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Undocumented people in the United States face innumerable legal and structural barriers to health and health care services, including for kidney failure. Their experiences vary across states and regions due to wide variation in insurance coverage and unreliable access to health-promoting resources, including medical-legal partnerships. This commentary on a case canvasses key policy about structural and legal determinants of health for undocumented persons. [ABSTRACT FROM AUTHOR]

The article discusses the activities and initiatives of the Agency for Toxic Substances and Disease Registry (ATSDR) to better understand the relationship between exposure to hazardous substances in the environment, its impact on human health, and how to protect public health. Topics discussed include background on per- and polyfluoroalkyl substances (PFAS) exposure, way clinicians can help patients with concerns about exposure to PFAS, and involvement of environmental health professionals.

The article offers update on the initiatives and activities of the All-Hazards Approach for the Agency for Toxic Substances and Disease Registry (ATSDR) Emergency Management Unit (EMU) at the U.S. Centers for Disease Control and Prevention. It outlines the core functions of the EMU and discusses the foundational frameworks of the EMU, hazardous materials foundational framework of the ATSDR, natural hazard foundational framework of the EMU, and ATSDR response to evolving emergencies.

Background: Headache disorders are a global public health concern affecting diverse populations. This review examines headache service organizations in low-, middle-, and high-income countries. It addresses global challenges in pharmacological headache treatment, with a focus on safety, tolerability, reproductive and child health, and outlines disparities in accessing innovative treatments worldwide. Main body: Organized headache services are essential due to the wide prevalence and varying severity of headache disorders. The tiered headache service model is globally recognized, although its implementation varies based on financial and workforce considerations. Headache burden affects well-being, causing disability, economic challenges, and work limitations, irrespective of location or income. All nations still require improved diagnosis and treatment, and the majority of countries face obstacles including limited access, awareness, economic barriers, and inadequate health policies. Provided adequate internet availability, telemedicine could help improve health equity by expanding access to headache care, since it can offer patients access to services without lengthy waiting times or extensive travel and can provide healthcare unavailable in underserved areas due to staff shortages. Numerous health disparities restrict global access to many headache medications, especially impacting individuals historically excluded from randomized controlled trials, such as those with cardiovascular and cerebrovascular conditions, as well as pregnant women. Furthermore, despite advancements in researching migraine treatments for young patients, the options for treatment remain limited. Access to headache treatment relies on factors like medication availability, approval, financial coverage, and healthcare provider expertise. Inadequate public awareness leads to neglect by policymakers and undertreatment by patients and healthcare providers. Global access discrepancies are exacerbated by the introduction of novel disease-specific medications, particularly impacting Asian, African, and Latin American nations excluded from clinical trials. While North America and Europe experience broad availability of migraine treatments, the majority of countries worldwide lack access to these therapies. Conclusions: Healthcare disparities, treatment access, and medication availability are concerning issues in headache medicine. Variations in national healthcare systems impact headache management, and costly innovative drugs are widening these gaps. Healthcare practitioners and experts should acknowledge these challenges and work towards minimizing access barriers for equitable global headache care in the future. [ABSTRACT FROM AUTHOR]

