Public Health Management Research Articles

How Does Psychological Distance Influence Public Risky Behavior During Public Health Emergencies.

Public health emergencies not only threaten the physical and mental health of the public but also trigger a series of risky behaviors of the public, which in turn lead to the emergence or intensification of risk events, disrupting existing economic and social order. Based on construal level theory, cognitive appraisal theory of emotions and mood maintenance hypothesis, the study aims to investigate the collectively effect of risk perception and psychological insecurity in the connection between psychological distance and public risky behavior. Cross-sectional data was derived from 257 China urban residents. All participants finished the psychological distance scale, risk perception scale, psychological insecurity scale, and risky behavior scale. The research hypothesis was tested using the PROCESS macro. The direct impact of psychological distance on risky behavior was not significant (β=-0.018, p>0.05). The indirect impact of psychological distance on risky behavior was significant. In other words, the impact of psychological distance on risky behavior was serially mediated via risk perception and psychological insecurity (β=0.011, 95% CI= [0.0013, 0.025]). Risk perception and psychological insecurity play serial mediating roles in the relationship between psychological distance and public risky behavior. We conclude that during public health emergencies, public health managers should pay extra attention to the risk perception and psychological insecurity level of the public with closer psychological distance, take measures to reduce their risk perception, enhance their psychological security, and reduce their risky behavior, thereby ensuring the physical and mental health of the public and maintaining the stability of economic and social order.

Association of Nutritional Pattern with Sleeping Pattern among Malaysian University Students

Good nutrition is crucial for overall health and well-being as well as plays a vital role in supporting growth, development, and disease prevention. Meanwhile sleep is important for maintaining good physical health, cognitive function, emotional well-being, and overall quality of life. Nutritional intake and the sleep quality are believed to be associated with each other. According to National Sleep Foundation, eating habit can be crucial to the quality of sleep. University students are the population that may be at risk for poor sleep quality and unhealthy eating habits due to few factors including the academic pressure as the major factor. Most research focused on the link between diet and sleep quality has been focused on general adults or particular gender. As a result, there has been less research focused on the relationship between sleep and nutrition among young adults and university students in particular especially in Malaysia setting of culture. Thus, this study came out with the objective to determine the nutritional pattern, sleeping pattern and the association between each other among the students of Universiti Teknologi Mara (UiTM), Puncak Alam Campus. The quantitative research design was being used in conducting this study and there were 103 (n=103) of students across faculty in UiTM Puncak Alam Campus who participated as the respondents. The study used a set of questionnaires which include few items such as Chrononutrition Profile Questionnaire (CP-Q), Dutch Eating Behavior Questionnaire (DEBQ), Morningness-Eveningness Questionnaire (MEQ) and Pittsburgh Sleep Quality Index (PSQI) as the instrument. The instruments were included in a single link of Google Form and distributed online. The data obtained then being analyzed using Statistical Package for Social Science (SPSS) software. Throughout the frequency analysis, it has been found that majority of the students developed emotional eating habit and most of the students are intermediate type which mean do not strongly lean towards being either a morning type or an evening type. Hence, chi-square test between the eating behavior and the morningness-eveningness type show a significant association (chi square = 10.788, df = 4. Sig = .029) which mean, the nutritional pattern indeed influences the sleeping pattern. This findings on the association of nutritional patterns and sleeping patterns among Malaysian university students have across-the-board implications for students, educators, and government stakeholders in the context of higher education and public health management.

Comprehensive assessment of per and polyfluoroalkyl substances (PFAS) contamination in groundwater of Kamrup, Assam, India: occurrence, health risks, and metabolomic insights.

