BACKGROUND: Guidelines for pharmacy practitioners regarding various clinical pharmacy activities have been published in a number of countries. There is a need to review the guidelines and identify the scope of activities covered as a prelude to developing internationally acceptable common guidelines. AIM: To review the scope of clinical pharmacy guidelines and assess the extent to which these guidelines conform to quality standards as per the AGREE II instrument. METHOD: Medline, Embase, Guideline Central, International Pharmaceutical Abstracts, Google Scholar and Google (for grey literature) were searched for the period 2010 to January 2023. Guidelines which focused on any health care setting and any clinical pharmacy activity were included. Data were extracted and quality assessed independently by two reviewers using the English version of the AGREE II instrument. RESULTS: Thirty-eight guidelines were included, mostly originating from Australia (n = 10), Ireland (n = 8), UK (n = 7) and USA (n = 5). Areas covered included medication reconciliation, medicines optimisation, medication management and transition of care. As per the AGREE II assessment, the highest score was obtained for the scope and purpose domain and the lowest score for rigour of development, mainly due to non-consideration of literature/evidence to inform guideline development. CONCLUSION: Clinical pharmacy guidelines development processes need to focus on all quality domains and should take a systematic approach to guideline development. Guidelines need to further emphasise person-centred care and clinical communication. There is a scope to harmonise the guidelines internationally considering the diverse practices, standards and legislations across different geographies.

• MeSH
• farmacie * MeSH
• komunikace * MeSH
• lidé MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• systematický přehled MeSH
• Geografické názvy
• Austrálie MeSH
• Irsko MeSH

BACKGROUND AND OBJECTIVES: The inability of individuals in the advanced stage of dementia to communicate about preferences in care at the end-of-life poses a challenge for healthcare professionals and family carers. The proven effective Family Carer Decision Support intervention has been designed to inform family carers about end-of-life care options available to a person living with advanced dementia. The objectives of the mySupport study were to adapt the application of the intervention for use in different countries, assess impact on family satisfaction and decision-making, and identify costs and supportive conditions for the implementation of the intervention. RESEARCH DESIGN AND METHODS: A multiple-case study design was chosen where the nursing home was the case. Nursing homes were enrolled from six countries: Canada, Czech Republic, Italy, Netherlands, Republic of Ireland, and United Kingdom. RESULTS: Seventeen cases (nursing homes) participated, with a total of 296 interviews completed including family carers, nursing home staff, and health providers. Five themes relevant to the implementation of the intervention were identified: supportive relationships; committed staff; perceived value of the intervention; the influence of external factors on the nursing home; and resource impact of delivery. DISCUSSION AND IMPLICATIONS: There is a commonality of facilitators and barriers across countries when introducing practice innovation. A key learning point was the importance of implementation being accompanied by committed and supported nursing home leadership. The nursing home context is dynamic and multiple factors influence implementation at different points of time.

• MeSH
• demence * MeSH
• lidé MeSH
• osoby pečující o pacienty * psychologie   MeSH
• péče o umírající MeSH
• pečovatelské domovy * organizace a řízení   MeSH
• předběžné plánování péče * MeSH
• rozhodování MeSH
• senioři MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH
• Irsko MeSH
• Itálie MeSH
• Kanada MeSH
• Nizozemsko MeSH
• Spojené království MeSH

Traditional health systems typologies were based on health system financing type, such as the well-known OECD typology. However, the number of dimensions captured in classifications increased to reflect health systems complexity. This study aims to develop a taxonomy of primary care (PC) systems based on the actors involved (state, societal and private) and mechanisms used in governance, financing and regulation, which conceptually represents the degree of decentralisation of functions. We use nonlinear canonical correlations analysis and agglomerative hierarchical clustering on data obtained from the European Observatory on Health Systems and Policy and informants from 24 WHO European Region countries. We obtain four clusters: 1) Bosnia Herzegovina, Czech Republic, Germany, Slovakia and Switzerland: corporatist and/or fragmented PC system, with state involvement in PC supply regulation, without gatekeeping; 2) Greece, Ireland, Israel, Malta, Sweden, and Ukraine: public and (re)centralised PC financing and regulation with private involvement, without gatekeeping; 3) Finland, Norway, Spain and United Kingdom: public financing and devolved regulation and organisation of PC, with gatekeeping; and 4) Bulgaria, Croatia, France, North Macedonia, Poland, Romania, Serbia, Slovenia and Turkey: public and deconcentrated with professional involvement in supply regulation, and gatekeeping. This taxonomy can serve as a framework for performance comparisons and a means to analyse the effect that different actors and levels of devolution or fragmentation of PC delivery may have in health outcomes.

