BACKGROUND At present,China has become the country with the largest number of individuals with diabetes mellitus(DM)in the world,with a total of approximately 140 million patients,the majority of whom have type 2 DM(T...BACKGROUND At present,China has become the country with the largest number of individuals with diabetes mellitus(DM)in the world,with a total of approximately 140 million patients,the majority of whom have type 2 DM(T2DM).Based on conven-tional nursing methods,community home care has important clinical significance in controlling blood sugar and disease progression.AIM To explore the impact of community public health nursing on treatment effect,health cognition,and self-management in patients with T2DM.METHODS One hundred patients with T2DM were selected as the research subjects.The patients were divided into either a conventional nursing group or community nursing(CN)group using the random number table method.The conventional nursing group(50 cases)received routine care,while the CN group(50 cases)received community public health care in addition to routine care as that for the conventional nursing group.The rate of excellent and good blood glucose control,fasting blood glucose before and after care,2-h postprandial blood glucose,health cognition,and self-management ability,and patient satisfaction were compared between the two groups.RESULTS The CN group had a higher rate of excellent blood sugar control than the conventional nursing group(88%vs 70%,P<0.05).Before care,there was no significant difference in fasting blood glucose or 2-h postprandial blood glucose between the two groups of patients(P>0.05).After nursing,fasting blood glucose and 2-h postprandial blood glucose were reduced to varying degrees in both groups,and both blood glucose levels in the CN group were lower than those of the conventional nursing group(P<0.05).Compared with the scores before care,the cognitive level score for diabetes and self-management ability score improved after care in both groups.The cognitive level and self-management ability of patients in the CN group were higher than those of the conventional nursing group(P<0.05).The overall satisfaction of the CN group was better than that of the conventional nursing group(98%vs 86%,P<0.05).CONCLUSION Community public health care based on conventional care of T2DM can achieve better blood sugar control,and improve patients’health cognitive level and self-management ability.展开更多
Objective: This study aims to analyze the distribution of positive human papillomavirus (HPV) infections among women of appropriate age in Beiliu City during cervical cancer screening in 2024, providing data support f...Objective: This study aims to analyze the distribution of positive human papillomavirus (HPV) infections among women of appropriate age in Beiliu City during cervical cancer screening in 2024, providing data support for subsequent public health interventions. Methods: A retrospective analysis was conducted on the HPV test results from January 1, 2024, to November 30, 2024, at Beiliu Maternal and Child Health Hospital. We statistically analyzed the positive rates of different HPV genotypes and the co-infection status of multiple genotypes. Results: A total of 7558 individuals were tested, with 1103 positive cases identified, resulting in a positivity rate of 14.59%. Among these, HPV type 52 had the highest positive rate, accounting for 18.47%. The co-infection analysis showed that there were 788 cases with single genotype positivity, 236 with double genotype positivity, and 58 with triple genotype positivity, while cases with multiple genotypes simultaneously positive were relatively rare. Conclusion: The HPV infection rate among women of appropriate age in Beiliu City is relatively high, especially for high-risk HPV types. To reduce the future incidence of cervical cancer, it is recommended to enhance health education and vaccination efforts for this population.展开更多
BACKGROUND Oesophageal cancer is a significant health concern worldwide,with high inci-dence and mortality rates.In China,the disease burden is particularly high,accounting for a substantial proportion of oesophageal ...BACKGROUND Oesophageal cancer is a significant health concern worldwide,with high inci-dence and mortality rates.In China,the disease burden is particularly high,accounting for a substantial proportion of oesophageal cancer cases and related deaths worldwide.AIM To explore the relationship between the mortality rate of oesophageal cancer patients and insurance type,out-of-pocket ratio,and the joint effects of insurance type and out-of-pocket ratio.METHODS The χ^(2) test was used to analyze patients’demographic and clinical characteristics.Multivariate logistic regression,the Cox proportional hazard model,and the competitive risk model were used to calculate the cumulative hazard ratios(HRs)of all-cause death and oesophageal cancer-specific death among patients with different types of insurance and out-of-pocket ratios.RESULTS Compared with patients covered by basic medical insurance for urban and rural residents,patients covered by urban employee basic medical insurance for urban workers(UEBMI)had a 23.30%increased risk of oesophageal cancer-specific death[HR=1.233,95%confidence interval(CI):1.093-1.391,P<0.005].Compared with patients in the low out-of-pocket ratio group,patients in the high out-of-pocket ratio group had a 25.80%reduction in the risk of oesophageal cancer-specific death(HR=0.742,95%CI:0.6555-0.84,P<0.005).With each 10%increase in the out-of-pocket ratio,the risk of oesophageal cancer-specific death decreased by 10.10%in patients covered by UEBMI.However,the risk of oesophageal cancer-specific death increased by 26.90%in patients in the high out-of-pocket ratio group.CONCLUSION This study reveals the relationships of the specific mortality rate of patients with oesophageal cancer with the out-of-pocket ratio and medical insurance types as well as their combined effects.This study provides practical suggestions and guidance for the formulation of relevant policies in this area.展开更多
Objective:Gambling is a complex topic in relation to health systems.It is always unclear how to strike a balance between the gambling economy and the impact of gambling on public health or social wellbeing at any age....Objective:Gambling is a complex topic in relation to health systems.It is always unclear how to strike a balance between the gambling economy and the impact of gambling on public health or social wellbeing at any age.There are limited studies considering the association between determinants of gambling and the life expectancy of the ageing population in a country.From an evaluation perspective,this article aims to demonstrate the correlation between life expectancy and gambling and public health systems.Methods:The approach of analysis has two parts.One is the influence of gambling prevalence in populations on life expectancy among old adults.Another is the association between the effect of changes in legal gambling provisions within public health systems and life expectancy among old adults.Healthy adjusted life expectancy at age 60 from the World Health Organization and gross gambling yield were used.ANOVA was performed with SPSS.Results:The population groups with HALE at age 60 of 15 years or over are likely more active in gambling than the population groups with smaller HALE at age 60 of 14 years or less.On the other hand,the influence of a health policy may be sidelined when it is implemented for older adult populations because the resource distribution magnitude or number of strategical techniques may not be the same for younger adult populations.The study here is marked as a good practical start,and there is room for further research with big data analysis on additional gambling variables against other life expectancy variables,quality of life variables or public health system variables.Conclusion:Associations between the determinants of gambling and the life expectancy of the ageing population in a country have not yet been identified.Continuous measurements of policy implementation and effectiveness and assessments of health equity,while gambling policies worldwide continue to change,have not yet been performed.Researchers and policy makers should understand the importance of holistic integration of the gambling economy and policy within a public health and social paradigm with the help of big data insights to achieve sustainability in their cities and health equity in their communities.展开更多
