Health informatics education has evolved since the 1960s with a strong research foundation primarily in medical schools across the USA and Europe. By 1989 health informatics education was provided in some form by at least 20 countries representing five continents. This continues to progress, in Europe with the help of a number of special projects, via the integration of informatics into pre registration health professional courses, undergraduate and post graduate course work and research degree programs. Each program is unique in terms or content and structure reflecting the many foundation disciplines which contribute or are incorporated in the health informatics discipline. Nursing informatics education is not as widespread. Indeed the evidence suggests a poor uptake of informatics by this profession. Advances in computer based educational technologies are making innovative modes of educational delivery possible and are facilitating a shift towards learner centred, flexible and life long learning. Greater cooperation between Universities is recommended. PMID:10947666
Hovenga, E J
Health informatics is the development and assessment of methods and systems for the acquisition, processing and interpretation of patient data with the help of knowledge from scientific research. This definition implies that health informatics is not tied to the application of computers but more generally to the entire management of information in healthcare. The focus is the patient and the
Michael Imhoff; Andrew Webb
Strengthening the capacity of public health systems to protect and promote the health of the global population continues to be essential in an increasingly connected world. Informatics practices and principles can play an important role for improving global health response capacity. A critical step is to develop an informatics agenda for global health so that efforts can be prioritized and important global health issues addressed. With the aim of building a foundation for this agenda, the authors developed a workshop to examine the evidence in this domain, recognize the gaps, and document evidence-based recommendations. On 21 August 2011, at the 2011 Public Health Informatics Conference in Atlanta, GA, USA, a four-hour interactive workshop was conducted with 85 participants from 15 countries representing governmental organizations, private sector companies, academia, and non-governmental organizations. The workshop discussion followed an agenda of a plenary session - planning and agenda setting - and four tracks: Policy and governance; knowledge management, collaborative networks and global partnerships; capacity building; and globally reusable resources: metrics, tools, processes, templates, and digital assets. Track discussions examined the evidence base and the participants’ experience to gather information about the current status, compelling and potential benefits, challenges, barriers, and gaps for global health informatics as well as document opportunities and recommendations. This report provides a summary of the discussions and key recommendations as a first step towards building an informatics agenda for global health. Attention to the identified topics and issues is expected to lead to measurable improvements in health equity, health outcomes, and impacts on population health. We propose the workshop report be used as a foundation for the development of the full agenda and a detailed roadmap for global health informatics activities based on further contribution from key stakeholders. The global health informatics agenda and roadmap can provide guidance to countries for developing and enhancing their individual and regional agendas.
Mirza, Muzna; Kratz, Mary; Medeiros, Donna; Pina, Jamie; Richards, Janise; Zhang, Xiaohui; Fraser, Hamish; Bailey, Christopher; Krishnamurthy, Ramesh
|Reviews literature related to health informatics and health information management. Provides examples covering types of information, library and information services outcomes, training of informatics professionals, areas of application, the impact of evidence based medicine, professional issues, integrated information systems, and the needs of…
MacDougall, Jennifer; And Others
As globalisation advances, patients in many nations increasingly access diverse medical systems including Western medicine, Traditional Chinese Medicine, Homeopathy and Ayervedic medicine. The trend toward co-existence of medical systems presents challenges for health informatics including the need to develop standards that can encompass the diversity required, the need to develop software applications that effectively inter-operate across diverse systems and the need to support patients when evaluating competing systems. This article advances the notion that the challenges can most effectively be met with the development of informatics approaches that do not assume the superiority of one medical system over another. Argument visualization to support patient decision making in selecting an appropriate medical system is presented as an application that exemplifies this stance. PMID:21191169
Stranieri, Andrew; Vaughan, Stephen
Health care leaders emphasize the need to include information technology and informatics concepts in formal education programs, yet integration of informatics into health educational programs has progressed slowly. The AMIA 1999 Spring Congress was held to address informatics educational issues across health professions, including the educational needs in the various health professions, goals for health informatics education, and implementation strategies to achieve these goals. This paper presents the results from AMIA work groups focused on informatics education for non-informatics health professionals. In the categories of informatics needs, goals, and strategies, conference attendees suggested elements in these areas: educational responsibilities for faculty and students, organizational responsibilities, core computer skills and informatics knowledge, how to learn informatics skills, and resources required to implement educational strategies.
Staggers, Nancy; Gassert, Carole A.; Skiba, Diane J.
Pathology informatics has evolved to varying levels around the world. The history of pathology informatics in different countries is a tale with many dimensions. At first glance, it is the familiar story of individuals solving problems that arise in their clinical practice to enhance efficiency, better manage (e.g., digitize) laboratory information, as well as exploit emerging information technologies. Under the surface, however, lie powerful resource, regulatory, and societal forces that helped shape our discipline into what it is today. In this monograph, for the first time in the history of our discipline, we collectively perform a global review of the field of pathology informatics. In doing so, we illustrate how general far-reaching trends such as the advent of computers, the Internet and digital imaging have affected pathology informatics in the world at large. Major drivers in the field included the need for pathologists to comply with national standards for health information technology and telepathology applications to meet the scarcity of pathology services and trained people in certain countries. Following trials by a multitude of investigators, not all of them successful, it is apparent that innovation alone did not assure the success of many informatics tools and solutions. Common, ongoing barriers to the widespread adoption of informatics devices include poor information technology infrastructure in undeveloped areas, the cost of technology, and regulatory issues. This review offers a deeper understanding of how pathology informatics historically developed and provides insights into what the promising future might hold.
Park, Seung; Parwani, Anil V.; Aller, Raymond D.; Banach, Lech; Becich, Michael J.; Borkenfeld, Stephan; Carter, Alexis B.; Friedman, Bruce A.; Rojo, Marcial Garcia; Georgiou, Andrew; Kayser, Gian; Kayser, Klaus; Legg, Michael; Naugler, Christopher; Sawai, Takashi; Weiner, Hal; Winsten, Dennis; Pantanowitz, Liron
A valuable session for anyone whether student or not, interested in learning more about Biomedical Engineering and Health Informatics as a career choice for women. Prominent women within the domains Biomedical Engineering and Health Informatics will present their research and their humanitarian interests that motivate them. Utilise the fantastic networking opportunity that will conclude this session to build and establish
Carolyn McGregor; Monique Frize
Objectives In this paper we present a contemporary understanding of "nursing informatics" and relate it to applications in three specific contexts, hospitals, community health, and home dwelling, to illustrate achievements that contribute to the overall schema of health informatics. Methods We identified literature through database searches in MEDLINE, EMBASE, CINAHL, and the Cochrane Library. Database searching was complemented by one author search and hand searches in six relevant journals. The literature review helped in conceptual clarification and elaborate on use that are supported by applications in different settings. Results Conceptual clarification of nursing data, information and knowledge has been expanded to include wisdom. Information systems and support for nursing practice benefits from conceptual clarification of nursing data, information, knowledge, and wisdom. We introduce three examples of information systems and point out core issues for information integration and practice development. Conclusions Exploring interplays of data, information, knowledge, and wisdom, nursing informatics takes a practice turn, accommodating to processes of application design and deployment for purposeful use by nurses in different settings. Collaborative efforts will be key to further achievements that support task shifting, mobility, and ubiquitous health care.
Maeland Knudsen, Lina Merete
Informatization process of the Croatian health care system started relatively early. Computer processing of data of persons not covered by health insurance started in 1968 in Zagreb. Remetinec Health Center served as a model of computer data processing (CDP) in primary health care and Sveti Duh General Hospital in inpatient CDP, whereas hospital administration and health service were first introduced to Zagreb University Hospital Center and Sestre Milosrdnice University Hospital. At Varazdin Medical Center CDP for health care services started in 1970. Several registries of chronic diseases have been established: cancer, psychosis, alcoholism, and hospital registries as well as pilot registries of lung tuberculosis patients and diabetics. Health statistics reports on healthcare services, work accidents and sick-leaves as well as on hospital mortality started to be produced by CDP in 1977. Besides alphanumeric data, the modern information technology (IT) can give digital images and signals. Communication in health care system demands a standardized format of all information, especially for telemedicine. In 2000, Technical Committee for Standardization in Medical Informatics was founded in Croatia, in order to monitor the activities of the International Standardization Organization (ISO) and Comite Européen de Normalisation (CEN), and to implement their international standards in the Croatian standardization procedure. The HL7 Croatia has also been founded to monitor developments in the communication standard HL7. So far, the Republic of Croatia has a number of acts regulating informatization in general and consequently the informatization of the health care system (Act on Personal Data Confidentiality, Act on Digital Signature, Act of Standardization) enacted. The ethical aspect of data security and data protection has been covered by the Code of Ethics for medical informaticians. It has been established by the International Medical Informatics Association (IMIA), and the Croatian Society of Medical Informatics (CSMI) has translated it into Croatian and published it on its website. Based on a survey of medical staff attitudes toward health care system informatization, the Croatian health system appears to be ready for informatization. The only requirement is that the present and future health care providers have appropriate medical informatics education, proper computer equipment at their workplace, and an opportunity to participate in the development and/or improvement of the health information system. One of the EU health strategy priorities is the improvement of health information and knowledge. It means that integrated health information systems are required, i.e. systems able to provide key information on health and health care system to the politicians, health professionals and public in general. PMID:16095187
Kern, Josipa; Strnad, Marija
As health care job opportunities continue to expand, a number of institutions have been developing online training materials to help support academic public health programs. One such program is the Michigan Informatics (MI-INFO) website, which contains a variety of tutorials that deal with health information and computer skills. All told, the site contains nine tutorials which include titles like "Evidence Based Public Health", "Finding Health Statistics Online", and "Searching the Public Health Literature". Each of the tutorials features key concept overviews, exercises, and case studies. Near the bottom of the site, visitors can find a user manual for the tutorials, and a place where they can offer their own feedback. The site is rounded out by the "Other Resources" area, which contains links to other relevant sites, such as the Michigan Public Health Training Center and the Greater Midwest Region of the National Network of Libraries of Medicine.
Objective: To ascertain health professionals' per- ceptions of health informatics skills required in their roles. Design: A paper-based survey with a stratified random sample of Australian health professionals and a web-based survey open to all Australian health professionals were conducted. Measurement: A questionnaire on the health pro- fessionals' perceived degree of competency required for a total of 69 specific skills
Sebastian Garde; David Harrison; Mohammed Huque; Evelyn JS Hovenga
|Explains consumer health informatics and describes the technology advances, the computer programs that are currently available, and the basic research that addresses both the effectiveness of computer health informatics and its impact on the future direction of health care. Highlights include commercial computer products for consumers and…
Jimison, Holly Brugge; Sher, Paul Phillip
Clinical Health Informatics (CHI), including integrated electronic medical records (EMR), is playing an increasingly important role in medical practice. It is widely felt that these tools have the potential to improve the quality of medical care and patient outcomes, while increasing efficiency and controlling overall health care costs. Studies have demonstrated the ability of CHI to have a significant impact
This paper examines the historical definitions of Health (Biomedical) Informatics. It is clear that a majority of the definitions refer to Health Informatics as a discipline. Rather it can be argued that the maturation of Health Informatics is beginning to culminate in a distinct science. This progress need to be reflected in academic programs as well as our conferences and publications. PMID:19592917
Turley, James P
The Information Era we live in has created new challenges and opportunities. This age of information highways has an economic price, which has not been properly evaluated. Detailed studies are needed to prove the cost and medical effectiveness of these technologies as well as its effects in the quality of life. Our society's future may depend on it. People are living longer, discoveries in genetics and in information technology are not only helping produce newer drugs faster but also providing the opportunity to exploit new areas such as disease prevention. These technologies provide a variety of opportunities to address public health challenges such as universal access for the uneducated, counter-bioterrorism, telemedicine, distance education, and home care. These opportunities present new challenges such as: surveillance, privacy/confidentiality/security of personal information which will affect all of our lives. No strategy has been presented publicly (yet) addressing (neither) the benefits (n)or the pitfalls of such technologies. From an economic point of view it is an imperative necessity to understand the importance of the Information Technology Infrastructure (ITI) and what it is. The investments in creating and maintaining this ITI will not come from a single application area such as healthcare, but rather from a combination of sources such as electronic commerce, banking, financial, manufacturing, entertainment, travelling, weather forecasting, pharmaceuticals, education, defence and many other 'industries' or application areas. PMID:11226613
Kun, L G
Objectives Health informatics programs usually are evaluated by national accreditation committees. Not always are the members of these committees well informed about the international level of (education in) health informatics. Therefore, when a program is accredited by a national accreditation committee, this does not always mean that the program is of an international level. The International Medical Informatics Association (IMIA) has expertise in the field of education. The IMIA Recommendations on Education in Biomedical and Health Informatics guide curricula development. The goal of this article is to show that IMIA can also play the role of accreditation agency and to present the IMIA accreditation protocol and experiences obtained with it. Methods The accreditation procedure used in the Netherlands and Belgium was taken as a template for the design of the IMIA accreditation protocol. In a trial period of one and a half year the protocol is tested out on six health informatics programs. Results An accreditation protocol was designed. For judging the curriculum of a program the IMIA Recommendations are used. The institution has to write a self-assessment report and a site visit committee visits the program and judges its quality, supported by the self-assessment report and discussions with all stakeholders of the program. Conclusions After having visited three programs it appears that the IMIA accreditation procedure works well. Only a few changes had to be introduced. Writing the self-assessment report already appears to be beneficial for the management of the program to obtain a better insight in the quality of their program.
The dominant contemporary conceptualization of consumers is as individual seekers of health information for their personal use. This individualistic view informs the development and deployment of technically sophisticated systems and is flawed in two ways. First, an individualistic view overlooks the socially embedded nature of consumer health engagements. Second, such a view reifies the rather problematic expert-centric view of health
We introduce the Applied Health Informatics Bootcamp. This is an intense, interactive on-site program, augmented by approximately 80 hours of online material. The Bootcamp is intended to introduce those with little or no knowledge of Health Informatics (HI) to the nature, key concepts, and applications of this discipline to addressing challenges in the health field. The focus of the program is on Applied Health Informatics (AHI), the discipline addressing the preparation for, and the procurement, deployment, implementation, resourcing, effective usage, and evaluation of informatics solutions in the health system. Although no program of this duration can cover all topics, we target the high profile areas of Health Informatics and point the participants in the direction of broader and deeper explorations.
Fenton, Shirley; Covvey, H. Dominic
Improving healthcare quality while simultaneously reducing cost has become a high priority of healthcare reform. Informatics is crucial in tackling this challenge. The American Recovery and Reinvestment Act of 2009 mandates adaptation and “meaningful use (MU)” of health information technology. In this review, we will highlight several areas in which informatics can make significant contributions, with a focus on radiology. We also discuss informatics related to the increasing imperatives of state and local regulations (such as radiation dose tracking) and quality initiatives.
Liu, Yueyi I.
Health care leaders emphasize the need to include information technology and informatics concepts in formal education programs, yet integration of informatics into health educational programs has progressed slowly. The AMIA 1999 Spring Congress was held to address informatics educational issues across health professions, including the educational needs in the various health professions, goals for health informatics education, and implementation strategies
Nancy Staggers; Carole A Gassert; Diane J Skiba
Public health surveillance is the ongoing, systematic collection, analysis, interpretation, and dissemination of data regarding a health-related event for use in public health action to reduce morbidity and mortality and to improve health by effective response management and coordination. As new pressures for early detection of disease outbreaks have arisen, particularly for outbreaks of possible bioterrorism (BT) origin, and as electronic health data have become increasingly available, so has the demand for public health situation awareness systems. Although these systems are valuable for early warning of public health emergencies, there remains the cost of developing and managing such large and complex systems and of investigating inevitable false alarms. Whether these systems are dependable and cost effective enough and can demonstrate a significant and indispensable role in detection or prevention of mass casualty events of BT origin remains to be proven. This article will focus on the complexities of design, analysis, implementation and evaluation of public health surveillance and situation awareness systems and, in some cases, will discuss the key technologies being studied in Center for Biosecurity Informatics Research at University of Texas, Health Science Center at Houston.
Mirhaji, Parsa; Zhang, Jiajie; Smith, Jack W.; Madjid, Mohammad; Casscells, Samuel W.; Lillibridge, Scott R.
The purpose of this study was to compare academic performance between distance-learning and on-campus health informatics students. A quantitative causal-comparative research design was utilized, and academic performance was measured by final GPA scores and Registered Health Information Administrator certification exam scores. Differences in previous academic performance between the two groups were also determined by comparing overall admission GPA and math/science admission GPA. The researchers found no difference in academic performance between the two groups when final GPA scores and total certification scores were compared. However, there were statistically significant differences between the two groups in 4 of the 17 sub-domains of the certification examination, with the on-campus students scoring slightly higher than the distance students. Correlation studies were also performed, and the researchers found significant correlations between overall admission GPA, math/science admission GPA, final GPA, and certification scores. PMID:18458788
Russell, Barbara L; Barefield, Amanda C; Turnbull, Diane; Leibach, Elizabeth; Pretlow, Lester
The purpose of this study was to compare academic performance between distance-learning and on-campus health informatics students. A quantitative causal-comparative research design was utilized, and academic performance was measured by final GPA scores and Registered Health Information Administrator certification exam scores. Differences in previous academic performance between the two groups were also determined by comparing overall admission GPA and math/science admission GPA. The researchers found no difference in academic performance between the two groups when final GPA scores and total certification scores were compared. However, there were statistically significant differences between the two groups in 4 of the 17 sub-domains of the certification examination, with the on-campus students scoring slightly higher than the distance students. Correlation studies were also performed, and the researchers found significant correlations between overall admission GPA, math/science admission GPA, final GPA, and certification scores.
Russell, Barbara L.; Barefield, Amanda C.; Turnbull, Diane; Leibach, Elizabeth; Pretlow, Lester
The TMC History project documents the history of informatics in the Texas Medical Center (TMC) and present it as a Web-based information resource that can be an adjunct to the education of graduate students in the health informatics program.
Walker, Kirt; Sagaram, Deepak; Turley, James P.
During the last two decades, biomedical informatics (BMI) has become a critical component in biomedical research and health care delivery, as evidenced by two recent phenomena. One, as discussed in the article by Bernstam and colleagues in this issue, has been the introduction of Clinical and Translational Science Awards. Perhaps even more important has been the recent, arguably long overdue, emphasis on deployment of health information technology (IT) nationally. BMI utilizes IT and computer science as tools and methods for improving data acquisition, data management, data analysis, and knowledge generation, but it is driven by a focus on applications based in deep understanding of the science and practice, problems, interactions, culture, and milieu of biomedicine and health. Building from Bernstam and colleagues' distinction between BMI and other IT disciplines, the authors discuss the evolving role of BMI professionals as individuals uniquely positioned to work within the human and organizational context and culture in which the IT is being applied. The focus is not on the IT but on the combination--the interactions of IT systems, human beings, and organizations aimed at achieving a particular purpose. There has never been a time when the need for individuals well trained in BMI--those who understand the complexities of the human, social, and organizational milieu of biomedicine and health--has been more critical than it is now, as the nation seeks to develop a national infrastructure for biomedicine and health care, and as these fields seek to broadly deploy IT wisely and appropriately. PMID:19550167
Greenes, Robert A; Shortliffe, Edward H
The rapid emergence of programmes in health informatics, medical informatics and biomedical informatics implies a need for core curricula in these diverse disciplines. This study investigated the recommended competencies for health and medical informatics, aiming to develop a framework for use in curricular development. Current health and medical programmes around the world were analysed to assess how these competencies are
Qi Rong Huang
This article discusses the ongoing development of a health informatics capstone program in a Midwest university from the hiring of a program coordinator to the development of a capstone course, through initial student results. University health informatics programs require a strong academic program to be successful but also require a spirited program coordinator to manage resources and organize an effective capstone course. This is particularly true of health informatics master's programs that support health industry career fields, whereby employers can locate and work with a pool of qualified applicants. The analysis of students' logs confirms that students' areas of focus and concern are consistent with course objectives and company work requirements during the work-study portion of the student capstone project. The article further discusses lessons learned and future improvements to be made in the health informatics capstone course. PMID:22783150
Hackbarth, Gary; Cata, Teuta; Cole, Laura
Consumer Health Informatics (CHI) means different things to patients, health professionals, and health care systems. A broader perspective on this new and rapidly developing field will enable us to understand and better apply its advances. This article provides an overview of CHI discussing its evolution and driving forces, along with advanced applications such as Personal Health Records, Internet transmission of personal health data, clinical e-mail, online pharmacies, and shared decision-making tools. Consumer Health Informatics will become integrated with medical care, electronic medical records, and patient education to impact the whole process and business of health care. PMID:12238015
Klein-Fedyshin, Michele S
Health informatics is one of the nation's largest growth industries. With the government's increasing interest in electronic health records and growing investment by healthcare organizations in technology, there is a large demand for a health informatics and health information technology workforce. To protect health information systems, it is highly important for health informatics professionals to be well educated and trained
Xiaohong Yuan; Jinsheng Xu; Kossi Edoh; Hong Wang
\\u000a Health informatics has the potential to improve the quality and provision of care while reducing the cost of health care delivery.\\u000a However, health informatics is often falsely regarded as synonymous with information management (IM). This chapter (i) provides\\u000a a clear definition and characteristic benefits of health informatics and information management in the context of health care\\u000a delivery, (ii) identifies and
Regina Gyampoh-Vidogah; Robert Moreton; David Sallah
Stanford's two decades of success in linking medical informatics and health services research in both training and investigational activities reflects advantageous geography and history as well as natural synergies in the two areas. Health services research and medical informatics at Stanford have long shared a quantitative, analytic orientation, along with linked administration, curriculum, and clinical activities. Both the medical informatics and the health services research curricula draw on diverse course offerings throughout the university, and both the training and research overlap in such areas as outcomes research, large database analysis, and decision analysis/decision support. The Stanford experience suggests that successful integration of programs in medical informatics and health services research requires areas of overlapping or synergistic interest and activity among the involved faculty and, hence, in time, among the students. This is enhanced by a mixture of casual and structured contact among students from both disciplines, including social interactions. The challenges to integration are how to overcome any geographic separation that may exist in a given institution; the proper management of relationships with those sub-areas of medical informatics that have less overlap with health services research; and the need to determine how best to exploit opportunities for collaboration that naturally occur.
Shortliffe, Edward H.; Garber, Alan M.
To develop a set of recommendations for authors of qualitative studies in the field of health informatics, we conducted an extensive literature search and also manually checked major journals in the field of biomedical informatics and qualitative research looking for papers, checklists, and guidelines pertaining to assessing and reporting of qualitative studies. We synthesized the found criteria to develop an initial set of reporting recommendations that are particularly relevant to qualitative studies of health information technology systems. This paper presents a preliminary version of these recommendations. We are planning to refine and revise this version using comments and suggestions of experts in evaluation of health informatics applications and publish a detailed set of recommendations. PMID:21893872
Niazkhani, Zahra; Pirnejad, Habibollah; Aarts, Jos; Adams, Samantha; Bal, Roland
Objective: The article offers a current perspective on medical informatics and health sciences librarianship. Narrative: The authors: (1) discuss how definitions of medical informatics have changed in relation to health sciences librarianship and the broader domain of information science; (2) compare the missions of health sciences librarianship and health sciences informatics, reviewing the characteristics of both disciplines; (3) propose a new definition of health sciences informatics; (4) consider the research agendas of both disciplines and the possibility that they have merged; and (5) conclude with some comments about actions and roles for health sciences librarians to flourish in the biomedical information environment of today and tomorrow. Summary: Boundaries are disappearing between the sources and types of and uses for health information managed by informaticians and librarians. Definitions of the professional domains of each have been impacted by these changes in information. Evolving definitions reflect the increasingly overlapping research agendas of both disciplines. Professionals in these disciplines are increasingly functioning collaboratively as “boundary spanners,” incorporating human factors that unite technology with health care delivery.
Perry, Gerald J.; Roderer, Nancy K.; Assar, Soraya
|While interest and activity in health informatics continues to increase worldwide, concerns about the most appropriate educational preparation for practice also arise. Health informatics is an interdisciplinary field that pursues effective use of data, information and knowledge to support effective decision making; in the health field, those…
Dalrymple, Prudence W.; Roderer, Nancy K.
Public health surveillance has benefitted from, and has often pioneered, informatics analyses and solutions. However, the field of informatics also serves other facets of public health including emergency response, environmental health, nursing, and administration. Public health informatics has been defined as the systematic application of information and computer science and technology to public health practice, research, and learning. It is an interdisciplinary profession that applies mathematics, engineering, information science, and related social sciences (e.g., decision analysis) to important public health problems and processes. Public health informatics is a subdomain of the larger field known as biomedical or health informatics. Health informatics is not synonymous with the term health information technology (IT). Although the concept of health IT encompasses the use of technology in the field of health care, one can think of health informatics as defining the science, the how and why, behind health IT. For example, health IT professionals should be able to resolve infrastructure problems with a network connection, whereas trained public health informaticians should be able to support public health decisions by facilitating the availability of timely, relevant, and high-quality information. In other words, they should always be able to provide advice on methods for achieving a public health goal faster, better, or at a lower cost by leveraging computer science, information science, or technology. PMID:22832993
Savel, Thomas G; Foldy, Seth
\\u000a After reading this chapter you should know the answers to these questions:\\u000a \\u000a \\u000a \\u000a \\u000a • \\u000a \\u000a \\u000a What are the three core functions of public health, and how do they help shape the different foci of public health and medicine?\\u000a \\u000a \\u000a \\u000a • \\u000a \\u000a \\u000a What are the current and potential effects of a) the genomics revolution; and b) 9\\/11 on public health informatics?\\u000a \\u000a \\u000a \\u000a • \\u000a \\u000a \\u000a What were the
William A. Yasnoff; Patrick W. O'Carroll; Andrew Friede
As the emphasis on individuals' active partnership in health care grows, so does the public's need for effective, comprehensible consumer health resources. Consumer health informatics has the potential to provide frameworks and strategies for designing effective health communication tools that empower users and improve their health decisions. This article presents an overview of the consumer health informatics field, discusses promising
Alla Keselman; Robert Logan; Catherine Arnott-Smith; Gondy Leroy; Qing Zeng-Treitler
As the emphasis on individuals' active partnership in health care grows, so does the public's need for effective, comprehensible consumer health resources. Consumer health informatics has the potential to provide frameworks and strategies for designing effective health communication tools that empower users and improve their health decisions. This article presents an overview of the consumer health informatics field, discusses promising
C. A. Smith; Alla Keselman; Q. Zeng-Treitler; R. Logan; Gondy Leroy
Whilst good health informatics can contribute directly to the delivery of effective patient care, bad informatics can kill. The UK is establishing a regulatory body to register health informatics specialists who can demonstrate that they meet agreed standards of professional practice: the UK Council for Health Informatics Professions (UKCHIP). UKCHIP will also manage the introduction of a Code of Conduct (based on the IMIA Code) and processes for continuous professional development, appeals, and removal from the Register. The challenge has been to design a process that provides a suitable structure for all informatics staff, including records, coding, audit, library and knowledge management, ICT, systems, information management and clinical management specialists. The contention is that this inclusive model of regulation has international applicability. PMID:15360944
Millen, Di; Lawton, Paul; Hayes, Glyn; Taylor, Chris
The Journal of Health Informatics in Developing Countries was established to meet a perceived need for Health Informaticians in developing countries to be able to share the results of their research in an affordable and easy-to-access online publication. The journal was developed using the open source platform "Open Journal System," and has now published 67 articles across 13 issues. A collaborative editorial approach has been established to address the problems of limited research budgets, difficulties with translating to English and other problems specific to authors from developing countries. The journal faces many challenges including ensuring future financial sustainability and inclusion in journal indexing systems. However, the continuing support of an international body of Associate Editors and Editorial Board Members has enabled a wide range of useful and informative health informatics research to be disseminated across the developing world. PMID:24155794
Paton, C; Househ, M; Malik, M
Informatization is the process through which the new communication technologies are used as a means for furthering socioeconomic development as a nation becomes more and more an information society. The informatization strategy in very recent years has provided an alternative to previous strategies of development communication. India is an example of such a shift, as the New Economic Policy of
Everett M. Rogers
Concerned about evidence-based health informatics, the authors conducted a limited pilot survey attempting to determine how many IT evaluation studies in health care are never published, and why. A survey distributed to 722 academics had a low response rate, with 136 respondents giving instructive comments on 217 evaluation studies. Of those studies, half were published in international journals, and more than one-third were never published. Reasons for not publishing (with multiple reasons per study possible) included: “results not of interest for others” (1/3 of all studies), “publication in preparation” (1/3), “no time for publication” (1/5), “limited scientific quality of study” (1/6), “political or legal reasons” (1/7), and “study only conducted for internal use” (1/8). Those reasons for non-publication in health informatics resembled those reported in other fields. Publication bias (preference for positive studies) did not appear to be a major issue. The authors believe that widespread application of guidelines in conducting health informatics evaluation studies and utilization of a registry for evaluation study results could improve the evidence base of the field.
Ammenwerth, Elske; de Keizer, Nicolette
The combination of the burgeoning interest in health, health care reform and the advent of the Information Age, represents a challenge and an opportunity for public health. If public health's effectiveness and profile are to grow, practitioners and researchers will need reliable, timely information with which to make information-driven decisions, better ways to communicate, and improved tools to analyze and present new knowledge. "Public Health Informatics" (PHI) is the science of applying Information-Age technology to serve the specialized needs of public health. In this paper we define Public Health Informatics, outline specific benefits that may accrue from its widespread application, and discuss why and how an academic discipline of public health informatics should be developed. Finally, we make specific recommendations for actions that government and academia can take to assure that public health professionals have the systems, tools, and training to use PHI to advance the mission of public health. PMID:7639873
Friede, A; Blum, H L; McDonald, M
Health care in the United States has entered a period of economic upheaval. Episodic, fee-for-service care financed by indemnity insurance is being replaced by managed care financed by fixed-price, capitated health plans. The resulting focus on reducing costs, especially in areas where there is competition fueled by oversupply of health services providers and facilities, poses new threats to the livelihood of medical libraries and medical librarians but also offers new opportunities. Internet services, consumer health education, and health services research will grow in importance, and organizational mergers will provide librarians with opportunities to assume new roles within their organizations.
Masys, D R
There is an increased level of activity in the biomedical and health informatics world (e-prescribing, electronic health records, personal health records) that, in the near future, will yield a wealth of available data that we can exploit meaningfully to strengthen knowledge building and evidence creation, and ultimately improve clinical and preventive care. The American Medical Informatics Association (AMIA) 2008 Health
Meryl Bloomrosen; Don E. Detmer
As the emphasis on individuals' active partnership in health care grows, so does the public's need for effective, comprehensible consumer health resources. Consumer health informatics has the potential to provide frameworks and strategies for designing effective health communication tools that empower users and improve their health decisions. This article presents an overview of the consumer health informatics field, discusses promising approaches to supporting health communication, and identifies challenges plus direction for future research and development. The authors' recommendations emphasize the need for drawing upon communication and social science theories of information behavior, reaching out to consumers via a range of traditional and novel formats, gaining better understanding of the public's health information needs, and developing informatics solutions for tailoring resources to users' needs and competencies. This article was written as a scholarly outreach and leadership project by members of the American Medical Informatics Association's Consumer Health Informatics Working Group.
Keselman, Alla; Logan, Robert; Smith, Catherine Arnott; Leroy, Gondy; Zeng-Treitler, Qing
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This paper details the development of a Masters in Health Informatics (MHI) program. It traces the design from conception through environmental scanning and curriculum development and into survey validation. One of the underlying characteristics identified in the analysis of other programs was that there seemed to be two subgroups or themes in health informatics programs: clinical and health administrative foci.
Ben Martz; Xiaoni Zhang; Gary Ozanich
A decision support system can be approached from two major disciplinary perspectives, those of information systems science (ISS) and artificial intelligence (AI). We present in this chapter an extended ontology for a decision support system in health informatics. The extended ontology is founded on related research in ISS and AI, and on performed case studies in health informatics. The ontology
Eight Canadian universities partnered to establish a Collaborative Health Informatics PhD/Postdoc Strategic Training Program (CHPSTP). The 6-year goal was to increase research capacity in health informatics in Canada. Three cohorts of 20 trainees participated in the training, which included online Research Learning Experiences, annual face-to-face…
Hebert, Marilynne; Lau, Francis
A variety of shifts emergent with globalization, which are reflected in part by nascent programs in “Global Public Health,” “Global Health Sciences,” and “Global Health,” are redefining international public health. We explore three of these shifts as a critical discourse and intervention in global health diplomacy: the expansion in non-governmental organization participation in international health programs, the globalization of science
Vincanne Adams; Thomas E. Novotny; Hannah Leslie
The computer is rapidly becoming an interactive workstation for medical research and for clinical decision-making and it has become a preferred instrument for communication and documentation throughout health care. However, when the attempt is made to use the rigid conventions of information processing to impose order on the characteristically volatile and unpredictable phenomena encountered in the clinical setting, deep seated logical issues are uncovered. This challenge has generated the new field of Medical Informatics, one major goal of which is to formulate computer logics that can properly relate the idealized descriptions of disease, the rules for medical practice and the general guidelines for health care to the intricate diversities encountered in the care of individual patients. The Integrated Academic Information Management System (IAIMS) program of the National Library of Medicine provides the most ambitious environment for research in this new endeavor. PMID:2203687
Lincoln, T L
Information and Communication Technology (ICT) has become a major tool in delivery of health services and has had an innovative impact on quality of life. ICT is affecting the way healthcare is delivered to clients. In this paper, we discuss the state of ICT and health informatics in Ghana. We also discuss the state of various relevant infrastructures for the successful implementation of ehealth projects. We analyse the past and present state of health informatics in Ghana, in comparison to other African countries. We also review the challenges facing successful implementation of health informatics projects in Ghana and suggest possible solutions.
Achampong, Emmanuel Kusi
Our greatest hope for the future of eHealth and the enabling of our health system is today's students. However, we face a challenge: few students are aware of careers in Health Informatics and other aspects of eHealth. This paper describes an initiative to engage our future workforce in HI. The National Student Forum for Health Informatics was established, in collaboration between the National Institutes of Health Informatics and COACH, to provide much needed opportunities for students to become involved in HI educational programs, research and student-student interaction. A key activity of NSF is the instantiation of Health Informatics Clubs at Canadian colleges and universities. We describe the rationale for NSF, its goals and objectives, its leadership and organization, and the development of the first HI Club at the University of Waterloo. Initiatives such as NSF are essential if we are to resolve the human resources crisis in HI. PMID:21335687
Fenton, Shirley L; Covvey, H Dominic
The Internet provides one of the most compelling examples of the way in which government research investments can, in time, lead to innovations of broad social and economic impact. This paper reviews the history of the Internet's evolution, emphasizing in particular its relationship to medical informatics and to the nation's health-care system. Current national research programs are summarized and the need for more involvement by the informatics community and by federal health-care agencies is emphasized.
Shortliffe, E. H.
This article addresses anthropology's engagement with the emerging discipline of global health. We develop a definition for global health and then present four principal contributions of anthropology to global health: (a) ethnographic studies of health inequities in political and economic contexts; (b) analysis of the impact on local worlds of the assemblages of science and technology that circulate globally; (c)
Craig R. Janes; Kitty K. Corbett
Summary Background Improving the quality of reporting of evaluation studies in health informatics is an important requirement towards the vision of evidence-based health informatics. The STARE-HI – Statement on Reporting of Evaluation Studies in health informatics, published in 2009, provides guidelines on the elements to be contained in an evaluation study report. Objectives To elaborate on and provide a rationale for the principles of STARE-HI and to guide authors and readers of evaluation studies in health informatics by providing explanatory examples of reporting. Methods A group of methodologists, researchers and editors prepared the present elaboration of the STARE-HI statement and selected examples from the literature. Results The 35 STARE-HI items to be addressed in evaluation papers describing health informatics interventions are discussed one by one and each is extended with examples and elaborations. Conclusion The STARE-HI statement and this elaboration document should be helpful resources to improve reporting of both quantitative and qualitative evaluation studies. Evaluation manuscripts adhering to the principles will enable readers of such papers to better place the studies in a proper context and judge their validity and generalizability, and thus in turn optimize the exploitation of the evidence contained therein. Limitations This paper is based on experiences of a group of editors, reviewers, authors of systematic reviews and readers of the scientific literature. The applicability of the details of these principles has to evolve as a function of their use in practice.
Brender, J.; Talmon, J.; de Keizer, N.; Nykanen, P.; Rigby, M.; Ammenwerth, E.
