Quality Health Research Articles

Work motivation of implementing nurses to improve the quality of health services

Introduction: The motivation of the implementing nurse is essential to improving the quality of health services. Implementing nurses plays a vital role in providing quality services to patients. High work motivation is crucial in enhancing nurses' performance and commitment to providing the best care. Objective: Knowing the motivation behind implementing nurses can improve the quality of health services. Method: This research is quantitative, with a cross-sectional study design using a quantitative analytical approach. The number of samples was 81 people using total sampling. The research instrument used was a questionnaire with a Likert scale. The analysis method uses the Fisher's exact test. Results: Based on the results of the analysis, these employees have discipline that is still lacking in completing work, while of the 5 respondents who have low work motivation, three respondents (3.7%) have good performance. This is because employees have effectiveness, efficiency, authority, responsibility, discipline, and good work initiative. The statistical test results using Fisher's exact test obtained p = 0.009, smaller than a = 0.05 (p < 0.05), which means Ho is accepted and Ha is rejected. This suggests there is a meaningful relationship between work motivation and. Conclusion: The researchers found that the work motivation of implementing nurses can improve the quality of health services. Implementing nurses can enhance healthcare quality, build team spirit, and achieve organisational goals. These efforts help increase patient satisfaction and improve job satisfaction and nurses' well-being. Therefore, understanding and applying compelling work motivation is the key to improving the quality of health services.

A cost-effective ECG monitoring in rural areas: leveraging artificial neural networks for efficient healthcare solutions

Cardiovascular diseases engender serious public health concerns in developing nations since access to specialized medical equipment is often limited and standard treatment expenses can be prohibitive. This study proposes an efficient and relatively affordable electrocardiogram (ECG) monitoring system that reads and analyzes a person's electrocardiogram data to provide affordable and quality healthcare solutions. The device initially extracts features from electrocardiogram records by reading electrical signals in the heart. Extracted data are then analyzed by a trained deep learning model to determine precisely if the heart is in a healthy state or undergoing complexities. Experimental results showed that the fine-tuned ANN architecture outperformed the state-of-the-art architectures in this field with an accuracy of 98.95%. The data can also be sent to specialists through an MQTT server if necessary, allowing for remote diagnosis and treatment. The system is intended to be deployed in countries where rural regions lack access to specialized healthcare equipment and professionals. Additionally, the device is inexpensive and, hence can be made accessible to people with limited affordability.

Investigating Potential Sources of Sore Throat: Physico-Chemical Attributes and Microbial Contamination in Rambutan from Fresh Harvests and Retail Stores

Rambutan (Nephelium lappaceum), a tropical fruit cherished for its succulent flesh and vibrant appearance, is cultivated extensively across various regions worldwide. However, despite its popularity, the fruit faces challenges related to particulate contamination during the harvesting process. Particulate matter contamination refers to the presence of solid or liquid particles suspended in the air or adhered to the fruit's surface, posing potential risks to both consumer health and fruit quality. Hence, this study aims to identify the factors in rambutan that could cause sore throats by analysing its physicochemical properties and conducting a microbiological study. For this study, two samples of rambutan fruit which are rambutan sold in stores (RS) and rambutan freshly harvested from the tree (RT) were collected and analysed for their external peel, internal peel, and pulp parts (n = 3). The assessment included the weight of visible fine dirt, pH value, oil content, surface morphology and total coliform (TPC). The results showed that the weight of visible fine dirt on RT external peel (93.50 ± 5.00 mg) and the pH value of its external peel and pulp (4.17 ± 0.00 - 5.17 ± 0.00) were significantly higher and more acidic (p<0.05) than those of RS. However, there were insignificant differences (p>0.05) in oil content (0.36 ± 0.7 - 0.38 ± 0.8%) between the external peels of the rambutan samples. Additionally, the surface morphology and image analysis of RS showed more foreign particles, represented as black or white dots on its internal peel and pulp, compared to RT, which was suspected to be yeast. Moreover, the total coliform count for both samples was significantly different (p<0.05) in their external peel and pulp, but it was still within the safe eating limit. The study concluded that environmental pollution and contamination during rambutan handling could cause sore throat.

