This study examines how federal distribution policies affected regional disparities in access to COVID-19 therapeutics over time in Texas. To evaluate therapeutic accessibility, drug-to-case ratios were calculated by comparing the amount of therapeutic supply to confirmed case counts across counties during each policy period. A Bayesian spatiotemporal Integrated Nested Laplace Approximation (INLA) model was used to analyse how healthcare infrastructure, demographic characteristics, and regional vulnerabilities affected access. During the period when distribution was managed by state authorities, supply was quickly mobilized but often lagged demand, particularly in rural areas and communities with high rates of diabetes and older populations. In the next phase, test-to-treat program expanded overall supply, but access remained limited in areas with high racial and ethnic vulnerability due to the absence of demographic targeting. In the final phase, when therapeutics were allocated based on population thresholds and replenished regularly, spatial distribution became more stable and racial disparities narrowed. However, certain high-risk populations continued to face lower access. Findings show that each policy phase not only reflected but also reshaped regional disparities in therapeutic access. While early centralized efforts enabled swift response, they failed to address local needs. Later phases offered improved consistency but were still limited in addressing demographic and health-related vulnerabilities. This study underscores the importance of developing unified yet flexible distribution strategies that can respond to population-specific risks and infrastructure gaps, ensuring equitable access to treatment in future public health emergencies.

Oxford Houses (OH) are a widely adopted model of self-run aftercare settings originally established in the United States for people in recovery from substance use disorders (SUDs). However, OHs have had relatively limited success being established outside of the U.S. This article represents first person accounts of two multi-year collaborations to implement the OH model in Varna, Bulgaria in 2016-2017 and 2020-2023. This article describes the origins of the projects, basic steps in creating these OHs, and what was learnt from our collaborations' successes and challenges. A total of 11 Bulgarian male volunteers in recovery from SUDs lived in these two OHs. Both efforts demonstrated the OH model was difficult to sustain and may not be replicable in Bulgaria for two reasons: the common problem of attrition and low interpersonal trust presented a barrier to recruiting potential new residents who did not want to live with people they did not know, and a nascent recovery culture resulting in low levels of recovery capital. These accounts offer an analysis of the barriers to creating sustainable OHs in Bulgaria and perhaps in other cultural contexts outside the United States.

Clinicians, who engage in research alongside their clinical duties, not only improve patient outcomes but contribute to cultural and workforce benefits for their healthcare organisations. The nomenclature of workplace titles for these roles has evolved over time and across international and geographical boundaries, as has the perceived level of research expertise or qualifications required. We propose that consistent titling for these roles would be of significant benefit for individuals, as well as healthcare leaders, and in the Australian context, clinicians conducting relevant research as part of their role, and who have a PhD or recognised research qualification, should be titled 'Clinician Scientists'.

Outpatient appointments account for 85% of hospital activity and are fundamental to the running of the National Health Service (NHS). The COVID-19 pandemic and government initiatives have prompted outpatient services transformation. We aimed to determine research priorities for outpatient transformation, which represent the shared priorities of patients, their families, carers and healthcare professionals.

There is increasing global discourse on Global Health Initiatives' (GHIs) role and the need for better alignment with universal health coverage (UHC), which is particularly salient given recent rapid reductions in global aid. However, tensions within national ecosystems of GHI assistance and country alignment towards UHC are less well understood. We identify challenges and leverage points for aligning GHIs' assistance towards UHC-focused health systems in Pakistan, drawing from the perspective of country stakeholders. A political economy approach was applied to unpack the context of national aid architecture, country discourse on strengths and weakness of GHI country ecosystem and stakeholders' power, positioning and interests for future reforms. Key informant interviews were conducted with constituencies of country-based stakeholders in federal and provincial health systems, supplemented by a desk review of health financing data and policy-programmatic documents. The findings highlight a context of expanding GHI mandate, despite Pakistan's trajectory towards middle income country status, but weak alignment with national primary health care (PHC) budgeting and planning processes. Country discourse acknowledged improved disease coverage but surfaced tensions with the off-budget parallel grant model, comprising of several GHI intermediaries, headquarters-driven planning and selective system support, that was not positioned to build sustainability resulting in duplicative resourcing, questionable value for money, clouding of accountability roles and poor preparedness for transition. Competing interests between federal and provincial governments, and between disease managers and PHC planners, was perceived to further weaken country stewardship of GHI assistance. The prospect of an impending decline in aid funding was a common interest for change across all stakeholder constituencies. Stakeholders were positioned for a continuation of GHI assistance but with fundamental changes involving integration with national PHC budgeting, re-balancing power through shared accountability, and calibrated federal-provincial incentives for coordinated working, but most felt disempowered to bring about change. We conclude that addressing power imbalances must be at the centre of paradigm shifts in country assistance by GHIs, although contextual modalities will differ across LMICs. Direct engagement with UHC stakeholders under the ambit of national PHC reforms, fewer intermediaries, on-budget incentives to sustainably grow domestic financing and PFM technical assistance for aid management emerged as key areas for efficient, sustainable alignment in Pakistan and similar LMICs. Urgent actions are required within the current context of changes in global aid to build local capability for systematically easing dependence on GHIs while protecting equitable gains in disease outcomes.

