Separate Room Research Articles

Hubungan Kualitas Pelayanan Dengan Kepuasan Pasien Poli Umum Puskesmas Mamburungan Kota Tarakan

Satisfying excellent service will definitely have an impact on achieving a standard value of satisfaction for patients or service recipients. Patient satisfaction is the best assessment of the description of the diversity of service quality received by patients. This research was conducted with the aim of knowing the relationship between service quality and patient satisfaction at the general polyclinic at the Mamburungan Health Center, Tarakan City, by applying the RATER concept, namely responsiveness, assurance, tangible, empathy, and reliability. This research is descriptive quantitative using the Cross Sectional Study method conducted on 165 respondents, using a questionnaire, with the result that the quality of service is good, and patient satisfaction at the Mamburungan Health Center is satisfied. The results of the data analysis test Rho Spearman's P value (Sig. (2-tailed) 0.00 and α 0.05 which proves that there is a significant relationship between service quality and patient satisfaction in the general polyclinic at the Mamburungan Health Center, Tarakan City. It is hoped that the Mamburungan Public Health Center can further improve quality services by creating separate examination rooms so that patient privacy can be better maintained, not combining multiple services so that patient privacy and comfort can be increased, and building cleanliness, service rooms, tidiness, and the appearance of officers so that they can be further improved so that maximum patient satisfaction can be achieved.

Modifying burn care in a low- and middle-income countries (LMIC) to meet global best practice: A burn unit or burn isolation ward?

The overwhelming burden of burns in low-income (LIC) and low-middle-income (LMIC) countries has been well-documented. Though best global practice is for major burns to be treated in burn units, the prohibitive cost makes it difficult. In this article we attempt to present the improvement in outcome recorded over a period of 3 years as we transitioned from nursing our burns patients in the general surgical wards (Group A), then a separate cubicle within the wards (Group B) and then an isolated burn ward (Group C). Other practices such as physiotherapy, traditional wound dressings, and limb splinting remained the same.Data of patients who met criteria for burn unit admission during these periods were analysed and compared. The groups were matched across age, depth of burn, total body surface area burned (TBSA) and length of hospital stay (LOHS). There was an improvement in the lethal area 50% (LA50) at 31.1 %, and in mean LOHS of 18 ± 3.8 days in group C.Most LICs and LMICs do not have functional health insurance schemes for burns patients and overall resources allocated for healthcare cannot support a state-of-the-art burn unit. Our report attempts to encourage such countries to adapt global practice to their economic reality. Minimal changes like an isolated burn ward, separate shower room for wound dressings, strict hygiene practices, and limiting visitor traffic may go a long way to improve burn patient outcome.

Cervical Cancer Screening Services in Nepal: A Descriptive Crosssectional Study.

Cervical cancer, the most prevalent cancer among women, is also the primary cause of cancer-related deaths in reproductive age women in Nepal. The study aims to assess the situation of cervical cancer screening services in Nepal. This cross-sectional study used quantitative methods to understand the situation of cervical cancer screening in 572 health facilities of Nepal. The research was conducted to assess screening facilities, the allocation of separate screening rooms, the availability of screening services on a routine basis throughout the week, screening facilities that are free of charge, human resources, and the availability of treatment. It was conducted in October to December 2022. The research was carried out among 572 healthcare facilities, out of which 134 (23.42%) had provision for cervical cancer screening services. Ethical approval was obtained from the Nepal Health Research Council (NHRC) under reference number 397/2022 P. Amongst those 134, 72 (53.73%) healthcare facilities had assigned separate rooms for screening intentions. One hundred and two (76.12%) healthcare facilities provided regular screening services throughout the week, while 112 (83.58 %) had free-of-charge screening services. Concerning trained personnel, 121 (90.30%) health facilities had personnel trained in visual inspection with Acetic acid, 9 (6.72%) had personnel trained in use of colposcopy, and 5 (3.73%) had personnel trained in use of Loop Electrosurgical Excision Procedure (LEEP). Lastly, 31 (23.13%) healthcare facilities offered treatment choices for cervical cancer. Most of the health care facilities did not have provision of cervical screening. Amongst those who had the provision, personnel trained in loop electrosurgical excision procedure colposcopy.

