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IntroductionTeenage parenthood presents multifaceted implications, affecting adolescent parents, their children, and extended families. Despite a decrease in teenage pregnancy rates across Europe, the phenomenon continues to present significant challenges, impacting not only the adolescent parents but also their offspring and extended families.MethodsA comprehensive literature review was conducted. Key factors influencing teenage pregnancies, including socioeconomic background, family structure, and access to sex education and contraception, were examined. This review was supplemented by expert opinions from the European Academy of Paediatrics (EAP) and the European Confederation of Primary Care Paediatricians (ECPCP).ResultsThe triad of mother, father, and child presents individual distinct healthcare needs and vulnerabilities, highlighting the importance of specialized support and healthcare. This paper explores the psychological, social, and educational repercussions of teenage parenthood on both parents and their children, including higher risks of postpartum depression, school dropout, and repeat pregnancies. Furthermore, it underscores the critical role that paediatricians and primary care providers play in supporting these young families.DiscussionThe position paper advocates for comprehensive care for adolescent parents and their children. It recommends preventive measures such as proper sex education and access to contraception to reduce unplanned teenage pregnancies. Additionally, it emphasizes the need for specialized healthcare and support for teenage parents to address their unique challenges and improve outcomes for both parents and their children.

Artificial intelligence and machine learning technologies have a variety of applications throughout the provision of health care, such as clinical documentation, diagnostic image processing, and clinical decision support. This position paper describes the American College of Physicians' (ACP) foundational positions and recommendations regarding the use of these technologies in the provision of health care. The foundation of these positions are principles in the ACP Ethics Manual. Internal medicine physicians are increasingly interacting with systems that implement artificial intelligence (AI) and machine learning (ML) technologies. Some physicians and health care systems are even developing their own AI models, both within and outside of electronic health record (EHR) systems. These technologies have various applications throughout the provision of health care, such as clinical documentation, diagnostic image processing, and clinical decision support. With the growing availability of vast amounts of patient data and unprecedented levels of clinician burnout, the proliferation of these technologies is cautiously welcomed by some physicians. Others think it presents challenges to the patient–physician relationship and the professional integrity of physicians. These dispositions are understandable, given the "black box" nature of some AI models, for which specifications and development methods can be closely guarded or proprietary, along with the relative lagging or absence of appropriate regulatory scrutiny and validation. This American College of Physicians (ACP) position paper describes the College's foundational positions and recommendations regarding the use of AI- and ML-enabled tools and systems in the provision of health care. Many of the College's positions and recommendations, such as those related to patient-centeredness, privacy, and transparency, are founded on principles in the ACP Ethics Manual. They are also derived from considerations for the clinical safety and effectiveness of the tools as well as their potential consequences regarding health disparities. The College calls for more research on the clinical and ethical implications of these technologies and their effects on patient health and well-being. [ABSTRACT FROM AUTHOR]

Background: The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) has long recognized and championed increasing diversity within the surgical workplace. SAGES initiated the Fundamentals of Leadership Development (FLD) Curriculum to address these needs and to provide surgeon leaders with the necessary tools and skills to promote diversity, equity, and inclusion (DEI) in surgical practice. In 2019, the American College of Surgeons issued a request for anti-racism initiatives which lead to the partnering of the two societies. The primary goal of FLD was to create the first surgeon-focused leadership curriculum dedicated to DEI. The rationale/development of this curriculum and its evaluation/feedback methods are detailed in this White Paper. Methods: The FLD curriculum was developed by a multidisciplinary task force that included surgeons, education experts, and diversity consultants. The curriculum development followed the Analysis, Design, Development, Implementation and Evaluation (ADDIE) instructional design model and utilized a problem-based learning approach. Competencies were identified, and specific learning objectives and assessments were developed. The implementation of the curriculum was designed to be completed in short intervals (virtual and in-person). Post-course surveys used the Kirkpatrick's model to evaluate the curriculum and provide valuable feedback. Results: The curriculum consisted of interactive online modules, an online discussion forum, and small group interactive sessions focused in three key areas: (1) increasing pipeline of underrepresented individuals in surgical leadership, (2) healthcare equity, and (3) conflict negotiation. By focusing on positive action items and utilizing a problem-solving approach, the curriculum aimed to provide a framework for surgical leaders to make meaningful changes in their institutions and organizations. Conclusion: The FLD curriculum is a novel leadership curriculum that provided surgeon leaders with the knowledge and tools to improve diversity in three areas: pipeline improvement, healthcare equity, and conflict negotiation. Future directions include using pilot course feedback to enhance curricular effectiveness and delivery. [ABSTRACT FROM AUTHOR]

Aim: The increase in the number of people with chronic obstructive pulmonary disease (COPD) and the disease burden, has prompted concerted efforts to improve healthcare, particularly outpatient services. In line with these attempts the Partnership-Based Nursing Practice Theoretical Framework for People with COPD was developed to guide outpatient nursing care. The principal approach of the framework is a ‘Dialogue’ with the patients, which has four components: ‘Establishing family involvement’, ‘Assisting living with symptoms’ and ‘Facilitating access to healthcare’, with the primary goal being ‘Enhancement of the health experience’. With new knowledge, research on the framework, and extensive experience in using it, a need arose to modify the framework to maximize its clinical utility. Design: Discursive paper. Methods: A narrative review and critical reflection was conducted to revise the nursing practice framework via selected literature search from 2012 to 2022, research on the framework, and the authors' reflections on the clinical experience of using the framework. Results: The nursing practice framework highlights capacities and possibilities that lie in the nurse–patient relationship. The overarching dialogue in the revised framework includes both patients and families. The action-related component ‘Assisting living with the disease’ was added to the framework to underscore the significance of attempting to understand what may lie ahead for patients and families. The other action-related components are as follows: ‘Assisting living with symptoms’ and ‘Facilitating access to healthcare’. The primary goal remains unchanged: enhancing the ‘Health experience’. Conclusion: Using the revised nursing practice framework in outpatient care may help to enhance the lives of people with COPD and their families, particularly at advanced stages of the disease. It may have transferability to other groups of people living with progressive diseases dealing with complicated health problems, and to reduce the usage of costly healthcare resources such as hospital care. Implications for the Profession and/or Patient Care: The partnership-based nursing practice framework assumes an extension of conventional specialized respiratory service and embraces a comprehensive account for that which may influence the patient's health problems. This guidance, which holistically attends to patient-family needs of living with complicated and progressive health predicaments, is fundamental. It contributes to strengthening the disciplinary focus of nursing, interdisciplinary collaboration, person-family-centred quality nursing care and inspires research initiatives. Critical reflections and updates on nursing practice frameworks, such as this revision, are essential to advance nursing and healthcare. [ABSTRACT FROM AUTHOR]

