Health Care Administration

Background Although the burden of influenza is often discussed in the context of historical pandemics and the threat of future pandemics, every year a substantial burden of lower respiratory tract infections (LRTIs) and other respiratory conditions (like chronic obstructive pulmonary disease) are attributable to seasonal influenza. The Global Burden of Disease Study (GBD) 2017 is a systematic scientific effort to quantify the health loss associated with a comprehensive set of diseases and disabilities. In this Article, we focus on LRTIs that can be attributed to influenza. We modelled the LRTI incidence, hospitalisations, and mortality attributable to influenza for every country and selected subnational locations by age and year from 1990 to 2017 as part of GBD 2017. We used a counterfactual approach that first estimated the LRTI incidence, hospitalisations, and mortality and then attributed a fraction of those outcomes to influenza. Influenza LRTI was responsible for an estimated 145 000 (95% uncertainty interval [UI] 99 000-200 000) deaths among all ages in 2017. The influenza LRTI mortality rate was highest among adults older than 70 years (16•4 deaths per 100 000 [95% UI 11•6-21•9]), and the highest rate among all ages was in eastern Europe (5•2 per 100 000 population [95% UI 3•5-7•2] ). We estimated that influenza LRTIs accounted for 9 459 000 (95% UI 3 709 000-22 935 000) hospitalisations due to LRTIs and 81 536 000 hospital days (24 330 000-259 851 000). We estimated that 11•5% (95% UI 10•0-12•9) of LRTI episodes were attributable to influenza, corresponding to 54 481 000 (38 465 000-73 864 000) episodes and 8 172 000 severe episodes (5 000 000-13 296 000). Interpretation This comprehensive assessment of the burden of influenza LRTIs shows the substantial annual effect of influenza on global health. Although preparedness planning will be important for potential pandemics, health loss due to seasonal influenza LRTIs should not be overlooked, and vaccine use should be considered. Efforts to improve influenza prevention measures are needed. Funding Bill & Melinda Gates Foundation.

9 India: Assessing the Reach of Three SEWA Health Services among the Poor M. Kent Ranson, Palak Joshi, Mittal Shah, and Yasmin Shaikh The Self-Employed Women's Association (SEWA), a trade union of informal women workers, was founded in 1972 by Ela Bhatt in ...

In Cameroon, formal social protection systems cover only a small fraction-approximately 15 and 25%-of the active population, while the informal sector accounts for 86.6% of employment, predominantly in non-agricultural activities. A significant portion of this population lives in poverty (37.7% below the national poverty line) and faces major barriers to accessing contributory insurance schemes, including income instability, limited education, lack of awareness, and complex administrative procedures. Notably, around 60% of poor individuals are employed, underscoring their heightened vulnerability to social risks. In response to this exclusion, informal and community-based mechanisms-particularly tontines and health mutuals-have emerged as vital alternatives. These systems, though informal, provide essential financial protection and social support, highlighting the need to better understand their role and explore pathways for integrating informal workers into broader social protection frameworks.

Cosmetics are widely used, with millions of people around the world including these products in their everyday routines. The study includes a 21 item semi structured questionnaire designed to obtain information on the participants knowledge about safe and effective use of cosmetics and ADR reporting. The objective of the study is to determine the awareness and knowledge of community members about safe and responsible cosmetics use practice and to identify the need for public health interventions. The questionnaire consisted of 2 parts, the first included the questions on the demographic variables such as age, gender, occupation and education level. The second part consisted of 20 questions which tested the participant's knowledge, attitude and practice towards the cosmetics usage. The aim of the study is to investigate cosmetics use and associated adverse events among community members and to inform public health strategies for safe and responsible cosmetics use. The questionnaire was distributed through google form and 304 responses were obtained, out of which 300 responses were selected as per the inclusion and exclusion criteria. The study underscores the widespread use of cosmetics and the significant occurrence of adverse events linked to their use. These findings stress the importance of increasing public awareness about cosmetic safety, advocating for stricter regulations on cosmetic products, and encouraging individuals to be more cautious when choosing and using these products to minimize potential risks. Encouraging the reporting of adverse reactions can help identify harmful ingredients and lead to quicker regulatory actions.

Cloud computing, a rapidly growing ICT sector, creates environmental problems. Cloud computing is popular due to its scalability, dependability, and low cost. Cloud computing has potential environmental, economic, and technological benefits. This research examines the usage of green cloud services in healthcare to ensure secure and energy-efficient resource consumption.EHR systems employ checklists, alarms, and tools to enhance patient safety and encourage evidencebased practice. These solutions include clinical guiding principles, computerized prescribing and testing methodologies to prevent errors, and discrete data sets for efficiency dashboards and compliancereporting.Quicker, more accurate interactions and streamlined processes have led to better fee collection, reduced duplicate testing, faster patient survey responses, optimized use of transcription staff, increased patient throughput, and access to government incentives. The survey aims to offer current recommendations for research in green cloud computing.

Interoperability challenges were different in context, depending upon the integration of the modules, levels (micro-meso-macro), types (foundational, technical, semantic, syntactic, etc..), HIS, EMR and EHR. It plays an important role in healthcare settings for seamless exchange of secured data, across different settings. Different countries solved the interoperability issues in different situations, whereas in India, it has been proposed to solve by using the Ayushman Bharat Digital Mission(ABDM) by the Government of India. Methods:The current study was conducted to review the published data on the interoperability challenges between the EMR System, at the micro level and the EHR systems at the macro level, similar to ABDM, across the world. Using keyword search techniques, AND, OR, NOT, +,|,-, * and different options provided by six different sources of databases were searched for related articles. The identified papers were screened and reviewed, based on title, and abstractat different stages which were relevant and valid. Results: The findings showed that interoperability challenges addressed using ICT tools, HL7 FHIR standards, SNOMED CT, LOINC, ABDM in an Indian context, HAPI FHIR Server using MPI, enabled by integrating with EMR, HIS, EHR System using HIE at micro, meso and macro levels. Conclusion:The interoperability has been discussed in terms of integrating different modules in the hospital settings, terms like e-prescribing, and patient portal. The micro, meso, and macro levels are discussed in terms of individual, organisational and policy. Further, the study can be focused on the usersof the EMR system at a micro level, the EMR system at a hospital setting at the meso level, and integrating the EMRs using the API, ABDM as EHR at the macro level.

