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Health improvement and inequality in local authority green infrastructure strategies in England: a policy review. 英格兰地方当局绿色基础设施战略中的健康改善和不平等:政策审查。
IF 3.1 Pub Date : 2026-02-07 DOI: 10.1093/pubmed/fdag006
Angela Hands, Jennifer Israelsson, Nina Reynolds, Elozona Umeh, Peninah Murage, Grace Turner

Introduction: Green spaces are increasingly recognized as critical to public health. This study examines English local planning authorities' green infrastructure strategies, evaluating how health improvement and inequality reduction goals are integrated.

Methods: A quantitative content analysis was conducted on publicly accessible green infrastructure strategy documents. Of 305 potential authorities, 133 (44%) were included based on eligibility criteria. Only strategies published from 2012 onwards were included. Data were coded across themes: health policy and actors, health outcomes, demographics and inequalities, environmental change and health. A scoring system quantified consideration of health and inequality, with descriptive statistics summarizing thematic presence, frequency, regional variation, and temporal trends.

Results: The integration of health and inequality varied substantially. Most strategies referenced general health outcomes, but fewer detailed actions targeting health inequalities or specific demographic groups. Regional differences were observed, and methods for monitoring health impacts were limited.

Conclusion: Local green infrastructure strategies in England increasingly recognize their health improvement potential, but inconsistent integration of health and inequality may limit impact. Stronger collaboration between planning and public health is needed to create equitable, accessible, health-promoting environments. Future research should explore longitudinal health impacts and identify best practices for integrating health equity in spatial planning.

引言:人们越来越认识到绿地对公共健康至关重要。本研究考察了英国地方规划当局的绿色基础设施战略,评估了如何将健康改善和减少不平等的目标结合起来。方法:对可公开获取的绿色基础设施战略文件进行定量内容分析。在305个潜在当局中,133个(44%)根据资格标准被纳入。仅包括2012年以后发布的战略。数据按以下主题编码:卫生政策和行为者、卫生成果、人口统计和不平等、环境变化和健康。一个评分系统量化了对健康和不平等的考虑,用描述性统计总结了专题存在、频率、区域差异和时间趋势。结果:健康与不平等的整合差异很大。大多数战略提到一般健康结果,但针对健康不平等或特定人口群体的详细行动较少。观察到地区差异,监测健康影响的方法有限。结论:英格兰地方绿色基础设施战略越来越认识到其改善健康的潜力,但健康与不平等的不一致整合可能会限制影响。需要加强规划和公共卫生之间的合作,以创造公平、便利和促进健康的环境。未来的研究应探索纵向健康影响,并确定将健康公平纳入空间规划的最佳做法。
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引用次数: 0
Correction to: When love hurts: emotional labor and hidden strains of intimate partner violence in toxic relationships. 修正:当爱受伤:有毒关系中亲密伴侣暴力的情绪劳动和隐藏的压力。
IF 3.1 Pub Date : 2026-02-01 DOI: 10.1093/pubmed/fdag008
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引用次数: 0
What happens beyond the excess weight threshold? Evidence from adult women in India. 超过超重阈值会发生什么?来自印度成年女性的证据。
IF 3.1 Pub Date : 2026-02-01 DOI: 10.1093/pubmed/fdag003
Jaya Jumrani

Background: Overweight and obesity rates have skyrocketed over the last three decades, particularly in developing countries. This study examines the prevalent trends, and spatial and temporal patterns of overweight/obesity among India's adult women.

Methods: Using unit-level data from the National Family Health Surveys (NFHSs), this study examines the extent of overweight/obesity among adult women. Majority of the extant studies in the Indian context focus on a single metric, i.e. headcount ratio. This approach only considers a single cut-off point and ignores the differences beyond this threshold. However, the obesity burden is unlikely to be evenly distributed. To address this, I incorporate measures that explicitly take this into consideration and resort to a distribution-sensitive metric, i.e. the Foster-Greer-Thorbecke index (FGT), to identify the underlying changes in the body mass index (BMI) distribution.

