: making more resources available for health systems, as part of the more general task of expanding and improving development assistance; expanding debt relief and taking poverty reduction more seriously; reforming the international trade regime; considering the implications of health as a human right; and protecting the policy space available to national governments to address social determinants of health, notably with respect to the hypermobility of financial capital. We conclude by suggesting that responses to globalization's effects on social determinants of health can be classified with reference to two contrasting visions of the future, reflecting quite distinct values.
A science writers' seminar to discuss the latest research in cancer genetics and global health efforts, including talks from leaders of NCI’s new centers of cancer genomics and global health will be held Dec. 13, 2011, at NCI.
Shea, Katherine M
There is broad scientific consensus that Earth's climate is warming rapidly and at an accelerating rate. Human activities, primarily the burning of fossil fuels, are very likely (>90% probability) to be the main cause of this warming. Climate-sensitive changes in ecosystems are already being observed, and fundamental, potentially irreversible, ecological changes may occur in the coming decades. Conservative environmental estimates of the impact of climate changes that are already in process indicate that they will result in numerous health effects to children. The nature and extent of these changes will be greatly affected by actions taken or not taken now at the global level. Physicians have written on the projected effects of climate change on public health, but little has been written specifically on anticipated effects of climate change on children's health. Children represent a particularly vulnerable group that is likely to suffer disproportionately from both direct and indirect adverse health effects of climate change. Pediatric health care professionals should understand these threats, anticipate their effects on children's health, and participate as children's advocates for strong mitigation and adaptation strategies now. Any solutions that address climate change must be developed within the context of overall sustainability (the use of resources by the current generation to meet current needs while ensuring that future generations will be able to meet their needs). Pediatric health care professionals can be leaders in a move away from a traditional focus on disease prevention to a broad, integrated focus on sustainability as synonymous with health. This policy statement is supported by a technical report that examines in some depth the nature of the problem of climate change, likely effects on children's health as a result of climate change, and the critical importance of responding promptly and aggressively to reduce activities that are contributing to
Corruption is a serious threat to global health outcomes, leading to financial waste and adverse health consequences. Yet, forms of corruption impacting global health are endemic worldwide in public and private sectors, and in developed and resource-poor settings alike. Allegations of misuse of funds and fraud in global health initiatives also threaten future investment. Current domestic and sectorial-level responses are fragmented and have been criticized as ineffective. In order to address this issue, we propose a global health governance framework calling for international recognition of “global health corruption” and development of a treaty protocol to combat this crucial issue. PMID:23088820
Petersen, Poul Erik
promotion of oral health needs to be integrated with chronic disease prevention and general health promotion as the risks to health are linked. The World Health Assembly (WHA) and the Executive Board (EB) are supreme governance bodies of WHO and for the first time in 25 years oral health was subject to......The World Health Organization (WHO) Global Oral Health Programme has worked hard over the past five years to increase the awareness of oral health worldwide as an important component of general health and quality of life. Meanwhile, oral disease is still a major public health problem in high income...... countries and the burden of oral disease is growing in many low- and middle income countries. In the World Oral Health Report 2003, the WHO Global Oral Health Programme formulated the policies and the necessary actions for the improvement of oral health. The strategy is that oral disease prevention and the...
Bjegovic-Mikanovic, Vesna; Jovic-Vranes, Aleksandra; Czabanowska, Katarzyna; Otok, Robert
Introduction: At the present time, higher education institutions dealing with education for public health in Europe and beyond are faced with a complex and comprehensive task of responding to global health challenges.Review: Literature reviews in public health and global health and exploration of internet presentations of regional and global organisations dealing with education for public health were the main methods employed in the work presented in this paper. Higher academic institutions a...
This paper introduces, describes and analyses the emerging concept of Global Mental Health (GMH). The birth of GMH can be traced to London, 2007, with the publication of a series of high-profile papers in The Lancet. Since then, GMH has developed into a movement with proponents, adherents, opponents, an ideology and core activities. The stated aims of the Movement for GMH are 'to improve services for people living with mental health problems and psychosocial disabilities worldwide, especially in low- and middle-income countries where effective services are often scarce'. GMH could be considered an attempt to right a historic wrong. During the colonial and post-colonial eras, the mental health of subject populations was accorded a very low priority. This was fuelled by scientific racism, which alleged that mental illness was uncommon in places such as Africa. As developing nations have made the epidemiological transition, the burden of mental illness has proportionately increased, with research suggesting a massive 'treatment gap' between those in need and those actually receiving formal mental health care. As such, much GMH research and action has been devoted to: (i) the identification and scale-up of cost-effective evidence-supported interventions that could be made more widely available; (ii) task-shifting of such intervention delivery to mental-health trained non-specialist Lay Health Workers. GMH has come under sustained critique. Critics suggest that GMH is colonial medicine come full circle, involving the top-down imposition of Western psychiatric models and solutions by Western-educated elites. These critiques suggest that GMH ignores the various indigenous modalities of healing present in non-Western cultures, which may be psychologically adaptive and curative. Relatedly, critics argue that GMH could be an unwitting Trojan horse for the mass medicalisation of people in developing countries, paving the way for exploitation by Big Pharma, while ignoring
Full Text Available Abstract Background Breast cancer is the leading cause of cancer mortality among Jordanian women. Breast malignancies are detected at late stages as a result of deferred breast health-seeking behaviour. The aim of this study was to explore Jordanian women’s views and perceptions about breast cancer and breast health. Methods We performed an explorative qualitative study with purposive sampling. Ten focus groups were conducted consisting of 64 women (aged 20 to 65 years with no previous history and no symptoms of breast cancer from four governorates in Jordan. The transcribed data was analysed using latent content analysis. Results Three themes were constructed from the group discussions: a Ambivalence in prioritizing own health; b Feeling fear of breast cancer; and c Feeling safe from breast cancer. The first theme was seen in women’s prioritizing children and family needs and in their experiencing family and social support towards seeking breast health care. The second theme was building on women’s perception of breast cancer as an incurable disease associated with suffering and death, their fear of the risk of diminished femininity, husband’s rejection and social stigmatization, adding to their apprehensions about breast health examinations. The third theme emerged from the women’s perceiving themselves as not being in the risk zone for breast cancer and in their accepting breast cancer as a test from God. In contrast, women also experienced comfort in acquiring breast health knowledge that soothed their fears and motivated them to seek early detection examinations. Conclusions Women’s ambivalence in prioritizing their own health and feelings of fear and safety could be better addressed by designing breast health interventions that emphasize the good prognosis for breast cancer when detected early, involve breast cancer survivors in breast health awareness campaigns and catalyse family support to encourage women to seek breast
Rajendra eKarkee; Jude eComfort; Helman eAlfonso
Global Public Health is increasingly being seen as a speciality field within the university education of Public Health. However, the exact meaning of Global Public Health is still unclear resulting in varied curricula and teaching units among universities. The contextual differences between high and low and middle income countries, and the process of globalisation need to be taken into account while developing any global public health course.Global Public Health and Public Health are not sepa...
Sarkar, Norma; Dallwig, Amber; Abbott, Patricia
Community Health Nursing (N456) is a required senior clinical course in the undergraduate nursing curriculum at the University of Michigan in which students learn to assess and address the health of populations and communities. In 2012, we began our efforts to internationalize the curriculum using a globally engaged nursing education framework. Our goal is for all students to have an intercultural learning experience understanding that all students are unable to travel internationally. Therefore, this intercultural learning was implemented through a range of experiences including actual immersion, virtual activities (videoconferencing) and interventions with local vulnerable populations. Grants were obtained to provide immersion experiences in Quito, Ecuador and New Delhi, India. Several technologies were initiated with partner nursing schools in Leogane, Haiti and New Delhi, India. Weekly videoconferencing utilizing BlueJeans software and exchange of knowledge through the Knowledge Gateway facilitated intercultural exchange of knowledge and culture. Local clinical groups work with a variety of vulnerable populations. A private blog was developed for all sections to share community assessment data from local and international communities. Qualitative evaluation data was collected for local and international students to begin to assess cultural competence and student learning. Analysis of data documented increased awareness of culture and identified the many positive benefits of interaction with a global partner. PMID:25980716
Full Text Available Objective: This paper examines the scope of practice of global health, drawing on the practical experience of a global health initiative of the Government of Canada – the Teasdale-Corti Global Health Research Partnership Program. A number of challenges in the practical application of theoretical definitions and understandings of global health are addressed. These challenges are grouped under five areas that form essential characteristics of global health: equity and egalitarian North–South partnerships, interdisciplinary scope, focus on upstream determinants of health, global conceptualization, and global health as an area of both research and practice. Design: Information in this paper is based on the results of an external evaluation of the program, which involved analysis of project proposals and technical reports, surveys with grantees and interviews with grantees and program designers, as well as case studies of three projects and a review of relevant literature. Results: The philosophy and recent definitions of global health represent a significant and important departure from the international health paradigm. However, the practical applicability of this maturing area of research and practice still faces significant systemic and structural impediments that, if not acknowledged and addressed, will continue to undermine the development of global health as an effective means to addressing health inequities globally and to better understanding, and acting upon, upstream determinants of health toward health for all. Conclusions: While it strives to redress global inequities, global health continues to be a construct that is promoted, studied, and dictated mostly by Northern institutions and scholars. Until practical mechanisms are put in place for truly egalitarian partnerships between North and South for both the study and practice of global health, the emerging philosophy of global health cannot be effectively put into practice.
thesis deals with scientific aspects and clinical results of a study aimed at assessing the impact of breast cancer (and its treatment) on the patients' quality of life. Studies such as this assessing the problems and symptoms experienced by the patients are often referred to as health-related quality of...... and we did not have a priori hypotheses for all these potential comparisons. Therefore, a staff survey involving experienced doctors and nurses was conducted in order to generate hypotheses that could be tested in the data from patients. We contacted 46 health care professionals and 36 (78%) responded...
Healy, N A; Glynn, R W; Scutaru, Cristian; Groneberg, David; Kerin, M J; Sweeney, K J
The h index is used to assess an individual's contribution to the literature. This metric should not be employed to compare individuals across research areas; rather each subject should have its own baseline and standard. This work aimed to identify global bibliometric benchmarks for those involved in breast cancer research, and specifically, to describe the bibliographic characteristics of breast surgeons in the UK and Ireland. Authorship data was extracted from breast cancer related output from 1945 to 2008, as indexed in the Web of Science. Authors' publications, citations and h indexes were identified. The breast-related output of 277 UK and Irish breast surgeons was evaluated, and a citation report generated for each. Strong correlation was noted between the h index and number of publications (r = 0.642, P research pertaining to the breast; the remainder had together produced 2,060 articles, accounting for 59,002 citations. The top quartile was responsible for 83% of output; the 90th percentile was 20 publications. The range of h index values for the surgeons was 0-50, with a median h index returned of 3 (IQR 1-6); the 90th percentile was 13.5. This work has identified bibliometric benchmarks to which those involved in breast cancer research might aspire. Our findings suggest that there is need for wider involvement of surgeons in the research process and raises questions regarding the future of scientific breast surgery. PMID:21399892
Siddharthan, Trishul; North, Crystal M; Attia, Engi F; Christiani, David C; Checkley, William; West, T Eoin
A growing number of pulmonary and critical care medicine fellowship programs in the United States offer global health training opportunities. Formal, integrated global health programs within pulmonary and critical care fellowships are relatively new but are built on principles and ideals of global health that focus on the mutually beneficial exchange of knowledge and social justice. Although core competencies consistent with these overarching themes in global health education have not been formalized for pulmonary and critical care trainees, relevant competency areas include clinical knowledge, international research training, cultural competency, and clinical and research capacity building. Existing global health education in U.S. pulmonary and critical care medicine training programs can generally be classified as one of three different models: integrated global health tracks, global health electives, and additional research years. Successful global health education programs foster partnerships and collaborations with international sites that emphasize bidirectional exchange. This bidirectional exchange includes ongoing, equitable commitments to mutual opportunities for training and professional development, including a focus on the particular knowledge and skill sets critical for addressing the unique priorities of individual countries. However, barriers related to the availability of mentorship, funding, and dedicated time exist to expanding global health education in pulmonary and critical care medicine. The implementation of global health training within pulmonary and critical care medicine programs requires continued optimization, but this training is essential to prepare the next generation of physicians to address the global aspects of respiratory disease and critical illness. PMID:26974557
Watson, Robert T.; Patz, Jonathan; Gubler, Duane J.; Parson, Edward A.; Vincent, James H.
This paper reviews the background that has led to the now almost-universally held opinion in the scientific community that global climate change is occurring and is inescapably linked with anthropogenic activity. The potential implications to human health are considerable and very diverse. These include, for example, the increased direct impacts of heat and of rises in sea level, exacerbated air and water-borne harmful agents, and - associated with all the preceding - the emergence of environmental refugees. Vector-borne diseases, in particular those associated with blood-sucking arthropods such as mosquitoes, may be significantly impacted, including redistribution of some of those diseases to areas not previously affected. Responses to possible impending environmental and public health crises must involve political and socio-economic considerations, adding even greater complexity to what is already a difficult challenge. In some areas, adjustments to national and international public health practices and policies may be effective, at least in the short and medium terms. But in others, more drastic measures will be required. Environmental monitoring, in its widest sense, will play a significant role in the future management of the problem. (Author)
Many countries in Asia, Africa, Latin America, and the Caribbean offer substantial tax breaks to foreign corporations that set up shops in free-trade zones and waive environmental regulations and repress trade unions to further induce this practice. Workers in these shops--mainly women--perform repetitive machine-based motions, are exposed to toxic chemicals and unsafe equipment, and face dangerously high production quotas. Health problems caused by these working conditions include headache and dizziness, fatigue, anemia, forgetfulness, stomach pains, respiratory problems, hypertension, heart disease, and allergies. Water and air pollution and dumping of hazardous waste affect the health of entire communities. Since free-trade zones are a permanent feature of the global economy, organizing to protect workers and communities assumes critical importance. Groups such as the Border Committee of Women Workers in Mexico are providing workers with skills and support to make demands such as better treatment of pregnant workers. International labor, environmental, and public health advocates can support such efforts by providing assistance to worker-controlled organizations and pressuring governments to enforce laws intended to protect workers and their communities. PMID:12348707
Rao R; Nair Suma; Nair N; Kamath V
Background: Breast cancer being one of the leading cancers among women in developing countries, prevention or identification of the disease at an early stage is of paramount importance in saving as well as improving the quality of life. Breast health awareness appears to be a pragmatic method for this. Objective: To determine the acceptability and effectiveness of an educational intervention programme on breast health awareness for rural women by trained female health workers. Settings and ...
