Journal of Public Health Research (PAGEPress Publications)
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Healthcare in Ghana amidst the coronavirus pandemic: a narrative literature review
Full text linkThe Coronavirus pandemic has caused more deaths than any other single disease since the outbreak was confirmed. The World Health Organization in collaboration with national and international health agencies continues to lead the way in bracing global healthcare systems to fight the pandemic. There are variations in national capacities towards the preparedness and management of the pandemic. The Government of Ghana, through the Ministry of Health and Ghana Health Service, continues to provide policy and operational directions towards the containment of the pandemic. The purpose of this study is to review the setup of the healthcare sector in Ghana in light of the ongoing pandemic. This study is a narrative literature review in which data was extracted from electronic databases such as PubMed, Google Scholar, Scopus and Ebscohost that published Covid-19 research articles from Ghana. Literature was analyzed and discussed based on the structures and systems available in the healthcare sector, as well as trends available from the global perspective. The healthcare sector in Ghana continues to support the citizenry in the wake of the Coronavirus pandemic. The government provides regular updates and continue to pledge their support in dealing with the effects of the pandemic. Challenges with accessibility, workforce, funding, and infrastructure remain the major hindrances in fighting the pandemic. The government and healthcare partners need to continually reform the healthcare system to meet the increasing demand for healthcare during the pandemic
Development and psychometric properties of the general public's attitudes toward advance care directives scale in Portugal
Full text linkBackground: To date, no instrument in Portugal has evaluated the attitudes of the population about advance care directives. This paper describes the development and testing of the General Public's Attitudes Toward Advance Care Directives (GPATACD) Scale.Design and Methods: Methodological study. The development of the instrument was based on a literature review, updated in 2018. Face and content validity were verified by an expert panel and piloted among six participants. Data were collected in an online survey of 1024 Portuguese adults. The obtained data were analyzed using Varimax rotation, while the reliability was evaluated by calculating Cronbach’s alpha.Results: The scale achieves good Item-Content Validity Index (I-CVI) values, between 0.89 and 1.00, and scale-CVI values of 0.91. A principal component analysis generated four dimensions with 26 items as a final scale, with overall Cronbach’s alpha of 0.848.Conclusions: The findings demonstrate that the scale is valid and reliable as a vehicle for assessment of the general public's attitudes toward advance care directives
Effectiveness of warning graphic labels on cigarette packs in enhancing late-teenagers’ perceived fear of smoking-related harms in Bangkok, Thailand
Full text linkBackground: This study investigated the level of fear of smoking-related harms for teenagers of different gender, different levels of smoking behaviour, and difference in smoking levels of friends and family members, as influenced by warning graphic images on cigarette packs. The study also compared levels of this fear in categories based on participants’ perception (e.g., scarier or less scary images).Design and Methods: The sample group was 353 undergraduate students at King Mongkut’s University of Technology Thonburi in Bangkok, Thailand. Questionnaires containing 21 warning graphic images, aimed at measuring levels of fear of smoking-related harms, were conducted. Both descriptive statistics and inferential statistics, such as independent and dependent t-test, were used to analyse the data.Results: The results showed that warning graphic images exhibiting patients suffering from cancers (e.g., lung cancer or laryngeal cancer) and images of damaged body parts were perceived as the scariest warning images. In contrast, images that did not illustrate serious disease suffered by smokers were perceived as the least scary images. The scariest images generated a significant higher level of fear of smoking-related harms than the least scary images. In addition, non-smoking participants were more sensitive to scary warning images than smoking participants. It was also found that the level of fear of smoking-related harms was significantly based on individual cognitive judgment, and it was not affected by the influence of social groups such as friends and family members.Conclusions: Developing effective warning graphic images could directly contribute to individuals’ perceived health risks and danger associated with smoking
Dynamic estimation of epidemiological parameters of COVID-19 outbreak and effects of interventions on its spread