A variety of terms, such as "antiepileptic," "anticonvulsant," and "antiseizure" have been historically applied to medications for the treatment of seizure disorders. Terminology is important because using terms that do not accurately reflect the action of specific treatments may result in a misunderstanding of their effects and inappropriate use. The present International League Against Epilepsy (ILAE) position paper used a Delphi approach to develop recommendations on English‐language terminology applicable to pharmacological agents currently approved for treating seizure disorders. There was consensus that these medications should be collectively named "antiseizure medications". This term accurately reflects their primarily symptomatic effect against seizures and reduces the possibility of health care practitioners, patients, or caregivers having undue expectations or an incorrect understanding of the real action of these medications. The term "antiseizure" to describe these agents does not exclude the possibility of beneficial effects on the course of the disease and comorbidities that result from the downstream effects of seizures, whenever these beneficial effects can be explained solely by the suppression of seizure activity. It is acknowledged that other treatments, mostly under development, can exert direct favorable actions on the underlying disease or its progression, by having "antiepileptogenic" or "disease‐modifying" effects. A more‐refined terminology to describe precisely these actions needs to be developed. [ABSTRACT FROM AUTHOR]

Reducing examination table paper (ETP) use may help curb carbon emissions from health care. Six participants applied Glo Germ (DMA International) to their hands before a common physical examination (abdominal, cardiorespiratory, hip and knee) both with and without ETP. After each exam, UV light was shined on the exam table and photographs were taken. The number of hand touches on ETP-covered areas and uncovered areas were tallied and compared using t tests. Despite covering more surface area, participants touched areas without ETP significantly more than ETP-covered areas (P <.05). Despite its continued use, patients do not have much hand contact with ETP during common clinical examinations. [ABSTRACT FROM AUTHOR]

Introduction: Over the last decade, the emergence and spread of personalized medicine (PM) have defined a substantial revolution in healthcare. In principle, healthcare system sustainability is challenged by the investments required for research and development, as well as the adoption of PM techniques in routine clinical care. The "Integrating China in the International Consortium for Personalized Medicine" (IC2PerMed) EU-funded project aims to integrate China into the "International Consortium for Personalized Medicine" (ICPerMed). IC2PerMed aims to align the EU and China's research agendas in this field to enable a swift development of approaches in the EU and China with strong leverage upon EU-Chinese collaborations. Methods: Within this project, we first mapped relevant policies on PM in both the EU and China, and then we involved European and Chinese experts in PM in workshops and Delphi surveys in order to identify relevant priorities for the implementation of PM in sustainable healthcare. Results: As a result of this process, we identified nine overarching priorities, each addressing specific aspects of the sustainability of healthcare systems and PM implementation, with the main goal of supporting policymakers in integrating PM approaches in the EU and China. Discussion/conclusion: The implementation of PM in health systems is appealing in terms of improved accuracy in diagnostics, treatment, and prevention of disease, as well as reduction of the side effects resulting from inefficient use of drugs. Research, development, and implementation of needed techniques require time and resources that can slow the adoption of PM in healthcare systems. The nine priorities we identified address some of the most critical points, trying to lay the foundations for a comprehensive approach. [ABSTRACT FROM AUTHOR]

An editorial is presented on the release of a white paper by the International Federation of Dental Hygienists (IFDH), summarizing findings from 5 global surveys on oral health conducted between 2019 and 2023. Topics discussed include toothpaste and electric toothbrush recommendations, oral-systemic links, sustainable dentistry, and oral hygiene instruction practices, revealing gaps between evidence-based knowledge and clinical decision making among dental hygienists.

Globally, the nursing profession constitutes the largest proportion of the health workforce; however, it is challenged by widespread workforce shortages relative to need. Strategies to promote recruitment of the nursing workforce are well-established, with a lesser focus on strategies to alleviate the burden on the existing workforce. This burden may be exacerbated by the impact of low-value health care, characterised as health care that provides little or no benefit for patients, or has the potential to cause harm. Low-value health care is a global problem, a major contributor to the waste of healthcare resources, and a key focus of health system reform. Evidence of variation in low-value health care has been identified across countries and system levels. Research on low-value health care has largely focused on the medical profession, with a paucity of research examining either low-value health care or the de-implementation of low-value health care from a nursing perspective. The objective of this paper is to provide a scholarly discussion of the literature around low-value health care and de-implementation, with the purpose of identifying implications for nursing research. With increasing pressures on the global nursing workforce, research identifying low-value health care and developing approaches to de-implement this care, is crucial. [ABSTRACT FROM AUTHOR]

Perioperative nurses must provide culturally competent care to all surgical patients, and understanding gender identity and gender diversity may be the first step to creating an inclusive perioperative practice for transgender and gender diverse patients. In the nurse--patient relationship, limited exposure to and knowledge of diverse populations may negatively affect the health of this important demographic. When nurses are unaware of how care can be affected by explicit (conscious) or implicit (unconscious) bias, they may use transphobic stereotyping behaviours or act with microaggressions, like using excessive protective attire. Such care may invalidate gender identity and impede trust. In contrast, nurses practising gender-affirming care validate the patient's gender identity and life experiences, which supports autonomy and creates trust. The aim of this paper is to provide perioperative nurses with a deeper understanding of factors that may affect gender diverse patient's perioperative outcomes. In addition, understanding the social determinants of health affecting this demographic may result in better health outcomes. As such, the holistic care of the transgender and gender diverse patient is the optimal goal, with clinicians employing a non-judgemental, sensitive and compassionate attitude. [ABSTRACT FROM AUTHOR]

The progressive improvement of the living conditions and medical care of the population in industrialized countries has led to improvement in healthcare interventions, including rehabilitation. From this perspective, Telerehabilitation (TR) plays an important role. TR consists of the application of telemedicine to rehabilitation to offer remote rehabilitation services to the population unable to reach healthcare. TR integrates therapy-recovery-assistance, with continuity of treatments, aimed at neurological and psychological recovery, involving the patient in a family environment, with an active role also of the caregivers. This leads to reduced healthcare costs and improves the continuity of specialist care, as well as showing efficacy for the treatment of cognitive disorders, and leading to advantages for patients and their families, such as avoiding travel, reducing associated costs, improving the frequency, continuity, and comfort of performing the rehabilitation in its own spaces, times and arrangements. The aim of this consensus paper is to investigate the current evidence on the use and effectiveness of TR in the cognitive field, trying to also suggest some recommendations and future perspectives. To the best of our knowledge, this is the first consensus paper among multiple expert researchers that comprehensively examines TR in different neurological diseases. Our results supported the efficacy and feasibility of TR with good adherence and no adverse events among patients. Our consensus summarizes the current evidence for the application of cognitive TR in neurological populations, highlighting the potential of this tool, but also the limitations that need to be explored further. [ABSTRACT FROM AUTHOR]

Over the years, survival of children with chronic diseases has significantly improved and a large proportion of them now are entering into adulthood. Transition of Care (ToC) of such patients with having childhood onset of chronic diseases to the adult health care system is well organized in developed countries, although it is an emerging concept in India. In situations where the systems for ToC are not in place, such cases are fraught with unsatisfactory health outcomes. With proper ToC in place, these patients are likely to receive uninterrupted care by the adult care physicians and hence reach their full potential. This document highlights the need, rationale and way forward for ToC of youth with special health care needs (YSHCN) across the country. It also describes the standard operating procedures to develop the ToC at a hospital level for clinicians and administrators. [ABSTRACT FROM AUTHOR]

