Professional Recommendations Research Articles

P-1725. A Cluster Randomized Trial of Bundled Interventions to Reduce Inappropriate Antibiotic Use in the Outpatient Setting

Abstract Background Antibiotics are often inappropriately prescribed in the outpatient settings. Among the most common reasons for inappropriate antibiotic prescriptions are upper respiratory tract infections (URI) which are known or highly likely to be viral in origin. Our aim was to test a bundle of complementary interventions to reduce inappropriate antibiotic prescriptions in the outpatient setting for patients presenting with various URIs. Here we present preliminary data from the cluster randomized trial using pre-intervention baseline data (August to October 2023) and after implementation of interventions (December 2023 to March 2024).Figure 1.Comparison of inappropriate antibiotic prescriptions for URTIs between the intervention and control groups during the pre-intervention (Aug 2023 – Oct 2023) and post-intervention phases (Dec 2023 - Mar 2024). Methods We randomly assigned 2 Primary Healthcare Centers (PHCC) in Qatar to receive a 4 component intervention: 1) extensive provider education; 2) providing an algorithm driven decision support tool based on professional society recommendations for appropriate use of antibiotics for various URIs; 3) option for deferred prescription; and 4) monthly feedback to all physicians regarding their prescription patterns including anonymized comparison with their peers. Two PHCCs in the control group received a single intervention which was randomly chosen. For this study, we identified 4 common URIs for which professional society guidelines do not recommend use of antibiotics (acute bronchitis, acute laryngitis, common cold, influenza without mention of pneumonia). Prescriptions written and corresponding diagnoses were retrieved from the electronic medical records. Children < 2 years of age, and individuals with any immune compromising condition or medications were excluded.Table. 1Appropriate and Inappropriate use of antibiotics in URTIs Results A total of 7,246 antibiotic prescriptions were written for 4 included URIs during the study period. The percentage of inappropriate prescriptions in the intervention group decreased from 67.7% to 62% in the first 4 months after the intervention (p-value >0.05). The proportion of inappropriate prescriptions in the control groups remained steady at 70% before and after the intervention. Conclusion While not statistically significant in this early stage, our preliminary results indicate a trend in reduction in inappropriate prescriptions of antibiotics for URIS in the outpatient setting. Disclosures Adeel A. Butt, MD, MS, Gilead Sciences: Grant/Research Support

Users´ perspectives and preferences on using wearables in epilepsy: A critical review.

Seizure detection devices (SDDs) offer promising technological advancements in epilepsy management, providing real-time seizure monitoring and alerts for patients and caregivers. This critical review explores user perspectives and experiences with SDDs to better understand factors influencing their adoption and sustained use. An electronic literature search identified 34 relevant studies addressing common themes such as usability, motivation, comfort, accuracy, barriers, and the financial burden of these devices. Usability emerged as the most frequently discussed factor, with patients and caregivers also emphasizing the importance of ease of use, long battery life, and waterproof design. Although validated devices showed high user satisfaction, technical challenges, false negatives, and false positives need much improvement. Motivation to use SDDs was driven by enhanced safety, symptom tracking, and health care professional recommendations. Comfort and wearability were also critical aspects, with users favoring lightweight, breathable, and discreet designs for long-term wear. Users reported the devices as "comfortable" and preferring wrist or arm-worn devices for the long term. Accuracy-particularly minimizing false positives and false negatives-was a priority for users. Barriers to adoption included device cost, limited insurance reimbursement, discomfort, and concerns about data privacy. Despite these challenges, many users were willing to use SDDs. Recommendations from health care professionals significantly increased user motivation. This review highlights the need for SDD designs that address user concerns regarding usability, comfort, looks, and accuracy, while also reducing financial and technical barriers. Enhancing clinical involvement and tailoring devices to specific patient needs may be crucial to promoting wider SDD adoption. Further research is needed to evaluate the impact of SDDs on quality of life and to explore ways to mitigate challenges in long-term use.

