a review

Introduction: eHealth and mHealth are technologies that allow services to be extended closer to patients, in pursuit of the objectives of Health 2020: a European policy framework and strategy for the 21st century and of the Global Strategy on Human Resources for Health: workforce 2030. As Europe faces increased demand for health services due to ageing populations, rising patient mobility, and a diminishing supply of health workers caused by retirement rates that surpass recruitment rates, this paper illustrates how eHealth and mHealth can improve the delivery of services by the health workforce in response to increasing demands. Methods: Through a scoping literature review, the impact of eHealth/mHealth on the health workforce was assessed by examining how these technologies affect four dimensions of the performance of health professionals, according to the so-called AAAQ: availability, accessibility, acceptability, and quality. Results: Few high-quality studies were found. Most studies focused on the utilization of text messaging (SMS) for patient behavior change, and some examined the potential of mhealth to strengthen health systems. We also found some limited literature reporting effects on clinical effectiveness, costs, and patient acceptability; we found none reporting on equity and safety issues. Facilitators and barriers to the optimal utilization of eHealth and mHealth were identified and categorized as they relate to individuals, professional groups, provider organizations, and the institutional environment. Discussion: There are ongoing clinical trial protocols of largescale, multidimensional mHealth interventions, suggesting that the current limited evidence base will expand in coming years. The requirement for new digital skills for human resources for health (HRH) was observed as significant. This has implications for the education of health workers, the management of health services, policy-making, and research.publishersversionpublishe

Health workforce metrics pre- and post-2015: A stimulus to public policy and planning

© 2017 The Author(s). Background: Evidence-based health workforce policies are essential to ensure the provision of high-quality health services and to support the attainment of universal health coverage (UHC). This paper describes the main characteristics of available health workforce data for 74 of the 75 countries identified under the 'Countdown to 2015' initiative as accounting for more than 95% of the world's maternal, newborn and child deaths. It also discusses best practices in the development of health workforce metrics post-2015. Methods: Using available health workforce data from the Global Health Workforce Statistics database from the Global Health Observatory, we generated descriptive statistics to explore the current status, recent trends in the number of skilled health professionals (SHPs: physicians, nurses, midwives) per 10 000 population, and future requirements to achieve adequate levels of health care in the 74 countries. A rapid literature review was conducted to obtain an overview of the types of methods and the types of data sources used in human resources for health (HRH) studies. Results: There are large intercountry and interregional differences in the density of SHPs to progress towards UHC in Countdown countries: a median of 10.2 per 10 000 population with range 1.6 to 142 per 10 000. Substantial efforts have been made in some countries to increase the availability of SHPs as shown by a positive average exponential growth rate (AEGR) in SHPs in 51% of Countdown countries for which there are data. Many of these countries will require large investments to achieve levels of workforce availability commensurate with UHC and the health-related sustainable development goals (SDGs). The availability, quality and comparability of global health workforce metrics remain limited. Most published workforce studies are descriptive, but more sophisticated needs-based workforce planning methods are being developed. Conclusions: There is a need for high-quality, comprehensive, interoperable sources of HRH data to support all policies towards UHC and the health-related SDGs. The recent WHO-led initiative of supporting countries in the development of National Health Workforce Accounts is a very promising move towards purposive health workforce metrics post-2015. Such data will allow more countries to apply the latest methods for health workforce planning

O conhecimento sobre o medicamento e literacia em saúde. Um estudo em adultos utentes de farmácias do concelho de Lisboa

