Care Administrators Research Articles

Administrative Structures Sustainability And Secondary Health Care Administration In Lagos, Nigeria


 The paper focused on the assessment of secondary healthcare administration in Lagos with respect to examined the administrative structure put in place in secondary healthcare facilities and evaluated the effects of administrative structure on secondary healthcare service in Lagos as well as analysed the challenges confronting the administration of secondary healthcare service in Lagos. The paper employed descriptive research design and quantitative research approach. The data were gathered through administration of structured questionnaire. The paper used 20% of the study population 1341, making 268 sample size for questionnaire which consisted of both medical and non-medical staff of three selected General Hospital in Lagos i.e. one from each senatorial district in Lagos State. Data collected were analysed using frequency distribution, percentages, tables, and t-test. The study revealed that sustainability of administrative structure put in place in Lagos State to manage the secondary healthcare service are impactful and has significant effects on the services rendered. Therefore, the paper recommended that hospital administration should provide up to date medical technology and infrastructure need to easy the work of health workers and promote service delivery and that government should be an increase in the financial commitment and budget allocation of the government to the health care sector to address the existing financial challenges. The paper concluded that sustainability of administrative structure has direct effect on secondary healthcare on service delivery in Lagos, Nigeria. 

Development of a Diabetes Mellitus Diagnostic System Using Self-Organizing Map Algorithm: A Machine Learning Approach

Delivery of Health care services in developing nations has posed a huge problem to the world at large. The United Nations and the World Health Organization have been on the front burner sorting for ways of improving these problems to abate the yearly mortality rates which are caused largely by inadequate health facilities, poor technical know-how, and poor health care administration. One disease that has a high number of patients is diabetes. In Nigeria, out of a population of 200 million, diabetes kills over 2% yearly. To reduce this menace, early diagnosis and awareness are important. And automation of the medical diagnostic system is one of the sure ways of achieving these feet. This paper explores the potential of a self-organizing map algorithm; a machine learning technique in the development of a diabetes mellitus diagnostic system (DMDS). Data collected from 120 patients from the University of Port Harcourt Teaching Hospital (UPTH) was used in the training and validation of the model. The confusion matrix formula was used in testing the sensitivity and accuracy of the model which yielded 75.63% and 87.2% respectively which are within the accepted range, predefined by expert physicians. Keywords Artificial Intelligence, self-organizing map, diagnosis, neural networks, diabetes mellitus

The Transformative Impact of Big Data in Healthcare: Improving Outcomes, Safety, and Efficiencies

The integration of Big Data analytics into the healthcare sector has initiated a period of unparalleled transformation, significantly influencing patient care, research, and healthcare administration. This detailed synthesis, derived from a systematic literature review of 31 articles published between 2013 and 2023, examines the extensive impact of Big Data within the healthcare industry. It addresses how Big Data enhances personalized medicine and optimizes treatment protocols, promotes the use of predictive analytics for the early detection and management of diseases, and bolsters patient safety through the implementation of real-time monitoring and decision support systems. The review also confronts the challenges and limitations associated with Big Data's application, including concerns over data privacy and security, ethical dilemmas, interoperability issues, and the necessity for both skilled personnel and advanced technological infrastructure. Furthermore, this overview ventures into future prospects and technological advancements, emphasizing the pivotal role of emerging technologies such as artificial intelligence (AI), machine learning, and blockchain in heralding a new era of healthcare. It highlights Big Data's instrumental role in supporting public health measures and preparing for pandemics, alongside forecasting the ongoing influence of Big Data in fostering innovative healthcare paradigms. This analysis advocates for a concerted effort among healthcare professionals, policymakers, and technology experts to fully leverage Big Data's capabilities in healthcare, aiming to enhance health outcomes, increase operational efficiencies, and ensure the long-term viability of healthcare systems.

