Emerging Health Challenges Research Articles

High-Quality Genome-Scale Models From Error-Prone, Long-Read Assemblies

Advances in nanopore-based sequencing techniques have enabled rapid characterization of genomes and transcriptomes. An emerging application of this sequencing technology is point-of-care characterization of pathogenic bacteria. However, genome assessments alone are unable to provide a complete understanding of the pathogenic phenotype. Genome-scale metabolic reconstruction and analysis is a bottom-up Systems Biology technique that has elucidated the phenotypic nuances of antimicrobial resistant (AMR) bacteria and other human pathogens. Combining these genome-scale models (GEMs) with point-of-care nanopore sequencing is a promising strategy for combating the emerging health challenge of AMR pathogens. However, the sequencing errors inherent to the nanopore technique may negatively affect the quality, and therefore the utility, of GEMs reconstructed from nanopore assemblies. Here we describe and validate a workflow for rapid construction of GEMs from nanopore (MinION) derived assemblies. Benchmarking the pipeline against a high-quality reference GEM of Escherichia coli K−12 resulted in nanopore-derived models that were >99% complete even at sequencing depths of less than 10× coverage. Applying the pipeline to clinical isolates of pathogenic bacteria resulted in strain-specific GEMs that identified canonical AMR genome content and enabled simulations of strain-specific microbial growth. Additionally, we show that treating the sequencing run as a mock metagenome did not degrade the quality of models derived from metagenome assemblies. Taken together, this study demonstrates that combining nanopore sequencing with GEM construction pipelines enables rapid, in situ characterization of microbial metabolism.

Facing the Ethical Challenges: Consumer Involvement in COVID-19 Pandemic Research.

Consumer involvement in clinical research is an essential component of a comprehensive response during emergent health challenges. During the COVID-19 pandemic, the moderation of research policies and regulation to facilitate research may raise ethical issues. Meaningful, diverse consumer involvement can help to identify practical approaches to prioritize, design, and conduct rapidly developed clinical research amid current events. Consumer involvement might also elucidate the acceptability of flexible ethics review approaches that aim to protect participants whilst being sensitive to the challenging context in which research is taking place. This article describes the main ethical challenges arising from pandemic research and how involving consumers and the community could enable resolution of such issues.

HIV is an emerging health challenge in Pakistan: risk factors and management strategies.

HIV is an emerging health challenge in Pakistan: risk factors and management strategies.

The Pearl River Declaration: a timely call for enhancing health security through fostering a regional one health collaboration in the Asia-Pacific

The Second International Symposium on One Health Research (ISOHR) was held in Guangzhou city, China on 23–24 November 2019. A transdisciplinary collaborative approach, One Health (OH), was the central theme of the symposium which brought together more than 260 experts, scholars and emerging researchers from human health, veterinary health, food safety, environmental health and related disciplines and sectors. More than 50 organizations including World Health Organization, Centers for Disease Control (USA), and Queensland Government (Australia) participated in the symposium. Scholars, experts and emerging researchers, policy-makers and practitioners in their respective fields delivered over 50 presentations at the symposium, highlighting the collective vulnerability to some of the emerging health challenges the region was combating. These included emerging infectious diseases, antimicrobial resistance, climate change, food safety and the growing burden of non-communicable diseases. The Pearl River Declaration, emanated from the symposium, called for establishing a One Health Cooperation Network in the Southeast Asia–Pacific region with a vision to strengthen regional health security through sharing each other’s knowledge and experience, and making investments in workforce development, scientific innovations such as vaccine research and development, sharing epidemic intelligence, risk identification, risk communication and appropriate response measures against emerging health threats.

6.E. Workshop: Health promotion: An integrative paradigm for sustainable health, wellbeing and development

Abstract This workshop addresses the importance of health promotion for enabling all human beings to have healthy lives, to maximise their health potential and ensure that no one is left behind. Health promotion is a critical component of modern health systems and a vital strategy for sustainable health development and human flourishing. Effective health promotion strategies are essential in addressing the broader determinants of health, reducing health inequities, and tackling current and emerging health challenges to human development. Achieving the UN Sustainable Development Goals (SDGs) and universal health coverage calls for concerted action on health promotion as an integral component of modern health systems and future development. While successive global health policies have endorsed the need to invest in health promotion, political commitment to implementing health promotion is lacking and health policies and budgets remain focused on curative approaches. Health promotion is often poorly understood, both within the health sector and society more widely, and there is a limited appreciation of what is required to translate health promotion into effective action. Transformative health promotion actions are needed to deliver on improved population health and wellbeing and the creation of a healthy society where human wellbeing can flourish. Objectives This workshop will engage participants in an interactive discussion on how health promotion policy, research and practice can be strengthened in order to advance human health and wellbeing. Critical insights will be exchanged on how to bring a renewed focus on health promotion as a key transformative and disruptive strategy for advancing human wellbeing development. The workshop will critically consider what mechanisms are needed for strengthening health promoting policies, implementation processes and structures, capacities and research, to advance population health and wellbeing and a healthier future for all. Key messages Health promotion actions are critical to the delivery of improved population health and health equity, transforming health systems and enhancing human wellbeing and sustainable development. Strengthening health promoting polices, practices and research is essential to achieve the UN Sustainable Development Goals and enable the conditions for a healthier world.

