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Medcalf A, Atkin K. Chronic challenges: picturing chronic disease by the World Health Organization. MEDICAL HUMANITIES 2024:medhum-2023-012737. [PMID: 39117422 DOI: 10.1136/medhum-2023-012737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/03/2024] [Indexed: 08/10/2024]
Abstract
Chronic diseases are among the leading causes of mortality in the world, the subject of major regional and international efforts to tackle shared risk factors, implement prevention and control measures and set national targets as part of the drive towards universal health coverage. Yet there is a growing conviction that chronic diseases suffer an image problem. It has been suggested that the terminology 'dulls the senses' to the problems, and in an age where the mass media affords unprecedented opportunities to inform and persuade people to care about their health and that of others, chronic disease representation remains a contested and much debated issue.This article investigates how WHO created and disseminated visual narratives to raise popular consciousness and build a visual vocabulary around chronic disease in the second half of the 20th century. It examines the measures taken to conceptualise, photograph and publicise chronic diseases, and considers who had control over their representation. In focussing predominantly on cancer, diabetes and cardiovascular disease, it reveals different narratives; the power of scientific and technological progress; individual and community action for health; promising utopian and parallel dystopian visions. It embeds these in a production context which reveals an intricate picturing process involving overcoming challenges of representation. It uses this historical background to discuss issues relating to how chronic disease and chronic pain have been narrated visually, such as the ideas of emotional response, moral failure, how people navigate the 'risk society' and ultimately the concerns regarding the intentional and unintentional influence that the media can have on the image of disease given to society.
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2
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Demiray O, Gunes ED, Kulak E, Dogan E, Karaketir SG, Cifcili S, Akman M, Sakarya S. Classification of patients with chronic disease by activation level using machine learning methods. Health Care Manag Sci 2023; 26:626-650. [PMID: 37824033 DOI: 10.1007/s10729-023-09653-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 09/04/2023] [Indexed: 10/13/2023]
Abstract
Patient Activation Measure (PAM) measures the activation level of patients with chronic conditions and correlates well with patient adherence behavior, health outcomes, and healthcare costs. PAM is increasingly used in practice to identify patients needing more support from the care team. We define PAM levels 1 and 2 as low PAM and investigate the performance of eight machine learning methods (Logistic Regression, Lasso Regression, Ridge Regression, Random Forest, Gradient Boosted Trees, Support Vector Machines, Decision Trees, Neural Networks) to classify patients. Primary data collected from adult patients (n=431) with Diabetes Mellitus (DM) or Hypertension (HT) attending Family Health Centers in Istanbul, Turkey, is used to test the methods. [Formula: see text] of patients in the dataset have a low PAM level. Classification performance with several feature sets was analyzed to understand the relative importance of different types of information and provide insights. The most important features are found as whether the patient performs self-monitoring, smoking and exercise habits, education, and socio-economic status. The best performance was achieved with the Logistic Regression algorithm, with Area Under the Curve (AUC)=0.72 with the best performing feature set. Alternative feature sets with similar prediction performance are also presented. The prediction performance was inferior with an automated feature selection method, supporting the importance of using domain knowledge in machine learning.
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Affiliation(s)
- Onur Demiray
- Department of Computing, Imperial College London, London, SW7 2AZ, UK
| | - Evrim D Gunes
- College of Administrative Sciences and Economics, Koç University, Rumeli Feneri Yolu, Sariyer-Istanbul, Turkey.
| | - Ercan Kulak
- Ministry of Health Caycuma District Health Directorate, Zonguldak, Turkey
| | - Emrah Dogan
- Ministry of Health, Zonguldak Community Health Center, Zonguldak, Turkey
| | | | - Serap Cifcili
- Department of Family Medicine, Marmara University School of Medicine, Istanbul, Turkey
| | - Mehmet Akman
- Department of Family Medicine, Marmara University School of Medicine, Istanbul, Turkey
| | - Sibel Sakarya
- MPH, MHPE, School of Medicine, Department of Public Health, Koç University, Rumeli Feneri Yolu, Sariyer-Istanbul, Turkey
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3
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Akselrod S, Collins TE, Berlina D, Collins A, Allen LN. The impact of UN high-level meetings on non-communicable disease funding and policy implementation. BMJ Glob Health 2023; 8:e012186. [PMID: 37907235 PMCID: PMC10619094 DOI: 10.1136/bmjgh-2023-012186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 06/16/2023] [Indexed: 11/02/2023] Open
Abstract
Since the original UN General Assembly 'special session' for HIV/AIDS, there has been a proliferation of health-related high-level meetings (HLMs), including three for non-communicable diseases (NCDs) and a 2019 HLM on universal health coverage that was closely aligned to the NCD framework. This paper attempts to assess the impact of these meetings in terms of funding allocations, domestic NCD policy implementation, as well as the level of international engagement with the HLMs by reviewing attendance data and records of statements ('interventions') made by country delegations. In contrast to HIV/AIDS, whilst NCDs have enjoyed a marked rise in international political exposure and high-level political commitments, these have not always translated into national policy implementation or greater funding allocations. This is true even for countries that have engaged most deeply with HLMs. These findings should give pause to NCD advocacy groups that expend substantial energy in calling for further high-level political commitments and highlight the need to focus support on the translation of commitments into sustainably funded action.
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Affiliation(s)
| | | | - Daria Berlina
- Global NCD Platform, World Health Organization, Geneve, Switzerland
| | - Amy Collins
- Healthcare Without Harm, Vancouver, British Columbia, Canada
| | - Luke N Allen
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
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Lemoh C, Xiao Y, Tran L, Yussf N, Moro P, Dutertre S, Wallace J. An Intersectional Approach to Hepatitis B. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4879. [PMID: 36981797 PMCID: PMC10049575 DOI: 10.3390/ijerph20064879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 03/03/2023] [Accepted: 03/07/2023] [Indexed: 06/18/2023]
Abstract
Hepatitis B is a chronic condition, primarily associated with hepatitis B viral infection in early life. The failure of prevention and appropriate management can lead to subsequent liver cirrhosis and cancer. Hepatitis B most commonly affects people born in Asia and Sub-Saharan Africa and their global diasporas. The physical, psychological, and social impacts of hepatitis B are strongly influenced by sex and gender. Inequities in access to timely, sensitive diagnosis and effective management arise from interactions between structural inequalities related to race, ethnicity, Indigenous/settler status, class, and geography. The biomedical response to hepatitis B has led to advances in prevention, diagnosis, and treatment, but many affected communities have explanatory health belief models that differ from that of biomedicine. We argue that an intersectional approach, led by affected people and communities, can integrate biomedicine with the lived experience and social context that give purpose to and shape all personal, communal, clinical, and public health responses to hepatitis B. This approach has the potential to enable a consciously equitable, effective response to the biopsychosocial complexities of hepatitis B, improve the health and wellbeing of people living with hepatitis B, and reduce hepatitis B-associated mortality.
