Search

The article discusses the La Habana 2016 workshop on writing scientific papers that was held in Cuba on March 9, 2016.

The article presents abstracts on medical topics including modern management of haemorrhoids, patient experience of postoperative symptoms after ambulatory surgery, and day surgery in rural India.

The article presents abstracts on ambulatory surgery related topics including the ambulatory surgery in the dental office, drug-induced sleep endoscopy, and ethic and professional aspects of ambulatory surgery.

Introduction: The Emergency Department (ED) acts as a safety net for our healthcare system. While studies have shown increased prevalence of social risks and needs among ED patients, there are many outstanding questions about the validity and use of social risks and needs screening tools in the ED setting. Methods: In this paper, we present research gaps and priorities pertaining to social risks and needs screening tools used in the ED, identified through a consensus approach informed by literature review and external expert feedback as part of the 2021 SAEM Consensus Conference -- From Bedside to Policy: Advancing Social Emergency Medicine and Population Health. Results: Four overarching research gaps were identified: (1) Defining the purpose and ethical implications of ED-based screening; (2) Identifying domains of social risks and needs; (3) Developing and validating screening tools; and (4) Defining the patient population and type of screening performed. Furthermore, the following research questions were determined to be of highest priority: (1) What screening tools should be used to identify social risks and needs? (2) Should individual EDs use a national standard screening tools or customized screening tools? (3) What are the most prevalent social risks and needs in the ED? and (4) Which social risks and needs are most amenable to intervention in the ED setting? Conclusion: Answering these research questions will facilitate the use of evidence-based social risks and needs screening tools that address knowledge gaps and improve the health of our communities by better understanding the underlying determinants contributing to their presentation and health outcomes. [ABSTRACT FROM AUTHOR]

Comments on the challenge of reaching public health goals in light of current trends in chronic diseases, including HIV. Effort of the World Health Organization to reach people in developing countries with antiretroviral therapy; Focus of the World Summit on Health Research in Mexico scheduled for November 2004; Statement that two-thirds of the 10 million preventable childhood deaths could be prevented with effective low-cost interventions; Indication that "The Lancet" commissioned a series of articles that will be published before the Mexico summit which will provide examples of rigorous research on health systems that could lead to high-quality health services.

Background Developing age-friendly communities is a significant global policy issue. The WHO (2007) age-friendly cities and communities initiative has had a significant influence on the development of Ireland's Age-Friendly Programme. With research on such programmes still at an early stage, this paper critically examines the utilisation of the WHO age-friendly planning framework in an Irish context. It explores older adults' experience of living in two towns in an 'age-friendly' county and, in parallel, examines stakeholders' perspectives on the development of the county's age-friendly programme. This multi-perspectival approach facilitates an assessment of how the age-friendly county programme addresses older residents' needs, and illustrates how the WHO conceptual and planning framework has worked in an Irish context. Methods The paper reports on a study which employed a mixed-method, qualitative case-study research design, using a constructivist grounded theory approach to explore the lived experience of older adults, and a case-study framework for the stakeholder perspective. Results The research identifies salient social and cultural dimensions of the day-to-day lived experience of older people which, although they impact on the age-friendliness of the places in which they live, are neglected in the WHO framework. It also identifies a unique combination of economic, political, cultural, and organisational factors which have impacted on age-friendly programme development in Ireland. Conclusion In critically analysing use of the WHO age-friendly model, the paper suggests ways in which the model can be modified to better accommodate the diverse experience of older adults not only in Ireland, but also in other geographic and cultural contexts. [ABSTRACT FROM AUTHOR]

Introduction: Despite health and care services being performed by similarly skilled professionals, using largely the same technology and with similar levels of governance, there are few specialisms where there is an exclusive 'dominant' model of high performance or high reliability unlike other sector models (e.g. automotive lean production or six sigma for the electronics sector). Competition and confusion exists in the health and care setting which obscures the benefits of one approach over another. Aim and Objectives: Adopting an improvement methodology can generate an absolute denial that any other approach is legitimate or worthy of use. This methodological fanaticism is concerning and often based on highlighting differences with other models and approaches to the detriment of staff learning. This paper presents a review of the competing approaches and methodologies employed by health and care organisations as the medium through which improvement interventions are undertaken and how there are significant gaps within and between the logic, application and potential for change offered by each approach. The study draws from 9 case studies of teams and organisations employing the lean, the theory of constraints, Value-Based Health Care, service improvement and Bevan Prudent Principles approaches to change. The case study service reviews were conducted over a 4-year period using interviews and secondary data collection. Results: The cases show how, over time, some approaches have endured only a short lifecycle of improvement and reached a 'ceiling' or stall point before either being stopped or moving towards another of the approaches. The study supports the view that there is a mastery process which underpins the journey of improvement teams and also that selecting an ineffective improvement approach can have detrimental impact on learning as well as staff willingness to engage in change in the future. The results clearly indicate without an essential model then implementation of change achieves some benefits but these are largely from 're-engineering' processes rather than from a process of continual learning. In addition, some methods are clearly confused in terms of their promotion of value generation yet their focus on cost savings. Conclusions: Improvement approaches are not the same. They have different logics, focus and lifecycles. Incorrectly selecting a method can therefore fail to deliver the benefits sought. Further, if every improvement methodology promotes the important feature of staff learning then it is illogical that organisations and teams "lock themselves" into a single model which lacks an essential logic to learning rather than emulation. Emulation involves copying others who are perceived as successful and involves "borrowing methods" from other sectors to ground the health and care approach. This paper shows how decisions are not binary and why emulated methods tend to fail because a contingent and integrated care systems approach is ignored in favour of 'point improvements" within a system. Implications for applicability/transferability: The Toyota Motor Corporation does not just make cars and its divisions operate a bespoke 'Toyota Production System'. At the heart of the system are significant skills investments "To make good products - we must first make good people". These "dialects" of improvement are seldom understood by healthcare professionals who instead emulate without contextualising the sustainability of improvement processes and how they need to be 'contextualised to the health and care setting. Only staff can innovate and locking into a single improvement solution is found to be unwise and constraining. [ABSTRACT FROM AUTHOR]