Results: The analysis reveals a consistent increase in most FGT index measures, particularly among urban women. The results suggest that interventions should preferably be group-specific and targeted in nature.

Conclusions: The findings highlight that a distribution-sensitive metric provides a more nuanced understanding of the prevalent inequalities in the BMI distribution. It helps to capture the non-linear health and economic dimensions of the growing overweight or obesity burden in India.

背景:超重和肥胖率在过去三十年中急剧上升,特别是在发展中国家。本研究调查了印度成年女性超重/肥胖的流行趋势和时空模式。方法:利用国家家庭健康调查(NFHSs)的单位数据,本研究调查了成年女性超重/肥胖的程度。在印度的背景下,现有的大多数研究都集中在一个单一的指标上,即员工人数比率。这种方法只考虑一个截止点,而忽略了超出该阈值的差异。然而,肥胖负担不太可能均匀分布。为了解决这个问题,我采用了明确考虑到这一点的措施,并求助于分布敏感指标,即福斯特-格里尔-托贝克指数(FGT),以确定身体质量指数(BMI)分布的潜在变化。结果:分析显示,大多数FGT指数指标持续增长,尤其是在城市女性中。结果表明,干预措施最好是针对特定群体和有针对性的。结论:研究结果强调,分布敏感指标提供了对BMI分布中普遍不平等的更细致的理解。它有助于捕捉印度日益增长的超重或肥胖负担的非线性健康和经济层面。
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引用次数: 0
Correction to: FOMO clouds and vapor trails: the invisible toll of E-cigarettes on youth well-being. 更正:FOMO云和蒸汽痕迹:电子烟对青少年健康的无形影响。
IF 3.1 Pub Date : 2026-01-30 DOI: 10.1093/pubmed/fdag007
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引用次数: 0
Patient, community, and clinician beliefs about multi-cancer detection tests: implications for the evidence needed to recommend routine use. 患者、社区和临床医生对多种癌症检测试验的看法:对推荐常规使用所需证据的影响
IF 3.1 Pub Date : 2026-01-30 DOI: 10.1093/pubmed/fdag001
E Marshall Brooks, Gabriela Villalobos, Carrie A Miller, Rebecca Alemu, Bryan A Bassig, Kendra Rowe, Jennifer F May, Rebecca Kaltman, Patrick Nana-Sinkam, John Sayles, Scott M Strayer, Bernard F Fuemmeler, Cynthia Allen, Alex H Krist

Background: Multi-cancer detection tests (MCDs) have the potential to reduce cancer-related deaths by identifying cancers early when they can be more effectively treated. While initial studies show promise in detecting multiple cancer types, there is a lack of large-scale, prospective trials evaluating their clinical utility and real-world impact.

Methods: We conducted 23 focus groups with 158 participants to identify and describe key stakeholders' perspectives on the benefits and risks of MCD tests. Participants included clinicians (n = 58), patients (n = 17), and community members recruited from partner community advisory boards (n = 83).

Results: Participants recognized the benefits of early cancer detection and the convenience of a single blood test in reducing barriers to cancer screening. However, they shared concerns about insufficient clinical validation for MCD tests and the potential physical and psychological harm that false positives, overdiagnosis, and overtreatment may cause. They also expressed concerns about the financial costs and time burden associated with follow-up care, as well as potential inequities in access and outcomes in underserved communities.

Conclusions: Patients and clinicians want better evidence before routine use of MCD testing for cancer screening. Future research should prioritize rigorous randomized controlled trials that evaluate cancer-mortality, quality of life, diagnostic workup, and potential harms.

