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2.
PLoS One ; 17(8): e0271824, 2022.
Article in English | MEDLINE | ID: covidwho-2079702

ABSTRACT

Impacts of the COVID-19 pandemic on the mental health of healthcare workers has been established, linking workplace factors with high levels of stress, anxiety, depression, insomnia and burnout. Less established is how COVID-19 affects both work, home and social life of nurses and midwives concurrently. This study describes the prevalence and severity of anxiety, depression, post-traumatic stress disorder (PTSD) and insomnia and examines their associations with stressors within the work, home and social environment, among nurses and midwives. A longitudinal, mixed-methods, online survey explored the psychological health of public sector nurses and midwives during the COVID-19 pandemic first year. Surveys were conducted in April (initial) and June 2020 (3-month), and April 2021 (12-month) and consisted of psychological tests including the Patient Health Questionnaire, General Anxiety Disorder, Insomnia Severity Index, and the Impact of Events Scale-Revised; workplace and lifestyle questions, together with free-text comments. The relative strengths of the associations between predictor and outcome variables were estimated using repeated measures ordered logistic regression, and free text responses were themed. Data show diagnostic levels of anxiety (23%, 18%, 21%) at surveys one, two and three respectively, depression (26%, 23% and 28%), PTSD (16%, 12% and 10%) and insomnia (19%, 19% and 21%). The strongest predictors of psychological distress were current home and family stress and poor clinical team support. Factors which will help preserve the mental health of nurses and midwives include strong workplace culture, reducing occupational risk, clear communication processes, and supporting stable and functional relationships at home. The COVID-19 pandemic has increased the visibility of mental distress on nurses and midwives and established they are pivotal to healthcare. The health service has a duty-of-care for the welfare of nurses and midwives who have entered this psychologically taxing profession to future proof service delivery and safeguard its service-response capacity.


Subject(s)
COVID-19 , Midwifery , Sleep Initiation and Maintenance Disorders , Anxiety/epidemiology , COVID-19/epidemiology , Depression/epidemiology , Depression/psychology , Female , Humans , Pandemics , Pregnancy , Public Sector , SARS-CoV-2 , Sleep Initiation and Maintenance Disorders/epidemiology , Tasmania
3.
Int J Environ Res Public Health ; 19(16)2022 08 09.
Article in English | MEDLINE | ID: covidwho-2023635

ABSTRACT

The healthcare sector is an ever-growing industry which produces a vast amount of waste each year, and it is crucial for healthcare systems to have an effective and sustainable medical waste management system in order to protect public health. Greek public hospitals in 2018 produced 9500 tons of hazardous healthcare wastes, and it is expected to reach 18,200 tons in 2025 and exceed 18,800 tons in 2030. In this paper, we investigated the factors that affect healthcare wastes. We obtained data from all Greek public hospitals and conducted a regression analysis, with the management cost of waste and the kilos of waste as the dependent variables, and a number of variables reflecting the characteristics of each hospital and its output as the independent variables. We applied and compared several models. Our study shows that healthcare wastes are affected by several individual-hospital characteristics, such as the number of beds, the type of the hospital, the services the hospital provides, the number of annual inpatients, the days of stay, the total number of surgeries, the existence of special units, and the total number of employees. Finally, our study presents two prediction models concerning the management costs and quantities of infectious waste for Greece's public hospitals and proposes specific actions to reduce healthcare wastes and the respective costs, as well as to implement and adopt certain tools, in terms of sustainability.


Subject(s)
Medical Waste Disposal , Waste Management , Delivery of Health Care , Greece , Hazardous Waste , Hospitals, Public , Humans , Public Sector
5.
Environ Manage ; 70(5): 697-709, 2022 11.
Article in English | MEDLINE | ID: covidwho-2007132

ABSTRACT

The resilience of public environmental agencies is an important but broadly under-researched discourse. This paper addresses this lacuna by drawing on a three-part typology of resilience from organizational studies and applying it to the English natural environment agency, Natural England, following a decade of public sector agency de-funding under the aegis of austerity. The research question was explored qualitatively through eleven semi-structured interviews with the senior management team of Natural England during the summer of 2020. The findings suggest that public agency multi-functionality equate to heterogenous resilience across agency functions; that generally agency resilience (as a function of capacities) is poor with consequences upon good governance; and that they are broadly poorly positioned for the aftermath of Covid-19. The findings speak directly to the regulatory and organizational literatures with public administration by evidencing the complex realities of understanding resiliencies in large multi-functional public environmental agencies.


