Search

The current study aims to examine how toxic management styles can lead to both psychological and physical withdrawal of employees in the healthcare sector. The quantitative approach was used in this research. Preliminary data was collected through online questionnaires from 413 employees working in private and public hospitals and health centers in France. Structural equation modeling was used to test the research hypotheses in the SmartPLS program. The research results indicate a direct positive effect of two styles of toxic leadership (unpredictability and authoritarian leadership) on physical withdrawal behaviors. The results also showed that self-promotion and unpredictability positively affect psychological withdrawal behaviors in hospitals and health centers. The results of the research can be useful for managing health centers to remove the behaviors of toxic leaders from the work environment and protect and support staff so that they can continue carrying out their duties. [ABSTRACT FROM AUTHOR]

Background & objectives Our study aims to provide the diversity of stem cell use for non-malignant, non-haematological diseases in India through the lens of clinical trials. Methods A PRISMA approach was used to evaluate the safety and efficacy of stem cell use for the period 2001-2021 in India. The outcomes were measured using each disease category, types of stem cells, the origin of stem cells, safety, and efficacy. Results Of the 9206 studies screened, 61 studies that were relevant to stem cell use for non-malignant diseases were included for analysis. Autologous stem cells (75%) were used predominantly compared to allogenic stem cells (18.33%), followed by mixed type (6.67%). Use of bone marrow-derived stem cells (51%) was dominant, followed by melanocytes (19%), adipose (7%), haematopoietic (12%), and (11%) other types of stem cells. The study revealed 37 randomized clinical trial studies conducted in the government research hospital compared to the non-government. Interpretation & conclusions Maintaining the gold standard for stem cell therapy requires randomized clinical trials with large sample sizes, control groups, failures, adverse effects, etc. It is important to have a monitoring and regulation system in stem cell clinical research activities with enough preclinical data and repeated exchanges between the bench and the bedside. [ABSTRACT FROM AUTHOR]

Background: The visit restrictions imposed as a result of COVID‐19 precluded the entrance of the patient's family into the confines of the intensive care unit. Aim: This study evaluated the experiences of intensive care nurses (ICNs) regarding COVID‐19 visit restrictions and their opinions on these restrictions. Study Design: From May 2023 to July 2023, semi‐structured interviews with 15 ICNs from intensive care units in a tertiary public hospital in Türkiye were conducted. Data were analysed using qualitative content analysis with an inductive approach. Reporting of the study followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. Results: The analysis revealed two main themes, 'widespread negative impacts of visit restrictions' and 'adaptive strategies to the visitation ban', and seven sub‐themes supporting the main themes. Nurses perceived that the visit restrictions imposed during the COVID‐19 pandemic had a severe negative effect on patients, their relatives, themselves and the care environment. They also did not support visit restriction in future pandemics. Conclusions: The COVID‐19 visitation policy weakened the involvement of family members in patient care and created serious challenges in the intensive care setting. The study revealed an urgent need for patient‐centred, family‐sensitive and consistently applied protocols in future pandemics. Relevance to Clinical Practice: In future pandemics, strategies such as the benefit–benefit ratio of the visit, the provision and use of adequate personal protective equipment, and vaccination requirements should be considered in visiting decisions of patients hospitalized because of infection. Participation of nurses responsible for patient care in decisions regarding visitor practices should be supported. [ABSTRACT FROM AUTHOR]

Background: The surge in critically ill COVID‐19 patients caused a shortage of intensive care unit (ICU) beds. Some hospitals temporarily transformed general wards into ICUs to meet this pressing health care demand. Aim: This study aims to evaluate and analyse the risk factors in temporary ICU from the perspective of nurses. By identifying these factors, the goal is to provide actionable insights and recommendations for effectively establishing and managing temporary ICUs in similar crisis scenarios in the future. Study Design: The study was conducted in China within a public hospital. Specifically, it focused on examining 62 nurses working in a temporary ICU that was converted from an infectious disease ward. The research utilized the Hazard Vulnerability Analysis (HVA) scoring method to identify potential threats, evaluate their probability, estimate their impact on specific organizations or regions and calculate the relative risk associated with such occurrences. Results: Staff demonstrated the highest risk percentage (32.74%), with Stuff (16.11%), Space (15.19%) and System (11.30%) following suit. The most critical risk factors included insufficient knowledge and decision‐making competence in critical care (56.14%), lacking decision‐making abilities and skills in renal replacement therapy care (55.37%), inadequate decision‐making capacity and relevant skills in respiratory support care (50.64%), limited decision‐making capability in circulatory support care (45.73%) and unfamiliarity with work procedures or systems (42.09%). Conclusions: Urgent implementation of tailored training and support for temporary ICU nurses is paramount. Addressing capability and skill‐related issues among these nurses supersedes resource availability, infrastructure, equipment and system considerations. Essential interventions must target challenges encompassing nurses' inability to perform critical treatment techniques autonomously and ensure standardized care. These measures are designed to heighten patient safety and elevate care quality during emergencies. These findings offer a viable avenue to mitigate potential moral distress, anxiety and depression among nurses, particularly those transitioning from non‐critical care backgrounds. These nurses swiftly assimilate into temporary ICUs, and the study's insights offer practical guidance to alleviate their specific challenges. Relevance to Clinical Practice: The study on risk factors for converting traditional wards into temporary ICU during the COVID‐19 pandemic, especially from the perspective of nurses, provides crucial insights into the challenges and requirements for effectively establishing and managing these emergency settings. The findings highlight several key areas of concern and opportunities for improvement directly related to clinical practice, particularly in situations where there is a rapid need to adapt to increased demands for critical care. By addressing the identified risk factors through enhanced training, support systems, resource management, process improvements and cultivating a culture of adaptability, not only can the quality of care in temporary ICUs be improved, but also can the health care system be better prepared for future emergencies. These actions will help mitigate the risks associated with such conversions, ultimately benefiting patient safety, staff well‐being and the overall effectiveness of health care services in crises. [ABSTRACT FROM AUTHOR]

Background: Despite excellent long-term outcomes, a small proportion of patients who undergo fundoplication with hiatal hernia repair (laparoscopic antireflux surgery [ARS]) for treatment of gastroesophageal reflux disease (GERD) may require reoperation. Esophagogastroduodenoscopy (EGD) assessment in patients presenting with symptom recurrence plays a critical role in surgical planning of redo-ARS by confirming failure of the fundoplication and revealing the pattern of failure. We aimed to compare the findings documented by external endoscopists (i.e., outside physicians) to those documented by internal endoscopists (i.e., operating foregut or thoracic surgeons) before redo-ARS. Methods: After IRB approval, we conducted a retrospective chart review of patients who underwent redo-ARS at a tertiary surgical center between November 2016 and March 2023. Patients with both external and internal EGD reports were included, and findings from the two reports were compared. Results: Of 197 patients who underwent redo-ARS, both preoperative EGD reports were available for 181 (136 [75.1%] women; median age, 61 years [IQR 53–69]; median BMI, 27.9 kg/m2 [IQR 24.9–31.3]). The median time between primary and redo-ARS was 89 months (IQR 38–153), and the median time between external and internal endoscopic evaluation was 5 months (IQR 2–12). Only 38.9% of external reports mentioned a prior fundoplication. Compared to the operating surgeons, external physicians reported a significantly lower proportion of Barrett's esophagus (52.4%, p <.001), slipped fundoplications (28.8%, p <.001), paraesophageal hernias (20.5%, p <.001), disrupted fundoplications (20%, p <.001), intrathoracic fundoplications (0%, p <.001), and twisted fundoplications (0%, p <.001). Conclusions: External endoscopists' reports of failed fundoplications are often incomplete and lack relevant details. Discrepancies between nonsurgical endoscopists and experienced surgeons are likely explained by a lack of training and experience to discern and document fundoplication changes accurately. To reduce this gap, we strongly recommend the adoption of standard definitions describing post-fundoplication endoscopic changes and the inclusion of relevant training within educational programs. [ABSTRACT FROM AUTHOR]

