Heymann D.L.,London School of Hygiene and Tropical Medicine |
Heymann D.L.,Center on Global Health Security |
Chen L.,China Medical Board |
Takemi K.,Japan House of Councillors |
And 26 more authors.
The Lancet | Year: 2015
The Ebola virus disease outbreak in West Africa was unprecedented in both its scale and impact. Out of this human calamity has come renewed attention to global health security - its definition, meaning, and the practical implications for programmes and policy. For example, how does a government begin to strengthen its core public health capacities, as demanded by the International Health Regulations? What counts as a global health security concern? In the context of the governance of global health, including WHO reform, it will be important to distil lessons learned from the Ebola outbreak. The Lancet invited a group of respected global health practitioners to reflect on these lessons, to explore the idea of global health security, and to offer suggestions for next steps. Their contributions describe some of the major threats to individual and collective human health, as well as the values and recommendations that should be considered to counteract such threats in the future. Many different perspectives are proposed. Their common goal is a more sustainable and resilient society for human health and wellbeing. © 2015 Elsevier Ltd.
Napier A.D.,University College London |
Ancarno C.,King's College London |
Butler B.,University College London |
Calabrese J.,University College London |
And 23 more authors.
The Lancet | Year: 2014
Planned and unplanned migrations, diverse social practices, and emerging disease vectors transform how health and wellbeing are understood and negotiated. Simultaneously, familiar illnesses-both communicable and non-communicable-continue to aff ect individual health and household, community, and state economies. Together, these forces shape medical knowledge and how it is understood, how it comes to be valued, and when and how it is adopted and applied. Perceptions of physical and psychological wellbeing diff er substantially across and within societies. Although cultures often merge and change, human diversity assures that diff erent lifestyles and beliefs will persist so that systems of value remain autonomous and distinct. In this sense, culture can be understood as not only habits and beliefs about perceived wellbeing, but also political, economic, legal, ethical, and moral practices and values. Although culture can be considered as a set of subjective values that oppose scientific objectivity, we challenge this view in this Commission by claiming that all people have systems of value that are unexamined. Such systems are, at times, diff use, and often taken for granted, but are always dynamic and changing. They produce novel and sometimes perplexing needs, to which established caregiving practices often adjust slowly. Ideas about health are, therefore, cultural. They vary widely across societies and should not merely be defined by measures of clinical care and disease. Health can be defined in worldwide terms or quite local and familiar ones. Yet, in clinical settings, a tendency to standardise human nature can be, paradoxically, driven by both an absence of awareness of the diversity with which wellbeing is contextualised and a commitment to express both patient needs and caregiver obligations in universally understandable terms. We believe, therefore, that the perceived distinction between the objectivity of science and the subjectivity of culture is itself a social fact (a common perception). We attribute the absence of awareness of the cultural dimensions of scientific practice to this distinction, especially for macrocultures and large societies, which define only small-scale, microcultures as cultural. We recommend a broad view of culture that embraces not only social systems of belief as cultural, but also presumptions of objectivity that permeate views of local and global health, health care, and health-care delivery. If the role of cultural systems of value in health is ignored, biological wellness can be focused on as the sole measure of wellbeing, and the potential for culture to become a key component in health maintenance and promotion can be eroded. This erosion is especially true where resources are scarce or absent. Under restricted and pressured conditions, behavioural variables that aff ect biological outcomes are dismissed as merely sociocultural, rather than medical. Especially when money is short, or when institutions claim to have discharged fully their public health obligations, blame for ill health can be projected onto those who are already disadvantaged. As a result, many thinkers in health-care provision across disciplines attribute poor health-care outcomes to factors that are beyond the control of care providers-namely, on peculiar, individual, or largely inaccessible cultural systems of value. Others, having