Search Results (47)

Primary Care Pharmacy (PCP) plays a vital role in healthcare systems. This study evaluated the competencies of pharmacy graduates from a community-focused curriculum, emphasizing their skills and personal traits. A structured questionnaire assessed four domains: general characteristics (11 items), PCP skills (16 items: 13 home visit and 3 community engagement skills), PCP personal traits (7 items), and readiness for PCP practice. Two sets of questionnaires were distributed in 2018 to recent pharmacy graduates: one for self-assessment and the other for evaluation by supervisors or co-workers. A 5-point scale (1 = least competent, 5 = most competent) was used. Co-workers gave higher scores than the graduates themselves. In home visit skills, “providing medicine advice” scored highest (4.4 ± 0.6 by graduates; 4.5 ± 0.2 by co-workers), while “performing essential physical exams” scored the lowest (3.5 ± 0.7). For co-workers, the lowest score was “working with a multidisciplinary team” (3.9 ± 0.9). Among community engagement skills, “solving health-related problems” rated highest (3.4 ± 0.7), and “identifying community health needs” rated lowest (3.2 ± 0.7). “Being friendly” and “responsibility” were top-rated personal traits by graduates and co-workers, respectively. The lowest was “coordinating with local organizations.” Graduates showed strong PCP traits and home visit skills but moderate community engagement. Community-based exposure is recommended to enhance these competencies. Full article

Natural and human-made disasters can severely impact communities and can result in high numbers of human injuries and deaths. Animals, both companion and livestock, are often injured as a result of these disasters and require veterinary care. Veterinarians are not only involved in providing care for these animals but also play important roles in planning and preparedness functions that occur before a disaster strikes. There are several examples of the use of multi-user virtual environments (MUVE) to provide human health care workers with valuable training centered on disaster response and disaster medicine. This communication provides a thorough review of a clinical rotation, as part of a professional veterinary curriculum, that uses a combination of classroom and experiential learning via an MUVE, Second Life^®. This rotation has provided more than 1800 senior veterinary students at a veterinary school in the United States with experiential learning opportunities focused on veterinary disaster preparedness, planning, and response training. The authors have prepared this communication to provide other institutions and educators with information on the practical implementation of Second Life^® in teaching and to offer recommendations based on our institutional experience. Full article

Pharmaceutical care as a concept was introduced in Montenegro during the last 10 years. The Pharmaceutical Chamber of Montenegro (PCM) and the Institute for Medicines and Medical Devices (CInMED) conducted SMART Pharmacist Program educational activities for pharmacists as a project to improve their impact on monitoring drug safety. In the period from September 2023 to May 2024, a total of 78 pharmacists participated in the project, of which 53 (68%) submitted valid reports of suspected adverse drug reactions (ADRs). During the project, a total of 302 valid reports were submitted, and the pharmacists’ share in total reporting increased to 74% in 2023 compared to less than 10% in the previous 5 years. The results of this research will be used to make recommendations for further improvement of the pharmacovigilance system, as well as to create plans for continuing education (CE) of other health workers in the area of rational and safe use of medicines. Full article

Background: Insomnia significantly impairs healthcare worker (HCW) well-being, particularly amid COVID-19 sequelae and shift work demands. We aimed to assess the prevalence of insomnia among HCWs, identify those needing clinical intervention, analyze shift work as a potential risk factor, and explore associations with COVID-19 sequelae and psychiatric comorbidities. Methods: A cross-sectional online survey was administered at the University of Salamanca University Care Complex (CAUSA) from March 2023 to January 2024. Validated scales (Insomnia Severity Index, Patient Health Questionnaire-4, Generalized Anxiety Disorder Scale-2) were used to measure insomnia, depression, and anxiety. Participants scoring ISI ≥ 7 were invited for Occupational Medicine follow-up. Descriptive and inferential analyses were performed. Results: Overall, 1121 HCWs participated (mean age 44.59 ± 11.78, 78.3% women). The mean ISI score was 10.5 ± 5.8 (subclinical insomnia), with 22.7% reporting moderate and 3% reporting severe insomnia. Depression and anxiety affected 28.4% and 33% of respondents, respectively. Shift workers had poorer sleep (mean ISI 11.3 ± 0.9 vs. 8.8 ± 0.3, p < 0.001). Individuals reporting COVID-19 sequelae were 3.1 times more likely to have insomnia than those who did not (mean ISI 13.89 ± 5.9 vs. 10.33 ± 5.7, p < 0.001). Over one-quarter reported at least the monthly use of sleep or psychiatric medications. Conclusions: Insomnia remains prevalent among HCWs, influenced by shift work, COVID-19 sequelae, and mental health factors. Targeted, multidisciplinary interventions, e.g., workplace policy changes, mental health programs, and shift schedule adjustments) are urgently needed to safeguard well-being, reduce burnout, and maintain quality patient care. Ensuring adequate sleep is central to minimizing errors and preserving professional performance. Future studies should investigate the impact of coordinated workplace strategies to effectively address insomnia. Full article

