scholarly journals Nurse migration in Germany, the UK, and Australia: a comparative situation analysis

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Ewers ◽  
J Smith ◽  
Z Tomkins ◽  
R Woodward-Kron
Keyword(s):  
Public Health ◽  
Labour Market ◽  
Health Systems ◽  
Grey Literature ◽  
Routine Data ◽  
Chronically Ill ◽  
Situation Analysis ◽  
Nurse Migration ◽  
Reporting Systems ◽  
The Uk

Abstract Background Nurse migration is increasingly seen as an appropriate response to address nursing shortages in overburdened health systems. This paper aims to analyse the situation in Germany, the UK and Australia and identify similarities and differences in the dimensions, perceptions and processing of nurse migration in different health systems. Methods A rapid evidence assessment and comparative situation analysis of routine data obtained from public health, education and labour market reporting systems, and academic and grey literature were carried out in Jan-Feb 2020. Primary outcome measures were key data of nurse population and migration, barriers and opportunities, and educational initiatives to support migrating nurses to meet the requirements to work in the destination country. Results Germany, the UK and Australia are confronted with an ageing and increasingly chronically ill population and severe nursing shortages. Skilled migration is seen as an opportunity to address these problems, but each country is faced with different contextual conditions and requirements. Data on the nurse workforce obtained from public health, educational and labour market reporting systems are more differentiated and extensive in the UK and Australia than in Germany. Furthermore, there is a substantial amount of published literature in the UK (n = 65) and Australia (n = 87) on nurse migration and on how the countries address challenges in this area; in comparison to the German context, where such research is limited (n = 7). Available research focuses on the economic, epidemiological and geographical impact and distribution of nurse migration. Qualitative dimensions and educational requirements are less well discussed. Conclusions Evidence on nursing migration is strongly based on quantitative factors and may not reflect current needs. More information about qualitative aspects of nurse migration is required to develop recommendations that support enhanced nursing workforce migration. Key messages Nurse Migration presents many challenges that have not yet been fully researched. Results of a comparative analysis of three countries offer the opportunity to highlight missed opportunities.

scholarly journals Artificial intelligence for good health: a scoping review of the ethics literature

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Kathleen Murphy ◽  
Erica Di Ruggiero ◽  
Ross Upshur ◽  
Donald J. Willison ◽  
Neha Malhotra ◽  
...  
Keyword(s):  
Public Health ◽  
Artificial Intelligence ◽  
Global Health ◽  
Population Health ◽  
Health Systems ◽  
Scoping Review ◽  
Industrial Revolution ◽  
Ethical Issues ◽  
Grey Literature ◽  
Ethical Implications

Abstract Background Artificial intelligence (AI) has been described as the “fourth industrial revolution” with transformative and global implications, including in healthcare, public health, and global health. AI approaches hold promise for improving health systems worldwide, as well as individual and population health outcomes. While AI may have potential for advancing health equity within and between countries, we must consider the ethical implications of its deployment in order to mitigate its potential harms, particularly for the most vulnerable. This scoping review addresses the following question: What ethical issues have been identified in relation to AI in the field of health, including from a global health perspective? Methods Eight electronic databases were searched for peer reviewed and grey literature published before April 2018 using the concepts of health, ethics, and AI, and their related terms. Records were independently screened by two reviewers and were included if they reported on AI in relation to health and ethics and were written in the English language. Data was charted on a piloted data charting form, and a descriptive and thematic analysis was performed. Results Upon reviewing 12,722 articles, 103 met the predetermined inclusion criteria. The literature was primarily focused on the ethics of AI in health care, particularly on carer robots, diagnostics, and precision medicine, but was largely silent on ethics of AI in public and population health. The literature highlighted a number of common ethical concerns related to privacy, trust, accountability and responsibility, and bias. Largely missing from the literature was the ethics of AI in global health, particularly in the context of low- and middle-income countries (LMICs). Conclusions The ethical issues surrounding AI in the field of health are both vast and complex. While AI holds the potential to improve health and health systems, our analysis suggests that its introduction should be approached with cautious optimism. The dearth of literature on the ethics of AI within LMICs, as well as in public health, also points to a critical need for further research into the ethical implications of AI within both global and public health, to ensure that its development and implementation is ethical for everyone, everywhere.

