Health Care Centers Research Articles

To Assess the Effect of Dyslipidemia on Treatment Outcome of Drug Sensitive TB Patients at a Tertiary Health Care Centre of North India

To Assess the Effect of Dyslipidemia on Treatment Outcome of Drug Sensitive TB Patients at a Tertiary Health Care Centre of North India

Natural Course of the Maxillary Sinus Fungus Ball: Results From Seoul National University Hospital Healthcare Center.

The frequency of paranasal sinus fungus balls, a common form of rhinosinusitis, has increased. Although treatment and causative factors have been well investigated, the evolving nature of the fungal balls remains unelucidated. This study aimed to investigate and analyze the changing patterns of fungus balls. This retrospective study analyzed data from 35 participants selected from a pool of 41,497 patients who underwent brain magnetic resonance imaging (MRI) at a large health care center. The extent of the fungus balls was evaluated by grading them from 1 to 4 based on the MR images. The changing process of the fungus ball was analyzed based on demographics, interval between the MRI scans, comorbidities, and specific dental interventions. The fungus ball grades showed significant progression over time. In the analysis of 29 sinuses with initially low-grade (grades 0, 1, and 2) fungus balls, 15 sinuses showed a grade change <2 (no/minimal change group), whereas 14 sinuses showed grade changes of ≥2 (substantial change group). Intergroup comparison showed that only the interval between the initial and final MRI scans differed significantly (p = 0.008). However, factors, such as age, sex, comorbidities, and history of dental procedures, did not differ significantly between the two groups. This study shows the extent of change in fungus balls, primarily over time. These results offer critical insights into the natural course and progression of the maxillary sinus fungus ball. 4 Laryngoscope, 2024.

An assessment of the content of antenatal care provided by obstetricians in Lebanon: A cross-sectional study.

Quality and timely antenatal care is a vital component of pregnancy care for the well-being of mothers and babies. The aim of this study of to assess self-reported obstetricians' adherence to national and international antenatal care guidelines in Lebanon. This cross-sectional study approached all obstetricians registered with the Lebanese Society of Obstetrics and Gynecology and the Lebanese Order of Physicians to participate in an online and telephone-based survey. The study tool included all of the items from the World Health Organization and national guidelines for antenatal care. Obstetricians' self-reported adherence was assessed across five modules including dietary interventions, dietary supplements, antenatal care assessment, fetal growth assessment, and antenatal care preventive measures. A total of 134 obstetricians completed the survey. Overall, adherence was high for most antenatal care guidelines except for providing nutrition services to undernourished pregnant women, screening for intimate partner violence, and providing tetanus vaccines. The number of recommended antenatal care visits (≥8 vs. <8 visits) was higher among obstetricians in Mount Lebanon or Beirut compared to other areas in Lebanon (72.7%vs.48.6%; p-value <0.01). Provision of tetanus or diphtheria, tetanus, and pertussis (DTP) vaccination was lower for obstetricians who provide care for women who pay out-of-pocket compared to obstetricians who provide care to women who use other payment methods (25.3%vs.45.7%; p-value = 0.024). Group B streptococcus screening test and the provision of at least five ultrasounds were higher among obstetricians who provide care in private clinics or clinics in private hospitals compared to clinics in public hospitals or primary healthcare centers (88.8%vs.66.7%; p-value = 0.023) and (83.6%vs.55.6%; p-value = 0.011), respectively. Reinforcing the adherence to all antenatal care guidelines by continuous monitoring of health facilities is crucial for best practice. Subsidies for essential services may be required for those who are unable to afford components of antenatal care.

