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As disasters become more frequent and severe worldwide, disaster planning as a human endeavor is more important than ever, with the potential to save millions of lives globally. In this important new book, the author offers a practical, step-by-step guide for writing, implementing, and measuring the quality of your own disaster plan to address any threat with an approach that has been tested in public health and medical settings worldwide. Filling a significant gap in the existing literature, this book offers a comprehensive reference for both the principles and the practice of disaster planning. Access to a 25-lecture training course provides ancillary teaching materials for college level courses, offering added value for academic readers. An essential resource for public health graduates and anyone responsible for the management of disasters, primarily public health professionals, emergency physicians, first responders, and emergency managers.
This study aims for a greater understanding of how older adults (age 65 and older) in Jackson County, Florida, are prepared for and cope with the effects of a natural disaster.
A multidisciplinary, international research team developed a survey examining: (1) resources available to individuals aged 65+ in rural communities for preparing for a disaster; (2) challenges they face when experiencing a disaster; and (3) their physical, social, emotional, and financial needs when it strikes. The survey was administered with older adults (65+) in Jackson County, Florida, following Hurricane Michael in 2018. The descriptive, multivariate logistic, and linear regression analyses were performed to examine the relationship between respondents’ demographic information and needs, concerns, and consequences of disaster.
Results indicated (n = 139) rural community-dwelling older adults rely on social support, community organizations, and trusted disaster relief agencies to prepare for and recover from disaster-related events.
Such findings can be used to inform the development of new interventions, programs, policies, practices, and tools for emergency management and social service agencies to improve disaster preparedness and resiliency among older populations in rural communities.
As the US faced its lowest levels of reported trust in government, the COVID-19 crisis revealed the essential service that various federal agencies provide as sources of information. This Element explores variations in trust across various levels of government and government agencies based on a nationally-representative survey conducted in March of 2020. First, it examines trust in agencies including the Department of Health and Human Services, state health departments, and local health care providers. This includes variation across key characteristics including party identification, age, and race. Second, the Element explores the evolution of trust in health-related organizations throughout 2020 as the pandemic continued. The Element concludes with a discussion of the implications for agency-specific assessments of trust and their importance as we address historically low levels of trust in government. This title is also available as Open Access on Cambridge Core.
Due to the COVID-19 pandemic, there is currently a need for accurate, rapid, and easy-to-administer diagnostic tools to help communities manage local outbreaks and assess the spread of disease. The use of Artificial Intelligence within the domain of breath analysis techniques has shown to have potential in diagnosing a variety of diseases such as cancer and lung disease by analyzing volatile organic compounds (VOCs) in exhaled breath. This combined with their rapid, easy-to-use, and non-invasive nature makes them a good candidate for use in diagnosing COVID-19 in large scale public health operations. However, there remains issues with their implementation when it comes to the infrastructure currently available to support their use on a broad scale. This includes issues of standardization, and whether or not a characteristic VOC pattern can be identified for COVID-19. Despite these difficulties, breathalysers offer potential to assist in pandemic responses and their use should be investigated.
The COVID-19 pandemic has continued to exert enormous pressure on public health policies and systems, with far-reaching implications. The race for vaccines has raised important intellectual property rights issues. These are evident in the need to advance the public interest and in the obligation of governments to address the challenge of access to vaccines, especially in sub-Saharan countries like Nigeria with relatively underdeveloped healthcare and innovation ecosystems. While the Nigerian Patents and Designs Act (PDA) establishes a compulsory licence regime that affords access to patented drugs, existing public healthcare is severely challenged in providing access to new medicines. This article examines the framework for patent protection of pharmaceuticals designed to meet public health challenges, such as those presented by the pandemic. It recommends the implementation of a government use provision under the PDA, with a view to addressing the challenge of access to COVID-19 vaccines.
