Concluding remarks

2020 ◽  
pp. 211-216
Author(s):  
Edmund Jessop ◽  
Martin Gulliford
Keyword(s):  
Public Health ◽  
Complex Systems ◽  
Old Age ◽  
Demographic Change ◽  
Healthcare Systems ◽  
Financial Resources ◽  
Coding Systems ◽  
Concepts Of Disease ◽  
Definition Of ◽  
Economic Constraints

Demographic change and economic constraints are likely to drive change in healthcare systems over the next few decades. It seems inevitable that both the amount and the shape of healthcare systems will be stretched by increasing numbers of old people, even as the definition of ‘old age’ is itself stretched. Concepts of ‘disease’ may need to change; such changes will need to be mirrored in coding systems. As healthcare becomes more specialized, pathways become more complex. This will disadvantage people who lack the cognitive, physical, and financial resources to navigate complex systems. Specialists in healthcare public health will need to adapt their knowledge, skills, and attitudes.

scholarly journals Emergency cricothyrotomy during the COVID-19 pandemic: how to suppress aerosolization

2020 ◽  
Vol 5 (1) ◽  
pp. e000542
Author(s):  
Nabil Issa ◽  
Whitney E Liddy ◽  
Sandeep Samant ◽  
David B Conley ◽  
Robert C Kern ◽  
...  
Keyword(s):  
Potential Risk ◽  
Healthcare Providers ◽  
Healthcare Setting ◽  
Healthcare Systems ◽  
Financial Resources ◽  
Risk Of Infection ◽  
X Ray ◽  
General Surgeons ◽  
Fluorescein Dye ◽  
Nose And Throat

BackgroundCricothyrotomy is associated with significant aerosolization that increases the potential risk of infection among healthcare providers. It is important to identify simple yet effective methods to suppress aerosolization and improve the safety of healthcare providers.Methods5 ear, nose and throat and general surgeons used a locally developed hybrid cricothyrotomy simulator with a porcine trachea to test three draping methods to suppress aerosolization during the procedure: an X-ray cassette drape, dry operating room (OR) towels and wet OR towels. The three methods were judged based on three categories: effectiveness of suppression, availability in all healthcare systems and ease of handling.ResultsAll five surgeons performed the procedure independently using each of the three suppression methods. The wet OR towel drape was found to be an effective method to suppress aerosolization, and it did not hinder the surgeons from performing the procedure accurately. This finding was confirmed by using an atomized fluorescein dye injection into the porcine trachea, representing aerosolized material while performing the procedure.ConclusionsWe present a novel intervention using wet towels to suppress aerosolization during cricothyrotomy. Wet towels are cheap and readily available within any healthcare setting regardless of the financial resources available.

Semantic Health Mediation and Access Control Manager for Interoperability Among Healthcare Systems

2018 ◽  
Vol 11 (4) ◽  
pp. 87-98
Author(s):  
Abdullah Alamri
Keyword(s):  
Medical Information ◽  
Clinical Information ◽  
Healthcare Systems ◽  
Patient Data ◽  
Dual Model ◽  
Healthcare Organizations ◽  
Reference Information ◽  
Proposed Model ◽  
Definition Of ◽  
Semantic Mediation

Healthcare systems have evolved to become more patient-centric. Many efforts have been made to transform paper-based patient data to automated medical information by developing electronic healthcare records (EHRs). Several international EHRs standards have been enabling healthcare interoperability and communication among a wide variety of medical centres. It is a dual-model methodology which comprises a reference information model and an archetype model. The archetype is responsible for the definition of clinical concepts which has limitations in terms of supporting complex reasoning and knowledge discovery requirements. The objective of this article is to propose a semantic-mediation architecture to support semantic interoperability among healthcare organizations. It provides an intermediate semantic layer to exploit clinical information based on richer ontological representations to create a “model of meaning” for enabling semantic mediation. The proposed model also provides secure mechanisms to allow interoperable sharing of patient data between healthcare organizations.