Per-and polyfluoroalkyl substances (PFAS) are synthetic chemicals that are known for their environmental persistence and adverse health effects. This study comprehensively assessed PFAS contamination in the Kamrup region of Assam, India, focusing on its presence in groundwater and associated health risks. The analysis detected 12 PFAS in groundwater samples from both the Kamrup Metro and Rural regions. In Kamrup Rural, Perfluorohexanoic acid (PFHxA), perfluorononanoic acid (PFNA), and perfluorooctanesulfonic acid (PFOS) were prevalent, whereas in Kamrup Metro, PFNA and PFOS were dominant, based on detection frequencies. These findings are noteworthy, as they demonstrate the widespread presence of PFAS in groundwater, a vital source of drinking water in the region. The assessment of PFAS health risks in India involved hazard quotient calculations for different age groups. Perfluorobutanesulfonic acid (PFBS) posed the highest risk, ranking children > boys > men > girls > women. Overall, ∑PFAS had low hazard (HQ: 0.27-0.41). Further, this study assessed PFBS and PFOS toxicity in human kidney epithelial cell lines (HEK293T) cells, revealing that PFBS was more cytotoxic than PFOS. The study examined the metabolomics of HEK293T cells after PFBS exposure, revealing significant alterations in lipid metabolism, particularly glycerophospholipids, potentially affecting cellular function and health. These findings underscore the importance of monitoring PFAS contamination in drinking water sources, especially in regions such as Kamrup, where groundwater is a primary source. Our metabolomics results show significant health effects at the cellular level, raising concerns about the impact of PFAS exposure on human health. This study highlights PFAS contamination in Kamrup, Assam's groundwater and its health risks, providing valuable insights for policymakers and public health management.

Measuring Efficiency and Effectiveness in Public Health Management: Methodologies and Applications

Measuring Efficiency and Effectiveness in Public Health Management: Methodologies and Applications

Utilization of Information Technology in Public Health Management: Trends and Challenges

Utilization of Information Technology in Public Health Management: Trends and Challenges

A Freidsonian Analysis of The Professional trajectories of Public Health Nursing Specialists in Minas Gerais, Brazil, 1988-1992.

To analyze the contributions of the Public Health Nursing Specialization Course (1988-1992) of Universidade Federal de Minas Gerais in improving the expertise and professional status of its graduates. Historical and social study in the history of nursing and expertise. The sources included 20 registration forms, enrollment documentation of graduates, and three course documents collected in the Memory Center of Escola de Enfermagem da Universidade Federal de Minas Gerais, combined with Lattes/CNPq curricula and analyzed through Eliot Freidson's Sociology of Professions. The specialists were selected through a strategy of construction of knowledge for socio-sanitary transformation. The specialization provided support for the professional career of graduates in administrative leadership, management, and visibility positions in public health; the group's profile was focused on academia, which creates its own knowledge. The specialization provided its graduates the opportunity to exercise professional autonomy, elevating the state of affairs and contributing to the professionalization of public health nursing.

Emergency awareness in Italy: The State of Art in Public Health Postgraduate Schools

Abstract Objective Italy frequently experiences major events like earthquakes, floods and migrant shipwrecks. Global concerns include climate change, pandemics and wars. We would assess the role of public health experts and the current state of Italian post-degree Public Health schools towards these challenges. Methods A cross-sectional online survey was conducted in Italy in June 2023, among all Italian Public Health residents enrolled in SItI. The study investigated the presence of trainings and updates about emergencies. It also explored interest and importance of topic, impact of Covid-19 pandemic and sources of information. Results Out of 289 respondents, 86.2% deemed the topic important and 74.4% expressed interest (both p<0.001). 90.1% pointed out the lack of dedicated courses and 93.1% as for specialized master’s programs (both p<0.001). Perceived importance in the topic correlates with the desire to attend dedicated conferences (p<0.001). For COVID-19, 24.6% recognized the importance of topic pre-pandemic, while 50.9% raised awareness during (both p<0.001). Conclusions A discussion is needed for enhanced training programs in public health emergency prevention and management across Italy, pledging for uniformity within different training networks. In this way, a more robust response to future emergencies may be ensured.