Introduction: NHS staff are no strangers to innovating practices or embracing new ways of working including technological, process innovations and improved competences to accommodate a variety of service demands. These pressures are increasing and combine with pressures to evidence positive changes in performance. The latter is a skill that few NHS staff possess, and few models exist to help guide professionals to conduct such assessments as to how contributed patients, staff, employer organisations, patient journeys across shifts and organisational hand overs have generated benefits. Aims and Objectives: This paper presents a model that has been developed to allow health and care staff to conduct and validate claims of improvement success. The paper is based on over 80 case studies of improvement that were conducted in Wales (over a 3-year period). It draws from the experiences of teams that have undertaken improvements across a wide spectrum of patient facing and support processes. The research draws from an extensive literature review, and the methodology was enacted using a training session (half day to full day of exercises and application) to introduce the methods to the improvement attendees and to allow them to calculate their savings in the form of released value and cost savings. The projects also included patients as informants to help coproduce the savings claimed. Results: The results of the practical methodology include a method of visualising the patient or service user pathway, distinguishing errors, issues and experiences of all staff, a structured project management approach and a systematic logic which relates 'time released' as the core currency of savings to a human resource constrained series of cases. Time is used to assess the combined activity cost savings for each staff member which is then converted into an annualised savings based on real demand for a service and allowing service users/staff to redirect their 'released time' towards more project and more personally rewarding higher value-added activities. The results show that no single project team (from those that voluntarily undertook the training) failed to create an output calculation of savings and typically the projects resulted in a significant payback that was many times the total annual salaries of the staff involved and have significantly improved process/patient experience performance levels as measured in terms of the 'sand cone' model (Rich et al., 2004). Conclusions: The methodology and its application have proven robust across a wide range of health and care settings. The results of the projects undertaken have been tested and validated with finance directors and their staff in terms of the usability and validity of the approach for the justification of savings. The method is therefore transferable and a means of engaging all stakeholders in improving a process. Significant savings have been achieved and validated at the team, patient pathway and national pathway approaches in Wales. Implications: The applicability and transferability of this form of assessment fills a gap in the skill sets of improvements undertaken by staff and adds another capability to innovation management processes. The 'easy to follow' method captures and allows a holistic assessment of a projects results on process performance based on a realistic 'costed time saving' which quantifies efficiency gains and staff/patient gains in a less daunting approach than other forms of costing. The approach provides a meaningful addition to the Plan-Do-Check-Act (PDCA) improvement cycle by allowing the 'check stage' to be quantified and in answering the basic questions of senior executives and directorate leaders as to what 'return' can and did we make from allocating scarce staff time to improvement activities. [ABSTRACT FROM AUTHOR]

Background: In studies of diagnostic performance that fail to detect a statistically significant difference between compared techniques, investigators often declare evidence of equivalence or similarity without having actually tested that assertion due to incorrect methodology or insufficient statistical power.Objective: The purpose of our investigation is to measure the prevalence of unfounded assertions of equivalence or similarity in comparison studies presented at the International Pediatric Radiology (IPR) meeting of 2016 and promote awareness of this fallacy of inference to the pediatric radiology community.Materials and Methods: Two pediatric radiologists independently reviewed the methodology and reporting quality of the 194 scientific paper abstracts from the 2016 IPR meeting. All comparison studies were identified and those failing to detect a statistically significance difference and making a claim of equivalence or similarity in the results or conclusion were assessed for a description of the study design type, statistical power and sample size estimator calculation.Results: Of 194 scientific paper abstracts, 112 (58%) were comparison studies. Of these, 36/112 (32%) made unfounded inferences of equivalence or similarity in diagnostic imaging performance. No study had an equivalence or non-inferiority design. No abstract specified the statistical power of the study, and only one abstract acknowledged a small sample size as a limitation in detecting a statistically significant difference.Conclusion: Inadequate reporting and unfounded inferences of equivalence or similarity were common in diagnostic performance comparison studies presented at IPR 2016. Failure to recognize these limitations could have adverse consequences by leading to the adoption of unvalidated imaging techniques. [ABSTRACT FROM AUTHOR]

Purpose: This is a position paper describing the elements of an international framework for assistive technology provision that could guide the development of policies, systems and service delivery procedures across the world. It describes general requirements, quality criteria and possible approaches that may help to enhance the accessibility of affordable and high quality assistive technology solutions. Materials and methods: The paper is based on the experience of the authors, an analysis of the existing literature and the inputs from many colleagues in the field of assistive technology provision. It includes the results of discussions of an earlier version of the paper during an international conference on the topic in August 2017. Results and conclusion: The paper ends with the recommendation to develop an international standard for assistive technology provision. Such a standard can have a major impact on the accessibility of AT for people with disabilities. The paper outlines some the key elements to be included in a standard. Implications for Rehabilitation: Assistive technology is a key element in rehabilitation, but many people have no access to affordable AT solutions. The recommendations in the paper aim to inform policies, systems and service delivery procedures on how to improve access to AT across the world. [ABSTRACT FROM AUTHOR]