In recent years, small vessel disease (SVD) has been recognized for its major impact on cognitive impairment in elderly people, where it is often difficult to separate its effects from those of neurodegenerative diseases individually. SVD is a systemic disease, probably related to diffuse endothelial dysfunction, which affects the perforating arterioles, capillaries and venules in the brain. Although often asymptomatic, it is responsible for almost half of all dementia cases and a significant proportion of stroke cases. Imaging features found on magnetic resonance include recent small subcortical infarctions, lacunes of presumed vascular origin, white matter hyperintensity of presumed vascular origin, prominent perivascular spaces and cerebral microbleeds. The recognition of these imaging findings as a spectrum of the same disease caused by endothelial dysfunction of small cerebral vessels can allow an overall analysis of the disease and thus the development of more effective preven...

Background and aims: Malnutrition (under and overnutrition) in paediatric cancer patients during and after treatment increases short and long-term side-effects; however, factors contributing to malnutrition and patterns of change in nutritional status are still unclear. The aims were to investigate the prevalence of malnutrition, patterns of change in nutritional status and factors contributing to malnutrition in Scottish paediatric cancer patients. Methods: A prospective cohort study of Scottish children aged <18 years, diagnosed with and treated for cancer between Aug 2010 and Jan 2014 was performed. Clinical and nutritional data were collected at defined periods up to 36 months. Measurements of weight and height/length and arm anthropometry (mid-upper arm circumference (MUAC) and triceps skin-fold thickness (TSF)) were collected. Body composition was estimated from arm anthropometry using Frisancho's references and bio-electrical impedance (BIA). Malnutrition was defined according to UK BMI curves; undernutrition (<2.3rd centile; À2 SD), overweight (!85th < 95th centile; !þ1.05 SD < 1.63 SD) and obese (!95th centile; !1.63 SD). We performed descriptive statistics and multilevel analysis. p < 0.05 was considered statistically significant. Results: Eighty-two patients [median (IQR) age 3.9 (1.9e8.8) years; 56% males] were recruited. At diagnosis, the prevalence of undernutrition was 13%, overweight 7% and obesity 15%. TSF identified the highest prevalence of undernutrition (15%) and the lowest of obesity (1%). BMI [p < 0.001; 95% CI (1.31 e3.47)] and FM (BIA) [p < 0.05; 95% CI (0.006e0.08)] significantly increased after 3 months of treatment, whilst FFM (BIA) [p < 0.05; 95% CI (À0.78 to (À0.01))] significantly decreased during the first three months and these patterns remained until the end of the study. High-treatment risk significantly contributed to undernutrition during the first three months of treatment [p ¼ 0.04; 95% CI (À16.8 to (À0.4))] and solid tumours had the highest prevalence of undernutrition [BMI (17%)]. Conclusions: Arm anthropometry (or BIA) alongside appropriate nutritional treatment that targets undernutrition initially and overnutrition at later stages should be implemented in routine clinical practice of paediatric cancer patients.

This draft proposal of the All UP Workers Union was made by the National Executive Board of the All UP Workers in response to a report that the Director f PGH told the UP Manila/PGH Chapter Executive Board of the Union for PGH to proceed with the CTI tagging of the more than 300+ Administrative Aide of PGH in compliance with a DBM letter, in exchange for the additional 1,224 regular items for PGH. Th Proposal calls for PGH to  already plan a new and upgraded staffing proposal to the DBM for the 2,200 beds upgraded PGH, instead of wasting its HR personnel and effort in CTI tagging for a 1,234-bed capacity hospital. The said effort was already overtaken by a new law (RA 12210)  enacted on May 21, 2025, mandating PGH to increase its bed capacity to 2,200.

This proposal, once finalized, will be submitted to the offices of the PGH Director, the UP Manila Chancellor, and the President of the University of the Philippines, for their appropriate action.

We are inviting your thought about this matter, for the best interest of Philippine Healthcare sector

Background Some drugs have a narrow therapeutic range and require monitoring and dose adjustments to optimize their efficacy and safety. Computerized clinical decision support systems (CCDSSs) may improve the net benefit of these drugs. The objective of this review was to determine if CCDSSs improve processes of care or patient outcomes for therapeutic drug monitoring and dosing. Methods We conducted a decision-maker-researcher partnership systematic review. Studies from our previous review were included, and new studies were sought until January 2010 in MEDLINE, EMBASE, Evidence-Based Medicine Reviews, and Inspec databases. Randomized controlled trials assessing the effect of a CCDSS on process of care or patient outcomes were selected by pairs of independent reviewers. A study was considered to have a positive effect (i.e., CCDSS showed improvement) if at least 50% of the relevant study outcomes were statistically significantly positive. Results Thirty-three randomized controlled ...

Aims and objectivesTo explore how change‐of‐shift handoffs relate to nurses&#39; clinical judgments regarding patient risk of deterioration.BackgroundThe transfer of responsibility for patients&#39; care comes with an exchange of information about their condition during change‐of‐shift handoff. However, it is unclear how this exchange affects nurses&#39; clinical judgments regarding patient risk of deterioration.DesignA sequential explanatory mixed‐methods study reported according to the STROBE and COREQ guidelines.MethodsOver four months, 62 nurses from one surgical and two medical units at a single Canadian hospital recorded their handoffs at change of shift. After each handoff, the two nurses involved each rated the patient&#39;s risk of experiencing cardiac arrest or being transferred to an intensive care unit in the next 24 hr separately. The information shared in handoffs was subjected to content analysis; code frequencies were contrasted per nurses&#39; ratings of patient ris...

