Health Planners Research Articles

Reproductive Tract Infections among Women in Pakistan: An Urban Case Study

Reproductive tract infections (RTIs) among women—despite being common and having grave consequences—are not given much attention by policy-makers and health planners. The asymptomatic nature of most infections makes their detection and diagnosis difficult, making laboratory testing the most accurate method of bio-medical diagnosis. The present paper assesses the magnitude and nature of infections as diagnosed through laboratory testing and looks into the variation in magnitude and the nature of RTIs among women with different socio-economic and demographic characteristics. The aetiological rate of infection among women is found to be 24 percent, with the majority of these women testing positive for endogenous infections. Factors significantly increasing the likelihood of having an infection include intrauterine device use or getting a tubectomy, short inter-pregnancy intervals, and lower economic status of women.

Magnitude of intestinal parasitic infections and its determinants among HIV/AIDS patients attending at antiretroviral treatment centers in East and West Gojam Zones, Northwest, Ethiopia: institution based cross-sectional study

BackgroundIntestinal parasitic infections (IP) are a major source of morbidity in people living with Human immunodeficiency virus (HIV), particularly in resource-limited settings, mostly as a result of high viral load. Hence, this study aimed to investigate the magnitude of intestinal parasitic infections and its determinants among patients with HIV/AIDS attending public health facilities in East and West Gojam Zones in Ethiopia.MethodsInstitution-based cross-sectional study was conducted on 327 people living with HIV visiting public health facilities from December 2022 to May 2023. A simple random sampling technique was used to recruit participants. Face-to-face interviews were used to collect socio-demographics and determinants. The fresh stool was collected from each patient, transported, and tested in accordance with laboratory standard operating procedures of wet mount, formol-ether concentration technique, and modified acid-fast staining. Data were entered and analyzed in the statistical package for Social Science (SPSS) version 20. A 95% CI with p-value < 0.05 was considered statistically significant.ResultsThe overall prevalence of IP in patients with HIV/AIDS was 19.3% (63/327). Hookworm was the most identified parasite 33.3% (21/63) followed by E.histolytica 17% (11/63) and G.lamblia 14.3% (9/63). Parasitic infections were significantly higher among viral load > 1000cps/ml (p = 0.035), WHO stage 4 (p = 0.002), CD4 < 200 cell/mm3 (p = 0.001), and bare foot walking (p = 0.001).ConclusionIP infections are moderately high among patients with HIV/AIDS in the study area. The proportion of parasites was greatly affected by high viral load, WHO stage 4, CD4 < 200 cell/mm3, and being barefoot; this gives valuable insight to health professionals, health planners and community health workers. As a result, viral load monitoring, and WHO stage controlling were periodically assessed in patients with HIV/AIDS. Health education, awareness creation, routine stool examination, and environmental hygiene were regularly advocated to increase the life of patients with HIV/AIDS.

Facilitators and barriers to self-management in Iranian men with chronic obstructive pulmonary disease: a qualitative study

IntroductionSelf-management, as the most common method of chronic obstructive pulmonary disease (COPD) management, is not an isolated behaviour, but a set of physical, social, cultural, psychological and existential factors affecting...

Mapping the Geographic Inequalities in Psychiatrist Distribution across Madhya Pradesh, India: An Exploratory Study.

The National Mental Health Survey identified a vast treatment gap across India. This treatment gap is partly attributed to the availability and accessibility of mental health services in different states. Accessibility to a psychiatrist in Madhya Pradesh (MP) is essential due to the significant disparity among urban, rural, and tribal regions across the state. The study attempted to identify the geographical disparity of psychiatrists in MP to improve future mental health service delivery. An online survey of practicing psychiatrists was conducted in December 2022 in the settings of public and private healthcare service delivery systems through offline and online accessibility/availability of psychiatrists practicing in MP, and the data were mapped using geo-locations of psychiatrists and were analyzed using ArcMap 10.8.1. In total, 152 psychiatrists were practicing in MP across 195 locations, which amounts to 0.21 psychiatrists per 100,000 population with a concentration around big cities. Out of 54 districts, 24 districts did not have any practicing psychiatrists. A total of 155 health facilities were identified across 30 (55.6%) districts where at least one psychiatrist provided mental health services. The nearest-neighbor index for 152 points was -13.69. Combining psychiatrist geo-mapping data with population data comprehensively explains the MP state's mental health service delivery needs. It could be wise to improve the spatial distribution of psychiatrists in each district rather than achieving the recommended ratio of doctors to patients per state. These data need to be supplemented with qualitative inquiry to help policymakers and health planners generate effective public-private partnerships in mental health service delivery in the coming time.