UK Public Health Systems

Public Health ◽  
2020 ◽  
Author(s):  
David Hunter
Keyword(s):  
Public Health ◽  
Health System ◽  
Health Systems ◽  
Public Health System ◽  
Well Being ◽  
Health Improvement ◽  
Public Health Systems ◽  
Science And Art ◽  
Definition Of ◽  
The Uk

Within the UK there are four public health systems covering each of four countries making up the UK: England is the largest country, followed by Scotland, Wales, and Northern Ireland. There are many commonalities between the systems in terms of their functions and workforce terms and conditions as well as the challenges each faces. But in keeping with the devolved systems of government enjoyed by each country, the public health systems are organized differently and their structures and priorities reflect the differing contexts in which they are located. Drawing on the three domains outlined by Griffiths, Jewell, and Donnelly in their seminal 2005 paper and comprising health protection, health improvement, and health service delivery and quality, UK public health systems exist to protect and promote health improvement and well-being in the population and do so through devising policies and strategies and providing services as well as contributing to the evidence base in regard to what works to improve health. The definition of a public health system is clearly contingent on the definition and scope of public health. The UK public health systems have adopted the definition of public health advanced by the UK Faculty of Public Health and other bodies and first produced by a former Chief Medical Officer for England, Sir Donald Acheson, in 1998: “Public health is the science and art of preventing disease, prolonging life and promoting health through organised efforts of society.” A slightly extended version appeared in a review of public health carried out for the UK government by its appointed independent adviser, Sir Derek Wanless, in 2004: “Public health is the science and art of preventing disease, prolonging life, and promoting health through the organised efforts and informed choices of society, organisations, public and private, communities and individuals.” These definitions share important characteristics including: public health is both a science and an art, essentially and always a combination of knowledge and action; the core purposes of public health are to prevent disease, prolong life, and promote health; public health is an organized societal function. Several aspects of these definitions can be highlighted as being especially pertinent to public health systems. Notable among these is the desire for closer links across health and the environmental sector; addressing social and political determinants of health as an essential and legitimate public health action; and the importance of health systems for public health improvement. Given these definitions with their whole-of-society focus, a public health system is wider and more inclusive than a health system. An effective public health system can be judged by the extent to which relevant groups, organizations, and sectors work effectively together on specific issues.

scholarly journals Artificial Intelligence for Good Health: A Scoping Review of the Ethics Literature

2020 ◽  
Author(s):  
Kathleen Murphy ◽  
Erica Di Ruggiero ◽  
Ross Upshur ◽  
Donald J. Willison ◽  
Neha Malhotra ◽  
...  
Keyword(s):  
Public Health ◽  
Artificial Intelligence ◽  
Global Health ◽  
Population Health ◽  
Health Systems ◽  
Scoping Review ◽  
Industrial Revolution ◽  
Ethical Issues ◽  
Grey Literature ◽  
Ethical Implications

