Demand For Care Research Articles

Factors associated with post acute care utilization after mastectomy for breast cancer patients.

Although the demand for care immediately after mastectomy is rising, and such medical services are referred to as post-acute care (PAC), there is limited evidence on the factors influencing PAC choices among these patients in Korea. A total of 106,670 patients diagnosed with breast cancer and undergoing mastectomy were extracted from the Central Cancer Registry data from 2012 to 2019 using Public Cancer Library data of KCURE. PAC was defined as utilization of long-term care hospital (LTCH), hospital-based nursing care (HBNC), or HBC (hospital-based care) within 2 months post-surgery. Multinomial logistic regression was used to identify factors associated with different types of PAC utilization. The utilization patterns of different types of PAC within 2 months after mastectomy were associated with age, income, cancer severity, and particularly the region of residence (Metropolitan; HBNC, OR 0.16, 95% CI 0.10-0.26; LTCH, OR 2.35, 95% CI 2.21-2.50; HBC, OR 2.17, 95% CI 1.97-2.39), as well as the location (capital areas; HBNC, OR 12.46, 95% CI 4.97-31.25; LTCH, OR 1.21, 95% CI 1.15-1.28; HBC, OR 1.90, 95% CI 1.74-2.07) and type of the hospital (tertiary hospital; HBNC, OR 13.70, 95% CI 7.86-23.86; LTCH, OR 1.45, 95% CI 1.37-1.53; HBC, OR 3.38, 95% CI 3.00-3.80) where the surgery was performed. In this study, we found the factors associated with PAC utilization on mastectomy patients. Our study found that middle-aged breast cancer patients, residents of metropolitan or rural areas, and those who underwent surgery at hospitals in capital area were particularly associated with higher utilization of inpatient-related PAC services. Breast cancer patients with higher income, older adults, metropolitan residents, patients who underwent breast cancer surgery at metropolitan hospitals, and those treated at tertiary hospitals were strongly associated with higher utilization of HBNC services. Identifying factors that determine the use of PAC has meaningful implications for patients and healthcare systems.

Emergency call utilization over a 10-years period: an observational study in Region Zealand, Denmark, 2013–2022

BackgroundImproving prehospital emergency care requires a comprehensive understanding of the efficiency of emergency medical services and demand fluctuations. The medical emergency call is the primary contact between citizens and the emergency medical dispatch center, serving as the gateway to accessing emergency assistance. This study aimed to characterize the emergency call population and analyze the development of emergency call utilization in Region Zealand in Denmark during a 10-years period.MethodsThis was an observational register-based study of administrative data from the emergency medical dispatch center in Region Zealand. Data was collected from 1 January 2013 to 31 December 2022. All unique emergency calls from residents to the emergency number “1-1-2” were included. Descriptive analyses were used to characterize the study population. Poisson regression models were used to calculate ratio estimates for the association between years and hospital catchment areas, using the incidence rate of emergency calls as outcome measure.ResultsA total of 641,457 emergency calls were included. A significant increase in the total number of emergency calls was found, with an increase from 58,454 annual calls to 80,819 calls over the study period. The incidence rate per 1000 residents per year increased from 71.1 to 95.2, a 35% increase. The southern part of the region had significantly more emergency calls per 1000 residents per year during the study period compared to the eastern part of the region (IRR 1.70). Demographically, males comprised 52.3% of cases, and patients aged 65 and older represented 48.2% of calls. Emergency calls were “Emergency level A” in 45.5% and “Emergency level B” in 39.1%. In 22.3% of cases, the emergency call was categorized as “Unclear problem.” The most frequent categories were “chest pain” (12.7%), “impaired consciousness” (9.6%), “breathing difficulties” (8.8%), “accidents” (7.9%), and “minor injuries” (7.6%).ConclusionsThe study revealed a significant increase in emergency calls, both in absolute numbers and per 1000 residents per year, indicating growing demand for emergency care, along with a surge in activity at the region's dispatch center. Regional disparities underscores the potential necessity for tailored developmental approaches over time.

Expectations and Requirements of Surgical Staff for an AI-Supported Clinical Decision Support System for Older Patients: Qualitative Study.

