Debate as an Active Learning Pedagogy Among Pharmacy Students in a Public Health Course.

OBJECTIVE: To evaluate the impact of a debate activity on pharmacy students' knowledge of public health and health policy topics. METHODS: Forty-six second-year pharmacy students in a required public health and health policy course debated universal healthcare coverage for Americans using the Lincoln-Douglas oral debate format. Demographic data, including age and gender, were collected. Knowledge (before/after) of universal healthcare principles was assessed via a rubric-embedded quiz related to the activity objectives. The students' perceptions of the educational value of the debate were assessed before and after the debate using a 12-item Likert scale (1 = strongly disagree through 5 = strongly agree) and open-ended questions. Descriptive statistics and thematic analysis were conducted using SPSS v25 and Atlas.ti version 9, respectively. Wilcoxon t tests were conducted to compare preknowledge and postknowledge scores. An α level of 0.05 was utilized. RESULTS: Forty-two students completed the perceptions survey, yielding a 96 % response rate. The mean age was 24 ± 4 years and primarily female (63 %). Most students had no previous experience with debates (80.4 %) and there was a statistically significant improvement in knowledge after the debate from 66.5 % ± 13.4 % to 80.7 % ± 12 % , for a total increase of 14.2 %. Open responses indicated that students believed their overall knowledge about other healthcare systems increased and they developed literature review and communications skills. CONCLUSION: The debate activity enhanced the students' knowledge and assessment of controversial public health issues that will be useful during their pharmacy education and careers. The students perceived that the debates enriched their learning.

Is the EU steering national social and health policy making? A case-study on Finland's national reform.

As part of the European Semester, Finland received country-specific recommendations (CSRs) in 2013-2020 that encouraged the reform of national social and health services. These recommendations were part of efforts to balance public finances and implement public-sector structural reforms. Finland has been struggling to reform the national social and health care system since 2005. Only on 1 January 2023 did the new wellbeing services counties become liable for organizing social, health, and rescue services. Studying the CSRs for Finland enables us to understand better what genuinely occurs at the EU member state level. This data-driven case study aims to disclose the relevance of the European Semester for Finland in the pursuit of a national social and health system reform. The mixed-method approach is based on the research tradition of governance, and the study contains features of data sourcing and methodological triangulation. Empirically, the research material consists of Finland's official policy documents and anonymous semi-structured elite interviews. The study highlights that although the received CSRs on the need to restructure social and health services corresponded to Finland's views, their influence to national reform efforts was limited. The CSRs were administered according to the established formal routines, but separately from the national reform preparations. The CSRs, however, delivered implicit steering, which were considered to affect social and health policy making in various ways.

Rehabilitation in primary care for an ageing population: a secondary analysis from a scoping review of rehabilitation delivery models.

BACKGROUND: The world population is ageing rapidly. Rehabilitation is one of the most effective health strategies for improving the health and functioning of older persons. An understanding of the current provision of rehabilitation services in primary care (PC) is needed to optimise access to rehabilitation for an ageing population. The objectives of this scoping review are a) to describe how rehabilitation services are currently offered in PC to older persons, and b) to explore age-related differences in the type of rehabilitation services provided. METHODS: We conducted a secondary analysis of a scoping review examining rehabilitation models for older persons, with a focus on PC. Medline and Embase (2015-2022) were searched to identify studies published in English on rehabilitation services for people aged 50 + . Two authors independently screened records and extracted data using the World Health Organization (WHO)'s operational framework, the Primary Health Care Systems (PRIMASYS) approach and the WHO paper on rehabilitation in PC. Data synthesis included quantitative and qualitative analysis. RESULTS: We synthesised data from 96 studies, 88.6% conducted in high-income countries (HICs), with 31,956 participants and identified five models for delivering rehabilitation to older persons in PC: community, home, telerehabilitation, outpatient and eldercare. Nurses, physiotherapists, and occupational therapists were the most common providers, with task-shifting reported in 15.6% of studies. The most common interventions were assessment of functioning, rehabilitation coordination, therapeutic exercise, psychological interventions, and self-management education. Environmental adaptations and assistive technology were rarely reported. CONCLUSIONS: We described how rehabilitation services are currently provided in PC and explored age-related differences in the type of rehabilitation services received. PC can play a key role in assessing functioning and coordinating the rehabilitation process and is also well-placed to deliver rehabilitation interventions. By understanding models of rehabilitation service delivery in PC, stakeholders can work towards developing more comprehensive and accessible services that meet the diverse needs of an ageing population. Our findings, which highlight the role of rehabilitation in healthy ageing, are a valuable resource for informing policy, practice and future research in the context of the United Nations Decade of Healthy Ageing, the Rehab2030 initiative and the recently adopted WHA resolution on strengthening rehabilitation in health systems, but the conclusions can only be applied to HICs and more studies are needed that reflect the reality in low- and middle-income countries.

