Health Professional Organizations Research Articles

Environment, Climate, and Diabetes: An International Topic.

Every person with diabetes is affected by changes in the environment and climate. At the same time, the therapy of many people itself has a negative impact on these factors. One might assume that the relevant professional associations and health organizations, as well as health policymakers, have initiated appropriate activities. The manufacturers of antidiabetic drugs and medical devices used in diabetes therapy are aware of the problems at hand. To what extent they really implement changes in the production, storage, and transport of their products is not easy to assess. In summary, it should be said that the importance of environmental factors for people with diabetes and their therapy is probably still not sufficiently recognized.

Using Anti-Blackness and Historical Inquiry to Ground Nursing and Research Practice in Black Populations.

Since the "Black Lives Matter" reckoning of 2020, professional health organizations have made public statements and apologized for not recognizing the role of racism in the creation of health disparities. For the American Nurses Association, this has taken the form of the National Commission to Address Racism in Nursing. One result of that work has been the Report on the History of Racism in Nursing, which details the constant maligning of the competence of Black nurses and their systematic exclusion from institutions within the profession. In this article, we want to take these ideas further and argue that the issue for nursing is not so much a generic kind of racism that a professional reorganization can address, but rather a deep and abiding "anti-blackness" that is intrinsic to the heart and soul of medical and health knowledge itself. Anti-blackness as an idea comes from a collection of theoretical interventions developed by Black philosophers, literary theorists, sociologists, and historians who continue to grapple with the question posed by W.E.B. DuBois: "How does it feel to be a problem?" Anti-blackness is the "relegation of Black people to inhumanity and non-being" and "is a global phenomenon that takes on distinct forms of expression in each sociocultural context." Given the call to understand the role of historical, social, political, environmental, and economic factors via the social determinants of health, a more expansive approach is needed to articulate the Black lived experience. Anti-blackness is one tool available to nurses interested in a deeper level of analysis.

Exploring the Foundations of Interprofessional Education: Reconnaissance Phase of an Action Research

Aim: Healthcare professionals need to learn with, together, and from each other during their training as they prepare for their collaborative roles in the field. This study aims to explore faculty members' awareness, needs, and thoughts on program design in the field of Interprofessional Education (IPE). Methods: The methodology of the research involves qualitative data collection and analysis in the exploratory stage of action research for IPE program design. The study is based on semi-structured in-depth interviews with 22 faculty members who do not practice IPE in a health education institution in Turkey. Data collection was conducted online through semi-structured interviews in 2021 and descriptive thematic analysis was applied using NVIVO software. Results: Findings show that 77.27% of the participants are female (n:17) with an average age of 42.31. Among the faculty members, 3 (13.63%) are professors, 9 (40.90%) are associate professors, and 10 (45.45%) are assistant professors. 9 (40.90%) of the faculty members are from the Medicine faculty, 10 (45.45%) from Health Sciences (Nursing, Nutrition and Dietetics, and Physiotherapy), and 3 (13.63%) are from the Dentistry faculty. After the qualitative data analysis, the main findings were divided into five main themes: Educational Philosophy and Importance, Application and Methodology, Educational Content and Methods, Institutional Culture and Practices, and Interprofessional Education and Metaphors. Each theme was examined in detail with participants' opinions and illustrative expressions. The study emphasizes the lack of collaboration in health services and how this parallels the need for strategies to strengthen collaboration between health education and professional health organizations. Researchers point out that health services need to be delivered more effectively, efficiently, and at lower cost, and in this process, the need for interprofessional collaboration and education is increasing. Conclusions: This study comprehensively addresses the importance and effectiveness of IPE in the health sector, encompassing faculty members' and health professionals' awareness, needs, and recommendations for IPE program design, and offers a guiding resource. The results of the research demonstrate the potential of IPE to enhance the quality of health services and improve patient health outcomes.

