Search

Background: In the United States chronic illnesses have become a way of life for multiple generations - they are the number one cause of death and disability (accounting for more than 70% of deaths), 60% of American adults have at least one chronic disease, and 40% have multiple chronic conditions. Although multiple factors contribute to the growth in chronic disease prevalence, a major factor has been overreliance on health care systems for promoting health and preventing disease. Large health care systems are ill equipped for this role since they are designed to detect, treat, and manage disease, not to promote health or address the underlying causes of disease., Methods: Improving health outcomes in the U.S. will require implementing broad-based prevention strategies combining biological, behavioral, and societal variables that move beyond clinical care. According to community medicine, clinical care alone cannot create, support, or maintain health. Rather, health can only ensue from combining clinical care with epidemiology and community organization, because health is a social outcome resulting from a combination of clinical science, collective responsibility, and informed social action., Results: During the past 20 years, our team has developed an operational community medicine approach known as community health science. Our model provides a simple framework for integrating clinical care, population health, and community organization, using community-based participatory research (CBPR) practices for developing place-based initiatives. In the present paper, we present a brief overview of the model and describe its evolution, applications, and outcomes in two major urban environments., Conclusion: The paper demonstrates means for integrating the social determinants of health into collaborative place-based approaches, for aligning community assets and reducing health disparities. It concludes by discussing how asset-based community development can promote social connectivity and improve health, and how our approach reflects the emerging national consensus on the importance of place-based population system change., (© 2020 John Wiley & Sons, Ltd.)

In 2006, the National Institutes of Health (NIH) initiated the Clinical and Translational Science Awards (CTSAs) as part of the NIH Roadmap Initiative, in order to improve the conduct and impact of NIH's clinical and translational research portfolio. The CTSA program is intended not only to transform the training programs and research infrastructure at individual academic institutions, but also to create a nation-wide collaborative consortium to transform the biomedical research enterprise. In January 2009, the NIH CTSA National Consortium adopted Strategic Goals to maximize the CTSAs' impact on the Nation's healthcare and health. Of these, the CTSA Strategic Goal 4 is to promote the translation of the results of clinical and translational research into practice and public policy. To advance this goal, a committee was constituted to focus on the organization and development of the CTSA Consortium's comparative effectiveness research (CER) capacity, an increasingly important component of research translation into practice and policy. This Committee's Workgroups took on a number of deliverables in service of this objective, including producing this White Paper on how the CTSA Consortium might best facilitate CER, for NIH's Institutes and Centers (ICs), other Federal agencies, outside stakeholders, and the healthcare system overall. This White Paper offers some specific suggestions for how the CTSA Consortium might support this emerging and crucial national effort to generate, synthesize, and disseminate CER in order to improve healthcare decision-making and health outcomes. Important points of reference for this White Paper are two Congressionally mandated reports on CER released at the end of June 2009, one by the Institute of Medicine (IOM) and another by the Federal Coordinating Council for CER (FCC-CER). The definitions of CER by each report, and their recommendations for the CER enterprise, are highly germane to the purpose of this CTSA Consortium White Paper. The CER definition used in the IOM Report was, "The generation and synthesis of evidence that compares the benefits and harms of alternative methods to prevent, diagnose, treat, and monitor a clinical condition or to improve the delivery of care. The purpose of CER is to assist patients, clinicians, purchasers, policy makers, and the public to make informed decisions that will improve health care at both the individual and population levels."… [ABSTRACT FROM PUBLISHER]

The 2014 outbreak of Ebola virus disease ( EVD) in West Africa has presented a significant public health crisis to the international health community and challenged U.S. emergency departments ( EDs) to prepare for patients with a disease of exceeding rarity in developed nations. With the presentation of patients with Ebola to U.S. acute care facilities, ethical questions have been raised in both the press and medical literature as to how U.S. EDs, emergency physicians ( EPs), emergency nurses, and other stakeholders in the health care system should approach the current epidemic and its potential for spread in the domestic environment. To address these concerns, the American College of Emergency Physicians, the Emergency Nurses Association, and the Society for Academic Emergency Medicine developed this joint position paper to provide guidance to U.S. EPs, emergency nurses, and other stakeholders in the health care system on how to approach the ethical dilemmas posed by the outbreak of EVD. This paper will address areas of immediate and potential ethical concern to U.S. EDs in how they approach preparation for and management of potential patients with EVD. [ABSTRACT FROM AUTHOR]

Presents analysis of two research in hypertension. Effect of lifestyle modification on blood pressure; Prevalence of hypertension in the U.S.

The article discusses the position of the American Dental Education Association (ADEA) on dental issues in the U.S. as approved by the 2003 House of Delegates. The ADEA requires dental education institutions to include in their curricula instruction in peer review. It emphasizes that the principles of instructional autonomy and academic freedom in faculty members are not negotiable. It stresses that the public health needs require a health care system that provides access to care.

The article describes the American Dental Association's (ADEA) official statement and recommendations on the roles and responsibilities of academic dental institutions in improving the oral health in the U.S. ADEA believes that with the collaboration of communities of dental education and dental practice and other health professions, the oral health care needs of the poor will be met. The association's believes that academic dental institutions are the fundamental of the country's oral health.

