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Public Health Centers of Japan. of which there are 468 across the country as of April 2022. are at the core of health crisis management. responding to natural disasters and infectious diseases according to the Community Health Act (1994). Under the Infectious Diseases Control La these centers have made repeated efforts to respond to COV1D-19 from the first to the seventh waves while epidemic dynamics changed. variants emerged. and pathogenicity fluctuated. All centers essentially play a common role in infectious disease control (answering questions and consultations. testing, registering cases, coordinating healthcare. transporting confirmed patients, following up with patients and close contacts. carrying out epidemiological investigations. issuing notifications for recommendations on hospital stays and work restrictions. etc.). 'forever, due to the varying number of cases and healthcare resources depending on the region, the actual work was not identical, and local governments. which operate the centers. took different appreoclws. Looking back on the epidemic, the first, second, and third waves saw travel restrictions implemented across the country, and were characterized by a demand for testing that exceeded capacity. At that time. COVID-19 was a threat to the respiratory system, no effective treatment or vaccination was available. and the number of healthcare institutions diagnosing and treating cases was inadequate. The fourth wave saw the Alpha variant ripping through nursing homes putting a significant burden on healthcare. while the fifth wave saw the Delta variant spreading mainly from Tokyo after the Olympics. The sixth and seventh waves came with the highly. Contagious Omicron variant. leading to skyrocketing patient numbers and the public health capacity quickly being overwhelmed. Local governments considered ways to reduce the burden on Public Health Centers, including outsourcing. Over this 2.5 year period, numerous advisories were issued by the Ministry of Health, Labor, and Welfare (MHLW), and the Japanese Association of Public Health Center Directors has advocated actively on behalf of the centers. Given that Japan is a disaster-prone country, Public Health Centers in Japan are expected to play a pivotal role in crisis preparedness, responses to, and recovery from natural disasters and infectious diseases. As a coordination hub to protect lives and maintain health, here we strongly suggest that public health centers implement the lessons learned from COVID-19 to collaborate with healthcare institutions and long-term care facilities, and evolve into a sustainable social framework to advance pandemic preparedness in their respective communities.
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BACKGROUND: Considering the heavy toll taken by COVID- 19 pandemic, the understanding of the epidemiological parameters as well as various risk factors is crucial for future preparedness and tackling the pandemic in a more effective manner. We wanted to study the socio-demographic correlates of COVID -19 cases in Assam, India. Also to find the relationship of clinical status of COVID -19 cases with co- morbidities and with substance use. METHODS: An institution-based cross-sectional study was undertaken from 1st April 2020 to 31st August 2020. Out of the total 12 COVID Care Centres / hospitals that had been established in Kamrup and Kamrup Metro districts of Assam, 6 were randomly selected. A total of 3000 patients were interviewed over telephone by using an android-based application;on or after discharge from the centres, while patient was put on mandatory quarantine. The patients were interviewed on various socio-demographic variables, co-morbidities and substance use behaviour. Categorical variables are expressed as percentages and the continuous variables are expressed as mean +or- standard deviation. t-test and chi-square test were used for continuous and categorical variables respectively. RESULTS: Mean age of moderate and severe cases were 55.10 and 55.9 years respectively. Smoking and use of alcohol were significantly associated with severity of symptoms. Diabetes, hypertension and co-existing lung diseases were found to be associated with status of symptoms. CONCLUSIONS: Epidemiological risk factors like age has to be relooked. Primary prevention on risk factors of non-communicable diseases proved to be crucial in prevention of severity of communicable pandemic like COVID-19. Further studies are required to enhance the knowledge on this aspect.
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Background and Aim: While India's vaccination drive against COVID-19 continues to progress, the number of Breakthrough Infections are also revealing an uptick due to Community spread of COVID-19. There is a dearth of data quantifying the extent of breakthrough infections, defined as infections following two doses of vaccine. We aimed to understand the occurrence of Breakthrough Infections among the public in the City of Thrissur, Kerala, India, during the recent surge of COVID-19 in Kerala. Methods: Patients visiting the Internal Medicine Outpatient Department (OPD) in a private hospital in the City of Thrissur in Kerala, India were selected for the study. Subjects above the age of 18 years presenting to the OPD between August 01, 2021 and September 30, 2021 were surveyed through a short interview on the COVID-19 infection history, symptoms, severity and vaccination status. Results: Of the 56 participants who tested positive for COVID-19, 38 had received both doses of vaccine and all had received their first dose of vaccine. 4 patients had no symptoms, 37 patients reported mild symptoms and nine patients reported moderate to severe symptoms. Conclusion: Our study demonstrates the occurrence and describes the epidemiology of COVID-19 breakthrough infections in a City from the Indian State of Kerala in a real-world setting. We conclude the occurrence of Symptomatic Breakthrough Infections of COVID-19 in patients who had received two doses of the vaccine were mild in the majority of the patients (87%). Further research is required to understand the mechanisms behind these Breakthrough infections.
