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A culture of safety and the prevention of health care associated infections are among important issues in health care quality and patient safety. This study aimed to evaluate the effectiveness of prevention strategies for eliminating hospital acquired infections, with a focus on ensuring patient safety. Systematic review of the literature reporting the factors essential for effective prevention of hospital acquired infections. Literature compilation was carried out between 9 April and 16 April. Keywords under the search criteria were entered to databases such as PubMed/Medline to find relevant resources published between 2008 and 2018. Among 40 articles identified in the literature search, 6 articles were included in this review. Implementation of the fundamental infection monitoring, prevention and control of recommendations for all hospitals will assist to enhance the control of infection rates and development of patient safety programs. Transparency and frequent evaluation of the effectiveness and proper training of health professionals, as well as institutional packages and guidelines have been identified as crucial factors contributing to the prevention of health associated infections and patient safety. Health care manager has to focus on improving infection control practices, such as an active learning collaboration, to improve patient safety. Guidelines and comprehensive care quality improvement programs should be prepared and effectively applied in order to prevent Hospital Acquired Infections and to improve patient safety. [ABSTRACT FROM AUTHOR]

This symposium Article describes how prison abolitionist arguments also support the hypothesis that a defining goal of health law should be the abolition of hospitals. Like prison abolitionism, the hospital abolition hypothesis can provide a constructive way to shift the focus of legal analysis from substantive dimensions (in health law — cost, quality, access, and equity) to the dimension of power. [ABSTRACT FROM AUTHOR]

It is believed that the intensification of livestock activity and the expansion of cultivated forage area in Brazil contributed to the emergence of diseases in pastures. Despite the importance of forage plants, there are few studies demonstrating the influence of seed health quality, as well as their role in the spread of phytopathogens and forage production in tropical areas. The aim this study was to characterize the physiological and sanitary quality in 31 lots of Brachiaria seeds, cultivated in the main producing regions of Brazil. The health was determined by the blotter test method, in addition to the germination potential. It was also evaluated the emergence, fungal transmission present in the seeds to the seedlings and their pathogenicity on the dry mass production and leaf area. The mycoflora of Brachiaria commercial seeds produced in the states of Bahia, Goiás, Mato Grosso, Mato Grosso do Sul and São Paulo, is composed mainly by the high frequency and incidence of fungi as Phoma, Curvularia and Bipolaris. Fungi like Bipolaris sorokiniana, Curvularia lunata and Exserohilum rostratum were pathogenic to B. brizantha cv. Marandu. It was also found that Bipolaris, Curvularia and Phoma were transmitted via seed-plant. It was found that the presence of fungi in the seeds caused reduction of germination and emergence of seedlings. However, it is important to emphasize in this study that, despite the epidemiological importance in the transmission and dissemination of phytopathogens, infections that occurred in the aerial part of the evaluated forages, causing leaf spots, showed little or no influence on the production of dry mass and leaf area. [ABSTRACT FROM AUTHOR]

Abstract Background The aim of our study is to evaluate the postoperative complications after the extraction of impacted third molar teeth and to investigate the effects of these complications on the quality of life of patients. Methods Demographic, clinical, and radiological evaluations were conducted, covering factors like age, gender, and tooth position. Clinical measurements, pain and edema assessments, and quality of life evaluations through OHIP-14 scores were performed. Preoperative and postoperative mouth opening, trismus, alveolitis and dehiscence were evaluated. Results A total of 100 patients were included in our study. No significant gender-based differences were found in measurements, pain, or swelling. There was no statistically significant difference between the preoperative and postoperative results of difference A-C, difference B-E, difference A-D, and difference mouth opening. Procedure duration correlated positively with age, alveolar osteitis, trismus, and swelling. Postoperative quality of life, assessed by OHIP-14, demonstrated a negative correlation with age and trismus. It was observed that the gender and the tooth positions of the patients had no effect on the severity of postoperative pain and edema. Conclusions As the age of the patients increases and the duration of the procedure increases, the rate of postoperative complications increases and it is concluded that the quality of life decreases significantly.

Background: The aim of our study is to evaluate the postoperative complications after the extraction of impacted third molar teeth and to investigate the effects of these complications on the quality of life of patients. Methods: Demographic, clinical, and radiological evaluations were conducted, covering factors like age, gender, and tooth position. Clinical measurements, pain and edema assessments, and quality of life evaluations through OHIP-14 scores were performed. Preoperative and postoperative mouth opening, trismus, alveolitis and dehiscence were evaluated. Results: A total of 100 patients were included in our study. No significant gender-based differences were found in measurements, pain, or swelling. There was no statistically significant difference between the preoperative and postoperative results of difference A-C, difference B-E, difference A-D, and difference mouth opening. Procedure duration correlated positively with age, alveolar osteitis, trismus, and swelling. Postoperative quality of life, assessed by OHIP-14, demonstrated a negative correlation with age and trismus. It was observed that the gender and the tooth positions of the patients had no effect on the severity of postoperative pain and edema. Conclusions: As the age of the patients increases and the duration of the procedure increases, the rate of postoperative complications increases and it is concluded that the quality of life decreases significantly. [ABSTRACT FROM AUTHOR]

Job satisfaction of the employees represents the significant factor for the effective functioning of the medical facilities. The aim of this study is to examine job satisfaction of physicians and to explore its associated factors. Quantitative study method is applied in this study. Two hundred and nine physicians from the large medical facilities in Tbilisi (Georgia) are participated in the survey. The most important components of satisfaction were: relation with managers (78.5%), relations with colleagues (77%), communication with patients (73.5%), possibility of continuous medical education (74.2%), and service quality (66%). Younger physicians were more likely to be dissatisfied than older physicians. Women were less satisfied with workload rather than men, which can be related with burden of solving the family issues for them, besides the career. Majority of the inquired respondents are not satisfied with ongoing incomes and remuneration methods. Family physicians seemed to be especially dissatisfied with remuneration. Most of the interviewed physicians (76%) assessed work/life balance in range of 1–3 points. Particular dissatisfaction was stated by the doctor-specialists, referring that they do not work with normal work schedule and their work/life balance is infringed. Satisfaction level depends on multiple factors (communication with patients, intellectual stimulation, possibility of CME, relationship with colleagues and managers). The main recommendation is a need to address job satisfaction among physicians in order to improve the quality of health care. Attention to working conditions, career and professional development, and salary/incentives is critical for sustaining the continuity of quality health care in Georgia. [ABSTRACT FROM AUTHOR]

This paper first uses VR to innovate the informationized teaching technology of college physical education courses, combine the innovation of education methods with mental health education, innovate the teaching content of education courses, and construct the informationized teaching innovation system of education courses from multiple perspectives. Then, the comparison experiment on the application of the information-based teaching innovation system of college physical courses was designed and equalized using relevant methods. Finally, the impact of the system on students’ positive psychology, health quality, and overall physical education performance was analyzed, and teaching satisfaction was explored. The results showed that the scores of the experimental class in each initiative test were higher than those of the control class by 9~12 points, the attendance rate was maintained at about 0.97, the tardiness rate was below 0.05, the level of health and physical education knowledge and physical education skills were improved by 0.23 and 0.22, respectively, and the majority of them were satisfied with the teaching mode. Based on this study, it can improve the effect of physical education teaching and enhance the physical fitness of college students. [ABSTRACT FROM AUTHOR]

