High-level Health Research Articles

The impact of basic health insurance participation characteristics on the health of mobile populations: the mediating role of health service utilization behavior.

It is a pivotal element of China's health system reform to improve the health security of health insurance for the mobile population. Achieving this objective is integral to the success of the reform. The aim of this study was to analyze the impact of different enrollment characteristics of basic health insurance on the health of the mobile population and to investigate the mediating role of health service utilization behavior. This cross-sectional study included 135,372 migrants who participated in the 2018 China Migrants Dynamic Survey (CMDS). Two indicators were employed in this study to assess the characteristics of the mobile population's involvement in basic health insurance-namely, whether or not they participated in local health insurance and the type of health insurance in which they participated. The health status of the mobile population was measured using self-assessed health. Health service utilization behavior was divided into public health service utilization and medical service utilization. Multivariate ordered logistic regression was employed to examine the effect of health insurance on the health of the mobile population. Subsequently, the Bootstrap method was applied to analyze the mediating effect of health service utilization behavior in the relationship between health insurance and the health of the mobile population. Health insurance had a positive impact on health, public health services, and health service utilization among the mobile population. However, enrollment in local health insurance (OR = 1.088, 95% CI = 1.043-1.134) and enrollment in Basic Medical Insurance for Urban Employees (OR = 1.178, 95% CI = 1.090-1.273) were more likely to be associated with higher levels of health and a greater likelihood of receiving health service utilization. The results of the mediating mechanism analysis indicated that health education, health records, family doctor contracting, receiving inpatient services, and being hospitalized locally all played a partially mediating role in the impact of the place of enrollment on health. Regarding the effect of the type of enrollment on health, three types of services-namely, health education, health records, and contracting with a family doctor-played a partially mediating role, while receiving inpatient services and being hospitalized locally did not exhibit a mediating effect. The effect of the type of participation on health is partially mediated. Based on the impact of the different enrolment characteristics of basic health insurance on the health of the mobile population and the mediating role of health service utilization in this impact, furthermore, improvement of health insurance coverage for the mobile population should focus on improving the accessibility of health services, increasing the level of health insurance coverage, mitigating differences in treatment between the different insurance systems, and simplifying the process of transferring the health insurance relationships.

Features of thinking and physical education of humanitarian universities students: a review article

Background and purpose
 Physical education in a higher educational institution should be based on students' professional training patterns. That's why the selection of means and methods of physical education for students according to the characteristics of their higher nervous activity deserves special attention. Purpose of the study: to determine whether there are features of higher nervous activity in students of humanitarian specialties and to determine the main directions of motor activity according to the characteristics of the higher nervous activity of students of humanitarian specialties.
 Material and methods
 The literature analysis was carried out based on a search in the scientometric databases Scopus and Web of Science, as well as based on data analysis in the PubMed and Google Scholar searches. The search was carried out using the keywords “psychophysiology”, “higher nervous activity”, “psychological types”, “students”, “humanitarian specialties”, technical specialties”, and “physical education”. The search was carried out as follows. First, one of the keywords was entered, then the search was refined using other keywords. In total, out of 1345 sources, 26 were selected that were most relevant to the topic of our research.
 Results
 It has been established that the problem of increasing the level of professionalism in any type of activity, including in the humanitarian professions, requires high levels of health and certain psychophysiological properties and characteristics of thinking. In this regard, physical education at universities should combine physical training and, psychological, and intellectual development of students. Certain features in the processes of higher nervous activity among representatives of humanitarian and technical specialties are shown: humanitarian professions require greater development of the artistic type of thinking, and technical professions require greater development of the logical type of thinking.
 Conclusions
 Based on the characteristics of the higher nervous activity of students of humanitarian specialties (the predominance of the artistic type), the following recommendations can be given regarding the use of means and methods of physical education: the use of aerobic-anaerobic exercises that require the mobility of the nervous system in combination with the general endurance of the body. Such exercises include team sports, martial arts, walking or running at a variable pace, gymnastic exercises of various types, and others.

PEDAGOGICAL TECHNOLOGIES IN THE SYSTEM OF PHYSICAL EDUCATION OF HIGH SCHOOL STUDENTS

The integration of Ukraine into the world community necessitates the reform of the national system of higher education. This reform should be focused on personality development of future specialists, ensuring their high level of health and physical fitness, preparing them for employment and competitiveness in modern economic conditions as persons with higher education. Recently, new educational models have been actively explored, and the rapid development of communication tools and information technologies has opened up significant opportunities for qualitative changes in educational technologies. These achievements can play an important role in the modernization of the Ukrainian education system.