Addressing obstetric violence: a scoping review of interventions in healthcare and their impact on maternal care quality.

The mistreatment and abuse of women during childbirth have been recognized as a major global health challenge, impeding facility-based delivery and contributing to the high maternal mortalities globally. The World Health Organization has specifically called for interventions to deal with obstetric violence. This scoping review consolidates the existing literature on interventions aimed at reducing obstetric violence and synthesizes existing knowledge on their impact in promoting respectful maternity care. Thirteen electronic databases were searched for relevant articles from January 2001 to March 2023. A total of 863 records were identified, and 72 full-text articles were retrieved for further screening. The review includes 16 studies, particularly from low- and middle-income countries, with interventions implemented at medical facilities and involving both women and healthcare providers. Eight of the studies were quantitative, three were qualitative and five used a mixed-methods approach. The results reveal a promising trend in reducing obstetric violence through various interventions. Ten different types of interventions were identified, highlighting strategies to improve the quality of maternity care and enhance patient-centered care. Improved patient-provider communication skills, increased privacy measures, and reduced abuse and mistreatment emerged as common themes. Enhanced communication skills, including open discussions and the right to be informed, were crucial in reducing obstetric violence. Privacy measures, such as separate rooms, curtains, and birth companions effectively decreased incidents of non-confidential care. General abuse and mistreatment, including physical abuse and neglect, were also reduced, leading to improved perceptions of respectful care during childbirth. Overall, the interventions had a favorable impact on obstetric violence reduction and women's childbirth experiences. However, despite promising results, obstetric violence remains prevalent worldwide, necessitating more efforts to implement effective interventions. To the best of our knowledge, this is the first scoping review on obstetric violence interventions, providing a comprehensive overview of the state of the art. We suggest that further research is needed to explore new interventions, particularly gender-sensitive interventions, to contribute to a growing body of knowledge on the prevention of obstetric violence.

Intriguing connection between diminished ovarian reserve and childhood traumatic experiences, a prospective case-control study

IntroductionDiminished ovarian reserve (DOR) presents a complex challenge in the field of infertility, with factors like age and genetics traditionally under scrutiny. However, the potential influence of adverse childhood experiences on ovarian reserve remains a relatively unexplored area. This research aims to contribute novel insights to the understanding of diminished ovarian reserve etiology, shedding light on previously unexplored risk factors and their potential implications. DesignThis case-control study was conducted at an Assisted Reproductive Technology (ART) Center of a university hospital. Infertile patients admitted to the ART center were enrolled in the study. The case group consisted of 102 infertile women diagnosed with diminished ovarian reserve, and the control group consisted of 103 healthy women with male factor infertility. An interview lasting approximately 30 min was held in a separate room with those who volunteered to participate in the study. Due to the sensitivity of the research subject, the data was collected anonymously. The Childhood Trauma Questionnaire was used to measure adverse childhood experiences, and the Hospital Anxiety and Depression Scale (HADS) was used to assess anxiety and depression in the study. The results were compared between the case and the control groups. ResultsOverall, the total score of the Childhood Trauma Questionnaire and all subscale scores were higher in the case group (38.28 ± 9.86) than in the control group (35.10 ± 9.52). According to HADS, the total score was 15.92 ± 7.98 in the case group and 14.22 ± 6.87 in the control group. ConclusionsOur pioneering study is designed to investigate a previously unexplored risk factor in low ovarian reserve. Considering our data and other studies in the literature examining childhood traumas as a risk, it makes us think that the issue is worth examining.

Student Satisfaction and Physical Health Effects of Online Learning Among Medical and Paramedical Undergraduates in Northern India: A Cross-Sectional Study.

