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Malsa J, Boudesocque-Delaye L, Wimel L, Auclair-Ronzaud J, Dumont B, Mach N, Reigner F, Guégnard F, Chereau A, Serreau D, Théry-Koné I, Sallé G, Fleurance G. Chicory (Cichorium intybus) reduces cyathostomin egg excretion and larval development in grazing horses. Int J Parasitol Drugs Drug Resist 2024; 24:100523. [PMID: 38368671 PMCID: PMC10884488 DOI: 10.1016/j.ijpddr.2024.100523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 01/19/2024] [Accepted: 01/21/2024] [Indexed: 02/20/2024]
Abstract
Cyathostomins are the most prevalent parasitic nematodes of grazing horses. They are responsible for colic and diarrhea in their hosts. After several decades of exposure to synthetic anthelmintics, they have evolved to become resistant to most compounds. In addition, the drug-associated environmental side-effects question their use in the field. Alternative control strategies, like bioactive forages, are needed to face these challenges. Among these, chicory (Cichorium intybus, Puna II cultivar (cv.)) is known to convey anthelmintic compounds and may control cyathostomins in grazing horses. To challenge this hypothesis, we measured fecal egg counts and the rate of larval development in 20 naturally infected young saddle horses (2-year-old) grazing either (i) a pasture sown with chicory (n = 10) or (ii) a mesophile grassland (n = 10) at the same stocking rate (2.4 livestock unit (LU)/ha). The grazing period lasted 45 days to prevent horse reinfection. Horses in the chicory group mostly grazed chicory (89% of the bites), while those of the control group grazed mainly grasses (73%). Cyathostomins egg excretion decreased in both groups throughout the experiment. Accounting for this trajectory, the fecal egg count reduction (FECR) measured in individuals grazing chicory relative to control individuals increased from 72.9% at day 16 to 85.5% at the end of the study. In addition, larval development in feces from horses grazed on chicory was reduced by more than 60% from d31 compared to control individuals. Using a metabarcoding approach, we also evidenced a significant decrease in cyathostomin species abundance in horses grazing chicory. Chicory extract enriched in sesquiterpenes lactones was tested on two cyathostomins isolates. The estimated IC50 was high (1 and 3.4 mg/ml) and varied according to the pyrantel sensitivity status of the worm isolate. We conclude that the grazing of chicory (cv. Puna II) by horses is a promising strategy for reducing cyathostomin egg excretion and larval development that may contribute to lower the reliance on synthetic anthelmintics. The underpinning modes of action remain to be explored further.
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Affiliation(s)
- Joshua Malsa
- INRAE, Université de Tours, UMR 1282 Infectiologie et Santé Publique, Nouzilly, France.
| | | | - Laurence Wimel
- Institut Français Du Cheval et de L'équitation, Plateau Technique de Chamberet, Chamberet, France
| | - Juliette Auclair-Ronzaud
- Institut Français Du Cheval et de L'équitation, Plateau Technique de Chamberet, Chamberet, France
| | - Bertrand Dumont
- INRAE, Université Clermont Auvergne, VetAgro Sup, UMR 1213 Herbivores, Saint-Genès-Champanelle, France
| | - Núria Mach
- IHAP, Université de Toulouse, INRAE, ENVT, Toulouse, Cedex 3, 31076, France
| | - Fabrice Reigner
- INRAE, Unité Expérimentale de Physiologie Animale de L'Orfrasière, Nouzilly, France
| | - Fabrice Guégnard
- INRAE, Université de Tours, UMR 1282 Infectiologie et Santé Publique, Nouzilly, France
| | - Angélique Chereau
- INRAE, Université de Tours, UMR 1282 Infectiologie et Santé Publique, Nouzilly, France
| | - Delphine Serreau
- INRAE, Université de Tours, UMR 1282 Infectiologie et Santé Publique, Nouzilly, France
| | - Isabelle Théry-Koné
- Université de Tours, EA 7502 Synthèse et Isolement de Molécules Bioactives, Tours, France
| | - Guillaume Sallé
- INRAE, Université de Tours, UMR 1282 Infectiologie et Santé Publique, Nouzilly, France
| | - Géraldine Fleurance
- INRAE, Université Clermont Auvergne, VetAgro Sup, UMR 1213 Herbivores, Saint-Genès-Champanelle, France; Institut Français Du Cheval et de L'équitation, Pôle Développement, Innovation et Recherche, Saint-Genès-Champanelle, France
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Trincanato E, Vagnoni E. Business intelligence and the leverage of information in healthcare organizations from a managerial perspective: a systematic literature review and research agenda. J Health Organ Manag 2024; ahead-of-print. [PMID: 38551408 DOI: 10.1108/jhom-02-2023-0039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
PURPOSE Business intelligence (BI) systems and tools are deemed to be a transformative source with the potential to contribute to reshaping the way different healthcare organizations' (HCOs) services are offered and managed. However, this emerging field of research still appears underdeveloped and fragmented. Hence, this paper aims to reconciling, analyzing and synthesizing different strands of managerial-oriented literature on BI in HCOs and to enhance both theoretical and applied future contributions. DESIGN/METHODOLOGY/APPROACH A literature-based framework was developed to establish and guide a three-stage state-of-the-art systematic literature review (SLR). The SLR was undertaken adopting a hybrid methodology that combines a bibliometric and a content analysis. FINDINGS In total, 34 peer-review articles were included. Results revealed significant heterogeneity in theoretical basis and methodological strategies. Nonetheless, the knowledge structure of this research's stream seems to be primarily composed of five clusters of interconnected topics: (1) decision-making, relevant capabilities and value creation; (2) user satisfaction and quality; (3) process management, organizational change and financial effectiveness; (4) decision-support information, dashboard and key performance indicators; and (5) performance management and organizational effectiveness. ORIGINALITY/VALUE To the authors' knowledge, this is the first SLR providing a business and management-related state-of-the-art on the topic. Besides, the paper offers an original framework disentangling future research directions from each emerged cluster into issues pertaining to BI implementation, utilization and impact in HCOs. The paper also discusses the need of future contributions to explore possible integrations of BI with emerging data-driven technologies (e.g. artificial intelligence) in HCOs, as the role of BI in addressing sustainability challenges.
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Affiliation(s)
- Edoardo Trincanato
- Department of Economics and Management, University of Ferrara, Ferrara, Italy
| | - Emidia Vagnoni
- Department of Economics and Management, University of Ferrara, Ferrara, Italy
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Pazin-Filho A, do Valle Dallora MEL, Velasco TR, Cardoso Dos Santos RDO, Volpe GJ, Moroço DM, de Souza DA, Canabrava CM, Garcia LV, Joviliano EE, Maciel BC. Surgical waiting lists and queue management in a Brazilian tertiary public hospital. BMC Health Serv Res 2024; 24:290. [PMID: 38448876 PMCID: PMC10916210 DOI: 10.1186/s12913-024-10735-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 02/15/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Centralized management of queues helps to reduce the surgical waiting time in the publicly funded healthcare system, but this is not a reality in the Brazilian Unified Healthcare System (BUHS). We describe the implementation of the "Patients with Surgical Indication" (PSI) in a Brazilian public tertiary hospital, the impact on waiting time, and its use in rationing oncological surgeries during the COVID-19 Pandemic. METHODS Retrospective observational study of elective surgical requests (2016-2022) in a Brazilian general, public, tertiary university hospital. We recovered information regarding the inflows (indications), outflows and their reasons, the number of patients, and waiting time in queue. RESULTS We enrolled 82,844 indications in the PSI (2016-2022). The waiting time (median and interquartile range) in days decreased from 98(48;168) in 2016 to 14(3;152) in 2022 (p < 0.01). The same occurred with the backlog that ranged from 6,884 in 2016 to 844 in 2022 (p < 001). During the Pandemic, there was a reduction in the number of non-oncological surgeries per month (95% confidence interval) of -10.9(-18.0;-3.8) during Phase I (January 2019-March 2020), maintenance in Phase II (April 2020-August 2021) 0.1(-10.0;10.4) and increment in Phase III (September 2021-December 2022) of 23.0(15.3;30.8). In the oncological conditions, these numbers were 0.6(-2.1;3.3) for Phase I, an increase of 3.2(0.7;5.6) in Phase II and 3.9(1,4;6,4) in Phase III. CONCLUSION Implementing a centralized list of surgical indications and developing queue management principles proved feasible, with effective rationing. It unprecedentedly demonstrated the decrease in the median waiting time in Brazil.
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Affiliation(s)
- Antonio Pazin-Filho
- Ribeirão Preto Medical School, University of São Paulo, Ribeirao Preto, São Paulo, Brazil.
| | | | - Tonicarlo Rodrigues Velasco
- Clinical Hospital - Ribeirão Preto Medical School, University of São Paulo, Ribeirao Preto, São Paulo, Brazil
| | | | - Gustavo Jardim Volpe
- Clinical Hospital - Ribeirão Preto Medical School, University of São Paulo, Ribeirao Preto, São Paulo, Brazil
| | - Diego Marques Moroço
- Clinical Hospital - Ribeirão Preto Medical School, University of São Paulo, Ribeirao Preto, São Paulo, Brazil
| | - Danilo Arruda de Souza
- Clinical Hospital - Ribeirão Preto Medical School, University of São Paulo, Ribeirao Preto, São Paulo, Brazil
| | | | - Luis Vicente Garcia
- Ribeirão Preto Medical School, University of São Paulo, Ribeirao Preto, São Paulo, Brazil
| | | | - Benedito Carlos Maciel
- Ribeirão Preto Medical School, University of São Paulo, Ribeirao Preto, São Paulo, Brazil
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Liang F, Yang X, Peng W, Zhen S, Cao W, Li Q, Xiao Z, Gong M, Wang Y, Gu D. Applications of digital health approaches for cardiometabolic diseases prevention and management in the Western Pacific region. Lancet Reg Health West Pac 2024; 43:100817. [PMID: 38456090 PMCID: PMC10920052 DOI: 10.1016/j.lanwpc.2023.100817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 05/04/2023] [Accepted: 05/23/2023] [Indexed: 03/09/2024]
Abstract
Cardiometabolic diseases (CMDs) are the major types of non-communicable diseases, contributing to huge disease burdens in the Western Pacific region (WPR). The use of digital health (dHealth) technologies, such as wearable gadgets, mobile apps, and artificial intelligence (AI), facilitates interventions for CMDs prevention and treatment. Currently, most studies on dHealth and CMDs in WPR were conducted in a few high- and middle-income countries like Australia, China, Japan, the Republic of Korea, and New Zealand. Evidence indicated that dHealth services promoted early prevention by behavior interventions, and AI-based innovation brought automated diagnosis and clinical decision-support. dHealth brought facilitators for the doctor-patient interplay in the effectiveness, experience, and communication skills during healthcare services, with rapidly development during the pandemic of coronavirus disease 2019. In the future, the improvement of dHealth services in WPR needs to gain more policy support, enhance technology innovation and privacy protection, and perform cost-effectiveness research.
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Affiliation(s)
- Fengchao Liang
- School of Public Health and Emergency Management, Southern University of Science and Technology, 1088 Xueyuan Avenue, Shenzhen 518055, People's Republic of China
| | - Xueli Yang
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin Medical University, 22 Qixiangtai Rd, Tianjin 300070, People's Republic of China
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, 22 Qixiangtai Rd, Tianjin 300070, People's Republic of China
| | - Wen Peng
- Nutrition and Health Promotion Center, Department of Public Health, Medical College, Qinghai University, 251 Ningda Road, Xining City 810016, People's Republic of China
- Qinghai Provincial Key Laboratory of Prevention and Control of Glucolipid Metabolic Diseases with Traditional Chinese Medicine, Xining 810008, People's Republic of China
| | - Shihan Zhen
- School of Public Health and Emergency Management, Southern University of Science and Technology, 1088 Xueyuan Avenue, Shenzhen 518055, People's Republic of China
| | - Wenzhe Cao
- School of Public Health and Emergency Management, Southern University of Science and Technology, 1088 Xueyuan Avenue, Shenzhen 518055, People's Republic of China
| | - Qian Li
- School of Public Health and Emergency Management, Southern University of Science and Technology, 1088 Xueyuan Avenue, Shenzhen 518055, People's Republic of China
| | - Zhiyi Xiao
- School of Public Health and Emergency Management, Southern University of Science and Technology, 1088 Xueyuan Avenue, Shenzhen 518055, People's Republic of China
| | - Mengchun Gong
- Institute of Health Management, Southern Medical University, No. 1023-1063, Shatai South Road, Guangzhou 510515, People's Republic of China
| | - Youfa Wang
- The First Affiliated Hospital of Xi'an Jiaotong University Public Health Institute, Global Health Institute, School of Public Health, International Obesity and Metabolic Disease Research Center, Xi'an Jiaotong University, Xi'an 710061, People's Republic of China
| | - Dongfeng Gu
- School of Public Health and Emergency Management, Southern University of Science and Technology, 1088 Xueyuan Avenue, Shenzhen 518055, People's Republic of China
- School of Medicine, Southern University of Science and Technology, 1088 Xueyuan Avenue, Shenzhen 518055, People's Republic of China
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Abe T, Okuyama K, Motohiro A, Shiratsuchi D, Isomura M. Association between different types of physical activity and occupational stress in Japanese workers: a cross-sectional study. Ind Health 2024:2023-0092. [PMID: 38233117 DOI: 10.2486/indhealth.2023-0092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
This cross-sectional study investigated the association between different types of physical activity (PA) and occupational psychological and physical stress responses among workers in Japan. Stress responses were assessed using the Brief Job Stress Questionnaire. Work-related PA (time spent sitting, sitting bouts, standing, walking, engaging in heavy labor, and moderate-to-vigorous PA [MVPA]) and exercise-based PA (frequencies [times/wk] of flexibility and muscle-strengthening activity, and walking) were measured using a questionnaire. Multiple linear regression was performed to examine the association between each type of PA and stress responses. Participants who engaged in >108 min/d of work-related MVPA exhibited a statistically significant association with higher psychological stress responses when compared to those who engaged in 0-42 min/d of work-related MVPA. For exercise-based PA, participants who engaged in flexibility activity or walking five or more times/wk, or muscle-strengthening activity one to three times/wk, demonstrated significantly lower psychological stress responses compared to those who did not exercise. Participants who engaged in flexibility activity five or more times/wok demonstrated significantly lower physical stress responses compared to those who did not exercise. This study suggests that work-related MVPA is associated with higher psychological stress responses, while exercise-based PA is associated with lower psychological or physical stress responses.
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Affiliation(s)
- Takafumi Abe
- Center for Community-Based Healthcare Research and Education (CoHRE), Head Office for Research and Academic Information, Shimane University, Japan
| | - Kenta Okuyama
- Center for Community-Based Healthcare Research and Education (CoHRE), Head Office for Research and Academic Information, Shimane University, Japan
- Center for Primary Health Care Research, Department of Clinical Sciences Malmö, Lund University, Sweden
| | - Atsushi Motohiro
- Center for Community-Based Healthcare Research and Education (CoHRE), Head Office for Research and Academic Information, Shimane University, Japan
- Canvas Inc., Japan
| | - Daijo Shiratsuchi
- Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, Japan
| | - Minoru Isomura
- Center for Community-Based Healthcare Research and Education (CoHRE), Head Office for Research and Academic Information, Shimane University, Japan
- Faculty of Human Sciences, Shimane University, Japan
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Zhang X, Liu K, Tian X, Xu J, Zhang K. Hydrated alginate polysaccharide fabrics grafted with sliver nanocrystals for wearable thermal and health management. Int J Biol Macromol 2023; 253:126797. [PMID: 37703963 DOI: 10.1016/j.ijbiomac.2023.126797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 09/05/2023] [Accepted: 09/06/2023] [Indexed: 09/15/2023]
Abstract
The creation of functional components with precise chemistries on carbohydrate polymers is of great significance for future wearable biomedicine and health management. Among various carbohydrate polymers, marine polysaccharide featured with antimicrobial, biodegradable and biocompatible properties is an ideal platform while the water-swelling nature makes it difficult to form stable interface. Here, well-dispersed silver nanoparticles have been in-situ assembled on hydrated alginate fabric (AF), involving chemical absorption of Ag ions and in-situ reduction of conductive Ag layer. Owing to the stable complex formed between Ag ions and carboxyl groups, the Ag-grafted AF exhibits superior Joule heating capability, including low operating voltage (1-3 V), high saturation temperature (63 °C), rapid response time (25 s) and outstanding durability against harsh conditions. Furthermore, the Ag-grafted AF demonstrates noticeable inhibition against E. coli and S. aureus as compared with the pristine AF. This work provides a rational strategy for the functionalization of hydrated polysaccharide and enables wearable thermotherapy devices for human health management.