Towards responding to climate change: practices in Iranian healthcare centers

The aim of this study was to investigate the prevailing practices suitable for Iranian healthcare centers to address climate change and to rank them in terms of priority. This paper, a mixed-methods study conducted in 2023, comprised a scoping review and a thematic analysis covering the period from 2000 to 2023 as the first phase of the study. In this regard, PubMed, Scopus, ProQuest, and the Cochrane Database of Systematic Reviews were searched. In the second phase, the authors engaged a group of experts to prioritize the most important practices suitable for Iranian healthcare centers to address climate change using the Grey MEREC-MABAC integrated approach. The scoping review resulted in 38 studies, and the thematic analysis revealed 11 primary categories of practices employed to address climate change. Subsequently, the Grey MEREC-MABAC approach indicated that the themes of 'Green Environment' (CC = 0.0929), 'Green Equipment, Waste, and Water Management' (CC = 0.0677), and 'Green Energy' (CC = 0.0653) were identified as having the highest priority among the practices deemed most important in the literature for addressing climate change within Iranian healthcare centers. The study proposed that practices or activities promoting biodiversity and environmental sustainability, such as organic food farming and tree planting, should be considered paramount approaches in Iranian healthcare centers to combat climate change.

Investigating the relationship between the anxiety of contracting corona virus and the symptoms of obsessive-compulsive disorder with the mediating role of mental confusion and emotion regulation in health care center employees

Introduction: anxiety caused by the Corona virus transmission are highly prevalent among medical staff, so this study aims to determine the relationship between the anxiety of affected by infectious diseases and the symptoms of obsessive-compulsive disorder with the mediating role of mental confusion and emotion regulation. MethodS and Materials: This study was carried out based on correlational method in the form of modeling of structural equations, in which 350 male and female employees working in the health and treatment centers of Neyshabur city were selected through available sampling. Data collection tools included Madsley Practical Obsession Scale, Corona Alipour Anxiety Questionnaire, Criver, Solly and Esomil's Deliberate and Automatic Disorientation Questionnaire, and Gross and John's Emotion Regulation Questionnaire. After completing the questionnaires, data analysis using Modeling of structural equations was done with Lisrel and SPSS softwares. Results: between the anxiety and obsessive symptoms with r = 0.576, between mental confusion and obsessive symptoms with r = 0.553, between mental confusion and anxiety with r = 0.481, There is a significant direct relationship at the level p&gt;0.01. But between emotional regulation and obsessive symptoms with r = -0.643, between emotional regulation and anxiety with r = -0.495, between emotional regulation and mental confusion with r = -0.611 there is an inverse significant relationship. Also, the results showed the role of two mediating variables of mental confusion and emotional regulation in the relationship between corona anxiety and obsessive symptoms. Conclusion: The model of the relationship between the anxiety caused by the transmission of the corona virus and the symptoms of obsessive-compulsive disorder according to the mediation of mental disorientation and emotion regulation has a good fit that with the increase in the number of emotions and defeat in regulating one's emotions, the symptoms of obsessive-compulsive disorder and confusion mental health also increases in the treatment staff. According to these findings, it is expected that health managers and medical centers will pay special attention to the psychological well-being of the personnel working in different parts of this profession.

Can a smoking cessation app benefit individuals in disadvantaged areas? A qualitative study on motivation, barriers, and perceptions of a digital app in stockholm, sweden

ObjectiveIn Sweden, the prevalence of daily smoking has decreased substantially over the past few decades. However, a socioeconomic divide is evident, contributing to health inequities. The current study focuses on the needs, facilitators, and barriers in relation to quitting smoking among individuals in disadvantaged areas and explores their perception of digital tools for smoking cessation. MethodSemi-structured interviews were conducted with 30 participants in Stockholm County between 2022 and 2023. Participants were recruited through health care centres, dental clinics, and civil society actors. A thematic analysis was performed. ResultsTwo cross-cutting main themes were identified; 1) Motivational factors and barriers in smoking cessation, including the subthemes “health, concern for loved ones and economic aspects” and “emotional, environmental, and cultural barriers” and 2) Benefits and limitations of a digital tool for smoking cessation, including the subthemes”important/relevant features in a digital app” and “limitations of digital support”. ConclusionsThe results reveal that most participants want to quit smoking but perceive it as difficult. The study highlights the importance of addressing social disparities in smoking and the need for accessible smoking cessation support. While mobile apps are viewed as promising for smoking cessation by some of the participants, scepticism exists among others. Moving forward, personalized approaches that integrate digital tools with traditional methods for smoking cessation can be important to reduce smoking prevalence. Ensuring accessibility of effective smoking cessation support for all is a key public health interest.

