Public Health Experts Research Articles

THE ROLE OF DHAKA'S COMMUNITY-BASED PARKS IN IMPROVING CHILDREN’S MENTAL AND PHYSICAL HEALTH

This study focused on the significance of Community Park for enhancing children’s mental and physical health at the grassroots level of the community of Dhaka city. To assess the practical scenario both primary and secondary data was used in this study. Convenience sampling techniques have been applied to collect data with a pre-designed structured questionnaire. To reach the study goal, regression analyses have been applied to see the correlation between children’s health and community park activities. Furthermore,categorized the impact to understand the vulnerability. The evidence identified that such community park contributes significantly to children's physical and mental well-being, fostering a positive impact on their holistic development. The study findings demonstrated that ∼ 80% of children think community parks significantly contribute to maintaining their mental wellbeing. Similarly, 61% of children expressed that park activities reduce their stress and anxiety. In addition, regular activities impact on their physical growth which was expressed by 90% of respondents. The result also finds out a strong correlation between the physical and mental health of the children. In addition, it analyzed the correlation of impact between their education and health. Besides, the study also assesses the levels of severity of depression, anxiety, and sleeping disorders in children after covid-19 pandemic. Indeed, results also disclose numerous factors such as infrastructural conditions, greenery stock, safety measures, children's activities and communityparticipation in the community parks. The novelty of the study will help public health experts, psychologists, urban planners, environmentalists, policymakers, public representatives to take an ecofriendly sustainable development plan, thereby fostering a positive impact on children’s holistic development. Furthermore, this study provides some recommendations to increase the overall health conditions of the park’s children's zone.

Knowledge, attitudes, and practices of Lebanese patients with type II diabetes towards the use and abuse of dietary supplements: A cross-sectional study.

Dietary supplements (DS) use among Lebanese patients with type 2 diabetes mellitus (T2DM) increased widely due to the country's economic and financial situation. This study was conducted (1) to estimate the prevalence of DS use among persons with T2DM amid the escalating economic crisis in Lebanon; (2) to explore the knowledge, attitude, and practice (KAP) of DS use; and (3) to determine any significant association between socio-economic and socio-demographic factors and the use of DS modality. A cross-sectional study was conducted during the worst episode of the economic crisis between October and April 2022 on 460 adult patients with T2DM of both sexes. Patients were interviewed using a pre-tested questionnaire. Almost 4 out of 10 patients with T2DM in our study were found to be using DS, where 27.6% take multivitamins frequently. One-third of the participants agreed that nutritional supplements are necessary to control diabetes symptoms and complications. Around 41.1% of the participants complained about hypoglycemia and used DS to control their blood sugar levels (56.4%), while the rest used it to improve their health (35.5%) and control their diet (2.2%). The predictors of DS usage were the patient's level of education [OR=3.9, CI=1.5-10, p=0.003), self-monitoring of blood sugars (OR=4.9, CI=1.68-14.6; p=0.004) and reading the nutrition label [OR=59.3, CI=6.3-55.8, p=0.000]. This study estimated the prevalence of DS use and abuse, among persons with diabetes type II and found three significant predictors of DS use among patients with T2DM. Public health experts should encourage healthy discussions and awareness with their patients to comprehend their views regarding DS use.

“It’s changing our lives, not for the better. It’s important that we have a say”. The role of young people in informing public health and policy decisions about gambling marketing