This study investigates the challenges and opportunities in addressing public health issues in the context of stunting in the Baduy community. Baduy is a remote indigenous group in Indonesia. The Indonesian government and NGOs such as SRI and Dompet Dhuafa have attempted to abolish stunting. However, factors such as cultural aspects, communication gaps, and logistic problems prevent the optimization of health interventions. Midwives and other health workers have yet to win the community’s trust and provide quality services, but the lack of sustainable solutions further worsens their problem. This studyhighlights the urgency of culturally appropriate, long-term strategies that stay within the unique Baduy lifestyle and belief system, including integrating the tribal leaders into health campaigns. This study also seeks to explain the role of modern healthcare in the Baduy community, particularly the functional acceptance of modern medicine due to its effectiveness in treating severe health problems. However, controversies regarding access to healthcare for Indigenous peoples, especially regarding government resources for care in urban centers, reveal broader issues of healthcare equity in Indonesia. The study finds the need to advocate improved and culturally sensitive interventions, particularly in health communication and government support, to ensure sustainable improvements in public health for Indigenous peoples such as the Baduy. Full article

Background: Creutzfeldt–Jakob disease (CJD) is a rare, fatal, and transmissible neurodegenerative disorder caused by prion proteins. Handling specimens from individuals with suspected or confirmed cases presents a safety challenge to hospital workers including clinical laboratory staff. As no national guidelines exist, the clinical pathology laboratory must establish protocols for handling these specimens to ensure sufficient protective measures. This study aims to explore how various medical institutions manage CJD specimens, as a first step toward developing standardized preanalytical protocols for safe specimen handling by health care professionals. Methods: An electronic survey was generated and disseminated to diplomats of the American Board of Clinical Chemistry and was posted on the Listserv platform of the American Society for Microbiology and the Artery forum of the Association for Diagnostics and Laboratory Medicine. The survey evaluated various procedures and precautions implemented, the nature of the specimens processed, and whether they are processed in-house or sent to reference laboratories. Results: A total of 49 responses were collected. Most respondents (64%) noted their laboratories process specimens with a clinical suspicion of CJD regardless of the level of suspicion, 13% handled specimens only if the degree of suspicion was low, and 16% did not process specimens in-house at all. Among those who process CJD specimens, practices varied greatly, including different levels of precautions, use of biological safety cabinets, aliquoting, disposal, and disinfection procedures. Conclusions: A lack of standardization across laboratories exists for the handling of specimens of patients with suspected CJD. This study summarizes the approaches reported by survey respondents, providing a rationale for developing protocols for the safe handling of these specimens and highlighting the need to develop uniform universal standardized processing procedures. Full article

This study aimed to describe the experiences of healthcare personnel and patients in the organization of free surgical campaigns and care for trachomatous trichiasis in the health district of Siguiri in Guinea, including challenges experienced in providing surgical care. This was an explanatory qualitative study conducted in 2022 in the health district of Siguiri. A total of 20 participants were interviewed including patients (n = 7; 35%), community health workers (n = 4; 20%), health services managers, and healthcare providers (n = 8; 40%). Two main data collection technics were used: documentary review and in-depth individual interviews. All interviews were transcribed and manually coded using an Excel extraction spreadsheet. Data were analysed using inductive and deductive approaches. The results showed several organizational, structural, and community challenges that underlined the low surgical coverage of trachomatous trichiasis in the health district of Siguiri. Organizational challenges included the low involvement of local actors in planning activities, the limited timeframe of the campaigns, and the lack of logistics for activities supervision and patients’ transportation to surgery sites. Structural challenges included the inadequacy of health centres to provide surgical services, poor health infrastructures, and sanitation conditions in some areas. Individual challenges included remoteness of surgical sites and costs associated with services provision including medicines. Community challenges included fear of surgery and the coincidence of the campaigns with agricultural and mining activities. The results of the study call on the national neglected tropical disease program and its partners to adopt and promote micro-planning of trachomatous trichiasis surgical activities, with the effective participation of local stakeholders in endemic health districts. They should also envision integrating the management of surgical treatment including costs associated with care (transportation, food, rehabilitation support for patients who have undergone surgery) and complications of surgical procedures for an expansion of the trachomatous trichiasis free surgical care coverage in endemic health districts in Guinea. Full article

