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Hulme A, Stanton NA, Walker GH, Waterson P, Salmon PM. Testing the reliability of accident analysis methods: a comparison of AcciMap, STAMP-CAST and AcciNet. Ergonomics 2024; 67:695-715. [PMID: 37523211 DOI: 10.1080/00140139.2023.2240048] [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] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 07/13/2023] [Indexed: 08/01/2023]
Abstract
Accident analysis methods are used to model the multifactorial cause of adverse incidents. Methods such as AcciMap, STAMP-CAST and recently AcciNet, are systemic approaches that support the identification of safety interventions across sociotechnical system levels. Despite their growing popularity, little is known about how reliable systems-based methods are when used to describe, model and classify contributory factors and relationships. Here, we conducted an intra-rater and inter-rater reliability assessment of AcciMap, STAMP-CAST and AcciNet using the Signal Detection Theory (SDT) paradigm. A total of 180 hours' worth of analyses across 360 comparisons were performed by 30 expert analysts. Findings revealed that all three methods produced a weak to moderate positive correlation coefficient, however the inter-rater reliability of STAMP-CAST was significantly higher compared to AcciMap and AcciNet. No statistically significant or practically meaningful differences were found between methods in the overall intra-rater reliability analyses. Implications and future research directions are discussed.
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Affiliation(s)
- Adam Hulme
- Centre for Human Factors and Sociotechnical Systems, Faculty of Arts, Business and Law, University of the Sunshine Coast, Sippy Downs, Australia
- Southern Queensland Rural Health (SQRH), Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Australia
| | - Neville A Stanton
- Centre for Human Factors and Sociotechnical Systems, Faculty of Arts, Business and Law, University of the Sunshine Coast, Sippy Downs, Australia
- Transportation Research Group, Faculty of Engineering and Physical Sciences, University of Southampton, Southampton, UK
| | - Guy H Walker
- Centre for Human Factors and Sociotechnical Systems, Faculty of Arts, Business and Law, University of the Sunshine Coast, Sippy Downs, Australia
- Centre for Sustainable Road Freight, School of Energy, Geoscience, Infrastructure and Society, Heriot-Watt University, Scotland, UK
| | - Patrick Waterson
- Human Factors and Complex Systems Group, Design School, Loughborough University, Leicestershire, UK
| | - Paul M Salmon
- Centre for Human Factors and Sociotechnical Systems, Faculty of Arts, Business and Law, University of the Sunshine Coast, Sippy Downs, Australia
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2
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Lawn S, Waddell E, Roberts L, Rioseco P, Beks T, Sharp T, McNeill L, Everitt D, Bowes L, Mordaunt D, Tarrant A, Van Hooff M, Lane J, Wadham B. No Women's Land: Australian Women Veterans' Experiences of the Culture of Military Service and Transition. Int J Environ Res Public Health 2024; 21:479. [PMID: 38673390 DOI: 10.3390/ijerph21040479] [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: 01/26/2024] [Revised: 04/01/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024]
Abstract
Women's experiences of military service and transition occur within a highly dominant masculinized culture. The vast majority of research on military veterans reflects men's experiences and needs. Women veterans' experiences, and therefore their transition support needs, are largely invisible. This study sought to understand the role and impact of gender in the context of the dominant masculinized culture on women veterans' experiences of military service and transition to civilian life. In-depth qualitative interviews with 22 Australian women veterans elicited four themes: (1) Fitting in a managing identity with the military; (2) Gender-based challenges in conforming to a masculinized culture-proving worthiness, assimilation, and survival strategies within that culture; (3) Women are valued less than men-consequences for women veterans, including misogyny, sexual harassment and assault, and system failures to recognize women's specific health needs and role as mothers; and (4) Separation and transition: being invisible as a woman veteran in the civilian world. Gendered military experiences can have long-term negative impacts on women veterans' mental and physical health, relationships, and identity due to a pervasive masculinized culture in which they remain largely invisible. This can create significant gender-based barriers to services and support for women veterans during their service, and it can also impede their transition support needs.
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Affiliation(s)
- Sharon Lawn
- Flinders University, Adelaide, SA 5042, Australia
- Open Door Initiative, Flinders University, Adelaide, SA 5042, Australia
- Lived Experience Australia, Adelaide, SA 5042, Australia
| | - Elaine Waddell
- Flinders University, Adelaide, SA 5042, Australia
- Open Door Initiative, Flinders University, Adelaide, SA 5042, Australia
| | - Louise Roberts
- Flinders University, Adelaide, SA 5042, Australia
- Open Door Initiative, Flinders University, Adelaide, SA 5042, Australia
| | - Pilar Rioseco
- Australian Institute of Family Studies, Melbourne, VIC 3006, Australia
| | - Tiffany Beks
- Open Door Initiative, Flinders University, Adelaide, SA 5042, Australia
- School of Education, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Tiffany Sharp
- Open Door Initiative, Flinders University, Adelaide, SA 5042, Australia
- Cambrian Executive, Adelaide, SA 5000, Australia
| | - Liz McNeill
- Flinders University, Adelaide, SA 5042, Australia
- Open Door Initiative, Flinders University, Adelaide, SA 5042, Australia
| | - David Everitt
- Open Door Initiative, Flinders University, Adelaide, SA 5042, Australia
- Defence Force Welfare Association SA, Adelaide, SA 5000, Australia
| | - Lee Bowes
- Open Door Initiative, Flinders University, Adelaide, SA 5042, Australia
- Defence Force Welfare Association SA, Adelaide, SA 5000, Australia
| | - Dylan Mordaunt
- Flinders University, Adelaide, SA 5042, Australia
- Open Door Initiative, Flinders University, Adelaide, SA 5042, Australia
- Southern Adelaide Local Health Network, Adelaide, SA 5042, Australia
| | - Amanda Tarrant
- Open Door Initiative, Flinders University, Adelaide, SA 5042, Australia
- Veterans SA, Adelaide, SA 5000, Australia
| | - Miranda Van Hooff
- Military and Services Health Australia (MESHA), Adelaide, SA 5011, Australia
| | - Jonathan Lane
- Department of Psychiatry, University of Tasmania, Hobart, TAS 7005, Australia
| | - Ben Wadham
- Flinders University, Adelaide, SA 5042, Australia
- Open Door Initiative, Flinders University, Adelaide, SA 5042, Australia
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3
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Bremshey S, Groß J, Renken K, Masseck OA. The role of serotonin in depression-A historical roundup and future directions. J Neurochem 2024. [PMID: 38477031 DOI: 10.1111/jnc.16097] [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: 10/30/2023] [Revised: 02/26/2024] [Accepted: 02/27/2024] [Indexed: 03/14/2024]
Abstract
Depression is one of the most common psychiatric disorders worldwide, affecting approximately 280 million people, with probably much higher unrecorded cases. Depression is associated with symptoms such as anhedonia, feelings of hopelessness, sleep disturbances, and even suicidal thoughts. Tragically, more than 700 000 people commit suicide each year. Although depression has been studied for many decades, the exact mechanisms that lead to depression are still unknown, and available treatments only help a fraction of patients. In the late 1960s, the serotonin hypothesis was published, suggesting that serotonin is the key player in depressive disorders. However, this hypothesis is being increasingly doubted as there is evidence for the influence of other neurotransmitters, such as noradrenaline, glutamate, and dopamine, as well as larger systemic causes such as altered activity in the limbic network or inflammatory processes. In this narrative review, we aim to contribute to the ongoing debate on the involvement of serotonin in depression. We will review the evolution of antidepressant treatments, systemic research on depression over the years, and future research applications that will help to bridge the gap between systemic research and neurotransmitter dynamics using biosensors. These new tools in combination with systemic applications, will in the future provide a deeper understanding of the serotonergic dynamics in depression.
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Affiliation(s)
- Svenja Bremshey
- Synthetic Biology, University of Bremen, Bremen, Germany
- Neuropharmacology, University of Bremen, Bremen, Germany
| | - Juliana Groß
- Synthetic Biology, University of Bremen, Bremen, Germany
| | - Kim Renken
- Synthetic Biology, University of Bremen, Bremen, Germany
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4
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Maltby J. Networking trait resilience: Unifying fragmented trait resilience systems from an ecological systems theory perspective. J Pers 2024. [PMID: 38429249 DOI: 10.1111/jopy.12925] [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: 10/20/2023] [Revised: 01/09/2024] [Accepted: 02/11/2024] [Indexed: 03/03/2024]
Abstract
OBJECTIVE This study reconceptualized trait resilience, defining it as a network of systems; utilizing direct resilience assessments-engineering, ecological, adaptive capacity, social cohesion-and proxy resilience assessments-personality, cognitive, emotional, eudaimonia, and health. BACKGROUND The background of the study addresses the fragmented conceptualization of trait resilience by proposing a unifying network model based on ecological systems theory, illustrating the dynamic interplay of resilience factors across varying levels of disturbance. METHOD In Study One, four USA or UK samples (total n = 2396) were used to depict the trait resilience network. Study Two (n = 1091) examined the relationship between the network and disturbance at two time-points, using mental health levels as a disturbance metric. RESULTS Study One found that adaptive capacity, and sometimes positive emotional processes, were central variables to the network. Study Two found that in lower disturbance groups, adaptive capacity remained important, while in higher disturbance groups, a broader set of variables became central to the network. CONCLUSIONS Study One suggests a Broaden-and-Build approach, where adaptive capacity is a foundational resilience capability, reciprocally associated with positive emotional mechanisms. Study Two suggests a new "Dynamic Resilience Spectrum Theory," proposing that increased disturbances necessitate the use of a more diverse set of resilience traits.
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Affiliation(s)
- John Maltby
- School of Psychology and Vision Sciences, College of Life Sciences, University of Leicester, Leicester, UK
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5
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DaViera AL, Bailey C, Lakind D, Kivell N, Areguy F, Byrd K. Identifying abolitionist alignments in community psychology: A path toward transformation. Am J Community Psychol 2024; 73:44-56. [PMID: 37133454 DOI: 10.1002/ajcp.12678] [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: 10/01/2021] [Revised: 12/01/2022] [Accepted: 02/13/2023] [Indexed: 05/04/2023]
Abstract
Psychology is grounded in the ethical principles of beneficence and nonmaleficence, that is, "do no harm." Yet many have argued that psychology as a field is attached to carceral systems and ideologies that uphold the prison industrial complex (PIC), including the field of community psychology (CP). There have been recent calls in other areas of psychology to transform the discipline into an abolitionist social science, but this discourse is nascent in CP. This paper uses the semantic device of "algorithms" (e.g., conventions to guide thinking and decision-making) to identify the areas of alignment and misalignment between abolition and CP in the service of moving us toward greater alignment. The authors propose that many in CP are already oriented to abolition because of our values and theories of empowerment, promotion, and systems change; our areas of misalignment between abolition and CP hold the potential to evolve. We conclude with proposing implications for the field of CP, including commitments to the belief that (1) the PIC cannot be reformed, and (2) abolition must be aligned with other transnational liberation efforts (e.g., decolonization).
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Affiliation(s)
- Andrea L DaViera
- Department of Psychology, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Caroline Bailey
- Department of Psychology, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Davielle Lakind
- Department of Clinical Psychology, Mercer University, Atlanta, Georgia, USA
| | - Natalie Kivell
- Department of Psychology, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Fitsum Areguy
- Department of Psychology, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Kymberly Byrd
- Department of Human and Organizational Development, Vanderbilt University, Nashville, Tennessee, USA
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6
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Bath MF, Hobbs L, Kohler K, Kuhn I, Nabulyato W, Kwizera A, Walker LE, Wilkins T, Stubbs D, Burnstein RM, Kolias A, Hutchinson PJ, Clarkson PJ, Halimah S, Bashford T. Does the implementation of a trauma system affect injury-related morbidity and economic outcomes? A systematic review. Emerg Med J 2024:emermed-2023-213782. [PMID: 38388191 DOI: 10.1136/emermed-2023-213782] [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: 11/20/2023] [Accepted: 02/10/2024] [Indexed: 02/24/2024]
Abstract
BACKGROUND Trauma accounts for a huge burden of disease worldwide. Trauma systems have been implemented in multiple countries across the globe, aiming to link and optimise multiple aspects of the trauma care pathway, and while they have been shown to reduce overall mortality, much less is known about their cost-effectiveness and impact on morbidity. METHODS We performed a systematic review to explore the impact the implementation of a trauma system has on morbidity, quality of life and economic outcomes, in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. All comparator study types published since 2000 were included, both retrospective and prospective in nature, and no limits were placed on language. Data were reported as a narrative review. RESULTS Seven articles were identified that met the inclusion criteria, all of which reported a pre-trauma and post-trauma system implementation comparison in high-income settings. The overall study quality was poor, with all studies demonstrating a severe risk of bias. Five studies reported across multiple types of trauma patients, the majority describing a positive impact across a variety of morbidity and health economic outcomes following trauma system implementation. Two studies focused specifically on traumatic brain injury and did not demonstrate any impact on morbidity outcomes. DISCUSSION There is currently limited and poor quality evidence that assesses the impact that trauma systems have on morbidity, quality of life and economic outcomes. While trauma systems have a fundamental role to play in high-quality trauma care, morbidity and disability data can have large economic and cultural consequences, even if mortality rates have improved. The sociocultural and political context of the surrounding healthcare infrastructure must be better understood before implementing any trauma system, particularly in resource-poor and fragile settings. PROSPERO REGISTRATION NUMBER CRD42022348529 LEVEL OF EVIDENCE: Level III.
