Objective:
to study the historical retrospective of the Soviet (1917-1991) and post-Soviet (1991 – present) periods of healthcare, the evolution of their legal support; to conduct a comprehensive ...criminological study and analysis of the criminal liability of medical staff who committed illegal acts in the historical periods under consideration.
Methods:
the methodological basis of the study was the methods of analysis, synthesis, comparison, formal and logical approach. In addition, the author used specific scientific methods, including the historical one.
Results:
in general, the analysis of the legal foundations of criminal prosecution of medical staff who committed illegal acts during the Soviet and post-Soviet period suggests that the institute of legal liability of medical staff, the medical science and practice developed in parallel under the influence of social, economic and political factors. Since the beginning of the Soviet period, the issues of liability of medical staff have caused numerous disputes among both researchers and practitioners, and today these disputes continue and do not subside. At the same time, it is important to emphasize that the Russian legislative system in the field of healthcare has always been formed solely with the special attitude of the state and society to medical staff, who were perceived as guardians of the health of the citizens and enjoyed their confidence, which in turn gave rise to special caution and responsibility among medical personnel.
Scientific novelty:
the study is distinguished by the author’s unique approach, which allowed stating the social conditionality of legal prohibitions for the illegal acts under consideration, as well as the causal relationship between the regulatory legal framework formed and the social consequences generated by it in the Soviet and post-Soviet periods.
Practical significance:
the conclusions obtained by studying the genesis of the problems related to the liability of medical personnel for committing illegal acts will contribute to the development of a scientific understanding of the essence of the phenomenon under consideration, as well as the identification of a modern causal complex contributing to the occurrence of these illegal acts.
The conceptual ambiguity of public trust in the healthcare system poses problems for governance and public trust measurement. Therefore, we aimed to answer: what is public trust in the healthcare ...system? We conducted in the context of the English NHS an analysis of online news with readership comments concerning the care.data initiative; a secondary analysis of interviews about participants’ experiences and perceptions of biobanks; and an analysis of public focus groups about perceptions of the 100,000 Genomes Project. Further, we engaged with existing conceptual work and trust theory. This resulted in a full conceptual framework of public trust in the healthcare system. Public trust is established in anticipation of net benefits. Public trust legitimises the actions of the healthcare system as well as encourages the public to participate in healthcare-related activities. Further, levels of public trust are affected by spill-over effects from high or low levels of public trust in other parts of the government system. Last, many actors inside and outside the healthcare system influence public trust. Future research needs to translate this conceptual framework into policy guidelines and a measurement scale, as well as to validate the conceptual framework for healthcare systems other than the British NHS.
Heat stress is one of the environmental factors influencing the health of individuals and the wider population. There is a large body of research to document significant increases in mortality and ...morbidity during heat waves all over the world. This paper presents key results of research dealing with heat-related mortality (HRM) in various cities in Poland which cover about 25% of the country’s population. Daily mortality and weather data reports for the years 1991–2000 were used. The intensity of heat stress was assessed by the universal thermal climate index (UTCI). The research considers also the projections of future bioclimate to the end of twenty-first century. Brain storming discussions were applied to find necessary adaptation strategies of healthcare system (HCS) in Poland, to minimise negative effects of heat stress. In general, in days with strong and very strong heat stress, ones must expect increase in mortality (in relation to no thermal stress days) of 12 and 47%, respectively. Because of projected rise in global temperature and heat stress frequency, we must expect significant increase in HRM to the end of twenty-first century of even 165% in comparison to present days. The results of research show necessity of urgent implementation of adaptation strategies to heat in HCS.
Due to an increasing global awareness of the need for sustainable development in academia and business, closed-loop supply chains in hospitals have become an important area of focus. Process ...reengineering in purchasing, materials management, work practices, and waste management can reduce environmental hazards and contain costs at the healthcare facilities. This paper demonstrates an application of the RFID-enabled process reengineering in sustainable healthcare system design, and presents a case study in the linens division of central sterilization services department at a Singaporean hospital using ARENA simulation.
Abstract
Background
Stepping into the role of an unpaid caregiver to offer help is often considered a natural expectation of family members or friends. In Canada, such contributions are substantial ...in terms of healthcare provision but this comes at a considerable cost to the caregivers in both health and economic terms.
Methods
In this study, we conducted a secondary analysis of a collection of qualitative interviews with 39 caregivers of people with chronic physical illness to assess how they described their particular roles in caring for a loved one. We used a model of caregiving roles, originally proposed by Twigg in 1989, as a guide for our analysis, which specified three predominant roles for caregivers – as a resource, as a co-worker, and as a co-client.
Results
The caregivers in this collection spoke about their roles in ways that aligned well with these roles, but they also described tasks and activities that fit best with a fourth role of ‘care-coordinator’, which required that they assume an oversight role in coordinating care across institutions, care providers and often advocate for care in line with their expectations. For each of these types of roles, we have highlighted the limitations and challenges they described in their interviews.
