BACKGROUND At present,China has become the country with the largest number of individuals with diabetes mellitus(DM)in the world,with a total of approximately 140 million patients,the majority of whom have type 2 DM(T...BACKGROUND At present,China has become the country with the largest number of individuals with diabetes mellitus(DM)in the world,with a total of approximately 140 million patients,the majority of whom have type 2 DM(T2DM).Based on conven-tional nursing methods,community home care has important clinical significance in controlling blood sugar and disease progression.AIM To explore the impact of community public health nursing on treatment effect,health cognition,and self-management in patients with T2DM.METHODS One hundred patients with T2DM were selected as the research subjects.The patients were divided into either a conventional nursing group or community nursing(CN)group using the random number table method.The conventional nursing group(50 cases)received routine care,while the CN group(50 cases)received community public health care in addition to routine care as that for the conventional nursing group.The rate of excellent and good blood glucose control,fasting blood glucose before and after care,2-h postprandial blood glucose,health cognition,and self-management ability,and patient satisfaction were compared between the two groups.RESULTS The CN group had a higher rate of excellent blood sugar control than the conventional nursing group(88%vs 70%,P<0.05).Before care,there was no significant difference in fasting blood glucose or 2-h postprandial blood glucose between the two groups of patients(P>0.05).After nursing,fasting blood glucose and 2-h postprandial blood glucose were reduced to varying degrees in both groups,and both blood glucose levels in the CN group were lower than those of the conventional nursing group(P<0.05).Compared with the scores before care,the cognitive level score for diabetes and self-management ability score improved after care in both groups.The cognitive level and self-management ability of patients in the CN group were higher than those of the conventional nursing group(P<0.05).The overall satisfaction of the CN group was better than that of the conventional nursing group(98%vs 86%,P<0.05).CONCLUSION Community public health care based on conventional care of T2DM can achieve better blood sugar control,and improve patients’health cognitive level and self-management ability.展开更多
This study examines the impact of waste management policies on public health in Bantar Gebang landfill which faces challenges such as inadequate infrastructure,low community participation,and ineffective policy implem...This study examines the impact of waste management policies on public health in Bantar Gebang landfill which faces challenges such as inadequate infrastructure,low community participation,and ineffective policy implementation.More than half of the waste generated is not transported to landfills,resulting in significant health and environmental risks,including respiratory infections,waterborne diseases,and vector-borne illnesses.The research adopts a qualitative phenomenological approach to understand the experiences of stakeholders,waste managers,and local communities.It also integrates the Waste Management Hierarchy,Community Participation Theory,and Policy Implementation Model to identify key gaps and propose potential solutions.The study reviews legal frameworks,including Indonesia’s Presidential Regulation No.97 of 2017,and specific regulations relevant to the site,evaluating their effectiveness in addressing waste and health issues.The findings highlight the need for stronger public education campaigns,increased investment in infrastructure,and the implementation of advanced technologies such as Waste-to-Energy plants.The study stresses that comprehensive policies on waste reduction,improved segregation,and better recycling practices are critical for achieving sustainable waste management.Additionally,greater inter-agency collaboration and active community engagement are essential for ensuring successful implementation.Drawing on experiences from Tokyo,Stockholm,and Berlin,the study suggests strategies to reduce landfill dependence and improve public health.展开更多
Along with various human production or consumption activities,large-scale air pollution,water pollution,noise,land subsidence and other public nuisances that are harmful to human health and the living environment have...Along with various human production or consumption activities,large-scale air pollution,water pollution,noise,land subsidence and other public nuisances that are harmful to human health and the living environment have emerged.With the emergence and rise of environmental awareness among the people of Taiwan region,in the face of the increasingly deteriorating environment,Taiwan has taken a series of measures.First of all,Article 9 of the Administrative Litigation Law first stipulates public interest litigation;then,Article 34 of the Basic Law on the Environment clearly stipulates the important documents for public interest litigation.In this paper,it is held that environmental maintenance and improvement is the responsibility of every citizen,not just that of the government.On the path of environmental public interest litigation,every citizen should have the right mindset and response strategies.展开更多
This review aims to analyze the development and impact of Artificial Intelligence(AI)in the context of Saudi Arabia’s public healthcare system to fulfill Vision 2030 objectives.It is extensively devoted to AI technol...This review aims to analyze the development and impact of Artificial Intelligence(AI)in the context of Saudi Arabia’s public healthcare system to fulfill Vision 2030 objectives.It is extensively devoted to AI technology deployment relevant to disease management,healthcare delivery,epidemiology,and policy-making.However,its AI is culturally sensitive and ethically grounded in Islam.Based on the PRISMA framework,an SLR evaluated primary academic literature,cases,and practices of Saudi Arabia’s AI implementation in the public healthcare sector.Instead,it categorizes prior research based on how AI can work,the issues it poses,and its implications for the Kingdom’s healthcare system.The Saudi Arabian context analyses show that AI has increased the discreet prediction of diseases,resource management,and monitoring outbreaks during mass congregations such as hajj.Therefore,the study outlines critical areas for defining the potential for artificial intelligence and areas for enhancing digital development to support global healthcare progress.The key themes emerging from the review include Saudi Arabia:(i)the effectiveness of AI with human interaction for sustainable health services;(ii)conditions and quality control to enhance the quality of health care services using AI;(iii)environmental factors as influencing factors for public health care;(iv)Artificial Intelligence,and advanced decision-making technology for Middle Eastern health care systems.For policymakers,healthcare managers,and researchers who will engage with AI innovation,the review proclaims that AI applications should respect the country’s socio-cultural and ethical practices and pave the way for sustainable healthcare provision.More empirical research is needed on the implementation issues with AI,creating culturally appropriate models of AI,and finding new applications of AI to address the increasing demand for healthcare services in Saudi Arabia.展开更多
Processing police incident data in public security involves complex natural language processing(NLP)tasks,including information extraction.This data contains extensive entity information—such as people,locations,and ...Processing police incident data in public security involves complex natural language processing(NLP)tasks,including information extraction.This data contains extensive entity information—such as people,locations,and events—while also involving reasoning tasks like personnel classification,relationship judgment,and implicit inference.Moreover,utilizing models for extracting information from police incident data poses a significant challenge—data scarcity,which limits the effectiveness of traditional rule-based and machine-learning methods.To address these,we propose TIPS.In collaboration with public security experts,we used de-identified police incident data to create templates that enable large language models(LLMs)to populate data slots and generate simulated data,enhancing data density and diversity.We then designed schemas to efficiently manage complex extraction and reasoning tasks,constructing a high-quality dataset and fine-tuning multiple open-source LLMs.Experiments showed that the fine-tuned ChatGLM-4-9B model achieved an F1 score of 87.14%,nearly 30%higher than the base model,significantly reducing error rates.Manual corrections further improved performance by 9.39%.This study demonstrates that combining largescale pre-trained models with limited high-quality domain-specific data can greatly enhance information extraction in low-resource environments,offering a new approach for intelligent public security applications.展开更多