Although child-centred care is increasingly referred to within the nursing literature, a clear definition of child-centred care and clarity around the concept is yet to be achieved. The objectives of this review were to examine the following: (1) What constitutes the concept of child-centred care in healthcare? (2) How has the concept of child-centred care developed? (3) What is the applicability of child-centred care and what are its limitations? (4) How does the concept of child-centred care benefit and inform children's healthcare? In total, 2984 papers were imported for screening, and, following the removal of duplicates and screening, 21 papers were included in the scoping review. The findings suggest that child-centred care is an emerging, ambiguous poorly defined concept; no clear consensus exists about what constitutes child-centred care. Although it seems antithetical to argue against child-centred care, little robust evidence was identified that demonstrates the impact and benefit of child-centred care. If child-centred care is to be a sustainable, convincing model to guide practice and compete with other models of care, it needs to establish robust evidence of its effectiveness, the impact on children and their families, as well as the wider impacts on the healthcare system. [ABSTRACT FROM AUTHOR]

The Internet of Things (IoT) has the potential to completely transform healthcare by allowing medical professionals to remotely monitor patients, gather data on their activity and health in real-time, and create more efficient treatment regimens. IoT technologies have the potential to save healthcare expenditures while also enhancing patient involvement and improving patient outcomes. However, the adoption of IoMT has been slow, and To ensure that the advantages of IoT are realised while reducing the hazards connected with its use, a number of hurdles must be overcome. The purpose of this research paper is to examine the current state of IoT implementation in healthcare, identify the benefits and challenges of IoMT, and explore the future implications of IoMT. The study starts off with a survey of the literature that has already been written on the use of IoT technology in healthcare, highlighting both the potential advantages and difficulties of doing so. The paper then presents the results of a survey of healthcare providers on the use of IoT technologies in healthcare, providing insights into the current state of IoT implementation in healthcare and the challenges that must be addressed to facilitate its adoption. [ABSTRACT FROM AUTHOR]

Background: International electives are often considered a valuable learning opportunity for medical students. Yet, as travelling to lower and middle income countries (LMICs) becomes more common, ethical considerations of such practices emerge. We conducted a scoping review to assess the extent to which five ethical themes were addressed in existing literature about electives, with the aim of investigating the ethical impacts of medical student electives on local resources, patients and clinicians in LMICs. Methods: We systematically searched PubMed, Global Health and Embase databases using the search terms "(ethics) AND (medical electives)". Thematic content analysis was undertaken using a combination of deductive and inductive themes. The deductive themes included: exceeding clinical competence, use of limited local resources, respect for patients and local culture, collaboration with local community/colleagues, and one-sided benefits in partnership. In addition, we also allowed for emerging themes within the data, and conducted a narrative synthesis of the results. Results: A total of 37 papers discussed ethical issues relating to medical student international electives to LMICs. More publications were written from the medical student perspective (n = 14), than by the host-institution (n = 5), with nearly half written from third-party perspectives (n = 18). Negative impacts on local host students and impact upon patient care were identified as additional ethical considerations. Conclusions: Our review demonstrated that while there is a degree of awareness in the existing literature of the potential negative impacts of medical electives to local LMIC students' access to medical education and patient care, continued work is needed to ensure equitable partnerships. We recommend that these ethical themes should be further explored in pre-departure elective teaching courses and post-elective debriefs to increase medical students' awareness of the impact of their presence on host communities. [ABSTRACT FROM AUTHOR]

Background Following years of sustained pressure on the UK health service, there is recognition amongst health professionals and stakeholders that current models of healthcare are likely to be inadequate going forward. Therefore, a fundamental review of existing social models of healthcare is needed to ascertain current thinking in this area, and whether there is a need to change perspective on current thinking. Method Through a systematic research review, this paper seeks to address how previous literature has conceptualized a social model of healthcare and, how implementation of the models has been evaluated. Analysis and data were extracted from 222 publications and explored the country of origin, methodological approach, and the health and social care contexts which they were set. Results The publications predominantly drawn from the USA, UK, Australia, Canada and Europe identified five themes namely: the lack of a clear and unified definition of a social model of health and wellbeing; the need to understand context; the need for cultural change; improved integration and collaboration towards a holistic and person-centred approach; measuring and evaluating the performance of a social model of health. Conclusion The review identified a need for a clear definition of a social model of health and wellbeing. Furthermore, consideration is needed on how a model integrates with current models and whether it will act as a descriptive framework or, will be developed into an operational model. The review highlights the importance of engagement with users and partner organizations in the co-creation of a model of healthcare. [ABSTRACT FROM AUTHOR]

The major objective of our work is to develop a secure healthcare system employing blockchain technology. When taking into account real-world scenarios in healthcare, the implementation is made possible by the integrity, security, and interoperability of blockchain, utilizing the programming language Solidity and other tools and methods like Web3.js, and Athena. Blockchain is built on the Ethereum network. In the secure healthcare system, a patient can schedule an appointment simply by logging into the application, regardless of the location or time. With the use of the hash key, all of the entered data is recorded on the blockchain. A distinct hash value in the blockchain is mapped to the patient ID. Decentralized blockchain-based solutions for smart healthcare tend to boost system performance. To validate the suggested strategy, this paper simulates the healthcare system. Blockchain technology has been discovered to have been used in practically every domain due to its benefits, including crypto-security, transparency, immutability, and a decentralized data network. In the modern era, a blockchainbased secure healthcare system offers security, effectiveness, transparency, and quick and easy access. [ABSTRACT FROM AUTHOR]

