Health Professionals Research Articles

The quality of psychosocial health and psychosocial illness among women with and without shelter homes: a cross-sectional study

BackgroundExisting research on the psychosocial wellbeing of sheltered women is primarily from Western contexts, with limited studies from collectivistic cultures like Pakistan. This study aims to compare the psychosocial health and illness of sheltered women in Pakistan with those of women living with their families.MethodsA total of 184 sheltered women and 207 women from the general population from four Pakistani cities participated in this study. Data were collected using two validated instruments: the Psychosocial Health Evaluator and the Sukoon Psychosocial Illness Scale. The study employed independent sample t-tests, simple linear regression and Pearson correlation.ResultsThe study revealed significant differences between women residing in shelters and those in the general population. Sheltered women exhibited lower levels of psychosocial health and higher levels of psychosocial illness. Emotional, sexual, spiritual, and social health were notably lower among sheltered women. Sheltered women also reported elevated levels of psychosocial problems, including emotional, social, and professional difficulties. Additionally, the length of stay in shelters was negatively correlated with psychosocial health and positively correlated with psychosocial illness, while education showed a positive correlation with psychosocial health.ConclusionThe current research highlights the psychosocial vulnerability of women residing in shelter homes. Government, non-governmental organizations, and mental health professionals are advised to work together to uplift the psychosocial health of women residing in Pakistani shelter homes. Appointments of psychological counselors in shelter homes are highly recommended in this regard.

Wearable sensors for cardiological monitoring in the SUS: regulatory challenges and impacts on Brazilian Public Health

Cardiovascular diseases are the leading cause of death in Brazil, with approximately 400,000 deaths annually, which corresponds to almost 30% of all deaths in the country. In addition to the impact on mortality, these conditions generate an enormous economic burden for the health system, with costs associated with the treatment of diseases such as heart attack and heart failure exceeding R$50 billion per year. In this context, the use of wearable devices for continuous monitoring of cardiovascular parameters emerges as an opportunity to improve the management and prevention of these diseases. This study conducts a scoping review of the regulatory challenges involved in the incorporation of wearables into the Unified Health System (SUS), with a focus on cardiological monitoring. Articles published between 2019 and 2024 were analyzed, discussing issues such as data accuracy, interoperability between systems, protection of sensitive data, and training of health professionals. In addition, the study examines the economic and social implications of the adoption of these technologies in a context of profound socioeconomic inequalities. The results indicate that, although wearables have the potential to transform cardiovascular care in Brazil, regulatory and technical barriers still limit their large-scale adoption in the SUS. Adequate regulation, aligned with the General Data Protection Law (LGPD), and investments in infrastructure and training are essential for the safe and effective integration of these technologies into public health.

FAMILY PLANNING AND MENTAL HEALTH IN PRIMARY CARE: NURSES' PERSPECTIVES

Family planning is among the actions in Primary Care that are relevant and impactful in terms of women's quality of life indicators, but the particularities of women with mental disorders are still invisible to health professionals. The study aims to evaluate family planning performed by Primary Care nurses aimed at women with mental disorders. This is a qualitative and cross-sectional study using Alceste Software for content analysis. The results showed that Primary Care nurses who perform family planning have difficulties in managing the program in their routines. When women with mental disorders are highlighted, these difficulties are accentuated, and in many cases, they are not even identified during the care, which remains fragmented in terms of the demand presented, without considering the woman's comprehensiveness. The nurses also pointed out that they feel a lack of matrix support and collaboration from CAPS in implementing the program. We conclude that family planning should have a prominent place in ongoing training and integrate nurses working in Mental Health, to achieve comprehensive care for women, demystifying myths about pathologies and providing quality of life for this population.

