Healthcare Support System Research Articles

MEDICINE COMPLIANCE AND BARRIERS TOWARDS THE HYPERTENSION MANAGEMENT IN PAKISTAN

Background: Hypertension poses a significant public health challenge in Pakistan, contributing substantially to morbidity and mortality. Medication compliance in hypertension management is a critical concern, often hindered by factors such as forgetfulness, financial constraints, and limited awareness. Although this issue is widely documented, there is a lack of data on medication compliance and barriers in the remote areas of Southern Sindh, where healthcare access and awareness are often limited. Objective: To explore medication compliance and identify barriers to hypertension management in Southern Sindh, Pakistan. Methods: A cross-sectional study was conducted among 260 hypertensive patients attending the outpatient department of a tertiary care hospital in Thatta, a district in Southern Sindh. Participants were selected using simple random sampling. Inclusion criteria included patients aged 20 years and above with a confirmed diagnosis of hypertension. Data were collected using a validated questionnaire following informed consent. Ethical approval was obtained from the relevant review board. The collected data were analyzed using SPSS version 25, with descriptive statistics used to summarize findings. Results: The study found that 63.8% of participants cited forgetfulness as the primary barrier to medication adherence. Financial constraints affected 16.9%, while 8.1% reported medication side effects as a barrier. Adherence levels varied, with 30.8% reporting no difficulty, 17.7% finding adherence slightly difficult, and 20.4% moderately difficult. A further 19.2% and 11.9% found adherence very difficult and extremely difficult, respectively. Demographically, 63.1% were male, and 43.8% had completed matriculation education. Conclusion: Medication compliance in hypertension management remains a significant challenge in Southern Sindh, primarily due to forgetfulness and financial barriers. Addressing these issues through improved patient education, affordable medication access, and enhanced healthcare support systems is vital for better hypertension management in this underserved region.

Cognitive Computing Approaches A Comprehensive Performance Evaluation Using the Weighted Property Method

In an era of rapid technological advancement, cognitive computing is emerging as a transformative paradigm that integrates methods from psychology, biology, signal processing, and mathematics to create intelligent computational systems. This research uses the Weighted Property Methodology (WPM) to comprehensively evaluate various cognitive computing approaches, analyzing their performance on important dimensions including ethical and social implications, learning rate, usability, and decision support. This study systematically examines five cognitive computing approaches: brain-inspired, human-like, adaptive, intelligent, and intelligent computing. Through rigorous multi-criteria analysis, brain-inspired computing distinguished itself as the best-performing approach, achieving a maximum priority score of 0.86755. The ability of this approach to model computational processes after human neural structures demonstrates significant potential for advanced technological development. Key findings reveal that cognitive computing is not a single concept but a complex ecosystem of interconnected methods. Human-like computing came in second, emphasizing the critical role of human-centered design in technological innovation. Adaptive computing came in third, highlighting the importance of dynamic computational reconfiguration. The research underscores the critical role of cognitive computing in addressing contemporary challenges in domains such as healthcare, web development, and decision support systems. By simulating human-like cognitive processes, these approaches offer unprecedented capabilities in processing complex, multidimensional data and making intelligent, context-aware decisions. This comprehensive analysis provides valuable insights into the evolving landscape of cognitive computing, and provides a roadmap for future research and technological innovation in a data-driven world.

Fecal carriage of ESBL-producing E. coli and genetic characterization in rural children and livestock in the Somali region, Ethiopia: a one health approach