Background Comprehensive and comparable estimates of health spending in each country are a key input for health policy and planning, and are necessary to support the achievement of national and international health goals. Previous studies have tracked past and projected future health spending until 2040 and shown that, with economic development, countries tend to spend more on health per capita, with a decreasing share of spending from development assistance and out-of-pocket sources. We aimed to characterise the past, present, and predicted future of global health spending, with an emphasis on equity in spending across countries. We estimated domestic health spending for 195 countries and territories from 1995 to 2016, split into three categories-government, out-of-pocket, and prepaid private health spending-and estimated development assistance for health (DAH) from 1990 to 2018. We estimated future scenarios of health spending using an ensemble of linear mixed-effects models with time series specifications to project domestic health spending from 2017 through 2050 and DAH from 2019 through 2050. Data were extracted from a broad set of sources tracking health spending and revenue, and were standardised and converted to inflation-adjusted 2018 US dollars. Incomplete or low-quality data were modelled and uncertainty was estimated, leading to a complete data series of total, government, prepaid private, and out-of-pocket health spending, and DAH. Estimates are reported in 2018 US dollars, 2018 purchasing-power parity-adjusted dollars, and as a percentage of gross domestic product. We used demographic decomposition methods to assess a set of factors associated with changes in government health spending between 1995 and 2016 and to examine evidence to support the theory of the health financing transition. We projected two alternative future scenarios based on higher government health spending to assess the potential ability of governments to generate more resources for health. Findings Between 1995 and 2016, health spending grew at a rate of 4•00% (95% uncertainty interval 3•89-4•12) annually, although it grew slower in per capita terms (2•72% [2•61-2•84]) and increased by less than $1 per capita over this period in 22 of 195 countries. The highest annual growth rates in per capita health spending were observed in upper-middle-income countries (5•55% [5•18-5•95]), mainly due to growth in government health spending, and in lower-middle-income countries (3•71% [3•10-4•34]), mainly from DAH. Health spending globally reached $8•0 trillion (7•8-8•1) in 2016 (comprising 8•6% [8•4-8•7] of the global economy and $10•3 trillion [10•1-10•6] in purchasing-power parity-adjusted dollars), with a per capita spending of US$5252 (5184-5319) in high-income countries, $491 (461-524) in upper-middle-income countries, $81 (74-89) in lower-middle-income countries, and $40 (38-43) in low-income countries. In 2016, 0•4% (0•3-0•4) of health spending globally was in low-income countries, despite these countries comprising 10•0% of the global population. In 2018, the largest proportion of DAH targeted HIV/AIDS ($9•5 billion, 24•3% of total DAH), although spending on other infectious diseases (excluding tuberculosis and malaria) grew fastest from 2010 to 2018 (6•27% per year). The leading sources of DAH were the USA and private philanthropy (excluding corporate donations and the Bill & Melinda Gates Foundation). For the first time, we included estimates of China's contribution to DAH ($644•7 million in 2018). Globally, health spending is projected to increase to $15•0 trillion (14•0-16•0) by 2050 (reaching 9•4% [7•6-11•3] of the global economy and $21•3 trillion [19•8-23•1] in purchasing-power parity-adjusted dollars), but at a lower growth rate of 1•84% (1•68-2•02) annually, and with continuing disparities in spending between countries. In 2050, we estimate that 0•6% (0•6-0•7) of health spending will occur in currently low-income countries, despite these countries comprising an estimated 15•7% of the global population by 2050. The ratio between per capita health spending in high-income and low-income countries was 130•2 (122•9-136•9) in 2016 and is projected to remain at similar levels in 2050 (125•9 [113•7-138•1]). The decomposition analysis identified governments' increased prioritisation of the health sector and economic development as the strongest factors associated with increases in government health spending globally. Future government health spending scenarios suggest that, with greater prioritisation of the health sector and increased government spending, health spending per capita could more than double, with greater impacts in countries that currently have the lowest levels of government health spending.

Cognitive impairment includes mild cognitive decline and dementia, such as Alzheimer&#39;s disease (AD) and cerebrovascular-related pathologies. To investigate the profile of AD-related CSF biomarkers in a sample of cognitively impaired and unimpaired older adults with concomitant subcortical cerebrovascular burden. Seventy-eight older adults attending an outpatient psychogeriatric clinic were enrolled. Diagnoses were based on clinical, neuropsychological, laboratory, and neuroimaging data. Participants were classified into: cognitively normal (controls, n = 30), mild cognitive impairment (MCI, n = 34), and dementia (AD, n = 14). All subjects were submitted to CSF analyses for determination of amyloid-beta (Aβ), total tau (t-tau), phosphorylated tau (p-tau) and Aβ/p-tau ratio according to the Luminex method. MRI was performed in all individuals, and was scored independently by two experts according to Fazekas scale. Statistical analyses were conducted with the aid of general linear ...

