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The prime instrument used to measure Psychosocial Safety Climate (PSC) at the workplace is the PSC-12 scale questionnaire, which has been widely used by researchers worldwide. We set out to translate the PSC-12 scale into Malay and validate it among Malaysian healthcare workers, the first time this has ever been attempted. We carried out a cross-sectional study among 250 healthcare workers from 3 government health clinics and 15 identified clinical work units in a public hospital in the Klang Valley area, Malaysia. The English version of the PSC-12 scale was translated into the Malay language (Bahasa Malaysia) and back into English to check for content accuracy and validity. Psychometric properties of the questionnaire were assessed for internal consistency (Cronbach's alpha coefficient), temporal stability for test-retest reliability (intra-class correlation) and construct validity (confirmatory factor analysis). The translated questionnaire had a persistently high content validity-index (CV-I) of 0.916. The hypothesised four-factor-structure model displayed high goodness of fit indices (RMSEA = 0.081, SRMR = 0.032, GFI = 0.919, AGFI = 0.869, CFI = 0.961, and TLI = 0.946), demonstrating good questionnaire construct validity. Each item subscale in the PSC-12 scale showed satisfactory internal consistency with Cronbach's alpha (α) coefficient between 0.895 to 0.921. There was satisfactory temporal stability and test-retest reliability with ICC (2,1) for scores of 0.954 (total item score), 0.897 (Domain 1 score), 0.910 (Domain 2 score), 0.807 (Domain 3 score) and 0.806 (Domain 4 score) over the two-week interval. The Malay version of the PSC-12 scale is a valid and reliable instrument for use among healthcare workers in Malaysia as evidenced by its satisfactory psychometric measure and construct structure properties. [ABSTRACT FROM AUTHOR]

Background: Preterm infants (PTIs) require hospitalization in different levels of neonatal care units (NCUs) for their survival and developmental needs. The quality of care provided at NCUs significantly influences infant outcomes and parents' experiences. Parents' experience of received support and care of PTIs is one of the indicators for determining the quality of care at NCUs. The study aims to investigate parents' perspectives on the PTIs care and support received from nurses in NCUs of Nepal. Methods: A descriptive phenomenological study was conducted within the NCUs of three public tertiary hospitals in Kathmandu, Nepal. In-depth interviews were conducted among 25 purposively selected parents, (both mothers and fathers) of low-birthweight PTIs admitted to the NCUs. Data was collected from November 2019 to February 2020. The data were meticulously analyzed using the Colaizzi method. Findings: The exploration of parents' experiences identified three main theme areas: (1) Care and support, (2) Initial involvement in PTI care, and (3) Outcome of care involvement. Parents appreciated competent and affectionate PTI care as well as informational support. However, they had varied experiences with communication, emotional support, and opportunities for infant-parent attachment. Guidance and support for PTI care from nurses and peer-parents proved instrumental in mitigating uncertainties related to initial care learning and involvement in PTI care. Parents' involvement in hands on care of their PTIs boosted infant-parent attachment, empowered for care giving, and provided emotional solace. Conclusion: Findings indicate that parents have positive experience with PTI care provided by nurses and their involvement in hands-on care of their PTIs. However, there are gaps in support expectations of parents including communication, emotional support, and care guidance. Findings have important implications for nurses, pediatricians, and policymakers for the enhancement of neonatal care practice by incorporating parental support and parents' involvement in hands on care of PTI across NCUs in Nepal. [ABSTRACT FROM AUTHOR]

Background: Cervical cancer (CC) is preventable, yet remains a significant public health threat, particularly in Sub-Saharan Africa. Despite considerable awareness, screening rates for CC in Kenya are low and loss to follow-up following treatment for premalignant cervical lesions remains high. This study investigates the efficacy of the Cancer Tracking System (CATSystem), a web-based intervention, to improve CC screening and treatment retention. Methods: A matched, cluster randomized controlled trial will be conducted in Kenyan government hospitals (n = 10) with five intervention and five standard-of-care (SOC) sites. The primary outcome is the proportion of women with a positive screen who receive appropriate treatment (onsite or referral). Secondary outcomes include CC screening uptake among all women and timeliness of treatment initiation. We will utilize mixed methods to assess intervention feasibility, acceptability, and cost-effectiveness. Discussion: The CATSystem has the potential to improve CC care in Kenya by leveraging existing technology to address known barriers in the screening and treatment cascade. This study will provide valuable evidence for potential scale-up of the intervention. [ABSTRACT FROM AUTHOR]

Background: Low- and middle-income countries experience higher burn-related morbidity and mortality compared to high-income countries. Prehospital Burn First Aid (BFA) improves outcomes. We assessed BFA knowledge and water lavage practices and their associated factors among burn victims, caregivers, and visitors at a tertiary health facility in Uganda. Methods: A cross-sectional study was conducted at the Burns Unit of Kiruddu National Referral Hospital in Kampala between 1st April 2022 and 30th November 2022. Participants included burn patients, caregivers, and hospital visitors. Data on BFA knowledge and practices were collected using an interviewer-administered questionnaire. BFA knowledge was evaluated using 13 questions, with a ≥80% score considered adequate. Logistic regression was used to assess for associations. Results: We enrolled 404 participants, comprising 68 (16.8%) burn victims, 161(39.9%) primary caregivers, and 175 (43.3%) hospital visitors. Overall, 339 (83.9%) participants had never received BFA information, and 392 (97.0%) had no first aid training. The mean BFA knowledge score was 56±13.9%, with only 5.4% of the participants demonstrating adequate knowledge. Only 26 (27.7%) of current and former burn victims used water lavage as BFA. No statistically significant associations were found between BFA knowledge, water lavage usage, and demographic variables at univariable and multivariable binary logistic regression analyses. Conclusion: We highlight inadequate BFA knowledge and practices among victims of burns, their caregivers, and the general population. Addressing these deficiencies through community-based initiatives is crucial to improving burn care in Uganda. [ABSTRACT FROM AUTHOR]

Background: Substantial weaknesses and omissions of surgical informed consent are evident and the current elements of the surgical informed consent process are largely neglected in daily practice. This study aimed to assess surgical informed consent practice and associated factors among adult postoperative patients in public hospitals of Mekelle, Tigray, Ethiopia. Methods: Institution based cross-sectional study was conducted among 314 adult postoperative patients in public hospitals of Mekelle, Tigray, Ethiopia. Participants were selected using systematic random sampling. A pretested interviewer-administered questionnaire was used to collect data. Descriptive, Descriptive, bivariate and multivariable logistic regression analyses were performed using statistical package for social science version 27. Result: Only 35.8% (CI 95%, 30.6, 41) of the respondents were identified to have received the recommended (6 or more) components of surgical informed consent. Educational level [AOR 5.76 (1.02, 32.6)], timing of surgical informed consent delivery [AOR 3.27 (1.5, 7.11)], qualification of counselor who took surgical informed consent them [AOR3.185 (1.21, 8.38)], hospital type [AOR 2.85 (1.26, 6.46)], and duration of counseling [AOR 6.9 (3.33, 14.3)] were statistically significant at P<0.05. Conclusion: Majority of participants did not receive comprehensive information during the surgical informed consent process in the study hospitals. To improve the delivery it is suggested that health professionals; create rapport with patient, spend more time during counseling. [ABSTRACT FROM AUTHOR]

Introduction: Cardiopulmonary resuscitation (CPR) is an evidence-based intervention that saves lives. In low- and middle-income countries like Nepal, the occurrence of the problem and its outcome are seldom studied. The study aims to highlight the prevalence, performance, and outcome of CPR in government hospitals of Nepal. Methods: A mixed method study was done for two months in central and provincial government hospitals of Nepal. A total of 80 resuscitations were evaluated using a questionnaire based on the American Heart Association 2020 guidelines for cardiopulmonary resuscitation. An in-depth interview was conducted with 15 active participants of the resuscitation in different sites. Thematic analysis was done using the framework of the chain of survival of arrest victims. Results: The overall prevalence of CPR was found to be 1.92% [95% CI: 0.01,0.02] with 5.4% in central hospitals and 0.65% in provincial hospitals with 60% cardiac arrests occurring in the intensive care unit. Estimated time from recognition of the arrest to initiating CPR was 1.9 ±1.4 minutes. Asystole 66.25% was the commonest arrest rhythm and 21.25% had difficulty interpreting rhythm. Only 11.25% of the victims had return of spontaneous circulation and were subsequently transferred for post-arrest care. The qualitative analysis highlighted the lack of trained staff, a dedicated system, feedback mechanism, and provision of post-arrest care. Conclusion: Across various level of Nepal's healthcare system, cardiopulmonary resuscitation is prevalent with poor performance and outcome. To improve outcomes, it is essential to implement standardized procedures and ensure high quality resuscitation delivery before and after the event supported by well-trained healthcare personnel and adequate infrastructure. [ABSTRACT FROM AUTHOR]

No updated data on people living with HIV (PLHIV) in Japan have been available since 2015, leaving a critical gap in understanding the current status of care and treatment. Therefore, this study aimed to conduct a nationwide evaluation of the second and third goals of the "90-90-90 target" defined by UNAIDS between 2016 and 2020. The study utilized data from approximately 360 core hospitals through structured questionnaires and the National Database of Health Insurance Claims and Specific Health Checkups (NDB). Key findings revealed that over 95% of diagnosed outpatients were retained in care (second 90), and more than 99% achieved successful viral suppression (third 90). A significant transition to single-tablet regimens and newer, highly effective antiretroviral drugs was observed, optimizing treatment adherence and outcomes. These results underscore the efficacy of Japan's universal health insurance system in ensuring consistent access to HIV care and treatment, supporting both individual patient outcomes and national surveillance efforts. [ABSTRACT FROM AUTHOR]

Background: Monitoring hospitalization rates associated with oral health conditions is an important part of epidemiological surveillance, especially when these conditions have increased significantly in low—and middle-income countries. This study aimed to evaluate the temporal trends in hospital discharges associated with oral health-related conditions in Ecuador from 2000 to 2023 and identify the leading diagnoses groups. Methods: An ecological time-series study was conducted based on annual data from the National Institute of Statistics and Censuses of Ecuador. We identified oral conditions using hospital discharge records, which were classified according to the International Classification of Diseases. We estimated crude and age-standardized rates per 100,000 inhabitants for the entire population and crude rates by sex, age, region, and the diagnosis. Joinpoint analysis was used to identify national trends in hospital discharges. Results: A total of 93652 hospitalizations were identified. Malignant tumors of the head, face, and neck were the most common diagnosis attributed to hospital discharges (16.5%), followed by cleft palate (14.5%) and cleft lip (7.8%) and other diseases of the jaws (5.4%). The crude rate of OHRC increased from 17.94 to 28.81 hospitalizations per 100,000 population between 2000 and 2023. Based on joinpoint analysis, hospital discharges increased by 2.2% annually during the study period. However, three temporal trends were identified: from 2000 to 2017, hospital discharges increased annually by 4.3% (p<0.05); from 2017 to 2020 decreased by 17.2%; and from 2020 to 2023 increased annually by 12.9%. Average hospitalization rates were higher among those aged 0–9 and > 64 years. Conclusions: Hospitalization rates associated with oral health-related conditions in Ecuador have increased significantly over the past twenty-four years, except during the COVID-19 pandemic, where cases dropped considerably. Many of the oral conditions identified in the study were malignancies, which are caused by a complex relationship between genetic, environmental, and behavioral factors. Conducting early detection analysis is essential to reduce their occurrence. [ABSTRACT FROM AUTHOR]

