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Sample records for breast health global

  1. Development and Psychometric Assessment of the Measure of Globalization Influence on Health Risk (MGIHR) Among Mexican Women with Breast Cancer.

    Science.gov (United States)

    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

    2015-08-01

    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

  2. Breast health global initiative (BHGI outline for program development in Latin America Breast health global initiative (BHGI planeamiento para el desarrollo de programas en América latina

    Directory of Open Access Journals (Sweden)

    Benjamin O. Anderson

    2009-01-01

    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

  3. Global Health System

    Science.gov (United States)

    ... 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 ...

  4. Global Health 2011%Global Health2011

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    BMJ Group and NICE International have joined forces to co- host a unique two day conference on policies for sustainable and effective healthcare.Taking place on 29 and 30 September 2011 at BMA House in London,Global Health 2011 will bring together experts from around the world to discuss and promote cost effective and evidence informed policy making as a means to improve health outcomes.

  5. Geography and global health.

    Science.gov (United States)

    Brown, Tim; Moon, Graham

    2012-01-01

    In the wake of the report of the World Health Organisation's Commission on the Social Determinants of Health, Closing the gap in a generation (Marmot 2008), this invited commentary considers the scope for geographical research on global health. We reflect on current work and note future possibilities, particularly those that take a critical perspective on the interplay of globalisation, security and health. PMID:22413171

  6. Promoting Global Health

    OpenAIRE

    Margaret A. Winker, MD; Lorraine E. Ferris, PhD, LLM

    2015-01-01

    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.

  7. Peopling Global Health

    Directory of Open Access Journals (Sweden)

    João Biehl

    2014-06-01

    Full Text Available The field of Global Health brings together a vastly diverse array of actors working to address pressing health issues worldwide with unprecedented financial and technological resources and informed by various agendas. While Global Health initiatives are booming and displacing earlier framings of the field (such as tropical medicine or international health, critical analyses of the social, political, and economic processes associated with this expanding field — an “open source anarchy” on the ground — are still few and far between. In this essay, we contend that, among the powerful players of Global Health, the supposed beneficiaries of interventions are generally lost from view and appear as having little to say or nothing to contribute. We make the case for a more comprehensive and people-centered approach and demonstrate the crucial role of ethnography as an empirical lantern in Global Health. By shifting the emphasis from diseases to people and environments, and from trickle-down access to equality, we have the opportunity to set a humane agenda that both realistically confronts challenges and expands our vision of the future of global communities.

  8. Global health justice and governance.

    Science.gov (United States)

    Ruger, Jennifer Prah

    2012-01-01

    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.

  9. Global health justice and governance.

    Science.gov (United States)

    Ruger, Jennifer Prah

    2012-01-01

    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

  10. The New Global Health

    Centers for Disease Control (CDC) Podcasts

    2013-08-13

    Dr. Mike Miller reads an abridged version of the Emerging Infectious Diseases’ Perspective, The New Global Health.  Created: 8/13/2013 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 8/14/2013.

  11. Global health knowledge

    OpenAIRE

    Abdolreza Jaberi Aghdam

    2013-01-01

    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...

  12. A United Nations Global Health Panel for Global Health Governance.

    Science.gov (United States)

    Mackey, Tim K; Liang, Bryan A

    2013-01-01

    The World Health Organization now relies upon voluntary contributions tied to specific projects, underwriting 75% of operations. A resulting cacophony of non-governmental, foundation, and private sector actors have emerged overlapping and fractionating WHO programs. In this expanding world of "global health organizations," WHO's role must be redefined. We propose coordination of global health initiatives through a United Nations Global Health Panel with active participation of WHO. Given recent events, the UN is poised to take a greater leadership role in global health.

  13. Global health education consortium: 20 years of leadership in global health and global health education.

    Science.gov (United States)

    Velji, Anvar

    2011-06-01

    The Global Health Education Consortium (GHEC) is a group of universities and institutions committed to improving the health and human rights of underserved populations worldwide through improved education and training of the global health workforce. In the early 1990s, GHEC brought together many of the global health programs in North America to improve competencies and curricula in global health as well as to involve member institutions in health policy, development issues, and delivery of care in the inner cities, marginalized areas, and abroad.

  14. Global transition in health.

    Science.gov (United States)

    Bygbjerg, Ib Christian; Meyrowitsch, Dan W

    2007-02-01

    "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 [1]. The effect of transition on health and diseases in populations was demonstrated by Frenkl et al in 1991 [2]. And which major public health problems following each other, and why, was underscored by LaPorte in 1995 [3]. 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

  15. Global solidarity, migration and global health inequity.

    Science.gov (United States)

    Eckenwiler, Lisa; Straehle, Christine; Chung, Ryoa

    2012-09-01

    The grounds for global solidarity have been theorized and conceptualized in recent years, and many have argued that we need a global concept of solidarity. But the question remains: what can motivate efforts of the international community and nation-states? Our focus is the grounding of solidarity with respect to global inequities in health. We explore what considerations could motivate acts of global solidarity in the specific context of health migration, and sketch briefly what form this kind of solidarity could take. First, we argue that the only plausible conceptualization of persons highlights their interdependence. We draw upon a conception of persons as 'ecological subjects' and from there illustrate what such a conception implies with the example of nurses migrating from low and middle-income countries to more affluent ones. Next, we address potential critics who might counter any such understanding of current international politics with a reference to real-politik and the insights of realist international political theory. We argue that national governments--while not always or even often motivated by moral reasons alone--may nevertheless be motivated to acts of global solidarity by prudential arguments. Solidarity then need not be, as many argue, a function of charitable inclination, or emergent from an acknowledgment of injustice suffered, but may in fact serve national and transnational interests. We conclude on a positive note: global solidarity may be conceptualized to helpfully address global health inequity, to the extent that personal and transnational interdependence are enough to motivate national governments into action.

  16. Global health diplomacy: advancing foreign policy and global health interests.

    Science.gov (United States)

    Michaud, Josh; Kates, Jennifer

    2013-03-01

    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. PMID:25276514

  17. Global health diplomacy: advancing foreign policy and global health interests

    OpenAIRE

    Michaud, Josh; Kates, Jennifer

    2013-01-01

    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.

  18. Global Health Innovation Technology Models

    OpenAIRE

    Kimberly Harding

    2016-01-01

    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 ...

  19. Globalized health and its governance

    Institute of Scientific and Technical Information of China (English)

    NIE Jian-gang; LI Juan

    2010-01-01

    @@ 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.

  20. Global Health Observatory (GHO): Life Expectancy

    Science.gov (United States)

    ... 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 ...

  1. Anthropologists in Global Health Experiments.

    Science.gov (United States)

    Hardon, Anita; Pool, Robert

    2016-01-01

    Can global health experiments be part of more flexible systems of knowledge generation, where different bodies of knowledge come together to provide understanding not only of the outcomes of new interventions but also of the mechanisms through which they affect people's well-being and health? Building past work in which they tried to transform how global health experiments are carried out and inspired by the articles in this special issue, the authors of this commentary argue that strategic collaboration is needed to break the hegemony of randomized controlled trials in designing global health technologies. More open-ended experiments are possible if anthropologists team up with innovative researchers in biomedicine to develop new conceptual models and to adopt novel observational techniques and 'smart' trials that incorporate ethnography to unravel complex interactions between local biologies, attributes of health systems, social infrastructures, and users' everyday lives. PMID:27618222

  2. Breast cancer risk factors and outcome: a global perspective

    NARCIS (Netherlands)

    Bhoo Pathy, N.

    2011-01-01

    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

  3. A Physical Mechanism and Global Quantification of Breast Cancer

    Science.gov (United States)

    Yu, Chong; Wang, Jin

    2016-01-01

    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

  4. Global transition in health

    DEFF Research Database (Denmark)

    Bygbjerg, Ib Christian; Meyrowitsch, Dan W

    2007-01-01

    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...

  5. Health Management of Breast Cancer Survivors

    Institute of Scientific and Technical Information of China (English)

    Min Li; Juan Chen; Zhendong Chen

    2009-01-01

    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.

  6. Breast cancer in limited-resource countries: health care systems and public policy.

    Science.gov (United States)

    Anderson, Benjamin O; Yip, Cheng-Har; Ramsey, Scott D; Bengoa, Rafael; Braun, Susan; Fitch, Margaret; Groot, Martijn; Sancho-Garnier, Helene; Tsu, Vivien D

    2006-01-01

    As the largest cancer killer of women around the globe, breast cancer adversely impacts countries at all levels of economic development. Despite major advances in the early detection, diagnosis, and treatment of breast cancer, health care ministries face multitiered challenges to create and support health care programs that can improve breast cancer outcomes. In addition to the financial and organizational problems inherent in any health care system, breast health programs are hindered by a lack of recognition of cancer as a public health priority, trained health care personnel shortages and migration, public and health care provider educational deficits, and social barriers that impede patient entry into early detection and cancer treatment programs. No perfect health care system exists, even in the wealthiest countries. Based on inevitable economic and practical constraints, all health care systems are compelled to make trade-offs among four factors: access to care, scope of service, quality of care, and cost containment. Given these trade-offs, guidelines can define stratified approaches by which economically realistic incremental improvements can be sequentially implemented within the context of resource constraints to improve breast health care. Disease-specific "vertical" programs warrant "horizontal" integration with existing health care systems in limited-resource countries. The Breast Health Global Initiative (BHGI) Health Care Systems and Public Policy Panel defined a stratified framework outlining recommended breast health care interventions for each of four incremental levels of resources (basic, limited, enhanced, and maximal). Reallocation of existing resources and integration of a breast health care program with existing programs and infrastructure can potentially improve outcomes in a cost-sensitive manner. This adaptable framework can be used as a tool by policymakers for program planning and research design to make best use of available resources

  7. Global health - multiple definitions, single goal

    Directory of Open Access Journals (Sweden)

    Ana Marušić

    2013-03-01

    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.

  8. Periodontal health and global public health

    DEFF Research Database (Denmark)

    Petersen, Poul E; Baehni, Pierre C

    2012-01-01

    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...

  9. Global Health and the Economy

    Directory of Open Access Journals (Sweden)

    Nadia Doytch

    2012-01-01

    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.

  10. PUBLIC HEALTH: Grand Challenges in Global Health

    OpenAIRE

    Varmus, H.; Klausner, R; Zerhouni, E.; Acharya, T.; Daar, A S; Singer, P A

    2003-01-01

    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.

  11. Global Health Innovation Technology Models

    Directory of Open Access Journals (Sweden)

    Kimberly Harding

    2016-04-01

    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.

  12. Improving musculoskeletal health: global issues.

    Science.gov (United States)

    Mody, Girish M; Brooks, Peter M

    2012-04-01

    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

  13. Session 1: Public health nutrition. Breast-feeding practices in Ireland.

    LENUS (Irish Health Repository)

    Tarrant, R C

    2008-11-01

    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.

  14. James Bond and Global Health Diplomacy.

    Science.gov (United States)

    Kevany, Sebastian

    2015-01-01

    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. PMID:26673467

  15. James Bond and Global Health Diplomacy

    Directory of Open Access Journals (Sweden)

    Sebastian Kevany

    2015-12-01

    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.

  16. Macropsychology, policy, and global health.

    Science.gov (United States)

    MacLachlan, Malcolm

    2014-11-01

    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

  17. The Impact of Breast Cancer Screening on Population Health

    NARCIS (Netherlands)

    N.T. van Ravesteyn (Nicolien)

    2013-01-01

    textabstractBreast cancer is an important public health problem with an estimated number of 1.38 million breast cancer cases and 458,000 deaths from the disease yearly worldwide. Randomized trials have shown that mammography screening significantly reduces breast cancer mortality. Besides the benefi

  18. The need for leadership in global health.

    Science.gov (United States)

    Leeder, Stephen R; Raymond, Susan U; Greenberg, Henry M

    2007-11-01

    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

  19. Distributed computing for global health

    CERN Document Server

    CERN. Geneva; Schwede, Torsten; Moore, Celia; Smith, Thomas E; Williams, Brian; Grey, François

    2005-01-01

    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...

  20. The Global Health Network and globalization of higher education

    OpenAIRE

    LaPorte, Ron

    1999-01-01

    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 ...

  1. The global health system: strengthening national health systems as the next step for global progress.

    OpenAIRE

    Julio Frenk

    2010-01-01

    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.

  2. Increasing women in leadership in global health.

    Science.gov (United States)

    Downs, Jennifer A; Reif, Lindsey K; Hokororo, Adolfine; Fitzgerald, Daniel W

    2014-08-01

    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.

  3. Increasing women in leadership in global health.

    Science.gov (United States)

    Downs, Jennifer A; Reif, Lindsey K; Hokororo, Adolfine; Fitzgerald, Daniel W

    2014-08-01

    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

  4. Health food store recommendations: implications for breast cancer patients

    OpenAIRE

    Mills, Edward; Ernst, Edzard; Singh, Rana; Ross, Cory; Wilson, Kumanan

    2003-01-01

    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 ...

  5. The impact of global health experiences.

    Science.gov (United States)

    Anderson, Halie; Liebe, Sarah; Bien, Matt

    2012-11-01

    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

  6. Global warming and reproductive health.

    Science.gov (United States)

    Potts, Malcolm; Henderson, Courtney E

    2012-10-01

    The largest absolute numbers of maternal deaths occur among the 40-50 million women who deliver annually without a skilled birth attendant. Most of these deaths occur in countries with a total fertility rate of greater than 4. The combination of global warming and rapid population growth in the Sahel and parts of the Middle East poses a serious threat to reproductive health and to food security. Poverty, lack of resources, and rapid population growth make it unlikely that most women in these countries will have access to skilled birth attendants or emergency obstetric care in the foreseeable future. Three strategies can be implemented to improve women's health and reproductive rights in high-fertility, low-resource settings: (1) make family planning accessible and remove non-evidenced-based barriers to contraception; (2) scale up community distribution of misoprostol for prevention of postpartum hemorrhage and, where it is legal, for medical abortion; and (3) eliminate child marriage and invest in girls and young women, thereby reducing early childbearing.

  7. Risk Profile in a Sample of Patients with Breast Cancer from the Public Health Perspective

    Directory of Open Access Journals (Sweden)

    Sorina IRIMIE

    2010-12-01

    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

  8. Increasing Women in Leadership in Global Health

    OpenAIRE

    Downs, Jennifer A.; Reif, Lindsey K.; Hokororo, Adolfine; Fitzgerald, Daniel W.

    2014-01-01

    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...

  9. World Health Organization and disease surveillance: Jeopardizing global public health?

    Science.gov (United States)

    Blouin Genest, Gabriel

    2015-11-01

    Health issues now evolve in a global context. Real-time global surveillance, global disease mapping and global risk management characterize what have been termed 'global public health'. It has generated many programmes and policies, notably through the work of the World Health Organization. This globalized form of public health raises, however, some important issues left unchallenged, including its effectiveness, objectivity and legitimacy. The general objective of this article is to underline the impacts of WHO disease surveillance on the practice and theorization of global public health. By using the surveillance structure established by the World Health Organization and reinforced by the 2005 International Health Regulations as a case study, we argue that the policing of 'circulating risks' emerged as a dramatic paradox for global public health policy. This situation severely affects the rationale of health interventions as well as the lives of millions around the world, while travestying the meaning of health, disease and risks. To do so, we use health surveillance data collected by the WHO Disease Outbreak News System in order to map the impacts of global health surveillance on health policy rationale and theory.

  10. Global public health today: connecting the dots

    Directory of Open Access Journals (Sweden)

    Marta Lomazzi

    2016-02-01

    Full Text Available Background: Global public health today faces new challenges and is impacted by a range of actors from within and outside state boundaries. The diversity of the actors involved has created challenges and a complex environment that requires a new context-tailored global approach. The World Federation of Public Health Associations has embarked on a collaborative consultation with the World Health Organization to encourage a debate on how to adapt public health to its future role in global health. Design: A qualitative study was undertaken. High-level stakeholders from leading universities, multilateral organizations, and other institutions worldwide participated in the study. Inductive content analyses were performed. Results: Stakeholders underscored that global public health today should tackle the political, commercial, economic, social, and environmental determinants of health and social inequalities. A multisectoral and holistic approach should be guaranteed, engaging public health in broad dialogues and a concerted decision-making process. The connection between neoliberal ideology and public health reforms should be taken into account. The WHO must show leadership and play a supervising and technical role. More and better data are required across many programmatic areas of public health. Resources should be allocated in a sustainable and accountable way. Public health professionals need new skills that should be provided by a collaborative global education system. A common framework context-tailored to influence governments has been evaluated as useful. Conclusions: The study highlighted some of the main public health challenges currently under debate in the global arena, providing interesting ideas. A more inclusive integrated vision of global health in its complexity, shared and advocated for by all stakeholders involved in decision-making processes, is crucial. This vision represents the first step in innovating public health at the

  11. Nursing education to improve global health

    OpenAIRE

    Hülya Kaya

    2010-01-01

    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...

  12. Making sense of the global health crisis: policy narratives, conflict, and global health governance.

    Science.gov (United States)

    Ney, Steven

    2012-04-01

    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

  13. Global health in the 21st century

    OpenAIRE

    Laaser, Ulrich; Brand, Helmut

    2014-01-01

    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...

  14. Innovation and technology for global public health.

    Science.gov (United States)

    Piot, Peter

    2012-01-01

    Recent decades have been marked by the explosive development of innovative scientific, technological and business products and processes. Despite their immense impact on health globally, little has been accomplished in the field of global public health to incorporate, address and harness such innovations in practice. In order to meet the world's growing health needs, it is essential that global public health accepts and adapts to these innovations. Moreover, such innovations must be implemented equitably in ways that will best serve their intended recipients, without deepening health- and access-related disparities. This article will briefly discuss the wide array of technologies in the pipeline that will affect global public health practice, their impact on the field and on populations and the issues facing the field in adopting these innovations. PMID:22780442

  15. Medicalization of global health 2: The medicalization of global mental health.

    Science.gov (United States)

    Clark, Jocalyn

    2014-01-01

    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

  16. Medicalization of global health 2: The medicalization of global mental health.

    Science.gov (United States)

    Clark, Jocalyn

    2014-01-01

    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.

  17. Global Health Governance at a Crossroads.

    Science.gov (United States)

    Ng, Nora Y; Ruger, Jennifer Prah

    2011-06-21

    This review takes stock of the global health governance (GHG) literature. We address the transition from international health governance (IHG) to global health governance, identify major actors, and explain some challenges and successes in GHG. We analyze the framing of health as national security, human security, human rights, and global public good, and the implications of these various frames. We also establish and examine from the literature GHG's major themes and issues, which include: 1) persistent GHG problems; 2) different approaches to tackling health challenges (vertical, horizontal, and diagonal); 3) health's multisectoral connections; 4) neoliberalism and the global economy; 5) the framing of health (e.g. as a security issue, as a foreign policy issue, as a human rights issue, and as a global public good); 6) global health inequalities; 7) local and country ownership and capacity; 8) international law in GHG; and 9) research gaps in GHG. We find that decades-old challenges in GHG persist and GHG needs a new way forward. A framework called shared health governance offers promise. PMID:24729828

  18. Global health governance - the next political revolution.

    Science.gov (United States)

    Kickbusch, I; Reddy, K S

    2015-07-01

    The recent Ebola crisis has re-opened the debate on global health governance and the role of the World Health Organization. In order to analyze what is at stake, we apply two conceptual approaches from the social sciences - the work on gridlock and the concept of cosmopolitan moments - to assess the ability of the multilateral governance system to reform. We find that gridlock can be broken open by a health crisis which in turn generates a political drive for change. We show that a set of cosmopolitan moments have led to the introduction of the imperative of health in a range of policy arenas and moved health into 'high politics' - this has been called a political revolution. We contend that this revolution has entered a second phase with increasing interest of heads of state in global health issues. Here lies the window of opportunity to reform global health governance.

  19. Pain as a global public health priority

    Directory of Open Access Journals (Sweden)

    McGee Summer J

    2011-10-01

    Full Text Available Abstract Background Pain is an enormous problem globally. Estimates suggest that 20% of adults suffer from pain globally and 10% are newly diagnosed with chronic pain each year. Nevertheless, the problem of pain has primarily been regarded as a medical problem, and has been little addressed by the field of public health. Discussion Despite the ubiquity of pain, whether acute, chronic or intermittent, public health scholars and practitioners have not addressed this issue as a public health problem. The importance of viewing pain through a public health lens allows one to understand pain as a multifaceted, interdisciplinary problem for which many of the causes are the social determinants of health. Addressing pain as a global public health issue will also aid in priority setting and formulating public health policy to address this problem, which, like most other chronic non-communicable diseases, is growing both in absolute numbers and in its inequitable distribution across the globe. Summary The prevalence, incidence, and vast social and health consequences of global pain requires that the public health community give due attention to this issue. Doing so will mean that health care providers and public health professionals will have a more comprehensive understanding of pain and the appropriate public health and social policy responses to this problem.

  20. Accessibility: global gateway to health literacy.

    Science.gov (United States)

    Perlow, Ellen

    2010-01-01

    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.

  1. Medicalization of global health 2: the medicalization of global mental health

    Directory of Open Access Journals (Sweden)

    Jocalyn Clark

    2014-05-01

    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.

  2. Framing health and foreign policy: lessons for global health diplomacy.

    Science.gov (United States)

    Labonté, Ronald; Gagnon, Michelle L

    2010-01-01

    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

  3. Framing health and foreign policy: lessons for global health diplomacy

    Directory of Open Access Journals (Sweden)

    Labonté Ronald

    2010-08-01

    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

  4. Globalization, health, and the future Canadian metropolis.

    OpenAIRE

    Schrecker, Ted

    2010-01-01

    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...

  5. Reducing global health inequalities. Part 1.

    Science.gov (United States)

    Stuart, Kenneth; Soulsby, E J L

    2011-08-01

    This paper summarizes four UK reviews of socially stratified health inequalities that were undertaken during the past five decades. It describes the background of misplaced optimism and false hopes which characterized the UK's own record of health inequalities; the broken promises on debt cancellations which was the experience of developing countries. It describes why the UK's past leadership record in international health provides grounds for optimism for the future and for benefits for both developed and developing countries through the adoption of more collaborative approaches to global health than have characterized international relationships in the past. It recalls the enthusiasm generated in the UK, and internationally, by the establishment of the Global Commission on the Social Determinants of Health. It promotes the perception of health both as a global public good and as a developmental issue and why a focus on poverty is essential to the address of global health issues. It sees the designing of appropriate strategies and partnerships towards the achievement of the Millennium Development Goals as an important first step for achieving successful address to global public health issues. PMID:21816930

  6. Operationalizing a One Health approach to global health challenges.

    Science.gov (United States)

    Conrad, Patricia A; Meek, Laura A; Dumit, Joe

    2013-05-01

    The One Health approach, which recognizes the interconnectedness of human, animal and ecosystem health, encourages collaboration between diverse disciplines to address complex health problems. The advantages and challenges posed by these interdisciplinary collaborations are described in this review. Learning networks where diverse participants can openly share processes, best practices, and case studies are discussed as a strategy for conducting transdisciplinary One Health research and tackling complex global health problems. The 11 papers in this special issue are also introduced as they illustrate how a One Health approach can be applied to better understand and control zoonotic pathogens, engage community stakeholders in One Health research and utilize wildlife species, most notably sea otters and birds, as sentinels of ecosystem health. Collaboration is rarely without complications; however, drawing on these insights may benefit the process of operationalizing the One Health approach to address today's global health challenges. PMID:23711930

  7. The changing global context of public health.

    Science.gov (United States)

    McMichael, A J; Beaglehole, R

    2000-08-01

    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

  8. Global Health, Geographical Contingency, and Contingent Geographies

    Science.gov (United States)

    Herrick, Clare

    2016-01-01

    Health geography has emerged from under the “shadow of the medical” to become one of the most vibrant of all the subdisciplines. Yet, this success has also meant that health research has become increasingly siloed within this subdisciplinary domain. As this article explores, this represents a potential lost opportunity with regard to the study of global health, which has instead come to be dominated by anthropology and political science. Chief among the former's concerns are exploring the gap between the programmatic intentions of global health and the unintended or unanticipated consequences of their deployment. This article asserts that recent work on contingency within geography offers significant conceptual potential for examining this gap. It therefore uses the example of alcohol taxation in Botswana, an emergent global health target and tool, to explore how geographical contingency and the emergent, contingent geographies that result might help counter the prevailing tendency for geography to be side-stepped within critical studies of global health. At the very least, then, this intervention aims to encourage reflection by geographers on how to make explicit the all-too-often implicit links between their research and global health debates located outside the discipline. PMID:27611662

  9. Globalization and health: results and options.

    Science.gov (United States)

    Cornia, G A

    2001-01-01

    The last two decades have witnessed the emergence and consolidation of an economic paradigm which emphasizes domestic deregulation and the removal of barriers to international trade and finance. If properly managed, such an approach can lead to perceptible gains in health status. Where markets are non-exclusionary, regulatory institutions strong and safety nets in place, globalization enhances the performance of countries with a good human and physical infrastructure but narrow domestic markets. Health gains in China, Costa Rica, the East Asian "tiger economies" and Viet Nam can be attributed in part to their growing access to global markets, savings and technology. However, for most of the remaining countries, many of them in Africa, Latin America and Eastern Europe, globalization has not lived up to its promises due to a combination of poor domestic conditions, an unequal distribution of foreign investments and the imposition of new conditions further limiting the access of their exports to the OECD markets. In these developing countries, the last twenty years have brought about a slow, unstable and unequal pattern of growth and stagnation in health indicators. Autarky is not the answer to this situation, but neither is premature, unconditional and unselective globalization. Further unilateral liberalization is unlikely to help them to improve their economic performance and health conditions. For them, a gradual and selective integration into the world economy linked to the removal of asymmetries in global markets and to the creation of democratic institutions of global governance is preferable to instant globalization. PMID:11584731

  10. Psychometric evaluation of Breast Health Behavior Questionnaire: Spanish version.

    Science.gov (United States)

    Wells, J N; Bush, H A; Marshall, D

    2001-08-01

    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

  11. The Global Transformation of National Health Systems

    OpenAIRE

    Edgar Brillas

    1999-01-01

    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

  12. Medical Education and Global Health Equity.

    Science.gov (United States)

    Drobac, Peter; Morse, Michelle

    2016-01-01

    Recent efforts to expand medical training in resource-constrained settings are laudable, but change that transforms health systems will require new educational approaches. Today's physician-leaders need to leverage clinical and global health knowledge with a nuanced understanding of the social forces that impact health, the ability to marshal political will, and the capacity to manage dynamic programs and institutions. In establishing the University of Global Health Equity, we have identified three reform principles. First, equipping medical schools with the tools and technology to deliver is imperative. Second, the mismatch between the skills taught in most medical schools and those needed to improve fragile health systems must be addressed. Finally, medical schools that strive to eliminate health inequities should "walk the walk," adopting progressive practices to institutionalize equity. PMID:27437820

  13. Preserving idealism in global health promotion.

    Science.gov (United States)

    Franco-Paredes, Carlos; Zeuli, Julia; Hernández-Ramos, Isabel; Santos-Preciado, Jose I

    2010-12-01

    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

  14. Potential effects on health of global warming

    Energy Technology Data Exchange (ETDEWEB)

    Haines, A. (Univ. College London Medical School, London (United Kingdom). Whittington Hospital); Parry, M. (Univ. of Oxford (United Kingdom). Environmental Change Unit)

    1993-12-01

    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.

  15. Comparison of Breast Health Teaching Methods for Adolescent Females: Results of a Quasi-Experimental Study

    Science.gov (United States)

    Evans, Retta R.; Horton, Jacqueline A.; Ahmad, Wajih A.; Davies, Susan L.; Snyder, Scott W.; Macrina, David M.

    2013-01-01

    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…

  16. Global public health and the information superhighway.

    Science.gov (United States)

    LaPorte, R E

    1994-06-25

    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

  17. Global public health and the information superhighway.

    Science.gov (United States)

    LaPorte, R E

    1994-06-25

    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

  18. Globalisation and global health governance: implications for public health.

    Science.gov (United States)

    Kruk, Margaret E

    2012-01-01

    Globalisation is a defining economic and social trend of the past several decades. Globalisation affects health directly and indirectly and creates economic and health disparities within and across countries. The political response to address these disparities, exemplified by the Millennium Development Goals, has put pressure on the global community to redress massive inequities in health and other determinants of human capability across countries. This, in turn, has accelerated a transformation in the architecture of global health governance. The entrance of new actors, such as private foundations and multi-stakeholder initiatives, contributed to a doubling of funds for global health between 2000 and 2010. Today the governance of public health is in flux, with diminished leadership from multilateral institutions, such as the WHO, and poor coherence in policy and programming that undermines the potential for sustainable health gains. These trends pose new challenges and opportunities for global public health, which is centrally concerned with identifying and addressing threats to the health of vulnerable populations worldwide.

  19. Moving global health forward in academic institutions

    Directory of Open Access Journals (Sweden)

    Didier Wernli

    2016-06-01

    Full Text Available Global health has attracted growing attention from academic institutions. Its emergence corresponds to the increasing interdependence that characterizes our time and provides a new worldview to address health challenges globally. There is still a large potential to better delineate the limits of the field, drawing on a wide perspective across sciences and geographical areas. As an implementation and integration science, academic global health aims primarily to respond to societal needs through research, education, and practice. From five academic institutions closely engaged with international Geneva, we propose here a definition of global health based on six core principles: 1 cross–border/multilevel approach, 2 inter–/trans–disciplinarity, 3 systems thinking, 4 innovation, 5 sustainability, and 6 human rights/equity. This definition aims to reduce the century–old divide between medicine and public health while extending our perspective to other highly relevant fields. Overall, this article provides an intellectual framework to improve health for all in our contemporary world with implications for academic institutions and science policy.

  20. Is globalization good for your health?

    OpenAIRE

    Dollar, D.

    2001-01-01

    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...

  1. Diet, health and globalization: five key questions.

    Science.gov (United States)

    Lang, T

    1999-05-01

    The present paper explores possible implications of the globalization of the food system for diet and health. The paper poses five key questions to clarify the relationship between food and globalization. The first question is what is globalization. The paper suggests that it is helpful to distinguish between economic, political, ideological and cultural processes. Globalization is also marked by internal oppositional dynamics: there are re-localization and regional tendencies which counter the global. The second question is whether there is anything new about globalization. Food has been a much traded commodity for millennia. The paper concludes that what is new about the current phases of globalization is the pace and scale of the change, and the fact that power is being concentrated into so few hands. New marketing techniques and supply-chain management consolidate these features. The third question is who is in control of the globalization era and who benefits and loses from the processes of globalization. It is argued that modern food economies are hypermarket rather than market economies, with power accruing to the distributor more than has been recognized. The fourth question concerns governance of the food system. Historically, systems of local and national government have regulated the food supply where appropriate. Now, new international systems are emerging, partly using existing bodies and partly creating new ones. The final question is of the future. Globalization is a value-laden area of study, yet its implications for dietary change and for health are considerable. The paper argues that dimensions of change can be discerned, although it would be rash to bet on which end of each dimension will emerge as dominant in the 21st century. PMID:10466175

  2. Women's health: a new global agenda.

    Science.gov (United States)

    Norton, Robyn

    2016-06-01

    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

  3. Understanding Breast Health Awareness in an Arabic Culture: A qualitative exploration

    OpenAIRE

    Madkhali, Norah Abdullah; Santin, Olinda; Noble, Helen; Reid, Joanne

    2016-01-01

    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...

  4. [Historical evolution and chinese definition of global health].

    Science.gov (United States)

    Su, Xiaoyou; Liang, Xiaohui; Mao, Zongfu; Sun, Jikuan; Jiang, Yu; Liu, Yuanli; Ren, Minghui

    2015-03-01

    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

  5. Mycotoxins: significance to global economics and health

    Science.gov (United States)

    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...

  6. Global health security and the International Health Regulations

    Directory of Open Access Journals (Sweden)

    Oliva Otavio

    2010-12-01

    Full Text Available Abstract Global nuclear proliferation, bioterrorism, and emerging infections have challenged national capacities to achieve and maintain global security. Over the last century, emerging infectious disease threats resulted in the development of the preliminary versions of the International Health Regulations (IHR of the World Health Organization (WHO. The current HR(2005 contain major differences compared to earlier versions, including: substantial shifts from containment at the border to containment at the source of the event; shifts from a rather small disease list (smallpox, plague, cholera, and yellow fever required to be reported, to all public health threats; and shifts from preset measures to tailored responses with more flexibility to deal with the local situations on the ground. The new IHR(2005 call for accountability. They also call for strengthened national capacity for surveillance and control; prevention, alert, and response to international public health emergencies beyond the traditional short list of required reporting; global partnership and collaboration; and human rights, obligations, accountability, and procedures of monitoring. Under these evolved regulations, as well as other measures, such as the Revolving Fund for vaccine procurement of the Pan American Health Organization (PAHO, global health security could be maintained in the response to urban yellow fever in Paraguay in 2008 and the influenza (H1N1 pandemic of 2009-2010.

  7. The World Health Organization and Global Health Governance: post-1990.

    Science.gov (United States)

    Lidén, J

    2014-02-01

    This article takes a historical perspective on the changing position of WHO in the global health architecture over the past two decades. From the early 1990s a number of weaknesses within the structure and governance of the World Health Organization were becoming apparent, as a rapidly changing post Cold War world placed more complex demands on the international organizations generally, but significantly so in the field of global health. Towards the end of that decade and during the first half of the next, WHO revitalized and played a crucial role in setting global health priorities. However, over the past decade, the organization has to some extent been bypassed for funding, and it lost some of its authority and its ability to set a global health agenda. The reasons for this decline are complex and multifaceted. Some of the main factors include WHO's inability to reform its core structure, the growing influence of non-governmental actors, a lack of coherence in the positions, priorities and funding decisions between the health ministries and the ministries overseeing development assistance in several donor member states, and the lack of strong leadership of the organization. PMID:24388640

  8. Anthropology, knowledge-flows and global health.

    Science.gov (United States)

    Feierman, S; Kleinman, A; Stewart, K; Farmer, D; Das, V

    2010-01-01

    Global health programmes are damaged by blockages in the upward flow of information from localities and regional centres about realities of professional practice and about patients' lives and conditions of treatment. Power differentials between local actors and national or international decision-makers present further obstacles to effective action. Anthropological research and action, in its most effective current forms, make important contributions to these issues. This research often continues over the long term, intensively. It can be multi-sited, studying actors at local, national and international levels simultaneously. It studies the relative knowledge and power of impoverished patients and global decision-makers, all within a single frame. By doing so, anthropological research is capable of providing new and important insights on the diverse meanings of patient decision-making, informed consent, non-compliance, public health reporting, the building of political coalitions for health and many other issues. PMID:20013523

  9. Global Climate Change and Children's Health.

    Science.gov (United States)

    Ahdoot, Samantha; Pacheco, Susan E

    2015-11-01

    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

  10. Family health nursing: a response to the global health challenges.

    Science.gov (United States)

    Martin, Paul; Duffy, Tim; Johnston, Brian; Banks, Pauline; Harkess-Murphy, Eileen; Martin, Colin R

    2013-02-01

    The European Family Health Nursing Project is a revitalized World Health Organization initiative led by the University of the West of Scotland. Partner countries include Armenia, Austria, Germany, Italy, Poland, Portugal, Romania, Slovenia, and Spain. European Union Lifelong Learning funding was received in 2011 to facilitate a consistency of approach in the development of a definition of family health nursing, required core competencies and capabilities, and consequent education and training requirements. Global health challenges have informed the development of the project: increasingly aging populations, the increasing incidence in noncommunicable diseases that are currently the main cause of death, and the significant progress made in the way health systems have developed to meet the demands in relation to access and equality of health services. Governments and policy makers should develop a health workforce based on the principles of teamwork and interdisciplinarity while recognizing the core contribution of the "specialist generalist" role in the primary care setting. PMID:23288887

  11. Health food store recommendations: implications for breast cancer patients

    International Nuclear Information System (INIS)

    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

  12. Understanding global health and development partnerships: Perspectives from African and global health system professionals.

    Science.gov (United States)

    Barnes, Amy; Brown, Garrett W; Harman, Sophie

    2016-06-01

    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

  13. Global Climate Change and Children's Health.

    Science.gov (United States)

    2015-11-01

    Rising global temperatures are causing major physical, chemical, and ecological changes in 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, and 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. The social foundations of children's mental and physical health are threatened by the specter of far-reaching effects of unchecked climate change, including community and global instability, mass migrations, and increased conflict. Given this knowledge, failure to take prompt, substantive action would be an act of injustice to all children. A paradigm shift in production and consumption of energy is both a necessity and an opportunity for major innovation, job creation, and significant, immediate associated health benefits. Pediatricians have a uniquely valuable role to play in the societal response to this global challenge.

  14. Building global health through a center-without-walls: the Vanderbilt Institute for Global Health.

    Science.gov (United States)

    Vermund, Sten H; Sahasrabuddhe, Vikrant V; Khedkar, Sheetal; Jia, Yujiang; Etherington, Carol; Vergara, Alfredo

    2008-02-01

    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, nursing, and language training, among others. The institute is a natural facilitator for team building and has been especially helpful in organizing institutional responses to global health solicitations from the National Institutes of Health (NIH), Centers for Disease Control (CDC), and other funding agencies. This center-without-walls philosophy nurtures noncompetitive partnerships among and within departments and schools. With extramural support from the NIH and from endowment and developmental investments from the school of medicine, the institute funds new pilot projects to nurture global educational and research exchanges related to health and development. Vanderbilt's newest programs are a CDC-supported HIV/AIDS service initiative in Africa and an overseas research training program for health science graduate students and clinical fellows. New opportunities are available for Vanderbilt students, staff, and faculty to work abroad in partnership with international health projects through a number of Tennessee institutions now networked with the institute. A center-without-walls may be a model for institutions contemplating strategic investments to better organize service and teaching opportunities abroad, and to achieve greater successes in leveraging extramural support for overseas and domestic work focused on tropical medicine and global health.

  15. Building global health through a center-without-walls: the Vanderbilt Institute for Global Health.

    Science.gov (United States)

    Vermund, Sten H; Sahasrabuddhe, Vikrant V; Khedkar, Sheetal; Jia, Yujiang; Etherington, Carol; Vergara, Alfredo

    2008-02-01

    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, nursing, and language training, among others. The institute is a natural facilitator for team building and has been especially helpful in organizing institutional responses to global health solicitations from the National Institutes of Health (NIH), Centers for Disease Control (CDC), and other funding agencies. This center-without-walls philosophy nurtures noncompetitive partnerships among and within departments and schools. With extramural support from the NIH and from endowment and developmental investments from the school of medicine, the institute funds new pilot projects to nurture global educational and research exchanges related to health and development. Vanderbilt's newest programs are a CDC-supported HIV/AIDS service initiative in Africa and an overseas research training program for health science graduate students and clinical fellows. New opportunities are available for Vanderbilt students, staff, and faculty to work abroad in partnership with international health projects through a number of Tennessee institutions now networked with the institute. A center-without-walls may be a model for institutions contemplating strategic investments to better organize service and teaching opportunities abroad, and to achieve greater successes in leveraging extramural support for overseas and domestic work focused on tropical medicine and global health. PMID:18303361

  16. Global climate change: Is global warming a health warning?

    Energy Technology Data Exchange (ETDEWEB)

    Rainham, D.

    1999-12-01

    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.

  17. Implications of global warming on human health

    International Nuclear Information System (INIS)

    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)

  18. Whose progress? The language of global health.

    Science.gov (United States)

    Laura Hall, Amy

    2006-06-01

    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

  19. Humanity and Justice in Global Health: Problems with Venkatapuram's Justification of the Global Health Duty.

    Science.gov (United States)

    Kollar, Eszter; Laukötter, Sebastian; Buyx, Alena

    2016-01-01

    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.

  20. Humanity and Justice in Global Health: Problems with Venkatapuram's Justification of the Global Health Duty.

    Science.gov (United States)

    Kollar, Eszter; Laukötter, Sebastian; Buyx, Alena

    2016-01-01

    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

  1. Child Homicide: A Global Public Health Concern

    OpenAIRE

    Naeemah Abrahams; Shanaaz Mathews; Martin, Lorna J.; Carl Lombard; Nadine Nannan; Rachel Jewkes

    2016-01-01

    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...

  2. Breast cancer in the global south and the limitations of a biomedical framing: a critical review of the literature.

    Science.gov (United States)

    Confortini, Catia C; Krong, Brianna

    2015-12-01

    Public health researchers are devoting increasing attention to the growing burden of breast cancer in low-and middle-income countries (LMICs), previously thought to be minimally impacted by this disease. A critical examination of this body of literature is needed to explore the assumptions, advantages and limitations of current approaches. In our critical literature review, we find that researchers and public health practitioners predominantly privilege a biomedical perspective focused on patients' adherence (or non-adherence) to 'preventive' practices, screening behaviours and treatment regimens. Cost-effective 'quick fixes' are prioritized, and prevention is framed in terms of individual 'risk behaviours'. Thus, individuals and communities are held responsible for the success of the biomedical system; traditional belief systems and 'harmful' social practices are problematized. Inherently personal, social and cultural experiences of pain and suffering are neglected or reduced to the issue of chemical palliation. This narrow approach obscures the complex aetiology of the disease and perpetuates silence around power relations. This article calls for a social justice-oriented interrogation of the role of power and inequity in the global breast cancer epidemic, which recognizes the agency and experiences of women (and men) who experience breast cancer in the global south.

  3. Global characterization of signalling networks associated with tamoxifen resistance in breast cancer

    DEFF Research Database (Denmark)

    Browne, Brigid C.; Hochgräfe, Falko; Wu, Jianmin;

    2013-01-01

    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......R cells had no effect on anti‐estrogen sensitivity, but significantly decreased cell motility. MARCKS expression was significantly higher in breast cancer cell lines than normal mammary epithelial cells and in ER‐negative versus ER‐positive breast cancer cell lines. In primary breast cancers, cytoplasmic...... MARCKS staining was significantly higher in basal‐like and HER2 cancers than in luminal cancers, and was independently predictive of poor survival in multivariate analyses of the whole cohort (P

  4. The Global Role of the World Health Organization.

    Science.gov (United States)

    Ruger, Jennifer Prah; Yach, Derek

    2009-04-01

    The 21(st) century global health landscape requires effective global action in the face of globalization of trade, travel, information, human rights, ideas, and disease. The new global health era is more plural, comprising a number of key actors, and requiring more coordination of effort, priorities and investments. The World Health Organization (WHO) plays an essential role in the global governance of health and disease; due to its core global functions of establishing, monitoring and enforcing international norms and standards, and coordinating multiple actors toward common goals. Global health governance requires WHO leadership and effective implementation of WHO's core global functions to ensure better effectiveness of all health actors, but achieving this global mission could be hampered by narrowing activities and budget reallocations from core global functions. PMID:24729827

  5. Globalization and social determinants of health: Promoting health equity in global governance (part 3 of 3

    Directory of Open Access Journals (Sweden)

    Schrecker Ted

    2007-06-01

    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.

