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Aging is an unavoidable part of life. Every human must go through the aging process. A decline in organ function is a part of the aging process that leads to various health-related challenges. These healthcare challenges may require critical care. The uniqueness of the aged population needs to be considered to provide adequate and satisfactory care befitting this subset of clients seeking critical care. Using the elder-friendly approach, improved care tailored to meet the demands of increased organ support can be achieved in the intensive care unit.
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Humans , Male , Female , Health Services Needs and Demand , Health PolicyABSTRACT
Objetivo: Analizar el proceso de implementación de una iniciativa de calidad de atención en el postaborto en tres hospitales de Santiago de Chile para su posterior escalamiento al ámbito nacional. Método: Se efectuó un estudio cualitativo, con base en una revisión documental sustentada en documentos normativos emitidos por el Ministerio de Salud y 23 entrevistas semiestructuradas a tomadores de decisiones, profesionales de salud y usuarias. Se realizó un análisis de contenido usando el programa Atlas-ti 8. Resultados: A nivel normativo, se identificaron acciones relacionadas con la implementación de la iniciativa, y a nivel de proceso se identificaron los aciertos, las dificultades y las resistencias que experimentaron los equipos involucrados en el piloto durante su implementación. A pesar de que la implementación de la iniciativa no fue planificada, tuvo efectos positivos para el bienestar de las mujeres y el desempeño de los profesionales de atención implicados en el proceso. Conclusiones: Esta experiencia es un punto de partida para planear la implementación nacional con base en estrategias bien definidas. Los resultados aportan una experiencia documentada para quienes desean desarrollar iniciativas o programas de atención a mujeres en situación de postaborto.
Objective: To analyze the implementation process of a quality post-abortion care initiative in three hospitals in Santiago de Chile for its subsequent scale up at the national level. Method: A qualitative study was carried out, based on a documentary review supported by governmental normative documents issued by the Ministry of Health and 23 semi-structured interviews with decision-makers, health providers and users. Content analysis was performed using the Atlas-ti 8 software. Results: At the regulatory level, actions related to the implementation of the initiative were identified, and at the process level, the success, difficulties and resistance experienced by the teams involved in the pilot during its implementation were identified. Although the implementation of the initiative was not planned, it had positive effects on the well-being of the women and the performance of the care providers involved in the process. Conclusions: This experience is a starting point to plan implementation at the national level with well-defined strategies. Our results provide a documented experience for those who wish to develop post-abortion care initiatives or programs.
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Humans , Female , Delivery of Health Care/legislation & jurisprudence , Chile , Evaluation Studies as Topic , Medical Device Legislation/organization & administrationABSTRACT
Chronic obstructive lung disease (COPD) is a major contributor to global disease burden with a huge socioeconomic impact. Global initiative for chronic obstructive lung disease (GOLD) strategy update 2023 is a step forward in the direction of evidence-based practice. Key topics like taxonomic classification, ABE grouping, single inhaler triple therapy, correct use of inhalers, etc. would have a positive impact on documentation and prescription practices in COPD management. The tobacco consumption habits are peculiar in India. There is a variation in prevalence estimates across diverse cultures. Non-smoking risk factors are important in Indian subcontinent especially in female and younger populations. We discuss the rationale of latest GOLD strategy update, its implications, and challenges in the management of COPD in Indian context.
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Asthma is the most common chronic respiratory disease in children, and its prevalence has shown an obvious upward trend in recent years.Adolescence is a critical stage when adolescents undergo rapid psychological and physical developmental changes.The management of asthma in adolescents is different from that in childhood and adulthood.Further attention should be paid to the diagnosis and management of asthma in adolescents.The Global Initiative for Asthma 2022 (GINA 2022) had updated the content of evaluation and treatment of severe asthma in adolescents.In this article, the contents related to the diagnosis, assessment, initial treatment and adjustment, severe asthma management and self-management of adolescent asthma in GINA 2022 were interpreted, in order to provide reference for the diagnosis and treatment of adolescent asthma and improve the management of asthma in adolescents.
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The patents of acupuncture and moxibustion in China and abroad was analyzed, aiming to provide support for the innovative development of acupuncture industry. With the China Think Tank of Patent of Traditional Chinese Medicine and the PatSnap database as data sources, based on the mathematical statistics method, the application trend, legal status, patent types, transformation and distribution of major technical fields of acupuncture patents in China and abroad were analyzed. As a result, a total of 53,422 acupuncture patents were screened, involving 49 countries and 4 organizations. The patent types were mainly utility model patents. Although the application number of acupuncture patent had increased rapidly, the average patent conversion rate was generally low, approximately 4%. In the context of global economic integration, the acupuncture industry is developing at a high speed. It is suggested to take advantage of the "Belt and Road Initiative" to improve the international acceptance of acupuncture and moxibustion, adhere to the principle of attaching equal importance to the number and quality of patents, promote the in-depth cooperation of industry-university-research, and promote high-quality development of acupuncture and moxibustion.
