The ongoing quest for the independent patient: an interview study on healthcare professionals' perspectives on integrating self-monitoring of blood pressure in hypertension care.

The mental health treatment gap is an important issue for young people in the East Mediterranean Region as financial constraints and cultural factors continue to play a limiting role. This paper examined predictors and barriers for help-seeking for mental health problems in children and adolescents in Lebanon. The Psychopathology in Children and Adolescents in Lebanon Study, a nationally-representative household sample of n = 1,517 youth aged 5-17 years, was used. Parents and adolescents completed several self-reported mental health questionnaires, and a demographic information sheet. Potential barriers to care utilization assessed included: (i) discomfort in discussing mental health, (ii) stigmatization, (iii) distrust in effectiveness of mental healthcare, (iv) costs, (v) unavailability of nearby services. Regression models were conducted to examine the correlates of help-seeking for psychiatric disorders. Of the n = 498 youth with a positive screen for a psychiatric disorder, only n = 25 (5.0%) reported ever receiving professional mental healthcare services. Male gender, receiving school accommodation, higher parent-reported hyperactivity and depression were associated with help-seeking after adjustment for other variables. For children with a positive screen who had not sought help, the most often endorsed barriers were costs (22.3% major barrier) and unavailability of nearby services (16.1% major barrier). This study showed that costs and unavailability of nearby services were the biggest barriers to help-seeking among children and adolescents in Lebanon, underscoring the importance of incorporating mental health in public health policies and budget allocation in the East Mediterranean Region.

Process mining is increasingly utilized in healthcare to analyze and optimize clinical pathways, offering opportunities to enhance care efficiency and patient outcomes. This systematic review aims to synthesize evidence on the application of process mining to clinical pathways, focusing on its impact on patient outcomes, operational efficiency, and pathway structure. A systematic search will be conducted in MEDLINE, Embase, Google Scholar, Web of Science, and ABI/Inform for studies published from 1999 onward. Eligible studies include observational studies, case reports, conference papers, and meta-analyses focusing on process mining applications to clinical pathways in hospital settings. Two independent reviewers will screen studies, extract data, and assess quality using the Mixed Methods Appraisal Tool (MMAT). Data will be extracted considering several pieces of information such as clinical pathway, settings, health outcomes, costs, and indicators, and will be presented in a structured format. A narrative synthesis will be conducted, and findings will be categorized and thematically analysed where possible. Disagreements will be resolved through consensus. Primary outcomes include improvements in care efficiency, patient flow, compliance with clinical guidelines, and reduction in delays or resource use. Secondary outcomes include challenges and limitations in applying process mining techniques. This review will provide a comprehensive synthesis of process mining applications in clinical pathways, highlighting successful strategies, key challenges, and future opportunities. Findings will inform healthcare professionals, policymakers, and researchers on leveraging process mining to optimize clinical care. PROSPERO CRD42024584540.

Medication history collection continues to be a growing area of innovation to meet the needs of complex patients. Pediatric patients are no exception to this need and often require health systems to dedicate resources to provide appropriate medication history collection and reconciliation for patients. This study reviews the implementation of a pharmacy technician medication history service for patients at a freestanding pediatric health system. In this study, technicians were able to complete 38.31% (n = 367) of medication histories for 1,000 patients with a pharmacy-completed medication history upon admission from the emergency department. Additionally, the study identified the impact of a medication history complexity scoring tool. The tool directs pharmacy technicians to complete medication histories that may be less complex and pharmacists to complete more complex medication histories and reconciliations. The study also looked at health system-assigned errors associated with medication histories to ensure patient safety with pharmacy technician medication history implementation. Medication history training in a didactic setting can help pharmacy technicians successfully complete medication histories, which could be extrapolated to benefit all healthcare professionals completing medication histories.