Emerging health challenges for children with physical disabilities and their parents during the COVID-19 pandemic: The ECHO French survey.

BackgroundThe daily lives of children with physical disabilities and their families have been significantly affected by the COVID-19 pandemic. The children face health risks, especially mental, behavioral, social and physical risks.ObjectiveThis study aimed to identify potential healthcare issues relating to the wellbeing of disabled children, continuity of rehabilitation and medical care, and parental concerns during the COVID-19 lockdown.MethodsThe Enfant Confinement Handicap besOins (ECHO [child lockdown disability needs]) national survey was developed by a multidisciplinary group and disseminated in France from April 6, 2020 via email and social networks. This online survey was addressed to the parents of children with physical disabilities aged 0 to 18 years. It explored the experiences of children and their families during the lockdown. Information regarding children's wellbeing, rehabilitation and family organization was collected. The first 1000 eligible surveys were analyzed.ResultsThe children (mean [SD] age 9.5 [4.8] years) mostly had cerebral palsy (42%) or neuromuscular diseases (11%). The lockdown had negative effects on morale (44% of children), behaviour (55% of children) and social interactions (55% no contact with other children). Overall, 44% of children stopped physical activities; 76% were educated at home; 22% maintained medical follow-up, and 48% and 27% continued physiotherapy and occupational therapy respectively. For more than 60% of children, parents performed the therapy. The main parental concern was rehabilitation (72%) and their main difficulty was the mental load (50%); parents complained of lack of help and support (60%).ConclusionsThis study highlighted substantial effects on the health of children with physical disabilities and loss of opportunity, with a massive interruption of medical follow-up and rehabilitation, during the lockdown. Regular assessment of the health benefit/risk is essential to support families and ensure continuity of care during a pandemic.

Achieving therapeutic gains for regional youth with emergent mental health issues through parental family system-based groups: Findings from a qualitative study.

This paper reports findings from a study that sought to better understand the experiences of parents and their children with emergent mental health challenges following the parent's participation in a nurse-led therapeutic group. This was an explorative qualitative study using semi-structured interviews which were then thematically analysed. Findings from this single-site study are drawn from regional Australia. Twenty parents and seven of their children aged between 13 and 24. Family systems based therapeutic group intervention delivered to the parents of young people attending headspace. In line with qualitative research approaches, the participants lived experience was the outcome measure. Three key themes were found in the data: (a) improved parent-child relationships, (b) understanding and being understood and (c) multi-generational perspectives. Regional and remote regions are challenged with comparatively fewer and less diverse services for youth mental health than in urban centres. Findings from this exploratory study highlight that young people can experience therapeutic gains where their parents are the recipients of the intervention. Recommendations from these findings include pursuing further research on the therapeutic gains of parental family system-based groups.

The essential role of law in achieving the health-related Sustainable Development Goals

In this article, we examine the essential role of law in achieving the health-related Sustainable Development Goals (SDGs). Following the World Health Organization’s broad definition of health, all SDGs can be seen to impact on human health and hence the health goal (SDG3) should be right at the centre of the entire 2030 Agenda for Sustainable Development. We note recent research on the contribution of law, including international human rights law, to achieving health for all and discuss the role of law in addressing seven emerging health challenges. Law can and should play an important role in achieving all health-related SDGs, by respecting, protecting and fulfilling the right to health, ensuring that no one is left behind.

The impact of health programmes to prevent vertical transmission of HIV. Advances, emerging health challenges and research priorities for children exposed to or living with HIV: Perspectives from South Africa.

