Health Care Services In Settings Research Articles

Language and cultural concordance to promote equity in organ transplantation for Hispanics with limited English proficiency.

Hispanics with limited English proficiency (LEP) face unique challenges in accessing organ transplantation due to limited culturally concordant care and linguistically appropriate resources, leading to disparities in healthcare delivery and transplantation outcomes. This review examines how language barriers affect access to kidney and liver transplant, and highlights the importance of institutional support for quality interpretation services in promoting healthcare equity in transplantation. Hispanics experience greater disease burden, but are less likely to receive a transplant compared to non-Hispanic Whites. LEP is a significant barrier to transplantation. Culturally and linguistically concordant interventions, such as the "Hispanic Kidney Transplant Program," have demonstrated success in improving transplant-related outcomes among Hispanics. However, limited resources affect widespread implementation, and the broad lack of interpretation services in healthcare settings delay timely care in transplantation. Despite some progress demonstrated by culturally and linguistically concordant clinical intervention trials, disparities in transplantation for Hispanics with LEP remain. Enhancing the availability of interpretation services, recruiting and hiring bilingual healthcare professionals, and training healthcare staff to effectively engage with language and interpretation resources are critical to improving health equity. Efforts must prioritize language access and cultural concordance to address the unique challenges faced by Hispanics with LEP.

Risk factors of intimate partner violence in women attending a community-based sexual health center: Perceived discrimination as a key factor

Gender-based violence (GBV), specifically intimate partner violence (IPV), is a global problem that predominantly impacts women. This study aimed to investigate IPV among women visiting community sexually transmitted infections’ prevention and testing centers in Athens and Thessaloniki, Greece. A sample of 187 cis and trans women filled out a questionnaire on perceived discrimination, IPV, and involvement in sexualized drug and alcohol use (SDU and SAU). Results revealed that 39.8% of women reported IPV experiences, and those who experienced IPV reported higher levels of perceived discrimination based on gender. Additionally, women reporting IPV experiences were more likely to engage in SDU and SAU. The study highlights the importance of addressing gender inequality, discrimination, and substance use when designing interventions and support services for IPV survivors. Implementing IPV screening and support services in healthcare settings, especially in inclusive community-based centers, could contribute to early detection and prevention efforts.

Multiphase optimization strategy to establish optimal delivery of nutrition-related services in healthcare settings: A step towards clinical trial

BackgroundMinorities living in the Southern US generally have greater incidence and prevalence of cardiometabolic diseases compared to other groups. Cardiometabolic disease prevalence and risk can be reduced by focusing on diet and lifestyle modifications. There is need for holistic and integrated care models for community-based healthcare organizations who are already working with minorities. This research aimed to select and optimize essential psychosocial and structural components to address diet behaviors among racial/ethnic minorities, and/or disadvantaged background young to middle aged adult populations in Mississippi. MethodsNutrition360 was guided by a community-academic team using a participatory approach and included a preparation and two optimization phases to examine different approaches to dietary interventions utilizing the multiphase optimization strategy. Each intervention arm included three different modalities to identify the most feasible delivery method. The intervention was conducted at a community-based, outpatient healthcare center located in Jackson, MS. Eligible participants were between 25 and 50 years old, residents of Jackson metropolitan area, at risk for cardiovascular disease-related premature mortality, and had internet access. Individuals who completed baseline surveys were randomly assigned to an intervention group and then to modality order. Co-primary outcomes were research participant burden and cost-effectiveness and secondary outcomes were attendance, and dietary measures. ResultsThirty-one, African American individuals with a mean age of 40.5 years completed baseline surveys and were randomized to an intervention program. ConclusionThe two most feasible and cost-effective interventions will be combined to further test this model's delivery in the real-world setting as part of the next optimization phase. RegistrationClinicalTrials.gov, NCT06286618. https://clinicaltrials.gov/study/NCT06286618

