Healthcare challenges

医疗保健挑战
  • 文章类型: Journal Article
    背景:被忽视的热带病(NTDs),包括土壤传播的蠕虫(STHs)和血吸虫病,继续施加沉重的负担,特别是在撒哈拉以南非洲和乌干达,尽管是可以预防的。将NTD管理整合到初级卫生保健中一直不够。虽然研究人员探索了社区观点,在理解医护人员(HCW)的观点方面存在显著差距,这对于有效的NTD控制策略至关重要。本研究探讨了乌干达东部的HCW观点,强调血吸虫病和性传播疾病预防和管理方面的挑战。
    方法:在这项定性的描述性研究中,我们对乌干达东部HCW的10名关键线人进行了半结构化访谈,这些线人具有管理STH和血吸虫病的经验.参与者是有目的地选择的,并在全面的采访指南的指导下通过Zoom进行了采访。数据被转录了,按主题编码和分析。
    结果:我们确定了有关NTD的影响和管理的五个关键主题:(i)NTD的负担,血吸虫病和STHs在靠近水体的儿童和社区中尤为普遍;(ii)NTDs的传播,强调水体和恶劣的卫生条件是疾病传播的主要途径;(iii)NTDs的临床表现,详述使诊断和管理复杂化的症状表现;(Iv)管理和诊断NTDs的挑战,强调基本药物和诊断工具的短缺,随着医疗保健系统中NTD的优先次序被低估;(v)由NTD引起的死亡和并发症,报告严重结局和因误诊导致的与NTDs相关的死亡报告不足,延迟治疗和传统的治疗偏好。
    结论:接受采访的乌干达HCW对血吸虫病和STHs有足够的了解,但由于诊断工具不足和药物短缺而面临挑战。该研究强调需要在直接资助和政府参与的情况下确定NTD优先次序,除了整合持续医疗培训的策略,有效的社区外展和增强的医疗系统反应,以减轻NTD的负担。
    BACKGROUND: Neglected tropical diseases (NTDs), including soil-transmitted helminths (STHs) and schistosomiasis, continue to impose a heavy burden, especially in sub-Saharan Africa and Uganda, despite being preventable. Integration of NTD management into primary healthcare has been inadequate. While researchers have explored community perspectives, there is a notable gap in understanding the viewpoints of healthcare workers (HCW), which is crucial for effective NTD control strategies. This study explores HCW\' perspectives in Eastern Uganda, highlighting challenges in schistosomiasis and STH prevention and management.
    METHODS: In this qualitative descriptive study, we conducted semistructured interviews with 10 key informants who were HCW in Eastern Uganda with experience in managing STHs and schistosomiasis. Participants were selected purposively and interviewed through Zoom guided by a comprehensive interview guide. The data were transcribed, coded and analyzed thematically.
    RESULTS: We identified five key themes regarding the impact and management of NTDs: (i) the burden of NTDs, where schistosomiasis and STHs were notably prevalent among children and communities adjacent to water bodies; (ii) transmission of NTDs, emphasizing water bodies and poor sanitation as primary routes of disease spread; (iii) clinical manifestations of NTDs, detailing the symptomatic presentations that complicate diagnosis and management; (iv) challenges in managing and diagnosing NTDs, highlighting the shortages of essential medications and diagnostic tools, along with the under-prioritization of NTDs within healthcare systems; and (v) fatalities and complications arising from NTDs, reporting on the severe outcomes and under-reporting of deaths associated with NTDs due to misdiagnosis, delayed treatment and traditional healing preferences.
    CONCLUSIONS: The interviewed Ugandan HCW demonstrated sufficient knowledge of schistosomiasis and STHs, but faced challenges due to inadequate diagnostic tools and medication shortages. The study underscores the need for NTD prioritization with direct funding and government involvement, alongside strategies that integrate continuous medical training, effective community outreach and an enhanced healthcare system response to reduce the burden of NTDs.