The nexus of minds unveiling the significance of AI in mental health and viable remedie

The world is evolving at a cutthroat rate, and the integration of mental well-being and technology can yield promising results. For this reason, I have created The Nexus of Minds, which focuses on exploring the role of AI in changing the dynamics and thought processes of how we address and approach mental health issues. I am focusing on the transformative potential of Artificial Intelligence as a force for accessible, personalized, and effective mental healthcare. Mental healthcare has a huge spectrum, and I am exploring the multifaceted applications of AI, which have the potential to change the landscape. Machine Learning, Data Analytics, and Natural Language Processing have shown immense advancements, which is empowering AI to redefine how mental health issues are diagnosed and treated. Ranging from earlier intervention through continuous monitoring to all-time support, this book focuses on different ways in which AI solutions are improving the quality of mental healthcare and clinical results. It focuses on how AI is empowering people on their mental health journey. In addition to the technological innovation, I will navigate through the ethical considerations that need to be focused on, including but not limited to privacy, algorithmic bias, data privacy and security, and the role of human connection and empathy in mental healthcare. By understanding these essentials, I am offering insights into the responsible, ethical, and balanced integration of AI into mental health support. Moreover, this book focuses on apps and chatbots that are already providing help to people struggling with mental health illnesses and how they are benefiting from AI-centric mental health services. As a result, the readers will be able to gain an understanding of how AI will improve the quality of mental healthcare and destigmatize mental health conditions. With "The Nexus of Minds," I envision a future where AI won't be merely a tool but an absolute force in mental healthcare by breaking down the stigma and societal barriers to give hope to struggling people. This book will become a guiding beacon, providing information about the seamless coexistence of ethical and compassionate mental healthcare and tech advancement. I have taken an interdisciplinary approach, making it a promising resource for healthcare professionals, policymakers, researchers, and common people who want to see a bright future in the mental health industry.

Impact of technological innovations on healthcare delivery: A literature review of efficiency, patient care, and operational challenges

The rapid integration of technology in healthcare systems globally has ushered in transformative changes in patient care, operational efficiency, and data management. This literature review assesses the impact of emerging technologies such as blockchain, information technology, electronic medical records (EMRs), and artificial intelligence (AI) within healthcare settings. Drawing from a wide range of peer-reviewed articles and empirical studies, this paper synthesizes current research findings to understand the multifaceted effects of these technologies on healthcare delivery. The review highlights how these innovations enhance healthcare quality, streamline operations, and tackle prevalent challenges, particularly focusing on their implementation in Saudi Arabian healthcare contexts. Key findings indicate that while technological advancements offer significant improvements in patient care and system management, they also introduce challenges related to privacy, security, and the need for significant infrastructure investments. The review underscores the necessity for ongoing research to navigate technology adoption’s complexities and optimize healthcare practices effectively. This paper contributes to academic and practical discussions on leveraging technology to foster more efficient and responsive healthcare systems worldwide.\

Unraveling the Determinants of Maternal Well-Being Among Tribal Populations of Kerala: A Systematic Review.

Despite Kerala's noteworthy achievements in health indices, the tribal population in the state continues to face significant challenges in achieving optimal health outcomes. This is particularly evident in the realm of maternal health, where tribal communities struggle. In light of this paradox, a systematic review was conducted to identify the factors influencing the quality of tribal maternal health and their determinants. A comprehensive search strategy was employed, utilizing computer-backed searches of eminent bibliographic databases, along with the exploration of additional cited references and hand-searching of relevant journals. The methodological quality of the selected studies was rigorously assessed through a transparent cataloguing system and analysis by reviewers, resulting in the inclusion of thirty studies following the filtering process. The selected studies were subjected to detailed analysis to identify the determinants of maternal health among tribal populations. Thematic analysis of thirty studies that met the inclusion criteria resulted in four sets of determinants that contribute to maternal health among tribal women; biological/demographic determinants, psychological determinants, social determinants, and cultural determinants. This review provides a comprehensive picture of tribal maternal health in Kerala, shedding light on their multifaceted challenges. The study provides a basis for the formulation of initiatives by addressing the broader determinants of health and accounting unique socio-cultural factors influencing well-being of tribal communities.

