Spatial epidemiology is the description and analysis of geographic patterns and variations in disease risk factors,morbidity and mortality with respect to their distributions associated with demographic,socioeconomic,...Spatial epidemiology is the description and analysis of geographic patterns and variations in disease risk factors,morbidity and mortality with respect to their distributions associated with demographic,socioeconomic,environmental,health behavior,and genetic risk factors,and time-varying changes.In the Letter to Editor,we had a brief description of the practice for the mortality and the spacetime patterns of John Snow's map of cholera epidemic in London,United Kingdom in 1854.This map is one of the earliest public heath practices of developing and applying spatial epidemiology.In the early history,spatial epidemiology was predominantly applied in infectious disease and risk factor studies.However,since the recent decades,noncommunicable diseases have become the leading cause of death in both developing and developed countries,spatial epidemiology has been used in the study of noncommunicable disease.In the Letter,we addressed two examples that applied spatial epidemiology to cluster and identify stroke belt and diabetes belt across the states and counties in the United States.Similar to any other epidemiological study design and analysis approaches,spatial epidemiology has its limitations.We should keep in mind when applying spatial epidemiology in research and in public health practice.展开更多
Cancer is a leading cause of death worldwide, with breast cancer being the most common (2.26 million new cases and 685,000 deaths). In Saudi Arabia, breast cancer ranked the first among females in 2014, accounting for...Cancer is a leading cause of death worldwide, with breast cancer being the most common (2.26 million new cases and 685,000 deaths). In Saudi Arabia, breast cancer ranked the first among females in 2014, accounting for 15.9% of all cancers reported among Saudi nationals and 28.7% of all cancers reported among females of all ages. Early detection of breast cancer could decrease the risks, have a better prognosis, and have better outcomes/more successful treatments. Prevalence of breast cancer reached more than 25% of all diagnosed cancer in the kingdom among women. Aim: This study aims to assess the knowledge and performance of women attending primary care centers about breast self-examination and mammogram screening for prevention and early detection of breast cancer in Abha city primary healthcare centers, Kingdom of Saudi Arabia. Research Method: cross sectional design was conducted by using questionnaire, which was distributed to primary care center nurses. The collected data was statistically analyzed using the Statistical Package for Social Sciences, version 25. Results: The study found that participants had poor awareness and knowledge about breast self-examination, risk factors for breast cancer, and trends and practices in early diagnosis of breast cancer. Conclusion and Recommendations: It recommends increasing awareness campaigns and providing educational programs to improve knowledge and practices.展开更多
Background: Dual Practice (DP) allows full-time public sector doctors to concurrently offer the same clinical services in the private sector. The debate against this practice seems to be largely influenced by its pote...Background: Dual Practice (DP) allows full-time public sector doctors to concurrently offer the same clinical services in the private sector. The debate against this practice seems to be largely influenced by its potential to reduce the contracted hours in the public sector and shift attention to private work. Purpose: The purpose of this secondary research is to estimate the monetary value of hours lost to the Nigerian public healthcare system when full-time government employee doctors are engaged in private practice. It attempts to quantify the amount of resource outflow from the public system due to absences and lateness arising from competition for time between the public system’s contracted hours and private practice. Methods: Sensitivity analysis in Excel 2010 was used to calculate doctors’ hourly pay in the public sector using the 2015 Consolidated Medical Salary Structure for medical and dental officers in Nigeria’s federal public service. The parameters used for the calculation were the official 40-hour working week and the average monthly gross pay of doctors on different grade levels. Hypothetical scenarios of hours lost due to absences associated with DP were created. The value of different hypothetical hour losses by the percentage of doctors assumed to engage in dual practice across all doctor grade levels was then computed. Results: The estimated annual value of hours lost from dual practice to a single public tertiary care hospital was N4,851,754 or 15,855 USD (best case scenario) and N19,407,017 or 63,422 USD (worst case scenario) for the normal routine work and N1,800,133 or 5883 USD (best case scenario) and N3,600,266 or 11,766 USD (worst case scenario) for the on-call duty. Conclusion: The government may have been paying salaries for large volumes of work not rendered in the public sector. The overall financial impact of dual practice in the Nigerian public system might be negative.展开更多
Objective: To study the public health Emergency Operations Centers(EOCs)in the US, the European Union, the UK and Australia, and summarize the good practice for the improvement of National Health Emergency Response Co...Objective: To study the public health Emergency Operations Centers(EOCs)in the US, the European Union, the UK and Australia, and summarize the good practice for the improvement of National Health Emergency Response Command Center in Chinese National Health and Family Planning Commission. Methods: Literature review was conducted to explore the EOCs of selected countries. Results: The study focused on EOC function, organizational structure, human resources and information management. The selected EOCs had the basic EOC functions of coordinating and commanding as well as the public health related functions such as monitoring the situation, risk assessment, and epidemiological briefings. The organizational structures of the EOCs were standardized, scalable and flexible. Incident Command System was the widely applied organizational structure with a strong preference. The EOCs were managed by a unit of emergency management during routine time and surge staff were engaged upon emergencies. The selected EOCs had clear information management framework including information collection, assessment and dissemination. Conclusions: The performance of National Health Emergency Response Command Center can be improved by learning from the good practice of the selected EOCs, including setting clear functions, standardizing the organizational structure, enhancing the human resource capacity and strengthening information management.展开更多