Objectives: Type 2 diabetes mellitus (T2DM) significantly deteriorates patients' quality of life (QOL). This study examined the dynamic interplay of factors that influence QOL in patients with T2DM, utilizing concepts from positive psychology and intrinsic mechanisms, to lay the groundwork for improving patient outcomes. Improving self-management behaviors is essential for effective disease management. Methods: Using a cross-sectional design, this study incorporated 408 patients with T2DM from the endocrinology department of a public hospital in Urumqi, who were selected through convenience sampling from December 29, 2023 to June 30, 2024. Data collection tools included the General Data Questionnaire, Summary of Diabetes Self-Care Activities, Self-Efficacy for Diabetes Questionnaire, Connor-Davidson Resilience Scale, and Diabetes-Specific Quality of Life Scale. Structural equation modeling and Model 15 of Hayes' SPSS-Process program facilitated the moderated mediation analysis. Results: The findings demonstrated that self-efficacy significantly enhanced the QOL (β = -0.8557, p < 0.01), with resilience serving as a partial mediator, accounting for 43.1% of this effect. Interactions between self-efficacy and self-management, and resilience and self-management, were also significant predictors of QOL (β = -0.0751, p < 0.01 and β = -0.0073, p < 0.05, respectively). Conclusion: These findings introduce a novel theoretical framework for T2DM from the perspective of positive psychology, which will be beneficial for intervention development. This study underscores the importance of promoting diabetes self-management as an effective strategy to enhance QOL. Additionally, healthcare providers must focus on fostering patients' positive psychological traits and reliable self-management behaviors. [ABSTRACT FROM AUTHOR]

Malnutrition is a prevalent complication in hemodialysis patients and is associated with increased mortality and morbidity. This study aimed to identify the risk factors associated with malnutrition among hemodialysis patients including patient's general characteristics, functional status, and dietary intake. This study involved hemodialysis patients in An-Najah National University Hospital at Nablus/Palestine. An interview-based questionnaire was used to collect data related to sociodemographic, lifestyle, hemodialysis, medical history, anthropometrics, biochemical indices, dietary data using 3-days diet recall, and functional status. Malnutrition-inflammation score tool (MIS) was used for malnutrition screening of the studied patients. The study involved 188 patients, with a mean age of 57.8±14 years. A total of 28.2% participants are reported malnourished. Malnutrition was significantly associated with being female (p = 0.001), unemployed (p = 0.009), nonsmoker or ex-smoker (p = 0.018). Patients with CVDs (p = 0.006), higher months on dialysis (p = 0.002), lower BMI (p = 0.018), and using catheter for dialysis access are more likely to develop malnutrition (p = 0.018). Furthermore, patients with poor functional status (poor handgrip strength (p<0.001), inability to walk (p<0.001), needing help in daily activity or in transfer (p<0.001)) were significantly associated with malnutrition. Additionally, malnutrition was significantly higher among patients who does not meet their recommended calorie intake (p = 0.008), whose sodium intake within recommendation (p = 0.049), patients with low levels of hemoglobin (p = 0.022), albumin (p<0.001), TIBC (p = 0.002), phosphate (p<0.001), and patients with higher levels of ferritin (p<0.001). Higher months on dialysis (Exp(B) = 1.02), unmet calorie intake (Exp(B) = 4.3), needing help in daily activities (Exp(B) = 0.238), and low albumin level (Exp(B) = 0.048) were the independent predictors of malnutrition. This study highlights the significant association between malnutrition and various demographic, clinical, functional, and dietary factors in hemodialysis patients, revealing the burden of malnutrition during HD. It also necessitates targeted intervention to address these risk factors and improve nutritional status and the overall health outcomes of HD patients. [ABSTRACT FROM AUTHOR]

Background: Anemia is a serious global public health problem, especially in developing nations. Anemia during pregnancy is appropriately recognized, whereas postpartum anemia especially after cesarean delivery in Ethiopia has received very little attention. Due to this it leads to poor quality of life, palpitations, an increase in maternal infections, exhaustion, diminished cognitive function and postpartum depression. Therefore, this study aimed to assess the prevalence and associated factors of postpartum anemia after cesarean delivery in public hospitals of Awi zone, North West Ethiopia, 2023. Method: A hospital-based cross-sectional study was conducted among 395 mothers who gave birth by cesarean delivery from May 1–30, 2023. Data were collected using a pretested checklist. A simple random sampling technique was used to select study participants. Then the data were entered into EPI-data version 4.6 and exported to the SPSS version 25 for analysis. A logistic regression model was fitted to assess the association between outcome and explanatory variables. Variables with a p-value of 0.25 or less in bivariable analysis were candidates for multivariable analysis and P-value < 0.05 in multivariable analysis was considered to declare a result as statistically significant in this study. Result: The prevalence of postpartum anemia after cesarean delivery was 18.9% (95% CI (15.1, 23.1)) with a response rate of 97.97%. Being primipara (AOR = 0.47,95%CI = 0.24,0.92), indication for current C/S (malpresentation) (AOR = 0.29,95%CI = 0.09,0.90), having pre-operation hemoglobin level <11g/dl (AOR = 14.5;95% CI = 4.11,51.16) and having medical complication during current pregnancy (AOR = 5.95,95%CI = 1.88,18.83) were significantly associated with postpartum anemia after cesarean delivery. Conclusion: The findings of the study show that the prevalence of postpartum anemia after cesarean delivery is a mild public health problem. Therefore, promoting the benefits of early detection and management of pregnancy complications such as predelivery anemia and medical complications is crucial. [ABSTRACT FROM AUTHOR]

Background: Oxygen is a vital therapy approved by WHO, crucial for critically ill patients as a supplemental treatment. Nurses' pivotal role in oxygen administration is poorly understood. This study aimed to assess factors associated with oxygen administration to critically ill patients among nurses at Muhimbili National Hospital (MNH) in Dar es Salaam, Tanzania. Methods: A descriptive cross-sectional study was conducted among 208 nurses using a simple random technique to recruit respondents. Data were collected in May 2022 via a self-administered questionnaire, designed and tested by the authors. Mean knowledge and practice scores were used to categorize knowledge and practice as high or low respectively. The Chi-square test and multiple logistic regression analyses were performed to evaluate factors associated with knowledge and practice regarding oxygen administration. Statistical significance was determined at a p-value less than 0.05. Results: Of the 208 respondents, 96(46.2%) and 78(37.5%) had low knowledge and low practices regarding oxygen administration, respectively. Receiving in-service training on oxygen administration (AOR: 3.515; p<0.001) was positively associated with knowledge of oxygen administration. None of the factors showed a statistically significant association with the practice of oxygen administration. Conclusion: A substantial proportion of nurses had inadequate knowledge and practices regarding oxygen administration. While none of the assessed factors were found to have a statistical association with practice on oxygen administration, it is important to note their clinical significance. Healthcare institutions can benefit from implementing regular in-service training programs to address these knowledge and skills gaps and ensure that nurses are well-prepared for proper oxygen administration. Additionally, ongoing monitoring and support are essential to help translate improved knowledge into effective clinical practices. [ABSTRACT FROM AUTHOR]

Background: Nurses are at risk of developing compassion fatigue, which has negative impacts on their well-being, quality care and leads to patient mortality and a financial burden on the healthcare system. However, data on compassion fatigue is scarce in Africa, particularly Ethiopia. Therefore, this study aimed to assess level compassion fatigue and associated factors among nurses in Jimma Zone public hospitals, Ethiopia. Method: A facility-based cross-sectional study was employed from May 25 to June 25, 2023. A systematic sampling technique was employed to select among 422 respondents. Data were collected using pretested self-administered questionnaires. Professional Quality of Life Scale-5 was used for measuring compassion fatigues. Data were entered using Epi data version 4.6 and analyzed using SPSS version 25. Linear regression were done to identify factors associated with compassion fatigue. Statistically significant was declared at a p-value of ≤ 0.05 with 95% CI. Result: From a total of 422 respondents, 412(97.6%) of them gave complete responses. 47% of respondents, had a moderate level of compassion fatigue. Total experience [β = -0.04; 95%CI (-0.06, -0.01); p = 0.005], perceived social support [β = -0.13; 95% CI (-0.17, -0.08); p<0.001], self-compassion [β = -0.09; 95% CI (-0.14, -0.03); p = 0.003], support seeking [β = -0.23; 95% CI (-0.42, -0.04 p = 0.017], emergency ward [β = 0.36; 95% CI (0.2, 0.51); p <0.001], ICU [β = 0.38; 95% CI (0.21, 0.54); p<0.001], pediatric ward [β = 0.23; 95% CI (0.10, 0.36); p < 0.001] and average sleep hours per day [β = 0.46; 95% CI (0.35, 0.57); p<0.001] were statistically signifantly factors. Conclusion and recommendation: The study revealed that one in four nurses had high level of compassion fatigue. The factors associated were work experience, perceived social support, self-compassion, coping strategies, work unit, and sleep hours. Therefore, stakeholders including hospital managers should implement targeted strategies to prevent compassion fatigue including training on coping strategy and, self-compassion and creating culture of team work among nurses. [ABSTRACT FROM AUTHOR]

The ARCR_Pred study was initiated to document and predict the safety and effectiveness of arthroscopic rotator cuff repair (ARCR) in a representative Swiss patient cohort. In the present manuscript, we aimed to describe the overall and baseline characteristics of the study, report on functional outcome data and explore case-mix adjustment and differences between public and private hospitals. Between June 2020 and November 2021, primary ARCR patients were prospectively enrolled in a multicenter cohort across 18 Swiss and one German orthopedic center. Baseline characteristics, including sociodemographic and diagnostic variables, were reported. Clinical scores and patient-reported outcome measures were assessed up to 24-month follow-up. After screening 2350 individuals, 973 patients with ARCR were included. Follow-up rates reached 99%, 95%, 89% and 88% at 6 weeks, 6, 12, and 24 months, respectively. While the proportion of massive tears was higher in the study population (44% vs. 20%, Std. Diff. = 0.56), there were no other major differences in key characteristics between enrolled and non-enrolled patients or in patients lost to follow-up. Functional scores improved over time, with positive changes rates ranging from 83% to 92% at 6-month, reaching 91% to 97% at 12- and 24-month follow-up. In linear mixed models, used to estimate the associations between baseline factors, hospital type and standardized 0–100 scores, marginal effects for time ranged from 20 to 30, 28 to 39 and 34 to 41 points at the 6-, 12- and 24-month follow-up, respectively. Except at the 12-month follow-up, where marginal effects for the interaction terms ranged from -5 to -4 points in the standardized scores, there were no consistent outcome differences between public and private hospitals. Increasing number of years of education was consistently associated with better scores, greater feelings of depression and anxiety, smoking and ASA group III-IV were consistently associated with worse scores. Tear severity showed a consistent negative association solely for the Constant-Score. The ARCR_Pred study shows high potential for generalizability to the population of patients undergoing an ARCR in Switzerland. Further analyses are needed to establish relevant clinimetrics for the Swiss population and to compare outcomes for surgical techniques, surgeon experiences profiles and post-operative management. [ABSTRACT FROM AUTHOR]