Formation, history of heritage and present of the Department of Social Medicine, Public Health and Health Care Management of the Dnipro State Medical University

Formation, history of heritage and present of the Department of Social Medicine, Public Health and Health Care Management of the Dnipro State Medical University

Analysis of Dengue and SARS‐CoV‐2 Coinfection in a Tertiary Care Hospital: A Retrospective Study

Introduction. Coinfection of dengue virus and SARS‐CoV‐2 infections in dengue‐endemic areas is a significant public health concern. Coinfections can result in severe illness. Hence, this study determines the incidence of dengue and COVID‐19 coinfection for a better understanding of the clinical presentation, laboratory parameters, and outcomes including mortality. Methods. The patients admitted to two tertiary hospitals with RT PCR‐proven COVID‐19 infection and dengue positive by NS1 rapid antigen or IgM dengue ELISA for two years between January 2020 and December 2022 were considered. Clinical data were retrieved from medical records including the laboratory findings and outcomes of these patients. The categorical data were analyzed in the form of frequency and proportion. The quantitative data were analyzed in the form of mean, median, and proportion. Results. Out of 2301 confirmed dengue samples and 3718 confirmed COVID‐19 samples, there were 14 cases of coinfection with the presence of COVID‐19 and dengue infection at the same time. ICU admission of 14.2% and mean hospital stay of 7 days were noted. Mainly the symptoms reported were fever at 92.9%, myalgia at 35.7%, and headache, vomiting, and cough at 28.6%. The laboratory findings were elevated lactate dehydrogenase and C‐reactive protein in 100% of patients, elevated ferritin in 92.9%, thrombocytopenia in 71.4%, elevated AST and ALT in 71.4%, and elevated D‐dimer in 57.1% of patients. There was no effect on morbidity and mortality seen among coinfection. Conclusion. COVID‐19 and dengue share similar clinical features and laboratory findings. Diagnosis of one disease cannot rule out the presence of other infections. There might be chances of misdiagnosis or missed diagnosis. Hence, it is important to stress about early detection using specific methods and confirmation of disease with timely management, as it is a potentially new dimension for public health concern and management.

Cholera detection system using CNN machine learning algorithm

A comprehensive cholera detection system leveraging cutting-edge technologies such as neural networks, machine learning, chatbots, live maps, and real-time statistical graphs is proposed. The system integrates a user-friendly chatbot interface to interact with individuals, prompting them to input relevant health information and symptoms. Behind the scenes, neural networks and machine learning algorithms analyze the data to detect potential cholera cases, offering users instant insights into their health status. The system incorporates live maps to track reported cases geographically, enabling a swift response from health authorities. Moreover, real-time statistical graphs provide dynamic visualizations of cholera trends, aiding in the identification of potential outbreak hotspots. By amalgamating these technologies, the cholera detection system not only facilitates early diagnosis and intervention but also enhances public health monitoring and management, contributing to the overall control and prevention of cholera outbreaks.

Lead exposure sources and public health investigations for children with elevated blood lead in England, 2014 to 2022.

Lead exposure at any concentration can adversely impact health, with children being more vulnerable to its effects. In England, children with an elevated blood lead concentration (BLC) are reported to Health Protection Teams (HPTs) for public health investigation. A detailed review of these cases has not yet been conducted. The objectives of this study were to describe the demographics, likely setting and sources of lead exposure, risk behaviours, public health investigations and outcomes for children aged <16 years with a BLC requiring public health action reported to HPTs between 2014-2022 in England. Data were collected via a lookback questionnaire and a live enhanced surveillance questionnaire. Data were deduplicated, cleaned and results summarised as numbers and percentages using R studio. A thematic analysis was conducted on qualitative responses to a question relating to problems experienced during case investigation. There were 340 cases in our study: the majority were aged 1-4 years old (53%) and male (69%). Ethnicity data was poorly recorded. A higher than expected proportion (31%) lived in the most deprived areas. Pica (76%) and learning difficulties (60%) were often present. Cases were primarily exposed to lead in the domestic setting (92%) with paint (43%) and soil (29%) the most common exposures. Most cases lived in rented accommodation (63%), with a higher proportion in social rentals (48%) than privately rented (37%). Case investigations were resource intensive and poor stakeholder engagement/response was most frequently identified as challenging by HPTs. Lead exposure is harmful to children and requires public health and clinical management, which can be complex and challenging. Prevention of lead exposure in children should be the focus of intervention efforts. Outreach, engagement and preventative work should focus on both renters and homeowners. Collecting ethnicity data consistently may enable identification of more specific groups at increased risk of lead exposure in England.

