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Palinkas LA, O’Donnell M, Kemp S, Tiatia J, Duque Y, Spencer M, Basu R, Del Rosario KI, Diemer K, Doma B, Forbes D, Gibson K, Graff-Zivin J, Harris BM, Hawley N, Johnston J, Lauraya F, Maniquiz NEF, Marlowe J, McCord GC, Nicholls I, Rao S, Saunders AK, Sortino S, Springgate B, Takeuchi D, Ugsang J, Villaverde V, Wells KB, Wong M. Regional Research-Practice-Policy Partnerships in Response to Climate-Related Disparities: Promoting Health Equity in the Pacific. Int J Environ Res Public Health 2022; 19:9758. [PMID: 35955120 PMCID: PMC9368677 DOI: 10.3390/ijerph19159758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/04/2022] [Accepted: 08/06/2022] [Indexed: 06/15/2023]
Abstract
Although climate change poses a threat to health and well-being globally, a regional approach to addressing climate-related health equity may be more suitable, appropriate, and appealing to under-resourced communities and countries. In support of this argument, this commentary describes an approach by a network of researchers, practitioners, and policymakers dedicated to promoting climate-related health equity in Small Island Developing States and low- and middle-income countries in the Pacific. We identify three primary sets of needs related to developing a regional capacity to address physical and mental health disparities through research, training, and assistance in policy and practice implementation: (1) limited healthcare facilities and qualified medical and mental health providers; (2) addressing the social impacts related to the cooccurrence of natural hazards, disease outbreaks, and complex emergencies; and (3) building the response capacity and resilience to climate-related extreme weather events and natural hazards.
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Affiliation(s)
- Lawrence A. Palinkas
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA 90089, USA
| | - Meaghan O’Donnell
- Phoenix Australia, Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Melbourne, VIC 3010, Australia
| | - Susan Kemp
- School of Counseling, Human Services and Social Work, University of Auckland, Auckland 1010, New Zealand
| | - Jemaima Tiatia
- Te Wānanga o Waipapa, School of Māori Studies and Pacific Studies at the University of Auckland, Auckland 1010, New Zealand
| | - Yvonette Duque
- Asian Disaster Preparedness Center, Bangkok 10400, Thailand
| | - Michael Spencer
- School of Social Work, University of Washington, Seattle, WA 98195, USA
| | - Rupa Basu
- Office of Environmental Health Hazard Assessment (OEHHA), California Environmental Protection Agency, Sacramento, CA 95812, USA
| | | | - Kristin Diemer
- School of Social Work, University of Melbourne, Melbourne, VIC 3010, Australia
| | - Bonifacio Doma
- Department of Chemical Engineering, Mapua University, Manila 1102, Philippines
| | - David Forbes
- Phoenix Australia, Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Melbourne, VIC 3010, Australia
| | - Kari Gibson
- Phoenix Australia, Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Melbourne, VIC 3010, Australia
| | - Joshua Graff-Zivin
- School of Global Policy and Strategy, University of California, San Diego, CA 92093, USA
| | - Bruce M. Harris
- Provincial Government of New Ireland, Kavieng 631, Papua New Guinea
| | - Nicola Hawley
- Department of Epidemiology and Chronic Disease, School of Public Health, Yale University, New Haven, CT 06520, USA
| | - Jill Johnston
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90007, USA
| | - Fay Lauraya
- Office of the President, University of Nueva Caceres, Naga 4400, Philippines
| | | | - Jay Marlowe
- School of Counseling, Human Services and Social Work, University of Auckland, Auckland 1010, New Zealand
| | - Gordon C. McCord
- School of Global Policy and Strategy, University of California, San Diego, CA 92093, USA
| | - Imogen Nicholls
- International Organization for Migration, Canberra, ACT 2601, Australia
| | - Smitha Rao
- College of Social Work, Ohio State University, Columbus, OH 43210, USA
| | | | - Salvatore Sortino
- International Organization for Migration, Majuro 96960, Marshall Islands
| | - Benjamin Springgate
- School of Medicine, LSU Health Sciences Center—New Orleans, School of Medicine and School of Public Health, New Orleans, LA 70112, USA
- School of Public Health, LSU Health Sciences Center—New Orleans, School of Medicine and School of Public Health, New Orleans, LA 70112, USA
| | - David Takeuchi
- School of Social Work, University of Washington, Seattle, WA 98195, USA
| | - Janette Ugsang
- Asian Disaster Preparedness Center, Bangkok 10400, Thailand
| | - Vivien Villaverde
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA 90089, USA
| | - Kenneth B. Wells
- Center for Health Services and Society, Jane and Terry Semel Institute, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA
- Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, CA 90095, USA
| | - Marleen Wong
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA 90089, USA
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Azoulay P, Graff-Zivin J, Uzzi B, Wang D, Williams H, Evans JA, Jin GZ, Lu SF, Jones BF, Börner K, Lakhani KR, Boudreau KJ, Guinan EC. Toward a more scientific science. Science 2018; 361:1194-1197. [PMID: 30237341 DOI: 10.1126/science.aav2484] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Climb atop shoulders and wait for funerals. That, suggested Newton and then Planck, is how science advances (more or less). We've come far since then, but many notions about how people and practices, policies, and resources influence the course of science are still more rooted in traditions and intuitions than in evidence. We can and must do better, lest we resign ourselves to “intuition-based policy” when making decisions and investments aimed at driving scientific progress.
