Improve Patient Health Outcomes Research Articles

Confidentiality for SUD records: Final rule issued

A week after the federal Department of Health and Human Services (HHS) issued a final rule liberalizing treatment for opioid use disorder (OUD) in opioid treatment programs, it issued a less patient‐friendly rule. ADAW has written about 400 articles on confidentiality and substance use disorder treatment, an area that has seen continued erosion since 2010 when the government started acceding to claims that requiring a patient to consent to the release of his or her substance use disorder (SUD) treatment information in a digital age (think “Electronic Health Record”) would be just too inconvenient. The most recent step came in the Federal Register issued Feb. 8, which changes the confidentiality rules to align with those of HIPAA. The rule, through the HHS Office for Civil Rights (OCR) and the Substance Abuse and Mental Health Services Administration (SAMHSA), finalized modifications to the Confidentiality of Substance Use Disorder (SUD) Patient Records regulations at 42 CFR part 2 (“Part 2”), which protect the privacy of patients' SUD treatment records. In a press release about the rule, HHS said this: “Specifically, today's final rule increases coordination among providers treating patients for SUDs, strengthens confidentiality protections through civil enforcement, and enhances integration of behavioral health information with other medical records to improve patient health outcomes.”

Family resilience, patient-reported symptoms in young stroke dyads: The effect of caregiver readiness and social support.

To investigate empirically the direct effect and potential mechanism of family resilience on patient-reported outcomes among young stroke dyads in China. Young patients with stroke have been becoming an important public health issue. According to relevant theories and previous studies, we found that family resilience might play an important role in patient's symptoms. However, it is less clear about the specific relationship and potential mechanisms of these two variables. We used a prospective cross-sectional design. A multi-item questionnaire was used to assess the constructs of interest. Researchers progressively constructed and validated conditional process models. The PROCESS macro was used to verify the research hypotheses. A total of 560 questionnaires were collected in this study. We found that family resilience of stroke patients and their spouses had a direct effect on the physical, psychological and social aspects of patient-reported symptoms. We further revealed that caregiver preparedness partially mediated the relationship between family resilience and patient's symptoms in stroke patient-spouse dyads, while perceived social support moderated the relationship between caregiver preparedness and patient's symptoms. Finally, we observed that the impact of caregiver readiness and social support on patients' symptoms predominantly manifested in physical and physiological outcomes. Our research provides evidence about the positive impact of family resilience on patient-reported symptoms in young stroke dyads. Meanwhile, it further revealed how caregiver preparedness and perceived social support may play out in the relationship. Our research introduces a novel perspective and pathway to enhance short-term recovery outcomes for patients. It also furnishes clinicians and nurses with evidence to guide the implementation of interventions aimed at improving patient health outcomes and facilitating smoother transitions from the hospital to home. What problem did the study address? Families play a crucial role in a patient's recovery process from illness, with family resilience serving as an important force for families to overcome adversity. However, the impact on patient symptoms and the underlying mechanisms of this relationship are uncertain. Empirical research is required to validate these aspects. What were the main findings? Family resilience has a positive impact on the physical, psychological and social aspects of patient-reported symptoms in young stroke dyads. Both the actor effect and partner effect are supported. The impact of caregiver readiness and social support on patient-reported symptoms is primarily observed in physical and physiological outcomes. Where and on whom will the research have an impact? This study offers a novel approach to enhance the short-term recovery of stroke patients. The researchers believe that the findings of this study will play an even more significant role during patients' transition from the hospital to home. This study followed the STROBE statement of cross-sectional studies. The study was conducted by patients, their spouses, healthcare professionals and the research team.

Pediatric oncology services in Nepal: A special focus on pharmacy practice.

The role of clinical pharmacists or oncology pharmacists in pediatric oncology has been established as important in anticancer regimen review, dose calculation, recommendation, chemocounseling, identification of drug-related problems, its resolution, and, prevention and monitoring of adverse drug reactions within high-income countries. With several hospitals providing pediatric oncology services in Nepal, clinical pharmacist involvement in these hospitals is very poor. Upon reviewing the reputed organization and association focused on pediatric oncology pharmacy practice, it looks imperative for Nepal to initiate clinical pharmacy services which will further help in improving patient health outcomes. As such in this commentary, we try to accentuate the pediatric oncology services and pediatric pharmacy practice within Nepal and try to pinpoint the potential areas for clinical pharmacists to focus if they intend to provide services in pediatric oncology pharmacy practice.

