Skills Of Healthcare Professionals Research Articles

Unmet need for heart transplantation in Africa

Heart transplantation is a critical treatment option for end-stage heart failure patients, offering a lifeline for those with severe cardiac conditions. However, in Africa, the unmet need for heart transplantation is a significant issue that poses challenges to the healthcare system and patient outcomes. Africa faces multiple barriers to heart transplantation, including limited infrastructure, a shortage of skilled healthcare professionals, a lack of funding, and inadequate organ donation systems. These challenges result in a considerable gap between the demand for heart transplants and the available resources to meet this need. As a result, many patients in Africa do not have access to life-saving heart transplantation procedures, leading to high mortality rates among those awaiting transplants. Addressing the unmet need for heart transplantation in Africa requires a multifaceted approach. The authors recommend that Africa as a continent build up a heart transplantation workforce involving a multidisciplinary team that consists of transplant surgeons, transplant physicians, nurses, anesthetists, pharmacists, etc. Heart transplant education and training programs should be well-constructed to ensure the delivery of safe and effective transplantation services. International collaborations have proven to be effective and should be encouraged between African institutions and transplant centers worldwide to facilitate knowledge transfer. Foreign and local organizations should promote public awareness about organ donation to address the myths about heart transplantation and promote heart donation. With these, African countries can improve access to heart transplantation, enhance patient outcomes, save lives in the region, and ultimately reduce the mortality rate in Africa.

FIGO good practice recommendations on optimizing models of care for the prevention and mitigation of preterm birth.

The global challenge of preterm birth persists with little or no progress being made to reduce its prevalence or mitigate its consequences, especially in low-resource settings where health systems are less well developed. Improved delivery of respectful person-centered care employing effective care models delivered by skilled healthcare professionals is essential for addressing these needs. These FIGO good practice recommendations provide an overview of the evidence regarding the effectiveness of the various care models for preventing and managing preterm birth across global contexts. We also highlight that continuity of care within existing, context-appropriate care models (such as midwifery-led care and group care), in primary as well as secondary care, is pivotal to delivering high quality care across the pregnancy continuum-prior to conception, through pregnancy and birth, and preparation for a subsequent pregnancy-to improve care to prevent and manage preterm birth.

Effective and safe pediatric sedation.

Pediatric sedation is a crucial tool for minimizing pain and anxiety during procedures and examinations in children. However, it is not without risks. This review provides a comprehensive review of pediatric sedation, including both established practices and recent advancements. A thorough pre-procedural evaluation is crucial to mitigate these risks. Skilled healthcare professionals trained in pediatric sedation are paramount to ensure a safe and effective procedure. The choice of sedative medication depends on various factors, such as the type of procedure and the patient's medical condition. Medications, used alone or in combination, offer sedation with varying onset times and durations. Non-pharmacological approaches can complement pharmacological sedation and further reduce potential complications. Preventing sedation-related complications requires a multidisciplinary approach. This includes collaborative decision-making, vigilant monitoring throughout the procedure, and a focus on patient safety. Recovery involves ensuring the child returns to their baseline status before discharge, following established criteria. In conclusion, successful pediatric sedation hinges on a comprehensive strategy. This strategy encompasses a thorough evaluation, skilled personnel, appropriate medication selection, vigilant monitoring, and a focus on patient safety throughout the process. By following these steps, we can minimize risks and achieve successful outcomes.

Evaluating the impact of distance learning on gender-affirming healthcare competence: knowledge acquisition and satisfaction among healthcare professionals in Italy.

Transgender and gender diverse (TGD) individuals face significant healthcare barriers, with one of the most critical being the inadequate knowledge and skills of healthcare professionals (HCPs) in TGD health. To address this issue, we undertook a project to develop a distance learning course for all healthcare professions, encompassing a comprehensive range of topics related to TGD health issues. This study aimed to evaluate the impact of a course on gender-affirming healthcare competence, with a focus on knowledge acquisition and satisfaction levels. The hypothesis was that participating in the course would enhance the participants' knowledge on the covered topics. A distance learning course, designed for all Continuing Medical Education professions, was conducted between March and September 2023. The course was structured according to the Problem-Based Learning methodology. We implemented a pre-test vs. post-test study design to evaluate the enhancement of knowledge, based on a set of Multiple Choice Questions (MCQs), and investigated users' satisfaction through the administration of a semi-structured questionnaire. We examined the pre- and post-course proportions of correct responses to questions, along with the mean score difference, categorized by learners' sex, age, and geographical area. Eventually, a Satisfaction Training Index was created. The maximum capacity was reached, with 29,998 out of 30,000 available spots filled. Of those enrolled, 18,282 HCPs successfully completed the training. Post-test results revealed an increase in correct answers across all MCQs, with overall mean score rising from 48.8 to 68.0 (p < 0.001). Stratified analysis indicated improvements across all participant categories. A higher average increase among female (19.87) compared to male enrollees (17.06) was detected (p < 0.001). Both "over 55" and "46-55" age groups showed the greatest score increases compared to "35-46" and "under 35" groups, despite no significant differences in pre-test scores. Course satisfaction was high, averaging 4.38 out of 5. Top-rated aspects included "learning new concepts" (4.49), "accessibility" (4.46), and "platform functionality" (4.46). Our research hypothesis was confirmed by the significant increase in knowledge going from pre-test to post-test and by the high level of user satisfaction. The obtained results serve as a foundation for planning additional professional education in TGD health.