Research priorities: Establishing discipline-based education research in prosthetics and orthotics

Background: Education research, as a field of study, is relatively new to the health professions. Research and scholarship in prosthetics and orthotics education is limited, and the priority areas and needs of individuals interested in pursuing this area of research and scholarship are unknown. Objectives: The objectives of this study were to collaboratively identify the areas in which education research in prosthetics and orthotics is needed, to prioritize these areas, and to evaluate the resources needed to support those interested in pursuing education research. Study design: Mixed methods. Methods: The researchers used a participatory action research approach. Focus group sessions were held at the 2022 International Society for Prosthetics and Orthotics (ISPO) Global Educators Meeting. Findings from the focus groups informed creation of a survey that was distributed internationally. The results of this survey were presented to attendees at the 2023 ISPO World Congress for review and ranking. Results: Findings from focus group discussions were used to create a 20-item survey. High priority categories included providing feedback to students, program evaluation, and clinical education and internship. Protected time and funding, faculty development, and program resources were identified as items needed to support faculty in pursuing education research. At the ISPO World Congress, participants highly rated the categories of academic v. clinical practice, program resources, and program evaluation. Conclusions: Many categories were identified as priorities for orthotic and prosthetic education research, and ways to support faculty pursuing this work were highlighted. This study identified opportunities for education researchers to focus their efforts on directly impacting needs of education programs and the profession.

Lived Experiences of Parents of Children Having Type-I Diabetes Aged 6 to 12 Years

Type I diabetes is chronic illness which change the life styles of parents, children as well as the entire family. Parents faced many challenges such as care, management (insulin administration, diabetic diet, blood glucose monitoring) and treatment cost. Objective of the study is to explore lived experience of parents of children having type I diabetes. A qualitative phenomenological study design was adopted, and total eleven parents (8 mothers and 3 fathers) were selected as participants by using non probability purposive sampling procedure. Data was gathered by using in-depth interview. The huge information was reduced to smaller statements by grouping similar responses to get actual meaning which were coded, categorized and organized to sub themes and themes. Findings revealed that parents had experienced so many ups and downs emotional feelings during the journey of treatment. They experienced nature of type I diabetes like treatment need for the whole of life, hardship during diagnosis process, facing the diabetes complications, financial crisis and need for treatment in emergency situation. The study also revealed that parents felt permanent impact from their child’s previous health condition and disruption of family unit but they were hopeful about their children’s future consequences. They struggled for supporting and caring their children’s lives at all times in the best possible ways. They learnt to live with children having Type-I diabetes. Parents suggested to launch awareness programs to educate school teachers, staffs and health worker for early diagnosis.

Prevalence and Factors Associated with the Fourth Standard Antenatal Care Utilization among Pregnant Women Attending Ruli District Hospital, Rwanda

Purpose: The purpose of this research is to identify the prevalence of adherence to the recommended four antenatal care (ANC) visits and to analyze factors associated with achieving the fourth ANC visit among pregnant women attending Ruli District Hospital in Gakenke District, Rwanda. The study aims to address gaps in ANC attendance, focusing on improving maternal and fetal health. Methodology: A cross-sectional study design was used, with a sample size of 421 women, determined through Fisher et al.'s (1998) formula. Systematic sampling was employed to select participants between November 20, 2023, and January 20, 2023. Data collection included informing participants about the study and obtaining consent. Confidentiality was maintained by anonymizing participant data. Analysis was conducted using SPSS version 25, applying descriptive statistics such as percentages, means, and frequencies. Bivariate and multivariate regression analyses were used to identify relationships between independent and dependent variables, with significance assessed at p < 0.05. Findings: The study found that 57.5% of respondents adhered to the four recommended ANC visits, while 42.5% attended fewer than four. Factors significantly associated with increased ANC attendance included higher educational attainment, abstinence from alcohol by both the mother (AOR=1.953, CI: 1.202-3.174, P<0.007) and husband (AOR=2.041, CI: 1.112-3.747, P<0.002), planned pregnancies (AOR=4.159, CI: 1.975-10.326, P<0.001), and absence of mistreatment toward women (AOR=3.040, CI: 1.367-6.762, P=0.006). Unique Contribution to Theory, Practice and Policy: The study recommends enhanced supportive supervision and mentorship of Community Health Workers for home visits to pregnant women. Additionally, improving customer care and the quality of ANC services is advised. These insights are expected to guide policymakers in Rwanda, including the Ministry of Health, Ruli District Hospital, and other stakeholders, in enhancing ANC adherence and improving maternal health outcomes.

