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2.
Nat Med ; 27(3): 396-400, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33723454

RESUMO

Fourteen months into the SARS-CoV-2 pandemic, we identify key lessons in the global and national responses to the pandemic. The World Health Organization has played a pivotal technical, normative and coordinating role, but has been constrained by its lack of authority over sovereign member states. Many governments also mistakenly attempted to manage COVID-19 like influenza, resulting in repeated lockdowns, high excess morbidity and mortality, and poor economic recovery. Despite the incredible speed of the development and approval of effective and safe vaccines, the emergence of new SARS-CoV-2 variants means that all countries will have to rely on a globally coordinated public health effort for several years to defeat this pandemic.


Assuntos
/epidemiologia , Controle de Doenças Transmissíveis , Saúde Global , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/organização & administração , Controle de Doenças Transmissíveis/tendências , Saúde Global/história , Saúde Global/tendências , Governo , História do Século XXI , Humanos , Pandemias/história , Saúde Pública/história , Saúde Pública/métodos , Saúde Pública/tendências , Administração em Saúde Pública/métodos , Administração em Saúde Pública/normas , Administração em Saúde Pública/tendências , /fisiologia
6.
East Mediterr Health J ; 26(12): 1570-1575, 2020 Dec 09.
Artigo em Inglês | MEDLINE | ID: mdl-33355398

RESUMO

Background: During the 2019 Hajj, the Ministry of Health in Saudi Arabia implemented for the first time a health early warning system for rapid detection and response to health threats. Aims: This study aimed to describe the early warning findings at the Hajj to highlight the pattern of health risks and the potential benefits of the disease surveillance system. Methods: Using syndromic surveillance and event-based surveillance data, the health early warning system generated automated alarms for public health events, triggered alerts for rapid epidemiological investigations and facilitated the monitoring of health events. Results: During the deployment period (4 July-31 August 2019), a total of 121 automated alarms were generated, of which 2 events (heat-related illnesses and injuries/trauma) were confirmed by the response teams. Conclusion: The surveillance system potentially improved the timeliness and situational awareness for health events, including non-infectious threats. In the context of the current COVID-19 pandemic, a health early warning system could enhance case detection and facilitate monitoring of the disease geographical spread and the effectiveness of control measures.


Assuntos
/epidemiologia , Controle de Doenças Transmissíveis/organização & administração , Surtos de Doenças/prevenção & controle , Islamismo , Administração em Saúde Pública/métodos , Vigilância em Saúde Pública/métodos , Aglomeração , Planejamento em Saúde/organização & administração , Humanos , Comportamento de Massa , Região do Mediterrâneo/epidemiologia , Pandemias , Arábia Saudita/epidemiologia , Vigilância de Evento Sentinela , Viagem
8.
PLoS One ; 15(9): e0237380, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32986698

RESUMO

OBJECTIVE: The objective of this study was to develop a measurement tool to capture local public health department (LHD) organizational characteristics that align with implementation of equity-oriented practice, which may be used to gauge progress in building public health structures and functions that address the needs of vulnerable populations and reduce health inequities. METHODS: We developed and tested a measurement tool, with practitioner input, based on an implementation science framework and informed by previous work defining public health essential services and practice recommendations for health equity. Measures assessed types of vulnerable populations served by the LHD, organizational climate, and four equity-oriented practice areas, including: assessment and planning, monitoring and analysis, leadership support, and obesity prevention. We also assessed opportunities for capacity building by identifying training needs of practitioners. Primary data were collected from Missouri local health department practitioners (n = 92, 80% response rate) via an online questionnaire, with a subset of the sample providing data for test-retest reliability. RESULTS: Measures of equity-oriented implementation climate indicated areas of variability with respect to strengths and gaps across LHDs. While implementation climate was strong with respect to perceived importance (86%), a substantial proportion of LHDs cited concern over other priorities conflicting with equity-oriented implementation (32%). Likewise, a strong internal push (67%) was often accompanied by limited external political (25%) and community support (40%). Implementation climate measures generally had good to excellent reliability and were significantly associated with areas of equity-oriented practice. Frequently identified (>70%) training needs included improving skills in applying frameworks, assessment methods, and evaluating collaborations around equity. CONCLUSION: We developed a theory-based, practitioner-informed questionnaire to assess capacity for equity-oriented practice and identify opportunities for capacity building in local public health departments to engage in effective change toward health equity.


