Journal of Public Health Research (PAGEPress Publications)
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Corporate social responsibility and external stakeholders’ health and wellbeing: a viewpoint
Get PDFIn recent years there has been increased interest in the role played by business corporate social responsibility (CSR) strategies in promoting the health and wellbeing of internal and external stakeholders. However, the sparse public health research to date has mainly focused on the health and wellbeing of internal stakeholders. This viewpoint article aims to ignite discussion of how CSR strategies need to also target external stakeholders beyond the workplace. Businesses have an opportunity to help address the most important societal challenges, especially the social determinants of health which are the root causes of inequities in health. However, while advancing a new agenda for promoting external stakeholders’ health, businesses need to take into account potential challenges that might arise from ethical conflicts when trying to balance their CSR initiatives against their business operations
Patient and clinician engagement with health information in the primary care waiting room: A mixed methods case study
Get PDFBackground. Primary care waiting rooms can be sites of health promotion and health literacy development through the provision of readily accessible health information. To date, few studies have considered patient engagement with televised health messages in the waiting room, nor have studies investigated whether patients ask their clinicians about this information. The aim of this study was therefore to examine patient (or accompanying person) and clinician engagement with waiting room health information, including televised health messages.
Design and methods. The mixed methods case study was undertaken in a regional general practice in Victoria, Australia, utilising patient questionnaires, waiting room observations, and clinician logbooks and interviews. The qualitative data were analysed by content analysis; the questionnaire data were analysed using descriptive statistics.
Results. Patients engaged with a range of health information in the waiting room and reportedly received health messages from this information. 44% of the questionnaire respondents (33 of 74) reported watching the television health program, and half of these reported receiving a take home health message from this source. Only one of the clinicians (N=9) recalled a patient asking about the televised health program.
Conclusions. The general practice waiting room remains a site where people engage with the available health information, with a televised health ‘infotainment’ program receiving most attention from patients. Our study showed that consumption of health information was primarily passive and tended not to activate patient discussions with clinicians. Future studies could investigate any link between the health infotainment program and behaviour change
In utero exposure to endocrine disrupting chemicals, micro-RNA profiles, and fetal growth: a pilot study protocol
Get PDFBackground: The developing fetus is particularly vulnerable to the effects of endocrine disrupting chemicals (EDCs). Molecular fingerprints of EDCs can be identified via microRNA (miRNA) expression profiles and may be etiologically implicated in the developmental origin of disease (DOHaD). Methods/design: This pilot study includes pregnant women at high risk (smoking at conception), and low risk (non-smoking at conception) for SGA birth (birthweight<10th percentile for gestational age). We have randomly selected 12 mothers (3 high-risk SGA birth, 3 low-risk SGA birth, 3 high-risk non-SGA birth, 3 low-risk non-SGA birth), with EDC measurements from gestational week 17. All offspring are female. We aim to test the stability of our samples (maternal serum, cord blood, placenta tissue), observe the differential expression of miRNA profiles over time (gestational weeks 17, 25, 33, 37, birth), and study the consistency between maternal EDC measures and miRNA expression profiles across our repeated measures. Expected impact of the study for Public Health: Results from this pilot study will inform the development of a larger cohort wide analysis, and will impact the current state of knowledge in the fields of public health, epigenetics, and the DOHaD
Online media scans: Applying systematic review techniques to assess statewide human papillomavirus vaccination activities
Get PDFBackground. Although the human papillomavirus (HPV) vaccine has been approved for use in adolescents in the US for over a decade, vaccination uptake remains low. Of concern, HPV vaccine coverage is below the national average in Minnesota, USA. To understand the reach of current HPV programming and research, we use an online media scan; this method may be applied to other jurisdictions to gain insight about various public health issues.Design and Methods. This online media scan describes the nature and scope of ongoing activities to increase HPV vaccination in Minnesota. The media scan included: a) structured internet searches of HPV vaccine health education/promotion activities ongoing in Minnesota since 2013, and b) searches in research databases of the published literature on HPV vaccination in Minnesota from 2013 to 2018. Results. Searches resulted in 880 online and 142 research article matches, with 40 and 36 meeting selection criteria. Results were categorized by activities focusing on race/ethnicity, sex, health providers, parents, lesbian, gay, bisexual, transgender and queer or questioning (LGBTQ) populations, geographic location, catchup vaccination, and insurance status. Most activities were statewide (52% health education/promotion and 35% research), followed by activities located in entirely urban areas (15% health education/promotion and 41% research) with only 6% of health education/promotion activities and 2% of research activities carried out in entirely rural areas.Conclusions. A range of local and statewide HPV vaccine health education/promotion and research activities were identified in Minnesota. Several efforts partnered with American Indian and Somali/Somali-American communities, but fewer activities focused on HPV vaccination among LGBTQ youth and HPV vaccination in rural areas
Vaccine hesitancy: An overview on parents' opinions about vaccination and possible reasons of vaccine refusal
Get PDFBackground. Vaccine hesitancy has increased worldwide with a subsequent decreasing of vaccination rates and outbreaks of vaccine-preventable diseases (i.e. measles, poliomyelitis and pertussis) in several developed countries, including Italy.
