Ethical challenges in cluster randomized controlled trials: experiences from
public health interventions in Africa and Asia
In order to put in place appropriate
public health interventions in an ongoing disease outbreak, it is vital to estimate death risk accurately in real time and identify risk factors such as age, gender, occupation and health conditions.
The R2HC programme aims to improve health outcomes by strengthening the evidence base for
public health interventions in humanitarian crises.
When we first promoted this intervention, it was considered controversial but now has become recognized as one of the most vital, cost - effective
public health interventions in the world.
Not exact matches
With more than 15 years of experience, Dr. Dubost has worked
in the areas of clinical nutrition, research,
public health intervention, education and communications.
Articles explore: the idea that violence should be thought of as a
public health problem analogous to infectious disease; examine from a scientific perspective the impacts on children's social, emotional, and cognitive development of growing up
in a violent community; share first - hand insights from children and caregivers; and explore various
interventions, from the favelas of Recife, Brazil, to the inner cities of Chicago, Illinois, United States (US), and Glasgow, Scotland, which are offering a tangible sense of hope.
Framing community breastfeeding education as a
public health strategy can allow us to look for opportunities
in childhood initiatives, mental
health programs, social
interventions, and more!
Views are particularly polarised
in the United States, with
interventions and costs of hospital births escalating and midwives involved with home births being denied the ability to be lead professionals
in hospital, with admitting and discharge privileges.5 Although several Canadian medical societies6 7 and the American
Public Health Association8 have adopted policies promoting or acknowledging the viability of home births, the American College of Obstetricians and Gynecologists continues to oppose it.9 Studies on home birth have been criticised if they have been too small to accurately assess perinatal mortality, unable to distinguish planned from unplanned home births accurately, or retrospective with the potential of bias from selective reporting.
Schools play an important role
in children's
health and are often prime settings for
public health interventions.
Public Health Service Task Force recommendations for use of antiretroviral drugs in pregnant HIV - infected women for maternal health and interventions to reduce perinatal HIV transmission in the United S
Health Service Task Force recommendations for use of antiretroviral drugs
in pregnant HIV - infected women for maternal
health and interventions to reduce perinatal HIV transmission in the United S
health and
interventions to reduce perinatal HIV transmission
in the United States.
Absolute inequality measures reflect not only inequalities across socioeconomic subgroups but also
public health importance of the outcome
in consideration, and they could provide different, even contradictory, patterns of inequalities from relative measures
in a given outcome.21, 22 However, measuring absolute inequality is often neglected
in health inequalities research.23 Relative risks (RRs) and absolute risk differences (RDs) of discontinuing breastfeeding among mothers with lower education compared with mothers with complete university education (reference category) were separately estimated
in the
intervention and
in the control group and then compared between the two groups.
Reducing socioeconomic inequalities
in health is an important
public health goal.1 A key first step toward achieving that goal is to evaluate and compare the impact of various
interventions across socioeconomic strata.
Dr Roderico Ofrin:
In any affected population in emergencies, breastfeeding is an important public health interventio
In any affected population
in emergencies, breastfeeding is an important public health interventio
in emergencies, breastfeeding is an important
public health intervention.
Summary: This study, published
in Public Health Nutrition
in April 2010, evaluated an educational
intervention aimed at improving complementary feeding...
In most cases, the early
intervention system may not use your
health care insurance (private or
public) without your express, written consent.
Results published
in the American Journal of
Public Health were based on evaluation data from Legacy for ChildrenTM, a public health intervention program designed to improve child outcomes by promoting positive parenting among low - income mothers of infants and young chi
Public Health were based on evaluation data from Legacy for ChildrenTM, a public health intervention program designed to improve child outcomes by promoting positive parenting among low - income mothers of infants and young chi
Health were based on evaluation data from Legacy for ChildrenTM, a
public health intervention program designed to improve child outcomes by promoting positive parenting among low - income mothers of infants and young chi
public health intervention program designed to improve child outcomes by promoting positive parenting among low - income mothers of infants and young chi
health intervention program designed to improve child outcomes by promoting positive parenting among low - income mothers of infants and young children.
Despite the evidence that investing
in breastfeeding is one of the most cost effective
public health interventions available, insufficient priority is being given to this, which put infants and children at risk of reaching their full potential...»
In such circumstances, «when ecosystems are able to support sustainable diets, nutrition programmes, policies and
interventions supporting the use of supplements, RUTF [ready - to - use therapeutic foods], fortificants and infant formulas are inappropriate and can lead to malnutrition, and the marketing of these food substitutes and related products can contribute to major
public health problems.»
