Hasil untuk "Public aspects of medicine"

Fidele Benimana, Christopher Kucha, Anupam Roy et al.

ABSTRACT The global demand for edible flowers has increased due to their diverse applications in food, nutraceuticals, and the medical field. However, issues of species identification, adulteration, contamination, and quality necessitate the use of advanced methods to authenticate product quality for edible flowers. Conventional methods are expensive, time‐consuming, and require highly skilled personnel and technical expertise. Spectroscopic methods, including Fourier transform infrared, near‐infrared, and Raman spectroscopy, are efficient, fast, and non‐destructive, providing rapid insight into the chemical structure and authenticity of edible flowers. This review systematically summarizes the recent advances in spectroscopic methods for authenticating edible flowers, including the detection of chemical changes and ensuring product integrity. The primary goal is to examine the applications of spectroscopic techniques for assessing quality changes in edible flowers during processing for food applications. Spectroscopic techniques, such as FT‐IR, NIR, and Raman spectroscopy, are rapid, accurate, and non‐destructive alternatives for authenticating the composition and quality of edible flowers. These methods enable the detection of bioactive compounds, differentiation of species, and identification of adulterants with minimal sample processing. Furthermore, chemometric models enhance data analysis, allowing for automated classification and real‐time quality monitoring of edible flowers.

Omar Basubrin

Artificial intelligence (AI) has rapidly emerged as a transformative force in medicine, revolutionizing various aspects of healthcare from diagnostics and treatment to public health and patient care. This narrative review synthesizes evidence from diverse study designs, exploring the current and future applications of AI in medicine. We highlight AI's role in improving diagnostic accuracy, optimizing treatment strategies, and enhancing patient care through personalized interventions and remote monitoring, drawing upon recent advancements and landmark studies. Emerging trends such as explainable AI and federated learning are also examined. While acknowledging the tremendous potential of AI in medicine, the review also addresses the barriers and ethical challenges that need to be overcome, including concerns about algorithmic bias, transparency, over-reliance, and the potential impact on the healthcare workforce. We emphasize the importance of establishing regulatory guidelines, fostering collaboration between clinicians and AI developers, and ensuring ongoing education for healthcare professionals. Despite these challenges, the future of AI in medicine holds immense promise, with the potential to significantly improve patient outcomes, transform healthcare delivery, and address healthcare disparities.

Livio Pagano, O. Fernández

Abstract Fungal diseases are of growing clinical concern in human medicine as the result of changes in the epidemiology, diversity in clinical presentation, emergence of new pathogens, difficulties in diagnosis and increasing resistance to antifungals of current available classes. There is a need for high disease awareness among the public and healthcare physicians, improvement in diagnostic methods and the development of drugs from new therapeutic classes with an improved resistance profile. In this article, we will explore some key aspects of fungal diseases in humans and provide a general overview of this important topic.

G. Kolifarhood, Mohammad Aghaali, H. Mozafar Saadati et al.

There are significant misconceptions and many obstacles in the way of illuminating the epidemiological and clinical aspects of COVID-19 as a new emerging epidemic. In addition, usefulness of some evidence published in the context of the recent epidemic for decision making in clinic as well as public health is questionable. However, misinterpreting or ignoring strong evidence in clinical practice and public health probably results in less effective and somehow more harmful decisions for individuals as well as subgroups in general populations of countries in the initial stages of this epidemic. Accordingly, our narrative review appraised epidemiological and clinical aspects of the disease including genetic diversity of coronavirus genus, mode of transmission, incubation period, infectivity, pathogenicity, virulence, immunogenicity, diagnosis, surveillance, clinical case management and also successful measures for preventing its spread in some communities.

Charan Kamal Sekhon, Ramandeep Kaur, Monika Airi et al.

Background: Women’s hypertension (HTN) is often underestimated and goes untreated due to the perception that women have a lesser risk of cardiovascular disease compared to males. Objectives: The purpose of this study was to assess the prevalence and major risk factors of HTN in adult women of Punjab. Materials and Methods: A community-based cross-sectional study with multistage sampling design was conducted among rural population of Punjab. The survey was designed in accordance with the WHO STEPwise approach for surveillance of noncommunicable disease to provide prevalence estimates of risk factors for three age groups for HTN. Village was considered a primary sampling unit (PSU). From each selected PSU in a rural area, households were selected. The ultimate sampling units were the households. Results: A total of 2160 females were screened for HTN. Eight hundred and twenty-seven (38.27%) were found to be hypertensive, with 27.9% in stage 1 and 10.4% in stage 2 HTN. Body mass index and reproductive health factors (P = 0.001) were substantially linked with HTN. Significant disparities emerged in nutritional habits: hypertensive subjects exhibited higher average sugar intake (P = 0.006) and salt intake (P = 0.007) and were more likely to add table salt during meals (P = 0.013). Conclusion: HTN prevalence is alarmingly high in Punjab, posing significant risks for chronic diseases and other health complications among its residents. The findings from this research could provide crucial insights that form the basis for developing tailored public health programs, policies, and awareness campaigns focused on HTN and its risk factors in rural communities.