Endometriosis is a clinical and recurrent condition characterized by the presence of functional endometrial tissue outside the uterine cavity and myometrium. It is estimated that 6% to 10% of women of reproductive age...Endometriosis is a clinical and recurrent condition characterized by the presence of functional endometrial tissue outside the uterine cavity and myometrium. It is estimated that 6% to 10% of women of reproductive age, 50% to 60% of adolescents and adults with pelvic pain, and up to 50% of women with infertility are pregnant from the condition. However, this proportion tends to be even greater due to the difficulty in diagnosing it: because it presents different symptoms, lack of information from health professionals, and a high-cost diagnostic test. Another aggravating factor is the average time from the onset of symptoms to the medical diagnosis, which even today ranges from five to ten years;this delay has consequences for disease progression, as it prevents early treatment, which is important for improving pain levels and physical and psychological well-being. Aware of these mishaps, it is therefore important to assess the difficulties faced by doctors in the diagnosis of endometriosis in the public health system, in Brazil, the Unified Health System (SUS). With this purpose, a cross sectional was carried out, developed in the virtual environment using traffic in Google forms, with the difficulties quantified in the Likert scale. Participating physicians pointed out a medium difficulty for patients with endometriosis to access the consultation (58%) and moderate difficulty (52%) to perform an ultrasound examination;also signaled great difficulty in performing magnetic resonance imaging (77%) and laparotomy (61%) in these patients. It is hoped that knowledge about the difficulties faced by physicians in the diagnosis of endometriosis in the SUS will give these physicians a voice and corroborate, even if minimally, so that there is more research that provokes the search for these difficulties, in order to improving the quality of life of these women.展开更多
Objectives:Bangladesh stands as a prominent global consumer of tobacco,with alarming consequences on public health.The Global Adult Tobacco Survey reported that tobacco consumption claimed over 126000 lives in 2018,co...Objectives:Bangladesh stands as a prominent global consumer of tobacco,with alarming consequences on public health.The Global Adult Tobacco Survey reported that tobacco consumption claimed over 126000 lives in 2018,contributing to 13.5%of all deaths in the country.This study aims to explore the effectiveness of higher tax rates and tobacco use regulation as control mechanisms in mitigating tobacco consumption and health care cost burden,with a particular emphasis on its implications for public health.Methods:This study is based on the annual time series data over the period 2000-2020.The study employs the ordinary least square method to analyze the quantitative confirming the stationarity of data at level.This research uses different models to investigate individual effects and combined effects on both tobacco consumption and tobacco health care cost burden.Results:The study finds a negative relationship between tobacco tax rate and tobacco consumption.More specifically,the higher tax rate of tobacco(low(β=-0.3495),medium(β=-0.2319),high(β=-0.9033),premium(β=-0.7322),filtered(β=-0.2114),and non-filtered(β=-0.3452)categories)is significant to reduce tobacco use at 1%level of significance.The study finds similar results when it applied tobacco retail price instead of tobacco tax rate as the independent variable.Finally,the study investigates the impact on health care cost through tobacco consumption,tobacco control law,growth rate,export-import,and tobacco production.The results indicate that tobacco consumption,export-import,and tobacco production increases health care cost burden while tobacco use regulatory decreases it.By reducing tobacco consumption,higher taxes and tobacco use regulation contribute to alleviating the burden on the healthcare system,promoting healthier lifestyles,and aligning with global health objectives.Conclusions:Higher tax rate on tobacco products is necessary to increase the retail price so that tobacco users cannot consume tobacco.Specific tax and uniform tax base are needed so that tobacco users cannot switch to lower priced brands.Tobacco control laws need to revised and proper implementation should be ensured as well,to achieve the goal of tobacco free Bangladesh by 2040.Tobacco-related diseases,responsible for a significant proportion of deaths in the country,could witness a considerable decline with the successful implementation of higher tax rates and tobacco use regulation.This study provides insights that not only contribute to the economic discourse but also accentuate the broader public health benefits arising from effective tobacco taxation policies.展开更多
The monkeypox,a viral zoonotic disease usually found in forest areas of Central and Western Africa,has spread worldwide through new modes of transmission little understood.The WHO on 23 July 2022,declared the virus a ...The monkeypox,a viral zoonotic disease usually found in forest areas of Central and Western Africa,has spread worldwide through new modes of transmission little understood.The WHO on 23 July 2022,declared the virus a Public Health Emergency of International Concern(PHEIC).The declaration has stirred criticism from leading scientists that the criteria for PHEIC as defined by International Health Regulation have not been met and it is non-transparent and contradictory.This paper reviews the criteria of PHEIC and weighs the rationales behind the declaration to increase the clarity of the WHO's decision,justifications,and legitimacy in the ongoing outbreak.展开更多
Globally,there have been multiple public health emergencies in recent decades.High rates of morbidity,occasionally mortality,and economic instability are usually associated with pandemics.One of the epidemics that has...Globally,there have been multiple public health emergencies in recent decades.High rates of morbidity,occasionally mortality,and economic instability are usually associated with pandemics.One of the epidemics that has significantly increased morbidity and mortality worldwide is the human immunodeficiency virus(HIV)and acquired immune deficiency syndrome(AIDS)pandemic.HIV has a disproportionately negative impact on key populations.Strong leadership,effective communication,and sound science are necessary for public health emergency(PHE)responses to be successful.These three PHE response pllars are also essential for bridging the HIV response gap among key populations in the setting of restrictive laws.In this review,we explored the importance of these three pillars of successful PHEs responses,and how they are essential to closing the gap in the HIV response among key populations.Leaders must make decisions and instil a sense of authority in the populace during PHEs to foster trust and confidence.Leaders should base their choices on scientific evidence.Effective communication during PHEs should be proactive,polite,imaginative,innovative,and constructive.To address gaps in the HIV response among key populations,leaders must create a supportive environment for effective communication and scientific research,communication should be used to raise awareness of HIV and to dispel stigma and discrimination,while science should provide evidence of efficacy and effectiveness of interventions amongkey populations.展开更多
Adolescent health(AH)is an integral part of public health with the goal of improving the healthy development,safety,and well‑being of adolescents because the behavioral patterns established during this period influenc...Adolescent health(AH)is an integral part of public health with the goal of improving the healthy development,safety,and well‑being of adolescents because the behavioral patterns established during this period influence the health status of the adolescents and the risk of developing chronic diseases during adulthood.Adolescence being a time of great physical and psychological change,many social and physical conditions as well as behavioral pattern can impact AH and heighten the risk of illness and diseases.This makes adolescents to be susceptible to various health issues by nature because of their stages of development,which affects their ability to make safe decisions,and the need to rely on significant others for support.Other factors like desire for greater autonomy,pressure to conform to peers,exploration of sexual identity,increased access to and use of technology,violence and sexual abuse,social and cultural norms,family circumstances,emotional and physical environment of the adolescents contribute significantly to adolescents’health issues.Therefore,nurses have significant roles to play to ensure optimal growth and development of the adolescents and to prevent and reduce the impact of changes associated with adolescence on the health and well‑being of the adolescents.This article presents the concept of adolescence,components of AH,health‑related challenges associated with adolescence,and role of public health nurses.展开更多