Resumen: Introducción: la educación en enfermería respecto a seguridad del paciente es un desafío constante para las escuelas universitarias, por lo que en el presente estudio, se mide el nivel de conocimientos y actitudes sobre seguridad del paciente en los estudiantes de Enfermería de una universidad privada de Santiago, Chile, contribuyendo al levantamiento de información sobre esta área y así aportar a la mejora continua. Material y métodos: estudio descriptivo, comparativo y transversal. Se aplicó un cuestionario que mide nivel de conocimientos y actitudes sobre seguridad del paciente a una muestra por conveniencia de 218 estudiantes de Enfermería de una universidad privada, de 3er, 4to y 5to año. Resultados: respecto a la variable <>, las dimensiones que se consideran como consolidadas en la muestra son: actitud proactiva para evitar riesgos en la seguridad y compresión del factor humano. Las dimensiones franqueza en la comunicación, consciencia del error y complejidad de los sistemas y su interrelación, se consideran como actitudes no consolidadas. Con respecto a la variable <>, si bien los resultados no son satisfactorios, se observa que existe un aumento del promedio que es directamente proporcional nivel al del curso. Conclusión: los puntajes no son satisfactorios en la mayoría de las variables evaluadas (actitudes y conocimientos), para establecer una consolidación. Además, no existen diferencias estadísticamente significativas entre los 3 cursos evaluados. Es necesario realizar alguna intervención con la intención de mejorar estos resultados y una nueva evaluación posterior. Abstract: Introduction: Nursing education regarding Patient Safety is a constant challenge for university schools, therefore, in the present study is measured the level of Knowledge and Attitudes on Patient Safety in Nursing students of a Private University of Santiago, Chile, contributing to the gathering of information on this area and thus contributing to continuous improvement. Methods: Descriptive, comparative and cross-sectional study. A questionnaire that measures the level of Knowledge and Attitudes about Patient Safety was applied to a convenience sample of 218 nursing students of 3rd, 4th and 5th year, at a Private University. Result: Respect to the Attitudes variable, which are considered as consolidated in the sample, are: Proactive Attitude to avoid security risks and Compression of the Human Factor. On the other hand, the dimensions Openness in communication with, Error awareness and Complexity of systems and their interrelation were considered as unconsolidated attitudes in the total sample. Regarding the Knowledge variable, although the results are not satisfactory, it is observed that there is an increase in the average that is directly proportional to the course that corresponds to it. Conclusion: In general, the scores are not satisfactory in most of the variables evaluated (Attitudes and Knowledge), to establish a consolidation, in addition there are no statistically significant differences between the 3 courses evaluated. Is necessary to perform some intervention with the intention of improving these results and a new subsequent evaluation.

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Every nation's healthcare system is one of the most critical industrial aspects. Nowadays, healthcare providers are under enormous pressure to meet the needs of the general public due to the abrupt rise of the COVID-19 pandemic. Conspicuously, evaluating the quality of healthcare services delivered by hospitals has become essential. Henceforth, a comprehensive Internet of Things (IoT) architecture is presented for time-sensitive ubiquitous information analysis in intelligent hospitals and clinical centers. The probabilistic Naive Bayes Model (NBM) is utilized to categorize information segments to estimate quantitative Measures of Healthcare Service (MHS). For the quantifiable analysis of healthcare quality, temporal data abstraction is performed to compute Health Quality Measure (HQM). A mathematical two-level decision tree is proposed to evaluate healthcare quality in a time-sensitive manner. A simulated environment with 250,145 data segments is used to validate the proposed architecture. Based on the experimental simulations, enhanced performance results of Sensitivity (93.23%), Precision (94.56%), Specificity (93.46%), Temporal Delay (100.35 s), and Reliability (86.45%), are registered in comparison with state-of-the-art techniques. [ABSTRACT FROM AUTHOR]

Abstract Background Quality healthcare services are considered one of the most effective vehicles for healthcare managers to achieve organizational goals. Therefore, this study aimed to combine the findings of comparable studies to identify consistencies and contradictions in the quality of outpatient services in Iran. Methods The current systematic review and meta-analysis study was conducted in 2022 according to PRISMA guideline. All relevant English and Persian studies were searched in databases, including Web of Sciences, PubMed, Scopus, Scientific Information Database, and Magiran. No year restriction was applied. The quality of the studies was assessed by the 22-item Strengthening the Reporting of Observational Studies in Epidemiology checklist. The meta-analysis was conducted by using Open Meta Analyst, and between-study heterogeneity was investigated with I-squared statistic. Results Of the 106 retrieved articles, seven studies with a total sample size of 2600 were included in the meta-analysis. The pooled estimate of mean for overall perception was 3.95 (95% CI: 3.34- 4.55, P< 0.001, I2= 99.97), while the pooled estimate of the mean for the overall expectation was 4.43 (95% CI: 4.11- 4.75, P< 0.001, I2= 99.93). The highest and lowest perception mean scores were related to tangibility (3.52, Gap= -0.86) and responsiveness (3.30, Gap= -1.04) dimensions. Conclusion Responsiveness was identified as the weakest dimension. Therefore, managers are recommended to design suitable workforce-development programs which focus on the provision of timely and prompt services, polite and courteous interactions with patients, and prioritization of patients’ needs. Moreover, training public sector practitioners along with incentives can fill up the existing gaps.