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  • 文章类型: Journal Article
    这篇透视论文探讨了区块链和人工智能(AI)在转变医疗保健方面的协同潜力。它首先概述了区块链在医疗保健数据管理中的作用,安全,药品供应链,临床试验,和健康保险。然后讨论转向人工智能对医疗保健的影响,其次是对集成AI-区块链平台及其好处的审查。技术挑战,局限性,与这些技术相关的解决方案正在审查中。该文件涉及法规遵从和道德考虑,并提出了未来的实施方向。它最后提出了研究和实施指南,提供利用区块链和人工智能来增强医疗保健成果的路线图。
    This perspective paper explores the synergistic potential of blockchain and artificial intelligence (AI) in transforming healthcare. It begins with an overview of blockchain\'s role in healthcare data management, security, the pharmaceutical supply chain, clinical trials, and health insurance. The discussion then shifts to the impact of AI on healthcare, followed by an examination of integrated AI-blockchain platforms and their benefits. Technical challenges, limitations, and solutions related to these technologies are scrutinized. The paper addresses regulatory compliance and ethical considerations, and proposes future directions for their implementation. It concludes with research and implementation guidelines, offering a roadmap for harnessing blockchain and AI to enhance healthcare outcomes.
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  • 文章类型: Journal Article
    背景:抚养患有脑积水的孩子可能非常具有挑战性,特别是在低收入和中等收入国家。在巴基斯坦,作为脑积水儿童的主要照顾者的母亲承受着巨大的压力。
    方法:本研究探讨了巴基斯坦母亲抚养脑积水儿童所面临的挑战,通过焦点小组讨论采用定性方法,包括巴基斯坦三级保健医院的10名脑积水婴儿母亲。
    结果:研究结果突出了三个主要主题:情感损失,社会孤立,和财务压力。由于社会上的耻辱和缺乏支持,母亲经历了巨大的情绪压力,特别是他们的丈夫和家人。社会孤立是普遍存在的,因为母亲害怕分担自己的负担,并因孩子的需要而面临身体上的禁闭。资金紧张是另一个主要问题,高昂的医疗费用增加了他们的经济困难。
    结论:该研究强调改善获得专门护理的机会,提高认识运动,以减少污名,财政援助,和更强大的社区支持网络来更好地支持这些母亲。解决这些未满足的需求对于增强巴基斯坦母亲的护理能力和改善脑积水儿童的生活质量至关重要。
    BACKGROUND: Raising a child with hydrocephalus can be very challenging, especially in low- and middle-income countries. In Pakistan, mothers being the primary caregivers for their hydrocephalic children are under tremendous stress.
    METHODS: This study explores the challenges faced by Pakistani mothers raising children with hydrocephalus, employing a qualitative methodology through focus group discussions comprising ten mothers of hydrocephalic babies at Tertiary Care Hospital in Pakistan.
    RESULTS: The findings highlight three main themes: emotional toll, social isolation, and financial strain. Mothers experience significant emotional stress due to societal stigma and a lack of support, particularly from their husbands and family. Social isolation is prevalent, as mothers fear sharing their burdens and face physical confinement due to their children\'s needs. Financial strain is another major issue, with high medical costs adding to their economic difficulties.
    CONCLUSIONS: The study emphasizes improved access to specialized care, awareness campaigns to reduce stigma, financial assistance, and stronger community support networks to support these mothers better. Addressing these unmet needs is crucial for empowering Pakistani mothers in their caregiving roles and improving the quality of life for their children with hydrocephalus.
