Health Care Initiatives Research Articles

Comparison of Physical Growth Between Low Birth Weight and Normal Birth Weight Babies Aged Between 24-36 Months Born in a Selected Hospital of Dhaka, Bangladesh

This study investigates the physical growth disparities between Low Birth Weight (LBW) and Normal Birth Weight (NBW) babies aged 24-36 months in a selected hospital in Dhaka. The research sample comprised 200 babies, evenly split between LBW (birth weight < 2500 grams) and NBW (birth weight ≥ 2500 grams) groups. Physical growth parameters including weight, height and head circumference were measured and analyzed using descriptive statistics and comparative tests. The findings reveal significant differences in all measured parameters between LBW and NBW infants. LBW babies exhibited lower mean values in weight (11.5 kg vs. 13.0 kg), height (85.0 cm vs. 89.0 cm) and head circumference (48.0 cm vs. 49.0 cm) compared to NBW babies. Statistical analyses confirmed these differences to be significant (p < 0.05), highlighting the persistent impact of birth weight on early childhood growth. These results underscore the importance of targeted healthcare interventions for LBW infants to mitigate growth disparities and promote optimal development. Early childhood growth failure in LBW infants has long-term implications for health and developmental outcomes, necessitating comprehensive healthcare strategies that include nutritional support, growth monitoring and developmental assessments. By addressing these challenges, healthcare providers and policymakers can improve the long-term health and well-being of LBW infants, ensuring they have the opportunity to achieve their full developmental potential. This study contributes valuable insights to the field of maternal and child health in Bangladesh, guiding future research and healthcare initiatives aimed at supporting LBW infants and reducing health disparities.

Inclusive Exploration of Harmonizing and Alternative Treatments for Hypothyroidism

: A clinical syndrome known as hypothyroidism occurs due to a shortage of thyroid hormone as a result of decreased production, abnormal distribution, or no action of thyroid hormones. The most typical clinical symptoms included are dry skin, hair loss, weight gain, painful-prolonged periods, infertility, balance problems, slow speech, bradycardia, hypothermia, fatigue, anxiety & depression, joint pain, and indigestion. Basically, age, gender, the severity of the ailment, and a few other factors affect the various signs and symptoms of hypothyroidism. The limitations of allopathic modalities necessitate the investigation of alternative treatment options. Future healthcare initiatives for the poor world will increasingly depend on CAM approaches to these concerns because lifestyle, diet, obesity, lack of exercise, and stress are significant contributing factors to the development of hypothyroidism. This review's objective is to provide information on herbs as well as complementary and alternative medications which are grouped into five major domains: Biologically Based therapies, Manipulative body-based therapies, Mind body-based therapies, and the whole Medical system. These have traditionally been used to treat thyroid dysfunction. The distribution of diseases in emerging nations is altering as a result of globalization. Hence the existing and potential roles of CAM techniques in the general practice of medicine are illustrated in these approaches. Scientists are being compelled to consider traditional herbal medical treatments and CAM therapy in order to combat adverse medication occurrences, high treatment costs, and compliance problems thus described in this review paper.

Tobacco, respiratory diseases, cardiovascular risk, and cancer: Classical approaches and new alternatives

Smoking tobacco is the main preventable aetiological factor of mortality worldwide, with a significant impact on respiratory and cardiovascular diseases and cancer. Smoking cessation and prevention must be prioritized in health care and legislative initiatives to reduce mortality and associated complications. To date, pharmacological treatments and behavioural therapies, along with community strategies, have been shown to be the most effective methods, especially when used in combination with a coordinated approach. However, their efficacy remains suboptimal and diminishes over time due to the high frequency of relapse. Data from the survey on alcohol and other drugs in Spain (EDADES) of the Spanish National Health System showed that the percentage of smokers has hardly decreased in recent decades and that many smokers do not intend to give up smoking, even those who have already suffered from some complications. In this context, the development of new products such as electronic cigarettes and heated tobacco may have some application in the population. The FDA recognition of risk-modifying products, the British Health System reports on electronic cigarettes, and the recommendations of the American College of Cardiology expert consensus on smoking cessation, among others, indicates the need to consider updating the multifactorial and multidisciplinary approach of smoking and its consequences.

