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Background: Suicide is the fourth most common cause of death for the 15–29 age group. Research on the impact of suicide on parents is scarce and, therefore, poorly understood. Aim: To explore parents' experiences who have lost a son or a daughter due to suicide and their experience of the services available to them. Methods: This phenomenological study involved 1–2 interviews with ten parents aged 40–65, seven mothers and three fathers in all 13 interviews. The age range of their sons and daughters was 17–37 years when they died. Results: For the parents, losing a son or a daughter to suicide is an overwhelming life experience characterised by Excruciating existential suffering and complicated grief where they are confronted with deep meaning‐making and existential questions without answers since the person who can answer most of them is no longer alive. They, therefore, felt stuck in their grief for up to 4 years. The initial experience was an immense paralysing shock and sense of unreality. The subsequent period was a blur, and they were numb. Then, their psyche and bodies collapsed, and for a long time, they felt no grief processing was taking place. They sorely needed long‐term professional trauma‐informed support and felt that, in too many cases, they had to reach out for help themselves. They would have liked to see the healthcare system embrace them with more open arms, offer help and be met with information and individualised support. Conclusions: Standard operating procedures must be installed to support suicide‐bereaved parents better. Long‐term professional support and trauma‐focused care are required following such major trauma, and providing such support could help to reduce their adverse health impacts. Nurses and other health professionals must be better educated on existential suffering in this context. [ABSTRACT FROM AUTHOR]

Consumer interest in cosmetic surgery has grown tremendously in recent years. However, despite the long‐lasting implications of cosmetic surgery decisions on consumer well‐being, existing insights on these decisions remain limited and scattered across various fields. Through an interdisciplinary bibliometric review, we identify that previous research has primarily focused on five aspects shaping consumers' decisions in cosmetic surgery: (1) differing perspectives, (2) social drivers, (3) individual drivers, (4) online media content, and (5) influences relevant to labiaplasty. These investigations stem from the fields of psychology, sociology, communication, and healthcare and aim to understand especially consumer intentions to undergo surgery at the pre‐consumption stage. In this research, we delineate how marketing researchers can advance insights along the entire consumer surgery journey (i.e., pre‐consumption, consumption, and post‐consumption stage) through a better understanding of (i) the phenomenon and its different treatments, (ii) the role of identity, (iii) stakeholder interactions, and (iv) how social media and technology shape cosmetic surgery decisions. Finally, we highlight how studying these topics can contribute to marketing theory through novel insights on the self and identity, the body's meaning in consumption, and self‐enhancement practices. [ABSTRACT FROM AUTHOR]

Background: There are several strategies used to assess involvement in their healthcare across service providers. However, there is no consensus on the most appropriate measurement tool to use when evaluating patient involvement initiatives. This qualitative study aimed to explore the perspectives of stakeholders from micro, meso, and macro levels within the Danish healthcare system on measuring patient involvement in their healthcare. Methods: This descriptive, explorative study employed semi-structured interviews with open-ended questions to elicit participants' views and experiences of patient involvement and measurement tools. A purposeful sample of participants was identified, to include decision makers, researchers, and health professionals (n = 20) with experiences of measuring patient involvement in healthcare at micro, meso, and macro levels across Danish organizations. Data underwent reflexive thematic analysis. Results: Three main themes were identified: 1) Determining the purpose of patient involvement practices and measurement alignment; 2) Reflecting on the qualities, fit, and usefulness of measures; 3) Recognizing conflicting stakeholder paradigms. Despite the interest in and positive attitudes toward patient involvement innovations, views on the meaning and value of evaluating involvement varied; in part, this was attributable to challenges in selecting criteria, methods, and measures for evaluation. Conclusion: The findings indicate the need to integrate the perspectives of all key stakeholders in designing the evaluation of patient involvement initiatives. The application of a multiple stakeholder approach and co-production of a multidimensional evaluation may provide some common ground for selecting evaluation criteria and measurement tools in the healthcare setting. Trial registration: Danish Data Protection Agency (1–16-02–400-21) 15 October 2021. [ABSTRACT FROM AUTHOR]

Background: Despite medication being the most common healthcare intervention and medication-related incidents being common in hospitals, many rural and remote hospitals in Australia lack onsite pharmacy services due to resource constraints. A Virtual Clinical Pharmacy Service (VCPS) staffed by two senior, rural generalist hospital pharmacists assigned to four hospitals each was implemented in rural and remote facilities to determine whether the VCPS increased adherence to National Safety and Quality Health Service Standards (NSQHS). Methods: A stepped-wedge randomised controlled trial was employed to sequentially implement a telehealth pharmacy service at one-month intervals in eight hospitals. The primary outcomes were patient-level medication reconciliation completion rates on admission and discharge. Secondary measures evaluated compliance with other NSQHS standards (including Best Possible Medication History, Medication Reconciliation and venous thromboembolism risk assessment), patient outcomes (including representation within 48 h, readmission within 28 days and length of stay), and detection of potential medication-related harms (including pharmacist identified medication related problems, reported medication errors and falls). Patients were invited to complete a patient-reported experience questionnaire. Data were collected from electronic medical records and analysed using mixed logistic regression models to estimate the effectiveness of the VCPS. Antimicrobial usage, falls, and medication errors were analysed at the facility level, while other data were analysed at the patient level. Results: Compared to control (n = 535), patients in the intervention period (n = 527) were more likely to have an admission medication reconciliation completed (Odds Ratio (OR) 11.16, 95% confidence interval (CI) 5.59–22.30, p < 0.001) in models adjusted for the study period. A similar improvement was observed for discharge medication reconciliation completion (OR 4.07, CI 2.38–6.95, p < 0.001), whereas a 33-fold improvement was seen in Best Possible Medication History completion (OR 33.27, CI 17.53–63.14, p < 0.001). The VCPS documented 879 medication related problems, with 61% of patients having at least one medication-related problem documented by a pharmacist. There was no change in length of stay, falls, readmission rates or reported medication error rates; however, the study was not powered to detect these changes. Patient feedback was positive and comparable to in-person care, with 95% (179/189) reporting their overall experience as 'good' or 'very good.' No unintended harms were reported. Conclusions: The VCPS improved compliance with national standards for medication safety, had high patient acceptability and resulted in the detection of clinically relevant medication-related issues in rural and remote settings. The applicability of virtual pharmacy should be explored in further rural and remote locations in addition to other settings such as metropolitan locations with no onsite clinical pharmacists. Ethics number: GWHREC 2019/ETH13355. Trial registration: ANZCTR registration number ACTRN12619001757101. Registered on 11/12/2019. Published trial protocol: A stepped wedge trial of efficacy and scalability of a virtual clinical pharmacy service (VCPS) in rural and remote NSW health facilities. [ABSTRACT FROM AUTHOR]

(1) Background: Worldwide, refugees may have some difficulties in accessing healthcare services. However, little is known about the factors that may predict the level of accessibility to the public healthcare system in the host countries. (2) Aim: To examine the level of accessibility of Syrian refugees to the public healthcare system in Jordan and further to identify the prediction of socioeconomic factors and barriers to healthcare access. (3) Methods: A cross-sectional study was conducted with a convenient sample of 356 Syrian refugees residing outside camps (Irbid, Ajloun, and Jarash). Data were collected using the Access to Healthcare Services Scale instrument (adopted from the Canadian Community Health Survey), which is composed of 2 sections: the general access scale (8 items) and the difficulties scale (20 items). One-way ANOVA test and independent t-test were used to examine epidemiological correlations among variables, whereas a hierarchical linear regression model was used to examine the predictability of socioeconomic factors and barriers to overall access to the public healthcare system by exploring the incremental impact of additional predictors. (4) Results: the mean age of the 356 participants was 35.22 years old, 56.5% were female, 67.4% were married, most of them 46.1% have secondary education, and non-employed 69.9%. Significant associations were observed among participants with different marital status (p < 0.001), educational level (mean 11.85 vs. 19.85, p < 0.001), working status (15.47 vs. 17.93, p < 0.001), family household number (16.42 vs. 17.0, p < 0.001), and health insurance (none: 15.50 vs. governmental 24.50, p < 0.001). Multivariate analysis revealed that the most important factors that may predict the overall access to healthcare services were: family monthly income (beta −0.19, p < 0.001), household family number (beta 0.17, <0.001), health insurance (beta −0.09, p = 0.047), and barriers (beta −0.43, <0.001), even after adjusting for potential confounding effects: sex, age, educational level, and place of residence. (5) Conclusions: Our findings indicate that socioeconomic factors and barriers may considerably predict overall access to public healthcare in Jordan. It is crucially important, therefore, for the Jordanian government and international organizations to create and develop strategic plans and programs that enhance refugees' access to health services, positively impacting their health and wellness. [ABSTRACT FROM AUTHOR]