Objective: Explore care providers' experiences with the organisation of the medical services for residents in round-the-clock staffed sheltered housing. Design: Qualitative study and thematic analysis of individual interviews after strategic sampling of participants. Setting: Round-the-clock staffed sheltered housing in seven municipalities, inhabited by various user groups, and GPs in various locations in Norway. Subjects: In-depth interviews with 18 participants: 11 managers or employees in sheltered housing and seven GPs. Main outcome measures: Main themes and subthemes reporting participants' experiences of medical provision to sheltered housing residents. Results: Three main models of organizing medical services for round-the-clock staffed sheltered housing were identified: (i) the 'multiple GP' model, where each resident has their own individual GP; (ii) the 'single GP' model, where all residents in the sheltered housing have one common GP; (iii) the 'hybrid' model, where a few dedicated GPs follow up the residents. Conclusion: Residents in round-the-clock staffed sheltered housing constitute a varied group that generally has substantial medical assistance needs. Given that many residents lack autonomy to manage their own care needs and make decisions, models with fewer GPs like models ii and iii seem to provide a better medical professional offer. Moving towards such an organising of the medical services for sheltered housing residents could have implications for GPs' workload and competence needs. Future studies are needed to test models and assess implications. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to describe circumstances concerning access for patients and relatives to take part in patient health and safety in a hospital setting. Design: This study used a qualitative descriptive design and was conducted at a Swedish university hospital. Method: The 79 complaints reported by patients and relatives included in this study were registered between January 2017 and June 2019. These complaints were classified as concerning access to healthcare services. Data were analysed using qualitative content analysis. Results: The overarching theme, struggling for access as a human being in the healthcare system, encompassed three themes describing patients' and relatives' needs. The three themes were (1) navigating through the healthcare organization, (2) making sense of self and what is going on and (3) being acknowledged as having needs. Conclusion: Patients and relatives continuously participate in various ways in healthcare to promote health and prevent patient harm. Our findings contribute important knowledge about the meaning of access from a broad healthcare system perspective. Access was restricted in terms of appropriateness in how patients' needs were met. This restriction of access risked the deterioration of patient health and safety. Impact: Patients and relatives play an active part in patient health and safety, although their attempts are sometimes hindered. Restrictions in the appropriateness of access prevented patients and relatives from taking part in patient health and safety, which appeared to mean that they had to adapt and expend effort to the point that it negatively affected their health and everyday life. These findings concern all patients, relatives and healthcare professionals in hospital‐associated settings. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To examine the current nurse manager (NM) recognition culture and climate in organizations and to develop a theoretical foundation for meaningful recognition. BACKGROUND: Nurse managers call for wider recognition, but the theoretical conceptualization and underpinnings of meaningful recognition are sparse in the literature. METHODS: A qualitative descriptive design was used utilizing individual interviews. The study participants included 30 individuals consisting of NMs, chief nursing officers, and chief nursing executives. Content analysis was conducted. RESULTS: A theoretical model with super-categories and supportive quoteswas created to operationalize a culture and climate of meaningful recognition in the organizations represented by the sample. CONCLUSION: This qualitative descriptive study highlights the importance of recognizing the value of NMs for their contributions to nursing leadership and patient care. Implications of recognizing NMs are counteracting the feeling of being invisible and mitigating issues within the work environment. [ABSTRACT FROM AUTHOR]

Local governmental environmental health programs play a critical role in safeguarding public health. Environmental health professionals administer a wide range of professional services, including food safety, septic systems, childhood lead poisoning prevention programs, air quality, water quality, healthy housing, and vector control. Despite the centrality of the environmental health workforce to modern life, a national standard or guidance does not exist for how local environmental health departments should be structured, staffed, and funded. This article aims to provide foundational information to support an effort to describe the characteristics of a minimum viable governmental environmental health department and provide recommendations on optimal structure, staffing, and funding. [ABSTRACT FROM AUTHOR]

The public relations as a main pillar of internal marketing of a providing health services organization, constitute an integral part of them. Their application is done in the internal clients, who are the medical, nursing, administrative and other personnel and the middle and senior management staff of the organization too. The role of the application of the public relations that take place in the structures of providing health services is major. Parameters as the gender, the age, the kind of occupation and the forms of job relations show the different components that have direct impact in the behavior and the attitude of the health professionals. The adoption of methods and tactics of public relations and the application of internal marketing in the health services considered indispensable for the accomplishment of positive balance in the mental and physical well-being of the health professionals and the increment of the population health level across the efficiency of the health system. The application of public relations in the units of providing health services concerns all the levels of care and the responsibility of their proper planning and implementation is domain of the leadership of the organization. The department of the public relations as well as the human resource management department either together or separately appear to fulfill the commitment of the leadership of the health unit to maximize the benefit of the individual and the collective improvement of the health professional. [ABSTRACT FROM AUTHOR]

Aims: To explore and describe registered nurses' perceptions and experiences of work well‐being extending from what inspired them to join the healthcare organization, what created a great day at work for them, through to what may have supported them to stay. Design: Qualitative descriptive study. Methods: Thirty‐nine Australian nurses who resigned in 2021 from two metropolitan healthcare organizations in Victoria were interviewed in 2022, each for 30–60 min. The semi‐structured interview transcripts were transcribed verbatim and analysed inductively and thematically. Results: Four themes were constructed for each of the key research questions. Inspiration to join the organizations transpired through organizational reputation, recruitment experiences, right position and right time, fit and feel. A great day at work was created through relationships with colleagues, experiences with managers, adequate resourcing and delivering quality care. Factors contributing to nurses resigning included COVID‐19, uncertainty of role, workload and rostering, and finally, not feeling supported, respected and valued. Factors that may have supported the nurses to stay included flexible work patterns and opportunities, improved workplace relationships, workload management and support, and supportive systems and environments. Cutting across these themes were five threads: (1) relationships, (2) communication, (3) a desire to learn and develop, (4) work–life balance and (5) providing quality patient care. Conclusions: Novel ways of working and supporting individuals, teams and organizations are needed to maintain and sustain nurses. The nurses' inspiration, what created a great day at work, and support needed to stay highlighted the importance of workplace initiatives to build nursing career pathways, provide equitable opportunities for professional development, workload and roster flexibility and implement professional relationship‐enhancing actions to foster authentic civility. Impact This study contributes an in‐depth exploration of the perceptions and experiences of nurses who resigned from two healthcare organizations and provides a description of (1) what inspired these nurses to initially join the organization, (2) what they perceived created a great day at work for them, (3) the factors contributing to their resignation and (4) what may have supported them to stay.The reasons nurses resign from an organization were identified as complex and multi‐factorial, with opportunities for promoting nursing career pathways, addressing equity in opportunities and implementing professional relationship‐enhancing actions.These contributions add both context and opportunity to strengthen organizational initiatives to attract, sustain and retain nurses. [ABSTRACT FROM AUTHOR]