ÖZ: Bir ülkede yaşayan bireylerin yaşam kalitesini ve ülkenin beşerî sermayesini yakından etkilemesi nedeniyle sağlık hizmetlerinin kalitesinin, performansının ve etkinliğinin ölçülmesi önemlidir. Bu çalışmanın amacı, sağlık sistemi kalitesi belirleyicileri ve göstergeleri arasındaki nedensel ilişkileri 2018 itibariyle 135 düşük, düşük-orta ve üst-orta gelirli ülkeler için araştırmaktır. Sağlık sisteminin performansını yansıtan değişkenler sağlık göstergeleri, sağlık sisteminin kalitesini etkileyen değişkenler ise sağlık sistemi belirleyicileri olarak tanımlanmıştır. Belirleyiciler olarak; okuryazarlık oranı, kentsel nüfus (%) ve GSYH, sağlık sistemi göstergeleri olarak ise tüberküloz insidansı, beş yaş altı ölüm oranı ve cerrahi müdahale durumunda fakirleşme riski araştırma modelinde yer almıştır. İstatistiksel yöntem olarak gözlenen değişkenlerle yol analizi kullanılmıştır. Analiz sonucu; belirleyici değişkenlerin, önsel beklentilere uygun olarak tüberküloz insidansı dışındaki sağlık göstergelerini negatif etkilediği saptanmıştır. Sağlık sistemi belirleyicileri ve göstergeleri arasındaki nedensel ilişkilerin araştırıldığı az sayıdaki geçmiş çalışmalarda, gözlem birimlerinin belli bir ülke grubu (örneğin; sadece Batı Avrupa ülkeleri) veya aynı ülkenin belli bölgeleri ile kısıtlı olduğu görülmektedir. Farklı özellikteki ülkeleri kapsayan bir gözlem seti üzerinde, sağlık belirleyici ve göstergelerinin nedensel ilişkilerinin araştırılması bakımından çalışmanın özgün olduğu düşünülmektedir. ABSTRACT: It is important to measure the quality, performance and effectiveness of health care services, as it closely affects the quality of life of individuals living in a country and the human capital of the country. The aim of this study is to investigate the causal relationships between health system quality determinants and its indicators for 135 low, low-middle-and upper-middle-income countries as of 2018 The variables reflecting the performance of the health system are defined as health indicators and the variables affecting the quality of the health system are defined as health system determinants. As determinants; literacy rate, urban population (%) and GDP were included in the research model, while tuberculosis incidence, mortality rate under the age of five and the risk of impoverishment in case of surgical intervention were included as indicators of the health system. As a statistical method, path analysis was used with the observed variables. As a result of the analysis; it was determined that the determining variables negatively affect health indicators other than the incidence of tuberculosis in accordance with a priori the expectations. In the few past studies investigating causal relationships between health system determinants and indicators, it seems that the observation units are limited to a certain country group (for example, only Western European countries) or certain regions of the same country. It is thought that the study is original in terms of investigating the causal relationships of health determinants and indicators on an observation set covering different countries.

Abstract Background To describe the relationship between longevity and local access to preventive healthcare at the county level. Methods We used Medicare outpatient reimbursement data from the 2010 Dartmouth Health Atlas and longevity data from Chetty et al. (2016) to identify the cross-sectional associations between county longevity, access to outpatient care, and the quality of primary care. Results We find that the cost of outpatient care is inversely correlated with area life expectancy for individuals in the bottom income quartile. Much of this correlation is driven by men in the bottom income quartile. We also find that disaggregating a preventive care index produces significant relationships between components of the index and longevity where none were previously found. Conclusions These results counter prior assertions that local health costs are not associated with life expectancy. Additionally, the results also suggest that the local cost of outpatient care and the quality of that care may influence the longevity of low-income populations, especially for low-income men.

Background: Quality healthcare services are considered one of the most effective vehicles for healthcare managers to achieve organizational goals. Therefore, this study aimed to combine the findings of comparable studies to identify consistencies and contradictions in the quality of outpatient services in Iran. Methods: The current systematic review and meta-analysis study was conducted in 2022 according to PRISMA guideline. All relevant English and Persian studies were searched in databases, including Web of Sciences, PubMed, Scopus, Scientific Information Database, and Magiran. No year restriction was applied. The quality of the studies was assessed by the 22-item Strengthening the Reporting of Observational Studies in Epidemiology checklist. The meta-analysis was conducted by using Open Meta Analyst, and between-study heterogeneity was investigated with I-squared statistic. Results: Of the 106 retrieved articles, seven studies with a total sample size of 2600 were included in the meta-analysis. The pooled estimate of mean for overall perception was 3.95 (95% CI: 3.34- 4.55, P< 0.001, I2= 99.97), while the pooled estimate of the mean for the overall expectation was 4.43 (95% CI: 4.11- 4.75, P< 0.001, I2= 99.93). The highest and lowest perception mean scores were related to tangibility (3.52, Gap= -0.86) and responsiveness (3.30, Gap= -1.04) dimensions. Conclusion: Responsiveness was identified as the weakest dimension. Therefore, managers are recommended to design suitable workforce-development programs which focus on the provision of timely and prompt services, polite and courteous interactions with patients, and prioritization of patients' needs. Moreover, training public sector practitioners along with incentives can fill up the existing gaps. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Management & Health / Revista Gestão & Saúde is the property of Revista Gestao e Saude and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Char land is well-known as a hard-to-reach community in Bangladesh where the basic health services are very pitiable. Drawing an example from two char land communities in Bangladesh, this study explored the status of the public health services and service gaps. The study collected data from 222 respondents (heads of the households) and used a quantitative research approach where a face-to-face structured interview schedule was employed for data collection. Results showed that the char land family members were suffering different types of diseases, but they did not have adequate scientific treatment facilities; manpower and institutional facilities for health services were lacking against needs; and the quality of health services was awfully poor. All of the respondents mentioned a high service gap between demand and supply on health tests, specialized services and emergency services. Findings would be important guidelines for policy makers, development practitioners, health providers, and health workers. [ABSTRACT FROM AUTHOR]

Users of benzodiazepines (BZDs) should have their quality of life monitored to minimize the risks associated with long-term treatments. The aim of this study is to use the EuroQol 5D-3L to analyze the quality of life of 127 patients under treatment with BZDs during the COVID-19 pandemic. The results show that lorazepam comprises 25.49% of all dispensing requests, and that the mean duration of BZDs treatments is four years (range: 0.3–25). When rating their general health status, BZDs users reported 59.29 points out of 100. Thirty-two percent of patients reported mobility problems; 16.5% reported having a lot of pain or discomfort despite being treated with BZDs, and 16.54% used a BZD together with an opioid analgesic. The EuroQol 5D-3L dimension "anxiety/depression" showed that, despite the use of BZDs, 48.2% of the patients reported being moderately anxious or depressed and 13.4% described themselves as very anxious or depressed. Nevertheless, 37.8% of BZDs users were identified as potential candidates to follow a BZD deprescription plan. In conclusion, BZDs users showed a low quality of life during the COVID-19 pandemic. Older patients and females have been identified as groups of patients that could benefit from integrating the use of the EuroQol 5D-3L instrument into the protocols of the pharmaceutical care follow up. [ABSTRACT FROM AUTHOR]

China has received significant foreign direct investment in the last few decades; the FDI inflow could affect the environment, income, and people’s health. Therefore, this paper aims to investigate the relationship between FDI, renewable energy consumption, CO2 emissions, and Population health quality in China for the period 1980–2020. We applied the VECM method for the data analysis for the short and long-run effects of the independent variables. In the short run, FDI and CO2 emissions did not affect health quality in China; however, in the long run, FDI and CO2 emissions improved life expectancy. Renewable energy has both run and long implications for the health quality in China. These results reflect that FDI creates more jobs in China and improves the overall income of Chinese citizens, contributing to more accessible healthcare services in the long run. Therefore, the government should provide incentives to increase the FDI inflow, which uses renewable energy in production. Furthermore, to mitigate the CO2 emissions government should implement a carbon tax on the industries which has substantial CO2 emissions in the country.

