County Hospital Research Articles

The Prevalence of ST-Segment Elevation Myocardial Infarction in Patients Presenting in the Emergency Service of Galati Hospital from 2015 to 2019.

The purpose of this study is to determine the prevalence of cardiovascular emergencies and the relationships between these emergencies and the personal medical histories of patients. This study is retrospective, observational, and longitudinal, spanning five years from 1 January 2015 to 31 December 2019. Descriptive elements were observed and recorded to conduct statistical analysis on the cardiovascular characteristics of 723 patients transported by air and treated at the Emergency County Hospital of Galati, Romania. Cardiovascular disease is a complex condition that often originates in the heart and presents with a variety of symptoms. Deaths related to cardiovascular diseases outnumber cancer-related deaths in both men and women worldwide. The one-year mortality rate for patients admitted to the hospital with acute pulmonary edema can be as high as 40%. Coronary heart disease is the leading cause of death and disability in the Western world and globally. The highest prevalence of cardiovascular diseases was noted in 2016, particularly among elderly men, who appear to be more affected by these conditions, while liver disease was minimal. In our study, the most prevalent cardiovascular disease was ST-elevation myocardial infarction. Gender plays a role in the risk of cardiovascular emergencies, with men being at a higher risk of developing life-threatening conditions. Additionally, there is a linear increase in risk with age for developing these pathologies.

The therapeutic benefits of NSAIDs and physical therapy in knee osteoarthritis.

Osteoarthritis (OA) has been established as a progressive wear and tear disease of the synovial joints, which also involves a certain degree of inflammation. Considering there is no disease modifying medication available at the moment, the current guidelines focus on the symptomatic treatment of the affection. Our study aimed to evaluate the therapeutic advantages of the synergistic use of non-steroidal anti-inflammatory drugs (NSAIDs) and physical therapy in the treatment of knee osteoarthritis (KOA). The study comprised 46 individuals who were diagnosed with KOA and were admitted to the Department of Physical Medicine and Rehabilitation at the Emergency Clinical County Hospital of Craiova, Romania, between January 2021 and April 2022. All the participants received the same combination of pharmacological (Diclofenac 150 mg∕day, no more than 10 days∕month as needed) and non-pharmacological treatment (a 24-week plan of physical therapy). The patient group exhibited a statistically significant reduction in both the average Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index (p=0.0142) and the average Visual Analog Scale (VAS) (p=0.0023). Additionally, there was a statistically significant increase in both the average Knee Outcome Survey-Activities of Daily Living (KOS-ADL) (p=0.0128) and the average Oxford Knee Score (OKS) (p=0.0023). The study found a significant positive correlation between higher VAS ratings and cholesterol levels (p=0.0092), but no significant correlation between VAS scores and triglyceride levels (p=0.0986). Patients were evaluated for a further 24 weeks beyond the conclusion of the research to see if surgical intervention was necessary during this time. Our investigation tracked the WOMAC, VAS, KOS-ADL, and OKS measurements in a cohort of patients with KOA. The results demonstrate that the utilization of NSAIDs in conjunction with physical therapy effectively alleviates pain and enhances joint functionality.

Epidemiology and Management Paradigm of Head and Neck Infections, Including COVID-19 Pandemic Period: A 10-Year Retrospective Study in a Maxillofacial Center of Cluj-Napoca.

Background. The management of odontogenic infections varies across the globe. To shed light on the subject, this study delves into the practices of the Oral and Maxillofacial Department at Cluj-Napoca County Hospital. Material and Methods. This comprehensive retrospective analysis of 10 years of clinical experience covered a range of factors, including demographics, clinical and investigations factors, medical and surgical treatment approaches, and follow-up. Additionally, the study examined the change in trends over the course of the COVID-19 pandemic. Results. While head and neck infection occurrence had a decreasing trend before the COVID-19 pandemic, during the pandemic era the number of patients almost doubled. The infections were prevalent in the submandibular space, teeth being the prevalent cause. Young adults are prone to suffer from odontogenic infections. High levels of C reactive protein, ASA II-IV risk, and hepatic dysfunction indicated a longer time of hospitalization. The majority of antibiograms were negative, and the positive ones indicated Streptococcus and Staphylococcus species as prevalent pathogens. Extra- or intraoral surgical drainage and wide-spectrum antibiotics proved to be the workhorse for odontogenic infections. Conclusion. This study advances our understanding of oral and maxillofacial surgery and offers actionable strategies for improving patient outcomes in similar healthcare institutions worldwide.

