This paper provides a brief overview of, and elaborates on, some of the presentations, discussions and conclusions from Day 4 of the 'WHO EURO 2014 International Healthy Cities Conference: Health and ...the City - Urban Living in the 21st Century', held in Athens, Greece on 25 October 2014. The Internet of Things (IoT) is made of sensors and other components that connect our version of the world made of atoms, i.e., humans/our bodies, our devices, vehicles, roads, buildings, plants, animals, etc., with a mirror digital version made of bits. This enables cities and regions to be self-aware and dynamically reconfigurable in real- or near-real-time, based on changes that are continuously monitored and captured by sensors, similar to the way the internal biological systems of a living being operate and respond to their environment (homeostasis). Data collected by various IoT sensors and processed via appropriate analytics can also help predict the immediate future with reasonable accuracy, which enables better planned responses and mitigation actions. Cities and regions can thus become more adaptable and resilient in face of adversity. Furthermore, IoT can link atoms (humans) to other atoms (humans) (again via bits), resulting in the formation of 'smart(er) communities' that are socially connected in new ways and potentially happier. Cities, but also less urbanised regions and the countryside, could all benefit from, and harness the power of, IoT to improve the health, well-being and overall quality of life of the local populations, actively engage citizens in a smarter governance of their region, empower them to better care for one another, promote stronger social inclusion, and ensure a greener, sustainable and more enjoyable environment for all. Technology can also help reverse the 'brain drain' from the countryside and smaller towns to larger metropolises by making the former more attractive and connected, with better services akin to those found in larger cities. The article also discusses some ways of measuring and benchmarking the performance of smart cities and their impact on well-being. However, it should be emphasised that technology is not a panacea and that other factors are equally important in creating happier and healthier cities and regions.
: Dementia affects more than 55 million patients worldwide, with a significant societal, economic, and psychological impact. However, many patients with Alzheimer's disease (AD) and other related ...dementias have limited access to effective and individualized treatment. Care provision for dementia is often unequal, fragmented, and inefficient. The COVID-19 pandemic accelerated telemedicine use, which holds promising potential for addressing this important gap. In this narrative review, we aim to analyze and discuss how telemedicine can improve the quality of healthcare for AD and related dementias in a structured manner, based on the seven dimensions of healthcare quality defined by the World Health Organization (WHO), 2018: effectiveness, safety, people-centeredness, timeliness, equitability, integrated care, and efficiency.
: MEDLINE and Scopus databases were searched for peer-reviewed articles investigating the role of telemedicine in the quality of care for patients with dementia. A narrative synthesis was based on the seven WHO dimensions.
: Most studies indicate that telemedicine is a valuable tool for AD and related dementias: it can improve effectiveness (better access to specialized care, accurate diagnosis, evidence-based treatment, avoidance of preventable hospitalizations), timeliness (reduction of waiting times and unnecessary transportation), patient-centeredness (personalized care for needs and values), safety (appropriate treatment, reduction of infection risk),integrated care (interdisciplinary approach through several dementia-related services), efficiency (mainly cost-effectiveness) and equitability (overcoming geographical barriers, cultural diversities). However, digital illiteracy, legal and organizational issues, as well as limited awareness, are significant potential barriers.
: Telemedicine may significantly improve all aspects of the quality of care for patients with dementia. However, future longitudinal studies with control groups including participants of a wide educational level spectrum will aid in our deeper understanding of the real impact of telemedicine in quality care for this population.
The 21st-century health landscape is shaped by growing global, regional and local interdependence and an increasingly complex array of interlinking factors that influence health and well-being. Most ...of today's major public health challenges, including noncommunicable diseases, antimicrobial resistance, health inequalities and the health effects of austerity measures in some countries, cannot be addressed effectively without intersectoral and coordinated action at supranational, national and local levels. The 53 countries of the WHO European Region developed and adopted a European policy framework and strategy for the 21st century (Health 2020) as a common, evidence-informed policy framework to support and encourage coordinated action by policy-makers at all levels and in all sectors to improve population health and well-being. This article presents the development process of Health 2020 and its main strategic goals, objectives and content. Further, we describe what is needed to successfully implement Health 2020 in countries and how can WHO provide technical assistance to countries that embark on developing health policy aligned with the Health 2020 policy framework.
