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The article discusses the urgent need for environmental accountability in nephrology clinical trials. It highlights the significant carbon dioxide equivalent (CO2e) emissions associated with clinical trials and emphasizes the lack of studies assessing the environmental impact of these trials. The article suggests various strategies to mitigate the environmental effects, such as optimizing trial site locations, reducing unnecessary data and sample collection, favoring local lab work, and minimizing travel for patients and the trial team. It also explores the potential benefits of digitalization, artificial intelligence (AI), and machine learning in improving the sustainability of clinical trials. The article calls for collective efforts from the nephrology community, including researchers, pharmaceutical companies, and funding bodies, to prioritize sustainability in clinical trials. [Extracted from the article]

Communities of practice are commonly used to support members in responding to public health issues. This study evaluated the outcomes of five co-designed communities of practice to determine if members' expectations were met, if knowledge sharing between members extended to knowledge translation, and if that supported members in addressing public health issues. Data were collected through an initial needs assessment, observations were made during community of practice sessions over 1 year, and qualitative interviews were conducted at the end of that year. The findings provided evidence that members' expectations were met, knowledge sharing took place within the communities of practice, and personal benefits gained supported members in advancing knowledge sharing with other members to knowledge translation outside their community of practice. Results demonstrate three outcomes of knowledge translation for members: disseminating knowledge to others, applying knowledge to make small-scale changes in practice and leveraging the knowledge to expand its reach beyond members' organizations. While the scale and speed of expanding outcomes were below initial expectations as indicated in the initial needs assessments, members remained optimistic about achieving larger-scale impacts in the future. This study showed that communities of practice achieve gradual progress rather than quick wins. Co-design supports the facilitators in meeting members' needs, which can positively contribute to members sharing knowledge and translating that knowledge to support their practice to address public health issues. [ABSTRACT FROM AUTHOR]

Accessible, up-to-date information on traumatic brain injury (TBI) can be challenging to find and is needed to address TBI knowledge gaps and improve outcomes for people who experience a TBI. The Understanding TBI Massive Open Online Course (TBI MOOC) was developed to increase TBI knowledge across a diverse global audience. We sought to characterize the TBI MOOC participant cohort, to understand the reach of the course among this target audience. Examining the characteristics of TBI MOOC enrollees showed that participants came from a wide range of demographic backgrounds, had a variety of TBI experiences and had multiple reasons for enrolling in the MOOC. The majority of course participants shared some characteristics with other groups of health information seekers. Four distinct demographic profiles were identified among TBI MOOC participants (education seekers, TBI-aware participants, TBI care providers and retirees) using a novel approach combining chi-squared tests and network modularity. Participants assigned to the TBI-aware and retiree profiles were most likely to complete all modules of the MOOC, and the TBI-aware profile was more highly represented in more recent iterations of the MOOC. Together, these data indicate that the TBI MOOC provided information to a wide range of people, and particularly engaged participants with personal or family experience of TBI. However, engagement with this course was minimal among some hard-to-reach populations, including men and people with low levels of education, indicating that additional strategies are needed to ensure equity in health promotion. [ABSTRACT FROM AUTHOR]

Do politicians behave opportunistically regarding their tax proposals during the election cycle, or do they maintain ideological sincerity? We examine U.S. governors' revenue proposals between the years of 1989 and 2018 to assess gubernatorial behavior during election years. We find that governors, in general, do indeed follow a political budget cycle where they request lower revenues during election years. However, this finding is largely driven by Democratic governors asking for significantly lower revenues during election years when compared to non‐election years. Republican governors are more ideologically sincere, maintaining behaviors that are consistent across the election cycle. [ABSTRACT FROM AUTHOR]

This study aims to analyze the implementation, implementation process, obstacles, and impacts of Electronic Customer Relationship Management (E-CRM) on the formation of Positive Word of Mouth at PT Mandiri Utama Finance. This study uses a qualitative approach with a descriptive research method. The research approach is carried out with case study approach. This research is expected to provide solutions to businesses at the company in determining strategic steps as well as making regulations or implementing appropriate policies, and providing input for the next implementation of E-CRM. The results show that the company's overall satisfaction was 6.35 or equivalent to 96%. The implementation process and obstacles in forming a positive word of mouth are identified as the main obstacles in the implementation process. The use of social media and other digital media plays an important role in the development of positive words of mouth. [ABSTRACT FROM AUTHOR]

The article discusses how the Medical Library Association (MLA) is adapting and navigating to changes and innovations. Topics discussed include the role of the board of directors in leading the direction of MLA, the strategies of MLA to grow the organization, address its financial challenges and achieve long-term sustainability, and its strategic goals from 2015 to 2024.

Professional associations provide resources to support members' career development and facilitate ways for members to engage with and learn from one another. This article describes Medical Library Association (MLA) activities related to the revision of professional competencies and the restructuring of the organization's communities during the past twenty-five years. Grounded in MLA's Platform for Change, the MLA competency statement underwent two revisions with core themes remaining consistent. Major efforts went into rethinking the structure of MLA communities, and it became a strategic goal of the association. Numerous groups spent considerable time guiding the changes in MLA's community structure. Sections and special interest groups were transformed into caucuses. Domain hubs were established to facilitate project coordination across caucuses and create more leadership opportunities for MLA members, but their implementation did not meet expectations. Member engagement and leadership are ongoing challenges for MLA. The next twenty-five years will undoubtedly see additional revisions to the competencies and continued iterations of the community structure. [ABSTRACT FROM AUTHOR]

Background The COVID-19 pandemic demanded quick exchanges between experts and institutions supporting governments to provide evidence-based information in response to the crisis. Initially, there was no regular cross-country forum in the field of population health. This paper describes the set-up and benefits of implementing such a forum. Methods A group of public health practitioners from academia, national public health institutes and ministries of health decided in April 2020 to meet bi-monthly to discuss a vast array of population health topics in a structured format called a Rapid Exchange Forum (REF). An ad-hoc mailing group was established to collect responses to questions brought forward in the forum from at least five countries within 24 h. This endeavour, which evolved as network of networks was awarded an EU grant in autumn 2020 and was called PHIRI (Population Health Information Research Infrastructure). Results Responses from up to 31 countries were compiled and shared immediately via the European Health Information Portal. This exchange was complemented by special REFs that focused on the advantages and disadvantages of vaccination, for example. By July 2023, 54 REFs had taken place with topics going beyond COVID-19. Conclusion The REF demonstrated its value for quick yet evidence-based cross-country exchange in times of crisis and was highly appreciated by countries and European Commission. It demonstrated its sustainability even after the acute crisis by expanding the topics covered and managing to continue exchange with the aim of capacity building and mutual learning, making it a true EU response and coordination mechanism. [ABSTRACT FROM AUTHOR]