Abstract Gender-based violence (GBV) is a global issue with severe impacts on individuals. Healthcare professionals, as frontline responders, play a crucial role in addressing GBV. This study evaluates healthcare professionals’ preparedness and training needs at JGMM Medical College in Hubballi, Karnataka. A cross-sectional survey targeted faculty and staff, including doctors and nurses, at JGMM Medical College. Data were collected from 138 participants using a modified, prevalidated structured questionnaire from IPPF-PAHO, assessing preparedness, training needs, knowledge, attitudes, and perceptions regarding GBV. Data were analyzed using SPSS Software Version 25. Of the 138 participants, 80.4% had not attended any GBV training sessions. Many, particularly female participants, felt inadequately trained in key areas such as providing care to GBV victims and detecting cases of violence. Significant gender differences in self-assessed training adequacy were observed, suggesting potential impacts of the Dunning-Kruger effect. Participants expressed a clear demand for further training on GBV-related topics, including legal issues and clinical examinations. According to the review of all postgraduate and undergraduate medical curriculum records in India, Gender-Based Violence (GBV) is a neglected issue. Enhanced training programs are urgently needed to equip healthcare professionals with the skills and knowledge to effectively address GBV. Improved preparedness and training will enable better support for survivors, contribute to better health outcomes, and promote gender equality. Integrating interdisciplinary training modules into medical curricula is essential to adequately prepare healthcare professionals to address gender-based violence effectively and compassionately.

Social media is one form of technological advancement that has become an integral part of students’ lives, including university students. Its use is not limited to communication and information sharing, but it may also generate psychological effects that influence both physical and mental health. The purpose of this review is to identify and explain the psychological impacts of social media use through appropriate theoretical approaches, which serve as a foundation for discussing the research findings. This study employs a literature review method by examining various academic books and relevant scientific articles. The findings indicate that excessive use of social media has the potential to cause psychological problems among university students, such as social comparison behavior, cyberbullying, decreased sleep quality, and reduced learning productivity. These issues are influenced by several factors, including the intensity of social media use, the type of content accessed, and individuals’ ability to manage emotions and time. Furthermore, uncontrolled social media use may lead to difficulties in social relationships, increased procrastination, poor time management, and reduced self-control in using social networking platforms. Therefore, students are encouraged to develop healthier patterns of social media use to reduce the risk of psychological disturbances. This review is also expected to assist healthcare professionals in understanding the relationship between the intensity of social media use and the occurrence of depressive symptoms among university students.

Background In modern society, health issues have gained increasing attention. Physical activity, a key factor in health maintenance, is vital for college students. As future healthcare professionals, medical students’ health impacts both their academic development and future professional performance. Therefore, studying their physical activity patterns is crucial for enhancing their health. Methods A stratified random sampling method was used to conduct a questionnaire survey among medical college students in three universities in Jiangsu Province. The questionnaire included sociodemographic information, the revised version of the Motives for Physical Activities Measure (MPAM-R), the Exercise Self-Efficacy Scale (SEE), the Kinesiophobia Causation Scale (KCS), and the short form of the International Physical Activity Questionnaire (IPAQ). Results There was a positive correlation between college students’ physical activity motivation and physical activity level ( r = 0.201, p < 0.01). Exercise self-efficacy played a partial mediating role between physical activity motivation and physical activity level, and the mediating effect accounted for 10.732% of the total effect. The kinesiophobia level could moderate the direct path of the mediation model. Conclusion The motivation for physical activity has a significant positive predictive effect on the level of physical activity. Exercise self-efficacy plays a partial mediating role in this relationship, and this mediation is moderated by the kinesiophobia level. Therefore, improving exercise self-efficacy and reducing the kinesiophobia level are effective ways to enhance the physical activity level of college students. It is recommended to attach great importance to this and take corresponding intervention measures.

