This study investigates public sentiment toward healthcare in Timor-Leste using Facebook comments from four pages: the Ministry of Health, Guido Valadares National Hospital, ANTIL, and Jornal Independente. Data from November 2023 to November 2024 were analyzed using Natural Language Processing (NLP) techniques, including Python’s VADER sentiment analyzer. The study categorized sentiments as positive, neutral, or negative and identified key healthcare themes, such as medicine availability, good healthcare policy, poor healthcare management, and health services. From the 2,095 comments analyzed, results reveal that positive sentiment dominates at 58.4%, followed by neutral (22.7%) and negative (18.9%). Comments on institutional pages showed predominantly positive sentiments, attributed to posts highlighting achievements and activities. Conversely, news agency posts received more negative sentiments due to coverage of issues like medicine shortages and hospital service criticisms. The findings demonstrate the significant role of agenda-setting and social media framing in shaping public perceptions of healthcare. This analysis highlights the need for strategic communication and reforms in healthcare delivery to address public concerns. It underscores the importance of using social media as a tool for gathering public feedback and enhancing healthcare policies in Timor-Leste.

Social and individual factors (beliefs, and health literacy) play a crucial role in health promotion and disease prevention among older culturally and linguistically diverse (CALD) populations. This review examines the recent publications regarding the impact of health beliefs, and health literacy on patients' medication use involving adherence, polypharmacy, and potentially inappropriate medications (PIMs) in older CALD population. Databases were systemically searched for articles published from inception to January 2025. Thirteen research articles on beliefs and medication use (randomized control trials [n=1], cross-sectional [n=6], observational [n=1], qualitative [n=2], or unknown [n=3]) were obtained from databases. Ten research articles (observational [n=2], cross-sectional [n=2], interview [n=5], randomized control trials [n=1]) were retrieved for health literacy and medication use. Findings were categorized into four themes: (1) beliefs and health promotion and disease prevention, (2) beliefs and medication adherence, (3) beliefs and polypharmacy, and PIM, and (4) health literacy and medication use. Results highlighted that beliefs and health literacy often negatively influenced medication use and health outcomes. While these findings, were specific to groups like Mexican Americans, African Americans, Indian Americans, and British Bangladeshis, the results emphasize the need for research into the influence of health beliefs, and health literacy on medication use in other older CALD populations. Future studies should address these gaps to develop culturally sensitive, interventions, and support mechanisms.

Objectives: To determine the differences in costs of providing vaccination services in contracted and non-contracted primary care facilities, and to analyze their effectiveness using vaccination volume data Design: Comparative case study Setting: The study was conducted from October to December 2024 in two contracted and two non-contracted districts in Sindh Province, Pakistan. Five primary healthcare centers were selected from each district. The CORE PLUS tool was used to estimate the costs. Main outcome measures: Data on actual vaccination volumes, standard treatment guidelines, catchment population, staff salaries, vaccines and supplies, work distribution time, and operating costs were collected for a period of one year. Annual average costs and vaccination service volumes per 10,000 population were estimated and compared between contracted and non-contracted facilities. The incremental cost effectives ratio (ICER) was calculated by dividing the incremental costs by the incremental vaccination service volumes per 10,000 population. Results: The overall annual standard cost of vaccination services per 10000 population was 14.8% higher in contracted facilities. Contracted facilities spent significantly more on salaries (p=0.028) and operating costs (p<0.001). A positive difference of 559.86 incremental vaccination doses per 10,000 population was observed in contracted facilities. The incremental cost effectiveness ratio (ICER) indicates that to provide one extra dose of vaccine, an additional 1.87 US$ were spent in contracted facilities. Average cost per DALY averted was US$137.12, which was within the threshold for contracting out to be a cost effective intervention. Conclusion: Contracting vaccination services resulted in higher service provision costs but was also effective in increasing service volumes.

Prescribing education is central to patient safety and effective clinical practice, yet it remains fragmented across health professions, often taught in disciplinary silos without sufficient interprofessional integration. Drawing on qualitative and cross-sectional studies in Australian dental prescribing education, including student interviews and national surveys, this paper highlights significant gaps between theoretical learning and clinical application, particularly in areas such as antimicrobial stewardship. These gaps reflect broader systemic issues, where limited collaboration between prescribers, pharmacists, and other healthcare professionals undermines safe prescribing practices. We argue that prescribing should be understood as a shared, patient-centred process requiring intentional, interprofessional education. To address these challenges, internationally aligned frameworks, integrated curricula, and collaborative assessment models that reflect real-world complexity. Preparing students for teamwork rather than isolated competencies will foster safer, more effective prescribing decisions and improve patient outcomes globally.

