Aiming to obtain a parallel recovery strategy for the interdependent transportation-healthcare system (ITHS) after the earthquake, this study proposes a framework for the resilience assessment and ...enhancement of ITHS integrating functionality loss (FL), total recovery time (TRT) and resilience (R). A novel metric from the spatial accessibility measurement can effectively quantify the interdependence during the restoration process considering the travel delay and medical service reduction. The Simulated Annealing algorithm is utilized to efficiently search for an optimal parallel restoration strategy under limited resources. Various uncertainties associated with seismic damages, functional loss and restoration time of each component in the ITHS are considered and explicitly modelled. An application case in a real city is used to demonstrate the identification of the resilience-based optimal recovery strategy when the components in the ITHS exhibit disturbances. The optimal restoration strategy considering interdependence during recovery can enhance the resilience of the ITHS compared to ignoring recovery coupling. This method can support decision-makers with post-disaster reconstruction and hence significantly enhance the resilience of the ITHS.
This commentary is a summary of two conversations among Brazilian former Minister of Health and oncologist Nelson Teich; Brazilian thoracic surgeon, Marcio Lucas; and anatomists Jeffrey Laitman and ...Daniella Curcio. We discuss a number of topics in Medical Education, Biomedical Science, and Healthcare, including the different stages of the Brazilian response to the COVID‐19 pandemic. The discussions also explore: Brazil's and Brazilians strengths and struggles in the advancement of biomedicine; universal barriers to furthering advances; and problems specific to Brazil.
Social, cultural, and structural factors are associated with delays in seeking help from mental health professionals and poor treatment adherence among patients with mood disorders. This qualitative ...study examined the perspectives on the services and response to treatments of individuals diagnosed with Bipolar Spectrum Disorder (BSD) in Iran through 37 in-depth semi-structured interviews with patients who had received BSD diagnosis and treatment (excluding Bipolar-I). Interviews explored two broad areas: 1) coping and help-seeking strategies; and 2) barriers to treatment and expectations of outcomes from treatment. Multiple factors influenced the help-seeking strategies and trajectories of patients with BSD diagnoses in Iran, including: structural limitations of the mental healthcare system; modes of practice of biological psychiatry; characteristics of the official psychology and counseling services permitted by Iran’s government; popular psychology and consultation (offered through social media from the diaspora) by Iranian psychologists and counsellors in the diaspora; and alternative spiritual and cult-based groups. To improve the quality and accessibility of mental health services, it is essential to have structural changes in the healthcare system that prioritize human rights and individuals’ values over the political and ideological values of the state and changes in the professions that promote secular training of mental healthcare providers and an ecosocial model of care.
When the 21 Swedish county councils decided to collaborate in the creation of a national system for knowledge-based management, patient participation was mandatory. Patient and next-of-kin ...representatives (PR) co-produced person-centred and cohesive clinical pathways together with healthcare professionals (HPR). Research on co-production in healthcare at the national level is scarce. The aim of this study is to explore experiences of patient participation from the perspectives of both PRs and HPRs when co-producing clinical pathways within the Swedish nationwide healthcare system for knowledge-based management. A qualitative study was conducted. A strategic sample of nine PRs and eight HPRs were interviewed individually between August 2022 and January 2023 using a semi-structured interview guide. We analysed data using an inductive content analysis. Three main categories were identified: (1) Finding appropriate patient representativeness; (2) Working methods that facilitate a patient perspective; and (3) Influence of the patient perspective in the clinical pathways. The study demonstrates the importance of patient and next-of-kin participation in the construction of clinical pathways at the national level. The results provide a platform for further research on patient participation on the national level and add to studies on if and how patient participation on this level has an impact on how the clinical pathways are put into practice at the micro level, and the support provided at the meso level. The study contributes to the growing body of literature studying patient participation and co-production.
Employee turnover is expensive and disruptive for an organization. Studies have already mentioned that the economic cost of turnover is huge, ranging from 90% to 200% of the existing employee’s ...salary. With an increase in turnover rate, the social fabric of an enterprise may be disrupted. Additionally, organizations with an increasing turnover are expected to lose intangible knowledge and skills, operational effectiveness, customer satisfaction, and product or service quality. In a healthcare context, an increasing turnover rate has more consequences than other sectors because the healthcare sector worldwide is already identified as a sector facing resource scarcity. Exacerbating the situation, current evidence suggests that employee turnover has been increasing globally in the healthcare sector. The literature suggests that an ethical leadership style may reduce employees’ likelihood of quitting an organization. However, such literature is sparse in healthcare, especially from the perspective of a developing economy in the Global South, which is more resource-deficient than the Global North. To fill this knowledge gap, this study investigates the relationship between ethical leadership style and turnover intentions in the healthcare context of the Global South. This study also tests the mediating effect of intrinsic motivation and psychological contract fulfillment in the above-proposed relationship. Furthermore, the conditional indirect effect of resilience is also tested. The data are collected from the hospital employees through a self-administered questionnaire. The hypothesized relationships are tested through structural equation modeling. The empirical evidence indicates that ethical leadership reduces employees’ turnover intentions significantly. The results further confirm the mediating and moderating effects of intrinsic motivation, psychological contract fulfillment, and resilience. These results have different theoretical and practical implications for the healthcare sector. The results especially highlight the role of ethical leaders in a hospital to deal with the challenge of turnover, which has been rising worldwide.
Objectives
To report the changes in volume and characteristics of medical activities in the Vatican City State during COVID‐19 pandemic.
