Contemporary Public Health Research Articles

Advancing Public Health Education Through Place-Based Learning: “On the Road in the Deep South”

Documented health disparities among racial and ethnic minorities exist in the United States, and health injustices frequently have deep historical ties, especially in the South. Therefore, it is critically important for students to understand root causes of both historical and contemporary public health issues and their effects on population health. In spring 2018, 15 undergraduate and graduate students from the University of Alabama at Birmingham participated in a six-credit-hour travel course by touring throughout the Deep South to learn more about the ways in which history and place interact with programs, policies, and practices to influence population health. Students saw firsthand how the social determinants of health frequently affected access to health care and discovered the value of a multidisciplinary approach to public health and health programs in addressing health equity. The purpose of this article is to describe student experiences with the travel course through an exploration of students’ reflective journal entries, blog posts, and student presentations. Additionally, the authors report results of a self-assessment designed to measure student interest and level of comfort in working with, or on behalf of, medically underserved populations. The article concludes with implications for public health and best practices for offering place-based courses across academic majors.

Effective approaches to health promotion in nursing practice.

This article defines the concept of health promotion and explains why it is essential for nurses to embed health promotion aims and values in their practice. It discusses how health promotion contributes to the improvement and maintenance of population health and contemporary public health agendas in the UK and worldwide. Using several practical activities, this article aims to encourage nurses to identify their own approach to promoting health in their professional role, consider how they can implement 'Making Every Contact Count' with the patients they care for, and enhance the overall effectiveness of their practice.

El Manual Para el Pueblo (The Manual for the People): a pictorial aid for community health workers to identify surgical conditions

Abstract Background Access to safe, effective, and affordable surgical care is a pressing contemporary public health issue. Deaths from surgically treated conditions exceed those from HIV, tuberculosis, and malaria combined. Community outreach is a potential driver of access to surgical treatment, yet education among community health workers (CHWs) about such conditions is insufficient. Here, we describe the development and testing of a picture-based curriculum—El Manual Para el Pueblo (The Manual for the People)—to help CHWs to identify and refer surgical conditions in a largely illiterate population. Methods Central American rural multi-ethnic indigenous groups and surgical providers provided context-specific expertise and advice for the development of El Manual Para el Pueblo, established in 2017. During a pilot implementation in July, 2018, the Ministry of Education and a local community leader recruited groups of CHWs, parents in the communities, and groups of students from the Olancho department of Honduras. We assessed participants before and after the teaching programme for situational problem-solving. Participants completed quantitative surveys to measure the efficacy of an accompanying curriculum on the scheme and iconography of the manual; we also collected qualitative data from participants about the utility of the programme for their practice patterns. Findings The surgical manual includes 13 chapters with 133 different medical and surgical conditions represented. For the surveys, participants used three sample pages of the manual to answer the questions. We included 403 participants; 68% were women and mean age was 26 years. Overall, 245 participants (61%) had scores of 75% or more on the pre-intervention survey and 170 (42%) had scores of 85% or more. Manual understanding and utilisation abilities improved from pre-intervention mean score of 15·37 (SD 3·10) to 15·91 (3·09) post-intervention out of a maximum score of 20 (p Interpretation Surgical disease burden is one of the most pressing public health problems globally and there is an important opportunity to improve care for the 5 billion people who lack adequate access to surgical care. El Manual Para el Pueblo is one such tool. Our data suggest that this curriculum can be an effective educational tool for improving on-the-ground understanding of the triage of surgical and medical disease, as well as techniques for best use of the manual. Finally, our study reinforces the need to invest in education for local personnel when implementing similar interventions to achieve the maximum societal effects. Funding Operation Smile, Agnew Surgical Society at the Perelman School of Medicine.

The challenges to public health nurse practice in rural Ireland.