Multilevel modelling of factors associated with eight or more antenatal care contacts in low and middle-income countries: findings from national representative data

Background: Antenatal care (ANC) is the care provided by skilled healthcare professionals to pregnant women in order to ensure the best health conditions for both mother and baby. Antenatal care provides a platform for important healthcare functions including risk identification, prevention and management of pregnancy-related diseases. Inadequate ANC utilization is a global problem especially for low and middle-income countries. The 2016 WHO ANC model with a minimum of eight ANC visits was aimed to provide pregnant women with person specific care at every contact. However, there are limited studies that investigate the associated factors of inadequate ANC after the endorsement of the WHO 2016 guideline. Therefore, to enrich the evidence in the low and middle-income countries (LMICs), this study aimed to determine the pooled prevalence and associated with eight or more ANC contacts during pregnancy. Methods: This study used data from 20 LMICs that have a recent Demographic and Health Survey. About 43 720 women aged 15–49 years who had live births within the year prior to the surveys were included. To identify associated factors of 8 or more ANC contacts, we used multilevel binary logistic regression, and four models were constructed. The results have been presented as odds ratios with 95% CIs, and P values less than 0.05 were considered significant factors for greater than or equal to 8 ANC contacts. Results: In LMICs, the pooled utilization of 8 or more ANC contact was 18.11% (95% CI: 12.64, 23.58), and it ranged from 0.27% in Rwanda to 76.62% in Jordan. In the final multilevel logistic regression model, women with higher education [adjusted odds ratio (AOR)=3.83, 95% CI: 3.32, 4.41], husbands with higher education (AOR=1.98, 95% CI: 1.72, 2.28), women who have access to media (AOR=1.32, 95% CI: 1.19, 1.45), women with decision-making autonomy (AOR=1.52, 95% CI: 1.39, 1.66), women aged 35–49 years (AOR=1.70, 95% CI: 1.5, 1.91), women from communities with high media access (AOR=1.38, 95% CI: 1.23, 1.53), and husbands residing in communities with high literacy (AOR=1.76, 95% CI: 1.55, 1.98) were associated with higher odds of greater than or equal to 8 ANC contacts. Conversely, women with a birth order of greater than or equal to 6 (AOR=0.65, 95% CI: 0.56, 0.76), women who perceive the distance to a health facility as a significant problem (AOR=0.90, 95% CI: 0.83, 0.96), those with unwanted pregnancies (AOR=0.85, 95% CI: 0.78, 0.93), delayed initiation of ANC (AOR=0.26, 95% CI: 0.23, 0.3), women from households with the richest wealth index (AOR=0.45, 95% CI: 0.40, 0.52), and rural residents (AOR=0.47, 95% CI: 0.43, 0.51) were associated with lower odds of ≥8 ANC contacts. Conclusion and recommendations: In compliance with the WHO guideline, the number of ANC contacts is low in LMICs. Individual-level, household-level, and community-level variables were associated with greater than or equal to 8 ANC contacts. Therefore, implementation strategies should focus on the identified factors in order to achieve the new WHO recommendation of greater than or equal to 8 ANC contacts.

