Health Care Management Research Papers (original) (raw)

2025

One of the main tasks of any country is to provide timely and quality medical care. This article analyzed organization of healthcare system (public and private health network; organization of system on different levels) and organization of insurance /payment system in Slovenia and Russian Federation. This article also provides information about important demographic and main healthcare indicators in order to compare healthcare systems in both countries.

2025, Zenodo (CERN European Organization for Nuclear Research)

In the revised version, the questionnaire was applied to both outpatients and inpatients. Results: A total of 18,034 patients applied to the Emergency Department of Ondokuz Mayıs University Hospital during the study period and 284 of whom were followed-up as in patients in the emergency observation unit. The study was carried out with 565 randomly selected patients meeting the inclusion criteria. Of these patients, 187 (33.10%) were treated in the emergency observation unit and 378 (66, 90%) were treated in the emergency outpatient clinic. The rate of the patients who stated that they were satisfied with the service they received was 80.4% (304) in those receiving treatment in the emergency outpatient clinic while 88.2% (1165) in those receiving treatment in the emergency observation unit. Behaviors of nurses and physicians as well as their care and interventions were determined to be the most influential factors on patient satisfaction. In addition, it was revealed that there was a negative correlation between satisfaction and patient education level, where as a positive correlation between satisfaction and patient age and inpatient follow-up.

2025, Journal of project management

Patient punctuality significantly impacts resource utilization and patient waiting times, among other quality indicators, within psychiatry clinics. In pursuit of service improvement, this study endeavors to develop effective appointment scheduling systems that optimally distribute patients' needs during clinical sessions, thereby enhancing resource utilization and patient satisfaction. In developing these scheduling rules, three patient-related uncertainties are considered: preference, availability, and punctuality. Various scheduling rules are evaluated based on their average total cost under different scenarios. The HSBGDM rules have emerged as a balanced approach for clinic operations, effectively managing physician time but occasionally leading to overtime variations. Increased patient delays often exacerbate physician idle times, particularly under IBVST and VBVST rules. Hybrid rules, such as the HSBGDM series, adapt well, improving patient wait times and managing unscheduled patients. However, scheduling systems like REPDM may prolong waits, potentially impacting patient satisfaction. Systems prioritizing new appointments can increase physician idle times due to unpredictability. While accommodating unscheduled patients enhances service quality, it may also cause disruptions. This study provides valuable insights into scheduling dynamics, assisting administrators in balancing efficiency, cost, and patient satisfaction.

2025, ACR North American Advances

Recent work identifies hope as an under-explored though potentially important emotion and suggests that hope can be differentiated from an often confused construct-hopefulness. A field experiment involving 272 real world consumers investigated the effects of both hope and hopefulness on consumers' decisions and actions related to retirement investing. The results show that hope and hopefulness are two distinct emotions and have very different effects on consumers' information search, risk perceptions, and choice outcomes in retirement investment decisions, with hopefulness impacting the likelihood that consumers would invest in a 401k retirement plan and hope impacting the extent of their information search and risky decision making.

2025, British Journal of General Practice

BackgroundStratifying patient populations by risk of adverse events was believed to support preventive care for those identified, but recent evidence does not support this. Emergency admission risk stratification (EARS) tools have been widely promoted in UK policy and GP contracts.AimTo describe availability and use of EARS tools across the UK, and identify factors perceived to influence implementation.Design and settingCross-sectional survey in UK.MethodOnline survey of 235 organisations responsible for UK primary care: 209 clinical commissioning groups (CCGs) in England; 14 health boards in Scotland; seven health boards in Wales; and five local commissioning groups (LCGs) in Northern Ireland. Analysis results are presented using descriptive statistics for closed questions and by theme for open questions.ResultsResponses were analysed from 171 (72.8%) organisations, of which 148 (86.5%) reported that risk tools were available in their areas. Organisations identified 39 different EA...

2025

Background: The Ministry of Health of Malaysia has invested significant resources to implement an electronic health record (EHR) system to ensure the full automation of hospitals for coordinated care delivery. Thus, evaluating whether the system has been effectively utilized is necessary, particularly regarding how it predicts the work performance of health care providers. Methods: Convenience sampling was employed for data collection in three government hospitals for seven months. A standardized efficacy survey for EHR systems was administered to primary health care providers (specialists, medical officers, and nurses) as they participated in medical education programs. Empirical data were assessed by employing partial least squares-structural equation modeling for hypothesis testing.Results: The results demonstrated that knowledge quality had the highest score for predicting performance and had a large effect size, whereas system compatibility was the strongest component of system...

2025, Studies in Computational Intelligence

Congratulations to Revlin Abbi PhD, from Elia ElDarzi's group at Harrow Campus of University of Westminster. His doctoral thesis 'A patient length of stay grouping and predicting methodology incorporating Gaussian Mixture models and Classification algorithms' breaks new ground and gives remarkable insights into the process of care. The thesis was co-supervised by Christos Vasilakis. The brilliance of Revlin's contribution, describes a novel clustering approach to separate out clinically meaningful groups in large data sets. Moreover, his approach enabled Prof Malcolm Faddy to describe four components, made up of several phases in the same data. See Readers write, page 6, for a letter from Malcolm pointing out the difference between components and phases. And pages 2 and 3 where Revlin describes the clinical relevance and practical potential of the new methodology using length of stay data for over a hundred thousand stroke patient data in the English National HES data set. There is an interesting relationship between the advent of the computer era, chaos in banking and bed crises in hospitals. Sally would instantly reply, "Correlation is not causation", and I agree. Let me explain, however, why, in both fields of endeavour, I think that misunderstanding of the use and abuse of computer generated 'numbers' is the root cause of current difficulties in both sectors. Both are human activity systems and in both beds and shares there are movers and stayers. Before the computer era, paper transactions were used in the Stock Exchange to buy and sell shares; similarly, manually collected midnight bed states and admission books underpinned performance comparison in hospitals. Now algorithmic trading or automated trading, also known as algo trading, black-box trading, or robo trading (Wikepedia) is used in financial markets. Nearly fifty percent of trades are now done by computers. Look at the daily pattern of share dealing. The speed of rise and fall clearly shows a herd generated chaotic system, driven down or up by computers generated numbers. Whereas, the reality is that most shareholders are not selling, and if people knew who was gambling, would everyone panic. Similarly, forty years after the dawn of the computer era changed the way that throughput in hospitals was measured, hospitals are in chaos. Is it cause and effect -I think so. Its twenty years since both Gary Harrison developed a mathematical two compartment model to explain the exponential nature of flow in midnight bed states. And Sally McClean began her research into the phases of care in cohort data sets. Now 11 doctoral theses and over 100 papers later the SCIENCE BASE OF NOSOKINETICS IS CLEAR -What next?

