Search

Background: Primary care practices are responding to calls to incorporate patients' social risk factors, such as housing, food, and economic insecurity, into clinical care. Healthcare likely relies on the expertise and resources of community-based organizations to improve patients' social conditions, yet little is known about the referral process.Objective: To characterize referrals to community-based organizations by primary care practices.Design: Qualitative study using semi-structured interviews with healthcare administrators responsible for social care efforts in their organization.Participants: Administrators at 50 diverse US healthcare organizations with efforts to address patients' social risks.Main Measures: Approaches used in primary care to implement social needs referral to community-based organizations.Results: Interviewed administrators reported that social needs referrals were an essential element in their social care activities. Administrators described the ideal referral programs as placing limited burden on care teams, providing patients with customized referrals, and facilitating closed-loop referrals. We identified three key challenges organizations experience when trying to implement the ideal referrals program: (1) developing and maintaining resources lists; (2) aligning referrals with patient needs; and (3) measuring the efficacy of referrals. Collectively, these challenges led to organizations relying on staff to manually develop and update resource lists and, in most cases, provide patients with generic referrals. Administrators not only hoped that referral platforms may help overcome some of these barriers, but also reported implementation challenges with platforms including inconsistent buy-in and use across staff; integration with electronic health records; management and prioritization of resources; and alignment with other organizations in their market.Conclusion and Relevance: Referrals to community-based organizations were used in primary care to improve patients' social conditions, but despite strong motivations, interviewees reported challenges providing tailored and up-to-date information to patients. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to provide a response to the previously published paper on "Gerontocracy". Design/methodology/approach: This paper views care services through the lens of safeguarding, risks and responsibility in contradistinction from the largely economic and cost relevant argument put forward in the original paper. Findings: This paper articulates the contribution of informal carers to integrated care solutions solely from an economic perspective overlooks the wider human and social dimensions of care provision in society. Originality/value: Engaging in the wider debate about the status, contribution of informal carers to care solutions highlights the complexity of the carers' role in society which should evoke a more holistic debate of this important topic. [ABSTRACT FROM AUTHOR]

The article discusses the significance of the Confederate States of America Medical Department and the periodical the "Confederate States Medical and Surgical Journal" in advancing Confederate nationalism and identity during the U.S. Civil War, particularly concerning what is referred to as a Confederate intellectual independence.

The article focuses on children who have survived cancer, particularly those treated with chemotherapy and/or radiotherapy, have a higher risk of adverse cardiac events later on, a pan-European study has found. Topics include the investigators has assessed the cumulative incidence of symptomatic cardiac ischaemia in childhood cancer survivors, and the patients diagnosed with cancer in childhood, between 1940-2009, from seven European countries including the Great Britain.

Aim: To present the first iteration of the caring life‐course theory. Background: Despite requiring care from birth to death, a person's universal or fundamental care needs and the subsequent care provision, either by self or others, has yet to be presented within a life‐course perspective. Accurately describing the care people require across their lifespan enables us to identify who, what type, how and where this care should be provided. This novel perspective can help to legitimise a person's care needs and the support they require from wider care systems and contexts. Design: Discussion paper outlines theory development. We adopted an inductive approach to theory development, drawing upon existing literature and the team's diverse experiences. Our theoretical insights were refined through a series of collaborative meetings to define the theory's constructs, until theoretical saturation was reached. Discussion: Fourteen constructs are identified as essential to the theory. We propose it is possible, using these constructs, to generate caring life‐course trajectories and predict divergences in these trajectories. The novel contribution of the theory is the interplay between understanding a person's care needs and provision within the context of their lifespan and personal histories, termed their care biography, and understanding a person's care needs and provision at specific points in time within a given care network and socio‐political context. Impact for Nursing: The caring life‐course theory can provide a roadmap to inform nursing and other care industry sectors, providing opportunities to integrate and deliver care from the perspective of the person and their care history, trajectories and networks, with those of professional care teams. It can help to shape health, social and economic policy and involve individuals, families and communities in more constructive ways of talking about the importance of care for improved quality of life and healthy societies. [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]

The article discusses the positive pain reduction outcomes of a personalized care pathway for chronic knee pain post-total knee replacement.

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]

The article presents the discussion on COVID-19 pandemic highlighting the contributions critical care. Topics include intensive care units (ICUs) around the world suddenly inundated with patients who were critically ill from an unknown virus, along with all the other patients needing critical care services; and warrants consideration of energy, clinical supplies, pharmaceuticals, technical equipment and physical facilities.

