Specific Health Care Research Articles

Evaluating Patient Rights and Agency: An In-depth Examination of Autonomous Decision-Making in AI-Powered Telemedicine

This study examines the adequacy of regulations concerning consent and patient autonomy in AI telemedicine in Ghana. Using the IRAC (Issue, Rule, Analysis, and Conclusion) method, the research analyzes existing Ghanaian healthcare laws and regulations in the context of AI-driven telemedicine. The study finds significant gaps in the current regulatory framework, including a lack of specific provisions for informed consent in AI telemedicine, unclear guidelines on maintaining patient autonomy, and inadequate addressing of liability issues in AI-assisted healthcare. Recommendations include developing specific AI healthcare legislation, updating existing laws to incorporate AI and telemedicine considerations, establishing AI ethics committees, and implementing short-term mitigation strategies such as interpretive guidelines and enhanced disclosure protocols. The study emphasizes the need for a two-pronged approach: long-term regulatory development and immediate implementation of interim measures to protect patient rights and ensure ethical use of AI in telemedicine.

Exploration of Features of Mobile Applications for Medication Adherence in Asia: Narrative Review.

Medication is crucial for managing chronic diseases, yet adherence rates are often suboptimal. With advanced integration of IT and mobile internet into health care, mobile apps present a substantial opportunity for improving adherence by incorporating personalized educational, behavioral, and organizational strategies. However, determining the most effective features and functionalities for these apps within the specific health care context in Asia remains a challenge. We aimed to review the existing literature, focusing on Asian countries, to identify the optimal features of mobile apps that can effectively enhance medication adherence within the unique context of Asian societies. We conducted a narrative review with the SPIDER (sample, phenomenon of interest, design, evaluation, research type) tool. We identified studies on mobile apps for medication adherence from January 2019 to August 2024 on PubMed and Scopus. Key search terms included "Asia," "chronic disease," "app," "application," "survey," "experiment," "questionnaire," "group," "medical adherence," "medication adherence," "case-control," "cohort study," "randomized controlled trial," "clinical trial," "observational study," "qualitative research," "mixed methods," and "analysis," combined using logical operators "OR" and "AND." The features of mobile apps identified in the studies were evaluated, compared, and summarized based on their disease focuses, developers, target users, features, usability, and use. The study identified 14 mobile apps designed to enhance medication adherence. Of these, 11 were developed by research teams, while 3 were created by commercial companies or hospitals. All the apps incorporated multiple features to support adherence, with reminders being the most common, present in 11 apps. Patient community forums were the least common, appearing in only 1 app. In total, 6 apps provided lifestyle modification functions, offering dietary and exercise recommendations, generating individualized plans, and monitoring progress. In addition, 6 apps featured health data recording and monitoring functions, with 4 allowing users to export and share records with researchers or health care professionals. Many apps included communication features, with 10 enabling feedback from researchers or health care professionals and 7 offering web-based consultation services. Educational content was available in 8 apps, and 7 used motivation strategies to encourage adherence. Six studies showed that mobile apps improved clinical outcomes, such as blood glucose, lipid, and pressure, while reducing adverse events and boosting physical activities. Twelve studies noted positive humanistic effects, including better medication adherence, quality of life, and user satisfaction. This review has identified key components integrated into mobile apps to support medication adherence. However, the lack of government and corporate involvement in their development limits the generalizability of any individual app. Beyond basic reminder functions, features such as multiuser support, feedback mechanisms, web-based consultations, motivational tools, and socialization features hold significant promise for improving medication adherence. Further pragmatic research is necessary to validate the effectiveness of these selected apps in enhancing adherence.

Enhanced Recovery After Craniotomy: Global Practices, Challenges, and Perspectives.

