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This study was conducted to estimate medical wastes generation rates in Viet Nam. Within 3 years (from 2017 to 2019), total medical wastes generated daily of 1,737 health-care facilities at different levels from 19/63 provinces in Viet Nam were surveyed. The calculation was based on the median daily generation (in kg) of 6 medical waste groups and total actual patient beds in 9 health-care facility categories. Six medical waste groups were sharps, non-sharps, high-risk infectious, pathological, non-infectious hazardous, recyclable and non-recyclable wastes. Surveyed health-care facilities were categorized in central general hospitals, central specialist hospitals, provincial general hospitals, provincial specialist hospitals, district health centers, regional clinics, commune health stations, private hospitals and private clinics. The results showed that waste generation rates varied from 0.0009 to 1.619 kg/bed/day depends on type of medical wastes or health-care facilities. For no-patient-bed facilities (commune health stations and private clinics), medical waste generation rates of these two were calculated in kg/day and varied from 0.1 to 1.75 kg/day. [ABSTRACT FROM AUTHOR] more...

Conclusion: The study found that the existing level of service preparedness and accessibility for NCDs at health-care institutions is inadequate and requires improvement. Some health facilities had poorer rankings as a result of inadequate drug supplies, a lack of skilled staff, and a lack of advice on NCD screening and treatment. Therefore, an emphasis on infrastructure, services, and health-care workers ready for NCD services is necessary to ensure efficacy. Introduction: To attain the Sustainable Development Goals by 2030, an urgent action is required, directed by the global action plan for prevention and control of noncommunicable diseases (NCDs) which contributed to 73% of worldwide deaths in 2017. The ability and limitations in primary care to meet the rising burden of NCDs remain unknown, nevertheless. The goal of this study was to evaluate the availability of primary health care facilities and their preparedness for NCDs in one block of UT Chandigarh. Methodology: This cross-sectional survey was conducted in 10 health facilities in Manimajra block of UT Chandigarh using the World Health Organization service availability and readiness assessment standard tool with local adaptations. We defined facility readiness along six domains: basic equipment, essential services, diagnostic capacity, NCD trainings, counseling services, and essential medicines. For each domain, an index as the mean score of items expressed as percentage was calculated. Results: The results highlight important gaps in service delivery that are obstacles to universal access to health services. Overall, among all health facilities offering service for NCDs, the availability of diagnosis and/or management of diabetes, cardiovascular disease, chronic respiratory disease, and cervical cancer were 89%, 77%, 44%, and 25%, respectively. Of all the health facilities that were providing screening or management of cervical cancer, none of them had all four items. more...

Background: The COVID-19 pandemic has raised serious public health concerns globally. Cases keep increasing across countries: exposing the emergency-containing capability, level of preparedness, emergency disease prevention, and risk management alertness of various healthcare facilities in managing the crisis. Aim: to assess the level of preparedness for the containment of the COVID-19 disease outbreak across health-care facilities in Nigeria. Materials and Methods: Participants were the stakeholders within selected healthcare facilities. Data were collected via in-depth interviews using a list of 37 structured questions to assess the level of preparedness of the Nigerian health-care facilities in containing the COVID-19 pandemic. The findings were manually and thematically analysed using the constructivist variant of the grounded theory methodology. Results: Overall, the level of preparedness across the selected health facilities was estimated as average, as several facilities were fairly prepared while a few others were relatively unprepared for the COVID-19 pandemic containment. Conclusion: The COVID-19 virus disease outbreak can be said to be fairly contained by the Nigerian health system from the standpoint of the available mortality and incidence indices. Meanwhile, there are still loopholes around financial, structural, and material provisions which are essential needs for better and sustainable pandemic containment. more...

Introduction: As part of the implementation of its mission "to integrate hygiene activities into healthcare", the general directorate of health conducted in 2018 with its technical structures, an evaluation of the implementation of Infection Prevention and Control (IPC) using the WHO IPCAF tool in 30 health-care facilities in the autonomous district of Abidjan. Materials and methods: This were a cross-sectional survey with a conceptualized component considering the issue of injection safety and sanitary waste management, which was conducted in the named health-care facilities from March 20 to 28, 2018. The scores of the essential components of the IPC made it possible to assess the IPC level of each health-care facility evaluated and the overall IPCAF score of all facilities. Results: The overall median IPCAF score of the health-care facilities was 242.5/800 and corresponded to an inadequate level overall. No facility reached the "advanced" level of performance, 5 facilities (17%) reached the "intermediate" level, 10 (33%) fell into the "basic" level, and 15 (50%) were at the "inadequate" level. Baseline institutions had much higher scores than first contact institutions. Conclusion: IPC component activities were inadequate and fragmented in the under-resourced health facilities at the time of the assessment. It would be appropriate to provide adequate resources and develop expertise in IPC through strong political will and leadership. This will contribute to the achievement of universal health insurance objectives with safe health services for patients. [ABSTRACT FROM AUTHOR] more...