Open Dialogue is a need‐adapted approach to mental health care that was originally developed in Finland. Like other need‐adapted approaches, Open Dialogue aims to meet consumer's needs and promote collaborative person‐centred dialogue to support recovery. Need‐adapted mental health care is distinguished by flexibility and responsiveness. Fidelity, defined from an implementation science perspective as the delivery of distinctive interventions in a high quality and effective fashion is a key consideration in health care. However, flexibility presents challenges for evaluating fidelity, which is much easier to evaluate when manualization and reproducible processes are possible. Hence, it remains unclear whether Open Dialogue and other need‐adapted mental health interventions can be meaningfully evaluated for fidelity. The aim of this paper was to critically appraise and advance the evaluation of fidelity in need‐adapted mental health care, using Open Dialogue as a case study. The paper opens a discussion about how fidelity should be evaluated in flexible, complex interventions, and identifies key questions that need to be asked by practitioners working in need‐adapted mental health care to ensure they deliver these interventions as intended and in an evidence‐based fashion. [ABSTRACT FROM AUTHOR]

Long-term management after stroke has not been standardized in contrast to acute and rehabilitative stroke care. The fragmented outpatient sector of healthcare allows a high degree of flexibility but also variability in the quality of care provided. The commission on long-term stroke care of the German Stroke Society developed a concept on how to provide standardized multiprofessional long-term stroke care with a focus on patient-centered comprehensive care. We propose a diagnostic work-up in stages, with an initial patient-reported screening, followed by an adapted in-depth assessment of affected domains. This includes internistic domains (management of risk factors) and also genuine neurological domains (spasticity, cognitive deficits etc.) that must be considered. This information is then merged with patient expectations and prioritization to a standardized treatment plan. Special challenges for the implementation of such a comprehensive care system are the intersectoral and intrasectoral communication between healthcare providers, patients and relatives, the need to create a compensation system for providers and the establishment of appropriate quality management services. Digital health applications are helpful tools to provide aspects of diagnostics, treatment and communication in long-term stroke care. [ABSTRACT FROM AUTHOR]

Background: The COVID‐19 pandemic and the UK government's subsequent coronavirus action plan have fundamentally impacted on every aspect of healthcare. One area that is severely affected is ear, nose and throat (ENT)/laryngology where speech and language therapists (SLTs) engage in a diverse range of practice with patients with a range of conditions, including voice disorders, airway problems, and head and neck cancers (HNCs). A large majority of these patients are in high‐risk categories, and many specialized clinical practices are vulnerable. In addition, workforce and research issues are challenged in both the immediate context and the future. Aims: To discuss the threats and opportunities from the COVID‐19 pandemic for SLTs in ENT/laryngology with specific reference to clinical practice, workforce and research leadership. Methods & Procedures: The relevant sections of the World Health Organisation's (WHO) health systems building blocks framework (2007) were used to structure the study. Expert agreement was determined by an iterative process of multiple‐group discussions, the use of all recent relevant policy documentation, and other literature and shared documentation/writing. The final paper was verified and agreed by all authors. Main Contribution: The main threats to ENT/laryngology SLT clinical services include increased patient complexity related to COVID‐19 voice and airway problems, delayed HNC diagnosis, reduced access to instrumental procedures and inequitable care provision. The main clinical opportunities include the potential for new modes of service delivery and collaborations, and harnessing SLT expertise in non‐instrumental assessment. There are several workforce issues, including redeployment (and impact on current services), training implications and psychological impact on staff. Workforce opportunities exist for service innovation and potential extended ENT/SLT practice roles. Research is threatened by a reduction in immediate funding calls and high competition. Current research is affected by very limited access to participants and the ability to conduct face‐to‐face and instrumental assessments. However, research opportunities may result in greater collaboration, and changes in service delivery necessitate robust investigation and evaluation. A new national set of research priorities is likely to emerge. Conclusions & Implications: The immediate impact of the pandemic has resulted in major disruption to all aspects of clinical delivery, workforce and research for ENT/laryngology SLT. It is unclear when any of these areas will resume operations and whether permanent changes to clinical practice, professional remits and research priorities will follow. However, significant opportunity exists in the post‐COVID era to re‐evaluate current practice, embrace opportunities and evaluate new ways of working. What this paper addsWhat is already known on the subjectENT/laryngology SLTs manage patients with a range of conditions, including voice disorders, airway problems and HNCs. The diverse scope of clinical practice involves highly specialized assessment and treatment practices in patients in high‐risk categories. A large majority of active research projects in this field are patient focused and involve instrumental assessment. The COVID‐19 pandemic has created both opportunities and threats for ENT SLT clinical services, workforce and research.What this paper adds to existing knowledgeThis study provides a discussion of the threats and opportunities from the COVID‐19 pandemic for ENT/laryngology SLT with specific reference to clinical practice, workforce and research leadership.What are the potential or actual clinical implications of this work?The COVID‐19 pandemic has resulted in major disruption to all aspects of clinical delivery, workforce and research for ENT/laryngology SLT. Changes to clinical practice, professional remits and research priorities are of indeterminant duration at this time, and some components could be permanent. Significant clinical practice, workforce and research opportunities may exist in the post‐COVID era. [ABSTRACT FROM AUTHOR]

