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Aim: The Dutch Sentinel General Practice Network (SGPN) was founded in 1970 for disease surveillance in primary care, based on paper questionnaires. Advances in information technology offered new prospects of data collection from electronic health records (EHRs). This study investigates the resulting challenges for the SGPN and its transition towards electronic data collection. Methods: A qualitative approach included triangulation of SGPN annual reports, network publications, its computerisation project protocol of 2004, public health policy documents, and expert interviews. Results: In the 1990s, the design of the SGPN, coordinated by the research institute NIVEL, no longer corresponded to new Dutch government information demands regarding developments in primary care utilisation and quality. The emergence of the EHR-based Netherlands Information Network of General Practice (LINH) could have rendered the SGPN obsolete. However, NIVEL researchers recognised that routine EHR data on health problems could not fully provide required information obtained by questionnaires and samples for laboratory analysis. They developed a plan (1) taking EHR-based routine data collection as a basis, and (2) simultaneously retaining the more detailed supplementary data collection that was the core of the SGPN. The transition towards electronic data collection from 2005 onwards was followed by the integration of both networks into the NIVEL Primary Care Database in 2014. Conclusion: The Dutch model is an example of a process responding to the challenges and opportunities associated with the emergence of electronic data collection, leading towards the integration of routine and supplementary data collection for both sentinel surveillance and health services research. [ABSTRACT FROM AUTHOR]

Background: While it is a generally accepted fact that many gambling screening tools are not fit for purpose when employed as part of a public health framework, the evidence supporting this claim is sporadic. The aim of this review is to identify and evaluate the gambling screening tools currently in use and examine their utility as part of a public health approach to harm reduction, providing a holistic snapshot of the field. Methods: A range of index tests measuring aspects of problem gambling were examined, including the South Oaks Gambling Screen (SOGS) and the Problem Gambling Severity Index (PGSI), among others. This review also examined a range of reference standards including the Diagnostic Interview for Gambling Severity (DIGS) and screening tools such as the SOGS. Results: The present review supports the belief held by many within the gambling research community that there is a need for a paradigm shift in the way gambling harm is conceptualised and measured, to facilitate early identification and harm prevention. Discussion: This review has identified a number of meaningful deficits regarding the overall quality of the psychometric testing employed when validating gambling screening tools. Primary among these was the lack of a consistent and reliable reference standard within many of the studies. Currently there are very few screening tools discussed in the literature that show good utility in the domain of public health, due to the focus on symptoms rather than risk factors. As such, these tools are generally ill-suited for identifying preclinical or low-risk gamblers. [ABSTRACT FROM AUTHOR]

Aim: This paper aims to better understand the relationship between homicide and other public health outcomes, by studying their trends over time. Subject and methods: Research in both criminology and public health has long identified that crime and violence tend to cluster together with adverse phenomena in the social and health domains. However, such work has relied primarily on cross-sectional analyses. Here, we instead study trends over time. We take data from the Netherlands, between 2000 and 2020, and ask whether homicide shows similar trends over time as other public health phenomena – such as smoking behaviour, alcohol use, child mortality, adolescent pregnancies, and suicide. Results: We observe, first, that all of the phenomena – with the exception of suicide – declined over the period under study. We then employ a time series analysis to examine whether these trends arise independently, or whether they are the result of structural similarities between phenomena. Results showed that the decline in homicide rates is linked to a similar decline in adolescent pregnancies – the rates of these phenomena 'move together' during the period under study. Conclusion: This work shows that the phenomenon of homicide shares structural similarities with teenage pregnancies – a decline in one is linked to a similar decline in the other. More generally, the current work furthers our understanding of the place of homicide in the domain of (public) health. [ABSTRACT FROM AUTHOR]

Aim: The Health Gym Program is the main health promotion strategy in the Brazilian public health system. This paper aims to measure the impact of the Health Gym Program on hospital admission expenses for stroke in the state of Pernambuco, Brazil. Subject and methods: This public health impact evaluation used a panel of socioeconomic, demographic, and epidemiological data from 2007 to 2019 for all 185 municipalities in the state of Pernambuco. The empirical strategy used pre-tests, ordinary least-squares econometric modeling, and quantile regression as a robustness test. Results: The municipalities that implemented the Health Gym Program spent an average of 21.04% less on hospitalizations for stroke than the municipalities that did not, and this result was statistically significant at the 1% level. Further, the density of program coverage within the municipality also impacts the reduction of expenses. This saving is directly proportional to the number of hubs of the program in the municipalities. An increase of one program hub for every 10,000 inhabitants results in a 4.57% reduction in expenditure on stroke hospitalizations in the municipalities. Conclusion: The presence of the Health Gym Program led to a reduction in expenses related to hospital admissions for stroke, which may indicate that this program effectively expands the scope of health promotion actions in primary healthcare. The evidence generated from this study can be used to implement evidence-based policies aimed at preventing and controlling chronic diseases in Brazil. [ABSTRACT FROM AUTHOR]

Background: According to the World Population Outlook (2019), people over 65, usually accompanied by various chronic diseases, will make up 16% of the population in 2050. Therefore, the health problems of middle-aged and elderly people are becoming the focus of current global attention. Some scholars have found that the health of middle-aged and elderly people is related to the childhood socio-economic environment. Methods: Using the China Health and Retirement Longitudinal Study (CHARLS) data, this paper innovatively constructed four measurement dimensions of health (namely, self-rated health, physical health, emotional health, and mental health). Moreover, logistic regression was used to explore the impact of childhood socio-economic environment (such as parent's education level, work experience, etc.) on the health status of middle-aged and elderly people. Results: Compared with a poor childhood social-economic environment, a good childhood socio-economic environment is more advantageous to the self-rated health of middle-aged and elderly people, especially a childhood socio-economic environment close to the medium level; the psychological health of middle-aged and elderly people who have experienced an adverse childhood socio-economic environment was better than those who did not; the childhood socio-economic environment has no apparent impact on the cognitive situation of middle-aged and elderly people. Conclusions: Some policy implications can be drawn. For example, the government should vigorously introduce policies to help migrant workers' children receive education in cities and provide special education guarantees for migrant workers' children. Societies and families should also pay more attention to the childhood socio-economic environment. [ABSTRACT FROM AUTHOR]