• MeSH
• lidé MeSH
• primární zdravotní péče * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Bosna a Hercegovina MeSH
• Bulharsko MeSH
• Česká republika MeSH
• Chorvatsko MeSH
• Evropa MeSH
• Finsko MeSH
• Francie MeSH
• Irsko MeSH
• Izrael MeSH
• Malta MeSH
• Německo MeSH
• Norsko MeSH
• Polsko MeSH
• Řecko MeSH
• Republika Severní Makedonie MeSH
• Rumunsko MeSH
• Slovenská republika MeSH
• Slovinsko MeSH
• Španělsko MeSH
• Spojené království MeSH
• Srbsko MeSH
• Švédsko MeSH
• Švýcarsko MeSH
• Turecko MeSH
• Ukrajina MeSH

• MeSH
• lidé MeSH
• zdravotní politika MeSH
• zdravotní služby pro osoby s postižením * dějiny   organizace a řízení   zákonodárství a právo   MeSH
• Check Tag
• lidé MeSH
• Geografické názvy
• Irsko MeSH

• MeSH
• lidé MeSH
• pomůcky pro sebeobsluhu statistika a číselné údaje   MeSH
• postižení statistika a číselné údaje   MeSH
• statistika jako téma MeSH
• uspokojení potřeb MeSH
• výzkum MeSH
• zdravotní služby pro osoby s postižením * statistika a číselné údaje   trendy   MeSH
• Check Tag
• lidé MeSH
• Geografické názvy
• Irsko MeSH

IntroductionPERTINENT is a pilot active surveillance system of infants hospitalised with pertussis in six European Union/European Economic Area countries (37 hospitals, seven sites).AimThis observational study aimed to estimate annual pertussis incidence per site from 2016 to 2018 and respective trends between 2017 and 2018. Pertussis cases were described, including their severity.MethodsWe developed a generic protocol and laboratory guidelines to harmonise practices across sites. Cases were hospitalised infants testing positive for Bordetella pertussis by PCR or culture. Sites collected demographic, clinical, laboratory data, vaccination status, and risk/protective factors. We estimated sites' annual incidences by dividing case numbers by the catchment populations.ResultsFrom December 2015 to December 2018, we identified 469 cases (247 males; 53%). The median age, birthweight and gestational age were 2.5 months (range: 0-11.6; interquartile range (IQR): 2.5), 3,280 g (range: 700-4,925; IQR: 720) and 39 weeks (range: 25-42; IQR: 2), respectively. Thirty cases (6%) had atypical presentation either with cough or cyanosis only or with absence of pertussis-like symptoms. Of 330 cases with information, 83 (25%) were admitted to intensive care units including five deceased infants too young to be vaccinated. Incidence rate ratios between 2018 and 2017 were 1.43 in Czech Republic (p = 0.468), 0.25 in Catalonia (p = 0.002), 0.71 in France (p = 0.034), 0.14 in Ireland (p = 0.002), 0.63 in Italy (p = 0.053), 0.21 in Navarra (p = 0.148) and zero in Norway.ConclusionsIncidence appeared to decrease between 2017 and 2018 in all but one site. Enhanced surveillance of hospitalised pertussis in Europe is essential to monitor pertussis epidemiology and disease burden.

