Improve Healthcare Providers Research Articles

Problem exploration for creating value propositions when developing point-of-care solutions

Point-of-care (POC) testing has been increasingly proposed as one of the most promising solutions for improving healthcare provision as it enables fast and accurate testing both inside and outside hospital settings. Many of these POC device stem from academic research. Yet, the commercialization of these devices through academic spin-offs is not straigthforward. Many academic spin-offs fail due to an inproperly articulated value proposition. To create a value proposition with biosensors it is crucial to understand how they can be used to address problems in the current diagnostics processes and protocols. Therefore, this paper studies how different university teams engage in problem exploration to better understand how they can translate the technical features of their POC testing solutions into an attractive value proposition. To be able to study this, a qualitative case study research design was chosen. In particular, 11 university student teams participating in the SensUs contest were studied. The main findings show that teams adopting search patterns involving a ‘broader’ (i.e., considering a wider range of problems and stakeholders) and a more ‘interconnected’ (i.e., thematically linking problems with one another) problem-exploration were more successful in creating contest outcomes (biosensing solutions) with greater commercial viability. Moreover, teams that sougth direct feedback from market experts generated more commercially viable projects than teams that relied primarly on advice from technical experts.

Parents Role in Providing Health Care for Their Children (Analytical Study of Smoking Parents and Children)

The health consequences of smoking are well-known, and yet, children continue to smoke, placing their health and well-being at risk. Parents of smoking children play a crucial role in facilitating healthcare for their children and promoting healthy habits. However, caring for smoking children can be challenging, and parents who smoke face several unique challenges when providing healthcare for their children. This study aimed to explore the challenges faced by parents of smoking children when providing healthcare for their children and to identify potential intervention strategies that can facilitate better healthcare provision. A qualitative research design was used, and semi-structured interviews were conducted with 15 parents who had smoking children. Thematic analysis was performed to identify common patterns and themes in the data. The study found that parents face several challenges when caring for their smoking children, including difficulty in communicating with their children about smoking, worry about the negative health effects of smoking, difficulty in accessing healthcare services, inadequate parental education, and limited availability of family-friendly work environments. Parents highlighted the need for multi-pronged approaches to address these challenges, including parental education programs, health promotion campaigns, policy advocacy, and the use of technology. Parental education programs can empower parents by providing them with knowledge and skills to manage and prevent smoking in their children. Health promotion campaigns can reinforce the benefits of healthy habits and promote a smoke-free environment. Policy advocacy can facilitate changes in policies and regulations to improve healthcare access and support family-friendly work environments. The use of technology, such as telemedicine, can provide parents with access to healthcare services from the comfort of their homes. In conclusion, caring for smoking children can be challenging for parents who smoke. This study highlights the need to develop tailored intervention strategies to address the challenges faced by parents and to improve healthcare provision for smoking children. The recommended intervention strategies can help parents to better manage and prevent smoking in their children and promote healthy habits, leading to improved health outcomes for smoking children. Further research is needed to evaluate the effectiveness of these intervention strategies in improving healthcare provision for smoking children.

How do speech pathologists use the Australian Aphasia Rehabilitation Pathway to inform practice? A qualitative study