Online modality of pedagogy was introduced in many medical institutes globally, especially during the COVID-19 pandemic. However, these techniques were not evaluated, either with respect to effectiveness or student satisfaction in terms of promoting successful educational outcomes. The current study was conducted to identify determinants of student satisfaction with respect to online learning, in the post-pandemic era. A pilot-tested and validated online questionnaire was administered to 370 medical/paramedical students who attended online classes during the pandemic. The students were selected randomly from four different streams of a medical university, representing all the years of study. The questionnaire included Likert-type questions and was divided into two parts: socio-demographic profile and satisfaction with online learning. The response rate was 81.4%. Overall satisfaction with online learning among students was 35.9% and the areas of most satisfaction for students were user-friendliness of the online portal (65.5%), self-directed responsibilities assigned to pupils (49.9%), faculty accessibility/availability (48.8%) and timely evaluation, test and feedback (47.9%).The areas of most dissatisfaction were lack of personal effect as compared to offline learning (n=71, 23.6%), effect on social life (n=54, 17.9%), and feeling of not belonging to the online session (n=38, 12.6%). Multiple regression analysis demonstrated that having previous exposure to online courses and having a separate room led to more satisfaction, whereas the emergence of health problems led to poor satisfaction with the course. The duration of previous exposure to online courses was not a statistically significant predictor of satisfaction. One or more health problems were reported by 176 (58.5%) of the respondents. Some of the common health problems reported were eye strain (72.8%), headache (56.1%), insomnia (47.2%), stress (35.2%), muscle fatigue (22.6) and tingling sensation (10.6%). Adopting a combination of online and offline approaches, i.e., blended pedagogy, involving different methods to involve students and their feedback are important to ensure student satisfaction.

Pharmacy Students’ perceptions on distance learning: A case of COVID-19

Online distance learning systems gained importance during school closures all over the world after the COVID-19 outbreak. Pharmacy schools in Türkiye were also affected by these changes and educational activities which shifted to online distance education. In this study, we aimed to evaluate the attitudes of pharmacy students concerning distance education during the pandemic regarding their gender, infrastructural issues, having separate rooms, their classes, residency areas and the number of theoretical and applied courses. We conducted a cross-sectional survey. Thus, a total of 380 pharmacy students participated from pharmacy schools in Türkiye. The perceptions of pharmacy students were compared as per their demographical and educational status. Except gender variable, no significant difference was found among the students. Switching to online distance education formed as a response to the crisis in the pandemic. Although student perceptions from different disciplines have been examined in the existing literature, pharmacy students' perceptions remained limited. Hence, it is important to understand and point out the students' perceptions related to online distance education in pharmacy schools to be prepared for future emergencies.

Exploring Forms and Practices of Menstruation in the Changing Social System: A Study of Suryabinayak-05, Katunje, Bhaktapur

Menstruation forms and practices with restriction have a long history not only in a single culture and region but in various religions and cultures may vary according to the level of their cultural norms, values and superstitions. The aim of the study is to explore the forms of practices of menstruation in the changing Nepali society. The qualitative data were collected from the Suryabinayak-05, Katunje, Bhaktapur district. All total 10 potential research participants were selected for in-depth interview along with non-participant observation in the field. The study indicates that the women from Brahmin and Chhetri community affiliated to Hindu religion are practicing almost all forms of discrimination due to menstruation. Stay in a separate room, eating in a separate room, bathing in separate bathroom, be away from social activities and not participate in religious activities. This discrimination should be addressed through awareness programs in the community.

29 Effects of using different dietary standardized ileal digestible lysine plans on growth performance and carcass characteristics of PIC 337 or PIC 800 sired grow-finish pigs