In sub-Saharan Africa, foodborne Salmonella infections cause around 680,000 deaths per year. The evolutionary aspects of the incidence of antibiotic resistance in Salmonella strains no longer seem to attract much inte...In sub-Saharan Africa, foodborne Salmonella infections cause around 680,000 deaths per year. The evolutionary aspects of the incidence of antibiotic resistance in Salmonella strains no longer seem to attract much interest in the Central African Republic (CAR), although salmonellosis remains a health problem requiring national and international surveillance. Methodology: The study conducted at the National Laboratory of Clinical Biology and Public Health, Bangui, Central African Republic (LNBCSP) was a retrospective descriptive study. The study duration was five years (January 2019 to December 2023). The study sample consisted of patients who underwent bacteriological testing of stool, blood and urine samples for Salmonella at the LNBCSP in Bangui during this period. Study variables were age, sex, year and bacteriological test results. Statistical tests were used to compare incidences. Relative risks (RR) were calculated to measure the degree of association. Results: From 2019 to 2023, we recorded 353 Salmonella strains, of which 5% were found in blood, 37% in urine and 58% in stool. Patient age ranged from 1 to 86 years, with a mean of 27 ± 22.05 years and a mode of 5 years. Children aged 0 to 14 years (34%) and females (55.81%) predominated. The highest rate of contamination by Salmonella strains was 1.69% in 2022. The overall incidence of salmonellosis was 6.72 in 2019, 7.05 in 2020, 6.91 in 2021, 16.9 in 2022 and 6.26 in 2023 per 1000 samples. Resistance was 30.47% to β_lactam antibiotics, 24.22% to fluroquinolones and 37.97% to Salmonella spp. For Salmonella arizonae strains, resistance was 20.25% to aminoglycosides, 43.67% to chloramphenicol and 7.59% to imipenem. Conclusion: Laboratory-based surveillance of antibiotic resistance in Salmonella strains is needed in both human and veterinary medicine. Another study based on molecular characterization will identify new antibiotic-resistant variants circulating in CAR.展开更多
BACKGROUND Oesophageal cancer is a significant health concern worldwide,with high inci-dence and mortality rates.In China,the disease burden is particularly high,accounting for a substantial proportion of oesophageal ...BACKGROUND Oesophageal cancer is a significant health concern worldwide,with high inci-dence and mortality rates.In China,the disease burden is particularly high,accounting for a substantial proportion of oesophageal cancer cases and related deaths worldwide.AIM To explore the relationship between the mortality rate of oesophageal cancer patients and insurance type,out-of-pocket ratio,and the joint effects of insurance type and out-of-pocket ratio.METHODS The χ^(2) test was used to analyze patients’demographic and clinical characteristics.Multivariate logistic regression,the Cox proportional hazard model,and the competitive risk model were used to calculate the cumulative hazard ratios(HRs)of all-cause death and oesophageal cancer-specific death among patients with different types of insurance and out-of-pocket ratios.RESULTS Compared with patients covered by basic medical insurance for urban and rural residents,patients covered by urban employee basic medical insurance for urban workers(UEBMI)had a 23.30%increased risk of oesophageal cancer-specific death[HR=1.233,95%confidence interval(CI):1.093-1.391,P<0.005].Compared with patients in the low out-of-pocket ratio group,patients in the high out-of-pocket ratio group had a 25.80%reduction in the risk of oesophageal cancer-specific death(HR=0.742,95%CI:0.6555-0.84,P<0.005).With each 10%increase in the out-of-pocket ratio,the risk of oesophageal cancer-specific death decreased by 10.10%in patients covered by UEBMI.However,the risk of oesophageal cancer-specific death increased by 26.90%in patients in the high out-of-pocket ratio group.CONCLUSION This study reveals the relationships of the specific mortality rate of patients with oesophageal cancer with the out-of-pocket ratio and medical insurance types as well as their combined effects.This study provides practical suggestions and guidance for the formulation of relevant policies in this area.展开更多
Zoonotic hookworm infections remain a significant public health problem,causing nearly 500 million cases globally and approximately four million disability-adjusted life years lost annually.More than one-fifth of thes...Zoonotic hookworm infections remain a significant public health problem,causing nearly 500 million cases globally and approximately four million disability-adjusted life years lost annually.More than one-fifth of these cases are attributed to Ancylostoma ceylanicum,an emerging zoonotic health issue in the Asia-Pacific region.This review presents key research gaps regarding the epidemiology,diagnosis,control,prevention and elimination of A.ceylanicum and other canine zoonotic hookworms as neglected health threats.A.ceylanicum is the second most prevalent human hookworm in the region;it is the most common hookworm among dogs and cats-reservoirs of zoonotic infections.Previous population genetic and phylogenetic analyses revealed that A.ceylanicum has three possible transmission dynamics:zoonotic,animal-only,and human-only pathways.The actual burden of zoonotic ancylostomiasis in most endemic countries remains unknown due to the use of parasitological techniques(e.g.,Kato-Katz thick smear and floatation techniques)that have reduced diagnostic performance and do not allow accurate species identification in helminth surveys.The emergence of benzimidazole resistance in soil-transmitted helminths(STHs),including hookworms,is a concern due to the protracted implementation of mass drug administration(MDA).Resistance is conferred by single nucleotide polymorphisms(SNPs)that occur in theβ-tubulin isotype 1 gene.These mutations have been reported in drug-resistant A.caninum but have not been found in A.ceylanicum in the field.A.ceylanicum remains understudied in the Asia-Pacific region.The zoonotic nature of the parasite warrants investigation of its occurrence in human and animal reservoir hosts to understand the dynamics of zoonotic transmission in different endemic foci.The detection of benzimidazole resistance-associated SNPs in zoonotic hookworms from Asia-Pacific countries has yet to be thoroughly explored.Considering the high level of hookworm endemicity in the region,the circulation of resistant isolates between humans and animals potentially presents a significant One Health threat that can undermine current MDA and proposed animal deworming-based control efforts.展开更多
BACKGROUND Thyroid cancer incidence is rising globally,including the Democratic Republic of Congo(DRC).Despite its increasing incidence,limited data exist on physicians’knowledge of thyroid cancer management in the D...BACKGROUND Thyroid cancer incidence is rising globally,including the Democratic Republic of Congo(DRC).Despite its increasing incidence,limited data exist on physicians’knowledge of thyroid cancer management in the DRC.AIM To evaluate the knowledge levels of Congolese physicians regarding the diagnosis and treatment of thyroid nodules and cancers,and to identify existing gaps and areas for improvement.METHODS A descriptive cross-sectional study was conducted from June to August 2024,involving 369 physicians practicing in healthcare facilities across Kinshasa,DRC.Participants were selected using a multi-stage sampling method.Data were collected via a structured questionnaire covering thyroid cancer epidemiology,diagnostic methods,treatment approaches,and prognosis.Data were analyzed using SPSS version 25,employing descriptive and inferential statistics,with a P value≤0.05 being considered as statistically significant.RESULTS Overall response rate was 96.1%.Of all participants,68%were female and 32%were male physicians.General practitioners constituted 84.8%of respondents,with an average age of 34 years.While 53.7%demonstrated adequate knowledge of hypothyroidism management post-thyroidectomy and 61.2%identified the approach for hypoparathyroidism,only 5.1%recognized the need for radiotherapy in metastatic thyroid cancer cases.Awareness of anaplastic thyroid cancer treatment was limited(6.5%),and 90.2%of physicians were unfamiliar with the surgical complications.Moderate understanding was noted in diagnostic protocols,with 44.2%correctly identifying repeat fine-needle aspiration timing in Bethesda I cases.Knowledge of molecular genetics,recurrence risks,and metastasis patterns was remarkably low.CONCLUSION This study highlights significant knowledge gaps among Congolese physicians regarding thyroid cancer management,especially about advanced treatment modalities and molecular genetics.Targeted educational programs and improved access to diagnostic tools are critical to bridging these deficits.Addressing these gaps can enhance the quality of thyroid cancer care and align clinical practices in the DRC with global standards.展开更多