ABSTRACT Background Packaged evidence syntheses such as Best Practice Statements are important knowledge translation tools for improving healthcare provision. The Australian Aphasia Rehabilitation Pathway (AARP) is an online tool (www.aphasiapathway.com.au) based on the Aphasia Rehabilitation Best Practice Statements, developed to guide evidence-based aphasia services across the continuum of care. However, there has been no formal evaluation of the AARP’s implementation to date. Therefore, it is currently unknown whether and how speech pathologists use the AARP to guide their aphasia management practices, and how it can be enhanced to meet clinicians’ needs. Aims To explore Australian speech pathologists’ perceptions of (1) the usability and utility of the AARP, (2) how the AARP is currently used to inform aphasia management practices, (3) the potential impact of the AARP, and (4) how the AARP could be enhanced to meet clinicians’ identified needs. Methods and Procedures Semi-structured interviews guided by a framework for the development, implementation, evaluation, and reporting of online knowledge translation resources (Levac et al., 2015) were conducted with Australian speech pathologists working in aphasia services. Interviews were conducted via Zoom and accompanied by observations of participants’ self-navigation of the AARP. Qualitative content analysis of interview transcripts consisted of a combined deductive and inductive analytic approach. Outcomes and Results Eleven speech pathologists participated, who worked in predominantly public services in various clinical settings (acute, rehabilitation, and community) and had between 1 and 30 years of clinical experience. Cumulative AARP use over the previous 12-month period varied from 15 minutes to 10 hours. Participants identified a range of AARP benefits, such as being a source of knowledge and evidence, providing an overview of the patient journey, and providing resources. The AARP was used as a service improvement tool, a learning tool, and for accessing evidence, and was perceived to have direct and indirect impacts on knowledge and practice. Participants also recommended a number of enhancements to the AARP’s content and design to improve translation and clinical relevance, including updated recommendations, additional implementation resources, and improvements to layout and navigation. Conclusions The Australian Aphasia Rehabilitation Pathway was perceived as a valuable tool to inform evidence-based aphasia management. In order to remain relevant and useful, updated recommendations and links to clinically relevant resources are required. The suggested changes to content and design will inform an update of the AARP, which may in turn facilitate enhanced translation of evidence into practice and improve aphasia services.

No prescription? No problem: A qualitative study investigating self-medication with novel psychoactive substances (NPS).

The proliferation of Novel Psychoactive Substances (NPS) presents a challenge for global drug policy. The ease of online drug purchase and the emergence of the dark web have created new avenues for the growth of NPS. Despite the global nature of this issue, limited research has examined motivations of use. These include perceived safety or convenience, an interest in novel pharmacology and self-exploration. Recent evidence has suggested individuals may be self-medicating with NPS, however this phenomenon has yet to be thoroughly explored. This study aims to investigate the occurrence of NPS self-medication, identify the specific NPS involved, and understand the motivations behind their use. Discussions surrounding self-medication using NPS were collected between October 2022 and February 2023 via a content analysis of a Reddit community. Ninety-three threads, comprising 182,490 words and 5023 comments, were collected and cleaned. A frequency analysis was conducted to identify the NPS discussed, and data was analysed systematically through the process of iterative categorization (IC). Our study revealed frequent discussions about the self-medication with several NPS, notably etizolam, clonazolam, diclazepam, flualprazolam, 2-FMA, 4F-MPH, 3-FPM and 3-MeO-PCP. Individuals were mainly self-treating ADHD, anxiety and depression. Motivations for choosing NPS included access, cost, legality and a dissatisfaction with conventional healthcare. Substances were often chosen based on a profile of "Functionality" and outcomes varied. The use of clonazolam was highlighted as particularly problematic. The current study provides insight into the phenomenon of self-medication with NPS within an internet demographic, exploring the motivations behind why individuals choose NPS for a variety of disorders. The easy access to NPS and lack of scientific data pose a significant challenge for drug policy. Future policies should focus on improving healthcare providers knowledge of NPS use, removing barriers to adult ADHD diagnosis and rebuilding trust between individuals and addiction services.

Successes and challenges of primary health care in Australia: A scoping review and comparative analysis.

Australia has achieved universal health insurance for its population since 1975 - a major step forward for increasing access to primary care (PC). Nevertheless, there are reports of several multi-layered challenges, including inequity, that persist. This analysis aims to undertake a scoping review of the success, explanatory factors, and challenges of Primary Health Care (PHC) in Australia guided by the World Health Organization (WHO)-defined key characteristics of good PC. We searched PubMed, Embase, Scopus and Web of Science using key terms related to PHC principles, attributes, system functioning and health care delivery modalities. We also used key PC terminologies used to assess key characteristics of good PC developed by WHO and key terms and attributes from Australia's health care landscape. We then integrated our search terms with the PHC Search Filters developed by Brown, L., et al. (2014). We restricted the search from 2013 to 2021. Two authors independently assessed study eligibility and performed a quality check on the extracted data. We presented findings according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We identified 112 articles on primary health care (PHC), represented from all Australian states and territories. Overall, Australian PHC has achieved comprehensiveness, access and coverage, quality of care, patient / person centeredness and service coordination indicators with exemplary evidence-base practice/knowledge translation and clinical decision-making practices at the PC settings. Yet, we identified complex and multilayered barriers including geographic and socio-economic berries and inequality, staff dissatisfaction/turn over, low adoption of person-centred care, inadequate sectoral collaboration, and inadequate infrastructure in rural and remote primary care units. Primary health care in Australia, which has evolved through major reforms, has been adapting to the complex health care needs of the socio-culturally diversified nation, and has achieved many of the PC attributes, including service diversity, accessibility, acceptability, and quality of care. Yet, there are persistent gaps in service delivery to socio-economically disadvantaged populations, including indigenous people, culturally and linguistically diverse (CALD) populations, and rural- and remote-residents. These challenges could be mitigated through system-wide and targeted policy-level intervention to further improve service delivery through effective and functional local health service coordination, sectoral integration, and improving health care providers' cultural competence.

