Public Health Hospital Research Articles

Factors associated with quality of life in outpatient with type 2 diabetes at Ha Dong General Hospital

Objective: To describe some associated factors with the quality of life in outpatient with type 2 diabetes at Ha Dong General Hospital in 2020 Method: A cross-sectional study was conducted in 327 outpatient with type 2 diabetes at Ha Dong General Hospital, in 2020. This study used a Vietnamese version of the Asian Diabetes Quality of Life. Results: Results showed a statistically significant difference (p<0.05) between the quality of life (QOL) and some factors such as gender, economic status, time to detect, treatment, and complications. Regarding mental health, there was a difference in age (p=0.028). The quality of life in patients with diabetes who had time to detect for under 5 years was lower than that of whose had time to detect for 5 years or more (p=0.000). The quality of health in patients in poor/near-poor households was significantly lower than that in the other (p=0.000). Conclusion: Our findings can be evidence to assist public health policymakers and hospital managers develop strategies to improve patient QOL.

"You knew you had to be there, it had to be done": Experiences of health professionals who faced the COVID-19 pandemic in one public hospital in Spain.

The COVID-19 pandemic highlighted the lack of a government contingency plan for an effective response to an unexpected health crisis. This study uses a phenomenological approach to explore the experience of healthcare professionals during the first three waves of the COVID-19 pandemic in a public health hospital in the Valencia region, Spain. It assesses the impact on their health, coping strategies, institutional support, organizational changes, quality of care, and lessons learned. We carried out a qualitative study with semi-structured interviews with doctors and nurses from the Preventive Medicine, Emergency, and Internal Medicine Services and the Intensive Care Unit, using the Colaizzi's 7-step data analysis method. During the first wave, lack of information and leadership led to feelings of uncertainty, fear of infection, and transmission to family members. Continuous organizational changes and lack of material and human resources brought limited results. The lack of space to accommodate patients, along with insufficient training in treating critical patients, and the frequent moving around of healthcare workers, reduced the quality of care. Despite the high levels of emotional stress reported, no sick leave was taken; the high levels of commitment and professional vocation helped in adapting to the intense work rhythms. Healthcare professionals in the medical services and support units reported higher levels of stress, and a greater sense of neglect by their institution than their colleagues in managerial roles. Family, social support, and camaraderie at work were effective coping strategies. Health professionals showed a strong collective spirit and sense of solidarity. This helped them cope with the additional stress and workload that accompanied the pandemic. In the wake of this experience, they highlight the need for a contingency plan adapted to each organizational context. Such a plan should include psychological counseling and continuous training in critical patient care. Above all, it needs to take advantage of the hard-won knowledge born of the COVID-19 pandemic.

Assessment of hepatitis B vaccination status and hepatitis B surface antibody titres among health care workers in selected public health hospitals in Kenya.

Healthcare workers (HCWs) have a significant occupational risk of hepatitis B virus (HBV) infection. Vaccination remains the most effective measure recommended to avert the risk. However, there's limited information on hepatitis B vaccine uptake rates and the seroprotection status of HCWs, especially in sub-Saharan Africa. This study aimed to assess hepatitis B vaccination status and also seroprotection status of HCWs in three selected public hospitals in Kenya. This was a cross-sectional study carried out among HCWs at Kenyatta National Hospital (KNH), Naivasha and Mbagathi County hospitals. Data on participants' demographics and hepatitis B vaccination status was collected using an interviewer-guided questionnaire. Blood samples were collected and tested for hepatitis B surface antigen (HBsAg), hepatitis B surface antibodies (anti-HBs), and hepatitis B core antibodies (anti-HBc) using Enzyme Linked Immuno Sorbent Assay technique. Data were analyzed using Statistical Package for the Social Sciences (SPSS) and Graph pad prism. Of the 145 eligible HCWs, 120 (82.8%) were vaccinated, with 77 (53.1%) having received the recommended three doses. Three quarters (108/145) of the vaccinated HCWs were seroprotected (titres ≥10 mIU/ml) against HBV infection, while 16.6% were non-responders (titres <10 mIU/ml). Vaccination with more than two doses and HBV exposure were significantly associated with anti-HBs titre levels (P<0.05). HCWs who received less than 2 doses of the vaccine were 70% less likely to have high anti-HBs titre levels (aOR, 0.3; 95% CI, 0.1-0.8; P = 0.013). Nearly all HCWs were vaccinated against hepatitis B virus. The majority of all HCWs were seroprotected against hepatitis B virus but a number of them had an insufficient immunity to the virus despite vaccination or prior exposure. There's need to sensitize HCWs and enforce mandatory full vaccination as per the recommended vaccination schedule.