Recent medicine shortages in Australia have significantly impacted pharmacists' professional practice. The inability to provide essential medicines to consumers in a timely manner has increased pharmacist workload whilst attempting to maintain quality patient care during and after the COVID‐19 pandemic. This study aimed to investigate the impact of medicine shortages on the operational responsibilities of community pharmacists, their ability to deliver health care, and the personal impact on community pharmacists. A nationwide anonymous survey was distributed to Australian community pharmacists via the Qualtrics survey platform between April – September 2023. Of the 142 pharmacists who responded to this survey, 89.5% (n = 127) reported having to purchase medicines from sources other than their regular wholesaler on at least a weekly basis in the last 3 months. The same number reported that they frequently needed to substitute medicines because of ongoing shortages. Most pharmacists (n = 128, 90.1%) reported that their workload had been affected by medicine shortages and that their motivation and engagement with work were frequently affected (n = 79, 55.7%). Pharmacists reported taking on additional administrative responsibilities to ensure access to treatment and health care. Current regulatory restrictions regarding the substitution of medicine dosage forms are often implemented only after community pharmacists are affected by medicine shortages. This survey highlights the need for improved awareness of medicine shortages and timely actions to be taken to ensure pharmacist wellbeing and patient access to health care in the face of medicine shortages. Ethics approval was granted by the University of South Australia Human Research Ethics Committee (reference no.: 205399) and the study conforms with the Australian National Statement on Ethical Conduct in Human Research. Informed consent was obtained from all participants. [ABSTRACT FROM AUTHOR]

In modern healthcare services, patient safety is a primary goal. With technological advancements, the complexity of healthcare services increases, which in turn creates increased pressure on health professionals during decision-making processes and can lead to errors worldwide. Communication gaps, human factors, patientoriginated issues, technical failures, and inadequate policies have been identified as the main causes of medical errors. While research shows that errors stem from human nature and are inevitable, it is emphasized that it is possible to develop methods that enhance patient safety. Utilizing digital technologies to improve the quality and efficiency of healthcare services is a crucial strategy. Innovations such as wearable technologies, mobile devices, digital media-delivered education and consulting services, telehealth applications, 3D printers, clinical decision support systems, and implantable biosensors encompass advancements in the digital health field. This research aims to analyze the complex and dynamic structure of healthcare services in the 21st century, especially considering the opportunities presented by the integration of artificial intelligence and genomic data, within the scope of the relevant literature. [ABSTRACT FROM AUTHOR]

Cloud computing and the Internet of Things (Cloud-IoT) in medical applications offer a promising avenue for enhancing healthcare data processing and analysis. Task Scheduling (TS) in Cloud-IoT is a vital challenge for healthcare services, impacting user fulfilment time. To combat this, several bio-inspired schemes were applied to address this issue, including the Hybrid Particle Swarm Optimization and Salp Swarm Algorithm (HPSOSSA). While HPSOSSA effectively reduces the waiting period, computation cost, makespan, and execution period of clinical demands on Cloud-IoT, it primarily focuses on minimizing CPU usage of VMs and maximizing medical resource utilization. However, optimizing other parameters such as throughput, memory utilization, and bandwidth is equally important. This article introduces a new hybrid TS algorithm to consider throughput, memory, and bandwidth requests for efficient TS. First, a Quasi-Recurrent Neural Network (Quasi-RNN) is used as a meta-learner to estimate Task Runtime Reliability (TRR), categorizing tasks into predictable and unpredictable tasks. Tasks with high Expected Runtime Accuracy (ERA) are scheduled utilizing a plan-based method with the Walrus Optimization Algorithm (WOA) while the residual ones are backfilled using the Deviation Backfilling (DB). To optimize resource utilization, a portion of CPU hubs is saved for backfilling and adjusted adaptively according to the Resource Use Ratio (RUR) of predictable tasks among newly submitted tasks. The proposed algorithm is called Hybrid Quasi-RNN with Walrus optimizer and DB (HQRWDB). The performance of this HQRWDB algorithm for TS in the Cloud-IoT system is evaluated using an HCSP-based dataset with scenario high heterogeneity of cloudlet with low heterogeneity of VMs. Simulation outcomes reveal that the HQRWDB achieves a 1943sec makespan, 0.9 average RUR, 0.09 Degree of Imbalance (DoI), 0.66 tasks/sec throughput, 37MB memory usage, and 224MB/sec bandwidth usage for 1000 cloudlets, compared to the HPSOSSA, Multi-Objective TS using an improved Ant Colony Optimization (MOTS-ACO), PSO with Phagocytosis-based Genetic Algorithm (PSO-PGA) and Multi-objective Grey Wolf Optimization (MGWO) algorithms for TS in Cloud-IoT. [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]

Abstract\nIMPLICATIONS FOR REHABILITATIONPurpose:Unaided (e.g., speech and gestures) and aided (e.g., symbol corpuses) communication modes facilitate older adults’ expression and comprehension. Adults aged 65 years and above constituted 18.27% of Taiwan’s total population in 2023; hence, prioritizing high-quality healthcare for older adults becomes critical. Commercial symbol corpuses, such as Picture Communication Symbols (PCS) and Voice Symbols (VS), play a vital role in aiding older adults with expression and comprehension in Taiwan. Previous studies on iconicity and preference of symbol corpuses have primarily been conducted in Western and South Asian cultural communities. However, these findings may not apply to all Asian communities. Hence, studies investigating these aspects in specific communities are needed. Through quantitative nonexperimental observations, we explored the iconicity of and preference for PCS and VS among 30 healthy older adults in Taiwan.Materials and Methods:A total of 12 practice words and test words each, familiar to the participants and socially and culturally validated, were selected for the developed VS–PCS iconicity and preference measurement. Verbal choices were made to select one line drawing in both measurements.Results & Conclusions:The findings revealed that VS is significantly more transparent and preferred than PCS. Accounting for the iconicity of and preferences for symbol corpuses is pivotal for symbol selection.Awareness about the learnability of the symbol corpuses being influenced by iconicity and preference, in addition to considering the needs and capabilities of older adults, within Taiwanese cultural communities is raised.Perceptions of iconicity cannot be generalized from one cultural community to another community, but transparency in symbol corpuses leads to higher preferences in similar cultural communities.Healthy older adults in Taiwan believed VS is more transparent and preferred.Awareness about the learnability of the symbol corpuses being influenced by iconicity and preference, in addition to considering the needs and capabilities of older adults, within Taiwanese cultural communities is raised.Perceptions of iconicity cannot be generalized from one cultural community to another community, but transparency in symbol corpuses leads to higher preferences in similar cultural communities.Healthy older adults in Taiwan believed VS is more transparent and preferred. [ABSTRACT FROM AUTHOR]

