Search

Background: Active school transportation (AST) is an important source of physical activity for children and a potentially important climate change mitigation strategy. However, few studies have examined factors associated with AST in the context of the COVID-19 pandemic. Methods: We used baseline data from a longitudinal survey to investigate correlates of AST during the second wave of COVID-19 (December 2020). We collected survey data from 2291 parents of 7- to 12-year-olds across Canada and linked this information with data on neighborhood walkability and weather from national databases. We assessed potential correlates representing multiple levels of influence of the social–ecological model. We used gender-stratified binary logistic regression models to determine the correlates of children's travel mode to/from school (dichotomized as active vs motorized), while controlling for household income. We examined the correlates of travel mode for both the morning and afternoon trips. Results: Consistent correlates of AST among Canadian children during the COVID-19 pandemic included greater independent mobility, warmer outdoor temperature, having a parent who actively commuted to work or school, living in a household owning fewer vehicles, and living in a more walkable neighborhood. These findings were largely consistent between boys and girls and between morning and afternoon school trips. Conclusions: Policymakers, urban planners, and public health workers aiming to promote AST should focus on these correlates while ensuring that neighborhoods are safe for children. Future research should monitor the prevalence and correlates of AST as COVID-19 restrictions are removed. [ABSTRACT FROM AUTHOR]

There is a lack of monitoring changes in the population scores of the most recent version, EQ-5D-5L, in mainland China. This study aimed to address this knowledge gap by assessing the EQ-5D-5L scores in mainland China using a nationally representative sample. Data were extracted from the 2021 Survey of Health Index of Chinese Families, which covered 31 provinces/autonomous regions/municipalities in mainland China. The survey used a multistage quota sampling strategy encompassing 120 prefecture-level cities. Quotas were allocated to each prefecture-level city in accordance with the 2020 China Population Census. This approach resulted in a final sample of 11 030 eligible questionnaires. The utility index (UI) and EuroQol Visual Analog Scale (EQ VAS) scores were reported for the entire sample (age-gender-urban/rural weighted) and by the characteristics of the study participants. The study participants had a weighted mean UI of 0.939 (SD 0.135) and EQ VAS score of 80.19 (SD 18.39). The most commonly reported problem was anxiety/depression (26.37%), whereas self-care was the least reported problem (6.18%). Those who were male, were younger, lived without chronic conditions and disabilities, had higher levels of education, earned higher monthly household income, and were covered by basic medical insurance for urban employees had higher scores in both the UI and EQ VAS. This study revealed slightly lower UI scores despite a much higher drop in EQ VAS scores whereas China maintained minimum cases of COVID-19 in 2021 compared with the population norms recorded in 2019. Further studies are warranted to unveil the full impacts of COVID-19 outbreaks. • Population scores in both the utility index and EuroQol visual analog scale are influenced by socioeconomic, cultural, and political factors. More than 20 countries worldwide have established their EQ-5D-5L population norms, often updating them regularly. In China, efforts have been made to develop population norms for the EQ-5D-5L. However, none have used a sample covering all provinces and urban and rural residents, despite significant socioeconomic disparities across and within areas. • This study presents population scores of the EQ-5D-5L in a nationally representative sample in mainland China, examining them overall and by age, gender, and urban-rural location. It fills a gap in the literature by reporting EQ-5D-5L results during a period when China experienced minimal COVID-19 cases in 2021 compared with previous population norms studies. • This study provides an up-to-date population score for EQ-5D-5L in mainland China, which can support health economic evaluation and health decision making. It aids in understanding differences in health status among various groups and areas in China, holding substantial implications for public health workers and policy makers. [ABSTRACT FROM AUTHOR]

Biological, clinicobiological and clinical conceptions of Alzheimer's disease and related dementias are being promoted simultaneously to different practical ends. The co‐existence of contemporary conceptions and the ‘scary label’ associated with older diagnostic criteria create the possibility of misunderstanding and harm. In this comment, we argue in favour of socio‐ethical interventions targeted to health workers and the general public so as to lower the uncertainties introduced by contemporary diagnostic criteria and to articulate how they relate to established criteria. [ABSTRACT FROM AUTHOR]

Copyright of Contaduría y Administración is the property of Facultad de Contaduria y Administracion-Universidad Nacional Autonoma de Mexico 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.)

Background: Public health emergencies, such as the Covid-19 pandemic, put great pressure on healthcare workers (HCW) across the world, possibly increasing the risk of experiencing ethically challenging situations (ECS). Whereas experiencing ECS as a HCW in such situations is likely unavoidable, mitigation of their adverse effects (e.g., moral distress) is necessary to reduce the risk of long-term negative consequences. One possible route of mitigation of these effects is via work environmental factors. Objectives: The current study aimed to examine: [1] risk factors associated with ECS among HCW [2], intensity of moral distress associated with ECS across various occupational factors (i.e., profession, degree of exposure to patients with Covid-19), and [3] the impact of work environmental factors on this association, in a sample of HCW during the pandemic. Methods: We employed multiple logistic and linear regression to self-report data from 977 HCWs at four Norwegian hospitals responding to a survey at the fourth wave of the pandemic. Results: About half of HCW in this study had experienced ECS during the pandemic, and levels of moral distress associated with such were higher than in previous studies using similar assessment methods. Younger age, female sex, geographical work area (mid-north of Norway), and profession (nurse) were all associated with higher odds (range of OR: 1.30–2.59) of experiencing ECS, as were direct contact with patients with Covid-19. Among those participants who reported that they had experienced ECS during the pandemic, moral distress levels when recalling those situations were moderate (Mean 5.7 on a 0–10 scale). Men reported somewhat lower intensity of moral distress (partial eta squared; ηp2 = 0.02). Reporting a manageable workload (ηp2 = 0.02), and greater opportunity to work according to best practice (ηp2 = 0.02), were associated with lower levels of moral distress. Conclusions: Our findings suggest that moral distress could potentially be mitigated on an organizational level, particularly by focusing on ensuring a manageable workload, and an ability to work according to best practice. To build sustainable healthcare systems robust enough to withstand future public health emergencies, healthcare organizations should implement measures to facilitate these aspects of HCWs' work environment. [ABSTRACT FROM AUTHOR]