Full text linkBackground: A key challenge in estimating epidemiological parameters for a pandemic such as the initial COVID-19 outbreak in Wuhan is the discrepancy between the officially reported number of infections and the true number of infections. A common approach to tackling the challenge is to use the number of infections exported from the originating city to infer the true number. This approach can only provide a static estimate of the epidemiological parameters before city lockdown because there are almost no exported cases thereafter.Methods: We propose a Bayesian estimation method that dynamically estimates the epidemiological parameters by recovering true numbers of infections from day-to-day official numbers. To illustrate the use of this method, we provide a comprehensive retrospection on how the COVID-19 had progressed in Wuhan from January 19 to March 5, 2020. Particularly, we estimate that the outbreak sizes by January 23 and March 5 were 11,239 [95% CI 4,794–22,372] and 124,506 [95% CI 69,526–265,113], respectively.Results: The effective reproduction number attained its maximum on January 24 (3.42 [95% CI 3.34–3.50]) and became less than 1 from February 7 (0.76 [95% CI 0.65–0.92]). We also estimate the effects of two major government interventions on the spread of COVID-19 in Wuhan.Conclusions: This case study by our proposed method affirms the believed importance and effectiveness of imposing tight non-essential travel restrictions and affirm the importance and effectiveness of government interventions (e.g., transportation suspension and large scale hospitalization) for effective mitigation of COVID-19 community spread
Awareness of dementia risk reduction among current and future healthcare professionals: A survey study
Full text linkBackground: The total number of people affected by dementia worldwide is increasing rapidly. Recent studies provided evidence for the contribution of modifiable risk and protective factors to dementia risk. Although healthcare professionals could play an essential role in informing the general public about the relationship between lifestyle and dementia, it is unclear what they know about this relationship. Therefore, this study assesses the awareness of dementia risk reduction among current and future healthcare professionals.Design and methods: An online survey was carried out among 182 healthcare students from Maastricht University and 20 general practitioners (GPs) and practice nurses in Limburg, The Netherlands. The survey assessed the knowledge about risk and protective factors of dementia and identified needs, wishes and barriers concerning dementia risk reduction strategies.Results: The majority of current (75.0%) and future (81.9%) healthcare professionals indicated that dementia risk reduction is possible. Among students, awareness of cardiovascular risk factors of dementia (e.g., coronary heart disease (44.5%), hypertension (53.8%)) was low. Most participants (>70.0%) would like to receive more information about dementia risk reduction.Conclusions: The majority of current and future healthcare professionals were aware of the relationship between lifestyle and dementia risk. However, there are still substantial gaps in knowledge regarding individual dementia risk factors. Given the essential role of healthcare professionals in providing lifestyle advice, there is a need to increase awareness by providing educational programs focused on dementia risk reduction
Environmental and biological monitoring of formaldehyde inside a hospital setting: a combined approach to manage chemical risk in workplaces
Full text linkBackground: The safety of healthcare workers exposed to formaldehyde remains a great matter of concern for healthcare management units. This work aimed at describing the results of a combined monitoring approach (environmental and biological) to manage occupational exposure to formaldehyde in a hospital setting.Design and Methods: Environmental monitoring of working spaces and biological monitoring of urinary formaldehyde in 16 exposed healthcare workers of the Anatomic Pathology Unit of a University Hospital in Southern Italy was performed on a four-year timescale (2016-2019).Results: Values of aero-dispersed formaldehyde identified were on average low; although workers' urinary formaldehyde levels were also minimal, the statistical analysis highlighted a slight weekly accumulation.Conclusions: Our data confirm that both environmental and biological monitoring are important to identify risk situations, in particular when values of hazardous compounds are below the accepted occupational exposure levels
Prevalence and associated factors of anxiety and depression in students at a Greek university during COVID-19 lockdown
