Care Outcomes Research Articles

A systematic review of racial health disparities among children and youth with physical disabilities.

Children and youth who belong to a racially minoritized group commonly experience multiple and complex forms of discrimination and health disparities. The purpose of this review was to explore racial disparities in health care and health outcomes among children and youth with physical disabilities. Six international databases (Ovid Medline, Healthstar, Embase, PsycINFO, Scopus, and Web of Science) were searched and screened for inclusion. A narrative synthesis was used to identify the common trends. Thirty-seven articles met the inclusion criteria, which involved 218555 children and youth with various types of physical disabilities spanning over 29years. We noted the following trends: (1) racial disparities in accessing or receiving care; (2) racial disparities in health outcomes and mortality rates; and (3) factors affecting racial disparities. Most studies reported at least one finding indicating that racially minoritized youth had differential access to care and/or disparities in health outcomes compared to white youth. Our findings highlight the concerning racial disparities among children and youth with physical disabilities within health care. There is an urgent need for advocacy and interventions at multiple levels to address the perpetual racism and racial disparities that racially minoritized youth with physical disabilities experience.Implications for rehabilitationThere is an urgent need for health care leaders and health care providers to address the systemic health inequalities in rehabilitation for racially minoritized children and youth with physical disabilities.Health care leaders and clinicians should recognize the racial disparities that racially minoritized youth with physical disabilities encounter in accessing or receiving care in addition to health outcomes.Health care leaders and decision-makers should advocate for policy change to optimize equitable and inclusive health care to enhance the well-being of racially minoritized children with disabilities.Health care providers should engage in training to understand how to recognize and address how intersectional forms of a child's identity such as disability, race, and socio-economic status can influence health care experiences and health outcomes.

The importance of continuing education in dentistry

Continuing education is vital for maintaining excellence in dentistry, enabling practitioners to refine clinical skills, integrate emerging technologies, and enhance patient outcomes. In an ever-evolving field, staying updated with advancements such as digital workflows, artificial intelligence (AI) -powered diagnostics, and minimally invasive procedures ensures that dentists can provide efficient, patient-centered care. The relationship between oral and systemic health further emphasizes the need for an interdisciplinary approach, with education playing a pivotal role in equipping practitioners to manage complex cases effectively. Technological innovations, including 3D imaging, laser dentistry, and advanced materials, have transformed dental practice. Dentists must continually adapt to these changes to ensure precision, improve diagnostics, and enhance treatment efficacy. Participation in hands-on training and workshops allows professionals to master these innovations while maintaining a high standard of care. Additionally, the growing focus on aesthetic and minimally invasive dentistry requires an understanding of new techniques that prioritize patient comfort and satisfaction. Beyond clinical applications, continuing education fosters professional growth by providing opportunities for specialization, leadership development, and networking. Through conferences, seminars, and collaborative learning, dental professionals can expand their expertise, gain insights from peers, and explore academic and research opportunities. Furthermore, staying compliant with regulatory requirements underscores a commitment to ethical and evidence-based practice. As dentistry continues to advance, lifelong learning ensures that practitioners are prepared to meet evolving patient needs and expectations. By embracing continuing education, dental professionals not only enhance their skills and knowledge but also contribute to the advancement of the profession, ultimately improving care delivery and outcomes.

The social experience of uncertainty: a qualitative analysis of emergency department care for suspected pneumonia for the design of decision support

BackgroundThis study sought to understand the process of clinical decision-making for suspected pneumonia by emergency departments (ED) providers in Veterans Affairs (VA) Medical Centers. The long-term goal of this work is to create clinical decision support tools to reduce unwarranted variation in diagnosis and treatment of suspected pneumonia.MethodsSemi-structured qualitative interviews were conducted with 16 ED clinicians from 9 VA facilities demonstrating variation in antibiotic and hospitalization decisions. Interviews of ED providers focused on understanding decision making for provider-selected pneumonia cases and providers’ organizational contexts.ResultsThematic analysis identified four salient themes: i) ED decision-making for suspected pneumonia is a social process; ii) the “diagnosis drives treatment” paradigm is poorly suited to pneumonia decision-making in the ED; iii) The unpredictability of the ED requires deliberate and effortful information management by providers in CAP decision-making; and iv) the emotional stakes and high uncertainty of pneumonia care drive conservative decision making.ConclusionsEnsuring CDS reflects the realities of clinical work as a socially organized process with high uncertainty may ultimately improve communication between ED and admitting providers, continuity of care and patient outcomes.

