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Evidence is sparse on how community-based health-promoting programs can be culturally adapted for racially minoritized, immigrant older adult populations. Choose to Move (CTM) is an evidence-based health-promoting program that enhances physical activity and mobility and diminished social isolation and loneliness in older adults in British Columbia, Canada. However, racially minoritized older adults were not reached in initial offerings. We purposively sampled CTM delivery staff (n = 8) from three not-for-profit organizations, in Metro Vancouver, British Columbia, that serve Chinese older adults. We used semistructured interviews, ethnographic observations, and meeting minutes to understand delivery staff's perspectives on factors that influence CTM adaptations for Chinese older adults. Deductive framework analysis guided by an adaptation framework, Framework for Reporting Adaptations and Modifications-Enhanced, found three dominant cultural- and immigration-related factors influenced CTM adaptations for Chinese older adults: (a) prioritizations, (b) familiarity, and (c) literacy. Findings may influence future program development and delivery to meet the needs of racially minoritized older adult populations. [ABSTRACT FROM AUTHOR]

Specialize? Diversify? Do patients care? The authors investigate the demand-side effects of a hospital's portfolio strategy, which entails decisions about the depth and breadth of its service offerings. Positing that both depth (focus) and breadth (related focus) signal expertise, the authors use both archival and experimental evidence to examine these effects. The archival study is based on Florida's State Inpatient Databases for 2006–2015 and spans all major departments in health care delivery. The empirical analysis exploits plausible exogenous variation from other health care markets and reveals that patient choice is positively influenced by a hospital's depth (focus) and breadth (related focus) of expertise in a department. Complementing the archival evidence, the authors also conducted online experiments to examine the signaling effects of hospital portfolio strategy on patient choice behavior. The results provide support for the idea that hospital portfolio strategy influences patients' perceptions of hospital expertise in focal and related areas and, subsequently, their choice behavior. The authors also highlight potential synergistic effects between focus and related focus and heterogeneity in the effects across departments, payer types, and hospital profit status. These findings underscore the need for managers to adopt a targeted approach to portfolio decisions in health care. [ABSTRACT FROM AUTHOR]

The prevalence and attributable risk of disease due to physical inactivity require it to be made a public health priority. Public health planning allows for prioritization and resource allocation, particularly at the state and local levels. The extent to which state planning efforts for physical activity exist in the United States is unknown. The purpose of this paper is to describe the scope in which physical activity is incorporated in state-level public health plans in the United States, with an emphasis on alignment with the national guidelines and the National Physical Activity Plan. A standardized internet search audit was developed and conducted for each of 50 US states and the District of Columbia between May 2017 and January 2018 to determine the prevalence and characteristics of health planning documents that include physical activity. Data abstracted for analysis used a standardized search protocol that included the components of the Physical Activity Guidelines for Americans and the US National Physical Activity Plan. Results found that most states had between 4 and 6 chronic disease prevention and control plans that mention physical activity; however, it was inconsistently aligned with recommendations from both the Guidelines and the National Plan. Only 2 states had stand-alone public health planning documents explicitly dedicated to physical activity promotion. No state planning documents addressed children and adolescents, adults, and older adults simultaneously. To be maximally effective, state public health planning for physical activity should be made a priority and these efforts should align as much as possible with current guidance from the Physical Activity Guidelines for Americans and the US National Physical Activity Plan. [ABSTRACT FROM AUTHOR]

In 2016, the Bloomberg Philanthropies Data for Health initiative assisted the Philippine Statistical Authority in implementing Iris, an automated coding software program that enables medical death certificates to be coded according to international standards. Iris was implemented to improve the quality, timeliness, and consistency of coded data as part of broader activities to strengthen the country's civil registration and vital statistics system. This study was conducted as part of the routine implementation of Iris to ensure that automatically coded cause of death data was of sufficient quality to be released and disseminated as national mortality statistics. Data from medical death certificates coded with Iris between 2017 and 2019 were analysed and evaluated for apparent errors and inconsistencies, and trends were examined for plausibility. Cause-specific mortality distributions were calculated for each of the 3 years and compared for consistency, and annual numeric and percentage changes were calculated and compared for all age groups. The typology, reasons, and proportions of records that could not be coded (Iris 'rejects') were also studied. Overall, the study found that the Philippine Statistical Authority successfully operates Iris. The cause-specific mortality fractions for the 20 leading causes of death showed reassuring stability after the introduction of Iris, and the type and proportion of rejects were similar to international experience. Broadly, this study demonstrates how an automated coding system can improve the accuracy and timeliness of cause of death data—providing critical country experiences to help build the evidence base on the topic. [ABSTRACT FROM AUTHOR]

Background: Disasters can cause casualties and significant financial loss. In accordance with the Sendai Framework for Disaster Risk Reduction, areas affected by disasters must be built back better. Accurate post-disaster damage and loss assessments are critical for the success of recovery programs. This scoping review aimed to identify the components and entities of the healthcare sector's post-disaster damage and loss assessment program. Methods: An comprehensive search for relevant literature was performed using several databases, including the Web of Science, PubMed, Scopus, ProQuest, and Magiran. The search was limited to papers published between 2010 and 2022. In addition, we searched the grey literature for resources related to post-disaster damage and loss assessments. Study selection and data extraction were evaluated by a third reviewer. The main themes were determined through a consensus process and agreement among team members. Results: A total of 845 papers were identified, 41 of which were included in the review. The grey literature search yielded 1015 documents, 23 of which were associated with the study's purpose. The findings were classified into five main themes, 20 subthemes, and 876 codes. The main-themes include the following: Concepts and Definitions; Post-Disaster Damage and Loss Assessment Procedures; Healthcare sector procedures; Assessments Tools, and Methods; Intra-sectoral, Inter-sectoral, and cross-cutting issues. Conclusions: The existing corpus of literature on post-disaster damage and loss assessment programs within the healthcare sector offers only limited insights into the entities and components involved. It is of great importance that stakeholders have an extensive grasp of these pivotal concepts and principles, as they are fundamental in enabling effective responses to disasters, informed decision-making, and facilitating rehabilitation and reconstruction efforts. Consequently, there is a considerable scope for further investigation in this area. Scoping review registration number: https://osf.io/nj3fk. [ABSTRACT FROM AUTHOR]

Breaking infection chains requires not just behaviours that allow individuals to stay healthy and uninfected (i.e. health protective behaviours) but also for those who are possibly infected to protect others from their harboured infection risk (i.e. socially responsible behaviours). However, socially responsible behaviours entail costs without clear, immediate benefits to the individual, such that public health‐risking lapses occur from time to time. In this important yet understudied area, the current exploratory study sought to identify possible psychological factors that may affect people's likelihood of engaging in socially responsible behaviours. Assuming that self‐perceived infection should provide an impetus to engage in socially responsible behaviours, we contend that lapses could occur in two scenarios: discounting of possible infection or prioritizing self‐interest over collective good. Through a vignette portraying COVID‐19 relevant symptoms presented to culturally diverse participants (Singapore and United States; N = 645), we found dispositional denialism (an ego defence mechanism) to exert a negative indirect effect on likelihood of engaging in socially responsible behaviours through its negative association with perceived infection status. Further, social value orientation and cultural orientation appeared to significantly moderate the positive association between perceived infection status and the likelihood of engaging in socially responsible behaviours, such that the positive association held only when individuals espouse both a prosocial value orientation and a collectivistic cultural orientation. Further analyses also point toward a possible attenuation of this positive association when individuals espouse a vertical cultural orientation. Future directions and implications for public health management are discussed. [ABSTRACT FROM AUTHOR]