Abstract: Health information technology (HIT) has become a significant tool in medical practice, and public and international health. Much has been written about HIT and its implications on policy development in the management, practice, and delivery of health care. To better understand the implications on policy development of HIT, a limited literature search was conducted using key terms and a simple search engine. Twelve peer‐reviewed published papers were chosen based on keywords and citation frequency from 2000 to 2012. Twelve papers were reviewed. The implications toward policy formulation based on the search terms and the number of citations the paper had from its initial appearance in the literature are presented. The range of citations is 379 to 2. Citation frequency improves over time and in this case, a low citation number reflects relatively recent publication. HIT is a significant tool in healthcare at all levels. Innovation since 2000 has rapidly outpaced technological innovation prior this decadal review. Policy formulation can be impacted by HIT as well as other innovation. However, the current policy framework is not adept to support the accelerated rate of change. The scholarly publications presented here highlight the impact HIT can have on policy and the need to amend the current policy framework. [ABSTRACT FROM AUTHOR]

Objective: To review and synthesise research related to the ageing farming workforce influence on the health and sustainability of agricultural communities. Design: Using the PRISMA framework as a guide, the CINHAL and Medline databases were searched. Search 1 used the key search terms of ageing OR aging, farm*, workforce. Search 2 used health, sustainability and 'agricultural OR farm communit*. Search 3 combined Searches 1 and 2. Search 4 followed journal citations to identify other relevant articles. A process of narrative synthesis was applied to the results through the prism of rural social capital that described the current state of knowledge and understanding under four themes. Result: Database searches and searching of citations identified 16 contemporary articles. Seven of the papers were from Australia, and the balance from five other high‐income countries. The four that themes emerged are: vulnerabilities of ageing farmers; economic and climatic drivers; social capital and sustainability; and integrative strategies, that might offer a way forward. Conclusion: Integrating these forces of nature, economics and sociology to address the ageing farming workforce and the associated health and sustainability of agricultural communities remains a major challenge for researchers, governments, the agricultural sector and rural communities. [ABSTRACT FROM AUTHOR]

Although there is substantial agreement how microeconomic forces—income, risk aversion—shape public health outcomes, there is substantial disagreement about the relationship between macroeconomic forces—market liberalization and economic freedom—on public health. In this paper, we investigate the relationship between public health, economic freedom, and wealth using a large sample of metropolitan‐level data from the United States. We find that economic freedom does have a statistically significant and positive impact on general, physical, and mental health, but the overall results are small in magnitude. When we disaggregate the three areas of economic freedom, we find that areas with lower government spending and freer labor markets have the strongest positive effect on physical and mental health. However, our results are strongest for the richest group of respondents, suggesting that the economic freedom‐health relationship is perhaps indirect, and shown through income. [ABSTRACT FROM AUTHOR]

The paper focuses on modeling of public health measures to control the COVID‐19 pandemic. The authors suggest a flexible integral model with distributed lags, which realistically describes COVID‐19 infectiousness period from clinical data. It contains susceptible–infectious–recovered (SIR), susceptible–exposed–infectious–recovered (SEIR), and other epidemic models as special cases. The model is used for assessing how government decisions to lockdown and reopen the economy affect epidemic spread. The authors demonstrate essential differences in transition and asymptotic dynamics of the integral model and the SIR model after lockdown. The provided simulation on real data accurately describes several waves of the COVID‐19 epidemic in the United States and is in good correspondence with government actions to curb the epidemic. [ABSTRACT FROM AUTHOR]

The K6 scale is a shortened version of the K10, a 10-question scale originally developed to provide an efficient population-level screen for serious mental disorders (SMI) in the USA. Evidence that the six-item shortened version performed as well as the original 10-item version, coupled with strong psychometric properties, led to rapid dissemination and replicated validation of the K6 in a number of other countries around the world. Based on these results, the K6 is now often included in large general-purpose government health tracking surveys in a number of different countries. Until now, though, the scoring rules for the K6 in these surveys were inconsistent. The first paper in this special issue introduces the K6 scale and summarizes the results of a series of investigations to resolve these inconsistencies by providing optimal scoring rules for the K6 in 14 countries. Subsequent papers explore the usefulness of the K6 to screen for serious emotional disturbance among adolescents and report findings from validation efforts based on independent diagnostic assessments as well as of other measures of impairment and disability (World Health organization Disability Assessment Scale). Finally a highly innovative analysis using a Bayesian multilevel modeling approach is presented, designed to estimate the prevalence of SMI in small areas, such as cities, states, or schools, from surveys carried out in a larger population that includes only relatively small samples of respondents in each of the areas in which prevalence estimates are to be made. Taken together, these studies demonstrate that the K6 is an efficient and useful screening tool. The psychometric and methodological explorations will hopefully stimulate additional interest in the use of short screening scales in large-scale general health surveys to supplement the more in-depth information obtained in periodic psychiatric epidemiological surveys on the basis of diagnostic interviews. Copyright © 2010 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Copyright of World Medical & Health Policy is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: Despite the efforts of numerous medical schools to produce rural physicians, many rural communities in the United States still experience physician shortages. This study describes the current landscape of rural efforts in US undergraduate medical education and catalogs medical school characteristics and activities that evidence has suggested, and that many experts in rural medical education believe, may result in more graduates choosing rural practice. Methods: This is a descriptive study of publicly available and rurally relevant characteristics of all 182 allopathic and osteopathic medical schools operating in the 50 states and the District of Columbia in 2016, with rural program information for these schools updated in 2019. The authors constructed a "rural program" definition in order to systematically catalog coordinated and strategic medical school efforts to produce a rural physician workforce. Findings: Few (8.2%) medical schools expressed an explicit commitment to producing rural physicians in public mission statements. However, most (64.8%) provided rural clinical experiences and many demonstrated their commitment in other ways. Only 39 (21.4%) did so through a formal rural program. Conclusions: In establishing an explicit rural program definition and documenting other markers of rural commitment, this paper provides a baseline for future studies of rural workforce production and medical school investment in these programs, activities, and personnel. Demonstrating the effectiveness of schools' rural physician education efforts will require collaboration across institutions and more intensive evaluations of programs involving students who, though relatively few in number, have great potential for contributing to the health of rural communities across the nation. [ABSTRACT FROM AUTHOR]