BackgroundThe emergence and spread of Extended-Spectrum Beta-Lactamase (ESBL)-producing Escherichia coli pose significant challenges for treatment of infections globally. This challenge is exacerbated in sub-Saharan African countries, where the prevalence of ESBL-producing E. coli is high. This, combined with the lack of a strong and supportive healthcare system, leads to increased morbidity and mortality due to treatment failures. Notably, studies in Ethiopia have primarily focused on hospital settings, leaving a gap in understanding ESBL prevalence in rural communities, where human-animal proximity may facilitate microbial exchange.MethodsWe conducted a community-based study in the rural Somali region of Ethiopia, simultaneously examining the fecal carriage of ESBL-producing E. coli in children aged 2–5 years and their livestock (cattle, camel, goat). Fecal samples from 366 children and 243 animals underwent phenotypic screening for ESBL-producing E. coli. Following phenotypic confirmation, ESBL resistance genes were identified via conventional PCR. Whole-genome sequencing (WGS) was performed on a subset of isolates from human feces.ResultsWe found that 43% (159/366) of children and 3.7% (9/244) of livestock harbored ESBL-producing E. coli. The ESBL gene blaCTX-M-15 was predominant in human (82.7%, 120/145) and livestock (100%) isolates. In the 48 human E. coli isolates subjected to WGS, a high diversity resulting in 40 sequence types (STs) was observed. Among these, ST-2353 was the most prevalent (5/48), followed by ST-10 and ST-48 (3/48) and ST-38, ST-450, and ST-4750 (2/48). These STs were associated with multiple resistance genes, such as blaCTX-M-15, blaTEM-1B, blaOXA-1, blaCTX-M-14 and blaTEM-35.ConclusionWe report a high prevalence of ESBL E. coli in rural children, which outnumbers its prevalence in livestock. These isolates displayed a high diversity of sequence types (STs) with ST-2353 being the dominant ST. Our study is the first to report the association of ST-2353 with multi-drug resistance genes in Ethiopia. Further research using an integrated approach including other domains such as water and food products is needed to truly understand and combat AMR transmission and acquisition in this region.

Beyond Housing First: rethinking neoliberal policies impacting homelessness.

This article critically examines the Housing First model within the broader context of neoliberal policies impacting homelessness, particularly at the intersection of mental illness, poverty, and addiction. While Housing First is celebrated for its effectiveness in providing immediate housing to chronically homeless individuals, this model's alignment with neoliberal principles prioritizes cost effectiveness and visible outcomes over comprehensive care. As a harm reduction approach, Housing First often overlooks the underlying mental health and addiction issues that maintain homelessness, resulting in a cycle of dependency rather than long-term recovery. In this article, we argue that the reduction in funding for transitional housing and mental health services, driven by neoliberal policies, has exacerbated the challenges faced by marginalized populations. A call is made for a shift toward more holistic and integrated approaches that balance immediate housing solutions with robust mental health care and social support systems, aiming for sustained recovery, independence, and social reintegration for individuals experiencing homelessness.

Patient perspectives on living with chronic myeloid leukemia in India: Quality of life, psychosocial support, and stigma

Chronic myeloid leukemia (CML) stands a frequently encountered type of blood cancer. Despite advancements in treatment, CML patients in India encounter obstacles in accessing healthcare and managing treatment-related side effects. This review focuses on understanding the experiences of patients living with CML in India. It delves into various aspects, such as their quality of life, the psychosocial support they receive, and the stigma they might face due to their condition. Psychological, emotional, and financial burdens are significant, compounded by limited social support and stigma. Coping strategies and psychosocial interventions play crucial roles in addressing these challenges. In addition, the review underscores the importance of patient-centred care and advocacy in enhancing outcomes and addressing unmet needs in CML management. Understanding the experiences of patients living with CML informs strategies for improving healthcare services and support systems to ensure holistic care and a better quality of life for patients.

Reproductive decision-making experiences of Australian adults with neurofibromatosis type 1 and schwannomatosis.

Individuals with neurofibromatosis type 1 and schwannomatosis (NF) often face difficult reproductive choices when family planning; however, their experiences and the barriers and enablers to reproductive decision-making are poorly understood. The purpose of this study was to explore the opinions and experiences of individuals with NF in Australia and inform the development of practice recommendations and resources. Focus groups with adults with NF were conducted using a semi-structured interview schedule developed by the research team. Partners were also invited. The focus groups were recorded, de-identified, transcribed, and analyzed using codebook thematic analysis. Three focus groups were conducted with 17 participants (12 = NF1, 4 = NF2-related schwannomatosis [NF2-SWN] and one partner). Three themes were identified: (1) Barriers and enablers; (2) Contemplating the options; and (3) Education and support needs. Barriers to reproductive decision-making included: difficulty accessing healthcare services to discuss reproductive planning; a lack of access to reliable information sources and support; and, in some cases, the financial cost of assistive reproductive technology. Conversely, positive healthcare experiences and support systems enabled reproductive choices. Participants reported many factors that contributed to their reproductive decisions, including: their personal experience of their condition; concern about their future health and that of an affected child; the impact of pregnancy on their health; and the opinion of healthcare providers, family, and friends. Many participants reported mental health difficulties related to their condition and additional stressors related to the reproductive journey. Participants' recommendations included increased access to healthcare services to discuss reproductive options, the development of comprehensive information resources, and improved psychological and peer support for individuals with NF considering family planning and, where relevant, their partners. In conclusion, people with NF and their partners identify a need for improved awareness of NF among healthcare professionals and increased access to appropriate services, information, and support to facilitate informed reproductive decision-making.

