A federal/state partnership for health system reform.

In view of the continued lack of consensus regarding health system reform, a new approach is needed to the pluralism that characterizes the U.S. political scene. A two-step strategy can help to break the deadlock around health care financing and provision: a framework around which to shape federal/state responsibility for health care and a process to ensure that policy is translated into action. This strategy, called a federal/state compact for health, builds on actions already under way in several states and represents a process that is both incremental and comprehensive in nature. The federal government would take the lead regarding policy making, financing, and establishing benefits. The states would administer the program with flexibility similar to that existing in Canada's provinces.     

A private organization and public agency partnership in community health education.

The authors address a unique partnership among private and public organizations, that of the American Red Cross and the Centers for Disease Control of the Public Health Service. The partnership stimulates an integrated community response to preventing and controlling human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) at the local level. The partnership channels information and provides education to local communities through the efforts of volunteers and staff members. Information is made available as well through other partnerships established under the cooperative agreement between the American Red Cross and the Centers for Disease Control. These partnerships include other national organizations, such as the National Leadership Coalition on AIDS, the National Association of People with AIDS, the National Urban League, and the National Council of La Raza. Education and information messages are designed to complement and be consistent with information and messages from the Public Health Service through the National AIDS Information and Education Program and the "America Responds to AIDS" public information campaign. The objectives are to mobilize local community support for efforts for HIV infection and AIDS prevention and services, as well as to heighten public awareness of the issues.     

The role of the educator in state, provincial, and federal health policy

Many faculty members of programs in health administration participate in the policy-setting process. It is critical at the present time of health care reform that faculty members play an active role in influencing health policy. Educators may become involved in this activity in a number of ways. First, there may be opportunities as researchers to conduct short-term or long-term projects which promote a policy agenda. Faculty members can bring a range of analytical skills and knowledge and may bring in multi-disciplinary perspectives on substantive policy issues. Second, educators need to re-examine curriculum content of university programs in health administration to assure appropriate policy content and to seek out opportunities for graduates in policy analysis positions. Third, through community services, educators may take on advocacy roles for the promotion of particular perspectives or the support of special interest groups. It is clear that there are going to be growing opportunities for faculty members to work with practitioners to substantially influence health policy.     

Exploring the Alberta Health Services COVID-19 provincial public health integrated outbreak prevention,preparedness, management,and response interventions to support congregate and communal living sites in Alberta

SettingOn March 17, 2020, a state of public health emergency was declared in Alberta under the Public Health Act in response to the COVID-19 pandemic. Congregate and communal living sites were environments with a high risk of exposure to and transmission of COVID-19. Consequently, provincial efforts to prevent and manage COVID-19 were required and prioritized.InterventionDuring the first 9 months of the pandemic, vaccines were unavailable and alternate strategies were used to prevent and manage COVID-19 (e.g., physical distancing, masking, symptom screening, testing, isolating cases). Alberta Health Services worked with local, provincial, and First Nations and Inuit Health Branch stakeholders to deliver interventions to support congregate and communal living sites. Interventions included resources and site visits to support prevention and preparedness, and the creation of a coordinated response line to serve as a single point of contact to access information and services in the event of an outbreak (e.g., guidance, testing, personal protective equipment, reporting).OutcomesData from an internal monitoring dashboard informed intervention uptake and use. Online survey results found high levels of awareness, acceptability, appropriateness, and use of the interventions among congregate and communal living site administrators (n = 550). Recommendations were developed from reported experiences, challenges, and facilitators, and processes were improved.ImplicationsProvincially coordinated prevention, preparedness, and outbreak management interventions supported congregate and communal living sites. Efforts to further develop adaptive system-level approaches for prevention and preparedness, in addition to communication and information sharing in complex rapidly changing contexts, could benefit future public health emergencies.     

肺结核病人心理护理及健康教育

目的探讨对肺结核病人进行心理护理的作用。方法针对病人的心理特点，进行系统的心理护理及健康教育，使得肺结核病人能够很好地配合治疗，不同程度地提高了疗效。结果肺结核病人病程长，心理状态受多种因素的影响，从而影响治疗，病情易反复。结论为提高疗效，针对病人的不同情况进行不同的心理护理。     

A public health-academic education partnership.

This article presents an academic-public health partnership needs assessment. Given the many health systems changes, the Delaware Division of Public Health and the University of Delaware joined forces to study partnership options and public health staff's education needs. This assessment was the first phase of a four-stage, multiyear research-service partnership. The top three education needs identified by the sample (n = 36) of public health staff were (1) community assessment, (2) partnership building, and (3) core functions. Distance education formats were selected as the most popular choice for education updates. Findings support the need for continued education and the use of academic-government partnerships as an education-service delivery resource. Perceived benefits of academic-public health partnerships include staff training, student learning opportunities, improved community services, and increased collaborative research.     

Tuberculosis among institutionalized elderly in Alberta, Canada.

Previous studies in the US have suggested that the risk of tuberculosis is increased among elderly residents of nursing homes. This registry-based study determined and compared the tuberculosis incidence rate for the elderly in nursing homes and community dwellings in Alberta, Canada, over the 5-year period 1979-1983. Rate ratios (RR) using the community elderly rate as baseline, were estimated for all notified cases and for culture positive cases only. Adjustment was made for the variables age, sex, and ethnicity. The nursing home elderly in Alberta did not have an increased risk of tuberculosis: adjusted RR = 1.09, 95% CI : 0.38-1.80.     

Academic health centers and public health departments: partnership matters

BACKGROUND: The Institute of Medicine has called for increased population-based training for healthcare professions students, and particularly medical students. For this to be effective, students should receive such training in the locations where population-based approaches to care take place, such as public health departments (HDs). However, little is known about currently existing relationships between academic health centers (AHCs) and HDs. METHODS: During the spring and summer of 2003, e-mail surveys on this topic were sent to the 104 members of the Association of Academic Health Centers, and 500 members of the National Association of City and County Health Officers and the Association of State and Territorial Health Officers. Results were received from 50 AHCs and 201 HDs. RESULTS: Survey results suggest that large numbers of healthcare professions students--residents, medical students, and others--are currently being trained in many HDs nationwide. The web of relationships between AHCs and HDs extends beyond education into research, service, and other purposes. CONCLUSIONS: These preliminary results require verification. Nevertheless, they raise questions about the types and quality of the education being offered in health departments, the impact of AHC/HD relationships on both parties, and how existing relationships may be enhanced to meet current and future national needs.     

Coalition, partnership, and constituency building by a state public health agency: a retrospective.

This article is a retrospective that traces the development of an evolutionary process for a state health agency in addressing the challenge of implementing core public health functions and the provision of essential services. Coalition, partnership, and constituency building were critical elements in the process. Various initiatives are described and their importance as building blocks to a larger process of organizational change is explained. Key lessons from the process are outlined.     

Zoonoses control and veterinary public health.

Because animals are essential in the life cycles of zoonoses, veterinary public health is necessary in the control of such diseases. A review of different operational phases of zoonoses control is presented, including surveillance, control in animals, control of vectors and vehicles, prevention in man and strategy selection. A practical scheme for zoonoses control is proposed along with its different constituents: legislation and administration, knowledge of the territory, knowledge of zoonoses, identification of diagnostic facilities, programme formulation, implementation and evaluation. The motivations for zoonoses control programmes and for their commencement and/or extension are discussed, with reference to their role as indicators of the social and economic status of a country.