Objective: Death from tuberculosis or HIV among people from racial and ethnic minority groups who are aged <65 years is a public health concern. We describe age-adjusted, absolute, and relative death rates from HIV or tuberculosis from 2011 through 2020 by sex, race, and ethnicity among US residents. Methods: We used mortality data from the Centers for Disease Control and Prevention online data system on deaths from multiple causes from 2011 through 2020 to calculate age-adjusted death rates and absolute and relative disparities in rates of death by sex, race, and ethnicity. We calculated corresponding 95% CIs for all rates and determined significance at P <.05 by using z tests. Results: For tuberculosis, when compared with non-Hispanic White residents, non-Hispanic American Indian or Alaska Native residents had the highest level of disparity in rate of death (666.7%). Similarly, as compared with non-Hispanic White female residents, American Indian or Alaska Native female residents had a high relative disparity in death from tuberculosis (620.0%). For HIV, the age-adjusted death rate was more than 8 times higher among non-Hispanic Black residents than among non-Hispanic White residents, and the relative disparity was 735.1%. When compared with non-Hispanic White female residents, Black female residents had a high relative disparity in death from HIV (1529.2%). Conclusion: Large disparities in rates of death from tuberculosis or HIV among US residents aged <65 years based on sex, race, and ethnicity indicate an ongoing unmet need for effective interventions. Intervention strategies are needed to address disparities in rates of death and infection among racial and ethnic minority populations. [ABSTRACT FROM AUTHOR]

Logic modelling is used widely in health promotion planning for complex health and social problems. It is often undertaken collaboratively with stakeholders across sectors that hold and enact different institutional approaches. We use hermeneutic philosophy to explore how knowledge is 'lived' by – and unfolds differently for – cross-sectoral stakeholders during comprehensive primary healthcare service planning. An Organisational Action Research partnership was established with a non-government organisation designing comprehensive primary health care for individuals experiencing homelessness in Adelaide, Australia. Grey literature, stakeholder input, academic feedback, a targeted literature review and evidence synthesis were integrated in iterative cycles to inform and refine the logic model. Diverse knowledge systems are active when cross-sectoral stakeholders collaborate on logic models for comprehensive primary health care planning. Considering logic modelling as a hermeneutic praxis helps to foreground and explore these differences. In our case, divergent ideas emerged in how health/wellbeing and trust were conceptualised; language had different meanings across sectors; and the outcomes and data sought were nuanced for various collaborators. We explicate these methodological insights and also contribute our evidence-informed, collaboratively-derived model for design of a comprehensive primary health care service with populations experiencing homelessness. We outline the value of considering cross-sectoral logic modelling as hermeneutic praxis. Engaging with points of difference in cross-sectoral knowledge systems can strengthen logic modelling processes, partnerships and potential outcomes for complex and comprehensive primary health care services. [ABSTRACT FROM AUTHOR]

Background: People with intellectual disabilities living in group homes often have complex health needs, are high health service users and need support from their service provider to access health services. In Australia, little is known about the types and amounts of these supports. Methods: A case study was conducted on a large Western Australian disability provider of group homes to 160 people with intellectual disability. Over an 18‐month period, including during the COVID‐19 pandemic, the study quantified health service use in hospital‐ and community‐based settings, ways by which the person was supported to access health care and the impact on other people supported by the provider. Economic costs of supporting access to health services were estimated. Findings: Overall, the disability provider supported 160 people in accessing health services an average of 23 times each (n = 3617, median = 20, interquartile range = 10–33) over the 18 months. Support included staff attending with the person (96%), following up with guardian/decision‐maker (50%), additional resourcing via overtime or staff backfills (6%) and transport (94%). The average cost of supporting one health visit was estimated at $78.51 AUD (2021). Impact on the person's household included loss of opportunity for housemates (30%), reduced supervision within the home (79%) and longer timeframes to complete care needs (32%). The impact of COVID‐19 restrictions saw a reduction in allied and mental health service use that did not return to prepandemic levels following the cessation of restrictions. Primary care, specialist, outpatient, pathology and emergency service use was also lower in the postrestriction period compared to the prepandemic period. Conclusions: For people living in group homes, the disability provider plays an essential role in supporting health service access, primarily through the provision of support staff and transport. The change in health service utilisation following the COVID‐19 restriction period indicates that altered health system priorities can potentially exacerbate access inequality for people with intellectual disability. Accessible summary: People with intellectual disability frequently need support to go to a health service.Our study looked at how people in group homes receive this support.We found that after COVID‐19 restrictions, people received fewer health services.This is important as we need to make sure that people receive the health services that they need. [ABSTRACT FROM AUTHOR]

Dementia is a global public health challenge, and its impact on Portugal is yet unclear. This study forecasts dementia prevalence in Portugal until 2080. Using the Gonçalves-Pereira et al (2021) method, we estimated dementia cases among older adults (≥65 years) in the community. Applying age-sex specific prevalence rates of the Gonçalves-Pereira study to population projections for Portugal between 2020-2080, based on the 10/66 Dementia Research Group criteria (10/66 DRG) and the Diagnostic and Statistical Manual of Mental Disorders IV criteria (DSM-IV), to Portugal's population projections (2020-2080) under various growth scenarios (low, medium, and high). We anticipate a more than 2-fold increase in dementia prevalence from 2020 to 2080, both for 10/66 DRG [2.1%-5.0%] and DSM-IV [.8%–2.0%]. By 2080, those aged ≥80 years are projected to constitute 75.0% (vs 59.0% in 2020) of all dementia cases, particularly affecting women. Addressing dementia growth in Portugal calls for a comprehensive global response, while country-level estimates facilitate informed public health planning, policy-making, and resource allocation. [ABSTRACT FROM AUTHOR]

Public Health Consortiums (PHC) in Brazil represent a strategy to enhance regionalization in the Public Health Care System (SUS in Portuguese) and State/interstate/intermunicipal cooperation. The establishment of regional polyclinics aims to improve access to services with greater technological concentration and closer to users’ homes. This study specifically aims to analyze the process of creating PHC and regional polyclinics in Bahia State, based on documental analysis, identifying aspects related to entering the political agenda that facilitate and hinder, the role of state administration, specificities of the composition of these PHC and regional polyclinics. A documental analysis was carried out of the minutes of the Comissão Intergestores Bipartite (CIB-BA) [Bipartite Administrative Commission] from 2015 to 2018 and of constitutive documents of the consortiums established in this state. The Ceará State experience inspired the creation of consortiums in Bahia, especially the structuring of polyclinics. Municipal administrators demonstrated a favorable position regarding the potential of consortiums with cooperation among municipalities. The role of the state government proved to be a facilitating condition, whereas the maintenance of the municipal counterpart in finance constituted a hindering element. The consortiums contributed to the regionalization of health in the state as well as expansion of access to specialized care. [ABSTRACT FROM AUTHOR]