The effectiveness of integrated health professional organization collaboration in the treatment of pulmonary tuberculosis: A qualitative study

Background: Tuberculosis (TB) is an infectious disease, the high incidence of tuberculosis and its impact have caused the world to pay special attention, one of which is through the target of the third issue of the sustainable development goals (SDGs), namely tackling the TB epidemic in 2030. Efforts to prevent and reduce TB incidence in Indonesia through to find, treat, and cure TB program. Approaches to finding, diagnosing, treating, and curing TB patients and stopping transmission in the community. The treatment is being carried out actively, massively, and intensively, but the problem-solving has not yet been completed, innovation is needed through the collaboration of integrated health professional organizations, to anticipate the treatment of TB independently, in the service units of private hospitals, clinics and doctors' independent practice places. This innovation is to increase the new case detection rate, and the tracking of initial lost to follow up patients. Purpose: To analyze the effectiveness of integrated health professional organization collaboration in the treatment of pulmonary tuberculosis Method: Qualitative research with descriptive and exploratory design. The source of data and information is informants from the health profession determined by purposive sampling. In-depth interview and focus group discussion interview methods. Informants are representative members of each health profession organization appointed by the organization's leadership. Results: Health professional organizations are committed to and contribute to the well-organized treatment of TB. Integrated activity programs, increasing the discovery of new case detection rates, identification of drug-resistant pulmonary tuberculosis (DR-PTB) and drug-sensitive pulmonary tuberculosis (DS-PTB), and active monitoring of patients initially lost to follow-up, as well as preventing independent case handling. Conclusion: The collaboration of health professional organizations is very effective in helping the government handle Tuberculosis, has a commitment to increase the new case detection rate, identification of drug-resistant pulmonary tuberculosis (DR-PTB) and drug-sensitive pulmonary tuberculosis (DS-PTB), and actively monitor patients who are initially Lost to follow up, which is carried out in an integrated manner.

Self-directed learning and the student learning experience in undergraduate clinical science programs: a scoping review.

Health professional organisations are increasingly promoting the use of self-directed learning. Furthermore, the rapidly evolving field of healthcare has meant that there is greater emphasis within tertiary education for students to become self-directed learners and possess the skills to engage in life-long learning. The aim of this scoping review was to explore the drivers that improve the student learning experience, in undergraduate clinical science programs that utilise self-directed learning. The Joanna Briggs Institute Scoping Review Methodology guided this study. The electronic databases MEDLINE, Embase, Emcare, Scopus and ERIC were comprehensively searched in April 2022 and re-run August 2023, for peer-reviewed research articles published in English. The original search was developed in MEDLINE and then adapted to each database. Following the Joanna Briggs Scoping Review methodology, articles were screened first by title and abstract and then by full text. Included articles were assessment for methodological quality. The search strategy yielded 2209 articles for screening. 19 met the inclusion criteria. Five key factors were identified which improve the student learning experience in self-directed learning: (i) curricular elements; (ii) educator influence; (iii) impact of peers, (iv) environment; and (v) clinical placement experiences. There are many curricular, environmental, and external factors which can improve the student learning experience in programs that utilise self-directed learning. Greater understanding of these factors will allow educators within clinical science programs to implement self-directed learning strategies more effectively within curriculum.

Nurse practitioner medication abortion providers in Canada: results from a national survey

BackgroundIn 2017, nurse practitioners (NPs) became the first non-physician healthcare providers authorised to independently provide medication abortion (MA) in Canada. We aimed to report on demographic and clinical characteristics of...