Eco-dentistry: Sustainable practices for healthier life and a greener planet

Background: Eco-friendly dentistry, or “Green Dentistry,” is a concept aimed at minimizing the environmental impact of dental practices by reducing waste, conserving energy, and preventing pollution. The idea first emerged during the 5th European Dental Students’ Association Congress in Belgrade, Serbia, in March 2003. It was proposed as a new and evolving practice to address the environmental harm caused by conventional dental methods. Objective: This review aims to present a series of “green” recommendations for dental professionals, patients, and dental industries, providing practical, sustainable alternatives to promote eco-friendly practices within the field of dentistry. Methods: An electronic search was conducted using the PubMed database, focusing on peer-reviewed articles up to February 2024 using the keywords “green dentistry,” “eco-friendly dentistry,” and “dental waste,” resulting in 45297, 1186, and 9372 items, respectively. After a thorough review, relevant data from other electronic sources were also included for additional information. Results: The adoption of green dentistry practices encourages the integration of sustainable technologies and methods by dental professionals. It promotes the use of eco-friendly materials, digital tools to reduce paper waste, energy-efficient equipment, and recycling programs, all of which contribute to reducing the ecological footprint of dental practices. Conclusion: Green dentistry offers a viable approach to making dental care more sustainable by reducing waste, conserving resources, and preventing pollution. By embracing sustainable practices, dental professionals, patients, and industries can collectively help minimize the environmental impact of dental care, ultimately promoting a greener wellness lifestyle.

Ethical Imperatives in Marketing Analytics: A Framework for Responsible Data Practice in the Digital Age

This article examines the ethical challenges and considerations in data analytics within marketing and public relations contexts, focusing on the intersection of technological advancement and professional responsibility. Through analysis of current practices, regulatory frameworks, and industry cases, the article explores critical issues including privacy protection, algorithmic bias, transparency in data collection, and professional accountability in automated decision-making. The article addresses the tension between leveraging detailed consumer insights and maintaining ethical boundaries, particularly in an era of increasing reliance on artificial intelligence and machine learning tools. The article proposes a comprehensive framework for ethical data analytics that encompasses privacy protection, bias mitigation, and transparent practices while acknowledging the evolving nature of digital marketing landscapes. The findings suggest that while regulatory compliance provides a foundation, organizations must develop robust ethical guidelines that go beyond basic requirements to build trust and ensure responsible data usage. This article contributes to the growing body of literature on digital ethics and provides practical recommendations for professionals navigating the complex relationship between data-driven decision-making and ethical responsibility in marketing and public relations.

Patient and Health Care Professional Perspectives on Barriers to and Facilitators of Healthy Eating and Exercise Among Patients With Cancer at a Safety-Net Oncology Clinic: A Qualitative Exploration.

Previous studies have described barriers to and facilitators of healthy eating and being physically active among patients with cancer, but few have done so in a safety-net community oncology setting. To understand multiple perspectives on the factors that influence diet and exercise in patients with cancer treated in safety-net settings, we conducted semistructured interviews between June and November 2021 with patients and oncology clinic medical professionals at a safety-net hospital in Houston, TX. Thirty-one patients with cancer were interviewed, including 11 patients on active treatment and 20 survivors, as well as 21 care health care professionals. Most patients thought that they had a healthy diet but did not exercise enough, mainly because of cancer-related symptoms. The majority stated that they would like to participate in healthy living programs and follow their doctor's recommendations although only half noted receiving any recommendations from their provider. Health care professionals perceived patients' barriers to healthy diet and exercise as lack of knowledge, low access to resources, and low motivation, potentially impacting adherence to lifestyle recommendations. Patients with cancer in a safety-net oncology clinic were motivated to participate in healthy living activities. However, health care professionals believed that patients faced barriers with the potential to impact adherence to health care professional recommendations. Further research is needed to better understand and optimize lifestyle counseling in a safety-net oncology setting and explore potential referral pathways to healthy living programs for patients.

