scholarly journals Precision Medicine and Public Health: New Challenges for Effective and Sustainable Health

2021 ◽  
Vol 11 (2) ◽  
pp. 135
Author(s):  
Deborah Traversi ◽  
Alessandra Pulliero ◽  
Alberto Izzotti ◽  
Elena Franchitti ◽  
Licia Iacoviello ◽  
...  

The development of high-throughput omics technologies represents an unmissable opportunity for evidence-based prevention of adverse effects on human health. However, the applicability and access to multi-omics tests are limited. In Italy, this is due to the rapid increase of knowledge and the high levels of skill and economic investment initially necessary. The fields of human genetics and public health have highlighted the relevance of an implementation strategy at a national level in Italy, including integration in sanitary regulations and governance instruments. In this review, the emerging field of public health genomics is discussed, including the polygenic scores approach, epigenetic modulation, nutrigenomics, and microbiomes implications. Moreover, the Italian state of implementation is presented. The omics sciences have important implications for the prevention of both communicable and noncommunicable diseases, especially because they can be used to assess the health status during the whole course of life. An effective population health gain is possible if omics tools are implemented for each person after a preliminary assessment of effectiveness in the medium to long term.

Antibiotics ◽  
2021 ◽  
Vol 10 (9) ◽  
pp. 1040
Author(s):  
Tânia Magalhães Silva ◽  
Marta Estrela ◽  
Eva Rebelo Gomes ◽  
Maria Piñeiro-Lamas ◽  
Adolfo Figueiras ◽  
...  

Coronavirus disease 2019 (COVID-19) has spread globally and is currently having a damaging impact on nearly all countries in the world. The implementation of stringent measures to stop COVID-19 dissemination had an influence on healthcare services and associated procedures, possibly causing antibiotic consumption fluctuations. This paper aims to evaluate the immediate and long-term impact of the COVID-19 pandemic on antibiotic prescribing trends in outpatient care of the Portuguese public health sector, including in primary healthcare centers and hospitals, as well as on specific antibiotic groups known to be closely associated with increased resistance. Segmented regression analysis with interrupted time series data was used to analyze whether the COVID-19 pandemic had an impact in antibiotic prescribing tendencies at a national level. The outcomes from this quasi-experimental approach demonstrate that, at the beginning of the pandemic, a significant, immediate decrease in the overall antibiotic prescribing trends was noticed in the context of outpatient care in Portugal, followed by a statistically non-significant fall over the long term. The data also showed a significant reduction in the prescription of particular antibiotic classes (antibiotics from the Watch group, 3rd-generation cephalosporins, fluoroquinolones, and clarithromycin) upon COVID-19 emergence. These findings revealed an important disruption in antibiotics prescribing caused by the current public health emergency.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
C Nordström ◽  
B Kumar

Abstract Issue Health in all policies is desirable, but moving from the silos approach is a challenge for health care systems. New health policies require more cooperation and broader collaboration between governmental, private and volunteer sector, as well as across professions. Though it is key to implementation of national policies and long-term public health work at the local level, intersectoral collaboration remains elusive. Professionals working with public health and migrant health across Norway often work independently of each other and other sectors. Description of the Problem Evaluation of the Norwegian network for migrant friendly hospitals showed that with the opportunity to meet and share experiences, participants used the new knowledge and network in developing their practice and organisation of services. They experienced greater support to challenge status quo in their institutions. However, fear of making the network “too big to handle” is a barrier to creating intersectoral network. In a recent survey (2017), health personnel ask for digital solutions for finding resources and support in their practice to give better health care to immigrant patients. Results The newly (2020) knowledge HUB part of JAHEE actions brings stakeholders together at the local, regional and national level, ensuring access to the same knowledge, increase evidence based decisions among stakeholders when choosing interventions on the local, regional and national level, including sharing of good practices and promising initiatives at a national level so that they can be replicated. Lessons Professional networks that are coordinated and collaborative are important for development of services and implementation of measures for migrant health. However, expanding them across sectors and fields may create challenges. Combining sectoral networks with a common digital platform may overcome some of these challenges. Key messages Exploiting the potential of collaborative digital solutions may help overcome some barriers to intersectoral approach to migrant health. Coordinated collaborative professional networks can support the participants in developing their practice and organisation of services for migrants.


