INNOVATIVE MEDICINES INITIATIVE: THE SPRINTT PROJECT

The current healthcare systems are built around the traditional paradigm of patients suffering from a single acute illness. They are therefore largely unprepared to face the increasing demands for health services arising from the expansion of an older population with specific medical needs related to multiple chronic disorders. As a consequence, the medical conditions of a large and growing segment of the older European population are not efficiently managed by the available healthcare services (1). Among these conditions, the geriatric syndrome of frailty has emerged as a significant public health priority. It is defined as a multidimensional condition characterised by decreased reserve and diminished resistance to stressors (2).

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Clostridium difficile Infection Epidemiology over a Period of 8 Years—A Single Centre Study

Sustainability ◽

10.3390/su12114439 ◽

2020 ◽

Vol 12 (11) ◽

pp. 4439 ◽

Cited By ~ 1

Author(s):

Nicoleta Negrut ◽

Delia Carmen Nistor-Cseppento ◽

Shamim Ahmad Khan ◽

Carmen Pantis ◽

Teodor Andrei Maghiar ◽

...

Keyword(s):

Public Health ◽

Clostridium Difficile ◽

Clostridium Difficile Infection ◽

Healthcare Services ◽

Common Infectious Disease ◽

Single Centre Study ◽

Significant Public Health ◽

The Mean ◽

North Western ◽

Antibiotic Associated Diarrhoea

Clostridium difficile infection (CDI) is the most common infectious disease related to antibiotic-associated diarrhoea and is a current leading cause of morbidity/mortality, with substantial consequences for healthcare services and overall public health. Thus, we performed a retrospective epidemiological study of CDI for a long period (8 years), in an infectious hospital located in north-western Romania, which serves an entire county of the country (617,827 inhabitants). From 2011 to 2018, 877 patients were diagnosed with CDI; the mean incidence of this disease was 2.76 cases/10,000 patient-days, with an increasing trend in the annual incidence until 2016, at which point there was a decrease. The most commonly afflicted were patients in the 75–84 age group, observed in winter and spring. The results show that the antibiotics were administered in 679 (77.42%) subjects, within the last 3 months before CDI, statistically significant more than proton-pump inhibitors (PPIs)—128 (14.60%) and antidepressant medications—60 (6.84%), which were administered during the same period (p < 0.001). No medication was reported in 10 (6.84%) cases of CDI, in the last 3 months of the study. The fatality rate attained 4.1%, tripling in 2018 vs. 2011. CDI became a significant public health conundrum that can, nevertheless, be combatted through a judicious use of antibiotics.

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Applications of digital health for public health responses to COVID-19: a systematic scoping review of artificial intelligence, telehealth and related technologies

npj Digital Medicine ◽

10.1038/s41746-021-00412-9 ◽

2021 ◽

Vol 4 (1) ◽

Author(s):

Dinesh Visva Gunasekeran ◽

Rachel Marjorie Wei Wen Tseng ◽

Yih-Chung Tham ◽

Tien Yin Wong

Keyword(s):

Public Health ◽

Artificial Intelligence ◽

Scoping Review ◽

Real World ◽

Digital Health ◽

Large Body ◽

Healthcare Services ◽

Digital Platforms ◽

Medical Needs ◽

Wide Range

AbstractThe coronavirus disease 2019 (COVID-19) pandemic has overwhelmed healthcare services, faced with the twin challenges in acutely meeting the medical needs of patients with COVID-19 while continuing essential services for non-COVID-19 illnesses. The need to re-invent, re-organize and transform healthcare and co-ordinate clinical services at a population level is urgent as countries that controlled initial outbreaks start to experience resurgences. A wide range of digital health solutions have been proposed, although the extent of successful real-world applications of these technologies is unclear. This study aims to review applications of artificial intelligence (AI), telehealth, and other relevant digital health solutions for public health responses in the healthcare operating environment amidst the COVID-19 pandemic. A systematic scoping review was performed to identify potentially relevant reports. Key findings include a large body of evidence for various clinical and operational applications of telehealth (40.1%, n = 99/247). Although a large quantity of reports investigated applications of artificial intelligence (AI) (44.9%, n = 111/247) and big data analytics (36.0%, n = 89/247), weaknesses in study design limit generalizability and translation, highlighting the need for more pragmatic real-world investigations. There were also few descriptions of applications for the internet of things (IoT) (2.0%, n = 5/247), digital platforms for communication (DC) (10.9%, 27/247), digital solutions for data management (DM) (1.6%, n = 4/247), and digital structural screening (DS) (8.9%, n = 22/247); representing gaps and opportunities for digital public health. Finally, the performance of digital health technology for operational applications related to population surveillance and points of entry have not been adequately evaluated.

