Health Professionals Research Articles

Geographical health inequalities in India: the impact of the COVID-19 pandemic on healthcare access and healthcare inequality.

With an emphasis on spatial health disparities, this study examines how COVID-19 has affected healthcare access and inequality in India. The study developed the Healthcare Access Index (HAI) and Healthcare Inequality Index (HII) to assess the pandemic's effects on healthcare. The study addresses spatial health disparities in healthcare access and inequality, filling gaps in the literature. The final aim of the study is to offer policy suggestions to lessen healthcare inequities in India, particularly in the context of COVID-19. The study incorporates secondary data from publicly accessible databases such as the National Family Health Survey, Niti-Ayog and Indian Census databases and employs a quantitative research design. The impact of the COVID-19 pandemic on healthcare access and healthcare inequality in India is examined using the HAI and the HII. The five dimensions of healthcare access - availability, accessibility, accommodation, cost and acceptability - were used in developing the HAI. The study uses a panel data analysis methodology to examine the HAI and HII scores for 19 states over the pre-COVID-19 (2015) and post-COVID-19 (2020) periods. In order to investigate the connection between healthcare access, healthcare inequality and the COVID-19 pandemic, the analysis employs statistical tests such as descriptive statistics, correlation analysis, factor analysis and visualization analysis. According to the study, COVID-19 impacted healthcare access and inequality in India, with notable regional inequalities between states. The pandemic has increased healthcare disparities by widening the gap between states with high and low HII ratings. Healthcare access is closely tied to healthcare inequality, with lower levels of access being associated with more significant levels of inequality. The report advises governmental initiatives to lessen healthcare disparities in India, such as raising healthcare spending, strengthening healthcare services in underperforming states and enhancing healthcare infrastructure. For Indian healthcare authorities and practitioners, the study has significant ramifications. In light of the COVID-19 pandemic, there has been a main focus on addressing geographic gaps in healthcare access and inequality. The report suggests upgrading transportation infrastructure, lowering out-of-pocket costs, increasing health insurance coverage and enhancing healthcare infrastructure and services in underperforming states. The HAI and the HII are tools that policymakers can use to identify states needing immediate attention and appropriately spend resources. These doable recommendations provide a framework for lowering healthcare disparities in India and enhancing healthcare outcomes for all communities. The study's originality resides in establishing the HAI and HII indices, using panel data analysis and assessing healthcare inequality regarding geographic disparities. Policy choices targeted at lowering healthcare disparities and enhancing healthcare outcomes for all people in India can be informed by the study's practical consequences.

Hospital nurses and physicians’ experiences practicing patient safety work to recognize deteriorating patients: a qualitative study

Abstract Background Measures to increase patient safety work aim to prevent patient harm and injuries in hospitals and are a priority worldwide. Several hospitals have implemented various rapid response systems to strengthen patient safety. Knowledge is limited concerning how health professionals interact and how they experience competence development and master emergency situations. The aim of the study was to explore and describe hospital nurses’ and physicians’ experiences with patient safety work, and the implications of this work for collaboration and competence in a hospital. Methods We used a qualitative descriptive design and interviewed 21 nurses and physicians from a hospital in Norway. Data were analysed with systematic text condensation, a four-step thematic cross-case analysis. The study adheres to the COREQ guidelines for conducting qualitative research. Results Through analysis, three categories were identified: strengthening a common clinical language for patient deterioration; sharing and transferring competencies across hospital wards and amongst professionals; and balancing time pressure and limited resources. The results showed that the patient safety work contributed to building bridges between health professionals and across hospital levels regarding deteriorating patients. It also provided structure and systematization to the hospital professionals’ work with deteriorating patients. However, the results also demonstrated the complexity of maintaining patient safety, pointing to the need to balance limited time and resources in hospital. Conclusions The patient safety work presumably provides better emergency care, which may enhance patient safety in hospital. The complexity of hospital work, however, can influence the patient safety performance negatively, requiring health professionals to adopt robust, up-to-date skills and competencies in observing and assessing patient deterioration. In a busy hospital setting, the ability of health professionals to collaborate and communicate is important as they are faced with the challenges of balancing time-pressure and limited resources, which can potentially compromise patient safety work.

