Healthcare Knowledge Research Articles

The role of humans in the future of medicine: Completing the cycle

<p>The progression of Artificial Intelligence (AI) has reshaped our understanding of intelligence, consciousness, and the human condition, challenging long-held assumptions about the mind and its relationship with machines. Starting with Alan Turing’s Imitation Game, the narrative of assessment of AI has continually evolved. This historical context underlines the importance of moving beyond mere facts to confront philosophical questions about AI’s role and limitations, especially in its capacity for consciousness and emotional resonance. In healthcare, the evolution of AI reflects a transformative cycle. Historically, medicine began as an empathic endeavor, where caregivers provided comfort amid limited knowledge. Over centuries, advancements in science elevated physicians to authoritative figures, creating a paternalistic doctor-patient dynamic. Today, with the advent of AI and technologies like the metaverse, healthcare knowledge is becoming democratized. Patients can increasingly access AI-driven diagnostics and interactions, creating a potential era of “<em>algorithmic paternalism</em>” where machines dominate the knowledge hierarchy. Looking to the future, as AI assumes cognitive and diagnostic responsibilities, the human aspect of medicine will gain renewed importance. Physicians will return to their foundational role as empathic caregivers, focusing on human connection and emotional support—qualities that AI, despite its advances, cannot fully replicate today. This shift completes a historical cycle, reaffirming the enduring value of humanity in medicine and positioning the physician as a central figure in the emotionally nuanced landscape of healthcare.</p>

Improving care experiences for premenstrual symptoms and disorders in the United Kingdom (UK): a mixed-methods approach

BackgroundPoor care experiences are reported for premenstrual disorders, which may result in negative outcomes such as distress, reduced healthcare engagement, and delays to diagnosis. This research aimed to explore healthcare experiences for premenstrual symptoms in the United Kingdom and identify areas for potential improvements based on participant responses.MethodAn online survey was delivered, with participants recruited via social media. Experiences of care were explored using quantitative and qualitative questions. Quantitative data were explored using descriptive statistics, with group differences investigated using Mann–Whitney U tests and chi-square tests as appropriate. Qualitative data regarding care improvements was explored using inductive thematic analysis.ResultsThe sample included 339 participants who completed at least 97% of the survey, reported premenstrual symptoms in consecutive cycles, and had sought formal help for these symptoms. Mean age was 34.66 (SD = 5.88), with the majority identifying as women (n = 332, 97.94%) and white/Caucasian (n = 311, 91.74%). 75.22% (n = 255) felt that care was poor. 44.25% (n = 150) felt their symptoms were not taken seriously. 37.76% perceived a lack of healthcare professional knowledge (n = 128). The majority did not receive recommendations of non-formal sources of help (i.e., websites, support groups; 84.96%, n = 288) or lifestyle changes (74.63%, n = 253). Better care experiences were associated with healthcare professionals taking symptoms seriously (U = 1383.00, p < .001), higher perceived healthcare professional knowledge (U = 1370.50, p < .001), and receiving recommendations of non-formal sources of help (X2 = 48.251, df = 1, p < .001, Φc = .382) or lifestyle changes (X2 = 7.849, df = 1, p = .005, Φc = .152). Thematic analysis revealed 8 aspects of care improvement: Empathetic care provision; Healthcare professional education, understanding, and research; Comprehensive symptom assessment and investigations; Diagnosis; Professional support and treatment provision; Signposting or referral to additional resources or sources of help; Wider healthcare system improvements; and Patient role/voice and preferences.ConclusionsPoor care experiences for premenstrual symptoms in the UK are characterised by dismissive attitudes and perceived lack of knowledge. Improved training provision for healthcare professionals is required to address this and other aspects of care identified by qualitative analysis. However, research is needed to identify appropriate methods to deliver training. Utilisation of standardised screening tools and patient-centred communication will likely ensure comprehensive assessments and reduce self-advocacy burdens.