The global demand for hospital care, driven by population growth and medical advances, emphasizes the importance of optimized resource management. Enhanced Recovery After Surgery (ERAS) protocols aim to expedite patient recovery and reduce health care costs without compromising patient safety or satisfaction. Its principles have been adopted in various surgical specialties but have not fully encompassed all areas of neurosurgery, including craniotomy. ERAS for craniotomy has been shown to reduce the length of hospital stay and costs without increasing complications. ERAS protocols may also reduce postoperative nausea and vomiting and perioperative opioid requirements, highlighting their potential to enhance patient outcomes and health care efficiency. Despite these benefits, guidelines, and strategies for ERAS in craniotomy remain limited. This narrative review explores the current global landscape of ERAS for craniotomy, assessing existing literature and highlighting knowledge gaps. Experts from 26 countries with diverse cultural and socioeconomic backgrounds contributed to this review, offering insights about current ERAS protocol applications, implementation challenges, and future perspectives, and providing a comprehensive global overview of ERAS for craniotomy. Representatives from all 6 World Health Organization geographical world areas reported that barriers to the implementation of ERAS for craniotomy include the absence of standardized protocols, provider resistance to change, resource constraints, insufficient education, and research scarcity. This review emphasizes the necessity of tailored ERAS protocols for low and middle-income countries, addressing differences in available resources. Acknowledging limitations in subjectivity and article selection, this review provides a comprehensive overview of ERAS for craniotomy from a global perspective and underscores the need for adaptable ERAS protocols tailored to specific health care systems and countries.

Adult Code Sepsis: A Narrative Review of its Implementation and Impact.

This narrative review explores the implementation and impact of sepsis code protocols, an urgent intervention strategy designed to improve clinical outcomes in patients with sepsis. We examined the degree of implementation, activation criteria, areas of implementation, personnel involved, responses after activation, goals and targets, impact on clinical indicators, and challenges in implementation. The reviewed evidence suggests that sepsis codes can significantly reduce sepsis-related mortality and enhance early administration of treatments. However, variability in activation criteria and inconsistent application present ongoing challenges. The review considers the incorporation of newer scoring systems, such as NEWS and MEWS, and the potential integration of machine learning tools for early sepsis detection. It highlights the importance of tailoring implementation to specific healthcare contexts and the value of ongoing training to optimize sepsis response. Limitations include the ongoing controversy surrounding sepsis definitions and the need for standardized, feasible quality indicators. Future research should focus on standardizing activation criteria, improving protocol adherence, and exploring emerging technologies to enhance early sepsis detection and management. Despite challenges, sepsis codes show promise in improving patient outcomes when implemented thoughtfully and consistently across healthcare settings.

Qualitatively Assessing ChatGPT Responses to Frequently Asked Questions Regarding Sexually Transmitted Diseases.

ChatGPT, a large language model artificial intelligence platform that uses natural language processing, has seen its implementation across a number of sectors, notably in healthcare. However, there remains limited understanding regarding the efficacy of ChatGPT in addressing commonly asked questions on public health subjects. This study aimed to investigate whether ChatGPT could appropriately answer frequently asked questions related to sexually transmitted diseases (STDs). Ten frequently asked questions on STDs were gathered from 25 different government agency websites. The questions were inputted into ChatGPT and subsequent responses were analyzed for accuracy, clarity, and appropriateness using an evidence-based approach on a 4-point grading scale. Of the responses provided by ChatGPT, four were determined to be excellent requiring no clarification and six requiring minimal clarification. No responses were graded as unsatisfactory. Additionally, the responses appropriately emphasized consulting a healthcare specialist. While the majority of responses required minimal clarification, ChatGPT has the potential to be an effective supplementary tool for patient education. Additional research is necessary to explore possible public health strategies that incorporate artificial intelligence to address concerns related to STDs.

A strategic brand development framework for expanding cardiovascular and endocrinology treatments in emerging markets

