Hospital Practitioners Research Articles

The potential of narrative-based medicine interventions targeting hospital practitioner burnout: findings from a scoping review

ABSTRACT Purpose To map the empirical literature with regards to narrative-based medicine interventions targeting burnout in hospital-based practitioners. Methods A systematic search of electronic databases (n = 6) and manual searches was conducted informed by the Joanna Briggs Institute scoping review guidelines. Papers were independently screened for quality. Semi-structured interviews were held with practitioners to further explore the acceptability and feasibility of the interventions from the review. Results The searches yielded 4,439 articles. Following screening by title and abstract, 73 papers remained for full-text review. Six papers were included in the final analysis. Gaps were noted in relation to reporting of intervention details, and of implementation considerations across the dataset. Narrative interventions were considered acceptable by stakeholders but significant issues of compatibility and feasibility were identified. Conclusions Narrative-based interventions are complex and warrant a systematic research approach. Addressing factors related to implementation in addition to mechanisms of action is essential to progress this promising interdisciplinary knowledge base.

Rôle des médecins hospitalo-universitaires de médecine interne dans la formation aux métiers de la santé et au sein des institutions en France : enquête du Collège National des Enseignants de Médecine Interne (CEMI)

RationaleOn the occasion of the General stage meeting of Internal Medicine, the National College of Internal Medicine Teachers (CEMI) conducted a survey on teaching activity among all French university hospital (HU) internal medicine specialists. MethodThe survey was carried out in September 2023 by sending an email to 101 hospital practitioners university professors (PU–PH) and 18 hospital practitioners assistant professors (MCU–PH) of internal medicine in subsection 53-01 of the National council of universities (CNU), as well as to the 11 HU internists working in immunology (subsection 47-01) or therapeutics (subsection 48-04). ResultsSeventy-three HUs (56.1%) responded to the survey, including 65 PU–PH, 7 MCU–PH and 1 university hospital practitioner (PHU). Internal medicine HUs participate in faculty teaching: 80% are responsible for teaching, 30% are responsible for the year or cycle or lead committees and 40% have had or have an elected mandate at the faculty or at university. Internal medicine HU are involved in the teaching of semiology during the first cycle of medical studies, but also in pharmaceutical sciences, dentistry, midwifery and in paramedical training. They are very invested in the implementation of the second cycle reform and 80% are involved in the preparation of Objective Structured Clinical Examinations (ECOS), mainly as examiners (90%). They also participate in teaching using simulation (60%), teaching advanced practice nurses (IPA) (25%), and writing CEMI books (75%). For ECOS, 90% participate as examiners, 60% participate in teaching using simulation, 25% are involved in teaching advanced practice nurses (IPA), 75% participated in the writing of CEMI works. Eight (12%) internal medicine HUs co-facilitate training with patients and 26 (38%) participate in master's courses at the Faculty of Sciences. Finally, 94% are affiliated with a research unit and 48% supervise university theses students. ConclusionInternal medicine universities teachers have a strong educational commitment, particularly in semiology and in the reform of the second cycle of medical studies with ECOS and simulation.

Prescription writing pattern among the dental practitioners of a tertiary care hospital in Karachi