The continued financial effect of COVID: Increasing costs for non-elective major lower extremity amputations

BackgroundThe COVID-19 pandemic necessitated changes in processes of care, which significantly impacted surgical care. This study evaluated the impact of these changes on patient outcomes and costs for non-elective major lower extremity amputations (LEA). MethodsThe 2019–2021 Florida Agency for Health Care Administration database was queried for adult patients who underwent non-elective major LEA. Per-patient inflation-adjusted costs were collected. Patient cohorts were established based on Florida COVID-19 mortality rates: COVID-heavy (CH) included nine months with the highest mortality, COVID-light (CL) included nine months with the lowest mortality, and pre-COVID (PC) included nine months before COVID (2019). Outcomes included in-hospital patient outcomes and hospitalization cost. Results6132 patients were included (1957 PC, 2104 CH, and 2071 CL). Compared to PC, there was increased patient acuity at presentation, but morbidity (31%), mortality (4%), and length of stay (median 12 [8–17] days) were unchanged during CH and CL. Additionally, costs significantly increased during the pandemic; median total cost rose 9%, room costs increased by 16%, ICU costs rose by 15%, and operating room costs rose by 15%. When COVID-positive patients were excluded, cost of care was still significantly higher during CH and CL. ConclusionsDespite maintaining pre-pandemic standards, as evidenced by unchanged outcomes, the pandemic led to increased costs for patients undergoing non-elective major LEA. This was likely due to increased patient acuity, resource strain, and supply chain shortages during the pandemic. Key messageWhile patient outcomes for non-elective major lower extremity amputations remained consistent during the COVID-19 pandemic, healthcare costs significantly increased, likely due to increased patient acuity and heightened pressures on resources and supply chains. These findings underscore the need for informed policy changes to mitigate the financial impact on patients and healthcare systems for future public health emergencies.

Incorporation of artificial intelligence in healthcare professions and patient education for fostering effective patient care

AbstractArtificial intelligence (AI) influences many aspects of modern life and has multiple applications in the delivery of healthcare. AI is designed to mimic human capabilities including pattern recognition, data analysis, and decision‐making and perform tasks more efficiently. It is capable of detecting patterns in large datasets that might elude human beings. AI has potential to improve patient care, patient safety, disease diagnosis and treatment; public health; health research; health administration; and the daily work of health professionals. In 2019, the US National Academy of Medicine emphasized the need for “physicians, nurses, and other clinicians, data scientists, health care administrators, public health officials, policy makers, regulators, purchasers of health care services, and patients to understand the basic concepts, current state of the art, and future implications of the revolution in AI and machine learning.” Therefore, it is incumbent on adult educators to incorporate AI training into health professions education and patient education.

Deciphering the Digital Healthscape: Unveiling the Intricacies of the Internet of Medical Things (IoMT)

Through the integration of networking, data analytics, and medical devices, the Internet of Medical Things (IoMT) has revolutionized patient care and healthcare administration. Presented here is extensive study on IoMT that sheds light on its impact on healthcare settings, including its origins, technical foundations, uses, security worries, interoperability problems, and potential future developments. The evolution of IoMT began with the integration of internet connection with medical devices and continues with the complex and linked environment of today. This shift in thinking makes possible preventative healthcare, individualized treatment plans, and remote patient monitoring. Technologies for data storage, networking, and sensors are the backbone of IoMT. Streamlined connection, real-time data transmission, and a robust IoMT architecture for healthcare applications are all described in the article. Remote patient monitoring and the management of chronic illnesses are two areas where IoMT finds application in healthcare. Literature show how IoMT describes a data-driven, proactive, and personalized healthcare delivery strategy that improves patient outcomes, treatment adherence, and resource utilization. The research addresses important topics related to IoMT, such as healthcare privacy and security. Securing IoMT and bolstering trust in connected healthcare are the goals of research into encryption, access controls, and data protection regulations. To implement IoMT, interoperability concerns must be addressed. The essay delves into the difficulties of integrating IoMT devices and systems, as well as the necessity of standardized frameworks to facilitate data sharing and interoperability. Future advances in the IoMT, such as the integration of AI and blockchain for security, are predicted in the research. The paper highlights the potential of IoMT to impact healthcare delivery and address global healthcare concerns. This study demonstrates the transformation of IoMT to academics, healthcare professionals, and policymakers. Keyword :Internet of Medical Things (IoMT), Digital Healthscape, Remote Patient Monitoring, Data Analytics, Security, Interoperability, Future Trends

Design and Implementation of a Career Guidance Program at Gachon University College of Medicine

