Health Professionals Research Articles

Internal Consistency and Reliability of the Filipino Gross Motor Functional Classification System – Expanded and Revised

Background and Objective. The Gross Motor Function Classification System – Expanded and Revised (GMFCS-E&R) is a valid tool commonly used by physicians, therapists, and potentially also by other healthcare workers even at the primary care and grassroots levels to facilitate immediate screening, appropriate referral, and management of children with disability needing mobility devices. As Filipinos comprise one of the largest diaspora populations, this study aimed to provide a Filipino version of the GMFCS-E&R and determine its internal consistency and inter- and intra-rater reliability. Methods. A multidisciplinary group of rehabilitation professionals at Philippine General Hospital worked with linguists to translate the original English GMFCS-E&R to Filipino/Tagalog, the Philippines’ official language. Several steps were done: authorization from the original tool developers (CanChild™); forward and backward translations; semantic analysis; content analysis; pilot testing; and submission of final version to CanChild™. Internal consistency and inter- and intra-rater reliability were determined. Results. The Filipino GMFCS-E&R translation was formulated and underwent several modifications. The final version yielded high internal consistency (Cronbach’s alpha: 0.96) and inter- and intra-rater reliability (interclass correlation coefficients: 0.895 and 0.928, respectively). Conclusion. The Filipino GMFCS-E&R is a reliable tool for use among pediatric Filipino patients for communication, clinical decision-making, registries, and research.

Factors bridging medical graduate students’ training and future academic achievements of dermatologists in China

Abstract Objectives Dermatology is highly competitive among medical students in China, yet, limited research has explored the factors influencing their career achievements during their studies. This study aims to examine how demographic and academic factors during training impact future career success in dermatology graduates. Methods A retrospective analysis of 61 dermatology graduates (2010–2020) from Wuhan Union Hospital was conducted. The correlation between demographic and academic data and career development indicators using Pearson’s chi-squared or Fisher’s exact test. Results The results revealed that pursuing a doctoral degree after completing master’s training, which entails a greater investment of time and effort, was closely associated with future career achievements. In contrast, the age of enrollment in graduate studies did not prove to be a determining factor. Additionally, in-depth training in research ability, demonstrated by the involvement in national research projects and the publication of high-quality science citation index (SCI) papers, exerted a positive influence on the future professional development. Besides, in terms of future promotions to administrative, teaching, and medical titles, male graduates exhibited a distinct advantage over their female counterparts. Conclusions These results suggest that in the medical field, the quality of education and training is more decisive for career development than other factors, such as the age of enrollment. On the other hand, the observed gender advantage in career promotions reflects potential structural inequalities within the medical profession, warranting further investigation and improvement.

An Active-Learning Framework for Educating Medical Students on SARS-CoV-2 Variants and COVID-19 Epidemiology

Background The emergence of multiple Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) variants presented an escalated risk to public health globally and prompted epidemiologic monitoring and classification. Health professionals are vital for patient education regarding Coronavirus Disease 2019 (COVID-19), discussing patient concerns, and providing guidance. Students enrolled in professional healthcare programs benefit from being adept with the evolution and spread of SARS-CoV-2 variants, and a team-based learning module can be helpful for applying foundational concepts to clinical problems. Methods This team-based learning (TBL) framework was developed in response to the COVID-19 pandemic and the emergence of viral variants. It was placed at the end of a hematology block within the first semester of year one of the medical school during the academic years 2021–2022. It consists of a 7-question readiness assurance process and a four-question application exercise. Results The average score increased from 58.8% (iRAT) to 85.9% (tRAT) (n=104). The post-session survey data showed an increase in students’ understanding of the classification of COVID-19 variants and the role of genetic mutations in viral pathogenesis. Qualitative data yielded positive feedback for the session, notably in students' ability to interpret phylogenetic trees and understand the role of variants. Conclusions This TBL framework cultivates higher-order thinking skills among medical students and effectively integrates virology, epidemiology, and pathology. Additionally, it provides a framework for developing a robust and up-to-date platform for the discussion of novel variants of COVID-19 or other infectious diseases.