Subject(s)
Environment , Organizational Culture , Public Sector , Financial Support , Financing, Government , Humans
6.
Eur Rev Med Pharmacol Sci ; 26(3): 1049-1055, 2022 02.
Article in English | MEDLINE | ID: covidwho-1708988

ABSTRACT

OBJECTIVE: The reorganization of cancer services and the increased work burden on health care providers during the COVID-19 pandemic are likely to be associated with significant negative psychological impact. The aim of this study is to evaluate the impact of COVID-19 pandemic on the psychological well-being of oncology clinicians in the Middle East and North Africa (MENA) region. MATERIALS AND METHODS: We randomly invited 1500 oncology clinicians including medical oncologists, clinical oncologists, radiation oncologists and surgical oncologists from 17 countries in the MENA region to complete a web-based survey to determine the level of psychological stress during the COVID-19 pandemic from October 2020 to January 2021. The questionnaire was based on the Perceived Stress Scale (PSS), Generalized Anxiety Disorders Scale (GAD-7) and WHO Well-being Index (WHO-5). The data was analyzed using SPSS version 21 and the difference between groups was measured by t-test and ANOVA. RESULTS: Overall, 520 (35%) clinicians including 368 (71%) males and 152 (29%) females participated in the survey with 247 (47%) participants between the ages of 36 to 45 years. Average score of 29.6 for males and 30.2 on PSS-10, indicative of high-perceived stress in both the genders. Compared to males, females had significantly higher anxiety levels on GAD-7 scale (p=.04), but this difference in stress level and well-being was not observed on PSS-10 (p=.134) and WHO -5 well-being index (p=.709). Clinicians of age 25-35 years had significantly higher anxiety levels on GAD-7 scale (p=.004) and higher stress on PSS (p=.000) as compared to other age groups. Age over 55 years was associated with lower levels of anxiety and stress on GAD-7 and PSS. Oncology clinicians working in public sector experienced significantly lower stress as compared to private sector on PSS scale (p=.041). CONCLUSIONS: Anxiety and stress levels among oncology clinicians have significantly increased in COVID-19 pandemic in the MENA region. Females and young clinicians had higher anxiety and stress, while oncology clinicians over the age of 55 years and working in the public sector reported less stress and anxiety. The general wellbeing of clinicians was well preserved even in a highly stressful and anxious situation.


Subject(s)
COVID-19/psychology , Oncologists/psychology , Stress, Psychological/epidemiology , Adult , Africa, Northern/epidemiology , Anxiety/epidemiology , Female , Health Surveys/statistics & numerical data , Humans , Male , Middle Aged , Middle East/epidemiology , Pandemics , Private Sector , Public Sector
7.
Front Public Health ; 9: 743748, 2021.
Article in English | MEDLINE | ID: covidwho-1607720

ABSTRACT

Strong leadership in public sector innovation can empower governments to address community challenges in new ways in light of the challenges posed by the global coronavirus pandemic. Coronavirus management policy, pandemic responses, needs, and options are reflected in various Asian countries in respective published literature, but a summarized synthesis is not available. Using a systematic review approach (PRISMA), this study has analyzed the role of leadership in public sector innovation in COVID-19 management and synthesized 23 articles from 23 different Asian countries. In the light of available data, public sector innovation (PSI) and the role played by the leadership of each country' have been found to be largely inter-dependent. The current review provides a cross-section of the ongoing nature of the pandemic, as management responses and trend data in the countries are still emerging or evolving. Additionally, our study contributes a current state report regarding the barriers facing the leadership of Asian countries in mitigating the global pandemic through PSI. Our study found that a strong political leadership presence combined with a technocratic approach and a highly-skilled public sector workforce, could lead to more tremendous success in managing the outbreak. Furthermore, religious leadership was also found to have a potentially significant role in COVID-19 management strategies.


