Comparison of digital behavioral interventions to prevent alcohol misuse among adolescents ages 12 to 19: A randomized clinical trial protocol.

Introduction: Efficient patient discharge is a critical component of hospital workflow that directly influences bed availability, patient satisfaction, and healthcare costs. However, delays in discharge remain a persistent challenge across hospitals, particularly in resource-constrained settings like the Wardha district. These delays are often the result of administrative inefficiencies, inadequate coordination among healthcare providers, and poor communication. Need of the study: With the National Accreditation Board for Hospitals (NABH) recommending that discharge be completed within 180 minutes, delays beyond this threshold indicate systemic inefficiencies. There is a pressing need to identify the underlying causes of these delays and to develop evidencebasedStandard Operating Procedures (SOPs) that can streamline the discharge process and improve hospital performance. Aim: To compare the efficacy of a process mapping plan of action versus a standardised high-line process strategy in reducing discharge Turnaround Time (TAT) and to develop validated SOPs that enhance discharge efficiency. Materials and Methods: A Randomised Controlled Trial (RCT) will be conducted at Acharya Vinobha Bhave Rural Hospital in Wardha, Maharashtra, India, from June 2025 to October 2025. Healthcare staff will be randomly allocated to either the experimental group (process mapping) or the control group (high-line process). Both quantitative and qualitative data will be collected on discharge TAT, workflow efficiency, and reasons for delay. A Chi-square test for categorical variables and a paired t-test will be used for time series data to evaluate the impact of both strategies. A p-value of <0.05 will be considered statistically significant.

Biochemical osteomalacia reaffirmed by signs and symptoms and perinatal outcome. A prospective cohort study of women in Sweden.

Cardiovascular diseases (CVD) are one of the leading causes of morbidity and mortality worldwide. Telemedicine has emerged as an effective tool to improve treatment adherence, facilitate access to medical care, and enable continuous patient monitoring. This review analyzes various telemedicine interventions, such as remote monitoring, mobile applications, and video consultations, which have shown to reduce blood pressure, lower hospitalization rates, and improve quality of life. However, challenges remain regarding technological access and healthcare staff training, particularly in rural areas. Inclusive public policies and strengthened technological infrastructure are recommended to maximize the impact of telemedicine.

Objective: The objective of this research was to establish the relationship between work environment and organizational commitment among the healthcare worker at Clinica Internacional of San Borja in the year 2023. Materials and methods: The study employedan analytical, cross-sectional correlational survey design with a prospective approach. The sample size consisted of 254 healthcare workers, including physicians, nurses, and nursing technicians, selected through simple random sampling without replacement.Two survey questionnaires were used: one assessing work environment, covering five dimensions: professional development, job involvement, supervision and control, communication, and working conditions. While the other evaluated organizational commitmentacross three dimensions: affective commitment, normative commitment, and continuance commitment. Results: The results indicated that the average age was 41.8 ± 12.15 years, with 74.4% female participants. Physicians accounted for 37% of the sample, while nursing technicians comprised 40.6%. The work environment was perceived as good by 50.8% and poor by 5.9% of the respondents, whereas organizational commitment was perceived as high by 46.9% and low by 7.5%. The relationship between these variables showed a direct linear correlation, with a Spearman's Rho coefficient of 0.651 (p=0.000). Conclusions: There is a direct linear relationship between work environment and organizational commitment, indicating that a better work environment correlates with higher organizationalcommitment among the healthcare staff at Clinica Internacional of San Borja.

The conflict between legal requirements and the principles of care ethics is one of the fundamental challenges in healthcare settings. Such conflicts can lead to moral distress, emotional exhaustion, and a crisis of professional identity among healthcare staff. This study aimed to identify and explain the dimensions and consequences of these conflicts in a hospital nursing care. This research employed thematic synthesis of qualitative studies. A systematic search was conducted in reputable national and international databases for studies published between 2010 and 2025. Of the retrieved literature, 15 qualitative studies were included that examined legal-ethical conflicts in hospital settings. Data were synthesized through open coding, axial categorization, and the development of analytical themes. Four overarching themes and twelve subthemes emerged: (1) Patient autonomy versus legal protection, (2) Organizational directives and resource allocation versus moral duty of care, (3) Defensive documentation versus ethical transparency, and (4) Hierarchy, inequality, and professional silence versus justice and integrity. These tensions frequently led to moral distress, erosion of professional identity, and emotional strain among healthcare professionals. Legal-ethical conflicts deeply affect both caregivers and institutional cultures. Mitigating their impact requires coordinated reforms: integrating ethics education and decision-making training into nursing curricula, revising legal frameworks to allow greater contextual flexibility, and establishing psychosocial and ethical support systems for staff exposed to recurring moral tensions. Such multi-level strategies can bridge the gap between law and moral care, fostering ethical coherence, professional sustainability, and trust within healthcare systems.