The Social Representations of Pornography Consumers Among Individuals in Romantic Relationships: Exploring the Roles of Gender, Relationship Satisfaction, and Sexual Satisfaction in a Romanian Sample

AbstractUnderstanding the psychological conflicts associated with pornography consumption can help professionals tailor their interventions to address the mental health risks faced by individuals struggling with issues related to their pornography use. The main objective of this research was to investigate how pornography consumers are perceived from a social representation theoretical perspective and to examine variations in these perceptions—or social representations—according to gender, relationship satisfaction, and sexual satisfaction. All participants (N = 875 Romanians) were in a romantic relationship at the time of participation. Our results indicated that the social representation of pornography consumers varied significantly depending on gender, sexual satisfaction, and relationship satisfaction. Also, our findings showed a potential psychological conflict in the long run, which can put individuals at risk for self-stigma, guilt, and subsequent mental health consequences. We discuss conclusions from both a theoretical and practical perspective, with a focus on the utility of our conclusions in the clinical practice context of psychologists, psychotherapists, and mental health workers when dealing with issues related to pornography use.

‘On a knife's edge’: medical, police, and legal responses to self‐harming protesters

AbstractTraditional liberal democratic theories of protest can readily account for protest violence against others or their property, and are quick to denounce and criminalize such actions. However, protests that involve self‐harm are harder to frame; they neither engage the harm principle, nor threaten a sovereign state of ostensible peace. Under liberal legalism, capacitous and consenting protesters should not have their rights of expression interfered with in such cases. However, in England and Wales, legal responses to self‐harming violence nevertheless emerge, not necessarily within a public order framework, but through a risk‐averse, medicalized lens. Co‐authored by a legal academic and a practising psychiatrist, this article argues that mental health practitioners, the police, and the courts engage in a ‘paternalistic pivot’ in self‐harming protest cases, which undermines human rights protections that are ordinarily afforded to protesters who are not causing a threat to others or their property.

A Novel Hybrid Model for Automatic Non-Small Cell Lung Cancer Classification Using Histopathological Images

Background/Objectives: Despite recent advances in research, cancer remains a significant public health concern and a leading cause of death. Among all cancer types, lung cancer is the most common cause of cancer-related deaths, with most cases linked to non-small cell lung cancer (NSCLC). Accurate classification of NSCLC subtypes is essential for developing treatment strategies. Medical professionals regard tissue biopsy as the gold standard for the identification of lung cancer subtypes. However, since biopsy images have very high resolutions, manual examination is time-consuming and depends on the pathologist’s expertise. Methods: In this study, we propose a hybrid model to assist pathologists in the classification of NSCLC subtypes from histopathological images. This model processes deep, textural and contextual features obtained by using EfficientNet-B0, local binary pattern (LBP) and vision transformer (ViT) encoder as feature extractors, respectively. In the proposed method, each feature matrix is flattened separately and then combined to form a comprehensive feature vector. The feature vector is given as input to machine learning classifiers to identify the NSCLC subtype. Results: We set up 13 different training scenarios to test 4 different classifiers: support vector machine (SVM), logistic regression (LR), light gradient boosting machine (LightGBM) and extreme gradient boosting (XGBoost). Among these scenarios, we obtained the highest classification accuracy (99.87%) with the combination of EfficientNet-B0 + LBP + ViT Encoder + SVM. The proposed hybrid model significantly enhanced the classification accuracy of NSCLC subtypes. Conclusions: The integration of deep, textural, and contextual features assisted the model in capturing subtle information from the images, thereby reducing the risk of misdiagnosis and facilitating more effective treatment planning.