Organizational silence and hidden threats to patients' dignity with schizophrenia: A qualitative study.

Maintaining patients' dignity is a key ethical requirement in healthcare and is emphasized in nursing standards. This issue is particularly significant for patients with schizophrenia because they face unique challenges such as physical and psychological difficulties, dependence on others, and social isolation, making them more vulnerable. Organizational factors can either threaten or preserve their dignity. However, there is little knowledge in this domain within the sociocultural context of Iran. This study aimed to explore the role of the healthcare organization in the dignity of patients with schizophrenia, based on the opinions of patients, healthcare personnel, and family caregivers. This qualitative study was conducted with 26 participants (16 patients, 4 family caregivers, 2 nurses, 3 psychologists, and 1 service worker) who were selected using a purposeful sampling method. The data were collected through semi-structured, in-depth face-to-face interviews until data saturation was reached. The data were analyzed via Graneheim and Lundman's method. The study protocol was approved by the Research Ethics Committee of Urmia University of Medical Sciences (IR.UMSU.REC.1401.099). Based on data analysis, participants reported the three following challenges as organizational hidden threats to patients' dignity: "Lack of facilities," "premature management," and "ineffective communication." The study findings indicated that the healthcare organization does not support the dignity of patients. Management inefficiency and lack of facilities are evident in psychiatric hospitals, and healthcare centers are not monitored based on standard criteria. Limited interactions between healthcare personnel and patients were identified as the main reasons for the neglect of patients with schizophrenia and the violation of their dignity. The results of this study can help healthcare policymakers in designing and implementing effective programs to preserve the dignity of patients with schizophrenia.

IMPLEMENTING AND EVALUATING A PAEDIATRIC EMERGENCY MANAGEMENT TRAINING PROGRAM FOR PRIMARY HEALTHCARE WORKERS IN ZARIA

Nigeria continues to grapple with alarmingly high under-five mortality rates, with approximately 2,300 children dying daily due to preventable and treatable diseases such as pneumonia, malaria, and diarrheal illnesses. This crisis is particularly pronounced in rural areas, where childhood mortality rates are significantly higher than in urban centres. For many rural communities, primary healthcare (PHC) centres serve as the sole access point to medical services, making these centres critical to addressing this public health challenge. Despite their importance, PHC centres often face significant challenges, including inadequate infrastructure, limited access to essential medications, and a shortage of adequately trained health personnel. This study aimed to implement and evaluate a Paediatric Emergency Management Training Program for healthcare workers at PHC centres in Zaria, Kaduna State. The primary objective was to assess the effectiveness of the training in improving the competency of health workers in managing common paediatric emergencies, thereby enhancing the overall quality of care provided at these centres. A cross-sectional descriptive study was conducted involving 139 healthcare workers from selected PHC centres in Sabon Gari and Zaria Local Government Areas, utilizing a multi-stage random sampling technique. Data collection was performed using a pre-tested, semi-structured, self-administered questionnaire designed to evaluate the participants' baseline knowledge, followed by an assessment after the training intervention. The data were analysed using SPSS version 21, with chi-square tests employed to examine the associations between variables. Results were presented using tables and charts for clarity. The findings revealed a generally low baseline competency in managing common paediatric emergencies among the healthcare workers. Specifically, 66 (48.5%) of the respondents demonstrated very poor knowledge regarding the causes of common paediatric emergencies, 32 (23.5%) had poor knowledge, 34 (25.0%) had good knowledge, and only 4 (2.9%) of the respondents exhibited excellent knowledge. Similarly, knowledge regarding the treatment of these emergencies was also lacking, with 46.7% of respondents showing very poor understanding, 34.1% having poor knowledge, 16.3% demonstrating good knowledge, and only 3.0% showing excellent knowledge. A statistically significant relationship was observed between academic qualifications and knowledge levels in both causes (p = 0.004) and treatment (p = 0.000) of paediatric emergencies. The low baseline knowledge underscores the critical need for targeted training interventions. The study highlights the importance of establishing a sustained partnership between the Department of Paediatrics at Ahmadu Bello University Teaching Hospital and the Departments of Primary Health Care in Zaria and Sabon Gari Local Governments. Regular training workshops, held quarterly, are recommended to continuously equip PHC workers with the necessary skills to effectively manage paediatric emergencies, ultimately contributing to a reduction in childhood mortality rates in the region.