witnessed the ramifications of such thinking, argue that all health-care provision should, rather, be made more culturally sensitive. Yet others declare merely that multiculturalism has failed and the concept should be abandoned, citing its divisive potential.1 Irrespective of who is blamed, failure to recognise the intersection of culture with other structural and societal factors creates and compounds poor health outcomes, multiplying financial, intellectual, and humanitarian costs. However, the eff ect of cultural systems of values on health outcomes is huge, within and across cultures, in multicultural settings, and even within the cultures of institutions established to advance health. In all cultural settings-local, national, worldwide, and even biomedical-the need to understand the relation between culture and health, especially the cultural factors that aff ect health-improving behaviours, is now crucial. In view of the financial fragility of so many systems of care around the world, and the wastefulness of so much of health-care spending, a line can no longer be drawn between biomedical care and systems of value that define our understanding of human wellbeing. Where economic limitations dictate what is feasible, socioeconomic status produces its own cultures of security and insecurity that cut across nationality, ethnic background, gender orientation, age, and political persuasion. Socio economic status produces new cultures defined by degrees of social security and limitations on choice that privilege some people and disadvantage others. Financial equity is, therefore, a very large part of the cultural picture; but it is not the entire picture. The capacity to attend to adversity- to believe that one can aff ect one's own future-is conditioned by a sense of social security that is only partly financial.
Guest J.F.,Health Catalyst |
Guest J.F.,King's College London |
Panca M.,Health Catalyst |
Baeyens J.-P.,University of Luxembourg |
And 4 more authors.
Clinical Nutrition | Year: 2011
Background & aims: To examine the effect of malnutrition on clinical outcomes and healthcare resource use from initial diagnosis by a general practitioner (GP) in the UK. Methods: 1000 records of malnourished patients were randomly selected from The Health Improvement Network database and matched with a sample of 996 patients' records with no previous history of malnutrition. Patients' outcomes and resource use were quantified for six months following diagnosis. Results: Malnourished patients utilised significantly more healthcare resources (e.g. 18.90 versus 9.12 GP consultations; p < 0.001, and 13% versus 5% were hospitalised; p < 0.05). The six-monthly cost of managing the malnourished and non-malnourished group was £1753 and £750 per patient respectively, generating an incremental cost of care following a diagnosis of malnutrition of £1003 per patient. Thirteen percent and 2% of patients died in the malnourished and non-malnourished group respectively (p < 0.001). Independent predictors of mortality were: malnutrition (OR: 7.70); age (per 10 years) (OR: 10.46); and the Charlson Comorbidity Index Score (per unit score) (OR: 1.24). Conclusion: The healthcare cost of managing malnourished patients was more than twice that of managing non-malnourished patients, due to increased use of healthcare resources. After adjusting for age and comorbidity, malnutrition remained an independent predictor of mortality. © 2011 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism.
Meijers J.M.M.,Maastricht University |
Halfens R.J.G.,Maastricht University |
Wilson L.,International Longevity Center |
Schols J.M.G.A.,Maastricht University
Clinical Nutrition | Year: 2012
Backgrounds & aims: Malnutrition in western health care involves a tremendous burden of illness. In this study the economic implications of malnutrition in Dutch nursing homes are investigated as part of the Health and Economic Impact of Malnutrition in Europe Study from the European Nutrition for Health Alliance. Methods: A questionnaire was developed, focussing on the additional time and resources spent to execute all relevant nutritional activities in nursing home patients with at risk of malnutrition or malnourished. Results were extrapolated on national level, based on the prevalence rates gathered within the national Prevalence Measurement of Care Problems 2009. Results: The normal nutritional costs are 319 million Euro per year. The total additional costs of managing the problem of malnutrition in Dutch nursing homes involve 279 million Euro per year and are related to extra efforts in nutritional screening, monitoring and treatment. The extra costs for managing nursing home residents at risk of malnutrition are 8000 euro per patient and 10000 euro for malnourished patients. Conclusions: The extra costs related to malnutrition are a considerable burden for the nursing home sector and urge for preventive measures. © 2011.
