Quality Health Research Articles

The impact of nurse empowerment program on patient safety culture in general public hospital in Indonesia

Background Patient safety is crucial to health-care quality and is one of the major parameters monitored by all health-care organizations around the world. Nurses play a critical role in improving the quality of care and patient safety because of their intensity in caring patients and families. Objectives This study aimed to determine the impact of nurse empowerment program on patient safety culture in general public hospital in Indonesia. Methods This study was designed as a quasi-experimental design in Indonesia. This program was conducted for three months with a five-day workshop (4 h for each day), followed by hanging up posters and handing out informative pamphlets to the experimental group's nurses and supervisors at their place of work in three common place that visited by nurses such as changing room, nurse station and near toilet. Results In the intervention group, patient safety culture practice score was significantly increased from 3.11(standard deviation [SD] = 1.43) before intervention to 4.89 (SD = 1.33) after three-month intervention (T2), with the t was 5.78, and p = .001. While in the control group, no significant increased score of patient safety culture practice before intervention and after three months intervention (3.05 ± 1.49 vs. 3.09 ± 1.25, t = 0.76, p = .516). Conclusion The implementation of this innovative empowerment program, which included nurses and supervisors, resulted in an increase in patient safety culture scores as well as growth in domain score. Therefore, this program can be used to advance these critical facets of patient safety culture, which are currently underdeveloped.

Societal Preferences for Granting Orphan Drugs Special Status in Reimbursement Decisions

BackgroundOrphan drugs, for patients with a rare disease, are increasingly available but often do not meet standard cost-effectiveness criteria for reimbursement. Consequently, policymakers regularly face the dilemma whether to relax these criteria for reimbursing orphan drugs. We examined whether—and why—there would be societal support for such differential treatment of orphan drugs. MethodsWe conducted a labelled discrete choice experiment in a sample of the adult population (n=1,172) in the Netherlands. Respondents were presented with ten choices whether to reimburse an orphan drug given that a non-orphan drug with similar characteristics would not be reimbursed, because it was not cost-effective, and explained their choices. We used random-intercept logit regression models and inductive coding for analysing the quantitative and qualitative data. ResultsOf respondents, 36.4% consistently chose for reimbursing the orphan drug, mostly because “everyone is entitled to live a healthy life and good quality healthcare”, and 17.3% consistently for not reimbursing the orphan drug, mostly because “[this] is unfair to patients with a common disease”. The remaining 46.3% made alternating choices and were more likely to choose for reimbursing orphan drugs when patients were aged between 1 and 70 years, had moderate disease severity, and considerable health gain from treatment. ConclusionsThis study finds considerable support but also strong preference heterogeneity among members of the public in the Netherlands for differential treatment of orphan drugs in reimbursement decisions, when these drugs do not meet common cost-effectiveness criteria. However, a substantial minority opposes differential treatment, mostly on moral grounds.

Inclusivity in health professional education: how can virtual simulation foster attitudes of inclusion?

Disparities in accessing quality healthcare persist among diverse populations. Health professional education should therefore promote more diversity in the health workforce, by fostering attitudes of inclusion. This paper outlines the potential of virtual simulation (VS), as one method in a system of health professional education, to promote inclusion and diversity. We conceptualise how VS can allow learners to experience an alternative to what HPE currently is by drawing on two social justice theorists, Paulo Freire, and Nancy Fraser and their ideas about ‘voice’ and ‘representation’. We present two principles for VS design and implementation: (1) giving voice to learners has the power to transform; and (2) representation in VS builds inclusion. We provide practical means of building voice and representation into VS learning activities, followed by an example. Purposeful and thoughtful integration of these principles paves the way for a more diverse and inclusive healthcare workforce.