Subject(s)
COVID-19 , Leadership , Humans , Pandemics/prevention & control , Public Sector , SARS-CoV-2
8.
Lancet Glob Health ; 10(2): e293-e297, 2022 02.
Article in English | MEDLINE | ID: covidwho-1573855

ABSTRACT

The COVID-19 pandemic has underlined the importance of an efficient and equitable supply of and access to essential health products. These factors are equally pertinent to the antimicrobial resistance pandemic, in which access to a portfolio of existing and pipeline antimicrobials plus complementary diagnostics is crucial. This Viewpoint focuses on market shaping in low-income and middle-income countries (LMICs), where the need for effective antimicrobials and complementary diagnostics is most acute. We propose the creation of a subscription and pooled procurement model that consolidates the growing demand for a portfolio of antimicrobials and diagnostics in LMICs. Anchored by regional market leaders, these pooling mechanisms would guarantee consistent private-sector and public-sector access in participating countries, while creating conditions for long-term best practice in stewardship. Supported by data from South Africa and India, this proposal sets out an innovative approach to tackle the antimicrobial resistance crisis in LMICs.


Subject(s)
Anti-Infective Agents/supply & distribution , COVID-19/epidemiology , Developing Countries , Diagnostic Tests, Routine , Anti-Infective Agents/economics , Drug Resistance, Microbial , Humans , Pandemics , Private Sector , Public Sector , SARS-CoV-2
9.
BMJ Open ; 11(12): e054010, 2021 12 08.
Article in English | MEDLINE | ID: covidwho-1559172

ABSTRACT

INTRODUCTION: In the wake of the unprecedented public health challenge of the COVID-19 pandemic, it is highly significant to recognise the mental health impact of this mounting threat on healthcare providers (HCPs) working in the obstetrics and gynaecology department. Experience from epidemics and emerging literature around COVID-19 show that the unparalleled amount of stress that HCPs are dealing with is linked with the increased burden of mental health conditions. We aim to conduct an exploratory qualitative descriptive study to assess HCPs' perceptions of mental health amid the COVID-19 pandemic in the obstetrics and gynaecology department of a public sector tertiary care hospital of Karachi, Pakistan. METHODS AND ANALYSIS: This study will use a qualitative descriptive approach where approximately 20-25 HCPs from the obstetrics and gynaecology department will be recruited using a purposive sampling approach. Data will be collected through semistructured interviews and it will be analysed thematically using NVivo V.12 Plus software. ETHICS AND DISSEMINATION: Ethical approval for this study has been obtained from the Institutional Review Board Committee of Jinnah Postgraduate Medical Center hospital. The study results will be disseminated to the scientific community and the HCPs participating in the study. The findings will help us to explore the doctor's perceptions of mental health during the current pandemic of COVID-19 and its impact on their daily lives and mental well-being.


Subject(s)
COVID-19 , Gynecology , Obstetrics , Health Personnel , Hospitals , Humans , Mental Health , Pakistan/epidemiology , Pandemics , Public Sector , SARS-CoV-2 , Tertiary Healthcare
11.
PLoS One ; 16(11): e0260142, 2021.
Article in English | MEDLINE | ID: covidwho-1526693

ABSTRACT

OBJECTIVE: To measure medicines' prices, availability, and affordability in Hanam, Vietnam. METHODS: The standardized methodology developed by the World Health Organization (WHO) and Health Action International was used to survey 30 essential medicines (EMs) in 30 public health facilities and 35 private medicine outlets in 2020. The availability of medicine was computed as the percentage of health facilities in which this medicine was found on the data-collection day. International reference prices (IRPs) from Management Sciences for Health (2015) were used to compute Median Price Ratio (MPR). The affordability of treatments for common diseases was computed as the number of days' wages of the lowest-paid unskilled government worker needed to purchase medicines prescribed at a standard dose. Statistic analysis was done using R software version 4.1.1. RESULTS: The mean availability of originator brands (OBs) and lowest-priced generics (LPGs) was 0.7%, 63.2% in the public sector, and 13.7%, 47.9% in the private sector, respectively. In private medicine outlets, the mean availability of both OBs and LPGs in urban areas was significantly higher than that in rural areas (p = 0.0013 and 0.0306, respectively). In the public sector, LPGs' prices were nearly equal to their IRPs (median MPRs = 0.95). In the private medicine outlets, OBs were generally sold at 6.24 times their IRPs while this figure for LPGs was 1.65. The affordability of LPGs in both sectors was good for all conditions, with standard treatments costing a day's wage or less. CONCLUSION: In both sectors, generic medicines were the predominant product type available. The availability of EMs was fairly high but still lower than WHO's benchmark. A national-scale study should be conducted to provide a comprehensive picture of the availability, prices, and affordability of EMs, thereby helping the government to identify the urgent priorities and improving access to EMs in Vietnam.