Predictors of the Use of Physician's Televisits During the COVID-19 Pandemic in Poland.

Telemedicine-based contacts between patients and physicians were allowed in Poland only in 2016. However, using such services was not common due to the lack of a relevant reimbursement scheme. During the COVID-19 pandemic, the use of telemedicine and e-health systems increased radically. The aim of this study was the assessment of factors predicting the use of physician's televisit in the Polish general adult population. The analysis was based on data from an online survey of 2410 Internet users performed in October 2020. The logistic regression modeling revealed that both health (HL) and e-health literacy (eHL), the use of e-health services before the pandemic, the use of social media, and from sociodemographic variables, age, gender, vocational status, and marital status were significant predictors of obtaining televisit from a physician during the pandemic. Pre-pandemic experience with ehealth applications strongly predicted utilizing televisits during the pandemic. Respondents with higher levels of HL and eHL were more likely to use such telemedicine services than those with lower levels.

Patterns of facility and patient related factors to the orthopedic and trauma admissions at the Kenyatta National Hospital: A qualitative assessment.

Inappropriate utilization of higher-level health facilities and ineffective management of the referral processes in resource-limited settings is increasingly becoming a concern in health care management in developing countries. This is characterized by self-referrals and frequent bypassing of nearest health facilities coupled with low formal referral mechanisms. This scenario lends itself to a situation where uncomplicated medical conditions are unnecessarily managed in a high-cost health facility. This situation compromises the ability and capacity of Kenyatta National Hospital (KNH) to function as a tertiary referral health facility as envisioned by Kenya Health Sector Referral Implementation Guidelines of 2014, Kenya 201 constitution and KNH legal statue of 1987. The study objective was to assess the patterns of facility and patient related factors to the orthopaedic and trauma admissions at the KNH. This was a descriptive qualitative study design. The study was conducted amongst the orthopaedic and trauma admission caseload for 2021. Data collection was done through a) data abstraction from 905 patients charts admitted during February to December 2021 and b) 10 (ten) semi-structured interviews with 10 major health facilities that refer to KNH to understand the reasons for referral to KNH. Quantitative data was analysed using Statistical Package for Social Science version 21.0 to calculate the frequency distribution. Qualitative data from the data abstraction and transcripts from the KIIs were analysed using NVivo version 12. The major facility and patient related factors to the orthopaedic and trauma admissions at KNH were inadequate human resource capacity and availability (42.7%), financial constraints (23.3%), inadequate Orthopaedic equipment's and implants availability (20.0%) and inadequate health facility infrastructure (6.3%) while the major patient related factor was patient's preference (23.4%). In conclusion, to decongest KNH requires that the lower-level health facilities need to be better equipped and resourced to handle essential orthopaedic and trauma care.

Health care utilisation in Cox's Bazar district, Bangladesh, during the first year of the COVID-19 pandemic: A mixed-methods study among host communities.

To respond to the COVID-19 pandemic, countries introduced public health and social measures that had indirect societal, economic consequences. Concerns during epidemics include continuity of routine health services. We investigate how healthcare utilisation and healthcare seeking behaviour changed during the first year of the COVID-19 pandemic among host communities in Cox's Bazar, Bangladesh. This mixed-methods study combines quantitative analyses of routine health data and population-based findings about healthcare seeking behaviours. Trends in consultations changed according to facility level (higher-level facilities included Upazila Health Complexes and District Hospitals; lower-level facilities included Community Clinics and Union Health and Family Welfare Centers). At the pandemic's beginning, drops were seen at higher-level health facilities for outpatient department (OPD) consultations, respiratory infections, and antenatal care. Minor reductions or increases were seen at lower-level facilities for the same services. Half of the subdistricts reported a cumulative increase in OPD and respiratory tract infection consultations. Most subdistricts reported a cumulative decrease in antenatal care. Child vaccinations dropped in all subdistricts, half of which did not catch-up, resulting in a cumulative decrease of delivered doses. Fear of contracting COVID-19 and financial constraints were the main reasons for decreased access. Drivers of healthcare seeking behaviours should be better understood to guide preparedness and service delivery modalities at primary and secondary levels.

Digital health literacy and associated factors among health professionals during the outbreak of corona virus pandemic in Ethiopia: A systematic review and meta-analysis.