Introduction: Patient length of stay is a crucial measure of the emergency department, and it is a vital indicator of health services to evaluate its efficacy, patient care, organizational management, and health care system. Despite this, there are a few studies conducted on pediatric emergency length of stay in developing countries. Therefore, this study serves as input for evidence of pediatric emergency length of stay and associated factors in public hospitals. Methods: An institution-based cross-sectional study was conducted among children who attended in pediatric emergency department of Eastern Ethiopia public hospital from May 01 to Jun 31, 2022. A total of 761 children were selected by systematic sampling technique and interview using structured questionnaires. After data is collected and cleaned, entered using Epi data version 4.6 and then exported to Stata version 14.1 for analysis. Finally, an AOR with a 95% CI was computed, and variables with a P-value < 0.05 in the multivariable analysis were taken as significant factors for prolonged length of stay. Result: The prevalence of prolonged length of stay in the emergency ward was 214 (72%). Living in a rural residence ([AOR = 1.65, 95% CI (1.10–2.48)], having a duration of pain > = 12 ([AOR = 1.92, 95% CI (1.13–3.25)], waiting time > = 5 minute ([AOR = 2.24, 95% CI (1.1–4.248541)], having comorbid illness ([AOR = 1.92, 95%CI, 1.13–3.25)], and higher acuity level and absence of medication in the hospital were ([AOR = 2.26, 95%CI (1.02–2.46]) were significantly associated factors for prolonged length of stay. Conclusion and recommendation: This study revealed that more than two-thirds of children admitted to pediatric emergency had prolonged lengths of stay. This result indicated that higher proportion of the length of stay in pediatric emergency in Eastern Ethiopian public hospitals compare to national. Hence, it is better to give priority to strengthening the focused evaluation of important variables and manage accordingly. [ABSTRACT FROM AUTHOR]

Background: Improving the efficiency of ophthalmology service is a global challenge to fight vision impairment, yet there is little concrete evidence of the current efficiency status. This study aimed to examine the efficiency of ophthalmology departments in the Hunan Province, China, and determine the associating factors of low-efficiency and high-efficiency ophthalmology departments. Methods: This cross-sectional study included a province-level survey of ophthalmology departments of public hospitals. All the ophthalmology departments of public hospitals in Hunan Province were invited to complete an online survey on ophthalmic competence resources. Bootstrap Data Envelopment Analysis was conducted to describe the service efficiency status of the ophthalmology departments using Maxdea (version 8.0) software. Then, we employed Fuzzy Set-Qualitative Comparative Analysis to explore the recipes of low-efficiency and high-efficiency ophthalmology departments using Fs-QCA (version 3.0) software. Results: One hundred and ninety-five ophthalmology departments (87 in tertiary and 108 in secondary public hospitals) completed the survey. The mean efficiency score was 0.78 for ophthalmology departments in tertiary hospitals and 0.82 for secondary hospitals. The number of ophthalmologists and equipment positively contributed to the efficiency of ophthalmology departments in tertiary and secondary hospitals. While increasing the bed capacity was not always beneficial to improving the efficiency of ophthalmology departments in secondary hospitals. For ophthalmology departments in tertiary hospitals, simply increasing the number of nurses did not universally increase efficiency unless there were enough ophthalmologists and equipment to support the nurses' work. This study also revealed 2 configurations for ophthalmology departments in secondary hospitals and 5 configurations for those in tertiary hospitals that could guide their efficiency improvement efforts. Conclusions: Moderate efficiency levels in ophthalmology departments at both tertiary and secondary hospitals were found. Prioritizing the number of ophthalmologists and equipment was recommended to achieve high efficiency for ophthalmology departments in tertiary and secondary hospitals. We also proposed that blindly increasing the number of beds and nurses was meaningless, and ophthalmology departments should flex the bed capacity and number of nurses after premising having high numbers of ophthalmologists and equipment. [ABSTRACT FROM AUTHOR]

Background: Almost everywhere, neonatal mortality can be decreased with ease if competent obstetricians give the necessary treatment. Unfortunately, observational techniques were not used to examine basic essential newborn care practice among obstetric care providers in Ethiopia. Thus, the purpose of this study was to evaluate factors related to essential newborn care practice using observational techniques among obstetric care providers in public hospitals in the Gamo, Gofa, and Wolayta zones, southern Ethiopia. Methods: An institutional-based cross-sectional study carried out from May 15 to June 30, 2022. A simple random sampling method was used. Structured self-administered questionnaires with a clinical observational checklist were used to collect data. Data imported into Epidata version 4.6 and analyzed using the SPSS Version 25. Bivariable and multivariable analyses were used to identify factors associated with essential newborn care practices. An odds ratio with a 95% confidence interval was used to assess the direction and strength of the association. Results: The overall magnitude of good essential newborn care practice among obstetric care providers was 53.5% (95% CI = 49, 58). Factors positively associated with the practice of essential newborn care were having interest on working in delivery room (AOR = 3.16, 95% CI = 1.71,5.83), having no work load (AOR = 2.96, 95% CI = 1.78,4.49), received in-service training (AOR = 3.09, 95% CI = 1.75,5.45), having supportive supervision (AOR = 3.41, 95% CI = 1.25, 9.24), and having good knowledge on essential newborn care (AOR = 3.04, 95% CI = 1.89,4.90). Conclusion: The observed level of essential newborn care practices among obstetric care providers underscores the necessity for targeted interventions that stimulate interest in delivery room work, effectively manage workloads, and offer comprehensive training along with supportive supervision. By concentrating on these aspects and enhancing providers' knowledge, we can significantly improve essential newborn care practices. [ABSTRACT FROM AUTHOR]

Introduction: Grip strength serves as a significant marker for diagnosing and assessing sarcopenia, particularly in elderly populations. The study aims to explore the relationship between individual thigh muscle volumes and grip strength, leveraging advanced AI-based UNETR segmentation techniques for accurate muscle volume assessment. Methods: The study included 49 participants from a cohort of 478 patients diagnosed with hip fractures at Gyeongsang National University Hospital. We recorded Grip strength and height and utilized UNETR-based segmentation techniques on CT scans, to calculate individual thigh muscle volumes. Point-biserial correlation was employed to explore the relationship between sarcopenia and thigh muscle volumes. The research also included a quantile analysis of grip strength. Results: Our findings revealed a strong statistical significance in specific thigh muscles like Rectus femoris, Vastus lateralis, and Vastus intermedius, particularly in males, in relation to sarcopenia. The male cohort displayed a trend where higher thigh muscle volumes correlated with better grip strengths. Meanwhile no such relationship was found within the female group. Conclusion: The findings indicate that stronger grip strength correlates with larger thigh muscles in males but not in females, with specific muscles like the Rectus femoris and Vastus lateralis linked to sarcopenia in men only. The study's small sample size calls for further research with more diverse and gender-balanced groups to verify these results. [ABSTRACT FROM AUTHOR]

Background: Healthcare-associated infections (HAIs) are a major global health threat, leading to higher morbidity and mortality, longer hospital stays, and increased healthcare expenses. Intensive care units (ICUs) present a particularly high risk of developing HAIs. This study aims to examine the risk factors of HAIs among healthcare workers (HCWs) in the ICUs of selected public hospitals. Methods: We employed a cross-sectional design using an online survey. Respondents were randomly selected from seven large public hospitals located in different areas of Riyadh, the capital city of Saudi Arabia. Data collection was conducted between November 1st to 15th, 2023. Logistic regression analysis was employed to examine previous exposure to HAIs as the response variable and selected predictors. Results: A total of 600 HCWs participated in the study (response rate 88.2%). Among the study HCWs, 75.1% were female, with nurses making up 50% of the sample. Of the respondents, 78% had at least a year's experience, 71% had applied infection prevention and control (IPC) training from the infection control department, and 93% reported they had good knowledge about infection control. The level of knowledge of IPC (OR = 0.9, p < 0.05) and applied IPC training (0.1, p < 0.001) were significantly associated with a lower risk of HAIs. Additionally, a higher risk of HAIs was associated with HCWs years of clinical experience (p < 0.001). Conclusion: Overall, the findings indicated that HCWs who have poor knowledge of IPC, who reported no previous IPC applied training, and who have more years of clinical work experience have a greater risk of HAIs. Thus, legislators and Health officials should prioritize the prevention of infections linked to healthcare, paying particular attention to tailored and applied IPC initiatives. [ABSTRACT FROM AUTHOR]

Objectives: To examine healthcare provider-related perceptions toward deprescribing inappropriate medications among older adults. Methods: A cross-sectional, correlational study used a convenience sample of outpatient older adults to measure their perception toward deprescribing using a Patient's Perceptions of Deprescribing (PPoD), which include 57 multiple-choice questions related to patients' sociodemographic data, health, medicines, healthcare providers, and experience of care provided by the clinic. Data were collected by a graduate nursing student from one pharmacy in a public hospital, five days per week, via in-person interviews. Results: Data were analyzed for 200 participants. The level of patient collaboration with their primary care providers (PCPs) is linked to their trust in PCPs, beliefs about medication use, PCP knowledge, and medication concerns (p <.0001). Patient involvement in medication deprescribing decision-making is also associated with trust in PCPs and willingness to stop a medication (p <.0001). Additionally, trust in PCPs is related to patient involvement in decision-making, PCP knowledge, general health, collaboration with PCPs, and receiving conflicting information about a medicine (p =.010). Lastly, PCP medication knowledge is associated with trust in PCPs, views on the importance of medicines, medication concerns, seeking help with medicines, interactions with clinical pharmacists, and being advised by a clinical pharmacist to discontinue medication (p <.0001). Conclusions: The study found that older adults' trust in their PCP, collaboration with their PCP, involvement in the decision-making of deprescribing, and knowledge about medication are associated with clinical and medicine-related factors. Therefore, PCPs should discuss the benefits of deprescribing inappropriate medications to prevent long-term side effects. Future studies should focus on the effectiveness of evidence-based deprescribing protocols for older adults. [ABSTRACT FROM AUTHOR]

