Concept Of Health Care Research Articles

Analysis and forecast of emissions associated with electricity consumption in hospitals: Encouraging a net zero healthcare roadmap in Brazil

In several countries, the concept of Net Zero Healthcare (NZH) has gained prominence within the healthcare domain as a response to national commitments on climate change. NZH plays a crucial role in advocating for customized commitments and objectives to reduce greenhouse gas (GHG) emissions across diverse healthcare units, serving as a catalyst for decarbonization strategies in both the public and private sectors. This paper addresses the absence of primary research on NZH in Brazil while asserting its substantial potential to support GHG-curbing initiatives. This is the first study to establish a foundational knowledge base for decarbonization initiatives in Brazilian healthcare sector, focused on assisting in the sustainability roadmap of a University Hospital situated in Northeast Brazil. The major contribution of this study is the quantification of the GHG emissions associated with the electricity consumption at the hospital, which serves as a gateway to a comprehensive GHG inventory of the entire unit. The hospital's GHG emissions are then registered for 2017-2023. Methodologically, this study employs a comprehensive framework encompassing data processing of the electric mix, calculation of emission factors via life cycle assessment, forecasting algorithms, and data visualization. GHG emissions from electricity consumption at the hospital amounted to approximately 230 t CO2e annually (2017-2023 average value). Short-term forecasts supported by SARIMA models projected emissions of 271.9 t CO2e in 2024, with 92% originating from off-peak consumption. The significance of this research is the potential to provide new insights into shaping strategies for a viable NZH roadmap in Brazil.

Age-Friendly Healthcare: An Evolutionary Concept Analysis.

Aging populations require adapting healthcare systems for older adult's specific needs. Numerous initiatives to improve older-patient care have emerged, but the field lacks a unified framework. The current study aims to provide a systematic concept analysis of 'age-friendly healthcare', examining its characteristics, components and structure. Rodger's evolutionary concept analysis. Searches were conducted in ProQuest, CINAHL, PubMed and Scopus databases between November 2022 and October 2023, utilising the PRISMA 2020 reporting checklist. A literature search using specific terms relevant to age-friendly healthcare retrieved 1407 articles. After screening for duplicates and relevance, 140 articles were examined for eligibility based on inclusion criteria for age-friendly care, language and full-text availability. Following full-text screening, 65 articles were included for data extraction by multiple researchers to synthesise theoretical, methodological and design elements. Our findings highlight key attributes of age-friendly healthcare: Respect for older adults' autonomy and needs; leadership and organisational knowledge and support; Proactive policies and processes of care; holistic care environments; and communication and follow-up with awareness of challenges and barriers as well as prioritisation of continuity-of-care. The concept of age-friendly healthcare is still developing, with much research focused on development and implementation rather than evaluation of real-world patient and health-system outcomes. Our analysis of the concept may help unify the field and clarify future research directions through identification of areas requiring further study and enable development of improved practices and policies for implementing age-friendly healthcare in a variety of settings. This concept analysis did not include any patient or public involvement. This study utilised the PRISMA reporting checklist.

2024 Walter C. Alvarez Award Recipient: Otis Brawley, MD

The Walter C. Alvarez Award is bestowed on a member or nonmember of AMWA to recognize excellence in communicating health care developments and concepts to the public.

Plastic Resilience: Rethinking Resilience in Illness with Catherine Malabou.

Drawing on Catherine Malabou's notion of plasticity, this article argues for a conception of resilience as plastic. Resilience has proven an important concept in health care, describing how we manage life-changing illnesses. Yet, resilience is not without its critics, who suggest it neglects a political, social, or personal dimension in illness. In this article, I propose that a concept of plastic resilience can address these criticisms. On this account, success should not be based on a return to function, but rather on how actively we are involved in the formation of a new self after illness. I address some approaches that can benefit from "plastic resilience," namely, art therapy, expert companionship, and shared decision-making. In each case, I underline how we should help patients thematize and engage with their new selves, while also being constantly vigilant for how these changes might impact our current assumptions around their preferences for treatment.