The primary objective was to understand the contemporary public health nurse's (PHN) role and the issues that they face working in rural Ireland. This study was based on an ethnographic approach with 13 PHNs working in rural areas in the South West of Ireland. A combination of solicited diaries and semi-structured interviews referred to as the diary/interview method were employed. Diaries were used by the PHNs to record their working day on a staggered basis from February to April 2017 with the subsequent interviews carried out in June and July 2017. Working as a PHN in a rural area presented a number of issues such as time spent on traveling as a result of geographical disparity & poor road networks; client transport issues; a sense of working in isolation; communication issues with respect to computer/tablet hardware availability, mobile phone and broadband connectivity and the availability of, and the physical access to services. PHNs operating in rural communities face a distinct set of challenges that they have a limited ability to address. Legislators, health care providers and policymakers need to create a supportive environment that helps address these challenges in Ireland.

Legislative Capture: Critical Considerations in the Commercial Determinants of Health

Contemporary public health literature contains an increasing emphasis on the commercial determinants of health including the influence of unhealthy food, beverage and tobacco industries on government harm prevention policy agendas and global Sustainable Development Goals. Effective capture by the industries of the crucial legislative process associated with the harm prevention initiatives would have a detrimental impact on public health. This article proposes a qualitative multi-spectrum prototype legislative capture test with broad application to a range of industries and jurisdictions at all levels of governments where legislative capture may be suspected. It is predicated on a finding of significant encroachment of the public interest by special interest groups and reciprocating beneficial conduct between the law makers and the group. The test is populated from a critical case study of key New South Wales alcohol industry statutory amendments within a doctrinal and social inquiry/power framework. It relies upon Parliamentary records and secondary data to critically analyse the 2015 ‘Fit for Purpose’ (FFP) reforms to NSW alcohol supply laws and their consistency with the public interest and other constitutional safeguards. It aligns the reforms with other research relating to the magnitude of alcohol and gambling industry political donations and the operation of the alcohol outlet post reform approval process. The application of the test to the case study finds that the 2015 FFP amendments are indicative of legislative capture and associated clientele corruption - critical new considerations in the commercial determination of health. It also identifies the commodification of the public interest.

Diné (Navajo) Healer Perspectives on Commercial Tobacco Use in Ceremonial Settings: An Oral Story Project to Promote Smoke-Free Life.

Many American Indian (AI) healers are faced with a dilemma of how to maintain the ceremonial uses of traditional tobacco meant to encourage the restoration and balance of mind, body, and spirit, while discouraging commercial tobacco use and protecting against secondhand smoke exposure in ceremonial settings. To explore this dilemma and offer culturally informed solutions, researchers conducted qualitative interviews with Navajo healers who describe the history and role of commercial tobacco within ceremonial contexts. Healers understand the importance of their role on their community's health and expressed deep concern about the use of commercial tobacco in the ceremonial setting. Healers play an important role in curbing the use of commercial tobacco and limiting the exposure to secondhand smoke in ceremonial settings and beyond. Study implications include the importance of understanding traditional and cultural knowledge and its potential as a pathway to solve contemporary public health issues facing AI communities.

Zapobieganie konwersji stanu przedcukrzycowego do cukrzycy typu 2 jako wyzwanie współczesnego zdrowia publicznego. Analiza aktualnego stanu badań, możliwości interwencji

1. Kushner RF, Sorensen KW. Lifestyle medicine: the future of chronic disease management. Curr Opin Endocrinol Diabetes Obes. 2013; 20: 389–395. Google Scholar

"The Defense of the Indefensible": The Uses and Abuses of Words in Contemporary Public Health Policy.

The Milbank QuarterlyVolume 97, Issue 1 p. 16-19 Opinion “The Defense of the Indefensible”: The Uses and Abuses of Words in Contemporary Public Health Policy DAVID ROSNER, Corresponding Author DAVID ROSNER DR289@columbia.edu Address correspondence to: David Rosner, Columbia University Mailman School of Public Health, 722 West 168th St, Rm 934, New York, NY 10032 (email: DR289@columbia.edu).Search for more papers by this author DAVID ROSNER, Corresponding Author DAVID ROSNER DR289@columbia.edu Address correspondence to: David Rosner, Columbia University Mailman School of Public Health, 722 West 168th St, Rm 934, New York, NY 10032 (email: DR289@columbia.edu).Search for more papers by this author First published: 04 December 2018 https://doi.org/10.1111/1468-0009.12361Read the full textAboutPDF ToolsExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Volume97, Issue1March 2019Pages 16-19 RelatedInformation