Aim: In response to the SARS-CoV-2 emergency, the Competence Centre on digital health 'TrentinoSalute4.0' has developed TreC_Televisita, a tele visit solution that meets the needs of the Trentino healthcare system and maintains high-quality patient–doctor interactions while respecting social distancing. This paper highlights how 'TreC_Televisita' was integrated into the Trentino healthcare system and its potential to become a structural and durable solution for the future local healthcare service provisioning. Subject and methods: This paper presents the multifactorial context that TreC_Televisita has faced for its implementation and the strategies adopted for its structural integration into the healthcare system. The analysis focuses on the main issues faced for the integration of the tele visits (e.g. privacy, payments) and how the context of TrentinoSalute4.0 permitted responding quickly to its implementation during the pandemic. It also describes how TreC_Televisita fits into the healthcare continuum from the organisational and technological standpoint, the end-user perspective and the barriers that could hamper the solution scalability. Results: TreC_Televisita has demonstrated to be a technological solution that can be contextualised for different clinical domains beyond SARS-CoV-2. Moreover, it has shown its potential to scale up the solution beyond the COVID-19 emergency to the whole healthcare provisioning system in the long term. Conclusion: Being a positive experience in the first months of its implementation, the long-term goal is to transform TreC_Televisita into a structural pillar of the Trentino healthcare system, setting the bases for a sustainable, win–win situation for all the stakeholders involved in healthcare service provisioning. [ABSTRACT FROM AUTHOR]

Purpose: With the coronavirus disease 2019 (COVID-19) pandemic spreading across the world, protective measures for containing the virus are essential, especially as long as no vaccine or effective treatment is available. One important measure is the so-called physical distancing or social distancing. Methods: In this paper, we propose an agent-based numerical simulation of pedestrian dynamics in order to assess the behavior of pedestrians in public places in the context of contact transmission of infectious diseases like COVID-19, and to gather insights about exposure times and the overall effectiveness of distancing measures. Results: To abide by the minimum distance of 1.5 m stipulated by the German government at an infection rate of 2%, our simulation results suggest that a density of one person per 16m2 or below is sufficient. Conclusions: The results of this study give insight into how physical distancing as a protective measure can be carried out more efficiently to help reduce the spread of COVID-19. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this study is to highlight the ethical, health, and technical concerns around manual scavenging in urban India. Subject and methods: As a country, India is passing through a transitional phase of urban development, with concepts of Smart Cities and Resilient Cities taking center stage on the urban development discourse. But the country is lagging in managing crucial indicators of social and human progress within a city, especially on issues of proper sewage and sanitation facilities. In view of this light, the horrendous practice of manual scavenging has been declared an illegal profession by Indian laws; however, the profession is still rampant, even in urban areas such as Delhi and Bengaluru. Thus, this paper discusses the ethical and health implications of this practice and simultaneously reviews the technologies being implemented in several countries. Additionally, an analysis is carried out on grave issues; for instance, the number of workers engaged in such practices and their death cases in recent years. Lastly, this study presents new thinking and approaches of technological advancement that could bring an end to this rather unethical practice. Results: The review paper shows that, although the field of manual scavenging has been highly mechanized in many countries, India is yet to find a permanent solution that separates human beings from manually cleaning sewers. Conclusion: This paper brings forth a combination of measures that are legislative and technical in nature, including societal awareness, to eradicate manual scavenging in Indian cities. [ABSTRACT FROM AUTHOR]

Aim: The goal of this paper is to analyze the COVID-19 policies of 10 European countries, including Sweden, Finland, Norway, Italy, France, Germany, Poland, Belgium, the Netherlands, and Hungary, with a time-series policy analysis tool. Subject and methods: The results of the COVID-19 policy analysis are based on a single time-series indicator, or daily population mortality rate: the number of COVID-19 daily cumulative deaths divided by the population in millions. The lower the score, the better the policy. Although many experts believe that the COVID-19 policy outcome analysis is premature, time series analysis is an excellent analysis that can provide information on the progress and transition of policy outcomes. In other words, the proposed time series analysis tool allows policymakers to identify and quantify when mistakes were made during the on-going COVID-19 pandemic. Results: The COVID-19 policy analysis discovered many useful facts. Sweden failed due to the herd immunity approach. Hungary made a fundamental mistake in COVID-19 tactics. Countries such as Sweden, Hungary, Belgium, and Poland showed time-series changes that differed from the others. Conclusion: Public health interventions can play a key role in mitigating the COVID-19 pandemic. The proposed policy analysis tool, hiscovid demonstrated the effectiveness of the time-series score behavior for discovering when policymakers made mistakes. [ABSTRACT FROM AUTHOR]

Aim: A novel corona virus disease 2019 (COVID-19) was declared as pandemic by WHO as global level and local levels in many countries. The movement of people might be one influencing factor, this paper aims to report the situation COVID-19 and spreading in Thailand, including influencing factors of spreading and control. Subject and method: Infected, confirmed COVID-19 data were obtained from the official website of the Department of Disease Control, Ministry of Public Health. Tourist data was downloaded from Ministry of Tourism and Sports. Researchers analyzed the situation from the first found case in Thailand until 15 April 2020 with the timeline of important influencing factors. Correlation coefficients of tourist data and infected case was calculated by person correlation coefficient. Results: The number of infected cases was significant associated (correlation coefficient > 0.7) with economic factor, namely; number of visitors, generated income from both Thai and foreigner tourist (p value <0.01). The influencing factors of slow increased rate were the enforcement and implementation of both central and local government regulation, the strength of the Thai health care system, the culture and social relation, the partnership among various governmental and private sectors. Conclusion: We found that the number of tourist and their activities were significant associated with number of infected, confirmed COVID-19 cases. The public education and social supporting were the key roles for regulation enforcement and implementation. [ABSTRACT FROM AUTHOR]

Public health and health care science take on an important role in the further development of palliative care. This study examines to what degree palliative care is represented in the pertinent academic journals of public health and health care science and what the major subjects are. We analysed the European journals that were listed in the Journal Citation Reports in the categories health care science and services, public, environmental and occupational health, as well as health policy and services. The literature search was conducted in the journals identified for the years 1996 through 2005, using the terms palliative care*, palliative medicine*, terminal care* and hospice care*. The analyses were based on the quantity of publications in the journals, the publication years, the impact factors and the subjects focused on. There were 82 journals included. Altogether, 57,737 publications appeared during the analysis period; 166 papers were on palliative care (0.3% of all papers). The majority of palliative care articles (55%, n = 91) were concentrated in a very small circle of journals (4%, n = 3). The absolute quantity of palliative publications and their percentage among all publications have continuously increased from 0.1% in 1996/1997 to 0.4% in 2004/2005. The largest group of papers on the subject (42%, n = 70) appeared in journals with impact factors less than 1, whereas the largest group of all papers was found in journals with impact factors of 1–1.999 (51%, n = 15,732). Most papers focus on patient orientation and health professionals’ perspective and education; subjects such as health care utilization and barriers are less frequently covered. There is need for more research on palliative care relevant for public health and health care science in terms of reach and top-level impact. For example, the research questions should deal with health care utilization and potential social and cultural barriers. The interdisciplinary community of public health sets the stage for the required collaborative research activities. [ABSTRACT FROM AUTHOR]

