[Factors associated with the intention to donate blood in patients of a hospital in Peru]. / Factores asociados a la intención de donación de sangre en pacientes de un hospital de Perú.

OBJECTIVE: Research on factors that modify the intention to donate blood voluntarily in the general population in Peru is scarce, and most of it are focused on health science personnel. The aim of the present study was to estimate the factors associated with the intention to donate blood in patients attending an outpatient clinic in a hospital in northern Peru. METHODS: A prospective unpaired study of cases (n=185) and controls (n=185) was designed. A case was defined as a patient who responded "if I would voluntarily donate blood in the future" to the initial filter question. The response variable was intention to donate blood and the exposure variables were sex, age, marital status, educational level, employment status, monthly income, religion, donation practices, and knowledge about donation. In addition, the motivations for blood donation were explored. To identify the associated factors, crude odds ratios (ORc) were calculated by means of generalized linear models, using the Poisson family, log link function and robust models; then the variables that showed a significant statistical association were adjusted by multivariate analysis, adjusting for sociodemographic variables, and the adjusted odds ratios (ORa) were obtained. RESULTS: In the multivariate analysis, male sex (ORa=1.37), having a high monthly income (ORa=1.26), professing the catholic religion (ORa=5.27), having a higher score in the knowledge questionnaire (ORa=1.04), having previously donated (ORa=1.64) and having a family member who had previously donated (ORa=1.72) increased the probability of intention to donate blood. On the other hand, older age (ORa=0.97) decreased said probability. CONCLUSIONS: Several factors associated with the intention to donate blood are identified, most of which were similar to previous studies. It is highlighted that a high level of knowledge, as well as previous donation experiences, increase the intention to donate blood.

OBJECTIVE: Las investigaciones sobre factores que modifiquen la intención de donar sangre voluntariamente en población general en Perú son escasas, y la mayoría se centran en el personal de Ciencias de la Salud. El objetivo del presente estudio fue estimar los factores asociados a la intención de donación de sangre en pacientes que acudían a consulta externa de un hospital del norte peruano. METHODS: Se diseñó un estudio de casos (n=185) y controles (n= 185) prospectivo no pareado. Se definió como caso al paciente que respondía "si donaría voluntariamente sangre en el futuro" a la pregunta filtro inicial. La variable respuesta fue la intención de donación de sangre y las de exposición fueron sexo, edad, estado civil, grado de instrucción, situación laboral, ingresos mensuales, religión, prácticas sobre la donación y conocimientos sobre la donación. Adicionalmente se exploraron las motivaciones para la donación de sangre. Para identificar los factores asociados se calcularon odds ratio crudos (ORc) mediante modelos lineales generalizados, haciendo uso de la familia Poisson, función de enlace log y modelos robustos; luego, las variables que mostraron asociación estadística significativa se ajustaron mediante análisis multivariado, ajustándolas por las variables sociodemográficas, y se obtuvieron los odds ratio ajustados (ORa). RESULTS: En el análisis multivariado aumentaron la probabilidad de intención de donación de sangre ser de sexo masculino (ORa=1,37), tener ingresos mensuales altos (ORa=1,26), profesar la religión católica (ORa=5,27), tener una mayor puntuación en el cuestionario de conocimientos (ORa=1,04), haber donado previamente (ORa=1,64) y que un familiar hubiera donado previamente (ORa=1,72). Por otro lado, la edad más avanzada (ORa=0,97) disminuyó dicha probabilidad. CONCLUSIONS: Se identifican diversos factores asociados a la intención de donación de sangre. Se resalta que el nivel de conocimientos elevado, así como experiencias previas en donación, aumentan la intención de donar sangre.

Development and transfer learning of self-attention model for major adverse cardiovascular events prediction across hospitals.

Predicting major adverse cardiovascular events (MACE) is crucial due to its high readmission rate and severe sequelae. Current risk scoring model of MACE are based on a few features of a patient status at a single time point. We developed a self-attention-based model to predict MACE within 3 years from time series data utilizing numerous features in electronic medical records (EMRs). In addition, we demonstrated transfer learning for hospitals with insufficient data through code mapping and feature selection by the calculated importance using Xgboost. We established operational definitions and categories for diagnoses, medications, and laboratory tests to streamline scattered codes, enhancing clinical interpretability across hospitals. This resulted in reduced feature size and improved data quality for transfer learning. The pre-trained model demonstrated an increase in AUROC after transfer learning, from 0.564 to 0.821. Furthermore, to validate the effectiveness of the predicted scores, we analyzed the data using traditional survival analysis, which confirmed an elevated hazard ratio for a group with high scores.

