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BACKGROUND: Health care provider stress and emotional distress were well documented long before the COVID-19 pandemic, and there is growing data suggesting these have increased in response to the pandemic. The goal of this study was to take advantage of the unique experiences of licensed mental health (MH) clinicians working with health care trainees and clinicians before and during the pandemic to identify how this crisis affected both ongoing as well as new sources of stress. The Healer Education, Assessment and Referral Program (HEAR) provides MH screening, support, and MH referrals to ~19 000 health care students, trainees, staff, and faculty. Since its inception in 2009, the program has been staffed by 4 licensed counseling professionals who have worked both before and since the COVID-19 pandemic. METHODS: Qualitative data obtained from semi-structured, 1-hour interviews and a follow-up 1-hour focus group with 4 HEAR counselors was analyzed using reflexive thematic analysis. RESULTS: Several preexisting stressors were amplified during the pandemic: financial concerns; long work hours; exposure to the suffering of illness, death, and dying; bullying; discordant values and moral distress; social inequities; individuals lack of adaptive coping; and individuals self-concept as a victim. New stressors included: health care demand greater than the workforce numbers and resources; caretaking for ill family/friends; homeschooling of children; social isolation; experiencing the COVID-19 crisis as a war, fire, or storm; fear of personal illness and death, especially before vaccines; and hopes of a cure with vaccines; followed by perceived opportunities for improvement in leadership response to staff concerns. CONCLUSION: Authentically responding to staff concerns/ideas, a patient and provider-centered health care culture, grief education and support, and attention to actionable stressors affecting providers well-being are indicated to meet the amplified and new stressors triggered by the COVID-19 pandemic and sequelae.

Objectives: Digital health behaviour change interventions may be adapted from in‐person interventions, without appropriate consideration of how the digital context might differ. Drawing on the wider literature on behaviour change intervention development, this research aims to explore the digital adaptation process of health behaviour change interventions and the specific considerations for digital modes of delivery. Design: A qualitative interview study. Methods: Interviews with 15 intervention developers/facilitators were analysed using inductive thematic analysis. Results: Findings highlight a continuum of digitalization, where variation in technology available and human support influences considerations for digital adaptation. 'What vs how: "trying to do the impossible"' describes the balance between retaining the intervention's active ingredients while modifying for digital delivery. Through 'Trial and error', participants described an iterative process based on experience of delivery. 'Creating connection and engagement' emphasizes the importance of social support and the challenges of replicating this. Conclusions: Several considerations for digital adaptations are proposed including the involvement of end‐users (facilitators and recipients) during adaptation, the need to understand the original intervention and new context for use, and the different motivational needs of digital intervention recipients. [ABSTRACT FROM AUTHOR]

Background: Employees' decision to speak up or to stay silent can have implications for health care providers, employees and people who need care. As a result, a shift is needed from blindly following guidelines to implementing a sustainable proactive organizational culture in which employees, especially nurses, can evaluate their work environment and take advantage of growth opportunities. The aim of this review is to analyse the characteristics of employee voice opportunities in the health care context, particularly for nurses. Methods: The search was conducted in April 2023 in the following databases: MEDLINE via PubMed, CINHAL via EBSCO, Scopus via Elsevier, Wiley/Web of Science and Cochrane Library. The search results were imported into the COVIDENCE program and screened by two researchers separately. We used the following search components: health care organization, opportunities, and employee voice. The review followed the PRISMA-ScR guidelines. We identified 951 studies in five databases and via citation tracking. After we removed 102 duplicates and screening 839 titles and abstracts, 23 full texts were assessed. According to our inclusion and exclusion criteria, we included 9 studies. Results: Three main characteristics of employee voice opportunities that need to be considered to enable nurses to have a voice in the organization were identified. These main categories are individual factors, organizational culture, and available voice channels. It is not possible to rank them in order of importance; they are interrelated. Conclusions: To conclude, employee voice is a process. In order for utilize employee voice opportunities, individual employee factors, organizational culture and its embedded context must be considered. Individual internal and external motivation, which is influenced by socio-cultural aspects and work hierarchies, must also be considered for successful use of opportunities. [ABSTRACT FROM AUTHOR]

Abstract Background Employees’ decision to speak up or to stay silent can have implications for health care providers, employees and people who need care. As a result, a shift is needed from blindly following guidelines to implementing a sustainable proactive organizational culture in which employees, especially nurses, can evaluate their work environment and take advantage of growth opportunities. The aim of this review is to analyse the characteristics of employee voice opportunities in the health care context, particularly for nurses. Methods The search was conducted in April 2023 in the following databases: MEDLINE via PubMed, CINHAL via EBSCO, Scopus via Elsevier, Wiley/Web of Science and Cochrane Library. The search results were imported into the COVIDENCE program and screened by two researchers separately. We used the following search components: health care organization, opportunities, and employee voice. The review followed the PRISMA-ScR guidelines. We identified 951 studies in five databases and via citation tracking. After we removed 102 duplicates and screening 839 titles and abstracts, 23 full texts were assessed. According to our inclusion and exclusion criteria, we included 9 studies. Results Three main characteristics of employee voice opportunities that need to be considered to enable nurses to have a voice in the organization were identified. These main categories are individual factors, organizational culture, and available voice channels. It is not possible to rank them in order of importance; they are interrelated. Conclusions To conclude, employee voice is a process. In order for utilize employee voice opportunities, individual employee factors, organizational culture and its embedded context must be considered. Individual internal and external motivation, which is influenced by socio-cultural aspects and work hierarchies, must also be considered for successful use of opportunities.

Background: Severe neonatal jaundice remains common in Nigeria. Phototherapy is the most commonly used inhospital treatment for neonatal hyperbilirubinaemia. Objectives: To describe the availability and distribution of phototherapy services as an essential neonatal service in hospitals in Jos, North-Central Nigeria. Methods: This was a crosssectional study of all secondary and tertiary level health facilities in Jos-North, Jos-South and Jos- East Local government Areas (LGAs) between January and March 2015. Results: There were 30 (90.9%) secondary and three (9.1%) tertiary health facilities. Twenty – eight (84.8%) were privately owned. Fourteen (42.4%) of the 33 hospitals provided phototherapy services, of which 11 (78.6%) were private. Phototherapy services were available in all the tertiary facilities and in only 11 (36.7%) of the secondary level health facilities. Most (10; 71.4%) of the hospitals with phototherapy were located in Jos-North LGA. There were 38 phototherapy units in all the 14 hospitals that offered phototherapy, consisting of 8 (21.1%) light emitting diodes (LED) and 30(78.9%) conventional units of which 25(83.3%) were locally fabricated. In all the hospitals that provided phototherapy, jaundiced neonates were managed by physicians of whom only 12% were fulltime paediatricians. All hospitals that offered phototherapy had laboratory facilities to assay bilirubin. Conclusions: Phototherapy services in Jos, Nigeria are inadequate and are concentrated in the urban private sector. An increase in phototherapy services especially in secondary public facilities is needed.

Abstract Background A negative attitude towards abortion among health care providers providing abortion services could be an obstacle even under a law, which permits abortion on request. Healthcare providers are expected to perform and be change agents of abortion services. However, little information is known about the attitude toward safe abortion among healthcare providers in Ethiopia. Objective This study aimed to assess health care provider’s attitudes towards safe abortion care and its associated factors at the public health facilities of Bahir Dar City, Northwest Ethiopia. Methods A health facility-based cross-sectional study was employed from March 1 to 30/2021 among 416 health-care providers. The data were collected by computer-based generated simple random sampling technique, entered, coded, and cleaned using Epi data version 4.2 and analyzed using Statistical Package of Social Sciences version 25.0. Bivariate and multivariable logistic regression analyses were employed to estimate the crude and adjusted odds ratio with a confidence interval of 95% and a P-value of less than 0.05 considered statistically significant. Results The response rate of the study was 99.3%, and 70.2% [95% CI: 65.6–74.6] of health-care providers had a favorable attitude towards safe abortion care. Multivariable analysis indicated that health care providers who are found in the age group of 25–29, 30–34, and ≥ 35 years [AOR = 3.34, 95% CI = 1.03–10.85], [AOR = 4.58, 95% CI = 1.33- 15.83] and [AOR = 5.30, 95% CI = 1.43–19.66] respectively, male health care providers [AOR = 3.20, 95% CI = 1.55–6.60], midwives [AOR = 6.50, 95% CI = 2.40–17.44], working at hospital [AOR = 4.77, 95% CI = 1.53–14.91], ever trained on safe abortion [AOR = 5.09, 95% CI = 2.29–11.32], practicing of an abortion procedure [AOR = 2.52, 95%, CI = 1.13–5.60], knowledge of abortion [AOR = 7.35, 95% CI = 3.23–16.71], awareness on revised abortion law [AOR = 6.44, 95% CI = 3.15–13.17] and need further legalization of abortion law [AOR = 11.78, 95% CI = 5.52–24.26] were associated with a favorable attitude towards safe abortion care. Conclusions Healthcare providers who had a favorable attitude toward safe abortion care were relatively high compared to the previous studies. Age, sex, profession, workplace, training, knowledge, and practice-related factors were associated with a favorable attitude toward safe abortion. This study indicated that, a need for intervention to help improve the attitude of healthcare providers toward safe abortion care, especially for those working in the maternity care units.