Introduction: Race and ethnicity along with social determinants of health have been identified as risk factors for COVID-19. The purpose of this clinical paper is to provide an overview of the National Coalition of Ethnic Minority Nurse Associations (NCEMNA), present COVID-19 epidemiological data on five racial–ethnic groups, identify culturally congruent health care strategies for each group, and provide directions for practice and research. Method : NCEMNA collaborated to provide a clinical paper that addresses information about COVID-19 and culturally congruent health care in five racial–ethnic groups. Results : Every organization presented common themes across the different groups and unique perspectives that each group is faced with during this challenge. Discussion : This article provides an introduction to the issues that minority groups are facing. It is imperative that data are collected to determine the extent of the impact of COVID-19 in diverse communities in the country. [ABSTRACT FROM AUTHOR]

Background: This position paper highlights the opportunistic integral role of the pharmacist across the patient pathway utilizing cardiovascular care as an example. The paper aims to highlight the potential roles that pharmacists worldwide can have (or already have) to provide efficient patient care in the context of interprofessional collaboration. Methods: It results from a literature review and experts seeking advice to identify existing interventions and potential innovative interventions. We developed a conceptual framework highlighting seven critical phases in the patient pathway and for each of those listed some of the initiatives identified by our experts worldwide. Results: Existing pharmacists' interventions in each of these phases have been identified globally. Various examples in the area of prevention and self‐management were found to exist for long; the contribution for early detection and subsequently to timely diagnosis were also quite clear; integration of care was perhaps one of the areas needing greater development, although interventions in secondary care were also quite common. Tertiary care and end of life interventions were found to often be left for other healthcare professionals. Conclusion: On the basis of the findings, we can argue that much has been done but globally consider that pharmacists are still an untapped resource potentially useful for improved patient care. [ABSTRACT FROM AUTHOR]

In its mission to optimise the quality of patient care and the level of clinician training within the fields of biotherapy, the BioTherapeutics, Education and Research (BTER) Foundation and its Maggot Therapy Competency Committee identified qualities and achievements assessed to be the minimum standards that health care professionals should attain in order to be deemed competent in maggot therapy. The set of six standards were selected to reflect the same high degree of professionalism that is used by the Accreditation Council of Graduate Medical Education for assessing other medical specialists, but with an emphasis on the principles and practice of maggot therapy. For each domain in which competency is expected, the rationale has been explained, specific competencies have been articulated, and methods for demonstrating or evaluating those competencies have been suggested. Applicable to any clinician applying maggot dressings professionally, these recommendations should assist those who wish to identify, assess, or achieve competency in maggot therapy. Specifically, these six competencies include: (1) knowledge about wound care in general and maggot therapy in particular; (2) skill in general patient care, to a level commensurate with their professional role; (3) ability to communicate effectively with colleagues, patients, and the general public; (4) professional and ethical behaviour; (5) ability to deliver systems‐based health care; (6) incorporation of continuing education and quality improvement into their practice. [ABSTRACT FROM AUTHOR]

Aim: To review the current nursing and midwifery contribution to leading digital health (DH) policy and practice and what facilitates and/or challenges this. Design: Integrative literature review. Methods: Pre‐defined inclusion criteria were used. Study selection and quality assessment using the appropriate critical appraisal tools were undertaken by two authors, followed by narrative synthesis. Data Sources: Six databases and hand searching for papers published from 2012 to February 2024. Findings: Four themes were identified from 24 included papers. These are discussed according to the World Health Organization's Global Strategic Directions for Nursing and Midwifery and indicate nurses/midwives are leading DH policy and practice, but this is not widespread or systematically enabled. Conclusion: Nurses and midwives are ideally placed to help improve health outcomes through digital healthcare transformation, but their policy leadership potential is underused. Implications for the profession and/or patient care: Nurses/midwives' DH leadership must be optimized to realize maximum benefit from digital transformation. A robust infrastructure enabling nursing/midwifery DH policy leadership is urgently needed. Impact: This study addresses the lack of nursing/midwifery voice in international DH policy leadership. It offers nurses/midwives and health policymakers internationally opportunity to: drive better understanding of nursing/midwifery leadership in a DH policy context; enhance population outcomes by optimizing their contribution; Develop a robust infrastructure to enable this. Reporting Method: Reporting adheres to the EQUATOR network, Preferred Reporting Items for Systematic Review and Meta‐Analysis (PRISMA) guidelines. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

The number of older people dying in long-term care facilities (LTCFs) is increasing globally, but care quality may be variable. A framework was developed drawing on empirical research findings from the Palliative Care for Older People (PACE) study and a scoping review of literature on the implementation of palliative care interventions in LTCFs. The PACE study mapped palliative care in LTCFs in Europe, evaluated quality of end-of-life care and quality of dying in a cross-sectional study of deceased residents of LTCFs in 6 countries, and undertook a cluster-randomized control trial that evaluated the impact of the PACE Steps to Success intervention in 7 countries. Working with the European Association for Palliative Care, a white paper was written that outlined recommendations for the implementation of interventions to improve palliative and end-of-life care for all older adults with serious illness, regardless of diagnosis, living in LTCFs. The goal of the article is to present these key domains and recommendations. Transparent expert consultation. International experts in LTCFs. Eighteen (of 20 invited) international experts from 15 countries participated in a 1-day face-to-face Transparent Expert Consultation (TEC) workshop in Bern, Switzerland, and 21 (of 28 invited) completed a follow-up online survey. The TEC study used (1) a face-to-face workshop to discuss a scoping review and initial recommendations and (2) an online survey. Thirty recommendations about implementing palliative care for older people in LTCFs were refined during the TEC workshop and, of these, 20 were selected following the survey. These 20 recommendations cover domains at micro (within organizations), meso (across organizations), and macro (at national or regional) levels addressed in 3 phases: establishing conditions for action, embedding in everyday practice, and sustaining ongoing change. We developed a framework of 20 recommendations to guide implementation of improvements in palliative care in LTCFs. [ABSTRACT FROM AUTHOR]

