PUBLIC HEALTH REVIEWS最新文献

Background: Born in the Chinese city of Wuhan, the consequences of the coronavirus pandemic on global health and economies have been and continue to be devastating. In Africa, its countries grieve for unprecedented burdens of caseloads and mortality due to COVID-19, the virus responsible for the disease. This narrative review aims to establish the scale of the health and economic crisis wrought by the pandemic in Africa, including its impact on the informal economic sector, projections of the effect on national GDP, as well as its political dimensions.

Methods: Documentary evidence issued between January and 8 August 2020 was sought from the Google Scholar, PubMed, Scopus, and Web of Science databases. Searches of published and unpublished abstracts were also conducted from appropriate websites, government documents, organizational reports, newspaper commentaries, and reports issued by global, regional, and local centers of disease control and prevention.

Results: The COVID-19 pandemic is responsible for a fourfold crisis in Africa: (1) a health crisis: the victimization of frontline healthcare workers and the looming caseload and death tolls with 1.039 million (12%) cases being confirmed and over 22,966 (2.4%) deaths as of 8 August 2020. The highest death toll was recorded in Southern Africa of 11,024 (48%) followed by North Africa with 6,989 (29.2%) deaths; (2) a social crisis: with the violation of human rights, the killing of citizens by security forces and increased crime. This, in turn, exacerbates social inequalities, the breakdown of households, instances of social unrest, and general impoverishment; (3) an economic crisis: manifested by a decline in GDP and mass unemployment; (4) a political crisis: implementation of measures that may not be appropriate for Africa, discrimination of refugees and immigrants, evacuation of citizens to their home countries, resulting in distrust of political leaders and postponement of national elections, and mounting cases of conflicts and unrest.

Conclusion: Lockdown during the COVID-19 outbreak is a prevention mechanism in affluent countries, in contrast to developing regions such as Africa, where it is a race against death and starvation. Policymakers must apply novel and locally relevant prevention and management strategies to cope with this growing disaster.

Background: Public Health remains central to understand health and its determinants, and Public Health teams are essential for an integrated collaborative medical practice. However, current teaching of public health to medical students varies in the European Region though an investment in multidisciplinary workforce is recognised essential to deliver high quality public health services. A recent medical education curricula restructuring in the University of Porto Medical School resulted in the inclusion of a Public Health module linking academic teaching to field practice and provided the opportunity to make an initial appraisal of students' perceptions.

Case study: We analysed final reports (n = 196), debriefing meetings notes (n = 2), and e-mails sent by students (n = 34) regarding the activities they observed or participated at, their contact with Public Health services' teams, knowledge and critical appraisal, and opinion about the module. Students gained basic knowledge about how epidemiological surveillance, environmental health, health planning, and health promotion are performed in practice. They reported a better understanding of the roles and importance of Public Health services and its teams. Most considered that this module had an important role in their training. Some activities observed in the field lacked the needed standardisation to provide the students the feeling that core operations were experienced, which needs to be addressed in the future.

Conclusions: Public Health practice-based training within field institutions may bring a better understanding of the discipline and specialty for medical students. It may strengthen interconnectivity and coordination of healthcare agents, which may improve future medical practice with potential improvement of patient-centred care and in terms of public health response, and back their roles as health agents and decision-makers.

Researchers conducting community-based participatory research (CBPR) with vulnerable populations in rural African settings are confronted with distinctive ethical and cultural challenges due to the community context of their research, their methods of investigation, and the implications of their findings for populations. Ethical considerations such as informed consent, the protection of privacy and confidentiality, and relationships between researchers and participants take on greater complexity and have implications beyond the individual research participant. Drawing on careful reflections of experiences from conducting mental health promotion intervention research using the CBPR approach and multi-methods in resource-poor rural communities in Ghana, we examine a range of ethico-cultural issues associated with community-based group intervention research in rural remote settings of Ghana. We offer suggestions to help researchers to envision and manage these complexities in a more appropriate way. Approaches aimed to promote relationships, fairness, respect, and cultural harmony between researchers and study participants are outlined. We urge prospective researchers to carefully explore and respect the cultural values and practices of community members and observe locally-defined ethical values and principles when conducting CBPRs in rural African settings to minimise ethics dumping and safeguard the integrity of their research.

Background: Ageing in place has recently gained visibility in healthcare policies and services. Technology has the potential to facilitate independence at home. The objective of this systematic review is to identify technologies that have been rigorously evaluated for supporting the ageing in place of healthy older adults. As well we explored the methods in engagement with technology in healthy older adults.

