Perspectives in Public Health最新文献

Aims: Dengue fever, transmitted by Aedes aegypti mosquitoes, presents a wide clinical spectrum ranging from mild febrile illness to severe manifestations such as dengue hemorrhagic fever. It poses a substantial global health concern, with India significantly contributing to its burden. Factors such as rapid urbanization, population density, and favorable climatic conditions facilitate its spread, particularly in states like Odisha. This study aimed to estimate the financial burden imposed by dengue on households in Bhubaneswar, Odisha, and to explore the coping strategies adopted by these households to address the financial burden of dengue.

Methods: A case-based cross-sectional study was conducted between May and July 2022 in Bhubaneswar, part of Khordha District. A total of 200 laboratory-confirmed dengue patients were enrolled. Quantitative data on sociodemographic details, health facility choices, and expenditure specifics were collected using structured questionnaires. In-depth interviews were conducted with a subset of patients and caregivers to understand the broader socioeconomic impact. Data analysis involved descriptive statistics, bivariate analysis, and linear regression.

Results: Majority of patients were urban residents, predominantly males aged 21-40 years. Private healthcare incurred significantly higher costs than government facilities (INR 21,859 versus INR 1225). The average out-of-pocket expenditure (OOPE) was INR 5567, disproportionately affecting females, older age groups, higher-income individuals, and married participants. Most households (93%) utilized savings, while only 3% relied on health insurance as a coping strategy.

Conclusion: Dengue fever inflicts a considerable financial and emotional toll on households in Odisha. The findings underscore the urgent need to strengthen public health infrastructure, increase awareness of financial protection schemes, regulate private healthcare costs, and integrate psychosocial support into dengue management strategies.

This short report examines the harmful health impacts of heatwaves in low- and middle-income countries across Sub-Saharan Africa (SSA) and underscores the urgent need to advance climate adaptation strategies in these vulnerable regions. Given the increasing frequency and severity of heatwaves due to climate change, the authors' work highlights the gaps in current heat-health policies, the disproportionate burden on vulnerable populations, and the necessary steps for strengthening public health resilience in SSA.

We argue in the paper that there is much to learn from previous public health advocacy and action against health-harming industries, such as tobacco, through a 'Commercial Determinants of Health' (CDoH) lens. The MPOWER framework is an example of work in tobacco control field which has been a valuable and cross-cutting framework used to guide and support tobacco policy implementation and prioritisation since its development in 2008, contributing to progress in reducing smoking rates and associated morbidity and mortality.

Aims: The media's influence on public opinion and support for policy change, particularly concerning climate action and its intersection with public health, has gained significant attention. The media serves as a significant platform for delivering public health messages to the general population. This article explores the central role of media in shaping public understanding and support for mitigation and adaptation efforts, with a specific focus on its implications for public health advocacy. It does this by investigating how health and multihazard early warning systems (MHEWS) have been covered in newspaper articles worldwide.

Methods: Through thematic content analysis, we examined how newspaper articles portray messages and use narrative techniques. The objective is to show differences in reporting strategies and understand the symbolic connotations linked to media discourse on health and MHEWS.

Results: The analysis identified seven key themes in the media's coverage of health and MHEWS. The themes cover strategies to reduce vulnerability to disasters, including health-related risks, governmental roles in policy implementation and resource allocation, international collaboration, community engagement, technological advancements, financial challenges, and health impacts and preparedness. They emphasise the importance of holistic approaches, local participation, and global cooperation in disaster risk reduction, adaptation, and resilience-building.

Conclusions: The research highlights the potential of media advocacy in raising awareness about the complex links between health and climate-related hazards, as well as the media's role in increasing support for planning and action. This article provides a comprehensive overview of the opportunities and challenges associated with the media to promote resilience and improve public health.

Aims: As a result of climate change, extreme weather events have increased in frequency, representing one of the most pressing concerns to physical and mental health globally, especially for children. Research suggests that extreme weather events uniquely and adversely affect children in low- and middle-income countries due to developmental and contextual factors. Given the advantages of early intervention, it is critical to aggregate and evaluate current interventions to support this population. This review aims to synthesise evidence on the impact of interventions targeting the development, mental health or wellbeing in early childhood (ages 0-8 years) following extreme weather events in low- and middle-income countries.

Methods: This review was preregistered with PROSPERO (CRD42023479342). Literature available on seven scientific databases (PsycINFO, Embase, MEDLINE, CINAHL, Web of Science, ERIC, and Cochrane) until February 2024 were reviewed and 744 articles were identified. A grey literature search via Google Scholar, ProQuest, and international agency websites (e.g. Oxfam, UNICEF, Save the Children) identified an additional 48 sources for screening. None of the sources met the inclusion criteria.

