Development of an instrument to measure the competencies of health professionals in the process of evidence-based healthcare: A Delphi study.

AIMS: To identify and reach consensus on dimensions and criteria of a competence assessment instrument for health professionals in relation to the process of evidence-based healthcare. DESIGN: A two-round Delphi survey was carried out from April to June 2023. METHODS: Consensus was sought from an expert panel on the instrument preliminarily established based on the JBI Model of Evidence-Based Healthcare and a rapid review of systematic reviews of relevant literature. The level of consensus was reflected by the concentration and coordination of experts' opinions and percentage of agreement. The instrument was revised significantly based on the combination of data analysis, the experts' comments and research group discussions. RESULTS: Sixteen national and three international experts were involved in the first-round Delphi survey and 17 experts participated in the second-round survey. In both rounds, full consensus was reached on the four dimensions of the instrument, namely evidence-generation, evidence-synthesis, evidence-transfer and evidence-implementation. In round-one, the instrument was revised from 77 to 61 items. In round-two, the instrument was further revised to have 57 items under the four dimensions in the final version. CONCLUSION: The Delphi survey achieved consensus on the instrument. The validity and reliability of the instrument needs to be tested in future research internationally. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Systematic assessment of nurses and other health professionals' competencies in different phases of evidence-based healthcare process based on this instrument provides implications for their professional development and multidisciplinary team collaboration in evidence-based practice and better care process and outcomes. IMPACT: This study addresses a research gap of lacking an instrument to systematically assess interprofessional competencies in relation to the process of EBHC. The instrument covers the four phases of EBHC process with minimal criteria, highlighting essential aspects of ability to be developed. Identification of health professionals' level of competence in these aspects helps strengthen their capacity accordingly so as to promote virtuous EBHC ecosystem for the ending purpose of improving global healthcare outcomes. REPORTING METHOD: This study was reported in line with the Conducting and REporting of DElphi studies (CREDES) guidance on Delphi studies. PATIENT AND PUBLIC CONTRIBUTION: No patient or public contribution.

Knowledge and beliefs of endocrine disruptors in pediatrics: all hands on deck!

Endocrine disruptors (ED) are ubiquitous pollutants, possibly implicated in chronic disease. Exposure of vulnerable populations; including neonates, infants and children; must therefore be limited. Informing parents is now a public health challenge. We conducted a quantitative cross-sectional study at the Lyon Mother and child Hospital. We used questionnaires to assess the beliefs and knowledge about ED of parents and pediatric healthcare professionals in the pediatric ward in Lyon, France. A total of 746 questionnaires were completed: 444 for professionals and 302 for parents. The majority of both populations had already heard of ED but only 10% of parents and 5% of professionals felt sufficiently informed. Professionals answered better than parents (73% vs. 60%). The main source of information was similar: media. Only 20% of professionals had read a scientific article about ED and 4% have followed a training. Environmental exposure and EDs is an increasing concern for parents but specific knowledge remains scare for parents and professionals. Specific training is needed.

An exploration of frontline health professional's current understanding of non-fatal strangulation.

AIM: To explore frontline health professionals' current understanding of non-fatal strangulation and their need for and support for a comprehensive education and screening package to support health delivery. DESIGN: A descriptive mixed-method approach was chosen to analyse responses to an anonymous, online survey consisting of ten Likert scale, open-ended and five demographic questions. 103 frontline health professionals (nurses, doctors, paramedics, midwives) participated in this study. METHODS: Content analysis of the Likert scale and open-ended questions describing the subjective experiences and perceptions of the participants was undertaken along with percentage and frequency counts of the rated Likert responses. RESULTS: The findings identified that 51.1% of health professionals do not ask about strangulation routinely and that 59% of health professionals reported receiving no formal education or professional development on NFS to enhance their knowledge or inform clinical practice. No health professionals identified mild traumatic brain injury as a consequence or sign of strangulation, nor did they identify an understanding that 50% of people may have no visible injuries after being strangled. Health professionals also do not routinely document the different agencies referred to or involved in supporting the person who experienced NFS. CONCLUSION: Findings suggest that frontline health professionals lack the confidence, skills and education needed to meet medical obligations to their patients and to fulfil their duty to 'do no harm'. Frontline health professionals would welcome a comprehensive education and screening package to guide recognition and response to non-fatal strangulation in their clinical settings. WHERE AND ON WHOM WILL THE RESEARCH HAVE AN IMPACT?: The purpose of the study was to understand and explore health professionals' knowledge about non-fatal strangulation so that improved education around better screening, and management of trauma-focused care to people who have been subjected to non-fatal strangulation could occur. NO PATIENT OR PUBLIC CONTRIBUTION: This review contains no patient or public contribution since it examines health professionals' knowledge of identifying non-fatal strangulation and the screening and assessment tools used in clinical practice.