Methods: Databases Pubmed, Scopus, PsycInfo and Cinahl were consulted for clinical controlled trials or randomised controlled trials between 2014 and 2019. Studies were included if they contained a technological intervention and focussed on supporting healthy older adults' independent living. PRISMA guidelines and the risk of bias tool of the Cochrane Collaboration were applied.

Results: The search identified 3662 articles of which only 7 made the final analysis. Through narrative analysis, technologies were categorised into three groups: accessible communication, emergency assistance and physical and mental well-being. Patient-centredness was extensively addressed by exploring how the participants engaged in the development and evaluation of the technology and how they were trained and monitored.

Conclusions: Literature concerning technology to support ageing, based on controlled trials and research performed in authentic home situations, is scarce. Thus, there is a need to investigate the subject in depth. The use of a neurofeedback headband, an accessible computer system, a wristband with pedometer, a biofeedback device and an online video platform can bring added value to ageing in place for healthy older adults. A patient-centred approach for developing, implementing and evaluating technology benefits ageing in place.

Background: Individual subjective well-being (SWB) is essential for creating and maintaining healthy, productive societies. The literature on SWB is vast and dispersed across multiple disciplines. However, few reviews have summarized the theoretical and empirical tenets of SWB literature across disciplinary boundaries.

Methods: We cataloged and consolidated SWB-related theories and empirical evidence from the fields of psychology and public health using a combination of online catalogs of scholarly articles and online search engines to retrieve relevant articles. For both theories and determinants/correlates of SWB, PubMed, PsychINFO, and Google Scholar were used to obtain relevant articles. Articles for the review were screened for relevance, varied perspectives, journal impact, geographic location of study, and topicality. A core theme of SWB empirical literature was the identification of SWB determinants/correlates, and over 100 research articles were reviewed and summarized for this review.

Results: We found that SWB theories can be classified into four groups: fulfillment and engagement theories, personal orientation theories, evaluative theories, and emotional theories. A critical analysis of the conflicts and overlaps between these theories reveals the lack of a coherent theoretical and methodological framework that would make empirical research systematically comparable. We found that determinants/correlates of SWB can be grouped into seven broad categories: basic demographics, socioeconomic status, health and functioning, personality, social support, religion and culture, and geography and infrastructure. However, these are rarely studied consistently or used to test theories.

Conclusions: The lack of a clear, unifying theoretical basis for categorizing and comparing empirical studies can potentially be overcome using an operationalizable criterion that focuses on the dimension of SWB studied, measure of SWB used, design of the study, study population, and types of determinants and correlates. From our review of the empirical literature on SWB, we found that the seven categories of determinants/correlates identified may potentially be used to improve the link between theory and empirical research, and that the overlap in the determinant/correlates as they relate to multiple theory categories may enable us to test theories in unison. However, doing so in the future would require a conscious effort by researchers in several areas, which are discussed.

Background: Housing is a social determinant of health. Extensive research has highlighted its adverse effects on health. However, less is known about the effects of cohousing typology on health, which has the potential to create lively social networks and healthy communities and environments. We report the findings of a scoping study designed to gather and synthesise all known evidence on the relationship between cohousing and wellbeing and health.

Method: Using the scoping review method, we conducted a literature review in PubMed, ProQuest, Scopus, Web of Science, Science Direct and JSTOR in May 2019 and selected articles published from 1960 onwards, with no geographical limit and no design restrictions. Retrieved articles underwent three sequential screening phases. The results were described through a narrative synthesis of the evidence.

Results: Of the 2560 articles identified, we selected 25 full-text articles analysing 77 experiences. All of them were conducted in high-income countries. Ten studies analysed the impact of cohousing on physical and mental health or quality of life and wellbeing. Eight of the 10 studies found a positive association. In addition, 22 studies analysed one or more psychosocial determinants of health (such as social support, sense of community and physical, emotional and economic security) and most found a positive association. Through these determinants, quality of life, wellbeing and health could be improved. However, the quality of the evidence was low.

Discussion: The cohousing model could enhance health and wellbeing mediated by psychosocial determinants of health. However, extreme caution should be exercised in drawing any conclusions due to the dearth of data identified and the designs used in the included studies, with most being cross-sectional or qualitative studies, which precluded causal-based interpretations. Because housing is a major social determinant of health, more evidence is needed on the impact of this model on health through both psychosocial and material pathways.

Background: Twenty-five years ago, the need for health care interpreting in Switzerland increased due to the sharp influx of asylum seekers from war zones and countries of political unrest. Due to complex health needs, there was a need to move away from using volunteers as interpreters towards qualified interpreter services.

