Medical countermeasures against henipaviruses: a review and public health perspective.
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ABSTRACT:
SUBMITTER: Gomez Roman R
PROVIDER: S-EPMC8694750 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Medical countermeasures, including new drugs and vaccines, are necessary to protect the public's health from novel diseases and terrorist threats. Experience with the 2001 anthrax attack and the 2009 H1N1 pandemic suggest that there is limited willingness to accept such drugs and that minority groups may respond differently from others. We conducted 148 intercept interviews in the metropolitan Washington, DC, area, examining 2 hypothetical scenarios: a new respiratory virus and public exposure to high levels of radiation. Findings provide insights into key factors that affect whether diverse members of the public comply with recommended protective actions like taking emergency authorized vaccines. These insights can help improve how public health practitioners communicate during uncertain times.
| S-EPMC5583561 | biostudies-other
Project description:PURPOSE OF REVIEW:Zika virus' impact on pregnancy became widely known in 2015 with a dramatic increase in the number of babies born with microcephaly in Recife, Brazil. A mosquito-borne virus resulting in congenital anomalies is unique, and Zika's ability to cause neurological defects on a large scale was a grim reminder of the Rubella epidemic in the 1950s. Over the past 2 years, studies have provided insight on how Zika virus (ZIKV) infects cells and causes disease, but much remains unknown about the long-term risks of Zika exposure on infant growth and development. RECENT FINDINGS:The impact of ZIKV on pregnancy extends beyond microcephaly and may only first be identified in infancy. The virus has a long latency in semen and can be transmitted sexually. Transplacental passage occurs through infection of Hofbauer cells in the trophoblast. A major difficulty in management of ZIKV disease is that most infections are asymptomatic and the diagnostic methods are not ideal, making both diagnosis and ascertainment of timing of infection problematic. Several different types of vaccines are in development. Large studies are ongoing to determine the risk and total spectrum of anomalies based on the timing of infection and other environmental exposures. SUMMARY:This review will summarize the epidemic, what we have learned, what we hope to learn, and current recommendations for care and management.
| S-EPMC6010228 | biostudies-literature
Project description:This paper systematically reviews existing United States-based water insecurity literature with the goal of understanding the evidence base for developing public health water insecurity intervention strategies in Oregon. The authors conducted the systematic literature review using an adjusted PRISMA reporting checklist to document the review process. Results find 11 public health-related water insecurity interventions including surveillance practices and indicator and policy development. Research on water insecurity health impacts and solutions is still an emerging field. Nevertheless, state agencies perceive a risk to communities from inadequate safe water and are taking steps to assess and reduce these risks. From the review, strategies include improving water affordability, carrying out community education events, documenting drought risk and water loss, and tracking improvements in safe drinking water compliance. The review finds opportunities to take varied approaches that are community-specific, partnership-based and culturally relevant. Recommendations for Oregon include characterizing communities experiencing water insecurity, assessing community needs, tracking regional water scarcity and recognizing the human right to water in Oregon.
| S-EPMC7037707 | biostudies-literature
Project description:Fruits and vegetables (FV) are very important for the prevention of noncommunicable diseases (NCDs), but it has been demonstrated that FV consumption is below that recommended. Several companies have worked to offer FV concentrates, but it remains unclear whether they represent a potentially effective means of reducing the burden of NCDs. The present study provides a systematic review aimed at assessing the effect of FV concentrate supplementation on select parameters that are known to be risk factors for NCDs. The systematic review was done according to the PRISMA guidelines. Relevant studies were identified through the online databases PubMed, Scopus, Web of Science, and Embase. The physiological parameters of interest were total cholesterol, low-density lipoprotein, plasmatic homocysteine, systolic blood pressure, and body mass index. Data extraction was performed in duplicate. The results of the systematic review provided input for a Markov chain simulation model aimed at estimating the public health consequences of various scenarios of FV concentrate utilization on NCDs burden. The present results suggest a positive and significant role of FV concentrate supplementation on select parameters known to affect the risk of NCDs. Such an effect might be hypothesized to turn into mitigation of the burden of those NCDs modulated by the physiological parameters analyzed in the present systematic review.