Beginning in July 2005, several major medical journals, including the Journal of Medical Internet Research, will only consider trials for publication that have been registered in a trial registry before they started. This is to reduce publication bias and to prevent selective reporting of positive outcomes. As existing clinical trial registers seem to be unsuitable or suboptimal for eHealth studies, a free International eHealth Study Registry (IESR) has been set up, allowing registration of trials (including non-randomized studies) in the field of health informatics and assigning an International eHealth Study Number (IESN). The IESR should meet the requirements of journal editors for a-priori registration of a study. We hope IESR will become the preferred choice for registration of eHealth studies and, as an secondary benefit, will become an international repository of ongoing eHealth projects, thereby enhancing global collaboration and reducing duplication of effort.
Global health reflects the realities of globalization, including worldwide dissemination of infectious and noninfectious public health risks. Global health architecture is complex and better coordination is needed between multiple organizations. Three overlapping themes determine global health action and prioritization: development, security, and public health. These themes play out against a background of demographic change, socioeconomic development, and urbanization. Infectious diseases remain critical factors, but are no longer the major cause of global illness and death. Traditional indicators of public health, such as maternal and infant mortality rates no longer describe the health status of whole societies; this change highlights the need for investment in vital registration and disease-specific reporting. Noncommunicable diseases, injuries, and mental health will require greater attention from the world in the future. The new global health requires broader engagement by health organizations and all countries for the objectives of health equity, access, and coverage as priorities beyond the Millennium Development Goals are set.
Simone, Patricia M.; Davison, Veronica; Slutsker, Laurence
|The Saudi health sector has witnessed a significant progress in recent decades with some Saudi hospitals receiving international recognition. However, this progress has not been accompanied by the same advancement in the health informatics field whose applications have become a necessity for hospitals in order to achieve important objectives such…
Objective The field of Biomedical and Health Informatics (BMHI) continues to define itself, and there are many educational programs offering ‘informatics’ degrees with varied foci. The goal of this study was to develop a scheme for systematic comparison of programs across the entire BMHI spectrum and to identify commonalities among informatics curricula. Design Guided by several published competency sets, a grounded theory approach was used to develop a program/curricula categorization scheme based on the descriptions of 636 courses offered by 73 public health, nursing, health, medical, and bioinformatics programs in the USA. The scheme was then used to compare the programs in the aforementioned five informatics disciplines. Results The authors developed a Course-Based Informatics Program Categorization (CBIPC) scheme that can be used both to classify coursework for any BMHI educational program and to compare programs from the same or related disciplines. The application of CBIPC scheme to the analysis of public health, nursing, health, medical, and bioinformatics programs reveals distinct intradisciplinary curricular patterns and a common core of courses across the entire BMHI education domain. Limitations The study is based on descriptions of courses from the university's webpages. Thus, it is limited to sampling courses at one moment in time, and classification for the coding scheme is based primarily on course titles and course descriptions. Conclusion The CBIPC scheme combines empirical data about educational curricula from diverse informatics programs and several published competency sets. It also provides a foundation for discussion of BMHI education as a whole and can help define subdisciplinary competencies.
Hemminger, Bradley M
This paper reports on a qualitative study of the attitudes of 23 South Australian practitioners in General Practice (GP) towards adopting an unspecified data amalgamating Health Informatics (HI) system. Findings suggest key areas of concern are associated with the potential for diminution of control over change and adoption was primarily influenced by a perceived need to protect the role and
John Knight; Margaret Patrickson; Bruce Gurd
Objectives This article seeks to describe the current state of informatics supported collaborative care and to point out areas of future research in this highly interdisciplinary field. Methods In this article, person-centered collaborative care is seen as a concept addressing both the provision of care over organizational borders between health and social care, and within care teams as well as the changed patient/client-care provider relationship characterized by increased patient/client involvement. Results From a health systems perspective, there are several attempts to describe the conceptual and theoretical basis for collaborative care indicating that agreement on core concepts and terminology is difficult. From an informatics perspective, focus is on standardization of clinical content models and terminology to achieve interoperability of information technology systems and to support standardized care pathways. Few examples look into how ad-hoc collaborative care processes can be supported using information technology and informatics standards. Nevertheless, promising examples do exist showing that integrational Information Communication Technology services can be supportive for collaborative care developments. However, the current landscape consists of many fragmented, often technology-driven eHealth solutions targeting specific diagnostic groups in geographically and/or organizationally restricted settings. Conclusions A systematic approach incorporating organizational, clinical, informatics and social science knowledge is needed to perform further research in areas such as virtual team partnerships, new paradigms of care delivery, data and knowledge management as well as its secure sharing. Also organizational and legal aspects need to be further researched in order to facilitate the coordinated provision of health and social care to citizens including self-management, utilizing informatics support in a societal context.
CLINT, which stands for Clinical Informatics NeTwork, is one of the clinical informatics initiatives in development at McMaster University's Health Information Research Unit. CLINT is a microcomputer-based system of over 60 workstations providing 24 hour availability of a set of clinical information resources to clinicians throughout our teaching hospital. CLINT encompasses three domains: (1) a user adaptable clinician-computer interface, (2) unique evidence-based health care content, and (3) automated data collection and viewing tools. An objective of the CLINT project is to determine CLINT's impact on the practice of health care. Early analysis of our data has revealed that over the past year, there has been widespread use of CLINT by clinicians from all clinical domains. Our next task is to evaluate CLINT's usefulness.
Langton, K. B.; Horsman, J.; Hayward, R. S.; Ross, S. A.
The paper describes the authors' work in the area of health informatics (HI) education involving emerging health information technologies. A range of information technologies promise to modernize health care. Foremost among these are electronic health records (EHRs), which are expected to significantly improve and streamline health care practice. Major national and international efforts are currently underway to increase EHR adoption. However, there have been numerous issues affecting the widespread use of such information technology, ranging from a complex array of technical problems to social issues. This paper describes work in the integration of information technologies directly into the education and training of HI students at both the undergraduate and graduate level. This has included work in (a) the development of Web-based computer tools and platforms to allow students to have hands-on access to the latest technologies and (b) development of interdisciplinary educational models that can be used to guide integrating information technologies into HI education. The paper describes approaches that allow for remote hands-on access by HI students to a range of EHRs and related technology. To date, this work has been applied in HI education in a variety of ways. Several approaches for integration of this essential technology into HI education and training are discussed, along with future directions for the integration of EHR technology into improving and informing the education of future health and HI professionals. PMID:22910506
Kushniruk, Andre; Borycki, Elizabeth; Armstrong, Brian; Kuo, Mu-Hsing
Advances in informatics, particularly the implementation of electronic health records (EHR), in dentistry have facilitated the exchange of information. The majority of dental schools in North America use the same EHR system, providing an unprecedented opportunity to integrate these data into a repository that can be used for oral health education and research. In 2007, fourteen dental schools formed the Consortium for Oral Health-Related Informatics (COHRI). Since its inception, COHRI has established structural and operational processes, governance and bylaws, and a number of work groups organized in two divisions: one focused on research (data standardization, integration, and analysis), and one focused on education (performance evaluations, virtual standardized patients, and objective structured clinical examinations). To date, COHRI (which now includes twenty dental schools) has been successful in developing a data repository, pilot-testing data integration, and sharing EHR enhancements among the group. This consortium has collaborated on standardizing medical and dental histories, developing diagnostic terminology, and promoting the utilization of informatics in dental education. The consortium is in the process of assembling the largest oral health database ever created. This will be an invaluable resource for research and provide a foundation for evidence-based dentistry for years to come.
Stark, Paul C.; Kalenderian, Elsbeth; White, Joel M.; Walji, Muhammad F.; Stewart, Denice C.L.; Kimmes, Nicole; Meng, Thomas R.; Willis, George P.; DeVries, Ted; Chapman, Robert J.
Information on global health conditions online is quite extensive, though it can be hard to separate the wheat from the chaff. Created and operated by the Kaiser Family Foundation (with support from the Bill & Melinda Gates Foundation), the Global Health Policy site is designed for journalists and the general public. The site is a frequently-updated and high-quality resource on information about the global health situation regarding HIV/AIDS, tuberculosis, and malaria. The site provides country-level data on these conditions, along recent articles on these matters. Additionally, visitors can sign up to receive email notifications and RSS feeds.
“Public health surveillance (PHS) is the ongoing and systematic collection, analysis, interpretation, and dissemination of data regarding a health-related event for use in public health action to reduce morbidity and mortality and to improve health.” As information technology gains acceptance as a core element of public health practice, many approaches to the design of PHS systems have been proposed, much
OBJECTIVE: With the increased routine use of advanced imaging in clinical diagnosis and treatment, it has become imperative to provide patients with a means to view and understand their imaging studies. We illustrate the feasibility of a patient portal that automatically structures and integrates radiology reports with corresponding imaging studies according to several information orientations tailored for the layperson. METHODS: The imaging patient portal is composed of an image processing module for the creation of a timeline that illustrates the progression of disease, a natural language processing module to extract salient concepts from radiology reports (73% accuracy, F1 score of 0.67), and an interactive user interface navigable by an imaging findings list. The portal was developed as a Java-based web application and is demonstrated for patients with brain cancer. RESULTS AND DISCUSSION: The system was exhibited at an international radiology conference to solicit feedback from a diverse group of healthcare professionals. There was wide support for educating patients about their imaging studies, and an appreciation for the informatics tools used to simplify images and reports for consumer interpretation. Primary concerns included the possibility of patients misunderstanding their results, as well as worries regarding accidental improper disclosure of medical information. CONCLUSIONS: Radiologic imaging composes a significant amount of the evidence used to make diagnostic and treatment decisions, yet there are few tools for explaining this information to patients. The proposed radiology patient portal provides a framework for organizing radiologic results into several information orientations to support patient education. PMID:23739614
Arnold, Corey W; McNamara, Mary; El-Saden, Suzie; Chen, Shawn; Taira, Ricky K; Bui, Alex A T
The Global Health database is available from Ovid Technologies, Inc., and also from CABI Publishing, EBSCO, and DataStar/ DIALOG. This database is really the combination of two others--the Public Health and Tropical Medicine database, formerly produced by the Bureau of Hygiene and Tropical Diseases, as well as human health and diseases information that is extracted from the CAB Abstracts database. This column will provide readers with an overview of the Global Health database, as well as present some searching hints. The Ovid interface will be used. PMID:16782667
Fitzpatrick, Roberta Bronson
Created in 1972, the Global Health Council (then known as the National Council of International Health) was created to identify priority world health problems and report on them to a wide range of parties, including government agencies and the global health community. In order to disseminate its findings and keep the public informed, the Council has created this well-organized website. The homepage offers visitors the basic layout of the site's contents, as it includes a selection of news briefs dealing with world health concerns and information on the most recent accomplishments of the Council. The top of the homepage offers subject links to the main programmatic areas of interest to the Council: women's health, child health, HIV/AIDS, and infectious disease. Of course, there is a strong publication section, which includes such timely documents as "Faith in Action: Examining the Role of Faith-Based Organizations in Addressing HIV/AIDS" and "Preventing Tuberculosis in HIV-Infected Persons".
|With the advent of twenty-four-hour news media, local, state, and national agencies' warnings and with the explosive role of the Internet, people are more aware of global health concerns that may have significant consequences for the world's population. As international travel continues to increase, health care professionals around the world are…
Rowland, Michael L.
The 13th World Congress on Medical and Health Informatics (Medinfo) was held in 2010 between 12 and 15 September in Cape Town, South Africa. This triennial international gathering is the official conference of the International Medical Informatics Association (IMIA) and brings together leading health informatics leaders, scientists, clinicians, researchers, vendors, developers and government and health care planners from around the globe. The conference attracted 905 submissions and resulted in a program that included 260 oral presentations, 349 posters presentations and 21 scientific demonstrations representing contributions from 58 countries. The Medinfo program covered all aspects of health informatics from traditional areas, such as hospital information systems, patient registries, nursing informatics, data integration, standards, interoperability issues and decision support, to innovative topics, such as translational bioinformatics, text mining, intelligent data analysis, emerging technologies, quality, social networking, workflow and organizational issues. The outgoing President of the IMIA, Professor Reinhold Haux, presented on health informatics challenges into the future, reinforcing that today and in the future, health care has to be considered as part of a continuous and coordinated life-time journey and not just as episodes of disease. Medical informatics has a key role to play in this paradigm shift. The new IMIA President, Professor Antoine Geissbuhler, was announced at the closing ceremony. The next Medinfo congress will take place in Copenhagen, Denmark, in September 2013.
The Global Health database is available from Ovid Technologies, Inc., and also from CABI Publishing, EBSCO, and DataStar\\/DIALOG. This database is really the combination of two others—the Public Health and Tropical Medicine database, formerly produced by the Bureau of Hygiene and Tropical Diseases, as well as human health and diseases information that is extracted from the CAB Abstracts database. This
Roberta Bronson Fitzpatrick
Given the definition of nursing informatics it should be a core activity for all nurses, and seen as a tool to support high quality care giving. Three studies reported in this paper show that this is not the case. Qualified nurses are perceived as having poor skills and knowledge, and as being resistant to IT as it takes them away
While there is a growing body of work on moral issues and global governance in the fields of global justice and international relations, little work has connected principles of global health justice with those of global health governance for a theory of global health. Such a theory would enable analysis and evaluation of the current global health system and would ethically and empirically ground proposals for reforming it to more closely align with moral values. Global health governance has been framed as an issue of national security, human security, human rights, and global public goods. The global health governance literature is essentially untethered to a theorized framework to illuminate or evaluate governance. This article ties global health justice and ethics to principles for governing the global health realm, developing a theoretical framework for global and domestic institutions and actors. PMID:23215931
Ruger, Jennifer Prah
Awareness of the importance of global health surveillance increased in the latter part of the 20th century with the global emergence of human immunodeficiency virus and novel strains of influenza. In the first decade of the 21st century, several events further highlighted global shared interests in and vulnerability to infectious diseases. Bioterrorist use of anthrax spores in 2001 raised awareness of the value of public health surveillance for national security. The epidemic of severe acute respiratory syndrome (SARS) in 2003, re-emergence of a panzootic of avian influenza A H5N1 in 2005, and the sudden emergence of pandemic H1N1 in North America in 2009 all highlighted the importance of shared global responsibility for surveillance and disease control. In particular, in 2003, SARS precipitated changes in awareness of the world's collective economic vulnerability to epidemic shocks. PMID:22832992
St Louis, Michael
Effective electronic health record (EHR) implementations in community settings are critical to promoting safe and reliable EHR use as well as mitigating provider dissatisfaction that often results. The implementation challenge is compounded given the scale and scope of EHR installations that are occurring and will continue to occur over the next five years. However, when compared to EHR evaluations relatively few biomedical informatics researchers have published on evaluating EHR implementations. Fewer still have evaluated EHR implementations in community settings. We report on the methods we used to achieve a novel application of an implementation science framework in informatics to qualitatively evaluate community-based EHR implementations. We briefly provide an overview of the implementation science framework, our methods for adapting it to informatics, the effects the framework had on our qualitative methods of inquiry and analysis, and discuss its potential value for informatics research. PMID:23304351
Richardson, Joshua E; Abramson, Erika L; Pfoh, Elizabeth R; Kaushal, Rainu
In this paper, we review the results of BIOINFOMED, a study funded by the European Commission (EC) with the purpose to analyse the different issues and challenges in the area where Medical Informatics and Bioinformatics meet. Traditionally, Medical Informatics has been focused on the intersection between computer science and clinical medicine, whereas Bioinformatics have been predominantly centered on the intersection between computer science and biological research. Although researchers from both areas have occasionally collaborated, their training, objectives and interests have been quite different. The results of the Human Genome and related projects have attracted the interest of many professionals, and introduced new challenges that will transform biomedical research and health care. A characteristic of the 'post genomic' era will be to correlate essential genotypic information with expressed phenotypic information. In this context, Biomedical Informatics (BMI) has emerged to describe the technology that brings both disciplines (BI and MI) together to support genomic medicine. In recognition of the dynamic nature of BMI, institutions such as the EC have launched several initiatives in support of a research agenda, including the BIOINFOMED study. PMID:15016384
Martin-Sanchez, F; Iakovidis, I; Nørager, S; Maojo, V; de Groen, P; Van der Lei, J; Jones, T; Abraham-Fuchs, K; Apweiler, R; Babic, A; Baud, R; Breton, V; Cinquin, P; Doupi, P; Dugas, M; Eils, R; Engelbrecht, R; Ghazal, P; Jehenson, P; Kulikowski, C; Lampe, K; De Moor, G; Orphanoudakis, S; Rossing, N; Sarachan, B; Sousa, A; Spekowius, G; Thireos, G; Zahlmann, G; Zvárová, J; Hermosilla, I; Vicente, F J
This paper reviews the research and development around a consumer health informatics system CHESS (The Comprehensive Health Enhancement Support System) developed and tested by the Center for Health Systems Research and Analysis at the University of Wisconsin. The review places particular emphasis on what has been found with regard to the acceptance and use of such systems by high risk
David H. Gustafson; Robert P. Hawkins; Eric W. Boberg; Fiona Mctavish; Betta Owens; Meg Wise; Haile Berhe; Suzanne Pingree
The literature suggests that there is a need for measuring public health informatics (PHI) competency to further understand whether current educational modules and modalities meet the needs of PHI practitioners and researchers to perform their jobs more effectively, particularly for mid-tier practitioners that constitute the majority of public health workers in the USA. The present study seeks to update current knowledge of the perceptions and experiences of PHI competencies proposed by the U.S. Council on Linkage in Public Health specifically for mid-tier PH practitioners and researchers. The results were collected and analyzed by using a Web-based survey (WBS) method administered among both practitioners and researchers. Researchers first compiled a draft list of candidate competency set by incorporating existing competency areas provided by: 1) the Council on Linkage; and by 2) those proposed by the USA's Centers for Disease Control CDC Public Health Informatics Work Group. Nine sets of competency statements with 120 competency items and demographic information of respondents were included in the WBS. The online survey instruments were pilot-tested accordingly to incorporate feedback from respondents of the pilot. Fifty-six subjects were recruited from PH experts who were: 1) members of the Health Informatics Information Technology (HIIT) group of American Public Health Association; and, 2) members from the Community of Science (COS) Website who were the first authors published in the PHI field from PubMed. The sample included diverse backgrounds of PHI workers. They expressed an increased need for training to improve their PHI competencies. Respondents agreed that four competency sets should be adequately represented, including Leadership and System Thinking Skills (82%), followed by Financial Planning and Management Skills (79%), Community Dimensions of Practice Skills (77%), and Policy Development/Program Planning Skills (63%). The findings parallel current literature indicating that there exists an expressed need for clarification of the public health practitioner's job-specific informatics competency. Findings of expressed needs for basic computer literacy training and community-based practice were consistent with those of the literature. Additional training and resources should be allocated to address the competency of leadership, management, community-based practice and policy advocacy skills for mid-tier public health practitioners to perform their jobs more effectively. Only when healthcare organizations properly identify PHI competency needs will public health practitioners likely improve their overall informatics skills while improving diversification for contribution across multiple settings. PMID:22447878
Hsu, Chiehwen Ed; Dunn, Kim; Juo, Hsin-Hsuan; Danko, Rick; Johnson, Drew; Mas, Francisco Soto; Sheu, Jiunn-Jye
This paper presents the rationale for designing and implementing the next-generation of public health information systems using grid computing concepts and tools. Our attempt is to evaluate all grid types including data grids for sharing information and computational grids for accessing computational resources on demand. Public health is a broad domain that requires coordinated uses of disparate and heterogeneous information systems. System interoperability in public health is limited. The next-generation public health information systems must overcome barriers to integration and interoperability, leverage advances in information technology, address emerging requirements, and meet the needs of all stakeholders. Grid-based architecture provides one potential technical solution that deserves serious consideration. Within this context, we describe three discrete public health information system problems and the process by which the Utah Department of Health (UDOH) and the Department of Biomedical Informatics at the University of Utah in the United States has approached the exploration for eventual deployment of a Utah Public Health Informatics Grid. These three problems are: i) integration of internal and external data sources with analytic tools and computational resources; ii) provide external stakeholders with access to public health data and services; and, iii) access, integrate, and analyze internal data for the timely monitoring of population health status and health services. After one year of experience, we have successfully implemented federated queries across disparate administrative domains, and have identified challenges and potential solutions concerning the selection of candidate analytic grid services, data sharing concerns, security models, and strategies for reducing expertise required at a public health agency to implement a public health grid. PMID:19545428
Staes, Catherine J; Xu, Wu; LeFevre, Samuel D; Price, Ronald C; Narus, Scott P; Gundlapalli, Adi; Rolfs, Robert; Nangle, Barry; Samore, Matthew; Facelli, Julio C
This paper presents the rationale for designing and implementing the next-generation of public health information systems using grid computing concepts and tools. Our attempt is to evaluate all grid types including data grids for sharing information and computational grids for accessing computational resources on demand. Public health is a broad domain that requires coordinated uses of disparate and heterogeneous information systems. System interoperability in public health is limited. The next-generation public health information systems must overcome barriers to integration and interoperability, leverage advances in information technology, address emerging requirements, and meet the needs of all stakeholders. Grid-based architecture provides one potential technical solution that deserves serious consideration. Within this context, we describe three discrete public health information system problems and the process by which the Utah Department of Health (UDOH) and the Department of Biomedical Informatics at the University of Utah in the United States has approached the exploration for eventual deployment of a Utah Public Health Informatics Grid. These three problems are: i) integration of internal and external data sources with analytic tools and computational resources; ii) provide external stakeholders with access to public health data and services; and, iii) access, integrate, and analyze internal data for the timely monitoring of population health status and health services. After one year of experience, we have successfully implemented federated queries across disparate administrative domains, and have identified challenges and potential solutions concerning the selection of candidate analytic grid services, data sharing concerns, security models, and strategies for reducing expertise required at a public health agency to implement a public health grid.
By the year 2008, a major reorganization of health care services in the United States will have evolved from the solo- and group-practice models of the 1940s, with fee-for-service and insurer-indemnification financing and paper-based information systems, to nationwide managed care plans employing enhanced computer-based information systems.
Collen, Morris F.
Vaccines have made a major contribution to global health in recent decades but they could do much more. In November 2011, a Royal Society discussion meeting, 'New vaccines for global health', was held in London to discuss the past contribution of vaccines to global health and to consider what more could be expected in the future. Papers presented at the meeting reviewed recent successes in the deployment of vaccines against major infections of childhood and the challenges faced in developing vaccines against some of the world's remaining major infectious diseases such as human immunodeficiency virus (HIV), malaria and tuberculosis. The important contribution that development of more effective veterinary vaccines could make to global health was also addressed. Some of the social and financial challenges to the development and deployment of new vaccines were reviewed. The latter issues were also discussed at a subsequent satellite meeting, 'Accelerating vaccine development', held at the Kavli Royal Society International Centre. Delegates at this meeting considered challenges to the more rapid development and deployment of both human and veterinary vaccines and how these might be addressed. Papers based on presentations at the discussion meeting and a summary of the main conclusions of the satellite meeting are included in this issue of Philosophical Transactions of the Royal Society B. PMID:21893534
Greenwood, Brian; Salisbury, David; Hill, Adrian V S
Primary care informatics is an emerging academic discipline that remains undefined. The unique nature of primary care necessitates the development of its own informatics discipline. A definition of primary care informatics is proposed, which encompasses the distinctive nature of primary care. The core concepts and theory that should underpin it are described. Primary care informatics is defined as a science and as a subset of health informatics. The proposed definition is intended to focus the development of a generalizable core theory for this informatics subspecialty.
de Lusignan, Simon
Global health is attracting an unprecedented level of interest. In this paper, we summarise recent trends and identify the unfinished and new agendas in global public health. We propose a global public health scorecard as a simple way to assess progress and suggest actions by public health practitioners and their organisations for improving the effectiveness of public health. Although we find many recent positive developments in global health, the potential for global cooperation and progress is still largely untapped. Compared with other components of development, health improvement should easily foster global cooperation; strong advocacy and political will are keys to continuing progress. We view global public health as a barometer of more general development. Our responses to the current health challenges are at the forefront of the global struggle for survival. PMID:18945485
Beaglehole, Robert; Bonita, Ruth
The context of the conference presentation that gave rise to this article was the importance of veterinarians becoming more engaged in the public-health challenges of today. During the presentation, I sought to point out some of the pressing reasons why. Of particular concern to me are the missed opportunities to help influence human health and well-being as private veterinary practitioners in addition to public-practice veterinarians. Key elements: Public health, the protection and improvement of community health by organized community effort; the global community, the entire world; social responsibility, being, as members of society, morally and legally responsible for the welfare of human beings; terrorism, the systematic use of terror (fear), especially as a means of coercion (it is always local!); system integration, the interaction of interdependent groups to form a unified whole. PMID:17035215
Blackwell, Michael J
Strategic Implications of Global Health responds to a request from the Undersecretary of State for Democratization and Global Affairs for an intelligence assessment on the connections between health and U.S. national interests. This study builds on a 2000...
This report presents the results of the authors' review of consumer health informatics--the use of modern computers and telecommunications to support consumers in obtaining information, analyzing their unique health care needs, and helping them make decis...
User-centered design (UCD) is well recognized as an effective human factor engineering strategy for designing ease of use in the total customer experience with products and information technology that has been applied specifically to health care information technology systems. We conducted a literature review to analyze the current research regarding the use of UCD methods and principles to support the development or evaluation of diabetes-related consumer health informatics technology (CHIT) initiatives. Findings indicate that (1) UCD activities have been applied across the technology development life cycle stages, (2) there are benefits to incorporating UCD to better inform CHIT development in this area, and (3) the degree of adoption of the UCD process is quite uneven across diabetes CHIT studies. In addition, few to no studies report on methods used across all phases of the life cycle with process detail. To address that void, the Appendix provides an illustrative case study example of UCD techniques across development stages. PMID:23911188
LeRouge, Cynthia; Wickramasinghe, Nilmini
The fields of health informatics and biomedical research increasingly depend on the availability of aggregated health data. Yet, despite over fifteen years of policy work on health data issues, the United States (U.S.) lacks coherent policy to guide users striving to navigate the ethical, political, technical, and economic challenges associated with health data use. In 2007, building on more than a decade of previous work, the American Medical Informatics Association (AMIA) convened a panel of experts to stimulate discussion about and action on a national framework for health data use. This initiative is being carried out in the context of rapidly accelerating advances in the fields of health informatics and biomedical research, many of which are dependent on the availability of aggregated health data. Use of these data poses complex challenges that must be addressed by public policy. This paper highlights the results of the meeting, presents data stewardship as a key building block in the national framework, and outlines stewardship principles for the management of health information. The authors also introduce a taxonomy developed to focus definitions and terminology in the evolving field of health data applications. Finally, they identify areas for further policy analysis and recommend that public and private sector organizations elevate consideration of a national framework on the uses of health data to a top priority.
Bloomrosen, Meryl; Detmer, Don
Biomedical informatics involves a core set of methodologies that can provide a foundation for crossing the "translational barriers" associated with translational medicine. To this end, the fundamental aspects of biomedical informatics (e.g., bioinformatics, imaging informatics, clinical informatics, and public health informatics) may be essential in helping improve the ability to bring basic research findings to the bedside, evaluate the efficacy of interventions across communities, and enable the assessment of the eventual impact of translational medicine innovations on health policies. Here, a brief description is provided for a selection of key biomedical informatics topics (Decision Support, Natural Language Processing, Standards, Information Retrieval, and Electronic Health Records) and their relevance to translational medicine. Based on contributions and advancements in each of these topic areas, the article proposes that biomedical informatics practitioners ("biomedical informaticians") can be essential members of translational medicine teams.
The BioHealthBase Bioinformatics Resource Center (BRC) (www.biohealthbase.org) is a public bio- informatics database and analysis resource for the study of specific biodefense and public health pathogens—Influenza virus, Francisella tularensis, Mycobacterium tuberculosis, Microsporidia species and ricin toxin. The BioHealthBase serves as an extensive integrated repository of data imported from public databases, data derived from various computational algorithms and information curated from
Burke Squires; Catherine Macken; Adolfo Garcia-sastre; Shubhada Godbole; Jyothi Noronha; Victoria Hunt; Roger Chang; Christopher N. Larsen; Ed Klem; Kevin Biersack; Richard H. Scheuermann
Health has long been intertwined with the foreign policies of states. In recent years, however, global health issues have risen to the highest levels of international politics and have become accepted as legitimate issues in foreign policy. This elevated political priority is in many ways a welcome development for proponents of global health, and it has resulted in increased funding for and attention to select global health issues. However, there has been less examination of the tensions that characterize the relationship between global health and foreign policy and of the potential effects of linking global health efforts with the foreign-policy interests of states. In this paper, the authors review the relationship between global health and foreign policy by examining the roles of health across 4 major components of foreign policy: aid, trade, diplomacy, and national security. For each of these aspects of foreign policy, the authors review current and historical issues and discuss how foreign-policy interests have aided or impeded global health efforts. The increasing relevance of global health to foreign policy holds both opportunities and dangers for global efforts to improve health. PMID:20423936
Feldbaum, Harley; Lee, Kelley; Michaud, Joshua
While much attention has been paid to the short-term impact that widespread adoption of health information technology (health IT) will have on the healthcare system, there is a corresponding need to look at the long-term effects that extant policies may have on health IT system resilience, innovation, and related ethical, social/legal issues. The American Medical Informatics Association's 2010 Health Policy Conference was convened to further the national discourse on the issues surrounding these longer-term considerations. Conference participants self-selected into three broad categories: resilience in healthcare and health IT; ethical, legal, and social challenges; and innovation, adoption, and sustainability. The discussions about problem areas lead to findings focusing on the lack of encouragement for long-term IT innovation that may result from current health IT policies; the potential impact of uneven adoption of health IT based on the exclusions of the current financial incentives; the weaknesses of contingency and risk mitigation planning that threaten system resilience; and evolving standards developed in response to challenges relating to the security, integrity, and availability of electronic health information. This paper discusses these findings and also offers recommendations that address the interwoven topics of innovation, resilience, and adoption. The goal of this paper is to encourage public and private sector organizations that have a role in shaping health information policy to increase attention to developing a national strategy that assures that health IT innovation and resilience are not impeded by shorter-term efforts to implement current approaches emphasizing adoption and meaningful use of electronic health records. PMID:22037887
McGowan, Julie J; Cusack, Caitlin M; Bloomrosen, Meryl
Introduction: Globalization is the process of international integration arising from the interchange of world views, products, ideas, and other aspects of culture. Globalization describes the interplay of macro-social forces across cultures. The purpose of this study is a systematic review of the bibliography on the impacts of globalization in health. The consequences of globalization on health present a twofold dimension, on the one hand affects the health of the population and on the other hand organization and functioning of health systems. As a result of globalization, there has been an undeniable economic development and technological progress to support the level of health around the world, improving the health status of certain populations with a beneficial increase in life expectancy. Conclusion: In many aspects globalization is good but there are many problems too. PMID:23823429
Ioannou, Andriani; Mechili, Aggelos; Kolokathi, Aikaterini; Diomidous, Marianna
The importance of informatics in healthcare is more than just a consequence of rapid information technology (IT) developments over the last couple of decades. Informatics-related activities are located at the very heart of healthcare and involve biomedical sciences, computer sciences and healthcare policy and management. Evidence based medicine (EBM) may be defined as the explicit and judicious use of current
The purpose of this study was to identify the level of awareness among undergraduate students regarding medical informatics and to ascertain whether educational training has progressed with time in the Department of Health Sciences at Hirosaki University, Japan, which is a co-medical staff training institution that conducts a 4-year university course in medical informatics. The university accepts students who have completed the 3rd grade of medical licensing tests and who have attended the medical informatics lectures for 4 years (2007-2010). The ratio of first sight terminology percentage in any given fiscal year in all the 30 terminology categories varied widely from 0% to 80%, but the trend in various categories did not vary between fiscal years. The terminology of informatics under medical technology students obtained high scores of 52.5-77.3% after attending courses, which was higher compared with students from other classes. On the other hand, student nurses and occupational therapy students obtained 0-44.2%. Each class scored a high percentage of correct answers in the medical information-related terminology. Among the radiology students who attended the classes, the percentage of correct answers in categories of "digital imaging and communication in medicine" and "picture archiving and communication system" were lower than other medical terminology categories. These results reflect the gaps in educational curriculum of 1st and 2nd grades of medical licensing tests. PMID:23358336
Monzen, Satoru; Matsutani, Hideya; Kashiwakura, Ikuo
Medical informatics is a new knowledge domain of computer and information science, engineering and technology in all fields of health and medicine, including research, education and practice. Medical informatics has evolved over the past 30 years as medicine learned to exploit the extraordinary capabilities of the electronic digital computer to better meet its complex information needs. The first articles on this subject appeared in the 1950s, the number of publications rapidly increased in the 1960s and medical informatics was identified as a new specialty in the 1970s.
Collen, Morris F.
The authors consider the ways in which the concept of human security expands understanding of the links between health and human development. After discussing the emergence of the concept of human security, they examine the ways in which human security is linked to global health, particularly as regards violence and conflict, global infectious diseases, and poverty and inequality. The authors
Lincoln Chen; Vasant Narasimhan
onsumer health informatics and e-health (ie, electronic health information and services avail- able over networks such as the Internet1,2 and related technologies such as digital TV\\/WebTV, wire- less media such as Web-compatible mobile phones and personal digital assistants (PDAs)) are emerging trends that will redefine health care in the 21st century. The desire of (most) consumers to assume more responsi-
GUNTHER EYSENBACH; THOMAS L. DIEPGEN
The grounds for global solidarity have been theorized and conceptualized in recent years, and many have argued that we need a global concept of solidarity. But the question remains: what can motivate efforts of the international community and nation-states? Our focus is the grounding of solidarity with respect to global inequities in health. We explore what considerations could motivate acts of global solidarity in the specific context of health migration, and sketch briefly what form this kind of solidarity could take. First, we argue that the only plausible conceptualization of persons highlights their interdependence. We draw upon a conception of persons as 'ecological subjects' and from there illustrate what such a conception implies with the example of nurses migrating from low and middle-income countries to more affluent ones. Next, we address potential critics who might counter any such understanding of current international politics with a reference to real-politik and the insights of realist international political theory. We argue that national governments--while not always or even often motivated by moral reasons alone--may nevertheless be motivated to acts of global solidarity by prudential arguments. Solidarity then need not be, as many argue, a function of charitable inclination, or emergent from an acknowledgment of injustice suffered, but may in fact serve national and transnational interests. We conclude on a positive note: global solidarity may be conceptualized to helpfully address global health inequity, to the extent that personal and transnational interdependence are enough to motivate national governments into action. PMID:22827320
Eckenwiler, Lisa; Straehle, Christine; Chung, Ryoa
This paper reports on a qualitative study investigating how Australian health professionals may be developing and deploying\\u000a essential clinical informatics capabilities in the first 5 years of their professional practice. It explores the experiences\\u000a of four professionals in applying what they have learned formally and informally during their university education and during\\u000a workplace learning and training. This study is based on
Kathleen Gray; Jenny Sim
For consumer health informatics (CHI) interventions to successfully aid laypeople, the interventions must fit and support their health work. This paper outlines a scenario-based human factors assessment of a disease management CHI intervention. Two student users undertook a patient use case and another user followed a nurse use case. Each user completed pre-specified tasks over a ten-day trial, recorded challenges encountered while utilizing the intervention, and logged daily time spent on each task. Results show the scenario-based user testing approach helps effectively and systematically assess potential physical, cognitive, and macroergonomic challenges for end-users, rate the severity of the challenges, and identify mediation strategies for each challenge. In particular, scenario-based user testing aids in identifying challenges that would be difficult, if not impossible, to detect in a laboratory-based usability study. With this information, CHI interventions can be re-designed and/or supplemented, making the intervention more closely fit end-users’ work.
Zayas-Caban, Teresa; Marquard, Jenna L.; Radhakrishnan, Kavita; Duffey, Noah; Evernden, Dana L.