Abstract The present study aimed to evaluate the impact of using different dietary standardized ileal digestible (SID) lysine (Lys) plans on growth performance of PIC 337 and PIC 800 sired grow-finish pigs. A total of 2,016 gilts and barrows were placed in 2 separate rooms with 48 single sex pens each (21 pigs/pen; 0.69 m2/pig). Pens were blocked by body weight (BW) and randomly allotted in a 2 × 2 × 2 factorial arrangement with genetic line (PIC 337 or 800), sex (barrows or gilts), and nutrition plan (current SID Lys curve recommendation for PIC 800 as % of PIC 337 SID Lys curve or alternative SID Lys curve) as factors. Pigs (27.4 ± 1.41 kg BW) were followed during the grower-finisher phase until slaughter. Pigs were fed either the current recommendation or an alternative SID Lys curve for PIC 800, in a 5 phase feeding program: phase 1 (23-40 kg; 97 vs 100%, respectively); phase 2 (40-60 kg; 97 vs 95%, respectively); phase 3 (60-80 kg; 97 vs 95%, respectively); phase 4 (80-105 kg; 97 vs 95%, respectively); and phase 5 (105-135 kg; 97 vs 90%, respectively). Pigs were fed isoenergetic diets. Performance and carcass traits, and removals and mortality were recorded. Data were analyzed using mixed models in R, and considering pen as the experimental unit for performance traits and individual carcasses for carcass traits. There was no evidence of interaction between genetic line and nutrition plan factors. Overall, PIC 337 vs 800 pigs did not differ on average daily gain (ADG; P > 0.05), but PIC 337 pigs consumed 150 g/d less and were 0.1 more feed efficient than PIC 800 pigs (P < 0.05; Table 1). Moreover, PIC 337 pigs had 1.9 kg less of hot carcass weight, but 2.1 mm more of loin depth compared with PIC 800 pigs (P < 0.05; Table 1). Regarding nutrition plan, no significant differences were observed for overall performance and carcass traits between pigs fed the current or alternative SID Lys curve (P > 0.05; Table 1). Additionally, no significant differences were observed for overall removals and mortality by genetic line or nutrition plan (P > 0.05; Table 1). In summary, different genetic sire line (PIC 337 and PIC 800) differed on performance and carcass traits. Further research is needed to continue studying the genetic evolution and nutrition plan for each genetic sire line in the grower-finisher period to understand their nutrient requirements.

Delivering clinical tutorials to medical students using the Microsoft HoloLens 2: A mixed-methods evaluation

BackgroundMixed reality offers potential educational advantages in the delivery of clinical teaching. Holographic artefacts can be rendered within a shared learning environment using devices such as the Microsoft HoloLens 2. In addition to facilitating remote access to clinical events, mixed reality may provide a means of sharing mental models, including the vertical and horizontal integration of curricular elements at the bedside. This study aimed to evaluate the feasibility of delivering clinical tutorials using the Microsoft HoloLens 2 and the learning efficacy achieved.MethodsFollowing receipt of institutional ethical approval, tutorials on preoperative anaesthetic history taking and upper airway examination were facilitated by a tutor who wore the HoloLens device. The tutor interacted face to face with a patient and two-way audio-visual interaction was facilitated using the HoloLens 2 and Microsoft Teams with groups of students who were located in a separate tutorial room. Holographic functions were employed by the tutor. The tutor completed the System Usability Scale, the tutor, technical facilitator, patients, and students provided quantitative and qualitative feedback, and three students participated in semi-structured feedback interviews. Students completed pre- and post-tutorial, and end-of-year examinations on the tutorial topics.ResultsTwelve patients and 78 students participated across 12 separate tutorials. Five students did not complete the examinations and were excluded from efficacy calculations. Student feedback contained 90 positive comments, including the technology’s ability to broadcast the tutor’s point-of-vision, and 62 negative comments, where students noted issues with the audio-visual quality, and concerns that the tutorial was not as beneficial as traditional in-person clinical tutorials. The technology and tutorial structure were viewed favourably by the tutor, facilitator and patients. Significant improvement was observed between students’ pre- and post-tutorial MCQ scores (mean 59.2% Vs 84.7%, p < 0.001).ConclusionsThis study demonstrates the feasibility of using the HoloLens 2 to facilitate remote bedside tutorials which incorporate holographic learning artefacts. Students’ examination performance supports substantial learning of the tutorial topics. The tutorial structure was agreeable to students, patients and tutor. Our results support the feasibility of offering effective clinical teaching and learning opportunities using the HoloLens 2. However, the technical limitations and costs of the device are significant, and further research is required to assess the effectiveness of this tutorial format against in-person tutorials before wider roll out of this technology can be recommended as a result of this study

A Comparative Study of Parent and Child Perspectives on Using the Intranasal Mucosal Atomization Device for Behavior Management in Pediatric Dental Sedation.