Special Report from the CDC: Provider knowledge and practices around driving safety and fall prevention screening and recommendations for their older adult patients, DocStyles 2019

Introduction: Falls and motor-vehicle crashes (MVCs) are leading causes of unintentional injury deaths among older adults (65+) in the United States. Injury prevention resources exist to help healthcare providers reduce fall and MVC risk among older adult patients. However, awareness of these resources among healthcare providers is unclear. Methods: Questions were included in the 2019 DocStyles survey that assessed healthcare provider awareness of three injury prevention resources: (1) the American Geriatrics Society’s (AGS’s) Clinician’s Guide to Assessing and Counseling Older Drivers, (2) the Clinical Assessment of Driving Related Skills (CADReS), and (3) the Centers for Disease Control and Prevention’s (CDC) Stopping Elderly Accidents, Deaths, and Injuries (STEADI) initiative. We also explored the circumstances and current practices for counseling older adult patients on fall prevention and driving safety. Results: Only 20% of providers reported awareness of any of the injury prevention resources. Providers were more likely to report either screening for fall risk or unsafe driving when an older adult presented with a fall concern (74.5%) or driving concern or recent crash (85.1%), compared to annual screening for fall risk (67.7%) or driving safety (47.7%). More providers reported discussing the increased fall or MVC risk associated with patient medications, referring patient for driving fitness evaluations, or discussing alternative transportation options with the patient after adverse events or patient-initiated concerns compared to routine annual discussions. Conclusion: Healthcare gaps persist in the screening and assessment of older adult risk factors for falls and unsafe driving. Limited provider awareness of clinical resources related to preventing older adult falls and unsafe driving may be contributing to these healthcare gaps. Practical Applications: Improving healthcare provider awareness of these resources could help them identify older adults at risk of a fall or MVC and promote injury prevention efforts in their clinical practices.

Establishing an International Interdisciplinary Research Network in Craniofacial Microsomia: The CARE Program.

Craniofacial microsomia (CFM) is a broad clinical term used to describe a congenital condition most commonly involving the underdevelopment of the external ear, mandible, soft tissues, and facial nerve. Despite medical advances, understanding of the psychological health and healthcare experiences of individuals with CFM and their caregivers remains limited. This article describes a research program designed to address these knowledge gaps, and identify opportunities for psychosocial intervention and improved healthcare provision. The Craniofacial microsomia: Accelerating Research and Education (CARE) research program aims to: 1) Conduct up to 160 narrative interviews with individuals and caregivers to validate a conceptual framework; 2) Administer an online international survey of up to 800 individuals with CFM and caregivers to identify predictors of psychological distress; 3) Perform up to 60 semi-structured interviews with healthcare providers and advocacy leaders to examine the extent to which current healthcare provisions address identified patient needs; and 4) Establish a participant registry to build a longitudinal database and develop an international community. Teams in the USA and UK have been established, alongside an international, interdisciplinary Advisory Committee. Data analysis for Aim 1 is ongoing and informing the delivery of Aims 2-3. Aim 4 is also in development. A dedicated website serves as a recruitment tool, educational resource, and mechanism for engaging with the CFM community. The CARE program provides a comprehensive approach to understanding the experiences of individuals with CFM and their caregivers. Challenges encountered and lessons learned are shared for the benefit of the community.

