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Future Healthcare Journal Jun 2024Maintaining care quality and affordability, in the face of increasing demand, complexity and resource constraints, is becoming more and more challenging. A mindset shift...
Maintaining care quality and affordability, in the face of increasing demand, complexity and resource constraints, is becoming more and more challenging. A mindset shift towards how we approach healthcare services is needed. I propose we segment much of the healthcare pathway into products, harnessing the capabilities of software and hardware, including judicious yet ambitious application of emerging artificial intelligence capabilities. In this future, digital tools and capabilities that enhance a greater proportion of self-care and signposting will do more of the heavy lifting of healthcare, vitally freeing up healthcare staff including doctors to do the higher-value relational, technical, and leadership and assurance tasks needed in this future landscape.
PubMed: 38952855
DOI: 10.1016/j.fhj.2024.100145 -
Frontiers in Plant Science 2024The potential distribution of crops will be impacted by climate change, but there is limited research on potential wheat distributions under specific global warming...
The potential distribution of crops will be impacted by climate change, but there is limited research on potential wheat distributions under specific global warming targets. This study employed the Maxent model to predict the potential distribution of wheat under the 1.5°C and 2°C warming targets based on data from the Inter-Sectoral Impact Model Intercomparison Project (ISI-MIP) multimodel ensemble, and the effect of global warming on wheat planting suitability was analyzed. Our results indicated global warming would significantly change wheat planting suitability. Over half of the areas experienced changes in wheat planting suitability under two warming targets, and the effect became more pronounced with increasing temperatures. Additionally, global warming might promote wheat planting in more regions. The area with an increase in wheat planting suitability was observed to be 9% higher than those experiencing a decrease on average. Moreover, global warming could exacerbate the disparity between global wheat supply and demand in countries/regions. Traditional wheat-producing countries/regions are poised to benefit from the warming effects of climate change, while less developed and wheat import-dependent countries/regions may face greater challenges in achieving wheat self-sufficiency. To address this potential challenge, the promotion and inter-regional exchange of agronomic technologies, and the development of more rational trade standards are urgently needed. Since socioeconomic factors have a significant impact on wheat cultivation, further investigation is required to determine how the wheat planting distribution may change in the future under the combined impact of climate change, supply-demand relationship, and policy.
PubMed: 38952841
DOI: 10.3389/fpls.2024.1410388 -
Journal of the Canadian Academy of... Jul 2024Youth involved in child welfare have high rates of mental health problems and are known to receive mental health services from multiple settings. Still, gaps remain in...
BACKGROUND
Youth involved in child welfare have high rates of mental health problems and are known to receive mental health services from multiple settings. Still, gaps remain in our understanding of service use patterns across settings over the course of youth's involvement with child welfare.
OBJECTIVE
To examine the settings, reasons for contact, persons involved in initiating care, and timing of each mental health service contact for individuals over their involvement with the child welfare system, and to identify factors that predict multi-setting use.
METHODS
Data on mental health service contacts were collected retrospectively from charts for youth aged 11-18 (n=226) during their involvement with child welfare services in Montreal, Quebec. Logistic regression analysis was conducted to determine predictors of multi-setting mental health services use (defined as ≥3 settings).
RESULTS
83% of youth had at least one mental health service contact over the course of their child welfare services follow-up, with 45% having multi-setting use. Emergency Departments were the top setting for mental health services. Youth with a higher number of placements and from neighborhoods with greater social and material deprivation were significantly likelier to use ≥3 mental health service settings over the course of their follow-up.
CONCLUSION
These findings suggest a need for enhanced collaboration between youth-serving sectors to ensure that continuous and appropriate mental health care is being offered to youth followed by child welfare systems. The relationship between placement instability and multi-setting mental health service use calls for specific policies to ensure that young people do not experience multiple discontinuities of care.
PubMed: 38952788
DOI: No ID Found -
SSM - Population Health Jun 2024Preschool childcare is considered an important policy for reducing inequalities in children's cognitive and socio-emotional development, although the population-level...
