Healthcare Professionals Research Articles

Psychometric properties of the Ethiopian national licensing exam in medicine: an analysis of multiple-choice questions using classical test theory

Background : The Ethiopian Ministry of Health introduced medical licensure examinations to maintain high standards in medical practice and build public trust in healthcare professionals. Studies also suggested significant issues in clinical competence among Ethiopian junior doctors as well concerns regarding unlicensed practice. Given the need to ensure safe health care, we investigated the psychometric properties of the multiple-choice items comprising the Ethiopian national licensing exam (NLE). These analyses help to provide an argument for the validity and reliability of the test scores. Method : We used a cross-sectional study design to analyze data from three cohorts of undergraduate medicine licensing examinations in Ethiopia (2020-2022, N = 2,213). Using Classical Test Theory, we assessed the psychometric properties of 600 MCQ items with 2400 single best answer choices, specifically item difficulty, item discrimination, and the number of nonfunctional distractors, and scale reliability. We provide results regarding the overall test and its sub-domains. Results : Ethiopia’s undergraduate medical licensure examination demonstrated acceptable reliability (Alpha > 0.80), with significant variability in item difficulty and examinee performance. Although these results indicate a sufficiently defensible exam, our results point to issues regarding item statistics, especially a high number of nonfunctional distractors. Conclusions : This study provides first evidence regarding the psychometric soundness of the Ethiopian NLE. However, a significant number of items should be carefully reviewed and possibly revised. As the examination is relatively new, ongoing refinement to item-development and review processes is essential to improve and ensure its quality.

Sexual Function and Quality of Life in Individuals Post Stroke.

Sexual function is commonly affected post stroke and impacts an individual's quality of life. This study aimed to determine the factors associated with sexual function in an individual post stroke and the association with quality of life. This cross-sectional study included 56 participants who had a stroke between three and 24months prior. The participants were assessed for: level of disability with the Modified Rankin Scale (MRS); quality of life with the Stroke Specific Quality of Life scale (SSQOL); and sexual function with the Changes in Sexual Functioning Questionnaire (CSFQ-14), and an open-ended questionnaire was administered. The average age of the participants was 51.32 (SD=±13.24) years, with 32 (57.1%) males and 24 (42.9%) females. According to the CSFQ-14, the majority of the study participants (n=35, 62.5%) had sexual dysfunction after their stroke. The factors associated with sexual dysfunction post stroke included age, disability, comorbidities, psychosocial factors such as self-esteem, role changes, and depression. Those with sexual dysfunction were found to have a lower mean SSQOL score (139.94±33.89) than those without sexual dysfunction (149.76±33.77), however, there was no significant difference (p=0.298) between the groups. Majority of the participants (n=37; 66.1%) did not know that healthcare professionals can assist with sexual dysfunction. The majority of participants experienced sexual dysfunction after their stroke. Factors such as pain, difficulty with positioning, self-esteem issues, lack of motivation, and change in desire, are important considerations for the multidisciplinary team in the rehabilitation of a patient's sexual function post stroke. This cross-sectional study did not require study registration.

Ethical considerations related to virtual visiting for families and critically ill patients in intensive care: a qualitative descriptive study

BackgroundDuring the COVID-19 pandemic, virtual visiting technologies were rapidly integrated into the care offered by intensive care units (ICUs) in the UK and across the globe. Today, these technologies offer a necessary adjunct to in-person visits for those with ICU access limited by geography, work/caregiving commitments, or frailty. However, few empirical studies explore the ethical issues associated with virtual visiting. This study aimed to explore the anticipated or unanticipated ethical issues raised by using virtual visiting in the ICU, such that healthcare professionals can be informed about how to carry out virtual visits ethically, safely and productively.MethodsWe used a descriptive exploratory qualitative research approach recruiting a convenience sample of newly-graduated junior doctors facilitating ICU virtual visits in a tertiary academic centre. Eight newly graduated junior doctors, seven female and one male, aged 23–27, participated in semi-structured interviews. We analysed transcripts using an inductive coding approach.ResultsFive overarching themes emerged. Two of the themes namely, ‘fulfilling a moral instinct to connect families’ and ‘promoting autonomy’, arose from participants’ descriptions of how virtual visits aligned with healthcare standards and practices they considered ethical. Three further themes, ‘preserving dignity and privacy’, ‘managing emotional distress’, and ‘providing equitable access’ to virtual visiting technologies, highlight how virtual visits might exacerbate ethical issues related to family communications.ConclusionVirtual visiting may potentially both ameliorate and exacerbate aspects of ethical healthcare delivery for ICU patients and family members. ICU team members should consider unique ethical considerations related to using virtual visiting. We recommend virtual communications skills training for staff and advocate for the use of easily accessible educational resources for families who wish to visit critically unwell patients remotely.