Background: Humanitarian crises increase the risk of mental health problems. Somalia has been affected by conflict, insecurity, and economic turmoil for over three decades, as well as climatic shocks. However, 80–90% of Somalis who have mental health problems do not have access to good-quality, and affordable mental health care. To develop an evidence-based, effective, equitable, and humane programme for mental health, we need to have a holistic understanding of mental health problems and care in relation to people's perceptions, experiences, and behaviour related to mental health. Methods: We undertook a qualitative study to explore Somalis' perceptions and experiences of mental health problems. We conducted three key informant interviews, two in-depth interviews, nine focus group discussions, 12 observations in private and public health facilities and more than 12 informal discussions. We used case vignettes translated into Somali during our discussion. We also studied three cases with experience of mental health problems to understand care-seeking behaviour and the experiences with services available. Results: Somalia has been moving from a traditional pastoral nomadic lifestyle to a settled one. A strong informal support system exists in the community within clans or family relations. Armed conflict often among clans, natural disasters, and khat use are the three main factors affecting mental health. The prevalence of mental problems is likely greater than is evident. It is perceived that about 95% of people suffering from mental illness remain outside of appropriate care. Few people seek care for mental health problems because they are not aware of it and because it is highly stigmatized and neglected. Those who do seek care usually go to traditional healers because of culture and cost. Resources for mental health care are grossly inadequate with a limited and often poorly trained workforce. At least two levels of barrier to mental health care exist, at the individual/family level (e.g. poor awareness of mental health and stigma) and service provider level (e.g. lack of staff and limited ability to diagnose, treat, or refer persons with mental health problems and stigma). No tool or evidence-based programme is available to address these barriers. Conclusion: A qualitative data-driven mental health programme that addresses all these issues is needed with more trained mental health professionals. Given the stigma about mental health problems, there is also a need for a tool to raise awareness about mental health and the importance of mental health care among both the public and health workers. [ABSTRACT FROM AUTHOR]

The Sudan virus disease outbreak in 2022 prompted the Denver Health High-Risk Infection Team (HITeam) to evaluate and implement novel strategies to respond to viral hemorrhagic fever (VHF) events. To improve the VHF response, HITeam members developed a virtual assessment model (VAM) for at-home evaluation of individuals who are suspected of having a VHF. The VAM incorporates aspects of care that would normally be rendered in a high-level isolation unit—including assessment and monitoring, specimen collection, provider consultation, patient and family teaching, and pharmaceutical intervention—into a mobile framework in which team members respond to a suspected case at the individual's home. Building this capability allows for more thorough assessment of a suspect case in the field, as well as the postponement of a decision about activation of the high-level isolation unit until more information is available. Development, testing, and implementation of the VAM required input from an interdisciplinary group of partners that demonstrated the ability of nurses, physicians, laboratorians, paramedics, emergency medical technicians, and public health personnel to integrate into 1 cohesive care team. The resulting model recenters VHF care on the patient by allowing the care team to gather critical information in an environment that is more comfortable for the suspect case while keeping communities safe and lowering exposure risks. The VAM has long-term sustainability implications for global VHF programs and provides solutions for broader challenges in healthcare by modeling cost-effective, patient-centered care within the highly nuanced subspecialty of special pathogen care. [ABSTRACT FROM AUTHOR]

Introduction: Burnout and moral injury are among the most pressing issues facing healthcare and public safety today. In 2021, Congress provided $120 million through the American Rescue Plan Act for 44 Health Resources and Services Administration grants to implement evidence-informed strategies to address burnout and improve mental health among the health workforce. This article examines facilitators and barriers to implementation and reported impact of grantees' interventions. Method: Key informant interviews (n = 39) and surveys (n = 36) with grantees were conducted between May and August 2023 and qualitatively analyzed using inductive and deductive approaches. Results: This study found grantees were adapting their program modality, timing, and content to meet the needs of their workforce. Many grantees were increasingly focused on training/engaging leadership, establishing structures for worker engagement, and allowing worker voice and priorities to guide operational changes. Though many grantees could not yet report program impact, those who could provide early data documented decreases in staff turnover, burnout, and moral distress. A common challenge was ongoing resource constraints, including staff and leadership turnover. Discussion: Findings suggest health and public safety organizations continued to struggle with staffing post-COVID, increasing the challenges of implementing their programs to improve burnout and well-being. However, just 18 months into their activities, grantees reported their efforts were leading to changes in organizations, culture, and the experiences of individuals. Key lessons include the importance of engaging workers, building trust, and developing intentional communication, evaluation, and feedback strategies to advance organizational-level efforts to improve worker and learner well-being. Public Significance Statement: The present study provides early evidence that the Dr. Lorna Breen Healthcare Provider Protection Act grantees are reporting changing organizations, culture, and the experiences of health and public safety workers. This occurs through continuously adapting initiatives to meet the diverse needs of their workforce. This research has implications for clinicians, organizations, and policymakers who seek to implement the changes needed to stop the cycle of health worker burnout and moral injury. [ABSTRACT FROM AUTHOR]

Introduction There have been nearly 1,600 new diagnoses of Human Immunodeficiency Virus (HIV) across the US Armed Forces between 2017 and 2022. While treatment has improved overall survival, self-perception of acquiring HIV may not align with actual risk of acquiring HIV, thus slowing diagnosis and treatment. We aim to evaluate self-perceived risk (SPR) versus calculated risk (CR) of HIV infection in US Air Force (USAF) members with incident HIV diagnosis. Methods All USAF members with new HIV diagnosis evaluated at a specialty care military medical center between January 2015 and March 2020 with case report forms were included (n  = 142). SPR was compared to CR using the Denver HIV Risk Score (DHRS). The study was approved by the Army Public Health Center's Public Health Review Board (#14-311) and the Walter Reed Army Institute of Research Human Subjects Protection Branch (#1861E). Results Patients were predominantly male (98%), with a median age of 26 (IQR 22-30) years, and the majority (85%) reported same-sex partners. Most patients reported a low SPR (n  = 78; 55%). A higher proportion of low SPR patients were married or partnered than high SPR patients (29% versus 14%; P  = 0.04). Both groups had median DHRS scores in the highest risk category with similar results by reason for HIV screening. Conclusion The majority of USAF members with incident HIV infection reported a low SPR despite risk factors and CRs identical to high SPR patients. In order to inform HIV prevention strategies in the military, further efforts are needed to educate the military population and providers about HIV risk perception. [ABSTRACT FROM AUTHOR]

Background: There is limited evidence about the mental health and intention to leave of the public health workforce in Canada during the COVID-19 pandemic. The objectives of this study were to determine the prevalence of burnout, symptoms of anxiety and depression, and intention to leave among the Canadian public health workforce, and associations with individual and workplace factors. Methods: A cross-sectional study was conducted using data collected by a Canada-wide survey from November 2022 to January 2023, where participants reported sociodemographic and workplace factors. Mental health outcomes were measured using validated tools including the Oldenburg Burnout Inventory, the 7-item Generalized Anxiety Disorder scale, and the 2-item Patient Health Questionnaire to measure symptoms of depression. Participants were asked to report if they intended to leave their position in public health. Logistic regression was used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (95% CI) for the associations between explanatory variables such as sociodemographic, workplace factors, and outcomes of mental health, and intention to leave public health. Results: Among the 671 participants, the prevalence of burnout, and symptoms of depression and anxiety in the two weeks prior were 64%, 26%, and 22% respectively. 33% of participants reported they were intending to leave their public health position in the coming year. Across all outcomes, sociodemographic factors were largely not associated with mental health and intention to leave. However, an exception to this was that those with 16–20 years of work experience had higher odds of burnout (aOR = 2.16; 95% CI = 1.12–4.18) compared to those with ≤ 5 years of work experience. Many workplace factors were associated with mental health outcomes and intention to leave public health. Those who felt bullied, threatened, or harassed because of work had increased odds of depressive symptoms (aOR = 1.85; 95% CI = 1.28–2.68), burnout (aOR = 1.61; 95% CI = 1.16–2.23), and intention to leave (aOR = 1.64; 95% CI = 1.13–2.37). Conclusions: During the COVID-19 pandemic, some of the public health workforce experienced negative impacts on their mental health. 33% of the sample indicated an intention to leave their role, which has the potential to exacerbate pre-existing challenges in workforce retention. Study findings create an impetus for policy and practice changes to mitigate risks to mental health and attrition to create safe and healthy working environments for public health workers during public health crises. [ABSTRACT FROM AUTHOR]