Background: The appropriate identification of target patients for methylxanthine therapy may optimize resource allocation and improve clinical outcomes, but data on routine care in low-resource settings are limited. Our study assessed methylxanthine use in clinical practice in two Sub-Saharan settings. Methods: This retrospective, registry-based study investigated methylxanthine use in newborns who were admitted to Tosamaganga Hospital (Tanzania) and Wolisso Hospital (Ethiopia) in 2022–2023. The prevalence and type of methylxanthine treatment were investigated. Neonates receiving methylxanthine were compared to those not receiving it in terms of baseline characteristics, clinical data, treatments, and discharge information. All data were retrieved from local registries. Results: Aminophylline was administered to 196/1674 neonates (11.7%), while caffeine was not available in these settings. This treatment was more common in preterm and smaller infants (p < 0.0001), asphyxiated neonates (p < 0.0001), and the sickest patients (p < 0.001). The need for respiratory support (p < 0.0001), intravenous lines (p < 0.0001), and antibiotic therapy (p < 0.0001), as well as the length of hospital stay (p < 0.0001) and mortality rate (p < 0.0001), were higher in neonates receiving aminophylline. Conclusions: In two Sub-Saharan settings, methylxanthine treatment was limited to aminophylline, which was given to around 12% of infants admitted to the special care units. Overall, the treatment was appropriately given to most eligible neonates, although a considerable subgroup of very preterm infants did not receive aminophylline prophylaxis. Further studies may investigate the reasons for protocol incompliance regarding aminophylline treatment and healthcare staff’s opinions on such an aspect.

Genomic testing informs treatment decisions for estrogen receptor-positive, progesterone receptor-positive, and HER2-negative early-stage breast cancer, yet uptake remains disproportionately low among racially and ethnically minoritized and low-income populations. Understanding the multilevel barriers driving these disparities is essential for equitable delivery of personalized cancer care. This study explores barriers to and potential solutions for equitable access to genomic testing, incorporating perspectives from patients, caregivers, clinicians, navigators, payers, and policymakers. We conducted a qualitative study using community-based participatory research principles in partnership with five community-based organizations. Semi-structured interviews were completed with 32 participants: patients (n = 20), caregivers (n = 2), clinicians (n = 4), navigators (n = 2), payers (n = 2), and policymakers (n = 2). Transcripts were analyzed using constructivist grounded theory and interpretive description. Three major themes emerged: (1) Limited awareness and information across interested groups, including confusion between genomic and genetic testing, particularly among patients, caregivers, and some healthcare staff; (2) Modifiable challenges in accessing genomic testing, such as administrative complexity, insurance barriers, and financial toxicity; and (3) Racial, ethnic, and socioeconomic factors, including language barriers and lack of culturally appropriate materials, that impede equitable access to testing. Equitable delivery of genomic testing in breast cancer requires multilevel interventions targeting structural barriers, administrative complexity, and culturally tailored education. Addressing these barriers is likely to reduce disparities and further improve health equity in cancer care.

BackgroundIt has been well documented that Indigenous people in northern remote communities in Canada continue to experience a disproportionate burden of health disparities due to complex interactions of multiple determinants of health, including food insecurity, colonialism, barriers in accessing primary healthcare, and disrupted socioeconomic and political structures. Health promotion programs are essential in building preventive measures and empowering communities to take control over their health by helping them make informed health choices. This study described Indigenous-led nutrition-related health programs, the Healthy Babies, Healthy Children Program (HBHCP) and the Diabetes Prevention Program (DPP), which respond to food insecurity drivers and support community needs in Moose Cree First Nation (MCFN). It also documented the on-the-ground realities of program delivery and highlighted community-informed priorities for improved programming.MethodsGrounded in community-based participatory research (CBPR) principles, our approach emphasized the importance of community engagement in supporting the healing process within this cultural context. Data collection included first-hand participation in program delivery alongside program coordinators, participant feedback, and semi-structured interviews from community members (n = 6) and Health Center staff (n = 3). Thematic analysis was used to identify themes across interview data, field notes, and community feedback.ResultsHigh food costs, limited access and availability, and poor food quality remain the primary food-related challenges experienced in the community. Health programs serve as frontline responders to community needs and address these challenges through culturally grounded and family-oriented nutrition education activities. Community members valued the programs’ knowledge-sharing approaches, tangible support, and social connections. However, systemic barriers significantly constrain program delivery, including inadequate funding, limited resources, staffing shortages, and the impact of COVID-19. These barriers limited the programs’ capacity to reach their full potential, despite strong community resilience.ConclusionIndigenous-led nutrition programs are vital in addressing food insecurity and promoting health in northern communities. The findings underscore the need for sustainable funding and stronger policy support that reflects the true cost of service delivery in remote Indigenous communities. The findings emphasize the need for policy changes that move beyond top-down approaches toward community-informed policies and Indigenous-led health programming.