The rapid spread of COVID-19 renewed the focus on how health systems across the globe are financed, especially during public health emergencies. Development assistance is an important source of health financing in many low-income countries, yet little is known about how much of this funding was disbursed for COVID-19. We aimed to put development assistance for health for COVID-19 in the context of broader trends in global health financing, and to estimate total health spending from 1995 to 2050 and development assistance for COVID-19 in 2020. We estimated domestic health spending and development assistance for health to generate total health-sector spending estimates for 204 countries and territories. We leveraged data from the WHO Global Health Expenditure Database to produce estimates of domestic health spending. To generate estimates for development assistance for health, we relied on project-level disbursement data from the major international development agencies' online databases and annual financial statements and reports for information on income sources. To adjust our estimates for 2020 to include disbursements related to COVID-19, we extracted project data on commitments and disbursements from a broader set of databases (because not all of the data sources used to estimate the historical series extend to 2020), including the UN Office of Humanitarian Assistance Financial Tracking Service and the International Aid Transparency Initiative. We reported all the historic and future spending estimates in inflation-adjusted 2020 US$, 2020 US$ per capita, purchasing-power parity-adjusted US$ per capita, and as a proportion of gross domestic product. We used various models to generate future health spending to 2050. In 2019, health spending globally reached $8•8 trillion (95% uncertainty interval [UI] 8•7-8•8) or $1132 (1119-1143) per person. Spending on health varied within and across income groups and geographical regions. Of this total, $40•4 billion (0•5%, 95% UI 0•5-0•5) was development assistance for health provided to low-income and middle-income countries, which made up 24•6% (UI 24•0-25•1) of total spending in low-income countries. We estimate that $54•8 billion in development assistance for health was disbursed in 2020. Of this, $13•7 billion was targeted toward the COVID-19 health response. $12•3 billion was newly committed and $1•4 billion was repurposed from existing health projects. $3•1 billion (22•4%) of the funds focused on country-level coordination and $2•4 billion (17•9%) was for supply chain and logistics. Only $714•4 million (7•7%) of COVID-19 development assistance for health went to Latin America, despite this region reporting 34•3% of total recorded COVID-19 deaths in low-income or middle-income countries in 2020. Spending on health is expected to rise to $1519 (1448-1591) per person in 2050, although spending across countries is expected to remain varied. Interpretation Global health spending is expected to continue to grow, but remain unequally distributed between countries. We estimate that development organisations substantially increased the amount of development assistance for health provided in 2020. Continued efforts are needed to raise sufficient resources to mitigate the pandemic for the most vulnerable, and to help curtail the pandemic for all. Funding Bill & Melinda Gates Foundation.

Genetic disorders result from gene mutations that impair body functions, and most remain untreatable. India experiences a high occurrence of these conditions due to its large population, high birth rates, and consanguineous marriages within certain communities. A cross-sectional study in the Chhindwara district of Madhya Pradesh examined comprehension and awareness of genetic diseases and available healthcare. The research found that Chhindwara inhabitants possess moderate knowledge about genetic disorders. Among 958 participants surveyed, epilepsy and sickle cell anaemia were more frequently recognized, while thalassemia and Down syndrome were less familiar. Misconceptions persisted, including the erroneous belief that genetic diseases are contagious. Only 25% of respondents were aware of local treatment options, yet 85.7% endorsed the establishment of local genetic counseling services. These results underscore the necessity for enhanced education, awareness, and accessibility to genetic counseling to boost public health outcomes.

Background: One of the elements controlling the quality of hospital health services is patient and employee satisfaction. The mean value of patient satisfaction with all parameters of inpatient rooms at the Islamic Hospital in Surabaya from January to August 2016 was 61.3% which is less than the standard of ≥ 90%. Whereas, people equity is a concept of human resource management that signs organizational performance. Aims: This study examined the correlation between patient satisfaction and people equity among paramedic staffs especially in inpatient rooms of the Islamic Hospital in Surabaya. Methods: This study focused on measuring people equity, patient satisfaction, and the correlation between people satisfaction and people equity. The questionnaire used in this study adopted RATER dimensions (Reliability, Assurance, Tangible, Empathy, and Responsiveness). Results: The study found that three inpatient rooms (Muzdalifah, Arofah, and Shofa) did not meet three elements of people equity (Alignment, Capabilities, and Engagement). Patient satisfaction with the inpatient rooms was good, except for the tangible dimension especially room cleanliness which is still relatively low. People equity among the paramedic staff has strong relevance and is directly proportional to patient satisfaction with the inpatient rooms of the Islamic Hospital in Surabaya. Internalizing an organizational culture that considers patient satisfaction and patient equity among paramedic staffs is essential to harmonize the goals, vision, and mission between the hospital and its staffs. This study recommends that there should be a more serious evaluation of the cleanliness of all service units at the Islamic Hospital in Surabaya.

Today, the methodological basis of disease pre­vention among various categories of the population, including students, is an innovative area of medical science and health care practice, namely medicine of borderline conditions. The development of a system of prenosological diagnosis of pathological conditions in young students and their hygienic correction for disease prevention are important both from a scientific and practical point of view. The study was conducted in the conditions of a natural experiment on the basis of three types of educational institutions, at the place of study of representatives of both sexes aged 14 to 23 years, adolescents and yound adults. In order to achieve the relevant objectives, the study used the following methods: analytic addressed at the study of educational programs, curricula, schedules, profile and regulatory documents; sanitary-hygienic; psychophysiological; psychological, statistic. Set of risk factors related to the educational process amo...

The prevalence of intestinal parasitic infection was studied by stool examination in institutionalized and non-institutionalized Thai people with mental handicaps. It was found that the prevalence of infection was much higher in institutionalized (57.6%) than in non-institutionalized people (7.5%). The common parasites found in institutionalized people were Trichuris trichiura (29.7%), Entamoeba coli (23.1%), Giardia intestinalis (8.0%), Hymenolepis nana (7.8%), and Entamoeba histolytica/dispar (7.1%). Institutionalized mentally handicapped people should be considered as a high risk group for intestinal parasitic infection and a parasitic control measure should be emphasized.

The Robert Wood Johnson Foundation’s Aligning Forces for Quality program commissioned this special report by the Dartmouth Atlas Project to highlight the uneven quality of health care being delivered across America and the need to improve the quality of care and reduce disparities in health in every community. Aligning Forces for Quality is working to lift the overall quality of health care in targeted communities across America, and provide models for national reform.

ObjectiveTo test the effectiveness of a telephone care management intervention to increase the use of primary and preventive care, reduce hospital admissions, and reduce emergency department visits for Medicaid beneficiaries with disabilities in a managed care setting.Data SourceFour years (2007–2011) of Medicaid claims data on blind and/or disabled beneficiaries, aged 20–64.Study DesignRandomized control trial with an intervention group (n = 3,540) that was enrolled in managed care with telephone care management and a control group (n = 1,524) who remained in fee‐for‐service system without care management services. Multi‐disciplinary care coordination teams provided telephone services to the intervention group to address patients&#39; medical and social needs.Data Collection/ExtractionMedicaid claims and encounter data for all participants were obtained from the state and the managed care organization.Principal FindingsThere was no significant difference in use of primary care, spe...