Holistic approaches to living well with endometriosis

Endometriosis is a common chronic non curable neuro-inflammatory condition, which can cause endometriosis-related pelvic pain (ERPP). Sufferers may struggle with side effects and/or risks from conventional medical and surgical treatments, or not get pain relief. Increasing numbers of endometriosis patients wish to explore holistic management with fewer side effects, however it is important that medical professionals maintain an evidence-based practice for recommended treatments. We present up-to-date evidence of holistic strategies used for managing ERPP including nutrition, body and mind therapies, acupuncture, traditional Chinese medicine (TCM) and the use of adjunct devices such as phallus length reducers and transcutaneous electrical nerve stimulation (TENS). Recent findings: Nutrition: Gluten-free, low-nickel and high intake of omega-3 polyunsaturated fatty acids diets improve ERPP. Low FODMAP (fermentable oligo-, di-, monosaccharides and polyols), plant-based diet and antioxidant vitamin supplementation is helpful including those with concurrent irritable bowel syndrome. Body and Mind: Cognitive behaviour therapy (CBT) is beneficial in postoperative pain reduction, whilst mindfulness has been shown to reduce pain scores and dyschezia. Progressive muscle relaxation therapy and regular yoga sessions improve ERPP and Quality of life. Acupuncture: Acupuncture and moxibustion show improved pain scores compared to conventional therapies alone. Adjunct devices: TENS improves deep dyspareunia and reduces the number of days pain is experienced. Summary: Holistic management strategies for ERPP should be incorporated into routine counselling when discussing conservative, medical and or surgical treatments for endometriosis. The growing evidence presented for the use of holistic management strategies gives hope to those patients who cannot have, or don’t respond to conventional approaches and as an adjunct alongside standard treatments. These findings should be incorporated into the routine counselling when seeing patients in the gynaecology outpatient setting presenting with chronic pelvic pain.

Effective communication by health care workers to promote HPV vaccination: Lessons learned from Kenya, India, and Nigeria

Health care workers play an essential role in maintaining the public trust in vaccination programmes globally, and more specifically, in low- and middle-income countries. This role is particularly important in building trust in the human papillomavirus (HPV) vaccine. While there are many factors that affect HPV vaccine acceptance, health care workers are one of the most critical influences in the decision-making process among parents as well as adolescent girls. In this paper, we sought to better understand how health care workers in a diverse set of countries communicate and promote HPV vaccines. We summarize communication approaches and lessons learned by health care workers in Kenya, India, and Nigeria through a case study approach. In Kenya, the utilization of a multisectoral approach proved to be very important. In India, intense social mobilization with targeted messaging by target audience laid the groundwork for community acceptance. An evolving communication strategy was essential in Nigeria, where there is no national HPV vaccination programme. Given the increase in vaccine hesitancy globally, the lessons learned through these three country examples highlight the importance of communication efforts in increasing vaccine acceptance.

Association Between Workplace Violence and Post-Traumatic Stress Disorder Among Healthcare Workers in China, 2020 to 2023.

This is the first study in China to investigate the prevalence of workplace violence (WPV) and its long-term association with post-traumatic stress disorder (PTSD) among healthcare workers. Conducted across various time points from March 27, 2020, to April 10, 2023, the research employed a four-wave repeated cross-sectional design involving 14,993 healthcare workers from 32 provincial administrative regions across the country. Nurses accounted for 34.3% of the sample, while doctors accounted for 65.7% of the sample, with a higher concentration in western China. Multivariate logistic regression analysis was employed to identify the risk factors for WPV, and hierarchical logistic regression models were used to examine the association between PTSD and WPV. The findings revealed that 71.4% of healthcare workers reported experiencing or witnessing WPV, with nearly half (47.5%) indicating exposure to violent incidents within the past year. Further analysis revealed significant associations between WPV incidence and various factors, including age, gender, work experience, work setting, and a history of contact with Coronavirus Disease 2019 (COVID-19) patients (the odds ratio [OR] of these influencing factors ranged from 1.10 to 2.03. All the p-values were less than .05). 28.5% of healthcare workers displayed symptoms of PTSD, with WPV identified as a major risk factor contributing to these symptoms (lifetime WPV: OR = 1.61, 95% CI [1.47-1.76]; 1-year WPV: OR = 1.75 [1.61-1.90]). Therefore, it is imperative to prioritize the mental health of healthcare workers and implement effective measures to prevent and mitigate WPV, ensuring their physical and psychological well-being as well as occupational safety.