We construct a dual-layer coupled complex network of communities and residents to represent the interconnected risk transmission network between communities and the disease transmission network among residents. It cha...We construct a dual-layer coupled complex network of communities and residents to represent the interconnected risk transmission network between communities and the disease transmission network among residents. It characterizes the process of infectious disease transmission among residents between communities through the SE2IHR model considering two types of infectors. By depicting a more fine-grained social structure and combining further simulation experiments, the study validates the crucial role of various prevention and control measures implemented by communities as primary executors in controlling the epidemic. Research shows that the geographical boundaries of communities and the social interaction patterns of residents have a significant impact on the spread of the epidemic, where early detection, isolation and treatment strategies at community level are essential for controlling the spread of the epidemic. In addition, the study explores the collaborative governance model and institutional advantages of communities and residents in epidemic prevention and control.展开更多
Background:With public health emergencies(PHE)worldwide increasing,the perceived risk of PHE has been one of the critical factors influencing college students’psychological distress.However,the mechanisms by which th...Background:With public health emergencies(PHE)worldwide increasing,the perceived risk of PHE has been one of the critical factors influencing college students’psychological distress.However,the mechanisms by which the perceived risk of PHE affects college students’psychological distress are not clear.The study’s purpose was to investigate the mediation roles of deviation from a balanced time perspective(DBTP)and negative coping styles between the perceived risk of PHE and psychological distress.Methods:A convenience sampling method was used to survey 1054 Chinese college students with self-reporting.Data was collected using the Public Risk Perception Scale(PRPS),the Zimbardo Time Perspective Inventory(ZTPI),the Simplified Coping Style Questionnaire(SCSQ),the PHE Anxiety Scale,and the Chinese version of the Patient Health Questionnaire(PHQ).The associations between the perceived risk of PHE,DBTP,negative coping styles,and psychological distress were clarified using the correlation analysis.Additionally,the mediating roles of DBTP and negative coping styles between the perceived risk of PHE and psychological distress were investigated using a structural equation model.Results:The findings revealed low to moderate correlations between the variables studied.Students’perceived risk of PHE was a positive predictor of their psychological distress(b=0.219,p<0.01).DBTP and negative coping styles played chain mediation roles between them with the effect being 0.009 and a 95%Boot CI of[0.003,0.023].This chain mediation model had an excellent fit index(χ^(2)/df=4.732,CFI=0.973,TLI=0.930,RMSEA=0.048,SRMR=0.047).Conclusion:These findings showed how the perceived risk of PHE affected college students’psychological distress.Specifically,these results suggested that improving students’mental ability to switch effectively among different time perspectives depending on task features and situational considerations and reducing their negative coping styles might be effective ways to promote their mental health.展开更多
The results of scientific studies of human social facts in the field of health show that the management of a patient should involve the patient’s entourage,whatever the status or size of the health establishment.In h...The results of scientific studies of human social facts in the field of health show that the management of a patient should involve the patient’s entourage,whatever the status or size of the health establishment.In healthcare establishments in the Congo,the following are recognised as being responsible for medical care:specialist doctors,doctors,midwives,nurses and care assistants.The patient’s family and close friends are responsible for looking after the patient and financing care.The hospital infrastructure does not provide any space for the patient warden who accompany the patient during reception and hospitalisation.This makes Congolese hospitals inefficient for patient care.How can we integrate the function of the Sick guard and the assistance of the family,in order to reduce the mortality rate and repair the harm caused to patients requiring the presence of relatives during their stay in hospital,which is considered to be a dangerous place?This article examines the functional principles for configuring the space that patient warden would occupy in the patient care system.On the basis of a documentary analysis of sociological and architectural studies of existing facilities,this article proposes a typical accommodation model with the spaces needed to ensure the well-being and effectiveness of the patient warden with the patient.These are rooms with minimum space for 2 to 4 individual beds,equipped with toilets and showers.The accommodation has a dining area,kitchen and laundry facilities.In the future,this accommodation will become part of the hospital estate and may be occupied by orderlies and patient warden recruited by the hospital administration.展开更多
In recent years,the compact development of high-density cities has sparked ongoing interest in healthy urban environments and public well-being.This study examines the relationship between cycling behaviors and the bu...In recent years,the compact development of high-density cities has sparked ongoing interest in healthy urban environments and public well-being.This study examines the relationship between cycling behaviors and the built environment of streets in Tiantongyuan Community,a typical high-density area in Beijing,China.By observing street spaces and summarizing residents’travel modes and behaviors,the study evaluates the impact of street design on cycling habits.In order to reveal the riding behavior characteristics of residents in different time periods and different street spaces,tools such as track recording APPs and the Gopro Motion Camera are employed to collect street view pictures and riding track data comprehensively,analyzing the various travel purposes of residents in Tiantongyuan community and the riding OD activity tracks of the main entrances and exits of the community.Meanwhile,by conducting the questionnaire survey of residents’travel demands and OD data of about:blank,and utilizing geographic information system(GIS)for data visualization,this study further investigates the distribution characteristics of cycling hotspots,cycling paths and cycling space,accurately identifies the cycling life circle of this community based on the spatial and temporal scales,and further puts forward the optimization strategy of the cycling network.Some cycling-friendly street space optimization strategies are suggested to deeply analyze the mechanism of the built environment of street space in high-density communities on the cycling activities and health of urban residents,with a view to provide accurate data support for the renewal of street cycling space.展开更多
The important role of greenway non-mortorized systems in urban sustainable development was summarized,pointing out their potential value in improving the ecological environment,promoting healthy living,and enhancing c...The important role of greenway non-mortorized systems in urban sustainable development was summarized,pointing out their potential value in improving the ecological environment,promoting healthy living,and enhancing community connections.Based on the analysis on some cases of urban greenway construction in China,specific transformation models and strategies were proposed for greenway construction,which could integrate green spaces with non-mortorized system,so as to enhance the comprehensive efficiency of urban linear spaces.展开更多
This commentary delves into the evolving landscape of cancer incidence and mortality in Costa Rica, presenting a comprehensive analysis of the data. Key findings reveal a concerning upward trajectory in cancer inciden...This commentary delves into the evolving landscape of cancer incidence and mortality in Costa Rica, presenting a comprehensive analysis of the data. Key findings reveal a concerning upward trajectory in cancer incidence rates, placing Costa Rica at the forefront within Central America. While prostate cancer and breast cancer dominate, disparities emerge when scrutinizing gender-specific trends. Notably, stomach and cervical cancers show declines, potentially attributed to targeted interventions. However, colorectal and liver cancers witness mortality increases, necessitating strategic responses. Geographical disparities persist across provinces, highlighting the need for equitable healthcare access. In conclusion, this commentary underscores the urgency of addressing the burgeoning cancer burden in Costa Rica, calling for evidence-based interventions and collaborative efforts on a global scale.展开更多