The “human factor”, i. e. the conflict and protest behavior of students and faculty, often becomes a key problem during and after university consolidations. This paper provides an insight into reorganization-related university transformations that are perceived as tangible and important by students, approaching the issue from the viewpoint of the radical organizational change theory. Four cases of Russian university mergers are investigated. Data btained from individual and group interviews with students who attended the universities during the reorganization is used to build clusters of “formal” and “informal” changes that the students tagged as the most important. It  transpired that students cared most about changes in the perceived value of their graduate diplomas and their potential status as prospective graduates of a particular university. Meanwhile, the content of education programs and the objective university performance indicators were rarely mentioned by students when th...

RESUMO O ingresso na vida acadêmica traz mudanças significativas, ligadas ao modelo de ensino-aprendizagem e à rotina do estudante. O engajamento é considerado o oposto do burnout: ao contrário dos estudantes que sofrem de estresse acadêmico, os alunos engajados se sentem muito conectados às atividades, percebendo-as como um desafio positivo. Esta pesquisa teve como objetivo geral avaliar o escore de engajamento entre estudantes do ensino superior das Ciências da Saúde; e como objetivos específicos, validar o instrumento Utrecht Work Engagement Scale (UWES-S) com estudantes do ensino superior nas Ciências da Saúde; avaliar Vigor, Dedicação e Absorção do constructo engajamento e comparar os escores entre variáveis de duas ou mais categorias para obter o escore de engajamento entre estudantes do ensino superior nas Ciências da Saúde. Método: Estudo observacional analítico transversal, com abordagem quantitativa. Resultados: O UWES-S alcançou validade confirmatoria ao ser aplicado a es...

O objetivo desse estudo foi verificar a qualidade de vida e as condições de saúde de acadêmicos do curso de fisioterapia da Faculdade Santa Maria. A pesquisa foi desenvolvida por meio de uma abordagem quantitativa de cunho analítico-descritivo. O estudo foi composto por 100 estudantes do curso de fisioterapia, a amostra se deu por conveniência e de forma aleatória. Foi utilizado um questionário elaborado pelos pesquisadores, contendo dados sobre o perfil sociodemográfico e condições de saúde. Foi utilizado o questionário Short Form-36 (SF-36) e o Self Report Questionnaire (SQR-20) para avaliação da saúde mental. Observou o predomino de sexo feminino (85%), faixa etária de 18 a 25 anos (81%) e solteiros (89%), não fumantes (95%), que consomem bebidas alcoólicas (50%), realizam atividade física (64%) e apresentando alterações na coluna vertebral (27%). Sobre a qualidade de vida, os domínios que apresentaram maiores percentuais foram os aspectos funcionais com a média de 97,8 e os aspe...

Background Although the burden of influenza is often discussed in the context of historical pandemics and the threat of future pandemics, every year a substantial burden of lower respiratory tract infections (LRTIs) and other respiratory conditions (like chronic obstructive pulmonary disease) are attributable to seasonal influenza. The Global Burden of Disease Study (GBD) 2017 is a systematic scientific effort to quantify the health loss associated with a comprehensive set of diseases and disabilities. In this Article, we focus on LRTIs that can be attributed to influenza. We modelled the LRTI incidence, hospitalisations, and mortality attributable to influenza for every country and selected subnational locations by age and year from 1990 to 2017 as part of GBD 2017. We used a counterfactual approach that first estimated the LRTI incidence, hospitalisations, and mortality and then attributed a fraction of those outcomes to influenza. Influenza LRTI was responsible for an estimated 145 000 (95% uncertainty interval [UI] 99 000-200 000) deaths among all ages in 2017. The influenza LRTI mortality rate was highest among adults older than 70 years (16•4 deaths per 100 000 [95% UI 11•6-21•9]), and the highest rate among all ages was in eastern Europe (5•2 per 100 000 population [95% UI 3•5-7•2] ). We estimated that influenza LRTIs accounted for 9 459 000 (95% UI 3 709 000-22 935 000) hospitalisations due to LRTIs and 81 536 000 hospital days (24 330 000-259 851 000). We estimated that 11•5% (95% UI 10•0-12•9) of LRTI episodes were attributable to influenza, corresponding to 54 481 000 (38 465 000-73 864 000) episodes and 8 172 000 severe episodes (5 000 000-13 296 000). Interpretation This comprehensive assessment of the burden of influenza LRTIs shows the substantial annual effect of influenza on global health. Although preparedness planning will be important for potential pandemics, health loss due to seasonal influenza LRTIs should not be overlooked, and vaccine use should be considered. Efforts to improve influenza prevention measures are needed. Funding Bill & Melinda Gates Foundation.

Penelitian ini membahas pengaruh gaji terhadap kinerja guru di Indonesia, dengan menyoroti keterkaitan antara kompensasi finansial dan motivasi kerja guru. Hasil kajian menunjukkan bahwa gaji yang layak mampu meningkatkan disiplin, tanggung jawab, dan semangat kerja guru. Namun, peningkatan gaji tidak serta-merta menjamin peningkatan kualitas pembelajaran tanpa dukungan sistemik seperti pelatihan, lingkungan kerja yang mendukung, dan kepemimpinan yang efektif. Ketimpangan penggajian, terutama pada guru honorer, menjadi tantangan utama yang dapat menurunkan mutu pendidikan secara keseluruhan. Oleh karena itu, kebijakan penggajian yang adil dan merata perlu dijadikan bagian integral dari strategi reformasi pendidikan nasional demi tercapainya kesejahteraan guru dan peningkatan mutu pendidikan secara berkelanjutan.