Background: The United States leads the world in several chronic health conditions (CHCs). Yet, CHCs are preventable. Aim: This paper examines influences on rating of the seriousness of CHCs among American adults. Subjects and Methods: The study involved 1011 American adults aged 18 or older. Data came from Obesity in the United States: Public perceptions. We explored factors that are associated with knowledge of the seriousness of CHCs, via a multiple linear regression analysis. Results: Significant associations were found between the rating of the seriousness of CHCs and obesogenic environment, age, sex, race, and education. For instance, respondents living in obesogenic environments rated CHCs as less serious. Younger people rated CHCs as less serious compared to older people. Also, Blacks and Hispanics rated CHCs as serious health issues facing America compared to Whites. However, the joint association of education and race showed that Blacks who had at most a high school degree rated CHCs as less serious compared to Whites and all college graduates. Conclusion: The determinants of rating of the seriousness of CHCs facing America may be complex and need more studies. However, inadequate knowledge of frequently occurring health conditions may possibly contribute to high incidence of CHCs. It is therefore necessary that Americans know about the seriousness of CHCs facing the United States. This knowledge may also help American adults buy into health policies geared toward health disparities reduction. [ABSTRACT FROM AUTHOR]

Background: Healthcare is a serious issue confronting governments and households and calling for repeated deliberations in international forums. Ensuring good health for all was the predominant call of the millennium development goals (MDGs), re-echoed again in the sustainable development goals (SDGs). The first objective of this study is to evaluate and compare the impact of public and private health spending on life expectancy, and the second objective is to examine the causal link among public health expenditure, private health expenditure and life expectancy in Cameroon. Methods: We used annual time series data from 1980 to 2014. Ordinary least squares (OLS) regression was employed to evaluate the effect of public and private health expenditure on life expectancy while the Toda and Yamamoto causality test was used to examine the relationship among public health expenditure, private health expenditure and life expectancy in Cameroon. Results: The result shows that private health expenditure has a positive and significant impact on life expectancy while public health expenditure has no significant impact on life expectancy in Cameroon. The results of the causality test show a bidirectional causality between private health expenditure and life expectancy and a unidirectional causality running from life expectancy to public health expenditure. Conclusions: The findings of this study suggest that the Cameroonian government should continue to embark on its poverty reduction strategy elaborated in its Growth and Employment Strategy Paper (GESP) and in pursuing its vision of attaining the SDGs by 2030. In addition, establishing effective public-private partnerships in developing the health sector could go a long way to improve the health status of the population. [ABSTRACT FROM AUTHOR]

Background: The ongoing Boko Haram insurgency in northeastern Nigeria has depleted the country's capability to deliver quality healthcare to her citizenry. The ailing health sector is overwhelmed with a rising incidence and prevalence of infectious and non-communicable diseases. Aim: The aim of this paper was to determine the trend of kidney disease, end-stage renal disease (ESRD), anaemia, malnutrition and human immunodeficiency virus (HIV) in northeastern Nigeria. Materials and methods: Data covering different periods between 1999 and 2017 were obtained from the University of Maiduguri Teaching Hospital (UMTH), Maiduguri in northeastern Nigeria. This hospital is the largest tertiary healthcare facility in the region. The data were demographic in nature, i.e. sex, age or simply the registered cases. A quadratic model of time-series analysis was used to create the various trends of the respective diseases with the aid of Minitab software (version 18.0). t-Tests and analysis of variance (ANOVA) were also performed, with a p-value of less than or equal to 0.05 being considered significant. Results: About three out of every five patients treated for kidney disease were male, while three out of every five patients treated for HIV were female. Patients between the ages of 31 and 50 years were at the greatest risk of developing kidney disease. The mean distribution of disease incidence was the same for both sexes for kidney disease, anaemia, malnutrition and HIV. The mean distribution disease incidence was different between age groups for kidney disease but the same for anaemia. The incidence of anaemia and malnutrition reported was almost the same for both sexes. Children under the age of 10 years old were at the most risk of anaemia, with the distribution decreasing with increasing age. The trend analysis of the incidence of kidney disease, ESRD, anaemia and malnutrition showed that these ailments were on the increase, while the number of patients that were on antiretroviral therapy (ART) was on the decline in northeastern Nigeria. Conclusion: These increasing trends are evidences of the effect of Boko Haram on the public health of the people of northeastern Nigeria and will continue to be a public health concern for the region and the country as a whole. [ABSTRACT FROM AUTHOR]

Aim: Non-pharmaceutical interventions such as lockdowns have played a critical role in preventing the spread of the Covid-19 pandemic, but may increase psychological burden. This study sought to examine emotions reflected in social media discourse following the introduction of social contact restrictions in Central Europe. Subjects and methods: German-language Twitter posts containing '#corona' and '#covid-19' were collected between 2020/03/18 – 2020/04/24. A total of 79,760 tweets were included in the final analysis. Rates of expressions of positive emotion, anxiety, sadness and anger were compared over time. Bi-term topic models were applied to extract topics of discussion and examine association with emotions. Results: Rates of anxiety, sadness and positive emotion decreased in the period following the introduction of social contact restrictions. A total of 16 topics were associated with emotions, which related to four general themes: social contact restrictions, life during lockdown, infection-related issues, and impact of the pandemic on public and private life. Several unique patterns of association between topics and emotions emerged. Conclusion: Results suggest decreasing polarity of emotions among the public following the introduction of social contact restrictions. Monitoring of social media activity may prove beneficial for an adaptive understanding of changing public concerns during the Covid-19 pandemic. [ABSTRACT FROM AUTHOR]

Aim: Gambling harm is a serious public health issue affecting the health, financial security, and social well-being of millions of people and their close relations around the world. Despite its population health implications, gambling harm is not typically viewed and treated as a public health policy issue. This paper critically reviews the evolution of the public health perspective on gambling harm. It also considers how gambling harm can be operationalized within a public health model. Methods: A critical historical review of the emerging public health perspective on gambling harm was conducted. Key documents covering three decades of development were reviewed and appraised through a process of deliberation and debate over source impact in the fields of research, policy, and programming internationally. Results: The first decade mainly focused on identifying gambling harm and framing the public health issue. The second decade featured the expansion of health assessment and emerging areas of policy and program development. The third decade saw an increased focus on public health frameworks that advanced understanding of harm mechanics and impact. As reflected by the essential functions of a general public health model, gambling harm prevention efforts emphasize health promotion over other key functions like health assessment and surveillance. Conclusion: Gambling harm is a public health issue requiring greater attention to health assessment and surveillance data development. [ABSTRACT FROM AUTHOR]

The aim of this paper is to provide a discussion on how the public health policy process can be influenced by both civil society groups and by public health practitioners. A discussion expressing the views of the author supported by the relevant literature drawn from a wide range of sources and using international case study material on influencing public policy. The first part of the paper discusses the role of empowerment in improving health outcomes. The second part of the article discusses the policy development process, and the third part explains, step by step, the opportunities that exist to influence this process by both practitioners and people in civil society. The paper concludes with the question: ‘To what extent can external public action have an effect on defining the policy concerns of government?’ and draws on the evidence presented in the paper to provide some solutions. The paper will be of interest to the planners and evaluators of public health programmes interested in improving effectiveness and promoting community empowerment approaches. [ABSTRACT FROM AUTHOR]