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  • 文章类型: Journal Article
    这篇全面的综述探讨了镰状细胞性贫血(SCA)患者医院感染的复杂动态,并倡导采取协作策略来加强预防。SCA患者,以免疫力受损和对感染的易感性为标志,面临独特的挑战,需要量身定制的预防措施。审查强调了疫苗接种的重要性,抗生素预防,教育,和环境卫生,以降低医院感染的风险。解决社会经济因素,医疗保健系统的局限性,患者相关问题,文化考虑对于有效预防至关重要。行动呼吁强调医疗保健专业人员的关键作用,政策制定者,研究人员,和社区参与实施有针对性的干预措施。通过促进集体努力,这篇综述展望了SCA患者感染预防的改善前景,提高他们的整体健康结果和生活质量。
    This comprehensive review explores the complex dynamics of nosocomial infections in individuals with sickle cell anemia (SCA) and advocates for a collaborative strategy to enhance prevention. SCA patients, marked by compromised immunity and susceptibility to infections, face unique challenges that necessitate tailored preventive measures. The review underscores the importance of vaccination, antibiotic prophylaxis, education, and environmental hygiene in mitigating the risk of nosocomial infections. Addressing socioeconomic factors, healthcare system limitations, patient-related issues, and cultural considerations is imperative for effective prevention. The call to action emphasizes the pivotal roles of healthcare professionals, policymakers, researchers, and community engagement in implementing targeted interventions. By fostering a collective effort, this review envisions an improved landscape for infection prevention in SCA patients, enhancing their overall health outcomes and quality of life.
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  • 文章类型: Journal Article
    医学教育必须为未来的专业人员提供必要的技能,以应对复杂的医疗保健环境。临床知识至关重要,批判性和创造性的思维能力对于应对系统的挑战至关重要。设计思维提供了一种整合创造力和创新的结构化方法,然而,它在医学教育中的应用是缺乏的。
    莱顿大学医学中心的必修MasterMinds挑战课程利用设计思维原则来应对现实世界的医疗保健挑战。最后一年的医学生参加了为期两天的课程。课程包括同情利益相关者,问题定义,idea,原型设计,和精炼解决方案。强调演示技巧,最终在一个研讨会上,团队展示他们的成果。MasterMinds挑战课程的实施取得了成功,向1217名医学生进行了33次课程。挑战涵盖了各种医疗保健主题,产生创造性但实用的结果。学生欣赏现实世界的医疗保健挑战,基于团队的方法,以及设计思维原则的适用性。挑战业主对学生的承诺表示满意,创造力,和移情能力。
    为了进一步增强MasterMinds挑战课程,正在设计一种更纵向的格式,实现更大的自主权,并强调完善和实施阶段。该课程可以扩展到医学研究生专业人员和跨学科合作,培养超越当前实践的创新思想。通过发展解决问题的能力,MasterMinds挑战课程有助于未来的医学教育计划,并为学生满足不断变化的医疗保健需求做好准备。
    Medical education must equip future professionals with the necessary skills to navigate the complex healthcare landscape. Clinical knowledge is essential, and critical and creative thinking skills are vital to meet the challenges of the system. Design thinking offers a structured approach that integrates creativity and innovation, yet its application in medical education is absent.
    The compulsory MasterMinds Challenge course at Leiden University Medical Center utilizes design thinking principles to address real world healthcare challenges. Final-year medical students participated in a two-day program. The course encompassed empathizing with stakeholders, problem definition, ideation, prototyping, and refining solutions. Presentation skills were emphasized, culminating in a symposium where teams showcase their outcomes. Implementation of the MasterMinds Challenge course was successful with 33 sessions delivered to 1217 medical students. Challenges covered various healthcare topics, yielding creative yet practical outcomes. Students appreciate the real world healthcare challenge, team-based approach, and the applicability of design thinking principles. Challenge owners expressed satisfaction with students\' commitment, creativity, and empathizing abilities.
    To further enhance the MasterMinds Challenge course, a more longitudinal format is being designed, enabling greater autonomy and emphasizing the refining and implementation phases. The course can be extended to medical postgraduate professionals and interdisciplinary collaborations, fostering innovative ideas beyond current practices. By developing problem-solving skills, the MasterMinds Challenge course contributes to a future-proof medical education program and prepares students to meet the evolving needs of healthcare.