Kneale D.,International Longevity Center |
Kneale D.,University of London |
Fletcher A.,London School of Hygiene and Tropical Medicine |
Wiggins R.,University of London |
Bonell C.,University of Oxford
Journal of Epidemiology and Community Health | Year: 2013
Purpose: In order to consider the potential contribution of universal versus targeted prevention interventions, the authors examined what is the distribution of established risk variables for teenage motherhood? from where in these distributions do births arise? and how does this distribution/determination of risk vary between studies? Methods: Secondary data analysis of three British longitudinal studies. Results: For all cohorts and variables, the 'risk' category was the least frequent. Continuous risk factors were normally distributed. A high rate of teenage motherhood within a risk category often translated into low 'contribution' to the overall rate (eg, expectation to leave school at the minimum age among the 1989/1990-born cohort) and vice versa. Most young women had a low probability of teenage motherhood. For any targeting strategy, combining risk factors and a low threshold of predicted probability would be necessary to achieve adequate sensitivity. Assessing between-cohort applicability of findings, the authors find that the numbers of teenage parents is poorly estimated and estimates of the variability and direction of risk may also be inadequate. Conclusions: With reference to a number of established risk factors, there is not a core of easily identifiable multiply disadvantaged girls who go on to constitute the majority of teenage mothers in these studies. While individual risk factors are unlikely to enable targeting, a composite may have some limited potential, albeit with a low threshold for 'risk' and with the caveat that evidence from one population may not inform good targeting in another. It is likely that universal approaches will have more impact.
News Article | December 9, 2016
BOSTON, MA, December 09, 2016-- Abigail Trafford has been included in Marquis Who's Who. As in all Marquis Who's Who biographical volumes, individuals profiled are selected on the basis of current reference value. Factors such as position, noteworthy accomplishments, visibility, and prominence in a field are all taken into account during the selection process.An award-winning journalist and public speaker, Ms. Trafford has amassed more than 50 years of experience as a writer, editor, and columnist. She began her career in 1962 upon receiving a Bachelor of Arts, cum laude, from Bryn Mawr College. Within two years, Ms. Trafford accepted a position as a researcher with the National Geographic Society in the District of Columbia. She spent a year in Australia where she was a teacher at the Finke River Mission at Hermannsburg in the Northern Territory. Since her return to the U.S. in 1968, Ms. Trafford has enjoyed various roles with a variety of print publications, including Time magazine as a special correspondent based in Houston, TX; U.S. News & World Report where she became an assistant managing editor; and The Washington Post where, as Health Editor, she produced a weekly section on medicine, science and society.Throughout the course of her career, Ms. Trafford has developed a reputation as a respected voice in her field. She has authored numerous creative works, including "Crazy Time: Surviving Divorce and Building a New Life," (third edition in 2014), "My Time: Making the Most of the Bonus Decades After Fifty" and "As Time Goes By," about love in an era of longevity. In 2007, Ms. Trafford served as a visiting scholar at the Stanford Center on Longevity at Stanford University. She was also previously a journalism fellow at the International Longevity Center in New York. An experienced health editor, Ms. Trafford completed two journalism fellowships at the Harvard School of Public Health. In addition, she gave a keynote address at the White House Conference on Aging. She has also served on the boards of the Washington Press Club Foundation, Partners in Island Education (PIE), Bryn Mawr Alumnae Association, and Trustees of the Ethel Walker School.In recognition of her contributions to the field of communications, Ms. Trafford has been featured in a wide variety of honors publications, including Who's Who in America, Who's Who of American Women, Who's Who in the East, Who's Who in Finance and Business, and Who's Who in the World. She was also selected for inclusion in the 1st edition of Who's Who in the Media and Communication, which was released in 1997.About Marquis Who's Who :Since 1899, when A. N. Marquis printed the First Edition of Who's Who in America , Marquis Who's Who has chronicled the lives of the most accomplished individuals and innovators from every significant field of endeavor, including politics, business, medicine, law, education, art, religion and entertainment. Today, Who's Who in America remains an essential biographical source for thousands of researchers, journalists, librarians and executive search firms around the world. Marquis now publishes many Who's Who titles, including Who's Who in America , Who's Who in the World , Who's Who in American Law , Who's Who in Medicine and Healthcare , Who's Who in Science and Engineering , and Who's Who in Asia . Marquis publications may be visited at the official Marquis Who's Who website at www.marquiswhoswho.com
Taylor R.,International Longevity Center
Nutrition Bulletin | Year: 2011
An International Longevity Centre Report (ILC-UK) on older people and functional foods examines current dietary recommendations for older people, looks at consumer behaviour towards functional foods and asks whether functional foods have a role to play in older people's diets. © 2011 The Author. Journal compilation © 2011 British Nutrition Foundation.