Successful Non-Operative Management of a Patient with Grade IV Right Renal Trauma Associated with Hepatic and Right Adrenal Trauma – A Case Report

In case of a traumatic event, preservation of the injured renal and kidney function represents the goal of non-operative management (NOM) of renal trauma. The substantial benefits of non-operative management for minor blunt renal injury have already been clearly described in current literature, but its value for major blunt and penetrating renal injuries are still under debate and not clearly highlighted. We hereby fully report a case of a 64 years old male patient with a history of a thoraco-abdominal blunt trauma, victim of aggression caused by a blunt object, which resulted in grade IV injury of the right kidney and associated grade II hepatic injury and right adrenal injury – grading according to the American Association for the Surgery of Trauma (AAST) injury scale guidelines – evaluated through contrast enhanced emergency CT imaging. The patient was hemodynamically stable upon admission to the Emergency Department of Clinical Emergency County Hospital of Brașov, Romania. Non-operative management strategy was chosen, therefore constant and close monitorization and follow-up CT examinations were performed. The patient was subsequently discharged after 8 days, with no further complications reported.

Irritable Bowel Syndrome Characterization in a Population from Bihor County Romania

Our aim was to analyse the characteristics of a large cohort of patients with IBS from Bihor County. We retrospectively studied 525 patients with IBS admitted between 2018-2023 in Bihor Emergency Clinical County Hospital. We extracted, interpreted and statistically analysed the following parameters: age, gender, environment, family history, smoking and alcohol status, Bristol scale, results of colonoscopy and treatment. The overall prevalence of IBS was 0.2%. Fifty-six % were women, 61% of patients were from urban environment, average age was 57.74 years, with a significant statistical difference between medium age in women vs men. There was a significant statistical correlation between the medium age, medium height, and weight of our patients and smoking status, alcohol consumption, and positive family history. Colonoscopy was done in 148 patients and conditions found in addition to IBS appeared in 7.6% of the cases. The dominant finding was tumoral (4% of IBS cases), followed by various inflammatory conditions. The mean age for patients with normal results was 55.07 years, 50.84 years for patients with inflammatory lesions and 67.81 years for tumoral lesions, with statistically significant correlations between age and the results of colonoscopy. We did not find statistical correlation between Bristol Scale and the results of colonoscopy. Only 142 patients followed specific treatment, suggesting low compliance. The epidemiological traits of our IBS patients seem to remain constant along the time as our research lines up with other studies. Among these, age, female gender and urban provenance seem to be the most significant factors, whereas habits, body mass index, and family history seem not to be statistically significant. As Rome criteria accurately diagnose IBS, we have to remember that colonoscopy should be recommended to a rather small and well selected cases of patients of older age, as in such cohorts tumoral lesions were most frequent.

Relation between the Dantu blood group variant and bacteraemia in Kenyan children: a population-based case control study.

The Dantu blood group variant protects against P. falciparum infections but its wider consequences have not been previously explored. Here, we investigate the impact of Dantu on susceptibility to bacteraemia. We conducted a case-control study in children presenting with community-acquired bacteraemia to Kilifi County Hospital in Kenya between 1998 and 2010. We used logistic regression to test for associations between the Dantu marker SNP rs186873296 A>G and both all-cause and pathogen-specific bacteraemia under an additive model. We used date of admission as a proxy measure of malaria transmission intensity, given known differences in malaria prevalence over the course of the study. Dantu was associated with protection from all-cause bacteraemia (OR=0.81, p=0.014), the association being greatest in homozygotes (OR=0.30, p=0.013). This protection was shared across the major bacterial pathogens but, notably, was only significant during the era of high malaria-transmission pre-2003 (OR=0.79, p=0.023). Consistent with previous studies showing the indirect impact on bacteraemia risk of other malaria-associated red cell variants, our study also shows that Dantu is protective against bacteraemia via its effect on malaria risk. Dantu does not appear to be under balancing selection through an increased risk of bacterial infections.

