How pandemics affect states’ affairs and international relations: The case of Covid-19

Determining whether the supply–demand matching (SDM) of urban public health resources is reasonable involves important issues such as health security and the rational use of resources. Using the central urban area of Tianjin as the research area, this paper used the Gaussian-based 2-step floating catchment area method (Ga2SFCA), combined with multi-source data, and comprehensively considered public medical, natural, and physical resources to evaluate the SDM of single-category and integrated public health resources in the research area. The results showed the following: (1) there was a good fit between supply and demand for public medical and natural health resources in Tianjin’s central urban area. For public physical health resources, there was a poor fit between supply and demand; the population in the supply insufficient and scarce areas for 82.78% of the total and was mainly distributed in the marginal areas of the four districts around the city and the six districts of the inner city. (2) For integrated public health resources, the degree of SDM was generally good. It had a circular structure that gradually shrank from the core to the edge. In order to promote the supply–demand balance of urban public health resources, this paper proposed three strategies involving three aspects: the supply, accessibility, and demand of urban public health resources. These strategies involve the service supply level, urban traffic network and slow traffic, development intensity, and population scale.

ObjectiveA case study on the visual-material components of story map journals as visual, new media interactive health reporting used in population health surveillance. The story map journal is demonstrated an effective tool that visually reports, maps and tracks global support networks and health resources for post-polio (PPS) survivors.IntroductionHow are interactive story map journals situated within the genre of interactive, health science reporting? How can reporting information to public audiences be theorized through traditional and contemporary understandings of new media genres in technical, health and science communication (1-7). Although the polio vaccine has eradicated the disease in the United States, and 99% worldwide (8), PPS has emerged as a present-day condition that continues to affect many polio survivors years after the initial onset and recovery. Since the symptoms of PPS are oftentimes mis-identified as other illnesses, the diagnosis and management of disease is especially challenging for PPS survivors due to the limited knowledge of and access to PPS resources and support networks (9-11).In 2011, Esri created the ArcGIS story map initiative to meet a need for public audiences who sought how to critically think, better understand, communicate, and interact with world news events. ArcGIS is a geospatially-driven, new media platform that enables audiences to engage with interactive storytelling of news events. Public health and news reporting agencies are now turning to Esri and similar interactive, geospatially driven new media platforms for health and disease surveillance (12-14). Esri’s ArcGIS mobile and web technology platform visually reports, maps and tracks population health data information. With the emergence of such new media applications, it is therefore important to recognize multimodal, visualization strategies that investigate how interaction design choices within the story map journal influence and engage public health audiences. In the field of technical and professional communication (15), applied concept of visual-material rhetorics is a useful mode of inquiry in the study of interactive story map journals. Propen’s concept presents a new understanding of how researchers in disease and public health surveillance can analyze the effectiveness of text and new media technology in relationship to space, place, and geospatial mapping. More specifically, Propen’s concept situates the visual-material as the applied use of text with visual, interactive multimodal components inclusive of images, video, and GPS/GIS mapping technologies.MethodsThis presentation includes a discussion of genre analysis as applied to visual-material components used to study the genre of new media-driven story map journals for the reporting of public and population health resources. Post-Polio Syndrome (PPS) is presented as a case study of how story map journals in population health can be used to create information about global support networks and resources for PPS survivors.ResultsThe story map journal is an effective genre of new media, interactive reporting in health and disease surveillance. The analysis alongside Propen’s mode of inquiry demonstrates the effectiveness of visual-material components of story maps, and how PPS survivors and medical clinicians can use the story map journal to easily access, visualize, and interact with information about diagnosis and disease management, as well as find connections to local and global support networks.ConclusionsStory map journals as visual, interactive reporting should be considered when analyzing the accessibility and surveillance of health data for public audiences. The case study of PPS global networks and resources, provides one example of how story map journals can assist public audiences who experience difficulties finding support networks and public health resources

Early Pandemic Experiences and Lessons Learned Within A Multinational Corporation: A Testimonial of the COVID-19 Pandemic.