Usabilidade de um aplicativo móvel de apoio aos profissionaisde saúde para cálculos de doses de vancomicina / Usability of a mobile application supporting healthprofessionals on vancomycin dosing calculation

O aplicativo móvel CalcVAN foi desenvolvido para auxiliar os profissionais de saúde para otimizar as doses de vancomicina em pacientes hospitalizados. Porém, é imprescindível avaliar a sua usabilidade antes de disponibilizá-lo para prática clínica. Assim, o objetivo do estudo é avaliar a usabilidade do aplicativo móvel na perspectiva dos profissionais de saúde. Trata-se de um estudo descritivo, de avaliação heurística da usabilidade de um aplicativo móvel. Foram convidados profissionais da área de saúde com expertise no tema de gerenciamento de antimicrobianos e vancomicina. O instrumento validado Smartphone Usability questionnaiRE (SURE) foi utilizado para mensuração da usabilidade por meio de um questionário on-line. Vinte e um especialistas participaram do estudo, com média de idade de 32,6 anos, sendo a maioria de mulheres (n = 14, 66,7%), profissionais farmacêuticos (n = 13, 61,9%), com pós-graduação lato sensu (n = 10, 47,6%), que trabalhavam em hospitais públicos ou privados (n = 15, 71,4%) e com média de experiência em 9,7 anos. Com base na interpretação dos resultados obtidos pelo instrumento SURE, a média de usabilidade geral do CalcVAN foi de 83 pontos, com escore menor de 78 e maior de 90 pontos. O teste de usabilidade foi enquadrado nos dois últimos níveis, 70 e 80, onde os profissionais de saúde passaram a concordar fortemente e totalmente, indicando que o aplicativo móvel apresenta uma usabilidade satisfatória. O CalcVAN atingiu uma usabilidade satisfatória e atende as necessidades e exigências dos profissionais de saúde, mostrando--se eficiente para realizar as funções propostas.

The CalcVAN app was developed to assist healthcare professionals in optimizing vancomycin doses for hospitalized patients. However, the usability test before making it available for clinical practice is essential. Therefore, the study aims to evaluate the usability of the app from the perspective of health professionals. A descriptive study, a heuristic evaluation of the usability of a mobile application was conducted. Healthcare professionals with expertise in antimicrobial management and vancomycin were invited to participate. The validated Smartphone Usability questionnaiRE (SURE) was used to measure usability through an online questionnaire. Twenty-one experts participated in the study, with a mean age of 32.6 years, mostly of them women (n = 14, 66.7%), pharmacists (n = 13, 61.9%), with postgraduate education (n = 10, 47.6%), working in private or public hospitals (n = 15, 71.4%), and a mean experience of 9.7 years. Overall usability score for CalcVAN was 83 points, ranging from a minimum of 78 to a maximum of 90 points. The usability test registered within the last two levels, 70 and 80, with users expressing strongly and fully agreed, indicating that the app demonstrates satisfactory usability. CalcVAN achieved satisfactory usability, fulfilling the needs and requirements of health professionals, proving to be efficient in performing the intended functions.

Unraveling Trust Issues Towards Mental Health Professionals Among Bedouin-Arab Minority in Israel.