Peri-urban water, sanitation and hygiene in Lusaka, Zambia: photovoice empowering local assessment via ecological theory

2021 ◽  
pp. 175797592199571
Author(s):  
Sikopo Nyambe ◽  
Taro Yamauchi
Keyword(s):  
Public Health ◽  
Public Policy ◽  
Health Hazard ◽  
Disease Outbreaks ◽  
Ecological Theory ◽  
Urban Slum ◽  
Health Concern ◽  
Minimal Impact ◽  
Sanitation And Hygiene ◽  
Definition Of

Water, sanitation and hygiene (WASH) factors are responsible for 11.4% of deaths in Zambia, making WASH a key public health concern. Despite annual waterborne disease outbreaks in the nation’s peri-urban (slum) settlements being linked to poor WASH, few studies have proactively analysed and conceptualised peri-urban WASH and its maintaining factors. Our study aimed to (a) establish residents’ definition of peri-urban WASH and their WASH priorities; and (b) use ecological theory to analyse the peri-urban WASH ecosystem, highlighting maintaining factors. Our study incorporated 16 young people (aged 17–24) residing in peri-urban Lusaka, Zambia in a photovoice exercise. Participants took photographs answering the framing question, ‘What is WASH in your community?’ Then, through contextualisation and basic codifying, participants told the stories of their photographs and made posters to summarise problems and WASH priorities. Participant contextualisation and codifying further underwent theoretical thematic analysis to pinpoint causal factors alongside key players, dissecting the peri-urban WASH ecosystem via the five-tier ecological theory ranging from intrapersonal to public policy levels. Via ecological theory, peri-urban WASH was defined as: (a) poor practice (intrapersonal, interpersonal); (b) a health hazard (community norm); (c) substandard and unregulated (public policy, organisational); and (d) offering hope for change (intrapersonal, interpersonal). Linked to these themes, participant findings revealed a community level gap, with public policy level standards, regulations and implementation having minimal impact on overall peri-urban WASH and public health due to shallow community engagement and poor acknowledgement of the WASH realities of high-density locations. Rather than a top-down approach, participants recommended increased government–resident collaboration, offering residents more ownership and empowerment for intervention, implementation and defending of preferred peri-urban WASH standards.

scholarly journals A public health perspective on mental health: lessons for population health in the 21st century

2021 ◽  
pp. 1-4
Author(s):  
James V. Lucey
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Population Health ◽  
Royal College ◽  
Public Support ◽  
Healthcare Systems ◽  
Lessons Learned ◽  
Public Health Perspective ◽  
The World ◽  
Shared Commitment

In December 2019, clinicians and academics from the disciplines of public health and psychiatry met in Dublin at the Royal College of Surgeons in Ireland (RCSI), to restate their shared commitment to population health. The purpose of this review is to bring our discussion to a wider audience. The meeting could not have been more timely. Six weeks later, the COVID-19 emergency emerged in China and within 12 months it had swept the world. This paper, the contents of which were presented at that meeting in December recommended that future healthcare would be guided more by public health perspectives and informed by an understanding of health economics, population health and the lessons learned by psychiatry in the 20th century. Ultimately two issues are at stake in 21st century healthcare: the sustainability of our healthcare systems and the maintenance of public support for population health. We must plan for the next generation of healthcare. We need to do this now since it is clear that COVID-19 marks the beginning of 21st century medicine.

scholarly journals The use of Qualitative Comparative Analysis (QCA) to address causality in complex systems: a systematic review of research on public health interventions

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Benjamin Hanckel ◽  
Mark Petticrew ◽  
James Thomas ◽  
Judith Green
Keyword(s):  
Public Health ◽  
Comparative Analysis ◽  
Complex Systems ◽  
Qualitative Comparative Analysis ◽  
Complex Interventions ◽  
Health Interventions ◽  
Data Availability ◽  
Future Research ◽  
Public Health Interventions ◽  
Minimum Criteria

Abstract Background Qualitative Comparative Analysis (QCA) is a method for identifying the configurations of conditions that lead to specific outcomes. Given its potential for providing evidence of causality in complex systems, QCA is increasingly used in evaluative research to examine the uptake or impacts of public health interventions. We map this emerging field, assessing the strengths and weaknesses of QCA approaches identified in published studies, and identify implications for future research and reporting. Methods PubMed, Scopus and Web of Science were systematically searched for peer-reviewed studies published in English up to December 2019 that had used QCA methods to identify the conditions associated with the uptake and/or effectiveness of interventions for public health. Data relating to the interventions studied (settings/level of intervention/populations), methods (type of QCA, case level, source of data, other methods used) and reported strengths and weaknesses of QCA were extracted and synthesised narratively. Results The search identified 1384 papers, of which 27 (describing 26 studies) met the inclusion criteria. Interventions evaluated ranged across: nutrition/obesity (n = 8); physical activity (n = 4); health inequalities (n = 3); mental health (n = 2); community engagement (n = 3); chronic condition management (n = 3); vaccine adoption or implementation (n = 2); programme implementation (n = 3); breastfeeding (n = 2), and general population health (n = 1). The majority of studies (n = 24) were of interventions solely or predominantly in high income countries. Key strengths reported were that QCA provides a method for addressing causal complexity; and that it provides a systematic approach for understanding the mechanisms at work in implementation across contexts. Weaknesses reported related to data availability limitations, especially on ineffective interventions. The majority of papers demonstrated good knowledge of cases, and justification of case selection, but other criteria of methodological quality were less comprehensively met. Conclusion QCA is a promising approach for addressing the role of context in complex interventions, and for identifying causal configurations of conditions that predict implementation and/or outcomes when there is sufficiently detailed understanding of a series of comparable cases. As the use of QCA in evaluative health research increases, there may be a need to develop advice for public health researchers and journals on minimum criteria for quality and reporting.