Relationship between Attitude Toward Aging, Health Literacy, and Utilization of Healthcare Services among Older Adults in Suburban Areas in Iligan City

Background and Aim Health literacy and attitudes towards aging have become increasingly important problems, especially as they relate to health care. This study focused on exploring the relationship between attitudes toward aging, health literacy, and utilization of healthcare services among older adults.  Methods Using quantitative, descriptive-correlational design, data were collected from 150 older adults through structured questionnaires.  Results Older adults agreed that the services are being provided adequately. The study found a positive correlation between having adequate knowledge to manage health and the accessibility of healthcare services, and it also indicated that providing adequate information to the public can increase their knowledge about health services and facilities provided. Providing adequate information to the public can increase their knowledge about the health services and facilities provided.  Conclusion These results highlight the need for intervention that increases the utilization of healthcare services among older adults. The overall attitude towards aging is positive. High levels of health literacy are essential to enhance their ability to access and improve utilization of healthcare services. A positive attitude toward aging correlates to the accessibility of healthcare highlighting the importance of considering attitudes in the healthcare concept. There was a significant relationship between attitude toward aging, health literacy, and utilization of healthcare services among older adults.

Artificial intelligence and social accountability in the Canadian health care landscape: A rapid literature review.

Situated within a larger project entitled "Exploring the Need for a Uniquely Different Approach in Northern Ontario: A Study of Socially Accountable Artificial Intelligence," this rapid review provides a broad look into how social accountability as an equity-oriented health policy strategy is guiding artificial intelligence (AI) across the Canadian health care landscape, particularly for marginalized regions and populations. This review synthesizes existing literature to answer the question: How is AI present and impacted by social accountability across the health care landscape in Canada? A multidisciplinary expert panel with experience in diverse health care roles and computer sciences was assembled from multiple institutions in Northern Ontario to guide the study design and research team. A search strategy was developed that broadly reflected the concepts of social accountability, AI and health care in Canada. EMBASE and Medline databases were searched for articles, which were reviewed for inclusion by 2 independent reviewers. Search results, a description of the studies, and a thematic analysis of the included studies were reported as the primary outcome. The search strategy yielded 679 articles of which 36 relevant studies were included. There were no studies identified that were guided by a comprehensive, equity-oriented social accountability strategy. Three major themes emerged from the thematic analysis: (1) designing equity into AI; (2) policies and regulations for AI; and (3) the inclusion of community voices in the implementation of AI in health care. Across the 3 main themes, equity, marginalized populations, and the need for community and partner engagement were frequently referenced, which are key concepts of a social accountability strategy. The findings suggest that unless there is a course correction, AI in the Canadian health care landscape will worsen the digital divide and health inequity. Social accountability as an equity-oriented strategy for AI could catalyze many of the changes required to prevent a worsening of the digital divide caused by the AI revolution in health care in Canada and should raise concerns for other global contexts.

Innovation Pipeline: A framework for value-based decision making.

The concept of value-based healthcare and focus on health outcomes is not new. While these ideas have been shared for decades, health systems still struggle to implement value-based decision making. This article describes the Innovation Pipeline, a framework that embeds value-based decision making in a healthcare organization. The Innovation Pipeline outlines the measurable evidence requirements needed to demonstrate organizational definitions of value. This evidence of value allows health leaders to make decisions supported by rigorous data, evidence, and evaluation, ensuring initiatives that bring organizational value progress from good ideas that require testing to evidence-based services embedded and sustained in operational workflows. The Innovation Pipeline is rigorous and customizable to all levels of the health system and designed to streamline evidence-generation activities, focusing on collecting evidence needed to demonstrate value and inform funding and resource allocation decisions.

Musculoskeletal Disorder (MSD) Health Data Collection, Personalized Management and Exchange Using Fast Healthcare Interoperability Resources (FHIR).

