How will the public health committees develop after COVID-19 pandemic in China? Exploration from mixed methods study in Pingshan District, Shenzhen

Introduction

The Public Health Committee has a long-standing presence in the Chinese Constitution. During the pandemic, it served as a grassroots self-governance organization and made significant contributions to China's community epidemic prevention and control system. Currently, 24 provinces in China have promoted the establishment of community public health committees.

Methods

To gather data, we conducted semi-structured interviews (n = 48) with the heads of superior departments of public health committees, the heads of public health committees, and the heads of community health centers, exploring aspects such as organizational structure, job responsibilities, and job security. In parallel, we administered a capacity-building survey to a sample of 23 community residents (n = 1,986) and performed regression analysis. Finally, we examined the impact of gender, age, and education level on the development of public health committees.

Results

Our study reveals that the development of public health committees displays features of administration across various dimensions, including personnel appointment, top-level design, medical professionalism, funding path dependence, and data path dependence. However, the decision-making function of the organization does not exhibit a significant impact.

Discussion

The construction of the Public Health Committee should demonstrate an "autonomization-administration" pendulum effect. Currently, due to the absence of decision-making functions within the Public Health Committee, autonomous organizations are exhibiting characteristics of administration. To prevent excessive autonomization or administrative nature in the development of committees, public health policies are continuously being refined based on the unique characteristics of public health committee construction. During exceptional circumstances or the initial stages of development, the establishment of public health committees should be primarily guided by administrative principles, utilizing political momentum to drive their progress. In contrast, during routine establishment phases or later stages of development, the establishment of public health committees should be primarily led by autonomization, restoring their capacity for self-decision making. It is essential to fully leverage the role of grassroots self-governance organizations, relying on the community to engage in self-management, self-education, and self-service within public health committees.

The Autonomization Principle in Vascularized Flaps: An Alternative Strategy for Composite Tissue Scaffold In Vivo Revascularization

Autonomization is a physiological process allowing a flap to develop neo-vascularization from the reconstructed wound bed. This phenomenon has been used since the early application of flap surgeries but still remains poorly understood. Reconstructive strategies have greatly evolved since, and fasciocutaneous flaps have progressively replaced muscle-based reconstructions, ensuring better functional outcomes with great reliability. However, plastic surgeons still encounter challenges in complex cases where conventional flap reconstruction reaches its limitations. Furthermore, emerging bioengineering applications, such as decellularized scaffolds allowing a complex extracellular matrix to be repopulated with autologous cells, also face the complexity of revascularization. The objective of this article is to gather evidence of autonomization phenomena. A systematic review of flap autonomization is then performed to document the minimum delay allowing this process. Finally, past and potential applications in bio- and tissue-engineering approaches are discussed, highlighting the potential for in vivo revascularization of acellular scaffolds.

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The transition is a key step for adolescents with chronic illnesses, as they are at risk of a disruption in care, complications and even mortality. Accompanying this process is based on two axes: autonomization of the young person (acquisition of knowledge and know-how in a perspective of empowerment) and structuring of the care pathway (transition measures, pediatric/adult service coordination).

Complete DIEP flap survival following pedicle resection, 4 years after its transfer. Clinical evidence of autonomization

We report a case of complete DIEP flap survival, following venous congestion due to the excision of a local recurrence with main pedicle, 4 years after its transfer for breast reconstruction.