Evaluating the Perceptions of Smile Aesthetics among Dental Students at King Abdul-Aziz University: A cross-Sectional Study

Background Individuals seek out cosmetic dentists not so much for improved dental function or overall health but rather to improve the appearance of their teeth and gain more social acceptance. This study aimed to evaluate how dental students at King Abdul-Aziz University (KAU) perceived smiles based on their gender. Methods The study included two hundred students with clinical experience from the College of Dentistry, KAU. The data were collected using a three-part validated questionnaire. The first part included socio-demographic items; the second part included two close-ended questions regarding aesthetic characteristics; and the third part consisted of perception to seventeen photos of digitally manipulated smiles to be assessed using a numeric rating scale (NRS), (1, best; 5, worst). Results The first facial feature to catch the attention of most students was a smile, which was followed by the eyes. Almost 98% of the participants considered the smile one of the most important features of facial aesthetics. According to Faradeni research, men valued their gingival smile characteristic (p=0.013) and teeth color (p=0.001) substantially higher than women. Conversely, females had higher crucial margin discrepancy (p=0.038) and convex occlusal plane (p>0.001) than males. Conclusion When it comes to the gingival smile, teeth color, and the initial facial feature that attracts the eye, women perceive smiles as more aesthetically pleasing than men. Gingival margin discrepancy and convex occlusal plane were more critical in males than females. Understanding smile aesthetics from the perspective of dental students enhances patient care, education, and overall treatment outcomes.

Analysis of pregnancy and neonatal outcomes in 100 pregnant women with Rh-negative blood type

BackgroundThis study aimed to explore variations in prenatal care, delivery methods, influencing factors, and neonatal outcomes among Rh-negative pregnant women, so as to improve pregnancy healthcare for this demographic, raise the quality of maternal–fetal management, and safeguard the health of both mother and infant.MethodsThis study included 200 women who received routine prenatal care, exhibited no other pregnancy complications, and were admitted for delivery. They were divided into an observation group (100 Rh-negative blood type) and a control group (100 Rh-positive blood type). The study examined differences in pregnancy management, clinical characteristics and pregnancy outcomes between the two groups.ResultsThe results indicated that singleton pregnancies in Rh-negative mothers are associated with significantly higher rates of postpartum blood loss (305.1 ± 183.8 vs. 246.1 ± 84.9 mL, P = 0.004), neonatal hyperbilirubinemia (39% vs. 23%, P = 0.014), low birth weight (11% vs. 2%, P = 0.01), and NICU admission (30% vs. 18%, P = 0.046) compared to the control group. Among Rh-negative mothers, subgroup analysis by ethnicity revealed a higher incidence of fetal distress in the other ethnic groups compared to the Han and Zhuang groups (16.7%, 0, 6.5%, respectively, P = 0.025). Subgroup analysis based on ABO blood type within Rh-negative mothers did not show any statistical significance in various outcomes (all P > 0.05). Infants with neonatal hyperbilirubinemia born to Rh-negative mothers experienced a quicker resolution of hyperbilirubinemia compared to those whose mothers did not receive intramuscular anti-D immunoglobulin [1.0 (1.0, 1.5) vs. 5.0 (1.5, 10.0), P = 0.002].ConclusionsThe Rh-negative blood type is linked to higher risks of neonatal hyperbilirubinemia, low birth weight, and increased postpartum hemorrhage, resulting in detrimental pregnancy outcomes. Administering anti-D immunoglobulin speeds up the resolution of neonatal hyperbilirubinemia. Thus, prudent and efficient use of anti-D immunoglobulin can mitigate adverse outcomes for both mothers and newborns.

Pediatric Emergency Care Coordinator Presence and Pediatric Care Quality Measures.