With the proliferation and growing complexity of healthcare systems emerges the challenge of implementing scalable and interoperable solutions to seamlessly integrate heterogenous data from sources such as wearables, electronic health records, and patient reports that can provide a comprehensive and personalized view of the patient's health. Lack of standardization hinders the coordination between systems and stakeholders, impacting continuity of care and patient outcomes. Common musculoskeletal conditions affect people of all ages and can have a significant impact on quality of life. With physical activity and rehabilitation, these conditions can be mitigated, promoting recovery and preventing recurrence. Proper management of patient data allows for clinical decision support, facilitating personalized interventions and a patient-centered approach. Fast Healthcare Interoperability Resources (FHIR) is a widely adopted standard that defines healthcare concepts with the objective of easing information exchange and enabling interoperability throughout the healthcare sector, reducing implementation complexity without losing information integrity. This article explores the literature that reviews the contemporary role of FHIR, approaching its functioning, benefits, and challenges, and presents a methodology for structuring several types of health and wellbeing data, that can be routinely collected as observations and then encapsulated in FHIR resources, to ensure interoperability across systems. These were developed considering health industry standard guidelines, technological specifications, and using the experience gained from the implementation in various study cases, within European health-related research projects, to assess its effectiveness in the exchange of patient data in existing healthcare systems towards improving musculoskeletal disorders (MSDs).

Care coordination models for transition and long-term follow-up among childhood cancer survivors: a scoping review

ObjectivesChildhood cancer survivors may experience complex health issues during transition and long-term follow-up (LTFU); therefore, high-quality healthcare is warranted. Care coordination is one of the essential concepts in advanced healthcare....

THE THEORY OF CONSUMER BEHAVIOUR AND DEMAND IN A NEW PARADIGM OF DIGITAL HEALTHCARE

The article assesses the changing trends in the behaviour of consumers of medical services and building a new behavioural integrated model of medical services in the context of digital transformation of healthcare. The methodological basis of the study is the analysis of relevant domestic and foreign scientific literature on the issues under consideration, as well as the results of published expert interviews with healthcare specialists. The authors describe the concept of digital healthcare as a fundamental ecosystem in terms of the formation of new channels of interaction with the patient while providing medical services. They then characterise the role of new investors in the field of digital medicine - the largest technological leaders in terms of market capitalisation. The paper examines the basic principles of consumer behaviour in the medical services market underlying the demand in the traditional doctorcentered model of medical care, formulates the key approaches to changing the behaviour of the consumer s under the influence of healthcare digital transformation. The authors argue that through digitalisation healthcare goes far beyond the medical industry and acquires an intersectoral integrated character. They build a behavioural patient-centered model of a consumer of medical services in the new paradigm of digital healthcare. The new role of the patient as a partner in managing the healthcare system is substantiated. The results of the work contribute to the economic theory of consumer behaviour in the provision of medical services, as well as to the theory of health economics. The practical significance of the work lies in the possibility to implement the proposed target model for the provision of medical care in primary and secondary health care organisations as part of digitalisation programs.

Concept Recognition and Characterization of Patients Undergoing Resection of Vestibular Schwannoma Using Natural Language Processing

Abstract Background Natural language processing (NLP), a subset of artificial intelligence (AI), aims to decipher unstructured human language. This study showcases NLP's application in surgical health care, focusing on vestibular schwannoma (VS). By employing an NLP platform, we identify prevalent text concepts in VS patients' electronic health care records (EHRs), creating concept panels covering symptomatology, comorbidities, and management. Through a case study, we illustrate NLP's potential in predicting postoperative cerebrospinal fluid (CSF) leaks. Methods An NLP model analyzed EHRs of surgically managed VS patients from 2008 to 2018 in a single center. The model underwent unsupervised (trained on one million documents from EHR) and supervised (300 documents annotated in duplicate) learning phases, extracting text concepts and generating concept panels related to symptoms, comorbidities, and management. Statistical analysis correlated concept occurrences with postoperative complications, notably CSF leaks. Results Analysis included 292 patients' records, yielding 6,901 unique concepts and 360,929 occurrences. Concept panels highlighted key associations with postoperative CSF leaks, including “antibiotics,” “sepsis,” and “intensive care unit admission.” The NLP model demonstrated high accuracy (precision 0.92, recall 0.96, macro F1 0.93). Conclusion Our NLP model effectively extracted concepts from VS patients' EHRs, facilitating personalized concept panels with diverse applications. NLP shows promise in surgical settings, aiding in early diagnosis, complication prediction, and patient care. Further validation of NLP's predictive capabilities is warranted.