In a rapidly changing health care system, Global Health Care: Issues and Policies equips students with up-to-date information exploring a variety of global health topics and perspectives: culture, religion and health, health research, ethics and health, reproductive health, infectious diseases, chronic diseases, nutrition, mental health, environmental health, aging, ambulatory care, economics and health care, health care insurance, and more. This
BACKGROUND: Current definitions of 'global health' lack specificity about the term 'global'. This debate presents and discusses existing definitions of 'global health' and a common problem inherent therein. It aims to provide a way forward towards an understanding of 'global health' while avoiding redundancy. The attention is concentrated on the dialectics of different concepts of 'global' in their application to
Objective The goal of this paper is to describe the successful application of a use case-based evaluation approach to guide the effective design, evaluation and redesign of inexpensive, commercial, off-the-shelf consumer health informatics (CHI) interventions. Design Researchers developed four CHI intervention use cases representing two distinct patient populations (patients with diabetes with high blood pressure, post-bariatric surgery patients), two commercial off-the-shelf CHI applications (Microsoft HealthVault, Google Health), and related devices (blood pressure monitor, pedometer, weight scale). Three patient proxies tested each intervention for 10?days. Measurements The patient proxies recorded their challenges while completing use case tasks, rating the severity of each challenge based on how much it hindered their use of the intervention. Two independent evaluators categorized the challenges by human factors domain (physical, cognitive, macroergonomic). Results The use case-based approach resulted in the identification of 122 challenges, with 12% physical, 50% cognitive and 38% macroergonomic. Thirty-nine challenges (32%) were at least moderately severe. Nine of 22 use case tasks (41%) accounted for 72% of the challenges. Limitations The study used two patient proxies and addressed two specific patient populations and low-cost, off-the-shelf CHI interventions, which may not perfectly generalize to a larger number of proxies, actual patient populations, or other CHI interventions. Conclusion CHI designers can employ the use case-based evaluation approach to assess the fit of a CHI intervention with patients' health work, in the context of their daily activities and environment, which would be difficult or impossible to evaluate by laboratory-based studies.
... Search the WHO .int site Submit Advanced search Global Health Observatory (GHO) Subnavigation Global Health Observatory Data repository ... years on average in 2011 MORE MORTALITY AND GLOBAL HEALTH ESTIMATES DATA PRODUCTS Maps About WHO mortality data ...
Background The Health Quality Measures Format (HQMF) is a Health Level 7 (HL7) standard for expressing computable Clinical Quality Measures (CQMs). Creating tools to process HQMF queries in clinical databases will become increasingly important as the United States moves forward with its Health Information Technology Strategic Plan to Stages 2 and 3 of the Meaningful Use incentive program (MU2 and MU3). Informatics for Integrating Biology and the Bedside (i2b2) is one of the analytical databases used as part of the Office of the National Coordinator (ONC)’s Query Health platform to move toward this goal. Objective Our goal is to integrate i2b2 with the Query Health HQMF architecture, to prepare for other HQMF use-cases (such as MU2 and MU3), and to articulate the functional overlap between i2b2 and HQMF. Therefore, we analyze the structure of HQMF, and then we apply this understanding to HQMF computation on the i2b2 clinical analytical database platform. Specifically, we develop a translator between two query languages, HQMF and i2b2, so that the i2b2 platform can compute HQMF queries. Methods We use the HQMF structure of queries for aggregate reporting, which define clinical data elements and the temporal and logical relationships between them. We use the i2b2 XML format, which allows flexible querying of a complex clinical data repository in an easy-to-understand domain-specific language. Results The translator can represent nearly any i2b2-XML query as HQMF and execute in i2b2 nearly any HQMF query expressible in i2b2-XML. This translator is part of the freely available reference implementation of the QueryHealth initiative. We analyze limitations of the conversion and find it covers many, but not all, of the complex temporal and logical operators required by quality measures. Conclusions HQMF is an expressive language for defining quality measures, and it will be important to understand and implement for CQM computation, in both meaningful use and population health. However, its current form might allow complexity that is intractable for current database systems (both in terms of implementation and computation). Our translator, which supports the subset of HQMF currently expressible in i2b2-XML, may represent the beginnings of a practical compromise. It is being pilot-tested in two Query Health demonstration projects, and it can be further expanded to balance computational tractability with the advanced features needed by measure developers.
Murphy, Shawn N
Clinical research informatics is the rapidly evolving sub-discipline within biomedical informatics that focuses on developing new informatics theories, tools, and solutions to accelerate the full translational continuum: basic research to clinical trials (T1), clinical trials to academic health center practice (T2), diffusion and implementation to community practice (T3), and ‘real world’ outcomes (T4). We present a conceptual model based on an informatics-enabled clinical research workflow, integration across heterogeneous data sources, and core informatics tools and platforms. We use this conceptual model to highlight 18 new articles in the JAMIA special issue on clinical research informatics.
Like many forms of education, health professions education is increasingly competency-based. At the same time, there is growing use of e-learning technologies, which can be linked to competencies via emerging e-learning standards. Health care has been slow to adopt competencies and e-learning standards. We report our efforts to facilitate access to competencies and e-learning content in the medical informatics domain, linked by content-competency associations, based on standards developed by the MedBiquitous Consortium. We demonstrate that such standards can be successfully used and their implementation in other domains is warranted.
Hersh, William R.; Bhupatiraju, Ravi Teja; Greene, Peter S.; Smothers, Valerie; Cohen, Cheryl
Like many forms of education, health professions education is increasingly competency-based. At the same time, there is growing use of e-learning technologies, which can be linked to competencies via emerging e-learning standards. Health care has been slow to adopt competencies and e-learning standards. We report our efforts to facilitate access to competencies and e-learning content in the medical informatics domain, linked by content-competency associations, based on standards developed by the MedBiquitous Consortium. We demonstrate that such standards can be successfully used and their implementation in other domains is warranted. PMID:17238358
Hersh, William R; Bhupatiraju, Ravi Teja; Greene, Peter; Smothers, Valerie; Cohen, Cheryl
The informatics moment is the moment when a person seeks help in using some digital technology that is new to him or her. This article examines the informatics moment in people's everyday lives as they sought help at a branch public library. Four types of literacy were involved: basic literacy (reading and writing), computer literacy (use of a…
Global trade and international trade agreements have transformed the capacity of governments to monitor and to protect public health, to regulate occupational and environmental health conditions and food products, and to ensure affordable access to medications. Proposals under negotiation for the World Trade Organization’s General Agreement on Trade in Services (GATS) and the regional Free Trade Area of the Americas (FTAA) agreement cover a wide range of health services, health facilities, clinician licensing, water and sanitation services, and tobacco and alcohol distribution services. Public health professionals and organizations rarely participate in trade negotiations or in resolution of trade disputes. The linkages among global trade, international trade agreements, and public health deserve more attention than they have received to date.
Shaffer, Ellen R.; Waitzkin, Howard; Brenner, Joseph; Jasso-Aguilar, Rebeca
Global trade and international trade agreements have transformed the capacity of governments to monitor and to protect public health, to regulate occupational and environmental health conditions and food products, and to ensure affordable access to medications. Proposals under negotiation for the World Trade Organization's General Agreement on Trade in Services (GATS) and the regional Free Trade Area of the Americas (FTAA) agreement cover a wide range of health services, health facilities, clinician licensing, water and sanitation services, and tobacco and alcohol distribution services. Public health professionals and organizations rarely participate in trade negotiations or in resolution of trade disputes. The linkages among global trade, international trade agreements, and public health deserve more attention than they have received to date. PMID:15623854
Shaffer, Ellen R; Waitzkin, Howard; Brenner, Joseph; Jasso-Aguilar, Rebeca
Radiology and public health have an emerging opportunity to collaborate, in which radiology's vast supply of imaging data can be integrated into public health information systems for epidemiologic assessments and responses to population health problems. Fueling the linkage of radiology and public health include (i) the transition from analog film to digital formats, enabling flexible use of radiologic data; (ii)
Daniel J. Mollura; John A. Carrino; Diane L. Matuszak; Zaruhi R. Mnatsakanyan; John Eng; Protagoras Cutchis; Steven M. Babin; Carol Sniegoski; Joseph S. Lombardo
Chronic diseases are a growing burden to people, to health-care systems and to societies across the world. The rapid increase in the burden of chronic diseases is particularly prevalent in the developing countries. Periodontal disease is one of the two most important oral diseases contributing to the global burden of chronic disease. In addition to social determinants, periodontal health status is related to several proximal factors. Modifiable risk factors, such as tobacco use, excessive alcohol consumption, poor diet and nutrition, obesity, psychological stress and insufficient personal/oral hygiene, are important and these principal risk factors for periodontal disease are shared by other chronic diseases. The present monograph is devoted to the existing evidence on the practice of public health related to periodontal health. Public health is defined as the process of mobilizing and engaging local, national and international resources to assure that people can be healthy. Social determinants of health, environmental hazards and unhealthy lifestyles are prioritized in modern public health-care. Disease prevention and health promotion are cornerstones in actions for public health. This volume of Periodontology 2000 is entitled ‘Periodontal health and global public health’; the 12 articles of this volume discuss different aspects of this statement. It covers a range of subjects from public health issues to patient care. This monograph intends to stimulate community action research in the field of periodontology in order to help the development of appropriate public health intervention and relevant surveillance programs. It also expects to stimulate health authorities and professional organizations to initiate and support actions to promote periodontal health in their respective countries. PMID:22909103
Petersen, Poul E; Baehni, Pierre C
‘Sustainability’ has become a central criterion used by funders – including foundations, governmental agencies and international agencies – in evaluating public health programmes. The criterion became important as a result of frustration with discontinuities in the provision of care. As a result of its application, projects that involve building infrastructure, training or relatively narrow objectives tend to receive support. In
Alice Yang; Paul E. Farmer; Anita M. McGahan
Don E. Detmer has served as President and Chief Executive Officer of the American Medical Informatics Association (AMIA) for the past five years, helping to set a course for the organization and demonstrating remarkable leadership as AMIA has evolved into a vibrant and influential professional association. On the occasion of Dr. Detmer's retirement, we fondly reflect on his professional life and his many contributions to biomedical informatics and, more generally, to health care in the U.S. and globally.
Shortliffe, Edward H.; Bates, David W.; Bloomrosen, Meryl; Greenwood, Karen; Safran, Charles; Steen, Elaine B.; Tang, Paul C.; Williamson, Jeffrey J.
The prevailing view of medical informatics as a primarily subservient discipline in health care is challenged. Developments in both general informatics and medical informatics are described to identify desirable properties of modeling languages and tools needed to solve key problems in the application field. For progress in medical informatics, it is considered essential to develop far more formal modeling languages, modeling techniques, and tools. A major aim of this development should be to expel ambiguity from concepts essential to medicine, positioning medical informatics “at the heart of health care.”
van der Maas, Arnoud A.F.; Ten Hoopen, A. Johannes; Ter Hofstede, Arthur H.M.
Personalization of healthcare has a number of claimants, including pHealth. However, to the citizen real personalization is the delivery of integrated support services to maintain their health and well-being, particularly in times of chronic illness and frailty. The integration of health and social care support has been identified a key but challenging step in this. The pHealth community faces the choice either of reinforcing the isolation of silos of care and thus fragmentation of service, or of seeking to become a unifying agent though thoughtful and considered development of sharing of monitoring from pHealth devices. PMID:22942029
Online courses will play a key role in the high-volume Informatics education required to train the personnel that will be necessary to fulfill the health IT needs of the country. Online courses can cause feelings of isolation in students. A common way to address these feelings is to hold synchronous online “chats” for students. Conventional chats, however, can be confusing and impose a high extrinsic cognitive load on their participants that hinders the learning process. In this paper we present a qualitative analysis that shows the causes of this high cognitive load and our solution through the use of a moderated chat system.
Herskovic, Jorge R.; Goodwin, J. Caleb; Bozzo Silva, Pamela A.; Willcockson, Irmgard; Franklin, Amy
Background: The current generation of medical students are the Net Generation. However there is a dearth of data on their Internet use to inform universities' approaches to using the Internet, especially Web 2.0, most effectively in medical education .In particular, we have little information on students' skills base to use in planning to build greater informatics capacity in the Australian
Kathleen Gray; Gregor Kennedy; Terry Judd
Whilst most health care is delivered to people living at home, the focus of innovation in health informatics concepts has been largely on acute hospitals. However, delivery of services in community settings, and often related to long-term conditions, is complex, and involves multiple professions and agencies, delivery of care in several locations including home settings, and individually tailored care for
The disciplines of health information management (HIM) and biomedical informatics (BMI) have many historical differences from the content of their educational programs to the level offered (i.e., graduate vs. undergraduate). As the adoption of the electronic health record (EHR) grows, however, the two fields share increasingly similar interests, competencies, and educational programs. In our effort to establish an HIM track in our BMI graduate program, leading to Registered Health Information Administrator (RHIA) certification, we had to compare our BMI curriculum with the American Health Information Management Association (AHIMA) knowledge clusters. We present the results of our analysis, which provide insights into the similarities and differences between such curricula. These results show that existing BMI courses met several of the knowledge clusters, which means that only a few additional courses need to be developed. PMID:18999208
Valerius, Joanne D; Hersh, William R
Summary Consumers of online health information are concerned with issues of quality and trust. No sites presently offer comprehensive child health information and tools for families seeking solutions to complex questions that may involve disease, lifestyle, behavioral, and educational issues. Parents of children with complex health issues as well as parents of typically developing children, need a trusted, comprehensive online resource to inform and guide. To meet this need, The Hospital for Sick Children, with the support of founding sponsor TD Securities, launched a unique initiative, AboutKidsHealth in June2004. The project employs web technology combined with social marketing campaigns to promote and deliver evidence-based information and programmes in all major areas influencing child health and family quality of life. The web-based infrastructure will also be used to support selected research projects, and to provide enhanced communication and services for families of children with complex conditions and health professionals.
Hetherington, Ross; James, Andrew; O'Neill, Angela; Meighan, Kimberly; Shaw, Brian
There is a tension between the preservation of academic freedom and the economic context in which the university currently finds itself. This tension embodies serious threats to global health as a result of three overlapping phenomena which impede the production and diffusion of valuable knowledge about health. These phenomena, the privatisation, commercialisation and instrumentalisation of knowledge are identified and examined in this paper in relation to human rights and international morality. PMID:21737839
Public health organizations in different nations face similar needs for gathering and analyzing population health data to detect and manage infectious disease outbreaks, including outbreaks of the 2009 Novel H1N1 Influenza A virus or "swine flu." This paper presents our progress to date on the design and assessment of a multi-national public health informatics infrastructure for data collection and disease surveillance. This initial work, under the aegis of an open health tools collaborative, lays the foundation for best practices in patient care and public health preparedness in the national health IT sector. This multinational collaboration is the first to identify essential electronic health record (EHR) data sets as well as standard public health informatics indicators to electronically monitor a notifiable public health condition internationally. PMID:20841727
Advani, Aneel; Turuvekere, Aarti M; Liu, Conan; Rubin, Ken; Lamer, Chris; Cullen, Theresa
|Discusses museum informatics that studies how information science and technology affect the museum environment. Examines digital technology; information organization and access; digitization, personal computers, and the Internet; data sharing; standards; social impacts of new technologies; collaboration; consortia; multimedia exhibits; virtual…
Marty, Paul F.; Rayward, W. Boyd; Twidale, Michael B.
Distributed computing harnesses the power of thousands of computers within organisations or over the Internet. In order to tackle global health problems, several groups of researchers have begun to use this approach to exceed by far the computing power of a single lab. This event illustrates how companies, research institutes and the general public are contributing their computing power to
Vincent Breton; Torsten Schwede; Celia Moore; Thomas E Smith; Brian Williams; François Grey
Violent conflict for political ends, including war and civil war, is a major cause of mental ill health and although there are different approaches and ways to understand this relationship some consensus is emerging on the psychological, social and cross sector responses to post conflict situations. Globalization has changed the relationships of nation states, corporations and international organizations creating different
|Provides a brief survey of informatics, defined as the application of information technology to various fields, with respect to its historical background, disciplinary identity, fundamental aspects, applications, and challenges. Highlights include biological, clinical, dental, environmental, geomatics, health, legal, management, medical, museum,…
Provides a brief survey of informatics, defined as the application of information technology to various fields, with respect to its historical background, disciplinary identity, fundamental aspects, applications, and challenges. Highlights include biological, clinical, dental, environmental, geomatics, health, legal, management, medical, museum,…
|This document provides an overview of the various telecommunications and information technologies available for rural communities to use in their health care systems. The first section explains the principal technologies of telecommunications such as the telephone, computer networking, audiographics, and video. It describes transmission systems…
Western Interstate Commission for Higher Education, Boulder, CO. Western Cooperative for Educational Communications.
The NCI Center for Global Health's Dr. Ted Trimble, Dr. Sudha Sivaram, and Kalina Duncan traveled to New Delhi, India for the End Game for Tobacco, Cancer Screening Workshop. The key goals for this visit were to support and facilitate the NCI-specific initiative to train tobacco control scientists, from low and middle income countries (LMICs), in the field of translational tobacco control research, and to facilitate interaction between NCI grantees and LMIC scientists.
In 2008, there were 12.4 million new cancer cases and 7.6 million cancer-related deaths worldwide. The World Health Organization (WHO) projected that by 2030, these figures could increase to 26.4 million new cases and 17 million cancer-related deaths. The majority of the global cancer burden is shifting from the more developed world to economically disadvantaged countries.
The purpose of this paper is to argue for an integration of cognitive and socio-technical approaches to assessing the impact of health information systems. Historically, health informatics research has examined the cognitive and socio-technical aspects of health information systems separately. In this paper we argue that evaluations of health information systems should consider aspects related to cognition as well as socio-technical aspects including impact on workflow (i.e. an integrated view). Using examples from the study of technology-induced error in healthcare, we argue for the use of simulations to evaluate the cognitive-socio-technical impacts of health information technology . Implications of clinical simulations and analysis of cognitive-social-technical impacts are discussed within the context of the system development life cycle to improve health information system design, implementation and evaluation.
Borycki, E.M; Kushniruk, A.W
A growing number of health care professionals (e.g., physicians, nurses, librarians, and administrators) desire to enhance their skills and knowledge in medical informatics. These individuals are usually in established careers with limited time as well as inability to relocate to one of the small number of health science universities which offer informatics training. As a result of inquiries about distance learning in medical informatics and a market survey which documented and detailed such interest, a distance learning program was launched by the medical informatics program at Oregon Health Sciences University (OHSU). In the 1999-2000 academic year, two graduate-level medical informatics courses in the OHSU program have been taught by distance learning. In the 2000-2001 academic year, an eight-course certificate program will be launched. Further information can be found at: http://www. ohsu.edu/bicc-informatics/distance/
Globalization presents nurses with the challenges and an ethical responsibility of being competent caregivers within a global society. The link between globalization and global health, and the contributions nursing can make to the global health environment are described in the delivery of a new required course for undergraduate nursing students in a four year degree program. Innovative approaches for the delivery of this course are described, which even though living locally, can encourage nursing students to think globally. The need for nursing programs to acknowledge the shared responsibilities for examining global health challenges is now part of our reality in many countries. PMID:23433848
Macneil, Joan; Ryan, Maureen
Background Current definitions of 'global health' lack specificity about the term 'global'. This debate presents and discusses existing definitions of 'global health' and a common problem inherent therein. It aims to provide a way forward towards an understanding of 'global health' while avoiding redundancy. The attention is concentrated on the dialectics of different concepts of 'global' in their application to malnutrition; HIV, tuberculosis & malaria; and maternal mortality. Further attention is payed to normative objectives attached to 'global health' definitions and to paradoxes involved in attempts to define the field. Discussion The manuscript identifies denotations of 'global' as 'worldwide', as 'transcending national boundaries' and as 'holistic'. A fourth concept of 'global' as 'supraterritorial' is presented and defined as 'links between the social determinants of health anywhere in the world'. The rhetorical power of the denotations impacts considerably on the object of 'global health', exemplified in the context of malnutrition; HIV, tuberculosis & malaria; and maternal mortality. The 'global' as 'worldwide', as 'transcending national boundaries' and as 'holistic' house contradictions which can be overcome by the fourth concept of 'global' as 'supraterritorial'. The 'global-local-relationship' inherent in the proposed concept coheres with influential anthropological and sociological views despite the use of different terminology. At the same time, it may be assembled with other views on 'global' or amend apparently conflicting ones. The author argues for detaching normative objectives from 'global health' definitions to avoid so called 'entanglement-problems'. Instead, it is argued that the proposed concept constitutes an un-euphemistical approach to describe the inherently politicised field of 'global health'. Summary While global-as-worldwide and global-as-transcending-national-boundaries are misleading and produce redundancy with public and international health, global-as-supraterritorial provides 'new' objects for research, education and practice while avoiding redundancy. Linked with 'health' as a human right, this concept preserves the rhetorical power of the term 'global health' for more innovative forms of study, research and practice. The dialectic approach reveals that the contradictions involved in the different notions of the term 'global' are only of apparent nature and not exclusive, but have to be seen as complementary to each other if expected to be useful in the final step.
The increasing ubiquity of digital technology, internet services and social media in our everyday lives allows for a seamless transitioning between the visible and the invisible infrastructure of cities: road systems, building complexes, information and communication technology, and people networks create a buzzing environment that is alive and exciting. Driven by curiosity, initiative and interdisciplinary exchange, the Urban Informatics Research
Marcus Foth; Jaz Hee-jeong Choi; Christine Satchell
Growth in global health interest in the past 20 years has been overwhelming and many universities throughout the world have created departments or institutes of global health. The essence of global health has to be promoting health equity globally. The global health agenda must embrace design of mixed health systems, involving both private and public components to address the emerging threat of noncommunicable diseases and existing communicable diseases as well as to reduce health inequity. The priority agenda for the twenty-first century is challenging but the improvements of the past give hope that the barriers to improving global health are surmountable. PMID:21628045
Alleyne, George A O
SUMMARY This paper explores the importance for health promotion of the rise of public health as a foreign policy issue. Although health promotion encompassed foreign policy as part of 'healthy public policy', mainstream foreign policy neglected public health and health promotion's role in it. Globalization forces health promotion, however, to address directly the relationship between public health and foreign policy.
DAVID P. FIDLER
This article explores the impact of globalization and neo-liberal reforms on the health of Venezuelans and Cubans during the 1980s and 1990s. It seeks to illustrate, through the lens of health care, how global economic forces affect national development and people's lives. Venezuela and Cuba struggled with severe economic crises and their health systems suffered. Cuba, however, was able to
George W. Schuyler
Despite the huge personal and social impact of mental illnesses, mental health globally is widely neglected and marginalised.\\u000a A conceptual change in thinking, from the biomedical to a public health model, is essential for integrating mental health\\u000a services into health systems across the globe. This article discusses the burden of mental health globally, resources available\\u000a to tackle the massive burden,
Benedetto Saraceno; Tarun Dua
Polymers are arguably the most important set of materials in common use. The increasing adoption of both combinatorial as well as high-throughput approaches, coupled with an increasing amount of interdisciplinarity, has wrought tremendous change in the field of polymer science. Yet the informatics tools required to support and further enhance these changes are almost completely absent. In the first part of the chapter, a critical analysis of the challenges facing modern polymer informatics is provided. It is argued, that most of the problems facing the field today are rooted in the current scholarly communication process and the way in which chemists and polymer scientists handle and publish data. Furthermore, the chapter reviews existing modes of representing and communicating polymer information and discusses the impact, which the emergence of semantic technologies will have on the way in which scientific and polymer data is published and transmitted. In the second part, a review of the use of informatics tools for the prediction of polymer properties and in silico design of polymers is offered.
The promise of health information technology (HIT) has led to call s for a larger and better trained wor k- force in medical informatics. University programs in applied health and biomedical informatics have been evolving in an effort to address the need for healt h- care professionals to be trained in informatics. One such evolution is the American Medical Informatics
Sue S. Feldman; William Hersh
A review of the status and problems of international health education considers the effects of the economy on health expenditures and problems and the extent of education. Health education can begin to achieve greater bases for global health when it educates maximal health care users of counterproductive expenditures for health in the United…
Text VersionPage 1. FDA Science Advisory Board Global Health Subcommittee Jeff Bender University of Minnesota School of Public Health and ... More results from www.fda.gov/downloads/advisorycommittees/committeesmeetingmaterials
About 14% of the global burden of disease has been attributed to neuropsychiatric disorders, mostly due to the chronically disabling nature of depression and other common mental disorders, alcohol-use and substance-use disorders, and psychoses. Such estimates have drawn attention to the importance of mental disorders for public health. However, because they stress the separate contributions of mental and physical disorders
Martin Prince; Vikram Patel; Shekhar Saxena; Mario Maj; Joanna Maselko; Michael R Phillips; Atif Rahman
The largest absolute numbers of maternal deaths occur among the 40-50 million women who deliver annually without a skilled birth attendant. Most of these deaths occur in countries with a total fertility rate of greater than 4. The combination of global warming and rapid population growth in the Sahel and parts of the Middle East poses a serious threat to reproductive health and to food security. Poverty, lack of resources, and rapid population growth make it unlikely that most women in these countries will have access to skilled birth attendants or emergency obstetric care in the foreseeable future. Three strategies can be implemented to improve women's health and reproductive rights in high-fertility, low-resource settings: (1) make family planning accessible and remove non-evidenced-based barriers to contraception; (2) scale up community distribution of misoprostol for prevention of postpartum hemorrhage and, where it is legal, for medical abortion; and (3) eliminate child marriage and invest in girls and young women, thereby reducing early childbearing. PMID:22883918
Potts, Malcolm; Henderson, Courtney E
Objective: Contemporary health care places enormous health information management demands on laypeople. Insights into their skills and habits complements current developments in consumer health innovations, including personal health records. Using a five-element human factors model of work, health information management in the household (HIMH) is characterized by the tasks completed by individuals within household organizations, using certain tools and technologies in a given physical environment. Design: We conducted a descriptive-exploratory study of the work of HIMH, involving 49 community-dwelling volunteers from a rural Midwestern community. Measurements: During in-person interviews, we collected data using semistructured questionnaires and photographs of artifacts used for HIMH. Results: The work of HIMH is largely the responsibility of a single individual, primarily engaged in the tasks of acquiring, managing, and organizing a diverse set of health information. Paper-based tools are most common, and residents develop strategies for storing information in the household environment aligned with anticipated use. Affiliative relationships, e.g., parent-child or spousal, within the household serve as the organization that gives rise to health information management practices. Synthesis of these findings led to identification of several storage strategies employed in HIMH. These strategies are labeled “just-in-time,” “just-because,” “just-in-case,” and “just-at-hand,” reflecting location of the artifacts of health information and anticipated urgency in the need to retrieve it. Conclusion: Laypeople develop and employ robust, complex strategies for managing health information in the home. Capitalizing on these strategies will complement and extend current consumer health innovations to provide functional support to people who face increasing demands to manage personal health information.
Moen, Anne; Brennan, Patricia Flatley
Prediction of the impacts of global climate change on health is complicated by a number of factors. These include: the difficulty in predicting regional changes in climate, the capacity for adaptation to climate change, the interactions between the effects of global climate change and a number of other key determinants of health, including population growth and poverty, and the availability
A. Haines; M. Parry
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The emerging eld of Ecosystem Informatics applies meth- ods from computer science and mathematics to address fundamental and applied problems in the ecosystem sciences. The ecosystem sciences are in the midst of a revolution driven by a combination of emerging tech- nologies for improved sensing and the critical need for better science to help manage global climate change. This paper
Thomas G. Dietterich
With the emergence of global health comes governance challenges which are equally global in nature. This article identifies some of the initial limitations in analyses of global health governance (GHG) before discussing the focus of this special supplement: the framing of global health issues and the manner in which this impacts upon GHG. Whilst not denying the importance of material factors (such as resources and institutional competencies), the article identifies how issues can be framed in different ways, thereby creating particular pathways of response which in turn affect the potential for and nature of GHG. It also identifies and discusses the key frames operating in global health: evidence-based medicine, human rights, security, economics and development. PMID:23113870
McInnes, Colin; Kamradt-Scott, Adam; Lee, Kelley; Reubi, David; Roemer-Mahler, Anne; Rushton, Simon; Williams, Owain David; Woodling, Marie
More than 2,000 people convened for the ninth annual Global Health and Innovation Conference at Yale University on April 21-22, 2012. Participants discussed the latest innovations, ideas in development, lessons learned, opportunities and challenges in global health activities. Several themes emerged, including the important role of frontline workers, strengthening health systems, leveraging social media, and sustainable and impact-driven philanthropy. Overall, the major outcome of the conference was the increased awareness of the potential of mobile technologies and social enterprises in transforming global health. Experts warned that donations and technological advances alone will not transform global health unless there are strong functioning health infrastructures and improved workforce. It was noted that there is a critical need for an integrated systems approach to global health problems and a need for scaling up promising pilot projects. Lack of funding, accountability, and sustainability were identified as major challenges in global health. PMID:23012591
Objective To report the results of a needs assessment of research and training in Medical Informatics (MI) and Bioinformatics (BI) in Latin America. Methods and results This assessment was conducted by QUIPU: The Andean Global Health Informatics Research and Training Center. After sending email invitations to MI–BI related professionals from Latin America, 142 surveys were received from 11 Latin American countries. The following were the top four ranked MI-related courses that a training programme should include: introduction to biomedical informatics; data representation and databases; mobile health; and courses that address issues of security, confidentiality and privacy. Several new courses and topics for research were suggested by survey participants. The information collected is guiding the development of curricula and a research agenda for the MI and BI QUIPU multidisciplinary programme for the Andean Region and Latin America.
Blas, Magaly M; Curioso, Walter H; Zimic, Mirko; Carcamo, Cesar P; Castagnetto, Jesus M; Lescano, Andres G; Lopez, Diego M
Objective To report the results of a needs assessment of research and training in Medical Informatics (MI) and Bioinformatics (BI) in Latin America. Methods and results This assessment was conducted by QUIPU: The Andean Global Health Informatics Research and Training Center. After sending email invitations to MI-BI related professionals from Latin America, 142 surveys were received from 11 Latin American countries. The following were the top four ranked MI-related courses that a training programme should include: introduction to biomedical informatics; data representation and databases; mobile health; and courses that address issues of security, confidentiality and privacy. Several new courses and topics for research were suggested by survey participants. The information collected is guiding the development of curricula and a research agenda for the MI and BI QUIPU multidisciplinary programme for the Andean Region and Latin America. PMID:22080537
Blas, Magaly M; Curioso, Walter H; Garcia, Patricia J; Zimic, Mirko; Carcamo, Cesar P; Castagnetto, Jesus M; Lescano, Andres G; Lopez, Diego M
Background Pain is an enormous problem globally. Estimates suggest that 20% of adults suffer from pain globally and 10% are newly diagnosed with chronic pain each year. Nevertheless, the problem of pain has primarily been regarded as a medical problem, and has been little addressed by the field of public health. Discussion Despite the ubiquity of pain, whether acute, chronic or intermittent, public health scholars and practitioners have not addressed this issue as a public health problem. The importance of viewing pain through a public health lens allows one to understand pain as a multifaceted, interdisciplinary problem for which many of the causes are the social determinants of health. Addressing pain as a global public health issue will also aid in priority setting and formulating public health policy to address this problem, which, like most other chronic non-communicable diseases, is growing both in absolute numbers and in its inequitable distribution across the globe. Summary The prevalence, incidence, and vast social and health consequences of global pain requires that the public health community give due attention to this issue. Doing so will mean that health care providers and public health professionals will have a more comprehensive understanding of pain and the appropriate public health and social policy responses to this problem.
The examination of public health law traditionally focuses on constitutions, statutes, regulations, and common law at the national and sub-national level. However, the determinants of health (e.g., pathogens, air, food, water, even lifestyle choices) do not originate solely within national borders. Health threats inexorably spread to neighboring countries, regions, and even continents. Peoples’ lives are profoundly affected by commerce, politics,
Lawrence O. Gostin
Health literacy, cited as essential to achieving Healthy People 2010's goals to "increase quality and years of healthy life" and to "eliminate health disparities," is defined by Healthy People as "the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions." Accessibility, by definition, the aforementioned "capacity to obtain," thus is health literacy's primary prerequisite. Accessibility's designation as the global gateway to health literacy is predicated also on life's realities: global aging and climate change, war and terrorism, and life-extending medical and technological advances. People with diverse access needs are health professionals' raison d'être. However, accessibility, consummately cross-cultural and universal, is virtually absent as a topic of health promotion and practice research and scholarly discussion of health literacy and equity. A call to action to place accessibility in its rightful premier position on the profession's agenda is issued. PMID:18955546
This paper presents the rationale for designing and implementing the next-generation of public health information systems using grid computing concepts and tools. Our attempt is to evaluate all grid types including data grids for sharing information and computational grids for accessing computational resources on demand. Public health is a broad domain that requires coordinated uses of disparate and heterogeneous information
Catherine J Staes; Wu Xu; Samuel D LeFevre; Ronald C Price; Scott P Narus; Adi Gundlapalli; Robert Rolfs; Barry Nangle; Matthew Samore; Julio C Facelli
The Global Health Network, an Internet "global training programme in public health," directed by Ronald E. LaPorte of the Graduate School of Public Health at the University of Pittsburg, and Shunichi Akazawa of the World Health Organization, among others, has recently released this new online Epidemiology course. The course consists of seventeen annotated slide based lectures at this time, including Disease Monitoring, An Introduction to Health Economics, Malaria, and Nutrition and Global Health, among others. Lectures contain between fifteen and 50 slides, and are accompanied by varying numbers of hypertext connections to relevant sites and documents. The first lecture has been peer reviewed and is available in eight languages. The remaining lectures (English only) are accompanied by calls for comments. Each lecture is also available in PowerPoint format, so that the content, if not the hyperlinks, can be used without an Internet connection.
Global health should encompass circumpolar health if it is to transcend the traditional approach of the "rich North" assisting the "poor South." Although the eight Arctic states are among the world's most highly developed countries, considerable health disparities exist among regions across the Arctic, as well as between northern and southern regions and between indigenous and nonindigenous populations within some of these states. While sharing commonalities such as a sparse population, geographical remoteness, harsh physical environment, and underdeveloped human resources, circumpolar regions in the northern hemisphere have developed different health systems, strategies, and practices, some of which are relevant to middle and lower income countries. As the Arctic gains prominence as a sentinel of global issues such as climate change, the health of circumpolar populations should be part of the global health discourse and policy development. PMID:22594729
Chatwood, Susan; Bjerregaard, Peter; Young, T Kue
The Global Health Beyond 2015 was organized in Stockholm in April 2013, which was announced as public engagement and where the dialogue focused on three main themes: social determinants of health, climate change and the non-communicable diseases. This event provided opportunity for both students and health professionals to interact and brainstorm ideas to be formalized into Stockholm Declaration on Global Health. Amongst the active participation of various health professionals, one that was found significantly missing was that of oral health. Keeping this as background in this debate, a case for inclusion of oral health professions is presented by organizing the argument in four areas: education, evidence base, political will and context and what each one offers at a time when Scandinavia is repositioning itself in global health. PMID:23863132
Global health financing has increased dramatically in recent years, indicative of a rise in health as a foreign policy issue. Several governments have issued specific foreign policy statements on global health and a new term, global health diplomacy, has been coined to describe the processes by which state and non-state actors engage to position health issues more prominently in foreign policy decision-making. Their ability to do so is important to advancing international cooperation in health. In this paper we review the arguments for health in foreign policy that inform global health diplomacy. These are organized into six policy frames: security, development, global public goods, trade, human rights and ethical/moral reasoning. Each of these frames has implications for how global health as a foreign policy issue is conceptualized. Differing arguments within and between these policy frames, while overlapping, can also be contradictory. This raises an important question about which arguments prevail in actual state decision-making. This question is addressed through an analysis of policy or policy-related documents and academic literature pertinent to each policy framing with some assessment of policy practice. The reference point for this analysis is the explicit goal of improving global health equity. This goal has increasing national traction within national public health discourse and decision-making and, through the Millennium Development Goals and other multilateral reports and declarations, is entering global health policy discussion. Initial findings support conventional international relations theory that most states, even when committed to health as a foreign policy goal, still make decisions primarily on the basis of the 'high politics' of national security and economic material interests. Development, human rights and ethical/moral arguments for global health assistance, the traditional 'low politics' of foreign policy, are present in discourse but do not appear to dominate practice. While political momentum for health as a foreign policy goal persists, the framing of this goal remains a contested issue. The analysis offered in this article may prove helpful to those engaged in global health diplomacy or in efforts to have global governance across a range of sectoral interests pay more attention to health equity impacts. PMID:20727211
Labonté, Ronald; Gagnon, Michelle L
Disease has traveled with goods and people since the earliest times. Armed globalization spread disease, to the extent of eliminating entire populations. The geography of disease shaped patterns of colonization and industrialization throughout the now poor world. Many see related threats to public health from current globalization. Multilateral and bilateral trade agreements do not always adequately represent the interests of
The One Health approach, which recognizes the interconnectedness of human, animal and ecosystem health, encourages collaboration between diverse disciplines to address complex health problems. The advantages and challenges posed by these interdisciplinary collaborations are described in this review. Learning networks where diverse participants can openly share processes, best practices, and case studies are discussed as a strategy for conducting transdisciplinary One Health research and tackling complex global health problems. The 11 papers in this special issue are also introduced as they illustrate how a One Health approach can be applied to better understand and control zoonotic pathogens, engage community stakeholders in One Health research and utilize wildlife species, most notably sea otters and birds, as sentinels of ecosystem health. Collaboration is rarely without complications; however, drawing on these insights may benefit the process of operationalizing the One Health approach to address today's global health challenges. PMID:23711930
Conrad, Patricia A; Meek, Laura A; Dumit, Joe
To improve on-orbit clinical capabilities by developing and providing operational support for intelligent, robust, reliable, and secure, enterprise-wide and comprehensive health care and biomedical informatics systems with increasing levels of autonomy, f...