Estimation of the influenza-associated respiratory hospitalization burden using sentinel surveillance data, Lebanon, 2015-2020.

Influenza epidemics cause around 3 to 5 million cases of severe illness worldwide every year. Estimates are needed for a better understanding of the burden of disease especially in low- and middle-income countries. The objective of this study is to estimate the number and rate of influenza-associated respiratory hospitalizations in Lebanon during five influenza seasons (2015-2016 to 2019-2020) by age and province of residence in addition to estimating the influenza burden by level of severity. The severe acute respiratory infection sentinel surveillance system was used to compute influenza positivity from the influenza laboratory confirmed cases. The total of respiratory hospitalizations under the influenza and pneumonia diagnosis was retrieved from the Ministry of Public Health hospital billing database. Age-specific and province-specific frequencies and rates were estimated for each season. Rates per 100 000 population were calculated with 95% confidence levels. The estimated seasonal average of influenza-associated hospital admission was 2866 for a rate of 48.1 (95% CI: 46.4-49.9) per 100 000. As for the distribution by age group, the highest rates were seen in the two age groups ≥65 years and 0-4years whereas the lowest rate was for the age group 15-49 years. For the distribution by province of residence, the highest influenza-associated hospitalization rates were reported from the Bekaa-Baalback/Hermel provinces. This study shows the substantial burden of influenza in Lebanon mainly on high-risk groups (≥65 years and <5years). It is crucial to translate these findings into policies and practices to reduce the burden and estimate the illness-related expenditure and indirect costs.

Pregnant Women’s Perceptions of the Quality of Antenatal Care in a Public Hospital in Punjab, Pakistan during COVID-19: A Cross-Sectional Study

Despite government efforts, many rural Pakistani women forgo regular antenatal visits, are unprepared for birth, and deliver at home or in private facilities, because they are dissatisfied with public health services. This study examined pregnant women's perceptions of public health hospital prenatal care to suggest areas for improvement. Using simple random sampling, 200 pregnant women visiting a secondary care public health facility in Sargodha District, Pakistan, were enrolled in a cross-sectional study. The quality of prenatal care was assessed using a structured and validated questionnaire. Descriptive analysis and multivariate linear regression stepwise models were used. Of participants, 52% consider the services to be of poor quality. Education, income, number of living children, and long waiting time influenced the perceived prenatal care quality in the study population. Stakeholders rated existing services as suboptimal, especially in terms of staff availability and time spent, which reduces service use. Facility managers and policymakers should work to improve the quality of services to satisfy patients, encourage them to use antenatal care, and improve the health of both mother and child, especially in rural areas.

