Barriers to enrolment of clients into community client led anti-retroviral therapy delivery (CCLAD) in selected health facilities in Kasese district, Uganda.

Background: Community Client Led Anti-retroviral therapy Delivery (CCLAD) Model has been associated with increased community participation and ownership, which leads to better treatment outcomes with reduced workload and increased client satisfaction of health services. Aim: To explore the barriers to enrolment of eligible clients into CCLAD in selected health facilities in Kasese District, Uganda. Materials & methods: Analytical cross-sectional study utilizing mixed method approach was conducted among 384 PLWHIV attending public health facilities of Kasese District. Sampling was done by simple random sampling method. Data was collected using researcher-administered questionnaire method and interview guide. Results: Most of the respondents 253(65.9%) had not yet enrolled into CCLAD. This was due to some client-related factors such as non-disclosure of HIV sero-status (p=0.040), person to whom HIV sero-status was disclosed to (p=0.009), not having ever heard about CCLAD (p=0.000), incorrect description of CCLAD (p=0.000), limited knowledge of advantages of CCLAD (p=0.000) or disadvantages of CCLAD (p=0.003). Other barriers were; failure to have access to organizations or groups that support PLWHIV to get treatment (p=0.025) and duration of ART refills [AOR=1.637, 95% CI (0.820 - 3.270)]. Conclusion: Adoption of CCLAD model among PLWHIV in Kasese District is still low.

Multishell Silver Indium Selenide-Based Quantum Dots and Their Poly(methyl methacrylate) Composites for Application in Red-Light-Emitting Diodes.

In this work, the production of novel multishell silver indium selenide quantum dots (QDs) shelled with zinc selenide and zinc sulfide through a multistep synthesis precisely designed to develop high-quality red-emitting QDs is explored. The formation of the multishell nanoheterostructure significantly improves the photoluminescence quantum yield of the nanocrystals from 3% observed for the silver indium selenide core to 27 and 46% after the deposition of the zinc selenide and zinc sulfide layers, respectively. Moreover, the incorporation of the multishelled QDs in a poly(methyl methacrylate) (PMMA) matrix via in situ radical polymerization is investigated, and the role of thiol ligand passivation is proven to be fundamental for the stabilization of the QDs during the polymerization step, preventing their decomposition and the relative luminescence quenching. In particular, the role of interface chemistry is investigated by considering both surface passivation by inorganic zinc chalcogenide layers, which allows us to improve the optical properties, and organic thiol ligand passivation, which is fundamental to ensuring the chemical stability of the nanocrystals during in situ radical polymerization. In this way, it is possible to produce silver-indium selenide QD-PMMA composites that exhibit bright red luminescence and high transparency, making them promising for potential applications in photonics. Finally, it is demonstrated that the new silver indium selenide QD-PMMA composites can serve as an efficient color conversion layer for the production of red light-emitting diodes.

Improving healthcare transition for young people with cancer: factors fundamental to the quality improvement journey.

BACKGROUND: Young people receiving cancer treatment in the South Thames Children's, Teenagers' and Young Adults' Cancer Operational Delivery Network usually receive care across two or more NHS trusts, meaning transition into adult services can be challenging. AIM: To develop a planned, co-ordinated approach to transition across the network that meets National Institute for Health and Care Excellence guidance recommendations for transition and the cancer service specifications. METHODS: A 2-year, nurse-led quality improvement (QI) project, using the principles of experience-based co-design. OUTCOMES: The QI project resulted in the development of six key principles of practice; refining and testing of a benchmarking tool; initiatives to facilitate first transition conversations; and the launch of an information hub. CONCLUSION: Robust QI processes, cross-network collaboration and wide stakeholder involvement required significant resource, but enabled deeper understanding of existing pathways and processes, facilitated the establishment of meaningful objectives, and enabled the testing of interventions to ensure the project outcomes met the needs of all stakeholders.

Recent advances in two-dimensional perovskite materials for light-emitting diodes.