  6. The hitchhiker's guide to global health blogging.

    Science.gov (United States)

    Frischtak, Helena; Sinha, Pranay

    2013-01-01

    Social media use in modern medicine is fraught with ethical dilemmas and risks of unprofessional behavior. This essay surveys the existing literature on the possibilities and pitfalls of social media use by health-care professionals and concludes that non-engagement with social media is not an option. A mindful approach, not vague guidelines or long checklists, will foster a generation of physicians comfortable using online platforms for education and reflection. The use of social media during global health experiences abroad has been largely ignored in the literature and presents special challenges. With a view to starting a reflective dialogue on this subject, this essay identifies some ethically nebulous aspects of global health blogging. The discussion focuses on physician and student blogging, but these principles should apply to other online platforms as well and should prove valuable for health-care professionals who are engaged in developing guidelines, educating medical students and resident physicians, or in sharing their experiences and insights on the internet.

  7. COMMENTARY: GLOBALIZATION, HEALTH SECTOR REFORM, AND THE HUMAN RIGHT TO HEALTH: IMPLICATIONS FOR FUTURE HEALTH POLICY.

    Science.gov (United States)

    Schuftan, Claudio

    2015-01-01

    The author here distills his long-time personal experience with the deleterious effects of globalization on health and on the health sector reforms embarked on in many of the more than 50 countries where he has worked in the last 25 years. He highlights the role that the "human right to health" framework can and should play in countering globalization's negative effects on health and in shaping future health policy. This is a testimonial article.

  8. Cancer Research from Molecular Discovery to Global Health

    Science.gov (United States)

    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.

  9. [The public health legislation in conditions of globalization].

    Science.gov (United States)

    Yefremov, D V; Jyliyaeva, E P

    2013-01-01

    The article demonstrates the impact of globalization on development of public health legislation at the international level and in particular countries. The legislation is considered as a tool to decrease the globalization health risks for population

  10. Global climate change and children's health.

    Science.gov (United States)

    Shea, Katherine M

    2007-11-01

    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

  11. World Health Organization global policy for improvement of oral health--World Health Assembly 2007

    DEFF Research Database (Denmark)

    Petersen, Poul Erik

    2008-01-01

    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...

  12. The h index and the identification of global benchmarks for breast cancer research output.

    Science.gov (United States)

    Healy, N A; Glynn, R W; Scutaru, Cristian; Groneberg, David; Kerin, M J; Sweeney, K J

    2011-06-01

    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

  13. Combating healthcare corruption and fraud with improved global health governance.

    Science.gov (United States)

    Mackey, Tim K; Liang, Bryan A

    2012-10-22

    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.

  14. Combating healthcare corruption and fraud with improved global health governance

    Directory of Open Access Journals (Sweden)

    Mackey Tim K

    2012-10-01

    Full Text Available Abstract 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.

  15. Non-communicable diseases and global health governance: enhancing global processes to improve health development.

    Science.gov (United States)

    Magnusson, Roger S

    2007-01-01

    This paper assesses progress in the development of a global framework for responding to non-communicable diseases, as reflected in the policies and initiatives of the World Health Organization (WHO), World Bank and the UN: the institutions most capable of shaping a coherent global policy. Responding to the global burden of chronic disease requires a strategic assessment of the global processes that are likely to be most effective in generating commitment to policy change at country level, and in influencing industry behaviour. WHO has adopted a legal process with tobacco (the WHO Framework Convention on Tobacco Control), but a non-legal, advocacy-based approach with diet and physical activity (the Global Strategy on Diet, Physical Activity and Health). The paper assesses the merits of the Millennium Development Goals (MDGs) and the FCTC as distinct global processes for advancing health development, before considering what lessons might be learned for enhancing the implementation of the Global Strategy on Diet. While global partnerships, economic incentives, and international legal instruments could each contribute to a more effective global response to chronic diseases, the paper makes a special case for the development of international legal standards in select areas of diet and nutrition, as a strategy for ensuring that the health of future generations does not become dependent on corporate charity and voluntary commitments. A broader frame of reference for lifestyle-related chronic diseases is needed: one that draws together WHO's work in tobacco, nutrition and physical activity, and that envisages selective use of international legal obligations, non-binding recommendations, advocacy and policy advice as tools of choice for promoting different elements of the strategy. PMID:17519005

  16. Non-communicable diseases and global health governance: enhancing global processes to improve health development

    Directory of Open Access Journals (Sweden)

    Magnusson Roger S

    2007-05-01

    Full Text Available Abstract This paper assesses progress in the development of a global framework for responding to non-communicable diseases, as reflected in the policies and initiatives of the World Health Organization (WHO, World Bank and the UN: the institutions most capable of shaping a coherent global policy. Responding to the global burden of chronic disease requires a strategic assessment of the global processes that are likely to be most effective in generating commitment to policy change at country level, and in influencing industry behaviour. WHO has adopted a legal process with tobacco (the WHO Framework Convention on Tobacco Control, but a non-legal, advocacy-based approach with diet and physical activity (the Global Strategy on Diet, Physical Activity and Health. The paper assesses the merits of the Millennium Development Goals (MDGs and the FCTC as distinct global processes for advancing health development, before considering what lessons might be learned for enhancing the implementation of the Global Strategy on Diet. While global partnerships, economic incentives, and international legal instruments could each contribute to a more effective global response to chronic diseases, the paper makes a special case for the development of international legal standards in select areas of diet and nutrition, as a strategy for ensuring that the health of future generations does not become dependent on corporate charity and voluntary commitments. A broader frame of reference for lifestyle-related chronic diseases is needed: one that draws together WHO's work in tobacco, nutrition and physical activity, and that envisages selective use of international legal obligations, non-binding recommendations, advocacy and policy advice as tools of choice for promoting different elements of the strategy.

  17. Education for public health in Europe and its global outreach

    OpenAIRE

    Bjegovic-Mikanovic, Vesna; Jovic-Vranes, Aleksandra; Czabanowska, Katarzyna; Otok, Robert

    2014-01-01

    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...

  18. Global Mental Health: concepts, conflicts and controversies.

    Science.gov (United States)

    Whitley, Rob

    2015-08-01

    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

  19. Global oral health inequalities: the view from a research funder.

    Science.gov (United States)

    Garcia, I; Tabak, L A

    2011-05-01

    Despite impressive worldwide improvements in oral health, inequalities in oral health status among and within countries remain a daunting public health challenge. Oral health inequalities arise from a complex web of health determinants, including social, behavioral, economic, genetic, environmental, and health system factors. Eliminating these inequalities cannot be accomplished in isolation of oral health from overall health, or without recognizing that oral health is influenced at multiple individual, family, community, and health systems levels. For several reasons, this is an opportune time for global efforts targeted at reducing oral health inequalities. Global health is increasingly viewed not just as a humanitarian obligation, but also as a vehicle for health diplomacy and part of the broader mission to reduce poverty, build stronger economies, and strengthen global security. Despite the global economic recession, there are trends that portend well for support of global health efforts: increased globalization of research and development, growing investment from private philanthropy, an absolute growth of spending in research and innovation, and an enhanced interest in global health among young people. More systematic and far-reaching efforts will be required to address oral health inequalities through the engagement of oral health funders and sponsors of research, with partners from multiple public and private sectors. The oral health community must be "at the table" with other health disciplines and create opportunities for eliminating inequalities through collaborations that can harness both the intellectual and financial resources of multiple sectors and institutions. PMID:21490232

  20. Community Health Nursing through a Global Lens.

    Science.gov (United States)

    Sarkar, Norma; Dallwig, Amber; Abbott, Patricia

    2015-01-01

    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

  1. Community Health Nursing through a Global Lens.

    Science.gov (United States)

    Sarkar, Norma; Dallwig, Amber; Abbott, Patricia

    2015-01-01

    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.

  2. Where theory and practice of global health intersect: the developmental history of a Canadian global health initiative

    Directory of Open Access Journals (Sweden)

    Ibrahim Daibes

    2014-07-01

    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.

  3. Defining and Developing Global Public Health Course for Public Health Graduates

    OpenAIRE

    Rajendra eKarkee; Jude eComfort; Helman eAlfonso

    2015-01-01

    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...

  4. Global Health Education in Pulmonary and Critical Care Medicine Fellowships.

    Science.gov (United States)

    Siddharthan, Trishul; North, Crystal M; Attia, Engi F; Christiani, David C; Checkley, William; West, T Eoin

    2016-06-01

    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

  5. Time to go global: a consultation on global health competencies for postgraduate doctors

    Science.gov (United States)

    Walpole, Sarah C.; Shortall, Clare; van Schalkwyk, May CI; Merriel, Abi; Ellis, Jayne; Obolensky, Lucy; Casanova Dias, Marisa; Watson, Jessica; Brown, Colin S.; Hall, Jennifer; Pettigrew, Luisa M.; Allen, Steve

    2016-01-01

    Background Globalisation is having profound impacts on health and healthcare. We solicited the views of a wide range of stakeholders in order to develop core global health competencies for postgraduate doctors. Methods Published literature and existing curricula informed writing of seven global health competencies for consultation. A modified policy Delphi involved an online survey and face-to-face and telephone interviews over three rounds. Results Over 250 stakeholders participated, including doctors, other health professionals, policymakers and members of the public from all continents of the world. Participants indicated that global health competence is essential for postgraduate doctors and other health professionals. Concerns were expressed about overburdening curricula and identifying what is ‘essential’ for whom. Conflicting perspectives emerged about the importance and relevance of different global health topics. Five core competencies were developed: (1) diversity, human rights and ethics; (2) environmental, social and economic determinants of health; (3) global epidemiology; (4) global health governance; and (5) health systems and health professionals. Conclusions Global health can bring important perspectives to postgraduate curricula, enhancing the ability of doctors to provide quality care. These global health competencies require tailoring to meet different trainees' needs and facilitate their incorporation into curricula. Healthcare and global health are ever-changing; therefore, the competencies will need to be regularly reviewed and updated. PMID:27241136

  6. Globalization causes a world of health problems.

    Science.gov (United States)

    Abell, H

    1998-01-01

    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.

  7. Environmental health implications of global climate change

    Energy Technology Data Exchange (ETDEWEB)

    Watson, Robert T.; Patz, Jonathan; Gubler, Duane J.; Parson, Edward A.; Vincent, James H.

    2005-07-01

    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)

  8. Globalization causes a world of health problems.

    Science.gov (United States)

    Abell, H

    1998-01-01

    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

  9. [Influenza vaccine: globalization of public health stakes].

    Science.gov (United States)

    Collin, N; Briand, S

    2009-08-01

    On June 11, 2009, Dr. Margaret Chan, Director-General of the World Health Organization (WHO), declared the first influenza pandemic of the 21st century. It was the first time in history that an influenza outbreak had been tracked in real-time from the emergence of a new strain of influenza A (H1N1) up to its spread to all continents over a period of 9 weeks. In recent years the international community has been working closely to prepare for such situations. A notable example of this cooperation occurred in response to the threat posed by the highly pathogenic avian influenza A virus (H5N1). Vaccine availability is a major challenge that will require increasing worldwide production and ensuring a widespread access. In this regard it is important to underline the fact that 70% of influenza vaccine is produced in Europe and the United States. In 2006 WHO implemented a global pandemic influenza action plan (GAP) aiming at increasing the world's production capacity for pandemic vaccine. The GAP contains three elements: (1) increased use of seasonal influenza vaccination in industrialized and developing countries (resolution WHA 56.19). (2) technology transfer. (3) development of new production technologies. Nevertheless numerous barriers still prevent people living in developing countries from rapid and fair access to pandemic influenza vaccine. Capacity for production of pandemic vaccine is limited and advanced purchase agreements between industrialized countries and vaccine manufacturers reduce potential access of developing countries to pandemic vaccine. Economic and logistic factors also limit global access to pandemic vaccine. Therefore, WHO is working with industrialized countries, pharmaceutical companies and the international community as a whole to promote global solidarity and cooperation and thus ensure distribution of pandemic vaccine in poor countries with no local production. The current pandemic situation highlights the increasing globalization of public

  10. Advancing Global Health – The Need for (Better) Social Science

    Science.gov (United States)

    Hanefeld, Johanna

    2016-01-01

    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

  11. Boreal forest health and global change.

    Science.gov (United States)

    Gauthier, S; Bernier, P; Kuuluvainen, T; Shvidenko, A Z; Schepaschenko, D G

    2015-08-21

    The boreal forest, one of the largest biomes on Earth, provides ecosystem services that benefit society at levels ranging from local to global. Currently, about two-thirds of the area covered by this biome is under some form of management, mostly for wood production. Services such as climate regulation are also provided by both the unmanaged and managed boreal forests. Although most of the boreal forests have retained the resilience to cope with current disturbances, projected environmental changes of unprecedented speed and amplitude pose a substantial threat to their health. Management options to reduce these threats are available and could be implemented, but economic incentives and a greater focus on the boreal biome in international fora are needed to support further adaptation and mitigation actions. PMID:26293953

  12. [The modern international public health and globalization challenges].

    Science.gov (United States)

    2012-01-01

    The article deals with the issues of impact of globalization on population health and public health. The positive and negative aspects of this process are analyzed. The role of international organizations (UN, WHO, UNESCO, ILO, UNISEF) is demonstrated in the area of management of globalization impact on public health of different countries, Russia included. PMID:23033581

  13. Building Global Health Research Competencies at the Undergraduate Level

    Science.gov (United States)

    Hatfield, Jennifer M.; Hecker, Kent G.; Jensen, Ashley E.

    2009-01-01

    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…

  14. Coping style, health beliefs, and breast self-examination.

    Science.gov (United States)

    Barron, C R; Houfek, J F; Foxall, M J

    1997-01-01

    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

  15. Development and Validation of the Assessment of Health Literacy in Breast and Cervical Cancer Screening

    OpenAIRE

    Han, Hae-Ra; Huh, Boyun; Kim, Miyong T.; Kim, Jiyun; Nguyen, Tam

    2014-01-01

    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 ...

  16. Global mental health: perspectives from Ethiopia

    Directory of Open Access Journals (Sweden)

    Abebaw Fekadu

    2014-09-01

    Full Text Available Background: Global mental health (GMH advocates for access to and the equitable provision of mental health care. Although the treatment gap is a useful construct to measure access and equitability of care, it fails to communicate the real-life consequences of the treatment gap and the urgent need to address care disparities. Objective: The aim of this article is to present a perspective on the practical application of the principles of GMH to understand the real-life impact of the treatment gap and the approaches taken to improve treatment coverage in Ethiopia. Design: A case study method is used. Results: Multiple international collaborations undertaken in Ethiopia and facilitated by GMH to improve care, capacity, and the evidence base for increased treatment coverage are described briefly. A series of steps taken at the local and national levels to address the treatment gap are highlighted. The stories of two patients are also presented to illustrate the real-life consequences of the treatment gap and the potential transformational impact of addressing the treatment gap on patients, families, and communities. Conclusions: GMH has a key role to play in addressing the treatment gap, which improves the life of people with mental disorders, their families, and their communities. However, national-level policy support and coordination are essential for any realistic improvement in treatment coverage. The reflections offered through the case examples may have utility in similar low-income settings.

  17. Computerized prediction of breast cancer risk: comparison between the global and local bilateral mammographic tissue asymmetry

    Science.gov (United States)

    Wang, Xingwei; Lederman, Dror; Tan, Jun; Wang, Xiao Hui; Zheng, Bin

    2011-03-01

    We have developed and preliminarily tested a new breast cancer risk prediction model based on computerized bilateral mammographic tissue asymmetry. In this study, we investigated and compared the performance difference of our risk prediction model when the bilateral mammographic tissue asymmetrical features were extracted in two different methods namely (1) the entire breast area and (2) the mirror-matched local strips between the left and right breast. A testing dataset including bilateral craniocaudal (CC) view images of 100 negative and 100 positive cases for developing breast abnormalities or cancer was selected from a large and diverse full-field digital mammography (FFDM) image database. To detect bilateral mammographic tissue asymmetry, a set of 20 initial "global" features were extracted from the entire breast areas of two bilateral mammograms in CC view and their differences were computed. Meanwhile, a pool of 16 local histogram-based statistic features was computed from eight mirror-matched strips between the left and right breast. Using a genetic algorithm (GA) to select optimal features, two artificial neural networks (ANN) were built to predict the risk of a test case developing cancer. Using the leave-one-case-out training and testing method, two GAoptimized ANNs yielded the areas under receiver operating characteristic (ROC) curves of 0.754+/-0.024 (using feature differences extracted from the entire breast area) and 0.726+/-0.026 (using the feature differences extracted from 8 pairs of local strips), respectively. The risk prediction model using either ANN is able to detect 58.3% (35/60) of cancer cases 6 to 18 months earlier at 80% specificity level. This study compared two methods to compute bilateral mammographic tissue asymmetry and demonstrated that bilateral mammographic tissue asymmetry was a useful breast cancer risk indicator with high discriminatory power.

  18. Pilot Implementation of Breast Cancer Early Detection Programs in Colombia

    OpenAIRE

    Murillo, Raúl; Díaz, Sandra; Sánchez, Oswaldo; Perry, Fernando; Piñeros, Marion; Poveda, César; Salguero, Edgar; Osorio, Dimelza

    2008-01-01

    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...

  19. Synthetic biology as a source of global health innovation

    OpenAIRE

    Rooke, Jenny

    2013-01-01

    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...

  20. Global citizenship is key to securing global health: the role of higher education.

    Science.gov (United States)

    Stoner, Lee; Perry, Lane; Wadsworth, Daniel; Stoner, Krystina R; Tarrant, Michael A

    2014-07-01

    Despite growing public awareness, health systems are struggling under the escalating burden of non-communicable diseases. While personal responsibility is crucial, alone it is insufficient. We argue that one must place themselves within the broader/global context to begin to truly understand the health implications of personal choices. Global citizenship competency has become an integral part of the higher education discourse; this discourse can and should be extended to include global health. A global citizen is someone who is (1) aware of global issues, (2) socially responsible, and (3) civically engaged. From this perspective, personal health is not solely an individual, self-serving act; rather, the consequences of our lifestyle choices and behaviors have far-reaching implications. This paper will argue that, through consciously identifying global health within the constructs of global citizenship, institutions of higher education can play an instrumental role in fostering civically engaged students capable of driving social change.

  1. Global Health Governance Challenges 2016 – Are We Ready?

    OpenAIRE

    Ilona Kickbusch

    2016-01-01

    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...

  2. The workforce for health in a globalized context--global shortages and international migration.

    Science.gov (United States)

    Aluttis, Christoph; Bishaw, Tewabech; Frank, Martina W

    2014-01-01

    The 'crisis in human resources' in the health sector has been described as one of the most pressing global health issues of our time. The World Health Organization (WHO) estimates that the world faces a global shortage of almost 4.3 million doctors, midwives, nurses, and other healthcare professionals. A global undersupply of these threatens the quality and sustainability of health systems worldwide. This undersupply is concurrent with globalization and the resulting liberalization of markets, which allow health workers to offer their services in countries other than those of their origin. The opportunities of health workers to seek employment abroad has led to a complex migration pattern, characterized by a flow of health professionals from low- to high-income countries. This global migration pattern has sparked a broad international debate about the consequences for health systems worldwide, including questions about sustainability, justice, and global social accountabilities. This article provides a review of this phenomenon and gives an overview of the current scope of health workforce migration patterns. It further focuses on the scientific discourse regarding health workforce migration and its effects on both high- and low-income countries in an interdependent world. The article also reviews the internal and external factors that fuel health worker migration and illustrates how health workforce migration is a classic global health issue of our time. Accordingly, it elaborates on the international community's approach to solving the workforce crisis, focusing in particular on the WHO Code of Practice, established in 2010.

  3. "Globalized public health." A transdisciplinary comprehensive framework for analyzing contemporary globalization's influences on the field of public health.

    Science.gov (United States)

    Lapaige, Véronique

    2009-01-01

    The current phase of globalization represents a "double-edged sword" challenge facing public health practitioners and health policy makers. The first "edge" throws light on two constructs in the field of public health: global health (formerly international health) and globalized public health. The second "edge" is that of global governance, and raises the question, "how can we construct public health regulations that adequately respond to both global and local complexities related to the two constructs mentioned earlier (global health and globalized public health)?" The two constructs call for the development of norms that will assure sustained population-wide health improvement and these two constructs have their own conceptual tools and theoretical models that permit a better understanding of them. In this paper, we introduce the "globalized public health" construct and we present an interactive comprehensive framework for critically analyzing contemporary globalization's influences on the field of public health. "Globalized public health", simultaneously a theoretical model and a conceptual framework, concerns the transformation of the field of public health in the sociohistorical context of globalization. The model is the fruit of an original theoretical research study conducted from 2005 to 2008 ("contextualized research," Gibbons' Mode II of knowledge production), founded on a QUAL-quant sequential mixed-method design. This research also reflects our political and ideological position, fuelled with aspirations of social democracy and cosmopolitical values. It is profoundly anchored in the pragmatic approach to globalization, looking to "reconcile" the market and equity. The model offers several features to users: (1) it is transdisciplinary; (2) it is interactive (CD-ROM); (3) it is nonlinear (nonlinear interrelations between the contextual globalization and the field of public health); (4) it is synchronic/diachronic (a double-crossed perspective permits

  4. Health care globalization: a need for virtual leadership.

    Science.gov (United States)

    Holland, J Brian; Malvey, Donna; Fottler, Myron D

    2009-01-01

    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

  5. Factors contributing to late breast cancer presentation for health care amongst women in Kumasi, Ghana

    Directory of Open Access Journals (Sweden)

    Comfort Asoogo

    2015-02-01

    Full Text Available Background: Delay in presenting breast cancer for health care is dangerous because it can increase the mortality rate amongst affected women. Delaying health care and treatment makes it difficult to manage advanced breast cancer successfully. Understanding the factors that contribute to delays in presentation for health care can save lives.Objectives: The purpose of the study was to describe the factors which contribute to the latepresentation of Ghanaian women with breast cancer for health care at a tertiary hospital in Kumasi, Ghana.Method: A descriptive qualitative research design was utilised to answer the research question: ‘What factors contribute to presenting with late breast cancer for health care amongst Ghanaian women who were treated for breast cancer at a tertiary hospital in Kumasi, Ghana?’ A sample of 30 women diagnosed with breast cancer and presented with Stage II and Stage III participated in the study. Semi-structured interviews and field notes were conducted for data collection. Content data analysis was used in line with the research question.Findings: Five themes were discovered as findings. These were: lack of knowledge about breast cancer; fear of cancer treatment and its outcomes; poverty; traditional and spiritual beliefs and treatments and caring for others.Conclusions: We recommend the development of breast cancer awareness programmes and health education at primary health care level.

  6. Aid alignment for global health research: the role of HIROs

    Directory of Open Access Journals (Sweden)

    Viergever Roderik F

    2011-03-01

    Full Text Available Abstract The lack of a mechanism that aligns financial flows for global health research towards public health priorities limits the impact of health research on health and health equity. Collaborative groups of health research funders appear to be particularly well situated to ameliorate this situation and to initiate discussion on aid alignment for global health research. One such group is the Heads of International Research Organizations (HIROs, which brings together a large number of major government and philanthropic funders of biomedical research. Surprisingly, there is hardly any information publicly available on HIROs' objectives, or on how it aims to achieve more harmonization in the field of research for health. Greater transparency on HIROs' objectives and on its current efforts towards addressing the gap between global health research needs and investments would be desirable, given the enormous potential benefits of more coordination by this group.

  7. Global Health, Medical Anthropology, and Social Marketing: Steps to the Ecology of Collaboration.

    Science.gov (United States)

    Whiteford, Linda

    2015-06-01

    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

  8. Global Health, Medical Anthropology, and Social Marketing: Steps to the Ecology of Collaboration.

    Science.gov (United States)

    Whiteford, Linda

    2015-06-01

    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.

  9. Global Health Education in Doctor of Pharmacy Programs

    Science.gov (United States)

    Bailey, Lydia C.

    2016-01-01

    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

  10. The ebola crisis : challenges for global health law

    NARCIS (Netherlands)

    Toebes, Brigit

    2015-01-01

    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

  11. Global diets link environmental sustainability and human health

    Science.gov (United States)

    Tilman, David; Clark, Michael

    2014-11-01

    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.

  12. Global health: the ethical responsibility of the pharmaceutical industry.

    Science.gov (United States)

    Lassen, Lars Christian; Thomsen, Mads Krogsgaard

    2007-02-01

    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

  13. Global health: networking innovative academic institutions.

    Science.gov (United States)

    Pálsdóttir, Björg; Neusy, André-Jacques

    2011-06-01

    Medically underserved communities suffer a high burden of morbidity and mortality, increasing with remoteness where access to health services is limited. Major challenges are the overall shortage and maldistribution of the health workforce. There is a lack of understanding of how academic institutions can best contribute to addressing these health inequities. A new international collaborative of health professions schools, Training for Health Equity Network, is developing and disseminating evidence, challenging assumptions, and developing tools that support health profession institutions striving to meet the health and health workforce needs of underserved communities.

  14. Health care provider's role in facing the future burden of breast cancer in Saudi

    International Nuclear Information System (INIS)

    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).

  15. Addressing the "Global Health Tax" and "Wild Cards": Practical Challenges to Building Academic Careers in Global Health.

    Science.gov (United States)

    Palazuelos, Daniel; Dhillon, Ranu

    2016-01-01

    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

  16. Leptospirosis: an emerging global public health problem

    Indian Academy of Sciences (India)

    P Vijayachari; A P Sugunan; A N Shriram

    2008-11-01

    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

  17. Breast Self-Examination Beliefs and Practices, Ethnicity, and Health Literacy: Implications for Health Education to Reduce Disparities

    Science.gov (United States)

    Armin, Julie; Torres, Cristina Huebner; Vivian, James; Vergara, Cunegundo; Shaw, Susan J.

    2014-01-01

    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…

  18. Optimizing eHealth breast cancer interventions: which types of eHealth services are effective?

    Science.gov (United States)

    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; Gustafson, David H

    2011-03-01

    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, but not coaching such as cognitive behavior therapy, produced significant benefits in health information competence and emotional processing. Provision of Information and Support ICCS services significantly benefited women with breast cancer. More complex and interactive services designed to train the user had negligible effects. PMID:21709810

  19. Globalization, democracy, and child health in developing countries.

    Science.gov (United States)

    Welander, Anna; Lyttkens, Carl Hampus; Nilsson, Therese

    2015-07-01

    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.

  20. Evaluation of Breast Cancer Knowledge Among Health Promoters in Mexico Before and After Focused Training

    OpenAIRE

    Keating, Nancy L.; Elena M. Kouri; Ornelas, Héctor Arreola; Méndez, Oscar; Valladares, Laura Magaña; Knaul, Felicia Marie

    2014-01-01

    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.

  1. Education in Global Health: Experience in Health-Promoting Schools Provides Trainees with Defined Core Competencies

    OpenAIRE

    Shreya Moodley; Arabat Kasangaki; Macnab, Andrew J.

    2012-01-01

    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...

  2. Global Health Governance Challenges 2016 – Are We Ready?

    Directory of Open Access Journals (Sweden)

    Ilona Kickbusch

    2016-06-01

    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.

  3. Global Health Governance Challenges 2016 - Are We Ready?

    Science.gov (United States)

    Kickbusch, Ilona

    2016-01-01

    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

  4. The Role of Health Education Specialists in Supporting Global Health and the Millennium Development Goals

    Science.gov (United States)

    Geiger, Brian F.; Davis, Thomas M.; Beric, Bojana; Devlin, Michele K.

    2011-01-01

    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…

  5. Global health in an open world requires an open mind

    DEFF Research Database (Denmark)

    Sodemann, Morten

    Why global health? Health has never been more clearly global than now. Social media have reorganized our way of talking, discussing and interacting globally by spreading happiness, hate speech, obesity and knowledge at the same time. Diseases have never had respect for border control. Polio has...... the real world context of global health. It took 186 years from the discovery of the Smallpox vaccine to the eradication of the disease; it took only 20 years from the onset of the global HIV epidemic to create a global HIV disaster caused by ignorance, negligence, political correctness, religious...... considerations and lobbying, epidemic stigma and counterproductive politically governed control measures. Governments have had to interpose themselves into controversies of sex, injected drugs, and other taboos in public media. Even the WHO has had trouble confronting such realities. The slow and inadequate...

  6. Understanding Breast Changes: A Health Guide for Women

    Science.gov (United States)

    Information on specific breast conditions and changes, including how these changes are detected, diagnosed and treated. Explains that while most breast changes are not cancer, all breast changes need to be checked by a doctor. Helps women understand the next steps after an abnormal mammogram result, and includes a list of questions to help women talk with their doctor about these issues.

  7. BRICS countries and the global movement for universal health coverage.

    Science.gov (United States)

    Tediosi, Fabrizio; Finch, Aureliano; Procacci, Christina; Marten, Robert; Missoni, Eduardo

    2016-07-01

    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

  8. BRICS countries and the global movement for universal health coverage.

    Science.gov (United States)

    Tediosi, Fabrizio; Finch, Aureliano; Procacci, Christina; Marten, Robert; Missoni, Eduardo

    2016-07-01

    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.

  9. The evolution of global health teaching in undergraduate medical curricula

    Directory of Open Access Journals (Sweden)

    Rowson Mike

    2012-11-01

    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

  10. Global Governance for Health: how to motivate political change?

    Science.gov (United States)

    McNeill, D; Ottersen, O P

    2015-07-01

    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

  11. Global Governance for Health: how to motivate political change?

    Science.gov (United States)

    McNeill, D; Ottersen, O P

    2015-07-01

    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.

  12. Global Health in the Social Studies Classroom

    Science.gov (United States)

    Smith, David J.

    2005-01-01

    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,…

  13. WHO global and regional strategies for health and environment

    International Nuclear Information System (INIS)

    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

  14. Understanding change in global health policy: ideas, discourse and networks.

    Science.gov (United States)

    Harmer, Andrew

    2011-01-01

    How is radical change in global health policy possible? Material factors such as economics or human resources are important, but ideational factors such as ideas and discourse play an important role as well. In this paper, I apply a theoretical framework to show how discourse made it possible for public and private actors to fundamentally change their way of working together--to shift from international public and private interactions to global health partnerships (GHPs)--and in the process create a new institutional mechanism for governing global health. Drawing on insights from constructivist analysis, I demonstrate how discourse justified, legitimised, communicated and coordinated ideas about the practice of GHPs through a concentrated network of partnership pioneers. As attention from health policy analysts turns increasingly to ideational explanations for answers to global health problems, this paper contributes to the debate by showing how, precisely, discourse makes change possible. PMID:20924870

  15. Politics or Technocracy – What Next for Global Health?

    Science.gov (United States)

    Kickbusch, Ilona

    2016-01-01

    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

  16. Global health diplomacy, 'smart power', and the new world order.

    Science.gov (United States)

    Kevany, Sebastian

    2014-01-01

    Both the theory and practice of foreign policy and diplomacy, including systems of hard and soft power, are undergoing paradigm shifts, with an increasing number of innovative actors and strategies contributing to international relations outcomes in the 'New World Order'. Concurrently, global health programmes continue to ascend the political spectrum in scale, scope and influence. This concatenation of circumstances has demanded a re-examination of the existing and potential effectiveness of global health programmes in the 'smart power' context, based on adherence to a range of design, implementation and assessment criteria, which may simultaneously optimise their humanitarian, foreign policy and diplomatic effectiveness. A synthesis of contemporary characteristics of 'global health diplomacy' and 'global health as foreign policy', grouped by common themes and generated in the context of related field experiences, are presented in the form of 'Top Ten' criteria lists for optimising both diplomatic and foreign policy effectiveness of global health programmes, and criteria are presented in concert with an examination of implications for programme design and delivery. Key criteria for global health programmes that are sensitised to both diplomatic and foreign policy goals include visibility, sustainability, geostrategic considerations, accountability, effectiveness and alignment with broader policy objectives. Though diplomacy is a component of foreign policy, criteria for 'diplomatically-sensitised' versus 'foreign policy-sensitised' global health programmes were not always consistent, and were occasionally in conflict, with each other. The desirability of making diplomatic and foreign policy criteria explicit, rather than implicit, in the context of global health programme design, delivery and evaluation are reflected in the identified implications for (1) international security, (2) programme evaluation, (3) funding and resource allocation decisions, (4) approval

  17. Advancing integrative “one-health” approaches to global health through multidisciplinary, faculty-led global health field courses

    OpenAIRE

    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

    2015-01-01

    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...

  18. Predictors of Self-Reported Family Health History of Breast Cancer.

    Science.gov (United States)

    Ricks-Santi, Luisel J; Thompson, Nicole; Ewing, Altovise; Harrison, Barbara; Higginbotham, Kimberly; Spencer, Cherie; Laiyemo, Adeyinka; DeWitty, Robert; Wilson, Lori; Horton, Sara; Dunmore-Griffith, Jacqueline; Williams, Carla; Frederick, Wayne

    2016-10-01

    The objective of this study was to identify predictors of self-reported family health history of breast cancer in an ethnically diverse population of women participating in a breast cancer screening program. Participants completed a self-administered questionnaire about their demography, health, breast health and family health history of breast cancer. The association between family health history of breast cancer and categorical variables were analyzed using the T test, chi square, and multi-nominal logistic regression. Those who were least likely to report a family history of cancer were African Americans (p = 0.02), and immigrant women from South America (p Africa (p = 0.04). However, 34.4 % reported having a second-degree maternal relative with breast cancer compared to 6.9 % who reported having a second degree paternal relative with breast cancer. Therefore, there is a need to increase efforts to educate families about the importance of collecting and sharing one's family health history. PMID:26201692

  19. Effects of a Mail and Telephone Intervention on Breast Health Behaviors

    Science.gov (United States)

    Bowen, Deborah J.; Powers, Diane

    2010-01-01

    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)…

  20. Health care utilisation and characteristics of long-term breast cancer survivors: nationwide survey in Denmark

    DEFF Research Database (Denmark)

    Peuckmann, V; Ekholm, O; Sjøgren, P;

    2008-01-01

    AIM: To investigate long-term female breast cancer survivors' (BCS') health care utilisation, health, and employment. METHODS: An age-stratified random sample of 2000 female breast cancer survivors (BCS) 5-15 years after primary surgery without recurrence was drawn from the Danish Breast Cancer...... Cooperative Group register. A self-administered questionnaire assessed sociodemography, health care utilisation, employment, and health-related quality of life (HRQOL). Associations with breast cancer treatment were investigated. RESULTS: Response rate was 79%. Significantly more BCS than the general women...... population reported health care utilisation (61% versus. 56%; age-standardised risk ratio (SRR): 1.10; 95% confidence interval (CI) 1.05-1.15), but significantly fewer BCS were disability pensioners (15% versus 19%; SRR: 0.77; 95% CI 0.64-0.93). 'Daily activities limited due to sequelae' were reported by 20...

  1. Developing a global health practitioner: time to act?

    Science.gov (United States)

    McKimm, Judy; McLean, Michelle

    2011-01-01

    Although many health issues transcend national boundaries and require international co-operation, global health is rarely an integral part of the medical curriculum. While medical schools have a social responsibility to train healthcare professionals to serve local communities, the internationalisation of medical education (e.g. international medical students, export of medical curricula or medical schools) makes it increasingly difficult to define it as 'local'. It is therefore necessary to produce practitioners who can practice medicine in an ever-changing and unpredictable world. These practitioners must be clinically and culturally competent as well as able to use their global knowledge and experience to improve health and well-being, irrespective of where they eventually practice medicine. Global health practitioners are tomorrow's leaders, change agents and members of effective multiprofessional teams and so need to be aware of the environmental, cultural, social and political factors that impact on health, serving as advocates of people's rights to access resources, education and healthcare. This article addresses some of the difficulties of developing global health practitioners, offering suggestions for a global health curriculum. It also acknowledges that creating a global health practitioner requires international collaboration and shared resources and practices and places the onus of social accountability on academic leaders. PMID:21774648

  2. Developing a global health practitioner: time to act?

    Science.gov (United States)

    McKimm, Judy; McLean, Michelle

    2011-01-01

    Although many health issues transcend national boundaries and require international co-operation, global health is rarely an integral part of the medical curriculum. While medical schools have a social responsibility to train healthcare professionals to serve local communities, the internationalisation of medical education (e.g. international medical students, export of medical curricula or medical schools) makes it increasingly difficult to define it as 'local'. It is therefore necessary to produce practitioners who can practice medicine in an ever-changing and unpredictable world. These practitioners must be clinically and culturally competent as well as able to use their global knowledge and experience to improve health and well-being, irrespective of where they eventually practice medicine. Global health practitioners are tomorrow's leaders, change agents and members of effective multiprofessional teams and so need to be aware of the environmental, cultural, social and political factors that impact on health, serving as advocates of people's rights to access resources, education and healthcare. This article addresses some of the difficulties of developing global health practitioners, offering suggestions for a global health curriculum. It also acknowledges that creating a global health practitioner requires international collaboration and shared resources and practices and places the onus of social accountability on academic leaders.

  3. Globalization and Health: developing the journal to advance the field

    OpenAIRE

    Martin, Greg; Maclachlan, Malcolm; Labonté, Ronald; Larkan, Fiona; Vallières, Frédérique; Bergin, Niamh

    2016-01-01

    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...

  4. Breast-feeding and Vitamin D Supplementation Rates in the Ochsner Health System

    OpenAIRE

    Ponnapakkam, Tulasi; Ravichandran, Anisha; Bradford, Elease; Tobin, Gregory; Gensure, Robert

    2008-01-01

    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...

  5. A Progressively Realizable Right to Health and Global Governance.

    Science.gov (United States)

    Daniels, Norman

    2015-12-01

    A moral right to health or health care is a special instance of a right to fair equality of opportunity. Nation-states generally have the capabilities to specify the entitlements of such a right and to raise the resources needed to satisfy those entitlements. Can these functions be replicated globally, as a global right to health or health care requires? The suggestion that "better global governance" is needed if such a global right is to be claimed requires that these two central capabilities be present. It is unlikely that nation-states would concede these two functions to a form of global governance, for doing so would seriously compromise the authority that is generally included in sovereignty. This claim is a specification of what is often recognized as the "sovereignty problem." The argument of this paper is not an "impossibility" claim, but a best guess about whether the necessary conditions for better global governance that supports a global right to health or health care can be achieved.

  6. Violence a global public health problem

    OpenAIRE

    Linda L. Dahlberg; Etienne G. Krug

    2006-01-01

    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...

  7. Functional health literacy in Spanish-speaking Latinas seeking breast cancer screening through the National Breast and Cervical Cancer Screening Program

    OpenAIRE

    Samantha Garbers; Karen Schmitt; Anne Marie Rappa; Mary Ann Chiasson

    2010-01-01

    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:...

  8. Microfinance: untapped potential for global health.

    Science.gov (United States)

    Patel, Ronak B

    2014-11-01

    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

  9. Violence a global public health problem

    Directory of Open Access Journals (Sweden)

    Linda L. Dahlberg

    2006-06-01

    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.

  10. Acceptability and effectiveness of a breast health awareness programme for rural women in India

    Directory of Open Access Journals (Sweden)

    Rao R

    2005-09-01

    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.

  11. Facilitative governance: transforming global health through complexity theory.

    Science.gov (United States)

    Haffeld, Just

    2012-01-01

    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

  12. Breast Cancer Treatment

    Science.gov (United States)

    ... 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 ...

  13. Stages of Breast Cancer

    Science.gov (United States)

    ... 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 ...

  14. Pediatric Global Health Education: Past, Present, and Future.

    Science.gov (United States)

    Pitt, Michael B; Gladding, Sophia P; Suchdev, Parminder S; Howard, Cynthia R

    2016-01-01

    Recent outbreaks of diseases erroneously thought by many to be contained by borders or eliminated by vaccines have highlighted the need for proper training of all residents in global health. Beyond infectious diseases, all pediatricians should know how to care for other conditions in global child health, ranging from malnutrition to the nuances of care for immigrant and refugee children. The call for broader education for pediatric residents in global health has been increasing over the last decade, with all major pediatric organizations underscoring its importance in statement and action. Herein, the current status of global child health education in pediatric residency training in the United States is summarized, highlighting where it has been, where it is now, and where it should go next.

  15. Center for Global Health announces grants to support portable technologies

    Science.gov (United States)

    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

  16. Globalization and Health: developing the journal to advance the field.

    Science.gov (United States)

    Martin, Greg; MacLachlan, Malcolm; Labonté, Ronald; Larkan, Fiona; Vallières, Frédérique; Bergin, Niamh

    2016-01-01

    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.

  17. Global health in foreign policy--and foreign policy in health? Evidence from the BRICS.

    Science.gov (United States)

    Watt, Nicola F; Gomez, Eduardo J; McKee, Martin

    2014-09-01

    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

  18. Global health in foreign policy--and foreign policy in health? Evidence from the BRICS.

    Science.gov (United States)

    Watt, Nicola F; Gomez, Eduardo J; McKee, Martin

    2014-09-01

    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.

  19. Comprehensive effective and efficient global public health surveillance

    Directory of Open Access Journals (Sweden)

    McNabb Scott JN

    2010-12-01

    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[2005]; 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

  20. Adverse health outcomes in offspring of mothers with cosmetic breast implants : A review

    NARCIS (Netherlands)

    Kjoller, Kim; Friis, Soren; Lipworth, Loren; McLaughlin, Joseph K.; Olsen, Jorgen H.

    2007-01-01

    Background: To assess whether maternal cosmetic breast implants are associated with adverse health outcomes among offspring, the authors examined published findings of epidemiologic studies that addressed this hypothesis. Methods: Four epidemiologic studies, ail from Scandinavia, were identified. Wo

  1. Globalization and social determinants of health: The role of the global marketplace (part 2 of 3

    Directory of Open Access Journals (Sweden)

    Schrecker Ted

    2007-06-01

    Full Text Available Abstract Globalization is a key context for the study of social determinants of health (SDH: broadly stated, SDH are the conditions in which people live and work, and that affect their opportunities to lead healthy lives. In the first article in this three part series, we described the origins of the series in work conducted for the Globalization Knowledge Network of the World Health Organization's Commission on Social Determinants of Health and in the Commission's specific concern with health equity. We identified and defended a definition of globalization that gives primacy to the drivers and effects of transnational economic integration, and addressed a number of important conceptual and methodological issues in studying globalization's effects on SDH and their distribution, emphasizing the need for transdisciplinary approaches that reflect the complexity of the topic. In this second article, we identify and describe several, often interacting clusters of pathways leading from globalization to changes in SDH that are relevant to health equity. These involve: trade liberalization; the global reorganization of production and labour markets; debt crises and economic restructuring; financial liberalization; urban settings; influences that operate by way of the physical environment; and health systems changed by the global marketplace.

  2. Globalization and social determinants of health: The role of the global marketplace (part 2 of 3).

    Science.gov (United States)

    Labonté, Ronald; Schrecker, Ted

    2007-06-19

    Globalization is a key context for the study of social determinants of health (SDH): broadly stated, SDH are the conditions in which people live and work, and that affect their opportunities to lead healthy lives. In the first article in this three part series, we described the origins of the series in work conducted for the Globalization Knowledge Network of the World Health Organization's Commission on Social Determinants of Health and in the Commission's specific concern with health equity. We identified and defended a definition of globalization that gives primacy to the drivers and effects of transnational economic integration, and addressed a number of important conceptual and methodological issues in studying globalization's effects on SDH and their distribution, emphasizing the need for transdisciplinary approaches that reflect the complexity of the topic. In this second article, we identify and describe several, often interacting clusters of pathways leading from globalization to changes in SDH that are relevant to health equity. These involve: trade liberalization; the global reorganization of production and labour markets; debt crises and economic restructuring; financial liberalization; urban settings; influences that operate by way of the physical environment; and health systems changed by the global marketplace.