Copyright of Croatian Nursing Journal is the property of University of Applied Health Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To study the factors associated with the subsequent (over next 9 years) full-text publication of papers presented at the 44 National Conference of Indian Academy of Pediatrics (PEDICON), 2007. Methods: All papers presented at PEDICON 2007 were searched for subsequent full-text publication over the next 9 years in English-language journals by an internet-based search. The published papers were compared with the conference-abstracts. Results: 74 (16%) of the 450 abstracts presented were subsequently published; 61 (82.4%) in Medline-indexed journals. Majority (50, 67.6%) of the papers was published within the first 36 mo in journals with mean (SD) impact factor of 2.62 (1.63). The factors significantly associated with subsequent publication were papers presented as award papers ( P<0.001), those reporting on Interventional trials ( P<0.001), and those from medical colleges ( P<0.05). On comparison of the conference abstracts with the subsequently published full-papers, 55% had a change in title; authors were changed in 65%, and participants' numbers were dissimilar in 8.6%. Conclusions: There is a need to identify the factors responsible for this low rate of subsequent publication, and interventions to improve it both at institutional and researchers' level. [ABSTRACT FROM AUTHOR]

Personalized Medicine is a challenge for healthcare systems in Central and Eastern Europe if they are to provide patients with personalized diagnosis and treatment. Personalized medicine (PM) is about tailoring a treatment as individualized as the disease. [1] Integrated care involves receiving care along a continuum of health promotion, disease prevention, diagnosis, treatment, disease-management, rehabilitation and palliative care services, coordinated across the different levels and sites of care within and beyond the health sector, and according to the needs of patients throughout the life course. Personalized Medicine and Integrated Care are among the most important concepts related to the management and organization of healthcare systems. This article intends to identify challenges to the adoption of personalized medicine and stimulate fruitful dialogue and debate about the evaluation of barriers and facilitators within the implementation of personalized medicine interventions, identify the barriers and take systematic actions to remove as many of them as possible to create a future where PM is fully integrated into real-life settings. [ABSTRACT FROM AUTHOR]

Artificial intelligence (AI) has made tremendous advances in recent years and will presumably have a major impact in health care. These advancements are expected to affect different aspects of clinical medicine and lead to improvement of delivered care but also optimization of available resources. As a modern specialty that extensively relies on imaging, interventional radiology (IR) is primed to be on the forefront of this development. This is especially relevant since IR is a highly advanced specialty that heavily relies on technology and thus is naturally susceptible to disruption by new technological developments. Disruption always means opportunity and interventionalists must therefore understand AI and be a central part of decision-making when such systems are developed, trained, and implemented. Furthermore, interventional radiologist must not only embrace but lead the change that AI technology will allow. The CIRSE position paper discusses the status quo as well as current developments and challenges. [ABSTRACT FROM AUTHOR]

Background: To assess multicystic dysplastic kidneys (MCDK) in children, their complications and associated congenital genitourinary anomalies. Methods: Children with unilateral MCDK, evaluated between 2012 and 2020, were analyzed. In this retrospective study, data were obtained from electronic and paper health care records. Results: There were 80 children included. Follow-up time was 8.0 +/− 5.2 years (mean +/− standard deviation). None of them had hypertension. In total, 43.8% of the children had associated congenital genitourinary anomalies, most commonly cryptorchidism and vesicoureteral reflux (VUR), and 6.3% of these children had chromosomopathy. All of them had normal kidney function except one child with dysplasia of the contralateral kidney. Urinalysis was normal in 90% of children. Extrarenal malformations occurred in 22.5% of them. We observed spontaneous involution of MCDK in 38.8% of children in the observed period. Nephrectomy was performed in 12.5% of children, at an average age of 2.0 years. Conclusions: Children with a unilateral MCDK have a very good prognosis if the contralateral kidney is normal. Associated congenital genitourinary anomalies are common. Cryptorchidism was found to be the most common associated anomaly among boys, which is unique for this study. Most of these children do not suffer from hypertension, kidney dysfunction or other complications. [ABSTRACT FROM AUTHOR]