This paper introduces a conceptual framework for strategic brand development in the pharmaceutical industry, specifically targeting the cardiovascular and endocrinology treatment sectors in emerging markets. The framework explores how stakeholder engagement, market segmentation, and brand positioning can enhance access to critical treatments, addressing growing public health challenges in these regions. Cardiovascular and endocrinological disorders, such as heart disease and diabetes, are rising rapidly in emerging markets due to lifestyle changes, urbanization, and increased life expectancy. Pharmaceutical companies face unique challenges in expanding their market presence in these regions, including varying healthcare infrastructure, economic disparities, and regulatory environments. The proposed framework emphasizes the importance of engaging key stakeholders—such as healthcare professionals, policymakers, and patients—through targeted educational campaigns, partnerships, and advocacy. Effective stakeholder engagement fosters trust and collaboration, which is essential for expanding access to life-saving treatments. In addition, market segmentation is a critical component of this strategy, allowing companies to tailor their marketing efforts to specific demographic groups, economic conditions, and healthcare needs in each region. By identifying the most relevant segments and understanding their unique needs, companies can ensure that their treatments reach the populations most at risk for cardiovascular and endocrinological diseases. Brand positioning is another cornerstone of this framework. By clearly defining and communicating the value of their treatments in terms of efficacy, affordability, and accessibility, pharmaceutical companies can differentiate themselves in increasingly competitive markets. Strategic positioning not only enhances brand visibility but also builds long-term customer loyalty, which is crucial for sustaining market growth in emerging economies. Overall, this conceptual framework provides a roadmap for pharmaceutical companies to strategically develop their brands in the cardiovascular and endocrinology sectors, ultimately contributing to improved public health outcomes in emerging markets.

COVID-19 and COVID-19 Vaccine-Related Skin Ulcerations in the Lower Extremities: A Case Report and Literature Review

Several associations have been made between COVID-19 and vasculitis. Recent data also shows the prevalence and association of de novo vasculitis with either COVID-19 infection or COVID-19 post vaccination. In this article, we present the case of new-onset leukocytoclastic vasculitis, secondary to COVID-19 vaccination, that was complicated by severe infected and nonhealing ulcers in the lower extremities. Case A 53-year-old male patient presented to the dermatology clinics with a three-week history of painful necrotic patches coalescent of the lateral malleolus of the right and left ankles. History goes back to when the patient reported developing pruritic papules two weeks after receiving his second shot of the Pfizer BioNTech COVID-19 vaccine (BNT162b2). Punch biopsy was consistent with leukocytoclastic vasculitis. He was prescribed a four-week course of systemic corticosteroids and antibiotics as per cultures. Vascular assessment confirmed normal peripheral arterial and venous system. Two months later, the patient re-presented with fever and worsening of his lower extremity ulcers. He underwent debridement of his wounds. Intra-operative cultures revealed multidrug resistant bacteria. He required an additional debridement session a few days later and a 14-day course of Piperacillin-Tazobactam. The patient was subsequently discharged on corticosteroids and Azathioprine and followed up in the vascular surgery and rheumatology clinics. At four months follow-up, the patient's wounds were almost completely healed. Conclusion This article highlights a case of severe new-onset COVID-19 vaccine-associated leukocytoclastic vasculitis complicated with infected ulcers that required debridement twice in addition to a prolonged course of antibiotics and immunosuppression therapy. To our knowledge, none of the cases reported in the literature were this severe in nature. In this post-pandemic era, it must remain high on the differential list, and healthcare specialists should maintain a high index of suspicion when evaluating sudden new-onset skin lesions that do not have an immediately apparent etiology.

The Investigation of Machine Learning and Deep Learning Classification of Internet of Things (IoT) Enabled Medical Devices

The present cross-sectional, quantitative study investigates the classification capabilities of ML and DL in processing data from IoT-enabled medical devices: heart rate variability (HRV), blood pressure, blood glucose levels, and physical activity in patients with diabetes and cardiovascular diseases. Eight patients from AIIMS, New Delhi participated in this study. In the current investigation, two types of measurements are taken into consideration: cardiovascular measures and diabetes management metrics, which include BMI, blood pressure, blood glucose, physical activity, and HRV. The outcomes showed a positive association with blood glucose level and age (0.55), negative correlation between blood glucose and physical activity (-0.68), which had significant significance towards exercising importance in diabetes management. Blood glucose correlated moderately favorably with BMI with 0.45, while age and BMI correlated at 0.32. These results show how ML and DL techniques can improve the interpretation of complex health parameters from IoT-enabled devices to better manage patients and develop specific healthcare plans in chronic diseases.