背景:多种癌症检测测试(MCDs)有可能通过在癌症可以更有效治疗的早期发现癌症来减少癌症相关的死亡。虽然最初的研究显示出检测多种癌症类型的希望,但缺乏大规模的前瞻性试验来评估其临床效用和现实世界的影响。方法:我们进行了23个焦点小组,共有158名参与者,以确定和描述关键利益相关者对MCD测试的益处和风险的观点。参与者包括临床医生(n = 58)、患者(n = 17)和从合作伙伴社区咨询委员会招募的社区成员(n = 83)。结果:参与者认识到早期癌症检测的好处和单一血液检查在减少癌症筛查障碍方面的便利性。然而,他们对MCD测试的临床验证不足以及假阳性、过度诊断和过度治疗可能导致的潜在生理和心理伤害表示担忧。他们还对与后续护理相关的财务成本和时间负担以及服务不足社区在获取和结果方面的潜在不平等表示关切。结论:在常规使用MCD检测进行癌症筛查之前,患者和临床医生需要更好的证据。未来的研究应优先考虑严格的随机对照试验,以评估癌症死亡率、生活质量、诊断检查和潜在危害。
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引用次数: 0
Child maltreatment and its association with incident irritable bowel syndrome: genetic risk and mediation pathways in the UK biobank. 儿童虐待及其与事件肠易激综合征的关联:遗传风险和调解途径在英国生物银行。
IF 3.1 Pub Date : 2026-01-30 DOI: 10.1093/pubmed/fdag004
Wenya Bai, Yudan Zheng, Shaoli Lin, Yuru Pan, Yiqiang Zhan, Miao Liu

Background: The associations and mediation pathways between child maltreatment and incident irritable bowel syndrome (IBS) remain unclear.

Methods: We carried out the Cox proportional hazard models to explore the associations of child maltreatment and its five subtypes with hazard ratios (HRs) of IBS, and mediation analyses were conducted to assess the roles of obesity, lifestyles, and mental disorders in such associations among participants with different genetic susceptibilities.

Results: Participants who reported two or more subtypes of child maltreatment exhibited the greatest risk of IBS with HR of 1.63 (95% CI: 1.56, 1.70), compared to those who did not suffer child maltreatment. All five subtypes of child maltreatment were associated with elevated incident IBS, particularly emotional abuse with HR of 1.56 (95% CI: 1.49, 1.63). Also, such associations were more evident in those with high genetic risk score (GRS) than the low GRS. Further, obesity, lifestyles (such as smoking, sedentary behavior, sleep duration, and physical activity), and mental disorders mediated the associations of child maltreatment with the incident IBS. Anxiety and depression showed larger mediated proportions, ranging from 10.79% to 22.21% than the mediation of lifestyles.

Conclusion: Child maltreatment and its five subtypes were associated with increased incident IBS, particularly in those with higher genetic predisposition. Obesity, lifestyles and mental disorders played mediated role in such association.

背景:儿童虐待与肠易激综合征(IBS)之间的关联和中介途径尚不清楚。方法:采用Cox比例风险模型,探讨儿童虐待及其5种亚型与IBS风险比(hr)的关系,并通过中介分析,评估肥胖、生活方式和精神障碍在不同遗传易感性参与者的风险比中的作用。结果:报告两种或两种以上儿童虐待亚型的参与者与没有遭受儿童虐待的参与者相比,IBS的风险最高,HR为1.63 (95% CI: 1.56, 1.70)。所有五种儿童虐待亚型均与IBS发生率升高相关,尤其是情绪虐待,风险比为1.56 (95% CI: 1.49, 1.63)。此外,这种关联在遗传风险评分(GRS)高的人群中比GRS低的人群更为明显。此外,肥胖、生活方式(如吸烟、久坐行为、睡眠时间和身体活动)和精神障碍介导了儿童虐待与肠易激综合征的关联。焦虑和抑郁的中介作用比生活方式的中介作用大,在10.79% ~ 22.21%之间。结论:儿童虐待及其五种亚型与IBS发生率增加有关,特别是在遗传易感性较高的儿童中。肥胖、生活方式和精神障碍在其中起中介作用。
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引用次数: 0
Maximizing impact: the power of early HPV vaccination for long-term protection-lessons from a systematic review and meta-regression analysis. 最大化影响:早期HPV疫苗接种对长期保护的作用——来自系统回顾和meta回归分析的经验教训。
IF 3.1 Pub Date : 2026-01-30 DOI: 10.1093/pubmed/fdag002
Adoración Navarro-Torné, Emmanuel Aris, Andrea Callegaro, Bernd Benninghoff, Huifeng Yun, Volker Vetter

Background: This systematic review and meta-regression analysis assessed the impact of human papillomavirus 16/18 (HPV16/18)-AS04 vaccine (Cervarix®) on advanced cervical lesions, including grade 3 cervical intraepithelial neoplasia or worse (CIN3, CIN3+), or cervical cancer, highlighting age-at-vaccination-dependent vaccine efficacy and effectiveness.