Assuntos
Fortalecimento Institucional , Equidade em Saúde , Governo Local , Obesidade/prevenção & controle , Administração em Saúde Pública/métodos , Saúde Pública/métodos , Feminino , Humanos , Masculino , Missouri , Inquéritos e Questionários
9.
Sensors (Basel) ; 20(17)2020 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-32887338

RESUMO

COVID-19 has shown a relatively low case fatality rate in young healthy individuals, with the majority of this group being asymptomatic or having mild symptoms. However, the severity of the disease among the elderly as well as in individuals with underlying health conditions has caused significant mortality rates worldwide. Understanding this variance amongst different sectors of society and modelling this will enable the different levels of risk to be determined to enable strategies to be applied to different groups. Long-established compartmental epidemiological models like SIR and SEIR do not account for the variability encountered in the severity of the SARS-CoV-2 disease across different population groups. The objective of this study is to investigate how a reduction in the exposure of vulnerable individuals to COVID-19 can minimise the number of deaths caused by the disease, using the UK as a case study. To overcome the limitation of long-established compartmental epidemiological models, it is proposed that a modified model, namely SEIR-v, through which the population is separated into two groups regarding their vulnerability to SARS-CoV-2 is applied. This enables the analysis of the spread of the epidemic when different contention measures are applied to different groups in society regarding their vulnerability to the disease. A Monte Carlo simulation (100,000 runs) along the proposed SEIR-v model is used to study the number of deaths which could be avoided as a function of the decrease in the exposure of vulnerable individuals to the disease. The results indicate a large number of deaths could be avoided by a slight realistic decrease in the exposure of vulnerable groups to the disease. The mean values across the simulations indicate 3681 and 7460 lives could be saved when such exposure is reduced by 10% and 20% respectively. From the encouraging results of the modelling a number of mechanisms are proposed to limit the exposure of vulnerable individuals to the disease. One option could be the provision of a wristband to vulnerable people and those without a smartphone and contact-tracing app, filling the gap created by systems relying on smartphone apps only. By combining very dense contact tracing data from smartphone apps and wristband signals with information about infection status and symptoms, vulnerable people can be protected and kept safer.


Assuntos
Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Transmissão de Doença Infecciosa/estatística & dados numéricos , Modelos Teóricos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Saúde Pública/métodos , Quarentena/organização & administração , Populações Vulneráveis , Busca de Comunicante/métodos , Infecções por Coronavirus/epidemiologia , Surtos de Doenças/prevenção & controle , Diretrizes para o Planejamento em Saúde , Necessidades e Demandas de Serviços de Saúde , Humanos , Controle de Infecções/métodos , Controle de Infecções/organização & administração , Controle de Infecções/estatística & dados numéricos , Invenções/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Serviços Preventivos de Saúde/métodos , Serviços Preventivos de Saúde/organização & administração , Serviços Preventivos de Saúde/normas , Saúde Pública/estatística & dados numéricos , Administração em Saúde Pública/métodos , Quarentena/métodos , Quarentena/estatística & dados numéricos , Reino Unido/epidemiologia , Populações Vulneráveis/estatística & dados numéricos
10.
J Allied Health ; 49(3): 228-229, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32877482

RESUMO

Local governments, especially in rural settings, may look to collaborate with neighboring communities to maintain public health services and efficiencies in face of restrictive local budgets. Cross-jurisdictional partnerships of rural health departments have allowed offering an increased range of prevention programs and community health initiatives. Genesee and Orleans counties, in rural Western New York, developed a cross-jurisdictional partnership 7 years ago which has been integral for the coronavirus disease 2019 (COVID-19) response for both county health departments. Using a cross-jurisdictional partnership and a joint incident command structure has allowed a coordinated approach towards contact tracing of COVID-19 confirmed cases.


Assuntos
Busca de Comunicante/métodos , Infecções por Coronavirus/epidemiologia , Governo Local , Pneumonia Viral/epidemiologia , Administração em Saúde Pública/métodos , Betacoronavirus , Comportamento Cooperativo , Humanos , Pandemias , Estados Unidos
12.
Public Health Rep ; 135(1_suppl): 75S-81S, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32735184

RESUMO

Policies facilitating integration of public health programs can improve the public health response, but the literature on approaches to integration across multiple system levels is limited. We describe the efforts of the Massachusetts Department of Public Health to integrate its HIV, viral hepatitis, sexually transmitted infection (STI), and tuberculosis response through policies that mandated contracted organizations to submit specimens for testing to the Massachusetts State Public Health Laboratory; co-test blood specimens for HIV, hepatitis C virus (HCV), and syphilis; integrate HIV, viral hepatitis, and STI disease surveillance and case management in a single data system; and implement an integrated infectious disease drug assistance program. From 2014 through 2018, the number of tests performed by the Massachusetts State Public Health Laboratory increased from 16 321 to 33 674 for HIV, from 11 054 to 33 670 for HCV, and from 19 169 to 30 830 for syphilis. Service contracts enabled rapid response to outbreaks of HIV, hepatitis A, and hepatitis B. Key challenges included lack of a billing infrastructure at the Massachusetts State Public Health Laboratory; the need to complete negotiations with insurers and to establish a retained revenue account to receive health insurance reimbursements for testing services; and time to train testing providers in phlebotomy for required testing. Investing in laboratory infrastructure; creating billing mechanisms to maximize health insurance reimbursement; proactively engaging providers, community members, and other stakeholders; and building capacity to transform practices are needed. Using multilevel policy approaches to integrate the public health response to HIV, STI, viral hepatitis, and tuberculosis is feasible and adaptable to other public health programs.