Introduction: Benin was embarked on phase 3 of the REDISSE Benin project (Regional Disease Surveillance Systems Enhancement) which began in 2018. The objectives were in five key components namely, Surveillance and hea...Introduction: Benin was embarked on phase 3 of the REDISSE Benin project (Regional Disease Surveillance Systems Enhancement) which began in 2018. The objectives were in five key components namely, Surveillance and health information;Laboratory capacity building;Emergency preparedness and response;Human resources management for effective disease surveillance and epidemic preparedness;and Institutional Capacity Building, Project Management, Coordination and Advocacy. After five years of implementation, this study aimed at the documentation of lessons learned and best practices. Methods: A descriptive cross-sectional study. Apart from individual semi-structured interviews, a thematic workshops bringing together the project’s main stakeholders recruited on an exhaustive way by component to identify and validate lessons learned, good practices and propose improvement mechanisms to be taken into account by the sector. Criteria were set up and used to validate best practices and lessons learned. Results: A total 54 (Surveillance workshop), 47 (Preparedness & response workshop), 53 (Human Resources workshop), 26 (Laboratories workshop) participated to the thematic workshops, and five interviews. The good practices (33: 9 for animal health, 7 for human health and 17 crosscutting) and lessons learned (10: 3 for animal health and 7 for human health) have been identified and have been the subject, depending on the case, of proposals for improvement or conditions necessary for their maintenance. Discussion: The richness of a project lies not only in the immediate achievement of its results, but also and above all, in its usefulness for similar interventions, whether in the local, regional, national or international context. It is in this context that the REDISSE project has set out to make public the various lessons learned and best practices from the implementation of its activities over a period of some five consecutive years.展开更多
Recent research has emphasized the growing use of artificial intelligence (AI) in public health communication. However, the effectiveness of AI in developing and implementing culturally sensitive health communication ...Recent research has emphasized the growing use of artificial intelligence (AI) in public health communication. However, the effectiveness of AI in developing and implementing culturally sensitive health communication strategies is poorly understood. The complexity of cultural diversity in public health communication prompted a scoping review to systematically examine existing research on the use of AI in developing and implementing culturally sensitive health communication strategies that promote cultural responsiveness and enhance public health. The present study employed a scoping review methodology in line with the Arksey and O’Malley framework and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. Data were collected from published studies from MEDLINE (PubMed), Scopus, and Google Scholar in the last five years. From the 933 studies initially identified, screening yielded 15 relevant articles spanning 2019 to 2024, assessing AI’s impact of AI across diverse geographical contexts, such as the USA, UK, and China. These studies affirm AI’s efficacy of AI in crafting public health messages that incorporate cultural nuances and ensure anonymity, thus addressing the specific needs of racially minoritized communities. However, varying levels of acceptance are often influenced by ethical concerns, resulting in low trust and patient acceptance of AI for culturally responsive communication in public health care. This scoping review underscores a significant uptick in AI-driven approaches to culturally sensitive public health communication. Despite notable advancements, the body of empirical evidence is limited and primarily focuses on AI systems with minimal decision-making autonomy. Persistent challenges in user acceptance, especially within culturally sensitive settings, indicate that cultural sensitivity and trust-building are pivotal for the successful integration of AI in public health messaging. These findings necessitate further research to deepen the understanding and enhance the effective deployment of AI in diverse cultural contexts.展开更多
In Laos,rates of undernutrition,especially among children under 5 years of age,remain high.In response,a large multidisciplinary team embarked on a multi-year project in Laos beginning in 2019 with the purpose of inst...In Laos,rates of undernutrition,especially among children under 5 years of age,remain high.In response,a large multidisciplinary team embarked on a multi-year project in Laos beginning in 2019 with the purpose of institutional strengthening around public health nutrition research.This paper summarizes the Applied Nutrition Research Capacity Building project’s activities,immediate project results,and prospects for sustaining impacts into the future.Eight primary activities were undertaken,including back-office strengthening,mentored research,and curriculum review and development.Requested training and skill development in areas related to public health nutrition,anthropometry,and research methods reached more than 1000 professionals.The first edition of a Lao-English Nutrition Glossary was produced,as was the country’s first National Nutrition Research Agenda,a document which sets locally-identified priorities for future research.Project success was achieved by focusing on the priorities of project partners and the Lao government,as articulated in the Lao National Nutrition Strategy and Action Plan.Project design elements that could guide similar efforts undertaken elsewhere include multi-year engagement,an emphasis on sustained peer mentorship,and the use of an extended period of pre-planning in collaboration with project stakeholders prior to the start of activities.展开更多
Background Infectious diseases persistently pose global threats,and it is imperative to accelerate the profession-alization of public health workforce.This study aimed to develop and validate the infectious disease co...Background Infectious diseases persistently pose global threats,and it is imperative to accelerate the profession-alization of public health workforce.This study aimed to develop and validate the infectious disease control compe-tency scale(IDCCS)for public health professionals to fill a theoretical gap and elevate practical capabilities by inform-ing public health professionals’development goals.Methods The initial item pool was generated through a literature review,and categorized into three dimensions(knowledge,practical skills,and leadership)based on the competency iceberg model and public health leadership framework.A two-round Delphi process was conducted to determine indicators within the scale.A pilot survey was utilized for item analysis and exploratory factor analysis(EFA).A formal survey was employed for confirmatory fac-tor analysis(CFA).The weight value of each indicator was calculated using the analytic hierarchy process.Results An initial scale with three primary items,14 secondary items,and 81 tertiary items was generated.Twenty experts participated in the two rounds of the Delphi process.Authority coefficients exceeded 0.9 in both rounds.Kendall’s W was 0.29 and 0.19,respectively(both P<0.001).Item analysis presented a Cronbach’s Alpha of 0.98,with corrected item-total correlation coefficients ranging from 0.33 to 0.78.EFA demonstrated that cumulative vari-ance explanations for the four primary dimensions(knowledge,practical skills,leadership,and personal quality)were 77.463%,73.976%,81.174%,and 68.654%,respectively.CFA indicated that all composite reliability values and aver-age variance extracted surpassed 0.8 and 0.5,respectively.The standardized factor loadings of the items ranged from 0.630 to 0.977.Among the seven model fit indices,each of the four dimensions satisfied at least five criteria.A final three-level scale comprising four primary items,14 secondary items,and 64 tertiary items was constructed.The weight values for the four primary items were 0.4064,0.2878,0.2082,and 0.0981,respectively.Conclusions The IDCCS was established to evaluate the competencies of knowledge,practical skills,leadership,and personal quality for public health professionals in infectious disease control.This scale demonstrates good reliability and validity,and can be used for performance evaluation,recruitment processes,curriculum development,and individual self-assessment.展开更多