Can proactive support prevent unscheduled care? A controlled observational retrospective cohort study in cancer patients in Scotland

IntroductionPreventative spend is a global health and social care strategy. Improving Cancer Journeys (ICJ) is a proactive, holistic, multidisciplinary project consistent with this agenda, currently being rolled out across Scotland and parts of UK. ICJ helps people with cancer access whatever support they need to mitigate their most pressing concerns. This study hypothesised that ICJ service users should subsequently use less unscheduled care than matched cohorts not using ICJ.MethodsRetrospective observational cohort study using linked national datasets. N = 1,214 ICJ users in Glasgow were matched for age, sex, deprivation, cancer type, stage, and diagnosis year to two control groups: 1. Cancer patients from Glasgow before ICJ (pre-2014), 2. Cancer patients from rest of Scotland during study period (2014–2018). Cancer registrations were linked for 12-month baseline and study periods to: NHS24 calls, A&E admissions, inpatient hospital admissions, unscheduled care, number & cost of psychotropic prescriptions. Per-person mean service uses were compared between groups.ResultsThere was a significant increase in NHS24 calls in the ICJ group (0.36 per person vs. -0.03 or 0.35), more and longer A&E attendances in ICJ (0.37 per person vs. 0.19 or 0.26; 2.19 h per person vs. 0.81–0.92 h), more and longer hospital admissions in ICJ (4.25 vs. 2.59 or 2.53; 12.05 days vs. 8.37 or 8.64), more care pathways involving more steps in ICJ (0.77 spells vs. 0.39 or 0.57; 1.88 steps vs. 1.56 or 1.21), more psychotropic drug prescriptions and higher costs in ICJ (1.88 prescription vs. 1.56 or 1.21; £9.51 vs. £9.57 or £6.95) in comparison to both control groups.DiscussionICJ users sourced significantly more unscheduled care than matched cohorts. These findings were consistent with much of the comparable literature examining the impact of non-health interventions on subsequent health spend. They also add to the growing evidence showing that ICJ reached its intended target, those with the greatest need. Together these findings raise the possibility that those choosing to use ICJ may also be self-identifying as a cohort of people more likely to use unscheduled care in future. This needs to be tested prospectively, because this understanding would be very helpful for health and social care planners in all countries where proactive holistic services exist.

'Acceleration' of the food delivery marketplace: Perspectives of local authority professionals in the North-East of England on temporary COVID regulations.

In January 2021, we assessed the implications of temporary regulations in the United Kingdom allowing pubs and restaurants to operate on a takeaway basis without instigating a change of use. Local authorities (LAs) across the North-East of England were unaware of any data regarding the take-up of these regulations, partially due to ongoing capacity issues; participants also raised health concerns around takeaway use increasing significantly. One year on, we repeated the study aiming to understand the impact of these regulations on the policy and practice of key professional groups. Specifically, we wanted to understand if LAs were still struggling with staff capacity to address the regulations, whether professionals still had public health trepidations, and if any unexpected changes had occurred across the local food environment because of the pandemic. We conversed with 16 public health professionals, planners and environmental health officers across seven LAs throughout the North-East of England via focus groups and interviews. Data collated were analysed via an inductive and semantic, reflexive-thematic approach. Through analysis of the data, three themes were generated and are discussed throughout: popular online delivery services as a mediator to increased takeaway usage; potential long-term health implications and challenges; continued uncertainty regarding the temporary regulations. This paper highlights important changes to local food environments, which public health professionals should be aware of, so they are better equipped to tackle health inequalities across urban and sub-urban areas.