Introduction: Research plays an important role in supporting integrated care (IC). However, IC networks may lack the capacity to leverage research. Moreover, many health system organizations (HSOs) struggle to identify and implement relevant research in a timely fashion. Embedded research is a promising strategy to align data with system priorities, increase the relevance and timeliness of evidence, and build capacity to conduct and use research. This study reviews two Canadian postdoctoral training programs that embed researchers in HSOs. We describe the programs, report on early lessons learned, and discuss implications for IC. Background: •IC is a priority in many Canadian jurisdictions. For example, Ontario Health Teams (OHTs) were introduced in 2019 to organize care in a more integrated way. •Embedded research requires different skills than traditional research. In response, new training programs have developed such as the Health System Impact Fellowship (HSIF) and the OHT Impact Fellows (OHTIF) programs. Aims: This paper describes the HSIF and OHTIF models and presents early lessons learned. Through surveys, program data, and interviews with participants, we identify key challenges and opportunities. Combined with insights from program leads, we provide an in-depth look at the design and implementation of these programs and how embedded research can support IC initiatives. Highlights: The HSIF program was launched in 2017 and has embedded more than 200 fellows in over 100 HSOs across Canada. Host organizations determine research priorities and are matched with fellows. Distinctive features include a focus on impact-oriented research, co-supervision with health system and academic leaders, professional development, protected time for academic research, and a national cohort that fosters networking and collaboration. Promising outcomes include advancement of HSO goals, increased system capacity for research, and enhanced leadership skills and early career success among fellows. The OHTIF program is modeled on HSIF and places researchers directly in OHTs where they support local projects and learning across organizations. Launched in 2021, the program saw strong demand from OHTs and trainees interested in IC research. Distinctive features include its focus on IC, intensive training activities, and ongoing mentorship for fellows. Early feedback is promising but also suggests areas for attention, including the unique needs of rural and remote regions and the multiple, often competing demands that fellows encounter. Both programs involve patients and caregivers on their advisory panels and offer training in patient engagement. Conclusions: Embedded research is a promising strategy to support IC and health system research. Data from two Canadian training programs show strong interest from HSOs keen to embed research talent within their teams, and from applicants interested in using their research skills to address real-world challenges. Early evidence also highlights the importance of matching, onboarding, and ongoing training for fellows, mentors, and host organizations to build a highperforming embedded research workforce. Implications: Our experience suggests embedded research programs provide important benefits both in augmenting the research and evidence translation capabilities of HSOs and in providing valuable training experiences for fellows, augmenting the research and evaluation skills gained in their graduate education. [ABSTRACT FROM AUTHOR]

Introduction: In 2020, the National Rehabilitation University Hospital (NRH) in Ireland, a complex specialist rehabilitation hospital transitioned to a new building. This transition presented a unique opportunity to explore interdisciplinary team dynamics, integration, connections and relationships within and across teams. Part of a larger project, this paper presents the results of a co-operative inquiry with the Medical Consultants. Aims and objectives: To assess the value of co-operative inquiry as a vehicle for supporting learning. The specific questions to be addressed were: •How can we as medical leaders facilitate transition to the new hospital with an improved staff and patient experience? •How might we develop the leadership skills to do this? Methodology: Action research (AR) was chosen because, similar to the biopsychosocial model of rehabilitation, it supports a collaborative, democratic approach to research based organisational change and improvement. Cooperative inquiry (CI) an experiential, participatory articulation of action research, was chosen as it has a solid evidence base in professional development in healthcare. In this articulation, small groups of co-researchers engage, in a non-hierarchical manner, multiple ways of knowing through cycles of action and reflection to explore areas of shared concern. Data generation: Data was generated from 6 action research cycles, with participants engaging in an 'extended epistemology' of experiential, presentational, propositional and practical ways of knowing. An integrative triangulation approach incorporated the first, second and third person inquiries. As there were multiple cycles of inquiry, there was a continuous process of innovation and data generation. A process folio approach was taken, to document, describe and analyze the data using a 10-step cyclical framework. Data analysis was ongoing, cyclical and reflexive, with participants engaging in the sense-making process at each session. Results: Through cycles of action and reflection, 2 key themes emerged; Communication and teamwork. Actions taken included the identification and creation of physical space to come together physically (Coffee room, informal get togethers) and virtual spaces (WhatsApp; Virtual meetings). These enhanced discovery, development, diffusion, and disruption connections. WhatsApp content analysis revealed an active dynamic exchange of diverse information that became a network of collaborative learning. These activities were supported by senior management through the 3rd person inquiry. 75% of participants felt our objectives were met. Through a process of abductive reasoning, colleagues felt they had learned to communicate better, trust, share and learn together and also patience and friendship. There was a commitment to continue as an action learning set. Conclusions: Cooperative inquiry, with a focus on action and shared reflection, facilitated the 'inpowerment' of a diverse group of colleagues to work together to develop practice in areas of mutual concern. CI was an effective vehicle for supporting learning which resulted in the stated goals of improved communication and teamwork. Implications and limitations: This study found that CI is a useful developmental method for teams engaging the collaborative dynamics of action and inquiry and the outcome of actionable knowledge. Although this approach was tested with 1 group, the approach is being extended to other groups within the organisation. [ABSTRACT FROM AUTHOR]

This perspective paper seeks to lay out an efficient approach for health care providers, researchers, and other stakeholders involved in interventions aimed at improving care coordination to partner in locating and using applicable care coordination theory. The objective is to learn from relevant theory-based literature about fit between intervention options and coordination needs, thereby bringing insights from theory to enhance intervention design, implementation, and troubleshooting. To take this idea from an abstract notion to tangible application, our workgroup on models and measures from the Veterans Health Administration (VA) State of the Art (SOTA) conference on care coordination first summarizes our distillation of care coordination theoretical frameworks (models) into three common conceptual domains-context of an intervention, locus in which an intervention is applied, and specific design features of the intervention. Then we apply these three conceptual domains to four cases of care coordination interventions ("use cases") chosen to represent various scopes and stages of interventions to improve care coordination for veterans. Taken together, these examples make theory more accessible and practical by demonstrating how it can be applied to specific cases. Drawing from theory offers one method to anticipate which intervention options match a particular coordination situation. [ABSTRACT FROM AUTHOR]