COVID-19,as one of the most serious sudden public health problems in this century,is a serious threat to people’s mental health.College students,as a vulnerable group,are more likely to develop mental health problems...COVID-19,as one of the most serious sudden public health problems in this century,is a serious threat to people’s mental health.College students,as a vulnerable group,are more likely to develop mental health problems.When the body is unable to adapt to new changes in the environment,the main mental health problem that arises is adjustment disorder.The aim of this study was to assess the prevalence and influencing factors of adjustment disorder among college students during the COVID-19 outbreak in China.Cross-sectional data collected by web-based questionnaires were obtained through convenience sampling and snowball sampling between March 07,2023 and March 14,2023.The online self-report questionnaire included measures of demographic characteristics,the International Adjustment Disorder Questionnaire(IADQ),and the Influencing Factors Scale.Data were analyzed through structural equation modeling.A total of 394 valid samples(55.33%female)were collected in this study,approximately 75.63%of college students had a confirmed diagnosis of COVID-19 and 28.68%of college students had an adjustment disorder.There was no significant difference between the different demographic characteristics and the prevalence of adjustment disorder,and almost all demographic characteristics had a high prevalence of adjustment disorder.Structural equation modeling revealed that physiological impact(^b=0.077),psychological impact(^b=0.626)and potential impact(^b=0.106)of the sudden COVID-19 outbreak had a significant positive effect on the prevalence of adjustment disorder.The prevalence of adjustment disorder among college students is increased under the outbreak of COVID-19.The government should provide psychosocial support and mental health services for college students while also paying attention to potential factors such as stressors to reduce the adverse effects of outbreaks.展开更多
Objective:The occurrence of some public health events inevitably endangers medical personnel,and medical personnel,as a special group,have to resume work on time to treat patients.This coronavirus disease-2019(COVID-1...Objective:The occurrence of some public health events inevitably endangers medical personnel,and medical personnel,as a special group,have to resume work on time to treat patients.This coronavirus disease-2019(COVID-19)infection is a good example,and what intensive care unit(ICU)nurses experience as the primary caregivers of critically ill patients after COVID-19 infection is our focus.To explore the work experience of ICU nurses after recovery from COVID-19,and to provide a theoretical basis for the intervention to improve the physical and mental health level and work experience of special workers in public health emergencies.Methods:We conducted an explorative descriptive study using an inductive thematic analysis.Using the maximum differential sampling method,a semi-structured interview was conducted among 13 ICU nurses suffered from COVID-19 in a tertiary grade A hospital in Qingdao,Shandong Province.This study carried on the theme analysis according to the inductive content analysis method and used MAXQDA 2020 Analytics Pro(VERBI Software GmbH,Berlin,Germany)to manage and summarize the interview data.Results:After being infected by the virus,SARS-Coronavirus-2(SARS-CoV-2),the pathogen of COVID-19,the work experience of ICU nurses was extracted from the following 5 themes:(1)Stress and challenge caused by the change of work focus;(2)downsizing,overtime,taking up work with illness,and physical discomfort;(3)dedication and family debt;(4)unknown fear and helplessness;and(5)professional responsibility and sense of benefit.Conclusions:Under the pressure of COVID-19,ICU nurses face multiple pressures and challenges,and their emotions are complex.We suggest that nursing managers should take corresponding measures to alleviate nurses'physical and psychological pressure and improve their work experience.展开更多
The coronavirus disease 2019(COVID-19)pandemic is challenging the current public health emergency response systems(PHERSs)of many countries.Although environmental factors,such as those influencing the survival of viru...The coronavirus disease 2019(COVID-19)pandemic is challenging the current public health emergency response systems(PHERSs)of many countries.Although environmental factors,such as those influencing the survival of viruses and their transmission between species including humans,play important roles in PHERSs,little attention has been given to these factors.This study describes and elucidates the roles of environmental factors in future PHERSs.To improve countries’capability to respond to public health emergencies associated with viral infections such as the COVID-19 pandemic,a number of environmental factors should be considered before,during,and after the responses to such emergencies.More specifically,to prevent pandemic outbreaks,we should strengthen environmental and wildlife protection,conduct detailed viral surveillance in animals and hotspots,and improve early-warning systems.During the pandemic,we must study the impacts of environmental factors on viral behaviors,develop control measures to minimize secondary environmental risks,and conduct timely assessments of viral risks and secondary environmental effects with a view to reducing the impacts of the pandemic on human health and on ecosystems.After the pandemic,we should further strengthen surveillance for viruses and the prevention of viral spread,maintain control measures for minimizing secondary environmental risks,develop our capability to scientifically predict pandemics and resurgences,and prepare for the next unexpected resurgence.Meanwhile,we should restore the normal life and production of the public based on the“One Health”concept,that views global human and environmental health as inextricably linked.Our recommendations are essential for improving nations’capability to respond to global public health emergencies.展开更多
Turkey launched a project in 2003 known as ＂Health Transformation Programme＂ （HTP）, which enabled Turkey to make considerable progress and radical changes to the health care system. The programme in 2003 included ...Turkey launched a project in 2003 known as ＂Health Transformation Programme＂ （HTP）, which enabled Turkey to make considerable progress and radical changes to the health care system. The programme in 2003 included the effectiveness and the efficiency factors within the process by setting them as the primary objectives to increase the health status of the population （effectiveness） and to use resources in the best possible manner and at the lowest possible cost （efficiency）. Accessing services according to the need of patients and state benefits according to their ability to pay would be viable under these objectives. In this study, initially, Turkish National Health System will be articulated on a literature-study basis approach to measure the efficiency of public expenditure on health. Then, the measured level of the efficiency will be analysed in Turkey, The paper serves a purpose to analyse the efficiency based on the outcomes of heath service such as satisfaction with public health services over the period of 2003-2013. A simple linear regression was employed to test the degree of statistical relation between public health expenditure and satisfaction with public health care services.展开更多
Ten hepatitis B virus （HBV） genotypes （A-J） and 34 HBV subgenotypes have been identified so far. HBV genotypes and subgenotypes have distinct geographical distributions, and have been shown to differ with regard t...Ten hepatitis B virus （HBV） genotypes （A-J） and 34 HBV subgenotypes have been identified so far. HBV genotypes and subgenotypes have distinct geographical distributions, and have been shown to differ with regard to clinical outcome, prognosis, and response to interferon treatment. Infection with subgenotype A2 is frequently associated with high viral load, resulting in acute infection via horizontal transmission. Genotypes A and B are more sensitive to interferon treatment than genotypes D and C, respectively. Genotype B is more frequent in acute hepatitis than genotype C, whereas genotype C （C2） is more frequently associated with an increased risk of hepatocellular carcinoma （HCC）, mostly cirrhotic, as compared with genotype B （B2）. Genotype mixture is associated with high viral load and worse outcome of HBV infection. HBV mutations in the S genes, especially amino acids substitution at position 145 （G145R）, are associated with immune escape, whereas mutations in the PreS or S genes which impair HBsAg secretion could present a risk to blood safety. HBV variants harboring mutations in the viral polymerase gene that confer resistance to nucleoside analogs may be selected during antiviral therapy. Different genotypes have distinct mutation patterns in the PreS and EnhH/BCP/Precore regions. PreS deletions, C1653T, T1753V, and A1762T/G1764A are associated with an increased risk of HCC. HCC- associated HBV mutants may not transmit via motherto-child transmission, and are likely generated during HBV-induced pathogenesis. Examination of HBV mutations alone or in combination and host genetic suscep-tibility will be helpful in classifying the HBV-infected subjects who will develop HCC and need active antiviral treatments.展开更多
