Global health education for the post-pandemic years: parity, people, planet, priorities, and practices

Global health degree programs are now offered by institutions of higher education in most world regions. Based on our review of the curricula for many of these programs, we identified five domains that are central to current global health education. “Parity” emphasizes health equity as the ultimate goal of global health. “People” comprises the social, economic, cultural, and political contributors to health and access to medical care for individuals and communities. “Planet” encompasses various aspects of globalization and environmental health that affect population health. “Priorities” and “practices” include the values, data, and tools used to design, implement, and evaluate partnerships, policies, programs, and other global health interventions in countries of all income levels. The pandemic is likely to increase student demand for global health education from the undergraduate through the graduate and professional levels. Our “5 Ps model of global health education” provides a comprehensive framework for the core student learning objectives for global health today. Knowledge of each of these domains is essential for preparing students for meaningful experiential learning and skilled professional practice in global health.

The seeking medical attention in the urban adult population prior and during the coronavirus pandemic (COVID-19)

Introduction. The appeal of the population for medical care in the conditions of a pandemic and strict quarantine measures has not been sufficiently analyzed in the scientific medical literature to date. The purpose of the work. Analysis of the urban adult population’s access to medical care before and during the COVID-19 pandemic. Material and methods. Based on the materials of the consolidated statistical reports of Krasnoyarsk, the indicators of the appeal and morbidity of the adult population for 2017-2020 were studied. The obtained information was analyzed using absolute and relative values. Results. The analysis of the adult population’s appeal indicators in the pre-pandemic period and the COVID-19 pandemic period showed a decrease of 43.8%. The decrease in the population’s treatment for preventive purposes occurred in all points, except for points Z20-Z29 (potential health hazard associated with infectious diseases), the indicators of which increased by 67.4% or 11.4%. The decrease in the overall morbidity rate during the pandemic was due to a decrease in the frequency of referrals with previously known diseases by 80.4%. The primary morbidity rate increased by 64.3%. Discussion. The indicators of the incidence of the adult population of COVID-19 obtained by us have differences but do not contradict the data obtained by other researchers. As our study showed, the measures taken did not lead to a significant decrease in the population’s appeal to medical institutions. Conclusion. The comparative data obtained allows assessing the impact of the COVID-19 pandemic and the ongoing anti-epidemic measures on the treatment and morbidity of the adult population.

The efficiency of the respiratory system of men at risk of social exclusion

Background: Some part of the Polish society, after 1989, especially that coming from the remote farming areas – on the bankrupt State Agriculatural Farm could not cope in the new reality. Unemployment and the associated bad financial situation, poor housing conditions, and even homelessness, difficult access to medical care often generated the beginnings of social exclusion. Did those aspects also generate the impairment of the respiratory system or do the socio-demographic conditions demonstrate the relationship with the efficiency of the respiratory system? Material and Methods: 210 people from Tuchola County at risk of social exclusion underwent spirometry testing. The spirometry results were demonstrated against a background of the same measurements carried out on the group of 95 people – physical labourers and white-collar workers of Kazimierz Wielki University. Basic socio-demographic conditions of people at risk of social exclusion were surveyed. Results: Low efficiency of the respiratory system is a characteristic feature of people at risk of social exclusion. Social and living conditions (including housing conditions and unemployment period) demonstrate vital relations with the efficiency of the respiratory system. Conclusions: Poor social and living conditions and smoking of the examined people significantly change their chances of the standard spirometry results. However, good social and living conditions suggest that there is a possibility of the compensation of bad effects of smoking.