Measuring the therapeutic bond in genetic counseling: Testing measurement error in the bond subscale of the Working Alliance Inventory.

The therapeutic relationship is a key component of successful genetic counseling. In psychotherapy, a strong therapeutic relationship can improve patient health outcomes and a poor relationship can worsen psychological functioning. Investigation of the therapeutic relationship in genetic counseling has shown evidence for a similar pattern. Reliable measurement of the therapeutic relationship is necessary for consistency across studies in the genetic counseling context. One measure that has been adapted for use in genetic counseling is the Working Alliance Inventory (WAI). However, there have been no studies of the factor structure or item-level method bias analyses for the genetic counseling-adapted version of the WAI. The goal of this study was to test the factor structure of the WAI observer version (WAI-O) bond subscale and assess method bias in a genetic counseling context. We hypothesized that differences in factor structures would exist for items that were positively (n = 9) versus negatively (n = 3) worded (reverse coded). Secondary data analysis was performed on two data sets that utilized the WAI-O in genetic counseling contexts. Data set 1 used simulated genetic counseling sessions that were judged by analog clients recruited through crowdsourcing platforms (N = 861). Data set 2 was conducted with genetic counseling clients, and sessions were evaluated by a research team (N = 120). Principal axis factor analysis with oblique oblimin rotation supported a two-factor solution for the WAI-O bond subscale across data sets. Items factored based on wording, with the positively worded items loading together and the negatively worded items loading on the second factor. Confirmatory factor analyses supported the removal of all negatively worded items from the instrument across data sets. Results suggest that the negatively worded items on the WAI-O may be capturing a construct inconsistent with the positively worded items and support rewording and/or excluding them from use for a more reliable measure of the therapeutic bond.

P646 Clinical decision support in the prevention of adverse effects associated with immunosuppressive drugs in patients with Inflammatory Bowel Disease

Abstract Background With the goal of effective and early prevention and detection of medication-related adverse effects, an explosion of technological advances is taking place. However, none of these systems are currently intelligent enough to ensure safe prescribing of treatments on their own. Purpose To design and integrate clinical decision rules (CDR) to increase the safety of immunosuppressive treatments in patients with inflammatory bowel disease (IBD) into an electronic prescribing assistance software (HIGEA). Methods This is a descriptive study conducted in a tertiary university hospital in Madrid (Spain). 1. We reviewed the technical product information sheet of the immunomodulatory drugs used in the treatment of patients with IBD and the current recommendations and clinical practice guidelines on the management of IBD. 2. The CDR were developed within a multidisciplinary team of physicians and pharmacists by integrating data from pharmacogenetics, microbiology, biochemistry, immunology and haematology laboratories, the electronic medical record and the electronic prescribing programme. 3. Integration was performed using a standard language (HL7). Results The technical product information sheet of 33 immunomodulatory drugs (19 biological therapies, 6 small molecules and 8 traditional disease-modifying drugs) and the clinical practice guidelines for the treatment of IBD of the European Crohn's and Colitis organisation (ECCO) and the Spanish working group on Crohn's disease and ulcerative colitis (GETECCU) were reviewed. A total of 169 CDR were developed: 2 related to pharmacogenetics laboratory values, 26 to microbiology, 38 to biochemistry, 24 to immunology, 42 to haematology, 28 to clinical history and 9 related to concomitant use of other drugs. Of the 169 CDR, 50 (29.58 %) were related to screening prior to initiation of immunosuppressive treatment, 10 (5.92%) to drug interactions and 109 (64.5%) related to clinical conditions requiring adjustment or discontinuation of immunosuppressive treatment. Conclusion The incorporation of personalised clinical rules into the medical prescription and pharmaceutical validation process will allow the selection of patients in whom there could be a safety problem with immunosuppressive treatment, increasing the percentage of early detected and avoided adverse events. Future steps will be to evaluate the impact of the implementation of the CDR tool on increasing safety, reducing healthcare costs and improving patient health outcomes.

Outcomes of Community Pharmacy Interventions on Patients with Medicines Under Additional Monitoring.