Next generation media monitoring: Global coverage of electronic nicotine delivery systems (electronic cigarettes) on Bing, Google and Twitter, 2013-2018

News media monitoring is an important scientific tool. By treating news reporters as data collectors and their reports as qualitative accounts of a fast changing public health landscape, researchers can glean many valuable insights. Yet, there have been surprisingly few innovations in public health media monitoring, with nearly all studies relying on labor-intensive content analyses limited to a small number of media reports. We propose to advance this subfield by using scalable machine learning. In potentially the largest contemporary public health media monitoring study to date, we systematically characterize global news reports surrounding electronic cigarettes or electronic nicotine delivery systems (ENDS) using natural language processing techniques. News reports including ENDS terms (e.g., “electronic cigarettes”) from over 100,000 sources (all sources archived on Google News or Bing News, as well as all news articles shared on Twitter) were monitored for 1 January 2013 through 31 July 2018. The geographic and subject (e.g., prevalence, bans, quitting, warnings, marketing, prices, age, flavor and industry) foci of news articles, their popularity among readers who share news on social media, and the sentiment behind news articles were assessed algorithmically. Globally there were 86,872 ENDS news reports with coverage increasing from 8 (standard deviation [SD] = 8) stories per day in 2013 to 75 (SD = 56) stories per day during 2018. The focus of ENDS news spanned 148 nations, with the plurality focusing on the United States (34% of all news). Potentially overlooked hotspots of ENDS media activity included China, Egypt, Russia, Ukraine, and Paraguay. The most common subject was warnings about ENDS (18%), followed by bans on using ENDS (13%) and ENDS prices (9%). Flavor and age restrictions were the least covered news subjects (~1% each). Among different subject foci, reports on quitting cigarettes using ENDS had the highest probability of scoring in the top three deciles of popularity rankings. Moreover, ENDS news on quitting and prices had a more positive sentiment on average than news with other subject foci. Public health leaders can use these trends to stay abreast of how ENDS are portrayed in the media, and potentially how the public perceives ENDS. Because our analytical strategies are updated in near real time, we aim to make media monitoring part of standard practice to support evidence-based tobacco control in the future.

PO-195 Effects of different exercises on cyocardial cell cycles

Objective With the advent of the era of great health, people's health awareness is increasing.As an economical and environment-friendly way, exercise should be viewed as a “first line” strategy for prevention and treatment of arterial aging and a vital component of a contemporary public health approach for reducing the projected increase in population Cardiovascular diseases burden.The objective of this work was to study the effect of 8-week spin training and swim training on normal cyocardial cell cycle.
 Methods A total of 30 C57BL/6 mice were randomly allocated to 8-week spin training and swim training program (intervention group) or no supervised exercise (control group). Normal cyocardial cell cycle proteins were measured by Western Blotting. All the outcomes were measured after 8 weeks. Repeated measures were analyzed using mean ±SD and T tests were used to analyze the data.
 Results Compared with the control group, Western Blotting shows that CDK4 of spin training significantly increase (0.7698± 0.01130 to 1.111 ±0.02027, p<0.001) and CDK4 of swim training significantly increase (0.7698 ±0.01130 to 1.258± 0.01427, p<0.001) ,following 8 weeks of exercise, CyclinD1 of spin training increase (0.8558 ± 0.007912 to 1.499 ± 0.06303, p<0.001) and CyclinD1 of swim training significantly increase (0.8558 ± 0.007912 to 2.097 ± 0.3622, p<0.05) .
 Conclusions The 8-week spin training and swim training was found to be effective in increasing cyocardial cell cycles proteins in normal mice. There was significant improvement inCDK4 and CyclinD1 in intervention group compared to control group.