Comprehensive Management of Drunkorexia: A Scoping Review of Influencing Factors and Opportunities for Intervention

Background and objectives: Drunkorexia is a novel alcohol-related disorder prevalent among adolescents and young adults. Extensive research on the causes and their relationship is lacking. Identifying these aspects could improve early detection and management by healthcare professionals. The aim of this review was to identify the influencing factors of drunkorexia in adolescents and young adults, as well as the main opportunities for action by health professionals. Methods: A scoping review was conducted in June and July 2024 using three databases (Pubmed, Scopus, and Web of Science). A search and review protocol were established and registered in PROSPERO. The research questions were formulated in Patient, Concept, Context (PCC) formats for an adequate literature review. Original articles from January 2008 to July 2024 were included. Reviews, meta-analyses, and doctoral theses or academic texts were excluded. In the screening phase, a methodological assessment was conducted using the Joanna Briggs Institute’s (JBI) critical appraisal tools to support study eligibility. Depending on the study design, different checklists were used, and cross-sectional studies that received scores of 4/8 or higher, quasi-experimental designs that obtained 5/9 or higher, and qualitative research that obtained 5/10 or higher were accepted. Results: A total of 1502 studies were initially found. After applying the inclusion/exclusion criteria, 20 studies were selected. Complications of emotion regulation, both positive and negative metacognitive beliefs, inability to effectively manage stress and anxiety, symptoms of post-traumatic stress disorder, self-discipline and self-control, or differences in social expectations are predisposing factors for drunkorexia. The management of malnutrition and dehydration is an opportunity for clinical professionals to address this problem. In addition, mental health issues can provide another opportunity to manage heavy alcohol consumption. Conclusions: Drunkorexia must be recognized as a new disease to be addressed from a multidisciplinary perspective. In this way, increasing research on this trend would support prevention and intervention strategies. The use of digital platforms is essential for raising social awareness of this negative habit.

Digital media in early childhood: risk factors for online harm and psychosocial correlates

IntroductionEarly and middle childhood are times of rapid development, and critical periods for laying the foundations of life-long trajectories of socioemotional well-being. High levels of screen media use are of growing concern to parents, health professionals, and researchers, given the increasing body of research demonstrating detrimental impacts of excessive screen use in young children. One particular consequence is the risk that children encounter online content or experiences that are upsetting or distressing, including exposure to inappropriate or adult content, cyberbullying, and interactions with strangers that they don't know.MethodsThis research examined experiences of online harm reported in a sample of 8-year-old children, with a focus on identifying risk factors and psychosocial correlates of online harm. Data for this study were collected from children and their mothers as part of the prospective longitudinal Growing Up in New Zealand (GUiNZ) study (n = 4,920 children with data at age 8). Children were assessed at 4.5-years-old and 8-years-old.ResultsThe findings of this research indicate that approximately a quarter of New Zealand children have experienced online harm (that is, have encountered online content that worried, upset, or bothered them) by the age of 8. Our analysis indicates that children with behavioral difficulties are at greater risk of online harm, as are children with more personal devices. Experiences of online harm were found to be negatively associated with child self-worth and positively associated with depressive symptoms.DiscussionFindings highlighting the critical importance of considering online harm as a contributing factor to child and youth well-being and mental health in our media-saturated world. Our results also point to practical solutions for parents, such as limiting the number of personal media devices that children have in early and middle childhood.

Participation in the digital transformation of healthcare: a review of qualitative studies.

The purpose of this review is to identify how health professionals perceive participation in implementation of new technology in healthcare organizations. A qualitative systematic review based on the PRISMA diagram, was conducted using qualitative synthesis. NVivo software was used for thematic analysis. The searches were performed in PubMed, CINAHL and Scopus. A total of 15 articles were included in the review, four themes describing how participation of health professionals in digital transformation affects the outcomes were identified, and three themes describing the factors that are necessary to promote participation. The underlying latent theme of an unmet desire to participate in the digital transformation was also identified in the analysis. The digital transformation of healthcare is complex and faces many obstacles if not managed correctly. Professional participation in the implementation seems to be essential for success. Focus on increased resources and planning during early stages, as well as teamwork and ethical reflection is important addressing the challenges that professionals face in digital transformation of healthcare.

Successful aging and older adults’ health outcomes through outdoor-based interventions like adventure therapy: A scoping review

AbstractOutdoor-based interventions, like adventure therapy, have numerous positive benefits, yet current literature is inconclusive on this topic regarding older adult participants. Therefore, the purpose of this study is to explore health outcomes for older adults engaging in outdoor-based interventions, including adventure therapy. A scoping review was conducted using 20 databases and specific journals, and a staged blinded review. The resulting data was synthesized into three groups that align with the components of successful aging: Prevention of disease/disability, retaining good physical/cognitive functioning, and active engagement. From these findings, implications for allied health professionals and experiential educators are discussed, and future research directions are recommended.

