Work experience of special workers returning to work after the public health emergency:taking ICU nurses who have been infected with COVID-19 as example

Objective:The occurrence of some public health events inevitably endangers medical personnel,and medical personnel,as a special group,have to resume work on time to treat patients.This coronavirus disease-2019(COVID-19)infection is a good example,and what intensive care unit(ICU)nurses experience as the primary caregivers of critically ill patients after COVID-19 infection is our focus.To explore the work experience of ICU nurses after recovery from COVID-19,and to provide a theoretical basis for the intervention to improve the physical and mental health level and work experience of special workers in public health emergencies.Methods:We conducted an explorative descriptive study using an inductive thematic analysis.Using the maximum differential sampling method,a semi-structured interview was conducted among 13 ICU nurses suffered from COVID-19 in a tertiary grade A hospital in Qingdao,Shandong Province.This study carried on the theme analysis according to the inductive content analysis method and used MAXQDA 2020 Analytics Pro(VERBI Software GmbH,Berlin,Germany)to manage and summarize the interview data.Results:After being infected by the virus,SARS-Coronavirus-2(SARS-CoV-2),the pathogen of COVID-19,the work experience of ICU nurses was extracted from the following 5 themes:(1)Stress and challenge caused by the change of work focus;(2)downsizing,overtime,taking up work with illness,and physical discomfort;(3)dedication and family debt;(4)unknown fear and helplessness;and(5)professional responsibility and sense of benefit.Conclusions:Under the pressure of COVID-19,ICU nurses face multiple pressures and challenges,and their emotions are complex.We suggest that nursing managers should take corresponding measures to alleviate nurses'physical and psychological pressure and improve their work experience.

The impact of the COVID-19 outbreak on Australia’s public health and medical industry in 2020

In 2020,the sudden new crown(COVID-19)virus swept the world.Countries have adopted different epidemic prevention measures.The COVID-19 has brought an extraordinary impact on the economic and social health of all countries.Australia,located in the southern hemisphere,promptly adopted the closure and other epidemic prevention policies in late January.The whole people mobilized to actively fight against the epidemic.Compared with the passive immunization of developed countries such as the United Kingdom and the United States,it has experienced several twists and turns and achieved relatively successful results.However,the epidemic has profoundly affected public health and medical care.They are mainly manifested in mental and psychological,hand hygiene,respiratory diseases,surgical spectrum,cancer screening,and changes in national leadership’s response methods and medical insurance policies.Australia’s early physical distancing measures,relatively high per capita testing rates,political stability,national wealth and geographic isolation are among the explanatory factors.The country’s response to the COVID-19 pandemic has,thus far,been among the most successful in the world.

The Intermediary Roles of Public Health Nurses (PHNs) in Utilizing Communication Robots (CRs) in Community Health Care Practice

Robot technology is expected to reduce the burden of medical professionals, a concern in the super-aged society. The aim of this article is to determine the intermediary roles of Public Health Nurses (PHNs) in using Communication Robots (CRs) in Community Health care. It is necessary to consider who will manage, and how to draw lines of responsibility when a problem occurs when using robots in the future. Regarding the mediator or intermediary role of PHNs in the use of CRs, PHNs are expected to be cognizant of varieties of robots for use with persons of diverse ages and health levels, as well as of robot performances. As one of the community healthcare workers who service the elderly living in the community, the role of PHNs as mediators or intermediaries is to pay attention to ethical and moral issues while working with CRs to manage the health of the community. Lack of understanding of the intermediary role might create possible ethico-moral issues in the future. Therefore, it is critical for PHNs to understand their role as intermediaries. In doing so, it is expected that older people at home will be able to live peaceful lives, as well as be physically and mentally healthy.

On Rural Medical Care and Health Undertaking Development during New Medical Reform

Based on in-depth survey of township hospitals in Lushan County of Henan Province, this paper studies the development situations of rural medical care and health undertaking in the course of new medical reform. Results show that both rural medical institution and public health undertaking have considerable development in this course. Working capital situation gradually turns better. However, there are still problems and challenge of shortage of high quality medical care personnel, lack of employment mechanism, poor medical environment, and imperfect bidding and purchasing system of medicines. To further develop rural medical situation, it should improve medical environment, speed up informationization construction, and give prominence to functional orientation.