Background: Dengue remains a persistent public health concern, especially in tropical and sub-tropical countries like Thailand. The development and utilization of quantitative tools and information technology show significant promise for enhancing public health policy decisions in integrated dengue control. However, the effective implementation of these tools faces multifaceted challenges and barriers that are relatively underexplored. Methods: This qualitative study employed in-depth interviews to gain a better understanding of the experiences and challenges of quantitative tool development and implementation with key stakeholders involved in dengue control in Thailand, using a phenomenological framework. A diverse range of participants, including public health workers and dengue control experts, participated in these interviews. The collected interview data were systematically managed and investigated using thematic analysis to extract meaningful insights. Results: The ability to collect dengue surveillance data and conduct ongoing analyses were contingent upon the availability of individuals possessing essential digital literacy and analytical skills, which were often in short supply. Furthermore, effective space-time early warning and precise data collection were hindered by the absence of user-friendly tools, efficient reporting systems, and complexities in data integration. Additionally, the study underscored the importance of the crucial role of community involvement and collaboration among organizations involved in integrated dengue surveillance, control and quantitative tool development. Conclusions: This study employed a qualitative approach to gain a deeper understanding of the contextual intricacies surrounding the development and implementation of quantitative tools, which, despite their potential for strengthening public health policy decisions in dengue control, remain relatively unexplored in the Thai context. The findings yield valuable insights and recommendations for the development and utilization of quantitative tools to support dengue control in Thailand. This information also has the potential to support use of such tools to exert impact beyond dengue to a broader spectrum of diseases. Author summary: This study investigated the persistent public health challenge posed by dengue in tropical nations, with a specific focus on Thailand. Through qualitative research, it examined the potential of quantitative tools and information technology in integrated dengue control. Interviews with stakeholders, including public health workers and experts, revealed significant challenges. For instance, there was a shortage of essential skills for data collection and analysis, hampering effective surveillance and intervention. Additionally, issues such as the lack of user-friendly tools and complexities in data integration were identified. The study highlighted the importance of community involvement and collaboration among organizations. Recommendations included addressing these barriers by enhancing digital literacy and providing user-friendly tools. Overall, the study provided valuable insights into the development and utilization of quantitative tools, not only for dengue control but also for tackling a broader range of diseases. [ABSTRACT FROM AUTHOR]

Introduction: The quality of COVID-19 surveillance in various developing countries, including Indonesia, is still a severe problem related to data quality influenced by multiple individual and institutional factors. The study aimed to determine what factors affect the effectiveness of COVID-19 surveillance at public health facilities in the Indonesian districts of Kuningan, Majalengka, Indramayu, Cirebon, and Cirebon City of West Java Province. Materials and methods: This study utilized a cross-sectional study, a sample of 190 Public Health Surveillance Workers in districts of Kuningan, Majalengka, Indramayu, Cirebon, and Cirebon City who met the inclusion and exclusion criteria. Interviews using an instrument questionnaire were used to collect data between 1 November 2022 and 30 January 2023. binary logistic regression in multivariate tests and univariate, bivariate, and chi-squared data analysis. Results: The results of multivariate analysis workload (p = 0.002, CI 95%=0.63-2.68, OR=5.24), supervision (p = 0.000, CI 95%=3.98-8.72, OR=576.4), and readiness of surveillance facilities (p = 0.001, CI 95%=0.89-3.25, OR=7.97). Conclusion: The variables of workload, supervision, and facility readiness are significantly related to the quality of surveillance. Public health centres are expected to regulate officers’ workload, maintain the quality of surveillance support facilities, and carry out routine supervision by the District Health Office. [ABSTRACT FROM AUTHOR]

Introduction: Suicide is an important health hazard across the world. The SDR (Suicidal Death Rate) observed in Indian females is over three times higher than the rate expected globally for regions with similar socio-demographic profile. Objectives: This study is aimed at analysing the pattern, probable motives, and socio-demographic factors of female suicidal deaths across all age groups subjected for autopsy to the Forensic Medicine department, M.S Ramaiah Medical College. Materials and Methods: Detailed information regarding the deceased and the circumstances of death were collected from the police and relatives by a standard proforma questionnaire. Data was analysed using computer software, Statistical Package for Social Sciences (SPSS) version 20.0. Results: Total of 93 cases of female suicides were autopsied in the study period, and the most common age group observed was 21-30 years (30%), commonly educated up to high school (32.2%), majority of cases falling within class IV socio-economic status with 38.7% cases (Modified Kuppuswamy's classification). Married women comprised 41.9% cases. Hanging(76.3%) was the most often used method, commonly occurring at the time periods of 6AM-12PM and 6PM-12AM with 29 cases (31.18%) each. Frequently motivatedby monetary reasons with 18.27% and mental illnesses accounting for16.12%. Conclusion: The increasing suicide rate creates a challenging obstacle for public health personnel. This study is a step toward a larger multi-centre study where deeper analysis and necessary interventions can be postulated. [ABSTRACT FROM AUTHOR]

Background: Needle Stick Injuries (NSIs) are defined as accidental skin-penetrating stab wounds from a hollow-bore needle containing another person's blood or body fluid. NSIs are one of the most potential hazards for health care workers. They pose a significant risk of occupational transmission of bloodborne pathogens. Objectives: The aim of the study is to assess knowledge and practice toward needle stick injuries among health care workers (HCWs) at public hospitals in Mukalla city. Methods: A descriptive cross-sectional study was conducted among health care workers at Ibn Sina General Hospital Authority and Mukalla Maternal and Childhood Hospital. A pre-tested, self-administered questionnaire was used for the data collection. Descriptive statistics were made to analyze the collected data using the Statistical Package for Social Sciences (SPSS) version 26. Results: Most respondents, 194 (75.8%) aged between (21-31) years, males and females were almost equally distributed. Vast majority of HCWs 234 (91.4%) have a good knowledge regarding NSIs, while only 22 (8.6%) have a poor knowledge. Most of HCWs 237 (92.6%) have a poor practice toward NSIs, while only 19 (7.4%) have a good practice. Conclusion: Majority of HCWs have a good knowledge, and poor practice toward NSIs. Most of them know that NSIs can be preventable. More than two thirds strongly agree that needles should be discarded immediately after use. Only less than one third use the one-hand method for recapping needles. [ABSTRACT FROM AUTHOR]