The research study on nurse retention stems from the need to address workplace challenges such as high nurse turnover, high nurse-to-patient ratios, limited financial incentives, and the migration of skilled nurses abroad, which are prevalent in both private and public hospitals. The purpose of this study is to identify and understand why nurses choose to stay and assess the level of influence, the level of job satisfaction and the level of retention on organizational culture, hospital engagement, financial rewards, and career advancement opportunities. Random Sampling Technique was adopted with an ideal sample size of two hundred and three (203) respondents who completed the 4-point Likert Rating Scale questionnaire. The study highlights that nurses thrive when pride, teamwork, a supportive work culture, and career growth opportunities intersect. The study recommends strategies including skill-based pay allowances, shuttle services, communication training, staffing high-demand wards, and on-site wellness spaces that can enhance nurse engagement and promote well-being among healthcare staff.

Objective: To assess the demand for auricular acupuncture among patients and the perceived need for applying this technique in treatment among traditional medicine physicians at Vinh Long Provincial Traditional Medicine Hospital Methods: A descriptive cross-sectional study was conducted on 385 patients and 21 traditional medicine physicians at Vinh Long Provincial Traditional Medicine Hospital from November 2023 to May 2024. Data were collected using a structured questionnaire based on the Health Belief Model (HBM) on a five-point Likert scale and analyzed using Stata 14.2. Results: A total of 78.2% of patients expressed a desire to receive auricular acupuncture, while 81% of physicians indicated willingness to apply the technique in clinical practice. The main barriers reported by patients included: the method not yet implemented in the hospital (60%), concerns about cost, and mild discomfort. Most physicians (61.9%) believed that the hospital lacked sufficient equipment for implementation; however, two-thirds stated that they would be confident in performing auricular acupuncture if provided with adequate training and professional support. Conclusion: Both patients and healthcare staff at Vinh Long Provincial Traditional Medicine Hospital demonstrated a high demand for the use and implementation of auricular acupuncture. Strengthening training activities, technical workshops, and infrastructure investment is essential to establishing auricular acupuncture as a routine therapeutic technique in the hospital.

Background/Objectives: Workplace violence in the healthcare sector is a growing global concern. Defined as incidents where staff are abused, threatened, or assaulted in work-related contexts, this issue affects over half of healthcare personnel worldwide, with nurses being particularly vulnerable. The consequences are far-reaching, leading to diminished service quality, workforce turnover, reduced healthcare access, and increased costs. Despite its physical and psychological impact, workplace violence remains underreported, especially in its psychological forms, which have historically been underestimated. Methods: This study applies Per Isdal’s typology of violence to analyze incident reports from a hospital setting. By doing so, it offers a structured framework for understanding the multifaceted nature of workplace violence. By categorizing and examining how different forms of violence co-occur and manifest in daily professional interactions, the study aims to contribute to more systematic documentation and theoretical understanding of the field. Results: In total, 247 incidents were analyzed. Physical violence was the most frequently reported type with 167 incidents, followed by psychological violence with 125 cases. Material violence accounted for 28 reports, sexual violence for 10, and latent violence for 4, indicating that physical and psychological aggression dominates the spectrum of workplace violence in this context. Conclusions: The prevalence and complexity of violent incidents targeting healthcare personnel highlight the pressing need for actionable policies and evidence-based interventions that prioritize staff safety and psychological well-being. Establishing clear definitions of violence, alongside fostering a culture of reporting, is essential to create safer and more resilient healthcare environments.

Patients undergoing cesarean section (CS) are at risk of developing wound complications, including infection, which directly affect patient safety, readmission rates, length of hospital stay, treatment costs, and patient’s quality of life. This community service project aimed to strengthen healthcare workers’ competence in recording, monitoring, and educating patients regarding cesarean section wound care through the PEDULI SC innovation, an integrated system combining a structured Google Form checklist and digital educational media. The program also promoted patient and family engagement in preventing Surgical Site Infection. Activities included counseling, dissemination, interactive discussions, and case simulations involving midwives at Eka Candrarini General Hospital, Surabaya. Evaluation through pre–post tests and satisfaction surveys showed a significant increase in knowledge (mean score 60.4 to 94.4) and positive feedback on usability. All participants successfully completed the form and identified SSI symptoms accurately. It demonstrates that simple, technology-based tools can enhance clinical documentation, empower healthcare staff, and foster patient participation.