ROUTE-T1D: A behavioral intervention to promote optimal continuous glucose monitor use among racially minoritized youth with type 1 diabetes: Design and development

BackgroundType 1 diabetes management is often challenging during adolescence, and many youth with type 1 diabetes struggle with sustained and optimal continuous glucose monitor (CGM) use. Due to racial oppression and racially discriminatory policies leading to inequitable access to quality healthcare and life necessities, racially minoritized youth are significantly less likely to use CGM. MethodsROUTE-T1D: Research on Optimizing the Use of Technology with Education is a pilot behavioral intervention designed to promote optimal CGM use among racially minoritized youth with type 1 diabetes. Intervention strategies include problem solving CGM challenges and promoting positive caregiver-youth communication related to CGM data. ResultsThis randomized waitlist intervention provides participants with access to three telemedicine sessions with a Certified Diabetes Care and Education Specialist. Caregiver participants are also connected with a peer-parent coach. ConclusionHypothesized findings and anticipated challenges are discussed. Future directions regarding sustaining and optimizing the use of diabetes technology among racially minoritized pediatric populations are reviewed.

The impact of the health microinsurance M-FUND on the utilization of health services among migrant workers and their dependents in Thailand: A case-control study

Background: Even though Thailand has launched multiple migrant health policies, migrants still face multiple barriers in accessing health care. To some extent, these barriers may be reduced by health microinsurance. The M-FUND is a low-cost, not-for-profit health protection scheme for migrant workers in Thailand, created by Dreamlopments Social Enterprise and Foundation to support sustainable access to quality healthcare services for migrants. We aimed to investigate the impact of the M-FUND on utilization of health services. Methods: Over a period of three months, we conducted quantitative face-to-face interviews with 408 M-FUND members, and 452 age, sex and location matched non-member controls in Tak Province, Thailand. We compared utilization of health services between members and non-members using logistic regression controlling for a number of socio-demographic variables and variables related to migration such as years in Thailand, legal status, etc. FindingsM-FUND members were more likely to have utilized outpatient services (adjusted odds ratio: 1·74, 95% confidence interval: 1·24-2·44), inpatient services (2·96, 1.11-7·92), and emergency care (1·89, 0·78-4·56), although the latter was not statistically significant. Members were more likely not to have purchased medicines over-the-counter (1·67, 1·22-2·27) than non-members. Members were also more likely to have utilized any additional specific service during a consultation (2·31, 1·49-3·58) including any type of imaging method (2·62, 1·29-5·29) and blood tests (1·64, 0·99-2·71). There were some differences between men and women, but most were not statistically significant. InterpretationThe M-FUND health microinsurance was positively associated with the utilization of all major types of health services among migrant workers and their dependents in Thailand. For migrants, particularly vulnerable migrant workers and their dependents, the M-FUND appears to be a good approach to reducing barriers to health care. This study of the impact of health microinsurance for migrants provides important information for policy and program planners in the field of migrant health. However, more research is needed on health microinsurance schemes for migrants in different settings and for other underserved communities as well as the sex-specific impact on health service utilization.

Local antibiotic delivery via intra-articular catheter infusion for the treatment of periprosthetic joint infection: a systematic review.

There is an increasing interest in the use of intra-articular (IA) antibiotic infusion as a stand-alone or adjuvant therapy to standard revision surgery for periprosthetic joint infection (PJI). The objective of this systematic review is to evaluate the evidence with respect to this up-and-coming treatment modality. A systematic review of studies published until April 2023 was conducted using PubMed, Embase, MEDLINE and Cochrane databases. Quality assessment was performed with the National Institute of Health quality assessment tool. Inclusion criteria were adult patients (≥ 18years) with a mean follow-up of ≥ 11months and a score ≥ 6 on the National Institute of Health quality assessment tool. Primary outcome was eradication of infection. 15 articles, encompassing 631 PJIs in 626 patients, were included in the final analysis, all level IV case series. The majority was treated with single-stage revision with adjuvant IA antibiotic infusion (79.1%). The remaining PJIs were treated with stand-alone IA antibiotic infusion (12.2%), DAIR (debridement, antibiotics and implant retention) with adjuvant IA antibiotic infusion (5.7%) or two-stage revision with adjuvant IA antibiotic infusion (3.0%). Mean duration of IA antibiotic infusion was 19days (range 3-50). An overall failure rate of approximately 11% was found. In total 117 complications occurred, 71 were non-catheter-related and 46 were catheter-related. The most common catheter-related complications were premature loss of the catheter (18/46) and elevated blood urea nitrogen (BUN) and creatinine levels (12/46). Due to the lack of comparative studies the (added) benefit of IA antibiotic infusion in the treatment of PJI remains uncertain. Based on the current evidence, we would advise against using it as a stand-alone treatment. A prospective randomized controlled trial using a well-described infusion protocol is needed to see if the potential benefits justify the increased costs and potential complications of this treatment modality.