A conceptual framework for digital health marketing strategies to enhance public health outcomes in underserved communities

This paper proposes a conceptual framework for integrating digital health marketing strategies with public health initiatives to enhance healthcare access and outcomes in underserved communities. The framework focuses on leveraging digital marketing tools such as social media, mobile applications, email campaigns, and search engine optimization to disseminate critical health information, promote preventive measures, and engage communities in healthier behaviors. It addresses the persistent challenges faced by underserved populations, including limited healthcare access, low health literacy, and cultural barriers, by utilizing the accessibility and broad reach of digital channels. The proposed framework incorporates three core components: (1) Health Information Dissemination, which explores the use of targeted digital campaigns to provide culturally relevant and accessible health education; (2) Community Engagement, which leverages interactive platforms such as social media and mobile apps to foster participation in preventive healthcare initiatives and healthy lifestyle practices; and (3) Behavioral Change Promotion, which emphasizes using digital tools to influence health behaviors through personalized messaging, reminders, and virtual support groups. By integrating digital marketing strategies into public health programs, the framework aims to improve healthcare outcomes by increasing awareness of preventive measures, enhancing early diagnosis, and promoting disease management. It also underscores the role of data analytics in refining outreach efforts by identifying specific health needs, tracking engagement, and measuring the effectiveness of interventions. This conceptual framework holds promise for healthcare providers, policymakers, and digital marketers seeking to enhance public health outcomes in underserved communities. It provides a structured approach to combining the strengths of digital marketing with public health goals, creating more inclusive, accessible, and effective health interventions. Future research and case studies can build on this model to refine digital health marketing strategies and assess their long-term impact on public health in underserved populations.

Enhancing HIV/AIDS and TB medication logistics: A comprehensive approach to global healthcare distribution

The distribution of HIV/AIDS and tuberculosis (TB) medications is critical to the success of global healthcare initiatives, particularly in regions with limited infrastructure and resources. This review examines the logistical challenges hindering the efficient delivery of these life-saving medications, including supply chain inefficiencies, poor infrastructure, and geographical barriers. It also explores innovative approaches to optimizing logistics, such as the use of blockchain, drones, and artificial intelligence (AI), alongside public-private partnerships (PPPs) and supportive policy frameworks. These emerging technologies have the potential to enhance the availability and effectiveness of HIV/AIDS and TB treatments by improving supply chain transparency, reducing stockouts, and overcoming transportation challenges in remote areas. The paper further assesses the impact of these logistical improvements on healthcare outcomes, demonstrating how they contribute to improved patient adherence, reduced disease transmission, and cost savings. Finally, recommendations are provided for policymakers, healthcare organizations, and stakeholders to adopt these innovations, and future research directions are proposed to expand these models to other medications and diseases.

4.N. Scientific session: Equity in Child Health: Leveraging Universal Health Promotion Services for Families Amid Uncertainty

Abstract This workshop addresses the urgent need to foster resilience and equity in child health within the context of an increasingly uncertain Europe. Rapid societal changes, exacerbated by events such as the COVID-19 pandemic and heightened risks of conflict, climate change and economic instability, underscore the importance of nurturing environments where children can thrive despite challenging circumstances. The workshop aims to explore strategies for promoting well-being and addressing social inequalities in child health within the context of universal health promotion services, such as school health services and child health clinics. Objectives are to 1) Elucidate the importance and impact of universal health promotion services in addressing social inequalities and promoting equitable opportunities for all children, regardless of background or circumstance; 2) Identify actionable steps for interventions mitigating social inequalities and promoting equitable opportunities focusing on health literacy among parents with immigrant backgrounds; 3) Showcase successful models and initiatives in universal healthcare and health promotion services for children and families, emphasizing early intervention and standardized evaluation tools; and 4) Facilitate dialogue and knowledge exchange among professionals, policymakers, and stakeholders involved in child and adolescent health promotion. This workshop’s added value lies in its multidisciplinary approach, fostering collaboration for innovative solutions in child health resilience and equity. The coherence between presentations lies in their joint focus on addressing social inequalities in the context of universal health promotion services for children and families. Each presentation offers a unique perspective on these themes, contributing to a comprehensive understanding of the challenges and opportunities in child health promotion. • Hanne Nissen Bjørnsen’s presentation on the role of universal services in public health and addressing social inequality sets the stage by examining the structural factors contributing to disparities in child health outcomes. • Kirsti Riiseŕs presentation conveys the importance of user, stakeholder, and community involvement in creating culturally sensitive strategies for effective health promotion services in the context of health literacy among parents with immigrant backgrounds • Kristin Haraldstad’s presentation on Starting Right, an evidence-based assessment of children in municipalities healthcare centers, highlights the importance of early intervention and targeted support in mitigating health inequalities and promoting well-being. Format of the workshop: Three 10-minute presentations followed by a 20-minute moderated discussion to delve into empowerment and equity in child health, encouraging rich idea exchanges. Key messages • Leveraging universal health promotion services effectively empowers children and families while addressing social inequalities amidst periods of uncertainty. • Collaborative, user-centered approaches and evidence-based working strategies are key to promoting equity and building resilience in child health.

