Global Health Environment Research Articles

Resmetirom and Metabolic Dysfunction-Associated Steatohepatitis: Perspectives on Multidisciplinary Management from Global Healthcare Professionals.

The approval of resmetirom brings great hope to patients with metabolic dysfunction-associated steatohepatitis (MASH). The purpose of this review is to explore its impact on the global health environment. The implementation of multidisciplinary management MASH is proposed. Resmetirom has benefits in the treatment of MASH, and its safety and effectiveness have been studied. The adverse events (AEs) need to be noticed. To improve patient outcomes, a multimodal approach with medication such as resmetirom, combined with metabolic and bariatric surgery (MBS) and lifestyle interventions can be conducted. MASH, a liver disease linked with obesity, is a challenging global healthcare burden compounded by the absence of any approved pharmacotherapy. The recent conditional approval by the Food and Drug Administration(FDA) in the United States of resmetirom, an oral, liver-directed, thyroid hormone receptor beta-selective agonist, marks a significant milestone, offering a treatment option for adults with non-cirrhotic MASH and who have moderate to advanced liver fibrosis. This narrative review discusses the efficacy and safety of resmetirom and its role in the therapeutic landscape of MASH treatment. Despite the promising hepatoprotective effect of resmetirom on histological liver endpoints, its use need further research, particularly regarding ethnic differences, effectiveness and cost-effectiveness, production scalability, social acceptance and accessibility. In addition, integrating resmetirom with other multidisciplinary therapeutic approaches, including lifestyle changes and MBS, might further improve clinical liver-related and cardiometabolic outcomes of individuals with MASH. This review highlights the importance of a comprehensive treatment strategy, supporting continued innovation and collaborative research to refine treatment guidelines and consensus for managing MASH, thereby improving clinical patient outcomes in the growing global epidemic of MASH. Studies done to date have been relatively short and ongoing, the course of the disease is highly variable, the conditions of various patients vary, and given this complex clinical phenotype, it may take many years of clinical trials to show long-term benefits.

Pandemics: past, present, and future: multitasking challenges in need of cross-disciplinary, transdisciplinary, and multidisciplinary collaborative solutions.

The extensive history of pandemics has spanned many centuries, profoundly impacting societies, economies, and public health, and thereby shaping the course of history in various ways. Advances in medicine, science, and public health practices have played a pivotal role in mitigating the effects of pandemics over time. This review explores the scientific landscape of contemporary pandemics, examining their diverse and complex nature. It goes beyond the biological aspects of pandemics to consider socioeconomic, environmental, and technological factors. Through a scientific lens, this study aims to understand the complexities of pandemics and contribute to the expanding knowledge base that helps humanity strengthen its defenses against global health threats. By elucidating the enigmas of pandemics, the study hopes to foster a more resilient and prepared global health environment. Highlighting the importance of a multidisciplinary, cross-disciplinary, and transdisciplinary approach, this exploration emphasizes the critical need to integrate biological, socioeconomic, environmental, and technological domains to develop more robust defenses against these global health challenges.

Global Health Competency of Nursing Personnel: A Cross-Sectional Study.

As global health issues become more important, nursing education is undergoing change to reflect the changing global health environment and new knowledge. Nurses are required to be able to understand and interact with patients of diverse cultural backgrounds and characteristics and have relevant global health competencies. The aims of this study were to determine the GHC status of nurses and to analyze the association between GHC and nurse characteristics. This study was a cross-sectional descriptive survey using a convenience sampling method. Data were collected from 473 nurses to collect information about participants' GHC and general characteristics, including gender, age, nursing experience (years), experience of caring for foreign patients, English communication skills, learning experience in global health, and global preparedness. Multiple regression analysis was used to determine the relationship between GHC and nurse characteristics. The mean GHC score of nurses was 2.21 out of 4. "Nursing practice in globalization" was the most important global health competency, while "resource management in globalization" was the one that was most necessary. In addition, "Resource management in globalization" was the highest priority for global health competency. Global preparedness (β = .25, p < .001) and the perceived necessity of GHC in nursing practice (β = .28, p < .001) were statistically significant factors influencing the global health competency of nurses. Based on the relationship identified between GHC and the characteristics of nurses, it is essential to develop an education program for enhancing global preparedness and perception of the necessity of GHC.