Background Dental anxiety in children often necessitates sedation for effective treatment. Different methods of sedation have proved to be beneficial. However, intranasalsedation provides a needleless, rapid drug delivery method that bypasses hepatic metabolism. Intranasal sedative drugs can be delivered using a mucosal atomization device (MAD). This study aimed to find the opinions, beliefs, and existing knowledge of parents and children regarding intranasal sedation and the method of drug delivery through MAD. Materials and methods The study comprised 50 parents, aged 20 to 50, who came in with a single child, aged five to nineyears. In separate rooms, parents and kids were each shown a video about the use of the intranasal sedation technique with MAD as a pharmaceutical help during routine dental procedures. After the video presentation, each participant was required to complete a pretested self-made questionnaire with 21 questions and multiple-choice options. The chi-square test was used in the statistical analysis of the completed questionnaires (P < 0.05). Paired t-test was used for behavior assessment of the children before and after intranasal sedation. Results A significant correlation between parental socioeconomic status and acceptance of intranasal sedation was observed. Parents with higher education levels exhibited a greater level of acceptance (P = 0.000). Parents whose children had prior dental experiences were more likely to view intranasal sedation as a safe option (P = 0.038). Additionally, a significant proportion of previously sedated children expressed willingness to undergo treatment using intranasal sedation. Evaluation of children's behavior before and after treatment revealed a notable improvement, indicating the effectiveness of intranasal sedation (P = 0.000). Conclusion The study thoroughly investigated how parents and children view intranasal sedation via MAD. It revealed a positive perception of safety and trust among parents regarding this method for pediatric dental procedures.

Long-baseline quantum sensor network as dark matter haloscope.

Ultralight dark photons constitute a well-motivated candidate for dark matter. A coherent electromagnetic wave is expected to be induced by dark photons when coupled with Standard-Model photons through kinetic mixing mechanism, and should be spatially correlated within the de Broglie wavelength of dark photons. Here we report the first search for correlated dark-photon signals using a long-baseline network of 15 atomic magnetometers, which are situated in two separated meter-scale shield rooms with a distance of about 1700 km. Both the network's multiple sensors and the shields large size significantly enhance the expected dark-photon electromagnetic signals, and long-baseline measurements confidently reduce many local noise sources. Using this network, we constrain the kinetic mixing coefficient of dark photon dark matter over the mass range 4.1 feV-2.1 peV, which represents the most stringent constraints derived from any terrestrial experiments operating over the aforementioned mass range. Our prospect indicates that future data releases may go beyond the astrophysical constraints from the cosmic microwave background and the plasma heating.

Averting Depletion in a Two-Player Common Pool Resource Game: Being Seen, the Expectation of Future Encounters, and Biophilia Play a Role in Cooperation

AbstractUsing a two-player common pool resource game, we investigated the influence of multiple factors on cooperation: (1) probability of future rounds, (2) visibility of other participants, (3) biophilia, (4) future discounting, and (5) life history. In each round, participants simultaneously and independently (without conferring) decided how much of the common pool to consume. Participants (n = 116) were informed that the shared resource would be fully replenished in the next round—but only if—both players together consumed ≤ 50% of the common pool in the current round. Additionally, participants were told the probability (0–100%) of further rounds of play with the same player (this probability was not real; it was purely to manipulate the player’s expectations). To assess the effect of the probability of future rounds, we developed a mathematical model to predict the threshold that would permit a Nash Equilibrium of Conditional Cooperation (CC). To manipulate visibility, half the pairs were tested in the same room (seen condition) and half in separate rooms (unseen condition). To measure biophilia, the “Nature Relatedness” (NR) scale was used. To measure future discounting, the “consideration of future consequences” (CFC) scale was used. To measure life history, the participant’s UK postcode was obtained (indicating possible residence in a deprived neighbourhood). Participants in our study were not paid. In our results, there was a significant effect showing more cooperation in the visible than not visible condition, but no significant effects of NR, CFC, nor postcodes (but NR was significant in interaction with visibility). For predictability of future rounds, we found a number of significant effects using different tests. A notable result was that there was significantly more CC when the probability of future rounds was ≥ 69% (congruent with one of our model predictions).

