Search results for: public health emergency

Authors: Juliet Sorensen, Megan Schliep

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Introduction: After a multidisciplinary assessment of health and human rights issues in central Mali, a musical album was created in 2014 in Douentza, Mali to provide health information on female genital mutilation/cutting (FGM/C), malaria, HIV/AIDS, girls’ education, breastfeeding, and sanitation. The objective of this study was to assess the impact of this album. Methods: A mixed-methods assessment was conducted with 149 individuals across 10 villages in Douentza Cercle. Analyses focused on the association of radio listening habits, age, sex, ethnicity and education with a public health knowledge score. Results: Over 90% of respondents reported daily radio listening, many listening five or more hours per day. Potential risks of FGM/C cited by participants included death (59%), difficulty in childbirth (48%), sterility (34%), and fistula (33%); when asked about their level of control over FGM/C, 28% stated they would never cut their daughters. Being a listener for 1-5 hours per day was associated with a 11.5% higher score of 'public health knowledge' compared to those listening only a little or not at all (p < 0.01). Education (marginal versus no formal education) was associated with 7.6% increased score (p < 0.01). Conclusion: Radio appears to be a significant part of community members’ daily routines and may be a valuable medium for transmitting information, particularly for lower literacy individuals.

Keywords: female genital cutting, public health and social justice education, radio, Mali

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Authors: Joseph Kimuli Balikuddembe

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Road traffic incidents (RTIs) continue to be a serious public health and development burden around the globe. Compared to high-income countries (HICs), the low and middle-income countries (LMICs) bear the heaviest brunt of RTIs. Like other LMICs, Uganda, a country located in Eastern Africa, has been experiencing a worryingly high burden of RTIs and their associated impacts. Over the years, the highest number of all the total registered RTIs in Uganda has taken place in the Greater Kampala Metropolitan Area (GKMA). This places a tremendous demand on the few existing emergency medical services (EMS) to adequately respond to those affected. In this regard, the overall objective of the study was to risk map RTIs in the GKMA so as to help in the better planning of EMS for the victims of RTIs. Other objectives included: (i) identifying the factors affecting the exposure, vulnerability and EMS capacity for the victims of RTIs; (ii) identifying the RTI prone-areas and estimating their associated risk factors; (iii) identifying the weaknesses and capacities which affect the EMS systems for RTIs; and (iv) determining the strategies and priority actions that can help to improve the EMS response for RTI victims in the GKMA. To achieve these objectives, a mixed methodological approach was used in four phrases for approximately 15 months. It employed a systematic review based on the preferred reporting items for systematic reviews and meta-data analysis guidelines; a Delphi panel technique; retrospective data analysis; and a cross-sectional method. With Uganda progressing forward as envisaged in its 'Vision 2040', the GKMA, which is the country’s political and socioeconomic epicenter, is experiencing significant changes in terms of population growth, urbanization, infrastructure development, rapid motorization and other factors. Unless appropriate actions are taken, these changes are likely to worsen the already alarming rate of RTIs in Uganda, and in turn also to put pressure on the few existing EMS and facilities to render care for those affected. Therefore, road safety vis-à-vis injury prevention measures, which are needed to reduce the burden of RTIs, should be multifaceted in nature so that they closely correlate with the ongoing dynamics that contribute to RTIs, particularly in the GKMA and Uganda as a whole.

Keywords: emergency medical services, Kampala, risk mapping, road traffic incidents

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Authors: Murat Iskender Aktaş, Sadi Ergin, Rasime Acar Aktaş

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In the light of fast-paced changes and developments in the health sector, the Ministry of Health started a new structuring with decree law numbered 663 within the scope of the Project of Transformation in Health. Accordingly, hospitals should ensure patient satisfaction through more efficient, more effective use of resources and sustainable finance by placing patients in the centre and should operate to increase efficiency to its maximum level while doing these. Within this study, in order to find out how efficient the hospitals were in terms of medical waste management between the years 2011-2014, the data from six hospitals of Amasya Public Hospitals Union were evaluated separately through Data Envelopment Analysis (DEA) method. First of all, input variables were determined. Input variables were the number of patients admitted to polyclinics, the number of inpatients in clinics, the number of patients who were operated and the number of patients who applied to the laboratory. Output variable was the cost of medical wastes in Turkish liras. Each hospital’s total medical waste level before and after public hospitals union; the amounts of average medical waste per patient admitted to polyclinics, per inpatient in clinics, per patient admitted to laboratory and per operated patient were compared within each group. In addition, average medical waste levels and costs were compared for Turkey in general and Europe in general. Paired samples t-test was used to find out whether the changes (increase-decrease) after public hospitals union were statistically significant. The health facilities that were unsuccessful in terms of medical waste management before and after public hospital union and the factors that caused this failure were determined. Based on the results, for each health facility that was ineffective in terms of medical waste management, the level of improvement required for each input was determined. The results of the study showed that there was an improvement in medical waste management applications after the health facilities became a member of public hospitals union; their medical waste levels were lower than the average of Turkey and Europe while the averages of cost of disposal were the highest.