The COVID-19 pandemic had a significant impact on healthcare delivery worldwide. Digital tools emerged as a preferred solution for maintaining healthcare services during this crisis. This study aimed to assess the magnitude of digital health literacy among healthcare professionals in Ethiopia in 2020-2023. A systematic review and meta-analysis were conducted following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Articles published from 2020 to 2023 were reviewed using various electronic databases such as Medline, PubMed, and Cochrane Library, CINAHL, HINARI, Science Direct, Google Scholar, and Global Health. Meta-analysis was performed using STATA 17, and publication bias and heterogeneity were assessed. Six studies involving a total of 2739 participants were included in the analysis. The pooled level of high digital health literacy among health professionals in Ethiopia during the pandemic was found to be 56.0% (95% CI: 55, 58). Several factors were identified as significant contributors to high digital health literacy, including internet use (AOR = 2.72, 95% CI: 1.86, 3.98), perceived ease of use (AOR = 2.79, 95% CI: 1.83, 4.25), favorable attitude (AOR = 2.49, 95% CI: 1.61, 3.85), perceived usefulness (AOR = 2.29, 95% CI: 1.65, 3.18), information-communication-technology training (AOR = 6.09, 95% CI: 1.83, 24.27), and educational level (AOR = 3.60, 95% CI: 2.96, 4.37). The study findings revealed a moderate level of high digital health literacy among Ethiopian health professionals. Factors such as internet use, favorable attitude, and information-communication-technology training were associated with high-level digital health literacy. To enhance digital health literacy, it is crucial to provide timely training and improve internet access for healthcare professionals. Additionally, promoting the perception of digital tools as useful and supporting evidence-based decision-making can further improve digital health literacy. Comprehensive information-communication-technology training programs should be implemented to equip healthcare professionals with necessary skills to effectively combat outbreaks like the COVID-19 pandemic.

Effect of enforcement of the national referral guidelines on patterns of orthopedic admissions to Kenyatta National Hospital, Kenya: Pre-post intervention study.

Inappropriate utilization of higher-level health facilities and ineffective management of referral processes in resource-limited settings are becoming increasingly a concern in health care management in developing countries. This is characterized by self-referral and frequent bypassing of the nearest health facilities coupled with low formal referral mechanisms. This scenario lends itself to a situation where uncomplicated medical conditions are unnecessarily managed in a high-cost health facility. On July 1, 2021, Kenyatta National Hospital (KNH) enforced the Kenya Health Sector Referral Implementation Guidelines, 2014, which required patients to receive approval from the KNH referral office and a formal referral letter to be admitted at KNH to reduce the number of walk-ins and allow KNH to function as a referral facility as envisioned by the Kenya 2010 Constitution and KNH legal statue of 1987. To determine the effect of enforcing the national referral guidelines on patterns of orthopaedic admissions to the KNH. This was a pre-post intervention study. Data abstraction was done for 459 and 446 charts before and after the enforcement of the national referral guidelines, respectively. Enforcement of the national referral guidelines reduced the proportion of walk-in admissions from 54.9% to 45.1%, while the proportion of facility referrals increased from 46.6% to 53.4% (p = 0.013). The percentage of non-trauma orthopaedic admissions doubled from 12.0% to 22.4% (p<0.001). There was also an increase in admissions through the Outpatient Clinic and Corporate Outpatient Clinic. The proportion of emergency admissions declined, while that of elective admissions increased. The increase in elective cases was mainly driven by the increase in female admissions with active insurance cover, tertiary education, non-trauma-related conditions and older age groups. However, the use of official formal written referral letters did not change despite the enforcement of the national referral guidelines. The enforcement of the national referral guidelines reduced the proportion of walk-ins' admissions to KNH. While the enforcement of the national referral guidelines had no effect on the use of official formal written referral letters, it did limit access and utilization of inpatient orthopedic services for young male patients with no active insurance cover and in need of emergency orthopedic care.

Integrated Health Care for frail elderly people with complex needs.

