scholarly journals 'You had to do something': prescribing antibiotics in Scotland during the COVID-19 pandemic restrictions and remobilisation

BDJ ◽  
2021 ◽  
Author(s):  
Eilidh M. Duncan ◽  
Beatriz Goulao ◽  
Janet Clarkson ◽  
Linda Young ◽  
Craig R. Ramsay
Keyword(s):  
Public Health ◽  
Antimicrobial Resistance ◽  
Health Service ◽  
Dental Care ◽  
Online Survey ◽  
Claims Data ◽  
Public Health Service ◽  
Antibiotic Prescribing ◽  
The Impact

AbstractIntroduction The COVID-19 pandemic brought about seismic change for dentistry including the direction to provide remote advice and prescribe analgesia and antimicrobials. The possibilities for care have widened, but the impact of both restrictions and remobilisation on antibiotic prescribing is not known.Aims To report the impact of COVID-19 restrictions and remobilisation on dental antibiotic prescriptions and explore dentists' intentions and attitudes towards antibiotic prescribing.Design and setting Public Health Scotland national prescribing and claims data are reported alongside an online survey of Scottish general and public health service dentists including closed and open-ended questions.Results Antibiotic prescribing rose by 49% following the suspension of routine dental care, to a peak of 34,993 antibiotics (July 2020). The data also show that since the remobilisation of NHS dental care, antibiotic prescribing remains raised at levels around 28% higher than pre-pandemic. The survey highlights dentists' frustrations and concerns about this increased use of antibiotics. Most dentists intend to reduce their prescribing; however, significant challenges to this being realised were raised.Conclusions The previous success within dentistry to protect against the development of antimicrobial resistance has suffered a knock-back during the pandemic. A renewed focus on reducing unnecessary antibiotics within dentistry is required but, crucially, needs to be approached sensitively alongside the current backdrop of challenges within the service.

Neuroradiological Assessment of Referrals for MR Brain Scan: Our Experience

2005 ◽  
Vol 18 (1) ◽  
pp. 9-15
Author(s):  
M. Leonardi ◽  
M. Maffei ◽  
S. Battaglia ◽  
C. Barbara ◽  
P. Cenni ◽  
...  
Keyword(s):  
Public Health ◽  
Health Service ◽  
Public Health Service ◽  
Waiting Lists ◽  
Ct Scans ◽  
Radiological Assessment ◽  
Appropriateness Criteria ◽  
Experimental Project ◽  
The Impact ◽  
Mr Scanning

The growing demand for brain MR scans in recent years has led to long waiting lists and indiscriminate referral with respect to the clinical need for imaging and appropriateness criteria for MR scanning. To overcome this problem, the Bologna Public Health Service in conjunction with S. Orsola-Malpighi Hospital devised an experimental project instituting a radiological assessment prior to booking MR scans, implemented on 1st November 2003. The assessment is carried out by doctors in the Radiology and neuroradiology units to establish whether referral for MR scan is appropriate and to draw up a priority scale for access to MR diagnosis. If MR investigation is deemed inappropriate, the project provides for an alternative procedure or specialist clinical examination. The patient is admitted to the charge of the service and followed throughout the diagnostic work-up, i.e. the doctor undertaking the assessment will prescribe a possible specialist clinical consultation or other radiological procedures, generally CT scans performed by the same Radiology or Neuroradiology unit. We report on neuroradiological assessment of referrals for brain MR scans on behalf of the Public Health Service and carried out at the Neuroradiology Unit in Bellaria Hospital, Bologna. From 1st November to 31st July 2004, 2659 assessments were undertaken. Of these 2163 were approved for MR scanning whereas 496 referrals were modified, mostly into CT scans and some patients were referred for otorhinolaringology, endocrinology or neurology specialist consultation. To assess the impact of this “filter”, we compared a sample period of six months from 1st February 2003 to 31st July 2003 before the radiological assessment project had been implemented with a period of the same length the following year. We found that the number of negative MR scans was halved after the project had been implemented (from 24.49% in 2003 to 12.18% in 2004), showing that in addition to shortening waiting lists for MR scans, there has been a sharp rise in the number of appropriate scans.

scholarly journals The Role of the Public Health Service Equalization Program in the Control of Hypertension in China: Results from a Cross-sectional Health Interview Survey

2019 ◽  
Author(s):  
Jiangmei Qin ◽  
Yanchun Zhang ◽  
Masha Fridman ◽  
Kim Sweeny ◽  
Lifang Zhang ◽  
...  
Keyword(s):  
Public Health ◽  
Health Service ◽  
Primary Healthcare ◽  
Public Health Service ◽  
Hypertension Control ◽  
Regional Variability ◽  
Cross Sectional ◽  
The Public ◽  
Interview Survey ◽  
The Impact