Transformative value, communities and service designs for sustainability

PurposeThe purpose of this transformative service research (TSR) is to apply, innovate on and extend the understanding of service-dominant logic (SDL) perspectives, sustainable service ecosystem design ideas, transformative value and meeting sustainable development goals (SDGs). This study explores these through volunteers’ lived experiences and their perceived health and well-being outcomes in the context of botanic gardens as health-care service settings.Design/methodology/approachA total of 3 UK botanic gardens and 84 volunteers between 22 and 87 years of age participated in this qualitative study. Volunteering stories were collected through emails, telephone exchanges, online and in-person interviews, free-flowing discussion and field observations. These were coded and analysed by using computer-assisted qualitative data analysis software, NVivo 14 Plus and Leximancer. Thematic analysis facilitated the mapping of well-being outcomes highlighting transformative value against existing health and well-being indices.FindingsInsights extend knowledge into SDL, TSR and transformative value experienced by volunteers across three UK botanic garden service ecosystems. Environmental, organisational and personal factors, and physical, mental and social health outcomes are presented to emphasise transformative value experienced, especially in retiree volunteers. Theoretical contribution is in the form of empirical evidence to support and extend insights about transformative value and more so, significant epistemological change and meeting SDGs in botanic gardens. Results add to contemporary TSR on health-care-related well-being outcomes and ideas regarding sustainable service ecosystem design.Research limitations/implicationsIt is recommended that service research be extended across other botanic gardens, as well as other novel underexplored contexts for comparative studies of transformative value. Continued development and consideration of service designs as ongoing efforts to redefine and reimagine services marketing innovation for botanic gardens are recommended. Botanic gardens are complex service ecosystems worthy of rigorous service research to capture and measure the impact and outcome of ongoing work of the sector in advancing SDGs and having a transformative effect on individual and societal health and well-being.Practical implicationsThis study highlights opportunities for greater area-based, coordinated, collaborative, multi-stakeholder services marketing partnerships for strategic sustainable service ecosystem design for the botanic gardens and health-care sectors. These sectors can make better use of service research and marketing to further innovate and co-develop health and well-being strategies, campaigns and opportunities to develop services to transform and influence positive health and well-being outcomes for people. Results reveal greater opportunities for collaborative partnership and services marketing’s role and practice for the ongoing vitality and viability of botanic gardens. Joint efforts would enable innovation on sustainable service ecosystem design, advancing SDGs and improving life on planet Earth.Social implicationsTransformative value linked to newfound life experiences and meaning to life after retiring with a range of factors, and health and well-being outcomes were prominent. Social connections to the wider community were present, revealing links to a range of people who may not have traditionally had contact with botanic garden heritage and their strategic efforts. Therefore, it is services marketing opportunities for botanic gardens that hold one key to greater transformative value, sustainability and greater influence and impact on individual and societal health and well-being.Originality/valueTo the best of the author’s knowledge, this is the first TSR on botanic gardens as health-care service settings, resulting in a conceptual framework on transformative value and well-being outcomes in meeting SDGs. It extends insights on SDL, sustainable service ecosystem design and roles of marketing for the common good. Botanic gardens are unique research institutes, highly acclaimed for research, conservation, education and displays of special botanical collections, as well as providing health care, among other impactful SDG opportunities. This can be made more explicit through ecosystemic thinking, service research and integrated services marketing of botanic garden’ roles and contributions worldwide.

A Mixed-methods Approach to Understanding Language Interpretation Services in Health Care Settings among Asian American Immigrants from Diverse Ethnic Backgrounds

Abstract: Background. Asian Americans (AA) face cultural and linguistic barriers to health care access, resulting in poor health outcomes. This study investigates the experiences of AAs using language interpretation services (LIS) in health care settings. Methods. Using a mixed-methods approach, we conducted a community survey (N=401) and seven focus groups between April and September 2023. We use the Andersen model to understand the experience around LIS for AAs and calculated descriptive statistics for predisposing (i.e., sociodemographic factors and attitudes toward LIS), enabling (i.e., perceived barriers), and need factors (i.e., perceived need for LIS). Focus groups were analyzed using a modified template approach to text analysis. Results. Quantitative and qualitative analyses found that although AAs recognize the benefits and need for LIS, various barriers (e.g., lack of interpreters when booking an appointment) preclude these communities from accessing these services. Conclusions. Results from this study will help inform interventions that seek to improve LIS within health care systems.

