Development Of Health Care System Research Articles

Quality criteria and certification for paediatric oncology centres: An international cross-sectional survey.

Background Quality criteria and certification possibilities for paediatric oncology centres vary between countries and are not widely used. An overview of the type and how quality criteria and certifications are used in countries with highly developed healthcare systems is missing. Methods This international cross-sectional survey investigated the use of quality criteria for paediatric oncology centres and whether certification is possible. We sent an online survey to paediatric oncologists from 32 countries worldwide and analysed the survey results and the provided regional or national documents on quality criteria and certification possibilities descriptively. Results Paediatric oncologists from 28 (88%) countries replied. In most countries, the paediatric oncology centres were partly or completely historically grown (75%), followed by the development based on predefined criteria (29%), and due to political reason (25%), with more than one reason in some countries. Quality criteria are available in 20 countries (71%). We newly identified or specified five quality criteria, in addition to those from a previously performed systematic review. Certification of paediatric oncology centres is possible in 13 countries (46%), with a specific certification for paediatric oncology in seven, and a mandatory certification in three of them. Conclusion The use of quality criteria and certification possibilities are heterogeneous, with quality criteria being more frequently used than certifications. Our study provides an overview of country-specific documents and links with quality criteria, and centre certification possibilities. It can serve as a reference document for stakeholders and may inform an international harmonization of quality criteria and centre certification between countries with similar healthcare systems.

Therapeutic itineraries of snakebite victims and antivenom access in southern Mexico.

Access to antivenoms in cases of snakebite continues to be an important public health issue around the world, especially in rural areas with poorly developed health care systems. This study aims to evaluate therapeutic itineraries and antivenom accessibility following snakebites in the states of Oaxaca and Chiapas in southern Mexico. Employing an intercultural health approach that seeks to understand and bridge allopathic and traditional medical perceptions and practices, we conducted field interviews with 47 snakebite victims, documenting the therapeutic itineraries of 54 separate snakebite incidents that occurred between 1977 and 2023. Most victims used traditional remedies as a first line of treatment, often to withstand the rigors of a long journey to find antivenoms. The main obstacles to antivenom access were distance, poor antivenom availability, and cost. Standard antivenom treatment is highly valued and sought after, even as traditional beliefs and practices persist within a cultural framework known as the "hot-cold" system. The findings are crucial for informing future enhancements to antivenom distribution systems, health education initiatives, and other interventions aimed at mitigating the impact of snakebites in the region.

Rethinking counterfeit medical supply chains: A critical review of the current literature.

The medical device and pharmaceutical industries include a range of drugs, machines, instruments, and apparatuses used to prevent, diagnose, treat disease and illness, or aid in rehabilitation for patients, and are expected to grow substantially in the coming years. However, they are often targets of criminal organizations who manufacture and profit from fraudulent products, infiltrating the market with counterfeit medical supply chains. In this paper, we discuss and analyze the extent and nature of this problem and make suggestions for mitigation and prevention of this worldwide challenge. Ultimately, we argue that a holistic approach is essential to addressing this problem, including the creation and dissemination of reliable and good quality data, developing healthcare systems to be more robust, establishing/enhancing intra- and international cooperation around this issue, and employing effective technological solutions, such as digital tracing.

Promoting transdisciplinary collaboration in academia: uniting for climate-resilient health

In a world where some regions are directly experiencing the effects of the climate change, while others are more vulnerable; this article dives into the deep and frequently catastrophic impact of the climate change on vulnerable countries. This review emphasizes the need for transdisciplinary academic collaboration, including social scientists, healthcare professionals, engineers, policy experts, and climate scientists, and underscores academia’s potential role in advancing climate-resilient health systems in these areas. The study promotes inclusive research that prioritizes at-risk groups, involves communities, and supports culturally sensible methodologies. Beyond their traditional tasks, academia has an obligation for action, learning, innovation, and change. To address the complex health concerns brought on by the planetary crisis, collaboration across academic fields and in tandem with communities, governments, and international organizations is crucial. Ongoing collaboration between academia, governments, and stakeholders is crucial to developing healthcare systems and technologies that are climate resilient. The complex role of academia involves developing pioneering solutions in healthcare for a sustainable future, advocating for policies based on evidence, and educating the next generation of professionals.