Being in a position to know: attuned responsiveness as the hallmark of experiential knowledge and expertise in mental healthcare

Inclusion of people with lived experience into various mental healthcare settings is rapidly increasing. In this article we explicate and address two challenges that hinder this development. First, a descriptive challenge: what is the unique and complementary epistemic contribution of people with lived experience in mental healthcare, precisely? Second, a normative challenge: how to evaluate these contributions of people with lived experience to mental healthcare? To address these challenges, we propose a novel conceptual ‘lens’ through which to understand the epistemic contributions of people with lived experience. Our approach diverges from the orthodox view by not construing these contributions in terms of (experiential) knowledge, but in terms of perceptual and agential skills which put people with lived experience in a unique ‘position to know’. More specifically, we reckon that such contributions are best understood in terms of what we call ‘responsiveness’ and ‘attunement’. The main goal of this paper is to show how the ‘Attuned Responsiveness’-Framework allows us to satisfactorily address the descriptive and normative challenge, thereby providing the practice of expertise-by-experience in mental healthcare with a more solid conceptual basis.

Challenges to Cardiovascular Health Among Female U.S. Veterans and Future Implications: A Scoping Review.

Cardiovascular disease (CVD) is the leading cause of death for women in the United States, and U.S. female Veterans have higher rates of CVD compared to civilian women. With an increasing number of women joining the military, the number of female Veterans is expected to rise; therefore, providing appropriate cardiovascular care must be a top priority for the DoD and the Veterans Health Administration (VHA). This scoping review will answer the question: "Among U.S. female Veterans, what are the challenges faced in cardiovascular health, and what are potential future implications and interventions?" We designed this scoping review to identify common themes and gaps in the literature, guide further investigations, and contribute to developing targeted interventions and policies to enhance cardiovascular outcomes among female Veterans. On May 1, 2024, a modified PRISMA-ScR search was performed using the following online databases: PubMed, CINAHL, and OVID. The inclusion criteria included U.S. female Veterans, CVD, and data collected from VHA database sources. Results from any literature source published in the past 10 years and written in English were considered. The search identified 107 studies. Two independent reviewers screened titles and abstracts and then performed full-text reviews. We identified 34 studies assessing challenges to cardiovascular care among female Veterans in areas of racial/ethnic and gender-specific disparities regarding the prevalence of nontraditional CVD risk factors, access to health care services, awareness and knowledge of CVD risk factors, and willingness to receive cardiovascular care. The review also identified potential areas for improvement initiatives in education, peer support, and future research. This review highlighted 3 main challenges female Veterans face in accessing CVD care from the VHA: perceived barriers, unique risk factors, and gender/racial disparities. It emphasized the need for improved CVD research, screening, education, and social support for female Veterans. The authors propose two main strategies to address these challenges: (1) pre-transition education from the DoD and (2) enhanced CVD training in the VHA. Cardiovascular disease risk factor recognition and prevention education should occur in military settings, allowing medical providers in DoD clinics to engage female service members in discussions and screenings before transitioning to VHA care. The VHA should educate providers on the barriers female Veterans face, the identification of nontraditional risk factors, and existing health care disparities. Additionally, it should continue to support successful initiatives focused on improving CVD care for female Veterans, such as the Women's Health Research Network, the Quality Enhancement Research Initiative, and the Enhancing Mental and Physical Health of Women through Engagement and Retention program.

Proficiency, Clarity, and Objectivity of Large Language Models Versus Specialists' Knowledge on COVID-19 Impacts in Pregnancy: A Cross-Sectional Pilot Study.