Light-emitting diodes (LEDs) are an indispensable part of our daily life. After being studied for a few decades, this field still has some room for improvement. In this regard, perovskite materials may take the leading role. In recent years, LEDs have become a most explored topic, owing to their various applications in photodetectors, solar cells, lasers, and so on. Noticeably, they exhibit significant characteristics in developing LEDs. The luminous efficiency of LEDs can be significantly enhanced by the combination of a poor illumination LED with low-dimensional perovskite. In 2014, the first perovskite-based LED was illuminated at room temperature. Furthermore, two-dimensional (2D) perovskites have enriched this field because of their optical and electronic properties and comparatively high stability in ambient conditions. Recent and relevant advancements in LEDs using low-dimensional perovskites including zero-dimensional to three-dimensional materials is reported. The major focus of this article is based on the 2D perovskites and their heterostructures (i.e., a combination of 2D perovskites with transition metal dichalcogenides, graphene, and hexagonal boron nitride). In comparison to 2D perovskites, heterostructures exhibit more potential for application in LEDs. State-of-the-art perovskite-based LEDs, current challenges, and prospects are also discussed.

The Crystallization Regulation Effect of the Phenyl Ring of Passivators for Blue Perovskite Light-Emitting Diodes.

Although metal halide perovskites (MHPs) have demonstrated remarkable external quantum efficiencies (EQEs) in red and green light-emitting diodes (LEDs), the blue ones confront efficiency and stability problems due to the high defect density in the perovskite films. Large amounts of defect passivation strategies are successfully developed to improve the device performance. Nevertheless, the influence of the molecular configuration of the passivators on the perovskite crystallization process has not been comprehensively investigated so far. Here, we investigate the effect of the phenyl ring on the perovskite crystallization dynamics and the passivation effect. The additive with a phenyl ring performs the π-π stacking ability with phenethylammonium (PEA+) molecules, resulting in a deteriorated crystallinity and a weakened passivation ability. Conversely, the additive without the phenyl ring is helpful to promote the participation of PEA+ molecules in the crystalline process, leading to a higher crystallinity and a stronger passivation effect. As a result, the EQE of the blue perovskite LED has increased from 4.72 to 11.06% by using the phenyl ring-free additive. Therefore, it is advisible to develop the conjugated nonplanar additives in the PEA+-assisted quasi-two-dimensional perovskites. This finding may enlighten the rational design of defect passivators for highly efficient perovskite LEDs.

Exploring psychosocial vulnerability among Dutch pregnant women: a register study.

In the Netherlands adverse perinatal outcomes are also associated with non-medical factors which vary across geographical locations. This study analyses the presence of non-medical vulnerabilities in pregnant women in two regions with high numbers of psychosocial adversity using the same definition for vulnerability in both regions. A register study was performed in 2 regions. Files from women in midwife-led care were analyzed using a standardized case report form addressing non-medical vulnerability based on the Rotterdam definition for vulnerability: measurement A in Groningen (n = 500), measurement B in South-Limburg (n = 538). Only in South-Limburg a second measurement was done after implementing an identification tool for vulnerability (C (n = 375)). In both regions about 10% of pregnant women had one or more urgent vulnerabilities and almost all of these women had an accumulation of several urgent and non-urgent vulnerabilities. Another 10% of women had an accumulation of three or more non-urgent vulnerabilities. This study showed that by using the Rotterdam definition of vulnerability in both regions about 20% of pregnant women seem to live in such a vulnerable situation that they may need psychosocial support. The definition seems a good tool to determine vulnerability. However, without considering protective factors it is difficult to establish precisely women's vulnerability. Research should reveal whether relevant women receive support and whether this approach contributes to better perinatal and child outcomes.

Impact of Pharmacist-Led Intervention on Adherence to Inhalers, Inhalation Technique, and Disease Control Among Asthma/COPD Patients in a Resource Limited Center: An Interventional Study.