Building health systems resilience: understanding the social, economic, and cultural impacts of climate change from stakeholders' perspectives in Indonesia

sObjectivesThis study explores stakeholders' perspectives on the direct, social, economic, and cultural impacts of climate change on health in Indonesia and identifies possible strategies to enhance health system resilience.MethodsThis study followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines to ensure comprehensive and transparent reporting. Purposive sampling was used to select 22 stakeholders with relevant expertise, including government officials, representatives from international and professional health organizations, health workers, and community representatives. Semi-structured interviews were conducted, and data were analyzed using directed content analysis. Data saturation was reached when no new themes emerged.ResultsThe findings reveal significant challenges to Indonesia's health system due to climate change. Community awareness varies widely, with higher levels in disaster-prone areas. Socially, climate change has fostered community cooperation through collective adaptation efforts but has also led to tensions due to inequitable resource distribution. Economically, rising healthcare costs and financial instability, particularly in rural and disaster-prone regions, place a strain on the system. Culturally, there is a growing emphasis on environmental conservation, promoting eco-friendly practices and the integration of traditional and modern health approaches.ConclusionBuilding health system resilience in Indonesia requires addressing the social, economic, and cultural impacts of climate change. Possible strategies include enhancing public health education, strengthening healthcare infrastructure, improving inter-agency coordination, and leveraging technology to support effective responses to climate-related health threats, ultimately promoting national health, social stability, and economic growth.

Fifty Years of Psychiatric Classification and Epidemiology Interactions: What is a Mental Disorder?

Psychiatric clinical diagnostic formulation has evolved over time. The changes alter our understanding and our ability to provide a public health perspective on the epidemiology of mental disorders in large populations. Epidemiology is an important perspective and set of tools to assess prevalence, treated prevalence, untreated prevalence, individual risks for mental disorders, and possible links to the etiology of disorders by following the trails of environmental exposures, biological measures, interpersonal dynamics, and genetic risk factors. As communities develop health-care services to treat individuals with mental disorders, knowledge about their prevalence and treatment requirements is also important. Since severe mental disorders may require institutional care, the diagnostic criteria used may either protect an individual’s liability for dangerous behavior (i.e. the insanity defense) or be used to control political and social dissidents. The criteria may also be used to determine evidence-based treatment options and eligibility for disability benefits. In this paper, using my vantage points as a physician scientist and public health officer, with leadership positions in national federal and professional mental health organizations, I address the developments in these areas over the past 50 years that have influenced institutional positions in the U.S. National Institute of Mental Health, the World Health Organization, the American Psychiatric Association, and the Center for the Study of Traumatic Stress. These perspectives may aid the next generation of investigators to advance the epidemiological and mental disorder classification scientific fields.

Primary healthcare providers' knowledge, practices and beliefs relating to preventive sexual and reproductive health care for women from refugee and asylum-seeking backgrounds in Australia: a national cross-sectional survey.

Background Many refugee women and women seeking asylum arrive in high-income countries with unmet preventive sexual and reproductive health (SRH) care needs. Primary healthcare providers (HCPs) are usually refugee and asylum seekers' first point of care. This study aimed to identify HCP characteristics associated with initiating conversations and discussing SRH opportunistically during other health interactions. Methods An anonymous online survey was distributed nationally to representatives of health professional organisations and Primary Health Networks. Hierarchical logistic regression analysed factors including HCP demographics, knowledge and awareness, perceived need for training and professional experience with refugee women were included in the models. Results Among 163 HCPs, those initiating conversations ranged from 27.3% (contraceptive care) to 35.2% (cervical screening). Opportunistic discussions ranged from 26.9% (breast screening) to 40.3% (contraceptive care). Positively associated factors included offering care to refugee women or women seeking asylum at least once every 2months 7.64 (95% CI 2.41;24.22, P P P P P P Conclusions Direct professional experience, frequency of service provision, years of practice, and part time work positively influence HCPs' SRH care practices. Enhancing bilingual health worker programs, outreach, education, and support for SRH and cultural competency training are essential to improving the preventive SRH care of refugee women and women seeking asylum.

Answering a Call to Action: Reducing Fetal Alcohol Spectrum Disorders Using a Healthcare Champion Model.

