Addressing Planetary Health through the Blockchain—Hype or Hope? A Scoping Review

Planetary health is an emergent transdisciplinary field, focused on understanding and addressing the interactions of climate change and human health, which offers interventional challenges given its complexity. While various articles have assessed the use of blockchain (web3) technologies in health, little consideration has been given to the potential use of web3 for addressing planetary health. A scoping review to explore the intersection of web3 and planetary health was conducted. Seven databases (Ovid Medline, Global Health, Web of Science, Scopus, Geobase, ACM Digital Library, and IEEE Xplore) were searched for peer-reviewed literature using key terms relating to planetary health and blockchain. Findings were reported narratively. A total of 3245 articles were identified and screened, with 23 articles included in the final review. The health focus of the articles included pandemics and disease outbreaks, the health of vulnerable groups, population health, health financing, research and medicines use, environmental health, and the negative impacts of blockchain mining on human health. All articles included the use of blockchain technology, with others additionally incorporating smart contracts, the Internet of Things, artificial intelligence and machine learning. The application of web3 to planetary health can be broadly categorised across data, financing, identity, medicines and devices, and research. Shared values that emerged include equity, decentralisation, transparency and trust, and managing complexity. Web3 has the potential to facilitate approaches towards planetary health, with the use of tools and applications that are underpinned by shared values. Further research, particularly primary research into blockchain for public goods and planetary health, will allow this hypothesis to be better tested

Analysis: Voices from the movement: What can the Trade Union Act (2016) tell us about trade union organising?

yesIntroduction It is easy to think of the Trade Union Act (2016) as ‘Thatcher Round 2’: the economic strategy of austerity once again pits the haves against the have-nots, creating the potential for a re-invigorated trade union movement to return to its economically disruptive habits, which the government seeks to constrict. Thus, TUC General Secretary Frances O’Grady condemned the Conservatives for ‘refighting the battles of the 1980s’ instead of taking a more constructive approach (O’Grady, 2016). However, while the trade union legislation of the 1980s followed a decade marked by entrenched union disputes, the Trade Union Act (2016) has been introduced against a very different backdrop. The UK currently has historically low levels of industrial action, stagnating levels of union membership and limited areas of union density (DBIS, 2015; Godard, 2011; Dix et al, 2008). Could it be that the Trade Union Act (TUA) has more to tell us about trade union weakness than their strength? The Act comes at an important moment in the history of the labour move- ment. The Conservative austerity agenda not only attacks living standards, but reduces union membership through extensive job losses. The significance of this for the movement is exacerbated because the public sector is the most heavily unionised sector. This matters for many reasons, not least because the movement’s ability to resist the worst excesses of the austerity agenda rests on its membership and strength. This situation in turn shines a spotlight on what is perhaps the most pressing question facing the movement – the need for a model of unionism which can reach beyond the public sector, and in particular which meets the needs of the ever-growing body of precarious workers

Effect of early glycemic control on HbA1c tracking and development of vascular complications after 5 years of childhood onset type 1 diabetes: Systematic review and meta-analysis.

OBJECTIVE: A systematic review and meta-analysis was conducted to investigate if glycemic control measured by glycated hemoglobin (HbA1c) levels near diagnosis are predictive of future glycemic outcomes and vascular complications in childhood onset type 1 diabetes (T1D). METHODS: Evidence was gathered using electronic databases (MEDLINE, EMBASE, Web of Science, CINAHL, Scopus, and Cochrane Library up to February 2017) and snowballing techniques. Studies investigating the association between the exposure "early glycemic control" and main outcome: "tracking of early control" and secondary outcome: risk of future complications; in children and young people aged 0 to 19 years at baseline; were systematically double-reviewed, quality assessed, and outcome data extracted for synthesis and meta-analysis. FINDINGS: Five studies (N = 4227 participants) were eligible. HbA1c levels were sub-optimal throughout the study period but tended to stabilize in a "track" by 6 months after T1D diagnosis. The group with low HbA1c <53 mmol/mol (<7%) at baseline had lower long-term HbA1c levels than the higher HbA1c group. The estimated standardized mean difference between the sub groups showed a reduction of HbA1c levels on average by 1.6% (range -0.95% to -2.28%) from baseline. Only one study investigated the association between early glycemic control and development of vascular complications in childhood onset T1D. INTERPRETATIONS: Glycemic control after the first few months of childhood onset T1D, remains stable but sub-optimal for a decade. The low and high HbA1c levels at baseline seem to "track" in their respective tracks during the 10-year follow-up, however, the initial difference between groups narrows over time. PROSPERO: CRD42015024546 http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42015024546

When a Dream Becomes a Nightmare: Why do Indigenous australian Medical Students Withdraw from Their Courses?

Abstract This paper investigates reasons Indigenous Australian medical students gave for leaving their courses prior to graduation. Indigenous students who had withdrawn or deferred from their medical courses were asked about the barriers and disincentives that had dissuaded them from graduating. Although the response rate to the questionnaire was very low, it opened up a way of looking at the particular experiences of Indigenous students. Of the 12 responses, the most prominent reason given for withdrawing was financial. Most were satisfied with enrolment processes but a number were disappointed with their courses and with teaching methods. More support from the university was the only encouragement that would have persuaded most respondents to continue. This paper explores the reasons for the high rate of withdrawal of Indigenous medical students and concludes by suggesting ways in which secondary schools, universities and their medical schools could respond to the recruitment and retention of Indigenous medical students

Use of Patient-Reported Experience Measures (PREMs) and Patient-Reported Outcome Measures (PROMs) in Routine Hospital Care of Children and Young People: A Scoping Literature Review

