Healthcare Officials Research Articles

Institutional distrust and levels of functional impairment related to indoor air-associated symptoms: A Finnish population-based study

IntroductionWhile distrust in social institutions has been linked with poor health outcomes, this association has not been examined in relation to indoor air (IA). We investigated the relationship between functional impairment due to IA-associated symptoms and distrust in social institutions, both in general and distrust particularly in IA-related questions. MethodsThe Finnish population-based Indoor Air and Health survey (n=1750) was utilized to assess any IA-associated symptoms and functional impairment due to these symptoms within the past 12 months. The associations between levels of functional impairment and distrust in social institutions (health care, juridical system, government officials, construction business, media, and social media) were analyzed using multinomial logistic regression adjusted for gender, age, and education. ResultsOf the respondents with symptoms (23.1 %), the level of functional impairment varied from severe (1.8 %) to no impairment (4.9 %). Distrust in social institutions was more common in IA-related questions than in general. Higher levels of functional impairment were associated with increased distrust particularized in IA-related questions in other institutions except for media and social media: higher levels of functional impairment were associated with increased trust in these institutions. The strongest associations were observed with distrust in health care and government officials (aOR 4.10, 95 %CI 1.97–8.53, and aOR 3.35, 95 %CI 1.62–6.94, for those with severe impairment compared to those with no IA-associated symptoms). ConclusionsHigher levels of self-reported functional impairment due to IA-associated symptoms were associated with decreased trust in most social institutions, but with increased trust in media and social media. These findings should be considered in communication on and prevention of IA-associated health issues.

Protocol for a cross-sectional study on factors affecting health-related quality of life among Afghan refugees in Pakistan

Background Pakistan served as a host for more than 1.4 million Afghan refugees for more than 40 years. Access to health care is the most important issue faced by refugees, because they might be at a higher risk for certain diseases. This risk can be attributed to a lack of awareness of health care facilities, health beliefs, inadequate hygiene, cultural differences, and malnutrition. Health of individuals is closely associated with their quality of life. Quality of life over the whole lifespan is pivotal to overall life satisfaction. It includes physical wellbeing, mental health, education, occupation, income, personal safety, as well as (religious) freedom. Until now, the health status of Afghan refugees has never been comprehensively investigated in Pakistan. Therefore, an assessment in this regard is needed to explore their health-related quality of life, for securing their human right to health. Methods A cross-sectional study has been designed to describe and explain the health-related quality of life of Afghan refugees in Pakistan. Multistage cluster sampling was applied for selection of study participants. The number of respondents from two regions in Pakistan was drawn through a proportionate sampling technique. A quantitative research method using pre-validated questionnaires was used for data collection. The questionnaire included items to assess well-being, mental health, health literacy, and factors affecting health and health care. Descriptive analysis was used, whereas inferential statistical tests (binary logistic regression model) was also performed. The study received ethically permission by the Advanced Studies and Research Board of the University of the Punjab, Lahore, Pakistan. Discussion The assessment of Afghan refugee’s quality of life in Pakistan should lead to recommendations disseminated to public and health care officials. This evidence is needed for policymaking related to adequate measures for improving health conditions of Afghan refugees in Pakistan.