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  • 文章类型: Letter
    暂无摘要。
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  • 文章类型: Journal Article
    饮食失调和糖尿病是截然不同但又密切相关的健康状况,在护理和管理方面提出了不同的挑战。进食障碍包括一系列以异常进食行为和体重调节中断为特征的精神健康障碍。研究表明,糖尿病患者患饮食失调的风险可能会增加。必须遵守特定的饮食指南,警惕地监测血糖水平,和管理药物管理可以共同导致对食物和身体形象的有害态度的出现。另一方面,暴饮暴食和净化等不正确的饮食行为会破坏血糖控制,显着影响糖尿病的发展和管理。这种复杂的关系强调了全面理解和专业护理的关键必要性,以有效地解决处理糖尿病和饮食失调的个人所面临的双重挑战。本文代表了对饮食失调与糖尿病之间错综复杂的联系的首次全面审查,从而照亮了以前研究不足的领域。从这篇综述中收集到的见解可能有助于开发综合干预措施,旨在改善与饮食失调和糖尿病的复杂性作斗争的个体的整体福祉和生活质量。
    Eating disorders and diabetes mellitus are distinct yet closely linked health conditions, presenting distinct challenges in terms of care and management. Eating disorders encompass a spectrum of mental health disorders characterized by abnormal eating behaviors and disruptions in weight regulation. Research indicates that individuals with diabetes might be at an elevated risk of developing eating disorders. The necessity to adhere to specific dietary guidelines, monitor blood sugar levels vigilantly, and manage drug administration can collectively contribute to the emergence of detrimental attitudes toward food and body image. On the other hand, incorrect eating behaviors such as binge eating and purging can disrupt blood sugar control, significantly impacting the development and management of diabetes. This intricate relationship emphasizes the crucial necessity for a comprehensive understanding and specialized care to effectively address the dual challenges faced by individuals dealing with both diabetes and eating disorders. This paper represents the inaugural comprehensive review delving into the intricate connection between eating disorders and diabetes, thereby illuminating previously under-researched areas. The insights gleaned from this review may contribute to developing integrated interventions that aim to improve the overall well-being and quality of life for individuals grappling with the complexities of eating disorders and diabetes.
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  • 文章类型: Journal Article
    全球医疗保健领域充满了质量,成本,股本,创新挑战。尽管如此,成功的医疗干预措施从意想不到的地方出现。在印度,根除某些传染病,扩大获得初级保健的机会,以及远程医疗等创新方法的实施已经证明了以社区为中心的护理的潜力。在美国(US),医疗保健质量的提高,可访问性,以及医疗技术的利用,比如远程医疗和人工智能的合并,强调了医疗保健服务中技术创新的机会。这篇手稿回顾了印度和美国医疗保健系统的历史和发展,突出每个系统的优势,弱点,吸取的教训,和改进的机会。通过检查这两个系统,我们努力推广一种纳入每个国家经验教训的医疗保健模式,以改善以社区为中心的护理,并最终为所有人提供公平的机会。
    The global healthcare landscape is fraught with quality, cost, equity, and innovation challenges. Despite this, successful healthcare interventions have emerged from unexpected locations. In India, the eradication of certain communicable diseases, the expansion of access to primary care, and the implementation of innovative methods such as telemedicine have demonstrated the potential for community-centered care. In the United States (US), improvements in healthcare quality, accessibility, and the utilization of medical technology, such as the incorporation of telehealth and artificial intelligence, have highlighted opportunities for technological innovation in healthcare delivery. This manuscript reviews the history and development of healthcare systems in India and the US, highlighting each system\'s strengths, weaknesses, lessons learned, and opportunities for improvement. By examining both systems, we strive to promote a healthcare model that incorporates lessons from each country to improve community-centered care and ultimately provide equitable access to all.
