Concept Of Care Research Articles

Evaluation and Management of Kidney Dysfunction in Advanced Heart Failure: A Scientific Statement From the American Heart Association.

Early identification of kidney dysfunction in patients with advanced heart failure is crucial for timely interventions. In addition to elevations in serum creatinine, kidney dysfunction encompasses inadequate maintenance of sodium and volume homeostasis, retention of uremic solutes, and disrupted endocrine functions. Hemodynamic derangements and maladaptive neurohormonal upregulations contribute to fluctuations in kidney indices and electrolytes that may recover with guideline-directed medical therapy. Quantifying the extent of underlying irreversible intrinsic kidney disease is crucial in predicting whether optimization of congestion and guideline-directed medical therapy can stabilize kidney function. This scientific statement focuses on clinical management of patients experiencing kidney dysfunction through the trajectory of advanced heart failure, with specific focus on (1) the conceptual framework for appropriate evaluation of kidney dysfunction within the context of clinical trajectories in advanced heart failure, including in the consideration of advanced heart failure therapies; (2) preoperative, perioperative, and postoperative approaches to evaluation and management of kidney disease for advanced surgical therapies (durable left ventricular assist device/heart transplantation) and kidney replacement therapies; and (3) the key concepts in palliative care and decision-making processes unique to individuals with concomitant advanced heart failure and kidney disease.

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.

О некоторых экономических аспектах оказания высокотехнологичной медицинской помощи на примере профиля «травматология и ортопедия».

The article is devoted to the consideration of a number of economic aspects of providing high-tech medical care using the example of traumatology and orthopedics: methodological approaches to the concept of high-tech medical care, assessment of economic efficiency, analysis of financial support methods, etc. These aspects are particularly relevant due to the high cost of providing high-tech medical care, especially against the background of the current sanctions policy of many Western states. The analysis of the sources and methods of financial support for the provision of high-tech medical care, including from the point of view of historical perspective and perspective, is given.

Ecological care in nursing practice: a Walker and Avant concept analysis

BackgroundToday, the human population faces an increasing array of emerging environmental challenges. Despite its importance, nurses often neglect ecological issues, which can compromise patient health. While the ecological nursing perspective has the potential to lead to innovative care approaches that benefit patients, the nursing profession, and the environment, the concept of ecological care lacks a clear definition and its dimensions remain unclear. This study aimed to analyze and clarify the concept of ‘ecological care’ in the nursing discipline.MethodsWalker and Avant’s analysis method was used to identify descriptions, antecedents, consequences, and empirical referents of the concept of ‘ecological care’ in nursing. We searched the databases (PubMed, Scopus, PsycINFO, CINAHL, ERIC, SID, and IranDoc) using the keywords “ecological,” “nurse,” and “nursing” using Boolean operators “AND” and “OR” in the title and abstract fields both in English and Persian to identify relevant literature on ecological care in nursing.ResultsEcological care, as a multidimensional concept, encompasses ecological thinking, ecological attitude, ecological awareness, ecological sensitivity, and ecological literacy. This entails the optimal utilization of environmental factors to provide patients with high-quality care and preserve ecological sustainability through environmentally friendly behaviors.ConclusionsThe findings highlight the need to elucidate, endorse, and solidify ecological thinking in all aspects of nursing care including nursing management, education, and research, which can lead to improved care quality, patient safety, and sustainability. Within this framework, nursing educators could play an essential role in integrating ecological care into nursing education. The study emphasizes the need to integrate ecological thinking into all aspects of nursing.