Keywords: medical waste management, cost of medical waste, public hospitals, data envelopment analysis

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Authors: Mekroud Amel

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Emergency departments are known for the workload, the variety of pathologies and the difficulties in their management with the continuous influx of patients The role of our service in the management of patients with two or three mild to moderate organ failures, involving several disciplines at the same time, as well as the effect of this management on the skills and efficiency of our team has been demonstrated Borderline cases between two or three or even more disciplines, with instability of a vital function, which have been successfully managed in the emergency room, the therapeutic procedures adopted, the consequences on the quality and level of care delivered by our team, as well as that the logistical consequences, and the pedagogical consequences are demonstrated. The consequences found are Positive on the emergency teams, in rare situations are negative Regarding clinical situations, it is the entanglement of hemodynamic distress with right, left or global participation, tamponade, low flow with acute pulmonary edema, and/or state of shock With respiratory distress with more or less profound hypoxemia, with haematosis disorder related to a bacterial or viral lung infection, pleurisy, pneumothorax, bronchoconstrictive crisis. With neurological disorders such as recent stroke, comatose state, or others With metabolic disorders such as hyperkalaemia renal insufficiency severe ionic disorders with accidents with anti vitamin K With or without septate effusion of one or more serous membranes with or without tamponade It’s a Retrospective, monocentric, descriptive study Period 05.01.2022 to 10.31.2022 the purpose of our work: Search for a statistically significant link between the type of moderate to severe pathology managed in the emergency room whose problems are multivisceral on the efficiency of the healthcare team and its level of care and optional care offered for patients Statistical Test used: Chi2 test to prove the significant link between the resolution of serious multidisciplinary cases in the emergency room and the effectiveness of the team in the management of complicated cases Search for a statistically significant link : The management of the most difficult clinical cases for organ specialties has given general practitioner emergency teams a great perspective and has been able to improve their efficiency in the face of emergencies received

Keywords: emergency care teams, management of patients with dysfunction of more than one organ, learning curve, quality of care

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Authors: Savaş Durduran, Ceren Yağci

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The nature of the events going on in the world, when people’s lives are considered significantly affects natural disasters. Considering thousands of years of earth history, it is seen that many natural disasters, particularly earthquakes located in our country. Behaving cautious, without occurring hazards, after being disaster is much easier and cost effective than returning to the normal life. The four phases of disaster management in the whole world has been described as; pre-disaster preparedness and mitigation, post-disaster response and rehabilitation studies. Pre-disaster and post-disaster phases has half the weight of disaster management. How much would be prepared for disaster, no matter how disaster damage reducing work gives important, we will be less harm from material and spiritual sense. To do this in a systematic way we use the Geographic Information Systems (GIS). The execution of the emergency services to be on time and emergency control mechanism against the development the most appropriate decision Geographic Information System GIS) can be useful. The execution of the emergency services to be on time and emergency control mechanism towards for developing to be the most appropriate decision Geographic Information System (GIS) can be useful. The results obtained by using products with GIS analysis of seismic data to the city, manager of the city required information and data that can be more healthy and satisfies the appropriate policy decisions can be produced. In this study, using ArcGIS software and benefiting reports of the earthquake that occurred in the Konya city, spatial and non-spatial data consisting databases created, by the help of this database a potential disaster management aimed in the city of Konya regard to urban earthquake, GIS-aided analyzes were performed.

Keywords: geographic information systems (GIS), disaster management, emergency control mechanism, Konya

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Authors: S. P. Hewagama

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Different kinds of distressing events happen in the world causing a wide range of reactions and feelings. Psychological first aid (PFA) is humane supportive response for suffering. All health workers especially PHMs who play a major role as first responders in a disaster should be able to provide basic PFA effectively. Aim of this study was to assess the knowledge, attitudes and associated factors on the provision of PFA among PHMs during disasters. A descriptive cross-sectional study was carried out among 307 Public Health Midwives in Colombo RDHS area. In the study population, 86.6% (n=266) of the respondents were aware of the term “Psychological first aid” while 13.4% (n=41) were not aware. The total knowledge score was good in majority 85.4%(n=262) of the respondents while only 14.3%(n=45) had a poor knowledge on PFA. There was the statistically significant difference in relation to the level of education with the total knowledge score. Comprehensive desirable attitudes towards PFA was low (30.61%, n=94). According to the study, only a less than a quarter (21.82%, (n = 67)) of the study population had received training on PFA. More than half (56%, n=172) of the respondents had experience in responding to disasters. Conclusions and Recommendations: The overall knowledge and attitudes were found to be satisfactory. However, it is important to improve the knowledge level of the PHMs by providing training and workshops on PFA.

Keywords: disaster, humane supportive assistance, psychological first aid, public health midwives

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Authors: Hj Mohd Sidek bin Hj Mohd Yusof

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More than 1.5 billion people around the world are adversely affected by floods. Floods account for about a third of all natural catastrophes, cause more than half of all fatalities and are responsible for a third of overall economic loss around the world. Giving advanced warning of impending disasters can reduce or even avoid the number of deaths, social and economic hardships that are so commonly reported after the event. Integrated catchment management recognizes that it is not practical or viable to provide structural measures that will keep floodwater away from the community and their property. Non-structural measures are therefore required to assist the community to cope when flooding occurs which exceeds the capacity of the structural measures. Non-structural measures may need to be used to influence the way land is used or buildings are constructed, or they may be used to improve the community’s preparedness and response to flooding. The development and implementation of non-structural measures may be guided and encouraged by policy and legislation, or through voluntary action by the community based on knowledge gained from public education programs. There is a range of non-structural measures that can be used for flood hazard mitigation which can be the use measures includes policies and rules applied by government to regulate the kinds of activities that are carried out in various flood-prone areas, including minimum floor levels and the type of development approved. Voluntary actions taken by the authorities and by the community living and working on the flood plain to lessen flooding effects on themselves and their properties including monitoring land use changes, monitoring and investigating the effects of bush / forest clearing in the catchment and providing relevant flood related information to the community. Response modification measures may include: flood warning system, flood education, community awareness and readiness, evacuation arrangements and recovery plan. A Civil Defense Emergency Management needs to be established for Brunei Darussalam in order to plan, co-ordinate and undertake flood emergency management. This responsibility may be taken by the Ministry of Home Affairs, Brunei Darussalam who is already responsible for Fire Fighting and Rescue services. Several pieces of legislation and planning instruments are in place to assist flood management, particularly: flood warning system, flood education Community awareness and readiness, evacuation arrangements and recovery plan.

