BACKGROUND: Shifting demographics, an aging population, and increased healthcare needs contribute to the global healthcare worker shortage. Migrant Health Care Workers (MHCWs) are crucial contributors to reducing this shortage by moving from low-and middle-income countries (LMICs) to high-income countries (HICs) for better opportunities. Economic factors and health workforce demand drive their migration, but they also face challenges adapting to a new country and new working environments. To effectively address these challenges, it is crucial to establish evidence-based policies. Failure to do so may result in the departure of Migrant Healthcare Workers (MHCWs) from host countries, thereby worsening the shortage of healthcare workers.
OBJECTIVE: To review and synthesize the barriers experienced by MHCWs as they adjust to a new country and their new foreign working environments.
METHODS: We followed the PRISMA guidelines and conducted a search in the PubMed and Embase databases. We included cross-sectional studies published after the year 2000, addressing MHCWs from LMIC countries migrating to high-income countries, and published in English. We established a data extraction tool and used the Appraisal tool for Cross-Sectional Studies (AXIS) to assess article quality based on predetermined categories.
RESULTS: Through a targeted search, we identified fourteen articles. These articles covered 11,025 MHCWS from low- to medium-income countries, focusing on Europe, the USA, Canada, Australia, New Zealand, and Israel. Participants and respondents\' rates were diverse ranging from 12% to 90%. Studies encompassed various healthcare roles and age ranges, mainly 25-45 years, with a significant female presence. Participants resided in host countries for 3-10 years on average. Results are categorized based on the Riverside Acculturation Stress Inventory (RASI) and expanded to include bureaucratic and employment barriers, Gender differences, Natives vs. non-natives, and orientation programs.
CONCLUSIONS: The findings emphasize the importance of cultural competence training and tailored support for MHCWs integration and job satisfaction. Time spent in the new healthcare setting and the influence of orientation programs are key factors in shaping their intentions to stay or leave. Despite limitations, these studies provide valuable insights, emphasizing the ongoing need for holistic strategies to facilitate successful integration, ultimately benefiting healthcare systems and well-being for all stakeholders.

BACKGROUND: Spatial transcriptomics (ST) is advancing our understanding of complex tissues and organisms. However, building a robust clustering algorithm to define spatially coherent regions in a single tissue slice and aligning or integrating multiple tissue slices originating from diverse sources for essential downstream analyses remains challenging. Numerous clustering, alignment, and integration methods have been specifically designed for ST data by leveraging its spatial information. The absence of comprehensive benchmark studies complicates the selection of methods and future method development.
RESULTS: In this study, we systematically benchmark a variety of state-of-the-art algorithms with a wide range of real and simulated datasets of varying sizes, technologies, species, and complexity. We analyze the strengths and weaknesses of each method using diverse quantitative and qualitative metrics and analyses, including eight metrics for spatial clustering accuracy and contiguity, uniform manifold approximation and projection visualization, layer-wise and spot-to-spot alignment accuracy, and 3D reconstruction, which are designed to assess method performance as well as data quality. The code used for evaluation is available on our GitHub. Additionally, we provide online notebook tutorials and documentation to facilitate the reproduction of all benchmarking results and to support the study of new methods and new datasets.
CONCLUSIONS: Our analyses lead to comprehensive recommendations that cover multiple aspects, helping users to select optimal tools for their specific needs and guide future method development.

UNASSIGNED: Virtual care appointments expanded rapidly during COVID-19 out of necessity and to enable access and continuity of care for many patients. While previous work has explored health care providers\' experiences with telehealth usage on small-scale projects, the broad-level adoption of virtual care during the pandemic has expounded opportunities for a better understanding of how to enhance the integration of telehealth as a regular mode of health care services delivery. Training and education for health care providers on the effective use of virtual care technologies are factors that can help facilitate improved adoption and use. We describe our approach to designing and developing an accredited continuing professional development (CPD) program using e-learning technologies to foster better knowledge and comfort among health care providers with the use of virtual care technologies. First, we discuss our approach to undertaking a systematic needs assessment study using a survey questionnaire of providers, key informant interviews, and a patient focus group. Next, we describe our steps in consulting with key stakeholder groups in the health system and arranging committees to inform the design of the program and address accreditation requirements. The instructional design features and aspects of the e-learning module are then described in depth, and our plan for evaluating the program is shared as well. As a CPD modality, e-learning offers the opportunity to enhance access to timely continuing professional education for health care providers who may be geographically dispersed across rural and remote communities.

