The case for simplifying and using absolute targets for viral hepatitis elimination goals

The 69th World Health Assembly endorsed the Global Health Sector Strategy for Viral Hepatitis, embracing a goal to eliminate hepatitis infection as a public health threat by 2030. This was followed by the World Health Organization\u27s (WHO) global targets for the care a The 69th World Health Assembly endorsed the Global Health Sector Strategy for Viral Hepatitis, embracing a goal to eliminate hepatitis infection as a public health threat by 2030. This was followed by the World Health Organization\u27s (WHO) global targets for the care and management of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections. These announcements and targets were important in raising awareness and calling for action; however, tracking countries\u27 progress towards these elimination goals has provided insights to the limitations of these targets. The existing targets compare a country\u27s progress relative to its 2015 values, penalizing countries who started their programmes prior to 2015, countries with a young population, or countries with a low prevalence. We recommend that (1) WHO simplify the hepatitis elimination targets, (2) change to absolute targets and (3) allow countries to achieve these disease targets with their own service coverage initiatives that will have the maximum impact. The recommended targets are as follows: reduce HCV new chronic cases to ≤5 per 100 000, reduce HBV prevalence among 1-year-olds to ≤0.1%, reduce HBV and HCV mortality to ≤5 per 100 000, and demonstrate HBV and HCV year-to-year decrease in new HCV- and HBV-related HCC cases. The objective of our recommendations is not to lower expectations or diminish the hepatitis elimination standards, but to provide clearer targets that recognize the past and current elimination efforts by countries, help measure progress towards true elimination, and motivate other countries to follow suit. nd management of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections. These announcements and targets were important in raising awareness and calling for action; however, tracking countries\u27 progress towards these elimination goals has provided insights to the limitations of these targets. The existing targets compare a country\u27s progress relative to its 2015 values, penalizing countries who started their programmes prior to 2015, countries with a young population, or countries with a low prevalence. We recommend that (1) WHO simplify the hepatitis elimination targets, (2) change to absolute targets and (3) allow countries to achieve these disease targets with their own service coverage initiatives that will have the maximum impact. The recommended targets are as follows: reduce HCV new chronic cases to ≤5 per 100 000, reduce HBV prevalence among 1-year-olds to ≤0.1%, reduce HBV and HCV mortality to ≤5 per 100 000, and demonstrate HBV and HCV year-to-year decrease in new HCV- and HBV-related HCC cases. The objective of our recommendations is not to lower expectations or diminish the hepatitis elimination standards, but to provide clearer targets that recognize the past and current elimination efforts by countries, help measure progress towards true elimination, and motivate other countries to follow suit

Data Gathering in Cognitive Radio Ad Hoc and Sensor Wireless Networks

Data gathering is a network communication task in which all of the network’s nodes send their individual messages to a distinguished sink node. In cognitive radio ad hoc and sensor wireless networks (CR-AHSWNs), unlicensed secondary users (SUs) opportunistically use channels when the licensed primary users are not using them. Therefore, the channels available to each SU vary with time and location, which makes the development of data gathering algorithms for CR-AHSWNs challenging. In this thesis, a data gathering protocol for CR-AHSWNs is proposed. The protocol consists of several distributed SU action selection and channel selection algorithms. An algorithm that can reduce the data gathering delay by selecting message forwarding SUs is also proposed. Finally, an algorithm that calculates an estimate of the successful data gathering ratio (SDGR) is proposed. The SDGR is affected by each SU’s channel availability and network collisions, and the exact value is extremely challenging to calculate

Obesity in The Geriatric Population

Obesity has been a focus of medical and public health attention for decades; however, a relative paucity of information exists regarding the management of obesity in the geriatric population. It is known that standard, young adult recommendations to manage weight cannot be applied directly to the older population due to the potential of adverse health outcomes, but the most effective strategies are controversial (Heintze et al., 20 l 0). The goal of weight management is unique for this population and poses a challenge for health care providers when managing, treating, and counseling patients. With the current trends of obesity and its associated health consequences, rare professionals are unable 10 ignore this health epidemic. The purpose of this project is to present evidence and accepted clinic\u3c1l practice guidelines that differentiate some of the most effective strategies for managing obesity in the geriatric population. The Health Belief Model (HBM) was the theoretical framework used in this study. This model was initiated to help examine why some people use preventive measures to keep themselves healthy, while others do not. By understanding the constructs of the HBM, health care professionals will be able to influence a person\u27s health care decision based on how he or she views their health status A comprehensive literature review unveiled the magnitude and seriousness of the obesity epidemic. It clearly illustrates the complexity of obesity, and it proves the idea that a multifaceted approach is essential to overcome the obesity epidemic. The literature review also provided the author an evaluation of weight management strategies for the obese geriatric population. This information will provide evidenced-based research that will educate individuals, communities, and health care professionals, about obesity and weight management strategies available to promote optimal healt

