Dialogues in health最新文献

Background

Methods

Results

Conclusions

Purpose

Genomic sequencing has been an invaluable tool to determine the evolution of SARS-CoV-2. In the present study, we provided a comprehensive description of the SARS-CoV-2 variants circulated in the Philippines.

Methods

The dataset from the human COVID-19 infections was acquired by downloading the sequences and their associated metadata spanning from March 2020 to April 2024. Then, we executed several filtering criteria to acquire the final dataset for the Philippine samples and performed spatial distribution analysis and phylogenetic tree construction of the reported SARS-CoV-2 sequences.

Results

A total of 16,679,203 SARS-CoV sequences were obtained, of which 17,393 (0.10 %) were sampled in the Philippines. Western Visayas reported the highest SARS-CoV-2 sequences (21.33 %), while the Bangsamoro Autonomous Region in Muslim Mindanao reported the least (0.48 %). The phylogenetic tree revealed the evolution of the detected SARS-CoV-2 variants circulating in the Philippines with 19 A as the first reported case (based on the GISAID submission), and 24 A (JN.1) as the currently circulating variant. Omicron variants have dominated the Philippines with 21 L (Omicron, BA.2) having 5102 cases (29.33 %), followed by 22B (BA.5) having 2184 cases (12.57 %). Using Pearson's Chi-square test of independence, we showed that there is a significant association between the age-groups and gender with the detection years.

Conclusion

Altogether, this analysis showed the updated epidemiological trends of the reported SARS-CoV-2 variants in the Philippines. This increases the importance of conducting surveillance on viral infectious diseases such as COVID-19 to provide the scope and trajectory of viral spread in a country.

Introduction

The COVID-19 pandemic had devastating effects on health systems globally. Emerging infectious diseases and pandemics will persist as a global health threat and preparedness for an evidence based response becomes challenging for decision makers. Epidemiological modeling can and has supported decision-making throughout pandemics. This study provides an update of the review “Publicly available software tools for decision-makers during an emergent epidemic—Systematic evaluation of utility and usability”^1.

Research question

What epidemiological modeling tools for decision-makers are open-sourced available for the usage in emerging epidemics or pandemics and how useful and user-friendly are these tools?

Methods

A scoping review was conducted. We identified relevant studies through a search of peer-reviewed (Medline Ovid, Embase Ovid, PubMed, Cochrane) and gray literature databases, search engines such as Google, searches through stakeholder websites as well as expert consultations.

Results

Of the 66 identified epidemiological modeling tools, 29 were included and qualitatively assessed using five-point-rating scales. The tools showed a good baseline of user-friendliness with variations in assessed components, features and utility. Room for improvement was found, specifically the capability to incorporate external data sources, detailed population descriptions, and geographic resolution.

Discussion

Development efforts should prioritize clear communication of uncertainties and expert review processes. Trainings for specific tools should be considered.

Conclusion

Tool usage can enhance decision-making when adapted to the user's needs and purpose. They should be consulted critically rather than followed blindly.

New graduate nurses are an untapped population for nursing professional governance and nursing research and evidenced-based practice councils. New graduate nurses can offer new insights into the management of patient care and nursing workflow. By educating new graduate nurses about the benefits of nursing research and evidence-based practice councils at the start of their careers, an early standard of excellence in the empowerment of applying evidenced-based practice principles to improve patient care quality can occur. This narrative literature inquiry explores new graduate nurses perspective of research and evidence-based practice councils, with the targeted goal of engagement for professional and personal growth as a nurse leader.

Purpose

Monitoring progress towards universal health coverage (UHC) has become increasingly important, especially given the centrality of UHC in achieving the sustainable development goals. We sought to estimate the progress towards UHC in the 22 Middle East and North Africa (MENA) countries.

Methods

Employing the Joint World Bank and World Health Organization Framework for Monitoring UHC, we estimated the UHC index for MENA countries using both service coverage and financial protection indicators. We also explored the correlation between the UHC index with government expenditure/investment in health.