Highly contagious diseases, such as mumps, are a global concern as new epidemics continue to emerge, even in highly vaccinated populations. The risk of transmission and spread of these viruses is even higher for individuals who are more likely to be exposed, including healthcare workers (HCWs). In healthcare settings, both HCWs and patients are at risk of infection during the care process, potentially leading to nosocomial epidemic outbreaks. Mumps is often underestimated compared with measles and rubella, despite being milder and less likely to spread. In fact, the risk of complications following mumps infection is extremely high, especially if the disease occurs in adulthood. The measles–mumps–rubella (MMR) vaccine has been shown to be an excellent preventive measure. Unfortunately, the mumps component appears to be less effective in inducing immunity than those for measles and rubella (two-dose effectiveness of 85%, 95% and 97%, respectively). The main aim of our study was to investigate the prevalence of detectable mumps antibodies (serum IgG antibodies) in a cohort of Italian and foreign HCWs in relation to personal and occupational factors. We included in the study 468 subjects who underwent health surveillance at the Occupational Medicine Unit of the Tor Vergata Polyclinic in Rome during the period from January 2021 to March 2023. In our study, the proportion of HCWs found to be unprotected against mumps was very high (8.3%), and those found to be immune are below the WHO threshold for herd immunity (95%). From our data, it seems essential that all occupational health services carry out an accurate screening with a dose of anti-mumps antibodies to assess serological protection before starting a job, regardless of an individual’s vaccination history. This approach is proving to be beneficial, accurate, as it allows all serologically non-immune individuals to be vaccinated in the workplace, including those who would be protected by their vaccination history but have lost the antibody response. Full article

Radioactivity is a process in which the nuclei of unstable atoms spontaneously decay, producing other nuclei and releasing energy in the form of ionizing radiation in the form of alpha (α) and beta (β) particles as well as the emission of gamma (γ) electromagnetic waves. People may be exposed to radiation in various forms, as casualties of nuclear accidents, workers in power plants, or while working and using different radiation sources in medicine and health care. Acute radiation syndrome (ARS) occurs in subjects exposed to a very high dose of radiation in a very short period of time. Each form of radiation has a unique pathophysiological effect. Unfortunately, higher organisms—human beings—in the course of evolution have not acquired receptors for the direct “capture” of radiation energy, which is transferred at the level of DNA, cells, tissues, and organs. Radiation in biological systems depends on the amount of absorbed energy and its spatial distribution, particularly depending on the linear energy transfer (LET). Photon radiation with low LET leads to homogeneous energy deposition in the entire tissue volume. On the other hand, radiation with a high LET produces a fast Bragg peak, which generates a low input dose, whereby the penetration depth into the tissue increases with the radiation energy. The consequences are mutations, apoptosis, the development of cancer, and cell death. The most sensitive cells are those that divide intensively—bone marrow cells, digestive tract cells, reproductive cells, and skin cells. The health care system and the public should raise awareness of the consequences of ionizing radiation. Therefore, our aim is to identify the consequences of ARS taking into account radiation damage to the respiratory system, nervous system, hematopoietic system, gastrointestinal tract, and skin. Full article

Artificial intelligence (AI) has emerged as a crucial tool in healthcare with the primary aim of improving patient outcomes and optimizing healthcare delivery. By harnessing machine learning algorithms, natural language processing, and computer vision, AI enables the analysis of complex medical data. The integration of AI into healthcare systems aims to support clinicians, personalize patient care, and enhance population health, all while addressing the challenges posed by rising costs and limited resources. As a subdivision of computer science, AI focuses on the development of advanced algorithms capable of performing complex tasks that were once reliant on human intelligence. The ultimate goal is to achieve human-level performance with improved efficiency and accuracy in problem-solving and task execution, thereby reducing the need for human intervention. Various industries, including engineering, media/entertainment, finance, and education, have already reaped significant benefits by incorporating AI systems into their operations. Notably, the healthcare sector has witnessed rapid growth in the utilization of AI technology. Nevertheless, there remains untapped potential for AI to truly revolutionize the industry. It is important to note that despite concerns about job displacement, AI in healthcare should not be viewed as a threat to human workers. Instead, AI systems are designed to augment and support healthcare professionals, freeing up their time to focus on more complex and critical tasks. By automating routine and repetitive tasks, AI can alleviate the burden on healthcare professionals, allowing them to dedicate more attention to patient care and meaningful interactions. However, legal and ethical challenges must be addressed when embracing AI technology in medicine, alongside comprehensive public education to ensure widespread acceptance. Full article