The Efficiency of Public Health Expenditure in Turkey Between 2003 and 2013

Turkey launched a project in 2003 known as ＂Health Transformation Programme＂ （HTP）, which enabled Turkey to make considerable progress and radical changes to the health care system. The programme in 2003 included the effectiveness and the efficiency factors within the process by setting them as the primary objectives to increase the health status of the population （effectiveness） and to use resources in the best possible manner and at the lowest possible cost （efficiency）. Accessing services according to the need of patients and state benefits according to their ability to pay would be viable under these objectives. In this study, initially, Turkish National Health System will be articulated on a literature-study basis approach to measure the efficiency of public expenditure on health. Then, the measured level of the efficiency will be analysed in Turkey, The paper serves a purpose to analyse the efficiency based on the outcomes of heath service such as satisfaction with public health services over the period of 2003-2013. A simple linear regression was employed to test the degree of statistical relation between public health expenditure and satisfaction with public health care services.

Does higher tax rate affect tobacco usage?Unravelling the nexus between tobacco regulatory control and public health concern

Objectives:Bangladesh stands as a prominent global consumer of tobacco,with alarming consequences on public health.The Global Adult Tobacco Survey reported that tobacco consumption claimed over 126000 lives in 2018,contributing to 13.5%of all deaths in the country.This study aims to explore the effectiveness of higher tax rates and tobacco use regulation as control mechanisms in mitigating tobacco consumption and health care cost burden,with a particular emphasis on its implications for public health.Methods:This study is based on the annual time series data over the period 2000-2020.The study employs the ordinary least square method to analyze the quantitative confirming the stationarity of data at level.This research uses different models to investigate individual effects and combined effects on both tobacco consumption and tobacco health care cost burden.Results:The study finds a negative relationship between tobacco tax rate and tobacco consumption.More specifically,the higher tax rate of tobacco(low(β=-0.3495),medium(β=-0.2319),high(β=-0.9033),premium(β=-0.7322),filtered(β=-0.2114),and non-filtered(β=-0.3452)categories)is significant to reduce tobacco use at 1%level of significance.The study finds similar results when it applied tobacco retail price instead of tobacco tax rate as the independent variable.Finally,the study investigates the impact on health care cost through tobacco consumption,tobacco control law,growth rate,export-import,and tobacco production.The results indicate that tobacco consumption,export-import,and tobacco production increases health care cost burden while tobacco use regulatory decreases it.By reducing tobacco consumption,higher taxes and tobacco use regulation contribute to alleviating the burden on the healthcare system,promoting healthier lifestyles,and aligning with global health objectives.Conclusions:Higher tax rate on tobacco products is necessary to increase the retail price so that tobacco users cannot consume tobacco.Specific tax and uniform tax base are needed so that tobacco users cannot switch to lower priced brands.Tobacco control laws need to revised and proper implementation should be ensured as well,to achieve the goal of tobacco free Bangladesh by 2040.Tobacco-related diseases,responsible for a significant proportion of deaths in the country,could witness a considerable decline with the successful implementation of higher tax rates and tobacco use regulation.This study provides insights that not only contribute to the economic discourse but also accentuate the broader public health benefits arising from effective tobacco taxation policies.

Family caregivers of demented elderly people and access to medical care: Who gets worn out, why and what for?

Demented persons in the process of slowly becoming dependent have to rely on the assistance of others. These others are health professionals (formal care), on the one hand and family carers (informal care) on the other hand. The latter, whether or not they have chosen to play a role which is hardly defined officially, have to face many difficult situations such as complicated access to care due to lack of equal opportunities under the health system, unable to support them efficiently. Taking care of a demented patient is a life challenge often leading to burn out, having impact on physical and mental health. Caregivers may thus even have no time or opportunity to take care of their own health. So, is it not high time for the decision-makers to think it over and take care of the carers by setting up programs and giving them the opportunity to learn, to work as a team with the professionals so as to protect themselves and their dignity as well as that of their patients. The difficulties/problems carers of demented patients may encounter should be a major issue for public health care because their role is a vital one and because the consequences which may have on their own health can be negative.

