Health Professionals Research Articles

Assessing optimal timing for orthodontic intervention: A scoping review

There is still debate over the ideal time to begin orthodontic treatment. To optimize growth potential and patient cooperation, definitive treatment typically is delayed until the late mixed dentition and is used to resolve functional issues and anomalies of dental development. However, for specific types of malocclusion, some medical professionals advise beginning treatment earlier. The degree of the malocclusion, the patient's age and level of development at the time the patient sought treatment, and the timing of the treatment interventions all had an impact. This article explains over all review of the timing of the orthodontic treatment.

Health care workers hospitalized for COVID-19 in Liberia: who were they, and what were their outcomes?

Background Sustaining a ‘fit-for-purpose’ health workforce requires a better understanding of the health care worker cadres that are affected during pandemics and their outcomes. In hospitalized health care workers with confirmed COVID-19 between March 2020 and May 2023 in Liberia, we determined the hospitalization and case fatality rates, type of health care worker cadres affected, their demographic and clinical characteristics and hospital exit outcomes. Methods This was a cohort study using routine data extracted from hospitalization forms for health care workers in 24 designated COVID-19 treatment facilities. Results Of the 424 health care workers with COVID-19, hospitalization rates progressively declined between 2020 and 2023, (P<0.001) with the highest rates in 2020 (24/1,000 health care workers) and 2021 (14/1,000 health care workers). Case fatality was 2% in both 2020 and 2021 with no deaths thereafter. Among those hospitalized, the highest proportions were nursing cadres with 191(45%), physicians with 63 (15%) and laboratory technicians with 42 (10%). The most frequent reported site for COVID-19 infection was the health facility (326, 89%). COVID-19 vaccination coverage in health care workers was 20%. The majority (91%) of hospitalizations were for mild symptomatic infections. Even in referral centres (n-52), 18 (35%) were for mild infections. Of the 424 who were hospitalized, 412 (97%) recovered, 9 (2%) died and 3 (1%) either left against medical advice or absconded. Of the nine deaths, none were vaccinated, seven had moderate-to-severe disease but were not referred to specialized COVID-19 treatment centers. Conclusions The hospitalized health care workers for COVID-19 were predominantly clinical and laboratory personnel who were mostly unvaccinated, and health facilities were hot-spots for contracting infections. The triage and referral system was weak with unnecessary hospitalization of mild infections. This study provides useful insights for outbreak preparedness including priority vaccination and improving health care worker safety in Liberia.

Exploring the unconventional: health professionals’ experiences into medication-free treatment for patients with severe mental illness

Abstract Background In January 2017, the Norwegian government mandated the establishment of an inpatient unit for “medication-free treatment” for patients with severe mental illness at the University Hospital of North Norway in Tromsø. This study aims to explore the employees’ experiences with this unit. Method Focus group interviews were conducted October 2021 – February 2022. For analysis, the participants were divided into three groups; S (staff working at the medication-free unit), M (people involved in management at the unit) and T (therapists working elsewhere in the hospital). The analysis followed the Systematic Text Condensation and interviews were recorded, transcribed and analysed using NVivo software. Results Health professionals described their experiences with medication-free treatment through five main concepts: 1) Employees’ motivation; 2) Frames; 3) Network; 4) Relations; and 5) Patients’ motivation. Staff and management expressed strong motivation for an alternative to “treatment as usual,” focusing more on recovery and relationships than on the absence of medication. Therapists from other hospital areas highlighted resource allocation concerns and expressed a desire to learn from the unit. Challenges were acknowledged by all groups. Conclusion The term “medication-free treatment’’ might be misleadning. While patiens at the unit can use medications, there is a strong emphasis on patient autonomy and the option to taper off medication and live a life without them. The study adds valuable knowledge about the the experiences of employees working at a medication-free unit, and provides insights into the complexity of treating severe mental illness, both with and without medication. It highlights the importance of sufficient time, stability and resources to focus on each patient’s strengths and challenges. All employees agree that tailored measures in long-term treatment and a clear focus on recovery should be integral, even without an emphasis on “medication-free treatment”.

