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Health Information Systems (HIS) constitute data compilation, reporting, dispensation and the use of information for better health service delivery at all levels. In Tanzania, health service is organised into three components (USAID, 2007): the district (the district hospital, health centres, dispensaries, and community health services), secondary and tertiary hospitals and other tertiary-level institutions (teaching institutions), and the central level which provides support services such as policy-making, donor coordination, monitoring and evaluation. The government of Tanzania is aware that improved HIS facilitates proper decision making regarding health care delivery. Using secondary data, this article discusses the application of information systems to improve health services delivery in Tanzania. Moreover, the article highlights the significance of digitally-based health information system in health care delivery. [ABSTRACT FROM AUTHOR]

The article discusses the completion design for the Cannonball field in offshore Trinidad. It notes that the design has selected 7⅝ inches production tubing with an open hole gravel pack (OHGP). Furthermore, a formation isolation device (FID) was used to prevent fluid loss to the formation after installation and for the reservoir's isolation. It states that the team developed a set of principles to guide them in the completion design, including the consistent the design and equipment.

Background: Many nurses join the profession because they have altruistic intentions, but some nurses experience barriers to acting on altruistic intentions which may be a source of job dissatisfaction or burnout., Objective: The purpose of this study was to evaluate construct validity, internal consistency, and convergence reliability of the Nursing Altruistic Execution Scale (NAES), a novel instrument assessing the perceived ability to help others through work., Methods: The NAES was developed based upon a literature review examining altruistic behavior as a motivator for nursing work, with expert feedback for instrument refinement. Participants completed the NAES, Copenhagen Burnout Inventory Work-Related Burnout Scale, and Satisfaction of Employees in Health Care Survey. Exploratory factor analysis examined construct validity and factor loadings. Confirmatory factor analysis verified consistency in factor structure. Linear regression assessed for convergence reliability with burnout and job satisfaction., Results: The sample included 843 acute care hospital nurses surveyed in January-March 2023. Exploratory factor analysis revealed a two-factor solution, named altruistic engagement with work and workplace barriers to altruism . Nine instrument items were retained and demonstrated strong internal consistency (Cronbach's alpha 0.79). There was a significant relationship between both factors of the NAES and both burnout and job satisfaction, demonstrating that greater altruistic execution is associated with lower burnout and greater job satisfaction., Conclusion: Preliminary findings support the use of the NAES as a valid and reliable scale. Findings show there is correlation between altruistic intentions and burnout. Interventions aimed at enhancing altruistic execution may reduce nurse burnout and thereby improve retention., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Gait analysis is a vital tool for evaluating overall health and predicting outcomes such as mortality and cognitive decline. This study explores how normal and obese BMI categories impact gait dynamics, addressing gaps in understanding the effect of body composition on specific gait parameters., Research Question: The primary objective is to investigate differences in spatiotemporal gait parameters-specifically, gait speed, step length, cadence, and double support time-between normal and obese BMI groups to understand the effects of obesity on gait., Methods: This observational case-control study analyzed spatiotemporal gait metrics from 163 participants, using inertial measurement units (IMUs) to collect data on various gait parameters. Statistical analyses explored the relationship between BMI categories and these metrics., Results: No significant differences were found in gait speed, cadence, stride duration, or double support time between the normal and obese groups. However, significant differences were identified in age, hypertension prevalence, balance problems, and the incidence of falls, emphasizing the complex effects of obesity on factors influencing gait stability., Significance: This study contributes to our understanding of obesity's impact on gait by highlighting the need to consider associated health and stability parameters. These findings prompt a re-evaluation of how BMI is integrated into clinical gait assessments and emphasize the necessity for personalized healthcare strategies. This research highlights the importance of future studies with larger, more diverse populations and a wider array of biomechanical measures to dissect the relationship between BMI, body composition, and gait dynamics.