Subject(s)
Drugs, Essential/economics , Economics, Medical/trends , Health Services Accessibility/economics , Consumer Behavior , Costs and Cost Analysis , Cross-Sectional Studies , Drugs, Generic/economics , Economics, Medical/statistics & numerical data , Government , Health Facilities , Health Services Accessibility/trends , Humans , Medicine , Private Sector , Public Sector , Vietnam
12.
Occup Environ Med ; 79(4): 233-241, 2022 04.
Article in English | MEDLINE | ID: covidwho-1410483

ABSTRACT

OBJECTIVES: To examine the associations of COVID-19-related changes in work with perceptions of psychosocial work environment and employee health. METHODS: In a cohort of 24 299 Finnish public sector employees, psychosocial work environment and employee well-being were assessed twice before (2016 and 2018=reference period) and once during (2020) the COVID-19 pandemic. Those who reported a change (='Exposed') in work due to the pandemic (working from home, new tasks or team reorganisation) were compared with those who did not report such change (='Non-exposed'). RESULTS: After adjusting for sex, age, socioeconomic status and lifestyle risk score, working from home (44%) was associated with greater increase in worktime control (standardised mean difference (SMD)Exposed=0.078, 95% CI 0.066 to 0.090; SMDNon-exposed=0.025, 95% CI 0.014 to 0.036), procedural justice (SMDExposed=0.101, 95% CI 0.084 to 0.118; SMDNon-exposed=0.053, 95% CI 0.038 to 0.068), workplace social capital (SMDExposed=0.094, 95% CI 0.077 to 0.110; SMDNon-exposed=0.034, 95% CI 0.019 to 0.048), less decline in self-rated health (SMDExposed=-0.038, 95% CI -0.054 to -0.022; SMDNon-exposed=-0.081, 95% CI -0.095 to -0.067), perceived work ability (SMDExposed=-0.091, 95% CI -0.108 to -0.074; SMDNon-exposed=-0.151, 95% CI -0.167 to -0.136) and less increase in psychological distress (risk ratio (RR)Exposed=1.06, 95% CI 1.02 to 1.09; RRNon-exposed=1.16, 95% CI 1.13 to 1.20). New tasks (6%) were associated with greater increase in psychological distress (RRExposed=1.28, 95% CI 1.19 to 1.39; RRNon-exposed=1.10, 95% CI 1.07 to 1.12) and team reorganisation (5%) with slightly steeper decline in perceived work ability (SMDExposed=-0.151 95% CI -0.203 to -0.098; SMDNon-exposed=-0.124, 95% CI -0.136 to -0.112). CONCLUSION: Employees who worked from home during the pandemic had more favourable psychosocial work environment and health, whereas those who were exposed to work task changes and team reorganisations experienced more adverse changes.


Subject(s)
COVID-19 , Occupational Health , COVID-19/epidemiology , Cohort Studies , Finland/epidemiology , Humans , Pandemics , Public Sector , Surveys and Questionnaires , Workplace/psychology
13.
Int J Tuberc Lung Dis ; 25(9): 777-778, 2021 09 01.
Article in English | MEDLINE | ID: covidwho-1395201
14.
PLoS One ; 16(5): e0251593, 2021.
Article in English | MEDLINE | ID: covidwho-1388913

