Reshaping Health Care Research Articles

Perspectives on Artificial Intelligence in Nursing in Asia.

Artificial intelligence (AI) is reshaping health care, including nursing, across Asia, presenting opportunities to improve patient care and outcomes. This viewpoint presents our perspective and interpretation of the current AI landscape, acknowledging its evolution driven by enhanced processing capabilities, extensive data sets, and refined algorithms. Notable applications in countries such as Singapore, South Korea, Japan, and China showcase the integration of AI-powered technologies such as chatbots, virtual assistants, data mining, and automated risk assessment systems. This paper further explores the transformative impact of AI on nursing education, emphasizing personalized learning, adaptive approaches, and AI-enriched simulation tools, and discusses the opportunities and challenges of these developments. We argue for the harmonious coexistence of traditional nursing values with AI innovations, marking a significant stride toward a promising health care future in Asia.

The impact of anthropogenic climate change on pediatric viral diseases.

The adverse effects of climate change on human health are unfolding in real time. Environmental fragmentation is amplifying spillover of viruses from wildlife to humans. Increasing temperatures are expanding mosquito and tick habitats, introducing vector-borne viruses into immunologically susceptible populations. More frequent flooding is spreading water-borne viral pathogens, while prolonged droughts reduce regional capacity to prevent and respond to disease outbreaks with adequate water, sanitation, and hygiene resources. Worsening air quality and altered transmission seasons due to an increasingly volatile climate may exacerbate the impacts of respiratory viruses. Furthermore, both extreme weather events and long-term climate variation are causing the destruction of health systems and large-scale migrations, reshaping health care delivery in the face of an evolving global burden of viral disease. Because of their immunological immaturity, differences in physiology (e.g., size), dependence on caregivers, and behavioral traits, children are particularly vulnerable to climate change. This investigation into the unique pediatric viral threats posed by an increasingly inhospitable world elucidates potential avenues of targeted programming and uncovers future research questions to effect equitable, actionable change. IMPACT: A review of the effects of climate change on viral threats to pediatric health, including zoonotic, vector-borne, water-borne, and respiratory viruses, as well as distal threats related to climate-induced migration and health systems. A unique focus on viruses offers a more in-depth look at the effect of climate change on vector competence, viral particle survival, co-morbidities, and host behavior. An examination of children as a particularly vulnerable population provokes programming tailored to their unique set of vulnerabilities and encourages reflection on equitable climate adaptation frameworks.

Separation of Maternal and Newborn Care in US Hospitals: A Systemic Threat to Survival, Health and Well-Being

ABSTRACT Through greater understanding of past social, cultural, economic, political, scientific and technological forces which shaped our current health systems to separate mothers and newborn infants, we can begin to devise effective approaches to reshape these systems to meet the needs of mothers and newborn infants today. Medical science and technology have evolved vastly in the last century; however, effects of historical factors persist in our current health care systems, reflected in separate maternal and neonatal care in different departments with distinct guidelines, providers, and treatment locations. This separation prevents maternal-infant skin-to-skin contact and bonding, which significantly affects infant development, well-being, and that of their caregivers. We explore historical precedents for the separation of maternal-newborn care, including the transition from midwifery home care to hospital obstetric care, reasons for the increase in hospital births and hospital nursery development, and the effects of world wars, federal acts, health insurance, rooming-in practices, and the development of medical advances such as antibiotics, on hospital infrastructure. This information is evaluated in the context of modern scientific advancements to show that the conditions which shaped health systems to separate mothers and newborns in the past no longer hold. The insights gained will help to identify strategic actions to reshape health care systems to enable more integrated maternal-newborn care and the practice of Kangaroo Mother Care, and to improve survival outcomes and well-being for mothers, families, and their newborn infants.

A new leadership frontier: Nurse practitioners and physician associates as inpatient medical directors.