Aging in China: perspectives on public health

In line with the worldwide trend in population aging,China has stepped into an aging society since 2000.The outstanding features of aging,including a large proportion of the older population,rapid growth,dramatic expansion of the oldest-old,and uneven aging distribution,have put China in a unique position.Besides,older population is expanding in parallel with the escalating burden of disease,high prevalence of disability,and low social involvement.However,China is not prepared to solve these problems in terms of the economy,awareness,geriatric care system,geriatric team,social security,or age-friendly environment.From the perspective of public health,we summarized the major challenges and proposed the following policy recommendations:(1)strengthening the top-level design and building a"government-leading,multi-sectoral-cooperating,and society-participating"pattern;(2)enhancing health services by implementing the"comprehensive health"strategy;(3)developing home and community care,coordinately enhance institutional care,promote integration of medical and care systems,and establish a multidimensional tailored care system;(4)optimizing geriatric the supporting system,included the construction of geriatric team and the long-term care insurance system;and(5)establishing a physical and socially age-friendly environment.

Impact of community public health care on treatment effect,health cognition,and self-management in patients with type 2 diabetes

BACKGROUND At present,China has become the country with the largest number of individuals with diabetes mellitus(DM)in the world,with a total of approximately 140 million patients,the majority of whom have type 2 DM(T2DM).Based on conven-tional nursing methods,community home care has important clinical significance in controlling blood sugar and disease progression.AIM To explore the impact of community public health nursing on treatment effect,health cognition,and self-management in patients with T2DM.METHODS One hundred patients with T2DM were selected as the research subjects.The patients were divided into either a conventional nursing group or community nursing(CN)group using the random number table method.The conventional nursing group(50 cases)received routine care,while the CN group(50 cases)received community public health care in addition to routine care as that for the conventional nursing group.The rate of excellent and good blood glucose control,fasting blood glucose before and after care,2-h postprandial blood glucose,health cognition,and self-management ability,and patient satisfaction were compared between the two groups.RESULTS The CN group had a higher rate of excellent blood sugar control than the conventional nursing group(88%vs 70%,P<0.05).Before care,there was no significant difference in fasting blood glucose or 2-h postprandial blood glucose between the two groups of patients(P>0.05).After nursing,fasting blood glucose and 2-h postprandial blood glucose were reduced to varying degrees in both groups,and both blood glucose levels in the CN group were lower than those of the conventional nursing group(P<0.05).Compared with the scores before care,the cognitive level score for diabetes and self-management ability score improved after care in both groups.The cognitive level and self-management ability of patients in the CN group were higher than those of the conventional nursing group(P<0.05).The overall satisfaction of the CN group was better than that of the conventional nursing group(98%vs 86%,P<0.05).CONCLUSION Community public health care based on conventional care of T2DM can achieve better blood sugar control,and improve patients’health cognitive level and self-management ability.

Public Health Campaigns and Medicine Use Awareness: A Systematic Literature Review

This study investigates the medicine awareness, which can be defined as the increase in knowledge and understanding of the general public on appropriate medicine use. Objective: To identify the characteristics of Public Health campaigns that focus on medicine use and/or medicine awareness. Study Design: Systematic review focusing on pre- and post-campaign surveys. Methods: Electronic databases: PubMed, Science Direct, Web of Knowledge, Scopus, Global Health, and Google Scholar were searched. Articles within the last 10 years, with a focus on adults over the age of 18 were used to report findings. Results: A total of 4336 studies were reviewed after which eight were identified, which focused on medicines use and/or awareness. Most campaigns emphasized the knowledge and understanding of patients on the importance of appropriate medicine use and drew a comparison from pre- to post-campaign results. A limited number of Public Health campaigns demonstrated an increase in the level of medicines use awareness of patients. Various tools were used to portray the message across in the campaigns. These included, video, written information, face to face approaches, as well as educational games. Four studies demonstrated a statistically significant increase, in awareness of the public in regards to medication. However, the remaining studies were not successful in portraying a significant impact. Conclusion: Most campaigns demonstrated a limited increase in level of medicine use awareness in their post-campaign surveys. The results support the need for a comprehensive Public Health campaign that focuses on medicine use.