Slow and steady-small, but insufficient, changes in food and drink availability after four years of implementing a healthy food policy in New Zealand hospitals.

BACKGROUND: A voluntary National Healthy Food and Drink Policy (the Policy) was introduced in public hospitals in New Zealand in 2016. This study assessed the changes in implementation of the Policy and its impact on providing healthier food and drinks for staff and visitors in four district health boards between 1 and 5 years after the initial Policy introduction. METHODS: Repeat, cross-sectional audits were undertaken at the same eight sites in four district health boards between April and August 2017 and again between January and September 2021. In 2017, there were 74 retail settings audited (and 99 in 2021), comprising 27 (34 in 2021) serviced food outlets and 47 (65 in 2021) vending machines. The Policy's traffic light criteria were used to classify 2652 items in 2017 and 3928 items in 2021. The primary outcome was alignment with the Policy guidance on the proportions of red, amber and green foods and drinks (≥ 55% green 'healthy' items and 0% red 'unhealthy' items). RESULTS: The distribution of the classification of items as red, amber and green changed from 2017 to 2021 (p < 0.001) overall and in serviced food outlets (p < 0.001) and vending machines (p < 0.001). In 2021, green items were a higher proportion of available items (20.7%, n = 815) compared to 2017 (14.0%, n = 371), as were amber items (49.8%, n = 1957) compared to 2017 (29.2%, n = 775). Fewer items were classified as red in 2021 (29.4%, n = 1156) than in 2017 (56.8%, n = 1506). Mixed dishes were the most prevalent green items in both years, representing 11.4% (n = 446) of all items in 2021 and 5.5% (n = 145) in 2017. Fewer red packaged snacks (11.6%, n = 457 vs 22.5%, n = 598) and red cold drinks (5.2%, n = 205 vs 12.5%, n = 331) were available in 2021 compared to 2017. However, at either time, no organisation or setting met the criteria for alignment with the Policy (≥ 55% green items, 0% red items). CONCLUSIONS: Introduction of the Policy improved the relative healthiness of food and drinks available, but the proportion of red items remained high. More dedicated support is required to fully implement the Policy.

Towards an update on the antimicrobial use in Adult Care Units in Brazil: insights from multi-hospital prevalence study.

Introduction. Efforts to understand the burden of antibiotic use in low- and middle-income countries such as Brazil are essential for developing strategies that are effective and appropriate in the context of endemic multidrug-resistant organisms.Aim. This study aims to determine antimicrobial-prescribing practices among patients hospitalized in intensive care units (ICUs) for adults in Brazil.Methodology. A 1-day point prevalence multicentre survey was conducted in 58 adult ICUs across the five regions of Brazil. The institutions were categorized according to their type and size. Detailed antimicrobial prescription data were prospectively provided to all patients hospitalized on the day of data collection.Results. A total of 620 patients were included in the study, of whom 63.9% were receiving at least one antimicrobial. Of these, 34.6% were treated for an infection, but only 39.9% of the cases were based on microbiological criteria. Empirical treatment was applied to 72.3% of the patients. Significant differences in antibiotic usage were observed across the different hospitals included in the study. Overall, treatment was most commonly directed towards pneumonia (51.8%) and bloodstream infections (29.6%). Glycopeptides (19.4%) and carbapenems (18.5%) were the most prescribed in teaching hospitals, while in non-teaching hospitals, carbapenems (17.8%) and broad-spectrum cephalosporins (16.8%) were most frequently used.Conclusion. Our study reveals alarming data on antibiotic use in adult ICUs in Brazil, with high frequencies of severe healthcare-associated infections acquired in these units, where patients are frequently subjected to empirical treatment.

Toward hospital resilience: a qualitative study on the identification of hospital shocks during disruption era in Indonesia.