Nurse practitioners and physician associates (NPs and PAs) have become an integral part of health care delivery in every clinical setting. Both NPs and PAs possess the knowledge and skills to deliver quality care to patients that may otherwise go without. There is a push to have NPs and PAs work to the top of their licenses and take on leadership roles as they help reshape health care delivery in the United States. However, high-level leadership positions for this group of clinicians are not abundant, and no specific pathway has been established to develop these skills. The aim of this report is to share the early experience of a small group of NPs and PAs, given the opportunity to function as inpatient medical directors (IMD) and the qualities that make them ideal for this novel leadership role.

The Effects of Obesity on Health Care Delivery

The rates of obesity continue to rise among adults and children in the United States; hence, it is natural that obesity is reshaping health care delivery. This is seen in numerous ways, including physiologic, physical, social, and economic impacts. This article reviews a broad range of topics, from the effects of increased adiposity on drug pharmacokinetics and pharmacodynamics to the changes health care environments are making to accommodate patients with obesity. The significant social impacts of weight bias are reviewed, as are the economic consequences of the obesity epidemic. Finally, a patient case that demonstrates the effects of obesity on health care delivery is examined.

The Efficiency of Internet Base Healthcare System in Gastroenterological diseases: An Updated Systematic Review

Digital health systems such as tablet devices, smartphones, and online websites, are swiftly transforming the practice of medical science and reshaping health care approaches. A PRISMA guidelines-based systematic review was conducted using research databases (PubMed, Google Scholar, and Web of Science) to identify the applications and fill the literature gap in Gastroenterological disorders. A total of 212 articles were searched, excluding duplicate records, sixty nine articles were founded out of which only fifteen were selected using specific inclusion and exclusion criteria. Risk of a bias assessment tool called ROBVIS 2 is used to examine the risk of predisposition and precision of all the fifteen studies included. Most of the patients in these trials were females, educated, and have inflammatory bowel diseases. These clinical studies concentrated on Ulcerative colitis (n=5), Crohn's disease (n=4), and inflammatory bowel disease (n=6) with feedback of mostly 3 months (n=5) and 6 months (n=5). The internet-based intervention varied from study to study but the outcomes in each study were clear that either this system was efficient or not. Based on the searched literature and selected studies it was concluded that online health technologies can effectively cope with Gastroenterological disorders and patients with digestive disorders have shown good acceptability and pleasure in all the selected studies. Keywords: eHealth technologies, Digestive disorders, Ulcerative colitis, Crohn’s disease, Review

Integrating Health and Care in China: Lessons Learned and Future Outlook.

Background:An aging population is one of the key drivers reshaping health care systems. In China, the complex needs of its huge aging population require integration across the health and care sectors.Policies and progress:Over the past decade, the central government of China promulgated a series of policies to promote the establishment of aftercare facilities, specify approaches to integrate health and care service delivery at institutional and community levels, pilot long-term care insurance (LTCI) as a funding mechanism, and reform administrative structures in favor of integration. Progress has been made towards organizational and clinical integration of service delivery both at institutional and community levels. LTCI has been introduced as the financing mechanism covering long term care services.Discussions and Conclusions:The experiences of China in the integration of health and care could be summarized as a top-down approach in policy formulation and implementation, the significant employment of pilots and demonstrations, and the activation of market forces. However, China is still in the initial stage of integrating health and care and is faced with system-level challenges in its financing, management, and workforce, and faces technical challenges, such as a lack of tools, and standards. In the future, these issues need to be addressed.

Community-Based Collaborations in Knowledge Generation: Reshaping Health Care in Partnership With People Living With Type 1 Diabetes and Diabetes Clinicians

Knowledge generation through community-based research collaboration is an important part of achieving meaningful research impact. The aim of this study is to develop methods for understanding the lived experiences of people living with type 1 diabetes (T1D) to inform quality improvement in diabetes health care.

Telemedicine in the Western Cape Department of Health during the first peak of the COVID-19 pandemic: Leveraging data to save lives by activating a telemedicine response.