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Affiliation(s)
- Xingmin Zhang
- State Key Laboratory of Bio-Fibers and Eco-Textiles, Collaborative Innovation Center for Marine Biomass Fibers, Materials and Textiles of Shandong Province, College of Materials Science and Engineering, Institute of Marine Biobased Materials, Qingdao University, Qingdao 266071, PR China
| | - Kai Liu
- State Key Laboratory of Bio-Fibers and Eco-Textiles, Collaborative Innovation Center for Marine Biomass Fibers, Materials and Textiles of Shandong Province, College of Materials Science and Engineering, Institute of Marine Biobased Materials, Qingdao University, Qingdao 266071, PR China
| | - Xiaozhu Tian
- State Key Laboratory of Bio-Fibers and Eco-Textiles, Collaborative Innovation Center for Marine Biomass Fibers, Materials and Textiles of Shandong Province, College of Materials Science and Engineering, Institute of Marine Biobased Materials, Qingdao University, Qingdao 266071, PR China
| | - Jin Xu
- Department of Dermatology, Air Force Medical Center, PLA, Beijing 100142, PR China
| | - Kewei Zhang
- State Key Laboratory of Bio-Fibers and Eco-Textiles, Collaborative Innovation Center for Marine Biomass Fibers, Materials and Textiles of Shandong Province, College of Materials Science and Engineering, Institute of Marine Biobased Materials, Qingdao University, Qingdao 266071, PR China.
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De la Torre-Lima J, Oteo JA, Pinilla J, Mansilla R, Zamora C, Ayala Vargas V, Morillo-Verdugo R, Moreno S, Fuster-Ruiz de Apodaca MJ, Pérez-Molina JA, Colom J. Study on the approach to HIV: health management and the healthcare process in Spain. Enferm Infecc Microbiol Clin (Engl Ed) 2023; 41:604-611. [PMID: 36624033 DOI: 10.1016/j.eimce.2022.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 07/06/2022] [Accepted: 07/06/2022] [Indexed: 01/09/2023]
Abstract
INTRODUCTION HIV continues to represent a problem of great relevance for public health in Spain. This study aims to carry out an analysis that will provide in-depth knowledge of the resources, clinical care, and management during the diagnosis, follow-up, and treatment phases of HIV infection in Spain. METHODS In the first phase, a multidisciplinary Scientific Committee designed an information collection tool in the form of a survey. In the second phase, carried out in the autonomous communities of Andalusia, Catalonia, and La Rioja, a multidisciplinary group of 42 experts, representatives of the public administration, clinical profiles, and representatives of NGOs in the field of HIV answered the survey. RESULTS The assessment of HIV resources is generally positive. As regards diagnosis, the experts considered that there was good coordination between Primary and Hospital care. Regarding treatment, the evaluations reflected good opinions on therapeutic conciliation and adherence, with a negative opinion in the evaluation of drug interactions with antiretroviral treatment. Regarding follow-up, the perception expressed was disparate concerning the coordination between Hospital and Primary Care as well as the adaptation of care to chronicity, aging, fragility, mental health, and oncological processes. CONCLUSION There are certain processes that can be improved in the management of HIV infection in people with HIV in Spain, including protocols for follow-up and coordination between primary and hospital care in the treatment and follow-up of the disease.
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Affiliation(s)
- Javier De la Torre-Lima
- Plan Andaluz frente al VIH/sida y otras ITS, Consejería de Salud y Consumo de la Junta de Andalucía, Spain; Grupo de Enfermedades Infecciosas de la Unidad de Medicina Interna, Hospital Costa del Sol, Málaga, Spain.
| | - José Antonio Oteo
- Centro de Rickettsiosis y Enfermedades Transmitidas por Artrópodos Vectores, Departamento de Enfermedades Infecciosas, Hospital Universitario San Pedro-Centro de Investigación Biomédica de La Rioja (CIBIR), Logroño, La Rioja, Spain
| | - Javier Pinilla
- Servicio de Medicina Interna, Complejo Hospitalario San Millán-San Pedro, Logroño, Spain; Comisión Ciudadana Anti-Sida de La Rioja (CCASLR), Logroño, La Rioja, Spain
| | - Rosa Mansilla
- Vigilancia, Prevención y Control de las Infecciones de Transmisión Sexual y el VIH, Subdirección General de Vigilancia y Respuesta a Emergencias de Salud Pública, Agencia de Salud Pública de Cataluña, Departamento de Salud, Generalidad de Cataluña, Barcelona, Spain
| | - Carmen Zamora
- Plan Andaluz frente al VIH y otras ITS, Consejería de Salud y Consumo de la Junta de Andalucía, Spain
| | | | - Ramón Morillo-Verdugo
- Servicio de Farmacia, Hospital de Valme, Área de Gestión Sanitaria Sur de Sevilla, Sevilla, Spain
| | - Santiago Moreno
- Hospital Universitario Ramón y Cajal, Universidad de Alcalá, IRYCIS, Madrid, Spain
| | - María José Fuster-Ruiz de Apodaca
- Departamento de Psicología Social y de las Organizaciones, UNED, Madrid, Spain; Sociedad Española Interdisciplinaria del Sida (SEISIDA), Madrid, Spain
| | - José A Pérez-Molina
- CSUR de Enfermedades Tropicales, Servicio de Enfermedades Infecciosas, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain
| | - Joan Colom
- Programa de Prevención, Control y Atención al VIH, las ETS y las Hepatitis Víricas de la Agencia de Salud Pública de Catalunya, Generalitat de Catalunya, Barcelona, Spain
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Chen Y, Luo F, Han L, Qin Q, Zeng Q, Zhou X, Huang Y, Gao Q, Wang W, Shi Q, Wang Q, Yu Z, Wang T, Jiang J. Centralized health management based on hot spring resort improves physical examination indicators and sleep quality in people at high risk of chronic diseases: a randomized controlled trial. Int J Biometeorol 2023; 67:2011-2024. [PMID: 37801161 DOI: 10.1007/s00484-023-02558-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 08/20/2023] [Accepted: 09/18/2023] [Indexed: 10/07/2023]
Abstract
We study the effects of centralized health management based on hot spring resorts on the physical examination index and sleep quality of people at high risk of chronic diseases. We recruited 114 volunteers at high risk of chronic diseases. We then divided them into 57 in the intervention group and 57 in the control group. The intervention group collectively received 4 weeks (28 days) of comprehensive health management interventions at Tongjing Hotspring Resort, including regular schedules, balanced diet, appropriate exercise, targeted health education, etc. The main outcomes are physical examination indicators (height, weight, waist circumference, blood pressure, lipids, and glucose) and sleep quality. Both groups underwent a questionnaire and physical examination at baseline, 2 weeks and 4 weeks. Intragroup comparisons grouped by exposure criteria showed decreases in BMI, waist circumference, triglycerides, total cholesterol, and blood glucose in the intervention group at both 2 and 4 weeks (all P < 0.05); however, in the control group, only triglycerides decreased at 4 weeks (P < 0.05). Intergroup comparisons showed BMI and waist circumference were significantly lower in the intervention group than in the control group at 4 weeks (all P < 0.05). Intragroup comparisons of insomnia severity index (ISI) scores showed a significant decrease in the intervention group at both 2 and 4 weeks (all P < 0.001) with no significant change in the control group (P > 0.05). Intergroup comparisons showed that the insomnia severity index (ISI) scores were significantly higher in the intervention group than in the control group at baseline (P = 0.006) but became significantly lower than the control group at 2 and 4 weeks (all P < 0.001). Thus, this pattern significantly improved BMI, waist circumference, triglycerides, and sleep in the intervention group. TRIAL REGISTRATION NUMBER: Chinese Clinical Trials Registry: ChiCTR2100053201, registered 14 Nov 2021. (Retroactive Registration).
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Affiliation(s)
- Yu Chen
- School of Public Health, Chongqing Medical University, Chongqing, China.
| | - Fan Luo
- School of Public Health, Chongqing Medical University, Chongqing, China
| | - Lingli Han
- School of Public Health, Chongqing Medical University, Chongqing, China
| | - Qizhong Qin
- Experimental Teaching Management Center, Chongqing Medical University, Chongqing, China
| | - Qing Zeng
- School of Public Health, Chongqing Medical University, Chongqing, China
| | - Xiangjun Zhou
- Institute for Infectious Disease Control and Prevention, Hangzhou Center for Disease Control and Prevention, Hangzhou, China
| | - Ying Huang
- School of Public Health, Chongqing Medical University, Chongqing, China
| | - Qiuyidi Gao
- School of Public Health, University of California, Berkeley, CA, USA
| | - Wen Wang
- Department of Internal Medicine, Nan'an District People's Hospital of Chongqing, Chongqing, China
| | - Qiuling Shi
- School of Public Health, Chongqing Medical University, Chongqing, China
| | - Qirui Wang
- School of Public Health, Chongqing Medical University, Chongqing, China
| | - Zhaoxia Yu
- Medical Department, Second Affiliated Hospital of Army Medical University, Chongqing, China
| | - Ting Wang
- School of Public Health, Chongqing Medical University, Chongqing, China
| | - Jishan Jiang
- School of Public Health, Chongqing Medical University, Chongqing, China
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Radaideh MI, Pappas C, Wezensky M, Cousineau S. Operational data for fault prognosis in particle accelerators with machine learning. Data Brief 2023; 51:109658. [PMID: 37928324 PMCID: PMC10622613 DOI: 10.1016/j.dib.2023.109658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 09/29/2023] [Accepted: 10/03/2023] [Indexed: 11/07/2023] Open
Abstract
This paper presents real operational data collected from the power systems of the Spallation Neutron Source facility, which provides the most intense neutron beam in the world. The authors have used a radio-frequency test facility (RFTF) and simulated system failures in the lab without causing a catastrophic system failure. Waveform signals have been collected from the RFTF normal operation as well as during fault induction efforts. The dataset provides a significant amount of normal and faulty signals for the training of statistical or machine learning models. Then, the authors performed 21 test experiments, where the faults are slowly induced into the RFTF system for the purpose of testing the models in fault prognosis to detect and prevent impending faults. The test experiments include interesting combinations of magnetic flux compensation and start pulse width adjustments, which cause gradual deterioration in the waveforms (e.g., system output voltage, system output current, insulated-gate bipolar transistor currents, magnetic fluxes), which mimic the fault scenarios. Accordingly, this dataset can be valuable for developing models to predict impending fault scenarios in power systems in general and in particle accelerators in specific. All experiments occurred in the Spallation Neutron Source facility of Oak Ridge National Laboratory in Oak Ridge, Tennessee of the United States in July 2022.
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Affiliation(s)
- Majdi I Radaideh
- Spallation Neutron Source, Oak Ridge National Laboratory, Oak Ridge, TN 37830, United States
- Department of Nuclear Engineering and Radiological Science, University of Michigan, Ann Arbor, MI 48109, United States
| | - Chris Pappas
- Spallation Neutron Source, Oak Ridge National Laboratory, Oak Ridge, TN 37830, United States
| | - Mark Wezensky
- Spallation Neutron Source, Oak Ridge National Laboratory, Oak Ridge, TN 37830, United States
| | - Sarah Cousineau
- Spallation Neutron Source, Oak Ridge National Laboratory, Oak Ridge, TN 37830, United States
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Wang W, Gu Y, Wei S, Xie J, Zheng X, Yu Y. Standardized community management on the diagnosis, treatment, and risk factors control for non-valvular atrial fibrillation in elderly patients. BMC Prim Care 2023; 24:257. [PMID: 38037007 PMCID: PMC10687903 DOI: 10.1186/s12875-023-02207-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 11/14/2023] [Indexed: 12/02/2023]
Abstract
BACKGROUND By investigating the knowledge, medication, occurrence of complications, and risks among elderly non-valvular atrial fibrillation (NVAF) patients in Shanghai communities, and providing standardized comprehensive management and follow-up, we aim to explore the impact of standardized community management on improving disease awareness, standardizing atrial fibrillation (AF) treatment, reducing the risk of complications occurrence, and addressing risk factors for AF patients. METHODS This research selected elderly atrial fibrillation patients from Zhuanqiao Community Health Service Center, Minhang District, Shanghai from July 2020 to October 2022. Their personal health records and examination results were reviewed, and the incidence of AF, awareness, medication, and complications were investigated. Age-adjusted Charlson Comorbidity Index (aCCI), CHA2DS2-VASc score, and HAS-BLED score were used to evaluate disease burden, thromboembolic risk, and bleeding risk, respectively. The patients were subjected to standardized community management, and the compliance rate of disease awareness, treatment, resting heart rate, blood pressure, fasting blood glucose, and body mass index (BMI) were assessed at the baseline, 6 months and 1 year after management. RESULTS A total of 243 NVAF patients were included, with an average aCCI score of (4.5 ± 1.1). Among them, 28% of the patients were aware of their AF, and 18.1% of the patients were aware of the hazards of AF. Of the patients, 11.9% used anticoagulant drugs, including 6.6% and 5.3% for warfarin and non-vitamin K antagonist oral anticoagulants (NOACs), respectively. 7% of patients used antiplatelet drugs. 26.7% of the patients used heart rate control drugs. 10.3% of the patients experienced thromboembolic events, and 0.8% of the patients experienced bleeding events. 93.0% of the patients were at high risk of thromboembolism, and 24.7% of the patients were at high risk of bleeding. Compared with the baseline, there were significant statistical differences (P < 0.001) in disease awareness, awareness of the hazards of AF, use of anticoagulant drugs and heart rate control drugs, and control of risk factors among NVAF patients after standardized community management. Moreover, with the extension of management time, there was a linear increase in the awareness of NVAF, awareness of the hazards of AF, utilization rate of anticoagulant drugs, utilization rate of heart rate control drugs, blood pressure, blood glucose, and BMI compliance rate (P < 0.001). CONCLUSION Currently, the awareness, treatment, and control of risk factors for AF in elderly NVAF patients in Shanghai community are not satisfactory. Standardized community management helps to improve the diagnosis, treatment, and control of risk factors in AF.
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Affiliation(s)
- Wei Wang
- Deparment of General practice, Zhuanqiao Community Health Service Center, Shanghai, Minhang District, China
| | - Yufeng Gu
- Department of Infectious Diseases, The Fifth People's Hospital of Shanghai, Shanghai, China
| | - Shan Wei
- Deparment of General practice, Zhuanqiao Community Health Service Center, Shanghai, Minhang District, China
| | - Juan Xie
- Deparment of General practice, The Fifth People's Hospital of Shanghai, Shanghai, China.
| | - Xiuli Zheng
- Deparment of General practice, Zhuanqiao Community Health Service Center, Shanghai, Minhang District, China.
| | - Yan Yu
- Department of Pharmacy, The Fifth People's Hospital of Shanghai, Shanghai, China.