P0524 Advanced therapy options, choice, access, and treatment empowerment for Inflammatory Bowel Disease (ADVOCATE-IBD): A UK-wide qualitative study

Abstract Background Inflammatory Bowel Disease (IBD) impairs the quality of life of more than 6.8 million people worldwide1 through symptoms such as severe abdominal pain and faecal urgency. Advanced therapies such as biologics, are increasingly being used in treatment, each holding unique characteristics that influence patient preferences. By understanding these, treatment adherence, long-term health outcomes and shared decision-making can be enhanced2. This study aimed to outline the core domains of patient priorities and values around advanced therapies which influence decision-making. Methods Guided by data saturation3, participants were recruited through social media and Crohn’s and Colitis UK using purposive sampling4. Participants undertook a single semi-structured interview that followed a topic guide informed by the results of a Patient and Public Involvement group. Audio-recordings of interviews were transcribed verbatim prior to undergoing reflexive thematic analysis. Results A total of 26 UK-based participants were recruited who were predominantly female (73.1%) and aged 31-40 (34.6%). The five themes identified were: “Fitting Treatment and Monitoring into Life”, “The influence of Drug Characteristics”, “Balancing Efficacy and Side-effects”, “Optimizing the Quality of Care”, and “Promoting Shared Decision Making and its Value”. Conclusion Patient decision-making and satisfaction with treatment are influenced by multiple factors that evolve in importance over time. For patients, shared decision-making involves having the autonomy to make choices that are disparate from professional recommendations but influenced by open discussions about their care. Shared decision-making also means being actively listened to and their preferences being integrated into their care. Patient decision-making was shaped by the perceived ease of physical drug administration, drug effectiveness at inducing and maintaining remission, and the flexibility of integrating a treatment and its monitoring requirements into their daily lives. Consideration of short- and long-term adverse reactions was generally minimal, as these risks were viewed to be necessary for achieving symptom control. To patients, high-quality care constituted being involved in decisions about their treatment, reliable access to healthcare services in a timely fashion, and comprehensive information about their disease and treatment.

Addressing challenges in pediatric thrombosis: a comprehensive guideline development

BackgroundPediatric thrombosis is a relatively rare but severe condition in the field of pediatrics, with far-reaching consequences. Recent studies have indicated a rising incidence of this disease in children over the years. Additionally, the pharmacological treatment of thrombotic diseases in children faces numerous challenges. Due to significant physiological differences between children and adults, guidelines for the prevention and treatment of thrombotic diseases in adults cannot be directly applied to pediatric patients.PurposeA systematic review of the existing evidence-based medical literature should be conducted to propose pharmacological prevention and treatment recommendations for pediatric thrombotic diseases. Developing a comprehensive and practical pharmacotherapy guideline for the prevention and treatment of pediatric thrombotic diseases is essential to enhancing the rational use of medications in managing these conditions in children.MethodsThe guideline development followed the World Health Organization's (WHO) Handbook for Guideline Development. This involves systematically searching and extensively collecting data on common medication issues in the prevention and treatment of pediatric thrombosis nationwide. The Delphi method was used to survey experts and identify the clinical issues to be included. Subsequently, a systematic literature review was conducted to evaluate existing primary studies, systematic reviews, and guidelines or consensus statements from professional organizations. The quality of the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. The Delphi method was employed again to reach a consensus on the recommendations and evidence levels. This process was culminated in the development of the Guideline for Pharmacological Management of Thrombotic Diseases in Children.ResultsDuring the guideline development process, a total of 29 clinical issues were collected and evaluated by 78 experts in clinical pharmacy and clinical medicine. Through two rounds of surveys, 13 clinical issues were selected. Under the supervision of two methodologists, 13 clinical pharmacotherapy recommendations were formulated.ConclusionBy conducting a comprehensive assessment of the feasibility and safety of clinical practices, the guideline provides specific anticoagulant medication recommendations for pediatric healthcare professionals. This will help enhance the prevention and treatment of pediatric thrombosis, promoting more standardized and effective medical practices.