Abstract Background Artificial intelligence (AI) has been described as the “fourth industrial revolution” with transformative and global implications, including in healthcare, public health, and global health. AI approaches hold promise for improving health systems worldwide, as well as individual and population health outcomes. While AI may have the potential to advance health equity within and between countries, we must consider the ethical implications of its deployment in order to mitigate its potential harms, particularly for the most vulnerable. This scoping review addresses the following question: What ethical issues have been identified in relation to AI in the field of health, including from a global health perspective? Methods Eight electronic databases were searched for peer reviewed and grey literature using the overarching concepts of health, ethics, and AI, and their related terms. Records were independently screened by two reviewers and were included if they reported on AI in relation to health and ethics and were written in the English language. Data was charted on a piloted data abstraction form, and a descriptive and thematic analysis was performed. Results Upon reviewing 12,722 articles, 103 met the predetermined inclusion criteria. The literature was primarily focused on the ethics of AI in health care, particularly on carer robots, diagnostics, and precision medicine, but was largely silent on ethics of AI in public and population health. The literature highlighted a number of common ethical concerns related to privacy, trust, accountability, and bias. Largely missing from the reviewed literature was the ethics of AI in global health, particularly in the context of low- and middle-income countries (LMICs). Conclusions The ethical issues surrounding AI in the field of health are both vast and complex. While AI holds the potential to improve health and health systems, our analysis suggests that its introduction should be approached with cautious optimism. The dearth of literature on the ethics of AI within LMICs, as well as in public health, also points to a critical need for further research into the ethical implications of AI within both global and public health, to ensure that its development and implementation is ethical for everyone, everywhere.

scholarly journals Artificial Intelligence for Good Health: A Scoping Review of the Ethics Literature

2021 ◽  
Author(s):  
Kathleen Murphy ◽  
Erica Di Ruggiero ◽  
Ross Upshur ◽  
Donald J. Willison ◽  
Neha Malhotra ◽  
...  
Keyword(s):  
Public Health ◽  
Artificial Intelligence ◽  
Global Health ◽  
Population Health ◽  
Health Systems ◽  
Scoping Review ◽  
Industrial Revolution ◽  
Ethical Issues ◽  
Grey Literature ◽  
Ethical Implications

Abstract Background: Artificial intelligence (AI) has been described as the “fourth industrial revolution” with transformative and global implications, including in healthcare, public health, and global health. AI approaches hold promise for improving health systems worldwide, as well as individual and population health outcomes. While AI may have potential for advancing health equity within and between countries, we must consider the ethical implications of its deployment in order to mitigate its potential harms, particularly for the most vulnerable. This scoping review addresses the following question: What ethical issues have been identified in relation to AI in the field of health, including from a global health perspective? Methods: Eight electronic databases were searched for peer reviewed and grey literature published before April 2018 using the concepts of health, ethics, and AI, and their related terms. Records were independently screened by two reviewers and were included if they reported on AI in relation to health and ethics and were written in the English language. Data was charted on a piloted data charting form, and a descriptive and thematic analysis was performed. Results: Upon reviewing 12,722 articles, 103 met the predetermined inclusion criteria. The literature was primarily focused on the ethics of AI in health care, particularly on carer robots, diagnostics, and precision medicine, but was largely silent on ethics of AI in public and population health. The literature highlighted a number of common ethical concerns related to privacy, trust, accountability and responsibility, and bias. Largely missing from the literature was the ethics of AI in global health, particularly in the context of low- and middle-income countries (LMICs). Conclusions: The ethical issues surrounding AI in the field of health are both vast and complex. While AI holds the potential to improve health and health systems, our analysis suggests that its introduction should be approached with cautious optimism. The dearth of literature on the ethics of AI within LMICs, as well as in public health, also points to a critical need for further research into the ethical implications of AI within both global and public health, to ensure that its development and implementation is ethical for everyone, everywhere.

scholarly journals Public Health and Health Systems Impacts of SARS-CoV-2 Variants of Concern: A Rapid Scoping Review

2021 ◽  
Author(s):  
Janet A Curran ◽  
Justine Dol ◽  
Leah Boulos ◽  
Mari Somerville ◽  
Bearach Reynolds ◽  
...  
Keyword(s):  
Public Health ◽  
Health System ◽  
Health Systems ◽  
Scoping Review ◽  
Grey Literature ◽  
Current Evidence ◽  
Risk Of Death ◽  
Health Measures ◽  
Guidance Documents ◽  
The Impact

