Public Health Perspective Research Articles

Public health care staff during the COVID-19 pandemic: a comparison of job demands and work functioning between temporary and permanent staff

BackgroundThe COVID-19 pandemic posed an enormous challenge on the public health workforce, leading to the hiring of much temporary staff. Temporary staff may experience poorer working conditions compared to permanent staff. From a public health perspective, we need to know how working conditions are experienced when there is an acute pressure on recruiting sufficient public health care staff. This study aimed to investigate differences in job demands and work functioning between temporary and permanent public health care staff, during the fourth wave of the COVID-19 pandemic in the Netherlands and compare it with available pre-pandemic data from the general working population.MethodsThis cross-sectional study included temporary (n = 193) and permanent (n = 98) public health care staff from a municipal health care service in the north of the Netherlands. The participants completed a questionnaire with items about quantitative, cognitive, emotional demands (Copenhagen PsychoSOcial Questionnaire, COPSOQ, range 1-100) and work functioning (Work Role Functioning Questionnaire, WRFQ, range 1-100). The participants’ scores were compared to the general working population and differences between temporary and permanent staff were investigated using linear regression analysis. In addition, explorative analyses were conducted with temporary staff stratified by task and permanent staff by department.ResultsPermanent staff had relatively high scores on job demands compared to the general working population, whereas temporary staff had relatively low scores. On work functioning, permanent staff had similar scores as the general working population and temporary staff had better scores. Compared to permanent staff, temporary staff had lower, i.e. better, scores on quantitative (regression coefficient (B)=-26.7; 95% Confidence Interval (CI) -30.8 to -22.5), cognitive (B=-24.4; 95% CI -29.0 to -19.9), and emotional demands (B=-11.8; 95% CI -16.0 to -7.7), and better scores on work functioning (B = 7.8; 95% CI 4.5 to 11.3).ConclusionsTemporary staff experienced lower job demands and reported better work functioning than permanent staff. The acute expansion of the public health workforce did not seem to negatively impact the job demands and work functioning of temporary public health care staff.

Exploring Pathways from Community Involvement to Empowerment in Sexual and Reproductive Health: A Public Health Perspective

The intersection of community involvement and empowerment in sexual and reproductive health (SRH) initiatives represents a critical area in public health. This scoping review aimed to explore the pathways from community involvement to empowerment within SRH initiatives, providing a comprehensive understanding of how public health strategies engage and build the capacity of communities. The literature from databases such as PubMed, Scopus and Web of Science were reviewed systematically, focusing on studies published between 2000 and 2023. The review identified various public health interventions that initially engage communities through participation, consultation and collaboration. These interventions often serve as the foundation for subsequent empowerment, characterised by capacity building, autonomy and advocacy. Key findings highlight that effective SRH initiatives involve community members in programme activities and foster environments where they can gain the skills, knowledge and confidence needed to take control of their health outcomes. Our analysis revealed that successful pathways from involvement to empowerment are multifaceted, requiring sustained commitment, resources and culturally sensitive approaches. The review underscores the importance of integrating community involvement and empowerment in designing and implementing SRH programmes to ensure sustainable and impactful health outcomes. This scoping review contributes to the existing literature by mapping the relationship between community involvement and empowerment, offering insights for public health practitioners and policymakers aiming to enhance SRH initiatives. Future research should focus on longitudinal studies to better understand the long-term impacts of these pathways on community health and well-being.

Healthcare Access and Financing: A Legal and Public Health Perspective

The welfare provisions of the current Constitution centre on healthcare. The Indian Constitution's Article 42 declares that the state has an obligation to take all reasonable steps to promote public health. Additionally, Article 47 of the Indian Constitution, another article containing Directive Principles of State Policy, mandates that the state carry out its primary duties to improve public health by raising the standard of living, improving nutrition, and improving public health. In particular, the state must work to outlaw the use of drugs and alcohol, unless prescribed, as these substances are harmful to health. It follows that welfare regulations clearly place an obligation on the state to increase its assistance in promoting the health of those individuals who are unable to pay for the expensive medical care needed to treat their illnesses. In light of the urgency and importance of the issue, the World Health Organisation designated Universal Health Coverage (UHC) as its top goal. Ensuring that everyone has access to necessary health services of adequate quality and is shielded from the financial burden of medical expenses is the goal of universal health coverage. In underdeveloped nations, financial security against medical expenses is just as important as access to healthcare.

