Avoidable healthcare costs of spinning-induced rhabdomyolysis: a case series.

Spinning-induced rhabdomyolysis (SIR) is a well documented cause of exertional rhabdomyolysis. We aim to raise awareness and to call for preventive action towards avoidable healthcare costs associated with SIR. To this end, we describe three cases of SIR, associated healthcare costs and possible preventive strategies. We propose that community-based preventive measures should be considered in addressing the economic consequences of SIR.

Low-wage migrant workers during coronavirus disease 2019: a social determinants analysis.

The severe acute respiratory syndrome coronavirus 2 pandemic has had disproportionate effects on economically and socially marginalized people. We explore the effects on low-wage migrant workers (migrant workers) in three countries: Singapore, South Korea and Brazil, through the lens of the social determinants of health. Our analysis shows that governments missed key opportunities to mitigate pandemic risks for migrant workers. Government measures demonstrate potential for effective and sustainable policy reform, including universal and equitable access to healthcare, social safety nets and labour rights for migrant workers-key concerns of the Global Compact for Migration. A whole-of-society and a whole-of-government approach with Health in All Policies, and migrant worker frameworks developed by the World Health Organization could be instrumental. The current situation indicates a need to frame public health crisis responses and policies in ways that recognize social determinants as fundamental to health.

Prolactin Assay Interference by Macroprolactin.

BACKGROUND: Macroprolactinemia is a common presentation especially in gynecology and fertility clinics. However, with this clinical condition, there is a potential for misdiagnosis and unnecessary investigations/treatments due to lack of awareness of its prevalence and diagnostic approaches amongst trainees and physicians. METHODS: In this paper, we discuss the causes of hyperprolactinemia, its pathobiology, and an approach to macro-prolactinemia including relevant clinical chemistry methods and their limitations through the case of a 45-year-old female with a history of irregular menstrual cycles, who was seen in the endocrine clinic. RESULTS: Patient did not have a history of infertility, galactorrhea, visual-disturbance, or headaches. Her physical examination and routine clinical chemistry investigations were unremarkable. Her initial prolactin level was 4,836 mIU/L (109 - 557) with subsequent results demonstrating diminishing levels of prolactin a month apart (1,023 mIU/L). Polyethylene glycol (PEG) precipitation test demonstrated the presence of macroprolactin with a 3% post-PEG recovery of prolactin and 111 mIU/L post-PEG prolactin concentration. CONCLUSIONS: Patient's post-PRL results and clinical course confirmed the presence of macroprolactin to be the cause of factitious hyperprolactinemia. A sound approach to macroprolactinemia is critical in clinical and laboratory practices.

User-Centered Design Process of an mHealth App for Health Professionals: Case Study.

BACKGROUND: User-centered design processes are infrequently employed and not fully explored for building mobile health (mHealth) apps that are particularly targeted to health professionals as end users. The authors have used a user-centered design-based approach to build an mHealth app for health professionals, tasked to deliver medical laboratory-related information on a daily basis. OBJECTIVE: Our objective is to generate a simple and functional user-centered design process for mHealth apps for health professionals. This paper presents the key learnings from design activities. METHODS: A stratified random sample of doctors and nurses was recruited for the study. The design activities were planned in the following sequence: focus group discussion for situation analysis and information architecture, design activity 1 for wireframe designing, design activity 2 for wireframe testing, and user testing sessions 1 and 2. RESULTS: The final design and functions of the app, information architecture, and interactive elements were largely influenced by the participatory design-based user-centered design activities. As a result of the design process, we could identify the mental models of processing requests for information and personal preferences based on the experience. These findings were directly or indirectly incorporated into the app design. Furthermore, finding alternative ways of working within time constraints and cultural barriers and the methods employed to manage the challenges of interdisciplinary discourse stood out among the lessons learned. CONCLUSIONS: We recommend a user-centered design process based on a participatory design approach in mHealth app design, enriched with focus group discussions where possible.