This paper addresses the growing recognition of occupational stressors impacting the mental health of public safety personnel (PSP) and their families. While numerous programs support PSP well‐being, limited attention is given to family members, who navigate increased worry, social isolation, and the challenge of supporting a psychologically injured spouse. Drawing from the functional disconnection/functional reconnection (FD/FR) framework, this paper introduces FD/FR family—a proactive model tailored to PSP families. Rooted in Stoicism, this innovative adaptation extends the application of FD/FR concepts to benefit not only PSP members but also their families. FD/FR family advocates temporarily setting aside personal reactions and improving emotional processing to enhance communication, flexibility, and mitigate vicarious trauma and mental health deterioration. This paper offers PSP family‐specific examples and urges future research to identify essential FD/FR components accepted by both PSP and their families. [ABSTRACT FROM AUTHOR]

A pigment is a naturally occurring colored substance that is created by plants, animals, and microbes. Pigments are utilized in a variety of industries, including food coloring, pharmaceuticals, fabric dying, cosmetics, ink plastics, coloring paints, and so on. The Natural pigments /Bio pigments are very expensive because mass production is difficult. There are more pigments in nature, but only a small number are available in large enough amounts to be useful for industry. This study is attempted to isolate a bacterial red pigmented organism from facial acne was identified as Serratia marcescens MBM‐17 according to Bergey's manual of determinative bacteriology and molecular characterization and production of red pigment was optimized at various growth factors, maximum pigment production was at pH 4, 72 h and 37 ± 2°C, that is, 15.56 g/ L. The partial purified pigment was characterized by UV–Vis, and maximum absorbance was at 533.5 nm. SEM analysis shows that the surface morphology and FTIR spectroscopy revealed the presence of prodigiosin. Prodigiosin has antibacterial efficacy against gram positive bacterial strains, Staphylococcus aureus, Bacillus sp, and gram negative bacterial strains. Klebsiella sp, Pseudomonas sp, Salmonella sp, antifungal potency against Aspergillus niger, Aspergillus flavus, Penicillium sp, Rhizopus sp, and Mucor sp, and checked the fabric dying effects of pigments. Prodigiosin used as fabric dye is applied on clothes, which shows good color tone. This study is highlighting the production of a natural pigment/drug, Prodigiosin with antimicrobial activity may be used for the manufacture of dyed dress materials and masks having antimicrobial action for public especially health workers in this pandemic situation. [ABSTRACT FROM AUTHOR]

Abstract Introduction Burnout is an occupational phenomenon resulting from chronic workplace stress. We conducted this review to estimate the pooled global prevalence of burnout among the public health workforce. Methods We conducted this review as per the PRISMA 2020 guidelines. We included only cross-sectional studies reporting outcome estimates among the study population. We included articles published before December 2023. We used a search strategy to systematically select the articles from PubMed, Embase, and Google Scholar. We assessed the quality of the studies using an adapted version of NIH's study tool assessment for cross-sectional and observational cohort studies. We estimated the pooled proportion using the random-effects model. Results We included eight studies in our review, covering a sample size of 215,787. The pooled proportion of burnout was 39% (95% CI: 25–53%; p-value:

Background: Nonadherence to national standards for malaria diagnosis and treatment has been reported in Sudan. In this study, qualitative research examined the clinical domains of nonadherence, factors influencing nonadherent practices and health workers' views on how to improve adherence. Methods: In September 2023, five Focus Group Discussions (FGDs) were undertaken with 104 health workers from 42 health facilities in Sudan's Northern State. The participants included medical assistants, doctors, nurses, laboratory personnel, pharmacists and public health officers. The FGDs followed a semi-structured guide reflecting the national malaria case management protocol. Qualitative thematic analysis was performed. Results: Nonadherent practices included disregarding parasitological test results, suboptimal paediatric artemether–lumefantrine (AL) dosing, lack of counselling, use of prohibited artemether injections for uncomplicated and severe malaria, artesunate dose approximations and suboptimal preparations, lack of AL follow on treatment for severe malaria; and rare use of primaquine for radical Plasmodium vivax treatment and dihydroartemisinin-piperaquine as the second-line treatment for uncomplicated malaria. Factors influencing nonadherence included stock-outs of anti-malarials and RDTs; staff shortages; lack of training, job aids and supervision; malpractice by specialists; distrust of malaria microscopy and RDTs; and patient pressure for diagnosis and treatment. Health workers recommended strengthening the supply chain; hiring personnel; providing in-service protocol training including specialists; establishing external quality assurance for malaria diagnosis; and providing onsite supportive supervision and public health campaigns. Conclusions: This study revealed a broad spectrum of behavioural and systemic challenges in malaria management among frontline health workers in Northern Sudan, including nonadherence to protocols due to resource shortages, training gaps, a lack of supportive supervision and patient pressure. These insights, including health workers' views about improvements, will inform evidence-based interventions by Sudan's National Malaria Control Programme to improve health systems readiness and the quality of malaria case management. [ABSTRACT FROM AUTHOR]

Chronic diseases, especially hypertension, are society's most common health problems. One of the government's efforts is to collaborate with BPJS Health in managing chronic diseases, especially hypertension, through Prolanis (Chronic Disease Management Program). In its implementation, Prolanis involves the important role of health workers at public health centers. This research aims to see the effectiveness of the role of health workers as communicators in increasing the accountability of Prolanis hypertension services in public health centers. This research uses a qualitative approach by conducting in-depth interviews with informants. Data analysis utilizes a qualitative study's content during the data collection and interpretation process. The data that has been collected and processed will be presented in narrative form. The results of the research explain that Prolanis officers and participants gave a good assessment of Prolanis. As communicators, Prolanis officers have thoroughly understood the information about Prolanis so they can provide accurate education to Prolanis participants. The information provided includes the intensity and dosage of medication, the dangers of hypertension and the negative impacts of not taking medication regularly, how to control blood pressure, foods that should be consumed and avoided, and other information related to hypertension. Moreover, Prolanis officers also appear as good and polite communicators and use language that is easy to understand. [ABSTRACT FROM AUTHOR]

Introduction: Burnout is an occupational phenomenon resulting from chronic workplace stress. We conducted this review to estimate the pooled global prevalence of burnout among the public health workforce. Methods: We conducted this review as per the PRISMA 2020 guidelines. We included only cross-sectional studies reporting outcome estimates among the study population. We included articles published before December 2023. We used a search strategy to systematically select the articles from PubMed, Embase, and Google Scholar. We assessed the quality of the studies using an adapted version of NIH's study tool assessment for cross-sectional and observational cohort studies. We estimated the pooled proportion using the random-effects model. Results: We included eight studies in our review, covering a sample size of 215,787. The pooled proportion of burnout was 39% (95% CI: 25–53%; p-value: < 0.001). We also identified high heterogeneity among the included studies in our review (I2: 99.67%; p-value: < 0.001). Seven out of the eight studies were of good quality. The pooled proportion of the studies conducted during the COVID-19 pandemic was 42% (95% CI: 17–66%), whereas for the studies conducted during the non-pandemic period, it was 35% (95% CI: 10–60%). Conclusion: In our review, more than one-third of public health workers suffer from burnout, which adversely affects individuals' mental and physical health. Burnout among the public health workforce requires attention to improve the well-being of this group. Multisite studies using standardized definitions are needed for appropriate comparisons and a better understanding of variations in burnout in various subgroups based on sociodemographic characteristics and type of work responsibilities. We must design and implement workplace interventions to cope with burnout and increase well-being. Limitations: Due to the limited research on burnout among public health workers, we could not perform a subgroup analysis on various factors that could have contributed to burnout. [ABSTRACT FROM AUTHOR]