Remote health monitoring services in nursing homes

Aged people are challenged by serious complications from chronic diseases, such as mood disorder, diabetes, heart disease, and infectious diseases, which are also the most common causes of death in older people. Therefore, elderly care facilities are more important than ever. The most common causes of death in elderly care facilities were reported to be diabetes, cardiovascular disease, and pneumonia. Recently, the coronavirus disease 2019 (COVID-19) pandemic have a great impact on blind spots of safety where aged people were isolated from society. Elderly care facilities were one of the blind spots in the midst of the pandemic, where major casualties were reported from COVID-19 complications because most people had one or two mortality risk factors, such as diabetes or cardiovascular disease. Therefore, medical governance of public health center and hospital, and elderly care facility is becoming important issue of priority. Thus, remote health monitoring service by the Internet of Medical Things (IoMT) sensors is more important than ever. Recently, technological breakthroughs have enabled healthcare professionals to have easy access to patients in medical blind spots through the use of IoT sensors. These sensors can detect medically urgent situations in a timely fashion and make medical decisions for aged people in elderly care facilities. Real-time electrocardiograms and blood sugar monitoring sensors are approved by the medical insurance service. Real-time monitoring services in medical blind spots, such as elderly care facilities, has been suggested. Heart rhythm monitoring could play a role in detecting early cardiovascular disease events and monitoring blood glucose levels in the management of chronic diseases, such as diabetes, in aged people in elderly care facilities. This review presents the potential usefulness of remote monitoring with IoMT sensors in medical blind spots and clinical suggestions for applications.

Importance of fasting abbreviation and analgesia in the satisfaction and recovery of elderly patients with hip and femur fractures. retrospective study with 1,001 patients

Background and objectives: There are several ways to assess patient satisfaction, as it is a standard indicator of the quality of care provided. The aim of this study was to evaluate whether the abbreviation of fasting with 200 ml CHO, the intake of the same beverage in the PACU, the return to oral feeding in the ward, and postoperative analgesia can improve comfort and satisfaction with anesthesia in elderly patients. with hip and femur fracture. Methods: A retrospective trial carried out in a Brazilian public health hospital (SUS), with 1,001 patients physical status ASA I-III submitted to hip and femur fracture surgery. The following items were evaluated: preoperative fasting time, evaluation of thirst and hunger upon arrival in the operating room, time of CHO administration in the PACU, time of reintroduction of oral feeding in the ward, and at this moment, the degree of satisfaction with the anesthetic conduct, abbreviation of fasting and early feeding. A satisfaction assessment was performed with YES and NO answers regarding the pre-anesthetic visit, the fasting abbreviation, the use of CHO in PACU, refeeding in the ward, and postoperative analgesia. Family members were also asked to return immediately to the ward, without intravenous hydration and without going through the ICU. Results: All patients had the fasting abbreviation between 1:20 h and 4:00 h. None of the 1,001 patients reported being thirsty when they arrived in the operating room, against only 26 patients reporting being hungry. The time of administration of dextrinomaltose in PACU ranged from 20 minutes to 5:45 h, and the reintroduction of oral feeding in the ward ranged from 4 h to 8:15 h. Analgesia with lumbar plexus block with a neurostimulator and levobupivacaine before or after providing mean analgesia of 22±4 h, with a minimum time of 13 h and a maximum of 34 h. All patients were able to be discharged from the hospital on the second postoperative day. Conclusion: This study with 1,001 patients clearly shows that in hospitalized elderly, the liberal use of CHO before surgery and immediately in PACU, and better quality analgesia is an easy and practical way to increase patient comfort and satisfaction with anesthesia care and with better outcomes.

Molecular Comparative Study of Virulence Factors Produced by Gram-Negative Bacteria Isolated from Several Cancer Cases and NonCancer Patients in Erbil Governorate, Iraq