Geriatric comanagement has been shown to improve outcomes of older surgical inpatients. Furthermore, the choice of discharge location, that is, continuity of care, can have a fundamental impact on convalescence. These challenges and demands have led to the SURGE-Ahead project that aims to develop a clinical decision support system (CDSS) for geriatric comanagement in surgical clinics including a decision support for the best continuity of care option, supported by artificial intelligence (AI) algorithms. This qualitative study aims to explore the current challenges and demands in surgical geriatric patient care. Based on these challenges, the study explores the attitude of interviewees toward the introduction of an AI-supported CDSS (AI-CDSS) in geriatric patient care in surgery, focusing on technical and general wishes about an AI-CDSS, as well as ethical considerations. In this study, 15 personal interviews with physicians, nurses, physiotherapists, and social workers, employed in surgical departments at a university hospital in Southern Germany, were conducted in April 2022. Interviews were conducted in person, transcribed, and coded by 2 researchers (AU, LB) using content and thematic analysis. During the analysis, quotes were sorted into the main categories of geriatric patient care, use of an AI-CDSS, and ethical considerations by 2 authors (AU, LB). The main themes of the interviews were subsequently described in a narrative synthesis, citing key quotes. In total, 399 quotes were extracted and categorized from the interviews. Most quotes could be assigned to the primary code challenges in geriatric patient care (111 quotes), with the most frequent subcode being medical challenges (45 quotes). More quotes were assigned to the primary code chances of an AI-CDSS (37 quotes), with its most frequent subcode being holistic patient overview (16 quotes), then to the primary code limits of an AI-CDSS (26 quotes). Regarding the primary code technical wishes (37 quotes), most quotes could be assigned to the subcode intuitive usability (15 quotes), followed by mobile availability and easy access (11 quotes). Regarding the main category ethical aspects of an AI-CDSS, most quotes could be assigned to the subcode critical position toward trust in an AI-CDSS (9 quotes), followed by the subcodes respecting the patient's will and individual situation (8 quotes) and responsibility remaining in the hands of humans (7 quotes). Support regarding medical geriatric challenges and responsible handling of AI-based recommendations, as well as necessity for a holistic approach focused on usability, were the most important topics of health care professionals in surgery regarding development of an AI-CDSS for geriatric care. These findings, together with the wish to preserve the patient-caregiver relationship, will help set the focus for the ongoing development of AI-supported CDSS.

Chronic wound management: a liquid diode-based smart bandage with ultrasensitive pH sensing ability

Chronic wounds, which require prolonged healing periods, pose significant impacts on individuals with diabetes, vascular diseases, and high blood pressure. Simultaneous drainage and monitoring of wound exudate are vital for advanced wound management. However, recently reported smart dressings either lack integration of wound cleaning and monitoring functions or fail to achieve dynamic in situ monitoring of wound status, which hinders their ability to meet the demands of wound care. In this study, a smart bandage is introduced, which integrates a biocompatible liquid diode membrane with an ultrasensitive 3D polyaniline mesh (M-PANI)-based pH biosensor. The smart bandage allows for unidirectional drainage of wound exudate while dynamically sensing the wound pH environment. Specifically, the proposed smart bandage effectively cleans excessive wound exudate while providing real-time information on the wound status during the drainage process. The M-PANI-based pH biosensor demonstrates a high sensitivity of 61.5 mV/pH and a wide pH detection range from 4.0 to 10.0, encompassing the pH range of normal and infected wounds. Moreover, the sensing module exhibits excellent stability after 48 hours of dynamic testing and 28 days of storage, with only a 4.8% decline in the detected signal, and high repeatability with a device-to-device relative standard deviation (RSD) of 3.1%. To evaluate the practicality of this smart bandage, simulated skin and rats have been employed, and the results indicate the immense potential of this smart bandage for clinical applications. In conclusion, the present smart bandage demonstrates considerable promise for wound exudate cleaning and monitoring in advanced wound care and offers a promising method for home-based wound management.

Can Informal Care Be a Substitute for Formal Care? Evidence from Older People with Disabilities in Beijing, China

Background: The demand for long-term care is increasing as the elderly population continues to grow, prompting a critical examination of care modalities. Methods: This study employs data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) to assess the relationship between informal and formal care for older people with disabilities in Beijing. The analysis employs the Probit model and incorporates the application of instrumental variable techniques and propensity score matching to ensure robustness in the results. Results: The findings highlight the important role of informal care. Conclusions: Policymakers should incorporate support policies for informal care into the overall design of the system, provide support to informal caregivers, and reduce their burden. Our research conclusions provide empirical reference for cities with similar characteristics to Beijing.