Excellent level in the certification process of the health quality agency of Andalusia

Excellent level in the certification process of the health quality agency of Andalusia

Medication reuse programs: a narrative review of the literature.

A proportion of returned medications may potentially meet quality standards to be reused safely. In Australia, there is no regulatory guidance available to facilitate such medication reuse. This narrative review aimed to identify and review international literature describing medication reuse programs to provide insight into their implementation and potential barriers. Using the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) -based guidelines, a literature search was conducted in Medline, Scopus, and Embase using key words such as 'medication' and 'reuse' to identify relevant articles. Two reviewers ascertained eligibility for inclusion. Inclusion criteria included English language and publication after 2010. From the articles selected, identified international medication reuse programs and relevant regulatory aspects were summarized. Details, both regulatory and operational, for the specific medication reuse programs, described in the selected articles was further explored via a grey literature search. Of the 1973 identified articles, 84 were assessed for eligibility and 17 were included in this review. Of these, 14 described scenarios where medication reuse is prohibited, 2 studies described programs allowing the reuse of medication and 1 study did not discuss whether reuse was prohibited or not. From these primary articles, secondary citations were identified, with eight from gray literature. Barriers to medication reuse included exposure to environmental extremes during storage, physical appearance, evidence of tampering, safety, and efficacy concerns for the returned medication. Programs that exist globally have overcome these barriers. Several programs that provide safe and effective reuse of medications were i© The Author(s) 2024. Published by Oxford University Press on behalf of International Society for Quality in Health Care. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site-for further information please contact journals.permissions@oup.com.dentified and described. The findings described in this review should be used to inform frameworks for legislative, regulatory, and professional practice change for medication reuse. Measures implemented in the UK's pandemic response to safely reuse medications in the nursing home and hospice settings and European medication donation programs should be further investigated. The concept of medication reuse is not novel and should be considered for the Australian setting.

Cancer diagnosis after emergency presentations in people with mental health and substance use conditions: a national cohort study

BackgroundCancer survival and mortality outcomes for people with mental health and substance use conditions (MHSUC) are worse than for people without MHSUC, which may be partly explained by poorer access to timely and appropriate healthcare, from screening and diagnosis through to treatment and follow-up. Access and quality of healthcare can be evaluated by comparing the proportion of people who receive a cancer diagnosis following an acute or emergency hospital admission (emergency presentation) across different population groups: those diagnosed with cancer following an emergency presentation have lower survival.MethodsNational mental health service use datasets (2002–2018) were linked to national cancer registry and hospitalisation data (2006–2018), to create a study population of people aged 15 years and older with one of four cancer diagnoses: lung, prostate, breast and colorectal. The exposure group included people with a history of mental health/addiction service contact within the five years before cancer diagnosis, with a subgroup of people with a diagnosis of bipolar disorder, schizophrenia or psychotic disorders. Marginal standardised rates were used to compare emergency presentations (hospital admission within 30 days of cancer diagnosis) in the exposure and comparison groups, adjusted for age, gender (for lung and colorectal cancers), ethnicity, area deprivation and stage at diagnosis.ResultsFor all four cancers, the rates of emergency presentation in the fully adjusted models were significantly higher in people with a history of mental health/addiction service use than people without (lung cancer, RR 1.19, 95% CI 1.13, 1.24; prostate cancer RR 1.69, 95% CI 1.44, 1.93; breast cancer RR 1.42, 95% CI 1.14, 1.69; colorectal cancer 1.31, 95% CI 1.22, 1.39). Rates were substantially higher in those with a diagnosis of schizophrenia, bipolar disorder or psychotic disorders.ConclusionsImplementing pathways for earlier detection and diagnosis of cancers in people with MHSUC could reduce the rates of emergency presentation, with improved cancer survival outcomes. All health services, including cancer screening programmes, primary and secondary care, have a responsibility to ensure equitable access to healthcare for people with MHSUC.