Changes in Pharmacy Students' Awareness of Hepatitis B Patients through Patient Lectures as Humanity Education: Findings from Questionnaire Surveys of Face-to-Face and Simultaneous Remote Classes.

In 2020, the coronavirus disease 2019 (COVID-19) pandemic made social distancing compulsory. In patient lectures by hepatitis B patients (Patient Lectures)-a humanity education initiative that had traditionally been delivered face-to-face to assembled students-it was necessary to divide the students into two groups, one that attended the Patient Lectures in person (face-to-face group) and another that assembled in a separate room to view the delivered lecture simultaneously and remotely via a teleconferencing platform (remote group). To investigate possible changes in students' awareness of hepatitis B patients before (pre-) and after (post-) the lecture that year, the face-to-face and remote-attendance groups were analyzed separately. The participants were 203 fourth-year students belonging to the Faculty of Pharmaceutical Sciences at Japan's Setsunan University, whose pre-clinical education curriculum prior to pharmacy practice experience included a Patient Lecture. The students were divided into two groups based on their student-ID numbers. Survey questionnaires were completed anonymously before and after the Patient Lecture. The students' awareness of hepatitis B patients' experience changed significantly after attending the Patient Lectures; this change was similar in both the face-to-face and remote-attendance groups. Regarding the possibility of hepatitis B virus infection, the remote group selected fewer answers implying strong convictions than did the face-to-face group, and both groups perceived several issues incorrectly. Although slight differences were observed between the two groups, the changes before and after the lectures were similar, indicating that humanity-education lectures are worthwhile not only when delivered in face-to-face contexts but also when delivered and viewed remotely within a class setting.

The effect of task on speech production and conversation behavior during conversation

The purpose of this study was to investigate how native-English, healthy-hearing individuals adapt their speech production and conversation behavior in the presence of noise and how this can vary based on conversational goal. Pairs of participants engaged in both free-form conversations as well as conversations based on solving a task (a “spot the difference” task using the Diapix UK pictures). Although seated in separate rooms, talkers could communicate via headset microphones and headphones with gains set to simulate levels that would be present if they were seated in the same room. The effects of task and noise on measures of speech production (e.g., articulation rate, speech level, etc.) and conversational behaviors (e.g. floor transfer offsets, turn length, etc.) are investigated. These results provide insights into how to infer listening effort via acoustical measures of communication in a broader range of settings.

Nurse anaesthetists’ experiences of student nurse anaesthetist learning during clinical practice: a qualitative interview study

BackgroundThe professional role of a nurse anaesthetist involves taking a pedagogical approach towards students, including supervision during clinical practice. Although supervisors are facilitators of student learning, they are offered little training in adult learning principles. The aim of this study was to describe supervisors’ experience of student nurse anaesthetist learning during clinical practice in the operating room.MethodIn this qualitative interview study, 12 semi-structured individual interviews were carried out with clinical supervising nurse anaesthetists. The data were analysed inductively using thematic analysis.ResultsThe results are illustrated with one theme and five sub-themes. The clinical learning situation of student nurse anaesthetists is described as a reflection of different cultures coming together. The operating room environment is a new context to students, and students enter with different clinical background and experiences. There is tension in facilitating student learning due to demands for productivity; supervisors suggest the use of separate operating rooms with a special focus on learning in the future.ConclusionClinical practice facilitates student learning and is a parallel process to routine care. Thus, it requires the cultures of higher education and healthcare organizations to co-exist. This is illustrated with the theme “Contributing to students’ future professional roles by bridging the hospital and university cultures”. In the operating room, student learning is challenged by a new context and time pressure as shown by subthemes. To overcome challenges and support student learning in the operating room from a supervisors’ perspective, interprofessional student teams are suggested as a future approach and need to be further investigated.

Prevalence oftrachomatous inflammation-follicular and associated factors among children aged 1-9 yearsin northeastern Ethiopia.

