34 research outputs found
Providing emergency medical care (New Eurohealth issue)
Providing timely emergency medical services for life-threatening situations as well as urgent care appropriate to patients’ clinical needs are the most enduring challenges facing national health care systems, particularly in light of rising numbers of unnecessary emergency department attendances in many countries. The latest issue of Eurohealth (volume 21, issue 4), which has just been published by the European Observatory on Health Systems and Policies (in which LSE Health is a partner), tackles this issue
The changing role of nursing (New Eurohealth issue)
There is no doubt that the role of nurses has been changing over the past few decades, not only in terms of their evolving clinical and managerial responsibilities but also in terms of their education and training. These processes have been affected in many ways by developments at the European level, not least through directives on the free movement of professionals as well as the mutual recognition of professional qualifications. The latest issue of Eurohealth (volume 22, issue 1), which has just been published by the European Observatory on Health Systems and Policies (in which LSE Health is a partner), looks at the changing role of nursing
Health system developments in former Soviet countries
Nearly 25 years after the dissolution of the Soviet Union all of the countries in the region are actively engaged in the process of reforming their health care systems, with various degrees of success. The latest issue of Eurohealth (volume 21, issue 2), just been published by the European Observatory on Health Systems and Policies (in which LSE Health is a partner), analyses developments in these countries
Health decentralization at a dead-end: towards new recovery plans for Italian hospitals
The recent introduction by the central government of recovery plans (RPs) for Italian hospitals provides useful insights into the recentralization tendencies that are being experienced within the country’s decentralized, regional health system. The measure also contributes evidence to the debate on whether there is a long-term structural shift in national health strategy towards more centralized stewardship. The hospital RPs aim to improve the clinical, financial and managerial performance of public-hospitals, teaching-hospitals and research-hospitals through monitoring trends in individual hospitals' expenditure and tackling improvements in clinical care. As such they represent the central governments recognition of the weaknesses of the decentralization process in the health sector. The opponents of the reform argue that financial stability will be restored mainly through across-the-board reductions in hospital expenditure, personnel layoffs and closing of wards, with considerable negative effects on the most vulnerable groups of patients. While hospital RPs are comprehensive and complex, unresolved issues remain as to whether hospitals have the necessary managerial skills for the development of effective and achievable plans. Without also devising an overall plan to tackle the long-standing managerial weaknesses of public hospitals, the objectives of the hospital RPs will be undermined and the decentralization process in the health system will gradually reach a dead-end
Eurohealth Volume 20, issue 2: Health behaviours and incentives
The last decade has seen an increasing interest in some countries of the potential of using behavioural science to inform our understanding and influence policy design. The Eurohealth Observer section kicks off with a look at the fashionable area of applying the principles of behavioural science to nudge populations towards better health and wellbeing. It discusses the growth in popularity of these health nudges and questions the evidence base on their effectiveness and cost effectiveness. It goes on to suggest where these principles may have a role to play in enhancing elements of health promotion and public health policy
Italy: Health System Review
Presentazione e valutazione del sistema sanitario italiano commissionato al CERGAS e al Gemelli di Roma da parte della World Health Organization
Роль организаций общественного здравоохранения в решении проблем общественного здоровья в Европе
Рост числа случаев избыточного веса и ожирения, неизменно высокие показатели вредного потребления алкоголя и растущая угроза УПП – это лишь часть тех факторов, которые представляют собой наибольшую опасность для здоровья жителей Европы. И хотя масштаб этих проблем в разных государствах различается, в Европе сегодня нет ни одной страны, которую бы они не затрагивали. Совершенно очевидно, что учреждения и организации общественного здравоохранения должны принимать участие в решении каждой из перечисленных проблем, для урегулирования которых требуется принятие мер не только на уровне системы здравоохранения, но и со стороны других секторов. Однако при этом остаются вопросы относительно той роли, которую организации общественного здравоохранения играют в решении этих проблем в настоящий момент. Данная работа призвана восполнить именно этот пробел. В ее основу легли страновые отчеты восьми стран Европы (Англия, Германия, Италия, Республика Молдова, Нидерланды, Польша, Франция и Швеция), посвященные усилиям организаций общественного здравоохранения по решению проблем ожирения и потребления алкоголя, и страновые отчеты девяти европейских стран (Англия, Германия, Италия, Республика Молдова, Нидерланды, Польша, Словения, Франция и Швеция) о работе по борьбе с устойчивостью к противомикробным препаратам