There is extensive research in the area of school violence prevention that has collectively helped to illuminate trends, identify disparities in experiences with school violence across various subgroups, drawn connections between the implications of these experiences to health and learning outcomes across childhood, and subsequently informed specific safety policies and practices that schools have been able to adapt and implement in their efforts to keep their students not only safe from violence but also promote schools as a space where children are able to thrive. This paper draws on a rich set of recent literature and seeks to further this critical discussion by highlighting a conceptual framework at the intersection of public health and education and its role in shaping conversations on school safety. A discussion on the emergence of trauma‐informed school spaces and the ways in which attending to a child's mental and physical health are tied to learning outcomes is also presented. Moreover, this work draws connections to how other public health issues that also exist in school spaces have been addressed as effective examples for how to speak about, study, and respond to the issue of violence in K‐12 schools. Given the unique ways in which school gun violence has more recently shaped safety decisions in schools across the United States, implications specifically for school gun violence prevention are also presented. [ABSTRACT FROM AUTHOR]

The COVID‐19 pandemic has impacted routine health care services including immunization delivery. The most common sexually transmitted infection in the United States is the human papillomavirus (HPV), and its sequelae may be prevented by vaccination. Sequelae that can develop if one's immune system is not able to clear the infection include warts, precancerous lesions, and cancer. The American College of Obstetricians & Gynecologists (ACOG) reports almost everyone who is sexually active will encounter the virus at some time during their life. Most of the estimated 79 million infections occur among people who are in their late teens or early 20s. Since 2006, there has been a vaccine available to prevent HPV infections in both males and females; however, administration of this vaccine has only been about half the rate of other vaccines and vaccine hesitancy may play a role. Public health nurses are vital in providing accurate and nonjudgmental vaccine education to their clients, especially unaccompanied minors seeking care in public health department clinics. This paper will explore the recommendations for providing this vaccine as well as a snapshot of current practice in two health departments in the Southeast region of the United States during the COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]

Introduction: While pharmacists in other countries have broad independent prescribing privileges, pharmacists in the United States are making progress. Pharmacist prescriptive authority in the U.S. occurs on a continuum with four identified models: patient‐specific collaborative prescribing through collaborative practice agreements (CPAs), population‐specific prescribing through CPAs, statewide protocols, and class‐specific prescribing. States have implemented pharmacist prescriptive authority across this spectrum. As approximately 90% of Americans reside within two miles of a community pharmacy, prescriptive authority of pharmacists leads to improved public health access points and outcomes. Objective: This paper is intended to provide insight into the current landscape of pharmacist prescriptive authority in the United States through 2019 in order to provide historical context and identify opportunities for state policy considerations. This was done through a review of published literature, national professional association resources, individual state pharmacy practice acts, and state legislation and regulations. Conclusion: Significant variability regarding what medications pharmacists can prescribe exists per state statutes. According to data collected from the National Alliance of State Pharmacy Associations (NASPA), 147 bills related to pharmacist provider status were introduced in 39 states during the 2019 legislative session. The interest in pharmacist prescribing stems from current and future challenges within the U.S. health care system: access to care, cost of care, and the anticipated shortage of physicians. The challenge to standardize prescriptive authority across states presents a unique opportunity for future considerations. [ABSTRACT FROM AUTHOR]

