| 1. |
- Silverstein, Arthur, et al.
(författare)
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Evolution of biomarker research in autoimmunity conditions for health professionals and clinical practice
- 2022
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Ingår i: Precision medicine. - : Elsevier. - 9780323997843 ; , s. 219-276
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Bokkapitel (refereegranskat)abstract
- Medical abzymology has made a great contribution to the development of general autoimmunity theory: it has put the autoantibodies (Ab) as the key brick of the theory to the level of physiological functionality by providing such Ab with the ability to catalyze and mediate direct and independent cytotoxic effect on cellular and molecular targets. Natural catalytic autoantibodies (abzymes) while being a pool of canonical Abs and possessing catalytic activity belong to the new group of physiologically active substances whose features and properties are evolutionary consolidated in one functionally active biomolecule. Therefore, further studies on Ab-mediated autoAg degradation and other targeted Ab-mediated proteolysis may provide biomarkers of newer generations and thus a supplementary tool for assessing the disease progression and predicting disability of the patients and persons at risks. This chapter is a summary of current knowledge and prognostic perspectives toward catalytic Abs in autoimmunity and thus some autoimmune clinical cases, their role in pathogenesis, and the exploitation of both whole molecules and their constituent parts in developing highly effective targeted drugs of the future to come, and thus the therapeutic protocols being individualized.
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| 2. |
- Bashkin, Osnat, et al.
(författare)
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Emerging lessons from the COVID-19 pandemic about the decisive competencies needed for the public health workforce : A qualitative study
- 2022
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Ingår i: Frontiers In Public Health. - : Frontiers Media S.A.. - 2296-2565. ; 10
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Tidskriftsartikel (refereegranskat)abstract
- The global COVID-19 crisis exposed the critical need for a highly qualified public health workforce. This qualitative research aimed to examine public health workforce competencies needed to face COVID-19 challenges and identify the gaps between training programs and the competency demands of real-world disasters and pandemics. Through a sample of thirty-one participant qualitative interviews, we examined the perspectives of diverse stakeholders from lead public health organizations in Israel. Grounded Theory was used to analyze the data. Six themes emerged from the content analysis: public health workforce's low professional status and the uncertain future of the public health workforce; links between the community and Higher Education institutions; the centrality of communication competencies; need to improve health promotion; the role of leadership, management, and partnership, and innovation in public health coherence. Increasing the attractiveness of the profession, professional and financial support, and improving the working conditions to ensure a sustainable and resilient PH system were deemed necessary. This paper describes and cultivates new knowledge and leadership skills among public health professionals, and lays the groundwork for future public health leadership preparedness programs.
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| 3. |
- Bashkin, Osnat, et al.
(författare)
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Identifying the Gaps Between Public Health Training and Practice : A Workforce Competencies Comparative Analysis
- 2022
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Ingår i: International Journal of Public Health. - : Frontiers Media S.A.. - 1661-8556 .- 1661-8564. ; 67
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The study aimed to generate insights on how best to enhance the compatibility between Public Health training program competencies and the implementation of competencies required by employers to address current and emerging public health needs.Methods: A survey adapted from the WHO-ASPHER Competency Framework for the Public Health Workforce was conducted online among Israeli public health managers from August to November 2021. The survey was formulated to mirror Essential Public Health Operations. Forty-nine managers participated (37.6% response rate) in an assessment of 44 public health competencies and the core organizational public health operations.Results: Analysis of Essential Public Health Operations revealed a notably high deficiency reported for Advocacy Communication and Social Mobilization for health competencies. Collaborations and Partnership and, Leadership and System Thinking were the most reported insufficient competencies, particularly in health departments and research institutes. Governmental offices reported Organizational Literacy and Adaptability competencies being deficient. Deficiencies were more impactful as the level of expertise increased.Conclusion: There is a clear need for public health professionals to acquire versatile and innovative competencies in response to the ever-changing health threats.
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| 4. |
- Brambilla, Andrea, et al.
