A Systematic Review on Professional Regulation and Credentialing of Public Health Workforce.

The public health workforce (PHW) counts a great variety of professionals, and how services are delivered differs in every country. The complexity and the diversity of PHW professions also reflect structural problems of supply and demand of PHW in various organizations and health care systems. Therefore, credentialing, regulation, and formal recognition are essential for a competent and responsive PHW to address public health challenges. To ensure comparability of the credentialing and regulation systems for the PHW and to enable its collective action at the macro level in the event of a health crisis, we systematically analyzed documented evidence on the PHW. A systematic review was selected to answer the research questions: (1) what are the most effective aspects and characteristics in identified programs (standards or activities) in professional credentialing and regulation of the PHW and (2) what are common evidence-based aspects and characteristics for the performance standards to support a qualified and competent PHW? The identification of professional credentialing systems and available practices of the PHW was performed systematically using a systematic review of international resources in the specialized literature published in English. The PRISMA framework was used to verify the reporting of combined findings from three databases: Google Scholar (GS), PubMed (PM), and Web of Science (WoS). The original search covered the period from 2000 until 2022. Out of 4839 citations based on the initial search, 71 publications were included in our review. Most of the studies were conducted in the US, UK, New Zealand, Canada, and Australia; one study was conducted in an international context for professional credentialing and regulation of the PHW. The review presents specific professional regulation and credentialing approaches without favoring one of the proposed methods. Our review was limited to articles focused on professional credentialing and regulation of the PHW in the specialized literature published in English and did not include a review of primary PHW development sources from international organizations. The process and requirements are unique processes displaying knowledge, competencies, and expertise, regardless of the field of practice. Continuous education, self-regulatory, and evidence-based approach can be seen as common characteristics for the performance standards on both community and national levels. Certification and regulation standards should be based on competencies that are currently used in practice. Therefore, answering questions about what criteria would be used, what is the process operation, what educational background the candidate should have, re-examination, and training are essential for a competent and responsive PHW and could stimulate the motivation of the PHW.

Using noninvasive multispectral imaging to quantitatively assess tissue vasculature.

This research describes a noninvasive, noncontact method used to quantitatively analyze the functional characteristics of tissue. Multispectral images collected at several near-infrared wavelengths are input into a mathematical optical skin model that considers the contributions from different analytes in the epidermis and dermis skin layers. Through a reconstruction algorithm, we can quantify the percent of blood in a given area of tissue and the fraction of that blood that is oxygenated. Imaging normal tissue confirms previously reported values for the percent of blood in tissue and the percent of blood that is oxygenated in tissue and surrounding vasculature, for the normal state and when ischemia is induced. This methodology has been applied to assess vascular Kaposi's sarcoma lesions and the surrounding tissue before and during experimental therapies. The multispectral imaging technique has been combined with laser Doppler imaging to gain additional information. Results indicate that these techniques are able to provide quantitative and functional information about tissue changes during experimental drug therapy and investigate progression of disease before changes are visibly apparent, suggesting a potential for them to be used as complementary imaging techniques to clinical assessment.

Advances in optical spectroscopy and imaging of breast lesions.

A review is presented of recent advances in optical imaging and spectroscopy and the use of light for addressing breast cancer issues. Spectroscopic techniques offer the means to characterize tissue components and obtain functional information in real time. Three-dimensional optical imaging of the breast using various illumination and signal collection schemes in combination with image reconstruction algorithms may provide a new tool for cancer detection and treatment monitoring.

Using quantitative imaging techniques to assess vascularity in AIDS-related Kaposi's sarcoma.

Three quantitative and non-invasive techniques were used to monitor angiogenesis in Kaposi's sarcoma patients: thermography, laser Doppler imaging (LDI), and near-infrared spectroscopy. Before and after combination cytotoxic and anti-angiogenesis therapy, blood volume, oxygenated hemoglobin, temperature, and blood flow were analyzed. These three techniques are objective, easy to perform, and appear to be very sensitive in assessing changes in the lesions upon administration of therapy.

Noninvasive Multimodality Imaging Techniques to Assess Kaposi's Sarcoma.

We evaluated three non-invasive method, thermography, laser Doppler imaging and near infrared multi-spectral imaging to quantitatively assess parameters of vascularity in Kaposi's sarcoma. The KS lesion generally has increased temperature, blood velocity and blood deoxy-hemoglobin. There is a strong correlation between temperature and blood velocity (R= 81, p <0.001). After treatment with experimental drug (liposomal doxorubicin and interleukin-12), temperature, blood velocity, blood volume and deoxy-hemoglobin of the lesions are reduced from the baseline at week 18. The techniques are objective, easy to perform, and appear to be very sensitive in assessing improvement in the lesions upon administration of therapy.

Noninvasive infrared imaging for quantitative assessment of tumor vasculature and response to therapy.

In this study we are investigating three infrared imaging techniques, thermography, multispectral imaging and Laser Doppler imaging (LDI) to assess parameters of vascularity in lesions of Kaposi's sarcoma (KS) and response to therapy. Thermography, multispectral imaging and LDI were recorded over the lesion and compare to normal skin either adjacent to the lesion or on the contralateral side. The KS lesions generally had increased temperature, blood volume (as measured by multispectral imaging) and blood flux (as measured by LDI) as compare to normal skin. After the treatment with experimental antiKS drug, temperature, blood volume and blood flow of the lesion were significantly reduced from the baseline. These techniques hold promise to assess physiological parameter in KS lesion and their changes with therapy.