Development of an Instrument to Assess Health and Social Care Professionals' Knowledge and Attitudes Towards Later-Life Intimacy and Sexuality (HSCP-KALLIS): A Delphi Study.

We aimed to ascertain the content validity of an instrument to assess health and social care professionals' knowledge and attitudes towards later-life intimacy and sexuality (HSCP-KALLIS). For older adults, intimacy and sexuality are important in maintaining their quality of life and well-being. However, addressing these needs remains challenging for health and social care professionals, particularly for nursing staff providing 24-h direct care to older people with dementia or those identified as lesbian, gay, bisexual, transgender, intersex or queer/questioning individuals. Existing instruments assessing knowledge and attitudes towards later-life intimacy and sexuality are dated and fail to adequately address dementia and sexual diversity. A two-round modified Delphi study was conducted. Initially, 79 knowledge and attitude items were generated through an integrative review. Panellists rated each item's clarity and importance using online questionnaires. The content validity index for the individual and overall items was calculated. The panellists' written feedback-along with their knowledge level of later-life intimacy and sexuality-was obtained. Panellists included health and social care professionals (n = 9); healthcare-related educators (n = 2); researchers specialising in later-life intimacy, sexuality, dementia care and sexual diversity support (n = 7); and family carers of older people with dementia (n = 2). The instrument was revised based on the feedback received. The components of dementia, LGBTIQ+ and the provision of sex worker services in healthcare settings were highlighted by the panellists. Notably, 46 knowledge and 40 attitude items fulfilled the consensus criteria for clarity and importance. Acceptable content validity was established for the knowledge and attitude items. Further research is required to establish the psychometric properties of the HSCP-KALLIS. This instrument has implications for clinical practice-specifically, in nursing care-by addressing issues to improve awareness regarding later-life intimacy and sexuality in healthcare settings. The HSCP-KALLIS has the potential to inform the educational needs regarding knowledge and attitudes towards later-life intimacy and sexuality for health and social care professionals, specifically nursing staff. The findings of the HSCP-KALLIS can be used for the development of competencies for later-life intimacy and sexuality, establishing policies and guidelines to support older adults' intimacy and sexuality needs in health care settings.

Optimization of Health Workers in The Implementation of Provider Initiated HIV Testing and Counseling (PITC)

Background: Provider Initiated HIV Testing and Counseling (PITC) is a service offering HIV testing by health workers to all patients in health facilities1. The quality of PITC services that do not meet standards is still a problem, thus becoming an obstacle to PITC services. This causes PITC user satisfaction to be low. The aim of this research is to determine efforts to optimize health workers in the implementation of provider-initiated HIV testing and counseling (PITC). This systematic research was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method to assess, review and synthesize research. Search through the database by entering the keywords "HIV", "HIV test", "Provider initiated HIV testing and counseling" "PITC", on PubMed, Science Direct, ProQuest. 9 research journals were selected after going through specified stages. Barriers for health workers are high workload, lack of human resources and not all health workers are trained in PITC. Optimizing PITC services in health care settings cannot stand alone, health services that are integrated with other health services require the ability of health workers to be able to offer HIV tests to patients. Optimizing human resources in the health sector can be done by increasing the ability of health workers to carry out PITC through good education and training. The complete implementation of PITC starting from the pretest and posttest will emphasize changes in patient behavior to improve their health status.