Higher pediatric readiness has been associated with improved quality and outcomes of care for children. Pediatric emergency care coordinators (PECCs) are a component of pediatric readiness, but the specific association between PECCs and quality-of-care measures is undefined. To examine the association between PECC presence and emergency department (ED) performance as reflected by quality-of-care measures. This cohort study of ED patients 18 years or younger used data across 8 states, combining the 2019 National Emergency Department Inventory-USA, 2019 State Emergency Department Database and State Inpatient Database, 2020 Supplemental National Emergency Department Inventory PECC Survey, and the 2021 National Pediatric Readiness Project Survey. This analysis was conducted from February 15, 2023, to July 9, 2024. Presence of a PECC. Hospitals were stratified by presence of pediatric resources (ie, pediatric intensive care and inpatient units), with exclusion of children's hospitals and comparison between pediatric-resourced and non-pediatric-resourced (unable to admit children, no pediatric intensive care unit) hospitals. The 7 measures chosen were length of stay longer than 1 day for discharged patients, left against medical advice or without completing treatment, death in the ED, return visits within 3 days, return visits with admission within 3 days, use of chest radiography in patients with asthma, and use of head computed tomography for patients with head trauma. For each stratum, multilevel generalized linear models were constructed to examine the association between PECC presence and process and utilization measure performance, adjusted for patient-level factors (age, sex, race and ethnicity, insurance, and complex chronic conditions) and ED-level factors (visit volume, patient census, and case mix [race and ethnicity, insurance, and complex chronic conditions]). There were 4 645 937 visits from pediatric patients (mean [SD] age, 7.8 [6.1] years; 51% male and 49% female) to 858 hospitals, including 849 non-freestanding pediatric hospitals, in the analytic sample. Highly resourced pediatric centers were most likely to have a PECC (52 of 59 [88%]) compared with moderately resourced (54 of 156 [35%]) and non-pediatric-resourced hospitals (66 of 519 [13%]). Among the 599 non-pediatric-resourced hospitals, PECC presence was associated with decreased rates of computed tomography in head trauma (adjusted odds ratio [AOR], 0.76; 95% CI, 0.66-0.87); in the pediatric-resourced hospitals, the AOR was 0.85 (95% CI, 0.73-1.00). For patients with asthma, PECC was associated with decreased chest radiography rates among pediatric-resourced hospitals (AOR, 0.77; 95% CI, 0.66-0.91) but not non-pediatric-resourced hospitals (AOR, 0.93; 95% CI, 0.78-1.12). The presence of a PECC was not consistently associated with quality-of-care measures. The presence of a PECC was variably associated with performance on imaging utilization measures, suggesting a potential influence of PECCs on clinical care processes. Additional studies are needed to understand the role of PECCs in driving adherence to clinical care guidelines and improving quality and patient outcomes.

The role of self-efficacy in managing type 2 diabetes and emotional well-being: a cross sectional study

BackgroundManaging chronic conditions like Type 2 diabetes presents significant challenges, with self-efficacy—one’s belief in their ability to manage their health—playing a crucial role. This study investigates the influence of self-efficacy on emotional distress and health outcomes among Type 2 diabetes patients.MethodsWe conducted a cross-sectional study in Damascus with 336 Type 2 diabetes patients from three healthcare facilities. Data were collected through face-to-face interviews using validated questionnaires: the Diabetes Management Self-Efficacy Scale (DMSES), Problem Areas in Diabetes (PAID-5), and the World Health Organization-Five Well-being Index (WHO-5).ResultsAnalysis revealed that female gender and older age are significant factors influencing diabetes distress, with higher levels of distress observed in females and older patients. A negative correlation was found between self-efficacy and age, indicating reduced confidence in diabetes management among older individuals. Treatment modalities, such as oral hypoglycemic agents, were positively associated with higher self-efficacy. Significant associations were found between diabetes duration, age, and diabetes distress (PAID-5 scores), while self-efficacy (DMSES scores) varied based on treatment types.ConclusionsDespite high levels of diabetes distress and low psychological well-being, patients demonstrated commendable self-efficacy in managing their diabetes. Targeted interventions should address the needs of elderly female patients and those undergoing specific treatments to improve care outcomes. This study highlights the importance of tailored support and a holistic approach to diabetes management.

Enhancing Ultrasound Image Quality Across Disease Domains: Application of Cycle-Consistent Generative Adversarial Network and Perceptual Loss.