  3. Advancing the right to health through global organizations: The potential role of a Framework Convention on Global Health.

    Science.gov (United States)

    Friedman, Eric A; Gostin, Lawrence O; Buse, Kent

    2013-01-01

    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

  4. Is globalization healthy: a statistical indicator analysis of the impacts of globalization on health

    Directory of Open Access Journals (Sweden)

    Martens Pim

    2010-09-01

    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.

  5. Is globalization healthy: a statistical indicator analysis of the impacts of globalization on health.

    Science.gov (United States)

    Martens, Pim; Akin, Su-Mia; Maud, Huynen; Mohsin, Raza

    2010-09-17

    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.

  6. Imagining Global Health with Justice: In Defense of the Right to Health.

    Science.gov (United States)

    Friedman, Eric A; Gostin, Lawrence O

    2015-12-01

    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

  7. Global health language and culture competency.

    Science.gov (United States)

    Beadling, Charles; Maza, John; Nakano, Gregg; Mahmood, Maysaa; Jawad, Shakir; Al-Ameri, Ali; Zuerlein, Scott; Anderson, Warner

    2012-01-01

    This article presents findings from a survey conducted to examine the availability of foreign language and culture training to Civil Affairs health personnel and the relevance of that training to the tasks they perform. Civil Affairs forces recognize the value of cross-cultural communication competence because their missions involve a significant level of interaction with foreign governments? officials, military, and civilians. Members of the 95th Civil Affairs Brigade (Airborne) who had a health-related military occupational specialty code were invited to participate in the survey. More than 45% of those surveyed were foreign language qualified. Many also received predeployment language and culture training specific to the area of deployment. Significantly more respondents reported receiving cultural training and training on how to work effectively with interpreters than having received foreign language training. Respondents perceived interpreters as important assets and were generally satisfied with their performance. Findings from the survey highlight a need to identify standard requirements for predeployment language training that focuses on medical and health terminology and to determine the best delivery platform(s). Civil Affairs health personnel would benefit from additional cultural training that focuses on health and healthcare in the country or region of deployment. Investing in the development of distance learning capabilities as a platform for delivering health-specific language and culture training may help ease the time and resources constraints that limit the ability of Civil Affairs health personnel to access the training they need.

  8. Global urbanization and impact on health.

    Science.gov (United States)

    Moore, Melinda; Gould, Philip; Keary, Barbara S

    2003-08-01

    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

  9. Rethinking global health challenges: towards a 'global compact' for reducing the burden of chronic disease.

    Science.gov (United States)

    Magnusson, R S

    2009-03-01

    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

  10. Health seeking behavioral analysis associated with breast cancer screening among Asian American women

    Directory of Open Access Journals (Sweden)

    Ma GX

    2012-05-01

    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

  11. The role of teleconferences in global public health education.

    Science.gov (United States)

    Pinzon-Perez, Helda; Zelinski, Christy

    2016-06-01

    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

  12. Globalization and disease: in an unequal world, unequal health!

    Directory of Open Access Journals (Sweden)

    Paulo Marchiori Buss

    2002-12-01

    Full Text Available In this paper, originally presented at an event held by the National Institutes of Health (NIH in the United States, the author analyzes the repercussions of globalization on various health aspects: the spread of infectious and parasitic diseases, bioterrorism, and new behavioral patterns in health, among others. He goes on to examine the positive and negative effects of international agreements on health, particularly in the trade area, including the TRIPS Agreement on medicines in the area of public health. The paper concludes that the resumption of cooperation among nations is the best way to achieve world progress in public health.

  13. The APRU Global Health Program: Past and Future.

    Science.gov (United States)

    Samet, Jonathan; Withers, Mellissa

    2016-01-01

    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

  14. The APRU Global Health Program: Past and Future

    Directory of Open Access Journals (Sweden)

    Jonathan Samet

    2016-04-01

    Full Text Available 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.

  15. Defining and Developing Global Public Health Course for Public Health Graduates

    Directory of Open Access Journals (Sweden)

    Rajendra eKarkee

    2015-07-01

    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.

  16. Global health diplomacy training for military medical researchers.

    Science.gov (United States)

    Katz, Rebecca; Blazes, David; Bae, Jennifer; Puntambekar, Nisha; Perdue, Christopher L; Fischer, Julie

    2014-04-01

    Given the unprecedented growth of global health initiatives in the past decade, informal diplomacy between technical partners plays an increasingly important role in shaping opportunities and outcomes. This article describes a course developed and executed specifically to equip U.S. military health professionals with core skills in practical diplomacy critical to help them successfully plan and implement public health surveillance, research, and capacity building programs with partner nation governments and organizations. We identified core competencies in practical diplomacy for laboratory and public health researchers, catalogued and evaluated existing training programs, and then developed a pilot course in global health diplomacy for military medical researchers. The pilot course was held in June 2012, and focused on analyzing contemporary issues related to global health diplomacy through the framework of actors, drivers, and policies that affect public health research and capacity-building, beginning at the level of global health governance and cooperation and moving progressively to regional (supranational), national, and institutional perspective. This course represents an approach geared toward meeting the needs specific to U.S. military public health personnel and researchers working in international settings. PMID:24690959

  17. 性活动与乳腺保健%Sexual activity and breast health

    Institute of Scientific and Technical Information of China (English)

    陈水娟

    1997-01-01

    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.

  18. Childhood obesity: A global public health crisis

    OpenAIRE

    Sameera Karnik; Amar Kanekar

    2012-01-01

    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...

  19. SEPP1 influences breast cancer risk among women with greater native american ancestry: the breast cancer health disparities study.

    Directory of Open Access Journals (Sweden)

    Andrew J Pellatt

    Full Text Available Selenoproteins are a class of proteins containing a selenocysteine residue, many of which have been shown to have redox functions, acting as antioxidants to decrease oxidative stress. Selenoproteins have previously been associated with risk of various cancers and redox-related diseases. In this study we evaluated possible associations between breast cancer risk and survival and single nucleotide polymorphisms (SNPs in the selenoprotein genes GPX1, GPX2, GPX3, GPX4, SELS, SEP15, SEPN1, SEPP1, SEPW1, TXNRD1, and TXNRD2 among Hispanic/Native American (2111 cases, 2597 controls and non-Hispanic white (NHW (1481 cases, 1586 controls women in the Breast Cancer Health Disparities Study. Adaptive Rank Truncated Product (ARTP analysis was used to determine both gene and pathway significance with these genes. The overall selenoprotein pathway PARTP was not significantly associated with breast cancer risk (PARTP = 0.69, and only one gene, GPX3, was of borderline significance for the overall population (PARTP =0.09 and marginally significant among women with 0-28% Native American (NA ancestry (PARTP=0.06. The SEPP1 gene was statistically significantly associated with breast cancer risk among women with higher NA ancestry (PARTP=0.002 and contributed to a significant pathway among those women (PARTP=0.04. GPX1, GPX3, and SELS were associated with Estrogen Receptor-/Progesterone Receptor+ status (PARTP = 0.002, 0.05, and 0.01, respectively. Four SNPs (GPX3 rs2070593, rsGPX4 rs2074451, SELS rs9874, and TXNRD1 rs17202060 significantly interacted with dietary oxidative balance score after adjustment for multiple comparisons to alter breast cancer risk. GPX4 was significantly associated with breast cancer survival among those with the highest NA ancestry (PARTP = 0.05 only. Our data suggest that SEPP1 alters breast cancer risk among women with higher levels of NA ancestry.

  20. Tobacco industry globalization and global health governance: towards an interdisciplinary research agenda

    OpenAIRE

    Kelley Lee; Jappe Eckhardt; Chris Holden

    2016-01-01

    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...

  1. [The impact of globalization on mental health].

    Science.gov (United States)

    de la Fuente, Juan Ramón

    2012-01-01

    Psychosis, dementias, anxiety, depression, suicide and suicide attempts, as well as psychiatric disorders associated to violence and poverty have increased the global burden of disease. Other related problems associated to special diets, body image, compulsive use of computers and mobile phones, and those frequently observed in migrants subjected to intense distress are reviewed as well. Information and communication technologies may have undesirable side effects affecting some individuals in their conduct and social interactions.

  2. Politics, Power, Poverty and Global Health: Systems and Frames

    Science.gov (United States)

    Benatar, Solomon

    2016-01-01

    Striking disparities in access to healthcare and in health outcomes are major characteristics of health across the globe. This inequitable state of global health and how it could be improved has become a highly popularized field of academic study. In a series of articles in this journal the roles of power and politics in global health have been addressed in considerable detail. Three points are added here to this debate. The first is consideration of how the use of definitions and common terms, for example ‘poverty eradication,’ can mask full exposure of the extent of rectification required, with consequent failure to understand what poverty eradication should mean, how this could be achieved and that a new definition is called for. Secondly, a criticism is offered of how the term ‘global health’ is used in a restricted manner to describe activities that focus on an anthropocentric and biomedical conception of health across the world. It is proposed that the discourse on ‘global health’ should be extended beyond conventional boundaries towards an ecocentric conception of global/planetary health in an increasingly interdependent planet characterised by a multitude of interlinked crises. Finally, it is noted that the paucity of workable strategies towards achieving greater equity in sustainable global health is not so much due to lack of understanding of, or insight into, the invisible dimensions of power, but is rather the outcome of seeking solutions from within belief systems and cognitive biases that cannot offer solutions. Hence the need for a new framing perspective for global health that could reshape our thinking and actions. PMID:27694651

  3. Beyond trade: taking globalization to the health sector.

    Science.gov (United States)

    Daulaire, Nils

    2003-01-01

    The pace of globalization has brought the world to the brink of a new era in international relations. While the world has outgrown traditional mechanisms for addressing global issues, it has not yet developed new forms of effective governance. This temporary void poses threats and enormous opportunities. The public health sector will play a crucial "formal" role--that is, carried out by existing bodies such as WHO and the UN. But WHO does not necessarily represent the full spectrum of views and its members necessarily work, to some degree, for separate national interests. The formal dimension must be supplemented. Globalization is not synonymous with lack of regulation. Many responsible businesses would welcome a transparent and universally applied regulatory regime to prevent a race to the lowest standards. The economic benefits of globalization may hit a glass ceiling if societies outside the global economy become progressively poorer and less healthy. The business community is recognizing that good health is essential for economic growth and social stability. Globalization may cause millions to migrate for economic opportunity. The private sector's forward-thinkers recognize the health threats of migration and are beginning to view global health promotion as a means to ensure optimal market access.

  4. Forging partnerships to solve the global health workforce crisis and achieve the health MDGs.

    Science.gov (United States)

    Cometto, Giorgio; Sheikh, Mubashar

    2010-01-01

    The health workforce is in many countries the weakest link in the effective and equitable delivery of quality health services, and the largest impediment to the achievement of health Millennium Development Goals. The Kampala Declaration and Agenda for Global Action, championed by the Global Health Workforce Alliance, provide an effective overarching framework for the bold, concerted and sustained action which is required at the international, national and local level.

  5. Big Food, Food Systems, and Global Health

    OpenAIRE

    Stuckler, David; Nestle, Marion

    2012-01-01

    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.

  6. Effectiveness of a Brief Health Education Intervention for Breast Cancer Prevention in Greece Under Economic Crisis

    Directory of Open Access Journals (Sweden)

    Kyriakoula Merakou

    2013-01-01

    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.

  7. Health workforce responses to global health initiatives funding: a comparison of Malawi and Zambia

    NARCIS (Netherlands)

    R. Brugha; J. Kadzandira; J. Simbaya; P. Dicker; V. Mwapasa; A. Walsh

    2010-01-01

    Background Shortages of health workers are obstacles to utilising global health initiative (GHI) funds effectively in Africa. This paper reports and analyses two countries' health workforce responses during a period of large increases in GHI funds. Methods Health facility record reviews were conduct

  8. Current understandings and perspectives on non-cancer health effects of benzene: A global concern

    International Nuclear Information System (INIS)

    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

  9. Current understandings and perspectives on non-cancer health effects of benzene: A global concern

    Energy Technology Data Exchange (ETDEWEB)

    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)

    2014-04-15

    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

  10. The need for global environmental health policy.

    Science.gov (United States)

    Carpenter, David O

    2003-01-01

    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

  11. Global health educational engagement - a tale of two models.

    Science.gov (United States)

    Rassiwala, Jasmine; Vaduganathan, Muthiah; Kupershtok, Mania; Castillo, Frank M; Evert, Jessica

    2013-11-01

    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

  12. Flat medicine? Exploring trends in the globalization of health care.

    Science.gov (United States)

    Crone, Robert K

    2008-02-01

    Trailing nearly every other industry, health care is finally globalizing. Highly trained and experienced expatriate health care professionals are returning to their home countries from training in the West or are staying home to work in newly developed corporate health care delivery systems that can compete quite favorably with less-than-perfect providers in Europe and North America. In turn, these health care systems are attracting patients from around the world who are interested in exploring high-quality, lower-cost health care alternatives. Much of this activity is occurring in the emerging economies of the Middle East, South and Southeast Asia, and beyond. Three Harvard Medical International collaborations--in Dubai, Turkey, and India--highlight these trends and demonstrate the potential for new models of global health care, as well as potential ramifications for patients and providers in the established economies of the West, including the United States. Although globalization is not a cure-all solution to achieving universal access to health care, it is not only a significant first step for patients in these emerging economies, but may also present alternative solutions for those patients in wealthier nations who nonetheless lack adequate health care coverage. The increase in health care quality and competitiveness around the globe is important, but these improvements will need to be matched by the development of comprehensive payer solutions, to benefit as many people as possible.

  13. Rethinking global health research: towards integrative expertise

    Directory of Open Access Journals (Sweden)

    MacLachlan Malcolm

    2009-07-01

    Full Text Available Abstract The Bamako Call for Action on Research for Health stresses the importance of inter-disciplinary, inter-ministerial and inter-sectoral working. This challenges much of our current research and postgraduate research training in health, which mostly seeks to produce narrowly focused content specialists. We now need to compliment this type of research and research training, by offering alternative pathways that seek to create expertise, not only in specific narrow content areas, but also in the process and context of research, as well as in the interaction of these different facets of knowledge. Such an approach, developing 'integrative expertise', could greatly facilitate better research utilisation, helping policy makers and practitioners work through more evidence-based practice and across traditional research boundaries.

  14. Capacity building in global mental health research.

    Science.gov (United States)

    Thornicroft, Graham; Cooper, Sara; Bortel, Tine Van; Kakuma, Ritsuko; Lund, Crick

    2012-01-01

    Research-generated information about mental disorders is crucial in order to establish the health needs in a given setting, to propose culturally apt and cost-effective individual and collective interventions, to investigate their implementation, and to explore the obstacles that prevent recommended strategies from being implemented. Yet the capacity to undertake such research in low- and middle-income countries is extremely limited. This article describes two methods that have proved successful in strengthening, or that have the potential to strengthen, mental health research capacity in low-resource settings. We identify the central challenges to be faced, review current programs offering training and mentorship, and summarize the key lessons learned. A structured approach is proposed for the career development of research staff at every career stage, to be accompanied by performance monitoring and support. A case example from the Mental Health and Poverty Project in sub-Saharan Africa illustrates how this approach can be put into practice-in particular, by focusing upon training in core transferrable research skills. PMID:22335179

  15. Public Health Surveillance: At the Core of the Global Health Security Agenda.

    Science.gov (United States)

    Wolicki, Sara Beth; Nuzzo, Jennifer B; Blazes, David L; Pitts, Dana L; Iskander, John K; Tappero, Jordan W

    2016-01-01

    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.

  16. Public Health Surveillance: At the Core of the Global Health Security Agenda.

    Science.gov (United States)

    Wolicki, Sara Beth; Nuzzo, Jennifer B; Blazes, David L; Pitts, Dana L; Iskander, John K; Tappero, Jordan W

    2016-01-01

    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

  17. Going global: considerations for introducing global health into family medicine training programs.

    Science.gov (United States)

    Evert, Jessica; Bazemore, Andrew; Hixon, Allen; Withy, Kelley

    2007-10-01

    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

  18. A computerized global MR image feature analysis scheme to assist diagnosis of breast cancer: a preliminary assessment

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Qian [College of Life Information Science and Instrument Engineering, Hangzhou Dianzi University, Hangzhou, 310018 (China); Li, Lihua, E-mail: lilh@hdu.edu.cn [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)

    2014-07-15

    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.

  19. Understanding and optimizing bone health in breast cancer.

    Science.gov (United States)

    Guise, Theresa A; Brufsky, Adam; Coleman, Robert E

    2010-12-01

    Bone is the preferred site of metastasis for breast cancer, and presence of skeletal lesions is associated with significant morbidity and poor prognosis. Skeletal-related effects such as pain, pathologic fractures, spinal compression, and hypercalcemia are frequent consequences of skeletal lesions of breast cancer that have debilitating effects on the patients' quality of life. In addition to direct cancer effects on the skeleton, therapies commonly used to treat patients with breast cancer such as chemotherapy and aromatase inhibitors (AI) result in cancer therapy-induced bone loss (CTIBL) which is associated with increased risk of skeletal complications such as fractures. Bisphosphonates are a class of antiresorptive drugs that are now firmly established as the cornerstone of the management of skeletal-related events due to breast cancer. Other novel bone-targeting agents such as the anti-receptor activator of NF-κB ligand (RANKL) monoclonal antibody denosumab are also showing promising activity in the treatment of bone metastasis secondary to breast cancer. Moreover, recent provocative evidence suggests that bisphosphonates might also exhibit antitumor activity via direct and indirect mechanisms. The goal of this review is to summarize the pathophysiology of osteolytic bone lesions secondary to breast cancer, provide clinical evidence of currently available bone-targeted drugs in the treatment of bone metastasis and CTIBL, and explore the antitumor activity of current bone-targeted agents in patients with breast cancer.

  20. Global health diplomacy: A critical review of the literature.

    Science.gov (United States)

    Ruckert, Arne; Labonté, Ronald; Lencucha, Raphael; Runnels, Vivien; Gagnon, Michelle

    2016-04-01

    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

  1. From Radical Mastectomy to Breast-Conserving Therapy and Oncoplastic Breast Surgery: A Narrative Review Comparing Oncological Result, Cosmetic Outcome, Quality of Life, and Health Economy

    OpenAIRE

    Kaviani, Ahmad; Sodagari, Nassim; Sheikhbahaei, Sara; Eslami, Vahid; Hafezi-Nejad, Nima; Safavi, Amin; Noparast, Maryam; Fitoussi, Alfred

    2013-01-01

    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...

  2. Abuse victimization and risk of breast cancer in the Black Women’s Health Study: Abuse and breast cancer risk in black women

    OpenAIRE

    Wise, Lauren A; Palmer, Julie R.; Boggs, Deborah A; Adams-Campbell, Lucile L.; Rosenberg, Lynn

    2011-01-01

    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...

  3. Influenza virus samples, international law, and global health diplomacy.

    Science.gov (United States)

    Fidler, David P

    2008-01-01

    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

  4. Influenza Virus Samples, International Law, and Global Health Diplomacy

    Science.gov (United States)

    2008-01-01

    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

  5. Global public goods and the global health agenda: problems, priorities and potential

    Directory of Open Access Journals (Sweden)

    MacKellar Landis

    2007-09-01

    Full Text Available Abstract The 'global public good' (GPG concept has gained increasing attention, in health as well as development circles. However, it has suffered in finding currency as a general tool for global resource mobilisation, and is at risk of being attached to almost anything promoting development. This overstretches and devalues the validity and usefulness of the concept. This paper first defines GPGs and describes the policy challenge that they pose. Second, it identifies two key areas, health R&D and communicable disease control, in which the GPG concept is clearly relevant and considers the extent to which it has been applied. We point out that that, while there have been many new initiatives, it is not clear that additional resources from non-traditional sources have been forthcoming. Yet achieving this is, in effect, the entire purpose of applying the GPG concept in global health. Moreover, the proliferation of disease-specific programs associated with GPG reasoning has tended to promote vertical interventions at the expense of more general health sector strengthening. Third, we examine two major global health policy initiatives, the Global Fund against AIDS, Tuberculosis and Malaria (GFATM and the bundling of long-standing international health goals in the form of Millennium Development Goals (MDG, asking how the GPG perspective has contributed to defining objectives and strategies. We conclude that both initiatives are best interpreted in the context of traditional development assistance and, one-world rhetoric aside, have little to do with the challenge posed by GPGs for health. The paper concludes by considering how the GPG concept can be more effectively used to promote global health.

  6. Relationship of optimism-pessimism and health-related quality of life in breast cancer survivors.

    Science.gov (United States)

    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

    2008-01-01

    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

  7. Scientometric trends and knowledge maps of global health systems research

    OpenAIRE

    Yao, Qiang; Chen, Kai; Yao, Lan; Lyu, Peng-hui; Yang, Tian-an; Luo, Fei; Chen, Shan-quan; He, Lu-yang; Liu, Zhi-Yong

    2014-01-01

    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...

  8. Mental health reform, economic globalization and the practice of citizenship.

    Science.gov (United States)

    Morrow, Marina

    2004-01-01

    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

  9. The Pan-University Network for Global Health: framework for collaboration and review of global health needs.

    Science.gov (United States)

    Winchester, M S; BeLue, R; Oni, T; Wittwer-Backofen, U; Deobagkar, D; Onya, H; Samuels, T A; Matthews, S A; Stone, C; Airhihenbuwa, C

    2016-01-01

    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

  10. The Pan-University Network for Global Health: framework for collaboration and review of global health needs.

    Science.gov (United States)

    Winchester, M S; BeLue, R; Oni, T; Wittwer-Backofen, U; Deobagkar, D; Onya, H; Samuels, T A; Matthews, S A; Stone, C; Airhihenbuwa, C

    2016-04-21

    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.

  11. Characteristics of human breast milk and infants' health on the radionuclide contaminated territories

    International Nuclear Information System (INIS)

    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

  12. Global health care leadership development: trends to consider

    Directory of Open Access Journals (Sweden)

    MacPhee M

    2013-06-01

    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

  13. The Politics of Global Health Security: Problemetizing a Social Evidence

    Directory of Open Access Journals (Sweden)

    Gabriel Blouin Genest

    2015-12-01

    Full Text Available Why have states, in a somewhat short period of time (1995-2005, suddenly decided to “cooperate” regarding global infectious disease surveillance? What kind of “cooperation” is it? Why did states apparently surrender part of their sovereign power to the WHO by giving it the power to declare pandemic at the global scale without state consent? These questions appear especially relevant in the context where issues of health and diseases at the global scale have been explicitly linked with the concepts of “risk”, “security”, “emergency”, “crisis”, “intelligence”, and “terrorism”. The objective of this article is to start answering these questions by first of all looking at the problems and paradoxes of the practices of Global Health Security through an analysis of the microbial space, capitalistic cooperation, and the production of information and data about health security. Secondly, the article draws the attention to the politics behind the structuration of Global Health Security as a social evidence by looking at contested concepts that represent promising research avenues.

  14. Great expectations for the World Health Organization: a Framework Convention on Global Health to achieve universal health coverage.

    Science.gov (United States)

    Ooms, G; Marten, R; Waris, A; Hammonds, R; Mulumba, M; Friedman, E A

    2014-02-01

    Establishing a reform agenda for the World Health Organization (WHO) requires understanding its role within the wider global health system and the purposes of that wider global health system. In this paper, the focus is on one particular purpose: achieving universal health coverage (UHC). The intention is to describe why achieving UHC requires something like a Framework Convention on Global Health (FCGH) that have been proposed elsewhere,(1) why WHO is in a unique position to usher in an FCGH, and what specific reforms would help enable WHO to assume this role.

  15. 1831: the map that launched the idea of global health.

    Science.gov (United States)

    Koch, Tom

    2014-08-01

    Today we take for granted the idea of global health, of disease as an international event. Increasingly, we assume as well that the international spread of disease can be traced to human travel patterns as well as to recurring environmental conditions. Perversely, the idea of ‘global health’ and its inverse, global disease, owes little to the three-dimensional imaging of the planet and almost everything to the two-dimensional plane of the map. Here the idea of global disease is traced from its beginnings in the 18th century to its 19th-century introduction in maps of the first cholera pandemic. This global perspective, and the responsibilities it promoted among civil officials, can be seen in modern studies of cancer, influenza and other conditions with both environmental foundations and international presence.

  16. International trade of health services: global trends and local impact.

    Science.gov (United States)

    Lautier, Marc

    2014-10-01

    Globalization is a key challenge facing health policy-makers. A significant dimension of this is trade in health services. Traditionally, the flow of health services exports went from North to South, with patients travelling in the opposite direction. This situation is changing and a number of papers have discussed the growth of health services exports from Southern countries in its different dimensions. Less attention has been paid to assess the real scope of this trade at the global level and its potential impact at the local level. Given the rapid development of this area, there are little empirical data. This paper therefore first built an estimate of the global size and of the growth trend of international trade in health services since 1997, which is compared with several country-based studies. The second purpose of the paper is to demonstrate the significant economic impact of this trade at the local level for the exporting country. We consider the case of health providers in the South-Mediterranean region for which the demand potential, the economic effects and the consequence for the health system are presented. These issues lead to the overall conclusion that different policy options would be appropriate, in relation to the nature of the demand. PMID:25063193

  17. A Church-Based, Spanish-Language Community Education Breast Health Program Increases Awareness and Utilization of Breast Diagnostic Services among Hispanics

    Science.gov (United States)

    Colon-Otero, Gerardo; Albertie, Monica; Rodriguez, Judith; Nicholson, Garik; Kolomeyer, Irina; Moreno-Aspitia, Alvaro; Lesperance, Mary; Perez, Edith A.

    2014-01-01

    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…

  18. Global health burden and needs of transgender populations: a review.

    Science.gov (United States)

    Reisner, Sari L; Poteat, Tonia; Keatley, JoAnne; Cabral, Mauro; Mothopeng, Tampose; Dunham, Emilia; Holland, Claire E; Max, Ryan; Baral, Stefan D

    2016-07-23

    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

  19. Health care voluntourism: addressing ethical concerns of undergraduate student participation in global health volunteer work.

    Science.gov (United States)

    McCall, Daniel; Iltis, Ana S

    2014-12-01

    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

  20. Culturally Competent Training Program: A Key to Training Lay Health Advisors for Promoting Breast Cancer Screening

    Science.gov (United States)

    Yu, Mei-yu; Song, Lixin; Seetoo, Amy; Cai, Cuijuan; Smith, Gary; Oakley, Deborah

    2007-01-01

    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…

  1. Meta-synthesis exploring barriers to health seeking behaviour among Malaysian breast cancer patients.

    Science.gov (United States)

    Yu, Foo Qing; Murugiah, Muthu Kumar; Khan, Amer Hayat; Mehmood, Tahir

    2015-01-01

    Barriers to health seeking constitute a challenging issue in the treatment of breast cancer. The current meta- synthesis aimed to explore common barriers to health seeking among Malaysian breast cancer patients. From the systematic search, nine studies were found meeting the inclusion criteria. Data extraction revealed that health behavior towards breast cancer among Malaysia women was influenced by knowledge, psychological, sociocultural and medical system factors. In terms of knowledge, most of the Malaysian patients were observed to have cursory information and the reliance on the information provided by media was limiting. Among psychological factors, stress and sense of denial were some of the common factors leading to delay in treatment seeking. Family member's advice, cultural beliefs towards traditional care were some of the common sociocultural factors hindering immediate access to advanced medical diagnosis and care. Lastly, the delay in referral was one of the most common health system-related problems highlighted in most of the studies. In conclusion, there is an immediate need to improve the knowledge and understanding of Malaysian women towards breast cancer. Mass media should liaise with the cancer specialists to disseminate accurate and up-to-date information for the readers and audience, helping in modification of cultural beliefs that hinder timing health seeking. However, such intervention will not improve or rectify the health system related barriers to treatment seeking. Therefore, there is an immediate need for resource adjustment and training programs among health professional to improve their competency and professionalism required to develop an efficient health system.

  2. Acute Kidney Injury:Global Health Alert

    Institute of Scientific and Technical Information of China (English)

    Philip Kam TaoLi; Emmanuel A Burdmann; Ravindra L Mehta

    2013-01-01

    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.

  3. Strategies for piloting a breast health promotion program in the Chinese-Australian population.

    Science.gov (United States)

    Koo, Fung Kuen; Kwok, Cannas; White, Kate; D'Abrew, Natalie; Roydhouse, Jessica K

    2012-01-01

    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

  4. The Grand Convergence: Closing the Divide between Public Health Funding and Global Health Needs.

    Directory of Open Access Journals (Sweden)

    Mary Moran

    2016-03-01

    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.

  5. Educating Young People on Global Determinants of Health

    DEFF Research Database (Denmark)

    Bruselius-Jensen, Maria; Renwick, Kerry; Aagaard-Hansen, Jens;

    that are very different for the two groups. They mention different approaches to education, different food cultures, different patterns of gender and chores at home and a different family structure. Mirroring their own health practices in that of their peers from another culture appeared to support learning...... of the cosmopolitan person, we argue that educating young people to understand and act upon global social determinants of health, means building reflexivity on their own cultural roots, traditions and practices and simultaneously open their minds towards the world (Hansen 2009). Thus, education on global health must...... from Kenya and Denmark, with the aim to promote reflections on differences and similarities in the everyday living conditions across cultures and nations, and their impact on health practices. Based on the findings this presentation will discuss the merits of this kind of education as a way to promote...

  6. Protecting Pakistan's health during the global economic crisis.

    Science.gov (United States)

    Jooma, R; Khan, A; Khan, A A

    2012-03-01

    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.

  7. A global perspective on vaccine safety and public health: the Global Advisory Committee on Vaccine Safety

    OpenAIRE

    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

    2004-01-01

    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...

  8. Induced abortion--a global health problem.

    Science.gov (United States)

    Odlind, V

    1997-01-01

    Every year around 500,000 women are estimated to die from pregnancy-related causes, the majority in the developing world and many as a consequence of unsafe abortion. Around 25 per cent of maternal deaths in Asia and 30-50 per cent of maternal deaths in Africa and Latin America occur as a result of induced abortion. Data on abortion related maternal morbidity is less reliable than mortality but suggests that for every maternal death 10-15 women suffer significant pregnancy-related morbidity, i.e. infertility, genito-urinary problems and/or chronic pain. Induced abortion occurs in practically every society in the world but only 40 per cent of the women in the world live in countries where abortion is legally free. A permissive legislation is an important prerequisite for medically safe and early abortion. Oppositely, with a restrictive law, abortion is difficult to obtain, costly and possibly unsafe, in particular to the least affluent women in the society. Induced abortion in a developed country with legal and easy access to services is a safe procedure with hardly any mortality and very low morbidity. The best strategy to reduce the number of unsafe abortions is prevention of unwanted pregnancy. The consequences of unsafe abortion on women's health need to be acknowledged by everybody in the society in order to improve abortion care. It is necessary to adjust legal and other barriers to medically safe abortion in order to follow the declaration at the UN conference on population in Cairo, 1994, which stated that abortion, wherever legal, should be safe. It is also necessary to introduce preventive measures where abortions are performed, i.e. good and easily accessible family planning services.

  9. Computer-aided global breast MR image feature analysis for prediction of tumor response to chemotherapy: performance assessment

    Science.gov (United States)

    Aghaei, Faranak; Tan, Maxine; Hollingsworth, Alan B.; Zheng, Bin; Cheng, Samuel

    2016-03-01

    Dynamic contrast-enhanced breast magnetic resonance imaging (DCE-MRI) has been used increasingly in breast cancer diagnosis and assessment of cancer treatment efficacy. In this study, we applied a computer-aided detection (CAD) scheme to automatically segment breast regions depicting on MR images and used the kinetic image features computed from the global breast MR images acquired before neoadjuvant chemotherapy to build a new quantitative model to predict response of the breast cancer patients to the chemotherapy. To assess performance and robustness of this new prediction model, an image dataset involving breast MR images acquired from 151 cancer patients before undergoing neoadjuvant chemotherapy was retrospectively assembled and used. Among them, 63 patients had "complete response" (CR) to chemotherapy in which the enhanced contrast levels inside the tumor volume (pre-treatment) was reduced to the level as the normal enhanced background parenchymal tissues (post-treatment), while 88 patients had "partially response" (PR) in which the high contrast enhancement remain in the tumor regions after treatment. We performed the studies to analyze the correlation among the 22 global kinetic image features and then select a set of 4 optimal features. Applying an artificial neural network trained with the fusion of these 4 kinetic image features, the prediction model yielded an area under ROC curve (AUC) of 0.83+/-0.04. This study demonstrated that by avoiding tumor segmentation, which is often difficult and unreliable, fusion of kinetic image features computed from global breast MR images without tumor segmentation can also generate a useful clinical marker in predicting efficacy of chemotherapy.

  10. Global Health Warning: Definitions Wield Power: Comment on "Navigating Between Stealth Advocacy and Unconscious Dogmatism: The Challenge of Researching the Norms, Politics and Power of Global Health"

    OpenAIRE

    Robert Marten

    2015-01-01

    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? ...

  11. Democracy – The Real ‘Ghost’ in the Machine of Global Health Policy; Comment on “A Ghost in the Machine? Politics in Global Health Policy”

    Directory of Open Access Journals (Sweden)

    Andrew Harmer

    2014-08-01

    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.

  12. The role of NGOs in global health research for development

    Directory of Open Access Journals (Sweden)

    Jones Lori

    2005-02-01

    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

  13. Medical Providers as Global Warming and Climate Change Health Educators: A Health Literacy Approach

    Science.gov (United States)

    Villagran, Melinda; Weathers, Melinda; Keefe, Brian; Sparks, Lisa

    2010-01-01

    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…

  14. Global oral health of older people--call for public health action

    DEFF Research Database (Denmark)

    Petersen, P E; Kandelman, D; Arpin, S;

    2010-01-01

    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...

  15. One Health: The global challenge of epidemic and endemic leishmaniasis

    OpenAIRE

    Day Michael J; Palatnik-de-Sousa Clarisa B.

    2011-01-01

    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...

  16. The Unknown Role of Mental Health in Global Development

    OpenAIRE

    Bolton, Paul A.

    2014-01-01

    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...

  17. Global health: a successful context for precollege training and advocacy.

    Directory of Open Access Journals (Sweden)

    Ana L Gervassi

    Full Text Available Despite a flourishing biomedical and global health industry too few of Washington state's precollege students are aware of this growing sector and emerging ideas on bacteria, fungi, parasites and viruses. Against the backdrop of numerous reports regarding declining precollege student interest in science, a precollege program was envisioned at Seattle Biomedical Research Institute (as of 2010, Seattle BioMed to increase youth engagement in biomedical research and global health, increase community interest in infectious diseases and mobilize a future biomedical workforce. Since 2005, 169 rising high school juniors have participated in the BioQuest Academy precollege immersion program at Seattle BioMed. Assembling in groups of 12, students conduct laboratory experiments (e.g., anopheline mosquito dissection, gene expression informed tuberculosis drug design and optimizing HIV immunization strategies related to global health alongside practicing scientific mentors, all within the footprint the institute. Laudable short-term impacts of the program include positive influences on student interest in global health (as seen in the students' subsequent school projects and their participation in Seattle BioMed community events, biomedical careers and graduate school (e.g., 16.9% of teens departing 2008-2009 Academy report revised goals of attaining a doctorate rather than a baccalaureate diploma. Long-term, 97% of alumni (2005-2008 are attending postsecondary schools throughout North America; eight graduates have already published scientific articles in peer-reviewed journals and/or presented their scientific data at national and international meetings, and 26 have been retained by Seattle BioMed researchers as compensated technicians and interns. Providing precollege students with structured access to practicing scientists and authentic research environments within the context of advancing global health has been a robust means of both building a future

  18. Power in global health agenda-setting: the role of private funding: Comment on "Knowledge, moral claims and the exercise of power in global health"

    OpenAIRE

    Levine, Ruth E.

    2015-01-01

    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.

  19. Medical intelligence, security and global health: the foundations of a new health agenda.

    Science.gov (United States)

    Bowsher, G; Milner, C; Sullivan, R

    2016-07-01

    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.

  20. Medical intelligence, security and global health: the foundations of a new health agenda.

    Science.gov (United States)

    Bowsher, G; Milner, C; Sullivan, R

    2016-07-01

    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

  1. The United Nations and One Health: the International Health Regulations (2005) and global health security.

    Science.gov (United States)

    Nuttall, I; Miyagishima, K; Roth, C; de La Rocque, S

    2014-08-01

    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

  2. Global AIDS medicines in East African health institutions

    NARCIS (Netherlands)

    A. Hardon; H. Dilger

    2011-01-01

    In this introduction to the special issue, we follow the journey of global AIDS medicines into diverse health facilities in East Africa, which for decades have been subjected to neoliberal reform processes and increasing fragmentation. The introduction explores the multifaceted and multidirectional

  3. Mentoring health researchers globally: Diverse experiences, programmes, challenges and responses.

    Science.gov (United States)

    Cole, Donald C; Johnson, Nancy; Mejia, Raul; McCullough, Hazel; Turcotte-Tremblay, Anne-Marie; Barnoya, Joaquin; Falabella Luco, María Soledad

    2016-10-01

    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

  4. Globalization, Health and Poverty: The role of civil society

    OpenAIRE

    Zafar Mizra

    2001-01-01

    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

  5. New report highlights epidemic of tobacco and global health inequalities

    Science.gov (United States)

    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

  6. Zika Virus: Anatomy of a Global Health Crisis

    OpenAIRE

    Fellner, Chris

    2016-01-01

    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.

  7. Recent patents in plant biotechnology: impact on global health.

    Science.gov (United States)

    Hefferon, Kathleen L

    2012-08-01

    Agricultural biotechnology offers a robust series of tools by which to address global concerns such as food security, crop protection, and fuel/energy requirements. A number of advances made recently in plant molecular biology also have resulted in applications which largely focus on improving global human health. This review describes some of the recent innovations in plant biotechnology that have come to the forefront over the past year. Included are novel techniques by which plants can be improved as platforms for biopharmaceutical protein production, a growing field also referred to as 'molecular pharming'. The metabolic engineering of plants to produce compounds which have additional nutritional benefits is also outlined. The review concludes with a discussion of the future impact that these innovations may have both on global health and on the development of our future intellectual property landscape. PMID:22642820

  8. Recent patents in plant biotechnology: impact on global health.

    Science.gov (United States)

    Hefferon, Kathleen L

    2012-08-01

    Agricultural biotechnology offers a robust series of tools by which to address global concerns such as food security, crop protection, and fuel/energy requirements. A number of advances made recently in plant molecular biology also have resulted in applications which largely focus on improving global human health. This review describes some of the recent innovations in plant biotechnology that have come to the forefront over the past year. Included are novel techniques by which plants can be improved as platforms for biopharmaceutical protein production, a growing field also referred to as 'molecular pharming'. The metabolic engineering of plants to produce compounds which have additional nutritional benefits is also outlined. The review concludes with a discussion of the future impact that these innovations may have both on global health and on the development of our future intellectual property landscape.

  9. Support for the hypothesis that sexual breast stimulation is an ancestral practice and a key to understanding women's health.

    Science.gov (United States)

    Robinson, V C

    2015-12-01

    Women's health is seriously impacted by sexual dysfunction, mental depression, breast cancer, and gynecological cancers. Breast feeding has been found to reduce the risk of in-situ cervical cancer, endometrial cancer of the uterus, ovarian cancer, and breast cancer. This protective effect of breast feeding supports the notion that another functional use of the breast, sexual breast stimulation, promoted by women to incite their sexual arousal and orgasm, is a practice which also reduces the risk of these same cancers, and protects against sexual dysfunction and mental depression. The significance of the practice of breast sex or "sexual breast love" lies with its deeply rooted past in the founding of our species, Homo sapiens. No other species exhibits breast sex, a human cultural activity that is implicated in women's desire, sexual satisfaction, and the development of human sociality. For species females as a whole, nipple stimulation by a partner during sex, over the adult life of a female, has occurred since the inception of H. sapiens, so that the failure to engage in this activity is counter to a species typical practice and endangers women's health. Breast sex results in nipple erection, and may micmic the effects of breast feeding, causing an increase of oxytocin in the body. Breast sex is an enriched type of sexuality that enables love between the sexes and the pair bond. The intimacy of breast sex creates a common ground of sexual knowledge, allowing empathy, cooperation, commitment, and communication. It induces reciprocity and therefore happiness. With breast sex, there is an increase of the positive emotions over the chimpanzees, promoting advanced cognition. Research into whether oxytocin release is caused by stimulation of the breasts in non-lactating women is inconclusive, but cultural studies demonstrate that breast stimulation induces sexual arousal, and research has shown that sexual arousal is associated with oxytocin release. PMID:26386486

  10. Globalisation and health: the need for a global vision.

    Science.gov (United States)

    Schrecker, Ted; Labonté, Ronald; De Vogli, Roberto

    2008-11-01

    The reduction of health inequities is an ethical imperative, according to the WHO Commission on Social Determinants of Health (CSDH). Drawing on detailed multidisciplinary evidence assembled by the Globalization Knowledge Network that supported the CSDH, we define globalisation in mainly economic terms. We consider and reject the presumption that globalisation will yield health benefits as a result of its contribution to rapid economic growth and associated reductions in poverty. Expanding on this point, we describe four disequalising dynamics by which contemporary globalisation causes divergence: the global reorganisation of production and emergence of a global labour-market; the increasing importance of binding trade agreements and processes to resolve disputes; the rapidly increasing mobility of financial capital; and the persistence of debt crises in developing countries. Generic policies designed to reduce health inequities are described with reference to the three Rs of redistribution, regulation, and rights. We conclude with an examination of the interconnected intellectual and institutional challenges to reduction of health inequities that are created by contemporary globalisation. PMID:18994665

  11. Globalisation and health: the need for a global vision.

    Science.gov (United States)

    Schrecker, Ted; Labonté, Ronald; De Vogli, Roberto

    2008-11-01

    The reduction of health inequities is an ethical imperative, according to the WHO Commission on Social Determinants of Health (CSDH). Drawing on detailed multidisciplinary evidence assembled by the Globalization Knowledge Network that supported the CSDH, we define globalisation in mainly economic terms. We consider and reject the presumption that globalisation will yield health benefits as a result of its contribution to rapid economic growth and associated reductions in poverty. Expanding on this point, we describe four disequalising dynamics by which contemporary globalisation causes divergence: the global reorganisation of production and emergence of a global labour-market; the increasing importance of binding trade agreements and processes to resolve disputes; the rapidly increasing mobility of financial capital; and the persistence of debt crises in developing countries. Generic policies designed to reduce health inequities are described with reference to the three Rs of redistribution, regulation, and rights. We conclude with an examination of the interconnected intellectual and institutional challenges to reduction of health inequities that are created by contemporary globalisation.