The COVID-19 pandemic has significantly strained healthcare systems globally, leading to an overwhelming influx of patients and exacerbating resource limitations. Concurrently, an "infodemic" of misinformation, particularly prevalent in women's health, has emerged. This challenge has been pivotal for healthcare providers, especially gynecologists and obstetricians, in managing pregnant women's health. The pandemic heightened risks for pregnant women from COVID-19, necessitating balanced advice from specialists on vaccine safety versus known risks. Additionally, the advent of generative Artificial Intelligence (AI), such as large language models (LLMs), offers promising support in healthcare. However, they necessitate rigorous testing. To assess LLMs' proficiency, clarity, and objectivity regarding COVID-19 impacts in pregnancy. This study evaluates four major AI prototypes (ChatGPT-3.5, ChatGPT-4, Microsoft Copilot, and Google Bard) using zero-shot prompts in a questionnaire validated among 159 Israeli gynecologists and obstetricians. The questionnaire assesses proficiency in providing accurate information on COVID-19 in relation to pregnancy. Text-mining, sentiment analysis, and readability (Flesch-Kincaid grade level and Flesch Reading Ease Score) were also conducted. In terms of LLMs' knowledge, ChatGPT-4 and Microsoft Copilot each scored 97% (n=32/33), Google Bard 94% (n=31/33), and ChatGPT-3.5 82% (n=27/33). ChatGPT-4 incorrectly stated an increased risk of miscarriage due to COVID-19. Google Bard and Microsoft Copilot had minor inaccuracies concerning COVID-19 transmission and complications. At the sentiment analysis, Microsoft Copilot achieved the least negative score (-4), followed by ChatGPT-4 (-6) and Google Bard ( -7), while ChatGPT-3.5 obtained the most negative score (-12). Finally, concerning the readability analysis, Flesch-Kincaid Grade Level and Flesch Reading Ease Score showed that Microsoft Copilot was the most accessible at 9.9 and 49, followed by ChatGPT-4 at 12.4 and 37.1, while ChatGPT-3.5 (12.9 and 35.6) and Google Bard (12.9 and 35.8) generated particularly complex responses. The study highlights varying knowledge levels of LLMs in relation to COVID-19 and pregnancy. ChatGPT-3.5 showed the least knowledge and alignment with scientific evidence. Readability and complexity analyses suggest that each AI's approach was tailored to specific audiences, with ChatGPT versions being more suitable for specialized readers and Microsoft Copilot for the general public. Sentiment analysis revealed notable variations in the way LLMs communicated critical information, underscoring the essential role of neutral and objective healthcare communication in ensuring that pregnant women, particularly vulnerable during the COVID-19 pandemic, receive accurate and reassuring guidance. Overall, ChatGPT-4, Microsoft Copilot, and Google Bard generally provided accurate, updated information on COVID-19 and vaccines in maternal and fetal health, aligning with health guidelines. The study demonstrated the potential role of AI in supplementing healthcare knowledge, with a need for continuous updating and verification of AI knowledge bases. The choice of AI tool should consider the target audience and required information detail level.

Awareness and Knowledge About Preconception Healthcare: A Cross-Sectional Study of Early Years UAE Medical Students.

Background: Preconception health is critical for improving maternal and child health. The main objective of the study was to explore medical students' health habits, quality of life, and knowledge of preconception healthcare. Methods: We conducted a cross-sectional study between 15 March 2023 and 31 May 2024 among medical students at United Arab Emirates University. To determine awareness and knowledge of preconception health, we administered a survey consisting of an author's questionnaire with 35 questions covering sociodemographic characteristics and general knowledge of preconception health, as well as the WHO Quality of Life Scale-BREF (WHOQOL-BREF). Results: The participants were predominantly under 25 years old (98.5%), Emirati (91.1%), single (92.6%), and female (95.8%); only 3.4% had been pregnant before. Regarding health awareness and behaviors, a significant number of females (58.0%) had never visited a gynecologist. The majority of students (72.4%) participated in sports activities. The overall level of knowledge was low, with a mean level of 7.5 (SD = 6.36) out of 24. The Internet (webpages, blogs, webinars) (64.5%) was the major source of knowledge regarding healthcare information, followed by social media platforms (Twitter, Facebook, TikTok, Instagram) and mobile applications (57.5%), books (48.6%), and family members (57.0%). There was a statistically significant correlation between knowledge levels and the Internet (p < 0.004) or family (p < 0.001) as a source of knowledge. Additionally, there was a statistically significant positive correlation between knowledge and quality of life across all four WHOQOL domains. Conclusions: Medical knowledge might positively affect general well-being. Fostering stronger social networks and support systems could benefit preconceptional awareness and knowledge.

Mixed-methods multicenter assessment of healthcare workers' knowledge, perceptions, and practices related to blood culture utilization in hospitalized adults.