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Naamati-Schneider L, Alt D. Enhancing collaborative learning in health management education: an investigation of Padlet-mediated interventions and the influence of flexible thinking. BMC Med Educ 2023; 23:846. [PMID: 37940924 PMCID: PMC10634016 DOI: 10.1186/s12909-023-04796-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 10/20/2023] [Indexed: 11/10/2023]
Abstract
This study had three primary goals. First, it aimed to craft an intervention program centered around collaborative learning enabled by Padlet. Second, it aimed to gauge the perceptions of health management students regarding this intervention and how it affected their collaborative learning experiences. Additionally, the third objective of the study aimed to investigate how students' flexible thinking within the learning process might shape their perceptions of the advantages derived from this instructional activity within the domain of online collaborative learning. Data for the analysis were gathered from 100 Israeli undergraduate students by two measurements: Flexible thinking in learning and Student perceptions of collaborative learning via Padlet. The intervention program included several stages. First, the students discussed the pedagogic objective of using Padlet. In the second stage, the students were presented with ill-structured problems related to the course content. Each group had to choose one problem and analyze it from three perspectives discussed in the course-healthcare provider, patient, and organization. Next, the students presented and explained their solutions employing the shared knowledge base. The final work was presented in different formats using various technologies. The PLS-SEM analysis has corroborated our hypothesis that students' flexible thinking might positively contribute to their perception of Padlet utilization. According to the empirical model, in general, students who perceived themselves as more flexible were found more receptive to utilizing the proposed technological tool (Padlet) and hence tended to appreciate its function as a collaborative learning platform enabler. This study mainly underscores the important role flexible thinking plays in motivating managers and medical professionals to embrace innovative technologies or methods for teamwork, that could enable them to weigh arguments, seek alternative solutions to authentic problems, and adjust their approaches effectively and collaboratively as new challenges emerge.
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Affiliation(s)
| | - Dorit Alt
- Faculty of Education and Instruction, Tel Hai College, Upper Galilee, Israel
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Guo L, Zhang M, Namassevayam G, Wei M, Zhang G, He Y, Guo Y, Liu Y. Effectiveness of health management among individuals at high risk of stroke: An intervention study based on the health ecology model and self-determination theory (HEM-SDT). Heliyon 2023; 9:e21301. [PMID: 37964830 PMCID: PMC10641168 DOI: 10.1016/j.heliyon.2023.e21301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 10/11/2023] [Accepted: 10/19/2023] [Indexed: 11/16/2023] Open
Abstract
Background Stroke is the second leading cause of death in adults worldwide. However, up to 80% of strokes can be prevented by modifying risk factors. Objective The study aims to assess the effectiveness of the Health Ecology Model and Self-Determination Theory (HEM-SDT) based health management intervention among individuals at high risk of stroke. Methods A randomized controlled trial was conducted in Zhengzhou from May 1st, 2020, to December 31st, 2020. A total of 229 participants were recruited for the study, with 116 individuals at high risk of stroke being randomly assigned to the HEM-SDT health management group, while 113 participants were enrolled in the control group, following their current routine practices. The Generalized Estimating Equation model (GEE) was used to analyze the differences in health knowledge, belief and, behavior between the two groups at the beginning of the intervention, and at 6-month intervals after the intervention. The chi-square test was utilized to assess the control rate of risk factors. Results After 6 months of intervention, there were significant improvements in health knowledge, behavior, and belief among the participants. The study found significant differences in the interaction effects between time and group for health knowledge (Mean, SD = 25.62 ± 3.88, 95%CI: 7.944-9.604, P<0.001), health belief (Mean, SD = 87.18 ± 14.21, 95%CI: 23.999-29.887, P<0.001), and health behavior (Mean, SD = 173.28 ± 24.22, 95%CI: 22.332-36.904, P<0.001). Additionally, the rates of hypertension, hyperglycemia, dyslipidemia, high or medium risk condition of stroke, obesity, hyperhomocysteinemia, smoking, alcohol consumption, and lack of exercise also showed statistical significance (P<0.05) after the intervention. Conclusion The HEM-SDT health management model improves the health knowledge, behavior, and beliefs in people at high risk of stroke and remarkably it shows improvement in modifiable risk factors. It can be recommended for systematic health management in people at high-risk of stroke.
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Affiliation(s)
- Lina Guo
- Department of Neurology, National Advanced Stroke Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Mengyv Zhang
- Department of Neurology, National Advanced Stroke Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Genoosha Namassevayam
- Department of Neurology, National Advanced Stroke Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- Department of Supplementary Health Sciences, Faculty of Health-Care Sciences, Eastern University, Sri Lanka
| | - Miao Wei
- Department of Neurology, National Advanced Stroke Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Gege Zhang
- Department of Neurology, National Advanced Stroke Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Yv He
- Department of Neurology, National Advanced Stroke Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- Reproductive Medicine Center, Sir Run Run Shaw Hospital, Hangzhou, Zhejiang, China
| | - Yuanli Guo
- Department of Neurology, National Advanced Stroke Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Yanjin Liu
- Department of Nursing, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, China
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Huang X. Treatment and management for children with urea cycle disorder in chronic stage. Zhejiang Da Xue Xue Bao Yi Xue Ban 2023; 52:744-750. [PMID: 37807629 PMCID: PMC10764184 DOI: 10.3724/zdxbyxb-2023-0378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 09/27/2023] [Indexed: 10/10/2023]
Abstract
Urea cycle disorder (UCD) is a group of inherited metabolic diseases with high disability or fatality rate, which need long-term drug treatment and diet management. Except those with Citrin deficiency or liver transplantation, all pediatric patients require lifelong low protein diet with safe levels of protein intake and adequate energy and lipids supply for their corresponding age; supplementing essential amino acids and protein-free milk are also needed if necessary. The drugs for long-term use include nitrogen scavengers (sodium benzoate, sodium phenylbutyrate, glycerol phenylbutyrate), urea cycle activation/substrate supplementation agents (N-carbamylglutamate, arginine, citrulline), etc. Liver transplantation is recommended for pediatric patients not responding to standard diet and drug treatment, and those with severe progressive liver disease and/or recurrent metabolic decompensations. Gene therapy, stem cell therapy, enzyme therapy and other novel technologies may offer options for treatment in UCD patients. The regular biochemical assessments like blood ammonia, liver function and plasma amino acid profile are needed, and physical growth, intellectual development, nutritional intake should be also evaluated for adjusting treatment in time.
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Affiliation(s)
- Xinwen Huang
- Department of Genetics and Metabolism, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China.
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Xian X, Chen Y, Qiao S, Shao J, Wang M, Sun L, Ye Z. Influencing factors of self-management behavior in cancer patients based on a theoretical domain framework. Zhejiang Da Xue Xue Bao Yi Xue Ban 2023; 52:605-615. [PMID: 37899400 PMCID: PMC10630062 DOI: 10.3724/zdxbyxb-2022-0716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 08/24/2023] [Indexed: 10/10/2023]
Abstract
OBJECTIVES To explore the factors that influence self-management behavior in cancer patients based on the theoretical domain framework. METHODS Studies in Chinese and English about factors influencing self-management behavior in cancer patients were searched from Wanfang database, CNKI, VIP, SinoMed, PubMed, Embase, CINAHL, Web of Science Core Collection, Cochrane library and Medline from inception to June 2022. Two investigators independently identified, extracted data, and collected characteristics and methodology of the studies. Factors were analyzed with Nvivo12, and the theoretical domain framework was mapped to the theoretical domain. Then the secondary node was generalized by theme analysis. Finally, the specific influencing factors were summarized and analyzed. RESULTS Thirty-four studies were included for analysis. A total of 194 factors were mapped to 13 theoretical domains, and 31 secondary nodes were summarized. Theoretical domains environmental context and resources, social/professional role and identity, and beliefs about consequences were the most common factors. Knowledge, age, self-efficacy, disease stage, social support, gender, economic status and physical status were the most influential factors for self-management in cancer patients. CONCLUSIONS The influencing factors of self-management of cancer patients involve most of the theoretical domains, are intersectional, multi-source and complex.
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Affiliation(s)
- Xuemei Xian
- Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China.
| | - Yilin Chen
- Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
| | - Shina Qiao
- Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
| | - Jing Shao
- Institute of Nursing Research, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Manjun Wang
- Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
| | - Liqiu Sun
- Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
| | - Zhihong Ye
- Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China.
- Institute of Nursing Research, Zhejiang University School of Medicine, Hangzhou 310058, China.
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Sun LH, Shaniya N, Xu Q, Pan KJ, Bao YXM, Han D, Zhang J. [Expanding antiviral indications for chronic hepatitis B using the concept of chronic disease health management: act again!]. Zhonghua Gan Zang Bing Za Zhi 2023; 31:1002-1003. [PMID: 37872098 DOI: 10.3760/cma.j.cn501113-20220501-00233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Affiliation(s)
- L H Sun
- Center for Infection-Liver Diseases, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830000, China
| | - Niyazi Shaniya
- Center for Infection-Liver Diseases, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830000, China
| | - Q Xu
- Center for Infection-Liver Diseases, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830000, China
| | - K J Pan
- Center for Infection-Liver Diseases, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830000, China
| | - Y X M Bao
- Center for Infection-Liver Diseases, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830000, China
| | - D Han
- Center for Infection-Liver Diseases, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830000, China
| | - J Zhang
- Center for Infection-Liver Diseases, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830000, China
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Korbus H, Hildebrand C, Schott N, Bischoff L, Otto AK, Jöllenbeck T, Schoene D, Voelcker-Rehage C, Vogt L, Weigelt M, Wollesen B. Health status, resources, and job demands in geriatric nursing staff: A cross-sectional study on determinants and relationships. Int J Nurs Stud 2023; 145:104523. [PMID: 37327686 DOI: 10.1016/j.ijnurstu.2023.104523] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 04/14/2023] [Accepted: 05/02/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND According to current estimates, the number of people needing care will double in the next 40 years. It is expected that between 130,000 and 190,000 additional nurses will be needed by 2030 in Germany. Physical and psychological burdens associated with nursing in long-term care facilities can develop into serious health risk factors and significantly impact occupational factors such as absenteeism, especially when linked to difficult working conditions. However, demands and resources specific to the nursing profession have not been analyzed extensively to preserve and promote nurses' workability and health adequately. OBJECTIVE Our study aimed to examine the extent to which perceived health among geriatric nursing staff in Germany is predicted by personal resources, job demands, and job resources. In addition, we analyzed the impact of different behavior and experience patterns on these relationships. DESIGN, SETTING, AND PARTICIPANTS An observational study was conducted between August 2018 and February 2020 in 48 nursing home facilities with 854 staff members in Germany as part of the project 'PROCARE - Prevention and occupational health in long-term care'. METHODS The survey contained instruments that measure workplace exposure, musculoskeletal complaints, physical and mental well-being, chronic stress, and work-related behavior and experience patterns. In addition, health-related information on physical activity and nutrition was collected. Data were analyzed using structural equation modeling. RESULTS The combined physical and mental workload for geriatric nurses is very high, with 75 % showing chronic stress. In the overall model, job and personal resources have a stronger association with mental health than physical health, while job demands have an equal impact on mental and physical health. Coping behavior also plays an important key role that should be assessed and considered. A behavior and experience risk pattern (health-endangering) is more strongly associated with a lower health status than a health-promoting behavior pattern. Results of the multigroup test showed that work-related behavior and experience patterns significantly moderate the relationship between physical health and mental health (χ2 = 392/p ≤ .001/df = 256/RMSEA = 0.028/CFI = 0.958/TLI = 0.931). Only 43 % show a health-friendly coping pattern. CONCLUSIONS Our findings underline the importance of holistic health promotion, which not only aims at changes at the behavioral level and the development of coping strategies but also takes on the task of reducing the workload and including measures to improve the working climate. TRIAL REGISTRATION NUMBER DRKS.de (DRKS00015241); August 9, 2018. TWEETABLE ABSTRACT Healthier coping patterns can benefit geriatric nurses' health. However, this is not a substitute for improving working conditions.
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Affiliation(s)
| | | | | | | | | | | | - Daniel Schoene
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Germany
| | | | - Lutz Vogt
- Goethe Universität Frankfurt am Main, Germany
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Chen L, Zhou Z, Han X, Zhang C, Ning P. A robust performance evaluation method based on interval evidential reasoning approach under uncertainty. ISA Trans 2023; 139:448-462. [PMID: 37024349 DOI: 10.1016/j.isatra.2023.03.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 03/28/2023] [Accepted: 03/28/2023] [Indexed: 06/19/2023]
Abstract
Performance evaluation (PE) is an important part of equipment health management. If the monitoring information of the equipment is interfered, the evaluation results may be erroneous. A robust performance evaluation (RPE) method is proposed to solve this problem. The performance evaluation results are obtained by distinguishing the cases of single evidence with interference and two evidence with interference, and a robustness measurement based on interval similarity is proposed. To improve the accuracy of the evaluation results, the referential values in the IER evaluation model are optimized. The robustness thresholds of the input indexes are obtained under the satisfaction of the robustness constraints. If the interference value of the input index is within the thresholds, the deviation between the evaluation results using monitoring information with interference and those using monitoring information without interference is small. Finally, the proposed method is applied to a type of electric servo mechanism performance evaluation, and the case shows the validity of the RPE method.
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Affiliation(s)
- Leiyu Chen
- High-Tech Institute of Xi'an, Xi'an, Shaanxi 710025, China.
| | - Zhijie Zhou
- High-Tech Institute of Xi'an, Xi'an, Shaanxi 710025, China.
| | - Xiaoxia Han
- High-Tech Institute of Xi'an, Xi'an, Shaanxi 710025, China.
| | - Chunchao Zhang
- High-Tech Institute of Xi'an, Xi'an, Shaanxi 710025, China.
| | - Pengyun Ning
- High-Tech Institute of Xi'an, Xi'an, Shaanxi 710025, China.
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Duarte HS, da Veiga CRP, da Veiga CP, Wainstein AJA, da Silva WV, Drummond-Lage AP. Does it fit in your pocket? economic burden of PD-1 inhibitors' toxicity in the supplementary health system: evidence from Brazil. BMC Health Serv Res 2023; 23:781. [PMID: 37480058 PMCID: PMC10360250 DOI: 10.1186/s12913-023-09736-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 06/22/2023] [Indexed: 07/23/2023] Open
Abstract
BACKGROUND A full understanding of the economic burden associated with treatment-related adverse events (AEs) can aid estimates of the incremental costs associated with incorporating new technologies and support cost-effective economic modeling in Brazil. In this context, the main objective of this work was to evaluate in a real-life database: (i) the direct medical cost of monitoring the occurrence of AEs (CMO); (ii) the direct medical cost of managing an identified AE (CMN); and (iii) the total direct medical cost of monitoring and managing AEs (TMC), in quarterly periods from 0 to 24 months of the monitoring of cancer patients who used a PD-1 inhibitor from the perspective of the supplementary health system in Brazil. METHODS This study was conducted from the supplementary health system (SSS) perspective and followed the methodological guidelines related to cost-of-illness studies. A bottom-up (person-based) approach was used to assess the use of health resources to monitor and manage AEs during the use of PD-1 inhibitors, which made it possible to capture differences in the mean frequency of the use of health services with stratification results for different subgroups. As the Brazilian SSS is complex, asymmetric, and fragmented, this study used information from different sources. The methodology was divided into three parts: (i) Data Source: clinical management of AEs; (ii) Microcosting: management of the economic burden of AEs; (iii) Statistical analysis: stratification of results for different subgroups. RESULTS Analysis of the economic burden of toxicity showed higher CMO costs than CMN in all the periods analyzed. In general, for every BRL 100 on average invested in the TMC of AEs, BRL 95 are used to monitor the occurrence of the AE and only BRL 5 to manage an identified AE. This work also showed that the sociodemographic characteristics of patients, the journey of oncological treatment, and the toxicity profile affect the economic burden related to AE. CONCLUSION This study provided real-world evidence of the economic burden of AEs associated with the use of PD-1 inhibitors in Brazil. This work also made methodological contributions by evaluating the economic burden of AE of PD-1 inhibitors considering the kinetics of toxicity occurrence and categorizing the costs in terms of CMO, CMN and TMC.
