Search Results (633)

From the corona virus pandemic in Japan that started with the “Diamond Princess” accident, it became clear that rapid detection, a high sensitivity, multiple diagnostic items, one-step one-base point mutation detection, a fast speed of system development, portability (small size and light weight), full automation, random access, and other conditions are required for future point-of-care testing systems. The Eprimer-SmartAmp technology that was developed possesses characteristics fully aligned with these requirements. Building upon this platform, the “GenPad” system was subsequently established. The GenPad system is widely applicable not only to emerging foreign infectious diseases, but also to cancer, lifestyle-related diseases, and other areas of healthcare through telemedicine and intraoperative nucleic acid diagnoses. In collaboration with telecommunication systems, GenPad is expected to contribute to the establishment of a smart medical city with a countermeasure against emerging foreign infectious diseases, where individuals can check their own health conditions in all healthcare areas. Full article

Hospital in the Home (HITH) programs are emerging as a key pillar of smart city healthcare infrastructure, leveraging technology to extend care beyond traditional hospital walls. The global healthcare sector has been conceptualizing the notion of a care without walls hospital, also called HITH, where virtual care takes precedence to address the multifaceted needs of an increasingly aging population grappling with a substantial burden of chronic disease. HITH programs have the potential to significantly reduce hospital bed occupancy, enabling hospitals to better manage the ever-increasing demand for inpatient care. Although many health providers and hospitals have established their own HITH programs, there is a lack of research that provides healthcare executives and HITH program managers with management models and frameworks for such initiatives. There is also a lack of research that provides strategies for improving HITH management in the health sector. To fill this gap, the current study ran a systematic literature review to explore state-of-the-art with regard to this topic. Out of 2631 articles in the pool of this systematic review, 20 articles were deemed to meet the eligibility criteria for the study. After analyzing these studies, nine management models were extracted, which were then categorized into three categories, namely, governance models, general models, and virtual models. Moreover, this study found 23 strategies and categorized them into five groups, namely, referral support, external support, care model support, technical support, and clinical team support. Finally, implications of findings for practitioners are carefully provided. These findings provide healthcare executives and HITH managers with practical frameworks for selecting appropriate management models and implementing evidence-based strategies to optimize program effectiveness, reduce costs, and improve patient outcomes while addressing the growing demand for home-based care. Full article

Background/Objectives: The social importance of health literacy (HL) is widely understood, and its measurement is the subject of various studies. Due to the recent pandemic, several instruments for measuring HL about COVID-19 have been proposed in different countries, including the HLS-COVID-Q22 questionnaire. The diversity of cultures and languages necessitates the cross-cultural adaptation of this instrument. Thus, the present study translates, adapts, and validates the psychometric properties of the HLS-COVID-Q22 questionnaire to provide its cross-cultural adaptation from English to Spanish (Peru). Methods: As part of ensuring that the final questionnaire accommodates the cultural nuances and idiosyncrasies of the target language, the following activities were carried out: (a) a survey of 40 respondents; and (b) a focus group with 10 participants, followed by expert approval. In addition, the validity and reliability of the health instrument have been ascertained through a further pilot test administered to 490 people in the city of Tacna in southern Peru. Results: The resulting questionnaire helps measure HL in Peru, aiding better-informed decision-making for individual health choices. Conclusions: The presence of such a tool is advantageous in case of similar global health emergencies, when the questionnaire can be made readily available to support a promotion of strategies towards better self-care. Moreover, it encourages other Latin American stakeholders to adjust the instrument to their own cultural, language, and socio-economic contexts, thus invigorating the regional and global expansion of the HL study network. Full article

Background: Prostate cancer (PC) is the second leading cause of cancer-related death in men in the United States. A subset of patients develops non-metastatic, castration-resistant PC (nmCRPC), for which management requires a personalized consideration for appropriate treatment. However, there is no consensus regarding when to switch from androgen deprivation therapy (ADT) to more aggressive treatments like abiraterone or enzalutamide. Methods: We analyzed 5037 nmCRPC patients and employed a Weibull Time to Event Recurrent Neural Network to identify patients who would benefit from switching from ADT to abiraterone/enzalutamide. We evaluated this model using differential treatment benefits measured by the Kaplan–Meier estimation and milestone probabilities. Results: The model achieved an area under the curve of 0.738 (standard deviation (SD): 0.057) for patients treated with abiraterone/enzalutamide and 0.693 (SD: 0.02) for patients exclusively treated with ADT at the 2-year milestone. The model recommended 14% of ADT patients switch to abiraterone/enzalutamide. Analysis showed a statistically significant absolute improvement using model-recommended treatments in progression-free survival (PFS) of 0.24 (95% confidence interval (CI): 0.23–0.24) at the 2-year milestone (PFS rate increasing from 0.50 to 0.74) with a hazard ratio of 0.44 (95% CI: 0.39–0.50). Conclusions: Our model successfully identified nmCRPC patients who would benefit from switching to abiraterone/enzalutamide, demonstrating potential outcome improvements. Full article