To understand healthcare workers' (HCWs) beliefs and practices toward blood culture (BCx) use. Cross-sectional electronic survey and semi-structured interviews. Academic hospitals in the United States. HCWs involved in BCx ordering and collection in adult intensive care units (ICU) and wards. We administered an anonymous electronic survey to HCWs and conducted semi-structured interviews with unit staff and quality improvement (QI) leaders in these institutions to understand their perspectives regarding BCx stewardship between February and November 2023. Of 314 HCWs who responded to the survey, most (67.4%) were physicians and were involved in BCx ordering (82.3%). Most survey respondents reported that clinicians had a low threshold to culture patients for fever (84.4%) and agreed they could safely reduce the number of BCx obtained in their units (65%). However, only half of them believed BCx was overused. Although most made BCx decisions as a team (74.1%), a minority reported these team discussions occurred daily (42.4%). A third of respondents reported not usually collecting the correct volume per BCx bottle, half were unaware of the improved sensitivity of 2 BCx sets, and most were unsure of the nationally recommended BCx contamination threshold (87.5%). Knowledge regarding the utility of BCx for common infections was limited. HCWs' understanding of best collection practices and yield of BCx was limited.

Barriers and supports for Indigenous youth and young adults with childhood- onset chronic health conditions transitioning from pediatric to adult healthcare: a qualitative study

BackgroundThis study examined the experiences of Indigenous youth and young adults with pediatric onset chronic health conditions who had or were about to transition from pediatric to adult healthcare services. Transition is the process by which youth develop the knowledge and self-management skills needed to manage their health condition, ideally beginning around age 12–13 and continuing until the mid-20s. There is a growing body of literature on healthcare transition, but there is an absence of literature on Indigenous youth, who face additional barriers to accessing healthcare relative to non-Indigenous Canadians. The primary objective of this study was to identify the supports and barriers for Indigenous youth with childhood-onset chronic health conditions transitioning from pediatric to adult healthcare services.MethodsThe research was done in the province of Alberta, Canada, in collaboration with a Community Advisory Committee comprised of Indigenous healthcare providers, Elders and Knowledge Keepers and guided by a community-based participatory research approach. Semi-structured qualitative interviews (n = 46) were conducted with Indigenous youth, caregivers, and healthcare providers. There were three Talking Circles, two for youth (9 participants) and one for caregivers (6 participants). Three research assistants coded the transcripts thematically using NVivo. The key findings were presented to the Community Advisory Committee for feedback to validate the interpretation of the qualitative data.ResultsThe thematic findings include: (1) systemic inequalities exacerbate gaps in healthcare; (2) intergenerational trauma created unique barriers for Indigenous youth; (3) long-term relationships with care providers as a protective factor; (4) the incorporation of Indigenous worldviews into healthcare services to aid transition; and (5) assuming new responsibilities as an adult. The participants provided recommendations to improve healthcare service delivery including the need for Indigenous transition supports in community and improving education for healthcare practitioners about transition and Indigenous worldviews.ConclusionThis study demonstrates the complexity of the transition experience for Indigenous youth with pediatric onset chronic health conditions. The identified barriers to successful transition could be addressed through systems level changes and the development of Indigenous specific transition support services. Such approaches need to be Indigenous-led and incorporate Indigenous culture, language, and teachings.

Knowledge about handling hazardous materials as factors associated with adherence to healthcare waste management practices among waste handlers at government district hospitals of Madhesh province, Nepal: A quantitative-qualitative methods study.

Healthcare Waste (HCW) is a special waste produced in healthcare institutions, including hospitals. It has a high potential for infection and injuries. The issue of waste disposal is growing as the number of hospitals, clinics, and diagnostic laboratories in Nepal continues to increase. The study aimed to assess the adherence to healthcare waste management (HCWM) practices and knowledge among waste handlers at the government district hospitals of Madhesh Province of Nepal which lies in the southern part of the country. A cross-sectional mixed-method study design was employed to assess the adherence of healthcare waste management practices and knowledge of healthcare waste management guideline among HCW handlers from 10 district-level hospitals in Madhesh Province. We developed a semi-structured questionnaire from Nepal's National HCWM Guideline 2014 and the World Health Organization HCWM Rapid Assessment Tool 2011, to interview 60 HCW handlers for quantitative information. Then 10 key informant interviews were conducted using KII guidelines with related stakeholders of district hospitals of Madhesh Province. A four-point Likert scale was used to assess the practices and knowledge of HCW handlers and health facility-related factors. Descriptive data analysis was presented in tables for frequency, percentage, mean, and standard deviation, and correlation was presented in Graphs. A thematic analysis was performed for qualitative data by using RQDA and discussing the findings before concluding the study. Among the sixty participants, the median age was thirty-five years while thirty percent were less than the median age. Among total participants, the majority of female were 65% and almost all of them (96.67%) were married. The majority (65%) were females and almost all (96.67%) were married. About one-third (36.67%) of participants were illiterate. Most of the participants had experience of 5 to 10 years. The mean adherence of HCWM was 74.88±9.66 SD. Among the participants, half of them had adequate knowledge while the median knowledge of HCWM was 39 and the inter-quartile range was 5 (q3 = 41, q1 = 36). The mean of the HCWM practice was 24.18±5.96. The median of health facilities-related factors was 13 and the interquartile range was 3 (q3 = 15 and q1 = 12). The full adherence to HCWM guideline 2014 was extremely low among healthcare waste handlers. The HCWs had less adequate knowledge of HCWM and they did not practice to manage HCW adequately in district hospitals. However, the hospitals had adequately provided amenities to manage healthcare waste.