Introduction: Racial/ethnic disparities exist in many aspects of health care, but data on racial/ethnic disparities for neurodegenerative diseases (NDDs), such as dementia and Parkinson's disease (PD), are limited. Methods: We used North and South Carolina Medicare claims from 2013 to 2017 to evaluate disparities in incidence of NDDs and in health‐care utilization and outcomes for patients with NDDs. Results: Disparities in incidence of NDD between Black and White beneficiaries narrowed by 0.37 per 100 person‐years from 2014 to 2017. After thorough covariate adjustment, Black beneficiaries had a 4% higher risk of all‐cause hospitalization, spent 8% more days in skilled nursing facilities and 14% fewer days in hospice facilities, were 38% less likely to receive physical/occupational therapy services, were 8% less likely to receive dementia medications, and were 19% less likely to receive PD medications than White beneficiaries. Discussion: Effective system‐level approaches to promote health equity in NDD diagnosis, treatment, and outcomes are clearly needed. Highlights: Racial disparities in neurodegenerative disease incidence narrowed between 2014 and 2017.Black patients were less likely than White patients to receive hospice services.Black patients were less likely than White patients to receive physical therapy.Black patients were less likely than White patients to receive Alzheimer's disease or Parkinson's disease medications.There is a shortage of neurologists in counties with high dementia incidence. [ABSTRACT FROM AUTHOR] more...

Developing and underdeveloped countries face innumerable problems related to the accessibility and quality of energy that put the lives of patients, health-care infrastructures, and health workers at risk. Current approaches, such as grid power, unsustainable energy sources such as diesel or gas, and mobile health clinics, have proven insufficient to address this issue. In response, access to reliable health care and electricity has undergone multiple transformations in the last decade, especially in remote and rural areas. Good health and clean energy are two of the 17 United Nations Sustainable Development Goals, originally designed to be a "shared blueprint for peace and prosperity for people and the planet, now and into the future." Unfortunately, little is known about the interaction between health-care access and energy access in developing and underdeveloped countries, mainly in remote or rural areas. For this reason, this study conducts a review of the literature, including current approaches, challenges, and opportunities for the implementation of solar energy in health centers. As a result, several challenges and opportunities in three impact areas are presented: (1) operational, (2) environmental, and (3) economic. This study delivers detailed information that allows the implementation of solar energy in the health-care sector (in a more effective manner) by sharing best practices. [ABSTRACT FROM AUTHOR] more...

Objective: This study aimed to examine the referral and counter-referral practices in obstetric emergencies among health-care providers in selected health facilities in Plateau state of Nigeria. Materials and Methods: A concurrent embedded descriptive mixed method consisting of both quantitative and qualitative methods was adopted for the study. Participants (104) were recruited using multistage sampling and 8 participants using purposive sampling techniques for quantitative and qualitative aspects of the study, respectively. The three-phase delay model directed the study. A self-developed structured questionnaire and an in-depth interview guide were used to elicit quantitative and qualitative responses from the participants. Quantitative instrument was tested for reliability, while the qualitative instrument went through the rigors of qualitative data. Results: Findings revealed low level of referral and counter-referral practices as only 19 (18.27%) and 30 (28.85%), respectively, of care providers referred patients above 10 times in a year. The study also revealed inadequate human and material resources for referrals and counter-referrals. The mean on barriers to referral was 2.90, which was above the cutoff of mean of 2.50, which indicates that the barriers are militating against referral and counter-referral in obstetric emergencies. Conclusions: Low levels of referral and counter-referral practices are identified with inadequate resources among others posing as barriers. Therefore, provision of standard operational procedures/protocols in every health-care facility as well as provision of adequate material and skilled human resources among others is recommended to enhance referral and counter-referral network in obstetric emergencies. There is also a need for teamwork and synergy among all stakeholders in the referral chain. [ABSTRACT FROM AUTHOR] more...