Review and Prospect of China’s Medical and Health Policy Since the Founding of the People’s Republic of China: Analysis based on Policy Tools / 中国医学伦理学

Policy tools are ways to quantitative analysis of policy text content and the construction of a "Policy Tools-Policy Objectives (X-Y Dimension)" framework to explore long-term stability and late-stage innovation of policy development. This paper reviewed the development process of medical and health policies since the founding of the People’s Republic of China, and divided 1949-2021 into four stages of reform breeding, institutional transformation, reform improvement and continuous deepening. Screening 121 medical and health policy texts issued at the national level since the founding of the People’s Republic of China, quantitatively analyzing 5 957 policy text cells from the perspective of policy tools, counting the use of policy tools in various periods, and excavating the inherent logic of policy texts, policy tools and policy objectives to derive development characteristics of internal logic deduction. The development of China’s medical and health policy in the new period will serve the people’s health in the first place, adhere to the development direction of equalization of basic public service, strengthen the coordinated development of scientific and technological innovation and talent training, build a health and healthy development system with Chinese characteristics.

A mixed method analysis of the Botswana schistosomiasis control policy and plans using the policy triangle framework.

BACKGROUND: The present goal of the World Health Organization (WHO) 2021-2030 roadmap for Neglected Tropical Diseases is to eliminate schistosomiasis as a public health problem, and reduce its prevalence of heavy infections to less than 1%. Given the evolution and impact of schistosomiasis in the Ngamiland district of Botswana, the aim of this study was to analyze the control policies for the district using the Policy Triangle Framework. METHODS: The study used a mixed method approaches of an analysis of policy documents and interviews with 12 informants who were purposively selected. Although the informants were recruited from all levels of the NTD sector, the analysis of the program was predominantly from the Ngamiland district. Data were analyzed using Braun and Clarke's approach to content analysis. RESULTS: The study highlights the presence of clear, objectives and targets for the Ngamiland control policy. Another theme was the success in morbidity control, which was realized primarily through cycles of MDA in schools. The contextual background for the policy was high morbidity and lack of programming data. The implementation process of the policy was centralized at the Ministry of Health (MOH) and WHO, and there was minimal involvement of the communities and other stakeholders. The policy implementation process was impeded by a lack of domestic resources and lack of comprehensive policy content on snail control and no expansion of the policy content beyond SAC. The actors were predominately MOH headquarters and WHO, with little representation of the district, local level settings, NGOs, and private sectors. CONCLUSIONS: The lack of resources and content in the control of environmental determinants and exclusion of other at-risk groups in the policy, impeded sustained elimination of the disease. There is a need to guide the treatment of preschool-aged children and develop national guidelines on treating foci of intense transmission. Moreover, the dynamic of the environmental transmissions and reorientation of the schistosomiasis policy to respond to the burden of schistosomiasis morbidity, local context, and health system context are required.

