The advances of modern medicine have inadvertently led to a globally ageing population plagued primarily with non-communicable diseases. In addition to traditional medical approaches, nature-based therapy is becoming an increasingly attractive option, with its potential to holistically address physical and mental facets of health and well-being, and to complement 'preventive' and 'population health' strategies, both of which form the bedrock of sustainable healthcare. However, at present, there is vast heterogeneity in the implementation of nature-based therapy, limiting its widespread and sustainable use. The aim of this review is to practically examine and provide a focussed summary of the current evidence with a view to identifying existing gaps and limitations, and to propose directions for future research and implementation within the healthcare setting.
Humans ; Singapore ; Tertiary Care Centers ; Hospitals, Public ; Delivery of Health Care ; Nature ; Complementary Therapies/methods* ; Medicine, Traditional/methods*

Coalescence of traditional medicine Ayurveda and in silico technology is a rigor for supplementary development of future-ready effective traditional medicine. Ayurveda is a popular traditional medicine in South Asia, emanating worldwide for the treatment of metabolic disorders and chronic illness. Techniques of in silico biology are not much explored for the investigation of a variety of bioactive phytochemicals of Ayurvedic herbs. Drug repurposing, reverse pharmacology, and polypharmacology in Ayurveda are areas in silico explorations that are needed to understand the rich repertoire of herbs, minerals, herbo-minerals, and assorted Ayurvedic formulations. This review emphasizes exploring the concept of Ayurveda with in silico approaches and the need for Ayurinformatics studies. It also provides an overview of in silico studies done on phytoconstituents of some important Ayurvedic plants, the utility of in silico studies in Ayurvedic phytoconstituents/formulations, limitations/challenges, and prospects of in silico studies in Ayurveda. This article discusses the convergence of in silico work, especially in the least explored field of Ayurveda. The focused coalesce of these two domains could present a predictive combinatorial platform to enhance translational research magnitude. In nutshell, it could provide new insight into an Ayurvedic drug discovery involving an in silico approach that could not only alleviate the process of traditional medicine research but also enhance its effectiveness in addressing health care.
Network Pharmacology ; Medicine, Traditional ; Medicine, Ayurvedic ; Drug Discovery/methods* ; Delivery of Health Care

PURPOSE: An injury surveillance information system (ISIS) collects, analyzes, and distributes data on injuries to promote health care delivery. The present study aimed to review the data elements and functional requirements of this system. METHOD: This study was conducted in 2019. Studies related to injury surveillance system were searched from January 2000 to September 2019 via the databases of PubMed, Web of Knowledge, ScienceDirect, and Scopus. Articles related to the epidemiology of injury, population survey, and letters to the editor were excluded, while the review and research articles related to ISISs were included in the study. Initially 324 articles were identified, and finally 22 studies were selected for review. Having reviewed the articles, the data needed were extracted and the results were synthesized narratively. RESULTS: The results showed that most of the systems reviewed in this study used the minimum data set suggested by the World Health Organization injury surveillance guidelines along with supplementary data. The main functions considered for the system were injury track, data analysis, report, data linkage, electronic monitoring and data dissemination. CONCLUSION ISISs can help to improve healthcare planning and injury prevention. Since different countries have various technical and organizational infrastructures, it is essential to identify system requirements in different settings.
Datasets as Topic ; Delivery of Health Care ; Health Information Systems ; Health Planning ; Humans ; Public Health Surveillance ; methods ; Wounds and Injuries ; prevention & control

PURPOSE: The purpose of this study was to define and clarify the concept of political competence for nurses.METHODS: A hybrid model method was used to investigate the dimensions, attributes, and definitions of the concept. In the theoretical stage of the study, literature on nursing, politics, and other discipline were reviewed. In the fieldwork stage, individual in-depth interviews and focus groups interviews were conducted with politically seasoned experts or activists who had an understanding of the concept of political competence for extensive descriptions in nursing and field of health care.RESULTS: The concept of political competence was represented in four dimensions as political knowledge, political efficacy, political interaction, and political activity. In the political knowledge dimension, there were three attributes, namely, political knowledge, political information and systematic analysis ability. The political efficacy dimension had three attributes of internal political efficacy, external political efficacy, and self-pride of nursing profession. The political interaction dimension had three attributes of organizations and community service, networking, and persuasive power. The political activity dimension had six attributes of political leadership, political expression, assertive behavior, political advocacy, political participation, and policy intervention.CONCLUSION: This concept development might provide a basic understanding of developing a measurement tool and for constructing a theory promoting nurses' political competence.
Concept Formation ; Delivery of Health Care ; Focus Groups ; Leadership ; Mental Competency ; Methods ; Nursing ; Politics ; Professional Competence ; Seasons ; Social Welfare