In a review of U.S. - based randomized trials evaluating breastfeeding
interventions targeting minorities,
interventions to change hospital or WIC policies, including enhanced practices and services, were among the
public health approaches found to successfully improve breastfeeding outcomes among minority women (9).
Although additional studies are required to confirm these findings and to understand the mechanisms of breast milk protection,
public health interventions to promote predominant breast feeding for at least six months and any breast feeding up to one year may reduce the prevalence and subsequent morbidity of respiratory illness and infection
in infancy.
This guideline provides global, evidence - informed recommendations on protection, promotion and support of optimal breastfeeding
in facilities providing maternity and newborn services, as a
public health intervention.
The closest parallel to this vision of an early
intervention society is found
in the Victorian era when local authorities invested on a massive scale
in public health: clean air, clean water, proper sewage treatment.
«This powerful
intervention from doctors and
health professionals underlines the compelling case for protecting children from smoking
in cars,» Labour shadow
public health minister Luciana Berger said.
Finally, a Brexit could decimate the UK's potential to bequeath the gold standard
in delivering
public health interventions across Europe.
The latter have long been on the
public health agenda, but we are arguing that
in order to make the most effective challenge to
health inequalities,
in addition a much wider range of
intervention needs to be brought into play.
In response, the Institute of Medicine committee created recommendations that focus on prevention and
intervention opportunities, seek to educate
health care practitioners, and help raise
public awareness of cognitive
health.
Epidemiology is the scientific study of factors affecting the
health and illness of individuals and populations, and serves as the foundation and logic of
interventions made
in the interest of
public health and preventive medicine.
Published
in BMC Medicine, the study underscores the need for effective substance use policies and
public health interventions, and provides key principles to guide policy decisions.
In a new, hospital - level analysis by
health policy researcher Laura Attanasio at the University of Massachusetts Amherst and Katy Kozhimannnil at the University of Minnesota School of Public Health, they report that women who gave birth at hospitals that had a larger percentage of midwife - attended births were less likely to have two specific medical interventions, cesarean delivery and episi
health policy researcher Laura Attanasio at the University of Massachusetts Amherst and Katy Kozhimannnil at the University of Minnesota School of
Public Health, they report that women who gave birth at hospitals that had a larger percentage of midwife - attended births were less likely to have two specific medical interventions, cesarean delivery and episi
Health, they report that women who gave birth at hospitals that had a larger percentage of midwife - attended births were less likely to have two specific medical
interventions, cesarean delivery and episiotomy.
Attanasio, an assistant professor of
health policy and management at UMass Amherst's School of Public Health and Health Sciences, explains that a growing body of research at the individual level has shown that compared to women cared for by physicians, women considered at low - risk for complications in childbirth who receive care from midwives have good outcomes that include lower use of interventions such as cesarean del
health policy and management at UMass Amherst's School of
Public Health and Health Sciences, explains that a growing body of research at the individual level has shown that compared to women cared for by physicians, women considered at low - risk for complications in childbirth who receive care from midwives have good outcomes that include lower use of interventions such as cesarean del
Health and
Health Sciences, explains that a growing body of research at the individual level has shown that compared to women cared for by physicians, women considered at low - risk for complications in childbirth who receive care from midwives have good outcomes that include lower use of interventions such as cesarean del
Health Sciences, explains that a growing body of research at the individual level has shown that compared to women cared for by physicians, women considered at low - risk for complications
in childbirth who receive care from midwives have good outcomes that include lower use of
interventions such as cesarean delivery.
In 2016, the US Centers for Disease Control and Prevention (CDC) recommended that public health officials trigger epidemic intervention when two non-familial locally - acquired cases of Zika are reported in an are
In 2016, the US Centers for Disease Control and Prevention (CDC) recommended that
public health officials trigger epidemic
intervention when two non-familial locally - acquired cases of Zika are reported
in an are
in an area.
As a
public -
health intervention, immunisation is already widely seen as one of
public health's «best buys», but by measuring the effectiveness
in terms of lives saved, it seems likely that we are undervaluing the benefits and the return on investment they offer.
«Given the ubiquity of mobile phones, mobile
health interventions offer promise
in improving
public health.»
The study, «Effectiveness of a Scaled Up Physical Activity
Intervention in Brazil: A Natural Experiment,» recently was published
in Preventive Medicine, an international journal devoted to the science and practice of disease prevention,
health promotion and
public health policymaking.