Like COVID-19, new infectious disease outbreaks emerge almost annually, and studies predict that this trend will continue due to a variety of factors, including an aging population, ease of travel, and globalization of the economy. In response to episodic public health crises, governments and organizations develop, implement, and enforce policies, procedures, protocols, and programs. The epidemiological triad is both a model of disease causation and fundamentally used to design and deploy such control measures. Here we adapt this model to the workplace setting and use the epidemiological triad to characterize the related ethical challenges in implementing the control measures employers face as a guide for a workplace intervention framework. Through this approach, our aim is to show how an integrated ethical framework, grounded in epidemiological principles, has important implications for how we categorize, understand, and resolve the difficult decisions that emerge in the workplace under pandemic conditions.
To investigate the influence of parental physical activity on offspring’s nutritional status in the 1993 Pelotas (Brazil) birth cohort.
Birth cohort study.
The main outcomes were overweight and obesity status of children. The main exposure was parental physical activity over time, measured during the 11, 15 and 18 years of age follow-ups. The exposure was operationalised as cumulative, and the most recent measure before the birth of child. We adjusted Poisson regression models with robust variance to evaluate crude and adjusted associations between parental physical activity and offspring’s nutritional status. All analyses were stratified according to the sex of the parent.
A total of 874 members from the 1993 Pelotas (Brazil) birth cohort followed-up at 22 years of age with their first-born child were analysed.
Children were, on average, 3·1 years old. Crude analyses showed that the mother’s cumulative physical activity measure had an indirect association with the prevalence of children’s obesity. The most recent maternal physical activity measure before the birth of the child was associated with 41 % lower prevalence of obesity in children, even after adjustment for confounders.
The most recent maternal physical activity measure was indirectly associated with the prevalence of obesity in children. No associations were found for fathers, reinforcing the hypothesis of a biological effect of maternal physical activity on offspring’s nutritional status.
Coronavirus disease 2019 (COVID-19) was first recognised in December 2019. The subsequent pandemic has caused 4.3 million deaths and affected the lives of billions. It has increased psychosocial risk factors for mental illness including fear, social isolation and financial insecurity and is likely to lead to an economic recession. COVID-19 is associated with a high rate of neuropsychiatric sequelae. The long-term effects of the pandemic on mental health remain uncertain but could be marked, with some predicting an increased demand for psychiatric services for years to come. COVID-19 has turned a spotlight on mental health for politicians, policy makers and the public and provides an opportunity to make mental health a higher public health priority. We review longstanding reasons for prioritising mental health and the urgency brought by the COVID-19 pandemic, and highlight strategies to improve mental health and reduce the psychiatric fallout of the pandemic.
Evidence of changes caused by the COVID-19 pandemic in food security and nutrition conditions, as well as in different food environments, has called researchers’ attention to substantial changes taking place in individuals’ dietary habits. The aim of this study is to present and address changes that have already happened in food environments, during the first COVID-19 pandemic year, in a middle-income country. Multiple changes were observed and had direct impact on the population, among them, worsened health and nutrition indicators and advanced dietary inequalities, as well as on its food profile in different life cycles, if one takes into consideration aspects such as food availability, financial access and dietary quality.
The role of ‘best investment’ methodology in shaping priorities in many health policy areas is becoming increasingly prominent. Whilst this has traditionally been seen as a technocratic exercise, the social and political context of such practices and the constructed nature of decisions are now considered significant. In this context, this article reports on a longitudinal case study of such a process that sought to identify ‘best investments’ in public health interventions related to promoting physical activity. Drawing on a series of conceptual resources, we describe and reflect upon the complex and invested elements that contributed to the grounded decision-making process. In conclusion we suggest the need to adopt a multifaceted and nuanced approach to resource investment decision making, including: deploying a range of appraisal assessment resources; maintaining a long-term processual perspective; involving a variety of stakeholders; accepting and embracing fallibility; and accommodating theoretical and empirical evidence-based principles.
In May 2020, the African Journal of Primary Health Care and Family Medicine invited submissions on lessons learnt from responses to the COVID-19 pandemic from primary care providers in Africa. This included descriptions of innovations and good practices, the management of COVID-19 in district health services and responses of communities to the outbreak.