P0767 Sub-optimal adherence with vaccination recommendations in immunosuppressed IBD patients in the post COVID-19 pandemic era

Abstract Background People with Inflammatory Bowel Disease (IBD) on immunosuppressive therapy are at increased risk of vaccine-preventable infectious diseases including influenza, COVID-19, pneumococcal pneumonia and varicella zoster (shingles).1 The COVID-19 pandemic has resulted in reduced trust in immunisation guidance.2 Our aim was to assess adherence to vaccination guidance in adult IBD patients and identify barriers to uptake.3,4 Methods A paper-based survey was completed by patients at two large UK centres (St Mark’s Hospital and Imperial College Healthcare Trust, London). Data were collected on demographics, vaccination history and attitudes and barriers to vaccination. The primary outcome was adherence to the recommended UK vaccination schedule for immunosuppressed individuals in 2023-2024. Univariable and multivariable analyses were performed to identify factors associated with vaccine uptake. Results 209 IBD patients (102 with ulcerative colitis, 99 with Crohn’s disease, 7 with IBD-unclassified, 1 unknown; 56% male; median age 39.5 years (range 18-86)) completed the survey between February and April 2024. 194 patients were on immunosuppressants (47.4% TNF inhibitors, 31.6% vedolizumab and 31.6% azathioprine/mercaptopurine, 11.5% systemic corticosteroids and 12.9% on other advanced therapies). Only 22.2% of patients reported receiving all recommended vaccinations. Vaccine uptake in eligible patients was influenza 64.4%, COVID-19 56.7%, pneumococcal 30.9%, and shingles (Shingrix®) 16.9% (Figure 1A). Increasing age (OR=1.03, CI=1.00-1.07) and receiving a recommendation for vaccination from a healthcare professional (OR=3.43, CI=1.73-6.92) were associated with increased uptake. Uncertainty about vaccine necessity (66.7% for COVID-19, 44.9% for influenza), lack of awareness of guidance (61.2% for pneumococcal) and concerns about safety (18.8% for Influenza, 17.9% for COVID-19) were the most common reasons for non-uptake (Figure 1B). Shingrix® eligibility in the UK is limited to individuals aged 50 years and above, but 12.1% of ineligible immunosuppressed patients (under 50 years old) reported having an episode of varicella-zoster (shingles). Conclusion Vaccination uptake in immunosuppressed IBD patients in the post COVID-19 pandemic era is suboptimal, increasing the risk from preventable infectious diseases. Healthcare professional recommendation plays an important role in reducing non-uptake and IBD clinicians should advocate strongly for patients to be immunised. We have identified high rates of shingles in our cohort and Shingrix® vaccination should be rolled out for all immunosuppressed adults with IBD.

Prediction models for post-traumatic stress disorder in family members of ICU patients: A systematic review.

Several predictive models have been developed for post-traumatic stress disorder (PTSD) in intensive care unit (ICU) family members. However, significant differences persist across related studies in terms of literature quality, model performance, predictor variables and scope of applicability. This study aimed to systematically review risk prediction models for PTSD in family members of ICU patients, to make recommendations for health care professionals in selecting appropriate predictive models. China National Knowledge Infrastructure, VIP database, Wanfang database, SinoMed, PubMed, Web of Science, Cumulative Index to Nursing and Allied Health Literature, The Cochrane Library, Embase and OVID were searched from inception to 1 May 2024. Two independent researchers conducted literature screening, data extraction and applied a risk of bias assessment tool for predictive models to evaluate included studies. The systematic review was registered on PROSPERO (registration number: CRD42024560815). Seventeen studies were included, with sample sizes ranging from 32 to 2734. Incidence rates of outcomes ranged from 1.6% to 63.6%. The most frequently used predictors were relative's female sex, longer duration of ICU stay, patient's death in the ICU and type of relationship with the patient. Two models reported area under the receiver operating characteristic curve (AUC) values ranging from 0.73 to 0.74; only three models reported calibration, and one study conducted internal validation. Overall, the 17 studies showed good applicability but exhibited a high risk of bias, particularly in data analysis. Research on predictive models for PTSD risk in family members of ICU patients is in the developmental stage. Future studies should validate existing models or develop high-performance localized predictive models. PTSD can have a significant impact on the families of ICU patients, making early identification of high-risk populations essential for health care professionals to implement timely interventions.