In 2014⁻2017, the Lithuanian University of Health Sciences and partners implemented the project, 'Development of the Model for the Strengthening of the Capacities to Identify and Reduce Health ...Inequalities', which was financed by The Norwegian Financial Mechanism 2009⁻2014 Public Health Initiatives Program. One of objectives of this project was to increase the awareness about public health and related specialist knowledge and skills in the field of health inequalities. This paper evaluates the effectiveness of capacity-training sessions on capacity building regarding increasing the awareness and knowledge that is needed for addressing health inequalities.
Participants attending capacity-building seminars were asked to complete the same questionnaires before and after these training sessions. A total of 145 questionnaires were received (response rate 71.8%). The evaluation of changes in the pre-survey and post-survey responses in relation to a nonparametric analysis of two related samples was performed using the Wilcoxon test.
Respondents were asked to identify the general importance of health inequalities to the national public health agenda. The pre-training median of the survey was nine (minimum four; maximum 10), and post-training was 10 minimum five; maximum 10 (p < 0.001). Unemployed, low-paid, and low-educated people were identified as the most vulnerable groups of society in terms of health inequalities. A more effective tobacco and alcohol control was identified as the most important inequality measure needed. An absolute majority of participants emphasized the need for intersectoral collaboration for the effective reduction of health inequalities.
The findings from our study suggest that capacity-building sessions can be effective measures for increasing awareness of health inequalities. It is expected that the outcomes of these training opportunities will act as facilitators for further engagement and ongoing approaches to addressing health inequalities.
The new European Health Policy Framework and Strategy: Health 2020 of the World Health Organization, draws upon the experience and insights of five phases, spanning 25 years, of the WHO European ...Healthy Cities Network (WHO-EHCN). Applying the 2020 health lens to
Healthy Cities
, equity in health and human-centered sustainable development are core values and cities have a profound influence on the wider determinants of health in the European population. “Making it Happen” relies on four action elements applied and tested by municipalities and their formal and informal partners: political commitment, vision and strategy, institutional change, and networking. In turn, the renewed commitment by member states of the WHO Regional Committee to work with all spheres and tiers of government is a new dawn for city governance, encouraging cities to redouble their investment in health and health equity in all policies, even in a period of austerity. For phase VI, the WHO-EHCN is being positioned as a strategic vehicle for implementing Health 2020 at the local level.
Healthy Cities
' leadership is more relevant than ever.
Cities are increasingly capturing the attention of major international actors and now regularly feature in multilateral processes. Yet while there are many studies on networking among cities, there ...have been few studies of ‘city networks’ as formal and institutionalized governance structures facilitating city‐to‐city and city‐to‐other actors cooperation, or ‘city diplomacy’. Institutionalized networks of cities, while not new, are becoming a growing presence on the international scene, almost omnipresent and perhaps even too common. Might it be time for a ‘Darwinian’ selection between city networking options? Diving deeper into this networked challenge, this essay focuses on the effects this networked diplomacy and overlap it might have on cities. Drawing on a research collaboration between the UCL City Leadership Laboratory at University College London and the World Health Organization's Healthy Cities Network and both a global dataset of city networks as well as qualitative focus group data, we consider the growth of these governance structures, their strengths, but also the weaknesses associated with their rapid growth, and how cities can engage with this networked landscape more strategically. In short, we argue that the potential of city networks must go hand‐in‐hand with more integrative and strategic thinking at both local and international levels.
As cities gain more outlets to participate in international diplomacy, they will also become more discerning. We expect to see a top‐tier of trend‐setting networks emerge, just as among state‐level international institutions there are clear fora which are particularly influential in shaping the debate on given topics.
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