Wake Up Safe in the USA & International Patient Safety.

Patient safety is the most important aspect of anesthetic care. For both healthcare professionals and patients, the ideal would be no significant morbidity or mortality under anesthesia. Lessons from harm during healthcare can be shared to reduce harm and to increase safety. Many nations and individual institutions have developed robust safety systems to improve the quality and safety of patient care. Large registries that collect rare events, analyze them, and share findings have been developed. The approach, the funding, the included population, support from institutions and government and the methods of each vary. Wake Up Safe (WUS) is a patient safety organization accredited by Agency for Healthcare Research and Quality. Wake Up Safe was established in the United States in 2008 by the Society for Pediatric Anesthesia. The initiative aims to gather data on adverse events, analyze these incidents to gain insights, and apply this knowledge to ultimately reduce their occurrence. The purpose of this review is to describe the patient safety approaches in the USA. Through a national patient safety database WUS. Similar approaches either through WUS international or independent safety approaches have been described in Australia-New Zealand, India, and Singapore. We examine the patient safety processes across the four countries, evaluating their incident review process and the distribution of acquired knowledge. Our focus is on assessing the potential benefits of a WUS collaboration, identifying existing barriers, and determining how such a collaboration would integrate with current incident review databases or systems.

Inpatients' experiences of falls: A qualitative meta-synthesis.

Identify and synthesize published qualitative research reporting inpatient experiences of a fall to determine novel insights and understandings of this longstanding complex problem. Qualitative meta-synthesis. Online databases were searched to systematically identify published research reporting inpatient experiences of a fall. The included studies were inductively analysed and interpreted then reported as a meta-synthesis. Databases Ovid MEDLINE, Embase, Ovid Emcare, CINAHL Complete, Scopus and ProQuest Dissertations and Theses Global were searched on 3rd August, 2023. From 10 included publications, four new themes of inpatients' experiences of a fall were constructed. Themes one, two and three related to antecedents of patient falls, and theme four related to consequences. Theme one, 'My foot didn't come with me: Physiological and anatomical changes', encompassed patients' experiences of medical conditions, medication, and anatomical changes. These aspects contributed to alterations in balance and strength, and misconceptions of capability in activities of daily (inpatient) living. Theme two, 'I was in a hurry: Help-seeking', encompassed patients' experiences striving for independence while balancing power and control, minimizing their own needs over care of others', and unavailability of support. Theme three, 'I couldn't find the call light: Environment and equipment', encompassed patients' experiences of not being able to reach or use equipment, and environment changes. Theme four, 'It was my fault too: Blame and confidence', encompassed patients' expressions of blame after their fall, blame directed at both themselves and/or others, and impacts on confidence and fear in mobilizing. Inpatient falls are embedded in a complexity of individual, relational, and environmental factors, yet there are potential ways forward both informed and led by the patient's voice. Strength-based approaches to address the tenuous balance between independence and support may be one opportunity to explore as a next step in complementing the existing multifaceted interventions. Inpatient falls are a complex and costly health safety and quality problem. Despite global initiatives in the prevention of inpatient falls, they remain intractable. This meta-synthesis provides an in-depth exploration of extant qualitative data on patients' experiences of falls in hospitals. Four themes were constructed expressing the inpatients' experiences: physiological and anatomical changes, help-seeking, environment and equipment, and blame and confidence. Novel considerations for future investigation are offered, drawing from self-determination theory and positive psychological interventions. This meta-synthesis elicits new considerations for future interventions based on people's experiences of their fall in hospital, offering healthcare professionals novel directions in fall prevention. The review was reported according to the Enhancing transparency in reporting the synthesis of qualitative research statement (ENTREQ; Tong etal., 2012). No Patient or Public Contribution. PROSPERO CRD42023445279.