2025, Indian journal of private psychiatry

Mental illness and homelessness are interlinked and constitute a vicious circle. Persons who are suffering from mental illness may get separated from their families because of their psychopathology or cognitive distortion. Sometimes they may not be able to recall their names and family residential address and wander away to faraway places. Being part of society is the key to having the important things in life that everyone wants. A person who is suffering from schizophrenia or other psychotic disorder also needs good health, relationships, food, shelter, and employment. With the help of new technology, like Google maps, and Aadhaar fingerprint, we can decrease the time spent for tracing the families of persons with mental illness and reintegrate the patients with their family members. Here, through this case study, an attempt has been made to discuss the efforts made and challenges faced concerning the reintegration of mentally ill persons with a special focus on enhancing social networks by using newer technology.

2025

The study examines the potential role of fintech-Islamic banking in eradicating poverty in Nigeria among population of selfemployed bankable adults who maintain formal account with the full fledge Islamic banks Jaiz and Tajbank as well as Sterling Plc being conventional bank with Islamic banking Window in Northwest geopolitical zone of Nigeria covering the seven states. The study used a set of questionnaire with six subscales alongside demographic variables having satisfied validity and reliability requirements being important psychometric properties for any data collection instrument. The study take 400 respondents drawn from multistage and purposive sampling techniques in four randomly selected states in the Northwest. The researcher however collected data through on spot data mechanism and were managed and processed using Statistical Package for Social Sciences (SPSS). The Data were analysed using hierarchical regression analysis involving predictor and criterion variables. The f...

2025

BACKGROUND The increasing integration of digital health tools into care may result in a greater flow of personal health information (PHI) between patients and providers. Although privacy legislation governs how entities may collect, use, or share PHI, such legislation has not kept pace with digital health innovations, resulting in a lack of guidance on implementing meaningful consent. Understanding patient perspectives when implementing meaningful consent is critical to ensure that it meets their needs. Consent for research in the context of digital health is limited. OBJECTIVE This state-of-the-art review aimed to understand the current state of research as it relates to patient perspectives on digital health consent. Its objectives were to explore what is known about the patient perspective and experience with digital health consent and provide recommendations on designing and implementing digital health consent based on the findings. METHODS A structured literature search was dev...

2025, Revue Africaine de Médecine Interne (RAFMI)

Objectives: The aim of this study was to evaluate the management of diabetes and its chronic complications in the country.
Methods: This was a cross-sectional, descriptive, multicenter, one-year study conducted in specialized diabetes care sites in Guinea. It covered diabetic patients followed up at these sites for at least one year. Data were collected from questioning, physical examination and patient records.
Results: A total of 630 diabetic patients were enrolled. The mean age of the patients was 55.4 ±12.3 years. Diabetes was type 2 in 97.1% of cases.
The average known duration of diabetes was 5.56 years. Mean values for HbA1c, fasting plasma glucose and postprandial plasma glucose were 9.5%, 1.92g/l and 2.57g/l respectively, with only 23.4% of patients achieving the ADA-recommended glycemic targets. ADOs were prescribed predominantly in 57.8% of patients. Hypertension was the most frequent risk factor (44.6%), with only 6.4% of patients achieving the recommended blood pressure targets. It was treated with calcium channel blocker monotherapy in 56.2% of cases. Diabetic peripheral polyneuropathy (39.4%) was the main microangiopathy, while macroangiopathy was dominated by coronary artery disease (15.1%).
Conclusion: The glycemic control of Guinean diabetics is inadequate. Treatment should be initiated earlier and made more intensive, targeting both hyperglycemia and other associated cardiovascular risk factors.

2025, International Journal of Advance Research in Medical Surgical Nursing

Background of the Study: Intravenous (IV) therapy is an integral part of modern medicine and is practiced in virtually every healthcare setting, dealing with critical and general ailments of a community. Majority of the IV drugs are administered by nurses, who are increasingly involved in the insertion of peripheral vascular access devices. The widespread use of IV therapy can lead to complacency about the risks and may result in poor standards of practice, putting patients at risk of clinical harm and making nurses vulnerable to a claim of negligence. Methodology: In order to achieve the objectives of the study the study design was factorial time series design. The sample consisted of 40 subjects (20 in each group-1 & group-2) who had developed mild symptoms of intravenous complication, selected by convenience sampling technique. In this study the dependent variables were complications of IV cannulation. The independent variables were two modalities of treatment (thrombophob ointment & hot fomentation). The pre-test score was assessed before treatment and treatment was given for two consecutive days. The post-test data were analysed using statistical tests like One-way ANOVA and T-Test. The mean value of pre-test of Group-I is 7.650, the SD is 1.843 and mean value of post test of group-I is 3.633, the SD is 1.070 and the't' value of Group I is 15.325. The obtained 't' value is greater than table value of t (18) = 2.09. So thrombophob with hot fomentation is effective in reducing complications of IV cannulation. The mean value of pre-test of Group -II is 7.950, the SD is 1.637 and mean value of post test of group-II is 4.166, the SD is 0.0861 and the 't' value of Group II is 12.281. The obtained 't' value is greater than table value of t (18) = 2.09. So thrombophob without hot fomentation is effective in reducing complications of IV cannulation. In order to find out the significant difference between the two scores in group I and group II unpaired 't' test value was computed. The obtained 't' value is lower than the table value of T (38)= 2.02. Calculated value is less than the table value so there is no significant difference between the two interventions provided by the researcher. There is no association between the mean differences & the selected background factors among patients on intravenous therapy in experimental group-I & experimental group -II. The investigator had chosen two modalities of treatment to prevent local complications of IV cannulisation. The study reiterated that both the interventions (Thrombophob ointment with & without hot fomentation) are effective in preventing local complications of IV cannulisation. This result should be incorporated practically and introduced as evidenced-based practice to students and nurses.