Formulation and Evalution of Herbal Beetroot Soap

The aim of our study was to develop the polyherbal hygienic soap by using cold process method and evaluate antimicrobial potential by agar Well diffusion method. Soap was prepared usin olive oil , Almond oil , Glycerine , Aloe Vera gel, Coffee powder , Vitamin E capsule, Glycerine soap base. Nosocomial infection has been recognized as a crucial issue in the outcome of hospital care, with Significant morbidity and mortality results. The primary routes of infection transmission to patients Are the hands of health-care workers. This also evokes utilization of antiseptics for hand- washing Purposes. Many of the antiseptics commercially available are sanitizers dependent on alcohol that Have certain shortcomings or harmful effects. Bacterial skin infections are most common amongst people, requiring significant attention for treatment and also for maintaining Healthy skin. Some herbal plant extracts and their oils were found to have antibacterial activity. The aim and objective of the present Study are to formulate and evaluate anti-bacterial herbal soapuse..

Factors associated with the implementation of dialectical behavior therapy by Spanish speaking mental health professionals who treat suicide risk.

The lack of training for professionals on how to manage suicide risk is an important barrier to effective intervention. Dialectical Behavior Therapy Intensive Training™ (DBT-IT) includes specific training for suicide and has shown promising results to enhance implementation of DBT. To our knowledge, no published studies have evaluated the effect of DBT-IT on therapists' attitudes towards treating suicide risk and among Spanish-speaking mental health professionals. The main aim of this study was to evaluate the effect of DBT-IT on therapists' attitudes regarding treating suicide risk and its relationship with the implementation of DBT before and after receiving DBT-IT. A total of 242 mental health workers (76.4% women, mean age 35.38, SD = 9.17; 77.7% from Latin America; 22.3% from Spain) who had received a DBT-IT participated in the study. Self-efficacy (Efficacy in Assessing and Managing Suicide Risk Scale) and concerns (Concerns about Treating Suicidal Clients Scale) in treating suicide, perceived burnout (Copenhagen Burnout Inventory), confidence in applying DBT (Behavioral Anticipation and Confidence Questionnaire), barriers to implementation (Barriers to Implementation Inventory), implementation of DBT and reach were measured via online survey at parts 1 (pre-training) and 2 (post-training, after 9 months of implementation) of the DBT-IT. Differences between pre-training and post-training (n = 61) indicated statistically significant improvements in self-efficacy, concerns about the lack of training and competence in treating suicide, and confidence in applying DBT. Statistically significant increases in the rates of DBT treatment modes implementation (except for individual therapy) and mindfulness practice, as well as the number of team members and consultation team hours, were also found. Findings also indicated statistically significant positive correlations between burnout and concerns about treating suicidal clients, as well as with structural and administrative implementation barriers, and between self-efficacy in managing suicide, confidence in applying DBT and implementation of DBT treatment modes. Participants with more implementation barriers reported lower rates of consultation team meetings and phone coaching implementation. DBT-IT could be an adequate training model to increase self-efficacy and confidence in treating suicide risk as well as to facilitate implementation of DBT treatment modes by Spanish-speaking mental health professionals. Not applicable.

The impact of different radiology report formats on patient information processing: a systematic review.

Since radiology reports are primarily written for health professionals, patients may experience difficulties understanding jargon and terminology used, leading to anxiety and confusion. This review evaluates the impact of different radiology report formats on outcomes related to patient information processing, including perception, decision (behavioral intention), action (actual health behavior), and memory (recall of information). PubMed, Web of Science, EMBASE, and PsycInfo were searched for relevant qualitative and quantitative articles describing or comparing ways of presenting diagnostic radiology reports to patients. Two reviewers independently screened for relevant articles and extracted data from those included. The quality of articles was assessed using the Mixed Methods Appraisal Tool. Eighteen studies, two qualitative and sixteen quantitative, were included. Sixteen studies compared multiple presentation formats, most frequently traditional unmodified reports (n = 15), or reports with anatomic illustrations (n = 8), lay summaries (n = 6) or glossaries (n = 6). Glossaries, illustrations, lay summaries, lay reports or lay conclusions all significantly improved participants' cognitive perception and perception of communication of radiology reports, compared to traditional reports. Furthermore, these formats increased affective perception (e.g., reduced anxiety and worry), although only significant for lay reports and conclusions. Modifying traditional radiology reports with glossaries, illustrations or lay language enhances patient information processing. Question Identifying the impact of different radiology report formats on outcomes related to patient information processing to enhance patient engagement through online access to radiology reports. Findings Lay language summaries, glossaries with patient-oriented definitions, and anatomic illustrations increase patients' satisfaction with and understanding of their radiology reports. Clinical relevance To increase patients' satisfaction, perceived usefulness and understanding with radiology reports, the use of lay language summaries, glossaries with patient-oriented definitions, and anatomic illustrations is recommended. These modifications decrease patients' unnecessary insecurity, confusion, anxiety and physician consultations after viewing reports.