Numerous studies have explored image processing techniques aimed at enhancing ultrasound images to narrow the performance gap between low-quality portable devices and high-end ultrasound equipment. These investigations often use registered image pairs created by modifying the same image through methods like down sampling or adding noise, rather than using separate images from different machines. Additionally, they rely on organ-specific features, limiting the models' generalizability across various imaging conditions and devices. The challenge remains to develop a universal framework capable of improving image quality across different devices and conditions, independent of registration or specific organ characteristics. This study aims to develop a robust framework that enhances the quality of ultrasound images, particularly those captured with compact, portable devices, which are often constrained by low quality due to hardware limitations. The framework is designed to effectively process nonregistered ultrasound image pairs, a common challenge in medical imaging, across various clinical settings and device types. By addressing these challenges, the research seeks to provide a more generalized and adaptable solution that can be widely applied across diverse medical scenarios, improving the accessibility and quality of diagnostic imaging. A retrospective analysis was conducted by using a cycle-consistent generative adversarial network (CycleGAN) framework enhanced with perceptual loss to improve the quality of ultrasound images, focusing on nonregistered image pairs from various organ systems. The perceptual loss was integrated to preserve anatomical integrity by comparing deep features extracted from pretrained neural networks. The model's performance was evaluated against corresponding high-resolution images, ensuring that the enhanced outputs closely mimic those from high-end ultrasound devices. The model was trained and validated using a publicly available, diverse dataset to ensure robustness and generalizability across different imaging scenarios. The advanced CycleGAN framework, enhanced with perceptual loss, significantly outperformed the previous state-of-the-art, stable CycleGAN, in multiple evaluation metrics. Specifically, our method achieved a structural similarity index of 0.2889 versus 0.2502 (P<.001), a peak signal-to-noise ratio of 15.8935 versus 14.9430 (P<.001), and a learned perceptual image patch similarity score of 0.4490 versus 0.5005 (P<.001). These results demonstrate the model's superior ability to enhance image quality while preserving critical anatomical details, thereby improving diagnostic usefulness. This study presents a significant advancement in ultrasound imaging by leveraging a CycleGAN model enhanced with perceptual loss to bridge the quality gap between images from different devices. By processing nonregistered image pairs, the model not only enhances visual quality but also ensures the preservation of essential anatomical structures, crucial for accurate diagnosis. This approach holds the potential to democratize high-quality ultrasound imaging, making it accessible through low-cost portable devices, thereby improving health care outcomes, particularly in resource-limited settings. Future research will focus on further validation and optimization for clinical use.

Growth of Health Economics and Outcomes Research and Real-World Evidence in Medical Communication, and Opportunities for Medical Writers

Over the past 2 decades, the expansion of health economics and outcomes research (HEOR) has been responsible for an increasing quantity of medical communication, providing evaluations of the economic, clinical, and quality of life outcomes of health care interventions. The discipline has evolved to include real-world evidence (RWE) collected outside traditional clinical trials. The International Society for Pharmacoeconomics and Outcomes Research plays a crucial role in advancing HEOR by promoting best practices and bridging the gap between research and practical application. Medical writers specializing in HEOR and RWE interpret and present data analyses to various stakeholders, supporting evidence-based decision-making. In this article, we describe the experiences of 2 medical writers who specialize in HEOR communication, the range of documents they work on, and the strengths of a good HEOR writer. The growing importance of HEOR and RWE in medical writing represents an expansion of value-based health care and patient-centric outcomes in the pharmaceutical and health care industries.

Trends, prospects, challenges, and security in the healthcare internet of things

The Healthcare Internet of Things (H-IoT) is a rapidly developing problem solving model with significant potential to improve patient care and healthcare outcomes. This study focuses on integrating cryptographic platforms into H-IoT systems to enable secure data access. We present insights on how to manage challenges such as cyber risks, resource constraints, latency, and energy consumption by exploring cryptographic approaches in diverse H-IoT applications. We explore important topics including big data management, blockchain, machine learning, edge computing, and software-defined networks. Additionally, we examine real-time operational challenges and emerging trends, such as remote patient monitoring and predictive analytics. Our research underscores the need for strong encryption mechanisms, access controls, device authentication, and proactive threat detection to improve the safety and efficiency of healthcare services. By combining cryptographic approaches with the architecture of the H-IoT system, this work provides the foundation for resilient healthcare infrastructures. Addressing current challenges and anticipating future opportunities contribute to strategic healthcare planning that prioritizes patient privacy and data security while anticipating future strategic healthcare planning opportunities. This article aims to provide valuable information to researchers by covering energy-efficient and resource-optimized healthcare system approaches that are integrated into the development of H-IoT systems.