Medication errors occurrence and reporting: A qualitative study of the Jordanian nurses' experiences

Background & Aim: Medication errors are a significant concern in healthcare, with effective management largely dependent on understanding its causes and reporting practices. This study aims to explore the experiences of Jordanian nurses in relation to medication error occurrence and reporting within the Jordanian context and the factors that may influence their decisions to report or not. Methods & Materials: A qualitative descriptive approach was used. 24 nurses from three different hospitals were interviewed. The hospitals included a major governmental institution, a private facility, and a university hospital, ensuring diverse healthcare settings. Data were analyzed using Braun and Clarke’s thematic analysis, and the study was reported guided by the COREQ checklist. Results: Three major themes were identified: Obsolete policies and guidelines, Adapting to an Unhealthy Environment, and Trying to adjust: creating own definition for MEs. In our study, medication errors emerged as a pervasive issue across Jordanian hospitals, attributed to both systemic failures and individual practices. Despite existing policies, participants reported frequent MEs due to obsolete guidelines, lack of adherence, and an environment that hinders effective medication administration. Conclusion: The study reveals the critical issues of medication errors in Jordanian hospitals due to outdated policies and challenging environments. It emphasizes the need for updated protocols and a culture supportive of error reporting. Addressing these factors is essential for improving patient safety and healthcare quality.

A more complete measure of vertical integration between physicians and hospitals.

To develop an accurate and reproducible measure of vertical integration between physicians and hospitals (defined as hospital or health system employment of physicians), which can be used to assess the impact of integration on healthcare quality and spending. We use multiple data sources including from the Internal Revenue Service, the Centers for Medicare and Medicaid Services, and others to determine the Tax Identification Numbers (TINs) that hospitals and physicians use to bill Medicare for services, and link physician billing TINs to hospital-related TINs. We developed a new measure of vertical integration, based on the TINs that hospitals and physicians use to bill Medicare, using a broad set of sources for hospital-related TINs. We considered physicians as hospital-employed if they bill Medicare primarily or exclusively using hospital-related TINs. We assessed integration status for all physicians who billed Medicare from 1999 to 2019. We compared this measure with others used in the existing literature. We conducted a simulation study which highlights the importance of accurately identifying integrated physicians when study the effects of integration. We extracted physician and hospital-related TINs from multiple sources, emphasizing specificity (a small proportion of nonintegrated physicians identified as integrated). We identified 12,269 hospital-related TINs, used for billing by 546,775 physicians. We estimate that the percentage of integrated physicians rose from 19% in 1999 to 43% in 2019. Our approach identifies many additional physician practices as integrated; a simpler TIN measure, comparable with prior work, identifies only 30% (3877) of the TINs we identify. A service location measure, used in prior work, has both many false positives and false negatives. We developed a new measure of hospital-physician integration. This measure is reproducible and identifies many additional physician practices as integrated.

Quality Coordinators' Perspectives on Quality Improvement in Primary Healthcare in Kosovo: A Qualitative Study.