• MeSH
• Bordetella pertussis MeSH
• Evropská unie MeSH
• hospitalizace MeSH
• incidence MeSH
• kojenec MeSH
• lidé MeSH
• nemocnice MeSH
• novorozenec MeSH
• pertuse * diagnóza   epidemiologie   prevence a kontrola   MeSH
• pertusová vakcína MeSH
• senioři MeSH
• vakcinace MeSH
• Check Tag
• kojenec MeSH
• lidé MeSH
• mužské pohlaví MeSH
• novorozenec MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• pozorovací studie MeSH
• Geografické názvy
• Česká republika MeSH
• Evropa MeSH
• Francie MeSH
• Irsko MeSH
• Itálie MeSH
• Norsko MeSH

INTRODUCTION: Assistive technology (AT) is important for the achievement of the sustainable development goals (SDGs) for persons with disabilities (PWD). Increasingly, studies suggest a significant gap between the need for and demand for and provisions of AT for PWD in low-income and middle-income settings. Evidence from high income countries highlights the importance of robust AT policies to the achievement of the recommendations of the World Health Assembly on AT. In Malawi, there is no standalone AT policy. The objectives of the Assistive Product List Implementation Creating Enablement of inclusive SDGs (APPLICABLE) project, are to propose and facilitate the development of a framework for creating effective national AT policy and specify a system capable of implementing such policies in low-income countries such as Malawi. METHOD AND ANALYSIS: We propose an action research process with stakeholders in AT in Malawi. APPLICABLE will adopt an action research paradigm, through developing a shared research agenda with stakeholders and including users of AT. This involves the formation of an Action Research Group that will specify the priorities for practice-and policy-based evidence, in order to facilitate the development of contextually realistic and achievable policy aspirations on AT in Malawi and provide system strengthening recommendations that will ensure that the policy is implementable for their realisation. We will undertake an evaluation of this policy by measuring supply and support for specific AT prior to, and following the implementation of the policy recommendations. ETHICS AND DISSEMINATION: The study protocol was approved by Maynooth University Research Ethics Committee (SRESC-2019-2378566) and University of Malawi Research Ethics Committee (P.01/20/10). Findings from the study will be disseminated by publication in peer-reviewed journals, presentations to stakeholders in Malawi, Ireland and international audiences at international conferences.

• MeSH
• celosvětové zdraví * MeSH
• lidé MeSH
• trvale udržitelný rozvoj * MeSH
• výzkum zdravotnických služeb MeSH
• zdravotní politika MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Irsko MeSH
• Malawi MeSH

BACKGROUND: Several studies have been performed on the relationship between working conditions and health. Numerous parameters still require further study, including working hours and obesity among different groups, specifically older workers in national, regional, and international levels. OBJECTIVE: Working hours have considerable effects on the socio-cultural, psychological, and economic aspects of people's lives and health. While long working hours increases income level and raises living standards, it increases the risk of certain health problems. This study investigated whether working hours are associated with obesity in upper-middle-aged workers. METHODS: The Survey of Health, Ageing and Retirement in Europe (SHARE) dataset was used for the analyses. Analyses were carried out by means of a Cox regression of the panel dataset created with the data in question, surveyed by European Commission to 12,000 participants. RESULTS: The survey was performed in Austria, Belgium, Switzerland, Germany, Denmark, Spain, France, Greece, Italy, the Netherlands, Sweden, the Czech Republic, Poland, and Ireland. We found that in most countries, especially Sweden and the Netherlands, upper-middle-aged employees working > 59 hours per week are more likely to gain weight than their counterparts working < 59 hours. CONCLUSIONS: Our findings raise awareness of obesity in older workers, and highlight the need to regulate working conditions and hours in the European Union and other countries.

• MeSH
• hmotnostní přírůstek * MeSH
• lidé středního věku MeSH
• lidé MeSH
• senioři MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Belgie MeSH
• Česká republika MeSH
• Evropa MeSH
• Francie MeSH
• Irsko MeSH
• Itálie MeSH
• Německo MeSH
• Nizozemsko MeSH
• Polsko MeSH
• Rakousko MeSH
• Řecko MeSH
• Španělsko MeSH
• Švédsko MeSH
• Švýcarsko MeSH