Chronic pain (CP) markedly impairs quality of life (QoL) and contributes to physical, psychological, and social dysfunction. In Saudi Arabia, limited research exists on CP and its impact on QoL. This cross-sectional questionnaire-based study conducted at King Abdullah Medical City, Makkah, over 3 months aimed to comparatively assess CP severity and the QoL between individuals who attended specialized pain clinics and those who did not. Data were collected from 250 participants by using a five-part questionnaire, including the RAND 36-Item Health Survey 1.0, to assess QoL. Statistical analysis included descriptive statistics and comparative analysis using the Statistical Package for the Social Sciences v22.0, with p-values of <0.05 considered significant. Most of the participants were female (56%), aged > 18 years (94.4%), Saudi nationals (88%), and married (72%). The most frequently reported pain site was the knee (33.6%). The mean scores for QoL domains were low, especially physical functioning (18.5), emotional well-being (38.4), and social functioning (38.8). Pain severity and poor general health were significantly associated with nationality, educational level, and clinic type. In conclusion, CP profoundly diminished QoL, particularly in terms of physical, emotional, and social aspects. Outcomes were influenced by factors such as educational level, employment, nationality, and clinical care settings. Full article

Background/Objectives: There is a need for randomized clinical trials with higher quality, especially for older people at high risk of falls, with interventions that consider individual needs, comprehensiveness of care, and connection with primary health care. We designed a randomized controlled trial to examine the effects of a case management intervention combined with a physical exercise protocol on risk factors for falls, falls data, adherence, satisfaction, costs, and implementation in community-dwelling older adults with high risk of falls. Methods: A minimum of 60 community-dwelling older people with high falls risk will participate in the randomized controlled assessor-blinded trial (MAGIC—v. 2). The trial will be conducted in a regional health department of São Paulo state (Brazil), which includes 6 cities. Participants will be randomized to the Intervention Group (case management intervention based on all individual risk factors for falls identified by a multidimensional assessment, over 16 weeks, once a week, by telephone calls). Both groups will perform a physical exercise protocol based on falls prevention for 16 weeks (twice a week) in Health Units. The assessment will be performed at baseline, after 16 weeks of intervention, after 6-month follow-up, and after 12-month follow-up. Primary outcome measures include falls data and potentially modifiable risk factors for falls. Discussion: This study has the potential to facilitate the future implementation of the intervention based on case management with a focus on fall prevention in the health sectors. Trial registration: Brazilian Registry of Clinical Trials (ReBEC). Full article

Africa’s rapid urbanization often exceeds the capacity of governments to provide essential services and infrastructure, exacerbating structural inequalities and exposing vulnerable populations to serious health risks. This paper examines the case of Douala, Cameroon, to demonstrate that health inequities in African cities are not simply the result of urban growth but are shaped by spatial inequities, historical legacies, and systemic exclusion. Disadvantaged neighborhoods are particularly impacted, becoming epicenters of health crises. Using a mixed-methods approach combining spatial analysis, household surveys and interviews, the study identifies three key findings: (1) Healthcare services in Douala are unevenly distributed and dominated by private providers, which limits access for low-income residents. (2) Inadequate infrastructure and environmental risks in informal settlements lead to a higher disease burden and an overflow of demand into better-equipped districts, which overwhelms public health centers across the city. (3) This structural mismatch fuels widespread reliance on informal and unregulated care practices. This study positions Douala as a microcosm of broader public health challenges in rapidly urbanizing African cities. It highlights the need for integrated urban planning and health system reforms that address spatial inequalities, strengthen public health infrastructure, and prioritize equity—key principles for achieving the third Sustainable Development Goal (ensuring good health and well-being for all residents) in sub-Saharan Africa. Full article