Victor Oluwatomiwa Ajekiigbe, Ikponmwosa Jude Ogieuhi, Temiloluwa Adebayo Odeniyi et al.

Abstract A well-documented mounting public health crisis is the antibiotic crisis, which is most significantly felt in low-resource countries like Nigeria. This article sheds light on the rising level of antibiotic resistance in newborns in Nigeria, a trend that poses a severe threat to neonatal survival and public health at large. A thorough database search was carried out using terms associated with antibiotic resistance in Nigerian neonates, including PubMed, Google Scholar, and other scholarly sources. Only original research conducted between the start of the study and June 2024 was included; articles without an English translation were not. Independent reviewers handled data management and screening. There has been an increasing prevalence of sepsis among newborns primarily due to Gram-negative bacteria, which highlights the urgency and need to be addressed. Studies show a significant rise in multi-drug-resistant infections, with almost half of Escherichia coli and 86% of Staphylococcus aureus strains among newborns resistant to conventionally used antibiotics like penicillin. Some reasons for the continuous trend include but are not limited to unregulated antibiotic purchase and use, inadequate surveillance systems, and cultural determinants and socioeconomic issues. Effective strategies are needed to curb the neonatal antibiotic crisis in Nigeria. This problem can be mitigated by enhancing public education, strengthening healthcare infrastructure, advocating for better maternal health, and promoting the rational use of antibiotics. Additionally, more research into non-antibiotic medications and understanding the barriers to compliance need to be addressed.

Tyler D VanderWeele

A framework is put forward for the proper scope of considerations concerning flourishing within medicine, psychiatry, clinical counselling, public health and public policy. Each of these disciplines and associated institutional practices have distinctive contributions to make in advancing flourishing within society. In each case, there are also various aspects of flourishing that extend beyond each practice’s purview; and yet to restrict attention only to health, narrowly conceived, limits what each of these practices can in fact accomplish. A clearer understanding of what aspects of flourishing do, and do not, lie within the bounds of each discipline and practice has the potential to better enable the pursuit of societal well-being.

Yvonne Tan, Danielle Pinder, Imaan Bayoumi et al.

Abstract Background Adverse childhood experiences (ACEs), in combination with adverse community environments, can result in traumatic stress reactions, increasing a person’s risk for chronic physical and mental health conditions. Family resilience refers to the ability of families to withstand and rebound from adversity; it involves coping with disruptions as well as positive growth in the face of sudden or challenging life events, trauma, or adversities. This study aimed to identify factors contributing to family and community resilience from the perspective of families who self-identified as having a history of adversity and being resilient during the COVID-19 pandemic. Methods This study used Photovoice, a visual participatory research method which asks participants to take photographs to illustrate their responses to a research question. Participants consisted of a maximum variation sample of families who demonstrated family level resilience in the context of the pair of ACEs during the COVID-19 pandemic. Family members were asked to collect approximately five images or videos that illustrated the facilitators and barriers to well-being for their family in their community. Semi-structured in-depth interviews were conducted using the SHOWeD framework to allow participants to share and elucidate the meaning of their photos. Using thematic analysis, two researchers then independently completed line-by-line coding of interview transcripts before collaborating to develop consensus regarding key themes and interpretations. Results Nine families were enrolled in the study. We identified five main themes that enhanced family resilience: (1) social support networks; (2) factors fostering children's development; (3) access and connection to nature; (4) having a space of one’s own; and (5) access to social services and community resources. Conclusions In the context of additional stresses related to the COVID-19 pandemic, resilient behaviours and strategies for families were identified. The creation or development of networks of intra- and inter-community bonds; the promotion of accessible parenting, housing, and other social services; and the conservation and expansion of natural environments may support resilience and health.