Object: Promoting the accessibility and equity of healthcare services, as well as enhancing service capacity, are crucial for building a sound healthcare system. Particularly in the past two years of the normalized COVID-19 situation, this issue has garnered widespread attention in the academic community. This study aims to investigate and analyze the characteristics and trends of the spatial-temporal evolution of healthcare service supply levels in China. It also seeks to explore the influencing factors and pathways for development, with the goal of optimizing the allocation of healthcare resources. Methods: This article uses the entropy weight TOPSIS method combined with Dagum Gini coefficient and Kernel density to evaluate the supply level of healthcare services in 31 provinces and cities in China from 2012 to 2020, and explores its development and spatial pattern characteristics. Then, through Moran index, panel regression model and spatial econometric testing, the spatial correlation problem and its influencing factors are further analyzed, and targeted policy recommendations are proposed based on it, laying the foundation for further promoting the balanced development of healthcare service supply capacity. Results: (1) Healthcare services supply levels in various provinces and cities in China have significantly increased, with a shift in spatial distribution from 'higher in the east and lower in the west' to 'convergence between east and west, with lower levels in the central regions.' (2) Relative differences among regions are narrowing annually, primarily due to interactions between the four regions rather than within each region, with expanding impact of overlapping regions. (3) Absolute differences among regions are also decreasing, moving towards uniformity with a contraction of extension and a restraint on the trend towards multipolarization. (4) Spatial correlation between adjacent regions is weakening, eventually becoming non-significant, with fading spatial effects. (5) The correlation between local economic development, population factors, institutional arrangements, and the current state of supply is significant, and the research design and conclusions remain robust even after thorough consideration of spatial effects. The study explores the development pathways based on the objective existence of regional development and the controllable government actions. Conclusion: The overall level of healthcare service supply in China has improved, but regional differences still exist. The objective level of regional development and the subjective behavior of local governments have a significant impact on the supply of healthcare services. Therefore, it is recommended that each region adapt to local conditions, identify its own strengths and weaknesses, coordinate resource supply and demand, consider the impact of key factors, and optimize the allocation of healthcare development resources. [ABSTRACT FROM AUTHOR]

Background: Implementing an electronic system of service categorization and a referral system in healthcare is a strategic approach to improving overall health outcomes and optimizing resource use. This study aimed to investigate challenges experienced with the electronic patient referral system in Mashhad University of Medical Sciences (MUMS). Methods: In this qualitative research, data were collected using semi-structured interviews. Participants included physicians, experts, and stakeholders working in the Family Physician Program and the referral system, selected through purposive sampling. The data were analyzed using a thematic analysis framework, in which a thematic framework was developed, and key themes were identified. Data analysis was performed using Atlas.ti8 software. Results: According to the interviewees, the challenges of digitizing the referral system can be categorized into three main themes: structure, process, and outcomes. These themes include ten sub-themes, such as challenges related to Internet Infrastructure and the Sina System, Patients' Choice of Desired Specialists, Receiving Payment for Services, Appointment Scheduling, Interdepartmental Coordination, Recording Definitive Diagnosis Codes Before Referral, False Referrals, Dissatisfaction, Feedbacks, and Health Indicators. Conclusion: To improve the e-referral in Iran's health system, several strategies can be implemented. These include sustainable resource allocation, designing consequence mechanisms within the referral system to motivate collaboration and improving appointment scheduling systems. Furthermore, addressing these challenges requires a collaborative approach involving healthcare providers, IT professionals, and patient representatives to ensure that the system is efficient, user-friendly, and effectively meets the needs of all parties involved. Not paying enough attention to these issues cause reform failure while solving them requires multi-dimensional, systematic and coordinated interventions with a deep understanding of the obstacles and challenges. Disregarding these factors may result in apathy over time, ultimately impacting both the quantity and, more importantly, the quality of services. [ABSTRACT FROM AUTHOR]

Purpose: To describe temporal trends in inpatient care use for adult mental disorders in Czechia from 1994 until 2015. Methods: Data from the nationwide register of inpatient care use and yearly census data were used to calculate (a) yearly admissions rates, (b) median length of stay, and (c) standardized inpatient-years for adult mental disorders (ICD-10 codes F0-F6] or G30). Segmented regressions were used to analyze age- and sex-specific temporal trends. Results: Admission rates were increasing in adults (average annual percent change = 0.51; 95% confidence interval = 0.16 to 0.86 for females and 1.01; 0.63 to 1.40 for males) and adolescents and emerging adults (3.27; 2.57 to 3.97 for females and 2.98; 2.08 to 3.88 for males), whereas in seniors, the trend was stable (1.22; -0.31 to 2.73 for females and 1.35; -0.30 to 2.98 for males). The median length of stay for studied mental disorders decreased across all age and sex strata except for a stable trend in male adolescents and emerging adults (-0.96; -2.02 to 0.10). Standardized inpatient-years were decreasing in adults of both sexes (-0.85; -1.42 to -0.28 for females and -0.87; -1.19 to -0.56 for males), increasing in female adolescents and emerging adults (0.95; 0.42 to 1.47), and stable in the remaining strata. Conclusion: Psychiatric hospital admissions were increasing or stable coupled with considerable reductions in median length of stay, suggesting that inpatient episodes for adult mental disorders have become more frequent and shorter over time. The overall psychiatric inpatient care use was decreasing or stable in adults and seniors, potentially implying a gradual shift away from hospital-based care. [ABSTRACT FROM AUTHOR]

Abstract Background Coronary artery angiography (CAG) and percutaneous coronary intervention (PCI) are superior to non-invasive approaches in reducing mortality in patients with ST-segment elevation myocardial infarction (STEMI). However, their efficacy remains uncertain in non-ST-elevation acute coronary syndromes (NSTE-ACS) and limited in low-resource settings. This study aimed to compare in-hospital and 5-year mortality rates between patients with a first event of STEMI and NSTE-ACS who underwent CAG and PCI and those with similar severity who did not undergo CAG and PCI. Methods A propensity-matched retrospective cohort study was conducted using population-based claims data of national universal coverage of Thailand for identification of patients with acute coronary syndromes. The mortality of recruited patients was additionally linked to the national database of vital registration. Patients aged ≥ 40 years who were hospitalized for STEMI and NSTE-ACS in 2017, with a focus on access to CAG and PCI were included. For each condition either STEMI or NSTE-ACS, patients who underwent CAG and PCI were matched to those who did not undergo using propensity score matching (PSM) to balance measured confounders, such as age, sex, and underlying conditions. In-hospital mortality rate ratio and 5-year mortality were analyzed as measures. Results Through PSM, 2,702 non-intervention STEMI patients were paired with an equal number of intervention patients, and similarly, 5,072 non-intervention NSTE-ACS patients were matched with an equivalent group who received interventions. For patients with STEMI, the in-hospital mortality rate ratio (95% confidence interval (CI)) for those who underwent CAG and PCI compared to those who did not was 30.1% (30.0%, 30.2%). Similar trends were observed in patients with NSTE-ACS with a mortality rate of 34.7% (34.6%, 34.8%). For the five-year mortality comparison, the hazard ratios (95% CI) of mortality after discharge were 0.55 (0.50, 0.62) for STEMI and 0.57 (0.54, 0.61) for NSTE-ACS cases. Conclusions Access to CAG and PCI was significantly associated with lower in-hospital and 5-year mortality rates in patients who experienced their first event of ACS, despite the limited availability of some unmeasured or residual confounders. Healthcare systems should expand their resources for CAG and PCI in Thailand and other countries to equitably enhance longevity.