Preserving the Midwifery Model of Care on a High Acuity Labor and Delivery Unit: Midwives' Perspectives Working in a US Tribal Health System.

Today nearly 9 out of 10 certified nurse-midwives/certified midwives (CNMs/CMs) attend births in hospitals. As the demand for hospital midwifery care has increased over the last quarter century, CNM/CMs' scope of practice has expanded to include care for high-risk patients. Hospital CNMs/CMs are faced with the challenge of balancing support for physiologic birth with an increasingly complex pregnant population cared for in a medicalized ecosystem. Varied perceptions of patient risk and unique philosophies of care can lead to complex discussions between midwives and physicians on the most appropriate care plan for patients. This article shares the experiences and successes of a hospital midwifery practice in the Alaska Native Tribal Health System and explores strategies for promoting the midwifery model of care (MMOC). Midwives in this Tribal Health System experience robust interprofessional collaboration and an organizational focus on patient-centered relationship-based care. Interprofessional collaboration is noted to be among the most critical elements for protecting a MMOC in a hospital setting. Although distinct from one another, the medical and midwifery models can be complementary in the care of high-risk patients, and the Indigenous concept of Two-Eyed Seeing is offered as an approach to integrating the 2 models of care to achieve optimal care for birthing people and their families.

The influence of religion and belief on mental healthcare professionals’ compassion satisfaction, resilience and coping styles

ABSTRACT Mental Health Professionals (MHPs) may experience a range of stress reactions including Compassion Fatigue (CF), Burnout (BO), and Secondary Traumatic Stress (STS), due to the demands of caring for others. This study aimed to assess Compassion Fatigue (CF), Resilience, Coping Styles, and the extent of Belief/Faith among Mental Health Professionals (MHPs), with a focus on comparing differences based on age groups and religious identification. The research also aimed to investigate the relationships among CF, Coping Styles, Resilience, and Belief/Faith extent. A convenient sampling method was employed to collect data from 415 MHPs aged between 23 and 40. Respondents completed demographic surveys and three scales: (ProQOL), (Brief-COPE), and (CD-RISC-10). Results revealed higher levels of Burnout, Secondary Traumatic Stress, and Avoidant coping styles among MHP’s aged 23–30. Additionally, individuals who did not identify with any religion/faith exhibited higher levels of Burnout and Secondary Traumatic Stress. A positive correlation was found between extent of Belief/Faith and Compassion Satisfaction, Resilience, and Emotion-Focused Coping. Conversely, extent of Belief/Faith showed a negative correlation with Burnout and Secondary Traumatic Stress. In conclusion, Belief/Faith appears to have a protective effect against Burnout and Secondary Traumatic Stress, while fostering positive aspects such as Compassion Satisfaction and Resilience.

A temporary hospital intensive care unit: a preparedness concept to increase intensive care capacity

IntroductionNorway faced the possibility of the most significant strain on its intensive care capacity in decades during the COVID-19 pandemic. All Regional Health Authorities in Norway were instructed to prepare for an increase in Intensive Care Units (ICU) capacity demands. To address the surge in demand for critical care, a gymnasium within Haukeland University Hospital premises was planned to be used as a 20-bed temporary ICU. A team-based care approach was trained, where non-ICU nurses received specialized training to support ICU procedures. Maintaining up-to-date medical devices and consumables stored for preparedness through a planned rotation system that feeds into daily use are important. While shortages of medical equipment, hospital beds, and intensive care facilities may occur, personnel shortages are likely to be more significant.ConclusionsThe concept demonstrates promising potential in enhancing preparedness and maintaining critical care surge capacity during pandemics or mass casualty incidents.