The aim of this paper is to provide a summary of the present state of discussion concerning a way forward for public health programming that is more empowering and more effective at achieving its goals as we move into the future. A discussion expressing the views of the author supported by the relevant literature drawn from a wide range of sources on public health programming. The first part of the paper discusses the present state of public health programming and why it has had only modest success in achieving its goals. The second part discusses why the planning of public health programmes in the future will have to take into account at least three important agendas. The third part of the paper discusses why the delivery of public health programming in the future will have to include the following design elements: engage communities to share priorities; build community capacity; mechanisms for flexible funding; evaluate sharing information and ideas; be creative to expand on successful local initiatives. The paper concludes with a reflection on the most rational way forward and on the role of practitioners in achieving a more empowering and effective public health. The paper will be of interest to the planners and evaluators of public health programmes interested in improving the effectiveness of public health. [ABSTRACT FROM AUTHOR]

The number of natural disasters and the severity of their impact have increased in recent decades. These developments highlight the need for improved preparedness and response in the health sector, inter alia, and the important role of public health in disaster management. The purpose of this paper, which is based on a literature review, is to provide background information about the general framework of disaster management and present the core concepts of disaster preparedness and response in health systems. Three different strategies were used to collect information for this article. First, information was collected from various international databases. Then, the virtual health library for disasters provided by the World Health Organization (WHO) and the WHO Health Action in Crisis (HAC) online sources were reviewed for relevant WHO and Pan American Health Organization (PAHO) books, working papers and reports. Finally, PubMed abstracts were searched with key words and phrases. For greater completeness, five disaster journals were hand searched. Additional sources such as text books, working papers, and articles were included, relying on the bibliography of the original study mentioned in the introduction to this paper. The studies reviewed indicated that fragmented and response-oriented approaches have begun to change world wide, at least in the literature. Despite the publication of increasing numbers of research projects in disaster issues, there are still gaps in sharing experience through scientific papers, such as systematic evaluation of activities in different phases of disaster situations. [ABSTRACT FROM AUTHOR]

Aim: Refugees often face barriers to accessing health services, especially after resettlement. The aim of this study is to identify key elements of effective public health interventions that address barriers to health services for refugees. Methods: Key online databases were searched to identify studies published between 2010 and 2019. Six studies met the inclusion criteria: two qualitative, one quantitative and three mixed-methods studies. An adapted narrative synthesis framework was used which included thematic analysis for systematic reviews. Results: Five themes were identified: peer support, translation services, accessible intervention, health education and a multidisciplinary approach. Conclusion: These key elements identified from this review could be incorporated into public health interventions to support refugees' access to health services. They could be useful for services targeting refugees generally, but also supporting services targeting refugee resettlement programmes such as the Syrian resettled refugees in the UK. Future research is needed to evaluate the impact of public health interventions where these elements have been integrated into the intervention. [ABSTRACT FROM AUTHOR]

Aim: To reveal inequity in health in India. Subject and methods: The global paradigm of the knowledge economy propounds that growth and equity will occur if there is a free-market economy without state intervention and if patents are provided as incentives for innovation. In this paper, we explore the veracity of this thesis by investigating growth in the pharmaceutical and biotech sectors in India, and by looking at equity issues through the lens of gender health and health costs for poor consumers. We used data from current publications to support this thesis. Results: We found that growth has been characterized by multiple handicaps and oligopoly, with the nature of expansion not having relevance for the disease profiles in India. The scenario of gender health and health costs of the poor is grim due to state retrenchment and neglect of the provision of public good, such as in health matters. Conclusion: One can conclude that equity has not occurred under a growing pharmaceutical sector. This finding has huge implications for public policy in India and other emerging nations. [ABSTRACT FROM AUTHOR]

Aim: In 2014, Sally Davis, England’s Chief Medical Officer, proposed a paradigm shift in public health—the 5th Wave—which should focus on the culture of health. Her paper was meant to spark a debate, but this has been largely absent until now. This article argues why the concept of the culture of health needs to be incorporated into the theory of public health and shows a possible direction for applying it in practice.Subjects and methods: Review of theoretical approaches and knowledge synthesis.Results: Applying the culture of the health approach to change health behavior requires taking several different strands of thought into account. Any proposed effective intervention should be based on a framework including the ‘behavioral system,’ ecosocial theory, complex systems science, and school health promotion approaches. Changing culture is impeded by its complexity, but to solve this wicked problem, the focus should likely be on health promotion in schools.Conclusion: To make interventions more effective, it is necessary for public health professionals to have an extensive debate on the interpretations of the role of the culture of health as highlighted in this article. [ABSTRACT FROM AUTHOR]

Purpose: The Millennium Development Goals (MDGs), an initiative by the United Nations, consisted of eight broad goals, which were envisaged to improve the living conditions of the world’s populations. In spite of the momentum and investments made to achieve the MDGs, significant challenges still exist at the global and national levels. In Ghana, the attainment of some MDGs was uneven across the goals and within the country. This paper critically reviews the implementation of the health MDGs in Ghana: specifically, MDG 4, MDG 5 and MDG 6. The study focuses on drawing key lessons from the national implementation strategies and institutional reforms adopted by Ghana towards achieving these health MDG targets.Methods: The study uses content analysis of policy documents in selected programmatic interventions which have been deemed influential in reaching the health MDGs in Ghana.Results: In brief, the results indicate that 73% of the 37 MDG indicators for Ghana were either achieved or could show significant progress. Ghana did not achieve MDG 4 and MDG 5 due to the slow progress it made in improving child and maternal health. The study indicates that key investments need to be made in the health sector, especially in the areas of access to good quality care, to narrow gaps in access and financing.Conclusions: Reducing maternal and child mortality in Ghana will require transforming the sectors that drive development, such as energy, agriculture and transportation. It is expected that the lessons learnt will enhance evidence-based policy-making towards achieving the SDGs in Ghana. [ABSTRACT FROM AUTHOR]

im: To report the prevalence and causes of suicide in Kerala, which is a well-developed Indian state in terms of better demographic and health indicators. Subject and methods: This paper is based on the data accessed from the annual statistical report of the National Crime Records Bureau. Data pertaining to suicides that occurred in Kerala in 2007 were analyzed. Results: Despite Kerala’s good standard of living with comparatively low birth and death rates, the state reports a high rate of suicides with 26.3 per 100,000 population, compared to the national rate of only 10.8 (in 2007). Family problems are cited as the major cause of suicide, followed by ill health and economic reasons. In Kerala state, men outnumber women (74% vs. 26%). While the majority of the male victims were self-employed, most of the female victims were home makers. More than 80% of the victims were in the age group between 15 and 59 years. Conclusions: The problem of suicide is discussed in the context of Kerala’s better demographic and health status compared to other Indian states. This problem has to be analyzed within the frame of reference of the broad and extensive socioeconomic status information concerning the victims and their settings. It is not adequate to intervene to change an individual’s suicidal behavior when the issue is related to the problems of the society as a whole. [ABSTRACT FROM AUTHOR]

