Training Of Healthcare Professionals Research Articles

Long-Term Effects of Individual-Focused and Team-Based Training on Health Professionals’ Intention to Have Serious Illness Conversations: A Cluster Randomised Trial

ABSTRACT We aimed to measure the sustainability of health professionals’ intention to have serious illness conversations with patients using the Serious Illness Conversation Guide (SICG) after individual-focused training versus team-based training. In a cluster randomised trial, we trained healthcare professionals in 40 primary care clinics and measured their intention to hold serious illness conversations immediately (T1), after 1 year (T2) and after 2 years (T3). Primary care clinics (n = 40) were randomly assigned to individual-focused training (comparator) or team-based training (intervention). Average age of the 373 participants was 35–44 years, 79% were women. On a scale of 1 to 7, at T1, the mean intention was 5.33 (SD 0.20) in the individual-focused group and 5.36 (SD 0.18) in the team-based group; at T2, these scores were 4.94 (SD 0.23) and 4.87 (SD 0.21) and at T3, 5.14 (SD 0.24) and 4.59 (SD 0.21), respectively. At T3, the difference in mean intention between study groups had a significant p-value of 0.01. Intention to have serious illness conversations was lower at T2 and T3 after team-based training than after individual-focused training, with a significant difference at 2 years in favour of individual-focused training. Health professionals reported not enough time during consultations for serious illness conversations as a major barrier. Registration number: ClinicalTrials.gov (ID NCT03577002) for the parent clinical trial.

Scoping review of enablers and challenges of implementing pharmacogenomics testing in the primary care settings.

Pharmacogenomic testing (PGx) plays a crucial role in improving patient medication safety, yet ethical concerns and limitations impede its clinical implementation in the primary care settings. To systematically review the current state of PGx in the primary care settings and determine the enablers and challenges of its implementation. A scoping review was carried out by adhering to Arksey and O'Malley's 6-stage methodological framework and the 2020 Joanna Briggs Institute and Levac et al. DATA SOURCES: Cochrane Library, EMBASE, Global Health, MEDLINE and PubMed were searched up to 17 July 2023. All peer-reviewed studies in English, reporting the enablers and the challenges of implementing PGx in the primary care settings were included. Two independent reviewers extracted the data. Information was synthesised based on the reported enablers and the challenges of implementing PGx testing in the primary care settings. Information was then presented to stakeholders for their inputs. 78 studies discussing the implementation of PGx testing are included, of which 57% were published between 2019 and 2023. 68% of the studies discussed PGx testing in the primary care setting as a disease-specific themes. Healthcare professionals were the major stakeholders, with primary care physicians (55%) being the most represented. Enablers encompassed various advantages such as diagnostic and therapeutic benefits, cost reduction and the empowerment of healthcare professionals. Challenges included the absence of sufficient scientific evidence, insufficient training for healthcare professionals, ethical and legal aspects of PGx data, low patient awareness and acceptance and the high costs linked to PGx testing. PGx testing integration in primary care requires increased consumer awareness, comprehensive healthcare provider training on legal and ethical aspects and global feasibility studies to better understand its implementation challenges. Managing high costs entails streamlining processes, advocating for reimbursement policies and investing in research on innovation and affordability research to improve life expectancy.

Growing Need for Web-Based Simulation in Low and Middle-Income Countries: A Narrative Review

Web-based simulation programs are poised to offer a productive means of delivering asynchronous training in healthcare professionals’ education. Similarly, web-based simulation programs could also sponsor specialty-specific, web-based fellowships for clinicians of low- and middle-income countries. Web-Based Simulation has been utilized for instruction in critical care fields such as emergency medicine and pediatric anesthesia. Studies have shown that enhanced self-reported knowledge and confidence have been achieved through tele simulation which is in line with in-person simulation. During the COVID-19 pandemic, simulations have helped clinicians hone their use of personal protective equipment and other infection control measures. Additionally, it has helped them in learning new and expanded roles, like processing equipment and assisting infected patients in prone position experiencing respiratory failure. However, web-based simulation programs also have unique challenges that must be satisfied: reliable broadband internet network access, multilingual capability, and programming quality. Studies indicate that cost-effective simulation training can be delivered to learners in remote, low-resource areas worldwide, including South Asia, where access to such education is limited. We aimed to explore the effectiveness, challenges, and strategies for implementing web-based simulation education in low- and middle-income countries, based on a thorough PubMed search focused on web-based simulation programs in medical education.