Background and objectives: Gram-negative bacteria are one of the most prevalent complications among immunocompromised cancer sufferers and pose the greatest threat to these patients. Our study aimed to conduct research on Gram-negative bacteria isolated from various clinical samples among cancerous patients and non-cancerous patients in Erbil city to analyze and compare some virulence genes among them such as tuf, atpD1, atpD2, ms-1, ms-2 and ms-3. Methods: The current study was carried out in Nanakaly hospital and other public health hospitals in Erbil- Kurdistan region at a period extending from August 2021 to March 2022. A total of 100 different clinical samples including urine, sputum, wound swab, stool, blood, have been collected from patients with different types of cancer (n=50) and non-cancerous patients (n=50), from both gender (male and female), without limited age group. Gram-negative bacterial isolates identified by microscopical, macroscopical analysis and Vitek II compact system. Results: The results of amplification of tuf gene among the cancerous patients were (70%), while the results among the non-cancerous patients was (52%). The percentage of atpD1 from cancer patients were (52%), as well as the appearance among non-cancerous patients were (44%) isolates. The results of atpD2 among cancer patients were (52%). However, the average of atpD2 among patients without cancer were (48%). The results of agarose gel electrophoresis of amplicons appeared that (32%) samples possess ms-1 among cancer cases, while there have not any positive results for control patients. Also, the results of ms-2 gene were (28%) from cancer patients, whereas, the prevalence of ms-2 gene marker among patients without cancer was (6%). The distribution of ms-3 gene was (22%) among cancer patients. Otherwise, the prevalence from samples of patients other than cancer were (20%). According to the statistical tests, the results showed no significant association between genes and type of bacteria in cancerous patients as well as in non-cancerous patients. Conclusions: tuf, atpD1 and atpD2 genes sealed a discriminated gene as a virulence factor encoding genes for identification of gram-negative bacteria. To the public health and especially from patients with cancer there is a main distribution of ms-1, ms-2 and ms-3 genes among gram-negative bacteria.

Impact of state Medicaid expansion on cross-sector health and social service networks: Evidence from a longitudinal cohort study.

To examine the impact of state Medicaid expansion on the delivery of population health activities in cross-sector health and social services networks. Community networks are multisector, interorganizational networks that provide services ranging from the direct provision of individual social services to the implementation of population-level initiatives addressing community outcomes. We used data measuring the composition of cross-sector population health networks 2006-2018 National Longitudinal Survey of Public Health Systems (NALSYS) linked with the Area Health Resource File. A difference-in-differences approach was used to examine the impact of expansion on organization engagement in population health activities and network structure. Stratified random sampling of local public health jurisdictions in the United States. We restricted our data to jurisdictions serving populations of 100,000 or more and states that had NALSYS observations across all time periods, resulting in a final sample size of 667. Results from our adjusted difference-in-differences estimates indicated that Medicaid expansion was associated with a 2.3 percentage point increase in the density of population health networks (p < 0.10). Communities in states that expanded Medicaid experienced significant increases in the participation of local public health, local government, hospital, nonprofit, insurer, and K-12 schools. Of the organizations with significant increases in expansion communities, nonprofits (7.7 percentage points, p < 0.01), local public health agencies (6.5 percentage points, p < 0.01), hospitals (5.8 percentage points, p < 0.01), and local government agencies (6.0 percentage points, p < 0.05) had the largest gains. Our study found increases in cross-sector participation in population health networks in states that expanded Medicaid compared with nonexpansion states, suggesting that additional coverage gains are associated with positive changes in population health network structure.

Uptake of perinatal immunoprophylaxis for infants born to women with a record of hepatitis B in Victoria (2009-2017).

