Science as a general education: Conceptual science should constitute the compulsory core of multi-disciplinary undergraduate degrees

It is plausible to assume that in the future science will form the compulsory core element both of school curricula and multi-disciplinary undergraduate degrees. But for this to happen entails a shift in the emphasis and methods of science teaching, away from the traditional concern with educating specialists and professionals. Traditional science teaching was essentially vocational, designed to provide precise and comprehensive scientific knowledge for practical application. By contrast, future science teaching will be a general education, hence primarily conceptual. Its aim should be to provide an education in flexible rationality. Vocational science teaching was focused on a single-discipline undergraduate degree, but a general education in abstract systematic thinking is best inculcated by studying several scientific disciplines. In this sense, 'science' is understood as mathematics and the natural sciences, but also the abstract and systematic aspects of disciplines such as economics, linguistics, music theory, history, sociology, political science and management science. Such a wide variety of science options in a multi-disciplinary degree will increase the possibility of student motivation and aptitude. Specialist vocational science education will progressively be shifted to post-graduate level, in Masters and Doctoral programs. A multi-disciplinary and conceptually-based science core curriculum should provide an appropriate preparation for dealing with the demands of modern societies; their complex and rapidly changing social systems; and the need for individual social and professional mobility. Training in rational conceptual thinking also has potential benefits to human health and happiness, since it allows people to over-ride inappropriate instincts, integrate conflicting desires and pursue long-term goals.     

Implementation science for the prevention and treatment of HIV/AIDS

Implementation science is the scientific study of methods to promote the integration of research findings and evidence-based interventions into health care policy and practice and hence to improve the quality and effectiveness of health services and care. Implementation science is distinguished from monitoring and evaluation by its emphasis on the use of the scientific method. The origins of implementation science include operations research, industrial engineering, and management science. Today, implementation science encompasses a broader range of methods and skills including decision science and operations research, health systems research, health outcomes research, health and behavioral economics, epidemiology, statistics, organization and management science, finance, policy analysis, anthropology, sociology, and ethics. Examples of implementation science research are presented for HIV prevention (prevention of mother-to-child transmission of HIV, male circumcision) and HIV and drug use (syringe distribution, treating drug users with antiretroviral therapy and opioid substitution therapy). For implementation science to become an established field in HIV/AIDS research, there needs to be better coordination between funders of research and funders of program delivery and greater consensus on scientific research approaches and standards of evidence.     

eHealth in Latin America and the Caribbean: development and policy issues

This paper reviews trends and issues in health and in the information and communication technologies (ICT) market as they relate to the deployment of eHealth solutions in Latin America and the Caribbean. Heretofore designed for industrialized countries and large organizations, eHealth solutions are being proposed as an answer to a variety of health-system management problems and health care demands faced by all health organizations including those in developing societies. Particularly, eHealth is seen as especially useful in the operational support of the new health care models being implemented in many countries. The authors examine those developments vis-à-vis the characteristics of the Latin American and the Caribbean health-sector organizational preparedness and technological infrastructure, and propose policy and organizational actions to foster the development of eHealth solutions in the region.     

The European network of transfusion medicine societies (EuroNet-TMS): The White Book 2005]

Europe is building up. It develops in a quite complex environment, in which health care represents an important field of activities. As for blood transfusion, it plays a major role especially in the development of medical activities as well as for the patients treatments. Today, blood components are still of human origin and there are no substitutes for them. As a medical discipline, Blood Transfusion represents a broad field in medicine which requests the involvement of numerous actors. It is up to professional medical/scientific societies to promote the discipline. This is why it has been considered necessary and relevant to build up a federation of transfusion medicine societies throughout the European Union (EU) ; it is called EuroNet-TMS, the European Network of Transfusion Medicine Societies. This network groups more than 7500 professionals of involved in blood transfusion activities. It has six major objectives: 1) To find coherent responses to issues at stake in transfusion; 2) To promote medical and scientific developments of blood transfusion in Europe; 3) To ensure the highest and most up-to-date scientific level to meet safety and quality standards; 4) To offer similar services to all EU citizens in the field of blood transfusion; 5) To share knowledge and date within Europe; 6) To develop interfaces with decision-makers among the diverse European countries. The first step is the writing of the "White Book 2005" which reports the state of the art of blood transfusion in Europe; a prospective plan is proposed to be discussed.     