Using an original public opinion survey, we study public attitudes and behaviors toward air pollution in Almaty, Kazakhstan. In the Health Belief Model (HBM) framework previously used to understand an individual’s he...Using an original public opinion survey, we study public attitudes and behaviors toward air pollution in Almaty, Kazakhstan. In the Health Belief Model (HBM) framework previously used to understand an individual’s health decision-making, we evaluate citizens’ awareness of the poor air quality, their perception of risk, and their willingness to devote time and resources to reduce their air pollution exposure. We find that although citizens are aware of the gravity and general harms of air pollution, they significantly underestimate their individual health risks, and, as a result, often engage in daily routines that exacerbate their exposure to pollution. We find that behaviors increasing the risk of pollution exposure are related to the underlying beliefs about personal health risks, self-efficacy, and material and economic limitations. This means that treating pollution as an individual health problem rather than social issue in public discourse may promote behaviors reducing exposure and improving personal and public health outcomes.展开更多
Song China was a period in which China experienced a great increase in its population.Concurrently,the Song dynasty also experienced a rise in the frequency of epidemics and two major wars with the Western Xia and Lia...Song China was a period in which China experienced a great increase in its population.Concurrently,the Song dynasty also experienced a rise in the frequency of epidemics and two major wars with the Western Xia and Liao dynasties during the 1000s and 1040s.The consequences of these changes were exacerbated by the increased geographical mobility of certain social groups such as traders and examinees attending civil service examinations.Thus,casualties of wars,epidemics,or disease,especially of people whose families were far away and could not care for them were left without care and“their corpses often lay bare along the roads.”This new social environment created a need for general relief.The Northern Song government(960-1127 CE),especially during the reign of Emperor Huizong,established an innovative public health system to address this issue.The public health system included poorhouses,public hospitals,and pauper’s cemeteries.The first were more of charity organizations,whereas the latter two promoted public health by providing medical services for the poor and burial for those that nobody cared for.In terms of rationale behind these institutions,on the one hand,they constituted an attempt to get the poor and homeless off the streets while providing them relief or burial.On the other hand,it seems that Huizong’s deep concern with medicine propelled him to design and implement a comprehensive public health system oriented to prevent contagion and outbreak of epidemics.This article depicts the background,the organization,and the functions of the system.The article also discusses the conditions and reasons that gave rise to such a unique undertaking by the Northern Song government.展开更多
Background: According to the diversification of the health needs and the expansion of health disparities, it is necessary to raise their reflective practice skills so that PHNs present more appropriate activities. The...Background: According to the diversification of the health needs and the expansion of health disparities, it is necessary to raise their reflective practice skills so that PHNs present more appropriate activities. The purpose of this study was to elucidate the realities of reflective practice skills among public health nurses in Japan and identify related factors. Methods: This study covered 1725 public health nurses in the Chugoku/Shikoku area. We conducted an anonymous self-completed questionnaire survey. As reflective practice skills (RPS), we adopted the six components of the six cycles of the Gibbs reflective model. We used the 20 criteria of the Scale for Practical Competence (SPC). We set 25 learning history/daily lifestyle items. The study plan was approved by the Ethics Committee of Okayama University. Results: We analyzed the 962 (55.8%) valid responses. Although years of experience as a public health nurse was highly correlated with practical skills as measured by SPC, with a correlation coefficient of 0.627, it was not closely related with RPS, with a correlation coefficient as low as 0.129. A logistic regression analysis of the eight learning history items and six daily lifestyle items associated with RPS, with the introduction of the high/low RPS groups as dependent variables, showed a convergence to five factors (odds ratio of 1.38 - 2.29). Conclusions: Going forward, we will need to consider how to accumulate learning on a daily basis and how to include positive health practice in PHN education, in connection with exploring the curriculum and method of training.展开更多
The British Medical Association(BMA)guidance on non-therapeutic circumcision(NTMC)of male children is limited to ethical,legal and religious issues.Here we evaluate criticisms of the BMA’s guidance by Lempert et al.W...The British Medical Association(BMA)guidance on non-therapeutic circumcision(NTMC)of male children is limited to ethical,legal and religious issues.Here we evaluate criticisms of the BMA’s guidance by Lempert et al.While their arguments promoting autonomy and consent might be superficially appealing,their claim of high procedural risks and negligible benefits seem one-sided and contrast with high quality evidence of low risk and lifelong benefits.Extensive literature reviews by the American Academy of Pediatrics and the United States Centers for Disease Control and Prevention in developing evidence-based policies,as well as risk-benefit analyses,have found that the medical benefits of infant NTMC greatly exceed the risks,and there is no reduction in sexual function and pleasure.The BMA’s failure to consider the medical benefits of early childhood NTMC may partly explain why this prophylactic intervention is discouraged in the United Kingdom.The consequence is higher prevalence of preventable infections,adverse medical conditions,suffering and net costs to the UK’s National Health Service for treatment of these.Many of the issues and contradictions in the BMA guidance identified by Lempert et al stem from the BMA’s guidance not being sufficiently evidence-based.Indeed,that document called for a review by others of the medical issues surrounding NTMC.While societal factors apply,ultimately,NTMC can only be justified rationally on scientific,evidence-based grounds.Parents are entitled to an accurate presentation of the medical evidence so that they can make an informed decision.Their decision either for or against NTMC should then be respected.展开更多