Introduction: The availability of vaccines started at the end of 2020 and health care professionals were on the priority lists, because of their special role as role models, as well as their critical contribution to the battle of stopping that health crisis. Purpose: Investigating the degree of intention to vaccinate health professionals, as well as searching for the determinants that have a positive or negative effect on it. Material and Method: A multicenter, cross-sectional study was conducted among health care professionals throughout the country. 2.484 records were collected using an online questionnaire and using the "snowballing sampling" method. Results: The vaccination intention rate of health professionals, between January and March 2021, was 72.1% and the factors found to have a positive determinant role in this were male gender (p<0.001), older age (p<0.001), medical profession (p<0.001), beliefs about the risk of the virus (p<0.001), higher level of knowledge about the virus and the vaccine (p=0.002), while negative factors were vaccine safety (p<0.001), and the influence of religious beliefs (p<0.001). Conclusions: In conclusion, the study revealed that most health professionals wished to be vaccinated. In the future and in similar situations, emphasis may need to be placed on the determinants associated with hesitancy. [ABSTRACT FROM AUTHOR]

In recent decades, there has been considerable discussion surrounding what it means to age successfully, and what supports, services, and programs are needed to facilitate successful aging. Rehabilitation scholars advocate for models of successful aging that take into account the unique needs and priorities of those aging with long-term physical disability. The aim of this study is to explore how organizations that serve those with physical disability define successful aging for this population, and whether their understanding of successful aging is consistent with the needs and priorities identified by those aging with physical disability. To do so, we analyze qualitative data from a national online survey of disability organizations (N = 106 organizations). Organizations described the following domains of successful aging for those with physical disability: (a) autonomy and/or maximized independence; (b) living arrangement; (c) health and well-being; and (d) social connection and meaningful community engagement. Overall, organizations' understandings of successful aging are consistent with the priorities identified by those aging with long-term physical disability. We discuss strategies that organizations can adopt to ensure that the programs and services that they offer facilitate these elements of successful aging. [ABSTRACT FROM AUTHOR]

The 'improvement' of health care is now established and growing as a field of research and practice. This article, based on qualitative data from interviews with 21 senior leaders in this field, analyses the growth of improvement expertise as not simply an expansion but also a multiplication of 'ways of knowing'. It illustrates how health‐care improvement is an area where contests about relevant kinds of knowledge, approaches and purposes proliferate and intersect. One dimension of this story relates to the increasing relevance of sociological expertise—both as a disciplinary contributor to this arena of research and practice and as a spur to reflexive critique. The analysis highlights the threat of persistent hierarchies within improvement expertise reproducing and amplifying restricted conceptions of both improvement and 'better' health care. [ABSTRACT FROM AUTHOR]

OBJECTIVE: This study explored the key characteristics and needs of midlevel nurse managers (MLNMs) who support and engage clinical nurses (CNs) in scholarly inquiry. BACKGROUND: Healthcare organizations expect CNs to participate in scholarly inquiry, incorporating evidence-based interventions to improve outcomes and safety. How the MLNM supports and engages CNs in scholarly inquiry remains unclear. METHODS: Twelve semistructured interviews of MLNMs occurred at several facilities in the mid-Atlantic region utilizing the institutional review board–acknowledged protocol. Theme interpretation utilized inductive analysis. RESULTS: Four recurrent themes emerged from the interviews related to the value of scholarly inquiry: 1) securing organizational resources to promote scholarly inquiry; 2) knowledge and experience in scholarly inquiry; 3) actions supporting scholarly inquiry; and 4) the value of scholarly inquiry within the organization. CONCLUSIONS: Senior nursing leadership and healthcare organizations must recognize the value and provide the infrastructure to support scholarly inquiry. Infrastructure includes education, dedicated time, access to expertise, and resources. [ABSTRACT FROM AUTHOR]

The article discusses the Agency for Toxic Substances and Disease Registry's (ATSDR) task to protect communities from the harmful effects of environmental contaminants. Topics covered include ATSDR's reliance on environmental data by other agencies, factors that are considered before conducting exposure investigation (EI) at a site, and the EI methodology and process. Also noted is ATSDR's evaluation of blood lead and urine arsenic levels in a Montana community with past smelting activities.

