Organization Of Public Health Services Research Articles

Serological and Molecular Evidence of the Circulation of the Venezuelan Equine Encephalitis Virus Subtype IIIA in Humans, Wild Vertebrates and Mosquitos in the Brazilian Amazon.

Understanding the interaction between viruses and ecosystems in areas with or without anthropic interference can contribute to the organization of public health services, as well as prevention and disease control. An arbovirus survey was conducted at Caxiuanã National Forest, Pará, Brazil, where 632 local residents, 338 vertebrates and 15,774 pools of hematophagous arthropods were investigated. Neutralization antibodies of the Venezuelan Equine Encephalitis virus, subtype IIIA, Mucambo virus (MUCV) were detected in 57.3% and 61.5% of humans and wild vertebrates, respectively; in addition, genomic fragments of MUCV were detected in pool of Uranotaenia (Ura.) geometrica. The obtained data suggest an enzootic circulation of MUCV in the area. Understanding the circulation of endemic and neglected arboviruses, such as MUCV, represents an important health problem for the local residents and for the people living in the nearby urban centers.

COVID-19 vaccination: engagement behavior patterns and implications for public health service communication

PurposeCOVID-19 vaccinations face a backdrop of widespread mistrust in their safety and effectiveness, specifically via social media platforms which constitute major barriers for the public health sector to manage COVID-19 (and future) pandemics. This study provides a more nuanced understanding of the public's engagement behavior toward COVID-19 vaccinations.Design/methodology/approachUsing Netnography, this study explores the public's interactions with vaccine communications by the WHO via Facebook. From WHO posts about the COVID-19 vaccination 23,726 public comments on Facebook were extracted and analyzed.FindingsBuilding on crisis communication, health and engagement literature, this paper identifies and conceptualizes seven patterns of engagement behavior toward the COVID-19 vaccination and develops the first framework of relationships between these patterns and the extant vaccine attitudes: vaccine acceptance, hesitancy and refusal.Practical implicationsThis paper helps policymakers identify and adapt interventions that increase vaccine confidence and tailor public health services communications accordingly.Originality/valueThis research offers the first typology of patterns of engagement behavior toward COVID-19 vaccinations and develops a framework of relationships between these patterns and the existing understanding in health literature. Finally, the study provides data-driven communication recommendations to public health service organizations.

Analysis of impact of ors with zinc & probiotics supplements in curing acute diarrhoea

Information about diarrheal diseases, their determinants in India, and prevention and control strategies must be reviewed in light of recent developments to ensure better planning and organization of public health services. In childhood, especially in developing countries, diarrhoea is most frequent. This research analyses the usage of ORS and measuring agents in diarrhoea management and care. To test the effectiveness of application of Zinc plus Saccharomyces boulardii(as probiotic) to WHO-ORS as well as to equate these results with WHO-ORS only. Currently, probiotics, in particular, in severe bacterial diarrhoea, are used in various preventive and treatment areas. In this analysis the regulation of vomiting between the three groups was not substantially different (p>0.05). In the ORS+Probiotic Group and ORS+Zinc Group, the patients were shown to be completely hydrated slightly earlier than the ORS group (p < 0.0001). But for the first day, ORS+Zinc Group and ORS+Probiotic Group greatly maintained the lack of stool frequency in contrast with the ORS Group patients. The incidence of losing stool in patients from Probiotic Group were also found to control considerably more quickly. Furthermore, in patients from Probiotic group, the mean length of diarrhoea was fewer. In our research, in the first 48 hours of care, children who were probiotic-present were more vulnerable to diarrhoea with stronger outcomes between 72 and 96 hours, and to increase continuity as well as shortening stays.

