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The First 1000 Days (the period from conception to a child's second birthday) is an important developmental period. However, little is known about experiences of parents with refugee and migrant backgrounds during this period. A systematic review was conducted according to PRISMA guidelines. Publications were identified through searches of the Embase, PsycINFO, PubMed, and Scopus databases, critically appraised, and synthesised using thematic analysis. A total of 35 papers met inclusion criteria. Depressive symptomatology was consistently higher than global averages, however maternal depression conceptualisations differed across studies. Several papers reported changes in relationship dynamics as a result of having a baby post-migration. Consistent relationships were found between social and health support and wellbeing. Conceptualisations of wellbeing may differ among migrant families. Limited understanding of health services and relationships with health providers may impede help-seeking. Several research gaps were identified, particularly in relation to the wellbeing of fathers, and of parents of children over 12 months old. [ABSTRACT FROM AUTHOR]

Objective: The aims of the study were: (1) to clarify the definitions of "migrant" used in occupational health research; (2) to summarize migrant workers' industry sectors, occupations and employment conditions; (3) to identify the occupational health and safety services available to migrant workers; (4) to summarize work-related health problems found among migrant workers; (5) to identify the methodological challenges to research into occupational health of migrant workers; and (6) to recommend improvements in migrant occupational health research. Methods: This position paper was prepared by researchers from several European countries and Australia, working within the EU COST Action OMEGA-NET. The paper drew on two recent systematic reviews on the occupational health of international migrant workers and other literature, and also identified uncertainties and gaps in the research literature. Migrants may, for example, be temporary or permanent, moving for specific jobs migrants or other reasons. Their ethnicity and language capabilities will affect their work opportunities. Results: The occupational health literature seldom adequately identifies the heterogeneity or characteristics of the migrant group being studied. Migrants tend to work in more physically and mentally demanding environments with higher exposures than native workers. Migrants tend to have an increased risk of physical and mental ill health, but less access to health care services. This has been demonstrated recently by high rates of COVID-19 and less access to health care. There have been a number of cross-sectional studies of migrant health but few long-term cohort studies were identified. Other study designs, such as registry-based studies, surveys and qualitative studies may complement cross-sectional studies. Mixed-methodology studies would be valuable in research on migrants' occupational health. Language and lack of trust are barriers to migrant research participation. Conclusion: Targeted research, especially longitudinal, identifying how these economically important but often-vulnerable workers can be best assisted is needed. Researchers should identify the characteristics of the migrant workers that they are studying including visa/migration circumstances (temporary, permanent, undocumented), racial and ethnic characteristics, existing skills and language abilities. [ABSTRACT FROM AUTHOR]

Background: The main aim of emergency medical services (EMS) should be to provide universal emergency medical care which is EMS system available to all those who need it. Most of the developed countries have an integrated EMS system that is accessible by a single dial number in the whole country. Nepal does not have a proper EMS system. We conducted a literature review regarding methods of developing an integrated EMS system in Nepal. Result: The fragmented system, high demand–low supply, inequity with the service, and inadequately trained responders are major problems associated with EMS in Nepal. Nepal too should develop an integrated single dial number EMS system to meet the current demand of EMS. Having a paramedic in ambulances as the first responders will prevent chaos and save critical time. Funding models have to be considered while developing an EMS considering the capital as well as operational cost. Conclusion: Nepal can develop a public private partnership model of EMS where capital cost is provided by the government and operational cost by other methods. Community-based insurance system looks more feasible in a country like Nepal for generating operational cost. [ABSTRACT FROM AUTHOR]

The predominant position in the reproductive rights literature argues that access to assisted reproductive technologies (ART) forms part of an individual's right to reproduce. On this reasoning, refusal of treatment by clinicians (via provision) violates a hopeful parent's reproductive right and discriminates against the infertile. I reject these views and suggest they wrongly contort what reproductive freedom entitles individuals to do and demand of others. I suggest these views find their origin, at least in part, in the way we define "reproduction" itself. This paper critically analyses two widely accepted definitions of human reproduction and demonstrates that both are fundamentally flawed. While the process of reproduction includes the biological acts of begetting and bearing a child, I argue that it does not extend to include rearing. This reworked definition has little impact in the realm of sexual reproduction. However, it has significant ethical implications for the formulation and assignment of reproductive rights and responsibilities in the non-sexual realm in two important ways. First, a claim to access ART where one has an intention to rear a child (but does not beget or bear) cannot be grounded in reproductive rights. Second, lacking an intention to rear does not extinguish the reproductive rights and responsibilities for those who collaborate in the process. I conclude that clinicians collaborate in non-sexual reproduction at the point of triggering conception (begetting) and therefore have the right to refuse to be involved in non-sexual reproduction, in some instances, as do all reproductive collaborators. [ABSTRACT FROM AUTHOR]

The authors discuss the disparity in African American infant mortality and suggest ways to surmount the problem. They believe the causes of the disparity are historical and biopsychosocial; racial and ethnic disparities are found in health outcomes. Eliminating factors that cause high rates of pre-term births (PTB) and low birth weight (LBW) is important as. The authors opine that a multidisciplinary approach would address the various causal factors.

This bibliometric review aims to identify key actors in the behavioral health services availability/accessibility literature. Coalescing information about these actors could support subsequent research efforts to improve the availability and accessibility of behavioral health services. The authors used a scoping review method and a bibliometric approach. The articles came from Medline, Embase, Web of Science, CINAHL, and PsycINFO. Articles were included if they assessed behavioral health service availability or accessibility quantitatively and were written in English. The final sample included 265 articles. Bibliometric data were extracted, coded, and verified. The authors analyzed the data using univariate and social network analyses. Publishing in this area has become more consistent and has grown since 2002. Psychiatric Services and Graduate Theses were the most frequently used publication venues. The National Institute on Drug Abuse, National Institute of Mental Health, and the Veterans Administration funded the most research. The most frequently used keyword was "health services accessibility." The findings suggest that this literature is growing. There are a few clusters of researchers in this area. Government organizations primarily fund this research. The paper and supplementary materials list the top researchers, publication venues, funding sources, and key terms to promote further behavioral health availability/accessibility research. [ABSTRACT FROM AUTHOR]

This paper reviews major structural drivers of place-based health disparities in the context of Canada, an industrialized nation with a strong public health system. Likelihood that the COVID-19 pandemic will facilitate rejuvenation of Canada's northern and remote areas through remote working, advances in online teaching and learning, and the increased use of telemedicine are also examined. The paper concludes by identifying some common themes to address healthcare disparities for northern and remote Canadian residents. [ABSTRACT FROM AUTHOR]