Previous studies have demonstrated that students who are engaged in learning tasks and make errors before receiving instruction on how to complete them, achieve better learning outcomes than students who first receive instruction and then complete the learning activities with the aim of avoiding errors. Although simulation literature often refers to errors as learning opportunities, to date, there is limited understanding of how pedagogical approaches that promote learning from errors can guide the design of simulation-based learning in healthcare education. To (a) present the Learning from Errors conceptual model; and (b) provide an example of how educators can use this model. The Learning from Errors model is drawn from critical elements of two pedagogical approaches, productive failure and error management training and pedagogical features of high-quality healthcare simulations. We describe the Learning from Errors model, which emphasises the need for adopting pedagogical methods that explicitly use errors as learning opportunities and ultimately inform simulation design. We then illustrate the application of this model to a simulation example. The model includes the following elements: i) normalisation of errors, ii) challenging simulation scenarios, iii) self-directed learning, iv) collaborative teamwork and v) comparison with best practice. This discussion paper presents the Learning from Errors conceptual model, an evidence-based approach that can assist educators in the design of simulations that embrace errors as a catalyst for learning. [ABSTRACT FROM AUTHOR]

Purpose: Children's perspectives in the context of health service delivery have historically been seen as unimportant. They have been viewed as unintelligent, unable to effectively share or tell of their experiences or fully participate in their care, potentially resulting in a sense of dehumanisation. Method: The present paper illustrates children's experiences when undergoing medical procedures, using application of the eight dimensions of humanised care theoretical framework. Results: Findings from six published papers were reflectively interrogated to identify implicit findings related to the dimensions of humanised care. These implicit findings show ways of caring for childrenwhichcan lead to enhanced human sensitivity in care or conversely where the dimensions of being human are obscured to greater or lesser degrees and can result in forms of dehumanisation. Conclusions: Inadvertent dehumanising features of practice can be mediated by encouraging the inclusion of children's own lifeworld perspective and make room for their voices in both care and research. In this way the present well documented power imbalance could be addressed. Adding the value of the theoretical framework highlights areas of need for young children to be cared for as human beings. [ABSTRACT FROM AUTHOR]

Background: Sharing experiences and learning from health measures taken during the outbreak of epidemics is a critical issue that affects the right and timely decisions in health crises. In the present study, an attempt has been made to review the health policies adopted against COVID-19 and extract critical points for resolving the epidemic crisis. Materials and Methods: This article was a comparative study. The study population comprised Canada, Japan, Germany, Korea, Turkey, and Iran. Ten effective indicators in the management of epidemics were extracted by reviewing the literature and interviewing disaster management experts, and the degree of conformity of the research community with them was examined. The study data were collected from articles published in scientific databases (Google Scholar, PubMed, Web of Science, and Scopus search engines) or information from COVID-19 disease management organizations from official sites. The obtained data were processed and analyzed by matrix content analysis. Results: The results showed the importance of 10 effective indicators in the management of epidemics during the outbreak of COVID-19 studied and noticed by the health system of most countries. And the government, local and private organizations have participated in the implementation of the studied indicators according to the conditions of each country's health system. Therefore, the success rate of countries in managing COVID-19 disease varies according to the time, type, and manner of implementation and monitoring of measures. Conclusion: Speed of action in adopting health policies and integration in its implementation, construction of convalescence, adequate training and access to personal protective equipment, prevention of nosocomial contamination, and voluntary assistance are essential issues in the fight against epidemics. These measures should be considered and used as teachings in managing health crises, especially emerging diseases and pandemics. [ABSTRACT FROM AUTHOR]

Background: The knowledge of Emergency Medical Technicians (EMTs) plays a crucial role in the outcomes of traumatic patients. This study aimed to assess the knowledge of EMTs about the prehospital care intensity index of spinal cord trauma in Ilam Province, Iran. Materials and Methods: This cross-sectional study was conducted on 98 EMTs chosen by the census sampling method. The study data were collected using a researcher-made questionnaire on the prehospital care intensity index of spinal cord trauma and were analyzed with SPSS 16. Results: The knowledge of the prehospital care intensity index of spinal cord trauma was at the advanced level in 87.7% of EMTs and the intermediate level in 15.3% of EMTs. There was a significant relationship between the technician's knowledge score and variables such as age, work record, overtime hours, and the number of missions (P=0.05). Conclusion: EMTs needed more specialized information on spinal trauma. It was recommended to hold in-service training programs more precisely and consider the training of necessary skills that most EMTs require. [ABSTRACT FROM AUTHOR]

Background: The role and function of Emergency Medical Service (EMS) in people's health and the need for continuous evaluation of its function, especially delivering services to the patients, are essential. So, the present study was conducted to determine the time indices of prehospital emergency services in Ardabil City, Iran. Materials and Methods: This study was a retrospective cross-sectional study. Out of all calls recorded in EMS centers of Ardabil in the first 6 months of 2020, 327 calls, which resulted in the patient's transfer to a hospital, were randomly selected. Then, the required data, including time indices and demographic information, were extracted from EMS forms filled by a medical emergency technician for each mission. The obtained data were analyzed using descriptive statistics, including mean, standard deviation, and inferential statistics, including 1-way analysis of variance and the Chi-square test in SPSS v. 22. Results: In terms of time indices, the average delay time (1.01 minutes), the response time (7.87 minutes), on-scene time (13.81 minutes), transport time (12.53 minutes), the total run time (transport time, response time, and on-scene time) (35.15 minutes), and the round trip time (52.50) had been recorded. According to the Chi-square test, there was a significant relationship between the total run time (transport time, response time, and on-scene time), transport time, round trip time, and the location of the emergency base. Conclusion: EMS time indices were at the desired level. Updating information systems, ambulances, medical equipment, and holding training courses for personnel working in this system can effectively improve time indicators. [ABSTRACT FROM AUTHOR]