Keywords: RTB, radio television brunei, DDMC, district disaster management center, FIR, flood incidence report, PWD, public works department

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Authors: Muqadis Shazia Rajpar, Lawrence Mitelberg, Rubaiat S. Ahmed, Jemer Garrido, Rukhsana Hossain, Sergey M. Motov

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Distraction techniques have been used as a means to reduce pain, anxiety, and stress in various healthcare settings to facilitate care and make visits less unpleasant. Using virtual reality (VR) in the pediatric emergency setting can be a valuable, effective, and safe non-pharmacological alternative to the current standard of care for pain and anxiety management in pediatric patients. Our pilot study aimed to evaluate the effectiveness of a VR-based intervention as an alternative distraction modality to alleviate pain and anxiety associated with pediatric emergency department (ED) visits and acute pain conditions. The pilot study period was from November 16 to December 9, 2022, for pediatric ED visits for pain, anxiety, or both. Patients were selected based on a novel VR protocol to receive the VR intervention with the administration of pre and post-intervention surveys concerning pain/anxiety ratings and pain scores (Wong-Baker FACES/NRS). Descriptive statistics, paired t-test, and a Fisher Exact Test were used for data analysis, assuming a p-value of 0.05 for significance. A total of 33 patients (21 females, 12 males), ages 5-20 (M = 10.5, SD = 3.43) participated in this study – 12 patients had pain, 2 patients had anxiety, and 19 patients had both pain and anxiety. There was a statistically significant decrease in post-intervention pain scores of less than one point on the rating scale (6.48 vs. 5.62, p < .001). There was a statistically significant reduction in the percentage of patients suffering from “considerable” or “great” pain after the VR intervention (51.6% to 42.3%, p < .001). Similarly, we noticed an increase in the number of patients with “slight” or “moderate” pain post–VR intervention (48.4% to 57.7%, p < .001). Lastly, we demonstrated a decrease in anxiety among patients after utilizing VR (63.6% vs. 36.4%, p < .001). To conclude, VR can alleviate pain and anxiety in pediatric patients and be a useful non-pharmacological tool in the emergency setting.

Keywords: anxiety, emergency room, pain management, pediatric emergency medicine, virtual reality

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Authors: Xiyang Li, Qi Yu, Lun Zhang

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In the face of natural disasters and other emergency situations, determining the optimal location of rescue centers is crucial for improving rescue efficiency and minimizing impact on affected populations. This paper proposes a method that integrates genetic algorithms (GA) and backpropagation neural networks (BPNN) to address the site selection optimization problem for emergency rescue centers. We utilize BPNN to accurately estimate the cost of delivering supplies from rescue centers to each temporary camp. Moreover, a genetic algorithm with a special partially matched crossover (PMX) strategy is employed to ensure that the number of temporary camps assigned to each rescue center adheres to predetermined limits. Using the population distribution data during the 2022 epidemic in Jiading District, Shanghai, as an experimental case, this paper verifies the effectiveness of the proposed method. The experimental results demonstrate that the BPNN-GA method proposed in this study outperforms existing algorithms in terms of computational efficiency and optimization performance. Especially considering the requirements for computational resources and response time in emergency situations, the proposed method shows its ability to achieve rapid convergence and optimal performance in the early and mid-stages. Future research could explore incorporating more real-world conditions and variables into the model to further improve its accuracy and applicability.

Keywords: emergency rescue centers, genetic algorithms, back-propagation neural networks, site selection optimization

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Authors: Scott Ashby, Emily Granger, Mark Connellan

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Objectives: 1) To identify if emergency coronary angiography improves outcomes in studies examining OHCA from assumed cardiac aetiology? 2) If so, is it indicated in all patients resuscitated following OHCA, and if not, who is it indicated for? 3) How effective are investigations for screening for the appropriate patients? Background: Out-of-hospital cardiac arrest is one of the leading mechanisms of death, and the most common causative pathology is coronary artery disease. In-hospital treatment following resuscitation greatly affects outcomes, yet there is debate over the most effective protocol. Methods: A literature search was conducted over multiple databases to identify all relevant articles published from 2005. An inclusion criterion was applied to all publications retrieved, which were then sorted by type. Results: A total of 3 existing reviews and 29 clinical studies were analysed in this review. There were conflicting conclusions, however increased use of angiography has shown to improve outcomes in the majority of studies, which cover a variety of settings and cohorts. Recommendations: Currently, emergency coronary angiography appears to improve outcomes in all/most cases of OHCA of assumed cardiac aetiology, regardless of ECG findings. Until a better tool for screening is available to reduce unnecessary procedures, the benefits appear to outweigh the costs/risks.

Keywords: out of hospital cardiac arrest, coronary angiography, resuscitation, emergency medicine

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Authors: Po-Ching Wang

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Public art may be regarded as a social agenda. It is assumed that public art acts as an intermediate form that contributes significantly to community resurgence. That is, public art may be regarded as a verb/process or social intervention. It functions as a vanguard form, attacking boundaries and providing a sensibility for social strategy. Public art in tradition is generally expected to bring aesthetic pleasure to public. Contemporary public art, however, not only focuses on art installation, but it also often offers a process that aims to comment on, question, and challenge the socio-cultural status quo. During the last few decades, accelerated changes in the values and expectations brought to bear on varied urban issues, together with the destruction of the hegemony of traditional art and of museum authorities, has begun to contribute to freer and more democratic representations of public art. It is said that part of a public artwork’s role is to ruffle sacred feathers. In many cases, public art is created to address the dynamic social contradictions and mutability of public life; and artists and community participants approach public art from a variety of social critical perspectives and methodologies. Urban issues, such as social and environmental justice, health problems, violence, and political statements, provide plentiful source materials that fuel the performance of public art in many different settings. Further, public artworks have been extensively adopted to express social identity, make political statements, and/or to remedy social and environmental crises. Many murals on urban walls, for instance, reflect social conflicts and address civic rights, and these projects are usually the work of artists who though denied access to traditional gallery and museum channels are supported by community engagement and involvement. Public art as a social practice challenges the traditional western view of artistic practice. Art in the public realm creates a new media that provides a platform for a dialogical exchange between diverse social groups. It seems that public art has evolved as an arena for activism that addresses wide-ranging and highly controversial social issues and civilian concerns. The findings of this study indicate that public artworks are capable of playing a role of activist in facilitating community evolution via social progress.