Ouyang, Yan-Qiong; Hu, Xiaoyan
Studies indicate that women in China are not frequently carrying out breast cancer prevention practices. This is assumed to be due to lack of knowledge and/or lack of personalized instruction. This study was to explore the effect of breast cancer health education on women's knowledge and attitudes on breast cancer and breast self-examination, behavior related to breast self-examination among women living in the catchment area of a community health center. A pretest and posttest assessment of a 1-h health education session was conducted with 38 participants. A telephone reminder and questionnaires were administered at 1 and 3 months after the education. Three instruments were administered at each contact to assess the knowledge and attitudes on breast cancer and behavior related to breast self-examination and accuracy of breast self-examination before education, 1- and 3-month follow-ups after education. The findings showed the incidence of self-examination, and scores on the accuracy of breast self-examination practice were significantly increased immediately following the intervention and at 1- and 3-month follow-ups. Furthermore, the scores of the health belief regarding perceived benefits, perceived competency, and perceived seriousness significantly improved. The current findings imply community-based intervention could be used to teach women about the general knowledge of breast cancer and how to perform breast self-examination correctly, especially for women who are lack of such information. PMID:24504664
Anderson, Emily E.; Hoskins, Kent
Research suggests that individual breast cancer risk assessment may improve adherence to recommended screening and prevention guidelines, thereby decreasing morbidity and mortality. Further research on the use of risk assessment models in underserved minority populations is critical to informing national public health efforts to eliminate breast cancer disparities. However, implementing individual breast cancer risk assessment in underserved patient populations raises particular ethical issue...
Recently, global health and global health surveillance have received unprecedented recognition of their importance because of the newly emerging and reemerging infectious diseases, new cycles of pandemics, and the threats of bioterrorism. The aim of this review is to provide an update of the current state of knowledge on health surveillance in a globalized world. Three key areas will be highlighted in this review: 1) the role of the new International Health Regulations, 2) the emergence of new global health networks for surveillance and bioterrorism, and 3) the reshaping of guidelines for the collection, dissemination, and interventions in global surveillance. A discussion is also presented of the more important challenges of global health surveillance. Global surveillance has been reshaped by important changes in the new International Health Regulations and the rapid development of new global networks for disease surveillance and bioterrorism. These networks provide for the first time at the global scale real-time information about potential outbreaks and epidemics of newly emerging and reemerging infectious diseases. The recent outbreaks of severe acute respiratory syndrome (SARS) and the influenza A (H1N1) pandemic provide evidence of the benefits of the new global monitoring and of the importance of the World Health Organization in its coordinating role in the multilateral response of the global public health community. PMID:20534776
In his perspective "Navigating between stealth advocacy and unconscious dogmatism: the challenge of researching the norms, politics and power of global health," Ooms argues that actions taken in the field of global health are dependent not only on available resources, but on the normative premise that guides how these resources are spent. This comment sets out how the application of a predominately biomedical positivist research tradition in global health, has potentially limited understanding of the value judgements underlying decisions in the field. To redress this critical social science, including health policy analysis has much to offer, to the field of global health including on questions of governance. PMID:27239873
Hatfield, Jennifer M.; Hecker, Kent G.; Jensen, Ashley E.
Faculty from the University of Calgary's bachelor of health sciences (BHSc) Global Health Program argue for the development of "global health research competencies" to prepare students for international placements in low- and middle-income countries. These competencies include the ability to define and describe (a) how to use the concept of health…
Geoffrey A. Cordell
Full Text Available Each day, Earth's finite resources are being depleted for energy, for material goods, for transportation, for housing, and for drugs. As we evolve scientifically and technologically, and as the population of the world rapidly approaches 7 billion and beyond, among the many issues with which we are faced is the continued availability of drugs for future global health care. Medicinal agents are primarily derived from two sources, synthetic and natural, or in some cases, as semi-synthetic compounds, a mixture of the two. For the developed world, efforts have been initiated to make drug production "greener", with milder reagents, shorter reaction times, and more efficient processing, thereby using less energy, and reactions which are more atom efficient, and generate fewer by-products. However, most of the world's population uses plants, in either crude or extract form, for their primary health care. There is relatively little discussion as yet, about the long term effects of the current, non-sustainable harvesting methods for medicinal plants from the wild, which are depleting these critical resources without concurrent initiatives to commercialize their cultivation. To meet future public health care needs, a paradigm shift is required in order to adopt new approaches using contemporary technology which will result in drugs being regarded as a sustainable commodity, irrespective of their source. In this presentation, several approaches to enhancing and sustaining the availability of drugs, both synthetic and natural, will be discussed, including the use of vegetables as chemical reagents, and the deployment of integrated strategies involving information systems, biotechnology, nanotechnology, and detection techniques for the development of medicinal plants with enhanced levels of bioactive agents.
Barron, C R; Houfek, J F; Foxall, M J
The purpose of this study was to determine the role of coping style in women's practice of breast self-examination (BSE). The framework was adapted from the Cognitive Transactional Model of Stress and Coping and the Health Belief Model. The convenience sample consisted of 269 women recruited from an employee list of a medical center and a membership list of a professional nurses' group. Survey booklets were distributed via interdepartmental or U.S. mail and contained measures of trait anxiety and defensiveness and questions related to health beliefs, BSE practice, and demographics. The sample was categorized by coping style (i.e., repressive, true high anxious, defensive high anxious, or true low anxious), and data were analyzed via MANOVAs, ANOVAs, and hierarchical regression. Results indicated that coping style predicted BSE practice (i.e., proficiency, frequency) and health beliefs of barriers, confidence, seriousness, and susceptibility. The findings provide nurses with information for developing interventions to foster BSE. PMID:9233171
Synthetic biology has the potential to contribute breakthrough innovations to the pursuit of new global health solutions. Wishing to harness the emerging tools of synthetic biology for the goals of global health, in 2011 the Bill & Melinda Gates Foundation put out a call for grant applications to “Apply Synthetic Biology to Global Health Challenges” under its “Grand Challenges Explorations” program. A highly diverse pool of over 700 applications was received. Proposed applications of syntheti...
Han, Hae-Ra; Huh, Boyun; Kim, Miyong T.; Kim, Jiyun; Nguyen, Tam
For many people limited health literacy is a major barrier to effective preventive health behavior such as cancer screening, yet a comprehensive health literacy measure that is specific to breast and cervical cancer screening is not readily available. The purpose of this paper is to describe the development and testing of a new instrument to measure health literacy in the context of breast and cervical cancer screening, the Assessment of Health Literacy in Cancer Screening (AHL-C). The AHL-C ...
The year 2016 could turn out to be a turning point for global health, new political realities and global insecurities will test governance and financing mechanisms in relation to both people and planet. But most importantly political factors such as the global power shift and “the rise of the rest” will define the future of global health. A new mix of health inequity and security challenges has emerged and the 2015 humanitarian and health crises have shown the limits of existing s...
Welch Saleeby, Patricia; Hunter-Jones, Josalin
Women with disabilities experience significant disparities in accessing breast health services. Many studies have focused on barriers, but few have explored facilitators to improving breast health services. This study used a participatory-research approach involving women with physical, mobility, sensory, and developmental disabilities to explore facilitators and barriers affecting the access and quality of breast health services. Findings confirmed commonly cited barriers including attitudinal, environmental, financial, and structural issues but also identified multiple facilitators such as enhancing accessibility of breast health facilities and equipment, improving information sources, and increasing training of health professionals. Findings from this study can be used in improving breast health services among women with disabilities by targeting not only the removal of barriers but also the increase in proven facilitators. PMID:27092980
Holland, J Brian; Malvey, Donna; Fottler, Myron D
As health care organizations expand and move into global markets, they face many leadership challenges, including the difficulty of leading individuals who are geographically dispersed. This article provides global managers with guidelines for leading and motivating individuals or teams from a distance while overcoming the typical challenges that "virtual leaders" and "virtual teams" face: employee isolation, confusion, language barriers, cultural differences, and technological breakdowns. Fortunately, technological advances in communications have provided various methods to accommodate geographically dispersed or "global virtual teams." Health care leaders now have the ability to lead global teams from afar by becoming "virtual leaders" with a responsibility to lead a "virtual team." Three models of globalization presented and discussed are outsourcing of health care services, medical tourism, and telerobotics. These models require global managers to lead virtually, and a positive relationship between the virtual leader and the virtual team member is vital in the success of global health care organizations. PMID:19433929
Inacia Sátiro Xavier de França
Full Text Available Objective: to assess the knowledge of blind women about the risk factors for breast cancer and whether they look for early detection of this cancer. Methods: a quasi-experimental study with 72 blind women distributed in focus groups. Data were collected through interviews. Results: few participants had knowledge about one or more risk factors for breast cancer, but most practiced early detection. Health education was developed using breast kits and demonstration of breast self-examination. It was obtained qualitative improvement of knowledge of the participants about breast cancer, its risk factors and early detection practices. In addition, participants demonstrated breast self-examination confidently. Conclusion: we need to develop in a harder manner educational activities to clarify about breast cancer risk factors and the importance of periodically carrying out breast self-examination, clinical examination and mammography.
This paper considers how operational research and management science can improve the design of health systems and the delivery of health care, particularly in low-resource settings. It identifies some gaps in the way operational research is typically used in global health and proposes steps to bridge them. It then outlines some analytical tools of operational research and management science and illustrates how their use can inform some typical design and delivery challenges in global health. ...
Murillo, Raúl; Díaz, Sandra; Sánchez, Oswaldo; Perry, Fernando; Piñeros, Marion; Poveda, César; Salguero, Edgar; Osorio, Dimelza
Breast cancer is increasing in developing countries, and Colombia has a double burden from cervical and breast cancer. Suitable guidelines for breast cancer early detection are needed, and the Breast Health Global Initiative provides a favorable framework for breast cancer control in low resource nations. The Colombian National Cancer Institute developed evidence-based guidelines for breast cancer early detection in which coordinated early detection in symptomatic women and hospital-based scr...
Sapag, Jaime C.; Herrera, Andrés; Trainor, Ruth; Caldera, Trinidad; Khenti, Akwatu
Background: Mental health is increasingly recognised as integral to good public health, but this area continues to lack sufficient planning, resources, and global strategy. It is a pressing concern in Latin America, where social determinants of health aggravate existing inequities in access to health services. Nicaragua faces serious mental health needs and challenges. One key strategy for addressing gaps in mental health services is building capacity at the primary healthcare and system leve...
Breast self-examination is a screening option for young women. Among students, knowledge about breast self-examination ranges from insufficient to average. This descriptive study was planned in order to determine the health beliefs and perceptions of nursing students regarding breast self-examinations. We recruited 538 nursing students in a single Higher Technological Educational Institute in Greece. Data were collected using the Champion's Health Belief Model Scale. Parametric tests were used in the data analysis. We found significant differences in the results of the subscales of Champion's Health Belief Model Scale on comparing people with respect to nationality, previous education about breast self-examination, smoking status and semester in which they were studying. The 'confidence' subscale was positively associated with the frequency of breast self-examination. The results of the present study demonstrated that nursing students have knowledge about breast-self examination but inadequate practice. PMID:24724812
Boyages, Costa S
Rio+20's proposed Sustainable Development Goals have the potential to redefine the course of international action on climate change. They recognise that environmental health is inextricably linked with human health, and that environmental sustainability is of paramount importance in safeguarding global health. Competition entrants were asked to discuss ways of making global health a central component of international sustainable development initiatives and environmental policy, using one or two concrete examples PMID:24099214
Bailey, Lydia C.
The objective of this Review is to characterize content related to global health in didactic and experiential curricula of doctor of pharmacy (PharmD) programs in the United States. The review was completed through a systematic website search of 133 US PharmD programs accredited or currently in the process of obtaining accreditation to identify global health dual degrees, minors/concentrations, required and elective courses, and experiential opportunities. Programs’ course catalogs were referenced as needed to find more specific course listings/descriptions. More than 50 programs offered an elective course related to global health; eight had a required course; eight offered a minor or certification for global health; three offered dual degrees in pharmacy and global health. Fourteen institutions had a center for global health studies on campus. More than 50 programs offered experiential education opportunities in global health including international advanced pharmacy practice experiences or medical mission trips. Inclusion of and focus on global health-related topics in US PharmD programs was widely varied. PMID:27293238
he recent Ebola crisis has caused approximately 20.000 deaths so far. Compared to other global health crises, including the deaths caused by armed conflicts and chronic diseases, this is still a small amount. Yet, from a global and domestic health law and governance perspective, this crisis raises a
Tilman, David; Clark, Michael
Diets link environmental and human health. Rising incomes and urbanization are driving a global dietary transition in which traditional diets are replaced by diets higher in refined sugars, refined fats, oils and meats. By 2050 these dietary trends, if unchecked, would be a major contributor to an estimated 80 per cent increase in global agricultural greenhouse gas emissions from food production and to global land clearing. Moreover, these dietary shifts are greatly increasing the incidence of type II diabetes, coronary heart disease and other chronic non-communicable diseases that lower global life expectancies. Alternative diets that offer substantial health benefits could, if widely adopted, reduce global agricultural greenhouse gas emissions, reduce land clearing and resultant species extinctions, and help prevent such diet-related chronic non-communicable diseases. The implementation of dietary solutions to the tightly linked diet-environment-health trilemma is a global challenge, and opportunity, of great environmental and public health importance.