Necessary prerequisites for evidence-based practice: results of investigating nurses’ informatics competency and information literacy skills

Abstract This study aimed to evaluate the correlation between nursing informatics (NI) competency and information literacy skills for evidence-based practice (EBP) among intensive care nurses. This cross-sectional study was conducted on 184 nurses working in intensive care units (ICUs). The study data were collected through demographic information, Nursing Informatics Competency Assessment Tool (NICAT), and information literacy skills for EBP questionnaires. The intensive care nurses received competent and low-moderate levels for the total scores of NI competency and information literacy skills, respectively. They received a moderate score for the use of different information resources but a low score for information searching skills, different search features, and knowledge about search operators, and only 31.5% of the nurses selected the most appropriate statement. NI competency and related subscales had a significant direct bidirectional correlation with information literacy skills for EBP and its subscales (P &lt; 0.05). Nurses require a high level of NI competency and information literacy for EBP to obtain up-to-date information and provide better care and decision-making. Health planners and policymakers should develop interventions to enhance NI competency and information literacy skills among nurses and motivate them to use EBP in clinical settings.

Communities catalyzing change with data to mitigate an invisible menace, traffic-related air pollution

ObjectivesTo identify strategies and tactics communities use to translate research into environmental health action.MethodsWe employed a qualitative case study design to explore public health action conducted by residents, organizers, and public health planners in two Massachusetts communities as part of a community based participatory (CBPR) research study. Data sources included key informant interviews (n = 24), reports and direct observation of research and community meetings (n = 10) and project meeting minutes from 2016–2021. Data were coded deductively drawing on the community organizing and implementation frameworks.ResultsIn Boston Chinatown, partners drew broad participation from community-based organizations, residents, and municipal leaders, which resulted in air pollution mitigation efforts being embedded in the master planning process. In Somerville, partners focused on change at multiple levels, developer behavior, and separate from the funded research, local legislative efforts, and litigation.ConclusionsCBPR affords communities the ability to environmental health efforts in a way that is locally meaningful, leveraging their respective strengths. External facilitation can support the continuity and sustainment of community led CBPR efforts.

Examining the Prevalence of Congenital Anomalies in Newborns: A Cross-Sectional Study at a Tertiary Care Maternity Hospital in Saudi Arabia.

Background: Congenital anomalies, representing structural or functional abnormalities present at birth, pose a substantial global health challenge, affecting 8 million newborns annually. With 3.3 million succumbing before age five and 3.2 million facing physical or mental disability, their diverse causes necessitate comprehensive understanding for effective healthcare planning. This study explores the prevalence of congenital anomalies among newborns in the Abha Maternity and Children Hospital (MCH) in Abha, Kingdom of Saudi Arabia. Methodology: A descriptive cross-sectional record-based study was conducted on newborns born between 2018 and 2022. Data were gathered in 4 months from September to December 2023. Purposive sampling was employed to select the case records of newborns with congenital anomalies after careful screening and considering inclusion and exclusion criteria. Data was acquired through a self-designed study tool, and the data were entered into Google Forms. Results: Congenital anomalies' five-year prevalence was 3.21%, and one year, in 2022, the prevalence was 4.02%. Female neonates exhibited higher anomalies (59.3%), and preterm births accounted for 39.6%, emphasizing their vulnerability. The findings indicate that consanguineous marriages are linked to 63.3% of anomalies, notably neural tube defects (25%) and congenital heart diseases (19.7%). Anomalies are not significantly associated with consanguinity or birth order, but maternal age, education, employment, and antenatal maternal medical issues are associated considerably. Conclusions: These study insights contribute to health planners planning targeted interventions and awareness programs that are crucial to mitigate risks associated with preterm births and consanguineous marriages. The promotion of 100% antenatal screening and prophylactic medication for high-risk women and couples is necessary to prevent inherited deformities. In future the Ministry of Health must plan large-group prospective research to better understand the associated risk factors that will help public health initiatives minimize congenital-associated neonatal mortality and improve pregnancy outcomes.

Epidemiology and Related Factors of Internet Addiction with Emphasizing the Role of Feeling Loneliness and Interpersonal Problems in University Students

