Websites Of Organizations Research Articles

Recommendations of the DGRh Committee on Complementary Medicine and Nutrition on the application of selected phytotherapeutic drugs and herbal medicines in rheumatology

Herbal preparations and phytotherapeutic substances are offered for symptoms and diseases of the rheumatic spectrum and are often intensively advertised in the lay press. The German Society for Rheumatology and Clinical Immunology (DGRh) Committee on Complementary Medicine and Nutrition reviewed the scientific literature on selected over the counter preparations and prescription phytotherapeutic substances and examined the possibilities for their use in rheumatology. In an online meeting of the Committee on 8 February 2023 alist of herbal preparations that are frequently used in rheumatology (mostly as self-medication) was drawn up. Each member of the committee then carried out aliterature search on one or two substances and summarized the results according to adefined matrix. Research was carried out on borage oil, stinging nettle preparations, cannabis preparations and preparations of dog rose, rosemary, saffron and willow bark. The data on the mixed preparation Phytodolor® (Bayer Vital GmbH, Germany) were also examined. The results were reviewed by a circulation procedure and approved in two further online meetings of the Committee. After review by the DGRh board, the recommendations were transferred to the professional organization's website. Even though there are reports of anti-inflammatory or immunological effects in vitro and/or in animal models for all the plant substances examined, the evidence for aclinically relevant benefit is sparse. None of the preparations investigated has atherapeutic efficacy that justifies its use in inflammatory joint diseases. Herbal preparations based on saffron and rosemary are generally not recommended. Borage oil from seeds can be taken in standardized form as part of ahealth-conscious diet but is not expected to have any significant anti-inflammatory effect. Rheumatologists need not advise against Phytodolor® or preparations based on stinging nettle, willow bark or dog rose, which are taken on the patient's initiative for degenerative joint diseases, if asensible therapy concept is otherwise adhered to. There is insufficient evidence to prescribe medicinal cannabis for inflammatory rheumatic diseases for disease modification or symptomatic therapy. In individual cases, however, its use to reduce chronic pain, particularly neuropathic pain and sleep disorders and to reduce opiate consumption may be justified. Even if the herbal preparations presented here must be considered in adifferentiated manner for rheumatology practice, the value of phytotherapy for the discipline is low.

Up‐to‐dateness of German patient versions of clinical practice guidelines and potential influencing factors: A mixed‐methods study

AbstractIntroductionClinical practice guidelines (CPGs) provide recommendations and are a fundamental part of clinical practice. Many guideline organisations also produce patient versions of CPGs (PVGs). To explore the up‐to‐dateness of German PVGs, potential methodological influence factors and experts' perspectives, we applied a convergent mixed‐methods design.MethodsFirst, a literature search to identify PVGs was performed between October 2022 and January 2023. We searched the websites of German guideline organisations, Google and the reference lists of included PVGs. We screened the title, downloaded the documents if relevant and retrieved the underlying CPGs and methods reports of CPGs. We aggregated the literature search dates of CPGs and calculated the time between the CPG literature search and PVG publication. Second, interviews with experts in the PVG development were conducted and analysed using qualitative content analysis (Mayring) with MAXQDA.Results49 PVGs were included and analysed. A median of 36 months elapsed between the literature search of CPGs and the publication of PVGs. A median of 25 months passed between the literature search and publication of CPGs, and a median of 7.5 months elapsed between the CPG and PVG publication. Six interviews were conducted and interviewees mostly perceived PVGs as up‐to‐date. However, they identified exceptions in the up‐to‐dateness depending on the topic or thematic chapters of PVGs. Interviewees mentioned different influencing factors such as the scientific progress and the editorial process of PVGs.DiscussionOur findings underline potential issues with the up‐to‐dateness of PVGs. In the context of a fast‐moving evidence basis, it seems doubtful whether PVGs actually reflect the current state of knowledge, especially in fields with high research activity. However, some factors may not be modifiable because they essentially contribute to the quality assurance of PVGs. Further research is desirable to investigate possible measures to improve the up‐to‐dateness of PVGs.