Introduction: Efficient communication and collaboration among local health departments (LHDs), healthcare organizations, governmental entities, and other community stakeholders are critical for public health preparedness and response. This study evaluates (1) the impact of informatics on LHDs’ frequency and collaboration in creating consistent COVID-19 messaging; (2) the influence of informatics on targeted messaging for vulnerable populations; and (3) LHD characteristics linked to their consistent and/or targeted messaging engagement. Methods: This study analyzed the 2020 National Association of County and City Health Officials (NACCHO) Forces of Change (FOC) survey, the COVID-19 Edition. Of the 2390 LHDs invited to complete the core questionnaire, 905 were asked to fill out the module questionnaire as well. The response rate for the core was 24% with 587 responses, while the module received 237 responses, achieving a 26% response rate. Descriptive analyses and six logistic regression models were utilized. Results: Over 80% (183) of LHDs collaborated regularly with public health partners, and 95% (222) used information management applications for COVID-19. Most interacted with local and state agencies, but only half with federal ones. LHDs that exchanged data with local non-health agencies, engaged with local non-health agencies, and communicated weekly to daily with the public about long-term/assisted care had higher odds of creating consistent messages for the public, and about the use and reuse of masks had lower odds of collaborating with public health partners to develop consistent messages for the public. Conclusion: Our findings underscore the centrality of informatics infrastructure and collaboration in ensuring equitable public health messaging. Strengthening public health agencies and investing in targeted training are crucial for effective communication across the communities served by these agencies. Full article

This study aims to explore the walkability of three small areas (basic healthcare areas) of Barcelona city (Catalonia, Spain) for frail older adults. A mixed methods study design was conducted with 132 frail older adults in three primary care centers of Barcelona: Larrard, Barceloneta, and Vila Olímpica. A literature review was conducted to identify urban design indicators related to walkability and the aging population. These were then reflected in the surveys administered to the program participants, capturing information on their preferred routes, usual destinations, and walkability perceptions. Findings reveal significant mobility challenges for older adults, particularly the ones related to safety issues, the adequacy of sidewalk widths, greenery and urban furniture maintenance, and the presence/absence of commercial activities. This research underscores the importance of age-sensitive urban design in healthcare environments and provides a framework for enhancing walkability and accessibility for populations at greater risk of mobility-related health problems, such as frail older adults. Full article

Background/Objectives: Tuberculosis (TB) remains a major public health challenge in Davao City, Philippines, with persistent issues in both disease burden and treatment outcomes. Understanding the risk factors for TB and its unsuccessful treatment is essential for guiding effective interventions. This study aimed to evaluate the association of sociodemographic and clinical factors with TB occurrence and to identify predictors of unsuccessful TB treatment outcomes among patients in Davao City. Methods: A retrospective cohort study was conducted using data from 521 patients diagnosed with drug-susceptible TB at Davao Chest Center between January 2021 and May 2024. The sociodemographic and clinical profiles of the patients were described using descriptive statistics. Chi-square tests were used to assess the associations between sociodemographic and clinical variables with TB risk and treatment outcomes. Results: The patient cohort was predominantly aged 31–50 years (n = 201, 38.58%), male (n = 284, 54.51%), and married (n = 285, 54.70%), with most residing in Districts I and II (n = 98, 38% each), and had no previous TB treatment (n = 344, 66.03%). Among the 456 patients assessed for comorbidities, 56.14% (n = 256) had at least one comorbidity. Evaluation of the risk factors for TB occurrence among the study population revealed that comorbidity status was not significantly associated with an increased risk of TB diagnosis (p = 0.682). However, among patients diagnosed with TB, the presence of comorbidities was significantly associated with unsuccessful treatment outcomes (p = 0.003). Conclusions: Although sociodemographic factors did not significantly influence TB risk or treatment outcomes, the presence of comorbidities was a significant predictor of unsuccessful TB treatment. These findings highlight the importance of integrating comorbidity management with TB care to improve treatment success in high-burden urban settings. Full article

Integrating nature-based solutions into sustainable urban design has become increasingly important in response to rapid urbanization and climate-related environmental challenges. As part of these solutions, green walls not only enhance the thermal and acoustic performance of buildings but also contribute to urban ecosystem health by supporting biodiversity. In this context, the careful selection of plant species is essential to ensure ecological efficiency, resilience, and low maintenance. This study presents a model for selecting plant species suitable for natural green walls in Mediterranean cities, with a focus on habitats protected under Directive 92/43/EEC. The selection followed a multi-phase process applied to the native flora of Italy, using criteria such as chorological type, life form, ecological indicator values, altitudinal range, and habitat type. Alien and invasive species were excluded, favoring only native Mediterranean species adapted to local pedoclimatic conditions and capable of providing ecosystem, esthetic, and functional benefits. The outcome of this rigorous screening led to the identification of a pool of species suitable for green wall systems in Mediterranean urban settings. These selections offer a practical contribution to mitigating the urban heat island effect, improving air quality, and enhancing biodiversity, thus providing a valuable tool for designing more sustainable and climate-adaptive buildings. Full article