Engaging Low-Wage Workers in Health and Well-Being Survey Research: Strategies From 5 Occupational Studies

Without perspectives of low-wage workers in studies of worker health and well-being, researchers cannot comprehensively assess occupational health and health equity impacts of workplace exposures and interventions. Researchers and practitioners have noted particular challenges in engaging low-wage workers in worksite-based health survey research, yet little scholarship has described strategies for improving their engagement and response rates. To fill this gap, we present case examples from 5 occupational studies conducted between 2020 and 2024 in industries including health care, food service, and fulfillment centers. For each case, we describe how we identified barriers to worker engagement in surveys, explain specific strategies we used to address those barriers, and assess the effectiveness of these actions. Then, summarizing across case examples, we offer practical recommendations to researchers surveying low-wage populations, highlighting that high-touch recruitment, building trust with workers and managers, and obtaining manager support to take surveys during work time (for worksite-based studies) are critical for obtaining reliable, representative data. Our work contributes to broader discussions on improving survey response rates in vulnerable worker populations and aims to support future researchers undertaking similar efforts. ( Am J Public Health. Published online ahead of print November 14, 2024:e1–e8. https://doi.org/10.2105/AJPH.2024.307875 )

Fuzzy synthetic evaluation of intervention measures to enhance the psychological health and well-being of expatriate construction professionals

PurposeWith the rise in international construction projects, addressing the psychological health concerns of expatriate construction professionals (EXCPs) has become of paramount importance. Therefore, this study aims to identify and evaluate effective intervention measures to promote optimal psychological health and well-being in overseas working environments.Design/methodology/approachIntervention measures were identified through a comprehensive literature review. Subsequently, using a case study of Chinese international contractors, data were collected via a quantitative survey administered to EXCPs holding managerial positions in international construction projects. Fuzzy synthetic evaluation was employed to analyze the data.FindingsThe findings identified 23 intervention measures and 4 constructs, among them, measures focused on enhancing organizational justice and training practices offer the greatest potential for enhancing the psychological health and well-being during international assignments. Furthermore, the analysis showed that the overall criticality of the intervention measures to the international contractors is significant, suggesting that if put into practice, the psychological health and well-being of EXCPs can be significantly enhanced.Originality/valueWhile prior research has explored intervention measures suitable for construction professionals working on domestic projects, little attention has been paid to EXCPs in the context of international construction projects. This study offers an initial exploration of the most crucial intervention measures and provides a valuable resource for policymakers and practitioners seeking to establish a psychologically healthy working environment for international construction projects.

New pedagogical tools for vaccine education: preparing future healthcare workers for the next pandemic

New pedagogical tools for vaccine education: preparing future healthcare workers for the next pandemic

Barriers and Facilitators to Becoming a Medical Physicist in Bangladesh

The notion of gender equity is debatable, and worldwide health professionals are exploring the argument. However, the contextual situation and experience are different in each country and vary across cultures. There is an extensive amount of literature that presents women’s participation and involvement as increased in science, technology, engineering and mathematics over the last decades (Frize et al., 2022); however, there are variations in data and analyses documented which refer to the gender disparity of medical physicists (MPs) Worldwide (Barabino et al., 2020; Crowe and Kairn, 2016). Medical physics is one of the fields in health care where women are underrepresented, with only 29.8% of the workforce reported identifying as females in this sector (Tsapaki et al., 2018; Tsapaki and Rehani, 2015). Historically, the healthcare profession is male-dominated (Witz, 1990), with women being underrepresented in many specialist fields like academic medicine, surgical specialities and leadership positions (Kramer et al., 2021). The Nursing profession is, however, excluded from this category and considered a woman’s job. Furthermore, women’s contributions to the healthcare industry are not frequently acknowledged (Paradis et al., 2021). Moreover, the career trail for men and women in the healthcare profession is suggestively different (Baig, 2020). Broadly, regarding leadership positions and the range of decision-making, there are observable gender discrepancies in the industry. One of the main reasons for this is social restrictions, which women in specific geographic locations like Bangladesh encounter frequently. The lack of support or a platform for women to practice their profession with autonomy impedes their progress or movement upward in their careers. Women's unhindered involvement, participation and career development in patient care will improve healthcare provision, especially in caring for vulnerable patient groups like the elderly, individuals with significant co-morbidities, and minorities (Covington et al., 2020). In addition, involving more women in healthcare will not only reduce the gender disparity and empower them but also create a sense of confidence in the professions and services provided and, as a result, improve overall well-being. This study will aim to understand the views and experiences of gender-based discrimination among practising medical physicists in Bangladesh.