Objective Allocation of human resources to address inequalities in the public health system has increasingly attracted societal and political attention.Using the Centers for Disease Control and Prevention(CDCs)system ...Objective Allocation of human resources to address inequalities in the public health system has increasingly attracted societal and political attention.Using the Centers for Disease Control and Prevention(CDCs)system of China as an example,we evaluated inequality in the public health workforce distribution across different regions in China between 2008 and 2017,with the aim of providing information for policymakers to support resource allocation and address growing health inequities.Methods We used three standard public health workforce inequality indices-Gini coefficient,Theil L,and Theil T-and spatial autocorrelation analysis to explore spatial clusters of the workforce in different provinces,visualized with geographical tools.Results The aggregate workforce-to-population ratio decreased from 1.47 to 1.42 per 10,000 population from 2008 to 2017,and was consistently lower than the National Health Commission’s(NHC)recommended critical shortage threshold of 1.75.The workforce distribution inequality indices varied by regional socioeconomic and health system development.Geographic clustering of CDCs workforce distribution was evident,with H–H and L–L clusters in western China and the Guangdong-Fujian region,respectively.Conclusions Our study addressed key issues for government and policymakers in allocation of public health human resources.There is an urgent need for careful identification of analytic questions that will help carry out public health functions in the new era,alongside policy implications for an equitable distribution of the public health workforce focusing on the western region and low–low cluster areas.展开更多
文摘BACKGROUND At present,China has become the country with the largest number of individuals with diabetes mellitus(DM)in the world,with a total of approximately 140 million patients,the majority of whom have type 2 DM(T2DM).Based on conven-tional nursing methods,community home care has important clinical significance in controlling blood sugar and disease progression.AIM To explore the impact of community public health nursing on treatment effect,health cognition,and self-management in patients with T2DM.METHODS One hundred patients with T2DM were selected as the research subjects.The patients were divided into either a conventional nursing group or community nursing(CN)group using the random number table method.The conventional nursing group(50 cases)received routine care,while the CN group(50 cases)received community public health care in addition to routine care as that for the conventional nursing group.The rate of excellent and good blood glucose control,fasting blood glucose before and after care,2-h postprandial blood glucose,health cognition,and self-management ability,and patient satisfaction were compared between the two groups.RESULTS The CN group had a higher rate of excellent blood sugar control than the conventional nursing group(88%vs 70%,P<0.05).Before care,there was no significant difference in fasting blood glucose or 2-h postprandial blood glucose between the two groups of patients(P>0.05).After nursing,fasting blood glucose and 2-h postprandial blood glucose were reduced to varying degrees in both groups,and both blood glucose levels in the CN group were lower than those of the conventional nursing group(P<0.05).Compared with the scores before care,the cognitive level score for diabetes and self-management ability score improved after care in both groups.The cognitive level and self-management ability of patients in the CN group were higher than those of the conventional nursing group(P<0.05).The overall satisfaction of the CN group was better than that of the conventional nursing group(98%vs 86%,P<0.05).CONCLUSION Community public health care based on conventional care of T2DM can achieve better blood sugar control,and improve patients’health cognitive level and self-management ability.
文摘Objective: This study aims to analyze the distribution of positive human papillomavirus (HPV) infections among women of appropriate age in Beiliu City during cervical cancer screening in 2024, providing data support for subsequent public health interventions. Methods: A retrospective analysis was conducted on the HPV test results from January 1, 2024, to November 30, 2024, at Beiliu Maternal and Child Health Hospital. We statistically analyzed the positive rates of different HPV genotypes and the co-infection status of multiple genotypes. Results: A total of 7558 individuals were tested, with 1103 positive cases identified, resulting in a positivity rate of 14.59%. Among these, HPV type 52 had the highest positive rate, accounting for 18.47%. The co-infection analysis showed that there were 788 cases with single genotype positivity, 236 with double genotype positivity, and 58 with triple genotype positivity, while cases with multiple genotypes simultaneously positive were relatively rare. Conclusion: The HPV infection rate among women of appropriate age in Beiliu City is relatively high, especially for high-risk HPV types. To reduce the future incidence of cervical cancer, it is recommended to enhance health education and vaccination efforts for this population.
基金Supported by the Chongqing Science and Health Joint Medical Research Project,No.2024MSXM065.
文摘BACKGROUND Oesophageal cancer is a significant health concern worldwide,with high inci-dence and mortality rates.In China,the disease burden is particularly high,accounting for a substantial proportion of oesophageal cancer cases and related deaths worldwide.AIM To explore the relationship between the mortality rate of oesophageal cancer patients and insurance type,out-of-pocket ratio,and the joint effects of insurance type and out-of-pocket ratio.METHODS The χ^(2) test was used to analyze patients’demographic and clinical characteristics.Multivariate logistic regression,the Cox proportional hazard model,and the competitive risk model were used to calculate the cumulative hazard ratios(HRs)of all-cause death and oesophageal cancer-specific death among patients with different types of insurance and out-of-pocket ratios.RESULTS Compared with patients covered by basic medical insurance for urban and rural residents,patients covered by urban employee basic medical insurance for urban workers(UEBMI)had a 23.30%increased risk of oesophageal cancer-specific death[HR=1.233,95%confidence interval(CI):1.093-1.391,P<0.005].Compared with patients in the low out-of-pocket ratio group,patients in the high out-of-pocket ratio group had a 25.80%reduction in the risk of oesophageal cancer-specific death(HR=0.742,95%CI:0.6555-0.84,P<0.005).With each 10%increase in the out-of-pocket ratio,the risk of oesophageal cancer-specific death decreased by 10.10%in patients covered by UEBMI.However,the risk of oesophageal cancer-specific death increased by 26.90%in patients in the high out-of-pocket ratio group.CONCLUSION This study reveals the relationships of the specific mortality rate of patients with oesophageal cancer with the out-of-pocket ratio and medical insurance types as well as their combined effects.This study provides practical suggestions and guidance for the formulation of relevant policies in this area.
文摘Objective:Gambling is a complex topic in relation to health systems.It is always unclear how to strike a balance between the gambling economy and the impact of gambling on public health or social wellbeing at any age.There are limited studies considering the association between determinants of gambling and the life expectancy of the ageing population in a country.From an evaluation perspective,this article aims to demonstrate the correlation between life expectancy and gambling and public health systems.Methods:The approach of analysis has two parts.One is the influence of gambling prevalence in populations on life expectancy among old adults.Another is the association between the effect of changes in legal gambling provisions within public health systems and life expectancy among old adults.Healthy adjusted life expectancy at age 60 from the World Health Organization and gross gambling yield were used.ANOVA was performed with SPSS.Results:The population groups with HALE at age 60 of 15 years or over are likely more active in gambling than the population groups with smaller HALE at age 60 of 14 years or less.On the other hand,the influence of a health policy may be sidelined when it is implemented for older adult populations because the resource distribution magnitude or number of strategical techniques may not be the same for younger adult populations.The study here is marked as a good practical start,and there is room for further research with big data analysis on additional gambling variables against other life expectancy variables,quality of life variables or public health system variables.Conclusion:Associations between the determinants of gambling and the life expectancy of the ageing population in a country have not yet been identified.Continuous measurements of policy implementation and effectiveness and assessments of health equity,while gambling policies worldwide continue to change,have not yet been performed.Researchers and policy makers should understand the importance of holistic integration of the gambling economy and policy within a public health and social paradigm with the help of big data insights to achieve sustainability in their cities and health equity in their communities.