Tuberculosis (TB) preventive therapy (TPT) reduces the incidence of TB among people living with the human immunodeficiency virus (PLHIV). However, despite an increase in TPT uptake, TB/HIV coinfection remains stagnant in Uganda especially in areas of increasing HIV incidence such as the Bunyoro sub-region. This study was a retrospective review records (antiretroviral therapy [ART] files) of PLHIV who were active on ART and completed TPT in 2019/2020 at three major hospitals in the Bunyoro sub-region, Uganda: Masindi General Hospital, Hoima Regional Referral Hospital, and Kiryandongo General Hospital. The sample size (987) for each facility was determined using a proportionate sampling method to ensure the study's power and precision. Factors independently associated with acquiring TB disease post TPT were determined using modified Poisson regression analysis. An adjusted prevalence risk ratio (aPRR) with corresponding 95% confidence intervals were reported. The participants' mean age was 38.23 (±11.70) and the majority were female (64.94%). Overall, 9.63% developed active TB disease post TPT completion. In the adjusted analysis, factors associated with active TB disease were a history of an unsuppressed viral load after TPT (aPRR 4.64 (2.85–7.56), p<0.001), opportunistic infections after TPT completion (aPRR 4.31 (aPRR 2.58–7.2), p<0.001), a history of TB active TB disease (aPRR 1.60 (1.06–2.41), p = 0.026), and chronic illness during or after TPT (aPRR 1.68 (1.03–2.73), p = 0.038). To reduce the development of TB disease post TPT thereby improving the effectiveness of TPT, ART adherence should be emphasized to resolve viral suppression and active management of chronic and opportunistic infections. Further clinical management consideration and research is needed for PLHIV who receive TPT but have a previous history of TB disease. [ABSTRACT FROM AUTHOR]

Background: Patient safety is an essential component of healthcare quality. Despite enormous advances in medical knowledge, many adverse events continue to endanger patient safety. Although mixed-method studies are necessary to gain a deeper understanding of safety culture, few studies provide practical evidence of patient safety culture and associated factors in Ethiopia. This study aimed to assess patient safety culture and associated factors among healthcare professionals in public hospitals in Bahir Dar City, Northwest Ethiopia. Methods: A cross-sectional study design was employed, in triangulation with qualitative methodologies, from March 10 to April 10, 2022. A stratified sampling technique was used to select 420 study participants from three public hospitals. A standardized tool measuring 12 patient safety culture composites was used for data collection. Purposive sampling was employed in the qualitative study. Bi-variable and multivariable linear regression analyses were performed using SPSS version 23, with significance set at a 95% confidence interval and a p-value of <0.05. Content analysis was utilized in the qualitative study. Results: The overall patient safety culture score was 47.6% (95% CI: 42.7, 52.5). Age (β = 1.196, 95% CI: (0.968, 1.322), patient safety training (β = 0.168, 95% CI: 0.040, 0.297), working in pediatric wards (β = 0.236, 95% CI: 0.099, 0.370), and resource availability (β = 0.346, 95% CI: 0.220, 0.473) were significantly associated with patient safety culture. The in-depth interviews identified infrastructure, communication barriers, lack of management support, poor governance, healthcare professionals' knowledge, skills, and attitudes, and patient involvement during treatment as factors affecting patient safety. Conclusions: This study concludes that the patient safety culture in the studied hospitals is suboptimal, falling below the acceptable threshold. Enhancing resource availability, providing continuous patient safety training, improving communication systems, and fostering a supportive management environment are essential steps towards building a safer healthcare system. [ABSTRACT FROM AUTHOR]

Background: Cataract surgery is a commonly performed procedure aimed at restoring vision in individuals affected by cataracts. The duration of recovery following cataract surgery can vary among patients and is influenced by a multitude of factors. Therefore, the purpose of this study was to determine the time to recovery from cataracts and its predictors among patients treated with cataract surgery at two selected Public Hospitals in Hawassa, Sidama regional state, Ethiopia. Methods: Institution-based retrospective cohort study was conducted among 444 cataract patients treated with surgery from January 01, 2019, to December 30, 2021. A simple random sampling method was used to select two public hospitals. The data was collected using Kobo toolbox Version 4 and trained data collectors. STATA Version 16 was used for analysis. To estimate the recovery time and compare survival probability among variables Kaplan-Meir curve and Log-rank test were used. The cox-Proportional hazards model was used to identify significant predictors of time to recovery. The association was reported using the adjusted hazards ratio (AHR) with a 95% confidence interval (95%CI), and the significance level was set at a p-value of 0.05. Results: This study showed that 76.14% of cataract patients recovered from cataracts. The average time taken to recover from a cataract was 30 weeks (IQR = 15 to 48) 95%, CI, (26–33). Age 40–60 years (AHR = 2.04 CI; 1.12–3.82), urban dwellers (AHR = 1.48; 95% CI, 1.13–1.93), medium/high level of visual acuity (AHR = 1.49 CI; 1.14–1.94), secondary cataract (AHR = 1.56 CI; 1.11–2.18) and traumatic cataract (AHR = 1.82 CI; 1.32–2.52) were associated with time to recovery of cataract patients. Conclusions: According to this study, the time to recovery of cataract patients was slightly high. Cataract patients' time to recovery was affected by age, residence, pre-operative visual acuity, presence of diabetes mellitus, and post-operative complications. To improve recovery time of cataract patients, treatment strategies must be prioritized. [ABSTRACT FROM AUTHOR]

Background: Burnout among healthcare workers is a global concern with significant implications for both the well-being of the workforce and the quality of patient care. This facility-based cross-sectional study aimed to identify factors associated with burnout among healthcare workers in central Uganda. Methods: The study, conducted between June and July 2023, utilized a cross-sectional design involving physicians, nurses, and technicians. The study covered both public and private hospitals in central Uganda, incorporating urban and rural settings. A sample size of 550 healthcare workers was selected using a simple random sampling. Data collection involved a socio-demographic survey, the Professional Quality of Life (ProQOL-5). Descriptive statistics, Pearson Chi-square test, and ordinal regression models were employed to analyze demographic factors associated with burnout. Results: Of 548 participants, 218(39.8%) experienced high burnout levels. Factors significantly associated with high burnout levels included having over 10 years of work experience (OR: 2.04, 95% CI: 1.12–3.73), working more than 40 hours per week (AOR: 4.46, 95% CI: 1.20–16.62), lack of management support (AOR: 14.45, 95% CI: 3.83–54.56), not experiencing workplace violence (AOR: 2.22, 95% CI: 1.31–3.76), and reporting inadequate sleep (AOR: 6.96, 95% CI: 3.86–12.57). Conclusion: Addressing burnout among healthcare workers in central Uganda requires targeted interventions tailored to the specific challenges faced in the region, including workload distribution, managerial support enhancement, violence prevention strategies, and promotion of adequate sleep. Urgent attention to these factors is essential for enhancing the well-being of healthcare professionals and maintaining quality patient care. [ABSTRACT FROM AUTHOR]

Background: Heart failure is a serious chronic medical condition that negatively impacts daily living. Living with heart failure can be challenging due to the physical symptoms, unpredictable nature of the disease, and lifestyle changes required. The objective of this study was to explore and describe the experiences of people living with heart failure and how it affects their health-related quality of life in Ethiopia. Methods: A qualitative descriptive design was employed to explore the experience of people living with heart failure, guided by the Theory of Symptom Management. A purposive sample of 14 participants was recruited from the cardiac outpatient clinics at two tertiary-level public hospitals in Ethiopia. Data were collected using a semi-structured interview. The recorded interviews were transcribed verbatim in Amharic, translated into English, and entered NVivo statistical software for analysis. An inductive-deductive hybrid thematic analysis method was used to analyse the data. Results: Three themes were identified deductively, while an additional three themes emerged inductively:—"Journey from diagnosis to daily life with heart failure"; "Symptom experience"; "Impact of heart failure on health-related quality of life"; "Perception of health-related quality of life and influencing factors"; "Symptom management and coping strategies"; and "Challenges faced in the journey of living with heart failure". Fatigue, and depression were the most frequently reported symptoms. Participants described how their condition affected their overall physical functioning. Participants utilized consistent follow up-care, adhered to their medications, ensured adequate rest, made dietary modifications, sought social support and engaged in spiritual activities to manage their symptoms and cope with their condition. Challenges they faced included financial difficulties, unavailability of medications, and a lack of continuity of care. Conclusion: People living with heart failure in Ethiopia experience various symptoms. The impact of heart failure on various aspects of their lives, combined with the challenges they face while living with heart failure, significantly affect their health-related quality of life. Health care providers caring for these people need to understand their experiences and the impact on their daily life. Effective multimodal interventions are needed to reduce the impact of heart failure and improve health-related quality of life in this population. [ABSTRACT FROM AUTHOR]

Background: Substance abuse admission to health facilities following the pandemic is often met with challenges. COVID-19 is causing an insurmountable psychosocial impact on the whole of mankind. Marginalized communities, particularly those with substance use disorders (SUDs), are also likely to suffer from greater psychosocial burden. Objectives: This study sought to evaluate substance abuse trends before and during the pandemic. Methods: A cross-sectional study was conducted among patients attending selected government hospitals in Malaysia. Data from the year 2018 to 2021 was utilized. Results: A total of 9,606 patients consisting of 7881 males and 1725 females were identified. Most of the patients involved with substance abuse from 2018 to 2021 were males, aged between 26 and 44 years old, Malays, high school students, singles, workers of private sectors and those residing in urban areas. The most abused substances over the four years were tobacco (61.8%), followed by amphetamine-type stimulants (ATS) (43.1%), alcohol (39.7%), cannabis (17.2%), opioids (13.0%), and kratom (8.8%). Those who worked in the private sector and were self-employed or unemployed were more associated with substance abuse during the pandemic compared to those who worked in the government sector. Those with a history of psychiatric illness were more associated with abuse of substances during the pandemic than those without the history (adjusted OR: 1.18, 95% CI 1.09–1.29, p <0.001). Conclusions: Targeted exploration of factors affecting substance abuse in Malaysia is essential. The results of this study assist in identifying variations in substance abuse treatment characteristics for those admitted to treatment in Malaysia. [ABSTRACT FROM AUTHOR]

This study retrospectively reviewed the microbiological and clinical characteristics of patients diagnosed with bacteremia. Results from the first positive blood cultures were consecutively collected from July 2022 to June 2023 at a public secondary hospital, a university-affiliated tertiary hospital, and a university-affiliated secondary hospital in the Seoul metropolitan area. Antibiotic spectrum coverage (ASC) scores were calculated on the day the blood culture was performed (B0) and on two days after the blood culture results were reported (R+2). A total of 3,397 isolates were collected from 3,094 patients. Among these, 949 isolates obtained from 893 patients were classified as multidrug-resistant organisms (MDRO), including 170 imipenem-resistant gram-negative bacteria, 714 methicillin-resistant staphylococci, and 65 vancomycin-resistant enterococci. Interestingly, 13 and 42 gram-positive isolates were resistant to linezolid and quinupristin/dalfopristin, respectively. Moreover, 44 and 181 gram-negative isolates were resistant to amikacin and tigecycline, respectively. The proportion of ASC scores corresponding to broad or extremely broad-spectrum coverage was not significantly different between MDRO and non-MDRO groups at B0 (p = 0.0925). However, it increased in the MDRO group at R+2 (p <0.001). This study found that resistance to last-resort antimicrobials is emerging. Therefore, developing and incorporating molecular diagnostics using a wide range of resistance targets may facilitate rapid, tailored antimicrobial treatments. [ABSTRACT FROM AUTHOR]