Background: Internet addiction is recognized as a global public health issue, with high prevalence among medical students. The identification of risk factors related to Internet addiction is crucial for reducing its prevalence and severity. Objectives: This study aimed to assess the epidemiology and related factors to Internet addiction, emphasizing the role of feeling loneliness and interpersonal problems. Methods: A cross-sectional correlational study was conducted in 2022, involving 414 students from the Nursing and Midwifery Faculty, Jundishapur University of Medical Sciences, Ahvaz, Iran. Young’s Internet addiction questionnaire, along with the assessments of interpersonal problems and loneliness, was used. Descriptive and inferential statistics (including correlation coefficients and hierarchical regression) were applied using SPSS software (version 22), with a significance level set at P &lt; 0.05. Results: All students had internet addiction; nevertheless, the majority (82.4%) of them were in the range of mild addiction, and none of them had severe Internet addiction. The average score of Internet addiction was 51.59 (4.77), which shows moderate Internet addiction among students. Internet addiction had a positive and significant relationship with students’ lodging (dormitory), feelings of loneliness, and interpersonal problems; however, there was no correlation with age, gender, marital status, major, and academic year. Conclusions: The prevalence of Internet addiction was significantly higher in the present study than in previous studies, serving as a critical warning for health practitioners and planners. Notably, the highest level of addiction observed was at a mild level, necessitating early intervention to prevent further escalation. Considering the correlation between Internet addiction and students’ lodging (dormitory), feelings of loneliness, and interpersonal problems, it is imperative to explore alternative activities within dormitories and provide regular psychological counseling for the early detection of these issues.

The Prerequisites of Executing the Accreditation Program for Primary Healthcare: A Systematic Review and Meta-Synthesis.

In Iran, the primary healthcare system is the front-line for society's encounter with healthcare. Health planners aim to enhance quality and administer an accreditation program. This study examined program administration prerequisites through systematic review and meta-synthesis. We conducted a systematic review and meta-synthesis of qualitative literature using Thomas and Hudson's framework. Peer-reviewed papers were searched in Scopus, PubMed, Web of Science, Google, and Google Scholar up to 2023. The search found 1308 articles, with 37 relevant ones selected for review. Data extraction included setting, participants, study design, data collection, analysis, and themes. Thirteen qualitative subthemes were identified and were categorized under three elements of the Donabedian model. Before implementing a plan, it is crucial to consider its executive prerequisites. Revision and trial-and-error approaches can be costly and time-consuming, potentially hindering the plan's effectiveness and diverting organizations from their primary goal, leading to failure.

Optimizing health service location in a highly urbanized city: Multi criteria decision making and P-Median problem models for public hospitals in Jeddah City, KSA.

Rapid urbanization and population growth have increased the need for optimizing the location of health services in highly urbanized countries like Kingdom of Saudi Arabia (KSA). This study employs a multiple-criteria decision making (MCDM) approach, e.g., fuzzy overlay technique by combining the P-Median location-allocation model, for optimizing health services. First, a geodatabase, containing public hospitals, road networks and population districts, was prepared. Next, we investigated the location and services of five public hospitals in Jeddah city of KSA, by using a MCDM model that included a fuzzy overlay technique with a location-allocation model. The results showed that the allocated five hospitals served 94 out of 110 districts in the study area. Our results suggested additional hospitals must be added to ensure that the entire city is covered with timely hospital services. To improve the existing situation, we prioritized demand locations using the maximize coverage (MC) location problem model. We then used the P-Median function to find the optimal locations of hospitals, and then combined these two methods to create the MC-P-Median optimizer. This optimizer eliminated any unallocated or redundant information. Health planners can use this model to determine the best locations for public hospitals in Jeddah city and similar settings.

Fruit and vegetable consumption in diabetics patients: Effect of pender health promotion model (HPM) intervention.

This study was aimed to investigate the effect of the intervention based on Pender's health promotion model (Pender's HPM) to improve the consumption of fruits and vegetables in diabetic patients. The present study was quasi-experiment community-based research conducted on 112 diabetic patients in Sirjan City. Eligible diabetic patients were randomly divided into two experimental and control groups. The data were collected by two questionnaires, Behavioral Risk Factor Surveillance System and the researcher-made based on Pender's HPM. In order to compare qualitative variables between two groups, Chi-square test was performed. P value <0.05 was considered significant. The findings showed that there is a significant difference in the consumption of fruit juice in men and women (P value = 0.016). In this study, the perceived obstacles structure and interpersonal influences structure was effective on the consumption of vegetables and salad in diabetic patients before and after the educational intervention. Perceived benefits and interpersonal and situational influencers are effective on the consumption of fruits and vegetables in diabetic people and health planners should design educational interventions in order to increase the consumption of fruits and vegetables in the target group by considering these effective determinants.