Evaluation of Midwifery Practices among Registered Midwives in Selected Hospitals in Limpopo Province, South Africa

Midwifery practices are defined as the level of midwifery care in which midwives use their expertise, management, and clinical leadership to provide personalized, evidence-based care to women independently and autonomously. Midwifery care includes antepartum, intrapartum, and postpartum care, which are defined by the WHO as the care provided by skilled healthcare professionals to pregnant women and adolescent girls to ensure the best health conditions for the mother and baby during the antepartum, intrapartum and postpartum period. The aim of this study was to evaluate midwifery practices among registered midwives in selected hospitals in Limpopo Province, South Africa. The quantitative, descriptive, and cross-sectional research design was used to assess and describe midwifery practices among registered midwives in selected hospitals in Limpopo Province, South Africa. The population size was 100 registered midwives in the selected hospitals. The sample size of 80 registered midwives was determined using the Slovin formula. Simple random sampling was used to select the sample. A self-developed questionnaire was tested and validated prior to conducting the main study. The findings of the pilot study were used to refine the questionnaire before being used for the main study. Reliability and validity were ensured. Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 27 with the assistance of a statistician. The study revealed inadequate provision of midwifery care during antepartum, intrapartum, and postpartum periods due to lack of resources and equipment. The shortage of midwives and the shorter experience in the clinical setting within the midwifery environment were overwhelming. The study concluded that the practices of registered midwives were inadequate due to some challenges they faced during the provision of midwifery care. Inadequate midwifery practices have serious implications for the health and well-being of mothers and newborns. These practices were influenced by various factors, such as inadequate material and human resources and lack and malfunctioning of available equipment. The study recommended that women have access to a variety of pain relief options during labor, including both pharmacological and non-pharmacological methods. In addition, the study recommended implementation of the presence of doulas during labor and childbirth.

Increasing pediatric radiation oncology capacity in sub-saharan Africa using technology: a pilot of a pediatric radiation oncology virtual training course

BackgroundThe shortage of skilled healthcare professionals in pediatric oncology and the limited access to training programs remain significant challenges in Nigeria and sub-Saharan Africa. The the Pediatric Radiation Oncology (Virtual) Course, ‘PedROC’ project aims to contribute to improving pediatric cancer outcomes in Nigeria by increasing the capacity of radiation oncology professionals. To address the gap in access to pediatric radiation oncology professional development, the PedROC project was created, harnessing technology to improve radiation oncology training via a curriculum delivered through web-conferencing. This study aimed to evaluate the effectiveness of the PedROC pilot in enhancing the capacity, confidence, and skill of radiation oncologists in decision-making, prescribing, and treatment planning of radiotherapy for children diagnosed with cancer.MethodsA multidisciplinary faculty of specialists in radiation oncology, pediatric oncology, oncology nursing, radiation therapy technology, and medical physics collaborated to identify the key learning needs in pediatric radiation oncology in the country. The team collaborated to develop a comprehensive curriculum covering the most common pediatric cancers in sub-Saharan Africa for the training program. The training course was conducted over two days, delivering twenty-four half-hour sessions for a total of 12 h, from July 31 to August 01, 2021.ResultsAnalysis of pre and post - training surveys showed a significant increase in self-reported confidence measures across all domains among radiation oncologists. The program successfully improved participants’ knowledge and confidence levels in managing common pediatric cancers using radiotherapy, particularly addressing radiotherapy-specific issues such as appropriate dose, target volume delineation, treatment planning, dose constraints, and plan evaluation.ConclusionThe PedROC pilot showed the efficacy of this model in enhancing the capacity and confidence of radiation oncology professionals involved in the treatment of pediatric cancer. The findings indicate that technology holds significant potential to increase pediatric radiation oncology capacity in Africa, ensuring improved access to proper treatment and ultimately improving pediatric cancer outcomes.

Work characteristics, job satisfaction and intention to leave: a cross-sectional survey of advanced nurse practitioners

Background Advanced Nurse Practitioners (ANPs) are highly skilled health care professionals with the potential to play a major role in improving the quality and accessibility of health care services. However, there is emerging evidence of disquiet among nurse practitioners who often work in suboptimal work environments. Therefore, it is important to understand the elements that contribute to ANPs’ job satisfaction and retention in healthcare services. Aim To examine the effects of commitment to the workplace, work engagement, and influence at work on job satisfaction and intention to leave of ANPs. Methods A total of 153 ANP’s on the advanced practice section of the Nursing and Midwifery Board of Ireland register completed a web survey between July and August 2020. Independent variables (commitment to the workplace, work engagement, and influence at work) were measured using the Copenhagen Psychosocial Questionnaire (COPSOQ). Multivariable logistic regression models were used to investigate the association between dependent and independent variables. Results Participants who reported higher levels of influence at work and higher levels of commitment to the workplace were also satisfied in their job (OR 1.05, 95% CI 1.01-1.09, p = 0.025), (OR 1.10, 95% CI 1.06–1.14, p < 0.001) respectively. Additionally, ANPs with higher levels of commitment to work were significantly less likely to leave their role (OR 0.94, 95% CI .92–.96, p < 0.001). Conclusion Healthcare organisations can improve job satisfaction and decrease intention to leave by creating environments in which ANPs are supported by their colleagues and supervisors, and facilitate their practice to the full extent of their capabilities.