Medication Adherence and Health Outcomes: A Public Health Perspective

Medicine is a two-edged sword: while it can treat a patient's illness, when applied carelessly, it also has the potential to do more harm than good. Ensuring that patients receive appropriate medication for their clinical condition at the appropriate time, by the appropriate channel, and in the appropriate doses should be the top priority for any healthcare system. Polypharmacy can be helpful because numerous morbidities are common, but it can also have unintended harmful effects. The co-morbidity-polypharmacy score uses the patient's physiological age rather than their chronological age to predict how their therapy will turn out. Any departure from the medication's intended therapeutic impact may be regarded as a drug-related issue. The purpose of this study was to examine the effects of clinical pharmacist interventions on drug-related issues in prescriptions for polypharmacy as well as the cost-benefit analysis of clinical pharmacy services. The particular goals were to recognise and address drug-related issues, find out how well health care providers received clinical pharmacist interventions, analyse the cost-benefit of clinical pharmacy services, and create and suggest a clinical pharmacists intervention form to standardise and record drug-related issues.

Livelihood vulnerability to climate change health impacts among Amhara Sayint district community, northeastern Ethiopia: A composite index approach

Climate change significantly impacts public health, affecting nearly everyone across the globe and contributing to approximately 10% of global mortality. Ethiopia is particularly vulnerable to the changing climate attributed impacts due to economic, and social determinants. While research on climate change is expanding, it often prioritizes its effects on agriculture. The impacts from public health perspective are frequently overlooked. We address this shortcoming by evaluating the vulnerability of the community in the district of Amhara Sayint, Amhara, northeastern Ethiopia, to the health impacts of climate change, and identifying factors involved. Data was collected using a community-based cross-sectional approach, involving 605 randomly selected households between July Twenty and September Five, 2022. The data collection process utilized a validated and pilot-tested questionnaire, which was administered through face-to-face interview with the aid of Kobo Collect toolbox. The community's vulnerability was assessed using the IPCC's framework of vulnerability. Household's Vulnerability status was then classified into three levels according to their Livelihood Vulnerability Index (LVI) score. A partial proportional oddsapproach of ordinal logistic regression model was used to identify factors associated with vulnerability to climate change attributed health impacts. Among the 605 respondents, 48% (95% CI: 44.1, 52.1) were identified as vulnerable, and about 4.6 % (95% CI: 3, 6.6) were classified as highly vulnerable. Wealth status (AOR1 = 1.8; 95 % CI: 1.2, 2.8), educational status (AOR1 = 2.8; 95% CI: 1.1, 7.3), marital status (AOR2 = 4.7, 95% CI: 1.6, 13.4), and home crowdedness (AOR2 = 2.9, 95% CI: 1.1, 8.1) significantly associated with vulnerability. Over half of the residents in the district wereeither being vulnerable or highly vulnerable to climate change attributed health impacts. Therefore, prioritizing prevention and preparedness along with conducting spatial analysis to identify high-risk areas for timely intervention, is essential.

The Importance of Accounting for the Dead in Migration

Executive Summary This article highlights the importance of accounting for the dead in migration contexts, from international humanitarian law (IHL), international human rights law (IHRL), and forensic perspectives. Starting by reviewing obligations under IHL and IHRL for the processes of accounting, the article discusses forensic action and the role that accounting can play to protect the dead and clarify the fate and whereabouts of the missing for their families. Considering the complexity of missing and deceased migrant cases, this problem must be approached from several complementary angles, including States codifying international legal obligations related to accounting for the dead in domestic legal or policy frameworks; developing national mechanisms to collect, centralize, and report disaggregated information on migrant deaths; addressing migrant deaths from a public health perspective; pursuing identification efforts including participating in transnational coordination mechanisms; developing strong partnerships with civil society actors; and coupling accounting initiatives with policies that promote the search for missing migrants.

The History of US Menstrual Health, School Nurses, and the Future of Menstrual Health Equity.