Four Alzheimer’s Apps to Implement into a Caregiver’s Daily Routine

Smartphones have become synonymous with modern living, providing users with countless apps to perform endless functions. Harnessing mobile technology to help caregivers of Alzheimer’s Disease patients offers users tools and resources to engage, organize and lessen the stress of caregiving. Medical Librarians, healthcare professionals, family and friends can all benefit from learning about four popular Alzheimer’s Disease caregiver apps to enable them to provide thoughtful recommendations to implement their use in caregivers’ daily lives.

PROJECT-BASED LEARNING AS A MEANS OF DEVELOPING SPEAKING SKILLS OF MEDICAL STUDENTS

This article explores the effectiveness of project-based learning (PBL) as a pedagogical approach to enhance speaking skills of medical students, emphasizing the practical application of language within professional field. In the context of evolving medical education, the need for proficient English language skills among healthcare professionals has become increasingly topical. By integrating constructivist, experiential, communicative, and task-based learning theories, PBL fosters critical thinking, collaboration, and creativity. Through active engagement in projects such as clinical simulations, case studies, and health campaigns, students not only acquire linguistic competence but also bridge knowledge across disciplines such as biology, pharmacology, ethics, etc. This study aims to analyze the methodologies, impacts, and potential obstacles of PBL in medical English education. The findings are intended to inform English language instructors in medical educational establishments, ultimately enhancing the quality of training for future healthcare professionals in a globalized surroundings. By promoting effective communication skills, PBL serves as a vital tool in preparing a new generation of adaptable and skilled practitioners.

Comparing fractional microneedle radiofrequency and fractional CO2 laser for striae distensae treatment: a systematic review and meta-analysis.

Striae distensae (SD) are a prevalent dermatological concern of women and approximately 90% of pregnant women experience these stretch marks. Fractional microneedle radiofrequency (FMR) and fractional CO2 laser (FCL) have gained substantial attention in the treatment of SD. In clinical studies, a clear superiority between FMR and FCL treatments is not found due to limited studies and sample sizes. In this systematic review and meta-analysis, a search of English-language articles was performed on PubMed, employing various combinations of keywords "fractional CO2 laser," "microneedle radiofrequency," and "striae". Studies that compared the treatments of FMR and FCL for SD and provided data regarding professional evaluation of improvement, patient self-assessment, and/or the presence of post-inflammatory hyperpigmentation (PIH) were included. We analyzed the incorporated studies utilizing both random and fixed-effects models to estimate pooled odds ratios (OR) and 95% confidence intervals (CI). Professional assessments of improvement showed no statistically significant difference between the FMR and FCL groups (OR: 1.27; 95% CI: 0.49-3.31). Similarly, patient self-assessments of improvement did not exhibit a significant difference (OR: 0.72; 95% CI: 0.13-3.90). However, the development of PIH was significantly less frequent in the FMR group when compared to the FCL group (OR: 0.24; 95% CI: 0.08-0.70). Both FMR and FCL demonstrate comparable performance in terms of improving lesions, as assessed by both healthcare professionals and patients. However, FCL is associated with a higher risk of developing PIH. This finding can guide clinicians especially who prefer a single treatment.