Innovative healthcare solutions for resource-limited settings expanding pharmaceutical care to remote populations

Access to essential healthcare and pharmaceutical services remains a significant challenge in resource-limited settings. This paper explores innovative strategies for expanding pharmaceutical care to remote populations, focusing on the integration of mobile health technologies and community-based interventions. Mobile health (mHealth) technologies, including telemedicine and mobile pharmacies, offer a cost-effective means of delivering healthcare services, enhancing access, and improving real-time monitoring. Community-based interventions, such as the deployment of community health workers, health education campaigns, and peer support groups, play a critical role in addressing healthcare disparities and improving health literacy and medication adherence. The paper also discusses the integration of pharmaceutical care models, emphasizing the importance of collaboration among healthcare providers, pharmacists, and community health workers. Future directions highlight emerging innovations like AI and blockchain technology, while policy recommendations emphasize the need for investment in healthcare infrastructure, professional training, and regulatory support. By leveraging these strategies and innovations, healthcare outcomes and equity in resource-limited settings can significantly improve.

Self-determination and self-affirmative paths of trans* and gender diverse people in Portugal: Diverse identities and healthcare

Abstract Background Trans* and gender diverse (TGD) people are very heterogeneous. While legal contexts and healthcare practices have been growingly endorsing self-determination and consent for gender affirmative care in some countries, gender affirmation trajectories need to be understood as unique and fluid processes, constructed and negotiated by each individual in a given social and cultural context. This study aimed to characterize diverse profiles of TGD people in Portugal, regarding individual choices and trajectories in social, legal, and medical gender affirmative processes. Methods A questionnaire, first developed in France and used in Brazil, Italy, Norway, and Chile, was adapted to the Portuguese context. The conducted survey is comprised of 120 questions, organized into six sections: 1) sociodemographic variables; 2) gender affirmation processes and medical and psychological care; 3) general health and sexual health; 4) mental health; 5) sexuality and sexual concerns; 6) experiences of discrimination and gender identity. Data were collected from a convenience sample of 115 adults who identified as TGD. Content analysis was performed on the written responses, and later categorized. Results Approximately 21% of people identified as men, 17% as trans men, 7% as women, 12% as trans women, 26% as non-binary persons, and 17% as agender or other identifications. Differences were calculated among profiles of TGD participants and their choices for affirmative care, social, and legal transition, revealing an association between the way people self-identify and the request for legal recognition of gender identity, as well as the choices of procedures (or aspirations) for medical affirmation (i.e., hormonal treatments, top surgery, bottom surgery). Conclusions The provision of health care practices consistent with the principles of self-determination requires training of health care professionals and adjustment of public policies, to allow for unique trajectories and profiles.

Tailoring vaccination interventions for the Turkish and Moroccan communities in the Netherlands

Abstract Background People with a Turkish or Moroccan migration background in the Netherlands have low HPV vaccination uptake. Health system barriers, including a lack of awareness raising initiatives on HPV, health care professionals being insufficiently trained to provide tailored care and insufficient delivery of HPV (vaccination) information, contribute to low uptake. To understand which promising interventions could be transferred, the interventions were discussed with a variety of stakeholders including community members. Methods By interviews and focus groups 33 key stakeholders were engaged to discuss on the promising evidence-based interventions. The interventions were extensively discussed on their effectiveness, cultural appropriateness, and potential transferability for which the Population-Intervention-Environment-Transfer Model of Transferability (PIET-T) model was used. Results Two interventions will be implemented of which one is focusing on the use of health promotors (trusted community members) who will provide parents of vaccine-eligible children with information on HPV and HPV vaccination. The educational sessions will be held together with health professionals in, for example, community centers or at schools. The other intervention focuses on training of healthcare professionals. Conclusions By engagement of key stakeholders including community members following the PIET-T model, final interventions could be developed that are tailored to the specific needs and contexts of people with a Turkish or Moroccan migration background in the Netherlands.

