Public Health Implications of Counterfeit Medications

Counterfeit medications are broadly defined as drugs that can contain inadequate amounts of active ingredients, contain the wrong active ingredients, be contaminated with harmful substances, and/or be falsely labeled. These medications are a public health issue globally, and their presence in the United States is growing. Counterfeit medications are produced without regulatory oversight and are distributed illegally, often via online sources. Use of these medications can result in adverse effects or a lack of improvement in a person's health condition. Nurses can assess where individuals are obtaining their medications and provide education about the potentially serious risks posed by counterfeit medications and how to avoid them.     

Nonalcoholic Fatty Liver Disease: Implications for Clinical Practice and Health Promotion

Nonalcoholic fatty liver disease (NAFLD), a condition caused by fatty infiltration of the liver, in the absence of large alcohol consumption, that can result in liver failure. It is the leading cause of elevated liver enzymes in adults and of liver disease in children, and it is increasing in the United States commensurately with obesity. Initially an asymptomatic disease, diagnosis is based on risk factor assessment, laboratory findings, and imaging studies. Prevention and early intervention require lifestyle changes. Prognosis is typically good, especially early in the disease course.     

Special Features: Health Policy: Hospital Nurse Staffing and Public Health Emergency Preparedness: Implications for Policy

Hospital restructuring policies and an impending nursing workforce shortage have threatened the nation's emergency preparedness. Current emergency response plans rely on sources of nurses that are limited and overestimated. A national investment in nursing education and workforce infrastructure, as well as incentives for hospitals to efficiently maximize nurse staffing, are needed to ensure emergency preparedness in the United States. This review highlights the challenges of maintaining hospital nursing surge capacity and policy implications of a nursing shortage.     

公共卫生的证据基础：为疾病与预防控制中心提供决策依据

1研究背景与资料 如同临床医生已经认识到循证临床实践的价值一样,公共卫生提供者也开始意识到循证证据的重要性。因此,2004年美国CDC开始促进公共卫生循证医学方法在疾病预防和干预中的应用。拟通过循证医学方法来评价公共卫生项目在人群干预过程中的有效性,即不同健康问题、可改变的危险因素与干预措施的相互关系,及控制危险因素可能减少的健康负担。     

Public Health Nursing and The Future of Public Health

The recent Institute of Medicine report, The Future of Public Health, reviews the history, current status, and potential of the public health system in the United States, and makes detailed recommendations for its revitalization. Although public reports such as this risk speedy obscurity, many are used by planners and legislators and a few exert significant influence. Public health nursing is inadequately represented in this potentially influential document, and this has unfortunate implications for public health nursing.     

The impact of stroke in Italy: first step for a National Burden of Disease Study

PURPOSE: To calculate the impact of stroke in Italy in 1998, expressed in terms of disability adjusted life years (DALYs) according to the WHO Global Burden of Disease (GBD) Study. METHOD: The data on first-ever stroke incidence (FES), remission rate and case fatality derived from the health information system and a research on post-FES disability of the Friuli Venezia-Giulia (FVG) Region, were used to compute the years of life lived with disability (YLDs), which were added to the years of life lost due to premature mortality (YLLs), calculated from stroke mortality data, to obtain the DALYs. The results were extrapolated to the rest of Italy after examination of national stroke registries data. RESULTS: Standardized estimated incidence of FES in FVG in 1998 was lower (135 cases of FES per 100 000 inhabitants) than that reported in other published national and international studies. Estimated case fatality rate and distribution of post-FES disability did not differ from other similar studies. About 100 000 YLLs and 273 000 YLDs due to FES were estimated in 1998 for Italy. CONCLUSIONS: The estimated proportion of the YLDs on total DALYs (27%) is comparable with that obtained in the EURO-A group (the European area including Italy) of the GBD 2000 Study (31%), and the Australian BoD Study (35%).     

The impact of stroke in Italy: First step for a National Burden of Disease Study

Purpose:?To calculate the impact of stroke in Italy in 1998, expressed in terms of disability adjusted life years (DALYs) according to the WHO Global Burden of Disease (GBD) Study.

Method:?The data on first-ever stroke incidence (FES), remission rate and case fatality derived from the health information system and a research on post-FES disability of the Friuli Venezia-Giulia (FVG) Region, were used to compute the years of life lived with disability (YLDs), which were added to the years of life lost due to premature mortality (YLLs), calculated from stroke mortality data, to obtain the DALYs. The results were extrapolated to the rest of Italy after examination of national stroke registries data.