Evaluating Supply Chain Network Models for Third Party Logistics Operated Supply-Processing-Distribution in Thai Hospitals: An AHP-Fuzzy TOPSIS Approach

Background: This study introduces a novel supply chain management (SCM) model tailored for the hospital industry in Thailand. The model emphasises the integration of third-party logistics (3PL) providers to streamline supply-processing-distribution (SPD) functions. By outsourcing non-core activities like SPD to 3PL providers, hospitals can enhance their operational efficiency, allowing healthcare professionals to focus on core tasks and ultimately improving service delivery. Methods: This research employed a dual methodology, combining an analytic hierarchy process (AHP) with a Fuzzy Technique for Order of Preference by Similarity to Ideal Solution (Fuzzy TOPSIS). These approaches evaluated various SCM models based on multiple hospital logistics performance attributes. Results: The AHP results highlighted on-time delivery, patient safety, utilisation rate, and emergency procurement as critical criteria for selecting the optimal model. Fuzzy TOPSIS analysis identified the SCIII: W-G-H model as the most suitable for implementation in Thai hospitals. This model incorporates a centralised warehouse for negotiation leverage, a Group Purchasing Organisation (GPO) for cost efficiency, and regional SPD hubs for effective inventory management and rapid responses to demand fluctuations or emergencies. Conclusions: Adopting this SCM model is expected to significantly enhance supply chain performance, reduce operational costs, and improve the quality and safety of patient care in Thai hospitals.

“Do You Yourself Have Any Idea What is Going On?”: Invitations for Lay Diagnosis in Dutch Primary Care Physiotherapy

ABSTRACT Lay perspectives are important in the recovery of patients with nonspecific pain as they influence levels of pain and patients’ pain experiences. Although previous interactional research has focused on patients’ unsolicited attempts to share their perspectives, health professions also employ specific techniques to solicit them. Physiotherapists are recommended to assess lay perspectives and include them in treatment. One way to do so is through invitations for lay diagnosis (this paper). However, little is known about how lay perspectives are constructed through these invitations and how physiotherapists follow up on them. In this study, physiotherapy intakes were analyzed using conversation analysis. We found that invitations for lay diagnosis are frequently embedded in previous health care visits or patients’ knowledge gathering activities. Patients often express low epistemic status when they construct their lay perspectives and engage in lay diagnostic activity in response to these invitations. Additionally, physiotherapists’ responses in the third position, such as follow-up questions, may influence the further development of patients’ lay perspectives. These invitations provide patients an opportunity to share their views on their health issues, but also create an interactional challenge due to the reversal of usual epistemic dynamics. The study highlights the complexity of doing lay diagnosis, which can include diagnoses or explanations of varying specificity. The specificity and elaboration of these perspectives are influenced by the physiotherapists’ subsequent responses. We provide recommendations for healthcare professionals to facilitate lay diagnosis, and our findings contribute to the discussion around patient empowerment, shared decision making, and patient centered care.

The intersection of financial modeling and public health: A conceptual exploration of cost-effective healthcare delivery

This review paper explores the intersection of financial modeling and public health, highlighting the importance of cost-effective healthcare delivery in contemporary health systems. Financial modeling serves as a crucial tool for policymakers, providing evidence-based insights that inform decision-making and optimize resource allocation. Key financial models, including cost-benefit analysis and predictive modeling, are examined for their applications in public health initiatives, particularly in areas such as preventive care and chronic disease management. The paper discusses core public health priorities—prevention, access, and quality—and the economic constraints faced by healthcare systems. Recommendations are provided for policymakers and healthcare professionals to enhance the application of financial models, emphasizing the need for training, investment in data infrastructure, and fostering cross-sector collaborations. By leveraging financial modeling, public health systems can achieve improved health outcomes while maximizing resource efficiency, ultimately contributing to a more sustainable and equitable healthcare landscape.. Keywords: Financial Modeling, Public Health, Cost-Effectiveness, Healthcare Delivery, Resource Allocation, Preventive Care.

Cloud based adaptive learning system: virtual reality and augmented reality assisted educational pedagogy development on clinical simulation

An adaptive learning system provides support for student’s academic progress by varying learning routes and pedagogical contents to satisfy various students’ unique academic needs. The primary goal of this research work is to enhance and expand occupational efficiency through the use of technological pedagogical content knowledge (TPCK) frameworks in nursing education. The authors developed an adaptive federated cloud computing learning system in order to better prepare students for the demands of real-world professional practice. The article examined the use of virtual reality(VR) and augmented (AR) technologies in nursing education and developed an instrument that skillfully combines knowledge from the reputable literature on clinical competencies with the peculiarities and ingenuousness particular to virtual simulations. Designated for the remote sharing and utilization of combined educational resources, cloud computing is a distributed information communication technology (ICT) infrastructure built on the Internet of Things (IoT) framework. To increase the occupational efficiency among the nurses and midwives, an educational simulation applied in a way that gamifies the curriculum component for interactive educational pedagogy will be necessary. As a completely integrated part of the curriculum, simulation has proven to be beneficial for nursing students at all levels of instruction. Nursing educators have a plethora of options at their disposal to introduce simulation-based learning approaches into their curricula in the modern era. A three-dimensional (3D) interactive environment that provides users with a sense of spatial presence is created through computer technology, which is an immersive digital ecosystem of VR and AR utilized to improve teaching and learning in nursing education. In this study, the authors offered a cost- effective clinical simulation laboratory for clinical students, nurses, midwives, and practicing healthcare professionals in a manner that ensures constant learning and occupational efficiency by adopting the TPCK model in its central discussion and implementation. The TPCK model has demonstrated how to recognize the boundaries between technological components and pedagogical structures as well as how they are connected when creating facts in nursing education.