In the United States, adolescents suffer from inadequate menstrual health, meaning that adolescents are unprepared for menarche, lack the practical resources they need to comfortably and confidently manage menstruation, and receive inadequate health education and care for menstrual pain and disorders. In this article, we provide a historical analysis of the role of school nurses in addressing menstruation from the early 20th century up to the present day. We contextualize the current realities of school nursing and menstrual health education and clinical support. We argue that the decentralized US school system, a cultural aversion to open discussion about menstruation, and the outsized influence of commercial menstrual product manufacturers have hampered the ability of school nurses to deliver menstrual health education along with menstrual health support. Finally, we discuss implications for today's schooling experiences as well as recommendations for how to support school nurses in aligning our national approach to menstrual health toward the public health perspective of menstrual equity. (Am J Public Health. 2024;114(9):903-908. https://doi.org/10.2105/AJPH.2024.307705).

Epidemiological evidence for the association between hearing loss and health in the community-dwelling population: a public health perspective on hearing loss prevention

Epidemiological evidence for the association between hearing loss and health in the community-dwelling population: a public health perspective on hearing loss prevention

Empowering Women's Health: Examining the Impact of Human Papillomavirus (HPV) Vaccination on Cervical Cancer Treatment and Beyond.

This study aims to identify the change in the health status of women, particularly in cervical cancer treatment through HPV vaccination. Thus, the research aims to measure the reduction in the incidence of cervical cancer in vaccinated women and evaluate the impact of HPV vaccination on the overall health and well-being of women treated for cervical cancer. The paper uses a research approach that involves reviewing the literature, analysing epidemiological data, and assessing the impact of the vaccination program. Major observations suggest that many developed countries' campaigns have reduced cervical cancer and enhanced treatment. Further, the study also addresses some additional effects of the intervention, both health-related with an emphasis on the decrease in healthcare costs and an enhancement of the quality of life among women, and social with a focus on the changes in women's status as a result of vaccination. The research also focusses on the community and economic points of view on HPV vaccination programs, its problems and opportunities regarding socio-economic factors, cultural disparities, and healthcare systems. This study implies that working on those barriers by implementing effective interventions, increasing awareness, and demanding relevant changes in policies could improve vaccination levels as well as outcomes. Hence, this research supports HPV vaccination as vital to the future health status of women. Through the use of survey data and the adoption of a public health perspective, the study can fill existing gaps in the literature on preventive interventions and cervical malignancies and consequently contribute to the enhancement of women's health, particularly in developing countries.

Assessment of Perceived Indoor Air Quality in the Classrooms of Slovenian Primary Schools and Its Association with Indoor Air Quality Factors, for the Design of Public Health Interventions

From a public health perspective, it is necessary to improve indoor air quality (IAQ) in schools. This study aims to assess the state of perceived IAQ in Slovenian school classrooms and its association with the selected IAQ factors to improve the understanding of perceived IAQ for designing public health interventions aimed to improve IAQ in schools. A national cross-sectional study was performed in all 454 Slovenian primary schools in the school year 2019/2020. The questionnaires were filled out by the 3rd-grade teachers with the support of the caretakers. Teachers rated the IAQ in the classroom as the worst in winter. We found that the teachers’ perceived IAQ in the classroom is statistically significantly associated with the micro location of the school and some of the IAQ factors. Poor IAQ is associated with reduced manual airing of classrooms due to the thermal comfort of the occupants. Interventions should be aimed at improving occupants’ adaptive behaviors to increase the frequency of natural ventilation in classrooms.

Geospatialization of Sporothrix spp: spreading knowledge in scientific circles

The Sporothrix fungus exists in different species, S. schenckii, S. americana, S. luriei , S. globosa, S. chilensis, S. pallida and S. brasiliensis . It can be found in soil and putrefactive plant matter, occurring in tropical and subtropical regions. It is observed that infections are the result of the traumatic inoculation of fungal filaments through the skin, affecting humans who have contact with contaminated soil, plants and domestic animals. It is recorded that occurrences of contamination of people with domestic animals have been increasing in Brazil, in the southeast and south regions. The objective was to reflect on research carried out in Brazilian universities, optionally considering doctoral theses studies. State of the Art and Bibliographic methods were used, considering ten years, with a time frame from 2011 to 2020, using two databases, CAPES and BDBTD platforms. For data analysis, statistical analysis was used through ANOVA and geospatialization with the QGIS software, version QGIS-OSGeo4W-3.24.0-2 (18.02.2022). With the results, 49 productions (theses) were retrieved, 18 from the CAPES platform and 31 from the BDBTD platform and analyzed from the perspective of the thematic axes public health, infection and treatment, pharmacology and veterinary sciences. It is concluded that there are records showing the presence of the fungus in the country since the 1980s, and the treatment of the disease caused by the pathogen is possible and dependent on therapy and effective drugs, considering that it is a zoonosis and, therefore, public health issue in some states by mandatory notification.

