Aspects Of Delivery Research Articles

Gaining stakeholder perspectives to shape a produce prescription program to improve maternal and birth outcomes: a qualitative study

IntroductionNutrition during pregnancy significantly impacts maternal and birth outcomes. A key factor contributing to the rise in adverse maternal and birth outcomes is poor nutrition. Produce prescription programs have the potential to address pregnancy-related adverse outcomes such as hypertensive disorders and gestational diabetes, but scientific evidence is limited.PurposeTo conduct qualitative interviews to gain an in-depth understanding of how, why, and in what context should produce prescriptions be implemented to best meet the needs of pregnant women in a clinical setting.MethodsWe conducted interviews with 11 patients with low incomes and/or experiencing food insecurity and 11 clinic staff from a major metropolitan OB/GYN clinic. Interview questions were designed to understand attitudes toward participating in or helping implement a produce prescription program. We analyzed the data using a deductive qualitative content analysis approach.ResultsBoth patients and clinic staff perceived many benefits to this type of program, including easing financial strain, removing barriers to access, and addressing nutrition security during pregnancy. Both groups described a need to consider participants’ autonomy in the program design. Patients also perceived some drawbacks to the home delivery aspect, such as limited participation by patients due to unstable housing. Staff expressed some concerns about the staff time needed to implement this type of program.ConclusionThere was strong support for produce prescription programs for this population; however, results indicate that they may best meet needs if patient autonomy and delivery-related barriers are considered in the design. Designating screening and enrollment tasks for ancillary staff may facilitate implementation in clinics.

Virtual primary care for people living with dementia in Canada: cross-sectional surveys of patients, care partners, and family physicians

BackgroundVirtual care (VC) for dementia in primary care settings is an important aspect of healthcare delivery in Canada. However, the evidence informing optimal and sustainable provision of VC for persons living with dementia (PLWD) and their care partners is scarce. The objectives of this study were to (1) describe the frequency of VC use, (2) identify characteristics of PLWD, care partners, and family physicians (FPs) that are associated with the use of VC, and (3) explore FPs’ perceptions of barriers and facilitators to provide VC for PLWD and their care partners.MethodsThe Alzheimer Society of Canada and College of Family Physicians of Canada conducted three nationwide cross-sectional surveys between October 2020 and April 2021: (1) One with PLWD, (2) one with care partners of PLWD, and (3) one with FPs. Virtual care was defined as two-way synchronous communication by telephone and/or a web camera. The prevalence of VC use among FPs, PLWD, and care partners was described. Logistic regression models were used to determine characteristics of participants (sociodemographic, urbanicity, frequency and availability of support for connecting with FPs, and FPs’ practice characteristics) associated with any VC use (phone and/or video). Inductive thematic analysis of open-ended questions explored FPs’ perceptions.Results131 PLWD, 341 care partners, and 125 FPs participated. 61.2% of PLWD, 59.5% of care partners, and 77.4% of FPs reported using VC. The models for PLWD (included age and ethnicity) and care partners (included gender/sex, urbanicity, and receiving support from a family member/friend to connect with FP) were inconclusive. FPs with > 20 years in practice were less likely to provide VC (OR = 0.23, 95%CI: 0.08–0.62, p < 0.01). FPs perceived that preferences regarding virtual vs. in-person care, office/family support, technology and family presence, and remuneration for FPs influenced VC use.ConclusionsVirtual primary dementia care uptake in Canada is substantial and mainly performed via telephone. According to FPs, physician-patient-caregiver partnerships and infrastructure for VC play key roles in using VC. Virtual care could facilitate access to primary care and minimize potential disruptions to in-person care for PLWD. Outcomes of virtual primary care for dementia need further investigation.