Mother-to-child transmission (MTCT) of hepatitis B virus (HBV) remains one of the leading causes of transmission worldwide. An estimated 90% of infants who are exposed to HBV and do not receive appropriate post exposure immunoprophylaxis will go on to develop chronic hepatitis B (CHB). In Australia, universal birth dose vaccination was adopted in 2000 and universal antenatal screening for hepatitis B was introduced in the 1990s, however up to 10% of women may have missed screening. There is no coordinated care or data collection that systematically reports the access to interventions to prevent mother-to-child transmission (PMTCT) for women with CHB. Therefore, the incidence rate of MTCT is unknown. We conducted retrospective data linkage of perinatal records, public health notification and hospital admission data to identify women with a record of HBV infection who had given birth to a live infant(s) in Victoria between 2009 and 2017. We assessed uptake of birth dose vaccination and hepatitis B immunoglobulin (HBIG) and explored factors associated with administration of birth dose recorded as administered within 7days. Among 690,052 live births, 6118 births (0.90%) were linked to 4196 women with a record of HBV infection. 89.4% of all Victorian infants (n=616,879), and 96.8% of infants linked to women with a positive record of CHB (n=5,925) received birth dose within 7days. Infants born in private hospitals had reduced odds of receiving birth dose when compared to public hospitals births (Victorian population, aOR=0.67, 95%CI=0.66, 0.69; CHB linked records aOR=0.17, 95%CI=0.11, 0.25). Of the 6118 infants linked to a positive maternal record of CHB, discrepant recording of maternal CHB status between the three datasets was identified in 72.4% of records and HBIG administration was recorded for only 2.3% of births. An approach that involves coordinated care and integrates data collection for women with CHB and their infants is required to support the elimination of MTCT of hepatitis B in Victoria.

Environmental and Health Services Factors Associated with New Covid19 Case in Central Java Province: A Spatial Analysis

Introduction: At the end of December 2020, there were 93,035 Covid19 cases reported in Central Java. The spatial analysis is useful for assessing the association of environmental and health services factors with new Covid19 cases. Methods: This study was conducted to identify a spatial autocorrelation between environmental conditions and health services on new Covid19 cases in Central Java Province in 2020. The data were obtained from Central Java Profile Published in 2021 with a cross-sectional design. This autocorrelation regression technique was used to determine the relationship between districts/cities for new Covid19 cases. The independent variables in this study were environmental factors such as access to quality drinking water, access to quality sanitation, percentage of Open Defecation Free (ODF) villages, and percentage of healthy food management places. In addition, the independent variables also covered health service factors such as the number of public health centers, hospitals, medical personnel, and population density. Results and Discussion: The findings found that in Central Java province, the factors that influenced new Covid19 cases included population density (p-value 0.0001; Morran I -0.032) and the number of medical personnel (p-value 0.0001; Morrans I 0.021). Conclusion: The new cases of Covid19 in Central Java Province formed a clustered pattern. Factors significantly influencing the regression test are population density and the number of medical personnel. Besides that, spatial autocorrelation was also found in other variables in this study but was not significant.

Nurses’ Knowledge, Attitude, and Practice Regarding Personal Protective Equipment for the Prevention of COVID-19 in Public Hospitals Khartoum State Sudan 2022

Since December 2019, there had been a series of unexplained cases of pneumonia reported in Wuhan, China, and on 12 January 2020, the World Health Organization (WHO) named this new virus as the 2019 novel coronavirus (2019-nCoV). The Novel Coronavirus disease (COVID-19) is an emerging, rapidly changing global health challenge affecting all sectors, including the health sector. This study aimed to investigate nurses’ knowledge, attitudes, and practices regarding the prevention and control of COVID-19. Methods: This cross-sectional study was conducted among nurses in three public health hospitals in Khartoum state. A self-administered questionnaire was used. A total of 14 knowledge questions were adopted. There are 5 questions constructed for attitude. A total of 12 practice questions were used. Mean score of knowledge considers as follows when the mean more than 75% considers as good knowledge while this percent uses as good practice and poor practice respectively to analyze the mean score differences of knowledge, attitudes, and practices between the independent variables. Spearman correlation was used to assess the relationship between mean knowledge and attitude scores. Results: Of the 101 nurses approached, a total of 100 nurses responded (99.0% response rate). The mean age of the participants was 27.6 (SD 5.3) years, and the majority of the participants were male (293/434, 67.5%). The mean knowledge score was 1.01 (SD 0.100). The mean attitude score was 10.5 (SD 4.1), and 54.8% (238/434) of the participants had a good attitude toward COVID-19. The mean practice score was 1.4176 (SD 1.4176). There was a negative correlation between knowledge and attitude scores (P < -0.014) and between knowledge and practice scores (P < -0.081). Conclusions: The overall levels of knowledge and practice and attitude were good.