Evaluasi Kinerja Website Pemerintah Kabupaten Pekalongan: Studi Kasus pada Website OPD Pekalongan

This study evaluates the performance of Regional Apparatus Organization (OPD) websites of the Pekalongan Regency Government in supporting the dissemination of public information. The evaluation was conducted using spesific criteria, including speed, accessibility, best practices, and search engine optimization (SEO). The method used in this study is the evaluation method, which involves the systematic collection and analysis of processes based on the defined criteria. The data obtained are measured against established standards to produce recommendations aimed at improving the quality of the websites. The research results show that the OPD websites perform well in terms of speed and implementation of best practices. However, the aspects of SEO and accessibility still require action to ensure that information can be easily accessed by the public, thereby supporting transparency and accountability in delivering public services.

Developing a comprehensive framework for evaluating public health emergency management program implementation: A scoping review.

Public health emergencies and disasters highlight gaps in health systems' emergency preparedness capabilities. Developing robust public health emergency management (PHEM) programs is crucial yet challenging. Existing assessment tools are limited in scope or lack standardized measurement. The aim of this study was to identify core domains of PHEM implementation status and key influencing factors. A scoping review. A literature review and focused desk review were conducted. We searched PubMed, Web of Science, Scopus, and Google Scholar to retrieve relevant studies that explored existing PHEM frameworks, core components, factors influencing implementation, and evaluation tools presented in empirical studies. Additionally, a systematic search of authoritative organizational websites was performed to identify relevant guidelines and frameworks. Subject matter experts consolidated the findings from these diverse data sources through a consultative desk review process. Out of 7232 studies identified, 50 studies met the eligibility criteria and were included in this review. Four core domains of PHEM implementation status were identified: overall implementation level; individual factors (capacity building, resources, engagement, and attitudes); organizational factors (information sharing, community involvement, planning, responsibilities, resources, leadership, monitoring/evaluation, coordination, infrastructure, and policies); and overarching factors (workforce, funding, governance, and collaboration. Nineteen key influencing factors emerged, including elements such as leadership, resource allocation, and stakeholder engagement. A conceptual framework was developed that incorporates these thematic domains from major health agencies and determinants identified through qualitative, quantitative, and mixed-methods research. This review developed a preliminary evaluation framework for PHEM programs based on a comprehensive synthesis of global evidence. The framework lays the groundwork for further validation and application to advance standardized assessments of PHEM capabilities across diverse contexts, ultimately aiming to strengthen health system resilience against emergencies.

Literacy among tobacco users and healthcare professionals about tobacco harm reduction strategies: a scoping review protocol

ObjectiveThe proposed review identifies and describes the extent of Tobacco Harm Reduction (THR) strategies in Pakistan. It also examines the awareness and understanding of these strategies among healthcare professionals and tobacco users in Pakistan.IntroductionTobacco consumption poses a significant threat to human health and is a leading cause of non-communicable diseases. Over the last two decades, the prevalence of tobacco use has increased in low-and middle-income countries (LMICs), which has considerably contributed to the increasing prevalence of Non-Communicable Diseases (NCDs). Tobacco is consumed in various forms, including manufactured cigarettes, hookah/shisha, chewing tobacco, and dipping tobacco. Tobacco use can be reduced and prevented through various strategies adopted by many countries worldwide. One prominent strategy is THR. THR involves the use of safer nicotine products in recommended doses to cope with the symptoms of withdrawal and increase tobacco users’ chances of quitting smoking. In Pakistan, the concept of tobacco harm reduction (THR) is not widely recognized by healthcare professionals and tobacco users.Inclusion and exclusion criteriaLiterature available on Pakistani adults and adolescents (aged 13 years and above) will be included. Literature available as free full text will be included regardless of the publication date. Furthermore, literature available in English or Urdu will be considered eligible. Also, literature available in any form of publication, such as research studies, reviews, organizational websites or blogs, will be considered eligible. Literature that includes Pakistani data mixed with data from any other country will be excluded.MethodsThe literature search will use PubMed, CINAHL, ProQuest Theses & Dissertations, EBSCO Dentistry and Oral Sciences, and PsycInfo databases for online and gray literature. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram will record the included and excluded literature. Two independent reviewers will screen all the retrieved literature. After confirming the eligibility criteria, data from included records will be extracted on an Excel sheet that will record the important characteristics of the literature source and the main findings. Meta-synthesis of collated data will be performed, and the results will be presented as narrative summaries and frequency tables.Systematic review registrationhttps://osf.io/dashboard.

