scholarly journals COVID-19 Testing in Sweden During 2020–Split Responsibilities and Multi-Level Challenges

2021 ◽  
Vol 9 ◽  
Author(s):  
Mio Fredriksson ◽  
Anna Hallberg
Keyword(s):  
Public Health ◽  
Communicable Disease ◽  
Health Agency ◽  
Good Deal ◽  
Medical Reason ◽  
The Public ◽  
System A ◽  
Response Measures ◽  
Multi Level ◽  
The Individual

Sweden's use of soft response measures early in the COVID-19 pandemic received a good deal of international attention. Within Sweden, one of the most debated aspects of the pandemic response has been COVID-19 testing and the time it took to increase testing capacity. In this article, the development of and the debate surrounding COVID-19 testing in Sweden during 2020 is described in detail, with a particular focus on the coordination between national and regional actors in the decentralised healthcare system. A qualitative case study was carried out based on qualitative document analysis with a chronological presentation. To understand COVID-19 testing in Sweden, two aspects of its public administration model emerged as particularly important: (i) the large and independent government agencies and (ii) self-governing regions and municipalities. In addition, the responsibility principle in Swedish crisis management was crucial. Overall, the results show that mass testing was a new area for coordination and involved a number of national and regional actors with partly different views on their respective roles, responsibilities and interpretations of the laws and regulations. The description shows the ambiguities in the purpose of testing and the shortcomings in communication and cooperation during the first half of 2020, but after that an increasing consistency among the crucial actors. During the first half of 2020, testing capacity in Sweden was limited and reserved to protect the most vulnerable in society. Because mass testing for viruses is not normally carried out by the 21 self-governing regions responsible for healthcare and communicable disease prevention, and the Public Health Agency of Sweden stated that there was no medical reason to test members of the public falling ill with COVID-like symptoms, the responsibility for mass testing fell through the cracks during the first few months of the pandemic. This article thus illustrates problems associated with multi-level governance in healthcare during a crisis and illustrates the discrepancy between the health service's focus on the individual and the public health-oriented work carried out within communicable disease control.

scholarly journals Leveraging public health's participation in a Health Information Exchange to improve communicable disease reporting

2017 ◽  
Vol 9 (2) ◽  
Author(s):  
Ian Painter ◽  
Debra Revere ◽  
P. Joseph Gibson ◽  
Janet Baseman
Keyword(s):  
Public Health ◽  
Health Information ◽  
Information Exchange ◽  
Health Information Exchange ◽  
Communicable Disease ◽  
Health Agency ◽  
Public Health Agency ◽  
Public Health Agencies ◽  
The Public ◽  
The Mean

Background: Infectious diseases can appear and spread rapidly. Timely information about disease patterns and trends allows public health agencies to quickly investigate and efficiently contain those diseases. But disease case reporting to public health has traditionally been paper-based, resulting in somewhat slow, burdensome processes. Fortunately, the expanding use of electronic health records and health information exchanges has created opportunities for more rapid, complete, and easily managed case reporting and investigation. To assess how this new service might impact the efficiency and quality of a public health agency's case investigations, we compared the timeliness of usual case investigation to that of case investigations based on case report forms that were partially pre-populated with electronic data. Intervention: Between September 2013-March 2014, chlamydia disease report forms for certain clinics in Indianapolis were electronically pre-populated with clinical, lab and patient data available through the Indiana Health Information Exchange, then provided to the patient’s doctor. Doctors could then sign the form and deliver it to public health for investigation and population-level disease tracking. Methods: We utilized a novel matched case analysis of timeliness changes in receipt and processing of communicable disease report forms. Each Chlamydia cases reported with the pre-populated form were matched to cases reported in usual ways. We assessed the time from receipt of the case at the public health agency: 1) inclusion of the case into the public health surveillance system and 2) to close to case. A hierarchical random effects model was used to compare mean difference in each outcome between the target cases and the matched cases, with random intercepts for case. Results: Twenty-one Chlamydia cases were reported to the public health agency using the pre-populated form. Sixteen of these pre-populated form cases were matched to at least one other case, with a mean of 23 matches per case. The mean Reporting Lag for the pre-populated form cases was 2.5 days, which was 2.7 days shorter than the mean Reporting Lag for the matched controls (p = <0.001). The mean time to close a pre-populated form case was 4.7 days, which was 0.2 days shorter than time to close for the matched controls (p = 0.792). Conclusions: Use of pre-populated forms significantly decreased the time it took for the local public health agency to begin documenting and closing chlamydia case investigations. Thoughtful use of electronic health data for case reporting may decrease the per-case workload of public health agencies, and improve the timeliness of information about the pattern and spread of disease.

scholarly journals At-a-glance - The Child Maltreatment Surveillance Indicator Framework