2025, EPRA International Journal of Research & Development (IJRD)

Introduction- Silicosis is one of the oldest occupational lung disease, which is incurable and is caused by inhalation of dust containing free crystalline silica. Silicosis is preventable disease. Still this disease kills thousands of workers around the worlds every year. Various studies have should that the quarry workers due not having awareness regarding silicosis and its prevention. In this study, distribution of booklet among quarry workers is an attempt to improve the knowledge regarding silicosis and it/s prevention. Material and Methods - Quantitative descriptive survey study approach and non experimental research design was used.Total 100 quarry workers working in mining and residing in Jodhpur were selected by purposive sampling technique.Data collection by structured knowledge questionnaire and analysed by using descriptive and inferential statistics. Result - The findings of the study reveals that to the level of awareness shows that majority (52%) of the sample had abov...

2025, British journal of hospital medicine

The COVID-19 pandemic forced changes to service delivery across healthcare. While some of these were by necessity temporary, others offered opportunities to change the way that healthcare is delivered for the benefit of both patients and healthcare professionals. In September 2021, a group of key stakeholders with experience in running integrated care systems to deliver cancer care and patient and public involvement came together to discuss their experiences during the pandemic and to offer recommendations for the safe transition and implementation of cancer care in the community setting. The meeting was sponsored by Becton Dickinson (BD).

2025, British Journal of Hospital Medicine

The COVID-19 pandemic challenged the NHS to make rapid adjustments to practice to ensure that patients could continue to access vital treatments while reducing the risk of infection. A roundtable discussion was convened, including professionals from cancer care delivery and those working in patient involvement, to discuss experiences during the pandemic and to offer recommendations for the safe transition and implementation of cancer care in the community setting.

2025, Saúde em Debate

RESUMO Este artigo analisa a série histórica de um conjunto de indicadores, de 2002 a 2014, relacionados ao Sistema Único de Saúde do Brasil, embasado na metodologia da Proposta de Avaliação de Desempenho do Sistema de Saúde. Os resultados mostram que houve uma sensível melhoria nos indicadores de dimensão socioeconômica e nos da dimensão condições de saúde. A melhoria dos indicadores de condições de saúde pode estar relacionada ao incremento de suporte financeiro; ao incremento de recursos humanos; ao aumento do acesso às consultas médicas e aos serviços de alta complexidade; e a uma maior disponibilização de horas de profissionais de saúde para a população residente.

2025, sosSanità

Dai numeri forniti dal Ministero dell'economia e delle finanze (MEF) emergono come 12 Regioni (Piemonte, Trento, Veneto, Friuli Venezia Giulia, Liguria, Toscana, Marche , Lazio, Abruzzo, Puglia, Basilicata e Calabria) non spendono tutte... more

2025, Proceedings of the First Transnational Webinar on Adult and Continuing Education (TRACED 2020)

The Kampung KB program is one of the innovations of the National Population and Family Planning Agency (Badan Kependudukan dan Keluarga Berencana Nasional, BKKBN) in Indonesia since 2014 in providing integrated services to the community, namely integrating population issues, economic welfare, public knowledge, public health, politics and other aspects. The aim is none other than to overcome the problem of population growth which is increasing and which results in obstruction of the pace of national development in various fields. This program is directed at democratization and decentralization, namely by encouraging community participation or involvement towards an independent society. The research was conducted using a qualitative approach to the case study method in Dusun Cigadung, Karyamukti Village, Paturaman District, City of Banjar. This village has received an Innovative Government Award in the field of public service of the Ministry of Home Affairs. The results illustrate the construction of a participatory model in forming a population alert village through the Kampung KB program.

2025

As we know, the Indonesian economy experienced a deflation of 0.1% in July 2020. This occurred in the food, beverage and tobacco category, which experienced a deflation of 0.79%. and contributed 0.19% to deflation. Foodstuffs that contributed to deflation included shallots, free-range chicken, rice, garlic, cayenne pepper, and sugar. Deflation in July and August 2020 was triggered more by falling prices for a number of food, beverages, and transportation, increasing demand amid the Covid-19 pandemic. Trends in other countries show that inflation and deflation are beating supply and demand. in 4 countries such as Indonesia, the Philippines, Thailand and Laos involving 3,831 MSME respondents explained that the contribution of MSMEs to Gross Domestic Product in these 4 countries was more than 50%. The enactment of the region had a negative impact on MSMEs, but some MSMEs continued to operate despite experiencing a decline in income of more than 40%.

2025, Voprosy Obrazovaniya / Educational Studies Moscow

The “human factor”, i. e. the conflict and protest behavior of students and faculty, often becomes a key problem during and after university consolidations. This paper provides an insight into reorganization-related university transformations that are perceived as tangible and important by students, approaching the issue from the viewpoint of the radical organizational change theory. Four cases of Russian university mergers are investigated. Data btained from individual and group interviews with students who attended the universities during the reorganization is used to build clusters of “formal” and “informal” changes that the students tagged as the most important. It transpired that students cared most about changes in the perceived value of their graduate diplomas and their potential status as prospective graduates of a particular university. Meanwhile, the content of education programs and the objective university performance indicators were rarely mentioned by students when th...