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Affiliation(s)
- Hugo Santos Duarte
- Faculdade de Ciências Médicas de Minas Gerais, Alameda Ezequiel Dias, 275, Belo Horizonte, MG, 30130-110, Brazil
| | - Cassia Rita Pereira da Veiga
- Departamento de Gestão de Serviços de Saúde, Escola de Enfermagem, Universidade Federal de Minas Gerais, Av. Alfredo Balena, 190, Belo Horizonte-MG, 30130-100, Brazil
| | - Claudimar Pereira da Veiga
- FDC Business School, Fundação Dom Cabral, , Av. Princesa Diana, 760,Alphaville Lagoa Dos Ingleses, Nova Lima, MG, 34018-006, Brazil
| | | | - Wesley Vieira da Silva
- Universidade Federal de Alagoas - UFAL, Av. Lourival Melo Mota, S/N, Tabuleiro Do Martins, Maceió, Alagoas, 57072-900, Brazil
| | - Ana Paula Drummond-Lage
- Faculdade de Ciências Médicas de Minas Gerais, Alameda Ezequiel Dias, 275, Belo Horizonte, MG, 30130-110, Brazil.
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Shao J, Li Y, Xia J, Zheng L, Sun Z, Guo C. Trends in ethnic disparities in clinical cardiovascular health among Chinese adults from 2016-2020. Nutr Metab Cardiovasc Dis 2023; 33:749-757. [PMID: 36805193 DOI: 10.1016/j.numecd.2023.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 01/05/2023] [Accepted: 01/09/2023] [Indexed: 01/15/2023]
Abstract
BACKGROUND AND AIMS Little is known about the long-term trends in ethnic differences in cardiovascular health (CVH) in China in recent years. This study aimed to investigate ethnic differences in CVH and identify long-term trends in China. METHODS AND RESULTS This survey was based on the physical examination data of Tacheng Prefecture in China from 2016 to 2020, and included 1,947,938 physical examination participants aged over 20 years for analysis. The American Heart Association (AHA) criteria were used to evaluate the clinical CVH of the subjects. The time trends from 2016 to 2020 were assessed using a weighted linear regression model stratified by ethnicity. The ethnic groups included Han, Kazakh, Hui, Mongolian, Uyghur, among others. The mean ideal clinical cardiovascular score was highest in Hui and lowest in Uyghur. The scores increased from 5.99 (5.95-6.03) to 6.11 (6.08-6.14) in Kazakh males and from 6.05 (5.99-6.11) to 6.11 (6.06-6.16) in Hui males among participants (Plinear trend < 0.001). The scores for the other groups declined significantly from 2016 to 2020(Plinear trend < 0.05). In the sensitivity analysis, the trend remained unchanged after calculating the body mass index (BMI) cut-off for China. CONCLUSION Clinical CVH differences still exist among different ethnic groups, with a decline in CVH from 2016 to 2020 in all except Kazakh and Hui males. This may indicate a higher incidence and poorer prognosis of cardiovascular disease in the future and can provide guidelines for improving CVH.
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Affiliation(s)
- Jingan Shao
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, Shenyang 110122, China; Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - Yuying Li
- Health Commission of Tacheng Prefecture, Tacheng Prefecture, 834799, China
| | - Jianjiang Xia
- People's Hospital of Tacheng Prefecture, 834799, China
| | - Liqiang Zheng
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
| | - Zhaoqing Sun
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang 110004, China.
| | - Chuanji Guo
- Department of Clinical Epidemiology,Shengjing Hospital of China Medical University, Shenyang 110004, China.
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20
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Chen X, Yang B, Zhao S, Wei W, Chen J, Ding J, Wang H, Sun P, Gan L. Management for stroke intelligent early warning empowered by big data. Comput Electr Eng 2023; 106:108602. [PMID: 36711055 PMCID: PMC9871473 DOI: 10.1016/j.compeleceng.2023.108602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 01/14/2023] [Accepted: 01/18/2023] [Indexed: 06/18/2023]
Abstract
Global aging population, especially with the global pandemic outbreak of the Corona Virus Disease 2019 (COVID-19), has endangered human health security. Digital information technology through big data empowerment and intelligent application is widely considered a key element to solve the problems. Stroke is a life-threaten disorder. We studied individual health management and disease risk perception using human health assessment model and make full use of wearable wireless sensor, Internet of Things, big data, and Artificial Intelligence for potential risk monitoring and real-time stroke warning. We proposed an effective method of monitoring, early warning and rescue to improve the stroke treatment. The result shows that the health management empowered by big data can generate new opportunities and ideas to solve early detection and warning of stroke.
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Affiliation(s)
- Xiaoyong Chen
- School of Health Industry Management, University of Sanya, Sanya, China
| | - Boxiong Yang
- School of Information & Intelligence Engineering, University of Sanya, Sanya, China
| | - Shuai Zhao
- School of Health Industry Management, University of Sanya, Sanya, China
| | - Wei Wei
- School of Health Industry Management, University of Sanya, Sanya, China
| | - Jialu Chen
- Sanya Traditional Chinese Medicine Hospital, Sanya, China
| | - Jie Ding
- Wound Healing Research Group, Department of Surgery, Faculty of Medicine and Dentistry University of Alberta, Canada
| | - Hong Wang
- Swiss TCM Clinic, Zurich, Switzerland
| | - Peng Sun
- Sanya People's Hospital, Sanya, China
| | - Lin Gan
- School of Information & Intelligence Engineering, University of Sanya, Sanya, China
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21
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Wu JM, Chen HS, Chen HH, Cheng BW, Huang CW, Chung MH. Enhancing patient self-management after a first stroke: An application of the wearable devices and the health management platform. Disabil Health J 2023; 16:101392. [PMID: 36333265 DOI: 10.1016/j.dhjo.2022.101392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 09/30/2022] [Accepted: 10/01/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Post-stroke disability restricts a patient's physical activity, affects the patient's quality of life, and leads to higher medical costs. Therefore, it is essential to promote patients' continuous exercise during this period of recovery. OBJECTIVE This study aimed to verify the effectiveness of applying a health management platform combined with wearable devices to enhance stroke patients' self-management of recovery and to allow comparisons with active care intervention management. METHOD This quasi-experimental study aimed at examining those participants who had sustained a stroke for the first time. A 90-day experiment was implemented with the intervention of monitoring and active care from the researchers who also interviewed the selected participants at the end of the study. A total of 26 participants were examined (14 in the experimental group and 12 in the control group). RESULT The participants in the experimental group made significant progress between the pre- and post-tests. Firstly, their six-minute walking distance improved by 89.5 m (p < 0.001). Secondly, their sit-to-stand transfers in 60 s improved 2.85 times (p = 0.017), and their Berg balance test improved by 6.36 points (p = 0.003). Finally, the Partners in Health scale (PIH) scores also improved. According to the data collected in the interviews, the researchers' intervention improved the patients' self-management ability. CONCLUSION The short-term physical performance in the experimental group after the intervention was better than that in the control group. In clinical practice, it is suggested that continuous interaction between medical staff and patients be sustained while applying wearable devices to promote the patient's self-management ability.
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Affiliation(s)
- Jia-Min Wu
- Department of Industrial Engineering and Management, National Yunlin University of Science and Technology, No.123 University Road, Section 3, Douliou, Yunlin City 64002, Taiwan, ROC
| | - Hsin-Shui Chen
- PhD Program for Aging, College of Medicine, China Medical University, No. 100, Sec. 1, Jingmao Rd, Beitun Dist, Taichung City 406040, Taiwan, ROC; Department of Physical Medicine & Rehabilitation, National Taiwan University Hospital Yunlin Branch, No.579, Sec. 2, Yunlin Rd, Douliu City, Yunlin County 640, Taiwan, ROC; School of Medicine, China Medical University, No. 91, Xueshi Rd, North District, Taichung City 404333, Taiwan, ROC.
| | - Hsin-Han Chen
- Department of Industrial Engineering and Management, National Yunlin University of Science and Technology, No.123 University Road, Section 3, Douliou, Yunlin City 64002, Taiwan, ROC
| | - Bor-Wen Cheng
- Department of Industrial Engineering and Management, National Yunlin University of Science and Technology, No.123 University Road, Section 3, Douliou, Yunlin City 64002, Taiwan, ROC
| | - Chiu-Wen Huang
- Department of Physical Medicine & Rehabilitation, National Taiwan University Hospital Yunlin Branch, No.579, Sec. 2, Yunlin Rd, Douliu City, Yunlin County 640, Taiwan, ROC
| | - Ming-Hung Chung
- Department of Physical Medicine & Rehabilitation, National Taiwan University Hospital Yunlin Branch, No.579, Sec. 2, Yunlin Rd, Douliu City, Yunlin County 640, Taiwan, ROC
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22
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梁 潇, 杜 信, 周 学. [Latest Research Findings on Health Management Based on Saliva Testing]. Sichuan Da Xue Xue Bao Yi Xue Ban 2022; 53:1110-1117. [PMID: 36443061 PMCID: PMC10408987 DOI: 10.12182/20221160510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Indexed: 06/16/2023]
Abstract
Being one of the most important exocrine fluids of the human body, saliva can reflect the health status of the body. Soliva collection has various advantages--it is simple, painless, fast, and safe, and soliva can be collected multiple times a day. Therefore, it has been gradually applied in the exploration for biomarkers for disease detection, providing a basis for the monitoring of the course of diseases, medication monitoring, and efficacy evaluation. We should implement health management based on saliva testing, collect the medical data of the healthy and diseased individuals and monitor their whole life cycle health, perform clinical cohort study, aggregate the data on platforms for big data on health and medicine, manage and provide guidance for the health status of populations, pinpoint the high-risk factors for pathogenesis, and provide effective intervention, early warning, and assessment of the vital signs of individuals, thereby reinforcing health management of the whole life cycle and safeguarding people's health in an all-round way. In addition, it drives the development of the health industry and bears strategic significance for the promotion of national economic development. It is becoming a hot research topic promising great potential and impressive applicational prospects. Herein, we reviewed new techniques for clinical saliva testing and health management based on saliva testing.
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Affiliation(s)
- 潇月 梁
- 口腔疾病研究国家重点实验室 国家口腔疾病临床医学研究中心 四川大学华西口腔医院 牙体牙髓病科 (成都 610041)State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - 信眉 杜
- 口腔疾病研究国家重点实验室 国家口腔疾病临床医学研究中心 四川大学华西口腔医院 牙体牙髓病科 (成都 610041)State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - 学东 周
- 口腔疾病研究国家重点实验室 国家口腔疾病临床医学研究中心 四川大学华西口腔医院 牙体牙髓病科 (成都 610041)State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
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23
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Oncologist Branch of the Chinese Medical Doctor Association, Pancreatic Disease Special Committee of the China International Exchange and Promotive Association for Medical and Health Care, Abdominal Tumor Special Committee of the China Medical Education Association. [Expert consensus on the whole-course management of home medical care for patients with pancreatic cancer in China]. Zhonghua Zhong Liu Za Zhi 2022; 44:1076-82. [PMID: 36319452 DOI: 10.3760/cma.j.cn112152-20220523-00362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Pancreatic cancer is known as the " king of cancer" . The incidence and mortality of pancreatic cancer are increasing year by year worldwide. The prognosis of pancreatic cancer is very poor, and the effect of existing diagnosis and treatment methods is limited. The Oncologist Branch of the Chinese Medical Doctor Association, the Pancreatic Disease Special Committee of the China International Exchange and Promotive Association for Medical and Health Care, and the Abdominal Tumor Special Committee of the China Medical Education Association convened relevant experts to put forward useful suggestions for clinical reference on nine aspects of home management of patients with pancreatic cancer, including condition communication, follow-up, nutritional support, cancer pain management, psychological adjustment, ascites management, jaundice management, and daily food management. The aim is to improve the quality of life and prolong the survival time of patients with pancreatic cancer.
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24
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Zhou D, Huang D, Zhang H, Yang J. Periodic analysis on gas path fault diagnosis of gas turbines. ISA Trans 2022; 129:429-441. [PMID: 35221094 DOI: 10.1016/j.isatra.2022.01.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Revised: 04/29/2021] [Accepted: 01/30/2022] [Indexed: 06/14/2023]
Abstract
The gas path fault diagnosis is considered widely to ensure the economy, safety and practicability of gas turbines. Traditional gas path diagnosis methods are vulnerable to various uncertainties, resulting in a deviation between the diagnostic results and the real states, which brings huge potential safety hazard to industrial production. Periodic analysis can suppress the uncertainty interference and extract accurately the features of performance parameters to improve the accuracy of health evaluation. Motivated by these, a novel periodic analysis method is proposed for detecting gas path faults, namely the changing periodicity of performance parameters representing the health state of gas turbine is detected to determine whether gas path fault occurs. It is theoretically analyzed that the relationship between the periodicity of observed performance parameters and that of boundary conditions, system uncertainties, and thermodynamic parameters. The simulation experiments are performed to analyze the effects of gas path faults on periodicity of boundary conditions, system uncertainties and thermodynamic parameters. The results show that most gas path faults break the periodicity of performance parameters, proving that the operating states can be monitored through the periodic analysis of performance parameters. An online diagnosis procedure is further proposed by combining signal decomposition and rolling periodic extraction method to judge whether the gas turbine is in health or not. The validity is verified by comparing the periodicity of performance parameters under healthy and fault states. Periodic analysis suppresses the effects of system and parameter uncertainties and detects sensitively gas path faults, which provides a new idea for the fault diagnosis of gas turbines.
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Affiliation(s)
- Dengji Zhou
- The Key Laboratory of Power Machinery and Engineering of Education Ministry, Shanghai Jiao Tong University, Shanghai 200240, PR China.
| | - Dawen Huang
- The Key Laboratory of Power Machinery and Engineering of Education Ministry, Shanghai Jiao Tong University, Shanghai 200240, PR China
| | - Huisheng Zhang
- The Key Laboratory of Power Machinery and Engineering of Education Ministry, Shanghai Jiao Tong University, Shanghai 200240, PR China
| | - Jianhua Yang
- School of Mechatronic Engineering, China University of Mining and Technology, Xuzhou 221116, PR China
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25
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Aubineau T, Guatteo R, Boudon A. Implementation of hypocalcaemia prevention programmes in commercial dairy herds: From theory to practice. Animal 2022; 16:100639. [PMID: 36174426 DOI: 10.1016/j.animal.2022.100639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 08/28/2022] [Accepted: 09/01/2022] [Indexed: 11/21/2022] Open
Abstract
Hypocalcaemia prevention programmes have been widely studied in experimental settings, but their feasibility has not been assessed under field conditions. The main objective of this study was to evaluate, in the context of small dairy farms in western France, whether and how dairy farmers implement prevention programmes and manage the feeding of dry cows to prevent hypocalcaemia. Seventy-nine commercial Holstein dairy farms in Brittany (France) were enrolled in a qualitative study in 2019. We conducted in-person interviews with the farmers to 1) understand the rationale behind the type and seasonality of prevention programmes they implemented and 2) assess how closely they followed common recommendations when implementing them. Most farmers (80 %) used at least one prevention programme, especially supplying a mineral mix formulated to meet the needs of dry cows in late gestation (53 %), acidifying the diet in late gestation (37 %), and supplying calcium at calving (oral or injectable form, 37 %). The use of programmes depended on whether the diet composition varied throughout the year. Among farmers who provided an acidified diet, 25 % did not supply a specific mineral mix to dry cows to ensure an adequate amount of P, Ca, and Mg, which could decrease the effectiveness of the acidification programme. A lack of reliability in feeding practices, such as not weighing feed or not delivering feed frequently enough, was identified for 61 % of contributing farms. Management practices could result in supplying an unsuitable amount of P, Ca, or Mg immediately before calving; for example, inappropriate batching practices around calving were identified for 22 % (cows) to 32 % (heifers) of farms. In addition, nearly all contributing farmers had no processes in place to monitor the effectiveness of the programmes implemented. Reasons for this overall lack of compliance should be explored.