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Affiliation(s)
- Michael F Bath
- International Health Systems Group, Department of Engineering, University of Cambridge, Cambridge, UK
- NIHR Global Health Research Group on Acquired Brain and Spine Injury, Division of Academic Neurosurgery, University of Cambridge, Cambridge, UK
| | - Laura Hobbs
- International Health Systems Group, Department of Engineering, University of Cambridge, Cambridge, UK
- NIHR Global Health Research Group on Acquired Brain and Spine Injury, Division of Academic Neurosurgery, University of Cambridge, Cambridge, UK
- Department of Anaesthesia, East and North Hertfordshire NHS Trust, Stevenage, UK
| | - Katharina Kohler
- International Health Systems Group, Department of Engineering, University of Cambridge, Cambridge, UK
- NIHR Global Health Research Group on Acquired Brain and Spine Injury, Division of Academic Neurosurgery, University of Cambridge, Cambridge, UK
- Department of Perioperative, Acute, Critical Care, and Emergency Medicine, Department of Medicine, University of Cambridge, Cambridge, UK
| | - Isla Kuhn
- University of Cambridge Medical Library, University of Cambridge, Cambridge, UK
| | - William Nabulyato
- International Health Systems Group, Department of Engineering, University of Cambridge, Cambridge, UK
| | - Arthur Kwizera
- Department of Anaesthesia and Intensive Care, Makerere University College of Health Sciences, Kampala, Uganda
| | - Laura E Walker
- Department of Emergency Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Tom Wilkins
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Daniel Stubbs
- Department of Perioperative, Acute, Critical Care, and Emergency Medicine, Department of Medicine, University of Cambridge, Cambridge, UK
| | - R M Burnstein
- Department of Perioperative, Acute, Critical Care, and Emergency Medicine, Department of Medicine, University of Cambridge, Cambridge, UK
| | - Angelos Kolias
- NIHR Global Health Research Group on Acquired Brain and Spine Injury, Division of Academic Neurosurgery, University of Cambridge, Cambridge, UK
| | - Peter John Hutchinson
- NIHR Global Health Research Group on Acquired Brain and Spine Injury, Division of Academic Neurosurgery, University of Cambridge, Cambridge, UK
| | - P John Clarkson
- International Health Systems Group, Department of Engineering, University of Cambridge, Cambridge, UK
- Cambridge Public Health Interdisciplinary Research Centre, University of Cambridge, Cambridge, UK
| | - Sara Halimah
- Trauma Operational Advisory Team, World Health Organization, Cairo, Egypt
| | - Tom Bashford
- International Health Systems Group, Department of Engineering, University of Cambridge, Cambridge, UK
- NIHR Global Health Research Group on Acquired Brain and Spine Injury, Division of Academic Neurosurgery, University of Cambridge, Cambridge, UK
- Department of Perioperative, Acute, Critical Care, and Emergency Medicine, Department of Medicine, University of Cambridge, Cambridge, UK
- Cambridge Public Health Interdisciplinary Research Centre, University of Cambridge, Cambridge, UK
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7
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Rempel H, Kalogirou MR, Dahlke S, Hunter KF. Understanding nurses' experience of climate change and then climate action in Western Canada. J Adv Nurs 2024. [PMID: 38323730 DOI: 10.1111/jan.16094] [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: 10/24/2023] [Revised: 12/29/2023] [Accepted: 01/21/2024] [Indexed: 02/08/2024]
Abstract
AIM To understand nurses' personal and professional experiences with the heat dome, drought and forest fires of 2021 and how those events impacted their perspectives on climate action. DESIGN A naturalistic inquiry using qualitative description. METHOD Twelve nurses from the interior of British Columbia, Canada, were interviewed using a semi-structured interview guide. Thematic analysis was employed. No patient or public involvement. RESULTS Data analysis yielded three themes to describe nurses' perspective on climate change: health impacts; climate action and system influences. These experiences contributed to nurses' beliefs about climate change, how to take climate action in their personal lives and their challenges enacting climate action in their workplace settings. CONCLUSIONS Nurses' challenges with enacting environmentally responsible practices in their workplace highlight the need for engagement throughout institutions in supporting environmentally friendly initiatives. IMPACT The importance of system-level changes in healthcare institutions for planetary health.
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Affiliation(s)
- Hannah Rempel
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Maya R Kalogirou
- Faculty of Nursing, MacEwan University, Edmonton, Alberta, Canada
| | - Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Kathleen F Hunter
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
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8
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Keshavarz Mohammadi N, Rezaei Z, Burggraf L, Pype P. Exploring settings as social complex adaptive systems in setting-based health research: a scoping review. Health Promot Int 2024; 39:daae001. [PMID: 38365190 DOI: 10.1093/heapro/daae001] [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: 02/18/2024] Open
Abstract
Since launching health health-promoting settings approach to health by WHO, valuable progress has happened in implementing its holistic concepts in settings such as cities, schools, workplaces, hospitals and healthcare services. However, significant knowledge-intention-success gaps still exist in creating sustainable health-promoting changes in settings. The complexity of the task of bridging this gap has contributed to the call for a complexity-informed paradigm shift to health as well as settings, followed by increasing consultation of relevant complexity theories, frameworks and tools in health research. This paper provides a critical scoping review of the application of complex adaptive system (CAS) theory in settings-based health promotion research. We included 14 papers, mostly qualitative studies, reporting on planning or implementation of change initiatives, less on its evaluation. CAS theory application was often incomplete thereby reducing the potential benefit of using this lens to understand change management. We suggest some recommendations how to comprehensively apply the CAS theory in setting-based health research and to report on all CAS characteristics to enhance the understanding of settings as adaptive health-promoting settings.
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Affiliation(s)
- Nastaran Keshavarz Mohammadi
- Department of Public Health, Shahid Beheshti University of Medical Sciences, Daneshjoo Blvd, 1985717443 Tehran, Iran
| | - Zahed Rezaei
- Deprtment of Public health, Asadabad School of Medical Sciences, Imam Khomeini Square, 6541843189 Asadabad, Iran
| | - Larissa Burggraf
- Department for Sociology, University of Education, Oberbettringer Street 200, 73525 Schwäbisch Gmünd, Germany
| | - Peter Pype
- Department of Public Health and Primary Care, University Hospital, Ghent University, Gent, Belgium
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9
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Mears DP, Aranda-Hughes V, Pesta GB. Managing Prisons Through Extended Solitary Confinement: A Necessary Approach or a Signal of Prison System Failure? Int J Offender Ther Comp Criminol 2024; 68:62-84. [PMID: 34784829 DOI: 10.1177/0306624x211058948] [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
In contemporary American corrections, extended solitary confinement (ESM) as a management tool has emerged as a strategy for avowedly controlling the most violent individuals and, in so doing, creating a safer prison system. We theorize that the emergence of this unique form of housing may also be viewed as a signal of prison system failure. To advance this argument, we identify how different theoretical perspectives can be used to anticipate the effects of ESM on prison system violence and order and then investigate the plausibility of this account by grounding it in analysis of qualitative data from a study of one state's prison system. The analysis suggests theoretical and empirical warrant for both views of ESM-as an effective tool and as a symptom of system failure. Implications of the study research and policy are discussed.
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10
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Palmer S, Burton-Obanla A, Goon S, Allison T, Mitchell A, Bogdonas K, Fombelle M, Hoffman A, Smith J, McCaffrey J, Prescott MP. Policy, Systems, and Environmental Changes in Child Nutrition Programs: A Systematic Literature Review. Adv Nutr 2024; 15:100116. [PMID: 37716534 PMCID: PMC10700153 DOI: 10.1016/j.advnut.2023.09.004] [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: 11/04/2022] [Revised: 09/06/2023] [Accepted: 09/13/2023] [Indexed: 09/18/2023] Open
Abstract
The National School Lunch Program (NSLP) provides healthy food to millions of children annually. To promote increased lunch consumption, policy, systems, and environmental (PSE) change strategies are being implemented in child nutrition programs. An evaluation of the current evidence supporting PSE interventions in school nutrition programs is needed to facilitate evidence-based practices across the nation for programs. This systematic review aims to determine the quality and breadth of available evidence of the effectiveness of PSE strategies on the consumption and waste of fruits, vegetables, milk, and water in the NSLP. The inclusion criteria required studies to occur in a United States K-12 school setting, data collection after 2012, report consumption and waste findings for fruit, vegetable, milk, or water, and be an original research article. Articles included in the review are restricted to positive or neutral quality. Thirty studies are included, policy level (n = 4), systems level (n = 8), environmental level (n = 10), and multi-category (n = 8). Results from positively rated policy-level studies suggest that recess before lunch may increase milk consumption, whereas removing flavored milk may decrease consumption. System-level studies of offering vegetables first in isolation of other meal components and offering spiced vegetables compared with traditional preparations may increase vegetable consumption, and locally procuring produce may increase fruit and vegetable consumption. Environmental-level studies such as water promotion strategies such as placing cups near drinking fountains may increase water consumption. Improving the convenience, attractiveness, and palatability of fruits and vegetables may increase consumption. Future PSE research in child nutrition programs should incorporate implementation aides and metrics into their study designs to allow a better understanding of how to sustain interventions from the perspective of school nutrition professionals.
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Affiliation(s)
- Shelly Palmer
- Department of Food Science and Human Nutrition, University of Illinois Urbana Champaign, Champaign, IL, United States
| | - Amirah Burton-Obanla
- Division of Nutritional Sciences, University of Illinois Urbana Champaign, Champaign, IL, United States
| | - Shatabdi Goon
- University of Illinois Extension, Urbana, IL, United States
| | | | - Ana Mitchell
- Division of Nutritional Sciences, University of Illinois Urbana Champaign, Champaign, IL, United States
| | | | | | - Ashley Hoffman
- University of Illinois Extension, Urbana, IL, United States
| | - Jenna Smith
- University of Illinois Extension, Urbana, IL, United States
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11
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Affiliation(s)
- Jamie Scott
- Emergency Department, Royal London Hospital, Bartshealth NHS trust, London, UK
- Physician Response Unit, Bartshealth NHS Trust, London, UK
| | - Nicholas Moore
- Emergency Department, Bristol Royal Infirmary, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
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12
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Zahedi Z, Mahmud F, Pinto C. Systemic Risk Management Plan for Electronic Medical Records (EMR): Why and How? Stud Health Technol Inform 2023; 311:25-43. [PMID: 34047283 DOI: 10.3233/shti200016] [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: 11/15/2022]
Abstract
Electronic patient data use and handling are critical issues in terms of privacy, confidentiality, security, and the Health Insurance Portability and Accountability Act (HIPAA) regulations. The risks associated with electronic patient data are not limited to identity theft but rather include a person's social, economic, and psychological well-being. However, there have not been many studies that have focused on the associated risk factors that could lead to these situations. This paper identifies those risks related to electronic patient data breaches by means of a grounded theory approach and develops a systemic risk management plan that enables engineering managers and risk managers to more effectively and efficiently overcome risks associated with electronic patient data. Purpose: The purpose of this paper is to identify the risks associated with electronic patient data breach using a grounded theory approach and also to recommend a set of guidelines to support a better, effective, and efficient system and thereby overcome these risks. Patients and methods: No patients were involved either to participate in this study or any of their opinions are reflected with this research.
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Affiliation(s)
- Ziniya Zahedi
- Georgetown University Law Center, Washington, DC, USA
| | - Faisal Mahmud
- Center for Learning and Teaching, Old Dominion University, Norfolk, Virginia, USA
| | - Cesar Pinto
- Engineering Management and Systems Engineering Department, Old Dominion University, Norfolk, Virginia, USA
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13
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Bartlett S, Ngom B, Olobio N, Badiane MD, Tarboh G, Diagne A, Nwosu C. Improving data use in trachomatous trichiasis programmes: operationalisation of the TT Tracker. Int Health 2023; 15:ii73-ii76. [PMID: 38048376 PMCID: PMC10695419 DOI: 10.1093/inthealth/ihad057] [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: 03/31/2023] [Revised: 05/31/2023] [Accepted: 07/19/2023] [Indexed: 12/06/2023] Open
Abstract
Trachoma is a disease of the eye and the leading infectious cause of blindness worldwide. Years of repeated infections can cause in-turning of the lashes so that they rub against the eyeball, causing pain, discomfort and, if left untreated, blindness. This is known as trachomatous trichiasis (TT) and can be remedied by surgery. To improve oversight and reporting of TT outreach, Sightsavers developed a mobile phone application called the TT Tracker so that TT surgeons, assistants and supervisors can collect and analyse information about surgical outcomes and performance and determine when and where follow-up appointments are required. The TT Tracker is being used by seven national programmes. Examples of use and programme improvements from Nigeria, Benin and Senegal are discussed here.