Emergency Departments (EDs) are high-pressure environments that place significant psychological and physiological stress on both patients and healthcare staff. Despite increasing awareness of stress-related impacts, proactive stress management interventions have limited uptake in healthcare. This proof-of-concept study will evaluate WeCare: a 6-week, wearable-integrated, self-guided program grounded in a “Learn–Track–Act” framework to support stress regulation, resilience, and wellbeing. The study will examine four key aspects of implementing the program: (1) feasibility, (2) acceptability and usability, (3) preliminary clinical effectiveness (self-report and physiological outcomes), and (4) preliminary economic impacts. Using a mixed-methods, multiple-baseline N-of-1 design, the program will be trialled with up to 32 participants across four ED-exposed groups: patients with non-severe or severe injuries, patients with acute medical presentations, and ED staff. The intervention includes digital psychoeducation, continuous biofeedback via a smart ring, personalised guidance, and evidence-based self-regulation strategies. Assessments will include standardised questionnaires combined with continuous physiological monitoring via a smartwatch, and interviews. Quantitative outcomes include heart rate variability, sleep patterns, perceived stress, wellbeing, healthcare use, and time off work. Qualitative interviews will explore user experience, usability, and perceived barriers. The findings will inform the refinement of the intervention and co-design of a larger-scale trial, contributing valuable evidence to support low-cost, wearable-enabled proactive mental healthcare in high-stress healthcare environments.

Objective: To analyze the factors that influence the organizational climate on patient safety at Santa Ana S.A.S. hospital institution, identifying strengths and critical aspects for improvement. Methods: This is a quantitative, descriptive, cross-sectional study with a sample of fifty nursing staff members selected through non-probabilistic convenience sampling. Data were collected using the patient safety climate survey “Adapted from the Hospital Survey on Patient Safety Culture, AHRQ.” The collected information was organized into a database and processed using the SPSS software, which allowed for a descriptive analysis of frequencies and percentages, complemented by basic association tests. Results: Among the most significant findings, weaknesses were identified in leadership, communication, training, participation in decision-making, and risk management. Likewise, low institutional support, limited opportunities for protocol updating, restricted involvement in decision-making processes, and a reduced response to error were observed, which limits the consolidation of a strong patient safety culture. Conclusions: The findings highlight the importance of strengthening institutional leadership, promoting open communication, implementing continuous training programs, and consolidating effective risk management strategies. These results contribute to the creation of safe environments for both patients and healthcare staff. Conversely, the absence of these factors increases the likelihood of adverse incidents and hinders organizational learning.

Indoor Air Quality (IAQ) is a major public health concern, as prolonged exposure to indoor environments can significantly affect users’ well-being. In this context, the research proposes a sampling protocol, developed in compliance with ISO 16000 principles, for the assessment of key chemical and physical parameters influencing air quality in inpatient rooms. These spaces host fragile users, while also requiring adequate protection for healthcare staff. Referring to the scope of the paper, the study outlines a comprehensive methodology for monitoring selected volatile organic compounds (VOCs) and microclimatic factors—temperature and relative humidity—using passive samplers and/or active sensors. The protocol also integrates outdoor measurements to better understand the contribution of internal emission sources. Monitoring activities are scheduled over one year, with regular sampling campaigns (at least one week per month) to analyze seasonal variations and long-term trends. The flexible structure of the protocol allows it to be adapted to different research objectives and types of healthcare facilities. Overall, the proposed approach provides a replicable framework for assessing IAQ in healthcare settings and identifying the main factors affecting indoor environmental performance. This supports improvements in both environmental quality and health protection within healing spaces.

ObjectivesTo explore the accessibility of mental health and gambling related support within the United Kingdom (UK) Armed Forces and investigate potential barriers to engagement.MethodsWe conducted a survey of Armed Forces service personnel (n = 438) and specialist healthcare and welfare staff (n = 94) regarding gambling harm and related challenges.ResultsPersonnel rarely sought on-base support and recognition of existing service provision was low. Among those who did seek help, healthcare and welfare staff were equally effective in engaging with personnel, with greater professional experience playing a key role in fostering meaningful interactions.ConclusionsImproving access to specialist gambling harm support may enhance help-seeking.