The present systematic review and meta-analysis study aimed to determine sociodemographic characteristics, risky behaviors, mental health disorders, and substance use disorders associated with suicide behaviors including suicidal ideation and suicide attempts among homeless individuals. PubMed, Scopus, Web of Science, and Cochrane Library databases were searched to identify the relevant studies published between January 1, 1995 and November 1, 2022. After initial evaluation of 9,094 papers, a total of 23 studies met the eligibility criteria. Results of the present study showed that chronic physical illnesses, violent behaviors, mood and psychotic disorders, and substance use disorders were significantly associated with both suicidal ideation and suicide attempts, while being older, having a history of physical abuse, and having mood and post-traumatic stress disorders were associated with suicide attempts only. The present study's findings suggest a crucial need for facilitating access to mental healthcare plans and promoting mental healthcare seeking among homeless individuals. [ABSTRACT FROM AUTHOR]

We set out to map the (1) living/occupational hazards, (2) health outcomes, and (3) barriers to care that exist for pregnant labor-trafficked people. Eight databases were systematically searched based on inclusion criteria. Five papers were eligible for inclusion. Data on study characteristics, social determinants, hazardous exposures, health outcomes, and barriers to care were extracted and synthesized. Common risk factors and occupational/living hazards were identified. Both were thematically connected with barriers to care and a host of adverse health outcomes. More importantly, a significant gap was discovered with no disaggregated quantitative data on the experience of pregnancy among labor-trafficked people. The interaction of risk factors, occupational/living hazards, and barriers to care experienced by pregnant labor-trafficked people may influence their susceptibility to adverse health outcomes. We need population-based studies, informed by those with lived experience of labor trafficking to examine the experience of pregnancy for labor-trafficked people to improve intervention and support efforts for this population. [ABSTRACT FROM AUTHOR]

The fourth paper "Feature Dynamic Deep Learning Approach for DDoS Mitigation within the ISP Domain" by Ili Ko, Desmond Chambers, and Enda Barrett, addresses DDoS attacks caused by compromised IoT devices. The paper introduces a stacked self-organizing map (SOM), which is a feature dynamic deep learning approach that utilizes Netflow data collected by the Internet service provider (ISP) to combat the dynamic nature of novel DDoS attacks. By exploring these regularities in IoT-related indicators such as destination port, type of service (ToS), and transmission control protocol (TCP) window size, the activities of attacking hosts associated with well-known classes of malware programs can be discovered. [Extracted from the article]

The editorial independence of biomedical journals allows flexibility to meet a wide range of research interests. However, it also is a barrier for coordination between journals to solve challenging issues such as racial bias in the scientific literature. A standardized tool to screen for racial bias could prevent the publication of racially biased papers. Biomedical journals would maintain editorial autonomy while still allowing comparable data to be collected and analyzed across journals. A racially diverse research team carried out a three-phase study to generate and test a racial bias assessment tool for biomedical research. Phase 1, an in-depth, structured literature search to identify recommendations, found near complete agreement in the literature on addressing race in biomedical research. Phase 2, construction of a framework from those recommendations, provides the major innovation of this paper. The framework includes three dimensions of race: 1) context, 2) tone and terminology, and 3) analysis, which are the basis for the Race Equity Vetting Instrument for Editorial Workflow (REVIEW) tool. Phase 3, pilot testing the assessment tool, showed that the REVIEW tool was effective at flagging multiple concerns in widely criticized articles. This study demonstrates the feasibility of the proposed REVIEW tool to reduce racial bias in research. Next steps include testing this tool on a broader sample of biomedical research to determine how the tool performs on more subtle examples of racial bias. [ABSTRACT FROM AUTHOR]

Efficiently allocating scarce healthcare resources requires nuanced understanding of individual and collective interests as well as relative concerns, which may overlap or conflict. This paper is the first to empirically investigate whether and to what extent self-interest (SI), positional concerns (PC) and distributional considerations (DC) simultaneously explain individual decision making related to access to healthcare services. Our investigation is based on a stated choice experiment conducted in two countries with different healthcare systems, the United States (US) and the United Kingdom (UK). The choice experiment is on allocation of medical treatment waiting times for a hypothetical disease. We carry out the investigation under two different perspectives: (i) in a socially inclusive personal perspective decision makers were asked to choose between waiting time distributions for themselves and (ii) in a social perspective decision makers were asked to make similar choices for a close relative or friend of opposite gender. The results obtained by estimating a variety of advanced choice models indicate that DC, SI and PC, in this order of importance, are significant drivers of choice behaviour in our empirical context. These findings are consistent regardless of the choice perspective and the country where decision makers live. Comparing the results from different choice perspectives, we find that US respondents who chose for their close relative or friend attach significantly larger weight to their close relative's or friend's waiting times as well as to the overall distribution of waiting times than US respondents who chose for themselves. Looking at differences between countries, our results show that UK respondents who made choices for themselves placed significantly larger weight on SI and DC than US respondents, while US respondents, in turn, displayed relatively stronger but not significantly different positional concerns than UK respondents. In addition, we observe that UK respondents who chose for their close relative or friend put a larger weight on DC than their US counterparts. We conclude that the methodological (data collection and analysis) approach allows for disentangling the relative importance of the three motivations and discusses the potential implications of these findings for healthcare decision making. [ABSTRACT FROM AUTHOR]

Despite artificial intelligence (AI) technology progresses at unprecedented rate, our ability to translate these advancements into clinical value and adoption at the bedside remains comparatively limited. This paper reviews the current use of implementation outcomes in randomized controlled trials evaluating AI-based clinical decision support and found limited adoption. To advance trust and clinical adoption of AI, there is a need to bridge the gap between traditional quantitative metrics and implementation outcomes to better grasp the reasons behind the success or failure of AI systems and improve their translation into clinical value. [ABSTRACT FROM AUTHOR]

