Elena V. Syurina

Genome-Based Health Literacy: A New Challenge for Public Health Genomics

So far health literacy has not been sufficiently discussed in the context of public health genomics. Primarily, not genomic but rather genome-based health information needs to be addressed taking into account genome-environment interactions and integrating all health determinants including genomics into a systemic and holistic approach. Translating findings from epigenomics and systems biomedicine will help to understand that individual biological pathways or networks are permanently interacting with environmental networks such as social networks. Thus, in the end also health literacy will become personalized. Genome-based health literacy is challenged by the question of which information is relevant for the individual, for what purpose, and at what time during the lifespan. Public health tools and expertise already in place can and should be used to tackle these huge challenges.

Other side of the coin for personalised medicine and healthcare: content analysis of 'personalised' practices in the literature.

Objectives Various terms and definitions are used to describe personalised approaches to medicine and healthcare, but in ambiguous and inconsistent ways. They mostly have been defined in a top-down manner. However, actual practices might take different paths. Here, we aimed to provide a ‘practice-based’ perspective on the debate by analysing the content of ‘personalised’ practices published in the literature. Methods The search in PubMed and EMBASE (April 2014) using the terms frequently used for personalised approaches resulted in 5333 records. 2 independent researchers used different strategies for screening, resulting in 157 articles describing 88 ‘personalised’ practices that were implemented/presented on at least 1 individual/patient case. The content analysis was grounded on these data and did not have a priori analytical frameworks. Results ‘Personalised medicine/healthcare’ can be a commodity in the healthcare market, a way how health services are provided, or a keyword for emerging applications. It can help individuals/patients to gain control of their health, health professionals to provide better services, healthcare organisations to increase effectiveness and efficiency, or national health systems to increase performance. Country examples indicated that for integration of practices into health services, attitude towards innovations and health system and policy context is important. Categorisation based on the terms or the technologies used, if any, was not possible. Conclusions This study is the first to provide a comprehensive content analysis of the ‘personalised’ practices in the literature. Unlike the top-down definitions, our findings highlighted not the technologies but real-life issues faced by the practices. ‘Personalised medicine’ and ‘personalised healthcare’ can be differentiated by using the former for specific tools available and the latter for health services with a holistic approach, implemented in certain contexts. To realise integration of ‘personalised medicine/healthcare’ into real life, science, technology, health policy and practice, and society domains must work together.

Music Interventions and Child Development: A Critical Review and Further Directions

Research on the impact of music interventions has indicated positive effects on a variety of skills. These findings suggest musical interventions may have further potential to support educational processes and development of children. This paper reviews the latest evidence on the effect of musical interventions on the development of primary school-aged children. Four electronic databases were searched from January 2010 through June 2016 using music, music instruction, music education, music lesson, music training, development, child, student, and pupil as key words for the search. Two reviewers independently evaluated the studies to determine whether they met the stated inclusion criteria. Studies were compared on study setup, methodological quality, intervention components, outcome variables, and efficacy. A review of these selected studies (n = 46) suggestive beneficial effects of music intervention on development of children, although clear conclusions cannot be drawn. Possible influencing factors that might contribute to the outcome of intervention are reviewed and recommendations for further research are made.

Concepts for the translation of genome-based innovations into public health: a comprehensive overview

Recent vast and rapid development of genome-related sciences is followed by the development of different assessment techniques or attempts to adapt the existing ones. The aim of this article is to give an overview of existing concepts for the assessment and translation of innovations into healthcare, applying a descriptive analysis of their present use by public health specialists and policy makers. The international literature review identified eight concepts including Health Technology Assessment, analytic validity, clinical validity, clinical utility, ethical, legal and social implications, Public Health Wheel and others. This study gives an overview of these concepts (including the level of current use) applying a descriptive analysis of their present use by public health specialists and policy makers. Despite the heterogeneity of the analyzed concepts and difference in use in everyday healthcare practice, the cross-integration of these concepts is important in order to improve translation speed and quality. Finally, some recommendations are made regarding the most applicable translational concepts.

Literature review : Use of family history for primary paediatric care as the next step towards use of genomics in healthcare

Introduction: Many childhood-onset diseases and developmental disorders have a strong genetic basis. However, up till now, the knowledge of this genetic component within multifactorial diseases is not frequently used in paediatric practice. A good family history collection can facilitate the link between the present paediatric practice and the advances in genetics. This paper explores the benefits and drawbacks of the existing validated family history tools from the viewpoint of paediatric primary practice, with special attention for the mental health issues. Methodology: A literature search was conducted in the following directories: PubMed, Cochrane, Embase and Google Scholar. The timeframe was 01.01.2000 - 01.09.2011. The articles meeting the following criteria were included: original research papers in English, containing description or validation of the family history tool, for multifactorial/complex common disorders. The data were extracted from the full text of the articles. They were classified according to 14 criteria including diseases in question, level of healthcare, validation sample characteristics and results of usability analysis. Results: The majority of the family history tools, described in the literature, deal with a narrow range of diseases (some cancers, diabetes and coronary heart disease). None were tested in the paediatric healthcare. The cost-effectiveness analysis was never reported. Conclusions: The major finding of the present study is the absence of the validated tools for the family history collection for the paediatric primary care in general and in mental health in particular. The existing advances create a solid base for composition of the unified tool for paediatric primary care.

