Dialogues in health最新文献

Background

During the COVID-19 pandemic there was a plethora of dynamical forecasting models created, but their ability to effectively describe future trajectories of disease was mixed. A major challenge in evaluating future case trends was forecasting the behavior of individuals. When behavior was incorporated into models, it was primarily incorporated exogenously (e.g., fitting to cellphone mobility data). Fewer models incorporated behavior endogenously (e.g., dynamically changing a model parameter throughout the simulation).

Methods

This review aimed to qualitatively characterize models that included an adaptive (endogenous) behavioral element in the context of COVID-19 transmission. We categorized studies into three approaches: 1) feedback loops, 2) game theory/utility theory, and 3) information/opinion spread.

Findings

Of the 92 included studies, 72% employed a feedback loop, 27% used game/utility theory, and 9% used a model if information/opinion spread. Among all studies, 89% used a compartmental model alone or in combination with other model types. Similarly, 15% used a network model, 11% used an agent-based model, 7% used a system dynamics model, and 1% used a Markov chain model. Descriptors of behavior change included mask-wearing, social distancing, vaccination, and others. Sixty-eight percent of studies calibrated their model to observed data and 25% compared simulated forecasts to observed data. Forty-one percent of studies compared versions of their model with and without endogenous behavior. Models with endogenous behavior tended to show a smaller and delayed initial peak with subsequent periodic waves.

Interpretation

While many COVID-19 models incorporated behavior exogenously, these approaches may fail to capture future adaptations in human behavior, resulting in under- or overestimates of disease burden. By incorporating behavior endogenously, the next generation of infectious disease models could more effectively predict outcomes so that decision makers can better prepare for and respond to epidemics.

Funding

This study was funded in-part by Centers for Disease Control and Prevention (CDC) MInD-Healthcare Program (1U01CK000536), the National Science Foundation (NSF) Modeling Dynamic Disease-Behavior Feedbacks for Improved Epidemic Prediction and Response grant (2229996), and the NSF PIPP Phase I: Evaluating the Effectiveness of Messaging and Modeling during Pandemics grant (2200256).

Sick Building Syndrome (SBS) is an illness among workers linked to time spent in a building. This study aimed to investigate the Indoor Air Quality (IAQ) and symptoms of Sick Building Syndrome (SBS) among administrative office workers. The IAQ parameters consist of ventilation performance indicators, and physical and chemical parameters were measured using specified instruments for three days during weekdays. The SBS symptoms were assessed by a questionnaire adopted from the Industry Code of Practice of Indoor Air Quality (ICOP-IAQ) 2010 among 19 employees from the office in East Coast Malaysia. Relationship between past symptoms and present symptoms which are draught (past symptoms) with feeling heavy headed (present symptoms) (r = 0.559, p < 0.05), room temperature too high (past symptoms) was highly correlated with feeling heavy headed (present symptoms) (r = 0.598, p < 0.01) and cough (present symptoms) (r = 0.596, p < 0.01). Room temperature (past symptoms) has a positive medium relationship with cough (present symptoms) (r = 0.477, p < 0.05) and scaling itching scalp or ears (present symptoms) has a relationship between stuffy bad air (r = 0.475, p < 0.05) and dry air (r = 0.536, p < 0.05). There was a significant association between RH with drowsiness (χ2 = 7.090, p = 0.049) and dizziness (χ2 = 7.090, p = 0.049). The association was found between temperature and SBS symptoms between temperature with headache (χ2 = 7.574, p = 0.051), feeling heavy-headed (χ2 = 8.090, p = 0.046), and skin rash itchiness (χ2 = 7.451, p = 0.044). Air movement also showed a positive association with symptoms of feeling heavy-headed (x2 = 8.726, p = 0.021). PM₁₀ has positive significance with SBSS which are feeling heavy-headed (χ2 = 7.980, p = 0.023), and eyer's irritation (χ2 = 7.419, p = 0.038). The conclusion of this study showed that there were positive significant between temperature and relative humidity toward SBSS.