Background: To describe the relationship between longevity and local access to preventive healthcare at the county level. Methods: We used Medicare outpatient reimbursement data from the 2010 Dartmouth Health Atlas and longevity data from Chetty et al. (2016) to identify the cross-sectional associations between county longevity, access to outpatient care, and the quality of primary care. Results: We find that the cost of outpatient care is inversely correlated with area life expectancy for individuals in the bottom income quartile. Much of this correlation is driven by men in the bottom income quartile. We also find that disaggregating a preventive care index produces significant relationships between components of the index and longevity where none were previously found. Conclusions: These results counter prior assertions that local health costs are not associated with life expectancy. Additionally, the results also suggest that the local cost of outpatient care and the quality of that care may influence the longevity of low-income populations, especially for low-income men. [ABSTRACT FROM AUTHOR]

Objective: Fatigue is considered a frequent and characteristic feature of sarcoidosis. This study was designed to determine the prevalence of fatigue in patients with sarcoidosis and to determine its potential clinical correlations in relation to symptom severity. Methods: A total of 56 sarcoidosis patients were included. Data on patient demographics, anthropometrics, disease characteristics, pulmonary function tests, 6-min walking distance (6MWD), blood biochemistry and hemogram findings were retrieved from hospital records. Psychometric instruments involved fatigue assessment scale (FAS), Beck Depression Inventory (BDI) and Short Form-36 (SF-36) for health-related QOL (HRQOL). Results: Mean±SD patient age was 50.9±11.9 years. Of 56 patients, 44 were females and 12 were males. When compared to FAS score <22 and FAS score ≥22-34 subgroups, FAS score ≥35 (severe fatigue) subgroup was associated with significantly higher patient age and significantly lower SF-36 physical health scores. Total FAS scores were correlated positively with age (r=0.349, p=0.008) and BDI scores (r=0.515, p<0.001), while negatively with MIP (r=-0.321, p=0.019) and SF-36 physical health (r=-0.402, p=0.003) and mental health (r=-0.351, p=0.009) scores. BDI score (OR 1.146, 95% CI: 1.020 to 1.288, p=0.021) was determined to be the single independent predictor of increased likelihood of a patient with sarcoidosis to have FAS score ≥22. Conclusions: Our findings emphasize that deterioration in respiratory functions may contribute to development of fatigue among sarcoidosis patients, and besides the fatigue, depressive symptoms and anxiety should also be an integral part of the multidisciplinary management of sarcoidosis patients. [ABSTRACT FROM AUTHOR]

It is important to measure the quality, performance and effectiveness of health care services, as it closely affects the quality of life of individuals living in a country and the human capital of the country. The aim of this study is to investigate the causal relationships between health system quality determinants and its indicators for 135 low, low-middle-and upper-middle-income countries as of 2018 The variables reflecting the performance of the health system are defined as health indicators and the variables affecting the quality of the health system are defined as health system determinants. As determinants; literacy rate, urban population (%) and GDP were included in the research model, while tuberculosis incidence, mortality rate under the age of five and the risk of impoverishment in case of surgical intervention were included as indicators of the health system. As a statistical method, path analysis was used with the observed variables. As a result of the analysis; it was determined that the determining variables negatively affect health indicators other than the incidence of tuberculosis in accordance with a priori the expectations. In the few past studies investigating causal relationships between health system determinants and indicators, it seems that the observation units are limited to a certain country group (for example, only Western European countries) or certain regions of the same country. It is thought that the study is original in terms of investigating the causal relationships of health determinants and indicators on an observation set covering different countries. [ABSTRACT FROM AUTHOR]

The trend of Total Hip Arthroplasty (THA) is projected to grow. Therefore, it has become imperative to find new measures to improve the outcomes of THA. Several studies have focused attention on the influence of psychological factors and sleep quality on surgical outcomes. The consequences of depressive states may affect outcomes and also interfere with rehabilitation. In addition, sleep quality may be an essential factor in determining surgical outcomes. To our knowledge, few articles focus on the influence of these factors on THA results. The present study investigates a possible correlation between preoperative depression or sleep quality and postoperative outcomes of THA. This study was conducted with 61 consecutive patients undergoing THA from January 2020 to January 2021. Patients were assessed preoperatively using GDS and PSQI, and six months postoperatively using FJS-12, SF-36, WOMAC, PSQI, and GDS. To simplify comparisons, the overall scores were normalized to range from 0 (worst condition) to 100 points (best condition). A total of 37 patients (60.7%) were classified as depressed and 24 as not depressed (39.3 %) in the preoperative assessment. A low–moderate positive correlation between preoperative GDS score and FJS-12 (rho = 0.22, p = 0.011), SF-36-PCS (rho = 0.328, p = 0.01), and SF-36-MCS (rho = 0.293, p = 0.022) scores at six-month follow-up was found. When the normalized preoperative GDS score was high (no depression), the FJS-12, SF-36-PCS, and SF-36-MCS scores tended to increase more compared to the other group. Statistically significant differences between the two groups were found in postoperative FJS-12 (p = 0.001), SF-36-PCS (p = 0.017), and SF-36-MCS scores (p = 0.016). No statistically significant correlation between preoperative PSQI score and postoperative outcome measures was found. Preoperatively depressed patients had a low–moderate positive correlation with postoperative SF-36 and FJS-12 scores. There was no correlation between sleep quality and postoperative outcome measures of THA. [ABSTRACT FROM AUTHOR]

Muhammad Imran Shah,1 Irfan Ullah,2 Xiao Xingjian,2 Huang Haipeng,2 Alam Rehman,3 Muhammad Zeeshan,4 Fakhr E Alam Afridi5 1School of Mathematics and Statistics, Wuhan University, Wuhan, People’s Republic of China; 2Reading Academy, Nanjing University of Information Science and Technology, Nanjing, People’s Republic of China; 3Faculty of Management Sciences, National University of Modern Languages Islamabad, Islamabad, Pakistan; 4College of Business Administration, Liaoning Technical University, XingCheng, Liaoning Province, 125105, People’s Republic of China; 5Islamia College Peshawar, Peshawar, PakistanCorrespondence: Irfan UllahReading Academy, Nanjing University of Information Science and Technology, People’s Republic of ChinaEmail irfnecon@nuist.edu.cnObjective: This study investigates life expectancy and trade openness in China for the period 1960– 2018.Methods: We purposed a theoretical model that is tested for China by applying regime-switching regression.Results: Our findings suggest that trade openness increases life expectancy in China; trade affects life expectancy from two aspects; firstly, trade expansion and industrialization lead to high economic activities and resulted in raise the income of the people in society leading to improve life expectancy. Secondly, industrial expansion increases the CO2 emissions which leads to imposes a negative implication on human health and thus reduces life expectancy.Conclusion: Thus, the net effect of trade liberalization depends on the value of income effect and volume of CO2 emissions. Therefore, the government needs to support the trade policies which causes a low level of CO2 emissions, the government may provide incentives to exports and industrialists to adopted green energy in the production process. Besides, the government may impose some regulations such as carbon tax to mitigate the CO2 emissions in society.Keywords: trade, life expectancy, CO2 emissions, health quality, regime-switching regression, China