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BACKGROUND: In 2016, the Government of the southern Indian state of Kerala launched the Aardram mission, a set of reforms in the state's health sector with the support of Local Self Governments (LSG). Primary Health Centres (PHCs) were slated for transformation into Family Health Centres (FHCs), with extended hours of operation as well as improved quality and range of services. With the COVID-19 pandemic emerging soon after their introduction, we studied the outcomes of the transformation from PHC to FHC and how they related to primary healthcare service delivery during COVID-19. METHODS: A qualitative study was conducted using In-depth interviews with 80 health system actors (male n = 32, female n = 48) aged between 30-63 years in eight primary care facilities of four districts in Kerala from July to October 2021. Participants included LSG members, medical and public health staff, as well as community leaders. Questions about the need for primary healthcare reforms, their implementation, challenges, achievements, and the impact of COVID-19 on service delivery were asked. Written informed consent was obtained and interview transcripts - transliterated into English-were thematically analysed by a team of four researchers using ATLAS.ti 9 software. RESULTS: LSG members and health staff felt that the PHC was an institution that guarantees preventive, promotive, and curative care to the poorest section of society and can help in reducing the high cost of care. Post-transformation to FHCs, improved timings, additional human resources, new services, fully functioning laboratories, and well stocked pharmacies were observed and linked to improved service utilization and reduced cost of care. Challenges of geographical access remained, along with concerns about the lack of attention to public health functions, and sustainability in low-revenue LSGs. COVID-19 pandemic restrictions disrupted promotive services, awareness sessions and outreach activities; newly introduced services were stopped, and outpatient numbers were reduced drastically. Essential health delivery and COVID-19 management increased the workload of health workers and LSG members, as the emphasis was placed on managing the COVID-19 pandemic and delivering essential health services. CONCLUSION: Most of the health system actors expressed their belief in and commitment to primary health care reforms and noted positive impacts on the clinical side with remaining challenges of access, outreach, and sustainability. COVID-19 reduced service coverage and utilisation, but motivated greater efforts on the part of both health workers and community representatives. Primary health care is a shared priority now, with a need for greater focus on systems strengthening, collaboration, and primary prevention.
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COVID-19 , Lepidoptera , Humans , Female , Male , Animals , Adult , Middle Aged , Health Care Reform , Pandemics , Government ProgramsABSTRACT
The use of reliable health literacy evaluation tools is an important condition in evaluating needs and adapting public health policies and interventions for the management of chronic illnesses and diabetes. (Global Health Promotion, 2022;29(4): 97–105) Health sovereignty as a conceptual framework of indigenous health: the case of Misak medicine Thelma Claudia Muñoz-Ibarra, Víctor Toledo-Manzur, Narciso Barrera-Bassols and Evodia Silva-Rivera Indigenous peoples maintain an inseparable link with nature, the result of a millennium-long dialogue from which emerges vast systems of integrated knowledge. (Global Health Promotion, 2022;29(4): 121–129) The tensions of healthcare models in the illness trajectories of people with risk factors for non-communicable chronic diseases Agustín Pernía, Natalia María Elli, Florencia Belén Fontana, Federico Ruscitto, Stephanie Lifszyc and Eugenia Sarcona Objective: to describe the elements that characterize healthcare models for illness trajectories of people with risk factors for non-communicable chronic diseases (NCDs) who visited three health centers in the Autonomous City of Buenos Aires. (Global Health Promotion, 2022;29(4): 161–170) Social support and obesity: the role of depressive symptoms and emotional eating in a model stratified by sex Belén Salinas-Rehbein, Jorge Schleef, Sebastián Neira-Vallejos and Manuel S. Ortiz Introduction: Obesity is a public health problem at
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Background: Pregnancy as a sensitive period of a woman's life can be affected by various psychological factors. Covid-19 pandemic is a new phenomenon;and there is limited information about its psychological consequences such as the Coronavirus disease anxiety in these women. So, the present study aimed to determine the level of Covid-19 anxiety in the third trimester of pregnancy and its related factors.