Best practice portals in health promotion and disease prevention: approaches, definitions, and intervention evaluation criteria

IntroductionThe evaluation of practices is a valuable source of evidence in the context of an evidence-based approach to public health. Best practice portals (BPPs) are promising tools for facilitating access to recommended programmes, monitoring and improving the quality of interventions. There are several such portals in Europe, but there is little work in the scientific literature on the subject. The study aimed to identify and characterise BPPs in health promotion and disease prevention and analyse the approaches, definitions, and criteria for evaluating interventions.MethodsTo identify portals, websites of public health institutions and organisations, the PubMed database and grey literature were searched. The material consisted of elements of each portal’s design, information available on their websites, and collected publications. The study applied a qualitative analysis with a descriptive approach and covered a detailed description of the four selected portals.ResultsAmong the analysed BPPs, three were from the European region, and one was from Canada (pioneer in developing best practice tools). The dates of launching the portals ranged from the year 2003 to 2016. The number of interventions collected in the databases ranged from 120 to 337. Portals were useful, well-designed, and developed tools. BPPs differed in terms of their objectives and roles, adopted standards and criteria for assessing practices, and other operational factors. In each portal, interventions underwent a rigorous and multilevel assessment process conducted by independent experts in the field and based on intervention evaluation criteria. Generally, the analysed catalogues described similar issues, e.g., Selection of the issue addressed by the practice, Description of a particular element of the practice, Theoretical foundation, or Evaluation/Effectiveness. However, we identified both similarities and differences in the adopted terms (names of criteria) and their definitions. It was shown that sometimes the same criterion had different names depending on the catalogue. On the other hand, criteria with identical or similar names could be defined differently within the detailed thematic scope.ConclusionThe similarities and differences presented in this work can serve as a valuable starting point for designing such tools to support practice-based and evidence-based decision-making in health promotion and disease prevention.

Exploring the potential benefits and challenges of artificial intelligence for research funding organisations: a scoping review

Background Artificial Intelligence (AI) is at the forefront of today’s technological revolution, enhancing efficiency in many organisations and sectors. However, in some research environments, its adoption is tempered by the risks AI poses to data protection, ethics, and research integrity. For research funding organisations (RFOs), although there is interest in the application of AI to boost productivity, there is also uncertainty around AI’s utility and its safe integration into organisational systems and processes. The scoping review explored: ‘What does the evidence say about the current and emerging use of AI?’; ‘What are the potential benefits of AI for RFOs?’ and ‘What are the considerations and risks of AI for RFOs?’ Methods A scoping review was undertaken with no study, language, or field limits. Due to the rapidly evolving AI field, searches were limited to the last three years (2022-2024). Four databases were searched for academic and grey literature in February 2024 (including 13 funding and professional research organisation websites). A classification framework captured the utility and potential, and considerations and risks of AI for RFOs. Results 122 eligible articles revealed that current and emerging AI solutions could potentially benefit RFOs by enhancing data processes, administration, research insights, operational management, and strategic decision-making. These solutions ranged from AI algorithms to data management platforms, frameworks, guidelines, and business models. However, several considerations and risks need to be addressed before RFOs can successfully integrate AI (e.g., improving data quality, regulating ethical use, data science training). Conclusion While RFOs could potentially benefit from a breadth of AI-driven solutions to improve operations, decision-making and data management, there is a need to assess organisational ‘AI readiness’. Although technological advances could be the solution there is a need to address AI accountability, governance and ethics, address societal impact, and the risks to the research funding landscape.

