scholarly journals Risk Assessment of Covid-19 in the Iranian Health System: A Brief Report

2021 ◽  
pp. 1-12
Author(s):  
Hamidreza Khankeh ◽  
Pirhossein Kolivand ◽  
Mohammad Fathi ◽  
Hamidreza Lornejad ◽  
Masoumeh Abbasabadi-Arab
Keyword(s):  
Risk Assessment ◽  
Health System ◽  
Medical Staff ◽  
Mixed Methods Research ◽  
Significant Risk ◽  
Healthcare Services ◽  
Management Program ◽  
Intersectoral Cooperation ◽  
The Matrix ◽  
Private Center

Abstract Objective: The outbreak of Covid-19 has exerted unprecedented pressure on healthcare systems throughout the world. This study was designed to develop a national health emergency management program based on risk assessment for COVID-19. Method: Mixed-methods research was used. Based on recommendations of the national epidemiology committee, two risk scenarios were used as basic scenarios for risk assessment. Two rounds of Focus Group Discussions (FGDs) were conducted between January and May 2020 with thirty representatives of the health system. The data were collected, analyzed, and Integrated by the research team. Findings: In the risk matrix, “Contamination of environment and Individuals” and “Burn out of Medical staff” occupied the red zone (Intolerable risk). “Defects in screening and admissions”, “Process disruption in Medical care and Rehabilitation”, “Increased mental disorders”, “Social dissatisfaction”,” The decline in healthcare Services”, and “Loss of medical staff” were identified as the orange zone (Significant risk) of the matrix. Conclusion: The risk of environmental, individual contamination, and healthcare workers’ burnout is the priority in Iran. Attention to intersectoral cooperation, the involvement of NGOs and private center capacities, integration of information health systems, and develop evidence-based protocols are other measures that can improve the health system’s capacity in the response COVID-19.

scholarly journals Pharmacy Electronic Records and Patient Clustering: Exploring New Ways to Increase the Provision of Tailored Pharmaceutical Services

2021 ◽  
Author(s):  
Lígia Reis ◽  
Miguel Monteiro ◽  
Luís Lourenço ◽  
João Gregório
Keyword(s):  
Risk Assessment ◽  
Health System ◽  
Community Pharmacy ◽  
Community Pharmacists ◽  
Healthcare Services ◽  
Electronic Records ◽  
Chronic Patients ◽  
Provision Of Services ◽  
Pharmaceutical Interventions ◽  
Untapped Resource

Patients’ electronic records in community pharmacy are an untapped resource to uncover new ways of providing healthcare services. In this paper, we present a preliminary work, where we explore this resource, aiming to identify patients’ clusters that will help to define a future algorithm. This algorithm will then enable community pharmacists to provide tailored pharmaceutical interventions according to patient’s risk assessment and needs. In this way, this work will provide a way to overcome known barriers for community pharmacists’ provision of services and integration in the health system, while also contributing to support a better care for chronic patients.

scholarly journals Socioeconomic determinants of unmet need for outpatient healthcare services in Iran: a national cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sajad Vahedi ◽  
Amin Torabipour ◽  
Amirhossein Takian ◽  
Saeed Mohammadpur ◽  
Alireza Olyaeemanesh ◽  
...  
Keyword(s):  
Health System ◽  
Age Groups ◽  
Unmet Need ◽  
Healthcare Services ◽  
Cross Sectional Study ◽  
Outpatient Services ◽  
Self Medication ◽  
Cross Sectional ◽  
Organizational Policies ◽  
Utilization Of Healthcare

Abstract Background Unmet need is a critical indicator of access to healthcare services. Despite concrete evidence about unmet need in Iran’s health system, no recent evidence of this negative outcome is available. This study aimed to measure the subjective unmet need (SUN), the factors associated with it and various reasons behind it in Iran. Methods We used the data of 13,005 respondents over the age of 15 from the Iranian Utilization of Healthcare Services Survey in 2016. SUN was defined as citizens whose needs were not sought through formal healthcare services, while they did not show a history of self-medication. The reasons for SUN were categorized into availability, accessibility, responsibility and acceptability of the health system. The multivariable logistic regression was used to determine significant predictors of SUN and associated major reasons. Results About 17% of the respondents (N = 2217) had unmet need for outpatient services. Nearly 40% of the respondents chose only accessibility, 4% selected only availability, 78% chose only responsibility, and 13% selected only acceptability as the main reasons for their unmet need. Higher outpatient needs was the only factor that significantly increased SUN, responsibility-related SUN and acceptability-related SUN. Low education was associated with higher SUN and responsibility-related SUN, while it could also reduce acceptability-related SUN. While SUN and responsibility-related SUN were prevalent among lower economic quintiles, having a complementary insurance was associated with decreased SUN and responsibility-related SUN. The people with basic insurance had lower chances to face with responsibility-related SUN, while employed individuals were at risk to experience SUN. Although the middle-aged group had higher odds to experience SUN, the responsibility-related SUN were prevalent among elderly, while higher age groups had significant chance to be exposed to acceptability-related SUN. Conclusion It seems that Iran is still suffering from unmet need for outpatient services, most of which emerges from its health system performance. The majority of the unmet health needs could be addressed through improving financial as well as organizational policies. Special attention is needed to address the unmet need among individuals with poor health status.