Results

The 2021 UHC index ranged from 48.2 (Somalia) to 90.3 (United Arab Emirates) with a mean, median, and standard deviation of 74.9, 77.4, and 11.1, respectively, with significant differences between low-income and high-income countries. Service coverage lags behind financial protection in most MENA countries. There is a significant positive relationship between UHC and government health spending/investments.

Conclusion

The majority of MENA countries are yet to achieve UHC. There is a need to expand healthcare services, especially PHC services, and adopt strategies that address concerns related to financial protection.

Background/purpose

In response to the opioid use challenges exacerbated from the COVID-19 pandemic, Fort Albany First Nation (FAFN), a remote Cree First Nation community situated in subarctic Ontario, Canada, implemented a buprenorphine-naloxone program. The newly initiated program was collaboratively developed by First Nations' nurses and community leaders, driven by the community's strengths, resilience, and forward-thinking approach. Using the First Nations Information Governance Centre strengths-based model, this article examines discussions with four community leaders to identify key strengths and challenges that emerged during the implementation of this program.

Methods

this qualitative study amplify the positive aspects and community strengths through the power of oral narratives. We conducted 20 semi-structured face-to-face interviews with community members who helped lead FAFN's COVID-19 pandemic response. Utilizing the Medicine Wheel framework, this work introduces a holistic model for the buprenorphine-naloxone program that addresses the cognitive, physical, spiritual, and emotional dimensions of well-being.

Results

Recommendations to support this initiative included the need for culturally competent staff, customized education programs, and the expanding of the program. Additionally, there is a pressing need for increased funding to support these initiatives effectively and sustainably. The development of this program, despite challenges, underscores the vital role of community leadership and cultural sensitivity to address the opioid crisis in a positive and culturally safe manner.

Conclusion

The study highlights the successes of the buprenorphine-naloxone program, which was developed in response to the needs arising from the pandemic, specifically addressing community members suffering from opioid addiction. The timely funding for this program came as the urgent needs of community members became apparent due to pandemic lockdowns and isolation. Holistic care, including mental health services and fostering community relations, is important. By centering conversations on community strengths and advocating for culturally sensitive mental health strategies that nurture well-being, resilience, and empowerment, these findings can be adapted and expanded to support other Indigenous communities contending with opioid addiction.

Introduction

Medical education presents significant challenges for medical students' mental health. Medical students are a vulnerable group, experiencing higher rates of mental health disorders, which can have implications for their well-being and academic performance. Consequently, evaluating Positive mental health (PMH) has become significant in a contemporary and demanding society, particularly among university students.

Aim

This study aimed to assess the levels of PMH and identify the association between PMH domains and socio-demographic and health related variables among medical students enrolled at a university in South Africa.

Methods

This quantitative, descriptive, and cross-sectional survey was conducted with 144 undergraduate medical students. Data were collected using a multi-dimensional PMH instrument and a sociodemographic and health related questionnaire, from 144 undergraduate medical students. The university's Research and Ethics Committee granted ethical clearance for the study. Results: The data were analysed using IBM SPSS version 29. The majority of the students were older than 20 years (79.2 %, n = 114), had no prior history of psychiatric illness, and had not previously taken any psychiatric medication (94.4 %, n = 136). More than half of the participants were single (66 %, n = 95), identified as Christians (76.4 %, n = 110), received a bursary (78.5 %, n = 113), had families living in rural areas (71.5 %, n = 103) and resided in the university housing (73.6 %, n = 106). Gender (p = 0.01), age (p = 0.02), religious affiliation (p = 0.03), history of psychiatric illness (p = 0.05) and treatment for psychiatric illness (p = 0.05) had a significant influence on the Total PMH score. Male participants reported higher mean scores in most PMH domains, excluding emotional support and spirituality domains. Participants aged between 22 and 23 years reported lower mean scores in Total PMH and most PMH domains. There is a significant difference in mean scores with gender (p = 0.02) and religious affiliation (p = 0.00) in the spirituality domain.

