8,085 results match your criteria goals challenges


What are women's experiences of immediate skin-to-skin contact at caesarean section birth? An integrative literature review.

Midwifery 2021 Jun 10;101:103063. Epub 2021 Jun 10.

Senior Lecturer School of Nursing, RN/RM/PhD, University of Wollongong. Electronic address:

Background: Skin-to-skin is a well-established practice at vaginal births promoting the health of women and babies. Facilitation of skin-to-skin at caesarean section birth is growing despite environmental and historical challenges. This is led by the expectancy of women and of health professionals increasingly understanding its importance. Read More

View Article and Full-Text PDF

A Typology of Existing Machine Learning-Based Predictive Analytic Tools Focused on Reducing Costs and Improving Quality in Health Care: Systematic Search and Content Analysis.

J Med Internet Res 2021 Jun 22;23(6):e26391. Epub 2021 Jun 22.

Stanford School of Medicine, Stanford Center for Biomedical Ethics, Stanford, CA, United States.

Background: Considerable effort has been devoted to the development of artificial intelligence, including machine learning-based predictive analytics (MLPA) for use in health care settings. The growth of MLPA could be fueled by payment reforms that hold health care organizations responsible for providing high-quality, cost-effective care. Policy analysts, ethicists, and computer scientists have identified unique ethical and regulatory challenges from the use of MLPA in health care. Read More

View Article and Full-Text PDF

An observational case series of targeted virtual geriatric medicine and palliative care consults for hospitalized older adults with COVID-19.

Ann Palliat Med 2021 Jun 18. Epub 2021 Jun 18.

Yale School of Medicine, Section of Geriatrics, Department of Internal Medicine, New Haven CT, USA.

Background: COVID-19 presents unique challenges to the care of hospitalized older adults, including fractured lines of communication and uncertainty surrounding long term trajectories in cognition and function. Geriatric medicine and palliative care clinicians bring specialized training in facilitating communication in the face of uncertainty. Insurance expansion of virtual visits enabled inpatient virtual consultation, which can preserve personal protective equipment and minimize exposure to clinicians. Read More

View Article and Full-Text PDF

Same goals, different challenges: a systematic review of perspectives of people with diabetes and healthcare professionals on Type 2 diabetes care.

Diabet Med 2021 Jun 21:e14625. Epub 2021 Jun 21.

Centre for Health Services Research, The University of Queensland, Brisbane, Australia.

Aims: To identify the views of people with diabetes (PWD) and healthcare professionals (HCP) about Type 2 diabetes care.

Methods: A systematic review of qualitative studies reporting both groups' views using thematic synthesis frameworked by the eHealth Enhanced Chronic Care Model was conducted.

Results: We searched six electronic databases between 2010-2020, identified 6,999 studies and included 21. Read More

View Article and Full-Text PDF

Geriatric Education on Telehealth (GET) Access: A medical student volunteer program to increase access to geriatric telehealth services at the onset of COVID-19.

J Telemed Telecare 2021 Jun 21:1357633X211023924. Epub 2021 Jun 21.

Department of Psychiatry, University of Michigan Medical School, USA.

The coronavirus disease 2019 pandemic placed an unprecedented demand on health systems to rapidly shift ambulatory in-person care to virtual care. Geriatric patients face more challenges with video visit access compared to younger patients due to discomfort with technology and less access to devices and internet. Medical students at the University of Michigan created an initiative to improve access to and comfort with video visits for geriatric patients. Read More

View Article and Full-Text PDF

Latest Developments in the Management of Nut Allergies.

Curr Treat Options Allergy 2021 Jun 15:1-14. Epub 2021 Jun 15.

Section of Allergy, Immunology and Retrovirology, Baylor College of Medicine, Houston, TX USA.

Purpose Of Review: In this review, we sought to describe the most recent advances in the dietary and medical management of peanut and tree nut allergy, including selective introduction and immunotherapy.

Recent Findings: Dietary updates include changes to labeling laws, improved information sources, and new apps for buying foods in shops and overseas to better protect individuals with nut allergies. There are still issues in the management of nut allergies in schools, such as parents having to resort to packed lunches instead of school meals and patients experiencing bullying. Read More

View Article and Full-Text PDF

Who aspires to be a scientist/who is allowed in science? Science identity as a lens to exploring the political dimension of the nature of science.

Cult Stud Sci Educ 2021 Jun 15:1-8. Epub 2021 Jun 15.