Gambaran Faktor Risiko Kejadian Stunting pada Ibu dengan Anak Balita Stunting di Wilayah Kerja Puskesmas Baregbeg

Stunting is one of the main nutritional issues that Indonesian toddlers face. The prevalence of stunting in toddlers (children under five years old) was 30.8% in 2018, according to the Basic Health Research (Riskesdas) results. This dropped to 27.67% in 2019 (Indonesian Nutrition Status Survey (SSGI), 2019), and then increased to 24.4% in 2021 (SSGI, 2021). The purpose of this study is to identify the risk factors for stunting in women in the Ciamis Regency working area of the Baregbeg Community Health Center who have stunted children under five in 2024. Descriptive research using a cross-sectional design was the methodology employed. Using a questionnaire, the study's population composed of all the mothers of 36 kids with stunting in the Baregbeg Health Center's working area. The majority of stunted toddlers had a history of exclusive breastfeeding (80.56%), middle class mothers in a middle educational level (55.56%), low parental income (86.11%), low birth weight babies (86.11%), infectious diarrheal diseases (86.11%), poor diet (77.78%), and an unvarried diet (88.88%), based to the research's results. To help to prevent potential problems with the child's growth and development, it is advised that moms of stunted children give their children greater care.

Perceived work-related stress and associated factors among the surgical workforce in a Nigerian tertiary health facility: A cross-sectional study

Healthcare workers continue to experience high levels of work-related stress which continue to negatively affect their psychological, physical, and emotional well-being. This is even more prevalent among healthcare workers who work in surgical specialities, with the surgical operation room becoming a known stressor at hospitals. This study aims to assess work-related stress among surgical team members at Ahmadu Bello University Teaching Hospital in Zaria between January 2021–2022. Data analysis involved descriptive and inferential statistical approaches using the Statistical Package for Social Science (SPSS) version 23.0. The study found an overall high prevalence of work-related stress, with 65% of participants reporting moderate levels of stress. The majority of the participants have a mean age of 39.4 ± 7.8 years, most of them being physicians (66.3%), being males (59.9%), and identified with a Hausa ethnic tribe. Notably, the multiple regression analysis found that tribe (p = 0.008), professional cadres (p = 0.001) and age/years of experience (p = 0.0035) emerged as significant predictors of work-related stress. Key determinants of work-related stress among surgical team members include workload, complexity of work, and conflicting cognitive job demands that continue to subject professionals to increasing workloads and constant decision-making about their job. Organizational factors, such as job policy and procedure, communication problems, and the nature of facilities, were identified as the highest contributors to work-related stress in organizational, interpersonal, and physical/environmental dimensions. The findings lead to the conclusion that a considerable proportion of surgical team members experience a relatively high level of work-related stress, primarily attributed to workload and cognitive demands. In light of these results, urgent efforts are recommended to improve the working conditions and environment for surgical team members. Furthermore, the integration of stress management measures into the educational programs for the surgical team is emphasized to effectively address and mitigate the impact of work-related stress.

Crimean-Congo haemorrhagic fever among healthcare workers in Iran 2000–2023, a report of National Reference Laboratory

Crimean-Congo haemorrhagic fever among healthcare workers in Iran 2000–2023, a report of National Reference Laboratory

When, where and how should we assess professionalism in undergraduate medical education? Practical tips from an international conference roundtable discussion

The assessment of professionalism in healthcare disciplines is a challenging and nuanced topic in medical education. The literature, although continually emerging, remains in its infancy in regards to the role of the assessment of professionalism, appropriate timing for assessment, methods to assess professionalism and the benefits and implications of assessment of professionalism. With emergence of healthcare professionalism in both undergraduate and postgraduate curricula and increasing awareness of professionalism’s pertinent role in developing as a healthcare practitioner, the concept of assessing this topic is being discussed regularly in international fora, but as yet there is no consensus decision in how best to proceed. The authors have over a decade of experience researching, promoting and delivering healthcare professionalism education. They presented a roundtable discussion to an international panel of medical educators at an international conference. The attendees represented multiple healthcare disciplines. Breakout rooms and pre-determined introductory questions were used to explore the international consensus on current thinking about assessment in healthcare professionalism. This paper presents these findings as practical tips for educators who are considering introducing or extending their assessment of undergraduate professionalism, all of which were taken from the main themes of the discussion. The aim of the paper is to support educators to think about their stance on this often divisive issue, consider their approaches and focus future research to clarify the remaining unknowns.