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Modeling Public Health and Healthcare Systems

10.1093/med/9780190667924.001.0001 ◽

2017 ◽

Author(s):

Sanjay Basu

Keyword(s):

Public Health ◽

Operations Research ◽

Queuing Theory ◽

Control Strategies ◽

Waiting Times ◽

Healthcare Services ◽

Healthcare Systems ◽

Systems Science ◽

Screening Programs ◽

Modeling Techniques

This book aims to empower readers to learn and apply engineering, operations research, and modeling techniques to improve public health programs and healthcare systems. Readers will engage in in-depth study of disease detection and control strategies from a “systems science” perspective, which involves the use of common engineering, operations research, and mathematical modeling techniques such as optimization, queuing theory, Markov and Kermack-McKendrick models, and microsimulation. Chapters focus on applying these techniques to classical public health dilemmas such as how to optimize screening programs, reduce waiting times for healthcare services, solve resource allocation problems, and compare macroscale disease control strategies that cannot be easily evaluated through standard public health methods such as randomized trials or cohort studies. The book is organized around solving real-world problems, typically derived from actual experiences by staff at nongovernmental organizations, departments of public health, and international health agencies. In addition to teaching the theory behind modeling methods, the book aims to confer practical skills to readers through practice in model implementation using the statistical software R.

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Integrated Healthcare and the Dilemma of Public Health Emergencies

Sustainability ◽

10.3390/su13084517 ◽

2021 ◽

Vol 13 (8) ◽

pp. 4517

Author(s):

Krzysztof Goniewicz ◽

Eric Carlström ◽

Attila J. Hertelendy ◽

Frederick M. Burkle ◽

Mariusz Goniewicz ◽

...

Keyword(s):

Public Health ◽

Patient Care ◽

Chronically Ill ◽

Healthcare Services ◽

Healthcare Systems ◽

Direct Patient Care ◽

Global Public Health ◽

Integrated Healthcare ◽

Public Health Emergencies ◽

The Individual

Traditional healthcare services have demonstrated structural shortcomings in the delivery of patient care and enforced numerous elements of integration in the delivery of healthcare services. Integrated healthcare aims at providing all healthcare that makes humans healthy. However, with mainly chronically ill people and seniors, typically suffering from numerous comorbidities and diseases, being recruited for care, there is a need for a change in the healthcare service structure beyond direct-patient care to be compatible in peacetime and during public health emergencies. This article’s objective is to discuss the opportunities and obstacles for increasing the effectiveness of healthcare through improved integration. A rapid evidence review approach was used by performing a systematic followed by a non-systematic literature review and content analysis. The results confirmed that integrated healthcare systems play an increasingly important role in healthcare system reforms undertaken in European Union countries. The essence of these changes is the transition from the episodic treatment of acute diseases to the provision of coordinated medical services, focused on chronic cases, prevention, and ensuring patient continuity. However, integrated healthcare, at a level not yet fully defined, will be necessary if we are to both define and attain the integrated practice of both global health and global public health emergencies. This paper attains the necessary global challenges to integrate healthcare effectively at every level of society. There is a need for more knowledge to effectively develop, support, and disseminate initiatives related to coordinated healthcare in the individual healthcare systems.

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Identifying changes in trends in the age standardized incidence of melanoma in Australia

SKIN The Journal of Cutaneous Medicine ◽

10.25251/skin.3.4.3 ◽

2019 ◽

Vol 3 (4) ◽

pp. 250-252 ◽

Cited By ~ 1

Author(s):

David M Hille

Keyword(s):

Public Health ◽

Linear Regression ◽

Iterative Process ◽

Linear Trend ◽

Piecewise Linear ◽

Health Issue ◽

Public Health Issue ◽

Piecewise Linear Regression ◽

Significant Public Health ◽

Males And Females

ObjectiveTo identify changes in the linear trend of the age-standardized incidence of melanoma in Australia for all persons, males, and females. MethodsA two-piece piecewise linear regression was fitted to the data. The piecewise breakpoint varied through an iterative process to determine the model that best fits the data.ResultsStatistically significant changes in the trendof the age-standardized incidence of melanoma in Australia were found for all persons, males, and females. The optimal breakpoint for all persons and males was at 1998. For females, the optimal breakpoint was at 2005. The trend after these breakpoints was flatter than prior to the breakpoints, but still positive.ConclusionMelanoma is a significant public health issue in Australia. Overall incidence continues to increase. However, the rate at which the incidence is increasing appears to be decreasing.