Survey of gastrointestinal coccidian parasites of pet birds in Tehran

ABSTRACT Birds of various families and genera comprise a notable proportion of veterinary clients in veterinary practice. Regarding the scarcity of information on avian coccidia in pet birds, this study was designed to investigate and identify the diversity of gastrointestinal coccidian protozoa in caged pet birds. Accordingly, droppings samples were collected in 2.5% potassium dichromate and examined for the presence of oocysts by wet smear and by flotation with the saturated salt solution. Detected oocysts were further morphologically specified. Special Modified Ziehl-Neelsen stain was used for the detection of Cryptosporidium spp. oocysts. Out of the 145 droppings that were collected for parasitological investigations, it was discovered that a Japanese quail (Coturnix japonica) had a Cryptosporidium sp. infection (1/145: 0.7%). Additionally, Isospora spp. was found in a common mynah and a canary (2/145: 1.4%), while Eimeria sp. was detected in a canary (1/145: 0.7%). Studied birds were clinically normal and no signs of intestinal infection were observed. The oocysts are described morphologically in detail and compared with the available data. Periodic faecal examination should be recommended for monitoring intestinal parasites in pet birds both from a public health perspective for Cryptosporidium and for avian host health in the case of non-zoonotic parasites. Additionally, the identification of parasite/host species composition will enhance our understanding of species diversity and the variety of hosts that coccidian parasites are capable of infecting.

Social Stigma and COVID-19 Vaccine Refusal in France

Context: In 2021, French health authorities strongly promoted vaccination against COVID-19. The authors assumed that refusing this vaccine became a stigma, and they investigated potential public stigma toward unvaccinated people among the French population. Methods: A representative sample of the French adult population (N = 2,015) completed an online questionnaire in September 2021. The authors focused on participants who were already vaccinated against COVID-19 or intended to get vaccinated (N = 1,742). A cluster analysis was used to obtain contrasted attitudinal profiles, and the authors investigated associated factors with logistic regressions. Findings: Regarding attitudes toward unvaccinated people, a majority of respondents supported several pejorative statements, and a significant minority also endorsed social rejection attitudes. The authors found four contrasting attitudinal profiles: moral condemnation only (32% of respondents), full stigma (26%), no stigma (26%), and stigma rejection (16%). Early vaccination, civic motives for it, faith in science, rejection of political extremes, and being aged 65 or older were the main factors associated with stigmatizing attitudes toward unvaccinated people. Conclusions: The authors found some evidence of stigmatization toward unvaccinated people, but further research is needed, especially to investigate perceived stigmatization among them. The authors discuss their results with reference to the concept of “folk devils” and from a public health perspective.

Modelling the role of tourism in the spread of HIV: A case study from Malaysia

This study aimed to assess the role of tourism in the spread of human immunodeficiency virus (HIV) using Malaysian epidemiological data on HIV and acquired immunodeficiency syndrome (AIDS) incidence from 1986 to 2004. A population-level mathematical model was developed with the following compartments: the population susceptible to HIV infection, the clinically confirmed HIV-positive population, the population diagnosed with AIDS, and the tourist population. Additionally, newborns infected with HIV were considered. Sensitivity analyses and variations in fixed parameter values were used to explore the effect of changes to various parameter values on HIV incidence in the model. It was determined that variations in the rate of HIV-positive inbound tourist entries and the rate of foreign tourist exits (i.e., the duration of time tourists spent in Malaysia) significantly impacted the predicted incidence of HIV and AIDS in Malaysia. The model's fit to observed HIV and AIDS incidence was evaluated, resulting in adjusted R2 values of 53.3% and 53.2% for HIV and AIDS, respectively. Furthermore, the reproduction number (R0) was also calculated to quantify the stability of the HIV endemicity in Malaysia. The findings suggest that a steady-state level of HIV in Malaysia is achievable based on the low value of R0 = 0.0136, and the disease-free equilibrium was stable from the negative eigenvalues obtained, which is encouraging from a public health perspective. The Partial Rank Correlation Coefficient (PRCC) values between the proportion of newborns born HIV-positive, the rate of Malaysian tourist entries returning home after contracting HIV, and the rate of foreign tourist exits have a significant impact on the R0. The methods provide a framework for epidemiological modelling of HIV spread through transient population groups. The model results suggest that the role of tourism should not be overlooked within the set of available measures to mitigate the spread of HIV.