Prenatal alcohol exposure and fetal alcohol spectrum disorders (FASDs) remain critical public health issues. Alcohol use in pregnancy is a leading preventable cause of birth defects, developmental disabilities, and learning disabilities. Alcohol screening and brief intervention (SBI) is effective at reducing excessive alcohol use. However, this clinical preventive service remains critically underutilized in primary care. In 2014, the Centers for Disease Control and Prevention called for the creation of FASD Champion programs to promote clinician education about FASDs. Six professional health organizations and groups providing reproductive and child health services set out to create FASD Champion programs. The American College of Obstetricians and Gynecologists FASDs Prevention Program was created to focus on reducing alcohol-exposed pregnancies. The American Academy of Pediatrics' Champion program maintains the goal of improving health outcomes for children with FASDs by improving pediatricians' diagnostic capacity. The American Academy of Family Physicians has prioritized training family physician champions to improve the delivery of alcohol SBI among adult patients. The University of Alaska Anchorage has partnered with the National Association of Nurse Practitioners in Women's Health, the American College of Nurse-Midwives, and the Association of Women's Health, Obstetric, and Neonatal Nurses to assure advanced practice registered nurses and midwives have the knowledge and skills to prevent alcohol-exposed pregnancies and FASDs. The American Association of Medical Assistants has prioritized expanding the knowledge and skills of medical assistants related to promoting alcohol-free pregnancies. Finally, the Champions program at the University of Texas at Austin was established to train health social workers in alcohol SBI. Through the advocacy, education, and mission of these 6 health sectors in collaboration with national organizations and educational institutions, the evidence-based approach of alcohol SBI is being disseminated throughout the United States to reduce the harmful effects of prenatal alcohol exposure.

How qualified is online information regarding space maintainers? A content-quality and readability analysis

Purpose: To evaluate the reliability, quality, and readability of information regarding space maintainers on English websites using different scales. Materials and Methods: The selected search terms 'space maintainer', 'band and loop', 'distal shoe space maintainer', 'nance appliance', and 'lingual arch' were searched by four search engines (Yahoo, Bing, Yandex, and Google), and 992 websites were recorded. The websites were evaluated using the Journal of American Medical Association (JAMA), Quality Criteria for Consumer Health Information (DISCERN), Flesch-Kincaid Grade Level (FKGL), and Flesch Reading Ease Score (FRES) instruments. Results: Among the 90 websites included in the study, Professional Health Organization (PHO) websites had significantly higher DISCERN scores in all sections and total (p0.05). Only 3 (3.3%) provided all JAMA criteria and PHO websites scored significantly higher than the others in almost all categories (p

Puerto Rican physician’s recommendations to mitigate medical migration from Puerto Rico to the mainland United States

Puerto Rico (PR) is a United States (US) territory with a history of colonial violence, poverty, and government corruption. Due to these sociopolitical factors and natural disasters (e.g., hurricanes and earthquakes), there has been a sharp increase in PR residents migrating to the mainland US. Local media and professional health organizations focus on the impact of medical migration on the PR health system (e.g., health personnel shortages and long waiting periods for critical care). According to the PR College of Physicians and Surgeons, 365–500 physicians have left annually since 2014, which represents a crisis of access to health services. However, few studies have focused on ways to mitigate medical migration from PR to the US mainland. This article describes the recommendations provided by migrating and non-migrating Puerto Rican Physicians (PRPs) to mitigate medical migration from PR to the US mainland. We focus on qualitative data from a mixed-methods NIH-funded study (1R01MD014188) to explore factors that motivate or mitigate migration among migrating (n = 26) and non-migrating (n = 24) PRPs. Interviews were analyzed following thematic analysis guidelines. Results show the following themes: 1) strategies to retain early-career medical residents living in PR; 2) recommendations for local government on future health policy; and 3) work environment initiatives for health institutions to mitigate physician migration. Findings suggest multilevel efforts are required to mitigate medical migration in PR.

Development, Implementation, and Assessment of an Online Modular Telehealth Curriculum for Health Professions Students.