The COVID-19 pandemic has had a major impact in healthcare systems across the world, with many hospitals having to come up with protocols and measures to contain the spread of the virus. This affects various specialties' clinical practices in many ways. Since early 2020 in Singapore, the Department of Otorhinolaryngology at Tan Tock Seng Hospital had to rapidly adapt to this pandemic as we provided services to the main healthcare facility combating the virus in our country. We had to design new workflows and also remain flexible in view of the ever-changing situation. There are 6 important domains for an otolaryngology department or any clinical department in general to consider when making adjustments to their practices in an outbreak: (1) clinical work, (2) education, (3) research, (4) safety of patients and staff, (5) morale of medical staff and (6) pandemic frontline work. We hope that the sharing of our experiences and the lessons learnt will be useful for both our local and international colleagues.
Ambulatory Care ; Biomedical Research ; COVID-19/prevention & control* ; Delivery of Health Care/methods* ; Education, Medical ; Elective Surgical Procedures ; Health Workforce ; Humans ; Morale ; Otolaryngology/methods* ; Otorhinolaryngologic Surgical Procedures ; Personal Protective Equipment ; Personnel Staffing and Scheduling ; SARS-CoV-2 ; Singapore/epidemiology* ; Workflow

The ongoing pandemic in Singapore is part of a global pandemic caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). To control the spread of COVID-19 and prevent the healthcare system from being overwhelmed, 'circuit breaker' measures were introduced between 7 April and 1 June 2020 in Singapore. There is thus a crucial need for innovative approaches to the provision and delivery of healthcare in the context of safe-distancing by harnessing telemedicine, especially for patients with chronic diseases who have traditionally been managed in tertiary institutions. We present a summary of how the Virtual Monitoring Clinic has benefited the practice of our outpatient rheumatology service during the COVID-19 pandemic. The virtual consultations address the need for safe-distancing by limiting face-to-face appointments and unnecessary exposure of patients to the hospital where feasible. This approach ensures that the patients are monitored appropriately for drug toxicities and side-effects, maintained on good disease control, and provided with patient education.
Ambulatory Care/methods* ; Antirheumatic Agents/therapeutic use* ; COVID-19 ; Delivery of Health Care ; Humans ; Nurse Practitioners ; Pharmacists ; Rheumatic Diseases/drug therapy* ; Rheumatology/methods* ; SARS-CoV-2 ; Singapore ; Telemedicine/organization & administration* ; Tertiary Care Centers

Allergy and Immunology ; Ambulatory Care ; Autoimmune Diseases/therapy* ; COVID-19 ; Communicable Disease Control ; Connective Tissue Diseases/therapy* ; Delivery of Health Care/methods* ; Dermatology ; Humans ; Immunosuppressive Agents/therapeutic use* ; Patient Selection ; SARS-CoV-2 ; Singapore ; Skin Diseases, Vesiculobullous/therapy* ; Telemedicine/methods* ; Tertiary Care Centers ; Vasculitis/therapy*