Barriers to the application of simulation technologies in the education of health care students

Abstract Simulation technologies (ST) in health and medical education are undergoing rapid development due to the undoubted advantages of the methods and forms of simulation used - high quality, significant efficiency, economy, reliability and safety for the patient. At the same time, the application of ST is still underrepresented in the education of health care students. The main aim of this study was to identify the barriers and perspectives for the application of ST in the education of health professional students in Bulgaria from the perspective of the respondents’ expertise. A qualitative study of the expert (n = 17) opinion of those directly involved in the introduction, application, and evaluation of the use of ST in the education of healthcare students was conducted in 2023 in Varna. The questionnaire regarding the barriers and perspectives in the use of ST in the education of undergraduate and postgraduate students in health specialties students was used. The main barriers to the widespread use of ST in the training of students were identified as follows: the lack of adapted curricula that combine traditional practical sessions with patients and those on simulators; the lack of a sufficient number of trained and motivated trainers; the reluctance of trainers to introduce or more widely use ST; lack of or insufficient space to locate a simulation centre or equipment in relevant core units; the high cost of purchasing and maintaining ST and limited financial resources, as well as the large number of students in the groups. According to one of the experts, ‘there are no barriers to the use of ST, but real patient contact and a personalized approach to the patient is impossible to replicate through technology,’ highlighting the importance in combining traditional training with real patients and modern with the use of technology. Ethical issues in training healthcare professionals with simulators appear to be a new aspect of medical education with the application of ST. Key messages • In the effort for widespread implementation of ST in the training of health professions students, it is important to achieve a balance with traditional training experienced with real patients. • Identifying and overcoming barriers is an important prerequisite for the rapid and widespread application of ST in the training of health care students.

From the first European Climate Risk Assessment to action in policy and practice

Abstract The first European Climate Risk Assessment (EUCRA), produced by the European Environment Agency in March 2024, engaging nearly 100 authors across Europe, highlights health among the most at-risk sectors. According to the structured risk assessment that was conducted to support the transparent identification of priorities for policy action, more and urgent action is needed to reduce health risks from heat indoors and outdoors; from wildfires and outbreaks of vector- and water-borne diseases. The responsibility for managing risks lies both with the EU and Member States, and the policy readiness varies depending on the risk. The European Climate and Health Observatory, set up to better understand, anticipate and prevent climate risks to human health in Europe, in the most recent report ‘Responding to climate change impacts on human health in Europe: focus on floods, droughts and water quality’ provides in-depth analyses of some climate-related risks to health and presents examples of responses to them in both policy and practice. Both assessments emphasise that without fast and systemic action to increase societal resilience, the health impacts of the changing climate will worsen, affecting already disadvantaged or vulnerable groups the most. Health and health-determining sectors have the opportunity to address the health impacts of climate change by, among others, increasing the climate resilience of health systems; developing, updating and implementing national health adaptation plans; and supporting the education and training of public health and healthcare professionals on climate change threats. At the same time, addressing health impacts from climate extremes requires responses across sectors, actors and spatial scales.

‘We do not include tests and treatment for those [STI] conditions’: the trouble in navigating access and care for STIs among gay, bisexual men and transgender and other MSM in Kenya and Rwanda