Trust in mental health professionals and services profoundly impacts health outcomes. However, understanding trust in mental health professionals, especially in ethnic minority contexts, is lacking. To explore this within the Bedouin-Arab minority, a qualitative study conducted semi-structured interviews with 25 Bedouins in southern Israel. Participants were primarily female (60%) married (60%), averaging 34.08 years old. Employing grounded theory, three themes emerged. Firstly, concerns about confidentiality were central, eroding trust due to societal repercussions. Secondly, factors influencing confidentiality concerns and distrust were tied to Bedouin-Arab social structures and cultural values rather than professional attributes. Lastly, the consequences of distrust included reduced help-seeking. This study enriches the understanding of trust in mental health professionals among non-Western ethnic minorities, highlighting how cultural factors shape perceptions of mental health services and distrust. Addressing confidentiality worries demands Bedouin mental health professionals to acknowledge hurdles, build community ties, and demonstrate expertise through personal connections and events.

The prevalence of PTSD and coping strategies among Palestinian mental health professionals during political violence and wartime.

Background: In times of war, mental health professionals are at an increased risk of developing psychological problems, including posttraumatic stress disorder (PTSD). The effects of conflicts or wars on mental health professionals in Palestine and their coping methods of dealing with these challenges remain unknown. This study aimed to assess the prevalence of PTSD symptoms and strategies for coping among mental health professionals in Palestine, in light of the ongoing Gaza war and political violence. Methods: The study utilized a cross-sectional research design. Self-reported questionnaires, including the PCL-5 and Brief COPE scales, were used to gather data. The relationship between the research variables and PTSD symptoms was investigated using frequencies, percentages, bivariate analysis, Pearson correlation, and Pearson's chi-square test. Results: A total of 514 participants were recruited, with an estimated prevalence of PTSD of 38.7%. Furthermore, the multivariate analysis revealed that having a prior history of trauma and feeling disabled or unable to deal with your patients during the current Gaza war and Israeli-Palestinian political violence increases the likelihood of developing PTSD symptoms. In addition, using venting, self-blame, and behavioral disengagement as coping strategies increases the likelihood of developing symptoms of PTSD. Moreover, using acceptance and substance use as coping strategies reduces the risk of developing PTSD symptoms. Conclusion: The findings revealed a high prevalence of PTSD symptoms among mental health professionals during wartime and political violence. As a result, mental health professionals need immediate assistance in enhancing their mental wellbeing through supervision, psychotherapy, and comprehensive and continuous training.

Prevalence and Risk Factors Associated with Chronic Occupational Low Back Pain among Healthcare Professionals Working at Hospitals: Exploratory Survey Study.

Objective This study aimed to describe the methodological process for developing a questionnaire to identify the prevalence and risk factors for chronic occupational low back pain in healthcare professionals working at hospitals. Method An exploratory crossectional survey study was carried out in Belo Horizonte, MG, Brazil, and its metropolitan region, in two stages. Initially, the authors prepared a questionnaire based on the Roland Morris disability questionnaire and sent it to a committee of low back pain specialists for validation using the Delphi technique. The second stage consisted of sending the final questionnaire to health professionals working in a hospital environment for at least 2 years and presenting chronic low back pain for at least 3 months. Results Validation occurred in two rounds of questionnaire adjustments by a panel consisting of physical therapists and physician experts in the field (orthopedists with more than 3 years of experience). Both rounds had 13 participants. The questionnaire initially consisted of 27 items, and, after validation, it had 19 items. The study included 65 subjects, with an average age of 40.91 years old and an average time working at a hospital of 40 hours per week. The total sample had 76.9% of physicians, 10.8% of physical therapists, and 12.3% of nurses or nursing technicians. Most (52.3%) subjects reported staying in uncomfortable positions affecting the lower back for 5 to 10 hours per day. Conclusion We developed and validated, using the Delphi technique, a questionnaire on the prevalence and risk factors associated with chronic occupational low back pain among healthcare professionals working at hospitals. This unprecedented tool can benefit the population studied since the questionnaires currently used to evaluate chronic low back pain are not specific for investigating the occupational cause of this condition.

Intervention Programs Targeting Burnout in Health Professionals: A Systematic Review.