Introduction: Patient safety remains a critical global health agenda, as emphasized by the WHO and IOM. Fostering a robust patient safety culture within hospitals is paramount for minimizing adverse events and improving the quality of care. Understanding the psychosocial factors that drive this culture is essential for effective organizational interventions. This study aims to explore the direct and indirect effects of transformational leadership and team cooperation on patient safety culture, with a particular focus on assessing the mediating function of motivation within these relationships among healthcare professionals. Methods: An analytical cross-sectional research design was applied in this study. Study utilized a survey to collect data from 198 Healthcare Providers (HCPs) at Sulianti Saroso Infectious Disease (SSIDH). The primary instrument was the Hospital Survey on Patient Safety Culture (HSOPS) Version 2.0. Data analysis involved Structural Equation Modelling (SEM) based on Partial Least Squares (PLS-SEM) using SmartPLS 4.0 to test the proposed causal relationships. Results: Descriptive analysis showed that the variables of Transformational Leadership, Team Cooperation, Motivation, and Patient Safety Culture were all in the moderate category. However, hypothesis testing revealed significant findings. Both transformational leadership and team cooperation demonstrated a direct and significant positive influence on patient safety culture. Crucially, motivation was found to significantly mediate the relationship between transformational leadership and safety culture, as well as the relationship between team cooperation and safety culture. Conclusion: This study confirms that transformational leadership and teamwork are crucial factors that effectively enhance patient safety culture. The central finding of this study is the vital role of motivation as a psychological mechanism that translates managerial initiatives and team collaboration into proactive safety behaviors. Therefore, the practical recommendations from this research focus on strategies that directly target motivation, such as strengthening programs for recognition and responsibility, accompanied by improved interprofessional communication and more specific leadership training programs.

Background Lifestyle interventions have potential to support people with Parkinson’s disease (PD) in self-managing their disease and improving quality of life. Growing evidence suggests positive effects of singular lifestyle interventions, such as physical activity, stress or nutrition. However, several challenges remain. First, despite potential additive and perhaps even synergistic effects, research on combining lifestyle interventions is limited. Second, lifestyle interventions are not routinely addressed as part of standard medical care. Finally, there are significant challenges related to changing behavior and adherence to lifestyle interventions. This study aims to evaluate the effectiveness and cost-effectiveness of an integrated, personalized and stepped care lifestyle approach for people with PD. Methods We will perform a 12-month single-blind randomized controlled trial. We aim to include 256 people with PD, randomized in a 1:1 ratio into a control and intervention group. Both groups receive a clinical assessment with a lifestyle coach and can partake in usual care. The intervention group receives an additional lifestyle intervention, consisting of guidance and interventions on different lifestyle domains: stress, exercise, nutrition, sleep and self-management (the SENSS approach). This intervention is offered remotely according to a stepped care model to personalize the intervention to the participants’ needs and abilities. The primary endpoint is the between-group difference in quality of life at 12 months (Parkinson’s Disease Questionnaire-39). Secondary endpoints include between-group differences in PD symptoms, health-related outcomes, self-management and personal goals. Cost-effectiveness and the experiences of participants and healthcare professionals will also be explored. Discussion This study evaluates the effectiveness of an integrated personalized lifestyle intervention for people with PD on both clinical and socio-economic outcomes. We expect this intervention to improve quality of life and self-management of people with PD, without increasing healthcare costs. We also expect to offer valuable insights into how such an intervention can be integrated into current daily care for people with PD. Clinical trial registration ClinicalTrials.gov , identifier NCT06669455.

Abstract Background Cochlear implant (CI) is a neuroprosthetic device that enables individuals with severe to profound hearing loss to hear and communicate. Selection of an appropriate CI manufacturer from amongst the three major global CI manufacturers, namely Advanced Bionics, Cochlear Corporation and MED-EL, can be a daunting and high-stakes decision for CI candidates. On this background, the present questionnaire-based, retrospective survey aimed to better understand the parental decision-making process regarding selection of CI manufacturer for their child. It examined the sources of information utilised by parents and the relative importance of the influencing factors in their decision-making. Results The survey incorporated 57 participants in all. It included parents of children who underwent cochlear implantation between January 2022 and January 2025, at the CI centre of a tertiary care hospital in Western India. Parents of children with cochlear deformity and those with cochlear implantation performed under government schemes were excluded from the study. The majority of the parents (68.42%) cited their auditory habilitationist as the most popular source of information when selecting a CI brand. Regardless of the CI manufacture chosen, parents ranked technology as the most important deciding factor while choosing the device. Conclusions Auditory habilitationist, audiologist and ENT Surgeon were the key sources of information for parents selecting CI manufacturer for their child. The majority of the parents prioritised technology and device construction during the selection process. Results of this study highlight the crucial role played by healthcare professionals in providing accurate, comprehensive and technology-focused guidance to support informed parental decision-making when selecting CI manufacturer.