Global health faces a broad spectrum of old and new challenges. Besides epidemiological problems, political conflicts, economic crisis and austerity policies are jeopardizing progress towards Universal Health Coverage (UHC), affecting the most vulnerable populations. During the 22nd International Union for Health Promotion and Education (IUHPE) World Conference on Health Promotion held in Curitiba, Brazil, in 2016, challenges and threats for global health, in addition to a wide range of innovative experiences in health promotion, were discussed with participants from 65 countries. At the end of the conference, a public statement was approved claiming for Democracy and Human Rights in all countries around the world as essential conditions for the promotion of health and equity. In this paper, we explore challenges, threats and innovations in global health promotion. We use scientific literature, analysis of the current situation of the Brazilian health system, and material presented during the 22nd IUHPE World Conference. Also, we discuss strategies to strengthen health systems, policies and practices through the approach of STI and illustrative local experiences presented at the congress mentioned above, including examples developed in the city of Curitiba. We conclude that STI is crucial to support strengthening local health systems, design effective intersectoral public policies, scaling up innovative initiates, and skilling staff in addressing the contemporary challenges. Finally, the Declaration of the 22nd World Conference on Health Promotion of the IUHPE is a fundamental policy statement based on the prioritization of democracy and human rights as essential conditions for the promotion of health and equity. [ABSTRACT FROM AUTHOR]

Introduction: Remediating failing medical learners has traditionally been a craft activity responding to individual learner and remediator circumstances. Although there have been moves towards more systematic approaches to remediation (at least at the institutional level), these changes have tended to focus on due process and defensibility rather than on educational principles. As remediation practice evolves, there is a growing need for common theoretical and systems-based perspectives to guide this work. Methods: This paper steps back from the practicalities of remediation practice to take a critical systems perspective on remediation in contemporary medical education. In doing so, the authors acknowledge the complex interactions between institutional, professional, and societal forces that are both facilitators of and barriers to effective remediation practices. Results: The authors propose a model that situates remediation within the contexts of society as a whole, the medical profession, and medical education institutions. They also outline a number of recommendations to constructively align remediation principles and practices, support a continuum of remediation practices, destigmatize remediation, and develop institutional communities of practice in remediation. Discussion: Medical educators must embrace a responsible and accountable systems-level approach to remediation if they are to meet their obligations to provide a safe and effective physician workforce. [ABSTRACT FROM AUTHOR]

This paper reports on a workshop held at the 19th National Family Practitioners Conference in August 2016. The aim of the workshop was to describe possible future scenarios for the discipline of family medicine in South Africa and identify possible options for action. The workshop led a group of 40 family physicians from academic, public and private sector settings through a scenario planning process developed by Clem Sunter and Chantell Ilbury. After an overview of the current situation the participants reached a consensus on the rules of the game, key uncertainties, future scenarios and options for action. The main message was that the South African Academy of Family Physicians as a professional body needs to take a stronger role in advocating for the contribution of family medicine to government, health managers and the public. [ABSTRACT FROM PUBLISHER]

Background and Objectives: The human being is a complex entity, involving interaction between microbes and the human host. Evidence shows that the nutritional value of food is influenced in part by the structure and operations of an individual's gut microbial community, and food in turn shapes the individual's microbiome. A conference was held to promote understanding of the intestinal microbiome and its implications for health and disease, particularly among Asian populations.Methods and Study Design: Papers describing 1) the intestinal ecosystem in Asian populations, 2) changes in intestinal microbiota through life and its effects, 3) the Asian gut microbiota in disease conditions, 4) indigenous probiotics to maintain a healthy gut microbiota, 5) probiotic regulation in an Asian country, and 6) the results of a panel discussion are included in this report.Conclusions: The gut microbial inhabitants of Asian people differ from those of Europe and North America. Geographic location, diet, and ethnic background influence intestinal microbial composition. Urbanization and economic development have brought changes in traditional Asian diets, which in turn affected the gut microbiome, contributing to a shift in the region's health burden from infectious diseases to non-communicable chronic diseases. Novel probiotic strains of Indonesian origin demonstrated significant enhancement of humoral immune response in human studies. Knowledge gaps and implications for research to further understand the Asian gut microbiome were discussed. [ABSTRACT FROM AUTHOR]

Introduction: Receiving client feedback is crucial for providers to identify gaps and improve services. Surveys are typically used to collect client input for quality improvement (QI) consideration - but was this enough? We did not think so. The ASBHNHH conducted client surveys in 2019 and 2020 revealing that clients with YOD and their care partners have unique needs. Embracing client engagement as a framework allows clients to be empowered decision makers who direct what services they need. This paper will focus on our recent shift to empowerment through a co-design investigative project and outcomes for persons with YOD and care partners. Aims Objectives Theory or Methods: With improved client engagement as a QI Plan indicator, the objectives of this project were to engage persons living with YOD and their care partners to identify gaps in service using codesigned, investigative strategies that promote people as partners in care. Qualitative research methods, including focus group discussions and semi-structured interviews, were used to examine the potential use of the co-design method in designing and delivering improved services. A YOD Advisory Group was assembled and meetings then took place through Zoom with the use of guiding questions, open dialogue, and Google Jam Board. Highlights or Results or Key Findings: The YOD Advisory Group identified two service gaps to improve and increase: support needs for YOD in general, and resources at the time of receiving a diagnosis. The findings informed the subsequent development of a resource guide outlining "everything to know" when one is diagnosed; and a peer support group for persons with YOD and another for their care partners. Evaluation was also co-designed to better inform the success of these projects. The co-design process was reported to have been significantly empowering for the YOD Advisory Group and staff involved. All reported having benefited from the experience and contributing to the solutions from their own perspectives. Our client engagement efforts through co-design resulted in the development of new programs and resources that now fill the identified service gaps. Conclusions: This work demonstrates the importance and value of establishing meaningful partnerships with YOD clients through engagement to ensure quality and relevance of services. Lived experience is viewed as a form of expertise and client engagement that is reflected in performance indicators related to the QI Plan for the ASBHNHH. Implications for applicability/transferability sustainability and limitations: It was evident that client engagement contributed to enhanced quality improvement. Lessons learned from the experience of the ASBHNHH can inspire other service providers to engage their clients through co-design and QI projects. Anecdotal accounts of QI planning can be references to inform many other community service contexts. [ABSTRACT FROM AUTHOR]