Abstract Background There are several strategies used to assess involvement in their healthcare across service providers. However, there is no consensus on the most appropriate measurement tool to use when evaluating patient involvement initiatives. This qualitative study aimed to explore the perspectives of stakeholders from micro, meso, and macro levels within the Danish healthcare system on measuring patient involvement in their healthcare. Methods This descriptive, explorative study employed semi-structured interviews with open-ended questions to elicit participants’ views and experiences of patient involvement and measurement tools. A purposeful sample of participants was identified, to include decision makers, researchers, and health professionals (n = 20) with experiences of measuring patient involvement in healthcare at micro, meso, and macro levels across Danish organizations. Data underwent reflexive thematic analysis. Results Three main themes were identified: 1) Determining the purpose of patient involvement practices and measurement alignment; 2) Reflecting on the qualities, fit, and usefulness of measures; 3) Recognizing conflicting stakeholder paradigms. Despite the interest in and positive attitudes toward patient involvement innovations, views on the meaning and value of evaluating involvement varied; in part, this was attributable to challenges in selecting criteria, methods, and measures for evaluation. Conclusion The findings indicate the need to integrate the perspectives of all key stakeholders in designing the evaluation of patient involvement initiatives. The application of a multiple stakeholder approach and co-production of a multidimensional evaluation may provide some common ground for selecting evaluation criteria and measurement tools in the healthcare setting. Trial registration Danish Data Protection Agency (1–16-02–400-21) 15 October 2021.

Abstract Background Despite medication being the most common healthcare intervention and medication-related incidents being common in hospitals, many rural and remote hospitals in Australia lack onsite pharmacy services due to resource constraints. A Virtual Clinical Pharmacy Service (VCPS) staffed by two senior, rural generalist hospital pharmacists assigned to four hospitals each was implemented in rural and remote facilities to determine whether the VCPS increased adherence to National Safety and Quality Health Service Standards (NSQHS). Methods A stepped-wedge randomised controlled trial was employed to sequentially implement a telehealth pharmacy service at one-month intervals in eight hospitals. The primary outcomes were patient-level medication reconciliation completion rates on admission and discharge. Secondary measures evaluated compliance with other NSQHS standards (including Best Possible Medication History, Medication Reconciliation and venous thromboembolism risk assessment), patient outcomes (including representation within 48 h, readmission within 28 days and length of stay), and detection of potential medication-related harms (including pharmacist identified medication related problems, reported medication errors and falls). Patients were invited to complete a patient-reported experience questionnaire. Data were collected from electronic medical records and analysed using mixed logistic regression models to estimate the effectiveness of the VCPS. Antimicrobial usage, falls, and medication errors were analysed at the facility level, while other data were analysed at the patient level. Results Compared to control (n = 535), patients in the intervention period (n = 527) were more likely to have an admission medication reconciliation completed (Odds Ratio (OR) 11.16, 95% confidence interval (CI) 5.59–22.30, p

Abstract Background This study aimed to examine the interactive effect of applying JCI accreditation standards and administrative control in improving the quality of health services in Yemeni hospitals. By examining the synergistic relationship between these two components, this study sought to shed light on how hospitals can improve their performance and achieve sustainable advancements in healthcare quality. Methods This study utilized a quantitative research design and collected data from Yemeni hospitals. The sample size was determined via the Krejcie and Morgan table, which provides a recommended sample size on the basis of the population. A total of 310 healthcare professionals were selected through a random sampling technique. Hypotheses were formulated to examine the impact of JCI accreditation standards and administrative control on healthcare quality. Statistical analyses were also conducted to test these hypotheses and determine the interaction effect between the two variables. Results The results confirmed that applying JCI accreditation standards has a statistically significant positive effect on improving the quality of health services in hospitals. Additionally, the practice of administrative control had a statistically significant effect on healthcare quality. Furthermore, there was an interactive effect between the application of JCI accreditation standards and administrative control, indicating that their combined implementation led to even greater improvements in healthcare quality. Conclusion The significance of this study lies in its potential to inform healthcare policymakers, administrators, and practitioners about the importance of integrating accreditation standards with robust administrative control measures. The findings emphasize the need for hospitals to prioritize both the implementation of accreditation standards and the establishment of effective administrative control systems to ensure the delivery of high-quality healthcare services. This study contributes to the literature by highlighting the interactive impact of these factors and providing insights into their synergistic relationship.

Abstract Object Promoting the accessibility and equity of healthcare services, as well as enhancing service capacity, are crucial for building a sound healthcare system. Particularly in the past two years of the normalized COVID-19 situation, this issue has garnered widespread attention in the academic community. This study aims to investigate and analyze the characteristics and trends of the spatial-temporal evolution of healthcare service supply levels in China. It also seeks to explore the influencing factors and pathways for development, with the goal of optimizing the allocation of healthcare resources. Methods This article uses the entropy weight TOPSIS method combined with Dagum Gini coefficient and Kernel density to evaluate the supply level of healthcare services in 31 provinces and cities in China from 2012 to 2020, and explores its development and spatial pattern characteristics. Then, through Moran index, panel regression model and spatial econometric testing, the spatial correlation problem and its influencing factors are further analyzed, and targeted policy recommendations are proposed based on it, laying the foundation for further promoting the balanced development of healthcare service supply capacity. Results (1) Healthcare services supply levels in various provinces and cities in China have significantly increased, with a shift in spatial distribution from ‘higher in the east and lower in the west’ to ‘convergence between east and west, with lower levels in the central regions.’ (2) Relative differences among regions are narrowing annually, primarily due to interactions between the four regions rather than within each region, with expanding impact of overlapping regions. (3) Absolute differences among regions are also decreasing, moving towards uniformity with a contraction of extension and a restraint on the trend towards multipolarization. (4) Spatial correlation between adjacent regions is weakening, eventually becoming non-significant, with fading spatial effects. (5) The correlation between local economic development, population factors, institutional arrangements, and the current state of supply is significant, and the research design and conclusions remain robust even after thorough consideration of spatial effects. The study explores the development pathways based on the objective existence of regional development and the controllable government actions. Conclusion The overall level of healthcare service supply in China has improved, but regional differences still exist. The objective level of regional development and the subjective behavior of local governments have a significant impact on the supply of healthcare services. Therefore, it is recommended that each region adapt to local conditions, identify its own strengths and weaknesses, coordinate resource supply and demand, consider the impact of key factors, and optimize the allocation of healthcare development resources.

Abstract Background Implementing an electronic system of service categorization and a referral system in healthcare is a strategic approach to improving overall health outcomes and optimizing resource use. This study aimed to investigate challenges experienced with the electronic patient referral system in Mashhad University of Medical Sciences (MUMS). Methods In this qualitative research, data were collected using semi-structured interviews. Participants included physicians, experts, and stakeholders working in the Family Physician Program and the referral system, selected through purposive sampling. The data were analyzed using a thematic analysis framework, in which a thematic framework was developed, and key themes were identified. Data analysis was performed using Atlas.ti8 software. Results According to the interviewees, the challenges of digitizing the referral system can be categorized into three main themes: structure, process, and outcomes. These themes include ten sub-themes, such as challenges related to Internet Infrastructure and the Sina System, Patients’ Choice of Desired Specialists, Receiving Payment for Services, Appointment Scheduling, Interdepartmental Coordination, Recording Definitive Diagnosis Codes Before Referral, False Referrals, Dissatisfaction, Feedbacks, and Health Indicators. Conclusion To improve the e-referral in Iran’s health system, several strategies can be implemented. These include sustainable resource allocation, designing consequence mechanisms within the referral system to motivate collaboration and improving appointment scheduling systems. Furthermore, addressing these challenges requires a collaborative approach involving healthcare providers, IT professionals, and patient representatives to ensure that the system is efficient, user-friendly, and effectively meets the needs of all parties involved. Not paying enough attention to these issues cause reform failure while solving them requires multi-dimensional, systematic and coordinated interventions with a deep understanding of the obstacles and challenges. Disregarding these factors may result in apathy over time, ultimately impacting both the quantity and, more importantly, the quality of services.