Cost of implementing the QualityRights programme in public hospitals in Gujarat providing mental healthcare.

Investment in mental health is quite meagre worldwide, including in India. The costs of new interventions must be clarified to ensure the appropriate utilization of available resources. The government of Gujarat implemented QualityRights intervention at six public mental health hospitals. This study was aimed to project the costs of scaling up of the Gujarat QualityRights intervention to understand the additional resources needed for a broader implementation. Economic costs of the QualityRights intervention were calculated using an ingredients-based approach from the health systems' perspective. Major activities within the QualityRights intervention included assessment visits, meetings, training of trainers, provision of peer support and onsite training. Total costs of implementing the QualityRights intervention varied from Indian Rupees (₹) 0.59 million to ₹ 2.59 million [1United States Dollars (US $) = ₹ 74.132] across six intervention sites at 2020 prices with 69-79 per cent of the cost being time cost. Scaling up the intervention to the entire State of Gujarat would require about two per cent increase in financial investment, or about 7.5 per cent increase in total cost including time costs over and above the costs of usual care for people with mental health conditions in public health facilities across the State. The findings of this study suggest that human resources were the major cost contributor of the programme. Given the shortage of trained human resources in the mental health sector, appropriate planning during the scale-up phase of the QualityRights intervention is required to ensure all staff members receive the required training, and the treatment is not compromised during this training phase. As only about two per cent increase in financial cost can improve the quality of mental healthcare significantly, the State government can plan for its scale-up across the State.

Analysis the readiness of implementing Electronic Medical Records (EMR) at dr. Rasidin Padang Regional Public Health Hospital

Regulation of the Minister Health of the Republic Indonesia No. 24, 2022 concerning EMR states that all health service facilities are required to maintain EMR no later than December 31, 2023. Therefore, dr. Rasidin Padang as a health service facility is also required to carry out EMR. This study aimed to analyze the readiness of implementing EMR at dr. Rasidin Padang. The research was conducted from November to June 2023 using qualitative methods and conducted on 6 informants by purposive sampling. Data were collected through in-depth interviews, observation. The results showed that in terms of organizational culture readiness, there is no timeline for planning activities and policies for the implementation of EMR. In terms of the readiness of human resources, there has been no training related to the implementation of EMR. In terms of computer hardware readiness, the software is still in the stage of perfecting the EMR application. EMR implementation readiness still needs to be improved, such as organizational culture readiness, Human Resources (HR), hardware, and software readiness. Hoped that the hospital will encourage readiness in the transition to electronic medical records with socialization and training that needs to be held immediately considering that EMR must be carried out no later than December 31, 2023.

Stunting at birth: linear growth failure at an early age among newborns in Hawassa city public health hospitals, Sidama region, Ethiopia: a facility-based cross-sectional study

Abstract On a global basis, 144 million people are stunted, and in Ethiopia, it remains a major public health problem. A limited number of studies have been conducted at the national level and in the study area to generate information on stunting at birth. The present study investigated the magnitude and predictors of stunting among newborns delivered at the Public Hospitals of Hawassa City, Ethiopia. A facility-based cross-sectional study was conducted between August and September 2021 among mothers and newborns (N 371). Data were collected through face-to-face interviews with the mother in a waiting room after the delivery of the child at the hospital. Newborn length and weight were measured and converted to length-for-age Z-score using WHO standards. The prevalence of stunting at birth (35⋅6 %) and low birth weight (24⋅6 %) were high. In the adjusted model, factors significantly associated with stunting were birth interval &lt;2 years, low birth weight, inadequate dietary diversity and food insecurity (P &lt; 0⋅01) mid-upper arm circumference (MUAC) of mother &lt;23 cm (P &lt; 0⋅05). The high magnitude of stunting and low birth weight calls all stakeholders and nutrition actors to work on preventing maternal undernutrition and improving their dietary practice through nutrition education. It is also recommended to mitigate food insecurity with evidence-based interventions using a combination of measures. Additionally improving maternal health services including family spacing was recommended to reduce stunting and low birth weight among newborns in the study area.