To synthesise the lessons learnt from the COVID-19 pandemic in the Africa region.
A thematic document analysis was conducted on twenty-seven short report publications from Botswana, Ghana, Nigeria, South Africa, Uganda and Zimbabwe. Findings: Eight major themes were derived from the data: community-based activities; screening and testing; reorganisation of health services; emergency care for COVID-19; maintenance of essential non-COVID-19 health services; caring for the vulnerable; use of information technology; and reframing training opportunities. Community health workers were a vital community resource, delivering medications and other supplies to homes, as well as following up on patients with chronic conditions. More investment in community partnerships and social mobilisation was proposed. Difficulties with procurement of test kits and turn-around times were constraints for most countries. Authors described how services were reorganised for focused COVID-19 activities, sometimes to the detriment of essential services and training of junior doctors. Innovations in use of internet technology for communication and remote consultations were explored. The contribution of family medicine principles in upholding the humanity of patients and their families, clear leadership and planning, multidisciplinary teamwork and continuity of care was emphasised even in the context of providing critical care.
The community-orientated primary care approach was emphasised as well as long-term benefits of technological innovations. The pandemic exposed the need to deliver on governmental commitments to strengthening primary health care and universal health coverage.
Based on an analysis of relevant laws and policies, regulator data portals, and information requests, we find that clinical data, including clinical study reports, submitted to the European Medicines Agency and Health Canada to support approval of medicines are routinely made publicly available.
It remains unknown whether coronavirus disease 2019 (COVID-19) patients with bipolar disorders (BDs) are at an increased risk of mortality. We aimed to establish whether health outcomes and care differed between patients infected with COVID-19 with BD and patients without a diagnosis of severe mental illness.
We conducted a population-based cohort study of all patients with identified COVID-19 and respiratory symptoms who were hospitalized in France between February and June 2020. The outcomes were in-hospital mortality and intensive care unit (ICU) admission. We used propensity score matching to control for confounding factors.
In total, 50 407 patients were included, of whom 480 were patients with BD. Patients with BD were 2 years older, more frequently women and had more comorbidities than controls without a diagnosis of severe mental illness. Patients with BD had an increased in-hospital mortality rate (26.6% v. 21.9%; p = 0.034) and similar ICU admission rate (27.9% v. 28.4%, p = 0.799), as confirmed by propensity analysis [odds ratio, 95% confidence interval (OR, 95% CI) for mortality: 1.30 (1.16–1.45), p < 0.0001]. Significant interactions between BD and age and between BD and social deprivation were found, highlighting that the most important inequalities in mortality were observed in the youngest [OR, 95% CI 2.28 (1.18–4.41), p = 0.0015] and most deprived patients with BD [OR, 95% CI 1.60 (1.33–1.92), p < 0.001].
COVID-19 patients with BD were at an increased risk of mortality, which was exacerbated in the youngest and most deprived patients with BD. Patients with BD should thus be targeted as a high-risk population for severe forms of COVID-19, requiring enhanced preventive and disease management strategies.
Chefs have the potential to influence diet quality and food systems sustainability through their work. We aimed to assess the attitudes and perceptions of culinary students about nutrition and sustainability as part of their roles, responsibilities and future work as chefs.
We surveyed students attending the Culinary Institute of America (CIA) in the fall of 2019 (n 546). Descriptive statistics compared food priority rankings and Likert-scale distributions of nutrition and sustainability attitudes and beliefs. Adjusted generalised linear models were used to evaluate whether there were differences in attitudes and beliefs across demographic groups.
The CIA, a private, not-for-profit college and culinary school with US campuses in New York, California and Texas.
Students >18 years old currently enrolled in any of the school’s associate’s or bachelor’s degree programs.
Students agreed that chefs should be knowledgeable about nutrition (96·0 %) and the environmental impact of their ingredients (90·8 %) but fewer considered healthfulness (57·8 %) and environmental impact (60·2 %) of their food to be primary considerations in their career as a chef. Taste was the primary factor influencing culinary students’ food choices but food priorities differed by race/ethnicity.