Reported Adverse Events and Associated Factors in Korean Coronavirus Disease 2019 Vaccinations.

Despite their effectiveness, coronavirus disease 2019 (COVID-19) vaccines have been associated with adverse effects, underscoring the importance of continuous surveillance to ensure vaccine safety and effective management of public health. Herein, the characteristics and risk factors of vaccine-related adverse events (AEs) were identified to gain an in-depth understanding of vaccine safety by investigating the impact of the vaccination dose on changes in post-vaccination AEs. Herein, a linked database of COVID-19 vaccination records from the Korea Disease Control and Prevention Agency, AE reports from the COVID-19 Vaccination Management System, and healthcare claims from the National Health Insurance Service, targeting ≥ 5-year-old individuals, was utilized (study duration = February 26, 2021, to January 31, 2023). The frequency and severity of reported post-vaccination AEs were evaluated. Furthermore, we specifically explored AEs in relation to the cumulative dosage of vaccines administered while evaluating associated risk factors. During the observation period, 42,804,523 individuals completed the COVID-19 vaccination series, with 365,900 reporting AEs, with headache, muscle pain, and fever being the most frequently reported. Notably, the AE reports were approximately twice as high for women than for men, which was further exacerbated following both doses. Analysis by age group revealed that AE reports were lower among children, adolescents, and older adults than in the middle-aged cohort (age = 50-64 years), with higher reports observed for 18-49-year-old individuals. Additionally, a higher risk of reporting was identified among individuals with lower socioeconomic status compared with those of middle socioeconomic status. Excluding dementia, the risk of reporting AEs was high in individuals with underlying diseases compared with those without, for instance, the risk of reporting AEs following two-dose vaccinations was approximately twice as high in individuals with chronic obstructive pulmonary disease and asthma. These findings indicate that women, younger people, those with a lower socioeconomic status, and those with underlying health conditions reported a higher incidence of AEs following COVID-19 vaccinations. This emphasizes the need for continued monitoring to ensure safe vaccination and address vaccine-related anxiety and fear, especially within the aforementioned groups.

КОНЦЕПТУАЛЬНЫЕ ОСНОВЫ ОПРЕДЕЛЕНИЯ ДЕТЕРМИНАНТ ОБЩЕСТВЕННОГО ЗДОРОВЬЯ

Significance. Public health is defined as a medical and social resource that ensures national security and potential for socio-economic development of the country. The possibilities of state management of public health as a medical and social resource are limited by the lack of methodology for assessing determinants that affect it. The presented study outlines the conceptual framework for defining determinants of public health from the standpoint of the risk-based approach to its protection, as well as its components of labor, military, reproductive, and reserve resources. Developing a concept of public health management serves as a theoretical justification of public policy measures to develop strategies to control the risks of reducing the quality of public health. The purpose of the study is to develop a conceptual framework for defining determinants of public health. Material and methods. When developing the conceptual framework, the provisions of the following standards have been used: GOST R ISO 31000-2019 standard “Risk management. principles and guidelines”, WHO standard “The urban health index”, GOST R ISO/TS 21667-2009 standard “Health informatics. A conceptual model of health indicators”, as well as “Glossary of health promotion terms”, 2021 by the World Health Organization. The study presents the procedure for identifying risk factors, differentiating them by types of determinants and controlling the risks for the loss of public health under the influence of these determinants. Factors can be identified based on expert assessments, as well as confirmed statistical significance of the factors. Results. The possibilities of public health management are limited by the lack of a comprehensive methodology for measuring determinants of public health. The authors evaluate a set of determinants of public health, including social, biological, behavioral, medical, and environmental determinants. The article has developed a four-stage model for identifying factors that contribute to public health strengthening and risk factors for the loss of public health. A set of unique factors should be identified for each determinant of public health. Conclusion. The developed conceptual framework for defining determinants of public health is focused on the fact that the determinants of public health should be correlated with the components of public health as a medical and social resource that ensures attainment of the strategically important national security goals: national defense capability, viability, reproduction, and protection of society. It is necessary to consider territorial differences in the set of risk factors associated with the causes of loss of public health, as well as changes in their significance depending on the state of determinants, the period of society's life, including the period of pre-crisis, crisis and sustainable development. Scope of application. The determinants of public health should be considered as a methodological basis for the development of strategies to improve public health in the interests of the national security. Developing a list of public health risk factors and a list of factors contributing to its growth plays an essential role in improving effectiveness of strategic planning tools for this resource.