Using Large Language Models to Abstract Complex Social Determinants of Health From Original and Deidentified Medical Notes: Development and Validation Study.

Social determinants of health (SDoH) such as housing insecurity are known to be intricately linked to patients' health status. More efficient methods for abstracting structured data on SDoH can help accelerate the inclusion of exposome variables in biomedical research and support health care systems in identifying patients who could benefit from proactive outreach. Large language models (LLMs) developed from Generative Pre-trained Transformers (GPTs) have shown potential for performing complex abstraction tasks on unstructured clinical notes. Here, we assess the performance of GPTs on identifying temporal aspects of housing insecurity and compare results between both original and deidentified notes. We compared the ability of GPT-3.5 and GPT-4 to identify instances of both current and past housing instability, as well as general housing status, from 25,217 notes from 795 pregnant women. Results were compared with manual abstraction, a named entity recognition model, and regular expressions. Compared with GPT-3.5 and the named entity recognition model, GPT-4 had the highest performance and had a much higher recall (0.924) than human abstractors (0.702) in identifying patients experiencing current or past housing instability, although precision was lower (0.850) compared with human abstractors (0.971). GPT-4's precision improved slightly (0.936 original, 0.939 deidentified) on deidentified versions of the same notes, while recall dropped (0.781 original, 0.704 deidentified). This work demonstrates that while manual abstraction is likely to yield slightly more accurate results overall, LLMs can provide a scalable, cost-effective solution with the advantage of greater recall. This could support semiautomated abstraction, but given the potential risk for harm, human review would be essential before using results for any patient engagement or care decisions. Furthermore, recall was lower when notes were deidentified prior to LLM abstraction.

1.N. Scientific session: Child injuries monitoring and reporting: Challenges and technological developments

Abstract Globally, more than 1,600 children and adolescents below the age of 19-years die every day from preventable injuries. Road traffic injuries, drowning and self-harm represent leading causes of death and injury among children and adolescents (WHO 2021; WHO Regional Office for Europe, 2021; Unicef, 2021). Most unintentional injuries in early childhood occur at home and children from less advantaged backgrounds are exposed to more hazardous home environments due to overcrowding or unsafe structures over which parents often have limited control (WHO, 2020). According to the IDB data analysis approximately 15% of home injuries could have been prevented by improved product safety and parental education. The COVID-19 pandemic and the conflict in Ukraine have created a complex and challenging situation for children and adolescents in the region, increasing their vulnerability and compromising their well-being. To efficiently prevent child injuries, one must account for a complex interplay between human factors as well as physical and socio-cultural environments. Multiple determinants of child injury cannot be addressed by the health sector alone, this is why a whole-of-government and a whole-of-society approaches are required. Schools have a crucial role to play for promoting the well-being of children and serve as a platform to increase access to health services. However, EU countries are still missing intersectoral collaboration and strong information systems to enable efficient response to the problem. Data on child injuries are still inconsistently collected in Europe due to substantial differences in coding systems, variation between injury mechanisms, different general policies pertaining to the admission of patients, and legal policies on reporting requirements. EU-wide networks such as the Eurosafe study (IDB network) collecting information on child injuries, are scarce. Likewise, access to healthcare services and support systems are unevenly distributed, particularly in underserved communities. Building country capacity in collecting, analysing and increasing the use of child injury data for decision making at global, regional, and national levels, is critical. Adequate epidemiological data on the burden of child injuries are necessary to allow governments prioritize areas for intervention and maximize the impact of their resources. Utilizing evidence-based tools and procedures and promoting intersectoral collaboration is vital. The workshop aims to discuss trends and inequalities of injury burden and present efficient measures and latest developments in monitoring and reporting child injuries across EU countries. The workshop will further discuss the methodological challenges in collecting and analysing data on child injuries. Evidence-informed tools for sharing health information and improved measurements of injury burden that are feasible and usable in both research and clinical contexts will be presented and success stories will be presented. Key messages • There is an EU-wide need for epidemiological data on the burden of child injuries. • Validated tools, well-designed injury data management systems and standard data collection procedures are missing.