Obesity treatment applying effective fuzzy soft multiset-based decision-making process

&lt;p&gt;Nowadays, obesity is recognized as a worldwide epidemic that has become a major cause of death and comorbidities. Recommending appropriate treatment is critical in the global health environment. For obesity treatment to be effective, the person must be able to follow a specific diet that meets his needs so that he can follow it for a long time or forever to maintain fitness. This research aims to determine the best diet among the trusted diets for every person based on his needs and circumstances. This occurs when applying a decision-making technique based on the effective fuzzy soft multiset concept. For this purpose, the definition of the effective fuzzy soft multiset as well as its types, operations, and properties are introduced. Furthermore, a decision-making method is proposed based on the effective fuzzy soft multiset environment. Using matrices operations, one can easily apply the decision-making process based on this new extension of sets to choose the optimal diet for everyone. Finally, an extensive comparative analysis of the previous methods is undertaken and also summarized in a chart to attract focus on the benefits of the suggested algorithm and to demonstrate how they differ from the current one.&lt;/p&gt;

The Relationship of Nurse's Compliance to Injection SOP and the Needlestick Accident in Irna 2 Surgery

Needle stick injury is important problems in occupational safety in global health environment. In fact there are still occurrences of needle sticks that may be related to compliance. This study at to determine relationship between nurse adherence on injection procedure with needle sticks injury at IRNA 2 Bedah RSUD dr. Saiful Anwar Malang. Descriptive analytic cross sectional involving 39 respondents selected by purposive sampling technique. Data were collected with injection procedure observation sheet and needle injury observation sheet. Data analysis used correlation test with = 0.05. A total of 39 respondents, almost all of them 35 respondents or 89.7% had complied with Injection procedure and there was still one incident of needle stick injury in respondent. Statistical test results p value = 0.002 or p &lt;0.05, there was a significant relationship between injection procedure and needle sticks injury at IRNA 2 Surgery RSUD Dr Saiful Anwar Malang

Leveraging nurse practitioner capacities to achieve global health for all: COVID-19 and beyond.

AimTo argue that nurse practitioners have been under‐utilized generally in the current global health environment, creating barriers to achieving universal health coverage and the Sustainable Development Goals.BackgroundNurse practitioners are advanced practice nurses possessing expert knowledge and leadership skills that can be optimized to narrow disparities and ensure access to high‐quality health care globally. Nurses worldwide have been challenged to meet global public health needs in the context of COVID‐19 (SARS‐CoV‐2 virus), and there are early indications that nurse practitioners are being called upon to the full extent of their capabilities in the current pandemic.Sources of evidencePubMed; Google Scholar; the International Council of Nurses; World Health Organization; United Nations; and the experiences of the authors.DiscussionSeveral international reports, nursing and health organizations have called for continued investment in and development of nursing to improve mechanisms that promote cost‐effective and universally accessible care. Expanding nurse practitioner scopes of practice across nations will leverage their clinical capacities, policy and advocacy skills, and talents to lead at all levels.ConclusionOngoing empirical data and policy change is needed to enable the full scope and strategic utilization of nurse practitioners across healthcare systems and contexts.Implications for nursing practice, and nursing and health policyWidespread education regarding nurse practitioner capacities for interdisciplinary partners, policymakers and the public is needed. Policies that safely expand their roles are critical. Role titles and remuneration reflective of their scope and service are required to lead, sustain and grow the workforce internationally.

Exploring the Nutritional Ecology of Stunting: New Approaches to an Old Problem.

Despite a declining prevalence, stunting remains an elusive target for the global health community. The perception is that stunting represents chronic undernutrition (i.e., due to inadequate nutrient intake associated with food insecurity, low-quality diet, and suboptimal infant feeding practices in the first two years of life). However, other causes include maternal–fetal interactions leading to intrauterine growth retardation, poor maternal nutrition during pregnancy and lactation, and maternal and pediatric infections. Moreover, physical, economic, demographic, and social environments are major contributors to both food insecurity and conditions that limit linear growth. Overall, factors representing both the internal and external “nutritional ecologies” need to be considered in efforts to reduce stunting rates. Nutritional assessment requires better understanding of the mechanism and role of nutrition in growth, clear expectations about the sensitivity and specificity of the tools used, and inclusion of bio-indicators reflecting the extent and nature of the functional effect of poor nutrition and environmental factors contributing to human physical growth. We provide a perspective on current knowledge about: (i) the biology and contribution of nutrition to stunting/poor growth; (ii) our current nutritional assessment toolkit; (iii) the implications of current assessment approaches for clinical care and public interventions; and (iv) future directions for addressing these challenges in a changing global health environment.

Comparison of Staging Systems to Assess Lymphedema Caused by Cancer Therapies, Lymphatic Filariasis, and Podoconiosis.

