Examining the Use and Application of the WHO Integrated People-Centred Health Services Framework in Research Globally - a Systematic Scoping Review.

Introduction: The World Health Organisation (WHO) accepted the Integrated People-centred Health Services (IPCHS) framework in 2016 as an essential component for achieving universal health coverage in fragmented health systems. We aimed to examine the empirical applications of the WHO IPCHS framework to guide its use in strengthening health-service research. Methods: Academic databases and the IPCHS website were searched for relevant articles published between 2016 and July 2023. Two reviewers independently screened and extracted data on the study design, setting, IPCHS framework components, and facilitators and barriers to implementing the IPCHS strategies. Descriptive and content analyses were conducted. Results: Six studies were identified using the IPCHS framework. Studies have examined a combination of the five IPCHS strategies. All studies reported building strong primary care-based systems and coordinating care for individuals. Continued relationships and trust, co-production of health programmes, diversity of health care team, and technology were major facilitators, while low health literacy, lack of primary setting capacity and healthcare workforce were principal barriers to IPCHS implementation. Conclusion: This scoping review offers an overview of IPCHS strategies employed in healthcare research. Generally, the IPCHS framework remains underutilised in primary research. These results offer guidance for future research to support effective healthcare delivery.

The role of wind field induced flow velocities in destratification and hypoxia reduction at Meiling Bay of large shallow Lake Taihu, China.

Wind induced flow velocity patterns and associated thermal destratification can drive to hypoxia reduction in large shallow lakes. The effects of wind induced hydrodynamic changes on destratification and hypoxia reduction were investigated at the Meiling bay (N 31° 22' 56.4″, E 120° 9' 38.3″) of Lake Taihu, China. Vertical flow velocity profile analysis showed surface flow velocities consistency with the wind field and lower flow velocity profiles were also consistent (but with delay response time) when the wind speed was higher than 6.2 m/s. Wind field and temperature found the control parameters for hypoxia reduction and for water quality conditions at the surface and bottom profiles of lake. The critical temperature for hypoxia reduction at the surface and the bottom profile was ≤24.1C° (below which hypoxic conditions were found reduced). Strong prevailing wind field (onshore wind directions ESE, SE, SSE and E, wind speed ranges of 2.4-9.1 m/s) reduced the temperature (22C° to 24.1C°) caused reduction of hypoxia at the near surface with a rise in water levels whereas, low to medium prevailing wind field did not supported destratification which increased temperature resulting in increased hypoxia. Non-prevailing wind directions (offshore) were not found supportive for the reduction of hypoxia in study area due to less variable wind field. Daytime wind field found more variable (as compared to night time) which increased the thermal destratification during daytime and found supportive for destratification and hypoxia reduction. The second order exponential correlation found between surface temperature and Chlorophyll-a (R2: 0.2858, Adjusted R-square: 0.2144 RMSE: 4.395), Dissolved Oxygen (R2: 0.596, Adjusted R-square: 0.5942, RMSE: 0.3042) concentrations. The findings of the present study reveal the driving mechanism of wind induced thermal destratification and hypoxic conditions, which may further help to evaluate the wind role in eutrophication process and algal blooms formation in shallow water environments. OUTCOME: Wind field is the key control factor for thermal destratification and hypoxia reduction. 24.1C° is the critical/threshold temperature for hypoxia, Chlorophyll-a and NH3-N concentrations of the shallow freshwater lake.

The relationship between birth weight and congenital heart disease at Ahmed Gasim Cardiac Centre, Bahri, Sudan.

Low birth weight is a known comorbidity of congenital heart disease (CHD). This study examines the relationship between CHD and birth weight of singletons, while attempting to remove factors that influence birth weight, and assesses the impact of CHD on growth in later life. The main objective is to study the relationship between birthweight and CHD. This is a cross-sectional study of 141 samples, covering all patients who were referred to the Paediatric Echocardiography Lab at Ahmed Gasim Cardiac Centre between September and October 2016. Infants with genetic syndromes or other major extracardiac abnormalities were excluded. The findings of this study clearly demonstrate that infants with CHD are more likely to be of low birth weight than the general Sudanese population, by a factor of 2.6. Of the sample, 31.9% were born with low or very low birthweight. The mean birth weight of the cases was 2.59 kg, which is 17.3% and 542.4 g less than the national average. CHD that cause a decrement in birth weight in a descending order of severity were atrial septal defect (-721 g/23%), patent ductus arteriosus (-669 g/21%), ventricular septal defect (-610 g/19%), pulmonary stenosis (-548 g/13%) and tetralogy of Fallot (248 g/8%). Pre/postnatal growth impairment is a common feature among children with CHD. No statistically significant relationship was found between the degree of birth weight/weight to age decrement and the specific type of hemodynamic disturbance. Our results are comparable to other studies that have been undertaken. However, Sudanese patients display larger birthweight deficits than other populations.