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Humans , Moxibustion , Acupuncture Therapy , China , Medicine, Chinese Traditional , Databases, FactualABSTRACT
Since the first medical reform, China has carried out three reforms and improvements to the medical system. However, there are still some shortcomings, the problems at different levels are mainly reflected in the doctor-patient relationship. Doctor-patient conflict has become one of the hot topics of social focus. Under the development of the country and the joint efforts of all parties, doctor-patient conflict has been alleviated to a certain extent, and the doctor-patient relationship has been developing in a better direction. With the proposal of the concept of "doctor-patient community with a shared future", the joint construction of a community between doctors and patients has become a further goal. Mencius’ theory of original goodness of human nature echoes the construction of the contemporary doctor-patient community with a shared future. It criticizes the empirical theory of human nature and emphasizes the constructive and initiative of goodness in nature, that is, to achieve goodness in nature through preservation and expansion. In the doctor-patient relationship, goodness in nature is the construction of doctor-patient community with a shared future, which requires both doctors and patients to work together with firm confidence and gradually complete the construction of the community by continuous practice.
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With the implementation of the "BRAIN initiative" in various countries, neuroethical governance has become an important concern of the international community. After ten years of development, the "BRAIN initiative" in the United States has formed a relatively complete ethical governance system. By interpreting the strategic report of the "BRAIN initiative" in the United States, analyzing its basic framework of ethical governance, dissecting its governance practice mechanism, and conducting research from the aspects of top-level design and construction, regulatory model innovation, promoting public participation, enhancing international dialogue, and improving soft and hard regulations, this paper provided some reference and thoughts for the ethical governance of the "BRAIN initiative" in China.
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Malnutrition is a common complication in patients with malignant tumors, which affects the clinical outcome of cancer patients. Accurate identification of malnutrition is the premise of nutritional intervention and treatment, but uniform diagnostic criteria for malnutrition are currently lacking. With the official release of the Global Leadership Initiative on Malnutrition (GLIM) initiated by global nutrition experts in 2018, a large cohort of studies have been carried out. In this article, the specific content and controversies of the GLIM criteria, its accuracy validation and clinical predictive value in patients with malignant tumors were mainly reviewed, aiming to provide reference for subsequent research and clinical application of malignant tumor-related malnutrition.
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Under the background of internationalization of medical education in China, the general medical education for foreign students started relatively late. At present, there are still some problems in it, such as imperfect curriculum system, lack of unified and standardized textbooks, inadequate language skills of community teachers, difficulties in carrying out practical courses, and cultural differences. Based on the current situation of general practice education for international students in China, this article proposes the following solutions: to insist on standardizing quality management and construct scientific training schemes; to understand the present situation of primary medical and health services in their country of origin, promote cultural integration, and actively explore the fit between training and demand; to write bilingual textbooks suitable for practical needs; to overcome language barriers and build a team of community teachers that speak English; to adopt flexible and diversified teaching modes and comprehensively improve the quality of general practice teaching for international students, so as to promote the communication and dissemination of basic medical and health concepts in China.
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Objective:To evaluate the effects of learning initiative on teaching effectiveness.Methods:The research subjects were the 2nd year medical students of Tongji Medical College of Huazhong University of Science and Technology. The learning initiative factor was calculated from the data of the attendance registration of the on-line learning of Physiology, and the performance of the on-line test was used as an evaluation indicator of teaching effectiveness. SPSS software was used to perform correlation analysis between the learning initiative factor and teaching effectiveness. Results:We found that learning initiative could significantly affect the teaching effectiveness, with differences among different specialties. There was a positive correlation between learning initiative and teaching effectiveness in clinical and pediatric medicine, while no correlation was observed in preventive medicine and medical imaging.Conclusion:In conclusion, learning initiative can affect teaching effectiveness, and the intensity of this effect shows difference among different specialties.
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In order to improve the students' initiative and values in knowledge seeking, this study integrates ideological and political elements into the medical physics curriculum. On the basis of the standard curriculum, 11 ideological and political elements corresponding to 6 knowledge points are added to the courseware and teaching plan and implemented in the classroom. The changes of students' ideological and moral level and values before and after teaching were statistically analyzed by questionnaire. The results show that through the integration of ideological and political elements, 98.15% (106/108) think it is necessary to integrate the ideological and political elements into the curriculum. The proportion of students who study for the purpose of working skills, national medical care and world medical care has increased, while the proportion of students who earn credits has decreased, which shows that students' learning initiative and values have been improved.