The medical psychological concept of inclusive health care

This study considers characteristics of attitude of medical workers to the disabled and persons with limited health capacities.The prerequisites of emergence of inclusive health care emergence were analyzed. The significance of documents of the UNO and the WHO considering both protection and conditions of granting human rights and freedoms to the disabled and reserving inclusive health care in society. The role of physicians in practical implementation of this phenomenon in the Russian Federation is determined from medical psychological positions. It is demonstrated that personality characteristics of the disabled are non-specific regarding their nosology since even the mentally ill disabled can be psychologically healthy. On basis of this assumption the role of physician in inclusive health care is revealed that comes to awareness of one's contribution to medical social psychological support of the disabled and persons with limited health capacities. The physician is to come out as activator of mobilization of medical psychological resources of persons with physical or mental defects. The study considers positions and activities of physician in the process of minimization of aftermaths of health disorder by means of medical psychological recommendations containing determination of "challenge" of one's own inferiority and resulting in leading to its compensation. The physicians are proposed to be guided by targeting this category of patients to lacking of sparing regimen in their life-style. This proposal means to resolve problem of integration of this category of patients into society (inclusion in fact) by setting tasks that are on verge of their resource capabilities. The concept of inclusive health care is formulated. Its core is actualization by physicians humanistic professional and civic position towards the disabled and persons with limited health capacities with disabilities and handicapped persons.

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.

P.449: The introduction of terminal care concept in organ donation: Ineffectiveness in emergency institutes and loss of recipient awareness.

P.449: The introduction of terminal care concept in organ donation: Ineffectiveness in emergency institutes and loss of recipient awareness.

Optimizing Antenatal Care: The Effects of a Holistic Nursing Android Application for Pregnant Women

Background: During the COVID-19 pandemic, face-to-face Ante Natal Care (ANC) services were limited. To address this, we developed the Android digital application “Guide Me” based on a holistic care concept to optimize ANC.Purpose: This study aimed to evaluate the effect of the Android digital application “Guide Me” on optimizing ANC.Methods: This study used an experimental research design. The participants included 302 pregnant women selected through block randomization, with 160 in the intervention group and 142 in the control group. The intervention involved providing ANC services using a digital Android application at home, with health services visited only when treatment was necessary. The intervention group received usual care along with the Android application, “Guide Me”, which included a holistic nursing concept program, while the control group received only the usual care. Data were collected three times, and the ANC scale was used to measure ANC optimization. Repeated measures ANOVA was used to analyze the data.Results: Significant differences were found in ANC optimization between the intervention and control groups ([F= 96.887, df (1, 300), p <0.001]). The intervention group showed significant improvements over three time points [F= 118.35, df (1, 308), p <0.001], with ANC optimization increasing from 45.79 to 59.16 in the intervention group compared to 44.09 to 45.77 in the control group.Conclusions: The “Guide Me” program effectively increased ANC optimization. Pregnant women reported feeling more at ease with home-based care and showed a preference for online apps and telemonitoring as alternatives to hospital visits. Healthcare providers may consider implementing this program in all antenatal clinics across Indonesia

Analysis of Library Building Design from the Concept of Green Building

Library is a symbol of urbanization in the present era. The external shape of the library is more elegant and solemn, and the interior also pays more attention to the convenience and comfort. In the design, we need to pay attention to the enjoyment of architectural art beauty, and at the same time, we need to make the layout of the library more scientific and applicable, and meet the needs of the public reading. As a public building with huge flow of people, the library needs to consume a lot of energy when it is open, which is not in line with the characteristics of green building advocated at present. Therefore, in order to implement the concept of environmental protection, it is necessary to integrate the design of library building with the concept of green building. At the same time, the library is also a cultural building, and it needs to reflect the scientific concept of humanistic care and people- oriented. Therefore, this paper mainly analyzes and discusses the library design under the concept of green building.

Designing and validating a clinical decision support algorithm for diabetic nephroprotection in older patients

BackgroundOlder patients with diabetic kidney disease (DKD) often do not receive optimal pharmacological treatment. Current clinical practice guidelines (CPGs) do not incorporate the concept of personalised care. Clinical decision support...

Support Services at a Francophone University in Quebec: Contrasting Viewpoints of Chinese International Students and University Professionals

This qualitative study showcases the viewpoints of Chinese international students and university professionals about the services offered at a francophone university in Montreal regarding “welcoming” and “integration.” Semi-directed interviews were conducted among 22 participants, of which 14 were students and 8 university professionals. Using the concept of care, we conducted a thematic analysis. According to the analysis, students mention the lack of effective support, while university professionals discuss the support offered and its pitfalls. In terms of recommendations, we stress the importance of tackling current structural issues rather than putting the responsibility for the quality of the experience on students’ shoulders. We also emphasize that professionals who provide services directly to students must be given proper training and resources through universities to enable them to change the current paradigm and offer services that reflect the concept of student care.