Background: A person-centered and collaborative practice is considered crucial in contemporary physiotherapy. These ideals are often embraced in theory but are difficult to put into practice. As problems and solutions are related, understanding and refining theory on practical problems can close the knowing-doing gap and link the problem to the development of possible solutions. Objective: To explore the challenges with providing physiotherapy as part of collaborative and person-centered rehabilitation services. Methods: This article reports on an all-day interactive workshop with eight focus group discussions where physiotherapists from six different professional settings participated. We draw on theories of institutional logics to interpret the results. Results: Challenges were linked to: 1) Professional level: Services being based on what the profession can offer – not on users' needs; 2) Organizational level: Rewarding efficiency instead of user outcomes; and 3) System level: Not knowing the other service providers involved or what they are doing. Conclusion: An innovative practice was constrained by multilevel social systems: the professional logic shaping the perceived professional scope, the organizational logic shaping the understanding of what was expected in the organizational context, and a system logic within a biomedical paradigm. Transforming and transcending these social systems is needed to realize collaborative and person-centered practice. [ABSTRACT FROM AUTHOR]

In Ethiopia, the first 3 days (72 h) after admission to the emergency department (ED) account for more than half (59.8%) of all deaths. However, little is known about the prevalence of early mortality and its associated factors in southern Ethiopia. The main objective of this study is to assess the prevalence and associated factors of early mortality among deaths in adult EDs at selected public hospitals in Hawassa, southern Ethiopia. An institutional-based retrospective cross-sectional study design was applied. A systematic random sampling technique was used to select 369 charts of patients who died in the adult EDs of selected public hospitals in the past 2 years. The data were collected using a standardized and pretested data abstraction tool using the Kobo Toolbox data collection tool. Logistic regression analyses were carried out to assess the strength of the association. Statistical significance was declared at p -value < 0.05, and an adjusted odds ratio (AOR) with a 95% confidence interval was used to report the strength of the association. According to the results of the current study, 288 patients, or 78% of the total, passed away within 72 h of admission to the ED. The following variables were significantly associated with early mortality: delayed initial intervention (AOR 2.338), red triage categories (AOR 3.9), lack of investigation (AOR 3.4), comorbid illness (AOR 3.2), absence of prehospital treatment (AOR 4.2), and road traffic accidents (AOR 4.1). There was an increased early mortality rate seen in this investigation. The following factors were significantly associated with an early death in the ED: comorbidity, delayed intervention, red warning score, road traffic accidents, absence of prehospital treatment, and lack of diagnostic testing. By addressing the variables that are strongly linked to an early mortality, every intervention should be undertaken to reduce the risk of an early death. [ABSTRACT FROM AUTHOR]

Purpose The 340B Drug Pricing Program is important to healthcare organizations that serve vulnerable communities. However, it is unknown whether healthcare providers in these organizations understand the 340B program and how it supports enhanced patient services. This study aims to characterize the knowledge, attitudes, and beliefs of healthcare providers toward the 340B program in a multisite federally qualified health center (FQHC). Methods This was a cross-sectional study. A 27-item survey designed to assess prescriber knowledge and perspectives toward the 340B program was developed and administered. Closed-ended items were summarized using descriptive statistics, and open-ended items were analyzed with qualitative methods. Results A total of 198 healthcare providers with prescribing authority received the survey; of those, 65 (32.8%) participated. The majority of respondents (66.2%) were female; 41.5% were 35 years of age or younger, and 49.2% were physicians. The majority of respondents agreed that patients benefited from access to the organization's 340B pharmacies (95.0%) and that 340B pricing is important to consider when prescribing medications (78.3%). However, knowledge of the 340B program was limited, with only half of respondents (54.0%) able to correctly answer at least 4 of 7 knowledge-focused items. Reponses to a patient case suggested that some providers may be unfamiliar with which drugs are available at reduced prices. Conclusion The findings suggest that providers believe the 340B program benefits patients and the organization but often lack a complete understanding of the program. Future research should focus on prescriber education as a strategy to help organizations optimize their 340B programs and facilitate patient access to medications. [ABSTRACT FROM AUTHOR]

Purpose: This study explored the relationships of emergency room nurses’ perceptions of a good death, sense of calling, empathy competence, and end-of-life care stress with attitudes toward end-of-life care. It also identified the factors influencing attitudes toward end-of-life care. Methods: Data collection was conducted from September 1 to September 27, 2023 among emergency room nurses from general hospitals in Korea. A total of 248 nurses were included in the final analysis. A structured questionnaire was used to collect data. Data analysis was performed using the SPSS Win 26.0 program. Results: The study found positive correlations between attitudes toward end-of-life care and perceptions of a good death (r = .48, p < .001), sense of calling (r = .33, p < .001), and empathy competence (r = .24, p < .001). Conversely, a negative correlation was observed between end-of-life care stress and attitudes toward end-of-life care (r = -.44, p < .001). Multiple regression analysis revealed that an experience of a family member`s death, perceptions of a good death, a sense of calling, and end-of-life care stress were factors that significantly influenced attitudes toward end-of-life care among the emergency room nurses. Conclusion: In order to foster positive end-of-life care attitudes among emergency room nurses, it is essential to provide education on perceptions of a good death. Systematic education can effectively alleviate end-of-life care stress and help nurses better support this important aspect of practice. [ABSTRACT FROM AUTHOR]

Objectives: Mitral regurgitation (MR) is the second most common valve disease in Europe, and differences between men and women have been described in relation to aetiology or management, which might impact the decision for intervention and patients' clinical and economic outcomes. Thus, the objective was to analyse the burden of MR in Spain by aetiology and sex, and the management of all patients suffering from MR being admitted to hospital between 2016–2021. Methods: An analysis was carried out with the Ministry of Health's database, including all patients in public and subsidised hospitals and defining two groups, general MR and those patients undergoing Transcatheter Edge-to-Edge repair (TEER), using a descriptive analysis of patients' characteristics, use of resources, and outcomes; standardised rates were calculated and observed outcomes were described. Results: Hospital admissions increased from 2016 (n = 32,806) to 2021 (total n = 61,036). In general, the women were older and presented more complications. The majority of patients suffered from degenerative MR (DMR) (n = 183,005, 59.55%), and 61.56% were women, contrary to functional MR (FMR) (n = 124,278), which consisted of 62.15% males. In total, 1,689 TEERs were performed, 23.33% of them in urgent admissions, and mostly in men (65.66%). All groups showed higher rates of intervention for males. Regarding costs, women presented lower mean costs in the general MR groups but those undergoing TEER presented, in all cases, costs higher than men. Conclusions: MR entails a significant burden for patients and the Spanish healthcare system, increasing over the period of study. Differences in aetiologies by sex have been found in patients' characteristics as well as outcomes. Further studies are needed to optimise patients' management and their outcomes in relation to sex and aetiology. [ABSTRACT FROM AUTHOR]