Background: Asthma and Chronic obstructive pulmonary disease (COPD) are chronic respiratory conditions characterized by airflow obstruction and respiratory symptoms. Adherence to prescribed inhaler therapy and correct inhalation technique are essential for effective disease management and optimal disease control. However, non-adherence and incorrect inhalation technique are common challenges faced by patients with asthma and COPD, leading to suboptimal treatment outcomes and increased healthcare burden. Purpose: To study the impact of a pharmacist-led intervention on inhaler adherence, inhalation technique, and disease control among patients with asthma and COPD. Patients and Methods: A pre-post interventional design assessed the effects of pharmacist-led intervention on inhaler adherence, inhalation techniques, and disease control in asthma and COPD patients at Dhulikhel Hospital in Nepal. Inclusion criteria: adult patient clinically diagnosed with asthma or COPD patients of all genders. The intervention comprised counseling patients with aids like videos, and informational leaflets. Impact was measured using checklist method for inhalation technique, the Test of Adherence to Inhaler (TAI) questionnaire for adherence to inhaler, and "Asthma Control Test (ACT)" or "COPD Assessment Test (CAT)" for disease control. Results: The pharmacist-led intervention significantly increased adherence to inhalers, evidenced by a notable rise in the proportion of patients with good adherence (P<0.001). Sporadic, deliberate, and unwitting noncompliance pattern also improved significantly after the intervention (P<0.001, P<0.001 and P=0.001). Inhalation technique exhibited substantial improvement after intervention (P<0.001). The analysis indicated significant moderate negative correlations between "TIA" and "CAT" [ρ=-0.31; P=0.01], and between "inhalation technique score" and "CAT score" [ρ=-0.31; P=0.01] suggesting that as adherence to inhaler usage and inhalation technique improve, CAT scores tend to decrease, indicating reduced disease impact on the patient. Conclusion: This study shows the potential efficacy of pharmacist-led intervention in enhancing adherence to inhaler, inhalation technique, and disease control in respiratory conditions such as asthma and COPD.

Ku Like Kakou: Utilizing a Community-led Model of Collaboration to Respond to the COVID-19 Pandemic.

The outbreak of COVID-19 in 2020 brought significant challenges for Native Hawaiians (NH), Pacific Islanders (PI), and other communities of color worldwide. Rapidly increasing rates of infection and transmission of the virus in Native Hawaiian and Pacific Islander (NHPI) communities and incomplete or unavailable data signaled to Hawai'i's leaders that advocacy and action needed to take place to minimize the impact of COVID-19. The Native Hawaiian and Pacific Islander Response, Recovery, and Resilience team (NHPI 3R Team) emerged from an effort to lead and fill gaps in response to COVID-19. Through the swift, intentional, and collaborative work of the team and its partners, NHPI communities and the entities that serve them were better equipped to navigate the pandemic, improve health outcomes, and contribute to a reduction in the number of infections, a rise in vaccination uptake, and an increase in NH and PI representation on various levels of government agencies. As the world shifts its focus from COVID-19 to broader health topics, the NHPI 3R Team will continue to serve as a hub for the exchange of resources and a model of community-led work that can be used to tackle issues like COVID-19 and beyond.

Clinical learning experiences of healthcare professional students in a student-led clinical learning environment (SLCLE) - A mixed methods evaluation.

AIM: To evaluate healthcare professional (HCP) students clinical learning experiences' whilst undertaking placements in a student-led clinical learning environment (SLCLE) and any changes in self-reported ratings of confidence. BACKGROUND: The English NHS Long Term Workforce Plan (2023) highlights the need to expand domestic education of HCPs to meet workforce shortages. The demand for quality clinical placements to support the preparation of HCP students remains a challenge globally. A creative solution has been the development of student-led learning clinical environments in healthcare settings. SLCLEs provide high-quality learning experience, increase clinical placement capacity whilst maintaining patient care standards. A multisite NHS Trust adopted this model as evidence suggests HCP students will be better prepared on qualification to adopt registered practitioner professional responsibilities. This model has been integrated across three hospital sites within a large teaching hospital, providing care for a diverse population and designed to accommodate students from a range of HCP disciplines and higher educational institutions. DESIGN: A mixed methods convergent design. METHODS: An online survey was administered to SLCLE allocated nursing and allied health profession (AHP) undergraduate and graduate-entry first, second and third-year students (n=132). Face to face focus groups/individual interviews were undertaken with a purposive sample of student participants (n=80) to evaluate their experiences of clinical learning in SLCLEs. Survey data were analysed using descriptive statistics and paired t-tests, interviews using framework method. RESULTS: Undergraduate and graduate-entry students from four UK universities completed the survey (n=132), 103 students (78 %) responded. Most were year 2 students (n=43/42 %), pursuing nursing programmes (n=82/80 %). Most considered the SLCLE met their expectations (n=76/74 %), reported increased confidence post-placement (n=84/82 %), felt supported by staff (n=80/78 %), peers (n=93/90 %) and clinical educators (n=93/90 %). Self-reported confidence scores post-SLCLE were significantly higher than pre-SLCLE. On-line pre-placement information was infrequently accessed yet identified as an omission. Four themes were identified: (i) preconceptions and initial anxiety; (ii) empowerment, growth and a unique learning experience; (iii) collaborative inter-professional learning and support; and (iv) insights and anticipations. CONCLUSIONS: The SLCLE allocation enhanced students' confidence and knowledge. Support from clinical educators, ward staff and doctors was perceived as invaluable for creating a positive learning culture. Peer support and opportunities to lead care delivery contributed to students' professional development. The format and method for providing pre-placement information needs review as do strategies for avoiding delays in completing assessment documentation. Overall, the SLCLE experience offers much potential as a nurturing and effective learning environment for HCP students.

