Suchergebnisse

ObjectivesMany studies use a reductionist approach to isolate the influence of one factor in childhood on multimorbidity rather than consider the combined effect of wider determinants. We aimed to explore how potential multiple early-life determinants of multimorbidity can be audited and characterised across three UK cohort studies.
ApproachWe used the 1958 National Child Development Study (NCDS), the 1970 British Cohort Study (BCS70), and the Aberdeen Children of the 1950s Study (ACONF) to identify and categorise early-life variables that fit into 12 previously conceptualised domains of early-life determinants of multimorbidity. A data audit manually assigned variables into the domain they best represented. Principal component analysis (PCA) reduced the dimensionality of the data and structured variables into subgroups. Important PCA components defined as the component that contributed the greatest proportion of the overall variance were identified.
ResultsSeven domains were characterised by 74 variables in ACONF, ten domains by 143 variables in the NCDS, and twelve domains by 289 variables in the BCS70. PCA analysis reduced the dimensionality of ACONF variables from 74 to 41, from 143 to 73 in the NCDS, and from 289 to 149 in the BCS70. Important PCA components included maternal fertility histories, long-term illnesses, educational ability, ethnicity, housing status and parental-child interactions.
Conclusions and ImplicationsConceptualising the risk of future multimorbidity as lifecourse domains composed of multiple factors can help challenge the existing understanding of disease aetiology and inform strategies for the prevention of multimorbidity.

Meningkatnya kemacetan di Kota Malang mendorong dilakukannya penetapan Rencana Sistem Jaringan Jalan untuk mengatasi masalah ini. Dalam hal ini, yaitu wilayah sekitar Jalan Kolonel Sugiono, dimana kondisi wilayah sekitar Jalan Kolonel Sugiono diperparah dengan adanya Terminal Gadang yang berdekatan dengan Pasar Induk Gadang. Tujuan penelitian ini adalah mengetahui dan menjelaskan implementasi kebijakan perpindahan Terminal Gadang ke Terminal Hamid Rusdi di Kota Malang. Jenis penelitian ini adalah deskriptif dengan pendekatan kualitatif. Implementasi kebijakan perpindahan Terminal Gadang ke Terminal Hamid Rusdi dalam penelitian ini difokuskan pada pengaruh kinerja kebijakan yang meliputi: ukuran dan tujuan kebijakan, sumber daya dalam implementasi kebijakan, karakteristik agen pelaksana kebijakan, sikap/kecenderuangan para pelaksana kebijakan, komunikasi antarorganisasi dan aktifitas pelaksana kebijakan, lingkungan ekonomi, sosial dan politik yang mempengaruhi implementasi kebijakan. Hasil penelitian menunjukkan bahwa perpindahan Terminal Gadang ke Terminal Hamid Rusid memiliki kendala dalam sumber daya khususnya sumber daya alat dan manusia yaitu infrastruktur pendukung kelancaran operasi terminal, seperti jalan raya dan koordinasi antar aktor, sehingga solusi dalam masalah implementasi kebijakan ini, yaitupercepatan pembangunan infrastruktur jalan di lingkar timur Kota Malang.

This article analyzes the geopolitical imaginations promoted via environmental
education in the school textbooks of five states in the Middle East and
North Africa (MENA) region. In doing so, it builds bridges between critical studies
of education and political ecology. It shows that, when addressing environmental
problems, the textbooks examined depoliticize environmental problems and
sustain political and economic power structures. They do so by individualizing
responsibility for environmental problems, legitimizing political and economic
elites, associating environmental protection with wider societal goals, and externalizing
environmental problems.