scholarly journals The contribution of political skill to the implementation of health services change: a systematic review and narrative synthesis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jenelle M. Clarke ◽  
Justin Waring ◽  
Simon Bishop ◽  
Jean Hartley ◽  
Mark Exworthy ◽  
...  
Keyword(s):  
Leadership Development ◽  
Health Services ◽  
Mixed Methods Research ◽  
Political Skill ◽  
Group Processes ◽  
Healthcare Services ◽  
Narrative Synthesis ◽  
Five Dimensions ◽  
Individual Level ◽  
Health System Change

Abstract Background The implementation of strategic health system change is often complicated by informal ‘politics’ in healthcare organisations. Leadership development programmes increasingly call for the development and use of ‘political skill’ as a means for understanding and managing the politics of healthcare organisations. The primary purpose of this review is to determine how political skill contributes to the implementation of health services change, within and across organisations. The secondary purpose is to demonstrate the conceptual variations within the literature. Methods The article is based upon a narrative synthesis that included quantitative, qualitative and mixed methods research papers, review articles and professional commentaries that deployed the concept of political skill (or associated terms) to describe and analyse the implementation of change in healthcare services. Results Sixty-two papers were included for review drawn from over four decades of empirically and conceptually diverse research. The literature is comprised of four distinct literatures with a lack of conceptual coherence. Within and across these domains, political skill is described as influencing health services change through five dimensions of leadership: personal performance; contextual awareness; inter-personal influence; stakeholder engagement, networks and alliances; and influence on policy processes. Conclusion There is a growing body of evidence showing how political skill can contribute to the implementation of health services change, but the evidence on explanatory processes is weak. Moreover, the conceptualisation of political skill is variable making comparative analysis difficult, with research often favouring individual-level psychological and behavioural properties over more social or group processes.

scholarly journals Bacteriophage-Based Biosensing of Pseudomonas aeruginosa: An Integrated Approach for the Putative Real-Time Detection of Multi-Drug-Resistant Strains

Biosensors ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 124
Author(s):  
Liliam K. Harada ◽  
Waldemar Bonventi Júnior ◽  
Erica C. Silva ◽  
Thais J. Oliveira ◽  
Fernanda C. Moreli ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Bacterial Infections ◽  
Research Effort ◽  
Acquired Resistance ◽  
Integrated Approach ◽  
Healthcare Services ◽  
Host Cells ◽  
Color Changes ◽  
Metabolic Versatility ◽  
The Matrix

During the last decennium, it has become widely accepted that ubiquitous bacterial viruses, or bacteriophages, exert enormous influences on our planet’s biosphere, killing between 4–50% of the daily produced bacteria and constituting the largest genetic diversity pool on our planet. Currently, bacterial infections linked to healthcare services are widespread, which, when associated with the increasing surge of antibiotic-resistant microorganisms, play a major role in patient morbidity and mortality. In this scenario, Pseudomonas aeruginosa alone is responsible for ca. 13–15% of all hospital-acquired infections. The pathogen P. aeruginosa is an opportunistic one, being endowed with metabolic versatility and high (both intrinsic and acquired) resistance to antibiotics. Bacteriophages (or phages) have been recognized as a tool with high potential for the detection of bacterial infections since these metabolically inert entities specifically attach to, and lyse, bacterial host cells, thus, allowing confirmation of the presence of viable cells. In the research effort described herein, three different phages with broad lytic spectrum capable of infecting P. aeruginosa were isolated from environmental sources. The isolated phages were elected on the basis of their ability to form clear and distinctive plaques, which is a hallmark characteristic of virulent phages. Next, their structural and functional stabilization was achieved via entrapment within the matrix of porous alginate, biopolymeric, and bio-reactive, chromogenic hydrogels aiming at their use as sensitive matrices producing both color changes and/or light emissions evolving from a reaction with (released) cytoplasmic moieties, as a bio-detection kit for P. aeruginosa cells. Full physicochemical and biological characterization of the isolated bacteriophages was the subject of a previous research paper.