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Affiliation(s)
- Sarah Bartlett
- Sightsavers, 35 Perrymount Road, Haywards Heath, West Sussex, RH16 3BW, UK
| | - Babacar Ngom
- Sightsavers, VDN Mermoz Pyrotechnique, N°18, Dakar, Senegal
| | - Nicholas Olobio
- Federal Ministry of Health, Federal Secretariat Complex phase 3, FCT, Abuja, Nigeria
| | - Mouctar Dieng Badiane
- Ministère de la Santé et de l'Action sociale, Rue Aimé Césaire, Fann Résidence - BP 4024, Dakar, Senegal
| | | | - Aliou Diagne
- Sightsavers, VDN Mermoz Pyrotechnique, N°18, Dakar, Senegal
| | - Christian Nwosu
- Sightsavers, 24 Tennesse Crescent, Maitama, FCT, Abuja, Nigeria
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Suhas S, Arvind BA, Sukumar GM, Banandur PS, Nirisha LP, Kumar CN, Benegal V, Rao GN, Varghese M, Gururaj G. A bird's eye view of the mental health systems in India. Indian J Psychiatry 2023; 65:1214-1222. [PMID: 38298873 PMCID: PMC10826870 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_845_23] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 10/25/2023] [Accepted: 11/07/2023] [Indexed: 02/02/2024] Open
Abstract
Background A staggering 85% of the global population resides in low- and middle-income countries (LAMICs). India stands as an exemplary pioneer in the realm of mental health initiatives among LAMICs, having launched its National Mental Health Program in 1982. It is imperative to effectively evaluate mental health systems periodically to cultivate a dynamic learning model sustained through continuous feedback from mental healthcare structures and processes. Materials and Methods The National Mental Health Survey (NMHS) embarked on the Mental Health Systems Assessment (MHSA) in 12 representative Indian states, following a pilot program that contextually adapted the World Health Organization's Assessment Instrument for Mental Health Systems. The methodology involved data collection from various sources and interviews with key stakeholders, yielding a set of 15 quantitative, 5 morbidity, and 10 qualitative indicators, which were employed to encapsulate the functional status of mental health systems within the surveyed states by using a scorecard framework. Results The NMHS MHSA for the year 2015-16 unveiled an array of indices, and the resultant scorecard succinctly encapsulated the outcomes of the systems' evaluation across the 12 surveyed states in India. Significantly, the findings revealed considerable interstate disparities, with some states such as Gujarat and Kerala emerging as frontrunners in the evaluation among the surveyed states. Nevertheless, notable gaps were identified in several domains within the assessed mental health systems. Conclusion MHSA, as conducted within the framework of NMHS, emerges as a dependable, valid, and holistic mechanism for documenting mental health systems in India. However, this process necessitates periodic iterations to serve as critical indicators guiding the national mental health agenda, including policies, programs, and their impact evaluation.
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Affiliation(s)
- Satish Suhas
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Banavaram A. Arvind
- Centre for Public Health, Department of Epidemiology, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Gautham M. Sukumar
- Centre for Public Health, Department of Epidemiology, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Pradeep S. Banandur
- Centre for Public Health, Department of Epidemiology, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Lakshmi P. Nirisha
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Channaveerachari N. Kumar
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Vivek Benegal
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Girish N. Rao
- Centre for Public Health, Department of Epidemiology, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Mathew Varghese
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Gopalkrishna Gururaj
- Centre for Public Health, Department of Epidemiology, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
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15
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Skelton JA, Vitolins M, Pratt KJ, DeWitt LH, Eagleton SG, Brown C. Rethinking family-based obesity treatment. Clin Obes 2023; 13:e12614. [PMID: 37532265 DOI: 10.1111/cob.12614] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 06/08/2023] [Accepted: 07/17/2023] [Indexed: 08/04/2023]
Abstract
Emerging research in paediatric obesity has demonstrated that parental involvement in the weight management process can improve weight outcomes in children. Recent guidelines by the American Academy of Pediatrics note the importance of parent and family involvement in treatment. However, it is currently unknown if including the entire family in obesity treatment can supersede outcomes associated with participation of only one parent. Family Systems Theory (FST) provides the theoretical foundation for examining one's healthy behaviours as they exist within the context of their family, defined by family dynamics. This narrative review aims to reconsider prior definitions of paediatric family-based management using the FST framework to be inclusive of family and household diversity and in doing so, inform research not only within weight management but also other domains of clinical care requiring family support or change. Applying FST to paediatric weight management highlights the link between family dynamics and paediatric obesity, demonstrating the association of dysfunctional family dynamics with more severe obesity. While family-based weight management remains the gold standard for treatment of paediatric obesity, more investigation is needed in expanding family-based interventions to impact entire families and potentially improve outcomes more broadly for overall family health and wellbeing.
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Affiliation(s)
- Joseph A Skelton
- Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
- Center for Prevention Science in Child and Family Health, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
- Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Mara Vitolins
- Center for Prevention Science in Child and Family Health, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
- Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Keeley J Pratt
- Department of Human Sciences, Human Development & Family Science Program, College of Education and Human Ecology, The Ohio State University, Columbus, Ohio, USA
- Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Leila Hamzi DeWitt
- Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
- Center for Prevention Science in Child and Family Health, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Sally G Eagleton
- Center for Prevention Science in Child and Family Health, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
- Clinical and Translational Science Institute, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Callie Brown
- Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
- Center for Prevention Science in Child and Family Health, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
- Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
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16
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Davey T. Cohesion: A Measure of Organisation and Epistemic Uncertainty of Incoherent Ensembles. Entropy (Basel) 2023; 25:1605. [PMID: 38136485 PMCID: PMC10742442 DOI: 10.3390/e25121605] [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: 11/06/2023] [Accepted: 11/28/2023] [Indexed: 12/24/2023]
Abstract
This paper offers a measure of how organised a system is, as defined by self-consistency. Complex dynamics such as tipping points and feedback loops can cause systems with identical initial parameters to vary greatly by their final state. These systems can be called non-ergodic or incoherent. This lack of consistency (or replicability) of a system can be seen to drive an additional form of uncertainty, beyond the variance that is typically considered. However, certain self-organising systems can be shown to have some self-consistency around these tipping points, when compared with systems that find no consistent final states. Here, we propose a measure of this self-consistency that is used to quantify our confidence in the outcomes of agent-based models, simulations or experiments of dynamical systems, which may or may not contain multiple attractors.
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Affiliation(s)
- Timothy Davey
- Research Department, London Interdisciplinary School, London E1 1EW, UK
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17
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Lacy-Nichols J, Jones A, Buse K. Corrigendum: Taking on the Commercial Determinants of Health at the level of actors, practices and systems. Front Public Health 2023; 11:1305512. [PMID: 38045971 PMCID: PMC10690595 DOI: 10.3389/fpubh.2023.1305512] [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: 10/01/2023] [Accepted: 10/13/2023] [Indexed: 12/05/2023] Open
Abstract
[This corrects the article DOI: 10.3389/fpubh.2022.981039.].
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Affiliation(s)
- Jennifer Lacy-Nichols
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
| | - Alexandra Jones
- The George Institute for Global Health, Sydney, NSW, Australia
| | - Kent Buse
- The George Institute for Global Health, Imperial College, London, United Kingdom
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18
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Aggarwal S, Armstrong G. How, when and where to intervene in self-harm in youth in low- and middle-income countries: Thinking beyond healthcare systems. Int J Soc Psychiatry 2023; 69:1837-1839. [PMID: 37162034 PMCID: PMC7615317 DOI: 10.1177/00207640231174368] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
BACKGROUND Low- and middle-income countries (LMICs) account for 78% of global suicides. Self-harm is the clearest antecedent of suicide. The health and social systems have struggled to provide adequate evidence based help to young people with self-harm. In addition, the negative attitudes towards those who self-harm in these settings interfere with help-seeking behaviour. AIMS AND METHOD In our submission of a comment, we discuss the reasons for thinking beyond healthcare systems in LMICs to address self-harm in youth and the possible ways to achieve it. RESULTS AND CONCLUSION We truly believe that harnessing the potential of social systems such as schools is important for addressing self-harm in LMICs. We present our arguments in favour of feasible measures that can be implemented to achieve this.
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Affiliation(s)
- Shilpa Aggarwal
- Public Health Foundation of India, New Delhi, India
- Centre for Adolescent Health, Murdoch Children’s Research Institute, Mellbourne, VIC, Australia
- Faculty of Health, School of Medicine, Deakin University, Geelong, VIC, Australia
| | - Greg Armstrong
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
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19
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Richardson MB, Toluhi AA, Baskin ML, Budhwani H, Julian ZI, Knight CC, Sinkey R, Szychowski JM, Tita AT, Wingate MS, Turan JM. Community and Systems Contributors and Strategies to Reduce Racial Inequities in Maternal Health in the Deep South: Provider Perspectives. Health Equity 2023; 7:581-591. [PMID: 37736520 PMCID: PMC10510686 DOI: 10.1089/heq.2023.0114] [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] [Accepted: 07/07/2023] [Indexed: 09/23/2023] Open
Abstract
Purpose Black pregnant individuals in Alabama are disproportionately affected by severe maternal morbidity and mortality (SMM). To understand why racial disparities in maternal health outcomes persist and identify potential strategies to reduce these inequities, we sought perspectives from obstetric health care providers, health administrators, and members of local organizations who provide pregnancy, delivery, and postpartum care services in Alabama. Methods We conducted qualitative in-depth interviews with stakeholders (n=20), purposively recruited from community-based organizations, clinical settings, government organizations, and academic institutions. Interview guides were based on Howell's conceptual model of pathways to racial disparities in maternal mortality. Data were coded using a modified framework theory approach and analyzed thematically. Results Racism, unjust laws and policies, and poverty/lack of infrastructure in communities emerged as major themes contributing to racial disparities in maternal health at the community and systems levels. Inadequate health insurance coverage was described as a strong driver of the disparities. Service providers suggested strategies for Alabama should be community focused, evidence based, and culturally sensitive. These should include Medicaid expansion, expanded parental leave, and removal of laws restricting choice. Community- and systems-level interventions should include community infrastructure improvements, choice in maternity services, and provision of digital communication options. Conclusions Providers shared perspectives on community and structural areas of intervention to reduce racial inequities in SMM. These results can inform discussions with health system and community partners about Alabama and other Deep South initiatives to improve maternal health outcomes in black communities.
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Affiliation(s)
- Molly B. Richardson
- Department of Health Policy and Organization, University of Alabama at Birmingham (UAB), Birmingham, Alabama, USA
| | - Angelina A. Toluhi
- Department of Health Policy and Organization, University of Alabama at Birmingham (UAB), Birmingham, Alabama, USA
| | - Monica L. Baskin
- Department of Medicine, University of Alabama at Birmingham (UAB), Birmingham, Alabama, USA
- Center for Women's Reproductive Health, UAB, Birmingham, Alabama, USA
| | - Henna Budhwani
- Center for Women's Reproductive Health, UAB, Birmingham, Alabama, USA
- Center of Population Sciences for Health Equity, College of Nursing, Florida State University (FSU), Tallahassee, Florida, USA
| | - Zoë I. Julian
- Department of Obstetrics and Gynecology, WellStar Kennestone Regional Medical Center, Marietta, Georgia, USA
| | - Candace C. Knight
- Center for Women's Reproductive Health, UAB, Birmingham, Alabama, USA
- School of Nursing, UAB, Birmingham, Alabama, USA
| | - Rachel Sinkey
- Center for Women's Reproductive Health, UAB, Birmingham, Alabama, USA
- Department of Obstetrics and Gynecology, UAB, Birmingham, Alabama, USA
| | - Jeff M. Szychowski
- Center for Women's Reproductive Health, UAB, Birmingham, Alabama, USA
- Department of Biostatistics, UAB, Birmingham, Alabama, USA
| | - Alan T.N. Tita
- Center for Women's Reproductive Health, UAB, Birmingham, Alabama, USA
- Department of Obstetrics and Gynecology, UAB, Birmingham, Alabama, USA
| | - Martha S. Wingate
- Department of Health Policy and Organization, University of Alabama at Birmingham (UAB), Birmingham, Alabama, USA
- Center for Women's Reproductive Health, UAB, Birmingham, Alabama, USA
| | - Janet M. Turan
- Department of Health Policy and Organization, University of Alabama at Birmingham (UAB), Birmingham, Alabama, USA
- Center for Women's Reproductive Health, UAB, Birmingham, Alabama, USA
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20
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Kovoor JG, Bacchi S, Gupta AK, Stretton B, Malycha J, Reddi BA, Liew D, O'Callaghan PG, Beltrame JF, Zannettino AC, Jones KL, Horowitz M, Dobbins C, Hewett PJ, Trochsler MI, Maddern GJ. The Adelaide Score: An artificial intelligence measure of readiness for discharge after general surgery. ANZ J Surg 2023; 93:2119-2124. [PMID: 37264548 DOI: 10.1111/ans.18546] [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: 04/19/2023] [Revised: 05/17/2023] [Accepted: 05/21/2023] [Indexed: 06/03/2023]
Abstract
BACKGROUND This study aimed to examine the performance of machine learning algorithms for the prediction of discharge within 12 and 24 h to produce a measure of readiness for discharge after general surgery. METHODS Consecutive general surgery patients at two tertiary hospitals, over a 2-year period, were included. Observation and laboratory parameter data were stratified into training, testing and validation datasets. Random forest, XGBoost and logistic regression models were evaluated. Each ward round note time was taken as a different event. Primary outcome was classification accuracy of the algorithmic model able to predict discharge within the next 12 h on the validation data set. RESULTS 42 572 ward round note timings were included from 8826 general surgery patients. Discharge occurred within 12 h for 8800 times (20.7%), and within 24 h for 9885 (23.2%). For predicting discharge within 12 h, model classification accuracies for derivation and validation data sets were: 0.84 and 0.85 random forest, 0.84 and 0.83 XGBoost, 0.80 and 0.81 logistic regression. For predicting discharge within 24 h, model classification accuracies for derivation and validation data sets were: 0.83 and 0.84 random forest, 0.82 and 0.81 XGBoost, 0.78 and 0.79 logistic regression. Algorithms generated a continuous number between 0 and 1 (or 0 and 100), representing readiness for discharge after general surgery. CONCLUSIONS A derived artificial intelligence measure (the Adelaide Score) successfully predicts discharge within the next 12 and 24 h in general surgery patients. This may be useful for both treating teams and allied health staff within surgical systems.