Healthcare Workers' Perceptions on the "SaferBirths Bundle of Care": A Qualitative Study.

Background: SaferBirths Bundle of Care (SBBC) is a package of innovative clinical and training tools coupled with low-dose high-frequency simulation-based on-job training guided by local data. This bundle of care is a new initiative being implemented in 30 health facilities from five regions of Tanzania aiming at improving birth outcomes. Objective: To assess the perception of healthcare workers and facility leaders on the "SaferBirths Bundle of Care" towards saving women's and newborns' lives at birth. Method: We used a qualitative approach using focused group discussion (FGD) and individual interviews. A total of 21 FGD and 43 individual interviews were conducted between August and November 2022. In total, 94 midwives and 12 doctors were involved, some of whom were in leadership roles. The framework method for the analysis of qualitative data was used for analysis. Results: Healthcare workers and facility leaders received the bundle well and regarded it as effective in saving lives and improving healthcare provision. Five themes emerged as facilitators to the acceptance of the bundle: (1) the bundle is appropriate to our needs, (2) the training modality and data use fit our context, (3) use of champions and periodic mentorship, (4) learning from our mistakes, and (5) clinical and training tools are of high quality but can be further improved. Conclusion: The relevance of SaferBirths Bundle of Care in addressing maternal and perinatal deaths, the quality and modality of training, and the culture that enhances learning from mistakes were among the facilitators of the acceptability of the SBBC. A well-accepted intervention has huge potential for bringing the intended impact in health provision.

Survey to measure the quality of life of patients with tuberculosis in Alexandria, Egypt: a cross-sectional study

BackgroundAssessment of quality of life (QoL) in patients with tuberculosis (TB) may improve healthcare providers’ understanding of the disease burden. This study aimed to investigate the QoL of patients with TB in Alexandria, Egypt.MethodsThis cross-sectional study was conducted in chest clinics and main chest hospitals in Alexandria, Egypt. A structured interview questionnaire was used to collect data from participants through face-to-face interviews from November 20, 2021, until the June 30, 2022. We included all adult patients aged 18 years or above during the intensive or continuation phase of treatment. The World Health Organization (WHO) WHOQOL-BREF instrument was used to measure QoL, which includes the physical, psychological, social relationships, and environmental health domains. Using propensity score matching, a group of TB free population was recruited from the same setting and completed the questionnaire.ResultsA total of 180 patients participated in the study: 74.4% were males, 54.4% were married, 60.0% were 18–40 years old, 83.3% lived in urban areas, 31.7% were illiterate, 69.5% reported insufficient income, and 10.0% had multidrug-resistant TB. The TB-free population group had higher QoL scores than the TB patients’ group: (65.0 ± 17.5 vs. 42.4 ± 17.8) for the physical domain, (59.2 ± 13.6 vs. 41.9 ± 15.1) for the psychological domain, (61.8 ± 19.9 vs. 50.3 ± 20.6) for the social domain, (56.3 ± 19.3 vs. 44.5 ± 12.8) for the environment domain, (4.0(3.0–4.0) vs. 3.0(2.0–4.0)) for general health, and (4.0(3.0–4.0) vs. 2.0(2.0–3.0)) for the general QoL, P < 0.0001. Patients with TB aged 18–30 years had the highest environmental score compared with the other age groups (P = 0.021).ConclusionsTB had a significant negative impact on QoL, with the physical and psychological domains being the most affected. This finding necessitates strategies to improve QoL of patients with to enhance their compliance to treatment.

The Impact of Extreme Heat Exposure on Pregnant People and Neonates: A State of the Science Review.

The relationship between heat exposure and perinatal morbidity and mortality is of increasing concern as global temperatures rise and extreme heat events become more frequent and intense. Heat exposure can lead to a multitude of harmful outcomes for pregnant individuals and neonates, including hospitalization and death. This state of the science review explored the evidence on the associations between heat exposure and negative health outcomes during pregnancy and the neonatal period. Findings suggest that improving health care provider and patient awareness of heat-related risks and implementing specific interventions could mitigate adverse outcomes. Furthermore, public health and other policy interventions are needed to increase thermal comfort and reduce societal exposure to extreme heat and related risks. Early warning systems, medical alerts, provider and patient education, and increased access to health care and thermal comfort may improve pregnancy and early life health outcomes.