End-user participation in drinking water management through Awareness, Education, and Resources: tools for Water Partnerships

ABSTRACT The long-term success of safely managed drinking water systems requires participation from many stakeholders, especially the water users, but also community leaders, technical experts, health practitioners, teachers, NGOs, and others. However, people may need to be empowered before they can be confident or able to contribute to meaningful decision making or governance roles in Water Partnerships. Discussions with water leaders from nine organizations on four continents revealed surprisingly a similar three-step approach to empowering end-user participation in water management. The first step is creating the Awareness of local water challenges and their impact on health. The second step is Education about the options for safe water. Together, Awareness + Education lead to people understanding their challenges and being able to devise a locally appropriate solution. The third step is Resources for water action. Through Awareness, Education, and Resources, water stakeholders including households can be empowered to participate in safely managing drinking water solutions.

INdependenT prEscribinG in community phaRmAcy; whaT works for whom, why and in what circumstancEs (INTEGRATE): Realist review study protocol

Introduction The last decades have witnessed a series of initiatives in the United Kingdom (UK) to enhance patient access to quality care including access to medicine without compromising patient’s safety. Pharmacist independent prescribing is one of the initiatives introduced in 2006 with the intention of making more effective use of the skills and competencies of health professionals. Community pharmacy has a key role in the NHS long-term plan since pharmacies offer convenient and accessible sources of healthcare advice for the public. This role is more evident with the introduction of prescribing for all qualified pharmacists at the point of registration starting 2026. This realist review aims to explore how does independent prescribing in community pharmacy works, for whom, in what circumstances and how. Method and analysis Realist research seeks to explore and explain complex social interventions by utilising programme theories providing causal explanations of outcomes in terms of context-mechanism-outcome configurations. INTEGRATE will progress through six stages. In the first stage, we will partner with Patient, Public, Involvement and Engagement Group (PPIE) and Practitioner Stakeholder Group (SG), to further scrutinise the review’s focus. In stage 2, we will develop initial programme theories for what makes independent prescribing effective in community pharmacy, for whom, in what circumstances and how. In the third stage, we will conduct literature searches to gather secondary data that will help refine our initial programme theories. In stage 4, we will select and appraise identified articles by screening titles, abstracts and full texts against inclusion and exclusion criteria. In stage 5, we will extract, document and code relevant data, followed by realist analysis with contributions from the PPIE and SG. Stage 6 focuses on refining programme theories and identifying key mechanisms that lead to desired outcomes. PROSPERO registration: CRD42023468451

The effectiveness of diabetes training of psychiatric health professionals on individuals with diabetes and psychiatric disorders – a pragmatic controlled trial in Denmark

The effectiveness of diabetes training of psychiatric health professionals on individuals with diabetes and psychiatric disorders – a pragmatic controlled trial in Denmark

Stakeholders’ perspectives on competency-based education program in Africa: A qualitative study

Background: Competency-based education (CBE) is adopted to reform health professionals’ education. The goal is to produce graduates who are not only competent in their fields but also equipped with the necessary social accountability skills for safe practice.Aim: The study aimed to explore nursing education stakeholders’ perspectives on competency-based primary healthcare (PHC)-oriented nursing education programmes in the South African context.Setting: The setting for this study was a higher education institution in South Africa.Methods: A descriptive qualitative method was used in this study. After taking ethical clearance from the university ethics committee, data were purposively collected and theoretically sampled from 40 participants through focus group discussion, individual interviews and document analysis.Results: The data findings reported categories that emerged from this study, which include the attributes of a competency-based PHC-oriented programme and the outcomes of a competency-based PHC-oriented programme.Conclusion: In the context of this study, the concept of CBE was portrayed as a programme with strong social accountability that aims at addressing priority health needs surrounding communities and ensuring that the health needs of the community are met while providing health delivery service to communities in their natural environment.Contribution: These findings add to the growing evidence base around CBE as an approach to strengthen PHC-oriented health services in low- and middle-income countries, a key aspect of which is providing service within communities. This enables the accessibility of quality healthcare closer to where people live and work to achieve Sustainable Development Goal number three.