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Affiliation(s)
- Christopher Lemoh
- Department of Medicine, Melbourne Medical School, The University of Melbourne, Parkville, VIC 3010, Australia
| | - Yinzong Xiao
- Burnet Institute, Melbourne, VIC 3004, Australia
| | - Lien Tran
- Department of Medicine, Melbourne Medical School, The University of Melbourne, Parkville, VIC 3010, Australia
- WHO Collaborating Centre for Viral Hepatitis, Peter Doherty Institute for Infection and Immunity, Parkville, VIC 3010, Australia
| | - Nafisa Yussf
- WHO Collaborating Centre for Viral Hepatitis, Peter Doherty Institute for Infection and Immunity, Parkville, VIC 3010, Australia
- Department of Infectious Diseases, The University of Melbourne, Melbourne, VIC 3004, Australia
| | - Piergiorgio Moro
- Centre for Culture, Ethnicity and Health, North Richmond Community Health, Richmond, VIC 3121, Australia
| | - Sophie Dutertre
- Centre for Culture, Ethnicity and Health, North Richmond Community Health, Richmond, VIC 3121, Australia
| | - Jack Wallace
- Burnet Institute, Melbourne, VIC 3004, Australia
- Centre for Social Research in Health, University of New South Wales, Kensington, NSW 2052, Australia
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5
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Martini J, Traoré AT, Mahieu C. What has been preventing the emergence of a broad social movement on diabetes (and NCDs)? Insights from the mobilisation of diabetes patients' associations in Bamako, Mali. Glob Public Health 2022; 17:2929-2945. [PMID: 34814787 DOI: 10.1080/17441692.2021.2005114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Non-communicable diseases (NCDs) are among the leading causes of morbidity and mortality globally. While international strategies for their prevention and control call for greater civil society participation, many observers regret the lack of a broad social movement to address these diseases. This study focuses on diabetes patients' associations engaged from 1991 to 2014 in Bamako, Mali, and explores what factors influenced their capacity to build a collective national movement to address this disease and shape policy reforms in this area. Our findings show that the emergence of such a movement was limited by several constraints. The focus of diabetes patients' associations on technical biomedical issues silenced the daily embodied experience of patients and reduced the use of human-rights approaches. Moreover, few financial, material and social resources coupled with a fragmented base limited the scope and strength of claims made by patients' associations to obtain treatment at reduced coasts. Finally, modes of actions performed failed to challenge more structural inequalities and imbalances of power. Exacerbated by limited political opportunities, these constraints weakened the associations' ability to drive policy change on diabetes. They reflect some of the current weaknesses of the global mobilisation to address diabetes and NCDs.
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Affiliation(s)
- Jessica Martini
- Research Centres CRISS (Social Approaches to Health) and POLISSI (Health Policy and Systems - International Health), School of Public Health, Université libre de Bruxelles, Brussels, Belgium
| | - Annick Tijou Traoré
- Research laboratory LAM (Les Afriques dans le Monde), Institute of Political Studies, CNRS/UMR 5115, Pessac, France
| | - Céline Mahieu
- Research Centres CRISS (Social Approaches to Health) and POLISSI (Health Policy and Systems - International Health), School of Public Health, Université libre de Bruxelles, Brussels, Belgium
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Bopape M, Taillie LS, Swart R. Perceived effect of warning label on parental food purchasing and drivers of food selection among South African parents–An exploratory study. Front Public Health 2022; 10:939937. [PMID: 35991029 PMCID: PMC9388905 DOI: 10.3389/fpubh.2022.939937] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 07/20/2022] [Indexed: 11/13/2022] Open
Abstract
Household food purchasing decision is a complex process influenced by factors such as marketing, cost, children food preference and parental choices. Most food products targeted toward children are unhealthy and are aggressively marketed to increase desirability among parents and children making healthier food selection even harder. The warning label (WL) is identified as a simple front-of-package labeling format that assist consumers to easily identify unhealthy foods and reduce their purchasing. This was a qualitative study that aimed to investigate the perceived effect of the warning label (WL) on parental food purchasing and drivers of food selection among parents. The study was conducted in a mainly rural part of South Africa, in Limpopo Province. Data were collected from 44 adult participants, all parents with children aged below 16 years selected using the snowball sampling method. Seven focus groups diversified according to age, literacy, income and urbanicity were utilized for data collection. Using a focus group discussion guide, parents were shown images of six products (crisps, soda, juice, biscuits, cereals, and yogurt) superimposed with the WL and questions asked were based on those images. Thematic analysis revealed that although some parents felt undeterred by the WL, some felt they would alter their food purchasing in the presence of the WL. Other parents felt they would reduce the frequency or the amount purchased or completely stop purchasing labeled products for their children. Motives behind perceived behavior modification included children's health being perceived as a priority and labeled products being viewed as unhealthy. Factors such as pressure from children, taste, poor nutrition knowledge and affordability seemed to influence parental food selection. These findings have important policy implications by providing evidence to policymakers that the WL may alter parental food purchasing and also provide insight into drivers of food selection among South African parents.
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Affiliation(s)
- Makoma Bopape
- Department of Human Nutrition and Dietetics, Faculty of Health Sciences, University of Limpopo, Polokwane, South Africa
- Faculty of Community and Health Sciences, School of Public Health, University of the Western Cape, Cape Town, South Africa
- *Correspondence: Makoma Bopape
| | - Lindsey Smith Taillie
- Carolina Population Center and Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Rina Swart
- Department of Dietetics and Nutrition, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa
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Sebastian AT, Rajkumar E, John R, Daniel M, George AJ, Greeshma R, James T. Emotional Self-Care: Exploring the Influencing Factors Among Individuals With Cancer. Front Psychol 2022; 13:898345. [PMID: 35734454 PMCID: PMC9207817 DOI: 10.3389/fpsyg.2022.898345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 04/25/2022] [Indexed: 11/13/2022] Open
Abstract
Cancer is a leading source of distress and fatality worldwide. Cancer-related aberrant cell proliferation causes excruciating pain and impairment. To cope with pain and manage symptoms and illness, pharmaceutical and non-pharmacological options are available. Self-care behaviors are recognized as a key source in symptom management and improving quality adherence to treatment among the current non-pharmacological strategies. The intervention measures to improve self-care were hardly impacted because of the narrow focus on physical self-care. Bringing in emotional self-care and addressing the individual's emotional health can enhance the effectiveness of interventions on a holistic level. Hence, this study has attempted to explore the factors that influence emotional self-care among individuals with cancer. Following an exploratory research design, the data were collected from 15 participants (4 men and 11 women) using purposive sampling and semi-structured interviews. Through thematic analysis, eight major themes were identified: physiological factors, social factors, family factors, psychological factors, individual factors, socioeconomic factors, cultural factors, and spiritual factors. The findings explained the emotional self-care among patients with cancer and how different identified factors influence their emotional self-care practices.