Tracking COVID-19 Infections Using Survey Data on Rapid At-Home Tests

Identifying and tracking new infections during an emerging pandemic is crucial to design and deploy interventions to protect populations and mitigate the pandemic's effects, yet it remains a challenging task. To characterize the ability of nonprobability online surveys to longitudinally estimate the number of COVID-19 infections in the population both in the presence and absence of institutionalized testing. Internet-based online nonprobability surveys were conducted among residents aged 18 years or older across 50 US states and the District of Columbia, using the PureSpectrum survey vendor, approximately every 6 weeks between June 1, 2020, and January 31, 2023, for a multiuniversity consortium-the COVID States Project. Surveys collected information on COVID-19 infections with representative state-level quotas applied to balance age, sex, race and ethnicity, and geographic distribution. The main outcomes were (1) survey-weighted estimates of new monthly confirmed COVID-19 cases in the US from January 2020 to January 2023 and (2) estimates of uncounted test-confirmed cases from February 1, 2022, to January 1, 2023. These estimates were compared with institutionally reported COVID-19 infections collected by Johns Hopkins University and wastewater viral concentrations for SARS-CoV-2 from Biobot Analytics. The survey spanned 17 waves deployed from June 1, 2020, to January 31, 2023, with a total of 408 515 responses from 306 799 respondents (mean [SD] age, 42.8 [13.0] years; 202 416 women [66.0%]). Overall, 64 946 respondents (15.9%) self-reported a test-confirmed COVID-19 infection. National survey-weighted test-confirmed COVID-19 estimates were strongly correlated with institutionally reported COVID-19 infections (Pearson correlation, r = 0.96; P < .001) from April 2020 to January 2022 (50-state correlation mean [SD] value, r = 0.88 [0.07]). This was before the government-led mass distribution of at-home rapid tests. After January 2022, correlation was diminished and no longer statistically significant (r = 0.55; P = .08; 50-state correlation mean [SD] value, r = 0.48 [0.23]). In contrast, survey COVID-19 estimates correlated highly with SARS-CoV-2 viral concentrations in wastewater both before (r = 0.92; P < .001) and after (r = 0.89; P < .001) January 2022. Institutionally reported COVID-19 cases correlated (r = 0.79; P < .001) with wastewater viral concentrations before January 2022, but poorly (r = 0.31; P = .35) after, suggesting that both survey and wastewater estimates may have better captured test-confirmed COVID-19 infections after January 2022. Consistent correlation patterns were observed at the state level. Based on national-level survey estimates, approximately 54 million COVID-19 cases were likely unaccounted for in official records between January 2022 and January 2023. This study suggests that nonprobability survey data can be used to estimate the temporal evolution of test-confirmed infections during an emerging disease outbreak. Self-reporting tools may enable government and health care officials to implement accessible and affordable at-home testing for efficient infection monitoring in the future.

Practice determinants for adherence to the Guide for the Comprehensive Clinical Care of Dengue Patients, Urabá (Colombia). A multifaceted approach to implementation research.

Dengue is a significant public health issue in the Urabá region, accounting for 37.5% of morbidity and 41.7% of mortality resulting from dengue in the department of Antioquia (Colombia) in 2018. Clinical Practice Guidelines (CPGs) are tools based on Evidence-Based Medicine, intended for medical personnel to bridge the gap between proven intervention efficacy and clinical decision-making. This study aims to identify barriers and facilitators in the implementation of CPGs for dengue patient care by healthcare officials in the municipalities of the banana axis in the Urabá region. From a multifaceted approach to implementation research, a mixed method study that combines qualitative and quantitative approaches, was conducted during the years 2020 and 2021, using combined instruments to identify determinants (Guide Indicative Factors, Individual factors of health professionals, Patient factors, Professional interactions, Incentives and resources, Capacity for organizational change, and lastly Social, political, and legal factors) affecting adherence to the Comprehensive Clinical Care Guide for Patients with Dengue (GACIPD). Semi-structured interviews and focus groups with healthcare workers were conducted to assess determinants based on clinical experience. Questionnaires on determinants of GACIPD adherence, using an adapted version of the Chronic Disease Implementation Checklist (TICD), were also employed. Qualitative analysis of the interviews and focus groups used a concept-based coding framework. The questionnaire responses were analyzed using Likert scaling and frequency counts of determinants within and across domains. Participants included general practitioners, other health professionals, researchers, academics, and administrators. There was a total of 103 participants in focus groups, 7 in semi-structured interviews, and 136 participants through questionnaires. Among the domains studied, the identification of barriers and facilitators emphasized institutional factors and individual factors. Organizational change capacity was identified as a major barrier, with only 3.6% of respondents indicating that their institution adjusted the prioritization of adequate care according to the guideline. The GACIPD domain received the highest facilitator rating, with 66.7% acceptance due to its practicality, simplicity, clarity, documentation, and ease of implementation, despite this, only 10% of professionals completely agree that their work is in accordance with the GACIPD. The determinant of patient factors was significant in the negative perception of adherence to GACIPD. Although barriers outweighed facilitators for GACIPD adherence, determinants for its use were generally positive, as most participants reported it as being a complete, documented, and easy-to-implement guide. The lack of knowledge of the guidelines impacting health professional's decision making was identified as a potentially modifiable barrier, and educational strategies could be implemented to overcome it. The region requires greater emphasis on the management of chronic health conditions, comorbidities, and coinfections of dengue with other endemic diseases.

Obesity and sexual health trends among a large, national sample of men who have sex with men on Grindr in the USA.