Background: A significant portion of South Korea's population, approximately a quarter, owns pets, with dogs being the most popular choice among them. However, studies analyzing the fecal organism communities of dogs in South Korea are lacking, and limited efforts have been exerted to identify pathogens with potential zoonotic implications. Therefore, this study aimed to investigate potential pathogens using metabarcoding analysis and evaluate the risk of zoonotic diseases in dog feces in Seoul, South Korea. Methodology: Fecal samples were collected from both pet and stray dogs in the Mapo district of Seoul. Next-generation sequencing (NGS) was utilized, employing 16S rRNA amplicon sequencing to identify prokaryotic pathogens, and 18S rRNA amplicon sequencing for eukaryotic pathogens. The data obtained from the QIIME2 pipeline were subjected to various statistical analyses to identify different putative pathogens and their compositions. Principal findings: Significant variations in microbiota composition were found between stray and pet dogs, and putative prokaryotic and eukaryotic pathogens were identified. The most prevalent putative bacterial pathogens were Fusobacterium, Helicobacter, and Campylobacter. The most prevalent putative eukaryotic pathogens were Giardia, Pentatrichomonas, and Cystoisospora. Interestingly, Campylobacter, Giardia, and Pentatrichomonas were found to be significantly more prevalent in stray dogs than in pet dogs. The variation in the prevalence of potential pathogens in dog feces could be attributed to environmental factors, including dietary variances and interactions with wildlife, particularly in stray dogs. These factors likely contributed to the observed differences in pathogen occurrence between stray and pet dogs. Conclusions/Significance: This study offers valuable insights into the zoonotic risks associated with dog populations residing in diverse environments. By identifying and characterizing putative pathogens in dog feces, this research provides essential information on the impact of habitat on dog-associated pathogens, highlighting the importance of public health planning and zoonotic risk management. Author summary: The ownership of pets, especially dogs, is widespread in South Korea, with millions of people choosing them as companions. However, there is a lack of research on the composition of organisms from dog feces and the identification of potential disease-causing pathogens that can affect both dogs and humans. Understanding these risks is crucial as many infectious diseases can be transmitted from animals to humans. In this study, we used metabarcoding techniques to analyze the fecal organisms of pet and stray dogs in Seoul, South Korea. We found significant differences in the microbiota composition between stray and pet dogs, and we identified putative bacterial pathogens, such as Helicobacter, Campylobacter, and Fusobacterium, and eukaryotic pathogens, such as Giardia, Pentatrichomonas, and Cystoisospora. The prevalence of these putative pathogens was higher in stray dogs compared to pet dogs. These findings emphasize the importance of public health planning and zoonotic disease control, particularly in densely populated urban areas where the risk of zoonotic pathogens associated with dogs is amplified. It is crucial to educate pet owners and the general public about the potential risks associated with exposure to dog feces and contaminated environments. [ABSTRACT FROM AUTHOR]

Background. Despite existing evidence on the efficacy of cardiac rehabilitation (CR), programs are underutilized. Factors affecting referral and enrolment in hospital‐based CR were identified; however, research into factors affecting referral and enrolment in community‐based CR is lacking. Aim. The purpose of this scoping review is to identify and synthesize facilitators and challenges in the transition of patient care from hospital to community healthcare services and how they influence CR referral and enrolment. Method. PubMed, Embase, CINAHL, Scopus, ProQuest, and Web of Science databases were searched for relevant publications. The data were analysed using thematic analysis by Braun and Clarke. The study followed the PRISMA extension for scoping reviews and the Joanna Briggs Institute's model. Result. In total, 36 studies were included in this analysis. The results show that facilitators and challenges for referral and enrolment in CR form a complex interaction. Factors influencing referral and enrolment may be setting‐dependent or ‐independent. However, each setting may influence the entire transition. Conclusion. The patient decision‐making process regarding CR may begin in the hospital, indicating that this period is the right time to encourage CR enrolment. To support patient transition, healthcare professionals at hospitals require knowledge of CR and the ability to prioritize patient support. Offering an initial meeting at a local site may decrease patient prejudice and facilitate enrolment. [ABSTRACT FROM AUTHOR]

Post COVID-19 Condition (PCC) is a clinical syndrome following COVID-19 disease. PCC symptoms in adults entail significant productivity loss and reduced quality of life. This study aimed at estimating the epidemiological and economic burden of PCC among the working-age population of Italy and the US. This ecological analysis was conducted on data from January 2020 to April 2023, regarding population aged 18–64. PCC incidence for the US was retrieved from publicly reported estimates, while for Italy it was estimated from COVID-19 cases. Prevalence of factors associated with PCC and parameters to calculate temporary productivity losses (TPL) were retrieved. An estimated incidence rate ratio (eIRR) of PCC incidence in Italy and the US was calculated. TPL for reduced earnings and total quality-adjusted life years (QALYs) lost were also estimated. The ecological eIRR Italy/US was 0.842 [95%CI 0.672–1.015], suggesting that, holding COVID-19 cases constant, 15.8% fewer PCC cases have occurred in Italy compared to the US. Overall PCC cases were found to be 12.0 [95%CI 9.9–14.1] million in the US, with 1.9 [95%CI 1.6–2.3] million QALYs lost, and 2.4 [95%CI 1.8–3.0] million in Italy, with 0.4 [95%CI 0.3–0.5] million QALYs lost. Up to April 2023, the TPL was estimated to be Int$7.5 [95%CI 5.8–10.1] billion in Italy and $41.5 [95%CI 34.3–48.7] billion in the US. PCC has had a significant epidemiological and economic impact on the working-age population. The findings from this study may be of use for health planning and policy regarding PCC in working-age adults. [ABSTRACT FROM AUTHOR]

Patients living with multiple myeloma (MM) have a substantial disease burden and face multiple barriers to care. Building upon our previous research using mixed methods, this focus group research aimed to identify patients' priorities regarding specific social and identity-related needs, map these prioritized needs to the disease journey, and describe patient-generated ideas to improve patient support. Participants noted that patients with MM need a range of emotional, social, and financial support throughout the disease journey. They identified initial MM diagnosis and treatment adherence as two critical points in the MM journey where patients need the most support and assistance. The findings of this research suggest that overall, patients with MM need comprehensive support, ideally from a multidisciplinary team consisting of health care providers, patient advocates, social workers, and psychologists to help patients understand their disease and treatment options, make informed treatment decisions, adhere to treatment, and ultimately reduce their disease burden and improve outcomes. This research revealed that patients with MM need varying types and levels of support, with the most common needs including information on disease and treatment, connections to financial resources and support systems, assistance with navigating insurance options, and transportation and logistical support for medical appointments. [ABSTRACT FROM AUTHOR]

Background: For more than a decade, the Patient-Centered Medical Home model has been a guiding vision for the modernization of primary care systems. In Canada, Ontario's Family Health Teams (FHTs) were designed in the mid-2000s with the medical home model in mind. These primary care clinics aim to provide accessible, comprehensive, and person-centered primary care services to communities across Ontario. Their services typically include mental health care for people experiencing common mental disorders, such as depression and anxiety disorders. It remains unclear, however, whether the mental health care delivered within FHTs is consistent with person-centered care approaches. In the current study, we aimed to explore the perspectives of FHT providers on the care delivered to people with common mental disorders to determine whether, and to what extent, they believed this care was person-centered. Methods: We conducted a qualitative grounded theory study involving interviews with 65 health professionals and administrators from 18 FHTs across Ontario. Transcripts were coded using a three-step process of initial, focused, and axial coding that mixed inductive and deductive approaches informed by sensitizing concepts on person-centeredness. Results: Practices and challenges associated with the delivery of mental health care in a person-centered way were captured by several themes regrouped into five domains: (1) patient as unique person, (2) patient-provider relationship, (3) sharing power and responsibility, (4) connecting to family and community, and (5) creating person-centered care environments. FHT providers perceived that they delivered person-centered care by delivering mental health care that was responsive, flexible, and consistent with biopsychosocial approaches. They emphasized the importance of creating long-lasting relationships with patients grounded in empathy and trust. Their challenges included being able to ensure continuity of care, adequately prioritizing patients' mental health issues, and meaningfully engaging patients and families as partners in care. Conclusions: Our findings suggest that FHT providers have adopted a range of person-centered practices for people with common mental disorders. However, greater attention to practices such as shared decision making, supporting self-management, and involving families in care would strengthen person-centeredness and bring teams closer to the Patient-Centered Medical Home vision. [ABSTRACT FROM AUTHOR]