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  • 文章类型: Journal Article
    COVID-19大流行期间的一个主要挑战是医疗设施的可及性有限,尤其是老年人口。本研究的目的是探索医疗系统在多大程度上满足阿德里安/爱奥尼亚地区有或没有认知障碍的老年人及其护理人员的医疗需求。数据是通过关于医疗保健系统充分性的电子问卷收集的,并匿名管理给以下国家的老年人和利益相关者提供者:斯洛文尼亚,意大利(卡拉布里亚),克罗地亚,波斯尼亚和黑塞哥维那,希腊,黑山,塞尔维亚。总的来说,722名老年人和267名医疗保健利益相关者参与了这项研究。在COVID-19大流行期间,医疗保健利益相关者和老年人都声称,所有国家的老年人及其护理人员的医疗保健需求都急剧增加,尤其是在意大利(卡拉布里亚),克罗地亚和波黑。根据我们的结果,在COVID-19大流行期间,阿德里安/爱奥尼亚地区的国家面临着适应老年人特殊需求的重大挑战,这可能是由于医疗设施的可及性机会有限。这些结果突出表明,在无法进行当面护理时,需要开发提供医疗援助和监督的替代方法。
    One major challenge during the COVID-19 pandemic was the limited accessibility to healthcare facilities, especially for the older population. The aim of the current study was the exploration of the extent to which the healthcare systems responded to the healthcare needs of the older people with or without cognitive impairment and their caregivers in the Adrion/Ionian region. Data were collected through e-questionnaires regarding the adequacy of the healthcare system and were anonymously administered to older individuals and stakeholder providers in the following countries: Slovenia, Italy (Calabria), Croatia, Bosnia and Herzegovina, Greece, Montenegro, and Serbia. Overall, 722 older people and 267 healthcare stakeholders participated in the study. During the COVID-19 pandemic, both healthcare stakeholders and the older population claimed that the healthcare needs of the older people and their caregivers increased dramatically in all countries, especially in Italy (Calabria), Croatia and BiH. According to our results, countries from the Adrion/Ionian regions faced significant challenges to adjust to the special needs of the older people during the COVID-19 pandemic, which was possibly due to limited accessibility opportunities to healthcare facilities. These results highlight the need for the development of alternative ways of providing medical assistance and supervision when in-person care is not possible.
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  • 文章类型: Journal Article
    目的:了解子宫肌瘤(肌瘤)患者在连续护理过程中的医疗保健经验,从早期症状到诊断,治疗,和管理,同时还调查健康差异。
    方法:我们对肌瘤患者进行了20次半结构化访谈。访谈被逐字转录,并使用主题分析进行定性分析。符合条件的参与者是18岁及以上的女性,居住在印第安纳州两个招聘地点(Tippecanoe或Marion县)之一的75英里内,美国。
    结果:女性经历了无数的身体症状,这往往表现为心理和性障碍,渗透到日常生活的各个方面。互联网搜索经常被称为其主要信息来源。生育成为决定治疗方案的一个重要因素。然而,健康差异阻止了一些人接受高质量的肌瘤医疗保健。一些妇女报告说,在COVID-19大流行期间呆在家里有助于治疗身体症状。总的来说,参与者提倡更大的子宫肌瘤意识和教育。
    结论:结果强调了肌瘤相关决定的障碍和促进因素,行为,和结果。将研究转化为实践是以综合的社会生态模型和健康框架的社会决定因素为指导的,以制定战略干预措施。
    结论:干预措施应旨在改善肌瘤的医疗服务,教育和意识,和少数族裔的患者提供者沟通,农村,和低社会经济地位的社区不成比例地受到肌瘤的影响。
    To understand healthcare experiences among patients with uterine fibroids (fibroids) across the continuum of care, from early symptoms through diagnosis, treatment, and management, while also investigating health disparities.
    We conducted 20 semi-structured interviews with patients with fibroids. Interviews were transcribed verbatim and qualitatively analyzed using thematic analysis. Eligible participants were women aged 18 and over, residing within 75 miles of one of the two recruitment locations (Tippecanoe or Marion County) in Indiana, USA.
    Women experienced myriad physical symptoms, which often manifested into psychological and sexual disturbances and infiltrated all aspects of daily life. Internet searches were frequently mentioned as their main information source. Fertility became a prominent factor in deciding treatment options. However, health disparities prevented some from receiving quality fibroids healthcare. Some women reported staying home during COVID-19 pandemic facilitated the management of physical symptoms. Overall, participants advocated for greater fibroids awareness and education.
    Results highlight barriers and facilitators to fibroids-related decisions, behaviors, and outcomes. Translation of research to practice was guided by a combined Social-Ecological Model and social determinants of health framework for development of strategic interventions.
    Interventions should aim to improve fibroids healthcare access, education and awareness, and patient-provider communication for minority, rural, and low socioeconomic status communities disproportionately impacted by fibroids.
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