Keywords: aesthetics, community regeneration, city development, publicness, public participation, social progress

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Authors: Bindhiya Thomas, Rehana Hafeez

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Background: The Surgical Ambulatory Unit (SAU) also known as the Same Day Emergency Care (SDEC) is an established part of many hospitals providing same day emergency care service to surgical patients who would have otherwise required admission through the A&E. Prior to Covid, the SAU was functioning as a 12-hour service, but during the Covid crisis this service was transformed to a 24 hour functioning Surgical Ambulatory Assessment unit (SAAU). We studied the effects that this change brought about in-patient care in our hospital. Objective: The objective of the study was to assess the impact of a 24-hour Surgical Ambulatory Assessment unit on patient care during the time of Covid, in particular its role in freeing A&E capacity and delivering effective patient care. Methods: We collected two sets of data retrospectively. The first set was collected over a 6-week period when the SAU was functioning at the Princess Royal University Hospital. On March 23rd, 2020, the SAU was transformed into a 24-hour SAAU. Following this transformation, a second set of patient data was collected over a period of 6 weeks. A comparison was made between data collected from when the hospital had a 12-hour Surgical Ambulatory unit and later when it was transformed into a 24-hour facility. Its effects on the change in the number of patients breaching the four hour waiting period and the number of emergency surgical admissions. Results: The 24-hour Surgical Ambulatory Assessment unit brought significant reductions in the number of patients breaching the waiting period of 4 hours in A&E from 44% during the period of the 12-hour Surgical Ambulatory care facility to 0% from when the 24-hour Surgical Ambulatory Assessment Unit was established. A 28% reduction was also seen in the number of surgical patients' admissions from A&E. Conclusions: The 24-hour SAAU was found to have a profound positive impact on emergency care of surgical patients. Especially during the Covid crisis, it played a crucial role in providing not only effective and accessible patient care but also in reducing the A&E workload and admissions. It thus proved to be a strategic tool that helped to deal with the immense workload in emergency care during the Covid crisis and helped free much needed headspace at a time of uncertainty for the A&E to better configure their services. If sustained, the 24-hour SAAU could be relied on to augment the NHS emergency services in the future, especially in the event of another crisis.

Keywords: Princess Royal University Hospital, surgical ambulatory assessment unit, surgical ambulatory unit, same day emergency care

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Authors: T. Mcgraw, F. N. Morin, N. Desai

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Background: Antimicrobial resistance is a critical issue in global health care and a significant contributor to increased patient morbidity and mortality. Suspected urinary tract infection (UTI) is a key area of inappropriate antibiotic prescription in pediatrics. Management patterns of infectious diseases have been shown to vary by provider type within a single setting. The aim of this study was to assess compliance with national UTI management guidelines by nurse practitioners in a pediatric emergency department (ED). Methods: This was a post-hoc analysis of a retrospective cohort study to review and evaluate visits to a tertiary care freestanding pediatric emergency department. Patients were included if they were 60 days to 36 months old and discharged with a diagnosis of UTI or ‘rule-out UTI’ between July 2015 and July 2020. Primary outcome measure was proportion of visits seen by Nurse Practitioners (NP) which were associated with national guideline compliance in the diagnosis and treatment of suspected UTI. We performed descriptive statistics and comparative analyses to determine differences in practice patterns between NPs, and physicians. Results: A total of 636 charts were reviewed, of which 402 patients met inclusion criteria. 17 patients were treated by NPs, 385 were treated by either Pediatric Emergency Medicine physicians (PEM) or non-PEM physicians. Overall, the proportion of infants receiving guideline-compliant care was 25.9% (21.8-30.4%). Of those who were prescribed antibiotics, 79.6% (74.7-83.8%) received first line guideline recommended therapy and 58.9% (53.8-63.8%) received fully compliant therapy with respect to age, dose, duration, and frequency. In patients treated by NPs, 16/17 (94%(95% CI:73.0-99.0)) required antibiotics, 15/16 (93%(95% CI: 71.7-98.9)) were treated with first line agent (cephalexin), 8/16 (50%(95% CI:28-72)) were guideline compliant of dose and duration. 5/8 (63%(95% CI:30.6-86.3)) were noncompliant for dose being too high. There was no difference in receiving guideline compliant empiric antibiotic therapy between physicians and nurse practitioners (OR: 0.837 CI: 0.302-2.69). Conclusion: In this post-hoc analysis, guideline noncompliance by nurse practitioners is common in children tested and treated for UTIs in a pediatric emergency department. Care by a Nurse Practitioner was not associated with greater rate of noncompliance than care by a Pediatric Emergency Medicine physician. Future appropriately powered studies may focus on confirming these results.