Patterns of handwashing among healthcare workers in APIN Public Health initiatives supported states in Southwest Nigeria

BackgroundEffective hand hygiene is crucial for preventing healthcare-associated infections (HAIs) among healthcare workers (HCWs) and patients. This study aimed to assess handwashing practices among HCWs providing routine HIV care to People Living with HIV (PLHIV) and to compare hand hygiene patterns among clinical and non-clinical health workers in APIN Public Health Initiatives-supported states in Southwest Nigeria.MethodsA cross-sectional study was conducted among HCWs providing routine HIV care to PLHIV in selected healthcare facilities across APIN-supported states (Oyo, Ogun, and Ondo) from January to June 2024. Data on handwashing patterns and compliance factors were collected using a semi-structured questionnaire. A total of 588 respondents were recruited using multi-stage stratified cluster sampling. Descriptive analysis was performed, hand hygiene patterns among clinical and non-clinical health workers were compared, and chi-square statistics determined the associations, with a p-value of < 0.05 considered significant.ResultsThe study found that 56.5% of participants had good awareness of handwashing practices, and 54.6% demonstrated good compliance. Additionally, 65.5% reported washing hands before and after routine activities. Handwashing awareness (60.3%) and compliance (60.5%) rates were highest among clinical professionals. Major barriers to handwashing included inadequate water supply, lack of materials, being too busy, and forgetfulness. Profession was significantly associated with hand hygiene awareness (odds ratio [OR] = 1.504, confidence interval [CI] = 1.075–2.104), while age (OR = 0.613, CI = 0.442–0.851) and profession (OR = 1.888, CI = 1.347–2.645) were significantly associated with compliance.ConclusionThe study highlights suboptimal handwashing practices among healthcare workers, with non-clinical workers demonstrating lower awareness and compliance to hand hygiene standards compared to clinical staff despite working in the same environment. Therefore, future tailored training sessions and interventions should be prioritized for non-clinical health workers.

Factors affecting healthcare workers burnout and their conceptual models: scoping review

BackgroundThe occupational stress that contributes to the development of burnout syndrome remains one of the greatest scientific challenges. Despite years of research into burnout and its determinants, burnout continues to attract the attention of researchers, and healthcare workers (HCWs) continue to experience burnout in large numbers. Burnout has a significant impact on both the mental and physical well-being of HCWs and reduces patient-centered healthcare. This review aims to identify the factors affecting healthcare workers’ burnout (FAHCWB) and their conceptual models.MethodsThe review was conducted according to Arksey and O'Malley's framework using Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Searches were conducted in PubMed, Scopus, Wiley, ProQuest, Sage, Science Direct, and EBSCO using the following keywords: healthcare professionals, burnout, and internal/external factors. Empirical, qualitative, quantitative, and mixed-design research articles published in English with full-text access in peer-reviewed journals that investigated the FAHCWB were included. For an in-depth analysis of the included articles, the authors developed a data synthesis table, and thematic analysis was applied to the analysis.ResultsAccording to the inclusion criteria, 38 articles were selected for further data analysis. Six main themes were identified: (1) FAHCWB; (2) conceptual models of FAHCWB; (3) research tools for studying FAHCWB; (4) findings on FAHCWB in the context of different models; (5) differences between findings from different models; (6) what is known and not known about FAHCWB. The results of the review show that most researchers conduct research on factors affecting burnout (FAB) based on factors related to the work environment, with fewer studies based on individual factors, including personality factors. Most of the research is based on the model developed by Maslach et al. The Maslach Burnout Inventory (MBI) has been used in most studies.ConclusionsDespite years of research, burnout continues to evolve rapidly, indicating that scientific research needs to be re-focused. Research should be conducted using different conceptual models and new research tools that allow the syndrome to be studied from a multidimensional perspective, including both the work environment and individual factors.

Therapeutic resources used by traditional communities of the Brazilian Amazon: a scoping review.