2025, Canadian Journal of Emergency Nursing

Background: Prior to the pandemic, every day approximately 28 long term care (LTC) residents were transferred to an emergency department (ED) in Alberta. This was placing increasing strain on healthcare resources and potentially negatively impacting the health and wellness of residents (e.g., exposure to iatrogenic harms). Many residents’ conditions could be managed within LTC if appropriate supports were provided. Poor communication between LTC and EDs can also lead to long ED lengths of stay, unnecessary resource utilization, sub-optimal health outcomes, and exposure to iatrogenic harms for LTC residents. Two INTERACT® tools (tools for early identification of acute medical issues) and a new care and referral pathway were implemented to help identify and address changes in health status among LTC residents sooner, improve communication between LTC and ED providers, and reduce unnecessary ED transfers. Methods: Between October 2019 and April 2022, 40 LTC homes and 4 EDs within the...

2025, Journal of the Operational Research Society

The aim of this paper is, on the one hand, to describe the movement of patients through a hospital department by using classical queueing theory and, on the other hand, to present a way of optimising the use of hospital resources in order to improve hospital care. A queueing model is used to determine the main characteristics of the access of patients to hospital, such as mean bed occupancy and the probability that a demand for hospital care is lost because all beds are occupied. Moreover, we present a technique for optimising the number of beds in order to maintain an acceptable delay probability at a sufficiently low level and, finally, a way of optimising the average cost per day by balancing costs of empty beds against costs of delayed patients.

2025, Academic Medicine

Few would dispute that health care should be provided in seamless, wellintegrated clinical care environments that bring together the various disciplines needed to provide patient-centered care, to educate trainees, and to conduct research into a particular disease or episode of care. Yet there are relatively few examples of successful or sustained clinical integration, either in the community setting or in academic health centers (AHCs). The authors draw on their experience with several AHCs and other health care settings to address why AHCs have not made better progress in developing integrated centers of clinical care. They characterize two fundamental types of integration that have evolved within the AHC setting: lateral and vertical. Lateral integration tends to occur among similarly situated specialties. It is easier to accomplish and far more common than is vertical integration, which brings together most, if not all, of the professionals and staff necessary to treat or manage many medical conditions and health problems. The vast majority of examples of clinical integration, whether lateral or vertical, fail to integrate essential administrative and financial functions, which has significant consequences for the ability of either laterally or vertically integrated centers to provide seamless, patient-centered care. The authors identify the emergence of several new examples of vertical clinical integration that also integrate administrative and financial functions as models for AHCs to follow and derive lessons and recommendations concerning how AHCs and others can address the cultural, financial, and governance issues that continue to limit the development of vertically integrated, patient-centered care.

2025, Cretaceous Research

Prior to 2010, Medicare payments for consultations (commonly billed by specialists) were substantially higher than for office visits of similar complexity (commonly billed by primary care physicians). In January 2010, Medicare eliminated consultation payments from the Part B Physician Fee Schedule and increased fees for office visits. This change was intended to be budget neutral and to decrease payments to specialists while increasing payments to primary care physicians. We assessed the impact of this policy on spending, volume, and complexity for outpatient office encounters in 2010. We examined outpatient claims from 2007 through 2010 for 2 247 810 Medicare beneficiaries with Medicare Supplemental (Medigap) coverage through large employers in the Thomson Reuters MarketScan Database. We used segmented regression analysis to study changes in spending, volume, and complexity of office encounters adjusted for age, sex, health status, secular trends, seasonality, and hospital referral region. Results: "New" office visits largely replaced consultations in 2010. An average of $10.20 more was spent per beneficiary per quarter on physician encounters after the policy (6.5% increase). The total volume of physician encounters did not change significantly. The increase in spending was largely explained by higher office-visit fees from the policy and a shift toward higher-complexity visits to both specialists and primary care physicians. The elimination of consultations led to a net increase in spending on visits to both primary care physicians and specialists. Higher prices, partially owing to the subjectivity of codes in the physician fee schedule, explained the spending increase, rather than higher volumes.

2025, Italian journal of medicine

Rome is vulnerable to chemical, biological, radiological, nuclear, and explosive (CBRNe) attacks. The study evaluates Rome's advanced emergency departments' state of emergency plans for massive influx of injures (PEIMAF) plans for CBRNe attacks. We propose a chemical attack on Saint Peter's Square during the Pope's General Assembly and its effects. The National Stockpile Antidotes' activation and territorial distribution timing work well for chemical attacks. We also estimated activation timing. Our data show that despite a good organization, travel times can be improved. We also believe that all major Roman hospitals must develop the PEIMAF, which should be followed by an organized training plan involving theoretical teaching and indoor and outdoor simulation to train hospital staff and evaluate PEIMAF weaknesses and vulnerabilities. The effectiveness and efficiency of first aid depend on timing, and each PEIMAF analyzed, while coherent and adequate for internal purposes, fails to integrate with the other hospitals. Integration can speed up National Stockpile Antidotes delivery and save lives. For the best CBRNe response, detailed intervention protocols must be created, updated daily, and exercised.

2025

Dokumen ini disusun sebagai bentuk refleksi sosial dan budaya oleh penulis remaja Indonesia.

2025, Archives of Public Health

Slum-dwellers lack several essential amenities (such as water, sanitation, and electricity) which make them more vulnerable than non-slum dwellers. As there is limited to no access to health and social care services in slums, the slum environment is expected to be an even more dangerous environment for older adults, negatively impacting their quality of life (QoL). To provide an overview of the perceived (unmet) health and social care needs and how it affects the QoL, this study aims to explore the self-perceived health and social needs of older adults in urban slums in Ghana. Using a phenomenological approach, 25 semi-structured interviews were conducted between May and June 2021, in the homes of older adults in two slums in Ghana. After coding and analysing the transcripts, five main themes emerged: (a) perception of health; (b) (de)motivators of health service use; (c) perception of social care, (d) social needs, and (e) influence of phenomena on QoL. It appeared that older adult...