The moderating role of environmental ethics in the effect of green innovation awareness on corporate social responsibility

PurposeThe purpose of this study is to examine how green innovation awareness is integrated into corporate social responsibility (CSR) practices and what regulatory role environmental ethics plays in this process. This study evaluates how green innovation shapes the environmental, social and economic responsibilities of businesses and its impact on achieving sustainable development goals.Design/methodology/approachThe population of this study consists of four field operation centers of a nuclear power plant operating in the Mediterranean Region of Turkey. The sample consists of 397 employees in the field operation center using simple random sampling method.FindingsThe findings of this study revealed positive and significant relationships between the variables. According to the results obtained from both models, green innovation awareness and environmental ethics variables have a positive and significant effect on CSR, but environmental ethics does not have a moderating role in the effect of green innovation awareness on CSR.Originality/valueThis study is important in that it will help to clarify the gray areas in the literature by developing recommendations for practitioners, researchers and professionals in line with the research results. In addition, the fact that the research was conducted in the field studies of a nuclear power plant, which is one of the best places to address the issues of green innovation, CSR and environmental ethics, increases its importance.

Awareness, knowledge, and attitudes of the Belgian general population towards paternal perinatal depression: a descriptive cross-sectional study.

Paternal perinatal depression affects 10% of fathers, implying a significant burden on families and public health. A better insight into the population's health literacy could guide professionals and policymakers in addressing these men and making better use of existing healthcare options. It is also crucial for caregivers, as they play a vital role in identifying symptoms, encouraging help-seeking, and reducing stigma. This study aimed to explore the awareness, knowledge, and attitudes of the general population in Belgium towards paternal perinatal depression, using the validated DDads (Depression in Dads) questionnaire. This descriptive, cross-sectional study was conducted between March and May 2020-2022 using convenience sampling. Participants aged over 18 years, with a good understanding of Dutch and residing in the Brussels-Capital Region or Flemish Brabant were invited to participate. Data were analysed using descriptive statistics, Chi² analysis, and independent sample t-test. A total of 314 participants, including women (n=165) and men (n=149) completed the questionnaire. Anxiousness was the most frequently cited mental health problem for men during their partners' pregnancy (82.5%) and in the postnatal period (68.5%). Over one-third (37.3%) viewed paternal depression as a 'normal' part of the transition to fatherhood. The recommended treatment for paternal depression was mostly non-pharmacological, with family support ranking first (79.9%) and seeking support from informal networks being the most recommended approach (45.2%). New personality characteristics such as withdrawal, cynicism, raging attacks, and irritability, among others, were seen as common symptoms (64.6%). Although 70% of respondents believed that perinatal depression requires specialized treatment, only 39.2% agreed that all men should be screened for depression during pregnancy. Recognition of paternal depression symptoms was relatively low but higher among females, participants with higher education, and those aware of paternal depression. Professional support recommendations were limited, especially among young people and those without children. The terms 'paternal perinatal depression' and 'perinatal mental health' are poorly understood. The findings highlight critical gaps in awareness and attitudes, offering valuable insights. Future research should develop tailored interventions to support men's mental well-being during the perinatal period. Targeted awareness campaigns and healthcare improvements are crucial for addressing this issue.

