Public Health in Practice最新文献

Objectives

This paper presents the evaluation results from the Adaptive Leadership Academy (ALA), a pilot program aimed at developing executive-level leaders in public and community health.

Study design

Mixed methods study.

Methods

The evaluation followed the Kirkpatrick Model to assess program participants’ satisfaction with the training, knowledge and skill gain, and behavior change. Data were collected beginning in December 2021 through August 2022 from 20 program participants via online surveys and key informant interviews.

Results

The findings indicated that ALA helped participants improve their leadership knowledge, skills, and capabilities. In particular, the study highlighted the effectiveness of cohort-based leadership development programs using adaptive leadership as the foundation for the curriculum. Participants found the cohort-based model and synchronous components particularly useful in creating a supportive environment in which to be vulnerable and grow.

Conclusions

Overall, the evaluation provided evidence that the ALA pilot enhanced leadership knowledge, skills, and capabilities. The findings support the use of adaptive leadership as a framework for leadership development programs in the public health sector.

This study examines dengue transmission, symptoms, vaccination efforts, treatment options, and global impact, focusing on Australia, especially Queensland. It evaluates current surveillance and response systems, identifies areas for improvement, and proposes strategies to enhance public health preparedness. Highlighting the socioeconomic impact of dengue outbreaks, the study underscores the need for integrated public health measures, effective vaccines, advanced surveillance methods, and sustainable mosquito control programs to mitigate the threat of dengue outbreaks and potential endemicity.

Objectives

The purpose of this study is to test the efficacy of a mobile-based multidomain application, Silvia Program, on cognitive functioning of residents in assisted living facilities (ALFs).

Study design

Pilot randomized controlled trial using a two-group pretest-posttest design.

Methods

Twenty participants living in ALFs were randomized to a Silvia group or usual care group. Silvia group received mobile-based Multidomain lifestyle intervention for 50–60 min, twice weekly, for 12 weeks. We assessed the cognitive functioning using the Montreal Cognitive Assessment (MoCA).

Results

Results are that the total MoCA scores of the Silvia group showed significant improvement while the total scores of the control group declined.

Conclusion

The present study provides suggestive evidence for an overall positive effect of the use of the Silvia Program on the cognitive functioning among residents in ALFs.

Objectives

The COVID-19 pandemic highlights the importance of understanding facilitators for disease transmission. Events such as Carnival, characterized by large gatherings and extensive social interactions, have the potential to become ‘super spreading events' for respiratory infections. This paper aims to assess the impact of large gatherings on virus transmission, providing crucial insights for the development of effective public health strategies.

Study design

An ecological study was performed.

Methods

The age-standardized number of COVID-19 cases reported in 2022, stratified by age (under 60 and 60+ years) was compared countrywide for Dutch provinces where Carnival was celebrated versus those where it was not. Additionally, we compared standardized hospitalization rates in 2022 and 2023 for both areas.

Results

Countrywide, 2,278,431 COVID-19 cases were reported between 06-02-2022 and 10-04-2022. Daily incidence increased after Carnival, peaking at 803 per 100,000 inhabitants for under 60s in carnival provinces and 368 in non-carnival provinces. For individuals 60+ daily incidence peaked at 396 in carnival provinces and 247 in non-carnival provinces. Over the 10 weeks following the start of Carnival, the carnival provinces demonstrated a 15 % (2022) 17 % (2023) higher hospitalization rate compared to non-carnival provinces.

Conclusions

The peak in cases and hospitalizations in regions actively celebrating Carnival compared to the rest of the Netherlands qualifies Carnival as a ‘super-spreading’ event. Our findings underscore the elevated risk of respiratory infections associated with large gatherings, advocating guided policies, including transparent risk communication and healthcare preparedness.