In May 2012, the Canadian Association of Geographers (CAG) annual meeting in Waterloo, Ontario, attracted strong attendance by scholars whose research explores the geographies of health and health care. The CAG's Geography of Health and Health Care Specialty Group organized 14 special paper sessions spanning three consecutive days and involving 53 presenters; 24 health-focused papers were also given in other sessions throughout the CAG meeting, for a total of 77 presenters. In this viewpoint, we draw upon the diverse geographies of health and health care scholarship presented at this meeting to provide a snapshot of some current research themes in Canadian health geography. Five interrelated themes were identified, namely: 1) aging, disability, and chronic disease; (2) environmental determinants and health; (3) accessing health and health-promoting services; (4) diversity and intersecting positions; and (5) research methods and frameworks. We believe that identifying themes from the 2012 CAG annual meeting provides insight regarding what issues, topics, methods, and frameworks are inspiring Canadian health geographers, while also serving as a baseline for comparison of future trends and directions for future research. [ABSTRACT FROM AUTHOR]

Introduction: Mexico has been one of the countries most affected by the international public health emergency brought on by COVID-19 (short for corona virus disease 2019), at the end of June 2021, the country has had 2.642.068 confirmed cases and 236.015 deaths. In response to the pandemic, governments around the world have reacted by implementing a wide variety of public health policies with a wide range of nuances and huge heterogeneity that make them difficult to compare and assess in view of scaling up some of them, as well as it complicates the possibility of making global recommendations. The aim of this paper is to analyze the decision making of the Mexican health system in the governance of the COVID-19 pandemic, and to assess its strengths according to the WHO guide for COVID-19 Strategic Preparedness and Response Plan (SPRP). We conducted a qualitative investigation based on semi-structured interviews of 41 key actors of the health system, from June to November, 2020. Interviews were audio-recorded, organized into categories following the framework of the COVID-19 SPRP and the ""health policy triangle"", using ATLAS.ti-v.9 software. Conclusions: The health policy response focused on intersectoral communication between the health sector and other sector such as education, economy or public security; advice of expert in health policies; portability of health-care services, equitable policies, and improving the information system (Epidemiological Stoplight); which allowed an intermediate response to COVID-19. Implications: Strengthening an effective response of the Mexican health system to face COVID-19, according to the WHO guide for COVID-19-SPRP, requires the prompt formulation of evidencebased policies, such as restrictions on international movement, efficient testing policy and contact tracing, in addition to the intersectoral, equitable, collaborative, and responsible policies currently implemented. [ABSTRACT FROM AUTHOR]

Introduction: The Australian National Disability Insurance Scheme (NDIS) offers an approach to disability support that is personalised via the provision of an individual budget which can then be used to 'purchase' services by NDIS service providers who compete for NDIS clients as part of a social care market. The scheme is prefaced on the concepts of 'choice and control' with individuals at the centre of decision making in relation to their budgets. However, individuals with complex needs themselves may be unable to organise their own care because of the situation they are in, or they may need supports that go beyond the boundaries of the NDIS, or they cannot purchase services because services do not exist in the market to meet their needs. This means that those individuals have a higher need for integration or are at higher risk of negative social and health outcomes. Aims and objectives: This paper will reflect on the example of the Integrated Service Response (ISR) which was a highly structured add-on to the NDIS created by the New South Wales State Government in Australia to increase inter-agency collaboration around the needs of people with extremely complex needs who were in a crisis situation that could not be easily resolved. The program aimed to 1) meet the needs of the individual and 2) join up the system to make it work more collaboratively going forwards. The ISR program involved a 3-month service which aimed to connect those services and agencies relevant to the individual and situation and develop a strategy to meet their needs. Highlights: We will describe the program and examine its effectiveness at meeting its aims by drawing on process observation and interview data. We will pay close attention to the validity of ISR and ISR-like programs that act at a systemic level to address client needs, but do not actually engage with the client/patient themselves beyond their consent to participate. Is this saving the client from being drawn into fixing a mess imposed by the system, or is it cutting the client out of decision making and therefore the antithesis of personalisation? Conclusions: We will look at the possibilities posed by these types of programs in operation in Australia more generally and their sometimes-complex relationship with the personalisation agenda of the NDIS and similar programs. [ABSTRACT FROM AUTHOR]

In September 2009 key stakeholders convened for the invitation-only Child and Adolescent Mental Health Services (CAMHS): Issues and Solutions conference. This paper provides a brief synopsis of the key high points and issues in children’s mental health (CMH) and describes the process by which participants collectively brainstormed the priorities and distilled the four key foci for the new action agenda, and summarizes the key outcomes. In addition, this paper offers participants’ perspectives on the conference. Based on observation notes and post-conference qualitative interviews, this paper reports conference participants’ feedback on the event, their views on the prospects for change generated by the conference and suggestions for follow-up. [ABSTRACT FROM AUTHOR]

Information about several papers discussed at the International Medical Informatics Association meeting on building worldwide capacity for the health informatics workforce is presented. Topics included the history of health informatics, occupational standards and career opportunities and international initiatives. The author notes that a particularly interesting paper was delivered by Steven Bedrick and Bill Hersh on language barriers.