Studies from single countries suggest that local labour market conditions, including rates of employment, tend to be associated with the health of the populations residing in those areas, even after adjustment for individual characteristics including employment status. The aim of this study is to strengthen the cross-national evidence base on the influence of regional employment levels and individual worklessness on health during the period of the Great Recession. We investigate whether higher regional employment levels are associated with better health over and above individual level employment. Individual level data (N = 23,078 aged 15-64 years) were taken from 16 countries (Austria, Belgium, Czech Republic, Denmark, Finland, France, Germany, Hungary, Ireland, Netherlands, Norway, Poland, Portugal, Spain, Sweden and United Kingdom) participating in the 2014 European Social Survey. Regional employment rates were extracted from Eurostat, corresponding with the start (2008) and end (2013) of the Great Recession. Health outcomes included self-reported heart or circulation problems, high blood pressure, diabetes, self-rated health, depression, obesity and allergies (as a falsification test). We calculated multilevel Poisson regression models, which included individuals nested within regions, controlling for potential confounding variables and country fixed effects. After adjustment for individual level socio-demographic factors, higher average regional employment rates (from 2008 to 2013) were associated with better health outcomes. Individual level worklessness was associated with worsened health outcomes, most strongly with poor self-rated health. In models including both individual worklessness and the average regional employment rate, regional employment remained associated with heart and circulation problems, depression and obesity. There was evidence of an interaction between individual worklessness and regional employment for poor self-rated health and depression. The findings suggest that across 16 European countries, for some key outcomes, higher levels of employment in the regional labour market may be beneficial for the health of the local population.

• MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• zaměstnanost * MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Belgie MeSH
• Česká republika MeSH
• Evropa MeSH
• Finsko MeSH
• Francie MeSH
• Irsko MeSH
• Maďarsko MeSH
• Německo MeSH
• Nizozemsko MeSH
• Norsko MeSH
• Polsko MeSH
• Portugalsko MeSH
• Rakousko MeSH
• Španělsko MeSH
• Spojené království MeSH
• Švédsko MeSH

OBJECTIVES: Treatment for progressive multiple sclerosis (pMS) is a key area of research. To date, whether MS type and the rehabilitation setting are associated with worse or better response to rehabilitation is unclear. We aimed to understand the association between balance and MS type, in/outpatient treatment and specificity of the intervention. METHODS: We assessed 150 people with MS before and after in/outpatient rehabilitation. The Berg Balance Scale (BBS) was used to discriminate between responders (≥+3-point improvement in BBS score; a clinically meaningful improvement) and non-responders to specific or non-specific balance rehabilitation. Factors associated with balance were analyzed by univariate and multivariable logistic regression analyses, estimating odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: Balance improved after rehabilitation: median (quartile 1 [Q1]-Q3) BBS score pre- and post-rehabilitation of 49 (45-53) and 52 (47-55) (P<0.001). Univariate logistic analysis revealed a clinically meaningful improvement in balance associated with pMS (OR 2.21 [95% CI 1.09-4.05]), inpatient therapy (0.41 [0.19-0.84]), using a walking aid (1.68 [1.06-2.69]), and low baseline BBS score (0.86 [0.81-0.92]). On multivariable analysis, probability of improvement was similar for participants with pMS and the relapsing-remitting form but was associated with low baseline BBS score and specific treatment (OR 0.81 [95% CI 0.74-0.89] and 5.66 [1.79-21.5]). CONCLUSION: A clinically meaningful improvement in balance was more likely when MS individuals with moderate to high disability had specific exercises targeting balance, but MS type did not influence the outcome.

• MeSH
• dospělí MeSH
• fyzioterapie (techniky) MeSH
• interval spolehlivosti MeSH
• lidé středního věku MeSH
• lidé MeSH
• logistické modely MeSH
• longitudinální studie MeSH
• odds ratio MeSH
• omezení pohyblivosti MeSH
• pacienti ambulantní MeSH
• pacienti hospitalizovaní MeSH
• poruchy senzitivity etiologie   terapie   MeSH
• posturální rovnováha * MeSH
• randomizované kontrolované studie jako téma statistika a číselné údaje   MeSH
• retrospektivní studie MeSH
• roztroušená skleróza komplikace   patofyziologie   rehabilitace   MeSH
• stupeň závažnosti nemoci MeSH
• úrazy pádem MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• pragmatická klinická studie MeSH
• Geografické názvy
• Irsko MeSH
• Itálie MeSH