Full text linkBackground: Restrictions on movement and lockdown are measures taken in many nations, in response to the COVID-19 pandemic. University students are additionally burdened by the transition to distance e-learning. The aims of the study were to investigate the prevalence of anxiety and depression in university students and to identify associated risk factors.Design and Methods: An online questionnaire was administered to 2,009 students in the University of Patras, Greece, during the national lockdown. Socio-demographic, academic data, and the forced disruption of daily life were assessed along with the Greek version of the Hospital Anxiety and Depression Scale.Results: Anxiety and depression prevalence was 35.8% and 51.2% respectively. Age, school of study, financial status, self-perceived health status, level of satisfaction with the state's and university's response and specific aspects in the daily routine were associated with both anxiety and depression scores. At higher odds of both depression and anxiety were students with low income, bad health status, annoyed at staying home and those who encountered difficulties with the online education system. Additional risk factors for depression were studies in humanities and social sciences, and low satisfaction with the university's response, while for anxiety were studies in agricultural sciences and absence of information about COVID-19.Conclusions: The proportion of Greek students showing depression and anxiety, during the restrictive measures, is alarming. Mental health in university students should be monitored. Mitigation strategies should focus on specific personal, academic and social variables that have been identified as protective factors
Drawbacks and aftermath of the Affordable Care Act: ex-ante moral hazard and inequalities in health care access
Full text linkBackground: Following the introduction of the Affordable Care Act, various studies have tried to identify the effects of the Reform, without reaching a clear consensus. The aim of this study was to investigate whether expansion of the Medicaid program has led to less inequality in access to health care and to a higher level of ex-ante moral hazard.Design and Methods: The analysis was conducted on two-year longitudinal data (2014-2015) regarding a cohort of 15,898 individuals from a Medical Expenditure Panel Survey (MEPS). After a data cleaning procedure, a sample of 9,255 individuals was selected for the inequality part of the study and 2,307 for the ex-ante moral hazard analysis. Propensity score matching with nearest-neighbour and kernel matching algorithms, difference-in-difference models and concentration index, corrected according to Erreygers methodology, were adopted.Results: The analysis showed that disparities were reduced between social classes although the ex-ante moral hazard is a real problem with the Affordable Care Act since individuals covered by public insurance tended to abuse the public service. Among those who benefited from the Act, a reduction in preventive behaviours was observed: there was an increase in smoking and a decrease in level of physical activity. As far as concerns access to health care, there was a decrease in inequality in emergency visits, inability to get care and getting care when needed among beneficiaries of the Reform.Conclusions: This study demonstrates that the extension of Medicaid has had a dual effect of reducing disparities in access to health care but, at the same time, it seems to have induced people to take less care of themselves
The experiences of women from Atoin Meto tribe who performed Sifon ritual in the context of HIV/AIDS transmission
Full text linkBackground: Sifon is ritual sexual intercourse after male circumcision from the Atoin Meto tribe that contributes to HIV/AIDS transmission. Ritual Sifon may put at risk for HIV infection and also sexual transmission diseases (STDs). Doing ritual Sifon as a culture, without using protection during intercourse becomes one way to get HIV infection from infected men. Few studies explore this phenomenon among women who become Sifon. Therefore, the aim of this study is to explore the experience of Sifon women in the context of HIV/AIDS transmission.Design and Methods: The data were collected from March to July 2020. This study used a phenomenological approach with a purposive sampling technique. Inclusion criteria: the women from Atoin Meto tribe aged above eighteen years old who have been Sifon women for at least six months. The participants were recruited through traditional healers in Nekbaun village of Kupang District and Timor Tengah Selatan District. The data were analyzed by the Colaizzi method.Results: Thirteen women were interviewed and we found four themes: lack of knowledge about HIV/AIDS transmission, unaware Sifon women, women who experienced STDs, using traditional medicine to treat STDs (Timor medicine).Conclusions: The interpretation of Sifon women’s experiences that performed Sifon rituals indicated that Sifon is a risk factor for transmitting HIV/AIDS. Preventive and promotional educational programs with a cultural approach are needed to reduce the risk of HIV/AIDS transmission