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With the COVID-19 outbreak, many provinces and municipalities have announced the first-level response to public health emergencies. As the backbone of fighting the epidemic, medical staff are faced with many ethical dilemmas, such as the lack of medical protection materials, the high risk of virus infection, discrimination and so on, and their health and life rights and interests have been impacted. Starting with the concept of public health emergencies and the right to life and health, the theory and display basis of the right of life and health were discussed based on the practical guidelines of public health emergencies. Taking the COVID-19 epidemic as an example, this paper proposed measures for ensuring the right to life and health of medical staff in public health emergencies, so as to better cope with the epidemic of COVID-19 and protect the life and health of medical workers.
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The Internet has become an important carrier of medical information.Good electronic health literacy can enhance the public’s ability to obtain correct medical and health information with the help of electronic resources,which is helpful for the public to use health information to prevent diseases,avoid drug abuse,reduce the waste of medical resources and strengthen the self-management of chronic diseases.The improvement of electronic health literacy is of great value to the healthy development of citizens’ health literacy and healthy behavior.In view of the late start and slow development in the field of electronic health literacy in China,by combing the theoretical and practical research experience of electronic health literacy outside the region and combining with the COVID-19,this paper put forward new thinking on electronic health literacy in China,in order to provide useful reference for improving electronic health literacy of Chinese citizens,realizing self-care,self-management and disease prevention.
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In order to understand the current status of the knowledge, attitude and practice (KAP) about prevention and control of COVID -19 in college students, and to provide theoretical basis for prevention and control work in college campus. This study investigated the KAP of COVID -19 of 1 847 college students in Shaanxi province by questionnaire using the convenience sampling method. Chisquare test and multivariate logistic regression analysis were used to analyze the influencing factors for the KAP of COVID -19. The results demonstrated that 48.3% of the students had a higher knowledge level of COVID -19, 11.7% had a fear attitude and 39.6% had good protective practices. Logistic regression results showed that female and urban household college students had higher cognitive level of COVID -19. The college students with anxiety state were more likely to have fear attitude. Students of female, urban household, anxiety, higher cognition and fear attitude showed better protective practices. The above results indicated that the knowledge level of COVID -19 in college students are not enough, and the attitude and protective practices need to be further improved. Therefore, relevant departments should follow the rules of KAP, carry out targeted propaganda and education on COVID -19 for college students, to improve their ability to cope with public health emergencies.
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In the fight against COVID-19, under the guidance of medical professionalism, the majority of medical workers adhered to the scientific spirit of rigorous truth-seeking and innovation, and the humanitarian feelings of boundless love and dedication, and made outstanding contributions to prevention and control. However, the epidemic situation fluctuates repeatedly, the virus mutates frequently, and the risk of major public health emergencies has caused deep thinking on the cultivation of medical students’ professionalism. Medical students are the reserve force for the sustainable development of China’s medical and health undertakings. The times and society endow medical students with a more lofty and arduous historical mission, and also call for strengthening the cultivation of medical students’ professional spirit. Under the background of normalization of epidemic prevention and control, responding to the demands of the times, providing high-quality medical talents for the society, promoting building the doctor-patient desting community, and promoting the reality of the healthy China strategy, efforts to explore the path of cultivating medical students’ professionalism with "three combinations, two considerations and one emphasis".
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【Objective:】 To understand the moral dilemma, coping style of frontline nurses and their correlation during the COVID -19. 【Methods:】 From March to April, 2021, 651 nurses working in designated hospitals for COVID -19 were selected by convenient sampling, and the Chinese version of Moral Distress Scale-Revised (MDS-R) and Chinese version of Coping Style Questionnaire (CSQ) were used for investigation. 【Results:】 Frontline nurses’ MDS-R score was 91.0, "value conflicts" was the moral dilemma with the highest frequency and intensity, more than half (51.0%) of the respondents had considered leaving their position because of moral dilemma. "Problem solving" and "seeking for help" were the major coping strategies adopted by the nurses. Nurses who directly provide medical services for COVID -19 patients, dissatisfied with hospital-related training and adopted negative coping strategies had higher moral dilemmas than other nurses. 【Conclusion:】 The moral dilemma of frontline nurses is at a high level during the period of epidemic prevention and control. Nursing managers should pay attention to guiding and helping nurses to establish positive coping styles and improve their ability to respond to major public health emergencies.
