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This study investigates the roles of informal gatekeepers in the context of First Nations health care in Canada. While existing literature focuses on gatekeeping by professionals, such as corporate board members, auditors, general practitioners, and specialists, we present empirical evidence on the role of informal First Nations' gatekeepers in a health care system. Gatekeepers engage with government and First Nations along a continuum of gatekeeping functions. Drawing on common pool theory, we use a case study to understand the gatekeepers' roles. We identify First Nations gatekeepers' roles to include health care program control, resource control, and ecosystem control. We also find that these gatekeepers constitute a viable long‐enduring common pool resource institution that can be useful for the federal government's phased approach in transitioning health care governance to the First Nations. [ABSTRACT FROM AUTHOR]

Copyright of Revista de Psiquiatría Infanto-Juvenil is the property of Asociacion Espanola de Psiquiatria del Nino y el Adolescente (AEPNyA) 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.)

The commodification of health care, particularly primary care, presents challenges to care and knowledge development. The purpose of this study is to examine how nurses perceive and develop their knowledge in a commodified context. A mixed‐methods study was conducted that included a closed‐question survey and in‐depth interviews with nurses in public primary care in Catalonia. There were 104 valid responses to the questionnaire and 10 in‐depth interviews. The main findings of the survey were related to workload and limited time for nursing care. Six themes emerged from the in‐depth interviews: (1) limited time for nursing, (2) feelings of burnout, (3) awareness of patient and family satisfaction, (4) organizational factors that favor nurses' needs, (5) organizational factors that hinder nurses' needs, and finally (6) public administration requirements. Participants perceive excessive workload and time constraints and feel that this affects their nursing care and their physical and mental health. However, nurses purposefully use knowledge patterns to cope with the problems associated with commodification. Nurses have multidimensional, contextualized, and integrated knowledge that allows them to optimize their care based on the needs of their patients. This research examines many challenges related to nursing practice and the nursing discipline and opens the door for further research that encompasses all areas of nursing. [ABSTRACT FROM AUTHOR]

Background Research indicates that Black cancer patients have higher rates of COVID-19 hospitalization than their White counterparts. However, the extent to which chronic diseases contribute to racial disparities remains uncertain. We aimed to quantify the effect of chronic diseases on racial disparity in COVID-19–associated hospitalization among cancer patients. Methods We linked Louisiana Tumor Registry's data with statewide COVID-19 data and hospital in-patient discharge data to identify patients diagnosed with cancer in 2015-2019 who tested positive for COVID-19 in 2020 and those with COVID-19–associated hospitalization. Multivariable logistic regression and mediation methods based on linear structural equations were employed to assess the effects of the number of chronic diseases (0, 1-2, ≥3) and individual chronic diseases. Results Of 6381 cancer patients who tested positive for COVID-19, 31.6% were non-Hispanic Black cancer patients. Compared with non-Hispanic White cancer patients, non-Hispanic Black cancer patients had a higher prevalence of chronic diseases (79.5% vs 66.0%) and higher COVID-19–associated hospitalization (27.2% vs 17.2%). The odds of COVID-19–associated hospitalization were 80% higher for non-Hispanic Black cancer patients than non-Hispanic White cancer patients (odds ratio = 1.80, 95% confidence interval = 1.59 to 2.04). After adjusting for age, sex, insurance, poverty, obesity, and cancer type, number of chronic diseases explained 37.8% of the racial disparity in COVID-19–associated hospitalization, and hypertension, diabetes, and chronic renal disease were the top 3 chronic diseases explaining 9.6%, 8.9%, and 7.3% of the racial disparity, respectively. Conclusion Chronic diseases played a substantial role in the racial disparity in COVID-19–associated hospitalization among cancer patients, especially hypertension, diabetes, and renal disease. Understanding and addressing the root causes are crucial for targeted interventions, policies, and health-care strategies to reduce racial disparity. [ABSTRACT FROM AUTHOR]

