National Public Services Research Articles

Business Process Reengineering of an Information Exchange Management System for a Nationwide Cyber Threat Intelligence

Nowadays, nations cyber security capabilities play an important role in a nation's defense. Security-critical infrastructures such as national defenses, public services, and financial services are now exposed to Advanced Persistent Threats (APT) and their resistance to such attacks effects the nations stability. Currently Cyber Threat Intelligence (CTI) is widely used by organizations to mitigate and deter APT for its ability to proactively protect their assets by using evidence-based knowledge. The evidence-based knowledge information can be exchanged among organizations and used by the receiving party to strengthen their cyber security management. This paper will discuss on the business process reengineering of the CTI information exchange management for a nationwide scaled control and governance by the government to better protect their national information security assets.

Outbreak of hepatitis A associated with men who have sex with men (MSM), England, July 2016 to January 2017.

Between July 2016 and January 2017, 37 confirmed cases of hepatitis A with two unique IA genotype strains primarily among men who have sex with men, were reported across eight areas in England and Northern Ireland. Epidemiological and laboratory investigations indicate that these strains may have been imported several times from Spain, with secondary sexual transmission in the United Kingdom. Local and national public health services are collaborating to control this ongoing outbreak.

EFFECTIVENESS OF INTERNATIONAL HEALTH REGULATIONS IN PREVENTION AND CONTROL OF EMERGENCY SITUATIONS OF SANITARY-EPIDEMIOLOGICAL AND BIOLOGICAL CHARACTER

The paper describes the International Health Regulations (2005), hereinafter referred as IHR (2005), by the example of SARS, A/H5N1/, A/H1N1/09, Zika fever, and MERS-CoV control as an effective tool for prevention and control of public health emergences (ES of sanitary-epidemiological character) of international concern. Late detection of Ebola fever epidemic in West Africa (2013–2016) and announcement of public health emergency of international concern at the time when epidemic up-scaled to a threat to national security of the affected countries and high-priority threat to global community (ES of biological character) is attributed to non-use of methodological capacities of IHR (2005) on verification of ES at an early stage of epidemic development because of unpreparedness of local, regional, national and international public health services to such an epidemic situation. WHO plans to achieve scientifically-based reduction of the time from the onset of epidemic events to the effective response measures. Russian Federation, scientifically implementing IHR (2005) from the very beginning and having devised methodology of IHR implementation on the national level, has a strong premise for scientific provision of this process.

Financing strategies to improve essential public health equalization and its effects in China.

BackgroundIn 2009, China launched a health reform to promote the equalization of national essential public health services package (NEPHSP). The present study aimed to describe the financing strategies and mechanisms to improve access to public health for all, identify the strengths and weaknesses of the different approaches, and showed evidence on equity improvement among different regions.MethodsWe reviewed the relevant literatures and identified 208 articles after screening and quality assessment and conducted six key informants’ interviews. Secondary data on national and local government health expenditures, NEPHSP coverage and health indicators in 2003–2014 were collected, descriptive and equity analyses were used.ResultsBefore 2009, the government subsidy to primary care institutions (PCIs) were mainly used for basic construction and a small part of personnel expenses. Since 2009, the new funds for NEPHSP have significantly expanded service coverage and population coverage. These funds have been allocated by central, provincial, municipal and county governments at different proportions in China’s tax distribution system. Due to the fiscal transfer payment, the Central Government allocated more subsides to less-developed western regions and all the funds were managed in a specific account. Several types of payment methods have been adopted including capitation, pay for performance (P4P), pay for service items, global budget and public health voucher, to address issues from both the supply and demand sides. The equalization of NEPHSP did well through the establishment of health records, systematic care of children and maternal women, etc. Our data showed that the gap between the eastern, central and western regions narrowed. However the coverage for migrants was still low and performance was needed improving in effectiveness of managing patients with chronic diseases.ConclusionsThe delivery of essential public health services was highly influenced by public fiscal policy, and the implementation of health reform since 2009 has led the public health development towards the right direction. However China still needs to increase the fiscal investments to expand service coverage as well as promote the quality of public health services and equality among regions. Independent scientific monitoring and evaluation are also needed.