Health Care Workers' Attitudes Toward and Knowledge of the Clinical Application of Classic Psychedelics for People with Serious Illness: A Systematic Review.

Background: Recent research indicates that psychedelic-assisted therapy (PAT) may be a safe and effective treatment for several psychiatric disorders, including those experienced by people with serious physical illness. Understanding health care workers' (HCWs') attitudes and knowledge about the clinical application of psychedelics for patients with serious illness is important in progressing research and identifying factors to consider in potential future implementation of PAT. Aim: The aim of this systematic review was to synthesize quantitative, qualitative, and mixed methods studies that explored HCWs' attitudes and knowledge about the role of psychedelics in treating psychological distress in patients with serious illness. Design: MEDLINE, PsycInfo, and CINAHL were searched for quantitative, qualitative, or mixed methods primary empirical studies, published in English from 2006 onward. Two reviewers independently screened articles for inclusion. The Joanna Briggs Institute (JBI) convergent approach to mixed methods systematic reviews guided synthesis of the findings of included studies. One reviewer extracted data from included studies which was checked for accuracy by another reviewer. Two reviewers independently critically appraised included studies using JBI critical appraisal tools. Results: The review included nine studies (seven qualitative, two quantitative) conducted in four countries. Five themes were developed: Polarized views about PAT for patients with serious illness; attitudes often informed by PAT research knowledge and heuristic methods; stronger evidence base needed to increase HCWs' confidence and support implementation of PAT; barriers may hinder PAT's potential integration into existing care models; and team-based approach and clinical education are essential to facilitate PAT. Conclusion: Although support for PAT varied, most HCWs perceived potential benefits in treating refractory distress, desired education about PAT, and called for further research to develop a stronger evidence base. Limitations of the review and included studies are discussed, along with implications of the findings and recommendations for future research.

SECOND SOUTHERN SCIENCE CONFERENCE: HEALTH SESSIONS

The Second Southern Science Conference brought together international researchers focused on health and diseases. The event featured expert lectures across various fields, including cell biology, neurobiology, immunology, and pharmacology. Notable presentations covered new tools for cell biology research, such as the RUSH and RUCH systems, which enable studying protein trafficking in cells. In microbiology, key topics included antibiotic resistance and bacterial and viral infections. In neurobiology, researchers presented advances in treating neurodegenerative diseases, including the use of nanoparticles for drug delivery. The conference also addressed immunology issues, such as COVID-19 vaccination effects, and aspects of diet in cell physiology. The event concluded with a lecture on academic entrepreneurship, demonstrating how research can be transformed into commercial products. The conference, hosted at the Universidad de Mendoza, provided a unique opportunity for sharing scientific knowledge and advances in healthcare, with the next edition scheduled for 2026.

Identifying key factors for recurrence of genetic disorder: insights from Indian families with multiple affected children.