COVID-19: НОВА ХВОРОБА ТА ХАОС ІЗ ПАНІКОЮ УНАСЛІДОК СТРЕСУ

COVID-19 (coronavirus disease – 2019) caused by SARS-CoV-2 (also known as 2019-nCoV) is a new infectious disease by etiology, but in manifestations it has some similarities with SARS (Sever Acute Respiratory Syndrome) that ravaged several countries of the world around 2003. Coronaviruses are RNA containing microbes that ‘hijack’ mammalian cells to replicate themselves intracellularly, just to be released in large quantities. SARS-CoV-2 first replicates in the upper respiratory tract, as opposed to SARS-CoV viruses in the ‘old’ SARS that attack the lower respiratory tree, especially the lungs and cause severe pneumonia. About 80% of COVID-19 patients are mild, some of them are even asymptomatic and only about 10-20% require hospitalization because of pulmonary edema and rapidly developing bronchopneumonia that often leads to multiorgan failure, especially in older patients with chronic comorbidities or immunocompromised system (e.g., obesity, diabetes mellitus, cardiovascular diseases).  The overall worldwide mortality is about 1-2%, but some of the genetic variants of the virus caused 4-6% mortality, especially in densely populated areas, like Northern Italy, New York city, Spain. In the most severe cases a ‘cytokine storm’ (a massive release of cytokines) have been described that aggravate the initial damage in the lungs and heart. Epidemiologically, the true incidence and prevalence of COVID-19, most likely, will never be known because of uneven testing in most of the countries for the viral RNA and/or for the developed IgM and IgG antibodies against the virus. From public health perspectives, the hardest hit areas of the world are those that were not prepared, had a poorly organized or underfunded public health service, and/or did not follow the preventive measures such as social distancing, isolation and frequent hand washing. The poor organization of public health services, especially if associated with initial denial of the rapid spread of the disease lead to chaos, panic and, predictably, sever distress in many people

Understanding policy problems: a refinement of past work

To better connect the concept of policy problems to policy solutions, this article builds on Guy Peters’ framework for identifying and applying ‘attributes’ of policy problems. It does so by applying the seven attributes of policy problems identified in Peters’ past work to a range of policy problems in the United States. The problems investigated include access to healthcare, the organization of public health services, and water pollution. By applying Peters’ attributes to these policy problems, we assess the range of the framework’s application to different types of policy problems. We also identify insights that can be used to enable improvements to the framework over time, which may enhance our ability to characterize policy problems in ways that guide policy design.

RUSSIAN EXPERIENCE OF PROFESSIONAL TRAINING OF PHYSICIANS IN THE SPECIALTY «ORGANIZATION OF PUBLIC HEALTH SERVICE AND PUBLIC HEALTH»

The article analyzes and generalizes the experience of the Department of the First MSMU I.M. Sechenov in the professional training of physicians in the specialty «Organization of public health service and public health». Educational and methodological materials, planning and report documents of the department over 2016-2017 were used in the work. The main directions of the activities in training of specialists at the department were career guidance of trainees, assistance to students in self-determination, professional education and quality holding of academic classes, maintenance of contacts with graduates of the residency, master and PhD programs. The complex approach to the work of the teaching staff of the Department of Public Health and Public Health Service named after N. A.Semashko creates conditions for professional training of prospective public health managers.

The organization of public health services in Europe

The organization of public health services in Europe

Organization of public oral health services for early diagnosis of potentially malignant disorders in the state of Rio de Janeiro, Brazil

This is a study of the organization of public health services in the state of Rio de Janeiro concerning the diagnosis of potentially malignant disorders. Secondary data from the database of the first phase of the Program for Enhancement for Access to and Quality of Primary Care were used. The implementation of actions at different levels for cancer prevention, the availability of diagnostic support services and the organization of the care network were assessed. The results show that only 58.8% of oral health teams record and monitor suspect cases; that only 47.1% reported having preferential channels for referring patients and there is great variation in waiting times to confirm the diagnosis. Local managerial and regional support actions can improve the organization of the care network for oral cancer prevention in the state.

Is the first-line nursing managers’ power congruent with that of the nursing group?