Perceptions of the acceptability and feasibility of reducing occupational sitting: review and thematic synthesis

BackgroundReducing workplace sedentary behaviour (sitting) is a topic of contemporary public health and occupational health interest. Understanding workers’ perspectives on the feasibility and acceptability of strategies, and barriers and facilitators to reducing workplace sitting time, can help inform the design and implementation of targeted interventions. The aim of this qualitative synthesis was to identify and synthesise the evidence on factors perceived to influence the acceptability and feasibility of reducing sitting at work, without, and with, an associated intervention component.MethodsA systematic search of the peer-reviewed literature was conducted across multiple databases in October 2017 to identify studies with a qualitative component relating to reducing workplace sitting time. Relevant data were extracted and imported into NVivo, and analysed by three of the authors by coding the results sections of papers line-by-line, with codes organised into sub-themes and then into overarching themes. Studies with and without an associated intervention were analysed separately.ResultsThirty-two studies met the inclusion criteria, 22 of which had collected qualitative data during and/or following a workplace intervention. Sample sizes ranged from five through to 71 participants. Studies predominately involved desk-based workers (28/32) and were most frequently conducted in Australia, USA or the United Kingdom (26/32). Similar themes were identified across non-intervention and intervention studies, particularly relating to barriers and facilitators to reducing workplace sitting. Predominately, work and social environment attributes were identified as barriers/facilitators, with desk-based work and work pressures influencing the perceived feasibility of reducing sitting, particularly for low-cost interventions. Support from co-workers and managers was considered a key facilitator to reducing sitting, while social norms that discouraged movement were a prominent barrier. Across all studies, some consistent perceptions of benefits to reducing sitting were identified, including improved physical health, enhanced emotional well-being and associated work-related benefits.ConclusionCommon barriers and facilitators to reducing workplace sitting time were identified across the literature, most prominently involving the social environment and job-related demands. These findings can inform the design and implementation of workplace sitting reduction strategies. To increase the generalisability of findings, further research is needed in a more diverse range of countries and industries.

A Genealogy of Animal Diseases and Social Anthropology (1870-2000).

Culling, vaccinating, and monitoring animals are the three main techniques used in contemporary veterinarypublic health to manage animal diseases that can be transmitted to humans. Each technique is underpinned by different ontological understandings of how microbes figure in relations between humans and animals. Therefore, animal diseases are not only a question for an applied anthropology but also involve the theoretical core of the discipline: that is, understanding how social causality emerges out of physical causality. To defendthis argument, the article describes what Herbert Spencer wrote aboutfoot-and-mouth disease; what William Robertson Smiththought about sacrifice in the context of bovine tuberculosis; how Emile Durkheim took vaccination for smallpox as a metaphor for the pathologies of the social; and what Claude Lévi-Strauss wrote about mad cow disease. The conceptions of the social in the writing of these four authors are analyzed through their understanding of the risk of transmission of animal diseases to humans, moving from prevention to precaution to preparedness.

Naming Institutionalized Racism in the Public Health Literature: A Systematic Literature Review.

Although a range of factors shapes health and well-being, institutionalized racism (societal allocation of privilege based on race) plays an important role in generating inequities by race. The goal of this analysis was to review the contemporary peer-reviewed public health literature from 2002-2015 to determine whether the concept of institutionalized racism was named (ie, explicitly mentioned) and whether it was a core concept in the article. We used a systematic literature review methodology to find articles from the top 50 highest-impact journals in each of 6 categories (249 journals in total) that most closely represented the public health field, were published during 2002-2015, were US focused, were indexed in PubMed/MEDLINE and/or Ovid/MEDLINE, and mentioned terms relating to institutionalized racism in their titles or abstracts. We analyzed the content of these articles for the use of related terms and concepts. We found only 25 articles that named institutionalized racism in the title or abstract among all articles published in the public health literature during 2002-2015 in the 50 highest-impact journals and 6 categories representing the public health field in the United States. Institutionalized racism was a core concept in 16 of the 25 articles. Although institutionalized racism is recognized as a fundamental cause of health inequities, it was not often explicitly named in the titles or abstracts of articles published in the public health literature during 2002-2015. Our results highlight the need to explicitly name institutionalized racism in articles in the public health literature and to make it a central concept in inequities research. More public health research on institutionalized racism could help efforts to overcome its substantial, longstanding effects on health and well-being.

