Public Health Management Research Articles

Exploring resilience among hospital workers: a Bayesian approach.

Healthcare professionals face significant workloads, as their roles are among the most demanding and stressful. Resilience serves as a crucial factor in helping them cope with the challenges encountered in their work environment and effectively manage stress. Assessing the level of resilience among healthcare workers and identifying potential variations across different groups is essential for effective public health management, preventing burnout, and ultimately enhancing patient care. To assess the resilience of various categories of workers operating within a tertiary care multisite hospital and understanding if there are any differences in resilience, based on their characteristics, the type of department they work in, and personality traits. This was a cross-sectional study conducted in January 2024 at EOC, a multi-site tertiary care hospital located in Southern Switzerland. 1,197 hospital workers answered an online survey which included: (1) an ad hoc questionnaire on personal and job characteristics, well-being-related activities, satisfaction level regarding communication, collaboration, support, and training opportunities in the workplace, (2) the Connor-Davidson Resilience Scale 10-Item on resilience, and (3) the Big Five Personality Inventory 10-item on personality traits. Proportion of resilient and highly resilient individuals within the various categories of workers were analyzed with Bayesian approach and Bayesian robust regression. Being part of the hospitality staff, working as a doctor, and having a male sex were associated to the highest scores of resilience. Surgery and emergency departments had the highest proportion of highly resilient individuals. Male sex, older age, seniority, higher hierarchical rank, engagement in physical activities, relaxation or mindfulness practices, religiosity, perception of good collaboration, communication, support, and physical activity correlated with higher resilience skills. This cross-sectional study found that physicians and hospitality staff within our multi-site Swiss hospital are more resilient compared to other categories of hospital workers, and among departments, those working in surgery and Emergency Medicine. Enhancing our comprehension of resilience is crucial for more precise management of healthcare systems and the development of employment policies aimed at sustaining the capacity of healthcare systems to serve patients effectively, while also mitigating shortages of healthcare professionals.

Urgent Warning: Evidence-Based Concerns Regarding Mass Gathering Events During Arbaeen in Hazardous Weather Conditions.

The Arbaeen ceremony is the largest annual mass gathering in the world, attracting millions of Muslim pilgrims each year. However, the event takes place during the summer in Iraq, coinciding with extreme heat and dust storms. Climate change hazards, such as heat waves and dust storms, can have destructive effects on human health, leading to increased mortality and the spread of various diseases. This manuscript recommends measures to stakeholders in emergency or public health management to develop a preventive plan for the Arbaeen ceremony. These measures include improving planning and risk assessment, enhancing capacities, reducing vulnerabilities, increasing knowledge and awareness among pilgrims, developing communication and support systems, ensuring compliance with safety protocols, and regularly assessing evacuation routes. Implementing these measures will contribute to ensuring the safety and well-being of participants during the Arbaeen ceremony in the years ahead.

Investigating the Determinants of Malaria Outbreak in Nono Benja Woreda, Jimma Zone, Ethiopia: A Case-Control Study.

Malaria is one of the most widespread infections worldwide, particularly in developing countries. Accordingly, Jimma Zone is one of the widely affected areas by malaria in Ethiopia. In 2020 woreda health offices have reported the possible malaria epidemic that needs further investigation. Accordingly, this study aims to characterize the scope, pinpoint determinants connected to the Nono Benja woreda malaria outbreak, and implement suitable public health management measures. A descriptive cross-sectional study was followed by an unmatched case-control study with a 1:1 ratio of cases to controls. The sample size of 136 individuals (68 cases and 68 controls) was used. The collected data was imported into Epi-data version 3.1 and analyzed using SPSS version 25.0. By doing multivariate logistic regression association was determined at 95% confidence intervals P value of 5%. A total of 687 instances were identified, giving an overall attack incidence of 1%. The assault rate ranged from 51.6 per 1000 people in Benja rural to 1.1 per 1000 people in Dhokonu Kebele. But there were no recorded deaths. Plasmodium falciparum and Plasmodium vivax were the major types of Plasmodium species reported. From independent variables absence of ITNS [AOR 3.98 (CI = 1.11-24.8)], residing in an unsprayed home [AOR = 3.83 (CI = 1.04-14.08], presence of stagnant water in residential area [AOR = 4.25, CI (1.37-12.24113.10)], and lack of awareness on malaria prevention [AOR = 8.28 (CI 2.31-29.73)] were significantly associated with Malaria outbreak. A number of factors, including lack of ITNS, lack of malaria health education, stagnant water, and IRS (indoor residual spray), were significantly linked with the occurrence of malaria outbreaks. The woreda health office should therefore provide ITNS to the community, use indoor residual spray, and disseminate health information regarding efficient and long-lasting malaria preventive and control techniques.