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Affiliation(s)
| | - Eslavath Rajkumar
- Department of Psychology, Central University of Karnataka, Gulbarga, India
- *Correspondence: Eslavath Rajkumar
| | - Romate John
- Department of Psychology, Central University of Karnataka, Gulbarga, India
| | - Monica Daniel
- Department of Psychology, Central University of Karnataka, Gulbarga, India
| | - Allen Joshua George
- Humanities and Applied Sciences, Indian Institute of Management Ranchi, Ranchi, India
| | - Rajgopal Greeshma
- Department of Psychology, Central University of Karnataka, Gulbarga, India
| | - Treasa James
- Department of Medicine, KMCT Medical College, Kozhikode, India
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Abstract
Amyloids are organized suprastructural polypeptide arrangements. The prevalence of amyloid-related processes of pathophysiological relevance has been linked to aging-related degenerative diseases. Besides the role of genetic polymorphisms on the relative risk of amyloid diseases, the contributions of nongenetic ontogenic cluster of factors remain elusive. In recent decades, mounting evidences have been suggesting the role of essential micronutrients, in particular transition metals, in the regulation of amyloidogenic processes, both directly (such as binding to amyloid proteins) or indirectly (such as regulating regulatory partners, processing enzymes, and membrane transporters). The features of transition metals as regulatory cofactors of amyloid proteins and the consequences of metal dyshomeostasis in triggering amyloidogenic processes, as well as the evidences showing amelioration of symptoms by dietary supplementation, suggest an exaptative role of metals in regulating amyloid pathways. The self- and cross-talk replicative nature of these amyloid processes along with their systemic distribution support the concept of their metastatic nature. The role of amyloidosis as nutrient sensors would act as intra- and transgenerational epigenetic metabolic programming factors determining health span and life span, viability, which could participate as an evolutive selective pressure.
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Affiliation(s)
- Luís Maurício T R Lima
- Laboratory for Pharmaceutical Biotechnology - pbiotech, Faculty of Pharmacy, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
- Laboratory for Macromolecules (LAMAC-DIMAV), National Institute of Metrology, Quality and Technology - INMETRO, Duque de Caxias, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Tháyna Sisnande
- Laboratory for Pharmaceutical Biotechnology - pbiotech, Faculty of Pharmacy, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
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Devi J, Raees A, Butt AS. Redefining non-alcoholic fatty liver disease to metabolic associated fatty liver disease: Is this plausible? World J Hepatol 2022; 14:158-167. [PMID: 35126845 PMCID: PMC8790389 DOI: 10.4254/wjh.v14.i1.158] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 06/17/2021] [Accepted: 12/22/2021] [Indexed: 02/06/2023] Open
Abstract
Recently, a single letter change has taken the world by storm. A group of experts have developed a consensus to upgrade the term non-alcoholic fatty liver disease (NAFLD) to metabolic associated fatty liver disease (MAFLD), suggesting that MAFLD would more accurately reflect not only the disease pathogenesis but would also help in patient stratification for management with NAFLD. However, the difference of opinion exists, which has made the NAFLD vs MAFLD debate the current talk of the town. This review will focus on the plausibility and implications of redefining NAFLD as MAFLD.
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Affiliation(s)
- Jalpa Devi
- Department of Gastroenterology, Liaquat University of Medical and Health Sciences, Jamshoro 74800, Pakistan
| | - Aimun Raees
- Department of Gastroenterology, Aga Khan University Hospital, Karachi 74800, Pakistan
| | - Amna Subhan Butt
- Department of Gastroenterology, Aga Khan University Hospital, Karachi 74800, Pakistan.
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Rosewarne E, Moore M, Chislett WK, Jones A, Trieu K, Webster J. An evaluation of the Victorian Salt Reduction Partnership's advocacy strategy for policy change. Health Res Policy Syst 2021; 19:100. [PMID: 34266477 PMCID: PMC8281636 DOI: 10.1186/s12961-021-00759-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 07/05/2021] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Public health advocacy strategies facilitate policy change by bringing key health issues to the forefront of public and political discourse, influencing decision-makers and public opinion, and increasing policy demand. The Victorian Salt Reduction Partnership (VSRP) was established in 2014 in response to inadequate government action to improve population diets in Australia. This study aimed to evaluate the success of the VSRP's advocacy strategy in achieving policy change. METHODS Documentation of VSRP activities and outputs were collected, and semi-structured interviews conducted as part of a comprehensive process evaluation. For this study, the Kotter Plus 10-step public health advocacy evaluation framework was used to guide data extraction, analysis, and synthesis. RESULTS A sense of urgency for salt reduction was generated by producing evidence and outlining the potential impact of a state-based salt reduction programme. This enabled the creation of a coalition with diverse skills and expertise, which facilitated the development of an innovative and collaborative advocacy action plan. A clear change vision was established, but communication of the vision to decision-makers was lacking, which reduced the impact of the programme as decision-makers were not provided with a clear incentive for policy change. As a result, while programme outputs were achieved, these did not translate to achieving broader strategic goals during a limited-term intervention in a political climate unconcerned with salt. CONCLUSIONS The Kotter Plus 10-step framework was a useful tool for evaluating the success of the VSRP advocacy strategy. The framework enabled the identification of key strengths, including the creation of the guiding coalition, and areas where efforts could be improved in future similar strategies, such as effective communication within partnerships and to decision-makers, to better influence policy and improve public health impact.
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Affiliation(s)
- Emalie Rosewarne
- The George Institute for Global Health, The University of New South Wales, Sydney, NSW, 2006, Australia.