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Hillebrecht M, Schmidt C, Saptoka BP, Riha J, Nachtnebel M, Bärnighausen T. Maintenance versus replacement of medical equipment: a cost-minimization analysis among district hospitals in Nepal. BMC Health Serv Res 2022; 22:1023. [PMID: 35953804 PMCID: PMC9373529 DOI: 10.1186/s12913-022-08392-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 07/21/2022] [Indexed: 12/05/2022] Open
Abstract
Background About half of all medical devices in low- and lower-middle-income countries are currently non-operational because equipment maintenance is lacking. Thus, choosing a cost-efficient equipment maintenance approach has the potential to increase both the quantity and quality of important health services. Between 2010 and 2014 Nepal’s Ministry of Health chose two of its development regions to pilot the contracting-out of maintenance services to the private sector. We develop a cost model and employ different data to calculate the cost of this contracted-out scheme. The latter we compare with two additional common approaches to maintenance: in-house maintenance and no maintenance. Methods We use invoiced pilot program costs, device depreciation estimates from the literature, and hospital case numbers from Nepal’s Health Management Information System. We estimate net-present values for a three-year horizon, incorporating both fixed and operational cost. Operational costs include downtime cost measured as lost revenues due to non-working equipment. Results The contracted-out maintenance scheme shows a strong relative cost performance. Its cost after 3 years amount to 4,501,574 International Dollars Purchasing Power Parity (I$ PPP), only 90% of the cost with no maintenance. The contracted-out scheme incurs 670,288 I$ PPP and 3,765,360 I$ PPP in fixed cost and operational cost, respectively. The cost for replacing broken devices is 1,920,467 I$ PPP lower with maintenance. In addition, after 3 years total cost of contracted-out maintenance is 489,333 I$ PPP (11%) below total cost of decentralized in-house maintenance. After 10 years, contracted-out maintenance saves 2.5 million I$ PPP (18%) compared to no maintenance. Conclusions We find that contracted-out maintenance provides cost-efficient medical equipment maintenance in a lower-middle income context. Our findings contrast with studies from high- and upper-middle-income countries, which reflect contexts with more in-house engineering expertise than in our study area. Since the per hospital fixed cost decrease with scheme size, our results lend support to an expansion of contracted-out maintenance to the remaining three development regions in Nepal. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08392-6.
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Affiliation(s)
- Michael Hillebrecht
- Heidelberg Institute of Global Health (HIGH), Medical Faculty and University Hospital, Heidelberg University, Heidelberg, Germany. .,South-Asia Institute, Heidelberg University, Heidelberg, Germany. .,Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH, Eschborn, Germany.
| | - Constantin Schmidt
- Heidelberg Institute of Global Health (HIGH), Medical Faculty and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Bhim Prasad Saptoka
- Health Coordination Division, Ministry of Health and Population, Kathmandu, Nepal.,Division of Infectious Diseases and Tropical Medicine, Center for International Health, University Hospital Munich, Ludwig-Maximilians-University, Munich, Germany
| | | | - Matthias Nachtnebel
- Health and Social Protection Asia, KfW Development Bank, Frankfurt am Main, Germany
| | - Till Bärnighausen
- Heidelberg Institute of Global Health (HIGH), Medical Faculty and University Hospital, Heidelberg University, Heidelberg, Germany.,Africa Health Research Institute (AHRI), Somkhele, KwaZulu-Natal, South Africa.,MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,Center for Population and Development Studies, Harvard University, Cambridge, MA, USA
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27
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Kok M, Bulthuis S, Dieleman M, Onvlee O, Murphy R, Akweongo P, Namakula J, Banda H, Wyss K, Raven J, Martineau T. Using a theory of change in monitoring, evaluating and steering scale-up of a district-level health management strengthening intervention in Ghana, Malawi, and Uganda - lessons from the PERFORM2Scale consortium. BMC Health Serv Res 2022; 22:1001. [PMID: 35932015 PMCID: PMC9356464 DOI: 10.1186/s12913-022-08354-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 07/12/2022] [Indexed: 11/29/2022] Open
Abstract
Background Since 2017, PERFORM2Scale, a research consortium with partners from seven countries in Africa and Europe, has steered the implementation and scale-up of a district-level health management strengthening intervention in Ghana, Malawi and Uganda. This article presents PERFORM2Scale’s theory of change (ToC) and reflections upon and adaptations of the ToC over time. The article aims to contribute to understanding the benefits and challenges of using a ToC-based approach for monitoring and evaluating the scale-up of health system strengthening interventions, because there is limited documentation of this in the literature. Methods The consortium held annual ToC reflections that entailed multiple participatory methods, including individual scoring exercises, country and consortium-wide group discussions and visualizations. The reflections were captured in detailed annual reports, on which this article is based. Results The PERFORM2Scale ToC describes how the management strengthening intervention, which targets district health management teams, was expected to improve health workforce performance and service delivery at scale, and which assumptions were instrumental to track over time. The annual ToC reflections proved valuable in gaining a nuanced understanding of how change did (and did not) happen. This helped in strategizing on actions to further steer the scale-up the intervention. It also led to adaptations of the ToC over time. Based on the annual reflections, these actions and adaptations related to: assessing the scalability of the intervention, documentation and dissemination of evidence about the effects of the intervention, understanding power relationships between key stakeholders, the importance of developing and monitoring a scale-up strategy and identification of opportunities to integrate (parts of) the intervention into existing structures and strategies. Conclusions PERFORM2Scale’s experience provides lessons for using ToCs to monitor and evaluate the scale-up of health system strengthening interventions. ToCs can help in establishing a common vision on intervention scale-up. ToC-based approaches should include a variety of stakeholders and require their continued commitment to reflection and learning on intervention implementation and scale-up. ToC-based approaches can help in adapting interventions as well as scale-up processes to be in tune with contextual changes and stakeholders involved, to potentially increase chances for successful scale-up.
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Affiliation(s)
- Maryse Kok
- KIT Royal Tropical Institute, Amsterdam, the Netherlands.
| | - Susan Bulthuis
- KIT Royal Tropical Institute, Amsterdam, the Netherlands.,Athena Institute, VU University, Amsterdam, the Netherlands
| | - Marjolein Dieleman
- KIT Royal Tropical Institute, Amsterdam, the Netherlands.,Athena Institute, VU University, Amsterdam, the Netherlands
| | - Olivier Onvlee
- KIT Royal Tropical Institute, Amsterdam, the Netherlands
| | - Rebecca Murphy
- Department of Psychology, Maynooth University, Kildare, Ireland
| | - Patricia Akweongo
- Department of Health Policy, Planning & Management, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | | | - Hastings Banda
- Research for Equity and Community Health (REACH) Trust, Lilongwe, Malawi
| | - Kaspar Wyss
- Swiss Centre for International Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland.,University of Basel, Basel, Switzerland
| | - Joanna Raven
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Tim Martineau
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
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28
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Khedmat L, Mohaghegh P, Veysizadeh M, Hosseinkhani A, Fayazi S, Mirzadeh M. Pregnant women and infants against the infection risk of COVID-19: a review of prenatal and postnatal symptoms, clinical diagnosis, adverse maternal and neonatal outcomes, and available treatments. Arch Gynecol Obstet 2022; 306:323-335. [PMID: 34842975 PMCID: PMC8628058 DOI: 10.1007/s00404-021-06325-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 10/01/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND The establishment of a risk-appropriate care approach for pregnant women and newborn infants under the COVID-19 pneumonia is vital to prevent the main pregnancy complications. OBJECTIVES AND DESIGN This study reviewed the vertical transmission (VT) potential of COVID-19 pneumonia in pregnant women. Key-related symptoms and adverse clinical outcomes for mothers and infants before and after childbirth were summarized. Some practical therapies and preventive health solutions were also proposed. RESULTS There was a high susceptibility in pregnant women to COVID-19 infection, especially in the third trimester of pregnancy. The most common symptoms in 22-40-year-old patients infected with COVID-19 were fever (87.6%), cough (52.3%), dyspnea (27.6%), fatigue (22.4%), sore throat (13.5%), malaise (9.4%), and diarrhea (3.4%), respectively. The viral infection led to an increase in preterm labor and cesarean delivery without any intrauterine infection and severe neonatal asphyxia. No infection in the newborn infants was reported despite a high risk of the VT phenomenon. The most important therapies were the reception of antiviral and antibiotic drugs, oxygenation therapy, psychological interventions, and food supplements with health-promoting effects. The best proposed medical strategies to control the COVID-19 infection were bi-monthly screening and following-up the mothers' and fetuses' health, not using the potent broad-spectrum antibiotics and corticosteroids, providing the delivery room with negative pressure for emergency cesarean section, and the immediate isolation of newborns after childbirth without direct breastfeeding. CONCLUSION Babies with respiratory problems may be born to some mothers with COVID-19, who have weak immune systems. Thus, the virus transmission cycle should be disrupted to prevent adverse maternal and fetal outcomes by integrating individual health guidelines, efficient medical care therapies, and hospital preventive practices.
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Affiliation(s)
- Leila Khedmat
- Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Pegah Mohaghegh
- Department of Community Medicine, School of Medicine, Arak University of Medical Sciences, Arak, Iran
| | - Maryam Veysizadeh
- Maternal, Fetal and Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Azadeh Hosseinkhani
- Department of Midwifery, School of Nursing and Midwifery, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Sanaz Fayazi
- Department of Midwifery, School of Nursing and Midwifery, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Monirsadat Mirzadeh
- Metabolic Disease Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Bahonar Boulevard, 34197-59811, Qazvin, Iran.
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29
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Bringsén Å, Lindström PN. Swedish managers' experience of yearly staff development dialogues, aiming for employee development, performance, and well-being. BMC Psychol 2022; 10:184. [PMID: 35897049 PMCID: PMC9327207 DOI: 10.1186/s40359-022-00890-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 07/14/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Societal development and a competitive corporate climate have resulted in increased emphasis on performance management (PM) but also sustainability and health challenges in working life. Opportunities for employee well-being, development and performance are thus highly relevant for organisations and society. PM includes a manager-employee dialogue process and is identified as a complex challenge when combined with employee development and well-being. Managers have a key role in PM, and research in collaboration with practitioners in specific contexts is needed. An exploratory study, focusing on managers' experience of dialogues between managers and employees in practice, was therefore conducted in collaboration with an inter-municipal corporation company in southern Sweden. METHODS A qualitative study with an inductive design, supported by semi-structured focus group interviews, was chosen based on the exploratory character of the study. Thirty-five managers were approached in the company and 15, of varying age and managerial experience, agreed to participate. Staff Development Dialogues (SDD) were used in the company PM model to facilitate employee development, performance, and well-being. Data was analysed using conventional qualitative content analysis to obtain new insights without using pre-set classifications. RESULTS The analysis resulted in three categories of SDD experiences: SDD in a business context; Managers in relation to SDD; and Employees in relation to SDD. The findings revealed varying SDD experiences as well as approaches, and analytical themes were considered in relation to the organisational context and the specific SDD content and process. The study showed the importance of SDD adaptation and a well-being perspective in the dialogues was related to relational aspects and the manager-employee approach to SDDs. DISCUSSION The findings confirm the complexity and challenges of PM including development and well-being. Adaptation to specific departments as well as employees is important, and using the same PM strategy throughout an organisation can be questioned. The identified link between a relational approach and a well-being perspective indicates a missed opportunity for systematic workplace health promotion. Strengthening the well-being perspective can, thus, improve the quality of an SDD model, which in turn can facilitate the creation of sustainable workplaces and better fulfilment of employers' health-related obligations for systematic work environment management.
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Affiliation(s)
- Åsa Bringsén
- Faculty of Health Sciences, Kristianstad University, 291 88, Kristianstad, Sweden.
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30
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Tan J, Sun XT, Peng DR. [Current research progress on health problems and health management of E-sports players]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2022; 40:392-395. [PMID: 35680588 DOI: 10.3760/cma.j.cn121094-20210401-00183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Electronic sports (E-sports) are series of competitive activities different from the traditional physical sports, and E-sports athlete is becoming a new profession. Along with the fast development of E-sports industry, the number of E-sports athletes increased tremendously. The early retirement of some top-ranking athletes caused by occupational injuries has aroused the societal attentions on the health problems of E-sports athletes. Facing special occupational exposure, E-sports athletes encounter different health issues comparing to the counterparts of their ages. It is necessary to scientifically identify their health hazards and common health issues, in order to conduct effective health management for this particular professional group. This review summarized global literature on health issues and health management on E-sports athletes. The research on their health issues were mainly descriptive and there was a paucity on interventional research and health management. These provide references and directions on the future health services and research on E-sports athletes.
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Affiliation(s)
- J Tan
- Research and Education Office, Pengpu Xincun Community Health Care Center of Shanghai Jing'an District Affiliated to Tongji University School of Medicine, Shanghai 200435, China
| | - X T Sun
- Postdoctoral Workstation, Shanghai Tenth People's Hospital of Tongji University, Shanghai 200072, China
| | - D R Peng
- Administration Office, Pengpu Xincun Community Health Care Center of Shanghai Jing'an District Affiliated to Tongji University School of Medicine, Shanghai 200435, China
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Subramanian I, Brindle S, Perepezko K, Chaudhuri KR. Wellness, sexual health, and nonmotor Parkinson's. Int Rev Neurobiol 2022; 162:171-184. [PMID: 35397785 DOI: 10.1016/bs.irn.2021.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Nonmotor symptoms of Parkinson's disease (PD) range from neuropsychiatric and cognitive to sleep, sensory, and genito-urinary disorders, and occur as a result of the disease process as well as due to side effects of drug treatment for PD. Sexual dysfunction is an important aspect of the nonmotor profile of Parkinson's but is rarely discussed. Sexual health is considered an integral element of holistic health, thus sexual dysfunction can also significantly impact quality of life in people with Parkinson's. The effect of sexual dysfunction of PD, both disease related and drug induced, on the concept of "wellness" of patients and their intimate partners is poorly understood, inadequately researched and a key unmet need in care and support. In this chapter we discuss the concept of "wellness" as applied to the treatment of PD, the ways in which nonmotor symptoms and other aspects of living may affect wellness in PD, and strategies for addressing sexual health utilizing a wellness model.
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Affiliation(s)
- Indu Subramanian
- David Geffen School of Medicine, UCLA, Department of Neurology, Los Angeles, CA, United States; PADRECC, West Los Angeles, Veterans Administration, Los Angeles, CA, United States
| | - Sarah Brindle
- Spinal Cord Injury/Disorders Service, Veterans Administration Long Beach Healthcare System, Long Beach, CA, United States
| | - Kate Perepezko
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MA, United States
| | - K Ray Chaudhuri
- Clinical Director Parkinson's Foundation Centre of Excellence, King's College Hospital, London, United Kingdom; Department of Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, United Kingdom.