The Current Dilemma of Health Care Data Sharing in China and Its Legal Responses

Promoting the circulation and sharing of health care data is not only a practical necessity for the advancement of the digital economy, but also a key to achieving the strategic goals of China's health care development. However, the sharing and utilization of China's health care data still face a series of challenges, including unclear allocation of rights and interests of data, breaches of personal privacy, misuse of personal information, and an underdeveloped collaborative mechanism. To overcome these barriers in the era of big data, firstly it is necessary to clarify the rights and interests’ allocation of health care data. Health care data involves three categories of stakeholders: patients, medical institutions, and the public. It is essential to appropriately allocate the rights and interests to health care data among patients, medical institutions, and public health management agencies. From the perspective of effectively utilizing health care data, the rights and interests of patients to their personal health care data are merely an extension of their individual rights and do not include the right to use the data in terms of resource utilization. The rights and interests to use health care data for resource utilization should be granted to medical institutions that actually own or control the health care data. For public health management agencies serving the public interest, only necessary rights and interests should be granted when meeting the needs of the public interest. Secondly, it is necessary to balance the inherent contradiction between sharing and privacy. This requires improving the means by which patients can exercise control over their personal information, establishing a tiered protection mechanism based on the type and sensitivity of health care data, and enhancing the enforcement of health care data regulations to ensure the protection of personal privacy and data security. Ensuring efficient sharing of health data, while respecting individual privacy. Lastly, strengthening the collaborative mechanism for health care data, accelerating the compilation of a health care data resource catalog, and developing universal standards for health care data. From both technical and institutional perspectives, this lays the foundation for the orderly and secure sharing of health care data.
 
 促进健康医疗数据的流通、共享，既是推动数字经济发展的现实需要，也是实现中国健康医疗发展战略目标的关键。然而，中国健康医疗数据共享利用仍然面临数据权益配置不明、个人隐私泄露、个人信息被滥用、协作机制不健全等一系列问题。为了破解大数据时代健康医疗数据共享利用的现实壁垒，首先是要明晰健康医疗数据的权益配置。健康医疗数据涉及患者个人、医疗机构、社会公众三类利益主体，需要妥当配置患者个人、医疗机构和公共卫生管理机构对健康医疗数据的权益。从有效利用健康医疗数据的角度来看，患者对其个人健康医疗数据的权益只是个人权利的延伸，并不包括健康医疗数据资源化利用意义上的使用权。健康医疗数据资源化利用的使用权，应该赋予实际上拥有或控制健康医疗数据的医疗机构。而对服务于公共利益的公共卫生管理机构而言，只应赋予其必要的权益以满足公共利益的需要。其次，还需平衡共享与隐私的内在矛盾，需完善患者个人信息自决的行使途径，健全基于医疗健康数据类型及其敏感性的分级保护机制，并且通过加强健康医疗数据的执法进一步让个人隐私、数据安全得到保证。确保医疗健康数据高效共享的同时，又让个人隐私得到应有的尊重。最后，强化医疗健康数据的协作机制，加快编制医疗健康数据资源目录，制定医疗健康数据通用标准。从技术、制度层面，进一步奠定医疗健�

Strategi Negara Kawasan Asia Tenggara dalam Pemulihan Ekonomi Pasca Pandemi Covid-19

The aim of this research is to analyze the strategies of countries in the Southeast Asia region in economic recovery after the COVID-19 pandemic. The method used in this research uses a qualitative approach with secondary data as a source of analysis. The research results show that the post-COVID-19 pandemic economic recovery strategy implemented by countries in the Southeast Asia region, especially Indonesia, Malaysia, Singapore, Vietnam and the Philippines, is in the form of fiscal and monetary policies, private sector support, public health management and intensifying tourism. Meanwhile, the current economic conditions in the country have shown gradual recovery.