K. A. Johnson-Throop
This review describes recent experimental and focus group research on graphics as a method of communication about quantitative health risks. Some of the studies discussed in this review assessed effect of graphs on quantitative reasoning, others assessed effects on behavior or behavioral intentions, and still others assessed viewers’ likes and dislikes. Graphical features that improve the accuracy of quantitative reasoning
Jessica S. Ancker; Yalini Senathirajah; Rita Kukafka; Justin B. Starren
Social network services are becoming increasingly popular, and people are using these networks to obtain and share information. The application of social network and social media to the collection, storage and review of personal information presents opportunities for improved personal health management. This paper presents a survey of the literature on the models for the use of online social networks
Noreen Kamal; Sidney Fels; Kendall Ho
There are three areas of potential legal exposure for an organization such as a trustmark authority involved in e-health quality rating. First, an e-health provider may make a complaint about negative or impliedly negative ratings rendered by the ratings body (false negative). Typically, a negative ratings complaint would rely on defamation or product disparagement causes of action. In some cases such complaints could be defended on the basis of absence of malice (US). Second, the rating body might render a positive rating on e-health data that a third party allegedly relied upon and suffered injury (false positive). While the primary cause of action would be against the e-health data provider, questions may arise as to the possible liability of the trustmark authority. For example, some US liability exposure is possible based on cases involving the potential liability of product warrantors, trade associations, and certifiers or endorsers. Third, a ratings body may face public law liability for its own web misfeasance. Several risk management approaches are possible and would not necessarily be mutually exclusive. These approaches will require careful investigation to assess their risk reduction potential and, in some cases, the introduction of legislation.
BACKGROUND: The 1980s marked the occasion when Geographical Information System (GIS) technology was broadly introduced into the geo-spatial community through the establishment of a strong GIS industry. This technology quickly disseminated across many countries, and has now become established as an important research, planning and commercial tool for a wider community that includes organisations in the public and private health
Tony Mathys; Maged N Kamel Boulos
Over the last 100 years the average temperature on the Earth has risen approximately 1ºFahrenheit (F), increasing at a rate twice as fast as has been noted for any period in the last 1,000 years. The Arctic ice cap is shrinking, glaciers are melting, and the Arctic permafrost is thawing. There is mounting evidence that these global climate changes are already affecting human health. This article provides a brief overview of global warming and climate changes, discusses effects of climate change on health, considers the factors which contribute to climate changes, and reviews individual and collective efforts related to reducing global warming. PMID:21848352
Afzal, Brenda M
The last two decades have witnessed the emergence and consolidation of an economic paradigm which emphasizes domestic deregulation and the removal of barriers to international trade and finance. If properly managed, such an approach can lead to perceptible gains in health status. Where markets are non-exclusionary, regulatory institutions strong and safety nets in place, globalization enhances the performance of countries with a good human and physical infrastructure but narrow domestic markets. Health gains in China, Costa Rica, the East Asian "tiger economies" and Viet Nam can be attributed in part to their growing access to global markets, savings and technology. However, for most of the remaining countries, many of them in Africa, Latin America and Eastern Europe, globalization has not lived up to its promises due to a combination of poor domestic conditions, an unequal distribution of foreign investments and the imposition of new conditions further limiting the access of their exports to the OECD markets. In these developing countries, the last twenty years have brought about a slow, unstable and unequal pattern of growth and stagnation in health indicators. Autarky is not the answer to this situation, but neither is premature, unconditional and unselective globalization. Further unilateral liberalization is unlikely to help them to improve their economic performance and health conditions. For them, a gradual and selective integration into the world economy linked to the removal of asymmetries in global markets and to the creation of democratic institutions of global governance is preferable to instant globalization.
Cornia, G. A.
If the field of global health is to evolve in the second decade of the new millennium, we need to revive the idealistic spirit and by using the lens of health equity work toward improved health status around the world. Morality and empathy are considered by-products of our evolutionary history as a human species. Idealism may be a trait that we may choose to preserve in our modern evolutionary history. PMID:21513081
Franco-Paredes, Carlos; Zeuli, Julia; Hernández-Ramos, Isabel; Santos-Preciado, Jose I
Prediction of the impacts of global climate change on health is complicated by a number of factors. These include: the difficulty in predicting regional changes in climate, the capacity for adaptation to climate change, the interactions between the effects of global climate change and a number of other key determinants of health, including population growth and poverty, and the availability of adequate preventive and curative facilities for diseases that may be effected by climate change. Nevertheless, it is of importance to consider the potential health impacts of global climate change for a number of reasons. It is also important to monitor diseases which could be effected by climate change in order to detect changes in incidence as early as possible and study possible interactions with other factors. It seems likely that the possible impacts on health of climate change will be a major determinant of the degree to which policies aimed at reducing global warming are followed, as perceptions of the effect of climate change to human health and well-being are particularly likely to influence public opinion. The potential health impacts of climate change can be divided into direct (primary) and indirect (secondary and tertiary) effects. Primary effects are those related to the effect of temperature on human well-being and disease. Secondary effects include the impacts on health of changes in food production, availability of water and of sea level rise. A tertiary level of impacts can also be hypothesized.
Haines, A. (Univ. College London Medical School, London (United Kingdom). Whittington Hospital); Parry, M. (Univ. of Oxford (United Kingdom). Environmental Change Unit)
Within health and health care, medical informatics and its subspecialties of biomedical, clinical, and public health informatics have emerged as a new discipline with increasing demands for its own work force. Knowledge and skills in medical informatics are widely acknowledged as crucial to future success in patient care, research relating to biomedicine, clinical care, and public health, as well as health policy design. The maturity of the domain and the demand on expertise necessitate standardized training and certification of professionals. The American Medical Informatics Association (AMIA) embarked on a major effort to create professional level education and certification for physicians of various professions and specialties in informatics. This article focuses on the AMIA effort in the professional structure of medical specialization, e.g., the American Board of Medical Specialties (ABMS) and the related Accreditation Council for Graduate Medical Education (ACGME). This report summarizes the current progress to create a recognized sub-certificate of competence in Clinical Informatics and discusses likely near term (three to five year) implications on training, certification, and work force with an emphasis on clinical applied informatics. PMID:23616825
Detmer, Don E; Munger, Benson S; Lehmann, Christoph U
Globalization and international trade are having an increasingly evident impact on the day-to-day duties of the health sector, and the phenomenon has aroused a great deal of interest among governments, nongovernmental organizations, international organizations, and the mass media. Up to this point the heated and polemical debate on the subject has seriously hindered objective discourse on the health implications of globalization and international trade. This piece examines the possible impact of the two processes on health in the Region of the Americas, in order to foster policies for equity that are adopted within the framework of public health in the Americas. The piece considers the relationships among globalization, trade, and health in general and then focuses on the special case of trade in health goods and services. The piece looks at the possible impact on health equity of the agreements for integration and free trade that are being negotiated in the Americas. The piece concludes with a summary of the activities that the Pan American Health Organization has been carrying out in this area. PMID:12162840
This paper reviews the health dimension and sociocultural, economic, and ecological determinants of health in existing global scenario studies. Not even half of the 31 scenarios reviewed gave a good description of future health developments and the different scenario studies did not handle health in a consistent way. Most of the global driving forces of health are addressed adequately in the selected scenarios, however, and it therefore would have been possible to describe the future developments in health as an outcome of these multiple driving forces. To provide examples on how future health can be incorporated in existing scenarios, we linked the sociocultural, economic, and environmental developments described in three sets of scenarios (special report on emission scenarios (SRES), global environmental outlook-3 (GEO3), and world water scenarios (WWS)) to three potential, but imaginary, health futures ("age of emerging infectious diseases", "age of medical technology", and "age of sustained health"). This paper provides useful insights into how to deal with future health in scenarios and shows that a comprehensive picture of future health evolves when all important driving forces and pressures are taken into account.
Martens, Pim; Huynen, Maud
Health promotion is very relevant today. There is a global acceptance that health and social wellbeing are determined by many factors outside the health system which include socioeconomic conditions, patterns of consumption associated with food and communication, demographic patterns, learning environments, family patterns, the cultural and social fabric of societies; sociopolitical and economic changes, including commercialization and trade and global environmental change. In such a situation, health issues can be effectively addressed by adopting a holistic approach by empowering individuals and communities to take action for their health, fostering leadership for public health, promoting intersectoral action to build healthy public policies in all sectors and creating sustainable health systems. Although, not a new concept, health promotion received an impetus following Alma Ata declaration. Recently it has evolved through a series of international conferences, with the first conference in Canada producing the famous Ottawa charter. Efforts at promoting health encompassing actions at individual and community levels, health system strengthening and multi sectoral partnership can be directed at specific health conditions. It should also include settings-based approach to promote health in specific settings such as schools, hospitals, workplaces, residential areas etc. Health promotion needs to be built into all the policies and if utilized efficiently will lead to positive health outcomes.
Kumar, Sanjiv; Preetha, GS
Despite widespread agreement that collective action to address shared health challenges across countries is desirable and necessary, the realm of global health governance has remained highly problematic. A key reason for this is the manner in which health issues are presented ('framed'). Because multiple frames are operating simultaneously, confusion and a range of competing policy recommendations and priorities result. Drawing on the previous articles published in this Special Supplement, these key findings explore how health issues are framed, what makes a framing successful, what frames are used for and what effects framing has. PMID:23088193
McInnes, Colin; Lee, Kelley
...Announcement 02140] Global Health Promotion and Health Education Initiatives...cooperative agreement for Global Health Promotion and Health Education Initiatives...announcement is to promote research, health promotion, and dissemination of...
Accelerating the translation of new scientific discoveries to improve human health and disease management is the overall goal of a series of initiatives integrated in the National Institutes of Health (NIH) “Roadmap for Medical Research.” The Clinical and Translational Research Award (CTSA) program is, arguably, the most visible component of the NIH Roadmap providing resources to institutions to transform their clinical and translational research enterprises along the goals of the Roadmap. The CTSA program emphasizes biomedical informatics as a critical component for the accomplishment of the NIH’s translational objectives. To be optimally effective, emerging biomedical informatics programs must link with the information technology (IT) platforms of the enterprise clinical operations within academic health centers. This report details one academic health center’s transdisciplinary initiative to create an integrated academic discipline of biomedical informatics through the development of its infrastructure for clinical and translational science infrastructure and response to the CTSA mechanism. This approach required a detailed informatics strategy to accomplish these goals. This transdisciplinary initiative was the impetus for creation of a specialized biomedical informatics core, the Center for Biomedical Informatics (CBI). Development of the CBI codified the need to incorporate medical informatics including quality and safety informatics and enterprise clinical information systems within the CBI. This paper describes the steps taken to develop the biomedical informatics infrastructure, its integration with clinical systems at one academic health center, successes achieved, and barriers encountered during these efforts.
Fahy, Brenda G.; Balke, C. William; Umberger, Gloria H.; Talbert, Jeffery; Canales, Denise Niles; Steltenkamp, Carol L.; Conigliaro, Joseph
\\u000a The goal of infectious disease informatics is to optimize the clinical and public health management of infectious diseases\\u000a through improvements in the development and use of antimicrobials, the design of more effective vaccines, the identification\\u000a of biomarkers for life-threatening infections, a better understanding of host-pathogen interactions, and biosurveillance and\\u000a clinical decision support. Infectious disease informatics can lead to more targeted
Reams of data pertaining directly to the core health services research mission are accumulating in large-scale organizational and clinical information systems. Health services researchers who grasp the structure of information systems and databases and the function of software applications can use existing data more effectively, assist in establishing new databases, and develop new tools to survey populations and collect data.
Kenneth D Mandl; Thomas H Lee
Informatics is a popular topic in literature, in media, and in education. However, nursing professionals and even nursing faculty may not have a clear understanding of informatics. The authors conducted a small simulation study to examine how nursing students enrolled in a doctor of philosophy program-future nursing educators-perceived informatics and its core elements. Using an online collaboration tool, the students were asked to create a plan for integrating informatics into a simulated undergraduate nursing program. The results of the study provide lessons for nursing professionals and educators. Students identified only a handful of competencies believed important by informatics initiatives led by the American Nurses Association and the Technology Informatics Guiding Education Reform. Although most students believed an undergraduate curriculum should teach computer skills, only a few participants identified information literacy skills, such as privacy and security of health information, as important for beginning nurses. Although limited, findings articulate the need for a universally accepted definition of informatics and a shared understanding of an informatics core curriculum. PMID:20304375
Dixon, Brian E; Newlon, Christine M
The track entitled “Consumer Informatics Supporting Patients as Co-Producers of Quality” at the AMIA Spring 2000 Congress was devoted to examining the new field of consumer health informatics. This area is developing rapidly, as worldwide changes are occurring in the organization and delivery of health care and in the traditional roles of patient and provider. This paper describes the key
Bonnie Kaplan; Patricia Flatley Brennan
Health as a global issue concerns all and clearly manifests global inequality. All stakeholders of the healthcare systems and disease treatment - including the pharmaceutical industry - have an ethical obligation to contribute to promoting global health. At Novo Nordisk we primarily focus on providing our contribution to global health through defeating diabetes. At the same time we stand by
Lars Christian Lassen; Mads Krogsgaard Thomsen
Four points are made about globalization and health. First, economic integration is a powerful force for raising the incomes of poor countries. In the past 20 years several large developing countries have opened up to trade and investment, and they are growing well — faster than the rich countries. Second, there is no tendency for income inequality to increase in
The Movement for Global Mental Health is a coalition of individuals and institutions committed to collective actions that aim to close the treatment gap for people living with mental disorders worldwide, based on two fundamental principles: evidence on effective treatments and the human rights of people with mental disorders.
Patel, Vikram; Collins, Pamela Y.; Copeland, John; Kakuma, Ritsuko; Katontoka, Sylvester; Lamichhane, Jagannath; Naik, Smita; Skeen, Sarah
Since its origins as a World War II-era malaria control center 55 years ago, the Centers for Disease Control and Prevention (CDC) has always been engaged in global health. Over the years, both the scope and nature of that engagement have changed dramatica...
Abstract The last two decades have witnessed the emergence and consolidation of an economic paradigm which emphasizes domestic deregulation and the removal of barriers to international trade and finance. If properly managed, such an approach can lead to perceptible gains in health status. Where markets are non-exclusionary, regulatory institutions strong and safety nets in place, globalization enhances the performance of
Giovanni Andrea Cornia
Global nuclear proliferation, bioterrorism, and emerging infections have challenged national capacities to achieve and maintain global security. Over the last century, emerging infectious disease threats resulted in the development of the preliminary versions of the International Health Regulations (IHR) of the World Health Organization (WHO). The current HR(2005) contain major differences compared to earlier versions, including: substantial shifts from containment at the border to containment at the source of the event; shifts from a rather small disease list (smallpox, plague, cholera, and yellow fever) required to be reported, to all public health threats; and shifts from preset measures to tailored responses with more flexibility to deal with the local situations on the ground. The new IHR(2005) call for accountability. They also call for strengthened national capacity for surveillance and control; prevention, alert, and response to international public health emergencies beyond the traditional short list of required reporting; global partnership and collaboration; and human rights, obligations, accountability, and procedures of monitoring. Under these evolved regulations, as well as other measures, such as the Revolving Fund for vaccine procurement of the Pan American Health Organization (PAHO), global health security could be maintained in the response to urban yellow fever in Paraguay in 2008 and the influenza (H1N1) pandemic of 2009-2010.
Global nuclear proliferation, bioterrorism, and emerging infections have challenged national capacities to achieve and maintain global security. Over the last century, emerging infectious disease threats resulted in the development of the preliminary versions of the International Health Regulations (IHR) of the World Health Organization (WHO). The current HR(2005) contain major differences compared to earlier versions, including: substantial shifts from containment at the border to containment at the source of the event; shifts from a rather small disease list (smallpox, plague, cholera, and yellow fever) required to be reported, to all public health threats; and shifts from preset measures to tailored responses with more flexibility to deal with the local situations on the ground. The new IHR(2005) call for accountability. They also call for strengthened national capacity for surveillance and control; prevention, alert, and response to international public health emergencies beyond the traditional short list of required reporting; global partnership and collaboration; and human rights, obligations, accountability, and procedures of monitoring. Under these evolved regulations, as well as other measures, such as the Revolving Fund for vaccine procurement of the Pan American Health Organization (PAHO), global health security could be maintained in the response to urban yellow fever in Paraguay in 2008 and the influenza (H1N1) pandemic of 2009-2010. PMID:21143824
Andrus, Jon Kim; Aguilera, Ximena; Oliva, Otavio; Aldighieri, Sylvain
Policy makers and healthcare providers often lack the resources or information to make effective healthcare decisions that im- pact their communities. Information must therefore be delivered to in a way that maximizes healthcare decision making. This pa- per examines the infrastructure of U.S. Healthcare using an In- ternet-based geographic information system (GIS). Internet GIS assists communities in accessing health information
Christopher L. Fulcher; Catherine E. Kaukinen
Background Experience with public engagement activities regarding the risks and benefits of science and technology (S&T) is growing, especially in the industrialized world. However, public engagement in the developing world regarding S&T risks and benefits to explore health issues has not been widely explored. Methods This paper gives an overview about public engagement and related concepts, with a particular focus on challenges and benefits in the developing world. We then describe an Internet-based platform, which seeks to both inform and engage youth and the broader public on global water issues and their health impacts. Finally, we outline a possible course for future action to scale up this and similar online public engagement platforms. Results The benefits of public engagement include creating an informed citizenry, generating new ideas from the public, increasing the chances of research being adopted, increasing public trust, and answering ethical research questions. Public engagement also fosters global communication, enables shared experiences and methodology, standardizes strategy, and generates global viewpoints. This is especially pertinent to the developing world, as it encourages previously marginalized populations to participate on a global stage. One of the core issues at stake in public engagement is global governance of science and technology. Also, beyond benefiting society at large, public engagement in science offers benefits to the scientific enterprise itself. Conclusion Successful public engagement with developing world stakeholders will be a critical part of implementing new services and technologies. Interactive engagement platforms, such as the Internet, have the potential to unite people globally around relevant health issues.
Cohen, Emma RM; Masum, Hassan; Berndtson, Kathryn; Saunders, Vicki; Hadfield, Tom; Panjwani, Dilzayn; Persad, Deepa L; Minhas, Gunjeet S; Daar, Abdallah S; Singh, Jerome A; Singer, Peter A
The Institute for Global Health at Vanderbilt enables the expansion and coordination of global health research, service, and training, reflecting the university's commitment to improve health services and outcomes in resource-limited settings. Global health encompasses both prevention via public health and treatment via medical care, all nested within a broader community-development context. This has fostered university-wide collaborations to address education, business/economics, engineering, nursing, and language training, among others. The institute is a natural facilitator for team building and has been especially helpful in organizing institutional responses to global health solicitations from the National Institutes of Health (NIH), Centers for Disease Control (CDC), and other funding agencies. This center-without-walls philosophy nurtures noncompetitive partnerships among and within departments and schools. With extramural support from the NIH and from endowment and developmental investments from the school of medicine, the institute funds new pilot projects to nurture global educational and research exchanges related to health and development. Vanderbilt's newest programs are a CDC-supported HIV/AIDS service initiative in Africa and an overseas research training program for health science graduate students and clinical fellows. New opportunities are available for Vanderbilt students, staff, and faculty to work abroad in partnership with international health projects through a number of Tennessee institutions now networked with the institute. A center-without-walls may be a model for institutions contemplating strategic investments to better organize service and teaching opportunities abroad, and to achieve greater successes in leveraging extramural support for overseas and domestic work focused on tropical medicine and global health. PMID:18303361
Vermund, Sten H; Sahasrabuddhe, Vikrant V; Khedkar, Sheetal; Jia, Yujiang; Etherington, Carol; Vergara, Alfredo
The Institute for Global Health at Vanderbilt enables the expansion and coordination of global health research, service, and training, reflecting the university's commitment to improve health services and outcomes in resource-limited settings. Global health encompasses both prevention via public health and treatment via medical care, all nested within a broader community-development context. This has fostered university-wide collaborations to address education, business/economics, engineering, nursing, and language training, among others. The institute is a natural facilitator for team building and has been especially helpful in organizing institutional responses to global health solicitations from the National Institutes of Health (NIH), Centers for Disease Control (CDC), and other funding agencies. This center-without-walls philosophy nurtures noncompetitive partnerships among and within departments and schools. With extramural support from the NIH and from endowment and developmental investments from the school of medicine, the institute funds new pilot projects to nurture global educational and research exchanges related to health and development. Vanderbilt's newest programs are a CDC-supported HIV/AIDS service initiative in Africa and an overseas research training program for health science graduate students and clinical fellows. New opportunities are available for Vanderbilt students, staff, and faculty to work abroad in partnership with international health projects through a number of Tennessee institutions now networked with the institute. A center-without-walls may be a model for institutions contemplating strategic investments to better organize service and teaching opportunities abroad, and to achieve greater successes in leveraging extramural support for overseas and domestic work focused on tropical medicine and global health.
Vermund, Sten H.; Sahasrabuddhe, Vikrant V.; Khedkar, Sheetal; Jia, Yujiang; Etherington, Carol; Vergara, Alfredo
To protect public health and national safety, AMIA recommends that the federal government dedicate technologic resources and medical informatics expertise to create a national health information infrastructure (NHII). An NHII provides the underlying information utility that connects local health providers and health officials through high-speed networks to national data systems necessary to detect and track global threats to public health.
Paul C Tang
The Constitution of the World Health Organization (1946) states that the "enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social position." The international legal framework for this right was laid by the Universal Declaration of Human Rights (1948) and reaffirmed in the International Covenant on Economic, Social, and Cultural Rights (1966) and the Declaration of Alma-Ata (1978). In recent years, the framework has been developed on 10 key elements: national and international human rights, laws, norms, and standards; resource constraints and progressive realization; obligations of immediate effect; freedoms and entitlements; available, accessible, acceptable, and good quality; respect, protect, and fulfill; non-discrimination, equality, and vulnerability; active and informed participation; international assistance and cooperation; and monitoring and accountability. Whereas public health law plays an essential role in the protection and promotion of the right to health, the emergence of SARS (2003) highlighted the urgent need to reform national public health laws and international obligations relating to public health in order to meet the new realities of a globalized world, leading to the WHO Framework Convention on Tobacco Control (2003) and the revision of the WHO International Health Regulations (2005). The Asian Institute for Bioethics and Health Law, in conjunction with the Republic of Korea's Ministry of Health and Welfare and the WHO International Digest of Health Legislation, conducted a comparative legal analysis of national public health laws in various countries through a project entitled Domestic Profiles of Public/Population Health Legislation (2006), which underscored the importance of recognizing the political and social contexts of distinct legal cultures, including Western, Asian, Islamic, and African. PMID:23093515
The impact of increased national wealth, as measured by Gross Domestic Product (GDP), on public health is widely understood, however an equally important but less well-acclaimed relationship exists between improvements in health and the growth of an economy. Communicable diseases such as HIV, TB, Malaria and the Neglected Tropical Diseases (NTDs) are impacting many of the world's poorest and most vulnerable populations, and depressing economic development. Sickness and disease has decreased the size and capabilities of the workforce through impeding access to education and suppressing foreign direct investment (FDI). There is clear evidence that by investing in health improvements a significant increase in GDP per capita can be attained in four ways: Firstly, healthier populations are more economically productive; secondly, proactive healthcare leads to decrease in many of the additive healthcare costs associated with lack of care (treating opportunistic infections in the case of HIV for example); thirdly, improved health represents a real economic and developmental outcome in-and-of itself and finally, healthcare spending capitalises on the Keynesian 'economic multiplier' effect. Continued under-investment in health and health systems represent an important threat to our future global prosperity. This editorial calls for a recognition of health as a major engine of economic growth and for commensurate investment in public health, particularly in poor countries. PMID:22490207
Martin, Greg; Grant, Alexandra; D'Agostino, Mark
The article demonstrates the impact of globalization on development of public health legislation at the international level and in particular countries. The legislation is considered as a tool to decrease the globalization health risks for population PMID:24027848
Background Biodiversity informatics is a relatively new discipline extending computer science in the context of biodiversity data, and its development to date has not been uniform throughout the world. Digitizing effort and capacity building are costly, and ways should be found to prioritize them rationally. The proposed 'Biodiversity Informatics Potential (BIP) Index' seeks to fulfill such a prioritization role. We propose that the potential for biodiversity informatics be assessed through three concepts: (a) the intrinsic biodiversity potential (the biological richness or ecological diversity) of a country; (b) the capacity of the country to generate biodiversity data records; and (c) the availability of technical infrastructure in a country for managing and publishing such records. Methods Broadly, the techniques used to construct the BIP Index were rank correlation, multiple regression analysis, principal components analysis and optimization by linear programming. We built the BIP Index by finding a parsimonious set of country-level human, economic and environmental variables that best predicted the availability of primary biodiversity data accessible through the Global Biodiversity Information Facility (GBIF) network, and constructing an optimized model with these variables. The model was then applied to all countries for which sufficient data existed, to obtain a score for each country. Countries were ranked according to that score. Results Many of the current GBIF participants ranked highly in the BIP Index, although some of them seemed not to have realized their biodiversity informatics potential. The BIP Index attributed low ranking to most non-participant countries; however, a few of them scored highly, suggesting that these would be high-return new participants if encouraged to contribute towards the GBIF mission of free and open access to biodiversity data. Conclusions The BIP Index could potentially help in (a) identifying countries most likely to contribute to filling gaps in digitized biodiversity data; (b) assisting countries potentially in need (for example mega-diverse) to mobilize resources and collect data that could be used in decision-making; and (c) allowing identification of which biodiversity informatics-resourced countries could afford to assist countries lacking in biodiversity informatics capacity, and which data-rich countries should benefit most from such help.
In recent decades, public health policy and practice have been increasingly challenged by globalization, even as global financing for health has increased dramatically. This article discusses globalization and its health challenges from a vantage of political science, emphasizing increased global flows (of pathogens, information, trade, finance, and people) as driving, and driven by, global market integration. This integration requires a
Ronald Labonté; Katia Mohindra; Ted Schrecker
In recent decades, public health policy and practice have been increasingly challenged by globalization, even as global financing for health has increased dramatically. This article discusses globalization and its health challenges from a vantage of political science, emphasizing increased global flows (of pathogens, information, trade, finance, and people) as driving, and driven by, global market integration. This integration requires a
Ronald Labonté; Katia Mohindra; Ted Schrecker
Corruption is a serious threat to global health outcomes, leading to financial waste and adverse health consequences. Yet, forms of corruption impacting global health are endemic worldwide in public and private sectors, and in developed and resource-poor settings alike. Allegations of misuse of funds and fraud in global health initiatives also threaten future investment. Current domestic and sectorial-level responses are fragmented and have been criticized as ineffective. In order to address this issue, we propose a global health governance framework calling for international recognition of "global health corruption" and development of a treaty protocol to combat this crucial issue. PMID:23088820
Mackey, Tim K; Liang, Bryan A
Corruption is a serious threat to global health outcomes, leading to financial waste and adverse health consequences. Yet, forms of corruption impacting global health are endemic worldwide in public and private sectors, and in developed and resource-poor settings alike. Allegations of misuse of funds and fraud in global health initiatives also threaten future investment. Current domestic and sectorial-level responses are fragmented and have been criticized as ineffective. In order to address this issue, we propose a global health governance framework calling for international recognition of “global health corruption” and development of a treaty protocol to combat this crucial issue.
Translational informatics (TI) is extremely important for the pharmaceutical industry, especially as the bar for regulatory approval of new medications is set higher and higher. This paper will explore three specific areas in the drug development lifecycle, from tools developed by precompetitive consortia to standardized clinical data collection to the effective delivery of medications using clinical decision support, in which TI has a major role to play. Advancing TI will require investment in new tools and algorithms, as well as ensuring that translational issues are addressed early in the design process of informatics projects, and also given higher weight in funding or publication decisions. Ultimately, the source of translational tools and differences between academia and industry are secondary, as long as they move towards the shared goal of improving health.
Global health promotion is now becoming an integral part of foreign policy of many countries. Health Promotion Practice has always kept pace with changes in the field of health education and promotion. The Society for Public Health Education Board of Trustees and the Editorial Board of Health Promotion Practice are pleased to announce the launch of a new department, “Global
Jagdish Khubchandani; Rob Simmons
The World Health Organization (WHO) Global Oral Health Programme has worked hard over the past five years to increase the awareness of oral health worldwide as an important component of general health and quality of life. Meanwhile, oral disease is still a major public health problem in high income countries and the burden of oral disease is growing in many
Poul Erik Petersen
Informatics technologies have radically changed number of systems including health, entertainment, economics, business and education. Informatics technologies use is crucial especially in education. Internet and distance learning, two instances for informatics technologies in education. Preschool and primary school teachers believe that computer and related technologies are useful in the process of speedup the information retrieval and improve the recognition and
Özlem UÇAR Erdem UÇAR; Cenk ATLI?; Yilmaz KILIÇASLAN
Lipid mediator informatics is an emerging area denoted to the identification of bioactive lipid mediators (LMs) and their biosynthetic profiles and pathways. LM informatics and proteomics applied to inflammation, systems tissues research provides a powerful means of uncovering key biomarkers for novel processes in health and disease. By incorporating them with system biology analysis, we review here our initial steps
Yan Lu; Song Hong; Katherine Gotlinger; Charles N. Serhan
This paper assesses progress in the development of a global framework for responding to non-communicable diseases, as reflected in the policies and initiatives of the World Health Organization (WHO), World Bank and the UN: the institutions most capable of shaping a coherent global policy. Responding to the global burden of chronic disease requires a strategic assessment of the global processes that are likely to be most effective in generating commitment to policy change at country level, and in influencing industry behaviour. WHO has adopted a legal process with tobacco (the WHO Framework Convention on Tobacco Control), but a non-legal, advocacy-based approach with diet and physical activity (the Global Strategy on Diet, Physical Activity and Health). The paper assesses the merits of the Millennium Development Goals (MDGs) and the FCTC as distinct global processes for advancing health development, before considering what lessons might be learned for enhancing the implementation of the Global Strategy on Diet. While global partnerships, economic incentives, and international legal instruments could each contribute to a more effective global response to chronic diseases, the paper makes a special case for the development of international legal standards in select areas of diet and nutrition, as a strategy for ensuring that the health of future generations does not become dependent on corporate charity and voluntary commitments. A broader frame of reference for lifestyle-related chronic diseases is needed: one that draws together WHO's work in tobacco, nutrition and physical activity, and that envisages selective use of international legal obligations, non-binding recommendations, advocacy and policy advice as tools of choice for promoting different elements of the strategy.
Magnusson, Roger S
There is broad scientific consensus that Earth's climate is warming rapidly and at an accelerating rate. Human activities, primarily the burning of fossil fuels, are very likely (>90% probability) to be the main cause of this warming. Climate-sensitive changes in ecosystems are already being observed, and fundamental, potentially irreversible, ecological changes may occur in the coming decades. Conservative environmental estimates of the impact of climate changes that are already in process indicate that they will result in numerous health effects to children. The nature and extent of these changes will be greatly affected by actions taken or not taken now at the global level. Physicians have written on the projected effects of climate change on public health, but little has been written specifically on anticipated effects of climate change on children's health. Children represent a particularly vulnerable group that is likely to suffer disproportionately from both direct and indirect adverse health effects of climate change. Pediatric health care professionals should understand these threats, anticipate their effects on children's health, and participate as children's advocates for strong mitigation and adaptation strategies now. Any solutions that address climate change must be developed within the context of overall sustainability (the use of resources by the current generation to meet current needs while ensuring that future generations will be able to meet their needs). Pediatric health care professionals can be leaders in a move away from a traditional focus on disease prevention to a broad, integrated focus on sustainability as synonymous with health. This policy statement is supported by a technical report that examines in some depth the nature of the problem of climate change, likely effects on children's health as a result of climate change, and the critical importance of responding promptly and aggressively to reduce activities that are contributing to this change. PMID:17967923
Shea, Katherine M
For German nurses it is difficult to join training in health informatics besides their professional activity. The authors have successfully established a German nursing informatics summer school in shape of a 5 day intensive curriculum which they offer to German nurses during the summer holidays. The summer school introduces nurses into health informatics and nursing informatics. It targets interested nursing staff, nurse executives, and nurse teachers. It promotes self learning abilities for continued self education of the participants. One of its goals is to enable participants to formulate their own requirements in health information processing and to influence system design and system introduction. The paper presents the curriculum, talks about first experiences, and demonstrates the results of an evaluation among the participants. Conclusions are drawn in a set of statements on informatics education of nurses. PMID:10725038
Bürkle, T; Schrader, U
Despite impressive worldwide improvements in oral health, inequalities in oral health status among and within countries remain a daunting public health challenge. Oral health inequalities arise from a complex web of health determinants, including social, behavioral, economic, genetic, environmental, and health system factors. Eliminating these inequalities cannot be accomplished in isolation of oral health from overall health, or without recognizing that oral health is influenced at multiple individual, family, community, and health systems levels. For several reasons, this is an opportune time for global efforts targeted at reducing oral health inequalities. Global health is increasingly viewed not just as a humanitarian obligation, but also as a vehicle for health diplomacy and part of the broader mission to reduce poverty, build stronger economies, and strengthen global security. Despite the global economic recession, there are trends that portend well for support of global health efforts: increased globalization of research and development, growing investment from private philanthropy, an absolute growth of spending in research and innovation, and an enhanced interest in global health among young people. More systematic and far-reaching efforts will be required to address oral health inequalities through the engagement of oral health funders and sponsors of research, with partners from multiple public and private sectors. The oral health community must be "at the table" with other health disciplines and create opportunities for eliminating inequalities through collaborations that can harness both the intellectual and financial resources of multiple sectors and institutions. PMID:21490232
Garcia, I; Tabak, L A
Alcohol's adverse public health impact includes disease, injury, violence, disability, social problems, psychiatric illness, drunk driving, drug use, unsafe sex, and premature death. Furthermore, alcohol is a confirmed human carcinogen. The International Agency for Research on Cancer concluded that alcohol causes cancer of the oral cavity, pharynx, larynx, esophagus, liver, colon-rectum, and breast. World Cancer Research Fund/American Institute for Cancer Research concluded that the evidence justifies recommending avoidance of consuming any alcohol, even in small quantities. Despite being responsible for 3.8% of global deaths (2,255,000 deaths) and 4.6% of global disability-adjusted life years in 2004, alcohol consumption is increasing rapidly in China and Asia. Contrary to the World Health Assembly's call for global control action, Hong Kong has reduced wine and beer taxes to zero since 2008. An International Framework Convention on Alcohol Control is urgently needed. Increasing alcohol taxation and banning alcohol advertisement and promotion are among the most effective policies. PMID:20566555
Lam, Tai Hing; Chim, David
Synthetic biology has the potential to contribute breakthrough innovations to the pursuit of new global health solutions. Wishing to harness the emerging tools of synthetic biology for the goals of global health, in 2011 the Bill & Melinda Gates Foundation put out a call for grant applications to "Apply Synthetic Biology to Global Health Challenges" under its "Grand Challenges Explorations" program. A highly diverse pool of over 700 applications was received. Proposed applications of synthetic biology to global health needs included interventions such as therapeutics, vaccines, and diagnostics, as well as strategies for biomanufacturing, and the design of tools and platforms that could further global health research. PMID:23946862
In understanding that the efforts made in improving global health affects the health of U.S. citizens, a policy analysis of President Barak Obama's Global Health Initiative was conducted. Using materials gathered from experts in the field of health and their findings and recommendations, paired with the current policies of other G8 countries that pledged to support the efforts of improving
In recent decades, public health policy and practice have been increasingly challenged by globalization, even as global financing for health has increased dramatically. This article discusses globalization and its health challenges from a vantage of political science, emphasizing increased global flows (of pathogens, information, trade, finance, and people) as driving, and driven by, global market integration. This integration requires a shift in public health thinking from a singular focus on international health (the higher disease burden in poor countries) to a more nuanced analysis of global health (in which health risks in both poor and rich countries are seen as having inherently global causes and consequences). Several globalization-related pathways to health exist, two key ones of which are described: globalized diseases and economic vulnerabilities. The article concludes with a call for national governments, especially those of wealthier nations, to take greater account of global health and its social determinants in all their foreign policies. PMID:21219153
Labonté, Ronald; Mohindra, Katia; Schrecker, Ted
Initiatives to address the unmet needs of those facing both poverty and serious illness have expanded significantly over the past decade. But many of them are designed in an ad-hoc manner to address one health problem among many; they are too rarely assessed; best practices spread slowly. When assessments of delivery do occur, they are often narrow studies of the cost-effectiveness of a single intervention rather than the complex set of them required to deliver value to patients and their families. We propose a framework for global health-care delivery and evaluation by considering efforts to introduce HIV/AIDS care to resource-poor settings. The framework introduces the notion of care delivery value chains that apply a systems-level analysis to the complex processes and interventions that must occur, across a health-care system and over time, to deliver high-value care for patients with HIV/AIDS and cooccurring conditions, from tuberculosis to malnutrition. To deliver value, vertical or stand-alone projects must be integrated into shared delivery infrastructure so that personnel and facilities are used wisely and economies of scale reaped. Two other integrative processes are necessary for delivering and assessing value in global health: one is the alignment of delivery with local context by incorporating knowledge of both barriers to good outcomes (from poor nutrition to a lack of water and sanitation) and broader social and economic determinants of health and wellbeing (jobs, housing, physical infrastructure). The second is the use of effective investments in care delivery to promote equitable economic development, especially for those struggling against poverty and high burdens of disease. We close by reporting our own shared experience of seeking to move towards a science of delivery by harnessing research and training to understand and improve care delivery. PMID:23697823
Kim, Jim Yong; Farmer, Paul; Porter, Michael E
Set in 2000, with a completion date of 2015, the deadline for the Millennium Development Goals is approaching, at which time a new global development infrastructure will become operational. Unsurprisingly, the discussions on goals, topics, priorities and monitoring and evaluation are gaining momentum. But this is a critical juncture. Over a decade of development programming offers a unique opportunity to reflect on its structure, function and purpose in a contemporary global context. This article examines the topic from an analytical health perspective and identifies universal health equity as an operational and analytical priority to encourage attention to the root causes of unnecessary and unfair illness and disease from the perspectives of those for whom the issues have most direct relevance. PMID:23561031
The contention of the author is that an informatics infrastructure is essential for evidenced-based practice. Five building blocks of an informatics infrastructure for evidence-based practice are proposed: 1) standardized terminologies and structures, 2) digital sources of evidence, 3) standards that facilitate health care data exchange among heterogeneous systems, 4) informatics processes that support the acquisition and application of evidence to a specific clinical situation, and 5) informatics competencies. Selected examples illustrate how each of these building blocks supports the application of evidence to practice and the building of evidence from practice. Although a number of major challenges remain, medical informatics can provide solutions that have the potential to decrease unintended variation in practice and health care errors.