Introduction: The set of values, beliefs and expectations that are widespread and accepted within an organization compose its organizational culture. The common culture acts as a cohesive link between the members of the health team, increasing both the sense of trust of the participants and the cohesion of the team. Aim: The main purpose of this study was to investigate the organizational culture of health professionals and the assessment of the identification or differentiation of the existing organizational culture from what members of the team deem as a desired one. Methodology: A cross-sectional study was conducted involving 155 health professionals working in public and private health care. The research tool used was the Organizational Culture Assessment Instrument - OCAI questionnaire, which quantitatively measures the quality parameters of the culture. It has 24 questions through which the six key dimensions of organizational culture for the present and the future are approached. The answers correspond to four different types of organizational culture with different orientations, assumptions, practices and values. The statistical analysis of the data was done with SPSS v24. Results: The predominant culture of the organizations of the participants was the Hierarchical Culture (27%) in which the organization focuses on coordination, stability and predictability. The next existing culture was the Market one, where the main characteristics were those of goal-orientation, competitive spirit and a demanding leadership. The culture of Generation (28%) in which the organization is interested in its employees and their personal development has emerged as a desirable culture. Second to that was the Open System culture, which promotes innovation and emphasizes the external environment, change and competitiveness. There was no identification of the existing culture with the desired one. Conclusion: The investigation and measurement of organizational culture in health services can contribute to the qualitative upgrade of offered health care through the adoption of common standards, perceptions and behaviors. [ABSTRACT FROM AUTHOR]

Introduction: East Toronto Health Partners (ETHP) is a network of organizations that serve residents of East Toronto, Ontario, Canada. ETHP is a newly formed integrated model of care in which hospital, primary care, community providers and patients/ families work together to improve population health. We describe and evaluate the evolution of this emerging integrated care system as it responded to a global health crisis. Description: This paper begins by describing ETHP’s pandemic response mapping out over two years of data. To evaluate the response, semi-structured interviews were conducted with 30 decision makers, clinicians, staff, and volunteers who were part of the response. The interviews were thematically analyzed, and emergent themes mapped onto the nine pillars of integrated care. Discussion: The ETHP pandemic response evolved rapidly. Early siloed responses gave way to collaborative efforts and equity emerged as a central priority. New alliances formed, resources were shared, leaders emerged, and community members stepped forward to contribute. Interviewees identified positives as well as many opportunities for improvement post-pandemic. Conclusion: The pandemic was a catalyst for change in East Toronto that accelerated existing initiatives to achieve integrated care. The East Toronto experience may serve as a useful guide for other emerging integrated care systems. [ABSTRACT FROM AUTHOR]

This commentary on a case suggests why health care organizations have responsibilities to serve food to their patients, guests, and employees that is ethically, nutritionally, culturally, and religiously appropriate. This article also investigates how inclusive, equitable, sustainable food services are key dimensions of health care organizations' civic and stewardship responsibilities to individuals and communities. [ABSTRACT FROM AUTHOR]

Victims of child abuse and neglect come from every racial, ethnic, and socioeconomic background, yet clinical evaluation, reporting to child protective services, and responses to reports inequitably harm Black children and malign families of color. Racial bias and inequity in suspicion, reporting, and substantiation of abuse and neglect and in services offered and delivered, foster care placement, and criminal prosecution are widely documented. In response, clinicians and health care organizations should promote equity by educating clinicians about racial bias, standardizing evaluation using clinical decision support tools, and working with policy makers to support prevention services. If we decide that it is ethically justifiable for clinicians to err on the side of overreporting, we must ensure fair distribution of associated benefits and harms among all children and families. [ABSTRACT FROM AUTHOR]

Current definitions of migraine that are based mainly on clinical characteristics do not account for other patient's features such as those related to an impaired quality of life, due to loss of social life and productivity, and the differences related to the geographical distribution of the disease and cultural misconceptions which tend to underestimate migraine as a psychosocial rather than neurobiological disorder. Global differences definition, care access, and health equity for headache disorders, especially migraine are reported in this paper from a collaborative group of the editorial board members of the Journal of Headache and Pain. Other components that affect patients with migraine, in addition to the impact promoted by the migraine symptoms such as stigma and social determinants, are also reported. [ABSTRACT FROM AUTHOR]

Motivating health equity requires taking deliberate steps toward desegregating health care, especially in academic health centers. One step should incorporate rigorous measurement and assessment of patients' access to health services and ongoing collection and review of patients' health outcomes data. Another step should develop, fund, incorporate and administer initiatives with community members that address social determinants of community and individual health, including academic health centers' inpatient and outpatient service delivery sites, insurance programs, and federal policy. Academic health centers must also be accountable for monitoring initiatives' successes and failures over short- and long-term trajectories and for modifying initiatives' methods as needed to achieve equity in access to health services and health outcomes. [ABSTRACT FROM AUTHOR]