基金Project supported by the Ministry of Education of China in the later stage of philosophy and social science research(Grant No.19JHG091)the National Natural Science Foundation of China(Grant No.72061003)+1 种基金the Major Program of National Social Science Fund of China(Grant No.20&ZD155)the Guizhou Provincial Science and Technology Projects(Grant No.[2020]4Y172)。
文摘We construct a dual-layer coupled complex network of communities and residents to represent the interconnected risk transmission network between communities and the disease transmission network among residents. It characterizes the process of infectious disease transmission among residents between communities through the SE2IHR model considering two types of infectors. By depicting a more fine-grained social structure and combining further simulation experiments, the study validates the crucial role of various prevention and control measures implemented by communities as primary executors in controlling the epidemic. Research shows that the geographical boundaries of communities and the social interaction patterns of residents have a significant impact on the spread of the epidemic, where early detection, isolation and treatment strategies at community level are essential for controlling the spread of the epidemic. In addition, the study explores the collaborative governance model and institutional advantages of communities and residents in epidemic prevention and control.
文摘Background:With public health emergencies(PHE)worldwide increasing,the perceived risk of PHE has been one of the critical factors influencing college students’psychological distress.However,the mechanisms by which the perceived risk of PHE affects college students’psychological distress are not clear.The study’s purpose was to investigate the mediation roles of deviation from a balanced time perspective(DBTP)and negative coping styles between the perceived risk of PHE and psychological distress.Methods:A convenience sampling method was used to survey 1054 Chinese college students with self-reporting.Data was collected using the Public Risk Perception Scale(PRPS),the Zimbardo Time Perspective Inventory(ZTPI),the Simplified Coping Style Questionnaire(SCSQ),the PHE Anxiety Scale,and the Chinese version of the Patient Health Questionnaire(PHQ).The associations between the perceived risk of PHE,DBTP,negative coping styles,and psychological distress were clarified using the correlation analysis.Additionally,the mediating roles of DBTP and negative coping styles between the perceived risk of PHE and psychological distress were investigated using a structural equation model.Results:The findings revealed low to moderate correlations between the variables studied.Students’perceived risk of PHE was a positive predictor of their psychological distress(b=0.219,p<0.01).DBTP and negative coping styles played chain mediation roles between them with the effect being 0.009 and a 95%Boot CI of[0.003,0.023].This chain mediation model had an excellent fit index(χ^(2)/df=4.732,CFI=0.973,TLI=0.930,RMSEA=0.048,SRMR=0.047).Conclusion:These findings showed how the perceived risk of PHE affected college students’psychological distress.Specifically,these results suggested that improving students’mental ability to switch effectively among different time perspectives depending on task features and situational considerations and reducing their negative coping styles might be effective ways to promote their mental health.
文摘The results of scientific studies of human social facts in the field of health show that the management of a patient should involve the patient’s entourage,whatever the status or size of the health establishment.In healthcare establishments in the Congo,the following are recognised as being responsible for medical care:specialist doctors,doctors,midwives,nurses and care assistants.The patient’s family and close friends are responsible for looking after the patient and financing care.The hospital infrastructure does not provide any space for the patient warden who accompany the patient during reception and hospitalisation.This makes Congolese hospitals inefficient for patient care.How can we integrate the function of the Sick guard and the assistance of the family,in order to reduce the mortality rate and repair the harm caused to patients requiring the presence of relatives during their stay in hospital,which is considered to be a dangerous place?This article examines the functional principles for configuring the space that patient warden would occupy in the patient care system.On the basis of a documentary analysis of sociological and architectural studies of existing facilities,this article proposes a typical accommodation model with the spaces needed to ensure the well-being and effectiveness of the patient warden with the patient.These are rooms with minimum space for 2 to 4 individual beds,equipped with toilets and showers.The accommodation has a dining area,kitchen and laundry facilities.In the future,this accommodation will become part of the hospital estate and may be occupied by orderlies and patient warden recruited by the hospital administration.
文摘In recent years,the compact development of high-density cities has sparked ongoing interest in healthy urban environments and public well-being.This study examines the relationship between cycling behaviors and the built environment of streets in Tiantongyuan Community,a typical high-density area in Beijing,China.By observing street spaces and summarizing residents’travel modes and behaviors,the study evaluates the impact of street design on cycling habits.In order to reveal the riding behavior characteristics of residents in different time periods and different street spaces,tools such as track recording APPs and the Gopro Motion Camera are employed to collect street view pictures and riding track data comprehensively,analyzing the various travel purposes of residents in Tiantongyuan community and the riding OD activity tracks of the main entrances and exits of the community.Meanwhile,by conducting the questionnaire survey of residents’travel demands and OD data of about:blank,and utilizing geographic information system(GIS)for data visualization,this study further investigates the distribution characteristics of cycling hotspots,cycling paths and cycling space,accurately identifies the cycling life circle of this community based on the spatial and temporal scales,and further puts forward the optimization strategy of the cycling network.Some cycling-friendly street space optimization strategies are suggested to deeply analyze the mechanism of the built environment of street space in high-density communities on the cycling activities and health of urban residents,with a view to provide accurate data support for the renewal of street cycling space.
文摘The important role of greenway non-mortorized systems in urban sustainable development was summarized,pointing out their potential value in improving the ecological environment,promoting healthy living,and enhancing community connections.Based on the analysis on some cases of urban greenway construction in China,specific transformation models and strategies were proposed for greenway construction,which could integrate green spaces with non-mortorized system,so as to enhance the comprehensive efficiency of urban linear spaces.
文摘This commentary delves into the evolving landscape of cancer incidence and mortality in Costa Rica, presenting a comprehensive analysis of the data. Key findings reveal a concerning upward trajectory in cancer incidence rates, placing Costa Rica at the forefront within Central America. While prostate cancer and breast cancer dominate, disparities emerge when scrutinizing gender-specific trends. Notably, stomach and cervical cancers show declines, potentially attributed to targeted interventions. However, colorectal and liver cancers witness mortality increases, necessitating strategic responses. Geographical disparities persist across provinces, highlighting the need for equitable healthcare access. In conclusion, this commentary underscores the urgency of addressing the burgeoning cancer burden in Costa Rica, calling for evidence-based interventions and collaborative efforts on a global scale.
文摘Introduction: Benin was embarked on phase 3 of the REDISSE Benin project (Regional Disease Surveillance Systems Enhancement) which began in 2018. The objectives were in five key components namely, Surveillance and health information;Laboratory capacity building;Emergency preparedness and response;Human resources management for effective disease surveillance and epidemic preparedness;and Institutional Capacity Building, Project Management, Coordination and Advocacy. After five years of implementation, this study aimed at the documentation of lessons learned and best practices. Methods: A descriptive cross-sectional study. Apart from individual semi-structured interviews, a thematic workshops bringing together the project’s main stakeholders recruited on an exhaustive way by component to identify and validate lessons learned, good practices and propose improvement mechanisms to be taken into account by the sector. Criteria were set up and used to validate best practices and lessons learned. Results: A total 54 (Surveillance workshop), 47 (Preparedness & response workshop), 53 (Human Resources workshop), 26 (Laboratories workshop) participated to the thematic workshops, and five interviews. The good practices (33: 9 for animal health, 7 for human health and 17 crosscutting) and lessons learned (10: 3 for animal health and 7 for human health) have been identified and have been the subject, depending on the case, of proposals for improvement or conditions necessary for their maintenance. Discussion: The richness of a project lies not only in the immediate achievement of its results, but also and above all, in its usefulness for similar interventions, whether in the local, regional, national or international context. It is in this context that the REDISSE project has set out to make public the various lessons learned and best practices from the implementation of its activities over a period of some five consecutive years.