Purpose: In an effort to address persistent inequities in maternal and infant health, policymakers and advocates have pushed to expand access to doula care. Several states, including California, now cover doula services through Medicaid. As coverage expands, research on the impact of doula care will likely increase. To develop best practices for research, it is critical to engage community doulas, clients, and other key stakeholders. Description: Our overarching goal was to build capacity for future doula- and client-centered research on community doula care. First, we established a Steering Committee with members from seven relevant stakeholder groups: community doulas, former or potential doula clients, clinicians, payers, advocates, researchers, and public health professionals. Second, we conducted a needs assessment to identify and understand stakeholders' needs and values for research on community doula care. Findings from the needs assessment informed our third step, conducting a research prioritization to develop a shared research agenda related to community doula care with the Steering Committee. We adapted the Research Prioritization by Affected Communities protocol to guide this process, which resulted in a final list of 21 priority research questions. Lastly, we offered a training to increase capacity among community doulas to engage in research on community doula care. Assessment: Our findings provide direction for those interested in conducting research on doula care, as well as policymakers and funders. Conclusion: The findings of our stakeholder-engaged process provide a roadmap that will lead to equity-oriented research centering clients, doulas, and their communities. Significance: What is Already Known on this Subject?: Doula care is often cited as a cost-effective intervention to improve maternal and infant health and health care experiences. However, research that focuses on the community-based model of doula care is limited. What this Study Adds?: This paper describes a stakeholder-engaged process that identified important understudied research questions about community doula care. Researchers can further refine these questions to conduct partnered research with multiple stakeholder groups, including community doulas, former or potential doula clients, clinicians, payers, advocates, and public health professionals. Further, this paper outlines best practices for research on community doula care. [ABSTRACT FROM AUTHOR]

Main: Electronic health record (EHR) applications are digital versions of paper-based patient health information. Traditionally, medical records are made on paper. However, nowadays, advances in information and communication technology have made it possible to change medical records from paper to EHR. Therefore, preserving user data privacy is extremely important in healthcare environments. The main challenges are providing ways to make EHR systems increasingly capable of ensuring data privacy and at the same time not compromising the performance and interoperability of these systems. Subject and methods: This systematic mapping study intends to investigate the current research on security and privacy requirements in EHR systems and identify potential research gaps in the literature. The main challenges are providing ways to make EHR systems increasingly capable of ensuring data privacy, and at the same time, not compromising the performance and interoperability of these systems. Our research was carried out in the Scopus database, the largest database of abstracts and citations in the literature with peer review. Results: We have collected 848 articles related to the area. After disambiguation and filtering, we selected 30 articles for analysis. The result of such an analysis provides a comprehensive view of current research. Conclusions: We can highlight some relevant research possibilities. First, we noticed a growing interest in privacy in EHR research in the last 6 years. Second, blockchain has been used in many EHR systems as a solution to achieve data privacy. However, it is a challenge to maintain traceability by recording metadata that can be mapped to private data of the users applying a particular mapping function that can be hosted outside the blockchain. Finally, the lack of a systematic approach between EHR solutions and existing laws or policies leads to better strategies for developing a certification process for EHR systems. [ABSTRACT FROM AUTHOR]

Socioeconomic situations in young people's families and communities make them more vulnerable to suicidal ideations. The Youth Helpline has made a significant difference in youth's lives and livelihoods by addressing their social and economic needs with positive mental health support. The quantitative and qualitative data validate the micro- and macro-level impact of the Youth Helpline in Puducherry. However, the multi-stakeholder model faces challenges in ensuring accountability, particularly from government partners. This paper highlights how direct intervention on the socio-economic determinants of youth suicidal ideation has positively affected youth mental health and reduced suicidal ideation in Puducherry. Social identity-based inequalities and access and affordability to mental health services are the major contributors to youth mental health problems. This paper critically discusses the Youth Helpline's multi-stakeholder process and youth-led approach to addressing socio-economic determinants, as well as the Helpline's impact on youth mental health. [ABSTRACT FROM AUTHOR]

This scoping review provides an overview of cancer interventions implemented with Arab Americans across the cancer control continuum, including an examination of outcomes and implementation processes. The search strategy included database searching and reviewing reference lists and forward citations to identify articles describing interventions with Arab adults living in the US, with no restrictions on date of publication or research methodology. The review included 23 papers describing 12 unique cancer interventions. Most interventions focused on individual-level determinants of breast and cervical cancer screening; used non-quasi-experimental research designs to evaluate intervention effectiveness; and demonstrated improvements in short-term cancer screening knowledge. Implementation processes were less commonly described. Most interventions were culturally and linguistically tailored to communities of focus; were delivered in educational sessions in community settings; engaged with the community mostly for recruitment and implementation; and were funded by foundation grants. Suggestions for research and intervention development are discussed. [ABSTRACT FROM AUTHOR]

Current definitions of migraine that are based mainly on clinical characteristics do not account for other patient's features such as those related to an impaired quality of life, due to loss of social life and productivity, and the differences related to the geographical distribution of the disease and cultural misconceptions which tend to underestimate migraine as a psychosocial rather than neurobiological disorder. Global differences definition, care access, and health equity for headache disorders, especially migraine are reported in this paper from a collaborative group of the editorial board members of the Journal of Headache and Pain. Other components that affect patients with migraine, in addition to the impact promoted by the migraine symptoms such as stigma and social determinants, are also reported. [ABSTRACT FROM AUTHOR]

This review paper describes the development of the pre-hospital system in Singapore from the pre-war days. Every country's prehospital community needs a deep understanding of how they developed over the years, factors that played a part, and the aspirations their community and government have set for this. This can guide future evolution of the services to ensure that care provided is relevant, applicable and in keeping with the community's needs. Countries with similar contextual circumstances, but at a different stage of development of their PECs, may learn from these. [ABSTRACT FROM AUTHOR]

Poor health is one of the fundamental causes behind the suffering and deprivation of human beings. One of the United Nations (UN) Sustainable Development Goals is to enhance the quality of healthcare for everyone, which includes economic coverage, availability of high-quality fundamental health-care services, and access to proper, efficient, high-quality, and affordable important vaccinations and medications. Question-Answering (QA) in the medical domain has recently piqued the interest among the researchers and other stakeholders. Medical QA systems have the potential to enhance access to healthcare services, improve patient interactions with doctors, and reduce medical costs through e-medicine. In this paper, we describe a knowledge enabled QA model, which demonstrates how large-scale medical information in the form of knowledge graphs can aid in extracting more relevant answers. The proposed model employs two scoring methods, viz.Medical Entity Scoring (MES) and Context Relevance Scoring (CRS). MES ranks the medical entities from graphs according to their relevance, while CRS is used to reason over the supporting paragraph using the query vector. The system's knowledge is obtained through the use of two distinct resources, viz. PharmKG is used for pharmaceutical terminology management, whereas Unified Medical Language System UMLS is used for general medical terminology management. Empirical results on the MASH-QA and COVID-QA datasets demonstrate that our proposed approach outperforms existing State-of-the-art in both machine evaluation and human judgment. [ABSTRACT FROM AUTHOR]