Additional monitoring (AM) medicines include (i) medicines containing a new active substance; (ii) biological medicines; (iii) medicines with conditional approval or authorized in special situations; (iv) medicines which require further studies; (v) medicines that have specific requirements regarding the reporting of suspected adverse drug reactions (ADRs). When AM medicines are marketed, their most common ADRs are known, but safety information is limited because relatively rare ADRs are often not detected in clinical trials. Their AM status warrants real-world studies to identify other safety issues; however, such studies are lacking. Correct use and adherence to dosage regimen by patients are key factors for the evaluation of the safety and efficacy of medicines. The objective of this work was assessing the impact on safety, adherence, use and knowledge (U&K) about medicines and patient's quality of life (QOL), of community pharmacist (CP)-led interventions in a new service focused on AM medicines targeted at three prevalent chronic diseases: diabetes mellitus type 2, chronic obstructive pulmonary disease and cardiovascular disease. A prospective interventional cohort study was conducted with a 6-month follow-up in 27 community pharmacies (145 patients). Safety, adherence to treatment, patient U&K and QOL were assessed at follow-up visits (months 0, 3 and 6). The number of detected ADRs was 163 with 41 patients referred to the doctor. At baseline, 24.1% of the patients were non-adherent, mainly due to unintentional causes. After six months and 130 interventions by CPs on adherence, a significant reduction to lower than 5.8% was achieved. The inadequate U&K of medicines also decreased, from 47.6% to 7.9% after 182 interventions. Also, the patient's QOL improved. A new patient-centered pharmacy service provides some evidence on the important role of CP in assisting the proper and safe use of AM medicines, improving patient health outcomes.

Quality and performance indicators for wound management towards value-based healthcare

Outpatient services and specialized wound care clinics have become an expanding practice worldwide, which may be related to the increased life expectancy, rise in chronic diseases, favoring the occurrence of vascular and diabetic ulcers, as well as prolonging their treatment and delaying improvement. The high costs and risks associated with hospitalization lead to the patient being referred to a specialized wound center for continued treatment. The adoption of value-based healthcare models seeks cost reduction but primarily focuses on improving patient health outcomes. Its design and implementation depend on data that allows for measuring the health outcomes and costs of care for each patient and utilizing that information to drive continuous improvements. This study aims to propose quality and performance indicators for becoming a standard practice in specialized nursing services in wound care to enable the adoption of value-based healthcare models. The consultation of 19 experts through the Delphi method enabled the systematic organization of a large number of indicators identified in the literature into 8 categories and 43 specific indicators.

Implementing Community Antimicrobial Stewardship Model in Nigeria: Lessons Learned from AMS Outpatient Setting among Community Pharmacists/Patent and Proprietary Medicine

Antimicrobial resistance (AMR) is a growing global concern primarily driven by the overuse and inappropriate utilization of antimicrobials. In Nigeria, AMR is exacerbated by the routine sale of prescription-only medicines, including antimicrobials, without proper monitoring. The National Action Plan for Antimicrobial Resistance (2017-2022) highlighted widespread inappropriate antibiotic use, with significant proportions obtained without prescriptions. Antimicrobial stewardship (AMS) in outpatient settings is a novel concept in Nigeria. This interventional study sought to contribute to the reduction of inappropriate antibiotic dispensing and use in community/outpatient settings in Nigeria, focusing on enhancing the skills and capacity of improved rational antibiotic therapy among community pharmacists and Patent and Proprietary Medicine Vendors (PPMVs), with the sole aim of improving patient health outcomes. The CAMS interventional study involves education, quality improvement capacity building, patient empowerment, and a multifaceted AMS strategy. Results from the CFID’s CAMS model indicated a significant improvement in the rational dispensing and use of antimicrobials within the intervention group, emphasizing the effectiveness of CAMS. Notable variations in post-visit actions between the intervention and monitoring groups further support the positive impact of the intervention. Variation in attitudes towards sharing of antibiotic to friends and relatives was reduced among the intervention group, offering clear understanding into the potential impact of CFID AMS outpatient setting (CAMS) intervention. The study’s conclusion underscores the pivotal role of implementing AMS in outpatient and community settings such as the CAMS interventional model in improving antibiotic-related practices in both urban and rural communities in Nigeria, emphasizing its relevance and impact.

Principles for the Physician-Led Patient-Centered Medical Home and Other Approaches to Team-Based Care: A Position Paper From the American College of Physicians.