OCCURRENCE OF HUMAN PAPILLOMAVIRUS (HPV) IN WOMEN OF LGBTQIA+ COMMUNITY TREATED IN MANAUS, AMAZONAS

Human papillomavirus (HPV) is a significant etiological factor for several types of cancer, including cervical carcinoma, with 80% of cases of cervical cancer occurring in Latin America. In Brazil, cervical carcinoma is the third most prevalent cancer among women, and the northern region and the state of Amazonas have the highest incidence in the country. However, not all women benefit from cervical cancer screening measures. Most women in the LGBTQIA+ community do not seek gynecological health services since they often face barriers related to female homosexuality when accesing sexual health services. Using PCR, this study perfomed the molecular detection and genotyping of HPV in thirty-six patients (20 homosexual and 16 bisexual women) from Manaus, Amazonas, Brazil. Samples of the cervical epithelium were taken during the preventive examination and genotyping was perfomed to detect HPV 16, 18, 31 and 58. Of the thirty-six patients analyzed in this study, 88% of bisexual women (n=14) and 60% of homosexual women (n=12) tested positive for HPV. The HPV 18 genotype was the most frequent among the findings. The results indicate that homosexual and bisexual women are more vulnerable to HPV infections due to the lack of more specific gynecological care directed to this group, which includes the lack of training of professionals to deal with the particularities of this population group. Therefore, more HPV screening studies for LGBTQIA+ women and improved training for specialized health professionals are needed.

Reactions to and Impact of Survivor Online Disclosures: A Qualitative Analysis

ABSTRACT Social reactions to disclosure of sexual victimization play an important role in the process of recovery. The purpose of this qualitative study was to explore the impact of online disclosure of sexual victimization. The sample for this qualitative study (n = 17) focused on participants who shared their experiences with disclosing about their sexual victimization online and the reactions received in these spaces. Using applied thematic analysis, the research team identified three major themes from the data, each with respective subthemes, including helpful, harmful, and mixed reactions to online disclosure. Findings highlighted the nuances of disclosing online and the diverse reactions that were received. Participants provided in-depth descriptions of not only how the disclosure experience and resulting reactions could be helpful or harmful but also nuanced, mixed, and simultaneously harmful and helpful. This data is a crucial reminder that survivors’ stories are unique and that survivors experience many varying motivations for choosing if, when, where, to whom, or for whom they may disclose. The findings may help inform clinical recommendations for mental health practitioners working with survivors of sexual victimization and holding therapeutic space to process these decisions of disclosure. Future researchers should also consider further studying online interactions, especially within and between survivors, including when and how survivors choose to connect or disconnect.

Systematic Review of Deep Learning Techniques in Skin Cancer Detection

Skin cancer is a serious health condition, as it can locally evolve into disfiguring states or metastasize to different tissues. Early detection of this disease is critical because it increases the effectiveness of treatment, which contributes to improved patient prognosis and reduced healthcare costs. Visual assessment and histopathological examination are the gold standards for diagnosing these types of lesions. Nevertheless, these processes are strongly dependent on dermatologists’ experience, with excision advised only when cancer is suspected by a physician. Multiple approaches have surfed over the last few years, particularly those based on deep learning (DL) strategies, with the goal of assisting medical professionals in the diagnosis process and ultimately diminishing diagnostic uncertainty. This systematic review focused on the analysis of relevant studies based on DL applications for skin cancer diagnosis. The qualitative assessment included 164 records relevant to the topic. The AlexNet, ResNet-50, VGG-16, and GoogLeNet architectures are considered the top choices for obtaining the best classification results, and multiclassification approaches are the current trend. Public databases are considered key elements in this area and should be maintained and improved to facilitate scientific research.

