The Quintuple Aim seeks to improve healthcare by addressing social determinants of health (SDOHs), which are responsible for 70-80% of medical outcomes. SDOH-related concerns have traditionally been addressed through referrals to social workers and community-based organizations (CBOs), but these pathways have had limited success in connecting patients with resources. Given that health inequity is expected to cost the United States nearly USD 300 billion by 2050, new artificial intelligence (AI) technology may aid providers in addressing SDOH. In this commentary, we present our experience with using ChatGPT to obtain SDOH management recommendations for archetypal patients in Philadelphia, PA. ChatGPT identified relevant SDOH resources and provided contact information for local organizations. Future exploration could improve AI prompts and integrate AI into electronic medical records to provide healthcare providers with real-time SDOH recommendations during appointments.

With the public heightened emphasis on mitigating the occurrence risks of health-related ailment and optimizing personal physical performance, portable chemical sensing devices emerged as an indispensable component of pervasive health monitoring. Chemical sensing enabled the immediate and on-site identification of biomarkers in biological fluids by integrating colorimetry, fluorescence, electrochemical, and other methods into portable sensor devices. These sensor devices incorporated microneedles, hydrogels, microfluidic modules, and papers, facilitating conformal human-device contact and providing several visual sensing options for disease prevention and healthcare management. This review systematically overviewed recent advancements in chemical sensors for marker detection, categorizing them based on monitoring device types. Furthermore, we also offered recommendations and opportunities for developing portable chemical sensing devices by summarizing sensor integration methods and tracking sites on the human body.

Demands, resources, and work engagement of lower and middle level nurse managers: a cross-sectional study Abstract. Background: Given their responsibilities, lower- and middle-level nurse managers hold a key role in the health care system. Their performance and health are affected by their work engagement, which according to the Job-Demands-Resources-Model depends on job-related demands and resources. To date, there is a lack of studies on the demands, resources, and work engagement of nurse managers in Germany. Objective: First, the study aimed to describe the job demands and resources as well as the work engagement of lower and mid-level nurse managers in hospitals and geriatric care facilities in Germany. Second, the aim was to explore potential differences in these areas between different groups, particularly regarding gender, age, and management level. Methods: The study used a cross-sectional design. Data were collected by an online survey. N = 408 cases could be evaluated. Results: Work overload is the most prominent demand, followed by emotional demands. In terms of resources, nurse managers can primarily draw on positive social relationships. The available professional resources are rated critically. Work engagement is moderate. Conclusions: The study indicates a clear need for action regarding an improvement in work engagement. In particular, work overload and professional resources need to be addressed by appropriate systemwide and organization-related measures.
Zusammenfassung. Hintergrund: Pflegemanager_innen im unteren und mittleren Management kommt eine zentrale Rolle im Gesundheitswesen zu. Für ihre Leistungsfähigkeit und Gesundheit ist insbesondere ihr Arbeitsengagement bedeutsam, das gemäß Job-Demands-Resources-Modell von arbeitsbezogenen Anforderungen und Ressourcen abhängt. Bisher mangelt es an Untersuchungen zu Anforderungen, Ressourcen und Arbeitsengagement von Pflegemanager_innen in Deutschland. Ziel: Ziel war es, die Arbeitsanforderungen und -ressourcen sowie das Arbeitsengagement von Pflegemanager_innen der unteren und mittleren Führungsebene in Krankenhäusern und Altenpflegeeinrichtungen in Deutschland zu beschreiben. Zudem sollten mögliche Unterschiede in diesen Bereichen zwischen verschiedenen Gruppen, insbesondere im Hinblick auf Geschlecht, Alter und Führungsebene, exploriert werden. Methoden: Die Studie wurde im Querschnittdesign durchgeführt. Die Daten wurden per Online-Fragebogen erhoben. Es konnten N = 408 Fälle ausgewertet werden. Ergebnisse: Arbeitsüberlastung ist die am stärksten ausgeprägte Anforderung, gefolgt von emotionalen Anforderungen. Ressourcenseitig können Pflegemanager_innen vor allem auf positive soziale Beziehungen zurückgreifen. Kritisch werden vor allem die verfügbaren professionellen Ressourcen bewertet. Das Arbeitsengagement ist moderat. Schlussfolgerungen: Die Studie zeigt klaren Handlungsbedarf bezüglich einer Verbesserung des Arbeitsengagements. Insbesondere Arbeitsüberlastung und professionelle Ressourcen sind durch geeignete systemweite und organisationsbezogene Maßnahmen zu adressieren.