Background Timely and high-quality population-level health information is needed to support evidence-informed decision-making, for planning and evaluation of prevention, care and cure activities as well as for research to generate new knowledge. FAIR (Findable, Accessible, Interoperable and Reusable) principles are one of the key elements supporting health research and making it more cost-effective through the reuse of already existing data. Currently, health data are in many countries dispersed and difficult to find and access. Methods Two EU Public Health Programmes co-funded Joint Actions, Information for Action (InfAct) and Population Health Information Research Infrastructure (PHIRI) have established a European Health Information Portal, a web-based service, to facilitate better findability, access, interoperability and reuse of existing health information. Results The European Health Information Portal (www.healthinformationportal.eu) has been established including sections on National Nodes, data sources, publications, health information projects within countries and across Europe, research networks and research infrastructures, ethical and legal issues for health information exchange and use, capacity-building activities in all areas of population health and a dedicated COVID-19 section. Conclusions The European Health Information Portal, being a central place for a wide range of population health information from EU Member States, is an information source for researchers, policy-makers and other relevant stakeholders. It is important to ensure the sustainability of the portal, especially in light of the European Health Data Space (EHDS) Regulation proposal and its requirements regarding the secondary use of health data. [ABSTRACT FROM AUTHOR]

Introduction and aim. Orthorexia nervosa is described as an obsession with consuming solely healthy foods accompanied by restrictive behaviors. Patients with chronic conditions frequently require dietary interventions alongside medication to manage symptoms and slow down disease progression. However, when dietary restrictions are taken to extremes, individuals may develop orthorexia nervosa, resulting in malnutrition and weight loss. This poses risks during treatment, where maintaining a balanced diet is vital. In this review we aim to display the prevalence of orthorexia nervosa in patients suffering from selected chronic diseases. Material and methods. A literature review was performed to investigate the prevalence of orthorexia nervosa among individuals with type 1 diabetes, inflammatory bowel disease, celiac disease, rheumatoid arthritis, and cancer. Description of the State of Knowledge. The occurrence of orthorexia reaches up to 7% in the general population, 72% in patients with type 1 diabetes mellitus, 77% in case of inflammatory bowel disease, 71% among individuals suffering from celiac disease, 75% in those with rheumatoid arthritis, and 50% in case of cancer. Orthorexia nervosa predominantly affects females who are younger, have higher levels of education, select organic foods, prepare their own meals, and have other concurrent chronic illnesses. The distress associated with diagnosis is considered the primary factor contributing to the development of this condition. Orthorexia ultimately leads to malnutrition, weight loss, impaired social functioning, and poses a risk of complications during the management of patients suffering from chronic diseases. Conclusion. The prevalence of orthorexia nervosa in patients suffering from the exhibited chronic illnesses is significantly higher compared to the general population. Therefore, early detection of this condition and intervention are necessary to improve patient management. Further research is needed to assess the frequency of orthorexia among individuals suffering from other chronic diseases. [ABSTRACT FROM AUTHOR]

The aim of the study is to analyze and compare statistical indicators of the amount of total health expenditure and expenditure on health subsystems in order to determine the need to introduce new policies for managing the supply and demand of health services. The hypothesis that the distribution of resources among the different subsystems in Bulgaria differs significantly from the EU average is tested. Material and methods. The analysis methodology used includes graphical presentation of data. According to Eurostat, a total of 27 countries were observed. Results: The study analyzed the total amount of health expenditure as a percentage of Bulgaria's GDP to the other EU countries and Bulgaria to have a close result to the average. The resource allocation data for health subsystems were then examined. The data showed that there are large discrepancies in the structure of healthcare spending in Bulgaria compared to the EU average. These data reflect the concentration of hospital care costs in Bulgaria. All this shows that in Bulgaria excessive resources are spent on providing medical care in hospital treatment for diseases that can be treated on an ambulatory treatment. This is an indicator of irrational behavior of participants in the market of medical care and services. Conclusion: The hypothesis was proved that in Bulgaria we still do not use cost control effectively by managing the supply and demand of health services. [ABSTRACT FROM AUTHOR]

Precision livestock farming (PLF) tools are increasingly used in daily herd management to improve health, welfare, and overall production. While not intended to reduce greenhouse gas (GHG) emissions on farm, PLF tools can do so indirectly by improving overall efficiency, thereby reducing the emissions per unit of product. This work modelled the potential effects of commercially available PLF tools on whole enterprise and product emissions of two average Scottish dairy farm systems (an 8,000 L and 10,000 L herd) using the Agrecalc carbon footprinting tool. Scenarios modelled included an improvement in fertility and an improvement in fertility and yield from the introduction of an accelerometer-based sensor, and an improvement in health from introduction of an accelerometer-based sensor, with and without the use of management interventions. Use of a sensor intended to improve fertility had the largest reduction in total emissions (kg CO2e) of -1.42% for a 10,000 L farm, with management changes applied. The largest reduction in emissions from milk production (kg CO2e) of -2.31% was observed via fertility technology application in an 8,000 L farm, without management changes. The largest reduction in kg CO2e per kg fat and protein corrected milk of -6.72% was observed from an improvement in fertility and yield in a 10,000 L herd, with management changes. This study has highlighted the realistic opportunities available to dairy farmers in low and high input dairy systems to reduce their emissions through adoption of animal mounted PLF technologies. [ABSTRACT FROM AUTHOR]

The capability of artificial intelligence (AI) is rapidly increasing and is now sitting on the threshold of the medical writing field. This article presents an AI integration framework that breaks down adoption of this new technology into manageable steps that ensure an informed and thorough approach. Using this framework, individuals and corporations can leverage the benefits of this evolving technology while minimizing risks. The first step, AI literacy, provides a foundation for informed decision making and appropriate expectations for AI capabilities. This knowledge inspires creative exploration of which use cases would be a suitable application of AI tools. Once the scope of potential uses is defined, risks can be assessed, including incorrect content generation, data leakage, and bias. AI tools can then be evaluated to find tools that can both satisfy the use cases and mitigate critical threats. The final step is to integrate the tools transparently with appropriate guardrails. Then the cycle begins again as AI technology evolves and new applications become possible. As medical writers are ushered further into the AI era, clear and consistent advocacy for a synergy point between the efficiency of AI and the experience, ability, and humanity of a medical writer will maximize the impact of these innovative models. [ABSTRACT FROM AUTHOR]