Methods: Studies reporting HPV16/18-AS04 vaccine efficacy or effectiveness were included with an intervention group receiving HPV16/18-AS04 vaccine and comparator group receiving placebo, another vaccine or being unvaccinated. Of 53 articles identified, nine were selected. Meta-analysis and meta-regression models with random effects and data-driven model selection determined vaccine effects (VEs) and impactful covariates.

Results: HPV16/18-AS04 vaccine effectively prevented advanced cervical premalignant lesions and cancer in adolescent girls and women vaccinated at 12-25 years. Combined randomized controlled trials and observational studies VEs on CIN3+ ranged between 76.78% (95% CI 28.15-92.49) for HPV16/18 and 56.19% (95% CI 24.76-74.49) irrespective of HPV type. Vaccine effectiveness was greatest in those vaccinated at the youngest ages.

Conclusions: HPV16/18-AS04 vaccine provides long-term protection against cervical premalignant lesions and cervical cancer in both controlled and real-world settings, particularly when administered at younger ages. The evidence urges policymakers and the community to ensure HPV vaccination begins at the youngest recommended ages.

背景:本系统综述和荟萃回归分析评估了人乳头瘤病毒16/18 (HPV16/18)-AS04疫苗(Cervarix®)对晚期宫颈病变(包括3级宫颈上皮内瘤变或更严重(CIN3、CIN3+)或宫颈癌)的影响,强调了疫苗接种年龄依赖性疫苗的疗效和有效性。方法:将报告HPV16/18-AS04疫苗疗效或有效性的研究纳入干预组,对照组接种HPV16/18-AS04疫苗,对照组接种安慰剂、其他疫苗或未接种疫苗。在鉴定的53篇文章中,选择了9篇。具有随机效应和数据驱动模型选择的元分析和元回归模型确定了疫苗效应(VEs)和有影响的协变量。结果:HPV16/18-AS04疫苗可有效预防12-25岁少女和妇女宫颈癌晚期癌前病变和癌症。无论HPV类型如何,联合随机对照试验和观察性研究对HPV16/18的CIN3+的影响范围为76.78% (95% CI 28.15-92.49)和56.19% (95% CI 24.76-74.49)。在最年轻的年龄接种疫苗的人,疫苗的有效性最高。结论:HPV16/18-AS04疫苗在对照和现实环境中对宫颈癌前病变和宫颈癌提供长期保护,特别是在年轻时接种。证据敦促政策制定者和社区确保在最年轻的推荐年龄开始接种HPV疫苗。
{"title":"Maximizing impact: the power of early HPV vaccination for long-term protection-lessons from a systematic review and meta-regression analysis.","authors":"Adoración Navarro-Torné, Emmanuel Aris, Andrea Callegaro, Bernd Benninghoff, Huifeng Yun, Volker Vetter","doi":"10.1093/pubmed/fdag002","DOIUrl":"https://doi.org/10.1093/pubmed/fdag002","url":null,"abstract":"<p><strong>Background: </strong>This systematic review and meta-regression analysis assessed the impact of human papillomavirus 16/18 (HPV16/18)-AS04 vaccine (Cervarix®) on advanced cervical lesions, including grade 3 cervical intraepithelial neoplasia or worse (CIN3, CIN3+), or cervical cancer, highlighting age-at-vaccination-dependent vaccine efficacy and effectiveness.</p><p><strong>Methods: </strong>Studies reporting HPV16/18-AS04 vaccine efficacy or effectiveness were included with an intervention group receiving HPV16/18-AS04 vaccine and comparator group receiving placebo, another vaccine or being unvaccinated. Of 53 articles identified, nine were selected. Meta-analysis and meta-regression models with random effects and data-driven model selection determined vaccine effects (VEs) and impactful covariates.</p><p><strong>Results: </strong>HPV16/18-AS04 vaccine effectively prevented advanced cervical premalignant lesions and cancer in adolescent girls and women vaccinated at 12-25 years. Combined randomized controlled trials and observational studies VEs on CIN3+ ranged between 76.78% (95% CI 28.15-92.49) for HPV16/18 and 56.19% (95% CI 24.76-74.49) irrespective of HPV type. Vaccine effectiveness was greatest in those vaccinated at the youngest ages.