2025, BMC Health Services Research

2025, Nature Medicine

A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4% (62.3 (55.1–70.8) million) to 6.4% (58.3 (47.6–70.7) million), but is predicted to remain above the World Health Organization’s Global Nutrition Target of <5% in over half of LMICs by 2025. Prevalence of overweight increased from 5.2% (30 (22.8–38.5) million) in 2000 to 6.0% (55.5 (44.8–67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, poli...

2025, The Lancet

Global, regional, and national disability-adjusted life years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2015: a systematic analysis for the Global Burden of Diseases, Injuries, and Risk Factors (GBD) 2015 Study GBD 2015 DALYs and HALE Collaborators Summary Background Healthy life expectancy (HALE) and disability-adjusted life years (DALYs) provide comparable summary measures of health across geography and time that can inform macro-level assessments of epidemiological patterns and health system performance, help prioritise investments in research and development, and monitor progress toward the Sustainable Development Goals (SDGs). We used Global Burden of Diseases, Injuries, and Risk Factors 2015 Study (GBD 2015) results on allcause mortality, cause-specific mortality, and nonfatal disease burden to derive HALE and DALYs by sex for 195 countries and territories from 1990 to 2015. We calculated DALYs by summing years of life lost (YLLs) and years of life lived with disability (YLDs) for each geography, age group, sex, and year. We then estimated HALE using the Sullivan method, which draws from age-specific death rates and YLDs per capita. We assessed how observed levels of DALYs and HALE differed from expected trends as related to Socio-demographic Index (SDI), a composite indicator constructed using measures of income per capita, average years of schooling, and total fertility rate. Health is improving globally, but this means more populations are spending more time with functional health loss-an absolute expansion of morbidity. The proportion of life spent in ill health decreases somewhat with increasing SDI-a relative compression of morbidity-which supports continued efforts to elevate personal income, improve education, and limit fertility. Our analysis of DALYs, HALE, and their relationship to SDI represents a robust framework on which to benchmark geography-specific health performance and SDG progress. Country-specific drivers of disease burden, particularly for causes with higher-than-expected DALYs, should inform financial and research investments, prevention efforts, health policies, and health system improvement initiatives for all countries along the development continuum. Evidence before this study Disability-adjusted life years (DALYs), a summary measure of population health based on estimates of premature mortality and nonfatal health loss, originated from the initial Global Burden of Disease (GBD) study in 1993. DALYs, in combination with other summary measures such as healthy life expectancy (HALE), offer relatively simple yet powerful metrics against which progress and challenges in improving disease burden and extending healthy lifespans can be effectively monitored over time. Published in 2012, GBD 2010 provided updated estimates of DALYs due to 291 causes and HALE in 187 countries from 1990 to 2010. GBD 2013 extended this time series to 2013, 188 countries, and 306 causes. Novel analyses for quantifying epidemiologic transitions were introduced as part of GBD 2013, enabling a comparison of shifts in years of life lost (YLLs) and years lived with disability (YLDs) with increasing levels of development. The World Health Organization (WHO) has produced estimates of DALYs and HALE largely based off GBD 2010 and GBD 2013; however, modifications were implemented for a subset of causes, disability weights, and countries, and a normative life table of 91.9 years at birth was used for calculating YLLs.

2025, The Lancet Global Health

Background Health-care needs change throughout the life course. It is thus crucial to assess whether health systems provide access to quality health care for all ages. Drawing from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019), we measured the Healthcare Access and Quality (HAQ) Index overall and for select age groups in 204 locations from 1990 to 2019. We distinguished the overall HAQ Index (ages 0-74 years) from scores for select age groups: the young (ages 0-14 years), working (ages 15-64 years), and post-working (ages 65-74 years) groups. For GBD 2019, HAQ Index construction methods were updated to use the arithmetic mean of scaled mortality-to-incidence ratios (MIRs) and risk-standardised death rates (RSDRs) for 32 causes of death that should not occur in the presence of timely, quality health care. Across locations and years, MIRs and RSDRs were scaled from 0 (worst) to 100 (best) separately, putting the HAQ Index on a different relative scale for each age group. We estimated absolute convergence for each group on the basis of whether the HAQ Index grew faster in absolute terms between 1990 and 2019 in countries with lower 1990 HAQ Index scores than countries with higher 1990 HAQ Index scores and by Socio-demographic Index (SDI) quintile. SDI is a summary metric of overall development. Between 1990 and 2019, the HAQ Index increased overall (by 19•6 points, 95% uncertainty interval 17•9-21•3), as well as among the young (22•5, 19•9-24•7), working (17•2, 15•2-19•1), and post-working (15•1, 13•2-17•0) age groups. Large differences in HAQ Index scores were present across SDI levels in 2019, with the overall index ranging from 30•7 (28•6-33•0) on average in low-SDI countries to 83•4 (82•4-84•3) on average in high-SDI countries. Similarly large ranges between low-SDI and high-SDI countries, respectively, were estimated in the HAQ Index for the young (40•4-89•0), working (33•8-82•8), and post-working (30•4-79•1) groups. Absolute convergence in HAQ Index was estimated in the young group only. In contrast, divergence was estimated among the working and post-working groups, driven by slow progress in low-SDI countries. Interpretation Although major gaps remain across levels of social and economic development, convergence in the young group is an encouraging sign of reduced disparities in health-care access and quality. However, divergence in the working and post-working groups indicates that health-care access and quality is lagging at lower levels of social and economic development. To meet the needs of ageing populations, health systems need to improve health-care access and quality for working-age adults and older populations while continuing to realise gains among the young. Funding Bill & Melinda Gates Foundation.