Core Elements of Excellent Hospital Leadership: Lessons from the 5 Top-performing Hospitals in China.

Substantial evidence indicates that leadership plays a critical role in an organization's success. Our study aims to conduct case studies on leadership attributes among China's five top-performing hospitals, examining their common practices. A semi-structured interview was conducted with 8 leaders, 39 managers, 19 doctors, and 16 nurses from the five sample hospitals in China. We collected information from these hospitals on the role of senior leadership, organizational governance, and social responsibility, aligning with the leadership assessment guidelines in the Baldrige Excellence Framework. Qualitative data underwent interpretation through content analysis, thematic analysis, and comparative analysis. This study adhered to the COREQ guidelines for reporting qualitative research. Our study revealed that the leaders of the five top-performing hospitals in China consistently established "Patient Needs First" as the core element of the hospital culture. Striving to build world-renowned hospitals with Chinese characteristics, the interviewees all believed strongly in scientific vigor, professionalism, and cooperative culture. The leaders adhered to a staff-centered approach, placing special emphasis on talent recruitment and development; creating a compensation system; and fostering a supportive environment conducive to enhancing medical knowledge, skills, and professional ethics. In terms of organizational governance, they continuously enhanced the communication between various departments and levels of staff, improved the quality and safety of medical care, and focused on innovative medical and scientific research, thereby establishing evidence-based, standardized hospital management with a feedback loop. Meanwhile, regarding social responsibility, they prioritized improvements in the quality of healthcare by providing international and domestic medical assistance, community outreach, and other programs. To a large extent, the excellent leadership of China's top-performing hospitals can be attributed to their commitment to a "Two Pillared Hospital Culture", which prioritizes putting patient needs first and adopting a staff-centered approach. Furthermore, the leaders of these hospitals emphasize hospital performance, operations management, and social responsibility.

The Mediating Role of Exercise in Depression and Fatigue in Patients with Advanced Cancer

This study explored the interconnections between sociodemographic elements, depression, fatigue, and exercise in patients suffering from incurable neoplasm, particularly emphasizing the mediating influence of exercise on the relationship between depression and fatigue This was a prospective, multicenter, observational study involving 15 hospitals across Spain. After three months of systemic cancer treatment, participants completed the Brief Symptom Inventory (BSI), the Godin-Shephard Leisure-Time Physical Activity Questionnaire (GSLTPAQ) and the Fatigue Assessment Scale (FAS) to measure levels of depression, fatigue, and exercise, respectively. A total of 616 subjects participated in this study. Activity levels differed markedly according to educational attainment, marital, and work status. There was a negative correlation between physical activity and depression, and a positive correlation between depression and fatigue (β = −0.18, and β = 0.46, respectively). Additionally, physical activity inversely influenced fatigue levels (β = 0.21). Physical activity served as a partial intermediary in the link between depression and fatigue among patients with advanced, unresectable cancer. Healthcare providers are urged to consider both the physical and emotional dimensions of cancer treatment, implementing physical activity programs to enhance overall patient quality of life and mental health.

Social support as a coping resource for psychosocial conditions in postpartum period: a systematic review and logic framework