El hospital y el enfoque de derechos / The hospital and rights approach

La pandemia por SARS-CoV-2 puso de forma abrupta al sistema de salud en la agenda pública. Evidenciando sus problemas y requiriendo acciones de emergencia para poder dar cuenta del desafío de responder social y sanitariamente a esta crisis. La respuesta hospitalaria fue el eje y centro de atención de la pandemia, casi con exclusividad. Relegando las otras posibilidades o dispositivos asistenciales, como el primer nivel de atención y la salud comunitaria. Por lo tanto, nos proponemos reflexionar sobre esta organización sanitaria, tan arraigada en el modelo médico social y el marco del enfoque de derechos. Definiremos el hospital, describiremos sus antecedentes, sus características y propondremos como repensarlo críticamente para aportar a su crecimiento en el marco del enfoque de derechos. La salud como derecho es el marco legal, político y teórico que proponemos para abordar esta reflexión y al hospital, tanto como singularidad histórica como pluralidad o multiplicidad de organizaciones en función de cada contexto donde se desarrolla, como una organización social y sanitaria que formar parte de un conjunto de organizaciones y políticas destinadas a garantizar ese derecho (AU)

The SARS-CoV-2 pandemic abruptly put the health system on the public agenda. Evidencing their problems and requiring emergency actions to be able to account for the challenge of responding socially and healthily to this crisis. The hospital response was the axis and center of attention of the pandemic, almost exclusively. Relegating the other possibilities or assistance devices, such as the first level of care and community health. Therefore, we intend to reflect on this health organization, so rooted in the social medical model and the framework of the rights approach. We will define the hospital, describe its background, its characteristics and propose how to rethink it critically to contribute to its growth within the framework of the rights approach. Health as a right is the legal, political and theoretical framework that we propose to address this reflection and the hospital, both as a historical singularity and as a plurality or multiplicity of organizations depending on each context where it is developed, as a social and health organization that is part of a set of organizations and policies aimed at guaranteeing that right (AU)

Huerta urbana comunitaria, más que lechugas entre cemento. Producción social de territorios saludables / Community Urban Garden, More Than Lettuce among Cement. Social Production of Healthy Territories

Resumen Lo urbano no es incompatible con la agricultura, incluso mejora aspectos como la seguridad alimentaria, el amor hacia el territorio y la vida cotidiana, lo que refleja esperanza en la producción de una ciudad saludable. El artículo da cuenta de las reflexiones en torno al estudio de caso, el proceso de implementación del proyecto Huerta urbana comunitaria (HUC) de Villa Juanita del programa Buen Vivir en el Municipio de Villamaría, Caldas, Colombia.

Abstract The urban is not incompatible with agriculture, it even improves aspects, such as food security, love for the territory, and daily life, which reflects hope in the production of a healthy city. The article reports on the reflections around the case study, the implementation process of the Villa Juanita urban vegetable garden project of the Buen Vivir program in the municipality of Villamaría, Caldas, Colombia.

Types and Characteristics of Fatal Accidents Caused by Multiple Processes in a Workplace: Based on Actual Cases in South Korea.

As the social cost of disasters increases and safety is being emphasized, policy regulations at the national level have been implemented. However, various fatal accidents are continually occurring as continued economic development and enhanced technologies have increased demand and complicated the industrial structure. Workers in different industries, performing similar jobs, often experience different workplace hazards, which can result in similar types of accidents. Therefore, new policy regulations have been established to separate multiple processes and work in workplaces and are being implemented in several countries to minimize damage caused by new types of industrial accidents. Supervision and management appropriate for contractors or safety and health officials with legal obligations are required to play a regulatory role when these types of industrial accidents are likely to occur. This study classified accidental types and their characteristics based on actual cases, in which potential risks exist at multiple processes in a workplace. First, raw data of work-related fatalities that occurred in South Korea were reviewed and classified as fatal accidents caused by multiple processes in workplaces using the proposed method. Next, the classified actual cases were prepared as statistical data and analyzed based on the various categories. Finally, the accident type based on multiple processes, including risks and characteristics, in workplaces was proposed. As a result, this study improved the safety awareness and understanding of regulatory subjects regarding industrial accidents caused by multiple processes in workplaces and is expected to improve the effectiveness of the existing policy to prevent workplace accidents.

Ketotifen is a Prodrug. Norketotifen is the active metabolite.

