Public Health in Practice最新文献

Objective

Exposure to tobacco smoke causes numerous health problems in children, and create burden on the population in terms of economy, morbidity and mortality. In order to protect the child from exposure to tobacco smoke in the outdoor environment, sufficient legislative enactments are available in Indian legislation. The objective of the present study is to investigate the fact that in absence of any specific laws stating about protection of children from exposure to tobacco smoke in indoor environment, whether outdoor related legislations are sufficient to protect children from exposureand to explore the scope for enforcement of both state and central laws in improving health of children in India.

Study design

The study considered cross-sectional survey data of Demographic and Health Survey Data on India, National Family and Health Survey fourth round (NFHS-4) for the year 2015-16 on Indian children (below age of four).

Methods

Both bivariate and multivariate logistic regression models were used to assess the impact of anti-smoking laws on the prevalence of acute respiratory infection (ARI) based on the place of residence, indoor tobacco smoke exposure and age of the child.

Results

The results have shown an inclination of ARI among children in association with states having single law, rural area resident, exposure to indoor tobacco smoke and age of the child, both as independent or in combination are quite conspicuous, and are found to be underestimated. The logistic regression also revealed the influence of these factors both as independent and even in interaction with other.

Conclusions

Legislative intervention through both at central (or national)and state levels through anti-smoking laws will decrease the indoor tobacco smoke exposure as a result ARI prevalence will also decrease among children in India.

Objectives

Previous research has shown the most common memory of physical education (PE) was embarrassment, and that childhood memories of PE relate to physical activity (PA) attitude, intention, and sedentary behavior in adulthood [13]. Recess memories may have a similar effect on adult attitudes towards PA, given that recess is a physically active part of the school day, yet is more autonomous and less supervised than PE. Recent literature has supported this, as Massey and colleagues (2021b) reported memories of recess enjoyment were associated with PA enjoyment in adulthood, whereas negative recess memories were associated with social isolation. In an effort to better understand recess memories, and how they may be related to adult behaviors, the purpose of this study was to examine qualitative descriptions of adults’ worst recess memories as it related to physical and social health.

Study design

Mixed methods design; inductive content analysis and analysis of covariance.

Methods

As part of a larger project, 433 participants between the ages of 19 and 77 (M = 44.91; SD = 15.35) were asked to recall their worst recess memories and the grades in which those memories occurred. Participants identified as predominantly female (52%), White (72%), and college educated (46%). Data analysis was conducted via an inductive content analysis by three research team members.

Results

The most common negative memories included isolating experiences, physical injuries, victimization, and contextual factors (e.g., weather). Through a series of analysis of covariance, self-reported isolation and self-efficacy of exercise were significantly related to participants with social isolation and physical injury memories respectively.

Conclusions

This study adds to a growing line of research documenting the importance of recess as a developmentally impactful environment with implications for physical and emotional health.

Identification and sharing of lessons is a key aspect of emergency preparedness, resilience and response (EPRR) activity in the national health service (NHS) in England (NHS England, 2022). The overall intent of the lessons identification and implementation process is to improve readiness and response to future major incidents and emergencies, such that, wherever possible, patient harm is minimised and staff well-being is maximised.

In this commentary, we draw on international literature to outline some of the major challenges in healthcare organisations to learning from major incidents and emergencies. We describe our experience of identifying lessons and set out the approach used by NHS England (London) to identifying lessons from the NHS response to the Covid-19 pandemic in the capital. We describe the knowledge garnered in our organisation about learning methods during the Covid-19 pandemic. The commentary considers the different approaches to identifying lessons, and the subsequent challenges of learning and implementation. This paper places its focus on the learning processes followed rather than what was learned as a result. It also explores whether the learning process undertaken by NHS England (London) demonstrates the hallmarks of a learning organisation.

Objectives

to provide objective quantitative data about medical-related scientific production in Hispanic Latin America compared to different regions and identify demographic and political variables that could improve research.

Study design

This is an analytical, observational, cross-section bibliometric study about all fields of medical-related scientific production over five years in different regions and its relationship with demographic and political variables that could impact research and the health system quality.

Methods

Data on the total scientific production of all Hispanic Latin American countries and other countries representing almost 90% of mundial publications between 2017 and 2021 were retrieved from the PubMed database. Demographic and political data were obtained from open online databases. Counts of publications were rationed to population and analyzed with all other demographic, region, and language variables, using univariate Poisson regression and negative binomial regression (for over-disperse variables) analysis. Multivariate negative binomial regression was used to analyze the combined effect of variables related to the healthcare and research Sectors.