This study investigates the factors contributing to the recurrence of severe genetic conditions in multiple children of the same couple, focusing on a cohort of 26 families who had more than one child affected by the same genetic disorder. Conducted at a genetic clinic in India, the study employed a qualitative methodology guided by COREQ guidelines, using semi-structured interviews to explore the interplay of individual beliefs, healthcare provider practices, and systemic healthcare inefficiencies. The interviews were transcribed and analyzed using a combination of content analysis and grounded theory, which allowed for the identification of recurrent themes and emerging ideas. The study found that strong religious and cultural beliefs often led families to disregard medical advice, contributing to the recurrence of genetic conditions. Additionally, significant gaps in healthcare provider knowledge and inadequate reproductive counseling were identified as critical barriers to timely diagnosis and prevention of recurrence. Another major theme was the inherent complexities of genetic diseases and genetic testing, where variable expression of conditions, delayed symptom onset, and limitations of genetic tests themselves often prevented early diagnosis and intervention. This research highlights the need for improved genetic literacy among healthcare providers, culturally sensitive counseling, and better integration of genetic services into the broader healthcare system. By addressing these barriers, the risk of recurrence can be significantly reduced, improving patient outcomes and family well-being. This study is one of the few in India to analyze such factors and underscore the critical need for targeted interventions at multiple levels.

Knowledge and Experiences of Oral Health Care and Periodontitis of Caregivers of Older Adults With Cognitive Impairment.

There is limited evidence on knowledge of related health among healthcare personnel who care for older adults. The objective of this study was to investigate the knowledge and experience of oral health care among family members and medical staff responsible for older adults with varying degrees of cognitive impairment and Alzheimer's disease. This qualitative study explored the experiences and knowledge of 30 family members and medical staff through in-depth, semi-structured interviews. The interviews were recorded using both audio and video formats: digital platforms were used for immediate family members, while formal caregivers were interviewed in person. Researchers transcribed and analysed the recordings, categorising the answers to identify emerging topics until reaching saturation. The core emerging themes among the direct family members were: (1) Lack of knowledge about oral health; (2) Oral hygiene role for the patients; (3) Consequences of a poor oral care; and (4) Recommendations for a better oral health care. For the formal caregivers the emerging themes were: (1) Lack of knowledge and experiences about oral health; (2) Deficient oral hygiene of residents; (3) Impact on quality of life; and (4) Suggestions for improving oral health. Despite recognising the significance of oral health, direct family members and formal caregivers of older adults with cognitive impairment or dementia still need additional tools to effectively carry out necessary hygiene techniques and care.

Focus on patient perspectives in climate action policies for healthcare. A German survey analysis on what patients are willing to do.

The healthcare sector, while dedicated to improving health, paradoxically contributes significantly to global carbon emissions, accounting for approximately 4.9% of global emissions. Despite growing public concern about climate change, few studies have explored patients' awareness and attitudes toward the environmental impact of healthcare. This study aims to assess patients' perspectives on climate change and the sustainability of healthcare practices. A cross-sectional survey was conducted at Ludwig-Maximilians-University (LMU) Hospital in Munich, Germany. Patients were invited to participate in a voluntary, anonymous online survey via strategically placed QR codes throughout the hospital. The survey explored patients' demographic information, environmental awareness, attitudes toward climate-friendly practices in healthcare, and willingness to support sustainable initiatives. Descriptive statistics and regression analyses were used to analyze the data. A total of 399 patients completed the survey (87% completion rate). The majority of respondents (92.3%) were aware of climate change, and 82.7% reported prioritizing climate-friendly practices in their personal lives. However, 55.9% of respondents were unaware of the healthcare system's contribution to carbon emissions, and only 18.3% knew about hospitals' climate impact. Despite this, 88.2% of respondents supported environmentally friendly initiatives in hospitals, and 86.5% were open to sustainable alternatives, provided that quality standards were maintained. Participants expressed significant interest in knowing the environmental impact of their treatments, with 63.2% in favor of a Nutri-Score-like system that would display the carbon footprint of medical procedures. Among those, 54.4% indicated that such a system would influence their choice of treatment. Similarly, 62.2% of respondents were interested in knowing the environmental impact of their medications, with 65% reporting that this information would affect their medication choices. A notable proportion of patients (66.2%) indicated willingness to support sustainable healthcare through shorter hospital stays and increased follow-up visits, while 35.8% were open to paying a CO2 compensation fee for their treatments. However, 81% were unwilling to pay higher insurance premiums to support environmentally friendly practices in hospitals. Regression analyses revealed that older age groups and having children were positively associated with environmental awareness (p < 0.05). However, factors such as gender, education level, relationship status, and illness severity did not significantly impact environmental attitudes. There was a significant correlation between patients' environmental friendliness and their readiness to take climate-protective actions (p < 0.001). The study highlights a gap between patients' environmental awareness and their knowledge of healthcare's carbon footprint. While patients are generally supportive of sustainable practices in healthcare, their willingness to act diminishes when personal costs or discomfort are involved. A coordinated approach involving policy changes, patient education, and market innovations is essential to promote sustainable practices in healthcare without compromising patient care quality. Further research is needed to explore strategies for bridging the gap between environmental awareness and action in healthcare settings.