  12. Depression and health related quality of life in breast cancer patients

    International Nuclear Information System (INIS)

    Objective: To investigate the prevalence of depression in women with breast cancer and relate it to their health-related quality of life. Methods: The cross-sectional study was conducted at the Imam Khomeini Hospital in Iran between January and December 2009, and comprised 60 women with breast cancer with a mean age of 43.8+-47.12 years. In order to assess the health-related quality of life, the study used the parameters of the Iranian version of the Functional Assessment of Cancer Therapy for Breast Cancer. To identify expressive symptoms, the Beck Depression Inventory was used. General linear model regression and SPSS 14 were used to analyse the data. Results: Significant differences in the prevalence of depression between treatment types was found. The presence of depression was significantly correlated with poorer overall health-related quality of life and the four subscales of the protocol. The patients reported statistically significant effects of depression in the overall category (p= 0.001). Participants with depression were more likely to have a poorer overall health-related quality of life, the exception being the social/family well-being subscale. Conclusions: Depression affects health-related quality of life in breast cancer patients. Although further studies are necessary to confirm our findings, but our results emphasise the necessity for better mental health strategies for such patients. (author)

  13. GIS applications to evaluate public health effects of global warming

    Energy Technology Data Exchange (ETDEWEB)

    Regens, J.L.; Hodges, D.G. [Tulane Univ. Medical Center, New Orleans, LA (United States)

    1996-12-31

    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.

  14. Globalization and health care: global justice and the role of physicians.

    Science.gov (United States)

    Toumi, Rabee

    2014-02-01

    In today's globalized world, nations cannot be totally isolated from or indifferent to their neighbors, especially in regards to medicine and health. While globalization has brought prosperity to millions, disparities among nations and nationals are growing raising once again the question of justice. Similarly, while medicine has developed dramatically over the past few decades, health disparities at the global level are staggering. Seemingly, what our humanity could achieve in matters of scientific development is not justly distributed to benefit everyone. In this paper, it will be argued that a global theoretical agreement on principles of justice may prove unattainable; however, a grass-roots change is warranted to change the current situation. The UNESCO Declaration on Bioethics and Human Rights will be considered as a starting point to achieve this change through extracting the main values embedded in its principles. These values, namely, respecting human dignity and tending to human vulnerability with a hospitable attitude, should then be revived in medical practice. Medical education will be one possible venue to achieve that, especially through role models. Future physicians will then become the fervent advocates for a global and just distribution of health care.

  15. Nordic School of Public Health NHV and its legacy in global health

    DEFF Research Database (Denmark)

    Krettek, A.; Eklund Karlsson, Leena; Toan, T. K.;

    2015-01-01

    This article describes the legacy of the Nordic School of Public Health NHV (NHV) in global health. We delineate how this field developed at NHV and describe selected research and research training endeavours with examples from Vietnam and Nepal as well as long-term teaching collaborations such a...... such as BRIMHEALTH (Baltic RIM Partnership for Public HEALTH) in the Baltic countries and Arkhangelsk International School of Public Health in Russia....

  16. Knowledge, Attitude and Health Seeking Behavior of Health Care Professionals regarding Breast and Cervical Cancer at Indian Medical College

    Directory of Open Access Journals (Sweden)

    Rajal Thaker*

    2015-01-01

    Full Text Available Research article Knowledge, Attitude and Health Seeking Behavior of Health Care Professionals regarding Breast and Cervical Cancer at Indian Medical College Rajal Thaker*,Kay Perrin**, Ellen Daley *** ,Cheryl Vamos ****,Pankaj Patel ***** * Associate Professor Obstetrics and Gynaecology, ***** Dean; Smt N H L Municipal Medical College, Ahmedabad 380 006, India. ** Associate Professor, *** Associate Professor, Co-Director, Center for Transdisciplinary Research in Women’s Health (CTR-WH, **** Research Assistant Professor, Associate Director; Center for Transdisciplinary Research in Women’s Health (CTR-WH; University of South Florida College of Public Health, USA Abstract Background: Women’s preventative health is a major public health issue across the globe. From prenatal care to post-menopausal screenings, women’s preventative care covers a wide spectrum of issues and topics. There is limited data on knowledge and practices of screening methods of breast and cervical cancers among female health care professionals in India. This study examines health care professionals’ knowledge and practices regarding breast and cervical cancer screenings in India. Material and Methods After clearance from Institutional Review Board (IRB of University of South Florida (USF and permission from Smt N H L Municipal Medical College (NHLMMC, a cross- sectional interview based survey was conducted amongst female teaching faculty and female consultants of NHLMMC, two affiliated teaching hospitals (Sheth V S General Hospital and Smt S C L General Hospital, and SBB college of Physiotherapy during the year 2010-2011. Conclusion Findings highlight the critical need for education and practice with regards to women’s preventive health care. Practice of Breast Self Examination (BSE and Pap test amongst the health care professionals was quite low; however, those who were 40 year or older were more conscious about their health. Findings also highlight the need for

  17. Sustainable Development Goals for Monitoring Action to Improve Global Health.

    Science.gov (United States)

    Cesario, Sandra K

    2016-01-01

    Women and children compose the largest segment of the more than 1 billion people worldwide who are unable to access needed health care services. To address this and other global health issues, the United Nations brought together world leaders to address growing health inequities, first by establishing the Millennium Development Goals in 2000 and more recently establishing Sustainable Development Goals, which are an intergovernmental set of 17 goals consisting of 169 targets with 304 indicators to measure compliance; they were designed to be applicable to all countries. Goal number 3, "Good Health and Well-Being: Ensure Heathy Lives and Promote Well-Being for All at All Ages," includes targets to improve the health of women and newborns.

  18. Sustainable Development Goals for Monitoring Action to Improve Global Health.

    Science.gov (United States)

    Cesario, Sandra K

    2016-01-01

    Women and children compose the largest segment of the more than 1 billion people worldwide who are unable to access needed health care services. To address this and other global health issues, the United Nations brought together world leaders to address growing health inequities, first by establishing the Millennium Development Goals in 2000 and more recently establishing Sustainable Development Goals, which are an intergovernmental set of 17 goals consisting of 169 targets with 304 indicators to measure compliance; they were designed to be applicable to all countries. Goal number 3, "Good Health and Well-Being: Ensure Heathy Lives and Promote Well-Being for All at All Ages," includes targets to improve the health of women and newborns. PMID:27520607

  19. Promoting health equity: WHO health inequality monitoring at global and national levels

    Directory of Open Access Journals (Sweden)

    Ahmad Reza Hosseinpoor

    2015-09-01

    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.

  20. Global health diplomacy: barriers to inserting health into Canadian foreign policy.

    Science.gov (United States)

    Runnels, Vivien; Labonté, Ronald; Ruckert, Arne

    2014-01-01

    Health opportunities and risks have become increasingly global in both cause and consequence. Governments have been slow to recognise the global dimensions of health, although this is beginning to change. A new concept - global health diplomacy (GHD) - has evolved to describe how health is now being positioned within national foreign policies and entering into regional or multilateral negotiations. Traditionally, health negotiations have been seen as 'low politics' in international affairs: however, attention is now being given to understanding better how health can increase its prominence in foreign policy priorities and multilateral forums. We sought to identify how these efforts were manifested in Canada, with a focus on current barriers to inserting health in foreign policy. We conducted individual interviews with Canadian informants who were well placed through their diplomatic experience and knowledge to address this issue. Barriers identified by the respondents included a lack of content expertise (scientific and technical understanding of health and its practice), insufficient diplomatic expertise (the practice and art of diplomacy, including legal and technical expertise), the limited ways in which health has become framed as a foreign policy issue, funding limitations and cuts for global health, and lack of cross-sectoral policy coordination and coherence, given the important role that non-health foreign policy interests (notably in trade and investment liberalisation) can play in shaping global health outcomes. We conclude with some reflections on how regime change and domestic government ideology can also function as a barrier to GHD, and what this implies for retaining or expanding the placement of health in foreign policy. PMID:25005028

  1. Strengthening global health security capacity--Vietnam demonstration project, 2013.

    Science.gov (United States)

    Tran, Phu Dac; Vu, Long Ngoc; Nguyen, Hien Tran; Phan, Lan Trong; Lowe, Wayne; McConnell, Michelle S; Iademarco, Michael F; Partridge, Jeffrey M; Kile, James C; Do, Trang; Nadol, Patrick J; Bui, Hien; Vu, Diep; Bond, Kyle; Nelson, David B; Anderson, Lauren; Hunt, Kenneth V; Smith, Nicole; Giannone, Paul; Klena, John; Beauvais, Denise; Becknell, Kristi; Tappero, Jordan W; Dowell, Scott F; Rzeszotarski, Peter; Chu, May; Kinkade, Carl

    2014-01-31

    Over the past decade, Vietnam has successfully responded to global health security (GHS) challenges, including domestic elimination of severe acute respiratory syndrome (SARS) and rapid public health responses to human infections with influenza A(H5N1) virus. However, new threats such as Middle East respiratory syndrome coronavirus (MERS-CoV) and influenza A(H7N9) present continued challenges, reinforcing the need to improve the global capacity to prevent, detect, and respond to public health threats. In June 2012, Vietnam, along with many other nations, obtained a 2-year extension for meeting core surveillance and response requirements of the 2005 International Health Regulations (IHR). During March-September 2013, CDC and the Vietnamese Ministry of Health (MoH) collaborated on a GHS demonstration project to improve public health emergency detection and response capacity. The project aimed to demonstrate, in a short period, that enhancements to Vietnam's health system in surveillance and early detection of and response to diseases and outbreaks could contribute to meeting the IHR core capacities, consistent with the Asia Pacific Strategy for Emerging Diseases. Work focused on enhancements to three interrelated priority areas and included achievements in 1) establishing an emergency operations center (EOC) at the General Department of Preventive Medicine with training of personnel for public health emergency management; 2) improving the nationwide laboratory system, including enhanced testing capability for several priority pathogens (i.e., those in Vietnam most likely to contribute to public health emergencies of international concern); and 3) creating an emergency response information systems platform, including a demonstration of real-time reporting capability. Lessons learned included awareness that integrated functions within the health system for GHS require careful planning, stakeholder buy-in, and intradepartmental and interdepartmental coordination and

  2. An Effective Model for Improving Global Health Nursing Competence.

    Science.gov (United States)

    Kang, Sun-Joo

    2016-01-01

    This paper proposed an effective model for improving global health nursing competence among undergraduate students. A descriptive case study was conducted by evaluation of four implemented programs by the author. All programs were conducted with students majoring in nursing and healthcare, where the researcher was a program director, professor, or facilitator. These programs were analyzed in terms of students' needs assessment, program design, and implementation and evaluation factors. The concept and composition of global nursing competence, identified within previous studies, were deemed appropriate in all of our programs. Program composition varied from curricular to extracurricular domains. During the implementation phase, some of the programs included non-Korean students to improve cultural diversity and overcome language barriers. Qualitative and quantitative surveys were conducted to assess program efficacy. Data triangulation from students' reflective journals was examined. Additionally, students' awareness regarding changes within global health nursing, improved critical thinking, cultural understanding, and global leadership skills were investigated pre- and post-program implementation. The importance of identifying students' needs regarding global nursing competence when developing appropriate curricula is discussed.

  3. An Effective Model for Improving Global Health Nursing Competence

    Science.gov (United States)

    Kang, Sun-Joo

    2016-01-01

    This paper proposed an effective model for improving global health nursing competence among undergraduate students. A descriptive case study was conducted by evaluation of four implemented programs by the author. All programs were conducted with students majoring in nursing and healthcare, where the researcher was a program director, professor, or facilitator. These programs were analyzed in terms of students’ needs assessment, program design, and implementation and evaluation factors. The concept and composition of global nursing competence, identified within previous studies, were deemed appropriate in all of our programs. Program composition varied from curricular to extracurricular domains. During the implementation phase, some of the programs included non-Korean students to improve cultural diversity and overcome language barriers. Qualitative and quantitative surveys were conducted to assess program efficacy. Data triangulation from students’ reflective journals was examined. Additionally, students’ awareness regarding changes within global health nursing, improved critical thinking, cultural understanding, and global leadership skills were investigated pre- and post-program implementation. The importance of identifying students’ needs regarding global nursing competence when developing appropriate curricula is discussed. PMID:27679793

  4. An Effective Model for Improving Global Health Nursing Competence

    Science.gov (United States)

    Kang, Sun-Joo

    2016-01-01

    This paper proposed an effective model for improving global health nursing competence among undergraduate students. A descriptive case study was conducted by evaluation of four implemented programs by the author. All programs were conducted with students majoring in nursing and healthcare, where the researcher was a program director, professor, or facilitator. These programs were analyzed in terms of students’ needs assessment, program design, and implementation and evaluation factors. The concept and composition of global nursing competence, identified within previous studies, were deemed appropriate in all of our programs. Program composition varied from curricular to extracurricular domains. During the implementation phase, some of the programs included non-Korean students to improve cultural diversity and overcome language barriers. Qualitative and quantitative surveys were conducted to assess program efficacy. Data triangulation from students’ reflective journals was examined. Additionally, students’ awareness regarding changes within global health nursing, improved critical thinking, cultural understanding, and global leadership skills were investigated pre- and post-program implementation. The importance of identifying students’ needs regarding global nursing competence when developing appropriate curricula is discussed.

  5. An Effective Model for Improving Global Health Nursing Competence.

    Science.gov (United States)

    Kang, Sun-Joo

    2016-01-01

    This paper proposed an effective model for improving global health nursing competence among undergraduate students. A descriptive case study was conducted by evaluation of four implemented programs by the author. All programs were conducted with students majoring in nursing and healthcare, where the researcher was a program director, professor, or facilitator. These programs were analyzed in terms of students' needs assessment, program design, and implementation and evaluation factors. The concept and composition of global nursing competence, identified within previous studies, were deemed appropriate in all of our programs. Program composition varied from curricular to extracurricular domains. During the implementation phase, some of the programs included non-Korean students to improve cultural diversity and overcome language barriers. Qualitative and quantitative surveys were conducted to assess program efficacy. Data triangulation from students' reflective journals was examined. Additionally, students' awareness regarding changes within global health nursing, improved critical thinking, cultural understanding, and global leadership skills were investigated pre- and post-program implementation. The importance of identifying students' needs regarding global nursing competence when developing appropriate curricula is discussed. PMID:27679793

  6. Inequities in the Global Health Workforce: The Greatest Impediment to Health in Sub-Saharan Africa

    OpenAIRE

    Chipayeni Mtonga; Anyangwe, Stella C. E.

    2007-01-01

    Health systems played a key role in the dramatic rise in global life expectancy that occurred during the 20th century, and have continued to contribute enormously to the improvement of the health of most of the world’s population. The health workforce is the backbone of each health system, the lubricant that facilitates the smooth implementation of health action for sustainable socio-economic development. It has been proved beyond reasonable doubt that the density of the health workforce...

  7. The G8 and global health: What now? What next?

    Science.gov (United States)

    Labonte, Ronald; Schrecker, Ted

    2006-01-01

    The policies of the G8 countries (the G7 industrialized countries plus Russia) matter for population health and the determinants of health worldwide. In the years before the 2005 Summit, relevant G7 commitments were more often broken than kept, representing an inadequate response to the scale of health crises in countries outside the industrialized world. The commitments made in 2005 by some G7 countries to increase development assistance to the longstanding target of 0.7% of Gross National Income, and by the G7 as a whole to additional debt cancellation for some developing countries, were welcome and overdue. However, Canada and the United States did not state timetables for reaching the development assistance target, and new conditionalities attached to debt relief may undermine the benefits for population health. Lack of adequate funding for the Global Fund to Fight AIDS, Tuberculosis and Malaria, even after the September 2005 replenishment meeting, is unconscionable; yet even if those funds were provided, additional resources for developing country health systems would be needed. Similarly, widespread agreement on the need for improving market access for developing country exports was not met with any concrete policy response to the "asymmetrical" nature of recent trade liberalization; neither was the need to control the deadly trade in small arms. To respond adequately to global health needs, the G8 will need to adopt an agenda that more fundamentally alters the distribution of economic and political power, within and among nations. PMID:16512325

  8. Global health: A lasting partnership in paediatric surgery

    Directory of Open Access Journals (Sweden)

    Kokila Lakhoo

    2015-01-01

    Full Text Available Background: To emphasise the value of on-going commitment in Global Health Partnerships. Materials and Methods: A hospital link, by invitation, was set up between United Kingdom and Tanzania since 2002. The project involved annual visits with activities ranging from exchange of skill to training health professionals. Furthermore, the programme attracted teaching and research activities. For continuity, there was electronic communication between visits. Results: Six paediatric surgeons are now fully trained with three further in training in Africa. Paediatric surgery services are now separate from adult services. Seven trainee exchanges have taken place with four awarded fellowships/scholarships. Twenty-three clinical projects have been presented internationally resulting in eight international publications. The programme has attracted other health professionals, especially nursing and engineering. The Tropical Health and Education Trust prize was recently achieved for nursing and radiography. National Health Service has benefited from volunteering staff bringing new cost-effective ideas. A fully funded medical student elective programme has been achieved since 2008. Conclusion: Global Health Partnerships are an excellent initiative in establishing specialist services in countries with limited resources. In the future, this will translate into improved patient care as long as it is sustained and valued by long term commitment.

  9. The Thalassemia International Federation: a global public health paradigm

    Directory of Open Access Journals (Sweden)

    Elpidoforos S. Soteriades

    2014-09-01

    Full Text Available Many international organizations are struggling today to coordinate limited economic and human resources in support of governments’ efforts to advance public health around the world. The United Nations and the World Health Organization, along with others play a pivotal role in this global effort. Furthermore, during the past few decades an increasingly higher percentage of global efforts on public health are carried out by specific health initiatives, international projects and non-governmental patient-oriented organizations. The Thalassemia International Federation (TIF is one such organization focusing on the control of thalassemia around the world. The current paper aims at presenting a comprehensive overview of the mission, goals, objectives and activities of this organization. Our ultimate goal is to highlight TIF’s public health paradigm and diffuse its success at an international levels for others to follow. TIF is devoted to disseminating information, knowledge, experience and best practices around the world to empower patients with thalassemia and their relatives, support health professionals providing care to such patients and promote national and international policies, which secure equal access to quality care for all patients with thalassemia.

  10. Breast cancer disparities: Frontline strategies, proceedings of the 7 th annual texas conference on health disparities

    Directory of Open Access Journals (Sweden)

    Marilyne Kpetemey

    2012-01-01

    Full Text Available There are striking disparities in health status, access to health care, and risk factors among racial and ethnic minorities and the general population in Texas. The disparities are multifactorial comprising genetic, sociocultural, and environmental variables. The Texas Center for Health Disparities (TCHD, a NIMHD Center of Excellence (COE, aims to prevent, reduce, and eliminate health disparities in the communities through research, education, and community-based programs. As part of the center′s outreach activities, an annual conference is organized to build awareness and knowledge on health disparities. The overall theme for the 2012 conference was "Battling Breast Cancer Disparities: Frontline Strategies". The scientific program consisted of three sessions: "Breakthroughs in Breast Cancer", "Triple Negative Breast Cancer," and "Hormone Resistant Breast Cancer" featuring different aspects of bench-research from molecular biology, proteomics, and genetics to the clinical aspects such as detection, diagnosis, and finally to community-based approaches. This article summarizes the proceedings of the meeting providing salient strategies and best practices presented by the speakers.

  11. Inequities in the global health workforce: the greatest impediment to health in sub-Saharan Africa.

    Science.gov (United States)

    Anyangwe, Stella C E; Mtonga, Chipayeni

    2007-06-01

    Health systems played a key role in the dramatic rise in global life expectancy that occurred during the 20th century, and have continued to contribute enormously to the improvement of the health of most of the world's population. The health workforce is the backbone of each health system, the lubricant that facilitates the smooth implementation of health action for sustainable socio-economic development. It has been proved beyond reasonable doubt that the density of the health workforce is directly correlated with positive health outcomes. In other words, health workers save lives and improve health. About 59 million people make up the health workforce of paid full-time health workers world-wide. However, enormous gaps remain between the potential of health systems and their actual performance, and there are far too many inequities in the distribution of health workers between countries and within countries. The Americas (mainly USA and Canada) are home to 14% of the world's population, bear only 10% of the world's disease burden, have 37% of the global health workforce and spend about 50% of the world's financial resources for health. Conversely, sub-Saharan Africa, with about 11% of the world's population bears over 24% of the global disease burden, is home to only 3% of the global health workforce, and spends less than 1% of the world's financial resources on health. In most developing countries, the health workforce is concentrated in the major towns and cities, while rural areas can only boast of about 23% and 38% of the country's doctors and nurses respectively. The imbalances exist not only in the total numbers and geographical distribution of health workers, but also in the skills mix of available health workers. WHO estimates that 57 countries world wide have a critical shortage of health workers, equivalent to a global deficit of about 2.4 million doctors, nurses and midwives. Thirty six of these countries are in sub- Saharan Africa. They would need to

  12. Inequities in the Global Health Workforce: The Greatest Impediment to Health in Sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Chipayeni Mtonga

    2007-06-01

    Full Text Available Health systems played a key role in the dramatic rise in global life expectancy that occurred during the 20th century, and have continued to contribute enormously to the improvement of the health of most of the world’s population. The health workforce is the backbone of each health system, the lubricant that facilitates the smooth implementation of health action for sustainable socio-economic development. It has been proved beyond reasonable doubt that the density of the health workforce is directly correlated with positive health outcomes. In other words, health workers save lives and improve health. About 59 million people make up the health workforce of paid full-time health workers world-wide. However, enormous gaps remain between the potential of health systems and their actual performance, and there are far too many inequities in the distribution of health workers between countries and within countries. The Americas (mainly USA and Canada are home to 14% of the world’s population, bear only 10% of the world’s disease burden, have 37% of the global health workforce and spend about 50% of the world’s financial resources for health. Conversely, sub-Saharan Africa, with about 11% of the world’s population bears over 24% of the global disease burden, is home to only 3% of the global health workforce, and spends less than 1% of the world’s financial resources on health. In most developing countries, the health workforce is concentrated in the major towns and cities, while rural areas can only boast of about 23% and 38% of the country’s doctors and nurses respectively. The imbalances exist not only in the total numbers and geographical distribution of health workers, but also in the skills mix of available health workers. WHO estimates that 57 countries world wide have a critical shortage of health workers, equivalent to a global deficit of about 2

  13. Breast

    International Nuclear Information System (INIS)

    Ultrasound is not an efficacious screening modality to detect early-stage breast malignancy in a clinically unremarkable population of women. Computed body tomography is similarly not practical for screening because of slice thickness and partial volume averaging, a higher radiation dose than modern mammography, and the lack of availability of such units for such a high throughput requirement. Nevertheless, these two imaging modalities can be very useful in management to guide the least invasive and efficacious treatment of the patient. X-ray mammography remains the principal imaging modality in the search for breast malignancy, but ultrasound is the single most important second study in the diagnostic evaluation of the breast. The combined use of these techniques and the ability to perform guided aspiration and localization procedures can result in a reduction in the surgical removal of benign cysts and reduction in the amount of tissue volume required if excision becomes necessary

  14. The global health financing revolution: why maternal health is missing the boat.

    Science.gov (United States)

    Ooms, G; Hammonds, R; Richard, F; De Brouwere, V

    2012-01-01

    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? The authors try to answer this question by first examining whether maternal health really missed out with respect to increased global funding and why this may have occurred. They then assess whether the new initiative will make a difference by comparing several elements of the approach taken by HIV/AIDS activist to that of maternal health activists. They suggest that real progress requires international financing, thus pledges must become robust and reliable commitments. They conclude that the absence of an organisational structure in the current initiative means the global maternal health financing revolution will probably not happen.

  15. Globalization of psychiatry - a barrier to mental health development.

    Science.gov (United States)

    Fernando, Suman

    2014-10-01

    The concept of globalization has been applied recently to ways in which mental health may be developed in low- and middle-income countries (LMICs), sometimes referred to as the 'Third World' or developing countries. This paper (1) describes the roots of psychiatry in western culture and its current domination by pharmacological therapies; (2) considers the history of mental health in LMICs, focusing on many being essentially non-western in cultural background with a tradition of using a plurality of systems of care and help for mental health problems, including religious and indigenous systems of medicine; and (3) concludes that in a post-colonial world, mental health development in LMICs should not be left to market forces, which are inevitably manipulated by the interests of multinational corporations mostly located in ex-colonizing countries, especially the pharmaceutical companies.

  16. Toxicological and epidemiological aspects of global warming on human health

    Energy Technology Data Exchange (ETDEWEB)

    Ando, M.; Yamamoto, S.; Wakamatsu, K.; Kawahara, I.; Asanuma, S. [National Inst. Environmental Studies, Tsukuba, Ibaraki (Japan)

    1996-12-31

    Since human activities are responsible for anthropogenic greenhouse gases emissions, climate models project an increase in the global surface temperature of 0.9 C to 4.0 C by 2100. For human health, it is projected that global warming may have a critical effect on the increased periods of severe heat stress in summer throughout the world. Global warming may have a critical issue on the increased periods of severe heat stress that have a potential impact on peroxidative damage in humans and animals. Lipid peroxidative damage is markedly related to GSH peroxidase activities, therefore the study was carried out to analyze the relationship between biochemical adaptability and the lipid peroxidative damage especially intracellular structure, such as mitochondria and endoplasmic reticulum depending on the exposure time of heat stress.

  17. Global climate changes, natural disasters, and travel health risks.

    Science.gov (United States)

    Diaz, James H

    2006-01-01

    Whether the result of cyclical atmospheric changes, anthropogenic activities, or combinations of both, authorities now agree that the earth is warming from a variety of climatic effects, including the cascading effects of greenhouse gas emissions to support human activities. To date, most reports of the public health outcomes of global warming have been anecdotal and retrospective in design and have focused on heat stroke deaths following heat waves, drowning deaths in floods and tsunamis, and mosquito-borne infectious disease outbreaks following tropical storms and cyclones. Accurate predictions of the true public health outcomes of global climate change are confounded by several effect modifiers including human acclimatization and adaptation, the contributions of natural climatic changes, and many conflicting atmospheric models of climate change. Nevertheless, temporal relationships between environmental factors and human health outcomes have been identified and may be used as criteria to judge the causality of associations between the human health outcomes of climate changes and climate-driven natural disasters. Travel medicine physicians are obligated to educate their patients about the known public health outcomes of climate changes, about the disease and injury risk factors their patients may face from climate-spawned natural disasters, and about the best preventive measures to reduce infectious diseases and injuries following natural disasters throughout the world. PMID:17107430

  18. [Global health--the ethical responsibility of the pharmaceutical industry].

    Science.gov (United States)

    Lassen, Lars Christian; Thomsen, Mads Krogsgaard

    2006-09-01

    Health is a global concern and all stakeholders in society--including the pharmaceutical industry--have an ethical responsibility to contribute to promote health. At Novo Nordisk, we have decided to focus on defeating diabetes since this is the area where the company can make the biggest difference. Financial viability goes hand in hand with environmental and social responsibility, not only in the external stakeholder dialogue, but also in the quest for attraction and retention of the best possible staff. Examples of the ethical obligations of a pharmaceutical company are presented, as are classical dilemmas faced by the industry. PMID:16999884

  19. Asbestos case and its current implications for global health

    Directory of Open Access Journals (Sweden)

    Daniela Marsili

    2013-09-01

    Full Text Available Notwithstanding a major body of evidence on the carcinogenicity of all asbestos fibres and a general consensus of the scientific community on the health impact of this agent, asbestos is still produced and used in a large number of countries, thus determining further harm for future generations. Prevention of asbestos-related disease requires international cooperation, transfer of know-how and dissemination of successful procedures in order to contrast asbestos exposure in the frame of a global environmental health approach.

  20. Do medical students want to learn about global health?

    Directory of Open Access Journals (Sweden)

    Anya Göpfert

    2014-05-01

    Full Text Available Background: One objective of the United Nations Global Strategy for Women's and Children's Health relates to ensuring a sufficiently skilled workforce. To prepare future healthcare professionals for their role in the 21st century as members of this workforce, awareness of global health is essential, but few studies have explored student perspectives on such education. The main objectives of this study were to establish the views of medical students on learning about women's and children's health in low-income countries, to identify the nature and extent of learning already experienced, and to assess the demand for such learning. Design: A questionnaire survey was conducted at three meetings of the International Federation of Medical Students Associations (IFMSA. Questionnaires were distributed to 500 participants from 75 countries and 336 medical schools, and 492 usable questionnaires were returned. Data were analysed using SPSS Version 20 and statistical analysis was undertaken using Fisher's exact test. Results: There were 492 questionnaires included in the analysis. Forty-eight per cent of participants were from low–middle income countries and 52% were from high-income countries. Less than half (43% of the respondents had received some teaching on women's and children's health in low-income countries. Teaching received was primarily (96% through lectures in the second year of study. Ninety-one per cent of respondents thought such teaching would be important and stated that group work (66% would be the preferred method. In total, only 14% thought they had received sufficient teaching on global health and on women's and children's health in low-income countries. Conclusions: This study has revealed a high demand among medical students for global health teaching, particularly on women's and children's health in low-income countries. The timing and methods of existing teaching on these topics does not match that desired by medical students. To

  1. Scientometric trends and knowledge maps of global health systems research

    Science.gov (United States)

    2014-01-01

    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 rapidly over the past 20 years. Currently, there are 28,787 research articles published in 3,674 journals that are listed in 140 Web of Science subject categories. The research in this field has mainly focused on public, environmental and occupational health (6,178, 21.46%), health care sciences and services (5,840, 20.29%), and general and internal medicine (3,783, 13.14%). The top 10 journals had published 2,969 (10.31%) articles and received 5,229 local citations and 40,271 global citations. The top 20 authors together contributed 628 papers, which accounted for a 2.18% share in the cumulative worldwide publications. The most productive author was McKee, from the London School of Hygiene & Tropical Medicine, with 48 articles. In addition, USA and American institutions ranked the first in health system research productivity, with high citation times, followed by the UK and Canada. Conclusions HSR is an interdisciplinary area. Organization for Economic Co-operation and Development countries showed they are the leading nations in HSR. Meanwhile, American and Canadian institutions and the World Health Organization play a dominant role in the production, collaboration, and citation of high quality articles. Moreover, health policy and analysis research, health systems and sub-systems research, healthcare and services research, health, epidemiology and economics of communicable and non-communicable diseases, primary care research, health economics and health costs, and pharmacy of

  2. Understanding health systems, health economies and globalization: the need for social science perspectives.

    Science.gov (United States)

    Murray, Susan F; Bisht, Ramila; Baru, Rama; Pitchforth, Emma

    2012-01-01

    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 paper published have also changed, with a growing proportion of empirical studies. A special issue on 'Health systems, health economies and globalization: social science perspectives' is introduced, a collection of contributions written from the vantage points of economics, political science, psychology, sociology, business studies, social policy and research policy. The papers concern a range of issues pertaining to the globalization of healthcare markets and governance and regulation issues. They highlight the important contribution that can be made by the social sciences to this field, and also the practical and methodological challenges implicit in the study of globalization and health.

  3. Statins and breast cancer stage and mortality in the Women’s Health Initiative

    Science.gov (United States)

    Desai, Pinkal; Lehman, Amy; Chlebowski, Rowan T.; Kwan, Marilyn L.; Arun, Monica; Manson, JoAnn E.; Lavasani, Sayeh; Wasswertheil-Smoller, Sylvia; Sarto, Gloria E.; LeBoff, Meryl; Cauley, Jane; Cote, Michele; Beebe-Dimmer, Jennifer; Jay, Allison

    2016-01-01

    Purpose To evaluate the association between statins and breast cancer stage and mortality in the Women’s Health Initiative. Methods The study population included 128,675 post-menopausal women aged 50–79 years, out of which there were 7,883 newly diagnosed cases of in situ (19 %), local (61 %)-, regional (19 %)- and distant (1 %)-stage breast cancer and 401 deaths due to breast cancer after an average of 11.5 (SD = 3.7) years of follow-up. Stage was coded using SEER criteria and was stratified into early (in situ and local)- versus late (regional and distant)-stage disease. Information on statins and other risk factors were collected by self- and interviewer-administered questionnaires. Cause of death was based on medical record review. Multivariable-adjusted hazards ratios (HR) and 95 % confidence intervals (CIs) evaluating the relationship between statin use (at baseline only and in a time-dependent manner) and diagnosis of late-stage breast cancer and breast cancer-specific mortality were computed from Cox proportional hazards analyses after adjusting for appropriate confounders. Results Statins were used by 10,474 women (8 %) at baseline. In the multivariable-adjusted time-dependent model, use of lipophilic statins was associated with a reduction in diagnosis of late-stage breast cancer (HR 0.80, 95 % CI 0.64–0.98, p = 0.035) which was also significant among women with estrogen receptor-positive disease (HR 0.72, 95 % CI 0.56–0.93, p = 0.012). Breast cancer mortality was marginally lower in statin users compared with nonusers (HR 0.59, 95 % CI 0.32–1.06, p = 0.075). Conclusions Prior statin use is associated with lower breast cancer stage at diagnosis. PMID:25736184

  4. The Role of Health Education on Breast Cancer Awareness among University of Calabar Female Undergraduates

    Science.gov (United States)

    Asuquo, I. M.; Olajide, T. E.

    2015-01-01

    The study sought to determine the role of health education on breast cancer awareness among University of Calabar female undergraduates. To achieve the purpose of the study, three hypotheses were formulated to guide the study. Related literature was reviewed, while a survey research design was adopted for the study. Appropriately develop and…

  5. Advancing Social Workers' Responsiveness to Health Disparities: The Case of Breast Cancer Screening

    Science.gov (United States)

    Altpeter, Mary; Mitchell, James F.; Pennell, Joan

    2005-01-01

    This study provides the basis for customizing culturally responsive social work health promotion programs aimed at eliminating breast cancer screening and mortality disparities between white and African American women. Survey data collected from a random sample of 853 women in rural North Carolina were used to explore the impact of psychosocial…

  6. Opportunistic screening actions for breast cancer performed by nurses working in primary health care

    Directory of Open Access Journals (Sweden)

    Débora Cherchiglia de Moraes

    2016-02-01

    Full Text Available Abstract OBJECTIVE To identify opportunistic screening actions for breast cancer performed by nurses working in primary health care units in Ribeirão Preto, São Paulo. METHOD Cross-sectional study with 60 nurses from 28 units, who had been working for at least one year in the public municipal health care network. Data were collected between December 2013 and March 2014, by means of a questionnaire, using descriptive analysis and the software IBM SPSS version 20 and Microsoft Excel 2010. RESULTS The results showed that 71.7% of the participants questioned their female patients as for risk factors for breast cancer, mainly during nursing consultation; 70.0% oriented users about the age to perform clinical breast exam, whereas 30.0% did not due to lack of knowledge and time; 60.0% explained about the age to perform mammogram; 73.3% did not refer patients with suspicious breast exam results to the referral department, citing scheduling as the main obstacle to referral. Educational activities were not performed by 78.3% of participants. CONCLUSION Investment is needed in professional training and management of breast cancer screening.

  7. Health domains for sale: the need for global health Internet governance.

    Science.gov (United States)

    Mackey, Tim Ken; Liang, Bryan A; Kohler, Jillian C; Attaran, Amir

    2014-03-05

    A debate on Internet governance for health, or "eHealth governance", is emerging with the impending award of a new dot-health (.health) generic top-level domain name (gTLD) along with a host of other health-related domains. This development is critical as it will shape the future of the health Internet, allowing largely unrestricted use of .health second-level domain names by future registrants, raising concerns about the potential for privacy, use and marketing of health-related information, credibility of online health content, and potential for Internet fraud and abuse. Yet, prospective .health gTLD applicants do not provide adequate safeguards for use of .health or related domains and have few or no ties to the global health community. If approved, one of these for-profit corporate applicants would effectively control the future of the .health address on the Internet with arguably no active oversight from important international public health stakeholders. This would represent a lost opportunity for the public health, medical, and broader health community in establishing a trusted, transparent and reliable source for health on the Internet. Countries, medical associations, civil society, and consumer advocates have objected to these applications on grounds that they do not meet the public interest. We argue that there is an immediate need for action to postpone awarding of the .health gTLD and other health-related gTLDs to address these concerns and ensure the appropriate development of sound eHealth governance rules, principles, and use. This would support the crucial need of ensuring access to quality and evidence-based sources of health information online, as well as establishing a safe and reliable space on the Internet for health. We believe, if properly governed, .health and other domains could represent such a promise in the future.

  8. Health domains for sale: the need for global health Internet governance.

    Science.gov (United States)

    Mackey, Tim Ken; Liang, Bryan A; Kohler, Jillian C; Attaran, Amir

    2014-01-01

    A debate on Internet governance for health, or "eHealth governance", is emerging with the impending award of a new dot-health (.health) generic top-level domain name (gTLD) along with a host of other health-related domains. This development is critical as it will shape the future of the health Internet, allowing largely unrestricted use of .health second-level domain names by future registrants, raising concerns about the potential for privacy, use and marketing of health-related information, credibility of online health content, and potential for Internet fraud and abuse. Yet, prospective .health gTLD applicants do not provide adequate safeguards for use of .health or related domains and have few or no ties to the global health community. If approved, one of these for-profit corporate applicants would effectively control the future of the .health address on the Internet with arguably no active oversight from important international public health stakeholders. This would represent a lost opportunity for the public health, medical, and broader health community in establishing a trusted, transparent and reliable source for health on the Internet. Countries, medical associations, civil society, and consumer advocates have objected to these applications on grounds that they do not meet the public interest. We argue that there is an immediate need for action to postpone awarding of the .health gTLD and other health-related gTLDs to address these concerns and ensure the appropriate development of sound eHealth governance rules, principles, and use. This would support the crucial need of ensuring access to quality and evidence-based sources of health information online, as well as establishing a safe and reliable space on the Internet for health. We believe, if properly governed, .health and other domains could represent such a promise in the future. PMID:24598602

  9. Child prostitution: global health burden, research needs, and interventions.

    Science.gov (United States)

    Willis, Brian M; Levy, Barry S

    2002-04-20

    Child prostitution is a significant global problem that has yet to receive appropriate medical and public health attention. Worldwide, an estimated 1 million children are forced into prostitution every year and the total number of prostituted children could be as high as 10 million. Inadequate data exist on the health problems faced by prostituted children, who are at high risk of infectious disease, pregnancy, mental illness, substance abuse, and violence. Child prostitution, like other forms of child sexual abuse, is not only a cause of death and high morbidity in millions of children, but also a gross violation of their rights and dignity. In this article we estimate morbidity and mortality among prostituted children, and propose research strategies and interventions to mitigate such health consequences. Our estimates underscore the need for health professionals to collaborate with individuals and organisations that provide direct services to prostituted children. Health professionals can help efforts to prevent child prostitution through identifying contributing factors, recording the magnitude and health effects of the problem, and assisting children who have escaped prostitution. They can also help governments, UN agencies, and non-governmental organisations (NGOs) to implement policies, laws, and programmes to prevent child prostitution and mitigate its effects on children's health. PMID:11978356

  10. Capacity building for global health diplomacy: Thailand's experience of trade and health.

    Science.gov (United States)

    Thaiprayoon, Suriwan; Smith, Richard

    2015-11-01

    A rapid expansion of trade liberalization in Thailand during the 1990s raised a critical question for policy transparency from various stakeholders. Particular attention was paid to a bilateral trade negotiation between Thailand and USA concerned with the impact of the 'Trade-Related Aspects of Intellectual Rights (TRIPS) plus' provisions on access to medicines. Other trade liberalization effects on health were also concerning health actors. In response, a number of interagency committees were established to engage with trade negotiations. In this respect, Thailand is often cited as a positive example of a country that has proactively sought, and achieved, trade and health policy coherence. This article investigates this relationship in more depth and suggests lessons for wider study and application of global health diplomacy (GHD). This study involved semi-structured interviews with 20 people involved in trade-related health negotiations, together with observation of 9 meetings concerning trade-related health issues. Capacity to engage with trade negotiations appears to have been developed by health actors through several stages; starting from the Individual (I) understanding of trade effects on health, through Nodes (N) that establish the mechanisms to enhance health interests, Networks (N) to advocate for health within these negotiations, and an Enabling environment (E) to retain health officials and further strengthen their capacities to deal with trade-related health issues. This INNE model seems to have worked well in Thailand. However, other contextual factors are also significant. This article suggests that, in building capacity in GHD, it is essential to educate both health and non-health actors on global health issues and to use a combination of formal and informal mechanisms to participate in GHD. And in developing sustainable capacity in GHD, it requires long term commitment and strong leadership from both health and non-health sectors. PMID:25339636

  11. Capacity building for global health diplomacy: Thailand's experience of trade and health.

    Science.gov (United States)

    Thaiprayoon, Suriwan; Smith, Richard

    2015-11-01

    A rapid expansion of trade liberalization in Thailand during the 1990s raised a critical question for policy transparency from various stakeholders. Particular attention was paid to a bilateral trade negotiation between Thailand and USA concerned with the impact of the 'Trade-Related Aspects of Intellectual Rights (TRIPS) plus' provisions on access to medicines. Other trade liberalization effects on health were also concerning health actors. In response, a number of interagency committees were established to engage with trade negotiations. In this respect, Thailand is often cited as a positive example of a country that has proactively sought, and achieved, trade and health policy coherence. This article investigates this relationship in more depth and suggests lessons for wider study and application of global health diplomacy (GHD). This study involved semi-structured interviews with 20 people involved in trade-related health negotiations, together with observation of 9 meetings concerning trade-related health issues. Capacity to engage with trade negotiations appears to have been developed by health actors through several stages; starting from the Individual (I) understanding of trade effects on health, through Nodes (N) that establish the mechanisms to enhance health interests, Networks (N) to advocate for health within these negotiations, and an Enabling environment (E) to retain health officials and further strengthen their capacities to deal with trade-related health issues. This INNE model seems to have worked well in Thailand. However, other contextual factors are also significant. This article suggests that, in building capacity in GHD, it is essential to educate both health and non-health actors on global health issues and to use a combination of formal and informal mechanisms to participate in GHD. And in developing sustainable capacity in GHD, it requires long term commitment and strong leadership from both health and non-health sectors.

  12. The Health Deviation of Post-Breast Cancer Lymphedema: Symptom Assessment and Impact on Self-Care Agency

    OpenAIRE

    Armer, Jane M.; Henggeler, Mary H; Brooks, Constance W.; Zagar, Eris A.; Homan, Sherri; Bob R. Stewart

    2008-01-01

    Breast cancer is the leading cancer among women world-wide, affecting 1 of 8 women during their lifetimes. In the US alone, some 2 million breast cancer survivors comprise 20% of all cancer survivors. Conservatively, it is estimated that some 20-40% of all breast cancer survivors will develop the health deviation of lymphedema or treatment-related limb swelling over their lifetimes. This chronic accumulation of protein-rich fluid predisposes to infection, leads to difficulties in fitting clot...

  13. Predictive factors of the survival of women with invasive breast cancer in French Guiana: the burden of health inequalities

    OpenAIRE

    Roué, Tristan; Labbé, Sylvain; Belliardo, Sophie; Plenet, Juliette; Douine, Maylis; Nacher, Mathieu

    2016-01-01

    International audience; This study aimed to compare the relative survival of patients with invasive breast cancer between women from French Guiana (a French territory in South America) and metropolitan France. No study hadever compared survival of breast cancer on the basis of immigrant status in France. Our study underlined that access to care for migrants is challenging whichwgenerates health inequalities. Background The prognosis of breast cancer in French Guiana is worse than in France wi...