Conclusion

The study results emphasised the complex nature of mental health and provided a rationale for assessing the various aspects of PMH in university students. By implementing evidence-based strategies and providing adequate support, medical schools can better support the mental health and well-being of their students, ultimately cultivating a healthier and more resilient future healthcare workforce.

Under the collective weight of growing test volume, staffing constraints, and Medicare reimbursements cuts, an enhancement-based, alternative payment structure focused on rewarding the laboratory's care delivery efforts via benchmarking is appealing. However, achieving a value-based payment model requires the development of an inclusive laboratory care delivery model (LCDM) framework. Today, a holistic, practical LCDM framework for laboratory medicine does not exist. However, such creation is essential for establishing unifying tenants of practice for value-tracing by which standardized key performance and population health indicators can be derived. LAB-CARES is the first step in formulating an LCDM with the primary objective of defining and streamlining the processes and strategies necessary to deliver and articulate the value of diagnostic excellence across the healthcare system. The goal of LAB-CARES is to maximize efficiencies, enhance quality, disseminate clinical expertise, increase patient safety, and promote integrative practice. LAB-CARES is designed to improve an individual patient's quality of life (longitudinal laboratory results – beyond one test) and their surrounding communities (e.g., through surveillance and prevention – beyond one patient). Further professional conversation and efforts are paramount to integrate LAB-CARES as a formalized structure within the healthcare landscape.

Objective

The provisions and recognition of Schedule Castes (SCs), the constitutional term for the Dalits in India, have been exclusively extended to Hindus, Buddhists, and Sikhs (HBS). Omission of Dalit Muslims and Christians (MC) from the SC category stripped them of the affirmative action benefits tied with the SC status. This study aimed to explore how such differential treatment might play a role in differential health outcomes in Dalit women in India.

Methods

Drawing data on 177,346 Dalit women, aged 20 to 49 years, from two successive nationally representative surveys, we assessed the differential likelihood of hypertension and diabetes, between MC- and HBS- Dalit women. Accounting for birth cohort-, survey wave-, and state of residence- fixed effects, along with socioeconomic conditions and cardiometabolic risk factors, we obtained adjusted odds of having hypertension and diabetes in MC women. To check the validity of our results, we conducted similar analyses using data on 170,889 Scheduled Tribe (ST) women, another marginalized group, whose ST-status recognition were not tied to religion.

Results

We found that Dalit MC women were 1.13 (95% CI: 1.03–1.25) and 1.19 (95% CI: 1.05–1.36) times more likely to have hypertension and diabetes, respectively, compared to Dalit HBS women. Conversely, no statistically significant differential likelihood of these conditions was observed between MC and HBS women in the ST sample.

Conclusion

Our investigation thus, indicated a potential link at the crossroads of religion and caste that may contribute to the health disparities among marginalized women in India.

Background

Traditional healing practices are prevalent in rural and mountainous areas of India where Western medicine is not accessible. WHO guidelines recommend integration of traditional and Western medicine to meet rural primary care needs. We explored three dimensions of rural patients' decision-making and satisfaction with their medical care: pregnancy-related concerns, pediatric care for children under five, and acute injuries.

Methods

We conducted a qualitative study using a phenomenological approach in India's Spiti Valley between August and October 2023. Sixteen individuals, age 18 years and older, participated in one-on-one interviews. The interviews were transcribed from Hindi into English, reviewed for accuracy by a native speaker, and imported into Dedoose software. Data were analyzed using inductive coding.

Findings

Multiparous women aged 35–44 were concerned about pregnancy complications, leading them to choose Western medicine despite access and cost barriers. Pediatric illness requiring urgent care at night was a concern for women with children under five. Those in the injuries group reported having to travel for care beyond basic first aid. Overall, concerns were about limited access to some services locally, as well as costs of travel, medical procedures, and medications when services were obtained beyond the local area.

Interpretation

All participants considered their traditional healer their first point of contact for medical care. A number of Western medical services were not available locally. These findings suggest a need to strengthen access to and integration of Western and traditional medical care in rural settings in India.