The home care workforce provides essential support for older people with dementia to live a life of fulfillment. " Enabling Choices," an evidence-informed conversation tool, aims to negotiate risk around everyday activities between home care workers, people with dementia and their informal carers. This paper describes tool conversion into electronic format and preparation for implementation throughout a large Australian health and aged care service provider, utilizing the Implementation Framework for Aged Care (IFAC). Using codesign principles, the tool was converted from paper-based to electronic format involving frontline, operational and Information Management Services staff, and people with dementia/carers. Focus groups and interviews identified tool acceptability, feasibility, and appropriateness. For implementation preparation, the wider socio-cultural-political context was mapped, and key questions of the IFAC addressed. Environment, workflow, and training requirements were determined, and strategies for behavior change ascertained. Numerous opportunities and challenges exist for the widespread upscale of an evidence-informed tool into practice. [ABSTRACT FROM AUTHOR]

The article offers information on how research is defined as a systematic inquiry using orderly disciplined methods to answer questions or to solve problems. Topics include the research requires academic discipline has coupled with specific research competencies so that an appropriate study is designed and conducted, and leading to the drawing of relevant conclusions relating to the explicit aim/s of the study.

Background: After the Kermanshah earthquake on November 12, 2017, Tabriz University of Medical Sciences dispatched a response team to the earthquake-stricken areas. This team provided the affected people with health services for 10 days. This article intends to examine the experience of this team in Kermanshah earthquake-stricken areas. Materials and Methods: After the team's return from Kermanshah, a meeting was held to examine the challenges and review the learned lessons with 60 participants, including authorities and the people who were members of the team. The discussed issues were coded using content analysis. The similar codes were merged, and then categories were extracted. Results: The analysis of discussions led to 9 categories of experiences that included delay in recalling process and its challenges, lack of preparedness, use of the virtual space capacity, lack of proper assessment of the health needs and the estimation of facilities, management experience of the team on the dispatch, shortcomings, and imperfections, managerial challenges, lack of coordination, and setting up of field hospitals without planning. Conclusion: Iran is susceptible to natural disasters, and from time to time, parts of the country are affected by these disasters. One of the priorities in these disasters is people's need for health services. Since health facilities in the area usually encounter problems in these circumstances, other medical universities should provide help and relief. The present experience shows that there are still many challenges that should be addressed. [ABSTRACT FROM AUTHOR]

The goal of the Ending the HIV Epidemic Initiative is to reduce new infections in the United States by 90% by 2030. Success will require fundamentally changing human immunodeficiency virus (HIV) prevention and care delivery to engage more persons with HIV and at risk of HIV in treatment. While the coronavirus disease 2019 (COVID-19) pandemic reduced in-person visits to care facilities and led to concern about interruptions in care, it also accelerated growth of alternative options, bolstered by additional funding support. These included the use of telehealth, medication delivery to the home, and increased flexibility facilitating access to Ryan White HIV/AIDS Program services. While the outcomes of these programs must be studied, many have improved accessibility during the pandemic. As the pandemic wanes, long-term policy changes are needed to preserve these options for those who benefit from them. These new care paradigms may provide a roadmap for progress for those with other chronic health issues as well. [ABSTRACT FROM AUTHOR]

In a resource-limited country like India, rationing of scarce critical care resources might be required to ensure appropriate delivery of care to the critically ill patients suffering from COVID-19 infection. Most of these patients require critical care support because of respiratory failure or presence of multiorgan dysfunction syndrome. As there is no pharmacological therapy available, respiratory support in the form of supplemental oxygen, noninvasive ventilation, and invasive mechanical ventilation remains mainstay of care in intensive care units. As there is still dearth of direct evidence, most of the data are extrapolated from the experience gained from the management of general critical care patients. [ABSTRACT FROM AUTHOR]

Persons living with human immunodeficiency virus (HIV) and others receiving antiretrovirals are at risk for medication errors during hospitalization and at transitions of care. These errors may result in adverse effects or viral resistance, limiting future treatment options. A range of interventions is described in the literature to decrease the occurrence or duration of medication errors, including review of electronic health records, clinical checklists at care transitions, and daily review of medication lists. To reduce the risk of medication-related errors, antiretroviral stewardship programs (ARVSPs) are needed to enhance patient safety. This call to action, endorsed by the Infectious Diseases Society of America, the HIV Medicine Association, and the American Academy of HIV Medicine, is modeled upon the success of antimicrobial stewardship programs now mandated by the Joint Commission. Herein, we propose definitions of ARVSPs, suggest resources for ARVSP leadership, and provide a summary of published, successful strategies for ARVSP that healthcare facilities may use to develop locally appropriate programs. [ABSTRACT FROM AUTHOR]