Harold D. Green PhD, Patrick C. Kaminski MA

Opioid overdose and Opioid Use Disorder (OUD) statistics underscore an urgent need to significantly expand access to evidence-based OUD treatment. Office Based Opioid Treatment (OBOT) has proven effective for treating OUD. However, limited access to these treatments persists. Recognizing the need for significant investment in clinical, behavioral, and translational research, the Indiana State Department of Health and Indiana University embarked on a research initiative supported by the “Responding to the Addictions Crisis” Grand Challenge Program. This brief presents recommendations based on existing research and our own analyses of medical claims data in Indiana, where opioid misuse is high and treatment access is limited. The recommendations cover target providers, intervention focus, priority regions, and delivery methods.

N. Hurley, Kristopher M. Schroeder, A. Hess

Large language models (LLMs) excel at answering knowledge‐based questions. Many aspects of blood banking and transfusion medicine involve no direct patient care and require only knowledge and judgment. We hypothesized that public LLMs could perform such tasks with accuracy and precision.

Marta Sumińska, Rafał Podgórski, Klaudia Bogusz-Górna et al.

World Health Organization defines obesity as abnormal or excess adipose tissue accumulation. Nowadays, this condition is a serious threat to the public health in most countries around the world. Obesity adversely affects physical, mental, and in most cultures, social well‐being. However, throughout the ages—from ancient times to the 21st century—this condition has been subject to various interpretations. As a matter of fact, obesity has not always been regarded as a disease. For many decades, excessive body weight has been considered rather a symbol of health. It was a marker of wealth and prosperity, as well as a sign of high social status. The centuries that passed on the development of science and medicine have gradually changed its face, but significant progress in understanding the causes and consequences of obesity has been made in the last 30 years. This paper presents the historical outline of obesity and its treatment from ancient times to the present—from its affirmation to the epidemic in the late 20th and 21st century.

B. Siswanto, Sri Setiawati, Ontran Sumantri Riyanto

Alternative, complementary medicine is non-conventional medicine aimed at improving public health status, including promotive, curative, preventive, and rehabilitative efforts obtained through structured education with high quality, safety, and effectiveness based on biomedical science, which has not been accepted in conventional medicine. In several hospitals in Indonesia, this complementary medicine has begun to be applied as supportive therapy or replacement therapy for patients who refuse traditional treatment methods. This complementary therapy can also be carried out at the patient's request or with the referral of other doctors. The approach method used in this study, namely normative juridical, is a method of legal research conducted on library materials or secondary data using deductive thinking methods based on truth criteria. Coherent. There is also a complementary therapy called holistic medicine, which is because the form of therapy can affect individuals. The limitations of conventional medicine are one of the reasons why complementary and alternative therapies are an option in treating/healthy Indonesian people. The development of complementary and alternative therapies must be the responsibility of health workers, especially nurses. Legality for complementary and integrated health services must have a Traditional Health Worker Registration Certificate (STRTKT) and a Traditional Health Worker Practice License (SIPTKT).

Joseph E. Stiglitz

Wanmin Su, Liulin Du, Yujun Fan et al.

Abstract Background To better meet people’s growing demand for medical and health services, 21 cities in Guangdong Province were involved in the reform of public hospitals in 2017. This paper evaluates the equity and efficiency of public hospitals’ health resource allocation in Guangdong Province and explores ways to change the current situation. Methods Data were collected from the Guangdong Health Statistical Yearbook 2016–2020 and Guangdong Statistical Yearbook 2017–2021. The Gini coefficient (G), Theil index (T), and health resource density index (HRDI) were used to measure the equity of health resource allocation. An improved three-stage DEA method was applied in efficiency evaluation. The entropy weight method was employed to calculate the weight of different indicators to obtain a comprehensive indicator representing the overall volume of health resources in each city. A two-dimensional matrix was drawn between the HRDI of the comprehensive indicator and efficiency and the per capita government financial subsidies and efficiency to observe the coordination of equity and efficiency across regions. Results From 2016 to 2020, the G of public hospital, bed, and health technician allocation by population remained below 0.2, while that by geographical area ranged from 0.4 to 0.6; the G of government financial subsidies by population was above 0.4, while that by geographical area was greater than 0.7. The results for T showed that inequality mainly comes from intraregional differences, and the Pearl River Delta contributes most to the overall differences. Although the HRDI of the Pearl River Delta is far greater than that of other regions, obvious differences exist across cities in the region. Only 38.1% of cities were found to be efficient in 2020. The Pearl River Delta was in the first quadrant, and the other three regions were in the third quadrant, accounting for a large proportion. Conclusion The equity of government financial subsidies allocation was the worst, and there were distinct regional differences in the geographical distribution of health resources. The development of healthcare within the Pearl River Delta was highly unbalanced. The development of healthcare was uneven between the Pearl River Delta, eastern, western, and mountainous regions. In addition, most cities in the eastern, western, and mountainous regions bore the dual pressures of relatively insufficient health resources and inefficiency.