BackgroundMarketing has a significant impact on the normalisation of gambling for youth across the globe. This has included shaping positive attitudes towards gambling, as well as increasing the social and cultural acceptance of gambling – particularly aligned with valued activities such as sport. Because of this, public health experts argue that gambling marketing poses a significant risk to the health and wellbeing of youth. While young people are increasingly exposed to, and impacted by marketing for gambling products, they are rarely consulted about policy issues and options. This study aimed to explore young Australians’ perceptions of current policy responses to gambling advertising, whether they thought young people should be involved in discussions and decisions about gambling marketing regulations, and their perceptions of the duty of governments to protect young people from gambling industry marketing strategies.MethodsQualitative focus groups (n = 22) were held with n = 64, 12–17 year olds in the Australian states of Victoria and New South Wales. Participants were asked to reflect on current gambling policies, particularly relating to marketing, what they thought should be done about gambling marketing, and if and how young people should be included in public health responses to gambling. An interpretivist ‘Big Q’ approach to reflexive thematic analysis was used.ResultsYoung people highlighted the need for more effective regulations around the content and frequency of gambling marketing. They also wanted to see more realistic representations of the negative impacts of gambling to counter persistent positive commercial marketing messages. Most thought that young people should be given an opportunity to have a say about responses to gambling due to their unique experiences. Participants identified mechanisms to increase young people’s engagement in decision making, such as direct lines of communication to different levels of government, involvement in research, and diversifying ways of engagement. Specific recommendations included more regulatory action such as bans on gambling advertising.ConclusionsCreating formal structures that facilitate the inclusion of young people’s perspectives in decisions made about gambling can result in more innovative and effective strategies to prevent the harms from gambling industry products, promotions, and practices.

Analysis and trend prediction of COVID-19 pandemic data based on big data visualization

Since the outbreak of COVID-19 at the end of 2019, this global public health crisis has profoundly impacted the socio-economic conditions and daily life of countries worldwide. To effectively combat the pandemic, scientists and public health experts rely on vast amounts of data to track the progression of the disease, evaluate the effectiveness of control measures, and predict future trends. Big data technology plays a crucial role in the analysis of pandemic data and trend forecasting. This paper will explore the methods of analyzing COVID-19 pandemic data and the application of trend forecasting.

A multicriteria vulnerability index for equitable resource allocation in public health funding.

This paper describes an action research project with the Centre universitaire intégré de santé et de services sociaux - Capitale Nationale (CIUSSS-CN) who identified a need to assess vulnerability in their territories in order toensure equitable distribution of the Integrated Perinatal and Early Childhood Services (SIPPE) program funds. The objective was to design and validate a multicriteria model to provide a more accurate portrait of vulnerability based on recent social realities. Our multidisciplinary research team of 7 members included experts in analytics, decision aiding, and community and public health. In collaboration with 6 CIUSSS-CN professionals, we co-constructed, during 9 workshops, a multicriteria model to aggregate the multiple dimensions of vulnerability. We used a value-focused thinking approach and applied the method MACBETH assisted by a geographic information system. Criteria, scales, and weights were validated and led to a vulnerability score for each CIUSSS-CN territory. This score provides a more accurate portrait of territorial disparities based on data and the participants' experience. The model was implemented in a dynamic user-friendly tool and serves to support decision-makers in the resource allocation process. Knowledge transfer was conducted during and after the process. This multidisciplinary research has served to anchor public health funding in local realities, with an emphasis on equity and stakeholder engagement. Our mixed-method approach integrating qualitative and quantitative data is adaptable to other contexts. Our results can enhance intervention effectiveness and allow for a better response to the needs of the population targeted by the SIPPE program.

COVID-19 risk perceptions in Japan: a cross-sectional study

We conducted a large-scale online survey in February 2023 to investigate the public’s perceptions of COVID-19 infection and fatality risks in Japan. We identified two key findings. First, univariate analysis comparing perceived and actual risk suggested overestimation and nonnegligible underestimation of COVID-19 risk. Second, multivariate logistic regression analyses revealed that age, income, education levels, health status, information sources, and experiences related to COVID-19 were associated with risk perceptions. Given that risk perceptions are closely correlated with daily socioeconomic activities and well-being, it is important for policy-makers and public health experts to understand how to communicate COVID-19 risk to the public effectively.