2020 ◽  
Vol 40 (2) ◽  
pp. 58-61
Author(s):  
Aimée Campeau ◽  
Shazmeera Qadri ◽  
Farah Barakat ◽  
Gabriella Williams ◽  
Wendy Hovdestad ◽  
...  
Keyword(s):  
Public Health ◽  
Child Maltreatment ◽  
Health Agency ◽  
Public Health Issue ◽  
Outcome Indicators ◽  
The Public ◽  
Indicator Framework ◽  
Interactive Data ◽  
The Individual ◽  
Meta Analyses

The federal health portfolio has conducted surveillance on child maltreatment as a public health issue since the 1990s. The Public Health Agency of Canada (PHAC) is now releasing the Child Maltreatment Indicator Framework, to take its place alongside other PHAC frameworks, such as the Suicide Surveillance Indicator Framework. Based on a scoping review of existing reviews and meta-analyses, this Framework, along with the online interactive data tool, presents child maltreatment outcome indicators and risk and protective factors at the individual, family, community and societal levels, disaggregated by sex, age and other sociodemographic variables. This Framework will function as a valuable resource pertaining to an issue that affects at least one in three Canadian adults.

Developmental Disorders in Canada

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Sarah Palmeter
Keyword(s):  
Public Health ◽  
Developmental Disorders ◽  
Health Agency ◽  
The Public ◽  
Age Of Diagnosis ◽  
High Level ◽  
Project Objectives ◽  
Disability Severity ◽  
Occupational Function ◽  
Improve Health

In the completion of my practicum at the Public Health Agency of Canada (PHAC) this summer, I worked to develop a surveillance knowledge product to support the national surveillance of developmental disorders. This project used Statistics Canada’s 2017 Canadian Survey on Disability to investigate the burden of developmental disorders in Canada. Developmental disorders are conditions with onset in the developmental period. They are associated with developmental deficits and impairments of personal, social, academic, and occupational function. The project objectives are to estimate the prevalence of developmental disorders in Canadians 15 years of age or older, overall and by age and sex, as well as report on the age of diagnosis, disability severity, and disability co-occurrence in those with developmental disorders. The majority of the analysis has been completed and preliminary results completed, which cannot be released prior to PHAC publication. Although not highly prevalent, developmental disorders are associated with a high level of disability in young Canadians. Early detection and interventions have been shown to improve health and social outcomes among affected individuals. Understanding the burden of developmental disorders in Canada is essential to the development of public health policies and services.

The Public Health Crisis Survival Guide

2018 ◽  
Author(s):  
Joshua M. Sharfstein
Keyword(s):  
Public Health ◽  
Police Officers ◽  
Health Agency ◽  
Health Improvement ◽  
Strong Response ◽  
Popular Imagination ◽  
Health Crisis ◽  
The Public ◽  
Public Health Crisis ◽  
Critical Skills

Firefighters fight fires. Police officers race to crime scenes, sirens blaring. And health officials? Health officials respond to crises. There are infectious disease crises, budget crises, environmental health crises, human resources crises—and many more. At such critical moments, what happens next really matters. A strong response can generate greater credibility and authority for a health agency and its leadership, while a bungled response can lead to humiliation and even resignation. Health officials must be able to manage and communicate effectively as emotions run high, communities become engaged, politicians lean in, and journalists circle. In popular imagination, leaders intuitively rise to the challenge of a crisis: Either they have what it takes or they do not. In fact, preparation is invaluable, and critical skills can be learned and practiced. Students and health officials alike can prepare not only to avoid catastrophe during crises, but to take advantage of new opportunities for health improvement. The Public Health Crisis Survival Guide provides historical perspective, managerial insight, and strategic guidance to help health officials at all levels not just survive but thrive in the most challenging of times.

THE PEDIATRICIAN AND THE PUBLIC

PEDIATRICS ◽  
1953 ◽  
Vol 11 (3) ◽  
pp. 284-285
Keyword(s):  
Public Health ◽  
Health Service ◽  
Professional Training ◽  
Public Health Service ◽  
Communicable Disease ◽  
Medical Engineering ◽  
Laboratory Research ◽  
Industrial Plant ◽  
Research Projects ◽  
The Public

I appreciate very much your invitation to bring to the readers of Pediatrics information about summer assignments in the Public Health Service, the qualifications required and the results that may be anticipated from a few months' experience with our Service. For more than four years, now, the Public Health Service has made available summer employment to a limited number of students in medical, engineering, and basic science professions. The practice has proved beneficial to the Service in providing assistance to selected public health clinical and research projects. It also has offered actual working experience in a supervised environment for students in the medical and allied scientific fields. Many students and a number of deans have expressed appreciation of the opportunities which summer employment has contributed to the professional training and development of the students. Our reason for initiating the summer program has been twofold. We need the temporary assistance of competent students in many of our operating and research programs and we want more students to become acquainted with the reasons for the conduct of public health activities. Students selected for these assignments receive civil service appointments which begin at the close of the academic year and terminate early in September. The salary is $284 a month. These summer assignments cover a wide area of Public Health Service activity. They range from laboratory research projects at the National Institutes of Health to investigations of communicable disease problems at the Communicable Disease Center; from clinical assistant posts in venereal disease clinics to assistant-ships in our psychiatric hospital; from studies of industrial plant hazards to epidemiological investigations of psittacosis.

