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Reducing fragmentation of primary healthcare financing for more equitable, people-centred primary healthcare.
BMJ Glob Health
January 2025
Results for Development Institute, Washington, District of Columbia, USA.
Despite primary healthcare (PHC) being recognised in global declarations-Alma Ata in 1978 and Astana in 2018-and prioritised in national health strategies, chronic under-resourcing of PHC persists in most low-income and middle-income countries. More public spending is needed for PHC, but macrofiscal and political constraints often limit the ability of governments to allocate more public resources to PHC. Under-resourcing has been compounded by fragmented and rigid funding flows, which are inefficient and may erode equity, quality of care and public trust in PHC.
View Article and Find Full Text PDFPermissive strategies in intensive care units (ICUs): actual trends?
Anesth Pain Med (Seoul)
January 2025
Department of Surgery, Faculty of Medicine, University of Medicine, Tirana, Albania.
Permissive strategies in the intensive care unit (PSICU) intentionally allow certain physiological parameters to deviate from traditionally strict control limits to mitigate the risks associated with overly aggressive interventions. These strategies have emerged in response to evidence that rigid adherence to normal physiological ranges may cause harm to critically ill patients, leading to iatrogenic complications or exacerbation of underlying conditions. This review discusses several permissive strategies, including those related to hypotension, hypercapnia, hypoxemia, and lower urinary output thresholds.
View Article and Find Full Text PDFProtocol for a mixed-methods randomised controlled trial evaluating the psychosocial effects of an expressive arts-based intervention on adults with age-related macular degeneration.
BMJ Open
December 2024
Department of Psychiatry, University of Hong Kong, Hong Kong, China.
Introduction: Age-related macular degeneration (AMD) is a prevalent eye disease among middle-aged and older adults. AMD leaves the patient with irreversible deteriorating vision, which profoundly impacts their daily lives and psychosocial well-being. Given the limited studies addressing the psychosocial needs of adults with AMD and, in particular, using an expressive arts-based intervention (EXABI) as an intervention, this study aims to investigate the effectiveness of such an intervention in enhancing the psychosocial well-being of adults with AMD.
View Article and Find Full Text PDFRandomised, placebo-controlled, double-blinded, four-way crossover trial to demonstrate the comparative pharmacodynamic equivalence of a non-invasive diagnostic test for adrenal insufficiency in a healthy population: the STARLIT-2 study protocol.
BMJ Open
December 2024
Clinical Medicine, School of Medicine and Population Health, The University of Sheffield, Sheffield, UK
Introduction: Cortisol is an essential stress hormone and failure of its production, known as adrenal insufficiency (AI), is associated with significant mortality due to adrenal crisis. The Short Synacthen Test (SST) is the current diagnostic test of choice for AI, but it is both invasive and resource intensive. Globally, there is an unmet need for a non-invasive, cost-effective test.
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