Design and Methods. We conducted a survey to investigate the attitudes of a parents’ sample about vaccinations by the distribution of questionnaires in six lower secondary schools of the Italian city of Messina.
Results. Regarding vaccinations carried out on children, the declared vaccination coverage rates ranged widely between good coverage percentages for some vaccinations (Measles-Mumps-Rubella, Diphtheria-Tetanus-Pertussis), and very low coverage rates for others, especially for “new” vaccinations (HPV, meningococcal, pneumococcal). The vaccinations carried out correlated negatively with both parents’ age and their level of education. Moreover, a favourable parents’ opinion was strongly influenced by a favourable opinion of the physician, while an unfavourable parents’ opinion seemed conditioned by a direct or indirect knowledge of people harmed by vaccines. In addition, our data show that parents do not often know or partially know the real composition of the vaccines and the diseases prevented by vaccinations.
Conclusions. Data analysis shows that parents are, theoretically, favourable towards vaccinations but have little knowledge of such practices, sometimes not being unaware of the types of vaccines administrated to their children. Health education and communication of correct information are certainly the cornerstones to improve the situation and to fight the widespread and non-grounded fears about vaccines
Decisional issues in antibiotic prescribing in French nursing homes: An ethnographic study
Get PDFBackground: Medication prescription is generally the responsibility of doctors. In nursing homes, the nursing staff is often the first to suspect an infection. Today, physicians are more confident with nursing assessment, relying primarily on nursing staff information. Very few studies have investigated the nurses’ influence on decision of medical prescription. This study investigates the role of nurses in antibiotic prescribing for the treatment of suspected infections in nursing home residents. Design and methods: An ethnographic study based on semi-structured interviews and participant observations was conducted. Sixteen nurses and five doctors working in five nursing homes in Paris, France participated between October 2015 and January 2016. Results: Given their proximity to elderly residents, registered nurses at the nursing homes occasionally assisted doctors in their medical diagnostic. However, nurses who are theoretically incompetent have met difficulties in their ability to participate in their decisions to prescribe antibiotics when managing residents’ infections.Conclusion: if proximity and nursing skills reinforce the relevance of the clinical judgment of nurses, the effective and collaborative communication between the nurse and the doctor may help the nurse to enhance their role in the antibiotic prescribing in nursing homes, which would enhance antimicrobial stewardship efficiency
Comparison of the performance of machine learning algorithms in breast cancer screening and detection: A protocol
Get PDFBackground: Breast Cancer (BC) is a known global crisis. TheWorld Health Organization reports a global 2.09 million inci-dences and 627,000 deaths in 2018 relating to BC. The traditionalBC screening method in developed countries is mammography,whilst developing countries employ breast self-examination andclinical breast examination. The prominent gold standard for BCdetection is triple assessment: i) clinical examination, ii) mam-mography and/or ultrasonography; and iii) Fine Needle AspirateCytology. However, the introduction of cheaper, efficient and non-invasive methods of BC screening and detection would be benefi-cial.
Design and methods: We propose the use of eight machinelearning algorithms: i) Logistic Regression; ii) Support VectorMachine; iii) K-Nearest Neighbors; iv) Decision Tree; v) RandomForest; vi) Adaptive Boosting; vii) Gradient Boosting; viii)eXtreme Gradient Boosting, and blood test results using BCCoimbra Dataset (BCCD) from University of California Irvineonline database to create models for BC prediction. To ensure themodels’ robustness, we will employ: i) Stratified k-fold Cross-Validation; ii) Correlation-based Feature Selection (CFS); and iii)parameter tuning. The models will be validated on validation andtest sets of BCCD for full features and reduced features. Featurereduction has an impact on algorithm performance. Seven metricswill be used for model evaluation, including accuracy.
