Epidemiological Study of the Brucellosis in Iran, Isfahan, 2010–2015

Background and aims: Brucellosis is one of the most common infectious diseases in both humans and animals. It has been controlled in developed countries; however, it is still regarded as a public health problem in developing countries including Iran. The aim of this study was to investigate the epidemiology of human brucellosis in Isfahan province. Methods: The present study is a cross-sectional descriptive study investigating the epidemiology of human brucellosis in Isfahan province from 2010 to 2015. Sampling was done using Isfahan’s disease registry database. Chi-square and t test were used for analyzing the data, and all data analyses were performed using SPSS software version 21.0. Results: A total of 3,245 patients were included in this study, and their mean (SD) age was 35.29 (18.00) years. The age group of 15-25 years with a frequency of 23.80% had the highest frequency of the disease. The annual incidence of the disease from 2010 to 2014 shows an increasing trend, reaching from 6.25 to 15 per 100000 people. It was reduced in 2015 and reached 12.25 per 100000. In addition, the highest incidence was observed in July. Conclusion: This study implies that the trend of human brucellosis has been increasing over the years, so it is recommended that people be educated on how to prevent it in humans and animals. The results of this study can help health administrators in the province to more effectively control the disease at the provincial level by identifying high-risk cities and focusing on health care in these areas.

Influenza Vaccination in Massachusetts Jails: A Mixed-Methods Analysis

Objectives Influenza infects millions of people each year and contributes to tens of thousands of deaths annually despite the availability of vaccines. People most at risk of influenza complications are disproportionately represented in people incarcerated in US prisons and jails. The objectives of this study were to survey health administrators in Massachusetts county jails about institutional influenza vaccine policies and practices and estimate influenza vaccination rates in Massachusetts jails from 2013 to 2020. Methods In April 2020, we administered surveys to the health services administrators in Massachusetts’ 14 county jails to gather information about influenza vaccination policies and delivery practices. To calculate influenza vaccination rates for each facility, we obtained data on influenza vaccine orders from the Massachusetts Department of Public Health for each county in Massachusetts for influenza seasons 2013-2020. We calculated summary statistics for each reporting facility and each year, conducted a Kruskal–Wallis analysis to compare vaccination rates between years, and used a linear regression model to identify predictors of vaccination rates. Results Influenza vaccination rates in Massachusetts jails ranged from 1.9% to 11.8%. We found no significant differences in vaccination rates between years. Influenza vaccine ordering and delivery practices varied by jail, and respondents had high levels of confidence in influenza policies and vaccine delivery practices. Conclusions Influenza vaccination rates in Massachusetts jails are low, and delivery practices in jails vary. Lack of influenza vaccinations in jails is a gap in health care that needs to be prioritized, especially considering the current COVID-19 pandemic. Further investigations for effective and equitable vaccination in this population should involve people who are incarcerated and people who make influenza vaccine policies in jails.

Tracking COVID-19 vaccine hesitancy and logistical challenges: A machine learning approach

In this study, we use an effective word embedding model (word2vec) to systematically track ’vaccine hesitancy’ and ’logistical challenges’ associated with the Covid-19 vaccines, in the USA. To that effect, we use news articles from reputed media sources and create dictionaries to estimate different aspects of vaccine hesitancy and logistical challenges. Using machine learning and natural language processing techniques, we have developed (i) three sub-dictionaries that indicate vaccine hesitancy, and (ii) another dictionary for logistical challenges associated with vaccine production and distribution. Vaccine hesitancy dictionaries capture three aspects: (a) general vaccine related concerns, mistrusts, skepticisms, and hesitancy, (b) discussions on symptoms and side-effects, and (c) discussions on vaccine related physical effects. The dictionary on logistical challenges includes the words and phrases related to the production, storage, and distribution of vaccines. Our results show that over time, as vaccine developers complete different phase trials and get approval for their respective vaccines, the number of vaccine related news articles increases sharply. Accordingly, we also see a sharp increase in vaccine hesitancy related topics in news articles. However, in January 2021, there has been a decrease in the vaccine hesitancy score, which will give some relief to the health administrators and regulators. Our findings further show that as we get closer to the breakthrough of effective Covid-19 vaccines, new logistical challenges continue to rise, even in recent months.