Purpose: The primary aim of this work was to convert the Information System for Research in Primary Care (SIDIAP) from Catalonia, Spain, to the Observational Medical Outcomes Partnership (OMOP) Common Data Model (CDM). Our second aim was to provide a descriptive analysis of COVID-19-related outcomes among the general population.Patients and Methods: We mapped patient-level data from SIDIAP to the OMOP CDM and we performed more than 3,400 data quality checks to assess its readiness for research. We established a general population cohort as of the 1st March 2020 and identified outpatient COVID-19 diagnoses or tested positive for, hospitalised with, admitted to intensive care units (ICU) with, died with, or vaccinated against COVID-19 up to 30th June 2022.Results: After verifying the high quality of the transformed dataset, we included 5,870,274 individuals in the general population cohort. Of those, 604,472 had either an outpatient COVID-19 diagnosis or positive test result, 58,991 had a hospitalisation, 5,642 had an ICU admission, and 11,233 died with COVID-19. A total of 4,584,515 received a COVID-19 vaccine. People who were hospitalised or died were more commonly older, male, and with more comorbidities. Those admitted to ICU with COVID-19 were generally younger and more often male than those hospitalised and those who died.Conclusion: We successfully transformed SIDIAP to the OMOP CDM. From this dataset, a general population cohort of 5.9 million individuals was identified and their COVID-19-related outcomes over time were described. The transformed SIDIAP database is a valuable resource that can enable distributed network research in COVID-19 and beyond. [ABSTRACT FROM AUTHOR]

Little is known about knowledge transfer with the public. We explored how citizens, physicians, and communication specialists understand knowledge transfer in public spaces such as libraries. The initial study aimed at evaluating the scaling up of a program on disseminating research findings on potentially inappropriate medication. Twenty-two citizen workshops were offered by 16 physicians and facilitated by 6 communication specialists to 322 citizens in libraries during spring 2019. We did secondary analysis using the recorded workshop discussions to explore the type of knowledge participants used. Participants described four kinds of knowledge: biomedical, sociocultural beliefs, value-based reasoning, and institutional knowledge. Biomedical knowledge included scientific evidence, research methods, clinical guidelines, and access to research outcomes. Participants discussed beliefs in scientific progress, innovative clinical practices, and doctors' behaviours. Participants discussed values related to reliability, transparency, respect for patient autonomy and participation in decision-making. All categories of participants used these four kinds of knowledge. However, their descriptions varied particularly for biomedical knowledge which was described by physician-speakers and communication specialists-facilitators as scientific evidence, epidemiological and clinical practice guidelines, and pathophysiological theories. Communication specialists-facilitators also described scientific journalistic sources and scientific journalistic reports as proxies of scientific evidence. Citizens described biomedical knowledge in terms of knowledge to make informed decisions. These findings offer insights for future scientific knowledge exchange interventions with the public. [ABSTRACT FROM AUTHOR]

Copyright of Meta: Avaliação is the property of Revista Meta: Avaliacao 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.)

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Copyright of Journal of Health Academics / Sağlık Akademisyenleri Dergisi is the property of Journal of Health Academics 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.)

The article presents an abstract of the article "Western European Best Practice in Primary Healthcare," by J. Gérvas and P. Fernández.

Ovarian serous cystadenocarcinoma (OV) is a fatal gynecologic cancer with a five-year survival rate of only 46%. Resistance to platinum-based chemotherapy is a prevalent factor in OV patients, leading to increased mortality. The platinum resistance in OV is driven by transcriptome heterogeneity and tumor heterogeneity. Studies have indicated that ovarian cancer stem cells (OCSCs), which are chemoresistant and help in disease recurrence, are enriched by platinum-based chemotherapy. Stem cells have a significant influence on the OV progression and prognosis of OV patients and are key pathology mediators of OV. However, the molecular mechanisms and targets of OV have not yet been fully understood. In this study, systematic research based on the TCGA-OV dataset was conducted for the identification and construction of key stem cell-related diagnostic and prognostic models for the development of multigene markers of OV. A six-gene diagnostic and prognostic model (C19orf33, CBX2, CSMD1, INSRR, PRLR, and SLC38A4) was developed based on the differentially expressed stem cell-related gene model, which can act as a potent diagnostic biomarker and can characterize the clinicopathological properties of OV. The key genes related to stem cells were identified by screening the genes differentially expressed in OV and control samples. The mRNA-miRNA-TF molecular network for the six-gene model was constructed, and the potential biological significance of this molecular model and its impact on the infiltration of immune cells in the OV tumor microenvironment were elucidated. The differences in immune infiltration and stem cell-related biological processes were determined using gene set variation analysis (GSVA) and single-sample gene set enrichment analysis (ssGSEA) for the selection of molecular treatment options and providing a reference for elucidating the posttranscriptional regulatory mechanisms in OV. [ABSTRACT FROM AUTHOR]