Synthesis of Hybrid Tin-Based Perovskite Microcrystals for LED Applications.

Considerable focus on tin-based perovskites lies on substitution to leadhalide perovskites for the fabrication of eco-friendly optoelectronic devices.The major concern related to tin-based perovskite devices are mainly thestability and the efficiency. However, thinking on the final commercializationscope, other considerations such as precursor stability and cost are majorfactors to carry about. In this regard, this work presents a robust and facilesynthesis of 2D A2SnX4 (A = 4-fluorophenethylammonium(4-FPEA); X = I, Br, I/Br) and 3D FASnI3 perovskite microcrystals followinga developed synthesis strategy with low-cost starting materials. In thisdeveloped methodology, acetic acid is used as a solvent, which helps to protectfrom water by making a hydrophobic network over the perovskite surface, andhence provides sufficient ambient and long-term inert atmosphere stability ofthe microcrystals. Further, the microcrystals are recrystallized in thin filmsfor LED application, allowing the fabrication of orange, near-infrared and purered emitting LEDs. The two-step recrystallized devices show better performanceand stability in comparison to the reference devices made by using commercialprecursors. Importantly, the developed synthesis methodology is defined as ageneric method for the preparation of varieties of hybrid tin-based perovskitesmicrocrystals and application in optoelectronic devices.

Carrier Recombination in Nitride-Based Light-Emitting Devices: Multiphonon Processes, Excited Defects, and Disordered Heterointerfaces.

We study recombination processes in nitride LEDs emitting from 270 to 540 nm with EQE ranging from 4% to 70%. We found a significant correlation between the LEDs' electro-optical properties and the degree of nanomaterial disorder (DND) in quantum wells (QWs) and heterointerfaces. DND depends on the nanoarrangement of domain structure, random alloy fluctuations, and the presence of local regions with disrupted alloy stoichiometry. The decrease in EQE values is attributed to increased DND and excited defect (ED) concentrations, which can exceed those of Shockley-Read-Hall defects. We identify two mechanisms of interaction between EDs and charge carriers that lead to a narrowing or broadening of electroluminescence spectra and increase or decrease EQE, respectively. Both mechanisms involve multiphonon carrier capture and ionization, impacting EQE reduction and efficiency droop. The losses caused by these mechanisms directly affect EQE dependencies on current density and the maximum EQE values for LEDs, regardless of the emission wavelength. Another manifestation of these mechanisms is the reversibility of LED degradation. Recombination processes vary depending on whether QWs are within or outside the space charge region of the p-n junction.

In Situ Synthesis of Cu2O Nanoparticles Using Eucalyptus globulus Extract to Remove a Dye via Advanced Oxidation.