Estudos recentes realizados nas farmácias portuguesas evidenciaram elevadas percentagens de indivíduos que não aderem à terapêutica. Em consequência, não controlam adequadamente o seu problema de saúde e geram desperdício do medicamento. A utilização do medicamento requer conhecimento, competências e motivação por parte do indivíduo/utilizador. A informação sobre o medicamento é disponibilizada de forma verbal e escrita, desconhecendo-se até hoje, na população portuguesa, em que medida as competências de literacia em saúde permitem a sua obtenção, o uso e a compreensão quando perante a necessidade de utilizar medicamentos. Foi objetivo do presente estudo a medição do conhecimento sobre o medicamento numa amostra de utentes de farmácia com idades compreendidas entre os 45 e os 64 anos, analisando de que forma está associado a competências de literacia em saúde. Realizou-se um estudo descritivo transversal com a colaboração voluntária de farmácias do concelho de Lisboa, que recolheram os dados mediante inquérito por entrevista quando o utente se encontrava na farmácia a adquirir a sua terapêutica. A amostra estudada foi constituída por 233 utentes com uma idade média de 57 anos (dp = 5,7), maioritariamente do género feminino, ativos, com uma escolaridade igual ou inferior ao 9.º ano e com hábitos gerais de leitura referindo ler frequentemente (26 por cento) ou muito frequentemente (30 por cento). Em média responderam corretamente a 10,48 perguntas num total de 13 (dp = 1,779), sendo este conhecimento independente do sexo (p = 0,791) e da idade (p = 0,131). O número de respostas corretas é, no entanto, maior quanto mais elevado o grau de escolaridade (p = 0,000), a categoria profissional exercida (p=0,000), os hábitos de leitura (p=0,000), o índice de compreensão de informação (p = 0,003), a intensidade de leitura de informação sobre saúde ou medicamento (p = 0,005), a facilidade de utilização do folheto informativo do medicamento (p = 0,027), a intensidade de cálculo (p = 0,018) e o tempo de utilização do medicamento (p = 0,047). Do conjunto de indicadores de literacia analisados, o grau de escolaridade, o índice de compreensão da informação transmitida pelos profissionais de saúde e a intensidade de leitura de materiais escritos relacionados com o medicamento ou saúde são os que mais contribuem para o conhecimento sobre o medicamento, embora se revelem fracamente preditivos do nível de conhecimento (r2 = 0,013). Evidencia-se neste estudo que o conhecimento que os indivíduos possuem sobre o medicamento é influenciado de forma positiva por competências de literacia em saúde. Em consequência, as intervenções que visam melhorar a utilização do medicamento e as estratégias de comunicação em saúde, tanto verbal como escrita, devem ter em consideração o nível de literacia em saúde da população.info:eu-repo/semantics/publishedVersio

Assessment of human resources management practices in Lebanese hospitals

© 2009 El-Jardali et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

Novel Amphiphilic Cyclobutene and Cyclobutane \u3ci\u3ecis\u3c/i\u3e-C18 Fatty Acid Derivatives Inhibit \u3ci\u3eMycobacterium avium\u3c/i\u3e subsp. \u3ci\u3eparatuberculosis\u3c/i\u3e Growth

Mycobacterium avium subspecies paratuberculosis (Map) is the etiologic agent of Johne’s disease in ruminants and has been associated with Crohn’s disease in humans. An effective control of Map by either vaccines or chemoprophylaxis is a paramount need for veterinary and possibly human medicine. Given the importance of fatty acids in the biosynthesis of mycolic acids and the mycobacterial cell wall, we tested novel amphiphilic C10 and C18 cyclobutene and cyclobutane fatty acid derivatives for Map inhibition. Microdilution minimal inhibitory concentrations (MIC) with 5 or 7 week endpoints were measured in Middlebrook 7H9 base broth media. We compared the Map MIC results with those obtained previously with Mycobacterium tuberculosis and Mycobacterium smegmatis. Several of the C18 compounds showed moderate effcacy (MICs 392 to 824 μM) against Map, while a higher level of inhibition (MICs 6 to 82 μM) was observed for M. tuberculosis for select analogs from both the C10 and C18 groups. For most of these analogs tested in M. smegmatis, their effcacy decreased in the presence of bovine or human serum albumin. Compound 5 (OA-CB, 1-(octanoic acid-8-yl)-2-octylcyclobutene) was identified as the best chemical lead against Map, which suggests derivatives with better pharmacodynamics may be of interest for evaluation in animal models