  14. Current initiatives in One Health: consolidating the One Health Global Network.

    Science.gov (United States)

    Vandersmissen, A; Welburn, S C

    2014-08-01

    The Global Response to Avian Influenza has led to a longer-term One Health movement, which addresses risks, including zoonoses, at the human-animal- environment interface, and requires the development of innovative partnerships at the political, institutional and technical levels. One Health is a sustainable and rational option when the cumulative effects of health hazards on food and economic security are considered, but demands long-term financial investment. Projections of growth in the demand for livestock production and consumption in Asia and Africa also call for effective One Health responses. However, an effective response also requires validated evidence of the socio-economic value that the One Health approach can provide. Implementing the One Health approach depends on forging strong links between human and animal health services, the environment and public policy. The authors present a list of some of the national and transnational partnerships established since 2006. Political support, good governance and effective policies and networks are crucial building blocks for One Health sustainability. The Global Response to Avian Influenza was initially established under the joint leadership of the European Union, the United States and the United Nations System Influenza Coordination Office. Since then it has supported numerous initiatives, including the World Health Organization (WHO)/Food and Agriculture Organization of the United Nations (FAO)/World Organisation for Animal Health (OIE) Global Early Warning System (GLEWS). Indeed, the Global Response to Avian Influenza paved the way for an unprecedented WHO/FAO/OIE tripartite partnership, which promoted the integration of foodborne, neglected zoonotic and tropical diseases within the One Health movement and led to the tripartite High-Level Technical Meeting of 2011 in Mexico. The One Health Global Network, which began as a proposition at an Expert Consultation in Winnipeg, Canada, in 2009, is now a reality

  15. Current initiatives in One Health: consolidating the One Health Global Network.

    Science.gov (United States)

    Vandersmissen, A; Welburn, S C

    2014-08-01

    The Global Response to Avian Influenza has led to a longer-term One Health movement, which addresses risks, including zoonoses, at the human-animal- environment interface, and requires the development of innovative partnerships at the political, institutional and technical levels. One Health is a sustainable and rational option when the cumulative effects of health hazards on food and economic security are considered, but demands long-term financial investment. Projections of growth in the demand for livestock production and consumption in Asia and Africa also call for effective One Health responses. However, an effective response also requires validated evidence of the socio-economic value that the One Health approach can provide. Implementing the One Health approach depends on forging strong links between human and animal health services, the environment and public policy. The authors present a list of some of the national and transnational partnerships established since 2006. Political support, good governance and effective policies and networks are crucial building blocks for One Health sustainability. The Global Response to Avian Influenza was initially established under the joint leadership of the European Union, the United States and the United Nations System Influenza Coordination Office. Since then it has supported numerous initiatives, including the World Health Organization (WHO)/Food and Agriculture Organization of the United Nations (FAO)/World Organisation for Animal Health (OIE) Global Early Warning System (GLEWS). Indeed, the Global Response to Avian Influenza paved the way for an unprecedented WHO/FAO/OIE tripartite partnership, which promoted the integration of foodborne, neglected zoonotic and tropical diseases within the One Health movement and led to the tripartite High-Level Technical Meeting of 2011 in Mexico. The One Health Global Network, which began as a proposition at an Expert Consultation in Winnipeg, Canada, in 2009, is now a reality

  16. The Role of Health Literacy in Reducing Negative Perceptions of Breast Health and Treatment Among Uninsured Primary Care Patients.

    Science.gov (United States)

    Kamimura, Akiko; Chernenko, Alla; Nourian, Maziar M; Aguilera, Guadalupe; Assasnik, Nushean; Ashby, Jeanie

    2016-08-01

    Breast cancer is the second leading cause of cancer death among women in the United States. There are disparities in breast cancer mortality by race/ethnicity and socio-economic factors. Health literacy may have an impact on breast health disparities. In addition, learning about people's perceptions of breast health and treatment is important to understand why some do not seek a mammogram or treatment for breast cancer. The purpose of this study is to examine the association between health literacy and negative perceptions of breast health and treatment among female uninsured primary care patients utilizing a free clinic for underserved populations. Women utilizing a free clinic who were aged 40 years or older (N = 276) participated in a self-administered survey from September to December in 2015. Higher levels of health literacy were associated with lower levels of negative perceptions of breast cancer and treatment. Non-US born English speakers reported higher levels of negative perceptions of breast cancer and treatment than US born English speakers and Spanish speakers. While there were no significant differences in health literacy among the groups, US born English speakers were less likely to have had a mammogram in the past 3 years compared with non-US born English speakers and Spanish speakers. Future research should consider where women are obtaining information and how the method of exposure shapes their attitudes towards breast health and in turn, their rates of examinations for breast cancer. Cultural factors may be also important determinants of the perceptions and need to be further examined. PMID:26856733

  17. On sitting and doing: ethnography as action in global health.

    Science.gov (United States)

    Pigg, Stacy Leigh

    2013-12-01

    Contemporary discussions within the arenas of medical anthropology and global health are often restricted by the driving imperatives to "do something" about a particular health problem. Drawing on ethnographic fieldwork conducted in Nepal in 1997, which sought to follow the translation of AIDS prevention policies into local awareness, this paper addresses the need to revitalize theories of ethnography for an understanding of global health goals. The Nepal example underscores how the path toward decisions is never entirely clear, nor is it always obvious who benefits or loses from different approaches, even as public health discourse seeks to set a strict agenda around what the problem is and what should be done about it. Ethnography shows that definitions of what matters as well as understandings of why certain things matter are formulated from specific social locations. The paper therefore advocates for a practice of patient ethnographic "sitting" as a means to understanding, as a form of critical reflexivity, and as a diagnostic of the politics of relevance.

  18. Health insurance mediation of the Mexican American non-Hispanic white disparity on early breast cancer diagnosis

    OpenAIRE

    Haji-Jama, Sundus; Gorey, Kevin M; Luginaah, Isaac N.; Balagurusamy, Madhan K; Hamm, Caroline

    2013-01-01

    We examined health insurance mediation of the Mexican American (MA) non-Hispanic white (NHW) disparity on early breast cancer diagnosis. Based on social capital and barrio advantage theories, we hypothesized a 3-way ethnicity by poverty by health insurance interaction, that is, that 2-way poverty by health insurance interaction effects would differ between ethnic groups. We secondarily analyzed registry data for 303 MA and 3,611 NHW women diagnosed with breast cancer between 1996 and 2000 who...

  19. Improving Breast Cancer Control via the Use of Community Health Workers in South Africa: A Critical Review

    OpenAIRE

    Wadler, Brianna M.; Judge, Christine M; Marianne Prout; Allen, Jennifer D.; Geller, Alan C.

    2011-01-01

    Breast cancer is a growing concern in low- and middle-income countries (LMCs). We explore community health worker (CHW) programs and describe their potential use in LMCs. We use South Africa as an example of how CHWs could improve access to breast health care because of its middle-income status, existing cancer centers, and history of CHW programs. CHWs could assume three main roles along the cancer control continuum: health education, screening, and patient navigation. By raising awareness a...

  20. Knowledge, attitudes and practice of breast cancer screening among female health workers in a Nigerian urban city

    OpenAIRE

    Omuemu Vivian O; Akhigbe Adenike O

    2009-01-01

    Abstract Background Late presentation has been observed as the hallmark of breast cancer in Nigerian women and an earlier onset has been reported in this population. This study was designed to assess the awareness of female health workers about risk factors and screening methods for early detection of breast cancer. Methods A cross-sectional descriptive study was carried out among female health workers in the two major government health institutions in Benin City, Edo State capital in Nigeria...

  1. Global disparities in health and human rights: a critical commentary.

    Science.gov (United States)

    Benatar, S R

    1998-02-01

    Widening disparities in health and human rights at a global level represent the dark side of progress associated with escalation of economic and military exploitation and exponential population growth in the 20th century. Even the most basic universal human rights cannot be achieved for all under these circumstances. The goal of improved population health will be similarly elusive while medical care is commodified and exploited for commercial gain in the marketplace. Recognition of the powerful forces that polarize our world and commitment to reversing them are essential for the achievement of human rights for all, for the improvement of public health, and for the peaceful progress required to protect the "rational self-interest" of the most privileged people on earth against the escalation of war, disease, and other destructive forces arising from widespread poverty and ecological degradation.

  2. The limits of global health diplomacy: Taiwan's observer status at the world health assembly.

    Science.gov (United States)

    Herington, Jonathan; Lee, Kelley

    2014-01-01

    In 2009, health authorities from Taiwan (under the name "Chinese Taipei")a formally attended the 62nd World Health Assembly (WHA) of the World Health Organization as observers, marking the country's participation for the first time since 1972. The long process of negotiating this breakthrough has been cited as an example of successful global health diplomacy. This paper analyses this negotiation process, drawing on government documents, formal representations from both sides of the Taiwan Strait, and key informant interviews. The actors and their motivations, along with the forums, practices and outcomes of the negotiation process, are detailed. While it is argued that non-traditional diplomatic action was important in establishing the case for Taiwan's inclusion at the WHA, traditional concerns regarding Taiwanese sovereignty and diplomatic representation ultimately played a decisive role. The persistent influence of these traditional diplomatic questions illustrates the limits of global health diplomacy. PMID:25270977

  3. Breast lift

    Science.gov (United States)

    ... One breast that is larger than the other (asymmetry of the breasts) Uneven position of the nipples ... to achieve this important distinction for online health information and services. Learn more about A.D.A. ...

  4. Breast cancer

    Science.gov (United States)

    ... perform breast self-exams each month. However, the importance of self-exams for detecting breast cancer is ... M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health ...

  5. From Advocacy to Action in Global Adolescent Health.

    Science.gov (United States)

    Patton, George C; Sawyer, Susan M; Ross, David A; Viner, Russell M; Santelli, John S

    2016-10-01

    In May 2016, The Lancet published a report titled, "Our Future: A Lancet Commission on Adolescent Health and Wellbeing," the culmination of three years of work from a geographically diverse interdisciplinary group. The report argued that healthy growth across adolescence and young adulthood shapes life course and intergenerational trajectories so that health investments yield a "triple dividend." With current global interest in adolescent health at an unprecedented level, it outlines three next steps to advance from advocacy to effective action: (1) there is a pressing need for comprehensive and integrated strategies, inclusive of, but extending beyond, sexual and reproductive health, and HIV; (2) interventions should address both adolescent health service coverage and determinants of health that lie in sectors such as education, justice, transport, and industry and employment, as well as families and local communities; and (3) scale-up of responses will require not only investments in country-level capacities for measuring need and responding with evidence-based practice but also the establishment of processes for accountability and meaningful youth engagement.

  6. Improving Breast Cancer Control via the Use of Community Health Workers in South Africa: A Critical Review

    Directory of Open Access Journals (Sweden)

    Brianna M. Wadler

    2011-01-01

    Full Text Available Breast cancer is a growing concern in low- and middle-income countries (LMCs. We explore community health worker (CHW programs and describe their potential use in LMCs. We use South Africa as an example of how CHWs could improve access to breast health care because of its middle-income status, existing cancer centers, and history of CHW programs. CHWs could assume three main roles along the cancer control continuum: health education, screening, and patient navigation. By raising awareness about breast cancer through education, women are more likely to undergo screening. Many more women can be screened resulting in earlier-stage disease if CHWs are trained to perform clinical breast exams. As patient navigators, CHWs can guide women through the screening and treatment process. It is suggested that these roles be combined within existing CHW programs to maximize resources and improve breast cancer outcomes in LMCs.

  7. Global health ethics: an introduction to prominent theories and relevant topics.

    Science.gov (United States)

    Stapleton, Greg; Schröder-Bäck, Peter; Laaser, Ulrich; Meershoek, Agnes; Popa, Daniela

    2014-01-01

    Global health ethics is a relatively new term that is used to conceptualize the process of applying moral value to health issues that are typically characterized by a global level effect or require action coordinated at a global level. It is important to acknowledge that this account of global health ethics takes a predominantly geographic approach and may infer that the subject relates primarily to macro-level health phenomena. However, global health ethics could alternatively be thought of as another branch of health ethics. It may then relate to specific topics in themselves, which might also include micro-level health phenomena. In its broadest sense, global health ethics is a normative project that is best characterized by the challenge of developing common values and universal norms for responding to global health threats. Consequently, many subjects fall within its scope. Whilst several accounts of global health ethics have been conceptualized in the literature, a concise demarcation of the paradigm is still needed. Through means of a literature review, this paper presents a two-part introduction to global health ethics. First, the framework of 'borrowed' ethics that currently form the core of global health ethics is discussed in relation to two essential ethical considerations: 1) what is the moral significance of health and 2) what is the moral significance of boundaries? Second, a selection of exemplar ethical topics is presented to illustrate the range of topics within global health ethics.

  8. Management Matters: A Leverage Point for Health Systems Strengthening in Global Health.

    Science.gov (United States)

    Bradley, Elizabeth H; Taylor, Lauren A; Cuellar, Carlos J

    2015-07-01

    Despite a renewed focus in the field of global health on strengthening health systems, inadequate attention has been directed to a key ingredient of high-performing health systems: management. We aimed to develop the argument that management - defined here as the process of achieving predetermined objectives through human, financial, and technical resources - is a cross-cutting function necessary for success in all World Health Organization (WHO) building blocks of health systems strengthening. Management within health systems is particularly critical in low-income settings where the efficient use of scarce resources is paramount to attaining health goals. More generally, investments in management capacity may be viewed as a key leverage point in grand strategy, as strong management enables the achievement of large ends with limited means. We also sought to delineate a set of core competencies and identify key roles to be targeted for management capacity building efforts. Several effective examples of management interventions have been described in the research literature. Together, the existing evidence underscores the importance of country ownership of management capacity building efforts, which often challenge the status quo and thus need country leadership to sustain despite inevitable friction. The literature also recognizes that management capacity efforts, as a key ingredient of effective systems change, take time to embed, as new protocols and ways of working become habitual and integrated as standard operating procedures. Despite these challenges, the field of health management as part of global health system strengthening efforts holds promise as a fundamental leverage point for achieving health system performance goals with existing human, technical, and financial resources. The evidence base consistently supports the role of management in performance improvement but would benefit from additional research with improved methodological rigor and longer

  9. Management Matters: A Leverage Point for Health Systems Strengthening in Global Health.

    Science.gov (United States)

    Bradley, Elizabeth H; Taylor, Lauren A; Cuellar, Carlos J

    2015-05-20

    Despite a renewed focus in the field of global health on strengthening health systems, inadequate attention has been directed to a key ingredient of high-performing health systems: management. We aimed to develop the argument that management - defined here as the process of achieving predetermined objectives through human, financial, and technical resources - is a cross-cutting function necessary for success in all World Health Organization (WHO) building blocks of health systems strengthening. Management within health systems is particularly critical in low-income settings where the efficient use of scarce resources is paramount to attaining health goals. More generally, investments in management capacity may be viewed as a key leverage point in grand strategy, as strong management enables the achievement of large ends with limited means. We also sought to delineate a set of core competencies and identify key roles to be targeted for management capacity building efforts. Several effective examples of management interventions have been described in the research literature. Together, the existing evidence underscores the importance of country ownership of management capacity building efforts, which often challenge the status quo and thus need country leadership to sustain despite inevitable friction. The literature also recognizes that management capacity efforts, as a key ingredient of effective systems change, take time to embed, as new protocols and ways of working become habitual and integrated as standard operating procedures. Despite these challenges, the field of health management as part of global health system strengthening efforts holds promise as a fundamental leverage point for achieving health system performance goals with existing human, technical, and financial resources. The evidence base consistently supports the role of management in performance improvement but would benefit from additional research with improved methodological rigor and longer

  10. Management Matters: A Leverage Point for Health Systems Strengthening in Global Health

    Directory of Open Access Journals (Sweden)

    Elizabeth H. Bradley

    2015-07-01

    Full Text Available Despite a renewed focus in the field of global health on strengthening health systems, inadequate attention has been directed to a key ingredient of high-performing health systems: management. We aimed to develop the argument that management – defined here as the process of achieving predetermined objectives through human, financial, and technical resources – is a cross-cutting function necessary for success in all World Health Organization (WHO building blocks of health systems strengthening. Management within health systems is particularly critical in low-income settings where the efficient use of scarce resources is paramount to attaining health goals. More generally, investments in management capacity may be viewed as a key leverage point in grand strategy, as strong management enables the achievement of large ends with limited means. We also sought to delineate a set of core competencies and identify key roles to be targeted for management capacity building efforts. Several effective examples of management interventions have been described in the research literature. Together, the existing evidence underscores the importance of country ownership of management capacity building efforts, which often challenge the status quo and thus need country leadership to sustain despite inevitable friction. The literature also recognizes that management capacity efforts, as a key ingredient of effective systems change, take time to embed, as new protocols and ways of working become habitual and integrated as standard operating procedures. Despite these challenges, the field of health management as part of global health system strengthening efforts holds promise as a fundamental leverage point for achieving health system performance goals with existing human, technical, and financial resources. The evidence base consistently supports the role of management in performance improvement but would benefit from additional research with improved

  11. Virtual reality and women's health: a breast biopsy system.

    Science.gov (United States)

    Vahora, F; Temkin, B; Marcy, W; Gorman, P J; Krummel, T M; Heinrichs, W L

    1999-01-01

    Minimally invasive procedures are becoming much more common in surgical practice because of the many advantages for patient comfort and convenience, and improved surgical access. However some of the major problems leading to occasional surgical errors with this minimal access method are restricted vision, limited sense of touch, difficulties in identification in 3D space of the position of the instrument tips, and their handling during delicate, short-distance movements toward the surgical target area. These factors emphasize the need for computer simulated training in surgical manipulations and procedures in preparation for conducting them in patients. The key new feature of our proof-of-concept training simulator is a preventive mechanism that serves at least two functions. As the surgical target (or a critical structure) is approached, a haptically generated preventive force forewarns the surgeon, making it possible to abort those maneuvers that may lead to adverse results. By announcing a potential collision of a virtual instrument tip with a surgical target, the time used for searching for the target is shortened, and the haptic signal minimizes the potential of tissue damage. This real-time, interactive, virtual reality based, haptic breast biopsy-training simulation is a PC/NT based multitasking, multithreading system. It is based upon an advanced force feedback device. The system monitors and indirectly guides the surgeon's movements, while providing high fidelity visual and force feedback cues as the area of surgical interest is approached. Our first application is with human breast. PMID:10538389

  12. Global Health Governance and Global Power: A Critical Commentary on the Lancet-University of Oslo Commission Report.

    Science.gov (United States)

    Gill, Stephen; Benatar, Solomon

    2016-01-01

    The Lancet-University of Oslo Commission Report on Global Governance for Health provides an insightful analysis of the global health inequalities that result from transnational activities consequent on what the authors call contemporary "global social norms." Our critique is that the analysis and suggested reforms to prevailing institutions and practices are confined within the perspective of the dominant-although unsustainable and inequitable-market-oriented, neoliberal development model of global capitalism. Consequently, the report both elides critical discussion of many key forms of material and political power under conditions of neoliberal development and governance that shape the nature and priorities of the global governance for health, and fails to point to the extent of changes required to sustainably improve global health. We propose that an alternative concept of progress-one grounded in history, political economy, and ecologically responsible health ethics-is sorely needed to better address challenges of global health governance in the new millennium. This might be premised on global solidarity and the "development of sustainability." We argue that the prevailing market civilization model that lies at the heart of global capitalism is being, and will further need to be, contested to avoid contradictions and dislocations associated with the commodification and privatization of health. PMID:26883181

  13. Urinary melatonin concentration and the risk of breast cancer in Nurses' Health Study II.

    Science.gov (United States)

    Brown, Susan B; Hankinson, Susan E; Eliassen, A Heather; Reeves, Katherine W; Qian, Jing; Arcaro, Kathleen F; Wegrzyn, Lani R; Willett, Walter C; Schernhammer, Eva S

    2015-02-01

    Experimental and epidemiologic data support a protective role for melatonin in breast cancer etiology, yet studies in premenopausal women are scarce. In a case-control study nested within the Nurses' Health Study II cohort, we measured the concentration of melatonin's major urinary metabolite, 6-sulfatoxymelatonin (aMT6s), in urine samples collected between 1996 and 1999 among 600 breast cancer cases and 786 matched controls. Cases were predominantly premenopausal women who were diagnosed with incident breast cancer after urine collection and before June 1, 2007. Using multivariable conditional logistic regression, we computed odds ratios and 95% confidence intervals. Melatonin levels were not significantly associated with total breast cancer risk (for the fourth (top) quartile (Q4) of aMT6s vs. the first (bottom) quartile (Q1), odds ratio (OR) = 0.91, 95% confidence interval (CI): 0.64, 1.28; Ptrend = 0.38) or risk of invasive or in situ breast cancer. Findings did not vary by body mass index, smoking status, menopausal status, or time between urine collection and diagnosis (all Pinteraction values ≥ 0.12). For example, the odds ratio for total breast cancer among women with ≤5 years between urine collection and diagnosis was 0.74 (Q4 vs. Q1; 95% CI: 0.45, 1.20; Ptrend = 0.09), and it was 1.20 (Q4 vs. Q1; 95% CI: 0.72, 1.98; Ptrend = 0.70) for women with >5 years. Our data do not support an overall association between urinary melatonin levels and breast cancer risk. PMID:25587174

  14. Tailored Lay Health Worker Intervention Improves Breast Cancer Screening Outcomes in Non-Adherent Korean-American Women

    Science.gov (United States)

    Han, Hae-Ra; Lee, H.; Kim, M. T.; Kim, K. B.

    2009-01-01

    Despite rapidly increasing incidence rates of breast cancer, recent immigrants such as Korean-American (KA) women report disproportionately lower utilization of screening tests compared with other ethnic groups. Early screening of breast cancer for this population may be greatly facilitated by indigenous lay health workers (LHWs). We conducted an…

  15. Breast cancer and urinary biomarkers of polycyclic aromatic hydrocarbon and oxidative stress in the Shanghai Women’s Health Study

    OpenAIRE

    Lee, Kyoung-Ho; Shu, Xiao-Ou; Gao, Yu-Tang; Ji, Bu-Tian; YANG, Gong; Blair, Aaron; Rothman, Nathaniel; Zheng, Wei; Chow, Wong-Ho; Kang, Daehee

    2010-01-01

    Polycyclic aromatic hydrocarbon (PAH) exposures and oxidative stress from such and other exposures have been associated with breast cancer in some studies. To further evaluate the role of PAH metabolites and oxidative stress on the development of breast cancer, we conducted a nested case-control study in the Shanghai Women’s Health Study (SWHS).

  16. Breast cancer and quality of life: medical information extraction from health forums.

    Science.gov (United States)

    Opitz, Thomas; Aze, Jérome; Bringay, Sandra; Joutard, Cyrille; Lavergne, Christian; Mollevi, Caroline

    2014-01-01

    Internet health forums are a rich textual resource with content generated through free exchanges among patients and, in certain cases, health professionals. We tackle the problem of retrieving clinically relevant information from such forums, with relevant topics being defined from clinical auto-questionnaires. Texts in forums are largely unstructured and noisy, calling for adapted preprocessing and query methods. We minimize the number of false negatives in queries by using a synonym tool to achieve query expansion of initial topic keywords. To avoid false positives, we propose a new measure based on a statistical comparison of frequent co-occurrences in a large reference corpus (Web) to keep only relevant expansions. Our work is motivated by a study of breast cancer patients' health-related quality of life (QoL). We consider topics defined from a breast-cancer specific QoL-questionnaire. We quantify and structure occurrences in posts of a specialized French forum and outline important future developments.

  17. Global Health and Social Media: Using Instagram and Twitter in an Open Online Class for Global Service-Learning Projects

    Science.gov (United States)

    Messner, Marcus; Medina-Messner, Vivian; Guidry, Jeanine

    2016-01-01

    Course description: An undergraduate open online course used Facebook, Twitter, and Instagram to explore global health issues and designed social media campaigns for nonprofit clients. Social media platforms were used as teaching as well as learning platforms to allow students to explore their real life applications in global health contexts.

  18. Career opportunities in global health: A snapshot of the current employment landscape

    Directory of Open Access Journals (Sweden)

    Quentin Eichbaum

    2015-06-01

    Full Text Available The demand for global health opportunities over the past decade has fueled a brisk increase in the number of global health training programs, yet the employment opportunities for graduates of such programs remain poorly understood. This pilot survey presents the characteristics of 178 global health employment opportunities available during two specific periods in 2014.

  19. Career opportunities in global health: A snapshot of the current employment landscape

    OpenAIRE

    Quentin Eichbaum; Adam Hoverman; William Cherniak; Jessica Evert; Elahe Nezami; Thomas Hall

    2015-01-01

    The demand for global health opportunities over the past decade has fueled a brisk increase in the number of global health training programs, yet the employment opportunities for graduates of such programs remain poorly understood. This pilot survey presents the characteristics of 178 global health employment opportunities available during two specific periods in 2014.

  20. Effect of health belief model and health promotion model on breast cancer early diagnosis behavior: a systematic review.

    Science.gov (United States)

    Ersin, Fatma; Bahar, Zuhal

    2011-01-01

    Breast cancer is an important public health problem on the grounds that it is frequently seen and it is a fatal disease. The objective of this systematic analysis is to indicate the effects of interventions performed by nurses by using the Health Belief Model (HBM) and Health Promotion Model (HPM) on the breast cancer early diagnosis behaviors and on the components of the Health Belief Model and Health Promotion Model. The reveiw was created in line with the Centre for Reviews and Dissemination guide dated 2009 (CRD) and developed by York University National Institute of Health Researches. Review was conducted by using PUBMED, OVID, EBSCO and COCHRANE databases. Six hundred seventy eight studies (PUBMED: 236, OVID: 162, EBSCO: 175, COCHRANE:105) were found in total at the end of the review. Abstracts and full texts of these six hundred seventy eight studies were evaluated in terms of inclusion and exclusion criteria and 9 studies were determined to meet the criteria. Samplings of the studies varied between ninety four and one thousand six hundred fifty five. It was detected in the studies that educations provided by taking the theories as basis became effective on the breast cancer early diagnosis behaviors. When the literature is examined, it is observed that the experimental researches which compare the concepts of Health Belief Model (HBM) and Health Promotion Model (HPM) preoperatively and postoperatively and show the effect of these concepts on education and are conducted by nurses are limited in number. Randomized controlled studies which compare HBM and HPM concepts preoperatively and postoperatively and show the efficiency of the interventions can be useful in evaluating the efficiency of the interventions.

  1. Vaginal Dryness and Beyond: The Sexual Health Needs of Women Diagnosed With Metastatic Breast Cancer.

    Science.gov (United States)

    McClelland, Sara I; Holland, Kathryn J; Griggs, Jennifer J

    2015-01-01

    While research on the sexual health of women with early stage cancer has grown extensively over the past decade, markedly less information is available to support the sexual health needs of women diagnosed with advanced breast cancer. Semistructured interviews were conducted with 32 women diagnosed with metastatic breast cancer (ages 35 to 77) about questions they had concerning their sexual health and intimate relationships. All participants were recruited from a comprehensive cancer center at a large Midwestern university. Three themes were examined: the role of sexual activity and intimate touch in participants' lives, unmet information needs about sexual health, and communication with medical providers about sexual concerns. Findings indicated that sexual activities with partners were important; however, participants worried about their own physical limitations and reported frequent physical (e.g., bone pains) and vaginal pain associated with intercourse. When women raised concerns about these issues in clinical settings, medical providers often focused exclusively on vaginal lubricants, which did not address the entirety of women's problems or concerns. In addition, women diagnosed with metastatic breast cancer reported needing additional resources about specialized vaginal lubricants, nonpenetrative and nongenitally focused sex, and sexual positions that did not compromise their physical health yet still provided pleasure.

  2. The World Health Organization Global Health Emergency Workforce: What Role Will the United States Play?

    Science.gov (United States)

    Burkle, Frederick M

    2016-08-01

    During the May 2016 World Health Assembly of 194 member states, the World Health Organization (WHO) announced the process of developing and launching emergency medical teams as a critical component of the global health workforce concept. Over 64 countries have either launched or are in the development stages of vetting accredited teams, both international and national, to provide surge support to national health systems through WHO Regional Organizations and the delivery of emergency clinical care to sudden-onset disasters and outbreak-affected populations. To date, the United States has not yet committed to adopting the emergency medical team concept in funding and registering an international field hospital level team. This article discusses future options available for health-related nongovernmental organizations and the required educational and training requirements for health care provider accreditation. (Disaster Med Public Health Preparedness. 2016;10:531-535). PMID:27364937

  3. DEPRESSIVE SYMPTOMS AFTER BREAST CANCER SURGERY: RELATIONSHIPS WITH GLOBAL, CANCER-RELATED, AND LIFE EVENT STRESS

    OpenAIRE

    Golden-Kreutz, Deanna M.; Andersen, Barbara L.

    2004-01-01

    For women with breast cancer, rates of depression are the third highest of any cancer diagnostic group. Stress, defined as life events or perceptions of stress, is associated with depressive symptoms. However, little is known about the relationships between different types of stress and these symptoms in women with breast cancer. This relationship was tested in 210 women assessed after initial surgical treatment for regional breast cancer. Using Hierarchical Multiple Regression, three types o...

  4. Health effects of global warming: Problems in assessment

    Energy Technology Data Exchange (ETDEWEB)

    Longstreth, J.

    1993-06-01

    Global warming is likely to result in a variety of environmental effects ranging from impacts on species diversity, changes in population size in flora and fauna, increases in sea level and possible impacts on the primary productivity of the sea. Potential impacts on human health and welfare have included possible increases in heat related mortality, changes in the distribution of disease vectors, and possible impacts on respiratory diseases including hayfever and asthma. Most of the focus thus far is on effects which are directly related to increases in temperature, e.g., heat stress or perhaps one step removed, e.g., changes in vector distribution. Some of the more severe impacts are likely to be much less direct, e.g., increases in migration due to agricultural failure following prolonged droughts. This paper discusses two possible approaches to the study of these less-direct impacts of global warming and presents information from on-going research using each of these approaches.

  5. Vaccinations for Neuroinfectious Disease: A Global Health Priority.

    Science.gov (United States)

    Leibovitch, Emily C; Jacobson, Steven

    2016-07-01

    Vaccines for neuroinfectious diseases are becoming an ever-increasing global health priority, as neurologic manifestations and sequelae from existing and emerging central nervous system infections account for significant worldwide morbidity and mortality. The prevention of neurotropic infections can be achieved through globally coordinated vaccination campaigns, which have successfully eradicated nonzoonotic agents such as the variola viruses and, hopefully soon, poliovirus. This review discusses vaccines that are currently available or under development for zoonotic flaviviruses and alphaviruses, including Japanese and tick-borne encephalitis, yellow fever, West Nile, dengue, Zika, encephalitic equine viruses, and chikungunya. Also discussed are nonzoonotic agents, including measles and human herpesviruses, as well as select bacterial, fungal, and protozoal pathogens. While therapeutic vaccines will be required to treat a multitude of ongoing infections of the nervous system, the ideal vaccination strategy is pre-exposure vaccination, with the ultimate goals of minimizing disease associated with zoonotic viruses and the total eradication of nonzoonotic agents. PMID:27365085

  6. Health effects of global warming: Problems in assessment

    International Nuclear Information System (INIS)

    Global warming is likely to result in a variety of environmental effects ranging from impacts on species diversity, changes in population size in flora and fauna, increases in sea level and possible impacts on the primary productivity of the sea. Potential impacts on human health and welfare have included possible increases in heat related mortality, changes in the distribution of disease vectors, and possible impacts on respiratory diseases including hayfever and asthma. Most of the focus thus far is on effects which are directly related to increases in temperature, e.g., heat stress or perhaps one step removed, e.g., changes in vector distribution. Some of the more severe impacts are likely to be much less direct, e.g., increases in migration due to agricultural failure following prolonged droughts. This paper discusses two possible approaches to the study of these less-direct impacts of global warming and presents information from on-going research using each of these approaches

  7. Counterfeit drugs as a global threat to health

    Directory of Open Access Journals (Sweden)

    Goločorbin-Kon Svetlana

    2011-01-01

    Full Text Available According to the World Health Organization, counterfeit medicines are medicines that are mislabeled deliberately and fraudulently regarding their identity and/or source. All kinds of medicines have been counterfeited, both branded and generic ones. Counterfeit medicines may include products containing correct or wrong ingredients; without active or with insufficiently or over-active ingredients, or with fake packaging. Many sources of information have been explored, including reports from the national medicine regulatory authorities, pharmaceutical companies and literature data. Since the time counterfeit drugs first appeared, they have become more sophisticated and more difficult to be detected. The World Health Organization estimate is that up to 1% of medicines available in the developed world are likely to be counterfeit. This figure rises to 10% globally, although in some developing countries it is 50%. The World Health Organization estimate is that 50% of medicines available via the internet are counterfeit. The knowledge about counterfeit drugs should be used to educate students of pharmacy and medicine, health professionals and patients. The most important players in campaign against counterfeit medicines are health professionals. Pharmacists and doctors should stay vigilant and report suspicious products, and consider counterfeits as a possible cause of adverse reactions or therapeutic failure. Patients should inform their pharmacists and doctors if they suspect any irregularity concerning their medication, if they experience side effects or a decrease in beneficial effect. The crucial step in the prevention of counterfeit medicines is to get supplied from reliable sources, i.e. licensed pharmacies.

  8. Environmental health risk assessment and management for global climate change

    Science.gov (United States)

    Carter, P.

    2014-12-01

    This environmental health risk assessment and management approach for atmospheric greenhouse gas (GHG) pollution is based almost entirely on IPCC AR5 (2014) content, but the IPCC does not make recommendations. Large climate model uncertainties may be large environmental health risks. In accordance with environmental health risk management, we use the standard (IPCC-endorsed) formula of risk as the product of magnitude times probability, with an extremely high standard of precaution. Atmospheric GHG pollution, causing global warming, climate change and ocean acidification, is increasing as fast as ever. Time is of the essence to inform and make recommendations to governments and the public. While the 2ºC target is the only formally agreed-upon policy limit, for the most vulnerable nations, a 1.5ºC limit is being considered by the UNFCCC Secretariat. The Climate Action Network International (2014), representing civil society, recommends that the 1.5ºC limit be kept open and that emissions decline from 2015. James Hansen et al (2013) have argued that 1ºC is the danger limit. Taking into account committed global warming, its millennial duration, multiple large sources of amplifying climate feedbacks and multiple adverse impacts of global warming and climate change on crops, and population health impacts, all the IPCC AR5 scenarios carry extreme environmental health risks to large human populations and to the future of humanity as a whole. Our risk consideration finds that 2ºC carries high risks of many catastrophic impacts, that 1.5ºC carries high risks of many disastrous impacts, and that 1ºC is the danger limit. IPCC AR4 (2007) showed that emissions must be reversed by 2015 for a 2ºC warming limit. For the IPCC AR5 only the best-case scenario RCP2.6, is projected to stay under 2ºC by 2100 but the upper range is just above 2ºC. It calls for emissions to decline by 2020. We recommend that for catastrophic environmental health risk aversion, emissions decline

  9. One Health: The global challenge of epidemic and endemic leishmaniasis

    Directory of Open Access Journals (Sweden)

    Day Michael J

    2011-10-01

    Full Text Available 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 leishmaniasis is a perfect example of a small companion animal disease for which prevention and control might abolish or decrease the suffering of canine and human patients, and which aligns well with the One Health approach. In this review we discuss how surveillance for leishmaniases is undertaken globally through the control of anthroponootic visceral leishmaniasis (AVL and zoonotic visceral leishmaniasis (ZVL. The ZVL epidemic has been managed to date by the culling of infected dogs, treatment of human cases and control of the sandfly vector by insecticidal treatment of human homes and the canine reservoir. Recently, preventive vaccination of dogs in Brazil has led to reduction in the incidence of the canine and human disease. Vaccination permits greater dog owner compliance with control measures than a culling programme. Another advance in disease control in Africa is provided by a surveillance programme that combines remote satellite sensing, ecological modelling, vector surveillance and geo-spatial mapping of the distribution of vectors and of the animal-to-animal or animal-to-human pathogen transmission. This coordinated programme generates advisory notices and alerts on emerging infectious disease outbreaks that may impede or avoid the spreading of visceral leishmaniasis to new areas of the planet as a consequence of global warming.

  10. Health-related quality of life in early breast cancer

    DEFF Research Database (Denmark)

    Grønvold, Mogens

    2010-01-01

    of life (HRQL) research. HRQL research deals with subjective experiences and raises challenging, scientific questions. Therefore, much attention was directed towards methodological issues in this clinically motivated project. The study was a prospective, longitudinal, questionnaire-based investigation...... in cases where medical decision-making involves complex trade-offs between treatment efficiency and HRQL issues is needed. Contrary to expectations, the analyses showed that fatigue and emotional function predicted the risk of recurrence and death independently of biological and clinical prognostic...... variables. In multivariate Cox regression analyses patients who were more fatigued or had poorer emotional function had a worse prognosis. These results are consistent with one small study, but are inconsistent with five similar studies in patients with primary breast cancer, which found...

  11. The gender perspective in climate change and global health

    Directory of Open Access Journals (Sweden)

    Birgitta Evengård

    2010-12-01

    Full Text Available Background: Population health is a primary goal of sustainable development. United Nations international conferences like the Beijing Platform for Action have highlighted the key role of women in ensuring sustainable development. In the context of climate change, women are affected the most while they display knowledge and skills to orient themselves toward climate adaptation activities within their societies. Objective: To investigate how the gender perspective is addressed as an issue in research and policy-making concerning climate change and global health. Methods: A broad literature search was undertaken using the databases Pubmed and Web of Science to explore the terms ‘climate change,’ ‘health,’ ‘gender,’ and ‘policy.’ Climate change and health-related policy documents of the World Health Organization (WHO and National Communications and National Adaptation Programs of Action reports submitted to the United Nations Framework Convention on Climate Change of selected countries were studied. Assessment guidelines to review these reports were developed from this study's viewpoint. Results: The database search results showed almost no articles when the four terms were searched together. The WHO documents lacked a gender perspective in their approach and future recommendations on climate policies. The reviewed UN reports were also neutral to gender perspective except one of the studied documents. Conclusion: Despite recognizing the differential effects of climate change on health of women and men as a consequence of complex social contexts and adaptive capacities, the study finds gender to be an underrepresented or non-existing variable both in research and studied policy documents in the field of climate change and health.

  12. Health literacy and breast cancer screening among Mexican American women in South Texas.

    Science.gov (United States)

    Pagán, José A; Brown, Cynthia J; Asch, David A; Armstrong, Katrina; Bastida, Elena; Guerra, Carmen

    2012-03-01

    Breast cancer is the main cause of cancer deaths for Hispanic women. This study analyzes the role of functional health literacy on mammography screening behavior and adherence of Hispanic women. Survey data from 722 Mexican American women age 40 and over residing in the Lower Rio Grande Valley of Texas in 2008 were used to estimate logistic regression models to assess the role of functional health literacy on mammography screening behavior and adherence. About 51% of survey respondents had a functional health literacy level deemed as inadequate or marginally functional. After adjusting for other factors, women with adequate health literacy levels were more likely to report to have ever had a mammogram (odds ratio [OR] = 2.92; 95% confidence interval [CI] = 1.62-5.28), to have had a mammogram within the last 2 years (OR = 1.70; 95% CI = 1.14-2.53) or to have had one within the last year (OR = 2.30; 95% CI = 1.54-3.43), compared to women with inadequate or marginally adequate functional health literacy levels. Inadequate/marginal functional health literacy is strongly associated with lower mammography screening. Large improvements in breast cancer control in this population may come from either basic advances in health literacy or by tailored approaches to help women with low literacy navigate local health care systems.

  13. Health workforce responses to global health initiatives funding: a comparison of Malawi and Zambia

    Directory of Open Access Journals (Sweden)

    Brugha Ruairí

    2010-08-01

    Full Text Available Abstract Background Shortages of health workers are obstacles to utilising global health initiative (GHI funds effectively in Africa. This paper reports and analyses two countries' health workforce responses during a period of large increases in GHI funds. Methods Health facility record reviews were conducted in 52 facilities in Malawi and 39 facilities in Zambia in 2006/07 and 2008; quarterly totals from the last quarter of 2005 to the first quarter of 2008 inclusive in Malawi; and annual totals for 2004 to 2007 inclusive in Zambia. Topic-guided interviews were conducted with facility and district managers in both countries, and with health workers in Malawi. Results Facility data confirm significant scale-up in HIV/AIDS service delivery in both countries. In Malawi, this was supported by a large increase in lower trained cadres and only a modest increase in clinical staff numbers. Routine outpatient workload fell in urban facilities, in rural health centres and in facilities not providing antiretroviral treatment (ART, while it increased at district hospitals and in facilities providing ART. In Zambia, total staff and clinical staff numbers stagnated between 2004 and 2007. In rural areas, outpatient workload, which was higher than at urban facilities, increased further. Key informants described the effects of increased workloads in both countries and attributed staff migration from public health facilities to non-government facilities in Zambia to PEPFAR. Conclusions Malawi, which received large levels of GHI funding from only the Global Fund, managed to increase facility staff across all levels of the health system: urban, district and rural health facilities, supported by task-shifting to lower trained staff. The more complex GHI arena in Zambia, where both Global Fund and PEPFAR provided large levels of support, may have undermined a coordinated national workforce response to addressing health worker shortages, leading to a less effective

  14. A global health problem caused by arsenic from natural sources

    Energy Technology Data Exchange (ETDEWEB)

    Ng, J.C.; Wang, J.P.; Shraim, A. [University of Queensland, Brisbane, Qld. (Australia). National Research Center for Environmental Toxicology

    2003-09-01

    Arsenic is a carcinogen to both humans and animals. Arsenicals have been associated with cancers of the skin, lung, and bladder. Clinical manifestations of chronic arsenic poisoning include non-cancer end point of hyper- and hypo-pigmentation, keratosis, hypertension, cardiovascular diseases and diabetes. Epidemiological evidence indicates that arsenic concentration exceeding 50 {mu}g l{sup -1} in the drinking water is not public health protective. The current WHO recommended guideline value for arsenic in drinking water is 10 {mu}g l{sup -1}, whereas many developing countries are still having a value of 50 {mu}g 1{sup -1}. It has been estimated that tens of millions of people are at risk exposing to excessive levels of arsenic from both contaminated water and arsenic-bearing coal from natural sources. The global health implication and possible intervention strategies were also discussed in this review article.

  15. The 2003 Australian Breast Health Survey: survey design and preliminary results

    Directory of Open Access Journals (Sweden)

    Favelle Simone

    2008-01-01

    Full Text Available Abstract Background The Breast Health Surveys, conducted by the National Breast Cancer Centre (NBCC in 1996 and 2003, are designed to gain insight into the knowledge, attitudes and behaviours of a nationally representative sample of Australian women on issues relevant to breast cancer. In this article, we focus on major aspects of the design and present results on respondents' knowledge about mammographic screening. Methods The 2003 BHS surveyed English-speaking Australian women aged 30–69 without a history of breast cancer using computer-assisted telephone interviewing. Questions covered the following themes: knowledge and perceptions about incidence, mortality and risk; knowledge and behaviour regarding early detection, symptoms and diagnosis; mammographic screening; treatment; and accessibility and availability of information and services. Respondents were selected using a complex sample design involving stratification. Sample weights against Australian population benchmarks were used in all statistical analyses. Means and proportions for the entire population and by age group and area of residence were calculated. Statistical tests were conducted using a level of significance of 0.01. Results Of the 3,144 respondents who consented to being interviewed, 138 (4.4% had a previous diagnosis of breast cancer and were excluded leaving 3,006 completed interviews eligible for analysis. A majority of respondents (61.1% reported ever having had a mammogram and 29.1% identified mammography as being the best way of finding breast cancer. A majority of women (85.9% had heard of the BreastScreen Australia (BSA program, the national mammographic screening program providing free biennial screening mammograms, with 94.5% believing that BSA attendance was available regardless of the presence or absence of symptoms. There have been substantial gains in women's knowledge about mammographic screening over the seven years between the two surveys. Conclusion The

  16. [Occurrence and relevance to health of persistent organic substances and phthalates in breast milk].