Social Media Influence on Factors Affecting Quality of Life among Breast Cancer Survivors: A Conceptual Study

Breast cancer disease remains a significant burden in global public health, affecting women with new cases and mortality. In 2018, Malaysian women of different races, like Malays, Chinese, and Indians, were diagnosed with breast cancer, approximately 17,000 in total. The consequence is that their quality of life was affected, especially in physical and emotional health. Nowadays, the use of social media among users is increasing, and in healthcare, it examines the role of social media in patient education and social support, which highlights the importance of modern digital technology. This conceptual study examines the factors affecting quality of life, moderated by the role of social media influence. Sociodemographic, psychological state, self-care behaviors, social support, and healthcare support systems were among the factors identified. The study relies on the integration of the quality-of-life model and social cognitive theory in conducting the literature review. Furthermore, this study has implications for improving the quality of life through social media, promoting patient-doctor engagement with social media, supporting policymakers in improving public health outcomes, and identifying potential future research topics. Theoretical contributions with integrated frameworks and an innovative approach to breast cancer survivorship were also identified. Policymakers and healthcare professionals have an opportunity to make practical contributions through the use of social media. The study's limitations were a narrow focus on cancer research, limited generalisability, and a broad range of social media investigations

Integration of Health Care Modules in Current Health Care Management Systems in India

Health care beyond worldwide boundaries is a critical problem, particularly when the population differs in terms of geographic position, culture, habits, socioeconomic background, medical strategy, and variations in disease burden over time. For countries like India, with a significant percentage of high-end medical experts as well as support and other health care systems, the development and integration of comprehensive and functionally versatile health care management systems are among the most important clinical problems addressed. The central dogma of a country that facilitates adopting a conglomeration will create a dedicated population to provide tailor-made health care in health shield, health protection, and health care delivery; a nation that takes care of a nation. Until now, it has given us E-Health, and offerings have been fine-tuned in research literature. In India, the health care domain is currently breaking the boundaries of knowledge workers in clinical and research domains working with the help of these workhorses (Fletcher-Brown et al. 2021). Many e-governance and public health reform programs in India are under consideration, and many of them are under implementation. This research focuses more on the integration of health care technology relevant to the paper topic within clinical setups, passive provision, and utilization of services for administrative purposes technologically implemented (Das et al. 2023).

Use of Creative Frameworks in Health Care to Solve Data and Information Problems: Scoping Review.

Digitization is vital for data management, especially in health care. However, problems still hinder health care stakeholders in their daily work while collecting, processing, and providing health data or information. Data are missing, incorrect, cannot be collected, or information is inadequately presented. These problems can be seen as data or information problems. A proven way to elicit requirements for (software) systems is by using creative frameworks (eg, user-centered design, design thinking, lean UX [user experience], or service design) or creative methods (eg, mind mapping, storyboarding, 6 thinking hats, or interaction room). However, to what extent they are used to solve data or information-related problems in health care is unclear. The primary objective of this scoping review is to investigate the use of creative frameworks in addressing data and information problems in health care. Following JBI guidelines and the PRISMA-ScR framework, this paper analyzes selected papers, answering whether creative frameworks addressed health care data or information problems. Focusing on data problems (elicitation or collection, processing) and information problems (provision or visualization), the review examined German and English papers published between 2018 and 2022 using keywords related to "data," "design," and "user-centered." The database SCOPUS was used. Of the 898 query results, only 23 papers described a data or information problem and a creative method to solve it. These were included in the follow-up analysis and divided into different problem categories: data collection (n=7), data processing (n=1), information visualization (n=11), and mixed problems meaning data and information problem present (n=4). The analysis showed that most identified problems fall into the information visualization category. This could indicate that creative frameworks are particularly suitable for solving information or visualization problems and less for other, more abstract areas such as data problems. The results also showed that most researchers applied a creative framework after they knew what specific (data or information) problem they had (n=21). Only a minority chose a creative framework to identify a problem and realize it was a data or information problem (n=2). In response to these findings, the paper discusses the need for a new approach that addresses health care data and information challenges by promoting collaboration, iterative feedback, and user-centered development. Although the potential of creative frameworks is undisputed, applying these in solving data and information problems is a minority. To harness this potential, a suitable method needs to be developed to support health care system stakeholders. This method could be the User-Centered Data Approach.