ABSTRACT Aims This paper describes alcohol industry involvement in the 2010 annual conference proceedings of the National Conference of State Liquor Administrators (NCSLA) in the United States. Design The author attended the conference, observed conference attendees and panelists and identified key themes in the panel sessions. Setting The NCSLA Annual Meeting took place 20-24 June 2010 in New Orleans, Louisiana. Participants NCSLA meeting attendees and panelists were professionals from state alcohol control systems; federal government agencies; and companies representing the alcohol industry. Measurements The total number of conference attendees and participants were counted as well as the number of attendees and participants from regulator, industry and public health sectors. Findings More than two-thirds (72.2%) of the 187 conference attendees were from alcohol producers, importers, wholesalers, retailers or their attorneys. Nearly two-thirds (65.0%) of the 40 panelists were from the alcohol industry. The author of this paper was the only attendee, and the only panelist, representing public health policy. Conclusions The National Conference of State Liquor Administrators in the United States is dominated by the private, global companies that produce, import, distribute and sell alcohol, highlighting a lack of public health considerations within the Association's liquor control agenda. [ABSTRACT FROM AUTHOR]

An evidence-based approach to Public/Community Health Nursing (P/CHN) requires that P/CHN educators prepare practitioners with the relevant skills, attitudes, and knowledge. Such education should be competency-based and have measurable outcomes to demonstrate student preparation. In 2003, the Quad Council competencies were developed to be applied at two levels of public health nursing practice: the staff nurse/generalist role and the manager/specialist/consultant role. This paper describes a process for evaluation and revision of a graduate curriculum to prepare Advanced Practice Clinical Nurse Specialists (CNS) in P/CHN, to ensure that the educational program addresses and develops knowledge and proficiency in all relevant competencies. This paper documents the process of integrating the competencies throughout the P/CHN graduate curriculum at varying levels, guiding students to achieve proficiency in each competency by the end of the program. Measurement of achievement in these competencies will be discussed, and examples provided. Advanced Practice Public Health Nurses educated via this competency-based approach will be prepared to sit for national certification as a CNS in Public/Community Health, and to assume leadership roles in public health nursing. [ABSTRACT FROM AUTHOR]

Racial discrimination has been increasingly reported to have a causal link with morbidity and mortality of Black Americans, yet this issue is rarely addressed in a public health perspective. Racism affects health at different levels: institutional racism is a structural and legalized system that results in differential access to health services; cultural racism refers to the negative racial stereotypes, often reinforced by media, that results in poorer psychological and physiological wellbeing of the minorities. Lastly, interpersonal racism refers to the persistence of racial prejudice that seriously undermines the doctor-patient relationship. After analysing these concepts with examples and relevant studies, this paper explores current literature. Racism as a Determinant of Health: A Systematic Review and Meta-Analyses (Paradies et al, 2015) is the most recent and comprehensive research on the issue, yet it cannot be used to base public health interventions as it contains several limitations. Forward Through Ferguson: A Path Toward Racial Equity (Ferguson Commission, 2015) is a report that identifies 4 priority areas for framing public health interventions: Racial Equity, Justice for All, Youth at the Centre and Opportunity to Thrive. This study represents an important milestone in the application of public health on racial injustices, yet racism must be tackled with a sustained, multilevel, and interdisciplinary approach. In conclusion, this paper addresses how public health interventions can empower Black minorities and bring forward long-term policies. Racism is a structural and long-standing system that can be eliminated only with the collective effort., (© 2018 John Wiley & Sons, Ltd.)

The article offers a rereading of "The Changing Concept of Public Health," by Edgar Sydenstricker, published in "The Milbank Memorial Fund Quarterly" in 1935 in order to achieve true progress in public health. Topics covered include the need to control all of the environmental factors that affect physical and mental well-being to achieve better health in populations, areas that are essential to the public's health, and the importance of universal access to health care.

Mounting evidence across different disciplines suggests that early-life conditions can have consequences on individual outcomes throughout the life cycle. Relative to other developed countries, the United States fares poorly on standard indicators of early-life health, and this disadvantage may have profound consequences not only for population well-being, but also for economic growth and competitiveness in a global economy. In this paper, we first discuss the research on the strength of the link between early-life health and adult outcomes, and then provide an evidence-based review of the effectiveness of existing U.S. policies targeting the early-life environment. We conclude that there is a robust and economically meaningful relationship between early-life conditions and well-being throughout the life cycle, as measured by adult health, educational attainment, labor market attachment, and other indicators of socioeconomic status. However, there is some variation in the degree to which current policies in the United States are effective in improving early-life conditions. Among existing programs, some of the most effective are the Special Supplemental Program for Women, Infants, and Children (WIC), home visiting with nurse practitioners, and high-quality, center-based early-childhood care and education. In contrast, the evidence on other policies such as prenatal care and family leave is more mixed and limited. [ABSTRACT FROM AUTHOR]

Since the War on Drugs began, U.S. drug policy has been dominated by a law and order policy model. The emphasis on incarceration and punishment as responses to drug use has resulted in the neglect of public health concerns related to drug addiction. In this paper I trace the development of drug policy in the United States and argue that the social construction of drug offenders as a deviant population has led to the dominance of the law and order approach to drugs. While other scholars have argued that perceptions of drug users affect drug policy, this analysis focuses specifically on the creation and consequences of social constructions for modern drug policy within the policy design framework. By analyzing current trends this paper identifies a way forward for drug policy reform and calls for the adoption of a public health approach to drug use. [ABSTRACT FROM AUTHOR]