2025

Current mainstream approach to sensor data monitoring usually relies on cloud access: samples are acquired by connected devices and data processing is performed on remote servers. To improve responsiveness, security and resilience, devices and programming methodologies must be improved, with the aim of enabling data analytics at the edge. Unfortunately this is not an easy task, especially in the IoT domain. In this paper, we present a research approach that manages at runtime the hardware/software configuration of a low-power processing system, with the aim of adapting to dynamically changing workloads optimizing power-relevant settings to the corresponding operating point. First, we present a first validation experiment, involving a hardware-software architecture for a connected sensor-processing node that allows the set of in-place processing tasks to be executed to be remotely controllable by an external user. The designed system is capable of dynamically adapting its operating p...

2025, E Jurnal Medika Udayana

Terapi adjuvan yang biasanya diberikan pada pasien kanker payudara dan kanker kolorektal adalah kemoterapi dan radioterapi. Terapi adjuvan biasanya diberikan setelah terapi primer untuk meningkatkan angka kesembuhan penyakit, mencegah rekurensi, dan membunuh sel-sel kanker yang tersisa ataupun yang telah bermetastasis (terutama mikrometastasis). Terapi adjuvan juga berfungsi sebagai terapi paliatif untuk meningkatkan harapan hidup pasien kanker. Dalam kenyataannya banyak pasien kanker, khususnya kanker payudara dan kolorektal yang menghindari tindakan kemoterapi dan radioterapi. Dari 38 orang pasien kanker payudara dan kolorektal, didapatkan bahwa 26,3% takut gagal, 39,5% takut efek samping, 7,9% biaya yang mahal, 10,5% karena berlangsung dalam jangka waktu yang lama, dan 15,8% tidak takut terhadap kemoterapi dan radioterapi. Hasil penelitian ini menunjukkan bahwa tingkat pemahaman pasien kanker payudara dan kanker kolorektal terhadap tindakan kemoterapi dan radioterapi masih cukup rendah dimana 68,4% sampel tidak tahu dan tidak mengerti tentang tindakan kemoterapi dan radioterapi. Pemahaman yang kurang tentang tindakan kemoterapi dan radioterapi ini nantinya dapat mengakibatkan timbulnya persepsi negatif terhadap tindakan kemoterapi dan radioterapi. Maka dari itu sangat diperlukan adanya suatu edukasi yang baik bagi setiap pasien tentang penyakit dan modalitas terapi yang akan diberikan. Dokter diharapkan mampu untuk mengubah persepsi negatif pasien terkait tindakan kemoterapi dan radioterapi.

2025

The subject of this research is relations between urban SODQQLQJ DQG VRFLDO HTXLSPHQWV RI PDMRU FLWLHV DW ZKHUH 'L\DUEDN×U Erzurum, Gaziantep, Kayseri and Konya. Urbanization, industrialization and related events in contemporary societies affect badly upon physical development of urban settlements. In fact, it is necessary to observe systematically all the events related to the spatial growth, to get data based upon field studies and to fix urban strategy through central and local programmes of implementation, in order to prepare development plans for urban settlements. All of these factors concerning of urban planning are checked by social quipments. This point of view is fundamental for each sectoral growth and zoning. It covers those areas including commercial, social, industrial, cultural, health, education and recreational activities. But this case include it serving by the state. So this study is defined a case of Turkey as a developing country. Planning problems concerning social equipments will be classified and to search thorougly.

2025, International Journal of Logistics Management

Purpose-The study identifies nine important research areas and critically maps the structural relationships among supply chain resilience (SCRES) dimensions, namely, vulnerabilities, capabilities, strategies and performance metrics. The analysis also revealed various influential authors, journals, institutions and trending articles, across SCRES literature. Design/methodology/approach-This study performs a bibliometric analysis of 771 articles published over the 32 years from 1988 to 2020, and network analysis in combination with content analysis of 90 most cited articles published in research fronts of SCRES. Findings-The results demonstrate the underlying research areas within the SCRES, which are clustered into nine research themes: (1) conceptual development of SCRES, (2) recent developments of designing resilient supply chain (SC) networks, (3) focus on identifying drivers of SC vulnerability and risks, (4) impact of risks on network resilience, (5) risk assessment to avoid breakdowns/disruptions, (6) measuring resilience approaches/ drivers to improve SC performance, (7) building resilient capabilities by integrating other SC dimensions, (8) quantification of SC network and (9) emphasis on developing robustness in SC networks. Practical implications-This research offers implications for classifying the works in literature based on bibliometric information and network analysis techniques. This can help researchers and practitioners to understand the prominent areas in SCRES and provide guidelines for future research in this area. Originality/value-This study provides an overview of the evolution of SCRES over time in the domain of supply chain management and also outlines a future research agenda claimed by the trending articles to encourage further investigations in the field of SCRES.

2025, The Lancet Neurology

Background Stroke is a leading cause of mortality and disability worldwide and the economic costs of treatment and post-stroke care are substantial. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic, comparable method of quantifying health loss by disease, age, sex, year, and location to provide information to health systems and policy makers on more than 300 causes of disease and injury, including stroke. The results presented here are the estimates of burden due to overall stroke and ischaemic and haemorrhagic stroke from GBD 2016. We report estimates and corresponding uncertainty intervals (UIs), from 1990 to 2016, for incidence, prevalence, deaths, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs). DALYs were generated by summing YLLs and YLDs. Cause-specific mortality was estimated using an ensemble modelling process with vital registration and verbal autopsy data as inputs. Non-fatal estimates were generated using Bayesian meta-regression incorporating data from registries, scientific literature, administrative records, and surveys. The Socio-demographic Index (SDI), a summary indicator generated using educational attainment, lagged distributed income, and total fertility rate, was used to group countries into quintiles. In 2016, there were 5•5 million (95% UI 5•3 to 5•7) deaths and 116•4 million (111•4 to 121•4) DALYs due to stroke. The global age-standardised mortality rate decreased by 36•2% (-39•3 to -33•6) from 1990 to 2016, with decreases in all SDI quintiles. Over the same period, the global age-standardised DALY rate declined by 34•2% (-37•2 to -31•5), also with decreases in all SDI quintiles. There were 13•7 million (12•7 to 14•7) new stroke cases in 2016. Global age-standardised incidence declined by 8•1% (-10•7 to -5•5) from 1990 to 2016 and decreased in all SDI quintiles except the middle SDI group. There were 80•1 million (74•1 to 86•3) prevalent cases of stroke globally in 2016; 41•1 million (38•0 to 44•3) in women and 39•0 million (36•1 to 42•1) in men. Interpretation Although age-standardised mortality rates have decreased sharply from 1990 to 2016, the decrease in age-standardised incidence has been less steep, indicating that the burden of stroke is likely to remain high. Planned updates to future GBD iterations include generating separate estimates for subarachnoid haemorrhage and intracerebral haemorrhage, generating estimates of transient ischaemic attack, and including atrial fibrillation as a risk factor.

