Health Care Science最新文献

The alarming state of global insulin access in low-resource settings presents a major barrier to diabetes care. A comprehensive review of these challenges is lacking at the global level. To address this weakness, enhance affordability and build capacity for a more sustainable approach to scaling up access. This review analyzes the specific issue of inconsistent access to insulin in low- and middle-income countries. Using this analysis, we mapped the scope and intensity of issues such as the unaffordability and unavailability of insulin. We also identified six innovative and integrative strategies for increasing and securing accessibility in the areas of policy making, marketing, clinical practice, health education, domestication, and multisectoral approaches.

Over the past several decades, significant scientific progress in xenotransplantation has brought the field to the threshold of clinical trials. In the past 3 years in the United States, experimental pig kidney and heart xenotransplantation have been performed on human subjects recently declared dead by neurological criteria (decedents). In addition, two pig heart transplants have been carried out in living patients under the United States Food and Drug Administration's expanded access guidelines. However, though there has been a flurry of activity there remain unanswered questions regarding how the public views xenotransplantation, what concerns may exist, and how to address these concerns in a meaningful way. This paper aims to underscore the importance of public engagement in xenotransplantation, emphasizing the ongoing need for studies to assess public opinions. The current evidence on public engagement studies is reviewed and gaps in our understanding are identified. We propose practical steps to advance this field. Additional studies to determine the extent of racial/ethnic differences in attitudes to xenotransplantation should be conducted. Empirical and descriptive analysis of certain religious viewpoints—especially minority faiths—would be valuable. As public engagement is an important aspect of public acceptance of novel research that is accompanied by risk, we suggest that xenotransplantation biotechnology companies might consider leading the way in funding this research.

A decade ago we asked the question, “Is there something in medicine that is eternal or enduring?” Our aim was to write a manuscript entitled, “That which does not change in medicine.” The publication begins as follows: “The practice of medicine involves continual change, driven by a constant stream of developments in the understanding of biological structure and function relevant to human diseases, and the parallel improvements in pharmacologic and other technological interventions. This change is also driven by evolving social philosophies, ethical trends, and lifestyles.” [1] That preamble reverberates as strongly now as then, perhaps even more so, given the velocity of technological change. When we deliberated on which aspects of medical practice should remain stable, we had few premonitions that implantable chips, robotic surgery, virtual reality, and artificial intelligence (AI) would soon become ubiquitous. The needle has clearly moved, propelled by extraordinary advances in bioengineering, computer and data sciences; major shifts in the governance and organization of clinical practice; and powerful sociocultural trends.

As we explore current transformative developments we are reminded of our earlier conclusions: that certain dimensions of medical practice are, indeed, immutable. Most importantly, the relationship between physician and patient depends on moral obligations, characterized by a compassionate response best described as clinical engagement [2]. The requisite virtues are affective as much as cognitive. The challenge for educators, physicians, and policymakers is to accommodate the benefits of transformational change, both technological and conceptual, whilst remaining true to the fundamental, dyadic clinical relationship. Thus, pedagogic change should welcome innovations but do so with restraint that is, with an attitudinal disposition that is neither cynical nor inhibitory but rather alert and mindful, especially when faced with announcements that a given innovation will solve the problems of an overburdened hospital system. By insisting on a cautious approach we may avoid the pendulum that swings too far, resulting in unintended consequences and costly backtracking to undo the damage of untrammeled enthusiasms.

We consider two illustrative innovations germane to healthcare delivery: one in medical education and one in technology. We try to anticipate and understand impacts and conclude by posing a set of questions that may be useful to those who manage systemic changes.

An innovation, unfolding in medical schools world-wide and often regarded as “transformative,” is competency-based medical education (CBME). We analyze this trend, relying on a hierarchy of knowledge as a frame of reference.

The historian Jill Lepore, using the metaphor of a filing cabinet with four drawers, proposed a categorization of knowledge [3]. Each drawer contains knowledge of a different

As we unveil the first issue of Health Care Science in 2024, it's a moment of reflection and anticipation. Under the astute guidance of our leadership and the collective wisdom of our distinguished Editorial Board Members, we've journeyed through an extraordinary year, marking significant milestones and embracing challenges with resilience and innovation. We believe our progress reflects not just a testament to our commitment but also an indication of our role in driving healthcare innovation and excellence.

International diversity: 2023, our journal emerged as a vibrant international academic platform, attracting manuscripts from 29 countries and regions. Focusing on technological innovation in healthcare services, we published six issues of 39 articles in 2023, reaching over 41,000 downloads from 166 countries and regions. This diversity is a clear indicator of our expanding global footprint and the trust the academic community places in us. The growth in our publications, alongside a dramatic increase in international manuscript submissions, highlights our journal's rising stature on the global healthcare community.

Impactful publications: 2023 saw us publishing groundbreaking work in the fields of healthcare management, healthcare policy, medical technology, and public health. We also delved into hot topics like xenotransplantation, gene editing, and the application of large language models in healthcare. Moreover, we published influential guides and research on technological responses to pandemics. These contributions include some of our most downloaded and cited articles since the launch of Health Care Science.

Milestone recognitions: The landmark achievements in 2023 were our inclusion in prestigious databases such as Scopus and the Directory of Open Access Journals (DOAJ), a recognition that came just a year after our launch. These inclusions are not just an honor but a responsibility to uphold the standards of scientific excellence and accessibility.

Key metrics of publication process: We are pleased to share some key metrics regarding our manuscript process. Our median time to first decision was 24 days and the median time to final decision stood at 37 days, demonstrating our commitment to providing timely feedback to authors while also reflecting our thorough review process. Overall, our acceptance rate in 2023 was 54%. For those articles accepted, the median time from acceptance to online publication was 46 days. We are actively optimizing our publication cycle to enhance efficiency, while firmly safeguarding the rigor of the peer review process. Our emerging Associate Editor (eAE) team, composed of 21 dynamic young talents in academia, has been instrumental in manuscript sourcing, reviewing, curated readings, and promotions, significantly contributing to our journal's success.

Goals for 2024: Looking ahead, we aim to streamline our editorial process whi