    Science.gov (United States)

    Fromme, H; Raab, U; Fürst, P; Vieth, B; Völkel, W; Albrecht, M; Schwegler, U

    2011-01-01

    The aim of this study is to give an overview of the concentrations of persistent organic pollutants like the polychlorinated dibenzo- P-dioxins (PCDD), polychlorinated dibenzofurans (PCDF), polychlorinated biphenyls (PCB), polybrominated diphenyl ether (PBDE), perfluorinated compounds (PFC) and of phthalates in breast milk. On the basis of median and 95 (th) percentile values an "average" and a "high" intake were calculated for a 3-month-old infant exclusively breast-fed. Moreover, the actual daily intake was compared with tolerable daily intakes (TDI) recommended by scientific institutions. On this basis, we found an "average" ("high") daily intake of 70 (140) pg TEQ/kg body weight (b. w.) for PCDD/F and dioxin-like PCB (dl-PCB), 10 (20) ng/kg b. w. for PFOS (perfluorooctanesulfonate), 20 (50) ng/kg b. w. for PFOA (perfluorooctanoate), 1.7 (7.5) ng/kg b. w. for BDE 47, and 0.6 (2.1) ng/kg b. w. for BDE 99. For di-2-ethylhexyl phthalate (DEHP) and di- N-butyl phthalate (DnBP) an "average" and "high" intake of 400 ng/kg b. w. and 2,000 ng/kg b. w. and of 100 and 500 ng/kg b.w. were assumed, respectively. For all of these substances we found a daily intake via breast milk below the TDI, established on a livelong basis. On contrary, the daily intake for the sum of the PCDD/F and dl-PCB considerably exceeded the recommended TDI value. Even with regard to the "high" daily intake values the share of PBDE, PFC, and phthalates on the TDI was only in the lower percentage. Scientific organisations assume that an exceeding of the PCDD/F and dl-PCB intake in relation to the TDI value is acceptable only on the basis of the still declining levels in breast milk and the fact that this high exposure only occurs during some months of the entire life when breast milk is consumed. On the basis of the recent exposure situation mothers can exclusively breast-feed their infants for 6 months without any hesitation. The well established health benefits for mothers and infants when

  17. From global campaign to global commitment: The World Health Assembly's Resolution on epilepsy.

    Science.gov (United States)

    Covanis, Athanasios; Guekht, Alla; Li, Shichuo; Secco, Mary; Shakir, Raad; Perucca, Emilio

    2015-11-01

    Tuesday May 26, 2015, will be remembered as an historic day in the fight against epilepsy. On that date, the World Health Assembly approved unanimously the Resolution on the "Global Burden of Epilepsy and the Need for Coordinated Action at the Country Level to Address its Health, Social and Public Knowledge Implications," which urges Member States to implement a coordinated action against epilepsy and its consequences. This event, which comes almost 20 years after the establishment of the Global Campaign against Epilepsy, is another landmark in the longstanding collaboration among the World Health Organization (WHO), the International League Against Epilepsy (ILAE), and the International Bureau for Epilepsy (IBE) in addressing the needs of people with epilepsy. It also acted as a catalyst for other professional societies, including the World Federation of Neurology (WFN), to join forces in promoting a common action against epilepsy. The Resolution did not happen by chance, but came at the end of a long journey that involved the hard and tireless work of many dedicated individuals around the globe.

  18. The relationship between body esteem and hope and mental health in breast cancer patients after mastectomy

    Directory of Open Access Journals (Sweden)

    Mohammad Heidari

    2015-01-01

    Full Text Available Background: Breast cancer and its treatment, including mastectomy, can cause feelings of mutilation, depreciation in the value of the body, reduction in attractiveness, and lead to mental disorders and hopelessness. Objective: The present study aimed to determine the relationship between appreciating the body, hope and mental health in women with breast cancer after mastectomy. Materials and Methods: This study was a descriptive study of 100 breast cancer patients who had undergone mastectomy and referred to the Sayed Al-Shohada Medical Center in Isfahan, Iran. The subjects were selected by convenient sampling. Data gathering tools were the Body Esteem Scale (BES, Herth Hope Index (HHI, and Symptom Checklist 25 (SCL-25 mental health questionnaire. Data analysis was performed using SPSS software. Results: Most of the patients had low body esteem. There was a significant direct linear relationship between body esteem and hope and mental health. This relationship was stronger between valuing the body and hope. Conclusion: Body esteem has a significant linear relationship with hope and mental health.

  19. Health Care Access and Breast Cancer Screening Among Latinas Along the California–Mexican Border

    Science.gov (United States)

    Malcarne, Vanessa L.; Foster-Fishman, Pennie G.; Davidson, William S.; Mumman, Manpreet K.; Riley, Natasha; Sadler, Georgia R.

    2013-01-01

    Latinas are more likely to exhibit late stage breast cancers at the time of diagnosis and have lower survival rates compared to white women. A contributing factor may be that Latinas have lower rates of mammography screening. This study was guided by the Behavioral Model of Health Services Use to examine factors associated with mammography screening utilization among middle-aged Latinas. An academic–community health center partnership collected data from community-based sample of 208 Latinas 40 years and older in the San Diego County who completed measures assessing psychosocial factors, health care access, and recent mammography screening. Results showed that 84.6 % had ever had a mammogram and 76.2 % of women had received a mammogram in the past 2 years. Characteristics associated with mammography screening adherence included a lower acculturation (OR 3.663) a recent physician visit in the past year (OR 6.304), and a greater confidence in filling out medical forms (OR 1.743), adjusting for covariates. Results demonstrate that an annual physical examination was the strongest predictor of recent breast cancer screening. Findings suggest that in this community, improving access to care among English-speaking Latinas and addressing health literacy issues are essential for promoting breast cancer screening utilization. PMID:24150421

  20. Health care access and breast cancer screening among Latinas along the California-Mexican border.

    Science.gov (United States)

    Castañeda, Sheila F; Malcarne, Vanessa L; Foster-Fishman, Pennie G; Davidson, William S; Mumman, Manpreet K; Riley, Natasha; Sadler, Georgia R

    2014-08-01

    Latinas are more likely to exhibit late stage breast cancers at the time of diagnosis and have lower survival rates compared to white women. A contributing factor may be that Latinas have lower rates of mammography screening. This study was guided by the Behavioral Model of Health Services Use to examine factors associated with mammography screening utilization among middle-aged Latinas. An academic-community health center partnership collected data from community-based sample of 208 Latinas 40 years and older in the San Diego County who completed measures assessing psychosocial factors, health care access, and recent mammography screening. Results showed that 84.6 % had ever had a mammogram and 76.2 % of women had received a mammogram in the past 2 years. Characteristics associated with mammography screening adherence included a lower acculturation (OR 3.663) a recent physician visit in the past year (OR 6.304), and a greater confidence in filling out medical forms (OR 1.743), adjusting for covariates. Results demonstrate that an annual physical examination was the strongest predictor of recent breast cancer screening. Findings suggest that in this community, improving access to care among English-speaking Latinas and addressing health literacy issues are essential for promoting breast cancer screening utilization.

  1. A model to optimize public health care and downstage breast cancer in limited-resource populations in southern Brazil. (Porto Alegre Breast Health Intervention Cohort

    Directory of Open Access Journals (Sweden)

    Giacomazzi Juliana

    2009-03-01

    Full Text Available Abstract Background Breast cancer (BC is a major public health problem, with rising incidence in many regions of the globe. Although mortality has recently dropped in developed countries, death rates are still increasing in some developing countries, as seen in Brazil. Among the reasons for this phenomenon are the lack of structured screening programs, a long waiting period between diagnosis and treatment, and lack of access to health services for a large proportion of the Brazilian population. Methods and design Since 2004, an intervention study in a cohort of women in Southern Brazil, denominated Porto Alegre Breast Health Intervention Cohort, is being conducted in order to test the effectiveness and cost-effectiveness of a model for BC early detection and treatment. In this study, over 4,000 women from underserved communities aged 40 to 69 years are being screened annually with mammography and clinical breast examination performed by a multidisciplinary team, which also involves nutritional counseling and genetic cancer risk assessment. Risk factors for BC development are also being evaluated. Active search of participants by lay community health workers is one of the major features of our program. The accrual of new participants was concluded in 2006 and the study will last for 10 years. The main goal of the study is to demonstrate significant downstaging of BC in an underserved population through proper screening, attaining a higher rate of early-stage BC diagnoses than usually seen in women diagnosed in the Brazilian Public Health System. Preliminary results show a very high BC incidence in this population (117 cases per 100,000 women per year, despite a low prevalence of classical risk factors. Discussion This study will allow us to test a model of BC early diagnosis and treatment and evaluate its cost-effectiveness in a developing country where the mortality associated with this disease is very high. Also, it might contribute to the

  2. Roundtable discussion on the Third Global Symposium on Health Systems Research

    DEFF Research Database (Denmark)

    Lazarus, Jeffrey V; Balabanova, Dina; Safreed-Harmon, Kelly;

    2015-01-01

    Health systems experts from around the world discuss why they were meeting at the Third Global Symposium on Health Systems Research while people were dying of Ebola in West Africa.......Health systems experts from around the world discuss why they were meeting at the Third Global Symposium on Health Systems Research while people were dying of Ebola in West Africa....

  3. Addressing the “Global Health Tax” and “Wild Cards”: Practical Challenges to Building Academic Careers in Global Health

    Science.gov (United States)

    Dhillon, Ranu

    2016-01-01

    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

  4. Globalized public health.” A transdisciplinary comprehensive framework for analyzing contemporary globalization’s influences on the field of public health

    OpenAIRE

    Lapaige, Véronique

    2009-01-01

    The current phase of globalization represents a “double-edged sword” challenge facing public health practitioners and health policy makers. The first “edge” throws light on two constructs in the field of public health: global health (formerly international health) and globalized public health. The second “edge” is that of global governance, and raises the question, “how can we construct public health regulations that adequately respond to both global and local complexities related to the two ...

  5. Global health and development: conceptualizing health between economic growth and environmental sustainability.

    Science.gov (United States)

    Borowy, Iris

    2013-07-01

    After World War II, health was firmly integrated into the discourse about national development. Transition theories portrayed health improvements as part of an overall development pattern based on economic growth as modeled by the recent history of industrialization in high-income countries. In the 1970s, an increasing awareness of the environmental degradation caused by industrialization challenged the conventional model of development. Gradually, it became clear that health improvements depended on poverty-reduction strategies including industrialization. Industrialization, in turn, risked aggravating environmental degradation with its negative effects on public health. Thus, public health in low-income countries threatened to suffer from lack of economic development as well as from the results of global economic development. Similarly, demands of developing countries risked being trapped between calls for global wealth redistribution, a political impossibility, and calls for unrestricted material development, which, in a world of finite land, water, air, energy, and resources, increasingly looked like a physical impossibility, too. Various international bodies, including the WHO, the Brundtland Commission, and the World Bank, tried to capture the problem and solution strategies in development theories. Broadly conceived, two models have emerged: a "localist model," which analyzes national health data and advocates growth policies with a strong focus on poverty reduction, and a "globalist" model, based on global health data, which calls for growth optimization, rather than maximization. Both models have focused on different types of health burdens and have received support from different institutions. In a nutshell, the health discourse epitomized a larger controversy regarding competing visions of development.

  6. Conjugated Equine Estrogens and Breast Cancer Risk in the Women’s Health Initiative Clinical Trial and Observational Study

    OpenAIRE

    Prentice, Ross L.; Chlebowski, Rowan T.; Stefanick, Marcia L.; Joann E Manson; Langer, Robert D; Pettinger, Mary; Hendrix, Susan L.; Hubbell, F Allan; Kooperberg, Charles; Lewis H Kuller; Lane, Dorothy S.; McTiernan, Anne; O’Sullivan, Mary Jo; Rossouw, Jacques E; Anderson, Garnet L.

    2008-01-01

    The Women’s Health Initiative randomized controlled trial found a trend (p = 0.09) toward a lower breast cancer risk among women assigned to daily 0.625-mg conjugated equine estrogens (CEEs) compared with placebo, in contrast to an observational literature that mostly reports a moderate increase in risk with estrogenalone preparations. In 1993–2004 at 40 US clinical centers, breast cancer hazard ratio estimates for this CEE regimen were compared between the Women’s Health Initiative clinical ...

  7. Health-Related Quality of Life in Breast Cancer Patients with Lymphedema Who Survived More than One Year after Surgery

    OpenAIRE

    Lee, So Hyun; Min, Yu-Sun; Park, Ho Yong; Jung, Tae-Du

    2012-01-01

    Purpose To identify the influence of lymphedema on health-related quality of life (HRQOL) more than 1 year after breast cancer surgery. Methods Ninety-six breast cancer patients who survived more than 1 year after surgery and 104 members of the general population were recruited. Patients were divided into 2 groups according to the presence of lymphedema. HRQOL was evaluated with the Short-Form 36-Item Health Survey. Results There were no statistically significant differences in any scales bet...

  8. Global, regional and local health impacts of civil aviation emissions

    Science.gov (United States)

    Yim, Steve H. L.; Lee, Gideon L.; Lee, In Hwan; Allroggen, Florian; Ashok, Akshay; Caiazzo, Fabio; Eastham, Sebastian D.; Malina, Robert; Barrett, Steven R. H.

    2015-03-01

    Aviation emissions impact surface air quality at multiple scales—from near-airport pollution peaks associated with airport landing and take off (LTO) emissions, to intercontinental pollution attributable to aircraft cruise emissions. Previous studies have quantified aviation’s air quality impacts around a specific airport, in a specific region, or at the global scale. However, no study has assessed the air quality and human health impacts of aviation, capturing effects on all aforementioned scales. This study uses a multi-scale modeling approach to quantify and monetize the air quality impact of civil aviation emissions, approximating effects of aircraft plume dynamics-related local dispersion (˜1 km), near-airport dispersion (˜10 km), regional (˜1000 km) and global (˜10 000 km) scale chemistry and transport. We use concentration-response functions to estimate premature deaths due to population exposure to aviation-attributable PM2.5 and ozone, finding that aviation emissions cause ˜16 000 (90% CI: 8300-24 000) premature deaths per year. Of these, LTO emissions contribute a quarter. Our estimate shows that premature deaths due to long-term exposure to aviation-attributable PM2.5 and O3 lead to costs of ˜21 bn per year. We compare these costs to other societal costs of aviation and find that they are on the same order of magnitude as global aviation-attributable climate costs, and one order of magnitude larger than aviation-attributable accident and noise costs.

  9. Direct health effects of global warming in Japan and China

    Energy Technology Data Exchange (ETDEWEB)

    Ando, M.; Yamamoto, S. [National Institute for Environmental Studies, Ibaraki (Japan); Tamura, K. [National Institute for Minamata Disease, Kumamoto (Japan)] [and others

    1997-12-31

    Combustion of fossil fuels and industrial and agricultural activities are resulting in greater emissions of some greenhouse gases such as carbon dioxide and methane into the atmosphere, therefore contributing to global warming. Using general circulation models, it is estimated that surface temperatures in temperate regions will rise 1 to 3 degrees C during the next 100 years. Because global warming may increase the frequency and length of high temperatures during hot summer months, various health risks caused by heat stress have been studied. According to our epidemiological survey, the incidence of heat-related illness was significantly correlated to hot environments in Tokyo, Japan and in Nanjing and Wuhan, China. The epidemiological results also showed that the incidence of heat-related morbidity and mortality in the elderly increased very rapidly in summer. The regression analysis on these data showed that the number of heat stroke patients increased exponentially when the mean daily temperature and maximum daily temperature exceeded 27C and 32C in Tokyo and 31C and 36C in Wuhan and Nanjing, respectively. Since the incidence of heat-related morbidity and mortality has been shown to increase as a result of exposure to long periods of hot summer temperatures, it is important to determine to what extent the incidence of heat stress-related morbidity and mortality will be affected as a result of global warming.

  10. [Globalization, the Camisea Project and the Matsigenkas health].

    Science.gov (United States)

    Torres-Slimming, Paola

    2010-09-01

    Globalization has been the consequence of an important opening of the economies, achieved through the reduction in the obstacles to commerce, elimination of the capital controls and exchange restrictions. The impact of the Camisea Project in the Peruvian economy has aroused great interest and controversy with respect to the future social and economic national impact, and especially, in the Matsigenka population, located in the 88 and 56 lots, where gas extraction is being done. The area of Camisea gas exploitation offers the challenge of a complex sanitary problem, not only because of the impacts and risks produced by the hidrocarbon exploitation, but also due to a legacy of economical and sanitary precariousness that has accumulated from other times. At the same time, this area offers the opportunity to rethink the public health system according to the indigenous reality. It is necessary to take action in the social determinants of inequity and poverty in order to reach the positive effects the globalization can have in health, ensuring the interests of developing countries and vulnerable populations. PMID:21152741

  11. Possible human health impacts of a global warming

    Energy Technology Data Exchange (ETDEWEB)

    Nichols, M.C.; Kalkstein, L.S.; Cheng, S. [Univ. of Delaware, Newark, DE (United States). Dept. of Geography

    1995-03-01

    Some ways in which a global warming may affect human health are discussed. Research is presented which explores the hypothesis that heat stress-induced mortality may increase substantially in the event of a worldwide temperature increase. Two procedures are applied to four disparate nations: the US, Canada, China and Egypt. Results indicate that significant increases in heat-related mortality are likely to occur, particularly in developing nations. Factors which might help to mitigate these increases, such as acclimatization and air conditioning, are also examined. Another human health impact of a global warming is the likely spread of certain vector-borne diseases into areas of the world where they do not currently exist. Two of these, onchocerciasis and malaria, have been chosen for a detailed international study. The initial steps in this effort are discussed. Policy options are proposed which may prepare international organizations and public officials for difficulties which may arise. Implementation of these procedures, which include continuation of internationally sponsored research, could help to ameliorate many of the problems outlined in this paper.

  12. [Globalization, the Camisea Project and the Matsigenkas health].

    Science.gov (United States)

    Torres-Slimming, Paola

    2010-09-01

    Globalization has been the consequence of an important opening of the economies, achieved through the reduction in the obstacles to commerce, elimination of the capital controls and exchange restrictions. The impact of the Camisea Project in the Peruvian economy has aroused great interest and controversy with respect to the future social and economic national impact, and especially, in the Matsigenka population, located in the 88 and 56 lots, where gas extraction is being done. The area of Camisea gas exploitation offers the challenge of a complex sanitary problem, not only because of the impacts and risks produced by the hidrocarbon exploitation, but also due to a legacy of economical and sanitary precariousness that has accumulated from other times. At the same time, this area offers the opportunity to rethink the public health system according to the indigenous reality. It is necessary to take action in the social determinants of inequity and poverty in order to reach the positive effects the globalization can have in health, ensuring the interests of developing countries and vulnerable populations.

  13. Training the next generation of global health experts: experiences and recommendations from Pacific Rim universities

    OpenAIRE

    Withers, Mellissa; Press, David; Wipfli, Heather; McCool, Judith; Chan, Chang-Chuan; Jimba, Masamine; Tremewan, Christopher; Samet, Jonathan

    2016-01-01

    Background Finding solutions to global health problems will require a highly-trained, inter-disciplinary workforce. Global health education and research can potentially have long-range impact in addressing the global burden of disease and protecting and improving the health of the global population. Methods We conducted an online survey of twelve higher education institutions in the Pacific Rim that spanned the period 2005–2011. Program administrators provided data on program concentrations, ...

  14. Defining and Acting on Global Health: The Case of Japan and the Refugee Crisis

    Directory of Open Access Journals (Sweden)

    Claire Leppold

    2016-08-01

    Full Text Available What counts as global health? There has been limited discourse to date on the ways in which country-level contexts may shape positioning in global health agendas. By reviewing Japan’s response to the refugee crisis, we demonstrate a clash between rhetoric and action on global responsibility, and suggest that cultural and historical factors may be related to the ways of perceiving and acting upon global health.

  15. Defining and Acting on Global Health: The Case of Japan and the Refugee Crisis

    Science.gov (United States)

    Leppold, Claire; Ozaki, Akihiko; Shimada, Yuki; Morita, Tomohiro; Tanimoto, Tetsuya

    2016-01-01

    What counts as global health? There has been limited discourse to date on the ways in which country-level contexts may shape positioning in global health agendas. By reviewing Japan’s response to the refugee crisis, we demonstrate a clash between rhetoric and action on global responsibility, and suggest that cultural and historical factors may be related to the ways of perceiving and acting upon global health.

  16. Health-related quality of life in long-term breast cancer survivors

    DEFF Research Database (Denmark)

    Peuckmann, Vera Irina; Ekholm, Ola; Rasmussen, N.K.;

    2007-01-01

    AIM: To investigate health-related quality of life (HRQOL) in a nationally representative sample of long-term breast cancer survivors (BCS) in Denmark. PARTICIPANTS AND METHODS: An age-stratified random sample of 2,000 female BCS > or = 5 years after primary surgery without recurrence was drawn...... from the Danish Breast Cancer Cooperative Group register, which is representative regarding long-term BCS in Denmark, and compared with 3,104 women of the nationally representative Danish Health and Morbidity Survey 2000. The Short Form-36 questionnaire assessed HRQOL and its association with BCS......' sociodemography, type of surgery, systemic therapy, radiotherapy, time since operation, receptor status, and low/high risk protocol. RESULTS: The response rate was 79%. BCS tended to rate HRQOL better than the general female population. BCS reported significantly less "bodily pain" (P

  17. The Alberta moving beyond breast cancer (AMBER cohort study: a prospective study of physical activity and health-related fitness in breast cancer survivors

    Directory of Open Access Journals (Sweden)

    Courneya Kerry S

    2012-11-01

    Full Text Available Abstract Background Limited research has examined the association between physical activity, health-related fitness, and disease outcomes in breast cancer survivors. Here, we present the rationale and design of the Alberta Moving Beyond Breast Cancer (AMBER Study, a prospective cohort study designed specifically to examine the role of physical activity and health-related fitness in breast cancer survivorship from the time of diagnosis and for the balance of life. The AMBER Study will examine the role of physical activity and health-related fitness in facilitating treatment completion, alleviating treatment side effects, hastening recovery after treatments, improving long term quality of life, and reducing the risks of disease recurrence, other chronic diseases, and premature death. Methods/Design The AMBER Study will enroll 1500 newly diagnosed, incident, stage I-IIIc breast cancer survivors in Alberta, Canada over a 5 year period. Assessments will be made at baseline (within 90 days of surgery, 1 year, and 3 years consisting of objective and self-reported measurements of physical activity, health-related fitness, blood collection, lymphedema, patient-reported outcomes, and determinants of physical activity. A final assessment at 5 years will measure patient-reported data only. The cohort members will be followed for an additional 5 years for disease outcomes. Discussion The AMBER cohort will answer key questions related to physical activity and health-related fitness in breast cancer survivors including: (1 the independent and interactive associations of physical activity and health-related fitness with disease outcomes (e.g., recurrence, breast cancer-specific mortality, overall survival, treatment completion rates, symptoms and side effects (e.g., pain, lymphedema, fatigue, neuropathy, quality of life, and psychosocial functioning (e.g., anxiety, depression, self-esteem, happiness, (2 the determinants of physical activity and

  18. Health anxiety and cognitive processes as risks for insomnia in women undergoing chemotherapy for breast cancer

    OpenAIRE

    Rissling, Michelle Brosemer

    2012-01-01

    Breast cancer patients have a high incidence of co-morbid chronic insomnia which frequently persists into survivorship. The mechanism behind this insomnia is poorly understood, yet maladaptive responses to the sleep disturbance resulting from an acute stressor are implicated in cognitive models of insomnia. Evidence suggests that health anxiety, pre-sleep cognitive arousal and compensatory sleep effort may predispose and/or perpetuate psychophysiological insomnia. These mechanisms have not be...

  19. Integrating eHealth with human services for breast cancer patients

    OpenAIRE

    Hawkins, Robert P.; Pingree, Suzanne; Baker, Timothy B; Roberts, Linda J.; Shaw, Bret R.; McDowell, Helene; Serlin, Ronald C; Dillenburg, Lisa; Swoboda, Christopher M; Han, Jeong-Yeob; Stewart, James A.; Carmack, Cindy L.; Salner, Andrew; Schlam, Tanya R.; McTavish, Fiona

    2011-01-01

    Following demonstrations of success of interactive cancer communication systems (ICCS) for patients, the challenge and opportunity are to integrate such systems with human resources. A randomized trial explored relative benefits of an ICCS, a human cancer information mentor, and a condition combining both. Women with breast cancer (N = 434) were randomized to have access to a tested ICCS (CHESS, the Comprehensive Health Enhancement Support System), a human cancer information mentor, both inte...

  20. Risk Factors, Preventive Practices, and Health Care Among Breast Cancer Survivors, United States, 2010

    OpenAIRE

    Homan, Sherri G.; Kayani, Noaman; Yun, Shumei

    2016-01-01

    Introduction We compared behavioral risk factors and preventive measures among female breast cancer survivors, female survivors of other types of cancers, and women without a history of cancer. Survivorship health care indicators for the 2 groups of cancer survivors were compared. Methods Using data from the 2010 Behavioral Risk Factor Surveillance System, we calculated the proportion of women with risk factors and their engagement in preventive practices, stratified by cancer status (cancer ...

  1. A Student-Led Global Health Education Initiative: Reflections on the Kenyan Village Medical Education Program

    OpenAIRE

    Christopher John; Heidi Asquith; Tom Wren; Stephanie Mercuri; Sian Brownlow

    2016-01-01

    The Kenyan Village Medical Education Program is a student-led global health initiative that seeks to improve health outcomes in rural Kenya through culturally appropriate health education. The month-long program, which is organised by the Melbourne University Health Initiative (Australia), is conducted each January in southern rural Kenya. Significance for public health The Kenyan Village Medical Education (KVME) Program is a student-led global health initiative that involves exploring well-e...

  2. Global Health Warning: Definitions Wield Power Comment on "Navigating Between Stealth Advocacy and Unconscious Dogmatism: The Challenge of Researching the Norms, Politics and Power of Global Health".

    Science.gov (United States)

    Marten, Robert

    2016-03-01

    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? This refocuses discussion on the importance of definitions and how they wield power. It also re-affirms the necessity of a deeper analysis and understanding of power and how it affects and shapes the practice of global health. PMID:26927595

  3. Global Health Warning: Definitions Wield Power Comment on "Navigating Between Stealth Advocacy and Unconscious Dogmatism: The Challenge of Researching the Norms, Politics and Power of Global Health".

    Science.gov (United States)

    Marten, Robert

    2015-12-25

    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? This refocuses discussion on the importance of definitions and how they wield power. It also re-affirms the necessity of a deeper analysis and understanding of power and how it affects and shapes the practice of global health.

  4. Global Health Security Demands a Strong International Health Regulations Treaty and Leadership From a Highly Resourced World Health Organization.

    Science.gov (United States)

    Burkle, Frederick M

    2015-10-01

    If the Ebola tragedy of West Africa has taught us anything, it should be that the 2005 International Health Regulations (IHR) Treaty, which gave unprecedented authority to the World Health Organization (WHO) to provide global public health security during public health emergencies of international concern, has fallen severely short of its original goal. After encouraging successes with the 2003 severe acute respiratory syndrome (SARS) pandemic, the intent of the legally binding Treaty to improve the capacity of all countries to detect, assess, notify, and respond to public health threats has shamefully lapsed. Despite the granting of 2-year extensions in 2012 to countries to meet core surveillance and response requirements, less than 20% of countries have complied. Today it is not realistic to expect that these gaps will be solved or narrowed in the foreseeable future by the IHR or the WHO alone under current provisions. The unfortunate failures that culminated in an inadequate response to the Ebola epidemic in West Africa are multifactorial, including funding, staffing, and poor leadership decisions, but all are reversible. A rush by the Global Health Security Agenda partners to fill critical gaps in administrative and operational areas has been crucial in the short term, but questions remain as to the real priorities of the G20 as time elapses and critical gaps in public health protections and infrastructure take precedence over the economic and security needs of the developed world. The response from the Global Outbreak Alert and Response Network and foreign medical teams to Ebola proved indispensable to global health security, but both deserve stronger strategic capacity support and institutional status under the WHO leadership granted by the IHR Treaty. Treaties are the most successful means the world has in preventing, preparing for, and controlling epidemics in an increasingly globalized world. Other options are not sustainable. Given the gravity of ongoing

  5. Global Health Security Demands a Strong International Health Regulations Treaty and Leadership From a Highly Resourced World Health Organization.

    Science.gov (United States)

    Burkle, Frederick M

    2015-10-01

    If the Ebola tragedy of West Africa has taught us anything, it should be that the 2005 International Health Regulations (IHR) Treaty, which gave unprecedented authority to the World Health Organization (WHO) to provide global public health security during public health emergencies of international concern, has fallen severely short of its original goal. After encouraging successes with the 2003 severe acute respiratory syndrome (SARS) pandemic, the intent of the legally binding Treaty to improve the capacity of all countries to detect, assess, notify, and respond to public health threats has shamefully lapsed. Despite the granting of 2-year extensions in 2012 to countries to meet core surveillance and response requirements, less than 20% of countries have complied. Today it is not realistic to expect that these gaps will be solved or narrowed in the foreseeable future by the IHR or the WHO alone under current provisions. The unfortunate failures that culminated in an inadequate response to the Ebola epidemic in West Africa are multifactorial, including funding, staffing, and poor leadership decisions, but all are reversible. A rush by the Global Health Security Agenda partners to fill critical gaps in administrative and operational areas has been crucial in the short term, but questions remain as to the real priorities of the G20 as time elapses and critical gaps in public health protections and infrastructure take precedence over the economic and security needs of the developed world. The response from the Global Outbreak Alert and Response Network and foreign medical teams to Ebola proved indispensable to global health security, but both deserve stronger strategic capacity support and institutional status under the WHO leadership granted by the IHR Treaty. Treaties are the most successful means the world has in preventing, preparing for, and controlling epidemics in an increasingly globalized world. Other options are not sustainable. Given the gravity of ongoing

  6. Structure, function and five basic needs of the global health research system

    OpenAIRE

    Rudan, Igor; Sridhar, Devi

    2016-01-01

    BACKGROUND: Two major initiatives that were set up to support and co-ordinate global health research efforts have been largely discontinued in recent years: the Global Forum for Health Research and World Health Organization's Department for Research Policy and Cooperation. These developments provide an interesting case study into the factors that contribute to the sustainability of initiatives to support and co-ordinate global health research in the 21st century.METHODS: We reviewed the histo...

  7. Power and priorities: the growing pains of global health Comment on "Knowledge, moral claims and the exercise of power in global health".

    Science.gov (United States)

    Grépin, Karen Ann

    2015-05-01

    Shiffman has argued that some actors have a great deal of power in global health, and that more reflection is needed on whether such forms of power are legitimate. Global health is a new and evolving field that builds upon the historical fields of public and international health, but is more multi-disciplinary and inter-disciplinary in nature. This article argues that the distribution of power in some global health institutions may be limiting the contributions of all researchers in the field. PMID:25905485

  8. Global health diplomacy: an integrative review of the literature and implications for nursing.

    Science.gov (United States)

    Hunter, Anita; Wilson, Lynda; Stanhope, Marcia; Hatcher, Barbara; Hattar, Marianne; Hilfinger Messias, Deanne K; Powell, Dorothy

    2013-01-01

    The increasing interconnectedness of the world and the factors that affect health lay the foundation for the evolving practice of global health diplomacy. There has been limited discussion in the nursing literature about the concept of global health diplomacy or the role of nurses in such initiatives. A discussion of this concept is presented here by the members of a Task Force on Global Health Diplomacy of the American Academy of Nursing Expert Panel on Global Nursing and Health (AAN EPGNH). The purpose of this article is to present an integrative review of literature on the concept of global health diplomacy and to identify implications of this emerging field for nursing education, practice, and research. The steps proposed by Whittemore and Knafl (2005) were adapted and applied to the integrative review of theoretical and descriptive articles about the concept of global health diplomacy. This review included an analysis of the historical background, definition, and challenges of global health diplomacy and suggestions about the preparation of global health diplomats. The article concludes with a discussion of implications for nursing practice, education, and research. The Task Force endorses the definition of global health diplomacy proposed by Adams, Novotny, and Leslie (2008) but recommends that further dialogue and research is necessary to identify opportunities and educational requirements for nurses to contribute to the emerging field of global health diplomacy. PMID:22999856

  9. Racial and ethnic disparities in the impact of obesity on breast cancer risk and survival: a global perspective.

    Science.gov (United States)

    Bandera, Elisa V; Maskarinec, Gertraud; Romieu, Isabelle; John, Esther M

    2015-11-01

    Obesity is a global concern, affecting both developed and developing countries. Although there are large variations in obesity and breast cancer rates worldwide and across racial/ethnic groups, most studies evaluating the impact of obesity on breast cancer risk and survival have been conducted in non-Hispanic white women in the United States or Europe. Given the known racial/ethnic differences in tumor hormone receptor subtype distribution, obesity prevalence, and risk factor profiles, we reviewed published data for women of African, Hispanic, and Asian ancestry in the United States and their countries of origin. Although the data are limited, current evidence suggests a stronger adverse effect of obesity on breast cancer risk and survival in women of Asian ancestry. For African Americans and Hispanics, the strength of the associations appears to be more comparable to that of non-Hispanic whites, particularly when accounting for subtype and menopausal status. Central obesity seems to have a stronger impact in African-American women than general adiposity as measured by body mass index. International data from countries undergoing economic transition offer a unique opportunity to evaluate the impact of rapid weight gain on breast cancer. Such studies should take into account genetic ancestry, which may help elucidate differences in associations between ethnically admixed populations. Overall, additional large studies that use a variety of adiposity measures are needed, because the current evidence is based on few studies, most with limited statistical power. Future investigations of obesity biomarkers will be useful to understand possible racial/ethnic biological differences underlying the complex association between obesity and breast cancer development and progression. PMID:26567202

  10. A structured review of health utility measures and elicitation in advanced/metastatic breast cancer

    Directory of Open Access Journals (Sweden)

    Hao Y

    2016-06-01

    Full Text Available Yanni Hao,1 Verena Wolfram,2 Jennifer Cook2 1Novartis Pharmaceuticals, East Hanover, NJ, USA; 2Adelphi Values, Bollington, UK Background: Health utilities are increasingly incorporated in health economic evaluations. Different elicitation methods, direct and indirect, have been established in the past. This study examined the evidence on health utility elicitation previously reported in advanced/metastatic breast cancer and aimed to link these results to requirements of reimbursement bodies. Methods: Searches were conducted using a detailed search strategy across several electronic databases (MEDLINE, EMBASE, Cochrane Library, and EconLit databases, online sources (Cost-effectiveness Analysis Registry and the Health Economics Research Center, and web sites of health technology assessment (HTA bodies. Publications were selected based on the search strategy and the overall study objectives. Results: A total of 768 publications were identified in the searches, and 26 publications, comprising 18 journal articles and eight submissions to HTA bodies, were included in the evidence review. Most journal articles derived utilities from the European Quality of Life Five-Dimensions questionnaire (EQ-5D. Other utility measures, such as the direct methods standard gamble (SG, time trade-off (TTO, and visual analog scale (VAS, were less frequently used. Several studies described mapping algorithms to generate utilities from disease-specific health-related quality of life (HRQOL instruments such as European Organization for Research and Treatment of Cancer Quality of Life Questionnaire – Core 30 (EORTC QLQ-C30, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire – Breast Cancer 23 (EORTC QLQ-BR23, Functional Assessment of Cancer Therapy – General questionnaire (FACT-G, and Utility-Based Questionnaire-Cancer (UBQ-C; most used EQ-5D as the reference. Sociodemographic factors that affect health utilities, such as age, sex

  11. Bridging the health security divide: department of defense support for the global health security agenda.

    Science.gov (United States)

    Moudy, Robin M; Ingerson-Mahar, Michael; Kanter, Jordan; Grant, Ashley M; Fisher, Dara R; Jones, Franca R

    2014-01-01

    In 2011, President Obama addressed the United Nations General Assembly and urged the global community to come together to prevent, detect, and fight every kind of biological danger, whether a pandemic, terrorist threat, or treatable disease. Over the past decade, the United States and key international partners have addressed these dangers through a variety of programs and strategies aimed at developing and enhancing countries' capacity to rapidly detect, assess, report, and respond to acute biological threats. Despite our collective efforts, however, an increasingly interconnected world presents heightened opportunities for human, animal, and zoonotic diseases to emerge and spread globally. Further, the technical capabilities required to develop biological agents into a weapon are relatively low. The launch of the Global Health Security Agenda (GHSA) provides an opportunity for the international community to enhance the linkages between the health and security sectors, accelerating global efforts to prevent avoidable epidemics and bioterrorism, detect threats early, and respond rapidly and effectively to biological threats. The US Department of Defense (DoD) plays a key role in achieving GHSA objectives through its force health protection, threat reduction, and biodefense efforts at home and abroad. This article focuses on GHSA activities conducted in the DoD Office of the Assistant Secretary of Defense for Nuclear, Chemical, and Biological Defense.

  12. Illinois Breast and Cervical Cancer Program: Implementing Effective Public-Private Partnerships to Assure Population Health.

    Science.gov (United States)

    Handler, Arden S; Henderson, Vida A; Rosenfeld, Amy; Rankin, Kristin; Jones, Brenda; Issel, L Michele

    2015-01-01

    With the implementation of the Affordable Care Act (ACA), it is essential for the public health sector to elucidate its role with respect to its mission of assuring population health, and to clarify its role with respect to the private health care system. To that end, we examined the value added to the population health enterprise of successful public-private partnerships (PPPs) such as those found in the Illinois Breast and Cervical Cancer Program (IBCCP), the Centers for Disease Control and Prevention's (CDC's) National Breast and Cervical Cancer Early Detection Program (NBCCEDP) in Illinois. Key Informant (KI) interviews focused on IBCCP implementation were conducted with IBCCP lead agency (LA) program coordinators (n = 35/36) in winter 2012-2013. Analysis was conducted using Atlas.ti software. The KI interviews revealed the existence of highly developed PPPs between the IBCCP LAs and individual medical providers and hospitals across Illinois. The data suggest that the small amount of funding provided by IBCCP to each LA in Illinois has been used to build and sustain robust PPPs in the majority of the IBCCP communities. The PPPs developed through the IBCCP can be seen as an unplanned benefit of CDC's investment in breast and cervical health through the NBCCEDP. While the IBCCP/NBCCEDP might be considered a "boutique" categorical program which some may consider no longer necessary as individuals gain insurance under the ACA, the KI data underscore the critical role of public sector dollars, not only to serve individuals and communities directly but also to mobilize the private health care sector to act in partnership with public entities and become advocates for underserved communities. PMID:25470661

  13. The future of global health cooperation: designing a new World Health Organization.

    Science.gov (United States)

    Forss, K; Stenson, B; Sterky, G

    1996-06-01

    This article discusses some needed changes to the functioning and management of the World Health Organization (WHO). WHO is unable to meet new challenges and needs reform. The Executive Board of WHO initiated an internal review in 1992 that led to a management-related focus, while informal groups within the agency tackled funding constraints. Some governments and nongovernmental groups have proposed reorganization of international health assistance. The authors urge that the public health sector and researchers join the reform effort. WHO was established in 1948 and was the sole global health agency. The demand for greater international health cooperation has increased over time. WHO is an association of sovereign states. WHO demonstrated success in eliminating smallpox, promotion of health policy, collection and dissemination of epidemiologic information, and establishment of standards in health care and medical ethics. WHO staff comprises about 5000 persons. The annual budget is too small at about US$900 million. In 1995 only 56% of receipts were collected. WHO's constitution mandates complete health for all, but there has been a widening gap between rich and poor and those with access to health services and those without. Absolute and relative poverty are the main determinants of premature mortality and ill health. The major challenge for health policy is this disparity; the focus of international collaboration should be on this issue. The machine metaphor of organizational structure no longer works in today's world. The authors propose that WHO limit functions in health development and create a full mandate for dealing with determinants of health. WHO should be participatory, open to constituents, autonomous, and flexible. Member states must be more powerful in policy formulation. Program implementation should occur in independent programs in a decentralized system. PMID:12291612

  14. Comparative Analysis: Potential Barriers to Career Participation by North American Physicians in Global Health

    Directory of Open Access Journals (Sweden)

    Daniel S. Rhee

    2014-01-01

    Full Text Available Physician interest in global health, particularly among family physicians, is reflected by an increasing proliferation of field training and service experiences. However, translating initial training involvement into a defined and sustainable global health career remains difficult and beset by numerous barriers. Existing global health literature has largely examined training experiences and related ethical considerations while neglecting the role of career development in global health. To explore this, this paper extrapolates potential barriers to global health career involvement from existing literature and compares these to salary and skills requirements for archetypal physician positions in global health, presenting a framework of possible barriers to sustained physician participation in global health work. Notable barriers identified include financial limitations, scheduling conflicts, security/family concerns, skills limitations, limited awareness of opportunities, and specialty choice, with family practice often closely aligned with global health experience. Proposed solutions include financial support, protected time, family relocation support, and additional training. This framework delineates barriers to career involvement in global health by physicians. Further research regarding these barriers as well as potential solutions may help direct policy and initiatives to better utilize physicians, particularly family physicians, as a valuable global health human resource.

  15. [Iron deficiency and iron deficiency anemia are global health problems].

    Science.gov (United States)

    Dahlerup, Jens; Lindgren, Stefan; Moum, Björn

    2015-03-10

    Iron deficiency and iron deficiency anemia are global health problems leading to deterioration in patients' quality of life and more serious prognosis in patients with chronic diseases. The cause of iron deficiency and anemia is usually a combination of increased loss and decreased intestinal absorption and delivery from iron stores due to inflammation. Oral iron is first line treatment, but often hampered by intolerance. Intravenous iron is safe, and the preferred treatment in patients with chronic inflammation and bowel diseases. The goal of treatment is normalisation of hemoglobin concentration and recovery of iron stores. It is important to follow up treatment to ensure that these objectives are met and also long-term in patients with chronic iron loss and/or inflammation to avoid recurrence of anemia.