Data Collection Module for a Centralized Electronic Health Records System

Electronic Health Records (EHRs) play a crucial role in modern healthcare, enhancing quality, safety, efficiency, and research capabilities. However, in Nigeria the full acceptance of such modern ways of managing healthcare delivery is marred with various challenges such as infrastructure, funding, technical expertise, and regulatory issues. This paper presents a proposed conceptual framework of a Data Collection Module for a Centralized EHR System in Nigeria, aimed at addressing data accessibility challenges faced by healthcare facilities for patients registering at their facilities. The module utilizes National Identification Numbers (NINs), barcodes, and biometric identification methods to collect and secure patient demographic data. It incorporates a web application, biometric software, and barcode/QR code software to ensure efficient data collection and verification. Our study demonstrates the feasibility and effectiveness of employing biometric identification techniques in data collection modules, offering enhanced accuracy, reliability, security, and usability of patient data in a developing healthcare system like Nigeria.The proposed module has not been tested in a real-world environment, so more study is required to determine its viability, scalability, and effect on the standard and results of healthcare.

Patient perceptions of healthcare service quality in Romania: Public versus private hospitals – Implications for developed and developing healthcare systems

Objective: Recent increases in per capita income and longevity in Central and Eastern European counties (CEECs), alongside a slow-changing soviet-era public healthcare system, has led to the emergence of private hospitals. This paper investigates the differential patient service quality perceptions for private versus public hospitals, as well as for three types of healthcare services: primary, ambulatory, and inpatient care.Methods: Data from 1,673 patients of private and public hospitals in the capital of Romania were collected in face-to-face interviews. Analysis of covariance and partial-least-squares techniques were used to examine the relationships between perceived service quality, hospital ownership status and the type of health service patients received.Results: Over 70% of women prefer private health facilities to public hospitals (compared to less than 30% of men). While private hospitals rank higher than public hospitals on most attributes, the interaction effect of gender and hospital type reveals that assurance and empathy are the only significant attributes in driving women to private hospitals. (Physical facilities and staff appearance) as well as intangible dimensions of service quality (assurance, responsiveness, reliability, and empathy) have a positive impact on perceived overall service quality of healthcare. Improvements in perceptions of hospital’s tangibles, staff’s responsiveness and empathy have the greatest potential to enhance perceived overall service quality.Conclusions: This paper demonstrates the importance of breaking down health services into various sub-categories both in terms of perceived healthcare attributes and in terms of tangible healthcare facilities, such as public and private hospitals.

A scoping review of continuing education models and statutory requirements for pharmacists globally

BackgroundIn the dynamic field of pharmacy amongst a diverse array of countries with disparate income levels, pharmacists play a pivotal role in integrating emerging scientific knowledge into their practice while adapting to evolving therapeutic interventions and expanding service delivery responsibilities. Lifelong Learning (LLL) is cultivated through continuing professional education (CPE) and continuing professional development (CPD), indispensable components ensuring sustained professional competence and heightened patient care quality. The global landscape witnesses diverse LLL activities tailored to pharmacists’ learning needs and preferences. This scoping review maps and synthesises a comprehensive global perspective on the existing knowledge regarding CPE/CPD models, statutory requirements, and pharmacists’ preferences for LLL activities.ObjectiveTo comprehensively investigate global models of CPE/CPD for pharmacists’ and examine the statutory requirements governing pharmacists’ registration and licensure.MethodA literature search of PubMed, Google Scholar, Web of Science, and the University of KwaZulu-Natal library search engine was undertaken for studies between January 2012 and February 2023. The article selection and reporting followed the recommendations made by PRISMA (Preferred Reporting Items of Systematic Reviews and Meta-Analyses) guidelines. The articles were tabulated based on their respective country’s income level, continuing education models employed, country-specific statutory requirements, and pharmacists’ preferences for LLL activities.ResultsOf the initial 3974 publications identified through the database search, 24 studies met the review criteria. The majority of the articles originated from high-income countries (HICs) (14/24, 58.3%), and most employed the mandatory CPD points system (21/24, 87.5%). However, in some HICs and upper-middle income countries (UMICs), the CPE/CPD is non-mandatory. While most countries (19/24, 79.2%) offer various LLL formats, the preference of pharmacists remains primarily face-to-face learning (13/24, 54.2%). However, workplace learning (3/24, 12.5%) and blended learning (7/24, 29.1%) are mentioned in some studies.ConclusionDiverse models of CPE/CPD alongside statutory requirements persist globally and evolve, shaped by varied implementation experiences. HICs lead in CPD models, while the implementation in low- and middle-income countries (LMICs) and low-income countries (LICs) requires further exploration for inclusivity and effectiveness. A few UMICs are either initiating or in early stages of implementing the CPD models. Structured planning for LLL activities is increasingly a global requirement for pharmacists’ licensure. The essential progression of pharmacy practice in developing healthcare systems necessitates a mandatory CPD model. Ongoing research is crucial to fortify the implementation, align and unify the CPD model with evolving pharmacy profession needs.