Family history of mental conditions in the preventive paediatric primary care: is it really used? Case of the Netherlands

Many child‐onset mental health diseases have strong epigenetic links, but no genetic tests are yet available for them. Family history (FH) information in paediatric primary care should be promoted to assist decision‐making. This study aims to explore the extent of the real‐life use of the FH for mental health issues by paediatric physicians.

Barriers to and facilitators of employment for people with psychiatric disabilities in Africa : a scoping review

ABSTRACT Background: Despite the importance of inclusive employment, described in Goal 8 of the Sustainable Development Goals (SDGs), employment of persons with psychiatric disabilities in Africa is lower than among the general population. Objective: The aim of this scoping review is to explore evidence related to the barriers to and facilitators of employment of persons with psychiatric disabilities in Africa. Methods: A literature search was conducted using six relevant electronic databases of articles published between 1990 and 2017. Results: Eight studies were identified and analysed regarding barriers and facilitators of employment of persons with psychiatric disabilities. The dynamic adaptation of the bio-psycho-social model was used as an analytical framework. Identified barriers include ill health, (anticipated) psychiatric illness, social stigma and discrimination, negative attitudes among employers and the lack of social support and government welfare. Facilitators of employment include stability of mental illness, heightened self-esteem, a personal decision to work despite stigma, competitive and supported employment, reduction in social barriers/stigma and workplace accommodations. Conclusion: Employment of persons with psychiatric disabilities is essential, yet there is dearth of scientific evidence to identify contextual models that might be useful in African countries and other low-and middle countries (LMICs). This gap in information would benefit from further research to improve the employment rates of persons with psychiatric disabilities in Africa.

Health Effects of the Relocation of Patients With Dementia : A Scoping Review to Inform Medical and Policy Decision-Making

Background and Objectives Research into the relocation (including international relocation) of people with dementia is increasingly important due to the aging population and latest developments in the international politics (including globalization and concerns over international migration). There is need for an overview of the health effects of relocation to facilitate and inform decision- and policy-making regarding these relocations. The aim of this literature review was to provide insight into the physical, psychological, and social consequences of varied types of relocations of older adults suffering from dementia. Research Design and Methods A scoping literature review with a systematic search was performed in PubMed, Web of Science, PsychInfo, JSTOR, and ScienceDirect. The articles dealing with subject of relocation of older adults from 1994 to 2017 were included and analyzed. Methodological quality assessment was performed for all articles. Results Final list included 13 articles. The effects of relocation were discussed in terms of mortality and morbidity. In most studies, the health effects of the relocation of older adults suffering from dementia were negative. A decline in physical, mental, behavioral, and functional well-being was reported. The most recurring effect was a higher level of stress, which is more problematic for patients with dementia. In general, unless it is carefully planned, it is best to avoid changing lives of people with dementia and it is recommended to actively work to reduce their exposure to stress. Discussion and Implications The outcomes of the study suggest definite evidence for the negative effects of relocation of the older adults. This research aims to be used as the support of the legal and medical decisions of relocation of patients with dementia.

Cultural phenomena believed to be associated with Orthorexia nervosa - Opinion study in dutch health professionals

Orthorexia Nervosa (ON) is a newly coined eating pattern which disproportionately affects Western countries. Research on the matter is scarce. This study aimed to investigate how the Dutch (mental) health professionals evaluate the influence of “Western culture” on the development of ON. This mixed methods study included interviews (n = 15) and a questionnaire (n = 157). The extent of influence of the “Western culture” was suggested to be quite high, with a score of 74 out of 100. The factors believed to affect Orthorexia included societal transitions (epidemiological and welfare) and cultural ideas (body ideal and control over life) which, in turn, are influenced by the internet and media. In addition, it was noted that ON is unique among the eating disorders since it does not carry the negative connotations of anorexia or obesity associated with “losing control.” The findings suggest that “Western culture” contributes to the establishment of a high-risk environment for the development of behaviors associated with ON.

The status of provision of post abortion care services for women and girls in Eastern and Southern Africa; a systematic review

OBJECTIVE To conduct a systematic review of the status of post-abortion care (PAC) provision in Eastern and Southern Africa with particular reference to reach, quality and costs of these services. STUDY DESIGN We searched Pubmed, EMBASE, Science Direct, POPLINE and Web of Science for articles published between 2000 and October 2017 presenting primary or secondary data from one or more countries in the region. RESULTS Seventy articles representing data from fourteen countries were abstracted and included in the review. Implementation of PAC services was found to be patchy across countries for which data was available. However, there is evidence of efforts to introduce PAC at lower level health facilities, to use mid-level providers and to employ less invasive medical techniques. Eleven countries from the region were not represented in this review, exposing a considerable knowledge gap over the state of PAC in the region. The disparate access for rural women and girls, the suboptimal service quality and the neglect of adolescent-specific needs were critical gaps in the current PAC provision. CONCLUSION PAC provision and research in this domain cannot be detached from the broader legal and societal context, as social stigma constitutes a major blockage to the advancement of the service. Adolescent girls are a particularly vulnerable and underserved group in the region. IMPLICATIONS The next generation research on PAC should favor multi-country and interdisciplinary study designs with a view to understanding inter-regional differences and supporting advancement towards universal access of PAC by 2030.