A Classification of Cloud Services and Their Security Assessment in the Healthcare Industry

The role of cloud-based services in healthcare settings is crucial in the 21st century. This paper discusses their advantages and tools in hospitals, clinics, and diagnostic centers, categorizing existing applications and services into data storage, computing power, networking, PaaS, SaaS, data analytics, business intelligence, and project management. It also provides an in-depth analysis of security and risk assessment issues in cloud-based services, supported by case studies. Additionally, it includes a comparative risk analysis diagram of secured versus non-secured cloud systems in healthcare. Finally, the paper concludes with recommendations for future work. Key Words: Healthcare facilities, diagnostic centers, cloud services, information technology systems, security, risk analysis.

Nurses’ characteristics and spiritual care knowledge in hospital setting: A cross-sectional study

Background: The low awareness among nurses regarding the provision of spiritual services in healthcare settings results in unmet spiritual needs among patients, leading hospitals to be perceived solely as centers focusing on physical aspects. This stems from nurses’ low competence in providing spiritual care services. Objective: This study aims to analyze the correlation between nurses’ characteristics and their knowledge of spiritual care in a hospital setting. Methods: A retrospective cross-sectional study was conducted, with respondents recruited using a purposive sampling technique. Inclusion criteria included nurses working in hospitals who directly care for patients. Data were analyzed using univariate analysis (frequency and percentage) and bivariate analysis using Fisher’s exact test. Result: A total of 117 nurses participated in this study, of whom 59.8% were female, 63.25% were aged <31 years old, 77.8% were permanent workers, 57.2% had work experience < 5 years, 91.5% were Muslim, 55.6% attended workshops/seminars, and 76.9% had moderate knowledge. Workshops/seminars had a positive correlation with knowledge and were statistically significant. Conclusion: Spiritual workshops/seminars have a positive correlation and are statistically significant in enhancing nurses’ knowledge of spiritual care in a hospital setting. Therefore, there is a need to improve nurses’ spiritual care knowledge through continuing education, such as training, seminars, or workshops.

DIGIDIA-project: Experiences of video-enabled receptions for prevention of type 2 diabetes

The time of the COVID-19 epidemic emphasized the need for the development and implementation of remote receptions and digital services, as preventive work was reduced, and people decreased their in-person visits in health care due to fear of infections. In 2020, the diagnoses of type 2 diabetes (T2D) decreased, despite the fact that diabetes is known to be increasing. DIGIDIA (Promoting Digital Skills in the Low Labour Market-Driven Diabetes Patients) project aimed to respond to this need. The project focused on developing digital health competence, health literacy, and practices that enable preparation for future unforeseen events. The project recruited adults from Tampere who were at risk of T2D, had prediabetes, or recently received a diagnosis of type 2 diabetes (n=60). Participants were provided with a digital learning environment, workshops, and video-enabled receptions. This article presents the use of video reception and user experiences (n=52) in the project. The participants appreciated all organized activities. All but one participant felt that video-enabled reception suited them well. The majority of participants (87%) expressed a desire for using video reception again in health care settings. However, it was pointed out that this form of telemedicine might not be suitable for everyone, and concerns about data security were also raised. As a conclusion, citizens were ready to use video-enabled services in healthcare settings. The use of video receptions should be increased in the management of type 2 diabetes (T2D).

Barriers Affecting Breastfeeding Practices of Refugee Mothers: A Critical Ethnography in Saskatchewan, Canada.