Introduction: In South Africa, approximately half a million individuals live with epilepsy. This means that half a million families and caregivers are impacted by epilepsy, with a limited number of healthcare providers responsible for treating people living with the condition, as well as their families and caregivers. Methods: This study explored the knowledge-based care and support healthcare providers give families and caregivers. Fifteen participants were purposefully selected from Limpopo and Mpumalanga provinces to participate in the study. Data were collected via an open-ended interview guide divided into two sections: Section A comprised sociodemographic questions, and Section B had questions on epilepsy care and support. Four of the participants were male, and 11 were female, seven were community health workers, five were nurse practitioners, and three were auxiliary nurses. Seven had a grade 12 qualification or lower, and only six had a degree. The data collected was analyzed using thematic analysis, coded by the researcher and co-coded by an independent expert. Two themes emerged from the raw data: epilepsy knowledge and epilepsy support and counselling. From these two themes, three subthemes were identified: psychosocial impact of epilepsy, epilepsy-related training, and counselling and support. Results: The study revealed a gap in professional capacity building and highlighted the need for intentional knowledge sharing and equipping of healthcare providers. Discussion: The findings suggest that equipping community health workers, in particular, may be a better and more efficient way to increase the quality of life for families and caregivers and people living with epilepsy in South Africa. [ABSTRACT FROM AUTHOR]

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Background: A negative attitude towards abortion among health care providers providing abortion services could be an obstacle even under a law, which permits abortion on request. Healthcare providers are expected to perform and be change agents of abortion services. However, little information is known about the attitude toward safe abortion among healthcare providers in Ethiopia. Objective: This study aimed to assess health care provider's attitudes towards safe abortion care and its associated factors at the public health facilities of Bahir Dar City, Northwest Ethiopia. Methods: A health facility-based cross-sectional study was employed from March 1 to 30/2021 among 416 health-care providers. The data were collected by computer-based generated simple random sampling technique, entered, coded, and cleaned using Epi data version 4.2 and analyzed using Statistical Package of Social Sciences version 25.0. Bivariate and multivariable logistic regression analyses were employed to estimate the crude and adjusted odds ratio with a confidence interval of 95% and a P-value of less than 0.05 considered statistically significant. Results: The response rate of the study was 99.3%, and 70.2% [95% CI: 65.6–74.6] of health-care providers had a favorable attitude towards safe abortion care. Multivariable analysis indicated that health care providers who are found in the age group of 25–29, 30–34, and ≥ 35 years [AOR = 3.34, 95% CI = 1.03–10.85], [AOR = 4.58, 95% CI = 1.33- 15.83] and [AOR = 5.30, 95% CI = 1.43–19.66] respectively, male health care providers [AOR = 3.20, 95% CI = 1.55–6.60], midwives [AOR = 6.50, 95% CI = 2.40–17.44], working at hospital [AOR = 4.77, 95% CI = 1.53–14.91], ever trained on safe abortion [AOR = 5.09, 95% CI = 2.29–11.32], practicing of an abortion procedure [AOR = 2.52, 95%, CI = 1.13–5.60], knowledge of abortion [AOR = 7.35, 95% CI = 3.23–16.71], awareness on revised abortion law [AOR = 6.44, 95% CI = 3.15–13.17] and need further legalization of abortion law [AOR = 11.78, 95% CI = 5.52–24.26] were associated with a favorable attitude towards safe abortion care. Conclusions: Healthcare providers who had a favorable attitude toward safe abortion care were relatively high compared to the previous studies. Age, sex, profession, workplace, training, knowledge, and practice-related factors were associated with a favorable attitude toward safe abortion. This study indicated that, a need for intervention to help improve the attitude of healthcare providers toward safe abortion care, especially for those working in the maternity care units. [ABSTRACT FROM AUTHOR]

Introduction: Fewer than a quarter of people considered to have factors associated with HIV acquisition are prescribed pre-exposure prophylaxis (PrEP) in the United States. Prior studies demonstrate disparities in provider comfort and knowledge regarding PrEP, suggesting a need for provider capacity building to support widespread PrEP availability. This study examined real-world PrEP clinical questions/cases from providers to a teleconsultation service to identify knowledge gaps and improve PrEP-related training materials and clinical guidelines. Methods: The National Clinician Consultation Center (NCCC) PrEPline provides educational teleconsultation services on clinical decision-making related to PrEP for U.S. health care providers. The NCCC PrEP consultation data collected between 2017 and 2020 were reviewed and systematically categorized by clinical topics, subtopics, and complexity levels (low, moderate, and high). Results: Within the study period, the PrEPline provided 1,754 teleconsultations. More than three quarters came from advanced practice nurses and physicians. The topics of questions commonly focused on medication-based HIV prevention strategies (22.7%), PrEP laboratory ordering/monitoring (17.4%), and side effects and contraindications (14.6%). The majority of teleconsultations (57.9%) involved sharing information that was directly available/addressed in the Centers for Disease Control and Prevention (CDC) 2017 PrEP Guidelines (i.e., low complexity). Discussion: The low frequency of consultations from nonphysician and non-nurse practitioner providers may suggest a need for increased training and collaborative opportunities for other types of providers. The high percentage of low-complexity inquiries may reveal a desire for capacity-building materials specifically designed for practicing providers (e.g., abridged versions of guidelines). This study may inform future research, best clinical practices, and aid in the development of training materials to increase providers' HIV prevention comfort and knowledge.

Abstract Background Having a sufficient and well-functioning health workforce is crucial for reducing the burden of disease and premature death. Health workforce development, focusing on availability, recruitment, retention, and education, is inseparable from acceptability, motivation, burnout, role and responsibility, and performance. Each aspect of workforce development may face several challenges, requiring specific strategies. However, there was little evidence on barriers and strategies towards comprehensive health workforce development. Therefore, this review explored barriers and strategies for health workforce development at the primary health care level around the world. Methods A scoping review of reviews was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analysis Extension for Scoping Reviews. The article search was performed in Google Scholar, PubMed, Web of Science, and EMBASE. We used EndNote x9 for managing the collected articles, screening processes, and citation purpose. The scoping review included any kind of review articles on the application of health workforce development concepts, such as availability, recruitment, retention, role and responsibility, education and training, motivation, and burnout, with primary health care and published in English anywhere in the world. Based on the concepts above, barriers and strategies for health workforce development were identified. The findings were synthesized qualitatively based on the building blocks of the health system framework. The analysis involved specific activities such as familiarization, construction of the thematic framework, indexing, charting, and interpretation. The results were presented in texts, tables, and figures. Results The search strategies yielded 7,276 papers were found. Of which, 69 were included in the scoping review. The most frequently cited barriers were financial challenges and issues related to health care delivery, such as workloads. Barriers affecting healthcare providers directly, including lack of training and ineffective teamwork, were also prominent. Other health system and governance barriers include lack of support, unclear responsibility, and inequity. Another notable barrier was the shortage of health care technology, which pertains to both health care supplies and information technology. The most common cited effective strategies were ongoing support and supervision, engaging with communities, establishing appropriate primary care settings, financial incentives, fostering teamwork, and promoting autonomous health care practice. Conclusions Effective leadership/governance, a robust health financing system, integration of health information and technology, such as mobile health and ensuring a consistent supply of adequate resources are also vital components of primary health care workforce development. The findings highlight the importance of continuous professional development, which includes training new cadres, implementing effective recruitment and retention mechanisms, optimising the skill mix, and promoting workplace wellness. These elements are essential in fostering a well-trained and resilient primary health care workforce.