The aim of this paper is to contribute technical arguments to the debate about the importance of health examination surveys and their continued use during the post-pandemic health financing crisis, and in the context of a technological innovation boom that offers new ways of collecting and analysing individual health data (e.g. artificial intelligence). Technical considerations demonstrate that health examination surveys make an irreplaceable contribution to the local availability of primary health data that can be used in a range of further studies (e.g. normative, burden-of-disease, care cascade, cost and policy impact studies) essential for informing several phases of the health planning cycle (e.g. surveillance, prioritization, resource mobilization and policy development). Examples of the use of health examination survey data in the World Health Organization (WHO) European Region (i.e. Finland, Italy, Malta and the United Kingdom of Great Britain and Northern Ireland) and the WHO Region of the Americas (i.e. Chile, Mexico, Peru and the United States of America) are presented, and reasons why health provider-led data cannot replace health examination survey data are discussed (e.g. underestimation of morbidity and susceptibility to bias). In addition, the importance of having nationally representative random samples of the general population is highlighted and we argue that health examination surveys make a critical contribution to external quality control for a country's health system by increasing the transparency and accountability of health spending. Finally, we consider future technological advances that can improve survey fieldwork and suggest ways of ensuring health examination surveys are sustainable in low-resource settings. [ABSTRACT FROM AUTHOR]

People from refugee and asylum seeker backgrounds resettling in Australia often experience intersecting risks for poor mental and physical health. Physical activity can promote better health outcomes, however there are limited programs tailored for this population. Therefore, understanding how to support refugees and asylum seekers to engage in physical activity is crucial. This paper aims to describe how the experience-based co-design (EBCD) process was used to identify priorities for a new physical activity service for refugees and asylum seekers. Using an EBCD framework we conducted qualitative interviews and co-design workshops with service users (refugees and asylum seekers living in the community) and service providers at a community Centre in Sydney, Australia. Sixteen participants, including eight service users and eight service providers engaged in the EBCD process over 12-months. The interviews revealed common themes or 'touchpoints' including barriers and enablers to physical activity participation such as access, safety and competing stressors. Subsequent co-design focus groups resulted in the establishment of five fundamental priorities and actionable strategies; ensuring cultural and psychological safety, promoting accessibility, facilitating support to access basic needs, enhancing physical activity literacy and fostering social connection. Using EBCD methodology, this study used the insights and lived experiences of both service users and providers to co-design a physical activity service for refugees and asylum seekers which is safe, supportive, social and accessible. The results of the implementation and evaluation of the program are ongoing. [ABSTRACT FROM AUTHOR]

Around eight-out-of-ten survivors of domestic violence in Lithuania are women, and of those, eight-out-of-ten suffer violence specifically from their intimate partners (IPV). Women who experience IPV are at higher risk of having mental health conditions. This study aims to explore the perspectives of mental health and social care professionals regarding the provision of mental health support to IPV survivors in Lithuania. Four focus groups were conducted among 29 service providers from across the country. Audio-recordings were transcribed verbatim and analyzed thematically using MAXQDA software. The five main themes derived from the analysis reveal: 1) low levels of IPV awareness among IPV survivors who seek support with their mental health; 2) a lack of specialized training among professionals as a barrier to effective support; 3) a low prioritization on the national level; 4) little inter-sectoral collaboration which undermines the complexity of needed responses; 5) broader systemic problems. The provision of mental health support to IPV survivors lacks the recognition that IPV is gender-based violence and a major public (mental) health problem. The complexity of needed services is absent. Further research needs to explore the utilization of mental health services by IPV survivors and their perceptions concerning it. [ABSTRACT FROM AUTHOR]

Disease surveillance is an essential component of public health and a core function of National Public Health Institutes (NPHIs), including to better prepare and respond to infectious diseases outbreaks. Strengthening NPHIs in their efforts to establish and maintain efficient surveillance systems is an opportunity to ensure future outbreak preparedness and response; yet, guidance on how to increase and prioritise capacity building efforts is limited. This study sought to investigate approaches to capacity building and training for disease surveillance at national level and understand the potential role of NPHIs. Qualitative study. This is a qualitative study, based on a literature review and interviews undertaken between June and November 2022. Fifty seven in-depth interviews were conducted in five countries: Côte d'Ivoire, Ecuador, Madagascar, Namibia, and the Kingdom of Saudi Arabia. Participants included a range of professionals from government, NPHIs, academic institutions and the private sector. Interviews were thematically analysed. Selected countries varied in terms of their disease surveillance capacities, as well as in the structure of their surveillance systems and decision-making. Research identified shared priority areas for action at national level, identifying common challenges and opportunities: 1) capacity building, here specifically the need for a training agenda at national level to ensure sustainability and guide donor funded training offers; 2) data tools and technology-to help decision-makers select the best software tool to address countries' identified need; 3) data sharing-the need for clear data sharing standards and norms for national to international data sharing; and 4) genomic sequencing-the need for national genomic surveillance strategies and reporting guidelines. Addressing challenges and using opportunities to strengthen disease surveillance at national level is an important step to build capacity in this area and to help prevent future epidemic and pandemics globally. The findings of this study help decision-makers to identify priority areas for capacity building and understand the potential role and significance of NPHIs. [ABSTRACT FROM AUTHOR]

Background: Chronic obstructive pulmonary disease (COPD) significantly increases morbidity, mortality, and healthcare costs. Patients need enhanced resources to improve COPD symptoms, avoid exacerbations, and manage their medications. My COPD Action Plan, a worksheet developed by the American Lung Association (ALA), is designed to help patients develop a personalized self-management plan with their providers. Methods: This QI project, conducted at a rural primary care Federally Qualified Health Center (FQHC) as part of the author's Doctor of Nursing Practice (DNP) program requirements, included patients with COPD. Participants completed a preintervention COPD Assessment Test (CAT) and then, together with their provider, completed a personalized ALA COPD action plan. Office staff followed up with patients weekly for 8 weeks to inquire about their ability to follow their COPD action plans and forwarded patient issues to the primary care provider. Postintervention CAT scores were then obtained at a follow-up office visit. Changes in CAT scores were analyzed using descriptive statistics. Results: Seventeen patients met project requirements, consented to participate, and completed all the steps. Preintervention CAT scores ranged from 11 to 37, with a median score of 31. Postintervention CAT scores ranged from 3 to 28, with a median score of 17. The CAT categories that improved the most were chest tightness, activity limitation, and confidence in leaving the home. Conclusion: This project evaluates how use of the ALA's COPD-centered action plan improves patients' perceived COPD burden and reduces healthcare resource utilization. [ABSTRACT FROM AUTHOR]