| | - Michael Moore
- The George Institute for Global Health, The University of New South Wales, Sydney, NSW, 2006, Australia
| | - Wai-Kwan Chislett
- The George Institute for Global Health, The University of New South Wales, Sydney, NSW, 2006, Australia
| | - Alexandra Jones
- The George Institute for Global Health, The University of New South Wales, Sydney, NSW, 2006, Australia
| | - Kathy Trieu
- The George Institute for Global Health, The University of New South Wales, Sydney, NSW, 2006, Australia
| | - Jacqui Webster
- The George Institute for Global Health, The University of New South Wales, Sydney, NSW, 2006, Australia
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Méndez-Sánchez N, Díaz-Orozco LE. Editorial: International Consensus Recommendations to Replace the Terminology of Non-Alcoholic Fatty Liver Disease (NAFLD) with Metabolic-Associated Fatty Liver Disease (MAFLD). Med Sci Monit 2021; 27:e933860. [PMID: 34248137 PMCID: PMC8284081 DOI: 10.12659/msm.933860] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 07/04/2021] [Indexed: 12/14/2022] Open
Abstract
In 2020, international consensus guidelines recommended the renaming of non-alcoholic fatty liver disease (NAFLD) to metabolic-associated fatty liver disease (MAFLD), supported by diagnostic criteria. MAFLD affects up to 25% of the global population. However, the rates of MAFLD are likely to be underestimated due to the increasing prevalence of type 2 diabetes mellitus (T2DM) and obesity. Within the next decade, MAFLD has been projected to become a major cause of cirrhosis and hepatocellular carcinoma (HCC) worldwide, as well as the most common indication for liver transplantation in the US. This transition in terminology and clinical criteria may increase momentum and clinical evidence at multiple levels, including patient diagnosis, management, and care, and provide the basis for new research areas and clinical development for therapeutics. The diagnostic criteria for MAFLD are practical, simple, and superior to the existing NAFLD criteria for identifying patients at increased risk of developing progressive liver disease. This Editorial aims to present the historical evolution of the terminology for fatty liver disease and the advantages of diagnosis, patient management, and future research on MAFLD.
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Affiliation(s)
- Nahum Méndez-Sánchez
- Liver Research Unit, Médica Sur Clinic and Foundation and Faculty of Medicine, Mexico City, Mexico
- National Autonomous University of Mexico, Mexico City, Mexico
| | - Luis Enrique Díaz-Orozco
- Liver Research Unit, Médica Sur Clinic and Foundation and Faculty of Medicine, Mexico City, Mexico
- National Autonomous University of Mexico, Mexico City, Mexico
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12
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Wai-Sun Wong V, Kanwal F. On the Proposed Definition of Metabolic-Associated Fatty Liver Disease. Clin Gastroenterol Hepatol 2021; 19:865-870. [PMID: 33453398 DOI: 10.1016/j.cgh.2021.01.017] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 01/08/2021] [Indexed: 02/07/2023]
Affiliation(s)
- Vincent Wai-Sun Wong
- Department of Medicine and Therapeutics, State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong
| | - Fasiha Kanwal
- Professor of Medicine, Chief, Gastroenterology and Hepatology, Sections of Gastroenterology and Hepatology, Health Services Research, Department of Medicine, Baylor College of Medicine, VA HSR&D Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas
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13
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Mahmood S, Bollipo S, Steele S, Bristow RG, Choudhury A, Oakland K, Martin J. It's All the RAVE: Time to Give up on the "Chronic Radiation Proctitis" Misnomer. Gastroenterology 2021; 160:635-638. [PMID: 33096102 DOI: 10.1053/j.gastro.2020.09.054] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 09/17/2020] [Accepted: 09/21/2020] [Indexed: 01/16/2023]
Affiliation(s)
- Sultan Mahmood
- Department of Medicine, University at Buffalo, Buffalo, New York
| | - Steven Bollipo
- School of Medicine and Public Health, University of Newcastle and, Department of Gastroenterology, John Hunter Hospital, Newcastle, New South Wales, Australia
| | - Scott Steele
- Department of Colorectal Surgery, Cleveland Clinic, Cleveland, Ohio
| | | | | | - Kathryn Oakland
- Department of Digestive Diseases, HCA Healthcare UK, London, UK
| | - Jarad Martin
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
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14
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Berardo C, Di Pasqua LG, Cagna M, Richelmi P, Vairetti M, Ferrigno A. Nonalcoholic Fatty Liver Disease and Non-Alcoholic Steatohepatitis: Current Issues and Future Perspectives in Preclinical and Clinical Research. Int J Mol Sci 2020; 21:ijms21249646. [PMID: 33348908 PMCID: PMC7766139 DOI: 10.3390/ijms21249646] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 12/15/2020] [Accepted: 12/16/2020] [Indexed: 02/07/2023] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD) is a continuum of liver abnormalities often starting as simple steatosis and to potentially progress into nonalcoholic steatohepatitis (NASH), fibrosis, cirrhosis and hepatocellular carcinoma. Because of its increasing prevalence, NAFLD is becoming a major public health concern, in parallel with a worldwide increase in the recurrence rate of diabetes and metabolic syndrome. It has been estimated that NASH cirrhosis may surpass viral hepatitis C and become the leading indication for liver transplantation in the next decades. The broadening of the knowledge about NASH pathogenesis and progression is of pivotal importance for the discovery of new targeted and more effective therapies; aim of this review is to offer a comprehensive and updated overview on NAFLD and NASH pathogenesis, the most recommended treatments, drugs under development and new drug targets. The most relevant in vitro and in vivo models of NAFLD and NASH will be also reviewed, as well as the main molecular pathways involved in NAFLD and NASH development.
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Affiliation(s)
| | | | | | | | | | - Andrea Ferrigno
- Correspondence: (L.G.D.P.); (A.F.); Tel.: +39-0382-986-451 (L.G.D.P.)
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15
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Hatefi A, Marten R, Smith RD. Global-scale action in health: a common language is a critical starting point to bolster global health financing. Health Policy Plan 2020; 35:1133-1136. [PMID: 32860681 DOI: 10.1093/heapol/czaa090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2020] [Indexed: 11/12/2022] Open
Affiliation(s)
- Arian Hatefi
- Department of Medicine and Institute for Global Health Sciences, University of California San Francisco, 533 Parnassus Ave, San Francisco, CA 94143, USA
| | - Robert Marten
- The Alliance for Health Policy and Systems Research and
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16
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Mousavi SB, Lecic-Tosevski D, Khalili H, Mousavi SZ. To be able, or disable, that is the question: A critical discussion on how language affects the stigma and self-determination in people with parability. Int J Soc Psychiatry 2020; 66:424-430. [PMID: 32281903 DOI: 10.1177/0020764020913308] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Despite several fruitful attempts in destigmatization, disability is still associated with stigma. The role of language, especially when addressing a disabling condition and people, has been the matter of social as well as scientific debates. This article poses an intriguing question about the language we apply when addressing people and disability. METHOD A narrative review of different models of disability with the emphasis on how labels and more generally language affect identity formation, and the extendibility of positive psychology concepts on the field of disability studies. RESULTS In this theoretical paper, the authors suggest that the term disability per se is contributing to increasing the stigma and has disempowering effect. Considering previous evidence from different lines of literature, the authors suggest a new approach of destigmatization, namely changing the term disability to a less stigmatizing one. Moreover, the authors discuss some theories to support this perspective. CONCLUSION Replacing 'dis' in 'disability' with the prefix 'para' in the term 'Para-ability' is suggested.