Background: Burnout is an occupational syndrome, with a higher prevalence in professionals whose close involvement with other people is significant. There is a great diversity of professionals at risk of burnout, and therefore the implementation of intervention programs is relevant, as helping people to maintain their mental and emotional health enables them to become more meaningfully involved in their communities and become more effective and active global citizens. We aimed to review systematically the characteristics of interventions targeting burnout in health professionals. Methods: The search was conducted in three databases: Scopus, Web of Science, and PubMed, following the PRISMA model, and 16 eligible articles were identified between 2012 and 2023. Results: Mindfulness showed great efficacy in preventing burnout, by reducing stress levels and promoting empathy. In addition, relaxation and breathing techniques, yoga, and music therapy showed to improve burnout and occupational stress levels. Balint groups have also helped slow the progression of burnout. Implications about the need for future research to foster the promotion of well-being and mental health of health professionals are mentioned. Conclusion: Mindfulness, relaxation and breathing techniques, yoga, music therapy and balint groups proved to be effective in preventing burnout.

We can use our superpower to help end fossil fuel pollution and rise to the challenge of climate change.

In this commentary, we argue that health professionals can play a pivotal role in accelerating the adoption of public policies that will help communities, nations, and the world end fossil fuel pollution and rise to the challenges of climate change. We briefly describe our previously published research showing that communicating about fossil fuel pollution and the health relevance of climate change has many benefits in building public support for climate action. Most importantly, we make the case that because health professionals, especially medical doctors and other clinicians, are highly trusted, we collectively have a unique opportunity to bring people together across the political continuum to have constructive dialogues about the intertwined problems of fossil fuel pollution and climate change and what to do about them - even in the current hyper-partisan environment.

Fear of COVID-19 among oral health professionals in South Africa.

Background: The coronavirus disease 2019 (COVID-19) pandemic caused widespread psychological morbidity, especially among frontline workers. Oral health professionals (OHPs) are at increased risk of contracting and dying from COVID-19 because pf their proximity to infected patients. The objective of this study was to measure the level of COVID-19 fear and its predictors among South African OHPs. Aim: To evaluate the severity of fear of COVID-19 among OHPs in South Africa. Setting: Online platforms. Methods: In this cross-sectional study, a Google Forms-based online survey was conducted. The fear scale of COVID-19 (FCV-19S) was used to assess the level of fear among OHPs. Statistical data analysis was performed using SPSS 28.0. The multivariate logistic regression model was developed to assess the predictors of COVID-19 fear. Results: A total of 462 OHPs participated in this study. Approximately half of the participants, 212 (45.6%), indicated having severe fear of COVID-19. The regression model showed a significant association between COVID-19 fear and increased age, clinical experience, employment sector, professional group, positive COVID-19 test and COVID-19 vaccination. Conclusion: The results indicate that South African OHPs had low levels of corona phobia. Females, older and vaccinated OHPs had the greatest odds of COVID-19 fear. Contribution: This study provides insights into the severity of fear and anxiety experienced by OHPs in the time of the pandemic. The findings will aid in the development of appropriate interventions and programmes to deal with similar outbreaks in the future.

Assessing knowledge of migrant sexual reproductive health and rights: a national cross-sectional survey among health professionals in Sweden.

Introduction: Despite the commitment of the Swedish government to ensuring equal access to Sexual Reproductive Health and Rights services for all citizens, shortcomings persist among the migrant population. In cases where healthcare providers lack sufficient knowledge or hold misconceptions and biases about these contentious issues, it can lead to the delivery of suboptimal care. Therefore, the objective of this study was to assess the level of knowledge of Swedish healthcare providers on global and Swedish migrant Sexual Reproductive Health and Rights. Methods: A national cross-sectional study was conducted using a questionnaire consisting of seven questions related to global and Swedish migrant Sexual Reproductive Health and Rights. The questionnaire was distributed among midwives, nurses, gynecologists and obstetricians, and hospital social workers (N = 731). The analysis was guided by the Factfulness framework developed by Hans Rosling to identify disparities between healthcare providers' viewpoints and evidence-based knowledge. Results: There was an overall lack of knowledge among the health care providers on these issues. The highest correct responses were on the question on abandonment of female genital cutting/mutilation after migration (74%). The findings indicated that healthcare providers originating from Sweden, physicians, those with fewer years of clinical experience, and exhibiting more migrant-friendly attitudes, demonstrated a higher level of knowledge regarding global and Swedish migrant Sexual and Reproductive Health and Rights. Conclusion: This study demonstrates that healthcare providers lacked knowledge of global and Swedish migrant Sexual Reproductive Health and Rights, which was almost uniformly distributed, except among those with more comprehensive and recent education. Contrary to expectations, healthcare professionals did not primarily rely on their education and experiences but were influenced by their personal values and opinions. The study underscores the importance of upgrading knowledge in Sexual Reproductive Health and Rights and encourages policymakers, professionals, and students to base their opinions on well-founded facts, particularly in the context of a diverse and globalized society.