Water pollution, particularly from organic contaminants like dyes, is a pressing issue, prompting exploration into advanced oxidation processes (AOPs) as potential solutions. This study focuses on synthesizing Cu2O on cellulose-based fabric using Eucalyptus globulus leaf extracts. The resulting catalysts effectively degraded methylene blue through photocatalysis under LED visible light and heterogeneous Fenton-like reactions with H2O2, demonstrating reusability. Mechanistic insights were gained through analyses of the extracts before and after Cu2O synthesis, revealing the role of phenolic compounds and reducing sugars in nanoparticle formation. Cu2O nanoparticles on cellulose-based fabric were characterized in terms of their morphology, structure, and bandgap via SEM-EDS, XRD, Raman, FTIR, UV-Vis DRS, and TGA. The degradation of methylene blue was pH-dependent; photocatalysis was more efficient at neutral pH due to hydroxyl and superoxide radical production, while Fenton-like reactions showed greater efficiency at acidic pH, primarily generating hydroxyl radicals. Cu2O used in Fenton-like reactions exhibited lower reusability compared to photocatalysis, suggesting deterioration. This research not only advances understanding of catalytic processes but also holds promise for sustainable water treatment solutions, contributing to environmental protection and resource conservation.

Clinically Relevant Topics and New Tendencies in Childhood Nutrition during the First 2 Years of Life: A Survey among Primary Care Spanish Paediatricians.

A multicenter cross-sectional study was conducted among 245 experienced Spanish paediatricians, who completed an online survey based on clinically relevant topics in nutrition during the first two years of life and their recommendations to parents in daily clinical practice. Most participants advise about the choking risk associated with baby-led weaning (BLW) and more than 60% consider that infants can receive an insufficient variety and quantity of nutrients with this practice. The general opinion is that there is a lack of evidence for delaying the introduction of gluten and other allergenic foods in the complementary feeding of healthy infants. Most participants agree/strongly agree that two servings of dairy products are the adequate daily amount in a diversified diet and 93.4% disagree/strongly disagree with the use of vegetal beverages under 1 year of life. There is a general agreement to avoid added salt and sugar before 12 months of life, the consideration that organic foods do not have a better nutritional profile than non-organic ones, and the limitations of vegetarian diets especially for adequate provision of micronutrients. Overall, there is an adequate knowledge of the new trends by paediatricians and younger ones seemed more in favor of them and interested in receiving more information on most topics.

High Power Pulsed LED Driver for Vibration Measurements.

Vibration measurements pose specific experimental challenges to be faced. In particular, optical methods can be used to obtain full-field vibration information. In this scenario, stereo-camera systems can be developed to obtain 3D displacement measurements. As vibration frequency increases, the common approach is to reduce camera exposure time to avoid blurred images, which can lead to under-exposed images and data loss, as well as issues with the synchronization of the stereo pair. Both of these problems can be solved by using high-intensity light pulses, which can produce high-quality images and guarantee camera synchronization since data is saved by both cameras only during the short-time light pulse. To this extent, high-power Light-Emitting Diodes (LEDs) can be used, but even if the LED itself can have a fast response time, specific electronic drivers are needed to ensure the desired timing of the light pulse. In this paper, a circuit is specifically designed to achieve high-intensity short-time light pulses in the range of 1 µs. A prototype of the designed board was assembled and tested to check its capability to respect the specification. Three different measurement methods are proposed and validated to achieve short-time light pulse measurements: shunt voltage measurement, direct photodiode measurement with a low-cost sensor, and indirect pulse measurement through a low-frame-rate digital camera.

The role of light emitting diode in wound healing: A systematic review of experimental studies.

Wounds represent a growing global issue demanding increased attention. To expedite wound healing, technologies are under development, and light emitting diode (LED) devices of varying wavelengths are being explored for their stimulating influence on the healing process. This article presents a systematic literature review aiming to compile, organize, and analyze the impacts of LED devices on wound healing. This review is registered on the PROSPERO platform [CRD42023403870]. Two blinded authors conducted searches in the Pubmed, Web of Science, Scopus, Embase, and ScienceDirect databases. In vitro and in vivo experimental studies assessing LED utilization in the wound healing process were included. The search yielded 1010 studies, of which 27 were included in the review. It was identified that LED stimulates different healing pathways, promoting enhanced cell proliferation and migration, angiogenesis stimulation, increased collagen deposition, and modulation of the inflammatory response. Thus, it can be concluded that the LED stimulates cellular and molecular processes contingent on the utilized parameters. The effects depend on the standards used. Cell migration and proliferation were better influenced by green and red LED. The extracellular matrix components and angiogenesis were regulated by all wavelengths and the modulation of inflammation was mediated by green, red, and infrared LEDs.