This study aims to assess seismic hazards and develop effective mitigation strategies for the Mentawai-Siberut region in Indonesia.The research uses quantitative and qualitative methods to analyze historical seismic d...This study aims to assess seismic hazards and develop effective mitigation strategies for the Mentawai-Siberut region in Indonesia.The research uses quantitative and qualitative methods to analyze historical seismic data,predictive models,and stakeholder perspectives.The quantitative analysis includes seismic hazard estimation using the Gutenberg-Richter formula,ground movement analysis based on GMPE,and time interval calculations to forecast future earthquakes.Qualitative methods involve Policy Network Theory to explore the roles and interactions of various stakeholders in disaster management,including government agencies,Indonesian Archipelago Youth Association(NGOs),local communities,and academic researchers.Findings reveal significant seismic activity in the area,with historical earthquakes of magnitudes 8 and 9 occurring at intervals of 18 to 232 years.Predictions suggest a potential magnitude 8 earthquake around 2083,with a megathrust event likely around 2123.The study also identifies economic costs and losses,with damage from a megathrust estimated between USD 1.5–2.5 billion and 10-20 billion,including destroyed homes and displaced populations.Challenges include infrastructure limitations,logistical constraints,and enhancing disaster preparedness and response.The study emphasizes the importance of improving infrastructure,strengthening disaster preparedness,and updating early warning systems.Effective collaboration among stakeholders and integrating local knowledge into disaster management strategies are crucial for enhancing regional resilience.Recommendations include completing infrastructure projects like the Trans-Mentawai Road,increasing community engagement,and utilizing scientific data for evidence-based policymaking.Addressing these recommendations and limitations is essential for developing a robust disaster management framework to mitigate regional seismic risks.展开更多
Addressing the core weaknesses in the innovation and entrepreneurship capabilities of vocational college graduates,such as market insight and risk tolerance,as well as issues with the existing training model,including...Addressing the core weaknesses in the innovation and entrepreneurship capabilities of vocational college graduates,such as market insight and risk tolerance,as well as issues with the existing training model,including courses that are disconnected from industry,a lack of systematic practical training,and superficial school-enterprise cooperation,this paper constructs a“three-dimensional,four-dimensional”training system.The“three-dimensional”foundational framework encompasses three pillars:curriculum,general education layer,professional integration layer,practical application layer,practice as in three stages:introductory,simulated,and practical,and support including dual mentors,policies,and platforms.The“four-dimensional”differentiated strategies include four implementation pathways:professional differentiation,stage differentiation,addressing capability shortcomings,and school-government-industry collaboration.This system is grounded in theories such as multiple intelligences theory and systems theory,forming a closed-loop process of“theoretical input—practical application—support mechanisms”.Based on the practices of Guangdong Vocational Institute of Public Administration,the paper proposes a competency development pathway tailored by major and stage,which can effectively enhance the innovative and entrepreneurial core competencies of vocational college graduates.This provides a replicable systematic solution for vocational college innovative and entrepreneurial education,supporting vocational education reform and regional economic development.展开更多
Background: The availability of essential medicines and medical supplies is crucial for effectively delivering healthcare services. In Zambia, the Logistics Management Information System (LMIS) is a key tool for manag...Background: The availability of essential medicines and medical supplies is crucial for effectively delivering healthcare services. In Zambia, the Logistics Management Information System (LMIS) is a key tool for managing the supply chain of these commodities. This study aimed to evaluate the effectiveness of LMIS in ensuring the availability of essential medicines and medical supplies in public hospitals in the Copperbelt Province of Zambia. Materials and Methods: From February to April 2022, a cross-sectional study was conducted in 12 public hospitals across the Copperbelt Province. Data were collected using structured questionnaires, checklists, and stock control cards. The study assessed LMIS availability, training, and knowledge among pharmacy personnel, as well as data accuracy, product availability, and order fill rates. Descriptive statistics were used to analyse the data. Results: All surveyed hospitals had LMIS implemented and were using eLMIS as the primary LMIS. Only 47% and 48% of pharmacy personnel received training in eLMIS and Essential Medicines Logistics Improvement Program (EMLIP), respectively. Most personnel demonstrated good knowledge of LMIS, with 77.7% able to log in to eLMIS Facility Edition, 76.6% able to locate stock control cards in the system, and 78.7% able to perform transactions. However, data accuracy from physical and electronic records varied from 0% to 60%, and product availability ranged from 50% to 80%. Order fill rates from Zambia Medicines and Medical Supplies Agency (ZAMMSA) were consistently below 30%. Discrepancies were observed between physical stock counts and eLMIS records. Conclusion: This study found that most hospitals in the Copperbelt Province of Zambia have implemented LMIS use. While LMIS implementation is high in the Copperbelt Province of Zambia, challenges such as low training levels, data inaccuracies, low product availability, and order fill rates persist. Addressing these issues requires a comprehensive approach, including capacity building, data quality improvement, supply chain coordination, and investment in infrastructure and human resources. Strengthening LMIS effectiveness is crucial for improving healthcare delivery and patient outcomes in Zambia.展开更多
Background:Oral health issues persistently affect the overall health and well-being of rural populations.Village health volunteers(VHVs)play a crucial role in advancing oral health literacy in their community.This stu...Background:Oral health issues persistently affect the overall health and well-being of rural populations.Village health volunteers(VHVs)play a crucial role in advancing oral health literacy in their community.This study aimed to examine the factors related to nutritional literacy for oral health among VHVs.Methods:This was a mixed-methods study employing an explanatory sequential design.The quantitative data were gathered through questionnaires distributed to a cohort of 10,514 VHVs registered in Health Region 1.A stratified random sampling technique was used to ensure adequate representation of various subgroups within the VHV population,considering factors such as age,education level,and geographical distribution across the region.This approach allowed for a more representative sample that accurately reflects the diversity of the VHV population.Qualitative data were obtained through semi-structured interviews with a purposive sampling of 20 participants based on specific criteria.Quantitative data were analyzed using descriptive statistics and biserial correlation techniques,while qualitative data were analyzed using content analysis.Results:The study found that the sample group possessed a moderate level of knowledge of health literacy principles and nutrition for oral health.However,their self-assessed skills in nutritional literacy for oral health were rated as high.A statistically significant negative correlation was found between knowledge of nutrition for oral health and skills in nutritional literacy for oral health.VHVs equated health literacy with knowledge because their public health training had focused more on imparting knowledge rather than developing skills based on health literacy principles.Conclusion:There is a need to emphasize skill-based health literacy training and to use effective skill development techniques that are tailored to the specific roles and responsibilities of health volunteers.It is also recommended to continuously monitor and evaluate the outcomes of these efforts.展开更多
Background and Objectives: Post-operative complications (POC) are new pathological phenomena occurring in the post-operative period and worsening the previous situation through their morbidity and mortality. Our aim w...Background and Objectives: Post-operative complications (POC) are new pathological phenomena occurring in the post-operative period and worsening the previous situation through their morbidity and mortality. Our aim was to determine the prevalence and preoperative factors associated with early POC at University Clinics of Kisangani (CUKIS). Methods: This was a cross-sectional study conducted in the CUKIS, Department of Surgery from 1 January 2014 to 31 December 2023. The target population consisted of all patients who had undergone full post-operative follow-up. A logistic regression model using RStudio version 4.4.0 software was used to determine the factors predicting early postoperative complications. Results: The prevalence of early POC was estimated at 35%, with surgical site infection the most frequent POC at 45.3%. After multivariate analysis using logistic regression, the social category of widow(er)s, transfer, previous laparotomy, acute generalised peritonitis, preoperative length of stay of more than 10 days and ASA score 2 and 5 were significant risk factors associated with the occurrence of POC in the preoperative period. Conclusion: Certain factors can predict the occurrence of POC. Knowledge of these factors can help practitioners to take useful measures before each surgical operation on a patient with these factors, with a view to preventing or managing POC.展开更多
