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Universal health access

Nynke de Groot, Gouke J Bonsel, Erwin Birnie, Nicole B Valentine
BACKGROUND: The concept 'vulnerability' is prevalent in the public domain, health care, social institutions and multidisciplinary research. Conceptual heterogeneity is present, hampering the creation of a common evidence-base of research achievements and successful policies. Recently an international expert group combined a specific literature review with a 2-stage Delphi procedure, arriving at a seemingly universal concept of vulnerability for the elderly with applications for research instruments...
2019: PloS One
Ildikó Szőcs, Dániel Bereczki, András Ajtay, Ferenc Oberfrank, Ildikó Vastagh
INTRODUCTION: Hungary has a single payer health insurance system offering free healthcare for acute cerebrovascular disorders. Within the capital, Budapest, however there are considerable microregional socioeconomic differences. We hypothesized that socioeconomic deprivation reflects in less favorable stroke characteristics despite universal access to care. METHODS: From the database of the National Health Insurance Fund, we identified 4779 patients hospitalized between 2002 and 2007 for acute cerebrovascular disease (hereafter ACV, i...
2019: PloS One
Brian E Bunnell, Gina Sprague, Suparna Qanungo, Michelle Nichols, Kathryn Magruder, Steven Lauzon, Jihad S Obeid, Leslie A Lenert, Brandon M Welch
BACKGROUND: Clinical trials are key to ensuring high-quality, effective, and safe health care interventions, but there are many barriers to their successful and timely implementation. Difficulties with participant recruitment and enrollment are largely affected by difficulties with obtaining informed consent. Teleconsent is a telemedicine- based approach to obtaining informed consent and offers a unique solution to limitations of traditional consent approaches. METHODS: We conducted a survey among 134 clinical trial researchers in academic/university-, industry-, and clinically based settings...
February 20, 2019: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
Eduardo Rocha Covre, Willian Augusto de Melo, Maria Fernanda do Prado Tostes, Carlos Alexandre Molena Fernandes
OBJECTIVE: to evaluate the trend of hospitalazions for surgical procedures and surgical mortality in Brazil, from 2008 to 2016. METHODS: we conducted an ecological, time-series study. We obtained the data on surgical hospitalizations and mortality between 2008 and 2016 from the Department of Informatics of the Unified Health System (SUS). We performed the trend analysis using polynomial regression models. RESULTS: in the period of the study, 37,565,785 surgical procedures were performed in the SUS, an average of 4,151,050 surgeries/year...
February 18, 2019: Revista do Colégio Brasileiro de Cirurgiões
Daniel Araujo Kramer de Mesquita, Erika Feitosa Queiroz, Maria Allyce de Oliveira, Carlos Magno Queiroz da Cunha, Fernanda Martins Maia, Rafaela Vieira Correa
BACKGROUND: Paracentesis is a routine medical procedure quite relevant in clinical practice. There are risks of complications related to paracentesis, so it is essential a proper trainee for the younger practicer. OBJECTIVE: The article describes the construction and the application of a low cost paracentesis simulator for undergraduate medical students and it also describes the perception of students about the simulator as well. METHODS: A low-cost model was developed by the Program of Tutorial Education for training medical students during three editions of an undergraduate theoretical-practical course of bedside invasive procedures...
October 2018: Arquivos de Gastroenterologia
Deidra C Crews, Aminu K Bello, Gamal Saadi
Kidney disease is a global public health problem, affecting over 750 million persons worldwide. The burden of kidney disease varies substantially across the world. In many settings, rates of kidney disease and the provision of its care are defined by socio-economic, cultural and political factors leading to significant disparities. World Kidney Day 2019 offers an opportunity to raise awareness of kidney disease and highlight disparities in its burden and current state of global capacity for prevention and management...
March 2019: Journal of Renal Care
Deidra C Crews, Aminu K Bello, Gamal Saadi
Kidney disease is a global public health problem, affecting over 750 million persons worldwide. The burden of kidney disease varies substantially across the world. In many settings, rates of kidney disease and the provision of its care are defined by socioeconomic, cultural, and political factors leading to significant disparities. World Kidney Day 2019 offers an opportunity to raise awareness of kidney disease and highlight disparities in its burden and current state of global capacity for prevention and management...
February 18, 2019: Nephron
Anneli Peolsson, Gunnel Peterson, Anna Hermansen, Maria Landén Ludvigsson, Åsa Dedering, Håkan Löfgren
INTRODUCTION: Patients suffering from remaining disability after anterior cervical decompression and fusion (ACDF) surgery for cervical disc disease may be prescribed physical activity (PPA) or neck-specific exercises (NSEs). Currently, we lack data for the success of either approach. There is also a knowledge gap concerning the use of internet-based care for cervical disc disease. The scarcity of these data, and the high proportion of patients with various degrees of incapacity following ACDF, warrant increased efforts to investigate and improve cost-effective rehabilitation...