Glucagon-like Peptide-1 receptor agonists versus dipeptidyl-peptidase 4 inhibitors in advanced chronic kidney disease and end stage kidney disease: Real world effectiveness and persistence of therapy

BackgroundAtherosclerotic cardiovascular disease is the leading cause of death in people with type 2 diabetes (T2D) and chronic kidney disease (CKD) or end-stage kidney disease (ESKD). Glucagon-Like Peptide-1 receptor agonists (GLP-1RA) reduce cardiovascular events, improve glycemic control, promote weight loss, and slow progression of nephropathy. Despite these benefits and professional society treatment guidelines recommendations, GLP-1RAs remain under-utilized in people with advanced CKD and ESKD due to tolerability and safety concerns. MethodsWe conducted a retrospective cohort study comparing clinical outcomes and medication use details after initiating GLP-1RA or dipeptidyl-peptidase 4 inhibitor (DPP-4i) in people with T2D and advanced CKD or ESKD. Eligible patients were identified via electronic health record query with extraction of baseline demographics, vital signs, and laboratory values. A manual chart review was undertaken to confirm eligibility, medication use, and extract a detailed account of all side effects. ResultsA total of 236 eligible patients (149 in the GLP-1RA group and 87 in the DPP-4i group) were identified. The average duration of treatment was 1036 (±909.9) and 1109 (±1090.9) days for GLP-1RA and DPP-4i, respectively. The average percentage weight loss from baseline to 36 months of treatment in the GLP-1RA group was −9.6 % (95 % CI, −11.3 to −7.8) versus −2.4 % (95 % CI, −5.4 to 0.5) in the DPP-4i group (estimated treatment difference (ETD) -7.1 (95 % CI, −10.6 to −3.7) percentage-points, p < 0.001). The change in HbA1c from baseline to 36 months of treatment was significantly greater in the GLP-1RA (−1.0 %) compared with the DPP-4i group (0.2 %) (ETD -1.2 (95 % CI, −2.1 to −0.3) percentage-points, p = 0.04). ConclusionIn patients with T2D and advanced CKD or ESKD, treatment with GLP-1RAs in a real-world setting had long treatment persistence, and compared to DPP-4is, was associated with greater weight loss and glycemic improvement.

PRESCRIPTIVE MAINTENANCE ON THE FACTORY FLOOR: ANALYTICAL THEORETICAL REFLECTION

Purpose: Analyze the perceptions of researchers and experts in the implementation of Prescriptive Maintenance on the factory floor in companies located in Espírito Santo, Southeast Region of Brazil considering the strategies recommended by carrying out the SWOT analysis. Methodology/Approach: The methodological procedures used were a combination of three data collection mechanisms, a bibliographical research, considering the impacts of Prescriptive Maintenance on the factory floor and an empirical work, by sending a questionnaire to researchers and experts to analyze their perceptions. Furthermore, the application of the SWOT analysis (Strengths, Weaknesses, Opportunities and Threats) to evaluate the strategic considerations arising from said analysis. Findings: The study provides recommendations for managers and professionals working on the factory floor, showing the needs for improvement in maintenance tasks that is, considering the strategic impacts of Prescriptive Maintenance and the importance of digitizing the factory floor. Research, practical &amp; social implications: The results of this study offer valuable perspectives for the formulation of strategic policies aimed at attracting the efficiency of physical assets. They also have important implications for Maintenance Management and can serve as a reference for future studies on the topic. Originality/ Value: Based on the data obtained, the authors present the importance of organizational synchronization between different sectors of companies considering the systemic view, therefore, recommending this model for small companies, due to the existence of barriers in the implementation of technological modernization in companies of this size using new methodologies of research.