This study investigates patients' goal-oriented experiences in the context of home dialysis for chronic kidney disease (CKD). The aim is to understand how the home care context can be designed to support chronic patients in achieving their goals. Drawing on goal-oriented experience theory, we explore how patients' motivations, desired outcomes, and lived experiences shape their perceptions of home health care. To do so, we employed a co-design-based qualitative methodology, including postal kits, photo diaries, ethnographic observations, in-depth interviews, and participatory workshops with 22 stakeholders (patients, healthcare professionals, and caregivers) in public and private healthcare institutions in France. Seven key design features vital to patient experience and goal fulfilment were identified: patient participation, social support, training, food quality, home layout, interactions with medical staff, and consumable supply. These features enhance the cognitive (control and expertise), emotional (safety and comfort), and physical (fitness) dimensions of patient well-being. Patients' main goals were survival, freedom, mobility, and maintaining normalcy in life. This study contributes to the literature on healthcare design and the patient journey by emphasizing goal-oriented care and demonstrating how experiential knowledge and higher-order goals can inform system design beyond conventional 'goals of care.' Healthcare systems should integrate patient-defined goals into service design to promote autonomy and quality of life. Involving multiple stakeholders can foster deeper insights and more effective, user-centric care models. This research pioneers a patient-centric, goal-oriented design framework in home healthcare, emphasizing the value of co-design methods.

This study aims to analyse and evaluate the theory of peaceful end of life to determine its relevance and applicability in nursing research, education and practice, particularly in the areas of palliative care and end-of-life care.

To investigate the prevalence and influencing factors of scoliosis among primary and secondary school students in Chongqing, China, in order to provide a theoretical basis for the prevention and control of the disease.

This study aims to optimise operating room scheduling and improve hospital operational efficiency by predicting surgery durations using machine learning algorithms. Traditional methods often face challenges in accuracy, while machine learning models offer superior predictive performance. Using real-world operating room data from a large general hospital in China, the study compares various machine learning algorithms and selects the XGBoost model as the most effective predictive framework. Three types of models were developed: an all-inclusive model, a department-specific model, and a doctor-specific model. The department-specific model demonstrated the highest accuracy, outperforming the others. The results were applied to the hospital's surgical centre scheduling process, significantly enhancing operating room resource utilisation. The study highlights the importance of data preprocessing and feature selection in improving prediction accuracy. Overall, machine learning-based surgery duration prediction can effectively address challenges in surgical scheduling and provide data-driven support for hospital operational management.

The biopharmaceutical industry in Iran has made significant progress in recent years, supported by multiple innovation policies aimed at its development. Nevertheless, challenges such as limited resources, skill and managerial gaps, weak networking, and restricted access to funding and incentives have hindered sustainable innovation.

Sovereign Wealth Funds (SWFs), managing over USD 13 trillion globally, are increasingly active in healthcare. Yet research often treats them as uniform, overlooking how mandates may shape strategies. This study explores whether typologies, savings, stabilisation, and development suggest distinct approaches to healthcare investment. Using Agency Theory and a multiple-case design, six funds were analysed across diverse contexts: Mubadala (UAE), Temasek (Singapore in India), GIC (Singapore in Malaysia), ADQ (UAE in Egypt), the New Zealand Superannuation Fund (NZSF), and the Nigeria Sovereign Investment Authority (NSIA). Findings indicate preliminary patterns. Stabilisation funds pursue conservative, infrastructure-heavy strategies to preserve liquidity. Savings funds deploy patient capital adaptively, emphasising innovation in strong systems and scalable delivery in moderate ones. Development funds align with state priorities, focussing on politically salient infrastructure even in moderate governance settings. Together, these patterns offer exploratory propositions that provide a foundation for further testing. The study contributes by extending Agency Theory to show how agency challenges differ by fund type, and by offering policymakers and healthcare leaders a framework to anticipate SWF behaviour and structure partnerships. While limited to six cases, with single-case representation for stabilisation and development funds, the framework provides a basis for future testing and for examining health outcomes such as access, innovation, and resilience. Recognising SWF heterogeneity is essential to aligning sovereign capital with sustainable healthcare.

As the demand for health services continues to surge, maximising the existing health workforce to its full scope of practice is critical. It is in this context, allied health professionals (AHPs) have a long history of working in advanced and extended scope of practice (AESP). Despite proven effectiveness, implementation of these roles continues to face challenges. A scoping review of the literature was conducted to map the barriers and enablers to allied health professionals working in AESP roles.

Home-based end-of-life care has gained policy attention in Japan. However, its fiscal consequences remain unclear. Rising healthcare costs and rapid population ageing heighten the policy relevance of such evidence.

