A Digital Care Pathway to Access Healthcare Without Time and Place Restrictions

A digital care pathway is a secure digital service channel for patients in a care relationship with a specialized health care hospital in Finland. It is part of the Health Village portal built in co-operation with the Virtual Hospital project by five Finnish university hospitals led by Helsinki University Hospital. Health Village services make healthcare services available to all Finns regardless of place of residence and income level, thus improving the equality of citizens.

Challenges and Future Implications for Ophthalmologists in COVID-19 Environment

In this brief communication, we have highlighted the challenges confronted by Ophthalmologists during COVID-19 pandemic and formulated steps to develop a comprehensive strategy towards minimizing risk of infection transmission between health care workers and patients. To reduce the risk of cross infection, screening and triaging of the patients was done at very initial stage with only high risk patients (red category) were seen directly on slit lamp biomicroscope with PPE. Green and yellow category (low risk) patients were seen via teaching aids or LCDS and telemedicine methods. Elective surgeries were postponed. Less number of attendants were allowed with the patients. Continued teaching services for undergraduate and post graduate students were done by online methods like zoom or Microsoft teams meeting. Departmental meetings were planned via video conferencing (zoom or Microsoft teams). Recommendations are made in this article to ensure safe access to specialized health care in face of COVID-19 pandemic. Key Words: COVID-19, Personal Protective Equipment, Ophthalmologists, Pandemic, Health care workers.

The balance between professional autonomy and organizational obligations in resilient management of specialized health care: A Norwegian document study

BACKGROUND: Adverse events in hospitals may jeopardize the safety of patients. Failure in professional autonomy, organizational learning or in the contact between these two factors may explain the occurrence of injurious incidents in hospitals. OBJECTIVE: To study reasons for failure in contact between professional autonomy and organizational learning in resilient management of specialized health care through document analysis. METHODS: A total of 20 reports from the Norwegian Board of Health Supervision were evaluated by a retrospective in-depth document analysis. In the analysis of adverse events, we applied the Braut model to identify function or failure of 1. Professional autonomy, 2. Organizational learning and 3. Contact between professional autonomy and organizational learning. RESULTS: Multivariable regression analysis showed that ‘Failure in organizational learning’ was the only explanatory variable for ‘Failure in contact between doctors and nurses’ autonomy and organizational learning’. ‘Failure in organizational learning’ had the strongest effect on ‘Failure in contact between doctors and nurse’s autonomy and organizational learning’ (B = 1.69; 95% CI = 0.45 to 2.92). ‘Failure in professional autonomy’ showed no significant effect on this contact. CONCLUSIONS: ‘Failure in organizational learning’ is associated with ‘Failure in contact between professional autonomy and organizational learning’. ‘Failure in professional autonomy’ did not influence this contact.

Highly specialized dental care in Ukraine in the conditions of transformation of the healthcare system of Ukraine

The gradual transformation of the health care system from April 1, 2020 impacted the reform of secondary (specialized) health care. Planning a model of hospital network transformation should take into account the needs of the population and ensure the creation of a multidisciplinary hospital with a focus on a patient. The article analyzes the human resources and infrastructure of medical institutions that provide dental care, including multidisciplinary hospitals. The main aspects that need to be taken into account when planning the transformation of the hospital network considering the interdisciplinary interaction of dentists, maxillofacial surgeons with general practitioners to improve the quality of care are also identified.

Initiation of antidepressant use among refugee and Swedish-born youth after diagnosis of a common mental disorder: findings from the REMAIN study

Purpose The objective of this study was to compare the initiation and type of antidepressant use between refugees and matched Swedish-born youth after a diagnosis of a common mental disorder (CMD) and assess sociodemographic and clinical factors associated with the initiation. Methods The study cohort included youth aged 16–25 years, with an incident diagnosis of CMD based on specialized health care registers in Sweden 2006–2016, without prior antidepressant use during 1 year. One Swedish-born person was matched for each identified refugee youth (N = 3936 in both groups). Initiation of antidepressant use and factors associated with the initiation, were investigated with logistic regression yielding Odds ratios, OR, and 95% Confidence Intervals, CI. Results Refugees were less likely to initiate antidepressant use compared with Swedish-born (40.5% vs. 59.6%, adjusted OR 0.43, 95% CI 0.39–0.48). Selective serotonin reuptake inhibitors (SSRIs) were less frequently initiated for refugees than Swedish-born (71.2% vs. 81.3% of initiations, p < 0.0001). Sertraline was the most commonly initiated antidepressant both for refugees (34.3%) and Swedish-born individuals (40.3%). Among refugees, factors associated with increased odds of antidepressant initiation were previous use of anxiolytics or hypnotics, previous sickness absence of < 90 days, cancer and older age (OR range 1.07–2.72), and less than 5 years duration of residency in Sweden was associated with decreased odds (OR 0.76, 95% CI 0.63–0.92). Conclusion Young refugees with a CMD seem to initiate antidepressants in general and those most effective considerably less often than their Swedish-born counterparts.

Students' Nutrition Literacy and the Existence of Health Care Providers in Iranian Schools

Background: The objective of this study was to investigate the relationship between Students' nutrition literacy and the existence of health care providers in Iranian schools. Study design: A cross-sectional study. Methods: This study was conducted on 504 students in Ardebil City, northwestern Iran from Oct 2017 to Jan 2018. The FLINT questionnaire was used to assessment the food and nutrition literacy. Socio-demographic characteristics and the existence of health care providers were collected using demographic questionnaire. Results: Nearly 75% of students had not a health care provider. Most students had a low FNLIT (62% males and 58.1% females). The probability of low FNLIT was lower in students with health care providers than those without them (OR=0.46, CI 95%; 0.10, 0.91). Conclusion: One of the reasons for the low nutritional literacy of students may be due to the lack of health care providers in schools. Health educational administrators employ specialized health care providers in Iranian schools.