Simple Summary: Over the last decade, optical sensors have demonstrated great potential to provide complementary data to monitor insect abundance. This article introduces a field-deployable and non-destructive optical instrument to monitor the abundance of flying insects, called an Entomological Bistatic Optical Sensor System, or eBoss. The study focuses on comparing abundance measurements made by the eBoss and physical traps over an 8-month field campaign. The eBoss made over 302,000 insect observations and evaluated the aerial density (#/m3) of all flying insects as well as specifically male and female mosquitoes with a 1 min resolution, allowing us to monitor both the abundance over the season and daily peak of activity. The study's objectives were to validate the optical sensor's data against physical trap collections, which confirmed the correlation between the two methods. However, the eBoss demonstrated superior temporal resolution (1 min versus approximately 3 days) and statistical power due to its larger sample size. These findings suggest that an eBoss can significantly enhance flying insect monitoring efforts, such as mosquitoes or pollinators, providing valuable insights for vector control strategies, agriculture and public health planning. Optical sensors have shown significant promise in offering additional data to track insect populations. This article presents a comparative study between abundance measurements obtained from a novel near-infrared optical sensor and physical traps. The optical instrument, named an Entomological Bistatic Optical Sensor System, or eBoss, is a non-destructive sensor operating in the near-infrared spectral range and designed to continuously monitor the population of flying insects. The research compares the mosquito aerial density (#/m3) obtained through the eBoss with trap counts from eight physical traps during an eight-month field study. The eBoss recorded over 302,000 insect sightings and assessed the aerial density of all airborne insects as well as male and female mosquitoes specifically with a resolution of one minute. This capability allows for monitoring population trends throughout the season as well as daily activity peaks. The results affirmed the correlation between the two methods. While optical instruments do not match traps in terms of taxonomic accuracy, the eBoss offered greater temporal resolution (one minute versus roughly three days) and statistical significance owing to its much larger sample size. These outcomes further indicate that entomological optical sensors can provide valuable complementary data to more common methods to monitor flying insect populations, such as mosquitoes or pollinators. [ABSTRACT FROM AUTHOR]

In western countries, palliative care is a part of the formal healthcare system, ruled by neoliberal, organisational ideas. This Danish study illuminates how nurses and patients with non-western immigrant backgrounds (inter)act in relation to encounters in palliative care settings. Two 'telling' cases were selected, based on interviews and participating observations from a multi-sited ethnographic field study in Denmark. The results showed different care consequences of the structural framework, referring to, for example, political healthcare logics, strategies, and priorities, and illuminated how neoliberally organised healthcare systems inflicted suffering on patients and frustration amongst professionals. It did not seem that the immigrant background per se induced the challenges. The understandings of care and treatment conflicted as nurses often represented a medical, neoliberal logic of disease, treatment, and care, and patients often represented a non-medical logic of disease, formed by their lives. When palliative care took place in a general setting, (inter)actions were also influenced by a curative agenda of treatment and care. The study added to the evidence of the power of neo-liberal rationality across different forms of care and populations, regardless of ethnicity or location of that care. [ABSTRACT FROM AUTHOR]

Aim: To catch a representative view of a multicultural population's needs. Design: Qualitative study. Methods: Semi‐structured interviews were conducted from July 2022 to January 2023 with the project's stakeholders, migrants, and residents. Data analysis was performed using a multimethod textual analysis technique. Findings: Territorial barriers, lack of social network, and specific professionals' training emerged as healthcare delivery obstacles. For migrants, language improvement emerged as a health priority. A deep relationship with migrants emerged as a deficiency for residents. Conclusion: A welcoming project equipped with solid leadership and the right resources can be fundamental in mediating health promotion and integration. In this process, the involvement of the resident population is essential. Implications for the Profession and/or Patient Care: Analysing the migrants' needs and the strengths and limitations of a reception system could help identify the challenges for professionals in delivering culturally competent care. In this context, the nurse's role becomes relevant, being responsible for taking charge and caring for the population and the link between professionals and the population. What Problem Did the Study Address?: The study addressed the problem of improving the overall health of migrants, refugees, and asylum seekers, mainly focusing on reception and integration into a new society process. What Were the Main Findings?: Worse health was identified with adaptation, integration, and family problems. Territorial barriers emerged, hindering good health. Where and on Whom Will the Research Have An Impact?: These research findings can be valuable for health professionals who want to improve the reception process and enhance a care model integrated with residents. Patient or Public Contribution: No patient or public contribution. Reporting Method: To describe the research report, we referred to the COREQ checklist (Tong et al., 2007). [ABSTRACT FROM AUTHOR]

Regional centres have smaller workforces in acute diabetes care compared to their metropolitan counterparts. A cross‐sectional audit performed at Albury Hospital identified a high prevalence (34%) of diabetes for inpatients compared with metropolitan centres. The high prevalence highlights the need for all healthcare services to consider appropriate resources for the management of diabetes in people admitted to hospital. [ABSTRACT FROM AUTHOR]

Introduction: The Finke Desert Race is an annual motorsport race (motorbikes, cars and buggies) held in Alice Springs resulting in a significant major trauma burden. This imposes unique challenges in one of the world's most remote healthcare settings. Objectives: To quantify the volume and characteristics of Finke Desert Race‐related trauma presenting to the Alice Springs Hospital. Design: A retrospective descriptive study was undertaken to review all patients presenting to the Alice Springs Hospital with Finke Desert Race‐related trauma over a 10‐year period. Information collected included demographic data, injury characteristics, patient disposition and required management. Findings: Over the 9 years the event was held, 325 patients were admitted to the Alice Springs Hospital. Patients were almost exclusively male (98.8%), with a mean age of 34.75 and residing outside of Alice Springs (82.2%). There were a total of 460 distinct injuries with the clavicle, spine and ribs the three most commonly injured sites. A total of 129 operations were required, of which 19 required retrieval to an interstate centre. Discussion: Alice Springs is one of the most remote and geographically isolated centres on Earth. This rurality poses unique challenges when trying to coordinate medical and retrieval services, exacerbated for a concentrated, yet highly resource intensive event such as Finke. It has far reaching impacts, placing additional stresses on all aspects of healthcare provision. Conclusion: This review has quantified the trauma burden of the event for the first time, enabling local and interstate stakeholders' ability to plan an adequate and sustainable response while also enabling the future effectiveness evaluation of recent safety reforms. [ABSTRACT FROM AUTHOR]

In many developing countries with surging vehicular traffic and inadequate traffic management, excessive road traffic noise exposure poses substantial health concerns, linked to increased stress, insomnia and other metabolic disorders. This study aims to assess the linkage between sociodemographic factors, traffic noise levels in residential areas and health effects using a cross-sectional study analyzing respondents' perceptions and reports. Noise levels were measured at 57 locations in Srinagar, India, using noise level meter. Sound PLAN software was employed to generate noise contour maps, enabling the visualization of noise monitoring locations and facilitating the assessment of noise levels along routes in proximity to residential areas. Correlation analysis showed a strong linear relationship between field-measured and modelled noise (r2 = 0.88). Further, a questionnaire-based survey was carried out near the sampling points to evaluate the association of ischemic heart disease with traffic noise. Residents exposed to noise levels (Lden > 60 dB(A)) were found to have a 2.24 times higher odds ratio. Compared to females, males reported a 16% higher prevalence of the disease. Multi-faceted policy strategies involving noise mapping initiatives, source noise standards, traffic flow urban mobility optimization, smart city initiatives and stringent litigatory measures could significantly reduce its detrimental impact on public health. Finally, this study envisions a region-specific strong regulatory framework for integrating noise pollution mitigation strategies into the public health action plans of developing nations. [ABSTRACT FROM AUTHOR]

People with diabetes receiving inpatient rehabilitation have multiple unique care needs. Although the condition, event, or disability resulting in admission to an inpatient rehabilitation facility (IRF) may not have a causal relationship with chronic conditions such as diabetes, the condition precipitating referral to IRF care may increase a person's risk for worsening cardiometabolic disease. Furthermore, diabetes management in the IRF setting may be complicated by stress hyperglycemia from illness and/or drug-induced hyperglycemia from the use of glucocorticoids or other offending medications. The availability of a multidisciplinary team of clinicians and therapists in the IRF setting holds great opportunity for development of robust diabetes care and education programs to optimize therapy, teach or reinforce diabetes self-management survival skills, and facilitate safe transitions of care to individuals' next setting of care. [ABSTRACT FROM AUTHOR]

