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Entropy and Healthcare in a Pandemic
Published in Lesley Kuhn, Kieran Le Plastrier, Managing Complexity in Healthcare, 2022
Lesley Kuhn, Kieran Le Plastrier
With the healthcare arrangements of a country dynamically entwined with the history of social and government preferences, per capita wealth, population size, along with regional and global relationships, the functioning of healthcare organisations in the midst of a pandemic reflect these multiple local, regional and global interdependencies. This means that mechanisms for preventing, detecting and responding to the outbreak of a pandemic, emerge reciprocally through the governing authorities, society and health-care organisations of a country, in the context of global interconnections.
European national public healthcare systems compared
Published in Linda Hantrais, Marie-Thérèse Letablier, Comparing and Contrasting the Impact of the COVID-19 Pandemic in the European Union, 2020
Linda Hantrais, Marie-Thérèse Letablier
Since hospital care accounts for more than half of expenditure on health, the number of curative care beds in relation to population size provides an indication of the resources available for delivering services to inpatients. The data are, however, not directly comparable because some countries exclude psychiatric and private sector beds (OECD, 2019a, p. 194). Since 2000, the number of beds per capita has been decreasing in most EU member states. By 2016, the largest reduction occurred in Finland, where the fall was over 50%, mainly affecting long-term care beds and psychiatric care beds. Part of the decrease can be attributed to advances in medical technology, allowing more surgery to be performed on a same-day basis, or as part of a broader policy strategy to reduce the number of hospital admissions.
Black and Minority Ethnic Groups
Published in Andrew Stevens, James Raftery, Jonathan Mant, Sue Simpson, Health Care Needs Assessment, 2018
Paramjit S. Gill, Joe Kai, Raj S. Bhopal, Sarah Wild
A common practice over the last 15 years is the combination of Indians, Pakistanis, Bangladeshis, and sometimes Sri Lankans and East Africans too, into one category, ‘South Asians’. As the above tables show, there are similarities and dissimilarities in mortality. Overall, it is probably wise to recognise the substantial heterogeneity in these populations’ health needs, even though the study of the separate groups poses additional challenges of smaller population size, and fewer deaths.
Safety of drugs used for the treatment of migraine during pregnancy: a narrative review
Published in Expert Review of Clinical Pharmacology, 2023
Jessica A Spiteri, Gabrielle Camilleri, Carlo Piccinni, Janet Sultana
Several limitations arise from extrapolating conclusions from most of the studies mentioned in this discussion. Pregnant subjects included in studies are often on these drugs for unspecified or even unrelated indications to migraine; for example, antiseizure drugs used in people with epilepsy. Drugs are often grouped together and any conclusions assumed to be a class effect. Timing of drug exposure to the stage of pregnancy is often not taken into account. Other times, recommendations are based on data extrapolated from nonpregnant counterparts, who have a different physiology to pregnant females, and/or case reports or retrospective observational studies at best as the inclusion of pregnant females in high-quality research trials has been considered unethical because of exposure of the fetus to research related risks. Meta-analysis holds much promise to increase much-needed study power and this has revolutionized the way that research in pregnant women is carried out [158,159]. Another way to improve knowledge in this area is by fostering international collaborations to create large multinational observational datasets. This increases the population size enormously. The ConcePTION project is a current example of such a collaboration on medication safety in pregnancy and breastfeeding (www.imi-conception.eu). EUROCAT is another important example of large-scale international collaboration to facilitate the surveillance of congenital anomalies [160].
Polypharmacy among adult and older adult users of primary care services delivered through the Unified Health System in Minas Gerais, Brazil
Published in Expert Review of Clinical Pharmacology, 2020
Thais Moreira, J Alvares-Teodoro, M. M Barbosa, R.C.R.M Do Nascimento, A. A Guerra Júnior, F. A Acurcio
Multi-stage sampling was used in this study. Cities were selected first (first stage). SUS-PHC services located in selected cities were then selected (second stage). Finally, users of selected SUS-PHC services were selected (third stage). Methods used for sample size calculation and selection of cities and health services have also been published elsewhere [24]. In brief, the selected cities were representative of the total number of those in each category. The total sample (104 cities) was stratified as follows: all cities headquartered in an enlarged health region in the state of Minas Gerais (19) were selected; 50% of the cities headquartered in a health region (totaling 29 cities) were selected by random lottery; and 56 cities among the other municipalities of the State were selected by random lottery, excluding the first two strata. To obtain the sample of the health services, primary health care units were selected according to the National Register of Health Establishments (Cadastro Nacional de Estabelecimentos de Saúde – CNES), totalizing 253 services. The number of services sampled in each city was proportional to the population size.
Serum interleukin-6 levels as an indicator of aseptic meningitis among children with enterovirus 71-induced hand, foot and mouth disease
Published in Postgraduate Medicine, 2018
Joo Young Lee, Minji Son, Jin Han Kang, Ui Yoon Choi
This is the first study suggesting the use of IL-6 as an indicator of aseptic meningitis among children with EV71-induced HFMD. The bedside measurement of IL-6 will facilitate making rapid decision-making regarding whether or not to proceed with a lumbar puncture. However, further studies are required before introducing POCT for the measurement of serum IL-6 levels in the hospital setting. This study had a number of limitations. First, the population sample was small. Further studies involving a greater population size and multiple hospitals are required. Second, this study included healthy children as controls. As IL-6 is produced in response to infection, the use of children with other viral infections and without neurological complications as controls may be more helpful in assessing the power of IL-6 to discriminate between children with or without meningitis among subjects with EV71-induced HFMD and to identify the optimal cutoff value. Third, in this study, the concentrations of IL-6 were measured by multiplexed fluorescent bead-based immunoassays, although the POCT device currently in use is based on lateral flow immunochromatography. Therefore, levels assessed by multiplexed fluorescent bead-based immunoassays and lateral flow immunochromatography should be compared.