Culinary students believe nutrition and sustainability are important. Opportunities exist to empower them with knowledge and skills for promoting public health and sustainable food systems in their future work as chefs.
This study sought to examine current national disaster risk management capacities, and identify governance barriers to strengthening national preparedness for responding to public health emergencies, associated with the anticipated climate-driven intensification of natural disaster cycles.
A mixed-methods online survey, assessing broader governance constraints to climate change adaptation (CCA) for public health, was distributed to representatives of national public health associations, and societies of 82 member countries under the World Federation of Public Health Associations. Specific questions relevant to disaster risk management capacities and barriers were analyzed as part of a narrowed focus on the CCA subdomain of emergency preparedness.
Existence of some technology, infrastructure, and/ or human resources, necessary to develop early warning and other surveillance systems for climate-related health risks was reported by 9 out of 11 responding countries. However, 7 reported persistent limitations and/ or regional discrepancies. Most significant identified barriers to strengthening emergency preparedness at the national level included governance coordination challenges, and, in the case of many developing countries, technical, medical, and human resource shortages.
The development of new frameworks for intersectoral governance and large-scale resource mobilization will prove crucial to ongoing efforts to strengthen national climate-health resiliency and prepare for disaster-associated health threats.
By exploring the uniquely dense urban network of the Low Countries, Janna Coomans debunks the myth of medieval cities as apathetic towards filth and disease. Based on new archival research and adopting a bio-political and spatial-material approach, Coomans traces how cities developed a broad range of practices to protect themselves and fight disease. Urban societies negotiated challenges to their collective health in the face of social, political and environmental change, transforming ideas on civic duties and the common good. Tasks were divided among different groups, including town governments, neighbours and guilds, and affected a wide range of areas, from water, fire and food, to pigs, prostitutes and plague. By studying these efforts in the round, Coomans offers new comparative insights and bolsters our understanding of the importance of population health and the physical world - infrastructures, flora and fauna - in governing medieval cities.
Nurses play an important role during disaster response and recovery. Few tools are available to assess the relative competence of nurses in disaster. This study aimed to develop, test, and evaluate a disaster nursing competency scale. This was an exploratory mixed methods study. In the qualitative phase, 35 Iranian nurses and managers with experience in disaster relief were asked about the skills they need to respond effectively to a disaster event. From the qualitative data, a 50-item questionnaire was developed. In the quantitative phase, exploratory factor analysis was conducted with 400 samples followed by a test-retest reliability assessment with 30 nurses. The developed and validated instrument was applied to 200 nurses in Iran to assess their competency. From content analysis of the qualitative data, 5 main themes emerged. In the quantitative phase, exploratory factor analysis loaded 50 items into 4 domains named management, legal and ethical, specific personal, and technical competence. Use of the tool showed that nurses estimated their competence overall at 70.28%. Findings demonstrate the necessity for new domains in disaster nursing competencies; which may be applicable as a useful tool and guideline to improve nursing education and practice.
The response of nurses in Japan to the Fukushima Daiichi Nuclear Power Plant accident was deemed inadequate. This study examined the issues in Japanese radiation nursing education.
Anonymous, self-administered postal questionnaires were sent to managers and teachers of 1053 basic nursing educational institutions in Japan.
Among the 342 institutions that completed the questionnaire, 218 (63.7%) had incorporated Radiological Nursing Education into their curriculum while 124 (36.3%) had not. Based on the time of their incorporation, they were divided into the pre-accident incorporation group and the post-accident incorporation groups. For 89 of 111 institutions (85.6%) in the former group, the main reason for the incorporation was radiotherapy care. For 11 of 26 institutions (42.3%) in the latter group, the incorporation was their response to the nuclear disaster.
Nursing education in Japan has been inadequate, and as such, nurses find it hard to respond to nuclear disasters. Examining the current nursing education system and building a new model based on the nuclear disaster experience are urgent issues.