Navigating brain drain: understanding public discourse on legislation to retain medical professionals in Nigeria

Navigating brain drain: understanding public discourse on legislation to retain medical professionals in Nigeria

The next generation of physician-researchers: undergraduate medical students’ and residents’ attitudes, challenges, and approaches towards addressing them

Abstract Background Undergraduate medical education and residency training are critical periods for conducting research. Medical diagnoses and therapies are direct results of successful research efforts that have advanced several scientific fields. This review highlights the importance of incorporating scientific research training into the curricula of undergraduate medical education and residency programs. Methods We utilized key databases such as PubMed, Web of Science, and Google Scholar to conduct a narrative review of English-language articles published between 2002 and 2024. Ultimately, we selected 49 studies that examined the attitudes of undergraduate medical students and residents toward research, the common challenges they encounter while participating in research activities, and the strategies that support and encourage their involvement, all in alignment with our study objectives and keywords. In addition, we identified several relevant themes, including the value of research experience in shaping well-rounded medical professionals; the integrity of research practices in residency selection, which addresses concerns such as the arms race and misrepresentation, as well as the balance between quality and quantity; striking a balance between research and clinical training while promoting equity and inclusion; and effective programs and mentorship strategies to enhance research engagement. Results Translating the positive attitudes of undergraduate medical students and residents into improved knowledge and practice necessitates the development of structured mentoring programs and advanced training systems. Institutions must provide the necessary tools, guidance, and support to overcome research barriers. This will help establish an environment in undergraduate medical education and residency training that values research, facilitates access to it, and integrates it into the curriculum. Conclusions To address the critical shortage of physician-researchers and improve evidence-based medical practice, it is crucial for medical schools to focus on research education and create avenues for student involvement. By tackling research challenges and implementing supportive strategies, these efforts empower the next generation of physician-researchers to embrace research, contribute to medical progress, and uphold the highest standards of patient care.

Clinical staff attitudes towards opt‐out consent for blood‐borne virus screening in emergency departments in England

AbstractObjectiveOpt‐out screening for blood‐borne viruses (BBVs) in emergency departments (EDs) has been established in areas with a high prevalence of HIV diagnoses in England. This multi‐site study explored the attitudes of healthcare workers (HCWs) towards BBV screening in EDs post‐implementation.DesignThis was a cross‐sectional electronic survey of HCWs.MethodsBetween November 2023 and February 2024, HCWs across 33 EDs in England participating in opt‐out BBV screening were invited to complete a survey about the feasibility and acceptability of screening, including the opt‐out consent process. Factors independently associated with acceptability of opt‐out screening were identified using multivariable logistic regression. Free‐text responses were analysed thematically.ResultsResponses from 610 HCWs in 19 EDs were provided: 50.4% were nurses, 43.1% doctors, and 6.5% other healthcare professionals. Acceptability of the screening programme and opt‐out consent was high (90.3% and 77.7%, respectively), with some variation between EDs. Acceptability of opt‐out consent was greater among doctors than among other HCWs, and among HCWs who proactively discussed screening further with patients who opted out. However, 50.8% of HCWs felt that patients should be verbally reminded at blood draw, and 44.3% of HCWs wanted more training in discussing opt‐out screening with patients. Free‐text answers suggested changes to test‐ordering systems, including simple integration of tick boxes to document whether patients opted out and to block repeated testing.ConclusionsThere was substantial support from ED HCWs for routine opt‐out ED BBV screening, including opt‐out consent. Key areas suggested for improvement included changes to test‐ordering systems and additional training for HCWs. Frequent preference for verbal reminders at the point of blood draw suggests continued HIV testing exceptionalism.

Economic Insecurity during the COVID-19 Pandemic among Healthcare Workers by Educational Attainment

Abstract Prior to the COVID-19 pandemic, healthcare workers with less formal education (e.g., nursing assistants, home care aides) versus more formal education (e.g., physicians, nurses) were more likely to experience economic insecurity, the real and/or perceived risk of financial losses. Given the unprecedented impact of COVID-19 on healthcare workers, we sought to describe economic insecurity among these workers during the pandemic. Using data from the U.S. Census Bureau’s Household Pulse Survey from July 2021 to July 2023, we examined economic insecurity among healthcare workers by educational attainment. Higher proportions of healthcare workers with an associate degree or below reported difficulty paying usual expenses, food insufficiency, and being behind on rent/mortgage payments compared to healthcare workers with a bachelor’s degree or higher. Accounting for other sociodemographic characteristics, higher educational attainment was associated with significantly lower odds of economic insecurity. Since the public health emergency has ended and temporary policies to support low wage workers during the pandemic have sunsetted, targeted policies to promote economic security among financially vulnerable low wage workers are critical to enable recruitment and retention of these essential healthcare workers.