</p><p><strong>Conclusions: </strong>HPV16/18-AS04 vaccine provides long-term protection against cervical premalignant lesions and cervical cancer in both controlled and real-world settings, particularly when administered at younger ages. The evidence urges policymakers and the community to ensure HPV vaccination begins at the youngest recommended ages.</p>","PeriodicalId":94107,"journal":{"name":"Journal of public health (Oxford, England)","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146088651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Racism and racial health inequity: four theories for public health. 种族主义与种族健康不平等:公共健康的四种理论。
IF 3.1 Pub Date : 2026-01-30 DOI: 10.1093/pubmed/fdag005
Caroline Parker, Adeola Agbebiyi, Aine Fuller, Maddy Gupta-Wright, Sandra Husbands, John Licorish, Safia Marcano, Lee Pinkerton, Anne Pordes Bowers, Melissa Parker
{"title":"Racism and racial health inequity: four theories for public health.","authors":"Caroline Parker, Adeola Agbebiyi, Aine Fuller, Maddy Gupta-Wright, Sandra Husbands, John Licorish, Safia Marcano, Lee Pinkerton, Anne Pordes Bowers, Melissa Parker","doi":"10.1093/pubmed/fdag005","DOIUrl":"https://doi.org/10.1093/pubmed/fdag005","url":null,"abstract":"","PeriodicalId":94107,"journal":{"name":"Journal of public health (Oxford, England)","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146088620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Lessons to be learned: a retrospective study of MBRRACE-UK perinatal mortality surveillance (2015-2024) to identify maternity services most consistently reporting higher- and lower-than-average deaths. 经验教训:对MBRRACE-UK围产期死亡率监测(2015-2024年)进行回顾性研究,以确定最一致报告死亡率高于和低于平均水平的产妇服务。
IF 3.1 Pub Date : 2026-01-15 DOI: 10.1093/pubmed/fdaf145
Pauline McDonagh Hull, Tiffany Boulton, Bonnie Lashewicz

Background: This study aimed to identify maternity services in England that most consistently reported both higher-than-average and lower-than-average rates of extended perinatal mortality (EPM), including stillbirths and neonatal deaths, throughout the government's decade-long National Maternity Safety Ambition to halve the rate of stillbirths and neonatal deaths.

Methods: We conducted a retrospective study of MBRRACE-UK Perinatal Mortality Surveillance Reports (2015-2024) to compare EPM rates for births occurring in 121 organizations providing maternity services in England between 2013 and 2022. Utilizing MBRRACE-UK definitions and designations, we devised a scoring method to determine which organizations most consistently reported higher-than-average and lower-than-average deaths.

Results: We identified 10 organisations providing maternity services (8.3%) with the five highest scores and 15 (12.4%) with the five lowest scores. A total of 20 organisations (16.5%) reported higher-than-average deaths in ≥80% of MBRRACE-UK reports and/or each of the past five years, and 22 (18.2%) reported lower-than-average deaths. Strong indications of a North-South divide for EPM were evident.

Conclusions: We provide evidence of regional EPM variation over the past decade, building on previous study findings of a North-South mortality divide in England. We propose that shared learning between outlier maternity services has the potential to ameliorate avoidable harm.

