Assessing the effectiveness of training programme on the competency of medical staffs in public health emergency.

BACKGROUND: The competencies of medical staff in the public health emergency system and evaluated the effects of system-based professional training were investigated. MATERIAL AND METHODS: A competency model for individuals in a public health emergency management system was developed, which contained 33 items with 5 domains. A competency-based intervention was performed. A total of 68 participants from 4 health emergency teams in Xinjiang, China were recruited and randomly divided into 2 groups: the intervention (N = 38) and control groups (N = 30). Participants in the intervention group received competency-based training, while those in the control group received no training. All participants responded to the COVID-19 activities. The competencies of medical staff in the 5 domains were then analyzed in the pre-intervention, post-first training, and post-COVID-19 intervention using a self-designed questionnaire. RESULTS: Participants' competencies were at the middle level at baseline. After the first training, competencies in the 5 domains significantly improved in the intervention group; in the control group, there was a significant increase in professional quality compared in the pre-training. After the response to COVID-19, the mean scores of competencies in the 5 domains significantly increased in both the intervention and control groups compared with those in the post-first training. Psychological resilience scores were higher in the intervention group than in the control group, whereas no significant differences in competencies were found in other domains. CONCLUSIONS: Competency-based interventions provided practice and showed a positive effect on improving the competencies of medical staff in public health teams. Med Pr. 2023;74(1):19-26.

Development and preliminary validation of a public health emergency competency model for medical staffs of national health emergency teams in China.

BACKGROUND: In the present study, we attempted to develop and validate a participatory competency model for medical workers and then evaluate the current status of competency characteristics of Chinese medical workers. METHODS: The competency model was constructed in a multistage process, including literature review, expert consultation, critical incident and focus group interview. A pilot study was conducted to refine the initial model among 90 participators and the viability and reliability were evaluated by a questionnaire survey among 121 medical workers. Then, the current status of competency characteristics was measured based on the final version of competency model. RESULTS: In the pilot study, ten questionnaires were dropped for the poor quality and thus the eligible rate was 92% (138/150). KMO value was 0.785 and Bartlett test showed that the χ2 = 6464.546 (df = 903) and p value < 0.001. Then, 10 items with double loading and factor loading < 0.4 were deleted. Finally, 33 items were retained with the lowest factor loading value of 0.465. The validity and reliability of competency model were determined with Cronbach's α coefficient of 0.975 and ICC value of 0.933. Finally, a revised competency model with 5 dimensions and 31 items was obtained. The overall competencies of current medical workers were in a high level, except for emergency knowledge related competencies. Age was an independent factor affecting the competencies. CONCLUSIONS: Our competency model was a reliable and validated tool for assessing the competences of medical staffs against public health emergencies, and the overall competencies of current medical workers in China were in a high level, except for emergency knowledge related competencies.

The associations among the stress symptoms, depressive symptoms, anxiety symptoms and insomnia symptoms in depressed patients after the first COVID-19 outbreak was initially controlled in China: A prospective cohort study.

BACKGROUND: Depressed patients suffered from severe psychological distress even after the first COVID-19 outbreak was initially controlled. The longitudinal changes and associations among stress and other psychological problems during this period remained unknown. In this study we investigated stress symptoms and the longitudinal impact of stress symptoms on other psychological symptoms in depressed patients after the first COVID-19 outbreak was initially controlled. METHODS: A total of 5241 depressed patients at the outpatients of 56 hospitals across mainland China were recruited from May 18 to June 18, 2020. Five months later, 2113 of them responded again. Demographic characteristics were collected and psychological symptoms were evaluated at baseline and the follow-up. The longitudinal associations between stress symptoms at baseline and the changes of other psychological problems were assessed using Poisson regression. RESULTS: The prevalence of stress symptoms, depressive symptoms, anxiety symptoms and insomnia symptoms declined over time. Having stress symptoms at baseline was positively associated with the new occurrences of depressive symptoms, anxiety symptoms and insomnia symptoms (range, adjusted RRs 1.69-1.81). LIMITATIONS: The sampling method and the high dropout rate are the major limitations. Additionally, the mental conditions of the participants were not obtained, which may lead to unavoidable bias. CONCLUSIONS: The prevalence of stress symptoms declined over time after the first COVID-19 outbreak was initially controlled. We found that having stress symptoms at baseline was a predictor for the new occurrences of depressive symptoms, anxiety symptoms and insomnia symptoms.

Herd Behaviors in Epidemics: A Dynamics-Coupled Evolutionary Games Approach.