Biosensors integrated with artificial intelligence (AI) hold immense potential for transforming healthcare through rapid, automated diagnostics and precision therapeutics. This paper reviews the convergence of biosensing and AI towards developing smart biomedical systems. The fundamentals, historical evolution, and classification of biosensors are presented, highlighting key applications across infections, chronic illnesses, and environmental monitoring. Core AI concepts, including machine learning, neural networks, computer vision, and natural language processing, are discussed, along with their implementation to augment biosensor functionality, connectivity, point-of-care adoption, and laboratory automation. Promising research directions and real-world case studies applying AI-integrated biosensors for early diagnosis and drug delivery are discussed. The opportunities and challenges in advancing this synergistic technology are contemplated, underscoring the need for cross-disciplinary collaboration, clinical validation, ethical vigilance and supportive policy environments to successfully translate AI-biosensors into practical healthcare solutions. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Open Dialogue was developed in Finland in the 1980s by clinical psychologist, Jaakko Seikkula. It is a development of family therapy, recognises previous trauma and has proven to be very effective in situations of acute mental illness, and in particular psychosis.Trauma Informed Care is a practice based on the understanding of and responsiveness to the impact of trauma. When people have experienced trauma, they may have difficulties in their everyday life and experience negative physical health outcomes as well as the risk of developing mental ill health.Open Dialogue is aligned to mental health care which aims to be trauma‐informed, person‐centred and rights‐based. Examples exist of the use of both approaches for service delivery with limited evaluation. What the paper adds to existing knowledge?: To our knowledge, no formal evaluation has been made of the use of open dialogue as a Trauma Informed therapy approach to support individuals and their family networks.Although both approaches recognise the impact of trauma on individuals, no study has explored the effectiveness of this treatment combination for use by mental health nurses.This review is timely as it provides insights into contemporary services that are trauma informed and have used Open Dialogue to extend therapy work with individuals and their family/networks.This scoping review was able to determine whether recommendations for clinical practice and training in Open Dialogue with Trauma Informed Care approaches could be identified. What are the implications for practice?: This review provided a broad overview on the current types of trauma‐informed care services incorporating Open Dialogue approaches into their practice.The literature, though sparce, identifies that Trauma Informed Care recognises multiple origins for mental ill health. Open dialogue has an affinity with the common values of mental health nurses. As combined therapies, they are demonstrating usefulness in engaging families and people in their journey towards recovery.Rigid adherence to Open Dialogue focus and delivery as well as training practices could be revised to make them more open to what people and their families wish to discuss. The person with mental ill health and previous trauma should be able to direct the narrative. Trauma Informed Practice principles could be adapted to improve consumer satisfaction with Open Dialogue approaches. Introduction: A large proportion of people who access mental health services have a lived experienced of trauma and are more likely to have a history of complex trauma. Open Dialogue and Trauma Informed Care practices identify previous trauma as a factor related to later psychosis. This scoping review has identified similarities and contrasts in how an Open Dialogue and Trauma Informed Care approach have been combined to complement one another for clinical work with people presenting with psychosis and previous trauma. Aim: We aimed to answer the following research question in this scoping review: What is known of the combined use of Open Dialogue and Trauma Informed Care practice when working with consumers and their family networks? As such, the purpose of this paper was to explore the application to practice and identify if any training existed and been evaluated. Method: This scoping review was based on the Arksey and O'Malley's framework. A comprehensive search was performed across five electronic databases. Grey literature was also searched through Psyche Info and Google Scholar for books, Dissertation and Theses, alongside hand searching of the reference of the studies. Articles searched was from January 2013 to January 2023. Results: Five distinct themes were identified from the literature: (1) Linking open dialogue with trauma, (2) Response to treatment, (3) Empowerment and information sharing, (4) Interpretation by clinical services, (5) Staff training outcomes. Discussion: Some tentative recommendations for practice recognised the individuals' unique story and perspective, suggested that trauma is an important concept to assess. Services practising as Trauma Informed Services that have incorporated an Open Dialogue approach have mixed experiences. The use of Open Dialogue may have some benefits for family work and exploring consumer narratives while building a network of support. However, consumers identified similar frustrations with service delivery as with the family therapy literature. For example, it was difficult to bring family members together and difficult to discuss previous traumatic events in front of family. People experiencing training in Open Dialogue reported it taking a slow pace and not what they were familiar with. Implications for Practice: Open Dialogue can facilitate engagement of consumers and their family networks and greater recognition of the peer workforce to promote collaboration in therapy is needed. Future research should also focus on evaluating the effectiveness of such services and comparing their outcomes across regions. [ABSTRACT FROM AUTHOR]

Aim: A survey of six of the highest impact psychiatric journal articles (2001), revealed the underrepresentation of non-Western countries. The current study looked at the new trends in the representation of psychiatric literature. We aimed to quantify the articles from High-Income Countries (HIC) and compare it with the rest of the world (RoW) in 11 high impact journals. Materials and Methods: A survey of the country of origin of research data and authors in published literature of 11 psychiatric journals: six of the same journals previously surveyed and five new journals from 2014 to 2016. Results: Out of the total of 5278 articles, the maximum number of 2093 (39.65 %) were from the other Euro-American countries (OEAC), followed by 1546 (29.29 %) from the United States of America (USA), and 727 (13.77 %) from the United Kingdom (UK), and 754 (14.28 %) were from rest of the world (RoW). The highest was in the Journal of Neurology, Neuro-Surgery and Psychiatry 131 (17.37 %), followed by the British Journal of Psychiatry, 85 (11.27 %) and Molecular Psychiatry; 65 (8.62 %). A comparison between the previous six journals and the current survey showed that RoW publications have increased from 6 % to 13.84 % over 15 years. Out of the additional five journals surveyed, a total of 327 papers were from RoW and the Journal of Neurology, Neuro-Surgery and Psychiatry had the highest representation of RoW literature: 131 (40 %). It was more than double of publications by the Lancet Psychiatry and Molecular Psychiatry. Biological Psychiatry had 46 (14.06 %) papers followed by the World Psychiatry which carried 25 (7.64 %). Conclusion: An overall increase in the number of articles from RoW is evident. It is a welcome trend; however, a significant underrepresentation is still evident. [ABSTRACT FROM AUTHOR]

The article discusses the concept of re-invention and its importance in aging well and maintaining health and well-being. It explores the role of design in facilitating re-invention and creating different perspectives. The article also highlights the use of design thinking and co-design in mental health and dementia caregiving, as well as the potential of storytelling and painting to challenge stigma and uncover different perspectives. Additionally, it examines the potential of design in re-imagining healthcare delivery models and evaluating the impact of 3D medical printing. The article concludes by acknowledging the departure of the Assistant Editor and expressing gratitude for her contributions. [Extracted from the article]

China's multilevel medical education system generates tremendous physician human capital heterogeneity. This paper attempts to take advantage of the differences level of doctors' human capital to reveal the relationship between healthcare service mismatch and doctors' human capital using the DRGs data of a province in China. This paper found that: first, a higher level of physician human capital (PHC) in hospitals significantly increases the mismatch of medical services; second, there is a complementary effect between doctors' human capital and medical care accessibility, which significantly increases the degree of healthcare service mismatch, and these conclusions still hold after controlling the endogeneity and a series of robustness tests. Third, the mismatch effect is more significant in surgery than that of in internal medicine departments and the mismatch effect is stronger in county hospitals than that of provincial hospitals. Therefore, both patients' great confidence in superior medical services and the heterogeneity of PHC contribute to the mismatch of medical services in China. [ABSTRACT FROM AUTHOR]

Telephone triage services are becoming increasingly commonplace in modern healthcare. Despite this widespread adoption, health researchers and practitioners seeking to understand evidence-based best practice face several challenges. Firstly, the few systematic reviews available yield small sample sizes, suggesting a small amount of research. Secondly, the rapid pace of development of telephone triage technologies means that there may be temporal validity issues with the available research, given some of this research is relatively old. Thirdly, researchers use different terminologies to describe telephone triage, meaning evidence may be more difficult to find than if consistent terminology was used. This bibliometric analysis therefore is aimed at providing a macroscopic overview of telephone triage, to understand the scale and scope of the available evidence (i.e., where, when, and by whom research is conducted), for interested researchers and practitioners. Additionally, it is aimed at quantifying the prevalence of terms used to describe telephone triage, to recommend consistent terminology for future use, and to improve accessibility of research. To address these aims, literature searches using three different key terms: "telephone triage," "remote triage," and "teletriage" were conducted in Scopus and PubMed. Corresponding bibliometric data was visualised and analysed using VOSviewer. This bibliometric review identified 784 papers since the term "telephone triage" first appears in 1980, confirming a paucity of literature in the field. An overview of telephone triage research up to 2021 is provided, which should serve as a useful foundation for future research and application of evidence-based practice. Gaps in telephone triage research are identified, and the use of consistent terminology is encouraged, with the aim of supporting telephone triage researchers in determining research priorities and improving the impact of future studies. [ABSTRACT FROM AUTHOR]