Lassen, Lars Christian; Thomsen, Mads Krogsgaard
Health as a global issue concerns all and clearly manifests global inequality. All stakeholders of the healthcare systems and disease treatment--including the pharmaceutical industry--have an ethical obligation to contribute to promoting global health. At Novo Nordisk we primarily focus on providing our contribution to global health through defeating diabetes. At the same time we stand by being a private company required to deliver a financial profit, which is why we must create positive results on the financial, the environmental and the social bottom lines. In this article we attempt to provide a brief overview of some of the initiatives that we think business companies can take--and therefore are also obliged to in promoting global health. Further, we have pointed out a number of dilemmas within research and development as well as business ethics that all companies face when they convert the ethical principles to daily practice globally. PMID:17349219
Anthropology and global health have long been a focus of research for both biological and medical anthropologists. Research has looked at physiological adaptations to high altitudes, community responses to water-borne diseases, the integration of traditional and biomedical approaches to health, global responses to HIV/AIDS, and more recently, to the application of cultural approaches to the control of the Ebola epidemic. Academic anthropology has employed theory and methods to extend knowledge, but less often to apply that knowledge. However, anthropologists outside of the academy have tackled global health issues such as family planning and breast-feeding by bringing together applied medical anthropology and social marketing. In 2014, that potent and provocative combination resulted in the University of South Florida in Tampa, Florida being made the home of an innovative center designed to combine academic and applied anthropology with social marketing in order to facilitate social change. This article discusses how inter- and intra-disciplinary research/application has led to the development of Florida's first World Health Organization Collaborating Center (WHO CC), and the first such center to focus on social marketing, social change and non-communicable diseases. This article explains the genesis of the Center and presents readers with a brief overview, basic principles and applications of social marketing by reviewing a case study of a water conservation project. The article concludes with thoughts on the ecology of collaboration among global health, medical anthropology and social marketing practitioners. PMID:26753444
Palazuelos, Daniel; Dhillon, Ranu
Among many possible benefits, global health efforts can expand the skills and experience of U.S. clinicians, improve health for communities in need, and generate innovations in care delivery with relevance everywhere. Yet, despite high rates of interest among students and medical trainees to include global health opportunities in their training, there is still no clear understanding of how this interest will translate into viable and sustained global health careers after graduation. Building on a growing conversation about how to support careers in academic global health, this Perspective describes the practical challenges faced by physicians pursuing these careers after they complete training. Writing from their perspective as junior faculty at one U.S. academic health center with a dedicated focus on global health training, the authors describe a number of practical issues they have found to be critical both for their own career development and for the advice they provide their mentees. With a particular emphasis on the financial, personal, professional, and logistical challenges that young "expat" global health physicians in academic institutions face, they underscore the importance of finding ways to support these career paths, and propose possible solutions. Such investments would not only respond to the rational and moral imperatives of global health work and advance the mission of improving human health but also help to fully leverage the potential of what is already an unprecedented movement within academic medicine. PMID:26244256
P Vijayachari; A P Sugunan; A N Shriram
Leptospirosis has been recognized as an emerging global public health problem because of its increasing incidence in both developing and developed countries. A number of leptospirosis outbreaks have occurred in the past few years in various places such as Nicaragua, Brazil and India. Some of these resulted due to natural calamities such as cyclone and floods. It is a direct zoonotic disease caused by spirochetes belonging to different pathogenic species of the genus Leptospira. Large number of animals acts as carriers or vectors. Human infection results from accidental contact with carrier animals or environment contaminated with leptospires. The primary source of leptospires is the excretor animal, from whose renal tubules leptospires are excreted into the environment with the animal urine. Majority of leptospiral infections are either sub clinical or result in very mild illness and recover without any complications. However, a small proportion develops various complications due to involvement of multiple organ systems. In such patients, the clinical presentation depends upon the predominant organs involved and the case fatality ratio could be about 40% or more. Febrile illness with icterus, splenomegaly and nephritis (known as Weil’s disease), acute febrile illness with severe muscle pain, febrile illness with pulmonary haemorrhages in the form of haemoptysis, jaundice with pulmonary haemorrhages, jaundice with heamaturea, meningitis with haemorrhages including sub conjunctival haemorrhage or febrile illness with cardiac arrhythmias with or without haemorrhages are some of the syndromes. Because of the protean manifestations of leptospirosis it is often misdiagnosed and under-reported. Although the basic principles of prevention such as source reduction, environmental sanitation, more hygienic work-related and personal practices etc., are same everywhere, there is no universal control method applicable to all epidemiological settings. Comprehensive
Geiger, Brian F.; Davis, Thomas M.; Beric, Bojana; Devlin, Michele K.
Knowledge and skills for global health program design, implementation and monitoring is an expectation for practicing public health professionals. Major health education professional organizations including American Association for Health Education (AAHE), Society of Public Health Education (SOPHE) and International Union for Health Promotion and…
Shreya Moodley; Arabat Kasangaki; Macnab, Andrew J.
Introduction. Medical education has defined essential “universal” core competencies. The value of global health education gained through participation in a health-promoting school project was assessed using Canada’s CanMEDS roles and competencies. Methods. The project involved health care trainees in delivery of “Brighter Smiles,” a global health education program addressing children’s oral health in Canada and Uganda based on the WHO health-promoting (HP) school model. Multidisciplinary team...
Welander, Anna; Lyttkens, Carl Hampus; Nilsson, Therese
Good health is crucial for human and economic development. In particular poor health in childhood is of utmost concern since it causes irreversible damage and has implications later in life. Recent research suggests globalization is a strong force affecting adult and child health outcomes. Yet, there is much unexplained variation with respect to the globalization effect on child health, in particular in low- and middle-income countries. One factor that could explain such variation across countries is the quality of democracy. Using panel data for 70 developing countries between 1970 and 2009 this paper disentangles the relationship between globalization, democracy, and child health. Specifically the paper examines how globalization and a country's democratic status and historical experience with democracy, respectively, affect infant mortality. In line with previous research, results suggest that globalization reduces infant mortality and that the level of democracy in a country generally improves child health outcomes. Additionally, democracy matters for the size of the globalization effect on child health. If for example Côte d'Ivoire had been a democracy in the 2000-2009 period, this effect would translate into 1200 fewer infant deaths in an average year compared to the situation without democracy. We also find that nutrition is the most important mediator in the relationship. To conclude, globalization and democracy together associate with better child health in developing countries. PMID:25982869
Jonathan Samet; Mellissa Withers
The Association of Pacific Rim Universities (APRU) is an international consortium of 45 universities in the Pacific Rim, representing 16 economies, 130 000 faculty members and more than two million students. The APRU Global Health Program aims to expand existing collaborative research efforts among universities to address regional and global health issues. Since its launch in 2007–08, the program has covered a significant range of topics including emerging public health threats, ageing and ch...
LARKAN, FIONA; Uduma, Ogenna; Lawal, Saheed Akinmayọwa; van Bavel, Bianca
Background The Centre for Global Health, Trinity College Dublin has as one of its goals, strengthening health systems in developing countries. In realising this goal we work across more than 40 countries with third-level, civil society, government, private sector and UN partners. Each of these requires that different relationships be established. Good principles must guide all global health research partnerships. An exploratory research project was undertaken with research partners of, and st...
To investigate the knowledge, attitude, and practice of health care professionals on the early detection of breast cancer. A cross-sectional study was conducted in Jeddah and Abha regions of Saudi Arabia from May to November 2009. A detailed questionnaire was distributed to 500 doctors from different hospitals. The questionnaire contained items on the practice of clinical breast examination and mammogram examination, and the doctor's perception of their roles in education. The results of 337 questionnaires analyzed indicated that most health care professionals do not practice clinical breast examination and mammography, and the perception of their roles in education is not as expected. Health care providers are one of the main barriers in improving early detection of breast cancer in Saudi Arabia. There is a need to increase awareness among health care providers of their role in the fight against breast cancer through focused education and training programs (Author).
Courtney, Brooke; Bond, Katherine C.; Maher, Carmen
In February 2014, health officials from around the world announced the Global Health Security Agenda, a critical effort to strengthen national and global systems to prevent, detect, and respond to infectious disease threats and to foster stronger collaboration across borders. With its increasing global roles and broad range of regulatory responsibilities in ensuring the availability, safety, and security of medical and food products, the US Food and Drug Administration (FDA) is engaged in a r...
Winchester, M. S.; BeLue, R.; Oni, T.; Wittwer-Backofen, U.; Deobagkar, D.; Onya, H.; Samuels, T. A.; Matthews, S. A.; Stone, C.; Airhihenbuwa, C.
In the current United Nations efforts to plan for post 2015-Millennium Development Goals, global partnership to address non-communicable diseases (NCDs) has become a critical goal to effectively respond to the complex global challenges of which inequity in health remains a persistent challenge. Building capacity in terms of well-equipped local researchers and service providers is a key to bridging the inequity in global health. Launched by Penn State University in 2014, the Pan University Net...
Full Text Available The year 2016 could turn out to be a turning point for global health, new political realities and global insecurities will test governance and financing mechanisms in relation to both people and planet. But most importantly political factors such as the global power shift and “the rise of the rest” will define the future of global health. A new mix of health inequity and security challenges has emerged and the 2015 humanitarian and health crises have shown the limits of existing systems. The global health as well as the humanitarian system will have to prove their capacity to respond and reform. The challenge ahead is deeply political, especially for the rising political actors. They are confronted with the consequences of a model of development that has neglected sustainability and equity, and was built on their exploitation. Some direction has been given by the path breaking international conferences in 2015. Especially the agreement on the Sustainable Development Goals (SDGs and the Paris agreement on climate change will shape action. Conceptually, we will need a different understanding of global health and its ultimate goals - the health of people can no longer be seen separate from the health of the planet and wealth measured by parameters of growth will no longer ensure health.
The year 2016 could turn out to be a turning point for global health, new political realities and global insecurities will test governance and financing mechanisms in relation to both people and planet. But most importantly political factors such as the global power shift and "the rise of the rest" will define the future of global health. A new mix of health inequity and security challenges has emerged and the 2015 humanitarian and health crises have shown the limits of existing systems. The global health as well as the humanitarian system will have to prove their capacity to respond and reform. The challenge ahead is deeply political, especially for the rising political actors. They are confronted with the consequences of a model of development that has neglected sustainability and equity, and was built on their exploitation. Some direction has been given by the path breaking international conferences in 2015. Especially the agreement on the Sustainable Development Goals (SDGs) and the Paris agreement on climate change will shape action. Conceptually, we will need a different understanding of global health and its ultimate goals - the health of people can no longer be seen separate from the health of the planet and wealth measured by parameters of growth will no longer ensure health. PMID:27285512
Armin, Julie; Torres, Cristina Huebner; Vivian, James; Vergara, Cunegundo; Shaw, Susan J.
Objective: This study aimed to quantitatively and qualitatively examine breast cancer screening practices, including breast self-examination (BSE), and health literacy among patients with chronic disease. Design: A prospective, multi-method study conducted with a targeted purposive sample of 297 patients with diabetes and/or hypertension from four…
This commentary argues that there are three major crises confronting global health: ongoing financial crises; deepening ecological crises; and rapidly escalating income and wealth inequalities within and between nations. Global rhetorical responses to these crises frequently invoke policy sentiments similar to those advised by the 2008 WHO Commission on Social Determinants of Health (CSDH). However, actual policy decisions run counter to the evidence reviewed by the Commission, and its final report recommendations. Failure to re-regulate financial capitalism, introduce regulatory standards for transnational companies, or subordinate trade and investment liberalization treaties to development goals and human rights treaties will exacerbate global health inequities into the future. More positively, there is increasing support for systems of global taxation. The challenge for global health, however, will remain the willingness of states to make domestic and foreign policy choices that strengthen income redistribution, economic regulation, and citizen rights. PMID:22277972
Baker, Timothy B.; Hawkins, Robert; Pingree, Suzanne; Roberts, Linda J.; McDowell, Helene E; Shaw, Bret R.; Serlin, Ron; Dillenburg, Lisa; Swoboda, Christopher M; Han, Jeong-Yeob; Stewart, James A.; Carmack-Taylor, Cindy L; Salner, Andrew; Schlam, Tanya R; McTAVISH, FIONA
Little is known about the effective elements of Interactive Cancer Communication Systems (ICCSs). A randomized trial explored which types of services of a multifaceted ICCS benefited patients and the nature of the benefit. Women with breast cancer (N = 450) were randomized to different types of ICCS services or to a control condition that provided internet access. The Comprehensive Health Enhancement Support System (CHESS), served as the ICCS. ICCS services providing information and support, ...
Full Text Available In this study new free-trade agreements are discussed, which are based on the breaking down of tariff and technical barriers and normally exclude most of the poorest countries in the world. Considering the current context of economic globalization and its health impacts, seven controversial points of these treaties and their possible implications for global public health are presented, mainly regarding health equity and other health determinants. Finally, this research proposes a greater social and health professionals participation in the formulation and discussion of these treaties, and a deeper insertion of Brazil in this important international agenda.
In this study new free-trade agreements are discussed, which are based on the breaking down of tariff and technical barriers and normally exclude most of the poorest countries in the world. Considering the current context of economic globalization and its health impacts, seven controversial points of these treaties and their possible implications for global public health are presented, mainly regarding health equity and other health determinants. Finally, this research proposes a greater social and health professionals participation in the formulation and discussion of these treaties, and a deeper insertion of Brazil in this important international agenda. PMID:26270018
Tediosi, Fabrizio; Finch, Aureliano; Procacci, Christina; Marten, Robert; Missoni, Eduardo
This article explores BRICS' engagement in the global movement for Universal Health Coverage (UHC) and the implications for global health governance. It is based on primary data collected from 43 key informant interviews, complemented by a review of BRICS' global commitments supporting UHC. Interviews were conducted using a semi-structured questionnaire that included both closed- and open-ended questions. Question development was informed by insights from the literature on UHC, Cox's framework for action, and Kingdon's multiple-stream theory of policy formation. The closed questions were analysed with simple descriptive statistics and the open-ended questions using grounded theory approach. The analysis demonstrates that most BRICS countries implicitly supported the global movement for UHC, and that they share an active engagement in promoting UHC. However, only Brazil, China and to some extent South Africa, were recognized as proactively pushing UHC in the global agenda. In addition, despite some concerted actions, BRICS countries seem to act more as individual countries rather that as an allied group. These findings suggest that BRICS are unlikely to be a unified political block that will transform global health governance. Yet the documented involvement of BRICS in the global movement supporting UHC, and their focus on domestic challenges, shows that BRICS individually are increasingly influential players in global health. So if BRICS countries should probably not be portrayed as the centre of future political community that will transform global health governance, their individual involvement in global health, and their documented concerted actions, may give greater voice to low- and middle-income countries supporting the emergence of multiple centres of powers in global health. PMID:26704179
Full Text Available Abstract Background Since the early 1990s there has been a burgeoning interest in global health teaching in undergraduate medical curricula. In this article we trace the evolution of this teaching and present recommendations for how the discipline might develop in future years. Discussion Undergraduate global health teaching has seen a marked growth over the past ten years, partly as a response to student demand and partly due to increasing globalization, cross-border movement of pathogens and international migration of health care workers. This teaching has many different strands and types in terms of topic focus, disciplinary background, the point in medical studies in which it is taught and whether it is compulsory or optional. We carried out a survey of medical schools across the world in an effort to analyse their teaching of global health. Results indicate that this teaching is rising in prominence, particularly through global health elective/exchange programmes and increasing teaching of subjects such as globalization and health and international comparison of health systems. Our findings indicate that global health teaching is moving away from its previous focus on tropical medicine towards issues of more global relevance. We suggest that there are three types of doctor who may wish to work in global health – the ‘globalised doctor’, ‘humanitarian doctor’ and ‘policy doctor’ – and that each of these three types will require different teaching in order to meet the required competencies. This teaching needs to be inserted into medical curricula in different ways, notably into core curricula, a special overseas doctor track, optional student selected components, elective programmes, optional intercalated degrees and postgraduate study. Summary We argue that teaching of global health in undergraduate medical curricula must respond to changing understandings of the term global health. In particular it must be taught from the
McNeill, D; Ottersen, O P
In this article, we address a central theme that was discussed at the Durham Health Summit: how can politics be brought back into global health governance and figure much more prominently in discussions around policy? We begin by briefly summarizing the report of the Lancet - University of Oslo Commission on Global Governance for Health: 'The Political Origins of Health Inequity' Ottersen et al. In order to provide compelling evidence of the central argument, the Commission selected seven case studies relating to, inter alia, economic and fiscal policy, food security, and foreign trade and investment agreements. Based on an analysis of these studies, the report concludes that the problems identified are often due to political choices: an unwillingness to change the global system of governance. This raises the question: what is the most effective way that a report of this kind can be used to motivate policy-makers, and the public at large, to demand change? What kind of moral or rational argument is most likely to lead to action? In this paper we assess the merits of various alternative perspectives: health as an investment; health as a global public good; health and human security; health and human development; health as a human right; health and global justice. We conclude that what is required in order to motivate change is a more explicitly political and moral perspective - favouring the later rather than the earlier alternatives just listed. PMID:26112127
Smith, David J.