Identification of raccoon rabies virus variant in a stray kitten: the role of veterinary practitioners in detection and reporting of a non-native zoonotic pathogen-Nebraska, 2023.

Rabies is a fatal encephalitic disease affecting all mammals. This report describes identification of raccoon rabies virus variant isolated from a stray kitten in an urban Midwestern city that is nonendemic for this virus variant. The kitten originally presented with nonspecific neurologic abnormalities. Astute veterinary, wildlife, and public health professionals played a critical role in the identification of this fatal zoonotic disease and the extensive public health and wildlife management response that ensued. This case serves as an important reminder of the risk of rabies in unvaccinated animals or those without known vaccination status, including stray animals.

Effect of an online training intervention on evidence-based practice in clinical nurses. #Evidencer Project.

Online learning is becoming increasingly essential for health professionals, and it is necessary to understand how this modality affects clinical nurses' learning of Evidence-Based Practice (EBP). For this reason, the present study sought to assess the effectiveness of an online training program in improving nurses' EBP competence. A quasi-experimental study with a pretest-posttest design was conducted with a control group and without randomization for a period of 6months. The intervention was an online self-learning course based on Melnyk's seven steps of Evidence-Based Practice (EBP). The course was structured into sequential modules requiring 72h of work, with task completions and tests necessary for progression. Participants had three months to complete the course. EBP competence was measured with the EBP-COQ Prof© questionnaire. Data analysis included percentages, means, standard deviations, chi-square tests, student's t-tests, and a two-way repeated measuresanalysis of covariance (ANCOVA). The analysis of the changes observed in each dimension and the overall EBP competence between the intervention group (IG) and the control group (CG) showed a significant group*time interaction in three of the four dimensions of the questionnaire. The results indicated that the online Evidence-Based Practice (EBP) course significantly improved knowledge, skills, and utilization three months after its completion. In the IG, the mean score was 44.04 (standard deviation (SD) = 7), compared to 37.83 (SD = 8.5) in the CG (p < 0.001). Regarding skills, the IG had a mean score of 24.24 (SD = 3.8), while the CG scored 23.01 (SD = 3.1) (p = 0.008). For utilization, the mean score in the IG was 36.77 (SD = 6.8), and the CG was 33.12 (SD = 6.3) (p = 0.005). Overall competence also showed a statistically significant difference, with the IG achieving a mean score of 141.22 (SD = 20.0) compared to the CG with a mean score of 130.34 (SD = 16.7) (p < 0.001). Training through an online education platform for three months (72h) is an effective tool for improving the competence in Evidence-Based Practice (EBP) of clinical nurses. A significant increase was observed in knowledge and moderate improvements in skills and the application of EBP. These online courses, adapted to the needs of professionals, can be an efficient way to prepare nurses and improve their application of EBP in a clinical setting.

Barriers and Facilitators Affecting Access to Health Care for People With Syphilis: Protocol for a Scoping Review.