Beach B.,International Longevity Center
Maturitas | Year: 2014
Population ageing has reshaped the notion of retirement. The changes carry important implications for aspirations to extend working life. Cultural expectations regarding work and retirement must adapt to the reality posed by longer lives. The modern world is characterised by perpetual - and sometime rapid - change. Transformation throughout the second half of the 20th century brought about substantial shifts in the health and longevity of people in societies across the world. Since the beginning of the 21st century, the impacts of population ageing have gathered greater awareness in public consciousness and within the policy arena. Notions of old age, retirement, and later life have been fundamentally transformed, presenting stark challenges alongside novel opportunities for individuals, communities, and governments. Many of the topics of interest with respect to ageing populations are themselves the result of shifts that were unforeseen. © 2014 Elsevier Ireland Ltd.
Bamford S.-M.,International Longevity Center |
Walker T.,International Longevity Center
Maturitas | Year: 2012
Objectives To inform our understanding of gender, sex and dementia for women's health and highlight both current and emerging issues. The purpose of this article is to provide policy makers with an improved understanding of the sex-specific and gender dimensions that exist to help formulate more effective and targeted health and social care policies. Methods The findings, from which this article is formed, were reported in the form of an evidence review which included both qualitative and quantitative studies from academic, clinical, research and grey literature. The issue of dementia was approached through the prism of sex and gender, in an attempt to understand the complex interaction between biologically and socially constructed roles. Findings There continues to be a pressing need to raise awareness of the impact of discrimination, exclusion and stigma associated with dementia and the impact for women in particular. While the 'feminisation of ageing' is a widely recognised trend, hitherto a comprehensive approach to the impact of dementia on women remains largely unexplored with regards to research and policy impact. Women face a 'triple jeopardy' as a result of the associated stigma attached to their age, gender and decline in cognitive functions. The need for further research of the sex and gender specific risk factors for dementia is highlighted alongside the need for greater evidence on diagnosis, treatment and response. The findings also expose the gender specific nature of unpaid care and the associated consequences for women as a result. Conclusions Based on analysis of the available data and assisted by the gender lens tool, the findings presented in this article posit that women across many parts of the world are and will continue to disproportionately bear the burden of dementia, with particular regard to either living with dementia and/or caring for family members with dementia. © 2012 Elsevier Ireland Ltd. All rights reserved.
Hamerman D.,International Longevity Center
Journals of Gerontology - Series A Biological Sciences and Medical Sciences | Year: 2010
Biogerontologists and academic geriatricians are both dedicated to promoting a healthier longevity for our society from their perspectives of scientific research on aging and education as part of clinical care for older persons. Yet at the present time, the prospects for translating research advances made by the biogerontologists to improve the outlook for health care provided by the geriatricians are limited by a "gulf" that exists between them, with little shared dialogue or scientific interchange. This article sets forth a basis for a union between both disciplines to prepare for the potential application of basic aging research to the provision of health care, with the aim ultimately to extend "health span" during our life span. © 2010 The Author.