It may surprise students to realize that health problems in other countries affect them, too. Where people live and the conditions under which they live directly affect their health. The health of a population can also offer insight into a region's social, political, and economic realities. As a powerful lens into how human societies function,…
This paper describes the WHO global and regional strategies for health and environment and discusses research needs on environmental health to support the implementation of the strategies. Particular emphasis on applied researches which generate information, for decision making, on health effects of development and environmental changes in specific locations
Politics play a central part in determining health and development outcomes as Gorik Ooms highlights in his recent commentary. As health becomes more global and more politicized the need grows to better understand the inherently political processes at all levels of governance, such as ideological positions, ideas, value judgments, and power. I agree that global health research should strengthen its contribution to generating such knowledge by drawing more on political science, such research is gaining ground. Even more important is – as Ooms indicates – that global health scholars better understand their own role in the political process. It is time to acknowledge that expert-based technocratic approaches are no less political. We will need to reflect and analyse the role of experts in global health governance to a greater extent and in that context explore the links between politics, expertise and democracy. PMID:26927593
Keating, Nancy L.; Elena M. Kouri; Ornelas, Héctor Arreola; Méndez, Oscar; Valladares, Laura Magaña; Knaul, Felicia Marie
This study assessed the effectiveness of a train-the-trainer program in two Mexican states in improving knowledge among professional and nonprofessional community health workers. Post-training surveys demonstrated increases in an understanding of breast cancer as a problem; an understanding of screening, treatment, and insurance coverage issues; and knowledge of breast cancer risk factors, symptoms, and what constitutes a family history of breast cancer.
Prof. C Olsen, DVM; J Conway, MD; L DiPrete-Brown, MSc; F Hutchins, PhD; K Poulsen, DVM; K Solheim, PhD; C Kraus, PharmD; D Gaus, MD; T Silawan, PhD
Background: Since 2003, the University of Wisconsin-Madison Global Health Institute, together with collaborating campus and in-country partners, has offered immersive, multidisciplinary, faculty-led, global health field courses in Ecuador and Thailand. These courses aim to help students to develop a working understanding of integrative one-health approaches and acquire the skills to work effectively across disciplines. That is, we aim to foster an appreciation of the role of culture in percep...
... your doctor may recommend Ductal carcinoma in situ (DCIS) Abnormal cells in the lining of a breast ... because doctors don't know which cases of DCIS may become invasive breast cancer. Treatment for DCIS ...
Radioisotopes and radiation technology are used around the world to advance global health. Prevention, diagnosis and treatment of disease require a secure supply of radioisotopes, and transportation is a vital link in ensuring this secure supply. International Atomic Energy Agency (IAEA) transport regulations have facilitated global health by providing a consistent framework for safe international transport. However, the complexity of regulations and inconsistent application have compromised the ability to supply essential radioisotopes around the world. IAEA, competent authorities and the industry need to work together to ensure that the needs of global health care are considered during the development and implementation of international transport regulations. (author)
Connor, Avonne E.; Baumgartner, Richard N.; Baumgartner, Kathy B.; Pinkston, Christina M; John, Esther M.; Torres-Mejía, Gabriela; Hines, Lisa M.; Giuliano, Anna R.; Wolff, Roger K.; Slattery, Martha L.
The epidermal growth factor receptor (EGFR), a member of the ErbB family of receptor tyrosine kinases, functions in cellular processes essential to the development of cancer. Overexpression of EGFR in primary breast tumors has been linked with poor prognosis. We investigated the associations between 34 EGFR tagging SNPs and breast cancer risk and breast cancer-specific mortality in 4,703 Hispanic and 3,030 non-Hispanic white women from the Breast Cancer Health Disparities Study. We evaluated ...
... poultry both show that diseases don't respect borders. Globalization has increased the movement of people and ... should that knowledge be applied? What are the cultural beliefs and practices that will need to be ...
Linda L. Dahlberg; Etienne G. Krug
This article is a version of the Introduction to the World Report on Violence and Health, published by the World Health Organization (WHO). It presents a general description about this phenomenon and points some basic questions: concepts and definitions about the theme; the state of knowledge about it; nature and typology on violence; proposal of a quantitative and qualitative approach of an ecological model; responsibilities and functions of the public health sector and its potentiality to p...
Patel, Ronak B
Microfinance has recently come under criticism for not meeting its potential for poverty reduction and its exploitation by for-profit entities. Access to finance still remains limited for many of the world’s poor. This re-examination of microfinance should not impede its proliferation and development into a tool to improve health for the underserved. There are significant returns on microfinance investments in health at the household level. Microfinance that allows the consumption of goods and services that can improve health can also lead to increased savings and productivity making it a financially viable and powerful tool for both health improvement and development. PMID:25418237
Linda L. Dahlberg
Full Text Available This article is a version of the Introduction to the World Report on Violence and Health, published by the World Health Organization (WHO. It presents a general description about this phenomenon and points some basic questions: concepts and definitions about the theme; the state of knowledge about it; nature and typology on violence; proposal of a quantitative and qualitative approach of an ecological model; responsibilities and functions of the public health sector and its potentiality to prevent and reduce violence in the world; the responsibilities of the nations and the policy makers in a intersetorial point of view; difficulties and obstacles for actuation and challenges for the health sector.
Bowen, Deborah J.; Powers, Diane
This study evaluated a mail and telephone intervention to improve breast health behaviors while maintaining quality of life. Women recruited from the general public were randomized to a stepped-intensity intervention consisting of mailings, telephone calls, and counseling (if requested or appropriate given a woman's genetic risk for breast cancer)…
Watt, Nicola F; Gomez, Eduardo J; McKee, Martin
Amidst the growing literature on global health, much has been written recently about the Brazil, Russia, India, China, South Africa (BRICS) countries and their involvement and potential impact in global health, particularly in relation to development assistance. Rather less has been said about countries' motivations for involvement in global health negotiations, and there is a notable absence of evidence when their motivations are speculated on. This article uses an existing framework linking engagement in global health to foreign policy to explore differing levels of engagement by BRICS countries in the global health arena, with a particular focus on access to medicines. It concludes that countries' differing and complex motivations reinforce the need for realistic, pragmatic approaches to global health debates and their analysis. It also underlines that these analyses should be informed by analysis from other areas of foreign policy. PMID:24072881
Any initiative to coordinate actions, plans, or initiatives to improve the interaction between global health stakeholders finds itself feeding into a vastly complex global system. By utilising complexity theory as part of a new scientific paradigm, complex adaptive behaviour can emerge to create coherence. A suggested global health convention facilitating incremental regime development could be a way to create good governance processes. Minimum specifications could provide wide space for innovation and encourage shared action. Such specifications would be both a product of, and a facilitator for, future generative relationships. The potential empowerment of individuals as a result of this has the potential to transform global health by creating an arena for continual cooperation, interaction and mutual dependence among global stakeholders. PMID:22248181
NCI’s Center for Global Health announced grants that will support the development and validation of low-cost, portable technologies. These technologies have the potential to improve early detection, diagnosis, and non-invasive or minimally invasive treatm
Martin, Greg; MacLachlan, Malcolm; Labonté, Ronald; Larkan, Fiona; Vallières, Frédérique; Bergin, Niamh
Founded in 2005, Globalization and Health was the first open access global health journal. The journal has since expanded the field, and its influence, with the number of downloaded papers rising 17-fold, to over 4 million. Its ground-breaking papers, leading authors -including a Nobel Prize winner- and an impact factor of 2.25 place it among the top global health journals in the world. To mark the ten years since the journal's founding, we, members of the current editorial board, undertook a review of the journal's progress over the last decade. Through the application of an inductive thematic analysis, we systematically identified themes of research published in the journal from 2005 to 2014. We identify key areas the journal has promoted and consider these in the context of an existing framework, identify current gaps in global health research and highlight areas we, as a journal, would like to see strengthened. PMID:26961760
Friedman, Eric A; Gostin, Lawrence O
The singular message in Global Health Law is that we must strive to achieve global health with justice--improved population health, with a fairer distribution of benefits of good health. Global health entails ensuring the conditions of good health--public health, universal health coverage, and the social determinants of health--while justice requires closing today’s vast domestic and global health inequities. These conditions for good health should be incorporated into public policy, supplemented by specific actions to overcome barriers to equity. A new global health treaty grounded in the right to health and aimed at health equity--a Framework Convention on Global Health (FCGH)--stands out for its possibilities in helping to achieve global health with justice. This far-reaching legal instrument would establish minimum standards for universal health coverage and public health measures, with an accompanying national and international financing framework, require a constant focus on health equity, promote Health in All Policies and global governance for health, and advance the principles of good governance, including accountability. While achieving an FCGH is certainly ambitious, it is a struggle worth the efforts of us all. The treaty’s basis in the right to health, which has been agreed to by all governments, has powerful potential to form the foundation of global governance for health. From interpretations of UN treaty bodies to judgments of national courts, the right to health is now sufficiently articulated to serve this role, with the individual’s right to health best understood as a function of a social, political, and economic environment aimed at equity. However great the political challenge of securing state agreement to the FCGH, it is possible. States have joined other treaties with significant resource requirements and limitations on their sovereignty without significant reciprocal benefits from other states, while important state interests would
McNabb Scott JN
Full Text Available Abstract At a crossroads, global public health surveillance exists in a fragmented state. Slow to detect, register, confirm, and analyze cases of public health significance, provide feedback, and communicate timely and useful information to stakeholders, global surveillance is neither maximally effective nor optimally efficient. Stakeholders lack a globa surveillance consensus policy and strategy; officials face inadequate training and scarce resources. Three movements now set the stage for transformation of surveillance: 1 adoption by Member States of the World Health Organization (WHO of the revised International Health Regulations (IHR; 2 maturation of information sciences and the penetration of information technologies to distal parts of the globe; and 3 consensus that the security and public health communities have overlapping interests and a mutual benefit in supporting public health functions. For these to enhance surveillance competencies, eight prerequisites should be in place: politics, policies, priorities, perspectives, procedures, practices, preparation, and payers. To achieve comprehensive, global surveillance, disparities in technical, logistic, governance, and financial capacities must be addressed. Challenges to closing these gaps include the lack of trust and transparency; perceived benefit at various levels; global governance to address data power and control; and specified financial support from globa partners. We propose an end-state perspective for comprehensive, effective and efficient global, multiple-hazard public health surveillance and describe a way forward to achieve it. This end-state is universal, global access to interoperable public health information when it’s needed, where it’s needed. This vision mitigates the tension between two fundamental human rights: first, the right to privacy, confidentiality, and security of personal health information combined with the right of sovereign, national entities
Ponnapakkam, Tulasi; Ravichandran, Anisha; Bradford, Elease; Tobin, Gregory; Gensure, Robert
Breast-feeding imparts many benefits to both mothers and infants. Because of these numerous recognized benefits, there has been an effort to increase breast-feeding rates nationwide; increasing breast-feeding rates was one of the goals of the U.S. Department of Health and Human Services' Healthy People 2010 initiative. This study examined the breast-feeding rate at the Ochsner Clinic Foundation by conducting a retrospective chart review of patients aged 0–12 months who visited any branch of t...
Friedman, Eric A; Gostin, Lawrence O; Buse, Kent
Organizations, partnerships, and alliances form the building blocks of global governance. Global health organizations thus have the potential to play a formative role in determining the extent to which people are able to realize their right to health. This article examines how major global health organizations, such as WHO, the Global Fund to Fight AIDS, TB and Malaria, UNAIDS, and GAVI approach human rights concerns, including equality, accountability, and inclusive participation. We argue that organizational support for the right to health must transition from ad hoc and partial to permanent and comprehensive. Drawing on the literature and our knowledge of global health organizations, we offer good practices that point to ways in which such agencies can advance the right to health, covering nine areas: 1) participation and representation in governance processes; 2) leadership and organizational ethos; 3) internal policies; 4) norm-setting and promotion; 5) organizational leadership through advocacy and communication; 6) monitoring and accountability; 7) capacity building; 8) funding policies; and 9) partnerships and engagement. In each of these areas, we offer elements of a proposed Framework Convention on Global Health (FCGH), which would commit state parties to support these standards through their board membership and other interactions with these agencies. We also explain how the FCGH could incorporate these organizations into its overall financing framework, initiate a new forum where they collaborate with each other, as well as organizations in other regimes, to advance the right to health, and ensure sufficient funding for right to health capacity building. We urge major global health organizations to follow the leadership of the UN Secretary-General and UNAIDS to champion the FCGH. It is only through a rights-based approach, enshrined in a new Convention, that we can expect to achieve health for all in our lifetimes. PMID:25006092
Fuster, Valentin; Kelly, Bridget B; Vedanthan, Rajesh
Cardiovascular disease (CVD) is the leading cause of mortality worldwide, with more than 80% of CVD deaths occurring in low- and middle-income countries (LMICs). There have been several calls for action to address the global burden of CVD, but there remains insufficient investment in and implementation of CVD prevention and disease management efforts in LMICs. To catalyze the action needed to control global CVD, the Institute of Medicine recently produced a report, Promoting Cardiovascular Health in the Developing World: A Critical Challenge to Achieve Global Health. This paper presents a commentary of the Institute of Medicine's report, focusing specifically on the intersectoral nature of intervention approaches required to promote global cardiovascular health. We describe 3 primary domains of intervention to control global CVD: 1) policy approaches; 2) health communication programs; and 3) healthcare delivery interventions. We argue that the intersectoral nature of global CVD interventions should ideally occur at 2 levels: first, all 3 domains of intervention must be activated and engaged simultaneously, rather than only 1 domain at a time; and second, within each domain, a synergistic combination of interventions must be implemented. A diversity of public and private sector actors, representing multiple sectors such as health, agriculture, urban planning, transportation, finance, broadcasting, education, and the food and pharmaceutical industries, will be required to collaborate for policies, programs, and interventions to be optimally aligned. Improved control of global CVD is eminently possible but requires an intersectoral approach involving a diversity of actors and stakeholders. PMID:21903051
Full Text Available Global Public Health is increasingly being seen as a speciality field within the university education of Public Health. However, the exact meaning of Global Public Health is still unclear resulting in varied curricula and teaching units among universities. The contextual differences between high and low and middle income countries, and the process of globalisation need to be taken into account while developing any global public health course.Global Public Health and Public Health are not separable and Global Public Health often appears as an extension of Public Health in the era of globalisation and interdependence. Though Global Public Health is readily understood as health of global population, it is mainly practised as health problems and their solutions set within low and middle income countries. Additional specialist competencies relevant to the context of low and middle income countries are needed to work in this field. Although there can be a long list of competencies relevant to this broad topic, available literature suggests that knowledge and skills related with ethics and vulnerable groups/issues; globalisation and its impact on health; disease burden; culture, society and politics; and management are important.