The authors from China and the United States take medical informatics from theory to practice by improving its research, application, and dissemination and by expanding its educational potential. We built a theoretical model and discussed its definition, approach, foundation, principles, and structure. Medical informatics is the interdisciplinary study of information science applied to medicine and health care. Its developing approach is transplantation. The foundation of medical informatics has "building blocks" of knowledge. They are: information procedure models; information classification principles; information processing methodologies; and functional hierarchical principles of information systems. The structure of medical informatics includes the main knowledge branches and their logical relations. There are four big branches: computer tools and systems methods; engineering equipment and methods; medical fields information systems; and health care management systems. Based on the investigation of the professional status (its theory and application, and its forms and the contents) of medical informatics, it can be seen that this new discipline is becoming mature. PMID:8591423
Li, Z; Mitchell, J; Tian, A; Rikli, A
Health care providers have a basic responsibility to protect patients from accidental harm. At the institutional level, creating safe health care organizations necessitates a systematic approach. Effective use of informatics to enhance safety requires the establishment and use of standards for concept definitions and for data exchange, development of acceptable models for knowledge representation, incentives for adoption of electronic health
Peter M. Kilbridge; David C. Classen
The 2001 U.S. Army Medical Research and Materiel Command (USAMRMC) Biomedical Informatics Roadmap Meeting was devoted to developing a strategic plan in four focus areas: Hospital and Clinical Informatics, E-Health, Combat Health Informatics, and Bioinformatics and Biomedical Computation. The driving force of this Roadmap Meeting was the recent accelerated pace of change in biomedical informatics in which emerging technologies have the potential to affect significantly the Army research portfolio and investment strategy in these focus areas. The meeting was structured so that the first two days were devoted to presentations from experts in the field, including representatives from the three services, other government agencies, academia, and the private sector, and the morning of the last day was devoted to capturing specific biomedical informatics research needs in the four focus areas. This white paper summarizes the key findings and recommendations and should be a powerful tool for the crafting of future requests for proposals to help align USAMRMC new strategic research investments with new developments and emerging technologies.
Reifman, Jaques; Gilbert, Gary R.; Fagan, Lawrence; Satava, Richard
The Supercourse website contains thousands of lectures on global health and prevention "designed to improve the teaching of prevention." Their network includes174 countries, and is available in no less than 30 languages. The site is located at the University of Pittsburgh and its core developers include Ronald LaPorte, Faina Linkov, Mita Lovalekar, and Eugene Shubnikov. It's a tremendous undertaking, and first-time visitors may wish to start by clicking through the "What is the Supercourse?" introduction section. After reading a bit about their work, visitors can move on to the "Supercourse Lectures" section. The lectures here are organized topically into headings that include epidemiology, public health, and special diseases. Additionally, visitors can browse the lectures by author or keywords. Further down the homepage, visitors will find the "Special Lectures" area and information for potential authors who would like to become part of this initiative.
Recently, global health and global health surveillance have received unprecedented recognition of their importance because of the newly emerging and reemerging infectious diseases, new cycles of pandemics, and the threats of bioterrorism. The aim of this review is to provide an update of the current state of knowledge on health surveillance in a globalized world. Three key areas will be highlighted in this review: 1) the role of the new International Health Regulations, 2) the emergence of new global health networks for surveillance and bioterrorism, and 3) the reshaping of guidelines for the collection, dissemination, and interventions in global surveillance. A discussion is also presented of the more important challenges of global health surveillance. Global surveillance has been reshaped by important changes in the new International Health Regulations and the rapid development of new global networks for disease surveillance and bioterrorism. These networks provide for the first time at the global scale real-time information about potential outbreaks and epidemics of newly emerging and reemerging infectious diseases. The recent outbreaks of severe acute respiratory syndrome (SARS) and the influenza A (H1N1) pandemic provide evidence of the benefits of the new global monitoring and of the importance of the World Health Organization in its coordinating role in the multilateral response of the global public health community. PMID:20534776
The Center for Research on Minority Health (CRMH) has translated the biopsychosocial framework to address global cancer health disparities through the integration of biological (e.g., endogenous steroids, genetic susceptibility and pesticide levels) and behavioral (e.g., dietary interventions) determinants, along with community-based research (e.g., comprehensive involvement of community advisory boards) and educational approaches (e.g., kindergarten through postgraduate training). Evidence of successful implementation of this framework includes: health disparities training for over two thousand individuals ranging from elementary to postgraduate level, and conducting transdisciplinary projects that incorporate traditional and non-traditional health professionals to examine associations between biological and non-biological determinants of health. Examples and recommendations for implementation of the biopsychosocial approach as it applies to cancer health disparities research are described.
King, Denae; Miranda, Patricia; Gor, Beverly; Fuchs-Young, Robin; Chilton, Janice; Hajek, Richard; Torres-Vigil, Isabel; Hernandez-Valero, Maria; Snipes, S. Amy; Jones, Lovell
As computer scientists, we have been trained in the methodology of natural science, which is analytic in its essence. Informatics, and particularly Artificial Intelligence, is not an analytic discipline. It is required to establish a constructive methodology.
Biomedical informatics lacks a clear and theoretically-grounded definition. Many proposed definitions focus on data, information, and knowledge, but do not provide an adequate definition of these terms. Leveraging insights from the philosophy of information, we define informatics as the science of information, where information is data plus meaning. Biomedical informatics is the science of information as applied to or studied in the context of biomedicine. Defining the object of study of informatics as data plus meaning clearly distinguishes the field from related fields, such as computer science, statistics and biomedicine, which have different objects of study. The emphasis on data plus meaning also suggests that biomedical informatics problems tend to be difficult when they deal with concepts that are hard to capture using formal, computational definitions. In other words, problems where meaning must be considered are more difficult than problems where manipulating data without regard for meaning is sufficient. Furthermore, the definition implies that informatics research, teaching, and service should focus on biomedical information as data plus meaning rather than only computer applications in biomedicine. PMID:19683067
Bernstam, Elmer V; Smith, Jack W; Johnson, Todd R
The security and foreign policy communities have increasingly addressed global health problems as threats to national security. Global health is a humanitarian endeavour that seeks to improve the world's health including the most vulnerable peoples, while national security works to protect the interests of people within a given state. The major statements of security policy by the United States and
Harley Feldbaum; Preeti Patel; Egbert Sondorp; Kelley Lee
|As a college course, global public health covers topics that affect individuals' welfare and thus should be accessible to the public, providing information to help people make informed decisions about their health. This article discusses the creation of DMP 844: Global Health, a graduate-level course in the College of Veterinary Medicine's…
Anders, Brent A.; Briggs, Deborah J.; Hai-Jew, Shalin; Caby, Zachary; Werick, Mary
As a college course, global public health covers topics that affect individuals' welfare and thus should be accessible to the public, providing information to help people make informed decisions about their health. This article discusses the creation of DMP 844: Global Health, a graduate-level course in the College of Veterinary Medicine's…
Anders, Brent A.; Briggs, Deborah J.; Hai-Jew, Shalin; Caby, Zachary; Werick, Mary
Early informatics contributions to the emergency planning and response agenda have focused largely on surveillance of threat detection. A broader assessment of possible informatics contributions unveils that informatics can also contribute to increasing the efficiency in disaster response as well as providing a tele-presence for remote medical caregivers. This presentation will explore current and future roles of informatics in emergency preparedness and response. Special challenges for data management occur with every emergency or disaster. Tracking of victims, electronic health records, and supply inventory are a few of the contributions that informatics can play during disasters. Modeling of response resources can provide the parameters for more effective decision making. Public relations reporting can be made more accurate if given the information in a timely fashion. Databases provide the infrastructure for reporting of data that can be used to manage volunteers or later be mined to determine the effectiveness of planning and response efforts. As informaticists, we have a moral obligation to contribute to the emergency response agenda worldwide. PMID:17911898
Weiner, Elizabeth E; Trangenstein, Patricia A
Indoor air pollution is ubiquitous, and takes many forms, ranging from smoke emitted from solid fuel combustion, especially in households in developing countries, to complex mixtures of volatile and semi-volatile organic compounds present in modern buildings. This paper reviews sources of, and health risks associated with, various indoor chemical pollutants, from a historical and global perspective. Health effects are presented for individual compounds or pollutant mixtures based on real-world exposure situations. Health risks from indoor air pollution are likely to be greatest in cities in developing countries, especially where risks associated with solid fuel combustion coincide with risk associated with modern buildings. Everyday exposure to multiple chemicals, most of which are present indoors, may contribute to increasing prevalence of asthma, autism, childhood cancer, medically unexplained symptoms, and perhaps other illnesses. Given that tobacco consumption and synthetic chemical usage will not be declining at least in the near future, concerns about indoor air pollution may be expected to remain. PMID:14757719
Zhang, Junfeng; Smith, Kirk R
Context: Accelerated globalization has produced obvious changes in diplomatic purposes and practices. Health issues have become increasingly preeminent in the evolving global diplomacy agenda. More leaders in academia and policy are thinking about how to structure and utilize diplomacy in pursuit of global health goals. Methods: In this article, we describe the context, practice, and components of global health diplomacy, as applied operationally. We examine the foundations of various approaches to global health diplomacy, along with their implications for the policies shaping the international public health and foreign policy environments. Based on these observations, we propose a taxonomy for the subdiscipline. Findings: Expanding demands on global health diplomacy require a delicate combination of technical expertise, legal knowledge, and diplomatic skills that have not been systematically cultivated among either foreign service or global health professionals. Nonetheless, high expectations that global health initiatives will achieve development and diplomatic goals beyond the immediate technical objectives may be thwarted by this gap. Conclusions: The deepening links between health and foreign policy require both the diplomatic and global health communities to reexamine the skills, comprehension, and resources necessary to achieve their mutual objectives.
Katz, Rebecca; Kornblet, Sarah; Arnold, Grace; Lief, Eric; Fischer, Julie E
As academic health sciences libraries assume larger roles in informatics instruction within medical school curricula, librarians are challenged to develop useful and accurate measures for assessing the effectiveness of instructional approaches. The need for this evaluation has intensified as medical schools increase their emphasis on integration of curriculum content and shift to competency-based education and assessment of medical students. This
Jane L. Blumenthal; Brynn E. Mays; Jeffrey M. Weinfeld; Marcus A. Banks; Janette Shaffer
Digital optical microscopy, coupled with parallel processing and a large arsenal of labeling techniques, offers tremendous values to localize, identify, and characterize cells and molecules. This generates many image informatics challenges in requiring new algorithms and tools to extract, classify, correlate, and model image features and content from massive amounts of cellular and molecular images acquired. Image informatics aims to fill this gap. Coupling automated microscopy and image analysis with biostatistical and data mining techniques to provide a system biologic approach in studying the cells, the basic unit of life, potentially leads to many exciting applications in life and health sciences. In this presentation, we describe certain new system biology applications enabled by image informatics technology.
Wong, Stephen T. C.
The current phase of globalization represents a “double-edged sword” challenge facing public health practitioners and health policy makers. The first “edge” throws light on two constructs in the field of public health: global health (formerly international health) and globalized public health. The second “edge” is that of global governance, and raises the question, “how can we construct public health regulations that adequately respond to both global and local complexities related to the two constructs mentioned earlier (global health and globalized public health)?” The two constructs call for the development of norms that will assure sustained population-wide health improvement and these two constructs have their own conceptual tools and theoretical models that permit a better understanding of them. In this paper, we introduce the “globalized public health” construct and we present an interactive comprehensive framework for critically analyzing contemporary globalization’s influences on the field of public health. “Globalized public health”, simultaneously a theoretical model and a conceptual framework, concerns the transformation of the field of public health in the sociohistorical context of globalization. The model is the fruit of an original theoretical research study conducted from 2005 to 2008 (“contextualized research,” Gibbons’ Mode II of knowledge production), founded on a QUAL-quant sequential mixed-method design. This research also reflects our political and ideological position, fuelled with aspirations of social democracy and cosmopolitical values. It is profoundly anchored in the pragmatic approach to globalization, looking to “reconcile” the market and equity. The model offers several features to users: (1) it is transdisciplinary; (2) it is interactive (CD-ROM); (3) it is nonlinear (nonlinear interrelations between the contextual globalization and the field of public health); (4) it is synchronic/diachronic (a double-crossed perspective permits analysis of global social change, the emergence of global agency and the transmutation of the field of public health, in the full complexity of their nonlinear interaction); (5) it offers five characteristics as an auto-eco-organized system of social interactions, or dynamic, nonlinear sociohistorical system. The model features a visual interface (five interrelated figures), a structure of 30 “integrator concepts” that integrates 114 other element-parts via 1,300 hypertext links. The model is both a knowledge translation tool and an interactive heuristic guide designed for practitioners and researchers in public health/community health/population health, as well as for decision-makers at all levels.
This editorial presents the views of the guest editors of this collection in summarising some of the general themes arising from a selection of papers presented at the 2008 Club Health Conference in Ibiza, Spain. Particular emphasis is placed upon the value of comparative approaches to club studies, youth culture and substance use so that researchers, policy-makers, and practitioners can gain new understanding of the interplay of local and global factors which shape club cultures, nightlife scenes, and individual lifestyles. By contextualizing the studies in this volume, the editorial outlines important themes and issues which will help promote Club Studies as an interdisciplinary field of endeavour well into the future. PMID:20011985
Measham, Fiona; Anderson, Tammy; Hadfield, Phil
Medical informatics, as a descriptive, scientific study, must be mathematically or theoretically described. Is it important to define a model for medical informatics? The answer is worth pursuing. The medical informatics profession stands to benefit three-fold: first, by clarifying the vagueness of the definition of medical informatics, secondly, by identifying the scope and content for educational programs, and, thirdly, by defining career opportunities for its graduates. Existing medical informatics curricula are not comparable. Consequently, the knowledge and skills of graduates from these programs are difficult to assess. The challenge is to promote academics that develops graduates for prospective employers to fulfill the criteria of the health care industry and, simultaneously, compete with computer science programs that produce information technology graduates. In order to meet this challenge, medical informatics programs must have unique curricula that distinguishes its graduates. The solution is to educate students in a comparable manner across the domain of medical informatics. This paper discusses a theoretical model for medical informatics. Images Figure
Chi, X.; Pavilcek, K.
Objectives: The objective is to highlight the important role that librarians have in teaching within a successful medical informatics program. Librarians regularly utilize skills that, although not technology dependent, are essential to conducting computer-based research. The Metropolis analogy is used to introduce the part librarians play as informatics partners. Science fiction is a modern mythology that, beyond a technical exterior, has lasting value in its ability to reflect the human condition. The teaching of medical informatics, an intersection of technology and knowledge, is also most relevant when it transcends the operation of databases and systems. Librarians can teach students to understand, research, and utilize information beyond specific technologies. Methods: A survey of twenty-six informatics programs was conducted during 2002, with specific emphasis on the role of the library service. Results: The survey demonstrated that librarians currently do have a central role in informatics instruction, and that library-focused skills form a significant part of the curriculum in many of those programs. In addition, librarians have creative opportunities to enhance their involvement in informatics training. As a sample program in the study, the development of the informatics course at the Massachusetts College of Pharmacy and Health Sciences is included. Conclusions: Medical informatics training is a wonderful opportunity for librarians to collaborate with professionals from the sciences and other information disciplines. Librarians' unique combination of human research and technology skills provides a valuable contribution to any program.
King, Samuel Bishop; MacDonald, Kate
The current phase of globalization represents a "double-edged sword" challenge facing public health practitioners and health policy makers. The first "edge" throws light on two constructs in the field of public health: global health (formerly international health) and globalized public health. The second "edge" is that of global governance, and raises the question, "how can we construct public health regulations that adequately respond to both global and local complexities related to the two constructs mentioned earlier (global health and globalized public health)?" The two constructs call for the development of norms that will assure sustained population-wide health improvement and these two constructs have their own conceptual tools and theoretical models that permit a better understanding of them. In this paper, we introduce the "globalized public health" construct and we present an interactive comprehensive framework for critically analyzing contemporary globalization's influences on the field of public health. "Globalized public health", simultaneously a theoretical model and a conceptual framework, concerns the transformation of the field of public health in the sociohistorical context of globalization. The model is the fruit of an original theoretical research study conducted from 2005 to 2008 ("contextualized research," Gibbons' Mode II of knowledge production), founded on a QUAL-quant sequential mixed-method design. This research also reflects our political and ideological position, fuelled with aspirations of social democracy and cosmopolitical values. It is profoundly anchored in the pragmatic approach to globalization, looking to "reconcile" the market and equity. The model offers several features to users: (1) it is transdisciplinary; (2) it is interactive (CD-ROM); (3) it is nonlinear (nonlinear interrelations between the contextual globalization and the field of public health); (4) it is synchronic/diachronic (a double-crossed perspective permits analysis of global social change, the emergence of global agency and the transmutation of the field of public health, in the full complexity of their nonlinear interaction); (5) it offers five characteristics as an auto-eco-organized system of social interactions, or dynamic, nonlinear sociohistorical system. The model features a visual interface (five interrelated figures), a structure of 30 "integrator concepts" that integrates 114 other element-parts via 1,300 hypertext links. The model is both a knowledge translation tool and an interactive heuristic guide designed for practitioners and researchers in public health/community health/population health, as well as for decision-makers at all levels. PMID:22312210
Secondary use of health data applies personal health information (PHI) for uses outside of direct health care delivery. It includes such activities as analysis, research, quality and safety measurement, public health, payment, provider certification or accreditation, marketing, and other business applications, including strictly commercial activities. Secondary use of health data can enhance health care experiences for individuals, expand knowledge about disease and appropriate treatments, strengthen understanding about effectiveness and efficiency of health care systems, support public health and security goals, and aid businesses in meeting customers’ needs. Yet, complex ethical, political, technical, and social issues surround the secondary use of health data. While not new, these issues play increasingly critical and complex roles given current public and private sector activities not only expanding health data volume, but also improving access to data. Lack of coherent policies and standard “good practices” for secondary use of health data impedes efforts to strengthen the U.S. health care system. The nation requires a framework for the secondary use of health data with a robust infrastructure of policies, standards, and best practices. Such a framework can guide and facilitate widespread collection, storage, aggregation, linkage, and transmission of health data. The framework will provide appropriate protections for legitimate secondary use.
Safran, Charles; Bloomrosen, Meryl; Hammond, W. Edward; Labkoff, Steven; Markel-Fox, Suzanne; Tang, Paul C.; Detmer, Don E.
Secondary use of health data applies personal health information (PHI) for uses outside of direct health care delivery. It includes such activities as analysis, research, quality and safety measurement, public health, payment, provider certification or accreditation, marketing, and other business applications, including strictly commercial activities. Secondary use of health data can enhance health care experiences for individuals, expand knowledge about disease and appropriate treatments, strengthen understanding about effectiveness and efficiency of health care systems, support public health and security goals, and aid businesses in meeting customers' needs. Yet, complex ethical, political, technical, and social issues surround the secondary use of health data. While not new, these issues play increasingly critical and complex roles given current public and private sector activities not only expanding health data volume, but also improving access to data. Lack of coherent policies and standard "good practices" for secondary use of health data impedes efforts to strengthen the U.S. health care system. The nation requires a framework for the secondary use of health data with a robust infrastructure of policies, standards, and best practices. Such a framework can guide and facilitate widespread collection, storage, aggregation, linkage, and transmission of health data. The framework will provide appropriate protections for legitimate secondary use. PMID:17077452
Safran, Charles; Bloomrosen, Meryl; Hammond, W Edward; Labkoff, Steven; Markel-Fox, Suzanne; Tang, Paul C; Detmer, Don E; Expert Panel
The National Cancer Institute's new Center for Global Health held a pivotal inaugural meeting to set short- and long-term goals for cancer research related to global health. This meeting provided an opportunity to review NCI's current global health research portfolio, identify unmet research needs, and determine areas of research where NCI should strengthen its collaborations with U.S. government agencies and organizations, as well as international governmental and non-governmental organizations.
As health care organizations expand and move into global markets, they face many leadership challenges, including the difficulty of leading individuals who are geographically dispersed. This article provides global managers with guidelines for leading and motivating individuals or teams from a distance while overcoming the typical challenges that "virtual leaders" and "virtual teams" face: employee isolation, confusion, language barriers, cultural differences, and technological breakdowns. Fortunately, technological advances in communications have provided various methods to accommodate geographically dispersed or "global virtual teams." Health care leaders now have the ability to lead global teams from afar by becoming "virtual leaders" with a responsibility to lead a "virtual team." Three models of globalization presented and discussed are outsourcing of health care services, medical tourism, and telerobotics. These models require global managers to lead virtually, and a positive relationship between the virtual leader and the virtual team member is vital in the success of global health care organizations. PMID:19433929
Holland, J Brian; Malvey, Donna; Fottler, Myron D
Abstract This paper considers how operational research and management science can improve the design of health systems and the delivery of health care, particularly in low-resource settings. It identifies some gaps in the way operational research is typically used in global health and proposes steps to bridge them. It then outlines some analytical tools of operational research and management science and illustrates how their use can inform some typical design and delivery challenges in global health. The paper concludes by considering factors that will increase and improve the contribution of operational research and management science to global health.
Sugary beverages represent a major global threat to the health of all populations. The shifts in distribution, marketing, and sales have made them the plague of the globe in terms of obesity, diabetes, and a host of other chronic health problems. The fructose-laden beverages have unique properties that lead to lack of dietary compensation and direct adverse effects on our health. Global efforts to limit marketing and sales are necessary to protect the health of the planet. PMID:22867870
Popkin, Barry M
The Information Era we live in has created new challenges and opportunities. This age of information highways has an economic price, which has not been properly evaluated. Detailed studies are needed to prove the cost and medical effectiveness of these technologies as well as its effects in the quality of life. Our society's future may depend on it. People are
Luis G. Kun
As new directions and priorities emerge in health care, nursing informatics leaders must prepare to guide the profession appropriately. To use an analogy, where a road bends or changes directions, guideposts indicate how drivers can stay on course. The AMIA Nursing Informatics Working Group (NIWG) produced this white paper as the product of a meeting convened: 1) to describe anticipated nationwide changes in demographics, health care quality, and health care informatics; 2) to assess the potential impact of genomic medicine and of new threats to society; 3) to align AMIA NIWG resources with emerging priorities; and 4) to identify guideposts in the form of an agenda to keep the NIWG on course in light of new opportunities. The anticipated societal changes provide opportunities for nursing informatics. Resources described below within the Department of Health and Human Services (HHS) and the National Committee for Health and Vital Statistics (NCVHS) can help to align AMIA NIWG with emerging priorities. The guideposts consist of priority areas for action in informatics, nursing education, and research. Nursing informatics professionals will collaborate as full participants in local, national, and international efforts related to the guideposts in order to make significant contributions that empower patients and providers for safer health care. PMID:17068358
McCormick, Kathleen A; Delaney, Connie J; Brennan, Patricia Flatley; Effken, Judith A; Kendrick, Kathie; Murphy, Judy; Skiba, Diane J; Warren, Judith J; Weaver, Charlotte A; Weiner, Betsy; Westra, Bonnie L
Global climate change is a qualitatively distinct, and very significant, addition to the spectrum of environmental health\\u000a hazards encountered by humankind. Historically, environmental health concerns have focused on toxicological or microbiological\\u000a risks to health from local exposures. However, the scale of environmental health hazards is today increasing; indeed, the\\u000a burgeoning human impact on the environment has begun to alter global
RT Watson; AJ McMichael
This article searches for solutions to the most perplexing problems in global health—problems so important that they affect the fate of millions of people, with economic, political, and security ramifications for the world's population. No State, acting alone, can insulate itself from major health hazards. It is for this reason that safeguarding the world's population requires cooperation and global governance.
Lawrence O. Gostin
At a crossroads, global public health surveillance exists in a fragmented state. Slow to detect, register, confirm, and analyze cases of public health significance, provide feedback, and communicate timely and useful information to stakeholders, global surveillance is neither maximally effective nor optimally efficient. Stakeholders lack a globa surveillance consensus policy and strategy; officials face inadequate training and scarce resources. Three
Scott JN McNabb
Time of information in which the authors live resulted in the increase of the amount of the information exponential growth of the new kind of knowledge, flourishing of the familiar ones and the appearance of the new sciences. Medical (health) informatics occupies the central place in all the segments of modern medicine in the past 30 years--in practical work, education and scientific research. In all that, computers have taken over the most important role and are used intensively for the development of the health information systems. Following activities develop within the area of health informatics: health-documentation, health-statistics, health-informatics and bio-medical, scientific and professional information. The pioneer in the development of the health statistics and informatics in Bosnia and Herzegovina (BiH) was Dr Evgenije Sherstnew, who was the Chief of Health Statistics in the Ministry of Health of BiH from 1946-1952, and who founded and led, from 1952 to the end of his life, the Department of Medical Documentation and Health Statistics of the Central Health Institute of BiH, the core around which a group of experts for the development of this field have gathered. In the eighties computers were intensively used as a tool for the processing medical data and with them the development of health information systems at the level of the outpatient-clinics, hospitals, clinical centers, as well as the integral information system of health, health insurance and the social security system of BiH began. Finally, Society for Medical Informatics of BiH, which as a professional association gathers experts in the area of health informatics, actively propagates this profession in the Republic, was founded. With reform of the lectures and curriculum at the medical faculty in Sarajevo, the course in 'Medical Informatics' has been in 1992. into the second semester, since it was assumed that an early insight into the principles of information along with studies of so called basic pre-clinic sciences, especially basics of information, would make things easier for the students the more informative education is in the course of their medical studies. The medical faculty in Sarajevo also established and accepted a course of health informatics and economics of post-graduate studies in 1979, of which the main objective is education of experts for work informatics jobs in health care system and services, especially for needs of the future information systems in BiH. PMID:9726498
The global integration of trade and financial markets that has been the hallmark of the past 30 years of neoliberal globalization means that local economies can be shaped by economic events seemingly unrelated to the scale or geography where women's empowerment projects unfold. These global–local interactions raise questions so far largely absent in public discussions of the 2008 crisis precipitated
K. S. Mohindra; Ronald Labonté; Denise Spitzer
This article examines current global oral health initiatives to underserved dental populations and assesses the level of familiarity with these initiatives among dental students. The World Health Organization (WHO)'s basic package of oral care (BPOC) is described, as well as successes and difficulties in global oral health initiatives. A survey was conducted of third-year dental students at a North American dental school to determine their familiarity with global oral health initiatives set out by the WHO and the World Dental Federation (FDI). The majority of the surveyed students (87 percent) expressed interest in volunteering their professional services in international settings. However, none of the surveyed students knew about the BPOC or the FDI's role in global oral health. The findings indicate that predoctoral dental public health courses in dental schools ought to include a course on global oral health to expose students to global oral health issues and equip them with interventions like the BPOC so they can provide better care to globally underserved dental populations. PMID:18981202
Karim, Asef; Mascarenhas, Ana Karina; Dharamsi, Shafik
Over the past decade there have been several attempts to rethink the basic strategies and scope of medical informatics. Meanwhile, bioinformatics has only recently experienced a similar debate about its scientific character. Both disciplines envision the development of novel diagnostic, therapeutic, and management tools, and products for patient care. A combination of the expertise of medical informatics in developing clinical applications and the focused principles that have guided bioinformatics could create a synergy between the two areas of application. Such interaction could have a great influence on future health research and the ultimate goal, namely continuity and individualization of health care. This article summarizes current activities related to facilitating synergy between medical informatics and bioinformatics, emphasizing activities in Europe while relating them to efforts in other parts of the world. The report provides examples of the analysis that European investigators are carrying out, aiming to propose new ideas for collaborations between medical informatics and bioinformatics researchers in a variety of areas. PMID:12198762
Maojo, V; Iakovidis, I; Martin-Sanchez, F; Crespo, J; Kulikowski, C
Health inequalities represent perhaps the most consequential global health challenge and yet they persist despite increased funding and innovative programs. The United Nations is revising the Millennium Development Goals (MDGs) that will shape the world for many years to come. What would a transformative post-MDG framework for global health justice look like? A global coalition of civil society and academics--the Joint Action and Learning Initiative on National and Global Responsibilities for Health (JALI)--has formed an international campaign to advocate for a Framework Convention on Global Health (FCGH). Recently endorsed by the UN Secretary-General, the FCGH would reimagine global governance for health, offering a new post-MDG vision. This Special Communication describes the key modalities of an FCGH to illustrate how it would improve health and reduce inequalities. The modalities would include defining national responsibilities for the population's health; defining international responsibilities for reliable, sustainable funding; setting global health priorities; coordinating fragmented activities; reshaping global governance for health; and providing strong global health leadership through the World Health Organization. PMID:22665108
Gostin, Lawrence O
The future of neonatal informatics will be driven by the availability of increasingly vast amounts of clinical and genetic data. The field of translational bioinformatics is concerned with linking and learning from these data and applying new findings to clinical care to transform the data into proactive, predictive, preventive, and participatory health. As a result of advances in translational informatics, the care of neonates will become more data driven, evidence based, and personalized. PMID:22924023
Palma, Jonathan P; Benitz, William E; Tarczy-Hornoch, Peter; Butte, Atul J; Longhurst, Christopher A
Leptospirosis has been recognized as an emerging global public health problem because of its increasing incidence in both developing and developed countries.A number of leptospirosis outbreaks have occurred in the past few years in various places such as Nicaragua, Brazil and India.Some of these resulted due to natural calamities such as cyclone and floods. It is a direct zoonotic disease caused by spirochetes belonging to different pathogenic species of the genus Leptospira. Large number of animals acts as carriers or vectors.Human infection results from accidental contact with carrier animals or environment contaminated with leptospires. The primary source of leptospires is the excretor animal, from whose renal tubules leptospires are excreted into the environment with the animal urine. Majority of leptospiral infections are either sub clinical or result in very mild illness and recover without any complications.However,a small proportion develops various complications due to involvement of multiple organ systems. In such patients, the clinical presentation depends upon the predominant organs involved and the case fatality ratio could be about 40% or more. Febrile illness with icterus, splenomegaly and nephritis (known as Weil's disease), acute febrile illness with severe muscle pain,febrile illness with pulmonary haemorrhages in the form of haemoptysis, jaundice with pulmonary haemorrhages, jaundice with heamaturea, meningitis with haemorrhages including sub conjunctival haemorrhage or febrile illness with cardiac arrhythmias with or without haemorrhages are some of the syndromes. Because of the protean manifestations of leptospirosis it is often misdiagnosed and under-reported. Although the basic principles of prevention such as source reduction,environmental sanitation, more hygienic work-related and personal practices etc., are same everywhere, there is no universal control method applicable to all epidemiological settings. Comprehensive understanding of the eco-epidemiological and cultural characteristics of a community that faces the problem of leptospirosis is an essential prerequisite for evolving an effective and acceptable control measure. PMID:19208981
Vijayachari, P; Sugunan, A P; Shriram, A N
|Five global health-related dilemmas requiring action are discussed, including (1) worldwide population aging; (2) rising worldwide poverty; (3) ethical dilemmas of new technologies; (4) need for adequate and affordable health care systems; and (5) need to allocate scarce resources to meet infinite health care demands. Five actions are…
Five global health-related dilemmas requiring action are discussed, including (1) worldwide population aging; (2) rising worldwide poverty; (3) ethical dilemmas of new technologies; (4) need for adequate and affordable health care systems; and (5) need to allocate scarce resources to meet infinite health care demands. Five actions are recommended,…
This paper examines the expanding presence of multinational cigarette companies into almost every country in the world, and discusses the health implications of this global penetration. Cigarettes deserve special attention because tobacco is the only legally available consumer product that is harmful to one's health when used as intended. A temptation exists to blame governments for the existence of health-threatening
Kenyon Rainier Stebbins
Although many health issues transcend national boundaries and require international co-operation, global health is rarely an integral part of the medical curriculum. While medical schools have a social responsibility to train healthcare professionals to serve local communities, the internationalisation of medical education (e.g. international medical students, export of medical curricula or medical schools) makes it increasingly difficult to define it as 'local'. It is therefore necessary to produce practitioners who can practice medicine in an ever-changing and unpredictable world. These practitioners must be clinically and culturally competent as well as able to use their global knowledge and experience to improve health and well-being, irrespective of where they eventually practice medicine. Global health practitioners are tomorrow's leaders, change agents and members of effective multiprofessional teams and so need to be aware of the environmental, cultural, social and political factors that impact on health, serving as advocates of people's rights to access resources, education and healthcare. This article addresses some of the difficulties of developing global health practitioners, offering suggestions for a global health curriculum. It also acknowledges that creating a global health practitioner requires international collaboration and shared resources and practices and places the onus of social accountability on academic leaders. PMID:21774648
McKimm, Judy; McLean, Michelle
The United States spends more than the rest of the world on healthcare. In 2000, the U.S. health bill was 1.3 trillion dollars, 14.5% of its gross domestic product. Yet, according to the WHO World Health Report 2000, the United States ranked 37th of 191 member nations in overall health system performance. Racial/ethnic disparities in health outcomes are the most obvious examples of an unbalanced healthcare system. This presentation will examine health disparities in the United States and reveal how health disparities among and within countries affect the health and well-being of the African Diaspora. PMID:15101675
Cox, Raymond L
The United States spends more than the rest of the world on healthcare. In 2000, the U.S. health bill was 1.3 trillion dollars, 14.5% of its gross domestic product. Yet, according to the WHO World Health Report 2000, the United States ranked 37th of 191 member nations in overall health system performance. Racial/ethnic disparities in health outcomes are the most obvious examples of an unbalanced healthcare system. This presentation will examine health disparities in the United States and reveal how health disparities among and within countries affect the health and well-being of the African Diaspora.