Aim This research examined the relationship between nursing managers’ power and nursing group power in public health service organizations. Approach/Methods A cross-sectional survey of first-line nurse managers ( n = 264) from 11 Finnish hospitals was conducted. The power of nurse managers and nursing groups was examined through two reliable instruments: the Nursing Managers’ Power instrument and the Sieloff-King Assessment of Group Power within Organizations instrument©. Findings The power of nurse managers was perceived to be moderate on a 5-point Likert scale. Managers reported that they gained the most power from their role and position as a nursing manager, and lastly, from their resources. The power of nurse managers correlated no more than moderately with nursing group power. Implications for Nursing Management Organizations need to ensure that nursing managers have the power and opportunity to influence nursing goals and outcomes.

The problem of suicides in Semipalatinsk region (Republic of Kazakhstan) (1179.4)

The analysis of the data on prevalence and structure of suicides in modern conditions of Semipalatinsk region testifies to practically unprece¬dented wave of increase of frequency of suicides in all groups of the population, frequency of suicide attempts accompanying with the most expressed growth in efficient groups of the population. The usual situation, thus, demands immediate actions on activation of preventive work of suicidologic serv¬ices. Constant active preventive and rehabilitation work is necessary for maintenance of reduction of a level of suicides, prevention of attempts of suicides, including repeated. In structure of suicidologic services joint functioning doctors and specialised departments of suicidologist and the social ‐ psy‐chological help for adult population, a psychiatric hospital are necessary. The special attention is nec¬essary for giving formation children's and teenage suicidologic services as in a significant part of cases of attempt of suicide to Semipalatinsk are made by teenagers. The society is interested in elimination of any exhibiting of suicides, and there was a requirement of deep knowledge suicides and management by it. In this plan the large interest represents an opportu¬nity of exercise of relative research of prevalence, frame, causes and socio‐economic consequences of suicides in various regions of Republic Kazakhstan with the purpose of the further development and expansion of frames, capable to carry out effective preventive, therapeutic and rehabilitational measures for downstroke of a level of suicidality in scales of all state. The given direction of scientific ‐ practical development should become one of the priorities in social medicine and organization of public health service in the republic. The basic share of service falls to studing of the social ‐ psychological help which provide realization rehabilitation programs and serve initial references and directions of doctors of general medical networks.

Measuring the Authority of Local Public Health Directors in the Context of Organizational Structure

Studies have reported a relationship between the organization of public health services and variability in public health practice at the local and state levels. A national research agenda has prioritized practice-based research to understand pathways that lead to this variation and examine the impact of these differences on outcomes. To measure the extent to which Minnesota local health directors report having key authorities and examine the relationship between organizational structure and authority of local health directors. : Multimodal. Minnesota local health departments. Directors of Minnesota local health departments. Director authorities. Most Minnesota local health directors reported having 6 key authorities related to budget preparation and modification and interaction with local elected officials (n = 51, 71%). Twelve directors (16%) reported that they have 4 or fewer of the 6 authorities. The authority most commonly reported as lacking was the authority to initiate communication with locally elected officials (n = 15, 21%). The percentage of directors who reported having all 6 authorities was higher among those in stand-alone departments (82%) than those in combined organizations (50%). This descriptive study illustrates that emerging practice-based research networks can successfully collaborate on small-scale research projects with immediate application for systems development. Study findings are being used by local public health officials to help articulate their role, aid in succession planning, and inform elected officials, who need to consider the public health implications of potential changes to local public health governance and organization. More studies are needed to refine measurement of authority and structure.

Workplace learning for the public good

PurposeThe purpose of this study is to describe preceptors' implementation experiences after implementing a workplace learning program in Texas WIC (women, infant, and children) agencies and identify implementation best practices.Design/methodology/approachThis research used qualitative description methodology. Data collection consisted of 11 semi‐structured interviews lasting approximately one hour with all preceptors who piloted a workplace learning program in five Texas local agencies to examine barriers, facilitating factors, best practices, and the workplace learning program's impact.FindingsThis research identified several workplace learning implementation best practices, including the importance of planning at multiple organizational levels, candidate selection, flexible implementation design, managerial buy‐in, preceptor knowledge and availability, open communication, and the establishment of clear expectations and timelines.Originality/valueExamining implementation of a workplace learning program across a multi‐level public health service organization using a multi‐theoretical approach contributes to the existing workplace learning literature. Recommendations regarding implementation best practices are discussed.