What are the mechanisms underlying the delivery of survivorship care information in Australia? A realist review.

Quality survivorship information is an essential component of cancer care. However, survivors often report not receiving this information and healthcare professionals report limited practical guidance on how to effectively deliver survivorship information. Therefore, this study used realist review methods to identify mechanisms reported within the published literature for communicating survivorship information and to understand the contextual factors that make these mechanisms effective. Full-text papers published in CINAHL, PubMed, Web of Science, Scopus, Cochrane Library, and Academic Search Ultimate were included. Studies included in this review were conducted in Australia between January 2006 and December 2023, and reported on how information regarding survivorship care was communicated to adult cancer survivors living in the community. This review utilized realist methodologies: text extracts were converted to if-then statements used to generate context-mechanism-outcome theories. Fifty-one studies were included and six theories for mechanisms that underpin the effective delivery of survivorship information were formed. These include: (1) tailoring information based on the survivors' background, (2) enhancing communication among providers, (3) employing dedicated survivorship staff, (4) providing survivorship training, (5) reducing the burden on survivors to navigate their care, and (6) using multiple modalities to provide information. Findings can inform practical guidance for how survivorship care information is best delivered in practice. Clinicians can apply this guidance to improve their individual interactions with cancer survivors, as can policymakers to develop healthcare systems and procedures that support effective communication of cancer survivorship information.

Navigating the genetic landscape of breast cancer in South Africa amidst a developing healthcare system.

Breast cancer is a significant global health issue as it represents the leading cause of death in women worldwide. In 2021, the World Health Organization established the Global Breast Cancer Initiative framework with the aim to reduce the breast cancer mortality rate by the year 2040. In countries with developing healthcare systems, such as South Africa, the implementation of first-world technologies has been slow. We provide an overview of the strides taken to improve the cost-effectiveness of genetic service delivery for breast cancer patients in South Africa - from advances in the technology utilized for BRCA founder genotyping to variant screening in moderate-to high-penetrance genes. We furthermore reflect on research undertaken to improve accessibility by means of population-directed point-of-care genetic testing that is ideal for use in a primary healthcare setting. We also report on a pilot study utilizing exome sequencing at the intersection between research and service delivery. Finally, we discuss and conclude on the controversies, research gaps, and future prospects based on the most recent developments in first-world countries that are implementable in developing countries to improve early detection of breast cancer and overall disease management.

Response to letter to the editor "Elevating Standards: A Comprehensive Model for Peritoneal Surface Malignancy Management in Developing Healthcare Systems".

Response to letter to the editor "Elevating Standards: A Comprehensive Model for Peritoneal Surface Malignancy Management in Developing Healthcare Systems".

COVID-19 and the adequacy of antenatal care among Indigenous women: A retrospective crossover analysis.

