Journal of Public Health Research (PAGEPress Publications)
Not a member yet
556 research outputs found
Sort by
Technical efficiency and productivity of public district hospitals in KwaZulu-Natal province, South Africa
Get PDFBackground: District hospitals (DHs) constitute a significant proportion of public hospitals and consume a more substantial percentage of the government’s total hospital budget. With the level of resources disbursed to DHs, it is essential to ensure efficient allocation and utilization. Hence, this study set out to assess the technical efficiency and productivity of public DHs in KwaZulu-Natal province, South Africa. Methods: Data envelopment analysis (DEA) and Malmquist total factor productivity (MTFP) were used to assess technical efficiency, identify adjustments required to make inefficient facilities more efficient, and determine overall productivity growth. Input data such as medical personnel and output information such as outpatient visits were retrieved from the databases of the district health information system (DHIS), and personnel salary systems (PERSAL) for three consecutive financial years (2014/15, 2015/16 and 2016/17). A total of 38 district hospitals were included in the study. Results: The proportion of technically efficient facilities according to constant return to scale (CRS) were 12 (31.6%), 16 (42.1%) and 14 (36.8%) in 2014/15, 2015/16 and 2016/17, respectively, while according to the variable return to scale (VRS) technically efficient facilities were 22 (57.9%), 19 (50.0) and 21 (55.2%), respectively, for the three consecutive years. On average, the total productivity of DHs increased by 4.8 percent over the three years, which is attributed majorly to technical growth of 6.9 percent. Conclusion: This study showed that a significant proportion of the district hospitals were technically inefficiency. Also, steps that could enable more efficient use of healthcare resources to yield optimal health service delivery were recommended
Applying systems thinking and human-centered design to development of intervention implementation strategies: an example from adolescent health research
Get PDFIntroducing innovative health interventions into clinic settings requires a comprehensive and creative approach to multiple implementation challenges. To optimize implementation of a sexual and reproductive health intervention for young women with depression, we applied systems thinking and human-centered design thinking methods to develop tools and strategies to address issues influencing intervention implementation in diverse clinics. We recruited staff from three clinics that provide sexual and reproductive health and behavioral health care to young women. Across five sessions (four video conference calls, one in-person workshop), we used systems mapping to identify key stakeholders and their relationships, processes, and challenges to care; formed clinic staff-investigator design teams; brainstormed about challenges that would influence intervention implementation and considered potential solutions; prioritized implementation challenges; and designed prototypes of solutions. Participants responded positively to the systems thinking perspective and collaborative design thinking process, which resulted in generalizable considerations about solving implementation challenges for clinic-based interventions
Trade and safety issues of raw beef from the countryside of Bahia state, Brazil
Get PDFBackground: Brazil is one of the world's largest meat exporters. However, there is a paradox in this situation due to existing non-inspected meat trade and technical-sanitary failures in retail marketing. Design and methods: This study aimed at characterizing the issues of trade, food safety and quality of raw beef in the street market of a municipality in the state of Bahia. An exploratory, quantitative and census study was carried out, at 17 raw beef vending locations. A questionnaire was administered and meat samples were collected (n=34), which were submitted to a physicochemical assessment, color analysis and microbiological analyses.Results: Meat sellers were between 20 and 64 years of age, predominantly males (82.4%), with limited education and without professional training (64.7%). Medians for temperature and pH in the small butcher shops samples were 18.10ºC and 5.75 respectively, and 21.80ºC and 5.50, in small supermarkets samples. The difference in pH was significant (p<0.05). The filtration test suggested quality changes in 17.65% of the samples. No frauds were detected. Total coliform count medians were 4.90 and 4.78 log CFU/g, for the samples taken from butcher shops and supermarkets, respectively. E. coli was identified in approximately 40.0% of the samples. Salmonella spp. were confirmed in two samples collected in the butcher shops. There was a significant association between inadequate storage conditions and microorganism counts (p<0.02).Conclusions: The results evidenced a meat supply with preservation failures and non-compliance with hygiene requirements, constituting a consumers’ health hazard, not in line with an agro-exporting country model
Using system mapping to help plan and implement city-wide action to promote physical activity
Get PDFBackground. There is growing interest in conceptualising public health problems such as physical inactivity as the outcome of multiple interacting factors within complex systems. Methods. We worked with stakeholders involved in a city-wide physical activity promotion programme in Derby, UK to prodiuce conceptual maps of the major modifiable drivers of physical activity, and used them to explore ways in which the existing programme took a systems approach, and how it might be enhanced. Semi-structured interviews were subsequently undertaken to assess their views on the contribution of the mapping approach. Results. Feedback from stakeholders described the mapping as valuable, especially in helping to identify the limitations of the original approach taken in the city. Conclusions. Even a very simple application of systems thinking can be a useful tool for disaggregating the key factors driving a system, helping to identify areas that merit greater attention, and supporting effective action.  