Background: As of April 2021, three SARS-CoV-2 variants of concern (VOC: B.1.1.7, B.1.351 and P.1) have been detected in over 132 countries. Increased transmissibility of VOC has implications for public health measures and health system arrangements. This rapid scoping review aims to provide a synthesis of current evidence related to public health measures and health system arrangements associated with VOC. Methods: Rapid scoping review. Seven databases were searched up to April 7, 2021 for terms related to VOC, transmission, public health and health systems. A grey literature search was conducted up to April 14, 2021. Title, abstracts and full text were screened independently by two reviewers. Data were double extracted using a standardized form. Studies were included if they reported on at least one of the VOC and public health or health system outcomes. Results: Of the 2487 articles and 59 grey literature sources retrieved, 37 studies and 21 guidance documents were included. Included studies used a wide range of designs and methods. Most of the studies and guidance documents reported on B.1.1.7, and 18 studies and 4 reports provided data for consideration in relation to public health measures. Public health measures, including lockdowns, physical distancing, testing and contact tracing, were identified as critical adjuncts to a comprehensive vaccination campaign. No studies reported on handwashing or masking procedures related to VOC. For health system arrangements, 17 studies were identified. Some studies found an increase in hospitalization due to B.1.1.7 but no difference in length of stay or ICU admission. Six studies found an increased risk of death ranging from 15-67% with B.1.1.7 compared non-B.1.1.7, but three studies reported no change. One study reported on the effectiveness of personal protective equipment in reducing VOC transmission in the hospital. No studies reported on screening staff and visitors, adjusting service provisions, or adjusting patient accommodations and shared spaces, which is a significant gap in the literature. Guidance documents did not tend to cite any evidence and were thus assumed to be based on expert opinion. Conclusion: While the findings should be interpreted with caution as most of the sources identified were preprints, findings suggest a combination of non-pharmaceutical interventions (e.g., masking, physical distancing, lockdowns, testing) should be employed alongside a vaccine strategy to improve population and health system outcomes. While the findings are mixed on the impact of VOC on health system arrangements, the evidence is trending towards increased hospitalization and death.

Digital mHealth and Virtual Care Use in Pandemics: Part 1 – A Rapid Landscape Review of Interventions Used Internationally During COVID-19 in 4 Countries (Preprint)

2020 ◽  
Author(s):  
Alison Müller ◽  
Alessandro Cau ◽  
Muhammed Semakula ◽  
Peter Lodokiyiia ◽  
Osman Abdullahi ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Patient Care ◽  
Grey Literature ◽  
Text Message ◽  
Rapid Expansion ◽  
Contact Tracing ◽  
Virtual Care ◽  
Health Organization ◽  
The Uk

BACKGROUND As a result of the Coronavirus Disease-2019 (COVID-19) pandemic, significantly fewer patients are able to communicate with their health care practitioners (HCPs) as a result of internationally encouraged physical distancing. This has led to an unprecedented rapid expansion of digital tools to provide digitalized virtual care globally, especially mobile phone facilitated health interventions, called mHealth. To help keep abreast of different mHealth and virtual care technologies being used internationally to facilitate patient care and public health during the COVID-19 pandemic we did a rapid investigation of solutions being deployed and considered in 4 countries. OBJECTIVE To evaluate mHealth, and digital and contact tracing technologies being used in healthcare among 4 countries. METHODS This data was procured by accessing a variety of resources including grey literature, government & health organization websites, in addition to contacting our collaborators in Canada, the UK, Rwanda, and Kenya. We specifically requested information regarding various mHealth and virtual care interventions being used to facilitate patient care and public health, such as case contact tracing. RESULTS We identified a variety of technology in Canada, the UK, Rwanda, and Kenya being used for patient care and public health. The afore-mentioned countries are using both video and text-message based platforms to facilitate communication with HCPs (ex. WelTel, Zoom). Nationally-developed contact-tracing apps are provided free to the public, with most of them using Bluetooth-based technology. We identified that often multiple complimentary technologies are being utilized for different aspects of patient care and public health with the common purpose to disseminate information safely. CONCLUSIONS Virtual care and mHealth technologies have evolved rapidly as a tool for health care support for both patient care and public health. It is evident that, on an international level, a variety of mHealth and virtual care interventions, often in combination, are required to be able to address patient care and public health concerns during the COVID-19 pandemic. CLINICALTRIAL N/A

scholarly journals Lessons in Public Health Leadership

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Latif
Keyword(s):  
Public Health ◽  
Health Systems ◽  
Public Health Systems ◽  
Health Leadership ◽  
Public Health Challenges ◽  
Competency Based ◽  
Systems Leadership ◽  
The Uk ◽  
The Right ◽  
Public Health Leadership