ObjectiveTo identify the frequency and types of prescription errors, assess adherence to WHO prescribing indicators, and highlight the gaps in current prescribing practices of Junior dental practitioners in a tertiary care hospital in Karachi, Pakistan.MethodsThis cross-sectional study was conducted from January 2021 to March 2021. The study included the prescriptions by house surgeons and junior postgraduate medical trainees for walk-in patients visiting the dental outpatient department. A total of 466 prescriptions were evaluated for WHO core drug prescribing indicators. The prescription error parameters were prepared by studying the WHO practical manual on guide to good prescribing and previous studies. Prescription errors, including errors of omission related to the physician and the patients, along with errors of omission related to the drug, were also noted. The statistical analysis was performed with SPSS version 25. Descriptive analysis was performed for qualitative variables in the study.ResultsThe average number of drugs per encounter was found to be 3.378 drugs per prescription. The percentage of encounters with antibiotics was 96.99%. Strikingly, only 16.95% of the drugs were prescribed by generic names and 23.55% of drugs belonged to the essential drug list. The majority lacked valuable information related to the prescriber, patient, and drugs. Such as contact details 419 (89.9%), date 261 (56%), medical license number 466 (100%), diagnosis 409 (87.8%), age and address of patient 453 (97.2%), form and route of drug 14 (3%), missing drug strength 69 (14.8%), missing frequency 126 (27%) and duration of treatment 72 (15.4%). Moreover, the wrong drug dosage was prescribed by 89 (19%) prescribers followed by the wrong drug in 52 (11.1%), wrong strength in 43 (9.2%) and wrong form in 9 (1.9%). Out of 1575 medicines prescribed in 466 prescriptions, 426 (27.04%) drug interactions were found and 299 (64%) had illegible handwriting.ConclusionThe study revealed that the prescription writing practices among junior dental practitioners are below optimum standards. The average number of drugs per encounter was high, with a significant percentage of encounters involving antibiotics. However, a low percentage of drugs were prescribed by generic name and from the essential drug list. Numerous prescription errors, both omissions and commissions, were identified, highlighting the need for improved training and adherence to WHO guidelines on good prescribing practices. Implementing targeted educational programs and stricter regulatory measures could enhance the quality of prescriptions and overall patient safety.

Professionals' Perceptions of the Colorectal Cancer Pathway: Results of a Co-Constructed Qualitative Study.

Qualitative research on the perceptions of healthcare professionals involved in cancer care about their respective roles in the patient care pathway is limited. Therefore, the aim of this qualitative study was to document these perceptions. A multidisciplinary team that included patient researchers constructed a semi-structured interview guide on the perceptions of the colorectal cancer care pathway by professionals. Interviews were conducted with healthcare professionals from two French hospitals that manage patients with colorectal cancer. Then, the interviews were fully transcribed and analysed by the whole multidisciplinary team. Thirteen healthcare professionals were interviewed (six nurses, four physicians, one psychologist, one social worker and one secretary). They described the colorectal care pathway using a great lexical diversity and listed a significant number of professionals as taking part in this pathway. Among the people mentioned were healthcare professionals working inside and outside the hospital, family members and non-conventional medicine practitioners. However, they did not spontaneously mention the patient. Their views on the role of the referring physician, the general practitioner and the patient were further explored. The interviews highlighted the coordination difficulties among the various professionals, particularly between general practitioners and hospital teams. These data provided interesting elements for developing a tool to help coordination among professionals. This preliminary study, with its participatory design, brings interesting elements of reflection on the care pathway for patients with colorectal cancer. It will continue through the creation of a larger participatory project. Patient partners were included in all steps of this study. This transdisciplinary project was coordinated by a group composed of three patient partners, two healthcare professionals and two humanities and social sciences researchers. Their knowledge of the patient's perspective on the care pathway enriched discussions from the study design to results analysis.

One-year of pulmonologist-based teleconsultation between hospital and general practitioners: an Italian exploratory investigation.

One-year of pulmonologist-based teleconsultation between hospital and general practitioners: an Italian exploratory investigation.

The challenge of adopting a collaborative information system for independent healthcare workers in France: a comprehensive study

This study aimed to explore the perception of an underutilised collaborative information system through qualitative research, utilizing semi-structured, in-depth interviews with independent midwives and physician. PROSPERO, is a collaborative information system designed to bridge the communication gap between community-based healthcare workers and hospital-based care teams for parturients in Lyon, France. Through 27 semi-structured in-depth interviews with midwives, obstetricians, and general practitioners, we identified key themes related to the system’s adoption: implementation challenges, utilisation barriers, interprofessional dynamics, and hidden variables affecting system use. Participants recognised the potential of PROSPERO to improve information sharing and care coordination but expressed concerns about the system’s integration into existing workflows, time constraints, and the need for adequate training and technical support. Interprofessional dynamics revealed differing perspectives between hospital and independent practitioners, emphasising the importance of trust-building and professional recognition. Hidden variables, such as hierarchical influences and confidentiality concerns, further complicated the system’s adoption. Despite the consensus on the benefits of a collaborative information system, its implementation was hindered by mistrust between healthcare workers (i.e. between independent practitioners and hospital staff). Our findings suggest that fostering trust and addressing the identified barriers are crucial steps towards successful system implementation. The study contributes to understanding the complex interplay of factors influencing the adoption of collaborative healthcare technologies and highlights the need for strategies that support effective interprofessional collaboration and communication.ClinicalTrials ID NCT02593292.