Widely hailed as a «breakthrough»
in HIV prevention by
public health officials, the studies — one of which dropped its placebo arm today because of the convincing effects of the
intervention — add powerful new tools to derail transmission of the virus
in the population that accounts for most of the 34 million infections
in the world.
Using Twitter as a window into a community's collective mental state may provide a useful tool
in epidemiology and for measuring the effectiveness of
public -
health interventions.
Early
intervention is also the goal
in another
public health concern, the brain deterioration that multiple hits to the head can trigger.
«Worksites are self - contained environments with established communication systems where
interventions that modify food options and provide physical activity have the potential to reach large numbers of adults,» said Diana Fernandez, M.D., M.P.H., Ph.D., an associate professor
in the University of Rochester Department of
Public Health Sciences and lead author of the study.
But the risk to
public health remains, and
interventions are still needed, such as ongoing monitoring that tracks Zika and other infectious diseases
in pregnancy, says Denise Jamieson, an obstetrician gynecologist at Emory University School of Medicine
in Atlanta.
«From a clinical point of view, this is relevant
in order to execute evidence - based counselling, and from a
public health perspective, it may guide
health interventions for the general population.»
«This has important
public health implications, given that standing is a common behaviour that usually replaces sitting, and that can be encouraged
in the workplace with
interventions such as sit - stand desks.
«Even though tobacco shops have rarely been targeted by the police or community for
intervention,» he added, «based on our data, we believe tobacco shops
in urban communities of color should be regulated to improve community
health in the same way as alcohol outlets and other
public nuisances.»
The most crowded emergency departments
in the U.S. have not adopted proven
interventions to address crowding, a major
public health concern.
The results of the new study are notable because positive effects of an
intervention, especially one that aims to improve self - regulation and academic achievement, can be difficult for researchers to find, said McClelland, the Katherine E. Smith Healthy Children and Families Professor
in the College of
Public Health and Human Sciences.
«For years
in public health we have been working on immunizations and other medical interventions to set the course for the health of disadvantaged children, and we have turned the tide,» says the study's lead author Allison Barlow, MPH, PhD, associate director of the Center for American Indian Health at the Johns Hopkins Bloomberg School of Public H
public health we have been working on immunizations and other medical interventions to set the course for the health of disadvantaged children, and we have turned the tide,» says the study's lead author Allison Barlow, MPH, PhD, associate director of the Center for American Indian Health at the Johns Hopkins Bloomberg School of Public H
health we have been working on immunizations and other medical
interventions to set the course for the
health of disadvantaged children, and we have turned the tide,» says the study's lead author Allison Barlow, MPH, PhD, associate director of the Center for American Indian Health at the Johns Hopkins Bloomberg School of Public H
health of disadvantaged children, and we have turned the tide,» says the study's lead author Allison Barlow, MPH, PhD, associate director of the Center for American Indian
Health at the Johns Hopkins Bloomberg School of Public H
Health at the Johns Hopkins Bloomberg School of
Public H
Public HealthHealth.
«We had hoped the new pharmacotherapy would help more people quit, but this is not what is happening,» said lead author Shu - Hong Zhu, PhD, a professor
in the Department of Family Medicine and
Public Health and director of Center for Research and
Intervention in Tobacco Control at UC San Diego.
Public health and research efforts must focus more intensely on identifying and implementing additional or new interventions that halt transmission in hospitals and community settings,» says Neel R. Gandhi, MD, associate professor of epidemiology at Emory's Rollins School of Public H
health and research efforts must focus more intensely on identifying and implementing additional or new
interventions that halt transmission
in hospitals and community settings,» says Neel R. Gandhi, MD, associate professor of epidemiology at Emory's Rollins School of
Public HealthHealth.
«Prenatal visits may present a good opportunity for screening and brief
intervention regarding tobacco and particularly alcohol use,» noted co-author Deborah Hasin, PhD, professor of Epidemiology at the Mailman School of
Public Health and
in the Department of Psychiatry at Columbia University Medical Center.
There is no easy answer
in our ongoing battle against obesity, but identifying the link between the drop
in physical activity and increased BMIs, as well as the groups particularly affected, can assist
public health officials to develop targeted, effective
interventions.
«The high burden of early complications
in youth with diabetes requires additional research to clarify the underlying causes and to identify effective
intervention strategies,» said Dr. Dana Dabelea, lead author and co-chair of the national SEARCH Study and professor of epidemiology at the Colorado School of
Public Health at the University of Colorado Anschutz Medical Campus.