Emergency Medical Services (EMS) clinicians provide patient care within a high-stakes, unpredictable, and complex work environment in which conflict is inevitable. Our objective was to explore the extent to which added stressors of the pandemic exacerbated EMS workplace conflict. We administered our survey to a sample of U.S. nationally certified EMS clinicians during the COVID-19 pandemic in April 2022. Out of 1881 respondents, 46% (n = 857) experienced conflict and 79% (n = 674) provided free-text descriptions of their experience. The responses were analyzed for themes using qualitative content analysis, and they were then sorted into codes using word unit sets. Code counts, frequencies, and rankings were tabulated, enabling quantitative comparisons of the codes. Of the fifteen codes to emerge, stress (a precursor of burnout) and burnout-related fatigue were the key factors contributing to EMS workplace conflict. We mapped our codes to a conceptual model guided by the National Academies of Sciences, Engineering, and Medicine (NASEM) report on using a systems approach to address clinician burnout and professional well-being to explore implications for addressing conflict within that framework. Factors attributed to conflict mapped to all levels of the NASEM model, lending empirical legitimacy to a broad systems approach to fostering worker well-being. Our findings lead us to propose that active surveillance (enhanced management information and feedback systems) of frontline clinicians’ experiences during public health emergencies could increase the effectiveness of regulations and policies across the healthcare system. Ideally, the contributions of the occupational health discipline would become a mainstay of a sustained response to promote ongoing worker well-being. The maintenance of a robust EMS workforce, and by extension the health professionals in its operational sphere, is unquestionably essential to our preparedness for the likelihood that pandemic threats may become more commonplace. Full article

Numerous studies have reported task shifting and task sharing due to various reasons and with varied scopes of health services, either task-shifted or -shared. However, very few studies have mapped the evidence on task shifting and task sharing. We conducted a scoping review to synthesize evidence on the rationale and scope of task shifting and task sharing in Africa. We identified peer-reviewed papers from PubMed, Scopus, and CINAHL bibliographic databases. Studies that met the eligibility criteria were charted to document data on the rationale for task shifting and task sharing, and the scope of tasks shifted or shared in Africa. The charted data were thematically analyzed. Sixty-one studies met the eligibility criteria, with fifty-three providing insights on the rationale and scope of task shifting and task sharing, and seven on the scope and one on rationale, respectively. The rationales for task shifting and task sharing were health worker shortages, to optimally utilize existing health workers, and to expand access to health services. The scope of health services shifted or shared in 23 countries were HIV/AIDS, tuberculosis, hypertension, diabetes, mental health, eyecare, maternal and child health, sexual and reproductive health, surgical care, medicines’ management, and emergency care. Task shifting and task sharing are widely implemented in Africa across various health services contexts towards ensuring access to health services. Full article

Qualitative research on malaria in pregnancy (MiP) is incipient, therefore its contextual, experiential and symbolic associated factors are unknown. This study systematizes the qualitative research on MiP, describes knowledge, perceptions and behaviors about MiP, and compiles individual, socioeconomic, cultural and health system determinants of MiP through a meta-synthesis in 10 databases. A total of 48 studies were included with 2600 pregnant women, 1300 healthcare workers, and 2200 relatives or community members. Extensive knowledge was demonstrated on ITN and case management, but it was lacking on SP-IPTp, risks and consequences of MiP. Attitudes were negative towards ANC and MiP prevention. There were high trustfulness scores and preference for traditional medicine and distrust in the safety of drugs. The main determinants of the Health System were rationing, copayments, delay in payment to clinics, high out-of-pocket expenses, shortage, low workforce and work overload, shortcomings in care quality, low knowledges of healthcare workers on MiP and negative attitude in care. The socioeconomic and cultural determinants were poverty and low educational level of pregnant women, distance to the hospital, patriarchal–sexist gender roles, and predominance of local conceptions on maternal–fetal–neonatal health. The meta-synthesis demonstrates the difficulty to detect MiP determinants and the importance of performed qualitative research before implementing MiP strategies to understand the multidimensionality of the disease. Full article