Several national health profession organizations endorse or have developed competencies for telehealth, yet there is no standardized curriculum for teaching telehealth to health professions students. Additionally, implementing telehealth curricula is challenging due to limited curricular space and differing needs of various health profession programs. We describe the development, implementation, and pilot assessment of an online, modular telehealth curriculum for health professions students. An online, modular telehealth curriculum for health professions students was developed in 2021-2022. Nine modules were created, focusing on the logistics of performing a telehealth visit and system-based virtual assessments. In academic year 2022-2023, course directors from the Duke doctor of medicine (MD), physician assistant (PA), and nurse practitioner (NP) programs utilized modules in their courses. For modules taken, students were surveyed and self-assessed their confidence, knowledge gained, and likelihood of utilizing the telehealth skills taught in the module(s). During the 2022-2023 academic year, MD, NP, and PA students at Duke participated in one or more of the telehealth modules in an existing course. The median responses to self-assessed confidence questions for all health profession students to be in the "moderately" or "very confident" range. Similarly, students reported a median response of "moderate knowledge gained" for each module taken. NP students reported slightly lower levels of confidence and likelihood of utilizing telehealth skills than other professions. No other significant differences in the remainder of responses were observed between health professions. Exposure of health professions students to telehealth through utilization of online, interactive modules may result in increased telehealth skill confidence and knowledge, and furthermore, a belief that they will utilize these skills in future practice. Larger scale implementation of the telehealth curriculum and development of outcome measures which assess clinical application of skills conveyed will provide more information about the efficacy of the curriculum.

Why did England change its law on deceased organ donation in 2019? The dynamic interplay between evidence and values.

In the three years since the law on adult deceased organ donation consent in England changed to include an opt-out system, there has been no discernible change to donation rates. The lack of a positive impact on donation rates was predicted by many of those who took part in debates before and during the passage of the Bill through Parliament. This invites the question as to why England moved to an opt-out system for organ donation despite equivocal evidence of likely benefit and opposition from expert health professional organisations. To address this question qualitative analyses of Parliamentary debates on organ donation was undertaken. This revealed a shift from a dominant position, which gave primacy to the evidence of likely effects, towards a more normative position where a deemed consent option was viewed as the 'correct thing to do' and the limited and conflicting evidence viewed in a positive light. By 2017, following Wales's move to an opt-out system, together with continued lobbying for similar changes for England by professional and patient groups, alongside sustained public popularity for organ donation, the balance of opinion had shifted towards a system where deemed consent would become the default position for most English adults.

An Intermittent Fasting Intervention for Black Adults Can Be Feasibly Implemented in Black Churches: A Cluster Randomized Controlled Pilot Study