Over the past three decades, tremendous global progress in preventing and treating paediatric HIV infection has been achieved. This paper highlights the emerging health challenges of HIV-exposed uninfected (HEU) children and the ageing population of children living with HIV (CLHIV), summarises programmatic opportunities for care, and highlights currently conducted research and remaining research priorities in high HIV-prevalence settings such as South Africa. Emerging health challenges amongst HEU children and CLHIV include preterm delivery, suboptimal growth, neurodevelopmental delay, mental health challenges, infectious disease morbidity and mortality, and acute and chronic respiratory illnesses including tuberculosis, pneumonia, bronchiectasis and lymphocytic interstitial pneumonitis. CLHIV and HEU children require three different categories of care: (i) optimal routine child health services applicable to all children; (ii) routine care currently provided to all HEU children and CLHIV, such as HIV testing or viral load monitoring, respectively, and (iii) additional care for CLHIV and HEU children who may have growth, neurodevelopmental, behavioural, cognitive or other deficits such as chronic lung disease, and require varying degrees of specialised care. However, the translation thereof into practice has been hampered by various systemic challenges, including shortages of trained healthcare staff, suboptimal use of the patient-held child's Road to Health book for screening and referral purposes, inadequate numbers and distribution of therapeutic staff, and shortages of assistive/diagnostic devices, where required. Additionally, in low-middle-income high HIV-prevalence settings, there is a lack of evidence-based solutions/models of care to optimise health amongst HEU and CLHIV. Current research priorities include understanding the mechanisms of preterm birth in women living with HIV to optimise preventive interventions; establishing pregnancy pharmacovigilance systems to understand the short-, medium- and long-term impact of in utero ART and HIV exposure; understanding the role of preconception maternal ART on HEU child infectious morbidity and long-term growth and neurodevelopmental trajectories in HEU children and CLHIV, understanding mental health outcomes and support required in HEU children and CLHIV through childhood and adolescence; monitoring HEU child morbidity and mortality compared with HIV-unexposed children; monitoring outcomes of CLHIV who initiated ART very early in life, sometimes with suboptimal ART regimens owing to medication formulation and registration issues; and testing sustainable models of care for HEU children and CLHIV including later reproductive care and support.

Border Securitisation and the Emerging Health Challenges at the Indo-Bangladesh Borderland

This article discuses some of the major health challenges and their impact on the Indian families living outside the Indo-Bangladesh border fence. Drawing on the qualitative data of 7 group interviews and 25 in-depth individual interviews conducted in the border area of Karimganj district of Assam, it analyses health issues experienced by people having no access to health services. The article argues that although the purpose of border fencing was to restrict the illegal activities across the border, it is causing serious problems for the Indian population who are left outside the border fence. The strict border rules and restriction in the movements across the border have led to lack of access to necessary health services, and people are experiencing a range of health issues without any treatment. Nevertheless, there is no proper intervention mechanism by the government. The article suggests some measures to address the problems of the border dwellers.

Students help shape medical education to keep up with the times

Wendy Glauser’s recent article outlined barriers for medical curricula to meet emerging health challenges.[1][1] However, trainees are helping to reshape education from the ground up to address an increasingly complex practice environment. Complexity should be embraced, as it reflects our richer

Transdisciplinary research as transformative space making for sustainability: enhancing propoor transformative agency in periurban contexts

In this paper we discuss how transdisciplinary development research (TDR), if approached in particular ways, can not only to produce new knowledge, but also foster deeper systemic changes in the knowledge system itself. We are concerned with systemic change that supports pro-poor sustainability transformations, and conceptualise the processes that contribute to this type of systemic change as 'transformative space making' (TSM). TDR as TSM can generate possibilities for the integration of diverse knowledges into decision making, whilst also creating new opportunities for subaltern knowledges to achieve greater influence, through enhancing the transformative agency of the poor. Thus, our conceptualization goes beyond the idea of TDR for the co-creation of solution-oriented knowledge, and recognizes the need to address structural injustices in knowledge systems. In TDR as TSM the development of strategies to reveal power relations and navigate the politics of structural injustices becomes as important as refining the principles for robust collaborative knowledge production. To demonstrate the operationalization of TDR as TSM, we draw insights from our long-term involvement in TDR case studies of emergent environmental and health challenges in peri-urban contexts in India. We identify mechanisms which build legitimacy of pro-poor knowledges, whilst simultaneously creating ‘readiness’ to take advantage of opportunities for interventions to support change in policy and practice at multiple scales. We highlight the politics of alliance building both within and beyond the research team; arguing that attention to alliances is central to understanding the role of TDR in creating possibilities for transformative change. Finally, we argue that development research funding and commissioning agencies should pay attention to the mechanisms of TSM, alongside more recognised aspects of the planning, monitoring and evaluation of TDR initiatives, in order to provide appropriate support for enhanced impact.