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Liu R, Li M, Wang P, Yu M, Wang Z, Zhang GZ. Preventive online and offline health management intervention in polycystic ovary syndrome. World J Clin Cases 2022; 10:3060-3068. [PMID: 35647126 PMCID: PMC9082701 DOI: 10.12998/wjcc.v10.i10.3060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 01/24/2022] [Accepted: 02/20/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is characterized by hyperandrogenism, hyperinsulinemia, ovarian polycystic changes, and irregular ovulation, often occurring in women of childbearing age for whom it can be a cause of infertility. Hypothalamus-pituitary-ovarian axis dysregulation is important in the pathogenesis of PCOS and the associated chronic excess of sex hormones can lead to cardiovascular and cerebrovascular diseases, diabetes, and malignancies such as endometrial cancer, and breast cancer. At present, most scholars agree that lifestyle interventions in conjunction with drug treatment can help PCOS patients achieve their goals of successful pregnancy and childbirth.
AIM To investigate the clinical effect of an online and offline (O2O) preventive health management model on PCOS with kidney deficiency and phlegm dampness.
METHODS A total of 82 patients with PCOS of the kidney deficiency and phlegm dampness type who were admitted to Beijing Luhe Hospital Affiliated to Capital Medical University from April 2019 to June 2020 were randomly divided into two groups. The treatment group was treated with oral Diane-35 for 3 mo and received preventive O2O medical health management for 6 mo (including eating and living, exercise, drug management). The control group was treated with oral Diane-35 for 3 mo and completed outpatient health education. The traditional Chinese medicine (TCM) syndrome score, acne score, hair score, sex hormone level and clinical effects were compared between the two groups before and after the intervention.
RESULTS After treatment, the TCM syndrome score, acne score, and serum luteinizing hormone/follicle stimulating hormone level were significantly lower in the treatment group than in the control group (P < 0.05). After 3 mo of treatment, the TCM syndrome curative effect index in the treatment group was 97.30% compared to 54.05% in the control group (P < 0.05), whereas the total treatment effect in the treatment group was 91.89%, compared to 54.05% in the control group (P < 0.05).
CONCLUSION An integrated therapeutic approach incorporating medication, TCM methods and social media is more effective than standard treatment for PCOS.
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Affiliation(s)
- Rui Liu
- Dermatological Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing 101100, China
- Chinese Medicine Department, Beijing Luhe Hospital, Capital Medical University, Beijing 101100, China
| | - Min Li
- Chinese Medicine Department, Beijing Luhe Hospital, Capital Medical University, Beijing 101100, China
| | - Pei Wang
- Chinese Medicine Department, Beijing Luhe Hospital, Capital Medical University, Beijing 101100, China
| | - Man Yu
- Chinese Medicine Department, Beijing Luhe Hospital, Capital Medical University, Beijing 101100, China
| | - Zheng Wang
- Chinese Medicine Department, Beijing Luhe Hospital, Capital Medical University, Beijing 101100, China
| | - Guang-Zhong Zhang
- Dermatological Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing 101100, China
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Zhang C, Chang Y, Yun Q, Lu J, Zheng X, Xue Y, Zhao X, Yuan W, Zou J, Zheng J. The impact of chronic diseases on depressive symptoms among the older adults: The role of sleep quality and empty nest status. J Affect Disord 2022; 302:94-100. [PMID: 35085671 DOI: 10.1016/j.jad.2022.01.090] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 01/18/2022] [Accepted: 01/22/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND Depression is the most prevalent mental disorder among older adults. This study aimed to explore the mediating effect of sleep quality on the relationship between chronic diseases and depressive symptoms, and the moderating role of empty nest status in the mediating model. METHODS A cross-sectional survey was conducted among 3637 older adults from Taiyuan, China, using a multi-stage random cluster sampling method. The data was collected with the general questionnaire for the elderly, with the Short Form Geriatric Depression Scale (GDS-15), and the Pittsburgh Sleep Quality Index (PSQI). The Bootstrap program and simple slope method were used to test the mediating effect of sleep quality and the moderating effect of empty nest status. RESULTS The overall prevalence of depressive symptoms in the population was 33.4%. The mediating effect analysis showed that chronic diseases had a significant direct impact on depressive symptoms in the elderly (β = 0.431, P < 0.001). Sleep quality as a mediation effect of 43.4% between chronic diseases and depressive symptoms was proven. The further moderating effect found that chronic diseases had a more significant impact on the sleep quality of the elderly who are in the empty nest status than those who are not (β = -0.431, P < 0.05 ). LIMITATIONS Given the cross-sectional study, the results cannot explain the causal relationships among the study variables. CONCLUSIONS Chronic diseases had a major impact on the depressive symptoms of the elderly. Sleep quality mediated the relationship between chronic diseases and depressive symptoms, and the empty nest status moderated the first half of the path in the mediation model. Therefore, to reduce the incidence of the depressive symptoms of the elderly, sleep quality and empty nest status should be the primary concern.
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Affiliation(s)
- Chichen Zhang
- School of Health Management, Southern Medical University, No.1023, Shatai Road, Guangzhou 510515, Guangdong, China; Department of Health Management, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China; Institute of Health Management, Southern Medical University, Guangzhou, Guangdong, China.
| | - Yunqi Chang
- Department of Preventive Medicine, Changzhi Medical College, Changzhi, Shanxi, China
| | - Qilong Yun
- Department of Mathematics, New York University, New York, NY, USA
| | - Jiao Lu
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Xiao Zheng
- School of Health Management, Southern Medical University, No.1023, Shatai Road, Guangzhou 510515, Guangdong, China
| | - Yaqing Xue
- School of Health Management, Southern Medical University, No.1023, Shatai Road, Guangzhou 510515, Guangdong, China
| | - Xinyue Zhao
- School of Management, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Wenpei Yuan
- School of Management, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Jiayu Zou
- School of Management, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Jianzhong Zheng
- Department of Preventive Medicine, Changzhi Medical College, Changzhi, Shanxi, China
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Abstract
Surplus male dairy calves experience significant health challenges after arrival at the veal and dairy beef facilities. To curb these challenges, the engagement of multiple stakeholders is needed starting with improved care on some dairy farms and better management of transportation. Differing management strategies are also needed if calves arrive at veal and dairy beef facilities under poor condition.
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Affiliation(s)
- David Renaud
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada.
| | - Bart Pardon
- Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, Merelbeke 9820, Belgium
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Itani O, Kaneita Y, Otsuka Y, Tokiya M, Jike M, Matsumoto Y, Nakagome S, Kinoshita Y. A cross-sectional epidemiological study of the relationship between sleep duration, quality, and rhythm and presenteeism in workers. Sleep Biol Rhythms 2022; 20:53-63. [PMID: 38469066 PMCID: PMC10897641 DOI: 10.1007/s41105-021-00339-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 06/27/2021] [Indexed: 10/20/2022]
Abstract
This study aims to examine the relationship of sleep (sleep duration, sleep quality, and sleep rhythm) with presenteeism in workers while controlling for other confounding factors. A total of 2375 workers of six Japanese companies received self-administered questionnaires from June to November 2018. Information on sleep duration was used to evaluate sleep quantity, the Athens Insomnia Scale (AIS) was used to evaluate sleep quality, and workers' engagement in shift work was used to determine their sleep rhythms. We used the World Health Organization Health and Work Performance Questionnaire to evaluate presenteeism. Information on lifestyle (exercise, smoking, etc.), sex, and age was also collected. We conducted a logistic regression analysis with high absolute/relative presenteeism as an objective variable, sleep duration, AIS, and shift work as dependent variables, and basic attributes and lifestyle factors as adjustment factors. Completed questionnaires were collected from 1992 workers (aged 18-79 years; 25.2% women; response rate: 83.9%). Logistic regression analysis showed that high absolute presenteeism was significantly associated with poor sleep quality (high AIS score; P < 0.001) but not with sleep duration (P = 0.326) and shift work (P = 0.177). High relative absenteeism was significantly associated with poor sleep quality (high AIS score; P = 0.001) but not with sleep duration (P = 0.461) or shift work (P = 0.245). We showed that poor sleep quality is significantly associated with a high level of presenteeism. This suggests focusing on improving sleep quality is important for reducing presenteeism among workers.
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Affiliation(s)
- Osamu Itani
- Division of Public Health, Department of Social Medicine, Nihon University School of Medicine, Itabashi-ku, Tokyo Japan
| | - Yoshitaka Kaneita
- Division of Public Health, Department of Social Medicine, Nihon University School of Medicine, Itabashi-ku, Tokyo Japan
| | - Yuichiro Otsuka
- Division of Public Health, Department of Social Medicine, Nihon University School of Medicine, Itabashi-ku, Tokyo Japan
| | - Mikiko Tokiya
- Department of Public Health and Epidemiology, Faculty of Medicine, Oita University, Yufu-city, Oita Japan
| | - Maki Jike
- Department of Food Safety and Management, Faculty of Food and Health Sciences, Showa Women’s University, Setagaya-ku, Tokyo Japan
| | - Yuuki Matsumoto
- Division of Public Health, Department of Social Medicine, Nihon University School of Medicine, Itabashi-ku, Tokyo Japan
| | - Sachi Nakagome
- Division of Public Health, Department of Social Medicine, Nihon University School of Medicine, Itabashi-ku, Tokyo Japan
| | - Yu Kinoshita
- Division of Public Health, Department of Social Medicine, Nihon University School of Medicine, Itabashi-ku, Tokyo Japan
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Wang ZR, Zhou JW, Liu XP, Cai GJ, Zhang QH, Mao JF. Effects of WeChat platform-based health management on health and self-management effectiveness of patients with severe chronic heart failure. World J Clin Cases 2021; 9:10576-10584. [PMID: 35004989 PMCID: PMC8686122 DOI: 10.12998/wjcc.v9.i34.10576] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 09/08/2021] [Accepted: 10/15/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Epidemiological studies have found that the prevalence of chronic heart failure in China is 0.9%, the number of people affected is more than 4 million, and the 5-year survival rate is even lower than that of malignant tumors.
AIM To determine the impact of WeChat platform-based health management on severe chronic heart failure patients’ health and self-management efficacy.
METHODS A total of 120 patients suffering from chronic heart failure with cardiac function grade III-IV, under the classification of the New York Heart Association, were admitted to our hospital in May 2017. In January 2020, they were divided into two groups: A control group (with routine nursing intervention) and an observation group (with WeChat platform-based health management intervention). Changes in cardiac function, 6-min walking distance (6MWD), high-sensitivity cardiac troponin (hs-cTnT), and N-terminal pro B-type natriuretic peptide (NT-proBNP) were detected in both groups. The Self-Care Ability Scale (ESCA) score, Minnesota Living with Heart Failure Questionnaire score, and compliance score were used to evaluate self-management ability, quality of life, and compliance of the two groups. During a follow-up period of 12 mo, the occurrence of cardiovascular adverse events in both the groups was counted.
RESULTS The left ventricular ejection fraction, stroke output, and 6MWD increased, and the hs-cTnT and NT-proBNP decreased in both the groups, as compared to those before the intervention. Further, cardiac function during the 6MWD, hs-cTnT, and NT-proBNP improved significantly in the observation group after intervention (P < 0.05). The scores of self-care responsibility, self-concept, self-care skills, and self-care health knowledge in the observation group were higher than those of the control group before intervention, and their ESCA scores were significantly improved after intervention (P < 0.05). The Minnesota heart failure quality of life (LiHFe) scores of physical restriction, disease symptoms, psychological emotion, social relations, and other items were decreased compared to those of the control group before intervention, and the LiHFe scores of the observation group were significantly improved compared to those of the control group (P < 0.05). With intervention, the compliance scores of rational diet, regular medication, healthy behavior, and timely reexamination were increased, thereby leading to the compliance scores of the observation group being significantly improved compared to those of the control group (P < 0.05). During the 12 mo follow-up, the incidence rates of acute myocardial infarction and cardiogenic rehospitalization in the observation group were lower than those of the control group, and the hospitalization time in the observation group was shorter than that of the control group, but there was no significant difference between the two groups (P > 0.05).
CONCLUSION WeChat platform-based health management can improve the self-care ability and compliance of patients with severe chronic heart failure, improve the cardiac function and related indexes, reduce the occurrence of cardiovascular adverse events, and enable the avoidance of rehospitalization.
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Affiliation(s)
- Zhan-Ru Wang
- Department of Critical Care Medicine, Shaoxing Hospital of China Medical University, Shaoxing 312000, Zhejiang Province, China
| | - Jia-Wu Zhou
- Department of Emergency Medicine, Shaoxing Hospital of China Medical University, Shaoxing 312000, Zhejiang Province, China
| | - Xiao-Ping Liu
- Department of Emergency Medicine, Shaoxing Hospital of China Medical University, Shaoxing 312000, Zhejiang Province, China
| | - Guo-Juan Cai
- Department of Emergency Medicine, Zhuji People's Hospital of Zhejiang Province, Zhuji 311800, Zhejiang Province, China
| | - Qi-Hong Zhang
- Department of Emergency Medicine, Zhuji People's Hospital of Zhejiang Province, Zhuji 311800, Zhejiang Province, China
| | - Jun-Fang Mao
- Department of Emergency Medicine, Zhuji People's Hospital of Zhejiang Province, Zhuji 311800, Zhejiang Province, China
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Klösch M, Sari-Kundt F, Reibnitz C, Osterbrink J. Patients' attitudes toward their health literacy and the use of digital apps in health and disease management. Br J Nurs 2021; 30:1242-1249. [PMID: 34839691 DOI: 10.12968/bjon.2021.30.21.1242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND No qualitative studies have so far been conducted about patients' attitudes and perceptions toward their own health literacy and the use of digital apps in health and disease management based in Austria. AIM In the context of digital apps, what are patients' attitudes and perceptions with regard to their own health literacy? METHOD Guided interviews were conducted with patients in an Austrian hospital to obtain qualitative data. Qualitative content analysis was used to analyse the data. FINDINGS Responses to the research questions fell into three main categories: 'health', 'health literacy' and 'digital applications in health and disease management', with each having its own set of subcategories. Digital apps appear to be an important strategy for helping patients optimise their own health literacy, as well as their health or disease management. Challenges referred to the handling of sensitive data or the possibility of publishing unfiltered information. CONCLUSION Further studies need to be carried out to gain a more detailed understanding of the findings. Personal experience plays an important role in supporting quantitative findings.
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Affiliation(s)
- Michael Klösch
- Research Assistant, Institute of Nursing Science and Practice, Paracelsus Medical University, Salzburg, Austria
| | - Firuzan Sari-Kundt
- Research Assistant, Institute of Nursing Science and Practice, Paracelsus Medical University, Salzburg, Austria
| | - Christine Reibnitz
- External Lecturer, Institute of Nursing Science and Practice, Paracelsus Medical University, Salzburg, Austria
| | - Jürgen Osterbrink
- Professor, Institute of Nursing Science and Practice, Paracelsus Medical University, Salzburg, Austria
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Dubron K, Verschaeve M, Roodhooft F. A time-driven activity-based costing approach for identifying variability in costs of childbirth between and within types of delivery. BMC Pregnancy Childbirth 2021; 21:705. [PMID: 34670514 PMCID: PMC8527632 DOI: 10.1186/s12884-021-04134-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 09/22/2021] [Indexed: 11/10/2022] Open
Abstract
Background Recently, time-driven activity-based costing (TDABC) is put forward as an alternative, more accurate costing method to calculate the cost of a medical treatment because it allows the assignment of costs directly to patients. The objective of this paper is the application of a time-driven activity-based method in order to estimate the cost of childbirth at a maternal department. Moreover, this study shows how this costing method can be used to outline how childbirth costs vary according to considered patient and disease characteristics. Through the use of process mapping, TDABC allows to exactly identify which activities and corresponding resources are impacted by these characteristics, leading to a more detailed understanding of childbirth cost. Methods A prospective cohort study design is performed in a maternity department. Process maps were developed for two types of childbirth, vaginal delivery (VD) and caesarean section (CS). Costs were obtained from the financial department and capacity cost rates were calculated accordingly. Results Overall, the cost of childbirth equals €1894,12 and is mainly driven by personnel costs (89,0%). Monitoring after birth is the most expensive activity on the pathway, costing €1149,70. Significant cost variations between type of delivery were found, with VD costing €1808,66 compared to €2463,98 for a CS. Prolonged clinical visit (+ 33,3 min) and monitoring (+ 775,2 min) in CS were the main contributors to this cost difference. Within each delivery type, age, parity, number of gestation weeks and education attainment were found to drive cost variations. In particular, for VD an age > 25 years, nulliparous, gestation weeks > 40 weeks and higher education attainment were associated with higher costs. Similar results were found within CS for age, parity and number of gestation weeks. Conclusions TDABC is a valuable approach to measure and understand the variability in costs of childbirth and its associated drivers over the full care cycle. Accordingly, these findings can inform health care providers, managers and regulators on process improvements and cost containment initiatives. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-04134-4.