This paper aims to unobtrusively identify gender patterns in diabetics' adherence to their medication regimen. Non-adherence is a major problem in health care as it affects both the patient’s individual health as well as public health. Seen worldwide, the problem of non-adherence is even more important due to the increasing numbers of the elderly population and of chronic diseases such as diabetes, asthma, HIV, etc. It is estimated that in Germany alone, non-adherence is responsible for costs of €10 billion per year. Finding useful health behaviour patterns could be especially important for the increasing number of patients with chronic diseases such as diabetes, where costs are high and consequences such as retino-, nephro- and neuropathy severe for 180 million diabetics worldwide. This paper analyses the records of two German pharmacies, P1 and P2, regarding gender patterns in adherence to oral antidiabetics as this analysis method has a high specificity. Out of 4,474 (P1) respectively 2,650 (P2) datasets, those were selected that showed the use of medication with oral drugs for diabetes based on ATC code level A10B. The selected medication datasets were fully analysed, also the respective adherence rate for drugs used for hypertension, ATC code level C. Average adherence rates for oral antidiabetic agents varied, with 25.4% (P1 women) and 34.6% (P1 men), and 27.8% (P2 women) and 26.1% (P2 men). In contrast, average adherence rates with drugs for the cardiovascular system were high, with 73.4% (P1 women) and 74.2% (P1 men), and 57.0% (P2 women) and 70.2% (P2 men). Adherence rates for oral antidiabetic agents showed no gender patterns. This finding is supported by varying adherence rates for medication for hypertension. In both cases, the chi-square test showed no significant correlation between gender and adherence classification, and also Cramer’s V only showed a small effect of gender on adherence behaviour. [ABSTRACT FROM AUTHOR]

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Purpose: The common saying that sports promote good health is in line with main results of sports medicine, but conflicting with the high amount of sports injuries and sports-related diseases. This paper contributes to the discussion of the pros and cons of sports, particularly of the martial arts. It intends to shed light on the benefits of sports in the general public and to explore the enormous and yet unexploited potential of individually tailored sport activities for public health. Methods: Comparative analyses and meta-synthesis of empirical studies on the health benefits of sports. Musicians with very heterogeneous work-related risk profiles serve as a model for inductive generalisation. Results: For health promotion and to avoid adverse outcomes, sport activities must take one's physical status and risk profiles into account and refer to well-adjusted training zones. This encompasses musculoskeletal and biomotor factors, behavioural means to rebalance the nervous system, cardiorespiratory fitness, mental health and psychological benefits, and active pain management and pain relief. Conclusion: Sports organisations provide a wide spectrum of facilities for sports-oriented lifestyles; however, informal experience and relevant publications let us assume that they rather do not explore how to optimise preventative and health-related benefits, except for training with personal coaches. And yet, relatively simple screening methods and individually adjusted intensities, modes, and frequencies of trainings can enhance benefits and greatly contribute to public health, which would, however, require a stronger health awareness of providers and specific education of sports coaches. [ABSTRACT FROM AUTHOR]

Aim: This paper examines the pattern, growth and determinants of household health spending in India and compares the growth of per capita household health spending and per capita consumption expenditure over the last two decades. Subject and methods: The unit data of various rounds of the National Sample Survey (consumption expenditure surveys 1993-1994, 2004-2005 and 2011-2012 and morbidity and health care surveys 1995-1996 and 2004) along with data from other secondary sources are used in the analyses. The patterns and growth of health spending are analyzed by demographic, social and economic attributes and economic well-being is measured using per capita consumption expenditure. Household health spending is subdivided into age structure, population growth, real cost of medical care and increased hospitalization. Descriptive statistics, fixed effect models and simple decomposition methods are used in the analyses. Results: Results suggest that during 1993-2012, the annual growth rate of real per capita household health spending was twice (6.14 %) the real per capita consumption expenditure (2.60 %). On average, per capita household health spending among the richest consumption quintile was at least eight times higher than that of the poorest consumption quintile, linking household health spending to ability to pay. Household health spending was income inelastic. Though medicine accounts for a larger share of household health spending, household spending on medical tests is growing fast. We found a strong and positive gradient of age on per capita household health spending after controlling for income and other confounders. During 1995-2004, the age structure, hospitalization and real cost of hospitalization accounted for a 14, 42 and 26 % increase in the cost of hospitalization respectively. Conclusion: Household health spending is growing faster than the consumption expenditure (economic well being) of household and changing age structure is significantly affecting health spending in India. Increased public spending on health, upgrading the public health system and increasing access to health insurance can reduce the household health spending in India. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this paper is to define the reasons for and the rates of absenteeism in Indonesian Community Health Centres and determine the pattern of health workers non-attendance in Indonesian public health facilities, chiefly in urban areas. Subject and methods: This research uses descriptive statistics methodology to sample a survey carried out in this case in Bengkulu City, Bengkulu Province, Sumatra in the Republic of Indonesia. The survey sampled 9 community health centres and involved the 20 doctors, 61 midwives and 76 paramedics who were employed at these institutions. Results: This research revealed that the level of health worker absenteeism in Bengkulu city was overall 23.4 %, this encompassed doctors at 26.5 %, midwives at 22.8 % and paramedics at 23.2 %. Conclusion: This study determined the absenteeism pattern of the health workers at these institutions and the reasons for their absences. Most of the recorded absences occurred at certain times of the day during similar periods, the highest level of absenteeism occurring on the weekend during the Saturday work period. It was also found that on most workdays many of the health workers were leaving the community health centres around 10:30 AM just before the closing time of the patient registration desk at 11:00 AM, even though the official closing time of is actually 1:30 PM. Additionally, on another point we found that there was no strong relationship between the actual working conditions and the absence rate of health workers. [ABSTRACT FROM AUTHOR]

Aim: Rising concern for demonstrated real world comparative effectiveness has heightened interest in 'pragmatic trials' design. Pragmatic trials investigate whether the efficacy, presumed or found in explanatory trials under ideal conditions, can also be detected under real world conditions, i.e. effectiveness. It is also recognized that 'real world' effects which are usually addressed in public health research gain growing interest in confirming the 'road capability' of results obtained under ideal study conditions. This paper demonstrates that studies under ideal or real world conditions use different methods, generate different information and cannot replace each other. Subjects and methods: The PCT design meets four requirements of public health and of effectiveness research. It includes all individuals who presented with the selected condition. It classifies the included individuals according to baseline risks. It enables plausibility controls. Finally, it compares the outcomes resulting from specified and not-specified interventions or treatments. Proposal: We propose a pragmatic controlled trial (PCT) design in which patient preference and other co-factors crucial in determining the actual effectiveness of interventional options will not be neutralized by concealed randomization and blinding. This design is applicable to record the selected interventions and generated outcomes in day-to-day health care and is capable of incorporating preference and other participative factors into assessment of effectiveness. Conclusions: The PCT design is useful for public health research, e.g. the effectiveness of interventions to change smoking habits or to prevent death from breast cancer, as well as for comparative effectiveness research where it will supplement the traditional randomized controlled trial (RCT). [ABSTRACT FROM AUTHOR]