Since December 2019, there had been a series of unexplained cases of pneumonia reported in Wuhan, China, and on 12 January 2020, the World Health Organization (WHO) named this new virus as the 2019 novel coronavirus (...Since December 2019, there had been a series of unexplained cases of pneumonia reported in Wuhan, China, and on 12 January 2020, the World Health Organization (WHO) named this new virus as the 2019 novel coronavirus (2019-nCoV). The Novel Coronavirus disease (COVID-19) is an emerging, rapidly changing global health challenge affecting all sectors, including the health sector. This study aimed to investigate nurses’ knowledge, attitudes, and practices regarding the prevention and control of COVID-19. Methods: This cross-sectional study was conducted among nurses in three public health hospitals in Khartoum state. A self-administered questionnaire was used. A total of 14 knowledge questions were adopted. There are 5 questions constructed for attitude. A total of 12 practice questions were used. Mean score of knowledge considers as follows when the mean more than 75% considers as good knowledge while this percent uses as good practice and poor practice respectively to analyze the mean score differences of knowledge, attitudes, and practices between the independent variables. Spearman correlation was used to assess the relationship between mean knowledge and attitude scores. Results: Of the 101 nurses approached, a total of 100 nurses responded (99.0% response rate). The mean age of the participants was 27.6 (SD 5.3) years, and the majority of the participants were male (293/434, 67.5%). The mean knowledge score was 1.01 (SD 0.100). The mean attitude score was 10.5 (SD 4.1), and 54.8% (238/434) of the participants had a good attitude toward COVID-19. The mean practice score was 1.4176 (SD 1.4176). There was a negative correlation between knowledge and attitude scores (P < -0.014) and between knowledge and practice scores (P < -0.081). Conclusions: The overall levels of knowledge and practice and attitude were good.展开更多
In this paper, the Foxconn epidemic event in Zhengzhou was taken as an example to analyze the evolution of online public opinion on public health emergencies. In order to improve the performance of online public opini...In this paper, the Foxconn epidemic event in Zhengzhou was taken as an example to analyze the evolution of online public opinion on public health emergencies. In order to improve the performance of online public opinion analysis, based on the life cycle theory and LDA theory, the emotional changes of Internet users in four stages of the Foxconn incident centered on the evolution of inscription were divided. The emotions of netizen speech at different stages are analyzed based on CNN-BiLSTM + Attention model, which uses Convolutional Neural Network (CNN) to extract local features. Bi-directional Long Short-Term Memory (BiLSTM) is used to efficiently extract contextual semantic features and long distance dependencies, and then combined with attention mechanism to add emotional features. Finally, Softmax classifier realizes text emotion prediction. The experimental results show that: compared with TextCNN, BiLSTM, BiLSTM + Attenion, CNN-BiLSTM model, the emotion classification model has better effects in the accuracy rate, accuracy rate, recall rate and F value. By analyzing the emotional distribution and evolution trend of public opinion under “text topic”, the paper accurately deconstructs the development characteristics of public opinion in public health emergencies, in order to provide reference for relevant departments to deal with public opinion in public health emergencies. .展开更多
How to deal with public health emergencies is an important issue related to the normal life of community residents. However, after the corresponding understanding, it is found that a series of unsustainable epidemic p...How to deal with public health emergencies is an important issue related to the normal life of community residents. However, after the corresponding understanding, it is found that a series of unsustainable epidemic prevention factors have been exposed in the community in the COVID-19, such as blocked access to basic materials, unsafe living environment, and lack of social platforms. In view of these problems, based on Maslow’s hierarchy of needs, the changes in the hierarchy of needs of residents during the epidemic were analyzed, and sustainable community epidemic prevention strategies were proposed from five aspects of material storage, safe environment, social platform, respect opportunity and self-worth realization, so as to provide effective reference for future response to public health emergencies.展开更多
To understand the needs of public health institutions in Zhejiang Province,China for public health personnel,and provide basis for training public health personnel.Methods:512 public health institutions in Zhejiang Pr...To understand the needs of public health institutions in Zhejiang Province,China for public health personnel,and provide basis for training public health personnel.Methods:512 public health institutions in Zhejiang Province were randomly selected from different levels and regions,and the number of ublic health professional and the demand for professional ability were investigated by questionnaire.Results:The preventive medicine personnel in public health institutions in Zhejiang Province are insufficient;There is a certain disjunction or dislocation between the abilities and needs of public health professional;The way of continuing education for public health professional is single and the opportunities are few.Conclusion:Zhejiang Province should appropriately expand the enrollment of preventive medicine majors,especially high-level preventive medicine talents,deepen the education and teaching reform of preventive medicine majors,and strengthen the continuing education and training of public health professional to meet the needs of public health services after the COVID-19 epidemic.展开更多
Water pollution is one of the current global problems.So many countries are suffering from this problem specifically most South Asian and Southeast Asian countries,and Bangladesh is one of those countries that are suf...Water pollution is one of the current global problems.So many countries are suffering from this problem specifically most South Asian and Southeast Asian countries,and Bangladesh is one of those countries that are suffering from water pollution.Furthermore,the city of Bangladesh,Dhaka is one of the most densely populated cities in the world and overpopulation is showing a negative impact on the water quality now.Most of the rivers are very polluted around Dhaka city because of anthropogenic causes.This study focused on Buriganga river pollution and its impact on public health.This study intended to find out the major cause of Buriganga river pollution and the health status of the community living beside the Buriganga river.Also the study identified all the common diseases which people are suffering from around the Buriganga river area.Then the study compared the results with other southeast Asian countries so that it can make the relationship and can make it easier to understand the current situation of water pollution on public health in East Asia and Southeast Asia regions.During the research work,it was noticed that the Buriganga river is very polluted due to human activities.The transportation system,fishing,and waste canals from industries become the primary reasons behind Buriganga’s current condition.Also irresponsibility of both the environmental department and civil society is the major factor in Buriganga river pollution.The hygienic level was also not in a good condition because so many wastes like plastic materials and other daily use materials were thrown out into the river.That’s why public health conditions around the Buriganga river become vulnerable nowadays.So policies have to be implemented from the right perspective and the institutions have to be strong enough to handle all the issues regarding the Buriganga River.展开更多
Objective To explore the factors influencing public health behaviors in China in the context of COVID-19 pandemic,and to propose suggestions and countermeasures for enhancing public health behaviors.Methods A public h...Objective To explore the factors influencing public health behaviors in China in the context of COVID-19 pandemic,and to propose suggestions and countermeasures for enhancing public health behaviors.Methods A public health behavior system based on Bandura’s reciprocal determinism was constructed,and public health behavior was analyzed from the perspective of the interaction of health awareness,health behavior and environment.Results and Conclusion The public health behavior was analyzed through the public health behavior system based on Bandura’s reciprocal determinism,and the results and conclusions were draw.The public can be urged to develop better health beliefs and form better health behaviors by strengthening publicity and interventions,improving personal awareness,and increasing government investment.展开更多