Methods
Data for general / emergency procedures , specialty ...consultations, radiology examinations and diagnostic procedures delivered by the Directorate of Health and Hygiene of the Vatican City State were retrospectively analysed. Analysis focused on the entire year 2020 and on the lockdown period 9 March – 18 May 2020.
Results
In 2020, 73.932 procedures were performed compared to 95.218 in 2019 (−22.4%). During lockdown, general / emergency activities decreased by 61.1%, specialty consultations by 85.3%, radiology examinations by 95.8%, and diagnostic procedures by 96.5%. A decrease was found for nearly all specialties; the most affected were occupational medicine and dermatology, whilst an increase was found for legal medicine, psychiatry and angiology.
Conclusion
Medical activities of the Vatican City State have been severely impacted, especially during the first months of the pandemic. However, organizational efforts allowed rapid restoration to near‐normal volumes.
Many individuals whose gender does not align with the sex they were assigned at birth (gender diverse GD people) report stressful health care encounters. We examined the relationship of these ...stressors to symptoms of emotional distress and impaired physical functioning among GD people.
This study was conducted using a cross-sectional design with data from the 2015 United States Transgender Survey.
Composite metrics of health care stressors and physical impairments were developed, and the Kessler Psychological Distress Scale (K-6) provided a measure of emotional distress. Linear and logistic regression were used to analyze the aims.
A total of 22,705 participants from diverse gender identity subgroups were included. Participants who experienced at least one stressor in health care during the past 12 months had more symptoms of emotional distress (β = 0.14, P < .001) and 85% greater odds of having a physical impairment (odds ratio = 1.85, P < .001). Transgender men exposed to stressors were more likely than transgender women to experience emotional distress and have a physical impairment, with other gender identity subgroups reporting less distress. Black participants exposed to stressful encounters reported more symptoms of emotional distress than White participants.
The results suggest that stressful encounters in health care are associated with symptoms of emotional distress and greater odds of physical impairment for GD people, with transgender men and Black individuals being at greatest risk of emotional distress. The findings indicate the need for assessment of factors that contribute to discriminatory or biased health care for GD people, education of health care workers, and support for GD people to reduce their risk of stressor-related symptoms.
Abstract
In today’s world more death occurs due to not immediate treatment for bed ridden patients. It also requires more man power. This document presents the model, installation and looks of a ...hardware and software platform for health monitoring system for patients. The main purpose of this system is to set up a system that can watch over bedridden patient’s health. This project depends on both hardware and software. It is developed using sp02, temperature, heartbeat connected to a raspberry pi micro controller, which get the sensor values and process it in machine learning process to produce a dosage prediction. It also intimates the doctor by triggering an automatic email. In addition, one can know the patients records and prediction of dosage from anywhere using the mobile application linked with it.
Experiences with racism predict healthcare system distrust among people of color, but Black and Latino young men who have sex with men (YMSM) also experience overlapping forms of stigma associated ...with their sexual identities and behaviors (i.e., homonegativity and internalized homonegativity). These forms of minority stress may drive healthcare system distrust among Black and Latino YMSM but have received far less attention.
To examine the associations of racism, homonegativity, and internalized homonegativity with healthcare system distrust among a community sample of Black and Latino YMSM.
Data came from waves 2–4 (years 2017–2018) of the Healthy Young Men's study, a longitudinal cohort study of Black and Latino YMSM living in Los Angeles County. Data across waves (n = 424, nobs = 1272) were combined and analyzed using a fixed effects approach and adjusting for repeated measures across participants. A series of regression models that added sets of covariates (demographics, syndemic indicators, and health-related factors) were tested to examine associations of racism, homonegativity, and internalized homonegativity with healthcare system distrust.
Adjusting for demographics and syndemic indicators, racism, but not homonegativity or internalized homonegativity, was associated with healthcare system distrust. Adjustment for health-related factors had little impact on results.
Among Black and Latino YMSM, greater exposure to racism is associated with greater healthcare system distrust. Efforts to strengthen healthcare system trust should explicitly target the institutional policies that disproportionately harm people of color.
•Community sample of Black and Latino young men who have sex with men (YMSM).•Black and Latino YMSM experience overlapping forms of discrimination.•Racism, homonegativity, internalized homonegativity may drive healthcare distrust.•Only racism was associated with greater distrust after full adjustment.
Elective surgeries were suspended during the national lockdown in March 2020 to curb the spread of the COVID-19 pandemic in Malaysia. We sought to evaluate the impact of the lockdown on cataract ...surgeries and suggest lessons for future outbreaks.
We conducted an interrupted time series analysis to examine rates of cataract surgery before and during the lockdown.
We used national cataract surgical data between 2015 and 2021 from the Malaysian Cataract Surgery Registry. Segmented regression with a seasonally adjusted Poisson model was used for the analysis. Stratified analyses were performed to establish whether the effect of the lockdown on cataract surgeries varied by hospital designation, type of cataract service, sex, and age groups.
Cataract surgeries began falling in March 2020 at the onset of the lockdown, reached a trough in April 2020, and subsequently increased but never recovered to pre-lockdown levels. Cataract surgical rates in December 2021 were still 43 % below the expected surgical volume, equivalent to 2513 lost cataract surgeries. There was no evidence of a differential effect of the lockdown between COVID-19 designated and non-COVID-19 designated hospitals. The relative decrease in cataract surgical rates appears to have been greatest in outreach services and in people 40 years and older.
The lockdown caused an immediate reduction in cataract surgical rates to nearly half of its baseline rate. Despite its gradual recovery, further delays remain to be expected should there be no redistribution or increase in resources to support backlogs and incoming new cases.
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