Background:Provider discussions about colorectal cancer (CRC) screening are the single most important predictor for CRC screening uptake. Methods:Using cross-sectional data from the 2022 Health Information National Trends Survey, we evaluated the relationship between telehealth use and provider discussion about CRC screening with a multivariable logistic regression model. Results:Of adults aged 45–75 years, 20.3% used telehealth services in the past year of which 69.5% had discussed CRC screening with their providers. There was no difference in provider discussion about CRC screening between telehealth users and nonusers (OR 1.26; 95% confidence interval 0.83–1.90). Conclusion:Telehealth is an important adjunct in health care delivery, enhancing patient–provider discussions about CRC screening. [ABSTRACT FROM AUTHOR]

Interest in health care provider (HCP) wellness and burnout is increasing; however, minimal literature explores HCP wellness in the context of Amyotrophic Lateral Sclerosis (ALS) care. We sought to determine rates of burnout and resiliency, as well as challenges and rewards in the provision of ALS care. A survey link was sent to physicians at all Canadian ALS centers for distribution to ALS HCPs in their network. The survey included demographics questions, and validated measures for resiliency and burnout; the Brief Resilient Coping Scale (BRCS) and the Single Item Burnout Score (SIBS). Participants were asked to describe challenges and rewards of ALS care, impact of COVID-19 pandemic, and how their workplace could better support them. There were 85 respondents across multiple disciplines. The rate of burnout was 47%. Burnout for female respondents was significantly higher (p = 0.007), but not for age, role, or years in ALS clinic. Most participants were medium resilient copers n = 48 (56.5%), but resiliency was not related to burnout. Challenges included feeling helpless while patients relentlessly progressed to death, and emotionally charged interactions. Participants found fulfillment in providing care, and through relationships with patients and colleagues. There was a strongly expressed desire for increased resources, team building/debriefing, and formal training in emotional exhaustion and burnout. The high rate of burnout and challenges of ALS care highlight the need for additional resources, team-building, and formal education around wellness. [ABSTRACT FROM AUTHOR]

Background: Having a sufficient and well-functioning health workforce is crucial for reducing the burden of disease and premature death. Health workforce development, focusing on availability, recruitment, retention, and education, is inseparable from acceptability, motivation, burnout, role and responsibility, and performance. Each aspect of workforce development may face several challenges, requiring specific strategies. However, there was little evidence on barriers and strategies towards comprehensive health workforce development. Therefore, this review explored barriers and strategies for health workforce development at the primary health care level around the world. Methods: A scoping review of reviews was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analysis Extension for Scoping Reviews. The article search was performed in Google Scholar, PubMed, Web of Science, and EMBASE. We used EndNote x9 for managing the collected articles, screening processes, and citation purpose. The scoping review included any kind of review articles on the application of health workforce development concepts, such as availability, recruitment, retention, role and responsibility, education and training, motivation, and burnout, with primary health care and published in English anywhere in the world. Based on the concepts above, barriers and strategies for health workforce development were identified. The findings were synthesized qualitatively based on the building blocks of the health system framework. The analysis involved specific activities such as familiarization, construction of the thematic framework, indexing, charting, and interpretation. The results were presented in texts, tables, and figures. Results: The search strategies yielded 7,276 papers were found. Of which, 69 were included in the scoping review. The most frequently cited barriers were financial challenges and issues related to health care delivery, such as workloads. Barriers affecting healthcare providers directly, including lack of training and ineffective teamwork, were also prominent. Other health system and governance barriers include lack of support, unclear responsibility, and inequity. Another notable barrier was the shortage of health care technology, which pertains to both health care supplies and information technology. The most common cited effective strategies were ongoing support and supervision, engaging with communities, establishing appropriate primary care settings, financial incentives, fostering teamwork, and promoting autonomous health care practice. Conclusions: Effective leadership/governance, a robust health financing system, integration of health information and technology, such as mobile health and ensuring a consistent supply of adequate resources are also vital components of primary health care workforce development. The findings highlight the importance of continuous professional development, which includes training new cadres, implementing effective recruitment and retention mechanisms, optimising the skill mix, and promoting workplace wellness. These elements are essential in fostering a well-trained and resilient primary health care workforce. [ABSTRACT FROM AUTHOR]

While the World Health Organization (WHO) has de-escalated coronavirus disease 2019 (COVID-19) from a global health emergency, ongoing discussions persist as new viral variants. This article aimed to consolidate German recommendations and international research to offer health care providers (HCPs) a comprehensive guide on COVID-19 boosters in 2024. The review outlines key recommendations from the German Robert Koch Institute. HCPs should receive COVID-19 boosters at least 12 months after their last vaccination or COVID-19 infection, contingent on the prevalent viral variant(s) in the region. However, excessive doses and/or frequent boosters, especially with mRNA vaccines, may lead to immune imprinting, T-cell exhaustion, and immunoglobulin (Ig) switching. Notably, this review highlights the significance of Ig, particularly IgA and IgG subclasses, in influencing infection risk and disease progression. Furthermore, it explores the implications of mRNA vaccine technology and potential adverse effects related to excessive dosing. In conclusion, this article provides a comprehensive analysis of COVID-19 vaccine boosters for HCPs, synthesising current recommendations, scientific debates, and considerations for optimising protection against SARS-CoV-2 in the evolving landscape of the post-pandemic era. [ABSTRACT FROM AUTHOR]

IntroductionIn South Africa, approximately half a million individuals live with epilepsy. This means that half a million families and caregivers are impacted by epilepsy, with a limited number of healthcare providers responsible for treating people living with the condition, as well as their families and caregivers.MethodsThis study explored the knowledge-based care and support healthcare providers give families and caregivers. Fifteen participants were purposefully selected from Limpopo and Mpumalanga provinces to participate in the study. Data were collected via an open-ended interview guide divided into two sections: Section A comprised sociodemographic questions, and Section B had questions on epilepsy care and support. Four of the participants were male, and 11 were female, seven were community health workers, five were nurse practitioners, and three were auxiliary nurses. Seven had a grade 12 qualification or lower, and only six had a degree. The data collected was analyzed using thematic analysis, coded by the researcher and co-coded by an independent expert. Two themes emerged from the raw data: epilepsy knowledge and epilepsy support and counselling. From these two themes, three subthemes were identified: psychosocial impact of epilepsy, epilepsy-related training, and counselling and support.ResultsThe study revealed a gap in professional capacity building and highlighted the need for intentional knowledge sharing and equipping of healthcare providers.DiscussionThe findings suggest that equipping community health workers, in particular, may be a better and more efficient way to increase the quality of life for families and caregivers and people living with epilepsy in South Africa.

Background: The Covid-19 disease was the most significant pandemic of the century. Health care providers showed great sacrifices in managing this disease and saving humanity, and they suffered many injuries. So, this study aimed to investigate the effect of Covid-19 on the resident’s quality of life and comparison with medical students. Methods: This cross-sectional study was performed on 223 Residents and 225 medical students. Using a random sampling method, WHOQOL-BREF 26 questionnaire was distributed among the participants. The collected data were analyzed with SPSS 21 software using T-test and ANCOVA. Results: The results showed that covid-19 had caused a decrease in the quality of life of residents compared to medical students (P value

Abstract Background The COVID-19 pandemic, which had recorded 769 million cases and resulted in 6.95 million deaths by August 2023, has put pressure on healthcare systems. Frontline medical professionals face stress, potentially leading to health challenges. This research aimed to examine the mental health of staff during the COVID-19 pandemic. Methods This cross-sectional descriptive-analytical study was conducted in several hospitals in Tehran, Kerman, and Golpayegan between 2021 and 2022. The study encompassed a population of 1,231 nurses and physicians. Data collection was done using the General Health Questionnaire-28 (GHQ-28). We applied the K-means clustering algorithm to unveil hidden patterns within the data and extract valuable insights from participants' responses to the GHQ-28. This method was chosen because our dataset lacked explicit labels, making grouping individuals with similar characteristics necessary. The primary aim was to delineate how the COVID-19 pandemic affected the mental health of hospital staff and identify which factors played a more significant role in this process. Results We have observed that Cluster two exhibits the highest scores in response to the GHQ-28 questions, indicating a more significant degree of mental distress. Within this cluster, 83.0% of individuals identify as female, 71.0% hold bachelor's degrees and 42.8% are nurses who have experienced the most substantial impact. Among these individuals, 90.4% did not have a history of smoking. Additionally, 59.7% are married, suggesting that these mental health issues may also affect their families. Conclusion Given that the most critical subscale is related to anxiety/insomnia within the second cluster, it is necessary to implement management plans aimed at appropriately redistributing night shifts to improve employee health.