South Africa shared with the world the warning of a new strain of SARS-CoV2, Omicron, in November 2021. As a result, many high-income countries (HICs) instituted complete travel bans on persons leaving South Africa and other neighbouring countries. These bans were unnecessary from a scientific standpoint, and they ran counter to the International Health Regulations. In short, South Africa was penalized for sharing data. Data sharing during pandemics is commonly justified by appeals to solidarity. In this paper, we argue that solidarity is, at best, an aspirational ideal to work toward but that it cannot ground an obligation to share data. Instead, low-and-middle income countries (LIMCs) should be guided by the principle of reciprocity, which states that we ought to return good for good received. Reciprocity is necessarily a conditional principle. LMICs, we argue, should only share data during future pandemics on the condition that HICs provide enforceable assurances that the benefits of data sharing will be equitably distributed and that LMICs won't be penalized for sharing information. [ABSTRACT FROM AUTHOR]

Solidarity between more and less vulnerable groups is fundamental to an effective public health response to a global pandemic. Yet in the case of COVID-19, a focus on deciding who can and who cannot be protected from harm has shaped the pandemic experience and continues to determine the post-pandemic trajectory of life with SARS-CoV-2. In this paper I discuss how this has affected our understanding and acceptance of solidarity. [ABSTRACT FROM AUTHOR]

The military lifestyle can be defined by a triad of unique stressors: frequent relocation, parental absence, and risk of injury, illness and/or death of a serving member. Research has suggested that this unique triad of stressors can impact the mental health of children and youth living in military families. However, research focusing on the mental health of children and youth living in military families overwhelmingly focuses on the American context. Due to key contextual differences, it is unclear to what extent the American findings are representative of military-connected children and youth living in other geographical contexts, such as Canada. A large qualitative study was conducted to explore the mental health of military-connected children in Canada from three perspectives: child, parent, and service provider. This paper reports on the service provider findings. Using individual semi-structured interviews, data were collected from 11 service providers. Data analysis was guided by qualitative content analysis. Two main themes emerged: (1) the mental health of children living in military families may be impacted by the military lifestyle stressors, and (2) the mental health of children living in military families can be impacted by the accessibility and availability of mental health services. While this qualitative study builds upon recent Canadian work that has considered the service provider perspective, additional research is needed to better understand the experiences of service providers who support military-connected children and youth. Highlights: American research shows that the military lifestyle factors can impact the mental health of military-connected children. The mental health of military-connected children has yet to be extensively explored in Canada. The mental health of children living in Canadian military families may be impacted by the military lifestyle stressors. The mental health of Canadian military-connected children can be impacted by the accessibility and availability of mental health services. Our findings can help build capacity and knowledge for service providers who support Canadian military-connected children. [ABSTRACT FROM AUTHOR]

Children with complex care needs (CCNs) are in need of improved access to healthcare services, communication, and support from healthcare professionals to ensure high-quality care is delivered to meet their needs. Integrated care is viewed as a key component of care delivery for children with CCNs, as it promotes the integration of healthcare systems to provide family and child-centred care across the entire health spectrum. There are many definitions and frameworks that support integrated care, but there is a lack of conceptual clarity around the term. Furthermore, it is often unclear how integrated care can be delivered to children with CCNs, therefore reinforcing the need for further clarification on how to define integrated care. An evolutionary concept analysis was conducted to clarify how integrated care for children with CCNs is defined within current literature. We found that integrated care for children with CCNs refers to highly specialised individualised care within or across services, that is co-produced by interdisciplinary teams, families, and children, supported by digital health technologies. Conclusion: Given the variation in terms of study design, outcomes, and patient populations this paper highlights the need for further research into methods to measure integrated care. What is Known: • Children with complex care needs require long-term care, and are in need of improved services, communication, and information from healthcare professionals to provide them with the ongoing support they need to manage their condition. • Integrated care is a key component in healthcare delivery for children with complex care needs as it has the potential to improve access to family-centred care across the entire health spectrum. What is New: • Integrated care for children with CCNs refers to highly specialised individualised care within or across services, that is co-produced by interdisciplinary teams, families, and children, supported by digital health technologies. • There is a need for the development of measurement tools to effectively assess integrated care within practice. [ABSTRACT FROM AUTHOR]

Introduction: Atopic dermatitis (AD) is a chronic, pruritic skin disease caused by a mixture of genetic, immunological, and environmental factors, characterized by periods of inflammation and remission. In Latin America (LA), the prevalence of AD ranges up to 25% in children and 1–3% in adults. The natural history of the disease for most patients is that AD goes into remission in adolescence and adult life. Only 10–30% of patients continue to have symptoms of the disease in adulthood. There are patients (3–4%) who have the onset of AD during adolescence or after adulthood. Those with limited access to healthcare services, such as diagnosis and treatment, have increased difficulties coping with AD. Healthcare disparities are a complex topic that include social, political, racial/ethnic, and geographical factors. Publications about healthcare disparities in AD in LA are scarce. As a result, recognizing and resolving healthcare inequalities is critical to improving the treatment and quality of life (QoL) of individuals with AD. Methods: A panel of Latin American experts in dermatology and allergies was provided with a series of relevant questions to address before a multiday conference. During this conference, the entire group discussed and edited each narrative through numerous drafts and rounds of discussion until they reached a consensus. Results: This paper examines the barriers to equal access to care and recommends realistic actions to overcome them. Inadequate disease knowledge, cultural and linguistic barriers, stigmatization, maldistribution of resources, absence of local clinical practice guidelines, arduous patient journey, and limited consultation time were identified as causes of health inequality. Conclusions: Among the suggested solutions are enhanced education for healthcare professionals, patients, and the general public, a focus on underprivileged communities, telemedicine and telementoring, translators, multidisciplinary teams, and local living clinical practice guidelines. [ABSTRACT FROM AUTHOR]

This paper offers an overview of the current status of individuals with autism spectrum disorders (ASD) and developmental disorders (DD) in Oman. A review of demographic and background information about Oman is first presented, followed by an overview of the current status of individuals with autism and developmental disorders, in terms of disability-related legislation, prevalence and diagnosis, as well as treatment and education. In the last section of the paper, major challenges faced in the field are addressed, including lack of autism awareness, lack of healthcare and educational programs or related services, lack of highly qualified professionals to implement evidence-based practices, issues regarding early identification and early intervention, as well as issues pertaining secondary transition, independent living and employment. Corresponding recommendation is proposed at the end of each challenge. [ABSTRACT FROM AUTHOR]