Clinical laboratory shadowing- an elective program in undergraduate health professions training: perception, strengths and challenges

Abstract Background The authors aim to evaluate the perception, strengths, and challenges in the implementation of “Clinical Laboratory Shadowing” as an elective module for third-year professional medical students. Methods Clinical Laboratory shadowing is an elective module designed by the faculty of Biochemistry for Phase III part-2 medical students. The elective comprises modules explaining the functioning of the Biochemistry Laboratory in a hospital. The students are provided insights into the different processes involved in laboratory testing. They are taught about total quality management of the Biochemistry Laboratory. Thirteen students from Batch 2019 and eight students from Batch 2020 volunteered to attend the elective. Students’ feedback regarding the learning was analyzed with the help of a questionnaire. Pre-test and post-test questions were evaluated to test the knowledge gained during the elective. Two focus group discussions were conducted regarding the benefits and areas for improvement for the elective. Results Following the elective module there was a significant improvement in the test score compared to baseline. A majority (84–95%) of students perceived that the shadowing elective was well planned, and materials were well prepared, there was appropriate engagement with the facilitators, gained knowledge on the principles of total quality management, good laboratory practices, disease process, and diagnosis. Most (53–74%) of the students felt that this elective was not monotonous and not difficult. Around 84–95% of students felt that this elective module enhanced the importance of interprofessional communication and teamwork. Moreover, through focused group discussions, several recurring themes emerged. Among these, the scope for improvement within the module is profound. The faculties were of the opinion that the shift from conventional training to competency-based learning was effectively embraced by the students, underscoring the importance of consistent small group activities in the module to enhance the skills of Good laboratory practices. The students expressed a desire for additional clinical correlation and interpretation classes in the elective module, showing their preference for student-centred clinically oriented learning. Conclusion The current study concludes that including an elective module on Clinical laboratory shadowing is an overall positive experience for medical students in enhancing their knowledge of basic sciences and application of the concepts in diagnosing cases. This elective may be desirable to adopt in other medical colleges in India.

Effectiveness of the Support From Community Health Workers and Health Care Professionals on the Sustained Use of Wearable Monitoring Devices Among Community-Dwelling Older Adults: Feasibility Randomized Controlled Trial

Background The wearable monitoring device (WMD) is emerging as a promising tool for community-dwelling older adults to monitor personal health, enhance awareness of their activities, and promote healthy behaviors. However, the sustained use of WMDs among this population remains a significant challenge. Objective This study aims to implement an interventional program that promotes and motivates the continued use of WMDs among older adults through a peer and professional support approach. This program will facilitate the integration of WMDs into their daily lives. Methods This feasibility trial examined the following: (1) the usability of the WMD from the users’ perspectives; (2) the feasibility of the Live With Wearable Monitoring Device program; and (3) the effectiveness of the Live With Wearable Monitoring Device program among community-dwelling older adults. The intervention, based on Self-Determination Theory, involved using the Live With Wearable Monitoring Device program over a 3-month period, with ongoing professional and peer support provided by community health workers, aided by a nurse and social workers. This support included 1 home visit and biweekly communication via WhatsApp. Data were collected at baseline and at 1, 3, and 6 months. Results A total of 39 participants were enrolled in the intervention group, while 37 participants were in the control group. The recruitment rate was high (76/89, 85%), and the attrition rate was low (8/76, 11%), indicating that the program is feasible for older adults. Participants in the intervention group exhibited higher self-efficacy, lower anxiety levels, and used the smartwatch more frequently, in terms of both days and hours, compared with the control group. A between-group difference was observed in self-efficacy between the intervention and control groups (β=3.31, 95% CI 0.36-6.25, P=.03), with statistically significant higher mean values recorded at all 4 time points. Conclusions It is clear that merely providing a WMD to older adults does not guarantee its usage, particularly for those unfamiliar with how to utilize its health-related functions in their daily routines. This study implemented a theory-based program aimed at enhancing the ongoing use of WMDs among older adults, suggesting that continuous professional and peer support may significantly influence WMD usage. Trial Registration ClinicalTrials.gov NCT05269303; https://clinicaltrials.gov/ct2/show/NCT05269303