Medeniyetler belli aralıklarla veba, kolera, tifo, tifüs, dizanteri, cüzzam, frengi, sıtma, verem ve çiçek gibi birçok bulaşıcı ve salgın hastalıklar ile mücadele etmek zorunda kalmıştır. Bu makale kapsamında, tarihsel süreçte çoğu afet boyutuna ulaşarak, önleyici tedbirlerin alınmasını gerektiren bulaşıcı ve salgın hastalıklar için sağlık sistemi içinde yapılan yasal düzenlemeler, mimari yapılanmalar ile tahaffuzhaneler, dezenfeksiyon merkezleri gibi koruyucu sağlık önlemleri ele alınmış, sağlık kurumlarından örnekler sunulmuştur. Dünya üzerinde çok sayıda insanın ölümüne neden olan bulaşıcı ve salgın hastalıkların geçmişte olduğu gibi gelecekte de farklı şekillerde canlıları tehdit edeceği COVID-19 ile bir kez daha gözler önüne serilmiştir. Bu nedenle, en çok kayıpların verildiği hastalıkları incelemek ve farklı dönemlerde insanların geliştirdiği çeşitli baş etme yöntemlerinin farklı disiplinlerce irdelenmesi, geleceğin tasarlanabilmesi için büyük önem taşımaktadır. Aralık 2019 sonrası, pandemi öncesinin dar penceresinden bakılamayacak kadar ciddi bir dönemi aralamıştır. Can kayıplarının yaşandığı bu zorlu süreçte tıp ve mimarlık disiplinlerinin kolektif hareket etmesi, yeni yaşam alanlarının oluşturulmasının önem taşıdığı görülmektedir. more...

The emergence of many infectious diseases has been of serious public health implication in the 21st century. Hospital preparedness is a key step in strengthening a country's ability to address any public health emergency of international concern caused by these diseases. In India, because 80% of the health-care utilization happens in the private hospitals, it is of at most importance to assess the preparedness level of these hospitals against emerging infectious diseases. The study was a cross-sectional study, and hospitals which provided consent were included. The estimated participants for the study were 54. The results were expressed in a descriptive manner. For the purpose of analysis, the questionnaire was redistributed based on the monitoring and evaluation framework of International Health Regulations and its core capacities. It was found that there was a need to enhance the preparedness of the hospitals in the response against emerging infectious diseases. There were gaps in the implementation of various plans and protocols for staff training, risk communication, surge capacity, laboratory capacity, and infection control in the hospitals. The findings were suggestive of a need for preparedness of the hospitals against the upsurge of emerging infectious diseases. [ABSTRACT FROM AUTHOR] more...

Immunosuppressed patients like patients with leukemia or lymphoma, but also patients after autologous or allogeneic stem cell transplantation are at particular risk for an infection with COVID‐19. We describe a COVID‐19 outbreak on our leukemia and stem cell transplantation unit (LSCT‐Unit) originating from a patient with newly diagnosed acute myeloid leukemia. The patient was treated with intensive induction chemotherapy and we characterize the subsequent outbreak of COVID‐19 on a LSCT‐Unit. We describe the characteristics of the 36 contacts among the medical team, the results of their PCR and antibody tests and clinical aspects and features of infected employees. Of these 36 close contacts, 9 employees of the LSCT‐Unit were infected and were tested positive by PCR and/or antibody‐testing. 8/9 of them were symptomatic, 3/9 with severe, 5/9 with mild symptoms, and one person without symptoms. Due to stringent hygiene measures, the outbreak did not lead to infections of other patients despite ongoing clinical work. Moreover, we demonstrate that incubation period and clinical course of a COVID‐19 infection in an immunosuppressed patient could be unusual compared to that of immunocompetent patients. Consistent PCR and antibody testing are helpful to understand, control, and prevent outbreaks. For the safety of health‐care workers and patients alike, all employees wore FFP2 masks and were trained to adhere to several further safety guidelines. The implementation of rigorous hygiene measures is the key to controlling an outbreak and preventing infections of other patients. [ABSTRACT FROM AUTHOR] more...