Urgent care practice (UCP) is a novel concept for India. Urgent care primarily deals with injuries or illnesses requiring immediate care. Medical emergency and urgency can happen anywhere unannounced. Research has shown that 90% of the morbidities can be resolved within the community by primary care physicians lead teams. Given the changing professional demands, non-specialists tend to refer away far too many cases to specialists, undermining generalist medical care, particularly in Indian settings. The spillover of the patient load from the primary care setting to the tertiary care centers is enormous leading to resource mismatch. Family physicians and other primary care providers are best positioned to develop practices and provide good quality urgent care to society. Family physicians, general practitioners, and medical officers are already functioning as the frontline care providers for any emergency or medical urgency arising within communities. Urgent care is essentially ambulatory care or outpatient care outside of a traditional hospital emergency room. "UCP aims to provide timely support, which is easily accessible with a focus on good clinical outcomes, e.g. survival, recovery, lack of adverse events, and complications. Core interventions of urgent care are centered on the 4Rs - Rescue, Resuscitate, Relate, and Refer. At present, there are no available, established training model for future faculty, residents, and medical students on "UCP" in India. [ABSTRACT FROM AUTHOR]

This original article outlines a theoretical path and posterior critical analysis regarding two relevant matters in modern nursing: patterns of knowing in nursing and commodification contexts in contemporary health systems. The aim of our manuscript is to examine the development of basic and contextual nursing knowledge in commodified contexts. For this purpose, we outline a discussion and reflexive dialogue based on a literature search and our clinical experience. To lay the foundation for an informed discussion, we conducted a literature search and selected relevant articles in English, Spanish, and Portuguese that included contents on patterns of knowing, commodification, and nursing published from 1978 to 2017. Globalization, commodification, and austerity measures seem to have negative effects on nursing. Work conditions are worsening, deteriorating nurse–patient relationships, and limiting reflection on practice. Nurses must develop knowledge to challenge and participate in institutional organization and public health policies. Development of nursing knowledge may be difficult to achieve in commodified environments. Consequently, therapeutic care relationships, healthcare services, and nurses' own health are compromised. However, by obtaining organizational, sociopolitical, and emancipatory knowledge, nurses can use strategies to adapt to or resist commodified contexts while constructing basic knowledge. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The aims of our study were to evaluate the outcome of office-based paper patch grafting in tympanic membrane (TM) perforation regardless of the disease duration or etiology and to compare the clinical factors influencing the successful closure of perforation between the success and failure groups of paper patch myringoplasty. MATERIALS and METHODS: This is a retrospective study of 114 patients that underwent paper patch myringoplasty in an outpatient setting (success group, 83 cases; failure group, 31 cases). Thirteen clinical factors with potential impact on the healing status of the TM were investigated: gender, age, laterality, etiology, duration of perforation, tinnitus, hearing loss, otorrhea, size and location of perforation, status of contralateral ear, ipsilateral findings of computed tomography, and duration of complete healing. The follow-up period was at least 1 year. RESULTS: The total success rate of paper patch grafting was 72.8%. The mean age of the failure group was significantly more higher than that of the success group. Significant differences in the etiology as well as in the history of otorrhea were found between the success and failure groups. There were no significant differences for any of the other factors between chronic and non-chronic perforations. CONCLUSION: The predictors of successful outcome were patient's age, etiology of perforation, and history of otorrhea. Clinicians can attempt paper patch myringoplasty first in younger patients, traumatic TM perforation cases, and in patients with no history of otorrhea. Paper patch grafting can also be considered before formal surgical myringoplasty in the case of small, dry, chronic TM perforations. [ABSTRACT FROM AUTHOR]

Coronavirus Disease 2019 (COVID-19) is escalating all over the world and has higher morbidities and mortalities in certain vulnerable populations. People Who Use Drugs (PWUD) are a marginalized and stigmatized group with weaker immunity responses, vulnerability to stress, poor health conditions, high-risk behaviors, and lower access to health care services. These conditions put them at a higher risk of COVID-19 infection and its complications. In this paper, an international group of experts on addiction medicine, infectious diseases, and disaster psychiatry explore the possible raised concerns in this issue and provide recommendations to manage the comorbidity of COVID-19 and Substance Use Disorder (SUD). [ABSTRACT FROM AUTHOR]

