Responding to labor shortages and rising healthcare expenses, hospitals increasingly turn to self-check-in kiosks to streamline service delivery and improve patients’ experiences. The purpose of this ...study was to reflect on the implementation of these self-check-in kiosks in a Dutch university hospital, particularly in relation to access to care for more vulnerable patients and intended efficiency goals. We followed a technology-in-practice approach to better understand how new technologies shape care practices in relation to in/exclusion and carried out an ethnographic action study involving desk research, participatory observations, semi-structured interviews, and reflection sessions with developers and hospital staff. Data were analyzed through ethnographic content analysis. Our results show that although self-check-in kiosks work well for some patients, many people experience practical and psychosocial difficulties, especially those who go through a complex care pathway, are low-literate, experience a distance the online world, or have sensory, motor, or cognitive impairments. Kiosks are not yet attuned to these patients and typically leave little flexibility and room for negotiation and personal support in what is, for many, a foreign environment. Therefore, patients frequently seek confirmation and assistance from already downsized or busy staff. In conclusion, we find that digitalization under the banner of efficiency within a healthcare system already under pressure carries risks, as it can unintentionally generate extra (invisible) work for patients and care professionals and threaten access to and quality of care for patients most in need. A more concentrated effort on refining the digitalization of healthcare processes using an inclusive-technology-in-practice approach has the potential to contribute to fairer and more efficient care for all patients.
Whilst the transformation towards digital healthcare is accelerating, there is still a substantial risk of excluding people with a distance to the online world. Groups like people with a low ...socioeconomic position, people with a migrant background or the elderly, who are already most at risk of experiencing health inequalities, are simultaneously experiencing increased digital exclusion. Researchers play a role in determining how eHealth access is framed and can thus impact how the barriers to its use are addressed. This qualitative meta-review critically evaluates the way researchers (as authors) discuss eHealth use in digitally marginalised groups. Specifically, it seeks to understand how eHealth is framed to address existing health systems problems; how the barriers to eHealth use are presented and which solutions are provided in response; and who authors suggest should be responsible for making eHealth work. The results of this review found four paradoxes in how current literature views eHealth use. Firstly, that health systems problems are complex and nuanced, yet eHealth is seen as a simple answer. Secondly, that there are many political, social and health systems-based solutions suggested to address eHealth use, however most of the identified barriers are individually framed. This focus on personal deficits results in misallocating responsibility for making these systemic improvements. Thirdly, although eHealth is meant to simplify the tasks of patients and healthcare workers, these are the groups most often burdened with the responsibility of ensuring its success. Lastly, despite tailoring eHealth to the user being the most suggested solution, researchers generally speak about groups as a homogenous entity – thus rendering tailoring difficult. Ultimately, this review finds that a shift to focus research on addressing systemic issues on a systems level is necessary to prevent further exacerbating existing health inequalities.
•This review examined framing of eHealth use amongst digitally marginalised groups in research.•eHealth is presented as a simple solution to highly complex health system problems.•Patients and health workers are seen as most responsible for addressing barriers.•Though barriers are framed as individual problems, solutions to improve eHealth are systems focused.•We urge researchers to shift to a systems paradigm to avoid perpetuating health inequalities.
In the present investigation, the phenolic compounds of Solanum elaeagnifolium were identified, and the plant’s anti-lipase and anti-glycation effects on hemoglobin were discovered through in vitro ...experiments, as well as its short-term antihyperglycemic and anti-inflammatory effects. The chemical compound composition was detected using HPLC-DAD, the anti-lipase activity was tested in vitro using 4-nitrophenyl butyrate as a substrate, and the antiglycation activity of the plant extracts was also tested in vitro using a haemoglobin model. The antihyperglycemic effect was determined by inhibiting pancreatic α-amylase and α-glycosidase activity and performing an in vivo glucose tolerance test on normal rats, and the anti-inflammatory activity was determined by inducing paw inflammation with carrageenan. In both the SEFR (fruit) and SEFE (leaf) extracts, chromatographic analysis revealed the presence of quercetin 3-O-β-D-glucoside, rutin, and quercetin. SEFR inhibited the pancreatic lipase enzyme more effectively, with an IC50 of 0.106 ± 0.00 mg/mL. S. elaeagnifolium extracts demonstrated significant antiglycation activity, with 3.990 ± 0.23 mg/mL of SEFE and 3.997 ± 0.14 mg/mL of SEFR. When compared to positive and negative controls, plant extracts had very significant anti-diabetic and anti-inflammatory effects. The findings in this study and previous research on this plant encourage us to investigate other pharmacological activities of this plant besides its duiretic, cictrisant, and anti-ulcer activity.