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Iron?deficiency anemia has continued to remain high in India. It is possibly due to relying on only iron–folic acid (IFA) supplementation through Anemia Control Program (ACP) that is National Iron Plus Initiative (NIPI). Based on the WHO’s recommendations, we studied different interventions that can help to increase the effectiveness of NIPI such as Vitamin C supplementation with IFA, low?dose iron (LDI) with intensified health education (IHE), LDI with Vitamin C, and iron?rich food items to increase hemoglobin (Hb%) among adolescent girls through public–private partnership named Rashtriya Kishor Swasthya Karyakram. Increments in Hb after 12 weeks of interventions were compared with that of control groups one with NIPI and the other without any intervention. Highest increment in Hb% was observed in IFA under NIPI plus Vitamin C group, followed by LDI plus IHE group which was comparable to Hb increment in only the NIPI group. It emphasizes the need of making existing NIPI more stringent and comprehensive by integrating effective measures based on up?to?date scientific knowledge.
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Objectives: Chronic obstructive pulmonary disease (COPD) being a disease with systemic consequences necessitate the use of multidimensional indices for a comprehensive assessment of the disease's impact including the future risk of exacerbations and mortality. To study the role of dyspnea, obstruction, smoking, and exacerbation (DOSE) index as a predictor of future disease severity and its correlation with chronic obstructive pulmonary disease test (CAT) score. Measurements and results: A total of 60 inpatients with COPD exacerbations were followed up for 6 months to record the number of exacerbations of COPD. The DOSE index and CAT score were calculated after stabilization within 48 hours of admission, at 1 week, and again at 6 months. The mean difference between DOSE index score at admission and at 1 week was 1.382 � 0.561 and at admission and at 6 months was 2.15 � 0.988, both being statistically significant (p < 0.001). A high DOSE index score (?4) was associated with a greater risk of 2 or more exacerbations [odds ratio (OR), 12 (3.09�.60) and risk estimate, 3.75 (1.53�17)]. For the prediction of exacerbations, the area under the curve (AUC) was larger for the DOSE index (0.854) than the global initiative for chronic obstructive lung disease (GOLD) stage (0.789), p < 0.001 for both. Furthermore, DOSE index correlated significantly with the CAT score, an established health status measure, at all stages of disease severity; at the onset of exacerbation (r = 0.719, p < 0.001), after stabilization at 1 week (r = 0.736, p < 0.001) and at 6 months (r = 0.884, p < 0.001). Conclusion: The DOSE index is a simple, practical multidimensional grading tool for assessing current symptoms, health status, and future risk in COPD and acts as a guide to disease management as its component items can be modified by interventions. Its correlation with CAT, a well-known score is a novel observation, which further corroborates the validity of the DOSE index.
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Malnutrition is closely related to clinical outcomes and accurate evaluation of nutritional status is the cornerstone of nutritional therapy. However, consistent diagnostic criteria for malnutrition have been absent for quite a long period. The Global Leadership Initiative on Malnutrition (GLIM) criteria were introduced in September 2018 and served as a consensus-based evaluation tool. As per GLIM criteria, evaluation of malnutrition should follow a two-step approach with nutritional screening as the first step and then malnutrition diagnosis assessment and severity grading based on etiologic as well as phenotypic metrics. Since debut, GLIM criteria have been applied in different countries, healthcare settings and populations, showing good accuracy and prognostic value for outcomes such as complications and survival. However, most of the studies are retrospective in nature and high-quality prospective studies are needed to better validate GLIM criteria. The way to steer nutritional interventions based on GLIM criteria is also worth future investigation.
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Objective:To construct the concept and its conceptual framework of hospital health literacy(HHL) for exploring the HHL promotion mechanism in the country.Methods:Based on the proceduralised grounded theory, twelve middle or senior managers of hospitals were selected for in-depth interviews and three hospitals were selected for field research from July 2021 to February 2022. Open coding, axial coding, and selective coding were used in data analysis, establishing the concept of HHL and its conceptual framework in China.Results:The conceptual framework of HHL was composed of an internal driver mechanism(hospitals improve their health literacy promotion management system, staff-led health literacy promotion, health literacy promoting physical environment construction), and an external driver mechanism(cooperate with external organizations and institutions to conduct health literacy promotion). The concept of HHL in China was derived as follows: the combination of supportive environments and human resources that health care organizations have in place can improve access and understandability of health information and simplify healthcare services to help patients of different health literacy levels more easily obtain, process, and understand health information as well as to make the most of medical services.Conclusions:Hospital health literacy promotion mechanism in China is a synergy between internal and external driver mechanisms.
