Reinforcement Learning Methods in Public Health

Understanding Care Needs of Older Adults with Disabilities: A Scoping Review

Purpose

To conducted a scoping review of care needs of older adults with disabilities at home and in the community and provide a comprehensive understanding of the essential needs of older adults with disabilities.

Methods

Eight databases were searched for relevant Chinese and English studies (supplemented by retrospective references of the included studies) from the establishment of the database to February 13, 2023. An thematic synthesis approach was used to qualitatively integrate the retrieved studies and identify need-related themes.

Results

A total of 6239 studies were retrieved, 2557 were de-weighted and excluded, and 56 were obtained after the double screening. Studies were from 11 countries. Thirty-three studies used a self-prepared survey instrument to investigate needs, and the other research tools commonly used were secondary databases and the Long-Term Care Needs of the Disabled Scale. A total of 78 specific need items were identified and summarized into three need themes based on the ICF framework: physical functioning needs, activity and participation needs, and environment needs.

Conclusion

The complex physical and mental health conditions faced by older adults with disabilities result in multifaceted, integrated needs that are difficult to identify and meet. Current research on older adults with disabilities is limited to common care. Future research should focus on the specificities of the older disabled population and understand the diverse care needs of people with disabilities in order to better target care services for this group. Policymakers should formulate more operational and strategic measures based on the actual needs of older adults with disabilities to expand the coverage of services and to pinpoint care services.

Cross fertilisation of Public Health and Translational Research

Public health is defined as the science of protecting the safety and improving the health of communities through education, policy-making and research for the prevention of disease (Gatseva and Argirova in J Public Health 19(3):205–6, 2011, 10.1007/s10389-011-0412-8; Winslow in Mod Med 2(1306):183–91, 1920. 10.1126/science.51.1306.23; What is public health. Centers for Disease Control Foundation. Centers for Disease Control, Atlanta, https://www.cdcfoundation.org/what-public-health; What is the WHO definition of health? from the Preamble to the Constitution of WHO as adopted by the International Health Conference, New York, On 7 April 1948. The definition has not been amended since. 22 July 1946; signed by the representatives of 61 States (Official Records of WHO, no. 2, p. 100) and entered into force, 19 June;1948. https://web.archive.org/web/20190307113324/https:/www.who.int/about/who-we-are/frequently-asked-questions). Translational research in healthcare is not only useful and satisfying for the researchers to bring their work to market but it would also support public health by bringing affordable, attainable and scalable solutions to the community at large. This is of high significance because instead of increasing the GDP spent in public health, we should focus on the increasing the translational research spending, as this would lead to improved solutions. Hence, the public health offering would reach a larger community at an improved cost. The COVID-19 pandemic and the huge number of lives it claimed exposes challenges in the public health. The pandemic has caused economic and social disruption to millions of people around the world, with many falling into extreme poverty. In early 2021, it was estimated nearly 690 million people are undernourished and by end of 2021 to increase further by 132 million (Joint statement by ILO, FAO, IFAD and WHO. Impact of COVID-19 on people's livelihoods, their health and our food systems https://www.who.int/news/item/13-10-2020-impact-of-covid-19-on-people's-livelihoods-their-health-and-our-food-systems). The spending for public health has increased many folds during the pandemic and this is where translational research in healthcare can play a transformative role to reduce the burden on government healthcare budget (Covid-19 and its impact on Indian society. https://timesofindia.indiatimes.com/readersblog/covid-19-and-its-impact-on-india/covid-19-and-its-impact-on-indian-society-27565/). Over the past decade, public health research has started playing a major role in Indian academic settings. COVID-19 pandemic has further highlighted the role of public health. However, the potential of using technological advancement has not been fully utilised. This is where translational research and public health can play a role to tap the full potential of technology. This review paper explores the public health practices to understand the different practices to examine how both public health and translational research can cross-fertilise. It concludes with a short discussion on implications on policymakers.