The ultimate goal of career guidance is to help medical students develop a career plan that matches their personal characteristics, allows them to train in their desired subspecialty, and helps them to adapt well to medical practice after graduation. Gachon Medical School has designed a longitudinal career guidance program called GLORI (Gachon Longitudinal Orientation and Career Development), which is based on the outcome of each phase. The program consists of regular courses and portfolio-based career guidance from a mentor professor. In phase 2 (basic medical science), the “Career Seminar” course was developed. This course focuses on self-understanding through a psychological inventory, exploration of postgraduate career paths, and interviews with professors in specialties of interest. In phase 3 (the integration of basic and clinical science), the “Exploring Nonclinical Career Options” course was introduced. This course presents perspectives from doctors who have followed various pioneering career trajectories, including biomedical engineering, medical journalism, writing, public health, health care administration, the pharmaceutical and medical device industries, and other areas. All teaching methods were designed to encourage student participation. The assessment methods are assignment-based, including self-reflective reports and presentations. In addition, a portfolio-based career guidance program is implemented in phases 3 and 4 (clinical clerkship). It is expected that this case study will serve as a practical example for developing comprehensive career guidance programs for medical schools.

Role-Play Based Gamification for Communication Skills and Nursing Competence in Internal Medicine Nursing

Objective: This study aims to the effect of role-play-based gamification on the analysis of symptoms in Internal Medicine Nursing, decision making, administration of appropriate nursing care, and the communication skills of nursing students. Methods: The study was designed in participatory action research as a qualitative design. In the action research, gamification elements were constructed on a role-play performance of the students in Nursing Department at a private university in Ankara-Türkiye. A gamification based on systems role play was performed for students taking the internal medicine nursing course (n=10). Checklists for each system regarding the selection and use of equipment appropriate for nursing interventions have been added to the games. At the end of the semester they were asked to evaluate this intervention via qualitative interview. In the in-depth interviews, data were collected by asking the students 9 unstructured open-ended questions prepared by the researchers. Data analysis was carried out by hand coding by the researchers. Codes were created from the research objectives based on Werbach's D6 Model for gamification design. Results: The qualitative analysis revealed six major themes (i) Defining Business Goals (ii) Delineating Target Behaviors (iii) Describing Players (iv) Devising Activity Loops (v) Deploying Tools (vi) Not forgetting the fun. In these themes, students stated that by using game elements in lessons, it became easier to remember and apply theoretical knowledge about internal medicine nursing, improved their practical skills, time management skills and critical decision-making abilities, and that they better understood the importance of effective communication within the team. Additionally, students stated that the experience of learning the basic aspects of internal diseases, which are difficult to learn in theory, became fun with the gamification technique. Conclusion: The use of gamification, students learned nursing care and communication skills related to Internal Medicine Nursing education in a motivated and more permanent manner.

Two Gender Medicine: Provider-Side Barriers to Caring for Transgender and Gender Diverse Patients

ABSTRACT Experienced and anticipated discrimination during health care visits result in lower health care utilization rates, which contribute to persistent health disparities between transgender and gender diverse (TGD) individuals and the general population. Most strategies for improving health care delivery to TGD patients place the responsibility on providers, overlooking the role of medical systems and institutions in creating the environments where negative health care experiences occur. Relying on the inhabited institutionalism framework, this study explores system- and institutional-level barriers to the provision of quality care to TGD patients identified by health care providers and administrators, including relevant contextual details of, and interactions between, these barriers. Based on interview data from health care providers and administrators from a variety of practices across Texas, we identified two overarching themes and six subthemes. We demonstrate how our interviewees’ responses reveal an institutional logic of “two-gender medicine,” which creates barriers to health care provision in both formal medical education and training and throughout the managed care model of practice. We also illustrate how health care workers find ways to resist this logic in the course of their practice. Addressing these barriers to delivering competent and compassionate care to TGD patients that providers encounter could make long overdue strides toward addressing health disparities.

Telehomecare: A Comprehensive Analysis of Its Relevance and Impact

The domestic conveyance of healthcare administrations to patients utilizing broadcast communications innovations that capture quiet clinical status estimations to empower and encourage timely instruction, data spread, social, emotional, and self-care support, as well as care administration by a healthcare professional at an outside location or unscheduled domestic visits based on require. This paper reviews the Telehomecare concepts, challenges, and constraints that need to be addressed for the successful implementation of the Telehomecare system. The narrative overview of the literature synthesizes the findings retrieved from searches of computerized databases, hand searches, and authoritative texts. The results have been summarized and categorized according to the parameters of the Telehomecare impact framework. This comprehensive analysis examines the relevance and impact of Telehomecare, highlighting its benefits, challenges, and future prospects. By understanding the implications of Telehomecare, healthcare systems can make informed decisions regarding its adoption and integration into existing care models.

