Diabetic retinopathy (DR) is a major cause of blindness globally. Effective screening programs are essential to mitigate this burden. This review outlines key principles and practices in implementing DR screening programs, emphasizing the roles of technology, patient education, and healthcare system integration. Our analysis highlights key principles for establishing successful screening initiatives, including the importance of regular screenings, optimal intervals, recommended technologies, and necessary infrastructure. We emphasize the roles of healthcare providers, patients, and policymakers in ensuring the effectiveness of these programs. Our recommendations aim to support the creation of robust policies that mitigate the impact of DR, ultimately improving public health outcomes and reducing the incidence of blindness due to diabetic retinopathy.
Introduction: In Central Europe, in Hungary, the state guarantees access to health care and basic health services partly through the Semmelweis Plan adopted in 2011. The primary objectives of the Semmelweis Plan include the optimisation and transformation of the health care system, starting with the integration of hospitals and the state control of previously municipally owned hospitals. The transformation of the health care system can have an impact on health services and thus on meeting the needs of the population. In addition to reducing health inequalities and costs, the relevant benefits include improving patients’ chances of recovery and increasing patient safety. The speciality under study is decubitus care. Our hypothesis is that integration will improve the chances of recovery for decubitus patients through access to smart dressings to promote patient safety. Objective: to investigate and demonstrate the effectiveness of integration in improving the chances of recovery for decubitus ulcer patients. Material and methods: The research compared two time periods in the municipality of Kalocsa, Bács-Kiskun County, Southern Hungary. We collected the number of decubitus patients arriving and leaving the hospital from the nursing records and compared the pre-integration period when decubitus patients were provided with conventional dressings (01.01.2006–2012.12.31) and the post-integration period, which entailed the introduction of smart dressings in decubitus care (01.01.2013–2012.12.31). The target population of the study was men and women aged 0–99 years who had developed some degree of decubitus. The sample size of the study was 4456. Independent samples t-test, Chow test and linear trend statistics were used to evaluate the results. Based on the empirical evidence, a SWOT analysis was conducted to further examine the effectiveness of integration. Results: The independent samples t-test model used was significant (for Phase I: t (166) = −16.872, p < 0.001; for Phase II: t (166) = −19.928, p < 0.001; for Phase III: t (166) = −19.928, p < 0.001; for Phase III: t (166) = −16.872, p < 0.001). For stage III: t (166) = −10.078, p < 0.001; for stage IV: t (166) = −10.078, p < 0.001; for stage III: t (166) = −10.078, p < 0.001). for stage III: t (166) = −14.066, p < 0.001). For the Chow test, the p-values were highly significant, indicating a structural break. Although the explanatory power of the regression models was variable (R-squared values ranged from 0.007 to 0.617), they generally supported the change in patient dynamics after integration. Both statistical analyses and SWOT analysis supported our hypothesis and showed that integration through access to smart dressings improves patients’ chances of recovery. Conclusions: Although only one segment of the evidence on the effectiveness of hospital integration was examined in this study, integration in the study area had a positive impact on the effective care of patients with decubitus ulcers, reduced inequalities in care and supported patient safety. In the context of the results obtained, these trends may reflect different systemic changes in patient management strategies in addition to efficient allocation of resources and quality of care.
Financial shocks have an incredible socioeconomic effect on both developed and developing countries. Various recent studies demonstrated that bad public governance impacted public health across all nations. In fact, this study aims to use panel data for 21 countries from the Middle East and North Africa (MENA) region over the period 2000–2020 to scrutinize the effect of both governance and financial crises on public health. We use the generalized method of moments (GMM) approach to carry out the empirical analysis. The objective of using this method is to deal with the issue of endogeneity between exogen variables. Results outline that there is a significant positive association between public governance indicators and public health. Moreover, we found a strong negative association between financial shocks and public health. Thus, the direct negative impact of financial crisis on public health could be mitigated by the indirect positive impacts via institutions and good public governance. This study gives insights to policymakers to take appropriate measures to decrease the severity of the financial shocks and improve healthcare services.
This qualitative research aimed to study the effectiveness of the local health constitution in controlling the spread of COVID-19. It reports the role of local communities, government agencies, and healthcare providers in implementing and enforcing local health constitutions and how their engagement can be improved to enhance surveillance. We also reported factors that influence compliance and strategies for improving compliance. We also evaluated the long-term sustainability of local health institutions beyond the pandemic. The population and sample group consisted of key members of the local health constitution teams at the provincial, sub-district, and village levels in the rural area of Ubon Ratchathani. Participants were purposively selected and volunteered to provide information. It included health science professionals, public health volunteers, community leaders, and local government officials, totaling 157 individuals. The study was conducted from December 2022 to September 2023. Our research shows that local health constitutions can better engage and educate communities to actively participate in pandemic surveillance and prevention. This approach is a learning experience for responding to emergencies, such as new infectious diseases that may arise in the future. This simplifies the work of officials, as everyone understands the guidelines for action. Relevant organizations contribute to disease prevention efforts, and there is sustainable improvement in work operations.
The COVID-19 outbreak on international cruise ships during the early stages of the pandemic has exposed deficiencies in the governance of public health emergencies within the framework of existing international law. These deficiencies encompass various aspects, including the shortcomings of the system of flag state jurisdiction, the vague definition and reasonableness of governments’ “additional health measures” as stipulated in the International Health Regulations (IHR) of 2005, the role of World Health Organization (WHO) in the protection of the fundamental rights of passengers and crew members during epidemic outbreaks on cruise ships, the application of the free pratique rule under the international health law, and other challenges that have not been adequately addressed in current international law. In the post-COVID era, it is essential to revisit these core issues of international law and reassess the allocation of responsibilities among all evolving actors to foster effective multilateral cooperation in epidemic control. This paper adopts the “Diamond Princess” incident as a case study, examining how such public health emergencies pose challenges to international laws, particularly when they occur within the context of a cruise ship. The paper argues that cooperation on global health emergencies will continue to be a challenge until responsibility is more clearly allocated among stakeholders. Additionally, the paper formulates three principles for enhancing governmental cooperation, namely the fairness principle, the nationality principle, and the principle of common but differentiated responsibilities. It is advisable to carefully consider these key principles when reevaluating the international laws on public health emergencies in the post-COVID era.
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