Has traditional medicine had its day? The need to redefine academic medicine

The fairness of health services is an important indicator of the World Health Organization's performance evaluation of health services, and the fairness of health resource allocation is the prerequisite for the fairness of health services. The research in this article aims to explore how to use health and medical resources fairly and effectively to allocate health resources in different fields, populations and projects, in order to achieve the maximization of social and economic benefits of health and medical resources. In the study of the distribution and equity of public health and medical resources, we comprehensively apply Gini coefficient, Theil index, Lorentz curve and difference index, based on the theory of health resource allocation and the theory of health equity, the province's health service resources have been researched and evaluated, combined with regional health planning theories and public health theories, a variety of scientific methods were used to analyze community health service resources at all levels across the country. At the same time, we reviewed the journal literature about the treatment of patients and children, and analyzed the patients admitted to medical institutions in various regions. The research in this paper found that from 2016 to 2020, the Gini coefficient of the province's health institutions according to population distribution has been fluctuating between 0.14 and 0.17. During this 5-year period, the Gini coefficient of the distribution of medical and health expenditures by population shows a downward trend year by year. From 2019, reach below 0.1, this shows that the fairness of the allocation of health resources according to population has a clear trend of improvement.

Infectious disease and malnutrition in children are public health problems in developing countries. Malnutrition is associated with higher levels of DNA damage, and this increased damage could be due to different factors, including the possibility that cells from malnourished children could be more susceptible to environmental damage. The aim of the present study was to evaluate the susceptibility of lymphocytes from malnourished children to DNA damage induced by antibiotics by using the comet assay. The same group of malnourished infected children were studied before and after a treatment period, and compared to a group of well-nourished infected children. Results showed that before and after drug treatment, tail length migration was two times greater in malnourished than in well-nourished children. The proportion of cells with high damage was also increased in malnourished children. Additionally in well-nourished and malnourished children, a cell subpopulation (non-damaged cells) more resistant to DNA damage induced by antibiotics was observed; this was more prevalent in the well-nourished children. Meanwhile, in malnourished children, a cell population seems to be more susceptible and reaches higher levels of DNA damage. This might help explain the impaired immune response observed in malnourished children. The increased DNA migration and the increased proportion of cells with higher levels of damage seem to indicate that malnourished children are more susceptible to DNA damage induced by drugs.

BackgroundGenerating insights into resource demands during outbreaks is an important aspect of pandemic preparedness. The EU PANDEM-2 project used resource modelling to explore the demand profile for key resources during pandemic scenarios. This review aimed to identify public health and healthcare resources needed to respond to pandemic threats and the ranges of parameter values on the use of these resources for pandemic influenza (including the novel influenza A(H1N1)pdm09 pandemic) and the COVID-19 pandemic, to support modelling activities.MethodsWe conducted a systematic literature review and searched Embase and Medline databases (1995 – June 2023) for articles that included a model, scenario, or simulation of pandemic resources and/or describe resource parameters, for example personal protective equipment (PPE) usage, length of stay (LoS) in intensive care unit (ICU), or vaccine efficacy. Papers with data on resource parameters from all countries were included.ResultsWe identified 2754 articles of which 147 were included in the final review. Forty-six different resource parameters with values related to non-ICU beds (n = 43 articles), ICU beds (n = 57), mechanical ventilation (n = 39), healthcare workers (n = 12), pharmaceuticals (n = 21), PPE (n = 8), vaccines (n = 26), and testing and tracing (n = 19). Differences between resource types related to pandemic influenza and COVID-19 were observed, for example on mechanical ventilation (mostly for COVID-19) and testing & tracing (all for COVID-19).ConclusionThis review provides an overview of public health and healthcare resources with associated parameters in the context of pandemic influenza and the COVID-19 pandemic. Providing insight into the ranges of plausible parameter values on the use of public health and healthcare resources improves the accuracy of results of modelling different scenarios, and thus decision-making by policy makers and hospital planners. This review also highlights a scarcity of published data on important public health resources.