Perspectives on Counseling Women of Reproductive Age About Emergency Preparedness by Primary Health Care Providers: DocStyles, United States, 2021 [ID: 1364512

INTRODUCTION: Pregnant, postpartum, and lactating women (PPLW) face unique challenges during disasters that may be mitigated by emergency preparedness. Health care providers have opportunities to counsel this population on emergency preparedness, but the extent of counseling has not been reported. Our objective is to report health care provider attitudes and practices related to counseling women of reproductive age (WRA), including PPLW, on emergency preparedness. METHODS: DocStyles, a web-based panel survey of a convenience sample of primary health care providers in the United States, was conducted from March 17 to May 17, 2021. Family practitioners, internists, obstetrician–gynecologists, nurse practitioners, and physician assistants were asked about importance of emergency preparedness counseling, confidence level of counseling, frequency of counseling, barriers to providing counseling, and preferred resources to support counseling among their WRA and PPLW patients. We calculated frequencies of provider attitudes and practices using R, version 4.0.3. RESULTS: Among 1,503 respondents, family practitioners (33%), internists (34%), obstetrician–gynecologists (17%), nurse practitioners (8%), and physician assistants (8%), 88% thought that emergency preparedness for keeping reproductive-aged patients safe, and counseling patients of reproductive age about emergency preparedness were both important. However, 45% of respondents were not confident in WRA emergency preparedness counseling, and most (70%) had never talked to PPLW about this topic. Respondents cited not having time during clinical visits (48%) and lack of preparedness knowledge (34%) as barriers. Most respondents (79%) stated they would use educational materials, especially fact sheets or brochures and patient text alerts. CONCLUSION: Emergency preparedness resources combined with training may improve health care provider confidence in counseling WRA and PPLW.

Documentary Short Film to Improve Healthcare Provider Understanding and Support of Family Caregivers of Individuals with Serious Illness: A Pilot Study with Medical Students (Sci225)

Documentary Short Film to Improve Healthcare Provider Understanding and Support of Family Caregivers of Individuals with Serious Illness: A Pilot Study with Medical Students (Sci225)

"How to start that conversation?": Experiences of developing a virtual simulation about sexual health care for breast cancer survivors.

Virtual simulation (VS) is an innovative and engaging knowledge translation strategy that can improve healthcare providers' knowledge and skills. However, there is no known literature published related to the use of simulation to improve cancer survivorship care. In this paper, we describe our experience of developing a VS to educate primary healthcare professionals about sexual health disturbances among breast cancer survivors. Based on literature in other contexts, this VS may help increase health professionals' knowledge and skills needed to assist breast cancer survivors with sexual health concerns. Our VS development experience can be used to encourage and guide other researchers planning to develop similar interventions in the future.

Norms and T-scores for screeners of alcohol use, depression and anxiety in the population of Suriname.

There is a considerable gap between care provision and the demand for care for common mental disorders in low-and-middle-income countries. Screening for these disorders, e.g., in primary care, will help to close this gap. However, appropriate norms and threshold values for screeners of common mental disorders are lacking. In a survey study, we gathered data on frequently used screeners for alcohol use disorders, (AUDIT), depression, (CES-D), and anxiety disorders (GAD-7, ACQ, and BSQ) in a representative sample from Suriname, a non-Latin American Caribbean country. A stratified sampling method was used by random selection of 2,863 respondents from 5 rural and 12 urban resorts. We established descriptive statistics of all scale scores and investigated unidimensionality. Furthermore, we compared scores by gender, age-group, and education level with t-test and Mann-Whitney U tests, using a significance level of p < 0.05. Norms and crosswalk tables were established for the conversion of raw scores into a common metric: T-scores. Furthermore, recommended cut-off values on the T-score metric for severity levels were compared with international cut-off values for raw scores on these screeners. The appropriateness of these cut-offs and the value of converting raw scores into T-scores are discussed. Cut-off values help with screening and early detection of those who are likely to have a common mental health disorder and may require treatment. Conversion of raw scores to a common metric in this study facilitates the interpretation of questionnaire results for clinicians and can improve health care provision through measurement-based care.