Abstract Background Lesbian, gay, bisexual men, and transgender persons (LGBT) in Kenya and Rwanda have a hard time accessing healthcare, in particular sexual health screening. We used a social norms and values framework to examine determinants of access to healthcare, with specific attention to sexual healthcare. Methods We draw on cross-sectional mixed methods research in Kenya and Rwanda that examined the lived experiences of sexual and gender minorities in access to health services. A cross-sectional quantitative survey in Rwanda (n = 499) and Kenya (n = 1,550) was conducted with LGBT people. We conducted key informant interviews (n = 81), in-depth interviews (n = 48), digital storytelling (n = 3), and focus group discussions (n = 30). We used a mixed-methods thematic and content analysis to integrate quantitative and qualitative findings. Findings Accessibility and quality of care were the main barriers to healthcare services. The results indicate widespread discrimination and stigma toward LGBT people in service provision. Approximately half of the survey participants, 47%, reported challenges accessing health services, and 25% indicated they experienced discrimination in healthcare. Qualitative results link low quality of care to stigma and discrimination. “Mostly at the hospitals, there are times people take too much time discussing who we are instead of giving us the treatment we seek, and send us to mental health to first deal with our sexuality issues since they think it is a ‘sickness.’” (Focus group, Muhanga, Rwanda). Our study highlights challenges in navigating sexual healthcare in government, faith-based, and donor-funded health facilities. Conclusions Access to healthcare services, particularly sexual health screening and prevention, is a growing issue for LGBT people in Kenya and Rwanda. Stigma acts as a significant barrier to high-quality healthcare. Sensitivity training and educational opportunities for healthcare professionals are urgently needed to address stigma.

Improving physical healthcare for people experiencing mental illness: The COMITMENT project

Abstract Background People experiencing mental illness (PMI) face significant challenges in accessing and using somatic healthcare services, reducing their overall life expectancy by up to 20 years. The COMITMENT project aimed to identify barriers and facilitators in accessing and using somatic healthcare services for PMI and co-design strategies that could address existing challenges. Methods This study employed a qualitative participatory approach, involving a “trialogic” steering group composed of a person with lived experience of mental illness, a family member and caregiver of PMI, as well as a health professional. Two co-design workshops were conducted with members of each trialogic group, based on “World Café” methodology, facilitating open discussion between and among the three perspectives. Data was gathered through participant observations and systematically collecting participants’ workshop contributions, and analyzed thematically. Results Overall, 52 people participated in the two workshops. Findings identified six overarching themes regarding challenges in somatic healthcare access/use for PMI: (1) accessibility and facility design, (2) support and bureaucracy, (3) awareness among healthcare professionals, (4) societal awareness, (5) structural diversity of services, and (6) lack of networking abilities. Notable insights include inclusivity design requirements for healthcare facilities and the importance of integrating lived experiences of PMI into the training of healthcare professionals to reduce stigma. Conclusions This study underscores the critical need for systemic changes to improve somatic care for PMI. It suggests that greater awareness among healthcare professionals, coupled with more inclusive service design and enhanced networking abilities, could substantially improve the quality of healthcare for PMI. The COMITMENT project provides robust and co-designed results for social, systemic, and political reforms aimed at reducing healthcare inequity. Key messages • This study shows how direct involvement of relevant stakeholders improves the design of interventions that truly meet the needs of people with mental illness regarding somatic healthcare services. • To improve healthcare access and treatment for people experiencing mental illness, systemic social, design, educational, and political changes and adaptations are required.

Integrating telemedicine in European healthcare settings: Key enablers for healthcare professionals

Abstract Background Conducted as part of WP4 (Sustainability) of the eCAN Joint Action (JA), we aimed to understand the facilitating factors for the use of telemedicine services in healthcare organisations (HCOs) involved in cancer care, such as comprehensive cancer centres and hospitals. eCAN JA runs pilot studies in 18 HCOs across 10 EU Member States (MS) to test the integration of telemedicine into the daily practice of healthcare professionals. Methods Based on a literature review, we identified 26 facilitators to implement telemedicine services at the organisational level; these were integrated to an online survey and sent to healthcare professionals working in cancer care. Next, they were invited to a foresight workshop to complement the quantitative survey data with qualitative insights. Results 24 healthcare professionals across 12 EU MS, predominantly from the pilot sites of the eCAN JA, responded to the survey. They advocate for trainings on telemedicine, emphasising the importance of user-friendly and interoperable platforms, alongside sufficient technological support, time, and financial resources to effectively implement telemedicine in HCOs. Trial periods for both healthcare professionals and patients should offer first-hand experience, while harmonising telemedicine protocols ensure consistency. In addition, promoting digital literacy among physicians and providing IT education from an early age could facilitate adoption. These strategies, coupled with awareness campaigns and infrastructure investments in HCOs, can pave the way for telemedicine adoption. Conclusions Based on the quantitative and qualitative outcomes, it can be concluded that policies should establish telemedicine training for healthcare professionals, support interoperability and user-friendliness of these services in HCOs. They should also address hospital workload challenges, create harmonised protocols, provide incentives, and invest in digital infrastructure in HCOs for telemedicine adoption. Key messages • Telemedicine implementation in HCOs requires equipping healthcare professionals with the necessary skills, ensuring system compatibility, and addressing resource constraints in HCOs for success. • Financial and infrastructural support to HCOs is crucial for the seamless integration of telemedicine services into the daily workflows of healthcare professionals, enhancing health service delivery.