Aim: This study aimed at the identification of environmental cleaning and managerial best practices for integration in competitive bidding documents for outsourcing of housekeeping services in tertiary care hospitals in India. Materials and Methods: This study design was cross-sectional. The sample comprised of tender documents of eight government super-specialty hospitals/corporations and housekeeping contract agreements of five private ones. Convenience sampling was used-current tenders of most popular government hospitals available online and housekeeping agreements of consenting popular private hospitals were considered. Excel sheet was used for the analysis. Results: Hospitals outsourced housekeeping services on performance or human resource basis, use risk classification (23%) of hospital areas for determining intensity of cleaning, and outlined scope of services (50%). Fifteen percent tenders provide comprehensive lists of material. Scrubber requirements ranged from one per 25–250 beds. In 40% tenders, scope included handling of biomedical waste. Workforce included managerial cadres. There is a focus on occupational health and safety. Quality assurance is inbuilt in the contracts including bid evaluation criteria for selecting competent agencies and penal provisions such as in case of adverse report (INR 10,000) and unsatisfactory survey reporting (1% of monthly payment). Conclusion: Since successful outsourcing must focus on above-mentioned parameters, this study provides necessary guidance for health-care administrators for patient satisfaction, positive image, reducing hospital-acquired infections, and ensuring provision of quality care services. more...

Introduction: There is considerable variation in brain death understanding and policies between medical institutions, however, studies have not yet compared different health-care professionals working in the same hospital. Research Questions: The overall aim of this study was to evaluate understanding of brain death among health-care professionals within intensive care units (ICUs) at a single institution. Design: Study participants included 217 attending physicians, residents, nurses, medical students, and other ICU team members in 6 ICUs. Participants completed a 21-question survey pertaining to knowledge of brain death and related institutional policies as well as opinions about brain death. Results: We found a wide range of brain death understanding among health-care professionals in ICUs. Attending physicians have the greatest understanding (94.7%), followed by nurses (72.4%). In contrast, approximately half of the students and residents do not have a basic understanding of brain death. Brain death understanding was correlated to health-care role, years of experience, and whether the participant had formal training in brain death. Although most participants had been involved in cases of brain death, a much smaller number had received formal training on death by neurological criteria. Discussion: The present study observed a paucity of clinical training in brain death among health-care professionals in the study ICUs. There is an opportunity for improved clinical education on brain death that could improve communication with families about brain death and potentially increase the number of organs transplanted. [ABSTRACT FROM AUTHOR] more...

Background: There are about 120 000 people on the US waiting list for a solid organ transplant; nearly 22 people die every day who could be helped through organ donation. Joining a donor registry and informing one's family of one's preferences increases recovery rates and can avoid misunderstandings during an emotionally difficult time. Although the vast majority of people support organ donation, only about half of adults have joined a state donor registry. Methods. A 3-group design was used. Primary care physician offices were randomly assigned to either web-based training, in-person training, or a control condition. The control condition consisted of a poster and traditional brochure and donor form placed in the waiting room. In the 2 intervention groups, the Patients Save Lives form was distributed during the check-in process in addition to the poster. Results: A total of 1521 physicians and office staff at 81 clinic sites (48 in-person and 33 web-based) received the training; there were 33 control locations. A total of 21 189 patients were exposed to the intervention over a 6-month period; 761 (8.1%) of 9428 people who were not already registered completed the designation form to be organ donors. There were no donor designations in the control group locations. Conclusion: Organ donor designation can be incorporated into the office check-in procedure without disrupting the workflow or burdening clinicians. The program is available online and can be sustained inexpensively with cooperation between primary care offices and regional Organ Procurement Organizations. [ABSTRACT FROM AUTHOR] more...

Background: A mixed-method study of role stress and work intensity among nurse practitioners (NPs) in mechanical circulatory support (MCS) programs in the United States reported a qualitative data related to burnout. We empirically investigated this phenomenon by pursuing the following specific aims: (1) describe levels of personal burnout (PB), work-related (WB) burnout, and client-related burnout (CB) and quality of work life (QOWL) among MCS-NPs; (2) determine the relationship between burnout and QOWL variables; and (3) identify which type of burnout is a predictor of QOWL. Methods: We employed an exploratory correlational research design. Demographics, work characteristics, and psychometrically robust measures of burnout and QOWL were completed by 47 MCS-NPs from various regions of the United States. Data were analyzed with descriptive and inferential statistics. Results: Higher levels of burnout (PB, WB, and CB) were associated with lower levels of QOWL (r = −.52 to −.64, P < .001). Of the 3 types of burnout, WB burnout showed a significant predictor of QOWL (R2 = .44, P < .01). Multiple regression models showed that a 1 point increase in mean score of WB would decrease a mean QOWL score by 0.64 after controlling the effect of PB and CB. Some dimensions of QOWL were associated with work/hospital characteristics (r > −.30, P values <.05). Conclusion: Work-related burnout is negatively associated with low QOWL among NPs. Hospital/work environment was contributing factors to high burnout and low QOWL. Further research is needed to confirm the findings including the effect of burnout and QOWL on patient and ventricular assist device program outcomes. [ABSTRACT FROM AUTHOR] more...