Commentary: the value of PrEP for people who inject drugs.

IntroductionThe offer of pre-exposure prophylaxis (PrEP) is recommended as an additional option for HIV prevention for people at substantial risk of HIV infection as part of combination HIV prevention approaches. Implementing this depends on integrating PrEP in public health programmes that address risky practices with evidence-based interventions, and that operate in an enabling legal and policy environment for the delivery of health services to those at higher risk of HIV infection. What does this recommendation mean in terms of the diverse range of HIV prevention needs of key populations, some of whom are so discriminated against that they exist essentially outside formal systems such as national public health services, and for whom a substantial risk of HIV is part of a larger adverse and hostile situation? We discuss this question with reference to people who inject drugs, informed by concerns and comments that emerged from a series of consultations.DiscussionHIV prevention is part of a spectrum of injecting drug users’ priorities, and their access and uptake of HIV prevention services is contingent on their wider “risk environment.” The need to address structural barriers to services and human rights violations, and to improve access to comprehensive harm reduction programmes are of prime importance and would have higher value than a mono-focus on HIV prevention. Where existing harm reduction activities are inadequate, fragile or dependent on external donors, shifts in funding priorities, including, for example, towards PrEP, could threaten investment in the broader programmes. For these reasons, it cannot be assumed that PrEP promotion will always be supported by people who inject drugs.The sexual partners of people who inject drugs, non-opioid users who also inject and for whom there is no established substitution treatment, as well as drug users who are unable to negotiate safe sex may value PrEP. As for all key populations, the involvement of people who inject drugs in shaping services for their consumption is vital and too often ignored.ConclusionsFor people who inject drugs and who experience discrimination, violence or harassment, implementation of PrEP should be guided by understanding and engaging with their interconnected range of needs, risk practices, priorities and options. The differentiated needs of sub-populations that inject a range of drugs, and their sexual partners, require further exploration.

Fifty years of Tanzania’s national/public library service

National cum public library services were set up in Tanzania and in a number of other African countries just before or shortly after independence. In addition to being the national public library service, the Tanzania Library Services Board (TLSB) is a legal deposit library and produces the national bibliography. Starting from virtually nothing, TLSB was operating purpose-built libraries in the main urban centres by the mid-1970s. It received much support from the Tanzanian government and from foreign donors up until then, but afterwards the financial situation became more difficult. However, 50 years after its introduction, TLSB operates 21 regional, 18 district, and one divisional library. It has approximately 400 staff. Like other national public library services in Africa, the main challenge has been to extend service to the rural areas where the majority of the population live. A newer challenge is to adapt a traditional service to the environment of young Tanzanians growing up with the mobile phone and the internet.

Professions in Policy and Knowledge Transfer: Adaptations of Lean Management, and Jurisdictional Conflict in a Reform of the French Public Service

The question of how lean management has been transferred to public services and adapted in differing professional and international contexts, though important, is underresearched in sociology and political science. This article addresses one main issue concerning lean: what role do professions play in the transfer and implementation of policy and knowledge? This article draws on policy transfer theories and the sociology of professions to examine how consultants and the French state agency in charge of “modernizing the administration” worked to implement lean management within national and local French public services, including the judicial system. This led them to take principles and methods developed in the private and corporate sectors and translate them to public, professional, and state rationales. Lean is a multipurpose management tool, and so easier for professionals to appropriate despite “jurisdictional conflicts” (Abbott 1988), either with consultants or else between professional groups. The article shows how the transfer of managerial instruments, rationale, and know-how can, in many cases, challenge professionalism and generate resistance.

