Harnessing technology to improve sleep in frontline healthcare workers: A pilot study of electronic noise-masking earbuds on subjective and objective sleep measures.

Objective: This pilot study assessed the effects of electronic noise-masking earbuds on subjective sleep perception and objective sleep parameters among healthcare workers (HCWs) reporting sleep difficulties during the COVID-19 pandemic. Methods: Using a pre-post design, 77 HCWs underwent 3 nights of baseline assessment followed by a 7-night intervention period. Participants wore an at-home sleep monitoring headband to assess objective sleep measures and completed subjective self-report assessments. The difference in mean sleep measures from baseline to intervention was estimated in linear mixed models. Results: Compared to baseline assessments, HCWs reported significant improvements in sleep quality as measured by the Insomnia Severity Index (ISI) (Cohen's d = 1.74, p < 0.001) and a significant reduction in perceived sleep onset latency (SOL) during the intervention (M = 17.2 minutes, SD = 7.7) compared to baseline (M = 24.7 minutes, SD = 16.1), (Cohen's d = -0.42, p = 0.001). There were no significant changes in objective SOL (p = 0.703). However, there was a significant interaction between baseline objective SOL (<20 minutes vs >20 minutes) and condition (baseline vs intervention) (p = 0.002), such that individuals with objective SOL >20 minutes experienced a significant decrease in objective SOL during the intervention period compared to baseline (p = 0.015). Conclusions: HCWs experienced a significant improvement in perceived SOL and ISI scores after using the electronic noise-masking earbuds. Our data provide preliminary evidence for a nonpharmacological intervention to improve the sleep quality of HCWs which should be confirmed by future controlled studies.

The effect of commuting time on burnout: the mediation effect of musculoskeletal pain.

OBJECTIVES: This study explores the relationship among commuting, musculoskeletal (MS) pain, and burnout. METHODS: An observational and cross-sectional study was conducted at a medical university-affiliated hospital in Taichung, Taiwan in 2021. The two questionnaire was used and they included the Copenhagen Burnout Inventory (CBI) and the Nordic Musculoskeletal Questionnaire (NMQ). All participants were invited to complete the cross-sectional survey. A multiple linear regression was assessed correlations between commuting, MS pain, and burnout. RESULTS: After excluding those with missing data, 1,615 healthcare workers were deemed valid as research participants. In multiple linear regression, commuting time longer than 50 min was associated with personal burnout (PB) in the presence of adjusted confounders; however, long commuting time was not associated with work-related burnout (WB). Furthermore, the choice of commuting method did not affect PB or WB. Notably, both neck and shoulder pain (NBSP) and ankle pain (BAP) increase the risk of PB and WB. The mediation analysis demonstrated that NBSP is a mediating factor, increasing the level of PB and WB for commuting times longer than 50 min. CONCLUSIONS: Healthcare workers who commute for more than 50 min should be considered part of a high-risk group for burnout and musculoskeletal pain. They should also be provided with resources and programs focused on burnout prevention and MS pain relief.

Inflammatory bowel disease patients' perspectives of non-medical needs.

BACKGROUND: Inflammatory bowel disease (IBD) imposes a huge burden on the healthcare systems and greatly declines the patient's quality of life. However, there is a paucity of detailed data regarding information and supportive needs as well as sources and methods of obtaining information to control different aspects of the disease from the perspectives of the patients themselves. This study aimed to establish the IBD patients' preferences of informational and supportive needs through Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA). METHODS: IBD patients were recruited from different centers. Considering inclusion and exclusion criteria, 521 participants were filled a predefined questionnaire. This questionnaire was prepared through literature review of the recent well-known guidelines on the needs of IBD patients, which was further approved by the experts of IBD area in three rounds of Delphi consensus. It includes 56 items in four sections of informational needs (25), supportive needs (15), sources of information (7), and methods of obtaining information (9). RESULTS: In particular, EFA was used to apply data reduction and structure detection. Given that this study tries to identify patterns, structures as well as inter-relationships and classification of the variables, EFA was utilized to simplify presentation of the variables in a way that large amounts of observations transform into fewer ones. Accordingly, the EFA identified five factors out of 25 items in the information needs section, three factors out of 15 items in the supportive needs section, two factors out of 7 items in the information sources section, and two factors out of 9 items in the information presentation methods. Through the CFA, all 4 models were supported by Root Mean Squared Error of Approximation (RMSEA); Incremental Fit Index (IFI); Comparative Fit Index (CFI); Tucker-Lewis Index (TLI); and SRMR. These values were within acceptable ranges, indicating that the twelve factors achieved from EFA were validated. CONCLUSIONS: This study introduced a reliable 12-factor model as an efficient tool to comprehensively identify preferences of IBD patients in informational and supportive needs along with sources and methods of obtaining information. An in-depth understanding of the needs of IBD patients facilitates informing and supporting health service provision. It also assists patients in a fundamental way to improve adaptation and increase the quality of life. We suggest that health care providers consider the use of this tool in clinical settings in order to precisely assess its efficacy.

The impact of social support on benefit finding among patients with advanced lung cancer and their caregivers: based on actor-partner interdependence mediation model.