How primary and tertiary care services collaborate in urgent care delivery: an evaluation of general practice advice lines

BackgroundTo address the rising demand for urgent care and decrease hospital use, health systems are implementing different strategies to support urgent care patients (i.e. patients who would have typically been treated in hospital) in the community, such as general practitioner (GP) advice lines. The aims of this study were to: identify the support and resources GPs need to manage urgent care patients in the community; assess the need for GP advice lines by primary care services in Australia; and identify the facilitators and barriers to adoption, and strategies to support the sustainability of GP advice lines.MethodsQualitative study involving semi-structured interviews with GPs, hospital-based healthcare providers, consumers, and healthcare management, recruited via existing investigator networks and snowballing approach. The interviews were conducted between February and August 2023. Major themes were identified by an iterative and inductive thematic analysis.ResultsWe interviewed 16 participants (median age 50, IQR 38–59). Based on the aims of the study, three themes emerged: support and resources for GPs; motivation for GP advice lines; and factors influencing the uptake and sustainability of GP advice lines. Participants reported that better communication from hospital services with GPs is critical to ensure continuity of care between tertiary and primary settings. They also noted that GP advice lines can help increase capacity to manage urgent care patients in the community by providing timely decision-support to GPs. However, a reported barrier to the uptake and ongoing use of GP advice lines was the limited hours of the service. To sustain GP advice lines, participants highlighted a need to broaden the scope of the service beyond the pandemic, conduct rigorous evaluation on health outcomes, and further digitise the service so that a tiered level of support could be provided based on risk stratification.ConclusionsThe benefits of GP advice lines are yet to be fully realised. With increasing technology sophistication, there remain opportunities to further digitise and optimise GP advice lines, whilst ensuring better integration within and across primary and tertiary care services. This is however dependent on continued financial and policy support from the government.

Policy Proposals for Mitigating Intensive Care Unit Strain: Insights from the COVID-19 Pandemic.

Intensive care unit (ICU) strain, characterized by a discrepancy between perceived or actual intensive care resources and demand, significantly impacts patient outcomes and healthcare worker well-being. The coronavirus disease (COVID-19) pandemic exacerbated ICU strain, leading to increased mortality and extended hospital stays, affecting both critically ill patients with and without COVID-19. A systematic review identified 16 leading and lagging indicators of ICU capacity strain, including queuing, premature and after-hours ICU discharge, use of temporary space, length of stay, burnout, staffing and nurse-to-patient ratio, ICU census, acuity and turnover, standardized mortality ratio, readmissions, availability of critical supplies, ventilator use, and surgery cancellation. However, variability in operational definitions and limited evidence regarding the reliability, validity, usability, and feasibility limit the value of single indicators for informed strategic planning and policy guidance. Regional and national policies and programs are essential to enhance real-time monitoring for effective management of critical care resources, and they mitigate the impact of ICU strain, facilitating complex interhospital transfers to reduce strain and ensuring comprehensive strategies for enhancing ICU resilience. Proactive regional cooperation is advocated for policy formulation, knowledge exchange, and resource allocation to anticipate and mitigate ICU strain, ensuring equitable healthcare access during global health crises. The policy implications for future preparedness emphasize the importance of evidence-based triage and adaptable patient management strategies alongside ethical considerations in resource allocation and the role of behavioral economic insights in optimizing resource utilization and collaborative healthcare practices. This multifaceted approach for addressing ICU strain comprehensively and effectively during a pandemic would promote health equity and enhance healthcare system resilience under both routine operations and crisis conditions.

Needs-based selection and prioritization of Technologies to Aid and Assist Nursing Staff in Inpatient Care of Elderly

Abstract Inpatient care facilities globally are facing a critical shortage of staff, posing significant challenges to resident well-being and care quality. This issue is further compounded by demographic shifts and increasing care demands. While technological advancements offer promise in alleviating nursing staff burdens, their effective integration remains complex, with nursing staff acceptance playing a pivotal role. This paper describes a systematic approach designed to streamline the process of identifying, categorizing, and prioritizing suitable technologies in inpatient care settings. By taking into account the specific needs and requirements of nursing staff, this approach, validated through a comprehensive case study, aims to facilitate targeted technology adoption, thereby contributing to the successful digitization of this occupational domain.

"Aging Amplifies Challenges": A Descriptive Phenomenological Exploration of the Lived Experiences andNeeds of Elderly Individuals With Schizophrenia.

Older adults diagnosed with schizophrenia face unique public health challenges, with specific treatment needs, complex care demands, accelerated aging, and increased susceptibility to health issues. This phenomenological study explored the existential realities and needs of older adults diagnosed with schizophrenia. Fifteen participants, with a mean age of 69.47 (SD ± 9.47) years, ranging from 62 to 79 years old and hailing from rural regions, participated in the study. Four main themes and eight sub-themes emerge: compounding the burden (challenges in symptom management, comorbidities); the abyss of a life filled with emptiness (loss of mental pillars, living in agony); living on the margins of society (the vicious cycle of social and self-isolation, unattainable social welfare); and glimmer of light in the darkness (support systems, self-adjustment). The study calls for healthcare professionals to improve follow-up care efficiency, strengthen engagement, understand patients' living conditions and needs, enforce existing welfare policies for older mentally ill patients, and enhance their mental health and quality of life.