Team-based care models such as the Patient-Centered Medical Home are associated with improved patient health outcomes, better team coordination and collaboration, and increased well-being among health care professionals. Despite these attributes, hindrances to wider adoption remain. In addition, some health care professionals have sought to practice independent of the physician-led health care team, potentially undermining patient access to physicians who have the skills and training to deliver whole-person, comprehensive, and longitudinal care. In this paper, the American College of Physicians reaffirms the importance of the physician-led health care team and offers policy recommendations on professionalism, payment models, training, licensure, and research to support the expansion of dynamic clinical care teams.

The effectiveness of continuing education programmes for health workers in rural and remote areas: a systematic review and meta-analysis.

Health workers in rural and remote areas shoulder heavy responsibilities for rural residents. This systematic review aims to assess the effectiveness of continuing education programs for health workers in rural and remote areas. Eight electronic databases were searched on 28 November 2021. Randomized controlled trials (RCTs) and quasi-experimental studies evaluating the effectiveness of continuing education for health workers in rural and remote areas were included. The quality of the studies was assessed using the risk of bias tool provided by Effective Practice and Organization of Care. A meta-analysis was performed for eligible trials, and the other findings were presented as a narrative review because of inconsistent study types and outcomes. A total of 17 studies were included, four of which were RCTs. The results of the meta-analysis showed that compared to no intervention, continuing education programs significantly improved the knowledge awareness rate of participants (odds ratio=4.09, 95% confidence interval 2.51-6.67, p<0.05). Qualitative analysis showed that 12 studies reported on the level of knowledge of participants, with all showing positive changes. Eight studies measured the performance of health workers in rural and remote areas, with 87.50% (n=7) finding improved performance. Two studies reported on the impact of continuing education programs for health workers in rural and remote areas on patient health, with only one showing a positive change. One study from India measured the health of communities, which showed a positive change. The results of this study showed that continuing education programs are an effective way to address the lack of knowledge and skills among health workers in rural and remote areas. Few studies have examined the effectiveness of education programs for health workers in rural and remote areas in improving patient health outcomes. It is not yet known whether the delivery of continuing education programs to health workers in rural areas has a positive impact on patient and community health. Future attention should continue to be paid to the impact on these outcomes.

Patients' Satisfaction With Medication Delivery Pharmacy Services in a Tertiary Hospital in Asir, Saudi Arabia: A Cross-Sectional Study.

Pharmaceutical care plays a crucial role in optimizing medication administration and improving patient health outcomes. However, medication adherence remains a challenge, with a significant percentage of patients discontinuing their medications. Value-added services (VASs), such as medication delivery, have been introduced to enhance pharmacy services and medication adherence. This study aims to evaluate satisfaction with a new medication delivery service at an Armed Forces Hospital outpatient pharmacy in Saudi Arabia and identify factors impacting utilization. A cross-sectional survey assessed patient satisfaction with a new pharmacy delivery service between January 2023 and March 2023. The target population consisted of adult patients who had used the pharmacy delivery service for at least one month. The survey contained 23 Likert scale questions assessing satisfaction across three domains: delivery process/personnel, medication quality, and pharmacist adherence to best practices. A total of 110 patients responded to the survey, 383 invited patients; the mean age was 51.2 ± 15.3, and most were male 92 (83.6%), married 97 (88.2%), and living in urban areas 63 (57.3%). The overall satisfaction rate was 97 (88.1%), with 67 (60.9%) reporting satisfaction with the medication delivery service. On the delivery process/personnel items, over half strongly agreed that the delivery person called before arriving 59 (53.6%), medications were received on time 58 (51.8%), and the delivery person was polite 64 (58.2%). Most strongly agreed that the service helped with adherence 70 (63.6%) and saved travel costs 72 (65.5%) for medication-quality items. Most also strongly agreed that medications were properly packaged 65 (59.1%) and labeled 71 (64.5%). Regarding pharmacist practices, approximately 56 (50.9%) strongly agreed that the pharmacist provided education materials, inquired about adherence 49 (44.5%), and was respectful 55 (50%). Bivariate analyses found no significant associations between satisfaction and age, gender, residence, education, marital status, income, or disease (all p > 0.05). Satisfaction remained uniformly high across subgroups. The medication delivery service demonstrated excellent patient reception regardless of its characteristics. Overall satisfaction with these services was high. There was no association between sociodemographic characteristics and the level of satisfaction. Continued monitoring and refinement could maximize the quality of pharmaceutical care afforded through innovative models supporting medication adherence.

Using Patient-Centered Dissemination and Implementation Frameworks and Strategies in Palliative Care Settings for Improved Quality of Life and Health Outcomes: A Scoping Review.

