Salir Adelante: Social capital and resilience during the Covid-19 pandemic in Argentina

The Covid-19 pandemic has stimulated new appraisals of how social cohesion, including neighborhood-level social capital, fosters resilience in the face of crisis. Several studies suggest better health outcomes in neighborhoods with higher level of social capital, in general and during the pandemic. Building on a growing body of research which suggests that those who live in close-knit neighborhoods have fared better during the pandemic, this article analyzes how social capital influences individual and collective perceptions and attitudes about the experiences of the Covid-19 pandemic in Tucumán, Argentina. To assess this question, we used a mixed-methods approach, combining focus groups, semi-structured interviews, and an online survey (n = 701 respondents) conducted in September 2021. We find widespread experiences of resilience in response to the Covid-19 pandemic, in spite of difficult socioeconomic conditions and perceived poor government performance. Results from logistic regression analysis indicate that perceptions of high neighborhood social capital are associated with more positive outcomes in many dimensions, including personal resilience, ability to cope with uncertainty, perceptions of community solidarity, and reported compliance with public health measures. We further argue that conceptualizations of social cohesion need to be adjusted to local or national-level cultural norms to accurately capture the experience of countries of the Global South.     

Institutional one health and animal-human health connections in Nthongoni,Eastern Kenya

In recent years, there has been increased global advocacy for the use of a collaborative, multisectoral, and transdisciplinary approach: a One Health approach, with the goal to achieve optimal health outcomes for people, animals and their shared environment. This study explored One Health implementation and practice in Kenya. Further, I used a case study of Nthongoni, a remote rural area in Eastern Kenya, to help us to understand and think about implementation of One Health in an area where mainstream biomedical system runs parallel to or is in conflict with, a deeply entrenched indigenous health system. I used a qualitative research approach including participant observation, and key informant and general respondents' in-depth interviews. Data was transcribed verbatim, translated, checked for consistency and coded for content and thematic analysis. The findings indicate that although Kenya's One Health approach was hailed as a key strategy and a model for other countries in the region, the approach faced significant challenges including insufficient funding, competing priorities and concerns over its sustainability. But while the formal One Health is embroiled in structural and politico-economic influences that curtail its operationalization and success, this study illuminates a lay one health that is part of lived realities in Nthongoni, inviting us to reflect on the place for and status of traditional healers, and meaning of health for people and animals. The study further provokes our thoughts over whether One Health should integrate or do away with traditional health systems, or be abandoned altogether. I argue that incorporating traditional health knowledge and practitioners in One Health might help to make health care more robust and culturally responsive. The work contributes to debates on anthropology of health in general and to anthropological understanding of both the lay one health and the institutional One Health agenda.     

Contributions of the NICHD neonatal research network's generic database to documenting and advancing the outcomes of extremely preterm infants

The Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network (NRN) maintains a database of extremely preterm infants known as the Generic Database (GDB). Begun in 1987, this database now includes more than 91,000 infants, most of whom are extremely preterm (<29 weeks gestation). The GDB has been the backbone of the NRN, providing high quality, prospectively collected data to study the changing epidemiology of extreme prematurity and its outcomes over time. In addition, GDB data have been used to generate hypotheses for prospective studies and to develop new clinical trials by providing information about the numbers and characteristics of available subjects and the expected event rates for conditions and complications to be studied. Since its inception, the GDB has been the basis of more than 200 publications in peer-reviewed journals, many of which have had a significant impact on the field of neonatology.     