Preschool childcare is considered an important policy for reducing inequalities in children's cognitive and socio-emotional development, although the population-level benefits for children under three years, is less clear. We examined the potential for childcare across the whole early years' period to benefit mental health and reduce inequalities, under different hypothetical policy scenarios, in the Growing Up in Scotland study. Marginal structural logistic regression models estimated odds ratios (ORs) to quantify inequalities in mental health and consider how these would be altered under different hypothetical scenarios. Mental health (the outcome) was measured using the total Strengths and Difficulties Questionnaire score at the start of primary school. Socioeconomic circumstances (the exposure) were represented by maternal educational measured in infancy. Sequence analysis identified common patterns of childcare usage from 10 months to four years (the mediator). Confounders were adjusted for using inverse probability of treatment weights and analyses accounted for sampling design and attrition (complete case sample, = 3205). With virtually universal uptake of government-funded childcare at 3-4 years, most variation was seen before age three. Four groups were identified: 'Parents, family & friends' (35.8%), 'Grandparents' (32.7%), 'Private group childcare' (e.g. nurseries 23.5%), 'Single professional care' (e.g. childminders 8.1%). Children whose mothers had low, compared to high, educational qualifications were 3.18 times more likely to have mental health problems (95% CI: 1.88-5.37). In a hypothetical scenario where everyone received private group childcare, inequalities increased slightly to 3.78 (95%CI: 1.46-9.76). In an alternative scenario, where everyone received single professional childcare, inequalities in mental health reduced to 2.42 (95% CI: 0.20-28.76), albeit with wide confidence intervals. Universal childcare provision before three years may widen or narrow socioeconomic inequalities in children's mental health, depending on the childcare type provided. Further research is required to understand the role of childcare quality, which we were unable to account for.
PubMed: 38952743
DOI: 10.1016/j.ssmph.2024.101682 -
SSM - Population Health Jun 2024Reducing socioeconomic inequalities in health has become an important health policy agenda. This study aimed to measure socioeconomic inequalities in health in Korea...
Reducing socioeconomic inequalities in health has become an important health policy agenda. This study aimed to measure socioeconomic inequalities in health in Korea over the past two decades and identify the contributing factors to the observed inequalities. Data from the Korea National Health and Nutrition Examination Survey (KNHANES) from 1998 to 2016/2018 were utilized. The concentration index (CI) was calculated to measure health inequalities, and decomposition analysis was applied to identify and quantify the contributing factors to the observed inequalities in health. The results indicated that health inequalities exist, suggesting that poor health was consistently more concentrated among Korean adults with lower income (1998: -0.154; 2016/2018: -0.152). Gender-stratified analyses also showed that poor health was more concentrated in lower income women and men, with the degree of inequalities slightly more pronounced among women. The decomposition approach revealed that income and educational attainment were the largest contributors to the observed health inequalities as higher income and education associated with better self-rated health. These findings suggest the importance of considering socioeconomic determinants, such as income and education, in efforts to tackling health inequalities, particularly considering that self-rated health is a predictor of future mortality and morbidity. Furthermore, it is essential to implement more egalitarian social, labour market, and health policies in order to eliminate the existing socioeconomic inequalities in health in Korea.
PubMed: 38952742
DOI: 10.1016/j.ssmph.2024.101689 -
Frontiers in Public Health 2024Due to hazardous working conditions, welders are more likely to be exposed to mild to severe eye issues during the welding process. Globally, this issue is a major... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Due to hazardous working conditions, welders are more likely to be exposed to mild to severe eye issues during the welding process. Globally, this issue is a major contributor to vision loss and blindness. One of the most frequent causes of unilateral blindness in the globe is ocular injury.
OBJECTIVE
This review aimed to assess the pooled prevalence of ocular protection practice and associated factors among welders in sub-Saharan Africa.
METHODS
Databases including PubMed, Scopus, web of Science, Google Scholar, and the African Journals Online were systematically searched for relevant literature. The statistical analysis was performed using STATA data analysis software version 14, while Microsoft Excel was used for data abstraction. We checked publication bias using a funnel plot and Egger and Begg regression tests. A -value < 0.05 was considered significant, suggesting the presence of presence publication bias. The I statistics were used to assess heterogeneity between studies. The study's overall effect was evaluated using the random effects model.
