其他最新文献

{"title":"Can a 19^th Century French Medical Debate Provide Guidance on How to Tackle Type 2 Diabetes?","authors":"Abdo S Yazbeck","doi":"10.1080/23288604.2025.2464977","DOIUrl":"https://doi.org/10.1080/23288604.2025.2464977","url":null,"abstract":"","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":"11 1","pages":"2464977"},"PeriodicalIF":0.0,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143506534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development Assistance for Health and the Challenge of NCDs Through the Lens of Type 2 Diabetes.","authors":"William Savedoff, Abdo S Yazbeck, David H Peters, Son Nam Nguyen","doi":"10.1080/23288604.2025.2531693","DOIUrl":"10.1080/23288604.2025.2531693","url":null,"abstract":"<p><p>Non-communicable diseases (NCDs) represent the largest burden of disease, even in low-and middle-income countries (LMICs). The long latency period, chronicity, and common environmental, behavioral and genetic etiologies of NCDs-as shown through the example of Type 2 diabetes mellitus (T2DM)-expose health system failures to undertake multi-sectoral public health actions, address early detection, and provide integrated care. Development assistance for health (DAH), with its focus on donor priorities, often exacerbates such health system challenges. DAH has mainly focused on infectious diseases along with conditions related to reproductive health. Some programs show how DAH could help LMICs reorient health systems by focusing on neglected areas like economic and social policies, along with environmental and behavioral drivers of diseases like T2DM. Furthermore, in an era of declining resources for DAH, external support needs to be catalytic, supporting reforms more than financing services. Orienting limited DAH to address NCDs could support the necessary transformation of service organization, financial allocation criteria, data generation and use, health promotion, and training of care providers. DAH could also strengthen the public institutions and policies that prevent NCDs like T2DM through economic policies, environmental regulation, and health promotion interventions that address social and behavioral risk factors. Four broad categories of actions can guide DAH to better orient health systems to address NCDs: \"First, do no harm,\" help transform health systems, think outside the box, and match tools to needs. Several existing assistance modalities are also presented to show specific ways that this reorientation can be implemented.</p>","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":"11 1","pages":"2531693"},"PeriodicalIF":1.9,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oncogenic <i>ALK</i> fusion in rare subtype of small intestine metastasis from occult lung cancer.","authors":"Tianhua Liu, Yizhuo Chen, Ziqing Xu, Ming Dong","doi":"10.1080/17581966.2024.2364582","DOIUrl":"10.1080/17581966.2024.2364582","url":null,"abstract":"<p><p>We present the case of a 66-year-old male patient who was found to have a lung nodule during the perioperative period for poorly differentiated carcinoma of the ileocecal region. Subsequent surgical procedures were performed to remove the intestinal and lung masses. Next-generation sequencing (NGS) testing demonstrated that the intestinal and lung lesions exhibited the same <i>ALK</i> pathogenic fusion. Following 7 months of Alectinib treatment, the patient's clinical evaluation showed stable disease. This is the first report of intestinal metastases from lung cancer with <i>ALK</i> fusion. Our findings indicate that a comprehensive approach, including histopathological examination and genetic testing, is necessary to diagnose and treat intestinal metastases from lung cancer accurately.</p>","PeriodicalId":43551,"journal":{"name":"Lung Cancer Management","volume":"14 1","pages":"2364582"},"PeriodicalIF":0.9,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11633444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Health Systems Approach to Nurse-Led Implementation of Diabetes Prevention and Management in Vulnerable Populations.","authors":"Patricia C Underwood, Brielle Ruscitti, Tam Nguyen, Cherlie Magny-Normilus, Katherine Wentzell, Sharon A Watts, Diana Bowser","doi":"10.1080/23288604.2025.2503648","DOIUrl":"https://doi.org/10.1080/23288604.2025.2503648","url":null,"abstract":"<p><p>Diabetes mellitus is seventh-leading cause of death in the United States, and has a substantial economic burden, contributing $237 billion in direct medical costs. The incidence rate of type 2 diabetes (T2DM) is expected to continue to increase, disproportionally impacting vulnerable groups. The increasing prevalence and disproportionate burden emphasize the need for health systems to effectively integrate and implement large- and small-scale, culturally tailored nurse-led diabetes prevention programs (DPP) and diabetes self-management education programs (DSME). This two-stage analysis uses a health system approach to provide a synopsis of evidence-based nurse-led DPP and DSME implementation across various health system settings. Using the results from an integrative review, a health system focused framework was developed and applied to two case studies highlighting specific aspects of how successful large- and small-scale nurse-led interventions are integrated into health systems across varying vulnerable populations specifically Veterans, Asian Americans and Haitians. Case study results use examples to show large-scale implementation of DSME across the federal Veterans Health Administration (VHA) improves diabetes self-management and access for Veterans and smaller-scale DPP and DSME programs within community health centers targeting vulnerable populations impact health literacy and diabetes self-management. These examples demonstrate key steps toward improving access and outcomes for diabetes management and the critical role of nurse-led diabetes interventions as a priority across the health system and the importance of financial and organizational support for DPP and DSME programs to overcome access barriers to improve diabetes interventions and management.