Use of specialist health care among Norwegian-born children with one immigrant parent

Abstract Background An increasing number of children grow up with one immigrant and one native born parent. We know little about health in this group. Our aim was to compare the risk of receiving diagnoses of physical health conditions in specialist health care among Norwegian-born children with one immigrant parent compared to Norwegian background children. Methods Data from Medical Birth Registry of Norway were linked to data from the Norwegian Patient Registry (diagnoses in specialist health care), and Statistics Norway (parental country of origin, education, and household income). We estimated hazard ratios (HR) with Cox proportional hazard regressions, with Norwegian background children as reference category, adjusted for sex, birth year, parental education, and household income. Results Children with an immigrant parent had lower hazards than Norwegian background children of diagnoses of most types of infections, but higher hazards of some, including tuberculosis, and skin infections. They also had higher hazards than Norwegian background children of receiving diagnoses of obesity and other nutritional deficiencies, and skin diseases, but lower hazards for other conditions, including chronic lower respiratory disease, disease of the digestive system, and visual or hearing impairment. The hazards of diagnoses of any neurological condition, sleeping disorders and epilepsy were lower among children with an immigrant mother, but higher among those with an immigrant father. Differences between children with one immigrant parent and Norwegian background could not be explained by differences in parental education or household income. Conclusions Children of one immigrant parent do not overall use specialist health care for physical health issues more than other children. Key messages • Awareness of diagnoses given most frequently to children of one immigrant parent can help promote timely diagnoses and adequate use of services, which is important for prevention of later illness. • Barriers to health care use among children of immigrants should be further researched.

Variations in access to acute care services by immigrant background and sociodemographic factors

Abstract Background The Emergency Medical Communication Center (EMCC) plays a vital role in the medical emergency response system by triaging contacts, notifying local physicians, and providing medical advice. The utilization of acute care services and the subsequent care pathway by individuals with immigrant background remains unclear in the Norwegian context. This study aims to investigate whether disparities exist in the acute care pathway for patients with different sociodemographic background who use ambulance services. Methods We examined all code red ambulance dispatches for life-threatening emergencies in 2021 in Norway. These ambulance dispatches were linked to primary health care and specialist health care contacts to trace patient pathways and outcomes. Statistical analyses were conducted using linear regression models, adjusted for patient characteristics, such as immigrant background, age, sex, municipality of residence, living condition, socioeconomic status, comorbidity and cause of emergency contact. Results Preliminary crude findings indicate that patients with immigrant background are overrepresented in the groups receiving acute primary care only and underrepresented in the groups transferred directly to specialist health care, within 8 hours after ambulance arrival at the patients’ location. Conclusions The preliminary results suggest challenges for the EMCC in triaging patients with immigrant background, but further research is needed to explore potential systematic differences. This study aims to improve understanding of disparities in access to acute care and inform targeted interventions to optimize resource allocation in emergency departments. Key messages • This study may improve understanding of disparities in access to acute care in Norway. • This study can inform targeted interventions to improve resource allocation in emergency departments.

Survey Defining Lip Health-Dermatology and Health Care Providers' Perspectives.

There currently exists no consensus on objective features which are relevant in the assessment of overall lip health. This study seeks to identify features and factors that are associated with healthy lips. This survey will ultimately enable clinicians to objectively track lip health for clinical evaluations and clinical research. An anonymous survey was conducted among allied healthcare professionals in-person and through email. The survey contained questions designed to assess the importance of features of lip health using a 5-point Likert scale. Features included lack of lip dryness; even tone or lack of hyperpigmentation; lip smoothness; lip color; lip shine, radiance, or luster; definition of the vermillion border/defined lip contour; lip fullness or plumpness; lack of lip lines; and lip firmness. The final questions prompted respondents to select the top three most important features when assessing lip health and to provide any additional pertinent factors. A total of 334 responses were received, including board-certified dermatologists (35.9%), dermatology residents (14.7%), and other healthcare specialties (49.4%). The features most cited were lack of lip dryness (65.8%), lip smoothness (38.4%), even tone or lack of hyperpigmentation (38.1%), definition of the vermillion border/defined lip contour (28.0%). Survey results reveal that lip dryness, lip smoothness, lack of hyperpigmentation, and definition of the vermillion border/defined lip contour were the features most associated with lip health. The results from this survey will provide a basis for future research in the field of lip health, research, and clinical treatment.