Kata kunci: gaji guru, kinerja, motivasi, kebijakan pendidikan, kesejahteraan guru.

Background Although overall cultural differences exist between individuals from the X and Y generations, to our knowledge few previous studies have contrasted their expectations regarding what good doctors are, and their perceptions on the training processes they undergo. Aims To conduct a study exploring perceptions on what good doctors are and their perceptions about training among a sample of Brazilian medical students at the University of Sao Paulo Medical School, comparing groups from 2000 and 2014. We aimed to provide information that can be used to guide curriculum development in medical schools. Methods We conducted a mixed methods study of a series of open questions asked to medical students from the University of São Paulo, Brazil, in 2000 and 2014. This qualitative analysis focused on uncovering emerging themes related to students’ perceptions regarding what good doctors are and how they see their training process. A subsequent quantitative analysis through Natural Langua...

Background Information: The rapid proliferation of healthcare data in sensor-cloud environments has generated apprehensions over privacy and safe access. Conventional approaches fail to ensure strong confidentiality and precise access control while also preserving scalability and efficiency in collaborative healthcare monitoring systems. Objectives: To establish a scalable, privacy-preserving architecture for healthcare monitoring that guarantees secure data exchange, efficient access management, and strong privacy protection utilising Multi-Authority Attribute-Based Encryption (MA-ABE) and Zero-Knowledge Proofs (ZKPs). Methods: The architecture incorporates MA-ABE for precise, multi-authority access regulation and ZKPs for authenticating data integrity while preserving privacy. Experimental evaluations examine scalability, privacy, and computing efficiency. Empirical results: The proposed system exhibited higher security, diminished authentication latency, and improved scalability. It upheld strong data confidentiality and effective real-time performance under fluctuating healthcare workloads.

This study integrates blockchain-assisted cloud storage (BCAS), MD5-based hash-tag authentication, and symbolic attribute-based access control (SABAC) to propose a strong security architecture for cloud data protection. With the help of vulnerabilities and preventive measures, the suggested method improves data availability, confidentiality, and integrity in cloud environments. While BCAS uses blockchain technology for tamper-proof storage and fine-grained access control, the SABAC approach uses facial recognition and cryptographic hashing for secure authentication. With 99.99% confidentiality, 99.95% integrity, and a quick 0.75-second authentication time, the combined approach performs well and offers a robust response to today's cloud security issues.

Komunikasi organisasi yang buruk sering menimbulkan ketidakpuasan dan penurunan kinerja karyawan. Pada studi kasus di divisi marketing PT Victory International Futures, ditemukan bahwa komunikasi antara manajemen dan karyawan tidak berlangsung secara terbuka dan transparan. Keputusan yang diambil sering tidak disertai penjelasan, sehingga karyawan merasa bingung, tidak dihargai, dan tidak memahami peran mereka dengan baik. Kondisi ini memicu ketidakpuasan dan konflik, yang kemudian berdampak negatif pada produktivitas serta efisiensi kerja tim. Untuk mengatasi masalah tersebut, beberapa langkah dapat diterapkan:

Paper ini berisi mengenai tugas mata kuliah Psikologi Industri tentang menentukan sumber masalah, solusi, hasil dan pembahasan mengenai salah satu jurnal yang berjudul "PENGARUH FASILITAS KERJA DAN KESEJAHTERAAN
KERJA TERHADAP KINERJA KARYAWAN" yang ditulis oleh Elisabeth Simanungkalit, Mustika Dewi, dan Bambang Suseno dari Universitas Deli Sumatera Medan

Cognitive Impairment (CI) is a common and distressing problem in Multiple Sclerosis (MS). Its identification is complicated and sometimes omitted in the routine evaluation by neurologists. The BICAMS (Brief International Cognitive Assessment for Multiple Sclerosis) is a promising tool to overcome this difficulty. However, there is some concern regarding the subjectivity in scoring of the BVMT-R (Brief Visuospatial Memory Test - Revised), one of its components. Objective: To evaluate the reliability of the BVMT-R in a sample of Brazilian MS patients, with the measure being administered and scored by neurologists. Methods: BICAMS was applied to seventy subjects comprising forty patients diagnosed with MS and thirty healthy controls. In the MS patients group, the coefficients of agreement between three different raters, using the same protocols, and the internal consistency of the BVMT-R were assessed. Also, the coefficients of correlation of the BVMT-R with the other tests of the BICA...

Population aging has taken place intensively worldwide, even in developing countries. These countries have population groups with low resources and basic unmet needs that are frequently omitted from epidemiological studies. OBJECTIVE: The purpose of this study was to determine the prevalence of cognitive impairment (CI) and dementia in an economic and socially vulnerable population from Argentina. METHODS: A door-to-door observational population-based survey among adults over 60 years of cognitive impairment and dementia in the social vulnerable area of the Matanza Riachuelo Basin, in the suburban area of Buenos Aires, Argentina was conducted. Trained psychologists interviewed subjects and a proxy informant. A standardized protocol including a socio-demographic questionnaire, the Mini-Mental State Examination, the Geriatric Depression Scale and a functional inventory for IADL and ADL was administered. Diagnoses were divided into three general categories: normal cognitive function, c...

This article explores the unique supervisory structure of nursing services at the Philippine General Hospital (PGH), where a model of both separated and integrated lines of authority ensures safe, ethical, and collaborative patient care. It addresses recent misunderstandings regarding reporting protocols and affirms the rationale behind maintaining professional autonomy for nurses through a distinct chain of command. At the same time, it highlights the collaborative roles nurses play within clinical departments. Amid policy shifts such as DBM-DOH Joint Circular No. 2, s. 2023, this article defends PGH’s nursing governance model as essential to preserving nursing leadership, patient safety, and interprofessional synergy.