Context: Patients never declared brain dead may represent an additional source of donor organs. Objective: To determine the number of likely brain dead potential donors who are never declared brain dead and to compare them with brain dead and donation after cardiac death potential organ donors. Design, Setting, and Participants: This study was a retrospective chart review of all catastrophically brain-injured patients referred to a single-organ procurement organization (OPO) over a 4-year period. This study identified 159 likely brain dead potential organ donors, 902 brain dead potential organ donors, and 357 potential donation after circulatory death donors over a 4-year period. Interventions: None. Main Outcome Measures: This study did not predetermine outcome measures before data collection because the study group, likely brain dead potential organ donors, had not previously been described. Results: Likely brain dead potential donors were significantly older than brain dead potential donors (P < .0001) but were otherwise not different demographically. They were more likely to be a late referral to the OPO (P < .0001) and less likely to be in the donor registry (P < .0001). The most commonly identified factors associated with a failure to declare brain death were an unwillingness to continue supportive care by the family, premention of donation, a nontimely imminent death referral, known prior objection to donation, terminal instability, and a lack of cooperation with the OPO. [ABSTRACT FROM AUTHOR] more...

Introduction: Patients with end-stage liver disease are at risk for clinical deterioration, often requiring hospital admissions while awaiting transplantation. Nurses observed that many patients were or became unstable soon after arrival, requiring transfers to the medical intensive care unit. Objective: To explore the incidence, timing, and factors associated with unplanned intensive care transfers. Design: We conducted a quality improvement project using plan-do-study-act methods to explore administrative data from adult patients admitted to the hepatology service's medical–surgical unit. Chi-square and t -tests were used to examine associations between demographic, clinical, and temporal factors and unplanned transfers. Data were analyzed at the hospital encounter level. Results: Unplanned transfers occurred in 8.6% of 1418 encounters. The number of transfers during these encounters ranged from 1 to 6. Most unplanned transfers (65.9%) occurred during the evening shift. On average, there was a 4.2-hour delay to the transfer. Fifty-one percent of these encounters required support from clinicians outside the unit while waiting for a bed. Factors associated with unplanned intensive care unit transfer were male sex (P =.02), self-referral to the emergency department (P <.001), and lower initial mean Rothman Index (P <.001). Discussion: Results validated nurses' concerns about the patients' severity of illnesses at the time of admission and frequent need for transfer to intensive care soon after admission. We now have actionable data that are being used by leaders to assess unit admission criteria and develop operating budgets for human and material resources needed to care for this challenging population. [ABSTRACT FROM AUTHOR] more...

Objective: Health services are the first and most important demand for the affected people after disasters. Hospitals and staff of health centers are directly affected by disasters, and this issue is more critical due to the hospital conditions, such as the presence of patients, medical facilities, and equipment. Therefore, it is necessary to make hospitals retrofit against disasters., Methods: This study was conducted qualitatively to extract experts' opinions about the factors affecting the retrofitting of health-care facilities in 2021. Semi-structured interviews were the basis of the data. In addition, to obtain data from different sources (triangulation), a focus group discussion (FGD) was held after the interviews., Results: The findings of this study were extracted from interviewees and FGD in the form of 2 categories, 6 subcategories, and 23 codes. Main categories included external and internal factors. The subcategories of external factors were General government policies to reduce risk, The Programs of the Ministry of Health, and medical universities for retrofitting and Uncontrollable external factors. The subcategories of internal factors were Exposure of managers and staff of health-care organizations to various disasters, determining the types of vulnerabilities in health-care facilities, and Factors related to managerial actions., Conclusions: Retrofitting health-care facilities is one of the requirements for designing and constructing these facilities. The role of governments in this issue is more than other stakeholders because governments are the trustee of the health system and are responsible for the people's health. Therefore, governments must plan for the retrofitting of health facilities according to the disaster risk analysis and prioritization and their resources. Although, external factors play a very important role in influencing retrofitting policies, the role of internal factors should not be neglected. None of the internal and external factors alone can have a significant effect on retrofitting activities. For this purpose, a suitable combination of factors should be determined and the goal of the system should be to achieve resistant and resilient facilities against disasters. more...