The healthcare industry is confronted with the challenge to offer an increasing variety of healthcare services while in the meantime controlling rapidly increasing healthcare costs. Mass customization has been proven to be an effective strategy to fulfill customers' individual specific needs with high efficiency and low cost in the manufacturing industry. This paper investigates the theoretical feasibility and practical applicability of adopting mass customization as a conceptual framework for designing a healthcare service delivery system. The nature of healthcare delivery systems and their evolution are discussed relative to those of manufacturing systems. Recent research in personalized medicine, consumer-driven healthcare, consumer healthcare informatics, and integrated healthcare delivery is reviewed as enabling technologies towards mass customization of healthcare services. By synthesizing these scattered efforts in different streams of literature, this paper concludes that mass customization can contribute to the redesign of healthcare service systems, and delineates a roadmap for future research. [ABSTRACT FROM AUTHOR]

Large language models (LLMs) have demonstrated remarkable capabilities in various natural language processing tasks, including question answering, text generation, and multimodal understanding. However, their performance in specialized domains such as healthcare and their propensity for generating hallucinated (false) information remains an area of active investigation. This research paper explores the capabilities and limitations of Mistral's LLM, mistral-large-2402, in tackling medical challenge problems and assessing its tendency to hallucinate. The study is motivated by the potential of LLMs to augment medical decision-making processes and the need to evaluate their reliability in critical domains like healthcare. We investigate mistrallarge-2402's performance on a curated dataset of medical challenge problems, spanning diagnosis, treatment recommendation, and medical condition analysis tasks. Additionally, we examine the model's propensity for hallucinating by analyzing its responses for factual inconsistencies and unsubstantiated claims. Through quantitative and qualitative analyses, we provide insights into mistral-large-2402's strengths and weaknesses in handling medical challenges. Our evaluation methodology involves measuring the model's accuracy, completeness, and coherence of responses, as well as its ability to recognize and mitigate hallucinations. The findings of this study contribute to the ongoing discourse on the responsible deployment of LLMs in healthcare and highlight potential areas for improvement in model design and training. [ABSTRACT FROM AUTHOR]

With the exponential growth of medical data, Machine Learning (ML) algorithms are becoming increasingly important to the management and organization of healthcare information. This study aims to explore the role that ML can play in optimizing the management and organization of healthcare records, by identifying the challenges, advantages, and limitations associated with this technology. Consequently, the current study will contribute to the understanding of how ML might be applied to the healthcare industry in a variety of circumstances. Using the findings of this study, healthcare professionals, researchers, and policymakers will be able to make informed decisions regarding the adoption and implementation of ML techniques for regulating healthcare records. The findings of this paper revealed that ML can play an important role in efficiently directing and classifying healthcare records using different perspectives. [ABSTRACT FROM AUTHOR]

This paper develops a queueing system model to analyze the operations of a hierarchical healthcare system consisting of general hospitals (GHs) and community healthcare centers (CHCs). GHs typically provide a higher level of health care service than CHCs, and thus are preferred choices for many patients' healthcare service needs. Consequently, GHs are often heavily congested and patients often incur excessive waiting time. In contrast, CHCs are often idle and resources are underutilized. To help balance the utilization of resources in GHs and CHCs, a congestion-based information guidance policy is proposed in this paper to inform patients in the GH service queue about the anticipated delay. Upon being informed the delay for GH service, patients may balk, remain in queue for GH service, or switch to receive service at CHCs. This policy is thus expected to relieve the congestion at GHs and promote CHC usage. To study the effects of the proposed policy, a hierarchical healthcare system is modeled as a queueing system with strategic patients. Stationary performance measures of the system are analytically characterized using a Markov chain model. Stochastic and numerical analyses provide insights on how to design information guidance policy that would help improve overall health care service quality under different scenarios. [ABSTRACT FROM AUTHOR]

Value based healthcare beyond the clinical domain is the focus of this case study. We share NSW Health's experiences in achieving value through a focus on outcomes in non-clinical and clinical support services using examples that demonstrate key aspects across the commissioning cycle. These include: the importance of stakeholder engagement in the planning phase to later success; the critical role of non-clinical services in patient experience; the opportunity to facilitate value by introducing new approaches in business areas such as procurement; and the role of clinical supports such as digital enablement to facilitate outcome-focussed clinical models. Applying a value lens to non-clinical services can increase the potential benefits to patients, clinicians and the system. What is known about the topic? Value based healthcare is a way of making transparent and equitable decisions about resource allocation to deliver better outcomes for individuals, health services and the system. What does this paper add? This paper reflects on the opportunity to deliver value based healthcare beyond clinical models of care, including in non-clinical and clinical support services, using a commissioning approach. What are the implications for practitioners? The learnings shared through the case studies presented can be applied by practitioners to their own projects to support value based approaches across all aspects of health care. This article belongs to the Special Issue: Value-based Healthcare. [ABSTRACT FROM AUTHOR]

Background: Despite disproportionate rates of mental ill-health compared with non-Indigenous populations, few programs have been tailored to the unique health, social, and cultural needs and preferences of young Aboriginal and Torres Strait Islander males. This paper describes the process of culturally adapting the US-based Young Black Men, Masculinities, and Mental Health (YBMen) Project to suit the needs, preferences, culture, and circumstances of Aboriginal and Torres Strait Islander males aged 16–25 years in the Northern Territory, Australia. YBMen is an evidence-based social media-based education and support program designed to promote mental health, expand understandings of gender and cultural identities, and enhance social support in college-aged Black men. Methods: Our adaptation followed an Extended Stages of Cultural Adaptation model. First, we established a rationale for adaptation that included assessing the appropriateness of YBMen's core components for the target population. We then investigated important and appropriate models to underpin the adapted program and conducted a non-linear, iterative process of gathering information from key sources, including young Aboriginal and Torres Strait Islander males, to inform program curriculum and delivery. Results: To maintain program fidelity, we retained the core curriculum components of mental health, healthy masculinities, and social connection and kept the small cohort, private social media group delivery but developed two models: 'online only' (the original online delivery format) and 'hybrid in-person/online' (combining online delivery with weekly in-person group sessions). Adaptations made included using an overarching Aboriginal and Torres Strait Islander social and emotional wellbeing framework and socio-cultural strengths-based approach; inclusion of modules on health and wellbeing, positive Indigenous masculinities, and respectful relationships; use of Indigenous designs and colours; and prominent placement of images of Aboriginal and Torres Strait Islander male sportspeople, musicians, activists, and local role models. Conclusions: This process resulted in a culturally responsive mental health, masculinities, and social support health promotion program for young Aboriginal and Torres Strait Islander males. Next steps will involve pilot testing to investigate the adapted program's acceptability and feasibility and inform further refinement. Keywords: Aboriginal, Torres Strait Islander, Indigenous, Australia, male, cultural adaptation, social media, mental health, masculinities, social support. [ABSTRACT FROM AUTHOR]