Therapeutic pluralism and the politics of disclosure: breast cancer patients' experiences in public healthcare.

Despite the widespread utilisation of complementary and or alternative medicine (CAM) by breast cancer patients in low-and-middle-income countries, few disclose CAM use to their physicians. This study examines disclosure CAM use among a small sample of women attending a breast cancer clinic in a public health hospital in the Western Cape, South Africa. An Interpretative Phenomenological Analysis (IPA) approach was utilised in this study. Semi-structured in-depth interviews were conducted with a convenience sample of 17 women attending a breast clinic in a public hospital. Non-disclosure of CAM use was attributed to minimal time for patient-doctor interactions due to resource constraints in public health facilities and the superior status accorded to biomedical doctors' superior knowledge, associated with paternalism, leading to patients' fear of reproach for using CAM. Consequently, disclosure of CAM only occurred in instances where it was deemed an absolute necessity. Considering the reality of an overstretched public healthcare system, what may be possible is an active attempt to communicate to patients that doctors are aware that patients may use a range of resources (such as CAM), which is their right, and further, recommend patient disclosure of CAM use to their doctors, because of the possibility of drug interactions and other potentially negative effects.

Dynamical Behaviour of a Modified Tuberculosis Model with Impact of Public Health Education and Hospital Treatment

Tuberculosis (TB), caused by Mycobacterium tuberculosis is one of the treacherous infectious diseases of global concern. In this paper, we consider a deterministic model of TB infection with the public health education and hospital treatment impact. The effective reproductive number, Rph, that measures the potential spread of TB is presented by employing the next generation matrix approach. We investigate local and global stability of the TB-free equilibrium point, endemic equilibrium point, and sensitivity analysis. The analyses of the proposed model show that the model undergoes the phenomenon of backward bifurcation when the effective reproduction number (Rph) is less than one, where two stable equilibria, namely, the DFE and an EEP coexist. Further, we compute the sensitivity of the impact of each parameter on the effective reproductive number of the model by employing a normalized sensitivity index formula. Numerical simulation of the proposed model was conducted using Maple 2016 and MatLab R2020b software and compared with the theoretical results for illustration purposes. The investigation results can be useful in providing information to policy makers and public health authorities in mitigating the spread of TB infection by public health education and hospital treatment.

Magnitude of NNM and associated factors among Newborns delivered at the North Shewa zone Public Health Hospital, Central Ethiopia: A multi-level analysis.

Neonatal near miss refers to a condition where a newborn is close to death within the first 28 days of life but ultimately survives either by chance or because of the quality of care they received. It is considered a major public health problem that contributes to the global burden of disease in less developing countries. For every death due to NMM, many others develop a severe complication. Despite this grim reality, there seems to be a gap in terms of the magnitude of and predictors of NNM in Ethiopia, where the previous study focused on neonatal death investigation. This study aimed to determine the magnitude of NNM and its determinants among the neonates delivered in the North Shewa zone, Central Ethiopia. A facility-based cross-sectional study was conducted using a systematic random sampling technique among 747 newly delivered babies in the North Shewa zone public hospital from January 30 to June 30, 2021. Neonatal near misses were identified with the help of the World Health Organization labeling criteria. Collected data were coded, entered, and cleaned by using Epi data 4.4.6 and analyzed using SPSS software (version 26) for analysis. Descriptive statistics were used to compute summary statistics and proportions. Variables at a cutoff value of 0.25 on bivariate and 0.05 on multivariate logistic regression were used to identify predictors. The prevalence of NNM was 35.3% (95% CI = 31.9-38.6) per 1,000 live births. Participant occupation [AOR: 0.55, CI: 0.33-0.90], marital status [AOR: 2.19; CI: 1.06-4.51], instrumental delivery [AOR: 1.98; CI: 1.10-3.55], intrapartum hemorrhage [AOR: 2.27; CI: 1.03-5.01], abortion history [AOR: 1.59; CI: 1.03-2.44], mal-presentation [AOR: 1.77; CI: 1.14-2.77], premature rupture of membrane [AOR: 2.36; CI: 1.59-3.51], and pregnancy-related infection [AOR: 1.99; CI: 1.14-3.46] were found to have statistically significant association. One-third of neonates face serious neonatal health conditions. Given this, addressing modifiable obstetric risk factors through providing skilled and quality care to mothers during pregnancy and during and after childbirth was important for improving neonatal health. Additionally, strengthening antenatal care services to minimize the infection occurring during pregnancy through the provision of appropriate services and counseling about the consequences of abortion was essential in reversing the problem.