Aim: Evaluate the prevalence of depression among professional healthcare workers (PHCW) during the COVID-19 pandemic. Methods: A cross-sectional study was conducted during the fourth wave of COVID-19 infection in Iraq. A semi-structured questionnaire in English was used to obtain information about the study variables. Results: The study included 314 participants, with a mean age of 34.3 years, slightly higher male to female sex (55.1 to 44.9%), doctors represent (26.1%), pharmacist represent (26.4%) while 36.9% includes other PHCW (nurse, laboratory technician, doctor assistance, and paramedics). There was a high prevalence of depression in the current study (98.4%). There was no significant association between total HADS with sex, specialty, and duration of working in COVID-19 isolation wards. Meanwhile, age above 50 years appears to be associated with higher HADS scores compared to younger PHCW. Conclusion: Healthcare practitioners faced a heightened susceptibility to experiencing depression throughout the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic, which had recorded 769 million cases and resulted in 6.95 million deaths by August 2023, has put pressure on healthcare systems. Frontline medical professionals face stress, potentially leading to health challenges. This research aimed to examine the mental health of staff during the COVID-19 pandemic. Methods: This cross-sectional descriptive-analytical study was conducted in several hospitals in Tehran, Kerman, and Golpayegan between 2021 and 2022. The study encompassed a population of 1,231 nurses and physicians. Data collection was done using the General Health Questionnaire-28 (GHQ-28). We applied the K-means clustering algorithm to unveil hidden patterns within the data and extract valuable insights from participants' responses to the GHQ-28. This method was chosen because our dataset lacked explicit labels, making grouping individuals with similar characteristics necessary. The primary aim was to delineate how the COVID-19 pandemic affected the mental health of hospital staff and identify which factors played a more significant role in this process. Results: We have observed that Cluster two exhibits the highest scores in response to the GHQ-28 questions, indicating a more significant degree of mental distress. Within this cluster, 83.0% of individuals identify as female, 71.0% hold bachelor's degrees and 42.8% are nurses who have experienced the most substantial impact. Among these individuals, 90.4% did not have a history of smoking. Additionally, 59.7% are married, suggesting that these mental health issues may also affect their families. Conclusion: Given that the most critical subscale is related to anxiety/insomnia within the second cluster, it is necessary to implement management plans aimed at appropriately redistributing night shifts to improve employee health. [ABSTRACT FROM AUTHOR]

Costase Ndayishimiye,1,2 Marzena Tambor,2 Katarzyna Dubas-Jakóbczyk2 1Doctoral School of Medical and Health Sciences, Jagiellonian University Medical College, Krakow, Poland; 2Health Economics and Social Security Department, Institute of Public Health, Jagiellonian University Medical College, Krakow, PolandCorrespondence: Costase Ndayishimiye, Doctoral School of Medical and Health Sciences, Jagiellonian University Medical College, ul. św. Łazarza 16, Krakow, 31-530, Poland, Tel +48579143137, Email costase.ndayishimiye@doctoral.uj.edu.plBackground: Changes to provider payment systems are among the most common reforms in health care. They are important levers for policymakers to influence the health system performance. The aim of this study was to identify, systematize, and map the existing literature on the factors that influence health-care provider payment reforms.Methods: A scoping review was conducted. Literature published in English between 2000 and 2022 was systematically searched in five databases, relevant organizations, and journals. Academic publications and grey literature on health-care provider payment reform and the factors influencing reform were considered. An inductive thematic analysis was applied to map the barriers and facilitators that influence payment reforms.Results: The study included 51 publications. They were divided into four categories: empirical studies (n=17), literature reviews (n=6), discussion/policy papers (n=18), and technical reports/policy briefs (n=9). Most of the studies were conducted in developed economy countries (n=36). The most frequently reformed payment method was fee-for-service (n=37), and the newly implemented methods included bundled payments (n=16), pay-for-performance (n=15), and diagnosis-related groups (n=11). This study identified 43 sub-themes on barriers to provider payment reforms, which were grouped into eight main themes. It identified 51 sub-themes on facilitators, which were grouped into six themes. Barriers include stakeholder opposition, challenges related to reform design, hurdles in implementation structures, insufficient resources, challenges related to market structures, legal barriers, knowledge and information gaps, and negative publicity. Facilitators include stakeholder involvement, complementary reforms/policies, relevant prior experience, good leadership and management of change, sufficient resources, and external pressure to introduce reform.Conclusion: The factors that influence health-care payment reforms are often contextual and interrelated, and encompass a variety of perspectives, including those of patients, providers, insurers, and policymakers. When planning reforms, one should anticipate potential barriers and devise appropriate interventions.Registration: The study was registered with the Open Science Framework.Keywords: barriers, facilitators, health care provider, health reform, payment reform

Issue Addressed: Adherence to smoking cessation medications is low and predicts the success of quit attempts. Health care providers (HCPs) role in delivering smoking cessation support is crucial. HCPs support to improve adherence to smoking cessation medication has not been evaluated in Australia. This study describes the attitudes and practices of HCPs in Australia towards adherence to smoking cessation medications (nicotine replacement therapies, varenicline and bupropion) and intervention options. Methods: A descriptive cross‐sectional study was conducted using a convenience sample of 70 HCPs in Australia. Participants were recruited through the social media platforms of professional societies in Australia. Data was collected in the periods between November 2020 and September 2021. Descriptive statistics were performed using SPSS statistical software version 27.0 and data was presented using proportions and percentages. Results: The majority of participants were doctors, nurses and midwives (82.8%). Almost two‐thirds of the participants (68.6%) self‐reported that they provided adequate adherence support to individuals taking smoking cessation medications. The majority of participants (87.1%) identified adherence support service as part of their professional role. Only 11.1% of the participants who did not believe supporting medication adherence to be their role reported providing adherence support. The main perceived barriers to adherence support are lack of skill, knowledge, time and resources. HCPs believed that providing additional counselling and monitoring of adherence can improve adherence rates. Conclusions: In an online survey conducted in Australia, HCPs indicated multiple barriers to providing adherence support and intervention strategies that should be considered for smoking cessation programs. A higher proportion of participants who perceived adherence support as their professional role reported supporting adherence to smoking cessation medications. So What?: Considerations should be given to improve HCPs attitudes and practices towards smoking cessation medications adherence support. Smoking cessation programs should consider the issue of adherence support. Further studies with a larger sample size across a broader range of HCPs are needed to extensively understand adherence service provision among HCPs in Australia. [ABSTRACT FROM AUTHOR]

This research addresses the current situation of international health service providers in Cali, identifying challenges and opportunities. Through a qualitative-inductive approach and using grounded theory, 8 providers selected by eligibility criteria were interviewed. The data were processed with Atlas.ti software. Strengths in quality, portfolio and infrastructure were identified. However, challenges such as lack of government support, limited bilingualism and citizen insecurity were highlighted. It was suggested that tourism should be promoted, health marketing should be strengthened, and greater government collaboration should be sought. As emphasized in the development, the importance of language skills to communicate with medical tourists. In conclusion, Cali shows potential in health services, but faces regulatory and competitive challenges. Promotion, collaboration and focus on the patient experience are essential for sustainable development in the sector and in the different activities that take place in these spaces. [ABSTRACT FROM AUTHOR]