This study examines the impact of health quality on tourism. We argue that the health quality of host countries is a significant factor influencing tourist decisions and destination choices. We introduce health quality as a determinant of international tourism receipts, assuming that a proxy for health quality is a set of six health measures. The analysis is conducted by employing the system GMM estimation in two panels of 44 developing and 39 developed economies over the period 2000–2016. Our results suggest that health quality has a significant effect on international tourism receipts. In particular, these are affected positively by life expectancy, and negatively by mortality and the lifetime risk of maternal death rate. The domestic general government health expenditure for developed countries has a weak positive effect on international tourism receipts, while the prevalence of undernourishment in developing countries has a strongly negative effect. Finally, the tuberculosis death rate in developing countries has a negative impact on international tourism receipts. [ABSTRACT FROM AUTHOR]

Health institutions aim to increase their service quality and efficiency by using developing science and technologies. Quality and efficient provision of health services, both human health and important economic dimensions, is an important service affecting the level of public health and welfare. Determination of the national health standard in the world has accelerated in 1950, with the health standards in health transformation program in 2003 has been raised in Turkey. It is aimed to compare the service quality of the public university hospitals in terms of health standards and hospitals with JCI accreditation according to the expected and perceived service quality of the patient-patient relatives, to examine the relationship between the patient-patient relatives demographic characteristics, hospital characteristics, and the service variables and the quality of service. A a result of the research, it was determined that the patient-patient relatives who received service from the state university hospital could not get the service quality they expected, the service score of the hospital with JCI accreditation was higher than the other hospitals, and the service score of the hospital with a JCI accreditation period was lower than those without JCI accreditation. It was determined that the service quality of the hospitals differed statistically according to gender, education level, outpatient clinic, type of service received, hospital bed capacity and number of doctors. [ABSTRACT FROM AUTHOR]

The present study aims to explore the common health problems and the healthseeking behavior among the tribal population in Koraput district of Odisha. In order to assess the common health problems and the treatment-seeking behavior, 300 tribal individuals from 173 households in the age group of 18-64 years and 24 health care staff were recruited for the study. Information regarding health facilities, their affordability, and morbidity status were obtained through prestructured questionnaires. Data analysis was carried out using SPSS-20 and Microsoft Excel software tools. Anemia, diarrheal problems, cold, pneumonia, vaginal problems, skin infection, fever, malnutrition, and sickle cell anemia were the common health problems reported by the respondents. In addition, the study found that the majority of the respondents relied on traditional health care practices. The initiation of proper awareness can help in reducing traditional health care practices among the tribal communities. Furthermore, the involvement of modern health care practitioners would help to reduce the disease burden in tribal communities. [ABSTRACT FROM AUTHOR]

Abstract Background Over the past decade, hospitals in many countries, including Israel, have undergone an accreditation process aimed at improving the quality of services provided. This process also refers to the protection and promotion of patients’ rights. However, reviewing the criteria and content included in this category in the Israeli context reveals definitions and implications that differ from those presented by the law – specifically the Patient’s Rights Act 1995. Moreover, the rights included in it are not necessarily equally represented in other legislation. Methods This study seeks to examine the question of whether and to what extent the scope, contents, and definitions of patients’ rights in the JCI Standards are similar to or different from patients’ rights as they are addressed and protected in national legislation. The article provides a comparison and examination of the different regulatory frameworks of patients’ rights, especially those in the accreditation of healthcare institution and legislation, analyzes the gaps between such frameworks, and suggests possible implications on our understanding of the concept of patients’ rights. Results The patients’ right chapter in the accreditation process introduces and promotes the concepts of patient and family rights, increases the awareness and compliance of such concepts, and may create greater consistency in their introduction and application. Conclusions Discussion of the Israeli case not only demonstrates how regulatory frameworks are instrumental – for broader policy purposes, especially in the area of patients’ rights and the rights of patients’ families – but also calls for a more general examination of the concept of patients’ rights in health policies and its contribution to the quality of health services. Reference to patients’ rights in accreditation of healthcare institutions may promote and enhance this concept and contribute to the delivery of care, thereby complementing a lacuna in the law.

Pemerintah Indonesia terus berupaya melaksanakan program Sekolah Sehat secara nasional. Namun disparitas dalam implementasinya masih tinggi. Sebagian besar sekolah di daerah terpencil belum mampu melaksanakannya. Seperti Sekolah Dasar Negeri 08 Berinang Mayun dan Sekolah Dasar Negeri 02 Sidan yang terletak di tengah-tengah perkebunan kelapa sawit di Landak, Kalimantan Barat. Siswa dan masyarakat sekitar kedua sekolah tersebut adalah masyarakat Dayak yang kualitas kesehatannya masih buruk. Atas dasar itu, kami mengadakan lokakarya Sekolah Sehat di kedua sekolah tersebut. Workshop dilakukan melalui ceramah, focus group discussion, dan simulasi. Pada akhirnya, peserta diharuskan membuat rencana sekolah yang mempromosikan kesehatan sebagai luaran. Sejumlah indikator seperti analisis KWL, tanggapan peserta, dan analisis pre-post test menunjukkan adanya peningkatan pengetahuan dan keterampilan peserta tentang program sekolah bina kesehatan. Namun pencapaian yang paling nyata adalah peserta telah merancang rencana Sekolah Sehat yang akan mereka laksanakan di sekolah masing-masing.

20. yüzyılda hekim ve hastalık merkezli yaklaşımlardan uzaklaşılarak hasta merkezlilik yaklaşımına geçiş başlamıştır. Hasta merkezli yaklaşımının benimsenmesi ile sağlıkta kalitenin artacağı ve bu yaklaşımın sağlığın gelişimine de katkı sağlayacağı kabul edilmektedir. Bu sayede hastalar, tedavi ve bakım süreçlerinde kararlara dâhil edilmekte ve oluşturulan bu ortak karar alma ortamı ile hasta memnuniyetinin de artırılacağı, tedavi ve bakım süreçlerinde ortaya çıkan gereksiz tanı ve testlerin ortadan kaldırılarak maliyetlerin düşürüleceği ve toplumda sağlık okuryazarlığının artarak sağlığın gelişimine katkı sağlanacağı öngörülmektedir. Literatür incelendiğinde klinik uygulamalar ve hastalık türleri gibi spesifik özelliklere göre ve özellikle hasta tedavi ve bakım süreçlerinde çalışan sağlık profesyonelleri üzerinde nicel araştırma yöntemleri kullanılarak hasta merkezli bakım araştırmaları yapılmıştır. Söz konusu araştırmalar da konu ile ilgili öngörüleri destekler niteliktedir. Türkçe alan yazında ise hasta merkezli bakım konusunda sınırlı sayıda çalışma yer almakta olup, bu çalışmalar daha ziyade birinci basamak sağlık hizmetlerinde hekim ve hasta ilişkisi üzerinde odaklanmaktadır. Bu araştırmada hasta merkezlilik ve hasta merkezli bakım kavramlarına, modellerine, hasta merkezli bakımın önündeki engeller ile olumlu ve olumsuz yönlerine yer verilmektedir. Bu çalışma ile hasta merkezlilik ve hasta merkezli bakım yaklaşımları için kavramsal bir çalışma ile alan yazına katkı sunulması amaçlanmaktadır. / In the 20th century, the shift from physician and disease-centered approaches to patient-centered approach began. It is accepted that the quality of health will increase with the adoption of patient-centered approach and this approach will contribute to the development of health. In this way, patients are included in the decisions in the treatment and care processes. It is foreseen that patient satisfaction will be increased with this common decision-making environment, the unnecessary diagnoses and tests in the treatment and care processes will be eliminated, costs will be reduced and health literacy in society will contribute to the development of health. When the literature was examined, patient-centered care researches were conducted by using quantitative research methods according to specific characteristics such as clinical applications and disease types and especially health professionals working in patient treatment and care processes. These studies support the projections on the subject. In the Turkish literature, there are a limited number of studies on patient-centered care and these studies focus on the relationship between physician and patient in primary health care. In this research, patient- centered and patient-centered care concepts, models, barriers to patient-centered care and their positive and negative aspects are included. This study aims to contribute to the field literature with a conceptual study for patient-centered and patient-centered care approaches.