This position paper and call to action submitted to the offices of the Philippines, DBM Secretary, President of the University of the Philippines, Chancellor of UP Manila, and Director of the Philippine General Hospital, by the All U.P. Workers Union, is a comprehensive and revised adaptation of an earlier paper authored by the undersigned as the National President of the All-UP Workers Union under the same title.

The paper critically examines the implications of DBM-DOH Joint Circular No. 2, s. 2023 on the nursing workforce structure of the Philippine General Hospital (PGH), the country’s National University Hospital. The Circular mandates the tagging of long-established nursing plantilla positions—from Staff Nurse to Chief Nursing Officer—as Co-Terminus with the Incumbent (CTI), framing them as “in excess” and thereby threatening institutional continuity, leadership development, and health system capacity.

Drawing on established legal frameworks such as Republic Act No. 6758 and its provisions for differentiated compensation systems, the paper argues that the application of a uniform staffing model to PGH constitutes a policy misalignment. PGH nurses perform expanded roles in clinical instruction, research, protocol development, and systems leadership—functions that extend beyond standard hospital care. The proposed downgrading undermines professionalization, eliminates senior supervisory pathways, and sets a precedent for nationwide erosion of public-sector nursing leadership.

Empirical and comparative analyses highlight the strategic value of a layered nursing hierarchy to quality care and patient safety. The paper advances a seven-point call to action, including the cancellation of CTI tagging, preservation of current position levels, creation of a clinical career track, and development of a differentiated staffing and compensation framework tailored to PGH’s academic, research, and referral mandates. These reforms are positioned as essential to sustaining institutional viability, upholding public health standards, and strengthening national resilience.

View metadata, citation and similar papers at core.ac.uk provided by University of Saskatchewan's Research Archive guided me throughout all the phases of the thesis. Thesis advice received from members of my advisory committee, including Professors Joseph Garcea, Zaheer Baber and Grant Isaac, are also commendable. My thanks also go to the faculty and support staff of the Department of Sociology, University of Saskatchewan. I am indebted to the Knowledge Utilization and Policy Implementation (KUPI) Project, especially its principal investigator, Dr. Carole Estabrooks for supporting me financially through out my programme. I would also like to extend my appreciation to Mr. Paul Graham of the KUPI Project at the University of Saskatchewan, for the valuable library resources he has made available to me. The academic support from the Centre for Knowledge Transfer is greatly appreciated. Professor Jean-Louis Denis of the Universite de Montreal deserves commendation for serving as the external examiner for my thesis, and passing very constructive comments that uplifted its quality.

Alzheimer&#39;s disease considerably compromises communication skills. Language changes become more prominent as the disease progresses. Deterioration of language and cognition reduces the ability of holding conversations, which has a negative impact on social interaction. To conduct a systematic review of the literature for articles reporting interventions focused on the language and communication of people with Alzheimer&#39;s disease (AD) without use of medication. We performed a search using the keywords Alzheimer&#39;s disease, language, communication, cognition, cognitive intervention, rehabilitation and therapy, and their corresponding Portuguese and Spanish terms, on the SciELO, LILACS, PubMed and PsychINFO databases. We analyzed intervention studies published from 1993 to 2016 that involved stimulation of language skills and/or communication with pre-and post-intervention quantitative results, and whose samples included at least 50% with a diagnosis of probable AD. Studies ...

OBJECTIVE: The aim of this study was to evaluate caregiver burden based on Zarit Burden Interview (ZBI) and depression in caregivers on the Beck Depression Inventory-II (BDI-II). METHODS: Literate individuals, 18 years or older, who spoke Spanish as their native language were included. Demographic characteristics: Age, sex, education, relationship to person with dementia, length of time caregiving, other sources of help for caring, impact on the household economy, family support, and perception of impaired health; and Clinical data on care-recipients: type of dementia, time since diagnosis, treatment, and Global Deterioration Scale (GDS); the ZBI and BDI-II. Descriptive and analytical statistics were employed to assess caregiver burden and predictors of higher burden in caregivers. RESULTS: A total of 92 informal caregivers were evaluated. Regarding care-recipients, 75% were 69 years old or over, 75% had at least one year since diagnosis, 73.9% had Alzheimer&#39;s disease, 84.8% rec...

Objective: To assess the value of cusum analysis in hospital bed management. Design: Comparative analysis of medical patient flows, bed occupancy, and emergency department admission rates and access block over 2 years. Setting: Internal Medicine Services and Emergency Department in a teaching hospital. Interventions: Improvements in bed use and changes in the level of available beds. Main outcome measures: Average length of stay; percentage occupancy of available beds; number of patients waiting more than 8 hours for admission (access block); number of medical patients occupying beds in non-medical wards; and number of elective surgical admissions. Results: Cusum analysis provided a simple means of revealing important trends in patient flows that were not obvious in conventional time-series data. This prompted improvements in bed use that resulted in a decrease of 9500 occupied bed-days over a year. Unfortunately and unexpectedly, after some initial improvement, the levels of access block, medical ward congestion and elective surgical admissions all then deteriorated significantly. This was probably caused by excessive bed closures in response to the initial improvement in bed use. Conclusion: Cusum analysis is a useful technique for the early detection of significant changes in patient flows and bed use, and in determining the appropriate number of MJA 2005; 183: 291-294 beds required for a given rate of patient flow.