Environmental justice (EJ) means socially and economically disadvantaged communities and citizens are entitled to an equally clean environment and resources to enjoy. EJ communities are mostly located close to polluters such as Superfund sites, coal‐fired power plants and landfills and are more likely to be exposed to higher levels of environmental hazards than the U.S. population on average. It is often a difficult task to identify EJ communities and the environmental hazards in the communities without using specific EJ screening tools. Therefore, the goal of this manuscript is to introduce public health nurses to map‐based EJ screening tools. This will help public health nurses to identify EJ communities and take appropriate actions. Public Health Nurses can also use other relevant web sites, such as the U.S. Environmental Protection Agency (EPA), National Institute of Environmental Health Sciences (NIEHS) and Toxicology Data Network (TOXNET) as resources concerning potential health effects of pollutants. Using the provided tools in this paper, nurses should be able to identify EJ communities and be united to recognize barriers of EJ communities and become promoters for EJ advocacy in practice, leadership and education. [ABSTRACT FROM AUTHOR]

The article presents author's comments on the Health Services Research exploiting the membership on a committee that advises Medicare on administered pricing system for physician services in Medicare Part B. It mentions that the traditional fee-for-service Medicare program depends on administered prices. It focuses on the Specialty Society Relative Value Scale Update Committee (RUC) and the U.S. Centers for Medicare & Medicaid Services (CMS).

Since the late 1980s, obesity in America has been a looming public health concern. Recently, medical researchers found that, for the 2011‐12 period, 35.3 percent of U.S. adults (aged 20 or older), 20.5 percent of teenagers (ages 12‐19), 17.7 percent of children (ages 6‐11), and 8.4 percent of young children (ages 2‐5) have obesity, and 6.3 percent of U.S. adults having severe obesity. In a recent working paper by Karnani, McFerran, and Mukhopadhyay (2015), these management scholars argue that obesity represents a market failure. In their study, Karnani et al. evaluate the effectiveness of corporate social responsibility, industry self‐regulation, social activism, and government regulation as to its effectiveness on consumer behavior and reducing obesity. Karnani et al. are advocates of "reasonable" government intervention, i.e., tax/subsidies, market regulation, and education, to address the public health issue of obesity. However, evidence shows that reasonable government intervention is also vulnerable to government failure and potential public health risk. Recommended is a mix of institutional activities found in corporate social responsibility, industry self‐regulation, social activism, and government intervention, all of which should provide the direction needed to continue this public health trend away from America's epidemic levels of obesity. [ABSTRACT FROM AUTHOR]

Objectives: To examine: (1) what elements of patient-centered medical homes (PCMHs) are typically provided to low-income populations, (2) whether PCMHs improve health behaviors, experiences, and outcomes for low-income groups.Data Sources/study Setting: Existing literature on PCMH utilization among health care organizations serving low-income populations.Study Design: Systematic review and meta-analysis.Data Collection/extraction Methods: We obtained papers through existing systematic and literature reviews and via PubMed, Web of Science, and the TRIP databases, which examined PCMHs serving low-income populations. A total of 434 studies were reviewed. Thirty-three articles met eligibility criteria.Principal Findings: Patient-centered medical home interventions usually were composed of five of the six recommended components. Overall positive effect of PCMH interventions was d = 0.247 (range -0.965 to 1.42). PCMH patients had better clinical outcomes (d = 0.395), higher adherence (0.392), and lower utilization of emergency rooms (d = -0.248), but there were apparent limitations in study quality.Conclusions: Evidence shows that the PCMH model can increase health outcomes among low-income populations. However, limitations to quality include no assessment for confounding variables. Implications are discussed. [ABSTRACT FROM AUTHOR]

Aim: Human immunodeficiency virus (HIV) nursing has become more prominent with the increase in chronic HIV infections. This study examined articles related to HIV nursing to determine how the profession has developed and its future direction. Design: A bibliometric analysis was conducted. Methods: HIV nursing‐related articles published in the Web of Science core collection between 1999 and 2022 were searched. VOSviewer was used to identify the contributions of countries, institutions and authors in HIV‐related care. Collaborative maps, hot topics and keywords trends were analysed using VOSviewer and CiteSpace. Results: A total of 1513 publications were extracted. An increase in articles published between 1999 and 2012 was observed. After 2012, the increase in the number of publications was relatively stable. Since 2016, a downward trend in the number of publications has occurred. The USA, South Africa and the UK were the leading contributors to publications related to HIV nursing. The focus of the HIV nursing research has gradually shifted from "HIV infection", "risk factors", and "transmission routes" to "social support", "depression", and "public health". The result shows that increased collaboration among countries/regions can improve the development of HIV nursing and effectively reduce the global HIV infection rate. The mental health of patients has become a research centre in the field of HIV nursing. This study provides direction in clinical practice and future research areas in this field. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND Behavioral support may be effective in increasing physical activity (PA) in school settings. However, there are no data collection systems to concurrently record PA and behavioral support. This paper describes the development and validation of the System for Observing Behavioral Ecology for Youth in Schools (SOBEYS)-an instrument used with existing observation systems to record PA within a behavioral ecological context. METHODS In 2013, experts created a set of behavioral categories to record prompting and reinforcement of PA during a recreational school activity program. The school provided supervision and equipment for lunchtime PA, making it possible to assess both PA and behavioral support. The system was implemented in spring semester 2014 at 1 suburban junior high school (N = 1452; 48% girls, 74% Caucasian) in the western Unites States. RESULTS Following multiple field trials, the SOBEYS instrument recorded behavioral categories of visual and verbal prompting, verbal, and nonreinforcement by adults and peers, and token reinforcement. Construct validity and acceptable interobserver agreement (>90%; kappa between 0.22 and 0.94) resulted. CONCLUSION Trained SOBEYS users can accurately and reliably record the presence of behavioral support aimed at prompting and reinforcing PA in conjunction with established systematic observation instruments to record PA context and quantity. [ABSTRACT FROM AUTHOR]