Science
invited experts to highlight key aspects of the scientific enterprise that are steadily yielding to empirical investigation—and to explain how Newton and Planck got it right (and Einstein got it wrong). —
Brad Wible
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Affiliation(s)
- Pierre Azoulay
- Massachusetts Institute of Technology (MIT), Cambridge, MA, USA.,National Bureau of Economic Research (NBER), Cambridge, MA, USA
| | - Joshua Graff-Zivin
- National Bureau of Economic Research (NBER), Cambridge, MA, USA.,University of California, San Diego, San Diego, CA, USA
| | - Brian Uzzi
- Kellogg School of Management, Northwestern University, Evanston, IL, USA.,McCormick School of Engineering, Northwestern University, Evanston, IL, USA.,Northwestern Institute on Complex Systems (NICO), Northwestern University, Evanston, IL, USA
| | - Dashun Wang
- Kellogg School of Management, Northwestern University, Evanston, IL, USA.,McCormick School of Engineering, Northwestern University, Evanston, IL, USA.,Northwestern Institute on Complex Systems (NICO), Northwestern University, Evanston, IL, USA
| | - Heidi Williams
- Massachusetts Institute of Technology (MIT), Cambridge, MA, USA.,National Bureau of Economic Research (NBER), Cambridge, MA, USA
| | | | - Ginger Zhe Jin
- National Bureau of Economic Research (NBER), Cambridge, MA, USA.,University of Maryland, College Park, MD, USA.,Purdue University, West Lafayette, IN, USA
| | | | - Benjamin F Jones
- Kellogg School of Management, Northwestern University, Evanston, IL, USA
| | - Katy Börner
- School of Informatics, Computing, and Engineering, Indiana University, Bloomington, IN, USA.,Alexander von Humboldt Fellow, Technische Universität Dresden, 01062 Dresden, Germany
| | - Karim R Lakhani
- National Bureau of Economic Research (NBER), Cambridge, MA, USA.,Harvard Business School, Boston, MA, USA.,Laboratory for Innovation Science, Harvard University, Cambridge, MA, USA
| | - Kevin J Boudreau
- National Bureau of Economic Research (NBER), Cambridge, MA, USA.,Northeastern University, Boston, MA, USA
| | - Eva C Guinan
- Laboratory for Innovation Science, Harvard University, Cambridge, MA, USA.,Dana Farber Cancer Institute, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
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Hoenigl M, Chaillon A, Mehta SR, Smith DM, Graff-Zivin J, Little SJ. Screening for acute HIV infection in community-based settings: Cost-effectiveness and impact on transmissions. J Infect 2016; 73:476-484. [PMID: 27521468 DOI: 10.1016/j.jinf.2016.07.019] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 07/30/2016] [Accepted: 07/30/2016] [Indexed: 12/26/2022]
Abstract
OBJECTIVES To determine cost-effectiveness of three community-based acute HIV infection (AHI) testing algorithms compared to HIV antibody testing alone by focusing on the potential of averting new infections occurring within a one-year time horizon among men who have sex with men (MSM). METHODS Data sources for model parameters included actual cost and prevalence data derived from a community-based AHI screening program in San Diego, and published studies. Main outcome measure was costs per infection averted (IA). The lower end of the cost range of discounted lifetime costs of an HIV infection (i.e. $236,948) was used for defining cost-effectiveness. RESULTS The most sensitive algorithm for AHI detection, which was based on HIV nucleic acid amplification testing, was estimated to prevent between 5 and 45 transmissions, with simulated costs per infection averted between $965 and $141,256 when compared to HIV antibody testing alone. CONCLUSION AHI testing was cost-effective in preventing new HIV infections among at risk MSM in San Diego, and also among other MSM populations with similar HIV prevalence but lower proportions of AHI diagnoses. These results indicate that community-based AHI testing among MSM in the United States can pay for itself over the long run.