Background and Objectives Partnerships between health care and social service organizations may contribute to lower health care use and spending. Such partnerships are increasing, including Area Agencies on Aging (AAAs) working and contracting with health care organizations. Nevertheless, knowledge about how AAAs establish and manage successful collaborations is limited. We sought to understand how AAAs establish and manage partnerships with health care organizations. Research Design and Methods We conducted an explanatory sequential mixed-methods study using a positive deviance approach. We used national-level data to identify AAAs with multiple health care partners serving areas with low utilization of nursing homes by residents with low-care needs (n = 9) and AAAs with few health care partners and high utilization for comparison (n = 3). We conducted in-depth interviews with key informants from these 12 AAAs and their partner organizations (total n = 130). A 5-person multidisciplinary team used the constant comparative method of analysis, supported by Atlas.ti software. Results Highly partnered AAAs were characterized by 3 distinctive features of organizational culture: (a) attention to external environments, (b) openness to innovation and change, and (c) risk-taking to learn, improve, and grow. AAAs and partners describe a broad set of organizational strategies and partnership development tactics, depending on their local contexts. These features were underdeveloped in AAAs with few health care partnerships. Discussion and Implications While federal and state policies can create more favorable environments for AAA–health care partnerships, AAAs can also work internally to foster an organizational culture that allows them to thrive in dynamic and challenging environments. [ABSTRACT FROM AUTHOR]

Aim: This research aims to understand the place and role of nurses holding a PhD or PhD students (nurse doctor [ND]/nurse doctoral students [NDS]) in health care organizations in France. Context: Worldwide, many nurses are undertaking doctoral studies. France is no exception. However, in France, there is no doctorate dedicated to nursing. The question of ND/NDS integration into health organizations is thus raised in a specific manner. Methods: We used a two‐stage mixed methodology. The first stage used data from questionnaires that were sent to 165 ND/NDS in France. To contextualize issues raised by these data, we used qualitative methods which comprised 45 semi‐structured interviews with nurses, 10 interviews with health managers and chief nurses and 27 h of in situ observations with research coordinators. Results: Seventy‐nine participants (47.9% response rate) completed questionnaires. The data showed that work organization in some departments—intensive care units (ICUs), oncology and psychiatry—favoured the development of scientific expertise among nurses. Favourable elements promoting the professional and academic development of ND/NDS included the potential for medical teaching in healthcare services, participation in research projects and, most importantly, medical proximity. Conversely, our data also identified poor visibility and recognition of nursing doctoral courses in French health organizations: A lack of task missions, a lack of suitable posts and poor integration into the nursing profession. Currently, French nurses define their profession as providing direct care to patients and their families—yet this definition fails to consider other important professional elements, such as research. Conclusions: Our study identified how proper ND/NDS integration is important to health care organizations. We identified key organization factors facilitating the integration of ND/NDS, such as participating in research teams and providing research support management. Implications for Nursing Management: In recent years, the nursing profession has significantly evolved. We are interested in the impact of these changes in work organizations following the development of new scientific skills. Our study investigates all aspects of the nursing profession (teaching, practice, research and organizations). Our study advocates managerial roles, among others, to improve ND and NDS integration into work organizations. We directly observed work organizations that helped develop nursing research. Our study is also aimed at managers who have roles as decision‐makers in promoting and facilitating research and nurse researchers. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editor discusses various reports within the issue on topics including factors linked to primary care physician turnover, findings on patient satisfaction based on trial results, and the link of cognitive decline to high and low-value care services.

Diabetes is a pervasive and lifelong condition and poses significant challenges, with one of its most debilitating complications being foot diseases, particularly foot ulceration. This condition not only places individuals at risk for infection but also represents a precursor to severe consequences, such as sepsis and lower-limb amputation (Lipsky et al, 2023). This article delves into the multidisciplinary role that is pivotal in mitigating lower-limb foot ulcer recurrence, a pervasive issue affecting a substantial portion of the diabetic population. [ABSTRACT FROM AUTHOR]