Georgia State University, Atlanta, USA.

Our purpose in this paper is to put forward an argument about both the need and the value for understanding how the constructs of science identity and the nature of science (NOS) might intersect and intertwine and offer useful insights about science participation in times of crises. Based on our knowledge and understanding of these two research areas, we maintain that science identity research has not been fully engaged in understanding how perspectives on NOS might be intersecting with the questions of who can be (or not) a scientist and who is allowed (or not) in science. In this paper, we argue that the formation of a disrupting science identity that challenges existing constructed systems of power in science, requires robust understandings of NOS that place emphasis on the socially-produced narratives about science and scientists. Read More

View Article and Full-Text PDF

Beyond A1C: A Practical Approach to Interpreting and Optimizing Continuous Glucose Data in Youth.

Diabetes Spectr 2021 May 25;34(2):139-148. Epub 2021 May 25.

Department of Pediatrics, Section of Diabetes and Endocrinology, Baylor College of Medicine and Texas Children's Hospital, Houston, TX.

Despite significant pharmacological and technological advances in the treatment of type 1 diabetes, the majority of youth in the United States do not meet the American Diabetes Association's recommended A1C goal. Understanding and managing glycemic variability is important in children and adolescents. Because A1C provides an incomplete picture of day-to-day glycemic fluctuations, continuous glucose monitoring (CGM)-derived metrics are a promising addition to address glycemic management challenges in youth with diabetes. Read More

View Article and Full-Text PDF

Implementation of a patient centred medical home (PCMH) initiative in general practices in New South Wales, Australia.

BMC Fam Pract 2021 Jun 21;22(1):120. Epub 2021 Jun 21.

General Practice Academic Unit, School of Medicine, University of Wollongong, Wollongong, Australia.

Background: With an ageing population and an increase in chronic disease burden in Australia, Patient Centred Medical Home (PCMH) models of care have been identified as potential options for primary care reform and improving health care outcomes. Adoption of PCMH models are not well described outside of North America. We examined the experiences of seven general practices in an Australian setting that implemented projects aligned with PCMH values and goals supported by their local Primary Health Network (PHN). Read More

View Article and Full-Text PDF

Utilisation, access and recommendations regarding technologies for people living with type 1 diabetes: consensus statement of the ADS/ADEA/APEG/ADIPS Working Group.

Med J Aust 2021 Jun 20. Epub 2021 Jun 20.

University of Sydney, Sydney, NSW.

Introduction: Type 1 diabetes presents significant challenges for optimal management. Despite intensive glycaemic control being the standard of care for several decades, glycaemic targets are infrequently achieved and the burden of complications remains high. Therefore, the advancement of diabetes management technologies has a major role in reducing the clinical and economic impact of the disease on people living with type 1 diabetes and on health care systems. Read More

View Article and Full-Text PDF

Parents Are the Experts: A Qualitative Study of the Experiences of Parents of Children with Severe Neurological Impairment During Decision-Making.

J Pain Symptom Manage 2021 Jun 17. Epub 2021 Jun 17.

Associate Professor, Division of Hematology/Oncology, Department of Pediatrics, University of Washington School of Medicine; Palliative Care and Resilience Lab, Center for Clinical and Translational Research, Seattle Children's Hospital and Research Institute, Seattle, WA. Electronic address:

Context: Parents of children with severe neurologic impairment (SNI) often face high-stakes medical decisions when their child is hospitalized. These decisions involve technology/surgery, goals of care/advance care planning, or transitions of care.

Objective: This study describes the experiences of parents of children with SNI during decision-making. Read More

View Article and Full-Text PDF

Mobility challenges and perceptions of autonomous vehicles for individuals with physical disabilities.

Disabil Health J 2021 Jun 7:101131. Epub 2021 Jun 7.

Department of Mechanical Engineering, Michigan State University, 428 S Shaw Lane, Rm 2555, East Lansing, MI, 48824, USA. Electronic address:

Background: Individuals with physical disabilities face many challenges, especially with mobility. Transportation plays a key role in an individual's health as it provides the access to critical services such as medical visits. Autonomous vehicles (AVs) can be one possible solution to increase transportation accessibility. Read More

View Article and Full-Text PDF

A qualitative study of stakeholder views on the use of a digital app for supported self-management in early intervention services for psychosis.

BMC Psychiatry 2021 Jun 19;21(1):311. Epub 2021 Jun 19.

Division of Psychiatry, University College London, Maple House, London, W1T 7NF, UK.