| S-EPMC6912365 | biostudies-literature
Project description:ObjectiveTo examine the relationship between public health system network density and organizational centrality in public health systems and public health governance, community size, and health status in three public health domains.Data sources/study settingDuring the fall and the winter of 2007-2008, primary data were collected on the organization and composition of eight rural public health systems.Study designMultivariate analysis and network graphical tools are used in a case comparative design to examine public health system network density and organizational centrality in the domains of adolescent health, senior health, and preparedness. Differences associated with public health governance (centralized, decentralized), urbanization (micropolitan, noncore), health status, public health domain, and collaboration area are described.Data collection/extraction methodsSite visit interviews with key informants from local organizations and a web-based survey administered to local stakeholders.Principal findingsGovernance, urbanization, public health domain, and health status are associated with public health system network structures. The centrality of local health departments (LHDs) varies across public health domains and urbanization. Collaboration is greater in assessment, assurance, and advocacy than in seeking funding.ConclusionsIf public health system organization is causally related to improved health status, studying individual system components such as LHDs will prove insufficient for studying the impact of public health systems.
| S-EPMC2758409 | biostudies-literature
Project description:Individuals with serious mental disorders (SMD) may have a higher risk of vitamin D (VIT-D) deficiency. They also experience higher mortality because of coronavirus disease 2019 (COVID-19) infection. Therefore, we have conducted a comprehensive review to examine the significance of VIT-D for public health and public mental health during the ongoing COVID-19 pandemic. This review had three specific aims, from a global perspective to (a) create a profile of VIT-D and review the epidemiology of VIT-D deficiency, (b) explore VIT-D deficiency as risk factor for SMD and COVID-19 infections and (c) examine the effectiveness of VIT-D supplementation for both conditions. We found that, in terms of SMD, the evidence from laboratory and observational studies points towards some association between VIT-D deficiency and depression or schizophrenia. Mendelian randomisation studies, however, suggest no, or reverse, causality. The evidence from intervention studies is conflicting. Concerning COVID-19 infection, on proof of principle, VIT-D could provide a plausible defence against the infection itself and against an adverse clinical course. But data from observational studies and the first preliminary intervention studies remain conflicting, with stronger evidence that VIT-D may mitigate the clinical course of COVID-19 infection rather than the risk of infection in the first place. From a public health and public mental health point of view, based on the currently limited knowledge, for individuals with SMD, the benefits of VIT-D optimisation through supplementation seem to outweigh the risks. VIT-D supplementation, however, should not substitute for vaccination or medical care for COVID-19 infection.
| S-EPMC8274110 | biostudies-literature
Project description:BackgroundImmunocompromised patients are vulnerable to severe or complicated influenza infection. Vaccination is widely recommended for this group. This systematic review and meta-analysis assesses influenza vaccination for immunocompromised patients in terms of preventing influenza-like illness and laboratory confirmed influenza, serological response and adverse events.Methodology/principal findingsElectronic databases and grey literature were searched and records were screened against eligibility criteria. Data extraction and risk of bias assessments were performed in duplicate. Results were synthesised narratively and meta-analyses were conducted where feasible. Heterogeneity was assessed using I(2) and publication bias was assessed using Begg's funnel plot and Egger's regression test. Many of the 209 eligible studies included an unclear or high risk of bias. Meta-analyses showed a significant effect of preventing influenza-like illness (odds ratio [OR]=0.23; 95% confidence interval [CI]=0.16-0.34; p<0.001) and laboratory confirmed influenza infection (OR=0.15; 95% CI=0.03-0.63; p=0.01) through vaccinating immunocompromised patie nts compared to placebo or unvaccinated controls. We found no difference in the odds of influenza-like illness compared to vaccinated immunocompetent controls. The pooled odds of seroconversion were lower in vaccinated patients compared to immunocompetent controls for seasonal influenza A(H1N1), A(H3N2) and B. A similar trend was identified for seroprotection. Meta-analyses of seroconversion showed higher odds in vaccinated patients compared to placebo or unvaccinated controls, although this reached significance for influenza B only. Publication bias was not detected and narrative synthesis supported our findings. No consistent evidence of safety concerns was identified.Conclusions/significanceInfection prevention and control strategies should recommend vaccinating immunocompromised patients. Potential for bias and confounding and the presence of heterogeneity mean the evidence reviewed is generally weak, although the directions of effects are consistent. Areas for further research are identified.