Exporting public–private partnerships in healthcare: export strategy and policy transfer

The literature on policy transfer has paid insufficient attention to the role of commercial interests in the transfer of policy. The British government has developed a healthcare industrial strategy that includes an attempt to export Public Private Partnership (PPP) services. This article analyses the application of the strategy to export PPP services in healthcare to developing and eastern European countries through a review of ‘scoping reports’. The analysis reveals that the strategy involves an attempt to utilize the UK Department for International Development, international financial institutions such as the World Bank, and private sector consultancies to influence developing country governments towards adopting the British Private Finance Initiative (PFI) model, in order to lay the basis for the winning of consultancy, construction and other contracts by British firms. The debate concerning the suitability of PPP/PFI arrangements for the financing of healthcare facilities in Britain is considered in terms of its implications for the adoption of such arrangements by developing and eastern European countries. The purported efficiency gains of PPP/PFI in the UK are unproven, yet the drawbacks of the model may be even more problematic for public health service organizations in developing and eastern European countries, where the expertise to negotiate, monitor and enforce robust contracts with the private sector may be more limited. The article concludes that the attempt to export PPP services entails a strategy of trying to ‘export’ the policy itself, despite the fact that the public sector technical capacity needed to make the policy effective may be lacking in the target countries.

Innovar en la gestión de servicios de salud pública: la experiencia de la Agencia de Salud Pública de Barcelona

We describe the evolution of the organization of public health services in the city of Barcelona (Catalonia, Spain) until the creation of the Barcelona Public Health Agency. This Agency is a consortium created by the Barcelona City Council and the Government of Catalonia as the sole entity responsible for regional and local public health services in the city. The underlying logic for the Agency's design, as well as its mission, vision and value statements, strategy, services' portfolio, and the role of leadership in the process, are analyzed. Aspects related to the Agency's quality and communication plans, as well as the design of its processes, and its policy in terms of alliances for research and training in public health, are discussed. Finally, the main challenges for the future are described.

La organización de la salud pública en un contexto federal. Aportaciones desde la perspectiva de Estados Unidos

The present article analyzes the structure of public health services in the USA. It aims to describe the perspective of 200 years of a federal organization of public health services, which could be useful in the current context in Spain. Information was obtained by interviews with key informants from the three levels of government (federal, state, and local) and with academics (many of whom had previous experience as public health officers). Special attention is paid to the organization, financing and activities of local and state health departments, as well as to the relationships between these departments. The implications for a country like Spain, which has evolved in a short period from a highly centralized system to a decentralized system based on 17 Autonomous Communities, is discussed.

The Reach of a Computer-Tailored Nutrition Education Program in the Dutch Heart Health Community Intervention “Hartslag Limburg”

Objective To study the reach of an efficacious, computer-tailored nutrition education tool in a field setting. Design Data from self-administered questionnaires were used. Setting The computer-tailored nutrition education tool (CTT) was adopted by a regional public health service organization and implemented in a regional heart-health community project. Participants The 1293 inhabitants of the region that requested the computer nutrition education tool during a 25-month implementation period. Main Outcome Measures Demographic characteristics; intake of fat, fruit, and vegetables; and psychosocial behavioral determinants. Analysis Descriptive statistics. Results The CTT reached almost 1% of the targeted population. Most participants were female (82%), and almost half were low educated. Many participants had diets higher in fat and lower in fruits and vegetables than recommended, were unaware of their unfavorable diets, and had low self-efficacy and intentions towards change. Conclusions and Implications Only a small, but possibly important, part of the target population was reached. Additional ways to reach more people should be explored.