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Affiliation(s)
- Joshua G Kovoor
- Queen Elizabeth Hospital, University of Adelaide, Adelaide, South Australia, Australia
- Royal Australasian College of Surgeons, Adelaide, South Australia, Australia
- Health and Information, Adelaide, South Australia, Australia
| | - Stephen Bacchi
- Health and Information, Adelaide, South Australia, Australia
- University of Adelaide, Adelaide, South Australia, Australia
- Flinders University, Adelaide, South Australia, Australia
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Aashray K Gupta
- Health and Information, Adelaide, South Australia, Australia
- University of Adelaide, Adelaide, South Australia, Australia
- Gold Coast University Hospital, Gold Coast, Queensland, Australia
| | - Brandon Stretton
- Queen Elizabeth Hospital, University of Adelaide, Adelaide, South Australia, Australia
- Health and Information, Adelaide, South Australia, Australia
- Flinders University, Adelaide, South Australia, Australia
| | - James Malycha
- University of Adelaide, Adelaide, South Australia, Australia
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Benjamin A Reddi
- University of Adelaide, Adelaide, South Australia, Australia
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Danny Liew
- University of Adelaide, Adelaide, South Australia, Australia
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Patrick G O'Callaghan
- University of Adelaide, Adelaide, South Australia, Australia
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - John F Beltrame
- Queen Elizabeth Hospital, University of Adelaide, Adelaide, South Australia, Australia
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | | | - Karen L Jones
- University of Adelaide, Adelaide, South Australia, Australia
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Michael Horowitz
- University of Adelaide, Adelaide, South Australia, Australia
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Christopher Dobbins
- University of Adelaide, Adelaide, South Australia, Australia
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Peter J Hewett
- Queen Elizabeth Hospital, University of Adelaide, Adelaide, South Australia, Australia
| | - Markus I Trochsler
- Queen Elizabeth Hospital, University of Adelaide, Adelaide, South Australia, Australia
| | - Guy J Maddern
- Queen Elizabeth Hospital, University of Adelaide, Adelaide, South Australia, Australia
- Royal Australasian College of Surgeons, Adelaide, South Australia, Australia
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21
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Xue P, Zisman E, Patel P, Jakhete N, Sakiani S, Mattingly TJ, Shetty K. A Description of Resource Utilization and Costs in Acute on Chronic Liver Failure. Prog Transplant 2023; 33:272-274. [PMID: 37489097 DOI: 10.1177/15269248231189876] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/26/2023]
Affiliation(s)
- Pei Xue
- Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Erin Zisman
- Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Preet Patel
- Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Neha Jakhete
- Department of Gastroenterology and Hepatology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Sasan Sakiani
- Department of Gastroenterology and Hepatology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - T Joseph Mattingly
- Department of Pharmacotherapy, University of Utah College of Pharmacy, Salt Lake City, UT, USA
| | - Kirti Shetty
- Department of Gastroenterology and Hepatology, University of Maryland School of Medicine, Baltimore, MD, USA
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Peisah C, Williams B, Hockey P, Lees P, Wright D, Rosenstein A. Pragmatic Systemic Solutions to the Wicked and Persistent Problem of the Unprofessional Disruptive Physician in the Health System. Healthcare (Basel) 2023; 11:2455. [PMID: 37685490 PMCID: PMC10487014 DOI: 10.3390/healthcare11172455] [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: 07/18/2023] [Revised: 08/22/2023] [Accepted: 08/22/2023] [Indexed: 09/10/2023] Open
Abstract
We have always had and will always have "disruptive" or "dysfunctional" doctors behaving unprofessionally within healthcare institutions. Disruptive physician behaviour (also called "unprofessional behaviour") was described almost 150 years ago, but remains a persistent, wicked problem in healthcare, largely fuelled by systemic inaction. In this Commentary, we aim to explore the following aspects from a systemic lens: (i) the gaps in understanding systemic resistance and difficulty in addressing this issue; and (ii) pragmatic approaches to its management in the healthcare system. In doing so, we hope to shift the systemic effect from nihilism and despair, to one of hopeful realism about disruptive or unprofessional behaviour. We suggest that solutions lie in cultural change to ensure systemic awareness, responsiveness and early intervention, and an understanding of what systemic failure looks like in this context. Staff education, policies and procedures that outline a consistent reporting and review process including triaging the problem, its source, its effects, and the attempted solutions, are also crucial. Finally, assessment and intervention from appropriately mental-health-trained personnel are required, recognising that this is a complex mental health problem. We are not doing anyone any favours by ignoring, acting as bystanders, or otherwise turning a blind eye to disruptive or unprofessional behaviour; otherwise, we share culpability.
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Affiliation(s)
- Carmelle Peisah
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia;
- Discipline of Psychiatry and Mental Health, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | - Betsy Williams
- Professional Renewal Center, Lawrence, KS 66049, USA;
- Continuing Medical Education Wales Behavioral Assessment, Lawrence, KS 66049, USA
- Department of Psychiatry, School of Medicine, University of Kansas, Kansas City, KS 66045, USA
| | - Peter Hockey
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia;
- Western Sydney Local Health District, Sydney, NSW 2145, Australia;
| | - Peter Lees
- Faculty of Medical Leadership and Management, London WC1R 4SG, UK;
| | - Danette Wright
- Western Sydney Local Health District, Sydney, NSW 2145, Australia;
- School of Medicine, Western Sydney University, Sydney, NSW 2560, Australia
| | - Alan Rosenstein
- Internal Medicine, Health Care Behavioral Management, San Francisco, CA 94118, USA;
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Ushimoto T, Yao S, Nunokawa C, Murasaka K, Inaba H. Association between the COVID-19 pandemic in 2020 and out-of-hospital cardiac arrest outcomes and bystander resuscitation efforts for working-age individuals in Japan: a nationwide observational and epidemiological analysis. Emerg Med J 2023; 40:556-563. [PMID: 37280044 PMCID: PMC10423471 DOI: 10.1136/emermed-2022-213001] [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: 11/25/2022] [Accepted: 05/20/2023] [Indexed: 06/08/2023]
Abstract
BACKGROUND Improving out-of-hospital cardiac arrest (OHCA) prognosis within the working-age population is important, but no studies have investigated the effects of COVID-19 pandemic specifically on the working-age population with OHCAs. We aimed to determine the association between the 2020 COVID-19 pandemic and OHCA outcomes and bystander resuscitation efforts among the working-age population. METHODS Prospectively collected nationwide, population-based records concerning 166 538 working-age individuals (men, 20-68 years; women, 20-62 years) with OHCA between 2017 and 2020 were assessed. We compared characteristics and outcome differences of the arrests between three prepandemic years (2017-2019) and the pandemic year 2020. The primary outcome was neurologically favourable 1-month survival (cerebral performance category 1 or 2). Secondary outcomes were bystander cardiopulmonary resuscitation (BCPR), dispatcher-assisted instruction for cardiopulmonary resuscitation (DAI-CPR), bystander-provided defibrillation (public access defibrillation (PAD)) and 1-month survival. We examined variations in bystander resuscitation efforts and outcomes among pandemic phase and regional classifications. RESULTS Among 149 300 OHCA cases, 1-month survival (2020, 11.2%; 2017-2019, 11.1% (crude OR (cOR) 1.00, 95% CI 0.97 to 1.05)) and 1-month neurologically favourable survival (7.3%-7.3% (cOR 1.00, 95% CI 0.96 to 1.05)) were unchanged; however, the neurologically favourable 1-month survival rate decreased in 12 of the most COVID-19-affected prefectures (7.2%-7.8% (cOR 0.90, 95% CI 0.85 to 0.96)), whereas it increased in 35 other prefectures (7.5%-6.6% (cOR 1.15, 95% CI 1.07 to 1.23)). Favourable outcomes decreased for OHCAs of presumed cardiac aetiology (10.3%-10.9% (cOR 0.94, 95% CI 0.90 to 0.99)) but increased for OHCAs of non-cardiac aetiology (2.5%-2.0% (cOR 1.27, 95% CI 1.12 to 1.44)). BCPR provision increased from 50.7% of arrests prepandemic to 52.3% (crude OR 1.07, 95% CI 1.04 to 1.09). Compared with 2017-2019, home-based OHCAs in 2020 increased (64.8% vs 62.3% (crude OR 1.12, 95% CI 1.09 to 1.14)), along with DAI-CPR attempts (59.5% vs 56.6% (cOR 1.13, 95% CI 1.10 to 1.15)) and multiple calls to determine a destination hospital (16.4% vs 14.5% (cOR 1.16, 95% CI 1.12 to 1.20)). PAD use decreased from 4.0% to 3.7% but only during the state of emergency period (7 April-24 May 2020) and in prefectures significantly affected by COVID-19. CONCLUSIONS Reviewing automated external defibrillator (AED) locations and increasing BCPR through DAI-CPR may help prevent pandemic-associated decreases in survival rates for patients with cardiac OHCAs.
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Affiliation(s)
- Tomoyuki Ushimoto
- Emergency Medicine, Kanazawa Medical University, Uchinada-machi, Japan
| | - Shintaro Yao
- Department of Emergency Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Chika Nunokawa
- Department of Emergency Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Kenshi Murasaka
- Emergency Medicine, Kanazawa Medical University, Kahoku-gun, Japan
| | - Hideo Inaba
- Emergency Medicine, Kanazawa Medical University, Uchinada-machi, Japan
- Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
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24
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Buan NR, Kappler U. Editorial: Rising stars in microbial physiology and metabolism: 2022. Front Microbiol 2023; 14:1254900. [PMID: 37533832 PMCID: PMC10392919 DOI: 10.3389/fmicb.2023.1254900] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 07/10/2023] [Indexed: 08/04/2023] Open
Affiliation(s)
- Nicole R. Buan
- Department of Biochemistry, University of Nebraska-Lincoln, Lincoln, NE, United States
| | - Ulrike Kappler
- School of Chemistry and Molecular Biosciences, The University of Queensland, Saint Lucia, QLD, Australia
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Fields B, Werner N, Shah MN, Hetzel S, Golden BP, Gilmore-Bykovskyi A, Farrar Edwards D. Adapting and Testing the Care Partner Hospital Assessment Tool for Use in Dementia Care: Protocol for a 2 Sequential Phase Study. JMIR Res Protoc 2023; 12:e46808. [PMID: 37347517 DOI: 10.2196/46808] [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: 02/26/2023] [Revised: 04/25/2023] [Accepted: 05/23/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND Research and policy demonstrate the value of and need for systematically identifying and preparing care partners for their caregiving responsibilities while their family member or friend living with dementia is hospitalized. The Care Partner Hospital Assessment Tool (CHAT) has undergone content and face validation and has been endorsed as appropriate by clinicians to facilitate the timely identification and preparation of care partners of older adult patients during their hospitalization. However, the CHAT has not yet been adapted or prospectively evaluated for use with care partners of hospitalized people living with dementia. Adapting and testing the CHAT via a pilot study will provide the necessary evidence to optimize feasibility and enable future efficacy trials. OBJECTIVE The purpose of this paper is to describe the study protocol for the adaptation and testing of the CHAT for use among care partners of hospitalized people living with dementia to better prepare them for their caregiving responsibilities after hospital discharge. METHODS Our protocol is based on the National Institutes of Health Stage Model and consists of 2 sequential phases, including formative research and the main trial. In phase 1, we will use a participatory human-centered design process that incorporates people living with dementia and their care partners, health care administrators, and clinicians to adapt the CHAT for dementia care (ie, the Dementia CHAT [D-CHAT]; stage IA). In phase 2, we will partner with a large academic medical system to complete a pilot randomized controlled trial to examine the feasibility and estimate the size of the effect of the D-CHAT on care partners' preparedness for caregiving (stage IB). We anticipate this study to take approximately 60 months to complete, from study start-up procedures to dissemination. The 2 phases will take place between December 1, 2022, and November 30, 2027. RESULTS The study protocol will yield (1) a converged-upon, ready-for-feasibility testing D-CHAT; (2) descriptive and feasibility characteristics of delivering the D-CHAT; and (3) effect size estimates of the D-CHAT on care partner preparedness. We anticipate that the resultant D-CHAT will provide clinicians with guidance on how to identify and better prepare care partners for hospitalized people living with dementia. In turn, care partners will feel equipped to fulfill caregiving roles for their family members or friends living with dementia. CONCLUSIONS The expected results of this study are to favorably impact hospital-based care processes and outcomes for people living with dementia and their care partners and to elucidate the essential caregiving role that so many care partners of people living with dementia assume. TRIAL REGISTRATION ClinicalTrials.gov NCT05592366; https://clinicaltrials.gov/ct2/show/NCT05592366. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/46808.