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Corrupt Practices in the Public Health Sector: A Focus on Metropolitan Local Government Areas of Kano State, Nigeria

The Nigerian Journal of Sociology and Anthropology ◽

10.36108/njsa/0202/81(0290) ◽

2020 ◽

Vol 18 (2) ◽

pp. 149

Author(s):

Mohammed Mustapha Namadi

Keyword(s):

Public Health ◽

Local Government ◽

Health Sector ◽

Sampling Technique ◽

Healthcare Services ◽

Healthcare Sector ◽

Healthcare Provision ◽

The Public ◽

Public Health Sector ◽

The Government

Corruption is pervasive in Nigeria at all levels. Thus, despite recent gains in healthcare provision, the health sector faces numerous corruption related challenges. This study aims at examining areas of corruption in the health sector with specific focus on its types and nature. A sample size of 480 respondents aged 18 years and above was drawn from the eight Metropolitan Local Government Areas of Kano State, using the multistage sampling technique. The results revealed evidence of corrupt practices including those related to unnecessary-absenteeism, diversion of patients from the public health facilities to the private sector, diverting money meant for the purchase of equipment, fuel and diesel, bribery, stealing of medications, fraud, misappropriation of medications and unjustifiable reimbursement claims. In order to resolve the problem of corrupt practices in the healthcare sector, the study recommended the need for enforcement of appropriate code of ethics guiding the conduct of the health professionals, adoption of anti-corruption strategies, and strengthening the government monitoring system to check corruption in public health sector in order to ensure equitable access to healthcare services among the under-privileged people in the society.

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Fidelity and Its Relationship to Implementation Effectiveness, Adaptation, and Dissemination

10.1093/oso/9780190683214.003.0016 ◽

2017 ◽

Cited By ~ 2

Author(s):

Jennifer D. Allen ◽

Rachel C. Shelton ◽

Karen M. Emmons ◽

Laura A. Linnan

Keyword(s):

Public Health ◽

Treatment Strategies ◽

Implementation Fidelity ◽

Population Level ◽

The United States ◽

Dissemination And Implementation ◽

Evidence Based ◽

Health Gains ◽

Significant Public Health ◽

Research Continuum

There is substantial variability in the implementation of evidence-based interventions across the United States, which leads to inconsistent access to evidence-based prevention and treatment strategies at a population level. Increased dissemination and implementation of evidence-based interventions could result in significant public health gains. While the availability of evidence-based interventions is increasing, study of implementation, adaptation, and dissemination has only recently gained attention in public health. To date, insufficient attention has been given to the issue of fidelity. Consideration of fidelity is necessary to balance the need for internal and external validity across the research continuum. There is also a need for a more robust literature to increase knowledge about factors that influence fidelity, strategies for maximizing fidelity, methods for measuring and analyzing fidelity, and examining sources of variability in implementation fidelity.

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Funding models and expenditures with primary healthcare in Salvador, Bahia, Brazil metropolitan area

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.551 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

T Vivas ◽

M Duarte ◽

A Pitta ◽

B Christovam

Keyword(s):