Moore, Melinda; Gould, Philip; Keary, Barbara S
Nearly half the world's population now lives in urban settlements. Cities offer the lure of better employment, education, health care, and culture; and they contribute disproportionately to national economies. However, rapid and often unplanned urban growth is often associated with poverty, environmental degradation and population demands that outstrip service capacity. These conditions place human health at risk. Reliable urban health statistics are largely unavailable throughout the world. Disaggregated intra-urban health data, i.e., for different areas within a city, are even more rare. Data that are available indicate a range of urban health hazards and associated health risks: substandard housing, crowding, air pollution, insufficient or contaminated drinking water, inadequate sanitation and solid waste disposal services, vector-borne diseases, industrial waste, increased motor vehicle traffic, stress associated with poverty and unemployment, among others. Local and national governments and multilateral organizations are all grappling with the challenges of urbanization. Urban health risks and concerns involve many different sectors, including health, environment, housing, energy, transportation, urban planning, and others. Two main policy implications are highlighted: the need for systematic and useful urban health statistics on a disaggregated, i.e., intra-urban, basis, and the need for more effective partnering across sectors. The humanitarian and economic imperative to create livable and sustainable cities must drive us to seek and successfully overcome challenges and capitalize on opportunities. Good urban planning and governance, exchange of best practice models and the determination and leadership of stakeholders across disciplines, sectors, communities and countries will be critical elements of success. PMID:12971682
The international disparities in health and health-care provision comprise the gravest problem of medical ethics. The implications are explored of three theories of justice: an expanded version of Rawlsian contractarianism, Nozick's historical account, and a consequentialism which prioritizes the satisfaction of basic needs. The second too little satisfies medical needs to be cogent. The third is found to incorporate the strengths of the others, and to uphold fair rules and practices. Like the first, it also involves obligations transcending those to an agent's relations and fellow-citizens. These conclusions are applied to international health-care provision, which they would transform. PMID:2231643
Pinzon-Perez, Helda; Zelinski, Christy
This paper presents a global health education program using a 'Teleconference' approach. It provides examples of how technology can be used to deliver health education at the international level. Two international teleconferences about public health issues were conducted in 2013 and 2014 involving universities and public health institutions in Colombia, Dominican Republic, Costa Rica, Uganda, and the United States. More than 400 students, faculty, and community members attended these educational events. These teleconferences served as the medium to unite countries despite the geographical distances and to facilitate collaborations and networking across nations. Teleconferences are an example of effective technology-based health education and health promotion programs. PMID:25783439
Full Text Available Background: Breast cancer being one of the leading cancers among women in developing countries, prevention or identification of the disease at an early stage is of paramount importance in saving as well as improving the quality of life. Breast health awareness appears to be a pragmatic method for this. Objective: To determine the acceptability and effectiveness of an educational intervention programme on breast health awareness for rural women by trained female health workers. Settings and Design: Community based nonrandomised educational intervention study carried out over a period of 1 year. Three hundred and sixty rural women in the age group 30-59 years were randomly selected (and age-wise stratified, from a coastal village in Southern India. Methods: Women were educated on breast health and breast self-examination by specifically trained health workers and their awareness and proficiency levels were evaluated at the end of 1 and 3 months postintervention. Statistical analysis: This was done using the Statistical Package for Social Sciences Version 10. Results: Following the educational intervention, a significant increase in overall awareness regarding breast cancer (z=-15.807; P<0.001 as well as in the performance of self-examination of the breast 321/342 (93% was observed. Forgetfulness or being too busy appeared to be the two most frequently perceived barriers. Conclusion: This study clearly shows that a community oriented educational intervention programme emphasizing on proper technique can bring about the desirable behavioural change among women.
Samet, Jonathan; Withers, Mellissa
The Association of Pacific Rim Universities (APRU) is an international consortium of 45 universities in the Pacific Rim, representing 16 economies, 130 000 faculty members and more than two million students. The APRU Global Health Program aims to expand existing collaborative research efforts among universities to address regional and global health issues. Since its launch in 2007–08, the program has covered a significant range of topics including emerging public health threats, ageing and chronic diseases, infectious diseases and health security issues, among others. The Program’s activities in research, training, and service around the globe illustrate the diverse dimensions of global health. In this paper, the major activities to date are outlined and future planned activities are discussed. PMID:27052883
Samet, Jonathan; Withers, Mellissa
The Association of Pacific Rim Universities (APRU) is an international consortium of 45 universities in the Pacific Rim, representing 16 economies, 130 000 faculty members and more than two million students. The APRU Global Health Program aims to expand existing collaborative research efforts among universities to address regional and global health issues. Since its launch in 2007-08, the program has covered a significant range of topics including emerging public health threats, ageing and chronic diseases, infectious diseases and health security issues, among others. The Program's activities in research, training, and service around the globe illustrate the diverse dimensions of global health. In this paper, the major activities to date are outlined and future planned activities are discussed. PMID:27052883
Samantha Garbers; Karen Schmitt; Anne Marie Rappa; Mary Ann Chiasson
Samantha Garbers1, Karen Schmitt2, Anne Marie Rappa2, Mary Ann Chiasson11Public Health Solutions, New York, NY, USA; 2Columbia University Breast Cancer Screening Program, New York, NY, USABackground: This analysis examines the association between functional health literacy and follow-up after mammography among women receiving breast cancer screening at a National Breast and Cervical Cancer Early Detection Program site in New York City that provides universal bilingual case management.Methods:...
Full Text Available Abstract It is clear that globalization is something more than a purely economic phenomenon manifesting itself on a global scale. Among the visible manifestations of globalization are the greater international movement of goods and services, financial capital, information and people. In addition, there are technological developments, more transboundary cultural exchanges, facilitated by the freer trade of more differentiated products as well as by tourism and immigration, changes in the political landscape and ecological consequences. In this paper, we link the Maastricht Globalization Index with health indicators to analyse if more globalized countries are doing better in terms of infant mortality rate, under-five mortality rate, and adult mortality rate. The results indicate a positive association between a high level of globalization and low mortality rates. In view of the arguments that globalization provides winners and losers, and might be seen as a disequalizing process, we should perhaps be careful in interpreting the observed positive association as simple evidence that globalization is mostly good for our health. It is our hope that a further analysis of health impacts of globalization may help in adjusting and optimising the process of globalization on every level in the direction of a sustainable and healthy development for all.
Magnusson, R S
Chronic diseases, including cardiovascular disease, diabetes and cancer, are the leading cause of death and disability in both the developed and developing world (excluding sub-Saharan Africa). At present, the global framework for action on chronic disease is strongly 'World Health Organization (WHO)-centric', defined by two WHO initiatives: the WHO Framework Convention on Tobacco Control, and the Global Strategy on Diet, Physical Activity and Health. This paper explores the difficulties of developing a collective response to global health challenges, and draws out some implications for chronic disease. It highlights how political partnerships and improved governance structures, economic processes, and international laws and standards function as three, concurrent pathways for encouraging policy implementation at country level and for building collective commitment to address the transnational determinants of chronic disease. The paper evaluates WHO's initiatives on chronic disease in terms of these pathways, and makes the case for a global compact on chronic disease as a possible structure for advancing WHO's free-standing goal of reducing mortality from chronic diseases by an additional 2% between 2005 and 2015. Beneath this overarching structure, the paper argues that global agencies, donor governments and other global health stakeholders could achieve greater impact by coordinating their efforts within a series of semi-autonomous 'policy channels' or 'workstreams'. These workstreams - including trade and agriculture, consumer health issues and workplace health promotion - could act as focal points for international cooperation, drawing in a wider range of health stakeholders within their areas of comparative advantage. PMID:19278695
Sameera Karnik; Amar Kanekar
Introduction: Childhood obesity is a major public health crisis nationally and internationally. The prevalence of childhood obesity has increased over few years. It is caused by imbalance between calorie intake and calories utilized. One or more factors (genetic, behavioral, and environmental) cause obesity in children. Physical, psychological, and social health problems are caused due to childhood obesity. Hence, effective intervention strategies are being used to prevent and control obesity...
Full Text Available Grace X Ma,1 Wanzhen Gao,1 Sunmin Lee,2 MinQi Wang,3 Yin Tan,1 Steven E Shive,1,41Department of Public Health, Center for Asian Health, College of Health Professions, Temple University, Philadelphia, PA, USA; 2Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, MD, USA; 3Department of Public and Community Health, University of Maryland, College Park, Maryland, MD, USA; 4East Stroudsburg University, East Stroudsburg, PA, USAObjective: The purpose of this community-based study was to apply a Sociocultural Health Behavior Model to determine the association of factors proposed in the model with breast cancer screening behaviors among Asian American women.Methods: A cross-sectional design included a sample of 682 Chinese, Korean, and Vietnamese women aged 40 years and older. The frequency distribution analysis and Chi-square analysis were used for the initial screening of the following variables: sociodemographic, cultural, enabling, environmental, and social support. Univariate and multivariate analyses were conducted on factors for breast cancer screening using multinomial logistic regression analysis.Results: Correlates to positive breast cancer screening included demographics (ethnicity, cultural factors (living in the United States for 15 years or more, speaking English well, enabling factors (having a regular physician to visit, health insurance covering the screening, and family/social support factors (those who had a family/friend receiving a mammogram.Conclusions: The results of this study suggest that breast cancer screening programs will be more effective if they include the cultural and health beliefs, enabling, and social support factors associated with breast cancer screening. The use of community organizations may play a role in helping to increase breast cancer screening rates among Asian American women.Keywords: breast cancer screening, Vietnamese, Korean, Chinese, breast
Kelley Lee; Jappe Eckhardt; Chris Holden
Shifting patterns of tobacco production and consumption, and the resultant disease burden worldwide since the late twentieth century prompted efforts to strengthen global health governance through adoption of the Framework Convention on Tobacco Control. While the treaty is rightfully considered an important achievement, to address a neglected public health issue through collective action, evidence suggests that tobacco industry globalization continues apace. In this article we provide a syste...
Objective:To explore the correalation of sexual in tercourse with breast diseases.Methods:Sexual intercourse information was inquired of 946 women at random in routine counseling after general gynecological disease survey.Results:Good or medicore status of sexual intercourse comprised 83.5%,while good status of sexuality with good economic condition accounted for 55.6%.The prevalence rate of breast diseases in patients with bad status of sexuality accounted for 40.9%,which was rather high.Conclusion:Strenthening the premarital guidance in sexual health is beneficial to marriage quality and breast health.
... of Breast & Gynecologic Cancers Breast Cancer Screening Research Breast Cancer Treatment (PDQ®)–Patient Version General Information About Breast Cancer Go to Health Professional Version Key Points Breast ...
... of Breast & Gynecologic Cancers Breast Cancer Screening Research Breast Cancer Treatment (PDQ®)–Patient Version General Information About Breast Cancer Go to Health Professional Version Key Points Breast ...
Browne, Brigid C.; Hochgräfe, Falko; Wu, Jianmin;
Acquired resistance to the anti‐estrogen tamoxifen remains a significant challenge in breast cancer management. In this study, we used an integrative approach to characterize global protein expression and tyrosine phosphorylation events in tamoxifen‐resistant MCF7 breast cancer cells (Tam...... perturbed in TamR cells, together with pathways enriched for proteins associated with growth factor, cell–cell and cell matrix‐initiated signalling. Consistent with known roles for Ras/MAPK and PI3‐kinase signalling in tamoxifen resistance, tyrosine‐phosphorylated MAPK1, SHC1 and PIK3R2 were elevated in Tam...... molecular alterations associated with the tamoxifen‐resistant phenotype, and identify MARCKS as a potential biomarker of therapeutic responsiveness that may assist in stratification of patients for optimal therapy....
Stuckler, David; Nestle, Marion
In an article that forms part of the PLoS Medicine series on Big Food, guest editors David Stuckler and Marion Nestle lay out why more examination of the food industry is necessary, and offer three competing views on how public health professionals might engage with Big Food.
Carol A. Dahl; Yamada, Tadataka
Advances in science and technology have transformed the health of the populations of the developed world, with substantial increases in life expectancy and reductions in morbidity. These advances have not, however, touched the lives of the poorest people of the world — the billions living in developing countries. This Review Series on global health highlights the key factors contributing to inequity in health across the globe and the scientific questions that remain unanswered but are critica...