Whistleblowing can bring suspected wrongdoing to the attention of someone who is in the position to rectify the problem. Whistleblowing research can help improve effectiveness of anti-corruption efforts in the health sector. The objective of this scoping review is to understand the extent and type of evidence on whistleblowing as an anti-corruption strategy in health and pharmaceutical organisations in low- and middle-income countries (LMICs). This scoping review searched the PubMed, Scopus, and EMBASE databases from 2005 to 2020, limited to English language. We also searched websites of multilateral agencies or international non-governmental organisations for policy documents, guidance and reports. Titles and abstracts were screened to remove those where the focus was not on health, pharmaceuticals, whistleblowing, or LMIC context. Articles focused on research misconduct were excluded. Full-text articles were assessed for eligibility on these same criteria. Included sources were analysed thematically, based on five categories including definitions and models; evidence of reporting frequency; factors influencing whistleblowing; cultural context; and outcomes. The review found 22 sources including reports, policies, and guidance documents (12, 55%), news articles (4, 18%), policy analyses/reviews (3, 14%), commentaries (2, 9%), and empirical studies (1, 5%). Most sources described whistleblowing policy and system components such as how whistleblowing is defined, who can report, and how confidentiality is assured. Few articles documented types and frequencies of corruption identified through whistleblowing or factors associated with whistleblowing. Several studies mentioned cultural norms as a potential limitation to whistleblowing effectiveness. About one-third of the sources described fear of retaliation and noted the need to strengthen protection for whistleblowers. Research on whistleblowing is scarce in health and pharmaceutical organisations in LMICs. Documentation of policies, factors associated with whistleblowing, and whistleblowing outcomes is needed and could help countries to mainstream whistleblowing as a sectoral anti-corruption strategy. [ABSTRACT FROM AUTHOR]

Background and purpose — Involvement of patient organizations is steadily increasing in guidelines for treatment of various diseases and conditions for better care from the patient's viewpoint and better comparability of outcomes. For this reason, the Osteogenesis Imperfecta Federation Europe and the Care4BrittleBones Foundation convened an interdisciplinary task force of 3 members from patient organizations and 12 healthcare professionals from recognized centers for interdisciplinary care for children and adults with osteogenesis imperfecta (OI) to develop guidelines for a basic roadmap to surgery in OI. Methods — All information from 9 telephone conferences, expert consultations, and face-to-face meetings during the International Conference for Quality of Life for Osteogenesis Imperfecta 2019 was used by the task force to define themes and associated recommendations. Results — Consensus on recommendations was reached within 4 themes: the interdisciplinary approach, the surgical decision-making conversation, surgical technique guidelines for OI, and the feedback loop after surgery. Interpretation — The basic guidelines of this roadmap for the interdisciplinary approach to surgical care in children and adults with OI is expected to improve standardization of clinical practice and comparability of outcomes across treatment centers. [ABSTRACT FROM AUTHOR]

Introduction: The COVID-19 contagion curve is steeply increasing again worldwide; however, this time we face the emergency with different knowledge.Areas covered: In this review article, we present international guidelines and updated literature merged with our experience from hospitals in Bergamo, the epicenter of the first European COVID-19 outbreak, and provide a protocol tailored for ophthalmology professionals for organizing ophthalmology services for the second-wave of COVID-19 pandemic, to satisfy ophthalmic care needs while minimizing viral spread. Results from this strategy are discussed. We have developed a protocol that can balance safety, costs and quality.Expert opinion: Re-shaping ophthalmology practice resulted in higher costs and longer working times, but this is necessary to ensure safety. Updating ophthalmology protocols should be a priority worldwide. [ABSTRACT FROM AUTHOR]

Coordination of primary care is essential to improving care delivery within health systems, especially for older adults with increased health/social needs. A program jointly funded by the Canadian Foundation for Healthcare Improvement and Canadian Frailty Network, was implemented in a nurse practitioner-led clinic to address the gap in frailty care for older adults. The clinic was situated within a health and social services organization with a mandate to enhance the quality of life of older adults living in the community. Through this program, a frailty assessment pathway and social/clinical prescriptions were implemented with necessary adaptations as a result of COVID-19. [ABSTRACT FROM AUTHOR]

Universal health coverage (UHC) has been elevated to the status of a global policy target, but this was at the expense of losing its aspirational meaning. As a case in point, Turkey has been one of the countries that has achieved UHC, according to the technocratic definition. This article employs a combination of deductive and inductive thematic analysis methods to explore patient organisation (PO) perspectives on the Turkish health‐care system based on 26 respondent interviews from 19 POs in Istanbul. Highlighting the inadequacy of the technocratic definition of UHC, the article maintains that an analysis of PO perspectives opens the way for a nuanced and bottom‐up assessment of essential service coverage and financial protection by identifying elusive gaps in both dimensions that would otherwise be lost in generalist evaluations. The findings also underline the importance of keeping intact the UHC's aspirational element to enable POs to participate in the politics of priority setting in health care. [ABSTRACT FROM AUTHOR]