Prevention has traditionally been categorized into three main areas: primary, secondary, and tertiary. In this Current Opinion, we present and discuss the concept of quaternary prevention in sports. Quaternary prevention aims to protect individuals from interventions that likely cause more harm than good, such as overdiagnosis, overtreatment, and overmedication. It includes preventing all types of harm associated with training and clinical interventions. Therefore, any sports injury prevention model or strategy should acknowledge the risks associated with training-related (i.e., overreaching and overuse) and clinical-related (i.e., overdiagnosis, over medicalization, and overtreatment) features. We propose a conceptual framework that integrates quaternary prevention into the contemporary injury prevention models in sports, taking into account that injury prevention is just one branch of the managerial, decision-making, and active hazard control process of risk management that athletes, coaches, and health and performance staff need to deal with. Therefore, we argue that integrating the concept of quaternary prevention into any form of prevention will significantly protect athletes from excessive, inappropriate, and ethically questionable interventions that may likely cause more harm than good. [ABSTRACT FROM AUTHOR]

This discussion piece argues for a refinement in our understanding of prevention in sexual abuse, suggesting that we include quaternary prevention on the grounds that this concept from medical literature has potential and helpful application to criminal justice and particularly to work with those who cause sexual harm. Located within the paradigm of Epidemiological Criminology (EpiCrim), quaternary prevention extends the prevention spectrum to enable a stronger distinction between tertiary level responses and long-term safe, sustainable reintegration into communities, particularly of those who sexually abuse others. The key principles of quaternary prevention are adapted and refined from current medical literature, and the potential usefulness of quaternary prevention to crime and sex abuse prevention is explored. [ABSTRACT FROM AUTHOR]

Aim: To describe experience using general practitioners (GPs), with an extended role (GPwER) in spinal medicine, to expedite assessment, triage, and management of patients referred from primary care for specialist spinal surgical opinion. Background: Low back and neck pain are common conditions in primary care. Indiscriminate or inappropriate referral to a spinal surgeon contributes to long waiting times. Previous attempts at triaging patients who really require a surgical opinion have used practice nurses, physiotherapists, clinical algorithms, and interdisciplinary screening clinics. Methods: Within the setting of an independent spinal care centre, we have used GPs specially trained in spinal practice to expedite the assessment and triage of new referrals between 2015 and 2021. We reviewed feedback from a Patient Satisfaction Questionnaire and the postgraduate backgrounds, training, practice with regard to triage of new referrals, and experiences of the GPs who were recruited Findings: Six GPwER had a mean of 26 years of postgraduate experience before appointment (range 10–44 years). The first four GPwER, appointed between 2015 and 2018, underwent an ad hoc in-house, interdisciplinary training programme and saw 2994 new patients between 2016 and 2020. After GPwER, assessment in only 18.9% (range 12.6 to 22.7%) of these patients was a spinal surgical opinion deemed necessary. Waiting times to see the spinal surgeon remained at 6–8 weeks despite a three-fold annual increase (from 340 to 1058) in new referrals. A Patient Satisfaction Questionnaire revealed high levels of satisfaction with the performances of the GPwER across seven dimensions. A dedicated training programme was designed in 2020, and the last two appointees underwent 20 h of clinical teaching prior to practice. Initial experience using GPwER, here termed 'Spinal Clinicians', suggests they are efficient at screening for patients needing spinal surgical referral. Establishing a recognised training programme, assessment, and certification for these practitioners are the next challenges. [ABSTRACT FROM AUTHOR]