The social context of parenting: mothers’ inner resources and social structures

Parenting occurs within families and communities and is shaped by parents’ internal resources and the structures that surround their life. Utilising a large national data-set, Understanding Society, this study examined the extent to which variation in mothers’ personality, cognitive ability and well-being, as well as structural and background factors is associated with affective and dialogic parenting and homework support. The findings revealed that psychosocial and structural factors had differential effects on aspects of parenting. Although mothers’ well-being, personality and cognitive factors exerted small-to-modest effects, filial and neighbourhood interactions and background factors emerged as strong predictors for affective and dialogic parenting and homework support. These findings have implications considering that families’ social contexts, in the form of social support networks and neighbourhood connectedness, are shrinking in the face of global recession and disappearing national resources and public services.

Novel respiratory viruses: what should the clinician be alert for?

Since 1990, several novel respiratory viruses affecting humans have been described. In this review, we focus on three pathogens that have caused significant human mortality and raise important public health concerns: severe acute respiratory syndrome (SARS)-coronavirus, Middle East respiratory syndrome (MERS)-coronavirus and avian influenza A viruses (H5N1 and H7N9). Novel respiratory viruses have the potential to instil fear in the public and physicians alike if they are associated with a high case fatality rate. Those viruses with a significant potential for onward human-to-human transmission (including in healthcare settings) might present significant challenges for national public health services and local hospital infection control.

A Review on Confronting Zoonoses: The Role of Veterinarian and Physician

Zoonoses are diseases and infections that are naturally transmitted between vertebrate animals and humans. The organisms causing zoonoses include viruses, bacteria, fungi, protozoa and other parasites, with both domestic and wild animals acting as reservoirs for the pathogens. Zoonoses comprise interaction between at least three species: one pathogen and two host species (animals and humans). They can be transmitted directly by contact with infected animals (e.g. rabies, through bite), via contaminated environment (e.g., anthrax) and via food (e.g., campylobacteriosis) or indirectly via vectors, such as mosquitoes or ticks (e.g., West Nile fever and Lyme disease, respectively).There are many factors influencing the zoonoses diseases. The convergence model organizes the potential factors into a series of broad domains that include: socioeconomic and biological factors; ecological and environmental factors; and the interface of domestic animals, wildlife, and human factors. Zoonoses have affected human health throughout times, and wildlife and domestic animals have always played a role for the transmission of the disease which is public health threats worldwide. So success in the preventing and controlling of major zoonoses depend on the capability to mobilize resources in different sectors and on coordination and intersectoral approaches, especially, between national (or international) veterinary and public health services.

The Impact of Government Expenditures upon Economic Growth in Post-Communist Countries

Abstract This paper examines the relationship between the structure and share of government expenditure into Gross Domestic Product (GDP) and the real GDP per capita. Our study uses a micro panel data for a sample made of ten countries from Central and East European, for the period 2002-2012. The empirical results of the linear regression show that the GDP/capita is positively correlated with public order and safety expenditures as well as with economic actions, while national defense and general public services are negatively correlated. The results obtained largely correspond with the ones reached by other researchers approaching the topic of the relationship between economic growth and composition of the government expenditures. The health and education expenses, though instrumental for the long-term development of any society, did not show any significant impact upon the evolution of the GDP/capita, probably as a result of the short-term available data.

SIROMAŠTVO I SOCIJALNA ISKLJUČENOST U MEDIJSKOM DISKURSU RADIO-STANICA SRBIJE

Kvаntitаtivno-kvаlitаtivnа аnаlizа medijskog diskursa o siromaštvu i socijalnojisključenosti obuhvаtilа je korpus od 27 centrаlnih rаdijskih informаtivnih emisijаkoje su emitovаne nа četiri radio-stanice: republičkom i pokrаjinskom jаvnom servisu,komercijаlnom regionalnom mediju, kаo i rаdio-stаnici koje su i dаlje u nаdležnosti lokаlnesаmouprаve. Ukupno je uočeno 37 tematskih priloga (oko 9 priloga u proseku po stanici)što je daleko manje od prethodnog istraživanja 2010, kada je uočeno 84 priloga u emisijamasedam radio- stanica (12 priloga u proseku po stanici).Anаlizа je pokаzаlа da su kao najčešće identifikovane socijalno isključene grupe:svi siromašni građani, žene, deca i radnici i studenti. U ulozi subjekta najčešće se javljajudržavni organi i sindikati, dok se glas „socijalno ugroženih” gotovo i ne čuje.

