Simulation of arbitrary shaped boundaries for hemodynamic studies

technical repor

It takes two to tango: Customization and standardization as colluding logics in healthcare: Comment on “(re) making the procrustean bed standardization and customization as competing logics in healthcare”

The healthcare context is characterized with new developments, technologies, ideas and expectations that are continually reshaping the frontline of care delivery. Mannion and Exworthy identify two key factors driving this complexity, ‘standardization’ and ‘customization,’ and their apparent resulting paradox to be negotiated by healthcare professionals, managers and policy makers. However, while they present a compelling argument an alternative viewpoint exists. An analysis is presented that shows instead of being ‘competing’ logics in healthcare, standardization and customization are long standing ‘colluding’ logics. Mannion and Exworthy’s call for further sustained work to understand this complex, contested space is endorsed, noting that it is critical to inform future debates and service decisions

Reconceptualising the standard of care in sport: The case of youth rugby in England and South Africa

Sport is an important area of civil society in both South Africa and England, and this article is broadly concerned with the relationship between sport and personal injury. More specifically, the article compares how rugby is regulated by the tort of negligence in England and delict in South Africa respectively. Regarding liability, for sport there are very specific factors that need to be taken into account. The article is concerned with, firstly, the broader context of sport as an important social and cultural activity, and secondly the specific sporting context that includes the rules of the game as well as the playing culture, with a focus on rugby at junior level. Through a critical and comparative analysis of how the standards of care in sport have been developed in both jurisdictions, the aim of this article is to consider how sport specific elements can be incorporated into the traditional legal principles. This comparative analysis contextualises the various discussions in the light of the differences between the English tort of negligence and the South African law of delict. Our argument is that the context and specificity of rugby should be more explicitly taken into account when evaluating potential liability. To establish a standard of care for sport is complex, with many factors to be taken into account and balanced against one another. The law of negligence/delict therefore needs to be adaptable and flexible to resolve new situations where injuries have occurred. Even in established situations where liability has been previously determined, novel events do occur and knowledge develops that requires a reconsideration of the principles that govern liability. In junior rugby, the risk of very serious injuries is relatively small and the law needs to tread a cautious path through liability, ensuring it is a vehicle that promotes sport rather than creating barriers to its enjoyment and practice. A greater understanding of sport, informed by detailed research, can unearth new areas of potential liability that will need to be considered in the future

A Gateway Framework to Guide Major Health System Changes Comment on “‘Attending to History’ in Major System Change in Healthcare in England: Specialist Cancer Surgery Service Reconfiguration”

Recent events – on both a global scale and within individual countries – including the lockdowns associated with COVID-19 pandemic, inflation concerns, and political tensions, have increased pressure to reconfigure social services for ongoing sustainability. Healthcare services across the world are undergoing major system change (MSC). Given the complexity and different contextual drivers across healthcare systems, there is a need to use a variety of perspectives to improve our understanding of the processes for MSC. To expand the knowledge base and develop strategies for MSC requires analysing change projects from different perspectives to distil the elements that drove the success. We offer the Gateway Framework as a collaborative transformational system tool to assess and reorganise operations, services, and systems of healthcare organisations. This framework and guiding questions, accounts for past events whilst being proactive, future orientated, and derived from externally defined and a standardised requirements to promote safe, high-quality care. Keywords: Major System Change, Restructuring, Health Systems, Healthcare Safety, Healthcare Quality Copyright: © 2023 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/ licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Citation: Eljiz K, Greenfield D, Derrett A. A gateway framework to guide major health system changes: Comment on “‘Attending to history’ in major system change in healthcare in England: specialist cancer surgery service reconfiguration.” Int J Health Policy Manag. 2023;12:7681. doi:10.34172/ijhpm.2023.7681

The embedded health management academic: A boundary spanning role for enabling knowledge translation comment on “cihr health system impact fellows: Reflections on ‘driving change’ within the health system”

Healthcare organisations are looking at strategies and activities to improve patient outcomes, beyond clinical interventions. Increasingly, health organisations are investing significant resources in leadership, management and team work training to optimise professional collaboration, shared decision-making and, by extension, high quality services. Embedded clinical academics are a norm in, and considered a strength of, healthcare organisations and universities. Their role contributes, formally and informally, to clinical teaching, knowledge sharing and research. An equivalent, but significantly less common role, addressing the management of healthcare organisations, is the embedded health management academic (EHMA). A stimulus encouraging this intertwined embedded academic role, in both clinical and managerial fields, is the demand for the translation of knowledge between academic and industry contexts. In this essay, we describe the EHMA role, its value, impact and potential for enabling healthcare organisation improvement. Focusing on the business of healthcare, the EHMA is a conduit between sectors, stakeholders and activities, enabling different organisations and experts to co-create, share and embed knowledge. The value and impact achieved is significant and ongoing, through the nurturing of an evidence-based management culture that promotes ongoing continuous improvement and research activities

Gender Equality, Drinking Cultures and Second-Hand Harms from Alcohol in the 50 US States.