ObjectivesThrough the Multidisciplinary Ecosystem to study Lifecourse Determinants and Prevention of Early-onset Burdensome Multimorbidity (MELD-B) project, we established the SAIL MELD-B e-cohort (SMC) and the SAIL MELD-B Young adults e-cohort (SMYC), with the aim to enhance the understanding of 'burdensomeness' in individuals living with multimorbidity, including identifying new clusters of burdensome indicators, exploring early life risk factors and modelling potential preventative scenarios.
ApproachWe use routinely-collected anonymised linked demographic, health and administrative data sources available within the SAIL Databank to define SMC and SMYC. These cohorts were developed using a reproducible, maintainable, methodological pipeline that allows for dynamic updates as data coverage expands. The pipeline efficiently processes new burdensomeness concepts, facilitating the extraction of relevant records associated with the concepts identified for use in the SMC and SMYC.
ResultsSMC and SMYC comprises of 5,180,602 and 896,155 individuals registered with a Welsh General Practice at any time between 1st January 2000 and 31st December 2022 respectively. Analysis of primary and secondary care health data reveals that the most common conditions in SMC were depression (21.6%), anxiety (21.1%), asthma (17.5%), hypertension (16.2%), and atopic eczema (14.1%). In SMYC, the most common conditions were atopic eczema (21.2%), asthma (11.6%), anxiety (6.0%), deafness (4.6%), and depression (4.3%).
Conclusions and ImplicationsSMC and SMYC provide two generalisable population samples, which can be used to address various research questions across MELD-B. The adaptability of the methodological pipeline allows cohort curation to be repurposed for other projects accessing population-scale data sources and trusted research environments.

Nursing education has a significant function in the development of the workforce in providing healthcare, and it acts as a virtual determinant of the quality of patient care. The changing face of healthcare, students with different demographics, advanced technologies, and specializing rather than generalizing healthcare needs require change in preparing the nurses for practice. This paper aims to review the existing state of nursing education, its problems, students' and professionals' challenges, and the incorporation of best evidence and information technology into the nursing curricula. The review also points to the need to encourage nurse education and professional development to keep nurses competent throughout their working years. By synthesizing the literature reviewed in this paper, it has been possible to offer input on the future of nursing education, clinical practice, and the workforce.

This literature review explores strategies to enhance nursing and pharmaceutical care management, emphasizing their critical roles in healthcare delivery and patient outcomes. The review analyzes recent studies (2016–2024) to identify challenges, best practices, and emerging trends in these fields. Key findings highlight the importance of patient-centered approaches, interdisciplinary collaboration, and the integration of technology, such as telemedicine and AI, in improving care quality and efficiency. Challenges like workforce shortages, training gaps, and resource limitations are examined, alongside solutions for bridging these gaps. The review provides actionable recommendations for healthcare administrators, practitioners, and policymakers to improve care delivery and foster collaboration between nursing and pharmaceutical teams. This work underscores the need for continuous innovation and research to address evolving healthcare demands and enhance patient safety and satisfaction.

The delivery of healthcare in Saudi Arabia has undergone a transformation at some stages, with special emphasis on the use of MDTs in order to improve the safety of patients. In this paper, the author showcases a critical evaluation of the factors associated with patient safety enhancement in Saudi Arabian hospitals through MDTs concerning communication, role definition, and decision-making. Consistent with a mixed-methods approach, the study demonstrates the difficulties these teams encounter and how such difficulties affect safety processes, such as errors and patients' satisfaction. Specific recommendations for enhancing MDT effectiveness are provided to reflect on Saudi Arabia's Vision 2030 goals in healthcare.

Law affects global health in multiple ways, by structuring, perpetuating, and mediating the social determinants of health. 2 Although law has been central to major public health achievements in the past, its capacity to advance global health with justice remains substantially underutilised, particularly among professionals in the fields of health and science. 3 The right to health, a legally binding norm, provides a foundation for advancing global health with justice and should underpin health-related legal reforms. 4 Every human being has a right to affordable, high quality health services. By embedding equity and accountability in all health systems, the law and the rule of law can achieve health coverage that is truly universal—delivering the Sustainable Development Goals' promise to leave no one behind. 5 Although the ability to enforce compliance with international legal obligations is generally limited, and largely dependent on power dynamics and political will, creative mechanisms can foster compliance and help establish impetus for action. 6 Law can address the pressing health concerns of the 21st century, across diverse areas. From tobacco control, non-communicable diseases, and road safety, to health emergencies, law can implement fair, evidence-based interventions to save lives. The global health community should champion evidence-based legal interventions and build the research case for legal action. 7 Laws that stigmatise or discriminate against marginalised populations are especially harmful and exacerbate health disparities. The global health community must oppose laws that undermine the right to health and to equity. 8 To realise the full potential of law to advance global health with justice, the global health community should build legal capacity and establish a sustained dialogue with legislators, regulators, judges, civil society, and researchers.