Background: Mistreatment of women during childbirth is a global health challenge. Maternity healthcare providers play a key role in influencing women's birth experience. This study aimed to assess the knowledge, attitudes, and practices of healthcare providers regarding mistreatment of women during labour and childbirth in public hospitals in Tehran, Iran. Methods: This cross-sectional study was part of an implementation research project that was conducted from October to December 2021 at five public teaching hospitals in Tehran. All eligible maternity healthcare providers (obstetricians and midwives) and students were invited to participate in this study. Data were collected using a questionnaire consisting of four sections: socio-demographic characteristics (11 items), knowledge (11 items), attitudes (13 items), and practices (14 items) about mistreatment. Knowledge, attitude, and practice scores were determined using Bloom's cut-off points. Logistic regression analyses were used to identify the socio-demographic characteristics associated with knowledge and attitudes. A p-value of <0.05 was considered statistically significant. Results: Of the 270 participants, 255 (94.5%) participated in the study. Majority of the participants (82.7%) had poor knowledge regarding mistreatment of women during labour and childbirth. Poor knowledge was more apparent in the categories of physical abuse, verbal abuse, poor rapport between women and providers, and failure to meet professional standards of care. Most participants (69.4%) had poor attitudes towards mistreatment; they were alright with physical abuse, verbal abuse, and discrimination. Only 3.1% of the participants reported moderate mistreatment practices towards birthing women. Verbal and physical abuse were the most prevalent categories used by the participants. The number of night shifts was associated with attitudes regarding mistreatment (AOR = 0.45, 95% CI = 0.22–0.89, p = 0.02). Conclusion: The knowledge and attitude of our participants regarding maternity mistreatment were poor. A small percentage of the participants reported mistreatment practices. The findings of our study have important implications for program planners and decision-makers in developing effective interventions to reduce mistreatment of women during labour and childbirth in Iran. [ABSTRACT FROM AUTHOR]

Nurses play a crucial role in the adoption and continued use of Electronic Health Records (EHRs), especially in developing countries. Existing literature scarcely addresses how personality traits and organisational support influence nurses' decision to persist with EHR use in these regions. This study developed a model combining the Five-Factor Model (FFM) and the Unified Theory of Acceptance and Use of Technology (UTAUT) to explore the impact of personality traits and organisational support on nurses' continuance intention to use EHR systems. Data were collected via a self-reported survey from 472 nurses across 10 public hospitals in Jordan and analyzed using a structural equation modeling approach (Smart PLS-SEM 4). The analysis revealed that personality traits, specifically Openness, Experience, and Conscientiousness, significantly influence nurses' decisions to continue using EHR systems. Furthermore, organisational support, enhanced by Performance Expectancy and Facilitating Conditions, positively affected their ongoing commitment to EHR use. The findings underscore the importance of considering individual personality traits and providing robust organisational support in promoting sustained EHR usage among nurses. These insights are vital for healthcare organisations aiming to foster a conducive environment for EHR system adoption, thereby enhancing patient care outcomes. [ABSTRACT FROM AUTHOR]

This paper examines the role of temporality in the negotiation of unplanned adaptive tasks that were part of the health system response to the Covid-19 pandemic in Colombia. While research has been carried out on the temporal aspects of emergency preparedness, we argue that there is an empirical gap concerning how health care organizations responded with temporal urgency to Covid-19. The dataset (118 interviews) from which a subset of interviews were analysed for this paper was collected during the first wave of the pandemic in Colombia in 2020. Interviewees included representatives of national and regional governments, public hospitals and private clinic managers, clinicians, including physicians and nurses, laboratory directors, and academics. Narratives of two tasks are presented: reconfiguring clinical laboratories to expand the testing capacity for Covid-19 and increasing intensive care unit capacity for patients hospitalized with Covid-19. Through thematic analysis of the navigation of these tasks, the concept of "temporal shifts", which signifies how organizations use time as a resource (analogous experiences, future projections) to negotiate unplanned service changes, is developed. This study highlights how powerful stakeholders deploy past and future projections to influence others´ perceptions in the negotiation of temporal shifts: a type of change that differs from the incremental and planned types described in previous organizational literature on temporality. This shift was initiated by rapid task delegation via organizational hierarchy, but accomplished through pressured, improvised actions at the operational level. The policy and practice implications we suggest relate to addressing social and organizational effects, including consequences for stakeholder engagement and staff wellbeing, generated by organizational leaders making decisions under "time stress". [ABSTRACT FROM AUTHOR]

Aims and objectives: To assess the effect of an instructional WhatsApp group on self-care and HbA1c levels among female patients with type 2 diabetes mellitus (T2DM). Background: T2DM is a chronic disease that requires effective self-care. WhatsApp is a free application that can be effectively used for patient education. Design: This study used a quasi-experimental design. Methods: A convenience sample of 62 female participants was recruited from the medical outpatient clinic of a tertiary hospital. The Diabetes Self-Care Scale was used to assess the self-care profiles of the participants pre- and post-intervention. HbA1c samples were also collected at baseline and three months after receiving instructions from the WhatsApp group. Sociodemographic and clinical data were collected during the pre-intervention stage. Results: The mean HbA1c level decreased from 8.61 ± 1.70 to 7.92 ± 1.60 after implementing the WhatsApp group instructions; the values showed a significant difference (t-value = 5.107 and P-value < 0.001). The post-test mean score of total self-care was higher than the pre-test mean score (t-value = 12.359, P-value <0.001), indicating a highly significant difference. Conclusions: The study demonstrated that the instructional WhatsApp group is an effective method for improving self-care and HbA1c levels in patients with T2DM. This study suggests the use of WhatsApp group instructions as a teaching method in the healthcare system for the education and follow-up of patients with T2DM. Relevance to clinical practice: The findings support the need to initiate effective and dynamic interventional follow-ups through WhatsApp groups for patients with T2DM to improve their self-care and HbA1c levels and ultimately reduce the burden on hospitals and governments. [ABSTRACT FROM AUTHOR]

Introduction: Southern Hemisphere countries have been underrepresented in epidemiological studies on acute kidney injury (AKI). The objectives of this study were to determine the frequency, risk factors, and outcomes of AKI in adult hospitalized patients from the emergency department of a public high-complexity teaching hospital in the city of São Paulo, Brazil. Methods: Observational and prospective study. AKI was defined by the KDIGO guidelines (Kidney Disease: Improving Global Outcomes) using only serum creatinine. Results: Among the 731 patients studied (age: median 61 years, IQR 47–72 years; 55% male), 48% had hypertension and 28% had diabetes as comorbidities. The frequency of AKI was 52.1% (25.9% community-based AKI [C-AKI] and 26.3% hospital-acquired AKI [H-AKI]). Dehydration, hypotension, and edema were found in 29%, 15%, and 15% of participants, respectively, at hospital admission. The in-hospital and 12-month mortality rates of patients with vs. without AKI were 25.2% vs. 11.1% (p<0.001) and 36.7% vs. 12.9% (p<0.001), respectively. The independent risk factors for C-AKI were chronic kidney disease (CKD), chronic liver disease, age, and hospitalization for cardiovascular disease. Those for H-AKI were CKD, heart failure as comorbidities, hypotension, and edema at hospital admission. H-AKI was an independent risk factor for death in the hospital, but not at 12 months. C-AKI was not a risk factor for death. Conclusions: AKI occurred in more than half of the admissions to the clinical emergency department of the hospital and was equally distributed between C-AKI and H-AKI. Many patients had correctable risk factors for AKI, such as dehydration and arterial hypotension (44%) at admission. The only independent risk factor for both C-AKI and H-AKI was CKD as comorbidity. [ABSTRACT FROM AUTHOR]

Introduction: There is increasing evidence in favor of enhancing adherence to antiretroviral therapy (ART) in people living with HIV (PLHIV) through mobile health (mHealth) assessment and intervention. The study aims to establish the willingness to adopt mobile phone technology to enhance adherence to ART among PLHIV. Methods: The Researchers adopted a cross-sectional survey. Systematic sampling was employed in selecting 237 PLHIV in the HIV clinic for adults at Ido-Ekiti's Federal Teaching Hospital, Nigeria. Data collection was via a 33-item semi-structured questionnaire administered by the interviewer. Information collected via the questionnaire included details on ownership of mobile phone technology, its usage, and willingness to use it to improve adherence to HIV medication. Descriptive statistics coupled with multivariate regression was employed in analyzing data, with the level of significance at 5%. Results: The respondent's had a mean ±SD age of 46.6 ±10 years. Most of the participants were female (77.6%), and have been on ART for over 2years (88.2%). The vast majority of study participants 233 (98.3%) owned a mobile phone. 168 (70.9%) of them were willing to embrace mHealth interventions on medication adherence. Some of the factors influencing the respondent's willingness to receive the intervention were older age (OR = 0.05, 95%Cl:[0.01–0.24]), having formal education (OR = 7.12, 95%Cl:[3.01–16.53]), being diagnosed over 10years ago (OR = 15.63, 95%Cl:[3.02–80.83]) and previous use of phone to send text messages, record video, access the internet, send email and search the internet for health-related information (OR = 2.2, 95%Cl:[1.2–3.9]; OR = 1.8, 95%Cl:[1.0–3.2]; OR = 2.5, 95%Cl:[1.4–4.7]; OR = 2.7, 95%Cl:[1.2–5.5] and OR = 2.0, 95%Cl:[1.0–3.8]) respectively. Conclusion: Many of the PLHIV had a cellphone and expressed willingness on their part to use it in receiving reminders to take their medication. Older age, formal education and internet users were significantly more willing to get reminders to take their medication. [ABSTRACT FROM AUTHOR]

Introduction: Bronchial asthma is a major public health issue that affects patients, families, and communities worldwide. Despite the growing importance of self-management and its clear link to better health outcomes, the uptake and use of self-management among asthmatic patients is not well understood. Thus, the study aimed to determine the level of self-management practice and associated factors among asthmatic patients on follow-up care at public tertiary hospitals found in south-west Ethiopia. Method: An institutional-based cross-sectional study design was employed from August 1 to September 30, 2022. The study included all asthmatic patients on follow-up care at public tertiary hospitals found in south west Ethiopia, among whom 274 were interviewed. All asthmatic patients who were registered at the chronic follow-up unit of each hospital and fulfilled inclusion criteria were included and interviewed consecutively. The data were collected using a structured interviewer-administered questionnaire adapted from previous studies, entered into EpiData version 4.6, and exported to SPSS version 25 for analysis. Descriptive statistics were used to summarize the participant's characteristics. Linear regression was used to identify variables associated with asthma self-management practice, and variables with a p-value of 0.05 were considered statistically significant. Finally, tables, graphs, and text were used to present the data. Result: Out of 274 interviewed asthmatic patients, 45.26% 95% CI (39, 51) had good asthma self-management practices. Advancing in age (ß = -0.009, P = 0.043), being a smoker (ß = -0.346, 95%, P = 0.03, being alcohol drinker (ß = -0.217, P = 0.001), having depression (ß = -0.038, P = 0.005), having anxiety (ß = -0.029, P = 0.02) and having social support (ß = 0.022, P<0.001) were identified as factors affecting asthma self-management practice. Conclusion: The finding revealed that four of every nine asthmatic patients had good asthma self-management practices. Age, alcohol consumption, smoking, anxiety, depression, and social support were significantly associated with asthma self-management practice. Ongoing self-management support and collaborative target interventions aimed at improving asthma self-management practices and identified factors are very crucial. [ABSTRACT FROM AUTHOR]

