A unique case of bradycardia recognized by wearable technology as first presentation of complete heart block

Wearable technology has advanced significantly, and the proposed health benefits have been widely touted. Most of the discussion has been surrounding the identification and diagnosis of asymptomatic atrial fibrillation. However, the heart monitoring functions of the wearable technology can also identify other abnormalities as well. We present the first case of wearable technology identified bradycardia diagnosed as the primary presentation of complete heart block. Wearable technology has advanced significantly, but still poses questions regarding its use in screening for rare conditions. One remaining challenge is balancing the desire to screen for rare asymptomatic conditions without overburdening emergency departments with patients responding to alarms on their devices.     

Higher levels of greenness and biodiversity associate with greater subjective wellbeing in adults living in Melbourne,Australia

Natural environments may be important for subjective wellbeing, yet evidence is sparse and measures of nature are unspecific. We used linear regression models to investigate the relationship between greenness, biodiversity and blue space and subjective wellbeing in 4,912 adults living in metropolitan Melbourne, Australia. Greenness (overall, private and public) and biodiversity associated with subjective wellbeing. In particular, we highlight the importance of the private greenness-subjective wellbeing association. Our work has implications for urban policy and planning in the context of increased urban densification.     

Parent perspectives on childhood vaccination: How to deal with vaccine hesitancy and refusal?

Background

The aims of the study are to evaluate attitudes about childhood vaccines and vaccine refusal or delay among parents and to assess the role played by the variables mapped as potential determinants to suggest strategies that could improve childhood vaccination rates.

A perception-based study to explore COVID-19 pandemic stress and its factors in Bangladesh

Background and aimsWorldwide the COVID-19 pandemic has accelerated sufferings of mental health and behaviour attitudes of people. Many countries, including Bangladesh, reported suicide as extreme consequences of the psychological burden influenced by COVID-19. The present study explores human stress and its factor influenced by COVID-19 in Bangladesh, which significantly affect the quality of life.MethodsAn online-based questionnaire survey was conducted among 651 adult Bangladeshi populations by capturing socio-demographic information, possible human stress, and consequences of the pandemic. A set of statistical tools such as Pearson's Correlation Matrix (PCM), T-test, Principal Component Analysis (PCA) and Hierarchical Cluster Analysis (HCA) were applied to identify the relationship between different factors and influential factors increasing human stress.ResultsMore than 83% of the participants are facing COVID-19 related mental stress, which results in short temper, sleep disorder, and family chaos. PCA and HCA outcomes indicated a significant relationship between the respondents' opinions and human stress factors, which harmonized with the country's existing scenario. PCM results enlighten the relationship between human stress factors and found financial hardship, cutting back daily spending, and food crisis are interconnected together causes stress. Also, hampering students' formal education and future career plans significantly contribute to mental stress.ConclusionBased on the above findings, it's crucial to introduce a time-oriented strategy and implement precaution monitoring plans for Bangladesh. The rescue plan will help people to manage the pandemic and improve mental health to fight against psychological challenges related to COVID-19 and future pandemics.     

Pro-equity immunization and health systems strengthening strategies in select Gavi-supported countries

BackgroundAchieving universal immunization coverage and reaching every child with life-saving vaccines will require the implementation of pro-equity immunization strategies, especially in poorer countries. Gavi-supported countries continue to implement and report strategies that aim to address implementation challenges and improve equity. This paper summarizes the first mapping of these strategies from country reports.MethodsThirteen Gavi-supported countries were purposively selected with emphasis on Gavi’s priority countries. Following a scoping of different documents submitted to Gavi by countries, 47 Gavi Joint Appraisals (JAs) for the period 2016–2019 from the 13 selected countries were included in the mapping. We used a consolidated framework synthesized from 16 different equity and health systems frameworks, which incorporated UNICEF’s coverage and equity assessment approach – an adaptation of the Tanahashi model. Using search terms, the mapping was conducted using a combination of manual search and the MAXQDA qualitative analysis tool. Pro-equity strategies meeting the inclusion criteria were identified and compiled in an Excel database, and then populated on a tableau visualization dashboard.ResultsIn total, 258 pro-equity strategies were implemented by the 13 sampled Gavi-supported countries between 2016 and 2019. The framework determinants of social norms, utilization, and management and coordination accounted for more than three-quarters of all pro-equity strategies implemented in these countries. The median number of strategies reported per country was 17. Afghanistan, Nigeria, and Uganda reported the highest number of strategies that we considered as pro-equity.ConclusionFindings from this mapping can be useful in addressing equity gaps, reaching partially immunized, and ‘zero-dose’ vaccinated children, and valuable resource for countries planning to implement pro-equity strategies, especially as immunization stakeholders reimagine immunization delivery in light of COVID-19, and as Gavi finalizes its fifth organizational strategy. Future efforts should seek to identify pro-equity strategies being implemented across additional countries, and to assess the extent to which these strategies have improved immunization coverage and equity.     

Children’s right to smoke-free air: Public support in Norway for banning smoking in vehicles with children present

Background

Children have a statutory right to a smoke-free environment, and tobacco control advocates are now considering regulation of smoking behavior in the private sphere. The Norwegian Institute of Public Health has investigated the support for a ban on smoking in cars with children compared to other possible extensions of the tobacco act among the Norwegian public.

以目标管理为核心的公立医院绩效考核制度建设

我国医改政策对医院绩效考核制度提出了新的要求,某医院以目标管理为核心,在分析自身管理需求的基础上设置整体目标,遴选核心指标将其分解到科室和个人层面,并开展绩效考核和绩效分配工作。客观分析了该院绩效考核取得的成绩,并阐述了对将目标管理应用于绩效考核工作的体会和思考,旨在为公立医院绩效考核制度建设及持续改进提供参考。     

基于新政府会计制度探究公立医院财务精细化管理

随着社会的高速发展,政府会计制度不断革新,医院是医疗卫生行业的重要构成部分,应当不断适应社会的发展而改革。基于此,该文以公立医院的财务管理作为分析目标,对公立医院财务管理中已有的问题和未来改善措施进行分析探讨,从而为以后的发展提供意见。     

我国公立医院成本效率研究进展(2014—2018年)

应用内容分析法对医疗成本效率测量方法进行梳理,采用关键词共现和聚类分析法探讨2014—2018年共五年来我国医院成本效率的研究热点和重点领域。结果表明,2014—2018年国内关于医院效率的研究创新性相对不足,主要表现在效率概念混淆和边界不清、研究方法相对单一、研究内容局限、研究对象样本量有限、研究成果指导意义不足等方面。最后提出了加强我国医院效率研究的具体建议。