Background: Chile, like many other countries, has seen major health reforms. It is now moving towards universal access using social protection strategies. It is essential at this point to have a clear view of the barriers to and facilitators of healthcare that Chile's population faces. Methods: We used ontological meta-analysis to formalize, standardize, and assess healthcare access in Chile by mapping the 200 research papers written about it. This methodology can be adapted to any other country to analyze its current situation. Results: The results highlight the frequent, infrequent, and absent research themes. Among some of the findings are the importance of improving access to healthcare using physical, virtual, and combined access, based on the resource conditions, type of care, and the adequacy of personnel providing care. Conclusions: This ontology and the analysis set the foundation for future research and establishment of policies in relevant areas where we are currently not paying enough attention. [ABSTRACT FROM AUTHOR]

Access to safe and effective sexual healthcare services for transgender and male sex workers (TMSW) is a human right. Globally, TMSW experience a higher prevalence of human immunodeficiency virus (HIV) and sexually transmitted infections than the general population or other sex workers, suggesting the existence of unique challenges for this group when accessing healthcare. A systematic database search identified 22 qualitative papers addressing barriers to accessing sexual healthcare services for TMSW. These papers were critically evaluated for adherence to best practice standards for qualitative research and research with sex workers. A coding process identified five themes. Stigma was the predominant barrier, and was divided into stigma related to sexuality, gender identity, HIV status, sex worker status, and internalised stigma. Other barriers were confidentiality concerns, sexual health literacy, fatalism, and structural barriers. Each of these themes were informed by the wider context of stigma. The literature presents a complex syndemic of social disadvantage and exclusion acting to produce and reinforce health disparities related to sexual health and access to screening and treatment for TMSW. [ABSTRACT FROM AUTHOR]

Children with medical complexity (CMC) are a high priority population with chronic illnesses dependent on the use of health services, on technological systems to support their vital functions and characterized by multiple health needs. One of the main challenges linked to chronic conditions is finding solutions to monitor CMC at home, avoiding re-hospitalization and the onset of complications. Telemedicine enables to remotely follow up patients and families. An integrative review was performed to assess whether telemedicine improves health outcomes for CMC. Medline/PubMed, CINAHL, Cochrane Library, Web of Science, and Scopus were searched to identify studies describing the effect of using telemedicine systems on health outcomes for CMC. The PRISMA guidelines were used to select the papers. The methodological quality of the studies was evaluated through the Johanna Briggs Institute critical appraisal tools and the Cochrane Collaboration ROB 2.0. A total of 17 papers met the quality criteria and were included. Specialized telemedicine systems (tele-visits), telehealth, and tele-monitoring have been reported to reduce unplanned hospitalizations and visits, decrease total costs for healthcare services and families, and increase satisfaction for family members. No effect was found on the quality of life in children and their families.Conclusion: Available evidence supporting the use of telemedicine in CMC is favorable but limited. High-quality methodological studies including other unexplored health outcomes such as mental health, hospital readmissions, mortality, caregiver competences, and self-efficacy are needed to confirm the effectiveness of telemedicine systems in improving health outcomes for CMC. What is Known: • CMC are an extremely fragile patient population with frequent access to healthcare services compared with other chronic conditions. • There is conflicting evidence of the effectiveness of telemedicine clinical outcomes, healthcare utilization, and costs in pediatrics. What is New: • There is some evidence that for CMC, telemedicine reduces unplanned hospitalizations, healthcare service costs, and financial burden for families, while increasing caregivers' satisfaction with care. • Further research is needed to confirm the effectiveness of telemedicine systems in improving health for CMC. [ABSTRACT FROM AUTHOR]

Immigrant and refugee populations face multiple barriers to accessing mental health services. This scoping review applies the (Levesque et al. in Int J Equity Health 12:18, 2013) Patient-Centred Access to Healthcare model in exploring the potential of increased access through virtual mental healthcare services VMHS for these populations by examining the affordability, availability/accommodation, and appropriateness and acceptability of virtual mental health interventions and assessments. A search in CINAHL, MEDLINE, PSYCINFO, EMBASE, SOCINDEX and SCOPUS following (Arksey and O'Malley in Int J Soc Res Methodol 8:19–32, 2005) guidelines found 44 papers and 41 unique interventions/assessment tools. Accessibility depended on individual (e.g., literacy), program (e.g., computer required) and contextual/social factors (e.g., housing characteristics, internet bandwidth). Participation often required financial and technical support, raising important questions about the generalizability and sustainability of VMHS' accessibility for immigrant and refugee populations. Given limitations in current research (i.e., frequent exclusion of patients with severe mental health issues; limited examination of cultural dimensions; de facto exclusion of those without access to technology), further research appears warranted. [ABSTRACT FROM AUTHOR]

Substance misuse and mental health disorders are commonly occurring co-morbidities in young people. This paper reports on a pilot project to embed three specialist Alcohol and Other Drug (AoD) workers to be embedded in a youth early psychosis service to upskill mental health clinicians in managing substance misuse. Evaluation of the project used a mixed methods approach. Quantitative results showed that clinical staff members' knowledge of substance misuse, knowledge of AoD treatments and services, and overall confidence in working with young people with a substance misuse issue improved following implementation of the project. Qualitative results indicated four themes which emerged: defining the role of the AoD workers; support and upskilling of the mental health staff; openness and effective communication between the embedded workers and mental health teams; and barriers to collaboration. The results provide support for the embedding of specialist alcohol and drug workers in youth mental health services. [ABSTRACT FROM AUTHOR]

The present century faces developmental fallout as vulnerability and risk mount on the global systems due to climate change, urbanisation, and population ageing. Moreover, population ageing is gaining a stronger hold in urban areas, and so are climate change and related shocks and stresses. Consequently, repercussions for the weakest sections of society – including the elderly – remain under academic consideration. In this context, the paper aims to understand the perilous predicament of older people due to the occurrence and interaction between climate change, urbanisation, and population ageing. This review investigates the underpinnings of the nature of the interaction among the three phenomena; and discerns how as a result of the interaction, various climate change related shocks and stresses affect older people in urban settings. It emerges that these three phenomena exhibit: concurrence; a positive trend of growth; and a cyclic pattern of interaction with four linkages, implying (i) rapid urbanisation is fuelling climate change, (ii) climate change is impacting urban areas, (iii) older people are increasing in urban areas, and (iv) urbanisation provides opportunities and barriers for older people. This interplay further discloses that older people stand vulnerable and at heightened risk from climate change related stressors in urban areas. These understandings highlight the need to ensure that urban environments remain age-friendly even in the face of climate change. [ABSTRACT FROM AUTHOR]