The pandemic caused by coronavirus disease 2019 (COVID-19) has put health systems across the globe under strain. There has been much suffering and loss, but a silver lining is emerging – a growing list of deeply contextualised, resource-light and patient-centric innovations that are showing the promise of reshaping health care delivery as we know it. Some of these innovations were lying latent in the system, waiting for the ‘dots to be joined’. The Western Cape was the first province in South Africa to experience a COVID-19 wave from May 2020 to July 2020, with 60–70 deaths being reported daily. To bend the mortality curve during this crisis was not easy but was made possible using a rudimentary telehealth system. This project represents an exemplar of innovation, built out of necessity to save lives and may well become a staple component of the health service in a post-crisis era.

Reshaping health care governance using pilot projects as public policy implementation instruments

Pilot projects are often used to test innovations; however, pilot projects, viewed as tools, are rarely addressed as an object for research. This paper, in which pilot projects are viewed as public policy instruments producing specific effects, addresses the research question: how does the use of multidisciplinary pilot projects as experimentation and implementation instruments reshape modes of public governance in the Belgian health sector in a context of transition and ongoing devolution? An ethnographic study was conducted, focusing on the specific case of the Belgian joint plan, “Integrated Care for Better Health”, which targets chronic patients and was intended to initiate a major transition from a fragmented to an integrated care system for chronic patients. The analysis concerns the specific implementation modalities designed by the authorities, which consisted of the launch of pilot projects involving professionals in the field coming from different sectors in an iterative and incremental co-creation process. This choice caused new vertical interdependences to emerge between the levels of the health care system, transforming the roles of both the authorities and hands-on professionals involved; it also denoted a transition towards a more negotiated governance, in the course of which several types of knowledge and evidence have been mobilised.

COVID-19: A Greek Perspective.

Greece has managed to timely and properly implement a public health safety plan and contained the burden of the coronavirus disease (COVID‐19) pandemic. On the contrary, COVID‐19 has led to a national catastrophe in countries with superior infrastructures, such as Italy, Spain, France, and the United States. At a time when our nation's healthcare resources were insufficient to meet this unprecedented demand, it was necessary to prioritize needs in the hopes of maximizing lives saved. Although delaying definitive treatment of disorders presented a risk to specific individuals, countless others afforded life‐saving resources necessary to overcome the most threatening manifestation of this illness. The cataclysm of COVID‐19 offered an opportunity to reshape health care in ways that may not have seemed possible just a few months ago. To help scientists and clinicians across disciplines connect their strengths, so that together we can advance the state of the art in medicine and lead the way to a new era of computational medicine.

Business Management, Organizational Behaviour, Quality and Safety in the Integrative Medicine Healthcare Model

Integrative medicine (IM) has the potential to reshape health care delivery in a more patient-centered direction. Those programs must prove themselves from financial and clinical operational perspectives in order to achieve this potential. The active clinical infrastructure of expertise in alternative therapies and well-done organizational behaviors (OB) are critical success factors. As with any health care project, there are no substitutes for clinical excellence or sound management. Implementation of integrative oncology programs should be based on the best evidence and should be continually under evaluation to ensure quality, optimization of techniques, collection of new data, and cost-effectiveness. Symptom control, adherence to treatment protocols, quality of life, individual outcomes, prevention, rehabilitation, potential advantages of a whole-systems health approach, and economics of health services are important clues in this field. .Applications and implications for the millennium addressed in this article.

Smart, Remote, and Targeted Health Care Facilitation Through Connected Health: Qualitative Study.