Aseptic osteonecrosis of the femoral head is defined as the death of bone cells in the femoral epiphysis due to an interruption of blood supply. Most cases are linked to trauma, but non-traumatic cases also occur and ...Aseptic osteonecrosis of the femoral head is defined as the death of bone cells in the femoral epiphysis due to an interruption of blood supply. Most cases are linked to trauma, but non-traumatic cases also occur and can be associated with several known risk factors. This study aims to describe these risk factors identified in the former Katanga province, a region with significant mining activity. Method and Patients: This is a descriptive cross-sectional study conducted over a seven-year period (2017-2024), including all cases of aseptic osteonecrosis of the femoral head diagnosed in the orthopedic department of Medpark Clinic in Lubumbashi. The investigation of risk factors was based on the analysis of sociodemographic, clinical, radiological, and biological data. Results: Our study included a total of 110 patients with a mean age of 47.5 years. Among them, there were 46 women (41.82%) and 64 men (58.18%). Twenty-five patients (27.5%) reported a family history of osteonecrosis, and 24% were diagnosed with sickle cell disease. Chronic alcoholism was noted in 14 patients (12.73%), while diabetes was present in 8 (7.2%). Four patients (3.64%) were obese, and three were HIV-positive (2.72%). The use of nonsteroidal anti-inflammatory drugs (NSAIDs) was common, and prolonged corticosteroid use was documented in 5 patients (4.5%). Abnormally high cholesterol levels were found in 26 patients (23.6%). One patient had gout, and two suffered from acute rheumatic fever (1.8%). Regarding inflammatory markers, C-reactive protein levels and erythrocyte sedimentation rates were within normal limits for almost all patients. Electrolyte levels and phosphocalcic profiles showed no abnormalities. Furthermore, 33 patients (30%) did not exhibit any of the previously mentioned risk factors. Most of these patients lived in the regions of Kolwezi, Likasi, and Lubumbashi. Among this group, 25 patients reported performing physically demanding labor, particularly in mining operations. Conclusion: Our study highlighted well-known risk factors for osteonecrosis of the femoral head (ONFH). However, it also identified a significant number of cases without any identifiable risk factors, classified as idiopathic. Among these cases, some patients engaged in intense physical labor, often linked to mining exposure.展开更多
In both academic research and policymaking,public sector debt and debt-to-GDP ratios are relied on for a multitude of important economic,political and socioeconomic decisions,especially as public sector balance sheets...In both academic research and policymaking,public sector debt and debt-to-GDP ratios are relied on for a multitude of important economic,political and socioeconomic decisions,especially as public sector balance sheets expand to an unprecedented size in the midst of the 2019–2020 COVID pandemic.The reliance on available data from reputable sources often overlooks the question of whether the denominator in this ratio is accurately measured or how well the denominator is understood by the audience interpreting it.Building on past work in international financial statistics,and making use of a unique and newly created dataset on media reporting of public sector debt,the purpose of this article is to examine the quality,accuracy,interpretation and overall meaningfulness of public sector financial statistics.The main findings suggest that i)most of the world’s governments still do not seem to feel sufficient pressure to voluntarily provide comprehensive financial statistics based on well-defined modern methodological frameworks and ii)high profile financial statistics,which are reported,have become increasingly numerous and complicated,making it difficult for non-experts to know which is most appropriate in the context of their analysis.展开更多
The concern for greater efficiency in the public sector has determined the application in countries of the European Union of the public internal control systems, stemm from the desire of management of national funds i...The concern for greater efficiency in the public sector has determined the application in countries of the European Union of the public internal control systems, stemm from the desire of management of national funds in economic conditions. This paper addresses such issues relating to highlighting elements reflecting the importance of the control function in the management process; and identifying the characteristics of the elements constituting the control systems in countries belonging to the European Union, which were grouped into two categories depending on the date of accession to the union, using public internal control related data provided by the European Commission. Particular attention is given to highlight the characteristics of the control system applied in Romania compared to other states. Research has revealed a greater number of similarities in the characteristics of the control systems of internal public in countries that joined the Union after 1990, compared with those who became members before this year, concerning the financing of the sector public, the accounting system applied, the coordination of such a system, who bears responsibility for financial management, or the limits of managerial responsibility.展开更多
Public institutions, such as kindergartens, are committed to ordering food according to the Slovenian Law on public procurement （ZJN-3）, which is compliant with EU legislation. There are many bread manufacturers in ...Public institutions, such as kindergartens, are committed to ordering food according to the Slovenian Law on public procurement （ZJN-3）, which is compliant with EU legislation. There are many bread manufacturers in the market, therefore contracting authority has the challenging task to provide a diverse and high-quality bread and bakery pastries through the process of public procurement. Each buyer has the option of ordering food through the so-called ＂short chain＂, which allows the ordering of locally produced cereals, bread from the organic and integrated production. The Ministry of Health of the Republic of Slovenia issued a ＂Guide to Quality Standards of Food in Public Ordering for Educational Institutions＂ which supports the ordering process. In addition to quality requirements, the buyer divides the tender documentation into several groups and subgroups （e.g. Bread, Bakery pastries and Bread of organic production）. The bakery industry is aware that in kindergartens high-quality bread and bakery pastries are required, therefore they already offer products with reduced salt, sugars, fats, products without trans-fatty acids and gluten. Taking into account the appropriate purchasing specifications and good knowledge of legislation, with respect to public procurement law-related orders, children in kindergartens can be provided with high-quality bread and bakery pastries.展开更多
Nowadays, with the development of the Internet, especially the mobile Internet, the appearance of WeCbat has a deep influence on the communication among people, WeChat public accounts have changed a lot to the experie...Nowadays, with the development of the Internet, especially the mobile Internet, the appearance of WeCbat has a deep influence on the communication among people, WeChat public accounts have changed a lot to the experience of getting information for people of all ages at the same time. As a new platform for public diplomacy, many foreign embassies and consulates in China have built their own public accounts of WeChat. These public accounts have become a new type of media to learn about these countries＇ culture, society, and so on. The paper takes the WeChat public account of the US embassy in China as an example, collecting information during a period of time and summarizing their characteristics and revelations. As a model of new media public diplomacy, WeChat public accounts have a silent transforming influence of public diplomacy. In addition, the new media public diplomacy plays an important role in promoting the development of China＇s public diplomacy strategy, which increasingly becomes a useful supplement to China＇s foreign policy. Therefore, in the mobile lnternet era, the research of new media public diplomacy has an important implication.展开更多