文摘Recent research has emphasized the growing use of artificial intelligence (AI) in public health communication. However, the effectiveness of AI in developing and implementing culturally sensitive health communication strategies is poorly understood. The complexity of cultural diversity in public health communication prompted a scoping review to systematically examine existing research on the use of AI in developing and implementing culturally sensitive health communication strategies that promote cultural responsiveness and enhance public health. The present study employed a scoping review methodology in line with the Arksey and O’Malley framework and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. Data were collected from published studies from MEDLINE (PubMed), Scopus, and Google Scholar in the last five years. From the 933 studies initially identified, screening yielded 15 relevant articles spanning 2019 to 2024, assessing AI’s impact of AI across diverse geographical contexts, such as the USA, UK, and China. These studies affirm AI’s efficacy of AI in crafting public health messages that incorporate cultural nuances and ensure anonymity, thus addressing the specific needs of racially minoritized communities. However, varying levels of acceptance are often influenced by ethical concerns, resulting in low trust and patient acceptance of AI for culturally responsive communication in public health care. This scoping review underscores a significant uptick in AI-driven approaches to culturally sensitive public health communication. Despite notable advancements, the body of empirical evidence is limited and primarily focuses on AI systems with minimal decision-making autonomy. Persistent challenges in user acceptance, especially within culturally sensitive settings, indicate that cultural sensitivity and trust-building are pivotal for the successful integration of AI in public health messaging. These findings necessitate further research to deepen the understanding and enhance the effective deployment of AI in diverse cultural contexts.
基金This work was made possible through support from the Innovation,Technology and Research Hub of the U.S.Agency for International Development(USAID),through the LASER PULSE Program led by Purdue University under the terms of Cooperative Agreement#7200AA18CA00009.
文摘In Laos,rates of undernutrition,especially among children under 5 years of age,remain high.In response,a large multidisciplinary team embarked on a multi-year project in Laos beginning in 2019 with the purpose of institutional strengthening around public health nutrition research.This paper summarizes the Applied Nutrition Research Capacity Building project’s activities,immediate project results,and prospects for sustaining impacts into the future.Eight primary activities were undertaken,including back-office strengthening,mentored research,and curriculum review and development.Requested training and skill development in areas related to public health nutrition,anthropometry,and research methods reached more than 1000 professionals.The first edition of a Lao-English Nutrition Glossary was produced,as was the country’s first National Nutrition Research Agenda,a document which sets locally-identified priorities for future research.Project success was achieved by focusing on the priorities of project partners and the Lao government,as articulated in the Lao National Nutrition Strategy and Action Plan.Project design elements that could guide similar efforts undertaken elsewhere include multi-year engagement,an emphasis on sustained peer mentorship,and the use of an extended period of pre-planning in collaboration with project stakeholders prior to the start of activities.
基金supported by the Joint Research Fund for Beijing Natural Science Foundation and Haidian Original Innovation(L222029,L242050,L202007 and L222028)PKU-MSD Joint Laboratory on Infectious Disease Prevention and Control.
文摘Background Infectious diseases persistently pose global threats,and it is imperative to accelerate the profession-alization of public health workforce.This study aimed to develop and validate the infectious disease control compe-tency scale(IDCCS)for public health professionals to fill a theoretical gap and elevate practical capabilities by inform-ing public health professionals’development goals.Methods The initial item pool was generated through a literature review,and categorized into three dimensions(knowledge,practical skills,and leadership)based on the competency iceberg model and public health leadership framework.A two-round Delphi process was conducted to determine indicators within the scale.A pilot survey was utilized for item analysis and exploratory factor analysis(EFA).A formal survey was employed for confirmatory fac-tor analysis(CFA).The weight value of each indicator was calculated using the analytic hierarchy process.Results An initial scale with three primary items,14 secondary items,and 81 tertiary items was generated.Twenty experts participated in the two rounds of the Delphi process.Authority coefficients exceeded 0.9 in both rounds.Kendall’s W was 0.29 and 0.19,respectively(both P<0.001).Item analysis presented a Cronbach’s Alpha of 0.98,with corrected item-total correlation coefficients ranging from 0.33 to 0.78.EFA demonstrated that cumulative vari-ance explanations for the four primary dimensions(knowledge,practical skills,leadership,and personal quality)were 77.463%,73.976%,81.174%,and 68.654%,respectively.CFA indicated that all composite reliability values and aver-age variance extracted surpassed 0.8 and 0.5,respectively.The standardized factor loadings of the items ranged from 0.630 to 0.977.Among the seven model fit indices,each of the four dimensions satisfied at least five criteria.A final three-level scale comprising four primary items,14 secondary items,and 64 tertiary items was constructed.The weight values for the four primary items were 0.4064,0.2878,0.2082,and 0.0981,respectively.Conclusions The IDCCS was established to evaluate the competencies of knowledge,practical skills,leadership,and personal quality for public health professionals in infectious disease control.This scale demonstrates good reliability and validity,and can be used for performance evaluation,recruitment processes,curriculum development,and individual self-assessment.
基金funded by the National Social Science Fund of China(Grant No.20BTJ005).
文摘COVID-19,as one of the most serious sudden public health problems in this century,is a serious threat to people’s mental health.College students,as a vulnerable group,are more likely to develop mental health problems.When the body is unable to adapt to new changes in the environment,the main mental health problem that arises is adjustment disorder.The aim of this study was to assess the prevalence and influencing factors of adjustment disorder among college students during the COVID-19 outbreak in China.Cross-sectional data collected by web-based questionnaires were obtained through convenience sampling and snowball sampling between March 07,2023 and March 14,2023.The online self-report questionnaire included measures of demographic characteristics,the International Adjustment Disorder Questionnaire(IADQ),and the Influencing Factors Scale.Data were analyzed through structural equation modeling.A total of 394 valid samples(55.33%female)were collected in this study,approximately 75.63%of college students had a confirmed diagnosis of COVID-19 and 28.68%of college students had an adjustment disorder.There was no significant difference between the different demographic characteristics and the prevalence of adjustment disorder,and almost all demographic characteristics had a high prevalence of adjustment disorder.Structural equation modeling revealed that physiological impact(^b=0.077),psychological impact(^b=0.626)and potential impact(^b=0.106)of the sudden COVID-19 outbreak had a significant positive effect on the prevalence of adjustment disorder.The prevalence of adjustment disorder among college students is increased under the outbreak of COVID-19.The government should provide psychosocial support and mental health services for college students while also paying attention to potential factors such as stressors to reduce the adverse effects of outbreaks.