The downtrending cost of robotic bariatric surgery: a cost analysis of 47,788 bariatric patients.

The surgical robot is assumed to be a fixed, indirect cost. We hypothesized rising volume of robotic bariatric procedures would decrease cost per patient over time. Patients who underwent elective, initial gastric bypass (GB) or sleeve gastrectomy (SG) for morbid obesity were selected from Florida Agency for Health Care Administration database from 2017 to 2021. Inflation-adjusted cost per patient was collected. Cost-over-time ($/patientyear) and change in cost-over-time were calculated for open, laparoscopic, and robotic cases. Linear regression on cost generated predictive parameters. Density plots utilizing area under the curve demonstrated cost overlap. Among 76 hospitals, 11,472 bypasses (223 open, 6885 laparoscopic, 4364 robotic) and 36,316 sleeves (26,596 laparoscopic, 9724 robotic) were included. Total cost for robotic was approximately 1.5-fold higher (p<0.001) than laparoscopic for both procedures. For GB, laparoscopic had lower total ($15,520) and operative ($6497) average cost compared to open (total $17,779; operative $9273) and robotic (total $21,756; operative $10,896). For SG, laparoscopic total cost was significantly less than robotic ($10,691 vs. $16,393). Robotic GB cost-over-time increased until 2021, when there was a large decrease in cost (-$944, compared with 2020). Robotic SG total cost-over time fluctuated, but decreased significantly in 2021 (-$490 compared with 2020). While surgical costs rose significantly in 2020 for bariatric procedures, our study suggests a possible downward trend in robotic bariatric surgery as total and operative costs are decreasing at a higher rate than laparoscopic costs.

The role of depression and anxiety symptom severity in remotely delivered mental health care.

This study examined differences in mental health characteristics of Veterans who received VA Video Connect (VVC) or audio-only care during initial phases of the COVID-19 pandemic. A cohort of Veterans with primary diagnoses of depressive or anxiety disorders (diagnosed between March 2019 and February 2020) was identified, and data were obtained for Veterans who engaged in virtual care from April to December 2020. Two groups were created: Veterans receiving audio-only care (n = 161,071) and Veterans receiving two or more VVC visits (n = 84,505). Multiple logistic regression models examined symptom severity in the year before COVID as a predictor of treatment modality during COVID. Chi-square tests examined associations between modality and the number of assessments. Symptom severity as evaluated by the nine-item Patient Health Questionnaire and Generalized Anxiety Disorder-7 significantly predicted modality of encounters during the pandemic such that those who had moderate or severe symptoms prior to COVID-19 were more likely than those with low or no symptoms to have two or more VVC encounters during the pandemic. Of those who received VVC, 55.62% had no Patient Health Questionnaire-9 assessments compared to 68.96% of those who received audio-only. In the VVC group, 70.36% had no Generalized Anxiety Disorder-7 assessments compared to 81.02% in the audio-only group. Taken together, these findings suggest that VVC, when compared to audio-only, was used during the pandemic to reach Veterans with more severe mental health symptomatology and to engage in administration of measurement-based care. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Healing of diabetic foot ulcer with topical and oral administrations of herbal products: A systematic review and meta-analysis of randomized controlled trials.

This systematic review aimed to qualitatively synthesize recent randomized controlled trials (RCTs) regarding the effect of topical application and oral intake of herbal products on the healing of diabetic foot ulcer (DFU). Also, we sought to pool the obtained findings in a meta-analysis using a random-effects model, if RCTs were relatively comparable and homogenous. A comprehensive search was performed on five electronic data sources from their inception through 23 January 2024. The RCTs, without restriction on the country of origin, were included if they compared the effect of administering standard treatments and/or placebo (i.e. control condition) to applying standard treatments and/or herbal products in topical or oral routes (i.e. experimental condition). Out of 1166 retrieved records, 28 RCTs were included. Studies used different poly and single herbal formulations. Based on the meta-analysis, administration of standard care plus daily dressing of the ulcer site with olive oil for 28 days significantly increased the total ulcer healing score (3 RCTs; weighted mean difference [WMD] = 89.30; p < 0.001), raised frequency of complete ulcer healing (2 RCTs; risk ratio [RR] = 12.44; p = 0.039) and declined ulcer degree (3 RCTs; WMD = -22.28; p = 0.002). Also, daily use of the bitter melon leaf extract in oral form for 28 days significantly increased the total ulcer healing score (2 RCTs; WMD = 0.40; p = 0.001). Additionally, based on qualitative synthesis, the adjuvant use of herbal agents seems an intriguing choice to manage DFU. Nonetheless, considering the undesirable methodological quality of most studies and the high heterogeneity in administered herbal formulations, more robust trials are required to build a solid conclusion regarding the use of herbal products for healing DFU.