Data analytics in public health, A USA perspective: A review

The integration of data analytics into public health practices represents a transformative paradigm shift in the United States. This review provides a comprehensive analysis of the impact and implications of data analytics on public health strategies, with a focus on disease surveillance and health policy within the USA. In the context of disease surveillance, data analytics has emerged as a crucial tool for real-time monitoring and early detection of health threats. Leveraging diverse datasets, including electronic health records and social media, allows for swift identification of trends and anomalies, enabling proactive responses to potential outbreaks. Advanced analytics techniques, such as machine learning and predictive modeling, contribute to the precision of surveillance efforts, facilitating targeted interventions and resource allocation. Beyond disease surveillance, data analytics significantly influences health policy. Evidence-based policy formulation is enhanced through data-driven insights, providing policymakers with a foundation for understanding the impact of interventions and designing strategies that align with the unique needs of diverse populations. Resource allocation strategies are optimized, ensuring efficient use of limited resources by analyzing health outcomes, service utilization patterns, and cost-effectiveness. Continuous monitoring and evaluation of implemented health policies through data analytics enable policymakers to adapt strategies in response to evolving health challenges, fostering a dynamic and adaptive public health ecosystem. As the landscape of public health evolves, data analytics in the USA continues to play a central role in shaping strategies and policies. The study delves into the historical context, key components, applications, and success stories, providing valuable insights for policymakers, public health professionals, and researchers aiming to navigate the complexities of data-driven public health management.

Integrated Care Systems in England: Progress towards forming new multi-stakeholder partnerships to develop quality.

Background: Health and social care services in England have been restructured to 42 Integrated Care Systems (ICS). ICSs are responsible for delivering integrated services in their local area to prevent illness; identify and treat illness effectively; and provide support to improve quality of life for people with long-term illness or disability. Under the umbrella of ICSs, previously siloed organisations need to work together to deliver quality care. This study aimed to understand how these new ways of working impact on the development of their quality agenda.
 Methods: Semi-structured interviews were undertaken with senior representatives in demographically and geographically diverse ICS. Interviews were audio recorded, transcribed verbatim and analysed in NVivo using a thematic framework approach. Two Patient and Public Involvement team members contributed to the study design and data analysis. The study is conducted at two points in time; the data reported here is the baseline collected shortly (November 2021 to May 2022) before the ICSs’ formal constitution in July 2022.
 Results: Sixty interviews across four ICSs were conducted with senior representatives (e.g. ICS CEO, chief nurse, quality leads, director of social services, director of public health, the public and local communities). Across all ICSs, progress had been made with creating ICS specific committees, with new roles created and leaders appointed, and new partnerships emerging. Positive learning on collaborating with diverse partners had occurred during the COVID-19 pandemic and through previous local initiatives to integrate services. In two ICSs, there was less history of such collaborative work and their new partnerships were emerging more slowly. 
 Generally, it was agreed that strong leadership, supported by broad and effective system partnerships, was essential to develop the ICSs’ structure and to deliver quality. Key partners to support the leadership were senior partners in acute hospital trusts, primary care, social care, public health, Healthwatch (the health and social care champion for service users), voluntary services, and patient representatives. 
 Some concerns were raised that made collaborations more challenging, including differences in language and work culture between the key partners, and health dominating the quality agenda. Overall, it was felt that social care, public health and voluntary services were heard less. They were being consulted, but rarely had leadership roles and leaders from these communities often felt that they were not equal partners. Most participants highlighted the importance of consulting patients and the public and acknowledged that this was not done effectively yet with too few people, who lacked diversity, consulted; and an overreliance on Healthwatch. 
 Discussion: This restructure of the health and social care system shows that new partnerships can be formed between previously siloed organisations but that these take time to develop. In particular, organisations or people who have traditionally been less consulted such as social care, public health, and patients and the public still need to become more equal partners in developing the quality agenda. Follow up interviews will bring greater clarity on how this restructure will maintain and promote quality across services. 

Adaptability of Integrated Community Care models in Moldova to overcome compounded crisis, including supporting refugees. 