P0935 A systematic review and quality assessment of clinical practice nursing guidelines for ostomy care

Abstract Background Patients living with stomas face numerous challenges following abdominal stoma surgery. Stoma nurse specialists play a crucial role in supporting these patients by utilizing evidence-based practices and specialist expertise. We evaluate nursing guidelines focused on the management of patients with ostomies, identify knowledge gaps, and support the development of evidence-based patient care pathways. Methods A comprehensive literature search was conducted across MEDLINE, Embase, and major nursing organization websites up to March 25 2024, to identify evidence-based practical guidelines developed specifically for nurses managing patients with abdominal stomas post-ostomy. Pre-specified inclusion (n=5) and exclusion (n=16) criteria were applied (Table 1). Two researchers independently screened references, extracted data, summarized the evidence, and assessed guideline quality using the AGREE II instrument. Results The database search yielded 97 references, with an additional 23 guidelines identified through major nursing organization websites. A total of 14 nursing guidelines met the inclusion criteria, originated from Australia, Canada, Italy, UK, USA, and three international groups. The guidelines varied in scope; offered recommendations across all stages of care, including preoperative, peri-operative, postoperative, and post-discharge phases. Key topics are presented in Table 2. Notably, no guideline statements specifically addressed patients with Crohn’s disease and permanent ostomies. Three guidelines did not specify whether a literature search and review were conducted. Five guidelines applied an evidence scale or numerical grading system, while only three used the GRADE approach. Most recommendations were based on a low level of evidence, often relying on retrospective or observational studies and expert opinion; two guidelines claimed their statements were consensus-based due to a lack of supporting evidence. In the AGREE II assessment, most guidelines were rated as moderate quality, with recommended modifications primarily in the rigor of development and applicability. Conclusion This quality assessment of clinical practice nursing guidelines for ostomy care highlights both strengths and weaknesses within current guidelines. Nursing guidelines offer extensive coverage of ostomy care topics and provide valuable first-line care experience and consensus statements, particularly for postoperative stoma and peristomal care. These insights are essential for non-nursing healthcare providers and contribute to the development of patient care pathways for individuals with Crohn’s disease and permanent ileostomies. However, the limited availability of high-quality evidence underscores the need for further research in ostomy care.

Creating codes of ethics for public health professionals and institutions.

The World Health Organization and the Association of Schools of Public Health in the European Region called for the professionalization of the public health workforce, including the creation of codes of ethics. In this article, the Public Health Ethics and Law Network provides guidance on creating such codes, based on values and principles commonly identified for public health. Our interest was in codes addressing public health broadly rather than disciplines within public health. Public Health codes of ethics are typically published on agency and organization websites rather than peer-reviewed literature. We searched several online databases, such as PubMed; United States government websites; Spanish language websites; and English language websites for public health organizations. We synthesized the principles found into 10 adjectives-such as caring, responsive, and trustworthy-with short elaborations. These terms are practical, for non-philosophers, and provide flexibility for adaptation to country contexts. The creation of a code of ethics should be followed by the identification and building of ethical competencies and capacity for public health professionals and institutions. There are plans to collaborate with pilot sites in the use and generation of further learning, and additional assistance for competencies and other resources to support a code of ethics and competencies.

Assessing the State of Published Research Concerning COVID-19 and Transgender and Nonbinary People in the United States via a Scoping Review: Lessons Learned for Future Public Health Crises.

Purpose: Transgender and nonbinary people (TNB) experienced a disproportionate burden of poor health and socioeconomic outcomes resulting from the coronavirus disease 2019 (COVID-19) pandemic, largely driven by increased vulnerability due to pervasive structural discrimination. To characterize the extent and nature of TNB inclusivity within COVID-19 research, we conducted a scoping review of studies published in English from 2019-2022 reporting COVID-19 pandemic impacts on TNB individuals in the United States. Methods: We searched PubMed (PubMed.gov), Embase (Elsevier), PsycInfo (EBSCO), Sociological Abstracts (ProQuest), and CINAHL (EBSCO), and TNB-focused organizational websites using search concepts 1) COVID-19, 2) TNB people. Studies were systematically reviewed for inclusion. Findings were extracted then summarized using systematic narrative synthesis. Results: Our search identified 1518 studies; 80 articles (65 peer-reviewed, 15 gray literature) met eligibility criteria. Most studies collected data early in the pandemic (69%) utilizing quantitative methods (79%), survey data (81%), and convenience sampling methods (65%); geographic foci varied. Many studies lacked transparent reporting on TNB involvement (80%), race/ethnicity of TNB subsamples (67%), and gender measurement (30%). The findings addressed COVID-19 (39%), mental health (29%), socioeconomics (26%), health care access (24%), physical health (13%), substance use (11%), violence/discrimination (8%), resiliency/coping (5%), gender identity/expression (5%), and sexual health (4%). Conclusions: A substantial amount of COVID-19 research inclusive of TNB people was conducted during the initial 2.5 years of the pandemic. However, there were key methodological (e.g., standardized measurement, enhanced community involvement) and topical gaps (e.g., social and structural resiliencies), which should be addressed in future research and practice to reduce TNB health disparities related to COVID-19 and future public health crises.