Objective To investigate thejob satisfaction and analyze influencing factors of health workers in basic public health service projects. Methods 164 primary medical institutions in Jiangxi Province were selected according to the method of phased cluster sampling. A questionnaire survey was conducted on the health personnel providing basic public health services in these institutions. Nonparametric test and ordered multiclass logistic regression were used to analyze the influencing factors of job satisfaction. Results Among the 3 018 basic public health service workers, the average score of job satisfaction was 24.52 ± 6.84 points. The proportion of very dissatisfied, relatively dissatisfied, average, fairly satisfied and very satisfied were 3.78%, 9.87%, 39.83%, 23.92% and 22.60%, respectively. Multiple linear regression analysis showed that educational background, job category, working years, income, overtime, training and performance reward mechanism had statistical significance on the overall job satisfaction score (P < 0.05). Conclusion The job satisfaction of health worker in basic public health service projects in Jiangxi Province was above average. In order to improve the job satisfaction, we can improve the promotion and guarantee mechanism for grassroots talents, strengthen vocational training, and improve the assessment mechanism. [ABSTRACT FROM AUTHOR]

Objective To establish a health emergency competency evaluation index system for public health personnel, so as to provide a theoretical basis for building a health emergency team. Methods The competency index was screened and the evaluation index frame was established by literature research method, expert association commercial method and Delphi method. The analytic hierarchy process was used to calculate the weight value of the importance of indicators at all levels, and the evaluation index system was formed. Results A total of 21 experts were invited to conduct letter inquiries, and the recovery rate of the two rounds of expert letter inquiries was 100%. The Cronbach's a coefficients of the expert letter consultation form were 0.968 and 0.963, expert authority level 0.865, Kendall's W coordination coefficient in 2 rounds of correspondence suggested that experts had a high consistency (P < 0.05) . The evaluation index system of public health personnel's competency in health emergency work included 3 first-level indicators, 11 second-level indicators and 68 third-level indicators. The weights of the first-level indicators are respectively health emergency literacy (0.517 4), professional literacy (0.336 1) and personal literacy (0.146 6). Conclusion Good health emergency literacy is the basis for public health personnel to respond to public health emergencies. The weight of each index in this index system is determined by Delphi method and analytic hierarchy process, and the results are scientific and reliable. [ABSTRACT FROM AUTHOR]

Introduction: the modern lifestyle, characterized by intense routines and inadequate diets, contributes to the increase in non-communicable diseases (NCDs), especially obesity, which can be influenced by stress. The relationship between stress, nutritional status, and NCDs lacks comprehensive studies, especially concerning public security professionals. Objective: to evaluate abdominal obesity and its association with stress symptoms in public safety personnel in a metropolitan region of a Brazilian capital. Methods: the study is part of the “SOMA-SI” program, which investigated the health of public security agents in Espírito Santo between April and December 2022. The sample included police officers, firefighters, and municipal guards (n=216). Healthy adults, who were public safety personnel, were included, while those on leave or under psychiatric treatment were excluded. Blood pressure measurements, anthropometric assessments, and the Lipp’s Inventory of Stress Symptoms for adults were among the variables measured. The Statistical Package for Social Science (SPSS) v. 25 for Windows® was used for statistical analyses. Chi-square and Mann-Whitney tests were performed at a significance level of 5%, exploring associations between categorical variables and differences in median stress scores. Results: the sample consisted of 216 participants, predominantly men (75.5%) and non-white (63.7%), revealing that 61.6% had more than 15 years of work experience, 81.1% had income above six minimum wages, and 77.3% had completed higher education. Military police officers represented the majority (67.6%), with 72.2% being parents, 57.9% alcohol consumers, and 9.3% smokers. Most participants had excess body fat (70.8%) and weight (77.3%). Statistical associations were observed between waist circumference and stress symptoms (p = 0.004). Conclusion: the study uncovered a prevalent occurrence of abdominal adiposity and stress among public safety personnel. Furthermore, it elucidates a significant prevalence of excess weight within the sample, coupled with a pronounced incidence of stress symptoms. These findings underscore a complex and mutually influential relationship between these variables. However, they also emphasize the critical need for more extensive research efforts to understand the impact of stress on individuals working in public safety roles. [ABSTRACT FROM AUTHOR]

This article provides an overview of the public health response to COVID-19 in the Kyrgyz Republic. The country faced challenges in its healthcare system, including a shortage of medical personnel, poor working conditions, and low wages. Nonpharmaceutical interventions were lifted prematurely, resulting in a surge in cases and overwhelming the healthcare system. Government ineffectiveness and corruption further hindered the response. Recommendations include strengthening the healthcare workforce, improving recruitment and retention efforts, and addressing government corruption. The article emphasizes the importance of adhering to nonpharmaceutical interventions and protecting healthcare personnel. The government must address these issues to effectively handle future public health emergencies. [Extracted from the article]

The article presents the discussion on Severe Maternal Morbidity (SMM) as a critical public health issue, noting its rising rate in Mississippi and the need for a causation model to reduce cases. Topics include potential preventability of SMM through a whole-person healthcare approach and the impact of maternal health factors; and collaborative efforts like AIM to implement patient safety measures.

Background: This study aims to determine how workplace violence experienced by healthcare workers in Turkey affects their job satisfaction and intention to leave. It also examines the mediating role of employees' work-family conflict between these effects. Methods: The PROCESS method was used in the study. The research was conducted on 595 health workers in three public hospital affiliated with the Istanbul Provincial Health Directorate. The convenience sampling method was used in the selection of the participants. Results: As a result of the analysis, it was determined that there is a positive, significant, moderate (R = 0.35, p < 0.01) relationship between workplace violence and work-family conflict, and a negative, significant and weak relationship between workplace violence and job satisfaction (R = -0.27, p < 0.01), there is a positive, significant, and weak (R = 0.26, p < 0.01) relationship between workplace violence and intention to leave. In addition, there is a negative, significant, and weak (R = -0.27, p < 0.01) relationship between workfamily conflict and job satisfaction, and a positive, significant, and weak (R = 0.28, p < 0.01) relationship between work-family conflict and intention to leave. Workplace violence had significant and negative effects on the employees' job satisfaction and significant and positive effects on the intention to leave and work-family conflicts. Discussion: As a result of the mediating variable analysis, it was determined that work-family conflict has a partial mediator role in the relationship between workplace violence, job satisfaction, and intention to leave. The results are very important, especially for managers working in the healthcare sector. Reducing workplace violence against healthcare personnel will contribute to increasing productivity in the sector and providing better quality service to the healthcare sector. [ABSTRACT FROM AUTHOR]