In developing countries, aging is rapid and new towns in suburban and rural districts are emerging. However, the spatial accessibility and equity of healthcare services for older adults in new towns is rarely examined. This study is among the earliest attempts to evaluate the spatial accessibility and equity of public hospitals for older adults, using data from Songjiang District, Shanghai, China. A modified Gaussian Huff-based three-step floating catchment area (GH3SFCA) method was adopted based on the real-time travel costs of public transit, driving, cycling, and walking. The Gini coefficient and Bivariate Moran's Index were integrated to estimate spatial equity. The results showed that the spatial accessibility of high-tier hospitals decreases from the central areas to the outskirts for older adults in Songjiang. Meanwhile, the accessibility of low-tier hospitals varies substantially across areas. Although the low-tier hospitals are distributed evenly, their Gini coefficient showed less equitable spatial accessibility than the high-tier hospitals. Furthermore, driving and cycling lead to more equitable spatial accessibility than public transit or walking. Finally, communities with a low-supply–high-demand mismatch for public hospitals were suggested to be improved preferentially. These findings will facilitate planning strategies for public hospitals for older adults in developing new towns. [ABSTRACT FROM AUTHOR]

Purpose: As primary care (PC) clinics seek to integrate behavioral health (BH) services into patient care, it is crucial to understand the experiences of the clinic team and the impact on workflow and well-being. This study was designed to identify perspectives and experiences of nurse practitioner-led PC teams as they implemented a behavioral health integration (BHI) model into their Federally Qualified Health Center PC practices. Methods: We conducted in-depth qualitative interviews with staff members at three clinic sites that implemented BHI. Interviewees were asked questions about the benefits and challenges encountered in the new BHI workflow, the dynamics of the warm hand-off, the tools and resources they used and desired, and the changes they would like to see to promote efficient workflows. Results: We interviewed 21 staff members during May and June of 2020. An analysis of the qualitative data showed the most frequently reported experiences and attitudes focused on (a) the availability of behavioral health consultants (BHC); (b) procedural uses of the warm hand-off; (c) the organization's productivity goals; and (d) desired tools and resources that are generally unavailable to the clinicians but could make a difference to patient care. Conclusion: Our results can assist FQHCs and similar organizations to achieve both BHI and the Quintuple aim. Integrating BH services into PC clinics is valuable and may mitigate clinician-staff burnout. However, PC organizations desiring to integrate new sustainable care models should consider involving staff in every phase of the transitional process phase to increase staff buy-in and staff rapport. [ABSTRACT FROM AUTHOR]

Background Newborns experience multiple painful and stressful procedures during their hospitalization in neonatal intensive care units (NICUs). Repeated or untreated pain can have negative consequences for the health and development of newborns. Despite the growing knowledge of pain assessment and intervention, several studies have shown that the practice of neonatal pain management among healthcare providers is poor. Therefore, data regarding neonatal pain management practice and affecting factors are essential for taking appropriate actions. This study assessed neonatal pain management practice and associated factors among healthcare providers working in the NICUs of public hospitals in eastern Ethiopia from 1 January to 28 February 2022. Methods An institution-based cross-sectional study design was used among 372 randomly selected healthcare providers working in the NICUs of public hospitals in eastern Ethiopia. Data were collected using a pre-tested structured self-administered questionnaire and an observation checklist. The collected data were reviewed, coded and entered into Epi-data version 3.1 and exported to SPSS version 25 for analysis. Bivariate and multivariable logistic regression were used to identify the associations between outcome and predictor variables at a 95% confidence level and P -values <0.05 were considered statistically significant. Results The study found that 185 (53.9%; 95% confidence interval [CI] 48.4 to 59.2) of the 343 respondents had good neonatal pain management practice with a mean of 11.38 (standard deviation 3.64). Receipt of in-service training in neonatal pain management (adjusted odds ratio [AOR] 2.12 [95% CI 1.15 to 3.91]), availability of protocols and guidelines in the NICUs (AOR 2.94 [95% CI 1.74 to 4.91]) and accessibility of analgesics in the NICUs (AOR 4.302 [95% CI 2.46 to 7.53]) were significantly associated with good neonatal pain management practice. Conclusions The overall practice of healthcare providers in neonatal pain management in public hospitals in eastern Ethiopia is relatively high compared with previous studies conducted in Ethiopia. Improving the availability of analgesics as well as neonatal pain management protocols and guidelines in NICUs will aid in the promotion of good neonatal pain management practices. In addition, providing ongoing in-service training on neonatal pain management will allow healthcare providers to better care for newborns in pain. [ABSTRACT FROM AUTHOR]

Background Timely access to safe blood and blood components is still a challenge in Nigeria. This study aimed to determine blood donation practices, processing and utilization of blood components across government tertiary hospitals (THs) in Nigeria. Methods This was a descriptive cross-sectional study done in Nigeria in June–July 2020. Data were analysed with SPSS version 21.0. Results Data were collected from 50 THs. The majority (68%) of the THs lack facilities for blood component preparation and only 18% and 32% provide cryoprecipitate and platelet concentrate, respectively. Whole blood was most commonly requested (57.04%). All facilities tested blood for HIV, HBV and HCV, but the majority (23 [46%]) employed rapid screening tests alone and nucleic acid testing was not available in any hospitals. The manual method was the most common method of compatibility testing in 90% (45/50) and none of the THs routinely perform extended red cell typing. The average time to process routine, emergency and uncross-matched requests were a mean of 109.58±79.76 min (range 45.00–360.00), 41.62±25.23 (10.00–240.00) and 11.09±4.92 (2.00–20.00), respectively. Conclusion Facilities for blood component preparation were not widely available. Concerned government authorities should provide facilities for blood component preparation. [ABSTRACT FROM AUTHOR]

Background & Objective: Nijmegen Questionnaire (NQ) was developed in order to screen hyperventilation syndrome (HVS) and for better understanding of its questions and in lieu with the patient-centric model, it has been translated into other languages. This study aimed at translating English version of NQ in to Urdu and for evaluating the reliability and validity of Urdu based NQ (UNQ) in healthy population and in patients with hyperventilation. Methodology: This study followed cross sectional design with non-probability convenient sampling technique. Study was completed over the period of 6 months w.e.f. 19th June, 2021 and recruited a total of 70 participants (50 with HVS and 20 healthy people) after getting approvals from pulmonary department based in a government hospital and institutional ethical research board committee. Urdu translation of NQ was a four steps process involving two bilingual translators and a backward translation. Intra class correlation coefficient (ICC), Cronbach's alpha, Pearson Correlation and content validity index were utilized for assessing reliability and validity. Results: ICC was 0.96, representing good test re-test reliability. The reliability and internal validity gave a value of 0.96. Pearson's correlation coefficients were measured at 0.78 for tightness across chest and 0.82 for shortness of breath. Conclusion: UNQ is a valid assessment tool for the patients with HVS. It represented overall good reliability, content and construct validity. [ABSTRACT FROM AUTHOR]

Aim: To estimate the burden of disease and evaluate which factors affect health care resource use (HCRU) in young children with cerebral palsy (CP). Method: Data were collected as part of a prospective, longitudinal cohort study of children with CP born in Queensland, Australia between 2006 and 2009. HCRU questionnaires were administered at six time points. Data on resource use, socio‐demographics, and disease severity were collected. Costs were sourced from Medicare, the Australian National Hospital Cost Data Collection, and market prices. A generalized linear model was used to identify factors influencing CP‐related costs. Results: A total of 794 questionnaires were completed by 222 participants (mean = 3.6 per participant). Physiotherapy (94%, n = 208) was the most widely accessed allied health care therapy; almost half of the participants (45%; 354 of 794) reported one or more hospital admissions. From the health care funder perspective, a child with CP costs on average A$24 950 per annum (A$12 475 per 6 months). Higher costs were associated with increased motor impairment (Gross Motor Function Classification System, p < 0.001) and increased comorbidities (p = 0.012). Interpretation: HCRU in preschool children with CP can be analysed according to disease severity. Both increased motor impairments and increased comorbidities were associated with higher health care costs. What this paper adds: Children with a higher number of comorbidities had higher health care costs, and more specifically, higher hospitalization costs.No significant change in costs was found over time as children aged from 18 months to 5 years. [ABSTRACT FROM AUTHOR]