Telemedical care concepts for heart failure: status and future

Telemedical care concepts provide opportunities to improve the care of patients with chronic heart failure (CHF). The current state of telemedical technologies enables the effective monitoring of the disease. Germany is one of the first European countries with an entitlement to telemedical supporting care for CHF patients. The decision of the German Federal Joint Committee in 2020 to introduce telemedical supporting care for CHF patients marks amilestone. For the first time, adigital care procedure was included in the benefits catalogue of the statutory health insurance funds due to its proven benefits in terms of morbidity and mortality. Privately insured CHF patients have been entitled to these benefits since January 2024. Future developments, particularly with respect to artificial intelligence procedures in telemedicine, are promising but require more evidence. Further research, technological innovation and supportive policy frameworks are needed to realize the full potential of these approaches. Continued collaboration between healthcare professionals, technology developers and policy makers will be crucial in sustainably improving the care of heart failure patients with telemedicine.

Viewing hospitality from an interdisciplinary lens: a systematic review of 30-year research on hospitality in health care

Purpose This study aims to examine the conceptual and empirical operations of hospitality at its intersections with health care, which includes medical and senior care. Design/methodology/approach This study conducts a systematic review of literature on hospitality in health care published in hospitality, tourism and leisure journals spanning from 1990 to 2023. A total of 50 studies meeting the inclusion criteria are reviewed, providing insights into how hospitality is conceptualized, its practical implementation and the proposed outcomes in health-care settings. Findings Hospitality in health care is conceptualized by hospitality scholars in three main ways: as service functions, as a service exchange and as an organizational culture. There is a significant overlap between the notion of hospitality and the concept of person-centered care in gerontology and health-care literature. Also, hospitality contributes positively to patient/resident experiences, organizational performance and societal impacts. Research limitations/implications The study is limited by its focus solely on the theoretical and practical aspects of hospitality in health care within hospitality, tourism and leisure journals, excluding relevant literature from gerontological and health-care journals. Originality/value Interdisciplinary research requires scholars from different disciplines to develop a common language and understanding of key concepts. This study presents the conceptual and practical domains of hospitality and its relevancy to health-care research and offers future directions to strengthen the interdisciplinary research between hospitality, health care and gerontology.

What does the general public know about palliative care? A population-based survey

ObjectivesThe need for public education on palliative care has been widely argued for. To develop effective educational strategies, a stronger evidence base is needed on what exactly is known and...

Infrastructures of support: Australian young people’s perspectives on caring during the pandemic and future disability and care policy reform

ABSTRACT Today’s young people are critical stakeholders in the future of social care policy and services, but their voices and perspectives are often overlooked in public debate and deliberation on disability services, aged care, and support for family carers. This article reports on a pilot project involving focus groups with young people in the Australian Capital Territory, Australia. Participants included young people with caring roles for family members with disability and chronic illness and young people without lived experience of disability or care. The article explores how young people’s understandings of care were profoundly shaped by their experiences during the COVID-19 pandemic. Lockdowns, health concerns and media coverage heightened their awareness of the diverse ways in which people support each other in families and communities and the systemic issues afflicting the formal care sector. The article draws on the concept of care as critical social and economic infrastructure to frame participants’ proposals for future reform of policy and services. The findings indicate that young people both with and without current care roles want to see significantly more investment in the care and support sectors, and these groups view meaningful engagement with service users as key to improving access to needed supports.