Strategies to Operationalize Health Equity in Island Area Health Departments.

Diabetic MedicineVolume 23, Issue 11 p. 1268-1270 Authors’ reply N. Forouhi, N. Forouhi MRC Epidemiology Unit, Strangeways Research Laboratory, Wort's Causeway, Cambridge, Yorkshire and Humber Public Health Observatory, Alcuin Research and Resource Centre, The University of York, York,Search for more papers by this authorE. Goyder, E. Goyder School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, andSearch for more papers by this authorD. Merrick, D. Merrick MRC Epidemiology Unit, Strangeways Research Laboratory, Wort's Causeway, Cambridge, Yorkshire and Humber Public Health Observatory, Alcuin Research and Resource Centre, The University of York, York,Search for more papers by this authorS. Wild, S. Wild Public Health Sciences, University of Edinburgh, Edinburgh, UKSearch for more papers by this authorB. Ferguson, B. Ferguson MRC Epidemiology Unit, Strangeways Research Laboratory, Wort's Causeway, Cambridge, Yorkshire and Humber Public Health Observatory, Alcuin Research and Resource Centre, The University of York, York,Search for more papers by this author N. Forouhi, N. Forouhi MRC Epidemiology Unit, Strangeways Research Laboratory, Wort's Causeway, Cambridge, Yorkshire and Humber Public Health Observatory, Alcuin Research and Resource Centre, The University of York, York,Search for more papers by this authorE. Goyder, E. Goyder School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, andSearch for more papers by this authorD. Merrick, D. Merrick MRC Epidemiology Unit, Strangeways Research Laboratory, Wort's Causeway, Cambridge, Yorkshire and Humber Public Health Observatory, Alcuin Research and Resource Centre, The University of York, York,Search for more papers by this authorS. Wild, S. Wild Public Health Sciences, University of Edinburgh, Edinburgh, UKSearch for more papers by this authorB. Ferguson, B. Ferguson MRC Epidemiology Unit, Strangeways Research Laboratory, Wort's Causeway, Cambridge, Yorkshire and Humber Public Health Observatory, Alcuin Research and Resource Centre, The University of York, York,Search for more papers by this author First published: 18 October 2006 https://doi.org/10.1111/j.1464-5491.2006.1938_2.xRead the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Volume23, Issue11November 2006Pages 1268-1270 RelatedInformation

The complex causes of India's 2021 COVID-19 surge

In the last two decades, the horse chestnut (Aesculus hippocastanum L.), introduced into the steppe zone of Ukraine, has been severely affected by the horse chestnut leaf miner Camereraria ohridella Deschka & Dimič, 1986, which results in damage to the assimilating organs, premature leaf defoliation and, as a consequence, a significant reduction in the reserve substances required for normal life of the plant. In recent studies, the main focus has been placed on the study of the pest’s effects on the non-enzymatic antioxidant protection system of the representatives of the genus Aesculus, while the enzymatic system of horse chestnut protection from the active forms of oxygen under stress is still poorly understood. The purpose of this study was to evaluate the reaction of catalase and two peroxidases of A. hippocastanum leaves, which differ in the level of damage by C. ohridella. The intensity of damage to A. hippocastanum leaves by the horse chestnut leaf miner in the park zones and botanical gardens of Dnipro city was determined, the activity and isoenzyme composition of benzidine-peroxidase, activity of guaiacol-peroxidase and catalase were measured. The lowest average benzidine-peroxidase activity was found in the group of trees with low level of leaf blight and the highest activity – in the group with high level. The opposite dependence was shown by catalase, the activity of which significantly decreases with increasing level of damage inflicted by the phytophage on the chestnut’s assimilating organs. Based on the determination of the variation coefficients, it has been shown that benzidine-peroxidase activity has a higher level of variability than that of catalase and guaiacol-peroxidase. It is established that under the influence of the leaf miner, activity of guaiacol-peroxidase was significantly higher by 87.1% and 75.6%, respectively, for medium and high levels of damage caused to the leaf by this phytophage as compared to that for low levels of damage. The increased level of leaf damage caused by the phytophage is reflected in the change in the isozyme profile of benzidine-peroxidase. The high activity of benzidine-peroxidase in the leaves of A. hippocastanum is due to the presence of several molecular forms that exhibit maximum activity in the narrow pH range (4.15–4.69). Quantitative redistribution of activity between the different molecular forms of benzidine peroxidase can be considered as the main regularity of changes in the expression of benzidine-peroxidase caused by different levels of leaf damage. The results showed that only one benzidine-peroxidase isoform with an isoelectric point of 4.15 shows a significant increase in activity (on average by 2.1 times) in A. hippocastanum leaves with medium and high levels of damage by C. ohridella. Significant reduction in activity is reported for dominant isoperoxidase with an isoelectric point of 4.25 revealing medium pest damage, and for high damage only a decreasing tendency is shown. The data obtained show that horse chestnut trees can specifically respond to mechanical damage by C. ohridella to leaves due to the changes in the activity of individual molecular forms of peroxidase. Further studies of oxidative metabolism are needed to understand the formation of resistance of representatives of the Aesculus genus to damage caused by this moth species based on a wider range of redox enzymes.