Career planning and development for occupational therapists working in mental health: A scoping review

Introduction: The recent UK Royal College of Occupational Therapists survey found a significant proportion of respondents expressed an intention to leave the profession despite the majority agreeing that occupational therapy is a rewarding career. This scoping review aimed to synthesize the literature on enablers and barriers to career planning and development for occupational therapists working in mental health. Methods: We searched Embase, CINAHL, Medline, Scopus, Web of Science, TROVE, Research Direct and websites of relevant professional organizations. Results: Twenty-six papers were included. Most of the articles were set exclusively in Australia and can be categorized into: career planning and development, workforce planning, onboarding, recruitment and retention. Resource shortages, gender, age, unmet expectations, organizational demands and the lack of a career pathway framework were identified as barriers. Enablers of career success include undergraduate mental health practice placements, early career programmes, personal motivation, greater flexibility, professional resilience, leadership training and research opportunities. Conclusion: A better understanding of the factors that influence career development can facilitate focused recruitment and help retention.

Post-Traumatic Growth in Finnish Parents After the Traumatic Death of a Child

The traumatic death of a child may cause a wide range of emotional and behavioral responses in parents. In contrast to the extensive research and literature on the negative aspects of parental bereavement, the topic of post-traumatic growth in parents has received relatively little attention. This study addressed a need for further understanding post-traumatic growth in parents following the traumatic death of a child. To recruit participants, an online advertisement was posted on the websites of Finnish bereavement organizations, their member mailing lists, and closed discussion groups. Seventeen parents were interviewed in-depth over the phone. This qualitative involved an inductive content analysis of 401 narratives of post-traumatic growth in the grief experiences of participants. The post-traumatic growth identified featured positive attitudes toward life, positive attitudes toward death, enhancing one’s spiritual life, improvements in well-being, concern about others’ needs and wanting to help, and meaningful relationships. The findings highlight the increasing complexity of topics in spirituality and social work with bereaved parents

A Multilayer, Multimethod Web and Language Accessibility Analysis of US Nonprofit Organization Websites: Considerations for the Marketing and Promotion of Online Giving

A Multilayer, Multimethod Web and Language Accessibility Analysis of US Nonprofit Organization Websites: Considerations for the Marketing and Promotion of Online Giving

Finnish parents’ perceptions of death following the traumatic death of a child

Children are expected to outlive and live longer than their parents. However, the traumatic death of a child challenges parents’ understanding of life and death. If parents are unable to form their own perceptions of death after such a loss, it can hinder their ability to cope and adjust. This study aims to explore parents’ perceptions of death following the traumatic death of a child. To recruit participants, an online advertisement was posted on the websites of Finnish bereavement organizations, their member mailing lists, and closed discussion groups. The study consisted of two phases. In the initial phase, 66 parents responded to open-ended questions via the LimeSurvey platform. Subsequently, 17 parents were interviewed in-depth over the phone. The findings were analyzed using thematic analysis. The perceptions of parents who had experienced the traumatic death of a child included death is universal, awakening or preparing for their own death, reunion in death, death and spiritual growth, and death is unjustified. These findings highlight the importance of providing support to parents following the traumatic death of a child, which can help them reconstruct perceptions of death and better adapt to their loss.