The recent COVID-19 pandemic has led to an increasing interest in the modeling and analysis of infectious diseases. The pandemic has made a significant impact on the way we behave and interact in our daily life. The past year has witnessed a strong interplay between human behaviors and epidemic spreading. In this paper, we propose an evolutionary game-theoretic framework to study the coupled evolution of herd behaviors and epidemics. Our framework extends the classical degree-based mean-field epidemic model over complex networks by coupling it with the evolutionary game dynamics. The statistically equivalent individuals in a population choose their social activity intensities based on the fitness or the payoffs that depend on the state of the epidemics. Meanwhile, the spreading of the infectious disease over the complex network is reciprocally influenced by the players' social activities. We analyze the coupled dynamics by studying the stationary properties of the epidemic for a given herd behavior and the structural properties of the game for a given epidemic process. The decisions of the herd turn out to be strategic substitutes. We formulate an equivalent finite-player game and an equivalent network to represent the interactions among the finite populations. We develop a structure-preserving approximation technique to study time-dependent properties of the joint evolution of the behavioral and epidemic dynamics. The resemblance between the simulated coupled dynamics and the real COVID-19 statistics in the numerical experiments indicates the predictive power of our framework.

Herd Behaviors in Epidemics: A Dynamics-Coupled Evolutionary Games Approach

The recent COVID-19 pandemic has led to an increasing interest in the modeling and analysis of infectious diseases. The pandemic has made a significant impact on the way we behave and interact in our daily life. The past year has witnessed a strong interplay between human behaviors and epidemic spreading. In this paper, we propose an evolutionary game-theoretic framework to study the coupled evolution of herd behaviors and epidemics. Our framework extends the classical degree-based mean-field epidemic model over complex networks by coupling it with the evolutionary game dynamics. The statistically equivalent individuals in a population choose their social activity intensities based on the fitness or the payoffs that depend on the state of the epidemics. Meanwhile, the spreading of the infectious disease over the complex network is reciprocally influenced by the players’ social activities. We analyze the coupled dynamics by studying the stationary properties of the epidemic for a given herd behavior and the structural properties of the game for a given epidemic process. The decisions of the herd turn out to be strategic substitutes. We formulate an equivalent finite-player game and an equivalent network to represent the interactions among the finite populations. We develop a structure-preserving approximation technique to study time-dependent properties of the joint evolution of the behavioral and epidemic dynamics. The resemblance between the simulated coupled dynamics and the real COVID-19 statistics in the numerical experiments indicates the predictive power of our framework.

Understanding the mechanism underlying the anti-diabetic effect of dietary component: a focus on gut microbiota.

Diabetes has become one of the biggest non-communicable diseases and threatens human health worldwide. The management of diabetes is a complex and multifaceted process including drug therapy and lifestyle interventions. Dietary components are essential for both diabetes management and health and survival of trillions of the gut microbiota (GM). Herein, we will discuss the relationship between diets and GM, the mechanism linking diabetes and gut dysbiosis, and the effects of dietary components (nutrients, phytochemicals, probiotics, food additives, etc.) on diabetes from the perspective of modulating GM. The GM of diabetic patients differs from that of health individuals and GM disorder contributes to the onset and maintenance of diabetes. Studies in humans and animal models consolidate that dietary component is a key regulator of diabetes and increasing evidence suggests that the alteration of GM plays a salient role in dietary interventions for diabetes. Given that diabetes is a major public health issue, especially that diabetes is linked with a high risk of mortality from COVID-19, this review provides compelling evidence for that targeting GM by dietary components is a promising strategy, and offers new insights into potential preventive or therapeutic approaches (dietary and pharmacological intervention) for the clinical management of diabetes.

Assessment on Land-Water Resources Carrying Capacity of Countries in Central Asia from the Perspective of Self-Supplied Agricultural Products

Despite the declining hunger in Central Asia, food insecurity remains an important issue due to the dry climate. Taking Kazakhstan, Uzbekistan, Kyrgyzstan, Turkmenistan, and Tajikistan as examples, this study assesses their land-water resources carrying capacity in 1999, 2009, and 2018, on the premise that agricultural water and farmland are spatially matched based on the “buckets effect”, using the ecological footprint and water footprint methods. Results show the following: (1) the total farmland area in Central Asia is sufficient to achieve food self-sufficiency;the available farmland area is 2.45 times that of the farmland required for self-sufficiency in 1999, which decreased to 1.71 times in 2009, but slightly increased to 1.92 times in 2018. Specifically, Kazakhstan maintains a surplus of more than 15 × 106 ha in farmland, while the other 4 countries could not achieve self-sufficiency. (2) The water resources pressure rises;the available agricultural water resource (AAWR) in Central Asia is 3.07 times that of the water demand for agricultural irrigation (WDAI), and 3.06 times that of the water demand for irrigation and environmental purification (WDIEP) in 1999, which decreased to 1.69 times of WDAI and to 1.60 times of WDIEP in 2018. Tajikistan has the highest level of water surplus, followed by Kyrgyzstan and Kazakhstan. Turkmenistan and Uzbekistan do not have enough water to sustain agricultural production. (3) The trend of land-water resources carrying capacity declines in Central Asia. In 1999, 2009, and 2018, the land-water resources could support the population’s food demand in this region when only considering farmland matched with WDAI. However, the population carrying capacity deficit would emerge if we considered the matching farmland with WDIEP.