Discovery of macrocyclic covalent inhibitors for severe acute respiratory syndrome coronavirus 2 3CL protease

The coronavirus disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been spread worldwide for more than 3 years. Although the hospitalization rate and mortality have decreased dramatically due to wide vaccination effort and improved treatment options, the disease is still a global health issue due to constant viral mutations, causing negative impact on social and economic activities. In addition, long COVID and complications arising from COVID-19 weeks after infection have become a concern for public health experts. Therefore, better treatments for COVID-19 are still needed. Herein, we describe a class of macrocyclic peptidomimetic compounds that are potent inhibitors of SARS-Cov-2 3CL protease (3CLpro). Significantly, some of the compounds showed a higher stability against human liver microsomes (HLM t1/2 > 180 min) and may be suitable for oral administration without the need for a pharmacokinetic (PK) boosting agent such as ritonavir.

Exploring Strategies to Mitigate the Adverse Health Impacts of Air Pollution on Children in India: A Qualitative Study.

Air pollution poses a significant threat to global public health, contributing to high rates of mortality and morbidity. India, home to the world's largest population of children, is particularly affected. This study aims to identify effective strategies to mitigate the adverse health impacts of air pollution on this vulnerable group. The study utilized directed content analysis using a deductive approach and purposeful sampling to carry out in-depth interviews with researchers, academicians, paediatricians, public health experts, and climate change experts from different organizations in India. In total, 17 interviews were conducted over two months in March and April 2024 until data saturation was reached. A total of 29 subcategories were extracted. The main sub-categories include strategies for reducing indoor emissions and multisectoral emission reduction, strategies to reduce exposure at home, schools and transit, strategies for public awareness, effective communication, health sector communication and awareness, and raising awareness by frontline workers and educational institutions, strategies for capacity building of health sector and frontline stakeholders, strategies for building research and knowledge translation, strategies forvertical and horizontal collaboration, strategies for child-centric policies, school closure policies, fiscal policies, comprehensive policymaking, sectoral policymaking, advocacy in policymaking, strategies for monitoring, and strategies for mother and child health. The results of this study indicate that mitigating the adverse health impacts of pollution for children would entail a multi-pronged approach encompassing effective communication and education strategies and awareness raising of important stakeholders such as health professionals, community, grassroots-level workers, parents, teachers and children. Such strategies could be useful to trigger the desired change in behaviour of all concerned. Also, there is a need for collaboration and partnership between various stakeholders and ministries as policy-making bodies. There is a need to build on the research and strengthen the monitoring and surveillance.

Microbiological Assessment of Smartphone Surfaces Obtained from Final Year Students at Hezekiah University Umudi, Nkwerre, Imo State, Nigeria.

Smartphones of students in tertiary institutions have been described as an understudied and under-explored microcosm by leading public health experts. The microbial quality of smartphone surfaces has been a constant reason for several scientific discussions. Two hundred students were initially targeted for the study, ten students in the final year class at the Hezekiah University Umudi permitted access to their phones during the sampling. The study carried by swabbing the surface of their phones with a normal saline-moistened swab stick using a square quadrant. The content was dislodged and diluted using a 10-fold serial dilution technique. The samples were evaluated for total heterotrophic count, coliform, fungal and Staphylococcal count. The bacterial isolates were tentatively identified using biochemical reactions. The total heterotrophic count of the samples obtained from the male students ranged from Log 2.82 CFU/cm2 to Log 3.21 CFU/cm2 while the total coliform count was observed to range from Log 1.3 CFU/cm2 to Log 1.6 CFU/cm2. The total heterotrophic count ranged from Log 2.82 CFU/cm2 to Log 3.21 CFU/cm2 for male students and from Log 1.6 CFU/cm2 to Log 2.73 CFU/cm2 for female students. The isolates obtained from the study were Acinetobacter sp., Escherichia coli, Proteus sp., Klebsiella sp., Pseudomonas sp. and Staphylococcus sp. There is a need for the University to educate students on the need to routinely use alcohol-based wipes to clean the surfaces of their phones as a precautionary measure to limit diseases associated with the use of mobile phones.