The effect of high-fidelity simulation in medical nursing based on the healthcare simulation standards of best practice

Background:High-fidelity simulation has been demonstrated to make great progress in learning.However,there is still ongoing exploration on how to fully harness the advantages of this teaching method and enhance its effectiveness.This study conducted high-fidelity simulation in medical nursing based on the Healthcare Simulation Standards of Best Practice and evaluated its effect.Methods:The study was conducted from September 2019 to June 2020.A total of 82 undergraduate nursing students from a university in Shanghai participated in the high-fidelity simulation in medical nursing.The simulation design scale,educational practices in simulation scale,and students’satisfaction and self-confidence were used to evaluate the effect.Results:The mean score of simulation design scale was 4.06±0.63 with the mean scores of all dimensions being over 3.0.The mean score of educational practices in simulation scale was 4.14±0.56 with the mean scores of all dimensions being over 4.0.The mean scores of students’satisfaction and self-confidence were 4.07±0.72 and 3.89±0.58,respectively.Conclusion:Students reported high levels of simulation design and educational practices in simulation.They were also satisfied with learning and reported high levels of self-confidence.Some key points need to be considered so that the learning effects might be optimized.

Public Health Crisis Response Mechanism with Equal Stress on Construction of the Medical System and Cultivation of Public Awareness:A Case Study on Japan

The COVID-19 pandemic has caused an unprecedented worldwide shutdown,and made urban planning reflect on and discuss how to respond to public health crises.Japan’s medical system has been repeatedly rated as the world’s number one by the World Health Organization.This paper analyzes Japan’s diversifed medical facility system,its prevention and control mechanism regarding public health emergencies,and the cultivation of social public awareness,and points out that the Japanese public health crisis response mechanism is characterized by an equal emphasis on the construction of the medical system and the cultivation of public awareness.It is proposed that an effective way to respond to daily medical needs and irregular public health security crises is to improve the community medical quality and grant administrative power to the director of public health centers,promote the"urbanization of people"with public awareness,and improve the resilience of the medical and health system.

Impact of Tobacco Smoking on Health Care Utilization and Medical Costs in Chronic Obstructive Pulmonary Disease,Coronary Heart Disease and Diabetes

Objective To determine the impact of smoking on disease-specific health care utilization and medical costs in patients with chronic non-communicable diseases(NCDs).Methods Participants were middle-aged and elderly adults with chronic NCDs from a prospective cohort in China.Logistic regressions and linear models were used to assess the relationship between tobacco smoking,health care utilization and medical costs.Results Totally,1020 patients with chronic obstructive pulmonary disease(COPD),3144 patients with coronary heart disease(CHD),and 1405 patients with diabetes were included in the analysis.Among patients with COPD,current smokers(β:0.030,95%CI:−0.032-0.092)and former smokers(β:0.072,95%CI:0.014-0.131)had 3.0%and 7.2%higher total medical costs than never smokers.Medical costs of patients who had smoked for 21-40 years(β:0.028,95%CI:−0.038-0.094)and≥41 years(β:0.053,95%CI:−0.004β0.110)were higher than those of never smokers.Patients who smoked≥21 cigarettes(β:0.145,95%CI:0.051-0.239)per day had more inpatient visits than never smokers.The association between smoking and health care utilization and medical costs in people with CHD group was similar to that in people with COPD;however,there were no significant associations in people with diabetes.Conclusion This study reveals that the impact of smoking on health care utilization and medical costs varies among patients with COPD,CHD,and diabetes.Tobacco control might be more effective at reducing the burden of disease for patients with COPD and CHD than for patients with diabetes.

U. S. Academic Medical Centers Under the Managed Health Care Environment

This research investigates the impact of managed health care on academic medical centers in the United States. Academic medical centers hold a unique position in the U. S. health care system through their missions of conducting cutting-edge biomedical researeh, pursuing clinical and technological innovations, Providing state-of-the-art medical care and producing highly qUalified health professionals. However, policies to control costs through the use of managed care and limiting resources are detrimental to academic medical centers and impede the advancement of medical sciTo survive the threats of managed care in the health care environment, acadendc medical centers must rely on their upper level managers to derive successful strategies. The methods used in this study include qualitative approaches in the form of key informants and case studies. In addition, a survey questionnaire was sent to 1h8 CEOs in all the academic medical centers in the U. S. The findings revealed that managers who perform the liaison, monitor, entrepreneur and resource allocator roles are crucial to ensure the survival of academic medical centers, so that academic medical centers can continue their missions to serve the general public and promote their well-being.