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Objective:To investigate the cognition of Chinese adults on respiratory health in the Healthy China Initiative (2019—2030).Methods:From January 2022 to February 2022, the electronic questionnaire was distributed by using the two-dimensional code on the Wechat platform. The questionnaire involving the respiratory health part of the Healthy China Initiative (2019—2030) was conducted among people aged ≥18 years (except pregnant and postpartum women) in 32 provincial administrative regions in China. A total of 5 892 questionnaires were distributed, 4 754 valid questionnaires were recovered. Chi square test was used to analyze the basic situation of the survey subjects, the cognition of people in different regions to the content, the correlation between physical activity and age stratification, the correlation between smoking cessation and disease, and the common cognitive misunderstanding of chronic obstructive pulmonary disease.Results:Of the 4 754 subjects in this study, 3 462 were from urban area and 1 292 were from rural area. In terms of active participation in lung cancer screening, regular physical examination, no awareness of reducing risk factors exposure, isolation of pulmonary tuberculosis patients, reduction of travel of pulmonary tuberculosis patients, wearing masks when contact with pulmonary tuberculosis patients, active learning of medical and health care knowledge, and timely medical treatment in case of health problems, the cognition status of people in the city was better than people in the rural areas (all P<0.05). The compliance rates of moderate intensity physical activity and high intensity physical activity were 72.7% and 83.8%, respectively, among the population aged 18—64 years old; the compliance rates of moderate intensity physical activity and high intensity physical activity were 82.3% and 85.7%, respectively, among the population aged≥65 years old; the proportions of light intensity physical activity in people aged 18—64 and ≥65 years old were 65.2% and 87.6%, respectively. There was a correlation between whether the patients had respiratory diseases and whether they were troubled by respiratory diseases for a long time and their determination to quit smoking (all P<0.05); the rate of common misconceptions about chronic obstructive pulmonary disease among Chinese adults was between 13.0% and 38.0%, and the rate of misconceptions among people with college education or above who believed that even if the cognition of chronic obstructive pulmonary disease was improved and the diagnosis and treatment were standardized, the treatment of the disease was still ineffective was as high as 30.3%; in addition, the rate of two cognitive misunderstandings (when the symptoms of chronic obstructive pulmonary disease were mild, no intervention was needed; the medication can be discontinued when the symptoms were relieved) of people with college education or above were 24.2% and 25.8%, respectively, which were higher than those with primary school education and junior high school education (all P<0.05). Conclusions:The cognition of Chinese adults on early screening of respiratory diseases, reduction of exposure to risk factors, prevention and control of tuberculosis, and acquisition of scientific knowledge in the Healthy China Initiative (2019—2030) is generally poor. The participation of people <65 years old in high-intensity physical activities is insufficient, and the cognition of people with high education level does not show advantages.
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Resumen Introducción. Las organizaciones de América Latina, han aumentado notablemente la divulgación de información sobre Responsabilidad Social Empresarial (RSE). Objetivo. Responder a la pregunta: ¿Cuál ha sido la evolución en la divulgación de la RSE en América Latina? Materiales y métodos. La divulgación voluntaria de memorias bajo las directrices de la Global Reporting Initiative (GRI) durante el período 2006-2015, es el marco a través del cual se presenta una visión sobre el avance alcanzado en la divulgación de información sobre RSE en América Latina. El análisis de los datos se realiza mediante una metodología descriptiva, las tendencias se identifican en el informe, se compara la propiedad, el tamaño y los sectores productivos. Resultados. Durante el período de estudio, se presenta un crecimiento promedio en la divulgación de memorias del 35 % anual y se percibe una concentración en los sectores financiero, energético y alimentario. Conclusiones. El incremento mostrado en la divulgación de memorias de sostenibilidad, confirma que las organizaciones responden a la incorporación de la RSE como parte de las políticas de gestión, las grandes empresas y los tres sectores señalados participan en mayor número. Pese a ello, la adopción del estándar GRI como modelo de reporte es heterogénea entre los diferentes países, lo cual sugiere la existencia de diferencias en el desarrollo de la responsabilidad social de las organizaciones.