Juncus acutus, acknowledged through its indigenous nomenclature “samar”, is part of the Juncaceae taxonomic lineage, bearing considerable import as a botanical reservoir harboring conceivable ...therapeutic attributes. Its historical precedence in traditional curative methodologies for the alleviation of infections and inflammatory conditions is notable. In the purview of Eastern traditional medicine, Juncus species seeds find application for their remedial efficacy in addressing diarrhea, while the botanical fruits are subjected to infusion processes targeting the attenuation of symptoms associated with cold manifestations. The primary objective of this study was to unravel the phytochemical composition of distinct constituents within J. acutus, specifically leaves (JALE) and roots (JARE), originating from the indigenous expanse of the Nador region in northeastern Morocco. The extraction of plant constituents was executed utilizing an ethanol-based extraction protocol. The subsequent elucidation of chemical constituents embedded within the extracts was accomplished employing analytical techniques based on high-performance liquid chromatography (HPLC). For the purpose of in vitro antioxidant evaluation, a dual approach was adopted, encompassing the radical scavenging technique employing 2,2-diphenyl-1-picrylhydrazyl (DPPH) and the total antioxidant capacity (TAC) assay. The acquired empirical data showcase substantial radical scavenging efficacy and pronounced relative antioxidant activity. Specifically, the DPPH and TAC methods yielded values of 483.45 ± 4.07 µg/mL and 54.59 ± 2.44 µg of ascorbic acid (AA)/mL, respectively, for the leaf extracts. Correspondingly, the root extracts demonstrated values of 297.03 ± 43.3 µg/mL and 65.615 ± 0.54 µg of AA/mL for the DPPH and TAC methods. In the realm of antimicrobial evaluation, the assessment of effects was undertaken through the agar well diffusion technique. The minimum inhibitory concentration, minimum bactericidal concentration, and minimum fungicidal concentration were determined for each extract. The inhibitory influence of the ethanol extracts was observed across bacterial strains including Staphylococcus aureus, Micrococcus luteus, and Pseudomonas aeruginosa, with the notable exception of Escherichia coli. However, fungal strains such as Candida glabrata and Rhodotorula glutinis exhibited comparatively lower resistance, whereas Aspergillus niger and Penicillium digitatum exhibited heightened resistance, evincing negligible antifungal activity. An anticipatory computational assessment of pharmacokinetic parameters was conducted, complemented by the application of the Pro-tox II web tool to delineate the potential toxicity profile of compounds intrinsic to the studied extracts. The culmination of these endeavors underpins the conceivable prospects of the investigated extracts as promising candidates for oral medicinal applications.
Juncus acutus, acknowledged through its indigenous nomenclature “samar”, is part of the Juncaceae taxonomic lineage, bearing considerable import as a botanical reservoir harboring conceivable ...therapeutic attributes. Its historical precedence in traditional curative methodologies for the alleviation of infections and inflammatory conditions is notable. In the purview of Eastern traditional medicine, Juncus species seeds find application for their remedial efficacy in addressing diarrhea, while the botanical fruits are subjected to infusion processes targeting the attenuation of symptoms associated with cold manifestations. The primary objective of this study was to unravel the phytochemical composition of distinct constituents within J. acutus, specifically leaves (JALE) and roots (JARE), originating from the indigenous expanse of the Nador region in northeastern Morocco. The extraction of plant constituents was executed utilizing an ethanol-based extraction protocol. The subsequent elucidation of chemical constituents embedded within the extracts was accomplished employing analytical techniques based on high-performance liquid chromatography (HPLC). For the purpose of in vitro antioxidant evaluation, a dual approach was adopted, encompassing the radical scavenging technique employing 2,2-diphenyl-1-picrylhydrazyl (DPPH) and the total antioxidant capacity (TAC) assay. The acquired empirical data showcase substantial radical scavenging efficacy and pronounced relative antioxidant activity. Specifically, the DPPH and TAC methods yielded values of 483.45 ± 4.07 µg/mL and 54.59 ± 2.44 µg of ascorbic acid (AA)/mL, respectively, for the leaf extracts. Correspondingly, the root extracts demonstrated values of 297.03 ± 43.3 µg/mL and 65.615 ± 0.54 µg of AA/mL for the DPPH and TAC methods. In the realm of antimicrobial evaluation, the assessment of effects was undertaken through the agar well diffusion technique. The minimum inhibitory concentration, minimum bactericidal concentration, and minimum fungicidal concentration were determined for each extract. The inhibitory influence of the ethanol extracts was observed across bacterial strains including Staphylococcus aureus, Micrococcus luteus, and Pseudomonas aeruginosa, with the notable exception of Escherichia coli. However, fungal strains such as Candida glabrata and Rhodotorula glutinis exhibited comparatively lower resistance, whereas Aspergillus niger and Penicillium digitatum exhibited heightened resistance, evincing negligible antifungal activity. An anticipatory computational assessment of pharmacokinetic parameters was conducted, complemented by the application of the Pro-tox II web tool to delineate the potential toxicity profile of compounds intrinsic to the studied extracts. The culmination of these endeavors underpins the conceivable prospects of the investigated extracts as promising candidates for oral medicinal applications.