Nature-Based Physical Activity in Pictures: A Photovoice Unit in (and Beyond) Physical and Health Education

Experts in public health and education alike have long advocated for the engagement of youth in nature to foster movement, human–nature connectedness, and mental wellbeing. Physical and health education teachers in school-based programs continue to find a variety of ways to help their students be physically active in the natural environment due to the plethora of positive benefits. This paper describes a unit entitled Nature-Based Physical Activity in Pictures that utilized Photovoice to engage youth and foster human–nature connectedness.

Diagnostic accuracy of active pulmonary tuberculosis screening during detention admission: a systematic review.

Individuals entering incarceration are at high risk for infectious diseases, other ill conditions, and risky behavior. Typically, the status of active pulmonary tuberculosis (PTB) is not known at the time of admission. Early detection and treatment are essential for effective TB control. So far, no study has compared the diagnostic accuracy of various TB screening tools in detention using a network meta-analysis (NMA). We aimed to investigate the diagnostic accuracy of active PTB screening tests upon detention admission. We searched PubMed, Global Index Medicus, the Cochrane Library electronic databases, and grey literature for publications reporting detention TB entry screening in March 2022 and January 2024. Inclusion was non-restrictive regarding time, language, location, reference standards, or screening tests. Eligible study designs comprised comparative, observational, and diagnostic studies. Publications had to report TB screening of individuals entering confinement and provide data for diagnostic accuracy calculations. The QUADAS-2 tool was designed to assess the quality of primary diagnostic accuracy studies. This systematic review was registered with PROSPERO (CRD42022307863) and conducted without external funding. We screened a total of 2,455 records. Despite extensive searching, no studies met our inclusion criteria. However, we identified evidence revealing key differences in screening algorithm application. In conclusion, more diagnostic accuracy data on TB screening algorithms for detention admission worldwide needs to be collected. We recommend that global TB initiatives set up multi-site studies to investigate the diagnostic accuracy of TB screening on admission in low- and high-prevalence criminal justice systems. Further network meta-analyses of these studies could inform policymakers and public health experts to establish or fine-tune TB control in detention settings.

Behavioral design in video games

Game design has an impact on health and well-being. Due to their evolving capacities, young people and children are especially sensitive to the negative and positive impacts of media design choices. To protect vulnerable people, ethical and responsible game design practices are necessary. But what constitutes “ethical” and responsible game design? Defining “behavioral design” as video game design decisions that elicit, either accidentally or purposefully, self-negative or self-beneficial behavior in the gamer, we draw from expertise in public health, game design, and legal scholarship to analyze current game design practices. Our work illustrates the centrality of changing business models with game design and the resulting tension within games. In practice, monetization strategies regularly guide decision-making in game design, facilitating risks for gamer welfare and finances.

Toward a Medication Information Literacy Indicator System for Older Adults: A Delphi Study.

The safety of medication use among older adults is a growing concern, given the aging population. Despite widespread attention, the exploration of medication literacy in older adults, particularly from the perspective of information literacy, is in its nascent stages. This study utilized the existing literature to define medication information literacy (MIL) as a theoretical framework. A two-round Delphi survey was conducted to identify the essential components of a MIL indicator system for older adults. The analytic hierarchy process (AHP) was then used to assign weights to each indicator. The study observed relatively high response rates in both rounds of the questionnaire, which, along with expert authority coefficients (Cr) of 0.86 and 0.89, underscores the credibility and expertise of the panellists. Additionally, Kendall's coefficient of concordance (Kendall's W) ranging from 0.157 to 0.33 (p < 0.05) indicates a consensus among experts on the identified indicators. Utilizing the Delphi process, a MIL indicator system for older adults was developed, comprising five primary and 23 secondary indicators. These indicators were weighted, with medication information cognition and acquisition emerging as pivotal factors in enhancing medication literacy among older adults. This study developed a MIL indicator system tailored for older adults using the Delphi approach. The findings can inform healthcare professionals in providing customized medication guidance and assist policymakers in crafting policies to enhance medication safety among older adults. Patient and public engagement played a pivotal role in the development of our medication information literacy indicator system for older adults. Their involvement contributed to shaping research questions, facilitating study participation, and enriching evidence interpretation. Collaborations with experts in geriatric nursing, medicine, and public health, along with discussions with caregivers and individuals with lived experience, provided invaluable insights into medication management among older adults. Their input guided our research direction and ensured the relevance and comprehensiveness of our findings.