Compassionate Communities in Canada: it is everyone's responsibility.

Prof. Allan Kellehear first developed a contemporary public health approach to palliative and end-of-life care. Countries around the world have since adopted the theory of practice that mobilizes palliative care as a public health issue-particularly the Compassionate Communities (CC) model. In the wake of Canada's Medical Assistance in Dying (MAiD) legislation and its growing senior population, quality palliative care has enjoyed a renewed focus. Pallium Canada is helping communities across the country understand and adopt the CC model, through education, knowledge mobilization, project facilitation, and leadership. Although it has made significant strides in the last few years, there is still progress to be made. The aim of this paper is to present the historical development of the public health approach to end-of-life care in Canada, including its successes and hardships thus far. Drawing from examples of regional, provincial, and national initiatives, future directions for community engagement as a public health approach to palliative care are discussed.

Disproportionate Sterilization of Latinos Under California's Eugenic Sterilization Program, 1920-1945.

To compare population-based sterilization rates between Latinas/os and non-Latinas/os sterilized under California's eugenics law. We used data from 17 362 forms recommending institutionalized patients for sterilization between 1920 and 1945. We abstracted patient gender, age, and institution of residence into a data set. We extracted data on institution populations from US Census microdata from 1920, 1930, and 1940 and interpolated between census years. We used Spanish surnames to identify Latinas/os in the absence of data on race/ethnicity. We used Poisson regression with a random effect for each patient's institution of residence to estimate incidence rate ratios (IRRs) and compare sterilization rates between Latinas/os and non-Latinas/os, stratifying on gender and adjusting for differences in age and year of sterilization. Latino men were more likely to be sterilized than were non-Latino men (IRR = 1.23; 95% confidence interval [CI] = 1.15, 1.31), and Latina women experienced an even more disproportionate risk of sterilization relative to non-Latinas (IRR = 1.59; 95% CI = 1.48, 1.70). Eugenic sterilization laws were disproportionately applied to Latina/o patients, particularly Latina women and girls. Understanding historical injustices in public health can inform contemporary public health practice.

How gender theories are used in contemporary public health research

BackgroundPublic health research often focuses on gender differences within certain diagnoses, but so far research has failed to explain these differences in a satisfactory way. Theoretical development could be one prerequisite for moving beyond categorical thinking. The aim of this paper was to analyse how gender theories have been used in public health research in relation to various methodological approaches.MethodSix special issues of gender research with public health relevance (comprising 33 papers in total) were identified from a search of PubMed and Web of Science, spanning a 10-year period. The papers were analysed inductively through posing questions to the text.ResultsGender theories were used in eight different ways: 1. to test hypotheses, 2. integrate theories, 3. develop gender concepts and models, 4. interpret findings, 5. understand health problems, 6. illustrate the validity of other theories, 7. integrated into a gender blind theory, as well as to 8. critique of other gender theories. The strategies applied seemed independent of the health aspects of the papers. However, the methodologies were of importance, indicating that both theoretical papers and papers using qualitative methodologies used almost all available strategies, while papers using quantitative empirical research used a limited number of strategies.ConclusionsThis study contributes to identifying how gender theories are used in contemporary public health research, which can help researchers move beyond a categorical understanding of gender in health research.

Putting the public (back) into public health: leadership, evidence and action.