BACKGROUND: Hospital resilience has been well recognized among healthcare managers and providers as disruption of hospital services that threatens their business environment. However, the shocks identified in the recent hospital resilience concept are mainly related to disaster situations. This study aims to identify potential shocks that hospitals face during disruptions in Indonesia. METHOD: This qualitative study was conducted in Makassar, Indonesia in August-November 2022. Data was collected through semi-structured interviews with hospital managers and resilience experts using a semi-structured interview guide. 20 key informants were interviewed and data were analyzed by thematic analysis. RESULTS: The study identified seven shocks to hospitals during the disruption era: policy, politics, economics, hospital management shifting paradigms, market and consumer behavior changes, disasters, and conflicts. It also identified barriers to making hospitals resilient, such as inappropriate organizational culture, weak cooperation across sectors, the traditional approach of hospital management, inadequate managerial and leadership skills, human resources inadequacies, a lack of business mindset and resistance to change. CONCLUSION: This study provides a comprehensive understanding of hospital shocks during disruptions. This may serve as a guide to redesigning the instruments and capabilities needed for a resilient hospital.

Health & Productivity Management Associated With Improved Efficiency of Inpatient Health Care: Cross-sectional Study Using FY2021 Bed Function Report.

This study examined the relationship between health and productivity management (H&PM) and inpatient health care efficiency in hospitals. This cross-sectional study is based on 1108 hospitals using data from the FY2021 Bed Function Report. The presence of Certified H&PM Organization was the proxy variable for H&PM implementation. The efficiency value obtained using the input-oriented Banker-Charners-Cooper model of data envelopment analysis was a proxy variable for inpatient health care efficiency. The input variables were the number of hospital beds, registered physicians, ward nurses, and other staff members in the ward. The output variable was the total number of patients in the ward per year. We conducted a Wilcoxon rank-sum test and compared certified and non-certified hospitals. The efficiency value was the objective variable, and certification presence was the explanatory variable. We used a stepwise method, including adjustment variables, to confirm whether the certification presence remained in the final multiple regression model. Efficiency was significantly higher in certified hospitals than non-certified hospitals. Certification presence remained in the final multiple regression model (ß = .027, CI = -0.004 to 0.057, P = .085). Although not statistically significant, certified hospitals tended to have higher efficiency compared to non-certified hospitals. These findings suggested that hospitals that actively engage in H&PM may have higher efficiency in inpatient health care. However, further research is needed to establish the causal relationship.

Empowering healthcare education: A multilingual ontology for medical informatics and digital health (MIMO) integrated to artificial intelligence powered training in smart hospitals.

Objective: A comprehensive understanding of professional and technical terms is essential to achieving practical results in multidisciplinary projects dealing with health informatics and digital health. The medical informatics multilingual ontology (MIMO) initiative has been created through international cooperation. MIMO is continuously updated and comprises over 3700 concepts in 37 languages on the Health Terminology/Ontology Portal (HeTOP). Methods: We conducted case studies to assess the feasibility and impact of integrating MIMO into real-world healthcare projects. In HosmartAI, MIMO is used to index technological tools in a dedicated marketplace and improve partners' communication. Then, in SaNuRN, MIMO supports the development of a "Catalog and Index of Digital Health Teaching Resources" (CIDHR) backing digital health resources retrieval for health and allied health students. Results: In HosmartAI, MIMO facilitates the indexation of technological tools and smooths partners' interactions. In SaNuRN within CIDHR, MIMO ensures that students and practitioners access up-to-date, multilingual, and high-quality resources to enhance their learning endeavors. Conclusion: Integrating MIMO into training in smart hospital projects allows healthcare students and experts worldwide with different mother tongues and knowledge to tackle challenges facing the health informatics and digital health landscape to find innovative solutions improving initial and continuous education.

Effectiveness of influenza vaccines in children aged 6 to 59 months: a test-negative case-control study at primary care and hospital level, Spain 2023/24.

During 2023/24, all children aged 6 to 59 months were targeted for seasonal influenza vaccination in Spain nationally. Using a test-negative case-control design with sentinel surveillance data, we estimated adjusted influenza vaccine effectiveness (IVE) against any influenza type to be 70% (95% confidence interval (CI): 51 to 81%) for primary care patients with acute respiratory illness (ARI) and 77% (95% CI: 21 to 93%) for hospitalised patients with severe ARI. In primary care, where most subtyped viruses (61%; 145/237) were A(H1N1), adjusted IVE was 77% (95% CI: 56 to 88%) against A(H1N1)pdm09.