PurposeThis review seeks to examine the current state of postpartum social support and psychosocial conditions among women around the world, as well as explore the relationship between these factors. Additionally, it aims to propose a logical framework for enhancing postpartum social support and psychosocial conditions in this population.MethodsFollowing the development of a search strategy, two databases, PubMed and Science Direct, were searched for studies published between January 2019 and May 2023. The search was conducted throughout the entire month of May 2023. The risk of bias in the included cross-sectional studies was assessed using the Newcastle–Ottawa Quality Assessment Scale, which was adapted for this specific study design. To determine if the main objective of the cross-sectional studies was to investigate the relationship between social support and postpartum psychosocial conditions, a review was conducted based on the AMSTAR checklist, PRISMA checklist and PRISMA flow diagram. Data extraction was performed with the consensus of two authors, and a narrative synthesis approach was chosen for data synthesis, following the guidelines provided by the Centre for Reviews and Dissemination (CRD).ResultsEleven cross-sectional studies were included in the final analysis. Our findings revealed that all reviewed studies provided evidence of a positive association between social support and healthy psychosocial conditions in postpartum period. However, due to the absence of standardized measurement indicators to identify and compare the outcomes of various studies, there was a need to develop a conceptual framework that could enhance our understanding of the postpartum psychosocial condition including anxiety, depression, unfavorable quality of life and social support status up to 24 month after child birth. This framework aimed to incorporate childbirth and motherhood as "stressful events," while considering social support as a crucial "coping resource." Furthermore, it acknowledged empowerment, help-seeking behavior, and peer support as important "coping actions," alongside implementing client-centered interventions. Lastly, it recognized postpartum mental health and optimal quality of life as significant "effects" of these factors.ConclusionsThe proposed conceptual framework could define postpartum women’s health as “the ability to adapt and self-manage.”

The relationship between health behaviors and quality of life: the mediating roles of activities of daily living and psychological distress

ObjectiveThe aim of this study is to examine the role of activities of daily living performance (ADLs) and psychological distress in mediating the process by which health behaviors affect QOL.MethodsA non-probabilistic study was conducted among 1,065 older adult people older than 60 years. Participants were assessed using the Barthel Index, Functional Activities Questionnaire (FAQ), Kessler Psychological Distress Scale (K10), Australian Active Survey, and EQ-VAS score. The SPSS22.0 software was used to analyze the differences in QOL scores among older adults with different demographic characteristics. Pearson correlation analysis was used to analyze the correlation between health behaviors, psychological distress, ADLs, and QOL. Amos23.0 software was used to construct structural equation model (SEM) to analyze the path of health behavior affecting QOL and the mediating role of BADLs, IADLs and psychological distress.Results(1) The direct effect of health behaviors on QOL was not significant in the model; (2) ADLs had multiple mediating effects on the relationship between health behaviors and QOL, and the incidence of ADL limitation was negatively correlated with the reported QOL in the older adult; (3) Psychological distress had a significant mediating effect on the relationship between health behaviors and QOL.ConclusionThe results of this study elucidated the mechanisms of the correlation between health behaviors and QOL, and added to the existing literature. In addition, these mediating factors and indirect pathways have been identified as targets for intervention to improve the QOL of older adult individuals, which is important for achieving healthy aging.

Reform of the first year of medical studies and diversification of student profiles in France: an unmet need?

ObjectivesTo determine whether the reform of the first year of medical studies implemented in September 2020 in France met its objective of diversifying the profiles of students admitted to second year at the faculty of medicine at the University of Tours.MethodsSingle-centered, retrospective study, covering students who passed the first year of medical studies between 2018 and 2022. Student profiles originating from three different entry gateways (PACES, PASS and L.AS) to the second year of medical studies were compared.ResultsOne thousand four hundred and seventy-nine students over five promotions were included (806 in PACES, 329 in PASS, 198 in L.AS). The ratio of students who had obtained a baccalaureate with high or highest honors was significantly higher in PACES (85%) and PASS (96%) compared to L.AS (66%; p < 0.001). These differences were related to increased student intake via a standard pass in L.AS (21% compared to 3.2% in PACES and 0.9% in PASS) (p < 0.001). In terms of geographical origin, the proportion of students residing in regions outside the University City area increased significantly in L.AS (11%) compared to PACES (1.7%) and PASS (3.3%) (p < 0.001). The mean number of parents from the white-collar and knowledge professional category was significantly higher in PACES (0.91) and PASS (1.06) compared to L.AS (0.80; p < 0.001).ConclusionStudents with a scientific background and who obtained highest honors in their high school diploma, remain the standard in PACES and PASS. Diversification of student profiles was achieved only within the L.AS gateway, which represented 42% of total second year admissions during the post-reform year. Student profile diversification was therefore a partially achieved objective and follow up studies of future promotions is needed to assess the medium and long-term impact of the reform. Particular attention should be paid to the future of these students who have different profiles between L.AS and PASS to determine whether these changes will have any impact in the quality of healthcare for the French population.