Quinary Prevention; It is a set of policies, conditions, actions and measures aimed at reducing the risks associated with disseminating inappropriate health-related information and minimizing the impact of such misinformation on the progression or development of diseases. Quinary Prevention is under the multi-layered responsibility of health professionals, professional organizations and legislators. Legislators should prepare laws/regulations to prevent and deter the spread of health-related misinformation. Health service providers should assume the primary responsibility of Quinary Prevention, constantly update themselves in the discipline they choose, disseminate correct information and increase health literacy, inform the public through professional organizations or sites where relevant experts are the controllers, and report those who share false information to the necessary authorities. The public should not blindly believe every information conveyed through social media and should consult a healthcare professional. In social media, the impact of which is increasing day by day, the legal infrastructure should be prepared for an accurate information presentation by taking the necessary precautions, and health service providers, who are experts in their work, should contribute to the health literacy of the public by providing information on these platforms. Family physicians, who provide preventive and curative health services together, must know the protection steps within the scope of preventive medicine and update themselves in this regard. In this context, 'Quinary Prevention', the newest preventive care steps, was mentioned to guide health service providers, especially family physicians. [ABSTRACT FROM AUTHOR]

Many underdeveloped countries still struggle with the public health issue of acute illnesses, especially with the emergence of injuries as a major category of acute diseases. Control of the acute disease is challenging particularly when it occurs as an outbreak, either in isolation or as part of a wider epidemic. This narrative review summarizes the definition, epidemiologic transition, pattern and modes of spread, classification, epidemiologic measures, community burden, prevention, control, and future challenges of acute disease. This review is to provide a reference for epidemiologists, clinicians, researchers, and policymakers. [ABSTRACT FROM AUTHOR]

Copyright of Physis: Revista de Saúde Coletiva is the property of CEPESC 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.)

Copyright of MEDISAN is the property of Centro Provincial de Informacion en Ciencias Medicas de Santiago de Cuba 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.)

Copyright of Revista Facultad Nacional de Salud Pública is the property of Universidad de Antioquia, Facultad Nacional de Salud Publica 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.)

Since 2015, hypertension care has been contentious because of a single study: SPRINT (Systolic Blood Pressure Intervention Trial).1 This study, sponsored by the National Institutes of Health, was designed to answer a question debated for more than half a century: Is treatment of mild hypertension with medications warranted and, if so, to what blood pressure targets?2 A 2014 review of mild hypertension that I coauthored found little, if any, benefit to treatment.3 Therefore, SPRINT's results surprised myself and others in primary care, as did differing specialty interpretations about how—or whether—these results should influence hypertension management. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to translate and ensure cross-cultural adaptation of a Japanese version of the INTERMED Self-Assessment Questionnaire (IMSA). Methods: A family medicine physician, a medical education specialist, a psychiatrist who prepared the Japanese version of the INTERMED, and two members of the INTERMED consortium were selected as committee members. We used the standard forward and backward translation method to translate the IMSA into Japanese. After translating the original IMSA into Japanese, all committee members discussed and reached a consensus on the proposed translation. The back-translation was performed by an English native professional translator who did not know the original text. We contacted the INTERMED consortium and asked them to review the conceptual equivalence of the back-translated Japanese version with the original version; after two reviews, the members approved the Japanese version. Thereafter, we conducted cognitive debriefings with four patients and nine healthcare professionals to ensure cross-cultural adaptation. Results: The members of the INTERMED consortium approved the use of the Japanese version. We modified some expressions and words, while retaining the original meaning, to make it easier for Japanese patients to understand. Conclusion: We developed a Japanese version of the IMSA. A future study will investigate the construct criterion-related validity and the reliability of the scale. [ABSTRACT FROM AUTHOR]