Background: Pneumonia among toddlers is still considered a serious health problem in Indonesia. It can be seen from the high-level coverage of pneumonia cases spread among toddlers. The continued sustainability of life being the key to healthcare development, access to healthcare services for this early-age group is very important. Purpose: This research aims to find out the coverage correlation between healthcare services on the occurrence of pneumonia among toddlers in the city of Surabaya. Methods: The researchers utilize an ecological study design for all districts in the city of Surabaya within the year 2019,2020, and 2021 with the district as the unit of the analysis. The data was analyzed by using Pearson’s and Spearman’s correlation. QGIS application is also used to map and visualize the extent of pneumonia issues and toddler healthcare coverage. Results: The results of the Pearson and Spearman correlation analysis show that toddler healthcare coverage did not correlate with the occurrence of toddler pneumonia in the city of Surabaya. However, several districts in Surabaya City exhibit disparities between toddler healthcare coverage and toddler pneumonia occurrence rates. Conclusion: In the years 2019-2021, the cases of toddler pneumonia fluctuated, whereas in 2020 the number of cases decreased compared to 2019 and then increased again in 2021. The same trend also occurred in toddler healthcare services coverage.

Abstract Background Hypertension remains a major global health challenge, including in low- and middle-income countries. In Rwanda, a lack of adequate information and healthcare services impacts healthcare-seeking behaviors, contributing to undiagnosed hypertension in rural areas. Therefore, the need to determine its prevalence and associated factors. Methods A cross-sectional study was conducted with 393 adults in the Ndera Sector, of Rwanda’s Gasabo District, through a multistage sampling technique. Data was gathered using the WHO STEP-wise approach to non-communicable disease risk factor surveillance (STEPS) questionnaire; physical examination was done to determine blood pressure and body-mass index (BMI), after which the data collected was analyzed using SPSS. Newly diagnosed hypertension was determined when on two different intervals, systolic blood pressure readings was > 140 mmHg, and/or the diastolic blood pressure readings was > 90 mmHg, in the absence of previous hypertension diagnosis. Results The overall prevalence of hypertension among patients at Ndera sector was 15%, all of which were newly diagnosed. The mean (SD) age of the participants was 37 (13.7) years and half (53%) were women. The mean systolic blood pressure for men was 124.3 mmHg compared to 120.9 mmHg for women (p = 0.043, 95%CI: 0.12–6.74). Women had a significantly higher mean BMI (26.0) compared to men (22.8) (p

Abstract Background Peer support has been extensively studied in specific areas of community-based primary care such as mental health, substance use, HIV, homelessness, and Indigenous health. These programs are often built on the assumption that peers must share similar social identities or lived experiences of disease to be effective. However, it remains unclear how peers can be integrated in general primary care setting that serves people with a diversity of health conditions and social backgrounds. Methods A participatory qualitative study was conducted between 2020 and 2022 to explore the feasibility, acceptability, and perceived effects of the integration of a peer support worker in a primary care setting in Montreal, Canada. A thematic analysis was performed based on semi-structured interviews (n = 18) with patients, relatives, clinicians, and a peer support worker. Findings Findings show that peers connect with patients through sharing their own hardships and how they overcame them, rather than sharing similar health or social conditions. Peers provide social support and coaching beyond the care trajectory and link identified needs with available resources in the community, bridging the gap between health and social care. Primary care clinicians benefit from peer support work, as it helps overcome therapeutic impasses and facilitates communication of patient needs. However, integrating a peer into a primary care team can be challenging due to clinicians’ understanding of the nature and limits of peer support work, financial compensation, and the absence of a formal status within healthcare system. Conclusion Our results show that to establish a relationship of trust, a peer does not need to share similar health or social conditions. Instead, they leverage their experiential knowledge, strengths, and abilities to create meaningful relationships and reliable connections that bridge the gap between health and social care. This, in turn, instills patients with hope for a better life, empowers them to take an active role in their own care, and helps them achieve life goals beyond healthcare. Finally, integrating peers in primary care contributes in overcoming obstacles to prevention and care, reduce distrust of institutions, prioritize needs, and help patients navigate the complexities of healthcare services.

Abstract Background People with acquired brain injury (ABI) may experience concurrent conditions such as, mental health and substance use concerns, that require specialized care. There are services that aim to support people with ABI and these conditions separately; however, little is known about the facilitators and barriers of these services. Therefore, the purpose of this study was to engage stakeholders to investigate the facilitators and barriers of healthcare services for ABI and concurrent issues. Methods Semi-structured focus groups were conducted in-person and virtually with people with ABI, caregivers, healthcare professionals, and policy makers during a one-day event in British Columbia, Canada. Manifest content analysis was used with a constructivist perspective to analyze data. Results 90 participants (including 34 people with ABI) provided insights during 15 simultaneous focus groups. Three categories were identified: (1) complexity of ABI, (2) supports, (3) structure of care. Complexity of ABI outlined the ongoing basic needs after ABI and highlighted the need for public awareness of ABI. Supports outlined healthcare professional and community-based supports. Structure of care described people with ABI needing to meet criteria for support, experiences of navigating through the system and necessity of integrated services. Conclusions These findings highlight the facilitators and barriers of healthcare services for ABI and concurrent conditions and provide insights into the changes that may be needed. Doing so can improve the accessibility and quality of ABI healthcare services.

The purpose of the qualitative research study was to identify factors and challenges that led to insecure housing among rural residents in Manitoba, Canada. Using a case study approach, five participants and two key informants were interviewed. When the participants were asked about personal factors and challenges affecting housing insecurity in rural Manitoba, their responses were focused on past and current health issues. Health, including acute and chronic conditions, became the critical intersection of housing insecurity and rurality. Systemic barriers such as invisibility, stigma, and lack of access to healthcare services in the rural setting created additional challenges for participants who required assistance and support to obtain and maintain stable housing. Integration of and collaboration among health, housing, and social service providers and informal supports in the rural community are required to address housing insecurity. Rural communities tend to be unique, therefore, strategies and interventions to diminish or prevent houselessness need to be flexible, targeted, and community-specific.

Background: Hypertension remains a major global health challenge, including in low- and middle-income countries. In Rwanda, a lack of adequate information and healthcare services impacts healthcare-seeking behaviors, contributing to undiagnosed hypertension in rural areas. Therefore, the need to determine its prevalence and associated factors. Methods: A cross-sectional study was conducted with 393 adults in the Ndera Sector, of Rwanda's Gasabo District, through a multistage sampling technique. Data was gathered using the WHO STEP-wise approach to non-communicable disease risk factor surveillance (STEPS) questionnaire; physical examination was done to determine blood pressure and body-mass index (BMI), after which the data collected was analyzed using SPSS. Newly diagnosed hypertension was determined when on two different intervals, systolic blood pressure readings was > 140 mmHg, and/or the diastolic blood pressure readings was > 90 mmHg, in the absence of previous hypertension diagnosis. Results: The overall prevalence of hypertension among patients at Ndera sector was 15%, all of which were newly diagnosed. The mean (SD) age of the participants was 37 (13.7) years and half (53%) were women. The mean systolic blood pressure for men was 124.3 mmHg compared to 120.9 mmHg for women (p = 0.043, 95%CI: 0.12–6.74). Women had a significantly higher mean BMI (26.0) compared to men (22.8) (p < 0.001, 95%CI: -4.18 - -2.31). Age (χ² = 37.400, p < 0.001), residence (χ² = 10.200, p < 0.001), BMI (χ² = 22.1, p < 0.001), and lack of knowledge about hypertension (χ² = 25.1, p < 0.001) were the factors with significantly undiagnosed hypertension. Conclusions: The high prevalence of undiagnosed hypertension in Ndera Sector is linked to gender, older age, higher BMI, location, and lack of hypertension knowledge. These findings call for multifaceted approaches, combining educational initiatives, geographical targeting, lifestyle modifications, and policy implementations, all aimed at mitigating the burden of undiagnosed hypertension and enhancing community health within the Ndera Sector. [ABSTRACT FROM AUTHOR]