Effective treatment of actinic keratosis on the hands with red light photodynamic therapy using BF-200 ALA.

BACKGROUND: Acral actinic keratosis (AK) lesions are considered difficult to treat, and published data for photodynamic therapy (PDT) on these lesions is limited. Thus, we evaluated sustained efficacy, safety, and satisfaction after PDT for AK on the hands. METHODS: We analysed subgroup data for treatment on the hands from a randomised, double-blind, intra-individual phase III study. All participants previously underwent up to two field-directed red light PDTs with 10% 5-aminolevulinic acid nanoemulsion gel (BF-200 ALA). Assessments included pain during PDT, clearance and recurrence rates, and satisfaction. RESULTS: 24 participants treated on the hands were included; 21 participants were analysed. Complete clearance rates with BF-200 ALA were 90.9% (lesion-based) and 76.2% (per participant's side), both markedly higher than with vehicle. The lesion recurrence rate with BF-200 ALA was 29.0%. Adverse events reflected the mode of action. Mean pain intensities were 4.8 ± 3.8 (BF-200 ALA) and 0.8 ± 2.1 (vehicle) on an 11-point numeric rating scale. Most participants (81.0%) rated their satisfaction with BF-200 ALA as very good or good. CONCLUSION: This subgroup analysis indicates that PDT with BF-200 ALA provides a suitable treatment for AK lesions on the hands.

The effect of pharmacist-led interventions on the appropriateness and clinical outcomes of anticoagulant therapy: a systematic review and meta-analysis.

AIM: Although pharmacist-led interventions in anticoagulant (AC) therapy are widely accepted, there is a lack of evidence comparing their effectiveness to usual care in terms of AC therapy appropriateness and clinical outcomes. We aimed to estimate the comparative effectiveness of pharmacist-led interventions on the appropriateness and clinical outcomes of AC therapy. METHODS AND RESULTS: Adhering to the PRISMA guidelines, we searched PubMed, EMBASE, and Scopus databases to identify randomised controlled trials and quasi-experimental and cohort studies published between 2010 and 2023. A random-effects model was used to calculate pooled intervention effects. We assessed heterogeneity (using Higgins' I2 and Cochran's Q) and publication bias (using Egger's test, the trim-and-fill method and visualisation of the funnel plot). In total, 35 studies involving 10 374 patients in the intervention groups and 11 840 in the control groups were included. The pharmacist-led interventions significantly improved the appropriateness of AC therapy (odds ratio [OR]: 3.43; 95% confidence interval [CI]: 2.33-5.06, p < 0.01). They significantly decreased total bleeding (relative risk [RR]: 0.75, 95% CI: 0.58-0.96, p = 0.03) and hospitalisation or readmission (RR: 0.64, 95% CI: 0.41-0.99, P = 0.04). However, the impact of the pharmacist-led interventions on thromboembolic events (RR: 0.69, 95% CI: 0.46-1.02, p = 0.07) and mortality (RR: 0.76, 95% CI: 0.51-1.13, p = 0.17) were not significant. CONCLUSION: Pharmacist-led interventions demonstrated superior outcomes in optimising AC therapy compared to usual care. Further research is needed to evaluate pharmacist-led interventions' cost-effectiveness and long-term sustainability.PROSPERO registration number CRD42023487362.

Light-mediated biosynthesis of size-tuned silver nanoparticles using Saccharomyces cerevisiae extract.