Resource coordination in surgical scheduling remains challenging in health care delivery systems. This is especially the case in highly-specialized settings such as coordinating Intraoperative Neurophysiologic Monitoring (IONM) resources. Inefficient coordination yields higher costs, limited access to care, and creates constraints to surgical quality and outcomes. To maximize utilization of IONM resources, optimization-based algorithms are proposed to effectively schedule IONM surgical cases and technologists and evaluate staffing needs. Data with 10 days of case volumes, their surgery durations, and technologist staffing was used to demonstrate method effectiveness. An iterative optimization-based model that determines both optimal surgery and technologist start time (operational scenario 4) was built in an Excel spreadsheet along with Excel's Solver settings. It was compared with current practice (operational scenario 1) and optimization solution on only surgery start time (operational scenario 2) or technologist start time (operational scenario 3). Comparisons are made with respect to technologist overtime and under-utilization time. The results conclude that scenario 4 significantly reduces overtime by 74% and under-utilization time by 86% as well as technologist needs by 10%. For practices that do not have flexibility to alter surgeon preference on surgery start time or IONM technologist staffing levels, both scenarios 2 and 3 also result in substantial reductions in technologist overtime and under-utilization. Moreover, IONM technologist staffing options are discussed to accommodate technologist preferences and set constraints for surgical case scheduling. All optimization-based approaches presented in this paper are able to improve utilization of IONM resources and ultimately improve the coordination and efficiency of highly-specialized resources. [ABSTRACT FROM AUTHOR]

Mental health challenges have been recognized as one of the most prevalent issues impacting children and families within the United States. Children and families of color are disproportionately affected by this due to lack of access to preventative and ongoing supports, and programs that can help address their overall well-being. These issues are even more severe for those that are at risk or interact with the child welfare system. Social workers use various clinical modalities to assess and support them. In the recent years, child welfare agencies have turned to Evidence based programs (EBPs) as a best practice to meet the needs of children and families. The Title IV-E Prevention Services Clearinghouse, established by the Administration of Children and Families is a landmark effort to review and promote such EBP's that prevents foster care placements, including mental health programs. While the Clearinghouse has reviewed 141 programs and services, out of which 71 have been rated as promising, supported, or well-supported, there is a dearth of culturally responsive programs that have met the Clearinghouse criteria. Given the overrepresentation of African American and Native American Families in the child welfare system, and the critical role of the Clearinghouse in reviewing and promoting EBPs, this paper highlights the philosophical, administrative, cultural and logistical barriers for culturally relevant programs to be accepted into the Clearinghouse. It also provides specific recommendations on how the Clearinghouse and researchers can build EBPs that account for the intersection between mental health, social location and cultural identities of the children and families that social workers serve. [ABSTRACT FROM AUTHOR]

Access to social protection in old age is crucial and yet contingent upon negotiations between the social structures of the welfare states and the personal networks within which individuals are embedded. International migration, changing family dynamics, and the transformation of care and other welfare policies in the global North make it challenging for older migrants to negotiate social protection. Drawing on 45 semi-structured interviews with first-generation older Turkish migrants in London and 13 semi-structured interviews with professional service providers for the community, the paper aims to investigate the assemblages of formal and informal social protection in the lives of older migrants. Findings indicate the complexity in accessing informal social protection and the navigation of formal care support in the UK for first generation older Turkish migrants and the contingency of access to formal care services on informal support networks for participants. It has been demonstrated that built infrastructure and policies aimed at older adults have great influence on assemblages of care, highlighting the need for more age-friendly and integrated policies to facilitate access to social protection for diverse groups of older adults. [ABSTRACT FROM AUTHOR]

Introduction: The SAGES Guidelines Committee creates evidence-based clinical practice guidelines. Due to existing health disparities, recommendations made in these guidelines may have different impacts on different populations. The updates to our standard operating procedure described herein will allow us to produce well-designed guidelines that take these disparities into account and potentially reduce health inequities. Methods: This paper outlines updates to the SAGES Guidelines Committee Standard Operating Procedure in order to incorporate issues of heath equity into our guideline development process with the goal of minimizing downstream health disparities. Results: SAGES has developed an evidence-based, standardized approach to consider issues of health equity throughout the guideline development process to allow physicians to better counsel patients and make research recommendations to better address disparities. Conclusion: Societies that promote guidelines within their organization must make an intentional effort to prevent the widening of health disparities as a result of their recommendations. The updates to the Guidelines Committee Standard Operating Procedure will hopefully lead to increased attention to these disparities and provide specific recommendations to reduce them. [ABSTRACT FROM AUTHOR]

Digital health, including telemedicine, has increased access to abortion care. The convenience, flexibility of appointment times, and ensured privacy to abortion users may make abortion services via telemedicine preferable. This scoping review systematically mapped studies conducted on abortion services via telemedicine, including their effectiveness and acceptability for abortion users and providers. All published papers included abortion services via telemedicine in the United States were considered. Articles were searched in PubMed, CINAHL, and Google Scholar databases in September 2022. The findings were synthesized narratively, and the PRISMA-ScR guidelines were used to report this study. Out of 757 retrieved articles, 33 articles were selected based on the inclusion criteria. These studies were published between 2011 and 2022, with 24 published in the last 3 years. The study found that telemedicine increased access to abortion care in the United States, especially for people in remote areas or those worried about stigma from in-person visits. The effectiveness of abortion services via telemedicine was comparable to in-clinic visits, with 6% or fewer abortions requiring surgical intervention. Both care providers and abortion seekers expressed positive perceptions of telemedicine-based abortion services. However, abortion users reported mixed emotions, with some preferring in-person visits. The most common reasons for choosing telemedicine included the distance to the abortion clinic, convenience, privacy, cost, flexibility of appointment times, and state laws imposing waiting periods or restrictive policies. Telemedicine offered a preferable option for abortion seekers and providers. The feasibility of accessing abortion services via telemedicine in low-resource settings needs further investigation. [ABSTRACT FROM AUTHOR]

Hope is essential to mental health recovery, yet little is known about how mental health services can foster hope. This paper addresses the question: How can mental health services influence the sense of hope experienced by people who access their services? Sixty-one people who accessed a new mental health service were interviewed about their experiences, including about how the service had influenced their sense of hope. Interviews were analysed using constant comparative analysis. The data revealed that hope increased when people perceived positive changes in themselves and their circumstances: developing new understandings and perspectives; having effective strategies to manage challenges; seeing progress or having plans; and having support. Changes were attributed to three major features of the service: accessibility; staff competence and wisdom; and caring interactions. The findings highlight that, while individual clinicians are important, other interactions with services and the wider service context are also critical for facilitating hope. [ABSTRACT FROM AUTHOR]