The Development of Operational Model Integrating Digital Technologies into Public Mental Healthcare Services in Nigeria

The availability and utilization of digital technologies can leverage the challenges of the sharp-depleting workforce due to the consistent migration of healthcare professionals (HCPs), the alarming ratio of the number of patients to HCPs, discretional use of digital technologies among HCPs in providing effective therapeutic interventions and mental healthcare services. This study aimed to develop an operational model that integrates digital technologies in mental healthcare service delivery for public facilities in Nigeria. The practice-oriented theory guides the development of the model. A qualitative method assessed the digital technologies used during the COVID-19 pandemic. A non-probability, purposive sampling technique that employed the snowball method was used in selecting the sixteen (16) HCPs from four (4) neuropsychiatric hospitals in South-West Nigeria. Thematic analysis was conducted on qualitative data. Findings from the qualitative analysis revealed several challenges in providing adequate and efficient services in public mental healthcare facilities in Nigeria, such as human resource challenges, brain drain, lack of infrastructure, and strains on HCPs. Findings from this study indicated that digital technologies are sparingly utilized in public mental healthcare service delivery due to a lack of policy and framework. HCPs perceive digital technologies to be beneficial to themselves and their clients. The highlighted benefits to patients are reduced stigmatization levels, decreased financial burden, enhanced accessibility to therapists, strengthened adherence, mitigated relapse incidences and improved intervention. The transition from the traditional/conventional space of mental healthcare service delivery to digital space requires a collaborative approach with Computer scientists (software developers, database administrators), Data scientists, investors, stakeholders and mental HCPs. The proposed model serves as a contemporary framework that the Government, policymakers in the Ministry of Health and management of mental health facilities in Nigeria can adopt, providing the needed awareness of the benefit of technological intervention.

Resilience, job satisfaction, occupational stress, and occupational accidents among healthcare professionals: A Bayesian network analysis.

Occupational accidents remain a critical challenge for healthcare professionals. In the present study, using the Bayesian network (BN) approach association among resilience, job satisfaction, stress, and occupational accidents among healthcare professionals is examined. Data was gathered using several valid questionnaires. The BN approach was utilized to analyze the r5/31/2024ionships between the variables of the current study. The performance of BN analysis was evaluated using related indexes. In total, 300 healthcare professionals participated in this study. Results showed that almost 23% of healthcare professionals had experienced occupational accidents. Results of the sensitivity analysis demonstrated that job satisfaction had the most significant influence on occupational accidents in healthcare settings. The belief updating analysis results showed that by increasing job satisfaction and decreasing stress of healthcare professionals the occurrence of occupational accidents decreased 9.8% and 6.4%, respectively. Moreover, decreasing the stress of healthcare professionals can lead to an increase in the level of job satisfaction. Evaluation indexes showed that the performance of the developed BN was acceptable (error rate: 16.09). The Findings reveal that both job satisfaction and stress had a significant influence on occupational accidents in healthcare professionals. Moreover, by influencing job satisfaction and stress, resilience can indirectly affect occupational accidents.

YouTube as a source of information in cardiopulmonary resuscitation for 2020 AHA Resuscitation Guidelines.