The editorial article of the magazine "Information, Culture and Society" celebrates its 50th edition, highlighting its commitment to quality and academic relevance. For 25 years, the magazine has been a space for interdisciplinary exchange in the field of Library Science and Information Sciences. Open access to publications is emphasized, which democratizes access to scientific and technical information. In addition, contributions are presented on topics such as digital preservation in Colombia, electronic documentation management, and local cultural policy in the Barcelona Library network, among others. [Extracted from the article]

COVID-19 disproportionately affects people experiencing homelessness or incarceration. While homelessness or incarceration alone may not impact vaccine effectiveness, medical comorbidities along with social conditions associated with homelessness or incarceration may impact estimated vaccine effectiveness. COVID-19 vaccines reduce rates of hospitalization and death; vaccine effectiveness (VE) against severe outcomes in people experiencing homelessness or incarceration is unknown. We conducted a retrospective, observational cohort study evaluating COVID-19 vaccine VE against SARS-CoV-2 related hospitalization (positive SARS-CoV-2 molecular test same week or within 3 weeks prior to hospital admission) among patients who had experienced homelessness or incarceration. We utilized data from 8 health systems in the Minnesota Electronic Health Record Consortium linked to data from Minnesota's immunization information system, Homeless Management Information System, and Department of Corrections. We included patients 18 years and older with a history of experiencing homelessness or incarceration. VE and 95% Confidence Intervals (CI) against SARS-CoV-2 hospitalization were estimated for primary series and one booster dose from Cox proportional hazard models as 100*(1-Hazard Ratio) during August 26, 2021, through October 8, 2022 adjusting for patient age, sex, comorbid medical conditions, and race/ethnicity. We included 80,051 individuals who had experienced homelessness or incarceration. Adjusted VE was 52% (95% CI, 41–60%) among those 22 weeks or more since their primary series, 66% (95% CI, 53–75%) among those less than 22 weeks since their primary series, and 69% (95% CI: 60–76%) among those with one booster. VE estimates were consistently lower during the Omicron predominance period compared with the combined Omicron and Delta periods. Despite higher exposure risk, COVID-19 vaccines provided good effectiveness against SARS-CoV-2 related hospitalizations in persons who have experienced homelessness or incarceration. [ABSTRACT FROM AUTHOR]

Sensitive images represent a new challenge in enterprise imaging. These images, often containing nudity or gruesome content, have the potential to cause emotional harm to patients and people who view the images. Unfortunately, the interoperability standards used in imaging informatics have not yet addressed this issue. Because of this, the software solutions used in healthcare information technology are not able to offer patients and other viewers of image protections. In this Health Information Management Systems Society (HIMSS)/Society for Imaging Informatics in Medicine (SIIM) Enterprise Imaging Community Whitepaper, we define sensitive images, identify unique challenges related to their management, and provide recommendations for future solutions to protect our patients. [ABSTRACT FROM AUTHOR]

Electronic state property management in Indonesia uses the State Property Management and Accounting Information System (SIMAK-BMN). SIMAK-BMN has succeeded in attracting the attention of many parties because it is believed to be able to facilitate the process of administering state property in an institution. Agencies that implemented electronic state property management have faced several challenges in the fields of human resources and information systems. This article aims to determine the effectiveness of electronic state property management in Indonesia. The research method used is a descriptive method with a qualitative approach. Data collection was carried out by studying secondary data literature, including scientific articles/journals, legal regulations, books, and websites related to state property management. The research results show that electronic state property management in Indonesia has been running effectively despite the challenges. Therefore, efforts to maximize the function of SIMAK-BMN continue to be carried out sustainably. [ABSTRACT FROM AUTHOR]

Healthcare is a critical area where blockchain technology (BT) is being heralded as a potential game-changer for facilitating secure and efficient data sharing. The purpose of this review is to examine BT applications, performance challenges, and solutions in healthcare. To begin, This review paper explores popular blockchain networks for data exchange, encompassing both public and permissioned platforms, such as Ethereum and Hyperledger Fabric. This paper analyzes the potential applications of BT's decentralized, immutable, and smart contract capabilities in healthcare settings, including secure and interoperable health data exchange, patient consent management, drug supply chain oversight, and clinical trial management. The healthcare industry might greatly benefit from the increased privacy, transparency, and accessibility that these technologies provide. Despite BT's promising medical uses, the technology is not without its drawbacks. High energy consumption, throughput, and scalability are all concerns. We wrapped up by discussing the solutions that have been implemented, including consensus processes, scalability measures like sharding, and off-chain transactions that are designed to mitigate the drawbacks. [ABSTRACT FROM AUTHOR]

Background: Low-quality data presents a significant challenge for community health workers (CHWs) in low and middle-income countries (LMICs). Mobile health (mHealth) applications offer a solution by enabling CHWs to record and submit data electronically. However, the barriers and benefits of mHealth usage among CHWs in informal urban settlements remain poorly understood. This study sought to determine the barriers and benefits of mHealth among CHWs in Banda parish, Kampala. Methods: This qualitative study involved 12 key informant interviews (KIIs) among focal persons from Kampala City Council Authority (KCCA) and NGOs involved in data collected by CHWs, and officials from the Ministry of Health (MOH) and two mixed-sex Focused Group Discussions (FGDs) of CHWs from Banda parish, Kampala district. Data analysis utilised Atlas Ti Version 7.5.7. Thematic analysis was conducted, and themes were aligned with the social-ecological model. Results: Three themes of institutional and policy, community and interpersonal, and individual aligning to the Social ecological model highlighted the factors contributing to barriers and the benefits of mHealth among CHWs for iCCM. The key barriers to usability, acceptability and sustainability included high training costs, CHW demotivation, infrastructure limitations, data security concerns, community awareness deficits, and skill deficiencies. Conversely, mHealth offers benefits such as timely data submission, enhanced data quality, geo-mapping capabilities, improved CHW performance monitoring, community health surveillance, cost-effective reporting, and CHW empowering with technology. Conclusion: Despite limited mHealth experience, CHWs expressed enthusiasm for its potential. Implementation was viewed as a solution to multiple challenges, facilitating access to health information, efficient data reporting, and administrative processes, particularly in resource-constrained settings. Successful mHealth implementation requires addressing CHWs' demotivation, ensuring reliable power and network connectivity, and enhancing capacity for digital data ethics and management. By overcoming these barriers, mHealth can significantly enhance healthcare delivery at the community level, leveraging technology to optimize resource utilization and improve health outcomes. mHealth holds promise for transforming CHW practices, yet its effective integration necessitates targeted interventions to address systemic challenges and ensure sustainable implementation in LMIC contexts. [ABSTRACT FROM AUTHOR]