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Objective To explore the current situation of nurses'emergency response ability of public health emergencies and analyze its influencing factors in Yunnan province,so as to provide empirical basis for the construction of emergency response ability training system in the future.Methods A total of 4821 clinical nurses from 43 hospitals in Yunnan province were selected by convenience sampling.A cross-sectional survey was conducted using the general information questionnaire,Nurses'Public Health Emergency response Capacity Scale and Nurses'Emergency attitude scale.The influencing factors were analyzed by stepwise multiple linear regression.Results The total score of public health emergency response ability of clinical nurses in Yunnan Province was(70.35±14.08),and the total score of public health emergency response attitude was(42.26±6.14).Gender,department,hospital level,working years,whether to participate in public health emergency training,whether to experience rescue activities in public health emergencies,and attitude towards public health emergencies were the influencing factors of nurses'public health emergency response ability(P<0.05),which explained 29.0%of the total variation.Conclusions The ability of clinical nurses to respond to public health emergencies in Yunnan Province is generally above the medium level,but there is still a significant shortage in emergency knowledge.Targeted training is needed.Nursing management should build targeted layered training programs combined with influencing factors to enhance nurses'ability to respond to public health emergencies.
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Rapid and living guidelines are those developed in response to public health emergencies in a short period of time using a scientific and standardized approach. Subsequently， they provide timely and credible recommendations for decision makers through regular and frequent updates of clinical evidence and recommendations. In this paper， we introduced the definition of rapid and living guideline as well as analyzed the basic characteristics of eight rapid and living guidelines in the field of traditional Chinese medicine （TCM） published till 2023 June， summarizing three core methodological issues in relation to how to rapidly develop guidelines， how to formulate recommendations when there is lack of evidence， and how to ensure the timeliness of guidelines. Based on the analysis of current rapid and living guidelines， it is implicated that there is necessity to carry out rapid and living guideline in the field of TCM， and the methodology of rapid integration of multivariate evidence in the field of TCM needs to be further explored； furthermore， it is necessary to further explore the obstacles of implementation of guidelines and promote timely updating， all of which provide certain theoretical references for relevant guideline developers and researchers.
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In April 2022,an epidemic occurred in Gongshu District,Hangzhou,where Zhejiang Cancer Hospital is loca-ted.And the hospital was confronted with the most extensive,the most unusual and the most urgent public health emergency crisis since its establishment.Taking patients as the core and proceeding from the public perspective,an authoritative voice of a hospital was conveyed in a timely and accurate manner,which demonstrated the hospital's resolution and executive power in the crisis.Based on Malcolm Gladwell's"tipping point"theory,the paper reveals the situation of online public opinion caused by the sudden epidemic and its response,discusses the hospital's communication practices in handling public health emergencies and provides hospitals with practical reference for brand promotion and operation.
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Resumo Distantes temporalmente da declaração da emergência em saúde pública de importância internacional (ESPII) e emergência em saúde pública de importância nacional (ESPIN) provocada pela epidemia de zika, no ano de 2015, enunciamos a herança da emergência humanitária. Com base em uma pesquisa qualitativa, por meio de grupos focais realizados com profissionais de saúde e familiares das crianças afetadas epidemia de zika em Natal e Feira de Santana, buscamos discutir esse fenômeno de saúde pública pelas lentes da Antropologia do Estado. Concluímos que o não reconhecimento do Estado como uma instância encarnada no cotidiano das práticas por parte dos seus agentes locais leva à reprodução de práticas discriminatórias esvaziadas de sentido político e do reconhecimento de moralidades que permeiam as ausências nas ações de promoção de saúde e estratégias de reconhecimento e busca por estratégias para a garantia do direito à saúde.
Abstract Temporarily distant from the declaration of the Public Health Emergency of International Importance (ESPII) and Public Health Emergency of National Importance (ESPIN) caused by the Zika epidemic, in 2015, we enunciate the legacy of the humanitarian emergency. Based on qualitative research, through focus groups with health professionals and families of children affected by the Zika epidemic in Natal and Feira de Santana, we seek to discuss this public health phenomenon through the lens of State Anthropology. We conclude that the non-recognition of the State as an instance embodied in the daily practices of its local agents leads to the reproduction of discriminatory practices emptied of political sense and the recognition of moralities that permeate the absences in health promotion actions and recognition strategies, and search for methods to guarantee the right to health.