Training deep learning models on medical images heavily depends on experts' expensive and laborious manual labels. In addition, these images, labels, and even models themselves are not widely publicly accessible and suffer from various kinds of bias and imbalances. In this paper, chest X-ray pre-trained model via self-supervised contrastive learning (CheSS) was proposed to learn models with various representations in chest radiographs (CXRs). Our contribution is a publicly accessible pretrained model trained with a 4.8-M CXR dataset using self-supervised learning with a contrastive learning and its validation with various kinds of downstream tasks including classification on the 6-class diseases in internal dataset, diseases classification in CheXpert, bone suppression, and nodule generation. When compared to a scratch model, on the 6-class classification test dataset, we achieved 28.5% increase in accuracy. On the CheXpert dataset, we achieved 1.3% increase in mean area under the receiver operating characteristic curve on the full dataset and 11.4% increase only using 1% data in stress test manner. On bone suppression with perceptual loss, we achieved improvement in peak signal to noise ratio from 34.99 to 37.77, structural similarity index measure from 0.976 to 0.977, and root-square-mean error from 4.410 to 3.301 when compared to ImageNet pretrained model. Finally, on nodule generation, we achieved improvement in Fréchet inception distance from 24.06 to 17.07. Our study showed the decent transferability of CheSS weights. CheSS weights can help researchers overcome data imbalance, data shortage, and inaccessibility of medical image datasets. CheSS weight is available at https://github.com/mi2rl/CheSS. [ABSTRACT FROM AUTHOR]

Qualitative studies on assisted reproductive technology commonly focus on the perspectives of participants living in major metropolises. In doing so, the experiences of those living outside major cities, and the unique way conditions of spatiality shape access to treatment, are elided. In this paper, we examine how location and regionality in Australia impact upon access and experience of reproductive services. We conducted twelve qualitative interviews with participants residing in regional areas across Australia. We asked participants to discuss their experience with assisted reproduction services and the impacts of location on access, service choice, and experience of care, and analysed the data using reflexive thematic analysis, as outlined by Braun and Clarke (2006, 2019). Participants in this study reported that their location impacted the services available to them, required considerable time in travel, and reduced continuity of care. We draw on these responses to examine the ethical implications of uneven distribution of reproductive services in commercial healthcare settings which rely on market-based mechanisms. [ABSTRACT FROM AUTHOR]

Rural, remote, and northern Indigenous communities in Canada frequently face limited access to healthcare services with ongoing physician and staff shortages, inadequate infrastructure, and resource challenges. These healthcare gaps have produced significantly poorer health outcomes for people living in remote communities than those living in southern and urban regions who have timely access to care. Telehealth has played a critical role in bridging long-standing gaps in accessing healthcare services by connecting patients and providers across distance. While the adoption of telehealth in Northern Saskatchewan is growing, its initial implementation faced several barriers related to limited and stretched human and financial resources, infrastructure challenges such as unreliable broadband, and a lack of community involvement and engaged decision-making. Emerging ethical issues during the initial implementation of telehealth in community contexts have been wide ranging including concerns around privacy that have also shaped patients' experiences and particularly the need to consider place and space within rural contexts. Drawing from a qualitative study with four Northern Saskatchewan communities, this paper offers critical perspectives on the resource challenges and place-based considerations that are shaping telehealth in the Saskatchewan context and provides recommendations and lessons learned that could inform other Canadian regions and countries. This work responds to the ethics of tele-healthcare in rural communities in Canada and contributes perspectives of community-based service providers, advisors, and researchers. [ABSTRACT FROM AUTHOR]

This critical essay evaluates the potential integration of distinct kinds of expertise in policymaking, especially during situations of critical emergencies, such as the COVID-19 pandemic. This article relies on two case studies: (i) herd immunity (UK) and (ii) restricted access to ventilators for disabled people (USA). These case studies are discussed as examples of experts' recommendations that have not been widely accepted, though they were made within the boundaries of expert epistemic authority. While the fundamental contribution of biomedical experts in devising public health policies during the COVID-19 pandemic is fully recognized, this paper intends to discuss potential issues and limitations that may arise when adopting a strict expert-based approach. By drawing attention to the interests of minorities (disenfranchized and underrepresented groups), the paper also claims a broader notion of "relevant expertise." This critical essay thus calls for the necessity of wider inclusiveness and representativeness in the process underlying public health policymaking. [ABSTRACT FROM AUTHOR]

Objectives: The South Carolina Pregnancy Assistance Fund (SCPAF) funded four counties to increase the amount, quality, and awareness of services for young parents; increase educational attainment among expectant and parenting youth; reduce the number of repeat teen pregnancies among youth; and improve parenting skills. The purpose of this paper is twofold: (1) to describe our application of the Ripple Effect Mapping (REM) technique as an innovative evaluation strategy to gather perspectives from SCPAF stakeholders and (2) to share key findings generated by participants in REM sessions on the perceived success of local SCPAF community collaboratives. Methods: REM, an innovative evaluation strategy, was used to gather perspectives from SCPAF stakeholders. Five REM sessions were conducted with 52 participants. REM sessions included partner interviews and collective development of visual maps to illustrate stakeholder perspectives of program successes. Visual maps, as well as transcripts of discussions, were analyzed using an inductive approach. Results: Stakeholders reported that the connections to resources, supports, and services provided through SCPAF had the potential to alter the life trajectories of expectant and parenting teens (EPT). Stakeholders also described that SCPAF fostered growth in collaboration among partners and reduced duplication of services in funded communities Conclusions for Practice: This paper describes how an innovative evaluation strategy was used to provide a space for stakeholders to dialogue, synthesize their experiences, and construct a collective narrative of key program successes. This paper also illustrates how such approaches can be applied to complex community initiatives. [ABSTRACT FROM AUTHOR]

Social justice has been identified as a foundational moral commitment for global health research ethics. Yet what a commitment to social justice means for community engagement in such research has not been critically examined. This paper draws on the rich social justice literature from political philosophy to explore the normative question: What should the ethical goals of community engagement be if it is to help connect global health research to social justice? Five ethical goals for community engagement are proposed that promote well-being, agency, and self-development, particularly for those considered disadvantaged and marginalized. The paper also considers how key terms used in the proposed goals should be defined using existing theories of health and social justice. This analysis is done to give global health researchers and their partners a better idea of what the ethical goals mean. Patterns of convergence amongst different theories are identified that support relying on particular definitions of key terms. [ABSTRACT FROM AUTHOR]