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Objective: To investigate a family cluster of coronavirus disease 2019(COVID-19)in Zibo, so as to analyze the characteristics of the epidemic.
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A mixed-methods study was performed to identify the physical and emotional needs of Hawai'i health care workers during the COVID-19 pandemic, and the degree to which these needs are being met by their clinic or hospital. Qualitative interviews and demographic surveys were conducted with two cohorts of health care workers. Cohort 1 (N=15) was interviewed between July 20 - August 7, 2020, and Cohort 2 (N=16) between September 28 - October 9, 2020. A thematic analysis of the interview data was then performed. Participants' primary concern was contracting the illness at work and transmitting it to their families. Solo practitioners working in outpatient clinics reported more financial challenges and greater difficulty obtaining PPE than those employed by hospitals or group practices. While telehealth visits increased for both inpatient and out-patient settings, the new visit type introduced new barriers to entry for patients. The study findings may serve to better understand the effect of COVID-19 on health care workers and support the development of hospital and clinic procedures. Further research into the impacts of COVID-19 on nurses in Hawai'i is recommended.
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Background: The ongoing coronavirus disease 2019 (COVID-19) pandemic has disrupted essential health services globally. COVID-19 related disruptions threaten malaria control and elimination as untreated and inappropriately treated malaria cases can lead to excess mortality and impede the COVID-19 response. This study characterized malaria service provision during the pandemic in Manicaland Province, Zimbabwe.
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Introduction. Secondary traumatic stress (STS) is a consequence of the indirect experience of trauma. The symptoms of STS are similar to those experienced by people who directly experience traumatic events in the form of posttraumatic stress disorder (PTSD). Aim. The aim of the study was to determine the frequency of the symptoms of PTSD and to establish the role of coping strategies in the development of PTSD symptoms among Polish nurses. The study was conducted before the COVID-19 pandemic. Material and methods. The study was conducted in the Podkarpackie Province (Poland) in clinical hospitals and hospital out-patient clinics. The results of studies conducted among 509 nurses were analyzed. The mean age of the respondents was 35 years, and the mean work seniority was 11 years. The IES-R scale and Mini-COPE were used in the study. Results. At least moderate PTSD symptoms were found in 42.4% of the surveyed nurses. The results showed that maladaptive stress coping strategies played a major role in the development of PTSD symptoms in the group of nurses. Conclusion. Nurses are a professional group exposed to a high risk of traumatic encounters that may result in PTSD/STS, therefore this professional group should be targeted at prophylactic programs and training in dealing with traumatic stress. The COVID pandemic and the related restrictions, organizational chaos, constant fear and a sense of danger are serious traumatizing factors and can seriously contribute to the increase in stress disorders among nurses and other medical professionals.
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People with major depressive disorder continue to be marred by chronically pernicious yet preventable outcomes in the biopsychosocial aspects. With the reallocation of healthcare resources towards the fight against the coronavirus 2019 pandemic, much emphasis has been placed on existing community mental health interventions to ameliorate the disruption of mental health services. Moreover, the recent propulsion of community mental health services by the World Health Organization Mental Health Action Plan 2013-2030 ignited the need to bolster existing community interventions by providing comprehensive, responsive and integrated mental healthcare. The enhanced emphasis on mental healthcare in the community and the heightened demands of people with major depressive disorder underscores the need to explore the current state of community mental health interventions. This scoping review examined 51 primary studies published from year 2010 to 2020 using Arskey & O'Malley's five-stage framework and provided an overview of the impact of existing community mental health interventions for people with major depressive disorder. Findings using thematic analysis have recommended the adoption of person-centred community mental healthcare via the biopsychosocial approach for people with major depressive disorder. Enablers of community mental health interventions were driven by culturally appropriate care and augmented by technology-driven modalities. Challenges and gaps of community mental health interventions include the perpetuation of stigma and misconception, complex demands of persons with major depressive disorder and lack of holistic and long-term outcomes. Given the impact of major depressive disorder on the various biopsychosocial aspects, it is envisioned that our insights into the enablers and barriers of community mental health interventions will guide prospective interdisciplinary and nurse-led interventions in holistically improving the care of persons with major depressive disorder in the community settings.