Background: Demographic changes will lead to an increase in older, frail and complex patients. This place a high demand on health care systems and requires the care system to work more preventively, user-driven and coherent. For the most efficient use of resources, it becomes important to identify patients with the greatest potential to benefit. Digital aids may help to identify such patients.&#x0D; Design, implementation and monitoring of the initiative: In this pilot project the patient group is frail elderly people with complex long-term needs who face multiple care providers. These patients are especially vulnerable to care fragmentation. This group also dominates the 5-10% top spenders who account for 2/3 of high-level health care spending both in Norway and internationally.&#x0D; Intervention: Akershus University Hospital (Ahus), a 1098 beds hospital has with 6 associated municipalities developed a model for closer interdisciplinary collaboration around the frail elderly with complex needs and high consumption of health care services. This model is called Integrated Health Care (IHT).&#x0D; We designed a computer application that uses deidentified health care data to identify risk patients based on age (&gt;65) and number of emergency admissions the last six months (&gt;3) spread over two or more different specialist departments. When a patient is included in IHT a multidisciplinary team (IHT-team) across primary and secondary care visit the patient at home. The IHT-team consists of a nurse and geriatrician from the hospital and a nurse and general practitioner from the municipality. In the conversation during the home visit, emphasis is placed on what is important to the patient. The team map risk areas and need for assistance. An individual treatment plan is created based on this conversation. The patient gets a contact person in the hospital and one in the municipality. If the patient is admitted to hospital, the IHT-team will receive an automatic notification and thus follow the patient during the hospital stay. Every 6 months there will be a follow-up conversation and opportunity to adjust the treatment plan. &#x0D; Results: The first patient was included in 2020 and so far 63 patients have been included (40 of these have been followed for longer than 12 months) and the feedback is good. The patients and relatives highlight the importance of a patient-centered approach. They feel that the IHT-project provides increased security and predictability. We have seen a dramatic decrease in acute hospital admission for those patients included in the program; from on average 3 acute admissions the 6 months prior to inclusion, and 1,25 acute admission the 6 months following inclusion in IHT. There has also been a decrease in use of short-term stays in the municipalities.&#x0D; Conlusion: Our IHT method is effective in identifying patients at risk of frequent hospital admissions. Offering targeted and multidisciplinary services to frail patients seems to be effective in reducing acute admissions and use of health care services in the muncipalities.&#x0D; Next steps: We are now about to expand our project to more municipalities, and aim to calculate health care costs.&#x0D; &#x0D; &#x0D; &#x0D;

Gambaran Persepsi Mutu Pelayanan Kesehatan pada Pasien Pengguna JKN di Puskesmas Karangmoncol

Health services are an integrated and sustainable effort to maintain and improve a high level of health. Protection of public health is realized through quality implementation in accordance with the demands of Law of the Republic of Indonesia Number 36 of 2009. Community Health Centers which have the largest service locations in Karangmoncol District should provide good mutual services. The aim of this research is to see a picture of mutual service for patients using JKN at the Karangmoncol Health Center in 2023. This type of research is quantitative descriptive and was carried out in May - July 2023. Sampling was taken using the purpouse sampling technique, resulting in 100 respondents. The data analysis used was univariate using frequency. From the research results, it was found that the dimensions of health service quality were reliability of 80%, responsiveness of 80%, assurance of 83%, empathy of 75%, tangible of 86 %. So it can be concluded that the majority of respondents in this study had a good perception of the quality of health services at the Karangmoncol Community Health Center.

Effects of remnant cholesterol on the efficacy of genotype-guided dual antiplatelet in CYP2C19 loss-of -function carriers with minor stroke or transient ischaemic attack: a post-hoc analysis of the CHANCE-2 trial