Developing Culturally Sensitive Suicide Prevention Programs for Medical Professionals in Indonesia

Introduction: Medical professionals in Indonesia experience high levels of stress, increasing their risk for mental health problems and suicidal behavior. Culturally appropriate suicide prevention programs are critical to address this issue. This study aimed to develop and evaluate the feasibility and acceptability of a culturally adapted suicide prevention program for Indonesian medical professionals. Methods: This mixed-methods study had two phases. Phase 1 involved program development, adapting an existing evidence-based suicide prevention program using a Delphi method with Indonesian mental health experts (n=10) and cultural consultants (n=5). Phase 2 comprised a pilot implementation of the program with 30 medical professionals. Quantitative data on program feasibility (attendance, completion rates) and acceptability (satisfaction surveys, qualitative feedback) were collected and analyzed. Results: The Delphi method resulted in a culturally adapted program incorporating Indonesian values related to collectivism, family support, religious beliefs, and stigma associated with mental health. Pilot implementation showed high attendance (87%) and program completion rates (93%). Participants expressed high satisfaction with the program's content, cultural relevance, and delivery format. Qualitative feedback emphasized the importance of peer support, spiritual integration, and addressing workplace stressors. Conclusion: This study provides preliminary evidence for the feasibility and acceptability of a culturally sensitive suicide prevention program for Indonesian medical professionals. Further research is needed to evaluate the program's effectiveness in reducing suicidal ideation and behavior.

Assessment of a Hearing Aid Training Program for Health Care Workers

Purpose: The purpose of the present study was to develop and evaluate an in-person hearing aid training program designed for health care workers and personal care aides (PCAs) who care for older adults. Method: Participants were 18 health care workers and PCAs whose clients were older adults. This was a randomized controlled study in which half of the participants were assigned to the experimental group ( n = 9) and the other half to a control group ( n = 9). The experimental group was administered a hearing aid training program that was developed in this study for health care workers and PCAs. Participants in the control group were trained on a task similar in complexity and administration time to the hearing aid training program. The Practical Hearing Aid Skills Test–Revised Version 2 (PHAST-Rv2) was administered before and immediately after training. A 2 × 2 mixed analysis of variance (ANOVA) was used to compare the pre- and post-training scores between and within the experimental and control groups. Descriptive statistics were used to examine the differences between pre- and post-training scores on each of the administered PHAST-Rv2 tasks. In addition, participants were asked about their experience helping clients with their hearing aids. Results: Mean pre- and post-training PHAST-Rv2 scores for the experimental group were 59.50% and 95.84%, respectively, and 57.66% and 59.96%, respectively, for the control group. Results from a 2 × 2 mixed ANOVA with time point (pre- and post-training) as the within-subject variable and group (experimental and control) as the between-subject variable demonstrated that hearing aid training significantly improved PHAST-Rv2 scores for the experimental group. Post-training, the tasks that the experimental group improved on the most were brushing the microphone port, cleaning the dome, placing the hearing aids in the charger, and inserting the hearing aid into the model ear. No demographic variables were significantly correlated with the participants' improvement on the PHAST-Rv2 post-training score. Conclusion: A hearing aid training program designed specifically for health care workers was shown to be an efficient and effective way to improve how well health care workers can care for and operate a hearing aid.

Older Migrant Patients and Health Care Professionals’ Experiences With Digital Translation Tools in Care Interactions: A Qualitative Literature Review

Introduction: Finding solutions to communicate difficulties in care interactions between health care professionals and older migrant patients may be facilitated by the use of digital translation tools. The aim was to explore older migrant patients’ and health professionals’ experiences using digital translation tools in transcultural care. Methodology: A systematic qualitative literature review, based on nine quality assessed articles published 2009 to 2024 from five databases, and analyzed using thematic analysis. Results: Three themes and eight subthemes emerged: advantages of using translation tools describes the benefits experienced using such tools; limitations and challenges highlights the problems identified in their use; and improvement suggestions for the functions of the translation apps describes adjustments and developments of the translation tools. Discussion: Digital translation used in basic care, may enhance relationships and equity of care, but should not substitute human interpreters in complex care conversations. Translation tools need to be developed according to older users’ abilities.