This paper focuses on medical ghostwriting in the United States. I argue that medical ghostwriting often involves plagiarism and, in those cases, can be treated as an act of research misconduct by both the federal government and research institutions. I also propose several anti-ghostwriting measures, including: 1) journals should implement guarantor policies so that researchers may be better held accountable for their work; 2) research institutions and the federal government should explicitly prohibit medical ghostwriting and outline appropriate penalties; and 3) a publicly available database should be created to record researchers' ethics violations. [ABSTRACT FROM AUTHOR]

Preventing the negative consequences of prenatal exposure to alcohol remains an unmet challenge. This paper presents the results of a workshop, designed to increase the implementation of fetal alcohol spectrum disorders (FASD) prevention interventions in 8 counties of New York. The workshop was based on constructivist learning theory and used the Population-Based Public Health Nursing Intervention Model as the structure for discussing potential interventions. The number and type of FASD interventions implemented were determined by surveys sent out postworkshop to 167 participants. At 4 months postworkshop, 37 participants reported implementing 226 primary, secondary, and tertiary interventions in 74 different worksites. The results indicate that incorporation of constructivist learning theory shows promise for future public health and continuing education programs aimed at changing or enhancing practice. [ABSTRACT FROM AUTHOR]

Introduction: Sustainable service delivery is a major challenge in the HIV response that is often not adequately addressed in project implementation. Sustainable strategies must be built into project design and implementation to enable HIV efforts to continue long after donor-supported projects are completed. Case description: This paper presents the experiences in operational sustainability of Family Health International's Zambia Prevention, Care and Treatment Partnership in Zambia, which is supported by the US President's Emergency Plan for AIDS Relief through United States Agency for International Development (October 2004 to September 2009). The partnership worked with Zambia's Ministry of Health to scale up HIV clinical services in five of the country's nine provinces, reaching 35 districts and 219 facilities. It provided technical and financial support from within the ministry's systems and structures. By completion of the project, 10 of the 35 districts had graduated beyond receiving ongoing technical support. Discussion and evaluation: By working within the ministry's policies, structures and systems, the partnership was able to increase the ministry's capacity to add a comprehensive HIV service delivery component to its health services. Ministry structures were improved through renovations of health facilities, training of healthcare workers, procurement of essential equipment, and establishment of a quality assurance plan to ensure continued quality of care. The quality assurance tools were implemented by both the ministry and project staff as the foundation for technical graduation. Facilities that met all the quality criteria for more than six months were graduated from project technical support, as were districts where most supported facilities met the criteria. The district health offices then provided ongoing supervision of services. This predetermined "graduation" exit strategy, with buy in of the provincial and district health offices, set the stage for continued delivery of high-quality HIV services. Conclusions: Achieving operational sustainability in a resource-limited setting is feasible. Developing and institutionalizing a quality assurance/quality improvement system is the basis on which facilities and districts can move beyond project support and, therefore, sustain services. Quality assurance/quality improvement tools should be based on national standards, and project implementation should use and improve existing health system structures. [ABSTRACT FROM AUTHOR]

Context: Obesity constitutes a major public health challenge in the United States. Obesogenic environments have increased owing to the consumption of calorie-dense foods of low nutritional value and the reduction of daily physical activity (e.g., increased portion sizes of meals eaten in and out of the home and fewer physical activity requirements in schools). Policymakers and public health practitioners need to know the best practices and have the competencies to use laws and legal authorities to reverse the obesity epidemic. For instance, statutes and regulations at the federal, state, and local levels of government have been implemented to improve nutritional choices and access to healthy foods, encourage physical activity, and educate consumers about adopting healthy lifestyles. Methods: In an effort to understand the application of laws and legal authorities for obesity prevention and control, in June 2008 the Centers for Disease Control and Prevention convened the National Summit on Legal Preparedness for Obesity Prevention and Control. An outcome of this summit will be the publication of the proceeding's white papers written by eight law and subject-matter experts with substantive contributions from summit participants, which will identify actionable options that sectors and organizations at various jurisdictional levels can consider adopting. Findings: Law has played a critical role in the control of chronic diseases and the behaviors that lead to them. The use of a systematic legal framework—the use of legislation, regulation, and policy to address the multiple factors that contribute to obesogenic environments—can assist in the development, implementation, and evaluation of a variety of legal approaches for obesity prevention and control. Conclusions: Although public health–focused legal interventions are in an early stage and the direct and indirect impact they may have on the obesity epidemic is not yet understood, efforts such as the summit and white papers should help determine potentially viable legal interventions and assess their impact on population-level change. [ABSTRACT FROM AUTHOR]