</p>","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":"11 1","pages":"2503648"},"PeriodicalIF":0.0,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Regularization Policies on Health Access: Examining Female Venezuelan Migrants' Access and Utilization of Healthcare Services in Colombia.","authors":"Diana M Bowser, Priya Agarwal-Harding, Brielle Ruscitti, Donald S Shepard, Arturo Harker Roa","doi":"10.1080/23288604.2025.2510769","DOIUrl":"10.1080/23288604.2025.2510769","url":null,"abstract":"<p><p>The Venezuelan humanitarian crisis has led to the displacement of over 7.7 million migrants, with Colombia hosting around one-third. Colombia has been praised for its progressive policies for Venezuelan migrant integration, and the government's <i>Estatuto Temporal de Protección para Migrantes Venezolanos</i> (ETPMV), introduced in February 2021, provides one of the region's most comprehensive regularization policies, permitting 10 years of residency and access to social protection services, including health insurance. We assessed the impact of the ETPMV on self-reported health insurance enrollment and formal healthcare utilization using two telephone surveys with 4,423 female Venezuelan migrants in 2020 and 2023. We used a difference-in-differences methodological approach, accounting for differences in levels of migrant health system integration across municipalities measured by a municipal enrollment index derived from secondary data. We find that the ETPMV significantly increases health insurance enrollment for female Venezuelan migrants and that while uninsured individuals experience a significant decline in healthcare utilization from 2020 to 2023, insured individuals experience no significant change. Additionally, the effect of insurance varies by municipal enrollment index, with greater impacts of insurance in areas with lower levels of regularization and health insurance enrollment. These results highlight the success of ETPMV in enhancing access to healthcare for Venezuelan migrants, with insurance enrollment providing a protective effect against declines in healthcare utilization compared to uninsured individuals. These findings underscore the importance of comprehensive regularization policies to address migrant health needs, while emphasizing the importance of continued efforts toward integration.</p>","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":"11 1","pages":"2510769"},"PeriodicalIF":1.9,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12376018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overweight, Obesity and Diabetes: Global Trends and a Better Future?","authors":"Barbara McPake","doi":"10.1080/23288604.2025.2518797","DOIUrl":"https://doi.org/10.1080/23288604.2025.2518797","url":null,"abstract":"<p><p>The related overweight, obesity and diabetes epidemics are more than five decades old and have progressed inexorably. A billion people in the world are now obese, and nearly a billion are diabetic. The belief that diabetes is caused by overweight and obesity has led to public health advice focused on lifestyle change as the main preventive approach. This advice has shifted over time, and some parts of the public health community have started to switch from a lifestyle to an environmental perspective. There is a growing but not yet conclusive evidence base that rather than diabetes being caused by overweight and obesity, the three conditions have a common third cause, and difficulties in controlling weight and blood glucose emerge in tandem. New classes of medications, including semaglutides and tirzepatides, effectively address these processes. They are in the early stages of development but have accumulated a safety record over the last decade. They are largely currently available only to those who can afford their relatively high cost, but new generations of related medications are capable of becoming lower cost, and wider access to them could transform the overweight, obesity and diabetes pandemics. There is a marked absence of enthusiasm for their potential role in the public health community. This appears to reflect stigmatized attitudes to overweight and obesity, which contrast with attitudes to diabetes. A successful medical treatment may be the key to resolving that stigma and reversing the three pandemics.</p>","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":"11 1","pages":"2518797"},"PeriodicalIF":0.0,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Politics, Political Science and the Pandemic.","authors":"Kevin Croke","doi":"10.1080/23288604.2025.2521182","DOIUrl":"10.1080/23288604.2025.2521182","url":null,"abstract":"<p><p>Health systems research as a field has increased its attention to political factors that shape health system development. However, there has been a lack of consensus about which conceptual frameworks and models from the academic discipline of political science are most relevant to the study of health systems. The COVID-19 pandemic underlined the centrality of politics to health, but it also demonstrated the limitations of existing frameworks used to analyze the politics of health. This article reviews the political science literature on the politics of COVID-19, identifies several gaps in the theoretical frameworks used in this work, and draws some conclusions for future work on the politics of pandemics and the politics of health system development writ large.