Barriers and facilitators to bridging the healthcare digital divide for the older adults: A qualitative research from patients in China.

The aim of this study was to explore the barriers and facilitators underlying the healthcare digital divide by using qualitative methodologies, integrated with the Capabilities, Opportunities, Motivations, and Behaviors (COM-B) as well as the Behavior Change Wheel (BCW) theoretical frameworks. To conduct a thorough analysis, semi-structured，in-depth interviews were orchestrated among a cohort of older patients who had experiences with digital healthcare systems. Data were meticulously analyzed via Colaizzi's seven-step methodological procedure. Nine barriers were elucidated, including physical limitation, inadequate training and support, self-imposed denial, failure to rebuild the digital healthcare environment, equipment constraints, deficits in communication and feedback, skepticism regarding data accuracy and validity, sense of social deprivation, and network information boycott. Conversely, eleven facilitators were identified, encompassing peer modeling, availability of training and support, reconstructive efforts toward the digital healthcare environment, mandatory usage, familial influence, media impact, scientific publicity and education, enhancement of self-efficacy, sense of social participation, perceived convenience, and access to healthful information. Based on the COM-B and BCW models, healthcare organizations may be able to improve their digital healthcare support systems (capabilities), technical design, network speed, and equipment configuration (opportunities), as well as focus on "human-computer integration," the parallel existence of digital technology and humanistic care, and taking into account the issues of information security, accuracy, and human rights equality (motivation) while benefiting the patients, in order to bridge the healthcare digital divide for the older adults.

The impact of climate variation on the spread of Shiga toxin-producing E. coli.

Shiga toxin-producing Escherichia coli (STEC) is influenced by seasonality, but there is limited understanding of how specific climatic variables contribute to disease spread. This information aids in understanding disease transmission dynamics and could potentially inform public health modeling. This retrospective cohort study analyzed public health data from Ontario, Canada, between 2012 and 2021, along with historical climate data from Environment Canada. We employed Seasonal Autoregressive Integrated Moving Average (S-ARIMA) models to assess how temperature and precipitation impact the incidence of STEC infections, measured per 10,000,000 population. The study included 1658 confirmed STEC cases. A significant correlation was found between STEC incidence and climatic variables. Each degree Celsius increase in maximum temperature was associated with a rise of 3 STEC cases per 10,000,000 population (Centers for Disease Control and Prevention (2024)). Additionally, each millimeter of increased precipitation correlated with an increase of 1.1 cases per 10,000,000 population. The findings demonstrate a significant impact of temperature and precipitation on STEC transmission, highlighting the importance of integrating meteorological data into public health surveillance. This integration may help inform public health responses and support healthcare systems in planning for future outbreaks. Further studies are needed to refine predictive models and develop effective early warning systems for clinical settings.

Deep Learning-Based System Combining Chest X-Ray and Computerized Tomography Images for COVID-19 Diagnosis.

Aims/Background: The coronavirus disease 2019 (COVID-19) pandemic has highlighted the need for accurate and efficient diagnostic methods. This study aims to improve COVID-19 detection by integrating chest X-ray (CXR) and computerized tomography (CT) images using deep learning techniques, further improving diagnostic accuracy by using a combined imaging approach. Methods: The study used two publicly accessible databases, COVID-19 Questionnaires for Understanding the Exposure (COVID-QU-Ex) and Integrated Clinical and Translational Cancer Foundation (iCTCF), containing CXR and CT images, respectively. The proposed system employed convolutional neural networks (CNNs) for classification, specifically EfficientNet and ResNet architectures. The data underwent preprocessing steps, including image resizing, Gaussian noise addition, and data augmentation. The dataset was divided into training, validation, and test sets. Gradient-weighted Class Activation Mapping (Grad-CAM) was used for model interpretability. Results: The EfficientNet-based models outperformed the ResNet-based models across all metrics. The highest accuracy achieved was 99.44% for CXR images and 99.81% for CT images with EfficientNetB5. The models also demonstrated high precision, recall, and F1 scores. For statistical significance, the p-values were less than 0.05, indicating that the results are significant. Conclusion: Integrating CXR and CT images using deep learning significantly improves the accuracy of COVID-19 diagnosis. The EfficientNet-based models, with their superior feature extraction capabilities, show better performance than ResNet models. Grad-CAM Visualizations provide insights into the model's decision-making process, potentially reducing diagnostic errors and accelerating diagnosis processes. This approach can improve patient care and support healthcare systems in managing the pandemic more effectively.

