Journal of Health Care and Research [ISSN: 2582-8967]

Since 2005, we have conducted a questionnaire survey on taste and olfaction, the salty taste test, and the olfactory test in Yakumo Town, Hokkaido, Japan. However, due to the COVID-19 epidemic, resident screening was canceled in 2020 and 2021. We investigated the potential impact of COVID-19 by comparing results from the salty taste test, olfactory tests, and questionnaire surveys. Data were analyzed for a total of 100 individuals, 42 males, and 58 females, who underwent screening in both 2019 and 2022. The questionnaire survey included items regarding the subjective presence or absence of dizziness, tinnitus, headache, taste, smell, and saliva secretion.
Furthermore, we obtained results from a salty taste test using the Solsave kit (manufactured by Advantech) and olfactory test results using the smell stick kit (manufactured by Daiichi Kogyo Co., Ltd.). Consequently, when comparing the results of the olfactory test between 2019 and 2022 for 42 males, a statistically significant difference (p = 0.004) emerged. The ability to understand odors was more challenging in 2022 compared to 2019. Specifically, distinguishing between the odors of perfume (p = 0.044), menthol (p = 0.032), mandarin orange (p = 0.032), and fried garlic (p = 0.019) proved to be difficult.
Similarly, in the comparison of 2019 and 2022 for 58 females, there was a statistically significant difference (p = 0.033) in olfactory test results, indicating that comprehending odors was more difficult in 2022 than in 2019. Particularly, distinguishing between the odors of perfume (p = 0.026), mandarin orange (p = 0.026), and condensed milk (p = 0.018) presented challenges. There was no statistically significant difference in the results of the salty taste test and questionnaire survey for both males and females. To determine whether the observed changes in olfactory sense are due to aging changes over the three years or the effects of COVID-19, ongoing investigation is crucial. It is necessary to continue assessing whether this diminished sense of smell will recover in the future.

The generation of health service delivery data in middle- and low-income countries typically relies on health facility surveys and routine health monitoring data. Previous studies on antenatal care (ANC) service delivery have not employed measurement parameters that accurately and cost-effectively encompass various aspects of ANC service availability, content, and organization. This study aimed to assess the agreement level between the Service Level Index (SLI) tool, which measures ANC service provision, and a standard Service Provision Assessment tool. The SLI tool integrates pertinent sub-domains relevant to ANC service provision processes at the health facility level, employing selected key elements from these sub-domains as proxy measures. This approach minimizes the complexities associated with the time and effort required for assessing service delivery comprehensively.
The study examined the agreement between the Service Level Index tool and the ANC module of the MEASURE/DHS Service Provision Assessment tool. To accomplish this, the results obtained from the service level index measurement for each health facility were compared with the outcomes derived from the MEASURE/DHS Service Provision Assessment tool. Statistical analysis using the Bland-Altman method was employed to ascertain the significance of differences between measurements obtained from the Service Level Index tool and the Service Provision Assessment tool. The estimated mean difference (d) and standard deviation (sd) were 0.1 and 0.507, respectively.
The agreement level between the two tools (-1.19 to 1.46) indicated that, for 95% of observations, the scoring of ANC service provision conducted using the SLI tool deviated between 1.19% lower and 1.46% higher than the scores generated by the reference tool. The results revealed that the Service Level Index tool has the potential to serve as an alternative to the ANC module of the standard Service Provision Assessment tool for evaluating ANC services at the micro-level.

In terms of happiness and well-being, various philosophies and perspectives may exist, including medicine, psychosomatic medicine, integrative medicine (IM), Hinohara-ism, and so on. Meaningful concepts can be found in Robert Waldinger, Simone Weil, John Tarrant, and Shigeaki Hinohara. Several keywords leading to happiness would be time, life, attention, caution, truth, love, meditation, mindfulness, human relationships, concentration, and others. The Five Facets of Mindfulness Questionnaire (FFMQ) has been useful for evaluating worry and anxiety in response to social problems, associated with item response theory (IRT) analyses. Hinohara-ism can present adequate missions, themes, and goals for obtaining happiness and well-being for everyone.

Universal Health Coverage does not exist in the United States for two reasons: (1) there is a general unwillingness to dismantle the historically grown framework of the world’s most complex mix of public and private sector health coverage, and (2) mere cost considerations. The first concern can be alleviated by establishing a Universal Health Coverage system that retains much of the existing U.S. health infrastructure. The two proposed pathways presented herein comprise either (1) a leveled solution through Medicare expansion for the uninsured only, or (2) a more complex solution through a national, 2-tier healthcare system for all Americans. Both pathways are based on solid financing without major tax increases, utilizing existing and/or yet untapped funding sources. For the sake of forming a more perfect union, as stated in the Constitution, Universal Health Coverage in the United States must no longer be an illusion that continues to haunt our society in the 21^st century.