Impact of COVID-19 lockdown on sleep-wake schedule and associated lifestyle related behavior: A national survey
Get PDFBackground: Lockdowns to prevent the community transmission of COVID-19 pandemic has confined the people at home and imposed social restrictions, which is expected to cause alterations in circadian driven sleep-wake schedule and its associated lifestyle behaviors. Design and Methods: An online questionnaire-based survey was conducted to assess the impact of lockdown on the sleep-wake pattern, meal timings and digital media exposure time on the Indian population during lockdown. Responses of 1511 participants (age ≥18 years) were analyzed to assess the effect of gender and age on these parameters before and during lockdown.Results: The sleep onset-wakeup times and meals’ time was significantly delayed during lockdown, which was more pronounced in younger subjects. However, young individuals reported increased sleep duration at this time. Increased digital media duration was evident in all age groups, mainly in males. However, females reported more delay in sleep onset-waking time and first meal timing with longer sleep duration during lockdown.Conclusions: Discord with social and natural cues due to complete lockdown during COVID-19 pandemic leads to a state of social jetlag with delayed sleep-wake, meal timings and excessive digital media exposure among Indians, which has differential impact on males and females as well as across different age groups. These findings have applied implications in sleep health and related behavior during longer social isolation conditions such as current COVID-19 or similar situations and may help to prepare better for any such future events
Family support and adaptation mechanisms of adults outpatients with schizophrenia
Get PDFBackground: The presence of psychotic symptoms in adults’ with schizophrenia need an increase in family control and support to prevent the risk of aggressive behavior. However, the issue of whether psychotic symptoms hold any clinical relevance in relatively stable outpatient samples has not been established. The purpose of this study, therefore, was to identify the relationship between family supports and adaptation mechanisms of adults’ outpatients with schizophrenia. Design and methods: The study design involves quantitative research and descriptive correlation, attained through purposive sampling approach. 101 samples were obtained from the population of schizophrenia outpatients. The questionnaires of House and Kahn were used as an instrument to evaluate family support, while Nursalam questionnaires were used to access adaptation skills. Results: Findings from Spearman’s rho test showed P<0.005, indicating the provision of high family support, while patients were highly adaptive to the symptoms of schizophrenia. Conclusions: This study indicates the positive influence of family support on the adaptability of schizophrenia outpatients, hence there is need for relatives to provide good level of support, in order to facilitate adaptability
Undocumented migrants during the Covid-19 pandemic: social conditions, clinical features and pharmacological treatment
No full textPopulation groups such as undocumented migrants have been almost completely forgotten during the COVID-19 pandemic, though they have been living in all European countries for decades and new arrivals have continued throughout the pandemic. The aim of this study was to investigate their health conditions during the current pandemic. We analysed the records of 272 patients with respiratory issues attending the outpatient clinic of a large charity in Milan, Italy: amongst them, 18 had COVID-19 confirmed by rhino-pharyngeal swab and 1 of them deceased. All the patients attending the clinic appeared to have several risk factors for COVID-19 and chronic conditions suspected to predispose to the disease and/or to worsen severity and outcomes: hypertension, immunosuppression and previous close contact with COVID-19 patients were the most important ones. Presenting symptoms were worse in patients with COVID-19 than in those with other respiratory issues. These results are discussed in light of the necessity to provide better healthcare to undocumented migrants
Feasibility and acceptability of an oral pathology asynchronous tele-mentoring intervention: A protocol