Introduction: Racial/ethnic disparities exist in many aspects of health care, but data on racial/ethnic disparities for neurodegenerative diseases (NDDs), such as dementia and Parkinson's disease (PD), are limited., Methods: We used North and South Carolina Medicare claims from 2013 to 2017 to evaluate disparities in incidence of NDDs and in health-care utilization and outcomes for patients with NDDs., Results: Disparities in incidence of NDD between Black and White beneficiaries narrowed by 0.37 per 100 person-years from 2014 to 2017. After thorough covariate adjustment, Black beneficiaries had a 4% higher risk of all-cause hospitalization, spent 8% more days in skilled nursing facilities and 14% fewer days in hospice facilities, were 38% less likely to receive physical/occupational therapy services, were 8% less likely to receive dementia medications, and were 19% less likely to receive PD medications than White beneficiaries., Discussion: Effective system-level approaches to promote health equity in NDD diagnosis, treatment, and outcomes are clearly needed., Highlights: Racial disparities in neurodegenerative disease incidence narrowed between 2014 and 2017. Black patients were less likely than White patients to receive hospice services. Black patients were less likely than White patients to receive physical therapy. Black patients were less likely than White patients to receive Alzheimer's disease or Parkinson's disease medications. There is a shortage of neurologists in counties with high dementia incidence., (© 2022 the Alzheimer's Association.) more...

This study was conducted to estimate medical wastes generation rates in Viet Nam. Within 3 years (from 2017 to 2019), total medical wastes generated daily of 1,737 health-care facilities at different levels from 19/63 provinces in Viet Nam were surveyed. The calculation was based on the median daily generation (in kg) of 6 medical waste groups and total actual patient beds in 9 health-care facility categories. Six medical waste groups were sharps, non-sharps, high-risk infectious, pathological, non-infectious hazardous, recyclable and non-recyclable wastes. Surveyed health-care facilities were categorized in central general hospitals, central specialist hospitals, provincial general hospitals, provincial specialist hospitals, district health centers, regional clinics, commune health stations, private hospitals and private clinics. The results showed that waste generation rates varied from 0.0009 to 1.619 kg/bed/day depends on type of medical wastes or health-care facilities. For no-patient-bed facilities (commune health stations and private clinics), medical waste generation rates of these two were calculated in kg/day and varied from 0.1 to 1.75 kg/day., (© 2023 Walter de Gruyter GmbH, Berlin/Boston.) more...

Aim The study aims to explore perceptions of the causes of nurse absenteeism. Background Nurse absenteeism is rising in many countries. However, there is little evidence as to how strategies adopted in order to cushion the effects of absenteeism on workload influence absenteeism itself. Method The study used a 'qualitative' method based on cognitive mapping techniques in order to represent perceptions about absenteeism graphically. The study was conducted in two health-care facilities with a sample of 55 interviewees. Results Absenteeism is due in part to strategies adopted in order to cushion the effects of absenteeism on organisations. Furthermore, the strategies are selflegitimising. The more they are used, the more they are regarded as normal and useful. Conclusions A plan to reduce absenteeism among nurses must explicitly take into account the strategies used to cushion its impact. Implications for nursing management To cushion the effects of absenteeism among caregivers, managers must make trade-offs that take into account, for example, the workload or disruption linked to the substitution of personnel. [ABSTRACT FROM AUTHOR] more...