Polio Vaccination Literacy Among Mothers of Selected Barangay Health Centers in a Component City

Every health worker strikes hard for every child's death, most notably when it is due to a disease that is readily preventable with a safe and effective vaccine. The tragedy is hard to accept when health practitioners see the consequences of children missing out on vaccination first-hand. This research was intended to bridge the literature gap on the knowledge, and the reasons mothers comply with polio vaccination. The study was intended to assess the level of literacy on polio vaccination of mothers in selected barangays in Bago City when they are taken as a whole and grouped according to age, educational attainment, distance to health facility, number of children, family income, and barangay location administered. A descriptive-comparative research design using a very highly reliable and valid researcher made questionnaire was administered to respondents. The level of literacy of mothers on polio vaccination in selected barangays of Bago City when grouped according to age, educational attainment, the distance of health facility, number of children, family income, and barangay location was very high. The major reasons for compliance of mothers with polio vaccination can be attributed to health workers who can give follow up through home visits and any health professional who can give the polio vaccine. Due to reported vaccine scare and the current pandemic the study will benefit rural health administrators, community health nurses, and future researchers. Findings could provide rural health administrators with insights to conduct a re-assessment of the implementation of vaccination programs initiated by the Department of Health

Collaborative care in secondary prevention of cardiovascular disease in India: Findings from a multi-stakeholder, qualitative analysis

Background. Cardiovascular disease (CVD) is pervasive in India, and little is known about the perception of patients and providers about collaborative care in secondary prevention of CVD. To fill this gap, we performed a needs assessment and investigated the barriers and facilitators of the collaborative quality improvement (C-QIP) strategy for secondary prevention of CVD in India.Methods. Between September 2019 – February 2020, we conducted semi-structured in-depth interviews with providers, health administrators, patients and caregivers to understand the challenges and facilitators of the C-QIP strategy consisting of electronic health records-decision support system (EHR-DSS), non-physician health worker and text messages for healthy lifestyle. Also, data were analyzed from the lens of consolidated framework for implementation research (CFIR) to guide effective implementation of the C-QIP strategy. We used an iterative approach for qualitative data analysis based on the framework method. Results. We interviewed 38 physicians, 14 non-physician health workers (nurses, community health workers, pharmacists), 4 health administrators, 16 patients and their caregivers. Challenges perceived from providers’ and health administrators’ perspectives to implement quality in CVD care were related to CFIR actors and inner and outer settings: high patient volume, too few specialists, time-constraints, physician burnout, lack of robust communication system or referral linkage, paucity of electronic health records, lack of patient counsellors, polypharmacy and lack of sustainable financing schemes for outpatient services. In addition, low health literacy, high cost of treatment, misinformation bias, and difficulty in maintaining lifestyle changes were key barriers from patients’ and caregivers’ perspectives. Potential benefits of the C-QIP strategy emerged, such as standardized treatment protocol to minimize variation in care, reduced medication errors, improved physician-patient relationships, and enhanced self-care management. However, concerns were raised about feasibility, adoption, and implementation of EHR-DSS across heterogenous healthcare settings, including related to interoperability, patient confidentiality and data security, appropriateness across diverse patient groups, and care delivery costs.Conclusions. Our findings reveal context-specific, patient-, provider- and health system factors that will influence C-QIP strategy implementation in India. Strategies to optimize chronic care of CVD need to be low-cost, culturally acceptable, targeted, and integrated into existing systems and care pathways to be successful.

Collaborative Care in Secondary Prevention of Cardiovascular Disease in India: Findings From A Multi-Stakeholder, Qualitative Analysis

Background. Cardiovascular disease (CVD) is pervasive in India, and little is known about the perception of patients and providers about collaborative care in secondary prevention of CVD. To fill this gap, we performed a needs assessment and investigated the barriers and facilitators of the collaborative quality improvement (C-QIP) strategy for secondary prevention of CVD in India.Methods. Between September 2019 – February 2020, we conducted semi-structured in-depth interviews with providers, health administrators, patients and caregivers to understand the challenges and facilitators of the C-QIP strategy consisting of electronic health records-decision support system (EHR-DSS), non-physician health worker and text messages for healthy lifestyle. Also, data were analyzed from the lens of consolidated framework for implementation research (CFIR) to guide effective implementation of the C-QIP strategy. We used an iterative approach for qualitative data analysis based on the framework method. Results. We interviewed 38 physicians, 14 non-physician health workers (nurses, community health workers, pharmacists), 4 health administrators, 16 patients and their caregivers. Challenges perceived from providers’ and health administrators’ perspectives to implement quality in CVD care were related to CFIR actors and inner and outer settings: high patient volume, too few specialists, time-constraints, physician burnout, lack of robust communication system or referral linkage, paucity of electronic health records, lack of patient counsellors, polypharmacy and lack of sustainable financing schemes for outpatient services. In addition, low health literacy, high cost of treatment, misinformation bias, and difficulty in maintaining lifestyle changes were key barriers from patients’ and caregivers’ perspectives. Potential benefits of the C-QIP strategy emerged, such as standardized treatment protocol to minimize variation in care, reduced medication errors, improved physician-patient relationships, and enhanced self-care management. However, concerns were raised about feasibility, adoption, and implementation of EHR-DSS across heterogenous healthcare settings, including related to interoperability, patient confidentiality and data security, appropriateness across diverse patient groups, and care delivery costs.Conclusions. Our findings reveal context-specific, patient-, provider- and health system factors that will influence C-QIP strategy implementation in India. Strategies to optimize chronic care of CVD need to be low-cost, culturally acceptable, targeted, and integrated into existing systems and care pathways to be successful.