Introduction: The Healthy Life Project in Moldova works and collaborates with local authorities across all sectors, including civil society organisations, community members and NCD patients to promote integrated, person-centered care. The aim is to ensure vulnerable people, including refugees, have access to health and social care. Overall, Moldova has received nearly 698,000 Ukrainian refugees, of which 96,646 currently remain in the country.
 Methods: Through intersectoral capacity building community teams developed local integrated care work plans, including joint assessments of people with NCDs and coordinated individual care across different sectors and community resources. The plans also involved a focus on responding to the needs of Ukrainian refugees. Within this continued implementation support, the project included questions of access to health and social care along the migratory cycle to maintain management of chronic conditions. Around 97% of refugees are residing in the host community, most of them require particular support in accessing their rights in practice, being women (59%), children (48%) and the elderly (21%).
 Results: Request for health care services from refugees (28,30%) is one of the forms of assistance expected in addition to cash handouts (76,84%) and in-kind support (35,79%). Therefore, in addition to building capacities for monitoring and management of NCDs, and the application of integrated care, the project considered specific actions for refugees. Training on managing NCDs within the refugee crisis was provided to Primary Health Care (PHC), hospital, Public Health, and emergency care management teams in 20 districts. To support and ensure mobility of PHC practitioners in responding to increased community needs due to hosted refugees, 835 medical kits were purchased and distributed, alongside protective equipment and disinfectants for both the health and social workers. A guide for community social workers on supporting refugees was developed in partnership with the National Social Assistance Agency and has since been embedded in the curricula of the social assistance faculty within the State Pedagogical University. 
 During 2022, 20 integrated community care centers have reached 8,464 persons with NCDs, with 77% having their wellbeing jointly assessed by a community nurse and social worker. As a result, most of them were included in preventive measures and supported to manage NCDs (7851 persons). The most vulnerable were identified and assisted, including 15% of NCD patients (675 persons) and supported to gain access to social benefits, while people with complex needs (663 persons) received access to home health and social care. Considerable progress has been made to promote integrated working locally, between health and social care. As everywhere, collaboration is reliant on personal motivation and local relationship building, and some teams take longer than others.
 Conclusions: Such community approaches are playing an important role in coordination of efforts to support the most vulnerable, as Moldova continues to face a refugee crisis. This continuous support to build capacity and ensure implementation of common approaches, facilitated by a jointly held normative framework supports a more integrated approach to service provision at community level, coordinated by local authorities thus making more efficient use of scarce resources.

Organised loneliness and its discontents

AbstractThis review paper offers a critique of the discourse of loneliness both in the popular and academic imagination. It questions the stance and approach of much loneliness research and the headlines that have been extracted from it. These position loneliness as an epidemic, framing it as a global public health problem, its aetiology and management located in the individual. The paper draws attention to overlooked alternative framings of loneliness as well as to the risks of maintaining our current levels of alarm regarding it. Finally, the work of Hannah Arendt is turned to, as part of a wider academic reappreciation of her work on loneliness. The paper ends by suggesting what can be learned by loneliness researchers in the medical humanities from such political analyses.

DEVELOPMENT OF AN ONLINE DISASTER PREPAREDNESS PROGRAM FOR CAREGIVERS OF PERSONS WITH DEMENTIA

Abstract Individuals with medical conditions, including persons with dementia (PWD), are vulnerable in disaster situations. Disasters limit caregivers’ ability to continue with care due to stress, reduced resources and limited social support. We previously developed and tested a disaster preparedness program for older adults, Disaster PrepWise, and showed its impact on improving preparedness and personal emergency support networks. Through community engaged approaches, we adopted this program to specifically support family caregivers of PWD. Contents were revised based on the emergency management and dementia caregiving literature, and input from the stakeholder advisory board (SAB) consisting of caregivers, aging service providers, public health, and emergency management agencies. The SAB also provided guidance on implementation strategies from the lens of over-burdened caregivers. The new program includes a five-step process with an emphasis on the needs of caregivers and caregiving tasks, for example, developing emergency caregiving network to be activated during and after a disaster. The program also informs caregivers of tasks involved in the event of an emergency and provides various information such as how to navigate staying at public shelters with PWD, identify services during and after an emergency, and manage stress. Preliminary data shows high levels of acceptance and perceived usefulness of this caregiver-specific program. The program is perceived to fill a gap in current disaster management approaches that have limited ability to support vulnerable populations. Caregivers and service providers also praised this program’s ability to connect caregivers to community programs and resources. Additional pilot data will be presented.