ABSTRACT

INTRODUCTION: SARS-CoV-2 transmission within schools and its contribution to community transmission are still a matter of debate. METHODS: A retrospective cohort study in all public schools in Catalonia was conducted using publicly available data assessing the association between the number of reported SARS-CoV-2 cases among students and staff in weeks 1-2 (Sept 14-27th, 2020) of the academic year with school SARS-CoV-2 incidence among students in weeks 4-5. A multilevel Poisson regression model adjusted for the community incidence in the corresponding basic health area (BHA) and the type of school (primary or secondary), with random effects at the sanitary region and BHA levels, was performed. RESULTS: A total of 2184 public schools opened on September 14th with 778,715 students. Multivariate analysis showed a significant association between the total number of SARS-CoV-2 cases in a centre in weeks 1-2 and the SARS-CoV-2 school incidence among students in weeks 4-5 (Risk Ratio (RR) 1.074, 95% CI 1.044-1.105, p-value <0.001). The adjusted BHA incidence in the first two weeks was associated with school incidence in weeks 4-5 (RR 1.002, 95% CI 1.002-1.003, p-value <0.001). Secondary schools showed an increased incidence in weeks 4 and 5 (RR primary vs secondary 1.709 95% CI 1.599-1.897, p-value <0.001). CONCLUSIONS: Safety measures adopted by schools were not enough to stop related-to-school transmission in students and could be improved. The safest way to keep schools open is to reduce community transmission down to a minimum.


Subject(s)
COVID-19/epidemiology , COVID-19/transmission , Schools/trends , Adolescent , Child , Cohort Studies , Female , Humans , Incidence , Male , Public Sector , Retrospective Studies , SARS-CoV-2/pathogenicity , Spain/epidemiology , Students
15.
PLoS Negl Trop Dis ; 15(8): e0009702, 2021 08.
Article in English | MEDLINE | ID: covidwho-1359097

ABSTRACT

BACKGROUND: Annually, about 2.7 million snakebite envenomings occur globally. Alongside antivenom, patients usually require additional care to treat envenoming symptoms and antivenom side effects. Efforts are underway to improve snakebite care, but evidence from the ground to inform this is scarce. This study, therefore, investigated the availability, affordability, and stock-outs of antivenom and commodities for supportive snakebite care in health facilities across Kenya. METHODOLOGY/PRINCIPAL FINDINGS: This study used an adaptation of the standardised World Health Organization (WHO)/Health Action International methodology. Data on commodity availability, prices and stock-outs were collected in July-August 2020 from public (n = 85), private (n = 36), and private not-for-profit (n = 12) facilities in Kenya. Stock-outs were measured retrospectively for a twelve-month period, enabling a comparison of a pre-COVID-19 period to stock-outs during COVID-19. Affordability was calculated using the wage of a lowest-paid government worker (LPGW) and the impoverishment approach. Accessibility was assessed combining the WHO availability target (≥80%) and LPGW affordability (<1 day's wage) measures. Overall availability of snakebite commodities was low (43.0%). Antivenom was available at 44.7% of public- and 19.4% of private facilities. Stock-outs of any snakebite commodity were common in the public- (18.6%) and private (11.7%) sectors, and had worsened during COVID-19 (10.6% versus 17.0% public sector, 8.4% versus 11.7% private sector). Affordability was not an issue in the public sector, while in the private sector the median cost of one vial of antivenom was 14.4 days' wage for an LPGW. Five commodities in the public sector and two in the private sector were deemed accessible. CONCLUSIONS: Access to snakebite care is problematic in Kenya and seemed to have worsened during COVID-19. To improve access, efforts should focus on ensuring availability at both lower- and higher-level facilities, and improving the supply chain to reduce stock-outs. Including antivenom into Universal Health Coverage benefits packages would further facilitate accessibility.


Subject(s)
Antivenins/therapeutic use , Equipment and Supplies, Hospital/statistics & numerical data , Health Services Accessibility/statistics & numerical data , Snake Bites/drug therapy , Antivenins/economics , COVID-19/epidemiology , Costs and Cost Analysis , Equipment and Supplies, Hospital/economics , Health Services Accessibility/economics , Humans , Kenya/epidemiology , Private Sector/economics , Private Sector/statistics & numerical data , Public Sector/economics , Public Sector/statistics & numerical data , Snake Bites/economics , Snake Bites/epidemiology
16.
J Med Internet Res ; 23(7): e28812, 2021 07 26.
Article in English | MEDLINE | ID: covidwho-1334873