L. Hasenclever, Caroline Miranda, G. Chaves et al.

This article aimed to present the problems related to accessibility of health services by re-reading four case studies which illustrate the different dimensions of the definition of health needs and their impact on the accessibility of medicine and health services. The theoretical model of Vargas-Peláez et al.1, which allows a better understanding of the complexity of the definition of health needs and its impact on the demand for medicines and services, was adopted to re-read the case studies on the prices of patented medicines, the models of public provision, hemodynamic services, and prescription of anxiolytics. The results may shed some light on the complexity of the challenges to achieve health rights in a peripheral capitalist society where the production and distribution of goods and services is organized from the perspective of the market, even though public policies seek to regulate them. In this sense, it seems essential that the State plays a major role in guaranteeing equality in the achievement of social rights, not only influencing the industrial sector in reducing the prices of medicines and improving their supply, but also guaranteeing access to medicine and health services.

Andrew D. Williams, Sandie Ha, Edmond Shenassa et al.

Abstract Background Asian/Pacific Islander (API) communities in the United States often reside in metropolitan areas with distinct social and environmental attributes. Residence in an ethnic enclave, a socially distinct area, is associated with lower gestational diabetes mellitus (GDM) risk, yet exposure to high levels of air pollution, including volatile organic compounds (VOCS), is associated with increased GDM risk. We examined the joint effects of ethnic enclaves and VOCs to better understand GDM risk among API women, the group with the highest prevalence of GDM. Methods We examined 9069 API births in the Consortium on Safe Labor (19 hospitals, 2002–2008). API ethnic enclaves were defined as areas ≥66th percentile for percent API residents, dissimilarity (geographic dispersal of API and White residents), and isolation (degree that API individuals interact with another API individual). High levels of 14 volatile organic compounds (VOC) were defined as ≥75th percentile. Four joint categories were created for each VOC: Low VOC/Enclave (reference group), Low VOC/No Enclave, High VOC/Enclave, High VOC/No Enclave. GDM was reported in medical records. Hierarchical logistic regression estimated odds ratios (OR) and 95% confidence intervals (95%CI) between joint exposures and GDM, adjusted for maternal factors and area-level poverty. Risk was estimated for 3-months preconception and first trimester exposures. Results Enclave residence was associated with lower GDM risk regardless of VOC exposure. Preconception benzene exposure was associated with increased risk when women resided outside enclaves [High VOC/No Enclave (OR:3.45, 95%CI:1.77,6.72)], and the effect was somewhat mitigated within enclaves, [High VOC/Enclave (OR:2.07, 95%:1.09,3.94)]. Risks were similar for 12 of 14 VOCs during preconception and 10 of 14 during the first trimester. Conclusions API residence in non-enclave areas is associated with higher GDM risk, regardless of VOC level. Ethnic enclave residence may mitigate effects of VOC exposure, perhaps due to lower stress levels. The potential benefit of ethnic enclaves warrants further study.

Paige C. Barker, Neal P. Holland, Oliver Shore et al.

Objective Completion of an advance directive (AD) document is one component of advanced care planning. We evaluated a brief intervention to enhance AD completion and assess whether the intervention effect varied according to health literacy. Methods A randomized controlled study was conducted in 2 internal medicine clinics. Participants were over 50, without documented AD, no diagnosis of dementia, and spoke English. Participants were screened for health literacy utilizing REALM-SF. Participants were randomized in a 1:1 ratio to the intervention, a 15-minute scripted introduction (grade 7 reading level) to our institution’s AD forms (grade 11 reading level) or to the control, in which subjects were handed blank AD forms without explanation. Both groups received reminder calls at 1, 3, and 5 months. The primary outcome was AD completion at 6 months. Results Five hundred twenty-nine subjects were enrolled; half were of limited and half were of adequate health literacy. The AD completion rate was 21.7% and was similar in the intervention vs. the control group (22.4% vs 22.2%, P  = .94).More participants with adequate health literacy completed an AD than those with limited health literacy (28.4% vs 16.2%, P  = .0008), although the effect of the intervention was no different within adequate or limited literacy groups. Conclusion A brief intervention had no impact on AD completion for subjects of adequate or limited health literacy. Practice Implications Our intervention was designed for easy implementation and to be accessible to patients of adequate or limited health literacy. This intervention was not more likely than the control (handing patients an AD form) to improve AD completion for patients of either limited or adequate health literacy. Future efforts and research to improve AD completion rates should focus on interventions that include: multiple inperson contacts with patients, contact with a trusted physician, documents at 5th grade reading level, and graphic/video decision aids. Trial Registration Number NCT02702284, Protocol ID IRB201500776