MHealth program for patients with advanced cancer receiving treatment in a public health hospital in Brazil.

Previous studies have suggested the benefit of routine screening for biopsychosocial symptoms among patients with cancer. In recognition of the lack of data from low- and middle-income countries, this study sought to test and determine the effect of a mHealth program to screen biopsychological symptoms among patients with advanced breast or gynecological cancer. This was a quasi-experimental pre-post study conducted in a public hospital located in central western Brazil. Patients diagnosed with advanced breast of gynecological cancer who were about to initiate chemotherapy treatment at this institution and had access to Internet by smartphone, computer or tablet were invited to participate. Patients received training on using the app Comfort, a program developed to rate their physical and emotional symptoms during the 6-month of the proposed study. Patients were also asked to complete the EuroQOL 5D (EQ-5D-3L) every month. Mann-Whitney U test was used to determine differences among groups of patients (engaged and non-engaged). RM-ANOVA was used to determine the effect of time on mean visual analog scale (VAS) score. A total of 125 patients were recruited (median age=46.6years old, 41.6% married). Mostly, patients possessed lower levels of education and had relatively low monthly incomes. Notably, 67.2% of patients engaged with the Comfort program, and few patients (4%) withdrew due to lack of engagement with the program or issues with internet connection. In general, patients who engaged with the program reported improvement in physical and emotional symptoms (p<0.01), as well as in their overall quality of life (VAS; p=0.009), compared with patients who did not engage with the program. This is the first mHealth program developed in Brazil for patients in a low resource setting. Our findings suggest that Comfort could be an effective resource to assist patients and health care providers track symptoms and improve patients' quality of life.

A retrospective review of a large series of groin hernia patients operated with robotically assisted laparoscopic technique (R-TAPP)

We have reviewed the patient outcome and the feasibility of robotically assisted inguinal hernia repair (R-TAPP) from the first 4-years period after its introduction in our department in a Scandinavian Public Health hospital. A total of 226 hernia repairs were performed in 195 patients (31 bilateral hernias). 160 patients had primary hernias, whereas 35 had recurrent hernias. Of the recurrent hernias, three had recurred twice. The majority of the hernias were in the right groin (53.3%) and the lateral location was the most common (65.0%). The hernia was scrotal in 29 cases. The mean operation time was significantly reduced throughout the observation period for our cohort, i.e. from 81 to 57 min (p < 0.001). The operation time was 27 min faster (mean value) in unilateral vs bilateral hernias and 19 min faster (mean value) in primary vs residual hernias. There were no statistically significant differences in operation time between lateral and medial hernias, and no differences in operation time between the obese and normal-weight cases. We experienced four severe per-operative complications (4/226; 1.8%): two cases of abdominal wall bleeding subsequently undergoing intravascular coiling, one perforation of the urinary bladder and one perforation of small bowel that were both closed by direct suture intraoperatively. There were no conversions to laparoscopy or open procedure. One hernia recurred during the observation period. Our findings suggest that the R-TAPP procedure in a Scandinavian Public Health hospital’s surgical department is both safe and feasible.