The Internet has transformed global information access, particularly through platforms like YouTube, which launched in 1995 and has since become the second largest search engine worldwide with over two billion monthly users. While YouTube offers extensive educational content, including health topics like cardiopulmonary resuscitation (CPR) and basic life support (BLS), it also poses risks due to potential misinformation. Our study focuses on evaluating the accuracy of CPR and BLS videos on YouTube according to the latest 2020 American Heart Association (AHA) guidelines. This research aims to highlight inconsistencies and provide insights into improving YouTube as a reliable educational resource for both lay rescuers and healthcare professionals. In this cross-sectional observational study, English YouTube videos uploaded between October 21, 2020, and May 1, 2023, were searched using keywords related to CPR and basic life support. Videos were assessed for their source, duration, views, use of human or mannequin models, and mean assessment scores by two emergency medicine physicians. A third physician's opinion was sought in cases of disagreement. The first assessment evaluated video validity based on specified information criteria, while the second assessed their ability to convey advanced medical information aligned with the 2020 AHA guidelines. In this study, 201 English YouTube videos uploaded between October 21, 2020, and May 1, 2023, were evaluated based on search terms related to CPR and BLS, resulting in 95 videos meeting inclusion criteria after excluding 106 due to various reasons. Most included videos were from healthcare professionals (49.5%), followed by anonymous sources (29.5%) and official medical organizations (21.1%). Video durations ranged widely from 43 to 6,019 seconds, with an average of 692 seconds. Videos featuring mannequins predominated (91.6%), followed by those using human subjects (5.3%) or both (3.2%). Healthcare professional and official medical organization videos scoring significantly higher than those of unknown origin (p=0.001). Video length did not correlate significantly with view counts, although shorter videos under 5 minutes tended to have higher average views. The results presented in this study demonstrated that English-language videos on YouTube related to BLS and CPR, throughout the study period, did not conform to the 2020 AHA guidelines in terms of providing basic information for lay rescuers. Furthermore, healthcare professionals cannot obtain advanced medical knowledge through these videos. We recommend a professional oversight mechanism in health-related videos that does not tolerate such misinformation.

Barriers to diagnosing and treating vulval lichen sclerosus: a survey study.

Background Vulval lichen sclerosus (VLS) is a chronic inflammatory condition that is frequently misdiagnosed and under-recognised. To date, qualitative research focuses on lived experience of VLS, with women attributing diagnostic delay to poor interactions with health care professionals (HCPs) often due to lack of knowledge. In the UK, women with VLS are most likely to present to primary care. Aim To establish HCPs perspectives on identification, management and education of vulval skin disease, with a focus on VLS. Design and Setting A survey was distributed to HCPs working in primary care. Method The survey was distributed via professional networks and at events. Analysis comprised of descriptive statistics, Spearman's rank correlations, and thematic analysis. Results Of 122 respondents, 53 were General Practitioners (GPs) and 59 were GP trainees. 37.7% of respondents had never participated in teaching nor learning on vulval skin disease. Confidence in the identification of vulval skin disease positively correlated with experience, exposure and female gender. The top identified barriers to diagnosis and treatment included lack of knowledge, embarrassment, and absence of VLS diagnostic criteria. Almost all participants (97.5%) felt VLS diagnostic criteria would be helpful in clinical practice. Conclusion This study provides insight into the barriers to diagnosing and treating VLS in primary care. HCPs recognise deficiencies in training, referral pathways and lack of tools to support VLS diagnosis. Training should include skills to address stigma and embarrassment. This study highlights the importance of developing interventions to overcome barriers, expediting diagnosis and treatment, such as reproducible diagnostic criteria.

The intelligent diabetes telemonitoring using decision support to treat patients on insulin therapy (DiaTRUST) trial: study protocol for a randomized controlled trial

BackgroundDiabetes affects 10.5% of adults globally, with type 2 diabetes accounting for 90–95% of cases. Achieving optimal glycemic control is crucial yet challenging, particularly with insulin therapy, where 30–50% of patients fail to meet treatment targets. Telemedicine can improve diabetes management but generates vast amounts of data, burdening healthcare professionals. Integrating clinical decision support tools into telemonitoring systems may enhance care efficiency and glycemic control.MethodsThe trial is a multicenter 3-month, three-arm, open-label, randomized controlled trial. The trial aims to enroll 51 participants with type 2 diabetes on insulin therapy. Participants will be divided with a 3:1:1 ratio into telemonitoring with decision support, telemonitoring without decision support, and usual care groups. The study employs connected insulin pens, continuous glucose monitors (CGMs), and activity trackers to enable telemonitoring. Outcomes measured include CGM time in range, HbA1c, hypo- and hyperglycemia incidents, total daily insulin dose, body weight, treatment satisfaction, and adherence.DiscussionTelemonitoring with decision support has the potential to revolutionize diabetes management by offering personalized treatment suggestions, thereby reducing the burden on healthcare professionals, and improving patient outcomes. This study will provide valuable insights into the effectiveness of such an approach in achieving glycemic control in people with type 2 diabetes on insulin therapy. By evaluating both clinical outcomes and patient and healthcare professionals’ satisfaction, the study aims to contribute to the development of efficient, scalable telehealth solutions for diabetes care.Trial registrationClinicalTrials.gov NCT06185296. Registered on December 14, 2023.