Rassiwala, Jasmine; Vaduganathan, Muthiah; Kupershtok, Mania; Castillo, Frank M; Evert, Jessica
Global health learning experiences for medical students sit at the intersection of capacity building, ethics, and education. As interest in global health programs during medical school continues to rise, Northwestern University Alliance for International Development, a student-led and -run organization at Northwestern University Feinberg School of Medicine, has provided students with the opportunity to engage in two contrasting models of global health educational engagement.Eleven students, accompanied by two Northwestern physicians, participated in a one-week trip to Matagalpa, Nicaragua, in December 2010. This model allowed learning within a familiar Western framework, facilitated high-volume care, and focused on hands-on experiences. This approach aimed to provide basic medical services to the local population.In July 2011, 10 other Feinberg students participated in a four-week program in Puerto Escondido, Mexico, which was coordinated by Child Family Health International, a nonprofit organization that partners with native health care providers. A longer duration, homestays, and daily language classes hallmarked this experience. An intermediary, third-party organization served to bridge the cultural and ethical gap between visiting medical students and the local population. This program focused on providing a holistic cultural experience for rotating students.Establishing comprehensive global health curricula requires finding a balance between providing medical students with a fulfilling educational experience and honoring the integrity of populations that are medically underserved. This article provides a rich comparison between two global health educational models and aims to inform future efforts to standardize global health education curricula. PMID:24072106
Wolicki, Sara Beth; Nuzzo, Jennifer B; Blazes, David L; Pitts, Dana L; Iskander, John K; Tappero, Jordan W
Global health security involves developing the infrastructure and capacity to protect the health of people and societies worldwide. The acceleration of global travel and trade poses greater opportunities for infectious diseases to emerge and spread. The International Health Regulations (IHR) were adopted in 2005 with the intent of proactively developing public health systems that could react to the spread of infectious disease and provide better containment. Various challenges delayed adherence to the IHR. The Global Health Security Agenda came about as an international collaborative effort, working multilaterally among governments and across sectors, seeking to implement the IHR and develop the capacities to prevent, detect, and respond to public health emergencies of international concern. When examining the recent West African Ebola epidemic as a case study for global health security, both strengths and weaknesses in the public health response are evident. The central role of public health surveillance is a lesson reiterated by Ebola. Through further implementation of the Global Health Security Agenda, identified gaps in surveillance can be filled and global health security strengthened. PMID:27314658
Carpenter, David O
The world economy has been growing by an average of 3.5% a year. Continued global development is sustainable if overall social assets remain constant or rise over time, including manufactured, human, and environmental capital. Sustainable development requires that society not decrease its overall assets. But unregulated global trade may result in long-term loss of environmental capital. Multilateral governance is needed. Classical business models tend to view environmental damage as an externality--an impact on a third party's welfare that is neither compensated nor appropriated. The Rio Declaration on Environment and Development clearly states that economic development must err on the side of environmental integrity. Whereas UN Environmental Program policy requires precaution in the face of scientific uncertainty, World Trade Organization policy requires scientific certainty before precaution can be used. The conflict is obvious. In fact, there is gross lack of policy coordination across institutions. This article looks at some environmental strains and concludes that trade policy must address all aspects of human welfare, not merely the economic. PMID:17208718
Aboud, Frances E; Yousafzai, Aisha K
Health and nutritional risks co-occur in the lives of children under the age of 2 years who live in developing countries. We review evidence showing how these risks, in addition to inadequate psychosocial stimulation, prevent children from developing expected cognitive and language abilities. A systematic review and meta-analysis of 21 interventions aimed at enhancing stimulation and 18 interventions that provided better nutrition--all conducted since 2000--revealed that stimulation had a medium effect size of 0.42 and 0.47 on cognitive and language development, respectively, whereas nutrition by itself had a small effect size of 0.09. The implementation processes of these interventions are described and compared. A number of unresolved issues are outlined and discussed, including ways to maximize parental health behavior change, assess mediators that account for intervention effects, and expand the assessment of young children's brain functions that underlie language and cognition and are affected by nutrition and stimulation. PMID:25196276
Bahadar, Haji [International Campus, Tehran University of Medical Sciences (Iran, Islamic Republic of); Pharmaceutical Sciences Research Center and Faculty of Pharmacy, Tehran University of Medical Sciences (Iran, Islamic Republic of); Mostafalou, Sara [Pharmaceutical Sciences Research Center and Faculty of Pharmacy, Tehran University of Medical Sciences (Iran, Islamic Republic of); Abdollahi, Mohammad, E-mail: Mohammad.Abdollahi@UToronto.Ca [Pharmaceutical Sciences Research Center and Faculty of Pharmacy, Tehran University of Medical Sciences (Iran, Islamic Republic of)
Objective: Benzene, as a volatile organic compound, is known as one of the main air pollutants in the environment. The aim of this review is to summarize all available evidences on non-cancerous health effects of benzene providing an overview of possible association of exposure to benzene with human chronic diseases, specially, in those regions of the world where benzene concentration is being poorly monitored. Methodology: A bibliographic search of scientific databases including PubMed, Google Scholar, and Scirus was conducted with key words of “benzene toxic health effects”, “environmental volatile organic compounds”, “diabetes mellitus and environmental pollutants”, “breast cancer and environmental pollution”, “prevalence of lung cancer”, and “diabetes prevalence”. More than 300 peer reviewed papers were examined. Experimental and epidemiologic studies reporting health effects of benzene and volatile organic compounds were included in the study. Results: Epidemiologic and experimental studies suggest that benzene exposure can lead to numerous non-cancerous health effects associated with functional aberration of vital systems in the body like reproductive, immune, nervous, endocrine, cardiovascular, and respiratory. Conclusion: Chronic diseases have become a health burden of global dimension with special emphasis in regions with poor monitoring over contents of benzene in petrochemicals. Benzene is a well known carcinogen of blood and its components, but the concern of benzene exposure is more than carcinogenicity of blood components and should be evaluated in both epidemiologic and experimental studies. Aspect of interactions and mechanism of toxicity in relation to human general health problems especially endocrine disturbances with particular reference to diabetes, breast and lung cancers should be followed up. - Highlights: • Benzene is a volatile organic compound and established blood carcinogen. • Exposure to benzene needs to be
Objective: Benzene, as a volatile organic compound, is known as one of the main air pollutants in the environment. The aim of this review is to summarize all available evidences on non-cancerous health effects of benzene providing an overview of possible association of exposure to benzene with human chronic diseases, specially, in those regions of the world where benzene concentration is being poorly monitored. Methodology: A bibliographic search of scientific databases including PubMed, Google Scholar, and Scirus was conducted with key words of “benzene toxic health effects”, “environmental volatile organic compounds”, “diabetes mellitus and environmental pollutants”, “breast cancer and environmental pollution”, “prevalence of lung cancer”, and “diabetes prevalence”. More than 300 peer reviewed papers were examined. Experimental and epidemiologic studies reporting health effects of benzene and volatile organic compounds were included in the study. Results: Epidemiologic and experimental studies suggest that benzene exposure can lead to numerous non-cancerous health effects associated with functional aberration of vital systems in the body like reproductive, immune, nervous, endocrine, cardiovascular, and respiratory. Conclusion: Chronic diseases have become a health burden of global dimension with special emphasis in regions with poor monitoring over contents of benzene in petrochemicals. Benzene is a well known carcinogen of blood and its components, but the concern of benzene exposure is more than carcinogenicity of blood components and should be evaluated in both epidemiologic and experimental studies. Aspect of interactions and mechanism of toxicity in relation to human general health problems especially endocrine disturbances with particular reference to diabetes, breast and lung cancers should be followed up. - Highlights: • Benzene is a volatile organic compound and established blood carcinogen. • Exposure to benzene needs to be
Female college students were surveyed regarding their acceptance of a film format for teaching breast self-examination. Factors that distinguished college women who regularly examined their breasts included: (1) conservatism; (2) confidence; (3) previous instruction; and (4) perception of the threat of cancer. (Author/PP)
Ruckert, Arne; Labonté, Ronald; Lencucha, Raphael; Runnels, Vivien; Gagnon, Michelle
Global health diplomacy (GHD) describes the practices by which governments and non-state actors attempt to coordinate and orchestrate global policy solutions to improve global health. As an emerging field of practice, there is little academic work that has comprehensively examined and synthesized the theorization of Global Health Diplomacy (GHD), nor looked at why specific health concerns enter into foreign policy discussion and agendas. With the objective of uncovering the driving forces behind and theoretical explanations of GHD, we conducted a critical literature review. We searched three English-language scholarly databases using standardized search terms which yielded 606 articles. After screening of abstracts based on our inclusion/exclusion criteria, we retained 135 articles for importing into NVivo10 and coding. We found a lack of rigorous theorizing about GHD and fragmentation of the GHD literature which is not clearly structured around key issues and their theoretical explanations. To address this lack of theoretical grounding, we link the findings from the GHD literature to how theoretical concepts used in International Relations (IR) have been, and could be invoked in explaining GHD more effectively. To do this, we develop a theoretical taxonomy to explain GHD outcomes based on a popular categorization in IR, identifying three levels of analysis (individual, domestic/national, and global/international) and the driving forces for the integration of health into foreign policy at each level. PMID:26994358
Full Text Available Background: Prevalence rates in breast cancer have now reached epidemic levels. One of the main reasons behind onset of breast cancer is poor preventive beliefs and behavior of women towards cancer prevention. We examined the effectiveness of health education intervention in two communities of South Greece.Objective: The study investigates the effectiveness of a brief health education intervention on women’s beliefs and behaviour changes concerning breast cancer prevention.Methodology: A 90-minute, one-off encounter, health education study was designed for 300 women from Peloponissos, South Greece. A Health Belief Model questionnaire, was used before the intervention, immediately after and 6-months after the intervention.Results: Despite certain perception-related barriers (embarrassment, anxiety, ect women’s overall beliefs towards breast cancer prevention (perceived susceptibility, perceived benefits and perceived barriers changed positively after the health education intervention and this change was sustained at 6-month follow up. However, specific barriers (embarrassment, fear of pain, anxiety when anticipating tests’ results were not maintained at the same level of post-intervention during the same follow up. During the follow up period, women performed breast self-examination every month (73% and 55.10% had breast examination by a clinician and underwent a mammography.Conclusions: Short, low cost, health education interventions for breast cancer prevention to women can be effective in changing beliefs and behaviour. Tailored interventions are necessary to overcome relapsing of specific barriers. Emphasis should be given on the importance of doctor/nurse role in breast screening.
Evert, Jessica; Bazemore, Andrew; Hixon, Allen; Withy, Kelley
Medical students and residents have shown increasing interest in international health experiences. Before attempting to establish a global health training program in a family medicine residency, program faculty must consider the goals of the international program, whether there are champions to support the program, the resources available, and the specific type of program that best fits with the residency. The program itself should include didactics, peer education, experiential learning in international and domestic settings, and methods for preparing learners and evaluating program outcomes. Several hurdles can be anticipated in developing global health programs, including finances, meeting curricular and supervision requirements, and issues related to employment law, liability, and sustainability. PMID:17932801
Fidler, David P
Indonesia's decision to withhold samples of avian influenza virus A (H5N1) from the World Health Organization for much of 2007 caused a crisis in global health. The World Health Assembly produced a resolution to try to address the crisis at its May 2007 meeting. I examine how the parties to this controversy used international law in framing and negotiating the dispute. Specifically, I analyze Indonesia's use of the international legal principle of sovereignty and its appeal to rules on the protection of biological and genetic resources found in the Convention on Biological Diversity. In addition, I consider how the International Health Regulations 2005 applied to the controversy. The incident involving Indonesia's actions with virus samples illustrates both the importance and the limitations of international law in global health diplomacy. PMID:18258086
Threats posed by new, emerging or re-emerging communicable diseases are taking a global dimension, to which the World Health Organization (WHO) Secretariat has been responding with determination since 1995. Key to the global strategy for tackling epidemics across borders is the concept of global public health surveillance, which has been expanded and formalized by WHO and its technical partners through a number of recently developed instruments and initiatives. The adoption by the 58th World Health Assembly of the revised (2005) International Health Regulations provides the legal framework for mandating countries to link and coordinate their action through a universal network of surveillance networks. While novel environmental threats and outbreak-prone diseases have been increasingly identified during the past three decades, new processes of influence have appeared more recently, driven by the real or perceived threats of bio-terrorism and disruption of the global economy. Accordingly, the global surveillance agenda is being endorsed, and to some extent seized upon by new actors representing security and economic interests. This paper explores external factors influencing political commitment to comply with international health regulations and it illustrates adverse effects generated by: perceived threats to sovereignty, blurred international health agendas, lack of internationally recognized codes of conduct for outbreak investigations, and erosion of the impartiality and independence of international agencies. A companion paper (published in this issue) addresses the intrinsic difficulties that health systems of low-income countries are facing when submitted to the ever-increasing pressure to upgrade their public health surveillance capacity. PMID:17237489
Yao, Qiang; Chen, Kai; Yao, Lan; Lyu, Peng-hui; Yang, Tian-an; Luo, Fei; Chen, Shan-quan; He, Lu-yang; Liu, Zhi-Yong
Background: In the last few decades, health systems research (HSR) has garnered much attention with a rapid increase in the related literature. This study aims to review and evaluate the global progress in HSR and assess the current quantitative trends. Methods: Based on data from the Web of Science database, scientometric methods and knowledge visualization techniques were applied to evaluate global scientific production and develop trends of HSR from 1900 to 2012. Results: HSR has increased...