Knowledge and skills of newborn resuscitation among health care professionals in East Africa. A systematic review and meta-analysis.

Newborn resuscitation is a medical intervention to support the establishment of breathing and circulation in the immediate intrauterine life. It takes the lion's share in reducing neonatal mortality and impairments. Healthcare providers' knowledge and skills are the key determinants of the success of newborn resuscitation. Many primary studies have been conducted in various countries to examine the level of knowledge and skills of newborn resuscitation and associated factors among healthcare providers. However, these studies had great discrepancies and inconsistent results across East Africa. Hence, this review aimed to synthesize the pooled level of knowledge and skills of newborn resuscitation and associated factors among healthcare providers in East Africa. Studies were systematically searched from February 11, 2023, to March 10, 2023, using PubMed, Google Scholar, HINARI, and grey literature. The effect size measurement of knowledge and skill of health care newborn resuscitation was estimated using the Random Effect Model. The data were extracted by Excel and analyzed using Stata 17 software. The Cochran's Q test and I2 statistic were used to assess the heterogeneity of studies. The symmetry of the funnel plot and Egger's test were used to check for publication bias. A subgroup analysis was done on the study years, sample sizes, and geographical location. Percentages and odds ratios (OR) with 95% CI were used to pool the effect measure. In this systematic review and meta-analysis, a total of 1953 articles were retrieved from various databases and registers. Finally, 17 studies with 7655 participants were included. The overall levels of knowledge and skills of healthcare providers on newborn resuscitation were 58.74% (95% CI: 44.34%, 73.14%) and 46.20% (95% CI: 25.16%, 67.24%), respectively. Newborn resuscitation training (OR = 3.95, 95% CI: 2.82, 5.56) and the availability of newborn resuscitation guidelines (OR = 2.71, 95% CI: 1.90, 3.86) were factors significantly associated with knowledge of health care professionals on newborn resuscitation. Work experience (OR = 5.92, 95% CI, 2.10, 16.70), newborn resuscitation training (OR = 2.83, 95% CI, 1.8, 4.45), knowledge (OR = 3.05, 95% CI, 1.78, 5.30), and the availability of newborn resuscitation equipment (OR = 4.92, 95% CI, 2.80, 8.62) were determinant factors of skills of health care professionals on newborn resuscitation. The knowledge and skills of healthcare providers on newborn resuscitation in East Africa were not adequate. Newborn resuscitation training and the availability of resuscitation guidelines were determinant factors of knowledge, whereas work experience, knowledge, and the availability of newborn resuscitation equipment and training were associated with the skills of healthcare providers in newborn resuscitation. Newborn resuscitation training, resuscitation guidelines and equipment availability, and work experience are recommended to improve healthcare providers' knowledge and skills.

Human resources management in healthcare: recruitment, retention, and workforce development: A review

This research paper explores Human Resources Management (HRM) in healthcare, focusing on the critical areas of recruitment, retention, and workforce development. Through a comprehensive literature review, the study highlights the challenges faced in attracting and retaining skilled healthcare professionals, alongside the importance of ongoing staff development. The paper examines evidence-based HR strategies, the role of technology and innovation, and future directions for HRM in the healthcare sector. Key findings emphasize the need for comprehensive recruitment and retention programs, investment in professional development, and technology adoption to improve HR practices. Implications for healthcare HR policy and practice are discussed, with recommendations for future research to enhance HRM effectiveness in healthcare settings. This study contributes valuable insights into improving HRM practices to ensure high-quality patient care and organizational effectiveness in the healthcare industry.