Results

Hispanic Latin America increased yearly from 29,445 publications in 2017 to 47,053 in 2021. This cumulative growth of almost 60% exceeded the 36% increment in all countries' publications and was only below that of Russia and China, which grew 92% and 87%, respectively. Negative binomial regression showed that the percentage of gross income dedicated to research (IRR 2.036, 95% CI: 1.624, 2.553, p< .001), life expectancy at birth (IRR 1.444, 95% CI: 1.338, 1.558, p< .001), and the number of medical doctors per inhabitant (IRR 1.581, 95% CI: 1.17, 2.13, p = .003) positively impacted scientific production. A higher mortality associated with chronic diseases between ages 30 and 70 (IRR 0.782, 95% CI: 0.743 0.822, p< .001) and a lower population with access to medicine (IRR 0.960, 95% CI: 0.933, 0.967, p< .001) were found to impact scientific production negatively. Hispanic Latin American countries published less than 20% of those with English as their native language (p< .001).

Conclusion

Hispanic Latin America has increased the gross number of publications by almost 60 % from 2017 to 2021. However, the number of publications per 100,000 inhabitants is still low compared to other countries. Our analysis highlights that this may be related to lower GDP, research investment, and less healthcare system quality.

Background

HPV (Human Papillomavirus) vaccination is a safe, effective method to prevent HPV-associated disease. Racial-ethnic disparities in HPV vaccination exist, which could lead to widening gaps in cervical cancer mortality. Provider discussion of HPV vaccination has been shown to be a primary factor for increasing vaccination rates. The objective of this study is to assess provider discussion of HPV vaccination pre and post implementation of an intervention, named the HPV Vaccine Toolkit, in an Obstetrics and Gynecology (OB/GYN) clinic in Boyle Heights, Los Angeles.

Study design and methods

This quality improvement study occurred over four cycles of development. Its design was guided by the Theory of Planned Behavior. The toolkit components included dot phrases (pre-written phrases to speed documentation), educational posters, electronic health record prompts, HPV vaccine referral guides, and educational sessions. Chart audits and pre- and post-providers surveys were performed between 2019 and 2021 to assess for an increase in provider discussion of the HPV vaccine, as well as to evaluate the various components of the toolkit.

Results

Provider discussion increased over the four cycles of this intervention, with HPV vaccination discussion documented in 15 % of patients in 2019, 19 % of patients in 2020 and 47 % of patients in 2021. Gaps identified included limited discussion of vaccination at postpartum visits. Provider uncertainty of where to refer patients for the HPV vaccine decreased following the intervention.

Conclusion

Discussion of HPV vaccination is an important preventative strategy that can be overlooked in OB/GYN clinics. Implementation of multicomponent strategies can increase provider discussion of HPV vaccination status, although barriers to discussion remain. Improved counseling on HPV vaccination could have significant impacts on reducing HPV-related disease.

Objective

Since the COVID-19 crisis in Thailand, the need for salons to have impeccable hygiene and client-hairdresser monitoring heightened. Due to scarce research on the COVID-19 preventive measures taken by hairdressing salons in semi-urban locations in Thailand during the pandemic, this study aimed to evaluate the standard of hair salons in preventing COVID-19 disease transmission in a semi-urban district in the northeastern region of Thailand.

Methods

Using the purposive sampling method, data were collected from 22 Hair Salons. Data collection tools were a self-completed questionnaire designed into different sections to obtain information on demographics, work conditions and environmental health standard compliance according to guidelines set by the Thai Ministry of Public Health during the COVID-19 pandemic. Descriptive analyses were done, such as mean, standard deviation, and frequency.

Results

The mean age of our respondents was 41.82 (±8.18) years, more than half were females (63.6 %). Most of the criteria assessing beauty salon standards according to Department of Health guidelines were passed, with all of the salons passing the lighting evaluation and mostly passing the heat and electric shock protection system evaluation, but the implementation of guidelines for preventive measures during the COVID-19 epidemic, according to Department of Health guidelines, suggested non-compliance by most hair Salons.

Conclusion

Beauty salons should implement and strictly adhere to guidelines according to Department of Health standards. Training or education sessions regarding the prevention of infectious disease transmission should be conducted, as hairdressers should be motivated to comply with health and environmental health standards for both salon staff and clients' confidence. Further research should also be done on the behaviours associated with health risks in beauty salons at the national or border-nation level.

Background

Drastic changes such as school closures and stay-at-home measures due to the global COVID-19 pandemic, may have long-term negative effects on children's mental health; however, longitudinal studies after 2021 are limited. This study aimed to observe the long-term effects of the COVID-19 pandemic on children's mental health by exploring changes in their mental health over a period of 18 months.

Study design

We conducted a longitudinal study at Chiba Prefecture in Japan, focusing on schoolchildren's mental health changes.