Nowadays, the adoption of the Internet of Things (IoT) framework in various healthcare industries has increased rapidly in recent years. The IoT devices generate vast amounts of sensitive data, such as personal health information. It is mandatory to protect medical records from unauthorized access and use. However, the finite resources nature of these devices can make it hard to implement robust security measures, such as encryption and authentication. A blockchain is a propitious approach for the secure management of medical records in an immutable way. This problem can be resolved with ciphertext-policy attribute-based encryption (CP-ABE), which permits granular access control in IoT. The local gateways that are directly interfaced with the Ethereum blockchain-based smart contract platform are utilized to create and implement a distributed and dependable user authentication and an access control mechanism for IoMT. In this paper, a DBC-based CP-ABE approach offers a secure and decentralized solution for secure communication and data protection and provides a more secure and trustworthy system. The system works on the concept of an Elliptical Curve Cryptography-based CP-ABE method to reduce complexity and provide data security in remote patient monitoring. On the other hand, blockchain-based smart contracts offer a dynamic, optimal, and self-adjusted access control in smart healthcare systems. It lowers the overhead of conducting resource-intensive authentication procedures and blockchain communications at IoT devices. The result provides the efficiency of the proposed work in computation as well as processing time and its resistance to various security intrusions over existing schemes. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To examine patient and provider perspectives on privacy and security considerations in telemedicine during the COVID-19 pandemic. STUDY DESIGN: Qualitative study with patients and providers from primary care practices in 3 National Patient- Centered Clinical Research Network sites in New York, New York; North Carolina; and Florida. METHODS: Semistructured interviews were conducted, audio recorded, transcribed verbatim, and coded using an inductive process. Data related to privacy and information security were analyzed. RESULTS: Sixty-five patients and 21 providers participated. Patients and providers faced technology-related security concerns as well as difficulties ensuring privacy in the transformed shared space of telemedicine. Patients expressed increased comfort doing telemedicine from home but often did not like their providers to offer virtual visits from outside an office setting. Providers initially struggled to find secure and Health Insurance Portability and Accountability Act--compliant platforms and devices to host the software. Whereas some patients preferred familiar platforms such as FaceTime, others recognized potential security concerns. Audio-only encounters sometimes raised patient concerns that they would not be able to confirm the identity of the provider. CONCLUSIONS: Telemedicine led to novel concerns about privacy because patients and providers were often at home or in public spaces, and they shared concerns about software and hardware security. In addition to technological safeguards, our study emphasizes the critical role of physical infrastructure in ensuring privacy and security. As telemedicine continues to evolve, it is important to address and mitigate concerns around privacy and security to ensure high-quality and safe delivery of care to patients in remote settings. [ABSTRACT FROM AUTHOR]

The current regulatory path for new drug registration in East Asian countries has led to significant delay of the new medicines in these countries. A unified regulatory path and allowance of mutual usage of clinical data in East Asian countries would lead to cost saving in drug development and expedite the new drug registration in these countries. The objectives of the present analysis are to compare the approval dates of a selection of products developed by Pfizer in the United States and East Asian countries (China, Japan, Korea) and compare the pharmacokinetics and recommended doses of these products in East Asian countries. Eighteen products (20 drugs, 2 products with 2 combination drugs) with exposure data available in at least 2 of the 3 East Asian countries across different therapeutic areas were included in the analyses. The results showed that most products had delayed approval in East Asian countries (up to 8 years) after US or EU approval. No distinct differences were observed in the drug exposure and recommended doses for the selected products in East Asian countries. These results together with literature data of genetic similarity of the East Asian populations support the mutual usage of the clinical data in the East Asian countries for expedited regulatory submission and approval. [ABSTRACT FROM AUTHOR]

Objectives: Management of medical records at Sandi Karsa Hospital Makassar is still lacking in the process of assembling, reporting, and filing. This study aims to analyze the inpatient medical record management system at Sandi Karsa Hospital, Makassar. Methods: The type of research used in this research is qualitative research and data collection using interviews, observation, and documentation with key informants and supporting informants using purposive sampling techniques. Result: There is a shortage of medical records officers, and they have not received training. There are fewer computers available, SIMRS is only integrated with patient registration, and the management room is combined with the filing room. The assembly process has not been carried out in the last few months, reporting has been delayed, and there is a backlog of files. Implementation of management SOPs has not been optimal, and socialization activities have not been carried out. Completeness and returns are not up to standard. Medical record quality indicators are low, and there are no feedback activities. Conclusion: Lack of staff they have never participated in training and socialization regarding SOPs. There is a lack of facilities such as computers, the medical record room has lots of files, SIMRS is not yet integrated with medical record management, and there are delays in returns and incomplete filling out of medical record files. The hospital can provide outreach and hold regularly scheduled meetings to evaluate or assess officers' performance managing medical records. [ABSTRACT FROM AUTHOR]

Background: Medical certification of cause of death (MCCD) provides valuable data regarding disease burden in a community and for formulating health policy. Inaccurate MCCDs can significantly impair the precision of national health information. Objective: To evaluate the accuracy of cause of death certificates prepared at two tertiary cancer care hospitals in Northern India during the study period (May 2018 to December 2020). Method: A retrospective observational study at two tertiary cancer care hospitals in Varanasi, India, over a period of two and a half years. Medical records and cause of death certificates of all decedents were examined. Demographic characteristics, administrative details and cause of death data were collected using the WHO recommended death certificates. Accuracy of death certification was validated by electronic medical records and errors were graded. Results: A total of 778 deaths occurred in the two centres during the study period. Of these, only 30 (3.9%) certificates were error-free; 591 (75.9%) certificates had an inappropriate immediate cause of death; 231 (29.7%) certificates had incorrectly labelled modes of death as the immediate cause of death; and 585 (75.2%) certificates had an incorrect underlying cause of death. The majority of certificates were prepared by junior doctors and were significantly associated with higher certification errors. Conclusion: A high rate of errors was identified in death certification at the cancer care hospitals during the study period. Inaccurate MCCDs related to cancers can potentially influence cancer statistics and thereby affect policy making for cancer control. Implications: This study has identified the pressing need for appropriate interventions to improve quality of certification through training of doctors. [ABSTRACT FROM AUTHOR]