Healthcare Capacity Building in Northwest Syria: Challenges, Successes, and Lessons Learned

The conflict in Syria has caused significant loss of life and widespread displacement. Northwest Syria (NWS) has been heavily impacted, leading to challenges in providing healthcare services. Attacks on healthcare workers and facilities have worsened the situation. Healthcare students and professionals have been specifically targeted, disrupting their education and resulting in migration and a shortage of skilled healthcare workers. To address these challenges, local and international organizations and institutions have supported long-term projects to improve healthcare facilities and provide a trained healthcare workforce. Collaborations with multiple stakeholders have been established to ensure comprehensive and effective training opportunities, enabling healthcare workers to better serve the population's healthcare needs. A range of undergraduate, postgraduate, and research programs have been developed to enhance healthcare capacity building. These programs aim to strengthen the knowledge and skills of healthcare professionals in NWS. Efforts have been made to strengthen the health system and build the capacity of policy makers in utilizing evidence-based knowledge for informed policy decisions. Global and regional partnerships, along with adequate funding, have played a significant role in the successful enhancement of capacity building activities at all levels.&#x0D; Building healthcare and health research capacity in underdeveloped and conflict-affected parts of NWS presents numerous challenges. Underdeveloped infrastructure, inadequate teaching and service delivery tools, gender disparities, and the sustainability of funding create obstacles to effective capacity building. The political context, coupled with security concerns further complicate efforts. The accreditation of education, and the brain drain of skilled healthcare professionals, add to the difficulties in strengthening the healthcare system in NWS. Addressing these challenges requires comprehensive and collaborative approaches that prioritize stability, security, gender equity, sustainable funding, and improved coordination and resources for education and service delivery. The lessons learned from capacity-building efforts in the Syrian conflict have broader implications for other regions facing similar challenges.

Abusive supervisor triggers counterproductive work behaviors in nursing staff: role of psychological contract breach and Islamic work ethics

PurposeAbusive supervision (AS) provides insights into the darker aspects of leadership behavior and its effects on employees. Understanding and addressing AS can contribute to creating healthier work environments and promoting employee well-being. The effect of abusive leadership (AS) on counterproductive work behaviors (CWB) in nursing staff is examined through the theoretical lens of the social exchange theory.Design/methodology/approachData were collected from 302 nursing staff working at public and private hospitals through a self-administered questionnaire. Measurement scales were adapted from the literature and the data were tested for validity and reliability before performing hypotheses testing through structural equation modeling in SmartPLS 4.0.FindingsAS positively affects CWB, and psychological contract breach mediates this relationship. However, employees with high Islamic work ethics (IWE) are less concerned with supervisors' dysfunctional behaviors and pay less attention to them; thus, IWE buffers the effect of AS on CWBs.Originality/valueA positive and supportive organizational climate is crucial for attracting and retaining skilled healthcare professionals. When healthcare professionals are subjected to abusive behaviors, their ability to share knowledge, adopt safety protocols and provide the best patient care may be hampered. Therefore, addressing AS in hospitals is vital to promoting a positive work environment, enhancing employee well-being and improving patient care.

Assessment of Skills of Health Care Professionals Posted in Labour Room and Maternity OTs Based on OSCE (Objective Structured Clinical Examination) Using LaQshya Guidelines

Background: Present study attempts to assess the skills of staff including Doctors and nurses posted in labourroom and maternity OTs based on OSCE (Objective Structured Clinical Examination) as mentioned in LaQshyaguidelines in selected areas of Indore and Ujjain district (M.P) regarding the management of normal labour, theactive management of third stage of labour, Newborn Resuscitation, management of PPH due to atonic uterus andmanagement of eclampsia. Even in these parameters many sub-parameters were studied.Materials and Methods: Pre designed semi structured Observation checklist for Health care providers regardingskill assessment of the staff based on OSCE guideline was used to assess Health care providers including Doctors,Staff nurses/ANMs, who are providing MCH services in LR (Labour room) and maternity OT of the selectedhospitals of Indore and Ujjain district.Results: Most of the manoeuvres were better performed by staff nurses posted in CHCs rather than those postedin PHCs. Breathing assessment of baby was lacking among staff nurses of both CHCs and PHCs and needed to betackled with by a reorientation training of paramedical staff in critical care. Decision to transfer (is usually afterConsultation with the in charge, hence it is usually the Medical officers prerogative) and bimanual compression/aortic compression/condom tamponade to control bleeding was done exclusively by MOs.Conclusion: OSCE helped to assess the skills of the staff of maternity wing in a comprehensive manner and waswell appreciated by the staff. Such OSCE modules should be developed and regularly used and updated to assessthe clinical skill of the staff in the maternity wing of any health centre or hospital.

Digital skills of health care professionals in cancer care: A systematic review.