This qualitative descriptive study provides insights into the experiences of quality coordinators (QCs) in primary healthcare to inform policy and practice actions and empower QCs to enhance healthcare quality. We conducted focus group discussions with purposefully selected QCs to understand their motivations, job experiences, factors influencing healthcare quality, and suggestions for quality improvement. Content analysis and deductive coding were used to scrutinize the responses and answer the research questions. The QCs thought highly about their job performance and were motivated by both extrinsic and intrinsic factors. Clinical audits, collegial reviews, and managerial support positively affected QCs' performance. In contrast, a lack of managerial support, limited working hours, and changes in organizing work caused the opposite. Empowerment and external support positively influenced healthcare quality, whereas lack of resources, managerial support, or training had a negative influence. Suggestions to improve quality include the role of QCs, external supervision, and centralization of the QCs' network. Appointing QCs alone does not guarantee quality improvement. It is essential to ensure that QCs have the appropriate skills, tools, management support, and open communication channels. Further research is required to evaluate the effects of sex and age on QCs' performance.

Cholesterol and Its Oxidation Derivatives Content in Market Dairy Products.

Cholesterol oxidation products (COPs) are contaminants of food of animal origin. Increased levels of these compounds in the human body are associated with an increased risk of many non-communicable diseases. Dairy products are mentioned among the main sources of these compounds in the diet. The objective of this study was to evaluate the contents of cholesterol and its oxidized derivatives in eleven groups of dairy products, willingly consumed in European countries. The levels of COPs were determined by applying the GC-TOF/MS method. In the tested products, cholesterol and its oxidation derivatives, such as 7-ketocholesterol, 7α-hydroxycholesterol, 7β-hydroxycholesterol, 5,6β-epoxycholesterol and 5,6α-epoxycholesterol, were determined. The studied dairy products differed in their contents and profiles of oxysterols. The highest contents of COPs were found in cheese with internal mold (13.8 ± 2.5 mg kg-1) and Cheddar (11.7 ± 3.5 mg kg-1), while the lowest levels were detected in yoghurt (0.94 ± 0.30 mg kg-1) and kefir (0.57 ± 0.11 mg kg-1). 7-ketocholesterol and 5,6β-epoxycholesterol were the dominant oxysterols. The ratio of oxidized derivatives to total cholesterol was on average 1.7%. Our results confirmed that dairy products are an important dietary source of COPs. Their levels should be monitored in dairy products to provide the best health quality.

Relationship between Knowledge Level and Hand Hygiene Compliance among Nurses at Kudungga Sangatta Regional Hospital

Hand hygiene is an effective step to break the chain of infection transmission. Root cause analysis shows that the knowledge factor is a determinant of hand hygiene compliance behavior. Knowledge of correct hand hygiene can provide protection against cross-contamination of diseases from one patient to another. The aim is to determine the relationship between knowledge level and hand hygiene compliance among nurses at Kudungga Regional Hospital. This type of quantitative research uses cross-sectional methods. The population in this study was 185 nurses at Kudungga Regional Hospital. Sample of 185 people/ The test results obtained a p-value = 0.000 (<0.05) with an odds ratio = 8.509. There is a relationship between the level of knowledge and hand hygiene compliance among nurses at Kudungga Sangatta Regional Hospital. It is hoped that the hospital will be able to improve the quality of service health to pay more attention to the risk of infection in the work environment.

Fatty acid and essential oil compositions of seeds of coriander (Coriandrum sativum L.) Cultivated in different regions of Ethiopia