Background: Patient-reported outcome measures (PROMs) are questionnaires measuring patients’ views of their health status; patient-reported experience measures (PREMs) are questionnaires measuring patients’ perceptions of their experience whilst receiving healthcare. Little is known about the routine use of PREMs and PROMs to improve experience and outcomes in paediatric clinical settings. Methods: The Joanna Briggs Institute review process was used to map studies that addressed how PREMs/PROMs are used to assess experiences and outcomes of children’s and young people’s (CYP) care and treatment in hospital and what the barriers and facilitators are to using PREMs/PROMs in routine hospital care. Key search terms were developed and seven data bases and sources of grey literature searched. Results: Abstracts of 24020 sources were screened; 269 were eligible for full-text review and 108 met criteria for inclusion. Ninety-four sources included data on PROM use only; 7 included data on PREM use only and 7 included both PROM and PREM use. Seventy-nine studies (78%) were undertaken in one of three countries (USA, UK and Netherlands) with 12 further countries undertaking 1-8 studies each. A diverse range of specialties (n=29) was included, with PROM and/or PREM use described in mental health and oncology most frequently. Participants included CYP, parent-proxies and health professionals with participant numbers ranging from 1-18687. Barriers to PROM/PREM use included time constraints, limited access to resources and perceived unhelpfulness. Studies reported facilitators as ease of use, perceived helpfulness to inform care and patient/parent perceptions of the importance of the opportunity to report on their experiences and outcomes. Conclusion: PROMs and PREMs data mayhave the potential to improve patient experiences and outcomes in routine clinical practice by improving the quality of care but their use is infrequently reported. Better reporting of their use and how findings are used to inform routine care is now required

Involvement of families in the design of hospital spaces for children and young people: A scoping review protocol

The objective of this scoping review is to explore the research conducted on the involvement of families in the design of hospital spaces, how their involvement promotes better healthcare design, and identify examples from the internal and external environment of a new design that has been directly shaped by this input. Findings will inform work underway on the development of a new cancer centre for children and young people

Access to and experience of education for children and adolescents with cancer: a scoping review protocol

Abstract Background Cancer diagnosis in childhood or adolescence impacts significantly on school attendance, experience and educational outcomes. While there is longstanding recognition in clinical practice that these effects span the whole illness trajectory and continue beyond treatment completion, further clarity is required on the specific barriers and facilitators to education during cancer treatment and beyond, as well as on the experiences of children and adolescents across the full range of education settings (hospital, home, virtual, original school of enrolment), in order to determine which interventions are successful in improving access and experience from their perspective. The aim of this review is to identify what is known from the existing literature about access to and experience of education for children and adolescents with cancer during and post treatment. Methods We have planned a scoping literature review searching the following databases from inception onwards: MEDLINE (Ovid), Embase and Embase Classic, Web of Science Core Collection, Education Resources Index, Sociological Abstracts, APA PsycINFO, SCOPUS, CINAHL Plus, Emcare and The Cochrane Library. In addition, DARE, conference abstracts, key journals, and institutional websites will be searched. Arksey and O’Malley’s six-step process will be followed, including a consultation exercise. Studies, reports and policies from any country providing care and treatment for children and adolescents with cancer published in English will be considered eligible for inclusion. Two reviewers will independently screen all citations, full-text articles and abstract data. A narrative summary of findings will be conducted. Data analysis will involve quantitative (e.g., frequencies) and qualitative (e.g., content and thematic analysis) methods. Discussion This is a timely examination given the increased incidence of childhood cancer, more intensive treatment regimens and improved survival rates for childhood cancer. The inclusion of a substantive consultation exercise with families and professionals will provide an important opportunity to examine the scoping review outputs. Findings will assist the childhood cancer community in developing a comprehensive evidence-based understanding of a significant associated bio-psychosocial impact of cancer diagnosis and treatment and will form the first step towards developing effective interventions and policies to mitigate identified detrimental effects. Systematic review registration Open Science Framework (osf/io/yc4wt

Human migration on a heating planet: A scoping review

Whilst people’s migration outcomes may be influenced by climate change, the interaction of heat with migration and migrants is little understood. This scoping review explores the relationship between heat and human migration, focusing on i) whether and how heat functions as a driver of migration, and ii) how migrants are impacted by heat across the migratory journey. Four databases were searched for peer-reviewed literature to identify studies reporting on the heat-migration nexus through 18 June 2021, alongside a grey literature search. Of 12,149 peer-reviewed and 476 grey literature records, 187 articles were screened in full, resulting in the inclusion of 50 records (47 peer-reviewed, 3 grey). Publications assessed the impact of heat on human migration (n = 32), or the experience of heat among migrants (n = 18). In the former, 16/32 report a significant positive association where exposure to heat increases the likelihood of migration or intention to migrate. Moderating factors in the heat-migration pathway include other climatic factors, agricultural productivity, economic opportunities, age, and gender. The vast majority of studies assessing the impact of heat on migrants reported negative impacts of heat (such as heat related illness, heat stress and premature mortality) among migrants compared to non-migrants. Heat impacts were aggravated by poor infrastructure, insufficient workplace adaptations, lower educational level, and socio-economic factors. Findings suggest heat may influence migratory patterns in terms of people’s intention to move, risk when on the move, and consequences of heat for settled migrants. However, the heterogeneous results suggest heat may not be a driver of migration in all contexts. No literature reported on a so-called ‘temperature threshold’ above which migration is certain. Developing comparability in measurements of heat, heat impacts, and definitions of environmentally-induced migration and migrants may support future research on, risk reduction for, and response to the impact of heat on migration and migrants.</jats:p