Objectives

Countries in the South East Asian region face similar challenges in control of infectious diseases. There is limited access to experiences and learnings of neighboring countries. The Indian Council - of Medical Research (ICMR) has established a Regional Enabler for the South-East Asia Research Collaboration for Health (RESEARCH) Platform for South East Asian Region (SEAR) countries to address the above issues. This paper discusses about current practices, implementation challenges and operations research priorities of Tuberculosis Preventive therapy (TPT) in eight SEAR countries.

Methods

A three day workshop on “Capacity Building for TB Research under Programmatic Settings”. was conducted under the aegis of this RESEARCH platform jointly ICMR and the Union which was participated by eight SEAR countries. Data were collected from a semi-structured questionnaire prior to the workshop and open discussions during the workshop.

Results

The various challenges faced for TPT implementation were broadly categorized as poor demand and low level of acceptance by the beneficiary, low level of acceptance to provide TPT among the providers, challenges in ruling out active TB, issues with supply and supply chain management of diagnostic tests and drugs. Many operations research priorities like person centric TPT driven models, capacity building for improving cascade of care for latent TB infection, health system strengthening and effective risk communication were identified.

Conclusion

Full implementation of the TPT guidelines requires focused attention and coordinated action from all stakeholders of the country to attain the full benefit of TB preventive therapy and the ultimate TB elimination goal.

Objectives

Epidemic Thunderstorm asthma (TA) is a serious public health threat with a potential to overwhelm health systems. Being the first documented incidence in Ghana, we sought to determine whether the chronic respiratory risk factors for the development of TA as identified in other countries were similar or different from that in Ghana.

Study design

A matched case-control study involving 41 cases and 82 controls was conducted in two conveniently selected health facilities in the Ashanti Region of Ghana.

Methods

Data were collected from pre-existing patient records and included general demography, a history of allergies and a history of asthma. A chi-square and multiple logistic regression analysis were conducted to identify risk factors for the development of TA.

Results

Overall, 53.7 % of the TA cases and 7.3 % of controls had a previous history of asthma (AOR = 4.53 p = 0.064, 95 % CI = 0.918–22.365). Also, 29.3 % of the cases and 1.2 % of the controls had a previous history of allergies (AOR = 12.48 p = 0.05, 95 % CI = 0.919–169.305).

Conclusions

A previous history of allergy was a significant risk factor for TA. A previous history of asthma though associated with TA, was not a significant risk factor for its development. The recognition and awareness of risk factors for TA, by clinicians and health managers, is essential for health education, case management and preparation for the surge capacity occasioned by the event.

Background

Financial incentives are being increasingly adopted to help improve standards of care within general practice. However their effects on care quality are unclear. This study aimed to evaluate the impact of practices opting out of the Quality and Outcomes Framework (QOF), a financial incentive scheme in UK general practice.

Study design

A retrospective before and after study of all practices in Tower Hamlets, east London.

Methods

Practices were given an option by local commissioners of opting out of QOF without a financial penalty and instead opting for a locally designed financial incentive scheme that promoted more holistic care. We compared those practices which opted out of QOF to those which continued. We used national, publicly available QOF achievement data from 2016/17 and 2017/18. We undertook a sub-analysis of 16 QOF indicators to better understand the impact of the intervention.

Results

Of the 36 practices in Tower Hamlets, 7 decided to continue with QOF and 29 opted out. The intervention resulted in a small but statistically significant reduction in the total QOF achievement scores of practices which opted out of QOF. The sub-analysis of 16 QOF indicators showed statistically significant reductions in most of achievement scores net of exceptions for the practices that opted out. The differences in performance between the two cohorts of practices became smaller when exceptions were included.

Conclusions

The removal of QOF financial incentives can result in a reduction in achievement of QOF-related indicators but the size of the effect seems to depend on the QOF exception rates. An alternative incentive scheme that promotes a more holistic approach to care seems to be welcomed by general practices.

Objectives

To develop and pilot an evaluation framework for assessing the engagement of local government public health teams in England on climate change and sustainability. These teams are uniquely positioned to address local health impacts of climate change and promote health co-benefits of mitigation. No statutory framework currently exists to support their engagement in this agenda.