Objective:To explore the role of the Centers for Disease Control and Prevention(CDC)in public health emergencies.Methods:The details of 12 public health events that occurred between January 2021 to December 2022 were ...Objective:To explore the role of the Centers for Disease Control and Prevention(CDC)in public health emergencies.Methods:The details of 12 public health events that occurred between January 2021 to December 2022 were analyzed to explore the roles of the CDC.Results:There were 160 patients involved in 10 public health events in 2021 and 48 patients involved in 2 public health events in 2022.Besides,the proportion of school public health events in 2022 was 0%,which was lower than in 2021,which was 80%(P<0.05).99.38%of patients during public health events were sent to the hospital promptly in 2022,which was higher than that in 2021,which was 81.25%(P<0.05).Furthermore,the average time taken for the CDC to control public health events in 2022 was 20.11±1.62 hours,and the average time taken to send inspection reports was shorter than that in 2021.The public satisfaction score was also higher in 2022 compared to 2021(P<0.05).Conclusion:The role of the CDC is to control infectious diseases.Therefore,it is important to pinpoint the existing problems in the strategies implemented by the CDC so that more improvements can be made to better prevent infectious diseases.展开更多
文摘Spatial epidemiology is the description and analysis of geographic patterns and variations in disease risk factors,morbidity and mortality with respect to their distributions associated with demographic,socioeconomic,environmental,health behavior,and genetic risk factors,and time-varying changes.In the Letter to Editor,we had a brief description of the practice for the mortality and the spacetime patterns of John Snow's map of cholera epidemic in London,United Kingdom in 1854.This map is one of the earliest public heath practices of developing and applying spatial epidemiology.In the early history,spatial epidemiology was predominantly applied in infectious disease and risk factor studies.However,since the recent decades,noncommunicable diseases have become the leading cause of death in both developing and developed countries,spatial epidemiology has been used in the study of noncommunicable disease.In the Letter,we addressed two examples that applied spatial epidemiology to cluster and identify stroke belt and diabetes belt across the states and counties in the United States.Similar to any other epidemiological study design and analysis approaches,spatial epidemiology has its limitations.We should keep in mind when applying spatial epidemiology in research and in public health practice.
文摘Cancer is a leading cause of death worldwide, with breast cancer being the most common (2.26 million new cases and 685,000 deaths). In Saudi Arabia, breast cancer ranked the first among females in 2014, accounting for 15.9% of all cancers reported among Saudi nationals and 28.7% of all cancers reported among females of all ages. Early detection of breast cancer could decrease the risks, have a better prognosis, and have better outcomes/more successful treatments. Prevalence of breast cancer reached more than 25% of all diagnosed cancer in the kingdom among women. Aim: This study aims to assess the knowledge and performance of women attending primary care centers about breast self-examination and mammogram screening for prevention and early detection of breast cancer in Abha city primary healthcare centers, Kingdom of Saudi Arabia. Research Method: cross sectional design was conducted by using questionnaire, which was distributed to primary care center nurses. The collected data was statistically analyzed using the Statistical Package for Social Sciences, version 25. Results: The study found that participants had poor awareness and knowledge about breast self-examination, risk factors for breast cancer, and trends and practices in early diagnosis of breast cancer. Conclusion and Recommendations: It recommends increasing awareness campaigns and providing educational programs to improve knowledge and practices.
文摘Background: Dual Practice (DP) allows full-time public sector doctors to concurrently offer the same clinical services in the private sector. The debate against this practice seems to be largely influenced by its potential to reduce the contracted hours in the public sector and shift attention to private work. Purpose: The purpose of this secondary research is to estimate the monetary value of hours lost to the Nigerian public healthcare system when full-time government employee doctors are engaged in private practice. It attempts to quantify the amount of resource outflow from the public system due to absences and lateness arising from competition for time between the public system’s contracted hours and private practice. Methods: Sensitivity analysis in Excel 2010 was used to calculate doctors’ hourly pay in the public sector using the 2015 Consolidated Medical Salary Structure for medical and dental officers in Nigeria’s federal public service. The parameters used for the calculation were the official 40-hour working week and the average monthly gross pay of doctors on different grade levels. Hypothetical scenarios of hours lost due to absences associated with DP were created. The value of different hypothetical hour losses by the percentage of doctors assumed to engage in dual practice across all doctor grade levels was then computed. Results: The estimated annual value of hours lost from dual practice to a single public tertiary care hospital was N4,851,754 or 15,855 USD (best case scenario) and N19,407,017 or 63,422 USD (worst case scenario) for the normal routine work and N1,800,133 or 5883 USD (best case scenario) and N3,600,266 or 11,766 USD (worst case scenario) for the on-call duty. Conclusion: The government may have been paying salaries for large volumes of work not rendered in the public sector. The overall financial impact of dual practice in the Nigerian public system might be negative.
文摘Objective: To study the public health Emergency Operations Centers(EOCs)in the US, the European Union, the UK and Australia, and summarize the good practice for the improvement of National Health Emergency Response Command Center in Chinese National Health and Family Planning Commission. Methods: Literature review was conducted to explore the EOCs of selected countries. Results: The study focused on EOC function, organizational structure, human resources and information management. The selected EOCs had the basic EOC functions of coordinating and commanding as well as the public health related functions such as monitoring the situation, risk assessment, and epidemiological briefings. The organizational structures of the EOCs were standardized, scalable and flexible. Incident Command System was the widely applied organizational structure with a strong preference. The EOCs were managed by a unit of emergency management during routine time and surge staff were engaged upon emergencies. The selected EOCs had clear information management framework including information collection, assessment and dissemination. Conclusions: The performance of National Health Emergency Response Command Center can be improved by learning from the good practice of the selected EOCs, including setting clear functions, standardizing the organizational structure, enhancing the human resource capacity and strengthening information management.