The health benefits of regular physical activity (PA) in youth are well-documented. Yet the adherence rate to PA guidelines among youth worldwide is alarmingly deficient with only 19% of youth worldwide adhering to the World Health Organization guidelines. This is reflective of a global proliferation of a physical inactivity pandemic among youth. The negative consequences of physical inactivity on health are profound, as they threaten to persist into adulthood, exacerbating the burden of preventable health issues. There is persuasive evidence that vigorous PA generates physical fitness and health benefits surpassing those of low- or moderate-intensity activity in youth. In addition, indications show that the adherence rate to vigorous PA among youth exceeds that relative to for low- or moderate-intensity activity. As a result, promoting vigorous PA can help mitigate the global issue of low adherence to PA in youth. Therefore, in this Current Opinion paper, we argue that vigorous PA, compared to low or moderate-intensity activity, holds greater significance for youth's health and physical fitness. Additionally, the potential implications derived from the existing evidence regarding vigorous PA on the current guidelines for youth are discussed. Key Points: The health benefits of regular physical activity in youth are well-established. Yet the adherence rate to physical activity guidelines among youth worldwide is alarmingly deficient with around 80% of youth worldwide not adhering to the World Health Organization guidelines. Persuasive evidence derived from observational, controlled interventions, as well as narrative and systematic reviews with meta-analysis, indicate that vigorous physical activity generates positive effects exceeding those induced by low- or moderate-intensity activity on youth health and physical fitness. The next generation of physical activity recommendations should place a greater emphasis on the significance of vigorous physical activity for youth. [ABSTRACT FROM AUTHOR]

The World Health Organization (WHO) has approved a resolution on social participation in national health planning and implementation, allowing people, communities, and civil society to have a stronger voice in decisions that affect their health. The resolution aims to address health inequities and the erosion of trust in health systems, particularly in the face of challenges like climate change, conflicts, and pandemics. The WHO will work with member states to implement the resolution by providing guidance, support, and reporting progress. Additionally, the WHO will develop a global strategy for emergency, critical, and operative care, as well as strengthen mental health and psychosocial support in emergency response. The organization also celebrated the 50th anniversary of the Expanded Programme on Immunization (EPI) and emphasized the importance of health as a vital investment in economies. [Extracted from the article]

Background: Person-centered care (PCC) is critical in addressing the diverse health priorities of older adults. Nurses play a pivotal role in implementing PCC, yet the nuances of the nurse-patient relationship in outpatient settings remain underexplored. This study aimed to gain insights into nurses' experiences, challenges, and strategies in caring for older adults through the lens of PCC. Methods: A qualitative descriptive design was employed, involving semi-structured interviews with 12 registered nurses from outpatient clinics serving older adults. Thematic analysis was conducted following the principles of trustworthiness and credibility. Results: Five main themes emerged: (1)Understanding and Implementing Person-Centered Care (PCC) (2) Experiences in Older Adult Care, highlighting the significance of trust-building, adapting care approaches, interdisciplinary collaboration, and emotional rewards; (3) Challenges in Care Delivery, including resource constraints, navigating family dynamics, keeping up with medical advances, and emotional strain; (4) Impact on Care Quality, encompassing consistency in care, patient satisfaction, professional development, and ethical considerations; and (5) Coping Strategies, such as peer support, work-life balance, reflective practice, and resilience building. Conclusions: The study underscores the complexities and rewards of the nurse-patient relationship in caring for older adults in outpatient settings. Nurses face formidable challenges but employ various coping strategies to maintain high-quality, person-centered care. Findings have implications for nursing practice, education, policy, and future research, emphasizing the need for supportive environments, continuous professional development, and recognition of the critical role nurses play in addressing the health priorities of the aging population. [ABSTRACT FROM AUTHOR]

The primary objective of this study was to enhance the operational efficiency of the current healthcare system by proposing a quicker and more effective approach for healthcare providers to deliver services to individuals facing acute heart failure (HF) and concurrent medical conditions. The aim was to support healthcare staff in providing urgent services more efficiently by developing an automated decision-support Patient Prioritization (PP) Tool that utilizes a tailored machine learning (ML) model to prioritize HF patients with chronic heart conditions and concurrent comorbidities during Urgent Care Unit admission. The study applies key ML models to the PhysioNet dataset, encompassing hospital admissions and mortality records of heart failure patients at Zigong Fourth People's Hospital in Sichuan, China, between 2016 and 2019. In addition, the model outcomes for the PhysioNet dataset are compared with the Healthcare Cost and Utilization Project (HCUP) Maryland (MD) State Inpatient Data (SID) for 2014, a secondary dataset containing heart failure patients, to assess the generalizability of results across diverse healthcare settings and patient demographics. The ML models in this project demonstrate efficiencies surpassing 97.8% and specificities exceeding 95% in identifying HF patients at a higher risk and ranking them based on their mortality risk level. Utilizing this machine learning for the PP approach underscores risk assessment, supporting healthcare professionals in managing HF patients more effectively and allocating resources to those in immediate need, whether in hospital or telehealth settings. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this review is to summarize the impact of the multidisciplinary tumor board as a tool or mechanism for orthopedic oncology care, to highlight its evolution and changing role over time, to assess its strengths and weaknesses, and to report our institutional experience as an NCI-Designated Comprehensive Cancer Center. Methods: We reviewed the relevant literature about multidisciplinary tumor boards in orthopedic oncology, and summarized the articles to provide a summary of the topic. Additionally, we retrospectively reviewed our electronic medical records to analyze the distribution, characteristics, and numbers of the cases that were discussed. Results: Our retrospective institutional review revealed a total of 1178 individual patients discussed between August 2018 and August 2023. There was an even distribution of patients by sex, with 549 female (50.2%) patients and 544 male (49.8%). Diagnoses peaked in the second and sixth decades of life (189 and 175 patients, respectively). The majority of patients were discussed once (55%) or twice (21%). The most common neoplastic diagnosis that was presented in these meetings was giant cell tumor of bone (n = 51). Osteosarcoma (n = 41) was the most common diagnosis among the primary malignant bone tumors, and liposarcomas (n = 41) were the most frequently discussed soft tissue sarcoma histology. Conclusion: Tumor boards have played a central role in cancer care for almost a century. Our experience at an NCI-designated comprehensive cancer center has yielded a review of over a thousand individual cases in only a 5-year span of time. [ABSTRACT FROM AUTHOR]

This article discusses the importance of advance health care planning, specifically focusing on medical decision making at the end-of-life. It emphasizes the need for individuals to communicate their treatment preferences to ensure they receive the medical care they want and to reduce stress for loved ones during a medical crisis. The article explains the concept of advance directives and the role of a medical power of attorney in making decisions on behalf of the patient. It also highlights the importance of discussing care preferences with family and medical teams, considering personal values, and exploring options like palliative care and hospice. The article concludes by encouraging readers to consider their values, have conversations with loved ones and medical providers, and familiarize themselves with their state's advance care planning documents. [Extracted from the article]

This article provides an update on patient safety data recently reviewed by and recommendations of the President's Council of Advisors on Science and Technology. This article attempts to capture the impact of the eroding ability of the nursing workforce to perform its traditional role of blocking errors before they harm patients. Some strategies, tactics, and practice examples to assist in renewing this protective capacity in today's challenging environment are presented. Finally, acknowledging the variability of substantive support for maintaining a safety culture provided by individual health care organizations, this article encourages and applauds the personal courage of nephrology nurses and other health care providers as they engage and assist their clinical and quality improvement teams in addressing the persistence of what Hughes (2008) termed the "everydayness of errors" (p. 1-7). [ABSTRACT FROM AUTHOR]