Over the past years, emerging technologies have always been crucial for organizations from various industries. Several organizations have implemented new technologies to serve customers' needs better and be more competitive in the market. Healthcare services are also one of the industries that need to stay up to date with recent technologies. Therefore, they can apply these technologies to their information systems projects. This paper aims to discuss a case of symptom checker development project carried out in a hospital in Thailand. Project management knowledge areas applied in the project are also identified from the activities performed in the project. Moreover, the main problems that occurred during the project were addressed along with the recommendations for solving the problems. The findings suggest that organizations apply only some project management knowledge areas from the framework. Those are project scope management, project procurement management, project integration management, project schedule management, project quality management, and project communication management. [ABSTRACT FROM AUTHOR]

Background: Pneumonia among toddlers is still considered a serious health problem in Indonesia. It can be seen from the high-level coverage of pneumonia cases spread among toddlers. The continued sustainability of life being the key to healthcare development, access to healthcare services for this early-age group is very important. Purpose: This research aims to find out the coverage correlation between healthcare services on the occurrence of pneumonia among toddlers in the city of Surabaya. Methods: The researchers utilize an ecological study design for all districts in the city of Surabaya within the year 2019,2020, and 2021 with the district as the unit of the analysis. The data was analyzed by using Pearson's and Spearman's correlation. QGIS application is also used to map and visualize the extent of pneumonia issues and toddler healthcare coverage. Results: The results of the Pearson and Spearman correlation analysis show that toddler healthcare coverage did not correlate with the occurrence of toddler pneumonia in the city of Surabaya. However, several districts in Surabaya City exhibit disparities between toddler healthcare coverage and toddler pneumonia occurrence rates. Conclusion: In the years 2019-2021, the cases of toddler pneumonia fluctuated, whereas in 2020 the number of cases decreased compared to 2019 and then increased again in 2021. The same trend also occurred in toddler healthcare services coverage. [ABSTRACT FROM AUTHOR]

Rationale: Despite cardiac rehabilitation and medical treatment being integrated parts of the pathway of patients with cardiovascular disease, as well as the well‐establish positive effect, cardiac rehabilitation remains underutilised. In recent years, cardiac rehabilitation has increasingly been moved from the hospitals to the community healthcare services. This transition may be challenging for patients with cardiovascular disease. Aim: To investigate reflections and perspectives of patients opting out of cardiac rehabilitation in community healthcare services to improve participation and adherence to cardiac rehabilitation in the future. Results: A total of eight patients opting out of cardiac rehabilitation participated in individual interviews. Opting out of cardiac rehabilitation is defined as never enroled or did not complete cardiac rehabilitation. The Interpretive Description methodology was used in the analysis where two themes and six subthemes were identified: (1) 'Structural and organisational factors' with three subthemes; Being a patient in the healthcare system, Enroling into CR when it is meaningful, and Getting back to work is vital, and (2) 'Patients' internal factors' with three subthemes; Feeling a desire to regain control, Seeing yourself as recovered, and Being aware of own needs. The analysis indicates that patients' decision to opt out of CR was multidimensional and based on a combination of factors. Conclusion: Ensuring that the healthcare professionals in the community have sufficient information regarding the patient and a clear communication plan between the healthcare professionals and the patient may reduce the transition causing confusion and frustrations for patients. Incorporating a vocational element in CR and ensuring that employers understand the importance of CR may hamper returning to work as a challenge to CR. Ensuring timely CR referral and enrolment and a transition coordinator may reduce the challenge of patients not viewing CR as meaningful. However, further studies are needed to fully understand how CR could become meaningful for patients opting out of CR. [ABSTRACT FROM AUTHOR]

Background: Privacy in healthcare is a fundamental right essential to maintain patient confidentiality and trust. Community pharmacies in Saudi Arabia (SA) play a critical role in the healthcare system by providing accessible services and serving as initial points of contact for medical advice. However, the open nature of these settings poses significant challenges in maintaining patient privacy. Methods: This cross-sectional study used electronic surveys distributed across various online platforms. The target sample included Saudi adults, with a sample size of 385 participants to achieve 80% statistical power at a 95% confidence interval. The survey comprised demographic questions and sections evaluating perceptions of privacy, the importance of privacy, and personal experiences regarding privacy in community pharmacies. Descriptive statistics and logistic regression models were used for the analysis. Results: A total of 511 responses were obtained. The mean age was 33.5 years, with an almost equal distribution of males (49.71%) and females (50.29%). Most participants held a bachelor's degree or higher (78.67%). Privacy perceptions varied, with only 9.0% strongly agreeing that there was a private space for consultations, while 64.0% felt that the design of community pharmacies did not adequately consider patient privacy, and 86.9% reported that conversations could be overheard. Privacy concerns were notable, with almost one-half of the participants (47.6%) having concerns about privacy and 56.6% doubting the confidentiality of their health information. Moreover, 17.6% reported being asked for unnecessary personal information when buying medication, and 56.2% admitted to avoiding discussing a health problem with the pharmacist due to privacy concerns. Experiences of privacy breaches were reported by 15.7% of respondents. Logistic regression analysis revealed that the availability of private space in the pharmacy and patients feeling that the pharmacy respects their privacy were associated with a lower likelihood of avoiding discussions with pharmacists due to privacy concerns (OR = 0.758, CI = 0.599–0.0957 and OR = 0.715, CI = 0.542–0.945 respectively) Conversely, greater privacy concerns and previous privacy breaches significantly increased the likelihood of avoiding discussions with pharmacists in the community pharmacy (OR = 1.657, CI = 1.317–2.102 and OR = 4.127, CI = 1.886–9.821 respectively). Conclusions: This study highlights the significant concerns regarding privacy practices in community pharmacies in SA. Thus, there is a need for standards to improve privacy in community pharmacies, such as mandating the need for private consultation areas and enhanced staff training on handling privacy-related issues. Addressing the issue of privacy is crucial for maintaining patient trust, improving healthcare service quality, and ensuring effective patient–pharmacist interactions. [ABSTRACT FROM AUTHOR]

Artificial Intelligence (AI) has shown remarkable potential to revolutionise healthcare by enhancing diagnostics, improving treatment outcomes, and streamlining administrative processes. In the global regulatory landscape, several countries are working on regulating AI in healthcare. There are five key regulatory issues that need to be addressed: (i) data security and protection—measures to cover the "digital health footprints" left unknowingly by patients when they access AI in health services; (ii) data quality—availability of safe and secure data and more open database sources for AI, algorithms, and datasets to ensure equity and prevent demographic bias; (iii) validation of algorithms—mapping of the explainability and causability of the AI system; (iv) accountability—whether this lies with the healthcare professional, healthcare organisation, or the personified AI algorithm; (v) ethics and equitable access—whether fundamental rights of people are met in an ethical manner. Policymakers may need to consider the entire life cycle of AI in healthcare services and the databases that were used for the training of the AI system, along with requirements for their risk assessments to be publicly accessible for effective regulatory oversight. AI services that enhance their functionality over time need to undergo repeated algorithmic impact assessment and must also demonstrate real-time performance. Harmonising regulatory frameworks at the international level would help to resolve cross-border issues of AI in healthcare services. [ABSTRACT FROM AUTHOR]

(1) Background: During and after the pandemic, individuals with type 1 and type 2 diabetes struggled to maintain a healthy lifestyle due to psychological distress and the struggle to accommodate contextual challenges and changes in their family and work obligations and expectations. This study aims to explore the long-term impacts of the pandemic on proactive self-management behaviors and outcomes that consider contextual and environmental factors, such as family and work dynamics. (2) Methods: In this mixed-method study, data were collected from 418 participants using the Hospital Anxiety and Depression Scale (HADS) and the Insomnia Severity Index (ISI), followed by 16 individual interviews. (3) Results: The prevalence of depression was 37.1%, that of anxiety was 59.1%, and that of insomnia was 66.3%. Significant differences were observed in anxiety by age (p = 0.02), while individuals with other comorbidities were more likely to report insomnia (p = 0.3). Overall, various challenges during the pandemic have exacerbated emotional distress and complicated self-care routines and adherence to healthy lifestyles. (5) Conclusions: The COVID-19 pandemic has prompted individuals with type 1 and 2 diabetes to adopt alternative health-management methods, such as self-care, proactive initiatives, and daily challenges. Enhancing proactiveness, awareness, and an understanding of individuals' needs is crucial for alleviating stress, controlling disease, and preparing for potential future health crises in the wake of the pandemic's long-term effects. [ABSTRACT FROM AUTHOR]