Progressive muscle relaxation alleviates anxiety and improves sleep quality among healthcare practitioners in a mobile cabin hospital: a pre-post comparative study in China.

To investigate the anxiety levels, sleep quality and potential risk factors of healthcare practitioners involved in the management of COVID-19 patients in a mobile cabin hospital, and further to assess the impact of progressive muscle relaxation (PMR) on their anxiety levels and sleep quality. We conducted a pre-post self-controlled trial. Healthcare practitioners meeting the inclusion criteria underwent daily 30-min PMR sessions for seven consecutive days. The Pittsburgh Sleep Quality Index (PSQI) and Hamilton Anxiety Scale (HAMA) were used to assess the anxiety and sleep quality of subjects pre- and post-intervention. Statistical analysis was performed using the Wilcoxon test, Mann-Whitney U test, Kruskal-Wallis H test, and Spearman rank correlation. A total of 94 participants completed the study. No statistically significant differences in HAMA or PSQI total scores were observed between groups categorized based on demographic variables such as age, sex, and years of education (p > 0.05). The PSQI total score and its components (excluding sleep medication usage) exhibited a positive correlation with the HAMA total score and its psychological anxiety component (p < 0.05), and a correlation was observed between somatic anxiety manifestations and several components of the PSQI. The PSQI total scores before and after intervention were 10.0 (8.0, 13.0) and 8.0 (6.0, 9.0) respectively (p < 0.001); the HAMA total scores were 8.0 (5.0, 13.0) and 6.0 (4.0, 9.5) respectively (p < 0.001). The detection rates of poor sleep and anxiety states, along with their severity, significantly decreased post-intervention (p < 0.001). Healthcare practitioners experience prominent anxiety and sleep issues in the mobile cabin hospital. PMR can be an effective intervention for improving the anxiety and sleep quality of healthcare professionals during support periods in the mobile cabin hospital. However, trials with larger samples are necessitated to further affirm these preliminary findings.

Abstract WMP19: A Brain Care Score for Risk of Late-Life Depression: Data From the UK Biobank Cohort

Introduction: The 21-point Brain Care Score (BCS), developed via a modified Delphi process with practitioners and patients, is a novel instrument designed to motivate behavioral and lifestyle changes, ultimately aiming to decrease incidence of dementia and stroke (Fig 1). Whether or not BCS components are associated with longitudinal changes in mood disorders is not clear. For this study, we tested the hypothesis that the BCS also significantly correlates to late-life depression incidence in the UK Biobank (UKB). Design / Methods: The BCS was derived from UKB participants (using both the hospital and general practitioners cohort) aged 40-69 years, at baseline (2006-2010). After excluding patients with prevalent psychiatric disorders, we performed multivariable Cox proportional hazard regression models between the BCS and risk of incident late-life depression, adjusting for sex and stratified by age groups (&lt;50, 50-59, &gt;59 years). Results: The total BCS (median: 12; IQR:11-14) was derived for 416,370/502,408 (83%) UKB participants with complete data (mean age: 57; females: 54%). After exclusion of 50,395 participants who had mood or psychiatric disorders other than depression, a total of 365,975 participants were included in our analysis. In total, 6,628 incident cases of late-life depression were documented during the median follow-up period of 13 years. Each five-point increase in BCS was associated with a 59% (HR: 0.41, 95% CI: -0.03-0.85) decreased incidence of late-life depression among UKB participants aged &lt;50, 35% (HR: 0.65, 95% CI: 0.57-0.74) among those aged 50-59; and 28% (HR: 0.72, 95% CI: 0.65-0.79) lower risk among those aged &gt;59). Conclusions: In addition to its associations with dementia and stroke incidence, the BCS strongly correlates with late-life depression incidence in the UK Biobank. Additional research is needed to understand the association between BCS elements and late life depression in additional, diverse cohorts.