Strategies for Improving Patient Experience and Satisfaction in Healthcare Facilities in USA

Patient experience and satisfaction are critical indicators of healthcare quality and play a pivotal role in shaping care outcomes, trust, and patient retention. This study examines key strategies to enhance patient satisfaction in healthcare facilities in the USA, focusing on communication, technology integration, staff training, environmental improvements, and operational efficiency. Findings reveal that effective communication, combined with empathy and cultural competence, significantly improves patient trust and compliance. Technological advancements like telehealth and patient portals enhance convenience but require addressing digital literacy challenges. Environmental and operational improvements, including noise reduction and workflow optimization, also contribute to positive experiences. The study highlights the need for a patient-centered approach that integrates these elements holistically. However, challenges such as resource constraints and cultural sensitivity require further exploration to ensure equitable implementation. These insights provide actionable recommendations for healthcare facilities to prioritize patient satisfaction as a cornerstone of quality care. Keywords: Patient Experience, Patient Satisfaction, Healthcare Quality, Communication Strategies, Technology Integration, Empathy Training, Environmental Improvements, Operational Efficiency, Patient-Centered Care.

The rise of artificial intelligence in teledentistry: A comprehensive review

The integration of Artificial Intelligence (AI) into teledentistry represents an unprecedented step towards increased accessibility in dental care, given India's diversity and vast population. This comprehensive review attempts to outline the practical applications of AI in teledentistry, from patient education, remote diagnosis, treatment planning, to follow-up care. It critically analyses works relating to AI's effectiveness on the detection of caries, monitoring orthodontic, and the preliminary screening of OPMDs in relation to improving health care outcomes, especially in underserved regions. It also highlights challenges such as data privacy, accuracy, acceptance, and need for regulatory clarity among dental professionals and patients. This review primarily proposes the recommendations that we should be attempting to fuse AI based solutions with a human touch as a fixture of provider of dental rendering, based on peer-reviewed study evidence. The practice will change as collaboration is required with AI to pursue a teledental practice that is ethical, effective and accessible to everyone.

Association between Home-Base Primary Care and Post-Discharge Outcomes among Older Adults in Korea

This study aimed to evaluate the association between home-based primary care (HBPC) and postdischarge outcomes in Korean older adults. HBPC was a service that provided medical care by visiting the homes of older adults with limited mobility. In this study, data from the National Health Insurance Service (NHIS) were used, and groups with and without HBPC services were matched 1:1 through propensity score matching. Cox proportional hazards model and linear regression analysis were performed to compare the HBPC group with the control group. Overall, 1580 older adults in Korea who used HBPC services after discharge from hospital and 1580 propensity score-matched older adults who did not use HBPC services were included. For 30-day readmission, hospitalizations, and admission to long-term care hospitals or facilities after discharge, this study used a Cox proportional hazards regression model. And linear regression analysis was performed considering that the dependent variable was a continuous variable to examine the average total medical costs after discharge from acute hospital. Older adults who used HBPC services exhibited a lower risk of readmission for the same disease (risk reduction of 0.66, 95% CI 0.50, 0.87) and hospitalization (risk reduction of 0.58, 95% CI 0.46, 0.73) compared with those who did not use HBPC services. The annual average total medical cost was $4764 lower for older adults who used HBPC services than for those who did not (95% CI -6469.49,-3057.52). There was no significant difference in the risk of admission to long-term care hospitals or facilities. HBPC services had a positive effect on reducing 30-day readmission due to the same disease, hospitalization, and annual average total medical costs among older adults after discharge.

Associations Between Successful Home Discharge and Posthospitalization Care Planning: Cross-Sectional Ecological Study.