  16. Information systems on human resources for health: a global review

    Directory of Open Access Journals (Sweden)

    Riley Patricia L

    2012-04-01

    Full Text Available Abstract Background Although attainment of the health-related Millennium Development Goals relies on countries having adequate numbers of human resources for health (HRH and their appropriate distribution, global understanding of the systems used to generate information for monitoring HRH stock and flows, known as human resources information systems (HRIS, is minimal. While HRIS are increasingly recognized as integral to health system performance assessment, baseline information regarding their scope and capability around the world has been limited. We conducted a review of the available literature on HRIS implementation processes in order to draw this baseline. Methods Our systematic search initially retrieved 11 923 articles in four languages published in peer-reviewed and grey literature. Following the selection of those articles which detailed HRIS implementation processes, reviews of their contents were conducted using two-person teams, each assigned to a national system. A data abstraction tool was developed and used to facilitate objective assessment. Results Ninety-five articles with relevant HRIS information were reviewed, mostly from the grey literature, which comprised 84 % of all documents. The articles represented 63 national HRIS and two regionally integrated systems. Whereas a high percentage of countries reported the capability to generate workforce supply and deployment data, few systems were documented as being used for HRH planning and decision-making. Of the systems examined, only 23 % explicitly stated they collect data on workforce attrition. The majority of countries experiencing crisis levels of HRH shortages (56 % did not report data on health worker qualifications or professional credentialing as part of their HRIS. Conclusion Although HRIS are critical for evidence-based human resource policy and practice, there is a dearth of information about these systems, including their current capabilities. The absence of

  17. Impact of Globalization on the Right to Health as an Instance of Human Rights

    Directory of Open Access Journals (Sweden)

    Jayashree Palande

    2011-07-01

    Full Text Available Since the advent of globalization, the issue of human rights - especially right to health- and their violation through the process of globalization was discussed. These impotent rights are affected both in positive and negative way by the globalization. Present study scrutinizes these effects and concludes that globalization is functioning as a double edged-sword in this regards.

  18. A global human health risk assessment for Decamethylcyclopentasiloxane (D5).

    Science.gov (United States)

    Franzen, Allison; Van Landingham, Cynthia; Greene, Tracy; Plotzke, Kathy; Gentry, Robinan

    2016-02-01

    Decamethylcyclopentasiloxane (D5) is a low-molecular-weight cyclic siloxane used primarily as an intermediate in the production of several widely-used industrial and consumer products and intentionally added to consumer products, personal products and some dry cleaning solvents. The global use requires consideration of consumer use information and risk assessment requirements from various sources and authoritative bodies. A global "harmonized" risk assessment was conducted to meet requirements for substance-specific risk assessments conducted by regulatory agencies such as USEPA's Integrated Risk Information System (IRIS), Health Canada and various independent scientific committees of the European Commission, as well as provide guidance for chemical safety assessments under REACH in Europe, and other relevant authoritative bodies. This risk assessment incorporates global exposure information combined with a Monte Carlo analysis to determine the most significant routes of exposure, utilization of a multi-species, multi-route physiologically based pharmacokinetic (PBPK) model to estimate internal dose metrics, benchmark modeling to determine a point of departure (POD), and a margin of safety (MOS) evaluation to compare the estimates of intake with the POD. Because of the specific pharmacokinetic behaviors of D5 including high lipophilicity, high volatility with low blood-to-air partition coefficients and extensive metabolic clearance that regulate tissue dose after exposure, the use of a PBPK model was essential to provide a comparison of a dose metric that reflects these processes. The characterization of the potential for adverse effects after exposure to D5 using a MOS approach based on an internal dose metric removes the subjective application of uncertainty factors that may be applied across various regulatory agencies and allows examination of the differences between internal dose metrics associated with exposure and those associated with adverse effects. PMID

  19. Implications for human health of global atmospheric changes

    International Nuclear Information System (INIS)

    The possible impacts of the greenhouse effect, ozone depletion and ultraviolet irradiation, acid precipitation, and resulting demographic changes are reviewed, along with the implications of global ecological changes on society and sustainable development. Some manifestations of global warming caused by the greenhouse effect could include more frequently extreme weather conditions, rises in sea level, disruption of ocean currents, and changes in composition and distribution of vegetation. Consequences of these manifestations on human health include an increase in the frequency of droughts and heat waves, migration of disease carrying vectors to other areas, submergence of coastal areas and disruption of water supplies, destruction of tropical species potentially useful for medicinal purposes, and impaired production of crops leading to food shortages. Consequences of stratospheric ozone depletion due to chlorofluorocarbon pollution are thought to be a direct result of increased exposure to ultraviolet light; these consequences include higher risks of non-melanoma skin cancer. The effects of acid precipitation are thought to be primarily ecological and indirect. 61 refs,

  20. Towards a feminist global bioethics: addressing women's health concerns worldwide.

    Science.gov (United States)

    Tong, R

    2001-01-01

    In this paper I argue that a global bioethics is possible. Specifically, I present the view that there are within feminist approaches to bioethics some conceptual and methodological tools necessary to forge a bioethics that embraces the health-related concerns of both developing and developed nations equally. To support my argument I discuss some of the challenges that have historically confronted feminists. If feminists accept the idea that women are entirely the same, then feminists present as fact the fiction of the essential "Woman." Not only does "Woman" not exist, -she" obscures important racial, ethnic, cultural, and class differences among women. However, if feminists stress women's differences too much, feminists lose the power to speak coherently and cogently about gender justice, women's rights, and sexual equality in general. Analyzing the ways in which the idea of difference as well as the idea of sameness have led feminists astray, I ask whether it is possible to avoid the Scylla of absolutism (imperialism, colonialism, hegemony) on the one hand and the Charybdis of relativism (postmodernism, fragmentation, Balkanization) on the other. Finally, after reflecting upon the work of Uma Narayan, Susan Muller Okin, and Martha Nussbaum, I conclude that there is a way out of this ethical bind. By focusing on women's, children's, and men's common human needs, it is possible to lay the foundation for a just and caring global bioethics.

  1. Health behavior changes following breast cancer treatment: a qualitative comparison among Chinese American, Korean American, and Mexican American survivors.

    Science.gov (United States)

    Lim, Jung-won; Gonzalez, Patricia; Wang-Letzkus, Ming F; Baik, Okmi; Ashing-Giwa, Kimlin T

    2013-05-01

    This study explored how Chinese American, Korean American, and Mexican American women modify their health behaviors following breast cancer treatment and identified motivators and barriers that influence their changes. An exploratory, descriptive, qualitative study was undertaken using six focus groups. Discussions were transcribed and translated for content analysis. Significant differences among the ethnic groups were noted in the following health behavior practices which were most commonly stated as changed behaviors after a breast cancer diagnosis: 1) eating habits, 2) physical activity, 3) alternative medicine, 4) sleeping, 5) social activity, 6) weight control, and 7) alcohol consumption. Family, financial concerns, environment, and religious faith were commonly mentioned as motivators of and/or barriers to changes in health behaviors. Findings provide insight into different perspectives related to changes in health behaviors by ethnicity, which is critical for developing culturally tailored behavioral interventions to improve underserved breast cancer survivors' quality of life and to reduce health disparities.

  2. An Avalanche of Ignoring-A Qualitative Study of Health Care Avoidance in Women With Malignant Breast Cancer Wounds

    DEFF Research Database (Denmark)

    Lund-Nielsen, Betina; Midtgaard, Julie; Rørth, Mikael;

    2011-01-01

    BACKGROUND:: A contributing factor to development of malignant wounds is patient-related delay caused by health care avoidance. OBJECTIVE:: The purpose of this study was to describe the experience of health care avoidance in women with advanced breast cancer who have developed malignant wounds....... RESULTS:: The women deliberately avoided health care for a median of 24 months (minimum, 3 months; maximum, 84 months). Despite being aware of the development of a malignant wound from a breast lump, the women avoided health care because of negative health care experiences and extremely burdening life....... METHODS:: A qualitative study was conducted based on semistructured interviews. Seventeen women with advanced breast cancer (median age, 69 years; range, 47-90 years) who had avoided medical treatment despite development of malignant wounds participated. Systematic text-condensation analysis was used...

  3. Educational Differences in Postmenopausal Breast Cancer - Quantifying Indirect Effects through Health Behaviors, Body Mass Index and Reproductive Patterns

    DEFF Research Database (Denmark)

    Hvidtfeldt, Ulla Arthur; Lange, Theis; Andersen, Ingelise;

    2013-01-01

    Studying mechanisms underlying social inequality in postmenopausal breast cancer is important in order to develop prevention strategies. Standard methods for investigating indirect effects, by comparing crude models to adjusted, are often biased. We applied a new method enabling the decomposition...... of the effect of educational level on breast cancer incidence into indirect effects through reproductive patterns (parity and age at first birth), body mass index and health behavior (alcohol consumption, physical inactivity, and hormone therapy use). The study was based on a pooled cohort of 6 studies from...... the Copenhagen area including 33,562 women (1,733 breast cancer cases) aged 50-70 years at baseline. The crude absolute rate of breast cancer was 399 cases per 100,000 person-years. A high educational level compared to low was associated with 74 (95% CI 22-125) extra breast cancer cases per 100,000 person...

  4. mHealth self-care interventions: managing symptoms following breast cancer treatment

    Science.gov (United States)

    Fu, Mei R.; Axelrod, Deborah; Guth, Amber A.; Rampertaap, Kavita; El-Shammaa, Nardin; Hiotis, Karen; Scagliola, Joan; Yu, Gary; Wang, Yao

    2016-01-01

    Background Many women suffer from daily distressing symptoms related to lymphedema following breast cancer treatment. Lymphedema, an abnormal accumulation of lymph fluid in the ipsilateral body area or upper limb, remains an ongoing major health problem affecting more than 40% of 3.1 million breast cancer survivors in the United States. Patient-centered care related to lymphedema symptom management is often inadequately addressed in clinical research and practice. mHealth plays a significant role in improving self-care, patient-clinician communication, and access to health information. The-Optimal-Lymph-Flow health IT system (TOLF) is a patient-centered, web-and-mobile-based educational and behavioral mHealth interventions focusing on safe, innovative, and pragmatic electronic assessment and self-care strategies for lymphedema symptom management. The purpose of this paper is to describe the development and test of TOLF system. Methods The development of TOLF was guided by the Model of Self-Care for Lymphedema Symptom Management and designed based on principles fostering accessibility, convenience, and efficiency of mHealth system to enhance training and motivating assessment of and self-care for lymphedema symptoms. Test of TOLF was accomplished by conducting a psychometric study to evaluate reliability, validity, and efficiency of the electronic version of Breast Cancer and Lymphedema Symptom Experience Index (BCLE-SEI), a usability testing and a pilot feasibility testing of mHealth self-care interventions. Results Findings from the psychometric study with 355 breast cancer survivors demonstrated high internal consistency of the electronic version of the instrument: a Cronbach’s alpha coefficient of 0.959 for the total scale, 0.919 for symptom occurrence, and 0.946 for symptom distress. Discriminant validity of the instrument was supported by a significant difference in symptom occurrence (z=−6.938, Psignificantly positive effects on less pain (P=0.031), less

  5. Intervention studies for improving global health and health care: An important arena for epidemiologists

    Directory of Open Access Journals (Sweden)

    Gunnar Kvåle

    2009-10-01

    Full Text Available Marginalised populations in many low- and middle-income countries experience an increasing burden of disease, in sub-Saharan Africa to a large extent due to faltering health systems and serious HIV epidemics. Also other poverty related diseases (PRDs are prevalent, especially respiratory and diarrhoeal diseases in children, malnutrition, maternal and perinatal health problems, tuberculosis and malaria. Daily, nearly 30,000 children under the age of 5 die, most from preventable causes, and 8,000 people die from HIV infections. In spite of the availability of powerful preventive and therapeutic tools for combating these PRDs, their implementation, especially in terms of equitable delivery, leaves much to be desired. The research community must address this tragic gap between knowledge and implementation. Epidemiologists have a very important role to play in conducting studies on diseases that account for the largest share of the global disease burden. A shift of focus of epidemiologic research towards intervention studies addressing health problems of major public health importance for disadvantaged population groups is needed. There is a need to generate an evidence-base for interventions that can be implemented on a large scale; this can result in increased funding of health promotion programs as well as enable rational prioritization and integration between different health interventions. This will require close and synergetic teamwork between epidemiologists and other professions across disciplines and sectors. In this way epidemiologists can contribute significantly to improve health and optimise health care delivery for marginalized populations.

  6. Missed opportunities for breast awareness information among women attending the maternal and child health services of an urban tertiary hospital in Northern Nigeria

    Directory of Open Access Journals (Sweden)

    Lofty-John Chukwuemeka Anyanwu

    2016-01-01

    Conclusion: Most of the opportunities to educate women on breast awareness were missed at the postnatal and ICs of our hospital. Integrating breast health education into MCH care programs in developing countries will assist in the early detection of breast pathologies.

  7. Data Resource Profile: The World Health Organization Study on global AGEing and adult health (SAGE)

    Science.gov (United States)

    Kowal, Paul; Chatterji, Somnath; Naidoo, Nirmala; Biritwum, Richard; Fan, Wu; Lopez Ridaura, Ruy; Maximova, Tamara; Arokiasamy, Perianayagam; Phaswana-Mafuya, Nancy; Williams, Sharon; Snodgrass, J Josh; Minicuci, Nadia; D'Este, Catherine; Peltzer, Karl; Boerma, J Ties; Yawson, A.; Mensah, G.; Yong, J.; Guo, Y.; Zheng, Y.; Parasuraman, P.; Lhungdim, H.; Sekher, TV.; Rosa, R.; Belov, VB.; Lushkina, NP; Peltzer, K.; Makiwane, M.; Zuma, K.; Ramlagan, S.; Davids, A.; Mbelle, N.; Matseke, G.; Schneider, M.; Tabane, C.; Tollman, S.; Kahn, K.; Ng, N.; Juvekar, S.; Sankoh, O.; Debpuur, CY.; Nguyen, TK Chuc; Gomez-Olive, FX.; Hakimi, M.; Hirve, S.; Abdullah, S.; Hodgson, A.; Kyobutungi, C.; Egondi, T.; Mayombana, C.; Minh, HV.; Mwanyangala, MA.; Razzaque, A.; Wilopo, S.; Streatfield, PK.; Byass, P.; Wall, S.; Scholten, F.; Mugisha, J.; Seeley, J.; Kinyanda, E.; Nyirenda, M.; Mutevedzi, P.; Newell, M-L.

    2012-01-01

    Population ageing is rapidly becoming a global issue and will have a major impact on health policies and programmes. The World Health Organization’s Study on global AGEing and adult health (SAGE) aims to address the gap in reliable data and scientific knowledge on ageing and health in low- and middle-income countries. SAGE is a longitudinal study with nationally representative samples of persons aged 50+ years in China, Ghana, India, Mexico, Russia and South Africa, with a smaller sample of adults aged 18–49 years in each country for comparisons. Instruments are compatible with other large high-income country longitudinal ageing studies. Wave 1 was conducted during 2007–2010 and included a total of 34 124 respondents aged 50+ and 8340 aged 18–49. In four countries, a subsample consisting of 8160 respondents participated in Wave 1 and the 2002/04 World Health Survey (referred to as SAGE Wave 0). Wave 2 data collection will start in 2012/13, following up all Wave 1 respondents. Wave 3 is planned for 2014/15. SAGE is committed to the public release of study instruments, protocols and meta- and micro-data: access is provided upon completion of a Users Agreement available through WHO’s SAGE website (www.who.int/healthinfo/systems/sage) and WHO’s archive using the National Data Archive application (http://apps.who.int/healthinfo/systems/surveydata). PMID:23283715

  8. Data resource profile: the World Health Organization Study on global AGEing and adult health (SAGE).

    Science.gov (United States)

    Kowal, Paul; Chatterji, Somnath; Naidoo, Nirmala; Biritwum, Richard; Fan, Wu; Lopez Ridaura, Ruy; Maximova, Tamara; Arokiasamy, Perianayagam; Phaswana-Mafuya, Nancy; Williams, Sharon; Snodgrass, J Josh; Minicuci, Nadia; D'Este, Catherine; Peltzer, Karl; Boerma, J Ties

    2012-12-01

    Population ageing is rapidly becoming a global issue and will have a major impact on health policies and programmes. The World Health Organization's Study on global AGEing and adult health (SAGE) aims to address the gap in reliable data and scientific knowledge on ageing and health in low- and middle-income countries. SAGE is a longitudinal study with nationally representative samples of persons aged 50+ years in China, Ghana, India, Mexico, Russia and South Africa, with a smaller sample of adults aged 18-49 years in each country for comparisons. Instruments are compatible with other large high-income country longitudinal ageing studies. Wave 1 was conducted during 2007-2010 and included a total of 34 124 respondents aged 50+ and 8340 aged 18-49. In four countries, a subsample consisting of 8160 respondents participated in Wave 1 and the 2002/04 World Health Survey (referred to as SAGE Wave 0). Wave 2 data collection will start in 2012/13, following up all Wave 1 respondents. Wave 3 is planned for 2014/15. SAGE is committed to the public release of study instruments, protocols and meta- and micro-data: access is provided upon completion of a Users Agreement available through WHO's SAGE website (www.who.int/healthinfo/systems/sage) and WHO's archive using the National Data Archive application (http://apps.who.int/healthinfo/systems/surveydata).

  9. Proliferative fibrocystic lesions in association with carcinoma breast- Study of mastectomy specimens

    OpenAIRE

    R, Shashikala; Ravindra, Savithri

    2015-01-01

    Background: Breast cancer remains a global health problem with an increasing incidence. Proliferative breast diseases are recognized as one of the risk factors in the development of carcinoma. The study was undertaken to know the frequency of proliferative fibrocystic lesions in association with breast carcinomas in mastectomy specimens.Material and methods: The present study included 100 cases of mastectomies for carcinoma breast at Kempegowda Institute of Medical Sciences, Bangalore from Au...

  10. WHO's role in the global health system: what can be learned from global R&D debates?

    Science.gov (United States)

    Moon, Suerie

    2014-02-01

    Recent global debates on the research and development (R&D) of health technologies, such as drugs, diagnostics and vaccines, can be seen as a microcosm of discussions on the role of the World Health Organization (WHO) in the global health system more broadly. The global R&D system has come under heightened scrutiny with the publication of a 2012 report by the WHO Consultative Expert Working Group on Research and Development (CEWG), which made a number of recommendations to more equitably meet global health needs. The CEWG report followed a decade-long process of debate at the WHO on the weaknesses of the global R&D system, which include problems of affordability, limited research where market returns are small or uncertain (such as the 'neglected diseases' that predominantly affect the world's poorest), inefficient overlap of research efforts, and overuse of medicines such as antibiotics. The CEWG report called on WHO Member States to develop a global framework to improve monitoring, coordination and financing of R&D efforts through the establishment of a Global Health R&D Observatory and the negotiation of a binding treaty on R&D. While the treaty option has been put on the back-burner for several years, Member States nevertheless agreed at the 2013 World Health Assembly (WHA) on concrete steps towards a global framework. Progress at the 2013 WHA reaffirmed the central role of WHO as a convener, and the WHA's decision to create the Observatory within the WHO Secretariat underscored the organization's role as a source of strategic knowledge in the global health system. However, despite WHO's constitutional mandate as the 'directing and coordinating authority on international health work', in reality it faces major challenges in coordinating autonomous R&D actors such as states, firms and foundations in the global system. Strengthening its ability to do so requires, at a minimum, reforming its financing arrangements to provide it with a greater degree of

  11. Individual Responsibility for Promoting Global Health: The Case for a New Kind of Socially Conscious Consumption.

    Science.gov (United States)

    Hassoun, Nicole

    2016-06-01

    The problems of global health are truly terrible. Millions suffer and die from diseases like tuberculosis, HIV/AIDS, and malaria. One way of addressing these problems is via a Global Health Impact labeling campaign (http://global-health-impact.org/). If even a small percentage of consumers promote global health by purchasing Global Health Impact products, the incentive to use this label will be substantial. One might wonder, however, whether consumers are morally obligation to purchase any these goods or whether doing so is even morally permissible. This paper suggests that if the proposal is implemented, purchasing Global Health Impact labelled goods is at least morally permissible, if not morally required. Its argument should, moreover, be of much more general interest to those considering different kinds of ethical consumption. PMID:27338607

  12. Teaching corner: the prospective case study : a pedagogical innovation for teaching global health ethics.

    Science.gov (United States)

    Stewart, Kearsley A

    2015-03-01

    Over the past decade, global health has emerged as one of the fastest growing academic programs in the United States. Ethics training is cited widely as an essential feature of U.S. global health programs, but generally it is not deeply integrated into the global health teaching and training curricula. A discussion about the pedagogy of teaching global health ethics is long overdue; to date, only a few papers specifically engage with pedagogy rather than competencies or content. This paper explores the value of case study pedagogy for a full-semester graduate course in global health ethics at an American university. I address some of the pedagogical challenges of teaching global health ethics through my innovative use of case study methodology-the "prospective case study" (PSC). PMID:25630595

  13. The evolution of human rights in World Health Organization policy and the future of human rights through global health governance.

    Science.gov (United States)

    Meier, B M; Onzivu, W

    2014-02-01

    The World Health Organization (WHO) was intended to serve at the forefront of efforts to realize human rights to advance global health, and yet this promise of a rights-based approach to health has long been threatened by political constraints in international relations, organizational resistance to legal discourses, and medical ambivalence toward human rights. Through legal research on international treaty obligations, historical research in the WHO organizational archives, and interview research with global health stakeholders, this research examines WHO's contributions to (and, in many cases, negligence of) the rights-based approach to health. Based upon such research, this article analyzes the evolving role of WHO in the development and implementation of human rights for global health, reviews the current state of human rights leadership in the WHO Secretariat, and looks to future institutions to reclaim the mantle of human rights as a normative framework for global health governance.

  14. The evolution of human rights in World Health Organization policy and the future of human rights through global health governance.

    Science.gov (United States)

    Meier, B M; Onzivu, W

    2014-02-01

    The World Health Organization (WHO) was intended to serve at the forefront of efforts to realize human rights to advance global health, and yet this promise of a rights-based approach to health has long been threatened by political constraints in international relations, organizational resistance to legal discourses, and medical ambivalence toward human rights. Through legal research on international treaty obligations, historical research in the WHO organizational archives, and interview research with global health stakeholders, this research examines WHO's contributions to (and, in many cases, negligence of) the rights-based approach to health. Based upon such research, this article analyzes the evolving role of WHO in the development and implementation of human rights for global health, reviews the current state of human rights leadership in the WHO Secretariat, and looks to future institutions to reclaim the mantle of human rights as a normative framework for global health governance. PMID:24439475

  15. Global Health Training and International Clinical Rotations during Residency: Current Status, Needs, and Opportunities

    OpenAIRE

    Drain, Paul K; Holmes, King K.; Skeff, Kelley M; Thomas L Hall; Gardner, Pierce

    2009-01-01

    Increasing international travel and migration have contributed to globalization of diseases. Physicians today must understand the global burden and epidemiology of diseases, the disparities and inequities in global health systems, and the importance of cross-cultural sensitivity. To meet these needs, resident physicians across all specialties have expressed growing interest in global health training and international clinical rotations. More residents are acquiring international experience, d...

  16. The Global Role of Health Care Delivery Science: Learning from Variation to Build Health Systems that Avoid Waste and Harm

    OpenAIRE

    Mulley, Albert G.

    2013-01-01

    This paper addresses the fourth theme of the Indiana Global Health Research Working Conference, Clinical Effectiveness and Health Systems Research. It explores geographic variation in health care delivery and health outcomes as a source of learning how to achieve better health outcomes at lower cost. It focuses particularly on the relationship between investments made in capacities to deliver different health care services to a population and the value thereby created by that care for individ...

  17. An outline of the need for psychology knowledge in health professionals: implications for community development and breast cancer prevention.

    Science.gov (United States)

    Ahmadian, Maryam; Samah, Asnarulkhadi Abu; Saidu, Mohammed Bashir

    2014-01-01

    Knowledge of health and community psychology in health professionals influences psychosocial and community determinants of health and promoting participation in disease prevention at the community level. This paper appraises the potential of knowledge on psychology in health care professionals and its contribution to community empowerment through individual behavior change and health practice. The authors proposed a schematic model for the use of psychological knowledge in health professionals to promote participation in health interventions/disease prevention programs in developing countries. By implication, the paper provides a vision on policies towards supporting breast cancer secondary prevention efforts for community health development in Asian countries.

  18. Impact of global health governance on country health systems: the case of HIV initiatives in Nigeria

    Directory of Open Access Journals (Sweden)

    Charles Chikodili Chima

    2015-06-01

    Full Text Available Background: Three global health initiatives (GHIs – the US President’s Emergency Plan for AIDS Relief, the Global Fund to Fight AIDS, Tuberculosis and Malaria, and the World Bank Multi–Country HIV/AIDS Program – finance most HIV services in Nigeria. Critics assert that GHIs burden fragile health systems in resource–poor countries and that health system limitations in these countries constrain the achievement of the objectives of GHIs. This study analyzed interactions between HIV GHIs and the Nigerian Health System and explored how the impact of the GHIs could be optimized. Methods: A country case study was conducted using qualitative methods, including: semi–structured interviews, direct observation, and archival review. Semi–structured interviews were held with key informants selected to reach a broad range of stakeholders including policymakers, program managers, service providers, representatives of donor agencies and their implementing partners; the WHO country office in Nigeria; independent consultants; and civil society organizations involved in HIV work. The fieldwork was conducted between June and August 2013. Findings: HIV GHIs have had a mixed impact on the health system. They have enhanced availability of and access to HIV services, improved quality of services, and strengthened health information systems and the role of non–state actors in health care. On the negative end, HIV donor funding has increased dependency on foreign aid, widened disparities in access to HIV services, done little to address the sustainability of the services, crowded out non–HIV health services, and led to the development of a parallel supply management system. They have also not invested significantly in the production of new health workers and have not addressed maldistribution problems, but have rather contributed to internal brain drain by luring health workers from the public sector to non–governmental organizations and have

  19. The global health concept of the German government: strengths, weaknesses, and opportunities

    OpenAIRE

    Bozorgmehr, Kayvan; Bruchhausen, Walter; Hein, Wolfgang; Knipper, Michael; Korte, Rolf; Razum, Oliver; Tinnemann, Peter

    2014-01-01

    Recognising global health as a rapidly emerging policy field, the German federal government recently released a national concept note for global health politics (July 10, 2013). As the German government could have a significant impact on health globally by making a coherent, evidence-informed, and long-term commitment in this field, we offer an initial appraisal of the strengths, weaknesses, and opportunities for development recognised in this document. We conclude that the national concept i...

  20. To the point: obstetrics and gynecology global health experiences for medical students.

    Science.gov (United States)

    Hampton, Brittany S; Chuang, Alice W; Abbott, Jodi F; Buery-Joyner, Samantha D; Cullimore, Amie J; Dalrymple, John L; Forstein, David A; Hueppchen, Nancy A; Kaczmarczyk, Joseph M; Page-Ramsey, Sarah; Pradhan, Archana; Wolf, Abigail; Dugoff, Lorraine

    2014-07-01

    This article, from the To the Point series prepared by the Association of Professors of Gynecology and Obstetrics Undergraduate Medical Education Committee, provides educators with an overview of considerations for obstetrics and gynecology global health experiences for the medical student. Options for integration of obstetrics and gynecology global health into undergraduate medical curricula are discussed. Specific considerations for global health clinical experiences for medical students, including choosing a clinical location, oversight and mentorship, goals and objectives, predeparture preparation, and evaluation, are reviewed.

  1. Modernisation, smoking and chronic disease: Of temporality and spatiality in global health

    OpenAIRE

    Reubi, David Herrick

    2016-01-01

    This article explores the spatio-temporal logics at work in global health. Influenced by ideas of time-space compression, the global health literature argues that the world is characterised by a convergence of disease patterns and biomedical knowledge. While not denying the influence of these temporalities and spatialities of globalisation within the global health and chronic disease field, the article argues that they sit alongside other, often-conflicting notions of time and space. To do so...

  2. Functional health literacy in Spanish-speaking Latinas seeking breast cancer screening through the National Breast and Cervical Cancer Screening Program

    Directory of Open Access Journals (Sweden)

    Samantha Garbers

    2009-03-01

    Full Text Available 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: A total of 707 Latinas who spoke Spanish as their primary language completed a survey of health and demographic characteristics and the Test of Functional Health Literacy in Spanish (TOFHLA-S. Survey results were matched with clinical outcome data.Results: Among the survey participants, 98% were foreign-born and 99% had no health insurance. While the study found significant differences in access to health information and past screening behavior, women without adequate health literacy in Spanish were no less likely to receive clinical resolution of abnormal mammograms within 60 days (81.8% overall; n = 110 or to return for a repeat mammogram within 18 months (57.2% overall; n = 697. In fact, among those referred for a Pap test (n = 310, women without adequate health literacy were more likely to receive a Pap test within 60 days of their mammogram than those with adequate health literacy (82% compared to 71%, OR: 1.83, 95% CI: 1.04–3.22.Discussion: The lack of significantly lower follow-up outcomes among women with inadequate and marginal functional health literacy in this population of primary Spanish-speaking Latinas suggests that, once women have accessed screening services, programmatic approaches may exist to mitigate barriers to follow-up and to ensure optimal cancer screening outcomes for women of all literacy levels.Keywords: health literacy, mammography, Latinas, case management, cancer screening

  3. One health security: an important component of the global health security agenda.

    Science.gov (United States)

    Gronvall, Gigi; Boddie, Crystal; Knutsson, Rickard; Colby, Michelle

    2014-01-01

    The objectives of the Global Health Security Agenda (GHSA) will require not only a "One Health" approach to counter natural disease threats against humans, animals, and the environment, but also a security focus to counter deliberate threats to human, animal, and agricultural health and to nations' economies. We have termed this merged approach "One Health Security." It will require the integration of professionals with expertise in security, law enforcement, and intelligence to join the veterinary, agricultural, environmental, and human health experts essential to One Health and the GHSA. Working across such different professions, which occasionally have conflicting aims and different professional cultures, poses multiple challenges, but a multidisciplinary and multisectoral approach is necessary to prevent disease threats; detect them as early as possible (when responses are likely to be most effective); and, in the case of deliberate threats, find who may be responsible. This article describes 2 project areas that exemplify One Health Security that were presented at a workshop in January 2014: the US government and private industry efforts to reduce vulnerabilities to foreign animal diseases, especially foot-and-mouth disease; and AniBioThreat, an EU project to counter deliberate threats to agriculture by raising awareness and implementing prevention and response policies and practices. PMID:25254909

  4. The health seeking trajectories of Malaysian women and their husbands in delay cases of breast cancer: a qualitative study.

    Science.gov (United States)

    Yusoff, Nasir; Taib, Nur Aishah Mohd; Ahmad, Aini

    2011-01-01

    The aim of this study was to assess why women delay in getting treatment (i.e. surgery) for breast cancer, as well as to explore on what type of issues are involved in such delay cases. Basic interpretative of qualitative methodology was applied to construct the reality of delay phenomena, and its interaction with social worlds. Six themes were identified: new conception of breast cancer treatment, psychological defenses, health support system, symtomatology experience, model and barriers. The delay issue in breast cancer requires attention as a multidimensional problem as this will facilitate more comprehensive and effective intervention to reduce delay.

  5. Towards Establishing Fiscal Legitimacy Through Settled Fiscal Principles in Global Health Financing.

    Science.gov (United States)

    Waris, Attiya; Latif, Laila Abdul

    2015-12-01

    Scholarship on international health law is currently pushing the boundaries while taking stock of achievements made over the past few decades. However despite the forward thinking approach of scholars working in the field of global health one area remains a stumbling block in the path to achieving the right to health universally: the financing of heath. This paper uses the book Global Health Law by Larry Gostin to reflect and take stock of the fiscal support provided to the right to health from both a global and an African perspective. It then sets out the key fiscal challenges facing global and African health and proposes an innovative solution for consideration: use of the domestic principles of tax to design the global health financing system.

  6. Towards Establishing Fiscal Legitimacy Through Settled Fiscal Principles in Global Health Financing.

    Science.gov (United States)

    Waris, Attiya; Latif, Laila Abdul

    2015-12-01

    Scholarship on international health law is currently pushing the boundaries while taking stock of achievements made over the past few decades. However despite the forward thinking approach of scholars working in the field of global health one area remains a stumbling block in the path to achieving the right to health universally: the financing of heath. This paper uses the book Global Health Law by Larry Gostin to reflect and take stock of the fiscal support provided to the right to health from both a global and an African perspective. It then sets out the key fiscal challenges facing global and African health and proposes an innovative solution for consideration: use of the domestic principles of tax to design the global health financing system. PMID:26337764

  7. Bringing (domestic) politics back in: global and local influences on health equity.

    Science.gov (United States)

    Schrecker, Ted

    2015-07-01

    The Lancet-University of Oslo Commission on Global Governance for health correctly concluded that: 'with globalization, health inequity increasingly results from transnational activities that involve actors with different interests and degrees of power'. At the same time, taking up that Commission's focus on political determinants of health and 'power asymmetries' requires recognizing the interplay of globalization with domestic politics, and the limits of global influences as explanations for policies that affect health inequalities. I make this case using three examples - trade policy, climate change policy, and the domestic politics of poverty reduction and social policy - and a concluding observation about the 2015 UK election.

  8. Health-related quality of life in survivors of stage I-II breast cancer: randomized trial of post-operative conventional radiotherapy and hypofractionated tomotherapy

    International Nuclear Information System (INIS)

    Health-related quality of life (HRQOL) assessment is a key component of clinical oncology trials. However, few breast cancer trials comparing adjuvant conventional radiotherapy (CR) and hypofractionated tomotherapy (TT) have investigated HRQOL. We compared HRQOL in stage I-II breast cancer patients who were randomized to receive either CR or TT. Tomotherapy uses an integrated computed tomography scanner to improve treatment accuracy, aiming to reduce the adverse effects of radiotherapy. A total of 121 stage I–II breast cancer patients who had undergone breast conserving surgery (BCS) or mastectomy (MA) were randomly assigned to receive either CR or TT. CR patients received 25 × 2 Gy over 5 weeks, and BCS patients also received a sequential boost of 8 × 2 Gy over 2 weeks. TT patients received 15 × 2.8 Gy over 3 weeks, and BCS patients also received a simultaneous integrated boost of 15 × 0.6 Gy over 3 weeks. Patients completed the EORTC QLQ-C30 and BR23 questionnaires. The mean score (± standard error) was calculated at baseline, the end of radiotherapy, and at 3 months and 1, 2, and 3 years post-radiotherapy. Data were analyzed by the 'intention-to-treat' principle. On the last day of radiotherapy, patients in both treatment arms had decreased global health status and functioning scores; increased fatigue (clinically meaningful in both treatment arms), nausea and vomiting, and constipation; decreased arm symptoms; clinically meaningful increased breast symptoms in CR patients and systemic side effects in TT patients; and slightly decreased body image and future perspective. At 3 months post-radiotherapy, TT patients had a clinically significant increase in role- and social-functioning scores and a clinically significant decrease in fatigue. The post-radiotherapy physical-, cognitive- and emotional-functioning scores improved faster in TT patients than CR patients. TT patients also had a better long-term recovery from fatigue than CR patients. ANOVA

  9. E-health and the Universitas 21 organization: 3. Global policy.

    Science.gov (United States)

    Scott, Richard E; Lee, Anna

    2005-01-01

    There is an urgent need to develop global e-health policy in order both to facilitate and to manage the potential of e-health. As part of the Universitas 21 (U21) project in e-health, an evaluation of the status of global e-health policy was performed using a SWOT analysis (strengths, weaknesses, opportunities and threats). The analysis showed that the greatest threat to global e-health policy is the autonomous nature of domestic health-care systems. The greatest opportunity may be the prospect for nations and individuals to work together in establishing mechanisms necessary to offer health-care access through global e-health--a new 'global public good'. Full integration of e-health into existing health-care systems could be achieved in both a practical and a policy sense through global e-health policy initiatives that facilitate integration across jurisdictions. There is a pressing need to resolve a range of e-health policy issues, and a concomitant need for research that will inform and support the process. A process that adopts a global approach is recommended.

  10. Creating a center for global health at the University of Wisconsin-Madison.

    Science.gov (United States)

    Haq, Cynthia; Baumann, Linda; Olsen, Christopher W; Brown, Lori DiPrete; Kraus, Connie; Bousquet, Gilles; Conway, James; Easterday, B C

    2008-02-01

    Globalization, migration, and widespread health disparities call for interdisciplinary approaches to improve health care at home and abroad. Health professions students are pursuing study abroad in increasing numbers, and universities are responding with programs to address these needs. The University of Wisconsin (UW)-Madison schools of medicine and public health, nursing, pharmacy, veterinary medicine, and the division of international studies have created an interdisciplinary center for global health (CGH). The CGH provides health professions and graduate students with courses, field experiences, and a new Certificate in Global Health. Educational programs have catalyzed a network of enthusiastic UW global health scholars. Partnerships with colleagues in less economically developed countries provide the foundation for education, research, and service programs. Participants have collaborated to improve the education of health professionals and nutrition in Uganda; explore the interplay between culture, community development, and health in Ecuador; improve animal health and address domestic violence in Mexico; and examine successful public health efforts in Thailand. These programs supply students with opportunities to understand the complex determinants of health and structure of health systems, develop adaptability and cross-cultural communication skills, experience learning and working in interdisciplinary teams, and promote equity and reduce health disparities at home and abroad. Based on the principles of equity, sustainability, and reciprocity, the CGH provides a strong foundation to address global health challenges through networking and collaboration among students, staff, and faculty within the UW and beyond. PMID:18303359

  11. Tailored lay health worker intervention improves breast cancer screening outcomes in non-adherent Korean-American women

    OpenAIRE

    Han, Hae-Ra; Lee, H.; Kim, M. T.; Kim, K. B.

    2008-01-01

    Despite rapidly increasing incidence rates of breast cancer, recent immigrants such as Korean-American (KA) women report disproportionately lower utilization of screening tests compared with other ethnic groups. Early screening of breast cancer for this population may be greatly facilitated by indigenous lay health workers (LHWs). We conducted an intervention trial with a 6-month follow-up. Trained LHWs recruited 100 KA women 40 years of age or older who had not had a mammogram during the pas...

  12. Violations of the International Code of Marketing of Breast Milk Substitutes in South African health facilities / Ndugiselo Muravha

    OpenAIRE

    Muravha, Ndugiselo

    2014-01-01

    INTRODUCTION Exclusive breastfeeding (EBF) for the first six months of an infant‟s life is recognized by the World Health Organisation (WHO) and the United Nations Children‟s Fund (UNICEF) as the most effective and essential strategy for optimal growth and prevention of infant mortality. One of the factors that influences a mothers choice to exclusively breastfeed her child, is the marketing of breast milk substitutes. The International Code of Marketing of Breast-milk Substitutes (ICMBS) ...

  13. Planning and executing a global health experience for undergraduate nursing students: A comprehensive guide to creating global citizens.

    Science.gov (United States)

    Visovsky, Constance; McGhee, Stephen; Jordan, Elizabeth; Dominic, Sara; Morrison-Beedy, Dianne

    2016-05-01

    The preparation of future baccalaureate-prepared nurses will require undergraduate students to have both cultural awareness and global or international health competencies in order to meet the increasingly complex health care needs of a diverse community. Additionally, the nursing accrediting bodies have identified global healthcare as an area of core knowledge for clinical nurses. In order to meet the workforce needs, and provide global education of the undergraduate student body, we designed an international clinical experience within the undergraduate Community/Population Health course. The purpose of this article is to provide a guide for faculty in the planning, infrastructure needs, and implementation of a global clinical experience for undergraduate nursing students, in the context of the United States with addressing university concerns for student safety and security while abroad. PMID:27125146

  14. Health economists, tobacco control and international development: On the economisation of global health beyond neoliberal structural adjustment policies.

    Science.gov (United States)

    Reubi, David

    2013-06-01

    This article addresses the increasing influence of economic rationalities in global health over the past 30 years by examining the genealogy of one economic strategy - taxation - that has become central to international anti-smoking initiatives in the global South. It argues that this genealogy sits uncomfortably with the usual story about economics and global health, which reduces the economisation of international health to neoliberal structural adjustment policies aimed at stabilisation, liberalisation and privatisation and laments their detrimental effect on health. While not disputing these policies' importance and damaging impact, the genealogy of tobacco taxes outlined in this article shows that the economisation of global health is not only about neoliberal structural adjustment policies but also about sin taxes, market failures and health economics. By stressing how changes in health like the global South's epidemiological transition can impact on economics and how beneficial taxation can be for health, it also shows that the relation between economics and health is not always unidirectional and detrimental to the latter. In doing so, the article contributes to the critique of the often mechanical use of neo-liberalism to explicate change and calls for other stories about the economisation of global health to be told. PMID:23750175

  15. Staff support for the Health Service Executive (HSE) global health programme.

    Science.gov (United States)

    Fitzpatrick, G; Weakliam, D; Boland, M; Fitzgerald, M

    2014-03-01

    The Global Health programme (GHP) within the Health Service Executive (HSE) aims to improve health in developing countries by creating partnerships between Irish and developing world healthcare institutions. To ascertain the level of interest among HSE staff for the GHP a web-based survey was conducted. 1,028 responses were received. Medical professionals, 202 (27.7%) composed the largest category of respondents. The majority, 503 (69.3%) of respondents wished to actively participate in the GHP. 237 (23.1%) staff had previous experience of working in the developing world. This survey highlighted a number of themes respondents considered important for successful partnerships including: reciprocal staff exchange, joint scientific research, the avoidance of "brain drain" and utilising the Internet to link institutions. Less than 1% (2/203) of comments expressed a negative view of the GHP.

  16. "Globalized public health.” A transdisciplinary comprehensive framework for analyzing contemporary globalization’s influences on the field of public health

    OpenAIRE

    Véronique Lapaige

    2009-01-01

    Véronique LapaigeCanadian Health Services Research Foundation Fellow, Centre intégré de formation en sciences de la santé (CIFSS), Université Laval, Québec, CanadaAbstract: The current phase of globalization represents a “double-edged sword” challenge facing public health practitioners and health policy makers. The first “edge” throws light on two constructs in the field of public health:...

  17. Tailored lay health worker intervention improves breast cancer screening outcomes in non-adherent Korean-American women.