This study investigates the impact of weather information sources on consequences associated with extreme heat events, employing a cross-sectional survey conducted on hospitalized individuals who have experienced heat stress in Central Vietnam. Multiple information channels, including official agencies and social media, were found to significantly reduce the Cost of Illness (COI) associated with heat-related ailments. Social media, in particular, emerged as a potent tool for climate adaptation. Improving the clarity and accessibility of weather information through official channels is crucial, especially for households with varying income levels. Demographic factors such as age and gender should be considered when fine-tuning communication strategies, with special attention given to individuals with underlying medical conditions, who are particularly susceptible to extreme heat effects. These findings underscore the need to maximize the reach of weather-related information and reduce economic burdens on affected populations. This provides valuable insights for policymakers aiming to bolster climate resilience in vulnerable regions like Vietnam, emphasizing the significance of diverse information sources and tailored communication in climate change adaptation.

Background

Antenatal care can play an important role in reducing the death of both mothers and children. This study was designed to find out the determinants of world health organization recommended antenatal care visits in six South Asian countries to achieve the targets for Sustainable Development Goal.

Methods

This study used recent demographic and health survey data from six South Asian countries such as Afghanistan (2015), Bangladesh (2017-18), India (2015-16), Maldives (2016-17), Nepal (2016), and Pakistan (2047-18). Descriptive statistics were calculated for the distribution and prevalence of antenatal care visits. Bivariate and multivariable logistic regressions were used to investigate the influencing factors of antenatal care visits.

Results

71,862 women aged 15 to 49 years were included in this study, and 46.64% (95% Confidence Interval = 45.59 - 47.69%) had world health organization recommended antenatal care visits. In the pooled data, urban women (AOR ([Adjusted Odds Ratio]=1.48; 95% CI [Confidence Interval]=1.33-1.66), richest family (AOR=1.48; 95% CI=1.25-1.76), women’s higher education (AOR=3.76; 95% CI=3.33-4.25), women’s partner/husband’s higher education (AOR=1.69; 95% CI=1.50-1.92), 35–49 years (AOR=1.25, 95% CI=1.11-1.42), women’s age at first birth >25 years (AOR=1.51, 95% CI=1.36-1.68) and fully media exposure (AOR=2.11; 95% CI=1.74-2.56) were significantly positively associated with WHO recommended antenatal care visits. Whereas, working women (AOR=0.82; 95% CI=0.76-0.88), healthcare decision maker by their husband/others (AOR=0.71, 95% CI=0.60-0.84), ≥7 children (AOR=0.59; 95% CI=0.50-0.69), and ≥7 family members (AOR=0.82; 95% CI=0.73-0.93) had significant negative effect on antenatal care visits. In country specific analysis, overall, media exposure, secondary and above education of women, ≥25 of years age at first birth, and <4 living children were the key factors of antenatal care visits.

Conclusions

This study reveals an overall scenario of the WHO-recommended antenatal care visit in South Asian countries, and significant factors related to ANC that we can concentrate onto improve accessibility to healthcare services and promote education and media exposure, especially for rural and less educated women, to increase the prevalence of WHO-recommended antenatal visits in South Asian countries In addition, evidence from this study can be used to assist the policymakers in planning and taking proper steps to increase WHO-recommended antenatal care visits by focusing on the related factors in South Asian countries.

Aim

The aim of this study was to analyze the well-being and coping strategies of nurses working in an organizational setting perceived as characterized by workplace bullying. The innovative aspect of this study is that we considered only those who perceive to work in an organizational environment characterized by workplace bullying, and not those who see themselves as victims and those who perceive they work in an organizational environment not characterized by workplace bullying.

Method

A questionnaire with the NAQ-R, PGWBI, Val.Mob. and Brief COPE scales was administered to nurses. To better understand this phenomenon, a comparison was made between 331 nurses and 166 workers in other professions who also work in an organizational environment perceived to be characterized by workplace bullying.