Burkholderia multivorans Infections Associated with Use of Ice and Water from Ice Machines for Patient Care Activities - Four Hospitals, California and Colorado, 2020-2024.

Ice machines can harbor water-related organisms, and the use of ice or tap water for clinical care activities has been associated with infections in health care settings. During 2021-2022, a total of 23 cases of infection by Burkholderia multivorans (sequence type ST659) were reported at two southern California hospitals and linked to contaminated ice and water from ice machines. In addition to these 23 cases, this report also includes 23 previously unreported cases of B. multivorans ST659 infections that occurred during 2020-2024: 13 at a northern California hospital, eight at a hospital in Colorado, and two additional cases at one of the southern California hospitals. The same brand of ice machine and brands of filters, descaling, and sanitizing products were used by all four hospitals; B. multivorans was isolated from samples collected from ice machines in two of the hospitals. Whole genome sequencing indicated that all clinical and ice machine isolates were highly genetically similar (0-14 single nucleotide variant differences across 81% of the selected reference genome). Recommendations from public health officials to halt the outbreak included avoiding ice and tap water during clinical care activities. An investigation is ongoing to determine possible sources of ice machine contamination. During outbreaks of water-related organisms in health care facilities, health care personnel should consider avoiding the use of tap water, including ice and water from ice machines, for patient care.

Hospital level interventions to improve outcomes after injury in India, a LMIC.

Background & objectives Trauma is one of the leading causes of disability and death, worldwide. Ninety per cent of trauma related mortality occurs in low- and middle-income countries (LMICs). Despite this, there is paucity of literature emanating from LMICs with studies that present and/or evaluate feasible interventions that can have a measurable impact on outcomes after injury, primarily mortality. The current article aims at developing such interventions key elements of implementation and measures of compliance and impact. Methods A literature review was conducted to evaluate the status of injury care among LMICs worldwide. Based on this review, interventions were identified/developed, that (i) were feasible to implement within the constraints of available resources; (ii) could be implemented within a two year timespan; and (iii) would improve outcomes primarily, mortality. These interventions were then discussed at a symposium of experts and stakeholders from around the world. Results The literature review identified gaps across the entire spectrum of injury care at all levels - primary, secondary and tertiary prevention. Additionally, lack of data systems capable of ensuring quality of care and driving performance improvement was identified. Utilizing the review as the basis and focusing on hospital level interventions, one policy intervention, five in-hospital interventions and one major research question were identified/developed that met the defined criteria. Interpretation & conclusions Gaps in trauma care in LMICs at every level and in data systems were identified. Feasible interventions that can be implemented within the resource constraints of LMICs in a reasonable timeframe and that can have a measurable impact on injury related mortality were developed and are presented.

Long-term probabilistic forecasts of activity mitigation in English hospitals: a national elicitation exercise providing an outside view based on judgements of experts in support of the New Hospital Programme.

OBJECTIVES: The planning process for a new hospital relies on assumptions about future levels of demand. Typically, such assumptions are characterised by point estimates, the flaw-of-averages, base-rate neglect and overoptimism from an inside view. To counteract these limitations, we elicited an outside view of probabilistic forecasts based on judgements of experts about the extent to which various types of hospital activity might be mitigated over 20 years, in support of the New Hospital Programme (NHP) in the English National Health Service. DESIGN: A prospective online elicitation exercise, over two rounds, to forecast the reduction (0% no reduction to 100% total reduction) in 77 types of hospital activity across England via five types of activity mitigation: outpatient attendance avoidance (n=8); inpatient admission avoidance (n=31); A&E attendance avoidance (n=12); outpatient delivery mode (n=4); inpatient length of stay reduction (n=22) and eight types of activity groups.Primary outcomes are the aggregated forecasts representing the percentage reduction (0%-100%) in hospital activity across England based on 'surprisingly low' (10th percentile-P10) to 'surprisingly high' (90th percentile-P90) forecasts from 17 experts. RESULTS: We had 657 forecasts from 17 experts. The most pessimistic forecast was for inpatient avoidance of frail elderly admissions (mean 5.71%, P10=0.43%, P90=16.40%). The most optimistic forecast was for inpatient admission avoidance for vascular surgery (mean 48.27%, P10=19.82%, P90=78.57%). The overall (n=77) aggregate means ranged from a low of 5.71% to a high of 48.27% with an average width of 50.08%. Experts highlighted mainly four types of mitigation mechanisms-prevention, displacement, quality improvement and de-adoption. CONCLUSION: A national elicitation exercise has provided long-term aggregate forecasts across England that make explicit the wide variation and uncertainty associated with future mitigation activities from an outside perspective. These aggregate forecasts may now be incorporated into the NHP, providing a more robust foundation for planning.