Burden of irregular menstrual cycle and its predictors among reproductive-age women in Ethiopia: Systematic review and meta-analysis.

Irregular menstrual cycle has negative health and psychosocial repercussions for women of reproductive age worldwide. However, there is no national data for policymakers and health planners in Ethiopia. Therefore, this review aimed to determine the overall burden of irregular menstrual cycle and predictors among reproductive-age women in Ethiopia. International databases (SCOPUS, CINAHL, CAB Abstract, EMBASE, PubMed, Web of Science, Google, and Google Scholar) and lists of references were employed to search literature in Ethiopia. The random-effects model was used to calculate the odds ratios of the outcome variable using STATA version 18. The heterogeneity of the studies was measured by computing I 2 and p-values. In addition, sensitivity analysis and funnel plots were performed to test the stability of pooled data in the presence of outliers and publication bias. The review includes 21 studies and 9109 populations. The overall burden of irregular menstrual cycles among reproductive-age women was 35% (95% CI: 30-41) with I 2 = 96.96%. Sleeping for <5 h a day (AOR: 2.49; 95% CI: 1.49-3.49) and a stressful life (AOR: 3.15; 95% CI: 1.44-4.85) were predictors of irregular menstrual cycles. More than one in every three reproductive-age women in Ethiopia experience irregular menstrual cycles. Sleeping for <5 h a day and stress increase the likelihood of an irregular menstrual cycle, which can be modified by improving sleeping hours and decreasing stress stimulators through psychotherapy.

Predictors of unmet needs among people with diabetes mellitus type 2 in Gampaha district of Sri Lanka.

Diabetes mellitus is a significant contributor to the disease burden in Sri Lanka. Despite government efforts to improve access to care for those with chronic illness, major gaps remain. We assessed the prevalence and correlates of unmet needs among persons with diabetes mellitus type 2 to inform policies on improving healthcare access in a predominantly tax-funded public healthcare system. A descriptive cross-sectional study identified 401 persons with diabetes mellitus type 2 using a multi-stage cluster sampling method from 1767 individuals aged 40-69 from the Gampaha district, just north of the capital Colombo. An interviewer-administered questionnaire gathered data on unmet needs for physician care, medicines, and investigations during the preceding year. Associated factors, identified from the health behaviour model, were examined using binomial logistic regression with significance set at p<0.05. One-fifth experienced an unmet need (95%CI:15.7-23.7), with 16% for physician care (95%CI:12.7-20.2), 4.2% for medicines (95%CI:2.5-6.7) and 6.0% for investigations (95%CI:3.9-8.8). People who frequently visited a private provider experienced less unmet needs overall. Being female (AOR 0.50; 95%CI:0.27-0.92) and having a higher income (AOR 0.37; 95%CI:0.16-0.83) reduced unmet need for physician care. Absence of other major chronic illnesses (AOR 0.31; 95%CI:0.12-0.80) and having a regular care provider in the public (AOR 0.24; 95%CI:0.07-0.89) or private sectors (AOR 0.18; 95%CI:0.05-0.68) reduced unmet need for investigations with the latter also reducing unmet need for medicines (AOR 0.11; 95%CI:0.02-0.77). Despite Sri Lanka having a predominantly publicly financed healthcare system, persons with diabetes mellitus experienced unmet healthcare needs, mainly for physician care which varied with socio-economic characteristics. It is important to ensure uninterrupted care, universally for all, through patient-centred models of care linked to a regular provider. Health planners should take account of unmet needs when expanding public sector coverage for chronic illness care.

Prevalence and determinants of scabies among schoolchildren in Africa: A systematic review and meta-analysis.