"Even Though the System Had Failed Him His Entire Life, We Were Failing Him Yet Again": How Clinical, Welfare, and Penal Medicine Interact to Drive Health Inequities and Medical Moral Injury.

Adam, a justice-involved young man, was brought into the emergency department at the county hospital in cardiogenic shock due to a recurring episode of injection-drug-use-related infective endocarditis (IDU-IE). Adam had initiated injection opioid use in prison. He was surgically treated for the previous episodes of IDU-IE but was unable to fully recover due to limitations in care within penal medicine. This case report explores the prison as a determinant of health, interactions between clinical, welfare, and penal medicine, to produce and maintain health inequities, and structural drivers of physician moral injury through an interview with Adam and reflexive writings from emergency medicine physicians. This case demonstrates the need for three types of structural health interventions: (1) restorative justice, community-based reentry programs, and housing as welfare medicine, (2) increased harm reduction services across healthcare, especially penal medicine, and (3) equitable institutional protocols (contrary to ambiguous guidelines) to treat clinical conditions like IDU-IE that disproportionately impact structurally vulnerable patients.

Combining Molecular and Traditional Prognostic Factors: A Holistic Approach to Breast Cancer Prognostication.

Breast cancer is a heterogeneous disease with various morphologies and molecular features, and it is the second leading cause of cancer death in women in developed countries. According to the literature, we currently lack both prognostic biomarkers and therapeutic targets. The most important prognostic factors are disease stage and Nottingham grade. We conducted a retrospective analysis involving 273 patients with BC who underwent neoadjuvant therapy before proceeding to curative surgical treatment between 1 January 2014 and 31 December 2023. Pathological procedures were conducted at the Department of Pathology, Emergency County Hospital of Targu Mureș, Romania. A statistical analysis was performed. Regarding the relationship between Nottingham grade and Ki67, grade I was associated with a Ki67 of less than 14. The relationship between tumor grade and luminal was similar (p = 0.0001): Grade I was associated with luminal A. Regarding TNM stage, it was statistically significantly correlated with TILs (p = 0.01) and RCB (p = 0.0001). Stages III and IV were associated with a high RCB and poor prognosis. Regarding the prognostic value, Nottingham grade 3 and TNM stages III and IV were correlated with low overall survival and disease-free survival, with poor prognosis, and, among the molecular variables, RCB played the most important prognostic role.

Impact of the COVID-19 Pandemic on the Surgical Management of Head and Neck Non-Melanoma Skin Cancers in a Maxillofacial Center of Cluj-Napoca.

Background: The COVID-19 era has been a bleak period for both cancer and non-cancer patients, with delayed non-emergency treatments, such as for non-melanoma skin cancer (NMSC). This study aimed to evaluate how the treatment of NMSC patients was influenced by the management of the COVID-19 pandemic in an Eastern European Maxillofacial Surgery center. Materials and Methods: A total of 176 patients with a histopathological diagnosis of head and neck NMSC who were surgically treated in Cluj-Napoca Emergency County Hospital between 2016 and 2022 were included in this study, and divided into two samples, pre-pandemic (2016-2019) and COVID-19 (2020-2022) periods. Results: The pandemic presented with a decrease of 46.15% in patients' hospitalization, with wealthy and educated patients being prevalent. Even if the waiting time for surgery was increased, the stage of cancer and preference method for reconstruction did not differ. Despite the lower addressability of NMSC patients during the pandemic, there were no changes in surgical treatment. Conclusions: During COVID-19, the number of patients was reduced, with a longer waiting time for surgery, but without any changes in tumor stage and treatment preferences. However, the benefit of removing a cancer tumor is higher compared to the risk of developing COVID-19 infection during hospitalization.