Trachoma is the most prevalent eye disease in Ethiopia, especially among children aged 1-9 years and continues to be a public health concern. Nevertheless, in Ethiopia's rural Jamma district in South Wollo Zone of Amhara Regional State, factors associated with trachomatous inflammation-follicular (TF) among children aged 1-9 yearshave not yet been studied. A community-based cross-sectional study was conducted among 616 children aged 1-9 years in rural Jamma district in Ethiopia from January-March, 2019. Data were collected using a pre-tested structured questionnaire, an observation checklist and clinical examination of study participants for active trachoma. The presence of TF and trachomatous inflammation-intense (TI) was clinically assessed by integrated eye care workers using the World Health Organization simplified grading system. Data were analysed using SPSS (Statistical Package for Social Sciences) Version 25.0. A logistic regression model with 95% CI was used. From the multivariable analysis, variables with p-value < 0.05 were declared as associated factors of TF. The prevalence of TF was 10.9% (95% CI [8.6 - 13.6%]) among the rural children aged 1-9 years.The mean family size was 5.5 ± 1.9 persons. About one-fifth (20.6%) of households kept domestic animals overnight in the same room as family. Almost one-sixth (17.5%) of the children involved in this study had an ocular discharge. Two-thirds of the children (68.8%) washed their hands once per day and just over half (55.8%) washed their faces once per day. From multivariable analysis, we found that the presence of domestic animals kept overnight in the same room as the family (adjusted odds ratio [AOR] = 4.32; 95%CI [2.49-9.52]), mother's/caregiver's illiteracy (AOR = 2.01; 95%CI [1.11-4.67]), household size (> 7 persons) (AOR = 3.50; 95%CI [1.66-8.50]), washing of children's hands and face without soap (AOR = 2.41; 95%CI [1.29-5.18]), feces observed in the compound (AOR = 5.10; 95%CI [2.01-10.14]), presence of ocular discharge (AOR = 7.23, 95%CI [4.10-12.51]) and nasal discharge (AOR = 4.54, 95%CI [1.95-9.26]) were significantly associated with TF. The prevalence of TF among rural children aged 1-9 years in this study was almost two times higher than the WHO-recommended threshold (TF < 5%) for trachoma elimination and beyond the trachoma control target (TF < 10%). Presence of domestic animals kept overnight in the same room as the family, mother's/caregiver's illiteracy, household size (> 7 persons), washing of children's hands and face without soap, feces observed in the compound, presence of ocular and nasal discharge were significantly associated with TF. We recommended interventions that will help household income to be improved to enable families to be able to construct separate rooms in which to keep animals overnight. Furthermore, we also recommend to policy makers to design mechanisms for enhancement of behavioural change among householdersto keep household compounds clean and creating awareness among mothers/caregivers about prevention of trachoma.

Factors influencing access to and utilization of youth-friendly sexual and reproductive health services in Isiolo County, Kenya

Background: Although there has been momentum in implementing sexual and reproductive health (SRH) services in most countries, young people typically remain underserved by these services despite their demonstrated need. This study aimed to determine the factors influencing access to and utilization of youth-friendly sexual and reproductive health (AYSRH) services in Isiolo County. This study was conducted under the Jhpiego-supported Accelerating Post pregnancy Family Planning Integration into Primary Healthcare (APIP) project that supports Isiolo.&#x0D; Methods: Mixed-methods qualitative and quantitative approach​ was used. Data were collected using the KOBO digital tool. and analysis was performed using NVivo and Stata for qualitative and quantitative data, respectively.&#x0D; Results: The baseline study found that 69% of the APIP-supported facilities offered YFSRHS, with 77% of the facilities conveniently located for ease of access by the youths. 69% of the facilities had AYSRH signages displayed outside the buildings, with 31% displaying the signages inside the building. 31% of the facilities had separate counseling and examination rooms to ensure privacy for the youths as they sought services. 54% of the facilities involved the youth in decision-making during the provision of the YFSRHS. The study also found that 31% of the facilities involved their communities and made them aware of the YFHS provided at the hospitals. &#x0D; Conclusion: Interventions focusing on implementing YFSRHS should aim at addressing challenges affecting quality services in health facilities to offer them according to the youth’s needs.