Artificial Intelligence (AI) technologies are expected to play an essential role in future healthcare systems for saving resources, improving treatment quality and enhancing patient safety. Governments worldwide are preparing for such a future by developing strategies and policies. Drawing on concepts and perspectives from Science and Technology Studies (STS), this article explores how government policies set the agenda for introducing AI in healthcare, using the Norwegian National Health and Hospital Plan 2020–2023 (NHSP) as an example. The article further investigates how the formal expectations included in the NHSP are met with informal anticipations expressed by actors working closer to clinical practices involved in an inquiry process initiated by the policy. Taking a qualitative approach, the article explores what characterises formal expectations of AI in healthcare and how these expectations are contested. The study finds that there are tensions between the different assumptions and that crucial issues concerning the future usage of AI are not yet on the Norwegian Government's agenda. Pairing the forces of the formal expectations with the ambiguous concept of AI, the current chasm between AI development and deployment, and the uncertainties constituted by the contesting elements, the article concludes by introducing a paradox of inevitability. [ABSTRACT FROM AUTHOR]

Objective Nationwide, obstetric clinics modified prenatal care to include telehealth visits in response to the coronavirus disease 2019 (COVID-19) pandemic, enabling the opportunity to investigate its impact on patient outcomes. We hypothesized that use of prenatal telehealth visits would increase the number of prenatal visits, decrease the frequency of urgent triage/emergency department (ED) visits, and improve perinatal outcomes. This study aimed to determine the impact of telehealth on number of obstetric prenatal visits and urgent triage/ED visits amidst the COVID-19 pandemic. Study Design This is a retrospective cohort of patients from a federally qualified health center in central Texas. Patients with a singleton gestation who delivered after 32 weeks were included. Comparison groups were made between those patients who delivered between May 2020 and December 2020 (presumed modified prenatal visit schedule with in-person and telehealth) and those patients delivering between June 2019 and February 2020 (the traditional care model with in-person visits only). Multivariable linear and logistic regression models were used to estimate differences in the number of prenatal visits and unscheduled triage/ED visits. Results A total of 1,654 patients were identified with 801 (48.4%) patients undergoing modified prenatal care and 853 (51.6%) patients receiving traditional care during the study period. No significant differences were seen in overall prenatal attendance or triage/ED presentations. However, when stratified by parity, multiparous patients undergoing modified prenatal care were less likely to experience an urgent triage/ED presentation (8.7 vs. 12.7%; odds ratio, 1.69; 95% confidence interval, 1.10–2.61). Conclusion When compared with a traditional prenatal visitation cohort prepandemic, patients who received modified telehealth prenatal care during the COVID-19 pandemic had similar prenatal attendance and unscheduled emergency presentations. However, multiparous patients experienced a decreased rate of unscheduled emergency presentations. Supplementing prenatal care with telehealth may provide overall comparable prenatal care delivery. Key Points Use of telehealth has the potential to improve prenatal care. The COVID-19 pandemic allowed for comparison to traditional prenatal care. Multiparous patients had a decreased frequency of ED visits. Similar prenatal attendance was seen between both prenatal models. [ABSTRACT FROM AUTHOR]

Simple Summary: This study assessed the supportive care services offered to breast cancer (BC) patients in Palestinian government hospitals and identified characteristics related to unmet needs. We performed a cross-sectional study involving 362 women, utilizing the Supportive Care Needs Survey (SCNS-SF34) through face-to-face questionnaires, and gathered data on sociodemographic, clinical, and social support variables. The findings indicated that 61% of participants encountered unmet supportive care needs, especially in the areas of health system and information (93.6%), physical and daily living (89.8%), and psychological support (75.1%). Elevated unmet needs are associated with variables like age, marital status, illness duration, analgesic usage, cancer treatments, family cancer history, and social support. This research highlights the urgent need to enhance supportive care services of the health system and information, physical and daily living, and psychological support, to elevate the quality of life for BC patients in Palestine. Background: Breast cancer (BC) is the most common cancer among women in Palestine, where the need for supportive care frequently goes unmet. Therefore, this study aims to assess the supportive care services provided at the governmental hospitals in the southern area of the West Bank and to determine the factors associated with the unmet needs of these services. Methods: A cross-sectional study was conducted on 362 women with BC. Data were collected using a face-to-face questionnaire that included the Supportive Care Needs Survey (SCNS-SF34), patients' sociodemographic, economic, and clinical characteristics, as well as familial history of cancer and social support. Results: The study revealed that 61% of participants had unmet supportive care needs, with health system information, physical support, and psychological support being the most unmet needs. Factors contributing to unmet needs included age, marital status, familial support, and a family history of cancer. Chemotherapy and surgery increased the probability of physical care needs by fivefold, while hormone therapy reduced the probability of psychological needs (AOR = 0.36, p < 0.001) and patient care and support needs (AOR = 0.49, p = 0.01). Additionally, radiotherapy reduced sexual care needs by 58% and biological therapy by 60%. Conclusions: There is an urgent need for enhanced supportive care services for BC patients in the West Bank, especially regarding health system information, physical care, and psychological support. Addressing these needs through targeted interventions could significantly improve patients' quality of life. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To compare rates and analyze health facility determinants of emergency department visits and hospitalizations for ambulatory care--sensitive conditions (ACSCs) among Medicaid patients by geographical location. STUDY DESIGN: Retrospective cross-sectional analysis of 48.3 million patients receiving Medicaid and their acute care visits across 34 states and the District of Columbia in 2019. METHODS: Descriptive analyses of county-level variations in emergency department visits and hospitalizations (acute care) for ACSCs, and multivariate regressions of proximity to and density of health facility infrastructure as correlates to utilization and spending. Regression models were adjusted for county-level poverty rates, chronic disease rates, and state fixed effects. RESULTS: Among the studied patient population receiving Medicaid, nearly 40% of acute care visits were for ACSCs, with variations across and within states. Rates ranged from 17.8 per 1000 member-months in Vermont to 39.0 in Mississippi, and from 5.9 to 77.9 between counties within states. Longer distances to the nearest urgent care center and primary care shortage area designation correlated to higher acute care visits for ACSCs (+ 4.3 per 1000 membermonths for every 100 miles; 95% CI, 2.9-5.7; P < .001; +1.5 per 1000 member-months if shortage area; 95% CI, 0.4-2.6; P = .006). Counties with more rural health clinics had fewer acute care visits for ACSCs (-3.4 fewer visits per rural clinic per 1000 population; 95% CI, -4.6 to -2.2; P < .001). Among 6 states with additional spending data, 4.2% of total Medicaid spending was attributable to acute care visits for ACSCs. CONCLUSIONS: Our evaluation revealed more than 13-fold variation in acute care utilization for ACSCs between Medicaid counties within the same state. Proximity to urgent care facilities and density of rural health clinics were major explanatory variables for these variations, underscoring the importance of local health infrastructure in reducing acute care utilization for ACSCs. [ABSTRACT FROM AUTHOR]