Using one health training for interprofessional team building: implications for research, policy, and practice in Nigeria.

In recent years, the concept of One Health (OH) has arisen as an approach that helps to catalyze the creation of transdisciplinary teams needed for surveillance and investigation of emerging disease dynamics. Besides a wealth of descriptions of what the OH approach encompasses, a dearth of information is available regarding the training of individuals in OH competencies. In 2019, the Nigerian Center for Disease Control developed an OH strategic plan to meet the country's human, animal, and environmental health challenges. In response to the demand for clinicians, scientists, climatologists, conservationists, and environmentalists, who have expertise in environment, human, plant, and animal health to work collaboratively in addressing OH challenges in Nigeria. An interprofessional group of faculty from the University of Texas Medical Branch, the University of Jos, and the National Veterinary Research Institute convened to develop a novel OH course 'entitled 'One Health for Translational Team Science. The objective of the course was to explore the evolution of an emerging epidemic, capitalizing on various learning environments, including animal, environmental, human, and public health perspectives. The 6-week course comprised of three parts: 2-weeks virtual part of case-based group discussions focusing on animal and environmental aspects, 2 weeks of individual field experiences, and a final virtual part focusing on human health. Pedagogical tools used were: case-based group discussions, breakout group presentations, role-play activities, field project write-up, peer evaluation, group writing assignments, and weekly reflections with the goal of working in teams to develop and practice the fundamental leadership and management skills in addressing emerging public health challenges. Post-course evaluations showed that all participants felt more confident identifying and practicing the necessary attitudes and skills to participate effectively in the evaluation of an outbreak. Furthermore, the roles, responsibilities, and "One Health ways of thinking" for the various disciplines and professions involved in improving global health were articulated and identified.

Expanding vaccination competencies to community pharmacists: modelling the organizational and economic impacts of new human papilloma virus (HPV) vaccine pathways in France

BackgroundThe vaccine coverage rate (VCR) for human papillomavirus (HPV) in France is one of the lowest in Europe, well below the target of 80% announced in the French Cancer Plan 2021–2030. The extension of vaccination competencies (prescription and administration) to new health care providers, such as community pharmacists (CPs), was a decisive step by the French Health Authority (HAS) in 2022 to simplify access to vaccination and improve the VCR. This research assessed the economic and organizational impacts (OIs) of the extension of vaccination competencies in France.MethodsA model was developed in Excel® to compare the current HPV vaccination pathway focused on general practitioners (GPs) to a mix of pathways (new and current) that extends pharmacists’ competencies (prescription and/or injection). The simulated population corresponded to girls and boys targeted by the French recommendations. The model was run from 2023 to 2030. HAS guidelines were used to identify OIs related to these new pathways. Model inputs were collected from national data sources and an acceptability study. The results focused on three OIs (HPV vaccination ability [defined as the number of adolescents who could be vaccinated in each pathway], the VCR projection, and flows of activity between health care professionals]). The economic impact was evaluated from the National Health Insurance (NHI) perspective in 2022.ResultsWith a mix of vaccination pathways, including an increasing role of pharmacists, the target of an 80% VCR could be reached in 2030 (versus 2032 with the current pathway) with lower investment than the current situation, resulting in cost savings for the NHI of €212 million. Expanding vaccination competencies will provide pharmacists with additional revenue (an average of €755,000/month for all vaccinating pharmacies) and will free up medical time for GPs (average of 603,000 consultations/year for all GPs).ConclusionsExpanding vaccination competencies to pharmacists has a positive impact on the entire ecosystem. From a public health perspective, the national VCR target can be achieved and better access to care can be provided, freeing up medical time. From an economic perspective, this approach can provide savings for the NHI and additional revenue for pharmacists.

Occupational health nursing and political action.