IntroductionA high cellular radiosensitivity is connected with a risk for development of severe side effects after radiotherapy. In this study we have attempted to find a correlation between the initial radiosensitivity of in vitro irradiated peripheral blood mononuclear cells (PBMC) of prostate cancer patients and the adverse side effects of radiotherapy.Material and methodsPBMCs isolated from 7 prostate cancer patients, before the onset of radiotherapy and 3 healthy men were exposed in vitro to 2 Gy of x-ray radiation (Varian, 6 MeV). Following irradiation cell death was measured using the Annexin V/PI assay. DNA repair kinetics (0 and 24 hour after irradiation) was performed using the comet assay, and the results were expressed as% of tail DNA. Acute toxicity were graded according to the EORTC radiation morbidity scoring scale.Results and discussionsOur data show that the in vitro irradiation of PBMCs in prostate cancer patients initially caused a significantly higher DNA damage than in the control group of healthy donors. After a repair time of 24 hour, samples from all healthy donors showed no residual DNA damage (average 2.6%) in PBMCs. If all patients are observed for 0 hour and 24 hour after in vitro PBMCs irradiation then there is a significant reduction in the degree of DNA damage, from 35.5 to 30.4 tail% DNA. What is also important is that 4 patients had a very low level of DNA damage, which can be considered as normal cellular reaction to irradiation, while 3 patients had a very high level of damage. Also, in 5 out of 7 examined prostate cancer patients, there was an increase in the percentage of PBMCs in the early and late stages of apoptosis 24 hour after in vitro irradiation of their PBMCs. Most patients had mild side reactions to radiotherapy and were graded as grade 1 (per EORTC scale). Only in 1 of 7 patients observed side effects are classified as grade 2 and this is in correlation with a very high level of DNA damage (82.25% initial, versus 64.77% 24 hour after in vitro irradiation).ConclusionOur study was insufficient to reveal the relationship between the risk of developing side effects to radiotherapy and the sensitivity of PBMCs irradiated in vitro, measured by comet assay. A larger number of patients and further studies are necessary to confirm the potential application of the comet assay.