Background: Airborne infection control (AIC) is a less focused aspect of tuberculosis (TB) prevention. We describe AIC practices in primary health care centres, awareness and practices of AIC among health care providers (HCPs) and TB patients. We implemented a package of interventions to improve awareness and practices among them and assessed its impact., Methodology: The study used a quasi-experimental study design. A semi-structured checklist was used for health facility assessment and a self-administered questionnaire of HCPs. Pre- and postintervention assessments were made in urban primary health centers (UPHCs), HCPs, and patients. Interventions included sharing facility-specific recommendations, AIC plans and guidelines, HCP training, and patient education. Statistical difference between the two time periods was assessed using the Chi-square test., Results: A total of 23 and 25 UPHCs were included for pre- and postintervention assessments. All 25 centers participated in interventions. Open areas were >20% of ground area in all facilities. No AIC committee was present in any of the facilities at both pre- and postintervention. Of all HCPs, 7% (23/337) versus 65% (202/310) had undergone AIC training. Good awareness improved from 24% (81/337) to 71% (220/310) after intervention (P < 0.001). Appropriate cough hygiene was known to 20% (51/262) versus 58% (152/263) patients at two assessments (P < 0.001)., Conclusion: Comprehensive intervention, including supportive supervision of health centers, training of HCPs, and patient education, can improve AIC practices. more...

Abstract: The energy use in the world is increasing significantly owing to increase in per capita consumption of energy and growing population. Due to increased energy demand and the depletion of existing fossil fuel based sources, it is required to use the energy more efficient. Researches show that, hospitals represent approximately 6% of total energy consumption in the utility buildings sector. Heating, Ventilation and Air Conditioning (HVAC) systems are the major part of electrical energy consumption at the hospitals. In this paper, the research papers and practical studies on energy efficiency and energy saving potentials on HVAC systems at the hospitals are presented. Under the following sections, the latest literatures including research articles, conferences, e-books, handbooks and company reports interested in energy efficiency, energy saving and energy management HVAC systems are summarized. Variant Refrigerant Flow (VRF) technology enables greater energy efficiency and cost savings compared with traditional HVAC systems is also introduced. This detailed review also focuses on the payback periods of some projects on HVAC including the installation of cogeneration, trigeneration, chiller, new burners, heat exchangers and steam trap systems. [Copyright &y& Elsevier] more...

The objectives of this study were to determine the prevalence of anti-hepatitis A virus (HAV) immunoglobulin G (IgG) antibody and associated factors among residents of Osogbo, a town in Nigeria with inadequate environmental sanitation and a shortage of potable water. This is a health facility–based study. Ninety one consenting, asymptomatic attendees of public healthcare facilities in Osogbo, Osun State, Nigeria, were consecutively selected for this study. Plasma samples of the study participants were tested for the presence of anti-HAV IgG using a HAV Ab Competitive Enzyme Immunoassay test kit. Ninety (98.9%) of the participants were seropositive for anti-HAV IgG antibody; group-specific prevalence was also high, but association of participants' variables with the prevalence could not be obtained due to limited sample size and high group-specific prevalence. Since the hepatitis A vaccine is not currently used in Nigeria, the chance is high that the HAV IgG antibody–positive individuals were naturally infected; consequently Osogbo can be described as highly endemic for HAV infection [ABSTRACT FROM AUTHOR] more...

An empirical analysis is presented to investigate the factors that have significant influence on the share of public financing into the total initial investment required to develop build-operate-transfer (BOT) health-care projects. Based on a model describing the main risks associated with public participation in BOT projects, a linear regression analysis has been conducted on a data set of Italian BOT hospital projects to yield implications. Outcomes reveal that the size of investment, the financial strength of the concessionaire, the duration of the concession period, the number of services, and the level of borrowing of the local health-care granting agency are significant factors of the level of public funding. The study confirms that public funding is provided not only to cover the non-self-financing portion of investment but also as a way to undertake a project in periods of scarce public financial resources. The methodology may be useful to refine the decision criteria for determining the level of public funding of a BOT hospital project in order to gain an understanding of the value that could be obtained from funding similar projects. [ABSTRACT FROM AUTHOR] more...

Few data exist on the current capacity of Tanzanian health-care facilities to deliver antiretroviral therapy (ART). We evaluated this capacity among Northern Zone facilities in 2004 using a questionnaire that addressed human resources, clinical facilities and services, and laboratory capacity. Of 19 facilities surveyed, nine (47%) had staff trained to manage ART and three (16%) prescribed ART. Two (11%) offered CD4 counts, five (26%) offered liver function tests, 16 (84%) offered chest radiography, and 18 (95%) offered acid-fast sputum staining. Of 12 (67%) facilities offering outpatient HIV/AIDS services, 12 (100%) provided co-trimoxazole to outpatients and six (50%) provided isoniazid (INH). All 19 (100%) facilities offered rapid HIV tests and full blood pictures. Overall in 2004, facilities needed strengthening to increase staff training in ART management and to implement INH for treatment of latent tuberculosis. Laboratory facilities for ART monitoring were inadequate, and outpatient ART was limited. [ABSTRACT FROM AUTHOR] more...