AbstractObjectivesNon-communicable diseases (NCDs) have become the main cause of mortality in China. In 2009, the Chinese government introduced the Public Health Service Equalization (PHSE) program to restore the primary healthcare system in both essential medical care and public health service provision. This study evaluates the impact of management on hypertension control and evaluate how the program works.MethodsThe China National Health Development Research Centre (CNHDRC) undertook the Cross-sectional Health Service Interview Survey (CHSIS) of 62,097 people from primary healthcare reform pilot areas, across 17 provinces from eastern, central and western parts of China in 2014. This study is based on CHSIS survey responses from 9,607 participants, who had been diagnosed with hypertension. Regression analysis was used to estimate the impact of management provided under PHSE on hypertension control adjusting for the effects of other known determinants of hypertension control.FindingsUncontrolled hypertension was markedly lower among respondents, whose hypertension had been managed (22.4% in managed patients versus 31.1% in unmanaged patients, p<0.001). The interaction between PHSE management and the geographical region was highly significant in the model (p<0.001), suggesting that the PHSE program was not equally effective in all regions. Further analysis suggested that approximately 10% of regional variability was attributed to differences in administrative systems, as there was a significant association (P=0.014) between the presence of established regional Information Management Systems (IMS) and increased PHSE effectiveness. Insurance (χ2(5)=4.4, p=0.496) and Hukou (χ2(1)=2.4, p=0.121), which denote social security and urban rural differences, respectively, were not significant predictor of hypertension control.ConclusionActive management of hypertension through the PHSE program was effective with 7.31 million more patients receiving hypertension control and equalization of service delivery was reflected to some extent. The link between established IMS and regional variability in the impact of PHSE highlights the importance of effective management of patient referrals and follow-up. Further investigation is needed to explore the factors that influence the effectiveness of PHSE.

scholarly journals “Mom Let’s Go to the Dentist!” Preliminary Feasibility of a Tailored Dental Intervention for Children with Autism Spectrum Disorder in the Italian Public Health Service

2020 ◽  
Vol 10 (7) ◽  
pp. 444 ◽  
Author(s):  
Antonio Narzisi ◽  
Mariasole Bondioli ◽  
Francesca Pardossi ◽  
Lucia Billeci ◽  
Maria Claudia Buzzi ◽  
...  
Keyword(s):  
Public Health ◽  
Autism Spectrum Disorder ◽  
Health Service ◽  
Information And Communication Technologies ◽  
Dental Care ◽  
Public Health Service ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Medical Setting

Children with autism spectrum disorder (ASD) show worse oral health than their peers. Their access to health services is, at present, inadequate: few high-quality interventions have been designed and implemented to improve their care procedures so far. The purpose of this study is to describe an experience of dental care supported by Information and Communication Technologies (ICT), for children with ASD in a public health service. In our study, 59 children (mean age 9.9 years; SD = 5.43) participated in the MyDentist project. It integrates classic dental care techniques with new practices for desensitization and fear control, delivered through an enhanced customized ICT-based intervention aiming at familiarizing the child with ASD with the medical setting and procedures. Two questionnaires were filled out by parents to describe the acceptability of the MyDentist experience for their children. Significant results were shown from T0 (before initiating MyDentist) to T1 (after 6 months of the MyDentist experience) regarding improved oral hygiene and cooperation during dental treatments. Families positively assessed the use of ICT support. In conclusion, the project demonstrated acceptability by parents, suggesting that public health dental care and prevention can be successfully implemented without resorting to costly pharmacological interventions (with potential side effects), taking better care of children’s health.

Twenty-first century emergency response efforts of the Commissioned Corps of the US Public Health Service

2018 ◽  
Vol 16 (5) ◽  
pp. 311
Author(s):  
Jeffery L. Sumter, DrPH ◽  
Adrienne Goodrich-Doctor, PhD ◽  
Jill Roberts, PhD ◽  
Thomas J. Mason, PhD
Keyword(s):  
Public Health ◽  
Health Service ◽  
Public Health Service ◽  
Health And Safety ◽  
Emerging Diseases ◽  
First Century ◽  
Surgeon General ◽  
The Us ◽  
Twenty First Century ◽  
The Impact

The impact of the Commissioned Corps of the US Public Health Service (Commissioned Corps) on the health and safety of the nation spans more than two centuries. The public health efforts of the highly qualified health professionals of this often-underreported uniformed service include fighting threats like the great flu pandemic of 1918, the anthrax attacks, Ebola, and natural disasters such as Hurricanes Maria, Irma, and Katrina. As we near the first quarter of the twenty-first century, it is important to take a snapshot of the critical contributions and response efforts the Commissioned Corps has made in the first 18 years of the twenty-first century. Today, the Commissioned Corps faces new challenges in the form of emerging diseases and a rapidly growing opioid epidemic, but under the guidance of the US Surgeon General, it remains vigilant and fully capable of minimizing any public health threat it encounters.

The impact of public health service increased risk donors in pediatric liver transplantation

2020 ◽  
Vol 24 (4) ◽  
Author(s):  
Andre A. S. Dick ◽  
Niviann M. Blondet ◽  
Kathryn Shaw ◽  
Patrick J. Healey ◽  
Simon Horslen ◽  
...  
Keyword(s):  
Public Health ◽  
Liver Transplantation ◽  
Health Service ◽  
Public Health Service ◽  
Pediatric Liver Transplantation ◽  
Pediatric Liver ◽  
Increased Risk ◽  
The Impact
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