An interview study to explore applied psychologists' experiences of implementing health psychology in global health partnerships: The Change Exchange

Introduction

Health partnerships in global health aim to build capacity by strengthening training and education. Health psychology has an important role to play, as traditionally health partnerships focus upon increasing capability such as increasing knowledge but do not tackle opportunity and motivation. The Change Exchange recruits applied psychologist volunteers to utilize health psychology in global health partnerships, which is a novel approach. This study aimed to understand the experiences of applied psychologist volunteers working in health partnerships and how such interventions were implemented.

Methods

Semi-structured interviews were carried out. Interviews were analysed using inductive thematic analysis to explore the translation and implementation of health psychology in health partnerships. A deductive approach was then taken using the higher level constructs of the Normalization Process Theory to inform and interpret the themes into recommendations.

Results

Fifteen applied psychologists, all of whom were from the UK and had volunteered in health partnerships between the UK and low- to middle-income countries participated. Key themes and sub-themes were identified: (1) The challenges of the application of behavioural science within the health partnerships, (2) Building relationships within the health partnership, (3) Exploring the communal and individual effort carried out within the health partnership and (4) Reflecting on the work carried out within the health partnership.

Discussion

Barriers exist in regards to the implementation of health psychology in health partnerships but capacity building is possible. Recommendations suggest, future work should establish clear roles for applied psychologists in health partnerships and critical evaluation of current psychological models, methods and measures for use outside of Western, Educated, Industrialized, Rich and Democratic societies.     

Geneticists' views on science policy formation and public outreach

Though much research about the public's views of scientists, genetic research and its moral, ethical, and social implications exists, little has been done to investigate how scientists view their own role(s) in public discussions and policy formation related to genetic research and technologies. We interviewed 20 academic geneticists in the United States about their perceptions of the roles they and others (e.g., professional societies, the public, ethicists, and elected officials) do and should play in the formation of science policy, the communication of science to the public, and the public discussions of moral and ethical issues raised by scientific advances. The participants in our study thought that scientists should be more actively involved in public outreach and science policy formation, but frequently they felt ill-equipped and unsupported by their peers and institutions to pursue these activities. Furthermore, many were skeptical of or did not trust elected officials--who they consider uninformed about the issues and too driven by political agendas--to formulate sound science policy. They do, however, have faith in the ability of scientific societies to influence policy effectively, and some thought that societies should play a larger role, both in science policy and as a liaison between scientists and the public. Finally, participants offered suggestions for increasing the involvement and influence of scientists in science-policy formation and public discourse.     

Quality of infertility care in poor-resource areas and the introduction of new reproductive technologies

The quality of infertility care is dependent upon adequate material resources and the appropriate use of it. In addition, a mutual understanding between physicians and patients is necessary. These imperatives are more salient in the era of the new reproductive technologies. However, in poor-resource areas these imperatives are insufficiently met. Moreover, in developing countries the negative consequences of childlessness are much stronger than in Western societies. Until recently, the problem of infertility in Third World countries has received little public attention. A plea is made for a stronger policy interest in Third World infertility care. In this it is important to focus on prevention, appropriate diagnosis and treatment at primary and secondary health-care level and to take the existing cultural beliefs into account.     

Overcoming the hurdles to providing urban health care in the 21st century.

The delivery of health care services to urban populations in the United States is a system of rapidly increasing complexity. With the emergence of superspecialized physicians, a scientific approach to disease management has received great emphasis. Those providing health care at the population level may also apply this evidence-based approach. Analysis of the process of health care delivery in its entirety is complicated, confusing, and may be fraught with bias. In this article, a powerful instrument for providing a scientific approach to urban health care health policy development is introduced. This tool allows for analysis and assessment of hurdles to health care delivery to urban populations by dividing the process into elements of "administration," "provision," and "utilization" (APU). This APU triangle model, while intuitive, also allows a more definitive analysis by parts than would be possible to make of the whole. Using this model, the authors explore some of the hurdles faced by each element as well as some potential solutions. Although this model is presented in the context of urban hurdles to health care, it is equally applicable to rural environments or other service-delivery systems. In conclusion, this article discusses the emergence of the role of the public health department as the facilitator and manager between sectors of the community not traditionally connected in a collaborative health care model. Thus, the urban public health department coordinates efforts to surmount the hurdles and provides the venue for analysis, development, and employment of successful strategies.     