Evaluation of the in vitro human liver microsome and hepatocyte metabolism of ketotifen demonstrated that norketotifen (NK) is the major demethylated hepatic metabolite of ketotifen. It is here reported that NK is completely devoid of the severe and dose-limiting sedative effects of ketotifen. Thus, while ketotifen is clinically dose-limited to 1 mg, bid, there are no dose-limiting sedative effects elicited by NK, even after the highest single-dose (16 mg) or after repeat-doses (8 mg × 7 days) in humans or after the highest doses given to dogs in repeat-dose toxicological studies (40 mg/kg × 14 days). In addition, NK-but not ketotifen-was found to express potent and dose-dependent inhibition of the release of the pro-inflammatory cytokine TNFα from activated human buffy coat preparations. Thus, when used as an anti-inflammatory drug, ketotifen is the sedating prodrug which is converted to NK a nonsedating metabolite with anti-inflammatory activity.

Lethal ageism in the shadow of pandemic response tactics.

AIM: This paper examines aspects of pandemic policy responses to the COVID-19 and SARS-CoV-2 variants and presents an integrated view of the consequences of response tactics at national and health service levels for older adults. BACKGROUND: Nurses are positioned at the intersection of health service and policy implementation; therefore, their influence on clinical protocols and health policy directions post pandemic is crucial to preventing further premature deaths in the 65+ years age group and others. SOURCES OF EVIDENCE: Perspectives presented here are based on a critical evaluation of the many published reports, comments, research and insights concerning the pandemic. That evidence, combined with my experience in various fields of study and professional service, enables me to envisage what some decisions and policies may mean for older people, nurses and societies worldwide. DISCUSSION: Established information on world population patterns and the location and health of national groups has been made less reliable by population shifts caused by years of geo-political conflicts and now the impact of the pandemic. Added to this already chaotic context, the pandemic has further disrupted societies, health services and economies. Ageist responses by these systems have further disadvantaged older people and generated trust deficits that need to be resolved. CONCLUSION: When the pandemic recedes, policy and management decisions taken by governments and hospital administrators will be a telling indicator of whether the established systematic ageism exposed during the pandemic will continue to compromise the health and longevity of older adults. IMPLICATIONS FOR NURSING, HEALTH AND SOCIAL POLICY: The ascendency of nursing influence within the health and social policy environment must be further strengthened to enable nurses to champion equity and fairness in the pandemic recovery effort.

Suggestion of an Improved Evaluation Method of Construction Companies' Industrial Accident Prevention Activities in South Korea.

Workers in the construction industry are constantly exposed to dangers during work that can lead to death or disability. Despite recent advances in construction technology, the presence of these risks for workers has become an unresolved social problem. In particular, most companies often recognize that it is necessary to mitigate against risks posed to worker only after an accident has occurred. Recently, there has been an increasing demand for the development of new safety technologies and policy proposals to ensure the safety of workers during construction or work. However, the right solution is not coping after an accident but preventing it, and this must be accompanied by voluntary efforts by the company. To work toward such solutions, Korea is implementing an evaluation of construction companies' industrial accident prevention activities without legal regulations or coercion to encourage voluntary accident prevention activities by companies. The purpose of this study is to propose an effective improvement direction for the system implemented by the Korea Occupational Safety and Health Agency. First, by analyzing the details of the system and the data of the evaluation results, the system's effectiveness and rationality are reviewed, and steps for improvement are determined. Next, an evaluation model is proposed considering the size of the company to be evaluated and the level of safety and health, and its validity is verified through a survey of construction workers. Finally, a plan to induce the voluntary participation of construction companies in this system and the role of the supervisory authority are presented. This study is expected to serve as an important example of an effective safety policy model by encouraging companies' voluntary efforts to prevent accidents in the construction industry and raise the level of potential safety and health awareness.

WITHDRAWN: The role of medical and health policies in the health risk management system.

Ahead of Print article withdrawn by publisher.