In the last 40 years, a significant increase in the incidence of lung infections by Aspergillus has been reported. The scarcity of studies that describe the costs of aspergillosis indicates that the economic impact of aspergillosis in the hospital environment is greater than that of other fungal infections. The objective of the study was to evaluate the direct healthcare costs associated with aspergillosis in the Spanish National Health System from 1997 to 2021. A retrospective nationwide longitudinal descriptive study was designed to review hospital records from the Minimum Basic Data Set of patients admitted to hospitals of the National Health System from 1997 to 2021, with a diagnosis of aspergillosis. A total of 44,586 patients were admitted for aspergillosis in the Spanish National Health System. There was a progressive increase in the average annual cost from 1997 to 2012, which reached a maximum peak, EUR 1,395,154.21 (±2,155,192.87). It decreased between 2014 and 2019, but increased again in 2020 and 2021, EUR 28,675.79 (±30,384.12). The Pearson correlation coefficient revealed a weak negative correlation between age and hospital costs and a moderate positive correlation between average length of stay and hospital costs. Our data show that the economic impact of hospitalizations for aspergillosis is significant and increasing at a rate proportionally higher than that of other prevalent diseases. Costs related to Aspergillus infection are associated mainly with respiratory diseases. The results of this economic evaluation may be useful for health authorities to develop a future economic strategy for managing this fungal infection. [ABSTRACT FROM AUTHOR]

Introduction: Sarcopenia has a detrimental impact on patient outcomes following colorectal surgery, increasing financial strain on the healthcare system. Given the absence of specific Australian data, this study aimed to measure the cost of sarcopenia in the context of colorectal surgery in an Australian public hospital. Methods: A retrospective cost analysis, following CHEERS guidelines, was conducted on major elective colorectal cancer surgical cases at the Royal Adelaide Hospital between 2018 and 2022. The cross‐sectional psoas area was measured through computed tomography (CT) imaging at the level of the third lumbar vertebrae, and sarcopenia was determined using gender‐specific thresholds. Hospital billing data was used to gather costings (AU$). Results: Out of 271 patients, 57 (21.0%) comprised the sarcopenic group (SG). SG patients were older (74 vs. 69 years, P < 0.001), had a higher American Society of Anaesthesiologists (>II, 71.9% vs. 53.7%, P = 0.014) and a lower median body mass index (24.8 vs. 28.7 kg/m2, P < 0.001). The SG exhibited a greater likelihood of complications (84.2 vs. 68.7%, P = 0.020) and prolonged hospital stay by 1 day (median 7 vs. 6 days, P = 0.027). Despite an increased mean total cost of hospital admission, no statistically significant difference was found (AU$37 712 vs. $34 845, P = 0.296). Multivariate analysis revealed hypoalbuminemia, prolonged operative time, postoperative ileus, return to theatre, Clavien‐Dindo grade ≥3 complications, and prolonged stay increased overall cost (P < 0.05). Conclusion: Sarcopenia was not associated with a significantly increased cost of colorectal surgery in our institution. Future studies examining the cost‐effectiveness of prehabilitation programmes targeting sarcopenia should be considered. [ABSTRACT FROM AUTHOR]

Background: The most susceptible group of people to spread methicillin-resistant Staphylococcus aureus (MRSA) among domestic cats is their owners' relatives. Aim: Considering the aforementioned, research at the Surabaya City Animal Hospital is necessary to determine whether the mecA gene may be detected in cat nasal swabs. Methods: Samples were taken using a sterile cotton swab, and the transport medium was buffered peptone water. Standard operating procedures in microbiology were then employed to identify the samples. Using five distinct antibiotic discs, the Kirby-Bauer diffusion method was used to determine the antibiotic resistance profile of S. aureus. All cefoxitin-resistant S. aureus isolates were tested for MRSA and then the mecA gene was detected. Results: Based on morphological culture features, Gram staining, and biochemical assays, 64 samples (64%) of the 100 isolated cat nose swab samples were positive for S. aureus, according to the results of the biochemical tests. The profile of antibiotic resistance developed from the results of the S. aureus resistance test to antibiotics revealed that five (7.81%) of the 64 S. aureus isolates were confirmed to be multidrug resistant. Out of the 6 MRSA isolates analyzed, the mecA gene was detected in 5 isolates. Conclusion: Based on the findings of this study, a thorough assessment of the impact of using antibiotics to prevent the spread of MRSA in veterinary hospitals on the general public's health is required in light of the detection of MRSA isolates bearing the mecA gene in the Surabaya veterinary hospital. [ABSTRACT FROM AUTHOR]

Background: Computerised static visual field testing using dedicated machines such as the Humphrey Field Analyzer (HFA) can assess and track changes in visual field sensitivity. The use of retrospective visual field databases is a novel undertaking, with no studies published utilising large scale population‐level data. This study phase developed a method to extract HFA data into a large standardised population‐based database including point sensitivity data with additional derived variables. Methods: Retrospective, longitudinal, population study of visual field data from people who attended an ophthalmology service and had a HFA field test, in Western Australia, between 1988 and 2022. Raw test data included patient demographic fields, sensitivity readings and test parameters. Calculated fields included reliability scores, and a novel combined reliability score. Results: There were 606 230 tests for 92 215 study individuals, from 22 ophthalmology practices in metropolitan Perth and three public hospital eye clinics, representing around 85% of the field tests performed by ophthalmologists each year. Raw sensitivity values were available for all tests, and additional descriptors were available for most tests (97.5%–100% of tests) with the exception of data variables retired by the manufacturer. Conclusions: Visual field data from 606 230 tests were collated into a single dataset, which is highly representative over a long period of time, for a defined population. This dataset has been linked to other administrative datasets to allow for epidemiological investigation of field of vision disorders. [ABSTRACT FROM AUTHOR]

India is aging. The growth of India's older population has increased our concerns about their well-being. While it is critical to explore the diverse needs and aging experience of older Indians, their voices are largely missing in the aging literature. In this context, data was collected from 63 community-dwelling and OAH residing older men and women of Delhi NCR to understand their aging experience, views about old age and perceived need for government intervention in old age care and support. Reflexive thematic analysis of their aging experience and perception of old age generated five themes and six sub-themes: The aging body encompassing three sub-themes "the older we become the more diseases we have", "the ointment called positive thinking", "women's quest for self-care"; Psychological gains and social losses; Affiliation, distraction and anticipation; The aging parent and the adult child comprising three sub-themes "filial relations—quality and quantity", "children these days and their mobile phones", "our daughter shows us more love and care"; and A time for religious and spiritual devotion. Lastly, the analysis of their perceived need for government support in old age care generated five sub-themes – Political cynicism, I was a private employee but am I not a part of this country? Government or Private Hospitals: A no-win situation, Everyday life and Reforms in OAHs. The present findings highlight the multidimensional and multidirectional experience of aging and the diverse needs of older persons in the Indian context. [ABSTRACT FROM AUTHOR]

Background: Subcutaneous immunoglobulin (SCIg) therapy is important in the treatment of primary (PID) and secondary immunodeficiencies (SID) and chronic inflammatory demyelinating polyneuropathy (CIDP). Patient support programmes (PSPs) help patients self‐administer medication regimens and play a more active role in the self‐management of their medical conditions. Aim: To describe the effectiveness of the CSL Behring CARES PSP in optimising the quality use of SCIg in a hospital‐free environment. Design: This retrospective, observational study analysed records of patients enroled in the CSL Behring CARES PSP. Key outcomes were accessibility and effectiveness. Data were extracted from the patient database and analysed using descriptive methods. Results: Seven hundred eighty‐nine patients with PID (30.8%), SID (53.4%) and CIDP (15.8%) were enroled in the CARES PSP, 92.8% of whom were referred from public hospitals and the remaining from private hospitals. Of the total patient population, 697 (88.3%) received the nurse‐led SCIg self‐administration training and education (COACH), out of which 656 (94.1%) completed training and achieved competency after an average of 2.3 training sessions. The proportions of patients who achieved competency were similar across age groups and prior SCIg hospital education status. Conclusion: This is the largest real‐world evidence study that describes the effectiveness of SCIg PSPs across three therapeutic disease states. These PSPs can optimise hospital resources such as infusion nurse time and allocation of infusion chairs that were once used for intravenous immunoglobulin infusions, improve patient access to SCIg therapy and enable patients self‐administer SCIg outside a hospital environment. [ABSTRACT FROM AUTHOR]

