Journal of Public Health Research (PAGEPress Publications)
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REXIC project: retrospective cross-sectional study of documentation of informed consent for research biobanking in a public research and teaching hospital
Get PDFBackground. The Center for Transfusion Medicine, Cell Therapy and Cryobiology, Milan, Northern Italy, is the headquarter of the POLI-MI biobank. It co-ordinates the biobank activities of the Fondazione Ca’ Granda Ospedale Maggiore Policlinico of Milan. Such activities require specific safeguarding of donors’ rights and protection of sensitive and genetic data. The Fondazione Ca’ Granda Ospedale Maggiore Policlinico has set up a project on informed consent with the aim of developing awareness and understanding of this issue. Within this project, it has been decided to evaluate how consent for biobanking material is expressed. Design and methods. The aim of the study was to evaluate the quality and completeness of consent to biobanking in the POLI-MI biobank. This was a retrospective study carried out in 2012 on samples of consent declarations collected by biobank units in 2011. Some units used a single, standard consent model available from a previous POLI-MI biobank workgroup. Other units used models which had been previouly formulated. Evaluation was made using a form that indicated the essential elements of consent. Results. A total of 48 consent declarations were collected using the single, standard model and 84 were collected using other models. The consent declarations that used the single, standard model were found to be the most complete and were filled in better than other models. Conclusions. Progressive adoption of a simple, standard consent model is expected to improve the quality of consent acquisition. Regular audit of the compliance of consent practices with ethical and legal requirements is mandatory to improve the quality of research biobanking
Correlation between body mass index and waist circumference in Nigerian adults: implication as indicators of health status
Get PDFBackground. Anthropometric measures have been widely used for body weight classification in humans. Waist circumference has been advanced as a useful parameter for measuring adiposity. This study evaluated the correlation between body mass index (BMI) and waist circumference and examined their significance as indicators of health status in adults.Design and Methods. The subject included 489 healthy adults from Ota, Nigeria, aged between 20 and 75 years, grouped into early adulthood (20-39 years), middle adulthood (40-59 years) and advanced adulthood (60 years and above). Weight, height and abdominal circumference were measured. BMI was calculated as weight kg/height2 (m2) and World Health Organization cut-offs were used to categorize them into normal, underweight, overweight and obese.Results. Abnormal weight categories accounted for 60 % of the subjects (underweight 11 %, overweight 31%, and obese 18%). The waist circumference of overweight and obese categories were significantly (P<0.05) higher than the normal weight category. There was no significant difference between waist circumference of underweight and normal subjects. The correlation coefficient values of BMI with waist circumference (r=0.63), body weight (r=0.76) and height (r=-0.31) were significant (P<0.01) for the total subjects.Conclusions. The study indicates that waist circumference can serve as a positive indicator of overweight and obesity in the selected communities; however, it may not be used to determine underweight in adults. Regular BMI and waist circumference screening is recommended as an easy and effective means of assessing body weight and in the prevention of weight related diseases in adults
Medical error disclosure and patient safety: legal aspects
Get PDFReducing the number of preventable adverse events has become a public health issue. The paper discusses in which ways the law can contribute to that goal, especially by encouraging a culture of safety among healthcare professionals. It assesses the need or the usefulness to pass so-called disclosure laws and apology laws, to adopt mandatory but strictly confidential Critical Incidents Reporting Systems in hospitals, to change the fault-based system of medical liability or to amend the rules on criminal liability. The paper eventually calls for adding the law to the present agenda of patient safety
Polychlorinated biphenyls, glycaemia and diabetes in a population living in a highly polychlorinated biphenyls-polluted area in northern Italy: a cross-sectional and cohort study
Get PDFBackground. Polychlorinated biphenyls (PCBs) have been found to be associated with diabetes in some, but not all, studies performed so far. The aim of this study was to assess the association between PCB serum levels and glycaemia and diabetes in people living in Brescia, a highly industrialised PCB-polluted town in Northern Italy. Design and Methods. 527 subjects were enrolled in a cross-sectional population-based study: they were interviewed face-to-face in 2003 and also provided a blood sample under fasting conditions. The concentration of 24 PCB congeners was determined using gas-chromatography (GC/MS). Subsequently, all subjects were included in a follow-up (cohort) study. According to the Local Health Authority health-care database, subjects were considered to be diabetic if they had diabetes at interview time (prevalent cases) or during a 7-year follow-up (incident cases). Results. A total of 53 subjects (10.0%) were diabetics: 28 had dia- betes at enrolment and other 25 developed the disease subsequently. Diabetes frequency increased according to the serum concentrations of total PCBs and single PCB congeners, but no association was found when estimates were adjusted for education, body mass index, age and gender by logistic regression analysis. Accordingly, glycaemia increased with PCB serum levels, but no association was observed when multiple regression analysis, including confounding factors, was performed. Conclusions. This study does not support the hypothesis that PCB environmental exposure is strictly associated with diabetes or glycaemia
Mining social media and web searches for disease detection