Background: The Australian hospital-acquired complication (HAC) policy was introduced to facilitate negative funding adjustments in Australian hospitals using ICD-10-AM codes. Objective: The aim of this study was to determine the positive predictive value (PPV) of the ICD-10-AM codes in the HAC framework to detect hospital-acquired pneumonia in patients with cancer and to describe any change in PPV before and after implementation of an electronic medical record (EMR) at our centre. Method: A retrospective case review of all coded pneumonia episodes at the Peter MacCallum Cancer Centre in Melbourne, Australia spanning two time periods (01 July 2015 to 30 June 2017 [pre-EMR period] and 01 September 2020 to 28 February 2021 [EMR period]) was performed to determine the proportion of events satisfying standardised surveillance definitions. Results: HAC-coded pneumonia occurred in 3.66% (n = 151) of 41,260 separations during the study period. Of the 151 coded pneumonia separations, 27 satisfied consensus surveillance criteria, corresponding to an overall PPV of 0.18 (95% CI: 0.12, 0.25). The PPV was approximately three times higher following EMR implementation (0.34 [95% CI: 0.19, 0.53] versus 0.13 [95% CI: 0.08, 0.21]; p =.013). Conclusion: The current HAC definition is a poor-to-moderate classifier for hospital-acquired pneumonia in patients with cancer and, therefore, may not accurately reflect hospital-level quality improvement. Implementation of an EMR did enhance case detection, and future refinements to administratively coded data in support of robust monitoring frameworks should focus on EMR systems. Implications: Although ICD-10-AM data are readily available in Australian healthcare settings, these data are not sufficient for monitoring and reporting of hospital-acquired pneumonia in haematology-oncology patients. [ABSTRACT FROM AUTHOR]

Objective: This article describes the first digital clinical information system tailored to support the operational needs of a forensic unit in Greece and to maintain its archives. Method: The development of our system was initiated towards the end of 2018, as a close collaboration between the Medical School of the University of Crete and the Forensic Medicine Unit of the University Hospital of Heraklion, Crete, where forensic pathologists assumed active roles during the specification and testing of the system. Results: The final prototype of the system was able to manage the life cycle of any forensic case by allowing users to create new records, assign them to forensic pathologists, upload reports, multimedia and any required files; mark the end of processing, issue certificates or appropriate legal documents, produce reports and generate statistics. For the first 4 years of digitised data (2017–2021), the system recorded 2936 forensic examinations categorised as 106 crime scene investigations, 259 external examinations, 912 autopsies, 102 post-mortem CT examinations, 804 histological examinations, 116 clinical examinations, 12 anthropological examinations and 625 embalmings. Conclusion: This research represents the first systematic effort to record forensic cases through a digital clinical information system in Greece, and to demonstrate its effectiveness, daily usability and vast potential for data extraction and for future research. [ABSTRACT FROM AUTHOR]

Background: Historically, national programs for collecting stroke data in Australia required the use of multiple online tools. Clinicians were required to enter overlapping variables for the same patient in the different databases. From 2013 to 2016, the Australian Stroke Data Tool (AuSDaT) was built as an integrated data management solution. Objective: In this article, we have described the development, implementation, and evaluation phases of establishing the AuSDaT. Method: In the development phase, a governance structure with representatives from different data collection programs was established. Harmonisation of data variables, drawn from six programs used in hospitals for monitoring stroke care, was facilitated through creating a National Stroke Data Dictionary. The implementation phase involved a staged deployment for two national programs over 12 months. The evaluation included an online survey of people who had used the AuSDaT between March 2018 and May 2018. Results: By July 2016, data entered for an individual patient was, for the first time, shared between national programs. Overall, 119/422 users (90% female, 61% aged 30–49 years, 57% nurses) completed the online evaluation survey. The two most positive features reported about the AuSDaT were (i) accessibility of the system (including simultaneous user access), and (ii) the ability to download reports to benchmark local data against peer hospitals or national performance. More than three quarters of respondents (n = 92, 77%) reported overall satisfaction with the data collection tool. Conclusion: The AuSDaT reduces duplication and enables users from different national programs for stroke to enter standardised data into a single system. Implications: This example may assist others who seek to establish a harmonised data management solution for different disease areas where multiple programs of data collection exist. The importance of undertaking continuous evaluation of end-users to identify preferences and aspects of the tool that are not meeting current requirements were illustrated. We also highlighted the opportunities to increase interoperability, utility, and facilitate the exchange of accurate and meaningful data. [ABSTRACT FROM AUTHOR]

Background: The professional identity and motivation of qualified health information managers (HIMs) is largely unexplored. Objectives: A larger study has investigated the motivators of HIMs in the construction of their professional identity and associated relationships to job satisfaction and engagement with their profession. The aims of this component of the study were to: (i) identify and analyse the characteristics of members of the profession who have different motivation profiles; (ii) obtain HIMs' perspectives on their professional identity; and (iii) measure correlation between HIMs' professional identity and different motivating factors. Method: A cross-sectional study design, with a convergent mixed-methods approach to data collection was employed. An online survey was administered to the 1985, 1995, 2005 and 2015 Australian health information management and medical record administration graduate cohorts from one university in Victoria. Results: Response rate: 72.7% (n = 72). There were no statistically significant correlations between the HIMs' motivation profile and professional identity. The HIMs were largely motivated by a need for achievement (striving for excellence) and continuous improvement; maintained high standards of work quality (95.8%); valued their work (94.4%) and work collaborations (84.7%); satisfactorily applied skills-knowledge (94%); demonstrated a very strong professional association (92% were proud to belong to the profession). Key factors in motivation that were consistently reported by members of all cohorts in the open-ended questions were as follows: intrinsic motivation; colleagues and teamwork; the variety of work performed; and contribution to the bigger picture. Overall, and notwithstanding between-cohort differences: 65.3% confidently directed others, 45.8% aspired to leadership and 38% actively networked. They related difficulty in explaining the profession to outsiders. Conclusion: There was no correlation between motivation profile and professional identity. Significantly, the HIMs demonstrated exceptionally strong positive professional identity, reflected particularly in pride in membership of the profession and their belief in the importance of their professional work. [ABSTRACT FROM AUTHOR]

Context: Access to real-time data that provide accurate and timely information about the status and extent of disease spread could assist management of the COVID-19 pandemic and inform decision-making. Aim: To demonstrate our experience with regard to implementation of technical and architectural infrastructure for a near real-time electronic health record-based surveillance system for COVID-19 in Iran. Method: This COVID-19 surveillance system was developed from hospital information and electronic health record (EHR) systems available in the study hospitals in conjunction with a set of open-source solutions; and designed to integrate data from multiple resources to provide near real-time access to COVID-19 patients' data, as well as a pool of health data for analytical and decision-making purposes. Outcomes: Using this surveillance system, we were able to monitor confirmed and suspected cases of COVID-19 in our population and to automatically notify stakeholders. Based on aggregated data collected, this surveillance system was able to facilitate many activities, such as resource allocation for hospitals, including managing bed allocations, providing and distributing equipment and funding, and setting up isolation centres. Conclusion: Electronic health record systems and an integrated data analytics infrastructure are effective tools to enable policymakers to make better decisions, and for epidemiologists to conduct improved analyses regarding COVID-19. Implications: Improved quality of clinical coding for better case finding, improved quality of health information in data sources, data-sharing agreements, and increased EHR coverage in the population can empower EHR-based COVID-19 surveillance systems. [ABSTRACT FROM AUTHOR]