Objective To explore the current situation of disease prevention and control ability and training needs of grassroots public health personnel in Luzhou, to provide a reference for improving the disease prevention and control ability of grassroots public health personnel in Luzhou, Methods A questionnaire survey was conducted on 1 075 people engaged in disease control work in township health centers, village clinics, and community health service centers (stations) in Luzhou City to analyze their disease prevention and control ability and influencing factors. Results The average self 一 evaluation score of basic disease prevention and control ability skills of primary public health personnel in Luzhou City was 57. 93 ± 27. 30 points, with a score rate of 46. 72%. Among them, r prevention and control of chronic non - communicable diseasesir had the highest score rate of 56. 94%, and, r prevention and control of endemic and parasitic diseases" had the lowest score rate of 37. 75%. Among the survey respondents, 92.37% had participated in basic knowledge or skills training in disease control, and the proportion of those who chose, r on - site guidance1 r as the desired form of training was the highest, at 80. 74%. The results of multiple linear regression analysis showed that the factors affecting the ability of primary public health personnel in disease prevention and control were mainly female(£ 二-3. 425, P = 0. 001), outside the establishment(£ 二 3. 322, P = 0. 001), not having participated in training in basic knowledge or skills of disease control(£ 二 -6. 119, P < 0.001), professional background (non 一 medical t - -2. 083, P = 0. 038) and professional background (non 一 medical £ 二 一 0. 083, P = 0. 038). Conclusion The disease prevention and control ability of grassroots public health personnel in Luzhou City is relatively weak, with gender, professional background, establishment, and whether they have participated in training being the main influencing factors, requiring targeted training in relevant knowledge and skills. [ABSTRACT FROM AUTHOR]

Copyright of Zdravotnicke listy is the property of Alexander Dubcek University in Trencin, Faculty of Nursing 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.)

Poor management of waste can cause serious disease to healthcare personnel, cleaners, waste handlers, patients and the public. An observation-supported cross-sectional study was conducted to assess healthcare waste (HCW) management practice and professional, management and resource availability-associated factors among healthcare workers of 23 public health facilities in Southwest Shewa Zone, Oromia regional state, Ethiopia, 2021. A total of 424 health workers participated in this study. The level of proper healthcare waste management (HCWM) practice was 38.4%. Lack of knowledge on different methods of healthcare waste treatment (adjusted odds ratio (AOR): 0.101, 95% confidence interval (CI) (0.042, 0.242, p < 0.05)), lack of knowledge about the types of healthcare waste (AOR: 0.136, 95% CI (0.039, 0.481, p < 0.05)), lack of knowledge on the use of different colour-coded waste bin and safety box (AOR: 0.145, 95% CI (0.040, 0.520, p < 0.05)), and healthcare workers who had no training/orientation on HCWM practice (AOR: 0.396, 95% CI (0.245, 0.639, p < 0.05)) were less likely to practice effective HCWM compared to their counterparts. The current HCWM practices in studied health facilities was inadequate. Professional knowledge and availability of training were independently associated with HCWM practice. Therefore, regular orientation during employment and on-job training on HCWM practice, regular monitoring and supervision of HCWM are important. Further research should be conducted on the area of HCWM, and its associated environmental impacts by using more strong methods and wider health facilities. [ABSTRACT FROM AUTHOR]

Background: Health disparities, inconsistent outcomes, and underwhelming health services continue to be problems for all nurses and doctors. Studies from a variety of nations have found that doctors and nurses have little familiarity with evidence-based practice. There is a knowledge vacuum about the degree of evidence-based nursing practice and its contributing factors in Ethiopia as well as the current study region. Objective: The study's objective was to evaluate how healthcare professionals working in government hospitals in the Sidama regional state of 2022 are implementing evidence-based clinical practice and to identify associated factors. Methods: From October 1 to December 30/2022, a cross-sectional institution-based study with a mix of quantitative and qualitative methods was carried out. A total of 422 healthcare workers were randomly selected to participate in the current study from 6 randomly selected public hospitals in the region. This study included 25 key informant interviews. The Friedman test and Funk's BARRIER scale were adapted into a semi-structured questionnaire quantitative. Multivariable logistic regression was used to assess the significance of the association between the dependent and independent variables. A pretest was conducted on 22 healthcare workers from Shashmane Hospital. Result: This study found that more than half, 51.7%, of the participants had a total implementation of evidence-based practice score below the mean score (40.4). only Access to the internet [having smart phone] (Adjusted Odds Ratio (AOR) = 3.03: 95% Confidence Interval (CI): (1.75–5.26))., favorable Attitude toward EBP of participants. (Adjusted Odds Ratio (AOR) = 1.84Confidence Interval (1.12–2.70)), inadequate Self-efficacy of Evidence-based practice skills (Adjusted Odds Ratio (AOR) = 0.29 Confidence interval = 0.19–0.46), and Knowledge of evidence-based practice (Adjusted Odds Ratio (AOR) = 0.45 Confidence interval = 0.30–0.77)were factors significantly associated with EBP implementation. Conclusion: More than half of the participants,51.7%, do not implement evidence-based practice in the care of their clients, which is unacceptable. The use of EBP has been significantly associated with access to the internet (having a smartphone), participants' positive attitudes toward it, their level of skill efficacy in finding and accessing it, and their knowledge of it. Therefore, stakeholders ought to think about addressing these obstacles to the adoption of EBP. [ABSTRACT FROM AUTHOR]

Introduction: Brucellosis is a febrile zoonosis occurring among high-risk groups such as livestock keepers and abattoir workers and is a public health priority in Uganda. The technical complexities of bacteriological and molecular methods make serological approaches the cornerstone of diagnosis of human brucellosis in resource limited settings. Therefore, proper application and interpretation of serological tests is central to achieve a correct diagnosis. Materials and methods: We conducted a cross-sectional study to estimate the seroprevalence and factors associated with anti-Brucella antibodies among slaughterhouse workers processing ruminants and pigs in three regions of the country with serial testing using a combination of the Rose Bengal Test (RBT) and the BrucellaCapt test. An authorized clinician collected 543 blood samples from consenting abattoir workers as well as attribute medical and social demographic data. Univariable and multivariable logistic regression were used to determine factors associated with anti-Brucella sero-positivity. Results and discussion: The sero-prevalence among ruminant slaughterhouse workers ranged from 7.3% (95% CI: 4.8–10.7) using BrucellaCapt to 9.0% (95% CI: 6.3–12.7) using RBT. Slaughterhouse workers from the Eastern regions (AOR = 9.84, 95%CI 2.27–69.2, p = 0.006) and those who graze animals for alternative income (AOR = 2.36, 95% CI: 1.91–6.63, p = 0.040) were at a higher risk of exposure to Brucella. Similarly, those who wore Personal Protective Equipment (AOR = 4.83, 95%CI:1.63–18.0, p = 0.009) and those who slaughter cattle (AOR = 2.12, 95%CI: 1.25–6.0, p = 0.006) were at a higher risk of exposure to Brucella. Those who slaughter small ruminants (AOR = 1.54, 95%CI: 1.32–4.01, p = 0.048) were also at a higher risk of exposure to Brucella. Conclusions and recommendations: Our study demonstrates the combined practical application of the RBT and BrucellaCapt in the diagnosis of human brucellosis in endemic settings. Both pharmaceutical (e.g., routine testing and timely therapeutic intervention), and non-pharmaceutical (e.g., higher index of suspicion of brucellosis when investigating fevers of unknown origin and observation of strict abattoir hygiene) countermeasures should be considered for control of the disease in high-risk groups. Author summary: Brucellosis is a febrile zoonosis occurring among high-risk groups such as abattoir workers and is a public health priority in Uganda. Whereas bacteriological isolation is conclusive, and some molecular methods have been found useful for diagnosis of brucellosis, they are technically complex and may delay commencement of treatment. Therefore, clinicians from resource poor settings rely on clinical examination and serology for diagnosis of human brucellosis. However, brucellosis lacks pathognomonic signs, and clinically resembles other endemic febrile illnesses which complicates diagnosis. Poor quality Brucella antigens, serological tests not validated for human use, and lack of consensus on the tests of choice complicate diagnosis of brucellosis. Previously, many studies employed a variety of tests to estimate sero-prevalence of brucellosis in high-risk groups leading in some cases to over estimation of the disease in Uganda. Here we applied the RBT and BrucellaCapt tests in a serial testing scheme to detect contacts, short and long evolution cases of brucellosis and report a sero-prevalence ranging from 7.3% to 9.0% among slaughterhouse workers in Uganda. Brucella seropositivity was associated with the region where participants worked, the slaughter of cattle, small ruminants, and grazing animals as an activity outside the work of the slaughterhouse. [ABSTRACT FROM AUTHOR]