Antimicrobial resistance and infection prevention in care for people with intellectual disabilities

Abstract Background Antimicrobial resistance (AMR) has become one of the major public health threats worldwide. However, little is known about antimicrobial resistance and infection prevention and control (IPC) in long-term care facilities for people with intellectual disabilities. This study aims to assess knowledge, attitudes and perceptions towards AMR and IPC among healthcare professionals working in long-term care facilities for people with intellectual disabilities (ID-LTCFs) in the Netherlands. Methods We conducted a web-based cross-sectional survey study among medical and nonmedical trained healthcare professionals working in ID-LTCFs in the Netherlands. The survey study was carried out between July and November 2023 and consisted of validated survey items expanded with expert opinion and setting-specific items. Results In total, 109 medical and nonmedical trained healthcare professionals working in 37 long-term care organizations for people with intellectual disabilities throughout the Netherlands completed the questionnaire. Overall, knowledge levels about AMR and IPC differed between medical and nonmedical trained healthcare professionals working in ID-LCTFs, with medically trained professionals having a significant overall higher score on both topics. Knowledge regarding the perceived protective value of glove use was found to be insufficient. Moreover, healthcare professionals expressed a need for easy-to-read resources and tailored setting-specific information on AMR and IPC targeting both healthcare professionals as well as people with disabilities. Conclusions There is room for improvement regarding setting-specific IPC and hygiene policies, such as appropriate glove use in ID-LTCFs. As nonmedically trained professionals comprise most of the workforce within this setting, it is important to further tailor follow-up studies to the underlying factors that influence knowledge, attitudes and perceptions of these specific professionals within ID-LTCFs. Key messages • Developing setting and context-specific policies for infection prevention and control is crucial, particularly in long-term care facilities for people with intellectual disabilities. • Inclusive policy-making is key to combating antimicrobial resistance, and improving infection prevention and control in long-term care facilities for people with intellectual disabilities.

The status of health information systems and digital transformation in the European Region

Abstract Although there have been investments in health information systems (HIS) and digitalization, WHO/Europe’s work with Member States (MS) shows that much can be improved still. Typically, there is a strong focus on data collection, but less on analysis and knowledge translation, resulting in available data not being optimally used to support decision making. Standards for data exchange and interoperability have not yet been fully implemented. Efforts are underway to train healthcare professionals, yet only half of MS have developed policies for digital health literacy. Fewer still have implemented a comprehensive digital inclusion plan, leaving disadvantaged populations at risk of falling behind. In line with the traditionally strong focus on HIS strengthening in WHO’s work, the European Programme of Work 2020-2025 (EPW) emphasises the need for MS to improve and modernise their HIS to ensure that decisions are data driven. One of the EPW flagship initiatives is Empowerment through Digital Health, promoting the leveraging and scaling up of digital transformation for better health. The Regional digital health action plan for the WHO European Region 2023-2030 outlines the strategic actions needed to achieve this, while fully respecting the values of equity, solidarity and human rights. Collaboration with MS and international partners is vital in this work. WHO/Europe has established several MS-driven health information networks in the past, most notably the European Health Information Initiative (the EHII). The EHII in 2023 has made a restart in the form of the European Health Information Network (HIN). The HIN will guide the work under the EU-funded action ‘Supporting Member States in the WHO European Region in strengthening health information systems and boosting health data governance’, which will be implemented by WHO/Europe. This strong European Commission and WHO/Europe partnership will be a main catalyst for HIS improvement in the Region the coming years.