Aboriginal and Torres Strait Islander people who inject drugs face persistent health inequities, highlighting the need for programs that meet the needs of these groups. This study explored how intersectional stigma and discrimination affect Aboriginal and Torres Strait Islander people’s access to quality healthcare. Aboriginal and Torres Strait Islander participants aged ≥18 years who had injected drugs within the past 12 months were recruited from two regional needle and syringe programs (NSPs) and a major city NSP in Queensland, Australia. Participants completed a structured survey and yarned with an Aboriginal researcher and non-Indigenous research assistant about their healthcare experiences. Through a process of reflexive and thematic analysis, three major qualitative themes emerged: participants’ social circumstances and mental health challenges made help-seeking difficult and complex; enacted stigma and racism diminished access to health services and the quality of care received; and injecting drug use was associated with disconnection from culture and community. Privileging the expertise and voices of those with lived/living experience is essential for the creation of culturally safe, inclusive, and destigmatising healthcare services for Aboriginal and Torres Strait Islander people who inject drugs. Full article

(1) Background: The Peruvian healthcare system is widely regarded as deficient, with ongoing improvements identified as a key area of need. This study sought to assess user satisfaction and the quality of care in two public hospitals in Trujillo. (2) Methods: A non-experimental, cross-sectional, and correlational study was carried out. A group of 384 people who used two public hospitals in the city of Trujillo was studied. The people in the study were chosen based on the researchers’ convenience sampling. Information was collected using a survey based on the SERVQUAL model. This survey was used to evaluate the quality of service. Descriptive and inferential analyses were performed, including Spearman’s correlation and multinomial logistic regression to assess associations and identify key predictors of perceived service quality. (3) Results: The results indicated that 97.66% of the users perceived a low quality of care and 100% expressed dissatisfaction with the services. The most critical dimensions were reliability and responsiveness, while tangible items obtained better results. A positive correlation (rho = 0.723) was identified between quality of care and user satisfaction, with empathy (rho = 0.559) and safety (rho = 0.543) emerging as the most influential dimensions. (4) Conclusions: Responsiveness and Security were identified as key predictors of the perceived service quality in two public hospitals in Trujillo, Peru. Despite high empathy correlations, only timely care and safety significantly influenced satisfaction. The findings align with SDG 3, calling for improved efficiency and humanized care in public health services. Full article

Objective: This study seeks to analyze the incidence of breastfeeding self-efficacy in postpartum woman who are undergoing prenatal care at the Family Health Strategy Units in the city of Tubarão, Santa Catarina (SC), Southern Brazil, from August to December 2022. Methods: An observational epidemiological study with a cross-sectional design was carried out with puerperal women—either primiparous or multiparous—who were followed in the municipal public network, along with their live-born children delivered at the maternity hospital of Hospital Nossa Senhora da Conceição in Tubarão, SC. Participants agreed to participate in the study. For data collection, an instrument developed by researchers and a validated instrument entitled Breastfeeding Self-Efficacy Scale-Short Form were used to assess the self-efficacy of breastfeeding. Results: The mean score of the Breastfeeding Self-Efficacy Scale (BSES) was 61.75 points (±6.39), indicating high self-efficacy. There was an association between the mean of the general score and/or the domains of the BSES with maternal characteristics. Women with higher education had greater technical mastery (p = 0.010), and those with previous breastfeeding experience and those who breastfed their children during the first hour of life had a higher average in the overall score and in the domains of the scale. In addition, those who planned the pregnancy (p = 0.024) and those who did not receive assistance from the milk bank (p = 0.047) had greater technical domain. Conclusions: In the present study, there was a predominance of high breastfeeding self-efficacy. It was verified that the personal and clinical aspects interfered in the self-efficacy of breastfeeding. Full article

Canada’s national surveillance shows an 11% year-over-year decline in deaths from opioid and other unregulated drug poisonings, and a 10% drop in related hospitalisations in 2024. In stark contrast, Québec, home to more than nine million residents, and Montréal, the country’s second-largest city, experienced a continued rise in suspected drug-poisoning mortality through 2024, with fentanyl or analogues detected in almost two-thirds of opioid deaths. We conducted a narrative synthesis of provincial coroner and public-health surveillance tables, Health Canada dashboards, and the 2022–2025 Québec Strategy on Psychoactive-Substance Overdose Prevention. Results indicate a 40% increase in opioid-related mortality since 2018, a parallel uptick in stimulant toxicity, and a five-fold rise in overdose reversals at Montréal supervised-consumption services during the COVID-19 pandemic recovery. We aim to summarise the key problems underlying this epidemic and offer province-specific public-health strategies while also sending a call to action for first-line clinicians and psychiatrists to integrate overdose-risk screening, take-home naloxone, and stimulant-use-disorder treatments into routine care. We further urge Québec healthcare professionals to deepen their knowledge of provincial services such as supervised-injection sites and stay up to date with the rapidly evolving substance-use-prevention literature. Québec’s divergent trajectory underscores the need for region-tailored harm-reduction investments and stronger policy-to-clinic feedback loops to reduce preventable deaths. Full article