Introduction: There were fluctuatif cases of maternal death at Banyuwangi District in 2014-2018. The cases of maternal mortality needs attention considering to reduction MMR. An information system for high- risk pregnant woman is needed as a basis for decision making and Local Area Monitoring (PWS). The research aims to analyze the need for developing an integrated early warning system for high-risk pregnant woman between PHC and Hospital. Materials and methods: A qualitative design and action research. Primary data was obtained from interviews, observations, and FGD. Informants are Head, Midwife Coordinator, and Area Midwife of PHC, Head of Medical Service, and Head of IT Public Hospital. Secondary data from PHC and hospital documents. Processing and analysis data descriptively. Results: Problem identification of existing system was manual for compilation, analysis, and mapping; no integrated system between PHC and hospital MIS; referral patient data was re-entered in referral patient registration; the presence of high-risk pregnant women not yet known by the hospital; and information on the availability of maternal rooms in the hospital cannot be accessed directly by referral patients. There was an opportunity to develop an integrated MIS. Conclusion: There was need for developing an information system for high-risk pregnant women between PHC and hospital, that can be used by all level users, can relied on to carry out data processing, easier to produce quality information. The MIS is based on websites (web-based) and Android for an integrated early warning system to prevent deaths of pregnant women. [ABSTRACT FROM AUTHOR]

Introduction: The plate and the foods create visual platescapes that can influence food intake in many ways. However, whether the plate colour could indirectly enhance hospitalised patients' appetite and reduce plate waste is unclear. This study aimed to determine plate waste percentage and whether blue plate (BP) has a lower plate waste percentage than white plate (WP) when served to hospitalised patients. This study also determined the interaction effect between plate colours on socio-demographic characteristics, medical background, nutritional status and appetite level with plate waste percentage. Materials and methods: This quasi-experimental study was conducted among patients who received a normal diet during one lunch hour and those in a public hospital in Selangor who received a normal diet. Plate waste was evaluated for the lunch menu for 125 meals. All the patients were randomly chosen to receive hospital meals from a WP or BP on the same day during lunch hour, and patients, with assistance from the researcher, completed the questionnaire. The primary outcome was the total plate waste percentage between the patients receiving BP and those receiving WP. Results: The result shows only a significant interaction effect between the plate colour and education level. After controlling for all the covariates, the plate waste percentage between the WP and BP remains significant. Conclusion: A significant difference in plate waste percentage between the plate colours suggests that BP indirectly improve appetite and reduces plate waste among hospitalised patients. [ABSTRACT FROM AUTHOR]

Objective: To determine the predictive ability of "platelet albumin bilirubin (PALBI)" scores in assessing outcomes among acute variceal hemorrhage (AVH) patients. Study Design: Cross-sectional study. Setting: Department of Gastroenterology, Liaquat National Hospital. Period: September 2022 to September 2023. Methods: Cirrhotic patients with upper gastrointestinal bleed of either gender of age at least 18 years were included. Patients with malignancies and unwilling to participate were excluded. Patients were enlisted with their written informed consent. Data was analyzed using IBM-SPSS version 26. Results: Total 300 patients were enrolled into the study with mean age of 59.9 ± 10.4 years and majority were males (73.7%). According to endoscopic findings, small, medium and large esophageal varices (EV) were seen in 9%, 28% and 63% patients respectively. Rebleeding was seen in 27.7%. On multivariable model, none of the score including "Child-Turcotte-Pugh (CTP)" score, "Model of End-stage Liver Disease (MELD)" score, "albumin-bilirubin (ALBI)" score and PALBI score were found to be associated with rebleeding. During the study in-hospital mortalities were seen in 10.3% cases. In multivariable regression analysis, when adjusted for confounders, prediction score MELD and PALBI were found to be linked with in-hospital mortality. Conclusion: The present study found that PALBI predicting in-hospital mortality even after adjusting other confounders. However, PALBI was not a promising marker for prediction of re-bleeding. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to evaluate the validity and reliability of the Korean version of the occupational coping self-efficacy for nurses (K-OCSE-N) scale. Methods: The English version of the OCSE-N scale was translated into Korean using a translation and back-translation process. Data were gathered from 213 nurses employed in a general hospital in South Korea. The content validity was assessed using the content validity index. The construct validity was verified through exploratory and confirmatory factor analyses. Criterion validity was assessed using Pearson's correlation coefficients with the job stress coping and general self-efficacy scales. Reliability was examined using item-total score correlation and Cronbach's α coefficient for internal consistency. Results: The exploratory factor analysis identified two factors that explained 61.8% of the cumulative variance: occupational burden and relational difficulty. In confirmatory factor analysis, the model exhibited adequate fit (χ²/df = 2.07, GFI = .95, SRMR = .04, RMSEA = .07, CFI = .97, and TLI = .95), with both convergent and discriminant validity deemed acceptable. The criterion validity presented a positive correlation of the K-OCSE-N with both job stress coping (r = .72, p < .001) and general self-efficacy (r = .72, p < .001). The internal consistency of the scale using Cronbach's α for the total items was .89. Conclusion: The K-OCSE-N scale is a valid and reliable tool for measuring nurses' occupational coping self-efficacy. This study suggests that various intervention studies can use the scale to assess and strengthen nurses' occupational coping self-efficacy in nursing practice. [ABSTRACT FROM AUTHOR]

Objective: This research was conducted to determine the effect on pain, psychosocial adjustment and self-care management of motivational interview-based counseling for individuals with a diagnosis of knee osteoarthritis. Methods: This study was conducted as a randomized controlled experimental study. The sample size for the study was calculated as 60 individuals (29 intervention, 31 controls) diagnosed with osteoarthritis. Study data were collected using a Personal Information Form, Visual Analogue Scale (VAS) for measuring pain intensity, Psychosocial Adjustment to Illness Self-Report Scale, and Self-Care Management Scale in Chronic Diseases. The intervention group received motivational interview-based counseling for four weeks and standard care was administered to the control group. At the end of four weeks, the post-test was applied to participants. Results: Motivational interview-based counseling for the intervention group lasting four weeks significantly decreased the mean scores for the Psychosocial Adjustment to Illness Self-Report Scale, indicating increased psychosocial adjustment levels. It significantly decreased VAS scores, and significantly increased mean scores for the Self-Care Management Scale in Chronic Diseases, indicating self-care management increased (P < .001). Conclusion: Motivational interview-based counseling for individuals with knee osteoarthritis reduces pain and increases psychosocial adjustment and self-care management. Practice Implementation: Health professionals can use motivational interviewing during the treatment, care and rehabilitation of individuals with knee osteoarthritis. [ABSTRACT FROM AUTHOR]

Background: The need for smartification is increasingly recognized in public hospitals, making it crucial to identify the current status, gaps, and factors influencing hospital smartness. Objectives: This study aimed to assess the smartness status of public hospitals and investigate its correlation with hospital characteristics and performance indicators. Methods: This descriptive-analytical cross-sectional study was conducted in seven public hospitals in Alborz Province, Iran, during 2023 - 2024. We assessed the characteristics and performance indicators of the hospitals using a researcher-developed questionnaire and evaluated their smartness status with the standardized "Smart Hospital Evaluation" checklist. Data analysis was performed using SPSS24 software, utilizing independent t-tests, Pearson's correlation, Spearman's correlation, and analysis of variance (ANOVA) tests. Results: The smartness status of the hospitals was found to be moderate, with 71% of hospitals falling into this category. A significant correlation was observed between the smartness of hospital units, the type of hospital (teaching or non-teaching), and the hospital's specialization (specialized or general) (P = 0.013). Significant and direct correlations were also found between information technology and hospital units (P = 0.043), management systems and clinical processes (P = 0.008), and overall smartness and clinical processes (P= 0.049). Conclusions: Public hospitals need improvements in smartness indicators. Factors such as whether the hospital is teaching or non-teaching and whether it is specialized or general should be taken into account. Moreover, hospital smartification efforts should adopt a comprehensive approach, considering all dimensions of smartness. [ABSTRACT FROM AUTHOR]