Objective: To study the public health Emergency Operations Centers(EOCs)in the US, the European Union, the UK and Australia, and summarize the good practice for the improvement of National Health Emergency Response Co...Objective: To study the public health Emergency Operations Centers(EOCs)in the US, the European Union, the UK and Australia, and summarize the good practice for the improvement of National Health Emergency Response Command Center in Chinese National Health and Family Planning Commission. Methods: Literature review was conducted to explore the EOCs of selected countries. Results: The study focused on EOC function, organizational structure, human resources and information management. The selected EOCs had the basic EOC functions of coordinating and commanding as well as the public health related functions such as monitoring the situation, risk assessment, and epidemiological briefings. The organizational structures of the EOCs were standardized, scalable and flexible. Incident Command System was the widely applied organizational structure with a strong preference. The EOCs were managed by a unit of emergency management during routine time and surge staff were engaged upon emergencies. The selected EOCs had clear information management framework including information collection, assessment and dissemination. Conclusions: The performance of National Health Emergency Response Command Center can be improved by learning from the good practice of the selected EOCs, including setting clear functions, standardizing the organizational structure, enhancing the human resource capacity and strengthening information management.展开更多
文摘BACKGROUND At present,China has become the country with the largest number of individuals with diabetes mellitus(DM)in the world,with a total of approximately 140 million patients,the majority of whom have type 2 DM(T2DM).Based on conven-tional nursing methods,community home care has important clinical significance in controlling blood sugar and disease progression.AIM To explore the impact of community public health nursing on treatment effect,health cognition,and self-management in patients with T2DM.METHODS One hundred patients with T2DM were selected as the research subjects.The patients were divided into either a conventional nursing group or community nursing(CN)group using the random number table method.The conventional nursing group(50 cases)received routine care,while the CN group(50 cases)received community public health care in addition to routine care as that for the conventional nursing group.The rate of excellent and good blood glucose control,fasting blood glucose before and after care,2-h postprandial blood glucose,health cognition,and self-management ability,and patient satisfaction were compared between the two groups.RESULTS The CN group had a higher rate of excellent blood sugar control than the conventional nursing group(88%vs 70%,P<0.05).Before care,there was no significant difference in fasting blood glucose or 2-h postprandial blood glucose between the two groups of patients(P>0.05).After nursing,fasting blood glucose and 2-h postprandial blood glucose were reduced to varying degrees in both groups,and both blood glucose levels in the CN group were lower than those of the conventional nursing group(P<0.05).Compared with the scores before care,the cognitive level score for diabetes and self-management ability score improved after care in both groups.The cognitive level and self-management ability of patients in the CN group were higher than those of the conventional nursing group(P<0.05).The overall satisfaction of the CN group was better than that of the conventional nursing group(98%vs 86%,P<0.05).CONCLUSION Community public health care based on conventional care of T2DM can achieve better blood sugar control,and improve patients’health cognitive level and self-management ability.
文摘This study examines the impact of waste management policies on public health in Bantar Gebang landfill which faces challenges such as inadequate infrastructure,low community participation,and ineffective policy implementation.More than half of the waste generated is not transported to landfills,resulting in significant health and environmental risks,including respiratory infections,waterborne diseases,and vector-borne illnesses.The research adopts a qualitative phenomenological approach to understand the experiences of stakeholders,waste managers,and local communities.It also integrates the Waste Management Hierarchy,Community Participation Theory,and Policy Implementation Model to identify key gaps and propose potential solutions.The study reviews legal frameworks,including Indonesia’s Presidential Regulation No.97 of 2017,and specific regulations relevant to the site,evaluating their effectiveness in addressing waste and health issues.The findings highlight the need for stronger public education campaigns,increased investment in infrastructure,and the implementation of advanced technologies such as Waste-to-Energy plants.The study stresses that comprehensive policies on waste reduction,improved segregation,and better recycling practices are critical for achieving sustainable waste management.Additionally,greater inter-agency collaboration and active community engagement are essential for ensuring successful implementation.Drawing on experiences from Tokyo,Stockholm,and Berlin,the study suggests strategies to reduce landfill dependence and improve public health.
文摘Along with various human production or consumption activities,large-scale air pollution,water pollution,noise,land subsidence and other public nuisances that are harmful to human health and the living environment have emerged.With the emergence and rise of environmental awareness among the people of Taiwan region,in the face of the increasingly deteriorating environment,Taiwan has taken a series of measures.First of all,Article 9 of the Administrative Litigation Law first stipulates public interest litigation;then,Article 34 of the Basic Law on the Environment clearly stipulates the important documents for public interest litigation.In this paper,it is held that environmental maintenance and improvement is the responsibility of every citizen,not just that of the government.On the path of environmental public interest litigation,every citizen should have the right mindset and response strategies.
基金funded by the Scientific ResearchDeanship at theUniversity ofHa’il-Saudi Arabia through project number-RG-23251.
文摘This review aims to analyze the development and impact of Artificial Intelligence(AI)in the context of Saudi Arabia’s public healthcare system to fulfill Vision 2030 objectives.It is extensively devoted to AI technology deployment relevant to disease management,healthcare delivery,epidemiology,and policy-making.However,its AI is culturally sensitive and ethically grounded in Islam.Based on the PRISMA framework,an SLR evaluated primary academic literature,cases,and practices of Saudi Arabia’s AI implementation in the public healthcare sector.Instead,it categorizes prior research based on how AI can work,the issues it poses,and its implications for the Kingdom’s healthcare system.The Saudi Arabian context analyses show that AI has increased the discreet prediction of diseases,resource management,and monitoring outbreaks during mass congregations such as hajj.Therefore,the study outlines critical areas for defining the potential for artificial intelligence and areas for enhancing digital development to support global healthcare progress.The key themes emerging from the review include Saudi Arabia:(i)the effectiveness of AI with human interaction for sustainable health services;(ii)conditions and quality control to enhance the quality of health care services using AI;(iii)environmental factors as influencing factors for public health care;(iv)Artificial Intelligence,and advanced decision-making technology for Middle Eastern health care systems.For policymakers,healthcare managers,and researchers who will engage with AI innovation,the review proclaims that AI applications should respect the country’s socio-cultural and ethical practices and pave the way for sustainable healthcare provision.More empirical research is needed on the implementation issues with AI,creating culturally appropriate models of AI,and finding new applications of AI to address the increasing demand for healthcare services in Saudi Arabia.
文摘Processing police incident data in public security involves complex natural language processing(NLP)tasks,including information extraction.This data contains extensive entity information—such as people,locations,and events—while also involving reasoning tasks like personnel classification,relationship judgment,and implicit inference.Moreover,utilizing models for extracting information from police incident data poses a significant challenge—data scarcity,which limits the effectiveness of traditional rule-based and machine-learning methods.To address these,we propose TIPS.In collaboration with public security experts,we used de-identified police incident data to create templates that enable large language models(LLMs)to populate data slots and generate simulated data,enhancing data density and diversity.We then designed schemas to efficiently manage complex extraction and reasoning tasks,constructing a high-quality dataset and fine-tuning multiple open-source LLMs.Experiments showed that the fine-tuned ChatGLM-4-9B model achieved an F1 score of 87.14%,nearly 30%higher than the base model,significantly reducing error rates.Manual corrections further improved performance by 9.39%.This study demonstrates that combining largescale pre-trained models with limited high-quality domain-specific data can greatly enhance information extraction in low-resource environments,offering a new approach for intelligent public security applications.