Results: The current review is an empty review with no interventions included.

Conclusion: The lack of eligible publications within this review indicates an absence of evaluations of interventions in early childhood that may support a population disproportionately vulnerable to the adverse effects of increasing extreme weather events. Research and policy efforts to address this significant gap should prioritise this critical area, focusing on rigorous evaluations and transparent reporting.

Background: Surface contamination via hands plays an important role in pathogen spread in public spaces, particularly where numerous people interact with shared surfaces and objects. This study aimed to identify frequently touched surfaces, examine their interconnections, and evaluate the spread of a surrogate virus in a hotel lobby.

Methods: In a working hotel lobby (in Arizona, USA) a total of 30 h of observation were performed to identify the surfaces and objects touched by hotel users. The observed area included the lobby entrance, check-in desk and other communal areas. The sequence of touches performed by each observed individual was recorded, from which surface-to-surface interactions and fomite interconnections were determined. An entry doorknob and first floor elevator button were seeded with a bacteriophage (Phi X174) tracer; 4 h later, 25 surfaces were swabbed to determine tracer distribution and contamination levels.

Results: A total of 324 individuals performed 627 touches of 13 different fomites. The elevator button and front desk counter were the most frequently touched (32% and 22%, respectively). More than half (56%) touched 2 or more surfaces. Touches from the elevator button to other surfaces and from other surfaces to the elevator button made up 50% of all interactions.From two seeded sites, the tracer spread to 13 surfaces over 4 h. The most contaminated surfaces were tables, counter tops and door handles.

Conclusions: The significant role of hands in transferring pathogens across frequently touched and highly interconnected surfaces in a hotel lobby was demonstrated through observations and sampling, highlighting the opportunity for hand and surface hygiene interventions to break the chain of infection in this hotel setting. These findings have implications for the optimisation of hygiene interventions in other hotel settings and are also applicable to similar public spaces, where common shared surfaces and objects (such as front desk counters and elevator buttons) could be targeted.

Aims: Smoking continues to pose a significant threat to health and well-being in Ireland. However, concerns have been raised about the enforcement of public health legislation in Ireland. The WHO has noted that enforcement of tobacco-control legislation is a vital factor in reducing tobacco-related harm. This research therefore sought to explore convictions, penalties, and associated costs imposed in the period 2014-2023 under various sections of the Public Health (Tobacco) Act 2002 as amended.

Method: This article is based on secondary descriptive statistical analysis of tobacco conviction data released annually by the Health Service Executive's (HSE) National Environmental Health Service.

Results: Over 1900 inspections annually identify evidence of non-compliance with tobacco-control legislation. Convictions for non-compliance are rare, with 1.12% of instances of non-compliance resulting in a conviction. In total, 93.1% of fines and 85.5% of costs charged were for sums of €1500 or less. Convictions under the tobacco-control legislation resulting in a 1-day ban or less on tobacco sales occurred in 56.9% of convictions.

Conclusion: The penalties imposed, which are at judicial discretion, are routinely far below the maximum possible under the Acts. The introduction of fixed penalty notices is recommended, as well as the re-introduction of minimum periods of removal from the Tobacco Retail Register to prohibit tobacco sales. The low level of enforcement and minimal penalties imposed undermine tobacco control in Ireland.

Background: 'Dark kitchens' are an innovative and potentially disruptive addition to the global food environment with potential implications for policy, practice and public health. In the UK, dark kitchens currently represent approximately 15% of all food retailers across the three major online food delivery platforms in England (e.g. Just Eat, Deliveroo, Uber Eats), contributing significantly to the digital food environment. To date, dark kitchens have been poorly defined, under-researched and their wider impact poorly understood.

Aim: Therefore, the aim of this work was to coproduce a consensus definition of dark kitchens to be used across multiple disciplines.

Methods: A series of consultations took place with stakeholders including consumers, local authority representatives, academics, dark kitchen employees, and national governing bodies to understand knowledge and currently used definitions of dark kitchens. Mixed-method approaches were used involving questionnaires, interviews, focus groups, and workshops.

Results: The stakeholder consultation process provided a robust methodology through which a consensus definition of dark kitchens was agreed. Each project group provided a definition which was scribed and annotated to understand the key components of importance within the definitions, while additional and unique components were discussed and debated by the expert working group before being accepted or rejected. In addition, short- and long-term benefits of such a definition were outlined for all stakeholder groups. Following peer-review from local authority, industry and governing body stakeholders, a final definition was produced.

Conclusion: The adoption of a consensus definition of dark kitchens is pivotal to the cross-sectoral work and understanding of many stakeholder groups. The definition allows for transparency and improved communication between dark kitchen stakeholders and provides the opportunity to drive public health agendas at multiple points within the food system.