Background: Provider uncertainty about the appropriate guideline-concordant evaluation of endometrial cancer (EC) symptoms may be a factor in racial inequities in EC. To evaluate the relationship between EC knowledge and reported practice patterns in a nationally representative survey of first-line providers for initial EC symptoms. Materials and Methods: This was a mailed cross-sectional survey of physicians and nurse practitioners from professional organization roster of providers from Obstetrics and Gynecology (OBGYN), Family Medicine, Internal Medicine, and Emergency Medicine. It queried demographics, practice characteristics, EC knowledge, and guideline-concordant practice patterns via three case vignettes. Regions of low response were retargeted to ensure strong representation among providers caring for Black women patients. EC knowledge was analyzed via a composite score (range: −3 to 10, with higher scores representing more EC knowledge), and adjusted prevalence ratios (PRs) used to test the association between knowledge and reported practice patterns. Results: Among 531 returned surveys (response rate = 38%), OBGYN had highest (53%) frequency of >6 (median) EC knowledge score, and Emergency Medicine had the lowest (15%) (p < 0.001). Nonguideline-concordant practice patterns were reported in 14%, 41%, and 35% of the three EC cases presented. Providers with knowledge >6, (n = 205) were significantly more likely to report guideline-concordant care on case vignettes (PR 1.28–1.36). Conclusions: In a national survey of multi-specialty backgrounds, there were basic knowledge gaps about EC and EC risk factors among providers, and a sizeable proportion reported nonguideline concordant practices. These findings indicate the importance of targeted education and training for first-line providers, as EC incidence rises. [ABSTRACT FROM AUTHOR]

Multilevel barriers to pre-exposure prophylaxis (PrEP) care among male sex workers (MSW) include aspects of interactions with health services and providers. We examined relationships between health service- and provider-level factors and PrEP care among MSW. Between 2017 and 2019, we enrolled 111 MSW in the Northeast United States who were not on PrEP, but expressed interest in potentially using PrEP, in a behavioral intervention to promote PrEP uptake and adherence. Using baseline data, we examined whether having a primary care provider, past year frequency of medical visits, comfort discussing sexual practices with providers, and transportation difficulties to accessing general health care were associated with PrEP use self-efficacy, anticipated barriers to PrEP uptake, adherence, and retention (linear regression), and intention to initiate PrEP (logistic regression). Models adjusted for age, race/ethnicity, sexual identity, education, and income. Participants' mean age was 34.2 [standard deviation (SD) = 8.5], and 47% were non-White. Three-quarters (76%) intended to initiate PrEP within the next month. Comfort discussing sexual practices with providers was associated with PrEP use self-efficacy (b = 0.41, p = 0.008). Comfort discussing sexual practices with providers was negatively associated with anticipated barriers to PrEP uptake (b = -0.29, p = 0.006). Transportation difficulties to accessing general health care were associated with barriers to PrEP uptake (b = 0.30, p = 0.007) and barriers to PrEP adherence and retention (b = 0.57, p

Background and objective: The World Health Organization recognizes the importance of positive childbirth experience. In Iraq, patient satisfaction during maternity care visits is not routinely collected. This study was aimed to find out the women’s expectation during labor from physicians and midwives and associated factors such as socio-demographic and obstetrical characteristics. Methods: This cross-sectional study was conducted in Erbil city, located in the Kurdistan region of Iraq. A total of 1,500 women were targeted while they were accompanying another person, including children, to receive health services in Erbil and eventually 1,196 participated in the study. Data were collected through direct interviews after receiving informed oral consent. Participants were asked to describe their expectations for childbirth using an open-ended question. Responses were then grouped and categorized into 20 expectation items based on overlapping themes. Chi-square tests were used to identify associations with key socio-demographic and obstetric characteristics. Results: Level of expectation was significantly associated with education (illiterate and high education, P = 0.028),residency (suburban, P = 0.003), parity (grand multipara, P = 0.001), satisfaction with care (those satisfied, P

BACKGROUND: Information and opinions shared by health care providers can affect patient vaccination decisions, but little is known about who health care providers themselves trust for information in the context of new COVID-19 vaccines. OBJECTIVE: The purpose of this study is to investigate which sources of information about COVID-19 vaccines are trusted by health care providers and how they communicate this information to patients. METHODS: This mixed methods study involved a one-time, web-based survey of health care providers and qualitative interviews with a subset of survey respondents. Health care providers (physicians, advanced practice providers, pharmacists, nurses) were recruited from an integrated health system in Southern California using voluntary response sampling, with follow-up interviews with providers who either accepted or declined a COVID-19 vaccine. The outcome was the type of information sources that respondents reported trusting for information about COVID-19 vaccines. Bivariate tests were used to compare trusted information sources by provider type; thematic analysis was used to explore perspectives about vaccine information and communicating with patients about vaccines. RESULTS: The survey was completed by 2948 providers, of whom 91% (n=2683) responded that they had received ≥1 dose of a COVID-19 vaccine. The most frequently trusted source of COVID-19 vaccine information was government agencies (n=2513, 84.2%); the least frequently trusted source was social media (n=691, 9.5%). More physicians trusted government agencies (n=1226, 93%) than nurses (n=927, 78%) or pharmacists (n=203, 78%; P

The transmission of medical data of deceased persons is inter alia a processing of personal data and is excluded, as a general rule, from the applicability and protection of the General Data Protection Regulation. National legislation in Romania is not sufficiently satisfactory to allow such a transmission of data, in relation to the requests existing in practice and the interests of various entities, including insurance companies, to obtain such medical data. This study highlights the problems encountered in practice and details the legal regime applicable to the protection of medical data of deceased patients. Finally, it is concluded that the transmission of any kind of medical data of deceased patients can only be done on the basis of express legal provisions. [ABSTRACT FROM AUTHOR]

Objective: To assess what impact does primary physician counseling have on contraceptive uptake. Study Design: Cross-sectional Comparative study. Setting: Study was done in three semi - government hospitals in three different cities. Period: April 2022 to May 2022. Material & Methods: Patients in outpatient clinics of the hospitals were given a questionnaire by simple random sampling. It was to assess women for their current use of contraception based on the source of their information about contraception. These groups were compared with each other for their contraception uptake. Associations between education, parity, working status and contraception use was also sought. The sample size was 175 women. Results: Out of 175 participants, 74 (42.3%) were practicing contraception at the time and 53 (30.3%) did not know about contraception. Reasons for not using contraception included side effects 71 (40.6%), Doctor never told them 56 (32%) and husband not willing 50 (28.6%). More women were of parity 4 or less (58 vs 34) and more working women used contraception (16 vs 6). The difference was not statistically significant. Illiterate women used contraceptives less. With education, there was significantly more use (38 vs 10) p < 0.001. Most Women knew about contraception from neighbor/relatives 57 (32.5%) and 41 (23.4%) did not practice any method. A doctor/health professional was the source in 37 (21.2%), only 12 (6.9%) did not adopt contraception with p = 0.003. There was a strong statistical significance. Conclusion: There was a strong association between the physician counseling and contraceptive use. There is a strong need of regular, persistent contraceptive advice during each antenatal visit to individualize a contraception plan to suit a couple. [ABSTRACT FROM AUTHOR]

Objective:To determine whether a single-use stethoscope diaphragm barrier surface remains aseptic when placed on pathogen-contaminated stethoscopes. Methods:From May 31 to August 5, 2019, we tested 2 separate barriers using 3 different strains of 7 human pathogens, including extended-spectrum β-lactamase-producing Escherichia coli, methicillin-resistant Staphylococcus aureus, and vancomycin resistant Enterococcus faecium. Results:For all diaphragms with either of the 2 barriers tested, no growth was recorded for any of the pathogens. Stethoscopes with aseptic barriers remained sterile for up to 24 hours. These single-use barriers also provided aseptic surfaces when stethoscope diaphragms were inoculated with human specimens, including saliva, stool, urine, and sputum. Conclusion:Disposable aseptic diaphragm barriers may provide robust and efficient solutions to reduce transmission of pathogens via stethoscopes.

Objectiv(s): The aim of this study was to determine the effect of pre-service e-learning on health care providers’, knowledge in terms of family health cares. Methods: This was a pre- and post-test design study. The framework for developing the course was based on the stages of the General Educational Design Model (ADDIE). First, the content was designed and uploaded in Learning Management System (LMS). Then, using the census sampling method, all female health care providers who had started working as health care provider in the health care facilities affiliated to Iran University of Medical Sciences in a period of 6 months in 2021-2022 were included in the study. First, their knowledge of the course contents was measured. They received training upon entering the service electronically. Finally, their knowledge and skills were assessed by an exam. The level of their satisfaction and skills after participating in the course was also assessed. The data were analyzed by SPSS statistical software. Results: In all 73 trainee included in the study. The results of the study showed that the mean total score of health care providers' knowledge, after participating in the designed e-learning course significantly increased compared to before participating in the course (p = 0.01). The findings showed that the highest satisfaction score of the participants was related to the suitability of the evaluation with the content presented in the course (86% of the participants reported good to very good level). The lowest satisfaction was related to support in technical issues (47% of the participants was reported good to very good level). The most acquired skill was related to the ability to assess a child health status (100% of the participants reported good to very good level) and the least acquired skill was related to the ability to identify the health status of pregnant mother (45% of the participants reported good to very good level). Conclusion: This study showed that participating in pre-service e-learning training may increase the knowledge of female health care providers in various components of family health care.