Background: Lymphedema is a disease of the skin and subcutaneous tissue resulting from a disturbance in lymph flow. Anyone can be affected, and causes include cancer therapy when lymph nodes are removed or irradiated, the parasitic disease lymphatic filariasis, and damage caused by exposure to irritant soils known as podoconiosis. Manifest lymphedema is progressive and a major contributor to disability, stigma, and social isolation for affected people. Although the pathogenesis of connective tissue changes in lymphedema will follow a similar course regardless of the disease of causation, several systems are used to stage progression. Disparity in these staging systems leads to inconsistency in reporting of the severity of lymphedema and prevents meta-analysis of research results. In the global health environment, integrated morbidity management for chronic illness is essential to meet the needs of affected people and to be sustainable for health care systems. Clinical descriptors for staging criteria within each system may assist clinicians in assessment and provide a format for consistency in reporting by lymphedema researchers.Methods and Results: Lymphedema staging systems used in oncology, filariasis, and podoconiosis settings were reviewed and the assessment techniques, diagnostic procedures, and clinical observations used by each system are described. The most commonly used staging systems are compared to identify similarities, and a matrix approach to lymphedema staging is proposed.Conclusion: A universal staging system would contribute to more consistent reporting of research on and clinical management of lymphedema arising from multiple causes.

Addressing NCDs: Penetration of the Producers of Hazardous Products into Global Health Environment Requires a Strong Response Comment on "Addressing NCDs: Challenges From Industry Market Promotion and Interferences"

Timely warnings and examples of industry interference in relation to tobacco, alcohol, food and breast milk substitutes are given in the editorial by Tangcharoensathien et al. Such interference is rife at national levels and also at the global level. In an era of ‘private public partnerships’ the alcohol and food industries have succeeded in insinuating themselves into the global health environment and their influence is seen in key recommendations regarding non-communicable disease (NCD) risk factors in United Nations (UN) reports. The absence of legally binding health treaties in these areas facilitates this industry engagement and the Framework Convention on Tobacco Control provides a valuable model to apply to control of other hazardous products.

The International Law of Overweight and Obesity

The number of overweight and obese persons is more than the number of those starving. The parallel growth of non-communicable diseases has triggered an alarmed response from the global public health system, which sees itself confronted by rising health-care costs from “lifestyle diseases” even as it continues to struggle with the economic and social burden of contagious disease. Although global public health attention to the “obesity epidemic” is only starting, the evidence points to a combination of causes and effects that span economic, political, social, and cultural aspects of eating and exercise. This makes the new global health environment more complex and more contentious than it was in the recent past. Clarity, it seems, exists only on one point for the mainstream public health advocates: overweight and obesity is a problem that governments need to address on the local, national, and international levels. Seeing weight as a problem to be targeted by governments, however, does not capture the full range of legal issues surrounding overweight and obesity. Because it is people that are overweight or obese, individual rights are unavoidably affected by measures impacting body weight. Thus, international human rights law must be given substantial attention when developing an international law of weight. Yet, while some human rights aim to protect individuals from overweight and obesity, other rights would protect overweight or obese individuals from governmental attempts to make them “healthy”. This article sets out the fundamentals of international overweight and obesity law, pointing out the legal approaches of global public health and human rights interests. It attempts to set a framework for further detailed examinations of the question of how weight can best be approached by international rules that must answer to societal concerns while protecting the dignity of individuals where those two interests collide.

Exploring the utility of institutional theory in analysing international health agency stasis and change

Of recent interest is the capacity of international health agencies to adapt to changes in the global health environment and country needs. Yet, little is known about the potential benefits of using social science institutional theory, such as path dependency and institutional change theory, to explain why some international agencies, such as the WHO and the Global Fund to Fight AIDS, Tuberculosis and Malaria, fail to adapt, whereas others, such as the World Bank and UNAIDS, have. This article suggests that these institutional theories can help to better understand these differences in international agency adaptive capacity, while highlighting new areas of policy research and analysis.

The 6th Meeting of the Global Alliance to Eliminate Lymphatic Filariasis: A half-time review of lymphatic filariasis elimination and its integration with the control of other neglected tropical diseases