Accelerating genomics-based surveillance for COVID-19 response in Africa

In early 2020, public health workers across the United States were called to respond to an emerging threat: COVID-19. Seemingly overnight, COVID-19 became a pandemic and, as many transitioned from offices and schools to home-based settings, essential workers braved the risk of infection to face the emergency and maintain essential health services. The pace of the response and the scale of the loss of life in the United States were unprecedented in recent history. Public health workers demonstrated their dedication to their mission by rising to these challenges, often stretching themselves beyond their capacity to meet the demands of the crisis. In the months and years since the first case of COVID-19, there has been a seismic shift in the way society engages the public health workforce. The 2021 Public Health Workforce Interests and Needs Survey (PH WINS) provides a snapshot of the burden carried by the public health community. Even before the emergence of COVID-19, many public health workers have moved from one emergency response to the next with little pause for recovery, exacerbating systemic challenges. Our experience managing multiple simultaneous and overlapping public health emergencies has demonstrated the fragility of our public health infrastructure and eroded public trust. As we face an increasing frequency and severity of public health disasters in the contexts of climate change and organized health disinformation, a deepening distrust of science has forever changed the nature of our work. In addition, as the field of public health recognizes systemic racism as a public health crisis and takes meaningful steps to dismantle it, it is threatened with mounting hostility from outside and within our government structures. These experiences, reflected in PH WINS 2021, have also brought to light a world of opportunities to build a better public health system that will sustain through and beyond the emergencies of the future (Table). TABLE - Pathways to Resilience Build internal tracks to leadership for staff from communities that are heavily impacted in emergencies. Transform COVID-19 temporary public health workers into a new public health workforce. Develop a dynamic public health emergency response infrastructure. Build resilience in essential basic public health functions. Create trauma-responsive environments for the public health workforce. Build Internal Tracks to Leadership for Staff From Communities That Are Heavily Impacted in Emergencies The COVID-19 pandemic highlighted long-standing health inequities. Structural oppression creates community- and neighborhood-level health vulnerabilities before, during, and after public health emergencies1–3; however, the makeup of our current public health leadership is limited by generations of exclusion of people from the communities that could most benefit from public health programming. Historic definitions of expertise in public health exclude some of the most critical “qualifications”—those gained by lived experience. During the COVID-19 response, health departments in need of critical community-level information often did not have to look far; highly adept individuals from heavily impacted communities were already part of the public health workforce, but their indispensable skills and knowledge were not measured in their job titles or work assignments. Emergency responses can exacerbate or dismantle long-standing inequities perpetuated by systemic racism within governmental agencies. Public health must embrace the opportunity to unravel systems of oppression by identifying staff who live in the hardest-hit communities, uplifting them into leadership roles, and developing intentional partnerships with communities. Such approaches during emergency response can give staff the opportunity to gain leadership experience, develop skills in rapid participatory action research and qualitative methods, and forge the robust partnerships with communities necessary to develop community-relevant solutions and meaningfully improve health equity.3 Transform Temporary Public Health Workers Who Worked in COVID-19 Into a New Public Health Workforce Public health emergencies create critical opportunities to invest in a dangerously underfunded system.4,5 Funding streams emerging after public health emergency responses should be invested in remediating the systemic challenges that prolong and exacerbate emergencies, particularly by building a workforce from impacted communities. During COVID-19, while rapid scaling of a temporary workforce resulted in public health gains, many workers hired through an influx of emergency funding were laid off as the response deescalated. For example, NYC Trace, the largest contact tracing operation in the country, rapidly hired thousands of New Yorkers at a time when unemployment was high and relatively safe remote jobs were scarce. Selective recruitment from highly impacted communities at that time increased the acceptability of services while both investing in impacted communities and cultivating a pool of trained public health workers.3 Unless these workers are reintegrated into the public health workforce, the field risks losing their newly gained expertise. Given massive workforce shortages experienced by public health departments across the country, decision makers could look to approaches adopted by global humanitarian response programs and the Public Health Corps and consider developing national assignments to fill short- and long-term gaps. Not only would this fulfill urgent, mounting workforce needs and support the development of the public health careers for many essential pandemic workers but this workforce would also bring greater community-centered knowledge and practice to the field, nationwide. Develop a Dynamic Public Health Emergency Response Infrastructure As we emerge from the acute phases of the COVID-19 pandemic, we have an opportunity to revisit the structure of our public health emergency response systems, building upon a strong backbone of essential public health competencies. Across the