Private Islamic Hospital Service Management Strategy Model in Pekanbaru Based on Accreditation with an Analytic Network Process Approach

There are many factors that are the burden and responsibility of Islamic Hospital Practitioners, experts and regulators in resolving sharia service and accreditation problems and prioritizing effective solutions for Islamic Hospitals. From problems (1)Sharia services that focus on Customer Oriented, Transparency, Healthy Competition and Justice. (2)Patient problems, namely no sharia consultations, unsatisfactory services received, long queues, lack of services for disabled patients (3)Accreditation problems that focus on low classification and accreditation, poor maintenance, unsophisticated information systems and a poor hospital environment. not properly maintained (4)Ethical problems and Islamic hospital Business Management Concepts trigger problems. Planning for future hospital performance is not fulfilled, experts and employees are less professional, coordination of hospital staff is ineffective and does not have a Sharia Supervisory Board (DPS). This thought is the research problem, how to use the ANP method to find a solution that must be solved in this problem, assisted by Super Decision software. The results of this research are Solution Priorities (1) Sharia services, namely focusing on the main priority of Justice, Customer Oriented (2) Solutions for patients with the same priority, namely Sharia consultations, services received that satisfy patients. (3) Accreditation solutions in the order that the hospital environment is well maintained and goes green, maintenance is improved, quality management is improved (4) Islamic hospital Ethics Solutions and Business Concepts with future planning sequences fulfilled and professional employee experts selected, effective staff coordination and forming a DPS. The strategic priorities being developed are the implementation of superior and complete sharia services.

Are Newly Graduated Pharmacists Competent to Perform Adequately in Hospitals? A Qualitative Study

Objectives: To assess the qualifications and performance of newly graduated pharmacists and explore factors that affect their performance in public hospitals. Methods: This qualitative study included face-to-face, semi-structured interviews with hospital practitioner pharmacists. It was conducted between March and May 2023 in Kerbala province, Iraq. The participating pharmacists were selected purposefully because they had three or more years of work experience at governmental hospitals. The audio-recording interviews were transcribed. Thematic analyses were used to generate themes and subthemes from the interviews. Results: Twenty-seven hospital pharmacists participated in this study. The study found that there are several factors that have a negative impact on the performance of newly graduated pharmacists, including college-related and hospital-related factors. Education factors include classic methods of college teaching and the inadequate qualifications of new colleges. Hospital features, including inadequate qualifications for continuous medical education, tools and resources, can also impact pharmacist performance. Additionally, the overwhelming number of pharmacists negatively impacts their training and qualifications. Conclusions: Greater emphasis should be placed on enhancing the pharmacists' practical skills. Close and integrated collaboration between the Ministry of Higher Education and the Ministry of Health is pivotal to enhancing the performance level of prospective pharmacists in hospitals. Finally, controlling the number of admitted students to pharmacy colleges is critical to providing them with adequate training.

Tracking climate adaptation in hospitals: An inventory of structural measures

Adaptation plays a critical role in reducing risks from climate change and the need for climate adaptation is increasingly being recognised in national policies. However, evidence of coherent action at sector level is varied and often lacking. This paper critically examines climate adaptation action taken in the health sector. This involved collecting and analysing data for an inventory of hospital-based cases, retrieved from scholarly and grey literature. This process highlighted a paucity of reporting on such interventions, which are not yet well-covered in wider efforts for sustainability or climate action reporting. We found 125 examples of implemented structural measures intended to adapt hospital facilities to respond more favourably to anticipated changes in climate. The inventory provides insight into what adaptation actions are being reported across regions around the world and the motivations behind them, which provides a basis for considering how business cases are being made for these investments.Doing so means we are able to make three contributions to the field of climate adaptation. First, our analysis of the initial data highlights nascent trends, for example, experience of a previous weather event or adherence to current building codes are the two dominant motivating factors for pursuing adaptation. Second, identifying the challenges involved in gathering and compiling adaptation data has implications for the field of climate adaptation itself, and the data needed to drive decision making and better understanding of what is happening. Notably, the evidence collected from various regions contain biases attributed to data retrievability, where North American examples are most readily available. Finally, it is anticipated that the inventory—which provides a baseline for categorising interventions in the sector—has value for generating understanding of what comprises adaptation practice, beneficial to both hospital practitioners and researchers alike.