Effective discharge planning is crucial for successful care transitions, reducing hospital length of stay and readmission rates. Japan offers a financial incentive to enhance the coordination of posthospitalization care planning for patients with complex needs. However, the national impact of this incentive remains unclear. This study aimed to (1) assess the association between the number of claims submitted for discharge planning, as an indicator of the provision of posthospitalization care planning, and key health care outcomes, including discharges to home, 30-day readmissions, length of stay, and medical expenditures at the prefectural level in Japan, and (2) to describe regional differences in the provision of posthospitalization care planning and explore associated factors. This ecological study used prefectural-level data from fiscal year 2020. Claims submitted for discharge planning were used as indicators that posthospitalization care planning was provided. Supply-adjusted standardized claim ratios (SCRs) were calculated using data from the Seventh National Database of Health Insurance Claims, to evaluate and compare the number of claims across 47 prefectures in Japan, accounting for differences in population structure. Key outcomes included discharges to home, 30-day readmissions, length of stay, and medical expenditures. Multivariate negative binomial regression models assessed associations between SCRs and outcomes, adjusting for socioeconomic covariates. In addition, regional differences in the provision of posthospitalization care planning and associated factors were analyzed using the Mann-Whitney U test. Prefectures were divided into 3 groups (low, medium, and high) based on tertiles of each factor, and supply-adjusted SCRs were compared across these groups. The ratio of the minimum to maximum supply-adjusted SCR was 10.63, highlighting significant regional variation. Higher supply-adjusted SCRs, indicating more frequent provision of posthospitalization care planning, were associated with an increase of 9.68 (95% CI 0.98-18.47) discharges to home per 1000 patients for each SD increase in supply-adjusted SCR. Several factors contributed to regional differences in the supply-adjusted SCR for posthospitalization care planning. A higher supply-adjusted SCR was significantly associated with a greater number of nurses per 100 hospital beds (median SCR in low, medium, and high groups: 0.055, 0.101, and 0.103, respectively); greater number of care manager offices per 100 km2 of habitable area (0.088, 0.082, and 0.116); higher proportion of hospitals providing electronic medical information to patients (0.083, 0.095, and 0.11); lower proportion of older adults living alone (0.116; 0.092; 0.071); and higher average per capita income (0.078, 0.102, and 0.102). The provision of posthospitalization care planning is associated with an increased likelihood of discharge to home, underscoring its importance in care transitions. However, significant regional disparities in care coordination exist. Addressing these disparities is crucial for equitable health care outcomes. Further research is needed to clarify causal mechanisms.

3-Year Survival Outcomes of Patients with Enhanced Recovery After Surgery vs. Conventional Care in Laparoscopic Distal Gastrectomy: The GISSG1901 Randomized Clinical Trial.

The efficacy of enhanced recovery after surgery (ERAS) to improve the prognosis of patients who undergo laparoscopic distal gastrectomy (LDG) for gastric cancer is uncertain. This randomized study compared oncological outcomes in LDG after ERAS or conventional care. At present, randomized controlled trials have confirmed that ERAS can improve the short-term clinical outcomes of patients undergoing LDG, but whether it improves survival has not been reported yet. A multicenter, randomized, controlled trial was performed to compare oncological outcomes of ERAS versus conventional care in LDG. Between April 4, 2019, and March 18, 2020, 527 patients with locally advanced lower gastric adenocarcinoma were recruited from 13 centers in China. The primary endpoints were 3-year overall survival (OS) and disease-free survival (DFS). The secondary endpoints were complications, mortality, recovery, time of receiving adjuvant chemotherapy and medical expenses. The full analysis set included 186 cases in the ERAS group and 184 in conventional group, well balanced with respect to patient demographics and baseline characteristics (published before). Postoperative hospital stay and the interval before adjuvant chemotherapy were obviously shorter in the ERAS group compared to conventional group as reported previously and with lower medical expenses. Compared with the conventional group, ERAS group had fewer overall complications (21.0% vs. 30.4%, respectively; P=0.037). The median (IQR) follow-up for all cases was 42.17 (range, 3.12-48.50) months. The 3-year OS and DFS in the ERAS group and conventional group were 86.56% and 80.11% (log-rank P=0.025), 79.57% and 69.57% (log-rank P=0.027), respectively. In a subgroup analysis of stage I and II disease patients, 3-year OS and DFS were similar between the groups (P=0.901; P=0.859 for stage I and P=0.421; P=0.459 for stage II). However, in the stage III disease, the ERAS group exhibited longer 3-year OS and DFS than the conventional group (79.41% vs. 64.47% for OS, log-rank P=0.046; 70.59% vs. 53.95% for DFS, log-rank P=0.046). Patients undergoing ERAS LDG had fewer overall complications, shorter hospital stay, decreased medical expenses, and improved 3-year OS and DFS rates, particularly in cases with stage III gastric cancer.