Methods

Data were obtained from the Strengths and Difficulties Questionnaire (SDQ) questionnaire conducted at single primary school three times from October 2021 to March 2023 which and included 183 participants. This study adopted a linear-mixed model to evaluate changes in children's SDQ scores, with sex and grade as the independent variables, and participants as a random effect.

Results

Regarding changes in SDQ scores, there were no significant changes in the total difficulty scores or in each subscale; Emotional Symptoms, Conduct Problems, Hyperactivity/Inattention, Peer Problems, and Prosocial Behavior. There was no statistically significant interaction between changes in SDQ scores and sex.

Conclusions

This report indicates that the impact of the COVID-19 pandemic on the mental health of Japanese primary schoolchildren was negligible in the later phase of the pandemic. However, the impact may differ from country to country owing to factors such as social restrictions during the COVID-19 pandemic.

Background

Elective surgeries were suspended during the national lockdown in March 2020 to curb the spread of the COVID-19 pandemic in Malaysia. We sought to evaluate the impact of the lockdown on cataract surgeries and suggest lessons for future outbreaks.

Study design

We conducted an interrupted time series analysis to examine rates of cataract surgery before and during the lockdown.

Methods

We used national cataract surgical data between 2015 and 2021 from the Malaysian Cataract Surgery Registry. Segmented regression with a seasonally adjusted Poisson model was used for the analysis. Stratified analyses were performed to establish whether the effect of the lockdown on cataract surgeries varied by hospital designation, type of cataract service, sex, and age groups.

Results

Cataract surgeries began falling in March 2020 at the onset of the lockdown, reached a trough in April 2020, and subsequently increased but never recovered to pre-lockdown levels. Cataract surgical rates in December 2021 were still 43 % below the expected surgical volume, equivalent to 2513 lost cataract surgeries. There was no evidence of a differential effect of the lockdown between COVID-19 designated and non-COVID-19 designated hospitals. The relative decrease in cataract surgical rates appears to have been greatest in outreach services and in people 40 years and older.

Conclusions

The lockdown caused an immediate reduction in cataract surgical rates to nearly half of its baseline rate. Despite its gradual recovery, further delays remain to be expected should there be no redistribution or increase in resources to support backlogs and incoming new cases.

Progress on addressing health inequalities is slow and in many places around the world the gap between the privileged and the disadvantaged is widening. This is driven largely by an unfair and unequal distribution of the social determinants of health. While upstream policy and agenda commitment is needed to improve social determinants of health at a population level, healthcare also has a role. Currently social information is sporadically collected and used in healthcare. Improving our understanding of social problems is crucial in targeting services and to reduce the overreliance on area-level measures of deprivation. This has the potential to improve patient care as well as more accurately capture socio-economic disadvantage. Here we argue that there is a role for primary care in screening for social needs to help address inequalities.

Social needs screening, more commonly used in North America than Europe, aims to systematically collect social information in health and care settings. Healthcare professionals ask patients about social issues including employment, finances, housing, education and social isolation and this information is used to prompt referral to community services to address any need identified.

Social needs screening has potential to address negative impacts of social determinants of health at an individual and population level. Providing a reliable measure of social need, screening gives healthcare professionals an opportunity to tailor and improve quality of care for patients and offer individualised support. It has been shown to improve individual social and health outcomes and positively impact healthcare utilisation. At a population level, social needs screening can improve the data on social determinants of health and therefore support policy makers and service delivery leaders to target resources and services more effectively to the communities most in need. Implementing social needs screening must take account of local healthcare service capacity and available community resources but where sustainable, effective programmes can be introduced, the potential benefits are manifold.

While primary care alone cannot solve the root causes of health inequalities, we argue it could be a powerful actor in the fight for health equity.

Background

Prior to the COVID-19 pandemic, local health departments (LHDs) faced several challenges including underfunding and understaffing. COVID-19 exacerbated these challenges and introduced new ones, including harassment of the agency, staff, and leadership. The objective of this study was to qualitatively understand the experiences and impact of harassment faced by LHDs during the pandemic and provide recommendations to prevent future harassment.

Study design

A qualitative study was conducted utilizing focus groups for data collection.

Methods

LHDs were sampled from the 2022 National Profile of Local Health Departments (Profile) study to ensure diversity in LHD size. Four virtual focus groups were conducted in Fall 2022 with a total of 16 LHD leaders surveyed in Profile, who were still in their positions. Focus group transcripts were then coded by two independent coders and analyzed using thematic analysis.

Findings

Four common domains arose from the data: aggravating factors of harassment, content and formats of harassment, protective factors, and effects on individuals and on the workforce.

Conclusion

Findings suggest that harassment was pervasive with many forms and impacts on the LHD leaders and workforce overall. Recommendations are proposed for the local as well as federal partners because the public health system is threatened without immediate, substantial, and coordinated solutions to address harassment and offer protection.