Integrating mental health and psychosocial support (MHPSS) into infectious disease outbreak response: Results of an expert consensus study

ObjectivesOutbreaks are associated with increased risk of anxiety disorders, depression, and severe mental conditions. Integrating mental health and psychosocial support (MHPSS) into outbreak response facilitates the delivery of holistic care to the affected community. As there is an increasing incidence of outbreaks globally, integrating MHPSS into preparedness and response plans is paramount to strengthen the capacity of existing health systems and respond to mental health and psychosocial needs. However, the attention given to MHPSS during outbreak response is critically low. The objectives of this study were to identify areas of MHPSS integration and explore the challenges that hinder the delivery of an integrated care during outbreak response. MethodsA participatory qualitative study was conducted to explore how MHPSS can be incorporated into outbreak preparedness and response plans as a cross-cutting intervention in the context of low- and middle-income countries. We brought together civil society representatives, key stakeholders, and public health experts to explore areas of MHPSS integration during outbreak response. ResultsSystematic integration of MHPSS into outbreak response was perceived to be feasible. Study participants strongly agreed that MHPSS can be integrated into most of the outbreak response pillars including partner coordination, case management, infection prevention and control, staff health and well-being, and risk communication and community engagement. However, the effort requires multi-sectoral collaboration, political commitment, and adequate recognition in planning and financing. ConclusionsDespite complex challenges, integrating MHPSS into outbreak pillars is possible. Moreover, emphasis should be placed on cultural adaptation of MHPSS guidelines and strong leadership in coordinating MHPSS into outbreak planning and response.

Dengue in Wardha City: Addressing Social and Clinical Challenges

Dengue fever, a major public health concern in tropical and subtropical areas, is a critical issue in Wardha city. The purpose of this study was to analyze Wardha inhabitants’ awareness, knowledge, and habits about dengue illness. The survey, which took place between November 2023 and April 2024, used a structured questionnaire and was delivered to a representative sample of 50 participants from various wards of the city. The questionnaire inquired about respondents’ knowledge of dengue symptoms, mechanisms of transmission, preventative measures, and attitudes toward local dengue control initiatives. Preliminary data show that, while many locals are aware of dengue and its symptoms, there are significant gaps in knowledge about effective preventative techniques, as well as widespread misunderstandings regarding transmission. The poll also preventative measures. Furthermore, the survey found diverse degrees of community engagement in dengue management operations, with many respondents advocating for more thorough and accessible teaching campaigns. These findings show the critical need for targeted educational initiatives and increased community engagement in Wardha city to improve dengue prevention and control. Public health experts and politicians are encouraged to use these findings to create and execute more effective, context-specific dengue control measures.

Exploring the accessibility of primary health care data in Europe's COVID-19 response: developing key indicators for managing future pandemics (Eurodata study)