Preconceptional and Antenatal Care through Life Style with special reference to Sadvritta: A Scoping Review

Sadvritta is a group of good conducts indicated to practice throughout life for everyone. Sadvritta plays significant role in prevention of all kind of diseases and in promotion of health. Female reproductive health is responsible for proper outcomes related to maternal and child health. There are guidelines in Ayurveda which consists of concepts of preconceptional, antenatal and post-natal health care of a mother and child. Wholesome life style with physical, psychological and verbal acts along with required medication and Panchakarma are mentioned. Special guidelines are mentioned for a couple as a Garbhadhan Vidhi (method of impregnation) which is supposed to follow at the time of preconception. Wholesome regimens at physical, mental and verbal level in life style of pregnant woman and a father at the time of conception is advised to maintain. Many factors described in Garbhini Paricharya and Sadvritta other than nutrition and medication are important for prevention. Emotional health of a mother is associated with the health of a child. Sadvritta and Ayurvedic life style consists guidelines which can reduce health issues due to stress. Many countries have developed national level health programmes for mother and child health. Goals of mother and child health programme emphases on antenatal, intra-natal and post- natal health care. Objectives of MCH programme are reduction of mortality and morbidity rates of mother and child. For it, care can be started at preconceptional phase. There may be a scope to advise Sadvritta guidelines to currently established MCH with Ayurveda health care. This article is an effort to view scope in MCH through Ayurveda and Sadvritta.

Shaping the Future of Healthcare: Integrating Ecology and Digital Innovation

The concept of sustainable healthcare is the subject of an increasingly intense, captivating, forward-looking, yet sometimes still overly theoretical debate. The aim of this contribution is to analyze the current scenarios of ecological and digital transition in the healthcare sector, considering its high energy consumption. In particular, we adopt a holistic and convergent vision of the energy mix and its infrastructure, moving beyond the ideological dichotomy of energy sources. Renewable sources, digital innovations, and the circular economy are seen as playing key roles in the future of the energy sector. In this research, a mixed methodology was employed, combining a questionnaire consisting of 31 questions with semi-structured interviews conducted with the top management of a major player in the private healthcare sector located in southern Italy in 2023. Consequently, we examine the main macro-guidelines of technological development, encompassing enabling technologies, new business models, roles, and professional skills. Based on the analyses conducted, we provide some insights to inform governmental policies and industrial strategies in the near future. Digitalization represents an opportunity to enhance the efficiency of healthcare services, reducing waste and ensuring quality. For instance, digital healthcare solutions enable personalized care on a global scale and offer decision support systems that can enhance overall healthcare performance. However, to maximize the benefits of digital transformation, it is essential to integrate new technologies effectively and sustainably into the existing healthcare ecosystem. A promising example is telemedicine, which can help reduce carbon emissions by decreasing healthcare workers’ travel.

Original Research: Exploring U.S. Nurses' Perceived Duty to Care During the COVID-19 Pandemic.