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Affiliation(s)
- Beth Fields
- Department of Kinesiology, University of Wisconsin-Madison, Madison, WI, United States
| | - Nicole Werner
- Department of Health and Wellness Design, Indiana University School of Public Health-Bloomington, Bloomington, IN, United States
| | - Manish N Shah
- BerbeeWalsh Department of Emergency Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Scott Hetzel
- Department of Statistics, School of Computer, Data and Information Sciences, University of Wisconsin-Madison, Madison, WI, United States
| | - Blair P Golden
- Division of Hospital Medicine, Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Andrea Gilmore-Bykovskyi
- BerbeeWalsh Department of Emergency Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Dorothy Farrar Edwards
- Department of Kinesiology, School of Education, University of Wisconsin-Madison, Madison, WI, United States
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Phang FTH, Weaver A, Blane DN, Murphy F, Dawson A, Hall S, De Natale A, Minnis H, McFadyen A. Using the candidacy framework to conceptualize systems and gaps when developing infant mental health (IMH) services: A qualitative study. Infant Ment Health J 2023. [PMID: 37339006 DOI: 10.1002/imhj.22072] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 05/03/2023] [Accepted: 05/25/2023] [Indexed: 06/22/2023]
Abstract
The development of infant mental health (IMH) services globally is still in its early stages. This qualitative study aims to understand the challenges of setting up IMH services and explores the views and experiences of 14 multi-disciplinary stakeholders who are part of the IMH implementation group in a large Scottish health board. Six major themes were identified through thematic analysis. This paper examines the most prominent theme "Systems" alongside the theme "Gaps in Current Service". The theoretical framework of "candidacy" is found to be a valuable way to conceptualize the complex systemic layers of micro, meso, and macro factors that contribute to the challenges of setting up services. At the micro level, key themes included the view that services must be accessible, individualized, and involve families. At the meso level, in line with the aims of the service, multiagency integration, aspects of early intervention, and clear operating conditions were all seen as important. Finally, at the macro level, perhaps the biggest challenge perceived by stakeholders is delivering a service that is entirely infant-focused. These findings will help inform policy makers about factors considered by professionals to be vital in the establishment of IMH services in Scotland and across the globe.
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Affiliation(s)
- Fifi T H Phang
- ST6 Specialist Registrar in Child and Adolescent Psychiatry, CAMHS, NHS Lanarkshire, Glasgow, UK
| | - Alicia Weaver
- Medical Student, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - David N Blane
- Senior Clinical Lecturer, General Practice and Primary Care, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Fionnghuala Murphy
- ST6 Specialist Registrar in Child and Adolescent Psychiatry, Specialist Children's Services, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - Andrew Dawson
- Professional Lead for Child Psychotherapy, Specialist Children's Services, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - Sophie Hall
- ST6 Specialist Registrar in Child and Adolescent Psychiatry, CAMHS, NHS Lanarkshire, Glasgow, UK
| | - Anna De Natale
- Medical Student, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Helen Minnis
- Professor of Child and Adolescent Psychiatry, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Anne McFadyen
- PhD Student, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
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Fields B, Still C, Medlin A, Strayer A, Arbaje AI, Gilmore-Bykovskyi A, Werner N. Care Partner Inclusion of People Hospitalized With Alzheimer Disease and Related Dementias: Protocol for a Mixed Methods Systems Engineering Approach to Designing a Health Care System Toolkit. JMIR Res Protoc 2023; 12:e45274. [PMID: 37191978 PMCID: PMC10230354 DOI: 10.2196/45274] [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: 12/22/2022] [Revised: 03/27/2023] [Accepted: 04/04/2023] [Indexed: 04/07/2023] Open
Abstract
BACKGROUND Research and policy demonstrate the value and need for the systematic inclusion of care partners in hospital care delivery of people living with Alzheimer disease and related dementias (ADRD). Support provided to care partners through information and training regarding caregiving responsibilities is important to facilitating their active inclusion and ultimately improving hospital outcomes of people living with ADRD. To promote care partners' active inclusion, a toolkit that guides health systems in the identification, assessment, and training of care partners is needed. User-centered approaches can address this gap in practice by creating toolkits that are practical and responsive to the needs of care partners and their hospitalized family members and friends living with ADRD. OBJECTIVE This paper describes the study protocol for the development and refinement of the ADRD Systematic Hospital Inclusion Family Toolkit (A-SHIFT). A-SHIFT will provide health care systems with guidance on how to effectively identify, assess, and train care partners of hospitalized persons living with ADRD. METHODS The A-SHIFT study protocol will use a 3-aimed, convergent mixed method approach to iteratively develop and refine the toolkit. In Aim 1, we will use a systems-engineering approach to characterize patterns of care partner inclusion in hospital care for people living with ADRD. In Aim 2, we will partner with stakeholders to identify and prioritize health care system facilitators and barriers to the inclusion for care partners of hospitalized people living with ADRD. In Aim 3, we will work with stakeholders to co-design an adaptable toolkit to be used by health systems to facilitate the identification, assessment, and training of care partners of hospitalized people living with ADRD. Our convergent mixed method approach will facilitate triangulation across all 3 aims to increase the credibility and transferability of results. We anticipate this study to take 24 months between September 1, 2022, and August 31, 2024. RESULTS The A-SHIFT study protocol will yield (1) optimal points in the hospital workflow for care partner inclusion, (2) a prioritized list of potentially modifiable barriers and facilitators to including care partners in the hospitalization of people living with ADRD, and (3) a converged-upon, ready for feasibility testing of the toolkit to guide the inclusion of care partners of people living with ADRD in hospital care. CONCLUSIONS We anticipate that the resultant A-SHIFT will provide health systems with a readiness checklist, implementation plan, and resources for identifying, assessing, and training care partners on how to fulfill their caregiving roles for people living with ADRD after hospital discharge. A-SHIFT has the potential to not only improve care partner preparedness but also help reduce health and service use outcomes for people living with ADRD after hospital discharge. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/45274.
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Affiliation(s)
- Beth Fields
- Department of Kinesiology, University of Wisconsin-Madison, Madison, WI, United States
| | - Catherine Still
- Department of Kinesiology, University of Wisconsin-Madison, Madison, WI, United States
| | - Austin Medlin
- Department of Design & Wellness, Indiana University, Bloomington, IN, United States
| | - Andrea Strayer
- College of Nursing, University of Iowa, Iowa City, IA, United States
- Department of Neurological Surgery, University of Wisconsin-Madison, Madison, WI, United States
| | - Alicia I Arbaje
- Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Andrea Gilmore-Bykovskyi
- BerbeeWalsh Department of Emergency Medicine, University of Wisconsin-Madison, Madison, WI, United States
| | - Nicole Werner
- Department of Design & Wellness, Indiana University, Bloomington, IN, United States
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Minatto G, Silva KS, Bandeira ADS, Santos PCD, Sandreschi PF, Manta SW, da Silva JRM, Parente RCM, Barbosa Filho VC. National policies on physical activity from 64 countries with different economies: a scoping review with thematic analysis. Health Policy Plan 2023:7151565. [PMID: 37140245 DOI: 10.1093/heapol/czad024] [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: 07/15/2022] [Revised: 04/05/2023] [Accepted: 05/03/2023] [Indexed: 05/05/2023] Open
Abstract
In 2018, the World Health Organization (WHO) launched a Global Action Plan on Physical Activity (PA), which included 20 policy actions for creating active societies, environments, people, and systems The objective of this scoping review was to summarize the themes/contents of national PA policies/plans conforming to the WHO's proposals and the country's economy. This review followed PRISMA guidelines for scoping reviews. A systematic search of electronic databases (Web of Science, Medline/PubMed, LILACS, PsycINFO, Scopus, and SPORTDiscus) and 441 government documents/websites from 215 countries/territories was conducted (February 2021). Documents on national-level policies, published in English, Spanish, and Portuguese since 2000 were eligible. The information on content and structure was systematically extracted and summarized into dimensions WHO's: active societies, environments, people, and systems The search identified 888 article references and 586 potentially relevant documents. After screening, 84 policy documents from 64 countries were eligible. Most documents(n = 46) provided detailed PA policies/plans amid other health topics (e.g. noncommunicable diseases, named 'general documents'), and 38 were PA-specific. The content analysis merged 54 visions, 65 missions, 108 principles, 119 objectives, 53 priorities, 105 targets, 126 indicators, and 1780 actions/strategies from 38 PA-specific and 46 general documents. Among the PA-specific documents, the active system's dimension was the most contemplated in the principles(n = 43), priorities(n = 51), and action/strategies(n = 530) elements. At the same time, the objectives(n = 39), targets(n = 52), and indicators(n = 58) presented contents more frequently related to the active people dimension. For the general documents, all principles(n = 4), objectives(n = 14), and priorities(n = 7) were related to the dimension of active people, while target(n = 51), indicator(n = 53), and actions/strategies(n = 292) elements presented content related to all dimensions. The increase in countries with national PA policies/plans should be followed by improving the current ones because important dimensions seem to be not considered in these documents. This will facilitate a global PA agenda that considers the complexity and multidimensionality of PA promotion.
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Affiliation(s)
- Giseli Minatto
- Department of Physical Education, Federal University of Santa Catarina, Campus Universitario Reitor João David Ferreira Lima, Florianópolis, Santa Catarina CEP: 88040-900, Brazil
| | - Kelly Samara Silva
- Department of Physical Education, Federal University of Santa Catarina, Campus Universitario Reitor João David Ferreira Lima, Florianópolis, Santa Catarina CEP: 88040-900, Brazil
| | - Alexsandra da Silva Bandeira
- Department of Physical Education, Federal University of Santa Catarina, Campus Universitario Reitor João David Ferreira Lima, Florianópolis, Santa Catarina CEP: 88040-900, Brazil
| | - Priscila Cristina Dos Santos
- Department of Physical Education, Federal University of Santa Catarina, Campus Universitario Reitor João David Ferreira Lima, Florianópolis, Santa Catarina CEP: 88040-900, Brazil
| | - Paula Fabricio Sandreschi
- Department of Physical Education, Federal University of Santa Catarina, Campus Universitario Reitor João David Ferreira Lima, Florianópolis, Santa Catarina CEP: 88040-900, Brazil
| | - Sofia Wolker Manta
- General Coordination of Physical Activity Promotion and Intersectoral Actions, Health Promotion Department, Secretariat of Primary Health Care, Ministry of Health of Brazil, Esplanada dos Ministérios, Bloco G, CEP: 70058-900, Brasília, Distrito Federal, Brazil
| | - Juliana Rezende Melo da Silva
- Health Promotion Department, Secretariat of Primary Health Care, Ministry of Health of Brazil, Esplanada dos Ministérios, Bloco G, Brasília, Distrito Federal CEP: 70058-900, Brazil
| | - Raphael Câmara Medeiros Parente
- Secretariat of Primary Health Care, Ministry of Health of Brazil, Esplanada dos Ministérios, Bloco G, Brasília, Distrito Federal CEP: 70058-900, Brazil
| | - Valter Cordeiro Barbosa Filho
- Federal Institute of Ceara-Campus Aracati, Rodovia CE-040, Km 137,1 s/n Aeroporto-Conj. Hab. Dr. Abelardo Filho, Ceará CEP: 62800-000, Brazil
- Postgraduate Program in Public Health, State University of Ceará, Avenida Dr. Silas Munguba, 1700, Campus do Itaperi, Fortaleza, Ceará CEP: 60714-903, Brazil
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Borg J, Winberg M, Eide AH, Calvo I, Khasnabis C, Zhang W. On the Relation between Assistive Technology System Elements and Access to Assistive Products Based on 20 Country Surveys. Healthcare (Basel) 2023; 11:1313. [PMID: 37174855 PMCID: PMC10178385 DOI: 10.3390/healthcare11091313] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 03/15/2023] [Revised: 04/28/2023] [Accepted: 04/30/2023] [Indexed: 05/15/2023] Open
Abstract
The objective of this study was to explore the relationship between assistive technology system elements and access to assistive products. Data on assistive technology system elements and self-reported survey data on access to assistive products from 20 countries were analyzed using multivariate statistical methods, including orthogonal partial least squares analyses. Access to assistive products was primarily associated with the geographic coverage of assistive technology services in a country, followed by system elements related to policy and personnel. To achieve universal access to assistive technology, geographic coverage of assistive technology services is an instrumental system element. However, it requires the implementation of appropriate policies along with sufficient funding, recruitment of adequately trained personnel, and availability of assistive products in need.
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Affiliation(s)
- Johan Borg
- School of Health and Welfare, Dalarna University, 79131 Falun, Sweden
| | - Mikael Winberg
- Department of Science and Mathematics Education, Umeå University, 90187 Umeå, Sweden;
| | - Arne H. Eide
- Department of Health Research, SINTEF Digital, 0373 Oslo, Norway;
| | - Irene Calvo
- Assistive Technology Access Team, Health Product Policy and Standards Department, World Health Organization, 1211 Geneva, Switzerland; (I.C.); (C.K.); (W.Z.)
| | - Chapal Khasnabis
- Assistive Technology Access Team, Health Product Policy and Standards Department, World Health Organization, 1211 Geneva, Switzerland; (I.C.); (C.K.); (W.Z.)
| | - Wei Zhang
- Assistive Technology Access Team, Health Product Policy and Standards Department, World Health Organization, 1211 Geneva, Switzerland; (I.C.); (C.K.); (W.Z.)