Assuntos
Serviços Contratados/organização & administração , Seguro Saúde/organização & administração , Administração em Saúde Pública/métodos , Vigilância em Saúde Pública/métodos , Doenças Sexualmente Transmissíveis/diagnóstico , Serviços Contratados/economia , Serviços Contratados/normas , Política de Saúde , Acesso aos Serviços de Saúde , Hepatite/diagnóstico , Humanos , Seguro Saúde/economia , Seguro Saúde/legislação & jurisprudência , Seguro Saúde/normas , Reembolso de Seguro de Saúde/economia , Reembolso de Seguro de Saúde/legislação & jurisprudência , Reembolso de Seguro de Saúde/normas , Relações Interinstitucionais , Massachusetts , Estudos de Casos Organizacionais , Avaliação de Programas e Projetos de Saúde , Administração em Saúde Pública/economia , Administração em Saúde Pública/legislação & jurisprudência , Administração em Saúde Pública/normas , Sífilis/diagnóstico
14.
Healthc Q ; 23(2): 16-17, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32762814

RESUMO

As a chief nurse in Ontario during the severe acute respiratory syndrome (SARS) outbreak in 2003, I never thought I would experience anything even remotely similar, let alone exponentially worse, in my lifetime. Seventeen years and almost 17,000 km later, the COVID-19 crisis feels eerily similar in many ways, and completely different in others.


Assuntos
Infecções por Coronavirus , Surtos de Doenças/prevenção & controle , Pandemias , Pneumonia Viral , Síndrome Respiratória Aguda Grave , Austrália/epidemiologia , Betacoronavirus , Canadá/epidemiologia , Administração Hospitalar , Humanos , Administração em Saúde Pública/métodos , Quarentena/organização & administração
15.
Am J Public Health ; 110(S2): S225-S231, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32663080

RESUMO

Objectives. To describe partnerships between US local health departments (LHDs) and community organizations and assess the relationship between the types of activities performed in these partnerships and LHD engagement in population-based activities to prevent mental health conditions.Methods. Data were derived from 457 LHDs that responded to module 1 of the 2016 Profile Study conducted by the National Association of County and City Health Officials. These data were used to assess the presence of partnerships with community organizations and examine associations between the types of activities performed in such partnerships and LHDs' participation in population-based activities to prevent mental health conditions.Results. LHDs had higher odds of participating in population-based activities to prevent mental health conditions if they shared personnel or resources or had written agreements with mental health or substance use disorder providers, held regularly scheduled meetings with hospitals, or shared personnel or resources with community health centers. Odds were reduced if they exchanged information with community health centers or shared personnel or resources with faith-based organizations.Conclusions. This study offers an improved understanding of how the types of activities performed in cross-sector partnerships affect LHDs' participation in population-based activities to prevent mental health conditions, which is important as public policies, programs, and funding initiatives continue to encourage cross-sector partnership building.


Assuntos
Transtornos Mentais/prevenção & controle , Administração em Saúde Pública/métodos , Parcerias Público-Privadas , Serviços de Saúde Comunitária , Comportamento Cooperativo , Humanos , Governo Local , Estados Unidos
16.
Tex Med ; 116(6): 27-28, 2020 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-32645182

RESUMO

Umair Shah, MD, Harris County Public Health executive director, on how COVID-19 has exposed gaps in the public health system.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Administração em Saúde Pública/métodos , Saúde Pública/métodos , Humanos , Pandemias , Texas/epidemiologia
17.
Int J Health Plann Manage ; 35(5): 997-1000, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32648280

RESUMO

BACKGROUND: The COVID-19 pandemic lead scientists and governmental authorities to issue clinical and public health recommendations based on progressively emerging evidence and expert opinions and many of these fast-tracked to peer-reviewed publications. Concerns were raised on scientific quality and generalizability of this emerging evidence. MAIN ARGUMENT: However, this way acting is not entirely new and often public health decisions are based on flawed and ambiguous evidence. Thus, to better guide decisions in these circumstances, in this article we argue that there is a need to follow fundamental principles in order to guide best public health practices. We purpose the usefulness of the framework of principalism in public which has been proved useful in real life conditions as a guide in the absence of reliable evidence. CONCLUSIONS: It is recommended the implementation of these principles in an integrated manner adopting an holistic system approach to health policies adapted to specificities of local contexts.


Assuntos
Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Administração em Saúde Pública , Infecções por Coronavirus/epidemiologia , Prática Clínica Baseada em Evidências , Política de Saúde , Humanos , Pneumonia Viral/epidemiologia , Administração em Saúde Pública/métodos
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