Abstract Introduction. Organizations in Latin America have notably increased the dissemination of information on Corporate Social Responsibility (CSR). Objectives. Answer the question: What has been the evolution in the dissemination of CSR in Latin America? Materials and methods. The voluntary disclosure of reports under the guidelines of the Global Reporting Initiative (GRI) during the period 2006-2015, is the framework through which a vision is presented on the progress achieved in the disclosure of information on CSR in Latin America. Data analysis is carried out using a descriptive methodology, trends are identified in the report, ownership, size and productive sectors are compared. Results. During the study period, there is an average growth in the disclosure of reports of 35% per year and a concentration is perceived in the financial, energy and food sectors. Conclusion. The increase shown in the dissemination of sustainability reports confirms that organizations respond to the incorporation of CSR as part of management policies, large companies and the three sectors mentioned participate in greater numbers. Despite this, the adoption of the GRI standard as a reporting model is heterogeneous among the different countries, which suggests the existence of differences in the development of the social responsibility of organizations.
Resumo Introdução. As organizações da América Latina aumentaram notavelmente a divulgação de informações sobre Responsabilidade Social Corporativa (RSC). Objetivos. Responda a pergunta: ¿Qual tem sido a evolução da disseminação da RSE na América Latina? Materiais e métodos. A divulgação voluntária de relatórios, segundo as diretrizes da Global Reporting Initiative (GRI), durante o período 2006-2015, é o arcabouço por meio do qual se apresenta uma visão sobre os avanços alcançados na divulgação de informações sobre RSE na América Latina. A análise dos dados é realizada por meio de uma metodologia descritiva, as tendências são identificadas no relatório, a propriedade, o porte e os setores produtivos são comparados. Resultados. No período do estudo, verifica-se um crescimento médio na divulgação de relatórios de 35% ao ano e percebe-se uma concentração nos setores financeiro, de energia e de alimentação. Conclusões. O aumento verificado na divulgação de relatórios de sustentabilidade confirma que as organizações respondem à incorporação da RSE como parte das políticas de gestão, as grandes empresas e os três setores mencionados participam em maior número. Apesar disso, a adoção do padrão GRI como modelo de relato é heterogênea entre os diferentes países, o que sugere a existência de diferenças no desenvolvimento da responsabilidade social das organizações.
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@#Virginia Henderson defined that the primary role of nurses for individuals, whether sick or well, is to assist them in regaining their health and promoting their independence in activities of daily living (Halloran, 2018). The gap that is noted in the definition of Henderson’s role of nurses is the lack of direction as to how will a nurse render care that is unique and satisfying to an individual, knowing that the demand of expectation rises. Thus, it motivated this paper to study the concept of the dynamic care nurse. This concept paper utilized Walker and Avant (2005) method of analysis. The attributes associated with the dynamic care nurse are (1) continuous learning; and (2) the utilization of best practices. The antecedents identified include (1) initiative, and (2) compassion (ICN, 2012, Hemberg et al., 2020, Kroning, et al., 2019). Dynamic care nurse exemplifies the attributes of continuous learning and the utilization of best practices. Nurses can bridge the gaps in the practice through these attributes and by possessing initiative and compassion, it is not by afar to achieve a better health care service and positive health outcomes.
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Practice Guidelines as Topic , Education, Continuing , Nursing Care , EmpathyABSTRACT
Health literacy serves as the foundation of health for all. Hence the authors introduced the connotation and extension of health literate health care organization(HLHO) and related concepts. On such basis, the paper presented the construction method of HLHO from the perspective of health policy, healthcare organizations and inter-institutional cooperation, in order to improve the health literacy of the Chinese people and implement the Healthy China initiative(2019—2030).
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Objective:To understand the practice of humanistic care and social worker voluntary service in public hospitals in China.Methods:From January to March 2021, 38 typical cases concerning " medical social worker and volunteer system" and " building a harmonious doctor-patient relationship through humanistic service" were collected by relying on the evaluation of China Healthcare Improvement Initiative. By means of statistics on the frequency of the subject words in the cases, hotspots of these hospitals in " paying attention to medical humanistic care and promoting social work voluntary service" were identified.Results:By classifying the keywords of the 38 cases, the hotspots mainly focused on strengthening the construction and management of social work volunteer platform and team, providing convenient and high-quality services, integrating humanistic care into diagnosis and treatment services, and building characteristic brand projects.Conclusions:The concept of humanistic care should be integrated into the hospital culture construction, the standardized and institutionalized development of humanistic care and volunteer work in the hospital should be promoted. Supporting measures should be introduced to promote the professional and stable development of talent team, and the routine service system should be established based on the needs assessment of both doctors and patients.