EMERGENCY TROLLEYS: AVAILABLE AND MAINTAINED, BUT ARE THEIR LOCATIONS KNOWN? – CLOSING THE LOOP

Emergency trolleys are developed and placed in strategic locations to improve the efficiency of the medical teams‘ response to emergencies. In order to close the loop on a previous audit, conducted a year earlier, a second survey was performed to assess the team of Anaesthetists‘ knowledge on the presence and location of those trolleys at the Victoria Ambulatory Care Hospital in Glasgow, Scotland. The results highlighted a considerable deficiency in the knowledge of those trolleys‘ locations, in both surveys. We suggest that similar surveys should be conducted as part of regular audits in all units and should include all staff involved in such emergencies. We also propose new approaches to tackle the problem and help improve the staff knowledge for quick and easy access; thus avoiding delays in critical care management

Interculturalidad y Comunitarismo en la Educación Superior: la experiencia de Bluefields Indian & Caribbean University

The quality of higher education has always been a controversial issue at the time of its discussion, if to this reality we add the integration of interculturalism and communitarianism as essential elements in the formation of the new professional, transcending the traditional technical education through a holistic vision. From this reality, what we know today as community universities with an intercultural approach is born. Nicaragua is not the exception with the presence of the BICU and URACCAN universities, both interesting cases of studying. It is from this experience that this review paper has been prepared in which the origins of this type of universities are addressed, the local, regional, national and international legal base that supports the need not only for its creation but also for its consolidation and expansion. This allows the presentation of an integrating and comprehensive conceptualization of what is a Community and Intercultural University that meets the needs of technical and professional training of its students, teachers and population without neglecting the quality of education that integrates the knowledge and ancestral knowledge of historically marginalized peoples.La calidad de la educación superior siempre ha sido un tema polémico al momento de su discusión; si a esta realidad sumamos la integración de la interculturalidad y comunitarismo como elementos esenciales en la formación del nuevo profesional, la tradicional formación técnica trasciende hacia una visión holística. A partir de esta realidad nace lo que hoy conocemos como universidades comunitarias con enfoque intercultural. Nicaragua no es la excepción, dada la presencia de las universidades BICU y URACCAN, ambos casos interesantes de estudiar. Es a partir de esta experiencia que se ha elaborado este artículo de revisión en el cual se abordan los orígenes de este tipo de universidades, así como la base legal local, regional, nacional e internacional que sostienen la necesidad no solo de su creación sino de su consolidación y expansión. Con ello se posibilita la presentación de una conceptualización integradora y amplia de lo que es una Universidad Comunitaria e Intercultural que atiende las necesidades de formación técnica y profesional de sus estudiantes, docentes y población, sin obviar la calidad de la educación integradora de los saberes y conocimientos ancestrales de los pueblos históricamente marginados

A 72h exploration of the co-evolution of food insecurity and international migration

Food insecurity, defined as the lack of physical or economic access to safe, nutritious and sufficient food, remains one of the main challenges of the 2030 Agenda for Sustainable Development. Food insecurity is a complex phenomenon, resulting from the interplay of environmental, socio-demographic, and political events. Previous work has investigated the nexus between climate change, conflict, migration and food security at the household level, however these relations are still largely unexplored at national scales. In this context, during the Complexity72h workshop, held at the Universidad Carlos III de Madrid in June 2024, we explored the co-evolution of international migration flows and food insecurity at the national scale, accounting for remittances, as well as for changes in the economic, conflict, and climate situation. To this aim, we gathered data from several publicly available sources (Food and Agriculture Organization, World Bank, and UN Department of Economic and Social Affairs) and analyzed the association between food insecurity and migration, migration and remittances, and remittances and food insecurity. We then propose a framework linking together these associations to model the co-evolution of food insecurity and international migrations

Promoting universal financial protection: constraints and enabling factors in scaling-up coverage with social health insurance in Nigeria.