Right-Siting Care and Decongesting Specialist Outpatient Clinics - A Singapore Case Study

Abstract Issue Globally, Specialist Outpatient Clinics (SOCs) face a growing burden due to rising chronic diseases. This strain on resources leads to long appointment wait times (LAWTs), delaying diagnoses and treatments. This is particularly of concern in countries with rapidly ageing populations such as Singapore. Description The Right-Site Care Program is a healthcare transformation initiative implemented by individual healthcare clusters within Singapore to improve access to timely SOC care by directing patients to the most appropriate care level (right-siting). This transitions stable chronic disease patients to primary care providers (PCPs) for ongoing management. A standardised approach utilises evidence-based guidelines for patient selection, followed by identification and transfer of suitable patients to PCPs. This multi-center program offers a real-world example of healthcare system optimisation for chronic disease management. Results A multi-source data analysis, including program reports and peer-reviewed studies from participating healthcare clusters, was conducted to evaluate program impact. The analysis focused on LAWTs, patient outcomes and implementation challenges. Right-siting yielded mixed results across various conditions. Right-sited patients had better survival rates, likely due to closer monitoring and management of chronic conditions with higher total outpatient attendance frequencies. (1) Improvements were particularly significant for diabetes mellitus patients who successfully transitioned to PCPs. (2) However, challenges such as patient scepticism about PCP competence and a preference for specialist care have been identified. (3) Lessons learned Right-siting care can improve patient outcomes for certain chronic diseases. The program’s impact varied across different chronic diseases, highlighting the need for tailored strategies. Educational interventions addressing patient concerns can facilitate smoother patient transitions and program success. Key messages • Right-siting care shows promise, with improved patient outcomes for conditions like diabetes mellitus. • Patient education is crucial to overcome patient scepticism and preference for specialists.

Evaluating mental health care initiatives after Ghana’s mental health act: a systematic analysis

Abstract Mental health disorders affect 970 million people worldwide. Particularly in Africa, mental health is a growing concern, as it faces poverty and limited healthcare services. The Ghana Mental Health Act (GMHA 2012) marked a significant milestone in the development of a legislative framework supporting the provision of mental healthcare. However, evidence of progress since then is scarce. This systematic review examines the mental health initiatives that have been implemented since GMHA. Bronfenbrenner’s Socio-Ecological and Vygotsky’s Sociocultural Theory are used as frameworks to organize the interventions by ecological layers and cultural practices. All peer-reviewed articles published since the GMHA were retrieved from PubMed, Cochrane and Science Direct, using “mental health interventions,” “-collaborations,” “-health programs” and “Ghana” as keywords. The search yielded 3839 articles. Next, publications that were not conducted in Ghana or did not focus on mental health were excluded yielding a final sample of 69 articles for the review. Consistent with the GMHA’s guidelines interventions were conducted in communities (n = 56; 81%) rather than hospitals (n = 13; 19%). Most of them focused on institutional ecological levels (i.e., schools, health centers, traditional healing conventions; n = 29; 42%), followed by interpersonal (n = 14; 20%) and community-level (n = 14; 20%) approaches. Half (n = 33; 48%) entailed some form of cultural responsiveness, such as adapting educational tools to cultural contexts or accounting for spiritual beliefs. Only 23% (n = 16) of the interventions targeted children or adolescents. The findings of this review suggest three implications for future mental health research. First, stigma reduction and mental health literacy need to become a stronger focus. Second, research on children and adolescents needs to be increased. Third, interventions led by European partners must be tailored carefully to the Ghanaian beliefs system. Key messages • Assessing the community-based approach of mental health interventions following the Mental Health Act’s legalization in Ghana. • European partners need to understand the context and the local culture before planning to research or implement intervention materials. Adaptation is key in the effectiveness of the intervention.