Background A growing number of men who have sex with men (MSM) utilise Grindr for seeking relationships and immediate/casual sexual encounters. Grindr and other mobile applications can be a valuable source of information on sociological predictors of health. One topic that is under reported is the use of Grindr by MSM with obesity. We described differences in Grindr use between MSM with and without obesity, and to use Grindr information to reveal trends which may serve as potential predictors of health. Methods Data was collected from 3744 Grindr users (mean age [s.d.], 32.3 years [9.1]) from the largest 50 metropolitan centres in the USA between February and May 2018. Users were divided into two cohorts based on BMI: (1) MSM with obesity (BMI>30), n =253; and (2) MSM without obesity, n =3491. Profile characteristics were compared. Results When evaluating potential predictors for obesity, we found that black/African-American and older MSM were significantly more likely to have obesity. Further, we found that obesity among MSM was significantly inversely associated with the population percent lesbian, gay, bisexual, and transgender (LGBT) within a city. Additionally, we found that MSM with obesity were significantly more likely to indicate interest in immediate sexual encounters. Conclusions These results highlight important trends that may serve as predictors of health in urban settings. Furthermore, our results suggest that MSM with obesity may be more likely to engage in risky sexual behaviours. These findings may be useful in informing providers and healthcare officials on when and how to provide outreach to this unique population.

Diabetic retinopathy detection using supervised and unsupervised deep learning: a review study

The severe progression of Diabetes Mellitus (DM) stands out as one of the most significant concerns for healthcare officials worldwide. Diabetic Retinopathy (DR) is a common complication associated with diabetes, particularly affecting individuals between the ages of 18 and 65. As per the findings of the International Diabetes Federation (IDF) report, 35–60% of individuals suffering from DR possess a diabetes history. DR emerges as a leading cause of worldwide visual impairment. Due to the absence of ophthalmologists worldwide, insufficient health resources, and healthcare services, patients cannot get timely eye screening services. Automated computer-aided detection of DR provides a wide range of potential benefits. In contrast to traditional observer-driven techniques, automatic detection allows for a more objective analysis of numerous images in a shorter time. Moreover, Unsupervised Learning (UL) holds a high potential for image classification in healthcare, particularly regarding explainability and interpretability. Many studies on the detection of DR with both supervised and unsupervised Deep Learning (DL) methodologies are available. Surprisingly, none of the reviews presented thus far have highlighted the potential benefits of both supervised and unsupervised DL methods in Medical Imaging for the detection of DR. After a rigorous selection process, 103 articles were retrieved from four diverse and well-known databases (Web of Science, Scopus, ScienceDirect, and IEEE). This review provides a comprehensive summary of both supervised and unsupervised DL methods applied in DR detection, explaining the significant benefits of both techniques and covering aspects such as datasets, pre-processing, segmentation techniques, and supervised and unsupervised DL methods for detection. The insights from this review will aid academics and researchers in medical imaging to make informed decisions and choose the best practices for DR detection.

Drug Dispensation by ‘Signature Pharmacists’ in South Asia

The phenomenon of ‘signature pharmacists’ in South Asia has allowed allopathic prescription medication to be dispensed without the necessary medical knowledge, specifically of drug interactions, dosages and side effects. This practice, in which qualified pharmacists delegate their professional inputs to often unqualified and unsupervised sales staff, persists due to complicity among pharmacists, other healthcare professionals and regulatory officials. The article discusses the extent of this significant risk to public health in South Asia and argues that pharmacy enforcement and education standards should be reformed to address these huge challenges to ensure consumer protection and the general public’s welfare. While the advice is that regulatory authorities should intensify their supervision and inspection efforts to ensure registered pharmacists actively participate in regular pharmacy operations, the article also identifies predicaments related to corruption that are difficult to tackle.

A Model for the Propagation and Control of Pulmonary Tuberculosis Disease in Kenya

Pulmonary tuberculosis is among the leading infectious diseases causing mortality worldwide. Therefore, scaling up intervention strategies to reduce the spread of infections in the population is imperative. In this paper, a population-based compartmental approach has been employed to formulate a mathematical model of pulmonary tuberculosis that incorporates an asymptomatic infectious population. The model includes asymptomatic infectious individuals since they spread infections incessantly to susceptible populations without being noticed, thus contributing to the high rate of infection transmission. Qualitative and numerical analyses were performed to determine the impact of various intervention strategies on controlling infection transmission in the population. Sensitivity and numerical results indicate that increasing screening of latently infected and asymptomatic infectious individuals reduces infection transmission to the susceptible population. Numerical results demonstrate that the combination of vaccination, screening, and treatment of all forms of pulmonary tuberculosis is the most effective intervention in decreasing infection transmission. Furthermore, a combination of screening and treatment of all forms of pulmonary tuberculosis proves more effective than a combination of vaccination and treatment of symptomatic infectious individuals alone. Treating the symptomatic infectious population alone is identified as the least effective intervention for curtailing infection transmission in the susceptible population. These study findings will guide healthcare officials in making decisions regarding the screening of latently infected and asymptomatic infectious pulmonary tuberculosis patients, thereby aiding in the fight against epidemics of this disease.