Often marginalized and disadvantaged by systems of oppression, Indigenous populations commonly face significant barriers to accessing adequate antenatal care (ANC). The COVID-19 pandemic had an unprecedented impact on healthcare systems worldwide, including on the provision of antenatal care; this was especially so for Indigenous communities in many regions. As such, our study aimed to estimate the association between the COVID-19 pandemic and adequate ANC received by Indigenous women in Chiapas, Mexico. We conducted a retrospective crossover analysis with data collected between June and December 2021 from Indigenous women who attended at least one ANC appointment at one of two health centers in San Cristóbal de las Casas, Chiapas. We used a multinomial logistic regression model considering the time frame (before and during the pandemic) as the primary independent variable. Adequate antenatal care comprised four dimensions: attendance by qualified personnel, timely first visit, sufficient frequency of visits, and adequacy of the content provided during the visits. During the COVID-19 pandemic, there was a significant drop in ANC adequacy, with 12.7% (95% CI: 8.3, 18.9) of Indigenous women receiving ANC, compared with the pre-pandemic rate of 52.5% (95% CI: 44.7, 60.3), among the 158 participants. The pandemic resulted in a reduction of 75.8% in the adequacy of ANC. Considering the four dimensions of adequacy, we found that having only one dimension was associated with a relative risk ratio (RRR) of 12.45 (95% CI: 6.40, 24.23), while having two or three dimensions was associated with a RRR of 5.23 (95% CI: 2.83, 9.65) when using adequate ANC as the category of reference. According to our results, Indigenous women's ANC adequacy was negatively affected by the COVID-19 pandemic. In light of these findings, we emphasize the importance of developing healthcare systems that are prepared to adapt consultation schemes by implementing virtual visits and incorporating community health workers.

Nurses’ Knowledge and Practice Regarding the Prevention of Complications COVID-19 at Shaheed Ziaur Rahman Medical College Hospital, Bogura, Bangladesh

Background: Coronavirus disease-2019 (COVID-19) was an emerging public health problem threatening the lives of over 2.4 million people globally. It was a great challenge for the management of all hospitals to respond to the coronavirus (COVID-19) outbreak at the early stage in the world. The most prominent problems were the arrangement of medical staff to diagnose and treat patients with COVID-19 and the allocation of medical protective equipment. The estimated basic reproductive number of the virus is significantly higher than many other infectious diseases, which can potentially result in the capacity of health facilities becoming overwhelmed, even in the countries with the most developed healthcare systems. Objective: The aim was to assess the level of nurses and practice regarding preventing complications of COVID-19 at Shaheed Ziaur Rahman Medical College Hospital, Bogura. Methodology: This descriptive cross-sectional study design was used, and a sample size of 110 that was a purposive sampling technique followed those who met the inclusion criteria to assess the nurses’ practice regarding the prevention of complications of COVID-19 at Shaheed Ziaur Rahman Medical College Hospital, Bogura. The study was conducted from July 2021 to December 2021. The instruments for data collection were a semi-structured questionnaire composed of three parts: Demographic variables, knowledge, and practice-based information on the prevention of COVID-19 complications. Results: The findings of the present study revealed that the demographic information the highest 40.91% were within ≤ 30 years of age, 77.27% were female, 90% were Muslim, 87.27% were married, and 46.36% were diploma in nursing. The average level of knowledge, 38.18%, was a high level of knowledge regarding the prevention of COVID-19, which may be due to their clinical experiences. Conclusion: Coronavirus disease 2019 (COVID-19) is a global public health threat, creating a pandemic worldwide. The preventive measures include strict quarantine and screening, as well as education to promote the use of masks and hand-washing practices. Nurses’ roles in the disease are an important cognitive key in public health regarding prevention and promotion.

Obstetric Violence in Developing Health Systems: An Evolving Problem Requiring Novel Intervention

While the term obstetric violence has a variable definition given its immensely personal and internally compassionate nature; many accept it to mean: harm inflicted during or in relation to pregnancy, childbearing, and the post-partum period often on the part of a healthcare provider. Obstetric violence, an enigmatic and labyrinthine concern, predominantly and disproportionality affects those experiencing pregnancy in nations with developing healthcare frameworks. The specific comparison that this article will explore is Canada versus Brazil. Due to sociopolitical factors that are beyond the scope of this article, Canada is often seen as a strong representation of developed healthcare whereas Brazil is often placed within the context of developing or underserved as it pertains to healthcare access and development. This is further reinforced by statistical rankings which in 2020 placed Canada as the 15th most developed healthcare system and Brazil ranked at 70.