Refugee mothers are vulnerable to cultural stereotyping and socioeconomic hardships when they migrate to a new country. This vulnerability often has a negative impact on refugee mothers' breastfeeding practices. Saskatchewan is one of the growing provinces in Canada that has a noticeable increase in refugee population with young children and limited availability of healthcare settings with baby-friendly status. Considering existing gaps in knowledge, this critical ethnographic study aimed to explore barriers that impede the breastfeeding practices of refugee mothers in Saskatchewan. After seeking ethics approval, data were collected using multiple methods, including in-depth interviews undertaken with 27 refugee mothers with young children of age range 1 day to 24 months, a review of media communications and field observations of community-based services/facilities available to refugee mothers. Findings suggest that psychosocial barriers, healthcare barriers, environmental barriers, and maternal and child health-related barriers impede the breastfeeding practices of refugee mothers in Saskatchewan. Breastfeeding practices of refugee mothers can be promoted through healthcare support, culturally appropriate services, interpretation services in healthcare settings, implementation of baby-friendly initiatives, hospital and community-based breastfeeding campaigns, and follow-up services. Collaborative efforts by healthcare settings, healthcare providers, policymakers, public health agencies, service providers, and governments are essential to support the breastfeeding practices of refugee mothers.

The Use of Mobile Medical Units for Populations Experiencing Homelessness in the United States: A Scoping Review.

With annual point-in-time counts indicating a rise in unsheltered homelessness in the United States, much attention has been paid to how to best provide care to this population. Mobile medical units (MMUs) have been utilized by many programs. However, little is known regarding the evidence behind their effectiveness. A scoping review is conducted of research on MMU provision of medical services for populations experiencing homelessness in the USA to examine the extent and nature of research activity, summarize available evidence, and identify research gaps in the existing literature. Following guidelines for scoping reviews, PubMed and Google Scholar were used to identify an initial 294 papers published from January 1, 1980, to May 1, 2023, using selected keywords, which were distilled to a final set of 50 studies that met eligibility criteria. Eligible articles were defined as those that pertain to the provision of healthcare (inclusive of dental, vision, and specialty services) to populations experiencing homelessness through a MMU in the United States and have been published after peer review. Of the 50 studies in the review, the majority utilized descriptive (40%) or observational methods (36%), with 4 review and 8 controlled studies and no completed randomized controlled trials. Outcome measures utilized by studies include MMU services provided (58%), patient demographics (34%), health outcomes (16%), patient-centered measures (14%), healthcare utilization (10%) and cost analysis (6%). The studies that exist suggest MMUs can facilitate effective treatment of substance use disorders, provision of primary care, and services for severe mental illness among people experiencing homelessness. MMUs have potential to provide community-based healthcare services in settings where homeless populations reside, but the paucity of randomized controlled trials indicates further research is needed to understand if MMUs are more effective than other care delivery models tailored to populations experiencing homelessness.

Parents' experiences of living with a child with cancer undergoing hematopoietic stem cell transplantation: a qualitative content analysis study.

Pediatric Hematopoietic Stem Cell Transplant (HSCT) profoundly impacts the physical, psychological, and social aspects of parents' lives. Thus, this study aimed to explore the experiences of parents living with a child with cancer who undergoes HSCT. This qualitative study involved 20 parents of children with cancer who were undergoing HSCT at a referral hospital in Iran. Purposive sampling was used to select the participants from February 2023 to November 2023. In-depth semi-structured interviews, featuring open-ended questions, were utilized for data collection. Data analysis was performed using conventional content analysis. Data analysis revealed two main themes. "Surrounded by hardships" and "Self-actualization." The first theme encompassed participants' experiences of facing difficulties in life after being aware of their child's need for HSCT. This theme consisted of four categories: "uncertainty about the child's future," "exhaustion from the child's treatment process," "worrying about the healthy child(ren)," and "helplessness." The second theme "self-actualization" included with two categories: "transformation in life's philosophy" and "acquisition of new capabilities." These categories highlighted the positive outcomes experienced by the participants following their child's HSCT. Our findings underscore the importance of healthcare providers being attuned to parents' experiences throughout their child's HSCT trajectory. It is crucial for healthcare providers to encourage parents to articulate their concerns and feelings and seek support from healthcare providers, family, and friends. The development of psychological support services in healthcare settings can facilitate tailored interventions to alleviate parents' difficulties.