V. Couture, Stéphane Delisle, A. Mercier et al.

BACKGROUND There is a global tendency for parents to conceive children later in life. The maternal dimension of the postponement transition has been thoroughly studied, but interest in the paternal side is more recent. For the moment, most literature reviews on the topic have focused on the consequences of advanced paternal age (APA) on fertility, pregnancy and the health of the child. OBJECTIVE AND RATIONALE The present review seeks to move the focus away from the biological and medical dimensions of APA and synthesise the knowledge of the other face of APA. SEARCH METHODS We used the scoping review methodology. Searches of interdisciplinary articles databases were performed with keywords pertaining to APA and its dimensions outside of biology and medicine. We included scientific articles, original research, essays, commentaries and editorials in the sample. The final sample of 177 documents was analysed with qualitative thematic analysis. OUTCOMES We identified six themes highlighting the interdisciplinary nature of APA research. The 'terminological aspects' highlight the lack of consensus on the definition of APA and the strategies developed to offer alternatives. The 'social aspects' focus on the postponement transition towards reproducing later in life and its cultural dimensions. The 'public health aspects' refer to attempts to analyse APA as a problem with wider health and economic implications. The 'psychological aspects' focus on the consequences of APA and older fatherhood on psychological characteristics of the child. The 'ethical aspects' reflect on issues of APA emerging at the intersection of parental autonomy, children's welfare and social responsibility. The 'regulatory aspects' group different suggestions to collectively approach the implications of APA. Our results show that the field of APA is still in the making and that evidence is lacking to fully address the issues of APA. The review suggests promising avenues of research such as introducing the voice of fathers of advanced age into the research agenda. WIDER IMPLICATIONS The results of this review will be useful for developing policies and preconception health interventions that consider and include prospective fathers of advanced age.

Tomomi Hisasue, Marie Kruse, Jani Raitanen et al.

Abstract Background The aim of this study was to examine associations between exposure to violence, quality of life, and psychological distress. Women aged 19–54 years who had been exposed to violence by someone in a close relationship were compared with women unexposed to violence in Finland. We also aimed to investigate associations between different forms of violence (physical, sexual, emotional, or any combination of these) with quality of life and psychological distress. Methods We selected a sample of 22,398 women who had returned self-completed questionnaires from a Finnish population-based health survey between 2013 and 2016. Exposure to violence during the past year was assessed through specific questions from the survey. The EUROHIS-QOL 8-item index was used to measure quality of life, and ordinary least square regressions were fitted. The mental health inventory (MHI-5) was used to measure psychological distress. We investigated associations with multivariate logistic regression analysis. Results Among women in Finland, the prevalence of exposure to violence in any type of close relationship during the past year was 7.6%. Women who had been exposed to violence had significantly worse scores of the EUROHIS-QOL 8-item index, and psychological distress was significantly worse (p < 0.001), compared with unexposed women. Strong associations were found between combinations of violence and both quality of life (coefficient − 0.51, p < 0.001) and mental health (odds ratio 4.16, 95% confidence interval 3.44–5.03). Compared with women who had been exposed to violence by a stranger, women who had been exposed to violence by someone in a close relationship had significantly lower quality-of-life scores (p < 0.001). Conclusions This study found that experience of close relationship violence had a negative influence on both quality of life and psychological distress among women in the general Finnish population. Comparison with victims of violence by strangers shows that some of the lower quality-of-life scores among victims are driven by the perpetrator and victim being in a close relationship. Preventive policies in primary care settings aimed at screening and educating young people should be considered as an early form of intervention to reduce the negative mental health consequences of violence.

Maria Zahiri, Shima Parviz, Seyed javad Hosseini

Considerable research has been done in the past few decades to treat ischemic heart disease (stroke). Although drug therapies can improve heart disease and reduce mortality in heart failure, none is able to regenerate damaged heart tissue. Therefore, stem cell-based therapies are considered as new approaches to correcting heart tissue remodeling. Since the depletion of cardiac muscle cells at the beginning of the myocardial infarction act as a stimulus for myocardial remodeling, the ability to replace these cells with their healthy counterparts is an effective treatment for many types of cardiovascular diseases. In this study, we reviewed the advances made in the treatment of myocardial infarction through cell therapy.