Users of benzodiazepines (BZDs) should have their quality of life monitored to minimize the risks associated with long-term treatments. The aim of this study is to use the EuroQol 5D-3L to analyze the quality of life of 127 patients under treatment with BZDs during the COVID-19 pandemic. The results show that lorazepam comprises 25.49% of all dispensing requests, and that the mean duration of BZDs treatments is four years (range: 0.3–25). When rating their general health status, BZDs users reported 59.29 points out of 100. Thirty-two percent of patients reported mobility problems; 16.5% reported having a lot of pain or discomfort despite being treated with BZDs, and 16.54% used a BZD together with an opioid analgesic. The EuroQol 5D-3L dimension “anxiety/depression” showed that, despite the use of BZDs, 48.2% of the patients reported being moderately anxious or depressed and 13.4% described themselves as very anxious or depressed. Nevertheless, 37.8% of BZDs users were identified as potential candidates to follow a BZD deprescription plan. In conclusion, BZDs users showed a low quality of life during the COVID-19 pandemic. Older patients and females have been identified as groups of patients that could benefit from integrating the use of the EuroQol 5D-3L instrument into the protocols of the pharmaceutical care follow up.

Objectives: This study aimed to comprehensively evaluate Mexico's health system performance from 1990 to 2019 utilising the Health Access and Quality Index (HAQI) as a primary indicator., Study Design: A retrospective ecological analysis was performed using data from the Global Burden of Diseases, Injuries and Risk Factors Study (GBD) study and the National Population Council (CONAPO)., Methods: HAQI values for 1990, 2000, 2010, 2015, and 2019 were examined for each state in Mexico and three age groups (young, working, and post-working). Additionally, the marginalisation index was employed to assess inequalities in the HAQI distribution across states. The concentration index of the HAQI for each year was estimated, and the efficiency of states in producing the HAQI was evaluated using a data envelopment approach., Results: Through the analysis of national and subnational data, results indicated an overall improvement in healthcare access and quality during the study period. Although differences in the HAQI value related to state marginalisation decreased from 1990 to 2015, by 2019, the inequality had returned to a level comparable to 2000. Efficiency in producing health (HAQI values) exhibited substantial heterogeneity and fluctuations in the ranking order over time. States such as Nuevo León consistently performed well, while others, such as Guerrero, Chihuahua, Mexico City, and Puebla, consistently underperformed., Conclusions: The findings from this study emphasise the necessity for nuanced strategies to address healthcare disparities and enhance the overall system performance. The study provides valuable insights for ongoing discussions about the future of Mexico's healthcare system, aiming to inform evidence-based policy decisions and improve the nationwide delivery of healthcare services., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Objective: The Joint Commission International (JCI) and the Health Information Management System Society (HIMSS) are global accreditation groups for healthcare. JCI focuses on overall care quality, while HIMSS-Electronic Medical Record Adoption Model (EMRAM) looks at digital processes. Meanwhile, the Health Quality Standards (SKS) is Turkey's own system. It aligns with JCI and evaluates healthcare similarly. When a health institution wants to be accredited with one of these models, similar scope, process and criteria are repeatedly reviewed from different perspectives. However, it is not known whether the scope, process and criteria included in these models are related to the postmodern management approach (PMMA), which is one of today's business approaches. It is observed that today's businesses are dominated by PMMAs. Similarly, healthcare organizations are also influenced by PMMAs since they are qualified as businesses., Yöntemler: This study investigated the compatibility of the concepts, processes and criteria covered by SKS, JCI and HIMSS-EMRAM models with PMMAs. Using the Delphi technique, PMMAs were explained to subject-matter experts (SMEs) in the form of written texts delivered. SMEs evaluated whether the standards/criteria are compatible with PMMAs. During this evaluation, they examined whether the standard/criteria included in the relevant model are directly or indirectly indicative of these approaches. SMEs developed their standards/criteria for the approaches which no standards/criteria could be matched with. The binary pairwise comparison method was used to determine the weighted value of the proposed standards/criteria., Sonuçlar: SMEs proposed a total of 24 standards and 18 indicators for nine postmodern organizational management approaches., Conclusion: The literature presented a proposal for new standards and indicators. They would be unique. They would address how well these three models fit the PMMA., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

Of the natural pastures grown in southern Brazil, those of the genus Paspalum are the most important. One of the factors that hinder their cultivation is the availability of quality seeds, that are often compromised by the presence of fungi. This study determined the in vitro sensitivity of Paspalum guenoarum ecotype azulão seed-associated fungus to certain fungicides and to measure the efficiency of chemical treatments for fungal control and seed physiological performance. Bipolaris micropus, Epicoccum sorghinum, Curvularia geniculata and Fusarium incarnatum associated with seeds were tested in vitro against Carbendazim; Tiram, Fludioxonil; Metalaxil-M, Carboxina; Tiram and Tiofanato-metílico at 0, 1, 2.5, 5, 10 and 30 µg/mL. This experiment was conducted in a completely randomized design (factorial 4 × 4 × 6). Qualitative variables were compared using the Tukey test (P = 0.05) and quantitative variables were subjected to regression analysis. Carbendazim; Tiram and Fludioxonil; Metalaxil-M had the best fungicidal performances, each inhibiting three of the four fungi with LD50s below 1 µg/mL. Subsequently, these two fungicides were used alone or in combination in the in vivo test. A completely randomized design was used and the means were compared using the Tukey test (P < 0.05). The chemical treatment of the seeds resulted in improvement of five of the six evaluated physiological parameters. The identification of the primary fungi associated with Paspalum seeds reported in this research, as well as damage done to them, can be diminished using appropriate measures such as seed treatments. [ABSTRACT FROM AUTHOR]