Ozone Sterilizer for Treatment and Health Care

Ozone is a green broad-spectrum bactericidal disinfectant, and a trace amount of ozone in the atmosphere makes many viruses and bacteria lose their biochemical activity and infectivity. Nature produces trace amounts of ozone in the air through lightning to purify the ecological environment. The product of ozone decomposition is oxygen, without secondary pollution. Ozone sterilizer is widely used in the epidemic prevention and control of intensive breeding farms and achieved remarkable results. If the concentration and action time of ozone can be accurately controlled, then ozone can quickly eliminate pathogens, without harming the normal cells in the human body. How to use medical ozone for epidemic prevention, treatment and health care is a subject worthy of serious study, which should arouse the attention of the experts in the field.

Access to Child Health Care, Medical Treatment of Sick Children and Childhood Mortality Relationships in Kenya

Child health care factors such as medical treatment of sick children have direct and indirect effect on childhood mortality. Through international cooperation, a number of countries including Kenya have gathered information on provision of child health services at facility level from periodic Service Provision Assessment (SPA) surveys. Kenya has also gathered information on medical treatment of sick children at household level from periodic Demographic and Health Surveys (DHS). However, establishing how health care information in the SPA surveys relates to childhood mortality and also how these factors relate to medical treatment of sick children in the DHS has been constrained by differences in sample designs of the surveys. This study deployed a fstrategy of constructing community level variables derived from the SPA survey data and incorporated them into DHS data which served as the main data source. The SPA and DHS sampling designs for Kenya allow computation of stable estimates of regional demographic and health service indicators at provincial level. This study analyzed information gathered from 690 health facilities in 2010 SPA and 6079 births born less than 60 months from 2008/09 DHS. The study found that access to child health services, waiting time before service in facility and time to the nearest referral facility were significant facilitating factors for medical treatment of sick children. The study also established that waiting time before service in facility was the only access to health care factor which had a significant effect on childhood mortality when HIV prevalence was excluded in the analysis. However, the significance of waiting time before service diminished with inclusion of HIV prevalence. Further research is required to refine definition and measurement for child health care variable on female autonomy.

Health and Medical Care for the Elderly

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Impact of the New Cooperative Medical Scheme on Health Care Service Utilization in Rural China

Using the 2000, 2004, and 2006 CHNS longitudinal survey data and econometric methods （random-effect probit regression model and DID methods）, this study conducted an empirical analysis to estimate the impact of NCMS. The major conclusions are as follows. First, predisposing factors, enabling factors, health care need factors, and lifestyle factors affect health care utilization. Second, results using DID methods indicate that NCMS did not affect health care service utilization （outpatient and inpatient） of individuals when ill, but it might increase the possibility of getting a health examination. Third, there is no difference in health care service utilization （both outpatient and inpatient） between the NCMS enrollment group and the non-enrollment group in both working age group （15-59） and the elderly group （60 and over）. Therefore, it can be said that NCMS did not affect the health care utilization in both the group. However, NCMS positively affects disease prevention behavior （visiting the hospital to receive a health examination） in the working age group, but the effect did not appear in the elderly group.

Exploration on the Implementation of the Integration of Medical and Preventive Model in China’s Primary Health Care Institutions

Objective To explore the different modes and approaches of medical and preventive integration in current primary health care institutions in China.Methods Through literature analysis,field research,telephone interviews,and other methods the implementation status was evaluated to systematically study the main experience and effect of implementing medical and preventive integration services in pilot areas.Results and Conclusion At present,there are three implementation modes of medical-prevention integration,namely,vertical mode based on the medical community,internal mode with optimized service process,and internal mode with great service capabilities.The three medical-prevention integration modes have their respective focuses,but they need to be further improved in terms of policy support,technical staffing,information system construction,and drug use.