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Background: The World Health Organisation (WHO) Regional Office for Africa (AFRO) has developed a comprehensive capacity development programme to support the successful implementation of the Integrated Disease Surveillance and Response 3 rd edition Technical Guidelines (IDSR). As part of the learning program, a series of asynchronous online courses are offered on Open WHO in English, French and Portuguese. This paper describes the use of five IDSR online courses and reports on feedback received from learners on Course 1 in the English series. Methods: An online learner survey was developed, and a descriptive analysis was conducted. This paper also reports on use related empirical metadata from the Open WHO platform. Results: Overall, learners (97%-n/N) of Course 1 IDSR English series indicated a positive perception toward their online learning experience because of the quality of course content, its organization, ease of use and relevance to their workplace needs. In addition, 88% (n/N) of learners reported that they had used their acquired knowledge at least sometimes and 54.4% (n/N) had shared their learning with others. Lastly, the quiz analyses showed an average of right answers of 78.97% for quiz 1 and 69.94% for quiz 2. Conclusion: Online learning is an essential component of a blended capacity development programme and provides cost effective, equitable and impactful learning. Learners who have a learning goal and find their needs met in courses tend to show more satisfaction and motivation to share their learning.
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Humans , Male , FemaleABSTRACT
Introduction: approximately 15% of COVID-19 patients develop symptoms necessitating admission. From 2020 to 2022, Mashonaland West Province had an institutional case fatality rate of 23% against a national rate of 7%. Therefore, we evaluated the COVID-19 admissions in the province to determine the factors associated with COVID-19 mortality. Methods: we conducted an analytical cross-sectional study based on secondary data from isolation centers across the province using all 672 death audit forms and patient records. We obtained data on patient demographics, signs and symptoms, clinical management and oxygen therapy administered, among other things. Data were entered into an electronic form and imported into Epi-info 7 for analysis bivariate and multivariate was conducted. Results: we found that being an older man, aOR 1.04 (1.03-1.05), who had diabetes aOR 6.0 (95% CI: 3.8-9.2) and hypertension aOR 4.5 (95% CI: 2.8-6.5) were independent risk factors. Patients put on dexamethasone aOR 2.4 (95% CI: 1.6-3.4) and heparin/clexane aOR 1.6 (95% CI: 1.1-2.2) had a higher mortality risk. However, vitamin C aOR 0.48 (95% CI: 0.31-0.71) and oxygen therapy aOR 0.14 (95% CI: 0.10-0.19) and being pregnant aOR 0.06 (95% CI: 0.02-0.14) were protective. Conclusion: mortality risk increased in older male patients with comorbidities and with those on dexamethasone and heparin therapy. Oxygen therapy and vitamin C were protective. There is a need to conduct further study of the source of these variations in risk across patients to establish the true impact of differences in individuals' mortality.
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Humans , Male , Female , Patient Admission , Therapeutics , Diagnosis , COVID-19 , Risk Factors , MortalityABSTRACT
Globally,there have been multiple public health emergencies in recent decades.High rates of morbidity,occa-sionally mortality,and economic instability are usually associated with pandemics.One of the epidemics that has significantly increased morbidity and mortality worldwide is the human immunodeficiency virus(HIV)and acquired immune deficiency syndrome(AIDS)pandemic.HIV has a disproportionately negative impact on key populations.Strong leadership,effective communication,and sound science are necessary for public health emer-gency(PHE)responses to be successful.These three PHE response pillars are also essential for bridging the HIV response gap among key populations in the setting of restrictive laws.In this review,we explored the importance of these three pillars of successful PHEs responses,and how they are essential to closing the gap in the HIV response among key populations.Leaders must make decisions and instil a sense of authority in the populace during PHEs to foster trust and confidence.Leaders should base their choices on scientific evidence.Effective communication during PHEs should be proactive,polite,imaginative,innovative,and constructive.To address gaps in the HIV response among key populations,leaders must create a supportive environment for effective communication and scientific research,communication should be used to raise awareness of HIV and to dispel stigma and discrimination,while science should provide evidence of efficacy and effectiveness of interventions among key populations.