Objectives: This paper reports the characteristics of recent public health nursing (PHN) practice change experienced by staff-level public health nurses. Recommendations for improving PHN practice offered by study participants are reported and discussed. Design: A cross-sectional written survey was used to collect data from 424 public health nurses in 76 local health departments (LHDs) in Wisconsin (68% response rate) in 2003. Characteristics of practice change were identified using a 15-item-scaled response set. Recommendations on improving practice were made through responses to an open-ended survey question. Content analysis was conducted to identify major themes among the responses. Results: PHN practice has become more population focused. Major themes emerging from the recommendations for practice improvement included increasing system and organizational resources, expanding visibility of public health, and strengthening collaboration. Conclusions: Implications for practice include the need for continuing education in concepts and skills required for population-focused PHN practice, advocacy for more public health resources, and collaboration with academic partners for education and research. [ABSTRACT FROM AUTHOR]

Introduces a series of papers on consumer-driven health care in the U.S. Emergence of consumer-driven health plans; State of the health care industry; Consumer response to the plan; Advantages over other managed care plans.

The objective of this paper is to introduce the issues discussed at the Early Childhood Caries Conference, held October 18-19, 1997, in Bethesda, Maryland. Early childhood cavies (ECC) is of epidemic proportions in some US minority populations and in many developing countries. However, the inadequate information and research on dental caries in infants and toddlers appears to have fostered acceptance of some incorrect assumptions regarding its etiology and prevention. To reexamine the current knowledge of ECC, leaders in this field have critically reviewed rite biological and psychosocial mechanisms, public health implications prevention, research and policy needs. An additional goal of the conference was to convey the health implications and societal costs of this highly prevalent childhood disease to the public health care providers and policy-makers. [ABSTRACT FROM AUTHOR]

ABSTRACT: This paper addresses implications of recent tobacco legislation, policy, and tobacco use among youth in the context of health care policy and services. Tobacco use prevalence and definitions and diagnoses of nicotine addiction and dependence are described. Assessment of smoking prevalence in Texas provides a case study of the problem and potential solutions for tobacco use among youth. The case study highlights specific implications to be considered when providing health care focused on prevention and risk reduction for youth. The paper concludes with implications and critical Internet resources for health care providers engaging in youth tobacco control. (J Sch Health. 2001;71 (3):89-95) [ABSTRACT FROM AUTHOR]

Policies governing the sale of raw milk-making the sales of raw milk more permissive-are gaining traction on the legislative agendas of dozens of states. This paper examines one contributor to this movement on the policy agenda: the role of competitive framing. By combining theoretical approaches from policy studies and political psychology theories of competitive framing, we offer evidence supporting the recent relative success of raw milk activists in several state legislatures. Using an Internet survey-based experiment with a sample size of 1,630 respondents from seven Midwestern states, we show that a frame emphasizing consumer choice and food freedom is more effective than the frame that dominates among the policy establishment, that emphasizing public health risks. This is true in both one-sided and competitive framing contexts. We further show that those previously aware of this issue were less influenced by the public health frame than those naïve to the issue. Our results suggest that the pro-raw milk movement may be making strides on the state policy agenda because their frames are more resonant among the public. We also highlight the advantages gained from considering psychological and policy processes simultaneously to understand policy change. [ABSTRACT FROM AUTHOR]

An editorial is presented which addresses the author's views about the public health aspects of electronic cigarettes (e-cigarettes), and it mentions the National Academies of Sciences' review of research papers on electronic nicotine delivery systems (ENDS), as well as the need for additional research and government regulatory action in the U.S. According to the article, ENDS may be harm-reducing for smokers who are seeking to quit and harm-creating for ex-smokers and young people.

This paper describes a new approach to training infant specialists. A joint Master's degree program, based in graduate schools of public health and education, emphasizes cross-disciplinary coursework in maternal and child health and special education. The program emphasizes the importance of forging crucial linkages among the different disciplines and agencies that care for handicapped and at-risk infants. The program emphasizes improved skills in assessing, planning, and intervening on behalf of infants at risk for developmental delays or with severe or multiple handicaps; the ability to work with families; and the ability to develop and appraise community resources. [ABSTRACT FROM AUTHOR]

As debates in industrialized countries over the last century indicate, health care and the role of government in its provision are complex and contentious issues. This article provides an orientation to the variety of topics guiding research and discourse in U.S. health policy, as well as how those topical areas influence and engage each other. This paper introduces five prominent themes in health policy research, namely (i) biomedical policy, (ii) public health policy, (iii) health economics, (iv) health care policy, and (v) health informatics policy. It also provides specific examples from current scholarship. Broad themes that connect those lines of inquiry are highlighted with recommendations for future research. [ABSTRACT FROM AUTHOR]