Enablers and barriers to rotavirus vaccine coverage in Assam, India- A qualitative study

BackgroundEstimates suggest that 78,000 children died due to rotavirus gastroenteritis annually between 2011 and 2013 in India. The north eastern state of Assam reported 38.4% pediatric diarrheal admissions testing positive for rotavirus. Rotavirus vaccine (RVV) was introduced in Assam in 2017 following which the National Family Health Survey-5 (NFHS-5) (2019) revealed low RVV coverage in Assam with wide variation between the districts. the current study was conceptualized and undertaken to capture the enablers and barriers to RVV coverage in Assam. MethodsQualitative study conducted in 5 randomly selected districts in Assam. Participants (key informants) were recruited by purposive sampling at each level of the health system including healthcare officials, service providers and caregivers based on availability. Thirty-five in-depth interviews (IDIs) and five focus group discussions (FGDs) were conducted. Interviews were tape recorded and transcribed. Data was coded and analyzed using the thematic framework approach. ResultsFindings from the qualitative data collection were collated and analyzed under 7 identified themes. Difficult terrain, limited service provider availability and no catch-up training for new recruits were some of the barriers to RVV coverage. In contrast, Information, Education & Communication (IEC) in vernacular language, RVV safety profile, development partner support and adequate RVV supply were identified as some of the enablers of RVV coverage. ConclusionFew broad recommendations to overcome identified barriers include comprehensive inter-sectoral coordination, regular monitoring and frequent refresher training sessions. There is a need for a future study utilizing existing coverage data and larger sample size to triangulate the findings of this study.

Determinants of health literacy and its impact on glycemic control among women with gestational diabetes mellitus in a tertiary care hospital, Puducherry - A cross-sectional analytical study.

Health literacy is vital during pregnancy, as maternal health knowledge and behavior have a significant impact on the health of both mother and child. Hence, this study aimed to assess the health literacy status of pregnant women diagnosed with gestational diabetes mellitus (GDM), as well as its associated factors and impact on glycemic control. The facility-based Cross-sectional analytical study was conducted among 200 pregnant women with GDM in a tertiary care hospital. The eligible participants were consecutively selected for the study. The study was conducted from September 2022 to March 2023. A validated semi-structured questionnaire, the Health Literacy Questionnaire (HLQ) for GDM, was used to measure health literacy status. Stata V.17 software was used for data analysis. Out of 200 pregnant women with GDM, the mean (SD) age of the participants is 29.5 (±5.5) years. It was observed that 164 (82%) of the participants had adequate health literacy, whereas 36 (18%) had inadequate health literacy about Gestational Diabetes. Adequate health literacy (HL) was observed among 88.5% of women with controlled blood sugar and 55.1% of women with uncontrolled blood sugar. Results of multivariate logistic regression analysis revealed that pregnant mothers' educational status (PR: 1.8; 95% CI: 1.2-2.5) and glycemic control (PR: 1.4; 95% CI (1.2-1.7) were associated with adequate HL. In conclusion, this study supports the association between adequate HL and glycemic control in pregnant women with GDM. Addressing this gap is essential for healthcare officials and planners to implement programs that promote women's HL during pregnancy, with a focus on low-educated groups.

Access to healthcare by undocumented Zimbabwean migrants in post-apartheid South Africa.

