Public Health in Practice最新文献

Background

Methods

Results

Conclusion

Objective

To rapidly identify and summarise evidence on key factors that affect access to support for minoritised informal adult carers which could be addressed at the level of local government policy-making.

Study design

Rapid evidence review.

Methods

A rapid umbrella review was undertaken of systematic reviews of qualitative, quantitative and/or mixed method studies. Systematic reviews were identified through database searches (Medline, Cochrane, Proquest), key author searching, referrals by experts (n = 2) of key reviews, and citation and reference checking of identified reviews in September–October 2023. Systematic review evidence was supplemented with grey literature identified by practitioners (n = 2) as locally-relevant. Data was extracted directly into a table and findings synthesised narratively by theme.

Results

Many factors were identified as affecting access to support for minoritised unpaid adult carers, including: inattention to socio-cultural diversity; issues of representation, racism and discrimination; and socio-economic inequality. Factors were themed around ten areas for local action, including: the importance of recognising intersectional disadvantage and diversity; ensuring support is socio-culturally appropriate; paying attention to gendered hierarchies in service design; identifying and ‘designing out’ racism and discrimination; addressing exclusions that minoritised carers with additional communication needs face; mitigating socio-economic inequality; and taking a ‘whole system’ approach that improves integration, routine data collection and support service evaluation.

Conclusions

We identified ten potential ways in which inequalities in support for minoritised unpaid adult carers could be addressed locally. Although the existing evidence base is limited, these ten areas could usefully be targeted for further investigation in research and within local policy development.

The purpose of this commentary is to describe combinatory play as a practice for elevating creativity and well-being among public health professionals. Albert Einstein introduced combinatory play in a letter to a colleague, and, in this commentary, we define it as engagement in an intrinsically enjoyable, cognitively stimulating artistic activity that is distinct from one's job tasks and conducive to connecting ideas toward insight and creative problem-solving. Combinatory play aligns with empirical and experiential evidence demonstrating connections between art and science. We present combinatory play in the context of research on creativity and well-being, including the growing issue of work-related stress among public health professionals. To provide an example of combinatory play, we recount how Robert Frost's poem “Mending Wall” inspired email blackout periods and an intervention for health researchers. Finally, we outline concrete strategies for public health professionals to integrate combinatory play into their lives. Overall, combinatory play is a promising practice for catalyzing novel solutions to public health issues while fueling the well-being of public health professionals themselves.

Background

With the increasing prevalence of wildfire smoke in the Pacific Northwest, it is important to quantify health impacts to plan for adequate health services. The Rogue Valley region has historically faced some of the greatest wildfire threats in the state. Health impacts from smoke have been estimated in several recent studies that include Oregon's Rogue Valley, but the results between studies are conflicting.

Objective

The objective is to critically examine impacts of wildfire smoke on health in the Rogue Valley area and translate the results to support hospital staffing decisions.

Study design

The study adopts a case-crossover approach.

Methods

Apply a conditional Poisson regression to analyze time stratified counts while controlling for mean temperature.

Results

Every 10 μ/m³ increase in PM_2.5 is associated with a 2% increase in same-day hospital or emergency room admission rates for respiratory conditions during fire season after adjusting for temperature and time (OR = 1.020; 95% CI: 1.004–1.034); a 10 μ/m³ increase in PM_2.5 lasting nine days is associated with a 4% increase in admission rates (OR = 1.041; 95% CI: 1.018–1.065). In other words, for each 10 μ/m³ single day increase in pollution from smoke, an additional 0.26 respiratory patients would be expected in the area hospitals. With a single day increase from 10 μ/m³ to 150 μ/m³, hospitals could expect an additional four patients.

Conclusions

There are small but significant health impacts in the Rogue Valley. These impacts are smaller than some statewide estimates. We need further research to understand these differences.

Background

Study design

Methods

Results

Conclusions

Background

Following the decriminalization of abortion in Colombia and amidst a global health crisis due to COVID-19, Profamilia implemented a telemedicine-assisted first-trimester Medication Abortion (MAB) program. This is an opportunity to reduce inequalities in access and to promote empowerment and sexual and reproductive rights. This study aims to describe socio-demographic and clinical characteristics of users and to assess its effectiveness and safety.

Study design

A retrospective cohort study.

Methods

The study analyzed data from users who received Profamilia's telemedicine abortion services between August 2021 and August 2022 (n = 3073). A descriptive analysis of their sociodemographic and clinical characteristics was performed, grouping, and comparing them according to follow-up status and abortion outcome. Effectiveness was assessed by the percentage of complete abortions without surgical intervention, and safety by the incidence of complications, potential adverse events, and potentially dangerous signs.

Results

Most of the users were less than 8 weeks gestation at the start of treatment (88.3 %), from low socioeconomic strata (84.8 %), affiliated to the subsidized healthcare system (87.6 %), with educational levels up to secondary school (81.6 %), between 18 and 35 years (87.4 %), from urban areas (97.8 %) and singles (90,8 %). 94.9 % of users had a complete abortion using medication, and 0.3 % of cases reported complications.

Conclusions

First-trimester MAB through telemedicine in the Latin American context is an effective and safe choice. Telehealth is an important strategy to expand access to safe abortion care, especially for those with limited financial means or educational backgrounds. Rural and marginalized populations need more attention to improve access.

Objective

Telehealth and patient travel cost subsidisation are two strategies used to reduce the effects of healthcare access inequity. Despite this shared goal, these programs are usually run independently, and their effects are infrequently compared in evaluation. Understanding how these programs are used helps ensure services are delivered efficiently.

Methods

Counts of telehealth outpatient service events (TH) (n = 250171) and patient travel subsidy scheme claims (PTSS) (n = 270933) for the 2022-23 financial year were captured. Comparisons of PTSS and TH activity were made by postcode, rurality (The Accessibility/Remoteness Index of Australia (ARIA)) and health jurisdiction (Hospital and Health Service (HHS)).

Results

Correlation analysis conducted on PTSS and TH activity revealed a statistically significant, moderate positive correlation (r = 0.449, p < 0.01). TH (coefficient = 0.650, p < 0.001) and rurality (coefficient = 26.208, p = 0.686) also retained their significance.

Conclusions

This study established that increases in TH activity is correlated with increases in PTSS, with both programs reporting greater activity as rurality increases.

Objectives

To investigate the relationship between long-term condition (LTC) status and adherence to protective behaviours against infectious disease (face covering, physical distancing, hand hygiene).

Study design

Representative cross-sectional observational survey in summer 2020 in Scotland.

Methods

Independent variable is LTC status (LTC, disability, no LTC); dependent variable is adherence to protective behaviours (face covering, hand hygiene, social distancing); moderator variables are age, gender and area deprivation; mediator variables are perceived threat and psychological distress. P values of p < 0.05 were taken as statistically significant.

Results

3972 participants of whom 2696 (67.9 %) indicated not having a LTC. People with no LTC had lowest adherence to protective behaviours, perceived threat and psychological distress. Age did not moderate the relationship between LTC status and adherence; females were more adherent than males and this gender difference was greater in people with disability compared to people with no LTC; adherence was greater for people with a LTC in the more deprived areas compared to the least deprived areas whereas adherence in those with no LTC was not related to area deprivation; threat appraisal partially mediated the relationship between having a LTC or disability and adherence; psychological distress did not mediate the relationship between LTC status and adherence.

Conclusions

This study addresses a gap in evidence about protective behaviours of people with LTCs. Perceptions of threat may be useful intervention targets against winter flu and during future pandemics in order to protect people with LTCs who are one of the most vulnerable groups of the population.