Chronic diseases—including diabetes mellitus, cardiovascular disease, chronic kidney disease, and autoimmune disorders—remain the leading causes of global morbidity and mortality. While biomedical pathophysiology defines the etiology and progression of these conditions, cultural factors significantly modulate how patients perceive illness, engage in treatment, and adhere to medical recommendations. This review synthesizes evidence from cross-cultural studies, with a specific focus on medical manifestations and therapeutic challenges, to examine how sociocultural determinants intersect with biological disease processes. We highlight nuanced case comparisons between South Asian, East Asian, Middle Eastern, African, Latinx, and Indigenous populations, illustrating how cultural constructs such as collectivism, fatalism, stigma, reliance on traditional medicine, and health literacy directly influence outcomes in chronic disease management. Importantly, we integrate evidence-based recommendations for healthcare professionals, emphasizing culturally tailored interventions, precision medicine approaches, and the role of interdisciplinary care teams.

This study investigates the impact of relationship-oriented leadership on organizational citizenship behavior among hospital nurses in the Turkish healthcare context, focusing on the mediating role of workplace flourishing. The research aims to fill gaps in understanding the indirect effects of leadership on organizational citizenship behavior through workplace well-being in the context of healthcare professionals. A cross-sectional design was employed, surveying 448 nurses from a university hospital using structured Likert-type scales. Data were analyzed through structural equation modeling and the bootstrap method to test the hypothesized relationships among the variables. The findings indicate that relationship-oriented leadership significantly affects organizational citizenship behavior dimensions such as altruism, conscientiousness, courtesy, and sportsmanship. Additionally, workplace flourishing was found to mediate the relationship between leadership style and organizational citizenship behavior, with flourishing showing a strong positive influence on organizational citizenship behavior dimensions. The study highlights that relationship-oriented leadership fosters workplace flourishing, which in turn enhances organizational citizenship behaviors. These results suggest that healthcare leaders can promote better workplace outcomes by fostering a flourishing environment, ultimately improving nurse engagement and citizenship behaviors.

This article presents a comprehensive analysis of the prevalence and underlying causes of mistreatment of medical students and residents in Mexico. The available evidence indicates that this phenomenon represents a critical and persistent problem with an alarmingly high prevalence, affecting a substantial proportion of future healthcare professionals. Beyond being merely an ethical or human resources concern, mistreatment constitutes a systemic public health crisis, as its direct consequences adversely affect trainees' mental health and, critically, the quality and safety of patient care. This behavior is perpetuated by a deeply entrenched hierarchical and punitive medical culture that normalizes abuse as a "rite of passage." Although laws and regulations aimed at addressing this issue exist, their enforcement remains ineffective due to institutional barriers and fear of retaliation. This analysis concludes by presenting a comprehensive reform plan that advocates for a multi-stakeholder approach, including revision of the regulatory framework, establishment of safe reporting mechanisms, promotion of a profound cultural shift, and prioritization of trainees' mental health.

We aimed to assess prescribing accuracy, error reduction, usability, and clinician confidence of Ask Eolas (a retrieval-augmented generation-enhanced AI-CDSS) compared to existing antimicrobial guidance tools. We conducted a structured simulation single-site study evaluating Ask Eolas across 45 prescribing cases with healthcare professionals to assess prescribing accuracy. Among 45 participants, Ask Eolas achieved zero prescribing errors versus six and eight documented errors in the two comparator groups (Eolas App and PDF Guidelines), respectively (p < 0.001). The number needed to treat was 1.9 for Ask Eolas versus traditional guidelines, indicating one additional error-free prescription for every two clinicians switching to Ask Eolas. Ask Eolas significantly improved prescribing accuracy while enhancing usability, clinician confidence, and system transparency compared to existing tools. These findings align with TRUST-AI framework principles for safe AI-CDSS deployment, supporting further investigation through real-world implementation studies incorporating live data integration, confidence calibration systems, and comprehensive auditability features in antimicrobial stewardship programmes.