Analyzing the Public Health Impact of Adopting Telehealth after a Pandemic: A Business Model

Abstract: In response to the global shift in healthcare delivery due to the COVID-19 pandemic, this study investigates the adoption of telehealth technologies and assesses their long-term sustainability within new public health paradigms. Telehealth, accelerated by the pandemic's demands, offers a unique perspective on evolving healthcare delivery methods that emphasize accessibility and efficiency. By employing a mixed-methods approach, which synthesizes quantitative data with qualitative insights from various stakeholders, this research evaluates how telehealth has enhanced the delivery of medical services, especially in remote and underserved communities. Despite challenges related to technological infrastructure and regulatory constraints, our analysis of revenue models and cost-benefit evaluations suggests that telehealth is economically feasible and possesses significant market potential. The findings advocate for robust policy support and technological investment to enhance global telehealth accessibility and implementation. Additionally, the study highlights the necessity of expanding educational training for healthcare professionals to effectively adapt to telehealth systems. These strategic measures are pivotal for promoting the widespread application and sustainable development of telehealth, positioning it as a cornerstone in the future landscape of global healthcare. Continued research is recommended to further refine telehealth models and develop comprehensive frameworks that address emerging healthcare challenges and disparities.

O IMPACTO DA VIOLÊNCIA OBSTÉTRICA NA SAÚDE MENTAL DAS MULHERES: UMA ANÁLISE DAS CONSEQUÊNCIAS PSICOLÓGICAS

Introduction: This paper addresses obstetric violence, a phenomenon that compromises not only the physical health but also the mental health of women during childbirth. The practice of obstetric violence is reflected in disrespect, negligence, and violations of the rights of parturient women, affecting their birthing experience and recovery. Objective: The objective of this study is to analyze the forms of obstetric violence, explore its impact on women's mental health, and discuss the relevance of nursing care in promoting the humanization of care. Methodology: This research adopted a quantitative approach, with article searches conducted in databases such as SCIELO and REVISTA COFEN. Articles that presented statistical data on women's experiences during childbirth, as well as their implications for physical and mental health, were included. Data collection was carried out based on information extracted from the selected articles, and analysis was performed using descriptive statistical techniques to identify patterns and trends. This approach allowed for an in-depth understanding of obstetric violence, contributing to the discussion of intervention strategies and the promotion of humanized care in obstetric practices. Results: The results indicate that obstetric violence manifests in various forms, such as misinformation, verbal abuse, and invasive procedures without consent. These experiences lead to significant consequences for women's mental health, including anxiety, depression, and trauma. Discussion: The discussion highlights the importance of training healthcare professionals in practices that promote respect and dignity for parturient women. Humanizing care is essential to preventing obstetric violence and improving the chidbirth experience. Final Considerations: The final considerations emphasize the need for respectful and welcoming care, as well as continuous work in nursing professional training. Promoting humanized care is crucial to ensuring the mental health and well-being of women in the obstetric context.Keywords: obstetric violence, mental health, nursing care, humanization of care.

A Realistic Ingeniously Designed Cleft Palate Simulator for Training of Residents: Bridging the Gap Between Theory and Practice.

Cleft palate is a congenital deformity that presents significant challenges in surgical correction. Proper training with an educational model for can greatly enhance the learning curve and improve patient outcomes. This article discusses the development and evaluation of an economical cleft palate model designed to enhance surgical skills and confidence among residents. The model was constructed using dental casts, acrylic resin, foam sheets, double-sided adhesives, infant feeding tubes, and red dye. Tertiary care center. Surgical residents. The assembly time and material costs were recorded. To evaluate its effectiveness, participants' feedbacks were collected and analyzed. The cleft palate model was produced at a cost of 250 INR per unit, with assembly taking approximately 15 minutes. Overall, 32 residents completed the simulation exercise of cleft surgery on the model. Participants gave the model an average score of 4 (±0.60) for realistic anatomical appearance, 3.5 (±1.3) for replicating the tactile nature of human tissue. Anatomical accuracy and ability to manipulate tissue and perform suturing received a rating of 3.4 (±1.1) and 3.7 (±0.81), respectively. The model's value as a training tool scored 4.4 (±0.51), with an overall satisfaction rating of 4.6 (±0.22) among residents. Our cleft palate model offers an economical, practical, and accessible solution for surgical training. This model is a viable alternative to more complex and expensive training tools and potentially enhancing the training of healthcare professionals in cleft palate repair.