Co-producing a live fieldwork broadcast in the biosciences

Most live broadcast work in education operates with an expert to novice delivery mode, and in indoor settings such as surgical teaching environments. Those few examples of live broadcasts from outdoor locations have heavy resource requirements, limiting their uptake within Higher Education. Working with undergraduates in a students as partners approach, this research aims to test the feasibility of a low-cost and low-tech solution to co-produce a live fieldwork broadcast within the biosciences. The co-production partnership successfully produced a live broadcast from conception to delivery in 2022–2023 with three placement students and in 2023–2024 with two placement students and three mentors. The students were involved in all aspects of design, development, and delivery of the live fieldwork broadcast. A pocket wireless modem creates an outdoor wireless network with a mobile device and wireless microphones used to deliver the broadcast. Semi-structured interviews, student self-assessments, and a reflective researcher diary explored the impact of this approach to co-produce a live fieldwork broadcast. Enjoyable aspects of the placement identified were the opportunity for new experiences and a sense of achievement. The live fieldwork broadcast placement enabled the placement students to develop 28 skills, with 73% of skills identified by at least two of the placement students. Most skills developed were transferable (54% of student identified skills), including teamwork and project planning. The simple and low-cost technology used provides a solution to address the barriers of technology integration within fieldwork and offers insight into the experience of working in partnership during a live fieldwork broadcast.

From Self-Assembly to Drug Delivery: Understanding and Exploring Protein Fibrils.

It is crucial to comprehend protein misfolding and aggregation in the domains of biomedicine, pharmaceuticals, and proteins. Amyloid fibrils are formed when proteins misfold and assemble, resulting in the debilitating illness known as "amyloidosis". This work investigates lysozyme fibrillation with pluronics (F68 and F127). The effect of pluronics on protein aggregation and fibrillation has been studied mechanistically using a combination of calorimetric and spectroscopic techniques. TEM images and the ThT binding experiment were used to analyze the conformation of protein fibrils, and the results showed that pluronics accelerated the fibrillation process. When pluronics interact with protein at different stages of fibrillation, their pre- and postmicellar concentrations show a decrease in ΔHm° value as the time of incubation increases. This indicates the formation of amorphous aggregates due to which endothermic enthalpy is observed. As a consequence, it was investigated if these generated aggregates can also act as drug delivery vehicle; therefore, the work was carried out with 5-fluorouracil and cytarabine. The endothermic enthalpy of interaction suggests that hydrophobic interaction is more prevalent when cytarabine is employed with protein fibrils, whereas the electrostatic interaction is more prevalent when 5-fluorouracil is combined with it. The former drug, however, showed a greater adsorption than the latter on the surface of protein fibrils. It is therefore determined that 5-fluorouracil has relatively significant adsorption on fibril surfaces, whereas cytarabine has weak adsorption and is easily desorbed in cells. Consequently, the combination of LFF127 and 5-FU is lethal to malignant cells. The drug encapsulation and delivery aspect of protein fibrils/aggregates needs further exploration.

OPTIMIZING CARE TRANSITIONS FOR OLDER ADULTS: A COLLABORATIVE APPROACH THROUGH INTERPROFESSIONAL EDUCATION

Abstract Optimizing care transitions for older adults is a critical aspect of healthcare delivery, particularly given the complex needs and potential social vulnerabilities of this population. Transitioning between different healthcare settings, such as hospitals, rehabilitation facilities, and home care, can be challenging and increase the risk of adverse events for older adults. Interprofessional Education (IPE) offers a collaborative approach to addressing these challenges and improving care transitions for older adults. IPE involves bringing together students and professionals from multiple healthcare disciplines to learn with, from, and about each other to improve collaboration and the quality of patient care. By fostering teamwork, communication, and mutual respect among healthcare providers, IPE can enhance the coordination and continuity of care for older adults during transitions between different care settings. Key strategies for optimizing care transitions for older adults through a collaborative approach with IPE include a team-based approach, comprehensive assessment, care coordination, communication and information sharing, patient and caregiver education, and follow-up and support. By adopting a collaborative approach through IPE, healthcare providers can enhance the quality, safety, and effectiveness of care transitions for older adults, ultimately improving health outcomes and quality of life for this vulnerable population. This presentation will offer strategies for adopting a collaborative approach through Interprofessional Education, thus promoting quality, safety, and effectiveness of care transitions for older adults, ultimately improving health outcomes and quality of life for this vulnerable population.