Scabies is one of the major neglected tropical diseases among children in deprived communities. Studies conducted among schoolchildren in Africa are limited and inconsistent. Thus, the aim of this study is to estimate the pooled magnitude and predictors of scabies in African schoolchildren. The pooled prevalence estimate with 95% confidence intervals was performed using a random-effects model. Heterogeneity between studies was assessed using the I 2 statistic. Subgroup analyses and sensitivity analyses were performed to explore potential sources of heterogeneity. Publication bias was evaluated using the funnel plot, Begg's, and Egger's tests. A total of 28,482 subjects from 19 studies were included. The pooled prevalence of scabies among African schoolchildren was 10.81% (2459/28482) with (95% CI: 7.10-14.51). Factors such as being male (aOR = 1.86; 95% CI: 0.72-3.01), children who have a history of sharing clothes with their family (aOR = 1.76; 95% CI: 0.62-2.91), having illiterate parents (aOR = 0.96; 95% CI: 0.51-1.41), having history of contact with skin itching cases/scabies (aOR = 3.37; 95% CI: 1.70-5.03), infrequent cloth wash (aOR = 5.30; 95% CI: 1.26-9.34), sharing common sleeping beds/fomites (aOR = 2.13; 95% CI: 0.04-4.22), family member with itchy signs/scabies (aOR = 5.83; 95% CI: 1.45-10.21), and not taking a bath with water and soap (aOR = 8.51; 95% CI: -4.14 to 21.15) were factors associated significantly with scabies. CRD42024542762. In the present scenario, scabies ranges from 2.0% to 17.80% and is higher in Cameroon. Therefore, policymakers and health planners should put a great deal of emphasis on the implementation of relevant prevention and control measures.

Magnitude, disparity, and predictors of poor-quality antenatal care service: A systematic review and meta-analysis.

Antenatal care is directed toward ensuring healthy pregnancy outcomes. Quality antenatal care increases the likelihood of receiving an effective intervention to maintain maternal, fetal, and neonatal well-being, while poor quality is linked to poor pregnancy outcomes. However, owing to the complex nature of quality, researchers have followed several approaches to systematically measure it. The evidence from these variable approaches appears inconsistence and poses challenges to programmers and policymakers. Hence, it is imperative to obtain a pooled estimate of the quality of antenatal care. Therefore, considering the scarcity of evidence on the quality of antenatal care, this study aimed to review, synthesize, and bring pooled estimates of accessible evidence. This study aimed to estimate the pooled magnitude and predictors of quality of antenatal care services and compare regional disparity. We conducted a comprehensive systematic three-step approach search of published and unpublished sources from 2002 to 2022. The methodological quality of eligible studies was checked using Joanna Briggs Institute critical appraisal tool for cross-sectional studies. Meta-analysis was carried out using STATA version 16. Statistical heterogeneity was assessed using Cochran's Q test. In the presence of moderate heterogeneity (I2 more than 50%), sensitivity and subgroup analyses were conducted and presented in a forest plot. Effect size was reported using standardized mean difference and its 95% confidence interval. Funnel plots and Egger's regression test were used to measure publication bias at the 5% significance level. A trim-and-fill analysis was conducted to adjust for publication bias. Pooled estimates were computed using random-effects models and weighted using the inverse variance method in the presence of high heterogeneity among studies. A 95% CI and 5% significance level were considered to declare significance variables. The global pooled poor-quality antenatal care was 64.28% (95% CI: 59.58%-68.98%) (I2 = 99.97%, p = 0.001). The identified pooled predictors of good-quality antenatal care service were: number of antenatal care visits (fourth and above antenatal care visit) (Adjusted odds ratio (AOR) = 2.6, 95% CI: 1.37-3.84), family wealth index (AOR = 2.72, 95% CI: 1.89-3.55), maternal education attainment (AOR = 3.03, 95% CI: 2.24-3.82), residence (urban dwellers) (AOR = 4.06, 95% CI: 0.95-7.17), and confidentiality antenatal care (AOR = 2.23, 95% CI: -0.36 to -4.82). The study found regional and country-level disparities in the quality of antenatal care services for pregnant women, where poor-quality antenatal care services were provided for more than two-thirds to three-fourths of antenatal care attendants. Therefore, policymakers and health planners should put a great deal of emphasis on addressing the quality of antenatal care services.

The effect of combined training (theoretical-practical) of palliative care on perceived self-efficacy of nursing students.