文摘In sub-Saharan Africa, foodborne Salmonella infections cause around 680,000 deaths per year. The evolutionary aspects of the incidence of antibiotic resistance in Salmonella strains no longer seem to attract much interest in the Central African Republic (CAR), although salmonellosis remains a health problem requiring national and international surveillance. Methodology: The study conducted at the National Laboratory of Clinical Biology and Public Health, Bangui, Central African Republic (LNBCSP) was a retrospective descriptive study. The study duration was five years (January 2019 to December 2023). The study sample consisted of patients who underwent bacteriological testing of stool, blood and urine samples for Salmonella at the LNBCSP in Bangui during this period. Study variables were age, sex, year and bacteriological test results. Statistical tests were used to compare incidences. Relative risks (RR) were calculated to measure the degree of association. Results: From 2019 to 2023, we recorded 353 Salmonella strains, of which 5% were found in blood, 37% in urine and 58% in stool. Patient age ranged from 1 to 86 years, with a mean of 27 ± 22.05 years and a mode of 5 years. Children aged 0 to 14 years (34%) and females (55.81%) predominated. The highest rate of contamination by Salmonella strains was 1.69% in 2022. The overall incidence of salmonellosis was 6.72 in 2019, 7.05 in 2020, 6.91 in 2021, 16.9 in 2022 and 6.26 in 2023 per 1000 samples. Resistance was 30.47% to β_lactam antibiotics, 24.22% to fluroquinolones and 37.97% to Salmonella spp. For Salmonella arizonae strains, resistance was 20.25% to aminoglycosides, 43.67% to chloramphenicol and 7.59% to imipenem. Conclusion: Laboratory-based surveillance of antibiotic resistance in Salmonella strains is needed in both human and veterinary medicine. Another study based on molecular characterization will identify new antibiotic-resistant variants circulating in CAR.
基金Supported by the Chongqing Science and Health Joint Medical Research Project,No.2024MSXM065.
文摘BACKGROUND Oesophageal cancer is a significant health concern worldwide,with high inci-dence and mortality rates.In China,the disease burden is particularly high,accounting for a substantial proportion of oesophageal cancer cases and related deaths worldwide.AIM To explore the relationship between the mortality rate of oesophageal cancer patients and insurance type,out-of-pocket ratio,and the joint effects of insurance type and out-of-pocket ratio.METHODS The χ^(2) test was used to analyze patients’demographic and clinical characteristics.Multivariate logistic regression,the Cox proportional hazard model,and the competitive risk model were used to calculate the cumulative hazard ratios(HRs)of all-cause death and oesophageal cancer-specific death among patients with different types of insurance and out-of-pocket ratios.RESULTS Compared with patients covered by basic medical insurance for urban and rural residents,patients covered by urban employee basic medical insurance for urban workers(UEBMI)had a 23.30%increased risk of oesophageal cancer-specific death[HR=1.233,95%confidence interval(CI):1.093-1.391,P<0.005].Compared with patients in the low out-of-pocket ratio group,patients in the high out-of-pocket ratio group had a 25.80%reduction in the risk of oesophageal cancer-specific death(HR=0.742,95%CI:0.6555-0.84,P<0.005).With each 10%increase in the out-of-pocket ratio,the risk of oesophageal cancer-specific death decreased by 10.10%in patients covered by UEBMI.However,the risk of oesophageal cancer-specific death increased by 26.90%in patients in the high out-of-pocket ratio group.CONCLUSION This study reveals the relationships of the specific mortality rate of patients with oesophageal cancer with the out-of-pocket ratio and medical insurance types as well as their combined effects.This study provides practical suggestions and guidance for the formulation of relevant policies in this area.
基金supported by a Postgraduate Study Support Grant from the Faculty of Medicine,Khon Kaen University.
文摘Zoonotic hookworm infections remain a significant public health problem,causing nearly 500 million cases globally and approximately four million disability-adjusted life years lost annually.More than one-fifth of these cases are attributed to Ancylostoma ceylanicum,an emerging zoonotic health issue in the Asia-Pacific region.This review presents key research gaps regarding the epidemiology,diagnosis,control,prevention and elimination of A.ceylanicum and other canine zoonotic hookworms as neglected health threats.A.ceylanicum is the second most prevalent human hookworm in the region;it is the most common hookworm among dogs and cats-reservoirs of zoonotic infections.Previous population genetic and phylogenetic analyses revealed that A.ceylanicum has three possible transmission dynamics:zoonotic,animal-only,and human-only pathways.The actual burden of zoonotic ancylostomiasis in most endemic countries remains unknown due to the use of parasitological techniques(e.g.,Kato-Katz thick smear and floatation techniques)that have reduced diagnostic performance and do not allow accurate species identification in helminth surveys.The emergence of benzimidazole resistance in soil-transmitted helminths(STHs),including hookworms,is a concern due to the protracted implementation of mass drug administration(MDA).Resistance is conferred by single nucleotide polymorphisms(SNPs)that occur in theβ-tubulin isotype 1 gene.These mutations have been reported in drug-resistant A.caninum but have not been found in A.ceylanicum in the field.A.ceylanicum remains understudied in the Asia-Pacific region.The zoonotic nature of the parasite warrants investigation of its occurrence in human and animal reservoir hosts to understand the dynamics of zoonotic transmission in different endemic foci.The detection of benzimidazole resistance-associated SNPs in zoonotic hookworms from Asia-Pacific countries has yet to be thoroughly explored.Considering the high level of hookworm endemicity in the region,the circulation of resistant isolates between humans and animals potentially presents a significant One Health threat that can undermine current MDA and proposed animal deworming-based control efforts.
文摘BACKGROUND Thyroid cancer incidence is rising globally,including the Democratic Republic of Congo(DRC).Despite its increasing incidence,limited data exist on physicians’knowledge of thyroid cancer management in the DRC.AIM To evaluate the knowledge levels of Congolese physicians regarding the diagnosis and treatment of thyroid nodules and cancers,and to identify existing gaps and areas for improvement.METHODS A descriptive cross-sectional study was conducted from June to August 2024,involving 369 physicians practicing in healthcare facilities across Kinshasa,DRC.Participants were selected using a multi-stage sampling method.Data were collected via a structured questionnaire covering thyroid cancer epidemiology,diagnostic methods,treatment approaches,and prognosis.Data were analyzed using SPSS version 25,employing descriptive and inferential statistics,with a P value≤0.05 being considered as statistically significant.RESULTS Overall response rate was 96.1%.Of all participants,68%were female and 32%were male physicians.General practitioners constituted 84.8%of respondents,with an average age of 34 years.While 53.7%demonstrated adequate knowledge of hypothyroidism management post-thyroidectomy and 61.2%identified the approach for hypoparathyroidism,only 5.1%recognized the need for radiotherapy in metastatic thyroid cancer cases.Awareness of anaplastic thyroid cancer treatment was limited(6.5%),and 90.2%of physicians were unfamiliar with the surgical complications.Moderate understanding was noted in diagnostic protocols,with 44.2%correctly identifying repeat fine-needle aspiration timing in Bethesda I cases.Knowledge of molecular genetics,recurrence risks,and metastasis patterns was remarkably low.CONCLUSION This study highlights significant knowledge gaps among Congolese physicians regarding thyroid cancer management,especially about advanced treatment modalities and molecular genetics.Targeted educational programs and improved access to diagnostic tools are critical to bridging these deficits.Addressing these gaps can enhance the quality of thyroid cancer care and align clinical practices in the DRC with global standards.