Adenoma Detection Rate and Polyp Detection Rate among Gastroenterology Fellows and Consultants in a Tertiary Hospital in the Philippines: A Cross-sectional Study.

Colorectal cancer (CRC) is the third most commonly diagnosed cancer and the fourth leading cause of cancer mortality worldwide. Likewise in the Philippines, the prevalence of CRC has shown to be increasing. Colonoscopy, a screening procedure for CRC, has parameters to gauge quality of detection. One of which is the Adenoma Detection Rate (ADR). Higher ADR has been linked to improved cancer detection. This study aimed to determine the ADR and Polyp Detection Rate (PDR) among Gastroenterology practitioners in a tertiary government university hospital in the Philippines, estimate ADR from PDR, and identify factors associated with ADR. An analytical, cross-sectional study among patients who underwent colonoscopy for the years 2021 and the first half of 2022 at the Central Endoscopy Unit (CENDU) of the Philippine General Hospital. Demographic data of fellows and consultants were collected through an online form, while those from patients were obtained from electronic records. Colonoscopy details and histopathology results were accessed through the hospital's Open Medical Record System (MRS). ADR, PDR, and estimated ADR were computed using established formulas. To evaluate the strength of the relationship between the estimated and actual ADR, Pearson's correlation coefficient was used. Chi-square analysis, Mann-Whitney U test, and Kruskal-Wallis H test were performed to identify the factors that might influence the ADR. A cut-off of p <0.05 was considered statistically significant. The total computed ADR of consultants and fellows combined is 22%. The difference between the ADRs of Gastroenterology consultants and Fellows-in-Training is statistically significant at 31.6% and 18.7%, respectively (p= 0.017). The total Polyp Detection Rate is 57.6% while the weighted group average Adenoma to Polyp Detection Rate Quotient (APDRQ) is 0.4085 or 40.85%. The estimated ADR has a moderate degree of correlation with the actual ADR when an outlier was excluded (r=0.521 (95% CI, 0.072-0.795, p=0.0266). Significant factors related to ADR include endoscopists' years of practice (p=0.020), number of colonoscopies done (p=0.031), and patient tobacco use (p=0.014). The overall ADR among consultants and fellows is at par with the standard guidelines. A moderate degree of correlation exists between actual and estimated ADR when an outlier is excluded; however, more studies are needed to determine the APDRQ in the wider local setting. Longer years in practice, total number of colonoscopies performed, and patient tobacco use are associated with increased ADR.

The genetics of falling susceptibility and identification of causal risk factors

Falls represent a huge health and economic burden. Whilst many factors are associated with fall risk (e.g. obesity and physical inactivity) there is limited evidence for the causal role of these risk factors. Here, we used hospital and general practitioner records in UK Biobank, deriving a balance specific fall phenotype in 20,789 cases and 180,658 controls, performed a Genome Wide Association Study (GWAS) and used Mendelian Randomisation (MR) to test causal pathways. GWAS indicated a small but significant SNP-based heritability (4.4%), identifying one variant (rs429358) in APOE at genome-wide significance (P < 5e-8). MR provided evidence for a causal role of higher BMI on higher fall risk even in the absence of adverse metabolic consequences. Depression and neuroticism predicted higher risk of falling, whilst higher hand grip strength and physical activity were protective. Our findings suggest promoting lower BMI, higher physical activity as well as psychological health is likely to reduce falls.