A extensão no curso de medicina como estratégia de formação para o Sistema Único de Saúde (SUS) / Extension project in medical course as a training strategy for the Brazilian Unified Health System (SUS) / La extensión del curso de medicina como estrategia de capacitación del Sistema Único de Salud (SUS)

Este relato tem por objetivo descrever a experiência de um projeto de extensão desenvolvido pelo curso de medicina da Universidade Federal de Sergipe, campus Lagarto. As atividades de ensino-aprendizagem tiveram o intuito de levar os estudantes a analisar criticamente as políticas e práticas de saúde desenvolvidas no âmbito da comunidade e das instituições estatais de saúde, constituindo-se um espaço de experimentação de práticas inovadoras a partir da adoção de metodologias de ensino-aprendizagem centradas no aluno, conforme orientado pelas Diretrizes Curriculares Nacionais. A implementação do programa contemplou ações envolvendo análise de documentos oficiais (leis e portarias) sobre as mudanças do novo modelo de financiamento de custeio da Atenção Primária à Saúde, a criação de um espaço de discussão virtual com as equipes de saúde e a produção de materiais informativos (físicos e virtuais), como vídeos e cartilhas. A realização do projeto apoiado na experiência de integração ensino-serviço-comunidade contribuiu para o esclarecimento de gestores e trabalhadores da área sobre as mudanças em curso, bem como para o desenvolvimento, nos discentes envolvidos, de competências tecnológicas e críticas focadas na qualidade do cuidado e voltadas à melhoria das condições de vida e saúde das populações. Esses fatores são concebidos como os principais paradigmas científicos atuais no campo das políticas públicas em saúde para superação de modelos de ensino que se mostram cada vez mais incapazes de atender à amplitude das necessidades sociais de saúde.

This report describes the experience of an extension project developed by the medical course of the Federal University of Sergipe, Lagarto campus. The teaching-learning activities sought to lead students to critically analyze health policies and practices developed within the community and state health institutions, constituting a space for experimentation with innovative practices based on student-centered methodologies, as established by the National Curriculum Guidelines. Its implementation included actions involving the analysis of official documents (laws and ordinances) about changes to the new model to finance Primary Health Care, the creation of a virtual discussion spaces with health teams and the production of informative materials (physical and virtual), such as videos and booklets. Supported by the experience of teaching-service-community integration, its execution contributed to clarify the changes underway, as well as to develop technological and critical skills focused on the quality of care aimed at improving the living conditions and health status of the population. These factors are the main current scientific paradigms in the field of public health policies to overcome teaching models that are increasingly unable to meet the social health needs.

El propósito del informe es reportar la experiencia de un proyecto de extensión desarrollado por la carrera de Medicina de la Universidad Federal de Sergipe, en el campus de Lagarto. Las actividades de enseñanza-aprendizaje tuvieron como objetivo llevar a los estudiantes a analizar críticamente las políticas y prácticas de salud desarrolladas dentro de la comunidad y las instituciones estatales de salud, constituyendo un espacio para experimentar con prácticas innovadoras basadas en la adopción de metodologías de enseñanza-aprendizaje centradas en el alumno como sujeto del aprendizaje según plantean las Directrices Curriculares Nacionales. La implementación del programa incluyó acciones de análisis de documentos oficiales (leyes y ordenanzas) sobre cambios al nuevo modelo de financiamiento de la Atención Primaria de Salud, la creación de un espacio de discusión virtual con equipos de salud y la producción de materiales informativos (físicos y virtuales) como videos y folletos. La realización del proyecto a partir de la experiencia de integración docencia-servicio-comunidad contribuyó al esclarecimiento de los directivos y trabajadores del área sobre los cambios en curso, así como al desarrollo de habilidades tecnológicas y críticas en los estudiantes involucrados, enfocadas en la calidad de atención para mejorar las condiciones de vida y salud de las poblaciones. Estos factores son considerados uno de los principales paradigmas científicos actuales en el campo de las políticas públicas de salud para superar modelos de enseñanza que son cada vez más incapaces de atender la expansión de las necesidades sociosanitarias.

Involuntary isolation: interpreting mental health legislation during the COVID-19 pandemic.

The coronavirus disease 2019 (COVID-19) pandemic poses new and unprecedented challenges to the interpretation of mental health law. The authors present pragmatic and ethical considerations in the psychiatric safety assessment at the intersection of COVID-19 and severe mental illness.

What factors drive the satisfaction of citizens with governments' responses to COVID-19?