Behind closed doors: Freelance nurses and the reality of unmet care needs in Italian home care setting. Insight from a phenomenological descriptive study.

The term 'Missed Nursing Care' (MNC) refers to any aspect of nursing care that is not delivered, partially delivered, or delayed. MNC has significant negative consequences, including adverse patient outcomes, safety risks, and decreased job satisfaction. While extensively studied in hospitals, MNC in community healthcare settings, remains under-researched, especially in Italy. This study aims to explore the phenomenon of MNC in Italian home care settings by documenting and analyzing the lived experiences of freelance nurses, focusing on the characteristics, influencing factors, and consequences of MNC as perceived by these healthcare professionals. This is a descriptive phenomenological study. Using snowball sampling, 12 Italian freelance nurses were recruited and interviewed from November 2022 to February 2023. Data collection was based on in-depth interviews, that have been transcribed and analyzed using Giorgi's phenomenological framework. The study report adhered to the COREQ-32 checklist for qualitative research. Thematic analysis revealed four main themes: dimensions of MNC, organizational challenges, consequences of MNC, and family-nurse collaboration. Freelance nurses frequently addressed unmet fundamental and complex nursing needs, highlighting significant clinical, psychological, and economic impacts on patients and families. Organizational issues, such as rigid public service schedules and inadequate staffing, were identified as primary contributors to MNC. Families played a crucial role in managing care and collaborating with freelance nurses to ensure continuity. This study provides novel insights into MNC in Italian home care settings, emphasizing the critical role of freelance nurses in filling care gaps. The findings suggest the need for systemic changes to improve flexibility, staffing, and integration of public and private nursing services. Further research, particularly quantitative studies, is essential to validate these findings and explore broader implications for patient care and health outcomes.

Rapid diagnosis of bacterial vaginosis using machine-learning-assisted surface-enhanced Raman spectroscopy of human vaginal fluids.

The accurate and rapid diagnosis of bacterial vaginosis (BV) is crucial due to its high prevalence and association with serious health complications, including increased risk of sexually transmitted infections and adverse pregnancy outcomes. Although widely used, traditional diagnostic methods have significant limitations in subjectivity, complexity, and cost. The development of a novel diagnostic approach that integrates SERS with ML offers a promising solution. The CNN model's high prediction accuracy, cost-effectiveness, and extraordinary rapidity underscore its significant potential to enhance the diagnosis of BV in clinical settings. This method not only addresses the limitations of current diagnostic tools but also provides a more accessible and reliable option for healthcare providers, ultimately enhancing patient care and health outcomes.

Measuring the empathy levels among pharmacy students: a journey toward enhancing effective communication and understanding in the pharmacist-patient relationship

BackgroundEmpathy is an essential skill for healthcare professionals, including pharmacists, because it improves person-centered care and treatment outcomes. Measuring the level of empathy among pharmacy students gives an understanding and insight into their readiness for incorporating a person-centered practice in their future work. This study aimed to assess empathy levels among Jordanian pharmacy students and explore the factors influencing these levels.MethodsA cross-sectional study using a web-based survey was conducted among currently enrolled pharmacy students from various academic years at both public and private Jordanian universities. The survey consisted of three sections; demographics, the Interpersonal Reactivity Index (IRI) to identify pharmacy students’ empathy level, and items specifically related to the pharmacist-patient relationship. Statistical analysis was conducted using SPSS software. Multiple linear regression was used to reveal the factors affecting students’ empathy.ResultsA total of 396 pharmacy students participated in the current study, with a mean age of 21.65 years (SD = 2.865), and about three-quarters were female (73.5%). The mean IRI score for the students was 70.89 (SD = 12.82), with subscale means as follows: perspective-taking (18.52), fantasy (17.05), empathic concern (20.16), and personal distress (15.16). Students’ age, gender, awareness of the term empathy, and studying empathy at universities were among the factors that significantly affected the students’ empathy scores.ConclusionThe present study reveals moderate empathy levels among Jordanian pharmacy students and sheds light on an understudied aspect within the pharmacy practice in Jordan. Significant demographic and educational factors affected the pharmacy students’ empathy levels. Incorporating empathy education in pharmacy curricula can better prepare pharmacy students for person-centered care.