Establishing a biologics and biosimilars committee/network: assessing educational requirements of pharmacy and other healthcare professionals

Abstract Introduction Successful professional networking involves shared, mutually beneficial interactions between individuals and/or individuals and groups1. Biologics and biosimilar medicines prescribing is rapidly evolving with an increasing number of clinical indications in healthcare2,3. Despite their importance, the absence of a structured national network dedicated to these complex therapies has left a gap in professional education and resource sharing among pharmacists. Recognising the necessity for a cohesive support system, this work explores the learning and professional needs of pharmacists regarding biologics and biosimilars and the potential development of a national pharmacy network to address these gaps. Aim The survey aimed to explore the educational needs and preference for a network and/or committee for pharmacy and other healthcare professionals focused on biologics and biosimilars medicines. Methods An electronic survey was developed and deployed for pharmacy and other healthcare professionals involved in the management of biologics and biosimilars via email cascade and social media, 12th February - 6th March 2023. The survey explored the preferred structure of the proposed group; formal committee and/or informal network, what the group would deliver, and any educational needs for members. The survey included questions about the respondent’s roles, sectors of work, regions and their clinical area(s). The open text responses were themed. The NHS health Research Authority tool was used to identify this project as service improvement and development, therefore did not require ethical approval. Results The responses received were from 46 pharmacists, 1 pharmacy technician, 15 doctors and nurses and 4 participants whose roles were unknown, working across multiple sectors; hospital, community, industry, and academia with representation from the devolved nations (n=3) and internationally (n=1). Most respondents expressed a need for a dedicated network and committee n=52 (79%), n=10 (15%) formal network, and n=4 (6%) informal committee. Common themes in response to what the group should deliver and educational needs included; harmonisation of approaches to guidelines and policies, pathway design, reduction in unwarranted variation (68%); platform to share new ideas, knowledge and peer advice (44%); strategy and leadership in service delivery and promotion of best practice and cost training, horizon scanning (29%); working collaboratively to produce multi-centre research projects (24%); to create a structured training programme for health care professionals (9%). Discussion/Conclusion The survey results highlight a gap in the current educational and professional support systems for PP’s concerning biologics and biosimilar medicines. The identified learning needs point to a strong demand for a structured network that can provide targeted education, share best practices and facilitate professional networking. The expertise within the group can also create formal eLearning programmes for healthcare professionals. This work serves as a foundational step towards the development this network, highlighting the critical areas of focus and the collective interest of the pharmacy community in bridging these gaps. The network should also facilitate communication and collaboration across different sectors, fostering a more cohesive and informed pharmacy community. Such an innovative network would not only enhance individual competency but also contribute to the overall advancement of pharmaceutical care in this specialised area.

Exploring patients’ views and experiences of side-effects and how they are reported, a focus group study

