Human Functioning: Developments and Grand Challenges

Bickenbach, Jerome

doi:10.3389/fresc.2020.617782

Cited by 8 publications

(7 citation statements)

References 34 publications

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“…Emphasis should however be placed on the importance of cultivating the capabilities of the older people by allocating resources to their healthcare and long-term support. The objective is to optimize their functional capacity, sustain productive work, and enhance overall health-related quality of life [34].…”

Section: Discussionmentioning

confidence: 99%

Navigating primary health care challenges: Insights from older people with multimorbidity in Malawi

Kwaitana,

Bates,

Msowoya

et al. 2024

Preprint

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The global population is undergoing a significant surge in aging leading to increased susceptibility to various forms of progressive illnesses. This phenomenon significantly impacts both individual health and healthcare systems. Low and Middle Income Countries face particular challenges, as their Primary Health Care (PHC) settings often lack the necessary human and material resources to effectively address the escalating healthcare demands of the older people. This study set out to explore the experiences of older people living with progressive multimorbidity in accessing PHC services in Malawi. Between July 2022 and January 2023, a total of sixty in-depth interviews were conducted with dyads of individuals aged ≥50 years and their caregivers, and twelve healthcare workers in three public hospitals across Malawi’s three administrative regions. The study employed a stratified selection of sites, ensuring representation from rural, peri-urban, and urban settings, allowing for a comprehensive comparison of diverse perspectives. Guided by the Andersen-Newman theoretical framework, the study assessed the barriers, facilitators, and need factors influencing PHC service utilization by the older people. Three themes, consistent across all sites emerged, encompassing barriers, facilitators, and need factors respectively. The themes include: (1) clinic environment: inconvenient clinic setup, reliable PHC services and research in diabetic foods; (2) geographical factors: bad road conditions, lack of comprehensive PHC at local health facility and need for community approaches; and (3) social factors: encompassing use of alternative medicine, transport support, perceived health care benefit and support with startup capital for small-scale businesses. This research highlights the impact of multiple factors on the access to and utilization of PHC services among older individuals, emphasizing the urgent need for enhanced nationwide availability of such services. It strongly recommends a thorough investigation into successful practices implemented in diverse health facilities in Malawi, with a specific focus on addressing the unique healthcare needs of the older population.

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Section: Discussionmentioning

confidence: 99%

Navigating primary health care challenges: Insights from older people with multimorbidity in Malawi

Kwaitana,

Bates,

Msowoya

et al. 2024

Preprint

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“…Instead of a set of categorical symptoms/deficits that present early and remain relatively static over time, autism might be better understood as a dynamic neurodevelopmental condition, structured on inter-related dimensional constructs (not just symptoms but also functional skills and family/contextual factors) that could vary within the same child but also from one child to another over time 14 15. This is in line with modern concepts promoted by the World Health Organization with the International Classification of Functioning, Disability and Health, and is often referred to as the ‘actual lived experience of health’ or ‘lived health’ 16…”

Section: Introductionmentioning

confidence: 92%

The Pediatric Autism Research Cohort (PARC) Study: protocol for a patient-oriented prospective study examining trajectories of functioning in children with autism

Kata,

McPhee,

Chen

et al. 2024

BMJ Open

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IntroductionThe developmentally variable nature of autism poses challenges in providing timely services tailored to a child’s needs. Despite a recent focus on longitudinal research, priority-setting initiatives with stakeholders highlighted the importance of studying a child’s day-to-day functioning and social determinants of health to inform clinical care. To address this, we are conducting a pragmatic multi-site, patient-oriented longitudinal investigation: thePediatric Autism Research Cohort(PARC) Study. In young children (<7 years of age) newly diagnosed with autism, we will: (1) examine variability in trajectories of adaptive functioning from the point of diagnosis into transition to school; and (2) identify factors associated with trajectories of adaptive functioning.Methods and analysisWe aim to recruit 1300 children under 7 years of age with a recent (within 12 months) diagnosis of autism from seven sites: six in Canada; one in Israel. Participants will be followed prospectively from diagnosis to age 8 years, with assessments at 6-month intervals. Parents/caregivers will complete questionnaires administered via a customized online research portal. Following each assessment timepoint, families will receive a research summary report describing their child’s progress on adaptive functioning and related domains. Analysis of the longitudinal data will map trajectories and examine child, family and service characteristics associated with chronogeneity (interindividual and intraindividual heterogeneity over time) and possible trajectory turning points around sensitive periods like the transition to school.Ethics and disseminationEthics approvals have been received by all sites. All parents/respondents will provide informed consent when enrolling in the study. Using an integrated knowledge translation approach, where stakeholders are directly engaged in the research process, thePARC Studywill identify factors associated with trajectories of functioning in children with autism. Resulting evidence will be shared with government policy makers to inform provincial and national programs. Findings will be disseminated at conferences and published in peer-reviewed journals.

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“…Within rehabilitation medicine this functionalist approach has long been acknowledged, and WHO has recently suggested that it could become a new paradigm for medicine as a whole [ 8 ]. In general practice in northern Europe the patient-centered clinical method and biopsychosocial model are at the core of most academic teaching.…”

Section: The Functionalist Paradigmmentioning

confidence: 99%

To reveal disease or to promote function – that is the question

Meland,

Hjörleifsson

2023

Scandinavian Journal of Primary Health Care

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Medicine faces challenges that indicate that it may not be sustainable. A descriptive disease concept is apt to what philosopher of science Ian Hacking called "looping effects”, which can explain why health care is faced with insatiable demands. Diseases are not only indifferent objects with an objective existence in the biology of individuals. They are often interactive identities that have attractive properties. We suggest a shift in medical practice where descriptive perspectives are complemented with functional perspectives to enable clinicians better to help people from merging with dysfunctional disease identities.

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Human Functioning: Developments and Grand Challenges

Cited by 8 publications

References 34 publications

Navigating primary health care challenges: Insights from older people with multimorbidity in Malawi

Navigating primary health care challenges: Insights from older people with multimorbidity in Malawi

The Pediatric Autism Research Cohort (PARC) Study: protocol for a patient-oriented prospective study examining trajectories of functioning in children with autism

To reveal disease or to promote function – that is the question

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