文摘Endometriosis is a clinical and recurrent condition characterized by the presence of functional endometrial tissue outside the uterine cavity and myometrium. It is estimated that 6% to 10% of women of reproductive age, 50% to 60% of adolescents and adults with pelvic pain, and up to 50% of women with infertility are pregnant from the condition. However, this proportion tends to be even greater due to the difficulty in diagnosing it: because it presents different symptoms, lack of information from health professionals, and a high-cost diagnostic test. Another aggravating factor is the average time from the onset of symptoms to the medical diagnosis, which even today ranges from five to ten years;this delay has consequences for disease progression, as it prevents early treatment, which is important for improving pain levels and physical and psychological well-being. Aware of these mishaps, it is therefore important to assess the difficulties faced by doctors in the diagnosis of endometriosis in the public health system, in Brazil, the Unified Health System (SUS). With this purpose, a cross sectional was carried out, developed in the virtual environment using traffic in Google forms, with the difficulties quantified in the Likert scale. Participating physicians pointed out a medium difficulty for patients with endometriosis to access the consultation (58%) and moderate difficulty (52%) to perform an ultrasound examination;also signaled great difficulty in performing magnetic resonance imaging (77%) and laparotomy (61%) in these patients. It is hoped that knowledge about the difficulties faced by physicians in the diagnosis of endometriosis in the SUS will give these physicians a voice and corroborate, even if minimally, so that there is more research that provokes the search for these difficulties, in order to improving the quality of life of these women.
文摘Objectives:Bangladesh stands as a prominent global consumer of tobacco,with alarming consequences on public health.The Global Adult Tobacco Survey reported that tobacco consumption claimed over 126000 lives in 2018,contributing to 13.5%of all deaths in the country.This study aims to explore the effectiveness of higher tax rates and tobacco use regulation as control mechanisms in mitigating tobacco consumption and health care cost burden,with a particular emphasis on its implications for public health.Methods:This study is based on the annual time series data over the period 2000-2020.The study employs the ordinary least square method to analyze the quantitative confirming the stationarity of data at level.This research uses different models to investigate individual effects and combined effects on both tobacco consumption and tobacco health care cost burden.Results:The study finds a negative relationship between tobacco tax rate and tobacco consumption.More specifically,the higher tax rate of tobacco(low(β=-0.3495),medium(β=-0.2319),high(β=-0.9033),premium(β=-0.7322),filtered(β=-0.2114),and non-filtered(β=-0.3452)categories)is significant to reduce tobacco use at 1%level of significance.The study finds similar results when it applied tobacco retail price instead of tobacco tax rate as the independent variable.Finally,the study investigates the impact on health care cost through tobacco consumption,tobacco control law,growth rate,export-import,and tobacco production.The results indicate that tobacco consumption,export-import,and tobacco production increases health care cost burden while tobacco use regulatory decreases it.By reducing tobacco consumption,higher taxes and tobacco use regulation contribute to alleviating the burden on the healthcare system,promoting healthier lifestyles,and aligning with global health objectives.Conclusions:Higher tax rate on tobacco products is necessary to increase the retail price so that tobacco users cannot consume tobacco.Specific tax and uniform tax base are needed so that tobacco users cannot switch to lower priced brands.Tobacco control laws need to revised and proper implementation should be ensured as well,to achieve the goal of tobacco free Bangladesh by 2040.Tobacco-related diseases,responsible for a significant proportion of deaths in the country,could witness a considerable decline with the successful implementation of higher tax rates and tobacco use regulation.This study provides insights that not only contribute to the economic discourse but also accentuate the broader public health benefits arising from effective tobacco taxation policies.
文摘The monkeypox,a viral zoonotic disease usually found in forest areas of Central and Western Africa,has spread worldwide through new modes of transmission little understood.The WHO on 23 July 2022,declared the virus a Public Health Emergency of International Concern(PHEIC).The declaration has stirred criticism from leading scientists that the criteria for PHEIC as defined by International Health Regulation have not been met and it is non-transparent and contradictory.This paper reviews the criteria of PHEIC and weighs the rationales behind the declaration to increase the clarity of the WHO's decision,justifications,and legitimacy in the ongoing outbreak.
文摘Globally,there have been multiple public health emergencies in recent decades.High rates of morbidity,occasionally mortality,and economic instability are usually associated with pandemics.One of the epidemics that has significantly increased morbidity and mortality worldwide is the human immunodeficiency virus(HIV)and acquired immune deficiency syndrome(AIDS)pandemic.HIV has a disproportionately negative impact on key populations.Strong leadership,effective communication,and sound science are necessary for public health emergency(PHE)responses to be successful.These three PHE response pllars are also essential for bridging the HIV response gap among key populations in the setting of restrictive laws.In this review,we explored the importance of these three pillars of successful PHEs responses,and how they are essential to closing the gap in the HIV response among key populations.Leaders must make decisions and instil a sense of authority in the populace during PHEs to foster trust and confidence.Leaders should base their choices on scientific evidence.Effective communication during PHEs should be proactive,polite,imaginative,innovative,and constructive.To address gaps in the HIV response among key populations,leaders must create a supportive environment for effective communication and scientific research,communication should be used to raise awareness of HIV and to dispel stigma and discrimination,while science should provide evidence of efficacy and effectiveness of interventions amongkey populations.
文摘Adolescent health(AH)is an integral part of public health with the goal of improving the healthy development,safety,and well‑being of adolescents because the behavioral patterns established during this period influence the health status of the adolescents and the risk of developing chronic diseases during adulthood.Adolescence being a time of great physical and psychological change,many social and physical conditions as well as behavioral pattern can impact AH and heighten the risk of illness and diseases.This makes adolescents to be susceptible to various health issues by nature because of their stages of development,which affects their ability to make safe decisions,and the need to rely on significant others for support.Other factors like desire for greater autonomy,pressure to conform to peers,exploration of sexual identity,increased access to and use of technology,violence and sexual abuse,social and cultural norms,family circumstances,emotional and physical environment of the adolescents contribute significantly to adolescents’health issues.Therefore,nurses have significant roles to play to ensure optimal growth and development of the adolescents and to prevent and reduce the impact of changes associated with adolescence on the health and well‑being of the adolescents.This article presents the concept of adolescence,components of AH,health‑related challenges associated with adolescence,and role of public health nurses.