Abstract Introduction Adverse drug reactions (ADRs) are an increasing health concern, causing considerable physical, psychological and economic impacts1,2. The yellow card scheme (YCS) is the UK’s spontaneous reporting system, allowing patients and healthcare professionals to report ADRs (3). Research has shown that patient reports could provide a beneficial insight into real-world situations and are a key aspect of pharmacovigilance2. Despite this, under-reporting by patients remains a significant issue that needs to be addressed1. Aim This study aimed to explore views and experiences of the public regarding ADR reporting. Methods Following approval from Cardiff University School of Pharmacy and Pharmaceutical Sciences Research Ethics Committee, adult members of the South Wales public who had experienced an ADR (“side-effect”) were invited via social media outlets such as Facebook and WhatsApp to participate in an online (Zoom) focus group to discuss their ADR experience (including whether they reported) and knowledge and views on the YCS. Healthcare professionals were excluded from the study. Written informed consent and demographic information via a short online survey were obtained prior to the focus group. The focus groups were audio and video recorded via Zoom and discussions were transcribed verbatim. A thematic analysis was executed to identify fundamental themes. Results Four focus groups, involving 11 participants took place. The sample consisted mostly of females between 18-30 years of age from an ethnic minority background. Themes identified were lack of knowledge of ADRs and the YCS; support and barriers to reporting ADRs and strategies for improving YCS reporting. There was a lack of knowledge of ADRs with uncertainty over the concept of “side-effect” and varying degrees of understanding on the topic. All participants had suffered side-effects that were severe in nature, affecting them physically, psychologically or cosmetically. None of the participants had any concept of the YCS and side-effect reporting. Despite this, participants felt reporting of side-effects was vital to ensure the safety of medications and prevention of patient harm. The majority of participants sought support for side-effects from a General Practitioner (GP) or community pharmacist, although difficulties accessing GP appointments was a barrier. Strategies suggested for increasing awareness of YCS to increase ADR reporting were use of posters, social media, QR codes, online prompts, coffee mornings and letters sent home to parents from schools. Discussion / Conclusion If patients are unsure around the concept of a side-effect and don’t know about the YCS, reporting rates will continue to fall. Although it is recognised that the sample is not fully representative of the Welsh population, this small-scale exploratory study has nevertheless identified some possible concerns but also some opportunities to engage patients in ADR reporting. Patient education by healthcare professionals on side-effects, alongside increased promotion of the YCS via social media and advertisements in healthcare settings are key opportunities to increase patients’ awareness and understanding of ADRs and ADR reporting. Further research is essential to understand the extent of these issues and also to investigate how healthcare professionals can facilitate this process. Follow-up studies are planned.

Exploration of Features of Mobile Applications for Medication Adherence in Asia: Narrative Review.

Medication is crucial for managing chronic diseases, yet adherence rates are often suboptimal. With advanced integration of IT and mobile internet into health care, mobile apps present a substantial opportunity for improving adherence by incorporating personalized educational, behavioral, and organizational strategies. However, determining the most effective features and functionalities for these apps within the specific health care context in Asia remains a challenge. We aimed to review the existing literature, focusing on Asian countries, to identify the optimal features of mobile apps that can effectively enhance medication adherence within the unique context of Asian societies. We conducted a narrative review with the SPIDER (sample, phenomenon of interest, design, evaluation, research type) tool. We identified studies on mobile apps for medication adherence from January 2019 to August 2024 on PubMed and Scopus. Key search terms included "Asia," "chronic disease," "app," "application," "survey," "experiment," "questionnaire," "group," "medical adherence," "medication adherence," "case-control," "cohort study," "randomized controlled trial," "clinical trial," "observational study," "qualitative research," "mixed methods," and "analysis," combined using logical operators "OR" and "AND." The features of mobile apps identified in the studies were evaluated, compared, and summarized based on their disease focuses, developers, target users, features, usability, and use. The study identified 14 mobile apps designed to enhance medication adherence. Of these, 11 were developed by research teams, while 3 were created by commercial companies or hospitals. All the apps incorporated multiple features to support adherence, with reminders being the most common, present in 11 apps. Patient community forums were the least common, appearing in only 1 app. In total, 6 apps provided lifestyle modification functions, offering dietary and exercise recommendations, generating individualized plans, and monitoring progress. In addition, 6 apps featured health data recording and monitoring functions, with 4 allowing users to export and share records with researchers or health care professionals. Many apps included communication features, with 10 enabling feedback from researchers or health care professionals and 7 offering web-based consultation services. Educational content was available in 8 apps, and 7 used motivation strategies to encourage adherence. Six studies showed that mobile apps improved clinical outcomes, such as blood glucose, lipid, and pressure, while reducing adverse events and boosting physical activities. Twelve studies noted positive humanistic effects, including better medication adherence, quality of life, and user satisfaction. This review has identified key components integrated into mobile apps to support medication adherence. However, the lack of government and corporate involvement in their development limits the generalizability of any individual app. Beyond basic reminder functions, features such as multiuser support, feedback mechanisms, web-based consultations, motivational tools, and socialization features hold significant promise for improving medication adherence. Further pragmatic research is necessary to validate the effectiveness of these selected apps in enhancing adherence.