文摘This study aims to assess seismic hazards and develop effective mitigation strategies for the Mentawai-Siberut region in Indonesia.The research uses quantitative and qualitative methods to analyze historical seismic data,predictive models,and stakeholder perspectives.The quantitative analysis includes seismic hazard estimation using the Gutenberg-Richter formula,ground movement analysis based on GMPE,and time interval calculations to forecast future earthquakes.Qualitative methods involve Policy Network Theory to explore the roles and interactions of various stakeholders in disaster management,including government agencies,Indonesian Archipelago Youth Association(NGOs),local communities,and academic researchers.Findings reveal significant seismic activity in the area,with historical earthquakes of magnitudes 8 and 9 occurring at intervals of 18 to 232 years.Predictions suggest a potential magnitude 8 earthquake around 2083,with a megathrust event likely around 2123.The study also identifies economic costs and losses,with damage from a megathrust estimated between USD 1.5–2.5 billion and 10-20 billion,including destroyed homes and displaced populations.Challenges include infrastructure limitations,logistical constraints,and enhancing disaster preparedness and response.The study emphasizes the importance of improving infrastructure,strengthening disaster preparedness,and updating early warning systems.Effective collaboration among stakeholders and integrating local knowledge into disaster management strategies are crucial for enhancing regional resilience.Recommendations include completing infrastructure projects like the Trans-Mentawai Road,increasing community engagement,and utilizing scientific data for evidence-based policymaking.Addressing these recommendations and limitations is essential for developing a robust disaster management framework to mitigate regional seismic risks.
基金2024 University-level Innovation and Entrepreneurship Educational Reform Project,“Research on the Innovation and Entrepreneurship Education Model of Higher Vocational Colleges Based on the Theory of Technological Innovation Diffusion”(Project No.:CYJG202414)Academic Year Higher Education Institution Graduate Employment and Entrepreneurship Research Project,“Research on Strategies for Cultivating Innovation and Entrepreneurship Abilities Among Graduates of Higher Vocational Colleges”(Project No.:GJXY2024N083)2024 Guangdong Province General Higher Education Institution Specialized Innovation Project,“Research on a Specialized-Entrepreneurial Integration Talent Development System Guided by Core Competencies in the Era of Artificial Intelligence”(Project No.:2024WTSCX339)。
文摘Addressing the core weaknesses in the innovation and entrepreneurship capabilities of vocational college graduates,such as market insight and risk tolerance,as well as issues with the existing training model,including courses that are disconnected from industry,a lack of systematic practical training,and superficial school-enterprise cooperation,this paper constructs a“three-dimensional,four-dimensional”training system.The“three-dimensional”foundational framework encompasses three pillars:curriculum,general education layer,professional integration layer,practical application layer,practice as in three stages:introductory,simulated,and practical,and support including dual mentors,policies,and platforms.The“four-dimensional”differentiated strategies include four implementation pathways:professional differentiation,stage differentiation,addressing capability shortcomings,and school-government-industry collaboration.This system is grounded in theories such as multiple intelligences theory and systems theory,forming a closed-loop process of“theoretical input—practical application—support mechanisms”.Based on the practices of Guangdong Vocational Institute of Public Administration,the paper proposes a competency development pathway tailored by major and stage,which can effectively enhance the innovative and entrepreneurial core competencies of vocational college graduates.This provides a replicable systematic solution for vocational college innovative and entrepreneurial education,supporting vocational education reform and regional economic development.
文摘Background: The availability of essential medicines and medical supplies is crucial for effectively delivering healthcare services. In Zambia, the Logistics Management Information System (LMIS) is a key tool for managing the supply chain of these commodities. This study aimed to evaluate the effectiveness of LMIS in ensuring the availability of essential medicines and medical supplies in public hospitals in the Copperbelt Province of Zambia. Materials and Methods: From February to April 2022, a cross-sectional study was conducted in 12 public hospitals across the Copperbelt Province. Data were collected using structured questionnaires, checklists, and stock control cards. The study assessed LMIS availability, training, and knowledge among pharmacy personnel, as well as data accuracy, product availability, and order fill rates. Descriptive statistics were used to analyse the data. Results: All surveyed hospitals had LMIS implemented and were using eLMIS as the primary LMIS. Only 47% and 48% of pharmacy personnel received training in eLMIS and Essential Medicines Logistics Improvement Program (EMLIP), respectively. Most personnel demonstrated good knowledge of LMIS, with 77.7% able to log in to eLMIS Facility Edition, 76.6% able to locate stock control cards in the system, and 78.7% able to perform transactions. However, data accuracy from physical and electronic records varied from 0% to 60%, and product availability ranged from 50% to 80%. Order fill rates from Zambia Medicines and Medical Supplies Agency (ZAMMSA) were consistently below 30%. Discrepancies were observed between physical stock counts and eLMIS records. Conclusion: This study found that most hospitals in the Copperbelt Province of Zambia have implemented LMIS use. While LMIS implementation is high in the Copperbelt Province of Zambia, challenges such as low training levels, data inaccuracies, low product availability, and order fill rates persist. Addressing these issues requires a comprehensive approach, including capacity building, data quality improvement, supply chain coordination, and investment in infrastructure and human resources. Strengthening LMIS effectiveness is crucial for improving healthcare delivery and patient outcomes in Zambia.
文摘Background:Oral health issues persistently affect the overall health and well-being of rural populations.Village health volunteers(VHVs)play a crucial role in advancing oral health literacy in their community.This study aimed to examine the factors related to nutritional literacy for oral health among VHVs.Methods:This was a mixed-methods study employing an explanatory sequential design.The quantitative data were gathered through questionnaires distributed to a cohort of 10,514 VHVs registered in Health Region 1.A stratified random sampling technique was used to ensure adequate representation of various subgroups within the VHV population,considering factors such as age,education level,and geographical distribution across the region.This approach allowed for a more representative sample that accurately reflects the diversity of the VHV population.Qualitative data were obtained through semi-structured interviews with a purposive sampling of 20 participants based on specific criteria.Quantitative data were analyzed using descriptive statistics and biserial correlation techniques,while qualitative data were analyzed using content analysis.Results:The study found that the sample group possessed a moderate level of knowledge of health literacy principles and nutrition for oral health.However,their self-assessed skills in nutritional literacy for oral health were rated as high.A statistically significant negative correlation was found between knowledge of nutrition for oral health and skills in nutritional literacy for oral health.VHVs equated health literacy with knowledge because their public health training had focused more on imparting knowledge rather than developing skills based on health literacy principles.Conclusion:There is a need to emphasize skill-based health literacy training and to use effective skill development techniques that are tailored to the specific roles and responsibilities of health volunteers.It is also recommended to continuously monitor and evaluate the outcomes of these efforts.