文摘Using an original public opinion survey, we study public attitudes and behaviors toward air pollution in Almaty, Kazakhstan. In the Health Belief Model (HBM) framework previously used to understand an individual’s health decision-making, we evaluate citizens’ awareness of the poor air quality, their perception of risk, and their willingness to devote time and resources to reduce their air pollution exposure. We find that although citizens are aware of the gravity and general harms of air pollution, they significantly underestimate their individual health risks, and, as a result, often engage in daily routines that exacerbate their exposure to pollution. We find that behaviors increasing the risk of pollution exposure are related to the underlying beliefs about personal health risks, self-efficacy, and material and economic limitations. This means that treating pollution as an individual health problem rather than social issue in public discourse may promote behaviors reducing exposure and improving personal and public health outcomes.
文摘Song China was a period in which China experienced a great increase in its population.Concurrently,the Song dynasty also experienced a rise in the frequency of epidemics and two major wars with the Western Xia and Liao dynasties during the 1000s and 1040s.The consequences of these changes were exacerbated by the increased geographical mobility of certain social groups such as traders and examinees attending civil service examinations.Thus,casualties of wars,epidemics,or disease,especially of people whose families were far away and could not care for them were left without care and“their corpses often lay bare along the roads.”This new social environment created a need for general relief.The Northern Song government(960-1127 CE),especially during the reign of Emperor Huizong,established an innovative public health system to address this issue.The public health system included poorhouses,public hospitals,and pauper’s cemeteries.The first were more of charity organizations,whereas the latter two promoted public health by providing medical services for the poor and burial for those that nobody cared for.In terms of rationale behind these institutions,on the one hand,they constituted an attempt to get the poor and homeless off the streets while providing them relief or burial.On the other hand,it seems that Huizong’s deep concern with medicine propelled him to design and implement a comprehensive public health system oriented to prevent contagion and outbreak of epidemics.This article depicts the background,the organization,and the functions of the system.The article also discusses the conditions and reasons that gave rise to such a unique undertaking by the Northern Song government.
文摘Background: According to the diversification of the health needs and the expansion of health disparities, it is necessary to raise their reflective practice skills so that PHNs present more appropriate activities. The purpose of this study was to elucidate the realities of reflective practice skills among public health nurses in Japan and identify related factors. Methods: This study covered 1725 public health nurses in the Chugoku/Shikoku area. We conducted an anonymous self-completed questionnaire survey. As reflective practice skills (RPS), we adopted the six components of the six cycles of the Gibbs reflective model. We used the 20 criteria of the Scale for Practical Competence (SPC). We set 25 learning history/daily lifestyle items. The study plan was approved by the Ethics Committee of Okayama University. Results: We analyzed the 962 (55.8%) valid responses. Although years of experience as a public health nurse was highly correlated with practical skills as measured by SPC, with a correlation coefficient of 0.627, it was not closely related with RPS, with a correlation coefficient as low as 0.129. A logistic regression analysis of the eight learning history items and six daily lifestyle items associated with RPS, with the introduction of the high/low RPS groups as dependent variables, showed a convergence to five factors (odds ratio of 1.38 - 2.29). Conclusions: Going forward, we will need to consider how to accumulate learning on a daily basis and how to include positive health practice in PHN education, in connection with exploring the curriculum and method of training.
文摘The British Medical Association(BMA)guidance on non-therapeutic circumcision(NTMC)of male children is limited to ethical,legal and religious issues.Here we evaluate criticisms of the BMA’s guidance by Lempert et al.While their arguments promoting autonomy and consent might be superficially appealing,their claim of high procedural risks and negligible benefits seem one-sided and contrast with high quality evidence of low risk and lifelong benefits.Extensive literature reviews by the American Academy of Pediatrics and the United States Centers for Disease Control and Prevention in developing evidence-based policies,as well as risk-benefit analyses,have found that the medical benefits of infant NTMC greatly exceed the risks,and there is no reduction in sexual function and pleasure.The BMA’s failure to consider the medical benefits of early childhood NTMC may partly explain why this prophylactic intervention is discouraged in the United Kingdom.The consequence is higher prevalence of preventable infections,adverse medical conditions,suffering and net costs to the UK’s National Health Service for treatment of these.Many of the issues and contradictions in the BMA guidance identified by Lempert et al stem from the BMA’s guidance not being sufficiently evidence-based.Indeed,that document called for a review by others of the medical issues surrounding NTMC.While societal factors apply,ultimately,NTMC can only be justified rationally on scientific,evidence-based grounds.Parents are entitled to an accurate presentation of the medical evidence so that they can make an informed decision.Their decision either for or against NTMC should then be respected.
文摘Since December 2019, there had been a series of unexplained cases of pneumonia reported in Wuhan, China, and on 12 January 2020, the World Health Organization (WHO) named this new virus as the 2019 novel coronavirus (2019-nCoV). The Novel Coronavirus disease (COVID-19) is an emerging, rapidly changing global health challenge affecting all sectors, including the health sector. This study aimed to investigate nurses’ knowledge, attitudes, and practices regarding the prevention and control of COVID-19. Methods: This cross-sectional study was conducted among nurses in three public health hospitals in Khartoum state. A self-administered questionnaire was used. A total of 14 knowledge questions were adopted. There are 5 questions constructed for attitude. A total of 12 practice questions were used. Mean score of knowledge considers as follows when the mean more than 75% considers as good knowledge while this percent uses as good practice and poor practice respectively to analyze the mean score differences of knowledge, attitudes, and practices between the independent variables. Spearman correlation was used to assess the relationship between mean knowledge and attitude scores. Results: Of the 101 nurses approached, a total of 100 nurses responded (99.0% response rate). The mean age of the participants was 27.6 (SD 5.3) years, and the majority of the participants were male (293/434, 67.5%). The mean knowledge score was 1.01 (SD 0.100). The mean attitude score was 10.5 (SD 4.1), and 54.8% (238/434) of the participants had a good attitude toward COVID-19. The mean practice score was 1.4176 (SD 1.4176). There was a negative correlation between knowledge and attitude scores (P < -0.014) and between knowledge and practice scores (P < -0.081). Conclusions: The overall levels of knowledge and practice and attitude were good.