Not a Waste: Wastewater Surveillance to Enhance Public Health
Domestic wastewater, when collected and evaluated appropriately, can provide valuable health-related information for a community. As a relatively unbiased and non-invasive approach, wastewater surveillance may complement current practices towards mitigating risks and protecting population health. Spurred by the COVID-19 pandemic, wastewater programs are now widely implemented to monitor viral infection trends in sewersheds and inform public health decision-making. This review summarizes recent developments in wastewater-based epidemiology for detecting and monitoring communicable infectious diseases, dissemination of antimicrobial resistance, and illicit drug consumption. Wastewater surveillance, a quickly advancing Frontier in environmental science, is becoming a new tool to enhance public health, improve disease prevention, and respond to future epidemics and pandemics
Wastewater Analysis of Mpox Virus in a City With Low Prevalence of Mpox Disease: an Environmental Surveillance Study
BACKGROUND: Tracking infectious diseases at the community level is challenging due to asymptomatic infections and the logistical complexities of mass surveillance. Wastewater surveillance has emerged as a valuable tool for monitoring infectious disease agents including SARS-CoV-2 and Mpox virus. However, detecting the Mpox virus in wastewater is particularly challenging due to its relatively low prevalence in the community. In this study, we aim to characterize three molecular assays for detecting and tracking the Mpox virus in wastewater from El Paso, Texas, during February and March 2023.
METHODS: In this study, a combined approach utilizing three real-time PCR assays targeting the C22L, F3L, and F8L genes and sequencing was employed to detect and track the Mpox virus in wastewater samples. The samples were collected from four sewersheds in the City of El Paso, Texas, during February and March 2023. Wastewater data was compared with reported clinical case data in the city.
FINDINGS: Mpox virus DNA was detected in wastewater from all the four sewersheds, whereas only one Mpox case was reported during the sampling period. Positive signals were still observed in multiple sewersheds after the Mpox case was identified. Higher viral concentrations were found in the pellet than in the supernatant of wastewater. Notably, an increasing trend in viral concentration was observed approximately 1-2 weeks before the reporting of the Mpox case. Further sequencing and epidemiological analysis provided supporting evidence for unreported Mpox infections in the city.
INTERPRETATION: Our analysis suggests that the Mpox cases in the community is underestimated. The findings emphasize the value of wastewater surveillance as a public health tool for monitoring infectious diseases even in low-prevalence areas, and the need for heightened vigilance to mitigate the spread of Mpox disease for safeguarding global health.
FUNDING: Center of Infectious Diseases at UTHealth, the University of Texas System, and the Texas Epidemic Public Health Institute. The content of this paper is solely the responsibility of the authors and does not necessarily represent the official views of these funding organizations
Wastewater Sequencing Reveals Community and Variant Dynamics of the Collective Human Virome
Wastewater is a discarded human by-product, but its analysis may help us understand the health of populations. Epidemiologists first analyzed wastewater to track outbreaks of poliovirus decades ago, but so-called wastewater-based epidemiology was reinvigorated to monitor SARS-CoV-2 levels while bypassing the difficulties and pit falls of individual testing. Current approaches overlook the activity of most human viruses and preclude a deeper understanding of human virome community dynamics. Here, we conduct a comprehensive sequencing-based analysis of 363 longitudinal wastewater samples from ten distinct sites in two major cities. Critical to detection is the use of a viral probe capture set targeting thousands of viral species or variants. Over 450 distinct pathogenic viruses from 28 viral families are observed, most of which have never been detected in such samples. Sequencing reads of established pathogens and emerging viruses correlate to clinical data sets of SARS-CoV-2, influenza virus, and monkeypox viruses, outlining the public health utility of this approach. Viral communities are tightly organized by space and time. Finally, the most abundant human viruses yield sequence variant information consistent with regional spread and evolution. We reveal the viral landscape of human wastewater and its potential to improve our understanding of outbreaks, transmission, and its effects on overall population health