文摘Background and Objectives: Post-operative complications (POC) are new pathological phenomena occurring in the post-operative period and worsening the previous situation through their morbidity and mortality. Our aim was to determine the prevalence and preoperative factors associated with early POC at University Clinics of Kisangani (CUKIS). Methods: This was a cross-sectional study conducted in the CUKIS, Department of Surgery from 1 January 2014 to 31 December 2023. The target population consisted of all patients who had undergone full post-operative follow-up. A logistic regression model using RStudio version 4.4.0 software was used to determine the factors predicting early postoperative complications. Results: The prevalence of early POC was estimated at 35%, with surgical site infection the most frequent POC at 45.3%. After multivariate analysis using logistic regression, the social category of widow(er)s, transfer, previous laparotomy, acute generalised peritonitis, preoperative length of stay of more than 10 days and ASA score 2 and 5 were significant risk factors associated with the occurrence of POC in the preoperative period. Conclusion: Certain factors can predict the occurrence of POC. Knowledge of these factors can help practitioners to take useful measures before each surgical operation on a patient with these factors, with a view to preventing or managing POC.
文摘Aseptic osteonecrosis of the femoral head is defined as the death of bone cells in the femoral epiphysis due to an interruption of blood supply. Most cases are linked to trauma, but non-traumatic cases also occur and can be associated with several known risk factors. This study aims to describe these risk factors identified in the former Katanga province, a region with significant mining activity. Method and Patients: This is a descriptive cross-sectional study conducted over a seven-year period (2017-2024), including all cases of aseptic osteonecrosis of the femoral head diagnosed in the orthopedic department of Medpark Clinic in Lubumbashi. The investigation of risk factors was based on the analysis of sociodemographic, clinical, radiological, and biological data. Results: Our study included a total of 110 patients with a mean age of 47.5 years. Among them, there were 46 women (41.82%) and 64 men (58.18%). Twenty-five patients (27.5%) reported a family history of osteonecrosis, and 24% were diagnosed with sickle cell disease. Chronic alcoholism was noted in 14 patients (12.73%), while diabetes was present in 8 (7.2%). Four patients (3.64%) were obese, and three were HIV-positive (2.72%). The use of nonsteroidal anti-inflammatory drugs (NSAIDs) was common, and prolonged corticosteroid use was documented in 5 patients (4.5%). Abnormally high cholesterol levels were found in 26 patients (23.6%). One patient had gout, and two suffered from acute rheumatic fever (1.8%). Regarding inflammatory markers, C-reactive protein levels and erythrocyte sedimentation rates were within normal limits for almost all patients. Electrolyte levels and phosphocalcic profiles showed no abnormalities. Furthermore, 33 patients (30%) did not exhibit any of the previously mentioned risk factors. Most of these patients lived in the regions of Kolwezi, Likasi, and Lubumbashi. Among this group, 25 patients reported performing physically demanding labor, particularly in mining operations. Conclusion: Our study highlighted well-known risk factors for osteonecrosis of the femoral head (ONFH). However, it also identified a significant number of cases without any identifiable risk factors, classified as idiopathic. Among these cases, some patients engaged in intense physical labor, often linked to mining exposure.
文摘In both academic research and policymaking,public sector debt and debt-to-GDP ratios are relied on for a multitude of important economic,political and socioeconomic decisions,especially as public sector balance sheets expand to an unprecedented size in the midst of the 2019–2020 COVID pandemic.The reliance on available data from reputable sources often overlooks the question of whether the denominator in this ratio is accurately measured or how well the denominator is understood by the audience interpreting it.Building on past work in international financial statistics,and making use of a unique and newly created dataset on media reporting of public sector debt,the purpose of this article is to examine the quality,accuracy,interpretation and overall meaningfulness of public sector financial statistics.The main findings suggest that i)most of the world’s governments still do not seem to feel sufficient pressure to voluntarily provide comprehensive financial statistics based on well-defined modern methodological frameworks and ii)high profile financial statistics,which are reported,have become increasingly numerous and complicated,making it difficult for non-experts to know which is most appropriate in the context of their analysis.
文摘The concern for greater efficiency in the public sector has determined the application in countries of the European Union of the public internal control systems, stemm from the desire of management of national funds in economic conditions. This paper addresses such issues relating to highlighting elements reflecting the importance of the control function in the management process; and identifying the characteristics of the elements constituting the control systems in countries belonging to the European Union, which were grouped into two categories depending on the date of accession to the union, using public internal control related data provided by the European Commission. Particular attention is given to highlight the characteristics of the control system applied in Romania compared to other states. Research has revealed a greater number of similarities in the characteristics of the control systems of internal public in countries that joined the Union after 1990, compared with those who became members before this year, concerning the financing of the sector public, the accounting system applied, the coordination of such a system, who bears responsibility for financial management, or the limits of managerial responsibility.
文摘Public institutions, such as kindergartens, are committed to ordering food according to the Slovenian Law on public procurement （ZJN-3）, which is compliant with EU legislation. There are many bread manufacturers in the market, therefore contracting authority has the challenging task to provide a diverse and high-quality bread and bakery pastries through the process of public procurement. Each buyer has the option of ordering food through the so-called ＂short chain＂, which allows the ordering of locally produced cereals, bread from the organic and integrated production. The Ministry of Health of the Republic of Slovenia issued a ＂Guide to Quality Standards of Food in Public Ordering for Educational Institutions＂ which supports the ordering process. In addition to quality requirements, the buyer divides the tender documentation into several groups and subgroups （e.g. Bread, Bakery pastries and Bread of organic production）. The bakery industry is aware that in kindergartens high-quality bread and bakery pastries are required, therefore they already offer products with reduced salt, sugars, fats, products without trans-fatty acids and gluten. Taking into account the appropriate purchasing specifications and good knowledge of legislation, with respect to public procurement law-related orders, children in kindergartens can be provided with high-quality bread and bakery pastries.
文摘Nowadays, with the development of the Internet, especially the mobile Internet, the appearance of WeCbat has a deep influence on the communication among people, WeChat public accounts have changed a lot to the experience of getting information for people of all ages at the same time. As a new platform for public diplomacy, many foreign embassies and consulates in China have built their own public accounts of WeChat. These public accounts have become a new type of media to learn about these countries＇ culture, society, and so on. The paper takes the WeChat public account of the US embassy in China as an example, collecting information during a period of time and summarizing their characteristics and revelations. As a model of new media public diplomacy, WeChat public accounts have a silent transforming influence of public diplomacy. In addition, the new media public diplomacy plays an important role in promoting the development of China＇s public diplomacy strategy, which increasingly becomes a useful supplement to China＇s foreign policy. Therefore, in the mobile lnternet era, the research of new media public diplomacy has an important implication.
文摘Objective: To study the public health Emergency Operations Centers(EOCs)in the US, the European Union, the UK and Australia, and summarize the good practice for the improvement of National Health Emergency Response Command Center in Chinese National Health and Family Planning Commission. Methods: Literature review was conducted to explore the EOCs of selected countries. Results: The study focused on EOC function, organizational structure, human resources and information management. The selected EOCs had the basic EOC functions of coordinating and commanding as well as the public health related functions such as monitoring the situation, risk assessment, and epidemiological briefings. The organizational structures of the EOCs were standardized, scalable and flexible. Incident Command System was the widely applied organizational structure with a strong preference. The EOCs were managed by a unit of emergency management during routine time and surge staff were engaged upon emergencies. The selected EOCs had clear information management framework including information collection, assessment and dissemination. Conclusions: The performance of National Health Emergency Response Command Center can be improved by learning from the good practice of the selected EOCs, including setting clear functions, standardizing the organizational structure, enhancing the human resource capacity and strengthening information management.