The impact of the COVID-19 pandemic on health-related quality of life of cancer patients in British Columbia

BackgroundThe COVID-19 pandemic resulted in unprecedented changes to cancer care in many countries, impacting cancer patients’ lives in numerous ways. This study examines the impact of changes in cancer care on patient’s health-related quality of life (HRQL), which is a key outcome in cancer care. The study aims to estimate patients’ self-reported HRQL before and during the pandemic and identify predictive factors for their physical and mental wellbeing.MethodThe study employed the large-scale Outpatient Cancer Care (OCC) Patient Experience Survey, including the Veterans RAND 12-Item Health Survey, to evaluate cancer patients’ experiences and HRQL before (January to May 2020) and during the COVID-19 pandemic (May to July 2021). Paired t-tests were conducted to compare differences in Physical Component Scores (PCS) and Mental Component Scores (MCS) before and during the pandemic. Multivariable linear regressions were employed to investigate the factors (sociodemographic, clinical, and patient-reported experience) influencing PCS and MCS during the pandemic.ResultsPCS decreased significantly during the pandemic, while MCS remained stable. Lower PCS contributors included older age, more telehealth visits, self-reported hospitalization, and a longer time since the last cancer diagnosis. Higher PCS was associated with urban residence, higher MCS during the pandemic, and perceived active Healthcare Provider (HCP) involvement. For MCS, lower scores related to female gender and more telehealth visits, while higher scores were associated with being white, higher education, high MCS before the pandemic, and perceived active HCP involvement.ConclusionThe OCC Patient Experience Survey provides a unique patient level data set measuring HRQL pre- and post- the onset of the COVID-19 pandemic. The study highlights challenges faced by cancer patients during the pandemic, with a significant reduction in PCS. However, the stability in MCS suggests effective coping mechanisms. Sociodemographic, clinical, and telehealth-related variables play a complex role in shaping both PCS and MCS. Perceived HCP involvement emerges as a crucial factor correlating with higher PCS and MCS. Navigating the post-pandemic era necessitates interventions fortifying patient-provider relationships, optimizing healthcare support systems, such as telehealth services, and prioritizing mental-well-being given its impact on both PCS and MCS.

Epigenetics of violence against women: a systematic review of the literature.

Violence against women is a pervasive global issue with profound impacts on victims' well-being, extending across cultural boundaries. Besides immediate physical harm, it triggers mental health consequences such as post-traumatic stress disorder (PTSD). Indeed, it is the trauma experienced during a violent event that can lead to epigenetic modifications, ultimately contributing to the onset of PTSD. While research on the epigenetic effects of trauma initially focused on war veterans and disaster survivors, there is a dearth of studies on violence against women. In this article, we performed a systematic review aimed to fill this gap, examining existing studies on the epigenetic impact of violence on women. The review assessed sample sizes, study validity, and gene-specific investigations. Currently, there is insufficient data for a comprehensive meta-analysis, highlighting a nascent stage in understanding this complex issue. Future research is crucial for deeper insights into the epigenetic mechanisms related to violence against women, contributing to improved interventions and support healthcare systems for affected individuals.

Unveiling the heart of disaster nursing: A qualitative study on motivations, challenges, and lessons from the devastating 2023 Turkey earthquakes.