Abstract Background: Health care providers and health volunteers play an important role in the collaborative provision of patient access and care regarding medical cannabis in district health systems (DHSs) according to their roles and responsibilities. However, there is limited evidence on the self-perceived knowledge, attitudes, and training needs regarding medical cannabis use by health care providers and health volunteers in DHSs. The aim of this study was to compare self-perceived knowledge, attitudes, and training needs regarding medical cannabis among health care providers and health volunteers in Phitsanulok Province, Thailand. Methods: A cross-sectional study was conducted in Phitsanulok Province. A total of 836 participants consisting of 166 health care providers and 670 health volunteers were recruited by stratified cluster random sampling. Descriptive and inferential statistics, including independent sample t tests and chi-square tests, were employed for data analyses. Results: The results revealed that self-perceived knowledge of medical cannabis was not significantly different between the health care providers and health volunteers (p = 0.875), whereas attitudes about medical cannabis were significantly different between the two groups (p

Background: Donated milk is the best choice for infants who cannot receive breast milk from their mothers. Researchers in this study evaluated the knowledge and attitude of healthcare providers regarding milk-donation and examined their socio-demographic predictors in Tabriz-Iran, 2021.Methods: In this cross-sectional analytic study, the total sample size consisted of 535 healthcare providers including 272 nurses and midwives working at maternal hospitals and 263 healthcare providers working at healthcare-centers. Census-sampling method was used during October 2020 to February 2021, and data collection tools included socio-demographic, knowledge and attitude questionnaires. Pearson-correlation test, independent t-test, one-way analysis of variance, and adjusted general linear model were used to analyze the data using SPSS version 16.Results: The mean (SD) of the knowledge score was 12.04±4.30 (score range of 0-22) and that of the attitude score was 134.27±20.23 (score range of 42-210). Results of general linear model was adjusted for socio-demographic characteristics and showed that predictors of knowledge variable were associated with having prior experience of breastfeeding another infant (P=0.006) and encouraging others to breastfeed (P=0.008); also, the predictor of attitude variable was aligned with encouraging others to breastfeed (P

Supplemental Digital Content is Available in the Text. Introduction: Up to 85% of newly qualified physicians report loss or illness in themselves or a loved one. These experiences can intensify feelings of grief in the professional setting, but the range of formal training that addresses personal illness or loss is unknown. This study aimed to explore interventions that teach health care providers and trainees about personal illness experience. Methods: A scoping review was conducted by searching three bibliographic databases using the terms "illness," "personal," "education," and synonyms. Article screening was performed in duplicate to identify studies that described an intervention that included teaching or learning on personal experiences with illness or loss for health care providers and trainees. Results: The search yielded 4168 studies, of which 13 were included. Education most often targeted medical students (54%), resident or attending physicians (31%), and nurses (31%). Other participants included social workers and psychologists. Personal illness was most frequently taught for reflection in the context of palliative care curricula (54%). Only two studies' primary purpose was to teach about coping with grief related to personal experiences. No studies within the scope of our defined methodology described training on how to support colleagues or trainees facing personal illness or loss. Reported outcomes included improved coping skills, decreased stress, and better ability to support bereaving patients. Discussion: Specific training on personal illness experience is limited, with gaps in continuity of learning, particularly for continuing medical education. Future curricula can equip providers with coping strategies while enabling improved resilience and patient care. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has led to increased burnout and staff turnover for health care providers (HCPs). The purpose of this pilot study was to evaluate the safety and acceptability of a Stress Resilience Program (SRP) for reducing perceived stress and improving resilience among HCPs during a pandemic. Method: Of the 12 HCPs expressing interest in the study, 10 were enrolled in this study. Participants attended three in-person visits (consent/screen, baseline, and end-of-study). The SRP consisted of education related to resilience enhancement and a breathing device (BreatherFit®) for combined respiratory muscle training (cRMT). Participants completed 4 weeks of cRMT and applied situational breathing strategies as needed. Outcomes measured were changes in stress (PSS-10), resilience (BRS), depression (PRIME-MD), and sleep (PSQI and Ōura Ring®). Findings: The majority of participants were male (60%) and White (60%) with an average age of 39.7 years. Changes from baseline to end-of-treatment indicated a positive trend with significant stress reduction (−3.2 ± 3.9, p =.028) and nonsignificant depression reduction (−0.5 ± 0.7, p =.05). Resilience was high at baseline and continued to stay high during the study with a nonsignificant increase at end-of-study (+0.07 ± 0.7, p =.77). No changes in overall sleep scores were noted. All participants agreed the study was worthwhile, 80% indicated they would repeat the experience, while 90% indicated they would recommend the study to others. Conclusion/Application to Practice: Because of its size and portability, SRP is an easily applicable and promising option for reducing stress among HCPs during a high-stress period, such as a pandemic. Larger studies are needed. [ABSTRACT FROM AUTHOR]

BackgroundDue to public restrictions during the early stages of the COVID-19 pandemic, many people were unable to visit and bid a proper farewell to their dying loved ones. This study aimed to address the loss-oriented aspects of grief and bereavement of relatives and relate these to the support they may have received from their dying relative's caring professionals.Materials and methodsPeople from Germany who experienced bereavement during the COVID-19 pandemic were enrolled in a cross-sectional study between July 2021 and May 2022, using standardized questionnaires (i.e., ICG, Inventory of Complicated Grief; BGL, Burdened by Grief and Loss scale; WHO-5, WHO-Five Wellbeing Index; and 5NRS, perception of burden related to the pandemic).ResultsMost participants (n = 196) had the opportunity to visit their relatives before death (59%). When this was not possible, being burdened by grief and loss was significantly higher (Eta2 = 0.153), while this had no significant influence on complicated grief or psychological wellbeing. Furthermore, 34% of participants felt well-supported by the treatment/care team. Their own support was moderately correlated with BGL scores (r = −0.38) and marginally with ICG scores (r = −15). Regression analyses showed that complicated grief symptoms as the dependent variable were predicted by (low) psychological wellbeing, relational status, and the perception of COVID-19-related burden (R2 = 0.70). In contrast, BGL as the dependent variable can be best explained by the perception of emotional affections because of restricted visits shortly before their death, by the (short) duration of visits before death, and by the relational status (R2 = 0.53). Although both were interconnected (r = 0.44), their predictor pattern was different.ConclusionBeing able to visit dying relatives was important for the mourning and bereavement processes. This emotional aspect was more relevant to the normal, non-pathological grief and loss processes than to complicated grief processes. Support from their dying relatives' treatment/care team was highly relevant to the mourning process, but the visiting relatives often lacked information about additional resources such as psychologists or pastoral care professionals or had limited access to them.

ABSTRACT Carbapenem-resistant Klebsiella pneumoniae (CRKp) is a pathogen of significant concern to public health, as it has become increasingly associated with difficult-to-treat community-acquired and hospital-associated infections. Transmission of K. pneumoniae between patients through interactions with shared health care personnel (HCP) has been described as a source of infection in health care settings. However, it is not known whether specific lineages or isolates of K. pneumoniae are associated with increased transmission. Thus, we used whole-genome sequencing to analyze the genetic diversity of 166 carbapenem-resistant K. pneumoniae isolates from five U.S. hospitals in four states as part of a multicenter study examining risk factors for glove and gown contamination by carbapenem-resistant Enterobacterales (CRE). The CRKp isolates exhibited considerable genomic diversity with 58 multilocus sequence types (STs), including four newly designated STs. ST258 was the most prevalent ST, representing 31% (52/166) of the CRKp isolates, but was similarly prevalent among patients who had high, intermediate, and low CRKp transmission. Increased transmission was associated with clinical characteristics including a nasogastric (NG) tube or an endotracheal tube or tracheostomy (ETT/Trach). Overall, our findings provide important insight into the diversity of CRKp associated with transmission from patients to the gloves and gowns of HCP. These findings suggest that certain clinical characteristics and the presence of CRKp in the respiratory tract, rather than specific lineages or genetic content, are more often associated with increased transmission of CRKp from patients to HCP. IMPORTANCE Carbapenem-resistant Klebsiella pneumoniae (CRKp) is a significant public health concern that has contributed to the spread of carbapenem resistance and has been linked to high morbidity and mortality. Transmission of K. pneumoniae among patients through interactions with shared health care personnel (HCP) has been described as a source of infection in health care settings; however, it remains unknown whether particular bacterial characteristics are associated with increased CRKp transmission. Using comparative genomics, we demonstrate that CRKp isolates associated with high or intermediate transmission exhibit considerable genomic diversity, and there were no K. pneumoniae lineages or genes that were universally predictive of increased transmission. Our findings suggest that certain clinical characteristics and the presence of CRKp, rather than specific lineages or genetic content of CRKp, are more often associated with increased transmission of CRKp from patients to HCP.