Get PDFIntroduction: Oral cancer remains prevalent, despite being largely preventable. The widespread use of technology at chairside, combined with advances in electronic health record (EHR) capabilities, present opportunities to improve oral cancer screening by dentists, especially for disadvantaged patients with severe health needs. Design and methods: Using a mixed-methods approach, we will evaluate the feasibility and acceptability of integrating a tele-mentoring component into the identification of oral lesions using the following 3 methods: 1) administering provider surveys that consist of a checklist of 10 key components of the intervention based on process, and asking the dental provider subjects if each one was covered; 2) conducting semi-structured interviews informed by the Consolidated Framework for Implementation Research and the Implementation Outcomes Framework with dental resident subjects to assess specific barriers to sustaining the intervention and strategies for addressing these barriers to facilitate integration of the intervention into the routine workflow of the dental clinics; and 3) administering brief exit interviews with patient subjects regarding the acceptability of the intervention to assess satisfaction with the use of intra-oral cameras at chairside to screen for and refer patients with oral lesions and identification of these oral lesions via EHR and secure e-mail tele-mentoring with an oral pathology expert.Expected impact of the study for public health: If successful, then later clinical trials will maximize the external validity of the intervention and facilitate the widespread implementation and dissemination of the model for the teaching of dentists and residents, with the ultimate goal of improving patient care
The fight against stigma: Multilevel stigma interventions in schizophrenia patients
Get PDFBackground: Stigma is one of the main factors causing pasung (physical restraint or confinement in Indonesian terms) in schizophrenia patients. It is the main obstacle to reducing the number of pasung throughout the world. Thus, there is a need for appropriate interventions to reduce stigma in schizophrenia patients who go through pasung. This study aims to identify multilevel stigma interventions in people with schizophrenia who go through pasung (physical restraint and confinement). It can be applied and adapted to various cultural contexts. Design and Methods: Quasi-experimental research with pretest and post-test analysis consists of 82 people with schizophrenia who go through pasung. Respondents were divided into the intervention group and the control group. A multilevel stigma intervention was given to the intervention group for three months.Results: There was a significant difference in the average stigma score in the control group (moderate category stigma) and the intervention group (mild category stigma) after multilevel stigma intervention (p-value = 0.04). The average stigma score of schizophrenia patients in the intervention group decreased by 8.2%, while the average stigma score in the control group increase of 20.4%.Conclusions: Multilevel stigma interventions are effective in reducing stigma in people with schizophrenia who go through pasung. We underline that multilevel stigma interventions through collaboration from various parties can provide great opportunities in stigma reduction programs in people with schizophrenia who go through pasung
Relationship between caring nurses and elderly loneliness
Get PDFBackground: Elderly people tend to experience biological, psychological, social, and spiritual changes due to the aging process. Changes in their psychology lead to a feeling of loneliness and depression, which have a negative impact on their physical health and overall well-being. Nurses as care providers, need to ensure they are always beside the elderly to prevent them from being lonely. This study, therefore, aims to determine the relationship between caring nurses and the level of loneliness of elderly. Design and Methods: This is an observational analytic design study with a cross sectional approach. Simple random sampling was used to obtain data from a total of 113 elderly people in home care. Furthermore, the CBI 24 Items and UCLA Loneliness Version 3, were used for data collection, while Spearmen’s Rho Test with a level of ρ <α = 0.05 was used for its analysis. Results: The results showed that caring nurses tend to prevent the emergence of loneliness in the elderly with a Spearmen’s Rho test P at 0.00015 (P≤0.05) and correlation coefficient r of -0.686. Conclusions: In conclusion, there is a relationship between caring nurses and the level of loneliness in the elderly