Zimbabwean undocumented migrants rely on the South African public health care system for treatment of non-communicable and communicable diseases, surgery and medical emergency services. A gap remains to understand undocumented migrant experiences at a time when accessing public healthcare has been topical in South Africa. This article aimed to describe and understand the experiences, challenges and health-seeking alternatives of undocumented Zimbabwean migrants in accessing healthcare services in Nellmapius in Pretoria. The study was conducted at Nellmapius in Pretoria. A qualitative descriptive research design was used. Structured interviews with 13 undocumented migrants were conducted by applying purposive and snowballing sampling techniques. The data were thematically analysed. Migrants reported that the attitudes by healthcare officials suggest unwillingness to provide services to undocumented migrants, aggravating their vulnerability and perennial illness. Migrants faced challenges of discrimination, a lack of professional service delivery, a lack of financial capacity to pay for services and a lack of documentation evoking health-seeking alternatives. Migrants continue to face challenges while accessing subsidised health care. This study confirms that medical xenophobia is generally present in the public health care centres, at least for the sampled undocumented Zimbabwean migrants. The majority of undocumented migrants cannot afford to pay for private healthcare.Contribution:The findings of this study inform national, provincial and local healthcare facilities to be ethical and provide dignified quality healthcare to undocumented migrants in line with international practices.

Allocating health care resources in jails and prisons during COVID-19: a qualitative study of carceral decision-makers.

COVID-19 created acute demands on health resources in jails and prisons, burdening health care providers and straining capacity. However, little is known about how carceral decision-makers balanced the allocation of scarce resources to optimize access to and quality of care for incarcerated individuals. This study analyzes a national sample of semi-structured interviews with health care and custody officials (n = 32) with decision-making authority in 1 or more carceral facilities during the COVID-19 pandemic. Interviews took place between May and October 2021. We coded transcripts using a directed content analysis approach and analyzed data for emergent themes. Participants reported that facilities distributed personal protective equipment to staff before incarcerated populations due to staff's unique role as potential vectors of COVID-19. The use of testing reflected not only an initial imperative to preserve limited supplies but also more complex decision-making about the value of test results to facility operations. Participants also emphasized the difficulties caused by limited physical space, insufficient staff, and stress from modifying job roles. The rapid onset of COVID-19 confronted decision-makers with unprecedented resource allocation decisions, often with life-or-death consequences. Planning for future resource allocation decisions now may promote more equitable decisions when confronted with a future pandemic event.

Mobilising Communities Prior to Healthcare Interventions: Reflections on the Role of Public Health Midwives Working With Vulnerable Communities of Sri Lanka.

Background: Public health midwives (PHMs) play a frontline role in the Sri Lankan public healthcare system, ensuring the health of children and women at the community level. However, cultural differences in diverse social contexts necessitate PHMs for customised interventions to ensure optimum child and maternal health, particularly in most vulnerable communities.Purpose: The objective of the present study is to explore how PHMs have adapted their roles as community change agents to facilitate community mobilisation before implementing healthcare interventions for children and mothers in the estate sector (a marginalised and vulnerable community) of Sri Lanka.Research Design and methods: Using an exploratory qualitative research design, data were collected through in-depth interviews with 16 participants. The thematic analysis revealed two main themes that describe how PHMs engage in community mobilisation in addition to their designated role as healthcare officials in the estate sector of Sri Lanka.Results: The first theme highlights PHMs'involvement in community mobilisation through context-relevant advocacy for effective service implementation. The second theme illustrates how PHMs'role has been reshaped as advocates to intervene in making the family a supportive institution for child and maternal health. PHMs who work in the estate sector in the country are morally committed to engaging in community mobilisation and advocacy. However, this obligation can be neglected due to the lack of formal arrangements and training in sociocultural determinants of health and working with vulnerable communities.Conclusions: The role of a PHM in the estate sector differs significantly from that in the urban and rural sectors, given the significance of their interventions in family health. Also, community mobilisation is a prerequisite for implementing health policies for child and maternal health in vulnerable communities. Both community-level and family-level advocacy interventions and mobilisation efforts are equally important to establishing a supportive environment, without which any child and maternal healthcare interventions are difficult to implement.

Capacity Assessment of Community Clinic (CC) as an Information and Support Hub during Future Outbreaks: Lessons Learnt from the COVID-19 Outbreak

The study delves into the potential of Community Clinics (CCs) in Bangladesh to function as crucial information and support hubs during pandemics and outbreaks. By examining both internal and external factors, including organizational structure, roles, responsibilities, infrastructure, skills, tools, existing organogram, government policies, and community clinic dynamics, the research assesses the capability of CCs in this role. Through a telephonic survey of 100 Community Health Care Providers (CHCP) and Key Informant Interviews (KII) with Community Based Health Care (CBHC) officials, valuable insights were gained. While the findings reveal that CCs may not be comprehensive treatment centers for pandemics, they can effectively serve as information and support hubs, aligning with their mandates. To enhance their efficiency in this role, upgrading the WASH sensitivity of CCs is recommended, along with other measures to improve their capacity during disease outbreaks. The study underscores the significance of recognizing CCs as vital assets in combating emerging health hazards, and strategic improvements can further strengthen their contributions in addressing public health challenges.&#x0D; The Dhaka University Journal of Earth and Environmental Sciences, Vol. 12(1), 2023, P 41-56