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Affiliation(s)
- Kathia Dubron
- KU Leuven, University Hospital Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium.
| | - Mathilde Verschaeve
- KU Leuven, Faculty of Economics and Business, Research Centre Accountancy, Leuven, Belgium
| | - Filip Roodhooft
- KU Leuven, Faculty of Economics and Business, Research Centre Accountancy, Leuven, Belgium.,Vlerick Business School, Accounting and Finance, Gent, Belgium
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Yeong CH, Azhari HA, Parveen S, Juyena NS, Nahar N, Islam MA, Mysore Kempegowda S, Karmaker N, Mumtaz T, Stoeva M. Health management during COVID-19 pandemic-contribution of women health informaticians, medical physicists and veterinarians from Bangladesh and Malaysia during the world crisis. Health Technol (Berl) 2021; 11:1149-1163. [PMID: 34485010 PMCID: PMC8403066 DOI: 10.1007/s12553-021-00588-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 08/05/2021] [Indexed: 11/26/2022]
Abstract
This article aims to highlight some of the contributions from Bangladeshi and Malaysian women scientists in the fields of health informatics, medical physics and biomedical engineering, and veterinary science in combating the COVID-19 world crisis. The status of COVID-19 situations in Bangladesh and Malaysia in respect to global scenario, some relevant government policies, lessons learnt from previous pandemics, socio-economic impacts of COVID-19, the impact on healthcare system and health management approaches taken by individual/institutional research group led by women scientists during the COVID-19 pandemic have been discussed and demonstrated in this article. These promising activities and initiatives will eventually motivate other women in science and extend their roles from laboratory to society in more aspects.
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Affiliation(s)
- Chai Hong Yeong
- Faculty of Health and Medical Science, School of Medicine, Taylor’s University, 47500 Subang Jaya, Malaysia
| | - Hasin Anupama Azhari
- Department of Medical Physics and Biomedical Engineering (MPBME), Gono Bishwabidyalay (University), Savar, Dhaka, Bangladesh
- South Asia Centre for Medical Physics and Cancer Research, Savar, Dhaka, Bangladesh
| | - Sharmin Parveen
- Department of Health Informatics, Bangladesh University of Health Sciences, Dhaka, Bangladesh
| | - Nasrin Sultana Juyena
- Department of Surgery and Obstetrics, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh, Bangladesh
| | - Nasreen Nahar
- Department of Reproductive and Child Health, Bangladesh University of Health Sciences, Dhaka, Bangladesh
| | - Md. Aminul Islam
- Department of Health Informatics, Bangladesh University of Health Sciences, Dhaka, Bangladesh
| | | | - Nupur Karmaker
- Department of Medical Physics and Biomedical Engineering (MPBME), Gono Bishwabidyalay (University), Savar, Dhaka, Bangladesh
| | - Tabassum Mumtaz
- Institute of Food and Radiation Biology, Bangladesh Atomic Energy Commission, Dhaka, 1207 Bangladesh
| | - Magdalena Stoeva
- Medical Imaging Department, Medical University, Plovdiv, Bulgaria
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Chen Y, Wu Q, Zhang L, Chen D, Liang Z. Relationship of abnormal mid-term oral glucose tolerance test and maternal weight gain with adverse pregnancy outcomes in women with gestational diabetes mellitus. Zhejiang Da Xue Xue Bao Yi Xue Ban 2021; 50:313-9. [PMID: 34402256 DOI: 10.3724/zdxbyxb-2020-0013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
To explore the correlation of mid-term oral glucose tolerance test (OGTT) and maternal weight gain with adverse pregnancy outcomes in women with gestational diabetes mellitus (GDM). A total of 2611 pregnant women with GDM who were examined and delivered in Women's Hospital, Zhejiang University School of Medicine from July 1st 2017 to 30th June 2018 were enrolled in this study. According to the number of abnormal items of mid-term OGTT results or maternal gestational weight gain (GWG), patients were classified. The incidence of adverse perinatal outcomes in each group and its relation with OGTT results and GWG were analyzed. The incidence of gestational hypertension, premature delivery, macrosomia and large for gestational age infant (LGA) in three abnormal items GDM patients were significantly higher than those in one or two abnormal items GDM patients (all <0.017). The incidence of gestational hypertension and premature delivery in two abnormal items GDM patients were higher than those in one abnormal item GDM patients (all <0.017). The incidence of gestational hypertension and macrosomia in excessive GWG patients were significantly higher than those in inadequate and appropriate GWG patients (all <0.017), and the incidence of LGA were higher than that in inadequate GWG patients (all <0.017). The incidence of premature delivery and low birth weight infants in appropriate GWG patients were significantly lower than those in inadequate and excessive GWG patients, and the incidence of small for gestational age infant (SGA) were significantly lower than that in inadequate GWG patients (all <0.017). In one abnormal item GDM patients, inadequate GWG was a risk factor for premature delivery and SGA (=1.66, 95%: 1.10-2.52; =2.20, 95%: 1.07-4.53), and protective factor for LGA (=0.40, 95%: 0.27-0.59). And excessive GWG was a risk factor for gestational hypertension, premature delivery and low birth weight infants (=2.15, 95%: 1.35-3.41; =1.80, 95%: 1.20-2.72; =2.18, 95%: 1.10-4.30).In two abnormal items GDM patients, inadequate GWG was a protective factor for macrosomia and LGA (=0.24, 95%: 0.09-0.67; =0.54, 95%: 0.34-0.86), while excessive GWG was risk factor for premature delivery (=1.98, 95%: 1.23-3.18).In three abnormal items GDM patients, there was no significant relationship between GWG and adverse pregnancy outcomes. For GDM women with one or two items of elevated blood glucose in OGTT, reasonable weight management during pregnancy can reduce the occurrence of adverse pregnancy outcomes. For those with three items of elevated blood glucose in OGTT, more strict blood glucose monitoring and active intervention measures should be taken in addition to weight management during pregnancy.
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Bosa I, Castelli A, Castelli M, Ciani O, Compagni A, Galizzi MM, Garofano M, Ghislandi S, Giannoni M, Marini G, Vainieri M. Corona-regionalism? Differences in regional responses to COVID-19 in Italy. Health Policy 2021; 125:1179-1187. [PMID: 34366171 PMCID: PMC8325551 DOI: 10.1016/j.healthpol.2021.07.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 07/14/2021] [Accepted: 07/28/2021] [Indexed: 01/07/2023]
Abstract
The paper discusses the responses to the COVID-19 crisis in the acute phase of the first wave of the pandemic (February-May 2020) by different Italian regions in Italy, which has a decentralised healthcare system. We consider five regions (Lombardy, Veneto, Emilia-Romagna, Umbria, Apulia) which are located in the north, centre and south of Italy. These five regions differ both in their healthcare systems and in the extent to which they were hit by the first wave of COVID-19 pandemic. We investigate their different responses to COVID-19 reflecting on seven management factors: (1) monitoring, (2) learning, (3) decision-making, (4) coordinating, (5) communicating, (6) leading, and (7) recovering capacity. In light of these factors, we discuss the analogies and differences among the regions and their different institutional choices.
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Affiliation(s)
- Iris Bosa
- Business School, University of Edinburgh, United Kingdom
| | | | - Michele Castelli
- Population Health Science Institute, Newcastle University, United Kingdom
| | - Oriani Ciani
- SDA Bocconi School of Management and CERGAS Bocconi, Bocconi University, Italy
| | - Amelia Compagni
- Department of Social and Political Sciences, Bocconi University, Italy
| | - Matteo M Galizzi
- Department of Psychological and Behavioural Science, LSE, United Kingdom
| | | | - Simone Ghislandi
- Department of Social and Political Sciences, Bocconi University, Italy
| | | | - Giorgia Marini
- Department of Juridical and Economic Studies, Sapienza University of Rome, Italy.
| | - Milena Vainieri
- Management and Health Lab, Institute of Management, Department of Embeds, Sant'Anna Advanced School of Pisa, Italy
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Kim K, Kim TW, Kim SH. Analysis of physiological data from long- term physical exercise: A basis for improving the health of rural residents of Korea. Technol Health Care 2021; 28:253-262. [PMID: 32364158 PMCID: PMC7369064 DOI: 10.3233/thc-209026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND: Analysis of the change pattern of a user’s physiological signals collected over a long time and user health information prediction technology based on personal history data can provide the user with accurate health information. OBJECTIVE: In this study, we analyzed the change pattern of health information that was altered by performing personal training (PT) at the beginning of the study and subsequently quitting exercise and only performing activities of daily living (ADL). METHODS: The subject performed PT for 75 days, and then consistently performed relatively simple ADL, such as standing, sitting, and walking, for 325 days that followed. After 400 days, the health information was analyzed through the change patterns of various physiological signals. Personal exercise information and heart rate data were collected through a smart watch (Apple watch Nike+, Apple Inc.) and the obesity parameters (i.e. information on the weight, body fat fate, and body muscle rate) were measured using a smart scale (PICOOC S1 Pro, EasySolar). RESULTS: We found that the weight and body fat rate linearly decreased and the body muscle rate increased for the first 75 days when hard training was performed whereas they repeatedly increased or decreased when only ADL were performed. As the daily exercise distance increased, weight and body fat rate tended to decrease while body muscle rate tended to increase. There was no significant change in the weight, body fat rate, and body muscle rate while daily activities were performed, but continuous exercise is expected to improve cardiac function by increasing the cardiac output of the heart. CONCLUSION: We expected that the simple physiological data measured with smart watches and smart scales can be used for the health management of the elderly living in rural areas in the future.
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Affiliation(s)
- Kyong Kim
- Department of Medical and Electronic Device, Chungbuk Provincial University, Okcheon-gun, Chungbuk, 29046, Korea
| | - Tae-Won Kim
- Department of Fusion Design, Chungbuk Provincial University, Okcheon-gun, Chungbuk, 29046, Korea
| | - Seong Hyun Kim
- Department of Medical and Electronic Device, Chungbuk Provincial University, Okcheon-gun, Chungbuk, 29046, Korea
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Furmenti MF, Barbara A, Voglino G, Beltramello C. Assessment of the healthcare managerial skills offered by the Italian post-graduate schools of public health. Ann Ig 2021; 33:141-151. [PMID: 33570086 DOI: 10.7416/ai.2021.2420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND The Italian National Health Service (Servizio Sanitario Nazionale, SSN) is facing relevant challenges due to decreased financing and increased healthcare costs (1). In this complex framework, most of the Italian Medical Doctors, after obtaining their Specialization degree in Public Health, develop their careers in organizational and managerial roles in public and private health organizations, i.e. hospitals, local health units, health districts or national and international agencies (1, 2). Public health technical competencies, in particular policy and management, are of crucial importance to develop, run and support healthcare services. However, some gaps exist between current public health needs and the extent to which Public Health Residents are trained in the above fields (3, 4). STUDY DESIGN The study is a cross-sectional cognitive survey carried out through a questionnaire sent by e-mail to Residents and Directors of the Italian Schools of Public Health, from May to November 2018. The questionnaire was sent only to the accredited Schools which had all four years of the course running. METHODS The questionnaire investigated 35 managerial topics divided into 4 macro-areas. It was sent to both Directors of the SPHs and the Residents of 32 Schools. The latter were asked to provide a single collective answer per School. Respondents could assign a score from 1 (topic not addressed at all) to 4 (topic addressed extensively and linked to other related topics) to each item, also taking into account the skills acquired through internships, seminars, etc. that involved all the Residents. RESULTS Answers were received from the Residents of 30/32 (93.8%) SPHs and from 15/32 (46.9%) of the Directors. Scores given by the Directors were higher than the ones of the Residents for every topic, and for 17 out of 35 items (48.6%) a statistically significant difference has been obtained. In the overall score of 3 macro-areas out of 4 (General issues, Managerial tools and macro-organisational Models) there are statistically significant differences. In Soft skills macro-area, the single scores of all topics are generally low for both Directors and Residents. CONCLUSION The study shows that the Residents declare a strong need for training improvement in the field pf healthcare organization and management: the median score is equal to or greater than 3 (topic addressed extensively) in only a few answers. The comparison between Directors' and Residents' scores highlights a different perception of the training offered in these areas. The study results could be pivotal for the improvement of the managerial skills provided to the Residents in Public Health of the Country.
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Affiliation(s)
- M F Furmenti
- Department of Public Health and Pediatric Science, University of Turin, Italy
| | - A Barbara
- Institute of Public Health - Section of Hygiene, Università Cattolica del Sacro Cuore, Rome, Italy
| | - G Voglino
- Department of Public Health and Pediatric Science, University of Turin, Italy
| | - C Beltramello
- Consultant and trainer in healthcare management and organization, Contract Professor at the University of Padua Medical School, Conegliano Branch, Italy
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Liu S, Liu Y, Zhang T, Wang L, Huang J, Liang H, Chen G, Liu C, Zhang Y. The developing family doctor system: evidence from the progress of the family doctor signing service from a longitudinal survey (2013-2016) in Pudong New Area, Shanghai. BMC Fam Pract 2021; 22:11. [PMID: 33419410 PMCID: PMC7792058 DOI: 10.1186/s12875-020-01353-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 12/13/2020] [Indexed: 12/03/2022]
Abstract
Background The family doctor system is a vital part of China’s national medical and health system reform. Evidence of the degree of implementation of the family doctor system is required to assist managers and policy makers in Pudong with resource allocation planning. This study analyzed changes in indicators (family doctor team construction, contracted medical services, health management services and so on) over time to evaluate the progress of the family doctor system in Pudong. Methods We used a cross-sectional design with an online questionnaire survey to collect 3-year (2013–2016) consecutive data. The online questionnaires were completed by the doctors responsible for information reporting in each community health service center of Pudong. The data were sorted, and the indices calculated and analyzed using descriptive statistics and statistical tests. Results The proportion of registered general practitioners increased each year, from 50.8% in 2013 to 66.5% in 2016; this difference was statistically significant (P = 0.000). The number of family doctors per 10,000 permanent residents rose each year, from 1.7 in 2013 to 2.1 in 2016. The rate of contracted household residents was 55.7% in 2013 and increased to 71.7% in 2016, with the difference being significant in different years (P = 0.012). Analysis of referral services showed the people times of contracted residents transferring to higher-level hospitals from family doctors increased each year, from 172,734 in 2013 to 341,615 in 2016; differences among different regions were statistically significant for 2013–2016. The rate of health screening for contracted residents also increased each year, with statistically significant differences in different years (P = 0.000). The rate of health assessment interventions for contracted residents rose each year, with statistically significant differences in different years (P = 0.003). Conclusions The family doctor signing service in Pudong made headway in general practitioner availability, contract service rate of household residents, and providing health management services. However, problems included family doctor shortages and limited supporting policies, especially in rural and suburban areas compared with urban divisions. Increasing the enrollment rate of family doctors and speeding up the implementation of “contract service fees” are key tasks for the sustainable development of the family doctor system in Pudong. Supplementary Information The online version contains supplementary material available at 10.1186/s12875-020-01353-0.