Government Services and Channel Choice: An Empirical Investigation of the Factors Influencing Channel Choice in the Southern Metropolitan Cities of India

India is a diverse country with varying demographic characteristics, different people tend to choose different channels to avail government services. With the varying preferences among the public multi-channel management thus has become one of the critical aspects of public service delivery. The channels such as traditional, electronic, and mobile government (MG) services are mainly used in delivering the services. In this direction, the study analysed the critical determinants impacting channel use and channel satisfaction for which primary data has been collected using a questionnaire survey (391 responses). The results of ordinal logistic regression indicated the significance of demographic factors viz. gender, education and income on channel use and satisfaction. Further age was found to have a critical influence on MG use. Further, the attitudinal dimensions (ease of use, usefulness), transparency, internet access and new technology acceptance were having a significant influence on both indicators of channel choice (use and satisfaction) especially stronger towards MG services. The discussions and implications both from theoretical and managerial perspectives are laid down accordingly based on the results in the paper.

Profiling current cancer survivorship practices and enhancing survivorship care in public hospitals in Victoria, Australia.

Comprehensive survivorship care involves cancer surveillance, management of post-treatment effects, health promotion and coordination between care sectors. This study aimed to understand current survivorship practices, build awareness and support improved survivorship care in Victoria, Australia. This project had three components: (1) a survey of 20 Victorian clinical sites, assessing elements described in the Victorian Quality Cancer Survivorship Framework; (2) educational webinars for oncology health professionals, to increase survivorship knowledge and awareness; (3) implementation of targeted survivorship care quality initiatives in a sample of health services. Survey, evaluation and outcome data were reported descriptively. All sites responded to the survey (3 hospitals have a common operating model hence supplied a single response). Most (11/18, 60%) rated their survivorship care as 'developing' and did not have a clear survivorship care policy (13/18, 72%). The provision of post-treatment information was inconsistent, as was the assessment for needs. Most sites do not stratify survivors (< 25% of survivors received stratified care at 13/18 sites, 72%), provide survivorship care plans (< 25% survivors received SCP at 8/18 sites, 44%) and collect limited outcome data. Webinars were well received, with 98% of health professionals reporting improved knowledge and awareness. All seven sites valued targeted implementation support to improve aspects of survivorship care. Current Victorian survivorship care appears suboptimal. There was good health professional engagement with educational webinars and with improvement activities. Results have informed survivorship improvement work, focusing on implementing policy, improving aspects of care delivery and building capability across the state.

KNOWLEDGE AND PRACTICES REGARDING BIO-MEDICAL WASTE MANAGEMENT AMONG STAFF NURSES IN TERTIARY CARE HOSPITAL

Biomedical waste (BMW) management is a critical aspect of healthcare delivery, ensuring safety for healthcare workers, patients, and the environment. In Pakistan, the implementation of effective BMW management practices remains a significant challenge due to limited resources and inconsistent adherence to protocols. Objective: To evaluate the knowledge and practices of staff nurses regarding BMW management in a tertiary care hospital in Lahore, Pakistan. Methods: A descriptive cross-sectional study was conducted among 130 female nurses. Data were collected using a structured questionnaire assessing knowledge and practices related to BMW management. Descriptive statistics, including frequencies and percentages, were analyzed using SPSS version 26. Results: All participants (100%) were aware of BMW generation and legislation, and 96.9% adhered to colour-coded waste segregation. However, only 82.3% used puncture-proof containers for sharps disposal, and 87.7% were aware of the preparation of disinfectant solutions. Most nurses (99.2%) reported wearing PPE, and 92.3% were immunised against Hepatitis B. Despite these strengths, gaps in adherence to storage time limits and sharp disposal protocols were noted. Conclusion: While awareness and adherence to certain BMW management practices were high, significant gaps remain in compliance with critical protocols. Enhanced training, monitoring, and resource provision are essential to ensure safe and effective BMW management in healthcare settings in Pakistan.

Prospects of Inhalable Formulations of Conventionally Administered Repurposed Drugs for Adjunctive Treatment of Drug-Resistant Tuberculosis: Supporting Evidence from Clinical Trials and Cohort Studies.