There is a need for patient-provider dissemination and implementation frameworks, strategies, and protocols in palliative care settings for a holistic approach when it comes to addressing pain and other distressing symptoms affecting the quality of life, function, and independence of patients with chronic illnesses. The purpose of this scoping review is to explore patient-centered D&I frameworks and strategies that have been adopted in PC settings to improve behavioral and environmental determinants influencing health outcomes through evidence-based programs and protocols. The five step Arksey and O'Malley's (2005) York methodology was adopted as a guiding framework: (1) identifying research questions; (2) searching for relevant studies; (3) selecting studies relevant to the research questions; (4) charting the data; and (5) collating, summarizing, and reporting results. Only 6 out of the 38 (16%) included studies applied a D&I theory and/or framework. The RE-AIM framework was the most prominently cited (n = 3), followed by the Diffusion of Innovation Model (n = 2), the CONNECT framework (n = 1), and the Transtheoretical Stages of Change Model (n = 1). The most frequently reported ERIC strategy was strategy #6 "Develop and organize quality monitoring systems", as it identified in all 38 of the included studies. This scoping review identifies D&I efforts to translate research into practice in U.S. palliative care settings. Results may contribute to enhancing future D&I initiatives for dissemination/adaptation, implementation, and sustainability efforts aiming to improve patient health outcomes and personal satisfaction with care received.

Abstract 15514: Ambulating Femoral Inserted Intra-Aortic Balloon Pump: Is It Safe?

Introduction: Patients undergoing heart transplant evaluation wait in the hospital for weeks. The intra-aortic balloon pump (IABP) is commonly used as a bridge to heart transplants. However, patients with a femoral-inserted IABP may face mobility limitations. Goal: To address this issue, the Cardiac Intensive Care Unit (CICU) implemented a modified Ramsey protocol aimed at ambulating patients with IABP. Goals: The goal was to improve patient health outcomes. The project aims to ambulate patients with f-IABP in Cardiac Intensive Care Unit (CICU) to prevent functional decline due to bed rest. Methods: The provider prescribed all IABP patients in the CICU ambulation. Before ambulation, patients who met the criteria were verticalized, utilizing the KREG Catalyst™ bed at 70 degrees for at least 45 minutes three times/day. After tolerating the verticalization at 70 degrees, nurses and physical therapists will assist the patient in stepping off the bed for at least 45 minutes 2 before ambulating around the unit. Results: A total of 14 patients were ambulated, of which twelve were male and two were female. The mean aged is 59 years, ranging from 30 to 72 years. The participants underwent an average of 15 ambulation sessions, with the minimum being one session and the maximum being 52 sessions. During these sessions, the participants covered an average total distance of 9619.29 feet, ranging from a minimum of 70 feet to a maximum of 36250 feet. The participants spent an average of 4061.86 seconds ambulating, with a minimum duration of one minute and a maximum of 30 minutes. The average catheter migration was 0.2229 centimeters upon implementation of the intervention. The findings show no significant adverse events with implementing this protocol. Conclusions: By implementing this protocol, healthcare professionals can enhance patient care and optimize post-heart transplant length of stay.

Design of exact reduct rough set hardware accelerator for early-stage diabetes risk prediction

Diabetes is a prevalent, chronic metabolic disorder worldwide. Detecting and predicting risks early are vital for timely intervention. In this paper, the design and implementation of an Exact Reduct Rough Set Hardware Accelerator is presented for early-stage diabetes risk prediction. The proposed hardware accelerator leverages the principles of Rough Set theory to identify essential features or attributes (reducts) from a large dataset that effectively predict the risk of diabetes at an early stage. The architecture of the hardware accelerator is optimized to efficiently handle large datasets commonly encountered in medical applications. It includes modules for data preprocessing, discernibility, matrix computation, and reduct determination. The proposed design is implemented on SPARTAN -6 Field Programmable Gate Array; it works on 100 MHz and supports 3 stages pipelining. The extensive experimentation, employing a comprehensive dataset of diabetes patients, unequivocally demonstrates the hardware accelerator's superior performance compared to traditional methods and software-based implementations. The Exact Reduct Rough Set Hardware Accelerator provides a powerful tool for medical professionals to identify patients at risk early on, enabling timely interventions and personalized care to improve patient health outcomes. The proposed accelerator contributes to the growing field of medical decision support systems and holds promise for broader applications in healthcare and beyond. The findings from this study can be seamlessly incorporated into the system-on-chip platform, contributing to the creation of intelligent tools for monitoring and managing diabetes. By offloading rough set computations to hardware accelerators on the wearable device, the data does not need to be continuously transmitted to external servers for analysis, ensuring user privacy and reducing communication overhead.