Exploring challenges and improvement strategies of adolescent-friendly health services in the northwest region of Namibia: A qualitative descriptive study.

Despite global agreements on adolescents' sexual and reproductive health and rights, access to and the utilisation of these services by the adolescents remain underutilised in low and middle-income countries. The aim of the study was to explore challenges and improvement strategies of adolescent-friendly health services in the northwest of Namibia. This study employed a qualitative approach utilising an explorative strategy. Semi-structured interviews were used to collect the data. Fifteen nurses were selected using a convenience sampling technique. The interviews were audio recorded, transcribed verbatim and the data were analysed using thematic analysis. The data analysis led to the emergence of the following three themes: Challenges affecting the delivery of Adolescent Friendly Health Services, Challenges affecting participation of adolescent to AFHS and strategies to improve the provision of adolescent-friendly health services. Findings from this study revealed several barriers reportedly faced by adolescents in accessing AFHS as including a lack of comprehensive sexual reproductive health (SRH) services in many healthcare facilities, a lack of trained staff, unfavourable environments for adolescents, a lack of information about the services provided, and recruitment of providers who are not friendly to young people and adolescents. This study findings may lead to an improvement in the provision of such services in healthcare settings. The study can lead to an improvement in the provision of adolescent-friendly services in health care settings. It can help the Ministry of Health and Social Services, along with its agencies, to formulate strategies that can be used to mitigate the challenges d in the provision of adolescent-friendly services.

The practice of pregnancy options counseling in social service and healthcare settings in the United States: a systematic literature review

ABSTRACT Introduction The purpose of this systematic literature was to summarize the literature on pregnancy options counseling for women and patients who experience an unintended pregnancy across healthcare and social service settings. Methods We conducted a systematic literature review using the PRISMA Checklist. Following the literature search of 8 electronic databases, we used a three-stage search process to screen articles for inclusion. Results A total of 20 peer-reviewed articles met the inclusion criteria for this study. Half (n = 10) of the articles reviewed were empirical studies utilizing quantitative or qualitative methodology while the other half (n = 10) were conceptual or non-empirical. The articles affirmed a shared definition of pregnancy options counseling, but terminology differences were noted over time. Lastly, variations of intervention practices appeared across practice settings, with referral practice variations being the most notable. Conclusion Pregnancy options counseling practices varied across settings, suggesting patients who received this intervention may not have accessed equitable or ethical care.

A quantitative and qualitative analysis of a medication health literacy workshop for newly and recently arrived refugees

AbstractIntroductionRefugees entering the United States are often unfamiliar with the healthcare system and have different medication beliefs. Since 2016, pharmacy students and faculty have been conducting medication literacy workshops to improve knowledge of medications for newly arriving refugees.ObjectivesThe primary study objective was to measure the newly arriving refugees' medication knowledge after a one‐time educational workshop.MethodsThis was a retrospective quantitative and qualitative evaluation. Participants engaged in a student‐led 90‐min educational workshop utilizing interpreters, translated materials, and demonstrations. Topics included medical definitions, information on getting sick, medication use, and label reading. A translated, postworkshop evaluation included 22 questions grouped into the following categories: demographics (n = 4), medication use (n = 7), label reading (n = 6), access (n = 3), and cultural beliefs (n = 2). Three optional, free‐response questions regarding overall workshop feedback were included. Quantitative data was analyzed utilizing descriptive statistics. Thematic analysis was used to analyze qualitative data. Two independent coders reviewed each free‐response question and discussed any discrepancies for consensus. The study team developed key themes based on the codes.ResultsTwenty‐one workshops were conducted with 419 participants from 42 countries. Correct responses were highest for medication beliefs (84%), label reading (78%), access (74%), and medication use (73%). Prescription label reading ability was high (86%), while preventative medicine understanding was lower (34%). Three major learning themes developed, including (1) Cultural differences impact medication habits, (2) Knowing provider roles and how to access different services in healthcare settings was important, and (3) Understanding how to read a label was useful. Researchers found that demonstrations were helpful in participants' learning and that additional education on prevention and specific disease states would be useful.ConclusionNewly and recently arrived refugees were able to correctly identify basic medication health information through a medication literacy workshop. Additional classes exploring other topics, including preventative medicine and medications, should be considered.