The atherogenicity of remnant cholesterol (RC), a contributor to residual risk of cardiovascular events, has been underlined by recent guidelines. We aimed to evaluate the relationship between RC levels and the efficacy and safety of genotype-guided dual antiplatelet therapy in the CHANCE-2 trial. This post-hoc study used data from the CHANCE-2 trial, which was a randomised, double-blind, placebo-controlled trial of 6412 patients (aged >40 years) enrolled from 202 hospitals in China, between Sept 23, 2019, and March 22, 2021, who carried CYP2C19 loss-of-function alleles and had either an acute minor stroke or high-risk transient ischaemic attack (TIA), and could start treatment within 24h of symptom onset. Participants received either (1:1) ticagrelor plus aspirin (control) or clopidogrel plus aspirin (intervention) and the effect of reducing the 3-month risk of any new stroke was assessed (ischemic or haemorrhagic, primary outcome). From the CHANCE-2 study population, we enrolled 5890 patients with complete data on RC. The cutoff point of RC for distinguishing patients with greater benefit from ticagrelor-aspirin versus clopidogrel-aspirin was determined with subpopulation treatment effect pattern plot. The primary efficacy and safety outcome was recurrent stroke and severe or moderate bleeding within 90 days, respectively. CHANCE-2 is registered with ClinicalTrials.gov, NCT04078737. The cutoff to define elevated RC was 0.91mmol/L. Ticagrelor-aspirin versus clopidogrel-aspirin was associated with a reduced risk of recurrent stroke in patients with non-elevated RC levels (122 [5.3%] versus 179 [7.8%]; hazard ratio [HR], 0.68; 95% confidence interval [CI], 0.54-0.85), but this benefit was absent in those with elevated RC levels (58 [8.4%] versus 48 [7.3%]; HR, 1.10; 95% CI, 0.73-1.65; P-interaction=0.03). When analyzed as a continuous variable, the benefit of ticagrelor-aspirin on recurrent stroke decreased as RC levels increased. The rates of severe or moderate bleeding between treatment groups were similar across RC categories (0.3% versus 0.3%, P-interaction=0.95). Our post-hoc findings suggest that RC could be a potential biomarker to discriminate patients who received more benefits from ticagrelor-aspirin versus clopidogrel-aspirin therapy in CYP2C19 loss-of-function carriers with minor stroke or TIA. These findings need to be validated in an independent study. The National Key Research and Development Program of China, Beijing Natural Science Foundation Haidian original innovation joint fund, Fund for Young Talents of Beijing Medical Management Center, the high-level public health talents, Training Fund for Open Projects at Clinical Institutes and Departments of Capital Medical University; and Salubris.

NIR-II fluorescence-guided liver cancer surgery by a small molecular HDAC6 targeting probe

Hepatocellular carcinoma (HCC) is the sixth most common malignancy globally and ranks third in terms of both mortality and incidence rates. Surgical resection holds potential as a curative approach for HCC. However, the residual disease contributes to a high 5-year recurrence rate of 70%. Due to their excellent specificity and optical properties, fluorescence-targeted probes are deemed effective auxiliary tools for addressing residual lesions, enabling precise surgical diagnosis and treatment. Research indicates histone deacetylase 6 (HDAC6) overexpression in HCC cells, making it a potential imaging biomarker. This study designed a targeted small-molecule fluorescent probe, SeCF3-IRDye800cw (SeCF3-IRD800), operating within the Second near-infrared window (NIR-II, 1000-1700nm). The study confirms the biocompatibility of SeCF3-IRD800 and proceeds to demonstrate its applications in imaging invivo, fluorescence-guided surgery (FGS) for liver cancer, liver fibrosis imaging, and clinical samples incubation, thereby preliminarily validating its utility in liver cancer. SeCF3-IRD800 was synthesized by combining the near-infrared fluorescent dye IRDye800cw-NHS with an improved HDAC6 inhibitor. Initially, a HepG2-Luc subcutaneous tumor model (n=12) was constructed to investigate the metabolic differences between SeCF3-IRD800 and ICG invivo. Subsequently, HepG2-Luc (n=12) and HCCLM3-Luc (n=6) subcutaneous xenograft mouse models were used to assess invivo targeting by SeCF3-IRD800. The HepG2-Luc orthotopic liver cancer model (n=6) was employed to showcase the application of SeCF3-IRD800 in FGS. Liver fibrosis (n=6) and HepG2-Luc orthotopic (n=6) model imaging results were used to evaluate the impact of different pathological backgrounds on SeCF3-IRD800 imaging. Three groups of fresh HCC and normal liver samples from patients with liver cancer were utilized for SeCF3-IRD800 incubation exvivo, while preclinical experiments illustrated its potential for clinical application. The HDAC6 inhibitor 6 (SeCF3) modified with trifluoromethyl was labeled with IRDy800CW-NHS to synthesize the small-molecule targeted probe SeCF3-IRD800, with NIR-II fluorescence signals. SeCF3-IRD800 was rapidly metabolized by the kidneys and exhibited excellent biocompatibility. Invivo validation demonstrated that SeCF3-IRD800 achieved optimal imaging within 8h, displaying high tumor fluorescence intensity (7658.41±933.34) and high tumor-to-background ratio (5.20±1.04). Imaging experiments with various expression levels revealed its capacity for HDAC6-specific targeting across multiple HCC tumor models, suitable for NIR-II intraoperative imaging. Fluorescence-guided surgery experiments were found feasible and capable of detecting sub-visible 2mm tumor lesions under white light, aiding surgical decision-making. Further imaging of liver fibrosis mice showed that SeCF3-IRD800's imaging efficacy remained unaffected by liver pathological conditions. Correlations were observed between HDAC6 expression levels and corresponding fluorescence intensity (R2=0.8124) among normal liver, liver fibrosis, and HCC tissues. SeCF3-IRD800 identified HDAC6-positive samples from patients with HCC, holding advantages for perspective intraoperative identification in liver cancer. Thus, the rapidly metabolized HDAC6-targeted small-molecule NIR-II fluorescence probe SeCF3-IRD800 holds significant clinical translational value. The successful application of NIR-II fluorescence-guided surgery in liver cancer indicates that SeCF3-IRD800 has great potential to improve the clinical diagnosis and treatment of liver cancer, and could be used as an auxiliary tool for surgical treatment of liver cancer without being affected by liver pathology. This paper is supported by the National Natural Science Foundation of China (NSFC) (92,059,207, 62,027,901, 81,930,053, 81,227,901, 82,272,105, U21A20386 and 81,971,773), CAS Youth Interdisciplinary Team (JCTD-2021-08), the Zhuhai High-level Health Personnel Team Project (Zhuhai HLHPTP201703), and Guangdong Basic and Applied Basic Research Foundation under Grant No. 2022A1515011244.