ABSTRACT

BACKGROUND: The COVID-19 pandemic has changed public health policies and human and community behaviors through lockdowns and mandates. Governments are rapidly evolving policies to increase hospital capacity and supply personal protective equipment and other equipment to mitigate disease spread in affected regions. Current models that predict COVID-19 case counts and spread are complex by nature and offer limited explainability and generalizability. This has highlighted the need for accurate and robust outbreak prediction models that balance model parsimony and performance. OBJECTIVE: We sought to leverage readily accessible data sets extracted from multiple states to train and evaluate a parsimonious predictive model capable of identifying county-level risk of COVID-19 outbreaks on a day-to-day basis. METHODS: Our modeling approach leveraged the following data inputs: COVID-19 case counts per county per day and county populations. We developed an outbreak gold standard across California, Indiana, and Iowa. The model utilized a per capita running 7-day sum of the case counts per county per day and the mean cumulative case count to develop baseline values. The model was trained with data recorded between March 1 and August 31, 2020, and tested on data recorded between September 1 and October 31, 2020. RESULTS: The model reported sensitivities of 81%, 92%, and 90% for California, Indiana, and Iowa, respectively. The precision in each state was above 85% while specificity and accuracy scores were generally >95%. CONCLUSIONS: Our parsimonious model provides a generalizable and simple alternative approach to outbreak prediction. This methodology can be applied to diverse regions to help state officials and hospitals with resource allocation and to guide risk management, community education, and mitigation strategies.


Subject(s)
COVID-19/epidemiology , Computer Simulation , Datasets as Topic , Disease Outbreaks/statistics & numerical data , Forecasting/methods , Heuristics , Public Sector , COVID-19/prevention & control , California/epidemiology , Humans , Indiana/epidemiology , Iowa/epidemiology , Models, Biological , SARS-CoV-2
17.
Salud Publica Mex ; 63(2, Mar-Abr): 225-231, 2021 Feb 26.
Article in Spanish | MEDLINE | ID: covidwho-1310306

ABSTRACT

Objetivo. Determinar el nivel de evidencia sobre la proba-bilidad de transmisión de enfermedades respiratorias agudas en el transporte público colectivo. Material y métodos. Se utilizó la metodología de revisiones rápidas de Cochrane. La estrategia de búsqueda abarcó una base de datos acadé-mica hasta el 10 de diciembre de 2020. Resultados. Se identificaron 16 manuscritos que cumplieron los criterios de selección. En estudios de cohorte agrupados se encontró que el momio de seroconversión por influenza A o B fue 54% mayor en personas con uso frecuente de transporte público colectivo en comparación con las personas con un uso poco frecuente (razón de momios: 1.54; IC95%:1.06-2.01). Conclusión. La probabilidad de contagio por enfermeda-des respiratorias agudas puede incrementar con el uso del transporte público colectivo. Algunas recomendaciones para reducir la probabilidad de contagio en el transporte público colectivo son el uso de cubrebocas y reducir el número de pasajeros y tiempo de traslado.


Subject(s)
Public Sector , Respiratory Tract Infections , Transportation , Humans , Probability , Respiratory Tract Infections/transmission , Transportation/statistics & numerical data
18.
Lancet ; 397(10291): 2304-2308, 2021 06 12.
Article in English | MEDLINE | ID: covidwho-1265895

ABSTRACT

Strong US-China collaboration on health and medicine is a crucial element of the global effort against COVID-19. We review the history of health collaboration and exchanges between the public and private sectors in the USA and China, including the long-lasting collaboration between governmental public health agencies of the two countries. Academic and scientific exchanges should be reinvigorated and the increasing valuable role of non-profit foundations acknowledged. The shared interests of the two countries and the magnitude of the pandemic necessitate both countries to collaborate and cooperate. We provide recommendations to the two governments and the global health community to control the ongoing COVID-19 pandemic and prepare for future threats. TRANSLATION: For the Chinese translation of the abstract see Supplementary Materials section.


Subject(s)
Health , International Cooperation/history , Medicine , China , Global Health , Government Agencies , History, 20th Century , History, 21st Century , Humans , Private Sector , Public Health , Public Sector , Science , United States , Universities
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