The traditional communities of the Brazilian Amazon possess significant knowledge regarding the huge therapeutic arsenal available from natural sources that can be used to care for their health problems. This study aimed to identify, map and synthesize the scientific evidence on the use of traditional medicine as a therapeutic resource when used by traditional communities of the Brazilian Amazon. This is a scoping review, which is a method used to map the main concepts of a research area, the available evidence and its sources. It is developed in five steps: (1) identification of the research question; (2) identification of relevant studies; (3) selection of studies; (4) data analysis; and (5) grouping, synthesis and presentation of data. Medicinal plants, vertebrates and invertebrates, among other medicinal products, are elements that are widely used by traditional populations. Plant stems, bark, leaves, flowers, fruits, seeds, roots, tubers and even the whole plant are prepared in various forms, such as teas, infusions, smoke for rituals, baths, macerations, oils, ointments, concoctions, dressings, incenses and exfoliants, among others. The main structures and forms used from animals are lards, fats, viscera, horns, cocoons, nests, feathers and beaks of birds, eggs and roes. These therapeutic practices are often carried out using endogenous, wild and domesticated natural resources present in the biodiverse environments of traditional populations. They involve magical-religious beliefs to treat all types of illnesses, including cultural syndromes that affect children, young people, adults and the elderly. This scoping review has an important role to disseminate and expand the discussion of traditional medicine practices, inviting readers - whether they are health professionals, community members, managers or decision-makers - to a continuing debate using an intercultural dialogue necessary to improve approaches. From this perspective, it is essential to consider the comprehensive legal and legal framework that guides the public policies of national health systems.

The effectiveness of immersive virtual reality applications (human anatomy) on self-directed learning competencies among undergraduate nursing students: A cross-sectional study.

Technological developments have significantly impacted various aspects of life, most notably healthcare and education. A nursing education shift was required to prepare digital generation. Consequently, nurse educators must adopt innovative approaches to teaching and learning, like incorporating immersive virtual reality (VR) into human anatomy courses to improve students' learning. To examine the influence of immersive VR applications (human anatomy) on self-directed learning (SDL) competencies among undergraduate nursing students. A cross-sectional design was conducted in the health profession's faculty at Al-Quds University among the first year of the nursing program, who were enrolled in an anatomy course (N = 137). The Self-Directed Learning Instrument was used, and independent sample t-tests were conducted to compare the level of SDL among students who utilized the VR application (Human Anatomy VR). The results showed that 93.9% of the total were approximately 20 years old, and 85.4% were females. 90.5% of participants expressed satisfaction with using the VR application and that it would be beneficial in nursing courses. The average score of SDL for the whole group was 72.03 ± 13.07, and there is a positive significant relationship between SDL and students utilizing VR (p < 0.001), between SDL competencies and technological skills (p = 0.009), and type of digital tools (p = 0.049). The highest coefficient of correlation was related to planning and self-monitoring (r = 0.918), and the lowest was related to interpersonal communications (r = 0.865). VR is an additional tool for enhancing learning, and nursing students perceive immersive VR technologies positively and prefer using three-dimensional images in their anatomy courses. SDL assists students in identifying learning objectives, barriers, and outcomes through using VR technologies as teaching strategies.

Relationship between sexual dysfunction and burnout among physicians in primary hospital: a cross-sectional study.

The relationship between sexual dysfunction and burnout among physicians remains unclear. To investigate the frequency of sexual dysfunction among physicians in primary hospital and explore the association between sexual dysfunction and burnout. This study was a cross-sectional survey conducted through a questionnaire. We used the Arizona Sexual Experience Scale and the Chinese version of the Maslach Burnout Inventory-Human Service Survey to assess sexual function and burnout among physicians in primary hospital. Considering the working environment of physicians, we also evaluated the doctor-patient relationship and sleep quality. Over one-third of physicians experience sexual dysfunction. Burnout is a significant factor to sexual dysfunction among medical professionals. A total of 382 doctors participated in this survey, and the prevalence of sexual dysfunction was 33.51%. Sexual arousal and orgasm were the main sexual dysfunctions faced by male and female doctors, respectively. The prevalence of burnout among physicians was 43.72%. The prevalence of sexual dysfunction among physicians experiencing burnout (45.51%) was higher than that observed in physicians without burnout (24.19%). Physicians with burnout exhibited significantly higher total and individual scores on the Arizona Sexual Experience Scale as compared with physicians without burnout (all P values <.05). There was a significant positive correlation between depersonalization and sexual drive (r = 0.508, P < .001), sexual arousal (r = 0.521, P < .001), lubrication (r = 0.432, P < .001), orgasm/erection (r = 0.420, P < .001), and sexual satisfaction (r = 0.434, P < .001). Logistic regression analysis confirmed that-in addition to burnout-older age, dissatisfaction with income, a poor doctor-patient relationship, and poor sleep were significant contributors to sexual dysfunction among physicians in primary hospitals. Sexual health is an integral aspect of well-being. Prioritizing the sexual health of medical professionals can significantly contribute to improving their productivity. First, our sample size was small, and the impact of different specialties on sexual functioning was somewhat overlooked. Second, we lacked laboratory data (eg, testosterone and prolactin levels) that could provide substantial support to sexual identification. Finally, although we used logistic regression to establish causality, the relationship between sexual dysfunction and certain factors may be bidirectional. The issue of sexual dysfunction among doctors needs more attention. We should make targeted efforts to improve the quality of physicians' sexual lives.