Characterizing hospital pathways for the care of acquired hemophilia in France using comprehensive national health data

PurposeAcquired hemophilia (AH) is a rare, serious bleeding disorder most often associated with older age and life-threatening complications. The patient care pathway for AH is complex because of the different types of bleeding, the presence of comorbidities, and the heterogeneity of medical specialists who care for these patients.MethodsThis observational study used the French national PMSI (Programme de médicalisation des systèmes d’information) database to characterize patients with AH in real-life practice and analyze their hospital pathway. In total, 180 patients with AH were identified over a 5-year study period (January 2010 to December 2014), based on three criteria: bypassing agent use, International Classification of Diseases, 10th revision code allocation, and aged over 65 years. Comparison of the incidence rate of AH versus registry data validated the PMSI as an epidemiological database.ResultsRituximab was prescribed more often (60/180; 33.3%) than expected following guidelines and was associated in half of cases to early infections (32/60; 53.3%), surgery procedures were frequently performed during the year before AH onset (29/159; 18.2%), which may suggest a triggering effect, extended hospital stays (median: 20 days) and mortality remaining high (66/180; 36.7%) that occurred mainly during the first month after AH diagnosis. Median costs and number of injections were comparable between recombinant activated factor VII and plasma-derived activated prothrombin complex concentrate.ConclusionThese findings could inform future medico-economic approaches in this AH population (duration of stays, bypassing agents, rituximab use, comorbidities, hospitalizations with infections).     

日本居家安宁疗护服务体系构建经验及其对我国的启示

21世纪的日本"少子高龄化"特征明显，发展居家安宁疗护、构建完备的居家安宁疗护服务体系，是日本卫生服务提供体制改革的重要方向。本文介绍了日本居家安宁疗护的含义与理念，以及关于居家安宁疗护服务提供机构、提供人员、提供内容及费用保障的法律规定，提示我国在条件成熟时应尽快健全安宁疗护相关立法，在卫生服务提供体系框架下实现居家安宁疗护的稳定发展，建立并强化安宁疗护过程中的协作机制，并为居家安宁疗护提供必要的经费保障，通过完善的制度设计保障老年人"居家善终"的权益。     

An assessment of the current practice of community pharmacists for the disposal of medication waste in the United Arab Emirates: A deep analysis at a glance

ObjectiveThe study aimed to identify the current practice carried out by community pharmacists to dispose of expired medications in their workplace and assess any practical steps utilized to reduce medication waste.MethodA cross-sectional study was conducted among community pharmacists in the United Arab Emirates (UAE). The participants were asked about their routine practice in disposing of different expired medications and the current actions taken to reduce the number of disposed medicines.ResultsThe study included (n = 418) community pharmacists. More than a third of expired liquid, solid, and semi-solid dosage forms were collected by licensed contractors. In addition, more than a third of the pharmacists disposed of different dosage forms via unauthorized methods (general garbage, sink and toilet). Most expired drugs were skin and hair products, antibiotics and analgesics. The majority of pharmacists (68.4 %, n = 286) agreed that expired pharmaceutical and non-pharmaceutical products, other than those disposed of via contractor, should be done through a specialized centre. This opinion was found to be strongly associated with years of practice as community pharmacists (P < 0.05).ConclusionPart of the existing disposal practices for expired pharmaceutical products in the UAE is carried out by contractors licensed by health authorities. However, concern remains regarding some pharmaceutical and non-pharmaceutical products that have not been disposed of correctly. Additionally, there is a need for a specialized center for medication disposal (p < 0.05). A stock limitation is the best practice for managing medication quantities in stock (p < 0.05).     

Telehealth: An Effective Model of Care for Renal Cancer Surveillance

The coronavirus disease 2019 pandemic presented challenges for urology patients to receive care in the format of a traditional clinic visit. For renal cancer patients, active surveillance and postintervention surveillance are the standard components of management. Telehealth, which was defined as a televideo encounter via the BlueJeans (Verizon) platform (a telehealth platform), was used to ensure continuity of care. Telehealth using the televideo modality was shown to be an effective model of care delivery to provide an optimal patient experience with ease of use.     

The Nurse Practitioners’ Role in Engaging Health Care Systems in Addressing Climate Change

A recent United Nations (UN) report concluded that the inability to curb fossil fuel emissions from burning coal, oil, and gas has resulted in a short window of time to prevent an abysmal future. The health care industry remains one of the largest contributors to climate change. NPs must not only recognize the clinical presentations resulting from climate change but must also contribute to the efforts presented by the UN report to create a health system that does not contribute to climate change. This article reviews potential ways to decrease the health care sector’s contribution to climate change.