基金supported by the Application for Qingdao Medical and Health Research guidance(No.2022-WJZD198)。
文摘Objective:The occurrence of some public health events inevitably endangers medical personnel,and medical personnel,as a special group,have to resume work on time to treat patients.This coronavirus disease-2019(COVID-19)infection is a good example,and what intensive care unit(ICU)nurses experience as the primary caregivers of critically ill patients after COVID-19 infection is our focus.To explore the work experience of ICU nurses after recovery from COVID-19,and to provide a theoretical basis for the intervention to improve the physical and mental health level and work experience of special workers in public health emergencies.Methods:We conducted an explorative descriptive study using an inductive thematic analysis.Using the maximum differential sampling method,a semi-structured interview was conducted among 13 ICU nurses suffered from COVID-19 in a tertiary grade A hospital in Qingdao,Shandong Province.This study carried on the theme analysis according to the inductive content analysis method and used MAXQDA 2020 Analytics Pro(VERBI Software GmbH,Berlin,Germany)to manage and summarize the interview data.Results:After being infected by the virus,SARS-Coronavirus-2(SARS-CoV-2),the pathogen of COVID-19,the work experience of ICU nurses was extracted from the following 5 themes:(1)Stress and challenge caused by the change of work focus;(2)downsizing,overtime,taking up work with illness,and physical discomfort;(3)dedication and family debt;(4)unknown fear and helplessness;and(5)professional responsibility and sense of benefit.Conclusions:Under the pressure of COVID-19,ICU nurses face multiple pressures and challenges,and their emotions are complex.We suggest that nursing managers should take corresponding measures to alleviate nurses'physical and psychological pressure and improve their work experience.
基金the National Science Foundation of China(41925031,41991315,and 41521003).
文摘The coronavirus disease 2019(COVID-19)pandemic is challenging the current public health emergency response systems(PHERSs)of many countries.Although environmental factors,such as those influencing the survival of viruses and their transmission between species including humans,play important roles in PHERSs,little attention has been given to these factors.This study describes and elucidates the roles of environmental factors in future PHERSs.To improve countries’capability to respond to public health emergencies associated with viral infections such as the COVID-19 pandemic,a number of environmental factors should be considered before,during,and after the responses to such emergencies.More specifically,to prevent pandemic outbreaks,we should strengthen environmental and wildlife protection,conduct detailed viral surveillance in animals and hotspots,and improve early-warning systems.During the pandemic,we must study the impacts of environmental factors on viral behaviors,develop control measures to minimize secondary environmental risks,and conduct timely assessments of viral risks and secondary environmental effects with a view to reducing the impacts of the pandemic on human health and on ecosystems.After the pandemic,we should further strengthen surveillance for viruses and the prevention of viral spread,maintain control measures for minimizing secondary environmental risks,develop our capability to scientifically predict pandemics and resurgences,and prepare for the next unexpected resurgence.Meanwhile,we should restore the normal life and production of the public based on the“One Health”concept,that views global human and environmental health as inextricably linked.Our recommendations are essential for improving nations’capability to respond to global public health emergencies.
文摘Turkey launched a project in 2003 known as ＂Health Transformation Programme＂ （HTP）, which enabled Turkey to make considerable progress and radical changes to the health care system. The programme in 2003 included the effectiveness and the efficiency factors within the process by setting them as the primary objectives to increase the health status of the population （effectiveness） and to use resources in the best possible manner and at the lowest possible cost （efficiency）. Accessing services according to the need of patients and state benefits according to their ability to pay would be viable under these objectives. In this study, initially, Turkish National Health System will be articulated on a literature-study basis approach to measure the efficiency of public expenditure on health. Then, the measured level of the efficiency will be analysed in Turkey, The paper serves a purpose to analyse the efficiency based on the outcomes of heath service such as satisfaction with public health services over the period of 2003-2013. A simple linear regression was employed to test the degree of statistical relation between public health expenditure and satisfaction with public health care services.
基金Supported by Ministry of Health of China,No.2008ZX10002-15National Natural Science Foundation of China,No.30921006+2 种基金Shanghai Science & Technology Committee,No.08XD14001Shanghai Board of Health,No.08GWD0208GWZX0201
文摘Ten hepatitis B virus （HBV） genotypes （A-J） and 34 HBV subgenotypes have been identified so far. HBV genotypes and subgenotypes have distinct geographical distributions, and have been shown to differ with regard to clinical outcome, prognosis, and response to interferon treatment. Infection with subgenotype A2 is frequently associated with high viral load, resulting in acute infection via horizontal transmission. Genotypes A and B are more sensitive to interferon treatment than genotypes D and C, respectively. Genotype B is more frequent in acute hepatitis than genotype C, whereas genotype C （C2） is more frequently associated with an increased risk of hepatocellular carcinoma （HCC）, mostly cirrhotic, as compared with genotype B （B2）. Genotype mixture is associated with high viral load and worse outcome of HBV infection. HBV mutations in the S genes, especially amino acids substitution at position 145 （G145R）, are associated with immune escape, whereas mutations in the PreS or S genes which impair HBsAg secretion could present a risk to blood safety. HBV variants harboring mutations in the viral polymerase gene that confer resistance to nucleoside analogs may be selected during antiviral therapy. Different genotypes have distinct mutation patterns in the PreS and EnhH/BCP/Precore regions. PreS deletions, C1653T, T1753V, and A1762T/G1764A are associated with an increased risk of HCC. HCC- associated HBV mutants may not transmit via motherto-child transmission, and are likely generated during HBV-induced pathogenesis. Examination of HBV mutations alone or in combination and host genetic suscep-tibility will be helpful in classifying the HBV-infected subjects who will develop HCC and need active antiviral treatments.
基金funded by China CDC’s Public Health and Emergency Response Mechanism Programme[131031001000150001]。
文摘Objective Allocation of human resources to address inequalities in the public health system has increasingly attracted societal and political attention.Using the Centers for Disease Control and Prevention(CDCs)system of China as an example,we evaluated inequality in the public health workforce distribution across different regions in China between 2008 and 2017,with the aim of providing information for policymakers to support resource allocation and address growing health inequities.Methods We used three standard public health workforce inequality indices-Gini coefficient,Theil L,and Theil T-and spatial autocorrelation analysis to explore spatial clusters of the workforce in different provinces,visualized with geographical tools.Results The aggregate workforce-to-population ratio decreased from 1.47 to 1.42 per 10,000 population from 2008 to 2017,and was consistently lower than the National Health Commission’s(NHC)recommended critical shortage threshold of 1.75.The workforce distribution inequality indices varied by regional socioeconomic and health system development.Geographic clustering of CDCs workforce distribution was evident,with H–H and L–L clusters in western China and the Guangdong-Fujian region,respectively.Conclusions Our study addressed key issues for government and policymakers in allocation of public health human resources.There is an urgent need for careful identification of analytic questions that will help carry out public health functions in the new era,alongside policy implications for an equitable distribution of the public health workforce focusing on the western region and low–low cluster areas.