ICU follow-up services and their impact on post-intensive care syndrome: a scoping review protocol

IntroductionPost-intensive care syndrome (PICS) seriously affects the quality of life of intensive care unit (ICU) survivors, their ability to return to work and society and the quality of life of...

Quantitative biomechanical analysis in validating a video-based model to remotely assess physical frailty: a potential solution to telehealth and globalized remote-patient monitoring.

Assessing physical frailty (PF) is vital for early risk detection, tailored interventions, preventive care, and efficient healthcare planning. However, traditional PF assessments are often impractical, requiring clinic visits and significant resources. We introduce a video-based frailty meter (vFM) that utilizes machine learning (ML) to assess PF indicators from a 20s exercise, facilitating remote and efficient healthcare planning. This study validates the vFM against a sensor-based frailty meter (sFM) through elbow flexion and extension exercises recorded via webcam and video conferencing app. We developed the vFM using Google's MediaPipe ML model to track elbow motion during a 20s elbow flexion and extension exercise, recorded via a standard webcam. To validate vFM, 65 participants aged 20-85 performed the exercise under single-task and dual-task conditions, the latter including counting backward from a random two-digit number. We analyzed elbow angular velocity to extract frailty indicators-slowness, weakness, rigidity, exhaustion, and unsteadiness-and compared these with sFM results using intraclass correlation coefficient analysis and Bland-Altman plots. The vFM results demonstrated high precision (0.00-7.14%) and low bias (0.00-0.09%), showing excellent agreement with sFM outcomes (ICC(2,1): 0.973-0.999), unaffected by clothing color or environmental factors. The vFM offers a quick, accurate method for remote PF assessment, surpassing previous video-based frailty assessments in accuracy and environmental robustness, particularly in estimating elbow motion as a surrogate for the 'rigidity' phenotype. This innovation simplifies PF assessments for telehealth applications, promising advancements in preventive care and healthcare planning without the need for sensors or specialized infrastructure.

Correlation between serum vitamin B12, vitamin D, and suboptimal semen parameters in male infertility: A hospital-based cross-sectional study

ABSTRACT Background: Micronutrients such as vitamin B12 and D have recently gained attention for their potential roles in male reproductive health. Despite their significance, there’s a critical gap in understanding their association with male infertility, particularly concerning suboptimal semen parameters. This study aimed to address this knowledge gap by examining serum vitamin B12 and D levels in infertile males, providing insights that could inform targeted interventions for couples facing male infertility challenges. Methods: This cross-sectional study, conducted at Tertiary Health care centre in north India for 2 years, enrolled 73 infertile males aged 20–40 years from the fertility clinic (participants exhibited suboptimal semen parameters). Clinical and demographic data were collected through interviews and record reviews, while semen samples underwent meticulous processing for the analysis of various parameters. Blood samples were collected after overnight fasting for serum vitamin B12 (ELISA) and vitamin D (CLIA) assessment. Statistical analyses, performed using SPSS, included t-tests, Chi-square tests, and Pearson’s correlation analyses to explore associations between serum vitamin levels and semen parameters, with a significance level set at P &lt; 0.05. Results: The study comprised 73 infertile males with suboptimal semen parameters. Serum vitamin B12 levels (mean ± SD: 243.4 ± 69.3 pg/mL) and vitamin D levels (22.5 ± 13.2 ng/mL) were measured. Low vitamin B12 (&lt;200 pg/mL) was observed in 29 participants (39.7%), while low vitamin D (&lt;20 ng/mL) was noted in 51 participants (69.9%). Semen parameters revealed significant differences in sperm count, motility, and morphology between low and normal vitamin B12 groups. Similar patterns were observed with vitamin D levels, emphasizing potential associations between vitamin status and semen quality. Conclusion: Our findings suggest a potential link between low serum vitamin B12 and D levels and suboptimal semen parameters in infertile males. Addressing these nutritional deficiencies may hold promise for improving male fertility outcomes. Further research is warranted to elucidate the mechanisms involved and explore targeted interventions.