Aims/Background The prevalence of pressure injuries (PIs) is a widely used clinical indicator of patient safety and quality of care. Nurses' understanding of pressure injury (PI) can significantly impact the treatment outcomes for patients. This study, based on latent profile analysis (LPA), reveals the characteristics associated with PI knowledge levels among clinical nurses in district and county tertiary medical institutions. We aim to help nursing managers formulate training plans accurately so that clinical nurses can provide high-level skin care services for patients. Method In June 2023, 1482 nurse staff from 4 tertiary general hospitals at the district and county level in Chengdu were chosen as research subjects using the convenience sampling method. Responses to the general information questionnaire, the Chinese Version of Pressure Ulcer Knowledge Assessment Tool (C-PUKAT), and the Chinese Version of Attitude towards Pressure ulcer Prevention (C-APuP) were used to compare the population's characteristics based on LPA. Results Three latent profiles of nurses' PI knowledge were identified: weak foundation type (46.3%), strengthening foundation type (42.7%), and special improvement type (11.0%). Subjects' departments, administrative positions, highest degrees and PI prevention attitude scores, as well as whether they have participated in the training, all differed significantly between latent profile groups (p < 0.05). Conclusion The PI knowledge level of nursing staff at the district and county tertiary general hospitals requires urgent improvement. Nursing managers should prioritize the management level and quality of PI training among clinical nursing staff. Precise training programs can be developed based on different categories of nursing staff to enhance their PI knowledge, thereby effectively improving the quality of healthcare for inpatients. [ABSTRACT FROM AUTHOR]

Background: Peer support has been extensively studied in specific areas of community-based primary care such as mental health, substance use, HIV, homelessness, and Indigenous health. These programs are often built on the assumption that peers must share similar social identities or lived experiences of disease to be effective. However, it remains unclear how peers can be integrated in general primary care setting that serves people with a diversity of health conditions and social backgrounds. Methods: A participatory qualitative study was conducted between 2020 and 2022 to explore the feasibility, acceptability, and perceived effects of the integration of a peer support worker in a primary care setting in Montreal, Canada. A thematic analysis was performed based on semi-structured interviews (n = 18) with patients, relatives, clinicians, and a peer support worker. Findings: Findings show that peers connect with patients through sharing their own hardships and how they overcame them, rather than sharing similar health or social conditions. Peers provide social support and coaching beyond the care trajectory and link identified needs with available resources in the community, bridging the gap between health and social care. Primary care clinicians benefit from peer support work, as it helps overcome therapeutic impasses and facilitates communication of patient needs. However, integrating a peer into a primary care team can be challenging due to clinicians' understanding of the nature and limits of peer support work, financial compensation, and the absence of a formal status within healthcare system. Conclusion: Our results show that to establish a relationship of trust, a peer does not need to share similar health or social conditions. Instead, they leverage their experiential knowledge, strengths, and abilities to create meaningful relationships and reliable connections that bridge the gap between health and social care. This, in turn, instills patients with hope for a better life, empowers them to take an active role in their own care, and helps them achieve life goals beyond healthcare. Finally, integrating peers in primary care contributes in overcoming obstacles to prevention and care, reduce distrust of institutions, prioritize needs, and help patients navigate the complexities of healthcare services. [ABSTRACT FROM AUTHOR]

There are few primary studies that focused on the older immigrants' food habits and meal preferences after immigration and settlement in a new country. A comprehensive database search for literature was conducted in May 2021 and upgraded in September 2021. Ten databases (Medline (Ovid), EMBASE (Ovid), PsycInfo (Ovid), Cinahl (EBSCOhost), Food Science Source (EBSCOhost), SocIndex (EBSCOhost), Social Care Online, Applied Social Sciences Index & Abstracts (ASSIA), Web of Science and Google Scholar), were scanned for original, peer-reviewed papers published in English. The review was conducted and reported in accordance with the PRISMA 2020 guidelines and SWiM items. Out of 3069 records, 10 papers were included for thematic synthesis. A data synthesis across all studies resulted in three main findings: (i) the significance of food in maintaining cultural identity, (ii) the continuity of traditional food culture and (iii) adapting to the host country's food culture. Although different forms of dietary acculturation occur throughout life, older immigrants often want to maintain their traditional food habits and meal preferences. For them, traditional eating habits offer comfort and security by serving as a means of identifying who they are and reminding them where they have come from. Public health and social services play an important role in providing cultural nutritional care to older immigrants; therefore, this issue should be carefully addressed by professionals and future research. Registration: The review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) on 27 September 2022 with registration number CRD42022358235. [ABSTRACT FROM AUTHOR]

The equality of healthcare services has been a focus among researchers and policymakers. The maximal accessibility equality (MAE) model is a widely used location-allocation model for the optimization of the accessibility equality of facilities. However, it might produce biased results due to the overlooking of multiple transport mode options for urban residents. This study develops a maximal multimodal accessibility equality (MMAE) model by incorporating the multimodal two-step floating catchment area (2SFCA) accessibility model. It reflects the multimodal context in cities and aims to maximize the equality of multimodal accessibility. A case study of healthcare facilities in Shenzhen demonstrates that the proposed MMAE model can significantly improve the equality of multimodal accessibility. However, the traditional single-modal MAE model generates unequal multimodal accessibility, which might yield biased planning recommendations in multimodal contexts. The findings highlight the superiority of the MMAE model against the traditional single-modal MAE model in terms of pursuing equal accessibility for all residents. The MMAE model can serve as a scientific tool to support the rational planning of healthcare facilities or other types of public facilities in multimodal contexts. [ABSTRACT FROM AUTHOR]

Background: People with acquired brain injury (ABI) may experience concurrent conditions such as, mental health and substance use concerns, that require specialized care. There are services that aim to support people with ABI and these conditions separately; however, little is known about the facilitators and barriers of these services. Therefore, the purpose of this study was to engage stakeholders to investigate the facilitators and barriers of healthcare services for ABI and concurrent issues. Methods: Semi-structured focus groups were conducted in-person and virtually with people with ABI, caregivers, healthcare professionals, and policy makers during a one-day event in British Columbia, Canada. Manifest content analysis was used with a constructivist perspective to analyze data. Results: 90 participants (including 34 people with ABI) provided insights during 15 simultaneous focus groups. Three categories were identified: (1) complexity of ABI, (2) supports, (3) structure of care. Complexity of ABI outlined the ongoing basic needs after ABI and highlighted the need for public awareness of ABI. Supports outlined healthcare professional and community-based supports. Structure of care described people with ABI needing to meet criteria for support, experiences of navigating through the system and necessity of integrated services. Conclusions: These findings highlight the facilitators and barriers of healthcare services for ABI and concurrent conditions and provide insights into the changes that may be needed. Doing so can improve the accessibility and quality of ABI healthcare services. [ABSTRACT FROM AUTHOR]

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre 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 Saudi Medical Journal is the property of Saudi Medical 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.)