Methods: A historical qualitative case study design was used to describe the evolution of the language assistance programmes at Geneva University Hospitals, between 1992 and 2017. The aim was to map the evolution of the interpreter services against the Bilingual Health Communication Model with the constructs-Communicative Goals, Individual Agency, System Norms and Quality and Equality of Care-while identifying key factors to optimise interpreter service and patient care.

Results and discussion: Five phases were identified during the 25 years of service evolution studied: (1) Service initiation-the interpreter services were first used in a small service that cared for refugees and asylum seekers. (2) Growth and formalisation-due to the arrival of high numbers of Albanian-speaking asylum seekers, Albanian-speaking interpreters were provided to all departments of the Geneva University Hospitals. This helped roll out the use of interpreters among doctors and nurses. (3) Ensuring quality-the care for all patients, whether foreign-language speaking or not, became an issue and led to research into the quality of patient-provider communication. (4) Institutionalisation-this phase dealt with challenges including the lack of interpreter financing regulation and the clarification of interpreter roles. (5) Equity-healthcare interpreter services were put in an overall framework of equity standards. The Bilingual Health Communication Model was applied and showed that some items were not implemented: clear shifts (i) towards a culturally sensitive focus, (ii) towards community interpreting, (iii) towards triadic communication, (iv) towards spelling out the right to have an interpreter and (v) towards the involvement of insurance companies. Finally, the inclusion of healthcare interpreting as an essential ingredient in healthcare provision, including chronic disease management, is incomplete or missing.

Conclusions: Healthcare interpreting at Geneva University Hospitals has evolved from a 'muddling-through' approach towards an institutional approach by addressing quality of care, by focussing on the mental health of asylum seekers, training of both interpreters and users of interpreters and institutional policy based on equity.

Background: Considering the low frequency of dairy intake in the population, interventions aiming to increase its consumption can be a priority for any health system.

Objective: This study aims to summarize community-based interventions for improving dairy consumption and their effectiveness to help policy-makers in designing coherent public health strategies.

Methods: This study was conducted in 2019, using PubMed/MEDLINE, Scopus, EMBASE, Cochrane Library, Web of Science, ProQuest, and Google Scholar. Two independent reviewers selected the eligible studies, and the outcomes of interest were extracted. The quality of eligible studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for randomized controlled trials and quasi-experimental studies.

Results: Out of 521 initially identified articles, 25 studies were included. Interventions reported in 19 studies were effective in increasing dairy consumption. Interventions in high-income countries were more effective than those in middle- and low-income countries. Interventions in health centers and supermarkets were more effective than the community and school-level interventions. Interventions in supermarkets and adolescents as target groups were more effective than children, middle-aged people, and the elderly. Also, educational interventions and changing buying/selling pattern were more effective than multiple interventions. Interventions longer than 24 and 48 weeks were more effective than shorter interventions.

Conclusion: Three policy options including educational interventions, multiple interventions, and changing the purchase pattern are suggested. It seems that applying all of the interventions together can be more effective. Also, long-term and well-designed future studies in different settings are recommended to confirm these results.

In Germany, an ageing population is affected by societal and political changes due to demographic transition, e.g. by a prolonged working life for older employees. Demographic change also influences persons of higher working age with a migrant background. In 2018, 25% of all employees in Germany had a migrant background. Those affected by poor health at a higher working age can benefit from medical rehabilitation services, which aim to prevent early retirement and disabilities. So far, the utilisation of medical rehabilitation has been lower among persons of foreign nationality (often the only available proxy for migrant background), compared to that of Germans. The aim of this scoping review is to assess the utilisation of medical rehabilitation services by those with migrant background (PMB) and those without (non-PMB) and to identify the differences between these groups. We included 25 studies in our analysis, which were mainly secondary analyses of routine data and also a small number of primary studies. The results were inconsistent: studies published before 2018 showed a lower use of rehabilitation services for persons of foreign nationality compared to Germans. However, no differences were found between PMB and non-PMB in studies published in 2018 or later. PMB, as well as foreign nationals, showed poorer health before medical rehabilitation utilisation and had a higher chance of occupational disease and a lower education level. We identified a lower work-related performance, as well as barriers (e.g. information deficits) in the utilisation of rehabilitation services for groups of PMB. Our review is limited in that we cannot generalise our results to all PMB living in Germany. This is because of the heterogeneity, the limited number of studies and lack of representativeness in some studies. In many cases, studies only analyse the nationality, but they lack information about the second generation PMB. Future studies should survey the utilisation of medical rehabilitation services by migrant background rather than by nationality and focus on changes in the provision of rehabilitation measures following diversity-centred strategies.