There is a strong evidence-based rationale for community capacity building and community empowerment as part of a strategic response to reduce health inequalities. Within the current UK policy context, there are calls for increased public engagement in prevention and local decision-making in order to give people greater control over the conditions that determine health. With reference to the challenges and opportunities within the English public health system, this essay seeks to open debate about what is required to mainstream community-centred approaches and ensure that the public is central to public health. The essay sets out the case for a reorientation of public health practice in order to build impactful action with communities at scale leading to a reduction in the health gap. National frameworks that support local practice are described. Four areas of challenge that could potentially drive an implementation gap are discussed: (i) achieving integration and scale, (ii) effective community mobilization, (iii) evidencing impact and (iv) achieving a shift in power. The essay concludes with a call to action for developing a contemporary public health practice that is rooted in communities and offers local leadership to strengthen local assets, increase community control and reduce health inequalities.

Assessment of the post-mortem inspection of beef, sheep, goats and pigs in Australia: Approach and qualitative risk-based results

A risk-based assessment of post-mortem inspection activities and disposition judgment criteria was undertaken for cattle, sheep, goats and pigs in Australia against the current Australian Standard (AS 4696). The assessment utilized Codex Alimentarius Commission principles and guidelines for the conduct of microbiological risk assessment and the Code of Hygienic Practice for Meat. The assessment aimed to identify priorities for evaluating alternative procedures that deliver equivalent or better food safety outcomes to the current standard. An initial qualitative risk assessment used contemporary public health and industry data for differentiating gross abnormalities as meat safety or wholesomeness issues and to assess the likely effect of current inspection procedures on overall food safety outcomes. This article details the approach taken and reports the results of the qualitative risk assessment. The priorities identified for further validation of alternative post-mortem inspection procedures, matched against the risk managers’ primary concerns include: (1) bovine tuberculosis, Cysticercus bovis and Caseous Lymphadenitis of sheep and goats - removing post-mortem inspection procedures that are no longer necessary due to the improving animal health status of Australian animals; (2) inspection of spleens and unenucleated kidneys of sheep and goats - altering or removing procedures where new knowledge of animal or foodborne disease indicates current risk management procedures are not effective; (3) routine visual inspection of pigs, visual inspection of offal of sheep and goats - assessing the effect of inspection on microbial contamination of edible product; (4) melanoma of pigs, peri-acute pneumonia of cattle and pigs, polyarthritis of cattle and pigs - reviewing the criteria used to determine disposition judgments; and (5) pleurisy of pigs - identifying procedures that are principally related to detecting gross abnormalities that affect product wholesomeness (AS4696) rather than food safety and might, therefore, be managed within quality assurance arrangements. The outcome sought from this work will be a standard where post-mortem inspection is commensurate with risk.

Characterisation of an ABC transporter of a resistant Candida glabrata clinical isolate.

BACKGROUND Candida glabrata ranks second in epidemiological surveillance studies, and is considered one of the main human yeast pathogens. Treatment of Candida infections represents a contemporary public health problem due to the limited availability of an antifungal arsenal, toxicity effects and increasing cases of resistance. C. glabrata presents intrinsic fluconazole resistance and is a significant concern in clinical practice and in hospital environments.OBJECTIVEThe aim of this study was to characterise the azole resistance mechanism presented by a C. glabrata clinical isolate from a Brazilian university hospital.METHODSAzole susceptibility assays, chemosensitisation, flow cytometry and mass spectrometry were performed.FINDINGSOur study demonstrated extremely high resistance to all azoles tested: fluconazole, voriconazole, posaconazole and itraconazole. This isolate was chemosensitised by FK506, a classical inhibitor of ABC transporters related to azole resistance, and Rhodamine 6G extrusion was observed. A mass spectrometry assay confirmed the ABC protein identification suggesting the probable role of efflux pumps in this resistance phenotype.MAIN CONCLUSIONSThis study emphasizes the importance of ABC proteins and their relation to the resistance mechanism in hospital environments and they may be an important target for the development of compounds able to unsettle drug extrusion.

Shafts of light from the past

ABSTRACTIn the first edition of Cities & Health Roderick Lawrence, Anthony Capon and Jose Siri used Hippocrates’ principles as a starting point for a discussion about contemporary health challenges and ecological public health policy. Here I want to explore more deeply some of the theories and practices of healthy town planning in ancient Greece and Rome. They are both surprising and inspiring. There are some salutary lessons to learn.