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Affiliation(s)
- S Bentolhoda Mousavi
- Department of Psychiatry, Psychosis Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | | | - Hassan Khalili
- Department of Ophthalmology, Alborz University of Medical Sciences, Karaj, Iran
| | - S Zeinab Mousavi
- Department of Psychology, Washington State University, Pullman, WA, USA
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17
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Fouad Y, Waked I, Bollipo S, Gomaa A, Ajlouni Y, Attia D. What's in a name? Renaming 'NAFLD' to 'MAFLD'. Liver Int 2020; 40:1254-1261. [PMID: 32301554 DOI: 10.1111/liv.14478] [Citation(s) in RCA: 190] [Impact Index Per Article: 47.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 04/12/2020] [Accepted: 04/13/2020] [Indexed: 12/13/2022]
Abstract
In medicine, language matters and the words used to name and describe a disease can have a profound impact on patients and their families. Over the last two decades, many criticisms have been voiced about the nomenclature and definition of non-alcoholic fatty liver disease (NAFLD) in regards not only to the prominent role that alcohol plays in the definition but also on the negative impacts of the nomenclature including trivialization, stigmatization and less consideration of the disease in health policy. Recently, a consensus of international experts proposed that the disease acronym be changed from NAFLD to metabolic (dysfunction) associated fatty liver disease or 'MAFLD'. This change goes far beyond a mere semantic revision and may be the first step that catalyses the process to better conceptualize the disease for health promotion, patient orientation, case identification, ongoing clinical trials and for health services delivery. Here we review the history of, and definitions of MAFLD in the context of advancing our understanding of the pathogenesis of the disease. We also address the reasons, signals, promises, challenges and the way going forward from the name change from various stakeholder perspectives.
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Affiliation(s)
- Yasser Fouad
- Department of Gastroenterology, Hepatology and Endemic Medicine, Faculty of Medicine, Minia University Hospitals, Minya, Egypt
| | - Imam Waked
- Hepatology Department National Liver Institute, Menoufia University, Shebeen El Kom, Egypt
| | - Steven Bollipo
- Department of Gastroenterology and Endoscopy, John Hunter Hospital, Newcastle, NSW, Australia.,School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
| | - Ahmed Gomaa
- Department of Hepatology, Gastroenterology and Endemic Medicine, Faculty of Medicine, Fayoum University, Fayoum, Egypt
| | - Yousef Ajlouni
- Gastroenterology and Hepatology Departement, King Hussein Medical Center, Amman, Jordan
| | - Dina Attia
- Department of Hepatology, Gastroenterology and Endemic Medicine, Faculty of Medicine, Beni-Suef University, Beni-suef, Egypt
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18
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Herrick C. The optics of noncommunicable diseases: from lifestyle to environmental toxicity. SOCIOLOGY OF HEALTH & ILLNESS 2020; 42:1041-1059. [PMID: 32162326 DOI: 10.1111/1467-9566.13078] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Until recently, the noncommunicable disease (NCD) category was composed of four chronic diseases (cancer, cardiovascular disease, diabetes and chronic respiratory disease) and four shared, 'modifiable' behavioural risk factors (smoking, diet, physical activity and alcohol). In late 2018, the NCD category was expanded to include mental health as an additional disease outcome and air pollution as an explicit environmental risk factor. The newly-expanded NCD category connects behavioural and environmental readings of risk and shifts attention from individual acts of consumption to unequal and inescapable conditions of environmental exposure. It thus renders the increasing 'toxicity' of everyday life amid ubiquitous environmental contamination a new conceptual and empirical concern for NCD research. It also, as this paper explores, signals a new 'optics' of a much-maligned disease category. This is particularly significant as chronic disease research has long been siloed between public and environmental health, with each discipline operationalising the notion of the 'environment' as a source of disease causation in contrasting ways. Given this, this paper is positioned as a significant contribution to both research on NCDs and environmental risk, bringing these interdisciplinary domains into a new critical conversation around the concept of toxicity.
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Affiliation(s)
- Clare Herrick
- Department of Geography, Kings College London, London, UK
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19
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Lescoat A, Cavalin C, Ehrlich R, Cazalets C, Ballerie A, Belhomme N, Coiffier G, de Saint Riquier M, Rosental PA, Hachulla E, Sobanski V, Jégo P. The nosology of systemic sclerosis: how lessons from the past offer new challenges in reframing an idiopathic rheumatological disorder. THE LANCET. RHEUMATOLOGY 2019; 1:e257-e264. [PMID: 38229382 DOI: 10.1016/s2665-9913(19)30038-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 07/09/2019] [Accepted: 07/10/2019] [Indexed: 11/24/2022]
Abstract
Systemic sclerosis is a rare connective tissue disease characterised by a wide range of clinical manifestations. Compared with previous sets of criteria, the 2013 American College of Rheumatology and European League Against Rheumatism (ACR/EULAR) classification of systemic sclerosis encompasses a broader and more relevant spectrum of the condition. Nonetheless, clinical and prognostic heterogeneity persists among patients fulfilling these criteria. The next task in the classification of systemic sclerosis is the development of new subset criteria that can successfully identify subgroups of patients with distinct prognostic or pathophysiological features. In this Viewpoint we describe the history of systemic sclerosis over the past century with the objective of highlighting the effect of previous nosological debates on efforts to understand and manage this disorder. Rather than seeking to present a systematic review of possible subgrouping for systemic sclerosis in relation to prognosis, we aim to clarify how nosological considerations have influenced our understanding of the cause and prognosis of this so-called idiopathic rheumatological disorder and how aetiological, prognostic, and pathophysiological hypotheses have helped to describe clusters within the disease. By reflecting on past nosological debates and endeavours, we identify challenges for the current initiative to develop a new subgrouping of systemic sclerosis.
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Affiliation(s)
- Alain Lescoat
- Department of Internal Medicine and Clinical Immunology, Rennes University Hospital, University of Rennes 1, Rennes, France; École des Hautes Études en Santé Publique, Research Institute for Environmental and Occupational Health, French National Institute of Health and Medical Research Unit 1085, Rennes University Hospital, University of Rennes 1, Rennes, France.