Drawing on research conducted in British Columbia, Ontario, and Quebec it is argued that tension exists between mental health reforms born out of concern for the well-being and care of people and those that are being driven by cost-containment and efficiency. Contributing to this tension are competing discourses about mental health and mental illness. It is argued that progressive change requires the meaningful engagement of mental health care recipients in policy decision-making processes and ongoing analysis about the interconnections between economic globalization, social welfare state restructuring and mental health reform. PMID:16138645
McCall, Daniel; Iltis, Ana S
The popularity and availability of global health experiences has increased, with organizations helping groups plan service trips and companies specializing in "voluntourism," health care professionals volunteering their services through different organizations, and medical students participating in global health electives. Much has been written about global health experiences in resource poor settings, but the literature focuses primarily on the work of health care professionals and medical students. This paper focuses on undergraduate student involvement in short term medical volunteer work in resource poor countries, a practice that has become popular among pre-health professions students. We argue that the participation of undergraduate students in global health experiences raises many of the ethical concerns associated with voluntourism and global health experiences for medical students. Some of these may be exacerbated by or emerge in unique ways when undergraduates volunteer. Guidelines and curricula for medical student engagement in global health experiences have been developed. Guidelines specific to undergraduate involvement in such trips and pre-departure curricula to prepare students should be developed and such training should be required of volunteers. We propose a framework for such guidelines and curricula, argue that universities should be the primary point of delivery even when universities are not organizing the trips, and recommend that curricula should be developed in light of additional data. PMID:25079381
Winchester, M S; BeLue, R; Oni, T; Wittwer-Backofen, U; Deobagkar, D; Onya, H; Samuels, T A; Matthews, S A; Stone, C; Airhihenbuwa, C
In the current United Nations efforts to plan for post 2015-Millennium Development Goals, global partnership to address non-communicable diseases (NCDs) has become a critical goal to effectively respond to the complex global challenges of which inequity in health remains a persistent challenge. Building capacity in terms of well-equipped local researchers and service providers is a key to bridging the inequity in global health. Launched by Penn State University in 2014, the Pan University Network for Global Health responds to this need by bridging researchers at more than 10 universities across the globe. In this paper we outline our framework for international and interdisciplinary collaboration, as well the rationale for our research areas, including a review of these two themes. After its initial meeting, the network has established two central thematic priorities: 1) urbanization and health and 2) the intersection of infectious diseases and NCDs. The urban population in the global south will nearly double in 25 years (approx. 2 billion today to over 3.5 billion by 2040). Urban population growth will have a direct impact on global health, and this growth will be burdened with uneven development and the persistence of urban spatial inequality, including health disparities. The NCD burden, which includes conditions such as hypertension, stroke, and diabetes, is outstripping infectious disease in countries in the global south that are considered to be disproportionately burdened by infectious diseases. Addressing these two priorities demands an interdisciplinary and multi-institutional model to stimulate innovation and synergy that will influence the overall framing of research questions as well as the integration and coordination of research. PMID:27097634
Reisner, Sari L; Poteat, Tonia; Keatley, JoAnne; Cabral, Mauro; Mothopeng, Tampose; Dunham, Emilia; Holland, Claire E; Max, Ryan; Baral, Stefan D
Transgender people are a diverse population affected by a range of negative health indicators across high-income, middle-income, and low-income settings. Studies consistently document a high prevalence of adverse health outcomes in this population, including HIV and other sexually transmitted infections, mental health distress, and substance use and abuse. However, many other health areas remain understudied, population-based representative samples and longitudinal studies are few, and routine surveillance efforts for transgender population health are scarce. The absence of survey items with which to identify transgender respondents in general surveys often restricts the availability of data with which to estimate the magnitude of health inequities and characterise the population-level health of transgender people globally. Despite the limitations, there are sufficient data highlighting the unique biological, behavioural, social, and structural contextual factors surrounding health risks and resiliencies for transgender people. To mitigate these risks and foster resilience, a comprehensive approach is needed that includes gender affirmation as a public health framework, improved health systems and access to health care informed by high quality data, and effective partnerships with local transgender communities to ensure responsiveness of and cultural specificity in programming. Consideration of transgender health underscores the need to explicitly consider sex and gender pathways in epidemiological research and public health surveillance more broadly. PMID:27323919
Full Text Available Maura MacPhee,1 Lilu Chang,2 Diana Lee,3 Wilza Spiri4 1University of British Columbia School of Nursing, Vancouver, British Columbia, Canada; 2Center for Advancement of Nursing Education, Koo Foundation, Sun Yat-Sen Cancer Center, Taipei, Taiwan; 3Nethersole School of Nursing, Chinese University of Hong Kong, Hong Kong, 4São Paulo State University, Botucatu, São Paulo, Brazil Abstract: This paper provides an overview of trends associated with global health care leadership development. Accompanying these trends are propositions based on current available evidence. These testable propositions should be considered when designing, implementing, and evaluating global health care leadership development models and programs. One particular leadership development model, a multilevel identity model, is presented as a potential model to use for leadership development. Other, complementary approaches, such as positive psychology and empowerment strategies, are discussed in relation to leadership identity formation. Specific issues related to global leadership are reviewed, including cultural intelligence and global mindset. An example is given of a nurse leadership development model that has been empirically tested in Canada. Through formal practice–academic–community collaborations, this model has been locally adapted and is being used for nurse leader training in Hong Kong, Taiwan, and Brazil. Collaborative work is under way to adapt the model for interprofessional health care leadership development. Keywords: health care leadership, development models, global trends, collective
The Global Health Security Agenda's objectives contain components that could help health departments address emerging public health challenges that threaten the population. As part of the agenda, partner countries with advanced public health systems will support the development of infrastructure in stakeholder health departments. To facilitate this process and augment local programs, state and local health departments may want to include concepts of health security in their public health preparedness offices in order to simultaneously build capacity. Health security programs developed by public health departments should complete projects that are closely aligned with the objectives outlined in the global agenda and that facilitate the completion of current preparedness grant requirements. This article identifies objectives and proposes tactical local projects that run parallel to the 9 primary objectives of the Global Health Security Agenda. Executing concurrent projects at the international and local levels in preparedness offices will accelerate the completion of these objectives and help prevent disease epidemics, detect health threats, and respond to public health emergencies. Additionally, future funding tied or related to health security may become more accessible to state and local health departments that have achieved these objectives. PMID:25396695
Petersen, Larra R; Clark, Matthew M; Novotny, Paul; Kung, Simon; Sloan, Jeff A; Patten, Christi A; Vickers, Kristin S; Rummans, Teresa A; Frost, Marlene H; Colligan, Robert C
Few studies have investigated the influence of optimism-pessimism in breast cancer survivors. This study used a retrospective design with 268 adult women who completed the Minnesota Multiphasic Personality Inventory (MMPI) as part of their medical care approximately 10 years prior to their breast cancer diagnosis and Medical Outcome Study Short-Form General Health Survey (SF-36 or SF-12), on average, 8 years after diagnosis. MMPI pessimism scores were divided into quartiles, and t tests were used to determine differences between those highest and lowest in pessimism on health-related quality-of-life (QOL) measures, demographics, and disease status. The mean age at diagnosis of breast cancer was 63 years, and 74% had early-stage breast cancer. Patients age 65 years and older were significantly lower on physical health related QOL scales. There were no significant differences in health-related QOL scores by stage of disease. Patients with a pessimistic explanatory style were significantly lower on all of the health-related QOL scores, compared to those with a nonpessimistic style. Breast cancer survivors who exhibit a pessimistic explanatory style report lower health-related QOL for years after receiving a cancer diagnosis, compared to nonpessimistic women. PMID:19042270
Jaime C. Sapag
Full Text Available Background: Mental health is increasingly recognised as integral to good public health, but this area continues to lack sufficient planning, resources, and global strategy. It is a pressing concern in Latin America, where social determinants of health aggravate existing inequities in access to health services. Nicaragua faces serious mental health needs and challenges. One key strategy for addressing gaps in mental health services is building capacity at the primary healthcare and system levels. Objective: Using the framework of best practice literature, this article analyses the four-year collaborative process between the National Autonomous University of Nicaragua in León (UNAN-León and the Centre for Addiction and Mental Health (CAMH in Canada, which is aimed at improving mental healthcare in Nicaragua. Design: Based on a critical analysis of evaluation reports, key documents, and discussion among partners, the central steps of the collaboration are analysed and main successes and challenges identified. Results: A participatory needs assessment identified local strengths and weaknesses, expected outcomes regarding competencies, and possible methodologies and recommendations for the development of a comprehensive capacity-building programme. The partners delivered two international workshops on mental health and addiction with an emphasis on primary healthcare. More recently, an innovative Diploma and Master programme was launched to foster interprofessional leadership and effective action to address mental health and addiction needs. Collaborative activities have taken place in Nicaragua and Canada. Discussion: To date, international collaboration between Nicaragua and CAMH has been successful in achieving the jointly defined goals. The process has led to mutual knowledge sharing, strong networking, and extensive educational opportunities. Evidence of effective and respectful global health capacity building is provided. Lessons learned and
Full Text Available The Global Health 2035 report notes that the "grand convergence"--closure of the infectious, maternal, and child mortality gap between rich and poor countries--is dependent on research and development (R&D of new drugs, vaccines, diagnostics, and other health tools. However, this convergence (and the R&D underpinning it will first require an even more fundamental convergence of the different worlds of public health and innovation, where a largely historical gap between global health experts and innovation experts is hindering achievement of the grand convergence in health.
Kaviani, Ahmad; Sodagari, Nassim; Sheikhbahaei, Sara; Eslami, Vahid; Hafezi-Nejad, Nima; Safavi, Amin; Noparast, Maryam; Fitoussi, Alfred
Surgical management of breast cancer has evolved considerably over the last two decades. There has been a major shift toward less-invasive local treatments, from radical mastectomy to breast-conserving therapy (BCT) and oncoplastic breast surgery (OBS). In order to investigate the efficacy of each of the three abovementioned methods, a literature review was conducted for measurable outcomes including local recurrence, survival, cosmetic outcome, quality of life (QOL), and health economy. From...
Wise, Lauren A; Palmer, Julie R.; Boggs, Deborah A; Adams-Campbell, Lucile L.; Rosenberg, Lynn
Few studies have examined the relation between abuse victimization and breast cancer, and results have been inconclusive. Using data from 35,728 participants in the Black Women’s Health Study, we conducted multivariable Cox regression to estimate incidence rate ratios (IRRs) and 95% confidence intervals (CI) for the association of abuse across the life span (childhood, adolescence, and adulthood) with breast cancer. Incident breast cancer diagnoses were reported during 1995–2009, and abuse hi...
Philip Kam TaoLi; Emmanuel A Burdmann; Ravindra L Mehta
Acute kidney injury (AKI) is increasingly prevalent in developing and developed countries and is associated with severe morbidity and mortality.Most etiologies of AKI can be prevented by interventions at the individual,community,regional and in-hospital levels.Effective measures must include community-wide efforts to increase an awareness of the devastating effects of AKI and provide guidance on preventive strategies,as well as early recognition and management.Efforts should be focused on minimizing causes of AKI,increasing awareness of the importance of serial measurements of serum creatinine in high risk patients,and documenting urine volume in acutely ill people to achieve early diagnosis; there is as yet no definitive role for alternative biomarkers.Protocols need to be developed to systematically manage prerenal conditions and specific infections.More accurate data about the true incidence and clinical impact of AKI will help to raise the importance of the disease in the community,increase awareness of AKI by governments,the public,general and family physicians and other health care professionals to help prevent the disease.Prevention is the key to avoid the heavy burden of mortality and morbidity associated with AKI.
Petersen, P E; Kandelman, D; Arpin, S;
The aim of this report is (1) to provide a global overview of oral health conditions in older people, use of oral health services, and self care practices; (2) to explore what types of oral health services are available to older people, and (3) to identify some major barriers to and opportunities...
Villagran, Melinda; Weathers, Melinda; Keefe, Brian; Sparks, Lisa
Climate change is a threat to wildlife and the environment, but it also one of the most pervasive threats to human health. The goal of this study was to examine the relationships among dimensions of health literacy, patient education about global warming and climate change (GWCC), and health behaviors. Results reveal that patients who have higher…
Jooma, R; Khan, A; Khan, A A
The world is facing an unprecedented global economic crisis, with many countries needing to reconsider their level of health care spending. This paper explores the many consequences of the global economic turndown on Pakistan's health, including reduced government and donor spending and increased poverty with the consequent diversion of funds away from health. Nevertheless, these challenges may provide opportunities not only to mitigate the adverse effects of the economic crisis but also to institute some much-needed reforms that may not receive political support during more affluent times. Our suggestions focus on setting priorities based on the national disease burden, prioritizing prevention interventions, demanding results, curbing corruption, experimenting with innovative funding mechanisms, advocating for increased funding by presenting health spending as an investment rather than an expense and by selected recourse to civil society interventions and philanthropy to bridge the gap between available and needed resources. PMID:22574485
Gorik Ooms recently made a strong case for considering the centrality of normative premises to analyzing and understanding the underappreciated importance of the nexus of politics, power and process in global health. This critical commentary raises serious questions for the practice and study of global health and global health governance. First and foremost, this commentary underlines the importance of the question of what is global health, and why as well as how does this definition matter? ...
Full Text Available Politics is not the ghost in the machine of global health policy. Conceptually, it makes little sense to argue otherwise, while history is replete with examples of individuals and movements engaging politically in global health policy. Were one looking for ghosts, a more likely candidate would be democracy, which is currently under attack by a new global health technocracy. Civil society movements offer an opportunity to breathe life into a vital, but dying, political component of global health policy.
Full Text Available Abstract Background Global health research is essential for development. A major issue is the inequitable distribution of research efforts and funds directed towards populations suffering the world's greatest health problems. This imbalance is fostering major attempts at redirecting research to the health problems of low and middle income countries. Following the creation of the Coalition for Global Health Research – Canada (CGHRC in 2001, the Canadian Society for International Health (CSIH decided to review the role of non-governmental organizations (NGOs in global health research. This paper highlights some of the prevalent thinking and is intended to encourage new thinking on how NGOs can further this role. Approach This paper was prepared by members of the Research Committee of the CSIH, with input from other members of the Society. Persons working in various international NGOs participated in individual interviews or group discussions on their involvement in different types of research activities. Case studies illustrate the roles of NGOs in global health research, their perceived strengths and weaknesses, and the constraints and opportunities to build capacity and develop partnerships for research. Highlights NGOs are contributing at all stages of the research cycle, fostering the relevance and effectiveness of the research, priority setting, and knowledge translation to action. They have a key role in stewardship (promoting and advocating for relevant global health research, resource mobilization for research, the generation, utilization and management of knowledge, and capacity development. Yet, typically, the involvement of NGOs in research is downstream from knowledge production and it usually takes the form of a partnership with universities or dedicated research agencies. Conclusion There is a need to more effectively include NGOs in all aspects of health research in order to maximize the potential benefits of research. NGOs
Day Michael J; Palatnik-de-Sousa Clarisa B.
Abstract 'One Health' proposes the unification of medical and veterinary sciences with the establishment of collaborative ventures in clinical care, surveillance and control of cross-species disease, education, and research into disease pathogenesis, diagnosis, therapy and vaccination. The concept encompasses the human population, domestic animals and wildlife, and the impact that environmental changes ('environmental health') such as global warming will have on these populations. Visceral le...
Bolton, Paul A.
In this paper, the author contrasts the substantial impact of mental health problems on global disability with the limited attention and resources these problems receive. The author discusses possible reasons for the disparity: Compared to physical disorders, mental health problems are considered less important, perhaps due to lower priority of disorders that primarily cause dysfunction rather than mortality, and skepticism that mental disorders are treatable in low-resource countries. He arg...
Koehn Peter H
Abstract Unprecedented migration, a core dimension of contemporary globalization, challenges population health. In a world of increasing human mobility, many health outcomes are shaped by transnational interactions among care providers and care recipients who meet in settings where nationality/ethnic match is not an option. This review article explores the value of transnational competence (TC) education as preparation for ethnically and socially discordant clinical encounters. The relevance ...