A survey of Psychiatric Disorders and Their Comorbidities in Children and Adolescents

Background: This community-based study aimed to investigate the psychiatric disorders and their comorbidities according to the kind of psychiatric disorders. Frequency of demographic factors and the prevalence of total psychiatric disorders in term of demographic charactheristics were obtained too. Materials and Methods: The present study focused on 1028 children and adolescent aged 6 to 18 years old across the Razavi Khorasan province by random sampling. The subjects included 496 boys and 532 girls from three age groups (6-9 years, 10-14 years and 15-18 years). Eight clinical psychologists trained to complete the Persian version of K-SADS-PL (Kiddie-SADS present and life time version). This scale measures five diagnostic appendixes of psychiatric disorders. Demographic data of participants were collected too. The data were recorded into the SPSS version 16. The relationship between psychiatric disorders and demographic factors deliberate by descriptive analysis and 95% confidence interval. Results: The total rate of psychiatric disorders among children and adolescent was estimated as 20.5%, elimination disorders with a rate of 12.9% was the most prevalent disorder in the subjects. The lowest prevalence belongs to psychotic disorder and bulimia nervosa (0.1%). Of participants with mood disorders about 71.4% have behavioral disorders too. Anxiety disorders also commonly occurred in person with mood disorders. The comparison of ORs and their 95% confidence interval revealed that there is a significant difference for total psychiatric disorder among boys and girls (OR=0.6 for girls; 95% CI: 0.44-0.82). The rate of total psychiatric disorders in rural and urban areas was 14.9% and 21.1% respectively. Conclusion: With attention to the high prevalence of psychiatric disorders among children and adolescents, it’s necessary that healthcare officials pay more attention to reinforcement of mental health care. [GMJ.2020;9:e1714]

Reproductive health challenges during a flood: A qualitative study.

The study aimed to investigate women's reproductive health challenges during floods. This study is qualitative, specifically employing content analysis with an inductive approach. Data were collected through in-depth, semi-structured individual interviews between July and December 2021. The study involved 13 women affected by floods in Golestan province, Aq Qala Township, and also included seven healthcare providers and officials. Before the interviews, informed and written consent was obtained from all participants. The sampling process continued until data saturation was achieved. The analysis of the participants' experiences in this study revealed four main categories of requirements, which were as follows: Maternal and Child Health with four subcategories, Essentials of Women's Health Care with two subcategories, Problems of Relationships with two subcategories, and Aggression and Physical Violence with two subcategories. In conclusion, during floods, women encounter numerous challenges in preserving their reproductive health. Recognizing and understanding these challenges can be instrumental in effectively planning measures to prevent or address them during disasters like floods. Every disaster has unique conditions and challenges. The health requirements of individuals impacted by floods differ from those affected by other natural disasters. By identifying the specific reproductive health needs of women affected by floods, midwives and other healthcare providers can enhance their planning efforts, enabling them to better address and fulfil these needs during such critical situations. Thirteen women were affected by floods, and seven healthcare providers and officials were interviewed.

Acceptance rate of COVID-19 vaccine among healthcare workers: A systematic review and meta-analysis

Background &amp; Aim: Vaccination is the most efficient strategy to tackle the COVID-19 epidemic, and it is important in many ways. Additionally, healthcare workers represent an important vaccine information source for the general population. This systematic review and meta-analysis aimed to evaluate the COVID-19 vaccine acceptance rate among healthcare workers.&#x0D; Methods &amp; Materials: This study was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline, and the protocol of this study was registered in PROSPERO with the registration number CRD42023402082. Searches were conducted up to 20 October 2023 in data resources, including PubMed, Scopus, Web of Science, and Google Scholar. The random-effects model was used for meta-analysis, and the I2 index was used to evaluate heterogeneity among studies. The STATA software (version 14) was used for data analysis.&#x0D; Results: During the initial search, 6132 articles were selected. After the screening, study selection, and quality assessment, 93 studies entered the meta-analysis process, and a total of 196235 healthcare workers were examined. The overall vaccine acceptance rate among healthcare workers was reported as 68.56% (95% confidence interval (CI) =18.7-99.7; I2 = 99.750%; p&lt; 0.001).&#x0D; Conclusion: The overall acceptance rate of the COVID-19 vaccine in healthcare workers was lower than expected. Also, some determining factors were identified. The analysis of the vaccine acceptance rate and the factors affecting it can help healthcare officials and policymakers with proper healthcare planning.