Objectives: Iran is exposed to a wide range of natural and man-made hazards. Health-care facilities can play a significant role in providing life-saving measures in the minutes and hours immediately following the impact or exposure. The aim of this study was to determine the preparedness of health-care facilities in disasters and emergencies., Methods: This cross-sectional study was conducted in Damghan, Semnan Province, in 2019. The samples consisted of all the 11 health-care facilities located in Damghan County. A developed checklist was used to collect the data, including 272 questions in 4 sections: understanding threatening hazards, functional, structural, and nonstructural vulnerability of health-care facilities. The data were analyzed using SPSS 21., Results: The results revealed that the health-care facilities were exposed to 22 different natural and man-made hazards throughout the county. The total level of preparedness of the health-care centers under assessment was 45.8%. The average functional, structural, and nonstructural vulnerability was assessed at 49.3%, 31.6%, and 56.4%, respectively., Conclusions: Conducting mitigation measures is necessary for promoting the functional and structural preparedness. Disaster educational programs and exercises are recommended among the health staff in health-care facilities. more...

The article discusses a national survey of all organ procurement organizations covering service areas with approved face or upper extremity transplant programs to examine whether they are involved in raising public awareness or offering educational tools to potential donor families about vascularized composite allograft donation. more...

The article describes the case of a 67-year-old Hispanic female with a transplanted kidney who developed a Page kidney after placement of a percutaneous nephroureteral stent, with topics mentioned such as percutaneous nephrostomy, hydronephrosis, and allograft kidney. more...

Background: Patient satisfaction is a comprehensive measurement of patients' happiness with the level of health care delivered to them both inside and outside the physician's office. It is commonly used as an indicator to assess the health-care quality and affects a wide range of components related to the provision of health services such as ease of access, medical malpractice, and clinical outcomes. The study aimed to analyze patients' satisfaction with the quality of health care they received at the outpatient department of Klinik Kesihatan Maharani Muar Healthcare Facility (KMMHF), Johor., Materials and Methods: This cross-sectional study was conducted between August and December 2019 period. Demographic information and information on patients' feelings about their physicians, treatment, and health facilities provided were collected from 407 consented patients in a simple random sampling survey using a researcher-made, an adapted Medical Interview Satisfaction, questionnaire which was pilot tested before administration to the patients. Data were analyzed with SPSS version 23. Descriptive statistics and correlational and group comparison analyses were utilized., Results: Of the 407 patients studied for physician-patient satisfaction, the overall mean of all the respondents responding was 4.089 ± 0.5, which was ranked the highest among the three objectives. The effectiveness of treatment came as the second highest with the overall mean of 4.088 ± 0.5. Finally, the overall health-care facilities had the lowest overall mean of 4.077 ± 0.5 among the three., Conclusion: Most patients who visited KMMHF were mostly satisfied with the outcomes of physician-patient interaction in the clinic., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Journal of Education and Health Promotion.) more...

Background: The emergence of many infectious diseases has been of serious public health implication in the 21st century. Hospital preparedness is a key step in strengthening a country's ability to address any public health emergency of international concern caused by these diseases. In India, because 80% of the health-care utilization happens in the private hospitals, it is of at most importance to assess the preparedness level of these hospitals against emerging infectious diseases., Methods: The study was a cross-sectional study, and hospitals which provided consent were included. The estimated participants for the study were 54., Results: The results were expressed in a descriptive manner. For the purpose of analysis, the questionnaire was redistributed based on the monitoring and evaluation framework of International Health Regulations and its core capacities. It was found that there was a need to enhance the preparedness of the hospitals in the response against emerging infectious diseases. There were gaps in the implementation of various plans and protocols for staff training, risk communication, surge capacity, laboratory capacity, and infection control in the hospitals., Conclusion: The findings were suggestive of a need for preparedness of the hospitals against the upsurge of emerging infectious diseases., Competing Interests: All authors have none to declare., (© 2020 Director General, Armed Forces Medical Services. Published by Elsevier, a division of RELX India Pvt. Ltd.) more...