(författare)
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Flexibility during the covid-19 pandemic response: Healthcare facility assessment tools for resilient evaluation
- 2021
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 18:21
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Tidskriftsartikel (refereegranskat)abstract
- Healthcare facilities are facing huge challenges due to the outbreak of COVID-19. Around the world, national healthcare contingency plans have struggled to cope with the population health impact of COVID-19, with healthcare facilities and critical care systems buckling under the ex-traordinary pressures. COVID-19 has starkly highlighted the lack of reliable operational tools for assessing the level sof flexibility of a hospital building to support strategic and agile decision making. The aim of this study was to modify, improve and test an existing assessment tool for evaluating hospital facilities flexibility and resilience. We followed a five-step process for collecting data by (i) doing a literature review about flexibility principles and strategies, (ii) reviewing healthcare design guidelines, (iii) examining international healthcare facilities case studies, (iv) conducting a critical review and optimization of the existing tool, and (v) assessing the usability of the evaluation tool. The new version of the OFAT framework (Optimized Flexibility Assessment Tool) is composed of nine evaluation parameters and subdivided into measurable variables with scores ranging from 0 to 10. The pilot testing of case studies enabled the assessment and verification the OFAT validity and reliability in support of decision makers in addressing flexibility of hospital design and/or operations. Healthcare buildings need to be designed and built based on principles of flexibility to accommodate current healthcare operations, adapting to time-sensitive physical transformations and responding to contemporary and future public health emergencies.
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| 5. |
- Dopelt, Keren, et al.
(författare)
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Simulation as a key training method for inculcating public health leadership skills : a mixed methods study
- 2023
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Ingår i: Frontiers in Public Health. - : Frontiers Media S.A.. - 2296-2565. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- Background: Successful management of public health challenges requires developing and nurturing leadership competencies. We aimed to evaluate the effectiveness of training simulations to assess public health leadership and decision-making competencies during emergencies as an effective learning and training method.Methods: We examined the effects of two simulation scenarios on public health school students in terms of their experience (compared to face-to-face learning) and new skills acquired for dealing with similar emergent situations in the future. A mixed-methods design included developing a validated and pre-tested questionnaire with open-and closed-ended questions that examined the simulation impact and the degree of student satisfaction with the conditions in which it was conducted. Semi-structured in-depth interviews were conducted with the students after going through the simulations. The questionnaire results were evaluated using descriptive analytics. The interviews were analyzed using thematic analyses. All data were collected during June 2022.Results: The questionnaire results indicate that students strengthened their interpersonal communication skills and learned about the importance of listening to the opinions of others before formulating their positions. Four themes emerged from 16 in-depth interviews, according to Kolb’s experimental learning cycle. Students emphasized the effectiveness of experiential learning versus traditional classroom learning. The simulation scenarios were felt to realistically convey critical issues regarding leadership, decision-making, and teamwork challenges. They effectively conveyed the importance of building a culture of conducting substantive and respectful discussions.Conclusion: Simulation is a powerful pedagogical training tool for public health leadership competencies. Simulations were seen to be advantageous over face-to-face learning in imparting a range of leadership skills and hands-on practice. We recommend integrating simulations in all public health leadership training programs.
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| 6. |
- Guillen-Grima, Francisco, et al.
(författare)
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Evaluating the Efficacy of ChatGPT in Navigating the Spanish Medical Residency Entrance Examination (MIR): Promising Horizons for AI in Clinical Medicine
- 2023
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Ingår i: CLINICS AND PRACTICE. - 2039-7275 .- 2039-7283. ; 13:6, s. 1460-1487
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Tidskriftsartikel (refereegranskat)abstract
- The rapid progress in artificial intelligence, machine learning, and natural language processing has led to increasingly sophisticated large language models (LLMs) for use in healthcare. This study assesses the performance of two LLMs, the GPT-3.5 and GPT-4 models, in passing the MIR medical examination for access to medical specialist training in Spain. Our objectives included gauging the model's overall performance, analyzing discrepancies across different medical specialties, discerning between theoretical and practical questions, estimating error proportions, and assessing the hypothetical severity of errors committed by a physician. Material and methods: We studied the 2022 Spanish MIR examination results after excluding those questions requiring image evaluations or having acknowledged errors. The remaining 182 questions were presented to the LLM GPT-4 and GPT-3.5 in Spanish and English. Logistic regression models analyzed the relationships between question length, sequence, and performance. We also analyzed the 23 questions with images, using GPT-4's new image analysis capability. Results: GPT-4 outperformed GPT-3.5, scoring 86.81% in Spanish (p < 0.001). English translations had a slightly enhanced performance. GPT-4 scored 26.1% of the questions with images in English. The results were worse when the questions were in Spanish, 13.0%, although the differences were not statistically significant (p = 0.250). Among medical specialties, GPT-4 achieved a 100% correct response rate in several areas, and the Pharmacology, Critical Care, and Infectious Diseases specialties showed lower performance. The error analysis revealed that while a 13.2% error rate existed, the gravest categories, such as "error requiring intervention to sustain life" and "error resulting in death", had a 0% rate. Conclusions: GPT-4 performs robustly on the Spanish MIR examination, with varying capabilities to discriminate knowledge across specialties. While the model's high success rate is commendable, understanding the error severity is critical, especially when considering AI's potential role in real-world medical practice and its implications for patient safety.
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