Delaware journal of public health最新文献

Over the past 20 years, the continental United States has experienced unprecedented local transmission of infectious diseases which were previously only known to be travel-associated. Confirmed infections have included malaria, dengue, chikungunya, zika, and leishmaniasis. Scientific projection models predict an increasing risk of such infections in the future, particularly in southern states along the Gulf Coast. Outbreaks may reflect changes in climate conditions, infrastructural capacity, and patterns of human behavior.

Delaware has made significant progress in the fight against HIV, thanks to increased access to testing, treatment, and community-driven prevention services. However, this progress is now at risk due to a heavy reliance on federal funding-particularly the $1.1 million annual support from the CDC's Division of HIV Prevention-which is currently under threat. Without sustained investment, Delaware could see drastic reductions in HIV testing, education, and outreach, especially among marginalized populations who are already disproportionately affected. Community-based organizations like AIDS Delaware and the Delaware HIV Consortium play a vital role in delivering culturally competent care, case management, and prevention services across the state. Funding cuts would not only jeopardize their efforts but could lead to a resurgence in HIV transmissions and long-term public health costs. Delaware's HIV response is a model of effectiveness, equity, and compassion-but it cannot survive without stable funding. Continued investment is both a fiscal responsibility and a moral obligation to protect the health of all Delawareans.

Antimicrobial resistance (AMR) is a global health problem, but it is only the 'tip of the iceberg' of microbial disruption caused by antibiotics. Under the surface, cultural factors such as understandings of and attitudes toward microbes may play a significant role influencing relationships between humans and microbes. Western strategies to address pathogenic microbes and AMR often overlook the symbiotic relationship humans share with beneficial microbes (our microbiota), viewing humans as separate from nature and focusing on control. Given the increasing prevalence of novel pathogens, antimicrobial resistance, and chronic illnesses associated with disturbed microbiota (dysbiosis), alternative approaches are needed. Cross-cultural studies may provide ways forward. An exploration of Japanese perspectives on microbes through the lens of food and health reveals practices where microbes are often regarded as partners and friends rather than foes.

Objective: To describe the use, activities, and human interactions of cobots as a delivery system for medications, supplies, and equipment within a complex and multi-level 900-bed hospital setting. Integrating collaborative robots (cobots) into existing hospital workflows as a secure delivery transportation system is an early innovation and emerging area to explore.

Methods: Guided by the Diffusion of Innovations theory, a qualitative descriptive design was used to build the foundational knowledge required to better understand and describe cobot implementation in the acute care hospital setting. The cobots were observed on all shifts, on different days of the week as they interacted with staff members, clinicians, and visitors while they traveled throughout the hospital completing deliveries. Data were analyzed among the study team members using an inductive coding approach followed by a qualitative content analysis level of interpretation.

Results: For seven weeks from November 2022 - December 2022, 33 hours were collected from 23 individual cobot observation sessions. These observations included 89 end-to-end cobot deliveries. After analysis, four major themes emerged: 1) humanization of robots, 2) usability of robots, 3) cobots' autonomy, and 4) cobots' functionality within a dynamic hospital environment.

Conclusions: Implementing cobots as a semi-autonomous delivery transporter is still in the early innovation phase. The cobots used in this study required human support to function adequately in a complicated and unpredictable environment. To sustainably augment current and future workflows exclusively performed by human, the cobots will need to transition toward greater model of autonomy and less human assistance.