An analysis of high-cost users at an Australian public health service organization

High-cost users generate extremely high costs when compared with average users in the same diagnostic-related group (DRG). They represent a major financial loss for a health service organization. The research was conducted using an area health service patient database for online analytical processing to produce descriptive statistics and graphs of 'high-cost' and 'non-high-cost users'. Trends and patterns were identified across key variables derived from clinical, financial and operational categories. The main results are: 20% of costs are spent by 3% of the population; elective admission is higher in the high-cost group; tracheostomy has the most number of cases and is the most expensive DRG; LOS is mostly longer for complex cases however, high costs can be attributed to other factors. In conclusion, these findings are potentially useful to patients, medical staff, management and health service decision-makers. The limitation of this study is the exclusion of profitability.

Processos de pensamento da TOC como alternativa sistêmica de análise organizacional: uma aplicação em saúde pública

O objetivo deste trabalho é discutir o uso dos processos de pensamento da teoria das restrições, TOC (do inglês Theory of Constraints) como alternativa para análise sistêmica em organizações. Iniciou-se com uma revisão conceitual do pensamento sistêmico, uma referência a um dos vários métodos existentes na bibliografia e uma revisão dos processos de pensamento da TOC. A seguir foi apresentado um estudo de caso de uma aplicação do método da TOC conduzida em uma organização de saúde pública e uma discussão comparada entre o método da TOC e o método sistêmico referenciado. Ao final se conclui acerca da relação existente entre os métodos e situações sistêmicas de interesse, delimitando os tipos de situação em que cada método parece se comportar melhor e parece conduzir a resultados organizacionais aceitáveis.

Eqüidade e atenção à saúde da gestante em Campinas (SP), Brasil

To compare the health care received during pregnancy, delivery, and the puerperium by women belonging to two different per capita family income strata: less than 1 minimum wage, and 1 or more minimum wages. This is a cross-sectional observational study that was carried out with a random sample of 248 female residents of the city of Campinas, in the state of São Paulo, Brasil, who had given birth between April 2001 and March 2002. Sociodemographic data, as well as information concerning maternal morbidity and health care during pregnancy, delivery, and the puerperium, were obtained through home interviews. The Kessner index, the Adequacy of Prenatal Care Utilization index, and an index proposed by the authors based on the recommendations of the Brazilian Department of Health were used to assess the adequacy of prenatal care. The minimum wage in Brazil at the time of the study was 180 reais (approximately 71.4 USD). The lower income group included a larger proportion of women with low schooling, as well as adolescents, black women, and single women. Prenatal care was provided by the public Unified Health System to 73.7% of the women in the lower income group, versus 33.3% in the higher income group. The women in the lower income group started attending prenatal care later and had fewer visits in all than higher-income women. However, some health care quality indicators, such as performance of routine laboratory tests and anti-HIV antibody testing, the proportion of cesarean sections, and the frequency of infant rooming-in, showed more favorable figures in the lower income group. Both groups received comparable counseling and had similar rates of clinical testing, post-delivery tubal sterilization, low birthweight children, and premature delivery. Although a significantly higher number of women in the higher income group received optimal prenatal care, the percentage of cases of inadequate care in the lower-income group was still relatively low. The frequency of health problems during pregnancy did not differ significantly between groups, except for anemia and vaginal hemorrhage, which were more frequent among women in the lower-income group (P < 0.001 and P = 0.033, respectively). Despite marked socio-demographic differences between women in the two income categories, resulting in different living conditions, there were no significant differences between groups in terms of health problems during pregnancy or the quality of the prenatal care received. These results suggest that the organization of public health services in Campinas has succeeded in promoting equity in health care, at least to a certain extent.

Public health in Quebec at the dawn of the 21st century

This paper summarises the status of public health in Quebec at the dawn of the 21st century. After introducing the current definition, the author lays out five basic functions of public health in Quebec: knowledge and surveillance of populations health and wellbeing, health protection; prevention of disease, trauma and social problems that influence health; health and wellbeing promotion; and service organization and evaluation. The organization of public health services is then described at the local level (CLSC), regional level (Public health units) and national level (Ministry, Public health directorate and National Institute of Public Health). Finally, the trends and priorities elaborated over the last ten years, as well as the National Public Health Program to be implemented over the next ten years are described.