In the present investigation, the phenolic compounds of Solanum elaeagnifolium were identified, and the plant’s anti-lipase and anti-glycation effects on hemoglobin were discovered through in vitro ...experiments, as well as its short-term antihyperglycemic and anti-inflammatory effects. The chemical compound composition was detected using HPLC-DAD, the anti-lipase activity was tested in vitro using 4-nitrophenyl butyrate as a substrate, and the antiglycation activity of the plant extracts was also tested in vitro using a haemoglobin model. The antihyperglycemic effect was determined by inhibiting pancreatic α-amylase and α-glycosidase activity and performing an in vivo glucose tolerance test on normal rats, and the anti-inflammatory activity was determined by inducing paw inflammation with carrageenan. In both the SEFR (fruit) and SEFE (leaf) extracts, chromatographic analysis revealed the presence of quercetin 3-O-β-D-glucoside, rutin, and quercetin. SEFR inhibited the pancreatic lipase enzyme more effectively, with an ICsub.50 of 0.106 ± 0.00 mg/mL. S. elaeagnifolium extracts demonstrated significant antiglycation activity, with 3.990 ± 0.23 mg/mL of SEFE and 3.997 ± 0.14 mg/mL of SEFR. When compared to positive and negative controls, plant extracts had very significant anti-diabetic and anti-inflammatory effects. The findings in this study and previous research on this plant encourage us to investigate other pharmacological activities of this plant besides its duiretic, cictrisant, and anti-ulcer activity.
La greffe allogénique de cellules souches hématopoïétiques (CSH) est une thérapeutique usuelle pour de nombreuses maladies hématologiques. Au cours des dernières décennies, des progrès importants ont ...été réalisés dans les domaines de la prise en charge des patients. La sélection des donneurs, les conditionnements de greffe et les soins de support des patients ont contribué à l’amélioration de la survie des patients. La plupart des procédures en rapport avec la greffe allogénique de CSH ont été standardisées par des recommandations nationales ou internationales amenant à des certifications telles que Joint Accreditation Committee ISCT-Europe & EBMT (JACIE). Mais tous ces standards et ces recommandations ne définissent pas de façon précise les moyens minimums humains et matériels nécessaires à la réalisation de telles procédures. En plus, les unités dans lesquelles sont placés ces patients sont soumises à des règles architecturales et procédurales non uniformisées. Lors de cet atelier, nous avons tenté de définir une trame minimale concernant le personnel, l’infrastructure architecturale et des pratiques d’hygiène générales pour les patients, le personnel et les visiteurs.
Allogeneic hematopoietic cell transplantation (HCT) is part of the standard of care for many hematological diseases. Over the last decades, significant advances in patient and donor selection, conditioning regimens as well as supportive care of patients undergoing allogeneic HCT leading to improved overall survival have been made. In view of many new treatment options in cellular and molecular targeted therapies, the place of allogeneic transplantation in therapy concepts must be reviewed. Most aspects of HCT are well standardized by national guidelines or laws as well as by certification labels such as FACT-JACIE. However, the requirements for human resources, construction and layout of a unit treating patients during the transplantation procedure and for different complications are not well defined. Here, we describe the process of planning a transplant unit in order to open a discussion that could lead to more precise guidelines in the field of personnel and infrastructural requirements for hospitals caring for people with severe immunosuppression.
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