IntroductionHuman papillomavirus (HPV) infection, an important pathogenic factor for cervical cancer, can be prevented by the HPV vaccine. Health care provider (HCP) recommendations contribute to improve HPV vaccination coverage. The aim of this study was to assess the frequency of HCP recommendations for HPV vaccination and associated factors.MethodsFrom Nov 8 to Dec 6 in 2018, a cross-sectional study was conducted through online questionnaires among HCPs (n = 1,371) from hospitals in three large cities in China (Shanghai, Guangzhou, and Shenzhen). Data on demographic characteristics, the frequency of HPV vaccination recommendations, HPV knowledge and related attitudes were collected through the questionnaires.ResultsAmong 1,371 participants, only 30.2% reported that they frequently recommended HPV vaccination. Multivariate analyses indicated that female sex, being employed in obstetrics or gynecology departments and community health service centers, and having higher self-reported and actual knowledge of HPV were factors associated with a higher recommendation frequency. Factors including a self-perceived non-obligation to provide recommendations and difficulties in discussing sexual topics were significantly correlated with less frequent recommendations. Employment in a community health service center (OR = 2.068, 95% CI: 1.070–3.999) was the strongest factor associated with the frequency of HCPs’ recommendations for HPV vaccination.DiscussionThe frequency of HCPs’ recommendations for HPV vaccination in China was much lower than that in many developed countries. To enhance the recommendation frequency, medical institutions should help HCPs gain more knowledge of HPV and master communication skills. At the same time, the government should take measures to enhance the accessibility of HPV vaccines. The media should help to alleviate people’s concerns and encourage them to face up sexual health.

BackgroundIn Germany, a growing number of neonatal intensive care units (NICUs) are equipped with webcams. The utilization of webcams in the NICU is gaining greater attention and the impact of this technology can be manifold. However, there has been no definite understanding of its impact. We will highlight the webcam's implications on the communication between parents and Health Care Professionals (HCPs) in German NICUs.Methods20 interviews were conducted with HCPs from three German NICUs between December 2019 and August 2020 according to a qualitative research design. Seven out of them had no webcam experience, whereas for 13 of them, webcam-use is part of their working routine. Interviews were analyzed following Kuckartz's thematic analysis. Findings were assessed in accordance with the NICU Communication Framework.ResultsHCPs consider the webcams as a beneficial addition to the interaction of parents with their infants, as well as the HCP-parent interaction. At the same time, HCPs created new pathways of communication with parents via the webcam. Any negative effects feared by HCPs without webcam experience regarding the communication with parents, including a lasting shift of conversation away from the infant and toward more technical aspects of the webcams, but also an increase in phone calls from parents and an associated increase in workload, could not be confirmed by HCPs with webcam experience.ConclusionThe findings indicate that the implementation of webcams in German NICUs not only has an influence on the communication between parents and HCPs, but it expands communicative pathways. It can be stated that they support tailored communication but are not necessarily sufficient to account for all aspects themselves. The results of this study help to assess the impact of webcams on communication between parents and HCPs and should be applied to strengthen it within NICUs equipped with webcams.Clinical trial registrationThe Neo-CamCare Study is registered at the German Clinical Trial Register. DRKS-ID: DRKS0001775; Date of registration: 05/09/2019.

U.S. Hispanic/Latino adults are at heightened risk for developing diet-related chronic diseases. Healthcare provider recommendations have shown to be effective for promoting health behavior change, but little is known about healthcare provider healthy eating recommendations among Hispanics/Latinos. To investigate the prevalence of and adherence to healthcare provider-delivered healthy eating recommendations among a U.S. sample of Hispanic/Latino adults, participants (N = 798; M = 39.6±15.1 years; 52% Mexican/Mexican American) were recruited via Qualtrics Panels to complete an online survey in January 2018. Most (61%) participants reported having ever received a healthcare provider-delivered dietary recommendation. Higher body mass index (AME = 0.015 [0.009, 0.021]) and having a chronic health condition (AME = 0.484 [0.398, 0.571]) were positively associated with receiving a dietary recommendation while age (AME = −0.004 [−0.007, −0.001]) and English proficiency (AME = −0.086 [−0.154, −0.018]) were negatively associated. Participants reported adhering regularly (49.7%) and sometimes (44.4%) to recommendations. There were no significant associations with patient characteristics and adherence to a healthcare provider-delivered dietary recommendation. Findings inform next steps toward increasing implementation of brief dietary counseling from healthcare providers to support prevention and management of chronic diseases among this under-studied population.

While the World Health Organization (WHO) has de-escalated coronavirus disease 2019 (COVID-19) from a global health emergency, ongoing discussions persist as new viral variants. This article aimed to consolidate German recommendations and international research to offer health care providers (HCPs) a comprehensive guide on COVID-19 boosters in 2024. The review outlines key recommendations from the German Robert Koch Institute. HCPs should receive COVID-19 boosters at least 12 months after their last vaccination or COVID-19 infection, contingent on the prevalent viral variant(s) in the region. However, excessive doses and/or frequent boosters, especially with mRNA vaccines, may lead to immune imprinting, T-cell exhaustion, and immunoglobulin (Ig) switching. Notably, this review highlights the significance of Ig, particularly IgA and IgG subclasses, in influencing infection risk and disease progression. Furthermore, it explores the implications of mRNA vaccine technology and potential adverse effects related to excessive dosing. In conclusion, this article provides a comprehensive analysis of COVID-19 vaccine boosters for HCPs, synthesising current recommendations, scientific debates, and considerations for optimising protection against SARS-CoV-2 in the evolving landscape of the post-pandemic era.

Background: Today, most universities around the world are looking for educational methods that promote healthcare providers. Due to the lack of study in this field and the importance of healthcare providers providing care services to patients, therefore, the purpose of this study was to compare the effect of the lecture and Jigsaw teaching technique on first-aid learning in healthcare provider students.Method: In this semi-experimental study, 50 healthcare provider students were randomly divided into control (traditional method) and case (Jigsaw method) groups with health care training for four sessions of 90 minutes in the form of basic first aid lessoning. At the first and end of the study, pre and post–exams have been taken from both groups. Results: In this research, the 50 students were studied in case and control groups. There were no significant differences in terms of age (P=0.678), sex (P=0.474), location (P=0.77), marital status (P=0.774), and total GPA (P=0.68) between the experimental and control groups. The results also showed that the difference between the mean and standard deviation of pre-and post-test results in the experimental group was significantly higher than in the control group (p

Many people will need support and help with their daily functioning during their adult life. The solution to this need for support might be either by using a formal or an informal care and support system. Informal care is delivered by nonprofessionals (usually family members) not paid for their duty, defined as the caregivers. The care provided by relatives requires understanding, knowledge, and skills in a wide variety of fields. In this interview, we try to shed light on the place and role of the caregiver, sometimes an invisible major player in the patient's journey. [ABSTRACT FROM AUTHOR]