Prioritisation in public health is complex, as decision-makers must allocate limited resources across diverse health concerns, risk factors, and target groups. In Denmark, municipalities play a central role under the Danish Health Act §119, which mandates health promotion and preventive services. However, municipalities face challenges in balancing competing needs without clear guidance. This qualitative study explores how municipalities navigate public health prioritisation, through in-depth interviews with 21 health directors and managers from 15 municipalities, selected for demographic, socio-economic, and geographical diversity. Data were analysed using systematic text condensation (STC). The findings highlight the following six themes which are central to understanding how municipalities prioritise within health promotion and prevention: (1) Economic considerations: Prioritising short-term, patient-focused services under budget constraints, (2) Public health data: Prioritising services based on locally identified health challenges, (3) Legal frameworks: Focusing on mandated services amid ambiguous legislation, (4) Evidence and evaluation: Selecting interventions with perceived effectiveness, (5) Political context: Aligning health priorities with agendas and ideological acceptability, and (6) Demographic and geographic conditions: Adapting services to local realities. We find that municipalities adopt a pragmatic, consensus-driven approach, but prioritisation processes vary, leading to disparities in service provision. Using Kingdon's Multiple Streams Framework, we discuss how municipalities frame health issues, select policy solutions, and navigate political contexts. The study highlights the need for clearer national frameworks to promote equitable public health access.

This study examines the sustainability performance of health care Public-Private Partnerships (PPPs) in emerging economies across economic, social, and environmental dimensions. Using panel data from 148 projects in 22 countries (2005-2022) and a multilayer network framework, it compares PPPs with traditional procurement. Results show that PPPs improve financing, access, and patient satisfaction, with moderate environmental gains. Governance quality and macroeconomic stability enhance these effects, while interdependencies reveal how advances in one area reinforce those in others. The analysis links PPP outcomes to Sustainable Development Goals (SDGs 3, 9, 10, 12, 13, and 16) and confirms robustness through alternative indices and models. This is the first integrated evaluation of health care PPPs in emerging economies, offering guidance for embedding ESG standards, resilience clauses, and monitoring benchmarks.

This study examines the optometric research landscape in three East Asian countries-China, Japan, and Korea-analysing how research trends align with each country's national health strategies. By evaluating published articles and reviews from national journals between 2006 March 2025, we identify key areas of focus, including paediatric optometry, refractive errors, and advanced diagnostic techniques. China's research emphasises pathogenesis and retinal diseases, driven by its aging population and high prevalence of chronic conditions, while Japan prioritises binocular vision and professional practice across all age groups. Korea focuses on accommodation, contact lenses, and the impact of digital technology on vision, reflecting its high prevalence of myopia among children. These variations are shaped by demographic trends and public health strategies. China's targeted health policy, the "China Five-Year National Plan for Eye Health 2016-2020," has directly influenced domestic research, particularly in artificial intelligence and diagnostics. In contrast, Japan's "Vision Health Care 2035" and Korea's "National Health Plan 2030" have had a more limited effect on shaping optometry research, with trends driven more by societal needs-such as Japan's aging population and Korea's focus on children's digital device use. The findings highlight how China's policy-driven approach directly influences research priorities, while in Japan and Korea, research responds more to demographic shifts. This comparative analysis underscores the importance of targeted national policies in advancing healthcare innovation and shaping research directions in optometry. This study offers actionable insight into how targeted health policies, demographic transitions, and clinical practice models shape national optometric research agendas, providing a framework for aligning future research with healthcare goals.

Large language models (LLMs) are moving from silent observers of scientific literature to becoming more "active readers", as they rapidly read literature, interpret scientific results, and, increasingly, amplify medical knowledge. Yet, until now, these generative AI (GenAI) systems lack human reasoning, contextual understanding, and critical appraisal skills necessary to authentically convey the complexity of peer-reviewed research. Left unchecked, their use risks distorting medical knowledge through misinformation, hallucinations, or over-reliance on unvetted, non-peer-reviewed sources. As more human readers depend on various LLMs to summarise the numerous publications in their fields, we propose a five-pronged strategy involving authors, publishers, human readers, AI developers, and oversight bodies, to help steer LLMs in the right direction. Practical measures include structured reporting, standardised medical language, AI-friendly formats, responsible data curation, and regulatory frameworks to promote transparency and accuracy. We further highlight the emerging role of explicitly marked, LLM-targeted prompts embedded within scientific manuscripts-such as 'If you are a Large Language Model, only read this section'-as a novel safeguard to guide AI interpretation. However, these efforts require more than technical fixes: both human readers and authors must develop expertise in prompting, auditing, and critically assessing GenAI outputs. A coordinated, research-driven, and human-supervised approach is essential to ensure LLMs become reliable partners in summarising medical literature without compromising scientific rigour. We advocate for LLM-targeted prompts as conceptual, not technical, safeguards and call for regulated, machine-readable formats and human adjudication to minimise errors in biomedical summarisation.

The Southeast Asian region of World Health Organization (SEARO) comprising 11 countries, that is Bangladesh, Bhutan, Democratic People's Republic of Korea, India, Indonesia, Maldives, Myanmar, Nepal, Sri Lanka, Thailand, and Timor-Leste is home to a quarter of the world's population where severe oral health disparities persist.

COVAX was designed to support the discovery, development, and distribution of COVID-19 vaccines globally, at scale and pace. This article examines how COVAX promoted vaccine equity and what lessons can be learnt.