BackgroundSocieties around the world are aging. Widespread aging creates problems for social services and health care practices. In this light, research on connected health (CH) is becoming essential. CH refers to a variety of technological measures that allow health care to be provided remotely with the aim of increasing efficiency, cost-effectiveness, and satisfaction on the part of health care recipients. CH is reshaping health care’s direction to be more proactive, more preventive, and more precisely targeted and, thus, more effective. CH has been demonstrated to have great value in managing and preventing chronic diseases, which create huge burdens on health care and social services. In short, CH provides promising solutions to diseases and social challenges associated with aging populations. However, there are many barriers that need to be overcome before CH can be successfully and widely implemented.ObjectiveThe research question of this study is as follows: How can CH facilitate smart, remote, and targeted health care? The objective is to identify how health care can be managed in more comprehensive ways, such as by providing timely, flexible, accessible, and personalized services to preserve continuity and offer high-quality seamless health care.MethodsA qualitative approach was used based on 60 multistage, semistructured stakeholder interviews.ResultsThe results can be divided into two functions of CH: ecosystem and platform. On the one hand, the interviews enabled the authors to develop a stakeholder classification and interaction diagram. These stakeholders interacted sequentially to provide technology-based content to end users. On the other hand, interviewees reflected on how CH serves as a platform to address remote monitoring and patient self-management. In the Discussion section, three innovation strategies are discussed to reflect the manner in which CH promotes smart, timely, and precise health care.ConclusionsThis study indicates that it is essential to continually revise CH business models, given the ongoing and rapid changes in technology across groups of CH stakeholders. We also found that global trends toward smart, timely, and precise health care shape what individuals expect from products and services, providing firms with unique opportunities for growth.

Targeting cancer cells with nanotherapeutics and nanodiagnostics: Current status and future perspectives.

Nanotechnology is reshaping health care strategies and is expected to exert a tremendous impact in the coming years offering better healthcare facilities. It has led to not only therapeutic drug delivery feasibility but also to diagnostics. Materials in the size of nano range (1-100 nm) used in the design, fabrication, regulation, and application of therapeutic drugs or devices are classified as medical nanotechnology and nanopharmacology. Delivery of more complex molecules to the specific site of action as well as gene therapy has pushed forward the nanoparticle-based drug delivery to its maximum. Areas that benefit from nano-based drug delivery systems are cancer, diabetes, infectious diseases, neurodegenerative diseases, blood disorders and orthopedic-related ailments. Moreover, development of nanotherapeutics with multi-functionalities has a considerable potential to fill the gaps that exist in the present therapeutic domain. In cancer treatment, nanomedicines have superiority over current therapeutic practices as they can effectively deliver the drug to the affected tissues, thus reducing drug toxicities. Along this line, polymeric conjugates of asparaginase and polymeric micelles of paclitaxel have recently been recommended for the treatment of various types of cancers. Nanotechnology-based therapeutics and diagnostics provide greater effectiveness with less or no toxicity concerns. Similarly, diagnostic imaging holds promising future applications with newer nano-level imaging elements. Advancements in nanotechnology have emerged to a newer direction which use nanorobotics for various applications in healthcare. Accordingly, this review comprehensively highlights the potentialities of various nanocarriers and nanomedicines for multifaceted applications in diagnostics and drug delivery, especially the potentialities of polymeric nanoparticle, nanoemulsion, solid-lipid nanoparticle, nanostructured lipid carrier, self-micellizing anticancer lipids, dendrimer, nanocapsule and nanosponge-based therapeutic approaches in the field of cancer. Furthermore, this article summarizes the most recent literature pertaining to the use of nano-technology in the field of medicine, particularly in treating cancer patients.

The value transformation of health care: Impact on neuromuscular and electrodiagnostic medicine.

Beginning in 2017, most physicians who participate in Medicare are subject to the Medicare Access and CHIP Reauthorization Act (MACRA), the milestone legislation that signals the US health care system's transition from volume-based to value-based care. Here we review emerging trends in development of value-based healthcare systems in the US. MACRA and the resulting Quality Payment Program create 2 participation pathways, the Merit-based Incentive Payment System (MIPS) and the Advanced Alternative Payment Model (AAPM) pathway. Although there are several program incentives for AAPM participation, to date there have been few AAPM options for specialists. MIPS and its widening bonus and penalty window will likely be the primary participation pathway in the early years of the program. Value-based payment has the potential to reshape health care delivery in the United States, with implications for neuromuscular and electrodiagnostic (EDX) specialists. Meaningful quality measures are required for neuromuscular and EDX specialists. Muscle Nerve 56: 679-683, 2017.