Globalization in science education: an inevitable and beneficial trend

Globalization is one aspect of the larger phenomenon of modernization, which describes societies characterized by progressive growth in the complexity of communications. Despite its inevitable problems, globalization is a generally desirable phenomenon, since it enables increased efficiency, effectiveness and capability of societies and thereby, potentially benefits most people most of the time. Scientific research was one of the first global communication systems, especially at its most advanced levels. And high quality scientific education at the post-doctoral level is also now essentially global. The next steps will be for lower level science education - at doctoral, undergraduate, and even school teaching levels - to become progressively globalized. This phenomenon is already happening in the mathematical and quantitative sciences, and will probably spread to include other kinds of science. But to be efficient requires the development of a trading medium of internationally standardized and quantitative educational credits - for instance, standard certificates, objective comparative examinations, and a hierarchical qualifications structure (which will almost certainly be based on the United States system). Globalized education also requires a common language for organizational communications, which is already in place for the quantitative and mathematical sciences, and will be increasingly the case as competence in a simplified form of international scientific English becomes more universal. As such a global science education system grows there will be increased competition and migration of teachers and students. The law of comparative advantage suggests that such mobility will encourage societies to specialize in what they do best. For example, some countries (even among wealthy nations) may provide little advanced scientific education, and import the necessary expertise from abroad - this situation seems to be developing in Germany and France, who lack any top-quality research universities. Conversely, just a few countries may provide the bulk of advanced science education teaching - as well as applied and pure research personnel - for the rest of the world: potentially China and India might supply most of world's mathematical expertise. In conclusion, there are two complementary aspects to the globalization of science education: these are standardization and specialization. We anticipate a simultaneous trend towards international convergence of basic educational structures, certificates and English usage; with increasing national differentiation of specialist educational functions.     

Epidemiological Influences and Requirements of Global Childhood Obesity Research

IntroductionObesity is classified as a global epidemic and judged to be the greatest public health threat in Western countries. The tremendously increasing prevalence rates in children lead to morbidity and mortality in adults. In many countries, prevalence has doubled since the 1980s. Other countries show a continuous increase or stagnate at a very high level. Given these regional differences, this study aims to draw a global world map of childhood obesity research, including regional epidemiological characteristics, to comprehensively assess research influences and needs.MethodsIn addition to established bibliometric parameters, this study uses epidemiological data to interpret metadata on childhood obesity research from the Web of Science in combination with state-of-the-art visualization methods, such as density equalizing map projections.ResultsIt was not until the 1990s that belated recognition of the dangerous effects of childhood obesity led to an increase in the number of publications worldwide. In addition, our findings show that countries'' study output does not correlate with epidemiologic rates of childhood obesity. In contrast, the primary driver of the research efforts on childhood obesity appears to be largely driven government funding structures.Discussion/ConclusionThe geographical differences in the epidemiological background of childhood obesity complicate the implementation of transnational research projects and cross-border prevention programs. Effective realization requires a sound scientific basis, which is facilitated by globally valid approaches. Hence, there is a need for information exchange between researchers, policy makers, and private initiatives worldwide.     

Asylum seekers,refugees, and the politics of access to health care: a UK perspective

The UK government has recently consulted on proposals to prohibit access to health care for some asylum seekers. This discussion paper considers the wider ethical, moral, and political issues that may arise from this policy. In particular, it explores the relationship between immigration and health and examines the impact of forced migration on health inequalities. It will be argued that it is both unethical and iniquitous to use health policy as a means of enforcing immigration policy. Instead, the founding principle of the NHS of equal access on the basis of need should be borne in mind when considering how to meet the needs of this population.     

A bridge to Africa: how health professionals can help in development

US secretary of Health and Human Services Sullivan addresses the issue of the role the US has now and the role it may play in improving health across the African continent. Progress made is attributed to the courageous individual commitment of many dedicated health care problems, and substantial cooperative international efforts. The 1990 US contribution through USAID is 80 million dollars for child survival in Africa and 80 million dollars for voluntary family planning activities. The 1991 figures increased in the total development fund from 560 million dollars to 800 million dollars. AIDS activities receive 11 million dollars out of a total world budget of 52 million dollars. An additional 14 million dollar grant was awarded for a Ugandan effort to fight AIDS and child health care problems and 242,000 dollar grant was given to the Soweto Township AIDS program and AIDS prevention and treatment. The future emphasis was directed to providing a steady, cooperative partnership with African countries, to increasing support for political stability and ending violence, and continuing US policy based on broad based economic growth which fosters sustainable and effective health assistance programs. Support must be provided to assist programs which develop indigenous primary health care systems. Work must be focused on helping Africans learn and practice personal health promotion and disease prevention, which is also of particular significance in breaking the AIDS transmission chain. Increased efforts must address malaria through applied and basic research and malaria control programs. US information technology in the form of, for instance, technical training in epidemiology, disease surveillance, and computer science and data use, needs to be provided to African health professionals. Utilitarian means in international cooperation and relief must be used to foster economic development, democracy, and delivery of health care improvements. The role for health professionals in the US must be to mobilize efforts to share information and expertise with their African counterparts; i.e., through University sponsored meetings and conferences, and private foundation efforts. The reach is with compassion, advanced technology and medical expertise and financial support.     

