Climate-sensitive health counselling for Planetary Health: Adapting a conceptual framework to local healthcare conditions in Accra, Ghana

Antimicrobial resistance is closely linked with the health and stability of environmental systems and therefore a challenge for the health of the planet. General Practitioners, owing to their trusted positions and close patient relationships, can play a crucial role in addressing antimicrobial resistance within the framework of Planetary Health. The goal of our study was to examine General Practitioners' knowledge, attitude, and practice regarding the linkage of antimicrobial resistance with Planetary Health to understand their potential as agents of change in this domain. We conducted 19 guided interviews with General Practitioners from four different German federal states (August-September 2022). Participants were selected from the intervention group of the RedAres randomized controlled trial, a study designed to optimize therapy and prescribing practices for uncomplicated urinary tract infections in general practice. Data were analyzed using Mayring's structured qualitative content analysis and the typology approach by Kelle and Kluge. General Practitioners generally demonstrated the ability to identify the interlinkages between antimicrobial resistance and Planetary Health. However, they exhibited varying levels of knowledge, problem awareness, and accountability for the associated challenges and partially outsourced the responsibility for Planetary Health. Some General Practitioners were capable of integrating Planetary Health arguments into patient counseling. They recognized rational prescribing practice, self-reflection on antimicrobial resistance and Planetary Health, interprofessional exchange, and raising awareness among patients as potential avenues for engagement in promoting Planetary Health. As antimicrobial resistance is increasingly recognized as a Planetary Health challenge, empowering General Practitioners as change agents requires tailored measures based on their level of previous knowledge and their attitude toward Planetary Health. General Practitioners express a need for concrete advice on how to integrate antimicrobial resistance as a Planetary Health topic into their daily activities. Developing and evaluating adaptable training materials is essential. Additionally, the integration of Planetary Health outcomes into clinical guidelines could accelerate the adoption of this dimension in antibiotic prescribing practices within primary care settings.

Cultural competence: A call to action

BACKGROUND AND OBJECTIVESLittle is known about the implementation of the patient bill of rights (PBR) in Saudi Arabia. Therefore, this study was conducted to explore to what extent health care recipients and providers know about the bill and its implementation.DESIGN AND SETTINGA cross-sectional survey conducted on health care professionals and patients at Primary Health Care Centers in Riyadh, Saudi Arabia, during July 2010.PATIENTS AND METHODSThe study employed a self-administered questionnaire to collect data from 500 patients (aged 18 years or older) and 500 health care providers (physicians and nurses) in primary health care (PHC) centers in Riyadh. Data was collected on the respondents’ knowledge of the existence and contents of the bill, the extent to which the bill is implemented, and the obstacles that may hinder bill implementation. The data was analyzed and presented in a descriptive fashion.RESULTSMore than three quarters of patients and one third of PHC providers did not know about the existence of the bill. Among those who knew about its existence, about three quarters of patients and almost half of PHC providers had little (or very little) knowledge about the bill contents. In general, patients scored lower means of perception than PHC staff about the implementation of the bill’s aspects. PHC staff reported several obstacles that may hinder the implementation of the PBR in Saudi Arabia.CONCLUSIONSPatients and health care providers lack necessary knowledge about the PBR. More dissemination of information about the bill, taking into account the particularities of the Saudi population is needed. Future research is required to establish measures that are effective in ensuring that patients rights are ensured.

Ocean conservation boosts climate change mitigation and adaptation

Integrating planetary health into clinical guidelines to sustainably transform health care

Kidney Health for All: Bridging the Gap in Kidney Health Education and Literacy

Planetary health: from concept to decisive action

Global health threats are also oral health threats

Over the past decade, long-term use of prescription opioids for chronic non-cancer pain has risen globally despite the associated risks. Most opioid users receive their first prescription in primary care. To investigate the perspective of patients who are long-term opioid users in primary care regarding the role of healthcare providers (HCPs) in their prolonged opioid use. Semi-structured interviews in Dutch primary care. We recruited patients who were long-term users of opioids for chronic non-cancer pain from seven community pharmacies in the Netherlands. In-depth, semi-structured interviews focused on patients' experiences with long-term opioid use, access to opioids, and the guidance of their HCPs (primarily their GPs and pharmacists). A directed content analysis was conducted on the transcribed interviews using NVivo. Participants (n = 25) described ways in which HCPs impacted their long-term use of opioids. These encompassed the initiation of treatment, chronic use of opioids, and discontinuation of treatment. Participants stressed the need for risk counselling during initial prescribing, ongoing medication evaluations including tapering conversations, and more support from their HCP during a tapering attempt. Patients' perspectives illustrate the important role of HCPs across the spectrum of opioid use - from initiation to tapering. The results of this study underscore the importance of clear risk counselling starting at initial prescribing, repeated medication assessments throughout treatment, addressing tapering at regular intervals, and strong support during tapering. These insights carry significant implications for clinical practice, emphasising the importance of informed and patient-centred care when it comes to opioid use for chronic non-cancer pain management.