Study design

Literature review and two cross sectional surveys.

Methods

A group of public health professionals conducted a literature review and agreed on criteria based on statutory responsibilities and remit of these teams, available information, and opportunities for local government action. With the resulting framework, this group evaluated all 11 local governments in the East of England region, and then conducted a follow-up survey to assess the framework’s impact and acceptability.

Results

An evaluation framework was developed with 21 criteria in two sections. The first assessed overall local government action and leadership in climate change and sustainability, to understand the context in which the public health team was situated. The second assessed the climate change related actions undertaken by the public health team.

All 11 local governments in the East of England region completed the evaluation. Results indicated inconsistencies in local public health team action on and engagement with climate change and health. Ten local governments completed the follow-up survey on acceptability and impact, reporting that the evaluation was easy to complete. Seven out of ten respondents found that the evaluation had influenced change or reflection within their organisation, for example through identifying gaps and prompting more collaboration between teams.

Conclusions

This evaluation framework is a useful and acceptable tool to assess local government public health engagement and leadership on climate change and sustainability. If used more widely, it could help to support public health teams to advance much-needed action in this area.

Objectives

This study aimed to map and describe the available evidence on dietary characteristics and diet-related health conditions among Haitian immigrants across the globe.

Study design

Scoping review.

Methods

This review was based on the international guide Preferred Reporting Items for Systematic review and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). The searches were conducted in several electronic databases in July 2023. Reports focusing on diet, nutrition, and diet-related health conditions among international Haitian immigrants published in English, Portuguese, French, or Spanish with no year limit were included. The data extracted was tabulated and presented in a narrative summary.

Results

Database search retrieved 502 records, of which 30 met the inclusion criteria. The categories that emerged from the analysis were: food consumption patterns and trends, food and nutrition insecurity, cultural identity, and diet-related health conditions. Findings suggest: available evidence underrepresents Latin America and the Caribbean context; research gaps related to adolescents and the elderly and also to noncommunicable diseases except obesity; changes in food consumption after immigration towards less healthy eating; the Haitian immigrant's preference for healthy and traditional eating patterns; many experiences of food insecurity related to poverty, unemployment, and lack of social support, especially in host countries in Latin America and the Caribbean; and a high prevalence of obesity, especially among women.

Conclusions

Further research is required in countries in Latin America, mainly. Diet-related chronic diseases, adolescents, and the elderly should be targeted for further research. We recommend: longitudinal and qualitative research; field action reports describing local and global strategies to manage Haitian migration-related food and nutrition issues; culturally appropriate dietary interventions; and policies to protect and support the most vulnerable Haitian immigrants to have their fundamental right to adequate food guaranteed, reducing health inequalities.

Background

Hong Kong enforced stringent travel restrictions during the COVID-19 pandemic. Understanding the characteristics of imported COVID-19 cases is important for establishing evidence-based control measures.

Methods

Retrospective cohort study summarising the characteristics of imported cases detected in Hong Kong between 13 November 2020 and 31 January 2022, when compulsory quarantine was implemented.

Findings

A total of 2269 imported COVID-19 cases aged 0–85 years were identified, of which 48.6 % detected on arrival. A shorter median delay from arrival to isolation was observed in Delta and Omicron cases (3 days) than in ancestral strain and other variants cases (12 days; p < 0.001). Lower Ct values at isolation were observed in Omicron cases than in ancestral strain or other variants cases. No Omicron cases were detected beyond 14 days after arrival. Cases detected after 14 days of quarantine (n=58, 2.6 %) were more likely asymptomatic at isolation and had higher Ct value during isolation, some of them indicating re-positivity or post-arrival infections.

Conclusions

Testing inbound travellers at arrival and during quarantine can detect imported cases early, but may not prevent all COVID-19 introductions into the community. Public health measures should be adapted in response to the emergence of SARS-CoV-2 variants based on evidence from ongoing surveillance.