2025, Health Care Management Review

Background: Community-academic health partnerships (CAHPs) have become increasingly common to bridge the knowledge-to-practice gap in health care. Because working in such partnerships can be excessively challenging, insights into the individual-level enablers of high performance will enable better management of CAHPs. Purpose: Steered by the goal-setting theory, this study examined the relations between goal clarity, goal stress, goal importance, and their interactions on perceived project performance among individuals working in CAHPs' constituting projects. Methodology: Using a convergent mixed-method research design, online survey data were collected from 268 participants working in a variety of CAHP projects in three German-speaking countries. We tested the hypotheses using structural equation modeling, after which thematic analysis was carried out on the 209 open-ended responses. Results: CAHP project performance was positively associated with goal clarity and negatively associated with goal stress. A three-way interaction analysis showed that when goal importance was high, the relationship between goal clarity and project performance remained positive regardless of the level of goal stress. The qualitative data corroborate this finding. In CAHP projects, high goal importance offsets the negative effect of goal stress on project performance, indicating that workers who perceive the project goals as important can manage the stress associated with demanding goals better. Practice Implications: To achieve high project performance in CAHPs, organizational and project leaders should (a) set clear project goals, (b) facilitate project workers in dealing with stress resulting from overly demanding goals, and (c) emphasize the importance of the project goals, especially when goal stress is high.

2025, Oklahoma Politics

How do legislators make up their minds when voting on complex issues such as health care reform? This paper seeks to answer that question and provide insight as to which sources legislators rely on for information. This paper uses a research strategy similar to that used by John in his study of congressional voting decisions and David Ray's 1982 study of voting cues in state legislatures. The research is based on the Oklahoma Legislature's adoption of a managed care system for its Medicaid program in 1993. The data for this study are drawn from a survey sent to members of the Oklahoma Legislature and interviews with 25 legislators and others involved in the policy process. In the early 1990s, states began launching efforts to reform their Medicaid programs. Federal mandates in the 1980s and 1990s required states to expand Medicaid eligibility. In Oklahoma, the number of Medicaid recipients increased by over 18 percent between 1992 and 1993 (Oklahoma Health Care Authority). Many states, under tremendous economic and political pressure, sought to change the way Medicaid was administered. Oklahoma's legislature voted to adopt a managed care system for those receiving Medicaid benefits in 1993. It was one of the first states to do so, and thus it did not have a great deal of experience from which to draw.

2025, Oklahoma Politics

2025, International Journal of Research Publication and Reviews

This research investigated the barriers to effective teamwork in hospital settings and proposed strategies to overcome these obstacles. Through a mixed-method approach involving qualitative and quantitative data collection, the study identified primary barriers such as hierarchical structures, communication issues, conflicts, unclear roles, resistance to change, staffing shortages, and cultural/language diversity. Strategies to address these challenges included fostering a collaborative culture, promoting clear communication channels, conflict resolution training, creating a change management team, emphasizing patient-centered care, recruitment/training/retention initiatives, and cultural competence training. The study was conducted in Todah Hospital (Obuasi East district) and Ataasi Nkwanta Health Center (Adansi South district, New Edubiase), involving 60 participants from health workers, District Health Directors, opinion leaders, health experts, and local chiefs. Data sources included interviews, observations, expert opinions, focus group discussions, articles, books, and websites. Data analysis involved organizing and summarizing data into tables. Findings revealed barriers impacting patient care and organizational performance, emphasizing the need for proactive strategies. Recommendations include fostering a collaborative culture, investing in training and development, implementing effective communication channels, updating conflict resolution strategies, and addressing staffing shortages. The study contributed to enhancing patient care, reducing stress, empowering organizations and individuals, and advancing academic knowledge.

2025, Revista Médica del …

Resumen Introducción: la revascularización miocárdica quirúrgica (RVMQ) incompleta es un factor determinante en la reaparición precoz de angina y determina una menor sobrevida para los pacientes. Objetivo: el objetivo del presente trabajo... more

2025, Management in Health

XVI/4/2012; pp. 9-12 measurements to prove that exposure to these risk factors have impact on cancer burden in Northern Sudan is urgently needed.

2025, Prosiding HEFA (Health Events for All)

2025, Antara Ilmu dan Nilai: Dinamika Penolakan Vaksinasi COVID 19 di Indonesia

Pada bulan Desember 2019, dunia kembali diguncang oleh sebuah peristiwa besar yang mengejutkan masyarakat, yakni munculnya pandemi COVID. WHO secara resmi menetapkan COVID-19 sebagai pandemi global termasuk di Indonesia. Berbagai upaya dilakukan untuk menanggulangi masalah COVID-19 ini salah satunya upaya pemberian vaksinasi untuk mencegah penyebaran dan mengurangi angka kematian. Vaksinasi merupakan upaya yang dianggap efektif. Menurut WHO pada tahun 2021, vaksin COVID-19 telah menyelamatkan setidaknya sekitar 14,4 juta jiwa di seluruh dunia dan vaksin COVID-19 telah melalui uji yang ketat terkait keamanan dan efektivitasnya. Namun, dalam realitasnya tidak semua masyarakat menerima upaya vaksinasi yang ada karena anggapan bahwa vaksinasi bertentangan dengan nilai-nilai yang dianut seperti sosial, agama, dan budaya. Pandemi COVID-19 tidak hanya menimbulkan masalah medis dan logistik, tetapi juga menimbulkan konflik antara nilai-nilai sosial budaya dan ilmu pengetahuan di masyarakat. Di