Reducing stigma and improving access to care for people with mental health conditions in the community: protocol for a multi-site feasibility intervention study (Indigo-Local)

Abstract Background Stigma and discrimination towards people with mental health conditions by their communities are common worldwide. This can result in a range of negative outcomes for affected persons, including poor access to health care. However, evidence is still patchy from low- and middle-income countries (LMICs) on affordable, community-based interventions to reduce mental health-related stigma and to improve access to mental health care. Methods This study aims to conduct a feasibility (proof-of-principle) pilot study that involves developing, implementing and evaluating a community-based, multi-component, awareness-raising intervention (titled Indigo-Local), designed to reduce stigma and discrimination and to increase referrals of people with mental health conditions for assessment and treatment. It is being piloted in seven sites in five LMICs—China, Ethiopia, India, Nepal and Tunisia—and includes several key components: a stakeholder group workshop; a stepped training programme (using a ‘Training of Trainers’ approach) of community health workers (or similar cadres of workers) and service users that includes repeated supervision and booster sessions; community engagement activities; and a media campaign. Social contact and service user involvement are instrumental to all components. The intervention is being evaluated through a mixed-methods pre-post study design that involves quantitative assessment of stigma outcomes measuring knowledge, attitudes and (discriminatory) behaviour; quantitative evaluation of mental health service utilization rates (optional, where feasible in sites); qualitative exploration of the potential effectiveness and impact of the Indigo-Local intervention; a process evaluation; implementation evaluation; and an evaluation of implementation costs. Discussion The output of this study will be a contextually adapted, evidence-based intervention to reduce mental health-related stigma in local communities in five LMICs to achieve improved access to healthcare. We will have replicable models of how to involve people with lived experience as an integral part of the intervention and will produce knowledge of how intervention content and implementation strategies vary across settings. The intervention and its delivery will be refined to be feasible and ready for larger-scale implementation and evaluation. This study thereby has the potential to make an important contribution to the evidence base on what works to reduce mental health-related stigma and discrimination and improve access to health care.

Prevention and Treatment of Glucocorticoid-Induced Osteoporosis in adults: Recommendations From the European Calcified Tissue Society

Abstract Introduction This report presents the recommendations of the European Calcified Tissue Society (ECTS) for the prevention and treatment of glucocorticoid-induced osteoporosis (GIOP) in adults. Our starting point was that the recommendations be evidence based, focused on non-bone specialists who treat patients with GC and broadly supported by ECTS. Methods The recommendations were developed by global experts. After a comprehensive review of the literature, twenty-five recommendations were formulated, based on quality evidence. For stratifying fracture risk and the most appropriate first line of treatment, we have classified patients into 3 categories: those at medium risk of fractures i.e. adults without a recent (in the last 2 years) history of fracture, those at high risk of fractures i.e. adults with recent history of fracture, and/or at least one vertebral fracture (grade ≥ 2 according to Genant classification), and those at very high risk of fractures i.e. adults aged ≥ 70 years with a recent hip fracture, pelvis fracture, and/or at least one vertebral fracture (grade ≥ 2 according to Genant classification) . The subtopics in the recommendations include Who to assess, How to assess, Who to treat, How to treat, and Follow-up and Monitoring. Results General measures are recommended for all patients who are being prescribed glucocorticoids (GCs) for > 3 months: i.e. calcium and protein intake should be normalized, a 25(OH) vitamin D concentration of 50-125 nmol/L should be attained, and the risk of falls be minimized. 1)Who to assess? (R1-2) A preliminary assessment of fracture risk should be routinely performed in patients likely to receive oral GCs for ≥ 3 months: (i) women and men ≥ 50 years and (ii) patients at increased risk of fracture (history of fragility fracture and/or have comorbidities or are on medications that are frequently associated with osteoporosis. 2)How to assess (fracture risk)? (R3-6) Clinical risk factors including history of fragility fracture, systematic vertebral imaging, and GCs dose-adjusted FRAX, measurement of BMD by DXA, fall risk, and biochemical testing. 3) Who to treat? (R7-12) Anti-osteoporosis treatment is indicated for women and men ≥ 50 years with (i) the presence of a recent history of vertebral and/or non-vertebral fracture (less than 2 years) (ii)and/or a GCs dosage ≥ 7.5 mg/day, (iii)and/or age ≥ 70 years (iv)and/or a T-score ≤ -1.5, (v)and/or 10-year probability risk above the country specific GC dose-adjusted FRAX® thresholds. In premenopausal women and men < 50 years with a Z-score ≤ -2 and/or a history of fragility fracture, it is recommended to refer the patient to a bone specialist. 4) How to treat? (R13-18) In women and men ≥ 50 years, (i) alendronate or risedronate is preferred as the first line of treatment in patients at medium risk of fractures, (ii) zoledronic acid or denosumab in patients at high risk of fractures, and (iii) teriparatide in patients at very high risk of fractures. It is imperative that sequential therapy be implemented in individuals receiving denosumab or teriparatide as their first-line treatment regimen. 5) Follow-up and Monitoring (R19-25): In patients receiving anti-osteoporosis treatment, monitoring of clinical risk factors (e.g., history of fragility fracture), systematic vertebral imaging, fall risk, BMD measurement using DXA, and biochemical testing should be performed regularly during follow-up. Conclusions The new, evidence-based recommendations by the ECTS for the prevention and treatment of GIOP provide clear and pragmatic advice to all health practitioners especially those who are not bone specialists.