Background: Routine health information is the pillar of the planning and management of health services and plays a vital role in effective and efficient health service delivery, decision making, and program improvement. Little is known about evidence-based actions to successively advance the use of information for decision making. Therefore, this study aimed to assess the level and determinants of routine health data utilization among health workers in public health facilities in the Harari region, Ethiopia. Methods: An institutional-based cross-sectional study design was used from June 1 to July 31, 2020. A total of 410 health care providers from two hospitals and five health centers were selected using a simple random sampling technique. Data were collected through a structured questionnaire complemented by an observational checklist. The collected data were thoroughly checked, coding, and entered into Epi-data version 4.6 before being transferred to Stata version 14 for analysis. Frequency and cross-tabulations were performed. To measure factors associated with routine use of health data, bivariate and multivariate logistic regression analyzes were performed. The odds ratio with a 95% CI was calculated, and then a p-value of less than 0.05 was considered significant. Result: The general utilization of routine health data was 65.6%. The use of routine health data was significantly associated with healthcare workers who had a positive attitude towards data [AOR = 4 (2.3–6.9)], received training [AOR = 2.1 (1.3–3.6)], had supportive supervision [AOR = 3.6 (2.1–6.2)], received regular feedback [AOR = 2.9 (1.7–5.0)] and perceived a culture of information use [AOR = 2.5 (1.3–4.6)]. Conclusions: Sixty percent of health professionals had used routine health data utilization. Training, supervision, feedback, and the perceived culture of information were independently associated with the use of routine health data utilization. Therefore, it is critical to focus on improving data utilization practices by addressing factors that influence the use of routine health data. [ABSTRACT FROM AUTHOR]

Objective To construct an evaluation index system of information literacy for public health personnel, and to provide reference for assessing the level of information literacy of public health personnel. Methods The indicator pool of the indicator system was constructed through the literature research method and combining with the actual work, 19 experts in related fields were invited to conduct two rounds of expert consultation by the Delphi method, so as to determine the final indicators, and the weights of indicators at all levels were determined by the hierarchical analysis method. Results The positive coefficients of the two rounds of expert consultation were greater than 90%, and the expert authority coefficients were 0. 895 and 0. 922. The expert Kendall coordination coefficients were 0. 152 and 0. 121, respectively P < 0. 001, and the differences were all statistically significant. Through two rounds of expert consultation, the evaluation index of information literacy of public health personnel constructed by 4 first 一 level indicators, 15 second 一 level indicator systems and 38 third 一 level indicators of information awareness, information knowledge, information competence and information utilization ethics were finalized. Conclusion The index system has certain reliability and scientificity, and can provide a reference basis for measuring the information literacy level of public health personnel. [ABSTRACT FROM AUTHOR]

The article offers information on the ongoing threat posed by H5N1 avian influenza and the U.S. government's failure to learn from the Covid-19 pandemic. Topics discussed include the weaknesses in pandemic preparedness; the risks of political and legal challenges to public health measures; and also mentions about the potential consequences of inadequate response to a new health crisis.

Mosquitoes transmit pathogens that pose a threat to millions of people globally. Unfortunately, widespread insecticide resistance makes it difficult to control these public health pests. General mechanisms of resistance, such as target site mutations or increased metabolic activity, are well established. However, many questions regarding the dynamics of these adaptations in the context of developmental and environmental conditions require additional exploration. One aspect of resistance that deserves further study is the role of heat shock proteins (HSPs) in insecticide tolerance. Studies show that mosquitoes experiencing heat stress before insecticide exposure demonstrate decreased mortality. This is similar to the observed reciprocal reduction in mortality in mosquitoes exposed to insecticide prior to heat stress. The environmental shifts associated with climate change will result in mosquitoes occupying environments with higher ambient temperatures, which could enhance existing insecticide resistance phenotypes. This physiological relationship adds a new dimension to the problem of insecticide resistance and further complicates the challenges that vector control and public health personnel face. This article reviews studies illustrating the relationship between insecticide resistance and HSPs or hsp genes as well as the intersection of thermotolerance and insecticide resistance. Further study of HSPs and insecticide resistance could lead to a deeper understanding of how environmental factors modulate the physiology of these important disease vectors to prepare for changing climatic conditions and the development of novel strategies to prevent vector-borne disease transmission. [ABSTRACT FROM AUTHOR]

Climate change is widely recognized as one of the most significant challenges facing our planet and human civilization. Human activities such as the burning of fossil fuels, deforestation, and industrial processes release greenhouse gases into the atmosphere, leading to a warming of the Earth's climate. The relationship between climate change and cardiovascular (CV) health, mediated by air pollution and increased ambient temperatures, is complex and very heterogeneous. The main mechanisms underlying the pathogenesis of CV disease at extreme temperatures involve several regulatory pathways, including temperature-sympathetic reactivity, the cold-activated renin-angiotensin system, dehydration, extreme temperature-induced electrolyte imbalances, and heat stroke-induced systemic inflammatory responses. The interplay of these mechanisms may vary based on individual factors, environmental conditions, and an overall health background. The net outcome is a significant increase in CV mortality and a higher incidence of hypertension, type II diabetes mellitus, acute myocardial infarction (AMI), heart failure, and cardiac arrhythmias. Patients with pre-existing CV disorders may be more vulnerable to the effects of global warming and extreme temperatures. There is an urgent need for a comprehensive intervention that spans from the individual level to a systemic or global approach to effectively address this existential problem. Future programs aimed at reducing CV and environmental burdens should require cross-disciplinary collaboration involving physicians, researchers, public health workers, political scientists, legislators, and national leaders to mitigate the effects of climate change. [ABSTRACT FROM AUTHOR]