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Affiliation(s)
- Shanshan Liu
- Pudong Institute for Health Development, Shanghai, China
| | - Yan Liu
- School of Public Health, Fudan University, Shanghai, China.,Health Inspection Agency of Shanghai Pudong New Area Health Commission, Shanghai, China
| | - Tao Zhang
- Jinyang Community Health Service Center of Pudong New Area, Shanghai, China
| | - Luan Wang
- Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Jiaoling Huang
- School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Hong Liang
- Pudong Institute for Health Development, Shanghai, China.,School of Social Development and Public Policy, Fudan University, Shanghai, China
| | - Gang Chen
- School of Public Health, Fudan University, Shanghai, China.
| | - Chengjun Liu
- School of Social Development and Public Policy, Fudan University, Shanghai, China. .,Eye and dental diseases prevention & treatment of Pudong new area, Shanghai, China.
| | - Yimin Zhang
- Pudong Institute for Health Development, Shanghai, China.
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Unger JP, Morales I, De Paepe P, Roland M. The physician and professionalism today: challenges to and strategies for ethical professional medical practice. BMC Health Serv Res 2020; 20:1069. [PMID: 33292178 PMCID: PMC7723462 DOI: 10.1186/s12913-020-05884-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Jean-Pierre Unger
- Department of Public Health, Institute of Tropical Medicine, Nationalestraat 155, B-2000 Antwerp, Belgium
| | - Ingrid Morales
- Office de la Naissance et de l’Enfance, French Community of Belgium, Chaussée de Charleroi 95, B-1060 Brussels, Belgium
| | - Pierre De Paepe
- Department of Public Health, Institute of Tropical Medicine, Nationalestraat 155, B-2000 Antwerp, Belgium
| | - Michel Roland
- Département de Médecine Générale, Université Libre de Bruxelles, Route de Lennik, 808, BP 612/1, B-1070 Brussels, Belgium
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Abstract
BACKGROUND Strong relations between medicine and public health have long been advocated. Today, professional medical practice assumes joint clinical/public health objectives: GPs are expected to practice community medicine; Hospital specialists can be involved in disease control and health service organisation; Doctors can teach, coach, evaluate, and coordinate care; Clinicians should interpret protocols with reference to clinical epidemiology. Public health physicians should tailor preventive medicine to individual health risks. This paper is targeted at those practitioners and academics responsible for their teams' professionalism and the accessibility of care, where the authors argue in favour of the epistemological integration of clinical medicine and public health. MAIN TEXT Based on empirical evidence the authors revisit the epistemological border of clinical and public health knowledge to support joint practice. From action-research and cognitive psychology, we derive clinical/public health knowledge categories that require different transmission and discovery techniques. The knowledge needed to support the universal human right to access professional care bridges both clinical and public health concepts, and summons professional ethics to validate medical decisions. To provide a rational framework for teaching and research, we propose the following categories: 'Know-how/practice techniques', corresponding a.o. to behavioural, communication, and manual skills; 'Procedural knowledge' to choose and apply procedures that meet explicit quality criteria; 'Practical knowledge' to design new procedures and inform the design of established procedures in new contexts; and Theoretical knowledge teaches the reasoning and theory of knowledge and the laws of existence and functioning of reality to validate clinical and public health procedures. Even though medical interventions benefit from science, they are, in essence, professional: science cannot standardise eco-biopsychosocial decisions; doctor-patient negotiations; emotional intelligence; manual and behavioural skills; and resolution of ethical conflicts. CONCLUSION Because the quality of care utilises the professionals' skill-base but is also affected by their intangible motivations, health systems should individually tailor continuing medical education and treat collective knowledge management as a priority. Teamwork and coaching by those with more experience provide such opportunities. In the future, physicians and health professionals could jointly develop clinical/public health integrated knowledge. To this end, governments should make provision to finance non-clinical activities.
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Affiliation(s)
- Jean-Pierre Unger
- Department of Public Health, Institute of Tropical Medicine, Nationalestraat 155, B-2000 Antwerp, Belgium
| | - Ingrid Morales
- Office de la Naissance et de l’Enfance, French Community of Belgium, Chaussée de Charleroi 95, B-1060 Brussels, Belgium
| | - Pierre De Paepe
- Department of Public Health, Institute of Tropical Medicine, Nationalestraat 155, B-2000 Antwerp, Belgium
| | - Michel Roland
- Département de Médecine Générale, Université Libre de Bruxelles, Route de Lennik, 808, BP 612/1, B-1070 Brussels, Belgium
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Unger JP, Morales I, De Paepe P, Roland M. A plea to merge clinical and public health practices: reasons and consequences. BMC Health Serv Res 2020; 20:1068. [PMID: 33292215 PMCID: PMC7725113 DOI: 10.1186/s12913-020-05885-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Revisiting professionalism, both as a medical ideal and educational topic, this paper asks whether, in the rise of artificial intelligence, healthcare commoditisation and environmental challenges, a rationale exists for merging clinical and public health practices. To optimize doctors' impact on community health, clinicians should introduce public health thinking and action into clinical practice, above and beyond controlling nosocomial infections and iatrogenesis. However, in the interest of effectiveness they should do everything possible to personalise care delivery. To solve this paradox, we explore why it is necessary for the boundaries between medicine and public health to be blurred. MAIN BODY Proceeding sequentially, we derive standards for medical professionalism from care quality criteria, neo-Hippocratic ethics, public health concepts, and policy outcomes. Thereby, we formulate benchmarks for health care management and apply them to policy evaluation. During this process we justify the social, professional - and by implication, non-commercial, non-industrial - mission of healthcare financing and policies. The complexity of ethical, person-centred, biopsychosocial practice requires a human interface between suffering, health risks and their therapeutic solution - and thus legitimises the medical profession's existence. Consequently, the universal human right to healthcare is a right to access professionally delivered care. Its enforcement requires significant updating of the existing medical culture, and not just in respect of the man/machine interface. This will allow physicians to focus on what artificial intelligence cannot do, or not do well. These duties should become the touchstone of their practice, knowledge and ethics. Artificial intelligence must support medical professionalism, not determine it. Because physicians need sufficient autonomy to exercise professional judgement, medical ethics will conflict with attempts to introduce clinical standardisation as a managerial paradigm, which is what happens when industrial-style management is applied to healthcare. CONCLUSION Public healthcare financing and policy ought to support medical professionalism, alongside integrated clinical and public health practice, and its management. Publicly-financed health management should actively promote ethics in publicly- oriented services. Commercialised healthcare is antithetical to ethical medical, and to clinical / public health practice integration. To lobby governments effectively, physicians need to appreciate the political economy of care.
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Affiliation(s)
- Jean-Pierre Unger
- Department of Public Health, Institute of Tropical Medicine, Nationalestraat 155, B-2000 Antwerp, Belgium
| | - Ingrid Morales
- Office de la Naissance et de l’Enfance, French Community of Belgium, Chaussée de Charleroi 95, B-1060 Brussels, Belgium
| | - Pierre De Paepe
- Department of Public Health, Institute of Tropical Medicine, Nationalestraat 155, B-2000 Antwerp, Belgium
| | - Michel Roland
- Département de Médecine Générale, Université Libre de Bruxelles, Route de Lennik, 808, BP 612/1, B-1070 Brussels, Belgium
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Fetene N, Patel A, Benyam T, Ayde A, Desai MM, Curry L, Linnander E. Experiences of managerial accountability in Ethiopia's primary healthcare system: a qualitative study. BMC Fam Pract 2020; 21:261. [PMID: 33280608 PMCID: PMC7720402 DOI: 10.1186/s12875-020-01332-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 11/25/2020] [Indexed: 12/03/2022]
Abstract
Background Despite calls for improved accountability in global health systems, and a set of clear and consistent theoretical accountability frameworks, empirical descriptions of how accountability is experienced and enacted in low- and middle- income country (LMIC) settings is limited. Therefore, we sought to characterize how managers at all levels of Ethiopia’s primary healthcare system experience accountability in their daily practice. Methods We conducted in-depth key informant interviews with 41 key stakeholders across 4 regions (Amhara, Oromia, Southern Nations Nationalities and Peoples, and Tigray) in the context of the Primary Healthcare Transformation Initiative (PTI). Consistent with the principles of grounded theory, our team used the constant comparative method to identify emergent themes related to concrete areas that could be targeted to allow an overall culture of accountability to flourish. Results Emergent themes were: development of a shared understanding of system-wide accountability, streamlining of managerial reporting lines, strengthening of medico-legal knowledge and systems, and development of mechanisms for bottom-up accountability. Conclusions Findings may be valuable to policymakers seeking to create more effective national accountability frameworks; practitioners and development partners seeking to strengthen implementation of evidence-based accountability systems and practices; and researchers aiming to develop meaningful, practical measures of accountability in public health.
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Affiliation(s)
- Netsanet Fetene
- Yale Global Health Leadership Initiative, Addis Ababa, Ethiopia
| | - Akshar Patel
- Yale School of Public Health, New Haven, CT, USA
| | - Tibebu Benyam
- Yale Global Health Leadership Initiative, Addis Ababa, Ethiopia
| | - Assefa Ayde
- Reform and Good Governance Directorate, Federal Ministry of Health, Addis Ababa, Ethiopia
| | - Mayur M Desai
- Yale Global Health Leadership Initiative and Yale School of Public Health, 60 College Street, PO Box 208034, New Haven, CT, 06520-8034, USA
| | - Leslie Curry
- Yale Global Health Leadership Initiative and Yale School of Public Health, 60 College Street, PO Box 208034, New Haven, CT, 06520-8034, USA
| | - Erika Linnander
- Yale Global Health Leadership Initiative and Yale School of Public Health, 60 College Street, PO Box 208034, New Haven, CT, 06520-8034, USA.
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Puertas EB, Sotelo JM, Ramos G. [Leadership and strategic management in health systems based on primary health care]. Rev Panam Salud Publica 2020; 44:e124. [PMID: 33165409 PMCID: PMC7603369 DOI: 10.26633/rpsp.2020.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 05/26/2020] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To identify and analyze various types of leadership and management that could contribute to the strengthening of health systems based on primary health care (PHC). METHODS A structured review of the literature on management and leadership applicable to PHC-based health systems was conducted. Of the 19 articles identified, relevant details were extracted using a standardized methodology. RESULTS PHC-based health systems should establish optimal management practices to achieve quality, efficiency, and effectiveness. Strategic planning and management facilitate the development of a common identity, although some organizations are overmanaged and poorly led. Universal health is a strategic driver that requires transformational leadership to move toward PHC-based systems. Leadership in these systems must focus on identifying adaptive challenges, linking staff and protecting grassroots leadership, as well as adapting to the times and combining the logic of action of the strategist to achieve a sector transformation. The quality models establish leadership criteria similar to other theories, emphasizing innovation and organizational identity. CONCLUSIONS Latin America must move towards health systems based on PHC, with leaders with emotional intelligence who discover their own transformative events, seek quality, and combine various types of leadership. They must be strategists to lead the system in its transition to resilient organizations, and "alchemists" to achieve true transformations in health, with the willingness and humility of those who work to achieve universal health.
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Affiliation(s)
- Eduardo Benjamin Puertas
- Organización Panamericana de la SaludSan SalvadorEl SalvadorOrganización Panamericana de la Salud, San Salvador, El Salvador
| | - Juan Manuel Sotelo
- Organización Panamericana de la SaludSan SalvadorEl SalvadorOrganización Panamericana de la Salud, San Salvador, El Salvador
| | - Gilma Ramos
- Consultora independienteSan SalvadorEl SalvadorConsultora independiente, San Salvador, El Salvador
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50
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Thompson JR, Nancharaiah YV, Gu X, Lee WL, Rajal VB, Haines MB, Girones R, Ng LC, Alm EJ, Wuertz S. Making waves: Wastewater surveillance of SARS-CoV-2 for population-based health management. Water Res 2020; 184:116181. [PMID: 32707307 PMCID: PMC7357518 DOI: 10.1016/j.watres.2020.116181] [Citation(s) in RCA: 108] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 07/11/2020] [Accepted: 07/13/2020] [Indexed: 05/18/2023]
Abstract
Worldwide, clinical data remain the gold standard for disease surveillance and tracking. However, such data are limited due to factors such as reporting bias and inability to track asymptomatic disease carriers. Disease agents are excreted in the urine and feces of infected individuals regardless of disease symptom severity. Wastewater surveillance - that is, monitoring disease via human effluent - represents a valuable complement to clinical approaches. Because wastewater is relatively inexpensive and easy to collect and can be monitored at different levels of population aggregation as needed, wastewater surveillance can offer a real-time, cost-effective view of a community's health that is independent of biases associated with case-reporting. For SARS-CoV-2 and other disease-causing agents we envision an aggregate wastewater-monitoring system at the level of a wastewater treatment plant and exploratory or confirmatory monitoring of the sewerage system at the neighborhood scale to identify or confirm clusters of infection or assess impact of control measures where transmission has been established. Implementation will require constructing a framework with collaborating government agencies, public or private utilities, and civil society organizations for appropriate use of data collected from wastewater, identification of an appropriate scale of sample collection and aggregation to balance privacy concerns and risk of stigmatization with public health preservation, and consideration of the social implications of wastewater surveillance.
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Affiliation(s)
- Janelle R Thompson
- Singapore Centre for Environmental Life Sciences Engineering, Nanyang Technological University (NTU), Singapore; Asian School of the Environment, NTU, Singapore; Campus for Research Excellence and Technological Enterprise (CREATE), Singapore.
| | - Yarlagadda V Nancharaiah
- Biofouling and Biofilm Processes, Water and Steam Chemistry Division, Chemistry Group, Bhabha Atomic Research Centre, Kalpakkam 603102, India; Homi Bhabha National Institute, BARC Training School Complex, Anushakti Nagar, Trombay, Mumbai 400 094, India
| | - Xiaoqiong Gu
- Campus for Research Excellence and Technological Enterprise (CREATE), Singapore; Singapore-MIT Alliance for Research and Technology, National University of Singapore, Singapore
| | - Wei Lin Lee
- Campus for Research Excellence and Technological Enterprise (CREATE), Singapore; Singapore-MIT Alliance for Research and Technology, National University of Singapore, Singapore
| | - Verónica B Rajal
- Singapore Centre for Environmental Life Sciences Engineering, Nanyang Technological University (NTU), Singapore; Instituto de Investigaciones para la Industria Química (INIQUI), CONICET, Universidad Nacional de Salta (UNSa), Av. Bolivia 5150, Salta 4400, Argentina; Facultad de Ingeniería, UNSa, Salta, Argentina
| | - Monamie B Haines
- Campus for Research Excellence and Technological Enterprise (CREATE), Singapore; School of Social Sciences, Sociology Division, NTU, Singapore
| | - Rosina Girones
- Section of Microbiology, Virology and Biotechnology, Department of Genetics, Microbiology and Statistics, Faculty of Biology, University of Barcelona, Diagonal, 643, 08028-Barcelona, Spain
| | - Lee Ching Ng
- Environmental Health Institute, National Environment Agency, Singapore
| | - Eric J Alm
- Campus for Research Excellence and Technological Enterprise (CREATE), Singapore; Singapore-MIT Alliance for Research and Technology, National University of Singapore, Singapore; Center for Microbiome Informatics and Therapeutics, Departments of Biological Engineering and Civil and Environmental Engineering, Massachusetts Institute of Technology, United States; Biobot Analytics, Cambridge MA, United States
| | - Stefan Wuertz
- Singapore Centre for Environmental Life Sciences Engineering, Nanyang Technological University (NTU), Singapore; Campus for Research Excellence and Technological Enterprise (CREATE), Singapore; School of Civil and Environmental Engineering, NTU, Singapore.
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