COVID-19 Impact and Vaccination Willingness among Romanian Patients with Autoimmune/Immune-Mediated Diseases

Background: During the COVID-19 pandemic, patients with immune diseases are a vulnerable population. We aimed to evaluate their access to medical care, as well as their awareness and willingness to obtain the vaccine after a year of the SARS-CoV-2 pandemic. Methods: A cross-sectional, multicenter study was conducted on a questionnaire basis, handled both online as well as in person. Results: 651 patients with autoimmune or immune mediated diseases were enrolled. More than half (339/641 [53%]) reported difficulties in obtaining medical care throughout the pandemic and 135/651 ([21%]) of them were confirmed with COVID-19; 442/651, ([68%]) expressed their willingness to be vaccinated against SARS-CoV-2. The factors associated with an increased probability of vaccination were the male gender (OR = 2.01, CI95% 1.2–3.7, p = 0.001), the patient’s opinion that she/he was well informed (OR = 3.2, CI 95% 2.1–6.01, p < 0.001), physician’s advice (OR = 2.1, CI 95% 1.3–3.5, p < 0.001), and flu vaccination in the past (OR = 1.5, CI 95% 1.1–2.3, p < 0.001), while those associated with a decreased probability of vaccination were COVID-19 disease in the past medical history (OR = 0.7, CI 95% 0.3-0.95, p = 0.02), and the opinion that patients with autoimmune diseases are at increased risk for adverse reactions (OR = 0.7, CI95% 0.53–0.89, p = 0.001). Conclusions: Given the fact that considering themselves informed regarding vaccination is the most important factor in order to be immunized against SARS-CoV-2, effective information campaigns would substantially increase willingness.

Quality of Telehealth Services in Delivery of Paediatric Surgical Care in Australia: A Systematic Literature Review

Telehealth services are commonly used in many aspects of medicine to improve access to medical care for populations in rural and remote regions, and can and do play an important role in ensuring equitable access to paediatric surgery in Australia’s more rural and remote areas.

Melanoma Management during the COVID-19 Pandemic Emergency: A Literature Review and Single-Center Experience

Background: The current COVID-19 pandemic has influenced the modus operandi of all fields of medicine, significantly impacting patients with oncological diseases and multiple comorbidities. Thus, in recent months, the establishment of melanoma management during the emergency has become a major area of interest. In addition to original articles, case reports and specific guidelines for the period have been developed. Purpose: This article aims to evaluate whether melanoma management has been changed by the outbreak of COVID-19, and if so, what the consequences are. We summarized the main issues concerning the screening of suspicious lesions, the diagnosis of primary melanoma, and the management of early-stage and advanced melanomas during the pandemic. Additionally, we report on the experience of our dermatological clinic in northern Italy. Methods: We performed a literature review evaluating articles on melanomas and COVID-19 published in the last two years on PubMed, as well as considering publications by major healthcare organizations. Concerning oncological practice in our center, we collected data on surgical and therapeutic procedures in patients with a melanoma performed during the first months of the pandemic. Conclusions: During the emergency period, the evaluation of suspicious skin lesions was ensured as much as possible. However, the reduced level of access to medical care led to a documented delay in the diagnosis of new melanomas. When detected, the management of early-stage and advanced melanomas was fully guaranteed, whereas the follow-up visits of disease-free patients have been postponed or replaced with a teleconsultation when possible.

Addressing the Adverse Effects of Climate Change on the Human Rights of Older Persons

The common consequences of climate change events include: displacement, loss of sustainable shelter and housing, and limited access to medical care and other resources such as food, clean water, and sanitation services. These adverse effects coincide to an alarming degree with the human rights most essential to those in vulnerable or marginalized groups, including older populations. Whether through displacement or disruption of supply, the stressors of climate change events greatly exacerbate older populations’ vulnerability, especially when compounded by negative social determinants of health, such as existing social, political, and economic barriers to successful aging. Using the SDGs as a framework to develop policies around (13) climate action and the use of improved (9) industry, innovation, and infrastructure to create (11) sustainable cities and communities, it is possible to establish (10) reduced inequalities to promote overall (3) good health and well-being in our older populations.