| | - Catherine Cavalin
- Interdisciplinary Research Institute for the Social Sciences, Université Paris-Dauphine, Université Paris Sciences et Lettres, Paris, France; Centre for European Studies and Comparative Politics, Sciences Po, Paris, France; Laboratory for Interdisciplinary Evaluation of Public Policies, Sciences Po, Paris, France; The Employment and Labour Research Centre, Noisy-le-Grand, France
| | - Rodney Ehrlich
- Centre for Occupational and Environmental Health Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Claire Cazalets
- Department of Internal Medicine and Clinical Immunology, Rennes University Hospital, University of Rennes 1, Rennes, France
| | - Alice Ballerie
- Department of Internal Medicine and Clinical Immunology, Rennes University Hospital, University of Rennes 1, Rennes, France; École des Hautes Études en Santé Publique, Research Institute for Environmental and Occupational Health, French National Institute of Health and Medical Research Unit 1085, Rennes University Hospital, University of Rennes 1, Rennes, France
| | - Nicolas Belhomme
- Department of Internal Medicine and Clinical Immunology, Rennes University Hospital, University of Rennes 1, Rennes, France
| | - Guillaume Coiffier
- Department of Rheumatology, Rennes University Hospital, University of Rennes 1, Rennes, France; French National Institute of Health and Medical Research Unit 1241, University of Rennes 1, Rennes, France
| | - Marine de Saint Riquier
- Department of Rheumatology, Rennes University Hospital, University of Rennes 1, Rennes, France
| | | | - Eric Hachulla
- Lille Inflammation Research International Center, University of Lille, Lille, France; French National Institute of Health and Medical Research, University of Lille, Lille, France; Département de Médecine Interne et Immunologie Clinique, Lille University Hospital, Lille, France; Centre National de Référence Maladies Systémiques et Auto-Immunes Rares du Nord et Nord-Ouest de France, Lille, France
| | - Vincent Sobanski
- Lille Inflammation Research International Center, University of Lille, Lille, France; French National Institute of Health and Medical Research, University of Lille, Lille, France; Département de Médecine Interne et Immunologie Clinique, Lille University Hospital, Lille, France; Centre National de Référence Maladies Systémiques et Auto-Immunes Rares du Nord et Nord-Ouest de France, Lille, France
| | - Patrick Jégo
- Department of Internal Medicine and Clinical Immunology, Rennes University Hospital, University of Rennes 1, Rennes, France; École des Hautes Études en Santé Publique, Research Institute for Environmental and Occupational Health, French National Institute of Health and Medical Research Unit 1085, Rennes University Hospital, University of Rennes 1, Rennes, France
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20
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Nelson DH, Perchaluk JM, Logan AC, Katzman MA. The Bell Tolls for Homeopathy: Time for Change in the Training and Practice of North American Naturopathic Physicians. J Evid Based Integr Med 2019; 24:2515690X18823696. [PMID: 30789055 PMCID: PMC6343431 DOI: 10.1177/2515690x18823696] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
North American naturopathic medicine is a distinct form of practice that is woven into the larger fabric of integrative medicine; in a number of US states and Canadian provinces, naturopathic doctors enjoy a wide scope of practice, including the ability to make diagnoses, order tests, use medical technology, write prescription drugs, and perform minor surgeries. However, the basic premise of naturopathic medicine and its guiding principles-considering the whole person and supporting healthy lifestyle behaviors-is the unifying approach in clinical practice. In the 1970s, homeopathy-considered in many circles to be a hypothesis-driven, fringe form of alternative medicine-became embedded into the training and practice of North American naturopathic doctors. Since the earliest days of its theory (circa 1800), homeopathy has escaped, and continues to escape, biological plausibility; however, the persistence of this modality (and the insistence by both its consumers and practitioners that it provides benefit) speaks to the role of expectations, beliefs, values, agency, context effects, and the placebo-at-large. It is our contention that the progression of professional naturopathic medicine in the 21st century requires a major transition in how it approaches the subject of homeopathy. We propose that students should be encouraged to critically analyze the tenets of homeopathy, its lesser known history, and the idea of homeopathy as a biomedicine that simply awaits untold chemicophysical mechanisms. Furthermore, the modality of homeopathy should be incorporated into the larger context of placebo studies, narrative medicine, ethics, and psychotherapeutic techniques.
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Affiliation(s)
- David H Nelson
- 1 Canadian College of Naturopathic Medicine, Toronto, Ontario, Canada
| | | | - Alan C Logan
- 3 inVIVO Planetary Health, Research Group of the Worldwide Universities Network (WUN), West New York, NJ, USA
| | - Martin A Katzman
- 4 The Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada
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21
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Morrison J, Akter K, Jennings HM, Kuddus A, Nahar T, King C, Shaha SK, Ahmed N, Haghparast-Bidgoli H, Costello A, Khan AKA, Azad K, Fottrell E. Implementation and fidelity of a participatory learning and action cycle intervention to prevent and control type 2 diabetes in rural Bangladesh. Glob Health Res Policy 2019; 4:19. [PMID: 31312722 PMCID: PMC6610980 DOI: 10.1186/s41256-019-0110-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 06/18/2019] [Indexed: 01/30/2023] Open
Abstract
INTRODUCTION There is an urgent need to address the growing type 2 diabetes disease burden. 20-30% of adults in rural areas of Bangladesh have intermediate hyperglycaemia and about 10% have diabetes. We report on the implementation and fidelity of a Participatory Learning and Action (PLA) intervention, evaluated through a three-arm cluster randomised controlled trial which reduced the incidence of diabetes and intermediate hyperglycaemia in rural Bangladesh. PLA interventions have been effective in addressing population level health problems in low income country contexts, and therefore we sought to use this approach to engage communities to identify and address community barriers to prevention and control of type 2 diabetes. METHODS We used a mixed methods approach collecting quantitative data through field reports and qualitative data through observations and focus group discussions. Through descriptive analysis, we considered fidelity to the participatory approach and implementation plans. RESULTS One hundred twenty-two groups per month were convened by 16 facilitators and supervised by two coordinators. Groups worked through a four phase PLA cycle of problem identification, planning together, implementation and evaluation to address the risk factors for diabetes - diet, physical activity, smoking and stress. Groups reported a lack of awareness about diabetes prevention and control, the prohibitive cost of care and healthy eating, and gender barriers to exercise for women. Groups set targets to encourage physical activity, kitchen-gardening, cooking with less oil, and reduced tobacco consumption. Anti-tobacco committees operated in 90 groups. One hundred twenty-two groups arranged blood glucose testing and 74 groups organized testing twice. Forty-one women's groups established funds, and 61 communities committed not to ridicule women exercising. Experienced and committed supervisors enabled fidelity to a participatory methodology. A longer intervention period and capacity building could enable engagement with systems barriers to behaviour change. CONCLUSION Our complex intervention was implemented as planned and is likely to be valid in similar contexts given the flexibility of the participatory approach to contextually specific barriers to prevention and control of type 2 diabetes. Fidelity to the participatory approach is key to implementing the intervention and effectively addressing type 2 diabetes in a low-income country.