Analysis of Cerebral Vascular Lesion Pools in Ischemic Stroke Based on the Analysis and the Prognostic Assessment of Risk Factors in Patients with Primary and Recurrent Ischemic Stroke

2016 ◽  
pp. 65-68
Author(s):  
Oksana Mikitey
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Ischemic Stroke ◽  
Recurrent Stroke ◽  
Significant Risk ◽  
Vascular Lesion ◽  
Assessment Tools ◽  
Vascular Lesions ◽  
Global Risk ◽  
Risk Assessment Tools

Stroke is an important medical and social problem, and stroke risk assessment tools have difficulty on the interaction of risk factors and the effects of certain risk factors with analysis by age, gender, race, because this information fully available to global risk assessment tools. In addition, these tools tend to be focused and usually do not include the entire range of possible factors contributing. The aim of the study was to conduct a comparison of brain vascular lesions pool with ischemic stroke (II) based predictive analysis and assessment of the main risk factors in patients with primary and recurrent ischemic stroke. Prognostically significant risk factors for recurrent ischemic stroke is not effective antihypertensive therapy, multiple stenoses any one pool vascular brain, duration of hypertension (AH) over 5 years and regular smoking patients (p<0.001). In the initial localization in the second vertebrobasilar recurrent stroke was significantly (p<0.05) more developed in the same pool in women than in men; and the localization of the primary carotid AI in the pool, re-developed stroke often unreliable in the same pool in women than in men.

Development of a probabilistic model for quantitative risk assessment of COVID-19 in Brazil

2021 ◽  
pp. 2150069
Author(s):  
Paulo Gabriel Santos Campos de Siqueira ◽  
Alexandre Calumbi Antunes de Oliveira ◽  
Heitor Oliveira Duarte ◽  
Márcio das Chagas Moura
Keyword(s):  
Public Health ◽  
Risk Assessment ◽  
Health System ◽  
Probabilistic Model ◽  
Public Health System ◽  
The Other ◽  
Quantitative Risk Assessment ◽  
The Public ◽  
Business As Usual ◽  
Excessive Number

We have developed a probabilistic model to quantify the risks of COVID-19 explosion in Brazil, the epicenter of COVID-19 in Latin America. By explosion, we mean an excessive number of new infections that would overload the public health system. We made predictions from July 12th to Oct 10th, 2020 for various containment strategies, including business as usual, stay at home (SAH) for young and elderly, flight restrictions among regions, gradual resumption of business and the compulsory wearing of masks. They indicate that: if a SAH strategy were sustained, there would be a negligible risk of explosion and the public health system would not be overloaded. For the other containment strategies, the scenario that combines the gradual resumption of business with the mandatory wearing of masks would be the most effective, reducing risk to considerable category. Should this strategy is applied together with the investment in more Intensive Care Unit beds, risk could be reduced to negligible levels. A sensitivity analysis sustained that risks would be negligible if SAH measures were adopted thoroughly.

Allied health: integral to transforming health

2016 ◽  
Vol 40 (2) ◽  
pp. 194 ◽  
Author(s):  
Lucylynn Lizarondo ◽  
Catherine Turnbull ◽  
Tracey Kroon ◽  
Karen Grimmer ◽  
Alison Bell ◽  
...  
Keyword(s):  
Health Services ◽  
Health System ◽  
Patient Outcomes ◽  
Allied Health ◽  
Systems Of Care ◽  
Healthcare Services ◽  
Supporting Evidence ◽  
Allied Health Professionals ◽  
Health Practitioners

Objective South Australia is taking an innovative step in transforming the way its healthcare is organised and delivered to better manage current and future demands on the health system. In an environment of transforming health services, there are clear opportunities for allied health to assist in determining solutions to various healthcare challenges. A recent opinion piece proposed 10 clinician-driven strategies to assist in maximising value and sustainability of healthcare in Australia. The present study aimed to seek the perspectives of allied health clinicians, educators, researchers, policy makers and managers on these strategies and their relevance to allied health. Methods A survey of allied health practitioners was undertaken to capture their perspectives on the 10 clinician-driven strategies for maximising value and sustainability of healthcare in Australia. Survey findings were then layered with evidence from the literature. Results Highly relevant across allied health are the strategies of discontinuation of low value practices, targeting clinical interventions to those getting greatest benefit, active involvement of patients in shared decision making and self-management and advocating for integrated systems of care. Conclusions Allied health professionals have been involved in the South Australian healthcare system for a prolonged period, but their services are poorly recognised, often overlooked and not greatly supported in existing traditional practices. The results of the present study highlight ways in which healthcare services can implement strategies not only to improve the quality of patient outcomes, but also to offer innovative solutions for future, sustainable healthcare. The findings call for concerted efforts to increase the utilisation of allied health services to ensure the ‘maximum value for spend’ of the increasingly scarce health dollar. What is known about the topic? In medicine, clinician-driven strategies have been proposed to minimise inappropriate and costly care and maximise highly appropriate and less expensive care. These strategies were developed based on clinical experiences and with supporting evidence from scientific studies. What does this paper add? Major changes to the health system are required to slow down the growth in healthcare expenditure. This paper describes opportunities in which allied health practitioners can implement similar strategies not only to improve the quality of patient outcomes, but also to offer cost-effective solutions for a sustainable healthcare. What are the implications for practitioners? Allied health practitioners can provide solutions to healthcare challenges and assist in the transformation of healthcare in Australia. However, for this to happen, there should be concerted efforts to increase recognition of and support for the use of allied health services.