A pilot study: Drug utilization pattern and prevalence of micro and macrovascular complication in type 2 diabetes patient

Background: Diabetes mellitus is a chronic metabolic disorder resulting from the deficiency of insulin secretion and insulin resistance. Currently, there is a death of nationwide data regarding the prevalence of micro and macro complications and drug utilization patterns. This study will help health-care professionals approach management more aggressively to prevent complications. Objectives: To assess the risk factors associated with complications in diabetes patients, and to determine the pattern of drug prescription among type-2 DM patients patterns at Virudhunagar Medical College &amp; Hospital. Methods: This is a Prospective, prescription-based, and observational study. A sample size of 50 was selected systematically. Data were collected from patient case records and Prescriptions. The obtained data were entered in the structured patient profile form, and the filled forms were analyzed. Results: Out of the total 50 cases evaluated, 60 (60%) were males and 20(40%) were females. The 28 patients (56%) had a family history of diabetes. The prevalence of the associated diabetic complications was as follows viz. Hypertension (17.65%), IHD (1.47%), retinopathy (17.65%), nephropathy (7.35%), Neuropathy (47.06%), Stroke (5.88%) and CHF (2.94%). The overall utilization pattern of drugs were as follows viz. anti-diabetics (28%), anti-hypertensive (9%), antiplatelets (4%), lipid lowering agents (7%), vitamins and minerals (17%),GI drugs (14%), antimicrobials(6%). Among anti-diabetic drugs 48(96%) biguanides and 44(88%) of sulfonylureas classes of antidiabetic drugs were utilized. Likewise, preferred drugs for the management of hypertension, IHD, dyslipidemia, and neuropathy were Diuretics (25.93%), Clopidogrel (66.66%), Atorvastatin (100%), and Acetominophine (67.74%) respectively. Conclusion: The prevalence of micro and macro complications among type 2 diabetic patients was found to be high. Although polypharmacy was observed, drug utilization patterns can be rational owing to the higher prevalence of complications. Patient are not aware of the severity of the disease so complication makes the therapeutic more challenging. Patient education on disease severity and healthcare professionals need more focus on disease complications and severity to treat the disease earlier to improve patient health outcomes.

Bluegrass Biodesign: Why an Integrated Biomedical Engineering Curriculum is Crucial for Medical Education.

Background Medical education often overlooks the significance of design and innovation literacy, resulting in a knowledge gap in undergraduate medical education (UME) regarding formal training in these areas. Incorporating innovation into UME's core curriculum is crucial as future physicians will encounter evolving technologies, and fostering a transdisciplinary approach can enable collaborative problem-solving and improve patient health outcomes. Methodology We developed a comprehensive medical biodesign curriculum focused on innovation, including problem identification, prototype testing, and product commercialization. Participants were selected based on applications, interviews, and diverse criteria. A survey was conducted before and after the program to assess students' biodesign experiences and knowledge, with data analyzed using descriptive statistics and paired t-tests. Results Of the 41 participants, 24 (58.5%) completed both pre- and post-program surveys. These five-point Likert surveys showed a significant shift frompre-program to responses demonstrating increased "comfort levels in explaining and applying biodesign principles" (p < 0.0001). Specifically, the "comfort level in taking a product to market" increased from 33% to 67% (p = 0.01), while the "comfort level in applying the biodesign process" increased from 29% to 92% (p < 0.0001). Moreover, 58.3% of participants expressed interest in continuing their current projects, and 70.8% of students stated feeling confident in generating ideas and solutions with their team members. Conclusions The medical biodesign curriculum demonstrated success in exposing undergraduate medical and engineering students to the concepts of medical innovation and biodesign. The program has led to a significant improvement in students' knowledge and comfort levels in applying the biodesign process and taking a product to market. The high level of interest and participation in the program highlight the need for incorporating innovative training in UME to foster creativity and prepare future physicians to contribute to the advancements in healthcare.