Abstract Background The UK Faculty of Public Health (FPH) is a world leader in developing a dynamic competency-based curriculum and delivering high quality training and professional development of a multidisciplinary public health specialist workforce in the UK. This includes capacity building and shaping tomorrow's public health leaders. Objectives Strong Leadership is increasingly the need of the day to deal with the complex public health challenges in a rapidly evolving and shifting global landscape. Can a public health curriculum and training (like that of the FPH) provide the framework for the knowledge, skills, attitudes and behaviours required for producing world class public health systems leaders? Body of the session Key principles of developing systems leadership include providing an enabling environment, developing the right skill mix, acquiring relevant knowledge, framing placements with experienced supervision and appropriate coaching and mentoring are some of the elements built into the training opportunities for public health registrars, their supervisors and new consultants. This presentation will give an overview of some lessons in public health leadership, the skills and knowledge base required to perform effectively as a public health systems leader and explore some of the challenges faced by the world of public health. The panel will encourage interactive discussion to share the learning from other countries and systems required to develop the next generation of public health leaders. Conclusions Public health, of all specialties, lends itself best to lead across and beyond organisational boundaries, lead without authority and create change whilst not being in charge. It is imperative that systems are put in place to train, develop and build public health leaders for tomorrow.

scholarly journals Opioid use disorder treatment disruptions during the early COVID-19 pandemic and other emergent disasters: a scoping review addressing dual public health emergencies

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rita Henderson ◽  
Ashley McInnes ◽  
Leslee Mackey ◽  
Myles Bruised Head ◽  
Lindsay Crowshoe ◽  
...  
Keyword(s):  
Public Health ◽  
Substance Use ◽  
Health Systems ◽  
Scoping Review ◽  
Scientific Journal ◽  
Grey Literature ◽  
Opioid Use Disorder ◽  
Nominal Group ◽  
Opioid Use ◽  
Public Health Emergencies

Abstract Background During public health emergencies, people with opioid use disorder (PWOUD) may be particularly impacted. Emergent disasters such as the COVID-19 pandemic disrupt already-strained harm reduction efforts and treatment availability. This study aims to answer three research questions. How do public health emergencies impact PWOUD? How can health systems respond to novel public health emergencies to serve PWOUD? How can the results of this scoping review be contextualized to the province of Alberta to inform local stakeholder responses to the pandemic? Methods We conducted a scoping review using the 6-stage Arksey and O’Malley framework to analyse early-pandemic and pre-pandemic disaster literature. The results of the scoping review were contextualized to the local pandemic response, through a Nominal Group Technique (NGT) process with frontline providers and stakeholders in Alberta, Canada. Results Sixty one scientific journal articles and 72 grey literature resources were included after full-text screening. Forty sources pertained to early COVID-19 responses, and 21 focused on OUD treatment during other disasters. PWOUD may be more impacted than the general population by common COVID-19 stressors including loss of income, isolation, lack of rewarding activities, housing instability, as well as fear and anxiety. They may also face unique challenges including threats to drug supplies, stigma, difficulty accessing clean substance use supplies, and closure of substance use treatment centres. All of these impacts put PWOUD at risk of negative outcomes including fatal overdose. Two NGT groups were held. One group (n = 7) represented voices from urban services, and the other (n = 4) Indigenous contexts. Stakeholders suggested that simultaneous attention to multiple crises, with adequate resources to allow attention to both social and health systems issues, can prepare a system to serve PWOUD during disasters. Conclusion This scoping review and NGT study uncovers how disasters impact PWOUD and offers suggestions for better serving PWOUD.