Quantitative remote wound monitoring has the potential to shorten patient recovery time and alleviate the workload of healthcare professionals. In this study, a nitrogen-doped horizontally grown graphene (NHG) antenna sensor with a working frequency of 2.45 GHz was designed for wireless real-time monitoring of wounds. The sensor comprises 32 NHG microtubes (1 mm in diameter), a porous Cu radiation electrode, a polydimethylsiloxane substrate with a cylindrical channel array, and a Cu ground plane. Its novel structure enables body fluid and its temperature and pH value sensing by tracking dual signals, such as resonance frequency and return loss, thereby facilitating the identification of living organisms and real-time quantitative wound assessment. Notably, the NHG microtubes, which penetrate the Cu electrode and PDMS substrate, regulate the radiofrequency radiation field and enhance the monitoring sensitivity. The sensor exhibits a minimum fluid response volume of 25 μL, a temperature detection range of 34-43 °C, a resolution of 0.1 °C, and a response time of 20 s. Furthermore, the NHG antenna sensor reliably evaluated the pH value, volume, and area of the wound using a machine learning algorithm. The system was successfully validated for real-time monitoring of wound healing in mice and has been preliminarily applied to monitor wounds of various sizes and locations in human patients.

Early detection of diseases plays a crucial role in improving patient survival rates and reducing medical complications. However, limited access to healthcare professionals, cost barriers, and delayed medical consultations often prevent timely diagnosis. HealthAI is a web-based intelligent disease prediction system developed to provide preliminary healthcare guidance using Natural Language Processing (NLP) and Machine Learning techniques. The system processes user-entered symptoms using TF-IDF vectorization and cosine similarity algorithms to match symptoms against a dataset of 200 diseases. The platform integrates an AI chatbot interface, emergency symptom detection, voice input processing, and hospital location services. Experimental evaluation demonstrates prediction confidence scores ranging from 90% to 98%. HealthAI provides fast, accessible, and reliable healthcare assistance, enabling early-stage disease awareness and timely medical intervention..

This study aimed to identify the behavioral determinants influencing the integration of physical activity into the care pathway of postmenopausal women with hormone receptor-positive breast cancer. It specifically addressed the following research question: What are the main barriers and facilitators, from both patient and healthcare professional perspectives, that influence the integration of physical activity into routine care? This qualitative study was based on the Theoretical Domains Framework and the Capability, Opportunity, Motivation - Behavior (COM-B) model. Semi-structured interviews were conducted and the analysis was guided by these frameworks, complemented by inductive thematic analysis, to capture nuanced insights in this clinical context. Barriers for patients include misconceptions, fatigue and difficulties with autonomous PA practice, while healthcare professionals emphasize the need for practical training and clear protocols. Key enablers included early physical activity assessment, personalized and playful interventions, peer support, and the emerging role of advanced practice nurses in structuring care transitions. Digital tools show promise for sustainable engagement when co-designed with patients and integrated into therapeutic relationships. The study identifies concrete levers for integrating physical activity into oncology care, combining behavioral frameworks with nursing science to better understand clinical realities. These findings provide practical guidance for developing sustainable strategies and reinforce the need for person-centered, coordinated approaches to make physical activity a fully recognized component of breast cancer care.

Do social skills improve healthcare data quality? A cross-sectional study in eight referral hospitals.

Tracheostomy decannulation process model: an interprofessional, Latin-American Delphi consensus.

Primary ovarian insufficiency (POI) is a heterogeneous condition that worldwide affects up to 3.7% of women under 40 years of age. POI manifestations are diverse, ranging from ovarian dysgenesis and primary amenorrhea to a later onset ovarian dysfunction, secondary amenorrhea, and diminished ovarian reserve. These conditions result in infertility and elevated risk for osteoporosis and cardiovascular disease. Over the past decade, substantial progress has been made in understanding the complexities of ovarian biology and oocyte development, particularly in identifying involved pathways, etiology, underlying mechanisms, and POI-associated genes. In this review, we focus on chromosomal and monogenic causes of POI leading to syndromic and isolated forms in humans. We provide an updated summary on 272 genes reported in at least two unrelated individuals with a clinical diagnosis of POI. This information supports healthcare professionals in making informed decisions regarding genetic testing and genetic counseling. This review underlines the critical role of molecular diagnosis in understanding and managing POI, highlighting both the current progress and the existing limitations in translating genetic findings and knowledge into effective diagnostic practice.