February 19, 2019: BMJ Open
Junichi Sugawara, Daisuke Ochi, Riu Yamashita, Takafumi Yamauchi, Daisuke Saigusa, Maiko Wagata, Taku Obara, Mami Ishikuro, Yoshiki Tsunemoto, Yuki Harada, Tomoko Shibata, Takahiro Mimori, Junko Kawashima, Fumiki Katsuoka, Takako Igarashi-Takai, Soichi Ogishima, Hirohito Metoki, Hiroaki Hashizume, Nobuo Fuse, Naoko Minegishi, Seizo Koshiba, Osamu Tanabe, Shinichi Kuriyama, Kengo Kinoshita, Shigeo Kure, Nobuo Yaegashi, Masayuki Yamamoto, Satoshi Hiyama, Masao Nagasaki
PURPOSE: A prospective cohort study for pregnant women, the Maternity Log study, was designed to construct a time-course high-resolution reference catalogue of bioinformatic data in pregnancy and explore the associations between genomic and environmental factors and the onset of pregnancy complications, such as hypertensive disorders of pregnancy, gestational diabetes mellitus and preterm labour, using continuous lifestyle monitoring combined with multiomics data on the genome, transcriptome, proteome, metabolome and microbiome...
February 19, 2019: BMJ Open
Anne Stevenson, Dickens Akena, Rocky E Stroud, Lukoye Atwoli, Megan M Campbell, Lori B Chibnik, Edith Kwobah, Symon M Kariuki, Alicia R Martin, Victoria de Menil, Charles R J C Newton, Goodman Sibeko, Dan J Stein, Solomon Teferra, Zukiswa Zingela, Karestan C Koenen
INTRODUCTION: Schizophrenia and bipolar disorder account for a large proportion of the global burden of disease. Despite their enormous impact, little is known about their pathophysiology. Given the high heritability of schizophrenia and bipolar disorder, unbiased genetic studies offer the opportunity to gain insight into their neurobiology. However, advances in understanding the genetic architecture of schizophrenia and bipolar disorder have been based almost exclusively on subjects of Northern European ancestry...
February 19, 2019: BMJ Open
Emily K Rousham, Mohammad Aminul Islam, Papreen Nahar, Patricia Jane Lucas, Nahitun Naher, Syed Masud Ahmed, Fosiul Alam Nizame, Leanne Unicomb
INTRODUCTION: Global actions to reduce antimicrobial resistance (AMR) include optimising the use of antimicrobial medicines in human and animal health. In countries with weak healthcare regulation, this requires a greater understanding of the drivers of antibiotic use from the perspective of providers and consumers. In Bangladesh, there is limited research on household decision-making and healthcare seeking in relation to antibiotic use and consumption for humans and livestock. Knowledge is similarly lacking on factors influencing the supply and demand for antibiotics among qualified and unqualified healthcare providers...
January 25, 2019: BMJ Open
Elizabeth A Fradgley, Jon Karnon, Della Roach, Katherine Harding, Laura Wilkinson-Meyers, Catherine Chojenta, Megan Campbell, Melissa L Harris, Jacqueline Cumming, Kim Dalziel, Janet McDonald, Tilley Pain, Kirsten Smiler, Christine L Paul
Objective This study reports on the characteristics of individuals conducting health service research (HSR) in Australia and New Zealand, the perceived accessibility of resources for HSR, the self-reported impact of HSR projects and perceived barriers to conducting HSR. Methods A sampling frame was compiled from funding announcements, trial registers and HSR organisation membership. Listed researchers were invited to complete online surveys. Close-ended survey items were analysed using basic descriptive statistics...
February 20, 2019: Australian Health Review: a Publication of the Australian Hospital Association
Diego A Forero, Marilyn H Oermann, Andrea Manca, Franca Deriu, Hugo Mendieta-Zerón, Mehdi Dadkhah, Roshan Bhad, Smita N Deshpande, Wei Wang, Myriam Patricia Cifuentes
Predatory journals (PJ) exploit the open-access model promising high acceptance rate and fast track publishing without proper peer review. At minimum, PJ are eroding the credibility of the scientific literature in the health sciences as they actually boost the propagation of errors. In this article, we identify issues with PJ and provide several responses, from international and interdisciplinary perspectives in health sciences. Authors, particularly researchers with limited previous experience with international publications, need to be careful when considering potential journals for submission, due to the current existence of large numbers of PJ...
November 5, 2018: Annals of Global Health
Astrid Buvik, Trine S Bergmo, Einar Bugge, Arvid Smaabrekke, Tom Wilsgaard, Jan Abel Olsen
BACKGROUND: Telemedicine consultations using real-time videoconferencing has the potential to improve access and quality of care, avoid patient travels, and reduce health care costs. OBJECTIVE: The aim of this study was to examine the cost-effectiveness of an orthopedic videoconferencing service between the University Hospital of North Norway and a regional medical center in a remote community located 148 km away. METHODS: An economic evaluation based on a randomized controlled trial of 389 patients (559 consultations) referred to the hospital for an orthopedic outpatient consultation was conducted...