Results:?Standardized estimated incidence of FES in FVG in 1998 was lower (135 cases of FES per 100?000 inhabitants) than that reported in other published national and international studies. Estimated case fatality rate and distribution of post-FES disability did not differ from other similar studies. About 100?000 YLLs and 273?000 YLDs due to FES were estimated in 1998 for Italy.

Conclusions:?The estimated proportion of the YLDs on total DALYs (27%) is comparable with that obtained in the EURO-A group (the European area including Italy) of the GBD 2000 Study (31%), and the Australian BoD Study (35%).     

Chronic Migraine: Epidemiology and Disease Burden

Chronic migraine is a common and disabling complication of migraine with a population prevalence of about 2%. Emerging evidence suggests that episodic migraine and chronic migraine differ not only in degree, but also in kind. Compared with patients with episodic migraine, those with chronic migraine have worse socioeconomic status, reduced health-related quality of life, increased headache-related burden (including impairment in occupational, social, and family functioning), and greater psychiatric and medical comorbidities. Each year, approximately 2.5% of patients with episodic migraine develop new-onset chronic migraine (ie, chronification). Understanding the natural disease course, improving treatment and management, and preventing the onset could reduce the enormous individual and societal burden of chronic migraine, and thus, have become important goals of headache research. This review provides a summary of the history of nomenclature and diagnostic criteria, as well as recent studies focusing on the epidemiology, natural history, and burden of chronic migraine.     

Case Commentary—Bass v. Barksdale: Implications for Public Health and Home Care Nurses

Abstract A recent malpractice case involved public health nurses. Given the legal issues based on this case, recommendations can be made to help ensure legal accountability, improve practice, and minimize liability risk. Areas of concern include doctor's orders and communication relating to telephone orders, the nurse's accountability to the client, documentation and patient teaching, the physician's duty to supervise the nurse, and corporate negligence. The court's analysis of the facts in finding areas of liability can guide nurses in avoiding malpractice litigation.     

Family History of Chronic Disease and Meeting Public Health Guidelines for Physical Activity: The Cooper Center Longitudinal Study

We aimed to assess whether a family history of coronary heart disease, diabetes, or cancer is linked to meeting public health guidelines for health-promoting physical activity. To achieve this objective, we analyzed data on 29,513 adults who came to the Cooper Clinic (Dallas, Texas) between January 1, 1990, and December 31, 2010, for a preventive medicine visit. Patients completed a comprehensive medical survey including information on family medical history, physical activity, and other lifestyle behaviors. Bivariate and multivariate logistic regression were used to examine the relationship between having a family history of chronic disease and meeting physical activity guidelines. The results indicated that individuals with a family history of disease had reduced odds for meeting or exceeding physical activity guidelines. For example, participants with a family history of 3 diseases were 36% less likely to meet or exceed physical activity guidelines than their counterparts without a family history of disease (odds ratio, 0.64; 95% CI, 0.58-0.72), while controlling for covariates. Among this large sample of adults, those with a family history of chronic disease were less inclined to regularly engage in physical activity. Thus, targeted programs encouraging adoption and maintenance of health-promoting physical activity might be warranted, specifically targeting individuals with familial history of disease.     

Osteoporosis: Implications for Community Health Nursing

Osteoporosis is a major public health problem as evidenced by the fact that it affects more than four million American women. It is a critical factor in virtually all of the 700,000 disabling hip fractures that occur yearly and it costs the economy almost $1 billion annually (Hodgson, 1982). The purpose of this article is to identify the major causes of osteoporosis and to present nursing interventions which diminish the devastating effects of this disease.     

Radon: Implications for the Health Professional

Radon is a colorless, odorless gas formed by radioactive decay of radium and uranium, which are naturally present in the earth's crust. When concentrated indoors, this invisible gas becomes a potential health hazard. The Environmental Protection Agency estimates that up to 20,000 lung cancer deaths annually can be attributed to prolonged radon exposure. Radon is an important health issue that should be understood by all health care professionals. This paper discusses some of the important issues regarding radon, such as the incidences of lung cancer believed to be attributable to radon, the high-risk areas in the United States, federal safety guidelines, and public apathy. These issues and their impact on the health care required by professionals, especially nurse practitioners, are discussed.     

Public Health Nursing in Japan: New Opportunities for Health Promotion

Major changes are taking place in public health nursing in Japan. These include significant developments in employment, education, and roles of public health nurses (PHNs). Demographic and economic factors have prompted the Japanese government to focus health service delivery on community-based care, particularly for the growing elderly population. Public health nurses are redefining their roles and are assuming important functions in planning, implementing, and evaluating community health programs for the elderly. Japanese PHNs are using a variety of health promotion strategies to initiate change at the local level. This article presents two case studies to highlight the leadership role of PHNs in creating new services that foster healthy communities.