BackgroundPrimary Health Care (PHC) plays a crucial role in managing the COVID-19 pandemic, with only 8% of cases requiring hospitalization. However, PHC COVID-19 data often goes unnoticed on European government dashboards and in media discussions. This project aims to examine official information on PHC patient care during the COVID-19 pandemic in Europe, with specific objectives: (1) Describe PHC’s clinical pathways for acute COVID-19 cases, including long-term care facilities, (2) Describe PHC COVID-19 pandemic indicators, (3) Develop COVID-19 PHC activity indicators, (4) Explain PHC’s role in vaccination strategies, and (5) Create a PHC contingency plan for future pandemics.MethodsA mixed-method study will employ two online questionnaires to gather retrospective PHC data on COVID-19 management and PHC involvement in vaccination strategies. Validation will occur through focus group discussions with medical and public health (PH) experts. A two-wave Delphi survey will establish a European PHC indicators dashboard for future pandemics. Additionally, a coordinated health system action plan involving PHC, secondary care, and PH will be devised to address future pandemic scenarios. Analysis: Quantitative data will be analysed using STATA v16.0 for descriptive and multivariate analyses. Qualitative data will be collected through peer-reviewed questionnaires and content analysis of focus group discussions. A Delphi survey and multiple focus groups will be employed to achieve consensus on PHC indicators and a common European health system response plan for future pandemics. The Eurodata research group involving researchers from 28 European countries support the development.DiscussionWhile PHC manages most COVID-19 acute cases, data remains limited in many European countries. This study collects data from numerous countries, offering a comprehensive perspective on PHC’s role during the pandemic in Europe. It pioneers the development of a PHC dashboard and health system plan for pandemics in Europe. These results may prove invaluable in future pandemics. However, data may have biases due to key informants’ involvement and may not fully represent all European GP practices. PHC has a significant role in the management of the COVID-19 pandemic, as most of the cases are mild or moderate and only 8% needed hospitalization. However, PHC COVID-19 activity data is invisible on governments’ daily dashboards in Europe, often overlooked in media and public debates.

Nutrients and Foods Recommended for Blood Pressure Control on Twitter in Japan: Content Analysis.

Management and prevention of hypertension are important public health issues. Healthy dietary habits are one of the modifiable factors. As Twitter (subsequently rebranded X) is a digital platform that can influence public eating behavior, there is a knowledge gap regarding the information about foods and nutrients recommended for blood pressure control and who disseminates them on Twitter. This study aimed to investigate the nature of the information people are exposed to on Twitter regarding nutrients and foods for blood pressure control. A total of 147,898 Japanese tweets were extracted from January 1, 2022, to December 31, 2022. The final sample of 2347 tweets with at least 1 retweet was manually coded into categories of food groups, nutrients, user characteristics, and themes. The number and percentage of tweets, retweets, and themes in each category were calculated. Of the 2347 tweets, 80% (n=1877) of tweets mentioned foods, which were categorized into 17 different food groups. Seasonings and spices, including salt, were most frequently mentioned (1356/1877, 72.2%). This was followed by vegetable and fruit groups. The 15 kinds of nutrients were mentioned in 1566 tweets, with sodium being the largest proportion at 83.1% (n=1301), followed by potassium at 8.4% (n=132). There was misinformation regarding salt intake for hypertension, accounting for 40.8% (n=531) of tweets referring to salt, including recommendations for salt intake to lower blood pressure. In total, 75% (n=21) of tweets from "doctors" mentioned salt reduction is effective for hypertension control, while 31.1% (n=74) of tweets from "health, losing weight, and beauty-related users," 25.9% (n=429) of tweets from "general public," and 23.5% (n=4) tweets from "dietitian or registered dietitian" denied salt reduction for hypertension. The antisalt reduction tweets accounted for 31.5% (n=106) of the most disseminated tweets related to nutrients and foods for blood pressure control. The large number of tweets in this study indicates a high interest in nutrients and foods for blood pressure control. Misinformation asserting antisalt reduction was posted primarily by the general public and self-proclaimed health experts. The number of tweets from nutritionists, registered dietitians, and doctors who were expected to correct misinformation and promote salt reduction was relatively low, and their messages were not always positive toward salt reduction. There is a need for communication strategies to combat misinformation, promote correct information on salt reduction, and train health care professionals to effectively communicate evidence-based information on this topic.

Cultural adaptation of a self-review tool for health promoting universities in Bulgaria.