Return on investments in the Health Extension Program in Ethiopia.

Since 2003, the government of Ethiopia has trained and deployed more than 42,000 Health Extension Workers across the country to provide primary healthcare services. However, no research has assessed the return on investments into human resources for health in this setting. This study aims to fill this gap by analyzing the return on investment within the context of the Ethiopian Health Extension Program. We collected data on associated costs and benefits attributed to the Health Extension Program from primary and secondary sources. Primary sources included patient exit interviews, surveys with Health Extension Workers and other health professionals, key informant interviews, and focus groups conducted in the following regions: Amhara, Oromia, Tigray, and the Southern Nations Nationalities and Peoples' Region. Secondary sources consisted of financial and administrative reports gathered from the Ministry of Health and its subsidiaries, as well as data accessed through the Lives Saved Tool. A long-run return on investment analysis was conducted considering program costs (personnel, recurrent, and capital investments) in comparison to benefits gained through improved productivity, equity, empowerment, and employment. Between 2008-2017, Health Extension Workers saved 50,700 maternal and child lives. Much of the benefits were accrued by low income, less educated, and rural women who had limited access to services at higher level health centers and hospitals. Regional return ranged from $1.27 to $6.64, with an overall return on investment in the range of $1.59 to $3.71. While evidence of return on investments are limited, results from the Health Extension Program in Ethiopia show promise for similar large, sustainable system redesigns. However, this evidence needs to be contextualized and adapted in different settings to inform policy and practice. The Ethiopian Health Extension Program can serve as a model for other nations of a large-scale human resources for health program containing strong economic benefits and long-term sustainability through successful government integration.

The influence of sports dance classes on the level of physical health of children 11-12 years old

The article assesses the level of physical health of children aged 11-12 years who attend sports dance classes. It also shows the dynamics that took place during the classes. We emphasize that sports dance classes include a wide range of exercises aimed at the development of various physical qualities, and as our research has shown, it also improves the level of health. By performing dance movements, children help strengthen the muscles of the legs, arms, and trunk, as well as the development of motor skills. At the end of the study, there were students with a high level of physical health, 12-year-old boys have a higher level of health - 25%, and 11-year-old boys - 16.7%. The system of physical education is one of the important tools for improving the physical health of children aged 11-12, which is aimed at developing such values in children as love for active movement, a healthy lifestyle, the importance of physical activity for health, and the formation of children's motivation to play sports. Physical exercises help children strengthen muscles, bones, heart, improve posture, develop coordination of movements, and cope with stress and anxiety. For this, it is important that physical exercises are interesting and exciting for children. It is also important for parents and teachers to set an example for a healthy lifestyle. If parents lead a sedentary lifestyle, it is unlikely that their children will be interested in sports. Therefore, to improve the physical health of children 11-12 years old, joint work of the physical education system, parents and teachers is necessary.