Background: There is growing recognition that healthcare should align with individuals' health priorities; however, these priorities remain undefined, especially among older adults. The Rehabilitation Using Mobile Health for Older Adults with Ischemic Heart Disease in the Home Setting (RESILIENT) trial, designed to test the efficacy of mobile health cardiac rehabilitation (mHealth‐CR) in an older cohort, also measures the attainment of participant‐defined health outcome goals as a prespecified secondary endpoint. This study aimed to characterize the health priorities of older adults with ischemic heart disease (IHD) using goal attainment scaling—a technique for measuring individualized goal achievement—in a sample of 100 RESILIENT participants. Methods: The ongoing RESILIENT trial randomizes patients aged ≥65 years with IHD (defined as hospitalization for acute coronary syndrome and/or coronary revascularization), to receive mHealth‐CR or usual care. For the current study, we qualitatively coded baseline goal attainment scales from randomly selected batches of 20 participants to identify participants' cardiac rehabilitation outcome goals and their perceptions of barriers and action plans for goal attainment. We used a deductive framework (i.e., 4 value categories from Patient Priorities Care) and inductive approaches to code and analyze interviews until thematic saturation. Results: This sample of 100 older adults set diverse health outcome goals. Most (54.6%) prioritized physical activity, fewer (17.1%) identified symptom management, fewer still (13.7%) prioritized health metrics, mostly comprised of weight loss goals (10.3%), and the fewest (<4%) were related to clinical metrics such as reducing cholesterol or preventing hospital readmission. Participants anticipated extrinsic (access to places to exercise, time) and intrinsic (non‐cardiac pain, motivation) barriers. Action plans detailed strategies for exercise, motivation, accountability, and overcoming time constraints. Conclusions: Using goal attainment scaling, we elicited specific and measurable goals among older adults with IHD beginning cardiac rehabilitation. Priorities were predominantly functional, diverging from clinical metrics emphasized by clinicians and healthcare systems. See related Editorial by Shanahan and Naik [ABSTRACT FROM AUTHOR]

Despite increasing mental health provider supply shortages, research on capacity planning and management in the field of outpatient community mental healthcare is limited. There is an immediate need for strategies to plan and manage the capacity of existing mental healthcare providers to ensure a balance between demand and resources. To address this need, research on capacity planning and management in healthcare and mental healthcare settings is reviewed. Next, the Capacity-to-Serve Model is introduced and defined as a data-driven process for quantifying and reporting real-time standardized estimates of mental health provider availability based on qualifications, monitoring of outcome targets, and use of the Capacity-to-Serve Ratio and Realizing Capacity Measure. Finally, implications for using the model as an innovative solution for capacity management to meet demand in mental health are addressed. A case example is provided to demonstrate the application of the model. Ultimately, the Capacity-to-Serve Model can standardize capacity reporting of existing provider organizations and networks, both small and large, to support increased access to and supply of mental health services. [ABSTRACT FROM AUTHOR]

This study reports the spectrum of discharge diagnoses in a national cohort of newborns admitted during a 3-month period to hospitals across Jamaica. The data were analyzed using measures of central tendency and risk assessed using odds ratio. Data on 1607 admissions were used to describe the spectrum of morbidity in hospitalized infants. Eight hundred and seven (50%) male and 754 (48%) female neonates were admitted. There was a 15% (240) readmission rate during the neonatal period. Infants of diabetic mothers were almost three times as likely to be admitted as infants whose mothers were not diabetic OR 2.89 (CI 1.96 − 4.13). Infants of women who were hypertensive were 1.5 times more likely to be admitted than infants of non-hypertensive women OR 1.56 (CI 1.56–1.9). The odds ratio for admission of an infant born to a woman delivere d by caesarean section was 2.1 (CI: 1.67–2.38). Premature infants constituted 50% of admissions. The most prevalent discharge diagnosis included presumed sepsis, respiratory distress and neonatal jaundice in both preterm and term neonates. In the extreme preterm infant respiratory distress syndrome was the most predominant discharge diagnosis. Multiple gestation was a significant risk for admission OR 2.7 (CI 1.8 to 3.9). Prematurity, multiple gestation, macrosomia, maternal diabetes, maternal hypertension and low 5 minute Apgar score < 7 were all found to be independent predictors of neonatal admission in a logistic regression model (p < 0.001). The recognition of the discharge morbidity is useful for future health planning for the most vulnerable in our population. [ABSTRACT FROM AUTHOR]

Palliative care is expanding in Africa as the continent faces a rising disease burden. As the specialty takes form, it is important to acknowledge the cultural mores regarding health and disease. Many Africans perceive health as more than the individual's physical body, instead include the spirituality and well-being of family, community and ancestors. Much of living is done with the goal of becoming an ancestor, which is tied to the individual's burial and ceremonies. Despite their importance, conversations about death are often thought to be culturally taboo. This poses a challenge to palliative care which is based on the individual preferences and priorities, usually identified through shared decision-making. Little is known about the end-of-life priorities and preferences in Africa, leading to the research question: What are the end-of-life preferences and priorities for community dwelling adults in Mozambique? This paper examines instruments that can be used to measure end-of-life preferences. [ABSTRACT FROM AUTHOR]

The cumulative impact of enhancement technologies may alter the human species in the very long‐term future. In this article, I will start showing how radical genetic enhancements may accelerate the conversion into a novel species. I will also clarify the concepts of 'biological species', 'transhuman' and 'posthuman'. Then, I will summarize some ethical arguments for creating a transhuman or posthuman species with a substantially higher level of well‐being than the human one. In particular, I will present what I shall call the Principle of the Best Interests of Posthumanity, which states that the enhancement of the human and transhuman species must be directed towards the creation of a posthuman existence that is substantially more valuable than its predecessors. I suggest that human extinction may be considered, within that principle, as one of the best interests of posthumanity. Finally, I will develop three objections that make that principle unattractive and that show that pursuing a full‐blown programme of posthuman evolution is ethically flawed. [ABSTRACT FROM AUTHOR]

Refugee children and young people have high levels of unmet mental health needs. A trauma‐informed service transformation framework was applied with 14 professionals in Turkey. Through participatory focus groups, professionals co‐produced service plans and considered enabling and challenging factors for implementation. Data were analysed through a thematic codebook approach. Established themes suggested that implementation should concurrently address societal barriers, agency fragmentation, lack of contextual interventions and sustainability. These led to the development of a Theory of Change. A trauma‐informed and scaled service model of collaborative care can holistically meet refugee children and young people's complex needs, while maximising sparse resources. [ABSTRACT FROM AUTHOR]

Purpose: There are multiple frameworks for goal writing that are applicable to the practice of speech-language pathology. Motor-based speech disorders are a subset of speech sound disorders that are thought to require specific elements of intervention that are typically not addressed in the traditional frameworks used in the clinical setting. The purpose of this tutorial is to review general approaches of goal writing and suggest additional elements that may be used to improve the efficiency and effectiveness of treatment for childhood motor speech disorders, specifically childhood apraxia of speech (CAS). Method: Existing models of goal writing were reviewed to ascertain elements common to most of these models. A basic framework was chosen and modified to include behaviors, conditions, and approaches to goal measurement tailored to the clinical needs of children with CAS. A resource for clinical decision making for children with CAS was developed to inform goal writing at the onset of treatment and adaptations that occur over the course of treatment. Case studies are presented to demonstrate how the presented framework can be applied to writing goals for motor-based treatment for two different children with CAS. Discussion: Children with CAS require a specialized approach to intervention, which requires goals to reflect the unique clinical needs of this population. This tutorial offers resources that use the best available research evidence and current understanding of effective treatment practices for CAS to guide clinical decision making for motor-based intervention and goal writing. This tutorial is intended to guide treatment planning across varied settings to facilitate progress and optimize treatment outcomes for children with CAS. [ABSTRACT FROM AUTHOR]