Background: Drug resistant tuberculosis is a major public health concern, since the causative agent Mycobacterium tuberculosis is resistant to the most effective drugs against tuberculosis treatment ie., rifampicin and isoniazid. Globally, it accounts 4.6 percent of the patients with tuberculosis, but in some low socioeconomic areas this proportion exceeds to 25 percent. The treatment of drug resistant tuberculosis is prolonged (9-12 months) and often have less favorable outcome with novel as well as recently repurposed drugs administered by conventional routes. Materials and Methods: Clinically, these repurposed drugs have shown several major concerns including low penetration of the drugs to the pulmonary region, emergence of resistant forms, first pass effects, drug-drug interactions, food effects, and serious side effects upon administration by conventional route of administration. Although, several antimicrobial agents have been either approved or are under investigation at different stages of clinical trials and in pre-clinical studies via inhalation route for the treatment of respiratory infections, inhalable formulation for the treatment of drug resistant tuberculosis is most untouched aspect of drug delivery to validate clinically. Only a single dry powder inhalation formulation of capreomycin is able to reach the milestone, ie., phase I for the treatment of drug resistant tuberculosis. Results: Administering inhalable formulations of repurposed drugs as adjuvant in the treatment of drug resistant tuberculosis could mitigate several concerns by targeting drugs directly in the vicinity of bacilli. Conclusion: This review focuses on the limitations and major concerns observed during clinical trials of repurposed drugs (host directed or bactericidal drugs) administered conventionally for the treatment of drug resistant tuberculosis. The outcomes and the concerns of these clinical trials rationalized the need of repurposing formulation which could be administered by inhalation route as adjunctive treatment of drug resistant tuberculosis. [Figure: see text].

Considerations for the continuation of blended learning and teaching modes in English education within Cambodian public schools

The global language of English is widely acknowledged for connecting people worldwide, including in Cambodia, where the field of English education has been working to incorporate blended learning (BL) and blended teaching modes into public schools. This integration is aimed at addressing the shortage of qualified English teachers and learning resources for English for specific purpose courses, showing significant potential in enhancing the educational experience for students. A comprehensive study was conducted to ensure the effectiveness and sustainability of this innovative approach, focusing on various aspects of English knowledge content delivery. The study revealed major concerns over the use of certain knowledge content websites, led by the European Union and the Cambodian government to act toward regulating and improving the quality of such sources; however, the primary responsibility for ensuring that selected knowledge content meeting the need of students lies in the schools themselves. It is essential to address the challenges and concerns related to the selection and preparation of English knowledge content sources to fully realize the potential of blended learning and teaching modes in English education in Cambodia. By collaborating with external stakeholders, schools can play a crucial role in providing students with high-quality and appropriate English content. Future studies can consider the effectiveness and concerns of BL in different educational settings using different research designs.

Evaluating provider report of fidelity to contingency management in opioid treatment programs.

With growing adoption of contingency management (CM) in addiction treatment programs, ensuring intervention fidelity over time is essential for improving patient outcomes. Nonetheless, ensuring an intervention is delivered as intended can be time- and resource-intensive for organizations. Finding ways to monitor fidelity without unduly burdening health systems is critical. This study evaluated the feasibility of using provider report to monitor CM fidelity compared to traditional observer ratings using the CM Competence Scale, leveraging data from 28 opioid treatment programs that participated in a hybrid implementation-effectiveness trial. Providers (n = 86) reported CM fidelity across 3143 sessions with observer ratings conducted for 72 of these sessions from 29 providers to assess concurrence of provider- and observer-ratings. Providers reported high fidelity for most CM practices, with high concordance with ratings from trained observers on practices that were easily observable/objective (e.g., discussing reinforcement earned in current and future session). In contrast, concordance between provider and observer ratings was lower for more nuanced practices (e.g., making connections between CM and the patients' broader treatment and recovery goals). Overall, our findings suggest that while provider-report may effectively capture many aspects of CM delivery, discrepancies in fidelity reporting of specific CM practices warrant further investigation. Future research is needed to determine the optimal approaches for ensuring providers consistently deliver all CM elements with fidelity.