Antiracist activism for immigrant rights and healthy coping: Initial evidence for a community‐based framework

AbstractRacist and xenophobic policies in the United States (e.g., family separations and lack of access to protected immigration statuses for undocumented immigrants) have historically excluded immigrants of color from accessing full civil rights, thus contributing to widening racial inequities in the US. Racism and xenophobia intersected with other systems of oppression during the COVID‐19 pandemic, exposing immigrants of color to detrimental health effects. Research shows that activism helps immigrants of color cope with systemic stressors and protect their psychological well‐being. In this manuscript, we introduce the antiracist activism for immigrant rights (AAIR) framework to clarify how activism in response to systemic stress may promote healthy coping. This framework was developed together by scholars and immigration activists in the US Critical and liberatory theory and research on empowerment and healing also informed AAIR. Using structural equation modeling, we tested the framework in a community sample of 204 immigrants of color. Results support the model, depicting antiracist immigration activism as a latent construct manifested as a combination of engagement in racial justice, immigrant rights, and electoral activism. Further, results support the link between antiracist immigration activism and healthy coping in response to stress from immigration and health. We provide recommendations for behavioral health professionals to promote antiracist immigration activism and healthy coping among immigrant communities.

Application Software for Water Quality Data Management (MajiBora-DM) in Tanzania

In Tanzania, water quality laboratories face the difficult task of managing all of the processes involved in handling water samples. These tasks include registering samples, evaluating their quality, documenting critical parameters, analyzing data, making professional recommendations on water treatment solutions to achieve superior results, and creating comprehensive reports for clients. In this paper, the authors explain the development of the Majibora-DM program, a comprehensive tool for managing water quality data. The authors developed MajiBora-DM using the Python Integrated Development Environment (IDE), pyinstaller, and the Inno compiler, then tested it on a Windows operating system computer. It demonstrated the ability to register samples, allow data sharing among computers connected to the internet, record water quality parameters, analyze water quality, interpret data, and generate reports with water treatment approach recommendations. The software plays a crucial role by calculating the impact of chemical dosages on water quality parameters in water treatment plants, thereby recommending the most effective dosage to achieve the desired quality. Also, it can simplify water quality data analysis, allow real-time data sharing, generate water quality reports, and suggest the appropriate water treatment method using artificial intelligence to achieve clean and safe water for the intended use.

Increasing Graduate Student Awareness of Cultural Competence Through Bias Exploration Related to Diverse Cultural Families.

Emphasis by the American Nurses Association and the American Association of Colleges of Nursing regarding the importance of cultural competence in nursing education led to the development of a strategy to address personal bias in graduate nursing students. With the updated Essentials and a change to competency-based education, a need to address culturally congruent practices while increasing awareness of professional organization recommendations exists. Since Domain 2 of the Essentials highlights that culturally competent care is essential to person-centered care, a strategy that enhances knowledge by expanding the definition of culture beyond ethnicity and race was developed.

Experiences of caregivers of adolescents with Autism Spectrum Disorder during COVID-19 in Colombia

In March 2020, Colombia reported the first case of COVID-19. For caregivers of adolescents with Autism Spectrum Disorder (ASD) the pandemic represented unexpected, additional challenges. This exploratory study reports some of the experiences these caregivers of adolescents diagnosed with ASD faced in this region. Fourteen caregivers of adolescents with ASD were interviewed in Bogota, Colombia. Results from the interviews show that there were barriers and facilitators in adjusting to the restrictions of the pandemic. Some barriers include changes in routines, which instigated behavioral changes in the adolescents, and a negative impact on the caregivers’ mental health. Facilitators like companion animals, the temperament of adolescents, and family support helped caregivers adjust to the pandemic. This data highlights the resilience of Colombian caregivers during the pandemic and provides some recommendations for caregivers and professionals to address some of the challenges related to adolescents during and after the pandemic and potential emergency situations.