Expected impact of the study for public health: The CFStogether with highest performing model(s) can serve to identifyimportant specific blood tests that point towards BC, which mayserve as an important BC biomarker. Highest performing model(s)may eventually be used to create an Artificial Intelligence tool toassist clinicians in BC screening and detection
The importance of financial recession for mental health among students: short- and long-term analyses from an ecosocial perspective
Get PDFBackground and aim: Referring to the ecosocial theory and utilising the ‘natural experiment’ setting provided by the global recession at the beginning of 1990s, the aim of our study was to analyse the short- and long-term associations between trade and mental health in young students followed until mid-adulthood. Method: The study was based on two prospective cohort studies, the older and the younger Northern Swedish Cohort which both consisted of all pupils in a middle-sized industrial town in Northern Sweden. At age 21, the younger cohort entered the labour market during the deep recession of the early 1990s, while the older cohort entered the labour market during the boom of the 1980s. Both cohorts were followed up with a high response rate in mid adulthood. For this study, all students were selected at age 21. Results: At age 21, those who studied during recession had more depressive and functional somatic symptoms than those who studied during boom. The cohort differences did not remain over age: by the follow-up in early middle age the differences between the cohorts were non-significant, most notably due to decreased depressive symptoms in the younger cohort and increase of functional somatic symptoms in the older cohort. Conclusions: The short-term mental health consequences of the business cycle seem to be more extensive than limited only to those who are unemployed, even though the possible long-term consequences seem to be more complex. Thus, the macrolevel had a great short-term impact on the individual level in relation to the microlevel setting of university/school. The chronosystem was also of major importance. Future research would benefit from taking the context into account
Care of acute conditions and chronic diseases in Canada and the United States: Rapid systematic review and meta-analysis
Get PDFThis study tested the hypothesis that socioeconomically vulnerable Canadians with diverse acute conditions or chronic diseases have health care access and survival advantages over their counterparts in the USA. A rapid systematic review retrieved 25 studies (34 independent cohorts) published between 2003 and 2018. They were synthesized with a streamlined meta-analysis. Very low-income Canadian patients were consistently and highly advantaged in terms of health care access and survival compared with their counterparts in the USA who lived in poverty and/or were uninsured or underinsured. In aggregate and controlling for specific conditions or diseases and typically 4 to 9 comorbid factors or biomarkers, Canadians’ chances of receiving better health care were estimated to be 36% greater than their American counterparts (RR=1.36, 95% CI 1.35-1.37). This estimate was significantly larger than that based on general patient or non-vulnerable population comparisons (RR=1.09, 95% CI 1.08-1.10). Contrary to prevalent political rhetoric, three studies observed that Americans experience more than twice the risk of long waits for breast or colon cancer care or of dying while they wait for an organ transplant (RR=2.36, 95% CI 2.09-2.66). These findings were replicated across externally valid national studies and more internally valid, metropolitan or provincial/state comparisons. Socioeconomically vulnerable Canadians are consistently and highly advantaged on health care access and outcomes compared to their American counterparts. Less vulnerable comparisons found more modest Canadian advantages. The Affordable Care Act ought to be fully supported including the expansion of Medicaid across all states. Canada’s single payer system ought to be maintained and strengthened, but not through privatization
Six shades of grey: Identifying drinking culture and potentially risky drinking behaviour in the grey zone between work and leisure. The WIRUS culture study
Get PDFObjectives: The aim of this study was to explore drinking culture and drinking situations that employers and employees encounter in the grey zone between work and leisure, and identify what might affect employees’ risky drinking behaviour. Methods: We used eight focus groups to interview 61 core company informants from eight Norwegian companies (private and public sector) participating in the WIRUS – Workplace-based interventions preventing risky alcohol use and sick leave – project. The informants represented employers and employees with a diversity of roles at multiple organisational levels. The transcribed interviews were analysed by applying a phenomenological hermeneutical approach. Results: The analysis revealed six dimensions of drinking culture representing potentially risky drinking behaviour in situations that fall in the grey zone between work and leisure: (1) “Who invited me?” (Degree of obligation towards inviter), (2) “Do I have to participate?” (Degree of participation volunteerism), (3) “To drink or not to drink?” (Degree of drinking volunteerism), (4) “Work talk or small talk?” (Degree of work-related conversation), (5) “Are there any drinking rules to follow?” (Degree of regulation), and (6) “The influence of being away from home” (degree of distance to home). Conclusions: The findings reveal that employers and employees’ experience of drinking culture can be categorised as six different “shades of grey”. The grey zone is shaded from light to dark grey, indicating how risky the informants perceive the grey zone to be. The findings may be useful when designing workplace health promotion programmes and alcohol regulations in the workplace