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Affiliation(s)
- Joanna Morrison
- University College London Institute for Global Health, London, UK
| | | | | | - Abdul Kuddus
- Diabetic Association of Bangladesh, Dhaka, Bangladesh
| | - Tasmin Nahar
- Diabetic Association of Bangladesh, Dhaka, Bangladesh
| | - Carina King
- University College London Institute for Global Health, London, UK
- Department for Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | | | - Naveed Ahmed
- Diabetic Association of Bangladesh, Dhaka, Bangladesh
| | | | - Anthony Costello
- University College London Institute for Global Health, London, UK
| | | | - Kishwar Azad
- Diabetic Association of Bangladesh, Dhaka, Bangladesh
| | - Edward Fottrell
- University College London Institute for Global Health, London, UK
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Abstract
Multiple global environmental changes (GECs) now under way, including climate change, biodiversity loss, freshwater depletion, tropical deforestation, overexploitation of fisheries, ocean acidification, and soil degradation, have substantial, but still imperfectly understood, implications for human health. Noncommunicable diseases (NCDs) make a major contribution to the global burden of disease. Many of the driving forces responsible for GEC also influence NCD risk through a range of mechanisms. This article provides an overview of pathways linking GEC and NCDs, focusing on five pathways: ( a) energy, air pollution, and climate change; ( b) urbanization; ( c) food, nutrition, and agriculture; ( d) the deposition of persistent chemicals in the environment; and ( e) biodiversity loss.
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Affiliation(s)
- Howard Frumkin
- Our Planet, Our Health Program, Wellcome Trust, London NW1 2BE, United Kingdom;
| | - Andy Haines
- Department of Public Health, Environments and Society and Department of Population Health, London School of Hygiene and Tropical Medicine, London WC1H 9SH, United Kingdom;
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Adjaye-Gbewonyo K, Vaughan M. Reframing NCDs? An analysis of current debates. Glob Health Action 2019; 12:1641043. [PMID: 31362599 PMCID: PMC6711186 DOI: 10.1080/16549716.2019.1641043] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 07/03/2019] [Indexed: 12/22/2022] Open
Abstract
There have been many debates in recent years as to whether the communicable disease versus non-communicable disease (NCD) division is a meaningful one in disease classification. Several critiques have been raised about the framing of NCDs, regarding not only the prominent role that infections play in the aetiology of NCDs, but also the communicability of many social determinants of NCDs and the individualistic, 'lifestyle' framing of NCDs that tends to focus on health behaviours to the neglect of socio-political, environmental, and structural determinants of health. In this paper, we give a historical overview of the usage of the NCD terminology and analyse some of the recent debates regarding the naming and framing of NCDs. We argue that a lack of reflection on the assumptions underlying the naming and framing of NCDs may lead to the collection of insufficient epidemiological data, the development of inappropriate interventions and the provision of inadequate care. Work in social epidemiology, health promotion, medical anthropology, demography, and other fields may provide insights into the ways in which efforts targeting NCDs may be reframed to improve impact and efficacy. In addition, concepts such as multimorbidity and syndemics, frameworks such as ecosocial theory and approaches based in the social sciences may provide a way forward in the conceptualization of disease.
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Affiliation(s)
| | - Megan Vaughan
- Institute of Advanced Studies, University College London, London, UK
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24
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Tansey CM, Pringle J, Davé A, Boulanger R, Hunt M. Earthquakes to Floods: A Scoping Review of Health-related Disaster Research in Low- and Middle-income Countries. PLOS CURRENTS 2018; 10. [PMID: 30254786 PMCID: PMC6126529 DOI: 10.1371/currents.dis.57d98a902a326361d88d54521e68b016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Health-related disaster research is a relatively small; but growing field of inquiry. A better understanding of the scope and scale of health-related disaster research that has occurred in low- and middle-income countries (LMICs) would be useful to funders, researchers, humanitarian aid organizations, and governments as they strive to identify gaps, disparities, trends, and needs of populations affected by disasters. METHODOLOGY We performed a scoping review using the process outlined by Arksey & O'Malley to assess the characteristics of peer-reviewed publications of empirical health-related disaster research conducted in LMICs and published in the years 2003-2012. RESULTS Five hundred and eighty-two relevant publications were identified. Earthquakes were by far the most commonly researched events (62% of articles) in the review's timeframe. More articles were published about disasters in China & South Asia/South East Asia than all other regions. Just over half of the articles (51%) were published by research teams in which all the authors' primary listed affiliations were with an institution located in the same country where the research was conducted. Most of the articles were classified as either mental health, neurology and stress physiology (35%) or as traumatology, wounds and surgery (19%). In just over half of the articles (54%), data collection was initiated within 3 months of the disaster, and in 13% research was initiated between 3 and 6 months following the disaster. The articles in our review were published in 282 different journals. DISCUSSION The high number of publications studying consequences of an earthquake may not be surprising, given that earthquakes are devastating sudden onset events in LMICs. Researchers study topics that require immediate attention following a disaster, such as trauma surgery, as well as health problems that manifest later, such as post-traumatic stress disorder. One neglected area of study during the review's timeframe was the impact of disasters on non-communicable and chronic diseases (excluding mental health), and the management of these conditions in the aftermath of disasters. Strengthening disaster research capacity is critical for fostering robust research in the aftermath of disasters, a particular need in LMICs.
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Affiliation(s)
- Catherine M Tansey
- Humanitarian Health Ethics Research Group, McGill University, Montréal, Québec, Canada and McMaster University, Montréal, Québec, Canada
| | - John Pringle
- Assistant Professor at the Ingram School of Nursing, McGill University, Montréal, Québec, Canada; Humanitarian Health Ethics Research Group, McGill University, Montréal, Québec, Canada and McMaster University, Hamilton, Canada
| | | | | | - Matthew Hunt
- Centre for Interdisciplinary Research in Rehabilitation, School of Physical and Occupational Therapy, McGill University, Montréal, Québec, Canada
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Yang JS, Mamudu HM, John R. Incorporating a structural approach to reducing the burden of non-communicable diseases. Global Health 2018; 14:66. [PMID: 29980215 PMCID: PMC6035457 DOI: 10.1186/s12992-018-0380-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 06/05/2018] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Non-communicable diseases (NCDs) account for over two-thirds of deaths worldwide, and global efforts to address NCDs have accelerated. Current prevention and control efforts rely primarily on individual behavior/lifestyle approaches that place the onus of responsibility for health on the individual. These approaches, however, have not stopped the increasing trend of NCDs worldwide. Thus, there is urgent need for exploring alternative approaches in order to attain the aim of reducing global premature NCDs mortality by 25% by 2025, and meeting the NCD reduction objective in the Sustainable Development Goals. DISCUSSION We suggest the need for a structural approach to addressing the NCDs epidemic that integrates social science and public health theories. We evaluate two overarching principles (empowerment and human rights) and three social determinants of health (labor and employment, trade and industry, and macroeconomics) addressed in the 2013 Global Action Plan for the Prevention and Control of NCDs to demonstrate how a structural approach to NCDs can be incorporated into existing NCD interventions. For each area considered, theoretical considerations for structural thinking are provided and conclude with recommended actions. CONCLUSION Achieving the global health agenda goals of reducing NCDs mortality will require a shift to a paradigm that embraces concerted efforts to address both behavioral/lifestyle factors and structural dimensions of NCDs.