아시아 국가들의 주관적 건강상태에 미치는 영향요인 분석

This study utilized self-rated health as a method of reducing the deviation between health index and actual health level in Asia. Using the Human Development Index (HDI) score of the United Nations Development Program (UNDP), countries were grouped into countries with relatively high health (Group A), middle-level countries (Group B), and countries with relatively low levels of health (Group C), Factors affecting subjective health status for each group with similar health levels were analyzed using the logit model. As an independent variable, psychological, political, economic, social, and environmental factors affecting subjective health were derived using World Values Survey (WVS) data, and the dependent variable was subjective health status. Spatial coverage includes Asian countries, including three Northeast Asian countries, China, Japan, and South Korea, and Southeast Asian countries, Bangladesh, Indonesia, Malaysia, Myanmar, Pakistan, Philippines, Thailand, and Vietnam within the scope of the data. The temporal range corresponds to WVS data Wave 7 from 2017 to 2019. As a result of logistic regression analysis, the variables common to the three groups were life satisfaction and happiness among psychological factors, financial condition satisfaction among economic factors, trust in neighbors among social factors, and medical condition among environmental factors. Group A, which has a relatively high level of health, needs to maintain the psychological and economic factors that have an overall influence, and trust in government, trust in neighbors, group activities, and competition, which are relatively low compared to groups B and C. This suggests that it is necessary to prepare policies to improve awareness and satisfaction with life safety variables. Group B, which has a moderate health index, has to deal with health policies in the direction of maintaining the relatively high level of political and social factors compared to groups A and C. Group C, which has a relatively low health index, has an overall impact. There is a need to improve health policies focusing on psychological and environmental factors that are affecting people's health.

Integration of prison health care into national disease surveillance and health informatic systems: opportunities and challenges for Europe and beyond

Abstract Approximately six million people are incarcerated annually in the WHO EURO region. The majority of these people spend only a minority of their lives in prison. Many people living in prison (PLP) experience significant health &amp; social care inequalities/inequities and have higher levels of health &amp; care needs than their peers in the community. Imprisonment can represent a public health opportunity to identify and address such needs. Programmes delivered in prisons targeting infectious diseases like HBV, HCV, HIV and tuberculosis (TB) can improve active case finding specifically in prison settings but can also impact on elimination and control targets for whole populations by addressing high risk transmission networks centred in and around prison associated populations. But too often prisons represent a ‘black hole’ for health &amp; care data flows, neither receiving health information from community-based health systems nor providing, in an accessible way, details of health interventions delivered in prisons. The result is discontinuity of care and inefficiencies (economic&amp;clinical) in treatment and care programmes. For example, people being screened multiple times for an infection (e.g. HCV) but not receiving treatment, or starting and stopping multiple courses of treatment in a chaotic way which could add to public health risks, e.g. multi-drug resistant TB. National disease surveillance systems missing data on prison populations also risk health security given the ability of prisons to amplify infectious diseases which could pose health threats to wider communities. Significant efforts are required to ensure that national disease surveillance and health information systems routinely include PLP to improve health intelligence, health security and continuity of care. This can support delivery of screening, diagnostic and therapeutic services. But can also enable health service evaluation, health &amp; care needs assessment, and quality improvement programmes.

A&amp;F effectiveness in reducing avoidable health differences: Equity issues &amp; COVID 19

Abstract Background Healthcare equity aims to ensure that everyone can access affordable, culturally competent healthcare since everyone has a fair and just opportunity to attain their highest level of health. Italian National Health Service is characterized by the principles of universality and equality with the aim of the progressive overcoming of inequalities and social and territorial imbalances. The development of the principle of equality has made it possible to focus on three different areas in which the corollary of equity must find concrete implementation: access to health benefits and services, health outcomes for individual subjects, and the allocation of resources and services as needed. Key performance indicators (KPIs) are described as essential in studying and enhancing healthcare performance. Methods Within the network project EASY-NET (NET code 2016-02364191), we carried out an A&amp;F study in Friuli Venezia Giulia region, Italy, over 4 years, evaluating the equity of emergency healthcare access. We calculated 6 KPIs investigating gender, education, residence, and nationality using administrative health databases. We calculated and compared 2019, 2020, and 2021 KPIs. Results We observed a reduction in emergency care access during the pandemic, greater among women than among men, as reported in the literature, and an increase in access among citizens with ‘not detected/no qualification’ scholarship level and citizens with non-EU or not detected country of birth. Conclusions Consistently with the literature, since the beginning of the pandemic, the population turned less to emergency health services, above all women. On the other hand, and contextually no-level-of-schooling citizens and non-EU-birth citizens turned more compared to the rest of the population. While healthcare systems were focused on COVID-19, a worrying reduction in access to care was observed, bringing attention to the issue of healthcare equity both during and post COVID. Key messages • We observed a reduction of healthcare access in the emergency context, above all for women, since the pandemic began. • Non-EU-birth citizens and citizens with no level of schooling had more frequent access to emergency health services than the rest of the population in the pandemic context.