Cox, Raymond L.
This paper identifies the contribution of health and clinical informatics in the support of healthcare in the 21st century. Although little is known about the health and clinical informatics workforce, there is widespread recognition that the health informatics workforce will require significant expansion to support national eHealth work agendas. Workforce issues including discipline definition and self-identification, formal professionalisation, weaknesses in training and education, multidisciplinarity and interprofessional tensions, career structure, managerial support, and financial allocation play a critical role in facilitating or hindering the development of a workforce that is capable of realising the benefits to be gained from eHealth in general and clinical informatics in particular. As well as the national coordination of higher level policies, local support of training and allocation of sufficient position hours in appropriately defined roles by executive and clinical managers is essential to develop the health and clinical informatics workforce and achieve the anticipated results from evolving eHealth initiatives. PMID:21612722
Smith, Susan E; Drake, Lesley E; Harris, Julie-Gai B; Watson, Kay; Pohlner, Peter G
In the wake of dynamic economic and political transitions worldwide, the Institute of Medicine recently released its report advocating investments in global health from the United States (US). The expert panel reinforces the ‘transnational and interdisciplinary’ nature of global health research and practice as an endeavor ‘to improve health and achieve greater equity for all people worldwide.’ This report was judiciously timed given the growing recognition of global health, and is also acknowledged for incorporating themes that are particularly pertinent to the twenty-first century. New paradigms are introduced, denouncing the dichotomous distinction between rich and poor countries with the rapidly transitioning countries emerging as global powers, and affirming the need for models of respectful partnership and wider translation of science into practice. Cultivating sustainable partnerships and investing in the understanding and combat of diseases worldwide will become increasingly important for the US to maintain its global competitiveness, and may offer lessons in innovation, efficiency, and organization of institutions and human resources.
Ali, Mohammed K.; Venkat Narayan, K.M.
Global public health is threatened by an imbalance in health worker migration from resource-poor countries to developed countries. This "brain drain" results in health workforce shortages, health system weakening, and economic loss and waste, threatening the well-being of vulnerable populations and effectiveness of global health interventions. Current structural imbalances in resource allocation and global incentive structures have resulted in 57 countries identified by WHO as having a "critical shortage" of health workers. Yet current efforts to strengthen domestic health systems have fallen short in addressing this issue. Instead, global solutions should focus on sustainable forms of equitable resource sharing. This can be accomplished by adoption of mandatory global resource and staff-sharing programs in conjunction with implementation of state-based health services corps. PMID:22572198
Mackey, Timothy Ken; Liang, Bryan Albert
Populations today face increasing health risks from human-induced regional and global environmental changes and resultant ecological nonsustainability. Localized environmental degradation that has long accompanied population growth, industrialization, and rising consumerism has now acquired a global and often systemic dimension (e.g., climate change, disrupted nitrogen cycling, biodiversity loss). Thus, the economic intensification and technological advances that previously contributed to health gains have now expanded such that humanity's environmental (and ecological) footprint jeopardizes global population health. International data show, in general, a positive correlation of a population's health with level of affluence and size of per-person footprint. Yet, beyond a modest threshold, larger footprints afford negligible health gain and may impair health (e.g., via the rise of obesity). Furthermore, some lower-income countries have attained high levels of health. Many changes now needed to promote ecological (and social) sustainability will benefit local health. Continued improvement of global health could thus coexist with an equitably shared global environmental footprint. PMID:21219161
McMichael, A J; Butler, C D
Objectives. We studied the impact of globalization on the making of health policy. Globalization is understood as economic interdependence among nations. The North American Free Trade Agreement is used as a marker to assess the effects of economic interdependence on binational health cooperation along the United States–Mexico border. Methods. We observed participants and conducted in-depth interviews with policymakers, public health specialists, representatives of professional organizations, and unions. Results. Globalization has not promoted binational health policy cooperation. Barriers that keep US and Mexican policymakers apart prevail while health problems that do not recognize international borders go unresolved. Conclusions. If international health problems are to be solved, political, cultural, and social interdependence need to be built with the same impetus by which policymakers promote international trade.
Homedes, Nuria; Ugalde, Antonio
Background Interest in short-term global health training and service programs continues to grow, yet they can be associated with a variety of ethical issues for which trainees or others with limited global health experience may not be prepared to address. Therefore, there is a clear need for educational interventions concerning these ethical issues. Methods We developed and evaluated an introductory curriculum, “Ethical Challenges in Short-term Global Health Training.” The curriculum was developed through solicitation of actual ethical issues experienced by trainees and program leaders; content drafting; and external content review. It was then evaluated from November 1, 2011, through July 1, 2012, by analyzing web usage data and by conducting user surveys. The survey included basic demographic data; prior experience in global health and global health ethics; and assessment of cases within the curriculum. Results The ten case curriculum is freely available at http://ethicsandglobalhealth.org. An average of 238 unique visitors accessed the site each month (standard deviation, 19). Of users who had been abroad before for global health training or service, only 31% reported prior ethics training related to short-term work. Most users (62%) reported accessing the site via personal referral or their training program; however, a significant number (28%) reported finding the site via web search, and 8% discovered it via web links. Users represented different fields: medicine (46%), public health (15%), and nursing (11%) were most common. All cases in the curriculum were evaluated favorably. Conclusions The curriculum is meeting a critical need for an introduction to the ethical issues in short-term global health training. Future work will integrate this curriculum within more comprehensive curricula for global health and evaluate specific knowledge and behavioral effects, including at training sites abroad.
The context for nursing informatics research has changed significantly since the National Institute of Nursing Research-funded Nursing Informatics Re- search Agenda was published in 1993 and the Delphi study of nursing informatics research priorities re- ported a decade ago. The authors focus on 3 specific aspects of context—genomic health care, shifting research paradigms, and social (Web 2.0) technolo- gies—that must
Suzanne Bakken; Patricia W. Stone; Elaine L. Larson
In its simplest terms, public health experts define disease surveillance as the generation of 'information for action'. Infectious disease surveillance provides national and international public health authorities with information that they need to plan a...
Background: There is a growing body of evidence linking health and well-being to key business issues. Despite this, corporate uptake of workplace health promotion programmes has been slow outside the USA. One possible reason for this is the lack of a generally available health risk measure that is quick and easy to administer and produces data that is rich enough
Peter R Mills
It may surprise students to realize that health problems in other countries affect them, too. Where people live and the conditions under which they live directly affect their health. The health of a population can also offer insight into a region's social, political, and economic realities. As a powerful lens into how human societies function,…
Smith, David J.
The objective of this study was to characterize the performance of an automated utility assessment instrument for measuring preferences for overall health. The study population consisted of 83 subjects recruited from the cafeteria of a large tertiary care hospital. We assessed utilities for current health relative to perfect health and death using the rating scale, time tradeoff and standard gamble
R. F. Nease Jr; R. Tsai; L. M. Hynes; B. Littenberg
Interest in global health (GH) among medical students worldwide is measurably increasing. There is a concomitant emphasis on emphasizing globally-relevant health professions education. Through a structured literature review, expert consensus recommendations, and contact with relevant professional organizations, we review the existing state of GH education in US medical schools for which data were available. Several recommendations from professional societies have been developed, along with a renewed emphasis on competencies in global health. The implementation of these recommendations was not observed as being uniform across medical schools, with variation noted in the presence of global health curricula. Recommendations for including GH in medical education are suggested, as well as ways to formalize GH curricula, while providing flexibility for innovation and adaptation. PMID:23331630
Khan, Omar A; Guerrant, Richard; Sanders, James; Carpenter, Charles; Spottswood, Margaret; Jones, David S; O'Callahan, Cliff; Brewer, Timothy F; Markuns, Jeffrey F; Gillam, Stephen; O'Neill, Joseph; Nathanson, Neal; Wright, Stephen
Interest in global health (GH) among medical students worldwide is measurably increasing. There is a concomitant emphasis on emphasizing globally-relevant health professions education. Through a structured literature review, expert consensus recommendations, and contact with relevant professional organizations, we review the existing state of GH education in US medical schools for which data were available. Several recommendations from professional societies have been developed, along with a renewed emphasis on competencies in global health. The implementation of these recommendations was not observed as being uniform across medical schools, with variation noted in the presence of global health curricula. Recommendations for including GH in medical education are suggested, as well as ways to formalize GH curricula, while providing flexibility for innovation and adaptation
... The Global Public Health Concern of Leishmaniasis: FDA Scientists Play a Major Role in Development of a Candidate Vaccine to Protect ... More results from www.fda.gov/biologicsbloodvaccines/scienceresearch
Tourism as well as international business travel creates health risks for individuals and populations both in host societies and home countries. One strategy to reduce health-related risks to travelers is to provide travelers and relevant caregivers timely, ongoing access to their own health information. Many websites offer health advice for travelers. For example, the WHO and US Department of State offer up-to-date health information about countries relevant to travel. However, little has been done to assure travelers that their medical information is available at the right place and time when the need might arise. Applications of Information and Communication Technology (ICT) utilizing mobile phones for health management are promising tools both for the delivery of healthcare services and the promotion of personal health. This paper describes the project developed by international informaticians under the umbrella of the International Medical Informatics Association. A template capable of becoming an international standard is proposed. This application is available free to anyone who is interested. Furthermore, its source code is made open. PMID:21849333
Li, Yu-Chuan; Detmer, Don E; Shabbir, Syed-Abdul; Nguyen, Phung Anh; Jian, Wen-Shan; Mihalas, George I; Shortliffe, Edward H; Tang, Paul; Haux, Reinhold; Kimura, Michio
Tourism as well as international business travel creates health risks for individuals and populations both in host societies and home countries. One strategy to reduce health-related risks to travelers is to provide travelers and relevant caregivers timely, ongoing access to their own health information. Many websites offer health advice for travelers. For example, the WHO and US Department of State offer up-to-date health information about countries relevant to travel. However, little has been done to assure travelers that their medical information is available at the right place and time when the need might arise. Applications of Information and Communication Technology (ICT) utilizing mobile phones for health management are promising tools both for the delivery of healthcare services and the promotion of personal health. This paper describes the project developed by international informaticians under the umbrella of the International Medical Informatics Association. A template capable of becoming an international standard is proposed. This application is available free to anyone who is interested. Furthermore, its source code is made open.
Detmer, Don E; Shabbir, Syed-Abdul; Nguyen, Phung Anh; Jian, Wen-Shan; Mihalas, George I; Shortliffe, Edward H; Tang, Paul; Haux, Reinhold; Kimura, Michio
Abstract Trailing nearly every other industry, health care is finally globalizing. Highly trained and experienced,expatriate health care professionals are returning to their home,countries from training in the West or are staying home,to work,in newly developed,corporate health care delivery systems that can compete,quite favorably with less-than-perfect providers in Europe and North America. In turn, these health care systems are attracting patients
Robert K. Crone
Globalization is a key context for the study of social determinants of health (SDH): broadly stated, SDH are the conditions in which people live and work, and that affect their opportunities to lead healthy lives. In the first article in this three part series, we described the origins of the series in work conducted for the Globalization Knowledge Network of the World Health Organization's Commission on Social Determinants of Health and in the Commission's specific concern with health equity. We identified and defended a definition of globalization that gives primacy to the drivers and effects of transnational economic integration, and addressed a number of important conceptual and methodological issues in studying globalization's effects on SDH and their distribution, emphasizing the need for transdisciplinary approaches that reflect the complexity of the topic. In this second article, we identify and describe several, often interacting clusters of pathways leading from globalization to changes in SDH that are relevant to health equity. These involve: trade liberalization; the global reorganization of production and labour markets; debt crises and economic restructuring; financial liberalization; urban settings; influences that operate by way of the physical environment; and health systems changed by the global marketplace.
Labonte, Ronald; Schrecker, Ted
Abstract People and organizational issues are critical in both implementing medical informatics systems and in dealing with the altered organizations that new systems often create. The people and organizational issues area—like medical informatics itself—is a blend of many disciplines. The academic disciplines of psychology, sociology, social psychology, social anthropology, organizational behavior and organizational development, management, and cognitive sciences are rich with research with significant potential to ease the introduction and on-going use of information technology in today's complex health systems. These academic areas contribute research data and core information for better understanding of such issues as the importance of and processes for creating future direction; managing a complex change process; effective strategies for involving individuals and groups in the informatics effort; and effectively managing the altered organization. This article reviews the behavioral and business referent disciplines that can potentially contribute to improved implementations and on-going management of change in the medical informatics arena.
Lorenzi, Nancy M.; Riley, Robert T.; Blyth, Andrew J. C.; Southon, Gray; Dixon, Bradley J.
The recent SARS epidemic has renewed widespread concerns about the global transmission of infectious diseases. In this commentary, we explore novel approaches to global infectious disease surveillance through a focus on an important Canadian contribution to the area--the Global Public Health Intelligence Network (GPHIN). GPHIN is a cutting-edge initiative that draws on the capacity of the Internet and newly available 24/7 global news coverage of health events to create a unique form of early warning outbreak detection. This commentary outlines the operation and development of GPHIN and compares it to ProMED-mail, another Internet-based approach to global health surveillance. We argue that GPHIN has created an important shift in the relationship of public health and news information. By exiting the pyramid of official reporting, GPHIN has created a new monitoring technique that has disrupted national boundaries of outbreak notification, while creating new possibilities for global outbreak response. By incorporating news within the emerging apparatus of global infectious disease surveillance, GPHIN has effectively responded to the global media's challenge to official country reporting of outbreak and enhanced the effectiveness and credibility of international public health. PMID:16512327
Mykhalovskiy, Eric; Weir, Lorna
It is clear that globalization is something more than a purely economic phenomenon manifesting itself on a global scale. Among the visible manifestations of globalization are the greater international movement of goods and services, financial capital, information and people. In addition, there are technological developments, more transboundary cultural exchanges, facilitated by the freer trade of more differentiated products as well as by tourism and immigration, changes in the political landscape and ecological consequences. In this paper, we link the Maastricht Globalization Index with health indicators to analyse if more globalized countries are doing better in terms of infant mortality rate, under-five mortality rate, and adult mortality rate. The results indicate a positive association between a high level of globalization and low mortality rates. In view of the arguments that globalization provides winners and losers, and might be seen as a disequalizing process, we should perhaps be careful in interpreting the observed positive association as simple evidence that globalization is mostly good for our health. It is our hope that a further analysis of health impacts of globalization may help in adjusting and optimising the process of globalization on every level in the direction of a sustainable and healthy development for all. PMID:20849605
Martens, Pim; Akin, Su-Mia; Maud, Huynen; Mohsin, Raza
One-third of all human lives end in early death from poverty-related causes. Most of these premature deaths are avoidable through global institutional reforms that would eradicate extreme poverty. Many are also avoidable through global health-system reform that would make medical knowledge freely available as a global public good. The rules should be redesigned so that the development of any new
Thomas W. Pogge
Background The Veterans Health Administration (VA) has invested significant resources in designing and implementing a comprehensive electronic health record (EHR) that supports clinical priorities. EHRs in general have been difficult to implement, with unclear cost-effectiveness. We describe VA clinical personnel interactions with and evaluations of the EHR. Methods As part of an evaluation of a quality improvement initiative, we interviewed 72 VA clinicians and managers using a semi-structured interview format. We conducted a qualitative analysis of interview transcripts, examining themes relating to participants' interactions with and evaluations of the VA EHR. Results Participants described their perceptions of the positive and negative effects of the EHR on their clinical workflow. Although they appreciated the speed and ease of documentation that the EHR afforded, they were concerned about the time cost of using the technology and the technology's potential for detracting from interpersonal interactions. Conclusions VA personnel value EHRs' contributions to supporting communication, education, and documentation. However, participants are concerned about EHRs' potential interference with other important aspects of healthcare, such as time for clinical care and interpersonal communication with patients and colleagues. We propose that initial implementation of an EHR is one step in an iterative process of ongoing quality improvement.
We examined recent special health initiatives to control HIV/AIDS, malaria, and tuberculosis, and make four policy recommendations for improving the sustainability of such initiatives. First, international cooperation on health should be seen as an issue of global public goods that concerns both poor and rich countries. Second, national health and other sector budgets should be tapped to ensure that global health concerns are fully and reliably funded; industrialized countries should lead the way. Third, a global research council should be established to foster more efficient health-related knowledge management. Fourth, managers for specific disease issues should be appointed, to facilitate policy partnerships. Policy changes in these areas have already begun and can provide a basis for further reform.
Kaul, I.; Faust, M.
Although health has improved for many people, the extent of health inequities between and within countries is growing. Meanwhile, humankind is disrupting the global climate and other life-supporting environmental systems, thereby creating serious risks for health and wellbeing, especially in vulnerable populations but ultimately for everybody. Underlying determinants of health inequity and environmental change overlap substantially; they are signs of an economic system predicated on asymmetric growth and competition, shaped by market forces that mostly disregard health and environmental consequences rather than by values of fairness and support. A shift is needed in priorities in economic development towards healthy forms of urbanisation, more efficient and renewable energy sources, and a sustainable and fairer food system. Global interconnectedness and interdependence enable the social and environmental determinants of health to be addressed in ways that will increase health equity, reduce poverty, and build societies that live within environmental limits. PMID:18994666
Friel, Sharon; Marmot, Michael; McMichael, Anthony J; Kjellstrom, Tord; Vågerö, Denny
The 'global public good' (GPG) concept has gained increasing attention, in health as well as development circles. However, it has suffered in finding currency as a general tool for global resource mobilisation, and is at risk of being attached to almost anything promoting development. This overstretches and devalues the validity and usefulness of the concept. This paper first defines GPGs
Richard D Smith; Landis MacKellar
The pace of globalization has brought the world to the brink of a new era in international relations. While the world has outgrown traditional mechanisms for addressing global issues, it has not yet developed new forms of effective governance. This temporary void poses threats and enormous opportunities. The public health sector will play a crucial "formal" role--that is, carried out by existing bodies such as WHO and the UN. But WHO does not necessarily represent the full spectrum of views and its members necessarily work, to some degree, for separate national interests. The formal dimension must be supplemented. Globalization is not synonymous with lack of regulation. Many responsible businesses would welcome a transparent and universally applied regulatory regime to prevent a race to the lowest standards. The economic benefits of globalization may hit a glass ceiling if societies outside the global economy become progressively poorer and less healthy. The business community is recognizing that good health is essential for economic growth and social stability. Globalization may cause millions to migrate for economic opportunity. The private sector's forward-thinkers recognize the health threats of migration and are beginning to view global health promotion as a means to ensure optimal market access. PMID:17208720
This article introduces the new journal Advances in School Mental Health Promotion. Following definitions of key concepts, critical themes associated with high-quality school mental health promotion are reviewed. Reasons for the growth of the field, along with evidence of progress in a number of developed nations, are presented. We then discuss challenges being encountered, including those related to high variability
Mark D. Weist; Michael Murray
term 'health biotechnology' evokes images of research-intensive universities such as Stanford University and the Massachusetts Institute of Technology (MIT), as well as initial public offerings on NASDAQ. Ty pically, we don't think about biotechnology in connection with health solutions for poor people in developing countries. Still, as has been demonstrated in a technology foresight exercise, biotechnology can potentially be applied
Uyen Quach; Douglas K Martin; Abdallah S Daar; Peter A Singer; Halla Thorsteinsdóttir
This textbook was published to: 1) raise awareness of changes in human health related to global ecosystem change; and 2) expand the scope of the traditional curriculum in environmental health to include the interactions of major environmental forces and public health on a global scale. The book covers such topics as global climate change, stratospheric ozone depletion, water resources management and ecology and infectious disease. Case studies of cholera, malaria, the effects of water resources and global climate change and air pollution illustrate the analysis and methodology. The book also includes a resource center describing places to start searches on the Web, guidelines for finding and evaluating information, suggested study projects and strategies for encouraging communication among course participants.
While there has been wide-ranging commitment to the One Health approach, its operationalisation has so far proven challenging. One Health calls upon the human, animal and environmental health sectors to cross professional, disciplinary and institutional boundaries, and to work in a more integrated fashion. At the global level, this paper argues that this vision is hindered by dysfunctions characterising current forms of global health governance (GHG), namely institutional proliferation, fragmentation, competition for scarce resources, lack of an overarching authority, and donor-driven vertical programmes. This has contributed, in part, to shortcomings in how One Health has been articulated to date. An agreed operational definition of One Health among key global institutions, efforts to build One Health institutions from the ground up, comparative case studies of what works or does not work institutionally, and high-level global support for research, training and career opportunities would all help to enable One Health to help remedy, and not be subsumed by, existing dysfunctions in GHG. PMID:23221123
Lee, Kelley; Brumme, Zabrina L
Interest in the quality and health of soil has been stimulated by recent awareness that soil is vital to both production of food and fiber and global ecosystems function. Soil health, or quality, can be broadly defined as the capacity of a living soil to function, within natural or managed ecosystem boundaries, to sustain plant and animal productivity, maintain or
John W. Doran
In an increasingly globalised world effective international communicable diseases control requires states to embrace basic norms informing global health governance. However, recent international public health crises have shown that states continue to use national sovereignty to justify non-compliance with these norms. In this article we use three recent high-profile examples from Asia in which the tight hold of state sovereignty
Michael A Stevenson; Andrew F Cooper
U.S. Government interagency working group was convened on December 14, 1994, to consider the global threat of emerging and re-emerging infectious diseases. the working group was established under the aegis of the Committee on International Science, Engine...
This article presents findings from a survey conducted to examine the availability of foreign language and culture training to Civil Affairs health personnel and the relevance of that training to the tasks they perform. Civil Affairs forces recognize the value of cross-cultural communication competence because their missions involve a significant level of interaction with foreign governments? officials, military, and civilians. Members of the 95th Civil Affairs Brigade (Airborne) who had a health-related military occupational specialty code were invited to participate in the survey. More than 45% of those surveyed were foreign language qualified. Many also received predeployment language and culture training specific to the area of deployment. Significantly more respondents reported receiving cultural training and training on how to work effectively with interpreters than having received foreign language training. Respondents perceived interpreters as important assets and were generally satisfied with their performance. Findings from the survey highlight a need to identify standard requirements for predeployment language training that focuses on medical and health terminology and to determine the best delivery platform(s). Civil Affairs health personnel would benefit from additional cultural training that focuses on health and healthcare in the country or region of deployment. Investing in the development of distance learning capabilities as a platform for delivering health-specific language and culture training may help ease the time and resources constraints that limit the ability of Civil Affairs health personnel to access the training they need. PMID:23536451
Beadling, Charles; Maza, John; Nakano, Gregg; Mahmood, Maysaa; Jawad, Shakir; Al-Ameri, Ali; Zuerlein, Scott; Anderson, Warner
Weaknesses in health systems contribute to a failure to improve health outcomes in developing countries, despite increased official development assistance. Changes in the demands on health systems, as well as their scope to respond, mean that the situation is likely to become more problematic in the future. Diverse global initiatives seek to strengthen health systems, but progress will require better
Dina Balabanova; Martin McKee; Anne Mills; Gill Walt; Andy Haines
The international disparities in health and health-care provision comprise the gravest problem of medical ethics. The implications are explored of three theories of justice: an expanded version of Rawlsian contractarianism, Nozick's historical account, and a consequentialism which prioritizes the satisfaction of basic needs. The second too little satisfies medical needs to be cogent. The third is found to incorporate the strengths of the others, and to uphold fair rules and practices. Like the first, it also involves obligations transcending those to an agent's relations and fellow-citizens. These conclusions are applied to international health-care provision, which they would transform.
In a recent brief to the Canadian Nurses Association's National Expert Commission on the Health of Our Nation, the Academy of Canadian Executive Nurses (ACEN) discussed leadership needs in the Canadian healthcare system, and promoted the pivotal role of nursing executives in transforming Canada's healthcare system into an integrated patient-centric system. Included among several recommendations was the need to develop innovative leadership competencies that enable nurse leaders to lead and advance transformative health system change. This paper focuses on an emerging "avant-garde executive leadership competency" recommended for today's health leaders to guide health system transformation. Specifically, this competency is articulated as "state of the art communication and technology savvy," and it implies linkages between nursing informatics competencies and transformational leadership roles for nurse executive. The authors of this paper propose that distinct nursing informatics competencies are required to augment traditional executive skills to support transformational outcomes of safe, integrated, high-quality care delivery through knowledge-driven care. International trends involving nursing informatics competencies and the evolution of new corporate informatics roles, such as chief nursing informatics officers (CNIOs), are demonstrating value and advanced transformational leadership as nursing executive roles that are informed by clinical data. PMID:23803423
Remus, Sally; Kennedy, Margaret Ann
The term “global health” is rapidly replacing the older terminology of “international health.” We describe the role of the World Health Organization (WHO) in both international and global health and in the transition from one to the other. We suggest that the term “global health” emerged as part of larger political and historical processes, in which WHO found its dominant role challenged and began to reposition itself within a shifting set of power alliances. Between 1948 and 1998, WHO moved from being the unquestioned leader of international health to being an organization in crisis, facing budget shortfalls and diminished status, especially given the growing influence of new and powerful players. We argue that WHO began to refashion itself as the coordinator, strategic planner, and leader of global health initiatives as a strategy of survival in response to this transformed international political context.
Brown, Theodore M.; Cueto, Marcos; Fee, Elizabeth
When are international inequalities in health unjust? This discussion falls short of providing an answer because we remain\\u000a unclear just what kinds of obligations states and international institutions and rule-making bodies have regarding health\\u000a inequalities across countries. To arrive at a real answer, we must carry out the task of explaining the substance of international\\u000a obligations for the various kinds
The Bamako Call for Action on Research for Health stresses the importance of inter-disciplinary, inter-ministerial and inter-sectoral working. This challenges much of our current research and postgraduate research training in health, which mostly seeks to produce narrowly focused content specialists. We now need to compliment this type of research and research training, by offering alternative pathways that seek to create
Global health learning experiences for medical students sit at the intersection of capacity building, ethics, and education. As interest in global health programs during medical school continues to rise, Northwestern University Alliance for International Development, a student-led and -run organization at Northwestern University Feinberg School of Medicine, has provided students with the opportunity to engage in two contrasting models of global health educational engagement.Eleven students, accompanied by two Northwestern physicians, participated in a one-week trip to Matagalpa, Nicaragua, in December 2010. This model allowed learning within a familiar Western framework, facilitated high-volume care, and focused on hands-on experiences. This approach aimed to provide basic medical services to the local population.In July 2011, 10 other Feinberg students participated in a four-week program in Puerto Escondido, Mexico, which was coordinated by Child Family Health International, a nonprofit organization that partners with native health care providers. A longer duration, homestays, and daily language classes hallmarked this experience. An intermediary, third-party organization served to bridge the cultural and ethical gap between visiting medical students and the local population. This program focused on providing a holistic cultural experience for rotating students.Establishing comprehensive global health curricula requires finding a balance between providing medical students with a fulfilling educational experience and honoring the integrity of populations that are medically underserved. This article provides a rich comparison between two global health educational models and aims to inform future efforts to standardize global health education curricula. PMID:24072106
Rassiwala, Jasmine; Vaduganathan, Muthiah; Kupershtok, Mania; Castillo, Frank M; Evert, Jessica
The Latvian Education Informatization System LIIS project covers the whole information grid: education content, management, information services, infrastructure and user training at several levels – schools, school boards and Ministry of Education and Science. Informatization is the maintained process of creating the technical, economical and social conditions for fulfilment of information needs. The initiative started in 1997. The strategy for
Janis Bicevskis; Agnis Andzans; Evalds Ikaunieks; Inga Medvedis; Uldis Straujums; Viesturs Vezis
The Agency for Healthcare Research and Quality and its predecessor organizations—collectively referred to here as AHRQ—have a productive history of funding research and development in the field of medical informatics, with grant investments since 1968 totaling $107 million. Many computerized interventions that are commonplace today, such as drug interaction alerts, had their genesis in early AHRQ initiatives.This review provides a
J Michael Fitzmaurice; Karen Adams; John M Eisenberg
The BC health information standards council 1 Presented at the International Medical Informatics Association Working Group 16 Conference on Standardisation in Medical Informatics, `Towards International Consensus and Cooperation', Bermuda, September 11–13, 1997. 1
The establishment of a British Columbia (BC) Health Information Standards Council is one of the strategies that is helping to develop and implement BCs vision for health information management. This vision is of effectively and efficiently managed information that enables informed decision making to achieve the results desired in our health system. The Council focuses on the identification of standards
James H Coward
It is now generally accepted that vitamin D deficiency is a worldwide health problem that affects not only musculoskeletal health but also a wide range of acute and chronic diseases. However, there remains cynicism about the lack of randomized controlled trials to support the association studies regarding the nonskeletal health benefits of vitamin D. This review was obtained by searching English-language studies published up to April 1, 2013, in PubMed, MEDLINE, and the Cochrane Central Register of Controlled Trials (search terms: vitamin D and supplementation) and focuses on recent challenges regarding the definition of vitamin D deficiency and how to achieve optimal serum 25-hydroxyvitamin D concentrations from dietary sources, supplements, and sun exposure. The effect of vitamin D on fetal programming epigenetics and gene regulation could potentially explain why vitamin D has been reported to have such wide-ranging health benefits throughout life. There is potentially a great upside to increasing the vitamin D status of children and adults worldwide for improving musculoskeletal health and reducing the risk of chronic illnesses, including some cancers, autoimmune diseases, infectious diseases, type 2 diabetes mellitus, neurocognitive disorders, and mortality. PMID:23790560
Hossein-Nezhad, Arash; Holick, Michael F
Automation and emerging information technologies are being adopted by cytology laboratories to augment Pap test screening and improve diagnostic accuracy. As a result, informatics, the application of computers and information systems to information management, has become essential for the successful operation of the cytopathology laboratory. This review describes how laboratory information management systems can be used to achieve an automated and seamless workflow process. The utilization of software, electronic databases and spreadsheets to perform necessary quality control measures are discussed, as well as a Lean production system and Six Sigma approach, to reduce errors in the cytopathology laboratory.
Hornish, Maryanne; Goulart, Robert A.
The last decade has seen a large explosion of health-related human centered computing research and practice focused on wellness (e.g., good nutrition and exercise promotion) with the intention of helping people avoid needing medical care. And while Health Informatics may appear to be the obvious home for these activities, it is a discipline that has focused on the design, development,
Rebecca E. Grinter; Katie A. Siek; Andrea Grimes
Unprecedented migration, a core dimension of contemporary globalization, challenges population health. In a world of increasing human mobility, many health outcomes are shaped by transnational interactions among care providers and care recipients who meet in settings where nationality/ethnic match is not an option. This review article explores the value of transnational competence (TC) education as preparation for ethnically and socially discordant clinical encounters. The relevance of TC's five core skill domains (analytic, emotional, creative, communicative, and functional) for migration health and the medical-school curriculum is elaborated. A pedagogical approach that prepares for the transnational health-care consultation is presented, with a focus on clinical-clerkship learning experiences. Educational preparation for contemporary medical encounters needs to include a comprehensive set of patient-focused interpersonal skills, be adaptable to a wide variety of service users and global practice sites, and possess utility in addressing both the quality of patient care and socio-political constraints on migration health.
Koehn, Peter H
Indonesia's decision to withhold samples of avian influenza virus A (H5N1) from the World Health Organization for much of 2007 caused a crisis in global health. The World Health Assembly produced a resolution to try to address the crisis at its May 2007 meeting. I examine how the parties to this controversy used international law in framing and negotiating the dispute. Specifically, I analyze Indonesia's use of the international legal principle of sovereignty and its appeal to rules on the protection of biological and genetic resources found in the Convention on Biological Diversity. In addition, I consider how the International Health Regulations 2005 applied to the controversy. The incident involving Indonesia's actions with virus samples illustrates both the importance and the limitations of international law in global health diplomacy. PMID:18258086
Fidler, David P
Current concerns about the spread of infectious diseases, especially unexpected ("emerging") infections such as pandemic influenza or severe acute respiratory syndrome (SARS), have renewed focus on the critical importance of global early warning and rapid response. Although considerable progress has been made, many gaps remain. A number of the gaps can be addressed through increased political will, resources for reporting, improved coordination and sharing of information, raising clinicians' awareness, and additional research to develop more rigorous triggers for action. The increasing availability of communications and information technologies worldwide offers new opportunities for reporting even in low-capacity settings. PMID:17630449
Morse, Stephen S
With the ecological stability of the world under threat, no country can stand alone. National security should no longer be viewed in a purely military light but rather as a matter demanding cooperation between all countries on a broad range of vital issues, not least those related to health and the environment. PMID:8185752
Collections reside in a conceptual continuum, extending from a minimalist view as static, archaic and dust ridden repositories to an increasingly enlightened vision where actual specimens drive an informatics revolution that is entirely global and interactive. Biological collections including tho...
Threats posed by new, emerging or re-emerging communicable diseases are taking a global dimension, to which the World Health Organization (WHO) Secretariat has been responding with determination since 1995. Key to the global strategy for tackling epidemics across borders is the concept of global public health surveillance, which has been expanded and formalized by WHO and its technical partners through a number of recently developed instruments and initiatives. The adoption by the 58th World Health Assembly of the revised (2005) International Health Regulations provides the legal framework for mandating countries to link and coordinate their action through a universal network of surveillance networks. While novel environmental threats and outbreak-prone diseases have been increasingly identified during the past three decades, new processes of influence have appeared more recently, driven by the real or perceived threats of bio-terrorism and disruption of the global economy. Accordingly, the global surveillance agenda is being endorsed, and to some extent seized upon by new actors representing security and economic interests. This paper explores external factors influencing political commitment to comply with international health regulations and it illustrates adverse effects generated by: perceived threats to sovereignty, blurred international health agendas, lack of internationally recognized codes of conduct for outbreak investigations, and erosion of the impartiality and independence of international agencies. A companion paper (published in this issue) addresses the intrinsic difficulties that health systems of low-income countries are facing when submitted to the ever-increasing pressure to upgrade their public health surveillance capacity. PMID:17237489
Well-trained people are urgently needed to tackle global health challenges through information and communication technologies. In this report, AMAUTA, a joint international collaborative training program between the Universidad Peruana Cayetano Heredia and the University of Washington, which has been training Peruvian health professionals in biomedical and health informatics since 1999, is described. Four short-term courses have been organized in Lima, offering training to more than 200 graduate-level students. Long-term training to masters or doctorate level has been undertaken by eight students at the University of Washington. A combination of short-term and long-term strategies was found to be effective for enhancing institutional research and training enterprise. The AMAUTA program promoted the development and institution of informatics research and training capacity in Peru, and has resulted in a group of trained people playing important roles at universities, non-government offices, and the Ministry of Health in Peru. At present, the hub is being extended into Latin American countries, promoting South-to-South collaborations.
Fuller, Sherrilynne; Garcia, Patricia J; Holmes, King K; Kimball, Ann Marie
This paper explains why the microelectronics and computer revolution has become a subject of extraordinary importance for the developing countries, because of the rapidity of technological change and the resulting global impacts on production and consumption. It stresses that a computer and informatics strategy must be developed in the national context, rather than piecemeal, and offers a framework for policy
The Bamako Call for Action on Research for Health stresses the importance of inter-disciplinary, inter-ministerial and inter-sectoral working. This challenges much of our current research and postgraduate research training in health, which mostly seeks to produce narrowly focused content specialists. We now need to compliment this type of research and research training, by offering alternative pathways that seek to create expertise, not only in specific narrow content areas, but also in the process and context of research, as well as in the interaction of these different facets of knowledge. Such an approach, developing 'integrative expertise', could greatly facilitate better research utilisation, helping policy makers and practitioners work through more evidence-based practice and across traditional research boundaries.
While many public health risks take turns dominating the media spotlight, influenza continues to be a very real risk for billions of people around the globe. While the most well-known influenza pandemic remains the world-wide outbreak of the disease in 1918, the World Health Organization (WHO) continues to explore and track incidences of this disease in an effort to avoid another outbreak. On the WHO page dedicated to this disease, visitors can read a factsheet about the disease, and also peruse the organization's mission statement and priority activities as regards monitoring influenza. The site also contains links to rather timely documents that include a set of policy recommendations for strengthening the response to pandemic influenza and also on the subject of avian influenza. Not surprisingly, visitors can also learn about the latest outbreaks of the disease as reported by WHO officials and correspondents.