Health professionals' intervention in the context of domestic violence against women: exploring perceptions and experiences of providing healthcare.

Domestic violence against women is a complex social phenomenon and a widely recognised issue of public health, which requires that all sectors of society, including the health sector, take the necessary action to prevent and address it. This paper aims to contribute to the discussion on the role of the primary health care in addressing domestic violence against women, by analysing health professionals' perceptions of their practice as well as the difficulties they experience in providing healthcare to victims. To fulfil this aim, a qualitative approach was chosen, using focus groups with health professionals working in the area of primary health care in an inland region of Portugal. The main findings point to the lack of a specific protocol and insufficient information and skills to respond to domestic violence situations, which hinders health professionals' confidence to intervene and tends to orientate them towards a more medical response. Resulting from these findings, implications for practice are discussed: the need for clear and specific orientations to guide health professionals' intervention; the need to offer training that enables them to provide appropriate healthcare to women experiencing domestic violence; and the need to position themselves in the context of an integrated, multi-sectoral intervention.

What are the experiences, preparation, and support needs of early career clinical educators within an Australian tertiary health service?: a qualitative study.

BACKGROUND: There is increasing demand for professional practice placement opportunities, supported by health professional educators, to enable future health workforce development. Early career health professionals performing the educator role is one strategy that can help meet this demand. However, there is a need to consider how best to prepare and support early career health professionals to become educators. This study aimed to explore the experiences and perspectives of early career occupational therapy clinical educators including their preparation and support needs. METHODS: Semi-structured interviews were completed with ten early career occupational therapists who had supervised their first or second student on a professional practice placement. The participants worked within an Australian tertiary hospital and health service in various clinical settings. Interviews were completed within six weeks of placement completion and lasted approximately one hour. They were recorded and transcribed verbatim and reflexive inductive thematic analysis was undertaken to identify key themes. RESULTS: Ten occupational therapists, who had been working for an average of two years and two months, consented to participate. Initially, participants expressed mixed emotions about taking on the clinical educator role. They then described their adjustment to the role responsibilities, challenges encountered, and the development of the educator-student relationship. Participants found that the experience of supervising a student enhanced their educator, clinical, and professional skills and confidence. The important support elements of tailored educator preparation, placement design, and timely access to relevant resources and experienced staff were identified. CONCLUSIONS: This study demonstrated how early career health professionals can possess desirable educator attributes, such as enthusiasm for taking on the role and cultivating collaborative learning relationships with their students. The experience of being an educator also presents a professional development opportunity for early career health professionals. Insights gained about the specific preparation and support needs of early career clinical educators warrant consideration by organisations and staff involved in the provision of student professional practice placements. Overall, this study's findings signify the importance of engaging and investing in early career health professionals to support student clinical education and to develop our current and future healthcare workforce.

Design and validation of a preliminary instrument to contextualize interactions through information technologies of health professionals.