scholarly journals Artificial Intelligence for Good Health: A Scoping Review of the Ethics Literature

2020 ◽  
Author(s):  
Kathleen Murphy ◽  
Erica Di Ruggiero ◽  
Ross Upshur ◽  
Donald J. Willison ◽  
Neha Malhotra ◽  
...  
Keyword(s):  
Public Health ◽  
Artificial Intelligence ◽  
Global Health ◽  
Population Health ◽  
Health Systems ◽  
Scoping Review ◽  
Industrial Revolution ◽  
Ethical Issues ◽  
Grey Literature ◽  
Ethical Implications

Abstract Background: Artificial intelligence (AI) has been described as the “fourth industrial revolution” with transformative and global implications, including in healthcare, public health, and global health. AI approaches hold promise for improving health systems worldwide, as well as individual and population health outcomes. While AI may have potential for advancing health equity within and between countries, we must consider the ethical implications of its deployment in order to mitigate its potential harms, particularly for the most vulnerable. This scoping review addresses the following question: What ethical issues have been identified in relation to AI in the field of health, including from a global health perspective? Methods: Eight electronic databases were searched for peer reviewed and grey literature published before April 2018 using the concepts of health, ethics, and AI, and their related terms. Records were independently screened by two reviewers and were included if they reported on AI in relation to health and ethics and were written in the English language. Data was charted on a piloted data charting form, and a descriptive and thematic analysis was performed. Results: Upon reviewing 12,722 articles, 103 met the predetermined inclusion criteria. The literature was primarily focused on the ethics of AI in health care, particularly on carer robots, diagnostics, and precision medicine, but was largely silent on ethics of AI in public and population health. The literature highlighted a number of common ethical concerns related to privacy, trust, accountability, and bias. Largely missing from the literature was the ethics of AI in global health, particularly in the context of low- and middle-income countries (LMICs). Conclusions: The ethical issues surrounding AI in the field of health are both vast and complex. While AI holds the potential to improve health and health systems, our analysis suggests that its introduction should be approached with cautious optimism. The dearth of literature on the ethics of AI within LMICs, as well as in public health, also points to a critical need for further research into the ethical implications of AI within both global and public health, to ensure that its development and implementation is ethical for everyone, everywhere.

scholarly journals Learning across the UK: a review of public health systems and policy approaches to early child development since political devolution

2019 ◽  
Vol 42 (2) ◽  
pp. 224-238 ◽  
Author(s):  
Michelle Black ◽  
Amy Barnes ◽  
Susan Baxter ◽  
Claire Beynon ◽  
Mark Clowes ◽  
...  
Keyword(s):  
Public Health ◽  
Child Development ◽  
Health Systems ◽  
Early Child Development ◽  
Future Health ◽  
Early Child ◽  
Public Health Systems ◽  
Explicit Recognition ◽  
The Uk ◽  
Systems Framework

Abstract Background Giving children the best start in life is critical for their future health and wellbeing. Political devolution in the UK provides a natural experiment to explore how public health systems contribute to children’s early developmental outcomes across four countries. Method A systematic literature review and input from a stakeholder group was used to develop a public health systems framework. This framework then informed analysis of public health policy approaches to early child development. Results A total of 118 studies met the inclusion criteria. All national policies championed a ‘prevention approach’ to early child development. Political factors shaped divergence, with variation in national conceptualizations of child development (‘preparing for life’ versus ‘preparing for school’) and pre-school provision (‘universal entitlement’ or ‘earned benefit’). Poverty and resourcing were identified as key system factors that influenced outcomes. Scotland and Wales have enacted distinctive legislation focusing on wider determinants. However, this is limited by the extent of devolved powers. Conclusion The systems framework clarifies policy complexity relating to early child development. The divergence of child development policies in the four countries and, particularly, the explicit recognition in Scottish and Welsh policy of wider determinants, creates scope for this topic to be a tracer area to compare UK public health systems longer term.

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