Pre-COVID-19‑pandemic differentiation of employment and wages in county hospitals in Poland

The difficult current global situation in the aspect of Human Resources for Health was clearly seen during the COVID-19 pandemic. The spending on healthcare is still increasing and the rate of increase outpaces the growth rate of GDP. Only part of these funds is dedicated to the training of new staff and current healthcare employees migrate in search for better job conditions and worklife balance. Personnel migration combined with the demographic structure in the high-income countries simultaneously leads to increasing demand for healthcare services and limits the supply of specialists who can provide such services. The confrontation between the demand for medical personnel and its supply will lead to a reduction in the quality of care and accessibility of services. In the study based on the large group of Polish county hospitals in 2015–2018, differences and similarities between the hospitals in terms of employment, measured in full-time equivalents (FTEs) and in terms of wages were analyzed. Similarity and dissimilarity analysis was conducted, based on distance measures and cluster analysis. Bigger differences between the hospitals were found for wages than employment levels. The hospitals with an ED and efficient units were less similar to one another than their counterparts in terms of employment (FTEs), except for 2016. When it comes to wages and both types of variables (wages and employment) considered simultaneously, the hospitals with an ED and high number of beds were characterized by lower similarity to one another than their counterparts during the whole period. Clustering all the 3 approaches (FTEs, wages, FTEs and wages) the results were the same. One of these groups was characterized by a rather low employment level per bed, while the other one – by high.

Baseline assessment of cervical cancer screening and treatment capacity in 25 counties in Kenya, 2022.

Cervical cancer is the leading cause of cancer deaths among women in Kenya. In the context of the Global strategy to accelerate the elimination of cervical cancer as a public health problem, Kenya is currently implementing screening and treatment scale-up. For effectively tracking the scale-up, a baseline assessment of cervical cancer screening and treatment service availability and readiness was conducted in 25 priority counties. We describe the findings of this assessment in the context of elimination efforts in Kenya. The survey was conducted from February 2021 to January 2022. All public hospitals in the target counties were included. We utilized healthcare workers trained in preparation for the scale-up as data collectors in each sub-county. Two electronic survey questionnaires (screening and treatment; and laboratory components) were used for data collection. All the health system building blocks were assessed. We used descriptive statistics to summarize the main service readiness indicators. Of 3,150 hospitals surveyed, 47.6% (1,499) offered cervical cancer screening only, while 5.3% (166) offered both screening and treatment for precancer lesions. Visual inspection with acetic acid (VIA) was used in 96.0% (1,599/1,665) of the hospitals as primary screening modality and HPV testing was available in 31 (1.0%) hospitals. Among the 166 hospitals offering treatment for precancerous lesions, 79.5% (132/166) used cryotherapy, 18.7% (31/166) performed thermal ablation and 25.3% (42/166) performed large loop excision of the transformation zone (LLETZ). Pathology services were offered in only 7.1% (17/238) of the hospitals expected to have the service (level 4 and above). Only 10.8% (2,955/27,363) of healthcare workers were trained in cervical cancer screening and treatment; of these, 71.0% (2,097/2,955) were offering the services. Less than half of the hospitals had cervical cancer screening and treatment commodities at time of survey. The main health system strength was presence of multiple screening points at hospitals, but frequent commodity stock-outs was a key weakness. Training, commodities, and diagnostic services are major gaps in the cervical cancer program in Kenya. To meet the 2030 elimination targets, the national and county governments should ensure adequate financing, training, and service integration, especially at primary care level.

Meaning of Life in Secondary Abstainers from Alcohol (Abstain From Alcohol and Meaning of Life)

Aim: Alcoholism is a major public health problem, and it has not yet been clarified which are the factors that influence the relapse of the disease. Aim of this research is to examine whether there is a connection between meaning of life in secondary abstainers from alcohol and variables (demographic, alcohol consumption and severity of addiction before abstinence) and to determine which variables are predictors of the meaning of life in secundary abstainers. Subjects and methods: The research was conducted in 2019 and 2020 at the County Hospital of Požega, at the Department of Neurology, Psychiatry and Clinical Psychology. 113 adults participated in this research who were diagnosed with alcohol addiction and are currently abstaining from alcohol. Results: Meaning of life in the examined addicts in abstinence is low positively related to the length of abstinence (p = 0.030), low negative with the number of hospitalizations due to alcohol addiction (p = 0.013), moderately negative with the severity of alcohol addiction before abstinence (p < 0.001) and moderately positive with financial status (p < 0.001). Hierarchical regression analysis showed that beeing unmerried (p = 0.021), financial status (p < 0.001) and severity of addiction (p < 0.001) are significant predictors of the meaning of life among abstainers from alcohol. Conclusion: It has been shown that alcoholism affects the meaning of life for alcohol addicts, and that it should be considered at the beginning and during the treatment of alcohol addicts.