Editorial

Objectives:To determine risk factors of cervical cancer and role of healthcare providers regarding awareness and counseling of PAP-smear.Methods:It was case-control study conducted from Jan-2021 till may-2021 at two tertiary care hospitals of Karachi South. The intended sample size was 255 subjects as 105 cases and 150 controls. The inclusion criteria were diagnosed cases of CA Cervix and under the age of 50 years. Controls were recruited from the general population. All the data were entered into SPSS version 23. The odds ratio was calculated to compare the risks of occurring CA cervix among cases and controls. The relationship of risk factors was assessed by binary logistic regression. P-value < 0.05 was considered as statistically significant.Results:Generally, highly significant p-value (<0.000) was observed; depicted a positive association for a level of education, age at first intercourse, and number of parity in cases of CA cervix and controls (OR=4.3). The correct predicted rate was 68.8% for having CA cervix among controls due to family history, the knowledge of PAP smear screening, ever counseled for a PAP smear, ever tested for a PAP smear, never been tested for PAP smear due to cost.Conclusion:Educational level, age at first intercourse, number of parity was the risk factors of CA cervix. Family history of CA Cervix, knowledge of cervical cancer screening, ever counseled for PAP smear, ever tested for PAP smear, never been tested for PAP smear due to cost were significantly predicted for CA cervix among controls.

Disclosing Adverse Events in Healthcare: Understanding the Gap Between Knowledge and Practice in Developing Countries.

&#x0D; East Kalimantan Province is very vulnerable to climate change, so it needs policies and strategies in managing climate change impacts through adaptation and mitigation actions. So it is necessary to stipulate local regulations on climate change adaptation and mitigation. Management of climate change in East Kalimantan is one of the local government's efforts in providing guarantees to the community to get a quality living environment. The purpose of this community service activity is to provide understanding to residents regarding East Kalimantan Regional Regulation No. 7 of 2019 concerning climate change adaptation and mitigation. The method of implementing this community service activity is in the form of counseling and discussion of East Kalimantan Regional Regulation No. 7 of 2019 concerning climate change adaptation and mitigation.&#x0D; &#x0D; Based on the results of community service activities related to the extension of East Kalimantan Regional Regulation No. 7 of 2019 regarding climate change adaptation and mitigation, it was concluded that many people still do not know about the regional regulation. Efforts to mitigate and adapt to climate change are not only the responsibility of the Government, but also the responsibility of the DPR. The DPR's climate change mitigation and adaptation efforts can be carried out through the implementation of its three functions, namely the budget function, the supervisory function, and the legislative function. Every stakeholder, including the community, must mitigate and adapt to climate change, because adaptation and mitigation is the key to addressing climate change, which is the key to reducing greenhouse gas emissions and increasing carbon stocks to reduce the impact of climate change. The active role of the regional government in formulating policies related to climate change is a must, the policy is expected to be a direction for stakeholders in East Kalimantan.

Research on climate change has increased significantly since the 1970s. There has also been a particular focus on Africa, given its vulnerability to climate change impacts and its urbanization trends that may have massive implications for climate change adaptation and mitigation. Despite the wealth of publications on climate change in Africa, there is a lack of review studies that highlight the overall research landscape. If this status of climate research is clarified, African countries can better deal with climate change. Hence, this paper aims to improve our understanding of the status and trends of research on climate change adaptation and mitigation in Africa. Our review, straddling from 1990 to late 2021, recognizes the foundations that underpin climate change adaptation and mitigation literature. Based on keywords associated with Africa's climate change adaptation and mitigation, we undertook bibliometric research by collecting 3,316 related SCI/SSCI articles. In addition, we provided a thematic evolution over three decades, compartmentalized into four sub-periods (1990–2007; 2008–2014; 2015–2019; 2020–2021). Priority research topics and themes have been dynamic over time, with some core concepts receiving more attention (vulnerability, food, water, and energy security). Although the number of published articles exhibited a rapidly growing trend, their distribution is extremely uneven. Articles were mainly published by institutions from certain parts of the continent, with the University of Cape Town, making the highest contribution. About 72% of the existing studies focused on climate change adaptation, while climate change mitigation was less represented with 22%. The results also showed that researchers have examined not all African countries. South Africa, Ethiopia, and Ghana are hot spots, while most countries are largely neglected. Africa and African countries need to improve their future research ability on climate change mitigation. Assessing climate change risks and measures in African countries should be prioritized.

This case study explores the innovative strategies employed by the Unjani Clinic in South Africa to address climate change within the primary healthcare system. By integrating renewable energy and water conservation practices, it highlights the dual role of healthcare providers in climate change mitigation and adaptation, especially in resource-limited settings. Operational data from annual reports and supplier quotes were analysed to evaluate Unjani Clinic's practices. Currently, 19 % of clinics operate with hybrid or off-grid solar energy systems, reducing utility costs by as much as ZAR 164,512 ($ 9139) and 23, 000 kg carbon emissions. Climate-related disruptions, including flooding and a tornado, significantly impacted clinic operations, underlining the importance of emergency preparedness and network support. The Unjani model demonstrates the viability of sustainability efforts to enhance healthcare delivery and environmental resilience. Flexible implementation and leadership support were key enablers. This approach emphasizes the need for aligning investment and policy support to scale such initiatives. The Unjani Clinics (https://www.unjaniclinic.co.za/) provide a replicable model of integrating climate resilience into primary healthcare. This study underscores the critical role of healthcare providers in advancing environmental sustainability and addressing health inequities in vulnerable communities.