2025

Prevalensi kejadian kegagalan pernapasan semakin tahun semakin meningkat. Kematian akibat gagal napas juga dilaporkan menduduki presentase tertinggi. Sehingga perlu perhatian dan penanganan yang tepat saat terjadi kegawatan pernafasan yaitu dengan bantuan alat bantu nafas ventilator. Masalah utama pasien dengan alat bantu nafas atau ventilator mekanik adalah bersihan jalan nafas inefektif. Hal ini mengakibatkan hipoksemia. Perubahan saturasi oksigen seseorang dipengaruhi oleh tindakan open suction. Tujuan penelitian ini adalah menjelaskan pengaruh perbedaan open suctioning pada pasien ventilator dengan tekanan 10 mmHg dan 15 mmHg terhadap perubahan SpO2. Penelitian ini menggunakan Quasy Experiment pre and post group design. Variabel independen penelitian ini adalah Open Suction. Variabel dependen penelitian ini adalah kadar saturasi oksigen. Populasi dalam penelitian ini adalah seluruh pasien ventilator yang di Rawat ICU RS Husada Utama Surabaya dan besar sampel yang didapatkan adal...

2025, RELATÓRIO DE INVESTIGAÇÃO DO SURTO DA MALÁRIA

O presente estudo analisou o surto da malária ocorrido no Distrito de Macate, Província de Manica, durante o mês de Fevereiro de 2025. Recorreu-se a uma abordagem metodológica mista, integrando dados epidemiológicos, climáticos e sociocomportamentais. Os resultados evidenciam que o surto esteve associado a condições climatéricas atípicas, caracterizadas por precipitação moderada a intensa e temperaturas elevadas, bem como a fragilidades nos mecanismos de prevenção e resposta existentes. A análise espacial revelou uma maior incidência nos povoados periféricos, correlacionada com factores de natureza social, ambiental e estrutural. Conclui-se que o referido surto resultou de uma complexa interação entre múltiplas variáveis, requerendo uma intervenção multissectorial coordenada para a sua mitigação e para a prevenção de ocorrências futuras.

2025, Jornal Brasileiro de Políticas Farmacêuticas

Introdução: A Assistência Farmacêutica (AF) é um componente do Sistema Único de Saúde (SUS), garantindo acesso a medicamentos e promovendo seu uso racional. A inclusão formal da AF no Plano Municipal de Saúde (PMS) é importante para seu fortalecimento e integração com as demais políticas de saúde. Objetivo: Orientar a elaboração do capítulo específico da AF nos PMS, garantindo que seus aspectos essenciais sejam contemplados de forma estratégica, técnica e financeira. Métodos: Trata-se de um ensaio teórico baseado na experiência acadêmica e técnica dos autores, além da análise de documentos normativos e estudos sobre a inserção da AF no planejamento municipal. Resultados: A análise situacional é destacada como ferramenta central para estruturar a AF nos PMS, permitindo definir diretrizes, objetivos, metas e indicadores. O planejamento da AF deve considerar sua evolução nos três modelos lógicos: distribuição de medicamentos, acesso a medicamentos e resolução das necessidades relacionadas à farmacoterapia. A integração política e financeira da AF é essencial para garantir sua execução e sustentabilidade. Conclusão: A presença da AF no PMS não pode ser meramente formal, deve ser embasada em um diagnóstico detalhado e na articulação com outros setores da saúde. A participação ativa dos farmacêuticos no planejamento é indispensável para garantir que a AF seja reconhecida como um pilar estratégico da gestão municipal, promovendo melhorias concretas na qualidade do cuidado e no uso racional de medicamentos.

2025, Gaceta Mexicana De Oncologia

Resumen En México, el Consentimiento Informado (CI) constituye una obligación ética y un requisito legal que se especifica en las leyes; sin embargo, algunos estudios han sugerido que el derecho a la autodeterminación, que es la base del respeto a la autonomía del paciente del movimiento anglo-americano de ética aplicada, debe ser adaptado a las particularidades del contexto mexicano. La mayor parte de los pacientes atendidos en el Instituto Nacional de Cancerología (INCan), son mujeres con neoplasias de mama o cáncer cérvico-uterino, seguidos de cánceres de tubo digestivo. Un porcentaje importante de pacientes vistos son analfabetas, y más de la mitad tiene 6 años o menos de escolaridad. En cuanto a la ocupación, casi el 70% de los enfermos están desempleados o con empleos no formales, con ingresos mensuales de menos de 3,000.00 pesos mexicanos. Se realizó una investigación cualitativa, método etnográfico y fenomenológico con técnica de observación participante, con entrevistas a profundidad de 10 casos. El estudio de casos colectivo situacional se llevó a cabo en el Servicio de Cuidados Paliativos. Nuestro estudio mostró que para asegurar que la firma del CI en cuidados paliativos sea realizada por el paciente y su familia cabalmente, se requiere considerar la condición física y emocional. El documento debe contener información clara, concisa, explícita y sin tecnicismos sobre los tratamientos paliativos, modelos de atención, referencia y contrarreferencia. Su aplicación será precisa y en su justa dimensión por el riesgo de iatrogenia informativa ante la aplicación estricta, según el punto de vista de pacientes y familiares encuestados. La visión del 95% de los pacientes sobre el CI mostró estar a favor de la información sobre los cuidados y medicina paliativa, y firmaron el documento. Documento descargado de el 04/03/2015. Copia para uso personal, se prohíbe la transmisión de este documento por cualquier medio o formato.