Background: The community-based health insurance (CBHI) scheme is a growing initiative aimed at enhancing healthcare access for the most impoverished members of the community. The Ethiopian CBHI scheme aims to enhance access to essential healthcare services, including medical laboratory services, for the poorest members of the community, but there is limited evidence on satisfaction levels. The aim of this study was to assess the satisfaction level of CBHI beneficiaries with laboratory services and their associated factors among selected public hospitals in Jimma Zone, Oromia Region, Ethiopia. Methods: A facility-based cross-sectional study was conducted on selected public hospitals in the Jimma Zone from September to October 2023. A total of 421 CBHI beneficiaries were enrolled in the study using a convenient sampling technique, and interviewers administered structured questionnaires to collect data. Data were entered into Epi-data and analyzed using the Statistical Package of Social Sciences version 25. Descriptive analysis was used to summarize independent variables; bivariate and multivariable logistic regression analyses were done to test the association between independent and dependent variables; and statistical significance was declared at P<0.05. Results: More than half (55.8%) of the 419 study participants were female. Above half, 57.5% of the respondents were satisfied by the clinical laboratory services at public hospitals in Jimma Zone. Components with a higher satisfaction rate were providers' professional appearances (98.3%), procedures for specimen collection (87.6%), and availability of entertainment facilities at the waiting area (67.8%). On the contrary, longer waiting times to receive the test results (76.6%), inefficiency of the reception area (74.7%), and the inability of professionals to explain diagnostic procedures (58.0%) were associated with higher rates of dissatisfaction. Educational status and the number of hospital visits were found to have a statistically significant association with level of satisfaction with laboratory services. Conclusions: CBHI beneficiaries' satisfaction with laboratory service was at a moderate level in Jimma Zone public hospitals. Therefore, attention should be given to continuous monitoring of patients' satisfaction with services, improving reception areas, and practicing routine explanations about the purposes and procedures during specimen collection to improve the beneficiaries' satisfaction level with clinical laboratory services. [ABSTRACT FROM AUTHOR]

Objective: Relative to explicit absenteeism, nurses' presenteeism has a more lasting impact and is more harmful and costly. This study aimed to explore the relationship between work-family conflict, perceived social support, and presenteeism and whether perceived social support mediates the relationship between work-family conflict and presenteeism among ICU nurses working on shifts in Chinese public hospitals. Materials and methods: A cross-sectional research design was conducted from January to April 2023 in Sichuan Province, China. A total of 609 valid questionnaires were collected. The questionnaires contained information on demographic characteristics, the Work-Family Conflict (WFC) scale, the Perceived Social Support Scale (PSSS), and Stanford Presenteeism Scale-6 (SPS-6). Multiple stratified regression was used to explore the mediating role of perceived social support between work-family conflict and presenteeism. The mediating effect of perceived social support in work-family conflict and presenteeism was tested by Model 4 in the PROCESS 4.1 macro program in SPSS. Results: A total of 609 nurses were included in this study, and the mean presenteeism score for ICU nurses working on shifts was 16.01 ± 4.293 (Mean ± SD), with high presenteeism accounting for 58.46%. After controlling for sociodemographic characteristic variables, work-family conflict was positively associated with presenteeism, explaining 7.7% of the variance. High perceived social support was related to low presenteeism, explaining 11.5% of the variance. Perceived social support mediated the association between work-family conflict and presenteeism among ICU nurses working on shifts. Conclusions: Chinese shift-work ICU nurses' high presenteeism scores deserve managers' attention. Work-family conflict is a significant predictor of nurses' presenteeism. Perceived social support is essential in improving nurses' work-family conflict and mediates the relationship between work-family conflict and presenteeism. Improving social support can reduce the impact of work-family conflict on presenteeism among nurses working shifts. [ABSTRACT FROM AUTHOR]

Background: Inappropriate utilization of higher-level health facilities and ineffective management of referral processes in resource-limited settings are becoming increasingly a concern in health care management in developing countries. This is characterized by self-referral and frequent bypassing of the nearest health facilities coupled with low formal referral mechanisms. This scenario lends itself to a situation where uncomplicated medical conditions are unnecessarily managed in a high-cost health facility. On July 1, 2021, Kenyatta National Hospital (KNH) enforced the Kenya Health Sector Referral Implementation Guidelines, 2014, which required patients to receive approval from the KNH referral office and a formal referral letter to be admitted at KNH to reduce the number of walk-ins and allow KNH to function as a referral facility as envisioned by the Kenya 2010 Constitution and KNH legal statue of 1987. Objective: To determine the effect of enforcing the national referral guidelines on patterns of orthopaedic admissions to the KNH. This was a pre-post intervention study. Data abstraction was done for 459 and 446 charts before and after the enforcement of the national referral guidelines, respectively. Results: Enforcement of the national referral guidelines reduced the proportion of walk-in admissions from 54.9% to 45.1%, while the proportion of facility referrals increased from 46.6% to 53.4% (p = 0.013). The percentage of non-trauma orthopaedic admissions doubled from 12.0% to 22.4% (p<0.001). There was also an increase in admissions through the Outpatient Clinic and Corporate Outpatient Clinic. The proportion of emergency admissions declined, while that of elective admissions increased. The increase in elective cases was mainly driven by the increase in female admissions with active insurance cover, tertiary education, non-trauma-related conditions and older age groups. However, the use of official formal written referral letters did not change despite the enforcement of the national referral guidelines. Conclusion: The enforcement of the national referral guidelines reduced the proportion of walk-ins' admissions to KNH. While the enforcement of the national referral guidelines had no effect on the use of official formal written referral letters, it did limit access and utilization of inpatient orthopedic services for young male patients with no active insurance cover and in need of emergency orthopedic care. [ABSTRACT FROM AUTHOR]

Background: Typical pneumonia is a pressing issue in the treatment of human immunodeficiency virus (HIV) patients, especially in Sub-Saharan Africa, where it remains a significant menace. Addressing this problem is crucial in improving health outcomes and the reduction of the burden of diseases in this vulnerable category of patients. Objective: To determine the prevalence of community-acquired typical pneumonia among HIV patients in Public Hospitals in southern Ethiopia. Methods: A cross-sectional study was done among 386 HIV patients clinically suspected of typical pneumonia attending the anti-retroviral therapy (ART) clinics of two hospitals from March to September 2022. A pretested structured questionnaire was employed to collect the demographic, clinical, and behavioral data. Sputum samples were collected and inspected for bacteria following standard procedures, and antimicrobial susceptibility testing was performed employing the Kirby-Bauer disk diffusion method. Besides, extended-spectrum β-lactamase (ESβL) and carbapenemase-producing Gram-negative bacteria were inspected by the double disk synergy test and modified carbapenem inactivation method. Descriptive and inferential statistical analyses were also done. Results: Overall, 39.1% (151/386) of sputum cultures (95% Confidence Interval: 32.4–44) were bacteriologically positive. A total of 151 bacteria were identified, comprising 72.8% (n = 110) of Gram-negative bacteria. The predominant isolate was Klebsiella pneumoniae (25.8%, n = 39), followed by Staphylococcus aureus (17.9%, n = 27); 59.6% (n = 90) of the entire isolates were multidrug-resistant (MDR). Forty percent (11/27) of S. aureus were methicillin-resistant S. aureus (MRSA), and 28.1% (n = 31) and 20.9% (n = 23) of Gram-negative bacteria were extended-spectrum beta-lactamases (ESBL) and carbapenemase producers, respectively. Occupational status, alcohol consumption, cluster of differentiation4 (CD4) Thymocyte cell count < 350, interruption of trimethoprim-sulfamethoxazole prophylaxis and antiretroviral treatment, and recent viral load ≥ 150 were found statistically significant. Conclusion: The higher rates of MDR, MRSA, ESBL, and carbapenem-resistant Enterobacterales (CRE) indicate that bacterial pneumonia is a vexing problem among HIV patients and therefore it is advisable to implement an antimicrobial stewardship program in the study area. [ABSTRACT FROM AUTHOR]

Background: Food-drug interaction (FDI) is prevalent in our day-to-day life. Widely recognised as drug expert, pharmacists are responsible to provide patient education, including on FDI, to ensure optimum safety and efficacy of treatment. Most pharmacists have knowledge and experience regarding FDI to certain extent. However, the level of knowledge, attitude and practice (KAP) towards FDI among pharmacists were yet to elucidated for many countries, including for Malaysia. Objective: This study aims to assess pharmacists' KAP on FDI, their inter-association, as well as association with sociodemographic characteristics in Sabah, Malaysia. Methods & materials: A cross-sectional study was conducted from 1 to 31 May 2023, using online, self-administered Google Form questionnaire, involving 24 government hospitals and 113 government health clinics in Sabah. Results: A total of 273 (or 35.5%) out of 768 pharmacists responded. Over two-third were female and serving government hospitals (79.6%). Mean score of KAP were 72.5 ± 14.3%, 93.2 ± 8.3% and 56.0 ± 16.7%, respectively, reflected good attitude but moderate knowledge and practice. Knowledge gaps identified include common medications such as paracetamol and metformin.Additionally, 28.2% respondents reported lack of FDI coverage during undergraduate, while merely 17.2% have received formal training on FDI after started working. Although 89.0% respondents agree that informing patients about possible FDIs is their responsibility, only 35.9% of the respondents usually or always practiced this. Such discrepancy maybe attributed to insufficient pharmacists' knowledge on FDI, where pharmacists with good level of knowledge have almost 2 times higher odd for good level of practice, compared to those with poor/moderate knowledge (odds ratio, OR: 1.92; 95% CI 1.02–3.61; p = 0.040) in this study. Conclusion: There are significant training gaps to be filled in. Pharmacist possessing good knowledge is a prerequisite for better pharmacy practice. Adequate education strategies covering FDI should be emphasised for all pharmacy undergraduates and practising pharmacists. [ABSTRACT FROM AUTHOR]