Characteristics and trends in global tea research: a Science Citation Index Expanded‐based analysis

SummaryA bibliometric approach to assess trends in global tea research using literature in the Science Citation Index Expanded database from 1991 to 2014 has been conducted. Articles were analysed by scientific output and research performances of countries and institutions. The distribution of keywords in the articles’ titles, author‐supplied keywords and KeyWords Plus as well as citation and publication trends of tea‐related articles was used to evaluate the research trends. The research output devoted to tea science increased greatly after the year 2002 indicating a paradigm shift that demonstrated that researchers became increasingly keen on biochemical relevance of active compounds in tea in mitigating emergent health challenges over classical tea research.

342P Social impact of pediatric acute myeloid leukaemia (AML) is biggest challenge in eastern India - A demographic, clinical and psychological study

Background Pediatric Acute Myeloid Leukemia (AML) is becoming an emerging health challenge in eastern India thus affecting not only physical growth of children but also their mental well being. An observational study was conducted in a tertiary cancer centre of Eastern India to find out the association between clinical and psychological parameters of pediatric AML patients. However, a comparison was also drawn with healthy children of the same family. Methods During May 2014-July 2016, total 87 pediatric AML patients (53 male and 34 female) aged between 4-15 years attended OPD of Netaji Subhas Chandra Bose Cancer Research Institute, were studied for physical and mental status. Age and sex matched 43 healthy children(age range:4-15 years) from these affected families were alsoincluded as control group. Demographic factors (age,sexetc.) and clinical parameters (CBC, Electrolyte Analysis, RFT, and LFT etc.) were collected from hospital records. Behavior pattern was assessed by using Child Behavior Checklist from parents. We have compared those factors according to treatment plan. Finally, clinical parameters and behavioral pattern were compared between patients and healthy group. Results The overall survival in 2 year was 70.2% in patients aged <15years (with mean age 11.2 years). The ratio between patients and control group was 2.02:1. 28.1% of patients experienced developmental decline. Abnormal performance status, CBC, Electrolyte Analysis, RFT, LFT etc. were associated with increased likelihood of developmental decline. In addition, patients undergoing chemotherapy had shown significant decline in above mentioned factors than non chemo patients. Significant difference among demographic and clinical parameters and psychological factors were seen. Conclusions Our unique findings emphasize that the intensity and extent of treatment with chemotherapy may disrupt psychological/psychosocial development as well as electrolyte imbalance and liver and renal dysfunction of pediatric AML patients. Legal entity responsible for the study N/A Funding Netaji Subhas Chandra Bose Cancer Research Institute Disclosure All authors have declared no conflicts of interest.

Adiponectin: Probe of the molecular paradigm associating diabetes and obesity.

Type 2 diabetes is an emerging health challenge all over the world as a result of urbanization, high prevalence of obesity, sedentary lifestyle and other stress related factors compounded with the genetic prevalence. The health consequences and economic burden of the obesity and related diabetes mellitus epidemic are enormous. Different signaling molecules secreted by adipocytes have been implicated in the development of obesity and associated insulin resistance in type 2 diabetes. Human adiponectin, a 244-amino acid collagen-like protein is solely secreted by adipocytes and acts as a hormone with anti-inflammatory and insulin-sensitizing properties. Adiponectin secretion, in contrast to secretion of other adipokines, is paradoxically decreased in obesity which may be attributable to inhibition of adiponectin gene transcription. There are several mechanisms through which adiponectin may decrease the risk of type 2 diabetes, including suppression of hepatic gluconeogenesis, stimulation of fatty acid oxidation in the liver, stimulation of fatty acid oxidation and glucose uptake in skeletal muscle, and stimulation of insulin secretion. To date, no systematic review has been conducted that evaluate the potential importance of adiponectin metabolism in insulin resistance. In this review attempt has been made to explore the relevance of adiponectin metabolism for the development of diabetes mellitus. This article also identifies this novel target for prospective therapeutic research aiming successful management of diabetes mellitus.

The importance of survivors and partners in improving breast cancer outcomes in Uganda

In limited-resource countries, cancer kills more people annually than AIDS, tuberculosis and malaria combined. Programs targeting early detection and treatment of cancer are virtually non-existent due to insufficient funding and attention given to this emerging health challenge. Breast cancer is the most common cancer in women worldwide and is also the leading cause of cancer-related death in females. In developing countries such as Uganda, breast cancer incidence is increasing and typically presents at an advanced stage of disease, for which treatment options are limited. Inadequate knowledge and understanding of the disease, social stigma, and barriers to care all contribute to a poorer prognosis. There are many challenges to reducing breast cancer incidence and mortality globally; however, there is evidence to suggest that advocacy and education, in particular through the efforts of breast cancer survivors and their partners, can play a critical role in improving overall outcomes in limited-resource countries.