Information about several papers and posters related to electroencephalography (EEG) presented at the 49th Annual Conference of the American Society of Electroneurodiagnostic Technologists is presented. The paper by Leo Happel focused on the effects of Hurricane Katrina on the medical community of New Orleans, Louisiana. The role of the abnormal findings on the cranial nerve functions in the diagnosis of the patient was discussed by Jennifer Walcoff.

The 2nd American Samueli Institute symposium was held January 22-25, 2004. The focus of this meeting was an exposition of optimal healing environments (OHE) in American health care. Fifty-five (55) invited guests participated; most had written one of the papers in this Supplement. The conduct of the meeting revolved around small group discussions and two plenary sessions. The ensuing dialogue refined and organized the definitions, components, and research protocols associated with creating and implementing an OHE. This Supplement contains both the invited papers and an abstract of the plenary session discussions. [ABSTRACT FROM AUTHOR]

Background: COVID-19 has reinforced the centrality of health workers at the core of a well performing and resilient health system. It has concomitantly exposed the risks of staffing and skills shortages and the importance of protecting the health workforce. This paper focuses on highlighting some of the lessons learnt, challenges and future needs of the health workforce in Europe in the context of COVID-19. Methods: We use secondary sources and expert information. Results: During the pandemic innovative and flexible approaches were implemented to meet increasing demand for health workers and new skills and responsibilities were adopted over a short period of time. We have seen the rapid adaptation and use of new technologies to deliver care. The pandemic has underlined the importance of valuing, protecting and caring for our health workforce and the need to invest appropriately and adequately in the health workforce to have sufficient, capable and wellmotivated health workers. Some of the main challenges that lie ahead of us include the imperative for better investment, to need to improve recruitment and retraining whilst better retaining health workers, a focus on domestic sustainability, redeploying and developing new skills and competences among health workers, enabling more effective multi-professional collaboration and team work, improving the quality of education and training, increasing the public health focus and promoting ethical and sustainable international recruitment of health workers. Conclusions: The WHO European Region through its European Programme of Work 2020-2025 is fully committed to support countries in their efforts to continue to respond to COVID-19 and whilst addressing upcoming health workforce challenges. [ABSTRACT FROM AUTHOR]

Information about several papers discussed at Second Global Conference on Contraception and Sexual and Reproductive Health and the 14th congress of the European Society for Contraception and Reproductive Health (ESC) held from 4-7 May 2016, at Basel, Switzerland is presented. Topics include reproductive health care and cultural and political issues of reproduction. The author reflects on ESC congress. He states that conference focused on reproductive health issues and its solutions.

Abstracts of research papers on topics related to nutrition and dietetic services are presented including the effectiveness of a dietician-led weight management intervention in patients with severe mental illness, allege unsafe workload for National Health Service (NHS) workforce, and division of work time of NHS dietetic workforce.

We describe a system that automatically extracts biological events from biomedical journal articles, and translates those events into Biological Expression Language (BEL) statements. The system incorporates existing text mining components for coreference resolution, biological event extraction and a previously formally untested strategy for BEL statement generation. Although addressing the BEL track (Track 4) at BioCreative V (2015), we also investigate how incorporating coreference resolution might impact event extraction in the biomedical domain. In this paper, we report that our system achieved the best performance of 20.2 and 35.2 in F-score for the full BEL statement level on both stage 1, and stage 2 using provided gold standard entities, respectively. We also report that our results evaluated on the training dataset show benefit from integrating coreference resolution with event extraction. [ABSTRACT FROM AUTHOR]

In 2015, at the International Conference on Communication in Healthcare in New Orleans, USA, we formed a symposium panel to discuss and debate how interdisciplinary research can inform interpreter-mediated medical consultation training. In all our work, a recurring theme is not just the strengths but also the shortcomings of the guidelines proposed in the textbooks and widely used in medical education. This paper is an account of our multidisciplinary reflections on a prominent issue of the lack of attention to interaction in communications, which shed light on the limitations of these guidelines and clinical communication models. We propose that an international network be established for all stakeholders to foster interprofessional and interdisciplinary collaboration for research and clinical interventions, and to inform training and policy making. [ABSTRACT FROM AUTHOR]

The aim of the present paper is to present the message transmitted by the Presidential Lecture given during the first congress of arthroscopy organised in Romania, in March 2016, by the Romanian Society of Arthroscopy and Sports Trauma (SRATS). The goal was to present the evolution of medical care in Romania over the years, with the remarkable progress made in the first half of the twentieth century and the current status of arthroscopic surgery as seen from the point of view of medical professionals, as well as from a governmental point of view. [ABSTRACT FROM AUTHOR]