One Health in practice: Benefits and challenges of multisectoral coordination and collaboration in managing public health risks: A meta-analysis

Background and Aim: One Health (OH) approach is crucial for the effective management of emerging and re-emerging infectious diseases and other public health threats. A meta-analysis was conducted to explore the benefits and challenges encountered in the practical implementation of multisectoral coordination in the fight against public health threats and to identify similarities between countries in the practical implementation of multisectoral coordination and cooperation across sectors in OH. Materials and Methods: To identify relevant studies published globally between 2010 and 2023, a literature search was conducted online using Google Scholar and PubMed search engines. Inclusion criteria were adopted based on key search terms “One Health,” “multisectoral coordination,” “One Health framework,” and related terms “multisectoral collaboration” and “multidisciplinary.” Unpublished manuscripts, dissertations, and conference reports were excluded from the review. A total of 307 articles were retrieved. Titles, abstracts, and keywords were screened for inclusion criteria. We extracted and analyzed 46 full-text articles published in English. Unpublished manuscripts, dissertations, and conference reports were excluded from the study. Results: This study found that most countries have similar challenges that hamper the coordination of OH activities implementation. Of the 46 articles reviewed, 69.6% (n = 32) focused on the benefits of adopting the OH approach and 73.9% (n = 34) focused on multisectoral coordination and collaboration among sectors. In addition, 58.7% (n = 27) of the articles indicated that governments need to invest more resources in OH implementation, and 50% (n = 23) proposed that policies, guidelines, and plans should be integrated to facilitate multisectoral coordination and collaboration. In addition to inadequate coordination and funding, other reported challenges were limited knowledge (34.8%) (n = 16) and inadequate resources (32.6%) (n = 15). In addition, 21.7% (n = 10) highlighted different sectoral priorities and interests as obstacles to effective coordination in the implementation of OH activities. Conclusion: Multisectoral coordination plays a key role in the effective management of public health threats through OH. The creation of mechanisms for regular communication, the promotion of mutual trust, and the strengthening of relations between sectors will enhance cooperation. The similarity in challenges across regions observed in this study calls for countries across regions to prioritize OH operationalization and collaboration among sectors, strengthen collaboration, and synergize activities to enhance future changes in the mitigation of public health threats. Keywords: multisectoral collaboration and multidisciplinary, multisectoral coordination, One Health, One Health framework.

Strategic management of public health

Public health is a priority area of socio-economic development of the country. The aim of the study is to develop a model of strategic management of public health to provide accessible, quality and effective services for the protection and strengthening of health, the prevention of diseases and the extension of life expectancy of citizens of the Kyrgyz Republic. The results of the study confirm that healthcare system is still underfunded, resulting in inefficient operation, outdated infrastructure, and a shortage of staff. As a result, the current healthcare system cannot cope with modern challenges. The growth of the country's population, the trend of population aging, the increased impact of risk factors, high mortality and incidence of non-communicable diseases. In view of the above, the Concept «Strategic Management of Public Health» has been developed, based on the recommendation of WHO, which contain an integrated approach at the national level to address the priority tasks in the field of public health.