Exploring the hidden demands for patients’ resources: How health researchers risk excluding patients from patient and public involvement in health research during recruitment

Patient involvement in health research is widely recognized to promote effective collaboration between health researchers and patients in endeavors to develop healthcare systems. Policy documents and research strategies stress the benefits of collaborative health research with patients. However, patient recruitment depends not only on health researchers' decisions but also on other key factors: patients' competencies and the structural framework of the healthcare and academic sectors. This article is a modest attempt to explain challenges connected to recruitment, as health researchers seek to involve citizens in health research. Through interviews with nurses and doctors who conduct research, I describe how and why different patients are recruited into research in the Danish healthcare system. I apply Bourdieu's concepts of field, cultural capital, and habitus to analyze how health researchers assess patients' social competencies as part of the recruitment process. I conclude that health researchers' positions shape the competencies and knowledge that are considered legitimate and can operate as capital in this complex and dynamic arena. Therefore, forms of competencies that can function as capital are unequally distributed and recruitment risks excluding marginalized and disadvantaged groups from becoming involved. The study contributes to the literature on participatory practices and highlights the hidden social demands that are produced between the healthcare sector and academic sector by understanding the experiences of health researchers and how they value communicative skills and knowledge about the healthcare sector. The paper ends with suggestions for future directions.

Multi-agent Intelligent System Design for Telemedicine Applications to Develop Health Care Systems of Developing Countries

Various factors controlling health care in any country, but still there is a weakness in the infrastructure of health care systems in some developing countries, including many Arab countries, due to the shortage of medical specialists personnel, global economic crisis, and wars and disasters that struck many countries. A crying need for a tele-medical care becomes a necessity, and in order to overcoming this weakness we have proposed a multi-agent intelligent Telemedicine system in this research. The proposed system can help solve the shortage of specialists urgently and at lower costs. Furthermore, it can save the efforts of the patients' expensive travel for treatment abroad. Moreover, it can avoid infections from social closeness in times of disasters and pandemics.
 Nowadays Telemedicine systems have gradually become a popular medical model which have always attracted much attention due to the continuous development of the multi-agents' structure and capabilities of the artificial intelligence systems. So we will focus in the prototype design of our system on the algorithms, techniques and devices that support the multi-agents' structure and AI technologies. The Multi-agent approach happens to be a suitable structure for the development of Telemedicine systems. Worth mentioning it can solve problems that are difficult or impossible for an individual agent or a monolithic system, and the AI capabilities will minimize human errors and improve health care outcomes.
 We will start by a state-of-the-art literature survey as conducted on the E-health system architecture, AI capabilities, and multi-agent platform, and then we will illustrate prototype design of the suggested Multi-agent intelligent system for Telemedicine which will contribute in the development of the health care systems in the developing countries.
 Keywords: Healthcare system; Medical System; Artificial Intelligence; Multi-Agent, Telemedicine; Telehealth.

Delays in Initiating Anti-Cancer Therapy for Early-Stage Breast Cancer-How Slow Can We Go?

Breast cancer is the most commonly diagnosed cancer among women worldwide, and is a leading cause of cancer-related deaths. When diagnosed at an early stage, appropriate and timely treatment results in a high cure rate and better quality of life. Delays in initiating anti-cancer therapy, including surgical resection, adjuvant/neoadjuvant chemotherapy and radiation therapy are commonly encountered, even in developed health care systems. Existing comorbidities that mandate referral to other services, genetic counseling and testing that may dictate the extent and type of anti-cancer therapy and insurance coverage, are among the most commonly cited factors. However, delays can be unavoidable; for over three years, health care systems across the globe were busy dealing with the unprecedented COVID-19 pandemic. War across hot zones around the globe resulted in millions of refugees; most of them have no access to cancer care, and when/where available, there may be significant delays. Thus, cancer patients across the globe will probably continue to suffer from significant delays in diagnosis and appropriate treatment. Many retrospective reports showed significant negative impacts on different aspects of treatment outcomes and on patients' psychosocial wellbeing and productivity. In this paper, we review the available data on the impact of delays in initiating appropriate treatment on the outcomes of patients with early-stage breast cancer.

The role of nanotechnology-based approaches for clinical infectious diseases and public health.