Syphilis is a systemic, preventable, and curable infection caused by the bacterium Treponema pallidum. Despite being treatable, syphilis continues to have a high incidence, with a resurgence observed even in countries with strong health surveillance systems. This highlights the need to understand the various strategies used globally to improve access to care for individuals with syphilis. This scoping review aims to identify and map the barriers and facilitators affecting access to health care for people with syphilis. This scoping review will follow the methodology outlined by the Joanna Briggs Institute. The search will be conducted across several databases, including PubMed/MEDLINE, Scopus, Embase, LILACS (Virtual Health Library), and CINAHL (EBSCO). In addition, sources of unpublished studies or gray literature will be explored. Studies focusing on access to health care for individuals with syphilis will be included, regardless of geographic location, country, or language. Two independent reviewers will assess the results, and data will be extracted using a tool specifically developed for this review. The extracted quantitative data will be presented in tables and analyzed using descending hierarchical classification, represented by a class dendrogram. Barriers and facilitators will be categorized into dimensions of access. Database searching began in October 2024. Full-text screening and review are expected to be completed in December 2024. Data extraction and analysis are expected to be completed by February 2025, and the final report will be completed in March 2025. The findings of this scoping review, guided by this protocol, will elucidate the main barriers and facilitators that affect access to syphilis treatment. This study may contribute to the practices of health professionals, managers, and the academic community, and provide relevant information for the population. Open Science Framework Registries osf.io/kpsab; https://osf.io/kpsab. PRR1-10.2196/63561.

Nurse training to enhance adherence counselling for HIV-tuberculosis coinfection in South Africa: Integrative review

Background: South Africa has seen strides in reducing HIV and tuberculosis (TB); however, adherence counselling for people living with HIV (PLHIV) coinfected with TB remains a challenge, particularly in specific sub-districts like Cape Town. Understanding the attributes of existing training programmes is crucial.Objectives: This study explored attributes of training programme development for nurses and other health professionals to enhance adherence counselling for PLHIV coinfected with TB in Cape Town.Method: An integrative literature review was conducted in five steps following PRISMA guidelines. Electronic searches encompassed multiple databases: COCHRANE, PsycINFO, PUBMED, ENMBASE, Science Direct, SCOPUS, SocINDEX, Academic Search Complete, Eric, SABINET, Health Resources and World Health Organization Global Health Library Regional Indexes. Inclusion criteria encompassed English language, peer-reviewed full-text studies on training programme development, qualitative and quantitative, published between January 2012 and May 2021. Exclusion criteria included non-English articles, conference proceedings and irrelevant studies. Thematic data analysis synthesised findings.Results: Three main themes emerged: participant identification, key programme content and programme implementation process, crucial for effective training programme development.Conclusion: Identifying participants, defining programme content and outlining implementation processes are pivotal in enhancing nurses’ adherence counselling skills. This approach could stabilise patient treatment adherence, potentially reducing treatment default, loss to follow-up and mortality rates.Contribution: These findings lay the groundwork for developing effective training programmes aimed at improving adherence counselling among nurses.

The digitalization of emergency department triage: the perspectives of health professionals and patients.

Digitalization in the healthcare sector offers several organizational advantages, ranging from enhanced service quality to cost savings. However, its adoption often progresses slowly and faces challenges, especially in critical settings like emergency departments, requiring prompt, clear, and efficient communication. As such, this study aims to comprehensively assess the factors influencing the preference for digitalized tools over traditional methods from the perspectives of both service providers and users. We employ two ad hoc stated preference surveys in which we ask respondents to reveal their preference in simulated triage scenarios. Three main alternatives are proposed: traditional procedures, a fully digitalized solution with no direct patient-professional interaction, and a hybrid option that combines traditional and digital aspects. Scenarios and alternatives vary according to predetermined attributes, selected among the features acknowledged to impact the triage efficiency and efficacy: the possibility to communicate in a known language, the completeness of information retrieved from the patient, the time dedicated to triage activity, and the level of privacy. Responses are analyzed by means of discrete choice models. Our findings reveal a preference for the hybrid approach, wherein patients use digital tools to input relevant information, followed by an interview with healthcare professionals. Nevertheless, distinct alternative- and case-specific features can favor the preference toward other kinds of triage. Respondents prefer shorter triage times and the opportunity to interact in a known language, while the level of privacy does not significantly impact their choices. Interestingly, the presence of an algorithm assigning urgency code diminishes the probability that healthcare professionals select the fully digitalized option. This study provides important insight into the utilization of digital tools in emergency departments. The results can be used by hospital managers and policy makers to develop digital tools that meet the needs of both users and healthcare professionals. This, in turn, may result in cost savings and improved quality of service.