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Affiliation(s)
- Martin Hoenigl
- Division of Infectious Diseases, University of California San Diego (UCSD), 220 Dickinson Street, Suite A, San Diego, CA 92103, United States; Division of Pulmonology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 20, 8036 Graz, Austria; Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria.
| | - Antoine Chaillon
- Division of Infectious Diseases, University of California San Diego (UCSD), 220 Dickinson Street, Suite A, San Diego, CA 92103, United States
| | - Sanjay R Mehta
- Division of Infectious Diseases, University of California San Diego (UCSD), 220 Dickinson Street, Suite A, San Diego, CA 92103, United States; Veterans Affairs Healthcare System, 3350 La Jolla Village Drive, San Diego, CA 92161, United States
| | - Davey M Smith
- Division of Infectious Diseases, University of California San Diego (UCSD), 220 Dickinson Street, Suite A, San Diego, CA 92103, United States; Veterans Affairs Healthcare System, 3350 La Jolla Village Drive, San Diego, CA 92161, United States
| | - Joshua Graff-Zivin
- School of International Relations and Pacific Studies, Department of Economics, UCSD, 9500 Gilman Dr. # 0520, La Jolla, CA 92093, United States
| | - Susan J Little
- Division of Infectious Diseases, University of California San Diego (UCSD), 220 Dickinson Street, Suite A, San Diego, CA 92103, United States
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Burke M, Craxton M, Kolstad CD, Onda C, Allcott H, Baker E, Barrage L, Carson R, Gillingham K, Graff-Zivin J, Greenstone M, Hallegatte S, Hanemann WM, Heal G, Hsiang S, Jones B, Kelly DL, Kopp R, Kotchen M, Mendelsohn R, Meng K, Metcalf G, Moreno-Cruz J, Pindyck R, Rose S, Rudik I, Stock J, Tol RSJ. CLIMATE ECONOMICS. Opportunities for advances in climate change economics. Science 2016; 352:292-3. [PMID: 27081055 DOI: 10.1126/science.aad9634] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- M Burke
- Stanford University, Stanford, CA, USA
| | - M Craxton
- Stanford University, Stanford, CA, USA
| | | | - C Onda
- Stanford University, Stanford, CA, USA
| | - H Allcott
- New York University, New York, NY, USA
| | - E Baker
- University of Massachusetts, Amherst, MA, USA
| | - L Barrage
- Brown University, Providence, RI, USA
| | - R Carson
- University of California, San Diego, CA, USA
| | | | | | | | | | | | - G Heal
- Columbia University, New York, NY, USA
| | - S Hsiang
- University of California, Berkeley, CA, USA
| | - B Jones
- Northwestern University, Evanston, IL, USA
| | - D L Kelly
- University of Miami, Coral Gables, FL, USA
| | - R Kopp
- Resources for the Future, Washington, DC, USA
| | | | | | - K Meng
- University of California, Santa Barbara, CA, USA
| | | | | | - R Pindyck
- Massachusetts Institute of Technology, Cambridge, MA, USA
| | - S Rose
- Electric Power Research Institute, Palo Alto, CA, USA
| | - I Rudik
- Iowa State University, Ames, IA, USA
| | - J Stock
- Harvard University, Cambridge, MA, USA
| | - R S J Tol
- University of Sussex, Falmer, UK, and Vrije Universiteit Amsterdam, Netherlands
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Hoenigl M, Graff-Zivin J, Little SJ. Costs per Diagnosis of Acute HIV Infection in Community-based Screening Strategies: A Comparative Analysis of Four Screening Algorithms. Clin Infect Dis 2015; 62:501-511. [PMID: 26508512 DOI: 10.1093/cid/civ912] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 10/20/2015] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND In nonhealthcare settings, widespread screening for acute human immunodeficiency virus (HIV) infection (AHI) is limited by cost and decision algorithms to better prioritize use of resources. Comparative cost analyses for available strategies are lacking. METHODS To determine cost-effectiveness of community-based testing strategies, we evaluated annual costs of 3 algorithms that detect AHI based on HIV nucleic acid amplification testing (EarlyTest algorithm) or on HIV p24 antigen (Ag) detection via Architect (Architect algorithm) or Determine (Determine algorithm) as well as 1 algorithm that relies on HIV antibody testing alone (Antibody algorithm). The cost model used data on men who have sex with men (MSM) undergoing community-based AHI screening in San Diego, California. Incremental cost-effectiveness ratios (ICERs) per diagnosis of AHI were calculated for programs with HIV prevalence rates between 0.1% and 2.9%. RESULTS Among MSM in San Diego, EarlyTest was cost-savings (ie, ICERs per AHI diagnosis less than $13.000) when compared with the 3 other algorithms. Cost analyses relative to regional HIV prevalence showed that EarlyTest was cost-effective (ie, ICERs less than $69.547) for similar populations of MSM with an HIV prevalence rate >0.4%; Architect was the second best alternative for HIV prevalence rates >0.6%. CONCLUSIONS Identification of AHI by the dual EarlyTest screening algorithm is likely to be cost-effective not only among at-risk MSM in San Diego but also among similar populations of MSM with HIV prevalence rates >0.4%.