Background: Digital tools such as Smartphones have the potential to increase access to mental health support including self-management interventions for individuals with psychosis, and ultimately to improve outcomes. Self-management strategies, including relapse prevention and crisis planning and setting personal recovery goals, are intended to assist people with long-term conditions to take an active role in their recovery, with evidence for a range of benefits. However, their implementation is inconsistent, and access and uptake need to be improved. Read More

View Article and Full-Text PDF

Molecular Imprinting: Green Perspectives and Strategies.

Adv Mater 2021 Jun 18:e2100543. Epub 2021 Jun 18.

CAS Key Laboratory of Coastal Environmental Processes and Ecological Remediation, Shandong Key Laboratory of Coastal Environmental Processes, Research Center for Coastal Environmental Engineering and Technology, Yantai Institute of Coastal Zone Research, Chinese Academy of Sciences, Yantai, 264003, China.

Advances in revolutionary technologies pose new challenges for human life; in response to them, global responsibility is pushing modern technologies toward greener pathways. Molecular imprinting technology (MIT) is a multidisciplinary mimic technology simulating the specific binding principle of enzymes to substrates or antigens to antibodies; along with its rapid progress and wide applications, MIT faces the challenge of complying with green sustainable development requirements. With the identification of environmental risks associated with unsustainable MIT, a new aspect of MIT, termed green MIT, has emerged and developed. Read More

View Article and Full-Text PDF

The COVID-19 pandemic and quality of life outcomes of people with intellectual and developmental disabilities.

Authors:
Carli Friedman

Disabil Health J 2021 May 18:101117. Epub 2021 May 18.

CQL, The Council on Quality and Leadership, 100 West Road, Suite 300, Towson, MD, 21204, USA. Electronic address:

Background: People with intellectual and developmental disabilities (PWIDD) are contracting and dying of COVID-19 at significantly greater rates than nondisabled people and people with other disabilities. Despite the increased risk of COVID-19 for the IDD community, there has been less attention drawn to the impact of the pandemic on people with IDD, especially beyond their health and safety. Yet, PWIDD also face unique challenges as a result of the pandemic compared to other populations. Read More

View Article and Full-Text PDF

Australian federal, state and territory policy on the health and wellbeing of young people: A scoping review.

Health Policy 2021 May 31. Epub 2021 May 31.

Faculty of Medicine and Health, Discipline of Child and Adolescent Medicine, University of Sydney, Camperdown New South Wales 2006, Australia; The Academic Department of Adolescent Medicine, The Children's Hospital at Westmead, Westmead New South Wales Australia 2145. Electronic address:

Background: The health and wellbeing of young people are critical for the future of society but the extent to which they are addressed by overarching Australian Federal, State and Territory health policy is difficult to determine. Analysing high-level youth health policy will help establish how Australian governments are articulating and prioritising issues and may guide local and international health agendas.

Methods: This scoping review aimed to determine the extent, range and nature of Australian high-level government policy focused on the general health and wellbeing of the general population of young people. Read More

View Article and Full-Text PDF

Implementing Patient-Reported Outcome Measures in Inpatient Rehabilitation: Challenges and Solutions.

Arch Phys Med Rehabil 2021 Jun 15. Epub 2021 Jun 15.

FRSC Professor, School of Epidemiology and Public Health, University of Ottawa, and Senior Scientist, Clinical Epidemiology Program, Ottawa Hospital Research Institute.

A project with the goal of implementing electronic health record (EHR) - based patient-reported outcome measures (PROMs) into a large inpatient spinal cord injury (SCI) rehabilitation program took twice as long as expected. This report details the lessons learned from the barriers, successes, and unexpected issues that arose during this prolonged, but now successful project. The goals of this implementation project were to (1) identify barriers and supports to the use of PROMs; (2) develop an implementation strategy to incorporate the use of PROMs into inpatient rehabilitation; and (3) implement the strategy and evaluate its effects on team communication. Read More

View Article and Full-Text PDF

Fukushima Daiichi decontamination and decommissioning: current status and challenges.

Authors:
Akira Ono

Ann ICRP 2021 Jun 18:1466453211010865. Epub 2021 Jun 18.