Prevalence and risk of occurrence of visible birth defects in mining areas in South Kivu: A hospital-based cross-sectional study.

BACKGROUND: Possible contamination related to mining activities might contribute with other risk factors in increasing the burden of birth defects (BDs) in many developing countries including the Democratic Republic of Congo. The subsequent prevalence is frequently underestimated. Implementation of focused public health interventions is hindered by the paucity of comprehensive data. We assessed the potential impact of mining on the prevalence and occurrence of visible BDs in neonates in South Kivu (SK). METHODS: A hospital-based cross-sectional study was conducted among 65,474 newborns registered in 7 hospitals in SK from 2016-2021. Hospitals were categorized based on mining activities in their respective catchment areas. Living in a mining zone was the exposure, whereas the outcome was visible BDs. Prevalence was estimated per 100,000 live births, and risk of occurrence with odds ratio (OR) and their 95% confidence interval. RESULTS: 261 neonates with visible BDs were recorded accounting for a prevalence of 399 cases per 100,000 live births. The prevalence ranges between 217 and 1365 cases per 100,000 live births. An increased risk was found in mining zones(OR=2.07; 95%CI=1.59-2.68), Mubumbano(OR=1.72, 95%CI=1.22-2.43), and Mwenga(OR=3.89, 95%CI=2.73-5.54), whereas a reduced risk was reported in non-mining zones(OR=0.48, 95%CI=0.37-0.62) in Katana (OR=0.49, 95%CI=0.33-0.73). Musculoskeletal(28.74%) and central nervous systems(19.92%) were the most common BDs. A significant difference in prevalence for BDs involving the face, GI system and abdominal wall, musculoskeletal, central nervous and genitourinary systems between mining and non-mining zones was found(p<0.001). CONCLUSION: There is an excessive risk for visible BDs in areas with hazardous mining activities in SK region.​​ More complex studies are needed to define the possible causal relationship. Moreover, findings generated herein should be corroborated by other research design, periodically monitored by public health authorities, and used to inform initiatives promoting enhanced environmental health, access to pediatric surgical care, and public health campaigns aimed at decreasing risk of BDs.

Environmental contamination with carbapenem resistant Acinetobacter baumannii in healthcare settings in Fiji: a potential source of infection.

Introduction: There are multiple ongoing outbreaks of carbapenem resistant Acinetobacter baumannii (CRAb) infection in Fiji's hospitals. CRAb is able to colonize and persist on various hospital surfaces for extended periods. We conducted a study to understand the extent of hospital environmental contamination and phylogenetic links with clinical isolates. Methods: Swabs were collected from high-touch surfaces at Colonial War Memorial Hospital (CWMH) September 2021 and December 2022; Lautoka Hospital (LTKH) August 2022; and Labasa Hospital (LBSH) November 2022. All bacterial isolates were identified, and antimicrobial susceptibility testing (AST) performed; isolates resistant to carbapenems and producing a carbapenemase underwent whole genome sequencing. Comparison was made to clinical isolates obtained from CWMH in 2016-2017 and 2019-2021 and from LTKH and LBSH from 2020-2021. Results: From the 180 environmental samples collected, ten (5.6%) CRAb were isolated; no other carbapenem-resistant gram-negative organisms were isolated. Seven (70%) of the CRAb were isolated from CWMH and three (30%) from LTKH; no CRAb were isolated from LBSH. Of the seven CWMH CRAb, two were sequence type 2 (ST2), three ST25, and two ST499. All LTKH isolates were ST499. The two environmental CRAb ST2 isolates were closely genetically linked to isolates obtained from patients in CWMH, LTKH, and LBSH 2020-2021. Similarly, the three environmental CRAb ST25 isolates were closely genetically linked to isolates obtained from patients admitted to CWMH in 2019-2021 and LBSH in 2020. The environmental CRAb ST499 isolates represented two distinct clones, with clone 1 comprising two genetically identical isolates from CWMH and clone 2 the three isolates from LTKH. Although no genetic linkages were observed when comparing environmental ST499 isolates to those from CWMH patients in 2020-2021, both clone 1 isolates were genetically identical to an isolate obtained from a patient admitted during the sampling period. Conclusion: Our study highlights the contamination of high-touch surfaces within Fiji hospitals with CRAb, suggesting that these may serve as important sources for CRAb. Phylogenetic linkages to CRAb isolated from patients since 2019 underscores the persistence of this resistant pathogen in hospital settings and the ongoing risk for hospital-acquired infections.