Decontamination Interventions for the Reuse of Surgical Mask Personal Protective Equipment: A Protocol for an Updated Systematic Review

The COVID-19 pandemic has placed surgical and medical facemask PPE in high demand. Their use spans a variety of healthcare settings and many hospitals have implemented universal masking policies. Furthermore, the emergence of COVID-19 variants with greater transmissibility and infectivity has led some countries to recommend or mandate widespread public use of 3-layer medical masks in lieu of homemade masks or face coverings. Since the publication of our original systematic review, COVID-19-related literature has evolved from >2000 citations in mid-March 2020 to >80,000 citations by the beginning of December 2020. Coupled with the protracted course of the COVID-19 pandemic continuing to threaten facemask PPE supply and demand, an updated systematic review on decontamination interventions for surgical masks is needed to reflect critical new evidence in order to best inform clinicians, infection control experts, and public health administrators on how best to advise safe decontamination and reuse practices. The objective of this systematic review is to update a previously conducted systematic review and identify and synthesize new data from published studies evaluating interventions used to decontaminate or treat surgical mask PPE for the purposes of reuse.

Temporal variation and geospatial clustering of dengue in Delhi, India 2015–2018

ObjectivesThe study was focused on geographical mapping of dengue cases and also to identify the hotspots or high-risk areas of dengue in Delhi.DesignA retrospective spatial–temporal (ecological) study. Descriptive analysis was used to know the distribution of dengue cases by age, sex, seasons and districts of Delhi. The spatiotemporal analysis was performed using inverse distance weighting and Getis-Ord Gi* statistic to know the geographical distribution and identify the hotspot areas.SettingsAll the confirmed and diagnosed dengue cases (IgM +ve or NS1 Antigen +ve ELISA) recorded by the Municipal Corporation of Delhi for the last 4 years (2015–2018) were collected with their local address. The location of all the dengue cases was geocoded using their address to prepare the spatiotemporal dengue database.ParticipantsRecord of all the dengue cases (4179) reported for treatment in the hospitals during the past 4 years were extracted and included in the study. Data were not collected directly from dengue patients.ResultsSeasonal occurrence of dengue cases (4179) shows that the cases start emerging in July, peaked in September–October and declined in December. The proportions of dengue cases were recorded high among the males 57.3% compared with females 42.6%, and differences were also recorded in all the age groups with more cases in age groups <15 and 16-30 years. Mapping of the cases reflects the spatial heterogeneity in the geographical distribution. The geomapping of cases indicates the presence of a significantly high number of cases in West, Southwest, South and Southeast districts of Delhi. High-risk areas or hotspots were also identified in this region.ConclusionDengue occurrence shows significant association with age, sex and seasons. The spatial analysis identified the high-risk areas, which can aid health administrators to take necessary action for prevention and better disease management.

An Integrated School Health Teacher for Whole Student Health in China: Professional Competency Inventory

This study aimed to develop a professional competency inventory for integrated school health teachers in the Chinese schooling system. It generated initial competency items through conducting job task analyses, group interviews, and expert consultations, which proposed 75 items in the following fields: general quality, basic health service, school health education, and school health management. A total of 312 school health administrators/instructors, principals, in-service health teachers, and preservice health teachers were surveyed during 2018-2019. Respondents valued aspects of health teacher’s professional competency differently. Exploratory factor analyses finally extracted 9 domains, and 70 competency standards were retained. The Cronbach’s α level was .983, with value for each domain ranging from .855 to .955. The final competency inventory for school health teachers contained 4 fields, 9 domains with 70 competencies. It provided a reliable framework for specialized training, evaluation, and professional development for school health teachers. The study also interpreted the differences in importance perception of competencies among stakeholders, provided across cultural views for elaborating values and meanings of school health personnel all over the world.

Knowledge and practices towards COVID-19 among Palestinians during the COVID-19 outbreak: A second round cross-sectional survey

Coronavirus disease 2019 (COVID-19) is a highly transmissible illness that spreads rapidly through human-to-human transmission. To assess the knowledge and practices of Palestinians towards COVID-19 after the ease of movement restrictions, we collected data from Palestinian adults between June 15th and June 30th 2020. The participants’ pool represented a stratified sample of 1355 adults from Palestinian households across 11 governorates in the West Bank. The questionnaire included 7 demographic questions, 13 questions about participants’ knowledge and awareness of COVID–19, and 4 questions regarding the participants’ safety measures that had been taken in the last three months. Based on the results of this study, we conclude that the majority of participants have a good knowledge about COVID-19, but were not adequately committed to the infection control measures necessary to protect themselves and others. The findings may provide valuable feedback to lawmakers and health administrators to prevent the spread of the epidemic.