Determinants of Nutritional Status of Pregnant Women at Njoro Sub County Hospital, Nakuru County, Kenya

Globally, maternal nutrition is an essential aspect of every pregnant woman’s life. Proper maternal nutrition during prenatal and post-natal periods has been shown to reduce the risks of maternal and infant complications. Pregnant women who have not achieved optimal nutrition are at higher risk of experiencing poor pregnancy outcomes. In many countries around the world, Kenya not an exception, the nutritional status of women is unacceptably poor, far too many women cannot access the nutrition services they need for optimal health. Therefore, the current study aimed at establishing the determinants of nutritional status of pregnant women at Njoro Sub County Hospital, Nakuru County, Kenya. The study used descriptive survey research design. A total sample of 80 pregnant women attending prenatal clinic at Njoro Sub County Hospital, Nakuru County was selected using simple random sampling technique. Data was collected through questionnaires to establish determinants of nutritional Status of pregnant women at Njoro Sub County Hospital. Descriptive statistics was used to analyze data. The result of the study reveals that the determinants of nutritional status of the respondents were maternal education, level of income, land ownership and crop farming. The findings show that the overall nutritional knowledge of the respondents was 33% high, 53.3% moderate and 13.3% low. Secondly, results indicate that a majority (90%) of pregnant women attending ANC at Njoro Sub County Hospital had good nutrient adequacy (>5 food groups) with only 10% having nutrient inadequacy. Thirdly, findings show that the nutritional status of the pregnant women was very good, standing at 96.7 % (MUAC above 23cm). The study recommends that health care workers should create awareness by providing nutrition education on the importance of optimal maternal nutrition, both to the baby and the mother. Secondly, Pregnant women who have financial difficulties need to be identified and support provided for them in terms of nutritious food. Finally, community health volunteers need to have a record and keep track of all pregnant women in the community to ensure that they seek early antenatal services.

Evaluating Access and Outcomes in Gender-affirming Breast Augmentation: A Comparative Study of a County Hospital and an Academic Center.

Research on the diverse patient population undergoing gender-affirming breast augmentation remains scarce. We compared patients undergoing this procedure at San Francisco General Hospital (ZSFG), a county hospital, and the University of California, San Francisco (UCSF), an academic medical center. This was a retrospective cohort study of patients who underwent primary gender-affirming breast augmentation at ZSFG (August 2019 to June 2023) and UCSF (March 2015 to June 2023). Differences in sociodemographic characteristics, surgical access, and outcomes between sites were assessed. Of 195 patients, 122 patients had surgery at UCSF and 73 patients at ZSFG. ZSFG patients were more likely to be unstably housed (P < 0.001), Spanish-speaking (P = 0.001), and to have obesity (P = 0.011) and HIV (P = 0.004). Patients at ZSFG took hormones for longer before surgical consultation (P < 0.001) but had shorter referral-to-surgery intervals (P = 0.024). Patients at ZSFG more frequently underwent a subglandular approach (P = 0.003) with longer operative times (P < 0.001). Major surgical complications were uncommon (2.1%) with no differences between sites. Aesthetically, implant malposition/rotation occurred more often in patients at UCSF (P = 0.031), but revision rates were similar at both sites. Patients at UCSF had longer follow-up periods (P = 0.008). County hospital patients seeking gender-affirming breast augmentation have distinct sociodemographic profiles and more comorbidities than academic medical center patients. County patients might experience greater barriers that delay surgical eligibility, such as stable housing. Nevertheless, this procedure can be safely and effectively performed in both patient populations.