Abstract: Introduction: A usability test was employed to evaluate two medical software applications at an expert conference setting. One software application is a medical diagnostic tool (electrocardiogram [ECG] viewer) and the other is a medical research tool (electrode misplacement simulator [EMS]). These novel applications have yet to be adopted by the healthcare domain, thus, (1) we wanted to determine the potential user acceptance of these applications and (2) we wanted to determine the feasibility of evaluating medical diagnostic and medical research software at a conference setting as opposed to the conventional laboratory setting. Methods: The medical diagnostic tool (ECG viewer) was evaluated using seven delegates and the medical research tool (EMS) was evaluated using 17 delegates that were recruited at the 2010 International Conference on Computing in Cardiology. Each delegate/participant was required to use the software and undertake a set of predefined tasks during the session breaks at the conference. User interactions with the software were recorded using screen-recording software. The ‘think-aloud’ protocol was also used to elicit verbal feedback from the participants whilst they attempted the pre-defined tasks. Before and after each session, participants completed a pre-test and a post-test questionnaire respectively. Results: The average duration of a usability session at the conference was 34.69min (SD=10.28). However, taking into account that 10min was dedicated to the pre-test and post-test questionnaires, the average time dedication to user interaction of the medical software was 24.69min (SD=10.28). Given we have shown that usability data can be collected at conferences, this paper details the advantages of conference-based usability studies over the laboratory-based approach. For example, given delegates gather at one geographical location, a conference-based usability evaluation facilitates recruitment of a convenient sample of international subject experts. This would otherwise be very expensive to arrange. A conference-based approach also allows for data to be collected over a few days as opposed to months by avoiding administration duties normally involved in laboratory based approach, e.g. mailing invitation letters as part of a recruitment campaign. Following analysis of the user video recordings, 41 (previously unknown) use errors were identified in the advanced ECG viewer and 29 were identified in the EMS application. All use errors were given a consensus severity rating from two independent usability experts. Out of a rating scale of 4 (where 1=cosmetic and 4=critical), the average severity rating for the ECG viewer was 2.24 (SD=1.09) and the average severity rating for the EMS application was 2.34 (SD=0.97). We were also able to extract task completion rates and times from the video recordings to determine the effectiveness of the software applications. For example, six out of seven tasks were completed by all participants when using both applications. This statistic alone suggests both applications already have a high degree of usability. As well as extracting data from the video recordings, we were also able to extract data from the questionnaires. Using a semantic differential scale (where 1=poor and 5=excellent), delegates highly rated the ‘responsiveness’, ‘usefulness’, ‘learnability’ and the ‘look and feel’ of both applications. Conclusion: This study has shown the potential user acceptance and user-friendliness of the novel EMS and the ECG viewer applications within the healthcare domain. It has also shown that both medical diagnostic software and medical research software can be evaluated for their usability at an expert conference setting. The primary advantage of a conference-based usability evaluation over a laboratory-based evaluation is the high concentration of experts at one location, which is convenient, less time consuming and less expensive. [Copyright &y& Elsevier]

Objective: Given the potential and importance of personalized or individualized medicine for health care delivery and its effects on patients’ quality of life, a plenary session was devoted to personalized medicine during the 19th Annual Conference of the International Society for Quality of Life Research held in October 2012 in Budapest, Hungary. This paper summarizes the three presentations and discusses their implications for quality-of-life research. Methods: Reviews of the literature and presentation of empirical studies. Results: Personalized screening for breast cancer. To individualize screening and only target those women with an increased risk for breast cancer, researchers at the Karolinska Institutet in Stockholm perform a large population-based study to identify high-risk women based on lifestyle, genetics, mammographic morphology, and other markers as well as quality of life. Personalized support for treatment adherence. Inclusion of a simple, brief adherence measure into the clinical visit has demonstrated significant improvement in medication-taking behaviour and resultant improvement in health status. Personalized diagnosis of mental disorders. The DSM-5, the current manual for mental disorders, contains patient-based symptom and diagnosis severity measures that allow more individualized diagnosis than was hitherto possible. Conclusions: Personalized medicine will continue to be increasingly applied and holds the potential to improve health outcomes including quality of life. At the same time, it will invite a host of new ethical, practical, and psychosocial questions. Further reflection and discussion of how our field can embrace and address these emerging challenges is needed. [ABSTRACT FROM AUTHOR]

A table is presented, which lists several research papers published in a 2013 issue of the periodical "Clinical Therapeutics."

The application of agent technology to the solution of problems in health care has in recent years become increasingly common. A workshop on this area of research was held as part of the 16th European Conference on Artificial Intelligence (ECAI-2004), in Valencia, August 2004, at which twelve papers were presented. This special issue contains extended versions of a selection of five of the papers presented at the workshop. [ABSTRACT FROM AUTHOR]

The article presents information about abstracts of various papers that will be discussed at the Neurobiology symposium that will be held on May 30, 2004. One of the papers that will be discussed is "Neuropeptides: Their Role in Neurotransmission and As Functional Makers in Epilepsy," by G. Sperk. Neuropeptides are widely distributed in the peripheral and central nervous systems and are involved in numerous physiological functions. Together with classical neurotransmitters they are stored in large dense core vesicles localized at the nerve terminals from where they can be released upon nerve stimulation by exocytosis. Other papers that will be discussed are, "The Role of Somatostatin in Epilepsy: Evidence From Human Tissue," by P. Doumaud and "Galanin, Kindling and Status Epilepticus," by M. Kokaia.

The burden of cardiovascular disease for Indigenous people in Australia and New Zealand is high and reflects the failings of our health care system to meet their needs. Improving the hospital care for Indigenous people is critical in improving health outcomes. This paper provides the results from a facilitated discussion on the disparities in acute hospital care and workforce issues. The workshop was held in Alice Springs, Australia at the second Cardiac Society of Australia and New Zealand (CSANZ) Indigenous Cardiovascular Health Conference. Critical issues to be addressed include: addressing systemic racism; reconfiguring models of care to address the needs of Indigenous people; cultural competence training for all health professionals; increasing participation of Indigenous people in the health workforce; improving information systems and facilitating communication across the health care sector and with Indigenous communities. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To estimate the morbidity and mortality conferences (MMC) impact in intensive care unit (ICU) setting on quality of care and patients’ safety. Data sources: A review of English and French articles in Medline database (1990–2011) related to MMC in the ICU. Keywords used: “morbidity (and) mortality conference(s)”, “intensive care unit”, “intensive/critical care medicine”. Additional studies identified by hand search in French national guidelines about MMCs and in the Annales Françaises d’Anesthésie Réanimation and Réanimation journals index. Identification and preliminary analysis performed using title and abstract, for every study related to MMC in the ICU. Study selection: Only original studies about MMC in the ICU setting that reported an assessment were included. Papers reporting guidelines and methods for MMC implementation were excluded. Data extraction: Extraction used predefined data fields, including study design, MMC characteristics, assessment methods and results. Data synthesis: Studies about MMC in the ICU are recent and scarce. Results comparison and synthesis are impaired by discrepancies in study designs. Although the effectiveness of MMC is not evidence-based, data are consistent for their positive impact on quality of care and patient safety in the ICU. Conclusion: Further studies are required to assess the impact of MMC in the ICU. Based on this literature review, a 4-level evaluation scheme can be suggested: 1) evaluation of MMC implementation in care units and facilities; 2) evaluation of MMC organization; 3) evaluation of MMC on quality of care; 4) evaluation of MMC impact on patients’ mortality and morbidity. [Copyright &y& Elsevier]