Economic Indicators, Quantity and Quality of Health Care Resources Affecting Post-surgical Mortality.

to identify correlations between quality and quantity of health care resources, national economic indicators, and postoperative in-hospital mortality as reported in the EUSOS study. Different variables were identified from a series of publicly available database. Postoperative in-hospital mortality was identified as reported by EUSOS study. Spearman non-parametric and Coefficients of non-linear regression were calculated. Quality of health care resources was strongly and negatively correlated to postoperative in-hospital mortality. Quantity of health care resources were negatively and moderately correlated to postoperative in-hospital mortality. National economic indicators were moderately and negatively correlated to postoperative in-hospital mortality. General mortality, as reported by WHO, was positively but very moderately correlated with postoperative in-hospital mortality. Postoperative in-hospital mortality is strongly determined by quality of health care instead of quantity of health resources and health expenditures. We suggest that improving the quality of health care system might reduce postoperative in-hospital mortality.

Experiences of birthing people during the COVID-19 pandemic: Analysis of comments from the 2020 Wisconsin Pregnancy Risk Assessment Monitoring System (PRAMS).

The COVID-19 pandemic has taken a significant toll on the US population, with birthing people having special clinical needs. The Pregnancy Risk Assessment Monitoring System (PRAMS) is a population-based surveillance system for monitoring birthing people's experiences. Comment data from the PRAMS survey can provide further insight into birthing people's experiences. This study aims to use PRAMS data to describe pandemic-related experiences in a representative sample of birthing people in Wisconsin to help inform future emergency preparedness planning. This study analyzed 2020 Wisconsin PRAMS data for births in March or later. Content analysis of pandemic-related comment data was conducted, and quantitative data on demographic characteristics and pandemic-related experiences were examined. Findings from 1406 respondents indicated that many birthing people were affected by the pandemic, including changes in healthcare visits and employment. One hundred respondents commented on pandemic-related experiences; four interrelated themes emerged from content analysis: changed nature and quality of healthcare, limited social support, increased anxiety, stress, or fear, and employment or financial burden. Most comments discussed negative impacts; some expressed positive aspects. Findings suggest opportunities for improving support for birthing people during public health emergencies, for example, through developing healthcare policies and public health guidelines that prioritize the protective mechanisms of social support for birthing people, identifying additional and immediately accessible policy protections to support birthing and postpartum people (e.g., insurance and paid leave) during public health emergencies, and implementing additional screening and support to help address increased mental health needs during public health emergencies.

No immediate attentional bias towards or choice bias for male secondary sexual characteristics in Bornean orang-utans (Pongo pygmaeus).

Primate faces provide information about a range of variant and invariant traits, including some that are relevant for mate choice. For example, faces of males may convey information about their health or genetic quality through symmetry or facial masculinity. Because perceiving and processing such information may have bearing on the reproductive success of an individual, cognitive systems are expected to be sensitive to facial cues of mate quality. However, few studies have investigated this topic in non-human primate species. Orang-utans are an interesting species to test mate-relevant cognitive biases, because they are characterised by male bimaturism: some adult males are fully developed and bear conspicuous flanges on the side of their face, while other males look relatively similar to females. Here, we describe two non-invasive computerised experiments with Bornean orang-utans (Pongo pygmaeus), testing (i) immediate attention towards large flanges and symmetrical faces using a dot-probe task (N = 3 individuals; 2F) and (ii) choice bias for pictures of flanged males over unflanged males using a preference test (N = 6 individuals; 4F). In contrast with our expectations, we found no immediate attentional bias towards either large flanges or symmetrical faces. In addition, individuals did not show a choice bias for stimuli of flanged males. We did find exploratory evidence for a colour bias and energy efficiency trade-offs in the preference task. We discuss our null results and exploratory results in the context of the evolutionary history of Bornean orang-utans, and provide suggestions for a more biocentric approach to the study oforang-utan cognition.