The aim of this research is to explore and analyse the functional status and experiences of complex patients located at levels 3–4 of the risk pyramid of the chronic care model in primary care, within the hospital system of two regions in Spain. The design was a mixed design (COREQ). The participants were enrolled in programs for chronic complex patients and their caregivers. Sociodemographic variables were gathered, together with the following measures: the Barthel test, the Mini mental test, the Zarit questionnaire, the IEXPAC scale and the Braden scale. A semi‐structured interview was conducted individually with patients in order to explore their experiences and narrative on the process of their illness and the support they had received. The sample comprised 206 chronic pluripathological patients, of whom 103 were from Cantabria and a further 103 were from Mallorca. The patient profile in both regions was very similar. There was an equal distribution across both gender and the patients were over 78 years old. They all had a basic (primary) education, an average income and required moderate physical dependence, receiving assistance primarily from their children. The qualitative analysis highlighted patients' awareness of the illness and their concern for the future, noting that, overall, patients were satisfied with the care provided by their caregivers and the health system. We can conclude that is the first multicentric study of these characteristics conducted in Spain, despite it being the country with the second largest ageing population in the world. It is important to test new organisational models with differentiating areas of advanced clinical practice in primary care, whereby both patients and their caregivers can be co‐responsible within the care process. [ABSTRACT FROM AUTHOR]

Background: Despite the increased deployment and added value of Advanced Practitioner Physiotherapy (APP) in musculoskeletal care internationally, APP is not yet widely accepted within Dutch primary care. This may be due to specific constraints in the implementation of APP within the Dutch healthcare system. This study aimed to explore the experiences and perceptions of Advanced Practitioner Physiotherapists (APPs) and General Practitioners (GPs) with respect to implementing APP within Dutch primary care.Methods: This explorative and interpretive qualitative study included 12 APPs and 3 GPs who were in various stages of implementing an APP care model. Semi-structured interviews were conducted between January and March 2021. The topic list was based on existing literature, the personal input of researchers, and the Constellation Approach framework. Data were analysed using a thematic inductive approach.Results: Four main themes emerged from the data; 1) Both GPs' trust in APP and a clear added value of APP are critical for starting implementation, 2) APPs need continuous support from GPs, 3) APPs believe that their position needs strengthening, and 4) Implementation of the APP model creates tension over ownership. These four themes highlight the perceived difficulties in gaining trust, lack of clarity over the added value of APP, ambiguity over APPs' professional profile and positioning, a need on behalf of GPs to maintain authority, lack of reimbursement structure, and the struggle APPs face to strike a balance with current care.Conclusion: This study demonstrates that implementing an APP model of care is challenging, in part, because the deployment of APP does not sufficiently align with the core values of GPs, while GPs appear reluctant to hand over control of elements of patient care to APPs. APPs do not appear to have ownership over the implementation, given their strong dependence on the practice, values and needs of GPs.Trial Registration: Ethical approval was obtained from the Medical Ethics Committee of VU University Medical Centre in Amsterdam; reference number 2020.17 . All participants were asked to provide written informed consent prior to participating in the study. [ABSTRACT FROM AUTHOR]

Introduction. Dr Ian McWhinney argued that the behaviour of patients should be classified in parallel with the taxonomy of disease. Therefore, he proposed a Taxonomy of Patient Behaviour, taking the doctor–patient contact as the reference point. Aim. To assess McWhinney’s Taxonomy of Patient Behaviour and explore its associations with patient age and gender, type, modality and the weekday of the appointment, in the context of the coronavirus disease 2019 (COVID-19) pandemic. Methods. This was a cross-sectional study in a Community Health Centre in Florianópolis, Brazil. We retrospectively collected data from electronic medical records and analysed 4 consecutive weeks of our clinical encounters where every appointment had the patient’s motivation for seeking their medical appointment coded as: ‘limit of tolerance’, ‘limit of anxiety’, ‘heterothetic’, ‘administrative’, or ‘no illness’. Results. There were 647 appointments. The frequencies of the taxonomic classifications were: 27.8% ‘administrative’, 26.6% ‘limit of tolerance’, 21.8% ‘limit of anxiety’, 18.1% ‘no illness’, and 5.7% ‘heterothetic’. Female patients had more consultations classified as ‘heterothetic’ and ‘limit of anxiety’. ‘Limit of tolerance’ and ‘heterothetic’ were more frequent in face-to-face appointments than in remote (on-line) consultations, and most of the ‘limit of anxiety’ consultations were same-day appointments. The average patient age was slightly higher on appointments classified as ‘heterothetic’ and lower on ‘limity of anxiety’ appointments. Discussion. The COVID-19 pandemic may have influenced the higher ‘administrative’ and ‘limit of anxiety’ frequency presentations. We hope to encourage other family doctors to adopt this system during their consultations and teaching functions and, perhaps, inspire more complex investigations. [ABSTRACT FROM AUTHOR]