Background: Depression is associated with a higher risk for experiencing barriers to care, unmet social needs, and poorer economic and mental health outcomes. Objective: To determine the impact of COVID-19 on ability to access care, social and economic needs, and mental health among Medicare beneficiaries with and without depression. Design and Participants: Cross-sectional study using data from the 2020 Medicare Current Beneficiary Survey COVID-19 Summer Supplement Public Use File. Main Measures: Access to medical care, inability to access food, medications, household supplies, pay rent or mortgage, feelings of economic security, and mental health effects since COVID-19, risk-adjusted for sociodemographic and clinical characteristics. Key Results: Participants were 11,080 Medicare beneficiaries (nationally representative of 55,960,783 beneficiaries), 27.0% with and 73.0% without a self-reported history of depression. As compared to those without a history of depression, Medicare beneficiaries with a self-reported history of depression were more likely to report inability to get care because of COVID-19 (aOR = 1.28, 95% CI, 1.09, 1.51; P = 0.003), to get household supplies such as toilet paper (aOR = 1.32, 95% CI, 1.10, 1.58; P = 0.003), and to pay rent or mortgage (aOR = 1.64, 95% CI, 1.07, 2.52; P = 0.02). Medicare beneficiaries with a self-reported history of depression were more likely to report feeling less financially secure (aOR = 1.43, 95% CI, 1.22, 1.68; P < 0.001), more stressed or anxious (aOR = 1.68, 95% CI, 1.49, 1.90; P < 0.001), more lonely or sad (aOR = 1.97, 95% CI, 1.68, 2.31; P < 0.001), and less socially connected (aOR = 1.27, 95% CI, 1.10, 1.47; P = 0.001). Conclusion: A self-reported history of depression was associated with greater inability to access care, more unmet social needs, and poorer economic and mental health outcomes, suggesting greater risk for adverse health outcomes during COVID-19. [ABSTRACT FROM AUTHOR]

Chile is a country crossed by economic inequalities. The constitutional process has opened a space to problematize the institutions that reproduce these inequalities. This paper joins into this discussion arguing that a nuanced focus on the right of access to healthcare under international law would fit the future Constitution better. I label this focus 'nuanced', in reaction to international law's limited ability to address justice claims located at the core of Chile's social and constitutional discontent. I argue that the right to health under international law is unlikely to address the problem of unequal enjoyment of healthcare services. The paper argues that a better approach would be to integrate a solidaristic understanding to this human right. The added value of solidarity translates in a more substantive conceptualization of social rights where they become at the service of the liberty of all. Through a critical discussion about the inception of the right to health under Chile's current Constitution, the paper shows the limitations of today's understanding and the underlying reasons for the transformation it proposes. [ABSTRACT FROM AUTHOR]

Objectives: With the rapid development and spread of information technology, mobile healthcare (M-healthcare) is emerging as a feasible option for improved monitoring and treatment of patients with chronic diseases such as diabetes, particularly for those with limited access to medical institutions. Our study group has developed and evaluated an M-healthcare system that provides remote guidance for diabetic patients. This paper introduces the diabetic M-healthcare system and describes progress in implementation for remote and mobile healthcare in China. We provide evidence that this system improves diabetic patient management and can contribute to the establishment of a new model for patient-centered mobile healthcare. Target audience: The main groups that this paper is aimed at are doctors, nurses, nutritionists, and sportspersons engaged in the design of mobile medical systems, and computer engineers involved in the construction of intelligent medical software systems. Scope: The present article has as its scope designing the M-healthcare clinical follow-up system, identifying the advantages that the M-healthcare system has in comparison with traditional medical treatment, the clinical application effect of the M-healthcare system, and the development status of remote/mobile medical research in China and abroad. [ABSTRACT FROM AUTHOR]

The Electronic Personal Health Record (EPHR) provides an innovative service for citizens and professionals to manage health data, promoting patient-centred care. It enhances communication between patients and physicians and improves accessibility to documents for remote medical information management. The study aims to assess the prevalence of awareness and acceptance of the EPHR in northern Italy and define determinants and barriers to its implementation. In 2022, a region-wide cross-sectional study was carried out through a paper-based and online survey shared among adult citizens. Univariable and multivariable regression models analysed the association between the outcome variables (knowledge and attitudes toward the EPHR) and selected independent variables. Overall, 1634 people were surveyed, and two-thirds were aware of the EPHR. Among those unaware of the EPHR, a high prevalence of specific socio-demographic groups, such as foreign-born individuals and those with lower educational levels, was highlighted. Multivariable regression models showed a positive association between being aware of the EPHR and educational level, health literacy, and perceived poor health status, whereas age was negatively associated. A higher knowledge of the EPHR was associated with a higher attitude towards the EPHR. The current analysis confirms a lack of awareness regarding the existence of the EPHR, especially among certain disadvantaged demographic groups. This should serve as a driving force for a powerful campaign tailored to specific categories of citizens for enhancing knowledge and usage of the EPHR. Involving professionals in promoting this tool is crucial for helping patients and managing health data. [ABSTRACT FROM AUTHOR]

In the United States, adults from marginalized communities experience disproportionate barriers to healthcare which can have a profound impact on overall health and well-being. This phenomenon is especially true for those within the African American, Latinx, and Native American communities. These barriers include Social Determinants of Health (SDOH) which refer to environmental conditions including economic stability, access to quality education, access to quality healthcare, access to quality housing, and community resources that profoundly impact health. One way to address healthcare barriers is to provide Home-Based Primary Care (HBPC) which brings care to individuals with complex healthcare needs where they are most comfortable. Despite the importance, many HBPC teams do not include social work services. Patients may benefit when these services are offered because social workers are experts in social care and work with adults with complex healthcare needs to address SDOH. In this paper, we discuss RUSH@Home which is one HBPC program where social work plays a critical role in patient care. [ABSTRACT FROM AUTHOR]

Digital health solutions have the potential to complement traditional healthcare approaches and deliver improved health outcomes, but there are system-wide challenges that need to be addressed. These include fragmentation of the digital health landscape, regulatory processes that lack the agility to accommodate the fast pace of digital health advances, and inadequate transparency around data sharing and data governance. All of these challenges have led to mistrust, limited understanding and sharing of best practices, a lack of digital education and awareness, and insufficient patient and public engagement and involvement. In this paper, we argue that for digital health solutions to fulfil their potential, there needs to be a significant increase in early, meaningful, and sustained engagement with the people they intend to benefit. The uptake as well as the impact of digital solutions created in partnership with patients for patients are greater and more relevant to the communities they address. [ABSTRACT FROM AUTHOR]