The digital transformation of healthcare enables new ways of working in cancer care directing attention on the digital skills of healthcare professionals. This systematic review aims to identify existing evidence about digital skills among health care professionals in cancer care to identify the needs for future education and research. Database searches were conducted in PubMed, CINAHL, Web of Science, Scopus, Cochrane and ERIC to identify studies until March 2023. The inclusion criteria were digital skills of health care professionals in cancer care as described by themselves, other health care professionals, patients or significant others. The CASP tool was used for quality assessment of the studies. Data was analysed following inductive content analysis. The search produced 4563 records, of which 24 studies were included (12 qualitative, 10 quantitative, 1 mixed methods design and 1 strategy paper). Four main categories were identified describing HCPs' required skills, existing skills and development areas of digital skills in cancer care: Skills for information technology, Skills for ethical practice, Skills for creating a human-oriented relationship and Skills for digital education and support. In development areas, one more main category, Skills for implementing digital health, was identified. The digital skills of health care professionals in cancer care are multifaceted and fundamental for quality cancer care. The skills need to be assessed to provide education based on actual learning needs. The review findings can be used for education and research in this field.

Antenatal Care Services in Sudan Before and During the 2023 War: A Review Article.

Antenatal care (ANC) is provided by skilled healthcare professionals to pregnant women to ensure the best health conditions for both mother and baby during pregnancy. It includes risk identification, prevention, management of pregnancy-related diseases, health education, and health promotion. Antenatal care has a great effect on vital health indicators such as maternal and neonatal mortality by identifying and treating pregnancy-related complications. Political instability and armed conflict have seriously affected the health system, which has catastrophic implications for pregnant women's health. This review aimed to summarize the literature on ANC in Sudan before and during political instability and war by highlighting its effect on maternal mortality, coverage, care providers, quality of care, accessibility, and utilization. Other aspects of this review are the ANC components and service provision during the war. In addition, the author tried to identify the gaps and point out the future research needs in Sudan. A total of 58 articles about ANC in Sudan have been reviewed through PubMed, Google Scholar, ResearchGate databases, and other search tools. The keywords used were "antenatal care", "coverage", "service providers", "service quality", "accessibility and utilization", "components", and "ANC during the war". All the keywords were followed by "Sudan" to confine the search. According to the reviewed data, ANC services in Sudan, even during normal political situations, were not sufficient and of poor quality in most of the reviewed regions. The political instability and armed conflicts worsened the situation, and it became catastrophic. To improve the accessibility and quality of ANC services, we will need the collaboration of all stakeholders to address the health needs of vulnerable groups, people in remote rural areas, and nomadic communities towards providing the required health services in general and ANC in particular. On the other hand, an important aspect of this development is the availability of skilled healthcare providers and the adoption, revision, and updating of working procedure guidelines to match the needs of the local communities. The main shareholders are the local communities; they must be empowered and involved by raising their awareness. Then, effective, punctual, and applicable contingency plans should be ready for any unfortunate crises.

IGF-1 as screening tool for acromegaly and adult-onset growth hormone deficiency in the Netherlands.

Insulin-like growth factor 1 (IGF-1) measurements play a central role in the diagnosis and follow-up of acromegaly and growth hormone deficiency. However, improving health care outcomes for these patients involves an intricate process of laboratory diagnostics and skilled health care professionals. The integrated effects of IGF-1 reports on diagnosis and treatment decisions are yet unknown. Extended quality assessment, distributing the description of five (real) patient cases with accompanying blood samples. Patients suspected or during follow up for acromegaly or adult onset of growth hormone deficiency were included. Laboratory specialists and endocrinologists in the same centre were asked to interpret their centre-specific IGF-1 results by using a laboratory and medical questionnaire. This way, insight could be obtained into the combined effects of different assays, assay harmonisation, reference value sets, and individual physician interpretation in relation to guidelines, thus reviewing the entire diagnostic and management process. Limited variation (CV 13.8 ± 2.8) was found in IGF-1 concentrations despite different use of the harmonization sample and factor among laboratories. This interlaboratory variation increased upon conversion to SD scores (CV 15.7 ± 40.7) as a consequence of the use of different reference value sets. Furthermore, there was a lack of adherence to international guidelines among endocrinologists. Highly variable diagnostic and treatment outcomes in acromegaly and AGHD in the Netherlands can be attributed to increased variability of IGF-1 upon conversion to SD scores and low adherence to clinical guidelines.