Communication Intervention in South Africa: Advocating for the Listening and Spoken Language Approach.

Adhering to Early Hearing Detection and Intervention (EHDI) guidelines is critical for the timely identification and management of infants with hearing impairment. Early intervention specifically focusses on family-centred communication interventions, of which the Listening and Spoken Language-South Africa (LSL-SA) approach is available for children with hearing impairment in South Africa. Studies have evidenced significant benefits for children with hearing impairment enrolled in LSL-SA compared to those enrolled in Traditional Speech-Language Therapy (TSLT), that is, age-equivalent communication outcomes, shorter duration of therapy until discharge, meritorious academic performance and integration into a hearing society. Despite these positive outcomes related to the LSL-SA approach, significant contextual barriers hinder effective implementation nationwide.Contribution:The successful implementation of EHDI guidelines in South Africa hinges on overcoming barriers through tailored healthcare strategies and contextualised delivery. Adapting frameworks such as LSL-SA to fit the local context is crucial for advancing equitable access to EHDI services, positively impacting children with hearing impairment and their families. This article highlights the systemic challenges in South Africa in optimising resources by adopting linguistically appropriate and culturally responsive early intervention approaches to champion hearing healthcare initiatives. Effective collaboration among diverse stakeholders is essential for enhancing the uptake of EHDI guidelines and translating policy into impactful communication interventions. Implementing the core principles of the LSL-SA approach will not only ensure access to this specialised service for suitable candidates but may also alleviate specific barriers to EHDI implementation within TSLT approaches.

Knowledge and attitudes of the Italian population on sharing health data: a cross-sectional study

Abstract Background Healthcare digitization enhances data accessibility but faces data management and privacy challenges. The study sought to explore the Italian public’s understanding and views on storing and sharing health data for treatment and research purposes, as well as factors influencing their attitudes toward health data management and sharing. Methods A cross-sectional questionnaire assessed socio-demographic information, knowledge about health data sharing, and attitudes toward sharing data for treatment and scientific purposes. Descriptive analyses and multivariable logistic regressions were performed to examine the associations between sociodemographic factors and knowledge/attitudes about data storage and sharing. Results A total of 1,389 citizens participated. Most respondents (65.4%) thought that healthcare providers could access personal health data nationwide, while 94% expressed willingness to share personal health data nationwide. A high percentage of respondents (73%) fully agreed that storing and sharing personal health-related data could improve research and quality of care. Males and younger individuals (<41 years) were likelier to have higher data-sharing knowledge (adjusted Odds Ratio [adjOR] 1.50, 95% Confidence Interval (CI) 1.03 - 2.18, and adjOR 1.99, 95% CI 1.29 - 3.08 respectively). Lower educational-level respondents exhibited lower positive attitudes towards sharing health data for treatment and research purposes (adjOR 0.18, 95% CI 0.05-0.58 for high school, and adjOR 0.11, 95% CI 0.03-0.41 for middle school or lower, compared to those with a university degree). Conclusions The findings offer valuable perspectives for European policymakers, healthcare practitioners, and researchers who aim to enhance data handling, foster cooperation, and maximize the benefits of health data for tailored care and scientific progress. Key messages • Italian citizens show strong willingness to share health data nationwide for treatment and research, suggesting a favorable environment for collaborative healthcare initiatives. • Sociodemographic factors such as age and education level influence attitudes towards health data sharing, stressing interventions to ensure equitable access and participation in data-driven healthcare.