Differences in IgG afucosylation between groups with and without carotid atherosclerosis

BackgroundA previous study demonstrated that N-glycosylation profiles of IgG are associated with subclinical atherosclerosis in a British population. However, the generalisability of this finding to other ethnic groups remains to be investigated, and it has yet to account for additional traditional atherosclerotic risk factors. The present study, thus, aims to explore IgG N-glycosylation profiles in Han Chinese with atherosclerosis, and their potential role in atherosclerosis, while controlling for traditional atherosclerotic risk factors.MethodsData of this case-control study were obtained from an established umbrella Health Examination Cohort Study (registration number: ChiCTR2100048740). The investigation was conducted at the Health Care Centre of the First Affiliated Hospital of Shantou University Medical College in China, from August 1, 2021, to July 31, 2022. A sample of 69 carotid atherosclerosis (CAS) cases was recruited from the umbrella cohort, along with 69 controls without carotid atherosclerosis, matched by traditional atherosclerosis-related risk factors, including gender, age, smoking, alcohol consumption, hypertension, diabetes, dyslipidemia and obesity. Subsequently, serum IgG N-glycosylation was profiled using Ultra-Performance Liquid Chromatography.ResultsAfter propensity score matching, the relative abundance of IgG fucosylation in CAS cases was significantly lower than that in controls [95.32 (92.96, 95.99) vs. 95.96 (94.70, 96.58), P = 0.022]. The traditional atherosclerosis-related risk factors showed no statistically significant difference between CAS cases and controls (P > 0.05).ConclusionsThe reduced fucosylation of IgG in CAS cases underscores the pivotal role of afucosylation in CAS. Enhancing the inflammatory capability of IgG via initiating antibody-dependent cell-mediated cytotoxicity could be the potential mechanism behind this, which should be further verified by functional studies.

Coexistence of aerobic vaginitis caused by Enterococcus faecalis and human papilloma virus (HPV) infection as a risk factor for the development of cervical intraepithelial lesions

&amp;lt;p&amp;gt;&amp;lt;strong&amp;gt;Aim&amp;lt;/strong&amp;gt; To determine the prevalence of aerobic vaginitis (AV) caused by &amp;lt;em&amp;gt;Enterococcus faecalis (E. faecalis)&amp;lt;/em&amp;gt; in human papilloma virus (HPV)-positive women with pathological Pap test and to determine the most prevalent HPV type associated with &amp;lt;em&amp;gt;E. faecalis&amp;lt;/em&amp;gt; infection.&amp;lt;br /&amp;gt;&amp;lt;strong&amp;gt;Methods&amp;lt;/strong&amp;gt; This prospective study was conducted at the Gynaecology Centre &amp;quot;Dr. Mahira Jahić&amp;quot; Tuzla and Primary Health Care Centre Te&amp;amp;scaron;anj (Bosnia and Herzegovina) in the period between February 2023 and March 2024. The research included 200 women aged 25 to 50 years. The examined group consisted of 100 women with a pathological (examined group) and 100 with a normal (control group) Pap test result.&amp;lt;br /&amp;gt;&amp;lt;strong&amp;gt;Results&amp;lt;/strong&amp;gt; Pathological Pap smears were found in 60 (out of 100; 60 %) women in the examined group: cervical intraepithelial neoplasia (CIN) 1 and CIN 2 &amp;amp;nbsp;in two women, respectively, CIN 3 in seven, atypical squamous cells of undetermined significance (ASCUS) in 29 and atypical squamous cells-high-grade cannot be excluded (ASC-H) in two women. Overall (both groups) prevalence of &amp;lt;em&amp;gt;E. faecalis&amp;lt;/em&amp;gt; was 25.5% (51women); in 45 (22.5%) women &amp;lt;em&amp;gt;E. faecalis&amp;lt;/em&amp;gt; was the only bacterial isolate, of which 42 (21%) in the examined group and three (1.5%) in the control group. High-risk HPV types were found in 62 (out of &amp;amp;nbsp;100; 62%) women with the pathological Pap smear test. The association of &amp;lt;em&amp;gt;E. faecalis&amp;lt;/em&amp;gt; and high-risk HPV positive women was found in 35 (35%) cases (moderately positive correlation; r=0.198).&amp;lt;br /&amp;gt;&amp;lt;strong&amp;gt;Conclusion&amp;lt;/strong&amp;gt; E. faecalis is very common in HPV 16 and 18 positive women and may represent a risk factor in the development of cervical intraepithelial lesions.&amp;lt;/p&amp;gt;