Trends in Israel's Medical Administration subspecialty, 1987–2022

BackgroundIsrael is unique in offering a formal subspecialty in Medical Administration and mandating it for physicians applying for senior roles. Data on the prevalence and characteristics of these specialists are limited.MethodsThe national registry of licensed physicians was used to identify all living physicians who completed the Medical Administration subspecialty by December 31, 2022. Data on year of medical licensing, city of residence, and list of additional recognized specialties along with their respective date of completion were extracted. Websites of key public health organizations were sampled to identify qualifications of persons in senior leadership positions.ResultsSince 1987, 277 physicians have completed the Medical Administration subspecialty, with a significant increase in annual certifications from 4.5 in 2015 (interquartile range [IQR] 4–6) to 13 (IQR 10.5–15) in 2022 (p < 0.001). Specialists completed the subspecialty a median of 18 years (IQR 13–21) post-licensing, with 269 physicians (97.1%) holding additional specialties, primarily in Internal Medicine, Pediatrics, Family Medicine, or Public Health. Compared to the general physician population, some base specialties like Public Health are over-represented while others, like Anesthesiology, are under-represented. Only 40 (14.4%) specialists reside outside major metropolitan areas. Nineteen (61.3%) general hospital CEOs, 2 (20%) psychiatric hospital CEOs, 13 (35.1%) Ministry of Health and 4 (7.8%) Sick Fund executives are specialists in Medical Administration (p < 0.005).ConclusionsThe steady growth in the number of specialists in Medical Administration demonstrates the sustainability and scalability of this model, which may serve as a template for other healthcare systems. However, the limited representation of these specialists in senior roles of some organizations, and their concentration within certain specialties and regions, indicates areas for policy attention to enhance leadership diversity and reduce healthcare disparities.

Projections of Public Spending on Pharmaceuticals: A Review of Methods.

Forecasting future public pharmaceutical expenditure is a challenge for healthcare payers, particularly owing to the unpredictability of new market introductions and their economic impact. No best-practice forecasting methods have been established so far. The literature distinguishes between the top-down approach, based on historical trends, and the bottom-up approach, using a combination of historical and horizon scanning data. The objective of this review is to describe the methods for projections of pharmaceutical expenditure that apply the "bottom-up" approach and to synthesize the knowledge of their predictive accuracy. Projections of public pharmaceutical expenditure applicable to Western economies including a comprehensive method description and published 2000-2024 were searched in scientific databases (MEDLINE, EMBASE, and EconLit) and in gray literature (websites of international health organizations and national healthcare authorities). The data sources, assumptions about the future market dynamics, analytical approaches, and the projection results are summarized. Twenty-four out of 3492 screened publications were included, associated with nine expenditure projection models. Four models were developed for all reimbursable drugs in the USA, the UK, the Stockholm region (Sweden), and seven European Union (EU) countries: France, Germany, Greece, Hungary, Poland, Portugal, and the UK, respectively. The other five models concerned specific groups of medicines: orphan drugs in Belgium, the Eurozone plus the UK, and Canada, respectively; psychotropic medications in the USA; and outpatient intravenous cancer medicines in the Province of Ontario (Canada). For trend analysis, drug coverage claims or sales data were used, applying linear and/or nonlinear models. The budget impact of new launches and patent expirations was estimated through (a form of) horizon scanning, i.e., a systematic monitoring of the pharmaceutical pipeline, with engagement of clinical expert judgment. Projections with a predictive time window greater than 3 years largely relied on previously observed trends to model new market introductions. Four models were validated through an ex post comparison of projected and observed expenditure. The absolute difference between the forecasted and actual percentual change in pharmaceutical expenditure was: 0.3% ("UK model"), 1.9% ("Stockholm model"), and 2% (nonfederal hospitals, "US model"). The "Ontario cancer drug model" overestimated the actual expenditure by 1%. Overall, the largest errors were attributable to new market launches and unforeseen policy reforms. Prediction accuracy decreased substantially for forecasts beyond 1 year in the future. For two not validated projections, a face validity check was feasible. One of the models forecasted a decrease in pharmaceutical expenditure from 2012 to 2016 in six European countries, contrasting with the currently available statistics. A 10-year projection of orphan drug expenditure underestimated the number of rare diseases treated in Europe by over 100%. Published projections of national pharmaceutical expenditure are scarce and marked by significant methodological variability. Short-term forecasts based on high-quality historical data and rigorous horizon scanning tend to be more accurate than long-term forecasts built on theoretical assumptions. The combination of mathematical algorithms and expert judgment should be further explored, to increase the accuracy and efficiency of pharmaceutical expenditure projections.