한국표준직업분류에 있어서 손톱관리사 직업분류체계의 문제점과 개선방안 연구

This study analyzes the problem that fingernail managers are not classified as an independent occupational group in the Korean Standard Classification of Occupations, which is published by Statistics Korea, but are included as a subclass of skin and body managers, and suggests improvements to the Korean Standard Classification of Occupations system. In the current 7th Korean Standard Classification of Occupations, the subcategory Beauty-related service workers of the large category service workers are subdivided into Hairdressers, Cosmetologists, Skin and body managers, Make-up artists and make-up workers, and Other beauty-related service workers. There are four national technical qualifications related to hairdressing: hairdresser (general), hairdresser (skin), hairdresser (fingernail), and hairdresser (makeup). The beauty industry defined by the Public Health Management Act is subdivided into general beauty, skin beauty, fingernail beauty, and makeup and makeup beauty. The National Competency Standards(NCS) also categorizes these services into hairdressing, skin care, makeup, fingernail care, and massage. Based on the National Technical Qualification, the Public Health Management Act, and the NCS, the occupation of fingernail Managers does not belong to Skin and Body Managers, and fingernail Managers should be upgraded to the same classification as Skin and Body Managers. Therefore, this study aims to improve the Korean Standard Classification of Occupations to enhance the professional competence of fingernail managers and raise their status.

Visually Estimating and Forecasting PM2.5 Levels Using Hybrid Architecture Deep Neural Network

Air pollutants, particularly particulate matter with a diameter of less than 2.5 microns (PM2.5), have been linked to a number of negative climatic and health effects, including irritation and damage to internal organs in the short and long term. Knowing current and future levels of PM2.5 is therefore crucial for both public health and environmental management. Photos of the sky and buildings can aid in assessing visibility and air quality because PM2.5 alters the appearance of the sky and its surroundings. This research proposes a method that employs digital images to not only estimate but also forecast PM2.5 concentration levels using deep learning technologies. A convolutional neural network (CNN) was used as the base layer to automatically extract image features, while a long short-term memory (LSTM) network was used as the output layer to analyze the sequence of features. The sky and its surroundings were captured hourly from a high-rise building in Bangkok, Thailand, and the ground-truth PM2.5 data were obtained from the nearest monitoring station facing the same direction. The experimental results show that the hybrid CNN and LSTM model outperformed conventional CNN models in estimating and forecasting PM2.5 levels by 5% and 30%, respectively.

INTEGRATING AI INTO HEALTH INFORMATICS FOR ENHANCED PUBLIC HEALTH IN AFRICA: A COMPREHENSIVE REVIEW

This study delves into the integration of Artificial Intelligence (AI) within the field of health informatics and its transformative effect on public health outcomes in Africa. It will cover how AI-driven solutions are being implemented to overcome challenges in disease surveillance, healthcare delivery, and public health policy. The paper aims to provide an in-depth analysis of current innovations, the effectiveness of these technological interventions, and their broader implications for health policy and management across the African continent. The integration of Artificial Intelligence (AI) into health informatics holds transformative potential for enhancing public health in Africa. This comprehensive review explores the multifaceted applications, challenges, and opportunities associated with the convergence of AI and health informatics on the African continent. The review encompasses various domains, including disease surveillance, diagnostics, treatment optimization, and public health management. Key themes addressed in the review include the adoption of AI-driven technologies in healthcare, the impact on disease detection and monitoring, and the potential for improving healthcare accessibility in resource-constrained settings. Moreover, the ethical considerations, regulatory challenges, and disparities in technology adoption across diverse African regions are examined, providing insights into the complexities of implementing AI in the African public health landscape. Through an in-depth analysis of current initiatives, case studies, and emerging trends, this review aims to contribute a comprehensive understanding of the opportunities and challenges associated with integrating AI into health informatics for the advancement of public health in Africa. Ultimately, this exploration seeks to inform policymakers, healthcare professionals, and researchers on the critical role AI can play in addressing public health challenges on the continent and fostering sustainable healthcare solutions.
 Keywords: Artificial Intelligence, Health Informatics, Health Management, Africa, Review, Disease Surveillance.

Principles for effective management of scabies outbreaks

Background: The contagious skin infestation scabies, is caused by the mite <i>Sarcoptes scabiei</i> var. <i>hominis</i>. These microscopic organisms navigate under the skin surface to lay eggs, creating burrows that cause notable discomfort and itching and enable the maturation and subsequent proliferation of the mites. Spread to other hosts can occur through direct, often prolonged, skin-to-skin contact or indirectly through shared items such as clothing, bedding, or towels.Current Concepts: Management of a scabies outbreak encompasses several pivotal steps: accurate diagnosis, comprehensive treatment with topical scabicides to kill the mites, rigorous environmental control (including washing all possibly infested materials in hot water), meticulous contact tracing of all close contacts, administration of symptomatic relief through antihistamines and corticosteroids, and meticulous follow-up to verify successful treatment outcomes.Discussion and Conclusion: The prevention of further infestation and recurrent outbreaks is crucial, necessitating a holistic, integrative public health management approach. This approach involves consistent communication and public education about preventive measures and prompt treatment strategies to curtail widespread infestation, thereby safeguarding community health.