Keywords: antibiotic stewardship, infectious disease, nurse practitioner, urinary tract infection

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Authors: Jacqueline P. Davies

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Introduction: Student nurses must develop skills in observation, communication and reflection as well as public health knowledge from their first year of training. This paper will explain a method developed for students to collect their own findings about public health in urban areas. These areas are both rich in the history of old public health that informs the content of many traditional public health walks, but are also locations where new public health concerns about chronic disease are concentrated. The learning method explained in this paper enables students to collect their own data and write original work as first year students. Examples of their findings will be given. Methodology: In small groups, health care students are instructed to walk in neighbourhoods near to the hospitals they will soon attend as apprentice nurses. On their walks, they wander slowly, engage in conversations, and enter places open to the public. As they drift, they observe with all five senses in the real three dimensional world to collect data for their reflective accounts of old and new public health. They are encouraged to stop for refreshments and taste, as well as look, hear, smell, and touch while on their walk. They reflect as a group and later develop an individual reflective account in which they write up their deep reflections about what they observed on their walk. In preparation for their walk, they are encouraged to look at studies of quality of Life and other neighbourhood statistics as well as undertaking a risk assessment for their walk. Findings: Reflecting on their walks, students apply theoretical concepts around social determinants of health and health inequalities to develop their understanding of communities in the neighbourhoods visited. They write about the treasured historical architecture made of stone, bronze and marble which have outlived those who built them; but also how the streets are used now. The students develop their observations into thematic analyses such as: what we drink as illustrated by the empty coke can tossed into a now disused drinking fountain; the shift in home-life balance illustrated by streets where families once lived over the shop which are now walked by commuters weaving around each other as they talk on their mobile phones; and security on the street, with CCTV cameras placed at regular intervals, signs warning trespasses and barbed wire; but little evidence of local people watching the street. Conclusion: In evaluations of their first year, students have reported the health walk as one of their best experiences. The innovative approach was commended by the UK governing body of nurse education and it received a quality award from the nurse education funding body. This approach to education allows students to develop skills in the real world and write original work.

Keywords: education, innovation, nursing, urban

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Authors: Celine Delacroix

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Analyses of global emission scenarios demonstrate that slowing population growth could lead to substantial emissions reductions and play an important role to avoid dangerous climate change. For this reason, the advancement of individual reproductive rights might represent a valid climate change mitigation and adaptation option. With this focus, we reflected on population ethics and the ethical dilemmas associated with environmental degradation and climate change. We conducted a mixed-methods qualitative data study consisting of an online survey followed by in-depth interviews with stakeholders of the reproductive health and rights and environmental sustainability movements to capture the ways in which the linkages between family planning, population growth, and environmental sustainability are perceived by these actors. We found that the multi-layered marginalization of this issue resulted in two processes, the polarization of opinions and its eschewal from the public fora through population reductionism. Our results indicate that stakeholders of the reproductive rights and environmental sustainability movements find that population size and family planning influence environmental sustainability and overwhelmingly find that the reproductive health and rights ideological framework should be integrated in a wider sustainability frame reflecting environmental considerations. This position, whilst majoritarily shared by all participants, was more likely to be adopted by stakeholders of the environmental sustainability sector than those from the reproductive health and rights sector. We conclude that these processes, taken in the context of a context of a climate emergency, threaten to weaken the reproductive health and rights movement.

Keywords: environmental sustainability, family planning, population growth, population ethics, reproductive rights

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Authors: A. F. G. Van Woezik, L. M. A. Braakman-Jansen, O. A. Kulyk, J. E. W. C. Van Gemert-Pijnen

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Background: Zoonoses pose a serious threat to public health and economies worldwide, especially as antimicrobial resistance grows and newly emerging zoonoses can cause unpredictable outbreaks. In order to prevent and control emerging and re-emerging zoonoses, collaboration between veterinary, human health and public health domains is essential. In reality however, there is a lack of cooperation between these three disciplines and uncertainties exist about their tasks and responsibilities. The objective of this ongoing research project (ZonMw funded, 2014-2018) is to develop an online education and communication One Health platform, “eZoon”, for the general public and professionals working in veterinary, human health and public health domains to support the risk communication of non-alimentary zoonoses in the Netherlands. The main focus is on education and communication in times of outbreak as well as in daily non-outbreak situations. Methods: A participatory development approach was used in which stakeholders from veterinary, human health and public health domains participated. Key stakeholders were identified using business modeling techniques previously used for the design and implementation of antibiotic stewardship interventions and consisted of a literature scan, expert recommendations, and snowball sampling. We used a stakeholder salience approach to rank stakeholders according to their power, legitimacy, and urgency. Semi-structured interviews were conducted with stakeholders (N=20) from all three disciplines to identify current problems in risk communication and stakeholder values for the One Health platform. Interviews were transcribed verbatim and coded inductively by two researchers. Results: The following key values were identified (but were not limited to): (a) need for improved awareness of veterinary and human health of each other’s fields, (b) information exchange between veterinary and human health, in particularly at a regional level; (c) legal regulations need to match with daily practice; (d) professionals and general public need to be addressed separately using tailored language and information; (e) information needs to be of value to professionals (relevant, important, accurate, and have financial or other important consequences if ignored) in order to be picked up; and (f) need for accurate information from trustworthy, centrally organised sources to inform the general public. Conclusion: By applying a participatory development approach, we gained insights from multiple perspectives into the main problems of current risk communication strategies in the Netherlands and stakeholder values. Next, we will continue the iterative development of the One Health platform by presenting key values to stakeholders for validation and ranking, which will guide further development. We will develop a communication platform with a serious game in which professionals at the regional level will be trained in shared decision making in time-critical outbreak situations, a smart Question & Answer (Q&A) system for the general public tailored towards different user profiles, and social media to inform the general public adequately during outbreaks.

Keywords: ehealth, one health, risk communication, stakeholder, zoonosis

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Authors: K. Y. Chen, Y. N. Jia, H. Chua, C. W. Kan

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As the largest developing country in the world, China is now facing the problem arising from the environment. Thus, China government increases the environmental investment yearly. In this study, we will analyse the effect of the public environmental investment on the sustainable development in China. Firstly, we will review the current situation of China's environmental issue. Secondly, we will collect the yearly environmental data as well as the information of public environmental investment. Finally, we will use the collected data to analyse and project the SWOT of public environmental investment in China. Therefore, the aim of this paper is to provide the relationship between public environmental investment and sustainable development in China. Based on the data collected, it was revealed that the public environmental investment had a positive impact on the sustainable development in China as well as the GDP growth. Acknowledgment: Authors would like to thank the financial support from the Hong Kong Polytechnic University for this work.