Conclusions
We argue that a deeper understanding of the different roles that caregivers assume, as well as their challenges, can contribute to the design and implementation of policies and services that would support their contributions and choices as integral members of the care team. We provide some examples of system-level policies and programs from different jurisdictions developed in recognition of the need to sustain caregivers in their role and respond to such limitations.
Background
Precision medicine has transformed cancer treatment by focusing on personalized approaches based on genomic abnormalities. However, comprehensive genomic profiling (CGP) and access to ...targeted therapies are limited in Japan. This study investigates the BELIEVE trial, which aims to improve drug accessibility for patients with actionable genetic abnormalities through off-label drug administration.
Methods
The BELIEVE trial is a platform trial with a single master protocol, conducted under the Clinical Trials Act and the patient-proposed health services (PPHS) scheme. Eligible patients with solid tumors exhibiting actionable alterations were enrolled, and CGP tests covered by national health insurance were employed. Treatment selection, study drugs from collaborating pharmaceutical companies, and treatment schedules adhered to predefined protocols. Primary and secondary endpoints were evaluated, and statistical analysis was conducted based on patient response rates.
Results
The BELIEVE trial offered treatment opportunities for patients with relapse/refractory disease who lacked standard therapies or clinical trial options. This study addresses unmet medical needs and contributes to the establishment of precision medicine systems. Similar trials like NCI-MATCH and TAPUR are being conducted globally. The BELIEVE trial provides a platform for off-label drug administration, collects essential clinical data, and contributes to drug approval applications.
Conclusion
The BELIEVE trial provides hope for patients with actionable genetic abnormalities by facilitating access to targeted therapies through off-label drug administration. It establishes a regulatory framework and promotes collaboration between industry and academia by expanding organ-specific and cross-organ biomarker-based treatments.
Perspectives of the core competencies of nurses are varied among postgraduate-year nurses, which makes it challenging to establish training programs and develop evaluation instruments. Particularly ...critical for nurses is the ongoing acquisition of competencies throughout life. Sometimes this acquisition is funded by the healthcare system, but the key question is how the system leverages this acquisition and ultimately how it translates into patient care. This study seeks to explore nurses' key competencies acquired through continuing education from the perspective of two groups of postgraduate nurses with different levels of experience and with different objectives to be assessed. An NGT procedure was applied to the group discussion. The participants were recruited according to basic factors such as the number of years of professional experience, their level of education, and their preferred professional status. Thus, seventeen professionals participated in the study, representing two public hospitals in the city. Following the NGT procedure, the competencies identified from the thematic analysis were scored and ranked to achieve a consensus. Eight core issues were derived in the novel group concerning transferring the competencies to patient care quality: holism, care work, organizational barriers, specialization, no transfer, confidence, knowledge, and instrumental tools. Four core issues were derived when asked about the relationship between the resources invested and the organizational and professional development of the nursing staff: professional development, positive learning, negative learning, and recognition. In the more experienced group, seven issues were derived from the first issue raised: continuous learning, quality, confidence, holism, safe care, autonomy, and technical issues. Additionally, six issues arose from the second question: satisfaction, autonomy, creativity, productivity, professional development, and recognition. In conclusion, the perceptions of the two selected groups are negative when it comes to assessing the extent to which the competencies acquired in lifelong learning are transferred to the patient and the system evaluates and recognizes these competencies for improvement.
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.
•ECCO essential requirements for quality cancer care (ERQCC) are position papers on delivering high-quality care.•Each paper focuses on a cancer type, in this case melanoma.•Advanced melanoma is ...complex to stage and treat, with many new options.•High-quality care can only be a carried out in specialised units or centres.•The essential, multidisciplinary details for such centres are set out by the ERQCC expert group.
ECCO essential requirements for quality cancer care (ERQCC) are explanations and descriptions of challenges, organisation and actions that are necessary to give high-quality care to patients who have a specific type of cancer. They are written by European experts representing all disciplines involved in cancer care.
ERQCC papers give oncology teams, patients, policymakers and managers an overview of the elements needed in any healthcare system to provide high quality of care throughout the patient journey. References are made to clinical guidelines and other resources where appropriate, and the focus is on care in Europe.
•Melanoma, the most-deadly skin cancer, is rising in incidence among fair-skinned people in Europe. Increasing complexity of care for advanced disease in clinical areas such as staging and new therapies requires attention to a number of challenges and inequalities in a diverse patient group.•Care for advanced melanoma must only be carried out in, or in collaboration with, specialist melanoma centres which have both a core multidisciplinary team and an extended team of allied professionals, and which are subject to quality and audit procedures. Access to such units is far from universal in all European countries.•It is essential that, to meet European aspirations for high-quality comprehensive cancer control, healthcare organisations implement the requirements in this paper, paying particular attention to multidisciplinarity and patient-centred pathways from diagnosis to treatment and follow-up, to improve survival and quality of life for patients.
Taken together, the information presented in this paper provides a comprehensive description of the essential requirements for establishing a high-quality service for melanoma. The ERQCC expert group is aware that it is not possible to propose a ‘one size fits all’ system for all countries, but urges that access to multidisciplinary teams and specialised treatments is guaranteed to all patients with melanoma.
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