Dynamic reconstruction for digital tomosynthesis: a phantom proof of concept for breast care

Objective. Digital tomosynthesis (DTS) is a type of limited-angle Computed Tomography (CT) used in orthopedic and oncology care to provide a pseudo-3D reconstructed volume of a body part from multiple x-ray projections. Patient motion during acquisitions results in artifacts which affect screening and diagnostic performances. Hence, accurate reconstruction of moving body parts from a tomosynthesis projection series is addressed in this paper, with a particular focus on the breast. The aim of this paper is to assess the feasibility of a novel dynamic reconstruction technique for DTS and evaluate its accuracy compared to an available ground truth. Approach. The proposed method is a combination of a 4D dynamic tomography strategy leveraging the formalism of Projection-based Digital Volume Correlation (P-DVC) with a multiscale approach to estimate and correct patient motion. Iterations of two operations are performed: (i) a motion-corrected reconstruction based on the Simultaneous Iterative Reconstruction Technique (SIRT) algorithm and (ii) a motion estimation from projection residuals, to obtain motion-free volumes. Performance is evaluated on a synthetic Digital Breast Tomosynthesis (DBT) case. Three slabs of a CIRS breast phantom are imaged on a Senographe PristinaTM, under plate-wise rigid body motions with amplitudes ranging up to 10 mm so that an independent measurement of the motion can be accessed. Results. Results show a motion estimation average precision down to 0.183 mm (1.83 voxels), when compared to the independent measurement. Moreover, an 84.2% improvement on the mean residual error and a 59.9% improvement on the root mean square error (RMSE) with the original static reconstruction are obtained. Significance. Visual and quantitative assessments of the dynamically reconstructed volumes show that the proposed method fully restores conspicuity for important clinical features contained in the phantom.

Multicultural Worship in the Song of Zechariah and Contemporary Christian Worship

This article explores the ethics of “speaking” the artistic languages or idioms of diverse cultures in the earliest Christian communities. This article presents a key New Testament text, the Song of Zechariah (the Benedictus in Luke 1:68–79), as a poetic text meant for communal performance and examines that cultural phenomenon through the lens of “musical caring” to examine the meaning such a poetic phenomenon has for modern Christian life and worship. First, I will briefly summarize the evidence for the Song of Zechariah as a lyrical poem containing the artistic “multilingualism” of both Hebrew and Greek poetic idioms. Then, I will assess such an artistic communal expression in its first-century context with Myrick’s concept of musical caring, broadened to allow for uncertainty of the Song of Zechariah’s first-century performance methods. Finally, I will consider the twenty-first-century implications or lessons from such care and inclusivity in the first century.

''While There's Life There's Hope'' Hope in Palliative Care: A Qualitative Study.

Hope is a critically important concept in palliative care that enables coping and increases quality of life. This qualitative study was conducted to determine how palliative care patients describe hope and the factors that increase or decrease hope after a hope intervention. Data were collected through semi-structural interviews with 10 palliative care patients. The analysis followed a thematic analysis approach. The participants defined hope as the joy of living in general, and the strength to cope with difficulties and stated that spending time with loved ones increased their hopes, the worsening of their diseases reduced their hopes, hope made them feel good psychologically, and health workers had an important role in increasing hope. It is recommended that hope interventions be person-centric in palliative care settings and that care should be structured by considering the factors that maintain and prevent hope.

Tracing a caring transition policy for the German coal region Lusatia

Coal mining and generation adversely affect several ecosystems, including climate, water and land. On the other hand, questions of justice and socio-economic considerations of affected regions are crucial for a successful coal phase-out, underlining the need for a nexus perspective. This includes taking a gender perspective, which thus far has received relatively little attention. We contribute to closing this gap through our study on the coal region Lusatia in Germany, where an unprecedentedly high amount of money is spent to shape the regional transition. The allocation of these funds is the subject of a contentious debate about which societal needs are considered most urgent to be met. We conducted a critical discourse analysis examining relevant policy documents and analyzing dominant ideas about what a successful transition in Lusatia should look like. Based on feminist care theory and interviews with locally organized women, we show that concepts of care for humans and nonhumans are severely underdeveloped. To address this gap, we propose based on women’s emerging discourse four pillars of care work as social infrastructure that should be central to transition processes: (1) aftercare for social and ecological residuals of coal mining, (2) social cohesion, (3) democratic care services, and (4) caring democracy: democratic decision-making on how to care.