Tokyo Electric Power Company Holdings, 1-1-3 Uchisaiwai-cho, Chiyoda-ku, Tokyo, 100-8560, Japan; e-mail:

It has been nearly 10 years since the accident at Fukushima Daiichi nuclear power plant. With the cooperation of those involved, the site, which was once in a crisis situation, has improved to the point where it is possible to look ahead and proceed with work on schedule. In the off-site area, conditions for returning home have been progressed, and evacuation orders for some areas have been lifted by the Japanese Government. Read More

View Article and Full-Text PDF

Developing an infrastructure for secure patient summary exchange in the EU context: Lessons learned from the KONFIDO project.

Health Informatics J 2021 Apr-Jun;27(2):14604582211021459

University of Naples Parthenope, Italy.

Background: The increase of healthcare digitalization comes along with potential information security risks. Thus, the EU H2020 KONFIDO project aimed to provide a toolkit supporting secure cross-border health data exchange.

Methods: KONFIDO focused on the so-called "User Goals", while also identifying barriers and facilitators regarding eHealth acceptance. Read More

View Article and Full-Text PDF

Design thinking in applied informatics: what can we learn from Project HealthDesign?

J Am Med Inform Assoc 2021 Jun 18. Epub 2021 Jun 18.

Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Objective: The goals of this study are to describe the value and impact of Project HealthDesign (PHD), a program of the Robert Wood Johnson Foundation that applied design thinking to personal health records, and to explore the applicability of the PHD model to another challenging translational informatics problem: the integration of AI into the healthcare system.

Materials And Methods: We assessed PHD's impact and value in 2 ways. First, we analyzed publication impact by calculating a PHD h-index and characterizing the professional domains of citing journals. Read More

View Article and Full-Text PDF

Key Elements on the Pathway to HCV Elimination: Lessons Learned From the AASLD HCV Special Interest Group 2020.

Hepatol Commun 2021 Jun 3;5(6):911-922. Epub 2021 May 3.

Coalition for Global Hepatitis Elimination The Task Force for Global Health Decatur GA USA.

With a decade left to reach the ambitious goals for viral hepatitis elimination set out by the World Health Organization, many challenges remain. Despite the remarkable improvements in therapy for hepatitis C virus (HCV) infection, most people living with the infection remain undiagnosed, and only a fraction have received curative therapy. Accordingly, the 2020 HCV Special Interest Group symposium at the annual American Association for the Study of Liver Diseases Liver Meeting examined policies and strategies for the scale-up of HCV testing and expanded access to HCV care and treatment outside the specialty setting, including primary care and drug treatment and settings for care of persons who inject drugs and other marginalized populations at risk for HCV infection. Read More

View Article and Full-Text PDF

Management of green economy in China and India: dynamics of poverty and policy drivers.

Environ Sci Pollut Res Int 2021 Jun 17. Epub 2021 Jun 17.

Pakistan Institute of Development Economics (PIDE), Islamabad, Pakistan.

Poverty eradication and environmental degradation are the two crucial challenges, and they are highly interlinked in the modern era. However, countries are still more emphasized in attaining poverty alleviation and alleviating environmental pollution which require enormous attention. Our study is a novel attempt to scrutinize the effect of poverty on carbon dioxide (CO) emissions for India and China over the sample period 1987-2019. Read More

View Article and Full-Text PDF

Which plants matter? A comparison of academic and community assessments of plant value and conservation status in the Moroccan High Atlas.

Ambio 2021 Jun 16. Epub 2021 Jun 16.

Global Diversity Foundation (GDF), 37 St. Margaret's Street, Canterbury, CT1 2TU, Kent, UK.

As interest in including local communities and their knowledge in biodiversity conservation increases, challenges to do so become clear. One of them is to harmonize local and academic assessments of conservation status. Here, we document the culturally valuable flora of two Amazigh communities in the Moroccan High Atlas Mountains and contrast local conservation observations with IUCN and other red-listing assessments. Read More

View Article and Full-Text PDF

Integrating Real-World Evidence in the Regulatory Decision-Making Process: A Systematic Analysis of Experiences in the US, EU, and China Using a Logic Model.

Front Med (Lausanne) 2021 31;8:669509. Epub 2021 May 31.

State Key Laboratory in Quality Research of Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao, China.

Real world evidence (RWE) and real-world data (RWD) are drawing ever-increasing attention in the pharmaceutical industry and drug regulatory authorities (DRAs) all over the world due to their paramount role in supporting drug development and regulatory decision making. However, there is little systematic documentary analysis about how RWE was integrated for the use by the DRAs in evaluating new treatment approaches and monitoring post-market safety. This study aimed to analyze and discuss the integration of RWE into regulatory decision-making process from the perspective of DRAs. Read More

View Article and Full-Text PDF

Global health diplomacy: Provision of specialist medical services in the Republic of Botswana.