scholarly journals Application of microbial risk assessment on a residentially-operated Bio-toilet

2006 ◽  
Vol 4 (4) ◽  
pp. 479-486 ◽  
Author(s):  
Naoko Nakagawa ◽  
Hana Oe ◽  
Masahiro Otaki ◽  
Katsuyoshi Ishizaki
Keyword(s):  
Risk Assessment ◽  
Water Content ◽  
Risk Level ◽  
Microbial Risk Assessment ◽  
Microbial Risk ◽  
Infectious Risk ◽  
The Matrix ◽  
Pathogenic Viruses ◽  
Scale Experiment ◽  
Time Required

The Sustainable Sanitation System is a new wastewater treatment system that incorporates a non-flushing toilet (Bio-toilet) that converts excreta into a reusable resource (as fertilizer or humus for organic agriculture) and reduces the pollution load to environments of the rivers, the lakes, and the sea. However, the risk of exposure to pathogens should be considered, because excrement is stored in the Bio-toilet. The aim of the present work is to analyze the health risk of dealing with the matrix (excreta and urine mixed with sawdust) of the Bio-toilet. Therefore, the fate of pathogenic viruses was investigated using coliphages as a virus index, and the modeling of the die-off rate in matrix was introduced. Then the microbial risk assessment was applied to a Bio-toilet that was actually used in a residential house; the infection risks of rotavirus and enterovirus as reference pathogens were calculated. According to the lab-scale experiment using coliphages for investing the die-off rate of viruses in the Bio-toilet, Qβ had a higher die-off, which was greatly influenced by the water content and temperature. On the other hand, T4 showed a lower rate and was independent of water content. Therefore, these two phages' data were used as critical examples, such as viruses having high or low possibilities of remaining in the Bio-toilet during the risk assessment analysis. As the result of the risk assessment, the storage time required for an acceptable infectious risk level has wide variations in both rotavirus and enterovirus cases depending on the phage that was used. These were 0–260 days' and 0–160 days' difference, respectively.

scholarly journals [South] Africa's Health System and Human Rights: A Critical African Perspective

2018 ◽  
Vol 10 (1(J)) ◽  
pp. 69-77
Author(s):  
Kgothatso Brucely Shai ◽  
Olusola Ogunnubi
Keyword(s):  
Human Rights ◽  
Health System ◽  
Critical Discourse Analysis ◽  
South African ◽  
Health Sector ◽  
Popular Literature ◽  
Healthcare Services ◽  
African National Congress ◽  
South Africans ◽  
Health Rights

For more than two decades, 21st March has been canonised and celebrated among South Africans as Human Rights Day. Earmarked by the newly democratic and inclusive South Africa, it commemorates the Sharpeville and Langa massacres. As history recorded, on the 21st March 1960, residents of Sharpeville and subsequently, Langa embarked on a peaceful anti-pass campaign led by the African National Congress (ANC) breakaway party, the Pan Africanist Congress of Azania (PAC). The pass (also known as dompas) was one of the most despised symbols of apartheid; a system declared internationally as a crime against humanity. In the post-apartheid era, it is expectedthat all South Africans enjoy and celebrate the full extent of their human rights. However, it appears that the envisaged rights are not equally enjoyed by all. This is because widening inequalities in the health-care system, in schooling, and in the lucrative sporting arena have not been amicably and irrevocably resolved. Furthermore, it is still the norm that the most vulnerable of South Africans, especially rural Africans, find it difficult, and sometimes, impossible to access adequate and even essential healthcare services. Central to the possible questions to emerge from this discourse are the following(i) What is the current state of South Africa’s health system at the turn of 23 years of its majority rule? (ii) Why is the South African health system still unable to sufficiently deliver the socioeconomic health rights of most South African people? It is against this background that this article uses a critical discourse analysis approach in its broadest form to provide a nuanced Afrocentric assessment of South Africa’s human rights record in the health sector since the year 1994. Data for this article is generated through the review of the cauldron of published and unpublished academic, official and popular literature. 

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