Pregnancy, childbirth, postpartum, and infant care are natural physiological processes. However, there is a potential for a life-threatening situation to arise during this period, which can pose a risk to both the mother and the baby and, in severe cases, even lead to death. If we can effectively detect them, we can prevent maternal deaths. One tool to detect high-risk pregnant women is the Poedji Rochjati Score Card (PRSC). The aim of this research is to determine the effectiveness of the Poedji Rochjati Score Card (PRSC) for detecting high risk in pregnant women in the Purwakarta Community Health Center area, Purwakarta Regency. The study's research design was a retrospective cohort with secondary data. The Tegalwaru Community Health Center, Tegalwaru District, Purwakarta Regency hosted the research from December 2023 to January 2023. In 2022, all 920 pregnant women were included in this study. This study used total population techniques to sample. There were 617 respondents (67.1%) of low-risk pregnant women, 279 respondents (30.3%) with high-risk pregnancies, and 24 respondents (2.6%) with very high-risk pregnancies. Pregnant women with a score of 2 had 617 respondents (67.1%), 6 had 235 respondents (25.5%), 10 had 44 respondents (4.8%), 14 had 20 respondents (2.2%), and 18 had 4 respondents (0.4%). The Poedji Rochjati Score Card (PRSC) is effective for detecting high-risk pregnant women. Based on the results of the Chi Square test, the p value was <0.001. The Poedji Rochjati Score Card (PRSC) effectively identifies high-risk pregnancies, comprehensive care is still necessary for pregnancies without risk, as the risk of pregnancy can fluctuate throughout pregnancy and delivery. [ABSTRACT FROM AUTHOR]

Population Health Management – often abbreviated to PHM – is a relatively new approach for healthcare planning, requiring the application of analytical techniques to linked patient level data. Despite expectations for greater uptake of PHM, there is a deficit of available solutions to help health services embed it into routine use. This paper concerns the development, application and use of an interactive tool which can be linked to a healthcare system's data warehouse and employed to readily perform key PHM tasks such as population segmentation, risk stratification, and deriving various performance metrics and descriptive summaries. Developed through open-source code in a large healthcare system in South West England, and used by others around the country, this paper demonstrates the importance of a scalable, purpose-built solution for improving the uptake of PHM in health services. [ABSTRACT FROM AUTHOR]

Across many countries, increases in inequality driven by rising top incomes and wealth have not been accompanied by growing popular concern. In fact, citizens in unequal societies are less concerned than those in more egalitarian societies. Understanding how the general public perceive richness is an essential step towards resolving this paradox. We discuss findings from focus group research in London, UK, a profoundly and visibly unequal city, which sought to explore public perceptions of richness and the rich. Participants from diverse socio-economic backgrounds discussed their views of the 'wealthy' and the 'super rich' with reference to both vast economic resources and more intangible aspects, including, crucially, security. High levels of wealth and income were perceived to be necessary for achieving security for oneself and one's family. The security of the rich was discussed in contrast to participants' own and others' insecurity in the context of a (neo)liberal welfare regime – specifically, insecurity about housing, personal finances, social security, health care and the future of the welfare state. In unequal countries, where insecurity is widespread, lack of confidence in collective welfare state provision may serve in the public imagination to legitimate private wealth accumulation and richness as a form of self-protection. [ABSTRACT FROM AUTHOR]

There is a large discrepancy in European countries between the measured impact of immigration on the welfare state and how this impact is perceived by citizens. This study examines the determinants of individuals' perception of the impact of immigration on the welfare state. A number of hypotheses at both the individual and contextual level are tested using a multilevel model with data from the European Social Survey. I find that the institutional features of welfare states are associated with different views on the impact of immigration on welfare states: generous contributory social welfare benefits are associated with more favourable attitudes about immigrants, while generous non-contributory benefits, by contrast, are associated with more pessimistic assessments about the fiscal impact of immigration. I argue that this can be because the latter potentially signals to natives that migrants could access generous benefits without any requisite work history. At the individual-level, the results indicate that subjective risk and general opposition to immigration are powerful individual-level predictors: people who feel more economically insecure or who are generally opposed to immigration are more likely to think that it constitutes a burden for the welfare state. [ABSTRACT FROM AUTHOR]

Severe opioid withdrawal, risk of patient-initiated discharge, and some inpatients' use of unregulated substances prompt clinical and ethical questions considered in this commentary on a case. Short-acting opioids can be used to manage inpatients' pain and opioid use disorder (OUD) withdrawal symptoms. Including evidence-based interventions--such as naloxone kits, substance use equipment, and supervised consumption--in some inpatients' care plans may make those patients safer and reduce their risk of death. These and other strategies align with clinicians' ethical duties to minimize harms and maximize benefits for inpatients with OUD. [ABSTRACT FROM AUTHOR]

Background: Iran will soon have an aging population. Healthcare providers must consider factors affecting the quality of life for those 60 and older. Understanding oral health as one of these factors can improve the elderly's quality of life. Oral health‐related quality of life (OHRQoL) is a crucial reflection of individuals' general well‐being and their overall quality of life linked to health. This study aimed to evaluate the OHRQoL among elderly Iranians referring to Azad University of Medical Sciences in Tehran. Methods: In this cross‐sectional study, 171 individuals over 65 (93 men and 78 women) were evaluated using OHIP‐14 and GOHAI‐12 questionnaires to analyze their quality of life. Gender, age, systemic diseases, using medications and dentures, the number of remaining teeth, and oral lesions were recorded. Salivary flow and xerostomia were analyzed with the spitting method and xerostomia index questionnaire, respectively. Also, four main flavor solutions were used to evaluate the taste perception. Data were analyzed using PASS11 and p value <.05 was the significance level. Results: Based on OHIP‐14 and GOHAI‐12, Iranian older people's quality of life can be affected by cardiovascular diseases, hypertension, xerostomia, and the number of remaining teeth (p <.05). The results also showed a significant correlation between the OHIP‐14 and GOHAI‐12 scores (p <.001). Both indexes revealed that the number of remaining teeth, xerostomia, salivary flow, and taste perception greatly influenced participants' quality of life. More remaining teeth, improved salivary flow, and better perception of sweetness and sourness were all linked to a higher quality of life, while increased xerostomia, reduced salivary flow, and bitter taste perception were linked to a decline in overall well‐being. Cardiovascular diseases, hypertension, and medication use were also found to significantly impact quality of life. Conclusion: This study's results indicate that cardiovascular diseases, hypertension, dry mouth, and tooth loss can negatively impact the elderly's quality of life. So, improving both systemic and oral health is vital for enhancing life quality in this age group. [ABSTRACT FROM AUTHOR]

Improving healthcare requires appropriate community involvement supported by appropriate partner engagement methods. This research aims to develop a complex tool for evaluating the social responsibility of health facilities regarding community involvement and development. We developed areas of a new reference framework for the sustainability of healthcare organizations, which includes the area of community involvement and expansion. It is made up of nine indicators. These were designed using the most representative activities reported by hospitals around the world. Their testing was conducted in an orthopedic emergency hospital. The designed indicators are community engagement actions; the interventions' content adapted to the community; partnership and networking; the involvement of volunteers and training networks; the involvement and participation of professional associations; community-involved local opinion leaders; satisfaction with partnerships; initiatives together with the community; and educational visits. The testing and validation of health practices of the indicators highlighted their adequacy with the proposed purpose of the research and the promotion of sustainable development. We have also verified their compatibility with the requirements of national hospital accreditation legislation and the European framework for quality assurance in hospitals. [ABSTRACT FROM AUTHOR]