Aims: The aims of this paper are (1) to assess if perceptions of the food environment are associated with select dietary intake by neighborhood, and (2) to map neighborhood-specific findings, demonstrating a method for policy-relevant research. Methods: Using pre-collected data from a Philadelphia, PA community health survey, we aggregated individual-level data ( n = 4,434 respondents) to neighborhoods ( n = 381 census tracts), adjusting for conceptually-relevant socio-demographic factors. We estimated Spearman correlations between multivariable adjusted food-environment perceptions (perceived produce availability, supermarket accessibility, grocery quality) and select dietary intake (reported fruit-and-vegetable and fast-food consumption), and mapped variables by neighborhood using geographic information systems (GIS). Results: Difficulty finding fruits and vegetables, having to travel outside of one's neighborhood to get to a supermarket, and poor grocery quality were each directly correlated with fast-food intake (rho = 0.21, 0.34, 0.64 respectively; p values <0.001); and inversely correlated with fruit-and-vegetable intake (rho = -0.35, -0.54, -0.56 respectively; p values <0.001). Maps identified neighborhoods within the city with the worst food-environment perceptions and poorest dietary intakes. Conclusion: Negative perceptions of the food environment were strongly correlated with less-healthy eating in neighborhoods. Maps showed the geographic areas of greatest concern. Our findings demonstrate a method that might be used prospectively in public health for policy planning (e.g. to identify neighborhoods most in need), or retrospectively for policy assessment (e.g. to identify changes in neighborhoods after policy implementation). [ABSTRACT FROM AUTHOR]

Background: In response to increased case numbers of meningococcal group C disease, catch-up vaccination strategies have been shown to be successful. This paper describes the results of a repeat vaccination program in Galicia, Spain, and the strategy used for it. Methods and results: Three vaccination waves were performed: first, in 1996/1997 with a meningococcal group A and C polysaccharide vaccine in individuals aged 18 months to 19 years; second, in 2000 with a conjugate serogroup C polysaccharide vaccine in children born since 1993 and all children and adolescents up to 19 years not previously vaccinated; third, a campaign in 2006 that became necessary because of the development of a new Neisseria strain and an increase in both the incidence and lethality of meningococcal C disease. The conjugate vaccine de-O-acetylated group C meningococcal polysaccharide coupled to tetanus toxoid was used (GCMP-TT; brand name, NeisVac-C). Results: Applying a strategy based on model calculations derived from the UK setting and focusing on a population aged 13-25 years, including students, employees of companies, and underage individuals, a total of 286,000 subjects were vaccinated, resulting in global vaccination coverage of 82.2% (all age groups over 74%). Only 17 adverse events in 17 individuals were reported, which all were mild. Incidence of meningococcal disease serogroup C by season was reduced from 0.84 cases per 100,000 in 2004/05 to 0.76 cases per 100,000 in 2005/2006 to 0.18/100,000 in 2007/08. In parallel, mortality was also decreased from 8 cases during 2005/06 (0.29 per 100,000) to 1 case in 2007/2008 (0.03 per 100,000). No cases of breakthrough disease occurred in the vaccinated population. Conclusion: In Galicia, a series of vaccination campaigns, particularly focusing on high-risk groups, has shown high effectiveness, with a marked reduction in the disease incidence in the vaccination cohort accompanied by a relevant reduction in the overall population. [ABSTRACT FROM AUTHOR]

Aim: This paper examines the behavioural factors that are linked to the gender gap in mortality phenomenon and connects theoretical implications with the findings of a qualitative grounded theory research. Subject and methods: Differences in the life expectancy of men and women are a well-known fact. Though several theories take into account the wide range of factors underlying this phenomenon, they can only partly explain it. To get a deeper understanding of these issues, we use a qualitative approach to study this topic from another point of view. Expert interviews with professionals in the medical field were conducted to gain insights about the health lifestyles of men and women that may reveal hypotheses as to why the gender gap in mortality is narrowing. Results: The results bear in mind that apart from biological factors, behavioural factors are strongly connected to the gender gap in the mortality issue. Men and women tend to behave differently and their behaviour is linked to social norms and expectations. They have a different understanding of illness and also behave in different ways with regard to seeing doctors. However, because of changing gender roles due to changing norms and other influential factors, these health behaviour patterns have started to diminish. Conclusion: A generational change in the health behaviour of men and women is currently taking place. Traditional gender roles are diminishing due to versatile attributes and behavioural patterns of men and women. This development may partly explain the narrowing of the gender gap in life expectancy in Austria. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to outline the potential of newly available vaccines and highlight the evolution of tools required for correctly assessing the impact of immunisation policies. We review an entire range of critical factors in the evaluation of the impact of new vaccines and vaccinations, including herd immunity, immunological memory, epidemiology and indirect effects of immunisation on vaccine-preventable diseases and illnesses. The impact of newer vaccines on public health has become as complex as it is promising: the benefits of vaccinating according to aged-based rather than at-risk-based recommendations (e.g. influenza vaccine); societal benefits going beyond the mere avoidance of death and hospitalisation (e.g. rotavirus vaccine); prevention of associated pathological states, of many confirmatory tests following a positive result of screening and psychological distress (e.g. human papillomavirus vaccine); or reduction of serious sequelae and associated chronic suffering (e.g. zoster vaccine). The changing context of vaccinology offers new challenges for research methods and orientations. Clearly, we must shift from the concept of prevention of disease to that of prevention of illness. Developing tools for the precise measurement of these phenomena involves multidisciplinary co-operation in the development of dynamic models; at the same time, we must improve our communication skills for explaining complex issues to the larger public. [ABSTRACT FROM AUTHOR]