Responsibilities of Medical Professionals Amidst Geopolitical Conflict

Responsibilities of Medical Professionals Amidst Geopolitical Conflict

Examining the Effects of Health Work Shortages and Deployment in Integrated Programme in Bihar, India: AnInstitutional Ethnography.

The integration of health programms in low-resource settings is a common approach aimed at providing quality and cost-effective healthcare services. However, programme integration can unintentionally impact service provision and disrupt the overall organisation of service delivery. In this paper, I examine the integrated programme for non-communicable diseases (NCDs) and explore the challenges related to the deployment of health workers. Specifically, I investigate the institutional processes that shape the work of health workers and the working conditions in district hospitals. To explore the social organisation of the implementation of the integrated NCD programme, I employed institutional ethnography as a research method. Data collection involved interviews, participant observation, and document reviews. Data analysis was conducted using social mapping, analytical writing, and textual analysis methods. The findings of the study suggest that due to staff shortages and a lack of doctors, health workers are continuously subjected to deployment and often required to undertake multiple tasks and responsibilities without any incentives or non-monetary benefits. Administrators perceive health workers in integrated programs as additional human resources available for use in district hospitals. However, the removal of health workers from integrated programs can have negative implications for service delivery and patients' health outcomes. Finding of the study suggests that it is recommended that administrators improve the staff recruitment process and promptly address the grievances of health workers to enhance healthcare delivery.

NSW cannabis medicines advisory service retrospective enquiry analysis to inform clinical guidance resource development

AbstractBackgroundAn innovative New South Wales government funded statewide Cannabis Medicines Advisory Service (CMAS) operated between January 2018 and June 2022. The service provided comprehensive patient‐specific and evidence‐based information to support health professionals in prescribing and patient care decisions. This study aimed to describe real‐world data collected by CMAS.MethodsA sub‐set of de‐identified, patient‐specific enquiries collected between January 2021 and June 2022 (n = 123/567; 21.7%) were analyzed using R version 4.2.1. Diagnosis, indication, and comorbidities were coded using Medical Dictionary for Regulatory Activities (MedDRA) terminology.ResultsMost patient‐specific enquiries from medical practitioners were from general practitioners (n = 103/123; 83.7%). Female (n = 53/123; 43.1%) and male (n = 59/123; 48.0%) patients were similarly represented. Sex was not specified for 8.9% (n = 11/123) of patients. The mean age of patients was 52.1 years (range <10–90). The most common three diagnoses were osteoarthritis, anxiety, and chronic pain. Indications that were most frequently reported included chronic pain, anxiety, back pain, non‐neuropathic pain, and insomnia. Comedications were most commonly non‐opioid and opioid analgesics and antidepressants. Most practitioners were considering prescribing a cannabidiol (CBD) product for their patient. Cannabinoid composition selection guidance provided by CMAS was predominantly (delta‐9‐tetrahydrocannabinol) THC:CBD ~1:1, followed by CBD‐only products. CMAS was contacted by health professionals regarding the management of potential adverse events for five patients.ConclusionThe findings of this study shed light on the information medical practitioners were seeking to inform their clinical decision‐making about medical cannabis and can inform the development of clinical guidance resources.