OBJECTIVES: Home-based nursing care services have increased over the past decade. However, accountability and privacy issues as well as security concerns become more challenging during care provider visits. Because of the heterogeneous combination of mobile and stationary assistive medical care devices, conventional systems lack architectural consistency, which leads to inherent time delays and inaccuracies in sharing information. The goal of our study is to develop an architecture that meets the competing goals of accountability and privacy and enhances security in distributed home-based care systems. METHODS: We realized this by using a context-aware approach to manage access to remote data. Our architecture uses a public certification service for individuals, the Japanese Public Key Infrastructure and Health Informatics-PKI to identify and validate the attributes of medical personnel. Both PKI mechanisms are provided by using separate smart cards issued by the government. RESULTS: Context-awareness enables users to have appropriate data access in home-based nursing environments. Our architecture ensures that healthcare providers perform the needed home care services by accessing patient data online and recording transactions. CONCLUSIONS: The proposed method aims to enhance healthcare data access and secure information delivery to preserve user's privacy. We implemented a prototype system and confirmed its feasibility by experimental evaluation. Our research can contribute to reducing patient neglect and wrongful treatment, and thus reduce health insurance costs by ensuring correct insurance claims. Our study can provide a baseline towards building distinctive intelligent treatment options to clinicians and serve as a model for home-based nursing care.
Asian Continental Ancestry Group ; Certification ; Computer Security ; Delivery of Health Care ; Electronic Health Records ; Health Information Exchange ; Health Personnel ; Health Smart Cards ; Home Care Services ; Home Health Nursing ; Humans ; Information Dissemination ; Insurance ; Insurance, Health ; Methods ; Nursing ; Nursing Care ; Privacy ; Social Responsibility

OBJECTIVES: The purpose of this study was to estimate the mediating effect of subjective unmet healthcare needs on poor health. The mediating effect of unmet needs on health outcomes was estimated. METHODS: Cross-sectional research method was used to analyze Korea Health Panel data from 2011 to 2015, investigating the mediating effect for each annual dataset and lagged dependent variables. RESULTS: The magnitude of the effect of low income on poor health and the mediating effect of unmet needs were estimated using age, sex, education level, employment status, healthcare insurance status, disability, and chronic disease as control variables and self-rated health as the dependent variable. The mediating effect of unmet needs due to financial reasons was between 14.7% to 32.9% of the total marginal effect, and 7.2% to 18.7% in lagged model. CONCLUSIONS: The fixed-effect logit model demonstrated that the existence of unmet needs raised the likelihood of poor self-rated health. However, only a small proportion of the effects of low income on health was mediated by unmet needs, and the results varied annually. Further studies are necessary to search for ways to explain the varying results in the Korea Health Panel data, as well as to consider a time series analysis of the mediating effect. The results of this study present the clear implication that even though it is crucial to address the unmet needs, but it is not enough to tackle the income related health inequalities.
Chronic Disease ; Dataset ; Delivery of Health Care ; Education ; Employment ; Healthcare Disparities ; Insurance Coverage ; Korea ; Logistic Models ; Methods ; Needs Assessment ; Negotiating ; Socioeconomic Factors

PURPOSE: This study was conducted to better understand the illness experiences and palliative care needs in community-dwelling persons with cardiometabolic diseases. METHODS: This qualitative descriptive study was conducted with 11 patients (and three family members) among 28 patients contacted. Interviews were led by the principal investigator in her office or at participants' home depending on their preference. All interviews were digitally recorded and transcribed by a research assistant. The interviews were analyzed by two independent researchers using a conventional method. RESULTS: Participants' ages ranged from 42 to 82 years (nine men and two women). Three themes were identified: (1) same disease, but different illness experiences; (2) I am in charge of my disease(s); (3) preparation for disease progression. Participants were informed of the name of their disease when they were diagnosed, but not provided with explanation of the diagnosis or meant or how to do self-care to delay the disease progression, which increased the feelings of uncertainty, hopelessness and anxiety. Taking medication was considered to be the primary treatment option and self-care a supplemental one. Advanced care plans were considered when they felt the progression of their disease(s) while refraining from sharing it with their family or health care professionals to save their concerns. All participants were willing to withhold life-sustaining treatment without making any preparation in writing. CONCLUSION: Education on self-care and advanced care planning should be provided to community-dwelling persons with cardiometabolic diseases. A patient-centered education program needs to be developed for this population.
Anxiety ; Chronic Disease ; Delivery of Health Care ; Diagnosis ; Disease Progression ; Education ; Humans ; Independent Living ; Male ; Methods ; Palliative Care ; Qualitative Research ; Research Personnel ; Self Care ; Uncertainty ; Writing