Braille use among Norwegian children from 1967 to 2007: trends in the underlying causes

The aim of the study was to estimate the occurrence, diagnoses and time trends among Norwegian children that have received education in braille from 1967 to 2007. We used a retrospective population-based study design. The health care system is free for all inhabitants in Norway. We included all children that had received braille education the last four decades. From each student's record, we abstracted year born, country of birth, gender, year diagnosed, diagnosis, classification of visual impairment and type of reading media. We identified 287 children (137 girls and 150 boys) that had received braille education over the last 40 years. Of these, 262 (91.3%) children were born in Norway, 145 (53.7%) were diagnosed within the first year of life and 59 (20.6%) from age of one to five. The most frequent diagnoses were Retinopathy of Prematurity (ROP), Juvenile Ceroid Lipofuscinoses (JNCL), Lebers Congenital Amaurosis (LCA) and Retinitis Pigmentosa (RP). Among the children, 63% (N = 170) used braille only, 9% (N = 25) braille and print, but priority braille, and 27% (N = 73) braille and print, priority print. The number of children with ROP using braille had a peak in 1977, then the number declined. The number diagnosed with LCA increased from 1987 to 1992. The number of braille users among children diagnosed with JNCL tended to increase substantially after 1992. Braille education seemed to be dependent of trends in diagnoses as well as trends in recommendations from professional educators.

Medical tourism: its potential impact on the health workforce and health systems in India

Globally there has been tremendous growth in the health service sector, catalyzed by inadequate national public health services, the spiralling cost of health services and the availability of cheaper alternatives in developing economies. This has led to the globalization of health care worldwide, illustrated by growing cross-border delivery of health services that is estimated to be in excess of US$140 billion (World Trade Organization 2001). In India, health care is one of the largest sectors, in terms of revenue and employment, and this sector is expanding rapidly. During the 1990s, the Indian health care sector grew at a compound annual rate of 16%. Today the total value of the sector is more than US$34 billion. By 2012, India’s health care sector is projected to grow to nearly US$40 billion (PricewaterhouseCoopers 2007). A major proportion of this growth is predicted to be attributable to the growth in the business of medical tourism. Medical tourism in India has gained momentum over the past few years. According to the Confederation of Indian Industries (CII), approximately 150 000 patients arrived in India in 2005 from across the globe for medical treatment, and this is expected to increase by 15% each year (Confederation of Indian Industries and McKinsey & Co. 2002). The medical tourism market in India was estimated at US$333 million in 2004 and has grown by about 25%. It is predicted to become a US$2 billion a year business opportunity by 2012 (Ernst & Young 2006).

Blaming Europe? Exploring the variable impact of national public service dissatisfaction on EU trust

European Social Survey data suggest that dissatisfaction with national public services has direct negative effects on EU trust in most EU15 countries, but also that there is significant country variation in their actual magnitude. Two-thirds of this variation can be explained jointly by two macro factors: the effect is stronger in larger welfare states where elites and citizens may perceive EU-induced obstacles for welfare state expansion. Likewise, it is stronger in political systems where the most Eurosceptic parties have tended to be the most welfare state-supporting ones. Under such conditions, it is more probable that citizens receive political cues conducive to a negative effect of dissatisfaction on EU trust.

Factors Associated with Severity of Intimate Partner Abuse in Mexico: Results of the First National Survey of Violence Against Women

To identify factors associated with the severity of intimate partner abuse (IPA) in Mexico.Data were gathered from the National Survey of Violence Against Women (November 2002-November 2003), a nationwide study in which 18,902 women over the age of 14 participated. Subjects were recipients of national public health care services. The severity of IPA was measured using a 27-item scale. Multinomial logistic regression analyses were performed to explore significant factors associated with partner violence.One in four participants reported experiencing IPA. This model showed that younger and less educated women had a higher risk of IPA. Working out of the home (OR [odds ratio] 1.3, 95% confidence interval [CI] 0.99-1.72), two or more children in the household (OR 1.44, CI 1.18-1.77), alcohol consumption (OR 2.51, CI 1.63-3.90) and history of childhood abuse (OR 3.7, CI 3.03-4.52) increased the possibility of severe violence. The most important predictor of severe IPA was the partner's alcohol consumption (daily or almost daily, OR 14.7, 95% CI 13.25-16.46).Awareness about the risk factors associated with IPA will help identify populations at greater risk of severe injury and could orient the health sector to direct actions toward this vulnerable population.