Background: Sonder's In-Home Withdrawal Service (IHWS) has been providing a unique home-based, multidisciplinary, wraparound withdrawal option for people with low-to-moderate levels of substance dependence since September 2019. This paper provides an evaluation of the service's overall impact on reducing substance use among clients through the delivery of this innovative service model. The evaluation explores the acceptability and feasibility of the service via client, stakeholder, and staff perspectives. Methods: A mixed-method design was used to evaluate the IHWS. Descriptive analysis of quantitative data was conducted using clinical assessments from client records and online feedback surveys. Qualitative data from client, staff, and stakeholder feedback surveys were analysed thematically. Results: Overall, 1166 referrals were received over the lifespan of the service, and a data set of 96 clients was included in the analysis. Self-reported measures showed that most clients decreased their substance use (89%), improved their psychological health status (75%), improved their physical health (65%), improved their quality of life (69%), and improved their understanding and ability to manage their alcohol and other drugs (AOD) use (84%). Client feedback suggests the service is providing a unique option for AOD withdrawal. Stakeholders commend the service's home-based setting, multidisciplinary and person-centred approach to care, and recommended expansion of the service to increase access for clients and reduce demand on inpatient settings. Conclusions: The IHWS is having a significant impact in reducing substance use and highlights the need for increased access to holistic approaches to withdrawal. This includes pre- and post-withdrawal support and the inclusion of multidisciplinary teams, and engaging lived experience practitioners. A focus on funding primary-based services is required to meet the rising costs of tertiary-based care and to better meet the needs of consumers. Individuals with low-to-moderate levels of substance dependence require targeted services to safely manage their withdrawal. This paper evaluates a holistic approach to withdrawal that broadens the common medicalised approach through pre- and post-withdrawal stages of care and support from a multidisciplinary team including lived experience practitioners. The service reduces levels of substance use while also improving overall quality of life, demonstrating the need for more withdrawal services to consider the inclusion of holistic approaches to substance dependence support. [ABSTRACT FROM AUTHOR]

The phenomenon of chemsex has emerged as an essential public health issue in recent years. This systematic review aimed to investigate currently available harm reduction strategies and to evaluate the efficacy of the corresponding interventions. Methods: A systematic review of the scientific literature related to harm and risk reduction strategies and the effectiveness of chemsex interventions. Between January 2024 and May 2024, the articles were retrieved from the electronic databases Pubmed, Web of Science, Scopus, PsycInfo, Cochrane, Dialnet, CUIDEN, and SciELO. The review protocol was registered in the PROSPERO database (registration number CRD42024508953). The inclusion criteria were as follows: (I) original studies published in peer-reviewed journals, (II) studies exploring harm reduction interventions for chemsex, and (III) studies reflecting the efficacy of harm reduction interventions for chemsex. Two reviewers independently selected articles by title, abstract, and full paper review and extracted data. Two authors described the selected studies and assessed their methodological quality. Results: The systematic review comprised six scientific papers that met the selection criteria and were obtained from five countries. Although a limited number of studies were included, it was observed that they presented a medium–high methodological quality. Programs evaluated interventions to reduce harm from chemsex, such as a web-based intervention that improved self-efficacy to refuse risky behaviors and accept HIV testing. The studies suggested that peer-led programs can be effective, especially with facilitators who have experienced chemsex dependence. Conclusion: Harm reduction strategies in chemsex are effective and should be promoted by health professionals. Interventions should be accessible, personalized, and non-judgmental to provide appropriate care and support, ensuring a comprehensive and effective public health response. [ABSTRACT FROM AUTHOR]

The global impact of drug shortages on healthcare systems is a concerning issue that needs urgent attention. These shortages not only jeopardize patient care, public health, and healthcare delivery but also pose distinct challenges for pediatric populations due to their specific medication requirements and vulnerabilities. It is imperative to address this issue to safeguard the health and wellbeing of this specific age group. This review Gaimed to conduct a systematic analysis of strategies for addressing drug shortages in pediatric care from 2014 to 2024. The search included five databases: PubMed, Reaxys, Embase, Scopus, and Science Direct, using the keywords "drug shortage" and "pediatric". The final protocol was developed following the guidelines outlined in the " The PRISMA 2020 statement: An updated guideline for reporting systematic reviews". In total, 234 publications were identified. After screening the search results and applying inclusion and exclusion measures, a total of 27 original research papers were included. The primary finding indicates that a comprehensive approach rooted in risk management can significantly mitigate drug shortages in pediatric settings. This approach should address underlying causes such as manufacturer and delivery challenges and focus on prevention through enhanced forecasting and vigilant shortage monitoring. The most prevalent response involved seeking alternative treatment options. It is imperative to implement institutional and national guidelines, foster communication, and provider education, and minimize waste to effectively mitigate drug shortages in pediatric settings. [ABSTRACT FROM AUTHOR]

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This review study investigates the role of Learning Management Systems (LMS) in education within the context of the Internet of Things (IoT). Higher education institutions, particularly universities, must adapt their contents, activities, and methods to function more efficiently in a digital context. LMS is a tool for creating, distributing, tracking, and managing educational and training materials. IoT, a transformative technology, significantly impacts various aspects of human life, including security, healthcare, recycling, and environmental monitoring. This paper addresses the significance of IoT technology in education, particularly in enhancing the efficiency of teaching and learning. The framework for an IoT-enhanced LMS is part of a three-year research project at the Arts, Sciences, and Technology. [ABSTRACT FROM AUTHOR]

Healthcare is a vital part of a healthcare system, which is governed by a set of responsibilities and responsibilities. This paper explores the evolution of healthcare systems through the use of the Internet of Things (IoT) and telemedicine. The paper aims to identify areas for improvement and explore strategies to leverage network technologies to enhance healthcare offerings and outcomes. The data analysis technique used was thematic analysis. Thematic analysis identified and categorized key themes related to challenges and innovations in the collected studies. Telemedicine, supported by cloud computing, offers significant potential for improving healthcare delivery but faces challenges related to high assurance, interoperability, and storage adaptability. The development and use of telecommunications technology in healthcare require careful policy considerations to address the significant challenges in healthcare delivery. The research also explores how technology influences the development of healthcare delivery systems known for its efficiency, accessibility, and improved patient welfare. [ABSTRACT FROM AUTHOR]

This document is a summary of a special issue in the journal Electronics, which focuses on emerging e-Health applications and medical information systems. The issue includes several research papers on various topics related to healthcare technology. Some of the topics covered include the use of machine learning and radar technology for COPD detection, an AI-based tool for detecting cognitive impairment, and a machine learning approach for preventing keratoconus. The papers highlight the potential of these technologies in improving healthcare delivery and offer insights into their advantages, limitations, and future developments. The authors express their gratitude to the contributors and reviewers of the special issue. [Extracted from the article]

Purpose: This study aims to investigate the healthcare sector of the United Arab Emirates (UAE) to explore the significance of servant leadership and collaborative culture in fostering social sustainability. The primary objective of this paper is to investigate how servant leadership and a collaborative culture contribute to social sustainability in health care in the UAE. With a focus on promoting well-being within healthcare organizations, the paper aims to uncover the synergies between servant leadership, collaborative culture, and social sustainability. Design/methodology/approach: This paper conducted a multilayer literature review of existing literature on servant leadership, collaborative culture and social sustainability in health care, both globally and specifically in the UAE context, and a conceptual model was proposed. Findings: Servant leadership proves to be a culturally pertinent and effective leadership model within the UAE due to its alignment with cultural values, emphasis on community support, and the robust health-care system that contributes to individual well-being. This combination establishes a solid foundation for fostering a healthy and sustainable society. Research limitations/implications: Limitations and implications are discussed. The current research has not identified the boundary conditions under which servant leadership and collaborative culture may be more or less effective. This could involve exploring industry-specific influences or contextual factors. Theoretical and practical implications are discussed. Originality/value: The research seeks to unravel the interconnections between servant leadership, collaborative culture and social sustainability. To the best of the author's knowledge, none of the studies have explored the interrelationships of these constructs, particularly in the UAE context. [ABSTRACT FROM AUTHOR]