Women's attitudes towards receiving family planning services from community health workers in rural Western Kenya

BackgroundKenya ranks among the countries in Africa with high fertility rates. In order to reverse the trends in high fertility rates, there is need to increase uptake of family planning services particularly by use of community health workers (CHWs) in providing these services in rural areas.ObjectiveTo describe the perceptions of women towards family planning service provision by CHWs in four rural districts of Western Kenya. It is based on baseline survey data from a three-year, rural community-based family planning project funded by The David and Lucile Packard Foundation.MethodsA cross-sectional baseline survey was conducted in Western Kenya. The data presented is part of a broader the broader survey . A survey questionnaire was administered to 1,997 women (15–49 years) but only 963 cases were valid for our analyses.ResultsThe findings revealed that only a third of the respondents exhibited high approval for Family Planning services from CHWs. Only four out of the thirteen variables explored showed significance on attitudes towards family planning services from CHWs. These are age, level of education, knowledge about family planning benefits and districts.ConclusionWomen''s perception towards family planning services delivered by CHWs in Western region in Kenya is quite low. To improve the demand and supply for family planning services in this region, there is need to invest a substantial amount of effort into sensitization of women on the relevance of CHWs in providing family planning services.     

Global transition in health

"Tempora mutantur et nos in illis" King Lothar I remarked by year 900 AD. What exactly changed in us over time, i.e. how patterns of the epidemiological transition in populations locally and globally might appear, was described by Omran in 1971 [1]. The effect of transition on health and diseases in populations was demonstrated by Frenkl et al in 1991 [2]. And which major public health problems following each other, and why, was underscored by LaPorte in 1995 [3]. In 2000, leaders of the world society decided to identify a range of common goals, the Millennium Development Goals (MDG), to be reached by year 2015. Many of the MDG are directly or indirectly related with the major health problems, particularly those hitting the poorest: lack of clean drinking water, unhealthy environment, high maternal mortality due to lack of care for the pregnant, and lack of control of major communicable, often fatal diseases like child diseases, malaria, HIV/AIDS and tuberculosis. It is remarkable that the specific chronic diseases of major public health relevance are in fact not mentioned in the MDG, even if these diseases increasingly are hitting populations in low- and middle-income societies, i.e. developing countries. The world community seems to prioritize the diseases that are most visible, and most often linked with poverty, namely the infectious diseases mentioned above, which together kill about 17 million people annually, often in combination with malnutrition, and the 0.6 million deaths related to birth and pregnancy. With the exception of HIV/AIDS, which also hit richer societies, these diseases of poverty have been under-prioritized regarding research as well. However, at the turn of the Millennium, the burden of "Western" non-communicable diseases was increasing fast in developing countries. And by 2025, the burden of non-communicable diseases is expected to have doubled globally, with half of the burden on developing countries. Therefore it may be rewarding to look backwards upon the three stages of Omran's original thesis on epidemiological transition, to understand life and death forwards, in a world in fast transition, cf. the Danish philosopher Soeren Kirkegaard: "it is true what philosophy tells us, that life must be understood backwards, while not forgetting the second sentence, that it must be lived forwards".     