country, public health workers were reassigned from their day jobs to emergency roles, often for years on end. PH WINS 2021 shows that all public health program areas contributed at least 20% of their workforce time to COVID-19 response efforts.6 This approach creates gaps in ongoing public health activities, burnout among employees, and limited institutional memory to inform future emergencies. To be responsive, emergency response systems need long-term investments to modernize and improve core public health functions. There is a clear need to institutionalize lessons learned and quickly integrate corrective actions. During and after a response, innovation and accountability in “hotwashes” and after-action reports could support this process but only if evaluation is followed by swift, measurable action. The resultant dynamic response system would support the translation of knowledge and skills from one response to another and produce a more efficient allocation of public health resources toward foundational infrastructure required in emergencies and core public health services. Build Resilience in Essential Basic Public Health Functions COVID-19's devastating legacy exceeds its direct morbidity and mortality. As case counts exploded in early 2020, routine public health operations and health care services screeched to a halt. While organizations worked around the clock to create electronic versions of services previously provided in person and emergency response programs incorporated wraparound services, not all services translated effectively and not all people had the same access to digital platforms. This has resulted in unprecedented setbacks in disease prevention, social-emotional learning, education, chronic and acute disease management, life expectancy, and more. At the same time, we are not seeing any reprieve from public health emergencies. These 2 are not separate: widening gaps in our public health systems multiply the impacts of public health disasters when they hit.1–3 Public health agencies must build capacity in core public health functions including surveillance and accompanying data informatics, data and risk communication systems, and robust mental health infrastructure. Instead of skirting along the edge of staff capacity and shying away from innovative modernization of public health informatics, we must invest in core functions that will not only ensure continuity of basic public health services for all people in all places in the United States but also facilitate smooth pivots to emergency response activities that rely on these same competencies. Create Trauma-Responsive Environments for the Public Health Workforce None of these initiatives or investments can move forward if no one is around to make them happen. PH WINS 2021 shows the devastating toll the past few years have had on the public health workforce, with nearly one-third of the governmental public health workforce considering leaving their organization in the next year for retirement or other reasons.7 Sector-wide burnout and related behavioral health impacts must be addressed while building sufficient capacity to prevent this scale of trauma from recurring in the next disaster. However, trauma is complex, long-lasting, and impacted by culture and environment; mitigation requires awareness and understanding. Now is the moment to build trauma-responsive environments for the public health community. Trauma-responsive environments promote healing and wellness, allow public health workers to access services and space to process their experiences, and support workers to heal. They must be built on a foundation of accessible mental health supports and integrative care approaches, which will be critical to sustaining services long after pandemic recovery funding is exhausted. Behavioral health services can only be accessible if social stigma and other barriers are reduced across the field of public health nationally. Some of these barriers are explicitly embedded in licensing and board requirements, leave policies, and organizational culture.8 Similarly, just as systemic and structurally intersectional inequities persist, so too do historical and intergenerational trauma via oppression, racism, and prejudice. Meaningful action is needed to revise policies that prevent public health workers from accessing behavioral health services. We must do more than ask our workers to “power through” because the next disaster is looming. It is time to improve our systems and way of work to build a foundation for trauma-responsive care throughout disaster response and recovery.

BackgroundSARS-CoV-2 is one of the most threatening pandemics in human history. As of the date of this analysis, it had claimed about 2 million lives worldwide, and the number is rising sharply. Governments, societies, and scientists are equally challenged under this burden.ObjectiveThis study aimed to map global coronavirus research in 2020 according to various influencing factors to highlight incentives or necessities for further research.MethodsThe application of established and advanced bibliometric methods combined with the visualization technique of density-equalizing mapping provided a global picture of incentives and efforts on coronavirus research in 2020. Countries’ funding patterns and their epidemiological and socioeconomic characteristics as well as their publication performance data were included.ResultsResearch output exploded in 2020 with momentum, including citation and networking parameters. China and the United States were the countries with the highest publication performance. Globally, however, publication output correlated significantly with COVID-19 cases. Research funding has also increased immensely.ConclusionsNonetheless, the abrupt decline in publication efforts following previous coronavirus epidemics should demonstrate to global researchers that they should not lose interest even after containment, as the next epidemiological challenge is certain to come. Validated reporting worldwide and the inclusion of low-income countries are additionally important for a successful future research strategy.