Hospital productivity and value in pay-for-performance healthcare programs

ABSTRACT Pay-for-performance (P4P) reimbursement models were launched in 2013 to incentivise the value of healthcare delivered by including quality outcomes, such as mortality, readmission, and patient satisfaction, in hospital reimbursement in the U.S. Although a decade has passed, the efficacy of these P4P programs remains unclear. This research intends to evaluate their long-term performance implications along two critical dimensions – productivity and healthcare value. Drawing on a nationwide sample of U.S. hospitals collected from 2008 to 2019, we utilise data envelopment analysis to measure hospital performance and the Malmquist index to evaluate their longitudinal trends. Although average hospital productivity and value improved since the rollout of the P4P programs, we observe that a large proportion of laggard hospitals were unable to catch up with improvements to the performance frontier, raising concerns about disparities in the impact of future value-based programs. Our analyses also indicate that horizontal integration across hospitals is associated with greater productivity and value. While greater physician-hospital (vertical) integration is associated with higher hospital productivity, it does not have a positive impact on value. Our study provides new insights into the antecedents and performance consequences of implementing value-based healthcare initiatives and their implications for hospital managers and policymakers.

Integrating Quantitative Data and Qualitative Insights to Understand 30-Day Readmission Rates: A Mixed-Methods Study.

The rate of patients readmitted to hospitals within 30 days of discharge is a critical indicator of healthcare quality. This study explored the factors contributing to 30-day hospital readmission rates nationally and at Arrowhead Regional Medical Center (ARMC) through a mixed-methods research design. Quantitative analysis utilized data from the Centers for Medicare & Medicaid Services (CMS) database, focusing on patient demographics, principal diagnoses, length of stay, and hospital characteristics. Multivariate regression and descriptive statistics were employed to identify predictors of 30-day readmission. The qualitative analysis sought to understand the specific medical conditions and patient profiles linked to higher readmission rates. The findings revealed that older age, specific principal diagnoses (e.g., heart failure, pneumonia, chronic obstructive pulmonary disease (COPD)), and longer initial hospital stays were associated with an increased likelihood of 30-day readmission. Gender disparities and hospital size/type also influenced readmission rates. These results provide valuable insights into the complex interplay of individual patient characteristics and hospital attributes in driving readmissions. The study's mixed-methods approach yielded a comprehensive understanding of the quantitative patterns and qualitative factors contributing to 30-day hospital readmission rates, offering important implications for healthcare quality improvement initiatives.

Advancing pharmaceutical care in rural and underserved communities: Strategies for improving global healthcare access

Pharmaceutical care in rural and underserved communities faces significant challenges, including limited access to healthcare services, geographic isolation, and infrastructure deficiencies. This review explores innovative strategies to optimize patient care delivery and expand access to essential medications in these areas. It highlights the potential of telepharmacy and digital health solutions in bridging the gap between patients and pharmacists, ensuring timely consultations, and enhancing medication adherence. Additionally, community-based healthcare initiatives and pharmacist-led interventions are examined as practical solutions for improving care delivery at the grassroots level. The review further discusses necessary policy reforms and incentives that can support healthcare professionals in underserved regions, along with long-term strategies such as localized drug production and international collaboration to sustain improvements in global healthcare access. By integrating these approaches, healthcare disparities can be reduced, leading to improved outcomes for vulnerable populations worldwide. Keywords: Telepharmacy, Rural Healthcare. Medication Access, Pharmacist-led Interventions, Policy Reforms.

Support of the health care initiative and the farmworker training and education program (EPA)

Support of the health care initiative and the farmworker training and education program (EPA)

Cultural Practices of Mothers and Babies during the Postnatal Period: A Qualitative Study in Rural Bangladesh

This study describes the experiences of women in rural Bangladesh, and the cultural practices related to how they take care of themselves and their babies, in the early postnatal period. Data were gathered through immersion in the field for six months, participant observation, document collection and in-depth interview techniques to gain a deep understanding of women’s everyday lives and practices during the postnatal period. In-depth interviews were undertaken with 28 mothers who had had at least one live child within the five years before the date of data collection, in Purba Sharifabad village of the Barisal Division in Bangladesh. The key findings of this study highlight the role of culture in the experiences of women during the postnatal period, and reveal that cultural practices, beliefs and traditions are deeply embedded in the lives of rural women. This study focuses on cultural practices which have an effect on the choices of women regarding care and support from healthcare facilities. Culture, together with poverty and low levels of education, leads them to resist healthcare from a skilled birth attendant and encourages them to believe in and trust traditional care practices during the postnatal period. Therefore, the findings of this study may contribute to future policies, planning, programs and research in Bangladesh by providing an understanding of the importance of culturally and socially rooted traditional beliefs and cultural practices. These need to be addressed for maternal and newborn healthcare initiatives to be effective, particularly in rural Bangladesh.