Challenges of having a child with congenital anomalies in Saudi Arabia: a qualitative exploration of mothers' experience.

Congenital anomalies in children lead to morbidity, mortality, or lifelong disabilities. Mothers of children with congenital anomalies face considerable obstacles in parenting their children because of their lack of knowledge about such health conditions, lack of family support, and lack of health, rehabilitation, and social care support. In Saudi Arabia, less attention are given to researching this important issue. In this context, the purpose of the study was to explore mothers' experiences and perceptions toward children with congenital anomalies. We employed a qualitative phenomenological study design. We purposively recruited 10 mothers of children with congenital anomalies from different cities in Saudi Arabia. We interviewed the mothers with an in-depth interview guideline. The interview questions were designed to explore their perception of congenital anomalies in children and their experience of parenting and seeking health, rehabilitation, education, and social care services for children with such anomalies. Analysis of our data suggest that mothers of children with congenital anomalies face considerable challenges because of a lack of medical, rehabilitation, and social care support, lack of knowledge about these conditions and their management, lack of responsiveness of the healthcare providers, lack of support from the family and the stigma associated with such conditions. Consequently, mothers experience poor mental and social well-being. Mothers are facing considerable challenges in raising children with congenital anomalies. Regular screening for early detection of congenital anomalies, counseling support for mothers, and improving healthcare providers' responsiveness, knowledge, and skills are necessary. In addition, appropriate awareness-raising programs need to be implemented at the community level to counteract the stigma and negative attitudes of the community toward children with congenital anomalies and their families.

Health Care Access and Lived Experience of American Indian/Alaska Native Two Spirit and LGBTQ+ Participants in the Pride and Connectedness Survey, 2020.

To better understand health experiences among Two Spirit and lesbian, gay, bisexual, transgender, and queer and questioning (LGBTQ+) American Indian/Alaska Native (AI/AN) people, we examined experiences with access to health care of 223 AI/AN Two Spirit and LGBTQ+ people. Participants of the Pride and Connectedness 2020 survey, conducted through the Northwest Portland Area Indian Health Board, were asked about barriers to seeking and accessing care through a 10-question scale. We compared cisgender and gender-diverse participant demographic and scale responses to explore potential differences based on gender identity using the Pearson χ2 test of independence and ordinal logistic regression, respectively. Both cisgender and gender-diverse participants experienced at least some difficulties accessing health care. Finances, lack of psychologists/other mental health support, and lack of psychological support groups for Two Spirit and LGBTQ+ communities were the top 3 barriers to care experienced by all participants (84%, 82%, and 80%, respectively). Compared with cisgender participants, gender-diverse participants were more likely to report difficulties accessing care for nearly all questions on the 10-question scale and nearly 3 times more likely to report fear of being mistreated within the health care system based on their gender identity (adjusted odds ratio = 2.9; 95% CI, 1.8-4.9; P < .001). Increased access to mental health services and improved health care provider training that focuses on culturally relevant and gender-affirming practices would benefit the health and well-being of AI/AN people who identify as Two Spirit and LGBTQ+.

Effectiveness of Training Program on Improving Health Care Providers' Readiness for Managing Domestic Violence in Jimma Medical Center: Pre-Experimental Study [Letter

Effectiveness of Training Program on Improving Health Care Providers' Readiness for Managing Domestic Violence in Jimma Medical Center: Pre-Experimental Study [Letter