Background: Health care providers and health volunteers play an important role in the collaborative provision of patient access and care regarding medical cannabis in district health systems (DHSs) according to their roles and responsibilities. However, there is limited evidence on the self-perceived knowledge, attitudes, and training needs regarding medical cannabis use by health care providers and health volunteers in DHSs. The aim of this study was to compare self-perceived knowledge, attitudes, and training needs regarding medical cannabis among health care providers and health volunteers in Phitsanulok Province, Thailand. Methods: A cross-sectional study was conducted in Phitsanulok Province. A total of 836 participants consisting of 166 health care providers and 670 health volunteers were recruited by stratified cluster random sampling. Descriptive and inferential statistics, including independent sample t tests and chi-square tests, were employed for data analyses. Results: The results revealed that self-perceived knowledge of medical cannabis was not significantly different between the health care providers and health volunteers (p = 0.875), whereas attitudes about medical cannabis were significantly different between the two groups (p < 0.001). The mean scores of attitudes were 29.10 for the health care providers and 31.84 for the health volunteers. Regarding training needs, the health care providers proposed training topics, including adverse effects of medical cannabis (27.5%), information on prescribing cannabis drugs (20.5%) and information on prescribing drugs that contain cannabis substances (14.7%). On the other hand, health volunteers preferred to obtain training on cannabis legislation (23.5%), information on caring for patients who used drugs containing cannabis substances (21.4%), and a history of medical cannabis use (17.6%). Conclusion: In summary, to ensure effective care in the DHSs, health care providers and health volunteers should be trained to be confident in their knowledge and attitudes towards the use of medical cannabis. Training topics should be designed with consideration for the role and responsibility of each group to prepare professionals and nonprofessional to achieve patients quality and safety with respect to medical cannabis use. [ABSTRACT FROM AUTHOR]

Background: Screening is a cancer prevention measure for groups who are asymptomatic, and diagnosis is a medical test for groups who are symptomatic. The occupational privilege of health care providers (HCPs) is expected to play a positive role in cancer screening practices. Therefore, this study aimed to assess perceptions and personal attitudes of HCPs regarding their decision to screen for cancer in the Eastern Province of Saudi Arabia. Design: A cross-sectional multicenter survey study was conducted. A well-designed and validated questionnaire was distributed to the HCPs at three tertiary hospitals in the Eastern Province of Saudi Arabia. Results: Out of 900 health care providers who received the questionnaire, 372 completed it. Two-thirds, 247 (66.4%) of them were nurses and the rest were physicians and the mean age was 34.1 ± 7.1 years. Regardless of gender, profession, or age, the overall rate of belief in the importance of regular cancer screening was high; 91.4%. The number of participants who did not screen for colonoscopy was significantly higher than those who screened. The number of females in the age group of between 45 and 54 years who screened with mammography was significantly higher than non-screened. In a similar way, male HCPs above 54 years who got themselves screened for Prostate-Specific Antigen (PSA) were significantly higher than those who did not. Conclusions: Findings of the current research and existing evidence specifically for the Saudi community indicated a need to raise awareness, emphasizing the role of HCPs in motivating themselves, their families, and their patients to implement various cancer screening programs. [ABSTRACT FROM AUTHOR]

الملخص: أهداف البحث: تهدف هذه الدراسة إلى معرفة العلاقة بين آلام أسفل الظهر وجودة النوم لدى مقدمي الرعاية الصحية في المملكة العربية السعودية. طرق البحث: تم إجراء دراسة مقطعية معتمدة على الاستبانة مستهدفة مقدمي الرعاية الصحية في المملكة العربية السعودية. حيث تتكون الاستبانة من ثلاثة أقسام؛ القسم الأول يتضمن بيانات السيرة الذاتية للمشاركين. الثاني هو مؤشر أوسويستري للإعاقة بالإضافة إلى استبانة الجهاز العضلي الهيكلي الاسكندنافي لآلام أسفل الظهر. القسم الثالث كان لمؤشر جودة النوم الكلية في تقييم بيتسبرغ. النتائج: شارك وأكمل الاستبانة ٤٤٢ مستجيبا. ومثل الذكور قرابة ثلثي المستجيبين (٦٢.٧٪). وكان معظم المشاركين يعيشون في المنطقة الوسطى (٢٣.٣٪) أو المنطقة الشمالية (٢٣.٣٪). وقد وُجد أن العلاقة بين مؤشر جودة النوم الكلية في تقييم بيتسبرغ العالمي ودرجة مؤشر أوسويستري للإعاقة ذات دلالة إحصائية عالية بشكل إيجابي، بينما وُجد أن الارتباط بين درجة مؤشر أوسويستري للإعاقة ومكونات مؤشر جودة النوم في تقييم بيتسبرغ، بما في ذلك التقييم الشخصاني لجودة النوم وكفاءة النوم المعتاد والخلل الوظيفي في الفترة النهارية ذات دلالة إحصائية عالية بشكل إيجابي. الاستنتاجات: أظهر مقدمو الرعاية الصحية في المملكة العربية السعودية الذين يعانون من ارتفاع في معدل الإعاقة في آلام أسفل الظهر جودة نوم أقل بشكل عام والعكس صحيح ومع ذلك، هناك حاجة إلى مزيد من البحث في هذا السياق لمعرفة ما إذا كانت هذه العلاقة سببية. Abstract: Objective: This study investigates the relationship between low back pain (LBP) and sleep quality among health care workers in KSA. Methods: In this cross-sectional study, an anonymous questionnaire consisting of three sections was administered to health care providers in KSA. The first part included the biographic data of participants, while the second comprised the Oswestry Disability Index (ODI) and the extended version of the Nordic Musculoskeletal Questionnaire (NMQ-E) for LBP. The third part contained the Pittsburgh Sleep Quality Index (PSQI). Results: A total of 442 healthcare providers completed the questionnaire. Nearly two-thirds of the respondents were male (62.7%). Most were living in either the central region (23.3%) or the northern region (23.3%). There was a statistically significant correlation between the global PSQI and ODI score (r = 0.235; p

Abstract Background Growing evidence shows that many parents begin the decision-making process about infant vaccination during pregnancy and these decisions – once established – may be resistant to change. Despite this, many interventions targeting vaccination are focused on communicating with parents after their baby is born. This suggests that the prenatal period may constitute a missed opportunity for communicating with expectant parents about infant vaccination. Methods Using a longitudinal qualitative design, we conducted two interviews (prepartum and postpartum) with women (n = 19) to explore the optimal timing of vaccination information. The data were analyzed thematically, and examined across all sets of pre- and post-partum interviews as well as within each individual participant to draw out salient themes. Results Most participants formed their intentions to vaccinate before the baby was born and indicated that they would welcome information about vaccination from their maternity care providers. However, few individuals recalled their maternity care providers initiating vaccination-related conversations with them. Conclusion The prenatal period is an important time to begin conversations with expectant parents about vaccinating their infants, particularly if these conversations are initiated by trusted maternity care providers. More information is needed on how maternity care providers can be better supported to have these conversations with their patients.

Abstract Background Rwanda implemented post-natal care home visits by maternal community health workers (M-CHWs) in charge of maternal and newborn health care in 2010 as a component of a home–based maternal and neonatal health care package (HB-MNHCP), this being a complementary strategy to facility-based postnatal care to improve survival. The country has not met its Sustainable Development Goal (SDG) 3 target of less than 70 maternal mortalities per 100,000 live births and less than 12 neonatal deaths per 1,000 live births. This study therefore aimed to establish the knowledge of the health providers, providing HB-MNHC services as part of their antenatal, delivery and postnatal care program, specifically the M-CHWs services. Methods The cross-sectional descriptive study included 79 purposively sampled health care providers who were directly involved in the various components of the HB-MNHCP, namely: professional nurses, midwives, M-CHW, social workers, supervisors and data managers. The Kibogora, Muhima and Nyamata District Hospitals and two rural, semi-urban and urban health facility were included. Data was collected using questionnaires from April to July 2018. This study followed the STROBE checklist form: Cross –sectional studies. Results Overall, 88.6% (n=70/79) of participants knew about the M-CHW three home visits scheduled during pregnancy, 73.4% (n=58/79) about the three postnatal home visits after birth when the weight was normal, and 64.6% (n=51/79) about the five PNC home visits for low birth weights. Most (97.5%, n=77/79) knew that the mother and newborn should be screened during the same M-CHW home visits, and 87.2% (n= 68/79) were aware of the seven postnatal core competencies of delivering key maternal and newborn interventions during PNC home visits. Conclusions There were varying levels of knowledge among the HB-MNHCP staff, indicating the need for ongoing monitoring and training to ensure that the correct information is provided to the mothers throughout the antenatal and postnatal periods. While most of the M-CHWs appear to have had the correct knowledge, their executing of some activities needs to be monitored to ensure that they provide the required services, as this is an important step in lowering the maternal and infant mortality and enabling Rwanda to meet its SDG 3. Home visits by the M-CHWs could increase referrals and reduce maternal and newborn mortality.