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@#Abstract: Objective To analyze the epidemiological characteristics of outbreaks of infectious diseases in schools in Yunnan Province from 2004 to 2021, to provide a scientific basis for prevention and control strategies. Methods The data on outbreaks of infectious diseases in schools in Yunnan Province from 2004 to 2021 from the National Emergency Public Health Events Information Management System and on-site epidemiological surveys were collected and analyzed using descriptive epidemiology method. Results From 2004 to 2021, a total of 1 806 outbreaks of infectious diseases in schools in Yunnan Province was reported. The majority of the reports were of general events (90.25%), affecting 2 183 493 people with reported cases numbering 94 643 and 13 deaths. The main modes of transmission were respiratory infectious diseases. The top three reported diseases were chickenpox (588), influenza (300) and hand-foot-and-mouth disease (267), accounting for 64.0% of the total reported events. The events were distributed in 121 counties and districts throughout the province, concentrated in March–June and September–January of the following year. The main outbreaks were of chickenpox, with an average duration of 19 days. Most public health emergencies (1 386) occurred in kindergartens and primary schools, and the median time to discover the outbreak was 7 days (ranging from 4 to 13 days). Conclusions Respiratory infectious diseases are the main type of outbreak of infectious diseases in schools in Yunnan Province. Kindergartens and primary schools are the focus of prevention and control. Early reporting and effective handling will help control the spread of events and reduce hazards. At the same time, the prevention and control of school infectious diseases and the emergency drill of the plan during peak periods need to be particularly strengthened.
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Objective:To develop and examine the reliability and validity of the adolescent health literacy evaluation scale under public health emergencies (AHLES-PHE) in junior middle school students.Methods:The initial version of AHLES-PHE was formed by combining the characteristics of public health emergencies and adolescent health literacy.The expert version of AHLES-PHE was formed by two rounds of Delphi expert consultation.Totally 1 729 adolescent students from three junior middle schools in Changzhou City were tested.The formal version of AHLES-PHE was formed through item analysis and factor analysis (structural validity). The content validity of the formal version of AHLES-PHE was evaluated by specialist analysis and sensibility analysis, and its correlation validity with the everyday health information literacy (EHIL) was tested.The internal consistency reliability, parity split-half coefficient and test-retest reliability were calculated.Results:(1)Item analysis: the correlation coefficient between the scores of each item and the total score of AHLES-PHE expert version was 0.420 to 0.722 ( P<0.01), and the CR of decision value was 10.140 to 66.980 ( P<0.01). (2)Validity analysis: the formal version of AHLES-PHE with 45 items and 8 factors was obtained by exploratory factor analysis.The 8 factors could explain 61.30% of the total variation.The fitting indexes of the confirmatory factor analysis model were χ2/ df=3.325, RMSEA=0.052, GFI=0.853, CFI=0.912, TLI=0.904, NFI=0.880.Sensibility analysis of the formal version of AHLES-PHE showed the Cronbach's α ranged from 0.957 to 0.958.The correlation coefficient between the total score of AHLES-PHE formal version and the total score of EHIL was 0.340 ( P<0.01). (3)Reliability analysis: the Cronbach's α coefficient and parity split-half coefficient of the formal version of AHLES-PHE were 0.958 and 0.975, respectively.The test-retest reliability of the formal version of AHLES-PHE was 0.753 ( P<0.01). Conclusion:The formal version of AHLES-PHE developed in this study has good reliability, structural validity and content validity, and the correlation validity with EHIL is common.This scale has a certain degree of applicability to the assessment of health literacy for junior middle school students under public health emergencies.
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Objective:To explore the factors affecting the management of medical devices in the COVID-19 pandemic, and to provide guidance for the management of medical devices in public health emergencies.Methods:A total of 184 hospitals caring COVID-19 patients in Jiangsu, Zhejiang, Shanghai, Anhui and Shandong were selected, and clinical engineers were randomly sampled. A self-compiled questionnaire was used to conduct an online survey on factors affecting medical device management during the COVID-19 pandemic from August to December 2021.The index system of influencing factors of medical device management during the COVID-19 pandemic was determined through an exploratory factor analysis, and then the structural equation model was used to verify the rationality and scientificity of the index system, while the relative weight method was used to calculate the weight of the index system.Results:277 valid questionnaires were recovered. Through the exploratory factor analysis, an index system of influencing factors of medical device management was established, which consisted of such level-indexes as the human factor, device factor, material factor, method factor, and environment factor, as well as 17 level-2 indexes. The fitness-indexes of the second-order structural equation model were finally fitted as follows: the chi-square to freedom ratio was 2.606, the approximate root mean square error was 0.076, and the value of value-added adaptation index, non-standard adaptation index and comparative adaptation index were 0.921, 0.903 and 0.920, respectively. The weights of the method factor, human factor, device factor, material factor and environment factor of the level-1 indexes were 0.216, 0.191, 0.175, 0.274 and 0.144, respectively. Such factors as manpower, regulations and institutional processes, and information technology ranked top three among the 17 level-2 indexes, which were 0.090, 0.082 and 0.080 respectively.Conclusions:The influencing factor model of medical device management during the COVID-19 pandemic in this study is ideal; human factors and method factors are the influencing factors deserving high priority in medical device management during the COVID-19 pandemic. Ensuring sufficient human resources, improving laws, regulations and processes, as well as enhancing information management level are breakthroughs expected in medical device management.