| S-EPMC3245259 | biostudies-literature
Project description:Due to increasing demand and scarce financial resources for healthcare, health system efficiency has become a major topic in political and scientific debates. While previous studies investigating determinants of health system efficiency focused primarily on economic and social influence factors, the role of the political regime has been neglected. In addition, there is a lack of formal theoretical work on this specific topic, which ensures transparency and logical consistency of arguments and implications. Using a public choice approach, this paper provides a rigorous theoretical and empirical investigation of the relationships between health system efficiency and political institutions. We develop a simple principal-agent model describing the behavior of a government with respect to investments in population health under different political regimes. The main implication of the theoretical model is that governments under more democratic regimes put more effort in reducing embezzlement of health expenditure than non-democratic regimes. Accordingly, democratic countries are predicted to have more efficient health systems than non-democratic countries. We test this hypothesis based on a broad dataset including 158 countries over the period 1995-2015. The empirical results clearly support the implications of the theoretical model and withstand several robustness checks, including the use of alternative indicators for population health and democracy and estimations accounting for endogeneity. The empirical results also indicate that the effect of democracy on health system efficiency is more pronounced in countries with higher income levels. From a policy perspective, we discuss the implications of our findings in the context of health development assistance.
| S-EPMC8423257 | biostudies-literature
Project description:Through the Public Health Research Data Forum, global health research funders are working together to increase the availability of public health and epidemiology research data in ways that are equitable, ethical, and efficient. The Wellcome Trust funded the research reported in this special edition as a first step toward building an evidence base on the perspectives of research stakeholders in low- and middle-income countries on the benefits and challenges of sharing health research data. We hope this work will make a key contribution to discussions aimed at creating policy frameworks for data access at local, national, and regional levels that are sensitive to different contexts and ensure the benefits to research and health are realized in an equitable manner.
| S-EPMC4547198 | biostudies-other
Project description:BackgroundHaving relevant public health content in the undergraduate medical curriculum is critical to preparing medical doctors for emerging health issues and increased public health roles. Medical educators are central to this effort.ObjectiveThis systematic review synthesises the most relevant and up-to-date evidence on medical educators' perspectives regarding the barriers and enablers on incorporating public health teaching in the undergraduate medical curricula.MethodsSeven databases were searched for articles published between 1 January 2010 and 31 December 2021. Articles were included if they were available in full-text English or Indonesian language, peer-reviewed, and focused on medical educators' perspectives on teaching public health in the undergraduate medical curricula. Findings were integrated to answer the review question using thematic analysis.ResultsTwenty-nine articles were included in the final review. Three major themes emerged: (i) space in the medical curricula, (ii) confidence/capabilities of medical educators, and (iii) institutional support. Overcrowded curricula, lack of consensus about the scope and level of public health to incorporate into teaching, ensuring the quality and the relevance of content with what is required in real practice, as well as inadequate institutional support are major challenges in teaching public health to medical students.ConclusionsIntegrating public health into other subjects is largely seen as a solution. This requires strong institutional support in the form of financial, logistic, and technical support; structured training for medical educators on how to incorporate the content into their subjects; and a recognition of the important role that public health educators play.
| S-EPMC9467537 | biostudies-literature