The Impact of Higher Education on Health Behavior during the COVID-19 Pandemic: Evidence from China

The COVID-19 pandemic and its associated illness significantly damage people’s physical and mental health. Previous studies focus on the role of strong government public-health management to improve people’s health conditions. The objective of this study is to explore the specific impact of higher education on health behavior and pandemic policy, which remains relatively unexplored. Using data from the 2021 Chinese Social Survey, we employ an OLS regression to examine the effect of education on the change in health behaviors. Then, we use China’s higher education expansion as an instrumental variable to mitigate the potential endogeneity. The results reveal a positive relationship between higher education and health behaviors, both due to improved socioeconomic conditions and enhanced psychological wellbeing. Additionally, we find that the health return of higher education differs significantly between rural and urban areas, suggesting the presence of education inequality. These findings underscore the importance of higher education and individual health behavior in controlling the spread of major pandemics, emphasizing the need for public policy to consider the role of higher education in pandemic management.

Greenness and chronic respiratory health issues: a systematic review and meta-analysis.

The number of chronic respiratory disease (CRD) individuals worldwide has been continuously increasing. Numerous studies have shown that greenness can improve chronic respiratory health issues through different mechanisms, with inconsistent evidence. By quantitatively summarizing existing studies, our purpose is to determine the connection between greenness exposure and various chronic respiratory health. We conducted a comprehensive search on PubMed, EMBASE, and Web of Science core databases to identify relevant studies on the correlation between greenness exposure and chronic respiratory health issues. Studies published up to January 2023 were included in the search. The study used the most frequent indicator (normalized difference vegetation index [NDVI]) as the definition of greenness exposure. We finally identified 35 studies for meta-analysis. We calculated pooled effects across studies using a random-effects model and conducted a subgroup analysis by age and buffer zones to discuss the effects on chronic respiratory health issues. This study showed that 0.1 increments in NDVI were significantly related to lower rates of asthma incidence, lung cancer incidence, and chronic obstructive pulmonary disease (COPD) mortality risk; the pooled RRs were 0.92 (95% CI: 0.85-0.98), 0.62 (95% CI: 0.40-0.95), and 0.95 (95% CI: 0.92- 0.99), respectively. For the age subgroup, the higher greenness exposure level was related to the incidence rate of asthma among teenagers aged 13-18years (RR: 0.91; 95% CI: 0.83-0.99). For the buffer subgroup, a positive relationship with greenness exposure and asthma incidence/prevalence at 200-300m and 800- 1000m buffers, as well as the COPD mortality at 800-1000m buffer, the pooled RRs were 0.92 (95% CI: 0.86-0.98), 0.87 (95% CI: 0.81-0.93), and 0.93 (95% CI: 0.88- 0.98), respectively. Evidence of publication bias was not detected in this study. Our study is the first global meta-analysis between greenness and various CRDs to report an inverse association. Further research is needed in order to determine the effect of greenness exposure on different CRDs. Therefore, when planning for green development, more consideration must be given to public health and green management as intervention measures.

Evaluating Healthcare-Associated Infections in Public Hospitals: A Cross-Sectional Study.

Hospital-acquired infections (HAIs) pose a significant danger to global public health, mainly because their numbers are growing exponentially each year. Additionally, the rise of bacterial strains resistant to current treatment options further exacerbates this threat. This study aimed to examine the occurrences of HAIs identified in public hospitals at the county level. We conducted a cross-sectional study utilizing data provided to the Mures Public Health Directorate from all the public hospitals within the studied county. We examined HAIs reported during the period spanning from 2017 to 2021, which amounted to a total of 4603 cases. The medical departments reported the highest prevalence of HAIs at 48.25%. The most common infections included enterocolitis with Clostridioides difficile (32.61%), COVID-19 (19.83%), bronchopneumonia (16.90%), sepsis, surgical wound infections, and urinary tract infections. The five most frequently identified pathogens were Clostridioides difficile (32.61%), SARS-CoV-2 (19.83%), Acinetobacter baumannii (11.82%), Klebsiella pneumoniae (9.58%), and Pseudomonas aeruginosa (7.95%). Acinetobacter baumannii was the predominant agent causing bronchopneumonia, while Klebsiella pneumoniae was the leading cause of sepsis cases. Escherichia coli was the primary agent behind the urinary tract infections, and Staphylococcus aureus MRSA was identified as the main etiology for wound infections and central catheter infections. Throughout the study period, there was a significant rise in Clostridioides difficile and Gram-negative bacteria prevalence rates. This study identified increased Clostridioides difficile in HAI cases during COVID-19, highlighting the need for careful antibiotic use and emphasizing the growing challenge of multi-resistant strains in post-pandemic state hospitals.