Keywords: China, public environmental investment, sustainable development, analysis

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Authors: Jennifer E. Lynette

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The purpose of this study is to develop a nation-wide assessment tool to gauge the quality and efficiency of response activities by emergency personnel to fires in Denmark. Current fire incident reports lack detailed information that can lead to breakthroughs in research and improve emergency response efforts. Information generated from the report database is analyzed and assessed for efficiency and quality. By utilizing information collection gaps in the incident reports, an improved, indepth, and streamlined quality gauging system is developed for use by fire brigades. This study pinpoints previously unrecorded factors involved in the response phases of a fire. Variables are recorded and ranked based on their influence to event outcome. By assessing and measuring these data points, quality standards are developed. These quality standards include details of the response phase previously overlooked which individually and cumulatively impact the overall success of a fire response effort. Through the application of this tool and implementation of associated quality standards at Denmark’s fire brigades, there is potential to increase efficiency and quality in the preparedness and response phases, thereby saving additional lives, property, and resources.

Keywords: emergency management, fire, preparedness, quality standards, response

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Authors: Jorge Iván Bañol-Betancur, Lina María Martínez-Sánchez, María de los Ángeles Rodríguez-Gázquez, Estefanía Bahamonde-Olaya, Ana María Gutiérrez-Tamayo, Laura Isabel Jaramillo-Jaramillo, Camilo Ruiz-Mejía, Natalia Morales-Quintero

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Acute chest pain is a distressing sensation between the diaphragm and the base of the neck and it represents a diagnostic challenge for any physician in the emergency department. Objective: To establish the main clinical and epidemiological characteristics of patients who present with chest pain to the emergency department in a private clinic from the city of Medellin, during 2014-2015. Methods: Cross-sectional retrospective observational study. Population and sample were patients who consulted for chest pain in the emergency department who met the eligibility criteria. The information was analyzed in SPSS program vr.21; qualitative variables were described through relative frequencies, and the quantitative through mean and standard deviation ‬or medians according to their distribution in the study population. Results: A total of 231 patients were evaluated, the mean age was 49.5 ± 19.9 years, 56.7% were females. The most frequent pathological antecedents were hypertension 35.5%, diabetes 10,8%, dyslipidemia 10.4% and coronary disease 5.2%. Regarding pain features, in 40.3% of the patients the pain began abruptly, in 38.2% it had a precordial location, for 20% of the cases physical activity acted as a trigger, and 60.6% was oppressive. Costochondritis was the most common cause of chest pain among patients with an established etiologic diagnosis, representing the 18.2%. Conclusions: Although the clinical features of pain reported coincide with the clinical presentation of an acute coronary syndrome, the most common cause of chest pain in study population was costochondritis instead, indicating that it is a differential diagnostic in the approach of patients with pain acute chest.

Keywords: acute coronary syndrome, chest pain, epidemiology, osteochondritis

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Authors: Kanyapat U. Tapao

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The purpose of this study is to analyze the operation strategy strategies and public relations trend for public relations strategies development in public television station in Thailand. This study is a qualitative approach by indent interview from the 6 key informants that are managers of Voice TV and Thairath TV Channel. The results showed that both TV stations have to do research before making a release on the operation strategy policy such as a slogan, segmentation, integrated marketing communication and PR activity and also in term of Public Relations trend are including online media, online content and online training before opening the station and start promoting. By the way, we found the PR strategy for both TV station should be including application on mobile, online content, CRM activity, online banner, special event, and brand ambassador in order to bring a very reliable way.

Keywords: online banner, operation strategy, public relations trend, public relations strategies development

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Authors: Ali Obaid Alyami

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In Saudi Arabia, the pandemic of Coronavirus (COVID-19) has been affecting administrative contracts in many different ways. Lots of planned projects were stopped temporarily or implemented partially. Many contractors have suffered financial struggles and the absence of manpower. These administrative contracts are governed by Government Tenders and Procurement Law (GTPL) which was issued by a royal decree in 2019. This law addresses some challenges that could be stumbling blocks in the way of implementing a contract. One significant challenge is emergency circumstances that occur during the implementation of an administrative contract. The law provides some solutions for this disruption, but these solutions may not compensate for the whole damages that contractors suffer. This study will use the doctrinal methodology to analyze the rules of law and their application to the research problem. Most importantly, the issue that arises in this research is the possibility of governmental entities’ consideration, in administrative contracts, of the pandemic Coronavirus (COVID-19) as an emergency circumstance. This study points out the conditions for applying the theory of emergency circumstances on administrative contracts in addition to the definition of the theory and analyzing its elements. The other significant question is the limits on governmental entities to make a change in an administrative contract to achieve contractual rebalancing. GPTL and its implementing regulation set the conditions and limits of contractual rebalancing. However, this study finds that although GTPL provides rules for contractual rebalancing, there are some other mechanisms that contractors may take to fully compensate for the damages. For instance, when the loss cannot be minimized by GTPL, contractors might file lawsuits before the administrative judiciary. The study concludes that GTPL is a very comprehensive law system that stipulates specific rules for contractual rebalance and treats the emergency circumstances that obstruct the performance of administrative contracts.

Keywords: administrative contracts, emergency circumstances, balance of contract, administrative judiciary, government tenders, procurement law

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Authors: Armen Yezekyan

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The main purpose of this research is to comprehensively explore and identify the problems of attestation of the public servants and to propose solutions for these issues through deeply analyzing laws and the legal theoretical literature. For the detailed analysis of the above-mentioned problems we will use some research methods, the implementation of which has a goal to ensure the objectivity and clarity of scientific research and its results.