This paper seeks to analyse the contribution of vaccine manufacturers to the establishment of immunisation policies. The recent evolution of the role of industry from product development to post-licensure studies is reviewed in detail. The primary responsibility of vaccine manufacturers has always been to develop vaccines and demonstrate their safety and efficacy. However, with the development of new vaccines it appears that vaccine manufacturers are expected to go beyond this role and to provide policy-makers with additional information required to support the establishment of optimal vaccination policies. This includes conducting extensive post-licensure risk management plans as part of follow-up measures to the initial marketing authorisation. Manufacturers are also requested to generate information on the epidemiology of the disease to be prevented as well as health-economics data and to assess the expected impact of the vaccine in the population. This requires additional in-house skills, external collaborations, not to mention considerable financial investment. Over the recent decades new functions and departments have been created to address all the technical aspects leading to the introduction and adoption of new vaccines, such as risk management, epidemiology, policy affairs, and outcome research. Nevertheless such activities cannot be properly conducted or managed without an active partnership between the private sector and national or international public heath or academic institutions. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Public Health (09431853) is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Public Health (09431853) is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Public Health (09431853) is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: Even though students attending vocational school are very vulnerable to the development of mental health problems, few studies identify the correlation between suicidal ideations and vocational education. Therefore, this study aimed to identify the prevalence and associated risk factors for suicidal ideations among vocational students in Germany. Methods: We conducted a cross sectional survey with a total of 555 pupils. The pupils received a standardized questionnaire, assessing sociodemographic data, the use of protective factors, possible risk factors, traits for neuroticism and depressive symptoms. For our study, we excluded item 9 from the Beck depression index (BDI-II) to identify the prevalence of suicidal ideation. Results: Our results show that the prevalence of suicidal ideation among students attending vocational school is 23.2%. A combination of feeling lonely, male sex, low importance of religion, little time for hobbies and BMI scores outside the norm show the highest risk for suicidal ideation and can be identified as significant predictors. Conclusion: This cross-sectional study highlights the mental burden vocational students in Germany are confronted with and underlines the necessity of paying special attention to this group of young adults. Furthermore, it emphasizes the necessity of further studies on this topic, especially including larger student populations. The results should be used to decrease the significant loss of life caused by suicidal behavior in young adults. [ABSTRACT FROM AUTHOR]

Aim: Population-level prevention initiatives are the cornerstone of public health practice. However, despite this normative practice, sexual health programming within public health has not utilized this approach to the same extent as other public health programs. Understanding requirements to put a population-level approach into practice is needed. The objective of this study was to explore the barriers and facilitators experienced by sexual health programs and services within public health when implementing a population health approach. Subject design and methods: The principles of qualitative description guided all sampling, data collection and analysis decisions. Data collection involved in-depth semi-structured interviews with 12 sexual health managers and/or supervisors from ten Ontario public health units. Directed content analysis was used to code and synthesize the data. Data collection and analysis was guided using constructs from the Consolidated Framework for Implementation Research. Results: Factors that served as either barriers and facilitators to implementing a population health approach, were mainly in the inner and outer setting domains of the Consolidated Framework for Implementation Research. Participants identified the presence of community partnerships, adequate staff training on population health, and access to data on population health served as facilitators. In comparison, barriers to implementation included a lack of resources (human, financial) and clinicians' value of and preferences for delivering services at the individual clinic level. Conclusion: Some clear barriers and facilitators influenced if staff in sexual health programs and services could implement a population health approach. Results indicate where public health resources need to be enhanced to move toward a population health approach and provide insight into what worked and should be considered by public health organizations. [ABSTRACT FROM AUTHOR]

Background and aim: Early action is important for promoting newly arrived migrants' health. Politicians are major actors in decision-making that affects health outcomes in the population. Therefore, the aim of this study was to explore local and regional politicians' considerations of newly arrived migrants' health in political decision-making: whether politicians reflect on or discuss the effects of decision-making specifically on newly arrived migrants' health, whether considerations differ between municipality and regional politicians, and how knowledge and attitudes are associated with such considerations. Subject and methods: A cross-sectional quantitative study was conducted. A total of 667 municipality and regional politicians from northern Sweden responded to a questionnaire developed based on interviews with politicians. Bivariate analyses were performed using χ2 tests, the independent samples t-test, and the Wilcoxon signed-rank test. Multivariate analysis was performed using binary logistic regression. Results: Politicians considered the effects on newly arrived migrants' health significantly less frequently than those on the total population's health. Regional politicians discussed such effects more often than municipality politicians. Knowledge (odds ratio [OR] = 1.343), attitude (OR = 5.962), previous experience working on public health issues (OR = 1.784), and female gender (OR = 1.787) were positively associated with considering effects on newly arrived migrants' health in decision-making. Conclusion: Politicians play important roles in health promotion, and most consider health-related effects in their decision-making. However, about a third do not consider such effects. General health-related knowledge and attitude are important factors that could be affected or changed during political assignments. [ABSTRACT FROM AUTHOR]

Background: According to recent polling, public trust in the healthcare sector remains low relative to other industries globally. The implications of low healthcare trust permeate throughout the industry in a number of ways, most visibly by discouraging therapy compliance. Methods: This study investigated four putative determinants of trust in healthcare-related scenarios: individuals vs. collective groups as communicators of healthcare advice; expert vs. laypeople as providers of healthcare communication; public vs. private healthcare sector; and positive vs. negative information. Two hundred seventy-four participants were recruited via Prolific Academic and were presented with four statements in random order, related to a positive reflection of the public healthcare sector, a negative reflection of the public healthcare sector, a positive reflection of the private healthcare sector and a negative reflection of the private healthcare sector. According to these reflection, participants were repeatedly asked to rate the system on its trustworthiness. Trust outcomes were constructed using a four-dimension framework, consisting of benevolence, reliability, competence and predictability. Results: Claims relating to the public sector had a significantly stronger impact on benevolence and reliability than claims relating to the private sector; claims from individuals had a significantly stronger impact on all trust variables than claims from collectives; and claims from laypeople had a significantly greater impact on reliability and competence ratings than claims from experts. Conclusions: The findings in this study offer insight into the patterns with which trust decisions are made in healthcare contexts. More importantly, this research offers a novel perspective of how different factors interact to affect the various facets of trust. These results provide a foundation for future study in this evolving area, and offer insights into designing effective communication strategies that cultivate greater levels of individual trust in the healthcare sector. [ABSTRACT FROM AUTHOR]

Background: We investigated the public health and economy outcomes of different levels of social distancing to control a 'second wave' outbreak in Australia and identify implications for public health management of COVID-19. Methods: Individual-based and compartment models were used to simulate the effects of different social distancing and detection strategies on Australian COVID-19 infections and the economy from March to July 2020. These models were used to evaluate the effects of different social distancing levels and the early relaxation of suppression measures, in terms of public health and economy outcomes. Results: The models, fitted to observations up to July 2020, yielded projections consistent with subsequent cases and showed that better public health outcomes and lower economy costs occur when social distancing measures are more stringent, implemented earlier and implemented for a sufficiently long duration. Early relaxation of suppression results in worse public health outcomes and higher economy costs. Conclusions: Better public health outcomes (reduced COVID-19 fatalities) are positively associated with lower economy costs and higher levels of social distancing; achieving zero community transmission lowers both public health and economy costs compared to allowing community transmission to continue; and early relaxation of social distancing increases both public health and economy costs. [ABSTRACT FROM AUTHOR]

Aim: In this paper we make the case for gambling-related harm treatment services in Britain to be mainstreamed within the remit of public health. Although the focus of this article is on the British situation many of these issues are generalisable to other jurisdictions. The profile of problem gamblers: In Britain, 0.9 % of adults are problem gamblers, and it is more common in the young, socially deprived and the ethnic minorities. Who provides and who should provide treatment services?: At present in Britain, almost all dedicated funding to address gambling-related harm is provided by voluntary contributions from the gambling industry and the level of service provision is far from adequate. Mainstreaming gambling treatment: Problem gambling is associated with a range of health and social harms yet it often goes unnoticed for a variety of reasons. Early interventions can minimise or prevent the negative effects of problem gambling on various spheres of the gambler's life, his/her family and wider society. Conclusion: Consistent with plans to move the commissioning of drug-misuse treatment services within the remit of public health, it would seem entirely logical to commission gambling-related harm treatment services from the public health 'purse', and to request that gambling-related harm falls under the remit of the new Health and Well-Being Boards. [ABSTRACT FROM AUTHOR]