scholarly journals Definitions and Prevalence of Multimorbidity in Large Database Studies: A Scoping Review

2021 ◽  
Vol 18 (4) ◽  
pp. 1673
Author(s):  
Ying Pin Chua ◽  
Ying Xie ◽  
Poay Sian Sabrina Lee ◽  
Eng Sing Lee
Keyword(s):  
Scoping Review ◽  
Chronic Conditions ◽  
Meta Analysis ◽  
Epidemiological Studies ◽  
Cross Sectional ◽  
Coding Systems ◽  
Wide Range ◽  
Scoping Reviews ◽  
Retrospective Cohort Studies ◽  
Definition Of

Background: Multimorbidity presents a key challenge to healthcare systems globally. However, heterogeneity in the definition of multimorbidity and design of epidemiological studies results in difficulty in comparing multimorbidity studies. This scoping review aimed to describe multimorbidity prevalence in studies using large datasets and report the differences in multimorbidity definition and study design. Methods: We conducted a systematic search of MEDLINE, EMBASE, and CINAHL databases to identify large epidemiological studies on multimorbidity. We used the Preferred Reporting Items for Systematic Reviews and Meta-analysis Extension for Scoping Reviews (PRISMA-ScR) protocol for reporting the results. Results: Twenty articles were identified. We found two key definitions of multimorbidity: at least two (MM2+) or at least three (MM3+) chronic conditions. The prevalence of multimorbidity MM2+ ranged from 15.3% to 93.1%, and 11.8% to 89.7% in MM3+. The number of chronic conditions used by the articles ranged from 15 to 147, which were organized into 21 body system categories. There were seventeen cross-sectional studies and three retrospective cohort studies, and four diagnosis coding systems were used. Conclusions: We found a wide range in reported prevalence, definition, and conduct of multimorbidity studies. Obtaining consensus in these areas will facilitate better understanding of the magnitude and epidemiology of multimorbidity.

scholarly journals Shining a Light also Casts a Shadow: Neuroimaging Incidental Findings in Neuromarketing Research

Neuroethics ◽  
2021 ◽  
Author(s):  
Owen M. Bradfield
Keyword(s):  
Public Health ◽  
Rapid Growth ◽  
Incidental Findings ◽  
Brain Research ◽  
Social Value ◽  
Financial Resources ◽  
Potential Health ◽  
Functional Brain ◽  
Public Health Systems ◽  
The Social

AbstractRapid growth in structural and functional brain research has led to increasing ethical discussion of what to do about incidental findings within the brains of healthy neuroimaging research participants that have potential health importance, but which are beyond the original aims of the study. This dilemma has been widely debated with respect to general neuroimaging research but has attracted little attention in the context of neuromarketing studies. In this paper, I argue that neuromarketing researchers owe participants the same ethical obligations as other neuroimaging researchers. The financial resources available to neuromarketing firms and the social value of neuromarketing studies should command greater attention to the elucidation and management of incidental findings. However, this needs to be balanced against finite resources available within most public health systems.

INSTITUTIONAL FRAMEWORK FOR REGULATING THE STATE FINANCIAL RESOURCES IN THE SUBJECTS OF THE RUSSIAN FEDERATION

2021 ◽  
Author(s):  
Елизавета Николаевна Валиева
Keyword(s):  
Public Finance ◽  
Russian Federation ◽  
The State ◽  
Institutional Framework ◽  
Financial Resources ◽  
The Russian Federation ◽  
Definition Of

В статье рассматривается проблематика общественных финансов. Дано определение государственным финансовым ресурсам. Охарактеризован процесс развития межбюджетных отношений в РФ, в результате которого формировался институт регулирования финансовых ресурсов государства. Сформулированы предложения, направленные на совершенствование данного института. The article deals with the problems of public finance. The definition of state financial resources is given. The process of development of interbudgetary relations in the Russian Federation, as a result of which the institution of regulation of financial resources of the state was formed, is characterized. Proposals are formulated aimed at improving this institution.

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