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Depressive Disorder, Major , Mental Health Services , Humans , Depressive Disorder, Major/therapy , Mental Health , Prospective Studies , Delivery of Health CareABSTRACT
Objective: This study aimed to determine the ethical issues experienced by nurses working in family health centers during the COVID-19 pandemic. Materials and Methods: This research was carried out as a qualitative study following a phenomenological pattern. The sample of the study consisted of eight nurses working in seven different family health centers in the European Region of Istanbul and who were added to the study using the snowball sampling method. Data were collected and recorded using the in-depth interview method on an online platform between June and July 2021. Data were collected in line with the interview form consisting of 12 questions. After transcription of the data, content analysis was performed using the MAXQDA 2020 program.
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Background: The disease produced by SARSCoV- 2 has led to severe situations and mortality in elderly people. The objective of this study was to describe the collaboration between hospital professionals and nursing homes when applying preventive measures for the transmission of COVID-19 and in the assistance of institutionalized patients.
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Aim & objective: Study of incidence of malaria, Dengue and Chikungunya fevers among febrile patients visiting tertiary care hospital (King George hospital) in Visakhapatnam. Method: The study is conducted in-patients visiting King George Hospital, which is a Government General Hospital located in Visakhapatnam, Andhra Pradesh, India. The hospital with 1237 beds serving the needs of north coastal Andhra Pradesh and adjacent Orissa for more than 150 years. Patients presenting to the health centre with some signs and symptoms compatible with the diagnosis of malaria, dengue and chikungunya (fever which can be recent or in evidence during the previous 2-4 days or/and other symptoms of febrile diseases such as chills, headache, joint, muscle and body pains).100 febrile patients shall be selected randomly at the age group of 13-60 years Patients shall also be selected on the basis of febrile and other symptoms such as chills, headache, joint, and muscle and body pains. Results and Conclusion: Age wise Distribution of Malaria, Dengue and Chikungunya, number of patients n=100 were taken, total n=72 patients were positive for Malaria, n=24 patients were positive for Dengue and n=4 patients were Chikungunya. With the Mean of 10.6 and Standard Deviation are 6.1. From the age group of "36 to 50"years n=28 number of patients positive for both males and females, form this total n=12 positive for malaria with the percentage of 16.6% and Females were n=16 with the percentage of 22.2%. From the age group "51 to 65"years n=8 number of patients positive for malaria in both males and females, from this total the male patients were n=4 positive for malaria with the percentage of 5.6%. The age wise description of Dengue a total "n=24"number of patients are positive for Dengue in both males and females. From the total n=16 number of male patients which are positive for Dengue with the percentage of 66.6% with the Mean of 5.3 and Standard Deviation is 4.7.females were n=8 number of patients with the percentage of 33.3% and in the Mean of 11.1 with Standard Deviation is 2.4. The age wise description of Chikungunya fever of different age groups a total "n=4"number of patients are positive for Chikungunya fever in both males and females. From the total n=02 number of male patients which are positive for malaria with the percentage of 50% with the Mean of 0.6 and Standard Deviation is 0.5 females were n=02 number of patients with the percentage of 50% and in the Mean of 0.6 and Standard Deviation is 0.5. Chikungunya fever in both males and females, from the total male patients were n=0 positive for Chikungunya fever and females were n=1 number of patients positive for Chikungunya with the percentage of 25%. The maximum peaks are observed equally in the age of 36 to 50 years age group. The Month wise Description of Malaria, Dengue and Chikungunya positive patients from the month of April 2017 to month of October 2017. To identify the seasonal variation of the disease, analysis of the data on monthly basis was done.
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Background: In modern health systems, emergency services (ES) constitute one of the cornerstones of health care, and they have an essential role in the conception of current health services. The objective of this work was to analyze the effect of sociodemographic characteristics and clinical factors in the use of ES.
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Background: Influenza vaccination coverages among health care students are low. The aim of this study was to find out which measures, according to medical and nursing students, could contribute to improve these vaccination rates.
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Efforts to prevent and limit the transmission of infection in health centers during the Covid-19 pandemic are important because of the many activities of health centers conducting swab tests, vaccination activities and other service activities that cause the transmission of infection. This study aimed to find out the picture of control and prevention of infectious diseases based on environmental health in the health center of district X. This study was a mixed method study with the determination of qualitative research inform an and purposive sampling and the sample of study was 75 respondents. The results showed that there was a lack of knowledge level of the health workers. Input: there were policies such as SOPs, HR PPI teams consisting of doctors, nurses, and sanitation workers, infrastructure facilities are available and funds come from BLUD. Process: the implementation of hand hygiene, PPE, waste management, environmental control has been implemented, and some are not in accordance with regulations such as sorting waste that is still mixed, transporting waste that is late and also waste storage that has not used coldstorage, Output: the management of medical waste puskesmas has been implemented and has not been in accordance with applicable regulations. The conclusion of medical waste management has not been in accordance with Decree No. 27/2017 and Permen LHK No. 56/2015. Suggestions to coordinates and cooperates with cross-sector related sectors in addressing medical waste problems and improving environmental health-based infection disease control and prevention efforts.