Background: Antepartum hemorrhage continues to be a major cause of maternal and perinatal morbidity and mortality in developing countries including Ethiopia and it complicates 2–5% of all pregnancies with an increased rate of maternal and perinatal morbidity and even mortality. Despite many activities, still, poor fetomaternal outcomes of antepartum hemorrhage are still there. Moreover, studies around the current study area emphasize the magnitude and associated factors for antepartum hemorrhage rather than its feto-maternal outcomes. Thus, there is a need to identify the determinants associated with the fetomaternal outcomes of antepartum hemorrhage to guide midwives and obstetricians in the early diagnosis and treatment. Method: An institution-based case-control study was conducted in four-year delivery charts diagnosed with antepartum hemorrhage from April 2, 2022, to May 12, 2022, at Awi Zone public hospitals. To see the association between dependent and independent variables logistic regression model along with a 95% confidence interval (CI) and a p-value of <0.05 were used. Result: No antenatal care follow-up (AOR: 2.5, 95% CI 1.49–4.2), rural residence (AOR: 1.706, 95%CI 1.09–2.66), delay to seek care >12 hours (AOR: 2.57, 95% CI: 1.57–4.23) and advanced maternal age (AOR: 3.43, 95% CI 1.784–6.59) were significant factors associated with feto-maternal outcomes of antepartum Hemorrhage. Conclusion: This study revealed that rural residence, delay in seeking the care of more than 12 hours, not having antenatal care follow up and advanced maternal age were significant factors associated with feto-maternal outcomes of Antepartum hemorrhage. Recommendation: The findings of our study suggest the need for health education about the importance of antenatal care follow-up which is the ideal entry point for health promotion and early detection of complications, especially for rural residents. [ABSTRACT FROM AUTHOR]

Background: Understanding and addressing the concerns of vaccine-hesitant individuals, including those with chronic diseases, is key to increasing vaccine acceptance and uptake. However, in Ethiopia, there is limited evidence on the COVID-19 vaccine hesitancy and predictor variables among diabetic patients. Hence, the study aimed to assess Covid-19 Vaccine Hesitancy and Predictor variables among Diabetic Patients on Follow-Up at Public Hospitals in Nekemte Town, Western Ethiopia. Method: Facility based cross sectional study was conducted among 422 diabetic patients attending public hospitals at Nekemte Town, Western Ethiopia between January, to February, 2023. Study participants were recruited by systematic random sampling. The data were collected interviewee administered pre-tested structured survey questioner. The collected data were entered and cleaned using Epi-Data software 4.6 version. The cleaned data were analyzed using SPSS. 25.0 Statical software. Descriptive statistics like frequency, mean and percentage, and binary logistic regression was applied to identify independent predictors of Covid-19 vaccine hesitancy and association between variables were declared at p-value of 0.05. Result: The overall magnitude of COVID-19 vaccine hesitancy was 15.2% (95% CI: 11.6–18.7). The top three listed reasons for the COVID-19 vaccine hesitancy were: negative information about the vaccine (32.90%), lack of enough information (21.80%), and vaccine safety concern (19.40%). The hesitancy of the COVID-19 vaccination uptake among diabetes patients was independently influenced by age between 40–49 (Adjusted Odd Ratio [AOR] = 4.52(1.04–19.66)), having vaccine awareness (AOR = 0.029(0.001–0.86)), having a great deal of trust on vaccine development (AOR = 0.028(0.002–0.52)), and a fear amount trust (AOR = 0.05(0.003–0.79)) on the vaccine preparation, vaccinated for COVID-19 (AOR = 0.13(0.04–0.51)), perceived exposure to COVID-19 infection after having the vaccine as strongly agree/agree (AOR = 0.03(0.01–0.17))and neither agree nor disagree (AOR = 0.07(0.02–0.30)). Conclusion: COVID-19 vaccine hesitancy among diabetic patients was relatively low. The identified independent predictors were age, vaccine awareness, COVID-19 vaccination history, awareness on vaccine preparation and exposure status to COVID-19 infection. The relevant agency should focus on efforts to translating these high levels of vaccine acceptance into actual uptake, through targeting identifying predictor variables and vaccine availability for a high-risk diabetes patient. [ABSTRACT FROM AUTHOR]

Objective: The Mexican government has pursued multiple initiatives to improve healthcare coverage and financial protection. Yet, out-of-pocket health spending and use of private sector providers in Mexico remains high. In this paper, we sought to describe the characteristics of public and private healthcare users, describe recent visit quality across provider types, and to assess whether perceiving the public healthcare sector as poor quality is associated with private health sector use. Methods and findings: We analyzed the cross-sectional People's Voice Survey conducted from December 2022 to January 2023. We used Chi-square tests to compare contextual, individual, and need-for-care factors and ratings of most recent visits between users of public (social security and other public providers) and private sector providers (stand-alone private providers and providers adjacent to pharmacies). We used a multivariable Poisson regression model to assess associations between low ratings of public healthcare sources and the use of private care. Among the 811 respondents with a healthcare visit in the past year, 31.2% used private sources. Private healthcare users were more educated and had higher incomes than public healthcare users. Quality of most recent visit was rated more highly in private providers (70.2% rating the visit as excellent or very good for stand-alone private providers and 54.3% for pharmacy-adjacent doctors) compared to social security (41.6%) and other public providers (46.6%). Those who perceived public health institutions as low quality had a higher probability of seeking private healthcare. Conclusion: Users rated public care visits poorly relative to private care; at the population level, perceptions of poor quality care may drive private care use and hence out-of-pocket costs. Improving public healthcare quality is necessary to ensure universal health coverage. [ABSTRACT FROM AUTHOR]

Background: Ethiopia has one of the highest maternal mortality ratios in Africa. Few have examined the quality of labour and delivery (L&D) care in the country. This study evaluated the quality of routine L&D care and identified patient-level and hospital-level factors associated with the quality of care in a subset of government hospitals. Materials and methods: This was a facility-based, cross-sectional study using direct non-participant observation carried out in 2016. All mothers who received routine L&D care services at government hospitals (n = 20) in one of the populous regions of Ethiopia, Southern Nations Nationalities and People's Region (SNNPR), were included. Mixed effects multilevel linear regression modeling was employed in two stages using hospital as a random effect, with quality of L&D care as the outcome and selected patient and hospital characteristics as independent variables. Patient characteristics included woman's age, number of previous births, number of skilled attendants involved in care process, and presence of any danger sign in current pregnancy. Hospital characteristics included teaching hospital status, mean number of attended births in the previous year, number of fulltime skilled attendants in the L&D ward, whether the hospital had offered refresher training on L&D care in the previous 12 months, and the extent to which the hospital met the 2014 Ethiopian Ministry of Health standards regarding to resources available for providing quality of L&D care (measured on a 0–100% scale). These standards pertain to availability of human resource by category and training status, availability of essential drugs, supplies and equipment in L&D ward, availability of laboratory services and safe blood, and availability of essential guidelines for key L&D care processes. Results: On average, the hospitals met two-thirds of the standards for L&D care quality, with substantial variation between hospitals (standard deviation 10.9 percentage points). While the highest performing hospital met 91.3% of standards, the lowest performing hospital met only 35.8% of the standards. Hospitals had the highest adherence to standards in the domain of immediate and essential newborn care practices (86.8%), followed by the domain of care during the second and third stages of labour (77.9%). Hospitals scored substantially lower in the domains of active management of third stage of labour (AMTSL) (42.2%), interpersonal communication (47.2%), and initial assessment of the woman in labour (59.6%). We found the quality of L&D care score was significantly higher for women who had a history of any danger sign (β = 5.66; p-value = 0.001) and for women who were cared for at a teaching hospital (β = 12.10; p-value = 0.005). Additionally, hospitals with lower volume and more resources available for L&D care (P-values < 0.01) had higher L&D quality scores. Conclusions: Overall, the quality of L&D care provided to labouring mothers at government hospitals in SNNPR was limited. Lack of adherence to standards in the areas of the critical tasks of initial assessment, AMTSL, interpersonal communication during L&D, and respect for women's preferences are especially concerning. Without greater attention to the quality of L&D care, regardless of how accessible hospital L&D care becomes, maternal and neonatal mortality rates are unlikely to decrease substantially. [ABSTRACT FROM AUTHOR]

Introduction: The largest risk of child mortality occurs within the first week after birth. Early neonatal mortality remains a global public health concern, especially in sub-Saharan African countries. More than 75% of neonatal death occurs within the first seven days of birth, but there are limited prospective follow- up studies to determine time to death, incidence and predictors of death in Ethiopia particularly in the study area. The study aimed to determine incidence and predictors of early neonatal mortality among neonates admitted to the neonatal intensive care unit of Addis Ababa public hospitals, Ethiopia 2021. Methods: Institutional prospective cohort study was conducted in four public hospitals found in Addis Ababa City, Ethiopia from June 7th, 2021 to July 13th, 2021. All early neonates consecutively admitted to the corresponding neonatal intensive care unit of selected hospitals were included in the study and followed until 7 days-old. Data were coded, cleaned, edited, and entered into Epi data version 3.1 and then exported to STATA software version 14.0 for analysis. The Kaplan Meier survival curve with log- rank test was used to compare survival time between groups. Moreover, both bi-variable and multivariable Cox proportional hazard regression model was used to identify the predictors of early neonatal mortality. All variables having P-value ≤0.2 in the bi-variable analysis model were further fitted to the multivariable model. The assumption of the model was checked graphically and using a global test. The goodness of fit of the model was performed using the Cox-Snell residual test and it was adequate. Results: A total of 391 early neonates with their mothers were involved in this study. The incidence rate among admitted early neonates was 33.25 per 1000 neonate day's observation [95% confidence interval (CI): 26.22, 42.17]. Being preterm birth [adjusted hazard ratio (AHR): 6.0 (95% CI 2.02, 17.50)], having low fifth minute Apgar score [AHR: 3.93 (95% CI; 1.5, 6.77)], low temperatures [AHR: 2.67 (95%CI; 1.41, 5.02)] and, resuscitating of early neonate [AHR: 2.80 (95% CI; 1.51,5.10)] were associated with increased hazard of early neonatal death. However, early neonatal crying at birth [AHR: 0.48 (95%CI; 0.26, 0.87)] was associated with reduced hazard of death. Conclusions: Early neonatal mortality is high in Addis Ababa public Hospitals. Preterm birth, low five-minute Apgar score, hypothermia and crying at birth were found to be independent predictors of early neonatal death. Good care and attention to neonate with low Apgar scores, premature, and hypothermic neonates. [ABSTRACT FROM AUTHOR]