RESULTS
From retrieved 2,326 original studies, 17 studies were included in the final pooled prevalence analysis. The overall prevalence of ocular protection practice among small-scale welders in sub-Saharan Africa was 53.71% (95% CI: 42.54, 64.88). Having pre and in-service training [AOR: 4.97, 95% CI: (2.64, 9.36)], having work experience as a welder [AOR: 4.94, 95% CI: (3.24, 7.54)], and having a history of ocular injury [AOR: 2.99, 95% CI: (1.58, 5.66)] were significantly associated with the ocular protection practices.
CONCLUSIONS
In sub-Saharan African countries, the ocular protection practices among small-scale welders were low. Furthermore, the current meta-analysis found ocular protection practice to be significantly associated with on-the-job training, work experience of welders, and a history of ocular injury in the past year of small-scale welders in sub-Saharan Africa. This review will serve as baseline data for further studies to generate inputs for eye care providers and policymakers to improve good practice levels about ocular protection. Policies should be put in place to ensure all welders use proper personal-protective equipment, and receive regular health training.
Topics: Humans; Africa South of the Sahara; Prevalence; Eye Injuries; Welding; Eye Protective Devices
PubMed: 38952737
DOI: 10.3389/fpubh.2024.1397578 -
Frontiers in Public Health 2024To assess the impact of the COVID-19 pandemic on the health condition of people ≥75 years of age and on their family caregivers in Spain.
AIMS
To assess the impact of the COVID-19 pandemic on the health condition of people ≥75 years of age and on their family caregivers in Spain.
DESIGN
Multicentric, mixed method concurrent study.
METHODS
This work, which will be conducted within the primary care setting in 11 administrative regions of Spain, will include three coordinated studies with different methodologies. The first is a population-based cohort study that will use real-life data to analyze the rates and evolution of health needs, care provision, and services utilization before, during, and after the pandemic. The second is a prospective cohort study with 18 months of follow-up that will evaluate the impact of COVID-19 disease on mortality, frailty, functional and cognitive capacity, and quality of life of the participants. Finally, the third will be a qualitative study with a critical social approach to understand and interpret the social, political, and economic dimensions associated with the use of health services during the pandemic. We have followed the SPIRIT Checklist to address trial protocol and related documents. This research is being funded by the Instituto de Salud Carlos III since 2021 and was approved by its ethics committee (June 2022).
DISCUSSION
The study findings will reveal the long-term impact of the COVID-19 pandemic on the older adults and their caregivers. This information will serve policymakers to adapt health policies to the needs of this population in situations of maximum stress, such as that produced by the COVID-19 pandemic.
TRIAL REGISTRATION
Identifier: NCT05249868 [ClinicalTrials.gov].
Topics: Humans; COVID-19; Spain; Aged; Self Care; Prospective Studies; Caregivers; Female; Aged, 80 and over; Quality of Life; Male; Health Status; SARS-CoV-2; Pandemics; Primary Health Care
PubMed: 38952731
DOI: 10.3389/fpubh.2024.1389641 -
Frontiers in Public Health 2024In China, the rapid progression of population aging presents significant challenges to society and the economy, drawing widespread attention to the health conditions of...
INTRODUCTION
In China, the rapid progression of population aging presents significant challenges to society and the economy, drawing widespread attention to the health conditions of older adults. While aging is often seen as a societal burden, the phenomenon of intergenerational economic support reveals the potential for older adults to continue playing an active role within their families. This study delves into how older parents' financial support to their children can reciprocally influence their own health, exploring the potential non-linear relationships involved.
METHODS
This research, utilizing data from the 2018 China Health and Retirement Longitudinal Study, employs instrumental variable techniques and cross-sectional threshold models to examine how financial support provided by older adults to their children affects their health. It particularly highlights the varied impacts of economic support on older adults' health at different levels of support.
RESULTS
The findings indicate that moderate intergenerational economic support significantly enhances the health of older adults, while either minimal or excessive financial support does not demonstrate the same positive effect. Additionally, subjective life expectancy plays a mediating role between intergenerational economic support and the health of older adults, further emphasizing the beneficial impact of economic support.
DISCUSSION
The study underscores the importance of moderate intergenerational economic support in improving the health of older adults amidst aging challenges. Future policies and practices should consider how to encourage and optimize such support to address the challenges of an aging society, enhance the welfare of older adults, and promote healthy aging.