Post Covid-19 Upturn in Acute MI Related Mortality Trends in Young to Middle Aged Type-2 Diabetics: Observations from CDC Wonder

COVID-19 outbreak negatively impacted all aspects of adequate delivery of healthcare by overburdening the modalities. Care for acute myocardial infarction was heavily impacted attributable, in part, to reduced hospitalizations and cardiac care units not being able to function at full capacity. This paper attempts to elicit the resultant trend shift in Acute myocardial infarction (AMI) related mortality in young to middle-aged diabetics.CDC WONDER database was queried from 1999-2021. Only patients younger than 54 years old were included. Age-adjusted mortality rates (AAMR) per 100,000 with 95% confidence intervals were obtained. Joinpoint 5.0 software was used to analyze trend shift with average annual percent change (AAPC) values.A total of 10,011 AMI related deaths were encountered in the young/middle aged diabetics during our study period. Of which, around 14% (1,381) deaths were recorded in the years 2020 & 2021 alone. In these 2 years, 20.24% of subjects passed away in their homes vs only 11.06% deaths recorded in-patient. Overall AAMR more than doubled from 1999 (AAMR: 0.14 [0.13,0.16]) to 2021 (AAMR: 0.32 [0.3,0.34]) (AAPC: 3.7 [2.9,5.5]). Males had higher mortality rates (AAMR1999-2020: 2.55 [2.52,2.57]) than females (AAMR1999-2020: 1.49 [1.47-1.50]). Rural counties (AAMR1999-2020: 3.68 [3.63,3.74]) had nearly triple the mortality rates of large metropolitans (AAMR1999-2020: 1.70 [1.68,1.72]). AAMR were highest in the Midwest (AAMR1999-2020:2.3 [2.27,2.32]) and lowest in the Northeast (AAMR1999-2020: 1.41 [1.39,1.43]).COVID-19 had profound effects on cardiovascular healthcare. Post-pandemic, developing robust mechanisms to reverse the damage dealt in terms of increased morbidity and mortality has become imperative.

Nanotechnology: Current Developments, Applications and Patents for Non-invasive Topical Cosmetics and Dermatological Therapeutic Delivery

: Nanotechnology exhibits the advancement in the field of invention, by improving the potency of the formulation through the delivery of inventive solutions. To resolve several limita-tions related to conventional formulations, nanotechnology applications are increasing in the cosmetics and dermatological area. Cosmetic and dermatological preparations are considered a thriving branch of the body care arena and their usage has increased dramatically through the past years. Scientists are designing innovative delivery mechanisms and emerging innovations that are presently being utilized in the development of cosmetics. Inventive nanocarriers such as nio-somes, liposomes, microemulsions, nanoemulsions, solid-lipid nanoparticles, nanospheres, and nanostructured (lipid) carriers have substituted the use of traditional drug delivery. These innova-tive nanocarriers have the convenience of better skin permeation, sustained and controlled drug delivery, precise location, higher stability, and greater incorporated capability. Since the usage of cosmetics has increased, the usual delivery system has been substituted by modern delivery ap-proaches. The introduction of newer advancements and novel drug delivery systems make cos-metics and cosmeceuticals more popular with increased market share. This review article on nan-otechnology employed in cosmetics and dermatology emphasizes the numerous innovative nanocarriers designed for cosmetic and dermatologic drug delivery, their negative and positive aspects, and their toxicity.

Bevacizumab: The future of chronic subdural hematoma.

Bevacizumab (BCZ), commercially known as Avastin, is a monoclonal antibody that targets vascular endothelial growth factor (VEGF). Initially recognized as a breakthrough in oncology, it has since gained FDA approval for various ocular conditions and more recently, for the treatment of glioblastoma multiforme (GBM). Bevacizumab's ability to inhibit excessive neovascularization suggests it may have a potential role in treating chronic subdural hematomas (cSDH). Recent studies have shown that the pathophysiology of cSDH is more complex than previously understood, with VEGF concentrations in subdural fluid significantly exceeding those in serum, contributing to the high recurrence rates. Intra-arterial administration of bevacizumab has shown promising results in recent case series against chronic subdural hematoma, and may be a viable alternative to middle meningeal artery embolization. If successful, this treatment could significantly decrease the rate of recurrence and result in lower rates of severe neurological complications such as visual loss. This literature review explores the connection between bevacizumab and cSDH, focusing on the pharmacological, safety, and delivery aspects of this approach while summarizing the current evidence supporting its use.

Examining the joint effect of clinical quality, meaningful use of HIT and patient-caregiver interaction on mortality rates in US acute care hospitals.