Public Health ◽

Metropolitan Area ◽

Primary Healthcare ◽

Healthcare Services ◽

Ministry Of Health ◽

Healthcare Budget ◽

Health Budget ◽

The Public ◽

Before And After ◽

The Government

Abstract Background The government investments in quality primary healthcare are the basis to strengthening the health systems and monitoring the public expenditure in this area is a way to assess the effectiveness and efficiency of the public health policies. The Brazil Ministry of Health changed, in 2017, the method of onlending federal resources to states and cities seeking to make the public funds management more flexible. This change, however, suppressed mandatory investments in primary healthcare. This research aims to determine the difference of expenditures on primary healthcare in Salvador, Bahia, Brazil metropolitan area before and after this funding reform, seeking to verify how it can impact the quality of primary healthcare services and programs. Methods This is an ecological time-series study that used data obtained in the Brazil Ministry of Health budget reports. The median and interquartile range of expenditures on primary healthcare (set as the percentage of total public health budget applied in primary care services and programs) of the 13 cities in the Salvador metropolitan area were compared two years before and after the reform. Results The median of expenditures on primary healthcare in Salvador metropolitan area was 25.5% (13,9% - 32,2%) of total public health budget before and 24.8% (20.8% - 30.0%) of total public health budget after the reform (-0.7% difference). Seven cities decreased the expenditures on primary healthcare after the reform, ranging from 1.2% to 10.8% reduction in the primary healthcare budget in five years. Conclusions Expenditures on primary healthcare in Salvador metropolitan area decreased after the 2017 funding reform. Seven of 13 cities reduced the government investments on primary healthcare services and programs in this scenario. Although the overall difference was -0.7%, the budget cuts ranged from 1.2% to 10.8% in the analyzed period and sample. More studies should assess these events in wide areas and with long time ranges. Key messages Public health funding models can impact the primary healthcare settings regardless of the health policy. Reforms in the funding models should consider the possible benefits before implementation. Funding models and methods that require mandatory investments in primary healthcare may be considered over more flexible ones.

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A public health perspective on mental health: lessons for population health in the 21st century

Irish Journal of Psychological Medicine ◽

10.1017/ipm.2021.44 ◽

2021 ◽

pp. 1-4

Author(s):

James V. Lucey

Keyword(s):

Public Health ◽

Mental Health ◽

Population Health ◽

Royal College ◽

Public Support ◽

Healthcare Systems ◽

Lessons Learned ◽

Public Health Perspective ◽

The World ◽

Shared Commitment

In December 2019, clinicians and academics from the disciplines of public health and psychiatry met in Dublin at the Royal College of Surgeons in Ireland (RCSI), to restate their shared commitment to population health. The purpose of this review is to bring our discussion to a wider audience. The meeting could not have been more timely. Six weeks later, the COVID-19 emergency emerged in China and within 12 months it had swept the world. This paper, the contents of which were presented at that meeting in December recommended that future healthcare would be guided more by public health perspectives and informed by an understanding of health economics, population health and the lessons learned by psychiatry in the 20th century. Ultimately two issues are at stake in 21st century healthcare: the sustainability of our healthcare systems and the maintenance of public support for population health. We must plan for the next generation of healthcare. We need to do this now since it is clear that COVID-19 marks the beginning of 21st century medicine.

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Global Health Impacts of Dust Storms: A Systematic Review

Environmental Health Insights ◽

10.1177/11786302211018390 ◽

2021 ◽

Vol 15 ◽

pp. 117863022110183

Author(s):

Hamidreza Aghababaeian ◽

Abbas Ostadtaghizadeh ◽

Ali Ardalan ◽

Ali Asgary ◽

Mehry Akbary ◽

...

Keyword(s):

Public Health ◽

Systematic Review ◽

Respiratory Health ◽

Dust Storms ◽

Health Impacts ◽

Public Health Issue ◽

Emergency Medical Dispatch ◽

Significant Public Health ◽

English Articles

Background: Dust storms and their impacts on health are becoming a major public health issue. The current study examines the health impacts of dust storms around the world to provide an overview of this issue. Method: In this systematic review, 140 relevant and authoritative English articles on the impacts of dust storms on health (up to September 2019) were identified and extracted from 28 968 articles using valid keywords from various databases (PubMed, WOS, EMBASE, and Scopus) and multiple screening steps. Selected papers were then qualitatively examined and evaluated. Evaluation results were summarized using an Extraction Table. Results: The results of the study are divided into two parts: short and long-term impacts of dust storms. Short-term impacts include mortality, visitation, emergency medical dispatch, hospitalization, increased symptoms, and decreased pulmonary function. Long-term impacts include pregnancy, cognitive difficulties, and birth problems. Additionally, this study shows that dust storms have devastating impacts on health, affecting cardiovascular and respiratory health in particular. Conclusion: The findings of this study show that dust storms have significant public health impacts. More attention should be paid to these natural hazards to prepare for, respond to, and mitigate these hazardous events to reduce their negative health impacts. Registration: PROSPERO registration number CRD42018093325

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