Design and validation of a structured instrument to assess the influence of sustainable supply chain management practices on sustainable performance in hospitals

PurposeThe purpose of this paper is to design and validate a reliable and comprehensive instrument to assess the influence of sustainable supply chain management (SSCM) practices on sustainable performance in hospitals.Design/methodology/approachA systematic and mixed-method approach was used to create and validate an instrument for assessing the level of implementation of hospital SSCM practices and the perceived extent of environmental, social and economic performance. This includes the development of preliminary items and the evaluation of content and construct validity. Data from Colombian hospitals was collected. Structural equation modeling was used to test the structural model.FindingsDuring the content validity phase, an initial version of the questionnaire consisting of 88 items was generated. This version was qualitatively and quantitatively reviewed and assessed by six academicians and two hospital practitioners, based on criteria of sufficiency, clarity, relevance and coherence. The computation of both individual and scale content validity indices, along with the qualitative feedback, led to the refinement of the questionnaire. The subsequent phase of construct validity involved the implementation of a pilot test with 55 responses gathered from Colombian hospitals. By considering the metrics of convergent validity and discriminant validity derived from the analysis of structural equation modeling, the final instrument was composed of 59 items. The results reveal that hospital SSCM practices can be conceptualized and measured through two dimensions: environmental and social. The former includes the underlying constructs of internal environmental management, green purchasing and green operations. The latter encompasses the constructs of working conditions and employee well-being, equity management, social purchasing and community development and participation. Sustainable performance is defined by its environmental, social and economic dimensions.Practical implicationsThis study is intended to provide useful insights for hospitals, researchers and policymakers to measure and develop strategies to enhance the implementation of SSCM practices, thereby improving sustainable performance. As a matter of fact, the instrument has already been applied in a recent empirical study conducted in Colombia, aimed at addressing the influence of SSCM practices on sustainable performance in hospitals.Originality/valueTo the best of the authors’ knowledge, this is the first study to develop and empirically test an instrument for measuring the influence of SSCM on sustainable performance, both in the hospital setting and in an emerging country.

End of Life Care for Unplanned Vascular Admissions

Unplanned vascular admissions have a high mortality. Previous studies have indicated that end of life care (EoLC) among this group of patients is low but there exist limited data on EoLC in the United Kingdom. The aim of this study was to evaluate the quality and predictors of EoLC for unplanned vascular admissions to a tertiary center in the United Kingdom. This was a retrospective single-center cohort study of unplanned vascular surgery admissions from August 1, 2019 to January 22,2020. Data on patient demographics, markers of quality of palliative care, mortality, and cause of death of unplanned admission to the vascular surgery department were collected from hospital and general practitioner records and evaluated against EoLC to evaluate predictors and efficacy of EoLC. Quality of palliative care markers included documentation of preferred place of death and care priorities, time spent in hospital and the intensive care unit toward the end of life, and realization of documented care objectives. EoLC input was defined as a dedicated palliative care consultation (PCC) by a palliative care professional, medical doctor, surgeon, or advanced care practitioner. We also conducted a subgroup analysis of patients within this group with chronic limb-threatening ischemia (CLTI), diabetic foot, and ruptured aortic aneurysms, as all patients in this group should be offered EoLC according to international guidelines. One-hundred and fifty patients were included. Median age at presentation was 70.5years, and the cohort consisted of mostly men (72%). CLTI (31%) was the most common reason for admission. Surgical intervention was carried out in 60% of patients. Two-year mortality was 36%, and pneumonia (22%) was the most common cause of death. Seven percent of patients received PCC, which occurred a median of 10days before death. Only a minority of patients had preferred place of care/death (14%), care priorities (37%), and family involvement during advance care planning (17%) documented in their notes; 29% of patients had Recommended Summary Plan for Emergency Care and Treatment forms in place. A diagnosis of left ventricular systolic dysfunction, chronic kidney disease, and increasing age predicted Recommended Summary Plan for Emergency Care and Treatment form completion. Patients with PCC were more likely to have advance care planning, but this did not translate into improvements in the other markers of quality of palliative and, consequently, EoLC. EoLC was insufficient and of low quality despite a high mortality in this group. Clinical guidelines and pathways are needed to ensure these patients are considered for EoLC and those with CLTI, diabetic foot sepsis or ruptured abdominal aortic aneurysms are offered it by default. Further research is needed to help identify vascular patients who would benefit from EoLC earlier to improve quality at end of life.