A multicentric survey and single-centre observational study of usage behaviour of sinks in intensive care: training is needed to minimize risk

Abstract Introduction Sinks have been introduced near patients to improve hand hygiene as part of infection prevention and control measures. However, sinks are a known reservoir for gram-negative bacterial pathogens in particular and their removal to prevent bacterial infections in intensive care patients is currently recommended by several international guidelines. Methods Healthcare workers (HCWs) in 15 intensive care units (ICUs) in Germany were given the opportunity to complete an anonymous survey on the use of sinks between August 2022 and January 2023. Observations were then made in three participating ICUs to determine the frequency and reason for contact with the sink. Results 258 questionnaires were returned (nurses 87%). 90% found it useful to very useful to have a sink in the patient room, and 56% reported using it daily for hand hygiene. We observed 33 contacts between nurses and sinks over 17 h. In 20/33 (60%) cases, the sink was used for waste disposal. In 3/33 (10%) it was used for hand washing. Discussion Sinks are still used for daily care in intensive care units. Educational Interventions in existing buildings to minimise risk through “sink hygiene” (i.e. separation of sinks for water disposal and uptake) can make an important contribution to infection prevention.

Traditional and Complementary Medicine in Health Tourism: Cupping and Leech Therapy Case from Kayseri

The primary objective of this research is to investigate the potential of traditional and complementary medicine (T&CM) practices, especially cupping and leech therapy, in the context of health tourism. The research aims to ascertain the extent of tourist mobility on national and international levels related to these two practices and identify potential future trends in this field. First, a literature review was undertaken to figure out the role of cupping and leech therapies in health tourism, which informed the development of the qualitative study research design. Subsequently, a semi-structured interview was employed to collect data from twelve health professionals, mostly working in T&CM units within hospitals in Kayseri. Findings obtained after content analysis, demonstrate a growing interest in cupping and leech therapy as T&CM practices in health tourism, particularly after the COVID-19 pandemic. However, the study noted that most health tourists coming to Kayseri for these therapies are expatriates or regional tourists rather than international tourists traveling specifically for these treatments. Based on findings, the study suggests that growth in this area depends on better promotion of these therapies which can also be seen as intangible cultural heritage. Additionally, the findings indicate that T&CM practices, including acupuncture, ozone therapy, homeopathy, and phytotherapy, could have significant potential to contribute to the future development of health tourism.

Assessing the interdependency among effectiveness, satisfaction and efficient use of the Lightwave Health Information Management System (LHIMS) by health professionals in Ghana.

The success of an electronic health records (EHR) system is dependent on the effectiveness, satisfaction, and efficient use of these systems by health professionals. This paper explores the interdependency among effectiveness, satisfaction, and efficient use of Lightwave Health Information Management Systems (LHIMS) which is an EHR by health professionals. A non-interventional descriptive cross-sectional study design was employed for this research. The study used stratified random sampling for the selection of participants. The population for the study was all the health professionals in the Central Region of Ghana. The number of health professionals who responded to the questions was 1126. The findings suggest that understanding the interdependency of efficiency, effectiveness and satisfaction is crucial for the successful implementation and adoption of LHIMS in healthcare organisations. The study investigated the interdependence among effectiveness, satisfaction, and efficient use of the LHIMS by health professionals, and found a positive but weak significant relationship between these factors. Inconclusion, this study aimed to assess the interdependency among effectiveness, satisfaction, and efficient use of LHIMS by health professionals. The. results support a positive but weak significant relationship between satisfaction, effectiveness, and efficient use of the LHIMS. These findings have implications for policymakers and hospital management in their efforts to improve the use of LHIMS. Policymakers can focus on any one of the three usability areas to enhance LHIMS use, with visible effects across the other two domains.