Building Stronger Health Systems: The Role of Leadership Training-Insights from International Public Health Management Development Program (IPHMDP).

Building Stronger Health Systems: The Role of Leadership Training-Insights from International Public Health Management Development Program (IPHMDP).

Mapping essential competencies: knowledge, skills and attitudes for public health management

RESUMO Trata-se de estudo de corte transversal, com abordagem quantitativa do tipo exploratório descritivo que teve como objetivo mapear as competências essenciais em saúde pública de profissionais que atuam na gestão de uma secretaria de estado da saúde. A coleta de dados ocorreu de modo on-line, por meio de um questionário. Os dados foram analisados descritivamente, e as competências avaliadas de acordo com seis domínios do Marco Regional de Competências Essenciais em Saúde Pública e o Grau de Expressão de Competências no Trabalho. Participaram do estudo 119 profissionais, com predomínio do sexo feminino (70,6%) e idade média de 46,7 anos. O Domínio 1 - Análise de Situação de Saúde - apresentou o maior Grau de Expressão de Competências no Trabalho; e o Domínio 6 - Saúde Internacional e Global - obteve o menor valor. Houve relação significativa entre as variáveis estudadas e a escolaridade, evidenciando que níveis mais baixos de escolaridade estão associados a menores escores de competência nos seis domínios analisados. Conclui-se que desenvolver competências é um desafio na gestão pública devido às suas especificidades. Nesse contexto, o mapeamento de competências desempenha um papel fundamental para que ações de Educação Permanente em Saúde sejam planejadas e implementadas de forma assertiva.

Mpox in UK households: estimating secondary attack rates and factors associated with transmission, May-November 2022.

We aimed to estimate the secondary attack rate of mpox among UK household contacts and determine factors associated with transmission to inform public health management of contacts, during the global outbreak in 2022. Information was collected via NHS and public health services and included age, gender, place of residence, setting, and type of contact. Aggregate information was summarized for the UK. Record level data was combined for England, Wales and Northern Ireland, and multivariable logistic regression was used to determine factors associated with transmission. The secondary attack rate among UK household mpox contacts was 4% (60/1526). Sexual contact with the index case was associated with a 11-fold increase in adjusted odds of becoming a case in England, Wales, and Northern Ireland (95% CI 5.5-22, p < 0.001). Household contacts outside of London had increased odds compared to London residents (adjusted OR 2.9, 95%CI 1.6-5.4, p < 0.001), while female contacts had reduced odds of becoming a case (aOR: 0.41, 95% CI: 0.15-0.95). We found a low overall secondary attack rate among household mpox contacts with strong evidence of increased transmission risk associated with sexual contact. This evidence will inform the risk assessment of contacts and support prioritization of those with close intimate contact for follow up.

Explosive Behavior in COVID-19 and Policy Responses: Lessons Learned for Public Health Management

Since the first case of COVID-19 in Turkey, there has been a lingering question as elsewhere in the world: “When will or should the government impose severe restrictions to protect public health?” From a public health perspective, there is value in developing a model to support proactive implementation of social policies. This study aimed to show the benefits of using a novel econometric test (the Generalized Supremum Augmented Dickey-Fuller Test) to detect explosive behavior (bubbles) in Turkey’s daily COVID-19 cases and deaths. Results from the analysis demonstrated a link between identified explosive episodes and critical public health decisions, especially in the case of daily new deaths. They also showed a negative relationship between the formation of exuberant behavior during the pandemic and the vaccination rate. Public health policymakers can incorporate this method into their arsenal to evaluate the overall health situation in combating the pandemic and respond accordingly. Furthermore, among the lessons learned from the Turkish experience is the importance of having a coronavirus scientific advisory board in the decision-making process and the ability to promptly implement policy measures. JEL Codes: C22, C58, I10, I18

Public Health Management for Maternal Mortality Reduction in Smart Cities

Public Health Management for Maternal Mortality Reduction in Smart Cities