Interprofessional Educational Needs for Shared Governance of Integrated Care.

This study investigated the educational needs of integrated care among professionals in the public sector of healthcare and social care services in South Korea. A cross-sectional secondary data analysis was performed. Original data were obtained from 10 metropolitan communities with a convenience sample of 210 integrated care professionals. The Borich Needs Assessment Model and the Locus for Focus Model were used to examine the priority educational needs of each integrated care professional. This study analyzed the key details of educational needs in integrated care by focusing on the competencies of integrated care approaches for person-centered care, interprofessional collaboration, and community involvement. The core educational needs of community care administrators, care coordinators, healthcare and social care providers, and community health champions, which are common to all professionals, and the specific educational needs for each type of professional were demonstrated, which contained specific content to implement integrated care. This study provides an opportunity to comprehensively understand the educational needs of integrated care professionals based on their competencies. They want better interprofessional cooperation through networking and collaborative strategies. The results of this study may be utilized as fundamental data by future instructors to provide evidence-based education programs.

Anatomy of the elephant in Quebec family practice

Background&#x0D; Whole person care has been a foundation of the modern practice of family medicine, and therefore one might expect that such an approach by family practitioners would evolve and mature over time. Some of these clinicians, however, currently question their ability to provide such holistic care because of external factors they perceive as negative, and over which they have little or no control.&#x0D; Objectives&#x0D; This presentation will explore perceived inhibiting factors affecting family doctors ability to provide whole person care within the publicly-funded health care system of the Canadian province of Quebec. &#x0D; Method&#x0D; The presenter, an academic and clinician scientist with forty-four years of experience practicing family medicine, will present personal perspectives, along with those gathered informally from a broad cadre of colleagues working in different settings. Using the idiom of “elephant in the room” to identify problems or obstacles that may not be voiced, this talk will start with consideration of elephant anatomy as being comprised of thirteen distinct anatomical parts that contribute to a functional whole. An analogy will be developed in which thirteen distinct factors are presented as likely impeding or discouraging whole person care by family physicians. &#x0D; Conclusion&#x0D; Some agendas and policies of health care planners and administrators, either alone or collectively, and intentionally or unintentionally, may decrease opportunity or ability of family physicians to provide whole person care.

The effectiveness of early administration of antifibrotic therapy as a reflection of properly organized medical care for patients with progressive pulmonary fibrosis

The issues of organization of medical care and early administration of antifibrotic therapy in patients with progressive fibrotic phenotype require in-depth study and implementation in real clinical practice.The aim of this paper is to provide a rationale for the early administration of antifibrotic drugs in patients with various forms of interstitial lung disease.Results. The article addresses organizational issues in the medical care for interstitial lung disease with a progressive fibrotic phenotype. Topical epidemiological problems are also addressed, in particular the high mortality rate in this disease. The main risk factors of the disease are considered. Diagnostic markers for the fibrosis progression are analyzed. Data from large-scale studies on the early initiation of antifibrotic therapy and its effect on disease outcomes are presented.Conclusion. The main reasons for early initiation of therapy in a progressive fibrotic phenotype are presented: an unfavorable prognosis, an unpredictable course, a progressive decrease in forced vital capacity, and the association of changes in FVC with an increase in mortality. Using the Chelyabinsk region as an example, a model of care for patients with interstitial lung diseases is considered, with a brief analysis of the effectiveness of antifibrotic therapy, its early initiation and the impact on mortality in patients with this disease.

Nurse Managers' Professional Quality of Life During the COVID-19 Pandemic.