Abstract C126: Communicating breast cancer risk to Spanish-speaking Hispanic women

Abstract INTRODUCTION Disparities in breast cancer (BC) screening are observed between Hispanic and non-Hispanic White women and stronger amongst Hispanic women with under- and uninsured statuses.1-2 Risk-based screening has been recommended by professional societies, including American Cancer Society, starting at age 30 and may be an important strategy for reducing disparities.3 The purpose of the study was to characterize whether women had been told their personal risk of BC and to identify differences in characteristics of patients informed of their personal risk. METHODS This is a cross-sectional analysis of data from a supplemental self-reported survey to an NIH-funded randomized trial conducted at a large Federally Qualified Health Center (FQHC) in Arizona (R01 MD09682-05). The survey was sent to a randomized 600 of the 1,356 participants. Between November 2022 and April 2023, 177 women completed the survey (response rate 29.5%). Participants were asked if a doctor or other healthcare provider had ever talked to them about their personal risk for BC. Differences between those who recalled being told their personal risk for BC and those who did not were assessed using Fisher exact test. RESULTS Overall, 66.3% were 50 years or older, 81.8% who speak primarily Spanish, and 64.8% of respondents had less than a high school education. Also, 22.4% reported a family history of BC, 27.4% have been previously recalled for additional imaging, 10.8% have had a history of prior breast biopsy, 59.9% stated having a regular provider, and 53.1% were found to have dense breast category C or D at screening visit. 40% did not report having a regular doctor although all participants received care at an FQHC. 30.5% of respondents stated that a healthcare professional had ever talked to them about their personal risk for BC. There was a trend toward women with a main doctor being more likely to recall being told their personal risk for BC as compared to those without a main doctor (38.5% vs 22.5%, p=0.06). CONCLUSIONS In this cohort of primarily Spanish-speaking Hispanic women who have had mammography screening and written report of their breast density, about a third of respondents recall being informed of their personal BC risk. These observations need to be confirmed in a larger population with greater response rate, but these results suggest that there is a cohort of patients who need different approaches for conveying risk. REFERENCES 1. Jadav, S., Rajan, S. S., Abughosh, S., & Sansgiry, S. S. (2015). The Role of Socioeconomic Status and Health Care Access in Breast Cancer Screening Compliance Among Hispanics. Journal of Public Health Management and Practice, 21(5), 467–476. https://www.jstor.org/stable/48517175 2. American Cancer Society. (2017). Breast cancer facts & figures 2017-2018. Atlanta, GA: American Cancer Society, Inc. 3. ACS Breast Cancer Screening Guidelines. (2022, January 14). https://www.cancer.org/cancer/types/breast-cancer/screening-tests-and-early-detection/american-cancer-society-recommendations-for-the-early-detection-of-breast-cancer.htm Citation Format: Jhenitza P. Raygoza Tapia, Sarah M. Jenkins, Jennifer L. Ridgeway, Aaron D. Norman, Crystal R. Gonzalez, Valentina Hernandez, Bhavika K. Patel, Celine M. Vachon, Jessica D. Austin. Communicating breast cancer risk to Spanish-speaking Hispanic women [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr C126.