Keywords: attestation, attestation commission, competition commission, public servant, public service, testing

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Authors: Mohammed Seid, Aklilu Azazh, Fikre Enquselassie, Engida Yisma

Abstract:

Background: Road traffic injuries are the eighth leading cause of death globally, and the leading cause of death for young people. More than a million people die each year on the world’s roads, and the risk of dying as a result of a road traffic injury is highest in the Africa. Methods: A prospective hospital-based study was undertaken to assess injury characteristics and outcome of road traffic accident among victims at Adult Emergency Department of Tikur Anbesa specialized hospital, Addis Ababa, Ethiopia. A structured pre-tested questionnaire was used to gather the required data. The collected data were analyzed using SPSS version 16.0. Results: A total of 230 road traffic accident victims were studied. The majority of the study subjects were men 165 (71.7%) and the male/female ratio was 2.6:1. The victims’ ages ranged from 14 to 80 years with the mean and standard deviations of 32.15 and ± 14.38 years respectively. Daily laborers (95 (41.3%)) and students (28 (12.2%)) were the majority of road traffic accident victims. Long-distance travelling Minibus (16.5%) was responsible for the majority of road traffic crash followed by followed by Taxi (14.8%) and pedestrians (62.6%) accounted for the majority of road traffic accident. Head (50.4%) and musculoskeletal (extremities) (47.0%) were the most common body region injured. Fractures (78.0%) and open wounds (56.5%) were the most common type of injuries sustained. Treatment of fracture was the most common procedure performed in 57.7 % of the victims. The overall length of hospital stay (LOS) ranged from 1 day to 61 days with mean (± standard deviation) of 7.12 ± 10.5 days and the mortality rate was 7.4 %. A significant higher proportion of victims aged 14-55 years were had less likelihood of death compared to those victims aged more than 55 years of age [Adjusted OR = 0.1 (95% CI: 0.01, 0.82)]. Conclusions: This study showed diverse injury characteristics and high morbidity and mortality among the victims attending Adult Emergency Department of Tikur Anbesa specialized hospital, Addis Ababa, Ethiopia. The findings reflect that road traffic accident is a major public health problem. Urgent road traffic accident preventive measures and prompt treatment of the victims are warranted in order to reduce morbidity and mortality among the victims.

Keywords: road traffic accident, injury characteristics, outcome, Tikur Anbesa specialized hospital, Addis Ababa, Ethiopia

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Authors: S. Kurian, S. Satpathy, S. K. Gupta, S. Arya, D. K. Sharma

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Advances in the use of health care technology have resulted in increased adverse events (AEs) related to the use of medical devices. The study focused on the existing reporting systems. This study was conducted in a tertiary care public sector hospital. Devices included Syringe infusion pumps, Cardiac monitors, Pulse oximeters, Ventilators and Defibrillators. A total of 211 respondents were recruited. Interviews were held with 30 key informants. Medical records were scrutinized. Relevant statistical tests were used. Resident doctors reported maximum frequency of AEs, followed by nurses; and least by consultants. A significant association was found between the cadre of health care personnel and awareness that the patients and bystanders have a risk of sustaining AE. Awareness regarding reporting of AEs was low, and it was generally done verbally. Other critical findings are discussed in the light of the barriers to reporting, reasons for non-compliance, recording system, and so on.

Keywords: adverse events, health care technology, medical devices, public sector hospital, reporting systems

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Authors: W. Kongnoo, J. Loysongkroa, S. Chotivichien, N. Viriyautsahakul, N. Saiwongse

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Obesity, stunting and wasting problems among Thai school-aged children are increasing due to inappropriate food consumption behavior and poor environments for desirable nutritional behavior. Because of a low school lunch budget of only 0.40 USD per person per day, food quality is not up to nutritional standards. Therefore, the Health Department with the Education Ministry and the Thai Health Promotion Foundation have developed a quality school lunch project during 2009–2013. The program objectives were development and management of public policy to increase school lunch budget. The methods used a healthy public policy motivation process and movement in 241 local administrative organizations and 538 schools. The problem and solution research was organized to study school food and nutrition management, create a best practice policy mobilization model and hold a public hearing to motivate an increase of school meal funding. The results showed that local public policy has been motivated during 2009-2011 to increase school meal budget using local budgets. School children with best food consumption behavior and exercise increased from 13.2% in 2009 to 51.6% in 2013 and stunting decreased from 6.0% in 2009 to 4.7% in 2013. As the result of national policy motivation (2012-2013), the cabinet meeting on October 22, 2013 has approved an increase of school lunch budget from 0.40 USD to 0.62 USD per person per day. Thus, 5,800,469 school children nationwide have benefited from the budget increase.

Keywords: public policy, quality school lunch, Thailand, obesity

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Authors: Jansirani Natarajan, Mickael Antoinne Joseph

