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BackgroundCameroon is amongst the worst affected countries by road traffic injuries with an estimated 1443 disability-adjusted life years per 100,000 population. There have been very limited reports on the crucial prehospital response to road traffic injuries in Cameroon. This study aimed to identify prehospital factors associated with RTI mortality in Cameroon.MethodsWe included patients enrolled between June 2022 and March 2023 in the Cameroon Trauma Registry. Information about prehospital factors and demographic data was obtained from patients or their proxies. We examined the association of prehospital care factors like care at the crash scene and type of transportation during crash with final patient outcome. We used Chi-squared test to investigate the association between selected independent variables and mortality. A multivariable logistic regression model was built to identify independent predictors of dying from an RTI.ResultsRTIs constituted 69.5% (n = 3203) of all injuries in the Cameroon Trauma Registry. Only 20.7% (n = 102) of 4 + wheel vehicle occupants had seatbelts on and just 2.7% (n = 53) of motorcycle riders were wearing helmets during the collision. Only 4.9% (n = 156) of patients received any form of scene care. In-hospital mortality was 4.3% (n = 139) and was associated with male sex (AOR = 1.7, 95%CI = 1.08-2.80), crashing on a motorcycle (AOR = 2.08, 95%CI = 1.1-3.67) and scene care (AOR = 0.25, 95%CI = 0.04-0.80).ConclusionsReceiving any type of care at the scene such as bleeding control or being placed in the recovery position by bystanders is associated with improved survival. Improving on existing informal prehospital care responses should be a priority in Cameroon.

Background: Underserved populations both globally and in Canada face serious cancer inequities that result from systemic economic, environmental, and social conditions. These pose barriers in access to cancer care and lead to suboptimal cancer care experiences and outcomes. Knowledge of effective interventions to improve access to cancer care is needed to inform the design of tailored interventions for these populations. Aim: To identify interventions and programs to improve access to cancer care for underserved populations in high income countries with universal health coverage (UHC) and the United States (US) throughout the cancer care continuum. Methods: We conducted a systematic review following the PRISMA standards. We searched Medline, EMBASE, PsycINFO, CINAHL, Scopus, and the Cochrane Library. Inclusion criteria: quantitative and qualitative studies published in English in the last 10 years (2013–2023), describing interventions/programs to improve access to cancer care for underserved populations (18 years and over). We included studies in the US given the body of scholarship on equity in cancer care in that country. Screening, data extraction and analysis were undertaken by two independent reviewers. Results: Our search yielded 7,549 articles, and 74 met the inclusion criteria. Of these, 56 were conducted in the US, 8 in Australia, 6 in Canada, and 4 in the United Kingdom. Most (90.5%) were quantitative studies and 47.3% were published between 2020–2023. Seven types of interventions were identified: patient navigation, education and counselling, virtual health, service redesign, financial support, improving geographical accessibility and multicomponent interventions. Interventions were mainly designed to mitigate language, distance, financial, lack of knowledge and cultural barriers. Most interventions focused on access to cancer screening, targeted rural populations, racialized groups and people with low socioeconomic status, and were conducted in community-based settings. The majority of interventions or programs significantly improved access to cancer care. Conclusion: Our systematic review findings suggest that interventions designed to remove specific barriers faced by underserved populations can improve access to cancer care. Few studies came from countries with UHC. Research is required to understand tailored interventions for underserved populations in countries with UHC. [ABSTRACT FROM AUTHOR]