État des lieux de l’oculoplastie française en France et en Europe

In 2023, oculoplastics in France is experiencing a paradox with an imbalance between demand and supply of trainees. The goal of this study is to establish a factual overview of oculoplastics in France, with its limitations, and make proposals to optimize this sector. An observational study was conducted by compiling epidemiological data related to oculoplastics. This included full-time hospital practitioners (HPs) in French university hospitals (FUH), data from the distributed computerized system for health assessment (SIDES), the specialized cross-disciplinary training (FST) in oculoplastics, the interuniversity diploma (DIU) in oculoplastics, the French University Ophthalmologists College (COUF), and the French Society of Reconstructive and Aesthetic Ophthalmology (SOPREF). Of the 32 FUH, only 11 full-time HPs (among them 5 academic) are specialized in oculoplastics. Several "priority" regions are underrepresented in oculoplastic surgeons. The number of ophthalmology residency coordinators and residents participating in the oculoplastics FST are decreasing over time and favoring other subspecialties. On the SIDES platform dedicated to residents, 26 (11.5%) of the 226 courses are devoted to oculoplastics. The role of women in oculoplastics is also discussed. Despite offering quality theoretical training, the future of French oculoplastics is clouded by a lack of practical training. Corrective measures include increasing oculoplastic surgeons in the FUH, developing private practice fellowships, prioritizing residents from "priority" regions for the oculoplastics DIU, optimizing the inter-CHU network, creating innovative teaching resources, and organizing specific congresses for the residents.

A-Quasi Experimental Study to Assess the Effectiveness of Video Assisted Teaching Programme on Knowledge regarding MTP among the Reproductive age group women (18-45years) in a selected area of District Chamba Himachal Pradesh

Background: -MTP is also called the medical termination of pregnancy. MTP is the safe legal procedure for abortion performed by the qualified registered medical practitioner in a approved hospital. The aim of the study was to improve the knowledge of the reproductive age group women (18-45years) regarding the Medical Termination of pregnancy (MTP). A Quantitative research was used to assess the effectiveness of video assisted teaching programme related to knowledge regarding the Medical Termination of pregnancy (MTP) among reproductive age group women (18-45years). The non- probability purposive sampling technique was used to select 60 women of reproductive age group (18-45years) in selected area of district Chamba, Himachal Pradesh. A semi structured knowledge questionnaire was used to assess the level of knowledge. Analysis of collected data was done according to the objectives of the study and data analyzed by using descriptive and inferential statistics. The study showed that out of60 women. 11.6% was 18-24years, 18.33% was 25-31years, 40% was 32-38years, 30% was 39-45years. According to the findings, the pre-test level of knowledge score of reproductive age group (18-45years) women 0% women had good knowledge, 31.6% women had average knowledge, 61.3% women had poor knowledge and the post-test level of knowledge score of reproductive age group (18-45years) women 83.3% women had good knowledge, 16.6% women had average knowledge and 0% women had poor knowledge score. It was concluded that video assisted teaching programme was an effective strategy in improving knowledge of reproductive age group women (18-45years) regarding the MTP (Medical termination of Pregnancy)

Comparison Of Learning Styles Used By Clinical Faculty Of Hospital And General Practitioners For Their Professional Development

Aims &amp; Objectives: To compare the learning styles used by hospital clinical faculty and general practitioners for their professional development/ continued medical education. Place and Duration of Study: This was a Comparative cross-sectional study carried out at Pakistan Kidney and Liver institute and research canter Lahore from October 2019 to November 2020. Material &amp; Methods: Total number of seventy-six medical professionals comprising thirty-eight members of clinical faculty and similar number of general practitioners were included in the study. Amongst these, 45 were males and 31 females’ Learning style questionnaire adopted from Honey and Mumford was distributed to all the participants. According to the learning styles they were grouped into Activists, reflectors, theorists and pragmatists with preference categorization of Very strong, strong, moderate, low and very low. Data was entered and analyzed usin SPSS version 22 Chi-square test was applied to see the significant difference in two groups and P value was calculated and value of less than 0.05 was considered significant. Results: There were 45 males and 31 females with ratio of 1.45:1 .In general practitioners the strongest learning style was reflector, followed by theorist, activist and pragmatists.While in the clinical faculty the strongest preference was again for reflectors, followed by activists then theorists and finally pragmatists, the significant difference statistically was only seen in the moderate preference in activist group which was 0.038. Conclusion: Reflector type of learning style based on pondering, experiencing and observing different perspectives was strongly observed in both genders of consultants and general practitioners. However, a moderate degree of activist type of learning style influenced by doing and feeling was also noted in the general practitioners. Further planning instructional strategy and assessment based on these learning styles could benefit the career growth of these two groups of health professionals.