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The COVID-19 pandemic has interrupted face-to-face education and forced universities into an emergency remote teaching curriculum over a short duration. This abrupt transition in the Spring 2020 semester left both faculty and students without proper preparation for continuing higher education in an online environment. Online learning took place in different formats, including fully synchronous, fully asynchronous, and blended in our university through the e-learning platform MOODLE. Studies have shown that students’ engagement, is a critical factor for optimal online teaching. Very few studies have assessed online engagement with ERT during the COVID-19 pandemic. Purpose: Therefore, this study, sought to understand how the sudden transition to emergency remote teaching impacted nursing students’ engagement with online courses in a Middle Eastern public university. Method: A cross-sectional descriptive research design was adopted in this study. Data were collected through a self-reported online survey using Dixon’s online students’ engagement questionnaire from a sample of 177 nursing students after the ERT learning semester. Results The maximum possible engagement score was 95, and the maximum scores in the domains of skills engagement, emotional engagement, participation engagement, and performance engagement were 30, 25, 30, and 10 respectively. Dixson (2010) noted that a mean item score of ≥3.5 (total score of ≥66.5) represents a highly engaged student. The majority of the participants were females (71.8%) and 84.2% were regular BSN students. Most of them (32.2%) were second-year students and 52% had a CGPA between 2 and 3. Most participants (56.5%) had low engagement scores with ERT learning during the COVID lockdown. Among the four engagement domains, 78% had low engagement scores for the participation domain. There was no significant association found between the engagement and the demographic characteristics of the participants. Conclusion The findings supported the importance of engaging students in all four categories skill, emotional, performance, and participation. Based on the results, training sessions were organized for faculty on various strategies for engaging nursing students in all domains by using the facilities available in the MOODLE (online e-learning platform). It added value as a dashboard of information regarding ERT for the administrators and nurse educators to introduce numerous active learning strategies to improve the quality of teaching and learning of nursing students in the University.

Keywords: engagement, perception, emergency remote learning, COVID-19

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Authors: Vera Lúcia Raposo

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The right to health care – usually known as the right to health – is recognized in many national laws and Constitutions, as well as in international human rights documents. The kind of health care that citizens are entitled to receive, especially in the framework of the National Health Service, is usually identified with conventional medicine. However, since ancient times that a different form of medicine – alternative, traditional or nonconventional medicine – exists. In recent times it is attracting increasing interest, as it is demonstrated by the use of its specific knowledge either by pharmaceutical companies either by modern health technologies. Alternative medicine refers to a holistic approach to body and mind using herbal products, animal parts and minerals instead of technology and pharmaceutical drugs. These notes contributed to a sense of distrust towards it, accusing alternative medicine of being based on superstition and ignorance. However, and without denying that some particular practices lack indeed any kind of evidence or scientific grounds, the fact is that a substantial part of alternative medicine can actually produce satisfactory results. The paper will not advocate the substitution of conventional medicine by alternative medicine, but the complementation between the two and their specific knowledge. In terms of the right to health, as a fundamental right and a human right, this thesis leads to the implementation of a wider range of therapeutic choices for patients, who should be entitled to receive different forms of health care that complement one another, both in public and private health facilities. This scenario would demand a proper regulation for alternative medicine, which nowadays does not exist in most countries, but it is essential to protect patients and public health in general and to reinforce confidence in alternative medicine.

Keywords: alternative medicine, conventional medicine, patient’s rights, right to health

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Authors: Michele Romanello

Abstract:

COVID-19 has spread rapidly in Brazil since March 2020, making the country one of the most affected in the world by the pandemic. From an economic point of view, Brazil came from a pre-pandemic period characterized by low or negative growth, with a resulting increase in the number of unemployed and informal workers. This paper considers lockdown implementation in the situation of the large presence of informality in the economy. The objective of the paper is to analyze how the country has tried to help workers affected by economic crisis after the implementation of measures against COVID-19 and whether the emergency assistance from the government has been adequate to contain the increase of informal workers and unemployed. The methodology used in this paper is survival analysis. Through this methodology, the formality – informality, and informality – unemployment transitions are analyzed. This analysis draws data from the Continuous National Household Sample Survey (Continuous PNAD) and from the National Household Sample Survey COVID-19 (PNAD COVID-19) covering the period of January 2020 – July 2020. The results indicate that emergency aid has been not sufficient to reduce the transitions of workers from formal to informal jobs and from informal jobs to unemployment. Emergency aid has been not sufficient considering the previous situation of the country, with levels of poverty and inequality very high. In the next months, another fundamental determinant of the income trajectory in the context of the COVID-19 crisis will be the continuity of the emergency aid, especially considering the fiscal adjustment policy pursued by the government. Therefore, the current negative portrait may be even worse in the coming months.

Keywords: Brazil, COVID-19, informality, survival analysis

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Authors: Sangita Bharati

Abstract:

Violence against women is now well recognised as a public health problem and human rights violation of worldwide significance. It is an important risk factor for women's ill health, with far reaching consequences for both their physical and mental health. Gender based violence takes many forms and results in physical, sexual and psychological harm to the women throughout their lives. Gender based violence often manifests unequal power relation between men and women in society and the secondary status of the women because of which women have to suffer a range of health problems in silence. This paper will aim at describing a few problems related to women’s health which are directly linked to their experience as victims of gender based violence.

Keywords: violence, health, women, society

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Authors: K. W. A. M. Kokila, Matsui Kenichi

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Sri Lanka’s disaster management policy aims to protect lives and developments in disaster affected areas by effectively using resources for disaster risk reduction, emergency management, and community awareness. However, funding for these action programs has posed a serious challenge to the country’s economy. This paper examines the extent to which private-public partnerships (PPPs) can facilitate and expedite disaster management works. In particular, it discusses the results of the questionnaire survey among policymakers, government administrators, NGOs, and private businesses. This questionnaire was conducted in 2017. All respondents were selected based on their experience in PPP projects in the past. The survey focused on clarifying the effectiveness of past PPP projects as well as their efficiency and transparency. The respondents also provided their own opinions and suggestions to improve the future PPP projects in Sri Lanka. The questionnaire was distributed to fifteen persons. The results show that almost all respondents think that PPP projects are beneficial and important for future disaster risk management in Sri Lanka. The respondents, however, showed some reservation about effectiveness and transparency of the PPP process. This paper also discusses the results on the respondents’ perceptions about their capacity regarding human resources and management. This paper, overall, sheds light on technological, financial and human resource management practices in developed countries as well as policy and legislation provisions regarding PPP projects.

Keywords: disaster management, policy, private public partnership, projects

Procedia PDF Downloads 139