Coriander (Coriandrum sativum L.) seeds are used as spices. In this study, fatty acids extracted from the coriander seeds collected from three places (Sululta, Jimma and Wolaita Sodo) in Ethiopia were determined as their methyl ester using GC-MS. The fatty acid components were assessed using linoleic acid ethyl ester as an external standard. Sululta sample showed five fatty acids, while Wolaita Sodo and Jimma three each with highest amount of petroselinic acid: 68.41%, 72.53%, and 64.4%, respectively, of the total fatty acids. Linoleic acid (omega-6) was found in the range of 18.24-22.37%. The polyunsaturated versus saturated (P/S) index values were found to be 1.69-2.39, which indicated that coriander seeds from the three sites have a good capacity to prevent the development of cardiovascular and some chronic diseases. The number of compounds identified in the essential oils of coriander seeds from Jimma, Sululta, and Wolaita Sodo were 7, 9, and 15 with total percent areas of 99.64, 75.14, and 96.68, respectively. The major component in the essential oils was linalool ranging from 36.72-88.50% of the total amount. In general, the chemical constituents of fatty acids and essential oils of coriander seeds indicates its good nutritional quality and usefulness for human health. KEY WORDS: Coriander seeds, Fatty acids, P/S index, Essential oils, Nutritional quality, Spice Bull. Chem. Soc. Ethiop. 2024, 38(4), 863-876.                                                              DOI: https://dx.doi.org/10.4314/bcse.v38i4.4

Service quality attributes on customers’ perceived value and behavioral intention of district health centres: a moderating effect of health-care subsidy

Purpose This study aims to explore the influence of health-care service quality on customers’ perceived value, satisfaction, effectiveness and behavioural intention concerning district health centres (DHCs) in Hong Kong. This research also intends to assess customers’ perception of the subsidy scheme and its influence on the relationships amongst the aforementioned constructs. Design/methodology/approach The convenience and snowball sampling approaches were adopted, and the self-administered questionnaire was sent to 309 customers of DHCs. Findings Service quality attributes in terms of staffing and procedures positively increased customers’ perceived value and staffing, procedures and operations. Physical facilities positively promoted customers’ satisfaction, consequently improving DHCs’ effectiveness and behavioural intention. However, core treatments and services of DHCs did not impact customers’ perceived value and satisfaction. Furthermore, customers receiving subsidies exhibited a more positive perception than those without subsidies. Practical implications Health-care organisations are advised to strategically allocate resources (staffing, facilities and procedures and operations management) to optimise overall performance outcomes. DHC operators could reinforce the core services of DHCs and health-care voucher subsidies to local citizens so as to enhance the effectiveness of DHCs and behavioural intention of customers. Originality/value This study integrates the input–process–output approach in measuring the effectiveness of and customers’ behavioural intention towards newly established DHCs.

Structural equation models of health behaviour, psychological well-being, symptom severity and quality of life in abdominal bloating.

The objective of this study was to investigate the inter-relationship between psychosocial variables and their impact on symptom severity and quality of life (QoL) concerning abdominal bloating. The study adopted a cross-sectional design with purposive sampling. Participants who consented and met the criteria for bloating based on the Rome IV classification completed designated questionnaires. Independent variables comprised health beliefs, intentions, health-promoting behaviors, social support, depression, and anxiety, while dependent variables included bloating severity (general and within 24 h) and QoL. Structural Equation Modeling (SEM) was conducted utilizing Mplus 8.0 to analyze the relationships between these factors. A total of 323 participants, with a mean age of 27.69 years (SD = 11.50), predominantly females (64.7%), volunteered to participate in the study. The final SEM model exhibited good fit based on various indices (CFI = 0.922, SRMR = 0.064, RMSEA (95% CI) = 0.048 (0.041-0.054), p-value = 0.714), with 15 significant path relationships identified. The model explained 12.0% of the variance in severity within 24 h, 6% in general severity, and 53.8% in QoL. The findings underscore the significant influence of health beliefs, intentions, behaviors, social support, depression, and anxiety on symptom severity and QoL in individuals experiencing abdominal bloating.