Paediatric patient perceptions of healthcare professionals: contributions to a communication curriculum

Communication skills are a vital but often neglected part of paediatric training. To make communication training more responsive to patient needs, children and adolescents should be involved in developing the communication curriculum for healthcare professionals, though this is rarely the case. The present study explored children and adolescents’ perceptions of healthcare professionals to identify recommendations for healthcare professionals to contribute to formulating goals, learning objectives, and competencies for an interprofessional paediatric communication curriculum. We used narrative and play-based interviews to include the perceptions of preschool children aged 3–6 years (n = 8) and an online questionnaire to explore those of schoolchildren and adolescents aged 5–18 years (n = 54). We did a thematic analysis of the qualitative interview data and open-ended questionnaire responses, which showed that preschool children found familiar approaches, physical contact, and their parents comforting and that healthcare professionals should use playful methods, child-friendly words, and tangible rewards. Schoolchildren and adolescents preferred healthcare professionals who were friendly, patient, attentive, communicated clearly, and engaged them in conversation. They did not like when healthcare professionals appeared stressed, did not keep their promises, or forced them to do something.Conclusions: We condensed perceptions of children and adolescents into tips and statements to be used in further development of a communication curriculum for paediatric healthcare professionals. Our findings emphasize that paediatric communication training should focus on healthcare professionals’ attitude and appearance, strategies for building trust and engaging patients in treatment and care, the use of age-appropriate communication, and understanding the cognitive development of children and adolescents.What is Known:• Communication is a core competence that all paediatric healthcare professionals must practice and maintain.• Children and adolescents can contribute to curriculum development, but only few studies have done so.What is New:• The perspectives of children and adolescents indicate that education programmes on paediatric communication should focus on the attitude and appearance of healthcare professionals, strategies to build trust and engage patients, age-appropriate communication, and understanding the cognitive development of children and adolescents.• Children and adolescents aged 3–18 years can contribute to the development of goals, learning objectives, and competencies for paediatric communication training, which may help promote more patient-centred approaches in practice.

Listening to my own and others’ voices: the experience of participants in teacher-education learning communities

ABSTRACT This study aimed to understand the dynamics of these collaborative frameworks and what characterized the relationships between the preservice teachers and the in-service teachers. The study followed the experiences of 131 participants in seven professional learning communities, a mix of preservice and in-service-cooperating teachers, established as part of a year-long (2021–22) practicum course at a teacher-education college. The in-service teachers taught at the schools where the preservice teachers practiced. Data from four different sources were collected and analyzed using qualitative strategies. The findings revealed three key practices that characterized the interpersonal relationships in these learning communities: hearing all participants’ voices; creating a space governed by social-emotional principles; and acknowledging the clinical supervisor’s important role as leader of the learning community. Findings are discussed in relation to the existing professional literature, and conclusions and recommendations are drawn.

Analyzing and Designing Decision Support Systems for Stroke Patient Daily Treatment

Stroke is one of the neurological diseases that often requires complex management and treatment. Making the right decisions in diagnosing and treating stroke patients can have a significant impact on the recovery process and the quality of life for patients. To assist healthcare professionals and patients in making more informed decisions, this research has developed the "StrokeCare Navigator," a web-based Decision Support System (DSS) that utilizes the Decision Tree C4.5 algorithm. This system allows users, including healthcare professionals and patients, to input symptoms and patient medical information, providing an initial diagnosis of the type and severity of the stroke. Additionally, the system offers personalized treatment guidelines, treatment recommendations, and online patient monitoring services. The Decision Tree C4.5 model used in this system was developed through training with relevant patient data. Evaluation results indicate that the system can provide accurate and beneficial recommendations for healthcare professionals and patients. Testing and patient monitoring in clinical practice also demonstrate the potential to enhance stroke patient care. Therefore, StrokeCare Navigator is expected to be a valuable tool in stroke patient management and treatment, ultimately improving the prospects of patient recovery and providing better guidance for healthcare professionals. This research also provides deeper insights into the implementation of the Decision Tree C4.5 algorithm in the context of Decision Support Systems (DSS) in the medical field.