A Study to Determine Why Students Enroll in ABE and GED Preparation Classes at Madison Career Center, Norfolk, Virginia

The goals of this research were as follows: 1. To determine why students enroll in ABE classes; 2. To determine why students enroll in GED Preparation classes; 3. To determine how students found out about the ABE and GED Preparation classes; 4. To determine how ABE and GED Preparation classes should be advertised in order to increase greater enrollment

Chief Justice O\u27Connor\u27s Juvenile Justice Jurisprudence: A Consistent Approach to Inconsistent Interests

Part II of this Article examines the growth of the juvenile justice system as a system apart from the adult criminal system. It reviews the goals of the juvenile court system—to treat children differently than adults, to rehabilitate, and to protect both the child and society. Part II also discusses the gradual movement to harsher sentencing of young offenders and transferring those offenders to the adult criminal justice system, as well as the subsequent exhortation of the United States Supreme Court that youth in the juvenile justice system must be afforded the protection of constitutional rights. Part III.A explains the framework that Chief Justice O’Connor has applied consistently in juvenile-rights cases. In In re C.S., the Supreme Court of Ohio held, in an opinion written by then-Justice O’Connor, that juveniles may waive their right to counsel only if, under a totality-of-the-circumstances analysis, the juvenile court concludes that the juvenile received “meaningful advice” regarding the waiver. Part III.B describes the importance of In re C.S., in that Ohio appellate courts have applied its holding to assure meaningful pre-waiver advice to juveniles and that important aspects of In re C.S.’s requirements have been codified. Part III.C explores State v. D.W., in which the Supreme Court of Ohio—again in an opinion written by Chief Justice O’Connor— concluded that juveniles have a right to a hearing before being transferred from the juvenile justice system to the adult criminal system. The section also examines the Chief Justice’s arguments, in dissent in In re M.W., that (1) juveniles have a statutory right to counsel, under the Ohio Revised Code § 2151.352, during a police interrogation and before a complaint is filed; and (2) the majority used an incorrect constitutional analysis in determining whether juveniles have a constitutional right to counsel in the context of police interrogation

Changing Early Childhood Education Environments with Partnership, Quality Improvement, and Intensive Consultation: A Look at One Case

To ensure that families get the childcare services they need, Sacramento County created the Quality Child Care Collaborative (QCCC). The QCCC is a partnership of several agencies focused on improving the quality of child care provided to children and their families. The QCCC practices can be worked into other childcare programs; other counties and states can benefit from emulating the QCCC’s actions, collabora-tion, and aims

Perceptions of African Americans Toward Premarital Counseling

AbstractResearch regarding premarital counseling programs has shown that premarital counseling can help individuals enhance the quality of their relationship and lower the likelihood of divorce after marriage. The research problem addressed in this study was that couples who do not participate in premarital counseling have lower relationship satisfaction and higher rates of divorce, and Black couples participate in premarital counseling less often compared to White couples. Using a generic qualitative research design, data was collected by conducting semi-structured interviews with five African American married couples who had not participated in premarital counseling to find out their perceptions as these were the reason behind not participating. Data was analyzed through the lens of Katz’s functional attitude theory using Colaizzi’s seven-step process for conducting thematic content analysis. The themes discovered were that the African American couples interviewed believe that premarital counseling has benefits, there are barriers to premarital counseling for African American couples, and premarital counseling should be better marketed to African American couples. Potential social change implications of the study include providing additional knowledge that could help professionals develop educational materials for African Americans about the benefits of premarital counseling to increase participation and relationship satisfaction and decrease divorce rates

It is More Than Just a Reproductive Healthcare Visit: Experiences from an Adolescent Medicine Clinic

The gynecologist may be the only physician that an adolescent depends on for primary and reproductive healthcare services. Because adolescent females often make personal healthcare decisions without the benefit of supportive parents/caregivers, it is imperative that the gynecologist understands the developmental issues encountered during this phase of life. The objective of this study is to identify cited complaints of adolescent females seeking reproductive care and, thus, provide gynecologists with needed information about the medical/mental health issues that may be encountered during routine reproductive care exams. The study group was adolescent females between the ages of 12 and 20 years old. The medical records of 479 adolescent females seeking reproductive care from an adolescent medicine clinic at a southeastern teaching medical center were reviewed to determine the most frequently cited medical/mental health complaints of adolescent females initiating a routine gynecological exam. Results indicated that adolescent females present for routine reproductive care exams with a myriad of concerns without formally requesting medical/mental health intervention upon initial presentation. The identified primary healthcare needs of adolescent females seeking reproductive healthcare include: 1) issues related to reproductive dysfunction (60%); 2) gastroenterological pain/issues (15%) 3) mental health issues (15%) and 4) general medical physical complaints (10%). Gynecologists are often asked to serve as a primary care provider as well as a reproductive healthcare specialist. Identification of the specific healthcare needs (reproductive and otherwise) of adolescent females will assist gynecologists in being uniquely prepared to practice in the setting of their choice