Exploring Future Pandemic Preparedness Through the Development of Preventive Vaccine Platforms and the Key Roles of International Organizations in a Global Health Crisis.

Background: The emergence of more than 40 new infectious diseases since the 1980s has emerged as a serious global health concern, many of which are zoonotic. In response, many international organizations, including the US Centers for Disease Control and Prevention (CDC), the World Health Organization (WHO), and the European Center for Disease Prevention and Control (ECDC), have developed strategies to combat these health threats. The need for rapid vaccine development has been highlighted by Coronavirus disease 2019 (COVID-19), and mRNA technology has shown promise as a platform. While the acceleration of vaccine development has been successful, concerns have been raised about the technical limits, safety, supply, and distribution of vaccines. Objective: This study analyzes the status of vaccine platform development in global pandemics and explores ways to respond to future pandemic crises through an overview of the roles of international organizations and their support programs. It examines the key roles and partnerships of international organizations such as the World Health Organization (WHO), vaccine research and development expertise of the Coalition for Epidemic Preparedness Innovations (CEPI), control of the vaccine supply chain and distribution by the Global Alliance for Vaccines and Immunization (GAVI), and technology transfer capabilities of the International Vaccine Institute (IVI) in supporting the development, production, and supply of vaccine platform technologies for pandemic priority diseases announced by WHO and CEPI and analyzes their vaccine support programs and policies to identify effective ways to rapidly respond to future pandemics caused by emerging infectious diseases. Methods: This study focused on vaccine platform technology and the key roles of international organizations in the pandemic crisis. Literature data on vaccine platform development was collected, compared, and analyzed through national and international literature data search sites, referring to articles, journals, research reports, publications, books, guidelines, clinical trial data, and related reports. In addition, the websites of international vaccine support organizations, such as WHO, CEPI, GAVI, and IVI, were used to examine vaccine support projects, initiatives, and collaborations through literature reviews and case study methods. Results: The COVID-19 pandemic brought focus on the necessity for developing innovative vaccine platforms. Despite initial concerns, the swift integration of cutting-edge development technologies, mass production capabilities, and global collaboration have made messenger RNA (mRNA) vaccines a game-changing technology. As a result of the successful application of novel vaccine platforms, it is important to address the remaining challenges, including technical limits, safety concerns, and equitable global distribution. To achieve this, it is essential to review the regulatory, policy, and support initiatives that have been implemented in response to the COVID-19 pandemic, with particular emphasis on the key stages of vaccine development, production, and distribution, to prepare for future pandemics. An analysis of the status of vaccine development for priority pandemic diseases implies the need for balanced vaccine platform development. Also, international organizations such as WHO, CEPI, GAVI, and IVI play key roles in pandemic preparedness and the development and distribution of preventive vaccines. These organizations collaborated to improve accessibility to vaccines, strengthen the global response to infectious diseases, and address global health issues. The COVID-19 pandemic response demonstrates how the synergistic collaboration of WHO's standardized guidelines, CEPI's vaccine research and development expertise, GAVI's control of the vaccine supply chain and distribution, and IVI's technology transfer capabilities can be united to create a successful process for vaccine development and distribution. Conclusions: In preparation for future pandemics, a balanced vaccine platform development is essential. It should include a balanced investment in both novel technologies such as mRNA and viral vector-based vaccines and traditional platforms. The goal is to develop vaccine platform technologies that can be applied to emerging infectious diseases efficiently and increase manufacturing and distribution capabilities for future pandemics. Moreover, international vaccine support organizations should play key roles in setting the direction of global networking and preparing for international vaccine support programs to address the limitations of previous pandemic responses. As a result, by transforming future pandemic threats from unpredictable crises to surmountable challenges, it is expected to strengthen global health systems and reduce the social and economic burden of emerging infectious diseases in the long term.

A Consistent Lack of Consistency: Definitions, Evidentiary Expectations and Potential Use of Meaningful Change Data in Clinical Outcome Assessments Across Stakeholders. Results from a DIA Working Group Literature Review and Survey.