Supporting rehabilitation practice for COVID-19 recovery: a descriptive qualitative analysis of allied health perspectives.

Objective The study aimed to explore the perspective of healthcare workers on the resources they need to provide quality rehabilitation for people recovering from coronavirus disease 2019 (COVID-19) infection. Methods A descriptive qualitative approach using reflexive thematic analysis was employed. Focus groups and interviews were performed with nine healthcare workers (one intensive care unit physiotherapist, one respiratory therapist and seven occupational therapists) with experience treating patients recovering from COVID-19 infection within hospital and in the community. Verbatim transcripts were coded and analysed for themes. Results Healthcare workers perceive an urgent need for resources about recovery from COVID-19 infection to support quality care. They particularly want detailed guidance about potential trajectories of recovery, and what should be expected over time for people with long COVID. Many observed that this group of patients had higher oxygen requirement and experienced slower recovery than others with serious respiratory conditions. Supports for quality care do exist but were not perceived as sufficient by participants. They want any new resources developed to be accessible, quick to access and targeted to specific healthcare worker roles and services settings. Participants identified several barriers to accessing practice supports, including the time poor nature of health care and financial costs to both patients and healthcare workers. Conclusion Healthcare workers perceive an urgent need for the development of resources to support quality rehabilitation for people recovering from COVID-19 infection, to support best outcomes for this group of patients. Any resources developed must consider identified barriers to their access and use to maximise their impact.

Exploring barriers to the use of trust translation services by pharmacy staff

Abstract Introduction 4.1 million people in England and Wales do not speak English as a first language.1 Whilst representing only 7.1% of the population, data suggests this cohort face greater barriers to effective healthcare than native English speakers. One study found they experience twice the rate of medication errors.2 One solution is the use of translation services in healthcare settings. However, national evidence shows service underutilisation.2 Research cites long waiting times, loss of phone connection and translator lack of familiarity with National Health Service (NHS) as contributors.3 Anecdotal data suggests underutilisation of services at Oxford Road Campus (ORC) of Manchester University Foundation Trust (MFT). 18% of ORC patients are not native English speakers, meaning there is a potential risk to patient outcomes if translation services are underutilised. Aim To explore the barriers pharmacy staff at ORC of MFT face when accessing the local translation service for patients; where its use would be appropriate and/or beneficial. Methods A literature search was conducted regarding use of translation services by healthcare staff and existing barriers to use. An interview proforma was formulated using the literature findings, existing questionnaires, discussions with a University of Manchester research Pharmacist and the group’s aims and objectives. The questions were formulated into the Qualtrics XMTM software. Data was collected using structured interviews to increase capture of qualitative data. The target audience was Trust pharmacy staff with patient contact. The sampling technique was opportunistic and captured 45 respondents. Quantitative data was analysed through Microsoft Excel, whilst qualitative data was analysed using thematic grouping. No ethical approval was required as this was a service evaluation. Results 97.8% of respondents had encountered at least one patient without English as a first language. Of these, 100% were aware of trust translation services, despite only 7% of staff having received training. Only 25% of participants reported the trust translation service was their primary method for translation. Preferred methods of overcoming language barriers were use of relatives/next of kin or a multilingual staff member. The most reported barriers in order of frequency were time, ease of access and preferring alternative methods. Some participants who had never used the service reported concerns over the accuracy of translation and high costs of the service. 78% of respondents indicated that they would use the service if barriers were rectified. When asked about features of an ideal service, exact waiting times, use without a PIN and dedicated ward phones were the most popular responses. Discussion/Conclusion Results obtained show numerous barriers to service use and accessibility. Of note, several staff who reported barriers had never used the service. These perceived barriers often related to factually incorrect views of the service such as cost and accuracy of translation. Thus, training for staff in conjunction with improvements to the service would increase utilisation of the translation service and therefore patient safety. One imitation of our project was that no data exists on number of patient facing staff so it is not possible to quantify the percentage of staff captured.