Aim: The coronavirus disease 2019 (COVID-19) has caused hundreds of thousands of deaths, impacted the flow of life and resulted in an immeasurable amount of socio-economic damage. However, not all of this damage is attributable to the disease itself; much of it has occurred due to the prevailing misinformation around COVID-19. This rapid integrative review will draw on knowledge from the literature about misinformation during previous abrupt large-scale infectious disease outbreaks to enable policymakers, governments and health institutions to proactively mitigate the spread and effect of misinformation. Subject and methods: For this rapid integrative review, we systematically searched MEDLINE and Google Scholar and extracted the literature on misinformation during abrupt large-scale infectious disease outbreaks since 2000. We screened articles using predetermined inclusion criteria. We followed an updated methodology for integrated reviews and adjusted it for our rapid review approach. Results: We found widespread misinformation in all aspects of large-scale infectious disease outbreaks since 2000, including prevention, treatment, risk factor, transmission mode, complications and vaccines. Conspiracy theories also prevailed, particularly involving vaccines. Misinformation most frequently has been reported regarding Ebola, and women and youth are particularly vulnerable to misinformation. A lack of scientific knowledge by individuals and a lack of trust in the government increased the consumption of misinformation, which is disseminated quickly by the unregulated media, particularly social media. Conclusion: This review identified the nature and pattern of misinformation during large-scale infectious disease outbreaks, which could potentially be used to address misinformation during the ongoing COVID-19 or any future pandemic. [ABSTRACT FROM AUTHOR]

The article discusses various reports published within the issue, including one by De Costa on the effective public health system in Madhya Pradesh province, India, one by Elmanama and Al-Hindi on the vancomycin-resistant enterococci case in Gaza City, Palestine, and one by Kolip and Buchter on first time mothers having cesarean section.

Aim: This study aims to detect the spatial cluster, the temporal cluster, as well as the spatio-temporal cluster of high dengue disease incidence in Peninsular Malaysia for the year 2015 until 2017. As dengue disease cases are properly recorded according to their location and time, cluster analysis of the dengue disease based on its spatial, temporal, as well as spatio-temporal similarity would be more efficient. Subject and Methods: Clustering is one of the essential components in disease mapping that could be helpful in controlling diseases, especially those related to infectious disease. It is used to group large sets of disease data based on their similarity. The clustering method that has been used in this study is Kulldorff's retrospective space-time scan statistics. The data used in this study are weekly dengue disease cases in districts of Peninsular Malaysia from 2015 to 2017. Results and Conclusions: From the results, there were significant spatial cluster, temporal cluster, and spatio-temporal clusters of dengue disease incidence in Peninsular Malaysia for 2015, 2016, and 2017. Results from spatial clustering focused on areas in Selangor as the dengue clustered area and results from temporal clustering revealed the weeks in October until December as the dengue clustered period. Meanwhile, the spatio-temporal clustering demonstrated that there exists another clustered region of high dengue disease incidence in different areas and time periods. [ABSTRACT FROM AUTHOR]

The aims of this work were to apply the Environmental Cleanliness and Clutter Scale (ECCS) in order to assess domestic squalor in dwellings of hoarders, prevent sanitary risks, and intervene in solving the problem. Methods: The ECCS is a domestic squalor scale, developed as a quantitative descriptive tool, based on ten items and a four-point scale. ECCS was applied in addition to the usual procedure during 40 site inspections in Milan, in two different surveys of dwellings of hoarders (2016 and 2019). A correction only for companion animal hoarders was introduced. Results: In the first investigation, which included animal accumulation, our 20 raters reported six cases of mild squalor and six and eight respectively of moderate and severe squalor. After our correction for animal hoarders' dwellings, we identified six cases of mild, four of moderate, and ten of severe squalor. In the second part of our assessment involving another 20 home visits, object hoarding only was assessed in order to evaluate the reliability of the ECCS method. We found varying total scores between the operators with different experience on this issue, but the same evaluation of the severity of the squalor in 14/15 (93%) cases therefore resulted in the same type of intervention. Conclusion: The ECCS score made an evaluation of the severity of hoarding/squalor, and supported the Local Health Protection Agency personnel in making decisions about timing and type of intervention. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to describe the development and analyze the content validity of an educational material with intervention strategies to promote a healthy consumer food environment according to the Dietary Guidelines for the Brazilian Population. Subject and methods: The recommendations of the Brazilian Dietary Guideline were used to develop the educational material. The content validity was performed by a panel of experts who assessed the aspects of clarity, pertinence, relevance, and representativeness for each of the 31 educational strategies included in the material. The content validity index (CVI > = 0.90) was used for the content validity analysis through item level-CVI and scale-CVI. The reliability was accessed by the percentage of the interrater agreement (IRA > 0.80 was considered great) to clarity and representativeness aspects. Results: The educational material was named Healthy Food Trade: A guide to action for public managers and retailers to promote a healthy food environment in the community (HFT). Ten experts participated in the content validation process; 20% worked in the public supply sector, 70% had academic experience in food retail environments, and 10% worked on communication strategies. The percentage of IRA was 0.93 to clarity and 0.94 to representativeness to the overall material. The S-CVI was 0.93. After the modifications, the final version presents intervention strategies that can be carried out in food retailers to make them healthier. Conclusion: The HFT Guide had intervention strategies validated by a panel of experts that could support public managers and food retailers in promoting a healthier consumer food environment. [ABSTRACT FROM AUTHOR]

Aim: This study assessed the contributions of the healthcare expenditure to life expectancy at birth in Nigeria for a period of 18 years (2000–2017). Subject and methods: The study adopted an exp post facto research design using time series data that were sourced from the World Bank annual report on the human development indicators. Robust least squares regression was adopted to estimate the model and test the study hypotheses. Results: Domestic general government health expenditure, out-of-pocket payment and external health expenditure had respective significant positive effects on life expectancy in Nigeria for the period under review. Specifically, when other variables are held constant, a $1% increase in the domestic general government health expenditure would lead to 6% increase in life expectancy at birth in Nigeria. Similarly, a $1% increase in out-of-pocket health expenditure would lead to 63% enhancement in life expectancy. Moreover, 11% improved life expectancy at birth will depend on a 1% increase in external health expenditure. Conclusions: Life expectancy in Nigeria was significantly influenced by the healthcare system funding sources for the past 18 years (2000–2017). However, out-of-pocket payment had the most significant positive effect on life expectancy in the country for the period under review. [ABSTRACT FROM AUTHOR]