Factors associated with severity of intimate partner abuse in Mexico: results of the first National Survey of Violence Against Women.

To identify factors associated with the severity of intimate partner abuse (IPA) in Mexico. Data were gathered from the National Survey of Violence Against Women (November 2002-November 2003), a nationwide study in which 18,902 women over the age of 14 participated. Subjects were recipients of national public health care services. The severity of IPA was measured using a 27-item scale. Multinomial logistic regression analyses were performed to explore significant factors associated with partner violence. One in four participants reported experiencing IPA. This model showed that younger and less educated women had a higher risk of IPA. Working out of the home (OR [odds ratio] 1.3, 95% confidence interval [CI] 0.99-1.72), two or more children in the household (OR 1.44, CI 1.18-1.77), alcohol consumption (OR 2.51, CI 1.63-3.90) and history of childhood abuse (OR 3.7, CI 3.03-4.52) increased the possibility of severe violence. The most important predictor of severe IPA was the partner's alcohol consumption (daily or almost daily, OR 14.7, 95% CI 13.25-16.46). Awareness about the risk factors associated with IPA will help identify populations at greater risk of severe injury and could orient the health sector to direct actions toward this vulnerable population.

Experience versus Perceptions: Accounting for the NHS “Perception Gap”

Between 2003 and 2006, annual Populus opinion polls have revealed a significant gap between personal experience and perceptions of the performance of national public services. The gap is most pronounced in the case of the NHS. In this paper, I examine whether social characteristics, party identification, newspaper readership, and variation in the levels of political awareness, issue salience, and partisan strength account for differences in evaluations of the NHS. Party identification appears to influence perceptions more than evaluations of personal experience; the evidence on newspaper readership is equivocal. Attaching importance to the NHS as an issue and strong identification with the Labour Party, along with social characteristics, party identification and newspaper readership also significantly affected the size of the gap between experience and perceptions. These findings suggest that perceptions, rather than views based on personal experience of the NHS, are more susceptible to partisan and, possibly, media influences. They also suggest that fluctuations in the NHS perception gap’s size, apparent between 2003 and 2006, are the product of changes in the intensity and direction of party support.

State Mental Health Policy: Overview and Goals of the Mississippi Youth Programs Around the Clock (MYPAC)

This column briefly outlines the Mississippi Youth Programs Around the Clock (MYPAC) Demonstration Project. MYPAC is a federally funded effort to examine community-based alternatives to residential placement for youths with severe emotional disturbance. The project is one of ten similarly structured grants awarded nationally and is among the first to reach implementation. Because such a large amount of funding has been dedicated to such a substantial cross-section of national public mental health services ($66,000,000 in Mississippi alone), it is important to make the field aware of developments in these projects as they occur.

Incorporation of specialists to primary health care to increase its efficiency

In the last decade, the number of general practitioners has decreased in Chile and there is a lack of interest among new doctors to work in Primary Care. The low number of positions for primary care physicians in the national public and community health services are one cause, among others, for this decrease. On top, there is a lack of incentives and continuous training in community health services. This situation lead to reinforce primary care with internists, gynecologist, surgeons and psychiatrists in training. During their residence, part of the working journey of these trainees will be carried out in general medical outpatients clinics. This solution has been criticized by university authorities. The other solution is to incorporate certified basic specialists in teams of three to five, in outpatient clinics of communities with high number of beneficiaries. This initiative is supported by the great number of specialists available in Chile, but is hampered by the lack of working positions and financing. It would increase the problem solving capacity at the primary level, decreasing the number of specialist derivations, that collapse secondary levels of health care.