The Society for Cardiovascular Magnetic Resonance (SCMR) last published its comprehensive expert panel report of clinical indications for CMR in 2004. This new Consensus Panel report brings those indications up to date for 2020 and includes the very substantial increase in scanning techniques, clinical applicability and adoption of CMR worldwide. We have used a nearly identical grading system for indications as in 2004 to ensure comparability with the previous report but have added the presence of randomized controlled trials as evidence for level 1 indications. In addition to the text, tables of the consensus indication levels are included for rapid assimilation and illustrative figures of some key techniques are provided. [ABSTRACT FROM AUTHOR]

Individual socioeconomic status is known to correlate with multimorbidity, but the role of neighbourhood-level socioeconomic deprivation is uncertain. Participants from five cities (n=16,313) from the Canadian Longitudinal Study on Aging were mapped by postal code and their local area socioeconomic deprivation scores were calculated using the Vancouver Area Neighbourhood Deprivation Index. Logistic regression models were used to estimate deprivation-associated odds of multimorbidity, controlling for age, sex, obesity, alcohol consumption, and tobacco use, and validated using a Bayesian machine learning technique. Significant associations with neighbourhood deprivation were observed, underscoring the importance of a person's local socioeconomic environment in multimorbidity risk, net of key covariates. The implications of the results are discussed in terms of community and health care organization and intervention programs targeting multimorbidity. [ABSTRACT FROM AUTHOR]

The concept of a multiple risk-factor intervention trial (MRFIT) originated in mid-20th century efforts to determine whether modifying the "risk factors" established by cardiovascular disease epidemiology would prevent heart attacks. The term "MRFIT" probably first appeared in the 1968 report to the National Heart Institute from investigators of the National Diet-Heart Feasibility Study. Based on their pilot experience, they recommended a trial of diet alone. Aware, however, that authorities might agree with the rationale but not the implementation of such a massive and risky undertaking, they also proposed an alternative: whether coronary heart disease was preventable at all by simultaneous intervention on several risk factors; that is, a multiple risk-factor intervention trial. After some years agonizing by serial expert committees, the National Heart Institute opted against an explanatory diet trial and for a pragmatic multiple risk-factor intervention, one designed by Institute staff and operated under contract. Meanwhile, an impatient community of investigators met together in the Makarska Conference, outlined a broad cardiovascular disease prevention policy, and submitted their idealized version of a multiple risk-factor trial, called JUMBO. But the National Heart Institute, because of the plan for its own trial, had no funds left for an investigator-initiated proposal. Hence, this background and story of the MRFIT that wasn't. [ABSTRACT FROM AUTHOR]

The purpose of this case study investigation is to understand how staff from a large multisite organization with demonstrated excellence in supporting persons with disabilities (PWDs) construct their understanding of disability and hiring practices related to PWDs. Better understanding how individual employees internalize organizational practices regarding PWDs is essential to facilitate expanded employment opportunities, enhanced organizational functioning, and more supportive work environments for PWDs. Drawing on the Theory of Planned Behavior, in this investigation we have sought to better understand how employees internalize (or do not) the organizational commitment to hire PWDs, and how individual employee understandings of PWDs negotiate (mis)alignments between their perspectives and organizational practices and values. Overall, we found fundamental differences in the understandings, motivations, rationales, support strategies, and concerns of participants related to the employment of PWDs. Even though participants in this study were recruited because of their direct involvement in supporting PWDs in the workplace, they articulate different definitions of disability, perceptions of organizational commitments, and investments in employment practices related to PWDs. We found that virtually each participant in this study is mission-driven, articulating a rationale for hiring and supporting PWDs that is connected to their perception of the organizational investment in the same. However, participants negotiate two very different rationales in articulating their perspectives--with one extreme being charity-oriented and the other human resource oriented. While some participants seemed to embody the elements of one extreme consistently, many incorporated elements of both in discussing their understandings. [ABSTRACT FROM AUTHOR]

Health care organizations are increasingly implementing programs to address patients' social conditions. To support these efforts, new technology platforms have emerged to facilitate referrals to community social services organizations. To understand the functionalities of these platforms and identify the lessons learned by their early adopters in health care, we reviewed nine platforms that were on the market in 2018 and interviewed representatives from thirty-five early-adopter health care organizations. We identified key informants through solicited expert recommendations and web searches. With minor variations, all platforms in the sample provided similar core functionalities: screening for social risks, a resource directory, referral management, care coordination, privacy protection, systems integration, and reporting and analytics. Early adopters reported three key implementation challenges: engaging community partners, managing internal change processes, and ensuring compliance with privacy regulations. We conclude that early engagement with social services partners, funding models that support both direct and indirect costs, and stronger evidence of effectiveness together could help advance platform adoption. [ABSTRACT FROM AUTHOR]

