Public health and epidemiological research in palliative care

Palliative care has been declared an important topic for public health. In turn, concepts of public health such as health promotion are highly relevant for populations in need of palliative care. In recent decades, public health and epidemiological research methods have been applied to study the circumstances of dying, including palliative care provision, in large communities or populations. This chapter starts by outlining several characteristics that distinguish public health from clinical research in palliative care. It subsequently gives an illustrative, rather than exhaustive, overview of several different methodological approaches that have been used in public health research in palliative care, as well as their advantages and limitations. The focus is on quantitative, epidemiological methods, which reflects the current dominant approach in public health research. These include population-based survey research and specifically the mortality follow-back design, the use of death certificate data to study place of death, studies of routinely collected administrative data on the population-level, and the use of existing epidemiological monitoring tools. Finally, the chapter describes the importance and contributions of qualitative and mixed methods public health research in palliative care. It does so by describing examples of community-centered palliative care initiatives and research in less visible populations. Acknowledging that no single of these methods can answer all relevant questions about a topic, this chapter argues that it is the combination of a diverse set of research methodologies that will lead to the best possible view on and understanding of the circumstances of dying and provision of palliative care in populations

The Potential for Emerging Microbiome-Mediated Therapeutics in Asthma

Purpose of Review: In terms of immune regulating functions, analysis of the microbiome has led the development of therapeutic strategies that may be applicable to asthma management. This review summarizes the current literature on the gut and lung microbiota in asthma pathogenesis with a focus on the roles of innate molecules and new microbiome-mediated therapeutics. Recent Findings: Recent clinical and basic studies to date have identified several possible therapeutics that can target innate immunity and the microbiota in asthma. Some of these drugs have shown beneficial effects in the treatment of certain asthma phenotypes and for protection against asthma during early life. Summary: Current clinical evidence does not support the use of these therapies for effective treatment of asthma. The integration of the data regarding microbiota with technologic advances, such as next generation sequencing and omics offers promise. Combining comprehensive bioinformatics, new molecules and approaches may shape future asthma treatment. © 2017, Springer Science+Business Media, LLC