The analysis of cancer genomes has benefited from the advances in technology that enable data to be generated on an unprecedented scale, describing a tumour genome's sequence and composition at increasingly high resolution and reducing cost. This progress is likely to increase further over the coming years as next-generation sequencing approaches are applied to the study of cancer genomes, in tandem with large-scale efforts such as the Cancer Genome Atlas and recently announced International Cancer Genome Consortium efforts to complement those already established such as the Sanger Institute Cancer Genome Project. This presents challenges for the cancer researcher and the research community in general, in terms of analysing the data generated in one's own projects and also in coordinating and interrogating data that are publicly available. This review aims to provide a brief overview of some of the main informatics resources currently available and their use, and some of the informatics approaches that may be applied in the study of cancer genomes. PMID:20238077
Barrett, Ian P
Research-generated information about mental disorders is crucial in order to establish the health needs in a given setting, to propose culturally apt and cost-effective individual and collective interventions, to investigate their implementation, and to explore the obstacles that prevent recommended strategies from being implemented. Yet the capacity to undertake such research in low- and middle-income countries is extremely limited. This article describes two methods that have proved successful in strengthening, or that have the potential to strengthen, mental health research capacity in low-resource settings. We identify the central challenges to be faced, review current programs offering training and mentorship, and summarize the key lessons learned. A structured approach is proposed for the career development of research staff at every career stage, to be accompanied by performance monitoring and support. A case example from the Mental Health and Poverty Project in sub-Saharan Africa illustrates how this approach can be put into practice-in particular, by focusing upon training in core transferrable research skills. PMID:22335179
Thornicroft, Graham; Cooper, Sara; Bortel, Tine Van; Kakuma, Ritsuko; Lund, Crick
Background: Immigration has been and remains an important force shaping Canadian demography and identity. Health characteristics associated with the movement of large numbers of people have current and future implications for migrants, health practitioners and health systems. We aimed to identify demographics and health status data for migrant populations in Canada. Methods: We systematically searched Ovid MEDLINE (1996–2009) and other relevant web-based databases to examine immigrant selection processes, demographic statistics, health status from population studies and health service implications associated with migration to Canada. Studies and data were selected based on relevance, use of recent data and quality. Results: Currently, immigration represents two-thirds of Canada’s population growth, and immigrants make up more than 20% of the nation’s population. Both of these metrics are expected to increase. In general, newly arriving immigrants are healthier than the Canadian population, but over time there is a decline in this healthy immigrant effect. Immigrants and children born to new immigrants represent growing cohorts; in some metropolitan regions of Canada, they represent the majority of the patient population. Access to health services and health conditions of some migrant populations differ from patterns among Canadian-born patients, and these disparities have implications for preventive care and provision of health services. Interpretation: Because the health characteristics of some migrant populations vary according to their origin and experience, improved understanding of the scope and nature of the immigration process will help practitioners who will be increasingly involved in the care of immigrant populations, including prevention, early detection of disease and treatment.
Gushulak, Brian D.; Pottie, Kevin; Roberts, Janet Hatcher; Torres, Sara; DesMeules, Marie
Background Mental health is increasingly recognised as integral to good public health, but this area continues to lack sufficient planning, resources, and global strategy. It is a pressing concern in Latin America, where social determinants of health aggravate existing inequities in access to health services. Nicaragua faces serious mental health needs and challenges. One key strategy for addressing gaps in mental health services is building capacity at the primary healthcare and system levels. Objective Using the framework of best practice literature, this article analyses the four-year collaborative process between the National Autonomous University of Nicaragua in León (UNAN-León) and the Centre for Addiction and Mental Health (CAMH) in Canada, which is aimed at improving mental healthcare in Nicaragua. Design Based on a critical analysis of evaluation reports, key documents, and discussion among partners, the central steps of the collaboration are analysed and main successes and challenges identified. Results A participatory needs assessment identified local strengths and weaknesses, expected outcomes regarding competencies, and possible methodologies and recommendations for the development of a comprehensive capacity-building programme. The partners delivered two international workshops on mental health and addiction with an emphasis on primary healthcare. More recently, an innovative Diploma and Master programme was launched to foster interprofessional leadership and effective action to address mental health and addiction needs. Collaborative activities have taken place in Nicaragua and Canada. Discussion To date, international collaboration between Nicaragua and CAMH has been successful in achieving the jointly defined goals. The process has led to mutual knowledge sharing, strong networking, and extensive educational opportunities. Evidence of effective and respectful global health capacity building is provided. Lessons learned and implications for global health action are identified and discussed.
Sapag, Jaime C.; Herrera, Andres; Trainor, Ruth; Caldera, Trinidad; Khenti, Akwatu
Background: Mental health is increasingly recognised as integral to good public health, but this area continues to lack sufficient planning, resources, and global strategy. It is a pressing concern in Latin America, where social determinants of health aggravate existing inequities in access to health services. Nicaragua faces serious mental health needs and challenges. One key strategy for addressing gaps in mental health services is building capacity at the primary healthcare and system levels. Objective: Using the framework of best practice literature, this article analyses the four-year collaborative process between the National Autonomous University of Nicaragua in León (UNAN-León) and the Centre for Addiction and Mental Health (CAMH) in Canada, which is aimed at improving mental healthcare in Nicaragua. Design: Based on a critical analysis of evaluation reports, key documents, and discussion among partners, the central steps of the collaboration are analysed and main successes and challenges identified. Results: A participatory needs assessment identified local strengths and weaknesses, expected outcomes regarding competencies, and possible methodologies and recommendations for the development of a comprehensive capacity-building programme. The partners delivered two international workshops on mental health and addiction with an emphasis on primary healthcare. More recently, an innovative Diploma and Master programme was launched to foster interprofessional leadership and effective action to address mental health and addiction needs. Collaborative activities have taken place in Nicaragua and Canada. Discussion: To date, international collaboration between Nicaragua and CAMH has been successful in achieving the jointly defined goals. The process has led to mutual knowledge sharing, strong networking, and extensive educational opportunities. Evidence of effective and respectful global health capacity building is provided. Lessons learned and implications for global health action are identified and discussed. PMID:24088364
Sapag, Jaime C; Herrera, Andrés; Trainor, Ruth; Caldera, Trinidad; Khenti, Akwatu
|Climate change is a threat to wildlife and the environment, but it also one of the most pervasive threats to human health. The goal of this study was to examine the relationships among dimensions of health literacy, patient education about global warming and climate change (GWCC), and health behaviors. Results reveal that patients who have higher…
Villagran, Melinda; Weathers, Melinda; Keefe, Brian; Sparks, Lisa
We suggest that the optimal approach to building capacity in global mental health care will require partnerships between professional resources in high-income countries and promising health-related institutions in low- and middle-income countries. The result of these partnerships will be sustainable academic relationships that can educate a new generation of in-country primary care physicians and, eventually, specialized health professionals. Research capabilities will be an essential educational component to inform policy and practice, and to ensure careful outcome measurements of training and of intervention, prevention, and promotion strategies. The goal of these academic centers of excellence will be to develop quality, in-country clinical and research professionals, and to build a productive environment for these professionals to advance their careers locally. In sum, this article discusses human capacity building in global mental health, provides recommendations for training, and offers examples of recent initiatives. (Harv Rev Psychiatry 2012;20:47–57.)
Fricchione, Gregory L; Borba, Christina P C; Alem, Atalay; Shibre, Teshome; Carney, Julia R; Henderson, David C
The world is facing an unprecedented global economic crisis, with many countries needing to reconsider their level of health care spending. This paper explores the many consequences of the global economic turndown on Pakistan's health, including reduced government and donor spending and increased poverty with the consequent diversion of funds away from health. Nevertheless, these challenges may provide opportunities not only to mitigate the adverse effects of the economic crisis but also to institute some much-needed reforms that may not receive political support during more affluent times. Our suggestions focus on setting priorities based on the national disease burden, prioritizing prevention interventions, demanding results, curbing corruption, experimenting with innovative funding mechanisms, advocating for increased funding by presenting health spending as an investment rather than an expense and by selected recourse to civil society interventions and philanthropy to bridge the gap between available and needed resources. PMID:22574485
Jooma, R; Khan, A; Khan, A A
CONFLICT OF INTEREST: NONE DECLARED Last two years, the health informatics profession celebrated five jubilees in Bosnia and Herzegovina: thirty years from the introduction of the first automatic manipulation of data, twenty years from the establishment of Society for Medical Informatics BiH, fifteen years from the establishment of the Scientific and Professional Journal of the Society for Medical Informatics of Bosnia and Herzegovina „Acta Informatica Medica“, fifteen years on from the establishment of the first Cathedra for Medical Informatics on Biomedical Faculties in Bosnia and Herzegovina and five years on from the introduction of the method of “Distance learning” in medical curriculum. The author of this article are eager to mark the importance of the above mentioned Anniversaries in the development of Health informatics in Bosnia and Herzegovina and have attempted, very briefly, to present the most significant events and persons with essential roles throughout this period.
Background Global health research is essential for development. A major issue is the inequitable distribution of research efforts and funds directed towards populations suffering the world's greatest health problems. This imbalance is fostering major attempts at redirecting research to the health problems of low and middle income countries. Following the creation of the Coalition for Global Health Research – Canada (CGHRC) in 2001, the Canadian Society for International Health (CSIH) decided to review the role of non-governmental organizations (NGOs) in global health research. This paper highlights some of the prevalent thinking and is intended to encourage new thinking on how NGOs can further this role. Approach This paper was prepared by members of the Research Committee of the CSIH, with input from other members of the Society. Persons working in various international NGOs participated in individual interviews or group discussions on their involvement in different types of research activities. Case studies illustrate the roles of NGOs in global health research, their perceived strengths and weaknesses, and the constraints and opportunities to build capacity and develop partnerships for research. Highlights NGOs are contributing at all stages of the research cycle, fostering the relevance and effectiveness of the research, priority setting, and knowledge translation to action. They have a key role in stewardship (promoting and advocating for relevant global health research), resource mobilization for research, the generation, utilization and management of knowledge, and capacity development. Yet, typically, the involvement of NGOs in research is downstream from knowledge production and it usually takes the form of a partnership with universities or dedicated research agencies. Conclusion There is a need to more effectively include NGOs in all aspects of health research in order to maximize the potential benefits of research. NGOs, moreover, can and should play an instrumental role in coalitions for global health research, such as the CGHRC. With a renewed sense of purpose and a common goal, NGOs and their partners intend to make strong and lasting inroads into reducing the disease burden of the world's most affected populations through effective research action.
Delisle, Helene; Roberts, Janet Hatcher; Munro, Michelle; Jones, Lori; Gyorkos, Theresa W
Climate change, as an environmental hazard operating at the global scale, poses a unique and “involuntary exposure” to many\\u000a societies, and therefore represents possibly the largest health inequity of our time. According to statistics from the World\\u000a Health Organization (WHO), regions or populations already experiencing the most increase in diseases attributable to temperature\\u000a rise in the past 30 years ironically
Jonathan A. Patz; Holly K. Gibbs; Jonathan A. Foley; Jamesine V. Rogers; Kirk R. Smith
In the wake of dynamic economic and political transitions worldwide, the Institute of Medicine recently released its report advocating investments in global health from the United States (US). The expert panel reinforces the 'transnational and interdisciplinary' nature of global health research and practice as an endeavor 'to improve health and achieve greater equity for all people worldwide.' This report was judiciously timed given the growing recognition of global health, and is also acknowledged for incorporating themes that are particularly pertinent to the twenty-first century. New paradigms are introduced, denouncing the dichotomous distinction between rich and poor countries with the rapidly transitioning countries emerging as global powers, and affirming the need for models of respectful partnership and wider translation of science into practice. Cultivating sustainable partnerships and investing in the understanding and combat of diseases worldwide will become increasingly important for the US to maintain its global competitiveness, and may offer lessons in innovation, efficiency, and organization of institutions and human resources. PMID:20027251
Ali, Mohammed K; Narayan, K M Venkat
Increased international support for both research into new vaccines and their deployment in developing countries has been evident over the past decade. In particular, the GAVI Alliance has had a major impact in increasing uptake of the six common infant vaccines as well as those against hepatitis B and yellow fever. It further aims to introduce pneumococcal and rotavirus vaccines in the near future and several others, including those against human papillomavirus, meningococcal disease, rubella and typhoid not long after that. In addition, there is advanced research into vaccines against malaria, HIV/AIDS and tuberculosis. By 2030, we may have about 20 vaccines that need to be used in the developing world. Finding the requisite funds to achieve this will pose a major problem. A second and urgent question is how to complete the job of global polio eradication. The new strategic plan calls for completion by 2013, but both pre-eradication and post-eradication challenges remain. Vaccines will eventually become available beyond the field of infectious diseases. Much interesting work is being done in both autoimmunity and cancer. Cutting across disease groupings, there are issues in methods of delivery and new adjuvant formulations. PMID:21893548
Nossal, G J V
Despite a flourishing biomedical and global health industry  too few of Washington state's precollege students are aware of this growing sector and emerging ideas on bacteria, fungi, parasites and viruses. Against the backdrop of numerous reports regarding declining precollege student interest in science , a precollege program was envisioned at Seattle Biomedical Research Institute (as of 2010, Seattle BioMed) to increase youth engagement in biomedical research and global health, increase community interest in infectious diseases and mobilize a future biomedical workforce. Since 2005, 169 rising high school juniors have participated in the BioQuest Academy precollege immersion program at Seattle BioMed. Assembling in groups of 12, students conduct laboratory experiments (e.g., anopheline mosquito dissection, gene expression informed tuberculosis drug design and optimizing HIV immunization strategies) related to global health alongside practicing scientific mentors, all within the footprint the institute. Laudable short-term impacts of the program include positive influences on student interest in global health (as seen in the students' subsequent school projects and their participation in Seattle BioMed community events), biomedical careers and graduate school (e.g., 16.9% of teens departing 2008–2009 Academy report revised goals of attaining a doctorate rather than a baccalaureate diploma). Long-term, 97% of alumni (2005–2008) are attending postsecondary schools throughout North America; eight graduates have already published scientific articles in peer-reviewed journals and/or presented their scientific data at national and international meetings, and 26 have been retained by Seattle BioMed researchers as compensated technicians and interns. Providing precollege students with structured access to practicing scientists and authentic research environments within the context of advancing global health has been a robust means of both building a future pool of talented leaders and engaged citizenry and increasing the visibility of health disparities within the community.
Gervassi, Ana L.; Collins, Laura J.; Britschgi, Theresa B.
Objectives. We assessed global inequality in eye health by using data on the global burden of disease measured in disability-adjusted life years (DALYs). Methods. We estimated the burden of eye disease by calculating the sum of DALYs (from the Global Burden of Disease study, 2004 update) due to trachoma, vitamin A deficiency, glaucoma, cataract, refractive errors, and macular degeneration. We assessed the geographic distribution of eye disease in relation to economic status and etiology by calculating the Gini coefficient, the Theil index, and the Atkinson index. Results. The global burden of eye disease was estimated at 61.4 million DALYs worldwide (4.0% of total DALYs). Vitamin A deficiency and trachoma were distributed more unevenly than were noncommunicable eye diseases, regardless of economic status. For noncommunicable eye diseases, the major contributor was refractive errors, regardless of economic status. The most uneven distribution was observed for cataract (high-income countries) and refractive errors (middle- and low-income countries). Conclusions. Creating new eye health service for refractive errors and reducing the unacceptable eye health disparity in refractive errors should be the highest priorities for international public health services in eye care and eye health.
Hiratsuka, Yoshimune; Murakami, Akira
This article reviews the development of international research on the relationship between discrimination and health. It provides an overview of theoretical and empirical work on stigma and prejudice and their impact on discrimination and health. It argues that the literature on these issues has drawn primarily from social psychology and has focused on the impact of attitudes associated with stigma and prejudice on discriminatory practices and consequently health outcomes. It also identifies a growing trend in recent research towards a reconceptualization of stigma, prejudice and discrimination from the perspective of social inequality and structural violence, highlighting relations of power and exclusion that reinforce vulnerability within a complex social and political process. It concludes by briefly examining the ways in which this reconceptualization of discriminatory practices has generated a growing interest in the linkages between health and human rights and renewed interest in health and social justice; two major trends in the field of global public health. PMID:22267076
Despite a flourishing biomedical and global health industry  too few of Washington state's precollege students are aware of this growing sector and emerging ideas on bacteria, fungi, parasites and viruses. Against the backdrop of numerous reports regarding declining precollege student interest in science , a precollege program was envisioned at Seattle Biomedical Research Institute (as of 2010, Seattle BioMed)
Ana L. Gervassi; Laura J. Collins; Theresa B. Britschgi; Abdisalan M. Noor
Some ways in which a global warming may affect human health are discussed. Research is presented which explores the hypothesis that heat stress-induced mortality may increase substantially in the event of a worldwide temperature increase. Two procedures are applied to four disparate nations: the US, Canada, China and Egypt. Results indicate that significant increases in heat-related mortality are likely to
M. C. Nichols; L. S. Kalkstein; S. Cheng
Global warming is likely to result in a variety of environmental effects ranging from impacts on species diversity, changes in population size in flora and fauna, increases in sea level and possible impacts on the primary productivity of the sea. Potential impacts on human health and welfare have included possible increases in heat related mortality, changes in the distribution of
How is radical change in global health policy possible? Material factors such as economics or human resources are important, but ideational factors such as ideas and discourse play an important role as well. In this paper, I apply a theoretical framework to show how discourse made it possible for public and private actors to fundamentally change their way of working
How is radical change in global health policy possible? Material factors such as economics or human resources are important, but ideational factors such as ideas and discourse play an important role as well. In this paper, I apply a theoretical framework to show how discourse made it possible for public and private actors to fundamentally change their way of working
A new global health fund is being set up to bridge the funding gap for the control of HIV infection and AIDS, tuberculosis, and malaria. The fund is due to be established this year, but it is not yet clear exactly what it will support and how it will be run. The planning burden on developing countries could be increased
Ruairi Brugha; Gill Walt
On November 6-7, 1989, the National Institute of Environmental Health Sciences (NIEHS) held a conference on Global Atmospheric Change and Human Health. As a result, and in the months since this conference, many important areas of research have been identified with regard to the impacts of climatic changes on human health. To develop comprehensive research programs that address important human health issues related to global warming, it is necessary to begin by recognizing that some of the health effects will be direct such as those due to temperature changes, and others will be indirect consequences of environmental alterations resulting in crop loss, changing disease vectors, population migration, etc. It should also be recognized that the conditions leading to global warming have importance to human health and the environment other than through increasing concentrations of CO[sub 2] in the atmosphere, rising surface temperatures, and rising sea levels. Much of the increase in CO[sub 2] in the atmosphere is due to the increased combustion of fossil fuels for transportation and electric power production. Over the next 30 years, the demand for electrical power is expected to grow at a rate of 2 to 4% per year in the United States alone, and even faster growth is likely for developing countries. Much of this energy will be derived from the combustion of fossil fuels, including coal, which result in pollutant emissions to the air such as metals, radioactivity, SO[sub x], NO[sub x], and particles. Therefore, with increasing concentrations of CO[sub 2] there will not only be the effects of global warming on health, but also increasing concentrations of many serious air pollutants in urban areas, including the precursors of acid rain and acid deposition over large regional areas.
Goldstein, B.D. (Univ. of Medicine and Dentistry, Robert Wood Johnson Medical School, Piscataway, NJ (United States)); Reed, D.J. (Oregon State Univ., Corvallis, OR (United States))
Academic global health programs are growing rapidly in scale and number. Students of many disciplines increasingly desire global health content in their curricula. Global health curricula often include field experiences that involve crossing international and socio-cultural borders. Although global health training experiences offer potential benefits to trainees and to sending institutions, these experiences are sometimes problematic and raise ethical challenges. The Working Group on Ethics Guidelines for Global Health Training (WEIGHT) developed a set of guidelines for institutions, trainees, and sponsors of field-based global health training on ethics and best practices in this setting. Because only limited data have been collected within the context of existing global health training, the guidelines were informed by the published literature and the experience of WEIGHT members. The Working Group on Ethics Guidelines for Global Health Training encourages efforts to develop and implement a means of assessing the potential benefits and harms of global health training programs. PMID:21118918
Crump, John A; Sugarman, Jeremy
Academic global health programs are growing rapidly in scale and number. Students of many disciplines increasingly desire global health content in their curricula. Global health curricula often include field experiences that involve crossing international and socio-cultural borders. Although global health training experiences offer potential benefits to trainees and to sending institutions, these experiences are sometimes problematic and raise ethical challenges. The Working Group on Ethics Guidelines for Global Health Training (WEIGHT) developed a set of guidelines for institutions, trainees, and sponsors of field-based global health training on ethics and best practices in this setting. Because only limited data have been collected within the context of existing global health training, the guidelines were informed by the published literature and the experience of WEIGHT members. The Working Group on Ethics Guidelines for Global Health Training encourages efforts to develop and implement a means of assessing the potential benefits and harms of global health training programs.
Crump, John A.; Sugarman, Jeremy
In 2012, Health/Medical informatics profession celebrates five jubilees in Bosnia and Herzegovina: a) Thirty five years from the introduction of the first automatic manipulation of data; b) Twenty five years from establishing Society for Medical Informatics BiH; c) Twenty years from establishing scientific and professional journal of the Society for Medical Informatics of Bosnia and Herzegovina "Acta Informatica Medica"; d) Twenty years from establishing first Cathdra for Medical Informatics on biomedical faculties in Bosnia and Herzegovina and e) Ten years from the introduction of "Distance learning" in medical curriculum. All of the five mentioned activities in the area of Medical informatics had special importance and gave appropriate contribution in the development of Health/Medical informatics in Bosnia And Herzegovina. PMID:23322947
In 2012, Health/Medical informatics profession celebrates five jubilees in Bosnia and Herzegovina: a) Thirty five years from the introduction of the first automatic manipulation of data; b) Twenty five years from establishing Society for Medical Informatics BiH; c) Twenty years from establishing scientific and professional journal of the Society for Medical Informatics of Bosnia and Herzegovina „Acta Informatica Medica“; d) Twenty years from establishing first Cathdra for Medical Informatics on biomedical faculties in Bosnia and Herzegovina and e) Ten years from the introduction of “Distance learning” in medical curriculum. All of the five mentioned activities in the area of Medical informatics had special importance and gave appropriate contribution in the development of Health/Medical informatics in Bosnia And Herzegovina.
Cancer is a leading global cause of death and disability, responsible for approximately 7.6 million deaths each year. Around one-third of cancers are attributable to a small number of preventable risk factors - including smoking and the harmful consumption of alcohol - for which effective interventions exist at the population level. Despite this, progress in global cancer control has been slow and patchy, largely due to the weak and fragmented nature of both the global and national responses. This has been exacerbated by the economic crisis and the tendency for other challenges involving food, energy security and climate change to overshadow cancer on the global policy agenda. This paper reviews the global burden of cancer, and summarizes knowledge about effective interventions. Responding to the global challenge of cancer requires a comprehensive and integrated approach that includes legislation and regulation. A re-invigorated approach to global cancer prevention, within the broader context of non-communicable disease prevention, is an important pathway to global health and development. PMID:22019360
Beaglehole, R; Bonita, R; Magnusson, R
...HEALTH AND HUMAN SERVICES Office of Global Health Affairs; Trans-Atlantic Task...TATFAR) AGENCY: Office of Global Health Affairs, HHS. ACTION: Notice...SUMMARY: The Office of Global Health Affairs is seeking comments...
In today's world, parasitic disease agents are not restricted by geography or economy, and have become a significant global threat. The increasing globalization of the fresh produce market and greater international trade and travels, have contributed to the spread of these organisms in the industrialized world. Parasitic protozoa cause waterborne and foodborne outbreaks of diarrhea. The unprecedented flow of people introduces cultural and behavior patterns around the world; the increasing tendency to eat raw or undercooked meat and seafood, favors the dissemination of several parasitic pathogens. Climate changes are predicted to cause a global increase in soil-transmitted helminthiases. The multidisciplinary study of these agents, and the interaction among scientists, global health organizations and governments are imperative to reduce the burden of these diseases and improve the life of a large segment of the world population. PMID:23781708
The world economy is entering an era of multiple crises, involving finance, food security and global environmental change. This article assesses the implications for global public health, describes the contours of post-2007 crises in food security and finance, and then briefly indicates the probable health impacts. There follows a discussion of the crisis of climate change, one that will unfold over a longer time frame but with manifestations that may already be upon us. The article then discusses the political economy of responses to these crises, noting the formidable obstacles that exist to equitable resolution. The article concludes by noting the threat that such crises present to recent progress in global health, arguing that global health researchers and practitioners must become more familiar with the relevant social processes, and that proposed solutions that neglect the continuing importance of the nation-state are misdirected. PMID:22657093
eHealth investments from developed countries to developing countries are expected to follow the emerging trend of eHealth for meeting global health problems. However, eHealth industry from developed countries will need to learn to make this impending venture a ‘win-win’ situation with profitable return on investments. This short paper highlights some of these challenges that must be overcome in order to achieve these objectives.
Iluyemi, Adesina; Briggs, Jim
ObjectiveTo explore the informatic requirements in the home care of chronically ill patients.DesignA number of strategies were deployed to help evoke a picture of home care informatics needs: A detailed questionnaire evaluating informational needs and assessing programmable technologies was distributed to a clinic population of parents of children with cancer. Open ended questionnaires were distributed to medical staff and parents
Regulatory science plays a vital role in protecting and promoting global public health by providing the scientific basis for ensuring that food and medical products are safe, properly labeled, and effective. Regulatory science research was first developed for the determination of product safety in the early part of the 20th Century, and continues to support innovation of the processes needed for regulatory policy decisions. Historically, public health laws and regulations were enacted following public health tragedies, and often the research tools and techniques required to execute these laws lagged behind the public health needs. Throughout history, similar public health problems relating to food and pharmaceutical products have occurred in countries around the world, and have usually led to the development of equivalent solutions. For example, most countries require a demonstration of pharmaceutical safety and efficacy prior to marketing these products using approaches that are similar to those initiated in the United States. The globalization of food and medical products has created a shift in regulatory compliance such that gaps in food and medical product safety can generate international problems. Improvements in regulatory research can advance the regulatory paradigm toward a more preventative, proactive framework. These improvements will advance at a greater pace with international collaboration by providing additional resources and new perspectives for approaching and anticipating public health problems. The following is a review of how past public health disasters have shaped the current regulatory landscape, and where innovation can facilitate the shift from reactive policies to proactive policies. PMID:22871603
Patel, Meghal; Miller, Margaret Ann
The global burden of neuropsychiatry diseases and related mental health conditions is enormous, underappreciated and under resourced, particularly in the developing nations. The absence of adequate and quality mental health infrastructure and workforce is increasingly recognized. The ethical implications of inequalities in mental health for people and nations are profound and must be addressed in efforts to fulfil key bioethics principles of medicine and public health: respect for individuals, justice, beneficence, and non-malfeasance. Stigma and discrimination against people living with mental disorders affects their education, employment, access to care and hampers their capacity to contribute to society. Mental health well-being is closely associated to several Millennium Development Goals and economic development sectors including education, labour force participation, and productivity. Limited access to mental health care increases patient and family suffering. Unmet mental health needs have a negative effect on poverty reduction initiatives and economic development. Untreated mental conditions contribute to economic loss because they increase school and work absenteeism and dropout rates, healthcare expenditure, and unemployment. Addressing unmet mental health needs will require development of better mental health infrastructure and workforce and overall integration of mental and physical health services with primary care, especially in the developing nations.
NGUI, EMMANUEL M.; KHASAKHALA, LINCOLN; NDETEI, DAVID; ROBERTS, LAURA WEISS
National animal health policies have at their foundation the overarching need to address society's concerns about animal disease control, the welfare of animals and the safety and security of the animal production food supply. However, in today's global, complex and interdependent context, national animal health policies also impact a broader range of policy outcomes, ranging from public health protection through ecosystem health and biodiversity to the economic well-being and performance of many countries. As a result, there are several fundamentally important elements that must be considered in the elaboration of effective and relevant animal health policies. Policies must be (i) proportionate to the risk to be managed, (ii) transparent (to ensure easy understanding and implementation), and (iii) responsive to constantly evolving and changing hazards and risk pathways. In addition, it is critical that there are sufficient resources and capacity to implement the policies as well as incentives for compliance on the part of affected parties. PMID:23413725
Evans, B; MacInnes, T
There are rapid changes occurring in the health care environment. Radiologists face new challenges but also new opportunities. The purpose of this report is to review how new informatics tools and developments can help the radiologist respond to the drive for safety, quality, and efficiency. These tools will be of assistance in conducting research and education. They not only provide greater efficiency in traditional operations but also open new pathways for the delivery of new services and imaging technologies. Our future as a specialty is dependent on integrating these informatics solutions into our daily practice. PMID:24029051
Mendelson, David S; Rubin, Daniel L
Significant efforts have been directed toward addressing the financial needs of the developing world for assistance with public health and related development problems. Both public and private organizations have made considerable economic contributions to assist with immediate and long term health challenges, and there is growing international support for programs of national debit relief. Still, there is a need for additional resources to combat international health problems, which go beyond largesse. This paper calls for the creation of a legally rooted, global tax as a mechanism for consistent long term funding. Specifically, the paper proposes engagement of the World Trade Organization as a vehicle to sponsor a global tax on multinational corporations who have benefited most from the international trading scheme. PMID:17639846
Blum, J D
Time of information in which the authors live resulted in the increase of the amount of the information exponential growth of the new kind of knowledge, flourishing of the familiar ones and the appearance of the new sciences. Medical (health) informatics occupies the central place in all the segments of modern medicine in the past 30 years—in practical work, education
The Biomedical Informatics Research Network is wide breadth project sponsored by the American National Institutes of Health (NIH) to promote the use of modern telecommunication for data exchange and collaboration in brain research. The project is attempting to buid a database and network infrastructure in which neuroscientists will post, query, and analyze raw data, processed data, and the results of
Simone Santini; Amarnath Gupta
Health systems played a key role in the dramatic rise in global life expectancy that occurred during the 20th century, and have continued to contribute enormously to the improvement of the health of most of the world's population. The health workforce is the backbone of each health system, the lubricant that facilitates the smooth implementation of health action for sustainable socio-economic development. It has been proved beyond reasonable doubt that the density of the health workforce is directly correlated with positive health outcomes. In other words, health workers save lives and improve health. About 59 million people make up the health workforce of paid full-time health workers world-wide. However, enormous gaps remain between the potential of health systems and their actual performance, and there are far too many inequities in the distribution of health workers between countries and within countries. The Americas (mainly USA and Canada) are home to 14% of the world's population, bear only 10% of the world's disease burden, have 37% of the global health workforce and spend about 50% of the world's financial resources for health. Conversely, sub-Saharan Africa, with about 11% of the world's population bears over 24% of the global disease burden, is home to only 3% of the global health workforce, and spends less than 1% of the world's financial resources on health. In most developing countries, the health workforce is concentrated in the major towns and cities, while rural areas can only boast of about 23% and 38% of the country's doctors and nurses respectively. The imbalances exist not only in the total numbers and geographical distribution of health workers, but also in the skills mix of available health workers. WHO estimates that 57 countries world wide have a critical shortage of health workers, equivalent to a global deficit of about 2.4 million doctors, nurses and midwives. Thirty six of these countries are in sub- Saharan Africa. They would need to increase their health workforce by about 140% to achieve enough coverage for essential health interventions to make a positive difference in the health and life expectancy of their populations. The extent causes and consequences of the health workforce crisis in Sub-Saharan Africa, and the various factors that influence and are related to it are well known and described. Although there is no "magic bullet" solution to the problem, there are several documented, tested and tried best practices from various countries. The global health workforce crisis can be tackled if there is global responsibility, political will, financial commitment and public-private partnership for country-led and country-specific interventions that seek solutions beyond the health sector. Only when enough health workers can be trained, sustained and retained in sub-Saharan African countries will there be meaningful socio-economic development and the faintest hope of attaining the Millennium Development Goals in the sub-continent. PMID:17617671
Anyangwe, Stella C E; Mtonga, Chipayeni
Background: Systematic reviews of health promotion and public health interventions are increasingly being conducted to assist public policy decision making. Many intra-country initiatives have been established to conduct systematic reviews in their relevant public health areas. The Cochrane Collaboration, an international organisation established to conduct and publish systematic reviews of healthcare interventions, is committed to high quality reviews that are regularly updated, published electronically, and meeting the needs of the consumers. Aims: To identify global priorities for Cochrane systematic reviews of public health topics. Methods: Systematic reviews of public health interventions were identified and mapped against global health risks. Global health organisations were engaged and nominated policy-urgent titles, evidence based selection criteria were applied to set priorities. Results: 26 priority systematic review titles were identified, addressing interventions such as community building activities, pre-natal and early infancy psychosocial outcomes, and improving the nutrition status of refugee and displaced populations. Discussion: The 26 priority titles provide an opportunity for potential reviewers and indeed, the Cochrane Collaboration as a whole, to address the previously unmet needs of global health policy and research agencies.
Doyle, J; Waters, E; Yach, D; McQueen, D; De Francisco, A; Stewart, T; Reddy, P; Gulmezoglu, A; Galea, G; Portela, A
Focusing mainly on the United States and Latin America, we aimed to identify the constructions of social reality held by the major stakeholders participating in policy debates about global trade, public health, and health services. In a multi-method, qualitative design, we used three sources of data: research and archival literature, 1980–2004; interviews with key informants who represented major organizations participating
Howard Waitzkin; Rebeca Jasso-Aguilar; Angela Landwehr
Focusing mainly on the United States and Latin America, we aimed to identify the constructions of social reality held by the major stakeholders participating in policy debates about global trade, public health, and health services. In a multi-method, qualitative design, we used three sources of data: research and archival literature, 1980-2004; interviews with key informants who represented major organizations participating in these debates, 2002-2004; and organizational reports, 1980-2004. We targeted several types of organizations: government agencies, international financial institutions (IFIs) and trade organizations, international health organizations, multinational corporations, and advocacy groups. Many governments in Latin America define health as a right and health services as a public good. Thus, the government bears responsibility for that right. In contrast, the US government's philosophy of free trade and promoting a market economy assumes that by expanding the private sector, improved economic conditions will improve overall health with a minimum government provision of health care. US government agencies also view promotion of global health as a means to serve US interests. IFIs have emphasized reforms that include reduction and privatization of public sector services. International health organizations have tended to adopt the policy perspectives of IFIs and trade organizations. Advocacy groups have emphasized the deleterious effects of international trade agreements on public health and health services. Organizational stakeholders hold widely divergent constructions of reality regarding trade, public health, and health services. Social constructions concerning trade and health reflect broad ideologies concerning the impacts of market processes. Such constructions manifest features of "creed," regarding the role of the market in advancing human purposes and meeting human needs. Differences in constructions of trade and health constrain policies to address the profound changes generated by global trade. PMID:15955394
Waitzkin, Howard; Jasso-Aguilar, Rebeca; Landwehr, Angela; Mountain, Carolyn
Recent studies have shown evidence of a direct and positive causal link between the number of health workers and health outcomes. Several studies have identified an adequate health workforce as one of the key ingredients to achieving improved health outcomes. Global health initiatives are faced with human resources issues as a major, system-wide constraint. This article explores how the Global
Sigrid Dräger; Gulin Gedik; Mario R Dal Poz
We assess the human health and economic impacts of projected 2000-2050 changes in ozone pollution using the MIT Emissions Prediction and Policy Analysis - Health Effects (EPPA-HE) model, in combination with results from the GEOS-Chem global tropospheric chemistry model of climate and chemistry effects of projected future emissions. We use EPPA-HE to assess the human health damages (including mortality and morbidity) caused by ozone pollution, and quantify their economic impacts in sixteen world regions. We compare the costs of ozone pollution under scenarios with 2000 and 2050 ozone precursor and greenhouse gas emissions (using the Intergovernmental Panel on Climate Change (IPCC) Special Report on Emissions Scenarios (SRES) A1B scenario). We estimate that health costs due to global ozone pollution above pre-industrial levels by 2050 will be 580 billion (year 2000) and that mortalities from acute exposure will exceed 2 million. We find that previous methodologies underestimate costs of air pollution by more than a third because they do not take into account the long-term, compounding effects of health costs. The economic effects of emissions changes far exceed the influence of climate alone.
Selin, N. E.; Wu, S.; Nam, K. M.; Reilly, J. M.; Paltsev, S.; Prinn, R. G.; Webster, M. D.