    Science.gov (United States)

    Han, Hae-Ra; Lee, H; Kim, M T; Kim, K B

    2009-04-01

    Despite rapidly increasing incidence rates of breast cancer, recent immigrants such as Korean-American (KA) women report disproportionately lower utilization of screening tests compared with other ethnic groups. Early screening of breast cancer for this population may be greatly facilitated by indigenous lay health workers (LHWs). We conducted an intervention trial with a 6-month follow-up. Trained LHWs recruited 100 KA women 40 years of age or older who had not had a mammogram during the past 2 years. Ninety-three completed follow-up questionnaires. A 120-min, in-class education combined with LHW follow-up counseling and navigation assistance through the health care system was provided. Rates of breast cancer screening behaviors significantly increased at 6 months (P < 0.001); changes between pre- and post-intervention were 31.9% for mammography, 23% for clinical breast examination and 36.2% for breast self-examination. Modesty toward screening significantly decreased over time, but we did not find any significant differences in breast cancer knowledge and beliefs before and after the intervention. Results support the efficacy of this neighborhood-based, culturally sensitive intervention. Further research should seek to replicate these findings and to incorporate more self-care skills such as health literacy when designing an intervention program for linguistically and culturally isolated immigrant women. PMID:18463411

  18. Intraoperative radiotherapy for early breast cancer: do health professionals choose convenience or risk?

    International Nuclear Information System (INIS)

    The randomized TARGIT trial comparing experimental intra-operative radiotherapy (IORT) to up to 7 weeks of daily conventional external beam radiotherapy (EBRT) recruited participants in Western Australia between 2003 and 2012. We aimed to understand preferences for this evolving radiotherapy treatment for early breast cancer (EBC) in health professionals, and how they changed over time and in response to emerging data. Preferences for single dose IORT or EBRT for EBC were elicited in 2004 and 2011, together with factors that may be associated with these preferences. Western Australian health professionals working with breast cancer patients were invited to complete a validated, self-administered questionnaire. The questionnaire used hypothetical scenarios and trade-off methodology to determine the maximum increase in risk of local recurrence health professionals were willing to accept in order to have a single dose of IORT in the place of EBRT if they were faced with this decision themselves. Health professional characteristics were similar across the two time points although 2011 included a higher number of nurse (49% vs. 36%) and allied health (10% vs. 4%) participants and a lower number of radiation therapists (17% vs. 32%) compared to 2004. Health professional preferences varied, with 7.5% and 3% judging IORT unacceptable at any risk, 18% and 21% judging IORT acceptable only if offering an equivalent risk, 56% and 59% judging IORT acceptable with a low maximum increase in risk (1-3%) and 19% and 17% judging a high maximum increase in risk acceptable (4-5%), in 2004 and 2011 respectively. A significantly greater number of nurses accepted IORT as a treatment option in 2011. Most Western Australian health professionals working with breast cancer patients are willing to accept an increase in risk of local recurrence in order to replace EBRT with IORT in a hypothetical setting. This finding was consistent over two time points spanning 7 years despite the duration of

  19. Developing a curriculum framework for global health in family medicine: emerging principles, competencies, and educational approaches

    Directory of Open Access Journals (Sweden)

    Wilson Briana

    2011-07-01

    Full Text Available Abstract Background Recognizing the growing demand from medical students and residents for more comprehensive global health training, and the paucity of explicit curricula on such issues, global health and curriculum experts from the six Ontario Family Medicine Residency Programs worked together to design a framework for global health curricula in family medicine training programs. Methods A working group comprised of global health educators from Ontario's six medical schools conducted a scoping review of global health curricula, competencies, and pedagogical approaches. The working group then hosted a full day meeting, inviting experts in education, clinical care, family medicine and public health, and developed a consensus process and draft framework to design global health curricula. Through a series of weekly teleconferences over the next six months, the framework was revised and used to guide the identification of enabling global health competencies (behaviours, skills and attitudes for Canadian Family Medicine training. Results The main outcome was an evidence-informed interactive framework http://globalhealth.ennovativesolution.com/ to provide a shared foundation to guide the design, delivery and evaluation of global health education programs for Ontario's family medicine residency programs. The curriculum framework blended a definition and mission for global health training, core values and principles, global health competencies aligning with the Canadian Medical Education Directives for Specialists (CanMEDS competencies, and key learning approaches. The framework guided the development of subsequent enabling competencies. Conclusions The shared curriculum framework can support the design, delivery and evaluation of global health curriculum in Canada and around the world, lay the foundation for research and development, provide consistency across programmes, and support the creation of learning and evaluation tools to align with the

  20. Economic, Social and Political Aspect of Globalization on Health in Developing Countries (with Segregation

    Directory of Open Access Journals (Sweden)

    Batool Rafat

    2013-07-01

    Full Text Available Today, scholars and human rights activists for more national and international responsibilities in a "right to health for everyone" exchange ideas and also propose some strategies. One of the major international problems of health hazards result from globalization. The Relationship between globalization and health aspects of economic, technological, political, social, scientific and cultural should be studied. This study intends to review the aspects of economic, social and political globalization on the health. In this case ,Kof index is which includes all three aspects of economic, social and political globalization agenda. The results show that economic globalization has a negative effect on health in developing countries and globalization, social and political effects are positive and statistically significant. The result is the same for both women and men, and there are only minor differences in the coefficients.

  1. Global policy for improvement of oral health in the 21st century--implications to oral health research of World Health Assembly 2007, World Health Organization

    DEFF Research Database (Denmark)

    Petersen, Poul Erik

    2009-01-01

    or adjustment of oral health programmes at national level. Clinical and public health research has shown that a number of individual, professional and community preventive measures are effective in preventing most oral diseases. However, advances in oral health science have not yet benefited the poor...... and disadvantaged populations worldwide. The major challenges of the future will be to translate knowledge and experiences in oral disease prevention and health promotion into action programmes. The WHO Global Oral Health Programme invites the international oral health research community to engage further...

  2. Risk Factors, Preventive Practices, and Health Care Among Breast Cancer Survivors, United States, 2010

    Directory of Open Access Journals (Sweden)

    Sherri G. Homan, RN, FNP, PhD

    2016-01-01

    Full Text Available Introduction We compared behavioral risk factors and preventive measures among female breast cancer survivors, female survivors of other types of cancers, and women without a history of cancer. Survivorship health care indicators for the 2 groups of cancer survivors were compared. Methods Using data from the 2010 Behavioral Risk Factor Surveillance System, we calculated the proportion of women with risk factors and their engagement in preventive practices, stratified by cancer status (cancer survivors or women with no history of cancer, and compared the proportions after adjusting for sociodemographic characteristics. Results A significantly higher proportion of breast cancer survivors had mammography in the previous year (79.5%; 95% confidence interval [CI], 76.0%–83.0% than did other cancer survivors (68.1%; 95% CI, 65.6%–70.7% or women with no history of cancer (66.4%; 95% CI, 65.5%–67.3%. Breast cancer survivors were also more likely to have had a Papanicolaou (Pap test within the previous 3 years than women with no history of cancer (89.4%; 95% CI, 85.9%–93.0 vs 85.1%; 95% CI, 84.4%–85.8% and a colonoscopy within the previous 10 years (75.4%; 95% CI, 71.7%–79.0% than women with no history of cancer (60.0%; 95% CI, 59.0%–61.0%. Current smoking was significantly lower among survivors of breast cancer (10.3%; 95% CI, 7.4%–13.2% than other cancer survivors (20.8%; 95% CI, 18.4%–23.3% and women with no history of cancer (18.3%; 95% CI, 17.5%–19.1%. After adjusting for sociodemographic characteristics, we found that breast cancer survivors were significantly more likely to have had mammography, a Pap test, and colonoscopy, and less likely to be current smokers. Conclusion Breast cancer survivors are more likely to engage in cancer screening and less likely to be current smokers than female survivors of other types of cancer or women with no history of cancer.

  3. Knowledge and networks - key sources of power in global health: Comment on "Knowledge, moral claims and the exercise of power in global health".

    Science.gov (United States)

    Hanefeld, Johanna; Walt, Gill

    2015-02-01

    Shiffman rightly raises questions about who exercises power in global health, suggesting power is a complex concept, and the way it is exercised is often opaque. Power that is not based on financial strength but on knowledge or experience, is difficult to estimate, and yet it may provide the legitimacy to make moral claims on what is, or ought to be, on global health agendas. Twenty years ago power was exercised in a much less complex health environment. The World Health Organization (WHO) was able to exert its authority as world health leader. The landscape today is very different. Financial resources for global health are being competed for by diverse organisations, and power is diffused and somewhat hidden in such a climate, where each organization has to establish and make its own moral claims loudly and publicly. We observe two ways which allow actors to capture moral authority in global health. One, through power based on scientific knowledge and two, through procedures in the policy process, most commonly associated with the notion of broad consultation and participation. We discuss these drawing on one particular framework provided by Bourdieu, who analyses the source of actor power by focusing on different sorts of capital. Different approaches or theories to understanding power will go some way to answering the challenge Shiffman throws to health policy analysts. We need to explore much more fully where power lies in global health, and how it is exercised in order to understand underlying health agendas and claims to legitimacy made by global health actors today. PMID:25674577

  4. Knowledge and networks - key sources of power in global health: Comment on "Knowledge, moral claims and the exercise of power in global health".

    Science.gov (United States)

    Hanefeld, Johanna; Walt, Gill

    2015-02-01

    Shiffman rightly raises questions about who exercises power in global health, suggesting power is a complex concept, and the way it is exercised is often opaque. Power that is not based on financial strength but on knowledge or experience, is difficult to estimate, and yet it may provide the legitimacy to make moral claims on what is, or ought to be, on global health agendas. Twenty years ago power was exercised in a much less complex health environment. The World Health Organization (WHO) was able to exert its authority as world health leader. The landscape today is very different. Financial resources for global health are being competed for by diverse organisations, and power is diffused and somewhat hidden in such a climate, where each organization has to establish and make its own moral claims loudly and publicly. We observe two ways which allow actors to capture moral authority in global health. One, through power based on scientific knowledge and two, through procedures in the policy process, most commonly associated with the notion of broad consultation and participation. We discuss these drawing on one particular framework provided by Bourdieu, who analyses the source of actor power by focusing on different sorts of capital. Different approaches or theories to understanding power will go some way to answering the challenge Shiffman throws to health policy analysts. We need to explore much more fully where power lies in global health, and how it is exercised in order to understand underlying health agendas and claims to legitimacy made by global health actors today.

  5. How does living with HIV impact on women's mental health? Voices from a global survey

    OpenAIRE

    Luisa Orza; Susan Bewley; Logie, Carmen H.; Elizabeth Tyler Crone; Svetlana Moroz; Sophie Strachan; Marijo Vazquez; Alice Welbourn

    2015-01-01

    Introduction: Women living with HIV experience a disproportionate burden of mental health issues. To date, global guidelines contain insufficient guidance on mental health support, particularly regarding perinatal care. The aim of this article is to describe the extent and impact of mental health issues as experienced by women living with HIV on their sexual and reproductive health and human rights (SRH&HR). Methods: A global, mixed-methods, user-led and designed survey on SRH&HR of women liv...

  6. Hispanic women's preferences for breast health information: subjective cultural influences on source, message, and channel.

    Science.gov (United States)

    Oetzel, John; De Vargas, Felicia; Ginossar, Tamar; Sanchez, Christina

    2007-01-01

    The purpose of this study was to investigate the influence of 3 subjective cultural variables--self-construals (independence and interdependence), ethnic identity (bicultural, assimilation, traditional, and marginal), and cultural health attributions (equity and behavioral-environmental attributions)--on source, message, and channel preferences for receiving breast health information by Hispanic women age 35 or older. Subjective cultural variables collectively accounted for 2% to 28% of the variance in communication preferences. In addition, several associations were discovered: (a) having an interdependent self-construal was associated positively with preferences for significant other as a source, family sources, fear messages, media channels, and face-to-face channels; (b) having a bicultural identity was associated positively with preferences for family sources and media channels, but negatively with a desire for no information; and (c) having a marginal identity and equity attributions were associated positively with preferences for fear messages and a desire for no information, but negatively with preferences for expert sources. These findings are discussed in the context of tailoring breast health information to Hispanic women using computer technology and entertainment-education.

  7. All together now: developing a team skills competency domain for global health education.

    Science.gov (United States)

    Rowthorn, Virginia; Olsen, Jody

    2014-01-01

    Global health is by definition and necessity a collaborative field; one that requires diverse professionals to address the clinical, biological, social, and political factors that contribute to the health of communities, regions, and nations. While much work has been done in recent years to define the field of global health and set forth discipline-specific global health competencies, less has been done in the area of interprofessional global health education. This paper documents the results of a roundtable that was convened to study the need for an interprofessional team skills competency domain for global health students. The paper sets forth a preliminary set of team competencies based on existing scholarship and the results of the roundtable. Once an agreed upon set of competencies is defined, a valuable next task will be development of a model curriculum to teach team skills to students in global health. The preliminary competencies offered in this paper represent a good first step toward ensuring that global health professionals are able to collaborate effectively to make the field as cohesive and collaborative as the mighty task of global health demands. PMID:25565620

  8. Genetic technology in health care. A global view.

    Science.gov (United States)

    Galjaard, H

    1994-01-01

    Clinical genetics services have become an integrated part of health care in nearly all European countries. The emphasis has been on postnatal cytogenetic, biochemical, and DNA diagnosis of congenital disorders, carrier detection, genetic counseling, and prenatal diagnosis. Use has been satisfactory, and very few ethical problems have arisen, apart from moral objections against abortion by minority groups. The progress of human gene mapping is associated with new perspectives in clinical genetics and will enable the identification of people at risk of major adult diseases. This prospect has caused some concern about psychosocial and ethical issues that are being dealt with in different ways in various postindustrial societies. In future decades, however, 95% of the world's population increase will occur in developing countries. In most of these countries, a low per capita income, female illiteracy, low rates of contraceptive use, teenage pregnancy, and religious and traditional cultural factors are major complications of implementing genetic services at a global level. There are, however, some exceptions, which are discussed. PMID:7843876

  9. Global health risks and cosmopolitisation: from emergence to interference.

    Science.gov (United States)

    Figuié, Muriel

    2013-02-01

    According to Beck's 'World at Risk' theory, global risks push nations towards a cosmopolitisation of their health policy and open opportunities for a democratic turn. This article provides an empirical analysis of Beck's theory, based on the experience of Vietnamese authorities from 2003 to 2007 in managing the emerging avian flu virus. It shows how Vietnam's framing of avian flu has shifted, under the pressure from international organisations and the US administration, from an epizootic and zoonotic risk (or a classic risk) to a pandemic threat (or a late modern risk). Vietnam's response was part of its overall strategy to join the World Trade Organization and it was limited by Vietnam's defence of its sovereignty. This strategy has been successful for Vietnam but has limited the possibility of cosmopolitan and democratic transformations. The case study highlights the constructed dimension of risks of late modernity and their possible instrumentalisation: it minimises the role of a community of fear relative to a community of trade. PMID:23517415

  10. The 'global health' education framework: a conceptual guide for monitoring, evaluation and practice

    Directory of Open Access Journals (Sweden)

    Tinnemann Peter

    2011-04-01

    Full Text Available Abstract Background In the past decades, the increasing importance of and rapid changes in the global health arena have provoked discussions on the implications for the education of health professionals. In the case of Germany, it remains yet unclear whether international or global aspects are sufficiently addressed within medical education. Evaluation challenges exist in Germany and elsewhere due to a lack of conceptual guides to develop, evaluate or assess education in this field. Objective To propose a framework conceptualising 'global health' education (GHE in practice, to guide the evaluation and monitoring of educational interventions and reforms through a set of key indicators that characterise GHE. Methods Literature review; deduction. Results and Conclusion Currently, 'new' health challenges and educational needs as a result of the globalisation process are discussed and linked to the evolving term 'global health'. The lack of a common definition of this term complicates attempts to analyse global health in the field of education. The proposed GHE framework addresses these problems and presents a set of key characteristics of education in this field. The framework builds on the models of 'social determinants of health' and 'globalisation and health' and is oriented towards 'health for all' and 'health equity'. It provides an action-oriented construct for a bottom-up engagement with global health by the health workforce. Ten indicators are deduced for use in monitoring and evaluation.

  11. A Peer Health Educator Program for Breast Cancer Screening Promotion: Arabic, Chinese, South Asian, and Vietnamese Immigrant Women's Perspectives.

    Science.gov (United States)

    Crawford, Joanne; Frisina, Angela; Hack, Tricia; Parascandalo, Faye

    2015-01-01

    This study explored Arabic, Chinese, South Asian, and Vietnamese immigrant women's experiences with a peer health educator program, a public health program that facilitated access to breast health information and mammography screening. Framed within critical social theory, this participatory action research project took place from July 2009 to January 2011. Ten focus groups and 14 individual interviews were conducted with 82 immigrant women 40 years of age and older. Qualitative methods were utilized. Thematic content analysis derived from grounded theory and other qualitative literature was employed to analyze data. Four dominant themes emerged: Breast Cancer Prevention focused on learning within the program, Social Support provided by the peer health educator and other women, Screening Services Access for Women centered on service provision, and Program Enhancements related to specific modifications required to meet the needs of immigrant women accessing the program. The findings provide insights into strategies used to promote breast health, mammography screening, and the improvement of public health programming. Perceived barriers that continue to persist are structural barriers, such as the provision of information on breast cancer and screening by family physicians. A future goal is to improve collaborations between public health and primary care to minimize this barrier.

  12. Mediation of the effects of living in extremely poor neighborhoods by health insurance: breast cancer care and survival in California, 1996 to 2011

    OpenAIRE

    Gorey, Kevin M; Luginaah, Isaac N.; Holowaty, Eric J.; Zou, GuangYong; Hamm, Caroline; Balagurusamy, Madhan K

    2013-01-01

    Background We examined the mediating effect of health insurance on poverty-breast cancer care and survival relationships and the moderating effect of poverty on health insurance-breast cancer care and survival relationships in California. Methods Registry data for 6,300 women with breast cancer diagnosed between 1996 and 2000 and followed until 2011 on stage at diagnosis, surgeries, adjuvant treatments and survival were analyzed. Socioeconomic data were obtained for residences from the 2000 c...

  13. Developmental origins of health and disease--global public health implications.

    Science.gov (United States)

    Hanson, M A; Gluckman, P D

    2015-01-01

    The rapidly rising prevalence of non-communicable diseases (NCDs) represents a major challenge to public health and clinical medicine globally. NCDs are increasing rapidly in high-income countries, but even more rapidly in some low-middle-income countries with insufficient resources to meet the challenge. Whilst not identified in the Millennium Development Goals, there is much attention paid to NCDs in the discussions at many levels on the Sustainable Development Goals, as they underpin economic, social and environmental development in the post-2015 era. In this article, we discuss how a life-course approach to health, commencing of necessity in early development, can provide new opportunities for addressing this challenge. The approach can leverage human health capital throughout life and across generations. New insights into mechanisms, especially those processes by which the developmental environment affects epigenetic processes in the developing offspring, offer the prospect of identifying biomarkers of future risks. New interventions to promote health literacy, lifestyle and physical fitness in adolescents, young adults and their children hold great promise. In this respect, health-care professionals concerned with preconceptional, pregnancy and newborn care will have a vital role to play. PMID:25225058

  14. Determinación global y salud: el marco amplio de los determinantes de la salud/ Global determination and health: the broad framework of the determinants of health

    Directory of Open Access Journals (Sweden)

    Álvaro Franco-Giraldo

    2013-08-01

    Full Text Available El propósito de este ensayo plantea los desafíos de la salud mundial en la última etapa del desarrollo del capitalismo global y su relación con los determinantes socio-sanitarios de la salud, la vida humana y la Tierra, a partir de un concepto novedoso: el de la determinación global. Metodológicamente se desarrollan algunos ejes temáticos: determinación global y su relación con los determinantes sociales de la salud, consecuencias del capitalismo global, desafíos para la humanidad y la salud global, gobernanza y respuesta social global. Se discute la globalización del capitalismo como el principal determinante para la acción gubernamental, las políticas sociales y las políticas públicas en salud y sus consecuencias: la amenaza de las guerras, la crisis económica, el hambre, la degradación de la biosfera, los desplazamientos étnicos, ente otros. Propugna por enfrentar el deterioro de condiciones de vida y el aumento de desigualdades sociales, el gran desafío que explica los demás problemas de la salud global: la inequidades sociales, causantes efectivamente de la mala salud y de las desigualdades en salud. Dichas inequidades se manifiestan por razones geográficas, edad, género, etnia, educación y distribución del ingreso, pero devienen en última instancia de determinantes globales que se generan en la espera supranacional de la determinación. Se concluye defendiendo la acción global para superar la desigualdad y las inequidades que azotan al mundo actual y se propone una nueva categoría para entender los determinantes sociales: la de la determinación global, que tiene una capacidad explicativa mayor que las diferentes corrientes teóricas sobre determinantes y determinación social. The purpose of this essay is to present the challenges faced by global health during the last stage of the development of global capitalism and its relationship with the social and sanitary determinants of health, life and earth based on a

  15. Health, fairness and New Zealand's contribution to global post-2020 climate change action.

    Science.gov (United States)

    Bennett, Hayley; Macmillan, Alex; Jones, Rhys

    2015-05-29

    Health and wellbeing have been largely ignored in discussions around climate change targets and action to date. The current public consultation around New Zealand's post-2020 climate target is an opportunity for health professionals to highlight the health implications of climate change. Without urgent global efforts to bring down global GHG (greenhouse gas) emissions, the world is heading towards high levels of global warming, which will have devastating impacts on human health and wellbeing. New Zealand's action to bring down GHG emissions (as part of the global effort) has potential to improve health and reduce costs on the health sector, if health and fairness are put at the centre of policies to address climate change. New Zealand should commit to at least 40 % reductions in GHG emissions by 2030, and zero carbon emissions before 2050, with healthy and fair policies across sectors to enable reaching these targets.

  16. Being global in public health practice and research: complementary competencies are needed.

    Science.gov (United States)

    Cole, Donald C; Davison, Colleen; Hanson, Lori; Jackson, Suzanne F; Page, Ashley; Lencuch, Raphael; Kakuma, Ritz

    2011-01-01

    Different sets of competencies in public health, global health and research have recently emerged, including the Core Competencies for Public Health in Canada (CCPHC). Within this context, we believe it is important to articulate competencies for globalhealth practitioners-educators and researchers that are in addition to those outlined in the CCPHC. In global health, we require knowledge and skills regarding: north-south power dynamics, linkages between local and global health problems, and the roles of international organizations. We must be able to work responsibly in low-resource settings, foster self-determination in a world rife with power differentials, and engage in dialogue with stakeholders globally. Skills in cross-cultural communication and the ability to critically self-reflect on one's own social location within the global context are essential. Those in global health must be committed to improving health equity through global systems changes and be willing to be mentored and to mentor others across borders. We call for dialogue on these competencies and for development of ways to assess both their demonstration in academic settings and their performance in global health practice and research. PMID:22032108

  17. Engineering, global health, and inclusive innovation: focus on partnership, system strengthening, and local impact for SDGs

    OpenAIRE

    Clifford, Katie L.; Muhammad H Zaman

    2016-01-01

    The recent drafting of the Sustainable Development Goals challenges the research community to rethink the traditional approach to global health and provides the opportunity for science, technology, engineering, and mathematical (STEM) disciplines, particularly engineering, to demonstrate their benefit to the field. Higher education offers a platform for engineering to intersect with global health research through interdisciplinary partnerships among international universities that provide exc...

  18. Challenges of creating synergy between global mental health and cultural psychiatry

    NARCIS (Netherlands)

    J.T.V.M. de Jong

    2014-01-01

    This article addresses four major challenges for efforts to create synergy between the global mental health movement and cultural psychiatry. First, although they appear to share domains of mutual interest, the worlds of global mental health and cultural psychiatry have distinct lineages. Expanding

  19. Global health competencies and approaches in medical education: a literature review

    Directory of Open Access Journals (Sweden)

    Hulme Jennifer

    2010-12-01

    Full Text Available Abstract Background Physicians today are increasingly faced with healthcare challenges that require an understanding of global health trends and practices, yet little is known about what constitutes appropriate global health training. Methods A literature review was undertaken to identify competencies and educational approaches for teaching global health in medical schools. Results Using a pre-defined search strategy, 32 articles were identified; 11 articles describing 15 global health competencies for undergraduate medical training were found. The most frequently mentioned competencies included an understanding of: the global burden of disease, travel medicine, healthcare disparities between countries, immigrant health, primary care within diverse cultural settings and skills to better interface with different populations, cultures and healthcare systems. However, no consensus on global health competencies for medical students was apparent. Didactics and experiential learning were the most common educational methods used, mentioned in 12 and 13 articles respectively. Of the 11 articles discussing competencies, 8 linked competencies directly to educational approaches. Conclusions This review highlights the imperative to document global health educational competencies and approaches used in medical schools and the need to facilitate greater consensus amongst medical educators on appropriate global health training for future physicians.

  20. The Undergraduate Field-Research Experience in Global Health: Study Abroad, Service Learning, Professional Training or "None of the Above"?

    Science.gov (United States)

    Stewart, Kearsley A.

    2013-01-01

    Interest in short-term international placements in global health training for U.S.-based medical students is growing; the trend is mirrored for global health undergraduate students. Best practices in field-based global health training can increase success for medical students, but we lack a critical framework for the undergraduate global health…

  1. Student interest and knowledge concerning global health electives: a USD Sanford School of Medicine study.

    Science.gov (United States)

    Liebe, Sarah; Elliott, Amy; Bien, Matt

    2013-06-01

    Due to society's globalization, medical students increasingly pursue electives in global health. Such international experiences hold several inherent benefits for both the student traveler and the sponsoring institution. In order to enhance global health education at the Sanford School of Medicine (SSOM) of the University of South Dakota (USD), the medical student body was surveyed regarding prior international travel experiences, interest in serving globally, prohibitive factors toward embarking on a global health experience, and objective knowledge concerning medical service in an international context. In total, almost 95 percent of students indicated they were either very interested or somewhat interested in serving internationally during medical school or later during their career. The most prohibitive factors were funding concerns, lack of information and travel preparation demands. The survey responses indicate there is a great interest in the development of a cohesive global health curriculum for the SSOM. PMID:23923681

  2. A structured review of health utility measures and elicitation in advanced/metastatic breast cancer

    Science.gov (United States)

    Hao, Yanni; Wolfram, Verena; Cook, Jennifer

    2016-01-01

    Background Health utilities are increasingly incorporated in health economic evaluations. Different elicitation methods, direct and indirect, have been established in the past. This study examined the evidence on health utility elicitation previously reported in advanced/metastatic breast cancer and aimed to link these results to requirements of reimbursement bodies. Methods Searches were conducted using a detailed search strategy across several electronic databases (MEDLINE, EMBASE, Cochrane Library, and EconLit databases), online sources (Cost-effectiveness Analysis Registry and the Health Economics Research Center), and web sites of health technology assessment (HTA) bodies. Publications were selected based on the search strategy and the overall study objectives. Results A total of 768 publications were identified in the searches, and 26 publications, comprising 18 journal articles and eight submissions to HTA bodies, were included in the evidence review. Most journal articles derived utilities from the European Quality of Life Five-Dimensions questionnaire (EQ-5D). Other utility measures, such as the direct methods standard gamble (SG), time trade-off (TTO), and visual analog scale (VAS), were less frequently used. Several studies described mapping algorithms to generate utilities from disease-specific health-related quality of life (HRQOL) instruments such as European Organization for Research and Treatment of Cancer Quality of Life Questionnaire – Core 30 (EORTC QLQ-C30), European Organization for Research and Treatment of Cancer Quality of Life Questionnaire – Breast Cancer 23 (EORTC QLQ-BR23), Functional Assessment of Cancer Therapy – General questionnaire (FACT-G), and Utility-Based Questionnaire-Cancer (UBQ-C); most used EQ-5D as the reference. Sociodemographic factors that affect health utilities, such as age, sex, income, and education, as well as disease progression, choice of utility elicitation method, and country settings, were identified

  3. Status of Breast Self-Examination Performance among Women Referring to Health Centers of Tabriz, Iran

    Directory of Open Access Journals (Sweden)

    Farshbaf-Khalili Azizeh

    2014-07-01

    Full Text Available Objective: Breast cancer is the most common type of cancer and the second principal cause of deaths from cancer in women. Breast self-examination (BSE is an inexpensive screening method and is carried out by women themselves. The purpose of this study was to examine the status of breast self-examination performance among women referring to health centers of Tabriz, Iran. Materials and Methods: This study was a descriptive/ cross-sectional research carried out on 400 women aged 20-50 years. The samples were recruited randomly from among female clients of health centers in Tabriz. A questionnaire and an observational checklist were used to elicit socio-demographic information and status of BSE performance among women. Content validity was used for validation and Cronbach’s alpha was calculated (0.80 for reliability of instrument. Descriptive and inferential statistics were used to analyze data through SPSS software. Results: The findings of this research showed that only 18.8% of women performed BSE. Among them, 46.67% performed BSE monthly, and 40% at the end of menstruation. The initiation age of BSE in 77% was between 21-30 years of age. It is considerable that 54.7% of them had received no advice on BSE from physicians and midwives. The majority of women did not perform the various steps of BSE. The quality of this screening was very desirable in 2 (0.5 %, desirable in 5 (1.3%, average in 19 (4.8%, undesirable in 36 (9%, and very undesirable in 338 (84.5% women. Chi-square test showed a significant relationship between the quality of BSE performance and level of education, employment, breastfeeding quality, and family history of breast cancer (P < 0.05. Conclusion: The findings showed that the status of BSE performance was very poor. Therefore, to encourage women to use BSE correctly and regularly, education programs should be performed through various media including television, radio, and leaflets. The role of Health personnel in this

  4. Global Challenges in People-Centered E-Health.

    Science.gov (United States)

    Quintana, Yuri; Safran, Charles

    2015-01-01

    People-centered health care seeks an active role for the patient while empowering all other members of the health care team. By promoting greater patient responsibility and optimal usage, patient-centered health care leads to improved health outcomes, quality of life and optimal value for health care investment. This paper reviews some definitions of people-centered health care and various e-health approaches around the world used to implement this vision. The barriers and enablers to implementation this type of approach are explored. This paper provides a proposed research agenda for future implementations of people-centered e-health.

  5. Bioethics and Human Rights in the Constitutional Formation of Global Health

    Directory of Open Access Journals (Sweden)

    Atina Krajewska

    2015-12-01

    Full Text Available “Global health” is an increasingly important area of research and practice, concerned with the profound implications of globalisation for individual and communal health (particularly in developing countries and focused on achieving health equity for all people worldwide. As such, it is often viewed as overlapping with public health and, thus, conceptually distinct from the field of biomedicine and bioethics. Both fields bear an uneasy relationship with the field of human rights, which remains largely unexplored. The paper constructively utilises insight derived from theories of global legal pluralism and global constitutionalism to argue, perhaps controversially, that recent developments in international biomedical law and bioethics, constitute an important phase in the constitutional construction of a global health law system. In doing so, the paper analyses the role of human rights in the growing constitutional autonomy and organization of global health.

  6. The coming health crisis: indirect health effects of global climate change.

    Science.gov (United States)

    Myers, Samuel S; Bernstein, Aaron

    2011-02-01

    Global climate change threatens the health of hundreds of millions of people. While much has been written about the direct impacts of climate change on health as a result of more severe storms, more intense heat stress, changes in the distribution of infectious disease, and reduced air quality, we are concerned that the indirect impacts of a disrupted climate system may be orders of magnitude more important in terms of the human suffering they cause. Because these indirect effects will result from changes in biophysical systems, which are inherently complex, there is significant uncertainty about their magnitude, timing, and location. However, the uncertainty that shrouds this issue should not be cause for complacency; rather it should serve as an organizing principle for adaptation to its ill effects.

  7. Light at night and melatonin have opposite effects on breast cancer tumors in mice assessed by growth rates and global DNA methylation.

    Science.gov (United States)

    Schwimmer, Hagit; Metzer, Avishag; Pilosof, Yonit; Szyf, Moshe; Machnes, Ziv M; Fares, Fuad; Harel, Orna; Haim, Abraham

    2014-02-01

    Light-at-night (LAN) is a worldwide problem co-distributed with breast cancer prevalence. We hypothesized that exposure to LAN is coincided with a decreased melatonin (MLT) secretion level, followed by epigenetic modifications and resulted in higher breast cancer tumors growth-rate. Accordingly, we studied the effect of LAN exposure and exogenous MLT on breast cancer tumors growth-rate. 4T1 cells were inoculated into BALB/c short day-acclimated mice, resulting in tumors growth. Growth rates were followed under various light exposures and global DNA methylations were measured. Results demonstrated the positive effect of LAN on tumors growth-rate, reversed by MLT through global DNA methylation. PMID:24131150

  8. Postmenopausal Breast Cancer, Aromatase Inhibitors, and Bone Health: What the Surgeon Should Know.

    Science.gov (United States)

    Baatjes, K J; Apffelstaedt, J P; Kotze, M J; Conradie, M

    2016-09-01

    Breast cancer, as the most common malignancy in women, remains a major public health issue despite countless advances across decades. Endocrine therapy is the cornerstone of treatment of the hormone-sensitive subtype of breast cancer. The use of aromatase inhibitors (AIs) in the postmenopausal women has extended the survival beyond that of Tamoxifen, but harbors a subset of side effects, most notably accelerated bone loss. This, however, does not occur in all women undergoing treatment. It is vital to identify susceptible patients early, to limit such events, employ early treatment thereof, or alter drug therapy. International trials on AIs, predominantly performed in North American and European females, provide little information on what to expect in women in developing countries. Here, surgeons often prescribe and manage endocrine therapy. The prescribing surgeon should be aware of the adverse effect of the endocrine therapy and be able to attend to side effects. This review highlights clinical and biochemical factors associated with decrease in bone mineral density in an, as yet, unidentified subgroup of postmenopausal women. In the era of personalized medical care, appropriate management of bone health by surgeons based on these factors becomes increasingly important. PMID:27189076

  9. Global visibility for global health: Is it time for a new descriptor in Medical Subject Heading (MeSH) of MEDLINE/PubMed?

    OpenAIRE

    Ana Marušic´

    2013-01-01

    Despite a large body of research in global health (almost 9000 articles published in PubMed until 2012), the term “global health” is not included in the Medical Subject Headings (MeSH) of the NLM – its controlled vocabulary thesaurus which NLM uses to index articles in MEDL INE. There are only 6 journals currently covered by PubMed which specialize in global health, including Journal of Global Health.

  10. Global visibility for global health: Is it time for a new descriptor in Medical Subject Heading (MeSH of MEDLINE/PubMed?

    Directory of Open Access Journals (Sweden)

    Ana Marušic´

    2013-06-01

    Full Text Available Despite a large body of research in global health (almost 9000 articles published in PubMed until 2012, the term “global health” is not included in the Medical Subject Headings (MeSH of the NLM – its controlled vocabulary thesaurus which NLM uses to index articles in MEDL INE. There are only 6 journals currently covered by PubMed which specialize in global health, including Journal of Global Health.

  11. Planted forest health: The need for a global strategy.

    Science.gov (United States)

    Wingfield, M J; Brockerhoff, E G; Wingfield, B D; Slippers, B

    2015-08-21

    Several key tree genera are used in planted forests worldwide, and these represent valuable global resources. Planted forests are increasingly threatened by insects and microbial pathogens, which are introduced accidentally and/or have adapted to new host trees. Globalization has hastened tree pest emergence, despite a growing awareness of the problem, improved understanding of the costs, and an increased focus on the importance of quarantine. To protect the value and potential of planted forests, innovative solutions and a better-coordinated global approach are needed. Mitigation strategies that are effective only in wealthy countries fail to contain invasions elsewhere in the world, ultimately leading to global impacts. Solutions to forest pest problems in the future should mainly focus on integrating management approaches globally, rather than single-country strategies. A global strategy to manage pest issues is vitally important and urgently needed. PMID:26293956

  12. Education projects: an opportunity for student fieldwork in global health academic programs.

    Science.gov (United States)

    Fyfe, Molly V

    2012-01-01

    Universities, especially in higher-income countries, increasingly offer programs in global health. These programs provide different types of fieldwork projects, at home and abroad, including: epidemiological research, community health, and clinical electives. I illustrate how and why education projects offer distinct learning opportunities for global health program fieldwork. As University of California students, we partnered in Tanzania with students from Muhimbili University of Health and Allied Science (MUHAS) to assist MUHAS faculty with a curricular project. We attended classes, clinical rounds, and community outreach sessions together, where we observed teaching, materials used, and the learning environment; and interviewed and gathered data from current students, alumni, and health professionals during a nationwide survey. We learned together about education of health professionals and health systems in our respective institutions. On the basis of this experience, I suggest some factors that contribute to the productivity of educational projects as global health fieldwork.

  13. Exploring insights towards definition and laws of health in Ayurveda: Global health perspective.

    Science.gov (United States)

    Basisht, Gopal

    2014-01-01

    The current healthcare system is focused on disease management. Our current approach to treatment begins only after the diagnosis, and then attempts to treat the symptoms and prevent the progression. Despite increased global healthcare spending, there has been an increasing incidence, and severity of diseases pointing to impaired health of the populace. This progressive deterioration in general health has created an unsustainable increase in healthcare costs that has hampered the economy. Much of the rising costs in healthcare are secondary to treating the progression of preventable diseases and focus on creating new treatments. There has been an ongoing discussion of incorporating a "defense" or prevention as part of our health system. However, there are few established guidelines beyond tactical use of vaccination in known infectious diseases and screening for chronic diseases and cancers. Ayurveda has the core competency and strategy for prevention of disease. Sushruta has propounded the laws of health, which are unknown to the current healthcare system. This article describes these laws and strategic combination of Ayurveda (defense) and modern medicine (offense) to create a complete healthcare system. This system is called Symbiohealth and is potentially more effective, less expensive, less toxic and creates a healthier society. PMID:26195894

  14. Commercial influence and global nongovernmental public action in health and pharmaceutical policies.

    Science.gov (United States)

    Koivusalo, Meri; Mackintosh, Maureen

    2011-01-01

    Nongovernmental public action has been effective in influencing global agenda-setting in health and pharmaceutical policies, yet its record in influencing solutions to the problems identified has been notably more limited. While trade policies have been particularly resistant to change, more substantial changes are observable in global health policies and global health governance. However, some of the directions of change may not be conducive to the democratic accountability of global health governance, to the wise use of public resources, to health systems development, or to longer-term access to health care within developing countries. The authors argue that observed changes in global health policies can be understood as accommodating to corporate concerns and priorities. Furthermore, the changing global context and the commercialization of global public action itself pose sharp challenges to the exercise of influence by global nongovernmental public actors. Nongovernmental organizations not only face a major challenge in terms of the imbalance in power and resources between themselves and corporate interest groups when seeking to influence policymaking; they also face the problem of corporate influence on public action itself. PMID:21842577

  15. Commercial influence and global nongovernmental public action in health and pharmaceutical policies.

    Science.gov (United States)

    Koivusalo, Meri; Mackintosh, Maureen

    2011-01-01

    Nongovernmental public action has been effective in influencing global agenda-setting in health and pharmaceutical policies, yet its record in influencing solutions to the problems identified has been notably more limited. While trade policies have been particularly resistant to change, more substantial changes are observable in global health policies and global health governance. However, some of the directions of change may not be conducive to the democratic accountability of global health governance, to the wise use of public resources, to health systems development, or to longer-term access to health care within developing countries. The authors argue that observed changes in global health policies can be understood as accommodating to corporate concerns and priorities. Furthermore, the changing global context and the commercialization of global public action itself pose sharp challenges to the exercise of influence by global nongovernmental public actors. Nongovernmental organizations not only face a major challenge in terms of the imbalance in power and resources between themselves and corporate interest groups when seeking to influence policymaking; they also face the problem of corporate influence on public action itself.

  16. Infant and Young Child Feeding Behavior among Working Mothers in India: Implications for Global Health Policy and Practice

    Directory of Open Access Journals (Sweden)

    Vinay Kumar, MD, MPH

    2014-12-01

    Full Text Available Background: The National Guidelines on Infant and Young Child Feeding introduced in 2006 recommended the initiation of breastfeeding immediately after birth, preferably within one hour; exclusive breastfeeding for the first six months; appropriate and adequate complementary feeding from six months of age while continuing breastfeeding; and continued breastfeeding up to the age of two years or beyond. Working women in India constitute a dominant and expanding pool of mothers. There is paucity of research focused on feeding behavior within this group. Method: One hundred and fifty working women answered a structured questionnaire about their demographics, birth history, levels of awareness and practice of feeding guidelines, and perceptions about breastfeeding and counseling. Data analysis was carried out using Microsoft Excel and the Statistical Package for the Social Sciences. Results: Majority of participants belonged to 21-39 years age group, had nuclear families, received college education, and delivered in institutional setups. Gaps were observed between the mother’s levels of awareness and practice for different tenets of national guidelines. Higher education, longer maternity leave, higher income, and utilization of counseling services facilitated adoption of optimal feeding behavior. Most women perceived breast milk to be superior to any alternative and favored provision of counseling during last trimester. Conclusions and Global Health Implications: Counseling women on optimal feeding behavior is a potential intervention to convert its awareness into actual practice. The lessons learned from this study can help refine both national and global Mother and Child Health policies and programs.

  17. A Basic Strategy to Manage Global Health with Reference to Livestock Production in Asia

    Directory of Open Access Journals (Sweden)

    David C. Hall

    2011-01-01

    Full Text Available Newly emerging infectious diseases (nEIDs have increased rapidly presenting alarming challenges to global health. We argue that for effective management of global health a basic strategy should include at least three essential tactical forms: actions of a directly focused nature, institutional coordination, and disciplinary integration in approaches to health management. Each level of action is illustrated with examples from the livestock sector in Asia. No clear example of all three tactical forms in place can be found from developing countries where food security is a significant threat although Vietnam is developing a comprehensive strategy. Finally, an ecosystem health approach to global health management is advocated; such an approach moves away from the traditional single disciplinary approach. Stronger guidance is needed to direct ecohealth research and application in the management of global health.

  18. [A Contribution to the Current Debate on Public and Global Health in Germany].

    Science.gov (United States)

    Hommes, F; von Philipsborn, P; Geffert, K; Karduck, L

    2016-02-01

    In June 2015 the German Academies of Science and Technology published a report on the structures, developments and challenges in the field of public and global health in Germany. Its call for a strengthening of public and global health in Germany was well received among researchers and practitioners in the field. At the same time criticism arose. Key controversies relate to the future institutional set-up of public and global health research in Germany, the consideration of the social determinants of health versus biomedical and technological approaches, the need for further research versus the need for political implementation of what is already known, and the consideration of the political context, such as intellectual property rights. This contribution provides an overview on the debate and lays down the perspective of the German Medical Students' Association (bvmd) and the Globalisation and Health Initiative (GandHI), putting forward demands regarding the role of public and global health in medical education in Germany. PMID:26906539

  19. Beyond shamanism: the relevance of African traditional medicine in global health policy.

    Science.gov (United States)

    Aginam, Obijiofor

    2007-06-01

    This article explores the tension between African traditional medicine and orthodox medicine, and argues for a cosmopolitan and inclusive health policy that integrates ethnomedical therapies into the core framework of global health architecture. The paper argues that age-old traditional therapies in Africa are relegated to the peripheries of orthodox health policy. The paper briefly discusses the accelerating pace of globalization of intellectual property rights (patents) as a factor that would continue to perpetrate bio-piracy and threaten traditional herbal therapies with extinction. The search for an inclusive global health policy opens a new vista in the interaction of traditional and orthodox medicine. The paper concludes that a sustained relegation of African traditional medicine to the margins of orthodox health policy is a phenomenon that would likely project the globalization of public health as predatory, discriminatory and unfair. PMID:17639845

  20. [A Contribution to the Current Debate on Public and Global Health in Germany].

    Science.gov (United States)

    Hommes, F; von Philipsborn, P; Geffert, K; Karduck, L

    2016-02-01

    In June 2015 the German Academies of Science and Technology published a report on the structures, developments and challenges in the field of public and global health in Germany. Its call for a strengthening of public and global health in Germany was well received among researchers and practitioners in the field. At the same time criticism arose. Key controversies relate to the future institutional set-up of public and global health research in Germany, the consideration of the social determinants of health versus biomedical and technological approaches, the need for further research versus the need for political implementation of what is already known, and the consideration of the political context, such as intellectual property rights. This contribution provides an overview on the debate and lays down the perspective of the German Medical Students' Association (bvmd) and the Globalisation and Health Initiative (GandHI), putting forward demands regarding the role of public and global health in medical education in Germany.