A scoping review of evidence on routine cervical cancer screening in South Asia: investigating factors affecting adoption and implementation.

Adopting the "Arksey and O'Malley and Levac et al." methodology, databases such as PubMed, CINAHL, Web of Science, and Scopus were scrutinized in the pursuit of relevant studies. Subsequently, the collected data were synthesized by adopting the Consolidated Framework for Implementation Research (CFIR) model. A total of 837 records were initially identified and screened for eligibility, including 55 studies. The successful adoption and implementation of cervical cancer screening in South Asia encounter numerous obstacles within the health system, including the absence of a comprehensive program protocol for screening, inadequate health infrastructure, and the presence of multiple sociocultural factors, such as social stigma, low levels of education, and concerns related to modesty. To optimize adoption and implementation, it is imperative to construct a customized policy framework that incorporates a risk communication strategy tailored to the specific contexts of these nations. Drawing insights from the experiences of South Asian countries in executing cervical cancer screening programs can inform the formulation of policies for similar healthcare initiatives aimed at facilitating the expansion of HPV vaccination efforts.

7513 Presence Of Hispanic/Latino Physicians In Academic Research. Are We There Yet?

Abstract Disclosure: C.E. Guillen Lopez: None. A. Patel: None. A. Rocha: None. C. Arima: None. A. Molkina: None. L. Robles: None. A. Arce Gastelum: None. Hispanic/Latino endocrinologists' presence and active involvement in diabetes research play a pivotal role in shaping the trajectory of healthcare initiatives in the United States. Diabetes, a prevalent and complex health condition, disproportionately affects diverse communities, with Hispanics/Latinos being among the groups facing higher incidence rates. In this context, the significance of Hispanic/Latino endocrinologists cannot be overstated, as their unique perspectives and cultural insights contribute to a more nuanced understanding of the multifaceted factors influencing diabetes prevalence, management, and outcomes in the U.S. By actively involving Hispanic/Latino endocrinologists in diabetes research, we not only enhance the representation of diverse patient populations but also foster a more comprehensive approach to addressing the intricate intersections of genetics, lifestyle, and socio-cultural factors contributing to diabetes disparities in the nation. In the 2021 Physician Specialty Data Report, the Association of American Medical Colleges (AAMC) incorporated physician race and ethnicity information for the first time. Within the 7,354 actively practicing endocrinologists surveyed, only 636 individuals identified as Hispanic/Latino. The majority of these endocrinologists were predominantly dedicated to clinical practice. A descriptive analysis of 1011 abstracts on diabetes and glucose metabolism presented at the Endo Society from 2021 to 2023 revealed that 549 were authored by women and 458 by men. The majority (705 posters, 69.7%) originated from the U.S., and 306 (30.26%) were classified as international posters. Among these, 152 posters (15%) were associated with the Hispanic or Latino authors, but only 91 (9%) were published in the U.S. In conclusion, the engagement of Hispanic/Latino physicians in endocrinology is indispensable for advancing healthcare. Their participation brings diverse perspectives, facilitates a better understanding of health disparities, and promotes innovative research and patient care strategies. By actively involving Hispanic/Latino physicians, we contribute to a more comprehensive understanding of endocrine disorders and work towards a healthcare system that prioritizes inclusivity, cultural sensitivity, and collaboration, ultimately benefiting the well-being of individuals across diverse communities. Presentation: 6/2/2024

Sexual orientation and gender identity (SOGI) data collection: Feasibility of implementation.