Expanding Medicaid, Expanding the Electorate: The Affordable Care Act's Short-Term Impact on Political Participation.

The Affordable Care Act is a landmark piece of social legislation with the potential to reshape health care in the United States. Its potential to reshape politics is also considerable, but existing scholarship suggests conflicting expectations about the law's policy feedbacks, especially given uneven state-level implementation. In this article I focus on the policy feedbacks of the law's Medicaid expansion on political participation, using district-level elections data for 2012 and 2014 US House races and cross-sectional survey data from 2014. I find that the increases in Medicaid enrollment associated with the expansion are related to considerably higher voter turnout and that this effect was likely due to both an increase in turnout for new beneficiaries and a backlash effect among conservative voters opposed to the law and its implementation. These results have important implications for our understanding of the ACA and of the impact of welfare state expansions on political participation, particularly in federalized systems.

Barriers to tuberculosis care delivery among miners and their families in South Africa: an ethnographic study.

South African miners suffer the highest tuberculosis (TB) rates in the world. Current efforts to stem the epidemic are insufficient. Historical legacies and persistent disease burden demand innovative approaches to reshape health care delivery to better serve this population. To characterize social and behavioral health determinants for successful TB care delivery and treatment from the perspective of miners/ex-miners, health care workers and policy makers/managers. We conducted applied ethnography with 30 miners/ex-miners, 13 family/community members, 14 health care providers, and 47 local policy makers/managers in South Africa. Miners/ex-miners felt health care delivery systems failed to meet their needs. Many had experienced unnecessary physical and psychological harm due to limited health education about TB, minimal engagement in their own care, lack of trust in providers, and a system that did not value their experience. Stigma and fear associated with TB result in denial of symptoms and delays in care seeking. Health care providers and policy makers/managers felt discouraged by system constraints in providing optimal care. Our findings describe long-term effects of perpetual TB misinformation and stigma resulting from fear and disempowerment among miners and their families/communities. To reduce the TB burden, there is an urgent need to co-design a care delivery system with miners to better meet their needs.

Peculiarity of Pharmaceutical Marketing in Serbia.

OPINION article Front. Public Health, 25 June 2015Sec. Epidemiology Volume 3 - 2015 | https://doi.org/10.3389/fpubh.2015.00150

Novel methods and technologies for 21st-century clinical trials: a review.

New technologies are rapidly reshaping health care. However, their effect on drug development to date generally has been limited. To evaluate disease modeling and simulation, alternative study design, novel objective measures, virtual research visits, and enhanced participant engagement and to examine their potential effects as methods and tools on clinical trials. We conducted a systematic search of relevant terms on PubMed (disease modeling and clinical trials; adaptive design, clinical trials, and neurology; Internet, clinical trials, and neurology; and telemedicine, clinical trials, and neurology), references of previous publications, and our files. The search encompassed articles published from January 1, 2000, through November 30, 2014, and produced 7976 articles, of which 22 were determined to be relevant and are included in this review. Few of these new methods and technologies have been applied to neurology clinical trials. Clinical outcomes, including cognitive and stroke outcomes, increasingly are captured remotely. Other therapeutic areas have successfully implemented many of these tools and technologies, including web-enabled clinical trials. Increased use of new tools and approaches in future clinical trials can enhance the design, improve the assessment, and engage participants in the evaluation of novel therapies for neurologic disorders.

Medical versus fiscal gatekeeping: navigating professional contingencies at the pharmacy counter.

This paper theorizes that care provision depends on the set of "contingencies," or organizational and institutional structures, rules, narratives, and routines, surrounding professional work. Drawing on 95 interviews with U.S. pharmacists, I demonstrate how pharmacists prioritize specific contingencies and reveal how ethical decision-making depends on both organizational positioning and locus in inter-professional hierarchies.