Factors Influencing Self-Management Behaviors Among Patients with Post-Kidney Transplantation: A Qualitative Study of the Chronic Phase Transition

Background: Kidney transplantation is an effective treatment for patients with kidney failure. Despite the advances in technology, a certain number of patients still deteriorate due to improper management. The purpose of this study was to identify the promoting and inhibitory factors that influence recipients’ self-management behaviors after a kidney transplant. Methods: We enrolled participants who had kidney transplants for more than one year, aged ≥20 years from outpatient clinics in Japan. Face-to-face interviews were conducted between April and December 2016. Results: Nine participants were included in this study. By qualitative content analysis, 115 codes and 8 categories were extracted for the factors resulting in maintenance and the promotion of self-management behaviors; those were [attentiveness to changes in one’s own body], [good partnership with medical care providers], [past painful experiences], [establishment of lifestyle habits], [autonomy to protect one’s own body], [support from family and others], [gratitude for kidney donation], and [increased self-efficacy]. We also extracted three categories that inhibited self-management behavior: [fading threat of worsening disease], [shifting priorities], and [decreased motivation to control the disease]. Conclusions: The passage of time after transplant became a barrier to continue self-management. Providing knowledge about the importance of self-management can prevent the deterioration of kidney function over time after a transplant.

THE IMPORTANCE OF COMMUNICATION OF MEDICAL RADIOLOGY ENGINEERS AND PATIENTS THROUGH THE LENS OF EMPATHY

Effective communication is essential for the quality of healthcare and patient satisfaction in medical institutions. Empathy as part of emotional intelligence plays a major role in the interaction between healthcare workers and the patient, as it helps to understand patient needs, reduce stress and improve patient experience. This paper analyzes theoretical concepts and practical aspects of empathy in the scope of medical radiology; it examines the challenges and preparations that may arise when communicating and provides guidance on how to improve the connection between medical radiology engineers and patients. Addressing this phenomenon enables the development of strategies to improve communication skills as well as compassion, which can lead to better patient outcomes and contribute to an effective working environment for medical staff.

PREVALENCE, Characteristics, and Awareness of Chronic Kidney Disease in Croatia: The EH-UH 2 Study

Background. National surveys have reported variable prevalence of chronic kidney disease (CKD), due to differences in the characteristics of the population, study design, equations used for the estimated glomerular filtration rate (eGFR), and definitions. The EH-UH 2 survey is the first study evaluating CKD prevalence, characteristics, and awareness in Croatia. Methods. This was a cross-sectional nationwide observational study designed to assess the prevalence of CKD and cardio–kidney–metabolic risk factors in Croatia, which included 1765 randomly selected subjects. We estimated the prevalence of CKD by means of the albumin-to-creatinine ratio (ACR) and eGFR (CKD-EPI equation). Comorbidities and anthropometric and social factors related to the prevalence of CKD were analyzed, and the CV risk profile was evaluated. Results. The weighted prevalence of CKD (any stage), CKD stage ≥G3A A2, and CKD defined only as an eGFR <60 mL/min/1.73 m2 were estimated at 17.1%, 9.8%, and 7.9%, respectively. The prevalence was higher in men than in women (11.8% vs. 7.9%; p < 0.001). The weighted prevalence of an ACR >30 mg/g was 15.1%. Older age, male gender, diabetes, ePWV, and uric acid were independently associated with CKD prevalence. The awareness of CKD was 9.5%. Persons unaware of CKD were older with lower income, less education, more frequent diabetes, hypertension (less frequently controlled), and milder renal impairment. Conclusions. In Croatia, the estimated prevalence of CKD is high, being presented more frequently in men than in women. CKD patients have an unfavorable CV risk profile. The awareness of CKD is very low, reflecting poor health literacy in the general population but also in health-care workers.