Unveiling the Burden of Nephrolithiasis in Low- and Lower-Middle Income Countries: A Review on Its Presentation, Risk Factors, Treatment Practices, and Future Directions

Background: Nephrolithiasis, or kidney stone disease, presents a significant global health burden, with global incidence rates and treatment practices varying widely. This study aims to discuss the epidemiology, risk factors, treatment modalities, and challenges for nephrolithiasis in the lower half of the World Bank rankings; that is, in low- and lower-middle-income countries. Methods: A comprehensive literature review was conducted using PubMed for each country on the list, focusing on studies published from January 2000 onwards and reporting data on prevalence, risk factors, treatment practices, and economic implications. Results: Nephrolithiasis represents a significant burden for healthcare systems, with noteworthy geographical variability in prevalence possibly dependent on socioeconomic status and gender. Risk factors include dietary habits, climate, pollution, and infectious diseases. Treatment practices in some regions still rely on open surgery due to limited access to advanced endourological techniques, while other regions demonstrate high proactivity in research. The burden is exacerbated by inadequate healthcare infrastructure and training. Conclusions: Addressing nephrolithiasis in challenging economic circumstances requires targeted interventions, including improved access to modern treatment methods, enhanced training for healthcare professionals, and better socioeconomic and environmental conditions. Future research should focus on region-specific strategies and the development of sustainable healthcare solutions.

Sexuality in Older Adults: Comprehensive Strategies for Clinicians and Patient-Centered Care

Introduction: Healthcare providers play a crucial role in promoting sexual health among older adults, an important yet often neglected aspect of aging well. Although sexuality evolves beyond the reproductive years, it remains a meaningful part of life for many. Despite the natural decline in sexual activity with age, numerous older adults continue to value and engage in fulfilling sexual relationships. Unfortunately, targeted interventions to support later-life sexuality are lacking, creating gaps in care. Intervention: Sexuality in older adults is influenced by biological, psychological, and social factors. Clinicians should include comprehensive sexual health assessments, including STI screenings, as part of routine care. Providing age-appropriate sexual education and resources helps promote lifelong sexual wellness. Open communication between healthcare providers and patients is vital for addressing sexual concerns, often left unspoken due to stigma or discomfort. Additionally, adopting lifestyle medicine principles—such as balanced nutrition, regular exercise, stress management, and social connection—can enhance sexual health and overall well-being. Conclusion: Specialized training for healthcare professionals on the unique aspects of older adult sexuality is essential to bridge knowledge gaps. A holistic, evidence-based approach will empower providers to better support the evolving sexual health needs of older adults, improving their quality of life.

The impact of a professional development workshop on healthcare professionals' knowledge and readiness to use telehealth etiquette in virtual care.

Telehealth is a growing part of the healthcare field, and healthcare professionals and trainees require training not only on the clinical skills relevant to telehealth but also on professionalism skills or telehealth etiquette. As healthcare outcomes are influenced by the patient-provider relationship, training healthcare professionals on telehealth etiquette skills is imperative. Forty-eight healthcare professionals across different disciplines, work settings, and experience levels participated in a telehealth etiquette skills educational intervention workshop wherein their knowledge and readiness to use the skills (specific to technology, environment, confidentiality, and communication) were assessed before and after the workshop. Paired sample t-tests revealed that participating in the educational intervention resulted in statistically significant improvements in knowledge and perceived readiness to use telehealth etiquette skills pertinent to technology, environment, and communication. There were no associations between participants' personal factors and post-educational intervention changes. Study findings are significant and suggest that training healthcare professionals in telehealth etiquette have a positive impact. Since there is a known positive association between provider communication and patient satisfaction and a known association between patient satisfaction and healthcare outcomes, gaining telehealth etiquette skills is critical for promoting a positive patient-provider relationship via telehealth.

Evaluation of new tobacco dependence training for health care professionals in acute inpatient hospitals

Evaluation of new tobacco dependence training for health care professionals in acute inpatient hospitals