Health systems cannot effectively support nurse managers without understanding psychosocial effects of the COVID-19 pandemic. The objective of this study was to describe the professional quality of life of frontline nursing management during the COVID-19 pandemic. A cross-sectional online survey of 54 nurses in management positions at a large Midwest academic medical center during 2022 was conducted. Participants completed an electronic survey including demographics, Professional Quality of Life Measure Version 5, and items assessing past consideration of and future intent to leave their position, organization, or profession. Most participants had previously considered changing roles (80%) or leaving the organization during the pandemic (76%). Fewer respondents reported that changing role (24%) or organization (20%) was likely during the upcoming 6-12 months. Most participants scored in moderate ranges of Compassion Satisfaction, Burnout, and Secondary Traumatic Stress scales (85%, 89%, and 74%, respectively). Higher Compassion Satisfaction was associated with extreme unlikelihood of leaving for an internal non-management role. Higher Burnout scores were associated with more time working and past consideration or future likelihood of leaving for an external non-nursing position. Secondary Traumatic Stress scores were higher for nurse managers and house operation managers than assistant nurse managers and associated with past consideration of moving to an internal non-management role or external non-nursing position and future likelihood of moving to an external non-nursing position. Nurse management occupies a demanding position between frontline staff needs and administrative requirements, profoundly impacted by COVID-19. Health care researchers, administration, and policymakers must learn how to support, retain, and sustain nursing management in a post-pandemic world.

2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association.

The American Heart Association (AHA), in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, nutrition, sleep, and obesity) and health factors (cholesterol, blood pressure, glucose control, and metabolic syndrome) that contribute to cardiovascular health. The AHA Heart Disease and Stroke Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, brain health, complications of pregnancy, kidney disease, congenital heart disease, rhythm disorders, sudden cardiac arrest, subclinical atherosclerosis, coronary heart disease, cardiomyopathy, heart failure, valvular disease, venous thromboembolism, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). The AHA, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States and globally to provide the most current information available in the annual Statistical Update with review of published literature through the year before writing. The 2024 AHA Statistical Update is the product of a full year's worth of effort in 2023 by dedicated volunteer clinicians and scientists, committed government professionals, and AHA staff members. The AHA strives to further understand and help heal health problems inflicted by structural racism, a public health crisis that can significantly damage physical and mental health and perpetuate disparities in access to health care, education, income, housing, and several other factors vital to healthy lives. This year's edition includes additional global data, as well as data on the monitoring and benefits of cardiovascular health in the population, with an enhanced focus on health equity across several key domains. Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.

The reality of transitioning from orphanages to family homes: Life in extended families in Zimbabwe

Summary Many young orphans in Zimbabwe grow up in residential care facilities, but according to governmental policies and literature in this field, these children should be transitioned to extended families to ensure optimal development. Thus, semi-structured interviews was conducted with a social worker, two residential care administrators and five extended families; whereas the participating orphans were asked to draw and narrate their lives in RCC and their extended families. This article provides empirically derived insights to the inner experiences of the transition processes of five young orphans and their extended family members, two residential care administrators, and one social worker. The theoretical approach taken to analyze the data consisted of the inductive data analysis. Findings Although transitioning to a family is deemed ideal for orphans it was apparent in this study that most of the orphans found their new family life challenging and stressful. Several themes emerged from the data, namely financial constraints hindering the transition experiences in families; lack of training of family members on how to support orphans in their families, as well as emotional and cognitive challenges faced by orphaned children. Application The insights of this study can be used to improve the transition experiences of young orphans, especially in Zimbabwe. Future practical and policy changes are also suggested.

Dual-responsive in situ gelling polymer matrix for tunable ketamine general anesthesia in experimental animals

Animal experimentation is a critical part of the drug development process and pharmaceutical research. General anesthesia is one of the most common procedures. Careful administration and dosing of anesthetics ensure animal safety and study success. However, repeated injections are needed to maintain anesthesia, leading to adverse effects. Ketamine, a dissociative anesthetic, is commonly used for inducing anesthesia in animals and suffers from a short half-life requiring repeated dosing. Herein, we report a novel system for controlled anesthesia post-intraperitoneal administration. A polymer solution called “premix” was developed using two stimuli-responsive polymers, Pluronic (PF) and Carbopol (CP). As the premix was mixed with ketamine solution and injected, it underwent in situ gelation, hence controlling ketamine release and anesthesia. The PF and CP concentrations were optimized for the gelation temperature and viscosity upon mixing with the ketamine solution. The optimal premix/ketamine formulation (1.5:1) was liquid at room temperature and gel at physiological conditions with favorable mucoadhesion and rheology. Premix retarded the release of ketamine, translating to tunable anesthesia in vivo. Anesthesia duration and recovery were tunable per ketamine dose with minimal side effects. Therefore, we propose the implementation of PF/CP premix as a vehicle for general anesthesia in animals for optimal duration and effect.