Frequency and genotyping of group A rotavirus among Egyptian children with acute gastroenteritis: a hospital-based cross-sectional study.

BACKGROUND: This hospital-based cross-sectional study aims to investigate the epidemiologic and clinical characteristics of rotavirus group A (RVA) infection among children with acute gastroenteritis and to detect the most common G and P genotypes in Egypt. METHODS: A total of 92 stool samples were collected from children under five who were diagnosed with acute gastroenteritis. RVA in stool samples was identified using ELISA and nested RT-PCR. Common G and P genotypes were identified utilizing multiplex nested RT-PCR assays. RESULTS: RVA was detected at a rate of 24% (22 /92) using ELISA and 26.1% (24 /92) using VP6 nested RT-PCR. The ELISA test demonstrated diagnostic sensitivity, specificity, and accuracy of 91.7%, 100%, and 97.8%, respectively. G3 was the most prevalent G type (37.5%), followed by G1 (12.5%), whereas the most commonly detected P type were P[8] (41.7%) and P[6] (8.2%). RVA-positive samples were significantly associated with younger aged children (p = 0.026), and bottle-fed (p = 0.033) children. In addition, RVA-positive samples were more common during cooler seasons (p = 0.0001). Children with rotaviral gastroenteritis had significantly more frequent episodes of diarrhea (10.87 ± 3.63 times/day) and vomiting (8.79 ± 3.57 times/day) per day (p = 0.013 and p = 0.011, respectively). Moreover, they had a more severe Vesikari clinical score (p = 0.049). CONCLUSION: RVA is a prevalent cause of acute gastroenteritis among Egyptian children in our locality. The discovery of various RVA genotypes in the local population, as well as the identification of common G and P untypeable strains, highlights the significance of implementing the rotavirus vaccine in Egyptian national immunization programs accompanied by continuous monitoring of strains.

Economic evaluation of the prevention of falls resulting from missed care in polish hospitals.

Objectives: Falls are associated with increased morbidity, mortality, prolonged hospitalization and an increase in the cost of treatment in hospitals. They contribute to the deterioration of fitness and quality of life, especially among older patients, thus posing a serious social and economic problem. They increase the risk of premature death. Falls are adverse, costly, and potentially preventable. The aim of the study was to analyze the cost-effectiveness of avoiding one fall by nurse care provided by the nurses with higher education, from the perspective of the health service provider. Methods: The economic analysis included and compared only the cost of nurse intervention measured by the hours of care provided with higher education in non-surgical departments (40.5%) with higher time spend by nurses with higher education level an increase in the number of hours by 10% (50.5%) to avoid one fall. The time horizon for the study is 1 year (2021). Cost-effectiveness and Cost-benefit analysis were performed. All registered falls of all hospitalized patients were included in the study. Results: In the analyzed was based on the case control study where, 7,305 patients were hospitalized, which amounted to 41,762 patient care days. Care was provided by 100 nurses, including 40 nurses with bachelor's degrees and nurses with Master of Science in Nursing. Increasing the hours number of high-educated nurses care by 10% in non-surgical departments decreased the chance for falls by 9%; however, this dependence was statistically insignificant (OR = 1.09; 95% CI: 0.72-1.65; p = 0.65). After the intervention (a 10% increase in Bachelor's Degrees/Master of Science in Nursing hours), the number of additional Bachelor's Degrees/Master of Science hours was 6100.5, and the cost was USD 7630.4. The intervention eliminated four falls. The cost of preventing one fall is CER = USD 1697.1. Conclusion: The results of these studies broaden the understanding of the relationship among nursing education, falls, and the economic outcomes of hospital care. According to the authors, the proposed intervention has an economic justification.