Topics: Humans; China; Aged; Longitudinal Studies; Female; Male; Intergenerational Relations; Cross-Sectional Studies; Middle Aged; Aging; Health Status; Aged, 80 and over; Financial Support
PubMed: 38952730
DOI: 10.3389/fpubh.2024.1337829 -
Frontiers in Health Services 2024Social needs screening can help modify care delivery to meet patient needs and address non-medical barriers to optimal health. However, there is a need to understand how...
BACKGROUND
Social needs screening can help modify care delivery to meet patient needs and address non-medical barriers to optimal health. However, there is a need to understand how factors that exist at multiple levels of the healthcare ecosystem influence the collection of these data in primary care settings.
METHODS
We conducted 20 semi-structured interviews involving healthcare providers and primary care clinic staff who represented 16 primary care practices. Interviews focused on barriers and facilitators to awareness of and assistance for patients' social needs in primary care settings in Maryland. The interviews were coded to abstract themes highlighting barriers and facilitators to conducting social needs screening. The themes were organized through an inductive approach using the socio-ecological model delineating individual-, clinic-, and system-level barriers and facilitators to identifying and addressing patients' social needs.
RESULTS
We identified several individual barriers to awareness, including patient stigma about verbalizing social needs, provider frustration at eliciting needs they were unable to address, and provider unfamiliarity with community-based resources to address social needs. Clinic-level barriers to awareness included limited appointment times and connecting patients to appropriate community-based organizations. System-level barriers to awareness included navigating documentation challenges on the electronic health record.
CONCLUSIONS
Overcoming barriers to effective screening for social needs in primary care requires not only practice- and provider-level process change but also an alignment of community resources and advocacy of policies to redistribute community assets to address social needs.
PubMed: 38952646
DOI: 10.3389/frhs.2024.1380589 -
Frontiers in Psychiatry 2024The aim of this study was to examine some psychometric characteristics of the Chilean-adapted version of the Quantitative Checklist for Autism in Toddlers (Q-CHAT-24)...
BACKGROUND
The aim of this study was to examine some psychometric characteristics of the Chilean-adapted version of the Quantitative Checklist for Autism in Toddlers (Q-CHAT-24) (24) in a group of unselected children (community sample). This version was administered remotely through an online version during the pandemic period to caregivers of children, aged 18-24 months, registered in four primary care polyclinics of the Health Service Araucanía Sur, Chile.
METHODS
An intentional non-probabilistic sampling was used. Three hundred and thirteen toddlers were examined. Participants completed an online version of the Q-CHAT-24 which was disseminated through the REDCap platform. Evidence of reliability through internal consistency and evidence of predictive validity through ROC curve analysis were realized.
RESULTS
The mean age of the children evaluated was 21.16 months. The Shapiro-Wilk test revealed that Q-CHAT-24 scores was normally distributed. 71 cases (23.12%) scored 38 points or more on the Q-CHAT-24, qualifying as Autistic Risk. 48 cases (15.63%) were confirmed as autistic through the ADOS-2 Module T. All items were positively correlated with Q-CHAT-24 total score. All items were positively correlated with Q-CHAT-24 total score. Internal consistency was acceptable for the Q-CHAT-24 (Cronbach ´s α=0.78). The internal consistencies were analyzed for the Q-CHAT-24 Factors, and they were good for factor 1 "Communication and Social Interaction" (Cronbach ´s α=0.85) and acceptable for factor 2 "Restrictive and Repetitive Patterns" (Cronbach ´s α=0.74). Receiver operating characteristic (ROC) curve analyses were performed. The AUC values were 0.93 with statistical significance (p<0.01). For the cut-off point of 38, the Sensitivity, Specificity and Youden index values were 0.89, 0.8 and 0.7, respectively. The Positive Predictive Value (PPV) was 86% and the Negative Predictive Value (NPV) was 85%.
CONCLUSIONS
In accordance with the objectives of this study, evidence of reliability and predictive validity was demonstrated for the Q-CHAT-24 in this Chilean population. More importantly, this study provides Sensitivity and Specificity data for a remote application version of an autism screening tool already validated in Chile. The implications of this have to do with the possibility of establishing a remote assessment system for children at risk of autism on a population scale.
PubMed: 38952633
DOI: 10.3389/fpsyt.2024.1363976