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Berg AC, Padilla HM, Sanders CE, Garner CT, Southall HG, Holmes G, Ashley S, Crosson L, Twilley B, Everson DD, Hubbard R, Brown CS, Lamm AJ, Johnson LP, Davis M. Community Gardens: A Catalyst for Community Change. Health Promot Pract 2023; 24:92S-107S. [PMID: 36999494 DOI: 10.1177/15248399221120808] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/01/2023]
Abstract
Community gardens are increasing in popularity and are associated with extensive physical and mental health benefits, increased access to fresh produce, and increased social connections. However, evidence is primarily from research in urban and school settings, and little is known about the role of community gardens in rural settings as part of policy, systems, and environmental (PSE) changes to promote health. This study explores the implementation of community gardens as part of an obesity prevention project, titled Healthier Together (HT), in five rural Georgia counties with limited food access and high obesity prevalence (>40%) using a mixed-methods research design that included data from project records, a community survey, interviews, and focus groups with county coalition members. Nineteen community gardens were implemented across five counties, 89% distributed produce direct to consumers, and 50% were integrated into the food system. Few (8.3%) of the survey respondents (n = 265) identified gardens as a food source, but 21.9% reported using an HT garden in the past year. Themes emerging from interviews (n = 39) and five focus groups suggested community gardens were a catalyst for broader community health change by increasing awareness of the value and absence of healthy food and generating excitement for future PSE initiatives to more comprehensively address food and physical activity access. Practitioners should consider placement of rural community gardens to optimize access to and distribution of produce as well as communication and marketing strategies to increase engagement and leverage gardens as gateways for PSE approaches to improve rural health.
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Lavinghouze SR, O’Toole TP, Petersen R. The Key to Pivoting and Adapting: Networked Partnerships, Long-Standing Relationships, and Functioning Program Infrastructure. Health Promot Pract 2023; 24:5S-9S. [PMID: 36707934 PMCID: PMC10947766 DOI: 10.1177/15248399221150781] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
| | | | - Ruth Petersen
- Centers for Disease Control and Prevention, Atlanta, GA, USA
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Abstract
Policy Points Hospital executives posit a number of rationales for system mergers which lack any basis in academic evidence. Decades of academic research question whether system combinations confer public benefits. Antitrust authorities need to continue to closely scrutinize these transactions. Recently, mergers of hospital systems that span different geographic markets are on the rise. Economists have alerted policymakers about the potential impacts such cross-market mergers may have on hospital prices. We suggest there are other reasons for concern that scholars have not often confonted. Cross-market mergers may be conducted for purely self-serving reasons of organizational growth that increases executive compensation. Combinations of sellers should have clear advantages to consumers. System executives and their boards should bear the burden of proof. Federal regulators and state attorney generals should be cognizant that rationales for cross-market systems advanced by merging parties are unlikely to be operative or dominant in merger decision making. Policymakers should be careful about passing legislation that encourages hospitals to consolidate. CONTEXT There is a growing trend of combinations among hospital systems that operate in different geographic markets known as cross-market mergers. Economists have analyzed these broader systems in terms of their anticompetitive behavior and pricing power over insurers. This paper evaluates the benefits advanced by these new hospital systems that speak to a different set of issues not usually studied: increased efficiencies, new capabilities, operating synergies, and addressing health inequities. The paper thus "looks under the hood" of these emerging, cross-market systems to assess what value they might bestow and upon whom. METHODS The paper examines recently announced cross-market mergers in terms of their supposed benefits, as expressed by the systems' executives as well as by industry consultants. These presumed benefits are then evaluated against existing evidence regarding hospital system outcomes. FINDINGS Advocates of cross-market hospital mergers cite a host of benefits. Research suggests these benefits are nonexistent. Additional evidence suggests other motives may be at play in the formation of cross-market mergers that have nothing to do with efficiencies, synergies, or community benefits. Instead these mergers may be self-serving efforts by system chief executive officers (CEOs) to boost their compensation. CONCLUSIONS Cross-market hospital mergers may yield no benefits to the hospitals involved or the communities in which they operate. The boards of hospital systems that engage in these cross-market mergers need to exercise greater diligence over the actions of their CEOs.
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Williams MD, Gupta V, Chan EY, Olaitan O. Perspectives on Donor-Derived Cell-Free DNA in Kidney Transplant Recipients with Systemic Lupus Erythematosus. Prog Transplant 2023; 33:182-183. [PMID: 36974516 DOI: 10.1177/15269248231164175] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Affiliation(s)
- Michael D Williams
- Division of Abdominal Transplant, Department of Surgery, 2468Rush University Medical Center, Chicago, IL, USA
| | - Vineet Gupta
- Department of Internal Medicine, Rush University Medical Center, Drug Discovery Center, Chicago, IL, USA
| | - Edie Y Chan
- Division of Abdominal Transplant, Department of Surgery, 2468Rush University Medical Center, Chicago, IL, USA
| | - Oyedolamu Olaitan
- Division of Abdominal Transplant, Department of Surgery, 2468Rush University Medical Center, Chicago, IL, USA
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Nonterah CW, Utsey SO, Gupta G, Wilkins S, Gardiner HM. A Nominal Group Technique Study of Patients Who Identify as Black or African American and Access to Renal Transplantation. Prog Transplant 2023; 33:141-149. [PMID: 36938608 DOI: 10.1177/15269248231164164] [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] [Indexed: 03/21/2023]
Abstract
Introduction: Completion of the renal transplant evaluation has been associated with several barriers for patients who identify as Black or African American. This study sought to prioritize barriers to and motivators of completing the renal transplant evaluation. Methods/Approach: Semi-structured interviews and focus groups with a nominal group technique were used to generate priority scores. Transplant professionals (N = 23) were recruited from 9 transplant centers in the Mid-Atlantic, Mid-Western, and Southeastern parts of the United States. Black or African American identifying renal patients (N = 30) diagnosed with end-stage kidney disease were recruited from 1 transplant center in the Mid-Atlantic region. Findings: Priority scores were created to assess the quantitative data of participant rankings of top barriers and motivators. The most significant barriers identified by both patients and transplant professionals comprised financial constraints, insurance issues, difficulty navigating the healthcare system, transportation difficulties, and multiple health problems. Facilitators consisted of family/social support, transplant education, patient navigators, comprehensive insurance, and physician repertoire and investment. A qualitative description of the ranked factors resulted in themes classified as intrapersonal, health, socioeconomic, transplant-specific healthcare, and general healthcare. Conclusion: These findings provided vital information to transplant centers nationwide about assessing the influences of renal transplant evaluation completion. Achieving equity in access to transplantation for Black or African American renal patients requires multilayered approaches.
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Affiliation(s)
- Camilla W Nonterah
- Department of Psychology, 6888University of Richmond, Richmond, VA, USA.,Department of Psychiatry, Virginia Commonwealth University, School of Medicine, Richmond, VA, USA
| | - Shawn O Utsey
- Department of Psychology, 6889Virginia Commonwealth University, Richmond, VA, USA
| | - Gaurav Gupta
- Department of Internal Medicine, Division of Nephrology, Virginia Commonwealth University, School of Medicine, Richmond, VA, USA
| | - Sawyer Wilkins
- Department of Psychology, 6889Virginia Commonwealth University, Richmond, VA, USA
| | - Heather M Gardiner
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, USA
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Hinkelman K, Yang Y, Zuo W. Design methodologies and engineering applications for ecosystem biomimicry: an interdisciplinary review spanning cyber, physical, and cyber-physical systems. Bioinspir Biomim 2023; 18:021001. [PMID: 36669206 DOI: 10.1088/1748-3190/acb520] [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: 09/09/2022] [Accepted: 01/20/2023] [Indexed: 06/17/2023]
Abstract
Ecosystem biomimicry is a promising pathway for sustainable development. However, while typical form- and process-level biomimicry is prevalent, system-level ecosystem biomimicry remains a nascent practice in numerous engineering fields. This critical review takes an interdisciplinary approach to synthesize trends across case studies, evaluate design methodologies, and identify future opportunities when applying ecosystem biomimicry to engineering practices, including cyber systems (CS), physical systems (PS), and cyber-physical systems (CPS). After systematically sourcing publications from major databases, the papers were first analyzed at a meta level for their bibliographic context and for statistical correlations among categorical variables. Then, we investigated deeper into the engineering applications and design methodologies. Results indicate that CPS most frequently mimic organisms and ecosystems, while CS and PS frequently mimic populations-communities and molecules-tissues-organ systems, respectively (statistically highly significant). An indirect approach is most often used for mimicry at organizational levels from populations to ecosystems, while a direct approach frequently suits levels from molecules to organisms (highly significant). Dominant themes across engineering applications include symbiotic organism search algorithms for CS and ecological network analysis for CPS, while PS are highly diverse. For design methodologies, this work summarizes and details ten well-documented biomimetic process models among literature, which addresses an outdated concern for a lack of systematic methods for ecosystem biomimicry. In addition to the Biomimetics Standard ISO 18458, these methods include the Natural Step and Techno-Ecological Synergy framework, among others. Further, the analyses revealed future opportunities from less utilized design methods (e.g. interdisciplinary teams tackling indirect, ecosystem-level projects) to well-established engineering concepts ready for technological advancement (e.g. implementing membrane computing for physical applications). For future studies, this review provides a comprehensive reference for ecosystem biomimetic design practices and application opportunities across multiple engineering domains.
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Affiliation(s)
- Kathryn Hinkelman
- Architectural Engineering, Pennsylvania State University, University Park, PA 16802, United States of America
| | - Yizhi Yang
- Architectural Engineering, Pennsylvania State University, University Park, PA 16802, United States of America
| | - Wangda Zuo
- Architectural Engineering, Pennsylvania State University, University Park, PA 16802, United States of America
- National Renewable Energy Laboratory, Golden, CO 80401, United States of America
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Weissensteiner JR. The global evolution of talent promotion within Olympic sports: A focus on the national systems and contribution of the former German Democratic Republic, Australia, and the United Kingdom. Front Sports Act Living 2023; 4:1124234. [PMID: 36819734 PMCID: PMC9934925 DOI: 10.3389/fspor.2022.1124234] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 12/30/2022] [Indexed: 02/05/2023] Open
Abstract
In this chapter we chronicle and explore the global evolution of national level talent promotion through the lens and respective journeys of the former German Democratic Republic, Australia and the United Kingdom. Whilst ideologically vastly different, core elements of talent promotion were mirrored and extended within the next national iteration. Key learnings obtained from this historical and comparative exploration serve to provide excellent learnings for policy makers, strategists, practitioners and researchers to support the review and development of current and future national talent promotion systems.
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Abstract
The impact of the COVID-19 pandemic on adolescents is significant. Educational progress and mental health, in particular, have been negatively affected. Among youth from vulnerable communities, pre-existing academic and health disparities have been exacerbated. Youth outcomes are often attributed to individual resilience - or lack thereof; in this paper, we describe how failure to adapt and effectively cope at the system level (ie, lack of system resilience) is implicated in the current dual educational and mental crisis. We describe opportunities to make our systems more nimble and better-equipped to support youth moving forward.
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Affiliation(s)
- Erum Nadeem
- Graduate School of Applied and Professional Psychology, Rutgers University, USA
| | - Anna R Van Meter
- Department of Child and Adolescent Psychiatry, New York University Grossman School of Medicine, USA
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Mumford EL, Martinez DJ, Tyance-Hassell K, Cook A, Hansen GR, Labonté R, Mazet JAK, Mumford EC, Rizzo DM, Togami E, Vreedzaam A, Parrish-Sprowl J. Evolution and expansion of the One Health approach to promote sustainable and resilient health and well-being: A call to action. Front Public Health 2023; 10:1056459. [PMID: 36711411 PMCID: PMC9880335 DOI: 10.3389/fpubh.2022.1056459] [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: 09/28/2022] [Accepted: 12/21/2022] [Indexed: 01/15/2023] Open
Abstract
One Health is a transdisciplinary approach used to address complex concerns related to human, animal, plant, and ecosystem health. One Health frameworks and operational tools are available to support countries and communities, particularly for the prevention and control of zoonotic diseases and antimicrobial resistance and the protection of food safety. However, One Health has yet to be implemented in a manner that fully considers the complexities and interconnectedness of the diverse influences that have impacts at a larger system level. This lack of consideration can undermine the sustainability of any positive outcomes. To ensure the One Health approach can function effectively within the new global context of converging and escalating health, social, economic, and ecological crises, it must evolve and expand in three overlapping dimensions: (1) Scope: the partners, knowledge, and knowledge systems included, (2) Approach: the techniques, methodologies, and scholarship considered, and (3) Worldview inclusivity: the interweaving of other worldviews together with the mainstream scientific worldview that currently predominates. Diverse partners and knowledge from outside the mainstream health and scientific sectors, including Indigenous peoples and representatives of local communities, and traditionally generated knowledge, must be included. These systems of knowledge can then be braided together with mainstream science to comprise a holistic framework for decision-making. Scholarship and methodologies being applied in other fields and contexts to solve complex challenges and manage uncertainty, such as collaborative governance, social-ecologic systems theory, and complexity science, must be recognized and incorporated. The spectrum of considered worldviews must also expand to authentically integrate the expanded scope and approach into action and sustainable impact. By increasing community and social engagement and by recognizing and entwining different worldviews, the plurality of disciplines, and traditional and scientific ways of knowing to address community concerns in the contexts in which they exist, we can ensure that One Health remains effective and true to its paradigm in our rapidly changing and complex world.