Nuttall, I; Miyagishima, K; Roth, C; de La Rocque, S
The One Health approach encompasses multiple themes and can be understood from many different perspectives. This paper expresses the viewpoint of those in charge of responding to public health events of international concern and, in particular, to outbreaks of zoonotic disease. Several international organisations are involved in responding to such outbreaks, including the United Nations (UN) and its technical agencies; principally, the Food and Agriculture Organization of the UN (FAO) and the World Health Organization (WHO); UN funds and programmes, such as the United Nations Development Programme, the World Food Programme, the United Nations Environment Programme, the United Nations Children's Fund; the UN-linked multilateral banking system (the World Bank and regional development banks); and partner organisations, such as the World Organisation for Animal Health (OIE). All of these organisations have benefited from the experiences gained during zoonotic disease outbreaks over the last decade, developing common approaches and mechanisms to foster good governance, promote policies that cut across different sectors, target investment more effectively and strengthen global and national capacities for dealing with emerging crises. Coordination among the various UN agencies and creating partnerships with related organisations have helped to improve disease surveillance in all countries, enabling more efficient detection of disease outbreaks and a faster response, greater transparency and stakeholder engagement and improved public health. The need to build more robust national public human and animal health systems, which are based on good governance and comply with the International Health Regulations (2005) and the international standards set by the OIE, prompted FAO, WHO and the OIE to join forces with the World Bank, to provide practical tools to help countries manage their zoonotic disease risks and develop adequate resources to prevent and control disease
206 samples of breast milk of mothers living on the radionuclide contaminated territories of the Republic of Belarus as well as their infants' health have been studied. Each sample was examined on content of cesium 137 and strontium 90 and reduce of the immunologic usefulness of milk was detected. The infants fed with the breast milk containing radionuclides suffer from anemia, infectious and inflammatory diseases more often than ones from 'clean' regions
Bowsher, G; Milner, C; Sullivan, R
Medical intelligence, security and global health are distinct fields that often overlap, especially as the drive towards a global health security agenda gathers pace. Here, we outline some of the ways in which this has happened in the recent past during the recent Ebola epidemic in West Africa and in the killing of Osama Bin laden by US intelligence services. We evaluate medical intelligence and the role it can play in global health security; we also attempt to define a framework that illustrates how medical intelligence can be incorporated into foreign policy action in order delineate the boundaries and scope of this growing field. PMID:27385714
Folb, Peter I; Bernatowska, Ewa; Chen, Robert; Clemens, John; Dodoo, Alex N O; Ellenberg, Susan S.; Farrington, C Patrick; John, T. Jacob; Lambert, Paul Henri; MacDonald, Noni E; Miller, Elizabeth; Salisbury, David; Schmitt, Heinz-J; Siegrist, Claire-Anne; Wimalaratne, Omala
Established in 1999, the Global Advisory Committee on Vaccine Safety advises the World Health Organization (WHO) on vaccine-related safety issues and enables WHO to respond promptly, efficiently, and with scientific rigor to issues of vaccine safety with potential global importance. The committee also assesses the implications of vaccine safety for practice worldwide and for WHO policies. We describe the principles on which the committee was established, its modus operandi, and the scope of t...
Yu, Mei-yu; Song, Lixin; Seetoo, Amy; Cai, Cuijuan; Smith, Gary; Oakley, Deborah
The lay health advisor (LHA) training program for breast cancer screening was conducted among Chinese-English bilingual trainees residing in Southeast Michigan. Guided by Bandura's Social Learning Theory, the development of the training curriculum followed the health communication process recommended by the National Cancer Institute. Data analysis…
Objectives: To develop a new computer-aided detection scheme to compute a global kinetic image feature from the dynamic contrast enhanced breast magnetic resonance imaging (DCE-MRI) and test the feasibility of using the computerized results for assisting classification between the DCE-MRI examinations associated with malignant and benign tumors. Materials and Methods: The scheme registers sequential images acquired from each DCE-MRI examination, segments breast areas on all images, searches for a fraction of voxels that have higher contrast enhancement values and computes an average contrast enhancement value of selected voxels. Combination of the maximum contrast enhancement values computed from two post-contrast series in one of two breasts is applied to predict the likelihood of the examination being positive for breast cancer. The scheme performance was evaluated when applying to a retrospectively collected database including 80 malignant and 50 benign cases. Results: In each of 91% of malignant cases and 66% of benign cases, the average contrast enhancement value computed from the top 0.43% of voxels is higher in the breast depicted suspicious lesions as compared to another negative (lesion-free) breast. In classifying between malignant and benign cases, using the computed image feature achieved an area under a receiver operating characteristic curve of 0.839 with 95% confidence interval of [0.762, 0.898]. Conclusions: We demonstrated that the global contrast enhancement feature of DCE-MRI can be relatively easily and robustly computed without accurate breast tumor detection and segmentation. This global feature provides supplementary information and a higher discriminatory power in assisting diagnosis of breast cancer
Yang, Qian [College of Life Information Science and Instrument Engineering, Hangzhou Dianzi University, Hangzhou, 310018 (China); Li, Lihua, E-mail: email@example.com [College of Life Information Science and Instrument Engineering, Hangzhou Dianzi University, Hangzhou, 310018 (China); Zhang, Juan; Shao, Guoliang [Zhejiang Cancer Hospital, Hangzhou, 310010 (China); Zheng, Bin [College of Life Information Science and Instrument Engineering, Hangzhou Dianzi University, Hangzhou, 310018 (China); School of Electrical and Computer Engineering, University of Oklahoma, Norman, OK 73019 (United States)
Objectives: To develop a new computer-aided detection scheme to compute a global kinetic image feature from the dynamic contrast enhanced breast magnetic resonance imaging (DCE-MRI) and test the feasibility of using the computerized results for assisting classification between the DCE-MRI examinations associated with malignant and benign tumors. Materials and Methods: The scheme registers sequential images acquired from each DCE-MRI examination, segments breast areas on all images, searches for a fraction of voxels that have higher contrast enhancement values and computes an average contrast enhancement value of selected voxels. Combination of the maximum contrast enhancement values computed from two post-contrast series in one of two breasts is applied to predict the likelihood of the examination being positive for breast cancer. The scheme performance was evaluated when applying to a retrospectively collected database including 80 malignant and 50 benign cases. Results: In each of 91% of malignant cases and 66% of benign cases, the average contrast enhancement value computed from the top 0.43% of voxels is higher in the breast depicted suspicious lesions as compared to another negative (lesion-free) breast. In classifying between malignant and benign cases, using the computed image feature achieved an area under a receiver operating characteristic curve of 0.839 with 95% confidence interval of [0.762, 0.898]. Conclusions: We demonstrated that the global contrast enhancement feature of DCE-MRI can be relatively easily and robustly computed without accurate breast tumor detection and segmentation. This global feature provides supplementary information and a higher discriminatory power in assisting diagnosis of breast cancer.
Levine, Ruth E.
The editorial by Jeremy Shiffman, "Knowledge, moral claims and the exercise of power in global health", highlights the influence on global health priority-setting of individuals and organizations that do not have a formal political mandate. This sheds light on the way key functions in global health depend on private funding, particularly from the Bill & Melinda Gates Foundation.
Koo, Fung Kuen; Kwok, Cannas; White, Kate; D'Abrew, Natalie; Roydhouse, Jessica K
In Australia, women from non-English-speaking backgrounds participate less frequently in breast cancer screening than English-speaking women, and Chinese immigrant women are 50% less likely to participate in breast examinations than Australian-born women. Chinese-born Australians comprise 10% of the overseas-born Australian population, and the immigrant Chinese population in Australia is rapidly increasing. We report on the strategies used in a pilot breast health promotion program, Living with Healthy Breasts, aimed at Cantonese-speaking adult immigrant women in Sydney, Australia. The program consisted of a 1-day education session and a 2-hour follow-up session. We used 5 types of strategies commonly used for cultural targeting (peripheral, evidential, sociocultural, linguistic, and constituent-involving) in a framework of traditional Chinese philosophies (Confucianism, Taoism, and Buddhism) to deliver breast health messages to Chinese-Australian immigrant women. Creating the program's content and materials required careful consideration of color (pink to indicate femininity and love), symbols (peach blossoms to imply longevity), word choice (avoidance of the word death), location and timing (held in a Chinese restaurant a few months after the Chinese New Year), communication patterns (the use of metaphors and cartoons for discussing health-related matters), and concern for modesty (emphasizing that all presenters and team members were female) to maximize cultural relevance. Using these strategies may be beneficial for designing and implementing breast cancer prevention programs in Cantonese-speaking Chinese immigrant communities. PMID:22172170
Colon-Otero, Gerardo; Albertie, Monica; Rodriguez, Judith; Nicholson, Garik; Kolomeyer, Irina; Moreno-Aspitia, Alvaro; Lesperance, Mary; Perez, Edith A.
The Mayo Clinic Disparities Program and the University of North Florida Brooks College of Health partnered with representatives of the Hispanic community of Northeast Florida to develop an educational program aimed at raising awareness of the importance of diet in breast cancer prevention and availability of free breast cancer screening. An…
Leggat, Sandra G; Tse, Nancy
Globalization is impacting on Hong Kong and Australia in different ways, but the experience of the public healthcare systems in both jurisdictions suggests a need for teaching and research hospitals to refocus from the management of international patients to better meet the needs for global health. Traditional globalization suggests a stockpiling of capital--a focus on improving global health suggests dismantling the stockpiles and sharing access to the necessary data, information, knowledge and discoveries to further develop local health expertise. Consistent with its position as a leading healthcare provider, the University Health Network (UHN) has been reflecting on the impact of increasing globalization on hospitals. The goals of the UHN paper on globalization are threefold--to suggest how the external and internal environments of hospitals will change as a result of globalization; to suggest a role for hospitals in a globalized world; and to stimulate discussion and debate. Given our perspective, from the other side of the world, we are pleased to contribute to the discussion and debate but will limit our comments to the future role of teaching and research hospitals based on some of the experiences of Australia and Hong Kong. The citizens of Hong Kong have been acutely aware of the issue of globalization--the excellent deep-water harbour has ensured the position of Hong Kong as a major trading hub. Hong Kong has also had a continually evolving role as a financial centre and gateway to China, and with China's accession to the World Trade Organization the impact of globalization will be even greater. On the other hand, the citizens of Australia have lived with geographic isolation, relatively limited natural resources and a small population, all of which have limited their role in global trade and financial markets. However, both Hong Kong and Australia have seen recent benefits from the increasing speed of communication and information transfer and exchange
Zafar Mizra looks at the linkages between globalization and health and the risks and opportunities for the poor from his reference point as a civil society activist following the World Trade Organization agreements. Development (2001) 44, 91–92. doi:10.1057/palgrave.development.1110220
Zika virus infection has emerged as the world's newest health threat, linked to microcephaly in infants and Guillain-Barré syndrome in adults. We address the rapid global spread of this disease, and the prospects for successful prevention and treatment. PMID:27069344
A new set of 11 global health studies calls attention to the burden of tobacco-related inequalities in low- and middle-income countries and finds that socioeconomic inequalities are associated with increased tobacco use, second-hand smoke exposure and tob
Cole, Donald C; Johnson, Nancy; Mejia, Raul; McCullough, Hazel; Turcotte-Tremblay, Anne-Marie; Barnoya, Joaquin; Falabella Luco, María Soledad
Mentoring experiences and programmes are becoming increasingly recognised as important by those engaged in capacity strengthening in global health research. Using a primarily qualitative study design, we studied three experiences of mentorship and eight mentorship programmes for early career global health researchers based in high-income and low- and middle-income countries. For the latter, we drew upon programme materials, existing unpublished data and more formal mixed-method evaluations, supplemented by individual email questionnaire responses. Research team members wrote stories, and the team assembled and analysed them for key themes. Across the diverse experiences and programmes, key emergent themes included: great mentors inspire others in an inter-generational cascade, mentorship is transformative in personal and professional development and involves reciprocity, and finding the right balance in mentoring relationships and programmes includes responding creatively to failure. Among the challenges encountered were: struggling for more level playing fields for new health researchers globally, changing mindsets in institutions that do not have a culture of mentorship and building collaboration not competition. Mentoring networks spanning institutions and countries using multiple virtual and face-to-face methods are a potential avenue for fostering organisational cultures supporting quality mentorship in global health research. PMID:26234691
Zika virus infection has emerged as the world’s newest health threat, linked to microcephaly in infants and Guillain–Barré syndrome in adults. We address the rapid global spread of this disease, and the prospects for successful prevention and treatment.
Full Text Available This article discusses the need for research on health systems,either through comparisons between systems or studies todepth of impact and performance of modern health systems.Global economic and political changes put pressure on healthsystems to become models adapted to the market, while theproblems of social inequality economies and epidemiologicalchanges require changes to improve the performance ofsystems. Actually exists a progressive grow of health spending,however some poor countries fail to cover all your healthneeds, while growing economies or developed countries facethe lack of control in the prices of intellectual property, and theinability to transform toward models preventive.
Ooms, G.; Hammonds, R.; Richard, F.; De Brouwere, V.
The first decade of the new millennium saw an upsurge in global financing for health. When the world took stock of progress on the Millennium Development Goals in mid-2010 the one addressing maternal health showed the least progress. Did maternal health miss the boat? In mid-2010 the Secretary-General of the United Nations launched a “Global Strategy for Women’s and Children’s Health”, also known as the “Every Woman Every Child” initiative. Has the tide now turned in favour of maternal health...
Ahmad Reza Hosseinpoor
Full Text Available Background: Health equity is a priority in the post-2015 sustainable development agenda and other major health initiatives. The World Health Organization (WHO has a history of promoting actions to achieve equity in health, including efforts to encourage the practice of health inequality monitoring. Health inequality monitoring systems use disaggregated data to identify disadvantaged subgroups within populations and inform equity-oriented health policies, programs, and practices. Objective: This paper provides an overview of a number of recent and current WHO initiatives related to health inequality monitoring at the global and/or national level. Design: We outline the scope, content, and intended uses/application of the following: Health Equity Monitor database and theme page; State of inequality: reproductive, maternal, newborn, and child health report; Handbook on health inequality monitoring: with a focus on low- and middle-income countries; Health inequality monitoring eLearning module; Monitoring health inequality: an essential step for achieving health equity advocacy booklet and accompanying video series; and capacity building workshops conducted in WHO Member States and Regions. Conclusions: The paper concludes by considering how the work of the WHO can be expanded upon to promote the establishment of sustainable and robust inequality monitoring systems across a variety of health topics among Member States and at the global level.
Regens, J.L.; Hodges, D.G. [Tulane Univ. Medical Center, New Orleans, LA (United States)
Modeling projections of future climatic conditions suggest changes in temperature and precipitation patterns that might induce direct adverse effects on human health by altering the extent and severity of infectious and vector-borne diseases. The incidence of mosquito-borne diseases, for example, could increase substantially in areas where temperature and relative humidity rise. The application of Geographic Information Systems (GIS) offers new methodologies to evaluate the impact of global warming on changes in the incidence of infectious and vector-borne diseases. This research illustrates the potential analytical and communication uses of GIS for monitoring historical patterns of climate and human health variables and for projecting changes in these health variables with global warming.
Murray Susan F; Bisht Ramila; Baru Rama; Pitchforth Emma
Abstract The complex relationship between globalization and health calls for research from many disciplinary and methodological perspectives. This editorial gives an overview of the content trajectory of the interdisciplinary journal ‘Globalization and Health’ over the first six years of production, 2005 to 2010. The findings show that bio-medical and population health perspectives have been dominant but that social science perspectives have become more evident in recent years. The types of p...