A sustainable community based model of non-communicable disease risk factor surveillance: “SHRADDHA-JAGRITHI project” (Preprint)

2021 ◽  
Author(s):  
Jaideep Menon ◽  
Mathews Numpeli ◽  
Sajeev.P. Kunjan ◽  
Beena.V. Karimbuvayilil ◽  
Aswathy Sreedevi ◽  
...  
Keyword(s):  
Public Health ◽  
Health System ◽  
Public Health System ◽  
Health Workers ◽  
Communicable Disease ◽  
Community Based ◽  
Frontline Health Workers ◽  
The Individual ◽  
Non Communicable Disease

UNSTRUCTURED Abstract: India has a massive non-communicable disease (NCD) burden at an enormous cost to the individual, family, society and health system at large, in spite of which prevention and surveillance is relatively neglected. Risk factors for atherosclerotic cardiovascular disease if diagnosed early and treated adequately would help decrease the mortality and morbidity burden. India is in a stage of rapid epidemiological transition with the state of Kerala being at the forefront, pointing us towards likely disease burden and outcomes for the rest of the country, in the future. A previous study done by the same investigators, in a population of >100,000, revealed poor awareness and treatment of NCDs and also poor adherence to medicines in individuals with CVD. The investigators are looking at a sustainable, community based model of surveillance for NCDs with corporate support wherein frontline health workers check all individuals in the target group ( > age 30 years) with further follow up and treatment planned in a “spoke and hub” model using the public health system of primary health centres (PHCs) as spokes to the hubs of Taluk or District hospitals. All data entry done by frontline health workers would be on a Tab PC ensuring rapid acquisition and transfer of participant health details to PHCs for further follow up and treatment. The model will be evaluated based on the utilisation rate of various services offered at all tier levels. The proportions of the target population screened, eligible individuals who reached the spoke or hub centres for risk stratification and care and community level control for hypertension and diabetes in annual surveys will be used as indicator variables. The model ensures diagnosis and follow up treatment at no cost to the individual entirely through the tiered public health system of the state and country.

scholarly journals A guideline on how to synthesize knowledge by reviews at the Public Health Agency of Sweden

2016 ◽  
Vol 26 (suppl_1) ◽  
Author(s):  
A Månsdotter ◽  
K Godoy ◽  
K Guldbrandsson ◽  
R Henriksson ◽  
S Löfdahl ◽  
...  
Keyword(s):  
Public Health ◽  
Health Agency ◽  
Public Health Agency ◽  
The Public

scholarly journals The Evolutionary Ecology of Age at Natural Menopause: Implications for Public Health

2020 ◽  
Author(s):  
Abigail Fraser ◽  
Elise Whitley ◽  
Cathy Johnman ◽  
Alex Alvergne
Keyword(s):  
Public Health ◽  
Evolutionary Ecology ◽  
Animal Kingdom ◽  
Natural Menopause ◽  
Biological Ageing ◽  
The Public ◽  
Age At Menopause ◽  
Multi Level ◽  
Evolutionary Perspectives ◽  
Do So

Evolutionary perspectives on menopause have focused on explaining why early reproductive cessation in females has emerged and why it is rare throughout the animal kingdom, but less attention has been given to exploring patterns of diversity in age at natural menopause. In this paper, we aim to generate new hypotheses for understanding human patterns of diversity in this trait, defined as age at final menstrual period. To do so, we develop a multi-level, inter-disciplinary framework, combining proximate, physiological understandings of ovarian ageing with ultimate, evolutionary perspectives on ageing. We begin by reviewing known patterns of diversity in age at natural menopause in humans, and highlight issues in how menopause is currently defined and measured. Second, we consider together ultimate explanations of menopause timing and proximate understandings of ovarian ageing. We find that ovarian ageing is highly constrained by ageing of the follicle - the somatic structure containing the oocyte - suggesting that menopause timing might be best understood as a by-product of ageing rather than a facultative adaptation. Third, we investigate whether the determinants of somatic senescence also underpin menopause timing. We show that diversity in age at menopause can be, at least partly, explained by the genetic, ecological and life-history determinants of somatic ageing. The public health implications of rethinking menopause as the by-product rather than the catalyst of biological ageing are discussed.

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