BackgroundGender inequality and cultures of binge drinking may increase the risk of second-hand harms from alcohol.MethodsUsing the 2014-2015 National Alcohol Survey and 2015 National Alcohol's Harm to Others Survey (N = 7792), we examine associations of state-level gender equality measures (contraceptive access, abortion rights, women's economic equality) and binge drinking cultures (rates of men's and women's binge drinking) with individual-level indicators of second-hand harms by drinking strangers and partners/spouses.ResultsIn main effects models, only male binge drinking was associated with greater odds of harms from drinking strangers. There were significant interactions of gender equality with male binge drinking: High male binge drinking rates were more strongly associated with stranger-perpetrated harms in states low on contraceptive access or abortion rights compared to states high on these measures. Conversely, male binge drinking was more strongly associated with spouse/partner-perpetrated second-hand harms in states with more economic equality, compared to states lower on this measure.ConclusionsDetrimental effects of high male binge drinking rates may be modified by gender equality. Targeted interventions may reduce alcohol-related harms experienced by women in states with high rates of male binge drinking. Restrictions in access to contraception and abortion may exacerbate harms due to men's drinking

Decline in Methylmercury in Museum-Preserved Bivalves from San Francisco Bay, California

There are ongoing efforts to manage mercury and nutrient pollution in San Francisco Bay (California, USA), but historical data on biological responses are limited. We used bivalves preserved in formalin or ethanol from museum collections to investigate long-term trends in methylmercury (MeHg) concentrations and carbon and nitrogen isotopic signatures. In the southern reach of the estuary, South Bay, MeHg in the Asian date mussel (Musculista senhousia) significantly declined over the study duration (1970 to 2012). Mean MeHg concentrations were highest (218 ng/g dry weight, dw) in 1975 and declined 3.8-fold (to 57 ng/g dw) by 2012. This decrease corresponded with closure of the New Almaden Mercury Mines and was consistent with previously observed declines in sediment core mercury concentrations. In contrast, across all sites, MeHg in the overbite clam (Potamocorbula amurensis) increased 1.3-fold from 64 ng/g dw before 2000 to 81 ng/g dw during the 2000s and was higher than in M. senhousia. Pearson correlation coefficients of the association between MeHg and δ13C or δ15N provided no evidence that food web alterations explained changing MeHg concentrations. However, isotopic composition shifted temporally. South Bay bivalve δ15N increased from 12‰ in the 1970s to 18‰ in 2012. This increase corresponded with increasing nitrogen loadings from wastewater treatment plants until the late 1980s and increasing phytoplankton biomass from the 1990s to 2012. Similarly, a 3‰ decline in δ13C from 2002 to 2012 may represent greater utilization of planktonic food sources. In a complimentary 90 day laboratory study to validate use of these preserved specimens, preservation had only minor effects (\u3c 0.5‰) on δ13C and δ15N. MeHg increased following preservation but then stabilized. These are the first documented long-term trends in biota MeHg and stable isotopes in this heavily impacted estuary and support the utility of preserved specimens to infer contaminant and biogeochemical trends

DNA barcoding reveals micro-evolutionary changes and river system-level phylogeographic resolution of African silver catfish, Schilbe intermedius (Actinopterygii: Siluriformes: Schilbeidae) from seven populations across different African river systems

Background. Under the tropics, less than 40% of known fishes are identified to species-level. Further, the ongoing global change poses unprecedented threat to biodiversity, and several taxa are likely to go extinct even before they could be described. Traditional ecological theory suggests that species would escape extinction risk posed by global threats (e.g., climate change) only by migrating to new environments. In this study, we hypothesise that micro-evolutionary changes (evolution within species and populations) are also important mechanisms for the survival of Schilbe intermedius in Africa, a continent subjected to uneven distribution of climate severity. Materials and methods. Using the mitochondrial cytochrome c oxidase subunit I (COI) gene, known as animal DNA barcode, we tested this hypothesis by analysing the genetic diversity and phylogenetic relations between seven populations of S. intermedius across different African river systems. Results. We reveal a clear geographical patterning in genetic variations, with three clear clusters (southern Africa, eastern Africa, and western Africa). In southern Africa, the South African population is distinct from that of Namibia and Botswana. In addition, within Nigerian populations of silver catfish, two sub-clusters emerged from two isolated river systems. We suggest that the phylogeographic pattern within African silver catfish populations mirror the past effects of selection and gene flow, and that the split within Nigerian silver catfish populations might be the result of micro-evolutionary adaptive responses to local selection pressures. Conclusion. We suggest that the strong genetic difference in African silver catfish among geographically isolated river systems might be the result of in situ micro-evolutionary adaptive responses to changing environments, and that DNA barcode has potential beyond species delimitation