The Health Promoting University initiative is unknown in Bulgaria, and the health promotion potential of Bulgarian universities has not been studied. In order to examine it, a suitable instrument is needed. The UK Healthy Universities Network provides an accessible Self-Review-Tool (SRT). Aim: To present the process of cultural adaptation of the SRT in Bulgarian language. The standardized WHO methodology for cultural adaptation of instruments was followed in four stages: (1) Two language translations of the instrument into Bulgarian were made; (2) An expert Delphi discussion reached a consensus on specific health promoting (HP) terms, followed by a backward translation; (3) Pilot testing of the tool among university community representatives was conducted through a survey among a small sample, with independent responses to the SRT questionnaire followed by cognitive interviews; (4) Final revision of the instrument. Ten public health experts reached a consensus on the name of the initiative and various HP terms. Ten other respondents pre-tested the tool. Difficulties in responding the SRT concerned the meaning of some HP terms, complex words, the system of answers, limited applicability of some statements. Changes were made to 61 of the total 68 elements in the SRT. All stages of the cultural adaptation were important for the final result. The adapted Bulgarian version of the SRT would be useful to Bulgarian universities that want to make a clear commitment to improving the health of their university community and the wider society.

The influence of political disagreements and corruption on state health leader turnover during the COVID-19 pandemic in Brazil

PurposeGovernments faced formidable challenges in coordinating public health responses to the COVID-19 pandemic. This study aims to enhance the understanding of effective organizational leadership during crises by investigating the factors influencing the turnover of health leaders during the COVID-19 pandemic in Brazil.Design/methodology/approachUsing primary data encompassing all appointments and dismissals of federal and state health secretaries, this paper conducted a quantitative analysis of the relational and reputational factors that contributed to leader turnover during the COVID-19 pandemic. This paper also examined whether leaders’ management and public health experience increase the duration of tenure.FindingsStates encountered significant challenges in retaining experienced and effective leadership during the health emergency, primarily due to political conflicts in policymaking and, to a lesser extent, allegations of corruption. Furthermore, leaders with expertise in public health were found to be less likely to be removed from office. However, managerial experience did not prolong the tenure of state health secretaries during the emergency.Research limitations/implicationsSince most health leaders have public health and management experience, the contributions of each factor to the duration of a secretary’s tenure are difficult to separate and analyze separately.Practical implicationsThis study provides empirical insights into what factors drive health leader turnover during major health emergencies.Social implicationsDuring major health emergencies, health leaders often strongly disagree with elected officials on the response. This paper test how crisis leadership theories help explain state health leaders’ duration in one of the world’s largest public health systems during the COVID-19 pandemic. This paper find that policy disagreements contributed to significant turnover.Originality/valueTo the best of the authors’ knowledge, this paper is the first that are aware of that uses novel primary data on public health executive leader characteristics and turnover causes in the context of the COVID-19 pandemic. It provides empirical evidence contributing to the crisis leadership literature by examining health leader turnover in one of the world’s largest public health systems.

Expert Evaluation of the Organizational Technology for Prolonging Doctors’ Professional Activity

Background. Healthcare professionals fall into the professions that significantly strengthen national economy. In order to avoid national economic losses, we should protect older healthcare professionals as a source of national workforce by developing and implementing a health-saving technology that prolongs their professional effective activity. Based on the previously conducted sociological survey of doctors providing medical care in the polyclinics of Moscow and Moscow Oblast, an assessment of the doctors’ professional competencies was carried out [1] and an organizational technology was formed [2] and then submitted to an expert evaluation. Objective. To expertly evaluate the importance of the activities that are included in the organizational technology prolonging the professional effective activity of older doctors. Materials and methods. The methods of sociological, statistical and expert evaluation were used for studying the experts’ opinions on the importance of each activity of organizational technology for prolonging the professional effective activity of healthcare professionals. Experts (n = 50) were asked to rank the activities according to the importance for achieving the result – support for the professional effective activity of doctors - in the case of the implementation of this organizational technology. The experts were specialists in the field of healthcare and public health: chief physicians, heads of departments of polyclinics in Moscow and Moscow Oblast, accredited in the specialty of the Higher Attestation Commission 03.02.03 "Public health, organization and sociology of healthcare, medical and social expertise" with leadership experience in healthcare from 1 to 29 years. The objectivity of experts’ judgment is based on their knowledge and expertise in healthcare and public health. Findings. The experts progressively evaluated the organizational technology, firstly by each stage and then as a whole. Thus, it was made a conclusion on the effectiveness of organizational technology preserving medical competencies and prolonging the professional effective activity of older doctors.