BackgroundIntensive lifestyle interventions, including modest reductions in daily caloric intake (ie, continuous calorie energy reduction [CER]), are recommended by US national professional health organizations (eg, American Heart Association). However, they are less effective in Black communities. A burgeoning literature has reported the promise of intermittent fasting (IF) as an alternative strategy for weight loss. However, IF studies have been conducted with White participants predominately and provided participant resources not readily available in real-world situations. ObjectiveWeight-loss and weight-related outcomes of a scalable (ie, able to be widely disseminated and implemented) IF intervention developed with and for Black adults were compared with a CER intervention for the purpose of determining IF’s feasibility (ie, initial effectiveness, adherence, and acceptance) in a Black community. DesignA cluster randomized controlled pilot study was conducted. Participants/settingA total of 42 Black adults with a body mass index (calculated as kg / m2) ≥25 were recruited from 5 Black churches (3 IF and 2 CER) in Western New York State from September 2021 to May 2022. Participants were free of medical conditions that might have contraindicated participation in a weight-reduction program and other factors that might affect weight loss. InterventionsCommunity health workers delivered the 6-month, 16-session, faith-based IF and CER interventions. Main outcome measuresThe primary outcome was feasibility, consisting of initial effectiveness on body weight (ie, percent body weight lost from baseline to 6-month follow-up), adherence, and acceptability. Statistical analyses performedDescriptive statistics and linear mixed models accounting for within-church clustering were used. A baseline covariate corresponding to the outcome variable was included in the model. Intent-to-treat analysis was used. ResultsThere was statistically significant weight loss within both arms (IF: –3.5 kg; 95% CI –6 to –0.9 kg, CER: –2.9 kg; 95% CI –5.1 to –0.8 kg) from baseline to 6-month follow-up. Compared with CER, IF led to significantly lower daily energy intake (414.2 kcal; 95% CI 55.2 to 773.2 kcal) and fat intake (16.1 g; 95% CI 2.4 to 29.8 g). IF may result in lower fruit and vegetable intake (–103.2 g; 95% CI –200.9 to –5.5 g) and fiber intake –5.4 g; 95% CI –8.7 to –2 g) compared with CER. Participants in the IF arm completed a mean (SE) of 3.8 (1.4) more self-monitoring booklets compared with those in the CER arm (P = .02). Participants reported high levels of satisfaction with the program. ConclusionsAn IF intervention developed with and for Black adults can be feasibly implemented in Black churches. Larger studies need to be conducted to ascertain the extent IF can serve as a viable weight-loss alternative to CER interventions in Black communities.

The Italian guideline on comprehensive geriatric assessment (CGA) for the older persons: a collaborative work of 25 Italian Scientific Societies and the National Institute of Health

BackgroundThe guideline was promoted by the Italian General Practitioners-Primary Care and Geriatrics Hospital-Community Societies and was carried out involving the National Institute of Health and an Expert Panel including representatives from 25 Scientific and Health-Professional Organizations. The aim of the Guideline was to develop evidence-based recommendations on the efficacy of CGA in older people across different clinical settings and the accuracy and utility of CGA-based tools to assess prognosis.MethodsAccording to the methodological handbook of the Italian National System of Guidelines and NICE criteria (National Institute for Health and Care Excellence in England), the Guideline was produced based on the Grading of Recommendations Assessment, Development and Evaluation. Over 20,000 records gathered through databases searches were initially selected. Sixteen recommendations on CGA efficacy were defined based on 117 studies that met the inclusion criteria and were performed in general practices and primary care (26 studies included), medical and surgical clinics (16 studies), emergency departments (17 studies), hospital medical and surgical wards (53 studies), long-term care facilities and nursing homes (5 studies), hospices and palliative care networks (no studies). Nine recommendations on CGA-based prognostic tools were issues based on 42 included studies carried out in general practices and primary care (5 studies), medical and surgical clinics (4 studies), and hospital wards (33 studies).ResultsUsing CGA can be useful to reduce hospitalization, mortality, institutionalization, the risk of delirium, and improve appropriateness in drug prescription and maintain functional activities in different settings. Further research on the efficacy of CGA in rehabilitative facilities, nursing homes, and hospice and palliative-care settings is recommended. CGA-based tools, particularly the Multidimensional Prognostic Index, should be used to predict some negative outcomes in different settings.ConclusionsThis Guideline may be useful in clinical practice and as a tool to support research on the use of CGA in older people.

Political Law of Health Professions Organizations

Health professional organizations play a central role in providing guidelines, standards, and ethics that maintain the integrity and quality of health care. Health services are a crucial aspect of human life, and to ensure their quality, professional organizations are needed. Method. The research method is the study of literature. Using document data published between 2000 and 2023. English and Indonesian speaking. Using google data base and google scholar. By keywords: professional organizations, health legislation. Professional ethics Research results obtained from 20 literature reviews from google and google schoolar data search period between 2000-2023.Conclusion. After Health Law No. 17 of 2023, Health professional organizations no longer have functions as before, which still raises pros and cons in the Indonesian Health world.