Mentorship of the next generation of One Health workers through experiential learning: A case of students of Makerere University

Abstract Multiple zoonotic disease outbreaks occurred in Uganda over the past two decades and have needed operationalization of the One Health (OH) Approach to respond effectively. Between 2016 and 2018, the African One Health University Network (AFROHUN) supported 61 students (25 females, 36 males) to join multisectoral and multidisciplinary government national and district task force disease response teams. The goal of joining these teams was to build and strengthen the students’ disease investigation and response skills in real time using a One Health approach. Qualitative methods were used to collect student and partner responses on their field experiences. The AFROHUN project identified the experiential knowledge and skills that the students gained. Student project reports were reviewed by the joint technical teams from the university and the national/district task forces. These included training materials and disease outbreak investigation and response reports. Partnerships and collaboration between the university One Health networks and the government enabled 35 graduate and 26 undergraduate students to receive joint mentorship from the national or district task force outbreak response teams. Most participants were from degree programs in Public Health, Epidemiology, Environmental Health, Veterinary, Wildlife Sciences, and Infectious Disease Management, while few students were from social sciences. Students were mentored in seven competency-based areas of disease management: (1) biorisk management, (2) community engagement and coordination, (3) epidemiology, (4) leadership, (5) outbreak investigation and response, (6) risk communication, and (7) surveillance. In conclusion, zoonotic outbreaks provided real-life learning opportunities for students in disease outbreak investigation and response using a multidisciplinary and multisectoral approach. The identified skills can be incorporated into educational materials such as curricula and present an ideal opportunity to build partnerships for workforce development. One Health impact statement The next generation of One Health workers, those capable of working across sectors and disciplines to improve the health of animals, humans, plants, and the environment, need soft and technical skills to guarantee optimal preparedness, prevention, and response to disease outbreaks and understand the animal to human transmission dynamics of disease. In countries where emerging, re-emerging, and endemic zoonoses and hemorrhagic fevers are prevalent, it is crucial to provide these real-life or experiential training opportunities for university students, working closely in multidisciplinary teams. The “real-time” joint mentorship by the government’s multidisciplinary and multisectoral outbreak response teams, during disease outbreaks, provides an opportunity to build and strengthen student skills in biorisk management, community engagement and coordination, epidemiology, leadership, outbreak investigation and response, risk communication, and surveillance.

생활숙박시설의 법적 쟁점에 관한 헌법적 연구

In Korea, a house is meaningful as a basic place in people's lives. People put all their effort into purchasing housing that is equivalent to food, clothing, and shelter. For that reason, in our country, the price of real estate, especially housing, fluctuates depending on people's needs over time. Korea has achieved economic development through industrialization, but with the urban concentration phenomenon and the rapid increase in urban housing demand, housing supply and demand has become an important national task.
 Economic development brought about changes in residential culture, giving rise to various housing types, with the emergence of single-family homes, townhouses, and apartment-type apartment complexes. However, as it could not cope with the overwhelming demand, officetel, a combination of an office and a hotel, which was popular abroad, was introduced. This officetel was also resolved after the Oran controversy by separating officetels for office use and residential use. Similar to this issue, controversy arose over residential lodging facilities, which are residential-type lodging facilities.
 Accommodation facilities are for people to stay for a short period of time, and there are various types. Among them, there are condos where you can stay for a while and cook, but most of them are short-term lodging facilities. Then, the form of residential accommodation emerged as a way to solve the problem of surplus accommodation and insufficient housing in cities. Living accommodation facilities, which began in the early 21st century, were initially used for long-term stays like officetels, with cooking facilities installed, and used for residential purposes.
 Living accommodation facilities are lodging facilities, but as people live there for a long period of time, they are used like houses, and their number gradually increases. However, because there was no legal basis, it spread indiscriminately, and from the public's perspective, it came to be perceived as purchasing housing at a low price. It was only in 2012 that living accommodation facilities gained their basis in the Enforcement Decree of the Public Sanitation Management Act. However, living accommodations were only a type of accommodation and not housing.
 Since the legal basis for living accommodation facilities is that only one type of accommodation facility is specified in the Enforcement Decree of the Public Health Management Act, there are no regulations regarding this, so in reality, they are continuously built and sold. Meanwhile, in 2020, the legal status of residential lodging facilities, a type of lodging facility, became an issue, and issues began to be raised about the fact that these facilities were being used for residential purposes rather than lodging facilities. As a result, it became a problem as it was regulated through a two-year transition provision.
 Living accommodation facilities are equivalent to housing for citizens who live there. This will not be resolved by postponing administrative dispositions for two years and an additional year without fundamentally resolving the issue. Rather than allowing people who purchased it for residential purposes to change its use to officetel, which is impossible, we need to find appropriate standards that fit the reality, guarantee property rights, and protect trust. Therefore, we need to actively work to guarantee the basic rights of people who are users of living accommodation facilities. There must be action.