Current Situation for Pharmacists in Japanese Veterinary Medicine: Exploring the Pharmaceutical Needs and Challenges of Veterinary Staff to Facilitate Collaborative Veterinary Care

While veterinary pharmacy is common overseas, it has yet to gain traction in Japan. To clarify the actual situation in Japan, two surveys were conducted, targeting 4017 facilities (2000 pharmacies/drug stores, 2000 veterinary medical facilities, and 17 university-affiliated veterinary hospitals). We received 324 responses from pharmacy staff and 217 from veterinary hospital staff. Pharmacists were involved in drug therapy for companion animals either via direct discussion with veterinarians or by referrals for prescriptions from veterinarians (11 respondents). Veterinary staff and pharmacists showed a disparity regarding pharmacists’ involvement in companion animal healthcare. Veterinary staff wanted pharmacists to provide pharmaceutical guidance, perform audits, supply drug information, and prepare drugs. Strong demand (72.2% of the veterinary staff) existed for consultations with pharmacists regarding medication issues. Veterinary medicine has evolved to meet the demand for the advanced care of companion animals. Veterinary staff have diverse and substantial requests for pharmacists. Integrating the expertise of both veterinary staff and pharmacists may facilitate a team-based approach to veterinary medicine and improve the quality of care for companion animals. Tailoring approaches to suit Japan’s unique circumstances and creating a conducive environment for effective communication between pharmacists and veterinary staff are pivotal for advancing veterinary pharmacy in Japan.

Measuring the impact of a pastoral care intervention to increase referrals and improve the quality of chaplain documentation in patient records

The complexity of patient care demands that health care teams collaborate effectively. This means that when pastoral care staff engage with patients, they need to communicate their findings to other members of the multidisciplinary team to maximize patient benefits. In 2016, an Australian hospital found that pastoral care staff were able to visit only 30% of admitted patients, and that documentation of pastoral care visits was minimal. This paper describes and measures the impact of a quality improvement education program for pastoral care workers by auditing patient medical records pre- and post-intervention. The intervention did not significantly increase the number of pastoral care visits or referrals. Documentation of pastoral care visits was significantly improved in terms of the detail provided. More work is required to standardize indications for pastoral care referral and templates for pastoral documentation in patient medical records.

Therapy Mode Preference Scale: Preliminary Validation Methodological Design.

The use of tele-mental health care increased rapidly in 2020 as a critical response to the COVID-19 pandemic, serving as an effective contact-free alternative to treatment. Today, tele-mental health care remains a viable option for individuals with geographic and physical barriers to treatment. However, there are several potential therapeutic disadvantages to tele-mental health care (ie, missing nonverbal signals, handling crises, confidentiality, weakened social connection in group therapy) that should be evaluated. While published literature has explored client satisfaction within teletherapy and the effect of using technology for tele-mental health care demands, there is a need for published surveys that evaluate the therapeutic experience in teletherapy and in-person mediums of care. The authors of this study sought to develop and validate a survey that could evaluate the comparative impact of teletherapy and in-person care from a therapeutic perspective across key factors (ie, therapeutic alliance, engagement, rapport, and confidentiality). Participants were clients who experienced both tele-mental health care and in-person therapy at an intensive outpatient mental health treatment program for young adults from April 2020 through June 2022. Generated items on the survey were formulated based on input from experts in the field and existing validated scales. All individuals completed the survey on the internet, following informed consent (n=89). An exploratory factor analysis was conducted to understand factor structure, and Cronbach α was used to determine internal consistency. Incremental validity was demonstrated through a hierarchical linear regression. The exploratory factor analysis revealed a 14-item, 3-factor structure. All 14 items correlated at a minimum of 0.30 with at least one other item. Kaiser-Meyer-Olkin measure of sampling adequacy was 0.75 and Bartlett's test of sphericity was significant (χ291=528.41, P<.001). In total, 3 factors accounted for 61% of the variance, and the preliminary Cronbach α (α=0.71) indicates a satisfactory level of internal consistency. The Zoom Exhaustion and Fatigue Scale (ZEF) and Client Satisfaction Questionnaire (CSQ; -0.29) were significantly correlated, as well as the ZEF and Therapy Mode Preference Scale (TMPS; -0.31), and CSQ and TMPS (0.50; P<.001). Hierarchical linear regression revealed that the CSQ significantly accounted for additional variance in the TMPS (P<.001). With the ZEF entered into the model, no further variance was accounted for (P=.06). Continual research is warranted to expand the current findings by validating this standardized tool for assessing the therapeutic impact of teletherapy versus in-person care in a generalizable population.