The communication of e-Health has been transformed with the advancement of information technologies, therefore it is feasible to carry out studies in the context of health professionals' interactions. Objective: This study aimed to design and validate a preliminary questionnaire to investigate the context of the communications of health professionals through information technologies considering three significant dimensions. Method: The stages provided by Hernández Sampieri guided the building, validation through Cronbach's alpha and factorial analysis. The questionnaire was applied to 43 participants who simulated health professionals. Results: We obtained an instrument that includes a demographic data section and 20 items distributed into three factors. Internal consistency reliability with Cronbach's alpha values generally of 0.848 and higher than 0.811 was obtained in each dimension. Kaiser-Meyer-Olkin's measure of sampling adequacy was regular, with 0.781, and Bartlett's test of sphericity was significant (p < 0.001). Conclusion: It is necessary to apply in real-world environments to reaffirm the results obtained.

Machine Learning Methods Using Artificial Intelligence Deployed on Electronic Health Record Data for Identification and Referral of At-Risk Patients From Primary Care Physicians to Eye Care Specialists: Retrospective, Case-Controlled Study.

BACKGROUND: Identification and referral of at-risk patients from primary care practitioners (PCPs) to eye care professionals remain a challenge. Approximately 1.9 million Americans suffer from vision loss as a result of undiagnosed or untreated ophthalmic conditions. In ophthalmology, artificial intelligence (AI) is used to predict glaucoma progression, recognize diabetic retinopathy (DR), and classify ocular tumors; however, AI has not yet been used to triage primary care patients for ophthalmology referral. OBJECTIVE: This study aimed to build and compare machine learning (ML) methods, applicable to electronic health records (EHRs) of PCPs, capable of triaging patients for referral to eye care specialists. METHODS: Accessing the Optum deidentified EHR data set, 743,039 patients with 5 leading vision conditions (age-related macular degeneration [AMD], visually significant cataract, DR, glaucoma, or ocular surface disease [OSD]) were exact-matched on age and gender to 743,039 controls without eye conditions. Between 142 and 182 non-ophthalmic parameters per patient were input into 5 ML methods: generalized linear model, L1-regularized logistic regression, random forest, Extreme Gradient Boosting (XGBoost), and J48 decision tree. Model performance was compared for each pathology to select the most predictive algorithm. The area under the curve (AUC) was assessed for all algorithms for each outcome. RESULTS: XGBoost demonstrated the best performance, showing, respectively, a prediction accuracy and an AUC of 78.6% (95% CI 78.3%-78.9%) and 0.878 for visually significant cataract, 77.4% (95% CI 76.7%-78.1%) and 0.858 for exudative AMD, 79.2% (95% CI 78.8%-79.6%) and 0.879 for nonexudative AMD, 72.2% (95% CI 69.9%-74.5%) and 0.803 for OSD requiring medication, 70.8% (95% CI 70.5%-71.1%) and 0.785 for glaucoma, 85.0% (95% CI 84.2%-85.8%) and 0.924 for type 1 nonproliferative diabetic retinopathy (NPDR), 82.2% (95% CI 80.4%-84.0%) and 0.911 for type 1 proliferative diabetic retinopathy (PDR), 81.3% (95% CI 81.0%-81.6%) and 0.891 for type 2 NPDR, and 82.1% (95% CI 81.3%-82.9%) and 0.900 for type 2 PDR. CONCLUSIONS: The 5 ML methods deployed were able to successfully identify patients with elevated odds ratios (ORs), thus capable of patient triage, for ocular pathology ranging from 2.4 (95% CI 2.4-2.5) for glaucoma to 5.7 (95% CI 5.0-6.4) for type 1 NPDR, with an average OR of 3.9. The application of these models could enable PCPs to better identify and triage patients at risk for treatable ophthalmic pathology. Early identification of patients with unrecognized sight-threatening conditions may lead to earlier treatment and a reduced economic burden. More importantly, such triage may improve patients' lives.

"I Felt a Sense of Mission during Moments of Crisis": Mental Health Professionals' Perspectives on Their Initial Treatment of Evacuees during the Israel-Hamas Conflict.