The need for a tailored National Dementia Plan in Ethiopia: a call for action

AbstractBackgroundGlobally, a rapid demographic transition is occurring with a significant increment in the proportion of older individuals. For the first time in history, individuals aged 65 and above outnumber that of children under five years of age.MethodA mini review was conducted to assess the burden and types of dementia risk factors in Ethiopia.ResultsIn Ethiopia, the life expectancy has shown dramatic improvements in the past few decades and is expected to reach 74 years by mid‐century. Older age is considered the most important non‐modifiable risk factor for dementia. Likewise, other modifiable diseases such as infectious diseases, non‐communicable diseases, particularly cardiovascular diseases, and traumatic brain injuries are associated with dementia. Despite, the high prevalence of dementia risk factors and impending economic and health impact from dementia, no country in the sub‐Saharan Africa (SSA), including Ethiopia, has developed a standalone national dementia strategic plan to guide the overall effort to improve dementia care in the country. It is vital to design and develop a national dementia plan in line with a framework outlined by the 2017 World Health Organization (WHO) global action plan. The health, social, &amp; economic burden from dementia is expected to be high to the developing countries such as Ethiopia unless clear prevention and management strategies are designed at a national level to cascade the care to the primary care level. The planned strategic policy may focus on improving the knowledge and skills of health care professionals. Translation and cultural adaptation of cognitive, functional, and behavioral assessment batteries is of paramount importance in improving the diagnostic accuracy along with availability of advanced imaging, biomarkers, and dementia treatment.ConclusionIn summary, this call for action paper recommends developing a tailored stand‐alone or an integrated national dementia prevention and care plan which is in congruent with the seven WHO global action plan.

Assessment of Knowledge Regarding Antenatal Care among Men in Selected Rural Areas of Himachal Pradesh

Background: WHO defined health as the state of complete physical, mental, and social well-being and not merely an absence of disease or infirmity, but it includes ability to lead socially and economically productive life.1 Being a man or women has a significant impact on health, as a result of both biological as well as gender related differences. Antenatal care (ANC) is most important aspect of women‘s reproductive health. The antenatal care is the care provided by skilled health care professionals to pregnant women and adolescent girls to ensure best health conditions for mother and baby during pregnancy. It reduces maternal and perinatal morbidity and mortality both directly, through detections and indirectly, through the identification of women and girls at increased risk of developing complications during labour, delivery and ensuring appropriate level of care.1 As per NFHS- 4, the 21% of pregnant women utilised full ANC, ranging from 2.3–65.9% across states. Overall, 51.6% had 4 or more ANC visits, 30.8% consumed IFA for at least 100 days and 91.1% had one or more doses of tetanus toxoid. Full ANC utilisation was inequitable across place of residence, caste, and maternal education. Registration of pregnancy, utilisation of government‘s Integrated Child Development Services (ICDS) and health insurance coverage were associated with higher odds of full ANC utilisation. Lower maternal education, lower wealth quintile, lack of father‘s participation during antenatal visits, higher birth order, teenage and unintended pregnancy were associated with lower odds of full ANC utilisation. This study assesses the knowledge about the antenatal care among married and unmarried men of 18-35 years age in selected rural areas of Himachal Pradesh. Methods: The study was an unmatched case and control design where married men were considered as a case and unmarried men as comparator group. This study was a part of large study for which sample size of 268 men in each group was calculated assuming prevalence of female contraceptives 70% in unmarried men and 85% in married men. This was carried out by cluster-based sampling in villages of Nagrota Bagwan and Shahpur health blocks of DRPGMC Tanda at Kangra. Results: The 93.3% participants among case group are aware of anaemia in pregnancy while only 64.9% among control group are aware of anaemia in pregnancy. The knowledge about all three causes of anaemia was statistically more in case group (61.9%) as compared to control group (38.8%). Assessment about high-risk pregnancy, about 72.4% participants among case group were aware about the risk factors in pregnancy as compared to 43.3% in control group with statistically significant differences (P=0.000). All the causes of high-risk pregnancy were reported by the participants of case group (44.0% vs 29.9%) with statistically significant differences. Conclusions: Married men had significantly more knowledge about various components of antenatal care. The awareness approach for unmarried men needs to be designed regarding antenatal care.