Introduction: Adherence to specialised diets when prescribed, is critical to support nutritional and general health and well-being for residents of aged care facilities. Understanding the organisational factors that health service and clinical managers action can address the nutritional health of residents of residential aged care facilities. Objective: Identify the organisational factors that influence the delivery of prescribed textured modified diets in residential aged care facilities. Design: A scoping review was conducted using searches across four databases. Papers were screened if they were published after 2014 in peer reviewed articles, in English and covered relevant concepts guided by the research questions. Organisational factors that influenced the delivery of prescribed diets in RACFs was then extracted from the studies that met the selection criteria and a quality assessment performed using the Critical Appraisal Skills Program (CASP) tool. Findings: Thirteen articles were included in the scoping review. The studies were observational and predominately qualitative, with one study incorporating a mixed method design. Six dominant themes were identified as significant factors influencing the influence the delivery of prescribed textured modified diets in residential aged care facilities. Conclusion: Based on the evidence identified in this scoping review, it highlights a significant gap in research that explores the multifactorial, organisational factors that influence the delivery of prescribed texture modified diets in residential aged care facilities. Recent knowledge from the Royal Commission into Aged Care Quality and Safety and the Aged Care Quality Standards can aid residential aged care facilities, tailored specifically to the organisation, can ensure the highest quality of care and standardised practices are provided for accurate and safe delivery of prescribed texture modified diets.

Background: Assessing health technology is a vital tool for determining whether interventions should be continued or stopped. Delivering efficient medical services in remote tribal, hilly regions demands careful planning to maximize limited resources. To identify the effectiveness of telemedicine centres, we conducted an economic evaluation of telemedicine services in term of avoidance of patient transportation costs. Methods: A qualitative telemedicine evaluation was conducted through in-depth interviews with patients and hospital authorities, as well as focused group discussions with medical officers and paramedical staff. By analyzing direct and indirect costs, including setup, operations, and patient-related expenses, as well as patient satisfaction levels, the study provides insights into the sustainability of telemedicine in resource-constrained settings. Main Outcome Measures: Cost-effectiveness of telemedicine services, Reduction in patient transportation expenses, financial sustainability of telemedicine centres, and Patient satisfaction and healthcare accessibility. Results: The analysis reveals that telemedicine can significantly reduce patient transportation costs, making healthcare more accessible and affordable, particularly for underserved populations in tribal and hilly regions. The study also highlights substantial operating costs driven by staff salaries and emphasizes the importance of efficient budget planning and resource allocation. Conclusions: The findings underscore the potential of telemedicine to promote health equity by reducing disparities and improving health outcomes. To fully understand the impact of telemedicine services, a comprehensive economic evaluation considering patient outcomes, quality of care, and long-term cost savings is recommended.

Background: Allied health professionals offered an additional workforce strategy to support the COVID-19 vaccination response. The aim of this study was to understand the experiences of Australian AHPs who worked in the COVID-19 vaccination response. Methods: An explanatory-sequential mixed-methods design was conducted, with the first phase involving a cross-sectional online survey. The survey consisted of 36 questions related to participant demographics, role/s undertaken in the COVID-19 vaccination response, and perceptions regarding benefits, concerns, and future roles for allied health professionals in vaccination responses. Results: 29 participants were eligible for study inclusion defined by completion of all survey questions representing three Australian states and five allied health professions (physiotherapy, speech pathology, occupational therapy, dietetics, and podiatry). The most reported benefit was ‘enhanced knowledge base related to vaccines’ (n=25, 86.25%), while concerns were expressed related to keeping current with guidelines and accidentally causing harm (each n=11, 37.9%). Theoretical domains enabling allied health professional participation were ‘knowledge’, ‘reinforcement’, ‘beliefs about consequences’, and ‘environmental context and resources’. Three key categories were identified in open-ended responses: “An appropriate role” for allied health? The impact of allied health participation; and, Processes shape the experience. Conclusions: Findings enhance our understanding of allied health professionals’ experiences in the COVID-19 vaccination response, and the benefits and barriers to their involvement. There is an opportunity to better utilise the AHP workforce. Organisations are implored to review their use of AHPs both in the COVID-19 pandemic and broadly in health service delivery to support enhanced use of this workforce in future extended scope of practice or disaster management responses.