Case conceptualization is central to the success of the therapeutic process. However, integrative case conceptualization research has lagged behind research on integrating therapeutic intervention techniques. A successful case conceptualization provides (a) a dynamic, context-sensitive, yet parsimonious model of the client\'s functioning; (b) relevant treatment targets and associated assessment procedures; and (c) a treatment plan including intervention phases and potential obstacles. Success in case conceptualization is a core clinical competency goal for trainees in clinical psychology and a career-long learning goal even for expert clinicians. Emerging technological trends and the formation of adversarial collaborative teams may assist research on the utility of well-constructed case conceptualizations.

This study explores integrating blockchain technology into the Internet of Medical Things (IoMT) to address security and privacy challenges. Blockchain\'s transparency, confidentiality, and decentralization offer significant potential benefits in the healthcare domain. The research examines various blockchain components, layers, and protocols, highlighting their role in IoMT. It also explores IoMT applications, security challenges, and methods for integrating blockchain to enhance security. Blockchain integration can be vital in securing and managing this data while preserving patient privacy. It also opens up new possibilities in healthcare, medical research, and data management. The results provide a practical approach to handling a large amount of data from IoMT devices. This strategy makes effective use of data resource fragmentation and encryption techniques. It is essential to have well-defined standards and norms, especially in the healthcare sector, where upholding safety and protecting the confidentiality of information are critical. These results illustrate that it is essential to follow standards like HIPAA, and blockchain technology can help ensure these criteria are met. Furthermore, the study explores the potential benefits of blockchain technology for enhancing inter-system communication in the healthcare industry while maintaining patient privacy protection. The results highlight the effectiveness of blockchain\'s consistency and cryptographic techniques in combining identity management and healthcare data protection, protecting patient privacy and data integrity. Blockchain is an unchangeable distributed ledger system. In short, the paper provides important insights into how blockchain technology may transform the healthcare industry by effectively addressing significant challenges and generating legal, safe, and interoperable solutions. Researchers, doctors, and graduate students are the audience for our paper.

UNASSIGNED: Brucellosis of the central nervous system (CNS) is rare and frequently fatal, often being overlooked or misdiagnosed.
UNASSIGNED: In April 2023, the Jinan CDC identified a case of CNS brucellosis in a 54-year-old woman through cerebrospinal fluid (CSF) culture. Upon confirming the diagnosis of brucellosis, the Jinan CDC immediately informed Qilu Hospital of Shandong University, to which the patient had been transferred, and she was subsequently tracked and successfully treated.
UNASSIGNED: The successful outcome can be attributed to the effective integration of a system that facilitated coordinated and collaborative actions between public health services and clinical institutions.

This study explored the potential of telemedicine integration into the eye health ecosystem with an aim of scaling effective refractive error coverage in Kenya. This exploratory study was conducted telephonically and through online interviews with key opinion leaders, ophthalmologists, optometrists, ophthalmic clinical officers, optical technicians and beneficiaries of the optical technician\'s services in rural areas. A telemedicine workflow was developed and validated based on the comments from the key opinion leaders using the Delphi technique. Quantitative and qualitative data were analysed using SPSS and NVivo Software respectively. All of the key opinion leaders agreed that telemedicine is relevant in the eye health ecosystem and recognition of primary vision technicians is critical for effective telemedicine integration. The reasons for the need of telemedicine integration were categorized into; good relationship, organized refractive error service delivery, convenience and availability and cost reduction. The possible factors influencing integration of telemedicine identified were categorized into cost, unwillingness, dominance, perception, lack of technical team, policies and network coverage. The limited human resources in the eye health ecosystem in developing countries cannot effectively deliver refractive error services to the growing population. Hence, integration of telemedicine and establishment of policies recognizing telemedicine are desirable to strengthen task shifting and scale effective refractive error coverage.