La Red Iberófona para la Responsabilidad Social en Salud. Una estrategia vital para confrontar los retos de la salud en contextos de incertidumbre y cambios constantes

The notion of social responsibility is becoming and will become more important as time goes by, because of the global awareness of the need to understand the human being and the effect of multiple interactions on the well-being of our societies, especially on health. Therefore, all institutions and all citizens will be called upon to assume some responsibility for maintaining and sustaining it.In September 2022, the Iberophone Network for Social Accountability in Health (RIRSS) was presented in Brussels, with the aim of responding effectively to the health demands of our populations, through close collaboration between all the Spanish Portuguese-speaking countries of Africa, America, Asia, and Europe that make up what has been called the Iberophone countries. This geopolitical "territory" groups, together thirty countries and more than 800 million people, whose health is the responsibility of all those involved in the health systems and the professionals who work in them. In the current global context, volatile, uncertain, complex and ambiguous, perhaps the major uncertainty that current generations have ever experienced, with wars, pandemics, environmental and economic crises, technological developments such as artificial intelligence and much more, we urgently need to work together to respond effectively to the health demands of our populations, who are increasingly distrustful of the management of their governments, politicians and institutions to preserve and maintain their health. Promoting a network based on our common history and our way of seeing the world, surely different from the most widespread and sponsored Anglo-Saxon vision, is the challenge, we invite you to take part in. The purpose of this article is to present the vision and strategic lines of this project.     

Eighty years of the Slovenian Institute of Public Health: challenges for the future

Eighty years after the first national public health institution was founded in Slovenia, the Institute of Public Health of the Republic of Slovenia (IPHRS) endeavors to meet ever-growing national demands. With the independence of Slovenia in 1991, new tasks had to be tackled, many of which were initially coupled with typical difficulties of a postcommunist country in transition. Also, increasing demands of the European Union (EU) and other international partners had to be met. The IPHRS monitors the health of the Slovenian population and its determinants and contributes to planning and implementation of population-based interventions for the better health of the whole nation. The diversity of the IPHRS activities is mirrored by the organization's internal complexity, multi-disciplinary approach, and links to various sectors. Currently, activities are organized within five centers: Center for Population Health Research; Center for Health Care Organization, Economics and Informatics; Center for Environmental Health; Center for Communicable Diseases; and Center for Health Promotion. The IPHRS is the key national institution in public health research, which is an integral part of all the areas covered by the Institute. The IPHRS also provides education programs in the field of public health. In the near future, it will be important to sustain current activities while integrating into the new program of Community action in the field of public health as well as contributing to the response to challenging public health issues in the wider context of the whole European region. Our aim is to integrate the Institute's activities in the programs relevant to public health issues of outstanding importance in this European sub-region. The IPHRS, given the geographic position and recent history, can act as an intermediate between the public health networks in EU and other countries in the sub-region.     

Introduction to the special section on psychological and behavioral approaches to occupational health

The history of the International Commission on Occupational Health is deeply bound to that of the 20th century. First and only international scientific society of such an importance, it was founded in 1906 to bring solutions to the problems caused by a great number of occupational injuries and diseases due to the developing of industry. With the passing years, from a small medical group it has become a multidisciplinary society, present in 90 countries, where researchers, government authorities, and practitioners are coexisting in a permanent exchange between practice and research. It is composed of international scientific committees, which organize regular conferences and meet every 3 years on the occasion of the great International Congress in Occupational Health. Owing to the changes due to the new technologies of work and to the globalization of economy, the orientation of its activities is in progress: larger opening toward developing countries and the phenomenon of development in general, emphasis on prevention in occupational health, and opening of a new field of research on the psychosocial factors and work organization. At the first conference on this theme, held in Copenhagen in August 1998, occupational health and occupational psychology specialists met. Indeed, new approaches are needed, like the setting up of adapted tools to face the consequences of these factors on health and the construction of a new paradigm of occupational health. Today, both the transcultural approach of the problems of occupational health and the ethical thought on fundamental values are necessary.     

A comprehensive model of factors affecting adoption of clinical practice guidelines in Korea

This study aims to investigate the factors related to the adoption of clinical practice guidelines in clinical settings in Korea; it also aims to determine how these factors differ depending on the specific situation of health care system and professional climate. The research sample comprised physicians who are board members of academic societies with experiences in development of clinical practice guidelines using a convenient sampling. We analyzed 324 physicians with pooling two-year sample of 2007 and 2008. From all the respondents, 48.8% stated that they followed Clinical Practice Guidelines, and 93.4% agreed with the content in the Clinical Practice Guidelines. With regard to the item on the self-efficacy of practicing guidelines, 90.3% of the respondents selected 'low level'. In the regression analysis, the factors associated with implementation were level of recognition, agreement and self-efficacy and positive attitude towards practice guidelines. Although the health care system in Korea differs from those in Western countries, our results revealed that the factors related to the adoption of practice guidelines were similar to the research results of Western countries. These results suggest that professionals' attitudes towards clinical practice guidelines are universal, and implementation strategies should be developed globally.