2019 ◽  
Vol 166 (2) ◽  
pp. 95-98 ◽  
Author(s):  
Samuel Alexander Clarke ◽  
A G A Weir

Following the deliberate chemical attacks in Salisbury last year, a review of UK resilience to chemical incidence was undertaken. The scope was not limited to deliberate attacks, related to terrorism, but was to include non-deliberate and accidental events. Chemical incidents have wide-reaching consequences irrespective of whether they are deliberate or not. The effects of these incidents manifest themselves in terms of immediate health consequences and will also include economic, political and public health effects that may have a much longer impact than the initial disruption. The economic consequences of the Novichok attack were devastating to the local population and businesses in both the short term and the long term, being felt over a year later. This review discusses the effects of these incidents on infrastructure, healthcare provision, law and order, economics and government at a local, regional and national level. The NHS Emergency Preparedness, Resilience and Response Framework was reviewed, and this provides a basic outline of advice for local government to follow in the case of chemical incidents. However, the wider issues of interdepartmental co-operation and how to maintain a response in the long term require further thought. Moreover, the methods by which interagency and regional resilience is maintained in preparing for such an event require a clearer guideline.


Author(s):  
Diana Hart

All countries are faced with the problem of the prevention and control of non-communicable diseases (NCD): implement prevention strategies eff ectively, keep up the momentum with long term benefi ts at the individual and the population level, at the same time tackling hea lth inequalities. Th e aff ordability of therapy and care including innovative therapies is going to be one of the key public health priorities in the years to come. Germany has taken in the prevention and control of NCDs. Germany’s health system has a long history of guaranteeing access to high-quality treatment through universal health care coverage. Th r ough their membership people are entitled to prevention and care services maintaining and restoring their health as well as long term follow-up. Like in many other countries general life expectancy has been increasing steadily in Germany. Currently, the average life expectancy is 83 and 79 years in women and men, respectively. Th e other side of the coin is that population aging is strongly associated with a growing burden of disease from NCDs. Already over 70 percent of all deaths in Germany are caused by four disease entities: cardiovascular disease, cancer, chronic respiratory disease and diabetes. Th ese diseases all share four common risk factors: smoking, alcohol abuse, lack of physical activity and overweight. At the same time, more and more people become long term survivors of disease due to improved therapy and care. Th e German Government and public health decision makers are aware of the need for action and have responded by initiating and implementing a wide spectrum of activities. One instrument by strengthening primary prevention is the Prevention Health Care Act. Its overarching aim is to prevent NCDs before they can manifest themselves by strengthening primary prevention and health promotion in diff erent sett ings. One of the main emphasis of the Prevention Health Care Act is the occupational health promotion at the workplace.


2020 ◽  
Vol 7 (04) ◽  
Author(s):  
K B SAXENA ◽  
A K CHOUDHARY ◽  
RAFAT K SULTANA

Pigeonpea [Cajanus cajan (L.) Millsp.] is a favourite crop of rain-fed farmers due to its high food value, drought tolerance and various soil improving properties. The productivity enhancement of this crop has been a long-term goal at the national level but with a little success. In this context, the advent of hybrid breeding technology with over 30% on-farm yield advantages has provided a much-needed breakthrough. The hybrids in pigeonpea were bred using a stable CMS system and natural out-crossing. It is believed that the adoption of locally adapted hybrids would contribute significantly towards both family income and nutrition.


Author(s):  
Jonathan H. Marks

Collaboration with industry has become the paradigm in public health. Governments commonly develop close relationships with companies that are creating or exacerbating the very problems public health agencies are trying to solve. Nowhere is this more evident than in partnerships with food and soda companies to address obesity and diet-related noncommunicable diseases. The author argues that public-private partnerships and multistakeholder initiatives create webs of influence that undermine the integrity of public health agencies; distort public health research and policy; and reinforce the framing of public health problems and their solutions in ways that are least threatening to the commercial interests of corporate “partners.” We should expect multinational corporations to develop strategies of influence. But public bodies need to develop counter-strategies to insulate themselves from corporate influence in all its forms. The author reviews the ways in which we regulate public-public interactions (separation of powers) and private-private interactions (antitrust and competition laws), and argues for an analogous set of norms to govern public-private interactions. The book also offers a novel framework that is designed to help public bodies identify the systemic ethical implications of their existing or proposed relationships with industry actors. The book makes a compelling case that, in public health, the paradigm public-private interaction should be at arm’s length: separation, not collaboration. The author calls for a new paradigm to protect and promote public health while avoiding the ethical perils of partnership with industry.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  