The effect of team-model on healthcare usage and treatment levels among people with type 2 diabetes

Abstract Background In North Karelia Finland, a team-based service model was implemented in some municipalities’ primary healthcare (PHC) centers during 2020. In this team-model, a healthcare customer contacts a nurse who initiates the service process immediately. Nurses can also consult or direct customers to other healthcare professionals and arrange physical appointments if needed. The aims of the model are improved customer and personnel experience and satisfaction, and improved quality and effectiveness of care. We assess the effect of this team-model on treatment levels, measurement activity, and health care usage among patients with type 2 diabetes (T2D). Methods Patients with T2D were identified using the ICD-10 code E11 from the regional electronic health records. The data include all patients diagnosed by 2016 who were alive and residing in North Karelia in 2023 (N = 6312). Diabetes-related contacts with nurses or doctors in outpatient PHC and specialized healthcare (SHC) were considered, along with measurement activity and levels of glycated hemoglobin (HbA1c) and low-density lipoproteins (LDL) between the years 2017 and 2022. Annual differences between areas were analyzed using logistic and linear mixed models. Results In 2017, patients’ mean age was 66 and age range 20-93. The proportion of men was 55% and 45% resided in team-model areas in 2023. The team-model increased T2D-related outpatient PHC remote contact with nurses for a couple of years. But eventually they decreased to a lower level than before. Additionally, the team-model reduced the number of other contacts. An increased difference between areas in measurement activity on HbA1c and LDL levels was also observed. But the difference between areas in proportion of those who achieved treatment targets stayed unchanged. Conclusions In the long-term, the team-model reduced the number of T2D-related contacts and increased the measurement activity of HbA1c and LDL, but it had no effect on treatment levels. Key messages • Team-based service models might potentially reduce service use in the long term. • More research and evidence are needed on the effectiveness and cost-effectiveness of team-based service models.

Healthcare access for people with disabilities: a scoping review of COVID-19 policies in Europe

Abstract Introduction The COVID-19 pandemic raised healthcare inequalities, affecting the most vulnerable groups. There is limited evidence of whether the COVID-19 measures and the health system’s preparedness for outbreaks among European countries were sufficient to cover the health access needs of PWDs. Aim To provide a structured overview of the COVID-19 measures and policies addressing access to primary and specialist health services for PWDs during the COVID-19 pandemic in the European Members States (MS) and the United Kingdom (UK), using ten dimensions of healthcare access by Levesque et al. (2013) and the PoliMap taxonomy. Methods This study followed the PRISMA guidelines for Scoping Reviews. A search strategy was employed on PubMed, Embase, Scopus, and Web of Science databases from January 2020 to January 2023. Studies published in peer-reviewed journals in English, Portuguese, and Spanish were included, informing a COVID-19 measure or policy and assessing or providing a rationale with access to primary or special healthcare services. Results The final search strategy yielded 2.076 results, 188 studies were reviewed for full-text analysis, and 74 were included in the final analysis. One hundred twenty-one policies or measures addressing primary or specialist care access were identified. Only thirteen target PWDs, focussing on intellectual or mental disability and addressing mental healthcare services. Results revealed that COVID-19 measures for PWDs were oriented to increase health system response capacity and reduce virus transmission, describing a predominantly negative effect on healthcare access for PWDs. Conclusions The needs of PWDs in access to primary and specialist care were not fully covered by the policies and measures placed during the COVID-19 pandemic among the MS and the UK. One-size approaches focussing on the attendance of COVID-19 infection with stigmatizing measures overlook the specific health necessities of this population. Key messages • Adopting disabled-inclusive measures in the daily healthcare provision and engaging PWDs in the policy cycle is paramount to preparing for the next outbreak and public health crises. • Additional research focusing on primary and specialized healthcare access during outbreaks for PWDs, especially with sensory and physical disabilities, is crucial to furthering health equity.