Disparities in accessing advanced stroke treatment have been recognized as a policy challenge in multiple countries, including Japan, necessitating priority solutions. Nevertheless, more practical healthcare policies must be implemented due to the limited availability of healthcare staff and financial resources in most nations. This study aimed to evaluate the supply and demand balance of mechanical thrombectomy (MT) and identify areas with high priority for enhancing stroke centers. The target area of this study was Hokkaido, Japan. We adopted the capacitated maximal covering location problem (CMCLP) to propose an optimal allocation without increasing the number of medical facilities. Four realistic scenarios with varying levels of total MT supply capacity for Primary stroke centers and assuming a range of 90 minutes by car from the center were created and simulated. From scenarios 1 to 4, the coverage increased by approximately 53% to 85%, scenarios 2 and 3 had 5% oversupply, and scenario 4 had an oversupply of approximately 20%. When the supply capacity cap was eliminated and 8 PSCs received 31 or more patients, they became priority enhancement targets. The CMCLP estimates demand coverage considering the supply and demand balance and indicates areas and facilities where MT supply capacity enhancement is a priority. [ABSTRACT FROM AUTHOR]

The rise of digital platforms has revolutionized the healthcare industry, offering new avenues for content marketing, particularly through YouTube healthcare channels. This paper examines the growing effectiveness of content marketing in healthcare services, with a special focus on YouTube as a platform for disseminating health information. This study explores how healthcare providers utilize YouTube to enhance patient education, improve public health outcomes, and build brand trust by analyzing case studies, audience engagement metrics, and content strategies. The findings reveal that content marketing on YouTube increases patient awareness and plays a critical role in influencing patient decisions, thereby contributing to better healthcare delivery. This research provides valuable insights for healthcare professionals and marketers on optimizing content strategies to maximize the impact of their online presence. [ABSTRACT FROM AUTHOR]

Objectives: During the coronavirus disease (COVID‐19) pandemic, patients with altered mental status (AMS: dementia, delirium and delirium superimposed on dementia) were profoundly affected by an abrupt transformation in healthcare systems. Here, we evaluated quality‐care outcomes, including length of stay (LOS), in‐hospital mortality, early readmission and mortality after hospital discharge, in older adults admitted for AMS during the pandemic and compared them to patients admitted prior to the pandemic. Methods: Chi‐squared and Fisher's exact tests were used to examine changes to admissions for AMS before and during the pandemic, and their outcomes. Logistic regression analyses, with reference to pre‐pandemic data, were conducted to examine the impact of the pandemic on outcomes. Design: Prospective data of 21,192 non‐COVID admissions to an acute general medical department in a Surrey (UK) hospital were collected from patients admitted before (1st April 2019 to 29th February 2020) and during the pandemic (1st March 2020 to 31st March 2021). Results: There were 10,173 (47.7% men) from the pre‐pandemic and 11,019 (47.5% men) from the pandemic periods; overall mean age = 68.3yr. During the pandemic AMS patients had significantly higher admission rates (1.1% vs 0.6%, P < 0.001). However, median LOS in hospital was shorter (9.0 days [IQR = 5.3–16.2] vs 15.5 days [IQR = 6.2–25.7], P < 0.001) and thus were less likely to stay in hospital >3 weeks: adjusted OR = 0.26 (95%CI = 0.12–0.57). In‐hospital mortality and readmission within 28 days of discharge did not change during the pandemic, but were less likely to die within 30 days of discharge: adjusted OR = 0.32 (95%CI = 0.11–0.96). Conclusions: This combination of higher admission rate, shorter LOS, and an unchanging early readmission suggests a higher admission‐discharge turnover of different patients with AMS and provides important insights into the potential impact of the COVID‐19 pandemic on healthcare delivery to individuals with AMS. Key points: During the coronavirus disease (COVID‐19) pandemic, patients with altered mental status (AMS: dementia, delirium and delirium superimposed on delirium) were profoundly affected by an abrupt transformation in healthcare systems.Patients admitted with AMS during the pandemic had higher admission rates but shorter length of stay (LOS) in hospital, whilst mortality in hospital and readmission within 28 days of discharge did not change during the pandemicThese observations suggest a higher admission‐discharge turnover of different patients with AMS and provide important insights into the potentially impact of the COVID‐19 pandemic on healthcare delivery to individuals with AMS. [ABSTRACT FROM AUTHOR]

Currently, telemedicine and telehealth have grown, prompting healthcare institutions to seek innovative ways to incorporate them into their services. Challenges such as resource allocation, system integration, and data compatibility persist in healthcare. Utilizing an open data approach in a versatile mobile platform holds great promise for addressing these challenges. This research focuses on adopting such an approach for a mobile platform catering to personalized care services. It aims to bridge identified gaps in healthcare, including fragmented communication channels and limited real-time data access, through an open data approach. This study builds upon previous research in omnichannel healthcare using prototyping to design a mobile companion for personalized care. By combining an omnichannel mobile companion with open data principles, this research successfully tackles key healthcare gaps, enhancing patient-centered care and improving data accessibility and integration. The strategy proves effective despite encountering challenges, although additional issues in personalized care services warrant further exploration and consideration. [ABSTRACT FROM AUTHOR]

The U.S. healthcare sector is a large and important industry. However, relatively little is known about the localization and colocalization patterns of healthcare services within an urban area. By using Yelp data from over 3000 healthcare service establishments in the Phoenix area, this paper applies a recent spatial econometric technique to the analysis of healthcare services. The results reveal that spatial concentration varies across distances and types of healthcare services. Localization is more prevalent at closer distances, and general practitioners tend to be more dispersed than specialists. Colocalization with hospitals is most likely for specialists while family practices and dentistry services tend to locate away from hospitals. Different types of location patterns across different types of healthcare services are relevant for informing policies addressing healthcare access and competition in healthcare markets. [ABSTRACT FROM AUTHOR]

AbstractThis study investigated the effect of role conflict and role ambiguity on emotional exhaustion among healthcare service employees in hospital settings. A questionnaire utilizing a 5-point Likert scale was administered to 181 employees of Kairuki Memorial Hospital. Out of these, 131 questionnaires were considered valid for data analysis. Descriptive and regression analyses were conducted using SPSS software. The findings indicated that role ambiguity had a positive and significant association with emotional exhaustion. Conversely, the association between role conflict and emotional exhaustion was negative but not significant. It should be noted that, unlike previous studies that focused on specific healthcare professionals, this study included all professionals working in the hospital setting, acknowledging that exposure to a stressful environment may differ based on one’s profession. However, as this study relied on a cross-sectional survey conducted in a single hospital, caution should be exercised in generalizing the findings. The study contributes to the literature on human resources management by shedding light on the effect of role ambiguity and role conflict. It also offers recommendations for managing emotional exhaustion by addressing the underlying causes of role ambiguity identified in the study.

ObjectiveInformal healthcare providers (IHCPs) play a big role in health systems in low-and middle-income countries (LMICs) and are often the first point of contact for healthcare in rural and underserved areas where formal healthcare infrastructure is insufficient or absent. This study was performed to systematically review the literature on interventions targeting IHCPs in improving the delivery of healthcare services in LMICs.MethodsPubMed, Embase, and Cochrane CENTRAL databases were searched for studies that assessed any type of intervention among IHCPs to improve the delivery of healthcare services in any LMIC. Outcomes included changes in knowledge, attitude, and reported practice of appropriate case diagnosis and management; improved referral services; effective contraceptive use; and medication appropriateness (PROSPERO ID: CRD42024521739).ResultsA total of 7,255 studies were screened and 38 were included. Most of the studies were conducted in Africa and Asia. The IHCPs who were trained included medicine sellers, community health workers/traditional healers, and traditional birth attendants. The main intervention used was educational programs in the form of training. The other interventions were health services, policy and guidelines, and community-based interventions. Most of the interventions were multi-faceted. The disease/service areas targeted were mainly maternal and child health, sexually transmitted diseases, common infectious diseases, medicine use/dispensing practices, and contraception. The outcomes that showed improvements were knowledge, attitude, and reported practice; diagnosis and case management; improved referral services; contraceptive uses; and medication appropriateness. Around one-fourth of the studies reported negative results. The certainty of evidence generated (GRADE criteria) was very low.ConclusionSome multifaceted interventions coupled with training showed improvements in the delivery of healthcare services by IHCPs. However, the improvements were inconsistent. Hence, it is unclear to identify any context-specific optimum intervention to improve the delivery of healthcare services by IHCPs.