Surgeon 2021 Jun 13. Epub 2021 Jun 13.

Department of Surgery, Uniformed Services University, Bethesda, USA. Electronic address:

Global Health Diplomacy (GHD) can be defined as the convergence between public health and international affairs. The following case report demonstrates the impact of "brain drain" on provision of specialist medical services in Botswana, a middle-income country in Southern Africa and how GHD is being used to address the challenge. Botswana's priorities include the attainment of Sustainable Development Goals (SDGs) by 2030 which are embedded within the Ministry of Health and Wellness (MOHW) strategy. Read More

View Article and Full-Text PDF

Reported health and social consequences of the COVID-19 pandemic on vulnerable populations and implemented solutions in six West African countries: A media content analysis.

PLoS One 2021 16;16(6):e0252890. Epub 2021 Jun 16.

Department of Epidemiology and Biostatistics, University of South Carolina Arnold School of Public Health, Columbia, South Carolina, United States of America.

Coronavirus has spread worldwide with over 140 million cases and resulting in more than 3 million deaths between November 2019 to April 2021, threatening the socio-economic and psychosocial stability of many families and communities. There has been limited research to understand the consequences of COVID-19 on vulnerable populations in West Africa, and whether such consequences differ by countries' previous experience with Ebola. Using a media analysis of leading online news sources, this study identified the populations particularly vulnerable to the threats of the COVID-19 pandemic, described the consequences of COVID-19 experienced by these populations, and reported on the solutions to address them. Read More

View Article and Full-Text PDF

Treatment Challenges and the Hope of Emerging Therapies in Early-Stage Alzheimer Disease.

J Clin Psychiatry 2021 Jun 15;82(4). Epub 2021 Jun 15.

Indiana University School of Medicine, Indianapolis, Indiana.

Alzheimer disease (AD), the most common cause of dementia, is a degenerative brain disease with no cure. In the United States alone, an estimated 5.8 million people are living with AD. Read More

View Article and Full-Text PDF

The Value of Measuring Diabetes Burnout.

Curr Diab Rep 2021 Jun 16;21(8):25. Epub 2021 Jun 16.

College of Medicine, Humanities and Public Health Sciences, Penn State University, Hershey, PA, USA.

Purpose Of Review: Diabetes represents a chronic illness with significant physical and psychological morbidities. This review aims to summarize current conceptualizations of diabetes burnout in individuals with diabetes and describe its associated adverse outcomes in this population while proposing possible mechanisms of action and targets of intervention.

Recent Findings: "Diabetes burnout" may result in adverse long-term outcomes including poor treatment compliance, diabetes complications, and depression. Read More

View Article and Full-Text PDF

[Health accounts from past to present for a political arithmeticContas da saúde do passado ao presente para a aritmética política].

Rev Panam Salud Publica 2021 11;45:e72. Epub 2021 Jun 11.

Organización Mundial de la Salud Ginebra Suiza Organización Mundial de la Salud, Ginebra, Suiza.

This report traces the progressive expansion of health accounts (HA) to measure national health expenditures, from the first attempts in 1926 by the American Medical Association to the present day. Milestones in the development of A System of Health Accounts (SHA) are covered, from the economic background to initial efforts by a few countries and organizations, to the need for a set of accounting standards for health care systems, and finally, to consolidation with SHA 2011. International organizations, such as the World Health Organization, Organization for Economic Cooperation and Development, Eurostat, the World Bank, and the United States Agency for International Development have been critical to expanding national HA exercises and ensuring that these are standardized, comparable, and become institutionalized. Read More

View Article and Full-Text PDF

Advancing estuarine ecological forecasts: seasonal hypoxia in Chesapeake Bay.

Ecol Appl 2021 Jun 14:e2384. Epub 2021 Jun 14.

U.S. Geological Survey Chesapeake Bay Program Office, Annapolis, MD, USA, 21403.

Ecological forecasts are quantitative tools that can guide ecosystem management. The co-emergence of extensive environmental monitoring and quantitative frameworks allows for widespread development and continued improvement of ecological forecasting systems. We use a relatively simple estuarine hypoxia model to demonstrate advances in addressing some of the most critical challenges and opportunities of contemporary ecological forecasting, including predictive accuracy, uncertainty characterization, and management relevance. Read More

View Article and Full-Text PDF