OBJECTIVES: This research scrutinizes the important factors influencing the satisfaction of citizens concerning their governments' responses to the COVID-19 pandemic based on an open-sourced survey of 14 countries. METHODS: To collect information on public sentiment regarding governments' reactions to COVID-19, we consider five factors for analysis: number of confirmed cases per million population, number of deaths per million population, and governments' containment and health policies, stringency policies, and economic support policies. We examine the Kendall correlations of variables in the 14 countries and use the wild bootstrap method for regression models to find important regressors. RESULTS: Our results show that people pay stronger attention to the results of their governments' battle against COVID-19 (number of confirmed cases and deaths per million population) rather than to what policies they initiate. Health policy and economic support do influence the approval of any national response to COVID-19. We also find that public satisfaction in Japan and South Korea toward the two governments' responses to the pandemic varies greatly compared to that of other countries' citizens to their governments' responses. CONCLUSIONS: The results herein offer some suggestions to governments when initiating policies to balance public health, livelihoods, and economic support.

Superación de la violencia de género en las relaciones de pareja: historias de vida / Overcoming gender violence within intimate relations: Life histories

Resumen Estudio cualitativo cuyo objetivo fue interpretar los relatos de las experiencias de vida de personas que han superado la violencia en las relaciones de pareja. Los contextos de violencia social y estructural se entrecruzan con la vida de pareja de ambos participantes. En su salud mental, la violencia, el valor de lo económico, episodios depresivos, y la distribución asimétrica de poder han marcado sus relaciones. Las políticas de salud mental pueden incluir la prevención y atención primaria de esta violencia.

Abstract It is a qualitative study, whose objective was to interpret the stories of people's life experiences, who have overcome violence in their intimate relations. The contexts of social and structural violence intersect with the life of both participants' partners. In their mental health, violence, the value of economics, depressive episodes, and the asymmetrical distribution of power have marked their relationships. Mental health policies may include prevention and primary care of this violence.

Recent Advances in Systems and Network Medicine: Meeting Report from the First International Conference in Systems and Network Medicine.

The First International Conference in Systems and Network Medicine gathered together 200 global thought leaders, scientists, clinicians, academicians, industry and government experts, medical and graduate students, postdoctoral scholars and policymakers. Held at Georgetown University Conference Center in Washington D.C. on September 11-13, 2019, the event featured a day of pre-conference lectures and hands-on bioinformatic computational workshops followed by two days of deep and diverse scientific talks, panel discussions with eminent thought leaders, and scientific poster presentations. Topics ranged from: Systems and Network Medicine in Clinical Practice; the role of -omics technologies in Health Care; the role of Education and Ethics in Clinical Practice, Systems Thinking, and Rare Diseases; and the role of Artificial Intelligence in Medicine. The conference served as a unique nexus for interdisciplinary discovery and dialogue and fostered formation of new insights and possibilities for health care systems advances.

Thoughts About Social Justice.

This is the second of two essays addressing equity and social justice, which are interrelated concepts of considerable interest to members of our discipline. The purpose of this essay is to define social justice within the context of the conceptual model of nursing and health policy and to link social justice with equity in population health and with practice. An essay about equity appeared in a previous issue of Nursing Science Quarterly.

The implications of health policy for nursing.

Nursing needs policy, it provides the context to nurses' practice, roles, and knowledge and frames patients' day-to-day lives. This article defines what is meant by policy and what influences its development. With the use of health policy examples, the implications for nursing are explained and ideas on how policy is implemented in practice set out. As health is a devolved issue policy comparisons are made between the four regions of the UK. Finally, the implications of current policy change on nursing roles and skill mix shows how future developments in the nursing profession are being directed.

Still More Thoughts About Conceptual Models and Literature Reviews: Focus on Health Policy.

This essay is the second of two essays about the use of a conceptual model to guide scoping reviews of literature. The first essay, published in the previous issue of Nursing Science Quarterly, provided examples of the use of the conceptual model of nursing and population health as a starting point for the construction of conceptual-theoretical-empirical structures for scoping reviews. In this essay, the examples are of the use of the conceptual model of nursing and health policy.