The incidence of measles has been significantly increased worldwide over recent years. The measles virus is transmitted by aerosol route and is highly contagious. The healthcare staff infected with measles is at particular risk, since they may contribute to the hospital-acquired spread of infection. At the same time, medical personnel are at risk for contact with measles patients and their biological material. The objective of the present study was to assess the contents dynamics of anti-measles antibodies in healthcare workers over a five-year period. We have evaluated the contents of anti-measles IgG antibodies in blood serum, being assayed by ELISA technique in 272 healthcare workers aged 22 to 62 years at the clinics of Samara State Medical University. Statistical processing was performed with StatTech v. 4.1.2. software. The healthcare workers were divided in two age groups: 22 to 44 years, and 45 to 62 years (average age, 43 years old). The baseline level of specific anti-measles IgG was assessed at the 1 st stage of the study in 2018. Individuals who demonstrated negative and questionable results were subjected to additional immunization. At the second stage, specific antibody levels were re-assessed in 2023. In both age groups, the average IgG concentration increased over the five-year period as a result of the 2018 revaccination (0.49 IU in 2023 vs. 0.20 IU in 2018). Any statistically significant differences between age groups could not be detected in 2018. By 2023, the antibody concentrations were higher among those over 45 years of age. In the group without re-immunization, the antibody values showed a trend for decrease over 5 years. The revaccinated group showed an increase in positive results, and a decreased ratio of negative and questionable results. Despite double injection of the anti-measles vaccine in childhood, the specific immunity does not persist in a subgroup of adult persons. The additional immunization of 2018 was, generally, quite effective. Individual characteristics of the host organism, as well as a new coronavirus infection, may affect development of humoral immunity against measles. A regular serology monitoring is necessary to follow the maintenance of anti-measles humoral immunity, especially for the risk-exposed cohorts, including healthcare workers.

Abstract - Healthcare workers work in very demanding settings where personality traits have a decisive role in behaviour, decision-making, performance and patient care outcomes. The current research investigates the major personality trait-related variables that determine job satisfaction among the healthcare professionals in Coimbatore City. The data were analyzed using statistical methods; Percentage Analysis and Factor Analysis. Sampling adequacy and applicability to the factor analysis were validated by the Kaiser Meyer Olkin (KMO) = 0.843 and highly significant Bartlett Test (p 0.001). The rotated factor matrix showed that the five important elements on impact job satisfaction and workplace behaviour are workplace management and communication, team support and emotional well-being, professional growth and compensation, work-life integration and job security, and innovation and recognition. The results state that work-life balance, employment security, salary, workload, and organizational culture are significant predictors of worker satisfaction and psychological performance. To develop more resilient and motivated healthcare staff, the study offers supportive supervisory practices, designed communication systems, skill enhancement opportunities, and employee recognition programs. The outcomes of this study can be useful to hospital administrators, policymakers, and teachers who strive to create a productive and emotionally healthy healthcare ecosystem.. Key Words: Personality Traits, Healthcare Professionals, Emotional Well-Being, Work–Life Balance, Organizational Culture, Factor Analysis, Coimbatore.

Background. Critical laboratory results indicate that a patient is in imminent danger without timely intervention, and prompt communication can improve patient safety. Our laboratory has been trialling different methods of communication to improve our service, including the patient referral application Vula. Objective. To evaluate clinicians’ perceptions of critical laboratory results reported by the Tygerberg Hospital Chemical Pathology Laboratory in South Africa (SA) at various levels of care to identify current challenges, areas for improvement, and preferred communication methods. Methods. A cross-sectional survey was utilised to explore medical professionals’ perceptions at different levels of health facilities within Cape Town, SA. The electronic survey targeted clinicians employed at the study sites and excluded auxiliary healthcare staff and was distributed from 10 September 2024 to 31 December 2024. The survey collected data on participants’ demographics, experiences, preferences, and expectations regarding critical result communication methods. Results. A total of 76 responses were obtained; 2 were incomplete and excluded. Over half of the respondents had at least 4 years of clinical experience across various disciplines. The majority (n=71, 95.9%) found the communication of critical results to impact patient care. Direct phone calls were favoured by 45.9% (n=34), whereas 44.6% (n=33) preferred mobile methods such as short message service (SMS) or WhatsApp. Conclusion. This study provides insights into clinicians’ perceptions of critical laboratory result reporting in healthcare facilities in Cape Town. The findings will help enhance communication practices and develop a standard operating procedure for the Tygerberg Hospital Chemical Pathology Laboratory.