Statement of Problem: Postoperative swelling following guided bone regeneration (GBR) may affect the dimensions of interim restorations and/or delivery timing. However, quantitative assessment of post-GBR swelling or its evaluation for possible impact on regenerative outcomes is lacking., Purpose: The purpose of this prospective clinical study was to quantify post-GBR swelling and correlate it with clinical parameters and outcomes., Material and Methods: Participants (n=25) undergoing standardized extraction and GBR protocol were recruited. Site-specific swelling was measured as ridge width, height, and volume changes based on intraoral scans recorded preoperatively, immediately postoperatively (IP), and at 2 days, 7 days, 14 days, and 4 months. The parameters and outcomes assessed were gingival and mucosal thickness, flap advancement, surgery duration, wound opening, and bone gain. The Friedman 2-way analysis of variance by ranks was performed, and the Spearman correlation coefficients (ρ) were computed (α=.05)., Results: Ridge width and height peaked at 2 days (2.1 mm for both from IP; P<.001 for both) and reached IP levels by 7 days and 14 days (P>.999 and P=.888, respectively). At 4 months, both decreased significantly compared with IP (-4.2 mm and -1.9 mm respectively, P<.001). Volume increases peaked at 2 days (19%, P<.001), and peak swelling (2 days) preceded maximum wound opening (7 days). Bone width at 4 months was correlated with gingival thickness (ρ=0.45, P=.043), mucosal thickness (ρ=0.51, P=.021), and flap advancement (ρ=0.58, P=.008)., Conclusions: Following GBR, site-specific swelling peaked on postoperative day 2 and subsided by day 7 (width) or 14 (height). Soft tissue thickness and flap advancement affected post-GBR bone width., (Copyright © 2024 Editorial Council for The Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Background: Adherence to study interventions is critical to the conduct of randomized controlled trials (RCTs). The relationships between participant characteristics and intervention adherence are understudied in pregnant populations. The purpose of this study was to conduct a secondary analysis of adherence to study capsules in a double-masked, placebo-controlled RCT of a probiotic intervention to reduce antenatal Group B Streptococcus colonization, in relationship to participant characteristics., Methods: We analyzed the relationship between capsule adherence rates and demographic characteristics among 81 RCT participants. Categorical variables were reported using counts and percentages, and continuous variables were expressed as means along with their standard deviations. For the univariate analyses, we compared demographic variables with adherence scores. A multivariate linear regression model was used to identify predictors of adherence., Results: Average adherence was similar for control and probiotic group participants (P = .86) Univariate analysis showed that average adherence increased directly with age, education, and income. Participants who were partnered or living with others had higher average adherence compared with those who were single and living alone. Asian and White participants had the highest and Black participants had the lowest average, and there was no difference based on Hispanic ethnicity. Adjusting for all the variables in the regression, participants who identified as Black were significantly less likely to adhere to capsules than White participants, and those who were married or living with partners were more likely to adhere than the single participants., Discussion: Diverse participants are critically important to RCTs. This secondary analysis provides evidence that participant characteristics and the social determinants of health play an important role in adherence to self-administered interventions in RCTs, although more research is needed. Our findings suggest that intentional consideration of RCT participant characteristics may allow for the development and tailoring of strategies to enhance intervention adherence. The study was registered on ClinicalTrials.gov (NCT03696953) on January 10, 2018., (© 2024 by the American College of Nurse‐Midwives.)

Background: Exposure to suffering can lead to compassion fatigue in undergraduate nursing students., Objective: Guided by resilience theory, a cross-sectional, correlational design was used to investigate the potential moderating effect of positive thinking skills on the relationships between views of suffering, compassion fatigue, and compassion satisfaction., Results: In 157 undergraduate nursing students, multiple regressions revealed that views of suffering and positive thinking explained 23.8% of the variance in compassion satisfaction ( F 11,145  = 4.121, P  < .001), and 21.9% of the variance in burnout ( F 11,144  = 3.786, P  < .001). The Suffering God view, which stresses the presence of a compassionate deity amid suffering, and positive thinking had significant main effects on compassion satisfaction (β = 0.349, P  = .025; and β = 0.309, P  < .001, respectively). Positive thinking, the Suffering God view, and the Random view, in which the occurrence of suffering is random and purposeless, had significant main effects on burnout (β = -0.280, P  < .001; β = -0.392, P  = .014; and β = -0.206, P  = .014, respectively). The Unorthodox view, in which a deity exists that allows suffering, had a significant main effect on secondary traumatic stress (β = 0.232, P  = .027). Positive thinking did not moderate any of the relationships between the views of suffering and the dependent variables., Conclusions: Knowledge of these relationships can aid in the assessment of nursing students at risk for poor outcomes and guide intervention development to promote professional quality of life., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Initially, the Hartmann's procedure was done to reduce mortality in surgery cases of malignant rectal lesions, and not benign disease. However, the procedure was popularized in the management of perforated diverticular disease (PDD) in the 1970s. Herein, we present a case of a patient who had laparotomy and colostomy for PDD. During the post-operative planning for reversal of the diverting colostomy, a contrast study was done that revealed that most of the sigmoid colon was in fact healthy. In this patient, the colon was severed at the point of the perforation and exteriorized, which allowed time for the resolution of the gut inflammatory changes. Thus, Hartmann's operation would have led to the unnecessary resection of the healthy sigmoid colon and possibly condemned the patient to an irreversible stoma. In severe PDD, where a Hartmann's procedure is considered, one could sever the colon at the site of perforation and bring out a colostomy while tacking the closed, unresected distal end near the ostomy. Further contrast studies of the colon could assist in planning resection and anastomosis., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Naraynsingh et al.)