Background: Lack of access to functional and hygienic toilets in healthcare facilities (HCFs) is a significant public health issue in low- and middle-income countries (LMICs), leading to the transmission of infectious diseases. Globally, there is a lack of studies characterising toilet conditions and estimating user-to-toilet ratios in large urban hospitals in LMICs. We conducted a cross-sectional study in 10-government and two-private hospitals to explore the availability, functionality, cleanliness, and user-to-toilet ratio in Dhaka, Bangladesh. Methods: From Aug-Dec 2022, we undertook infrastructure assessments of toilets in selected hospitals. We observed all toilets and recorded attributes of intended users, including sex, disability status, patient status (in-patient/out-patient/caregiver) and/or staff (doctor/nurse/cleaner/mixed-gender/shared). Toilet functionality was defined according to criteria used by the WHO/UNICEF Joint-Monitoring Programme in HCFs. Toilet cleanliness was assessed, considering visible feces on any surface, strong fecal odor, presence of flies, sputum, insects, and rodents, and solid waste. Results: Amongst 2875 toilets, 2459 (86%) were observed. Sixty-eight-percent of government hospital toilets and 92% of private hospital toilets were functional. Only 33% of toilets in government hospitals and 56% in private hospitals were clean. A high user-to-toilet ratio was observed in government hospitals' outpatients service (214:1) compared to inpatients service (17:1). User-to-toilet ratio was also high in private hospitals' outpatients service (94:1) compared to inpatients wards (19:1). Only 3% of toilets had bins for menstrual-pad disposal and <1% of toilets had facilities for disabled people. Conclusion: A high percentage of unclean toilets coupled with high user-to-toilet ratio hinders the achievement of SDG by 2030 and risks poor infection-control. Increasing the number of usable, clean toilets in proportion to users is crucial. The findings suggest an urgent call for attention to ensure basic sanitation facilities in Dhaka's HCFs. The policy makers should allocate resources for adequate toilets, maintenance staff, cleanliness, along with strong leadership of the hospital administrators. [ABSTRACT FROM AUTHOR]

Background: Low birth weight (LBW), defined as a birth weight less than 2500 g, irrespective of gestational age, poses a significant health concern for newborns. Despite efforts, the incidence of LBW in sub-Saharan Africa has remained stagnant over the past decade, warranting attention from healthcare providers, policymakers, and researchers. Objective: This study aimed to identify factors associated with LBW among newborns delivered in public hospitals of North Shewa Zone, Amhara Region, Ethiopia, from May 2 to June 10, 2023. Methods and materials: An unmatched case-control study was conducted from May 2 to June 10, 2023, involving 318 participants (106 cases and 212 controls). Data were collected using pretested interviewer-administered structured questionnaires, medical record reviews, and direct anthropometric measurements. Bivariate analyses were conducted, and variables with a p-value ≤ 0.25 were included in a multivariable logistic regression model to determine significant determinants of LBW. A significance level of p < 0.05 was used. Results: A total of 309 newborns (103 cases and 206 controls) were included, yielding a response rate of 97.2%. Among the findings, females exhibited a higher risk of LBW (adjusted odds ratio [AOR]: 3.13, 95% CI: 1.34, 7.32, p = 0.008), as did mothers aged 20 or younger (AOR: 3.42, 95% CI: 1.35, 8.66, p = 0.009). Lack of formal education was associated with increased risk (AOR: 6.82, 95% CI: 2.94, 15.3, p < 0.001), as were unplanned pregnancies (AOR: 3.08, 95% CI: 1.38, 6.84, p = 0.006) and missed antenatal care visits (AOR: 2.74, 95% CI: 1.16, 6.49, p = 0.021). No significant associations were found with residency type or maternal age above 35. Conclusion: Mothers aged ≤ 20 years, with inadequate minimum dietary diversity, lack of antenatal care attendance, and unplanned pregnancies, faced heightened risks of LBW. Addressing these factors is vital for reducing LBW occurrences and improving newborn health outcomes in Ethiopia. [ABSTRACT FROM AUTHOR]

Study objective: This study assessed the overall satisfaction with oncological care, including barriers to care, and identified its associated predictors among adult cancer patients in Vietnam. Methods: In this cross-sectional study, we enrolled 300 adult cancer patients receiving inpatient care at a large urban oncological hospital between June and July 2022. Multivariable linear regression analyses examined associations between patient experiences and overall satisfaction ratings with cancer care. Results: The mean overall satisfaction with oncological care was 8.82 out of 10, with 98.0% recommending this facility to their friends and family. In an adjusted model, being female (β = 0.29, 95%CI: 0.04, 0.53), endorsing satisfaction with patient-nurse communication (β = 0.33, 95%CI: 0.13, 0.53), patient-doctor communication (β = 0.40, 95%CI: 0.11, 0.70), and psychoeducation about oncological medication management (β = 0.30, 95%CI: 0.14, 0.45) were positively associated with overall ratings. In contrast, individuals with delays in treatment scheduling reported lower overall satisfaction with oncological care (β = -0.38, 95%CI: -0.64, -0.13). Patients perceived health system, social/environmental, and individual barriers to care: worries about income loss due to attending treatment (43.3%); fear, depression, anxiety, and distress (36.8%); concerns about affordability of treatment (36.7%) and transportation problems (36.7%); and excessive waiting times for appointments (28.8%). Conclusion: This study showed high overall patient satisfaction with cancer care quality. Patient-centered communication strategies and psychoeducation about oncological medication management may be targeted to further enhance the cancer inpatient experience. Raising awareness about treatment options and services, and integrating mental health awareness into oncological care may ameliorate patient distress and facilitate greater satisfaction with oncological treatment processes. [ABSTRACT FROM AUTHOR]

Background: Lebanon has a high caesarean section use and consequently, placenta accreta spectrum (PAS) is becoming more common. Objectives: To compare maternal characteristics, management, and outcomes of women with PAS by planned or urgent delivery at a major public referral hospital in Lebanon. Design: Secondary data analysis of prospectively collected data. Setting: Rafik Hariri University Hospital (public referral hospital), Beirut, Lebanon. Participants: 159 pregnant and postpartum women with confirmed PAS between 2007–2020. Main outcome measures: Maternal characteristics, management, and maternal and neonatal outcomes. Results: Out of the 159 women with PAS included, 107 (67.3%) underwent planned caesarean delivery and 52 (32.7%) had urgent delivery. Women who underwent urgent delivery for PAS management were more likely to experience antenatal vaginal bleeding compared to those in the planned group (55.8% vs 28.0%, p<0.001). Median gestational age at delivery was significantly lower for the urgent group compared to the planned (34 vs. 36 weeks, p<0.001). There were no significant differences in terms of blood transfusion rates and major maternal morbidity between the two groups; however, median estimated blood loss was significantly higher for women with urgent delivery (1500ml vs. 1200ml, p = 0.011). Furthermore, the urgent delivery group had a significantly lower birth weight (2177.5g vs. 2560g, p<0.001) with higher rates of neonatal intensive care unit (NICU) admission (53.7% vs 23.8%, p<0.001) and perinatal mortality (18.5% vs 3.8%, p = 0.005). Conclusion: Urgent delivery among women with PAS is associated with worse maternal and neonatal outcomes compared to the planned approach. Therefore, early referral of women with known or suspected PAS to specialized centres is highly desirable to maximise optimal outcomes for both women and infants. [ABSTRACT FROM AUTHOR]

Background: Pain is the most misunderstood, underdiagnosed, and undertreated/untreated medical problem, particularly in children. The main aim of this study was to assess practice and factors associated with pediatrics pain management among nurses working in Bahir Dar city public hospitals, Amhara region, North West Ethiopia, 2022. Method: An institutional-based cross-sectional concurrent mixed study design was conducted on randomly selected 421 nurses from November 1 to 30/2022. Purposively selected 8 nurses in different positions and qualifications were included in a qualitative study. A structured self-administered questionnaire and a semi-structured in-depth interview questionnaire were used for data collection. Epi info version 7.1 was used for data entry and SPSS version 25 was used for analysis. ATLAS ti version 7.0 and thematic analysis were used for qualitative study. Binary logistic regression was done to identify predictor variables associated with outcome variables at p <0.05 with a 95% confidence interval. Hosmer and Lemeshow's tests were checked for model goodness of fit, which was 0.71. Result: The good practice of pediatric pain management among nurses for hospitalized children was 216 (53.6%) (95% CI- 48.4% to 58.3%). Knowledge [AOR = 3.95; 95%CI: (2.30, 6.79)], attitude [AOR = 2.57; 95% CI: (1.53–4.30)], qualified in BSC pediatrics and child health nurses [AOR = 6.53; 95%CI: (1.56–27.25)], year of experience in pediatrics unit [(AOR = 1.92; 95% CI: (1.03–3.56)] and gating pain management training [AOR = 3.31; 95% CI: (1.73–6.33)] were significant factors. Four themes inadequate knowledge of pain assessment and management practice, inadequate professional commitment, organization-related factors, and impacts of family knowledge, culture, and economic status were explored. Conclusion: Only half of the participants had good practice. Knowledge, attitude, nurses qualified in BSC pediatrics and child health, years of experience in the pediatrics department, and pain management training were associated factors. From the qualitative findings, the unavailability of anti-pain drugs, lack of training, assessment tools, continuous monitoring and evaluation, updated protocols, shortage of resources, and others were the barriers to proper pain management. This study concludes that applying effective pain management practices to hospitalized children remains a challenge. Therefore, it is better to put further effort towards improving pediatric pain management practice. [ABSTRACT FROM AUTHOR]

Background: One of the largest problems facing the world today is the morbidity and mortality caused by antibiotic resistance in bacterial infections. A major factor in antimicrobial resistance (AMR) is the irrational use of antibiotics. The objective of this study was to assess the prescribing pattern and cost of antibiotics in two major governmental hospitals in the West Bank of Palestine. Methods: A retrospective cohort study was conducted on 428 inpatient prescriptions containing antibiotics from two major governmental hospitals, they were evaluated by some drug use indicators. The cost of antibiotics in these prescriptions was calculated based on the local cost. Descriptive statistics were performed using IBM-SPSS version 21. Results: The mean ± SD number of drugs per prescription (NDPP) was 6.72 ± 4.37. Of these medicines, 38.9% were antibiotics. The mean ± SD number of antibiotics per prescription (NAPP) was 2.61 ± 1.54. The average ± SD cost per prescription (CPP) was 392 ± 744 USD. The average ± SD antibiotic cost per prescription (ACPP) was 276 ± 553 USD. The most commonly prescribed antibiotics were ceftriaxone (52.8%), metronidazole (24.8%), and vancomycin (21.0%). About 19% of the antibiotics were prescribed for intra-abdominal infections; followed by 16% used as prophylactics to prevent infections. Almost all antibiotics prescribed were administered intravenously (IV) 94.63%. In general, the average duration of antibiotic therapy was 7.33 ± 8.19 days. The study indicated that the number of antibiotics per prescription was statistically different between the hospitals (p = 0.022), and it was also affected by other variables like the diagnosis (p = 0.006), the duration of hospitalization (p < 0.001), and the NDPP (p < 0.001). The most commonly prescribed antibiotics and the cost of antibiotics per prescription were significantly different between the two hospitals (p < 0.001); The cost was much higher in the Palestinian Medical Complex. Conclusion: The practice of prescribing antibiotics in Palestine's public hospitals may be unnecessary and expensive. This has to be improved through education, adherence to recommendations, yearly immunization, and stewardship programs; intra-abdominal infections were the most commonly seen infection in inpatients and ceftriaxone was the most frequently administered antibiotic. [ABSTRACT FROM AUTHOR]