Duty to care is both an integral concept in health care and a fundamental nursing obligation. But nurses' perceptions of duty to care can be moderated by their experiences in the practice setting. Research examining nurses' perceptions of their duty to care during the COVID-19 pandemic could shed light on how the pandemic is affecting the nursing workforce. This study aimed to examine nurses' sense of duty to care during the early months of the pandemic, using the Nash Duty to Care Scale (NDCS), and to compare the high-scoring nurses with the low-scoring nurses. This quantitative study used a descriptive, cross-sectional design. It was conducted among licensed RNs enrolled at two accredited nursing programs in the Northeast region of the United States. Data were collected via a demographics questionnaire and the NDCS. A two-step cluster procedure was used to categorize participants into two groups: those with high perceived duty to care (HPDC) and those with low perceived duty to care (LPDC). Independent t tests were performed to compare NDCS results between the two groups. Nearly two-thirds (61%) of the participants had total NDCS scores indicating an HPDC, while 39% had scores indicating an LPDC. Of the NDCS's four subscales, perceived obligation and perceived risk were the most important in separating participants into the low- and high-scoring groups. This study adds to the literature about the components that affected nurses' perceived duty to care and willingness to report to work during the early months of the pandemic. Just as nurses have a duty to care, health care organizations have an obligation to provide a safe working environment so that nurses can fulfill that duty without sacrificing personal safety. The study findings may guide health care leaders, systems, and organizations regarding how to create safer work environments that support the nurse's duty to care during disasters.

A Primer on Artificial Intelligence for Healthcare Administrators.

Healthcare administrators steer their organizations' strategic direction with an emphasis on quality, value and efficiency, aiming to improve patient outcomes and ensure operational sustainability. Artificial intelligence (AI) has become a transformative force in healthcare in the past decade, with Canadian health systems and research institutions investing in AI solutions to address critical healthcare challenges. This primer delivers a fundamental guide to essential AI concepts in healthcare and provides practical guidance to prepare organizations for AI readiness.

Addressing Non-Communicable Diseases: Unveiling “Collateral Damage” and Pursuing Solutions at the Grassroots

Public health professionals are crucial in developing strategies to prevent and manage diseases while promoting overall population health. Despite some successes in controlling diseases like smallpox and polio, the 21st century has seen a shift in disease dynamics, with non-communicable diseases (NCDs) disproportionately affecting low- and middle-income countries. These nations bear over three-quarters of global NCD-related deaths annually, posing a significant challenge to healthcare administrators. It's essential to view NCDs as unintended consequences of lifestyle decisions, allowing policymakers to reformulate policies accordingly. “collateral damage”, whether in military contexts or medicine, refers to unintended harm or negative consequences. Adverse effects like antibiotic resistance or antibiotic-associated diarrhoea illustrate this concept in healthcare. Furthermore, NCDs often result from factors outside the healthcare sector, such as poverty-driven dietary choices or inadequate urban planning, leading to sedentary lifestyles. Globalisation exacerbates NCDs by promoting unhealthy Western lifestyles, including the consumption of fast foods with inferior quality in low-income countries. Uncontrolled urbanisation further compounds the issue by fostering unhealthy behaviours. Aging populations also contribute, with elderly individuals adopting sedentary lifestyles that increase their risk of NCDs. Health promotion offers a proactive approach to address “collateral damage”, emphasising action through advocacy, policy formulation, and health education. Effective control of NCDs requires primary prevention measures like healthy diets and physical exercise, alongside public health legislation and collaborative efforts among various sectors. Preventing NCDs necessitates auditing decisions across industries to assess potential “collateral damage”s, involving the Ministry of Health and Family Welfare(MOHFW) in authorising new ventures like liquor shops or fast-food centres. While the battle against NCDs has yet to begin, concerted efforts are required to implement strategies and actions effectively and efficiently. This paper discusses innovative grassroots strategies and intersectoral collaborations that have shown promise in combating NCDs, aiming to inspire actionable solutions.