Social networks as a protective factor for worsened self-perceived health status related to self-perceived changes in loneliness and health conditions in adults aged 50+ during the COVID-19 outbreak

The coronavirus disease 2019 (COVID-19) has emerged as a global pandemic, leading millions of people to change their lifestyles, especially older individuals who are the most at-risk population. Social isolation, the main preventive action to slow the pandemic's spread, reduced and drastically limited social connections, increasing older individuals' loneliness and stress, and worsening their health. We examined the connection between self-perceived changes in loneliness, the existence and type of social contact (face-to-face/electronic), and health conditions on self-perceived changes in health status during the outbreak, analyzing 51,778 individuals aged 50 plus from the Survey of Health, Ageing and Retirement in Europe (SHARE) database Wave 8 beta (June–August 2020). We found that the odds for worsened self-perceived health status were 249% higher among individuals who reported increased loneliness compared to the non-increase group and were lower in individuals with face-to-face contact (31%) or electronic contact (54%) during the outbreak. In addition, the odds for worsened self-perceived health status were higher for individuals with hypertension (17%), cancer (19%), chronic lung disease (25%), heart problems (27%), and other illnesses (32%). Based on the results obtained, electronic contact has shown a stronger connection as a protective factor for worsened self-perceived health since the outbreak compared to face-to-face interactions. Thus, adopting a policy that encourages the usage of electronic communications could reduce the burden on the healthcare system, particularly during pandemics, while improving patient health outcomes and minimizing pandemic-related health risks. This approach is especially important for older individuals, for whom any departure from home can cause an additional risk of exposure to the virus.

Health literacy strategies: a Caribbean approach

Low health literacy is linked to poor health outcomes. Adequate health literacy depends on effective communication between patients and their healthcare providers, so it is important that physicians use health literacy strategies. This review article provides a brief account of the evolution of health literacy which shows a clear need to improve rates worldwide. It also addresses the relationship between the use of health literacy strategies and health outcomes; the physician’s role in health literacy including their implicit biases, training, gender, and region of training; and recommendations to improve policy-making, practice, and education in a Caribbean context. The implications for positive social change include the potential for health literacy training and inclusion in medical school curricula. The provision of health literacy training at all levels of education and practice aid in ensuring physicians are knowledgeable about the health literacy process, able to use strategies that can improve patients’ health literacy, and able to improve patient health outcomes. Recommendations on improving community literacy by engagement and empowerment are also discussed.

Health literacy strategies: a Caribbean approach

Low health literacy is linked to poor health outcomes. Adequate health literacy depends on effective communication between patients and their healthcare providers, so it is important that physicians use health literacy strategies. This review article provides a brief account of the evolution of health literacy which shows a clear need to improve rates worldwide. It also addresses the relationship between the use of health literacy strategies and health outcomes; the physician’s role in health literacy including their implicit biases, training, gender, and region of training; and recommendations to improve policy-making, practice, and education in a Caribbean context. The implications for positive social change include the potential for health literacy training and inclusion in medical school curricula. The provision of health literacy training at all levels of education and practice aid in ensuring physicians are knowledgeable about the health literacy process, able to use strategies that can improve patients’ health literacy, and able to improve patient health outcomes. Recommendations on improving community literacy by engagement and empowerment are also discussed.

Obstacle Analysis And Community Medicine Interprofessional Communication Solutions In Medical And Dental Students

Poor communication between doctors, patients and between health professionals, has a negative impact. The patient becomes disobedient to the doctor's intervention, the doctor becomes the target of violence due to the patient's ignorance. The World Health Organization (WHO) initiated Interprofessional Education (IPE) learning at the undergraduate level to improve communication and collaboration of health workers to improve patient health outcomes. This study aimed to analyze the barriers and solutions to community medicine interprofessional communication among medical and dental students. This study uses a qualitative method with a case study design. Observational data collection and focus group discussion (FGD). Students were divided into 16 groups, each consisting of 9 medical students and three dentistry students. Observation of IPE activities on collaborative practices in community residents in Sendangmulyo with five meetings for each group. FGD activities were carried out after collaborative approach with student representatives from each group. The results showed that the obstacles that occurred included: differences in competence and knowledge, lack of cooperation, lack of confidence, signal interference, differences in medical terms, miscommunication, and lack of response. Solutions: collaboration and complementarity, holding offline meetings, building closeness, gathering ideas, respecting each other's opinions, more accurate information, being open and trusting each other, being active listeners, giving others opportunities to express opinions, and using language that is easy to understand, repeating the explanation given