Results

In both groups (nurses and workers), the results were approximately the same in terms of personal bullying and workplace bullying episodes and the number of physical and emotive symptoms. The PGWBI score was lower for nurses than for workers in other fields. Among the individual symptoms, nurses and registered nurses were more likely to report gastritis, insomnia and heartburn than workers in other contexts. Workers in other contexts were more likely than nurses to report symptoms of anxiety, fear, feelings of insecurity, inferiority and guilt. In terms of coping strategies, nurses were more likely than other workers to report distraction, substance use, emotional support, disengagement, venting, positive reframing, humor, and religion. Workers in other professional context were more likely than nurses to report active coping, denial, instrumental support, planning, acceptance, and self-blame.

Conclusion

Results suggest that the consequences of working in a perceived organizational environment characterized by workplace bullying are similar for both groups of workers, with nonstatistical differences in perceived workplace bullying episodes and sum of physical and emotive symptoms.

Implication

Overall, findings suggest that workplace bullying prevention is a fundamental element in training workers in all types of workplaces and should be an integral part of curriculum activities.

In September 2023, a surge of violence against healthcare professionals occurred in Nepal within a two-week span, despite recent legal amendments aimed at curbing such incidents. This manuscript explores whether stricter legislation effectively deters these acts. The violence is rooted in Nepal's healthcare system's inadequacies, leading to overcrowded and understaffed hospitals, patient frustration, and healthcare professional burnout. Misinformation and rumors, particularly in rural areas, can trigger outbreaks of violence, exacerbated by media sensationalism. The lack of legal consequences for attackers is a significant factor. Perpetrators often go unpunished, emboldening others to resort to violence when dissatisfied with medical services. Political affiliations and third-party involvement for financial gain are common. The psychological toll on healthcare workers is profound, resulting in burnout, depression, and post-traumatic stress disorder, contributing to a significant brain drain of doctors from Nepal. This paper underscores the importance of enforcing existing laws to create a safe workplace and making the malpractice complaint process accessible to the public to deter resorting to violence.

Background

Masks are well accepted in Japan, where they were already part of daily life even before the COVID-19 pandemic. Unlike many other countries where mask mandates were lifted as soon as the pandemic was under control, Japan was one of the last countries to ease mask-wearing guidelines. Even after the formal announcement to allow masks-off in mid-March 2023, many Japanese still voluntarily wear masks. In this work, possible reasons for this extreme “mask-affinity” of Japanese people were studied by exploring various information sources including tweets (now known as X posts) and subsequent text-analysis, online news, and medical literature.

Methods

An observational study was conducted based on tweets prospectively collected during 5 months from June 26^th, 2022 to November 26^th, 2022. Tweets with the hashtag “mask (in Japanese)” were collected weekly via the Twitter application programming interface by using R version 4.0.3 to gauge public opinions. The word clouds to allow intuitive understanding of the key words were drawn from the tokenized text.

Results

The data collection period included the 7^th flareups of the newly infected cases i.e. “the 7^th surge”. In total, 161,592 tweets were collected. Word clouds for 1) before the 7^th surge based on 18,000 tweets on June 26^th and 2) during/after the 7^th surge based on 143,592 tweets between July-November were created with the R package “wordcloud2”. The results indicated that the people wanted to take off masks due to the heat in summer, then shifted again toward mask-wearing along with the 7^th surge but with a certainly growing “no-mask” sentiment.

Conclusions

Subsequent review of domestic information sources suggested that various factors, not only well-known peer pressure, may have contributed the public’s mask affinity in Japan. This work revealed an aspect of Japanese struggle toward adaptation to life in an unexpected pandemic by focusing on masks as our closest daily adjunct over the past 3 years of isolation.

Trial registration: not applicable.

Background/Purpose

Midwife-led continuity of care (MLCC) is an evidence-based care model positively influencing the health and wellbeing of women and their families. Despite the evidence, a sustainable future of the model is uncertain. The aim of this paper is to give an example of a theoretical exercise that enhances the understanding of the trends and developments impacting MLCC’s future state.