Assessing the Nepalese health system's readiness to manage gender-based violence and deliver psychosocial counselling.

Violence against women (VAW), particularly intimate partner violence (IPV) or domestic violence, is a major public health issue, garnering more attention globally post-coronavirus disease 2019 (COVID-19) lockdown. Health providers often represent the first point of contact for IPV victims. Thus, health systems and health providers must be equipped to address survivors' physical, sexual and mental health care needs. However, there is a notable lack of evidence regarding such readiness in Nepal. This study, utilizing a concurrent triangulation design, evaluated the readiness of public health facilities in Nepal's Madhesh Province in managing VAW, focusing on providers' motivation to offer psychosocial counselling to survivors. A cross-sectional study was conducted across 11 hospitals and 17 primary health care centres, where 46 health care providers were interviewed in February-April 2022. The study employed the World Health Organization's tools for policy readiness and the Physician Readiness to Manage IPV Survey for data collection. Quantitative and qualitative data were collected via face-to-face interviews and analysed using descriptive and content analysis, respectively. Only around 28% of health facilities had trained their staff in the management of VAW. Two out of 11 hospitals had a psychiatrist, and a psychosocial counsellor was available in four hospitals and two out of 17 primary health care centres. Two-thirds of all health facilities had designated rooms for physical examinations, but only a minority had separate rooms for counselling. Though a few health facilities had guidelines for violence management, the implementation of these guidelines and the referral networks were notably weak. Hospitals with one-stop crisis management centres demonstrated readiness in VAW management. Health providers acknowledged the burden of IPV or domestic violence and expressed motivation to deliver psychosocial counselling, but many had limited knowledge. This barrier can only be resolved through appropriate training and investment in violence management skills at all tiers of the health system.

Exploring the Effect of Head-Worn Displays on Prehospital Teamwork Using Online Simulation: A Crossover Randomized Controlled Trial.

Prehospital teamwork occurs in dynamic environments where paramedics work together using technologies to care for patients. Despite increasing interest in using head-worn displays (HWDs) to support prehospital workers, little is known about how HWDs affect teamwork. We tested the effect of HWDs on the team processes and patient care of paramedic trainee teams in a laboratory study using an online prehospital simulation environment, SPECTRa. In a randomized crossover design, 20 two-person teams worked in the SPECTRa laptop environment from separate physical rooms to assess and treat 2 simulated patients in 3 prehospital patient care scenarios. In each scenario, each trainee used either an HWD, a tablet computer (TAB), or no mobile device (CON) to help them monitor the vital signs of both patients. We measured team processes based around 3 themes of mutual understanding, team performance, and administered an 18-item questionnaire about teamwork and use of the devices. The mean number (HWD = 11; TAB = 7; P = 0.061) and duration (HWD = 1746 milliseconds; TAB = 1563 milliseconds; P = 0.504) of attention switches that teams made toward the mobile device did not differ with HWDs or TABs. However, teams switched attention between patients less with HWDs than with TABs ( P = 0.026) or CON ( P = 0.007) (medians: HWD = 5; TAB = 8; CON = 8). Teams communicated less when using HWDs than TABs ( P = 0.017) (medians: HWD = 76; TAB = 96; CON = 83), but there were other mixed effects on communication. Team performance did not differ across device conditions on the timeliness to notice critical patient changes ( P = 0.387) (medians: HWD = 244 seconds; TAB = 246 seconds; CON = 168 seconds) or to complete the scenarios ( P = 0.212) (medians: HWD = 800 seconds; TAB = 913 seconds; CON = 835 seconds). Questionnaire results revealed some perceived benefits of the HWD. Head-worn displays may let prehospital teams monitor each other's performance more efficiently than TABs or CON, requiring less communication to maintain patient care performance with lower workload than with TABs. However, improvements in mutual understanding with HWDs compared with CON were more evident in teams' preferences than in actual behavior. Further research is needed to confirm and extend these results.