Transforming Alzheimer's Digital Caregiving through Large Language Models.

Alzheimer's Disease and Related Dementias (AD/ADRD) present significant caregiving challenges, with increasing burdens on informal caregivers. This study examines the potential of AI-driven Large Language Models (LLMs) in developing digital caregiving strategies for AD/ADRD. The objectives include analyzing existing caregiving education materials (CEMs) and mobile application descriptions (MADs) and aligning key caregiving tasks with digital functions across different stages of disease progression. We analyzed 38 CEMs from the National Library of Medicine's MedlinePlus, along with associated hyperlinked web resources, and 57 MADs focused on AD digital caregiving. Using ChatGPT 3.5, essential caregiving tasks were extracted and matched with digital functionalities suitable for each stage of AD progression, while also highlighting digital literacy requirements for caregivers. The analysis categorizes AD caregiving into 4 stages-Pre-Clinical, Mild, Moderate, and Severe-identifying key tasks, such as behavior monitoring, daily assistance, direct supervision, and ensuring a safe environment. These tasks were supported by digital aids, including memory- enhancing apps, Global Positioning System (GPS) tracking, voice-controlled devices, and advanced GPS tracking for comprehensive care. Additionally, 6 essential digital literacy skills for AD/ADRD caregiving were identified: basic digital skills, communication, information management, safety and privacy, healthcare knowledge, and caregiver coordination, highlighting the need for tailored training. The findings advocate for an LLM-driven strategy in designing digital caregiving interventions, particularly emphasizing a novel paradigm in AD/ADRD support, offering adaptive assistance that evolves with caregivers' needs, thereby enhancing their shared decision-making and patient care capabilities.

Inequality in Reproductive Health Care and Medical Research Knowledge in The Welkin by Lucy Kirkwood

Inequality in Reproductive Health Care and Medical Research Knowledge in The Welkin by Lucy Kirkwood

How accurately can ChatGPT 3.5 answer frequently asked questions by patients on glenohumeral osteoarthritis?

Abstract Background Conversational artificial intelligence (AI) systems like ChatGPT have emerged as valuable assets in providing accessible information across various domains, including the healthcare system. The use of ChatGPT may contribute to better patient education and better general healthcare knowledge. However, there is a paucity of data on the reliability of responses generated by ChatGPT in the context of specific medical diagnoses. Methods We identified 12 frequently asked questions by patients about glenohumeral osteoarthritis. These questions were formulated in both English and German, using common and medical terms for the condition, thus creating four groups for evaluation. The questions were then presented to ChatGPT 3.5. The generated responses were evaluated for accuracy by four independent orthopedic and trauma surgery consultants using a Likert scale (0 = fully inaccurate to 4 = fully accurate). Results Although there were two questions in two groups, all questions across all versions were answered with good accuracy by ChatGPT 3.5. The highest score on the Likert scale was 3.9 for the group where questions were posed in English using the medical term “glenohumeral osteoarthritis.” The lowest score of 3.2 was for the group where questions were posed in English using the common term “shoulder arthrosis.” On average, questions in English received a score of 3.5 on the Likert scale, slightly higher than those in German, which received a score of 3.4. Conclusion ChatGPT 3.5 can already provide accurate responses to patients’ frequently asked questions on glenohumeral osteoarthritis. ChatGPT can therefore be a valuable tool for patient communication and education in the field of orthopedics. Further studies, however, have to be performed in order to fully understand the mechanisms and impact of ChatGPT in the field.

Cross sectional survey of maternal and newborn quality of care in Niger: Selected findings, lessons learned and recommendations.