The current state and prospects of peptides use in cosmeceuticals

Aim. To analyze the range of peptides in cosmeceuticals. Materials and methods. The study materials were publications in scientific periodicals. The study used methods of content analysis, comparative, logical, analytical methods and generalization of information. Results. The analysis of scientific literature data has shown that bioactive peptides of various origins are widely used as active ingredients in cosmeceuticals. In 2022, the global market for the synthesis of cosmetic peptides was estimated in 195.3 million USD. The market is expanding due to the growing consumer demand for skin care and anti-ageing products. Consumers are shifting towards a holistic approach to beauty, appreciating products that not only provide instant results, but also support the skin’s natural processes. Peptides, with their various benefits, perfectly match this approach by promoting skin elasticity from the inside, providing a long-lasting positive result. Peptides can be used to address specific skin problems, such as hyperpigmentation, acne and inflammation. According to the mechanism of action, biologically active peptides are classified as carrier peptides, signal peptides, neurotransmitter inhibitor peptides and enzyme inhibitor peptides. Carrier peptides facilitate the transport of cofactors, such as copper and manganese, across the skin barrier. Both cofactors are essential for enzymatic reactions involved in preventing aging and wound healing. Copper tripeptide-1 and manganese tripeptide-1 are examples of carrier peptides that have been successfully used to reduce fine lines, wrinkles and hyperpigmentation associated with photoaging. Signal peptides or matrikines are derived from extracellular matrix proteins, such as collagen, elastin and fibronectin. Matrikines interact with specific receptors that stimulate the synthesis, repair and remodeling of the extracellular matrix. These peptides also regulate the activity of certain key enzymes involved in the aging process, such as collagenase, elastase, tyrosinase and hyaluronidase. Neurotransmitter inhibitor peptides are the latest cosmeceutical peptides. Similar to botulinum toxins, these peptides prevent the release of acetylcholine, a neurotransmitter responsible for muscle contraction. Inhibiting this process relaxes facial muscles, preventing the formation of fine lines and wrinkles. Neurotransmitter inhibitor peptides are a safer alternative to traditional botulinum toxin treatment with fewer potential side effects. Enzyme inhibitor peptides have become popular active ingredients in anti-ageing cosmetics. This class of peptides inhibits the activity of certain enzymes involved in various biochemical processes of the skin. Their application in cosmeceuticals is to control or inhibit those processes that cause skin damage, aging or loss of elasticity. Conclusions. The study of peptides for use in cosmeceuticals has opened new prospects in skin care and aesthetic medicine. Bioactive peptides of various origins – from plants, animals, marine organisms, and edible insects – exhibit a wide range of properties, including antiaging, antioxidant, anti-inflammatory, and antimicrobial effects. Peptides open new horizons in the creation of innovative cosmeceuticals, especially when combined with other active components, such as antioxidants or retinoids. Their safety, ability to biodegrade and spot impact make peptides an attractive ingredient for solving various dermatological problems without the side effects of more aggressive skin correction methods.

Enhancing healthcare planning using population data generated from mobile phone networks in Futaba County after the Great East Japan earthquake

After the Great East Japan Earthquake, planning appropriate healthcare resource allocation was crucial. However, accurately estimating medical care demand was challenging due to substantial population fluctuations caused by extensive evacuations, compounded by the inaccuracy of conventional Resident Resister data in this context. This study employs population data generated from mobile phone network from 2019 to 2020 to conduct a detailed temporal and spatial population estimation in Futaba County, originally a complete evacuation zone. To enhance the precision of population estimates, population data independently collected by each municipality were used as reference data in the estimation process. Further, the utility of the estimated population data for calculating emergency transport rates was assessed. Our findings revealed discrepancies between daytime and nighttime populations within Okuma and Futaba Town, where median day/night population ratio exceeded three across both weekdays and weekends. Additionally, sex–age-adjusted emergency transport rates calculated using the estimated population demonstrated closer alignment with the national average compared to those calculated based on census data. This study demonstrates the importance of considering dynamic population data, such as that generated from mobile phone networks, in enhancing healthcare planning and ensuring that resources are efficiently allocated to meet communities’ evolving needs during recovery periods.