Effectiveness of specialist involvement in case discussion conferences with primary healthcare providers on the management of type 2 diabetes patients: a study protocol for a cluster randomized controlled trial

BackgroundIn supporting primary healthcare in delivering high-quality care for individuals with type 2 diabetes mellitus (T2DM), previous research emphasized strategies to facilitate communication and collaboration between primary healthcare providers and hospitals. This study aims to evaluate the effectiveness of case discussion conferences between specialists from hospitals and primary healthcare providers in China on the optimization of diabetes management and the improvement of patient health outcomes.MethodsThis study will be a parallel cluster randomized controlled trial in which primary healthcare institutions in Shouguang city and Shangsi County will be randomly allocated to the intervention and control groups. The intervention will involve regular case discussion conferences where attendants will meet to discuss complex cases with patients diagnosed with type 2 diabetes mellitus, exchange experiences, and seek and provide expert advice. Family doctor teams from primary healthcare institutions and specialists from secondary or tertiary hospitals will engage in these conferences. Data will be collected at baseline and at the 6- and 12-month follow-ups. The primary clinical outcome measures will focus on the changes in the HbA1c and FBG levels of patients under management. The secondary outcomes will include other physiological indicators, such as blood pressure, BMI, and cholesterol. The evaluation will extend to changes in the capabilities and behaviors of primary healthcare providers. Furthermore, the feasibility and adherence of this intervention will be thoroughly assessed.DiscussionThis study is designed to generate robust evidence on the effectiveness of case discussion conferences, an interprofessional collaboration strategy, in enhancing diabetes care delivery in primary healthcare, with the ultimate goal of improving patient health outcomes.Trial registrationChinese Clinical Trial Registry ChiCTR2300078829. Registered on December 19, 2023. https://www.chictr.org.cn/showproj.html?proj=210293

New evidence on household financial protection against out-of-pocket payments for health in Poland

Abstract Background Protecting households against financial hardship when using health care is an integral element of universal health coverage. Previous analysis showed that in Poland, catastrophic spending on health is more common than in many European countries. Over the last decade, several measures were undertaken to reduce the burden of out-of-pocket payments for households in Poland. Methods The study aimed to assess financial protection in Poland using the indicators of catastrophic and impoverishing health spending. It relies on the methodology developed by the WHO Region Office for Europe. Catastrophic expenditure is defined as out-of-pocket payments that are greater than 40% of household capacity to pay. The study uses data from the Polish household budget surveys in 2013-2021. Results The incidence of catastrophic health spending remained relatively constant over the years analyzed, with 9% of households affected. Only in the first year of the COVID-19 pandemic (2020) it reached nearly 10%, although overall household out-of-pocket expenditure declined that year. The share of households impoverished or further impoverished due to out-of-pocket payments decreased from 4% in 2013 to 3% in 2021. Payments on medicines are the main driver of catastrophic spending, particularly among poorer households, although their role has diminished over time. Household’s available resources, gender, age, education, disability status, residence place, number of children, and household’s main source of income are significantly associated with catastrophic health payments. Conclusions Despite the implemented policies, household financial protection against out-of-pocket payments in Poland did not improve significantly between 2013 and 2021. Available evidence should be used to design well-tailored measures to reduce the burden of out-of-pocket payments, targeting the most vulnerable population groups and specific healthcare areas. Key messages • Household financial protection against out-of-pocket payments in Poland did not improve significantly between 2013 and 2021. • Out-of-pocket payments for medicines are the main cause of financial hardship for Polish households.

4.C. Scientific session: Navigating through complex challenges of responding to outbreaks of multidrug-resistant organisms