Antenatal education – Putting research into practice: A guideline review

ProblemAntenatal care guidelines used in Australia are inconsistent in their recommendations for childbirth and parenting education (CBPE) classes for preparation of women and parents for pregnancy, childbirth, and early parenting. BackgroundClinical practice guidelines in maternity care are developed to assist healthcare practitioners and consumers to make decisions about appropriate care. The benefit of such guidelines relies on the translation and quality of the evidence contained within them. In the context of antenatal care guidelines, there is a potential evidence-practice gap with regard to CBPE. AimsThis review aims to appraise the quality of Australian antenatal care guidelines in their recommendations for CBPE for women and partners. MethodsPublicly available Australian antenatal care guidelines were identified including local health district websites and professional organisations pertaining to maternity care. Guidelines were reviewed independently, and the quality was assessed using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool. FindingsFive guidelines were included in the review and appraised using AGREE II. With the exception of the Department of Health Pregnancy Care Guidelines, guidelines scored poorly across all six domains. When appraised according to specific CBPE recommendations for rigour of development, presentation, and applicability; all guidelines received low scores. DiscussionPrenatal services remain largely unregulated across the board, with no systematic approach to make recommendations for CBPE and guidelines lacking in rigour with regard to CBPE. ConclusionWithin the guidelines reviewed there was a lack of evidence-based recommendations provided for educators or consumers regarding childbirth and parenting education.

Real-World Evidence to Inform Regulatory Decision Making: A Scoping Review.

Real-world evidence (RWE) is increasingly considered in regulatory decision making. When, and to which extent, RWE is considered relevant by regulators likely depends on many factors. This review aimed to identify factors that make RWE necessary or desirable to inform regulatory decision making. A scoping review was conducted using literature databases (PubMed, Embase, Emcare, Web of Science, and Cochrane Library) and websites of regulatory agencies, health technology assessment agencies, research institutes, and professional organizations involved with RWE. Articles were included if: (1) they discussed factors or contexts that impact whether RWE could be necessary or desirable in regulatory decision making; (2) focused on pharmacological or biological interventions in humans; and (3) considered decision making in Europe or North America, or without a focus on a specific region. We included 118 articles in the scoping review. Two major themes and six subthemes were identified. The first theme concerns questions addressable with RWE, with subthemes epidemiology and benefit-risk assessment. The second theme concerns contextual factors, with subthemes feasibility, ethical considerations, limitations of available evidence, and disease and treatment-specific aspects. Collectively, these themes encompassed 43 factors influencing the need for RWE in regulatory decisions. Although single factors may not make RWE fully necessary, their cumulative influence could make RWE essential and pivotal in regulatory decision making. This overview contributes to ongoing discussions emphasizing the nuanced interplay of factors influencing the necessity or desirability of RWE to inform regulatory decision making.

Impact of Climate Change, Environmental Toxins and Pollution on the AOFOG region: What can OBGYNs do?

Climate change is occurring rapidly, and this crisis should now be recognized as a "global emergency". It is one of the major global health threats brought about by global warming, resulting from human activity due in large part to increasing levels of greenhouse gases. The ongoing climate crisis poses significant risks to women, pregnant mothers, unborn fetuses and offspring, who were exposed in-utero to climate stressors, especially those in marginalized communities where effects are magnified. A focus on education, research, and advocacy in responding to changing health consequences and global awareness are key to educating our professional healthcare providers, patients, the lay public, key personnel in the government and other leaders, and by making the changes necessary to address this crisis. Building on the pillars that FIGO has identified (advocacy, research interpretation, capacity building, and education), and following the footsteps of the FIGO Committee on "Climate Change and Toxic Environmental Exposures", the baby steps yet focussed efforts taken by AOFOG through its recently formed "Climate Change & Pollution Working Group" will be highlighted in this review article. After all, investing in the health of women is investing in the health of current and future generations, and we, as healthcare providers along with health professional organizations should be in the forefront of environmental health advocacy to save the present generation and future generations through engagement as public opinion leaders.