Efficacy and Safety Evaluation of 177Lu-FAP-2286 in the Treatment of Advanced Lung Cancer

Purpose The aim of this study was to evaluate the efficacy and safety of peptide-targeted radionuclide therapy (PTRT) with 177Lu-FAP-2286 in advanced lung cancer. Patients and Methods This single-center prospective study included 9 patients diagnosed with advanced lung cancer. These patients met the inclusion criteria and received PTRT with 177Lu-FAP-2286. Short-term efficacy was assessed using RECIST 1.1 and PERCIST 1.0 criteria. Long-term efficacy was evaluated through overall survival, progression-free survival (PFS), overall response rate, EORTC QLQ-C30 v3.0, Eastern Cooperative Oncology Group, and Karnofsky Performance Status. Toxicity response was assessed using CTCAE v5.0. Results The results based on RECIST 1.1 and PERCIST 1.0 criteria were comparable, with 44% of patients showing a partial metabolic response, 33.3% with stable metabolic disease, and 22.22% with progressive metabolic disease. The highest metabolic response after treatment reached 66.89%, and the overall response rate could reach 77.78%. In the long-term efficacy assessment, the median overall survival and PFS were 10 months and 6 months, respectively. The 2 patients with the lowest PFS (3 months) started PTRT relatively late. EORTC QLQ-C30 v3.0, Eastern Cooperative Oncology Group, and Karnofsky Performance Status scores showed that the overall health status, symptom response, and quality of life of patients improved after 177Lu-FAP-2286 treatment. The most noticeable improvements in clinical symptoms were dyspnea and cancer-related pain. No grade III/IV toxicity events were observed during follow-up period, and fibrinogen decreased significantly after treatment. Conclusions 177Lu-FAP-2286 has the potential to be a viable PTRT option for patients with advanced lung cancer.

Trastuzumab-emtansine versus other anti-HER2 regimens in early or unresectable or metastatic HER-2 positive breast cancer: systematic review and network meta-analysis.

Motivation for the study. Treatment options for HER2-positive breast cancer were evaluated, focusing on the efficacy and safety of trastuzumab-emtansine (T-DM1) compared to other anti-HER2 therapies. Main findings. Trastuzumab-deruxtecan (T-DXd) and PyroCap emerged as promising alternatives, showing substantial improvements in progression-free survival for locally advanced or metastatic breast cancer. T-DM1 showed superior efficacy to the other treatments. Implications. Our findings could inform healthcare decision-making processes to optimize strategies for HER2-positive breast cancer, and potentially improve health outcomes and quality of life. We aimed to study the efficacy and safety of trastuzumab-emtansine (T-DM1) versus other anti-HER2 therapies in HER2+ breast cancer (BC). We performed a network meta-analysis (NMA) of randomized controlled trials (RCTs). Our study focused on patients undergoing treatment for unresectable locally advanced breast cancer (LABC) or metastatic breast cancer (mBC), which included regimens involving trastuzumab and taxanes. Additionally, we considered cases within the first 6 months of treatment for HER2+ early breast cancer (EBC). A total of 23 RCTs and 41 reports were included in our analysis. LABC and mBC showed no statistically significant difference in any of the comparisons of T-DM1 versus the other anti-HER2+ therapies. When assessing progression-free survival (PFS), trastuzumab-deruxtecan (T-DXd) and PyroCap demonstrated greater efficacy compared to other treatments (Hazard Ratio [HR]: 3.57; 95% confidence interval [CI]: 2.75-4.63 and HR: 1.82; 95% CI: 1.35-2.44; respectively), while T-DM1 alone exhibited superior effectiveness compared to LapCap (HR: 0.65; 95% CI: 0.55-0.77), TrasCap (HR: 0.65; 95% CI: 0.46-0.91), LapCapCitu (HR: 0.60; 95% CI: 0.33-1.10), Nera (HR: 0.55; 95% CI: 0.39-0.77), and Cap (HR: 0.37; 95% CI: 0.28-0.49). NMA allows a ranking based on the comparative efficacy and safety among the interventions available. Although superior to other schemes, T-DM1 showed a lower efficacy performance in PFS and overall response rate and a trend towards worse overall survival than T-DXd.