Behavioural intentions towards use of digital video consultations in primary care: a survey study on physicians’, nurses’ and psychologists’ perceptions in Swedish primary care

ObjectivesThe study aimed to describe the experiences of physicians, nurses and psychologists employed in primary care in using digital video consultations. The second objective was to study the association between...

Benefits of an educational intervention on functional capacity in community-dwelling older adults with frailty phenotype: A randomized controlled trial

BackgroundThere is an urgent demand for nurses to expand their knowledge and skills in managing frailty in primary care. Frailty is a multifaceted condition that is prevalent among older adults and often leads to reduced functional capacity. Currently, there is a limited understanding of the effectiveness of educational interventions aimed at improving functional capacity among community-dwelling frail older adults in a primary care setting. ObjectiveThis study aimed to evaluate the impact of an educational program on functional capacity among pre-frail and frail older adults living in the community. DesignA 12-month, multicenter, randomized controlled trial. SettingsThe FRAGSALUD study was conducted across 14 healthcare centers situated within the regions of Cadiz and Malaga, Spain. ParticipantsA total of 199 frail/pre-frail community-dwelling older adults (74.2 ± 6.4 years). MethodsParticipants who met at least one Fried's criteria were assigned to either the control group (n = 90), which received usual healthcare assistance, or the intervention group (n = 109). The 6-month intervention comprised four group sessions and six telephone calls conducted by professional nurses, sport scientists, and nutritionists. This educational program focused on guidelines for physical activity, nutritional habits, cognition, and psychosocial well-being. Functional capacity was assessed using questionnaires for basic (Barthel Index) and instrumental (Lawton & Brody Scale) activities of daily living. All outcome measures were evaluated at baseline, immediately after the intervention (6-month), and six months after the intervention as a follow-up (12-month). Differences in functional capacity (Barthel Index and Lawton and Brody Scale scores) across the three time points were analyzed using Friedman's ANOVA, with Wilcoxon signed-rank test for pairwise comparisons. ResultsAt both 6-month and 12-month assessments, the control group showed a statistically significant decline in basic and instrumental activities of daily living compared to the intervention group, which maintained similar levels, preventing this age-related decline. ConclusionsThe educational intervention, designed for easy implementation within healthcare systems, especially for nurses, successfully maintained levels of functional capacity in basic and instrumental activities of daily living, while the control group experienced a decline in functional capacity during the 12-month follow-up. Thus, educational interventions are encouraged for preserving the functional independence of frail/pre-frail older adults living in the community. RegistrationThis trial was registered at ClinicalTrials.gov (Identifier: NCT05610605) and the first participant was registered in March 2022.Tweetable abstract: The FRAGSALUD educational intervention prevents the age-related decline in functional independence over 12 months in frail older adults.

Acceptability, barriers and facilitators of using dried blood spots-point-of-care testing for sickle cell disease in Africa: an implementation science protocol for a multinational qualitative study

BackgroundSickle cell disease (SCD) is a prevalent inherited blood disorder. Globally, approximately 515 000 babies are born with SCD annually, with 75% of these births occurring in Africa. Integrating newborn...