Background: Chronic low back pain is considered to be one of the main causes of absenteeism from work and primary and specialized consultations. The symptoms of nonspecific chronic low back pain may be accompanied by the activation of myofascial trigger points in the muscles, together with local and/or referred pain. Electrical dry needling is increasingly used in the treatment of lumbar myofascial pain. Conventional physiotherapy, however, is a popular approach to chronic pathologies, and there is evidence of different modalities of physiotherapy being used in the treatment of chronic low back pain. The aim of this study has been to determine the effectiveness of electrical dry needling versus conventional physiotherapy when applied to active and latent myofascial trigger points in patients with nonspecific chronic low back pain.Methods: This is a controlled, randomized, two-arm, double-blind study. A total of 92 patients with chronic low back pain (time to onset ≥ 3 months, Roland Morris Disability Questionnaire score ≥ 4) will be recruited from the University of Almería. Participants will be divided into two study groups (n = 40) to receive treatment of low back pain with electrical dry needling and conventional physiotherapy (ischaemic compression, analytic stretching and postural education training dossier). A total of 6 sessions will be administered once a week for 6 weeks. Pain intensity, disability, fear of movement, quality of life, quality of sleep, anxiety and depression, pressure pain threshold, abdominal strength and lumbar mobility will be recorded at 6 weeks (post-immediate) and 2 months after the end of treatment.Discussion: We believe that an approach including electrical dry needling to chronic low back pain dysfunction will be more effective in these patients. The results of this study will inform clinicians on which type of treatment is more beneficial for patients with chronic low back pain.Trial Registration: ClinicalTrials.gov NCT04804228. Registered on 14 January 2021. [ABSTRACT FROM AUTHOR]

Introduction: Primary care providers and community volunteers have important roles in supporting patient system navigation and utilization of community-based health and social services (CBHSS). This study aimed to explore the experiences and impacts of system navigation in a complex intervention supporting older adults. Methods: We used a convergent mixed methods design. Participants included primary care team members (n = 67), community volunteers (n = 38), and programme clients (n = 128) across six communities in Ontario, Canada. Data sources included focus groups, interviews, system navigation function survey for volunteers, CBHSS use survey for clients, and implementation data on CBHSS recommended by providers and volunteers and used by clients. Results: Results showed the different patterns of how CBHSS categories were recommended and ultimately used. Exercise-related CBHSS were both recommended and used, independence-related CBHSS were mostly only recommended with less uptake, and chronic health condition and diet/nutrition CBHSS were most often used by clients. Discussion: Primary care teams' practice of system navigation was impacted by programme participation, including through learning about local CBHSS. However, volunteers felt more confident in tasks that did not include connecting to CBHSS. The programme did seem to result in many referrals, though the actual client uptake tended to be to more clinical rather than healthy lifestyle resources. [ABSTRACT FROM AUTHOR]

Copyright of Revista Colombiana de Psicología is the property of Universidad Nacional de Colombia, Departamento de Psicologia 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.)