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Background: Italy was one of the first European countries to report COVID-19 cases, at the end of January 2020.1 In mid-February, the country reported community-based transmission, especially in the northern regions of Lombardia, Piemonte and Emilia-Romagna.2 The COVID-19 pandemic overstretched the structural capacity of health care facilities, and several hospitals in Emilia-Romagna undertook emergency measures to renovate, expand and reconstruct existing facilities. The Italian Ministry of Health required that emergency rooms be reorganized and restructured to separate the flow of human traffic and create permanent isolated areas for patients waiting for the results of tests for COVID-19.3 Emilia-Romagna, with WHO headquarters and the WHO regional and country offices, then launched the "hospital of tomorrow" project to set new standards to be applied to health-care facilities after COVID-19. Below, we present the preliminary results of the initial steps, covering 3 months of project (Figure 1). The case study will last one year (October 2020-November 2021) and further results will be discussed at the end of the project. Setting: St Orsola-Malpighi polyclinic, the facility selected for this pilot project, is an internationally acclaimed institution that dates back more than 4 centuries. It represents the European architectural heritage, with a mix of old and new pavilions, integrated into a city context. It is organized into 7 departments with 91 operative units. Before the COVID-19 pandemic, it was equipped with 1758 beds and had more than 5000 staff, with annual outpatient and inpatient turnovers of 400 000 and 72 000 patients, respectively. On any given day, approximately 20 000 staff, students, university lecturers and researchers, patients, visitors and suppliers are present on the hospital grounds.4 Process and outcomes: The hospital directors in collaboration with the WHO team defined the key macro areas for the intervention to enhance the facility's strengths and reduce its weaknesses in the health-care standards required to prevent the spread of SARS-CoV-2 and other infections and to improve the well-being of patients and staff and the quality of services. Working groups were established for each macro area, with representatives and group members selected by the hospital's Board of Directors. Representatives of the groups met weekly to coordinate activities and to serve as contact persons for group activities and liaison among the groups. The groups formed initially addressed staff spaces, high-tech logistics, "wayfinding", patient and visitor spaces, operational system support, user reception and access and telemedicine.
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Patients have developed a well-informed sense of validation concerning maintaining hygiene standards. The pandemic, somehow in disguise, presented the valuable perspective of life reflection and gratitude. The attitude of a majority of patients engaged was immensely that of a deep reflection of the privilege of having access to early diagnosis, treatment, and adequate support. However, the complaints of the past, knowing that they are alive and have hope to keep fighting on with gratitude and sense of acceptance. However, they wished that the experience of the social media - health engagement platform should continue as it provided a good level of the bridge of gap of information. The cost of treatment remains a major concern as it largely translates to possible dropout from treatment courses for most cancer patients who can't afford the current cost. The concerns of the cancer patients and survivors during and after the covid-19 pandemic are similarly a concern to public health professionals worldwide. The need to aid their return to routine health care services is more important and therefore requires an urgent reorganization of cancer management services. An urgent intervention should be focused on patient re-orientation /pandemic control, staff training and retraining, awareness campaign, screening and result accessibility, special pandemic services, amongst others. The outcome reflected a very huge level of poor cancer patient experience in the public cancer treatment centres, while the reverse is the case with the private cancer treatment centres. This can be managed if an urgent intervention as proffered is implemented.
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Coronavirus disease 2019 (COVID-19) has resulted in considerable morbidity and mortality worldwide since December 2019. Diseases such as diabetes, hypertension, cardiovascular and pulmonary diseases are common comorbidities in COVID-19 patients and have been correlated with increased disease severity. Comorbidities lead the COVID-19 patient into a vicious infectious circle and are substantially associated with significant morbidity and mortality. This study was aimed to estimate prevalence of comorbidities in severe category of COVID survivors and non survivors. More than 90% patients with multiple comorbidities admitted to ICU did not survive compared to those with one or two comorbidities. Diabetes followed by hypertension was the most common comorbidity in these patients. Thus comorbid individuals must adopt vigilant preventive measures including vaccination and they require intensive management for better outcome.