What factors do health and human services leaders assess when considering collaborative opportunities, and what do they worry about? How organizational decision makers perceive risk can influence the success or failure of cross-sector partnerships designed to address social determinants of health. This article captures insights from leaders at twenty-two health and human services organizations in Oregon who were involved in the Centers for Medicare and Medicaid Services' Accountable Health Communities initiative in 2019 and familiar with efforts by their local health systems to identify people with unmet social needs and refer them to community programs. We explore perspectives on the risks and benefits associated with this cross-sector work. Leaders from both sectors perceived collaboration risks to reputation, sustainability, and compliance with regulatory or funder requirements. They also had difficulty gauging the reliability of partners that were sometimes perceived as competitive or coercive. Risk perceptions were manifested differently across sectors, which has implications for the design, implementation, and governance of cross-sector initiatives. [ABSTRACT FROM AUTHOR]

In 2015, the Centers for Disease Control and Prevention (CDC) funded Project PrIDE, a national initiative to implement and evaluate demonstration projects to increase PrEP uptake among HIV-negative individuals and to re-engage HIV-positive individuals in HIV care. Our team served as the Evaluation Center for Project PrIDE organizations in Chicago and used an empowerment evaluation (EE) approach to enhance evaluation capacity at these organizations. To evaluate our approach, we assessed organizations' evaluation capacity and engagement in technical assistance and capacity building activities in 2016 and 2018. Respondents who self-reported higher engagement with the Evaluation Center and who spent a greater number of hours engaged with our evaluators experienced greater increases in evaluation capacity tied to implementation of evaluation activities and technical assistance utilization. These findings demonstrate that multisite EE can be successfully applied to increase the evaluation capacity of organizations providing both HIV prevention and care services. [ABSTRACT FROM AUTHOR]

The article offers International Society of Cardiovascular Ultrasound (ISCU)news briefs. Topic include XXVI World Congress of Echocardiography and Allied Techniques will be held July 16-18, 2020 in Lima, Peru; XXVII World Congress of Echocardiography and Allied Techniques will be held September 26-28, 2021 in Tyumen, Russia; and XXVIII World Congress of Echocardiography and Allied Techniques will be held in Adelaide, Australia in April, 2022.

When the degree of variation between healthcare organisations or geographical regions is quantified, there is often a failure to account for the role of chance, which can lead to an overestimation of the true variation. Mixed-effects models account for the role of chance and estimate the true/underlying variation between organisations or regions. In this paper, we explore how a random intercept model can be applied to rate or proportion indicators and how to interpret the estimated variance parameter. [ABSTRACT FROM AUTHOR]

The article offers information on the conference related to the International Society of Cardiovascular Ultrasound including XXVI World Congress of Echocardiography and Allied Techniques holding on July 16-18, 2020 in Lima, Peru.

Risk assessment and risk prediction have become essential in the prevention of cardiovascular disease. Even though risk prediction tools are recommended in the European guidelines, they are not adequately implemented in clinical practice. Risk prediction tools are meant to estimate prognosis in an unbiased and reliable way and to provide objective information on outcome probabilities. They support informed treatment decisions about the initiation or adjustment of preventive medication. Risk prediction tools facilitate risk communication to the patient and their family, and this may increase commitment and motivation to improve their health. Over the years many risk algorithms have been developed to predict 10-year cardiovascular mortality or lifetime risk in different populations, such as in healthy individuals, patients with established cardiovascular disease and patients with diabetes mellitus. Each risk algorithm has its own limitations, so different algorithms should be used in different patient populations. Risk algorithms are made available for use in clinical practice by means of – usually interactive and online available – tools. To help the clinician to choose the right tool for the right patient, a summary of available tools is provided. When choosing a tool, physicians should consider medical history, geographical region, clinical guidelines and additional risk measures among other things. Currently, the U-prevent.com website is the only risk prediction tool providing prediction algorithms for all patient categories, and its implementation in clinical practice is suggested/advised by the European Association of Preventive Cardiology. [ABSTRACT FROM AUTHOR]

Aim: To offer a new conceptual framework for formalizing nurses' work in managing emergent organisation in health and social care. Background: Much health and social care requires continuous oversight and adjustments in response to contingencies. Nurses have an important role in managing these relationships. Evaluation: A longstanding programme of research on the social organisation of health and social care work provided the foundations for the article. Key issue: Nurses' work in managing emergent organisation may be conceptualized as care trajectory management and factors contributing to trajectory complexity are explored. Conclusions: Care trajectory management is essential for the quality and safety of health and social care but poorly served by existing management frameworks. Implications for Nursing Management: Care trajectory management offers a conceptual framework for the development of new management structures to support an important but poorly supported element of nursing practice. [ABSTRACT FROM AUTHOR]