Nurses and researchers emphasize the importance of adding educational content of palliative care to nursing curricula in Iran as a means to improve the quality of care at the end of life and self-efficacy is considered as an important determinant in palliative care nursing. However, undergraduate nursing students are not sufficiently trained to achieve the qualifications required in palliative care. The aim of this study was to determine the effect of combined training (theoretical-practical) of palliative care on the perceived self-efficacy of nursing students. This is a semi-experimental study with a pretest-posttest design. Sampling was nonrandomized with convenience method and included 23 seventh-semester students. The intervention consisted of palliative care training for ten theoretical sessions and three practical sessions. Data were collected using demographic and the perceived self-efficacy questionnaires completed before and after the intervention. Data were then analyzed in the statistical SPSS 23 software using descriptive and analytical statistics. The mean age of the samples was 22.78 (SD1.17). Most of the participants were male (56.5%) and single(91.3%). The findings showed that, perceived self-efficacy, psycho-social support and symptom management improved significantly after the intervention (p<0.05). Palliative care training can increase the nursing students perceived self-efficacy. Since nursing students are the future nurses of the care system, therefore, managers and planners can take a step towards improving the quality of nursing care by using palliative care training programs. Since nursing students will be future nurses in health care system, therefore, managers and planners can take steps to improve the quality of nursing care by using palliative care education programs.

Key Factors Impacting a Medical Ventilator Supply Chain During the COVID- 19 Pandemic: Lessons for Pandemic Preparedness.

Future pandemics may cause more severe respiratory illness in younger age groups than COVID-19, requiring many more mechanical ventilators. This publication synthesizes the experiences of diverse contributors to Medtronic's mechanical ventilator supply chain during the pandemic, serving as a record of what worked and what didn't, while identifying key factors affecting production ramp-up in this healthcare crisis. In-depth, one-on-one interviews (n = 17) were held with key Medtronic personnel and suppliers. Template analysis was used, and interview content was analyzed for signals, initiatives, actions, and outcomes, as well as influencing forces. Key findings revealed many factors limiting ventilator production ramp-up. Supply chain strengths and weaknesses were identified. Political factors played a role in allocating ventilators and also supported production. Commercial considerations were not priority, but economic awareness was essential to support suppliers. Workers were motivated and flexible. Component shortages, space, production processes, and logistics were challenges. Legally based pressures were reported e.g., import and export restrictions. Crisis response alone is not enough; preparation is essential. Coordinated international strategies are more effective than individual country responses. Supply chain resilience based on visibility and flexibility is key. This research can help public health planners and the medical device industry prepare for future healthcare crises.

Effect of topical emollient oil application on weight of preterm newborns: A systematic review and meta-analysis.

Synthesizing current evidence on interventions to improve survival outcomes in preterm infants is crucial for informing programs and policies. The objective of this study is to investigate the impact of topical emollient oil application on the weight of preterm infants. A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted. To identify relevant studies, comprehensive searches were conducted across multiple databases, including PubMed, Cochrane, Scopus, Clinical trials, ProQuest Central, Epistemonikos, and gray literature sources. The inclusion criteria were based on the PICO (Population, Intervention, Comparison, and Outcomes) format. Study quality was assessed using the Cochrane risk of bias tool for randomized trials (RoB 2.0). Data analysis was performed using StataCrop MP V.17 software, which included evaluating heterogeneity, conducting subgroup analysis, sensitivity analysis, and meta-regression. The findings were reported in accordance with the PRISMA checklist, and the review was registered with PROSPERO (CRD42023413770). Out of the initial pool of 2734 articles, a total of 18 studies involving 1454 preterm neonates were included in the final analysis. Fourteen of these studies provided data that contributed to the calculation of the pooled difference in mean weight gain in preterm neonates. The random effects meta-analysis revealed a significant pooled difference in mean weight gain of 52.15 grams (95% CI: 45.96, 58.35), albeit with high heterogeneity (I2 > 93.24%, p 0.000). Subgroup analyses were conducted, revealing that preterm infants who received massages three times daily with either sunflower oil or coconut oil exhibited greater mean differences in weight gain. Meta-regression analysis indicated that the type of emollient oil, duration of therapy, and frequency of application significantly contributed to the observed heterogeneity. A sensitivity analysis was performed, excluding two outlier studies, resulting in a pooled mean weight difference of 78.57grams (95% CI: 52.46, 104.68). Among the nine studies that reported adverse events, only two mentioned occurrences of rash and accidental slippage in the intervention groups. The available evidence suggests that the application of topical emollient oil in preterm neonates is likely to be effective in promoting weight gain, with a moderate-to-high level of certainty. Based on these findings, it is recommended that local policymakers and health planners prioritize the routine use of emollient oils in newborn care for preterm infants. By incorporating emollient oils into standard care protocols, healthcare providers can provide additional support to promote optimal growth and development in preterm infants.