Predictors for unplanned hospital admissions in community dwelling adults: A dynamic cohort study

BackgroundPolypharmacy and inappropriate medication use are associated with unplanned hospital admissions. Targeted interventions might reduce the hospitalization risk. Yet, it remains unclear which patient profiles derive the largest benefit from such interventions. ObjectiveThe aim of this study was to determine independent risk factors, among which polypharmacy, for unplanned hospital admissions in a cohort of community dwelling adults. MethodsA retrospective study was performed using a large general practice registry and an insurance database in Flanders, Belgium. Community dwelling adults aged 40 years or older with data for 2013–2015 were included. The index date was the last general practitioner contact in 2014. Determinants were collected during the preceding year. Unplanned hospital admissions were determined during the year after the index date. Univariable logistic regression models were fitted on each risk factor for an unplanned hospital admission as the primary outcome. Two multivariable models were derived. ResultsIn total, 40411 patients were included and 2126 (5.26%) experienced an unplanned hospital admission. Mean age was 58.3 (±12.3) years. The two models identified the following determinants for an unplanned hospital admission: excessive polypharmacy, older age, male sex, number of comorbidities, atrial fibrillation, chronic obstructive pulmonary disease or stroke, low hemoglobin, use of hypnotics, antipsychotics, antidepressants or antiepileptics and prior hospital and general practitioner visits. Prior hospital visits was the largest determinant. ConclusionsIn our study we identified and confirmed the presence of known determinants for unplanned hospital admissions in community dwelling adults, most of which align with a geriatric phenotype. Our findings can inform the allocation of interventions aiming to reduce unplanned hospital admissions.

Ethical Sensitivity and its Association with Caring Behavior among Healthcare Workers in Delta State, Nigeria: A Cross-Sectional Study

Introduction: Caring behavior is a unique behavior that can promote patients’ well-being, the performance of healthcare workers, and the general effectiveness of healthcare institutions. The mechanism and possible predictors of caring behavior are under-researched in health and organizational behavior literature. Based on the aforementioned, this study examined the predictive effect of ethical sensitivity (dimensions included) on caring behavior, and gender differences in caring behavior and ethical sensitivity among public healthcare workers in Delta State, Nigeria. Methods: A cross-sectional research design and a quantitative approach for data collection were adopted. Simple random sampling was adopted for selecting the participating hospitals while the convenience sampling technique was utilized for selecting the healthcare workers. Two instruments with good psychometric properties were used for the data collection. The simple linear regression and independent sample t-test were used for testing the hypotheses via the IBM-SPSS v.25. Results: The participants comprised 150 healthcare workers from public-owned hospitals consisting of 73(48.7%) males and 77(51.3%) females with a mean age of 40.60 years and a standard deviation of 9.30. The results of the study indicated that ethical sensitivity positively and significantly predicted caring behavior. Also, two dimensions of ethical sensitivity, moral strength, and moral responsibility positively and significantly predicted caring behavior while a sense of moral burden did not. Finally, there was no significant gender difference in caring behavior and ethical sensitivity. Conclusion: This study highlights the role of ethical sensitivity, moral strength, and moral responsibility in predicting higher levels of caring behavior among healthcare workers. Thus, it was recommended that hospital administrators, health policymakers, and practitioners seeking to boost the caring behavior of healthcare workers should focus on enhancing factors such as sensitivity to ethical standards. Also, administrators of medical education can nurture intending healthcare workers (medical students) on the importance of ethics in the medical profession.