An Analysis of Medical Care Services for Children With Rare Diseases in the Russian Federation

Rare diseases continue to present numerous challenges for the medical field worldwide. Understanding innovative mechanisms of service provision for patients with rare conditions through shared communication across different healthcare systems should be encouraged. This study presents the organization of medical care for people with rare diseases in Russia, while also exploring the epidemiology of both life-threatening and chronic, progressive, rare diseases. Further, the regulation of medical care provision is examined, including the preferential provision of medicines in different Russian regions and potential role of compulsory medical insurance. The principles guiding patient referrals to appropriate specialist centres for rare diseases are outlined, including considering the increased role that public-patient organizations have in developing healthcare systems. In reviewing the specialized resources available for patients with rare diseases, medical genetics services offering diagnostics and counselling are discussed. Additionally, population-level preventive care necessitates significant investment, principally in diagnostic technology and screening programs. As seen elsewhere, these initiatives involve forming reference centres and tertiary-level pediatric departments staffed by multidisciplinary specialists in rare diseases. Numerous challenges are highlighted relating to Russian healthcare systems, including the financing of expensive treatments and ensuring equitable access to medical care for those patients with rare diseases outside of State-subsidized programs. Recommendations are made on creating international registries for knowledge sharing, quality appraisal, newborn screening, diagnostic challenges, available treatments and rehabilitation services. Given the high cost of rare diseases, cost-effective interventions are advisable, particularly developing preventive programs and targeting the most common and severe mutations in patients planning pregnancies.

A Qualitative Exploration of Prisoners’ Strategies for Coping with Food Insecurity in Prisons in Kinshasa, DRC

Background: Contravention of prisoners’ basic human rights, over-crowding, poor living conditions, food insecurity, disease and lack of access to medical care in prisons constitute a serious public health concern in many low-income countries in Africa, including the Democratic Republic of Congo (DRC). This study aimed to explore prisoners’ experiences of food insecurity and strategies prisoners employ to overcome food insecurity in two prisons in Kinshasa, DRC.Methods: A qualitative study was conducted among 31 prisoners, both men and women. In-depth interviews were conducted in N’dolo and Makala prisons by two researchers in the local language (Lingala). For security reasons of prisoners interviews were not audio recorded, however, interviewers took thorough notes during interviews. Thematic analysis was used to analyze dataResults: Prisoners in both prisons described experiences of food insecurity. Food was normally served once a day, late in the afternoon. Prisoners complained about a monotonous diet, and that the food was of poor quality, inadequate quantity, and was unhygienically prepared. Most prisoners relied on outside support from family and friends for food provision, but those who did not have such support endured hunger and severe food insecurity. Prisoners employed different coping strategies to manage their hunger, which strategies they described for less severe, severe and very severe food insecurity depending on what they had to do to survive. Strategies included prisoners sharing food with each other, drinking water throughout the day, selling their belongings to buy food, begging food from visitors, looking for food in rubbish bins, or exchanging sex for food.Conclusion: Urgent attention is needed to improve nutrition and living conditions in Congolese prisons. All stakeholders need to formulate a comprehensive plan that will address issues faced by prisoners and improve their quality of life. Regular inspection of prisons is essential to ensure prisoners are treated fairly and their human rights are respected.

Mental Health Effects of Hurricane Sandy on Older Adults

Objectives To examine whether hurricane exposure, lack of access to medical care (LAMC), and displacement during Hurricane Sandy were associated with PTSD and other mental health (MH) symptoms among older adult New York residents. Methods Participants ( N = 411) were ≥60 years old at the time of survey data collection (1–4 years post-Sandy). Outcomes included PTSD, depression, and anxiety symptoms and stress. Hurricane exposure, displacement, and LAMC were primary predictors. Results Older adults with greater hurricane exposure had increased PTSD, anxiety, and stress symptoms. LAMC had a strong association (ORadj = 4.11) with PTSD symptoms but was not associated with other MH symptoms. Displacement was not associated with MH outcomes. Discussion This is the first study to examine exposure, displacement, and LAMC together and to examine their varying impacts on different MH outcomes among older adults post-hurricane. Findings support the importance of disaster preparedness interventions tailored to the MH needs of community-dwelling older adults.