Background: The International Classification of Diseases (ICD) is widely used by clinical coders worldwide for clinical coding morbidity data into administrative health databases. Accordingly, hospital data quality largely depends on the coders' skills acquired during ICD training, which varies greatly across countries. Objective: To characterise the current landscape of international ICD clinical coding training. Method: An online questionnaire was created to survey the 194 World Health Organization (WHO) member countries. Questions focused on the training provided to clinical coding professionals. The survey was distributed to potential participants who met specific criteria, and to organisations specialised in the topic, such as WHO Collaborating Centres, to be forwarded to their representatives. Responses were analysed using descriptive statistics. Results: Data from 47 respondents from 26 countries revealed disparities in all inquired topics. However, most participants reported clinical coders as the primary person assigning ICD codes. Although training was available in all countries, some did not mandate training qualifications, and those that did differed in type and duration of training, with college or university degree being most common. Clinical coding certificates most frequently entailed passing a certification exam. Most countries offered continuing training opportunities, and provided a range of support resources for clinical coders. Conclusion: Variability in clinical coder training could affect data collection worldwide, thus potentially hindering international comparability of health data. Implications: These findings could encourage countries to improve their resources and training programs available for clinical coders and will ultimately be valuable to the WHO for the standardisation of ICD training. [ABSTRACT FROM AUTHOR]

Heavy metal pollution in agricultural soils is one of the main problems in agricultural production worldwide, which threatens human health and the environment. To evaluate the pollution levels of heavy metals and the ecological risks in an agricultural area from Sánchez Ramírez Province, Dominican Republic, the concentration levels of heavy metals (Fe, Mn, Cr, Ni, Cu, Zn, Pb, and As) were measured using energy-dispersive X-ray fluorescence spectroscopy (EDXRF). Several pollution indices, including the geo-accumulation index (Igeo), enrichment factor (EF), and single pollution index (PI), were used to investigate the pollution status. The spatial distribution of different heavy metals in the studied soils was also determined. The mean concentrations of Fe, Mn, Cr, Ni, Cu, Zn, Pb, and As were 73735, 1616, 426; 34; 20; 200; 43; and 5 mg kg−1, respectively. These results indicated that the mean concentration of Cr, Cu, Zn, and Pb exceeded FAO-recommended levels for healthy agricultural soils. However, the potential ecological risks assessment indicated a low-risk status. The results obtained could help improve soil–rice–environment management practices and prevent heavy metal pollution in this type of production system, protecting the health of the local population and the environment. [ABSTRACT FROM AUTHOR]

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Background: Food safety has always been a major concern for people, and frequent food safety incidents pose a serious threat to people's health and safety. To identify high-risk patterns in the field of food safety and assist regulatory authorities in scientifically managing food safety risks, this study aims to evaluate food safety risks from multiple dimensions and provide a scientific basis for formulating targeted food safety management measures. Methods: The risk matrix method, along with the Borda method, is used to evaluate food safety risks. Based on the constructed food safety incident database, the risk matrix method is applied for static risk assessment from seven aspects: food categories, years, provinces, incident entities, causes, pollution sources, and links, and for dynamic risk assessment in different provinces. Results: The top five food categories in risk ranking are meat and meat products, fruits and vegetables, grain and grain products, other category, and aquatic products. Food safety risks show an increasing trend year by year, with the years 2006, 2012-2015 and 2019 having higher risk rankings. The top three provinces in risk ranking are Hunan, Guangdong, and Shaanxi. The top four entities in risk ranking are restaurants, enterprises, households, and canteens. The top four causes in risk ranking are human intention, human error, mismanagement, and production and social environment. The top four pollution sources in risk ranking include chemical pollution, other pollution, biological pollution, and food additives. The top three links in risk ranking include production and processing link, catering link, and agricultural production link. Across provinces, food safety risks in the years 2012-2015 are generally higher compared to other years, with the highest number of high-risk provinces in 2014. Implication: The findings of this study have significant implications for food safety management in China. By implementing food safety risk prevention and control countermeasures proposed, China can strengthen its food safety management framework, reduce the incidence of food safety incidents, and safeguard the health and well-being of its population. [ABSTRACT FROM AUTHOR]

Background: Family doctors, serving as gatekeepers, are the core of primary health care to meet basic health needs, provide accessible care, and improve attainable health. The study objective was to evaluate the impact of the family doctor system on health service utilization among patients with hypertension and diabetes in China. Methods: Difference-in-Differences (DID) models are constructed to estimate the net effect of the family doctor system, based on the official health management records and medical insurance claim data of patients with hypertension and diabetes in an eastern city of China. Results: The family doctor system significantly increases follow-up visits (hypertension patients coef. = 0.13, diabetes patients coef. = 0.08, both p < 0.001) and outpatient visits (hypertension patients coef. = 0.08, diabetes patients coef. = 0.05, both p < 0.001) among the contracted compared to the non-contracted. The proportion of outpatient visits in community health centers among the contracted significantly rose (hypertension patients coef. = 0.02, diabetes patients coef. = 0.04, both p < 0.001) due to significantly more outpatient visits in community health centers and fewer in secondary and tertiary hospitals. It also significantly mitigates the increase in inpatient admissions among hypertension patients but not among diabetes patients. Conclusions: The examined family doctor system strengthens primary care, both by increasing follow-up visits and outpatient visits and promoting a rationalized structure of outpatient utilization in China. [ABSTRACT FROM AUTHOR]