25-year experience of surgical treatment of thyroid diseases in a multidisciplinary hospital

BACKGROUND: Every year there is an increase in the number of patients with thyroid diseases, thus improving surgical treatment methods with decreased traumatic effect and postoperative complications, remains relevant. AIM: To summarize the results of 25-year work of the team (surgeons and endocrinologists) of specialists from the multidisciplinary hospital of Saint Petersburg and the departments of the North-Western State medical university named after I.I. Mechnikov on the diagnosis and treatment of patients with surgical pathology of the thyroid gland. MATERIALS AND METHODS: The results of surgical treatment of 3977 patients with thyroid diseases operated accoding to the traditional Kocher approach, asymmetric “floating” mini-approach and video-assisted mini-approach were analyzed. RESULTS: In the analyzed time period, a rapid increase in the number of minimally invasive techniques for surgical operations on the thyroid gland is characteristic, which are used for nodular euthyroid goiter, multi-nodular euthyroid goiter and toxic thyroid adenoma. With the help of traditional approach, surgical intervention was performed mainly for diffuse toxic goiter and multinodular toxic goiter. The introduction of new techniques and approaches in the provision of medical care to patients with surgical diseases of the thyroid gland can significantly improve the results of treatment. CONCLUSIONS: 25-year experience of the endocrinological center of the Elizabethan Hospital demonstrates that collaboration of departments and doctors of a multidisciplinary hospital allows to introduce new approaches to treating surgical thyroid diseases and improve its results without increasing the number of postoperative complications.

Perceptions of healthcare finance and system quality among Nigerian healthcare workers

Perceptions of healthcare finance and system quality among Nigerian healthcare workers

The impact of COVID-19 on routine child immunisation in South Africa

BackgroundThe COVID-19 pandemic disrupted immunisation programs worldwide, reversing gains that had brought vaccine-preventable diseases largely under control. This study explored the impact of COVID-19 on the uptake of routine child immunisation services in South Africa.MethodsWe conducted qualitative research using in-depth interviews with 51 purposively selected parents/caregivers of children below the age of five who missed or delayed one or more scheduled immunisation doses in 2020–2022 and with 12 healthcare providers who provided public immunisation services during the pandemic.ResultsDuring the pandemic lockdowns, most caregivers perceived the risk of their child being infected with COVID-19 during a clinic visit as more salient than the risk of missing immunisation doses. Caregivers reported minimal exposure to routine immunisation communication, as well as shortages of routine vaccines for children at public health facilities, healthcare workers experienced anxiety and burnout. There was a post-pandemic shift to more active decision-making about immunisation, which had previously been an almost automatic behaviour, leading some caregivers to delay vaccinating their children. There was also evidence of a “bad vaccine” mental model among some caregivers regarding COVID vaccinations, which could lead to doubts about the safety of routine childhood vaccinations.DiscussionThe shift from default to active decision-making highlights a risk that routine immunisation will backslide in future pandemics. Governments should build resilient health systems at all levels and communicate clearly about the benefits and availability of RIs and the safety of vaccinations in general, alongside supply-side interventions.ConclusionRoutine immunisation is widely accepted in South Africa, driven by generational norms and provider recommendations. During the COVID-19 pandemic, many caregivers faced the dilemma of balancing COVID-19 exposure risk with the risk of their child developing a deadly VPD, leading to missed RI visits. This shift to active decision-making highlights a future pandemic risk. Governments should build resilient health systems and focus on understanding and engaging procrastinating and doubtful caregivers. Clear communication about RI benefits and vaccine safety is crucial, as misinformation can lead to distrust in new vaccines.