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Affiliation(s)
- Elizabeth L. Mumford
- School of Veterinary Medicine, University of Surrey, Guildford, United Kingdom,*Correspondence: Elizabeth L. Mumford ✉
| | - Deniss J. Martinez
- Graduate Group in Ecology, University of California, Davis, Davis, CA, United States
| | - Karli Tyance-Hassell
- (Anishinaabe) Office of Research and Community Engagement, Alaska Pacific University, Anchorage, AK, United States
| | - Alasdair Cook
- Department of Veterinary Epidemiology and Public Health, University of Surrey, Guildford, United Kingdom
| | | | - Ronald Labonté
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Jonna A. K. Mazet
- Grand Challenges, University of California, Davis, Davis, CA, United States
| | | | - David M. Rizzo
- Department of Plant Pathology, University of California, Davis, Davis, CA, United States
| | - Eri Togami
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | | | - John Parrish-Sprowl
- Department of Communication Studies, Indiana University, Indianapolis, IN, United States
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Lacy-Nichols J, Jones A, Buse K. Taking on the Commercial Determinants of Health at the level of actors, practices and systems. Front Public Health 2023; 10:981039. [PMID: 36703840 PMCID: PMC9872788 DOI: 10.3389/fpubh.2022.981039] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 11/24/2022] [Indexed: 01/06/2023] Open
Abstract
Tackling the Commercial Determinants of Health (CDoH) is necessary for progress on health equity and will determine whether or not the health-related targets of the SDGs are met. We present a simple visual heuristic of three core aspects of CDoH: commercial actors, commercial practices, and system-level dynamics (which commercial actors influence and perpetuate). We use this heuristic to highlight key research gaps, in particular the need for more voices and evidence on CDoH from the Global South, particularly on what works to curb harmful impacts. We also propose an agenda to address CDoH and actions for different stakeholders. While efforts to curb specific commercial practices are important, far more attention and effort are needed at the systems level, as they can fundamentally shift the way power is distributed in society to improve health equity.
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Affiliation(s)
- Jennifer Lacy-Nichols
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
| | - Alexandra Jones
- The George Institute for Global Health, Sydney, NSW, Australia
| | - Kent Buse
- The George Institute for Global Health, Imperial College, London, United Kingdom
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Francia L, Lam T, Berg A, Morgan K, Savic M, Lubman DI, Nielsen S. Putting out the welcome mat-A qualitative exploration of service delivery processes and procedures as barriers to treatment-seeking for people who use alcohol and other drugs. Drug Alcohol Rev 2023; 42:193-202. [PMID: 36169553 PMCID: PMC10947049 DOI: 10.1111/dar.13551] [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: 03/24/2022] [Revised: 08/26/2022] [Accepted: 08/30/2022] [Indexed: 01/10/2023]
Abstract
INTRODUCTION There are a range of models and structures that determine features of alcohol and other drug treatment. Despite some structures being long-established, less is known about how specific aspects of service delivery impact treatment-seeking for people who use alcohol and other drugs. This Australian qualitative study explored both people with lived experience of problematic alcohol and other drug use, and health care staff's experiences of service delivery. METHODS Thirty-nine semi-structured interviews with people with lived experience and staff from either alcohol and other drug specialist, or broader health-care services, explored experiences of service delivery processes and procedures. Transcripts were thematically analysed and guided by a broad interest in barriers to treatment-seeking. RESULTS Within alcohol and other drug specialist services (i) time spent on wait lists; and (ii) poor implementation of assessment processes were identified barriers to treatment-seeking and engagement. Within broader health-care services (i) organisational expectations around behaviour and engagement; (ii) alcohol and other drugs viewed as separate to service role; and (iii) limited opportunities to informally engage were identified barriers to treatment-seeking. DISCUSSION AND CONCLUSIONS Results suggest opportunities to engage and undertake needs-based care planning are yet to be fully realised, particularly at the intake and assessment stages of alcohol and other drug service delivery; with frequent reassessment resulting in people repeatedly recounting traumatic experiences, often to different people, only to be placed back on wait lists with no support. Within broader health-care services aspects of service delivery may perpetuate stigma that places such people outside the purview of health care.
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Affiliation(s)
- Leanne Francia
- Monash Addiction Research Centre, Eastern Health Clinical SchoolMonash UniversityMelbourneAustralia
| | - Tina Lam
- Monash Addiction Research Centre, Eastern Health Clinical SchoolMonash UniversityMelbourneAustralia
| | - Amelia Berg
- Association of Participating Services UsersSelf Help Addiction Resource CentreMelbourneAustralia
| | | | - Michael Savic
- Turning PointEastern Health Clinical SchoolMelbourneAustralia
- Monash UniversityMelbourneAustralia
| | - Dan I. Lubman
- Turning PointEastern Health Clinical SchoolMelbourneAustralia
- Monash UniversityMelbourneAustralia
| | - Suzanne Nielsen
- Monash Addiction Research Centre, Eastern Health Clinical SchoolMonash UniversityMelbourneAustralia
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Bredesen DE, Toups K, Hathaway A, Gordon D, Chung H, Raji C, Boyd A, Hill BD, Hausman-Cohen S, Attarha M, Chwa WJ, Kurakin A, Jarrett M. Precision Medicine Approach to Alzheimer's Disease: Rationale and Implications. J Alzheimers Dis 2023; 96:429-437. [PMID: 37807782 PMCID: PMC10741308 DOI: 10.3233/jad-230467] [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] [Accepted: 08/28/2023] [Indexed: 10/10/2023]
Abstract
The neurodegenerative disease field has enjoyed extremely limited success in the development of effective therapeutics. One potential reason is the lack of disease models that yield accurate predictions and optimal therapeutic targets. Standard clinical trials have pre-determined a single treatment modality, which may be unrelated to the primary drivers of neurodegeneration. Recent proof-of-concept clinical trials using a precision medicine approach suggest a new model of Alzheimer's disease (AD) as a chronic innate encephalitis that creates a network insufficiency. Identifying and addressing the multiple potential contributors to cognitive decline for each patient may represent a more effective strategy. Here we review the rationale for a precision medicine approach in prevention and treatment of cognitive decline associated with AD. Results and implications from recent proof-of-concept clinical trials are presented. Randomized controlled trials, with much larger patient numbers, are likely to be significant to establishing precision medicine protocols as a standard of care for prevention and treatment of cognitive decline. Furthermore, combining this approach with the pharmaceutical approach offers the potential for enhanced outcomes. However, incorporating precision medicine approaches into everyday evaluation and care, as well as future clinical trials, would require fundamental changes in trial design, IRB considerations, funding considerations, laboratory evaluation, personalized treatment plans, treatment teams, and ultimately in reimbursement guidelines. Nonetheless, precision medicine approaches to AD, based on a novel model of AD pathophysiology, offer promise that has not been realized to date with monotherapeutic approaches.
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Affiliation(s)
- Dale E. Bredesen
- Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - Kat Toups
- Bay Area Wellness, Walnut Creek, CA, USA
| | | | | | | | - Cyrus Raji
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Alan Boyd
- CNS Vital Signs, Morrisville, NC, USA
| | - Benjamin D. Hill
- Department of Psychology, University of South Alabama, Mobile, AL, USA
| | | | | | - Won Jong Chwa
- Department of Radiology, St. Louis University, St. Louis, MO, USA
| | - Alexei Kurakin
- Department of Neurology, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
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Fomenkov A, Weigele P, McClung C, Madinger C, Roberts RJ. Complete genome assembly and methylome dissection of Methanococcus aeolicus PL15/H p. Front Microbiol 2023; 14:1112734. [PMID: 37089567 PMCID: PMC10113651 DOI: 10.3389/fmicb.2023.1112734] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 03/21/2023] [Indexed: 04/25/2023] Open
Abstract
Although restriction-modification systems are found in both Eubacterial and Archaeal kingdoms, comparatively less is known about patterns of DNA methylation and genome defense systems in archaea. Here we report the complete closed genome sequence and methylome analysis of Methanococcus aeolicus PL15/H p , a strain of the CO2-reducing methanogenic archaeon and a commercial source for MaeI, MaeII, and MaeIII restriction endonucleases. The M. aeolicus PL15/H p genome consists of a 1.68 megabase circular chromosome predicted to contain 1,615 protein coding genes and 38 tRNAs. A combination of methylome sequencing, homology-based genome annotation, and recombinant gene expression identified five restriction-modification systems encoded by this organism, including the methyltransferase and site-specific endonuclease of MaeIII. The MaeIII restriction endonuclease was recombinantly expressed, purified and shown to have site-specific DNA cleavage activity in vitro.
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Jenkins CL, Wills J, Sykes S. Settings for the development of health literacy: A conceptual review. Front Public Health 2023; 11:1105640. [PMID: 36875396 PMCID: PMC9978221 DOI: 10.3389/fpubh.2023.1105640] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 01/31/2023] [Indexed: 02/18/2023] Open
Abstract
Advances in conceptualizing settings in health promotion include understanding settings as complex and interlinked systems with a core commitment to health and related outcomes such as health literacy. Traditional settings for the development of health literacy include health care environments and schools. There is a need to identify and conceptualize non-traditional and emerging settings of twenty-first-century everyday life. The aim of this conceptual review is to inform a conceptual model of a "non-traditional" setting for the development of health literacy. The model uses the example of the public library to propose four equity-focused antecedents required in a setting for the development of health literacy: the setting acknowledges the wider determinants of health, is open access, involves local communities in how it is run, and facilitates informed action for health. The review concludes that a settings approach to the development of health literacy can be conceptualized as part of a coordinated "supersetting approach," where multiple settings work in synergy with each other.
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Affiliation(s)
- Catherine L Jenkins
- Institute of Health and Social Care, London South Bank University, London, United Kingdom
| | - Jane Wills
- Institute of Health and Social Care, London South Bank University, London, United Kingdom
| | - Susie Sykes
- Institute of Health and Social Care, London South Bank University, London, United Kingdom
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McCabe M, Dokus MK, Ryan NJ, Shi H, James A, Meadow ME, Dolan JG, Veazie P, Judge S, Orloff M, McIntosh S, Kashyap R. Assessing the Effectiveness of a Primary Care Provider Office-Based Intervention for Increasing Organ Donor Registration Rates in Two New York State Counties. Prog Transplant 2022; 32:292-299. [PMID: 36039516 DOI: 10.1177/15269248221122885] [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] [Indexed: 12/29/2022]
Abstract
Introduction: Despite strong public support, organ donor registration rates (RR) continue to lag while need only grows. In the United States, the traditional registration site is the Department of Motor Vehicles (DMV), however Primary care provider (PCP) offices have been considered as alternate locations for increasing RR. Methods: Twelve PCP offices across 2 New York Counties were subjected to a control week where participants received only a registration opportunity and an intervention week with the addition of a motivational poster and informational brochure. Zip code level sociodemographic data were obtained for each site. RR from the DMV over the same period served as historical control. Results: There were 1292 participants in the control phase and 1099 in the experimental phase. New registration rate for the control was 33.8% (289/897); experimental phase 7.88% (61/769); DMV registration 21.02% (1902/9050). The intervention was associated with a significant decrease in registrations (OR 0.181 (95% CI 0.135-0.244, P < 0.001)). Offices were clustered based on sociodemographic factors and regressed in 2 clusters. Lower educational attainment was associated with lower registration in the first but not second cluster (OR = 0.948 (0.923-0.974, P < 0.001)). Conclusions: This study provided evidence that PCP offices were a feasible site for organ donor registration and calls into question the efficacy of written materials-only interventions for increasing organ donor RR. It reiterated the negative effect of lower educational attainment on registration and suggested future studies focus on more active methods of engagement.
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Affiliation(s)
- Michael McCabe
- University of Rochester, School of Medicine and Dentistry, Rochester NY, USA
| | - M Katherine Dokus
- Department of Surgery, Univesrity of Rochester Medical Center, , Rochester, NY, USA
| | - Nancy J Ryan
- Finger Lakes Donor Recovery Network, Rochester NY, USA
| | - Hangchuan Shi
- University of Rochester, School of Medicine and Dentistry, Rochester NY, USA
| | - Amy James
- Finger Lakes Donor Recovery Network, Rochester NY, USA
| | - Michael E Meadow
- University of Rochester, School of Medicine and Dentistry, Rochester NY, USA
| | - James G Dolan
- Department of Public Health Sciences, 12299University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Peter Veazie
- Department of Public Health Sciences, 12299University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Stephen Judge
- 227713Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Mark Orloff
- Department of Surgery, Univesrity of Rochester Medical Center, , Rochester, NY, USA
| | - Scott McIntosh
- Department of Public Health Sciences, 12299University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Randeep Kashyap
- Department of Surgery, Univesrity of Rochester Medical Center, , Rochester, NY, USA
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Williams MD, Olaitan O. Opportunities to Improve Outcomes of Graft-Versus-Host Disease in Solid Organ Transplantation. Prog Transplant 2022; 32:370-371. [PMID: 36039528 DOI: 10.1177/15269248221122866] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Michael D Williams
- Department of Surgery University Transplant Program, 2468Rush University Medical Center, Chicago, IL, USA
| | - Oyedolamu Olaitan
- Department of Surgery University Transplant Program, 2468Rush University Medical Center, Chicago, IL, USA
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Cable J, Arlotta P, Parker KK, Hughes AJ, Goodwin K, Mummery CL, Kamm RD, Engle SJ, Tagle DA, Boj SF, Stanton AE, Morishita Y, Kemp ML, Norfleet DA, May EE, Lu A, Bashir R, Feinberg AW, Hull SM, Gonzalez AL, Blatchley MR, Montserrat Pulido N, Morizane R, McDevitt TC, Mishra D, Mulero-Russe A. Engineering multicellular living systems-a Keystone Symposia report. Ann N Y Acad Sci 2022; 1518:183-195. [PMID: 36177947 PMCID: PMC9771928 DOI: 10.1111/nyas.14896] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The ability to engineer complex multicellular systems has enormous potential to inform our understanding of biological processes and disease and alter the drug development process. Engineering living systems to emulate natural processes or to incorporate new functions relies on a detailed understanding of the biochemical, mechanical, and other cues between cells and between cells and their environment that result in the coordinated action of multicellular systems. On April 3-6, 2022, experts in the field met at the Keystone symposium "Engineering Multicellular Living Systems" to discuss recent advances in understanding how cells cooperate within a multicellular system, as well as recent efforts to engineer systems like organ-on-a-chip models, biological robots, and organoids. Given the similarities and common themes, this meeting was held in conjunction with the symposium "Organoids as Tools for Fundamental Discovery and Translation".