Ülkemizde ekonomik büyümenin önemli unsurlarından birisi olan telekomünikasyon sektöründe kullanıcı sayısındaki artış, vergi politikaları açısından sektörün öneminin artmasına neden olmuştur. 2000 yılından sonra farklı vergi kanunları ile yürürlüğe giren birçok düzenleme, telekomünikasyon sektöründe dolaylı vergi yüklerinin ve telekomünikasyon işletmecileri üzerindeki mali yükümlülüklerin artmasına, aynı zamanda mali yükümlülükler ile ilgili uygulamaların daha karmaşık hale gelmesine neden olmuştur. Bu yükümlülükler sektörde faaliyet gösteren işletmecilerin faaliyet türlerine göre de (sabit, mobil, internet, kablo TV vb.) farklılık göstermektedir. Türkiye'de telekomünikasyon sektöründeki vergi yükleri incelendiğinde; telekomünikasyon sektörünün sunduğu hizmetlerin yüksek gelirli kişiler tarafından talep edilen hizmetlermiş gibi değerlendirildiği için, söz konusu hizmetin maliyetinin aşırı vergi yükleriyle karşılandığı görülmektedir. Sektörün talep yapısı incelendiğinde; penetrasyon oranlarındaki artışla birlikte sektörde sunulan hizmetlerin farklı gelir düzeylerindeki kişiler tarafından da yoğun olarak kullanıldığı görülmektedir. Telekomünikasyon sektöründe dolaylı vergi yüklerinin yüksekliği vergilemede adalet, eşitlik gibi temel prensipleri zedeleyen sonuçlar yaratacak niteliktedir. Telekomünikasyon sektöründe yapılacak vergi düzenlemelerinde ana hedefin, sektördeki vergi yüklerini azaltmak ve sabit, mobil, internet ile diğer elektronik haberleşme alt sektörleri arasındaki vergilendirme asimetrisini kaldırmak olmalıdır.

Cognitive impairment is frequent in cerebral palsy (CP) and there is a lack of multiprofessional screening instruments. The aim of this study was to investigate the utility of the Mini-Mental State Examination for Children (MMC), an adapted version of the Mini-Mental State Examination, in screening for cognitive impairments in children with CP. We assessed 397 Brazilian children, 310 with typical development and 87 with CP (hemiplegic and quadriplegic forms), aged 5-16 years. Association between the MMC and general intelligence was assessed by the Colored Progressive Matrices instrument. Psychometric indexes for the MMC were adequate. ROC analyses revealed effective diagnostic accuracy in all ages assessed. Cut-off values are reported. Major difficulties on the MMC were observed in children with CP, particularly individuals with the quadriplegic form. Moreover, the MMC showed moderate correlation with the intelligence test, and was reliable in discriminating, among clinical cases, t...

Background: This study intends to determine the prevalence of obesity among children in the University Primary School, Legon. It also intends to determine relationship between the prevalence of obesity in children and socio-economic status of their parents and the most endemic age group. Method: The study was conducted using 270 students sampled at random in the basic school. Children's height, weight and skin fold measurement were taken. Children's parent's socio-economic status was assessed using close and open-ended questionnaires administered to parents. Data obtained was then analyzed using SPSS software. Results: Prevalence of obesity in the university primary school was found to be 10.9% with higher prevalence in girls (15.0%) than in boys (7.2%) (P-value=0.001). There was higher prevalence among children from high socioeconomic background (21 -23%) with least prevalence in those from low socioeconomic homes (10 -20%) though this was not significant (p-value=0.23). Girls showed a higher body fat composition between 10 -12years, whiles boys showed higher body fat stores between 8 -10 years old. Increasing mother educational level reduced prevalence of child obesity (p-value=0.043) but this was not seen in increasing fathers ' educational level (p-value=0.261). The prevalence of obesity in children in University primary school was very high and worrying. The prevalence increased with socio-economic status and it is more common in females than males. It was recommended that similar study should be expanded nationwide.

The rapid spread of COVID-19 renewed the focus on how health systems across the globe are financed, especially during public health emergencies. Development assistance is an important source of health financing in many low-income countries, yet little is known about how much of this funding was disbursed for COVID-19. We aimed to put development assistance for health for COVID-19 in the context of broader trends in global health financing, and to estimate total health spending from 1995 to 2050 and development assistance for COVID-19 in 2020. We estimated domestic health spending and development assistance for health to generate total health-sector spending estimates for 204 countries and territories. We leveraged data from the WHO Global Health Expenditure Database to produce estimates of domestic health spending. To generate estimates for development assistance for health, we relied on project-level disbursement data from the major international development agencies' online databases and annual financial statements and reports for information on income sources. To adjust our estimates for 2020 to include disbursements related to COVID-19, we extracted project data on commitments and disbursements from a broader set of databases (because not all of the data sources used to estimate the historical series extend to 2020), including the UN Office of Humanitarian Assistance Financial Tracking Service and the International Aid Transparency Initiative. We reported all the historic and future spending estimates in inflation-adjusted 2020 US$, 2020 US$ per capita, purchasing-power parity-adjusted US$ per capita, and as a proportion of gross domestic product. We used various models to generate future health spending to 2050. In 2019, health spending globally reached $8•8 trillion (95% uncertainty interval [UI] 8•7-8•8) or $1132 (1119-1143) per person. Spending on health varied within and across income groups and geographical regions. Of this total, $40•4 billion (0•5%, 95% UI 0•5-0•5) was development assistance for health provided to low-income and middle-income countries, which made up 24•6% (UI 24•0-25•1) of total spending in low-income countries. We estimate that $54•8 billion in development assistance for health was disbursed in 2020. Of this, $13•7 billion was targeted toward the COVID-19 health response. $12•3 billion was newly committed and $1•4 billion was repurposed from existing health projects. $3•1 billion (22•4%) of the funds focused on country-level coordination and $2•4 billion (17•9%) was for supply chain and logistics. Only $714•4 million (7•7%) of COVID-19 development assistance for health went to Latin America, despite this region reporting 34•3% of total recorded COVID-19 deaths in low-income or middle-income countries in 2020. Spending on health is expected to rise to $1519 (1448-1591) per person in 2050, although spending across countries is expected to remain varied. Interpretation Global health spending is expected to continue to grow, but remain unequally distributed between countries. We estimate that development organisations substantially increased the amount of development assistance for health provided in 2020. Continued efforts are needed to raise sufficient resources to mitigate the pandemic for the most vulnerable, and to help curtail the pandemic for all. Funding Bill & Melinda Gates Foundation.