背景:本研究旨在确定英国的产科服务,在政府长达十年的国家生育安全雄心中将死产和新生儿死亡率减半的过程中,最一致地报告了高于平均水平和低于平均水平的延长围产期死亡率(EPM),包括死产和新生儿死亡。方法:我们对MBRRACE-UK围产期死亡率监测报告(2015-2024)进行了回顾性研究,比较2013年至2022年期间英格兰121家提供产科服务的组织的分娩EPM率。利用MBRRACE-UK的定义和名称,我们设计了一种评分方法,以确定哪些组织最一致地报告高于平均水平和低于平均水平的死亡率。结果:我们确定了10个提供产妇服务的组织(8.3%),其中五个得分最高,15个(12.4%)得分最低。共有20个组织(16.5%)在MBRRACE-UK报告的≥80%和/或过去五年中报告的死亡率高于平均水平,22个组织(18.2%)报告的死亡率低于平均水平。有明显的迹象表明,南北在环境保护方案方面存在分歧。结论:我们提供了证据的区域EPM变化在过去的十年中,建立在以前的研究结果的南北死亡率差距在英格兰。我们建议,在异常产科服务之间共享学习有可能改善可避免的伤害。
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引用次数: 0
Dynamics of public health messaging and healthcare activity in children during the 2022 iGAS surge: an observational study in England. 2022年iGAS激增期间儿童公共卫生信息和保健活动的动态:英国的一项观察性研究
IF 3.1 Pub Date : 2026-01-12 DOI: 10.1093/pubmed/fdaf163
Alexandra L Creavin, Ruth Kipping, Alastair D Hay

Background: Public health messaging during infectious disease outbreaks can influence healthcare demand. The winter 2022 surge in Group A Streptococcus (GAS) in England provided an opportunity to examine the relationship between communications and National Health Service (NHS) activity, informing future strategies for resilience and risk communication.

Methods: This observational study analysed UK Health Security Agency (UKHSA) invasive GAS (iGAS) notifications, NHS 111, General Practice (GP), and emergency department (ED) surveillance data, prescription records, internet searches, and media reports. Temporal associations were assessed descriptively, with weekly differences from winter averages calculated.

Results: Following initial media reports and UKHSA messaging, internet search interest rose sharply (4%-63%). In the subsequent week, there were increases in NHS 111 contacts (fevers +256%, sore throats +953%), acute respiratory infection ED visits (+155%), GP pharyngitis consultations (+356%), and community penicillin prescriptions (+134%) compared to winter averages. Compared to the previous week, consultations for scarlet fever declined.

Conclusions: This is the first study to link outbreak communications with system-wide NHS activity in real time. Messaging likely prompted appropriate care-seeking, but the rapid return to baseline and the low predictive value of consultations for iGAS suggest that many were for self-limiting illness. Findings highlight the need for tailored messaging, interdisciplinary collaboration, and scalable healthcare capacity during outbreaks.

背景:传染病暴发期间的公共卫生信息传递可以影响医疗保健需求。2022年冬季英格兰A群链球菌(GAS)的激增为研究通信与国家卫生服务(NHS)活动之间的关系提供了机会,为未来的弹性和风险沟通战略提供了信息。方法:本观察性研究分析了英国卫生安全局(UKHSA)侵入性气体(iGAS)通知、NHS 111、全科医生(GP)和急诊科(ED)监测数据、处方记录、互联网搜索和媒体报道。描述性地评估了时间关联,计算了与冬季平均值的周差异。结果:在最初的媒体报道和UKHSA消息之后,互联网搜索兴趣急剧上升(4%-63%)。在随后的一周,与冬季平均水平相比,NHS 111接触(发烧+256%,喉咙痛+953%),急性呼吸道感染急诊(+155%),全科医生咽炎咨询(+356%)和社区青霉素处方(+134%)增加。与前一周相比,猩红热的咨询减少了。结论:这是第一个将疫情传播与全系统的NHS活动实时联系起来的研究。信息传递可能会促使人们寻求适当的护理,但iGAS咨询的快速回归基线和低预测价值表明,许多人是针对自限性疾病。调查结果强调了疫情期间需要定制消息传递、跨学科协作和可扩展的医疗保健能力。
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引用次数: 0
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Journal of public health (Oxford, England)
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