Background: The objective is to study the effect of Medicaid expansion on postoperative radiation therapy (PORT) delay in patients with head and neck squamous cell carcinoma (HNSCC). Methods: Patients from the National Cancer Database with HNSCC undergoing curative‐intent surgery in the 2 years before and after Medicaid expansion were analyzed (n = 11 717) using the difference‐in‐differences technique to study the effect on PORT delay. Results: The rate of PORT delay before and after expansion was 66.0% and 66.9%, respectively. Medicaid patients had more frequent PORT delay than privately insured patients (pre‐expansion 77.2% vs. 59.4%, p < 0.001; post‐expansion 76.5% vs. 60.9%, p < 0.001). Medicaid expansion had no effect on PORT delay [hazard ratio 0.95, 95% confidence interval 0.81–1.12]. Supplemental analyses revealed that pathologic stage, number of treating facilities, and comorbidities were among several factors associated with PORT delay in the cohort. Conclusion: PORT delay is unacceptably frequent. Improvement in timely adjuvant therapy requires more than Medicaid expansion. [ABSTRACT FROM AUTHOR]

Introduction: Asthma is a very common disease worldwide. Chronic hyperresponsiveness with inflammation of the airway involving mast cells, eosinophils, and T-lymphocytes. General health questionnaires such as the Short Form Health Survey (SF-36) are used to provide an idea about the scale of restriction on the patient's life. The SF-36 questionnaire is rarely used to assess asthma patients' lives. In this study, we aimed to analyze the quality of life of asthma patients using the SF-36 questionnaire and the correlation between asthma severity and the SF-36 scale. Method: Our study included a control group and a patient group. The subjects were above 18 years of age and they applied to Bezmialem Vakıf University Hospital Respiratory Diseases Polyclinic. Diagnosis was made according to the Global Initiative for Asthma criteria. Power analysis was performed by the Bezmialem Vakıf University, Faculty of Medicine, Statistics Department. At a 95% confidence level, 80% power, and importance attributed to the mean difference of 14 units between the groups, the study requires a minimum of 34 patients in each group. The patients presented with daily asthmatic symptoms and had no other respiratory diseases. The SF-36 is a self-assessment scale consisting of 8 sub-headings that assess the patients' general physical and mental health. Results: Thirty five patients and 34 healthy people participated in the survey. There was a significant difference in terms of physical difficulties, physical condition, mental and general health perception, and social functioning (p<0.001) where asthma patients were in a worse state compared with healthy people. In contrast, there was no significant difference between patients and healthy people in terms of pain perception (p=0.899), emotional difficulty (p=0.172) and energy (p=0.723). Conclusion: Asthma negatively affects the patient's quality of life. An apparent relationship between asthma and the SF-36 questionnaire was observed. [ABSTRACT FROM AUTHOR]

Objective: In hospitals, physicians-in-training are major contributors to the burden of tests ordered, increasing cost and resource utilization. We implemented an intervention to discourage overutilization of the complete blood count (CBC) and the basic metabolic panel (BMP). Methods: An intervention was designed, comprising education on high-value care and burden of over-testing, encouragement of competition, and use of positive reinforcement. The intervention was monitored by a test index determined by dividing the total number of a specific laboratory test ordered for a patient by the total number of hospital days. Results: Following a 6-month intervention, the mean CBC index decreased from 1.56 ± 0.02 to 1.45 ± 0.03 (p

ABSTRACT: Of the natural pastures grown in southern Brazil, those of the genus Paspalum are the most important. One of the factors that hinder their cultivation is the availability of quality seeds, that are often compromised by the presence of fungi. This study determined the in vitro sensitivity of Paspalum guenoarum ecotype azulão seed-associated fungus to certain fungicides and to measure the efficiency of chemical treatments for fungal control and seed physiological performance. Bipolaris micropus, Epicoccum sorghinum, Curvularia geniculata and Fusarium incarnatum associated with seeds were tested in vitro against Carbendazim; Tiram, Fludioxonil; Metalaxil-M, Carboxina; Tiram and Tiofanato-metílico at 0, 1, 2.5, 5, 10 and 30 µg/mL. This experiment was conducted in a completely randomized design (factorial 4 × 4 × 6). Qualitative variables were compared using the Tukey test (P ≤ 0.05) and quantitative variables were subjected to regression analysis. Carbendazim; Tiram and Fludioxonil; Metalaxil-M had the best fungicidal performances, each inhibiting three of the four fungi with LD50s below 1 µg/mL. Subsequently, these two fungicides were used alone or in combination in the in vivo test. A completely randomized design was used and the means were compared using the Tukey test (P < 0.05). The chemical treatment of the seeds resulted in improvement of five of the six evaluated physiological parameters. The identification of the primary fungi associated with Paspalum seeds reported in this research, as well as damage done to them, can be diminished using appropriate measures such as seed treatments.

BackgroundExperimental data highlight the potential benefits and health system cost savings related to surgical prehabilitation; however, adequately powered randomized controlled trial (RCT) data remain nascent. Emerging prehabilitation services may be informed by early RCT data but can be limited in informing real-world program development. Pragmatic trials emphasize external validity and generalizability to understand and advise intervention development and implementation in clinical settings. This paper presents the methodology of a pragmatic prehabilitation trial to complement emerging phase III clinical trials and inform implementation strategies.MethodsThis is a pilot pragmatic clinical trial conducted in a large academic hospital in Toronto, Ontario, Canada to assess feasibility of clinical implementation and derive estimates of effectiveness. Feasibility data include program referral rates, enrolment and attrition, intervention adherence and safety, participant satisfaction, and barriers and facilitators to programming. The study aims to receive 150 eligible referrals for adult, English-speaking, preoperative oncology patients with an identified indication for prehabilitation (e.g., frailty, deconditioning, malnutrition, psychological distress). Study participants undergo a baseline assessment and shared-decision making regarding the intervention setting: either facility-based prehabilitation or home-based prehabilitation. In both scenarios, participants receive an individualized exercise prescription, stress-reduction psychological support, nutrition counseling, and protein supplementation, and if appropriate, smoking cessation program referrals. Secondary objectives include estimating intervention effects at the week prior to surgery and 30 and 90 days postoperatively. Outcomes include surgical complications, postoperative length of stay, mortality, hospital readmissions, physical fitness, psychological well-being, and quality of life. Data from participants who decline the intervention but consent for research-related access to health records will serve as comparators. The COVID-19 pandemic required the introduction of a ‘virtual program’ using only telephone or internet-based communication for screening, assessments, or intervention was introduced.ConclusionThis pragmatic trial will provide evidence on the feasibility and viability of prehabilitation services delivered under usual clinical conditions. Study amendments due to the COVID-19 pandemic are presented as strategies to maintain prehabilitation research and services to potentially mitigate the consequences of extended surgery wait times.