Projected Global Trends in Hematological Malignancies: Incidence, Mortality, and Disability-Adjusted Life Years from 2020 to 2030

Introduction: Hematological malignancies encompass a diverse group of conditions affecting the blood and its components, including anemia, bleeding disorders, hematologic malignancies, and inherited blood disorders. These disorders have a substantial impact on global health, posing challenges for health care systems worldwide. Understanding the future trends in the incidence, mortality, and disability-adjusted life years (DALYs) associated with hematological malignancies is crucial for effective health care planning and resource allocation. This study was designed to project the global trends in hematological malignancies from 2020 to 2030 and provide insights into the anticipated burden of these conditions. Methods: Estimated annual percentage changes (EAPCs) were utilized to forecast trends in the incidence, deaths, and DALYs associated with hematological malignancies between 2020 and 2030. EAPCs were derived using generalized additive models and data from the Global Burden of Disease study spanning from 1990 to 2019. The analysis involved utilizing a comprehensive and systematic approach, incorporating data from multiple sources, including population-based surveys, disease registries, health care databases, and vital statistics. Age-specific and sex-specific incidence rates, mortality rates, and DALYs were calculated for each specific hematological disorder. Advanced statistical modeling techniques, including time series analysis and predictive modeling, were employed to estimate future trends. The projections took into account demographic changes, epidemiological transitions, and advancements in medical technology. Results: The projections for the next decade indicate a varied trend in the age-standardized incidence, mortality, and disability-adjusted life year (DALY) rates of hematological malignancies globally. By 2030, the incidence rates per 100,000 individuals are expected to rise to 0.045 for multiple myeloma (EAPC = 1.70%), 0.016 for leukemia (EAPC = 0.79%), 0.012 for non-Hodgkin lymphoma (EAPC = 1.65%), and 0.002 for Hodgkin lymphoma (EAPC = 0.55%). The global age-standardized mortality rates associated with hematological malignancies show a differential trend. The mortality rates per 100,000 population are projected to increase to 0.016 for multiple myeloma (EAPC = 1.68%) and 0.008 for leukemia (EAPC = 0.40%). On the other hand, a decrease in mortality rate is expected for Hodgkin lymphoma (EAPC = -0.13%), while non-Hodgkin lymphoma exhibits a rise in mortality rate to 0.007 (EAPC = 1.31%). Similarly, the DALY rates per 100,000 population are expected to increase to 0.242 for multiple myeloma (EAPC = 1.54%) and 0.174 for non-Hodgkin lymphoma (EAPC = 0.90%). In contrast, the DALY rates for leukemia and Hodgkin lymphoma are projected to decrease to 0.248 (EAPC = -0.62%) and 0.023 (EAPC = -0.50%), respectively. In terms of geographical distribution, China is expected to face a considerable surge in the total number of hematological malignancy cases, with an estimate of approximately 859,692 cases by 2030. Globally, the total number of hematological malignancy cases is projected to reach approximately 4,634,937. The projected total number of hematological malignancy cases by 2030 across different levels of SDI are as follows: 1,113,313 cases in high-SDI areas, 1,004,403 cases in high-middle SDI areas, 475,496 cases in low-SDI areas, 795,475 cases in low-middle SDI areas, and 1,244,424 cases in middle-SDI areas. Conclusions: The projected global trends in hematological malignancies highlight the urgent need for comprehensive strategies to address this growing burden. Prevention and early detection programs should be strengthened to mitigate the increasing incidence of these malignancies . Accurate diagnosis, appropriate management, and access to affordable treatments are crucial for improving patient outcomes. Health care systems must allocate adequate resources, including health care infrastructure, skilled health care professionals, and specialized services, to effectively manage the growing impact of hematological malignancies . Furthermore, collaboration among health care providers, researchers, policy-makers, and patient advocacy groups is essential to develop and implement evidence-based strategies that can alleviate the future challenges posed by hematological malignancies.

The Ability for Teaching Self-Efficacy by Clinical Preceptors in Diagnostic Medical Sonography

Objective: This study was designed to explore the teaching self-efficacy, by clinical preceptors instructing sonography students, in bachelor’s degree-accredited sonography programs. Materials and Methods: A survey was provided to sonography clinical preceptors, to gauge their level of teaching self-efficacy. The survey instrument, Sonography Preceptor Teaching Self-Efficacy Inventory (SPTSEI) was used. The intent of the survey was to gauge, holistically, sonography preceptors’ perceptions of influencing student learning, in a clinical setting. Results: The survey respondents suggested that they had a high level of confidence in their skill to transmit knowledge and abilities to students. However, it was found that preceptors who had received some type of professional development, as preceptor, had a statistically significant higher level of teaching self-efficacy than those who had not received any type of training. Conclusion: Clinical preceptors are skilled health care professionals in their chosen discipline but may have little to no teaching experience. If preceptors do not fully understand their role in the educational process, both they and their students may not attain educational goals. It is therefore critically important that proper training and education, to support clinical preceptors, be provided for them. This survey would suggest that clinical preceptors, with training, can better perform their educational roles and better handle any challenges that might arise, as a part of providing clinical education.