Extensive literature reports an increase in physical disorders (pain, pathologies, dysfunctions) and mental malaise/uneasiness (stress, burnout) affecting dental professionals in relation to fast and pressing rhythms of work, long working hours, increasingly demanding patients, ever-evolving technologies, etc. This project has been conceived to bring the science of yoga around the world to dental professionals as a preventive (occupational) medicine and to provide knowledge and means for self-care. Yoga is a concentrative self-discipline of the mind, senses, and physical body, that requires regular daily exercise (or meditation), attention, intention, and disciplined action. M&M: The study aimed to design a Yoga protocol specifically devised for dental professionals (dentists, dental hygienists, and dental assistants) including positions (āsana) to be practiced/used in the dental office. The protocol is targeted for the upper body, namely neck, upper back, chest, shoulder girdle, and wrists, being areas greatly affected by work-related musculoskeletal disorders. This paper represents a yoga-based guideline for the self-cure of musculoskeletal disorders among dental professionals. Results: The protocol includes both sitting (Upavistha position) and standing (Utthana or Sama position) āsana, with twisting (Parivrtta), side bending (Parsva), flexion and forward bending (Pashima), and extension and arching (Purva) āsana to mobilize and decompress, and to provide nourishment and oxygen to the musculo-articular system. The paper delivers different concepts and theories developed and deepened by the authors and introduces and spreads yoga as a medical science among dental professionals for the prevention and treatment of work-related musculoskeletal disorders. We articulate notions ranging from stretching out using the vinyāsa method (breath-driven movement) and inward-focused attention to contemplative/concentrative science, interoceptive attention, self-awareness, the mind–body connection, and receptive attitude. The theory of “muscles are bone ties” is coined and delivered with regard to tensegrity musculoskeletal fascial structures connecting, pulling together, and nearing the bone segments where they are anchored. The paper describes over 60 āsana envisaged to be performed on dental stools or using the walls of a dental office or a dental unit chair. A detailed guideline on the work-related disorders that can find relief with the protocol is provided, including the description of breath control for the practice of āsana in vinyāsa. The foundations of the technique reside in the Iyengar Yoga method and Parināma Yoga method. Conclusions: This paper represents a guideline for self-cure in the prevention or treatment of musculoskeletal disorders affecting dental professionals. Yoga is a powerful concentrative self-discipline able to provide physical and mental well-being, representing great help and support in daily life and business for dental professionals. Yógāsana restores retracted and stiff muscles, giving relief to the strained and tired limbs of dental professionals. Yoga is not intended for flexible or physically performing persons but for people who decide to take care of themselves. The practice of specific āsana represents a powerful tool for the prevention or treatment of MSDs related to poor posture, forward head, chronic neck tension (and related headache), depressed chest, compressive disorders on wrists and shoulders as carpal tunnel, impingement syndromes, outlet syndrome, subacromial pain syndrome and spinal disc pathologies. Yoga, as an integrative science in medicine and public health, represents a powerful tool for the prevention and treatment of occupational musculoskeletal disorders and an extraordinary path for the self-care of dental professionals, sitting job workers, and healthcare providers suffering from occupational biomechanical stresses and awkward postures. Full article

Gender is one of the important social determinants of health known to be highly associated with health status. Despite the importance of gender awareness, it has not been addressed and researched in the Arab region, including Palestine. This study aimed to contextualize an Arabic version of the Nijmegen Gender Awareness in Medicine Scale (N-GAMS) and to assess the level of gender awareness and its associated factors among primary health care providers. The N-GAMS tool was translated and adapted through a gender expert consultation and a focus group discussion. Then, it was administered online to a sample of primary health care general physicians and nurses of all health care providing actors in Ramallah and al-Bireh Governorate. The reliability of the N-GAMS subscales using Cronbach’s alpha (α) was 0.681 for the gender sensitivity (GS) scale (9 items), 0.658 for the gender role ideology towards co-workers (GRIC) scale (6 items), and α = 0.848 for the gender role ideology towards patients (GRIP) scale (11 items). The results showed that participants had scored near the midpoint of the gender sensitivity subscale (M = 2.84, SD = 0.486). They also expressed moderate gender stereotypes towards patients (M = 3.11, SD = 0.624), where females held lower stereotypical thinking. Participants also expressed low to moderate stereotypes towards co-workers (M = 2.72, SD = 0.660) and females expressed less stereotypical thinking compared to males. Furthermore, the participant’s age had some effect on the outcome, specifically on the GRIP subscale, while gender was associated with both GRIP and GRID subscales. The rest of the social and other variables showed no association with the gender awareness subscales. This study adds to our understanding of gender awareness. Further tests are required to confirm the psychometric qualities of the instrument. Full article