Does higher performance in a national licensing examination predict better quality of care? A longitudinal observational study of Ethiopian anesthetists.

Ethiopia made a national licensing examination (NLE) for associate clinician anesthetists a requirement for entry into the practice workforce. However, there is limited empirical evidence on whether the NLE scores of associate clinicians predict the quality of health care they provide in low-income countries. This study aimed to assess the association between anesthetists' NLE scores and three selected quality of patient care indicators. A multicenter longitudinal observational study was conducted between January 8 and February 7, 2023, to collect quality of care (QoC) data on surgical patients attended by anesthetists (n = 56) who had taken the Ethiopian anesthetist NLE since 2019. The three QoC indicators were standards for safe anesthesia practice, critical incidents, and patient satisfaction. The medical records of 991 patients were reviewed to determine the standards for safe anesthesia practice and critical incidents. A total of 400 patients responded to the patient satisfaction survey. Multivariable regressions were employed to determine whether the anesthetist NLE score predicted QoC indicators. The mean percentage of safe anesthesia practice standards met was 69.14%, and the mean satisfaction score was 85.22%. There were 1,120 critical incidents among 911 patients, with three out of five experiencing at least one. After controlling for patient, anesthetist, facility, and clinical care-related confounding variables, the NLE score predicted the occurrence of critical incidents. For every 1% point increase in the total NLE score, the odds of developing one or more critical incidents decreased by 18% (aOR = 0.82; 95% CI = 0.70 = 0.96; p = 0.016). No statistically significant associations existed between the other two QoC indicators and NLE scores. The NLE score had an inverse relationship with the occurrence of critical incidents, supporting the validity of the examination in assessing graduates' ability to provide safe and effective care. The lack of an association with the other two QoC indicators requires further investigation. Our findings may help improve education quality and the impact of NLEs in Ethiopia and beyond.

Patients' satisfaction with cancer pain treatment at adult oncologic centers in Northern Ethiopia; a multi-center cross-sectional study.

Patient satisfaction is an important indicator of the quality of healthcare. Pain is one of the most common symptoms among cancer patients that needs optimal treatment; rather, it compromises the quality of life of patients. To assess the levels and associated factors of satisfaction with cancer pain treatment among adult patients at cancer centers found in Northern Ethiopia in 2023. After obtaining ethical approval, a multi-center cross-sectional study was conducted at four cancer care centers in northern Ethiopia. The data were collected using an interviewer-administered structured questionnaire that included the Lubeck Medication Satisfaction Questionnaire (LMSQ). The severity of pain was assessed by a numerical rating scale from 0 to 10 with a pain score of 0 = no pain, 1-3 = mild pain, 4-6 = moderate pain, and 7-10 = severe pain Binary logistic regression analysis was employed, and the strength of association was described in an adjusted odds ratio with a 95% confidence interval. A total of 397 cancer patients participated in this study, with a response rate of 98.3%. We found that 70.3% of patients were satisfied with their cancer pain treatment. Being married (AOR = 5.6, CI = 2.6-12, P < 0.001) and being single (never married) (AOR = 3.5, CI = 1.3-9.7, P = 0.017) as compared to divorced, receiving adequate pain management (AOR = 2.4, CI = 1.1-5.3, P = 0.03) as compared to those who didn't receive it, and having lower pain severity (AOR = 2.6, CI = 1.5-4.8, P < 0.001) as compared to those who had higher level of pain severity were found to be associated with satisfaction with cancer pain treatment. The majority of cancer patients were satisfied with cancer pain treatment. Being married, being single (never married), lower pain severity, and receiving adequate pain management were found to be associated with satisfaction with cancer pain treatment. It would be better to enhance the use of multimodal analgesia in combination with strong opioids to ensure adequate pain management and lower pain severity scores.