OBJECTIVE: Norway, like other welfare states, seeks to leverage data to transform its pressured public healthcare system. While managers will be central to doing so, we lack knowledge about how specifically they would do so and what constraints and expectations they operate under. Public sources, like the Norwegian policy documents investigated here, provide important backdrops against which such managerial work emerges. This article therefore aims to analyze how key Norwegian policy documents construe data use in health management.
METHODS: We analyzed five notable policy documents using a \"practice-oriented\" framework, considering these as arenas for \"organizing visions\" (OVs) about managerial use of data in healthcare organizations. This framework considers documents as not just texts that comment on a topic but as discursive tools that formulate, negotiate and shape issues of national importance, such as expectations about data use in health management.
RESULTS: The OVs we identify anticipate a bold future for health management, where data use is supported through interconnected information systems that provide relevant information on demand. These OVs are similar to discourse on \"evidence-based management,\" but differ in important ways. Managers are consistently framed as key stakeholders that can benefit from using secondary data, but this requires better data integration across the health system. Despite forward-looking OVs, we find considerable ambiguity regarding the practical, social and epistemic dimensions of data use in health management. Our analysis calls for a reframing, by moving away from the hype of \"data-driven\" health management toward an empirically-oriented, \"data-centric\" approach that recognizes the situated and relational nature of managerial work on secondary data.
CONCLUSIONS: By exploring OVs in the Norwegian health policy landscape, this study adds to our growing understanding of expectations towards healthcare managers\' use of data. Given Norway\'s highly digitized health system, our analysis has relevance for health services in other countries.

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The Polish healthcare system faces many problems, among which the shortage of healthcare professionals is one of the most urgent. In less than ten years, more than twenty Higher Education Institutions (HEIs) have been allowed to add medical programmes to their offer, aiming to increase the number of doctors in Poland. Recently, the healthcare system was faced with a proposal to abolish the mandatory postgraduate internship which has been a mandatory component of medical training for years. Two main reforms were considered. The first one focused on the programme of the internship and aimed to update it. The second one recommended an abolition of the internship. The authors of this article analysed the opinions and positions of key players within the system regarding the postgraduate internship. Opinions in this regard are diverse, leading to the conclusion that additional actions would be required prior to the internship abolition. Undergraduate training has changed and currently students are taught in modern facilities, using new teaching methods. On the other hand, internship allows trainees to improve or even acquire skills they may not have obtained during their studies. The postgraduate internship is an essential part of doctors\' training. However, in Poland, there is still a lack of a well-thought, long-term policy or strategy for physicians\' workforce development. Our study presents a Polish perspective on common challenges in medical training and workforce policy, highlighting the clash over the growing demand for physicians and the limitations of the existing system.

OBJECTIVE: As the population ages, vascular surgeons are treating progressively older, multimorbid patients at risk of peri-operative complications. An embedded physician has been shown to improve outcomes in general and orthopaedic surgery. This systematic review and meta-analysis aimed to investigate the impact of surgeon-physician co-management models on morbidity and mortality in vascular inpatients.
METHODS: PubMed, Scopus, Embase, conference abstract listings, and clinical trial registries.
METHODS: Studies comparing adult vascular surgery inpatients under co-management with \"standard of care\" were eligible. The relative risks (RRs) of mortality, medical complications, and 30 day re-admission between co-management and standard care were calculated. The effect of co-management on the mean length of stay was calculated using weighted means. Risk of bias was assessed using the Methodological Index for Non-Randomised Studies, and certainty assessment with the GRADE analysis tools.
RESULTS: No randomised trials were identified. Eight single institution studies between 2011 and 2020 with 7 410 patients were included. All studies were observational using before-after methodology. Studies were of high to moderate risk of bias, and outcomes were of very low GRADE certainty of evidence. Co-management was associated with a statistically significantly lower relative risk of mortality (RR 0.64, 95% confidence interval [CI] 0.44 - 0.92; p = .02), cardiac complications (RR 0.47, 95% CI 0.25 - 0.87; p = .02), and infective complications (RR 0.49, 95% CI 0.35 - 0.67; p < .001) in vascular inpatients. No statistically significant differences in length of stay (MD -0.6 days, 95% CI -1.44 - 0.24 days; p = .16) and 30 day re-admission (RR 0.96, 95% CI 0.84 - 1.08; p = .49) were noted.
CONCLUSIONS: Early results of physician and surgeon co-management for vascular surgery inpatients showed promising results from very low certainty data. Further well designed, prospective studies are needed to determine how to maximise the impact of physicians within a vascular service to improve patient outcomes while effectively using hospital resources.