Turkey has faced a notable escalation in earthquake disasters in the last two decades. Despite initiating a health and disaster management system, nurses' pivotal roles and experiences in handling such crises have been disregarded. This qualitative study analyzed nurses' experiences before, during, and after deployment in response to the 2023 Turkey earthquakes to enhance disaster-response efforts. This descriptive qualitative study was conducted between March and May 2023 using semistructured interviews with 15 nurses purposively sampled among those who volunteered to work in the earthquake zone. The MIRACLE and COREQ guidelines were followed for reporting qualitative research. The analysis exposed five main themes for pre-tasking: moral obligation, motivation, insufficient experience, balancing responsibilities, and preparation challenges. The peri-task themes include responsibilities, skills, bravery and characteristics, workload management, teamwork, and outcomes. Post-tasking has three themes: competence assessment, career goals and aspirations, and support. Training and coping with anxiety and stress are common themes for all phases. Disaster relief requires a comprehensive and coordinated response from healthcare organizations, government agencies, and support systems. Providing adequate training, ensuring safety protocols, offering mental health support, and fostering a fair and supportive work environment are crucial steps in mitigating the adverse effects on nurses and, by extension, the patient care process in earthquake-affected areas. Nurse training in disaster preparedness should cover various response methods and involve multiple disciplines. Managers can help by arranging drills, simulations, online courses, and workshops and promoting partnerships for improved collaboration. Psychological support should be included to address emotional challenges. Regularly updating response policies based on past experiences is crucial for preparedness and efficiency.

Digital Transformation of Medical Libraries

The prospects presented by digital transformation holds the potential of greatly increasing the capacity of medical libraries, which in turn it will make it possible for these libraries to provide better services and increasing accessibility. But how can digital technologies be adopted in transforming medical libraries' services and operations, in the digital transformation era? This study looked at the opportunities and challenges associated with implementing digital technologies in medical libraries through digital transformation. The study thus reviewed literature on digital transformation of medical libraries services, as a way to support healthcare systems in South Africa. The chapter revealed that digital transformation has the potential to enhance libraries processes, practices, performance, and to stay relevant in their increasingly competitive environment.

Addressing the challenges of dementia care in Nigeria: A call for a comprehensive national strategy

AbstractDespite the growing prevalence of dementia, driven by an ageing population and compounded by cultural misunderstandings and stigma, Nigeria lacks a coherent national plan to address this issue. The article points out that although Nigeria has enacted policies such as the National Aging Policy, which do not sufficiently address the specific needs of people living with dementia. It underscores the necessity of integrating a dementia strategy within the broader health and social care systems of Nigeria. The article draws on the World Health Organization's Global Dementia Action Plan to elaborates on several critical areas for action, including public health prioritization of dementia, awareness and stigma reduction, improved diagnosis, treatment, care, and support, alongside bolstering support for caregivers. It stresses the importance of a dementia‐friendly infrastructure, research and innovation, and leveraging community support to foster a more inclusive society. Furthermore, the article outlines current state of healthcare and social support systems in Nigeria, pointing to significant gaps in infrastructure, healthcare workforce, and financial mechanisms that hinder effective dementia care. Hence, elevating dementia care as a national health priority, and increasing access to quality care and support, Nigeria is well positioned to mitigate the impact of dementia on families and the person with dementia. The call to action is clear: a national dementia strategy, informed by global best practices and tailored to Nigeria's unique cultural and societal context, is essential for addressing the challenges of dementia care and improving the well‐being of affected individuals and their families in Nigeria.

Moving forward with dementia: an explorative cross-country qualitative study into post-diagnostic experiences

Objectives This explorative cross-country qualitative study aims to describe experiences of receiving a dementia diagnosis and experiences of support following a diagnosis in Australia, Canada, the Netherlands and Poland. Method Qualitative study using projective techniques during online focus groups, online and telephone interviews with people with dementia and caregivers. Results Twenty-three people with dementia and 53 caregivers participated. Qualitative content analysis revealed five themes; (1) ‘Coming to terms with dementia’ helped people deal with complex emotions to move forward. (3) ‘The social network as a source of support’ and (4) ‘The challenges and realities of formal support’ and impacted ‘Coming to terms with dementia’. (2) ‘Navigating life with dementia as a caregiver’ highlights caregiver burden and was impacted by (4) ‘The challenges and realities of formal support’. People were (5) ‘Self-caring and preparing for tomorrow’ as they focused on maintaining current health whilst planning the future. Despite differences in healthcare and post-diagnostic support systems, there were more similarities across countries than differences. Conclusion Across countries, formal support and support from friends and family are crucial for people with dementia and caregivers to come to terms with dementia and maintain carer wellbeing to ultimately live well with dementia.