Public health system

公共卫生系统
  • 文章类型: Case Reports
    在COVID-19大流行期间,公共卫生人员经历了从健康促进等核心职能的重新部署,疾病预防,和健康保护,预防和追踪COVID-19的传播。随着大流行的持续部署,以及大流行导致的现有健康差距加剧,公共卫生系统需要与COVID-19活动一起重新启动核心公共卫生规划的交付。本次范围界定审查的目的是确定支持核心公共卫生规划与正在进行的大流行或应急响应的重新整合的战略。
    乔安娜·布里格斯研究所的范围审查方法被用来指导这项研究。使用以下方式进行了全面搜索:a)在线数据库,b)灰色文献,c)内容专家确定额外的参考文献,和d)搜索相关研究的参考列表。所有参考文献均由两名团队成员筛选。包括符合以下标准的参考资料:a)涉及公共卫生组织(当地,区域,国家,和国际);b)提供了支持适应或实施常规公共卫生措施以及灾害应对的战略描述;c)定量,定性,或描述性设计。语言没有限制,发布状态,出版日期,或结果。有关研究特征的数据,干预/战略,关键发现由两名团队成员独立提取。紧急主题是由两名团队成员通过独立的归纳分析建立的。
    在确认的44,087条记录中,17项研究纳入审查。纳入研究的研究设计各不相同:描述性(n=8);定性(n=4);混合方法(n=2);横截面(n=1);病例报告(n=1);单组测试前/测试后设计(n=1)。纳入的研究来自北美(n=10),非洲(n=4),和亚洲(n=3),并解决了包括自然灾害在内的各种公共卫生灾难(n=9),传染病流行(n=5),武装冲突(n=2)和危险物质灾害(n=1)。确定了五个紧急主题,以支持核心公共卫生服务的重新整合:a)社区参与,b)社区评估,c)协作伙伴关系和协调,d)劳动力能力开发和分配,e)增加资金/资源。
    公共卫生组织可以将本研究的新主题用作对策略的初步理解,这些策略可以支持在COVID-19恢复中重新引入基本公共卫生服务和计划。
    During the COVID-19 pandemic, the public health workforce has experienced re-deployment from core functions such as health promotion, disease prevention, and health protection, to preventing and tracking the spread of COVID-19. With continued pandemic deployment coupled with the exacerbation of existing health disparities due to the pandemic, public health systems need to re-start the delivery of core public health programming alongside COVID-19 activities. The purpose of this scoping review was to identify strategies that support the re-integration of core public health programming alongside ongoing pandemic or emergency response.
    The Joanna Briggs Institute methodology for scoping reviews was used to guide this study. A comprehensive search was conducted using: a) online databases, b) grey literature, c) content experts to identify additional references, and d) searching reference lists of pertinent studies. All references were screened by two team members. References were included that met the following criteria: a) involved public health organizations (local, regional, national, and international); b) provided descriptions of strategies to support adaptation or delivery of routine public health measures alongside disaster response; and c) quantitative, qualitative, or descriptive designs. No restrictions were placed on language, publication status, publication date, or outcomes. Data on study characteristics, intervention/strategy, and key findings were independently extracted by two team members. Emergent themes were established through independent inductive analysis by two team members.
    Of 44,087 records identified, 17 studies were included in the review. Study designs of included studies varied: descriptive (n = 8); qualitative (n = 4); mixed-methods (n = 2); cross-sectional (n = 1); case report (n = 1); single-group pretest/post-test design (n = 1). Included studies were from North America (n = 10), Africa (n = 4), and Asia (n = 3) and addressed various public health disasters including natural disasters (n = 9), infectious disease epidemics (n = 5), armed conflict (n = 2) and hazardous material disasters (n = 1). Five emergent themes were identified on strategies to support the re-integration of core public health services: a) community engagement, b) community assessment, c) collaborative partnerships and coordination, d) workforce capacity development and allocation, and e) funding/resource enhancement.
    Emergent themes from this study can be used by public health organizations as a beginning understanding of strategies that can support the re-introduction of essential public health services and programs in COVID-19 recovery.
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  • 文章类型: Journal Article
    目前,巴西缺乏国家哮喘管理计划,每年因该病而住院近200,000人,每天约有5人死亡。本文的目的是分析巴西严重哮喘的当前问题,由于诊断和治疗的状况基本上是未知的,并提供可行的建议以引起迫在眉睫的行动。在为期多天的会议之前,向巴西重症哮喘领域的医学专家小组提供了一系列相关问题。在这次会议中,每个叙述都由整个小组讨论和编辑。通过多轮讨论取得了共识。为了克服哮喘治疗的障碍,该小组建议可在短期内实施的具体举措,以减轻巴西严重哮喘的负担.随着医疗保健成本的增加和全球资源的有限,有机会在其他国家实施这些建议,以实现充分的哮喘护理.严重哮喘是一种异质性和复杂性疾病,具有各种表型,需要严格注意诊断和管理。虽然这种疾病只影响一小部分哮喘患者,它给医疗保健系统带来了巨大的负担。因此,诊断的障碍,治疗,应尽快有效地克服管理。
    Currently, Brazil lacks a national asthma management program and is burdened with nearly 200,000 hospitalizations due to the disease per year and approximately 5 deaths per day. The purpose of this article was to analyze the current issues surrounding severe asthma in Brazil, as the status of diagnosis and treatment is largely unknown, and to provide feasible recommendations to elicit imminent action. A panel of Brazilian medical experts in the field of severe asthma was provided with a series of relevant questions to address prior to a multi-day conference. Within this conference, each narrative was discussed and edited by the entire group. Through numerous rounds of discussion consensus was achieved. In order to overcome barriers to adequate asthma treatment, this panel recommends specific initiatives that can be implemented in the short-term to decrease the burden of severe asthma in Brazil. With increasing healthcare costs and limited resources globally, there is an opportunity to implement these recommendations in other countries in order to achieve adequate asthma care. Severe asthma is a heterogeneous and complex disease with various phenotypes that requires strict attention for diagnosis and management. Although this disease affects only a small proportion of the population with asthma, it poses a great burden to healthcare systems. Thus, barriers to diagnosis, treatment, and management should be overcome as quickly and efficiently as possible.
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  • 文章类型: Journal Article
    This paper investigates the epidemiology and public health response of novel coronavirus infection (COVID-19) in the Nordic region. The data on cases and deaths due to COVID-19 were drawn from the European Centre for Disease Prevention and Control. The data on age- and sex-wise cases, deaths and intensive care unit (ICU) admissions, and public health interventions in the Nordic region through November 10, 2020, were obtained from respective countries\' health ministries. Sweden accounted for 60.59% of cases (162 240 of 267 768 cases) and 81% of deaths (6057 of 7477 cases) in the Nordic region. The incidence rate for the Nordic region was 989.59 per 100 000, varying from 327.30 per 100 000 in Finland to 1616.51 per 100 000 in Sweden, and the mortality rate for the region was 27.63 per 100 000, ranging from 5.3 per 100 000 in Norway to 60.35 per 100 000 in Sweden. The case-fatality ratio of the Nordic region was 2.79%. Females were more susceptible to COVID-19 infection than males (52.30% vs 47.66%), while males had a greater proportion of deaths (54.7%) and ICU need (71.99%) than females. It is imperative to continue with social distancing, mandatory masks, testing, prohibition of mass gatherings, isolation of confirmed cases, and preventing the importation of cases from other countries to avoid the further resurgence of cases.
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