Evaluation of medication errors in nursing during the COVID-19 pandemic and their relationship with shift work at teaching hospitals: a cross-sectional study in Iran.

Medication errors in nursing negatively affect the quality of the provided health-treatment services and society's mentality about the health system, threatening the patient's life. Therefore, this study evaluates medication errors in nursing during the COVID-19 pandemic and their relationship with shift work at teaching hospitals. All the nurses working at teaching hospitals affiliated with Ahvaz Jundishapur University of Medical Sciences (southwest of Iran) comprised the statistical population of this research (260 participants). Data were collected using three questionnaires: a demographic characteristics questionnaire, a medication error questionnaire, and the standard Circadian Type Inventory (CTI) for a normal physiological cycle. At least one medication error was observed in 83.1% of nurses during their work span. A medication error was found in 36.2% of nurses during the COVID-19 pandemic (over the past year). Most medication errors (65.8%) occurred during the night shift. A significant relationship was detected between medication errors and shift work. Medicating one patient's drug to another (28.84%) and giving the wrong dose of drugs (27.69) were the most common types of medication errors. The utmost medication error was reported in emergency wards. The fear of reporting (with an average of 33.06) was the most important reason for not reporting medication errors (p < 0.01). Most nurses experienced a history of medication errors, which were increased by shift work and the COVID-19 pandemic. Necessary plans are recommended to reduce the fatigue and anxiety of nurses and prevent their burnout, particularly in critical situations. Efforts to identify risky areas, setting up reporting systems and error reduction strategies can help to develop preventive medicine. On the other hand, since the quality of people's lives is considered the standard of countries' superiority, by clarifying medical errors, a higher level of health, satisfaction and safety of patients will be provided.

Building management and innovation capabilities for global health: a senior executive program.

Accurately approaching the major challenges associated with global health management has become a mandatory key point in the training of medical leaders around the world. The Senior Executive Program in Global Health Innovation Management (SEPGHIM) seeks to provide an answer to the need for innovation and managerial capacity building in Global Health and to address the current detachment between Public Health Organizations and Business Schools. In 2019, SEPGHIM's first edition was led by five prestigious academic institutions on three continents. The first cohort included a total of 27 high-level health professionals and executives from 16 countries with 7-10 years of working experience who participated during the 11 months of the course. The program sought to fill an often-found knowledge gap among health professionals in terms of health innovation, leadership, and management. SEPGHIM relied on multiple pedagogical methods conveyed through a robust theoretical and applied syllabus that included case studies, simulations, guest speakers, debates, site visits, and an executive challenge. The program achieved various results. First, it recruited high-level health professionals that ensured diversity of backgrounds, allowing an exchange of experiences and different ways of addressing global health challenges. Second, it created a network of health professionals for possible future collaborations that can anticipate new trends and opportunities in global health and work together with stakeholders from other sectors. This networking was one of the most highly rated benefits by the students. Finally, the participants expressed great eagerness to recommend the program (4.9 out of 5) to other decision-makers and leaders in the global health field. These results provide positive insights regarding the value of such a training program for senior health professionals.

AVAILABILITY OF INFRASTRUCTURE AND CLEAN AND HEALTHY LIVING BEHAVIOR IN PUBLIC AND PRIVATE JUNIOR HIGH SCHOOLS: A COMPARATIVE STUDY

Introduction: Students can achieve a high level of health and obtain good learning achievements by maintaining clean and healthy living behavior (PHBS). Aims: analyze differences in knowledge, attitudes, and practice in private and public junior high school students regarding PHBS. Methods: This research used a comparative design. The study subjects were grade IX students from a private and public junior high school in Surabaya with total sample of 185 students. The observed variables were knowledge, attitude, and practice on clean and healthy living behavior. Data were statistically analyzed using Independent T-test for the continuous data, and chi-square test applied to the categorical data. Result: showed that the average knowledge score of private and public junior high school students is still sufficient (34.5±12.3), while attitude (63.7±10.4) and practice (53.4±6.4) regarding clean and healthy living behavior (PHBS) in private and public junior high school students were categorized as positive and good. Statistical analysis revealed that there was different score for knowledge of PHBS between students in private and public junior high school (p = 0.002), but score of attitude and practice were not different between two groups, with p-value of 0.084 and 0.746, respectively. Conclusion: It concluded that knowledge on clean and healthy living seems not followed by the attitude and practice in daily living of students in state and private junior high school students.