Излечение здравоохранения: исторический опыт старых демократий и уроки для России

Contrary to widespread belief government-run Healthcare was not the first mass affordable solution for medical problems. Governmental healthcare has not caused main breakthroughs in the mortality decrease and significant increase in average life expectancy. Safeguards for private property and ironclad protection of personal rights and liberties caused modern economic growth phenomena, a rise in wealth, and unleashed scientific and technical progress. The rise in wealth and scientific progress were the principal reasons behind progress in medicine. Nowadays huge government spending and poor efficiency make unclear the overall impact of government-run healthcare on public health. The government's Famous attempts to protect drug consumers caused huge costs possibly outweighing their benefits. The foremost public concern ought to be the numerous ethical challenges of the governmental rule in Healthcare, the power usurped by healthcare officials to decide for and instead the patient his fate.

Socioeconomic Factors and their Influence on Suicide Rate: A Multiple Regression Case Study in Washington

Washington State’s suicide rate is 11% higher than the national average, making it one of the top 10 states with the highest suicide rates in the U.S.. Although efforts have been made to address behavioral factors that contribute to suicide risk, little attention has been given to the impact of socioeconomic factors on the mental health of Washington residents. The purpose of the research is to investigate the relationship between socioeconomic status and suicide rates in Washington State. The results of the study can help guide policymakers and healthcare professionals in developing intervention strategies to reduce suicide risk. The suicide rate among Washington residents from 2011-2020 was provided by the 57 vital statistics jurisdictions participating in the Vital Statistics Cooperative Program. Three indicators, including poverty rate, lower than high school graduate rate, and unemployment rate, were chosen to explore the relationship between socioeconomic factors and suicide rate. The data from 57 jurisdictions were analyzed using R, with F tests and multiple linear regressions employed. The multiple R-squared value was 0.7648, indicating that 76.48% of the variation can be explained by the independent variables. These results suggest that poverty and employment rates have a significant positive relationship with suicide rate. However, the relationship between lower educational attainment and suicide rate was not statistically significant. Addressing the issue of rising suicide rates requires a collaborative effort between healthcare officials and policymakers. Policymakers should prioritize promoting job opportunities and providing educational resources to alleviate financial stress and increase access to mental healthcare.

Police officers' perspective on doping and prevention among recreational athletes: a cross-sectional study.

The use of anabolic androgenic steroids among recreational athletes has received growing attention in recent decades. Several countries have implemented bans on doping; however, recreational athletes and other subpopulations continue to use doping substances. Recognizing that the police play a crucial role in preventing the use and dealing of doping substances in Sweden, efforts have been made to intensify police interventions and enhance collaboration with other key actors. This study examined police officers' perceptions of doping as defined in Swedish law, related problems, and suggestions for effective prevention of doping in the society. A cross-sectional survey study was conducted using a web survey of police officers (N = 597). Data were analyzed using descriptive statistics and free-form text responses were analyzed using content analysis. Participant responses to the survey (73.7% response rate) indicated that approximately 62.6% thought that doping is a societal problem, and approximately 26% perceived that the availability of doping substances has increased over the past three years. A total of 95.6% of respondents believed that doping occurred in connection with other crimes such as intimate partner violence (88.2%) and drug-related crimes (88.0%). Further, 96.3% of respondents perceived that it was their duty to prevent doping, but 63.8% indicated that doping-related work was not prioritized within their local police district. Police officers perceived doping as a societal problem and expressed motivation to counteract it, highlighting increased knowledge, legislative changes, intensified doping prevention in gyms, and commitment from other societal actors to increase the effectiveness of doping prevention. Suggestions for increasing the efficiency of doping prevention included education and increased knowledge at all levels in the police organization, intensified prevention efforts at gyms, legislative changes to permit simplified doping test procedures, and breach of secrecy for postal items. There was also a suggestion for further engagement from other actors, such as healthcare workers, school officials, and non-governmental organizations.