Healthcare quality has long been defined and assessed using different theories that outline care delivery as a product of clinical and non-clinical aspects. The clinical aspect is medicinal in nature, while the non-clinical symbolizes social and technological aspects of care. To the best of our knowledge, the joint effect of the clinical, social, and technological aspects of care on outcome quality of care has not been investigated in the literature. The current study empirically investigates, using the joint effect of the clinical, social, and technological care quality dimensions on mortality rates through analyzing longitudinal data from 3081 US hospitals. Six-year data from 3081 acute care hospitals are collected and analyzed using econometric analysis with two-stage least square instrumental variable regression models. Hospitals that jointly focus on clinical, social, and technological care dimensions realize lower mortality rates. Combining clinical quality (CM) with either patient-caregiver interaction (PCI) or meaningful use of health infomration technology (MUHIT) reduces mortality rates. The lowest mortality rate is realized when hospitals combine CM, PCI, and MUHIT. Our study provides empirical evidence on the importance of combining clinical and non-clinical care measures to reduce mortality rates in hospitals. Our results indicate that hospitals that combine dual quality dimensions, clinical quality with either PCI or MUHIT, can also realize improvement in mortality rates. However, the best outcome can be realized by focusing on the triple quality dimensions (CM, PCI, and MUHIT). The study provides pointers to healthcare professionals and policymakers on the impact of non-clinical care on the clinical-mortality link in hospitals.

Ethical considerations related to virtual visiting for families and critically ill patients in intensive care: a qualitative descriptive study

BackgroundDuring the COVID-19 pandemic, virtual visiting technologies were rapidly integrated into the care offered by intensive care units (ICUs) in the UK and across the globe. Today, these technologies offer a necessary adjunct to in-person visits for those with ICU access limited by geography, work/caregiving commitments, or frailty. However, few empirical studies explore the ethical issues associated with virtual visiting. This study aimed to explore the anticipated or unanticipated ethical issues raised by using virtual visiting in the ICU, such that healthcare professionals can be informed about how to carry out virtual visits ethically, safely and productively.MethodsWe used a descriptive exploratory qualitative research approach recruiting a convenience sample of newly-graduated junior doctors facilitating ICU virtual visits in a tertiary academic centre. Eight newly graduated junior doctors, seven female and one male, aged 23–27, participated in semi-structured interviews. We analysed transcripts using an inductive coding approach.ResultsFive overarching themes emerged. Two of the themes namely, ‘fulfilling a moral instinct to connect families’ and ‘promoting autonomy’, arose from participants’ descriptions of how virtual visits aligned with healthcare standards and practices they considered ethical. Three further themes, ‘preserving dignity and privacy’, ‘managing emotional distress’, and ‘providing equitable access’ to virtual visiting technologies, highlight how virtual visits might exacerbate ethical issues related to family communications.ConclusionVirtual visiting may potentially both ameliorate and exacerbate aspects of ethical healthcare delivery for ICU patients and family members. ICU team members should consider unique ethical considerations related to using virtual visiting. We recommend virtual communications skills training for staff and advocate for the use of easily accessible educational resources for families who wish to visit critically unwell patients remotely.

Personalized cancer vaccine design using AI-powered technologies.

Immunotherapy has ushered in a new era of cancer treatment, yet cancer remains a leading cause of global mortality. Among various therapeutic strategies, cancer vaccines have shown promise by activating the immune system to specifically target cancer cells. While current cancer vaccines are primarily prophylactic, advancements in targeting tumor-associated antigens (TAAs) and neoantigens have paved the way for therapeutic vaccines. The integration of artificial intelligence (AI) into cancer vaccine development is revolutionizing the field by enhancing various aspect of design and delivery. This review explores how AI facilitates precise epitope design, optimizes mRNA and DNA vaccine instructions, and enables personalized vaccine strategies by predicting patient responses. By utilizing AI technologies, researchers can navigate complex biological datasets and uncover novel therapeutic targets, thereby improving the precision and efficacy of cancer vaccines. Despite the promise of AI-powered cancer vaccines, significant challenges remain, such as tumor heterogeneity and genetic variability, which can limit the effectiveness of neoantigen prediction. Moreover, ethical and regulatory concerns surrounding data privacy and algorithmic bias must be addressed to ensure responsible AI deployment. The future of cancer vaccine development lies in the seamless integration of AI to create personalized immunotherapies that offer targeted and effective cancer treatments. This review underscores the importance of interdisciplinary collaboration and innovation in overcoming these challenges and advancing cancer vaccine development.