This document is a summary of a special issue of the journal Applied Sciences that focuses on eHealth innovative approaches and applications. It covers various topics including COVID-19 classification, AI in medical imaging, cyber security in healthcare, and the use of Large Language Models (LLMs) for coding diagnoses. The papers provide insights into the latest developments in eHealth and address issues such as data privacy, cyber security, and the challenges of implementing new technologies in healthcare. The document acknowledges the contributions of the authors and reviewers and expresses gratitude for their support. [Extracted from the article]

This editorial discusses the need for innovative healthcare solutions to meet the complex needs of the growing elderly population. It emphasizes the importance of emerging technologies such as artificial intelligence, immersive technologies, and the Internet of Things in the healthcare sector. The document provides a summary of research papers submitted to the topic, including studies on video-based ambient assisted living technologies and evaluating individuals' processing speed. The research papers explore advancements in cross-disciplinary studies in fields such as ambient assistive technology, immersive technology, artificial intelligence, machine learning, deep learning, signal processing, healthcare solutions, and medicine. The papers contribute to the understanding of cognitive processing, motor functioning, and brain rehabilitation, and highlight the potential of artificial intelligence-driven applications in healthcare. [Extracted from the article]

Aims: This paper explores two critical feminist methodologies for nursing research: feminist political economy and feminist critical discourse analysis. The aim was to appreciate varied methodological approaches available for nurses to understand complexities in healthcare environments, above and beyond socially normative ways of knowing. Design: Discursive paper. Data Sources: Published articles from nursing databases (CINAHL and ProQuest; no date restrictions) and interdisciplinary databases (Women's Studies International, Sociological Abstracts and Ovid MEDLINE; publication dates between 2017 and 2022). Methods: A discursive paper exploring and critically synthesizing the literature on feminist political economy and feminist critical discourse analysis to demonstrate how each methodological approach can be used in nursing. Results: The findings of this discursive paper suggest there is an opportunity to draw on interdisciplinary studies for creative insights into how these methodologies may be helpful for nurses' scholarship and programmes of research. Although few nursing studies explicitly name a feminist political economy or feminist critical discourse analysis approach, several studies apply principles of these methodological approaches. Conclusion: There is an opportunity for these methodologies to be applied within the same project when there is a fit between the research questions and aims of both methodologies (studies where notions of gender and power are considered central and there are potential insights from exploring social progress, structures and the material, along with the social relations of discourses). Implications for the Profession and/or Patient Care: Feminist political economy and feminist critical discourse analysis offer novel options for methodological analyses. Impact: Application of these methodologies may benefit critical nursing scholars looking for diverse critical methodological avenues to explore and to broaden nursing's methodological toolbox towards meeting social justice aims. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Background: Achieving universal health coverage (UHC) in the context of limited resources will require prioritising the most vulnerable and ensuring health policies and services are responsive to their needs. One way of addressing this is through the engagement of marginalised voices in the priority setting process. Public engagement approaches that enable group level deliberation as well as individual level preference capturing might be valuable in this regard, but there are limited examples of their practical application, and gaps in understanding their outcomes, especially with rural populations. Objective: To address this gap, we implemented a modified priority setting tool (Choosing All Together—CHAT) that enables individuals and groups to make trade‐offs to demonstrate the type of health services packages that may be acceptable to a rural population. The paper presents the findings from the individual choices as compared to the group choices, as well as the differences among the individual choices using this tool. Methods: Participants worked in groups and as individuals to allocate stickers representing the available budget to different health topics and interventions using the CHAT tool. The allocations were recorded at each stage of the study. We calculated the median and interquartile range across study participants for the topic totals. To examine differences in individual choices, we performed Wilcoxon rank sum tests. Results: The results show that individual interests were mostly aligned with societal ones, and there were no statistically significant differences between the individual and group choices. However, there were some statistically significant differences between individual priorities based on demographic characteristics like age. Discussion: The study demonstrates that giving individuals greater control and agency in designing health services packages can increase their participation in the priority setting process, align individual and community priorities, and potentially enhance the legitimacy and acceptability of priority setting. Methods that enable group level deliberation and individual level priority setting may be necessary to reconcile plurality. The paper also highlights the importance of capturing the details of public engagement processes and transparently reporting on these details to ensure valuable outcomes. Public Contribution: The facilitator of the CHAT groups was a member from the community and underwent training from the research team. The fieldworkers were also from the community and were trained and paid to capture the data. The participants were all members of the rural community‐ the study represents their priorities. [ABSTRACT FROM AUTHOR]

The rapid advancement of technology has created new opportunities to improve the accuracy and efficiency of medical diagnoses, treatments, and overall patient care in several medical domains, including mental health. One promising novel approach is federated learning, a machine learning approach that allows multiple devices to train a shared model without exchanging raw data. Instead of centralizing the data in one location, each device or machine holds a portion of the data and collaborates with other devices to update the shared model. In this way, federated learning enables training on more extensive and diverse datasets than would be possible with centralized training while preserving the privacy and security of individual data. In the mental health domain, federated learning has the potential to improve mental disorders' detection, diagnosis, and treatment. By pooling data from multiple sources while maintaining patient privacy by keeping data secure and ensuring that they are not used for unauthorized purposes. This literature survey reviews recent studies that have exploited federated learning in the psychiatric domain, covering multiple data resources and different machine-learning techniques. Furthermore, we formulate the gap in the current methodologies and propose new research directions. [ABSTRACT FROM AUTHOR]

Background: The National Health Service (NHS) and general practice are increasingly adopting digital services. These services can impact both positively and negatively upon patient experiences, and access to digital services is not equal amongst all groups. Within a wider project examining digital facilitation (the Di-Facto study) our team conducted a patient survey amongst English primary care practices aiming to investigate patient views of what supports uptake and use of web-based services. This paper reports on the analysis of the free-text responses from the patient survey. Methods: The Di-Facto patient survey was distributed to practices in eight clinical commissioning groups (CCGs) in England between 2021–2022. We examined free-text responses to two questions relating to access to primary care web-based and support for web-based services. We used qualitative reflexive thematic analysis based on a six-stage process to analyse responses. Results: Of the 3051 patients who responded to the Di-Facto survey, 2246 provided a free-text response. We present our findings in two major themes: systems and structures and their impact on use of web-based services, and 'what works for me', a description of how respondents described what worked, or did not work in terms of their interactions with web-based services. Respondents described how the technology, such as poor practice website design, confusion over multiple digital apps, data security and concerns about eConsultation offerings impacted on use of web-based services. Respondents described practice level barriers, such as a lack of or inconsistent provision, which prevented optimal use of web-based services. Respondents described personal and technical barriers that impacted on their use of digital services, and described which web-based services worked well for them. Respondents felt that web-based services were not a replacement for face-to-face interactions with a doctor. Conclusions: This analysis of free-text responses from a large patient survey highlights the system, practice, and person level barriers and facilitators to use of digital services in primary care. With an increasing push towards digital solutions in NHS primary care, practices should consider the design, rollout and communication of their web-based services to support patient access. [ABSTRACT FROM AUTHOR]