Financing the Millennium Development Goals for health and beyond: sustaining the 'Big Push'

Many of the Millennium Development Goals are not being achieved in the world's poorest countries, yet only five years remain until the target date. The financing of these Goals is not merely insufficient; current evidence indicates that the temporary nature of the financing, as well as challenges to coordinating its delivery and directing it to the most needy recipients, hinder achievement of the Goals in countries that may benefit most. Traditional approaches to providing development assistance for health have not been able to address both prevalent and emergent public health challenges captured in the Goals; these challenges demand sustained forms of financial redistribution through a coordinated mechanism. A global social health protection fund is proposed to address recurring failures in the modern aid distribution mechanism. Such a Fund could use established and effective strategies for aid delivery to mitigate many financial problems currently undermining the Millennium Development Goals initiative.

Risk, Knowledge and Health in Africa: Introduction to the Symposium

African Development ReviewVolume 21, Issue 1 p. 1-4 Risk, Knowledge and Health in Africa: Introduction to the Symposium Olu Ajakaiye, Olu AjakaiyeSearch for more papers by this authorChristopher B. Barrett, Christopher B. BarrettSearch for more papers by this authorRavi Kanbur, Ravi KanburSearch for more papers by this authorDavid E. Sahn, David E. SahnSearch for more papers by this authorStephen D. Younger, Stephen D. YoungerSearch for more papers by this author Olu Ajakaiye, Olu AjakaiyeSearch for more papers by this authorChristopher B. Barrett, Christopher B. BarrettSearch for more papers by this authorRavi Kanbur, Ravi KanburSearch for more papers by this authorDavid E. Sahn, David E. SahnSearch for more papers by this authorStephen D. Younger, Stephen D. YoungerSearch for more papers by this author First published: 11 March 2009 https://doi.org/10.1111/j.1467-8268.2009.00200.xRead the full textAboutPDF ToolsRequest permissionExport 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 Volume21, Issue1April/Avril 2009Pages 1-4 RelatedInformation

The Live Well Collaborative: A New Model for Universities and Companies to Work Together to Meet the Needs of 50+ Consumers

A new opportunity has emerged for universities and corporations to align in response to the global trend of countries with significant percentages of their population over the age of 50. This trend is driven by the dramatic increase in the birth rate starting in 1945 after World War II and ending in 1965 (a population commonly referred to in the United States as “baby boomers”). As they reach retirement, this age cohort has a unique expectation of a continued high quality of life in spite of the emerging health challenges they face. The boomer’s lifestyle expectation has tremendous impact on the design of new products and services in every sector of the economy. To achieve effective translational research (from laboratory to marketable products), universities and companies must integrate the qualitative innovation processes used by design fields like industrial design into the quantitative research techniques embraced by medicine and engineering. The University of Cincinnati is one of the few universities in the United States with all the necessary components in place to respond to this opportunity. P&G with global headquarters in Cincinnati is the right corporate partner to define this new university-corporate relationship.

Globalization and local response to epidemiological overlap in 21st century Ecuador

BackgroundThird World countries are confronted by a complex overlay of two sets of health problems. Traditional maladies, including communicable diseases, malnutrition, and environmental health hazards coexist with emerging health challenges, including cardiovascular disease, cancer, and increasing levels of obesity. Using Ecuador as an example, this paper proposes a conceptual framework for linking epidemiologic overlap to emerging social structures and processes at the national and global levels.DiscussionEpidemiologic trends can be seen as part of broader processes related to globalization, but this does not imply that globalization is a monolithic force that inevitably and uniformly affects nations, communities, and households in the same manner. Rather, characteristics and forms of social organization at the subnational level can shape the way that globalization takes place. Thus, globalization has affected Ecuador in specific ways and is, at the same time, intimately related to the form in which the epidemiologic transition has transpired in that country.SummaryEcuador is among neither the poorest nor the wealthiest countries and its situation may illuminate trends in other parts of the world.As in other countries, insertion into the global economy has not taken place in a vacuum; rather, Ecuador has experienced unprecedented social and demographic change in the past several decades, producing profound transformation in its social structure. Examples of local represent alternatives to centralized health systems that do not effectively address the complex overlay of traditional and emerging health problems.