Public healthcare crises are extremely critical to any health care system in the world, to the well-being of society and the nations of individual countries, to the economic performance and national security of each state on the world map. The unprecedented global health emergency, which began in 2019 and completely subjugated all economic and political processes in 2020, proved that public authorities around the world are reorienting their priorities due to a pandemic that has led to an unprecedented crisis in public healthcare. That is why last two years, the main research efforts of the scientific community in the field of crisis knowledge and management has been focused on the unprecedented global public health crisis caused by the SARS-Cov-19. The scientific resources on the subject are numerous and open, but at the moment they are still focused on searching the medical solution to the disease and the non-medical interventions to overcome the pandemic. Predominant emphasis of the COVID-19 epidemic is that it is a unique experience in highlighting the role of knowledge and research in addressing global public health crises and that it is an opportunity for research systems to improve and uphold the importance of their existence, being adequately responsible for overcoming the crisis. And it is the lesson of the COVID-19 pandemic that provide a broad basis for discussing and seeking the most appropriate approaches to show, through research and studies, how regulation, policy and joint efforts can support the timely establishment and preparedness for adequate crisis response in public healthcare and how to mitigate and cope with them. A comprehensive study of public health crises definitions, reasons and types requires an understanding of how different crises affect different dimensions of an organization or system at different stages of their development. The unusual and complex nature of crises makes them difficult to systematical study. Because of these challenges, there is limited empirical research on the nature of crises and how an organization, especially in public healthcare, can prepare for and deal with them effectively. The article provides an overview of the existing literature on the organizational crisis and the limitations of this literature. 47 references has been reviewed to provide a theoretical basis for the study of crises in public administration and public healthcare, focusing mainly on the definitions, typology and reasons for their occurrence, described in the scientific literature. [ABSTRACT FROM AUTHOR]

Type 2 diabetes mellitus (T2DM) is a chronic progressive disorder and is associated with significant morbidity and mortality. The concept of T2DM remission and the reversal of diabetic parameters to normal levels has been gaining momentum over the past years. T2DM remission is increasingly being recognized by various global guidelines. Multiple models have been developed and validated for quantifying the extent of remission achieved. Based on favorable clinical evidence, T2DM remission can be considered as the therapeutic goal in diabetes management and, in select cases, as an alternative to expensive treatment options, which can be burdensome as T2DM progresses. This narrative review discusses the available strategies, such as lifestyle interventions, physical activity, bariatric surgery, medical nutrition therapy, and non-insulin glucose-lowering medications, for achieving T2DM remission. Although the concept of T2DM remission has emerged as a realworld option, effective implementation in routine clinical practice may not be feasible until long-term studies prove the efficacy of different approaches in this regard. [ABSTRACT FROM AUTHOR]

Introduction: Screening, a routine procedure done on individuals with or without disease, results in the early detection of disease. The aim of this study was to assess healthcare professionals' (HCPs) level of knowledge related to and the adherence to screening. Methods: A survey was conducted in HCPs, using a self-administered questionnaire. Knowledge was defined based on the correct or incorrect responses to the questions. Adherence to screening was considered if a test was done at least once in the past one year. Results: Of the 379 participants, 61% were nurses, 34% physicians, and 5% pharmacists. The majority 68.78% were female. The average age of pharmacists was 29.17± 7.09, physicians 35.57± 10.08, and nurses 35.46± 8.63 years. The knowledge related to breast cancer screening ranged between 50% and 57% and of a Pap smear, 41– 54%. 94% nurses and 90% pharmacists had recorded an incorrect response to the required age of colon cancer screening. The overall screening adherence to diabetes was 46%, hypertension 68%, liver profile 43%, lipid profile 50%, breast cancer 10.38%, Pap smear 26%, prostate cancer 33%, and colon cancer 2.37%. HCPs aged ≥ 45 years had good adherence to diabetes screening. Pharmacists (88%) had the highest level of adherence to hypertension screening. Female HCPs poorly adhered to breast 38% and cervical cancer 26% screening. Only a third 33% of males, aged > 50 years, were screened for prostate cancer. Among HCPs aged ≥ 50 years (n=32), only three were screened for colon cancer. Conclusion: Despite the increased incidence of diabetes, breast and colon cancer in Saudi Arabia, HCPs displayed poor knowledge related to screening. The adherence to diabetes screening was good. However, HCPs in a high-risk group displayed poor adherence to screening, specifically for breast, cervical and colon cancer. The medical and cancer screening guidelines should be made available to all HCPs regardless of their specialty. [ABSTRACT FROM AUTHOR]

