Articles: patients.
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The lancet oncology · Jan 2025
ReviewIntegrating cancer into crisis: a global vision for action from WHO and partners.
More than a billion people live in fragile, conflict-affected, and vulnerable settings requiring humanitarian support, where cancer is a substantial health issue. Despite its substantial effect on populations, cancer care remains underprioritised in emergency preparedness and response frameworks and humanitarian operational planning. This Policy Review summarises the perspectives and actionable recommendations from the First Global High-Level Technical Meeting on Non-communicable Diseases in Humanitarian Settings, with a focus on cancer. ⋯ Key solutions include: integrating the cancer care continuum into national preparedness and response plans to enhance health-care system resilience; integrating cancer into humanitarian responses efforts; addressing the specific needs of paediatric patients with cancer; improving cancer intelligence and surveillance systems; and developing strategies to navigate the logistical and financial challenges of providing cancer care during crises. Additionally, the paper outlines practical actions and next steps for international cooperation needed to drive a shift in global health priorities and elevate cancer in the global health security agenda. We hope the presented notions will help prevent millions of avoidable deaths among people with cancer.
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Review
Interventions to improve equity in emergency departments for Indigenous people: A scoping review.
Disparities in health outcomes, including increased chronic disease prevalence and decreased life expectancy for Indigenous people, have been shown across settings affected by white settler colonialism including Canada, the United States, Australia, and New Zealand. Emergency departments (EDs) represent a unique setting in which urgent patient need and provider strain interact to amplify inequities within society. The aim of this scoping review was to map the ED-based interventions aimed at improving equity in care for Indigenous patients in EDs. ⋯ Relatively few interventions for improving equity in care were identified. We found that a minority of interventions are aimed at creating organizational-level change and suggest that future interventions could benefit from targeting system-level changes as opposed to or in addition to incorporating new roles in EDs.
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Anesthesia and analgesia · Jan 2025
ReviewPerioperative Care of Patients Using Wearable Diabetes Devices.
The increasing prevalence of diabetes mellitus has been accompanied by a rapid expansion in wearable continuous glucose monitoring (CGM) devices and insulin pumps. Systems combining these components in a "closed loop," where interstitial glucose measurement guides automated insulin delivery (AID, or closed loop) based on sophisticated algorithms, are increasingly common. While these devices' efficacy in achieving near-normoglycemia is contributing to increasing usage among patients with diabetes, the management of these patients in operative and procedural environments remains understudied with limited published guidance available, particularly regarding AID systems. ⋯ Procedure duration and invasiveness is an important factor as longer procedures increase the risk of stress hyperglycemia, tissue malperfusion, and device malfunction. Whether insulin pumps should be continued through procedures, or substituted by alternative insulin delivery methods, is a complex decision that requires all parties to understand potential risks and contingency plans relating to patient and procedural factors. Currently available CGMs and insulin pumps are reviewed, and practical recommendations for safe glycemic management during the phases of perioperative care are provided.
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Restrictive covenants (RCs) are clauses placed into employment agreements across various industries, and they are frequently used in health care-specifically within physician contracts. Given the most recent guidance and rule determined by the Federal Trade Commission in April 2024, the relevancy of RCs in health care has come under even more scrutiny in the latter half of 2024. This review will focus on the history of RC law and review the value of these clauses from the perspectives of the employer, practicing physician, and patient. We also provide the stakeholder responses to both the ban and the subsequent blockage of enforcement by a Texas federal court in August of 2024.
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Multicenter Study
Assessment of Prognostic Scores for Emergency Department Patients With Upper Gastrointestinal Bleeding.
Early prognostic stratification could optimize the management of patients with upper gastrointestinal bleeding and reduce unnecessary hospitalizations. The aim of this study was to assess and compare the performance of existing prognostic scores in predicting therapeutic intervention and death. ⋯ The GBS and the modified GBS are the 2 best performing scores because they achieve both key objectives: stratifying patients based on their risk of therapeutic intervention and/or death and identifying low-risk patients who may qualify for outpatient management.