Healthiness and sustainability of food service in healthcare settings in Germany

Abstract Background Current dietary patterns threaten individual and planetary health. Healthcare settings can set a positive example for dietary change, but data on the quality of food they offer is scarce. The aim of our study was to assess the environmental footprint and nutritional quality of food service in hospitals and nursing homes in Germany. Methods We collected 6-12 months of food procurement data and all available meal plans from three nursing homes and two hospitals in Germany. Procured food items were categorized into 50 food groups (e.g., potatoes, beef, apples), and the environmental footprint was calculated (i.e., land use, greenhouse gas (GHG) emissions, acidification, eutrophication, and water use) using life-cycle analysis factors based on a recent meta-analysis. Lunches from a representative week were broken down into their constituent ingredients and analyzed for adherence to the Planetary Health Diet (PHD) using an established dietary index (PHDI). Results Preliminary analysis of one nursing home and one hospital showed that animal-source foods (ASF) accounted for 70% of overall GHG emissions and land use and 76% of water use, primarily from beef, pork, milk, and cheese. Among plant-based foods, coffee disproportionately contributed to the environmental footprint. Red meat accounted for 30-45% of lunch calories consumed (13-25% of weight) and potatoes accounted for 20-24% of calories (31-35% of weight), whereas vegetables and legumes combined accounted for 11-15% of calories (33-35% of weight). Nursing home meals achieved 61 and hospital meals 71 out of 150 points on the PHDI. Conclusions Healthcare institutions in Germany have poor adherence to the PHD, with up to two-thirds of calories derived from red meat and potatoes. Unsurprisingly, ASF account for the majority of the institutions’ environmental food footprint. Policies to make healthcare foodservice more environmentally sustainable while ensuring nutritional adequacy are urgently needed. Key messages • Foodservice in German hospitals and nursing homes is neither healthy nor environmentally sustainable. • Policies are needed to improve healthcare food service for individual and planetary health.

Experiences and Beliefs on Tobacco Use, Cessation in India: A Qualitative Study.

Almost 80% of global tobacco usage is concentrated in low- and-middle-income countries (LMICs) like India. Added to this, there is dearth of dedicated tobacco cessation specialist services in healthcare settings in these regions. Identification of challenges in the delivery of cessation interventions and understanding the experiences of tobacco users will aid in formulating successful quit strategies. This qualitative study in India aimed to understand the perspectives of tobacco-using patients in healthcare facilities regarding tobacco use and cessation. This qualitative study was conducted in urban and rural areas of four study sites, two each in the North and South India. Using purposive sampling, patients who were tobacco users were selected from healthcare facilities. The interviews were transcribed, coded and organised into themes. Analysis was done using NVivo 10 software. A total of 22 in-depth interviews were conducted on participants aged 23 to 80 years who were either current or past tobacco users. A majority of the participants were aware of their increased health risks associated with tobacco consumption and had attempted quitting; however, barriers such as peer influence, formed habit, certain cultural barriers and the addictive nature of nicotine prevented them from successfully quitting. Familial and peer support, the government's role in spreading public awareness, and limiting the sale of tobacco were stated as facilitators for tobacco cessation. The findings of this study point out that despite awareness of the perils of tobacco among smokers, there are various barriers and beliefs related to tobacco use and cessation. These findings would prove advantageous for policy-makers to implement and promote addiction treatment programmes for successful tobacco cessation efforts. In order to optimise strategies, policies must be well informed by ongoing dialogue between the public, service providers and policy-makers.