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Affiliation(s)
- Joshua S. Yang
- Department of Health Science, California State University, Fullerton, KHS 161A, 800 N. State College Blvd., Fullerton, CA 92834 USA
| | - Hadii M. Mamudu
- College of Public Health, East Tennessee State University, Room G42-D, Lamb Hall, Johnson City, TN 37614 USA
| | - Rijo John
- Centre for Public Policy Research, Anitha, 1st floor, S.A Road, Elamkulam, Kochi, Kerala 682020 India
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Fiorini G, Cerri C, Rigamonti AE, Bini S, Marazzi N, Sartorio A, Cella SG. Gender and age related differences in the use of medicines for chronic diseases among undocumented migrants. INTERNATIONAL JOURNAL OF MIGRATION, HEALTH AND SOCIAL CARE 2018. [DOI: 10.1108/ijmhsc-11-2017-0047] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this paper is to evaluate gender-related differences in the use of drugs for chronic diseases in undocumented migrants.
Design/methodology/approach
The authors analyzed the databases of two charitable organizations providing medical help and medicines to undocumented migrants. Data were available for 9,822 patients in the period 2014–2016. The authors grouped medicines according to the Anatomical Therapeutic Chemical (ATC) classification. We considered the ATC group as an indicator of a group of diseases.
Findings
Both males and females needed medicines for chronic diseases in a comparable manner. When we analyzed the age distribution, The authors noticed that males showed a tendency to begin to be affected at an earlier age; however, this cumulative difference was not statistically significant. But when we looked at six groups of drugs separately (cardiovascular, respiratory, anti-thrombotic, neurologic, psychiatric, anti-diabetic), the authors found that females always needed drugs for chronic diseases at a later age, always with a significant difference (p<0.0001 for cardiovascular, antithrombotic, antidiabetic and psychoactive drugs; p<0.002 for neurologic products; p<0.04 for drugs used in chronic respiratory conditions).
Research limitations/implications
This is a retrospective study based on the analysis of existing databases, but the peculiar features of this population (undocumented migrants) do not allow at the moment controlled studies.
Practical implications
Our observations could be important when planning public health strategies, especially in the field of prevention.
Originality/value
This is the first report of gender differences in the use of medicines for chronic diseases within a large sample of undocumented migrants.
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Knaul FM, Gómez-Dantés O, Bhadelia A, Frenk J. Beyond divisive dichotomies in disease classification. LANCET GLOBAL HEALTH 2018; 5:e1073-e1074. [PMID: 29025628 DOI: 10.1016/s2214-109x(17)30376-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 08/29/2017] [Indexed: 11/26/2022]
Affiliation(s)
| | | | - Afsan Bhadelia
- Harvard TH Chan School of Public Health, Boston, MA, USA
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Reframing non-communicable diseases as socially transmitted conditions. LANCET GLOBAL HEALTH 2018; 5:e644-e646. [PMID: 28619214 DOI: 10.1016/s2214-109x(17)30200-0] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 04/19/2017] [Indexed: 11/24/2022]
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Dysbiotic drift and biopsychosocial medicine: how the microbiome links personal, public and planetary health. Biopsychosoc Med 2018; 12:7. [PMID: 29743938 PMCID: PMC5932796 DOI: 10.1186/s13030-018-0126-z] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 04/23/2018] [Indexed: 02/06/2023] Open
Abstract
The emerging concept of planetary health emphasizes that the health of human civilization is intricately connected to the health of natural systems within the Earth’s biosphere; here, we focus on the rapidly progressing microbiome science - the microbiota-mental health research in particular - as a way to illustrate the pathways by which exposure to biodiversity supports health. Microbiome science is illuminating the ways in which stress, socioeconomic disadvantage and social polices interact with lifestyle and behaviour to influence the micro and macro-level biodiversity that otherwise mediates health. Although the unfolding microbiome and mental health research is dominated by optimism in biomedical solutions (e.g. probiotics, prebiotics), we focus on the upstream psychosocial and ecological factors implicated in dysbiosis; we connect grand scale biodiversity in the external environment with differences in human-associated microbiota, and, by extension, differences in immune function and mental outlook. We argue that the success of planetary health as a new concept will be strengthened by a more sophisticated understanding of the ways in which individuals develop emotional connections to nature (nature relatedness) and the social policies and practices which facilitate or inhibit the pro-environmental values that otherwise support personal, public and planetary health.
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Cavalin C, Lescoat A. From (re-)framing NCDs to shaping public health policies on NCDs and communicable diseases. Lancet 2017; 390:1830-1831. [PMID: 29082874 DOI: 10.1016/s0140-6736(17)32419-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 08/18/2017] [Indexed: 11/26/2022]
Affiliation(s)
- Catherine Cavalin
- Centre for European Studies and Laboratory of Interdisciplinary Evaluation of Public Policies, Sciences Po, 75 337 Paris CEDEX 07, France; Centre for Employment and Labour Studies, Cnam Centre, Noisy-le-Grand, France.
| | - Alain Lescoat
- UMR Inserm U1085, Research Institute in Health, Environment and Occupation/Institut de Recherche sur la Santé, l'Environnement et le Travail, and Department of Internal Medicine, University of Rennes 1, Rennes, France
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Allen LN. You're not speaking my language: reframing NCDs for politicians and policy makers. Lancet 2017; 390:1831. [PMID: 29082875 DOI: 10.1016/s0140-6736(17)32429-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Accepted: 08/18/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Luke N Allen
- Nuffield Department of Primary Health Care Sciences, University of Oxford, Oxford OX2 6GG, UK.
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Renaming non-communicable diseases. THE LANCET GLOBAL HEALTH 2017; 5:e656. [DOI: 10.1016/s2214-109x(17)30218-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Accepted: 04/19/2017] [Indexed: 01/22/2023] Open
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Lincoln P. Renaming non-communicable diseases. Lancet Glob Health 2017; 5:e654. [DOI: 10.1016/s2214-109x(17)30219-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 04/19/2017] [Indexed: 01/22/2023]
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Renaming non-communicable diseases. THE LANCET GLOBAL HEALTH 2017; 5:e655. [DOI: 10.1016/s2214-109x(17)30211-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 04/19/2017] [Indexed: 01/22/2023] Open
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Renaming non-communicable diseases. LANCET GLOBAL HEALTH 2017; 5:e653. [DOI: 10.1016/s2214-109x(17)30216-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 04/19/2017] [Indexed: 11/21/2022]
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