Aims: To map evidence on the nature and extent of use of nurse‐led palliative care models in low‐ and middle‐income countries serving adults with life‐limiting conditions. Design: A scoping review of the literature was undertaken. Data Sources: A systematic search was performed from database inception to March 2022 in: Medline, EMBASE, CINAHL, Wiley Cochrane Library, SCOPUS, Web of Science, SciELO and Global Health. Main search terms included: Nurse‐led AND Palliative care AND Low‐and middle‐income countries. Grey literature was searched from Proquest Dissertations and Theses Global, the World Health Organization and selected palliative care websites. We searched the reference list of included articles for additional studies. Review Methods: We used the framework by Arksey and O'Malley and the PRISMA‐ScR guidelines. Titles and abstracts were screened by one reviewer and full text by two reviewers. Thematic analysis was used to synthesize data and results are presented descriptively using themes and categories. Results: Eighteen studies were included, with majority from Sub‐Saharan Africa (10/20). Three nurse‐led palliative care models emerged: nurse‐led empowering care, nurse‐led symptom control and nurse‐led multicomponent palliative care. They served particularly cancer and HIV patients and were delivered in person or by telehealth care. Reported outcomes were adherence to therapy, improved self‐care ability, improved quality of life and increased access to palliative. Conclusions: The use of nurse‐led palliative care in low‐ and middle‐income countries is in its developing stages and seems feasible. Nursing roles in in low‐ and middle‐income countries need to be expanded by developing advanced practice nurses and nurse practitioner programmes, with palliative care content. More impact evaluation studies on the use of nurse‐led palliative care models in these countries are needed. Impact This review highlights nurse‐led care models that can enhance access and quality of life of patients with life‐limiting conditions in low‐ and middle‐income countries. [ABSTRACT FROM AUTHOR]

Introduction: The development of a structured curriculum, relevant teaching and learning methods, and support facilities and access is necessary to improve palliative care education by preparing nursing students as future professional nurses in the palliative care area. This review aims to synthesize available literature explaining the barriers and enablers in implementing palliative care education in undergraduate nursing students. Method: This review uses a systematic narrative review approach. Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) was used in this study. Studies were identified from the PubMed, Scopus, CINAHL, and ProQuest Nursing databases from January 2012 to August 2022. Results: A total 23 of 890 studies were included. The findings were grouped into obstacles and enablers in four parts, namely curriculum and learning strategies, personal and professional competencies, relationships and enablers, and facilities and access. Conclusions: Identifying barriers and enablers can help educational institutions to provide palliative care education according to the needs and expected developments in clinical practice. Collaboration and cooperation between stakeholders must be increased effectively to help provide maximum education. [ABSTRACT FROM AUTHOR]

Background: Palliative care education for non-specialist health professionals is an important strategy for widening access to palliative care. Aim: To describe Cameroonian nursing students' experiences and perceptions of the strengths and weaknesses of a palliative care course, with a view to refining the course. Methods: Three focus groups were conducted with 23 students, and data were analysed thematically using the framework approach. Results: The students reported connecting with their past personal and professional experiences in the care of patients with palliative care needs during the course. The main course strength reported was its use of a variety of interactive educational strategies, such as role plays, group discussions and case studies. The course's main reported weakness was the lack of supervised clinical practice in palliative care. Conclusion: The use of a variety of interactive educational strategies—including supervised clinical practice—is considered by nursing students as vital to enhancing learning in palliative care education. However, the lack of supervised palliative care clinical practice opportunities is a challenge in Cameroon. [ABSTRACT FROM AUTHOR]

Background/objectives: Access to palliative care is an urgent global need. Countries with the greatest palliative care needs have limited access. In Cameroon, demand for palliative care is growing due to the rising incidence of life-limiting conditions. Identifying available palliative care services and programs could provide an understanding of access gaps and inform future roadmaps for palliative care development in the country. We aim to map available palliative care services, identify gaps and inform recommendations to promote early access to palliative care in Cameroon., Methods: We undertook a literature review of articles reporting any aspects of palliative care in Cameroon. We searched Embase, MEDLINE, Scopus, PsycINFO, CINAHL, PubMed and gray literature. Data were analyzed thematically using the World Health Organization model for the assessment of palliative care development., Results: We identified 41 articles reporting 21 organizations with some form of palliative care services such as clinical services, education, advocacy and research. These were led mostly by individual health care providers or private and faith-based organizations. Major palliative care initiatives included training in the form of workshops, and adult and pediatric outpatient, in-patient and community-based palliative care. There were few reports of oral morphine production, community engagement, advocacy and palliative care research., Conclusions: Progress in palliative care development was reported in five regions of Cameroon over the last two decades. Findings suggest the need for an intersectoral approach including government, community, and health care stakeholders to achieve sustainable palliative care. This could potentially ensure equitable access to palliative care in Cameroon.