Bio-based production of silver nanoparticles represents a sustainable alternative to commercially applied physicochemical manufacturing approaches and provides qualitatively highly valuable nanomaterials due to their narrow size dispersity, high stability and biocompatibility with broad application potentials. The intrinsic features of nanoparticles depend on size and shape, whereby the controlled synthesis is a challenging necessity. In the present study, the biosynthesis of size-tuned silver nanoparticles based on cell-free extracts of Saccharomyces cerevisiae DSM 1333 was investigated. Single parameter optimization strategies in phases of cultivation, extraction, and synthesis were performed to modify the nanoparticle scale and yield. Visible light was exploited as a tool in nanoparticle production. The influence of white light on the biosynthesis of silver nanoparticles was determined by using novel LED systems with the exposition of varying irradiation intensities and simultaneous performance of control experiments in the dark. Characterization of the resulting nanomaterials by spectrophotometric analysis, dynamic light scattering, scanning electron microscopy, and energy dispersive X-ray spectroscopy, revealed spherical silver nanoparticles with controlled, light-mediated size shifts in markedly increased quantities. Matching of irradiated and non-irradiated reaction mixtures mirrored the enormous functionality of photon input and the high sensitivity of the biosynthesis process. The silver nanoparticle yields increased by more than 90% with irradiation at 1.0 ± 0.2 mW cm - 2 and the reduction of particle dimensions was achieved with significant shifts of size-specific absorption maxima from 440 to 410 nm, corresponding to particle sizes of 130 nm and 100 nm, respectively. White light emerged as an excellent tool for nano-manufacturing with advantageous effects for modulating unique particle properties.

Defining community-led monitoring and its role in programme-embedded learning: lessons from the Citizen Science Project in Malawi and South Africa.

INTRODUCTION: Programme Science (PS) and community-led monitoring (CLM) intersect in unexpected and promising ways. This commentary examines a CLM initiative in Malawi and South Africa to highlight the crucial role of CLM in bolstering the PS framework. By leveraging data sources often overlooked by conventional research and evaluation approaches, CLM emerges as a pivotal element in enhancing programme effectiveness. This paper delineates the fundamental principles of CLM, presents programme outcomes derived from CLM methodologies and contextualizes these findings within the broader framework of PS. DISCUSSION: The Citizen Science Project implements CLM continuously at 33 health facilities: 14 in Malawi (eight in Kasungu District and six in Dedza District), and 19 in South Africa (all in the West Rand District), representing a total catchment area of 989,848 people. Monitoring indicators are developed in an iterative process with community groups. The indicators are unique to each country, but both focus on the uptake of health services (quantitative) and barriers to access (qualitative). Monthly clinic records surveys capture 34 indicators in Malawi and 20 in South Africa and are supplemented by qualitative interviews with care recipients and healthcare workers. Qualitative interviews provide additional granularity and help confirm and explain the more macro trends in service coverage as described in quantitative data. The resulting data analysis reveals key themes that help stakeholders and decision-makers to solve problems collaboratively. Noteworthy outcomes include a substantial increase in multi-month dispensing of antiretroviral therapy (ART) during COVID-19 (from 6% to 31%) with a subsequent recovery surpassing of HIV service benchmarks in Malawi post-pandemic. CONCLUSIONS: While quantifying direct impact remains challenging due to the project's design, CLM proves to be a robust methodology that generates credible data and produces impactful outcomes. Its potential extends beyond the health sector, empowering community leadership and fostering interventions aligned with community needs. As CLM continues to evolve, its integration into PS promises to improve relevance, quality and impact across diverse disciplines.

Using quality improvement frameworks to develop, implement, and evaluate a novel ambulatory oncology pharmacy practice model: A descriptive example.

DISCLAIMER: In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. PURPOSE: To describe the application of the Plan-Do-Study-Act quality improvement framework in the development, implementation, and evaluation of a novel pharmacy practice model in ambulatory oncology. SUMMARY: Four iterations of the Plan-Do-Study-Act framework were completed to develop a patient-facing, pharmacist-led ambulatory oncology clinic program. The clinic provided care to patients with prostate cancer on oral anticancer therapy. Metrics were collected throughout all stages of development to inform target processes for improvement. The pharmacist saw 136 patients between July 2019 and January 2023, resulting in 464 total encounters. The pharmacist provided clinical interventions and counseling to patients newly starting on oral anticancer therapy and those established on therapy using a longitudinal model of care. CONCLUSION: Application of the Plan-Do-Study-Act quality improvement framework to a novel pharmacy practice model supported the development, evaluation, and sustainability of a pharmacist-led ambulatory oncology clinic providing care to patients with prostate cancer on oral anticancer therapy.