Background: Eastern equine encephalitis virus (EEEV) is a rare mosquito-borne illness exhibiting rapid neurological deterioration and permanent damage. Despite its >30% mortality and >60% long-term neurological damage, EEEV has no approved antiviral medication or vaccination. This report uniquely aims to describe a rare case of EEEV and provide a current literature review of therapeutic and preventative options from the clinical perspective to guide clinicians and public health workers, along with informing them about its impact and current knowledge gaps. Methods: A retrospective chart review of the electronic medical record was performed for a patient's 10-day hospital admission in July 2021. In addition, PubMed was searched using relevant keywords for a literature review of EEEV. Results: A 61-year-old woman presented with dysarthria and right-sided facial droop. Acute ischemic stroke was ruled out, and empiric intravenous (IV) antibiotics were initiated for possible infectious etiology. The patient developed worsening mental status and fever and was intubated, with antibiotics broadened with concern for meningitis along with tick-borne illness. The patient remained encephalopathic and febrile, and lumbar serologies were consistent with viral meningoencephalitis or acute disseminated encephalomyelitis. Several days after collection, quantitative antibody testing returned positive for EEEV. The patient was pronounced dead on hospital day 10. On review of the literature regarding EEEV, supportive care and prevention remain the cornerstone of management. Although early IV immunoglobulin and high-dose steroids have shown potential as treatments to reduce morbidity and mortality, no vaccines have been approved to date. Conclusion: Prospective trials and further investigations into treatment and preventative options may be useful in reducing the morbidity and mortality associated with EEEV. [ABSTRACT FROM AUTHOR]

Poisoning is the leading cause of injury-related morbidity and mortality in the United States. The highest rates of exposure to poisons occur in children five years and younger, but opioid overdoses in young adults account for most deaths from poisonings in recent years. Intentional or accidental medication poisoning should be considered when evaluating patients with mental status changes, vital sign abnormalities, seizures, and gastrointestinal or cardiovascular problems. For all poisoned patients, a comprehensive history and physical examination are needed. Knowledge of toxidromes may help identify the cause in unknown ingestions; however, their usefulness may be limited when multiple toxins are ingested. Electrocardiography is indicated in patients reporting chest pain and dyspnea and in overdoses of beta blockers, tricyclic antidepressants, and antidysrhythmics. Measurement of electrolyte, serum creatinine, and serum bicarbonate levels and calculation of the anion gap may be helpful based on the clinical presentation. Treatment of a patient with acute poisoning is based on resuscitation and stabilization with a focus on airway, breathing, and circulation. When poisoning is suspected, the Poison Control provides health care workers and the public with access to a specialist 24 hours a day. (Am Fam Physician. 2024; 109(2): 143–153. Copyright © 2024 American Academy of Family Physicians.) Poisoning is the leading cause of injury-related morbidity and mortality in the United States. The highest rates of exposure to poisons occur in children five years and younger, but opioid overdoses in young adults account for most deaths from poisonings in recent years. Intentional or accidental medication poisoning should be considered when evaluating patients with mental status changes, vital sign abnormalities, seizures, and gastrointestinal or cardiovascular problems. For all poisoned patients, a comprehensive history and physical examination are needed. Knowledge of toxidromes may help identify the cause in unknown ingestions; however, their usefulness may be limited when multiple toxins are ingested. Electrocardiography is indicated in patients reporting chest pain and dyspnea and in overdoses of beta blockers, tricyclic antidepressants, and antidysrhythmics. Measurement of electrolyte, serum creatinine, and serum bicarbonate levels and calculation of the anion gap may be helpful based on the clinical presentation. Treatment of a patient with acute poisoning is based on resuscitation and stabilization with a focus on airway, breathing, and circulation. When poisoning is suspected, the Poison Control provides health care workers and the public with access to a specialist 24 hours a day. [ABSTRACT FROM AUTHOR]

Background: The shortage of public health personnel and the uneven distribution between urban and rural areas are thorny issues in China. Master of public health (MPH) is an integral part of public health human resources in the future, and it is of far-reaching significance to discuss their work preferences. The present study wants to investigate the job preference of MPH, understand the relative importance of different job attributes, and then put forward targeted incentive measures. Methods: Discrete choice experiment (DCE) was used to evaluate the job preference of MPHs in two medical colleges in Liaoning Province. Attributes include employment location, bianzhi, working environment, career development prospects, work value and monthly income. Thirty-six choice sets were developed using a fractional factorial design. Mixed logit models were used to analysis the DCE data. Results: The final sample comprised 327 MPHs. All the attributes and levels included in the study are statistically significant. Monthly income is the most important factor for MPHs. For non-economic factors, they value career development prospects most, followed by the employment location. Respondents' preferences are heterogeneous and influenced by individual characteristics. Subgroup analysis showed that respondents from different family backgrounds have different job preferences. Policy simulation suggested that respondents were most sensitive to a salary increase, and the combination of several non-economic factors can also achieve the same effect. Conclusions: Economic factors and non-economic factors significantly affect the job preference of MPHs. To alleviate the shortage and uneven distribution of public health personnel, more effective policy intervention should comprehensively consider the incentive measures of the work itself and pay attention to the individual characteristics and family backgrounds of the target object. [ABSTRACT FROM AUTHOR]

Background: This study presents the prevalence of burnout among the Canadian public health workforce after three years of the COVID-19 pandemic and its association with work-related factors. Methods: Data were collected using an online survey distributed through Canadian public health associations and professional networks between November 2022 and January 2023. Burnout was measured using a modified version of the Oldenburg Burnout Inventory (OLBI). Logistic regressions were used to model the relationship between burnout and work-related factors including years of work experience, redeployment to pandemic response, workplace safety and supports, and harassment. Burnout and the intention to leave or retire as a result of the COVID-19 pandemic was explored using multinomial logistic regressions. Results: In 2,079 participants who completed the OLBI, the prevalence of burnout was 78.7%. Additionally, 49.1% of participants reported being harassed because of their work during the pandemic. Burnout was positively associated with years of work experience, redeployment to the pandemic response, being harassed during the pandemic, feeling unsafe in the workplace and not being offered workplace supports. Furthermore, burnout was associated with greater odds of intending to leave public health or retire earlier than anticipated. Conclusion: The high levels of burnout among our large sample of Canadian public health workers and its association with work-related factors suggest that public health organizations should consider interventions that mitigate burnout and promote recovery. [ABSTRACT FROM AUTHOR]

Obstetric fistula is a chronic health condition that leaves affected women medically, socially, physically, and psychologically battered and traumatized. Those with the health condition live their lives as a social recluse because of the unpleasant smell the disease produces in them thereby making people avoid them. Adequate social support to those affected by the disease from all quarters has helped in the management and prevention of the health condition. This study, therefore, aims at exploring and connecting the link between social work and social support in the management of obstetric fistula in Nigeria and the reintegration of survivors into the society. The study adopted a qualitative approach using interviews and focus group discussions to collect data from 51 participants, and the data were thematically analyzed. The results of the study highlighted the potential roles of social workers in enhancing social support for the management and reintegration of victims of obstetric fistula in Nigeria. The findings also revealed challenges confronting social workers in enhancing social support in fistula victims. Findings from the study have implication for policy development, hence, the full involvement and expansion of the coverage of social workers in maternal and public health is recommended. [ABSTRACT FROM AUTHOR]