The disability profile in primary care may depend on the type of care and pain aspects.

OBJECTIVE: To investigate the relationship between sociodemographic factors, musculoskeletalpain and its characteristics, and the type of primary health care received with self-reported disability.METHODS: This is a cross-sectional study, interviewing individuals selected from spontaneous demand for health care in two types of care: health center and family health unit. Disability was investigated using the World Health Organization Disability Assessment Schedule (WHODAS) 2.0 and characteristics of intensity, frequency, duration, number of pain sites, and regions. Measures of association between predictors and disability were performed with non-parametric statistical tests, whereas non-parametric regression models were presented for pain characteristics and for the general population.RESULTS: In total, 2.3% of family health users and 7.2% of health center users had severe levels ofdisability. Health center users had more self-reported disability than family health users (p &lt; 0.001). Fewer years of life (p = 0.034) and lower per capita income quintile (p = 0.014) were associated with greater disability. The most intense pain and pain in the greatest number of sites increased the disability score by 1.8 (95%CI = 1.0–2.6) and 6.3 (95%CI = 0.1–12.2) points, respectively. CONCLUSION: Users who had more disabilities sought care at walk-in health centers, had lower per capita income, presented musculoskeletal pain of worse intensity, and pain in a greater number of sites.

Optimal multiresource planning for the elderly care system: a case study

This paper investigates an optimal long-term bed and caregiver plan for the elderly care system (ECS) to meet the increasing care demand due to accelerating population aging in China. Care demand is dynamic due to various arrival ratepatterns, heterogeneous lengths of stay, health status, and balking and reneging behaviours, while supply depends on health/age/waiting-time-based priority queueing strategies. We develop a simulation-optimisation model that combines discrete event simulation, a bisection search algorithm and a feasibility detection procedure for this problem. Based on data from the Chinese Longitudinal Healthy Longevity Survey, the Ministry of Civil Affairs of China, and the queue system for senior care institutions in Shenzhen, the results show that the increasing arrival pattern saves operational costs and waiting time. The age-based-priority (ABP) strategy can reduce evaluation and waiting costs and prevent rent-seeking before application because it counts only older adult’ age. Balking helps to reduce reneging. Low ratio of caregivers to seniors will lead to significant underestimation of caregiver capacity. The ECS can purchase beds step by step, apply the ABP strategy for admission, release waiting information to induce balking behaviour, and hire part-time caregivers or rent service robots to reach the optimal plan while serving more older adults.

Increasing Access to Palliative Care in Cameroon: Progress, Gaps, and Recommendations.

Access to palliative care is an urgent global need. Countries with the greatest palliative care needs have limited access. In Cameroon, demand for palliative care is growing due to the rising incidence of life-limiting conditions. Identifying available palliative care services and programs could provide an understanding of access gaps and inform future roadmaps for palliative care development in the country. We aim to map available palliative care services, identify gaps and inform recommendations to promote early access to palliative care in Cameroon. We undertook a literature review of articles reporting any aspects of palliative care in Cameroon. We searched Embase, MEDLINE, Scopus, PsycINFO, CINAHL, PubMed and gray literature. Data were analyzed thematically using the World Health Organization model for the assessment of palliative care development. We identified 41 articles reporting 21 organizations with some form of palliative care services such as clinical services, education, advocacy and research. These were led mostly by individual health care providers or private and faith-based organizations. Major palliative care initiatives included training in the form of workshops, and adult and pediatric outpatient, in-patient and community-based palliative care. There were few reports of oral morphine production, community engagement, advocacy and palliative care research. Progress in palliative care development was reported in five regions of Cameroon over the last two decades. Findings suggest the need for an intersectoral approach including government, community, and health care stakeholders to achieve sustainable palliative care. This could potentially ensure equitable access to palliative care in Cameroon.