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Affiliation(s)
| | - Paola Arlotta
- Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, Massachusetts, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | - Kevin Kit Parker
- Wyss Institute for Biologically Inspired Engineering and John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, Massachusetts, USA
- Harvard Stem Cell Institute, Harvard University, Cambridge, Massachusetts, USA
| | - Alex J Hughes
- Department of Bioengineering, School of Engineering and Applied Science and Department of Cell and Developmental Biology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Katharine Goodwin
- Lewis-Sigler Institute for Integrative Genomics, Princeton University, Princeton, New Jersey, USA
| | - Christine L Mummery
- Department of Anatomy and Embryology and LUMC hiPSC Hotel, Leiden University Medical Center, Leiden, the Netherlands
| | - Roger D Kamm
- Department of Mechanical Engineering and Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Sandra J Engle
- Translational Biology, Biogen, Cambridge, Massachusetts, USA
| | - Danilo A Tagle
- National Center for Advancing Translational Sciences, National Institutes of Health, Bethesda, Maryland, USA
| | - Sylvia F Boj
- Hubrecht Organoid Technology (HUB), Utrecht, the Netherlands
| | - Alice E Stanton
- Department of Chemical Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Yoshihiro Morishita
- Laboratory for Developmental Morphogeometry, RIKEN Center for Biosystems Dynamics Research, Kobe, Japan
- Precursory Research for Embryonic Science and Technology (PRESTO) Program, Japan Science and Technology Agency, Kawaguchi, Japan
| | - Melissa L Kemp
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia, USA
| | - Dennis A Norfleet
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia, USA
| | - Elebeoba E May
- Department of Biomedical Engineering and HEALTH Research Institute, University of Houston, Houston, Texas, USA
- Wisconsin Institute of Discovery and Department of Medical Microbiology & Immunology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Aric Lu
- Wyss Institute for Biologically Inspired Engineering and John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, Massachusetts, USA
- Draper Laboratory, Biological Engineering Division, Cambridge, Massachusetts, USA
| | - Rashid Bashir
- Beckman Institute for Advanced Science and Technology, Urbana, Illinois, USA
- Holonyak Micro & Nanotechnology Laboratory, Department of Electrical and Computer Engineering and Department of Bioengineering, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - Adam W Feinberg
- Department of Biomedical Engineering and Department of Materials Science & Engineering, Carnegie Mellon University, Pittsburgh, Pennsylvania, USA
| | - Sarah M Hull
- Department of Chemical Engineering, Stanford University, Stanford, California, USA
| | - Anjelica L Gonzalez
- Department of Biomedical Engineering, Yale University, New Haven, Connecticut, USA
| | - Michael R Blatchley
- BioFrontiers Institute and Department of Chemical and Biological Engineering, University of Colorado Boulder, Boulder, Colorado, USA
| | | | - Ryuji Morizane
- Nephrology Division, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Todd C McDevitt
- The Gladstone Institutes and Department of Bioengineering and Therapeutic Sciences, University of California San Francisco, San Francisco, California, USA
| | - Deepak Mishra
- Department of Biological Engineering, Synthetic Biology Center, Cambridge, Massachusetts, USA
- Computer Science and Artificial Intelligence Laboratory, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Adriana Mulero-Russe
- Parker H. Petit Institute for Bioengineering and Bioscience and School of Chemical and Biomolecular Engineering, Georgia Institute of Technology, Atlanta, Georgia, USA
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Schommer JC, Gaither CA, Alvarez NA, Lee S, Shaughnessy AM, Arya V, Planas LG, Fadare O, Witry MJ. Pharmacy Workplace Wellbeing and Resilience: Themes Identified from a Hermeneutic Phenomenological Analysis with Future Recommendations. Pharmacy (Basel) 2022; 10:pharmacy10060158. [PMID: 36548314 PMCID: PMC9781627 DOI: 10.3390/pharmacy10060158] [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: 10/12/2022] [Revised: 11/12/2022] [Accepted: 11/17/2022] [Indexed: 11/24/2022] Open
Abstract
This study applied a hermeneutic phenomenological approach to better understand pharmacy workplace wellbeing and resilience using respondents' written comments along with a blend of the researchers' understanding of the phenomenon and the published literature. Our goal was to apply this understanding to recommendations for the pharmacy workforce and corresponding future research. Data were obtained from the 2021 APhA/NASPA National State-Based Pharmacy Workplace Survey, launched in the United States in April 2021. Promotion of the online survey to pharmacy personnel was accomplished through social media, email, and online periodicals. Responses continued to be received through the end of 2021. A data file containing 6973 responses was downloaded on 7 January 2022 for analysis. Usable responses were from those who wrote an in-depth comment detailing stories and experiences related to pharmacy workplace and resilience. There were 614 respondents who wrote such comments. The findings revealed that business models driven by mechanized assembly line processes, business metrics that supersede patient outcomes, and reduction of pharmacy personnel's professional judgement have contributed to the decline in the experience of providing patient care in today's health systems. The portrait of respondents' lived experiences regarding pharmacy workplace wellbeing and resilience was beyond the individual level and revealed the need for systems change. We propose several areas for expanded inquiry in this domain: (1) shared trauma, (2) professional responsibility and autonomy, (3) learned subjection, (4) moral injury and moral distress, (5) sociocultural effects, and (6) health systems change.
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Affiliation(s)
- Jon C. Schommer
- Department of Pharmaceutical Care & Health Systems (PCHS), College of Pharmacy, University of Minnesota, 308 Harvard Street SE, Minneapolis, MN 55455, USA
- Correspondence: ; Tel.: +1-612-626-9915
| | - Caroline A. Gaither
- Department of Pharmaceutical Care & Health Systems (PCHS), College of Pharmacy, University of Minnesota, 308 Harvard Street SE, Minneapolis, MN 55455, USA
| | - Nancy A. Alvarez
- R. Ken Coit College of Pharmacy–Phoenix, University of Arizona, 650 East Van Buren Street, Phoenix, AZ 85004, USA
| | - SuHak Lee
- Department of Pharmaceutical Care & Health Systems (PCHS), College of Pharmacy, University of Minnesota, 308 Harvard Street SE, Minneapolis, MN 55455, USA
| | - April M. Shaughnessy
- American Pharmacists Association, 2215 Constitution Avenue NW, Washington, DC 20037, USA
| | - Vibhuti Arya
- College of Pharmacy and Health Sciences, St. John’s University, 8000 Utopia Parkway, Queens, New York, NY 11439, USA
| | - Lourdes G. Planas
- College of Pharmacy, University of Oklahoma, 1110 N Stonewall, Room 243, Oklahoma City, OK 73117, USA
| | - Olajide Fadare
- College of Pharmacy, University of Iowa, 180 South Grand Avenue, Iowa City, IA 52242, USA
| | - Matthew J. Witry
- College of Pharmacy, University of Iowa, 180 South Grand Avenue, Iowa City, IA 52242, USA
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Qi Y, Ramström O. Polymerization, Stimuli-induced Depolymerization, and Precipitation-driven Macrocyclization in a Nitroaldol Reaction System. Chemistry 2022; 28:e202201863. [PMID: 35971799 PMCID: PMC9826525 DOI: 10.1002/chem.202201863] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Indexed: 01/11/2023]
Abstract
Dynamic covalent polymers of different topology have been synthesized from an aromatic dialdehyde and α,ω-dinitroalkanes via the nitroaldol reaction. All dinitroalkanes yielded dynamers with the dialdehyde, where the length of the dinitroalkane chain played a vital role in determining the structure of the final products. For longer dinitroalkanes, linear dynamers were produced, where the degree of polymerization reached a plateau at higher feed concentrations. In the reactions involving 1,4-dinitrobutane and 1,5-dinitropentane, specific macrocycles were formed through depolymerization of the linear chains, further driven by precipitation. At lower temperature, the same systemic self-sorting effect was also observed for the 1,6-dinitrohexane-based dynamers. Moreover, the dynamers showed a clear adaptive behavior, displaying depolymerization and rearrangement of the dynamer chains in response to alternative building blocks as external stimuli.
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Affiliation(s)
- Yunchuan Qi
- Department of ChemistryUniversity of Massachusetts LowellOne University Ave.LowellMA 01854USA
| | - Olof Ramström
- Department of ChemistryUniversity of Massachusetts LowellOne University Ave.LowellMA 01854USA,Department of Chemistry and Biomedical SciencesLinnaeus UniversitySE-39182KalmarSweden
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Xun K, Cui J. Family-oriented practice in disability Services in Hong Kong: A cross-sectoral social work perspectives in the fields of intellectual disability and mental illness. Health Soc Care Community 2022; 30:e5714-e5724. [PMID: 36069289 PMCID: PMC10087483 DOI: 10.1111/hsc.14001] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 08/08/2022] [Accepted: 08/20/2022] [Indexed: 06/15/2023]
Abstract
Supporting the families of people with disabilities has become a crucial aim of disability services. In disability services, where people with disabilities are usually positioned at the centre of service provision, family-oriented practice implies practice directions to work with clients' families in service delivery. The study aims at exploring how social workers in intellectual disability services and mental health services deliver a family-oriented practice in Hong Kong. We performed a qualitative analysis, using in-depth interview data collected from two broader studies about social workers' experiences in the fields of intellectual disability and mental illness respectively. Thirteen participants in intellectual disability settings and another 13 participants in mental health settings shared their understanding of and concern with family-oriented practice. Four themes were identified in the participants' accounts regarding the importance of family connectedness, family members' constructions of clients' identity, the scope of activities and the intervention space between individual and family. These findings reflect that family-oriented practice was jointly shaped by clients' family systems and disability service system, and shed light on the strategies for future service development at the broader systematic level.
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Affiliation(s)
- Kangwei Xun
- Social Work and Social PolicySchool of Allied Health, Human Services and SportLa Trobe UniversityMelbourneVictoriaAustralia
- Living with Disability Research CentreLa Trobe UniversityMelbourneVictoriaAustralia
| | - Jialiang Cui
- Department of Social WorkThe Chinese University of Hong KongHong KongChina
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Seiler M, Crosier V, Vance J, O'Hara Tompkins N. Activating Worksites to Implement Policy, Systems, and Environmental Changes: Outcomes and Overcoming Challenges. Am J Health Promot 2022; 37:520-523. [PMID: 36271657 DOI: 10.1177/08901171221135593] [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] [Indexed: 11/16/2022]
Abstract
PURPOSE Although workplaces are prime settings for health promotion, little is known about the implementation of policy, systems, and environmental (PSE) changes focused on chronic disease. PSEs have broader reach and are more sustainable than individual level strategies. DESIGN non-experimental, one group design with no control.Setting: West Virginia, a state with significant chronic disease-related health disparities. SUBJECTS Convenience sample of 27 workplaces, representing 6 industry types. INTERVENTION $1000 in micro funding awarded to workplaces to participate in Centers for Disease Control and Prevention (CDC) Work@Health®/ScoreCard, and implement PSEs. MEASURES ScoreCard baseline results; post project survey results. ANALYSIS Descriptive analysis of ScoreCard; survey responses coded into PSE and I (individual level strategies) categories; frequencies were calculated. RESULTS 63% of the workplaces were very small (1-100 employees). Chronic disease-related organizational practices (ScoreCard) were minimal: nutrition (5/24), physical activity (7/22), diabetes (5/15), cholesterol (4/13), and high blood pressure (6/16). Workplaces reported a total of 95 PSEs: P-8, S-55, and E-32. CONCLUSION Policy change was the least frequently attempted and reported PSE strategy. More research with a stronger study design is needed to determine if (1) baseline organizational practices (Scorecard scores) improve, (2) PSEs (especially P) can be implemented without micro funding/TA, (3) workplace-type is related to use of the funds/TA, and (4) enacting PSE changes leads to healthier employees.
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Affiliation(s)
| | | | - James Vance
- Division of Health Promotion and Chronic Disease, 161119West Virginia Bureau for Public Health, Charleston, WV, USA
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