Abstract A001: Navigating the future of therapeutic development: innovations in safety and efficacy through advanced research methodologies and nanotechnology

Abstract In recent years, the field of therapeutic development has experienced a significant paradigm shift driven by strategic scientific innovations that prioritize safety and efficacy in therapeutic agents. This paper explores the intersection of advanced research methodologies, novel material sciences, and biotechnological advancements that are revolutionizing the approach to drug formulation and delivery systems. The integration of precision medicine principles alongside cutting-edge technologies allows for the design of therapeutics that are not only effective in targeting specific diseases but are also engineered to minimize adverse effects associated with conventional therapies. One focal point of this exploration is the application of nanotechnology in drug delivery systems. By utilizing nanoparticles, researchers can enhance the bioavailability of therapeutic agents while reducing systemic toxicity. This targeted approach enables the delivery of higher concentrations of drugs to the affected areas, thereby maximizing therapeutic efficacy and minimizing side effects. Additionally, the paper highlights the role of computational modeling and simulations in predicting the interaction of therapeutic agents at the molecular level, facilitating the identification of safer compounds through virtual screening methods. Another significant aspect addressed in this paper is the development of biologics and biosimilars as safer alternatives to traditional synthetic drugs. The advancement of biomanufacturing processes has made it feasible to produce complex molecules with high specificity and reduced immunogenicity, paving the way for innovative therapies that cater to individual patient profiles. Furthermore, the strategic incorporation of pharmacogenomics in drug development allows for the customization of therapeutic agents, ensuring that treatment regimens are tailored to the genetic makeup of patients, which can drastically improve safety and treatment outcomes. The paper also discusses the regulatory landscape surrounding the introduction of these innovative therapeutic agents. It emphasizes the need for adaptive regulatory frameworks that keep pace with scientific advancements while ensuring patient safety and efficacy. Collaborative efforts between researchers, regulatory bodies, and pharmaceutical companies are essential to facilitate the translation of innovative therapies from the laboratory to clinical practice. In conclusion, this paper underscores the critical importance of strategic scientific innovations in the quest for safer therapeutic agents. By harnessing the potential of advanced technologies, researchers can develop therapeutics that not only meet the growing demand for efficacy but also uphold the highest standards of safety, ultimately improving patient care and health outcomes. The findings presented advocate for continued investment in research and collaboration across disciplines to drive future advancements in therapeutic development. Citation Format: Peter O. David. Navigating the future of therapeutic development: innovations in safety and efficacy through advanced research methodologies and nanotechnology. [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Optimizing Therapeutic Efficacy and Tolerability through Cancer Chemistry; 2024 Dec 9-11; Toronto, Ontario, Canada. Philadelphia (PA): AACR; Mol Cancer Ther 2024;23(12_Suppl):Abstract nr A001

Diagnosing and treating upper back pain: insights from New Zealand’s manipulative physiotherapists and osteopaths

ABSTRACT Background Manual therapy is routinely used in the management of upper back pain (UBP), a disabling condition. However, the approach to diagnosis and treatment techniques used by manipulative physiotherapists and osteopaths is largely unknown. Objectives To explore knowledge about UBP, including diagnosis and treatment, by New Zealand (NZ) osteopaths and manipulative physiotherapists and to investigate differences (if any) in the self-reported approaches to diagnosis and management of UBP between the professions. Design A cross-sectional survey administered through an online platform (Qualtrics) between September 2023 and January 2024. Participants One hundred and ten NZ osteopaths and manipulative physiotherapists completed the survey. Results Forty-eight percent (n = 53) of respondents identified their profession as physiotherapists and 52% (n = 57) as osteopaths. Over three-quarters of respondents (77%) ‘strongly agreed’ that a multimodal approach is essential for effective UBP management. Osteopaths were significantly more likely to often proffer ‘wear and tear/degeneration’ (p < 0.01) and ‘visceral referred pain’ (p = 0.02) as the cause of a patient’s UBP. In terms of management, osteopaths were significantly more likely to use soft tissue techniques (p < 0.01), spinal manipulations (p < 0.01), rib manipulations (p < 0.01), rib mobilizations (p < 0.01), and visceral techniques (p < 0.01), compared to physiotherapists. Conclusions The survey highlights a strong consensus among respondents that a multimodal approach is essential for effective UBP management. The survey also identified profession-specific approaches to the diagnosis and management of UBP. Future research using qualitative methods is required to further explore these profession-specific differences and explore outcomes of care.