Methods

The industrial complex theory scaffolded the theoretical approach. The intuitive logics scenario development methodology was used to structure the key variables that influence the utility of MLCC. Dimensionally structured scenarios representing the probable, possible and probable MLCC futures were written.

Results

Thirteen key variables that greatly impact the future MLCC, with varying degrees of certainty were identified. A theoretical framework representing two underlying meta dimensions of MLCC was constructed: identity system of midwife-led continuity of care (fixed vs fluid) and embodied orientation to the world (reasoning vs meaning making). Within the framework, four different storylines of possible, plausible prospective futures emerged: Sense & sensibility, The birth of mothers, Too many sisters and One-stop-shop.

Conclusion

The paper is an example of how to approach the future of MLCC, the method serving as a tool to establish a theoretical truth of how its future state may unfold, the scenarios facilitating a dialogue among stakeholders and informing the public.

Introduction

Despite global progress in gender equality, still not every woman has access to safe and the highest quality health care. Visually impaired young adult women represent one of the most vulnerable groups with a poorer ability to access necessary healthcare services. This study aims to explore and comprehend the experiences of visually impaired young adult women in accessing healthcare services in Nepal.

Methods

A descriptive phenomenological study was conducted among 16 visually impaired women aged 20 to 35 years who had utilized healthcare services within the past 12 months. Face-to-face, in-depth interviews were conducted for data collection, and thematic analysis was conducted for data analysis.

Results

Our study revealed a range of challenges faced by visually impaired young women that impeded their healthcare-seeking. These challenges included sexual harassment by male healthcare providers, disability-related stigma, financial difficulties, limited autonomy in decision-making, and a lack of disability-friendly healthcare facilities and services. Particularly, experiencing sexual harassment from male healthcare providers, coupled with underlying disability-related stigma, profoundly influenced the avoidance of healthcare. To navigate these challenges, some women sought support by having family members or friends accompany them or by requesting to be seen by a female healthcare provider. Nevertheless, financial dependence on families and women lacking employment and income led to a feeling of burden on the family, contributing to a reluctance among women to seek expensive healthcare. Social organization-based, collaborative efforts and peer support networks played a significant role in breaking down barriers and improving overall healthcare experiences.

Conclusions

While integrating disability-friendly healthcare services and infrastructure is essential, fostering attitudinal and behavioral change—particularly among male healthcare providers—is more important to ensure safety for young women in healthcare settings. The implementation of anti-sexual harassment policies is imperative to ensure a safe and respectful environment. Community mobilizing and peer group-based programs can be tested for increasing visually impaired women’s utilization of relevant healthcare services.

Introduction

Health policies reflect the ideas and interests of the actors involved. The Indian Government constituted many health committees for policy recommendations on myriad issues concerning public health, ranging from tribal health to drug regulation. However, little is known about their composition and backgrounds. We reviewed these committees to map the actors and institutions.

Methods

We elicited information on all relevant health committees available in the public domain. All were constituted post-independence, except two, with recommendations that remain pertinent to date. Data for chairpersons and members - their professions, gender, institutions, and location were extracted and analysed. Reliable online sources were used to collate the information.

Results

We identified 23 national health committees from 1943 to 2020 with available reports. There were 25 chairpersons and 316 members. All except three chairpersons were men. Among members, only 11% were women. The majority (51%) had experience working in health systems; however, most were medical doctors, with negligible representation of other cadres. We noted the centralization of location, with 44% of members based in the national capital of Delhi. Government administrators were maximally represented (55%), followed by medical academia (19%). Post-2000, we have observed slightly improved diversity across some parameters like gender (15% women vs 9% earlier) and affiliation. However, the centralization of the location to the national capital had increased (55% post-2000 vs. 39% pre-2000).

Conclusion

Indian health committees lack diversity in representation from multiple perspectives. Henceforth, health policymakers should prioritize including diverse social, geographical, and health systems actors to ensure equitable policymaking.