Addressing global mental health is a major 21st-century challenge. Current treatments have recognized limitations; in this context, new ones that are prophylactic and effective across diagnostic boundaries would represent a major advance. The view that there exists a core of transdiagnostic overlap between psychiatric disorders has re-emerged in recent years, and evidence that psychedelic therapy holds promise for a range of psychiatric disorders supports the position that it may be transdiagnostically effective. Here, we propose that psychedelic therapy's core, transdiagnostically relevant action lies in its ability to increase neuronal and mental plasticity, thus enhancing the potential for change, which we consider to be a key to its therapeutic benefits. Moreover, we suggest that enhanced plasticity via psychedelics, combined with a psychotherapeutic approach, can aid healthy adaptability and resilience, which are protective factors for long-term well-being. We present candidate neurological and psychological markers of this plasticity and link them with a predictive processing model of the action of psychedelics. We propose that a model of psychedelic-induced plasticity combined with an adequate therapeutic context has prophylactic and transdiagnostic potential, implying that it could have a broad, positive impact on public health. [ABSTRACT FROM AUTHOR]

Copyright of Gaceta Médica de Caracas is the property of Academia Nacional de Medicina 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.)

Background: Telephone triage is used to facilitate efficient and adequate acute care allocation, for instance in out-of-hours primary care services (OPCSs). Remote assessment of health problems is challenging and could be impeded by a patient's ambiguous formulation of his or her healthcare need. Socioeconomically vulnerable patients may experience more difficulty in expressing their healthcare need. We aimed to assess whether income differences exist in the patient's presented symptoms, assessed urgency and allocation of follow-up care in OPCS.Method: Data were derived from Nivel Primary Care Database encompassing electronic health record data of 1.3 million patients from 28 OPCSs in 2017 in the Netherlands. These were linked to sociodemographic population registry data. Multilevel logistic regression analyses (contacts clustered in patients), adjusted for patient characteristics (eg, age, sex), were conducted to study associations of symptoms, urgency assessment and follow-up care with patients' income (standardised for household size as socioeconomic status (SES) indicator).Results: The most frequently presented symptoms deduced during triage slightly differed across SES groups, with a larger relative share of trauma in the high-income groups. No SES differences were observed in urgency assessment. After triage, low income was associated with a higher probability of receiving telephone advice and home visits, and fewer consultations at the OPCS.Conclusions: SES differences in the patient's presented symptom and in follow-up in OPCS suggest that the underlying health status and the ability to express care needs affect the telephone triage process . Further research should focus on opportunities to better tailor the telephone triage process to socioeconomically vulnerable patients. [ABSTRACT FROM AUTHOR]

Background: Hospitalisations for Ambulatory Care Sensitive Conditions (ACSC) cause harm to users and to health systems, as these events are potentially avoidable. In 2009, Portugal was hit by an economic and financial crisis and in 2011 it resorted to foreign assistance ("Memorandum of Understanding" (2011-2014)). The aim of this study was to analyse the association between the Troika intervention and hospitalisations for ACSC.Methods: We analysed inpatient data of all public NHS hospitals of mainland Portugal from 2007 to 2016, and identified hospitalisations for ACSC (pneumonia, chronic obstructive pulmonary disease, hearth failure, hypertensive heart disease, urinary tract infections, diabetes), according to the AHRQ methodology. Rates of hospitalisations for ACSC, the rate of enrollment in the employment center and average monthly earnings were compared among the pre-crisis, crisis and post-crisis periods to see if there were differences. A Spearman's correlation between socioeconomic variables and hospitalisations was performed.Results: Among 8,160,762 admissions, 892,759 (10.94%) were classified as ACSC hospitalizations, for which 40% corresponded to pneumonia. The rates of total hospitalisations and hospitalisations for ACSC increased between 2007 and 2016, with the central and northern regions of the country presenting the highest rates. No correlations between socioeconomic variables and hospitalisation rates were found.Conclusions: During the period of economic and financial crisis based on Troika's intervention, there was an increase in potentially preventable hospitalisations in Portugal, with disparities between the municipalities. The high use of resources from ACSC hospitalisations and the consequences of the measures taken during the crisis are factors that health management must take into account. [ABSTRACT FROM AUTHOR]

Copyright of Salud Colectiva is the property of Instituto de Salud Colectiva Universidad Nacional de Lanus 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.)

Copyright of Revista Baiana de Enfermagem is the property of Universidade Federal da Bahia 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.)