The 6th Meeting of the Global Alliance to Eliminate Lymphatic Filariasis (GAELF6) was held 1-3 June, 2010 in Seoul, Korea, with 150 participants from 38 countries. The year 2010 marks the midpoint between the first GAELF meeting, in 2000, and the World Health Organization (WHO) 2020 goal of global elimination of lymphatic filariasis (LF) as a public health problem. The theme of the meeting, "Half-time in LF Elimination: Teaming Up with Neglected Tropical Diseases (NTDs)," reflected significant integration of LF elimination programmes into a comprehensive initiative to control NTDs. Presentations on LF epidemiology, treatment, research, and programmes highlighted both accomplishments and remaining challenges.The WHO strategy to interrupt LF transmission is based on annual mass drug administration (MDA) using two-drug combinations. After mapping the geographic distribution of LF, MDA is implemented for ≥ 5 years, followed by a period of post-MDA surveillance, and, ultimately, verification of LF elimination. Morbidity management further reduces disease burden.Of 81 countries considered LF-endemic in 2000, 52 (64.2%) have begun MDA; 10 (12.3%) others with low-level transmission are unlikely to require MDA. In 2008, ~695 million people were offered treatment (51.7% of the at-risk population); ~496 million participated. Approximately 22 million people have been protected from LF infection and disease, with savings of ~US $24.2 billion. Morbidity management programmes have been implemented in 27 (33.3%) countries.Significant challenges to LF elimination remain. These include: initiating MDA in the remaining 19 countries that require it; achieving full geographic coverage in countries where MDA has started; finding alternative strategies to address the problem of Loa loa co-endemicity in Central Africa; developing strategies to treat urban populations; initiating and sustaining MDA in settings of armed conflict; developing refined guidelines and procedures for stopping MDA, for post-MDA surveillance, and for verifying the elimination of LF; and integrating morbidity management into all LF elimination programmes. Scientific research and enhanced advocacy for NTDs remain critical for addressing these challenges.GAELF6 was characterized by enthusiasm and recognition that "teaming up with NTDs" offers opportunities for new partnerships, fresh perspectives, enhanced advocacy, and greater programmatic integration in a rapidly changing global health environment.

The Future of TDR: The Need to Adapt to a Changing Global Health Environment

The Future of TDR: The Need to Adapt to a Changing Global Health Environment

Lessons Learned From China's Healthcare System and Nursing Profession

To examine the healthcare policy and the nursing profession in China and to share insights learned from that country, which can be used to inform health-policy decision makers in the US. Despite their significant cultural, political, and historical differences, many healthcare issues are the same for China and the US. Both countries face rising healthcare costs and widening disparities between wealthy and poor individuals, and between urban and rural sectors. Some of the ideas that can be gleaned from China's healthcare system include rewarding physicians for prescribing preventive services; using trained laypeople as gatekeepers to the healthcare system in rural areas; communicating to the public and to health-policy decision makers the importance of nurses so that staffing, work conditions, and professional status can be improved; and including nurses in health-policy decisions. Lessons learned from China's healthcare policy and healthcare system have implications for public health policy change that could lead to improved patient outcomes in the US. The current changing global health environment calls for healthcare providers to learn from and work with our international neighbors to improve health outcomes for all patients.

The Global Fund at five: what next for universal access for HIV/AIDS, TB and malaria?

In 2001 the G8 committed to the creation of the Global Fund to fight AIDS, Tuberculosis and Malaria (the Global Fund) as an independent financing agency to attract, manage and disburse funds from a wide range of donors, including bilateral, multilateral and private sector organizations. With its focused financial appeal for the three diseases which account for over 6 million deaths per year and widespread political support, the Global Fund in its first five years has raised and disbursed an unprecedented volume of resources.1 Its ability to make grants in nearly all developing countries, its operational capacity to move swiftly and transparently in approving project proposals, its direct involvement with civil society, and continuing capacity for critical introspection have led to impressive successes at the country level between 2001-2006.2 As many had hoped at its inception, the Global Fund has become one of the most potent weapons to halt HIV, tuberculosis and malaria among the world's most marginalized populations. Yet, at the end of five years, both the Global Fund as well as many of us who have keenly followed its progress are aware that this organization stands at a critical juncture, facing important questions over its future directions. Some of these concerns arise from lessons learnt from the Global Fund's past experience. Others are catalyzed by the pressures imposed and opportunities provided by the evolving global health environment. The most important of these opportunities is the country level commitment world over to move towards universal access for prevention, treatment and care for HIV prevention, treatment and care. Proposed access to treatment for AIDS was contested as late as 2002, at the launch of the World Health Organization's (WHO) ‘3 by 5’ initiative. At the beginning of this year, thousands of people across the world, from all walks of life, argued for universal access to HIV prevention, treatment and care.3 This sea change in attitudes has brought the AIDS response to a unique historical juncture. Exceptionally, multiple elements necessary for effective scaling-up, including political commitment, broad-based societal involvement, and advanced knowledge of the epidemiological and sociological pathways of the disease, stand primed for action. All eyes are now focused on the leadership and support the Global Fund will provide to drive forward the universal access agenda. Beyond the obvious and important potential role of providing predictable and sustainable financing, the Global Fund has the capacity to respond rapidly to country needs to accelerate the pace of action and results in countries. Its response will also be able to sustain broad-based and inclusive, country level involvement. Both features fulfill key recommendations arising from the Universal Access country and regional consultations.4 Yet, to fully realize these roles, the Global Fund will need to address four key questions.