Background: Countries designing a health benefit package (HBP) to support progress towards universal health coverage (UHC) require robust cost-effectiveness evidence. This paper reports on Pakistan's approach to assessing the applicability of global cost-effectiveness evidence to country context as part of a HBP design process. Methods: A seven-step process was developed and implemented with Disease Control Priority 3 (DCP3) project partners to assess the applicability of global incremental cost-effectiveness ratios (ICERs) to Pakistan. First, the scope of the interventions to be assessed was defined and an independent, interdisciplinary team was formed. Second, the team familiarized itself with intervention descriptions. Third, the team identified studies from the Tufts Medical School Global Health Cost-Effectiveness Analysis (GH-CEA) registry. Fourth, the team applied specific knock-out criteria to match identified studies to local intervention descriptions. Matches were then cross-checked across reviewers and further selection was made where there were multiple ICER matches. Sixth, a quality scoring system was applied to ICER values. Finally, a database was created containing all the ICER results with a justification for each decision, which was made available to decision-makers during HBP deliberation. Results: We found that less than 50% of the interventions in DCP3 could be supported with evidence of cost-effectiveness applicable to the country context. Out of 78 ICERs identified as applicable to Pakistan from the Tufts GH-CEA registry, only 20 ICERs were exact matches of the DCP3 Pakistan intervention descriptions and 58 were partial matches. Conclusion: This paper presents the first attempt globally to use the main public GH-CEA database to estimate costeffectiveness in the context of HBPs at a country level. This approach is a useful learning for all countries trying to develop essential packages informed by the global database on ICERs, and it will support the design of future evidence and further development of methods. [ABSTRACT FROM AUTHOR]

Background: The Disease Control Priorities 3 (DCP3) project provides long-term support to Pakistan in the development and implementation of its universal health coverage essential package of health services (UHC-EPHS). This paper reports on the priority setting process used in the design of the EPHS during the period 2019-2020, employing the framework of evidence-informed deliberative processes (EDPs), a tool for priority setting with the explicit aim of optimising the legitimacy of decision-making in the development of health benefit packages. Methods: We planned the six steps of the framework during two workshops in the Netherlands with participants from all DCP3 Pakistan partners (October 2019 and February 2020), who implemented these at the country level in Pakistan in 2019 and 2020. Following implementation, we conducted a semi-structured online survey to collect the views of participants in the UHC benefit package design about the prioritisation process. Results: The key steps in the EDP framework were the installation of advisory committees (involving more than 150 members in several Technical Working Groups [TWGs] and a National Advisory Committee [NAC]), definition of decision criteria (effectiveness, cost-effectiveness, avoidable burden of disease, equity, financial risk protection, budget impact, socio-economic impact and feasibility), selection of interventions for evaluation (a total of 170), and assessment and appraisal (across the three dimensions of the UHC cube) of these interventions. Survey respondents were generally positive across several aspects of the priority setting process. Conclusion: Despite several challenges, including a partial disruption because of the COVID-19 pandemic, implementation of the priority setting process may have improved the legitimacy of decision-making by involving stakeholders through participation with deliberation, and being evidence-informed and transparent. Important lessons were learned that can be beneficial for other countries designing their own health benefit package such as on the options and limitations of broad stakeholder involvement. [ABSTRACT FROM AUTHOR]

This article traces the development of Creative Nursing from its origin in 1981 as a newsletter about Primary Nursing to its current position as a quarterly international, interdisciplinary, peer-reviewed, indexed, themed journal that continues to nurture novice authors, welcome international submissions, review articles that other journals won't consider, and address subjects that many journals avoid. Future directions include content in multiple languages, new author guidelines that invite submissions of research methods papers, moving beyond statistical significance based on p-value thresholds, asking authors to make explicit the implications for knowledge translation in their papers, and thinking creatively about how artificial intelligence can be leveraged for research, education, and practice. [ABSTRACT FROM AUTHOR]

Computable biomedical knowledge (CBK) is: "the result of an analytic and/or deliberative process about human health, or affecting human health, that is explicit, and therefore can be represented and reasned upon using logic, formal standards, and mathematical approaches." Representing biomedical knowledge in a machine-interpretable, computable form increases its ability to be discovered, accessed, understood, and deployed. Computable knowledge artifacts can greatly advance the potential for implementation, reproducibility, or extension of the knowledge by users, who may include practitioners, researchers, and learners. Enriching computable knowledge artifacts may help facilitate reuse and translation into practice. Following the examples of 10 Simple Rules papers for scientific code, software, and applications, we present 10 Simple Rules intended to make shared computable knowledge artifacts more useful and reusable. These rules are mainly for researchers and their teams who have decided that sharing their computable knowledge is important, who wish to go beyond simply describing results, algorithms, or models via traditional publication pathways, and who want to both make their research findings more accessible, and to help others use their computable knowledge. These rules are roughly organized into 3 categories: planning, engineering, and documentation. Finally, while many of the following examples are of computable knowledge in biomedical domains, these rules are generalizable to computable knowledge in any research domain. Author summary: Computable biomedical knowledge, including algorithms, models, and evidence, is already impacting—and will likely transform—health research and healthcare delivery. Representing this knowledge in formats that can be discovered and processed by computers increases its potential for use at scale. Similarly, making these algorithms, models, etc. (aka computable knowledge artifacts) understandable and reusable by others can help facilitate reuse and translation into practice. However, as with other types of scientific software or research data, creating artifacts that are usable by and useful to others requires intentionality, and often additional time and effort. We've developed over 100 computable knowledge artifacts in diverse areas of health research and healthcare and we've learned a few things along the way. We've distilled these lessons learned into 10 Simple Rules to help researchers who would like to make their computational research products available and useful to others. Our work centers on knowledge in the biomedical domain, but we believe these 10 Simple Rules are generalizable and valuable as design principles for any researcher wishing to share computational research products. [ABSTRACT FROM AUTHOR]

This paper explores the question of whether clinical ethicists should engage in prayer with patients to establish a deeper connection and gain a better understanding of their perspectives. By examining the ethical considerations, potential benefits, and limitations associated with prayer in clinical settings, this paper aims to contribute to the ongoing discourse surrounding the role of spirituality in health care. [ABSTRACT FROM AUTHOR]

A large proportion of hospital inpatients are affected by cognitive impairment, posing challenges in the provision of their care in busy, fast-paced acute wards. Signs and symbols, known as visual identifiers, are employed in many U.K. hospitals with the intention of helping healthcare professionals identify and respond to the needs of these patients. Although widely considered useful, these tools are used inconsistently, have not been subject to full evaluation, and attract criticism for acting as a shorthand for a routinized response. In order for visual identifiers to be used effectively in acute care settings, thorough consideration must be given to the ethical and legal issues that are engaged in this context, and their potential benefits and harms must be weighed and balanced. This paper proposes a set of legal and ethical principles that can be used to guide the implementation of visual identifiers. Together, these principles provide a framework applicable in the design and implementation phases to systematically identify relevant considerations arising from the use of these tools. We outline some tensions that arise between principles and conclude that selecting a preferred moral framework could help to guide decision-making, as does clarity around the purpose and objectives of the identifier. [ABSTRACT FROM AUTHOR]