Clinical outcome assessments (COAs) measure how patients feel or function and can be used to understand which patients experience benefits of treatment and which do not. Interpretation of COA data is influenced by how meaningful change is defined. We aimed to compare how different stakeholders define, assess, and use meaningful change for decisions that impact patients. A targeted literature review was undertaken in July 2021 using Medline, Embase, online grey literature search engines, and stakeholder organization websites. Additionally, a stakeholder survey on meaningful change was fielded between March and June 2023. Both quantitative and qualitative methods were used to analyze responses and identify key themes. The literature review resulted in 86 references. These revealed different approaches to define, measure and validate meaningful change. There were 248 survey responses. Many respondents felt the terminology and methods for defining meaningful change are confusing. Respondents also emphasized the importance of distinguishing within-patient and between-group change, and defining meaningfulness from the patient perspective (most patients and caregivers do not share a similar definition of meaningfulness as their healthcare professionals). Four key recommendations for defining, establishing, and interpreting meaningful change estimates for COAs are: (1) Be clear on the type of "meaningful change" that is discussed or needed for a COA, (2) Ensure the "patient voice" is informing meaningful change estimates/definitions, (3) Acknowledge that a meaningful change estimate for a COA may differ between populations, diseases, and disease states, and (4) Disseminate data in a way that reduces ambiguity.

Developing a Framework to Measure Health Literacy Demands of Consumer-Facing Healthcare Organization Websites

Many consumer-facing healthcare organization websites are challenging for people with low e-health literacy skills to navigate and use the information to make informed decisions. Though searchers may be familiar with how to use the Internet, navigating website designs, often referred to as eHealth literacy, can make finding health information confusing. Health literacy demands, related to eHealth literacy skills concerning the content and design, can make the difference between consumers’ frustration and success. In this study, we aimed to create a framework to measure the accessibility and usability of healthcare organization consumer-facing websites using this question, “How can the information offered, and navigation of consumer-facing healthcare organization websites be improved to increase accessibility and usability?” We scored select healthcare organizations’ consumer-facing websites including their home page and two patient education pages, using Social Cognitive Theory and Health Literacy constructs both of which promote better accessibility and usability of health information. In addition, we analyzed how the health literacy demands of these pages support or obstruct the eHealth literacy skills of consumers. Results indicated that only 50% of Social Cognitive Theory constructs and 47% of Health Literacy constructs were observed. However, by examining the missing constructs healthcare organizations can assess where to focus consumer-facing website improvement efforts. Therefore, we concluded that Social Cognitive Theory combined with Health Literacy constructs offer a viable framework for measuring and potentially improving consumer-facing healthcare websites.

Young Adults Rehabilitation experiences and Needs following Stroke (YARNS): A scoping review of the rehabilitation care experiences and outcomes of young adults post-stroke.

Stroke is one of the leading disabling conditions in the United Kingdom. While an increasing focus on the rehabilitation care for stroke survivors has been noted, practice guidelines, targets and services tend to be tailored for the elderly population rather than young adults. This scoping review aimed to map the existing literature on the rehabilitation care experiences and outcomes of young adults post-stroke aged between 18 and 45 years within acute and social care settings. A scoping review was conducted to identify existing practice and published academic and evidence-based literature related to the topic. Arksey and O'Malley's framework guided the review and reporting followed the PRISMA-ScR checklist. Electronic databases and grey literature were searched to capture the potentially recent and relevant literature available in English from year 2000-2022. The databases included CINAHL, MEDLINE, EMBASE, PsycINFO, ASSIA, AMED, PEDro, Cochrane Library and Web of Science. Grey literature was searched from the following sources: Google Scholar, websites of networks, organisations and charities related to stroke. Hand searches were performed on the reference lists of the included articles and grey literature to find relevant references. Data were extracted on young adults' experiences of stroke and rehabilitation care and their outcomes and experiences of a particular stroke rehabilitation programme in acute and social care settings. Eighty-five articles were included in this review. In most instances, stroke was reported to negatively impact young adults, although positive consequences were also documented. The focus and the outcomes of stroke rehabilitation were predominantly physical especially in the areas of movement, communication and memory. Young adults experienced a lack of age-adapted stroke rehabilitation in acute and social care settings. Our results highlight the unmet needs of young adults in their stroke recovery journey. Effective rehabilitation programmes and interventions should be developed to support young adults following stroke and meet their age-specific needs.