文摘In this paper, the Foxconn epidemic event in Zhengzhou was taken as an example to analyze the evolution of online public opinion on public health emergencies. In order to improve the performance of online public opinion analysis, based on the life cycle theory and LDA theory, the emotional changes of Internet users in four stages of the Foxconn incident centered on the evolution of inscription were divided. The emotions of netizen speech at different stages are analyzed based on CNN-BiLSTM + Attention model, which uses Convolutional Neural Network (CNN) to extract local features. Bi-directional Long Short-Term Memory (BiLSTM) is used to efficiently extract contextual semantic features and long distance dependencies, and then combined with attention mechanism to add emotional features. Finally, Softmax classifier realizes text emotion prediction. The experimental results show that: compared with TextCNN, BiLSTM, BiLSTM + Attenion, CNN-BiLSTM model, the emotion classification model has better effects in the accuracy rate, accuracy rate, recall rate and F value. By analyzing the emotional distribution and evolution trend of public opinion under “text topic”, the paper accurately deconstructs the development characteristics of public opinion in public health emergencies, in order to provide reference for relevant departments to deal with public opinion in public health emergencies. .
文摘How to deal with public health emergencies is an important issue related to the normal life of community residents. However, after the corresponding understanding, it is found that a series of unsustainable epidemic prevention factors have been exposed in the community in the COVID-19, such as blocked access to basic materials, unsafe living environment, and lack of social platforms. In view of these problems, based on Maslow’s hierarchy of needs, the changes in the hierarchy of needs of residents during the epidemic were analyzed, and sustainable community epidemic prevention strategies were proposed from five aspects of material storage, safe environment, social platform, respect opportunity and self-worth realization, so as to provide effective reference for future response to public health emergencies.
基金supported by Zhejiang Soft Science Research Program(2021C35016)。
文摘To understand the needs of public health institutions in Zhejiang Province,China for public health personnel,and provide basis for training public health personnel.Methods:512 public health institutions in Zhejiang Province were randomly selected from different levels and regions,and the number of ublic health professional and the demand for professional ability were investigated by questionnaire.Results:The preventive medicine personnel in public health institutions in Zhejiang Province are insufficient;There is a certain disjunction or dislocation between the abilities and needs of public health professional;The way of continuing education for public health professional is single and the opportunities are few.Conclusion:Zhejiang Province should appropriately expand the enrollment of preventive medicine majors,especially high-level preventive medicine talents,deepen the education and teaching reform of preventive medicine majors,and strengthen the continuing education and training of public health professional to meet the needs of public health services after the COVID-19 epidemic.
文摘Water pollution is one of the current global problems.So many countries are suffering from this problem specifically most South Asian and Southeast Asian countries,and Bangladesh is one of those countries that are suffering from water pollution.Furthermore,the city of Bangladesh,Dhaka is one of the most densely populated cities in the world and overpopulation is showing a negative impact on the water quality now.Most of the rivers are very polluted around Dhaka city because of anthropogenic causes.This study focused on Buriganga river pollution and its impact on public health.This study intended to find out the major cause of Buriganga river pollution and the health status of the community living beside the Buriganga river.Also the study identified all the common diseases which people are suffering from around the Buriganga river area.Then the study compared the results with other southeast Asian countries so that it can make the relationship and can make it easier to understand the current situation of water pollution on public health in East Asia and Southeast Asia regions.During the research work,it was noticed that the Buriganga river is very polluted due to human activities.The transportation system,fishing,and waste canals from industries become the primary reasons behind Buriganga’s current condition.Also irresponsibility of both the environmental department and civil society is the major factor in Buriganga river pollution.The hygienic level was also not in a good condition because so many wastes like plastic materials and other daily use materials were thrown out into the river.That’s why public health conditions around the Buriganga river become vulnerable nowadays.So policies have to be implemented from the right perspective and the institutions have to be strong enough to handle all the issues regarding the Buriganga River.
基金Shenyang Social Science Foundation Project 2020(No.SZ202001L).
文摘Objective To explore the factors influencing public health behaviors in China in the context of COVID-19 pandemic,and to propose suggestions and countermeasures for enhancing public health behaviors.Methods A public health behavior system based on Bandura’s reciprocal determinism was constructed,and public health behavior was analyzed from the perspective of the interaction of health awareness,health behavior and environment.Results and Conclusion The public health behavior was analyzed through the public health behavior system based on Bandura’s reciprocal determinism,and the results and conclusions were draw.The public can be urged to develop better health beliefs and form better health behaviors by strengthening publicity and interventions,improving personal awareness,and increasing government investment.
文摘Objective:To explore the role of the Centers for Disease Control and Prevention(CDC)in public health emergencies.Methods:The details of 12 public health events that occurred between January 2021 to December 2022 were analyzed to explore the roles of the CDC.Results:There were 160 patients involved in 10 public health events in 2021 and 48 patients involved in 2 public health events in 2022.Besides,the proportion of school public health events in 2022 was 0%,which was lower than in 2021,which was 80%(P<0.05).99.38%of patients during public health events were sent to the hospital promptly in 2022,which was higher than that in 2021,which was 81.25%(P<0.05).Furthermore,the average time taken for the CDC to control public health events in 2022 was 20.11±1.62 hours,and the average time taken to send inspection reports was shorter than that in 2021.The public satisfaction score was also higher in 2022 compared to 2021(P<0.05).Conclusion:The role of the CDC is to control infectious diseases.Therefore,it is important to pinpoint the existing problems in the strategies implemented by the CDC so that more improvements can be made to better prevent infectious diseases.