Copyright of Interscientific Health Care is the property of University of Thessaly, Medical School / Technological Education Institute, Nursing Department and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

purposed a theoretical model that is tested for China by applying regime-switching regression. Results: Our findings suggest that trade openness increases life expectancy in China; trade affects life expectancy from two aspects; firstly, trade expansion and industrialization lead to high economic activities and resulted in raise the income of the people in society leading to improve life expectancy. Secondly, industrial expansion increases the CO2 emissions which leads to imposes a negative implication on human health and thus reduces life expectancy. Conclusion: Thus, the net effect of trade liberalization depends on the value of income effect and volume of CO2 emissions. Therefore, the government needs to support the trade policies which causes a low level of CO2 emissions, the government may provide incentives to exports and industrialists to adopted green energy in the production process. Besides, the government may impose some regulations such as carbon tax to mitigate the CO2 emissions in society. [ABSTRACT FROM AUTHOR]

Copyright of Agronomy Science is the property of University of Life Sciences in Lublin and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Experimental data highlight the potential benefits and health system cost savings related to surgical prehabilitation; however, adequately powered randomized controlled trial (RCT) data remain nascent. Emerging prehabilitation services may be informed by early RCT data but can be limited in informing real-world program development. Pragmatic trials emphasize external validity and generalizability to understand and advise intervention development and implementation in clinical settings. This paper presents the methodology of a pragmatic prehabilitation trial to complement emerging phase III clinical trials and inform implementation strategies. Methods: This is a pilot pragmatic clinical trial conducted in a large academic hospital in Toronto, Ontario, Canada to assess feasibility of clinical implementation and derive estimates of effectiveness. Feasibility data include program referral rates, enrolment and attrition, intervention adherence and safety, participant satisfaction, and barriers and facilitators to programming. The study aims to receive 150 eligible referrals for adult, English-speaking, preoperative oncology patients with an identified indication for prehabilitation (e.g., frailty, deconditioning, malnutrition, psychological distress). Study participants undergo a baseline assessment and shared-decision making regarding the intervention setting: either facility-based prehabilitation or home-based prehabilitation. In both scenarios, participants receive an individualized exercise prescription, stress-reduction psychological support, nutrition counseling, and protein supplementation, and if appropriate, smoking cessation program referrals. Secondary objectives include estimating intervention effects at the week prior to surgery and 30 and 90 days postoperatively. Outcomes include surgical complications, postoperative length of stay, mortality, hospital readmissions, physical fitness, psychological well-being, and quality of life. Data from participants who decline the intervention but consent for research-related access to health records will serve as comparators. The COVID-19 pandemic required the introduction of a 'virtual program' using only telephone or internet-based communication for screening, assessments, or intervention was introduced. Conclusion: This pragmatic trial will provide evidence on the feasibility and viability of prehabilitation services delivered under usual clinical conditions. Study amendments due to the COVID-19 pandemic are presented as strategies to maintain prehabilitation research and services to potentially mitigate the consequences of extended surgery wait times. [ABSTRACT FROM AUTHOR]

Background: Arab countries account for almost 6% of the global population, yet they make up only 5% of the total cases and less than 3% of the global death toll attributed to COVID-19. COVID-19 has put the health systems in the various Arab Countries and their ability to deliver healthcare services under tremendous strain. The capacity and stability of any health system is important in any type of response to the pandemic, in order to ensure an effective and efficient delivery of care to the public through COVID-19 and beyond. The objective of this study is to identify the various response of health systems in Arab Countries to COVID-19, and highlight the legal and health challenges faced during the pandemic. The study identified both gaps and good practices that may be utilized in order to guide the efforts in response to COVID-19 and the recovery efforts once the pandemic is over. Methods: To determine why the response of some health systems in Arab Countries responses are more effective than others, a three-step framework is adopted which includes, detection, containment, and treatment stages. In order to identify which countries are excelling at detection, containment, and treatment stages, several indicators were selected for each stage. To be able to understand the legal and health challenges of response to the COVID-19 pandemic, an analysis of the health systems, the resources in terms of quality and access, health workforce, and finance was conducted. Secondary data published by the Global Burden of Disease Study, and the Global Change Data Lab of the University of Oxford was used to study identified gaps and good practices to guide the responses to COVID-19 and recovery efforts once the pandemic is over. Results: The epidemiologic record demonstrates that that certain Arab countries are managing to control the pandemic, through a combination of mitigation strategies, suppression strategy and elimination strategy. There are several barriers and challenges in Arab health systems which have been amplified due to COVID-19 and if ignored may pose a further significant challenge in the future. Health systems in Arab countries are not sufficiently equipped to handle all healthcare needs related to COVID-19, in particular issues relating to administration, equity, finances, the supply side of healthcare, and usage of information technology. Conclusion: In Arab counties, the standard response to COVID-19 was enforced by new health laws, which consist of a combination of the traditional disease control measures (testing, contact-tracing, social distancing), population-based physical distancing (including stay-at-home orders, school and business closures, and social gathering bans), travel limits (including travel bans, and border closures), and economic support measures. Acceptable healthcare quality and access, sufficient health workforce, and sufficient funds are the most imperative needs in the health system in Arab counties to provide a sustainable response to the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

The field of health services research is broad and seeks to answer questions about the health care system. It is inherently interdisciplinary, and epidemiologists have made crucial contributions. Parametric regression techniques remain standard practice in health services research with machine learning techniques currently having low penetrance in comparison. However, studies in several prominent areas, including health care spending, outcomes and quality, have begun deploying machine learning tools for these applications. Nevertheless, major advances in epidemiological methods are also as yet underleveraged in health services research. This article summarizes the current state of machine learning in key areas of health services research, and discusses important future directions at the intersection of machine learning and epidemiological methods for health services research. [ABSTRACT FROM AUTHOR]

Copyright of Revista Nutrición Clínica y Dietética Hospitalaria is the property of Sociedad Espanola de Dietetica y Ciencias de la Alimentacion and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The importance of health quality is the desire for everyone and generally healthcare can be done by health professionals such as nurses or paramedics. The implications of good health realization can be seen from the ability of nurses in educating the society regarding the dangers of viruses transmission from COVID-19 which is a global pandemic that occurs in almost all parts of Indonesia Objective: The purpose of this study is to describe the role of nurses as an educator in overcoming the occurrence of Coronavirus transmission. Method: Qualitative approach is used to explore and describe the problems of the disease-related the phenomenon that occurs in the society by educating related the transmission and how to overcome the Coronaviruses for people living in the urban areas Result: COVID-19 is a new type of virus and has a fast transmission to the community. And the lack of personal protection equipment is certainly a problem of nurses or paramedics to educate the society regarding the danger's effects of virus transmission to communities that living in urban areas. Conclusion: The important role of nurses as health educators for the public is certainly beneficial in helping people avoid the spread of COVID 19 viruses in urban areas. However, the lack of personal protective equipment, of course, will impact anxiety for nurses when conducting socialization on how to effectively avoid transmission of the viruses. [ABSTRACT FROM AUTHOR]

Objective: to report the implementation of Safety Huddle in intensive care units during the COVID-19 pandemic through an electronic tool, developed by a group of intensive care nurses and information technology professionals working in health. Method: this is an experience report on the implementation of the Safety Huddle tool, using the agile Scrum method. Results: the first step was to identify the indicators that should be included for the Safety Huddle in the Intensive Care Units and necessary for monitoring and discussion during safety meetings. The second stage was the implementation of the proposed model, with the presentation of the operational flow of the Safety Huddle tool with daily dispatch of the alert entitled "COVID Alert-19". Conclusion: contributed to the management and agility in the identification of patients affected by COVID-19, prioritizing care according to the patient's clinical condition allowing the availability of beds, optimization of resources and ensuring assistance services in the institution. [ABSTRACT FROM AUTHOR]