Relationship Between Patients' "Sense of Participation" in Healthcare and Their Satisfaction A Survey of 5 Hospitals.

Patient participation is considered important for the safety and quality of care. The patient's perception of actually being able to participate in healthcare, namely, the sense of participation, may influence patient satisfaction (PS). This study aimed to quantitatively determine the relationship between sense of participation to healthcare and PS. A questionnaire survey was conducted among 100 inpatients from each of the 5 target hospitals. The questionnaire included 6 PS items and 4 patient achievement goals, which were indicators of whether the patients had a sense of participation. The response rate was 60.6% (303/500). Patients who perceived that they could choose a treatment that reflected their values and wishes had significantly higher scores on all PS items. Patients who achieved the goal of "I want to be a member of the medical team and participate actively in treatment and safety activities" showed significantly higher PS related to coping to reduce pain and symptoms. Additionally, patients who achieved the goal of "I believe I am able to voluntarily learn about the disease/treatment and use it to make decisions" had significantly higher PS related to psychological support. Sense of participation may improve PS in a wide range of areas. Hospitals and healthcare workers are expected to empower patients to develop a sense of participation.

Hospital Capacity Data and Extreme Heat Event Vulnerability.

This qualitative study examines how regional health care capacity is associated with extreme heat event vulnerability.

Epidemiological characterization of hand, foot, and mouth disease among hospitalized children from 2014 to 2023 in a hospital in Henan Province: Longitudinal surveillance study.

Hand, foot, and mouth disease (HFMD) is an acute infectious illness primarily caused by enteroviruses. The present study aimed to describe the epidemiological characteristics of hospitalized HFMD patients in a hospital in Henan Province (Zhengzhou, China), and to predict the future epidemiological parameters. In this study, we conducted a retrospective analysis of general demographic and clinical data on hospitalized children who were diagnosed with HFMD from 2014 to 2023. We used wavelet analysis to determine the periodicity of the disease. We also conducted an analysis of the impact of the COVID-19 epidemic on the detection ratio of severe illness. Additionally, we employed a Seasonal Difference Autoregressive Moving Average (SARIMA) model to forecast characteristics of future newly hospitalized HFMD children. A total of 19 487 HFMD cases were included in the dataset. Among these cases, 1515 (7.8%) were classified as severe. The peak incidence of HFMD typically fell between May and July, exhibiting pronounced seasonality. The emergence of COVID-19 pandemic changed the ratio of severe illness. In addition, the best-fitted seasonal ARIMA model was identified as (2,0,2)(1,0,1)12. The incidence of severe cases decreased significantly following the introduction of the vaccine to the market (χ2 = 109.9, p < 0.05). The number of hospitalized HFMD cases in Henan Province exhibited a seasonal and declining trend from 2014 to 2023. Non-pharmacological interventions implemented during the COVID-19 pandemic have led to a reduction in the incidence of severe illness.

Biofilm formation, antibiotic-resistance and clonal relatedness among clinical isolates of Acinetobacterbaumannii.

In this work, the antibiotic resistance, biofilm formation capability, and clonal relatedness of 50 A. baumannii isolates collected from three hospitals in Ardabil city, Iran, were evaluated. Antibiotic sensitivity and biofilm formation of isolates were determined by disk diffusion and microtiter-plate methods, respectively. Molecular typing of isolates was also performed using repetitive sequence-based PCR (REP-PCR). The majority of isolates were resistant to cephems, aminoglycosides, and carbapenems, with 80 % classified as multi-drug resistant (MDR). While, only isolates collected from blood and tracheal were resistant to colistin. Additionally, 42 isolates (84 %) had biofilm formation capability. According to rep-PCR results, 34 isolates showed similar banding patterns, while 16 isolates had unique banding patterns. Finally, based on the molecular analysis, there was a direct relationship between biofilm formation and the antibiotic resistance of isolates. In other words, MDR isolates had a higher ability to form biofilm.