Purpose: Timely and accurate data on the epidemiology of sepsis are essential to inform policy decisions and research priorities. We aimed to investigate the validity of inpatient administrative health data (IAHD) for surveillance and quality assurance of sepsis care. Methods: We conducted a retrospective validation study in a disproportional stratified random sample of 10,334 inpatient cases of age ≥ 15 years treated in 2015–2017 in ten German hospitals. The accuracy of coding of sepsis and risk factors for mortality in IAHD was assessed compared to reference standard diagnoses obtained by a chart review. Hospital-level risk-adjusted mortality of sepsis as calculated from IAHD information was compared to mortality calculated from chart review information. Results: ICD-coding of sepsis in IAHD showed high positive predictive value (76.9–85.7% depending on sepsis definition), but low sensitivity (26.8–38%), which led to an underestimation of sepsis incidence (1.4% vs. 3.3% for severe sepsis-1). Not naming sepsis in the chart was strongly associated with under-coding of sepsis. The frequency of correctly naming sepsis and ICD-coding of sepsis varied strongly between hospitals (range of sensitivity of naming: 29–71.7%, of ICD-diagnosis: 10.7–58.5%). Risk-adjusted mortality of sepsis per hospital calculated from coding in IAHD showed no substantial correlation to reference standard risk-adjusted mortality (r = 0.09). Conclusion: Due to the under-coding of sepsis in IAHD, previous epidemiological studies underestimated the burden of sepsis in Germany. There is a large variability between hospitals in accuracy of diagnosing and coding of sepsis. Therefore, IAHD alone is not suited to assess quality of sepsis care. [ABSTRACT FROM AUTHOR]

E-health is being adapted in modern hospitals as a significant addition to the existing healthcare services. To this end, modern hospitals urgently require a mobile, high-capacity, secure, and cost-effective communication infrastructure. In this paper, we explore potential applications of a hybrid broadband power line communication (PLC) and Wi-Fi in an indoor hospital scenario. It utilizes the existing power line cables and Wi-Fi plug-and-play devices for indoor broadband communication. Broadband power line (BPL) adaptors with Wi-Fi outputs are used to build an access network in hospitals, particularly in areas where the wireless router signal is poor. The Tenda PH10 AV1,000 AC Wi-Fi power line adapter is a set of BPL adapters that offer operational bandwidth of up to 1,000 Mbps. These adapters are based on the HomePlug AV2 protocol and can provide a data rate up to 200 Mbps on the physical layer. An experiment using the PLC Wi-Fi kit is carried out to show that a Wi-Fi and PLC hybrid network is the best candidate to provide wide range of practical applications in a hospital including, but not limited to, telemedicine, electronic medical records, early-stage disease diagnosis, health management, real-time monitoring, and remote surgeries. [ABSTRACT FROM AUTHOR]

The article offers a perspective on options, opportunities and limits of health system evaluation. Innovations in evaluation methods, approach and data that have opened possibilities for health system evaluation include randomized health system trials, causal inference methods and technologies for data collection and analysis. It discusses the challenges of data quality and completeness in regions that lack registration data system, as well as the applications of big data for health research.

The benefits of research data sharing abound in the literature. However, some factors define how researchers and clinicians approach the challenges surrounding sharing human movement health research data. To describe the perceptions of human movement researchers and clinicians on the barriers and facilitators to research data sharing in Africa. A qualitative descriptive design with a purposive sampling method was used. In-depth interviews with human movement researchers and clinicians across Africa were conducted online via Microsoft Teams. Sixteen (n = 16) participants took part in this study. This sample size was representative of East, West, Northern, and Southern Africa. Efforts made to engage with participants in Central Africa were unsuccessful. Five themes emerged: 1) the researcher-clinician gap; 2) technological pros and cons in Africa; 3) cost matters; 4) bureaucracy and ethical factors; and 5) the unique African perspective. Mainly, barriers rather than facilitators to data sharing exist among African human movement researchers and clinicians. There needs to be a societal and psychological shift through reorientation to encourage data sharing among African human movement researchers and clinicians. [ABSTRACT FROM AUTHOR]

Death is an inevitable part of life and highly relevant to information management: its approach often requires preparation, and its occurrence often demands a response. Many works in information science have acknowledged so much, and yet death is rarely a focused topic, appearing instead sporadically and disconnected across research. As a result there is no introduction to, overview of, or synthesis across studies on death and information. We therefore conducted an extensive literature search and reviewed nearly 300 scholarly publications at the intersection of death and information (and data) management. Covering seven topics in total, we review two groups of work directly engaging information management in relation to death (digital possessions, inheritance, and legacy; information behavior, needs, and practices around death), three engaging death and technology that require information and its management (death and the Internet, thanatosensitive design and technology‐augmented death practices, and the digital afterlife and digital immortality), and two reflecting the ethical and legal dimensions unique to death and information. We then integrate the collective findings to summarize the landscape of death‐related information research, outline remaining challenges for individuals, families, institutions, and society, and identify promising directions for future information science research. [ABSTRACT FROM AUTHOR]

Background During the pandemic, countries utilized various forms of statistical estimations of coronavirus disease-2019 (COVID-19) impact. Differences between databases make direct comparisons and interpretations of data in different countries a challenge. We evaluated country-specific approaches to COVID-19 data and recommended changes that would improve future international collaborations. Methods We compared the COVID-19 reports presented on official UK (National Health System), Israeli (Department of Health), Latvian (Center for Disease Prevention and Control) and USA (Centers for Disease Control and Prevention) health authorities' websites. Results Our analysis demonstrated critical differences in the ways COVID-19 statistics were made available to the general and scientific communities. Specifically, the differences in approaches were found in the presentation of the number of infected cases and tests, and percentage of positive cases, the number of severe cases, the number of vaccinated, and the number and percent of deaths. Conclusion Findability, Accessibility, Interoperability and Reusability principles could guide the development of essential global standards that provide a basis for communication within and outside of the scientific community. [ABSTRACT FROM AUTHOR]

Background: The term infodemic refers to the proliferation of both accurate and inaccurate information that creates a challenge in identifying trustworthy and credible sources. Among the strategies employed to mitigate the impact of the infodemic, social media literacy has emerged as a significant and effective approach. This systematic review examines the role of social media literacy in the management of the infodemic. Methods: Six databases, including SID, Magiran, Scopus, PubMed, Google Scholar and Web of Science were systematically searched using relevant keywords. We included the relevant publications between 2012 and 2023 in our analysis. To ensure a qualitative assessment of the studies, we used the STROBE and AMSTAR checklists as evaluation tools. The Preferred Reporting Items for Systematic Reviews (PRISMA) guideline was used for the design of this review study. Finally, we organized the studies into groups based on similarities and retrieved and analyzed evidence pertaining to the challenges and opportunities identified. Results: Eleven papers were included in this study after reviewing the retrieved studies. Five of them examined the effect of social media literacy and health literacy on acceptance of health behaviors. Four studies investigated the role of media literacy in managing misinformation and fake news related to health. Two studies focused on infodemic management and promoting citizen engagement during health crises. Results showed that health-related infodemics are derived from the users' lack of media knowledge, distrust of government service systems, local influencers and peers, rapid circulation of information through mass media messages, weakness of solutions proposed by health care providers, failure to pay attention to the needs of the audience, vertical management, and inconsistency of published messages. Conclusion: The findings of this study highlight the importance of increasing social media literacy among the general public as a recognized strategy for managing the infodemic. Consequently, it is recommended that relevant organizations and institutions, such as the Ministry of Health, develop targeted training programs to effectively address this need. [ABSTRACT FROM AUTHOR]