Abstract Antimicrobial resistance is one of the top ten global public health threats according to the WHO, contributing to millions of deaths each year. While outbreaks of multidrug-resistant organisms (MDROs) are well studied in hospital and nursing home settings, knowledge gaps exist concerning the complex challenges of outbreaks of MDROs among vulnerable patient populations, such as patients with intellectual disabilities or elderly patients living longer at home with multiple comorbidities. The coordination of such outbreaks requires a multidisciplinary approach as these patients often receive care throughout different healthcare settings, including long-term care and home-based nursing care. We delve into the complexities of coordinating an MDRO outbreak response involving healthcare professionals from various healthcare settings. The challenges inherent to the coordination of multidisciplinary involvement and the use of innovative strategies for outbreak preparedness and surveillance, will be thoroughly examined based on scientific evidence and practice based experiences. Workshop objectives • To exchange experiences on managing cross-institutional outbreaks of MDROs • To foster deeper understanding of the complexities of multidisciplinary involvement during MDRO outbreaks among vulnerable patient populations The workshop structure: - A brief introduction will be provided on the generic challenges in providing long-term care to vulnerable patient populations carrying MDROs. We will subsequently illustrate potential challenges faced during a cross-institutional MDRO outbreak among these patients through a realistic scenario (5 min): A patient with severe intellectual and physical disabilities living in both a long-term care facility as well as with family at home, unexpectedly turns out to be carrying an MDRO after recent hospital admission. As the patient receives nursing care from both from family members and nursing staff in different healthcare settings, a cross-institutional MDRO outbreak has occurred requiring a coordinated response. - Hereafter, individual presenters will address evidence- and experience-based challenges faced in MDRO outbreak responses within the specific healthcare settings covered in the previously presented scenario. We will navigate through the scenario together with the participants, discussing practical and ethical dilemmas, and explore ways for containing the MDRO outbreak while maintaining effective and compassionate healthcare delivery. In addition, we will discuss the use of public health innovations, such as social network analysis as a basis for the development of a stress test exercise to improve preparedness for MDRO outbreaks, and the role of wastewater surveillance in MDRO outbreaks. Discussions will be facilitated by (online) voting tools to invite participants to exchange experiences (40 min). We conclude with an exciting quiz to summarize the key messages of this workshop (10 min). Key messages • Healthcare setting, knowledge, proportionality and well-being of vulnerable patients populations are important to acknowledge during cross-institutional MDRO outbreaks. • Novel stress test exercise and wastewater surveillance are potential methods to improve preparedness and surveillance, respectively, during cross-institutional MDRO outbreak responses.

Assessment of the research potential of healthcare specialists in the Republic of Kazakhstan in the implementation of clinical research: results of online questionnaires and self-assessments. Global crisis of clinical researcher shortage

The study aimed to identify and analyze the potential of practical healthcare professionals in terms of skills and knowledge for conducting clinical research in Kazakhstan, as well as to identify obstacles that may arise and cause the low involvement of specialists in research activities.Materials and methods. A specially developed questionnaire was conducted online. Various healthcare professionals (doctors, nurses, teachers of medical educational organizations) from all regions of Kazakhstan participated. By random sampling, 337 respondents answered the questions. Data was collected anonymously through Google Forms.Results and discussion. 29,7% respondents had participated in clinical research. Most respondents do not have sufficient knowledge in conducting clinical research; on average, 35% of respondents answered correctly. On average, respondents' self-assessment of knowledge and skills in choosing a study design, forming groups of study objects, collecting, analyzing, and interpreting data obtained during clinical trials, and performing statistical processing of results was 3 points (max = 5 points). A majority expressed a need for further training in clinical research. The main barriers to conducting clinical research were identified as lack of working time (44%), insufficient knowledge in conducting clinical research (34%), inaccessibility of educational programs (28%), lack of personal interest (27%), non-compliance of clinical base infrastructure (23%), difficulties in patient recruitment (20%), and the risk of losing professional autonomy (13%).Conclusions: The survey results show an unsatisfactory level of existing research potential of healthcare professionals in the organization and conduct of clinical research. the findings reveal a significant gap in the research potential of healthcare professionals in Kazakhstan. There is a lack of understanding of clinical research concepts, international standards, and local legislative requirements. The main obstacles are inadequate time for research, insufficient knowledge and experience, limited access to training, and low interest among professionals.

Inadequate health literacy and higher healthcare utilisation among older adults in Switzerland: cross-sectional evidence from a population-based study.