Development of a Framework to Improve the Provision of Water, Sanitation, and Hygiene in Healthcare Facilities of Mwandi District in Western Province

Healthcare facilities (HCFs) require safe water, sanitation, hygiene, environmental cleaning, and waste management (WASH) in the provision of quality services to promote, restore, maintain, and improve health. However, the unavailability of studies on the challenges and opportunities of WASH services in HCFs of Mwandi District has limited the potential for improved health care and quality of life. Without proper elucidation, this has the potency to dissuade women from using HCFs for childbirth and healthcare, potentially increasing maternal mortality rates. To examine the challenges and opportunities in accessing safe WASH services in HCFs in Mwandi District, more of Qualitative techniques were utilized to gather data from 8 HCFs in Mwandi District. This involved initial observations employing the WASH Status Checklist, followed by focus group discussions with expectant mothers and 23 key informant interviews. Thematic analysis was used to analyse the data.  The results showed that only half of the investigated facilities provided basic water services, hampered by water salinity issues. Even though most facilities had improved sanitation facilities, they, however, do not meet the basic sanitation standards. This was primarily due to issues such as corroded pipes, insufficient accessible toilets for people with disabilities, and the absence of menstrual hygiene facilities. Many facilities lacked gender-segregated staff facilities. Most of the facilities had functional hand hygiene facilities but also did not meet the basic standards due to a lack of soap for hand washing. A significant number encounter inefficiencies in cleaning protocols, and the majority face poor infrastructure conditions. The findings further revealed that these challenges stem from inadequate prioritization and funding for Water, Sanitation, and Hygiene (WASH) initiatives. The existing knowledge often concentrates on individual components, the findings stress the necessity for an integrated approach that collectively addresses water supply, sanitation, hygiene, and waste management. This holistic perspective can significantly contribute to the development of more effective guidelines and policies, offering a nuanced understanding of the interconnected nature of WASH components. Furthermore, the research sheds light on the pivotal role of localized political will, specifically highlighting the influence of Health Centre Advisory Committees (HAHC) in shaping governance at the community level, especially concerning WASH projects. The study offers a comprehensive overview of challenges and sustainability opportunities related to WASH services, crucial for their effective functioning. It emphasizes the necessity for heightened awareness and increased budget allocation for the sustainable maintenance of WASH services

What you need to know about common skin problems in older adults.

Skin ageing is a multifaceted process impacted by both intrinsic and extrinsic factors. Drier and less elastic skin with declining sebum levels in older age makes ageing skin more vulnerable to various skin conditions, including infections, inflammatory dermatoses, and cancers. Skin problems are common among older adults due to the effects of ageing, polypharmacy and multimorbidity impacting not only physical health but wellbeing and quality of life. In the UK, older adults in geriatric medicine wards may present with various skin conditions. Hospitalised older individuals may have undiagnosed skin problems unrelated to their admission, making hospitalisation an opportunity to manage unmet needs. Asteatotic eczema, incontinence associated dermatitis, seborrhoeic dermatitis, chronic venous insufficiency, and cellulitis are common disorders clinicians encounter in the geriatric medicine wards. This article outlines the importance of performing comprehensive skin assessments to help diagnose and commence management for these common conditions.

Assessment of nutritional status and health behaviors in yoga-trained women versus exercisers.

Recreational physical activity is becoming more popular due to the increased public awareness about the beneficial effects on health status and quality of life. The aim of the study was to assess the nutritional status and health behaviors of women who regularly practice yoga as a form of physical recreation and to compare them with those who had not practiced before and had just signed up for yoga classes. A total of 143 women took part in this study. The nutritional status was assessed based on the obtained anthropometric measurements. The following indicators were calculated: Body Mass Index (BMI) and waist-to-hip ratio (WHR), determining the visceral accumulation of fat tissue. Health behaviors were assessed using a standardized five-point scale Health Behavior Inventory (HBI). There were significant differences in the value of the general health behavior index, the sten scale, and the subscale regarding proper eating habits in the study groups compared to women who had not practiced yoga before (control group). Health behaviors indicators, particularly proper eating habits, are significantly higher in women participating regularly in yoga exercises, indicating a higher awareness among yoga practitioners. It can be suggested that yoga participation as a recreational physical activity can be an appropriate option for pursuing healthy habits.