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In major public health incident emergencies, the cultivation of medicine students’ dedication is the need of the times to ensure the predecessors of health cause successors, the value highlights of people-centred, and the main demand to help the growth and development of medical students. The cultivation of medical students’ dedication in major public health emergencies is confronted with the impact of diverse social ideologies, the deconstruction of the network and the fragmentation of the cultivation, etc. On the choice of specific countermeasures, it is necessary to strengthen the education of ideals and beliefs to enhance the initiative of the times, make good use of the practical carrier to improve the effectiveness, firmly establish the classroom position to reinforce the pertinence, incorporate the main force of family and society to enhance cooperation, and practice the community of mankind common health to highlight universality.
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【Objective:】 To summarize the research status, problems and countermeasures of ethical issues related to volunteer action in public health emergencies by reviewing relevant literature. 【Methods:】 Using four keywords: public health emergencies, volunteers, ethics, and research, this paper searched the Chinese and English databases for the literature published from December 2006 to December 2021 (15 years in total) on "ethical research on volunteer action in public health emergencies". After searching, it was found that there were not many related papers. A total of 31 papers were retrieved, and only 23 papers were selected. 【Results:】 The ethical problems faced by volunteers in public health emergencies were complex and diverse, and the individual ethical behavior of volunteers was affected by many factors. The strategies to solve the relevant ethical issues were not yet perfect. 【Conclusions:】 The ethical issues related to volunteer actions in public health emergencies needed to be further studied.
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【Objective:】 To construct a questionnaire on medical students’ cognition level of public health ethics, and to provide a scientific and objective evaluation tool for understanding the cognitive level of medical students on public health ethics. 【Methods:】 Based on the literature review and focus group discussion, the initial questionnaire was constructed. The Delphi method was used to conduct three rounds of correspondence with 12 experts, and the final questionnaire was drafted. And exploratory factor analysis and internal consistency were used to evaluate the questionnaire. 【Results:】 In the three rounds of correspondence, the enthusiasms of experts were all 100%, the authority coefficients were all 0.84, the coefficients of variation were 0~0.32, 0~0.26, 0~0.12, respectively, and the coordination coefficients were 0.206, 0.163, and 0.250, respectively (all P<0.05). The analysis of the items showed that the critical ratio values and related coefficients of the questionnaire items were statistically different. The structural validity analysis showed that the cumulative variance contribution rate of the extracted two common factors was 61.015%. The intrinsic consistency reliability analysis showed that the questionnaire Cronbach’s coefficient was 0.956. Finally, the questionnaire of 26 items was formed, including two dimensions: knowledge of public health ethics and application of public health ethics. 【Conclusion:】 The questionnaire on medical students’ cognition level of public health ethics is reliable and has good reliability and validity, and can be used as a tool for medical students’ public health ethics cognition level.
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Ideological and political education is an important means to effectively respond to public health emergencies. In response to the huge impact of major public health emergencies on people’s emotions and ideological cognition, this paper combined the relevant theories of emergency ideological and political education and integrated the mission and tasks of responding to major public health emergencies and ideological and political education, so as to improve the pertinence of emergency ideological and political education. This paper elaborated the concepts of major public health emergencies and emergency ideological and political education, introduced the research basis of emergency ideological and political education, focused on exploring the basic characteristics, development criteria, and value pursuit of emergency ideological and political education in major public health emergencies, and prospected the development direction of emergency ideological and political education in the new era.
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Public health emergencies not only bring great challenges to the conventional public health system, but also face some ethical dilemmas in the governance process. For example, the compulsory isolation measures affect the normal lives of some citizens, the normal medical treatment of non-epidemic patients may be constrained by complex governance environments, and the relationship between patient privacy protection and the public’s right to know needs to be deeply considered and balanced. To respond the ethical dilemmas in public health emergencies, it is necessary to explore more effective new ideas and methods under ethical concepts, combine with ethical needs in the governance of public health emergencies, comprehensively improve governance capabilities starting from the basic principles and behavioral standards of governance, with a view to providing more effective ethical support for the governance of public health emergencies.