Whether the result of cyclical atmospheric changes, anthropogenic activities, or combinations of both, authorities now agree that the earth is warming from a variety of climatic effects, including the cascading effects of greenhouse gas emissions to support human activities. To date, most reports of the public health outcomes of global warming have been anecdotal and retrospective in design and have focused on heat stroke deaths following heat waves, drowning deaths in floods and tsunamis, and mosquito-borne infectious disease outbreaks following tropical storms and cyclones. Accurate predictions of the true public health outcomes of global climate change are confounded by several effect modifiers including human acclimatization and adaptation, the contributions of natural climatic changes, and many conflicting atmospheric models of climate change. Nevertheless, temporal relationships between environmental factors and human health outcomes have been identified and may be used as criteria to judge the causality of associations between the human health outcomes of climate changes and climate-driven natural disasters. Travel medicine physicians are obligated to educate their patients about the known public health outcomes of climate changes, about the disease and injury risk factors their patients may face from climate-spawned natural disasters, and about the best preventive measures to reduce infectious diseases and injuries following natural disasters throughout the world. PMID:17107430
Diaz, James H
Background:This article examines the multifaceted structures and complex operations of the World Health Organization and its regional offices; it also reassesses the form and the workings of the global smallpox eradication programme with which these bodies were closely linked in the 1960s and 1970s.Methods:Using the case study of South Asia, it seeks to highlight the importance of writing nuanced histories
ABSTRACT: The transition in global health from infectious to chronic disease, especially cardiovascular disease, poses a threat to the economies of the less developed world. As a more sophisticated workforce becomes,a highly valued and harder-to-replace economic,in- vestment, the increasing prevalence of cardiovascular risk factors becomes a threat to eco- nomic,development. The next two decades,offer a critical period for intervention to
Henry Greenberg; Susan U. Raymond; Stephen R. Leeder
Vaccine informatics is an emerging research area that focuses on development and applications of bioinformatics methods that can be used to facilitate every aspect of the preclinical, clinical, and postlicensure vaccine enterprises. Many immunoinformatics algorithms and resources have been developed to predict T- and B-cell immune epitopes for epitope vaccine development and protective immunity analysis. Vaccine protein candidates are predictable in silico from genome sequences using reverse vaccinology. Systematic transcriptomics and proteomics gene expression analyses facilitate rational vaccine design and identification of gene responses that are correlates of protection in vivo. Mathematical simulations have been used to model host-pathogen interactions and improve vaccine production and vaccination protocols. Computational methods have also been used for development of immunization registries or immunization information systems, assessment of vaccine safety and efficacy, and immunization modeling. Computational literature mining and databases effectively process, mine, and store large amounts of vaccine literature and data. Vaccine Ontology (VO) has been initiated to integrate various vaccine data and support automated reasoning.
He, Yongqun; Rappuoli, Rino; De Groot, Anne S.; Chen, Robert T.
December 1st marks World AIDS Day with the theme 'Getting to zero'. Three years ago, UNAIDS articulated what was then considered to be an ambitious vision, the aspiration for zero new HIV infections and zero-AIDS related deaths underpinned by zero discrimination. As we imagine the Post-2015 development agenda, we can and should reconceptualise this vision as a set of concrete goals.This Viewpoint argues that today's rapidly changing world, including its shifting geo-political and economic landscape, requires policy responses that are context-sensitive. We highlight the Shared Responsibility-Global Solidarity agenda, as pioneered by the African Union in its recent Roadmap on AIDS, tuberculosis, and malaria, to illustrate ways in which global health can be re-thought to tackle twenty-first century challenges. In light of the emerging debate on what a Post-2015 development agenda and accountability framework should look like, we argue that the AIDS response offers lessons as a pathfinder which can pave the way for global health responses in which the most marginalised are at the centre of the debate, human rights are protected under the rule of law, strong accountability is in place for results for people, and community and participatory processes are the norm. These hard-learned and -won principles of the AIDS response are critical if we are to realize a world in which there is zero inequality and health justice for all. PMID:23199137
Buse, Kent; Blackshaw, Ruth; Ndayisaba, Marie-Goretti Harakeye
‘Researcher identity’ affects global health research in profound and complex ways. Anthropologists in particular have led the way in portraying the multiple, and sometimes tension-generating, identities that researchers ascribe to themselves, or have ascribed to them, in their places of research. However, the central importance of researcher identity in the ethical conduct of global health research has yet to be fully appreciated. The capacity of researchers to respond effectively to the ethical tensions surrounding their identities is hampered by lack of conceptual clarity, as to the nature and scope of the issues involved. This paper strives to provide some clarification of these ethical tensions by considering researcher identity from the perspective of (1) Guillemin and Heggen’s (2009) key distinction between procedural ethics and ethics in practice, and (2) our own distinction between perceptions of identity that are either symmetrical or asymmetrical, with the potential to shift research relationships toward greater or lesser ethical harmony. Discussion of these concepts is supported with ethnographic examples from relevant literature and from our own (United States (US) Government-funded) research in South Africa. A preliminary set of recommendations is provided in an effort to equip researchers with a greater sense of organization and control over the ethics of researcher identity. The paper concludes that the complex construction of researcher identity needs to be central among the ethical concerns of global health researchers, and that the conceptual tools discussed in the paper are a useful starting point for better organizing and acting on these ethical concerns.
Simon, Christian; Mosavel, Maghboeba
December 1st marks World AIDS Day with the theme ‘Getting to zero’. Three years ago, UNAIDS articulated what was then considered to be an ambitious vision, the aspiration for zero new HIV infections and zero-AIDS related deaths underpinned by zero discrimination. As we imagine the Post-2015 development agenda, we can and should reconceptualise this vision as a set of concrete goals. This Viewpoint argues that today’s rapidly changing world, including its shifting geo-political and economic landscape, requires policy responses that are context-sensitive. We highlight the Shared Responsibility-Global Solidarity agenda, as pioneered by the African Union in its recent Roadmap on AIDS, tuberculosis, and malaria, to illustrate ways in which global health can be re-thought to tackle twenty-first century challenges. In light of the emerging debate on what a Post-2015 development agenda and accountability framework should look like, we argue that the AIDS response offers lessons as a pathfinder which can pave the way for global health responses in which the most marginalised are at the centre of the debate, human rights are protected under the rule of law, strong accountability is in place for results for people, and community and participatory processes are the norm. These hard-learned and -won principles of the AIDS response are critical if we are to realize a world in which there is zero inequality and health justice for all.
|As far as the authors are aware, there is no published information that assesses the beliefs of students regarding global health issues. The purpose of this study was twofold: first, to assess students' baseline knowledge and beliefs regarding issues in global health and second, to evaluate the effectiveness of a new global health course by…
Moore, Brianna; Sorensen, William; Cooper, Cheryl; Daussat, Lura
As far as the authors are aware, there is no published information that assesses the beliefs of students regarding global health issues. The purpose of this study was twofold: first, to assess students' baseline knowledge and beliefs regarding issues in global health and second, to evaluate the effectiveness of a new global health course by…
Moore, Brianna; Sorensen, William; Cooper, Cheryl; Daussat, Lura
A survey of global health experts attending an invited meeting provided a means to map key issues perceived to be shaping emerging global public health agendas. Eighty-five participants proposed three major issues likely to have the most significant impact on the field of global health in the coming years. Six raters grouped the resultant items, with multi-dimensional scaling (MDS) analysis
Alastair Ager; Gary Yu; Sabrina Hermosilla
For the practicing physician, the behavioral implications of preventing, diagnosing, and treating cancer are many and varied. Fortunately, an enhanced capacity in informatics may help create a redesigned ecosystem in which applying evidence-based principles from behavioral medicine will become a routine part of care. Innovation to support this evolution will be spurred by the “meaningful use” criteria stipulated by the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009, and by focused research and development efforts within the broader health information ecosystem. The implications for how to better integrate evidence-based principles in behavioral medicine into oncology care through both spheres of development are discussed within the framework of the cancer control continuum. The promise of using the data collected through these tools to accelerate discovery in psycho-oncology is also discussed. If nurtured appropriately, these developments should help accelerate successes against cancer by altering the behavioral milieu.
Hesse, Bradford W.; Suls, Jerry M.
Intimate partner violence--physical, psychological, or sexual abuse of women perpetrated by intimate partners--is one of the most common forms of violence against women, and is associated with adverse women's reproductive and maternal health outcomes. We review the opportunities for addressing intimate partner violence by the health system, examine promising approaches, and outline future challenges for developing effective health-systems responses to violence. Evidence shows that women seldom approach support services in response to violence, but do seek health care at some point in their lives. In fact, women's utilization of reproductive-health services in particular has been increasing globally. These services have a broad reach and represent an important opportunity to engage in violence prevention. Although health systems-based responses to intimate partner violence have emerged, rigorous evaluations to guide program planning and policy efforts to reduce violence are limited. Programs in the United States have expanded from improving individual provider prevention practices to instituting system-wide changes to ensure sustainability of these practices. Developing-country program responses, though limited, have been system-wide and multisectoral right from the start. Our review highlights 3 challenges for developing and expanding health-systems responses to violence. First, interventions should focus on creating a supportive environment within the health system and strengthening linkages across health care and allied sectors. Second, rigorous evaluations of health sector-based interventions are needed for a sound evidence base to guide programmatic and policy decisions. Finally, research is needed to identify the entry points for engaging men on violence prevention, and to examine the feasibility and effectiveness of such interventions. PMID:21598270
Chibber, Karuna S; Krishnan, Suneeta
Biobanks can have a pivotal role in elucidating disease etiology, translation, and advancing public health. However, meeting these challenges hinges on a critical shift in the way science is conducted and requires biobank harmonization. There is growing recognition that a common strategy is imperative to develop biobanking globally and effectively. To help guide this strategy, we articulate key principles, goals, and priorities underpinning a roadmap for global biobanking to accelerate health science, patient care, and public health. The need to manage and share very large amounts of data has driven innovations on many fronts. Although technological solutions are allowing biobanks to reach new levels of integration, increasingly powerful data-collection tools, analytical techniques, and the results they generate raise new ethical and legal issues and challenges, necessitating a reconsideration of previous policies, practices, and ethical norms. These manifold advances and the investments that support them are also fueling opportunities for biobanks to ultimately become integral parts of health-care systems in many countries. International harmonization to increase interoperability and sustainability are two strategic priorities for biobanking. Tackling these issues requires an environment favorably inclined toward scientific funding and equipped to address socio-ethical challenges. Cooperation and collaboration must extend beyond systems to enable the exchange of data and samples to strategic alliances between many organizations, including governmental bodies, funding agencies, public and private science enterprises, and other stakeholders, including patients. A common vision is required and we articulate the essential basis of such a vision herein.
Harris, Jennifer R; Burton, Paul; Knoppers, Bartha Maria; Lindpaintner, Klaus; Bledsoe, Marianna; Brookes, Anthony J; Budin-Lj?sne, Isabelle; Chisholm, Rex; Cox, David; Deschenes, Mylene; Fortier, Isabel; Hainaut, Pierre; Hewitt, Robert; Kaye, Jane; Litton, Jan-Eric; Metspalu, Andres; Ollier, Bill; Palmer, Lyle J; Palotie, Aarno; Pasterk, Markus; Perola, Markus; Riegman, Peter H J; van Ommen, Gert-Jan; Yuille, Martin; Zatloukal, Kurt
Reproductive health research in low-resource settings poses unique and complex challenges that must be addressed to ensure that global research is conducted with strict adherence to ethical principles, offers direct benefit to the research subjects, and has the potential for adoption of positive findings to the target population. This article addresses challenges to conducting reproductive health research in low-resource settings in the following areas: (1) establishment and maintenance of global collaboration, (2) community partnerships, (3) ethical issues, including informed consent and the role of incentives, (4) staff training and development, (5) data collection and management, and (6) infrastructure and logistics. Particular attention to these challenges is important to ensure that research is culturally appropriate and methodologically sound and enhances the adoption of health-promoting behaviors. Rigorous evaluation of interventions in low-resource settings may be a cost-effective and time-efficient way to identify interventions for large-scale program replication to improve women's health. PMID:20849297
Stenson, Amy L; Kapungu, Chisina T; Geller, Stacie E; Miller, Suellen
Biobanks can have a pivotal role in elucidating disease etiology, translation, and advancing public health. However, meeting these challenges hinges on a critical shift in the way science is conducted and requires biobank harmonization. There is growing recognition that a common strategy is imperative to develop biobanking globally and effectively. To help guide this strategy, we articulate key principles, goals, and priorities underpinning a roadmap for global biobanking to accelerate health science, patient care, and public health. The need to manage and share very large amounts of data has driven innovations on many fronts. Although technological solutions are allowing biobanks to reach new levels of integration, increasingly powerful data-collection tools, analytical techniques, and the results they generate raise new ethical and legal issues and challenges, necessitating a reconsideration of previous policies, practices, and ethical norms. These manifold advances and the investments that support them are also fueling opportunities for biobanks to ultimately become integral parts of health-care systems in many countries. International harmonization to increase interoperability and sustainability are two strategic priorities for biobanking. Tackling these issues requires an environment favorably inclined toward scientific funding and equipped to address socio-ethical challenges. Cooperation and collaboration must extend beyond systems to enable the exchange of data and samples to strategic alliances between many organizations, including governmental bodies, funding agencies, public and private science enterprises, and other stakeholders, including patients. A common vision is required and we articulate the essential basis of such a vision herein. PMID:22713808
Harris, Jennifer R; Burton, Paul; Knoppers, Bartha Maria; Lindpaintner, Klaus; Bledsoe, Marianna; Brookes, Anthony J; Budin-Ljøsne, Isabelle; Chisholm, Rex; Cox, David; Deschênes, Mylène; Fortier, Isabel; Hainaut, Pierre; Hewitt, Robert; Kaye, Jane; Litton, Jan-Eric; Metspalu, Andres; Ollier, Bill; Palmer, Lyle J; Palotie, Aarno; Pasterk, Markus; Perola, Markus; Riegman, Peter H J; van Ommen, Gert-Jan; Yuille, Martin; Zatloukal, Kurt
Over the last twenty years there have been great advances in light microscopy with the result that multi-dimensional imaging has driven a revolution in modern biology. The development of new approaches of data acquisition are reportedly frequently, and yet the significant data management and analysis challenges presented by these new complex datasets remains largely unsolved. Like the well-developed field of genome bioinformatics, central repositories are and will be key resources, but there is a critical need for informatics tools in individual laboratories to help manage, share, visualize, and analyze image data. In this article we present the recent efforts by the bioimage informatics community to tackle these challenges and discuss our own vision for future development of bioimage informatics solution.
Swedlow, Jason R.; Goldberg, Ilya G.; Eliceiri, Kevin W.
Widening disparities in health and human rights at a global level represent the dark side of progress associated with escalation of economic and military exploitation and exponential population growth in the 20th century. Even the most basic universal human rights cannot be achieved for all under these circumstances. The goal of improved population health will be similarly elusive while medical care is commodified and exploited for commercial gain in the marketplace. Recognition of the powerful forces that polarize our world and commitment to reversing them are essential for the achievement of human rights for all, for the improvement of public health, and for the peaceful progress required to protect the "rational self-interest" of the most privileged people on earth against the escalation of war, disease, and other destructive forces arising from widespread poverty and ecological degradation.
Benatar, S R
Building on its experience as a principal participant in the President's Emergency Plan for AIDS Relief, the Department of Health and Human Services has embarked on a new era of global initiatives that ultimately will protect the health of Americans. The Global Health Strategy announced by health and human services secretary Kathleen Sebelius in January 2012 recognizes that the health of Americans is intertwined with that of the rest of the world. The initiative features ten objectives that range from enhanced global health surveillance and preventing infectious diseases and health threats to health diplomacy. The Global Health Strategy is designed to make optimal use of the department's many specialty agencies and their considerable technical and programmatic expertise. The strategy moves beyond the President's Emergency Plan for AIDS Relief to redefine Health and Human Services' role outside US borders in addressing the health challenges of the twenty-first century. PMID:22778347
Over the last decade development assistance for health has more than doubled. This increase provides an unprecedented opportunity to scale up health services, and in doing so, achieve the health Millennium Development Goals. However, sustaining scaling up will in turn require sustainable donor support until domestic health financing can substitute for it. The provision of long-term predictable finance is of particular concern in health because the bulk of costs are recurrent and many interventions require sustained, multi-year support to be successful. This is also true for health systems strengthening efforts. As the bulk of new aid resources flow through Global Health Partnerships (GHPs), their ability to make long-term commitments is critical to health systems development. In order to better understand the constraints that prevent development partners from making long-term commitments of health aid, the World Health Organization reviewed the practices of seven major health partners in committing development assistance funds over the long term. The review found increasing evidence of long-term commitments of aid for health in each of the seven agencies. The GHPs and their funders have been at the forefront of this trend, pioneering many of the new approaches. The study concludes that all partners have scope to improve the duration of aid within existing rules and regulations, and that the main constraints to doing so are political. Predictability is even more of a concern in current global economic circumstances, as access to resources begins to be squeezed. In this context it is important that we learn from GHPs, which have successfully tested innovative approaches to both raising and disbursing health funds. The prospects for change associated with the new administration in the United States-the largest health donor and the most unpredictable, but also a major supporter of GHPs-make this task even more urgent. PMID:20472694
Dodd, Rebecca; Lane, Christopher
Biological threats to health are challenging governments worldwide. National strategies for preventing and managing existing and emerging threats require significant collaboration across borders, sectors, services, agencies and professions. Perhaps most important are the partnerships of key national health leaders who can develop and foster these relationships. Government Chief Nursing Officers (CNOs) and Chief Medical Officers (CMOs), providing leadership in more than 100 countries worldwide, play crucial roles in addressing biological threats to health. However, much of this leadership is exercised without the benefit of strong collaborative relationships between these two key national leaders. Unfortunately, without functional partnerships between nurses and physicians at all levels, national and global capacity to address biological and other threats will be greatly compromised. For these reasons, the first ever global forum for CNOs and CMOs teams was hosted by the Lillian Carter Center for International Nursing in Atlanta, in June 2004. Representatives from 70 countries focused on biological threats in relation to three key purposes: (1) gaining shared scientific and practical knowledge; (2) developing and strengthening collaboration and partnerships among CNOs and CMOs; and, (3) creating a joint plan for advancing national preparedness. This article describes the content, process and outcomes of this historic meeting. PMID:15989164
Salmon, Marla E
Global warming is likely to result in a variety of environmental effects ranging from impacts on species diversity, changes in population size in flora and fauna, increases in sea level and possible impacts on the primary productivity of the sea. Potential impacts on human health and welfare have included possible increases in heat related mortality, changes in the distribution of disease vectors, and possible impacts on respiratory diseases including hayfever and asthma. Most of the focus thus far is on effects which are directly related to increases in temperature, e.g., heat stress or perhaps one step removed, e.g., changes in vector distribution. Some of the more severe impacts are likely to be much less direct, e.g., increases in migration due to agricultural failure following prolonged droughts. This paper discusses two possible approaches to the study of these less-direct impacts of global warming and presents information from on-going research using each of these approaches.
International health electives offer unique experiences for medical students to develop clinical skills and cultural competencies in unique and diverse environments. Medical students have been increasingly pursuing these learning opportunities despite the challenges. However, their goals in pursuing these opportunities and the relation between their learning objectives and actual experiences have not been studied adequately. It is important to assess these programs based on student objectives and whether those objectives are met. Thirty-seven medical students from five cohorts at a US medical school completed pre-post questionnaires regarding their global health elective objectives and learning experiences. The questionnaires included mostly open-ended questions and a Likert-scale rating of their overall experience. Qualitative thematic analysis involved inductive coding and followed a content-driven immersion-crystallization approach. Quantitative program evaluation measures yielded descriptive statistics. Five general objectives and four types of learning experiences were identified. Student objectives were: (1) to observe the practice and organization of health care in another country; (2) improve medical/surgical skills; (3) improve language skills; (4) learn about another culture; and (5) deepen knowledge of infectious diseases. All of their objectives were achieved. Moreover, one learning theme, "self-reflection and personal growth," was not a student objective. Quantitative assessment showed that most students had a favorable elective experience. Program challenges were also identified. Students in a global health elective were able to fulfill self-identified learning objectives, while also gaining other unexpected yet important lessons. Students' learning objectives also should be considered in evaluating learning experiences in international health electives. PMID:22367606
Holmes, David; Zayas, Luis E; Koyfman, Alex
The ability of communities to respond to the pressures of globalization is an important determinant of community health. Tourism is a rapidly growing industry and there is an increasing concern about its health impact on local communities. Nonetheless, little research has been conducted to identify potential mitigating measures. We therefore took advantage of the 'natural experiment' provided by the expansion of tourism in Cuba, and conducted four focus groups and key informants interviews in each of two coastal communities. Participants expressed concerns about psycho-social impacts as well as occupational and environmental concerns, and both infectious and chronic diseases. A wide array of programs that had been developed to mitigate potential negative were described. Some of the programs were national in scope and others were locally developed. The programs particularly targeted youth as the most vulnerable population at risk of addictions and sexually transmitted infections. Occupational health concerns for workers in the tourism sector were also addressed, with many of the measures implemented protecting tourists as well. The health promotion and various other participatory action initiatives implemented showed a strong commitment to address the impacts of tourism and also contributed to building capacity in the two communities. Although longitudinal studies are needed to assess the sustainability of these programs and to evaluate their long-term impact in protecting health, other communities can learn from the initiatives taken. PMID:18083687
Spiegel, J M; Gonzalez, M; Cabrera, G J; Catasus, S; Vidal, C; Yassi, A
'One Health' proposes the unification of medical and veterinary sciences with the establishment of collaborative ventures in clinical care, surveillance and control of cross-species disease, education, and research into disease pathogenesis, diagnosis, therapy and vaccination. The concept encompasses the human population, domestic animals and wildlife, and the impact that environmental changes ('environmental health') such as global warming will have on these populations. Visceral leishmaniasis is a perfect example of a small companion animal disease for which prevention and control might abolish or decrease the suffering of canine and human patients, and which aligns well with the One Health approach. In this review we discuss how surveillance for leishmaniases is undertaken globally through the control of anthroponootic visceral leishmaniasis (AVL) and zoonotic visceral leishmaniasis (ZVL). The ZVL epidemic has been managed to date by the culling of infected dogs, treatment of human cases and control of the sandfly vector by insecticidal treatment of human homes and the canine reservoir. Recently, preventive vaccination of dogs in Brazil has led to reduction in the incidence of the canine and human disease. Vaccination permits greater dog owner compliance with control measures than a culling programme. Another advance in disease control in Africa is provided by a surveillance programme that combines remote satellite sensing, ecological modelling, vector surveillance and geo-spatial mapping of the distribution of vectors and of the animal-to-animal or animal-to-human pathogen transmission. This coordinated programme generates advisory notices and alerts on emerging infectious disease outbreaks that may impede or avoid the spreading of visceral leishmaniasis to new areas of the planet as a consequence of global warming. PMID:21985335
Palatnik-de-Sousa, Clarisa B; Day, Michael J
The Center for Global Health (CGH) Short-Term Scientist Exchange Program (STSEP) promotes collaborative research between established U.S. and foreign scientists from low, middle, and upper-middle income countries by supporting, in part, exchange visits of cancer researchers between U.S. and foreign laboratories.The visits vary in duration. Applications are accepted throughout the year, with application deadlines of June 1, September 1, December 1, and March 1. Candidates are notified of the funding decision within one month of these deadlines.
Increased availability of large repositories of chemical compounds is creating new challenges and opportunities for the application of machine learning methods to problems in computational chemistry and chemical informatics. Because chemical compounds are often represented by the graph of their covalent bonds, machine learning methods in this domain must be capable of processing graphical structures with variable size. Here we
Liva Ralaivola; Sanjay Joshua Swamidass; Hiroto Saigo; Pierre Baldi
Community informatics is a promising strategy for taking advantage of information and communication technologies (ICTs) to further goals of community development. It is important, however, that proponents of this approach recognize that it is based on the assumption that technology in itself can lead to positive social development. This \\
The increasing interconnectedness of the world and the factors that affect health lay the foundation for the evolving practice of global health diplomacy. There has been limited discussion in the nursing literature about the concept of global health diplomacy or the role of nurses in such initiatives. A discussion of this concept is presented here by the members of a Task Force on Global Health Diplomacy of the American Academy of Nursing Expert Panel on Global Nursing and Health (AAN EPGNH). The purpose of this article is to present an integrative review of literature on the concept of global health diplomacy and to identify implications of this emerging field for nursing education, practice, and research. The steps proposed by Whittemore and Knafl (2005) were adapted and applied to the integrative review of theoretical and descriptive articles about the concept of global health diplomacy. This review included an analysis of the historical background, definition, and challenges of global health diplomacy and suggestions about the preparation of global health diplomats. The article concludes with a discussion of implications for nursing practice, education, and research. The Task Force endorses the definition of global health diplomacy proposed by Adams, Novotny, and Leslie (2008) but recommends that further dialogue and research is necessary to identify opportunities and educational requirements for nurses to contribute to the emerging field of global health diplomacy. PMID:22999856
Hunter, Anita; Wilson, Lynda; Stanhope, Marcia; Hatcher, Barbara; Hattar, Marianne; Hilfinger Messias, Deanne K; Powell, Dorothy
Background Although attainment of the health-related Millennium Development Goals relies on countries having adequate numbers of human resources for health (HRH) and their appropriate distribution, global understanding of the systems used to generate information for monitoring HRH stock and flows, known as human resources information systems (HRIS), is minimal. While HRIS are increasingly recognized as integral to health system performance assessment, baseline information regarding their scope and capability around the world has been limited. We conducted a review of the available literature on HRIS implementation processes in order to draw this baseline. Methods Our systematic search initially retrieved 11 923 articles in four languages published in peer-reviewed and grey literature. Following the selection of those articles which detailed HRIS implementation processes, reviews of their contents were conducted using two-person teams, each assigned to a national system. A data abstraction tool was developed and used to facilitate objective assessment. Results Ninety-five articles with relevant HRIS information were reviewed, mostly from the grey literature, which comprised 84?% of all documents. The articles represented 63 national HRIS and two regionally integrated systems. Whereas a high percentage of countries reported the capability to generate workforce supply and deployment data, few systems were documented as being used for HRH planning and decision-making. Of the systems examined, only 23?% explicitly stated they collect data on workforce attrition. The majority of countries experiencing crisis levels of HRH shortages (56?%) did not report data on health worker qualifications or professional credentialing as part of their HRIS. Conclusion Although HRIS are critical for evidence-based human resource policy and practice, there is a dearth of information about these systems, including their current capabilities. The absence of standardized HRIS profiles (including documented processes for data collection, management, and use) limits understanding of the availability and quality of information that can be used to support effective and efficient HRH strategies and investments at the national, regional, and global levels.
After World War II, health was firmly integrated into the discourse about national development. Transition theories portrayed health improvements as part of an overall development pattern based on economic growth as modeled by the recent history of industrialization in high-income countries. In the 1970s, an increasing awareness of the environmental degradation caused by industrialization challenged the conventional model of development. Gradually, it became clear that health improvements depended on poverty-reduction strategies including industrialization. Industrialization, in turn, risked aggravating environmental degradation with its negative effects on public health. Thus, public health in low-income countries threatened to suffer from lack of economic development as well as from the results of global economic development. Similarly, demands of developing countries risked being trapped between calls for global wealth redistribution, a political impossibility, and calls for unrestricted material development, which, in a world of finite land, water, air, energy, and resources, increasingly looked like a physical impossibility, too. Various international bodies, including the WHO, the Brundtland Commission, and the World Bank, tried to capture the problem and solution strategies in development theories. Broadly conceived, two models have emerged: a "localist model," which analyzes national health data and advocates growth policies with a strong focus on poverty reduction, and a "globalist" model, based on global health data, which calls for growth optimization, rather than maximization. Both models have focused on different types of health burdens and have received support from different institutions. In a nutshell, the health discourse epitomized a larger controversy regarding competing visions of development. PMID:22467707
SUMMARY This paper discusses what is meant by 'global health promotion' and the extent to which global governance architecture is emerging, enabling people to increase control over, and to improve, their health within an increasingly global context. A review of selected initiatives on breast-milk substitutes, healthy cities, tobacco control and diet and nutrition suggests that existing institutions are uneven in
Remarkable advances have been achieved over the past decade in confronting the global HIV epidemic. By the end of 2010, 6.5 million persons living with HIV had initiated antiretroviral therapy in low and middle-income countries, the majority in sub Saharan Africa. Of the total of 2.5 new HIV infections that occurred in 2010, 1.9 million occurred in sub Saharan Africa. Nonetheless, 22 countries in sub Saharan Africa have experienced a decrease in HIV incidence. These remarkable achievements have involved a transformation of fragile health system. Examples include new models of care, task shifting, infrastructure enhancement, establishment of new data systems and mobilization of communities. However, many of the same countries where HIV is prevalent also confront other health threats including high maternal and child mortality, high rates of tuberculosis and malaria as well as a burgeoning non-communicable chronic disease threat. Addressing these health threats requires taking the lessons learned from the HIV response and adapting them to confront these threats. Through building on the foundation established, similar progress may be achieved in addressing these health threats while maintaining the momentum of the HIV response.
In recent years, there has been increasing awareness about autism spectrum disorders (ASD) around the world, including in low and middle income countries. Unlike countries in Western Europe and North America where infrastructure and capacity are available to help meet some of the needs of individuals with ASD, little expertise or capacity exists in most of the developing world. In 2008 Autism Speaks launched the Global Autism Public Health (GAPH) Initiative to facilitate the development of systematic and sustainable solutions for enhancing global autism awareness, research, training and service delivery. In the last 3 years Autism Speaks has established collaboration with stakeholders from over 20 countries who are working alongside dedicated local and international stakeholders to effect change. In this article, the GAPH framework is described, along with a few brief case examples that illustrate how the framework for implementation of the model can occur. GAPH is still in its infancy but has the potential to have significant impact through inclusive collaboration with local and international stakeholders to develop effective and sustainable public health solutions for disseminating best practices and delivering tangible benefits to individuals with ASD and their families. PMID:22605577
Wallace, Simon; Fein, Deborah; Rosanoff, Michael; Dawson, Geraldine; Hossain, Saima; Brennan, Lynn; Como, Ariel; Shih, Andy
International Physicians for the Prevention of Nuclear War has had an impressive public impact in the 1980s, helping to shatter the myths of surviving and medically responding to a nuclear attack. The 1990s present a new challenge for the medical community in a different social and international context characterized by increasing global interdependence. Another view of physician activism is presented to complement advocacy for nuclear disarmament in the promotion of peace. A framework for analysis is provided by "fateful visions"--accepted policy views of prospective superpower relations--drawn from practitioners of foreign policy, international relations, and security affairs. A perceptual gap may exist between physicians who wish to address underlying ethical and public health concerns on security issues and policy practitioners who are accustomed to discussion within existing policy frames of reference that can be pragmatically used. A strategy is proposed for physicians to use their specialized training and skills to evaluate trends in global health interdependence. The international physicians' movement may contribute substantively to the formulation of policy by expanding and interpreting an increasingly complex database on interdependence, and by creating a dialogue with policy formulators based on mutual recognition of the value and legitimacy of each professions' expertise and complementary contributions to international security policy. PMID:2366302
Gellert, G A
Some ways in which a global warming may affect human health are discussed. Research is presented which explores the hypothesis that heat stress-induced mortality may increase substantially in the event of a worldwide temperature increase. Two procedures are applied to four disparate nations: the US, Canada, China and Egypt. Results indicate that significant increases in heat-related mortality are likely to occur, particularly in developing nations. Factors which might help to mitigate these increases, such as acclimatization and air conditioning, are also examined. Another human health impact of a global warming is the likely spread of certain vector-borne diseases into areas of the world where they do not currently exist. Two of these, onchocerciasis and malaria, have been chosen for a detailed international study. The initial steps in this effort are discussed. Policy options are proposed which may prepare international organizations and public officials for difficulties which may arise. Implementation of these procedures, which include continuation of internationally sponsored research, could help to ameliorate many of the problems outlined in this paper.
Nichols, M.C.; Kalkstein, L.S.; Cheng, S. [Univ. of Delaware, Newark, DE (United States). Dept. of Geography
The scientific diaspora is a unique resource for U.S. universities. By drawing on the expertise, experience, and catalytic potential of diaspora scientists, universities can capitalize more fully on their diverse intellectual resources to make lasting contributions to global health. This article examines the unique contributions of the diaspora in international research collaborations, advantages of harnessing the diaspora and benefits to U.S. universities of fostering these collaborations, challenges faced by scientists who want to work with their home countries, examples of scientists engaging with their home countries, and specific strategies U.S. universities and donors can implement to catalyze these collaborations. The contributions of the diaspora to the United States are immense: International students enrolled in academic year 2007-2008 contributed an estimated $15 billion to the U.S. economy. As scientific research becomes increasingly global, the percentage of scientific publications with authors from foreign countries has grown from 8% in 1988 to 20% in 2005. Diaspora scientists can help build trusting relationships with scientists abroad, and international collaborations may improve the health of underserved populations at home. Although opportunities for diaspora networks are increasing, most home countries often lack enabling policies, infrastructure, and resources to effectively utilize their diaspora communities abroad. This article examines how some governments have successfully mobilized their scientific diaspora to become increasingly engaged in their national research agendas. Recommendations include specific strategies, including those that encourage U.S. universities to promote mini-sabbaticals and provide seed funding and flexible time frames. PMID:19318794
Anand, Nalini P; Hofman, Karen J; Glass, Roger I
International Physicians for the Prevention of Nuclear War has had an impressive public impact in the 1980s, helping to shatter the myths of surviving and medically responding to a nuclear attack. The 1990s present a new challenge for the medical community in a different social and international context characterized by increasing global interdependence. Another view of physician activism is presented to complement advocacy for nuclear disarmament in the promotion of peace. A framework for analysis is provided by fateful visions--accepted policy views of prospective superpower relations--drawn from practitioners of foreign policy, international relations, and security affairs. A perceptual gap may exist between physicians who wish to address underlying ethical and public health concerns on security issues and policy practitioners who are accustomed to discussion within existing policy frames of reference that can be pragmatically used. A strategy is proposed for physicians to use their specialized training and skills to evaluate trends in global health interdependence. The international physicians' movement may contribute substantively to the formulation of policy by expanding and interpreting an increasingly complex database on interdependence, and by creating a dialogue with policy formulators based on mutual recognition of the value and legitimacy of each professions' expertise and complementary contributions to international security policy.
Gellert, G.A. (Harvard Univ., Cambridge, MA (USA))
In this paper, the meaning and significance of ethical choices in the arena of health under conditions of globalization are explored. The paper first discusses globalization, its theorized sources and consequences, exposing connections between globalization and local developments in diverse milieux. It is pointed out that the ways in which global and local developments interact are related to specific socio-historical
Pacific Island countries (PICs) are experiencing an epidemic of obesity and consequent chronic diseases. Despite investment in the development of National Plans of Action for Nutrition (NPANs) and interventions to promote healthy eating and physical activity, nutritional status appears to show little improvement. This paper presents a synthesis of the findings from two research papers that were prepared for a 2003 food safety and quality meeting in Nadi, Fiji. The findings indicate that although lifestyle behaviours might be the immediate cause of dietary imbalances, greater attention should focus on omnipresent influences of globalization as a critical element of the nutrition transition in the Pacific. In particular, those aspects of globalization mediated through the World Trade Organization (WTO) Agreements that are placing pressures on food security and fostering increased dependence on imported food of poor nutritional quality. Rapid, significant and sustainable improvements in public health in PICs require interventions that can tackle these underlying contributors to ill health. There are opportunities to explore the use of food regulatory approaches to influence the composition, availability and accessibility of food products. Within the context of the WTO Agreements the legitimacy of food regulatory approaches will depend upon the case to demonstrate the relationship between the intervention and the protection of food security and public health nutrition. The challenges in realising these opportunities are: 1) to have the capacity to construct a case, 2) meet the technical and financial demands to administer and enforce regulatory approaches, and 3) to take advantage of opportunities available and to be able to fully participate in the international policy-making process. PMID:16326635
Hughes, Robert G; Lawrence, Mark A
Objective: To obtain an overview of study designs and study methods used in research eval- uating IT in health care, to present a list of quality criteria by which all kinds of reported evaluation studies on IT systems in health care can be assessed, and to assess the quality of reported evaluation studies on IT in health care and its
Nicolette De Keizer; Elske Ammenwerth