Background: Many patients critically ill with COVID-19 develop acute respiratory distress syndrome (ARDS) necessitating mechanical ventilation and proning. Although proning is lifesaving, it has been linked to the occurrence of facial pressure injuries (PIs)., Objectives: To evaluate the incidence and use of prevention strategies and identify predictors of facial PIs in patients who received ventilator and proning treatments in COVID-designated intensive care units at 2 large quaternary medical centers in the Midwest., Method: This was a retrospective cohort study using data extracted from an electronic health record between October 2020 and February 2022. Demographics, clinical and care variables, and PI outcomes were analyzed to identify predictors of PI using logistic and Cox regression., Results: The cohort (N = 150) included patients from 2 units, unit a (n = 97) and unit b (n = 53) with a mean age of 60 years, with 68% identifying as male. Patients were vented for an average of 18 (SD, 16.2) days and proned for an average of 3 (SD, 2.5) days. Many (71%) died. Over half (56%) developed facial PI with a proning-exposure-adjusted incidence rate of 18.5%. Patients with PI were significantly different in several factors. Logistic regression showed predictors of PIs were duration of mechanical ventilation (in days; P = .02) and head turned (P = .01). Cox regression also identified head turn as predictive (P < .01), with Black/African American race as protective (P = .03)., Discussion: Critically ill patients with COVID-19 receiving ventilator and proning therapy developed facial PIs despite the use of recommended prevention practices. Further research on effective PI prevention strategies is needed., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Sepsis poses a significant global health challenge in low- and middle-income countries (LMICs). Several aspects of sepsis management recommended in international guidelines are often difficult or impossible to implement in resource-limited settings (RLS) due to issues related to cost, infrastructure, or lack of trained healthcare workers. The Indian Society of Critical Care Medicine (ISCCM) drafted a position statement for the management of sepsis in RLS focusing on India, facilitated by a task force of 18 intensivists using a Delphi process, to achieve consensus on various aspects of sepsis management which are challenging to implement in RLS. The process involved a comprehensive literature review, controlled feedback, and four iterative surveys conducted between 21 August 2023 and 21 September 2023. The domains addressed in the Delphi process included the need for a position statement, challenges in sepsis management, considerations for diagnosis, patient management while awaiting an intensive care unit (ICU) bed, and treatment of sepsis and septic shock in RLS. Consensus was achieved when 70% or more of the task force members voted either for or against statements using a Likert scale or a multiple-choice question (MCQ). The Delphi process with 100% participation of Task Force members in all rounds, generated consensus in 32 statements (91%) from which 20 clinical practice statements were drafted for the management of sepsis in RLS. The clinical practice statements will complement the existing international guidelines for the management of sepsis and provide valuable insights into tailoring sepsis interventions in the context of RLS, contributing to the global discourse on sepsis management. Future international guidelines should address the management of sepsis in RLS., How to Cite This Article: Juneja D, Nasa P, Chanchalani G, Cherian A, Jagiasi BG, Javeri Y, et al . The Indian Society of Critical Care Medicine Position Statement on the Management of Sepsis in Resource-limited Settings. Indian J Crit Care Med 2024;28(S2):S4-S19., Competing Interests: Source of support: Nil Conflict of interest: None, (Copyright © 2024; The Author(s).)

Short peripheral intravenous catheters (short PIVCs) are commonly used in acute care, guided by evidence-based policy with interventions to limit premature failure. Research on how nurses use evidence and change processes to optimize outcomes is needed. The study objective was to use a theory-based implementation science approach to evaluate and improve short PIVC insertion and care processes and reduce removals for adverse outcomes in acute care. This mixed-methods study was conducted with inpatient nursing units (n = 23) at a large urban quaternary medical center. Units identified and implemented one PIVC care intervention that could lower catheter removals for adverse outcomes over 3 months. Data from multiple sources were convergently analyzed to evaluate process and outcomes postintervention. Although overall frequency of PIVC removals for adverse outcomes was unchanged, several units improved their outcomes using implementation strategies. The determinant framework provides a plausible explanation for the study results. While adverse outcome rates remained below published rates, some units had limited success improving outcomes with traditional change strategies. Implementation strategies and readily accessible data can offer nursing units a new approach to effectively deploy, monitor, and maintain interventions to achieve improved outcomes., Competing Interests: Conflict of Interest: The authors of this article have no conflicts of interest to disclose., (Copyright © 2024 Infusion Nurses Society.)