The Association of Psychologists in Academic Health Centers (APAHC) convened its 5th National APAHC Conference in Boston March 3-5 2011. The conference and its theme, ' Preparing Psychologists for a Rapidly Changing Health Care Environment,' brought psychologists from academic health centers together to examine how psychology can adapt to and help lead health care efforts in the face of health care reform. This paper reports on the conference and introduces the special issue of JCPMS that is dedicated to the conference. The conference theme is framed in the historical context of the four national conferences that preceded it. In examining the focus and topics of the preceding conferences, recurrent themes are identified and progress in certain areas is highlighted. [ABSTRACT FROM AUTHOR]

An introduction to the special issue of "Social Work in Health Care," focusing on the papers submitted to the 6th International Conference on Social Work in Health and in Mental Health held in Dublin, Ireland in 2010, is presented.

Background: Calls have been made for governments to adopt a cohesive approach to rare diseases through the development of national plans. At present, Australia does not have a national plan for rare diseases. To progress such a plan an inaugural Australian Rare Diseases Symposium was held in Western Australia in April 2011. This paper describes the key issues identified by symposium attendees for the development of a national plan, compares these to the content of EUROPLAN and national plans elsewhere and discusses how the outcomes might be integrated for national planning. Methods: The symposium was comprised of a series of plenary sessions followed by workshops. The topics covered were; 1) Development of national plans for rare diseases; 2) Patient empowerment; 3) Patient care, support and management; 4) Research and translation; 5) Networks, partnerships and collaboration. All stakeholders within the rare diseases community were invited to participate, including: people affected by rare diseases such as patients, carers, and families; clinicians and allied health practitioners; social and disability services; researchers; patient support groups; industry (e.g. pharmaceutical, biotechnology and medical device companies); regulators and policy-makers. Results: All of these stakeholder groups were represented at the symposium. Workshop participants indicated the need for a national plan, a national peak body, a standard definition of 'rare diseases', education campaigns, lobbying of government, research infrastructure, streamlined whole-of-lifetime service provision, case co-ordination, early diagnosis, support for health professionals and dedicated funding. Conclusions: These findings are consistent with frameworks and initiatives being undertaken internationally (such as EUROPLAN), and with national plans in other countries. This implies that the development of an Australian national plan could plausibly draw on frameworks for plan development that have been proposed for use in other jurisdictions. The translation of the symposium outcomes to government policy (i.e. a national plan) requires the consideration of several factors such as the under-representation of some stakeholder groups (e.g. clinicians) and the current lack of evidence required to translate some of the symposium outcomes to policy options. The acquisition of evidence provides a necessary first step in a comprehensive planning approach. [ABSTRACT FROM AUTHOR]

The article presents updates on the American Association of Neuromuscular and Electrodiagnostic Medicine (AANEM) as of May 2011. According to Dr. Charles Jablecki, EDX physicians must focus on the preparing quality EDX reports with emphasis on quality patient care. AANEM aims to help physicians enhance the quality of their reports through its report template based on its educational paper titled "Reporting the Results of Needle EMG and Nerve Conduction Studies." AANEM will have its 58th annual meeting in San Francisco, California in September 2011.

Abstract: Held on 21st to 23rd November 2009 in Hiroshima, the SiHIS working conference aimed at finding solutions to approach to an idealistic society where (1) the individual can trust information with full understanding and responsibility, (2) the individual can allow the use of information backed by sound legitimated environment, (3) information can play its role for better healthcare and the improvement of medicine. The purpose of this paper is to propose recommendations from this working conference. [ABSTRACT FROM AUTHOR]

Abstract: The WHO Position Paper on Vaccines against Human Papillomavirus (HPV): This article presents the WHO recommendations for use of the HPV vaccine excerpted from the recently published WHO Position on HPV Vaccines. These recommendations were formulated in a multiyear collaboration involving internal and external experts in the field, culminating in production of a detailed Background paper summarizing the evidence. After a series of meetings and careful consideration of the evidence for HPV vaccine introduction, WHO''s Strategic Advisory Group of Experts (SAGE) on vaccines and immunization recommended use of HPV vaccine in November 2008. WHO published a complete position paper in April 2009, which presents the WHO Position. Additional evidence including a detailed Background paper summarizing the evidence last presented to SAGE is available at http://www.who.int/immunization/documents/positionpapers/en/index.html. [Copyright &y& Elsevier]

The APA Ethical Code struggles to offer guidance in the rapidly changing field of clinical health psychology. Professional challenges anticipated in the next decade are described, and their implications for ethical practice examined. This paper is based in part on a presentation at the 2009 Conference at the Association of Psychologists in Academic Health Centers held in St. Louis, Missouri. [ABSTRACT FROM AUTHOR]

A conference paper about preventative medicine as a solution to the U.S. health care crisis is presented. It discusses preventative health in the U.S., including a brief historical overview of health prevention as a prominent feature in health care reforms during the 1960s and 1970s. It examines the U.S. Preventive Services Task Force's (USPSTF's) "Guide to Clinical Preventive Services" and challenges to the traditional health care model to reactive medicine.