BACKGROUND: The National Health Insurance Scheme (NHIS) in Nigeria was launched in 2005 as part of efforts by the federal government to achieve universal coverage using financial risk protection mechanisms. However, only 4% of the population, and mainly federal government employees, are currently covered by health insurance and this is primarily through the Formal Sector Social Health Insurance Programme (FSSHIP) of the NHIS. This study aimed to understand why different state (sub-national) governments decided whether or not to adopt the FSSHIP for their employees. METHODS: This study used a comparative case study approach. Data were collected through document reviews and 48 in-depth interviews with policy makers, programme managers, health providers, and civil servant leaders. RESULTS: Although the programme's benefits seemed acceptable to state policy makers and the intended beneficiaries (employees), the feasibility of employer contributions, concerns about transparency in the NHIS and the role of states in the FSSHIP, the roles of policy champions such as state governors and resistance by employees to making contributions, all influenced the decision of state governments on adoption. Overall, the power of state governments over state-level health reforms, attributed to the prevailing system of government that allows states to deliberate on certain national-level policies, enhanced by the NHIS legislation that made adoption voluntary, enabled states to adopt or not to adopt the program. CONCLUSIONS: The study demonstrates and supports observations that even when the content of a programme is generally acceptable, context, actor roles, and the wider implications of programme design on actor interests can explain decision on policy adoption. Policy implementers involved in scaling-up the NHIS programme need to consider the prevailing contextual factors, and effectively engage policy champions to overcome known challenges in order to encourage adoption by sub-national governments. Policy makers and implementers in countries scaling-up health insurance coverage should, early enough, develop strategies to overcome political challenges inherent in the path to scaling-up, to avoid delay or stunting of the process. They should also consider the potential pitfalls of reforms that first focus on civil servants, especially when the use of public funds potentially compromises coverage for other citizens

The counseling african americans to control hypertension (caatch) trial: baseline demographic, clinical, psychosocial, and behavioral characteristics

<p>Abstract</p> <p>Background</p> <p>Effectiveness of combined physician and patient-level interventions for blood pressure (BP) control in low-income, hypertensive African Americans with multiple co-morbid conditions remains largely untested in community-based primary care practices. Demographic, clinical, psychosocial, and behavioral characteristics of participants in the Counseling African American to Control Hypertension (CAATCH) Trial are described. CAATCH evaluates the effectiveness of a multi-level, multi-component, evidence-based intervention compared with usual care (UC) in improving BP control among poorly controlled hypertensive African Americans who receive primary care in Community Health Centers (CHCs).</p> <p>Methods</p> <p>Participants included 1,039 hypertensive African Americans receiving care in 30 CHCs in the New York Metropolitan area. Baseline data on participant demographic, clinical (<it>e.g</it>., BP, anti-hypertensive medications), psychosocial (<it>e.g</it>., depression, medication adherence, self-efficacy), and behavioral (<it>e.g</it>., exercise, diet) characteristics were gathered through direct observation, chart review, and interview.</p> <p>Results</p> <p>The sample was primarily female (71.6%), middle-aged (mean age = 56.9 ± 12.1 years), high school educated (62.4%), low-income (72.4% reporting less than $20,000/year income), and received Medicaid (35.9%) or Medicare (12.6%). Mean systolic and diastolic BP were 150.7 ± 16.7 mm Hg and 91.0 ± 10.6 mm Hg, respectively. Participants were prescribed an average of 2.5 ± 1.9 antihypertensive medications; 54.8% were on a diuretic; 33.8% were on a beta blocker; 41.9% were on calcium channel blockers; 64.8% were on angiotensin converting enzyme (ACE) inhibitors/angiotensin receptor blockers (ARBs). One-quarter (25.6%) of the sample had resistant hypertension; one-half (55.7%) reported medication non-adherence. Most (79.7%) reported one or more co-morbid medical conditions. The majority of the patients had a Charlson Co-morbidity score ≥ 2. Diabetes mellitus was common (35.8%), and moderate/severe depression was present in 16% of participants. Participants were sedentary (835.3 ± 1,644.2 Kcal burned per week), obese (59.7%), and had poor global physical health, poor eating habits, high health literacy, and good overall mental health.</p> <p>Conclusions</p> <p>A majority of patients in the CAATCH trial exhibited adverse lifestyle behaviors, and had significant medical and psychosocial barriers to adequate BP control. Trial outcomes will shed light on the effectiveness of evidence-based interventions for BP control when implemented in real-world medical settings that serve high numbers of low-income hypertensive African-Americans with multiple co-morbidity and significant barriers to behavior change.</p