Family medicine is the internationally recognized nomenclature for the academic discipline, knowledge domain, and medical specialty of primary care doctors, working in the community setting. Family medicine is defined as a specialty of medicine which is concerned with providing comprehensive care to individuals and families by integrating biomedical, behavioral, and social sciences in the community setting. The distinction of family medicine lies in the tradition of medical generalism, promoting whole person care, in a life cycle mode; providing optimal preventive, promotive, and curative healthcare services in a wide spectrum of setting from home to hospital. In 2016, 92nd report of the department‑related parliamentary standing committee on health and family welfare on the “Functioning of the Medical Council of India” has emphasized the need for postgraduate in family medicine. The committee report has noted that “the medical education system is designed in a way that the concept of family physicians has been ignored. The committee recommends that the Government of India in coordination with State Governments should establish robust PG Programs in Family Medicine and facilitate introduction of Family Medicine discipline in all medical colleges. This will not only minimize the need for frequent referrals to specialist and decrease the load on tertiary care but also provide continuous healthcare for the individuals and families. The successive National Health Policies of Government of India–NHP 2002 and 2017 have emphasized the need of family medicine training in India. The recently enacted National Medical Commission Act 2019 has mandated NMC to promote training in family medicine at both undergraduate and postgraduate levels. Therefore, in the background of the stated policies of the Government of India the concept of family doctors, which was earlier neglected should be institutionalized within the mainstream medical education system of India. It is now time to accelerate and upgrade family medicine training and thereby strengthen the concept of comprehensive primary care in India. This white paper presents the review of family medicine training in India and proposes a way forward. [ABSTRACT FROM AUTHOR]

'Paper-based microfluidics' or 'lab on paper,' as a burgeoning research field with its beginning in 2007, provides a novel system for fluid handling and fluid analysis for a variety of applications including health diagnostics, environmental monitoring as well as food quality testing. The reasons why paper becomes an attractive substrate for making microfluidic systems include: (1) it is a ubiquitous and extremely cheap cellulosic material; (2) it is compatible with many chemical/biochemical/medical applications; and (3) it transports liquids using capillary forces without the assistance of external forces. By building microfluidic channels on paper, liquid flow is confined within the channels, and therefore, liquid flow can be guided in a controlled manner. A variety of 2D and even 3D microfluidic channels have been created on paper, which are able to transport liquids in the predesigned pathways on paper. At the current stage of its development, paper-based microfluidic system is claimed to be low-cost, easy-to-use, disposable, and equipment-free, and therefore, is a rising technology particularly relevant to improving the healthcare and disease screening in the developing world, especially for those areas with no- or low-infrastructure and limited trained medical and health professionals. The research in paper-based microfluidics is experiencing a period of explosion; most published works have focused on: (1) inventing low-cost and simple fabrication techniques for paper-based microfluidic devices; and (2) exploring new applications of paper-based microfluidics by incorporating efficient detection methods. This paper aims to review both the fabrication techniques and applications of paper-based microfluidics reported to date. This paper also attempts to convey to the readers, from the authors' point of view the current limitations of paper-based microfluidics which require further research, and a few perspective directions this new analytical system may take in its development. [ABSTRACT FROM AUTHOR]

Background: Schools, as social infrastructure and an integral part of society, play an essential role in creating the resilience of the community to natural disasters. This study aims to systematically review and identify and categorize the components affecting schools' resilience against emergencies and disasters. Materials and Methods: Without any time limit, we will search the PubMed, Scopus, Web of Science, and Google Scholar databases using the three keywords of "Disaster", "School", "resilience", and their synonyms according to the MeSH website terms defined in the PubMed database. The inclusion criteria will be the articles related to school resilience, schools and emergencies and disasters, and school safety and resistance to threats. There will be no restrictions on the type of documentation, and all articles, books, and conference papers will be evaluated in this study. Search syntax strategies will be defined based on the guidance of each database. The final version of EndNote X8 is used to manage databases, delete duplicate and irrelevant articles, and extract relevant articles. The evaluation and selection of articles are based on the research question and the PRISMA checklist. Dissemination: The results of this systematic review determine appropriate criteria for school resilience, which are valuable for decision-makers and politicians, researchers in the field of education, Ministry of Health and Medical Education, Welfare Organization, Red Crescent, and people interested in research in the field of students and schools, especially in the event of emergencies and disasters. Also, according to the criteria extracted from this systematic review, the difference between resilient and non-resilient schools can be shown from an international perspective. [ABSTRACT FROM AUTHOR]

Abstract Nowadays, point-of-care testing (POCT) techniques have achieved flourishing development in human health monitoring, where paper-based POCT platforms have exhibited superior properties of low cost, easy accessibility and eco-friendliness. For fabrication of paper-based POCT platforms, the pen-on-paper (PoP) strategies through directly writing desired functional materials on paper have been creatively developed in recent years. The PoP strategies are characterized by simplicity, rapid prototyping and do-it-yourself capability, and are also likely to realize scalable manufacturing through integration with software-controlled plotter. In this review, we firstly introduce various kinds of papers and pens employed in the PoP strategies, and then summarize the state-of-art advances of PoP strategies for making paper-based POCT platforms. Subsequently, we discuss the representative applications of PoP strategies for human health monitoring. Conclusions, current challenges and future perspectives of the PoP strategies for human health related POCT uses are finally given. Highlights • A variety of pens and papers involved in pen-on-paper (PoP) strategies are summarized. • The state-of-art of PoP strategies in realizing key steps involved in construction of POCT platforms are reviewed. • Representative applications of PoP strategies in human health monitoring are discussed. • Possible roadmaps can be oriented to move PoP strategies a giant step forward for human health. [ABSTRACT FROM AUTHOR]