Given the high incidence of infection and the growing resistance of bacterial and viral infections to the traditional antiseptic, the need for novel antiseptics is critical. Therefore, novel approaches are urgently required to reduce the activity of bacterial and viral infections. Nanotechnology is increasingly being exploited for medical purposes and is of significant interest in eliminating or limiting the activity of various pathogens. Due to the increased surface-to-volume ratio of a given mass of particles, the antimicrobial properties of some naturally occurring antibacterial materials, such as zinc and silver, increase as particle size decreases into the nanometer regime. However, the physical structure of a nanoparticle and the way it interacts with and penetrates the bacteria also appear to provide unique bactericidal mechanisms. To measure the efficacy of nanoparticles (diameter 100nm) as antimicrobial agents, it is necessary to comprehend the range of approaches for evaluating the viability of bacteria; each of them has its advantages and disadvantages. The nanotechnology-based disinfectants and sensors for SARS-CoV-2 provide a roadmap for creating more effective sensors and disinfectants for detecting and preventing coronaviruses and other infections. Moreover, there is an increasing role of nanotechnology-based approaches in various infections, including wound healing and related infection, nosocomial infections, and various bacterial infections. To meet the demand for patient care, nanotechnology-based disinfectants need to be further advanced with optimum approaches. Herein, we review the current burden of infectious diseases with a focus on SARS-CoV-2 and bacterial infection that significantly burdens developed healthcare systems and small healthcare communities. We then highlight how nanotechnology could aid in improving existing treatment modalities and diagnosis of those infectious agents. Finally, we conclude the current development and future perspective of nanotechnology for combating infectious diseases. The overall goal is to update healthcare providers on the existing role and future of nanotechnology in tackling those common infectious diseases.

Analysis And Prediction of COVID-19 Based on Machine Learning

Artificial intelligence (AI) technology is in high demand today for wireless infrastructure integration, real-time data collecting, and end-user device processing. The most innovative answer at hand right now is the use of AI to recognize and forecast widespread epidemics. The pandemic, which started with COVID-19, has had a terrible impact on world society and placed a significant load on the most developed healthcare systems globally. According to the European Centre for Disease Prevention and Control (ECDC), as of May 11, 2020, there had been 282,244 fatalities and more than 4,063,525 confirmed cases. However, given the current exponential and rapid development in the number of patients, it is essential to make use of AI technology to quickly and accurately estimate the prognosis of infected individuals.

Measuring Patient Experience and Patient Satisfaction—How Are We Doing It and Why Does It Matter? A Comparison of European and U.S. American Approaches

(1) Background: Patients' experiences and satisfaction with their treatment are becoming increasingly important in the context of quality assurance, but the measurement of these parameters is accompanied by several disadvantages such as poor cross-country comparability and methodological problems. The aim of this review is to describe and summarize the process of measuring, publishing, and utilizing patient experience and satisfaction data in countries with highly developed healthcare systems in Europe (Germany, Sweden, Finland, Norway, the United Kingdom) and the USA to identify possible approaches for improvement. (2) Methods: Articles published between 2000 and 2021 that address the topics described were identified. Furthermore, patient feedback in social media and the influence of sociodemographic and hospital characteristics on patient satisfaction and experience were evaluated. (3) Results: The literature reveals that all countries perform well in collecting patient satisfaction and experience data and making them publicly available. However, due to the use of various different questionnaires, comparability of the results is difficult, and consequences drawn from these data remain largely unclear. (4) Conclusions: Surveying patient experience and satisfaction with more unified as well as regularly updated questionnaires would be helpful to eliminate some of the described problems. Additionally, social media platforms must be considered as an increasingly important source to expand the range of patient feedback.

Cytomegalovirus infection after COVID-19 in a kidney transplant patient, a case report

COVID-19, with its complications and co-infections is the most important pandemic, which has placed great strain on even the most developed health care systems, especially on the kidney transplant patients. We present a case of cytomegalovirus (CMV) reactivation after remission of COVID-19 in a kidney transplant patient, admitted to the emergency department. Fever, dyspnea, weakness and tachypnea are the most common symptoms of COVID-19, which can mislead physicians to make inappropriate decisions. We concluded that CMV can potentially increase the mortality risk of kidney transplant recipients (KTRs).