Considering growing demand of medical record management it has been considered that there is requirement to keep patient record and identity management in healthcare. To improve the safety and reliability of medical records, the blockchain technology has been determined to be an appropriate tool. The function of blockchain technology in healthcare data security is the focus of this study article. An example of a transaction in this system would be the recording and storage of a patient's medical history in a public ledger known as a block. Two parties are required for a transaction to take place. For every transaction to go through, the system needs the approval of the vast majority of users. Records of transactions kept on a blockchain are immutable and resistant to tampering. Researchers are now encrypting patient data before storing it on blockchain, which adds an extra degree of protection. Additionally, blockchain's security and speed have been enhanced by the use of advanced hashing mechanisms. [ABSTRACT FROM AUTHOR]

Objective: In the age of digital transformation, there is a need for a sustainable information management vision in health. Understanding the accumulation of health information management (HIM) knowledge from the past to the present and building a new vision to meet this need reveals the importance of understanding the available scientific knowledge. With this research, it is aimed to examine the scientific documents of the last 40 years of HIM literature with a holistic approach using science mapping techniques and to guide future research. Methods: This study used a bibliometric analysis method for science mapping. Co-citation and co-occurrence document analyses were performed on 630 academic publications selected from the Web of Science core collection (WoSCC) database using the keyword "Health Information Management" and inclusion criteria. The analyses were performed using the R-based software Bibliometrix (Version 4.0; K-Synth Srl), Python (Version 3.12.1; The Python Software Foundation), and Microsoft® Excel® 2016. Results: Co-occurrence analyses revealed the themes of personal health records, clinical coding and data quality, and health information management. The HIM theme consisted of five subthemes: "electronic records", "medical informatics", "e-health and telemedicine", "health education and awareness", and "health information systems (HISs)". As a result of the co-citation analysis, the prominent themes were technology acceptance, standardized clinical coding, the success of HISs, types of electronic records, people with HIM, health informatics used by consumers, e-health, e-mobile health technologies, and countries' frameworks and standards for HISs. Conclusions: This comprehensive bibliometric study shows that structured information can be helpful in understanding research trends in HIM. This study identified critical issues in HIM, identified meaningful themes, and explained the topic from a holistic perspective for all health system actors and stakeholders who want to work in the field of HIM. [ABSTRACT FROM AUTHOR]

Purpose: To compare the efficacy and safety of micropercutaneous nephrolithotomy (MPCNL) and flexible ureteroscopy (FURS) in the treatment of single upper ureteral calculi measuring 1 to 2 centimeters. Methods: This study is a retrospective analysis that combines a review of medical records with an outcomes management database. A total of 163 patients who underwent MPCNL and 137 patients who had FURS were identified between January 2017 and December 2021. Demographic data, operation time, hospitalization time, stone-free rate, and complication rate were collected and analyzed. Results: Preoperative general data of sex, age, BMI, serum creatinine, time of stone existence, stone hardness, stone diameter, preoperative hydronephrosis, and preoperative infection of the MPCNL group have no statistically significant difference with that of the FURS group. All MPCNL or FURS operations in both groups were successfully completed without any instances of reoperation or conversion to another surgical procedure. Patients who underwent MPCNL had a considerably reduced operation time (49.6 vs. 72.4 min; P<0.001), but a higher duration of hospitalization (9.1 vs. 3.9 days; P<0.001) compared to those who underwent FURS. The stone-free rate in the MPCNL group was superior to that of the FURS group, with a percentage of 90.8% compared to 71.5% (P<0.001). There was no statistically significant disparity in the rate of complications between the two groups (13.5% vs. 15.3%; P = 0.741). Conclusion: Both MPCNL and FURS are viable and secure surgical choices for individuals with solitary upper ureteral calculi measuring 1 to 2 cm. The FURS procedure resulted in a shorter duration of hospitalization compared to MPCNL. However, it had a comparatively lower rate of successfully removing the stones and required a longer duration for the operation.There were no substantial disparities observed in the complication rate between the two groups.FURS is the preferable option for treating uncomplicated upper ureteral calculi, whereas MPCNL is the preferable option for treating complicated upper ureteral calculi.Prior to making treatment options, it is crucial to take into account the expertise of surgeons, the quality of the equipment, and the preferences of the patient. Trial registration: No. [ABSTRACT FROM AUTHOR]

Background: Recurrences of low back pain (LBP) are frequent and associated with high levels of disability and medical costs. Regular exercise practice may be an effective strategy to prevent recurrences of LBP, however, the promotion of this behaviour by physiotherapists seems to be challenging. This study aims to explore physiotherapists' perceived barriers and facilitators to the implementation of a behaviour change-informed exercise intervention to promote the adoption of regular exercise practice by patients at risk of recurrence of low back pain. Methods: Two focus groups with primary healthcare physiotherapists were conducted, based on a semi-structured interview schedule informed by the Behaviour Change Wheel, including the Capability, Opportunity, Motivation–Behaviour (COM-B) model and the Theoretical Domains Framework (TDF). All focus groups were held through videoconference, audio and video recorded and transcribed verbatim. A deductive content analysis, using a coding matrix based on the COM-B and TDF, was performed by two independent researchers. A third researcher was approached to settle disagreements. Results: In total, 14 physiotherapists participated in the focus groups. The analysis revealed a total of 13 barriers (4 COM-B components and 7 TDF domains) and 23 facilitators (5 COM-B and 13 TDF) to physiotherapists' implementation of a behaviour change-informed exercise intervention. The most common barriers were the lack of skills and confidence to implement the proposed intervention. These were explained by the fact that it differs from the usual practice of most participants and requires the learning of new skills applied to their contexts. However, for those who had already implemented other similar interventions or whose rationale is aligned with the new intervention, there seemed to exist more positive determinants, such as potential benefits for physiotherapists and the profession, improvement of quality of care and willingness to change clinical practice. For others who did not previously succeed in implementing these types of interventions, more context-related barriers were mentioned, such as lack of time to implement the intervention, schedule incompatibilities and lack of material and human resources. Conclusions: This study identified modifiable barriers and facilitators to physiotherapists' implementation of a behaviour change-informed exercise intervention for patients at risk of recurrence of LBP in primary healthcare. The findings of this study will allow the systematic and theory-based development of a behaviour change-informed training programme, aimed at physiotherapists and supporting the successful implementation of the exercise intervention. [ABSTRACT FROM AUTHOR]