Objectives: To study changes in oral health with focus on reported dental fear prevalence and interrelationships between dental fear and prevalence of dental caries and performed restorative dental treatment in preschool child populations attending regular public dental health care between 1983 and 2013. Methods: Every 10 years, random samples of about 100 children aged 3 and 5 years, respectively, took part in cross‐sectional studies based on oral examination and a questionnaire. One question, put to the child and answered by the parent, mirrored dental fear: "What do you feel at the prospect of an appointment with a dentist?". Agreement to at least one of three alternatives, ill at ease, frightened and sick, indicated dental fear. Frightened and/or sick mirrored severe dental fear. 79%–94% of the samples answered the question and constituted the study group. Prevalence of caries and number of filled tooth surfaces were recorded. Dental parameters were presented in mean values. Results: During the 30 years, dental fear prevalence was fairly constant. 21% of 3‐year‐olds and 15% of 5‐year‐olds reported dental fear in 2013. Positive relationships between dental fear prevalence and caries prevalence and number of filled tooth surfaces were found. Dental caries was reduced during the study time, but to a lesser degree in children with dental fear compared to children without dental fear. Conclusions: Although children were offered public dental health care, the prevalence of dental fear remained high. Children with dental fear are caries risk individuals. [ABSTRACT FROM AUTHOR]

To provide an overview of the information recorded in the DHMR and to highlight its strengths and limitations as a pharmacoepidemiological research tool. Methods: We reviewed the registry´s geographic and clinical specialty coverage and medications recorded according to the main groups of the Anatomical Therapeutic Chemical classification system. Results: From May 2018 through December 2023, the DHMR recorded data on more than 1.9 million unique patients from all approximately 50 public hospitals and associated hospital outpatient clinics, totaling 105.3 million recordings of hospital medication use. The registry records detailed data on the indication for medication, medication type, pharmaceutical form, dosage, and administration time, collected through electronic medical record systems. Although the data quality has not yet been evaluated in a scientific context, some potential limitations are known. These include regional differences in the data collection and a lack of data from certain clinical specialties. Due to its recent establishment in 2018, the registered number of patients treated may still be limited for some rarely used medications. Conclusion: The DHMR is an important new resource for research in Denmark. Combined with the Danish National Prescription Registry, which covers all community pharmacies, it offers access to accurate data on medication exposure in the Danish population. Users should be aware of potential issues with lack of information before 2018. [ABSTRACT FROM AUTHOR]

BACKGROUND: Morphological and structural abnormalities are common dental anomalies. Identifying DA and determining their prevalence can play an important role in reducing the risk of surgical intervention and improving occlusion, leading to successful dental treatments. Thus, this study aimed to determine the prevalence of DA using panoramic radiographs (OPG) in Makkah, Saudi Arabia according to gender. MATERIALS AND METHODS: A retrospective radiographic investigation was performed, and the digital OPG of 923 patients (age range, 8–27 years) were collected. Records were collected from patients admitted at a government hospital in Makkah between January 2020 and DA in terms of tooth shape (microdontia, macrodontia, gemination, and fusion), number (supernumerary and congenitally missing teeth), and position (impaction and ectopic eruption). Several other abnormalities, such as ankyloses, dens in dents, dilacerations, and taurodontism, have also been reported. Digital radiographs from patients were systematically evaluated to diagnose each radiograph with consistent screen brightness and resolution. RESULTS: The most prevalent DA were impaction (53.8%), hypodontia (13.6%), microdontia (8.2%), and ectopic eruption (6.7%). Taurodontism was observed more frequently in male compared to female (7.5% and 2.2%, respectively). However, there was no significant difference between gender in the distribution of other DA. CONCLUSION: This study found that 27.8% of the Saudi population of Makkah city have DA. Clinical examination and radiographic evaluation are crucial for providing the proper treatment for patients seeking dental treatment. [ABSTRACT FROM AUTHOR]

Polypharmacy, commonly described as the use of five or more prescribed medications, is a prevalent health issue among seniors because of the potential adverse side effects due to medication interactions. The main purpose of this study was to investigate the association between dietary patterns and number of medications used. We hypothesized that a plant-based diet and healthy lifestyle choices decreases morbidities and number of medications taken. Data on 328 participants, aged 60 years or older, were collected through questionnaires and measurements at the Loma Linda University Drayson Center in Loma Linda, CA, between 2015 and 2016. The dependent variable was the number of pills taken, used as counts, and the main exposure was the type of diet adopted. Negative binomial regression was used for analysis. Results suggest that a vegan diet reduces the number of pills by 58% compared to non-vegetarian (IRR=.42 [95% CI:.25-.70]), even after adjusting for covariates. Increases in age, body mass index (BMI), and presence of disease suggest an increased number of pills taken. A vegan diet showed the lowest amount of pills in this sample. Body mass index also had a significant positive association with the number of pills. [ABSTRACT FROM AUTHOR]

The public sector, particularly hospitals, plays a crucial role in the provision of quality health services. However, many hospitals, including RSUD Datu Sanggul, face challenges in human resource management (HRM) that result in service performance. This study aims to analyze the functions of human resource management (HRM) in the Regional General Hospital (RSUD) Datu Sanggul and its impact on service performance, especially in the Surgical Poly. The method used is a qualitative approach with an exploratory design. Data were collected through observation, questionnaires, and documentation studies, involving 14 hospital leaders as respondents. The results showed that the recruitment and selection process of medical personnel at RSUD Datu Sanggul was still less than optimal, with several inequities and competency mismatches. The implementation of training and development programs for medical personnel recorded activities, but the evaluation of the results was minimal, indicating a lack of impact on performance improvement. In addition, performance appraisal systems and compensation policies also need to be improved to attract and retain medical personnel. This study provides recommendations to improve transparency and standards in the recruitment process, training evaluation, and compensation policy adjustments in order to improve the quality of health services at RSUD Datu Sanggul. [ABSTRACT FROM AUTHOR]

Background: Nurses play a critical role in delivering healthcare services, and their perception of the quality of those services is critical to better patient care. This study aimed to capture nurses' perceptions of healthcare services in India. Materials and Methods: An exploratory study design was adopted. 554 nurses from selected public and private hospitals in Kerala, India, were randomly selected for the study. The data were analyzed quantitatively with SPSS 23.0. Results: The perception of nurses in all dimensions of the HQP is observed as high (>3.5), with the exception of their involvement in quality management, which is reported as medium (2.5–3.49). Further, a significant difference between public and private hospitals (p < 0.05) is observed for all variables, except for the perceived effectiveness of quality improvement (p = 0.81) and the availability of training and development opportunities (p = 0.80). Additionally, nurses working in accredited hospitals (mean = 3.78) have more positive perceptions than non-accredited hospitals (mean = 3.69) (p < 0.05). Female nurses show a significantly more positive attitude toward the quality of health services than their male colleagues. Conclusion: The participating nurses were aware of various aspects of the quality management systems in their respective hospitals. In addition, the public and private hospitals and the accredited and non-accredited hospitals differed in their quality practices, as reflected in the nurses' voices. This study would help healthcare policy planners enhance the quality of the public sectors in India. [ABSTRACT FROM AUTHOR]