Background: Adequate information and data are required for assessing the primary health care system’s performance. This study aimed to assess the physical and functional aspects of a sample of primary health care centers in Erbil, Iraqi Kurdistan Region. Methods: This quantitative cross-sectional study was conducted on eight randomly selected primary health care centers in Erbil, Iraqi Kurdistan Region. An assessment tool was designed to evaluate the selected centers' physical and functional performance, including physical infrastructure, workforce, preventive care, curative care, and support. We adopted a scoring system to measure performance based on several criteria for every aspect. Results: The overall quality of physical and functional aspects of the primary health care centers was low. Two primary health care centers were judged to perform well, and both were in Erbil city. The centers located in Erbil city performed best in most aspects, followed by the centers in areas around Erbil city. The primary concerns causing the poor performance of various aspects were poor building status and unsuitable waiting areas for the physical structure component, unavailability of diagnostic facilities for curative care, and shortage of family planning services and lack of female doctors for preventive care. Other major concerns were the low health staff ratio compared to administrative staff and the unavailability of training and continuing professional development opportunities. Conclusions: The primary health care centers performed poorly in most physical and functional aspects. This poor performance was particularly evident in the centers located outside Erbil city. The main components and issues affecting the performance were recognized and described.

Objectives: This study evaluates the prevalence of emotional and behavioral difficulties using the SDQ-25 self-report version and identifies factors associated with these difficulties among adolescents in urban Vietnam with divorced or separated parents. Methods: We conducted a cross-sectional study with 309 participants, collecting data through a self-administered questionnaire featuring the SDQ-25 self-report version for assessing emotional and behavioral difficulties. Results: Findings indicated that 17.5% of students experienced emotional and behavioral difficulties. Among them, 15.2% had both emotional symptoms and peer issues, while 14.9% faced conduct problems, 12.3% showed prosocial behavior, and 9.4% experienced hyperactivity/inattention. Multivariable logistic regression showed that the duration since parental divorce or separation (OR = 4.34; 95% CI: 1.37 - 13.75; p = 0.013) and involvement in physical fights (OR = 2.58; 95% CI: 1.00 - 6.64; p = 0.049) were significant predictors of mental health issues in these adolescents. Conclusions: The study found a notable prevalence of emotional and behavioral difficulties among adolescents from divorced or separated families, who face a higher risk of these disorders. The length of time since parental divorce or separation and engagement in physical fights were identified as significant predictors of these issues.

Objective: This study aims to develop an accreditation model for Baqiyatallah University of Medical Sciences, employing a wisdom-based university approach through a mixed exploratory method (qualitative-quantitative). Methods: A mixed exploratory design was used in this study. In the qualitative phase, data were collected via semi-structured interviews with 16 experts and analyzed using MAXQDA software. The quantitative phase involved a descriptive-analytical survey-correlation design, analyzing data with LISREL software. The statistical population included academic staff and officials from Baqiyatallah University and experts from wisdom-based universities, with a sample size of 305 participants. A researcher-developed questionnaire, validated for content (CVR and CVI), face validity, and construct validity (confirmatory factor analysis), was implemented. The questionnaire comprised 7 categories and 35 items, achieving a reliability score of 0.80 via Cronbach's alpha. Results: Inferential data analysis confirmed the model's fit through structural equation modelling. The validation results indicated significant paths and model strength, leading to the recognition of the proposed accreditation model as suitable. Conclusion: The accreditation model for Baqiyatallah University of Medical Sciences encompasses seven areas: 1) Strategies and Mission; 2) Faculty Members; 3) Executive Management; 4) Social Accountability; 5) Educational and Content Environment; 6) Assessment for Learning; and 7) Education and Research Process. It includes 22 main measures and 91 sub-measures. A wisdom-based university is characterized by integrating science, experience, reason, philosophy, imagination, and revelation into its curriculum, emphasizing practical learning, social service, teamwork, and the cultivation of national self-confidence among students and staff.