Physical Activity Level among Physicians of the Philippine General Hospital during the COVID-19 Pandemic Crisis: A Cross-sectional Study

Introduction. COVID-19 is a pandemic that shut down businesses and industries worldwide. The spread of the disease changed social behavior as residents around the world were obliged to endure lockdown and quarantine measures, reducing their physical activity. Objective. To determine the level of physical activity before and during the pandemic among physicians. Methods. A cross-sectional study was carried out on 422 qualified physicians of the Philippine General Hospital, University of the Philippines Manila. The data was obtained from a self-administered questionnaire. Results. Results of the study revealed a shift of lifestyle from physically active to sedentary in 42.4-57.11% of the respondents during the pandemic. There was no change between the activity levels at work before and during COVID while there was a change in the travel and recreational activities. The results also showed that significant factors including lack of energy, fear of injury, lack of skill, resources, social influences, support seeking activities, and positive alternatives affected their activity levels. Conclusion. During the pandemic, overall physical activity level decreased. Similarly, factors that motivate health workers to be physically active or sedentary during the COVID-19 pandemic can affect their physical activity levels. Based on this study, the hospital can create guidelines to ensure physical activity among its doctors, especially during a pandemic.

A Reflective Thematic Analysis Into the Perceptions of Pregnant Radiographers Regarding the Usefulness of the PregiDose Mobile App to Enhance Fetal Dosimetry and Well-Being: Qualitative Exploration.

Pregnancy apps are widely used by pregnant women, who benefit from self-tracking features to support their health goals. Pregnant radiographers are considered a high-risk group of health workers practicing in ionizing radiation environments. Radiation exposure above threshold limits can cause harmful genetic effects on a fetus. Accordingly, pregnant radiographers are required to wear special fetal dosimeters, which provide real-time readings of radiation dose exposure to the fetus. Pregnant radiographers have the responsibility to self-track their fetal doses to ensure that the threshold limit of 1 mGy is not exceeded. The traditional method used to track doses includes a written log of doses in a notebook. Thus, PregiDose, a unique offering in the context of pregnancy apps, was developed to enhance fetal dose tracking and monitoring using technological methods. This study aims to describe the users' perceptions of the app's usefulness using PregiDose in a natural setting. The overarching framework adopted for the study was a design science research (DSR) methodology encompassing five steps, namely (1) problem awareness, (2) suggestion, (3) development, (4) evaluation, and (5) conclusion. This paper presents the evaluation step of DSR. DSR step 4 included a qualitative approach to explore users' perceptions regarding the app. Data were collected using a semistructured interview guide. Open-ended questions were guided by the app's core features, namely dose tracking, education, and wellness. In total, 17 pregnant radiographers in South Africa enrolled to use the app, 9 (53%) engaged with the app, and 4 (24%) agreed to participate in the feedback interviews. The data were collected from October 2023 to March 2024 and analyzed using a reflective thematic data analysis method. Three overarching themes emerged from the data, namely (1) usefulness of PregiDose, (2) barriers to PregiDose adoption and use, and (3) recommendations for the advancement of PregiDose. Users labeled the app's usefulness as positive and perceived it as a modern approach to traditional dose-tracking methods. They perceived the graph output of the dose-tracking feature to be useful for viewing their accumulative doses. They did not fully engage with the journaling feature, indicating that it was a personal preference and not a practice they would usually engage in. Physiological barriers, such as fatigue and "pregnancy brain," were contributors to decreased engagement. Finally, because of the demanding workload and fast-paced nature of the radiography department, users recommended the automation of fetal dosimetry through the Internet of Things. PregiDose is an occupational health and safety mobile app developed for pregnant radiographers through a DSR approach. The app offers a modern method of dose tracking consistent with technological advancements in the context of self-tracking. However, future implementation would require using Internet of Things to make fetal dose tracking more effective.

Assessment of the quality of malaria surveillance and laboratory services for diagnosis in three districts of Gujarat state, India

ObjectivesSurveillance is the backbone for the control of malaria and its elimination. In the state of Gujarat, situated in the western region of India, some of the districts reported a high annual blood examination rate (ABER) for malaria. Therefore, a study was conducted to identify the underlying reasons for the increase in the ABER for malaria.MethodsPlanned investigations were carried out in three of the state districts, scrutinizing records of malaria forms and other epidemiological data collected during health worker surveillance, assessment of laboratory services, and rapid fever surveys.ResultsThe rate of fever ranged from 8 to 57% in the primary health centers that were surveyed. Analysis of epidemiological data revealed that malaria parasite positivity was more from passive than active surveillance. Increased ABER was accounted for by multiple factors, including blood slides collected during the mass survey and contact smears, which were included in the ABER and not mentioned separately. Blood slides prepared for the migrant population were included in the ABER, but the migrant population was not counted while calculating the ABER.ConclusionThe ABER in villages surveyed varied from 1.6 to 78%, which is mainly due to indiscriminate preparation of blood slides, i.e., without fever symptoms. Addressing the key gaps identified in data recording may aid in channeling the limited resources efficiently, thereby progressing toward malaria elimination. Adequate surveillance activities, along with systematic data recording, will enable timely, informed decision-making for the effective allocation of resources, ultimately supporting malaria elimination efforts in the state.

