Enlightenment from the COVID-19 Pandemic:The Roles of Environmental Factors in Future Public Health Emergency Response

The coronavirus disease 2019(COVID-19)pandemic is challenging the current public health emergency response systems(PHERSs)of many countries.Although environmental factors,such as those influencing the survival of viruses and their transmission between species including humans,play important roles in PHERSs,little attention has been given to these factors.This study describes and elucidates the roles of environmental factors in future PHERSs.To improve countries’capability to respond to public health emergencies associated with viral infections such as the COVID-19 pandemic,a number of environmental factors should be considered before,during,and after the responses to such emergencies.More specifically,to prevent pandemic outbreaks,we should strengthen environmental and wildlife protection,conduct detailed viral surveillance in animals and hotspots,and improve early-warning systems.During the pandemic,we must study the impacts of environmental factors on viral behaviors,develop control measures to minimize secondary environmental risks,and conduct timely assessments of viral risks and secondary environmental effects with a view to reducing the impacts of the pandemic on human health and on ecosystems.After the pandemic,we should further strengthen surveillance for viruses and the prevention of viral spread,maintain control measures for minimizing secondary environmental risks,develop our capability to scientifically predict pandemics and resurgences,and prepare for the next unexpected resurgence.Meanwhile,we should restore the normal life and production of the public based on the“One Health”concept,that views global human and environmental health as inextricably linked.Our recommendations are essential for improving nations’capability to respond to global public health emergencies.

Dilemma of healthcare reform and invention of new discipline of health fiscalogy

Background:China's Reform and Open up Policy in 1980s has brought rapid economic development to Chinese society.With the deepening of economic reform,the withdrawal of the state in China has had visible and worrisome consequences for health and for the functioning of health services.The new round of healthcare reform after 2009 has made significant achievements on improving fundamental health and bringing back the nature of welfare of health.However,the financing mechanism of health system has not been established,and the underlying reason behind the healthcare reform dilemma and the theoretical solution need to be found.Methods:This study used the methods of literature review,theoretical research and comparative research to summarize and analyze the reasons and solutions of current dilemma in healthcare reform,and created the new discipline of health fiscalogy through theoretical analysis and vertical and horizontal comparison of healthcare system,especially health financing.Results:Dilemma in healthcare system emerged from the circumstances of rapid process of industrialization,urbanization and population aging,including the profit-driven phenomena,tendency of excessive marketization in public hospitals,strained doctor-patient relationship,high disease burden on individuals and families,and so on.It can be concluded that the theoretical basis of healthcare system and the nature of health resources are crucial in solving the dilemma of healthcare reform.The theoretical basis of healthcare reform should be health fiscalogy focusing on government as the main body of health care responsibility rather than health economics focusing on anti-monopoly.There are two key differences between health economics and health fiscalogy:responsible person/department of disease and health welfare,and nature of resource.The new discipline of health fiscalogy has universal and important implications on both China’s healthcare reform and the healthcare reform in the world.Conclusions:China’s healthcare reform should return from the paradigm of health economics and marketization financing model to the paradigm of health fiscalogy and government-led financing model,which is reflected in the main position of government and social welfare.

Participatory approach to design social accountability interventions to improve maternal health services:a case study from the Democratic Republic of the Congo

Background:Social accountability(SA)comprises a set of mechanisms aiming to,on the one hand,enable users to raise their concerns about the health services provided to them(voice),and to hold health providers(HPs)accountable for actions and decisions related to the health service provision.On the other hand,they aim to facilitate HPs to take into account users’needs and expectations in providing care.This article describes the development of a SA intervention that aims to improve health services responsiveness in two health zones in the Democratic Republic of the Congo.Methods:Beneficiaries including men,women,community health workers(CHWs),representatives of the health sector and local authorities were purposively selected and involved in an advisory process using the Dialogue Model in the two health zones:(1)Eight focus group discussions(FGDs)were organized separately during consultation aimed at sharing and discussing results from the situation analysis,and collecting suggestions for improvement,(2)Representatives of participants in previous FGDs were involved in dialogue meetings for prioritizing and integrating suggestions from FGDs,and(3)the integrated suggestions were discussed by research partners and set as intervention components.All the processes were audio-taped,transcribed and analysed using inductive content analysis.Results:Overall there were 121 participants involved in the process,51 were female.They provided 48 suggestions.Their suggestions were integrated into six intervention components during dialogue meetings:(1)use CHWs and a health committee for collecting and transmitting community concerns about health services,(2)build the capacity of the community in terms of knowledge and information,(3)involve community leaders through dialogue meetings,(4)improve the attitude of HPs towards voice and the management of voice at health facility level,(5)involve the health service supervisors in community participation and;(6)use other existing interventions.These components were then articulated into three intervention components during programming to:create a formal voice system,introduce dialogue meetings improving enforceability and answerability,and enhance the health providers’responsiveness.Conclusions:The use of the Dialogue Model,a participatory process,allowed beneficiaries to be involved with other community stakeholders having different perspectives and types of knowledge in an advisory process and to articulate their suggestions on a combination of SA intervention components,specific for the two health zones contexts.

Finite element model validation of bridge based on structural health monitoring——Part I: Response surface-based finite element model updating

In the engineering practice, merging statistical analysis into structural evaluation and assessment is a tendency in the future. As a combination of mathematical and statistical techniques, response surface （RS） methodology has been successfully applied to design optimization, response prediction and model validation. With the aid of RS methodology, these two serial papers present a finite element （FE） model updating and validation method for bridge structures based on structural health monitoring. The key issues to implement such a model updating are discussed in this paper, such as design of experiment, parameter screening, construction of high-order polynomial response surface model, optimization methods and precision inspection of RS model. The proposed procedure is illustrated by a prestressed concrete continuous rigid-frame bridge monitored under operational conditions. The results from the updated FE model have been compared with those obtained from online health monitoring system. The real application to a full-size bridge has demonstrated that the FE model updating process is efficient and convenient. The updated FE model can relatively reflect the actual condition of Xiabaishi Bridge in the design space of parameters and can be further applied to FE model validation and damage identification.

The Impact of Some Family Variables on the Dimension of Social Responsibility

The current study discusses the social and psychological studies conducted on the concept of the social responsibility, as well as the symbolic interactive trend as a theoretical basis for interpretation; moreover, discussing the social responsibility in the light of family variables. The aim of this study is to investigate the family variables, including domicile, parents＇ education, their age, the type of work they do, family size, and family income. As to the social responsibility＇s dimensions for sample selected for this study; hence, it includes personal, ethical, national, environmental, health, and social responsibility. The current study adopted the descriptive approach along with a demographic data form and the social responsibility＇s scale. The sample selected consisted of 330 female students from various colleges within King Abdulaziz University. The results indicated that there was an impact on all the variables, thus such impact was in favor of those living in rural areas as to the ethical dimension and in favor of urban people as to the dimensions of accountability, parents＇ level of education, parents＇ seniority, working mothers, greater family size, and higher income.

COVID-19 containment: China provides important lessons for global response

The world must act fast to contain wider international spread of the epidemic of COVID-19 now.The unprecedented public health efforts in China have contained the spread of this new virus.Measures taken in China are currently proven to reduce human-to-human transmission successfully.We summarized the effective intervention and prevention measures in the fields of public health response,clinical management,and research development in China,which may provide vital lessons for the global response.It is really important to take collaborative actions now to save more lives from the pandemic of COVID-19.