Evaluation and management of antrochoanal polyps in children

Abstract BACKGROUND. Antrochoanal polyps (ACP) were originally reported by Gustav Killian in 1906. Antrochoanal polyps (ACPs) are benign polypoid lesions that begin in the maxillary antrum and extend into the choana. Although there have been recorded occurrences of bilateral ACPs in the literature, ACPs are mostly unilateral. They typically have an impact on youth and youngsters. MATERIAL AND METHODS. In a trial of 15 cases treated and admitted to our ENT Pediatric Department at the Emergency County Hospital Timisoara over the previous four years, the pathology, differential diagnosis, treatment, complications, etiopathogenesis, clinical features, positive and differential diagnosis, preoperative evaluation, pathology, and treatment of ACPs were reviewed in this study. RESULTS. The patients age group comprised five females (33.33%) and ten boys (66.67%), ranging in age from 7 to 16 years. The most common presenting symptoms were unilateral nasal obstruction (100%), purulent rhinorrhea (66.67%), olfactory impairment (53.33%), and mouth breathing (46.67%). A nasal endoscopy and a craniofacial CT scan were the gold standards for diagnosing ACP. The chosen course of treatment for all pediatric patients included in the study was surgery: 12 patients (80%) underwent transnasal endoscopic polypectomy, and 3 patients (20%) underwent both transnasal polypectomy and transcanine fossa approach. The success rate of the combined endoscopic and transcanine fossa approach was 100%, whereas the transnasal endoscopic surgery (polypectomy) had an 80% success rate. CONCLUSION. Polypectomy combined with a transcanine fossa approach technique and transnasal polypectomy is the optimal course of treatment.

Prevalence of Rhesus D negativity and barriers to immuno- prophylaxis among obstetric patients in Kitengela Sub- county Hospital: A cross-sectional study

Background: Rhesus (Rh) alloimmunization is a serious but preventable disease that develops in women who are Rh(D)-negative. This disease contributes significantly to perinatal morbidity and mortality. Prevalence data of Rh(D)-negative blood type among pregnant women in Kenya are scarce. This study aimed to determine the prevalence of Rh(D)-negative blood type, barriers to immunoprophylaxis, and ABO blood type patterns among the obstetric population in Kitengela Subcounty Hospital, Kajiado, Kenya. Methods: A cross-sectional study design was employed in which medical records of Rh-negative women as documented at the first antenatal visit were retrieved. Data were collected, extracted into a data collection tool, and analyzed using the Statistical Package for Social Scientists Software (SPSS version 23). Results: Of the 7141 women screened, 1.2 % (85) were Rh-negative. Among these, blood group O was the most common (48.2%), followed by blood groups B (24.7%), A (23.5%), and AB (3.5%). Most Rh-negative women (45.9%) were aged 15-23 years. Following delivery, only half of the women received anti-D immunoglobulin. Among those who did not receive anti-D postnatally, 80.8% lacked a documented reason, whereas 12.2% and 4.9% of the patients lacked access and did not know their Rh status, respectively. None of these patients had fetal blood grouping conducted before anti-D administration. Conclusion: Rh(D) negativity remains prevalent in the Kenyan population. However, access restrictions at both diagnostic and therapeutic levels remain. In addition, there is an overt hiatus in neonatal blood grouping.

Predicting Factors and Clinical Characteristics of Pruritus in Psoriasis: A Cross-Sectional Survey.

Pruritus is an important symptom among patients affected by psoriasis. To date, no general agreement has been established regarding pruritus as a measure of psoriasis severity. This study aims to assess psoriatic pruritis prevalence and characteristics using a comprehensive itch questionnaire. A semi-structured questionnaire consisting of 48 questions was applied to patients diagnosed with psoriasis and admitted to the Dermatology Department of Mures Clinical County Hospital, Romania. A total of 163 patients were enrolled, out of which 115 (70.55%) reported itch. Patients with itch had higher PASI (p = 0.003) and DLQI scores (p < 0.001). The itch was most frequently described as a crawling sensation, mainly located in the lesional skin and aggravated by stress and temperature variation. It had a moderate intensity (6.18 ± 2.46). Emollients were the treatment preferred by most patients in alleviating itch, while biologics exerted a protective effect on itch development (OR = -0.24; p < 0.0001) and negatively correlated with itch intensity (r = -0.23; p < 0.0001). Advanced age, high BMI, and PASI scores were indicators of itch presence, while female gender, high PASI score, and frequent itch episodes indicate highly intense pruritus (≥7 on the VAS). A better understanding of itch and its clinical features will guide physicians toward the best treatment option and would, ultimately, benefit the patient.