</p>","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":"11 1","pages":"2521182"},"PeriodicalIF":0.0,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A 10-Step Method for Fair Priority-Setting Processes: A Qualitative Case Study from Zanzibar.","authors":"Omar Mwalim, Sanaa Said, Subira Suleiman, Fatma Bakar, Haji Khamis, Dhameera Mohammed, Zuhura Amour, Omar Mussa, Abdulmajid Jecha, Abdul-Latif Haji, Ole F Norheim, Ingrid Miljeteig, Austen Davis, Peter Hangoma, Kjell Arne Johansson","doi":"10.1080/23288604.2025.2516903","DOIUrl":"10.1080/23288604.2025.2516903","url":null,"abstract":"<p><p>Health systems worldwide face challenges in managing resource scarcity, necessitating systematic and fair approaches to prioritize essential health services. Practical guidance on structuring transparent and inclusive priority setting processes remains limited. This paper presents a 10-step method for designing fair priority-setting processes, demonstrated through the revision of the Zanzibar Essential Health Care Package (2019-2022). The 10-step method provides pragmatic and context-specific guidance, bridging the gap between global frameworks and local implementation in resource-limited settings. These 10 steps build upon recognized and accepted conditions and principles for health priorities and include: (1) development of a roadmap, (2) establishment of management, (3) selection of criteria for priority setting, (4) identification of candidate interventions, (5) formulation of financing strategies, (6) evidence generation, (7) employment of analytics, (8) setting priorities, (9) implementation arrangement, and (10) monitoring and evaluation to track implementation. The core team guided each step based on three fundamental principles-stakeholder involvement, transparency, and structured deliberation. In Zanzibar, consensus-building workshops were held to determine the criteria for setting priorities: cost-effectiveness, budget impact, disease burden, and equity. Political/public acceptability emerged as an additional criterion due to the challenges associated with including abortion services. Financial risk protection was deemed significant but was instead incorporated into the implementation and health financing plans. The core team offered preliminary training sessions on health priorities to stakeholders. This structured 10-step method encourages participation and inclusivity of marginalized groups usually excluded from such discussions, trust, and legitimacy in Essential Health Care Package processes, thereby providing policymakers with a tool for improvement.</p>","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":"11 1","pages":"2516903"},"PeriodicalIF":1.9,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12312743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Care for Preschool Children with Disabilities During Disasters in Japan.","authors":"Koji Yamawaki, Aya Goto, Kimiko Ueda","doi":"10.1080/23288604.2025.2521185","DOIUrl":"https://doi.org/10.1080/23288604.2025.2521185","url":null,"abstract":"<p><p>This commentary traces the origins of Japan's special education system and explores the need to equip preschool teachers with the specific knowledge and skills necessary to care for children under the age of six with disabilities during disasters in Japan. Japan's slow implementation of inclusive education, in which children with and without disabilities are educated together, was noted by the UN Committee on the Rights of Persons with Disabilities in 2022. The Committee also recommended improved care for persons with disabilities in disaster situations and humanitarian emergencies. Historically, Japan has promoted policies that segregate children with disabilities from children without disabilities. Integrated childcare began in the 1970s, but there continues to be a lack of suitable systems and practical guidelines for disaster management in inclusive childcare. The curricula of institutions that train childcare professionals were reviewed. As of April 1, 2023, there were 666 designated childcare teacher training institutions in Japan. Of these, 498 training institutions offered courses to obtain both kindergarten and nursery teaching licenses. Thirty-seven of the institutions were national and public schools, of which the present study included 36 schools whose syllabus was available online and whose course content could be confirmed. Only one school (2.8%) was found to include \"disaster and childcare\" in its curriculum, and three schools (8.3%) included \"safety of children with disabilities\" in their curriculum. Specialist disaster preparedness training to enable teachers to care for preschool children with disabilities in the event of a disaster is critical in the context of inclusive childcare.</p>","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":"11 1","pages":"2521185"},"PeriodicalIF":0.0,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rethinking Trust and Public Health Compliance: Introducing a Trust Continuum for Policy and Practice.","authors":"Ashley Fox, Victoria Y Fan, Heeun Kim, Minah Kang","doi":"10.1080/23288604.2025.2457239","DOIUrl":"10.1080/23288604.2025.2457239","url":null,"abstract":"<p><p>Trust in government has emerged as one of the strongest predictors of national performance in fighting COVID-19. This commentary aims to take stock of the vast literature on trust and compliance with public health measures that has emerged during the pandemic to synthesize policy-relevant recommendations about: 1) How to conceptualize trust; 2) Whether trust is always deserved; and 3) How governments can earn (appropriate levels of) trust. Based on a critical reading of the literature, we develop a framework that conceptualizes trust as falling along a continuum ranging from extreme distrust to blind trust with the ideal point- \"informed\" or \"basic\" trust-falling in the mid-point of the continuum. We illustrate the continuum with examples and provide recommendations regarding how governments can build more nuanced disease responses that account for individuals and sub-groups at different rungs on the continuum while (re)building trust. We conclude that trust-building is a long-term project that must continue in non-crisis times.</p>","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":"11 1","pages":"2457239"},"PeriodicalIF":0.0,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}