Comprehensive assessments of quality of care (QoC) are essential for monitoring progress towards meeting global and national maternal and newborn health (MNH) targets. Liverpool School of Tropical Medicine (LSTM) and the Niger Ministry of Public Health adapted a 2014 WHO QoC tool to cover antenatal care (ANC) and postnatal care (PNC) and include client voices through exit interviews. The objectives of the study were to assess quality of MNH care in Niger and to document lessons learnt from implementing the LSTM QoC tool. Quality of Care (QoC) was assessed using five tools: health facility survey (using register and official record data), partograph reviews, healthcare provider knowledge assessment, exit interviews with clients, and observation of antenatal and postnatal care. A nationally representative sample of 110 public healthcare facilities at three levels (integrated health centres, district hospitals and mother-child hospitals) and 2153 women were included. Descriptive analysis with 95% confidence intervals was presented. The health facility survey showed variable access to electricity (63% [53-72]), water (72% [62-81]), and transportation (40% [31-50]). Tests and treatment for HIV, TB, and malaria were found in more than 90% of relevant facilities. During observation of first ANC visit, 62% [48-74] women were tested for HIV; 13% [5-30] for pre-eclampsia and 22% [12-36] for anaemia. Observation of PNC showed much lower rates of screening (15% [7-27] tested for HIV and 4% [0;11] for malaria). Partographs were used in 86% of deliveries with inconsistent completion. At client interviews, respectful care indicators were variable, with providers not always explaining results to clients (59% [50-67]). Targeted allocation of resources and training could impact on QoC and reduce missed opportunities for prevention, screening and management of diseases among pregnant women and babies. The QoC assessment tool proved capable of offering a comprehensive overview of priorities in MNH, while maintaining feasibility in the Nigerien context.

Impact of the COVID-19 pandemic on medical office assistants (MOAs) Working in Primary Care: A Qualitative Study.

Medical Office Assistants (MOAs), also known as receptionists and clerks, are front line workers and the most accessible member of the primary care team. Historically, their contributions to primary care have been unrecognised and undervalued. The COVID-19 pandemic put pressure on existing roles and systems in primary care: how MOAs adapted is unknown. To explore the experiences of MOAs working in primary care during the COVID-19 pandemic from the perspectives of MOAs and family physicians (FPs) who worked with MOAs during this period. A qualitative study using Constructivist Grounded Theory, conducted in Ontario, Canada METHOD: Seventeen participants were recruited through professional contacts of the research team. Individual semi-structured interviews were conducted with MOAs and FPs across the province. MOAs' many responsibilities in primary care intensified during the pandemic. MOAs leveraged their healthcare system knowledge and therapeutic relationships with patients to reduce patient distress. Unfortunately, MOAs experienced more frustration, and in some cases, abuse from patients. MOAs' ability to adapt to new systems and respond to high patient needs seemed to be positively influenced by their relationships with patients and FPs. FPs expressed concern for MOA welfare and recognised their critical role on primary care teams. MOAs made significant contributions to primary care during the COVID-19 pandemic. This study suggests MOAs have greater capacity than previously recognised which has important implications for planning in an era of under-resourced healthcare.

I had to tell to survive“- a cross-sectional study on exposure to intimate partner violence in pregnant women and the importance of screening

BackgroundThere is a lack of knowledge in Swedish healthcare regarding correlations of exposure to intimate partner violence (IPV) from before to during pregnancy, and associated factors as well as pregnant women’s perceptions related to screening for IPV in healthcare settings. The frequency of women exposed to IPV during pregnancy is difficult to establish as it is reported at different rates across different studies, depending on the definitions and screening strategies used. Aims1. Describe prevalence of IPV experienced by pregnant women. 2. Investigate changes in IPV exposure before and during pregnancy. 3. Examine frequency of screening and women’s opportunities and willingness to talk about IPV exposure. Methods.A cross-sectional survey in Stockholm, Sweden. Findings6.2 % of women (n = 202) reported exposure to IPV before pregnancy and 2.1 % (n = 72) reported exposure during pregnancy, of these, sixteen women reported exposure only during pregnancy. There were significant associations between exposure to IPV and symptoms of depression, age, living situations and employment status. Sixty-four percent of the exposed women were asked about violence in healthcare settings. DiscussionAn important finding was that the frequency of IPV decreased from before to during pregnancy. The reasons for this are unknown but may be multi-factorial. ConclusionOur investigation provides crucial insights into IPV during pregnancy. Results highlight that relying solely on prevalence rates is inadequate to understand the complexity of IPV exposure related to pregnancy. Screening for IPV and understanding how women perceive and disclose their exposure is complex yet vital for midwives in antenatal care.