Prevalence of undiagnosed hypertension and its associated factors among psychiatric patients: A cross sectional study at a tertiary healthcare center

Prevalence of undiagnosed hypertension and its associated factors among psychiatric patients: A cross sectional study at a tertiary healthcare center

A comparative study of the growth indicators of infants born before and during the Covid-19 pandemic

IntroductionGrowth disorders pose significant mental and physical health challenges with long-term complications for children. As monitoring children's growth is of paramount importance, in the present study attempts are made to compare growth indicators of infants from birth to 12 months before and during the outbreak of COVID-19 pandemic. Material and methodThe present descriptive-analytical study was conducted using cluster sampling method in 10 comprehensive healthcare centers and on 200 infants in southwest of Iran during 2023. The infants’ health records and growth chart before and during the outbreak of COVID-19 pandemic served as data collection instruments. The collected data were analyzed using SPSS 21 software and descriptive and analytical statistics. ResultEconomic hardship, job loss, maternal disease and neonatal acquired disease were found to be significantly higher during the pandemic outbreak compared to the pre-pandemic time. the average weight and BMI of the infants in both groups showed no significant difference from birth to two months old, but the difference was found to be significantly higher from 4 months to 1-year-old among infants born during the pandemic (P-value<0.05). Result this study showed that during the pandemic trend of The age of word articulation by infants was increasing (P-value=0.022) and at this time 6 cases of missed vaccination were observed. ConclusionThe results indicate that the COVID-19 pandemic can affect the growth and development of infants, and may, in some cases, disrupt the growth and routine vaccination schedule during infancy and breastfeeding, which should be prevented by proper parental training.

Understanding COVID-19 Vaccine Acceptance Among Iranian Pregnant Women: Insights From a Multicenter Cross-Sectional Study.

Despite significant advancements in COVID-19 vaccine research and development, hesitancy in its acceptance, particularly among pregnant women, is recognized as a health threat. Based on the Health Belief Model, this study aimed to identify the factors influencing vaccine nonacceptance among pregnant women in the cities of Zahedan and Tabriz, Iran. The present research was a multicenter cross-sectional study conducted among pregnant women in two Iranian provinces, Zahedan and Tabriz, covering both high and low fertility regions. The study was conducted from February 2022 to August 2022. The sample size comprised 650 pregnant women attending selected healthcare centers. Data collection tools included questionnaires on sociodemographic characteristics, awareness, vaccine acceptance, and health beliefs related to vaccination. Data were analyzed using descriptive and analytical methods, including Analysis of variance (ANOVA), Independent t-test, and multivariable logistic regression. Among the 650 pregnant women, the vaccine acceptance rate was 47.4% and 52.6% of pregnant women reported vaccine nonacceptance during pregnancy. The logistic regression model indicated that the odds of vaccine acceptance increase with maternal employment (OR = 11.53, 95% CI: 4.81-27.63), higher maternal education levels (OR = 6.97, 95% CI: 3.11-15.63), higher income (OR = 1.60, 95% CI: 1.07-2.55), and increased awareness levels (OR = 1.37, 95% CI: 1.03-1.52). Additionally, the odds of vaccine acceptance increase with increased perceived susceptibility (OR = 2.55, 95% CI: 0.47-3.76), increased perceived benefits (OR = 2.22, 95% CI: 1.06-4.61), increased perceived barriers (OR = 0.42, 95% CI: 0.18-1.12), and increased cues to action (OR = 2.01, 95% CI: 1.03-3.92). Our study underscores the multifaceted nature of COVID-19 vaccine acceptance among pregnant women, with socioeconomic, awareness-related, and psychological factors all playing pivotal roles. These findings can inform targeted interventions and strategies aimed at increasing vaccine acceptance in this vulnerable population, ultimately contributing to enhanced maternal and fetal health during the ongoing pandemic.

Patient and family engagement in infection prevention during the COVID-19 pandemic: A Q-methodology study with stakeholders from a Canadian university healthcare center

Patient and family engagement in infection prevention during the COVID-19 pandemic: A Q-methodology study with stakeholders from a Canadian university healthcare center