The therapeutic landscape for the treatment of chronic hepatitis C virus infection has been rapidly evolving, and by 2016 there will be six approved, all-oral regimens for use in patients in the USA and most of Western Europe. However, as many as patient populations will have limited access to new direct acting antiviral regimens, patients and physicians are often faced with the challenge of selecting the best regimen available, as opposed to the optimal treatment. In this paper, the challenges and opportunities in developing a high cure regimen for different patient populations will be discussed and highlighted through case-based scenarios. [ABSTRACT FROM AUTHOR]

Based on the case of the Great Lakes, which is the United States’ largest supply of fresh water and is contaminated by nonpoint source pollution from agricultural runoff, this paper examines the role that language plays in providing definitions for environmental protection and regulation. The interdisciplinary research presented here identifies “agriculturalese” as a specialized and highly technical language of agribusiness and environmental projection, and it considers some of the underinvestigated challenges that its ambiguity and complexity present to lay stakeholders’ public participation in environmental decision making, protection, and enforcement. [ABSTRACT FROM AUTHOR]

Objective To develop estimates of the direct cost of epilepsy in the United States for the general epilepsy population and sub-populations by systematically comparing similarities and differences in types of estimates and estimation methods from recently published studies. Methods Papers published since 1995 were identified by systematic literature search. Information on types of estimates, study designs, data sources, types of epilepsy, and estimation methods was extracted from each study. Annual per person cost estimates from methodologically similar studies were identified, converted to 2013 U.S. dollars, and compared. Results From 4,104 publications discovered in the literature search, 21 were selected for review. Three were added that were published after the search. Eighteen were identified that reported estimates of average annual direct costs for the general epilepsy population in the United States. For general epilepsy populations (comprising all clinically defined subgroups), total direct healthcare costs per person ranged from $10,192 to $47,862 and epilepsy-specific costs ranged from $1,022 to $19,749. Four recent studies using claims data from large general populations yielded relatively similar epilepsy-specific annual cost estimates ranging from $8,412 to $11,354. Although more difficult to compare, studies examining direct cost differences for epilepsy sub-populations indicated a consistent pattern of markedly higher costs for those with uncontrolled or refractory epilepsy, and for those with comorbidities. Significance This systematic review found that various approaches have been used to estimate the direct costs of epilepsy in the United States. However, recent studies using large claims databases and similar methods allow estimation of the direct cost burden of epilepsy for the general disease population, and show that it is greater for some patient subgroups. Additional research is needed to further understand the broader economic burden of epilepsy and how it varies across subpopulations. [ABSTRACT FROM AUTHOR]

The article highlights the several State Innovation Models (SIM) to reform health care delivery and payment methods to improve health and its cost. It discussed the implementation of new clinical and payment models and to integrate behavioral health and primary care; and mentions the impact of Accountable Care Organizations that established with SIM support.

Coalition-based efforts that use a science-based approach to prevention can improve the wellbeing of community youth. This study measured several coalition capacities that are hypothesized to facilitate the adoption of a science-based approach to prevention in communities. Using data from 12 coalitions participating in a community-randomized trial of the prevention strategy Communities That Care (CTC), this paper describes select measurement properties of five salient coalition capacities (member substantive knowledge of prevention, member acquisition of new skills, member attitudes toward CTC, organizational linkages, and influence on organizations), as reported by coalition members, and examines the degree to which these capacities facilitated the community leader reports of the community-wide adoption of a science-based approach to prevention. Findings indicated that the five coalition capacities could be reliably measured using coalition member reports. Meta-regression analyses found that CTC had a greater impact on the adoption of a science-based prevention approach in 12 matched pairs of control and CTC communities where the CTC coalition had greater member (new skill acquisition) and organizational capacities (organizational linkages). [ABSTRACT FROM AUTHOR]

Objectives Biological anthropologists within academia and in other sectors are increasingly engaged in a variety of problem-oriented research and in the design, implementation, or evaluation of policies and programs, domestically and abroad. Such work can have distinctive requirements in terms of disciplinary background, professional orientation, and professional development. This article explores these issues through the author's autobiographical account of a career in food and nutrition policy from within an academic nutrition department. Methods The article is guided by an analytical framework that compares eight projects in terms of their mode of knowledge production, academic impact, public impacts, and personal rewards. The projects range from village-based surveys in Samoa and Malawi to food security planning in upstate New York communities, US policies on genetically engineered (GE) foods, and participant-observer research on nutrition policy development in low-income countries. Results and Conclusions The cumulative experience reveals the importance of a commitment to problem-solving, a transdisciplinary orientation, intellectual and methodological dexterity, ongoing engagement with policy actors and openness to emergent research questions, new research settings, and nontraditional funding sources. Am. J. Hum. Biol. 27:16-26, 2015. © 2014 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

The article discusses a meeting organized by the Food and Health Forum of the Royal Society of Medicine that was held in Great Britain on March 27, 2014. At the meeting various papers on dietary guidelines are presented by several professors including Jayne Woodside, Tom Sanders and Peter Aggett. It also informs that attendees at the conference are welcomed by Anthony Mander, President of the Food and Health Forum.