The field of healthcare quality and safety has been informed by the study of Human Factors contributing to adverse events. Hitherto, much of the study of Human Factors has been focused on a narrow lens of human error, identifying cognitive‐based or knowledge‐based errors and cognitive processes such as loss of situational awareness contributing to error. While these factors are important, this narrow approach fails to consider the complexity of relational and systemic factors that also contribute to adverse events. We aimed to explore the relational and systemic human factors, including shared clinician attitudes and behavior, that contribute to serious adverse patient events in a public health setting. The study, set in a metropolitan local health district in New South Wales, Australia, was conducted using a retrospective qualitative multi‐incident content analysis design. Serious adverse event reviews (SAER) over 6 months (2022–2023) were subject to qualitative content analysis until data saturation was reached. Data saturation reached at 20 reports. Emergent themes related to human factors in serious adverse events included: (i) delays and inertia—with a subtheme of inertia of ageism; (ii) "All‐or‐nothing" approach to end‐of‐life care and planning; (iii) communication lapses; and (iv) implementation gap between standards and practice. Error‐based incidents accounted for only 35% of the serious adverse events examined. The sample studied involved mostly (65%) male patients, with a mean age of 69 (70% aged >65), managed across the gamut of specialties, with the most common incident being the management of acutely deteriorating patients. In conclusion, there is more to Human Factors in adverse events than cognitive or knowledge‐based error. While identifying and correcting errors is absolutely essential, we need adjunctive "soft measures" to address clinical attitudes, behaviors, and relationships in health care, particularly in increasingly complex, fraught, and stressful health care environments. [ABSTRACT FROM AUTHOR]

Copyright of Microbes & Infectious Diseases is the property of Microbes & Infectious Diseases and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

OBJECTIVE: In our study, we attempted to determine the accreditation process experience of hospital senior managers accredited by the Turkish Health Care Quality and Accreditation Institute (TUSKA). Along with the institutions' accomplishments through the accreditation program, the major challenges they faced during the accreditation process were revealed. METHODS: One of the qualitative research designs used was interpretive phenomenological analysis, which was carried out through semi-structured interviews with hospital senior managers. RESULTS: In the study conducted with eight participants, 55 sub-themes emerged under 12 main themes. The participants expressed their opinions on a wide range of topics, from the achievements related to the accreditation process to the difficulties they encountered, from their strengths to the dissemination of accreditation throughout the country. CONCLUSION: It has been understood that the national hospital accreditations carried out in our country provide important gains to the institutions in management and clinical activities, while the expectations on incentives and other similar issues have not yet been met. [ABSTRACT FROM AUTHOR]

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of International Journal of Professional Business Review (JPBReview) is the property of Open Access Publications LLC and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: In Gabon, studies on the characterization of extended-spectrum beta-lactamase-producing Escherichia coli in young children with diarrhoea are almost nonexistent. The objective was to evaluate the prevalence of antibiotic resistance to extended-spectrum beta-lactamase-producing Escherichia coli in children at public hospitals in Franceville, Gabon. Methods: Seventy diarrhoea faecal samples were collected from children aged 0–5 years. The culture and isolation of colonies were carried out on MacConkey agar. The colonies were identified using VITEK 2. The determination of the extended-spectrum beta-lactamase's profiles was accomplished using the double disk method. The identification of phylogroups and pathotypes was performed by PCR. Identification of the ESBL genes was performed by sequencing. Results: A total of 26 strains of Escherichia coli (33.0%) were identified from 78 bacterial isolates. Twenty (77.0%) Escherichia coli strains carried extended-spectrum beta-lactamases blaCTX-M-15 and 5.0% carried blaSHV-12 subtypes. Phylogroup D (62.0%) was predominant, followed by B1 (12.0%), B2 (8.0%) and E (4.0%). The bacterial pathogens causing diarrhoea were enterohemorrhagic E. coli (12.0%), typical enteropathogenic Escherichia coli (8.0%), atypical enteropathogenic Escherichia coli (4.0%), Enteroaggregative Escherichia coli (4.0%) and enteroinvasive E. coli (4.0%). Conclusions: This study showed a high prevalence of extended-spectrum beta-lactamase, Escherichia coli of phylogroup D and pathotype enterohemorrhagic Escherichia coli in children under 5 years old in public hospitals in Franceville, most probably due to the misuse or inappropriate consumption of beta-lactams. [ABSTRACT FROM AUTHOR]

Copyright of Baghdad Science Journal is the property of Republic of Iraq Ministry of Higher Education & Scientific Research (MOHESR) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Environmental & Social Management Journal / Revista de Gestão Social e Ambiental is the property of Environmental & Social Management Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background and Objectives: Patient satisfaction is an essential parameter in assessing the quality of care and healthcare facility performance and the most important competitive advantage of the government and private hospitals. The study aims to investigate patients' satisfaction regarding the quality of nursing care in both public and private hospitals. Methods: A quantitative, comparative study was conducted among 330 patients (165 from public hospitals and 165 from private hospitals) in Erbil City from October 2023 to February 2024. Data were collected through structured interviews using a standardized questionnaire and analyzed using descriptive and inferential statistics via the Statistical Package for the Social Sciences. Results: Among the 330 patients surveyed, the majority were aged 18 to 39 years (55.8%), predominantly female (65.5%) and married (75.2%). Notably, 50.3% had been hospitalized over four times in public hospitals. Patients reported their health status as fair (38.8% before hospitalization), with 64.2% transferred from other facilities. In private hospitals, 100% of patients had single occupancy in their rooms. Satisfaction scores for nursing care were significantly higher in private hospitals compared to public ones (p < 0.001). Significant associations were observed between sociodemographic factors and nursing care satisfaction (p < 0.001), with gender showing no significant association (p = 0.819). Conclusions: The study concludes that patients in private hospitals exhibit strong satisfaction with the quality of nursing care compared to those in public hospitals. This highlights the importance of addressing disparities in nursing care quality between hospital types to enhance overall patient satisfaction and healthcare outcomes. [ABSTRACT FROM AUTHOR]

Background: The Heart Failure Post-Acute Care [HF-PAC] program is a specialized healthcare program aimed at providing comprehensive care and support for patients with heart failure [HF] as they transition from acute hospital settings to home. But the impact of the coronavirus disease 2019 [COVID-19] pandemic on the HF-PAC program remains unknown. Furthermore, the effects of the comprehensive COVID-19 vaccination program on these patients with HF-PAC warrants further investigation. Methods: A total of 265 patients with acute decompensated HF were admitted to the hospital between May 2020 and October 2022. Of these, 159 patients underwent planned HF-PAC follow-up for 6 months, followed by scheduled follow-up visits every 3 months and unscheduled telephone randomized visits for at least another 6 months. Results: The program completion rate was nearly 92%. COVID-19 significantly impacted patients with HF-PAC, leading to an increased mortality [13.3%] compared to before the pandemic [6.5%]. In our patient cohort, 83% had received at least 1 dose of vaccine and 61% had received > 3 doses. Of these patients with HF-PAC, 34% contracted COVID-19 infection post discharge, and 8.8% died owing to the infection. Of the mortality group, 42.9% patients were not vaccinated, and 28.6% received 1 vaccine dose, and their vaccination rate was lower than in the survival group [p = 0.01]. Conclusions: The COVID-19 pandemic had a significant impact on patients enrolled in the HF-PAC program; receiving more than 3 doses of the COVID-19 vaccine was associated with a significant reduction in mortality rates among these patients. [ABSTRACT FROM AUTHOR]