Get PDFWeb-based social media is increasingly being used across different settings in the health care industry. The increased frequency in the use of the Internet via computer or mobile devices provides an opportunity for social media to be the medium through which people can be provided with valuable health information quickly and directly. While traditional methods of detection relied predominately on hierarchical or bureaucratic lines of communication, these often failed to yield timely and accurate epidemiological intelligence. New web-based platforms promise increased opportunities for a more timely and accurate spreading of information and analysis. This article aims to provide an overview and discussion of the availability of timely and accurate information. It is especially useful for the rapid identification of an outbreak of an infectious disease that is necessary to promptly and effectively develop public health responses. These web-based platforms include search queries, data mining of web and social media, process and analysis of blogs containing epidemic key words, text mining, and geographical information system data analyses. These new sources of analysis and information are intended to complement traditional sources of epidemic intelligence. Despite the attractiveness of these new approaches, further study is needed to determine the accuracy of blogger statements, as increases in public participation may not necessarily mean the information provided is more accurate
Crisis communication in the area of risk management: the CriCoRM project
Get PDFBackground. During the last H1N1 pandemic has emerged the importance of crisis communication as an essential part of health crisis management. The Project aims specifically to improve the understanding of crisis communication dynamics and effective tools and to allow public health institutions to communicate better with the public during health emergencies.Design and Methods. The Project will perform different activities: i) state of the art review; ii) identification of key stakeholders; iii) communicational analysis performed using data collected on stakeholder communication activities and their outcomes considering the lessons learnt from the analysis of the reasons for differing public reactions during pandemics; iv) improvement of the existing guidelines; v) development of Web 2.0 tools as web-platform and feed service and implementation of impact assessment algorithms; vi) organization of exercises and training on this issues.Expected impact of the study for public health. In the context of health security policies at an EU level, the project aims to find a common and innovative approach to health crisis communication that was displayed by differing reactions to the H1N1 pandemic policies. The focus on new social media tools aims to enhance the role of e-health, and the project aims to use these tools in the specific field of health institutions and citizens. The development of Web 2.0 tools for health crisis communication will allow an effective two-way exchange of information between public health institutions and citizens. An effective communication strategy will increase population compliance with public health recommendations
The use of collaboration to implement evidence-based safe practices
Get PDFThe Pennsylvania Patient Safety Authority receives over 235,000 reports of medical error per year. Near miss and serious event reports of common and interesting problems are analysed to identify best practices for preventing harmful errors. Dissemination of this evidence-based information in the peer-reviewed Pennsylvania Patient Safety Advisory and presentations to medical staffs are not sufficient for adoption of best practices. Adoption of best practices has required working with institutions to identify local barriers to and incentives for adopting best practices and redesigning the delivery system to make desired behaviour easy and undesirable behaviour more difficult. Collaborations, where institutions can learn from the experiences of others, have show decreases in harmful events. The Pennsylvania Program to Prevent Wrong-Site Surgery is used as an example. Two collaborations to prevent wrong-site surgery have been completed, one with 30 institutions in eastern Pennsylvania and one with 19 in western Pennsylvania. The first collaboration achieved a 73% decrease in the rolling average of wrong-site events over 18 months. The second collaboration experienced no wrong-site operating room procedures over more than one year
The Ten Beads method: a novel way to collect quantitative data in rural Uganda
Get PDFThis paper illustrates how locally appropriate methods can be used to collect quantitative data from illiterate respondents. This method uses local beads to represent quantities, which is a novel yet potentially valuable methodological improvement over standard Western survey methods
Gender and regional differentials in health expectancy in Greece
Get PDFBackground. Differentials and inequalities in heath status are closely related to the implementation and the sustainability of public health policies. The paper investigates differences in health expectancy as an indicator of population health among regions and between genders.Design and Methods. Based on activity limitation, we compute Healthy Life Years indicator by applying the prevalence-based Sullivan method. The analysis is based on data from the National Health Survey conducted in Greece in 2009 by the Hellenic Statistical Authority, carried out on a multistage probability sample of 6172 individuals.Results. The results show that men are more likely than women to live a greater part of their life in good health. When regions are considered (NUTS_1 and NUTS_2 levels), the resulting diversities in healthy life years are more pronounced than those in life expectancy.Conclusions. The paper provides additional insights about health status discrepancies among Greek geographic regions and between genders. The results indicate that men are more likely to report to be in good health than women, and the differences by gender are more pronounced at regional than at national level. This empirical evidence can be used for monitoring both, the population health status and the undesired differentials in health expectancy, and may therefore be a useful tool for health policies aiming at reducing heath inequalities among individuals
(Re)Introducing communication competence to the health professions
Get PDFDespite the central role that communication skills play in contemporary accounts of effective health care delivery in general, and the communication of medical error specifically, there is no common or consensual core in the health professions regarding the nature of such skills. This lack of consensus reflects, in part, the tendency for disciplines to reinvent concepts and measures without first situating such development in disciplines with more cognate specialization in such concepts. In this essay, an integrative model of communication competence is introduced, along with its theoretical background and rationale. Communication competence is defined as an impression of appropriateness and effectiveness, which is functionally related to individual motivation, knowledge, skills, and contextual facilitators and constraints. Within this conceptualization, error disclosure contexts are utilized to illustrate the heuristic value of the theory, and implications for assessment are suggested