Ein Update zu digitalen Interventionen in der Logopädie/Sprachtherapie

Due to the COVID-19 pandemic, digitalization in speech language therapy has progressed rapidly. Teletherapy, in particular, has become part of regular speech language therapy, as it has been reimbursed by German health insurance companies since March 2020. At the same time, political innovations such as the E-Health Act (E-Health-Gesetz, 2015), the Act to Improve Healthcare Provision through Digitalization and Innovation (Digital Healthcare Act – DVG, 2019), and the law on digital modernization of healthcare (DVPMG) (2021) offered new opportunities but also generate (future) tasks for speech and language therapists. For example, since the DVG was approved, applications (apps) can be prescribed by physicians and the statutory health insurance pays for them. In addition, speech language therapists are also to be connected to the telematics infrastructure starting in 2026. These and other digital innovations offer a variety of opportunities for improved care in speech language therapy but also incorporate new duties and responsibilities in the professional range of tasks of speech and language therapists. In order to be able to specify requirements and critically accompany (new) technological developments, it is highly relevant that speech language therapists acquire a critically reflected attitude towards digital technologies to acquire or expand digital competence. In addition, goal-oriented political frameworks and specifications are of enormous importance for successful implementation of digital technologies in speech language therapy Keywords: aphasia,

Effectiveness of Training Program on Improving Health Care Providers' Readiness for Managing Domestic Violence in Jimma Medical Center: Pre-Experimental Study.

Domestic violence (DV) is a pervasive human-right violation and is an impediment to the achievement of Sustainable Development Goals by 2030. Although they may not often disclose their violence, survivors of DV are most likely to be treated by health care providers. Thus, this study aimed to assess the effectiveness of training intervention in improving the readiness of health care providers for managing domestic violence in Jimma Medical Center. Pre-experimental study design was undertaken among 64 health care providers of Jimma Medical Center on two rounds from March 16 to 19 and from May 18 to 21/2022. Data were collected by using a structured self-administered questionnaire and entered into Epi-data version 4.6 and exported to SPSS version 23 for analysis. To test the difference in the participants' readiness to manage DV in terms of knowledge and attitude; a Paired-samples t-test analysis was done at 95%-confidence-interval and p-value <0.05. To quantify the magnitude of the intervention's effect, Eta-squared was computed as an effect size statistic. The overall knowledge score was improved from pre-intervention (M= 12.44, SD=4.55) to post-intervention (M=15.66, SD= 5.48, t(4.29), p<0.0005). The overall attitude score was improved from pre-intervention (M= 156.4, SD= 15.68) to post-intervention (M=169.1, SD=20.67, t(3.8), p<0.0005). The Eta-squared value for the knowledge was 0.23 and for the attitude was 0.19 both indicating a large effect size. Significant improvement in the study participants' readiness for managing DV was a result in this study with a large effect size. Thus, different concerned stakeholders should provide training intervention for health care providers of Jimma Medical center to improve their readiness to manage survivors of domestic violence thereby contributing to the reduction of the negative consequences that can be resulted from poor management of domestic violence.

Malnutrition among Hospitalized Children in the United States: A 2012-2019 Update of Annual Trends.

Malnutrition is associated with adverse clinical outcomes and increased health care utilization for hospitalized children. Yet pediatric malnutrition often goes undiagnosed and national prevalence research in this population is scarce. The aim was to assess change in the coded diagnosis of malnutrition (CDM) among US hospitalized children given increased awareness of the need for improved recognition and standardized diagnosis. Retrospective, cross-sectional analysis using nationally representative data from the Nationwide Inpatient Sample. Our sample was 13.2 million hospitalizations from 2012 to 2019 among pediatric patients between age 1 month and 17 years. CDM using International Classification of Diseases Ninth and 10th Revision-Clinical Modification diagnosis codes. Descriptive statistics and sampling weights were used to estimate the national frequency and prevalence of CDM. Temporal trends in CDM overall and stratified by age, race/ethnicity, and hospital type were analyzed using joinpoint regression. CDM prevalence increased from 3.9% in 2012 to 6.4% in 2019. During this period, failure to thrive decreased from 40.6% to 23.3% of all cases with concomitant increases in the diagnosis of protein-calorie malnutrition and children identified with more than one malnutrition subtype. Differences in CDM diagnoses are evident by hospital type, race/ethnicity, and age of the patient. Although pediatric malnutrition continues to be underdiagnosed in hospital settings, this study demonstrates improvement over time. There continues to be a need for continued professional education regarding best practices for diagnosis to improve health care provider knowledge and self-efficacy on this topic, especially in nonteaching hospitals.