Nurses' health education competence and health literacy: A cross-sectional survey in Chinese county hospitals

AimThis study aims to assess the health education competence of nurses in China's county hospitals, examining its relationship with health literacy and other influencing factors, such as receipt of health education training, and acquisition of health knowledge. BackgroundNurses are pivotal in delivering health education, which is crucial for improving health outcomes. In rural China, the prevalent low health literacy, stemming from limited access to health guidance, necessitates an evaluation of nurses' health education competence in county hospitals. Understanding these competencies and their influencing factors is essential to enhance the health literacy of the Chinese population. DesignA cross-sectional study. MethodsThe study surveyed 692 nurses from nine county hospitals in Shanxi Province, China, using convenience sampling. The analysis employed descriptive statistics, t-tests, ANOVA, Pearson's correlation, and hierarchical multiple linear regression. ResultsThe study revealed a low level of health education competence among the surveyed nurses, with total health education scores averaging 3.77±0.60, and mean scores for knowledge, skills, and attitudes being 3.73±0.67, 3.77±0.64, and 3.89±0.64, respectively. The multiple regression models were significant (P<0.001), with R2 values ranging from 0.143 to 0.197. Key predictors included the incentive mechanism for health education, receipt of health education training, acquisition of health knowledge, and literacies in infectious disease prevention, scientific health concepts, and chronic disease prevention. ConclusionsThis study assessed the health education competence of nurses in county hospitals in China and investigated the impact of various dimensions of health literacy on this competence. The findings indicate that the health education competence of nurses in these settings remains relatively low. Additionally, health education training and incentive mechanisms were found to significantly enhance nurses' health education competence in areas lacking medical resources.

Statins for neuroprotection in spontaneous intracerebral haemorrhage (STATIC): protocol for a multicentre, prospective and randomised controlled trial

IntroductionIntracerebral haemorrhage (ICH) is a neurological emergency with high morbidity and mortality, and current treatment is limited. Emerging evidence has reported that statins can exert neuroprotective effects in cerebrovascular diseases....

Influence of Job Analysis on Employee Performance in Private Hospitals of Kisii County-Kenya

Purpose: This research aims to examine the impact of job analysis on employee performance in the private hospitals of Kisii County. Even though the hiring procedures in these hospitals are strict, some of the employees working in these hospitals have been found to be performing poorly and have various challenges such as low morale, high turnover rate and poor performance. Methodology: The study adopted the use of a cross-sectional descriptive survey which was used to collect detailed information about he under-study issue, the practice of job analysis and its impact on worker productivity in Kisii County hospitals. The researcher adopted a descriptive study design, and the data for the study was collected from 108 healthcare professionals and administrators from different private hospitals in Kisii County. The collected data was then analysed using SPSS Version 24. The results were then represented tables and graphs for easy analysis. Descriptive and inferential statistics highlighted the effects of job analysis on employees’ performance. Results: The results of the study indicate that external recruitment excels with the highest mean score as can be seen by the respondents who view it as being highly effective. This is drawn from the different scores related to different study items. For instance, the mean score for job analysis was 3.78 which indicates that most respondents agreed that job analysis had a positive impact on job performance. Internal recruitment also recorded a mean score of 3.52 and a standard deviation of 1.05. On external recruitment, the scores were a 4.21 mean with a standard deviation of 0.87 which showed a very small variation in the answer spread. Lastly, employee performance scored a mean of 3.95 which indicated that employees were perceived to be running at high level based on the feedback provided. Firms that used both internal and external sources of recruitment had higher productivity than those that relied on internal sources only. However, there are some limitations such as the use of self-reported data may bring in some bias. Unique Contribution to Theory, Practice and Policy: Based on the study results, the researcher makes the following recommendations to the hospitals administration. First, there is need to undertake routine and comprehensive job analysis by companies to ensure that the company has competent employees. Secondly, the involving of employees in job analysis has numerous advantages and job satisfaction. Lastly, the researcher hypothesises that capacity building of HR employees significantly improves on the quality of job analysis. Similarly, to hospitals in Kisii County, the researcher recommends the adoption of job analysis to improve on their manpower.