Oral health is situated within the framework of the global health agenda, addressing facets pertaining to well-being and quality of life. The research is based on the need to address variables at the community level to improve schoolchildren\'s oral health and promote healthy behaviors and aims to carry out an in-depth analysis from the perspective of the factors that influence children\'s oral health. Step 1, designed by the World Health Organization, was utilized. An easy-to-use web interface was created for data collection. The statistical analysis consisted of using multinomial and binominal logistic regression models. The level of education of the adult has a high probability of influencing the consumption of unhealthy or healthy foods, it has a significant probability of exerting influence on social or medical problems and a correlation was found between the level of academic education and the pattern of dental visits. The development of health-promoting behaviors begins in childhood and involves parents, who have an essential role in the education of their children. Oral health promotion programs in schools need to target the child-adult-teacher-dentist relationships. Taking into consideration the aforementioned, a threefold viewpoint is necessary for the development of a national program aimed at promoting the oral health of schoolchildren in Romania.

This scoping review addresses the transformation and development of new healthcare systems in nine countries -Armenia, Azerbaijan, Belarus, Kazakhstan, Kyrgyzstan, Russia, Tajikistan, Turkmenistan, and Uzbekistan over the period following the collapse of the Soviet Union from 1991 to the present. This assessment focuses on maternal and child health, mental health, communicable diseases, and non-communicable diseases in an effort to highlight the changes in the healthcare status of these nine countries under scrutiny. Considering that all the post-Soviet nations are officially recognized members of the World Health Organization (WHO) and have demonstrated their commitment to attaining the WHO\'s objectives, the evaluation of healthcare system progress and improvement was carried out utilizing indicators provided by the WHO. This review reveals that the evolution of healthcare systems could be considered sustainable, given that average life expectancy has returned to the level it was in 1991- the year of the USSR\'s breakup, and people\'s health has improved since the turn of the twenty-first century. To enhance the potential success of future healthcare reforms, however, governments must monitor implementation of the reform process, evaluate the achievement of objectives, and make necessary adjustments. The success of future healthcare changes will depend on the active involvement of the government, medical community, and patient community, as well as obtaining the support of local health authorities. This study may help identify successful and failed strategies, guiding future healthcare changes and investments.

UNASSIGNED: The purpose of this article is to investigate the relationship between the structural empowerment of first-line health managers and health facility performance, examining the mediating roles of resilience and social climate in shaping the ratings of Slovak hospitals. Additionally, we aim to investigate the deeper mechanisms of this relationship, particularly the impact of resilience and the social climate, which can positively influence it.
UNASSIGNED: The data collection was conducted through a questionnaire survey in February 2022. Respondents included 540 healthcare managers at the first level of management from 44 Slovak hospitals, all of which were part of the evaluation by the Institute for Economic and Social Reforms (INEKO). The analysis involved the use of the PLS-SEM method to examine the relationships between variables and assess direct and indirect effects, utilizing SmartPLS 3.3 software.
UNASSIGNED: The findings reveal a positive association between the structural empowerment of first-level managers and the ranking of health facilities. The hypotheses regarding the mediation of both variables - First-Level Managers\' (FLMs) resilience and social climate - are supported, whether considered separately or jointly. In the case of joint mediation, a significant portion of the indirect effect is conveyed through FLMs\' resilience, suggesting a potential avenue of support from hospital management to enhance health facility ratings.
UNASSIGNED: Structural empowerment of first-line managers establishes the conditions for improving the ratings of health facilities. The total effect is significantly more pronounced in promoting their resilience and fostering a supportive social climate.