Exploring the Predictors of Successful Learning Action Cell Practices of Special Education Teachers

Learning Action Cells (LACs) have emerged as a powerful tool for fostering professional development among educators. By creating collaborative learning communities, LACs empower teachers to share knowledge, reflect on practice, and implement innovative strategies. This study aimed to explore the factors influencing the effective implementation of LACs among Elementary Special Education (SPED) teachers in Davao City. Specifically, the study investigated the extent of LAC session practices and the level of self-efficacy of SPED teachers. A regression analysis was employed to examine the relationship between these variables. The findings revealed a significant positive correlation between LAC session practices and teachers' self-efficacy. SPED teachers demonstrated strong performance in various aspects of LAC implementation, including contextualization, process adherence, and content delivery. Similarly, they exhibited high levels of self-efficacy in classroom management, student engagement, instructional practices, and commitment. These results underscore the effectiveness of LACs in enhancing the professional capabilities of SPED teachers and ultimately improving student outcomes. The study recommends the continued implementation of LACs, with a focus on integrating 21st-century skills and assigning specific roles to team members to maximize their expertise. Future research could explore the long-term impact of LACs on teacher retention, student achievement, and overall school improvement.

UNDERSTANDING THE LEVEL OF KNOWLEDGE AMONG NURSES ABOUT FIRE SAFETY IN TERTIARY CARE HOSPITAL LAHORE

Fire safety in healthcare facilities is an important but frequently disregarded part of hospital administration and patient care. Despite substantial study on different aspects of healthcare delivery, there is still a significant gap in understanding and measuring fire safety knowledge and practices among healthcare personnel, particularly in Pakistan's tertiary care facilities. Objective: The purpose of this study was to assess the degree of fire safety knowledge among medical personnel at a tertiary care hospital in Lahore, Pakistan, to identify any shortcomings that may affect their capacity to respond effectively in the event of a fire. Methods: A cross sectional quantitative descriptive study was conducted at Public Tertiary care hospital in Lahore involving 202 nurses. A customized questionnaire was administered to assess the participant’s fire safety knowledge, selected through successive sampling. Data analysis was performed using SPSS version 22.0, categorizing knowledge level as poor, average and good. Results: 85% of survey participants were aware of fire response procedures. However, only 15% knew the fire department contact numbers, and 25% were unaware that foam or water extinguishers are ineffective against grease fires. Additionally, a significant proportion of participants struggled to correctly identify different types of fire extinguishers (65%) and fire categories (50%). The finding underscore the importance of comprehensive fire safety training to address significant knowledge gaps. Conclusions: Healthcare institutions should develop comprehensive fire safety training programs that extend beyond basic emergency protocols. Regular fire drills and simulations should be held to check staff members' understanding and reinforce fire safety procedures. Administrators should examine and update fire safety protocols on a regular basis to reflect new technology, legislation, and lessons learnt from previous events.

Infection control nurse: A scoping review.

Infection control is a crucial aspect of healthcare delivery aimed at curtailing the spread of infections within healthcare settings. The role of infection control nurses (ICNs) is reported to have a significant contribution in limiting healthcare-associated infections. Scholarly investigations have explored various domains of ICNs. However, a lack of comprehensive coverage of existing studies in the area is observed. Therefore, the current review attempts to determine the scope of the literature published on ICNs. A search was conducted on PubMed, Scopus, CINAHL, Embase, and Web of Science from January 2000 to December 2023 to retrieve research outputs on ICNs. The identified data underwent two screening stages to extract relevant articles based on the inclusion and exclusion criteria. The key outcomes were the factors that influenced the performance of ICNs and ICN programs. Out of 1869 articles, 25 were selected for the final review. The study summary identifies themes such as the roles and factors influencing ICNs and evaluating ICN programs. The review highlights a lack of high-quality evidence on ICN programs. Therefore, future studies should focus on implementing and evaluating these programs. Mapping and designing the structure, job responsibilities, and the role of ICNs demand attention from the research community.