Occupational health and safety are central elements of work. Throughout its history as a speciality, occupational health nursing (OHN) has been expanding the development of academic competencies and the improvement of clinical skills. The literature highlights that OHN is more involved in the application of policies with a public health perspective focused on the well-being of the worker than in their design and development. REFLECTIONS FROM A SOCIO-OCCUPATIONAL AND PROFESSIONAL PERSPECTIVE OF OCCUPATIONAL HEALTH NURSING: From this premise, the current reality contributes to establishing priorities for action, generates consensus as a discipline, induces self-criticism and favours development as a profession. The article points out the strategies that favour political participation in companies, the factors that limit public representation and some of the benefits of establishing this type of initiative in organisations. The OHN is a key agent of change in the design and development of health policies in the workplace. From a panoramic view of how health strategies can influence companies, and the care of the working population, political awareness and civic participation in its different aspects are part of the commitment to this nursing speciality.

Clustering of Dietary Patterns Associated with Health-Related Quality of Life in Spanish Children and Adolescents.

The aim of the current study was to examine the association between dietary patterns and health-related quality of life (HRQoL) among Spanish children and adolescents. A modified version of the parental version of 10 items of the Screening for and Promotion of Health-Related Quality of Life in Children and Adolescents-a European Public Health perspective (KIDSCREEN-10) was used to assess children's HRQoL in three areas: subjective physical, mental, and social status. To evaluate dietary habits, a food frequency questionnaire was employed. To identify different feeding patterns in the sample of children and adolescents examined, cluster analyses were carried out. In addition, a generalized linear model with a Gaussian distribution was applied to test the associations between the determined clusters and HRQoL. The lowest HRQoL was identified in participants located in the unhealthiest cluster (Cluster 1) (mean [M] = 85.2; 95% confidence interval [CI] 83.7 to 86.7). In comparison with the unhealthiest cluster (Cluster 1), a greater estimated marginal mean of HRQoL was identified for participants in the moderately healthy cluster (Cluster 1) (p = 0.020) and in the healthiest cluster (Cluster 2) (p = 0.044). Based on our findings, dietary habits based on the low consumption of bread, cereals, and dairy products (mainly), together with low intake of fruits and vegetables, are related to lower HRQoL in children and adolescents. These results underscore the importance of promoting balanced and nutrient-rich diets among young populations. Public health initiatives should focus on educating parents, caregivers, and children about the benefits of a varied diet that includes adequate portions of fruits, vegetables, whole grains, and dairy products.

Antibiotic use in Uganda’s livestock-keeping households: prevalence, patterns, and determinants

Livestock farming is vital to global food systems, but the misuse of antibiotics in this sector has raised concerns about its role in the emergence of antimicrobial resistance - now a public health issue. Addressing the misuse of antibiotics requires an understanding of usage patterns and determinants among livestock farmers. This study investigated antibiotic use among livestock farmers in Uganda, examining the frequency of use and factors influencing usage with data from the 2018 Uganda Annual Agricultural Survey. Descriptive results showed that on average one in every three livestock keepers had used antibiotics in the previous year, with 15% of them using antibiotics at least every month in the previous year. Regression analysis results revealed that, among other factors, production systems (keeping cattle, keeping exotic livestock, and herd size) and keepers’ perceptions of the continued efficacy of antibiotics in controlling target diseases even with continuous use significantly influenced the decision to use antibiotics and the frequency with which they were used. The results of this study confirmed the growing concern that antibiotic use in Uganda is no longer limited to humans but has significantly expanded to the livestock sector too. The results further affirmed that antibiotic use in livestock production has reached significant levels that require streamlining from a public health perspective. The study recommends strengthening veterinary education and increasing public awareness of appropriate antibiotic use to combat wrong perceptions towards antibiotic use and encourage safe use.

Public health perspectives on mental health: Reflections from teaching.

The mental health discourse in India has been primarily viewed through a biomedical lens that often overlooks the cultural context and social inequalities. To ensure equitable access to preventive, promotive, curative, and rehabilitative mental healthcare, India needs practitioners who combine a social perspective with an empathetic approach. To address this need, we designed a course titled "Critical Perspectives on Mental Health" that aims to introduce the relevant perspectives and community-based approaches to mental health. In this article, we share our reflections on designing this course and facilitating it in the form of a post-graduation programme.