Prevalence and Determinants of Modern Contraceptive Use among Rohingya Women of Reproductive Age Residing in Refugee Camps in Bangladesh: A Cross-Sectional Survey

Background: Comprehensive studies on the determinants of modern contraceptive use in humanitarian settings are relatively uncommon in Bangladesh. The aim of this study was to examine the prevalence and determinants of modern contraceptive use among Rohingya women living in the refugee camp of Cox's Bazar, Bangladesh. Methods: A cross-sectional survey was conducted among 160 Rohingya refugee women aged 15-49 living in unregistered camps (Camps 7 and 14) in Ukhiya Upazila, Cox's Bazar. In the study, participants were selected using a convenience sampling method, and the sample size was calculated using the single population proportion formula. However, only 160 participants were recruited due to travel restrictions and safety measures implemented throughout Bangladesh during the COVID-19 pandemic. The data were gathered via a structured questionnaire. Results were summarized using both descriptive and inferential statistics and SPSS v.23 software was used for data analysis at 5% level of significance. Results: The prevalence of contraceptive use was found to be 41.9%. The most commonly used contraceptives were Injection Depot-Provera (65.7%) and Oral Contraceptive Pill (OCP) (28.4%) followed by implant (4.5%) and intrauterine device (IUD) (1.5%). Multivariate logistic regression revealed lower odds of modern contraceptive use among women who had more than a 1.5 year interval between the last two pregnancies (OR = 0.19; 95% CI = 0.07– 0.51) and higher odds were found who expressed a lack of desire for future pregnancies (OR = 13.69; 95% CI = 3.43–54.68). Community Health Workers (CHWs) (80.4%) were the main sources of information on modern contraceptives, whereas hospitals (83.6%) were the most accessible places to obtain contraceptives. Conclusion: Community health workers play a vital role in disseminating information, emphasizing the need for their training and involvement in relevant programs. These findings are crucial for shaping future research, policies, and reproductive health services in humanitarian settings.

A model for integrating palliative care into Eastern Mediterranean health systems with a primary care approach.

Palliative care in the Eastern Mediterranean Region (EMR) faces challenges despite the high number of patients in need. To provide accessible, affordable, and timely services, it is crucial to adopt a suitable care model. World health organization (WHO) recommends integrating palliative care with primary health care (PHC). Given the unique conditions of EMR countries, there is a need to design a model tailored to these contexts. This study is a multi-method research project conducted through several sub-studies, including a literature review, policy analysis, expert opinion (Delphi Method), dimension-specific analysis, model development, and its validation and refinement (Delphi Method). Drawing from the WHO model, six dimensions: policy, drug availability, education, community integration, service delivery, and research were considered to developing the model and implementation requirements. Within each dimension, evidence-based solutions tailored to the region's context were explored. A successful palliative care model requires, in the policy dimension, oversight by the Ministry of Health (MOH). Having a focal-person or working group within the MOH is crucial for policy-making, formulation, and approval of clinical guidelines, as well as addressing care challenges. It is essential to provide access to morphine and other essential medications, along with facilitating the administration and consumption of morphine at home. Conducting empowerment courses for care providers, can address various challenges. Community involvement through volunteers, charities, and non-governmental organizations (NGOs) is also important. To ensure service provision, monitoring and evaluating systems are crucial, along with striving for service continuity through an appropriate payment system. Lastly, research is necessary for needs assessment, evidence-based practice, and designing evaluation indicators. The proposed model relies on community health workers, especially nurses, as multitasking professionals available for community palliative care. In the presented model, special attention has been given to networking, collaboration, and the use of digital health technologies to support nurses. The model proposed for integrating palliative care into PHC should serve as a framework that enhances access to available and affordable services for countries in the region. While this model was developed based on the overall conditions of the region, each country can tailor it to its unique strengths and opportunities.