338 Background: The 2011 Institute of Medicine report, The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding called for consistent recording of sexual orientation and gender identity (SOGI) data in clinical settings. In 2016, SOGI data were listed as required elements in the Uniform Data System (HRSA); however, implementation of this recommendation is inconsistent. The state of New Jersey (NJ) mandated SOGI data collection for patients seen within any healthcare system in NJ to start in June 2023. Jefferson Health (JH), a health system with locations in both Pennsylvania (PA) and NJ, provided SOGI data collection education for its NJ staff. The Sidney Kimmel Cancer Center (SKCC) at JH has clinical sites in both states. In this study, we report on SOGI data collection between SKCC PA (Center City/CC) and SKCC NJ to assess the impact of the educational preparation on data collection. Methods: Patients seen at SKCC’s CC and NJ locations from May 16, 2023 to May 15, 2024 were included. SOGI data between both locations were compared to assess the impact of the educational preparation. Data were collected from the electronic record. Results: Of the 6,921 patients in CC, 1,725 identified as female, 859 identified as male, 67 chose not to disclose their gender identity, and 4270 had missing data. Of the 1788 patients in NJ, 1,118 identified as female, 449 identified as male, 12 chose not to disclose, 209 had missing data. (Table). Conclusions: Educational preparation resulted in significantly improved SOGI data collection with a significant drop in missing data. Regular recording and analysis of SOGI data can identify health inequities, support the design of targeted interventions, and evaluate the effectiveness of LGBTQIA+ healthcare initiatives. SOGI data comparison. Center City (CC)/PA New Jersey (NJ) Total 6921 1788 Female Gender 1725 (24.9%) 1118 (62.5%) Male Gender 859 (12.4%) 449 (25.1%) Chose not to disclose 67 (0.01%) 12 (0.01%) Missing data 4270 (61.7%) 209 (11.7%)

A qualitative study of what motivates, facilitates, and hinders climate-engaged healthcare trainees to advance healthcare sustainability

IntroductionThere is a critical need for low-carbon, environmentally-sustainable health systems in the climate crisis. Healthcare trainees can play a vital role in this process, and we have aimed to explore how they can be motivated and supported by faculties of medicine and health systems to pursue this ambition by conducting an exploratory, qualitative descriptive study of Canadian healthcare trainees engaged in healthcare sustainability initiatives. Materials and MethodsTranscripts from individual in-depth interviews were analyzed to identify themes related to the actions that healthcare trainees can take to promote sustainable healthcare, as well as the motivators, barriers and facilitators of healthcare trainee engagement in sustainable healthcare. ResultsParticipants (N=17) engaged in a spectrum of healthcare sustainability initiatives, including education, quality improvement and advocacy. They were motivated to advance healthcare sustainability through positive role models, the health impacts of climate change, observation of unsustainable healthcare practices, and a sense of social responsibility. Participants articulated that supportive networks, access to resources and funding, and having a growth mindset were facilitators to their engagement, while the lack of institutional prioritization of healthcare sustainability, limitations of the trainee role, challenges finding allies, and the perceived futility of their individual actions were characterized as barriers. DiscussionHealthcare trainees could support healthcare decarbonization efforts if they are adequately supported by their learning environments. The study's findings can guide educational innovations and health systems transformations to motivate and empower healthcare trainees to reduce the climate impact of healthcare throughout their careers.

Trends in the incidence and prevalence of cirrhosis in Manitoba, Canada: A population-based study (2010-2019)

Introduction and objectivesThe burden of chronic liver disease and cirrhosis continues to increase in North America. We sought to estimate the incidence and prevalence of cirrhosis in Manitoba, Canada over time and assess changes in trends between 2010-2019. Material and methodsWe performed a population-based study using Manitoba administrative health care data, and two validated case-finding algorithms. Annual incidence and prevalence rates were estimated using a generalized linear model with generalized estimating equations, adjusting for age and sex. Changes in estimates were tested using linear trend regression models. ResultsTwo algorithms estimated the number of prevalent cirrhosis to be 16,140 and 29,943 respectively. The age- and sex-adjusted incidence rates increased over the study (from 149 to 264 cases per 100,000 population in 2010, to 177 to 388 cases per 100,000 population in 2019). Cirrhosis incidence increased annually by 2-6 %, with the largest increase (6-8 % 95 % CI 7-9 %, p <0.0001) in those aged 18-44 years. Irrespective of the algorithm used, females consistently exhibited higher cirrhosis incidence and prevalence compared to males over time (P <0.0001). Prevalence demonstrated an upward trend among all age groups over time for both algorithms (P < 0.0001). ConclusionsThis population-based study highlights concerning temporal trends in cirrhosis, characterized by rising annual incidence and prevalence estimates, particularly among young adults and females. These findings underscore the urgent need for comprehensive strategies that encompass prevention, early detection, and the delivery of high-quality healthcare and public health initiatives to effectively tackle this escalating health burden.