Population ageing in Switzerland poses significant challenges, including for the healthcare system. Inadequate health literacy can hinder individuals' ability to seek appropriate treatments and navigate the healthcare system efficiently. This study explores the associations between health literacy and the number of consultations with general practitioners and healthcare specialists in a population-based sample of adults aged 58+ in Switzerland. We used data from 1424 older adults who participated in Wave 8 (2020) of the Survey of Health, Ageing, and Retirement in Europe (SHARE). The analysis focuses on two outcomes: the reported number of consultations with (1) general practitioners or (2) healthcare specialists in the year prior to the interview. Health literacy, i.e. the ability to find, understand, assess and apply health information, is measured using the short version of the European Health Literacy Survey questionnaire (HLS-EU-Q16). The final health literacy score ranged from 0 to 16 and was categorised into three health literacy levels: inadequate (0-8), problematic (9-12) and sufficient (13-16). Bivariate analyses were conducted using Kruskal-Wallis tests. Partial associations were examined using multivariate generalised Poisson regression models controlling for key sociodemographic, regional and health-related variables. Overall, 68.5% of the respondents were classified as having sufficient health literacy, while the health literacy level of 23.5% and 7.9% of respondents was classified as problematic or inadequate, respectively. The median number of general practitioner consultations and specialist visits was 2 and 1, respectively, both with an interquartile range of 1. Lower levels of health literacy were statistically significantly associated (p = 0.0011) with a higher number of general practitioner consultations in the year prior to the interview. By contrast, we did not find any significant association between health literacy and the number of specialist consultations. This study finds that lower health literacy is associated with higher healthcare utilisation for older adults in Switzerland. The findings may suggest that general practitioners could have a significant role as advisors for individuals with low levels of health literacy, while a similar pattern is not observed for specialists. This discrepancy might be attributed, at least in part, to the role of general practitioners as intermediaries between patients and specialised care providers. Ensuring accessibility to general practitioners, particularly for individuals with low health literacy, could prove to be a beneficial strategy in addressing the healthcare requirements of this particularly vulnerable patient group. Additionally, improving health literacy in the population may provide further health benefits and lead to resource savings.

Work ability data management in multisectoral services for people with disabilities: a cross-sectional study

Successful collaboration between professionals working in multisectoral services for people with disabilities requires access to data on the client’s work ability. This study examines work ability data needs, availability, and acquisition in social and health care services and employment services and explores possible differences between these service sectors. A cross-sectional survey was carried out using a self-developed questionnaire based on Choo’s information management process model, the Work Ability House model and previous research on work ability data. The questionnaire was targeted at physicians, nurses, physiotherapists, psychologists, and experts who support the work ability of people with disabilities and who work in primary health care, specialised health care, social services or employment services. The findings indicate that data on clients’ self-perceived health status is more frequently available than data on self-perceived work ability. This variability in data availability exists across professional sectors, highlighting the need for enhanced data management practices related to work ability assessment and support among professionals in social and health care services and employment services. The study underscores the importance of increasing professionals’ willingness to discuss work ability issues with working-age clients, particularly in primary health care and social services. These findings are pertinent in terms of enhancing multisectoral collaboration among professionals who need to comprehensively assess and support the work ability and employment of people with disabilities. Also, the study provides a diverse list of individual pieces of data related to work ability.

Identifying the need for a nurse-driven palliative care intervention for American Indian and rural family caregivers.

The purpose of this qualitative study was to understand the needs of family caregivers (FCGs) from the perspectives of health care professionals delivering cancer care to American Indian and rural populations. A descriptive content analysis of 18 interviews with multidisciplinary health care professionals delivering cancer care at a rural cancer institute in the Great Plains region was conducted. We identified three themes: access, support, and awareness with six subthemes. Consideration of these core needs, coupled with the individual cultural circumstance, is critical in addressing disparities faced by American Indian/Alaska Native and rural FCGs. The availability of specialized health care services, like palliative care, can positively impact the experience of FCGs providing care. However, access is limited. The needs and challenges faced by American Indian/Alaska Native and rural FCGs described in this study can inform the development of a culturally responsive palliative care intervention. Nurses are well positioned to develop and lead this intervention, which will be the first of its kind. (PsycInfo Database Record (c) 2024 APA, all rights reserved).