Organizational Overview of Maslow and Management Research

Maslow's theory of motivation or hierarchy of needs; has been the subject of much research on a global scale in the physiological, psychological, and sociological framework. This situation, especially in terms of organizations (public or private), concerns both the employees and the management mechanism. Maslow and management generally reveal the theoretical and relational results in the policies applied in organizations. In the literature, studies in which studies carried out in Maslow and management research are systematically expressed quite limited. The research was carried out using the R program and bibliometric analysis applications with the help of the WoS database on Maslow and management research. As a result of the research analysis, the most emphasized keywords by the authors; motivation, Maslow, Maslow's hierarchy of needs, needs hierarchy, needs, management, self-actualization, leadership, psychology, innovation, sustainability, job satisfaction, China, satisfaction, commitment, human psychology, human needs, Covid-19, management theory, personality division, hierarchy, Maslow's theory, performance, spirituality, sustainable development, theory, Abraham Maslow, creativity, productivity, quality life, rural, safety, culture, values, need, human resource management, well-being, workplace, academic libraries cold war, behavior, cognition, demand, and development. As a result of the analysis, it was understood that the concepts of management, performance, work, job satisfaction, personality, self, attitudes, environment, healthcare, perceptions, participation, antecedents, and science have strong relationships together. The results obtained in Maslow and management research have revealed that organizational activities are also effective in addition to the needs and psychological aspects of individuals.

2023 Walter C. Alvarez Award Address

The Walter C. Alvarez Award is named in honor of Walter C. Alvarez, MD, a pioneer in the field of medical communication. The award is presented to either a member or nonmember of the American Medical Writers Association (AMWA) to honor excellence in communicating health care developments and concepts to the public. The Alvarez Award is presented during AMWA’s Medical Writing & Communication Conference.

Suspected Hematuria: Adverse Effects of Rivaroxaban in Older Adult Treated for Atrial Fibrillation

Background: The modern concept of pharmaceutical healthcare implies monitoring the pharmacotherapy outcomes and reporting adverse drug reactions. Objective: To present a suspected hematuria as the adverse rivaroxaban reaction in a patient with atrial fibrillation observed by pharmacists in a community pharmacy. Case presentation: A 69-year-old female patient came to a pharmacy with a prescription for cranberry-based supplement. She was diagnosed with a mild urinary infection after experiencing blood in her urine for about two weeks. The pharmaceutical anamnesis revealed that the patient was treated with irbesartan and rivaroxaban. Rivaroxaban was applied for atrial fibrillation, and the patient was treated for nine months. The patient was treated with omeprazole gastro-resistant capsules for mild dyspepsia and stomach ache over a three-week period. The pharmacist counselled the patient to contact the clinician who introduced rivaroxaban, further suggesting substitution with different anticoagulant. Although the urine culture was negative, the physician introduced ciprofloxacin, which was followed by blood in the patient’s stool. Thus, gastroscopy, colonoscopy, and gynecological examination were advised. All findings were normal. Four days after rivaroxaban was substituted with acenocoumarol, no blood in the urine or stool was detected. Conclusions: Rivaroxaban can cause spot urine blood even when applied in therapeutic doses among older female patients when applied with omeprazole. Possible rivaroxaban interaction with omeprazole metabolites is suspected and should be carefully monitored.

Innovative subsidy schemes under a limited budget: how and when do they matter

ABSTRACT Inspired by the global budget concept in health care, we propose an innovative subsidy scheme in which governments do not commit the subsidy amount in advance but determine it by the end of the subsidy period. The performance of the traditional and proposed subsidy schemes is evaluated in an oligopoly without competition, where each manufacturer decides its product quality and production quantity under the diseconomies of scale in production. Both types of schemes can take into account product quality or not. Our results show that compared to the traditional scheme, the proposed scheme drives manufacturers to reduce production quantity but improves product quality and brings them higher profits. Furthermore, the scheme results in greater social welfare when the subsidy budget is large. Finally, we conduct robustness checking by considering the market competition and absence of the diseconomies of scale, respectively. The result shows that the main findings in the basic model continue to hold, while there are additional findings. In the first scenario, as the market competition intensity increases, our proposed scheme becomes more preferable to the manufacturers and the government. In the second scenario, subsidy schemes that take product quality into account are never preferable.