BACKGROUND:  Collaboration between traditional health practitioners (THPs) and biomedical health practitioners (BHPs) is highly recommended in catering for pluralistic healthcare users. Little is known about bidirectional collaborations at healthcare service provision level.
OBJECTIVE:  To map global evidence on collaboration attempts between THPs and BHPs between January 1978 and August 2023.
METHODS:  We followed the Arksey and O\'Malley framework in conducting this scoping review. Two reviewers independently screened articles for eligibility. A descriptive numerical and content analysis was performed on ATLAS.ti 22. A narrative summary of the findings was reported using the PRISMAScR guideline.
RESULTS:  Of the 8404 screened studies, 10 studies from 12 articles were included in the final review. Studies came from America (n = 5), Africa (n = 2), China (n = 2) and New Zealand (n = 1). Eight studies reported case studies of bidirectional collaboration programmes, while two studies reported on experimental research. All collaborations occurred within biomedical healthcare facilities. Collaboration often entailed activities such as relationship building, training of all practitioners, coordinated meetings, cross-referrals, treatment plan discussions and joint health promotion activities.
CONCLUSIONS:  This study confirmed that practitioner-level collaborations within healthcare are few and sparse. More work is needed to move policy on integration of the two systems into implementation. There is a need to conduct more research and document emerging collaborations.Contribution: This research illuminates the contextual challenges associated with sustaining collaborations. The data would be important in informing areas that need strengthening in the work towards integration of THPs and BHPs.

BACKGROUND: Type 2 Diabetes mellitus (T2DM) and periodontitis share common risk factors and influence one another. However, primary care and oral health care continue to operate separate from each other and fail to synchronize care for patients with T2DM and periodontitis. The purpose of this practice-based trial is to evaluate the implementation of a new integrated care pathway for patients with T2DM and periodontitis. The new approach integrates a screening for T2DM risk in dental care settings in patients with periodontitis, a screening for periodontitis risk in primary care settings in patients with T2DM, and mutual referrals between dentists and primary care physicians.
METHODS: Two practice-based studies will be carried out in parallel: (i) In dental care settings: a practice-based, multi-centric, cluster-randomized, controlled trial with a control and an intervention group; (ii) in primary care settings: a practice-based, multi-centric, non-randomized, controlled trial with a synthetic control group calculated from claims data. Following a two-step recruitment approach, 166 dentists and 248 general practitioners will be recruited, who themselves will recruit a total of 3808 patients in their practices. Patient data will be collected at baseline, 12 months, and 24 months after study enrollment. The evaluation comprises: (i) impact evaluation, using a hierarchical linear mixed model; (ii) process evaluation, based on surveys alongside the trials; (iii) economic evaluation. In addition, a Discrete-Choice-Experiment will identify provider\'s payment preferences for the new care approach.
CONCLUSIONS: Upon successful implementation, the intervention will enable health care providers to detect a risk for T2DM and periodontitis in patients at an early stage, thus providing patients an opportunity for timely diagnosis and therapy. Ultimately, this can lead to increased quality of life and reduced health care expenditures. On a methodologic level, the project provides novel insights into a complex intervention on the intersection of general practice and dental care.
BACKGROUND: The study was prospectively registered at the German Clinical Trials Register ( https://drks.de/search/de/trial/DRKS00030587 ) on 3. July 2023 under ID \"DRKS00030587\".

Indonesia is experiencing an increase in the elderly population, which is a challenge for health services. One of the health programs specifically designed for older people is the integration health program, known as \"Posbindu\". Posbindu is a community-based health service that provides health promotion, disease prevention, and early detection services for the elderly. However, its utilization has not been maximized, so a study was conducted to analyze the factors related to the utilization of Posbindu in Indonesia. The research design used a scoping review and data analysis narrative approach. The researcher searched articles using the PCC framework, with the elderly as the population (including pre-elderly), the factors as concept, and the context as utilization of Posbindu. It used Indonesian and English keywords in the Google Scholar, Pubmed, ProQuest, and Researchgate databases. Then, the article selection process used the PRISMA-ScR flow chart, and 201 articles were obtained that matched the inclusion criteria, 192 articles, and the final result was nine articles were analyzed. The results of the article analysis showed that the average value of older people\'s participation in Posbindu was 47.51%, which means it did not reach the target. Factors related to this are predisposition factors found in eight articles (intentions, knowledge, attitudes, education, traditions, beliefs, and control over actions), enabling factors in five articles (distance to Posbindu, access to information, and quality of Posbindu for older people), and reinforcing factors in seven articles (family support and health voluntary support). From all p-values for these factors, the most strongly related to Posbindu for the elderly was reinforcing elements, with a p-value of less than 0.03 in all analyzed articles. So, it can be concluded that the reinforcing factor is the most related to the utilization of the elderly Posbindu. So, it is crucial to involve all sector to increase the participation of older people in Posbindu program.