February 19, 2019: Journal of Medical Internet Research
Marion Bourdoncle, Blandine Juillard-Condat, Florence Taboulet
BACKGROUND: Since incentives were introduced to promote orphan drugs in Europe, several dozens of drugs have been registered at the European level. However, patient access on a national level remains very heterogeneous across Europe. This can be explained by healthcare organization and drug reimbursement, which are within the purview of each Member State. We studied access to orphan drugs in France from the patients' point of view, including marketing but also ease of supply from patients' perspective, financial and time-based dimensions...
February 18, 2019: Orphanet Journal of Rare Diseases
Anderson Moreira Aristides Dos Santos, Julian Perelman, Paulo de Andrade Jacinto, Cesar Augusto Oviedo Tejada, Aluísio J D Barros, Andréa D Bertoldi, Alicia Matijasevich, Iná S Santos
The Brazilian Unified Health System was created in the late 1980s to ensure free universal access to health care and was funded by taxes and social contributions. The persistent inequity in access to health services in favour of richer individuals in Brazil has been observed in the literature. However, to the best of our knowledge, no measurement of inequality in medicine use or private health insurance (PHI) among children has been performed with longitudinal data. This paper uses inequality indices and their decompositions to analyse the income-related inequalities/inequities in children's health care in the city of Pelotas, Brazil, using longitudinal data following children from 12 to 72 months of age...
February 4, 2019: Social Science & Medicine
Connie Kim Yen Nguyen-Truong, Janessa M Graves, Electra Enslow, Wendy Williams-Gilbert
BACKGROUND: Open educational resources (OERs) increase access to high-quality academic learning materials and promote affordable education in nursing. PROBLEM: Integrating OERs into existing nursing courses can be arduous for faculty. APPROACH: An academic and community-engaged approach involved faculty, university librarians, and community stakeholders. Community leaders and population health experts helped identify OERs for a population health theory course...
February 11, 2019: Nurse Educator
Katriona Brooksbank, Joanne O'Donnell, Vicky Corbett, Sarah Shield, Rachel Ainsworth, Ross Shearer, Susan Montgomery, Andrew Gallagher, Hannah Duncan, Lorna Hamilton, Valerie Laszlo, Rhonda Noone, Anna Baxendale, David Blane, Jennifer Logue
BACKGROUND: Guidelines for the management of type 2 diabetes universally recommend that adults with type 2 diabetes and obesity be offered individualized interventions to encourage weight loss. Yet despite the existing recommendations, provision of weight management services is currently patchy around the United Kingdom and where services are available, high attrition rates are often reported. In addition, individuals often fail to take up services, that is, after discussion with a general practitioner or practice nurse, individuals are referred to the service but do not attend for an appointment...
February 15, 2019: JMIR Research Protocols
Dong Roman Xu, Mengyao Hu, Wenjun He, Jing Liao, Yiyuan Cai, Sean Sylvia, Kara Hanson, Yaolong Chen, Jay Pan, Zhongliang Zhou, Nan Zhang, Chengxiang Tang, Xiaohui Wang, Scott Rozelle, Hua He, Hong Wang, Gary Chan, Edmundo Roberto Melipillán, Wei Zhou, Wenjie Gong
INTRODUCTION: Primary healthcare (PHC) serves as the cornerstone for the attainment of universal health coverage (UHC). Efforts to promote UHC should focus on the expansion of access and on healthcare quality. However, robust quality evidence has remained scarce in China. Common quality assessment methods such as chart abstraction, patient rating and clinical vignette use indirect information that may not represent real practice. This study will send standardised patients (SP or healthy person trained to consistently simulate the medical history, physical symptoms and emotional characteristics of a real patient) unannounced to PHC providers to collect quality information and represent real practice...
February 13, 2019: BMJ Open
Gilberto A Santiago, Glenda L González, Fabiola Cruz-López, Jorge L Muñoz-Jordan
The global expansion of dengue viruses (DENV-1-4) has contributed to the divergence, transmission, and establishment of genetic lineages of epidemiological concern; however, tracking phylogenetic relationships of these virus is not always possible due to inability of standardized sequencing procedures in resource-limited public health laboratories Consequently, public genomic data banks contain inadequate representation of geographical regions and historical periods. In order to improve detection of DENV-1-4 lineages, we report the development of a serotype-specific Sanger-based method standardized to sequence DENV-1-4 directly from clinical samples using universal primers that detect most DENV genotypes...
February 13, 2019: Journal of Clinical Microbiology
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