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Affiliation(s)
- Martin Hoenigl
- Division of Infectious Diseases, University of California-San Diego.,Division of Pulmonology.,Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Austria
| | - Joshua Graff-Zivin
- School of International Relations and Pacific Studies and Department of Economics, University of California-San Diego
| | - Susan J Little
- Division of Infectious Diseases, University of California-San Diego
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Montgomery GH, Bovbjerg DH, Schnur JB, David D, Goldfarb A, Weltz CR, Schechter C, Graff-Zivin J, Tatrow K, Price DD, Silverstein JH. A Randomized Clinical Trial of a Brief Hypnosis Intervention to Control Side Effects in Breast Surgery Patients. J Natl Cancer Inst 2007; 99:1304-12. [PMID: 17728216 DOI: 10.1093/jnci/djm106] [Citation(s) in RCA: 176] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Breast cancer surgery is associated with side effects, including postsurgical pain, nausea, and fatigue. We carried out a randomized clinical trial to test the hypotheses that a brief presurgery hypnosis intervention would decrease intraoperative anesthesia and analgesic use and side effects associated with breast cancer surgery and that it would be cost effective. METHODS We randomly assigned 200 patients who were scheduled to undergo excisional breast biopsy or lumpectomy (mean age 48.5 years) to a 15-minute presurgery hypnosis session conducted by a psychologist or nondirective empathic listening (attention control). Patients were not blinded to group assignment. Intraoperative anesthesia use (i.e., of the analgesics lidocaine and fentanyl and the sedatives propofol and midazolam) was assessed. Patient-reported pain and other side effects as measured on a visual analog scale (0-100) were assessed at discharge, as was use of analgesics in the recovery room. Institutional costs and time in the operating room were assessed via chart review. RESULTS Patients in the hypnosis group required less propofol (means = 64.01 versus 96.64 microg; difference = 32.63; 95% confidence interval [CI] = 3.95 to 61.30) and lidocaine (means = 24.23 versus 31.09 mL; difference = 6.86; 95% CI = 3.05 to 10.68) than patients in the control group. Patients in the hypnosis group also reported less pain intensity (means = 22.43 versus 47.83; difference = 25.40; 95% CI = 17.56 to 33.25), pain unpleasantness (means = 21.19 versus 39.05; difference = 17.86; 95% CI = 9.92 to 25.80), nausea (means = 6.57 versus 25.49; difference = 18.92; 95% CI = 12.98 to 24.87), fatigue (means = 29.47 versus 54.20; difference = 24.73; 95% CI = 16.64 to 32.83), discomfort (means = 23.01 versus 43.20; difference = 20.19; 95% CI = 12.36 to 28.02), and emotional upset (means = 8.67 versus 33.46; difference = 24.79; 95% CI = 18.56 to 31.03). No statistically significant differences were seen in the use of fentanyl, midazolam, or recovery room analgesics. Institutional costs for surgical breast cancer procedures were $8561 per patient at Mount Sinai School of Medicine. Patients in the hypnosis group cost the institution $772.71 less per patient than those in the control group (95% CI = 75.10 to 1469.89), mainly due to reduced surgical time. CONCLUSIONS Hypnosis was superior to attention control regarding propofol and lidocaine use; pain, nausea, fatigue, discomfort, and emotional upset at discharge; and institutional cost. Overall, the present data support the use of hypnosis with breast cancer surgery patients.
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Affiliation(s)
- Guy H Montgomery
- Department of Oncological Sciences, Mount Sinai School of Medicine, Box 1130, 1 Gustave L. Levy Place, New York, NY 10029-6574, USA.
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