Abstract Countries have a wide range of lifestyles, environmental exposures and different health(care) systems providing a large natural experiment to be investigated. Through pan-European comparative studies, underlying determinants of population health can be explored and provide rich new insights into the dynamics of population health and care such as the safety, quality, effectiveness and costs of interventions. Additionally, in the big data era, secondary use of data has become one of the major cornerstones of digital transformation for health systems improvement. Several countries are reviewing governance models and regulatory framework for data reuse. Precision medicine and public health intelligence share the same population-based approach, as such, aligning secondary use of data initiatives will increase cost-efficiency of the data conversion value chain by ensuring that different stakeholders needs are accounted for since the beginning. At EU level, the European Commission has been raising awareness of the need to create adequate data ecosystems for innovative use of big data for health, specially ensuring responsible development and deployment of data science and artificial intelligence technologies in the medical and public health sectors. To this end, the Joint Action on Health Information (InfAct) is setting up the Distributed Infrastructure on Population Health (DIPoH). DIPoH provides a framework for international and multi-sectoral collaborations in health information. More specifically, DIPoH facilitates the sharing of research methods, data and results through participation of countries and already existing research networks. DIPoH's efforts include harmonization and interoperability, strengthening of the research capacity in MSs and providing European and worldwide perspectives to national data. In order to be embedded in the health information landscape, DIPoH aims to interact with existing (inter)national initiatives to identify common interfaces, to avoid duplication of the work and establish a sustainable long-term health information research infrastructure. In this workshop, InfAct lays down DIPoH's core elements in coherence with national and European initiatives and actors i.e. To-Reach, eHAction, the French Health Data Hub and ECHO. Pitch presentations on DIPoH and its national nodes will set the scene. In the format of a round table, possible collaborations with existing initiatives at (inter)national level will be debated with the audience. Synergies will be sought, reflections on community needs will be made and expectations on services will be discussed. The workshop will increase the knowledge of delegates around the latest health information infrastructure and initiatives that strive for better public health and health systems in countries. The workshop also serves as a capacity building activity to promote cooperation between initiatives and actors in the field. Key messages DIPoH an infrastructure aiming to interact with existing (inter)national initiatives to identify common interfaces, avoid duplication and enable a long-term health information research infrastructure. National nodes can improve coordination, communication and cooperation between health information stakeholders in a country, potentially reducing overlap and duplication of research and field-work.


2021 ◽  
Vol 10 (1) ◽  
pp. 155-172
Author(s):  
Michael Witter

The Caribbean has experienced an overlapping and interconnected series of challenges, including economic, social, and environmental, which pose an existential threat to the region. This article focuses on the nature of this threat as it evolved before and during the pandemic crisis. Under neoliberal globalization, Caribbean economies transformed themselves rapidly into service providers, most having resorted to developing a tourism sector, while some moved into oil production. In all cases, traditional agricultural exports declined with the loss of protected markets where they earned preferential prices. The COVID-19 pandemic has intensified the Caribbean’s existential crisis and revealed the inextricable links among the environment, economy, and public health. This article focuses on these links and suggests a way forward for public policy in the short, medium, and long term.


Obesity Facts ◽  
2021 ◽  
pp. 1-6
Author(s):  
Michele O. Carruba ◽  
Luca Busetto ◽  
Sheree Bryant ◽  
Antonio Caretto ◽  
Nathalie J. Farpour-Lambert ◽  
...  

The Milan Charter on Urban Obesity highlights the challenges of urban environments as a battleground for human health, as cities are often organized to subvert public health goals, and promote rather than prevent the development of obesity and consequent non-communicable diseases. The Charter articulates ten principles which detail actions and strategies through which general practitioners, diverse medical specialists, related healthcare professionals, administrators and healthcare practice managers, policy actors – within health systems and at a national level – along with experts across disciplines, and citizens, can work in cooperation to meet this challenge and improve public health. The Charter urges the adoption of decisions that deliver the following: (i) policies which enable our cities to become healthier and less obesogenic, more supportive of well-being and less health-disruptive in general, and (ii) policies that fully support primary prevention strategies, that address social stigma, and that ensure fair access to treatment for people living with obesity. The Milan Charter on Urban Obesity aims to raise awareness of our shared responsibility for the health of all citizens, and focuses on addressing the health of people living with obesity – not only as a challenge in its own right, but a gateway to other major non-communicable diseases, including cardiovascular diseases, type 2 diabetes, and some cancers.


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