Advocating for planetary health is an essential part of advocating for children's health.

Burning of fossil fuels along with deforestation and ecological disruption have led to the warming of the Earth and climate change. Children are especially vulnerable to adverse health effects of climate change associated changes in the air, soil, and water as their organs are still developing, have a faster breathing rate, higher per pound ingested and inhaled exposures, and greater relative body surface area. To protect this vulnerable population, health care professionals need to play a leading role. In 2015, the American Academy of Pediatrics (AAP) updated their original 2007 Global Climate Change and Children's Health policy statement (again updated in 2024) stating that, "failure to take prompt, substantive action would be an act of injustice to all children." Health care professionals need to educate themselves and their patients of the health risks posed by climate change and incorporate climate change counseling into their practice. They also need to go beyond the framework of the healthcare system and work collaboratively with communities, corporations, and governments to advocate for policies and solutions to mitigate and adapt to climate change. The health and wellbeing of future generations rests upon the actions we take today. IMPACT: Summarizes the adverse effects of increased anthropogenic activity and burning of fossil fuels on planetary and human health Details the increased vulnerability of children to environmental assaults and their long-term effects Provides guidance and resources to health care professionals to empower them to act as advocates for systemic and structural changes that protect children's health.

Evaluation of the current use and impact of the United Kingdom Clinical Pharmacy Association (UKCPA) handbook of perioperative medicines

Abstract Introduction Originally a paper-based resource, the UKCPA Handbook of Perioperative Medicines1 moved online in 2019 and the website was updated in March 2024, with improved functionality. The resource aims to standardise management of medication during the perioperative period by providing evidence-based advice and guidance for healthcare professionals, removing the need for local Trust guidelines. Aim To evaluate current use of, and opinions of users of, the UKCPA Handbook of Perioperative Medicines. Methods Usage data, including engagement rate and time and frequently accessed monographs, was obtained for 4th-March-2024 to 29th-May-2024 from Google Analytics and the website dashboard. Further usage information and user opinion was collected using a 9-question survey hosted on Survey Monkey and disseminated via UKCPA’s ‘X’ account and Surgery and Theatres Committee, plus NHS England non-medical pre-operative association network. Ethical approval was not required as this was a service evaluation.2 Results Analytics Most (79%, 23158) users are from the United Kingdom where the engagement rate is 64%. Outside the UK most users are from Australia (1858), Ireland (785) and the United States (575). The average engagement time is 3-minutes and 42-seconds. Frequently accessed monographs include antiplatelets (aspirin, clopidogrel), direct oral anticoagulants (apixaban, edoxaban) and diabetic medication (sodium glucose co-transporter 2 inhibitors, insulin). Survey Of the 237 responses received, individual question completion rates varied. 72% (170) of respondents were aware of the Handbook of which 89% (151) use it, with 22% (34) having it as their sole resource. Respondents were predominantly from NHS secondary care sector and comprised of pharmacists (24%, 58), pre-assessment nurses (21%, 49) and anaesthetists (19%, 44). Most (84%, 133) users access it via desktop. 85% (132) of respondents either “strongly agreed” or “agreed” that it has a professional appearance, 82% (128) that it has good search functionality and 80% (126) that they could find the required information. Discussion and conclusion The Handbook is mostly accessed within the United Kingdom, where it has a good engagement rate.3 However, there is usage on a global scale from countries including Australia, Ireland, USA, NZ, Canada, and Germany. Monographs for medicines considered ‘high-risk’ or where there is potential controversy about their perioperative management are the most accessed. There is good awareness of the Handbook from respondents, with the majority of those familiar with it using it in their area of work. It is expected that those who are aware of the Handbook would be more likely to respond to the survey. The Handbook is mainly used within the NHS secondary care setting, where most surgical procedures take place. However, it is likely that due to how the survey was disseminated, this influenced the healthcare professional groups that responded. In general, the Handbook is deemed to have a professional appearance, good search functionality and includes information that healthcare professionals require. The aim of the Handbook is to provide a standardised, evidence-based resource for healthcare professionals for perioperative medicines management. The survey results indicate that there is still variation in practice with centres choosing to use it in conjunction with other guidelines as opposed to their sole resource.