This study examines mental health service providers who provided care to evacuees during the Israel-Hamas conflict. Utilizing a phenomenological qualitative method, the research delves into the psychological impact on the participants' lived experiences. The sample included 25 mental health providers (13 female, age range 28-63, mean 42.4, SD 7.3; 15 psychologists and 10 social worker, average seniority 10.8 years, SD 5.2, range 2-18 years). Data were collected through semi-structured interviews conducted between December 2023 and March 2024. The data analysis revealed a dual narrative: Participants paid a major personal price and experienced secondary traumatization manifesting in emotional detachment, physical symptoms, and heightened arousal. They also derived a profound sense of meaning and fulfillment from their work, contributing to personal and professional growth. These findings underscore the complexity of their experiences, which were marked by the challenges of secondary trauma and the resilience fostered through their work. This study emphasizes the importance of support systems, including social and familial networks and professional supervision, in navigating these challenges. This study has several limitations, including small sample size and the use of virtual interviews, suggesting the need for further research with a broader participant base and in different contexts.

Exploring the sustainable impacts of a clinical healthcare research scholarship programme.

BACKGROUND: The NHS is the first public body globally to commit to net zero. AIM: This study aimed to explore the environmental sustainability impact of a hospital scholarship programme. METHOD: A sustainable quality improvement value framework was used to measure the programme's environmental, social and financial effects. RESULTS: The social impact through face-to-face contact was most valued by scholars; there were also savings in carbon emissions and costs. DISCUSSION: Training in sustainability is essential for the workforce but little infrastructure and expertise are available within organisations to support staff to provide sustainable healthcare in day-to-day practice. CONCLUSION: Sustainable healthcare should be supported by education and national guidance and implementation plans should be drawn up to this end. The social impact of the framework used is often seen as less important than its environmental and financial components; however, as its value to scholars illustrates, the components are intertwined and should be considered of equal importance.

Modern educational needs of specialists in the public health system.

OBJECTIVE: Aim: Studying the opinion of public health system workers (emlpoyees) regarding existing educational problems and needs in the context of continuous professional development. PATIENTS AND METHODS: Materials and Methods: Bibliosemantic, medical-statistical, sociological methods are used in the study. The research program provided for conducting sociological surveys of public health specialists in different regions of the country regarding the establishment of priority training topics for public health specialists; preferred methods of learning; barriers to access to education, etc. The scientific base of the research the regional centers for disease control and prevention have become. Statistical processing and mathematical analysis of materials was carried out using methods of statistical analysis. RESULTS: Results: The research has found that the priority topics of training for public health specialists are issues of epidemiology (which were indicated as very important by 67.7±3.7 and as important by 22.0±3.2 per 100 respondents); emergency and disaster management (67.7±3.7 and 31.1±3.6 per 100 respondents), quality and safety (53.0±3.9 and 38.4±3.8), practices based on on evidence (42.1±3.9 and 45.7±3.9) eHealth and digitalization (40.2±3.8 and 38.4±3.8), statistics (38.4±3.8 and 51 ,2±3.9), research methodology (32.9±3.7 and 51.2±3.9) and research ethics (12.8±2.6 and 67.7±3.7, respectively). Webinars (62.2±3.8 per 100 respondents) and online training (60.4±3.8), classroom (42.1±3.9) and hybrid (40.2±3.8) were identified as preferred forms. teaching. The obstacles to the continuous professional development of public health specialists are a lack of time and a lack of finances, a lack of information about desired training programs, their regulations, insufficient support from management, military aggression and the problems caused by it, etc. CONCLUSION: Conclusions: The priority topics of training for public health specialists, preferred methods of training and barriers to access to training determined in the course of the study are the basis for improving the organization of continuous professional development of employees of public health centers.

Readiness of Exercise Physiologists, Physiotherapists and Other Allied Health Professionals to Respond to Gender-Based Violence: A Mixed-Methods Study.

Experiencing gender-based violence (GBV) is associated with health conditions that are common indications for referral to exercise physiologists, physiotherapists and other allied health professionals (AHPs). The readiness of AHPs to identify and respond to GBV is currently unknown. This study aimed to determine the readiness of AHPs to respond to a person who had experienced GBV. Participants completed the modified Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS) and/or an interview. The AHPs felt underprepared, had low perceived knowledge and lacked confidence to respond to and support people who have experienced GBV, despite recognition of the importance and agreement of the relevance to AHPs' practice.