PURPOSE: Advanced lung cancer and its treatment serve as a sudden stressful event that profoundly impacts the psychological experience of both the patients and their primary caregiver. This study used dyadic analyses to explore the dyadic effects of social support on benefit finding and whether hope level mediates the patient-caregiver dyads in advanced lung cancer. METHODS: Two hundred ninety-five pairs of patients with advanced lung cancer and primary caregivers completed the Social Support Rating Scale (SSRS), the Herth Hope Index (HHI), and the Benefit Finding Scale (BFS). Dyadic analyses were conducted using structural equation modelling based on the actor-partner interdependence mediation model. RESULTS: The results indicated that for both patients (B = 0.259, 95% CI = 0.135-0.423, P < 0.001) and their primary caregivers (B = 0.596, 95% CI = 0.403-0.838, P < 0.001), hope level mediated the actor effect of social support on benefit finding; social support was positively associated with hope level and further enhanced benefit finding. Regarding partner effects (B = 0.242, 95% CI = 0.119-0.404, P < 0.001), primary caregivers' social support significantly indirectly affected patients' benefit finding through patients' hope level. CONCLUSION: There is an interaction between social support, hope level, and benefit finding in patients with advanced lung cancer and their primary caregivers. Healthcare professionals ought to be vigilant in recognizing patients and caregivers who are vulnerable, have limited social support, and possess diminished hope levels. At the same time, nurses should provide timely psychological support and counseling to patients and their caregivers, encourage them to actively participate in social activities, and inspire their confidence and hope in life, thus improving their benefit findings.

Literature review on sexuality in the elderly: What is being taught and with what technologies. / Revisión de literatura sobre sexualidad en las personas mayores: qué se educa y con qué tecnologías.

Chile is facing an increasingly aging population and, with it, changes in its demographic, epidemiological, and healthcare structure. As a result, the sexual health of the elderly is an emerging area at the social level and in healthcare systems. This research aims to identify general aspects of sexuality in the elderly and learn about educational content delivered to this group using digital technologies. To do this, we proposed a review of scientific literature on the subject between January 1st, 2018, and December 31st, 2022, in the databases Web of Science, MEDLINE/PubMed, LILACS, Cochrane, Scopus, and Google Scholar. The articles found, and the emerging information was analyzed. A total of 1573 articles were found, of which 21 papers were finally included, 11 with qualitative methodology, six quantitative, and four mixed. In addition, nine addressed the area of sexuality, and 12 focused on technological innovations for the elderly. Sexuality is a growing topic worldwide, carrying with it sociocultural beliefs associated with dogmatic opinions and myths, with discrimination against this age group, especially if they belong to sexual minorities. This group also has better access to new digital technologies that facilitate access to training, social integration, and timely healthcare. Scientific evidence shows that the sexuality of the elderly is a topic of global interest, invisibilized, with low education and training of healthcare workers. The latter are neither informed nor able to solve the reasons for consultation in the traditional way or with new digital health technologies.

Chile es un país que enfrenta un envejecimiento poblacional acelerado, y con ello cambios en la estructura demográfica, epidemiológica y asistencial, donde la salud sexual de las personas mayores es un área emergente a nivel social y en los sistemas de salud. Esta investigación tiene por objetivos identificar aspectos generales de la sexualidad en las personas mayores, y conocer contenidos educativos entregados a este grupo con tecnologías digitales. Para ello, se propuso una revisión de literatura científica que buscó investigaciones en la materia entre el 1 de enero de 2018 y el 31 diciembre de 2022, en las bases de datos, A partir de ello se analizaron los artículos encontrados y la información emergente. Se encontraron 1573 artículos de los cuales se incluyeron 21 trabajos, 11 con metodología cualitativa, 6 cuantitativa y 4 mixta. Además, 9 trataron el área de sexualidad y 12 respecto de innovaciones tecnológicas en personas mayores. Se aprecia que la sexualidad es un tema creciente a nivel mundial, que arrastra idearios socioculturales asociados a visiones dogmáticas y a mitos, con discriminación hacia este grupo de edad, sobre todo si pertenecen a minorías sexuales. También se observa en este grupo de interés un mejor acceso a nuevas tecnologías digitales para acceder a capacitación, integración social y atención oportuna en salud. La evidencia científica demuestra que la sexualidad de las personas mayores es un tema de interés mundial, invisibilizado, con baja formación y capacitación del personal sanitario. Este personal no educa ni resuelve estos motivos de consulta en forma tradicional o con nuevas tecnologías digitales en salud.

Methicillin-Resistant Staphylococcus aureus Carriage among Neonate Mothers, Healthcare Workers, and Environmental Samples in Neonatal Intensive Care Units: A Systematic Review.

Background: Methicillin-resistant Staphylococcus aureus (MRSA) is a significant cause of morbidity and mortality among neonates admitted to neonatal intensive care units (NICUs). The MRSA colonization of neonates, attributed to various sources, including mothers, healthcare workers, and environmental surfaces, can lead to severe infection, prolonged hospital stays, and even death, imposing substantial economic burdens. Given the pressing need to mitigate MRSA spread in these vulnerable environments, further examination of the subject is warranted. This systematic review is aimed at synthesizing available evidence on MRSA carriage proportions among mothers of newborns, healthcare workers, and environmental surfaces in NICUs. Methodology. We included observational studies published in English or French from database inception to March 21, 2023. These studies focused on MRSA in nonoutbreak NICU settings, encompassing healthy neonate mothers and healthcare workers, and environmental surfaces. Literature search involved systematic scanning of databases, including Medline, Embase, Web of Science, Global Health, and Global Index Medicus. The quality of the selected studies was assessed using the Hoy et al. critical appraisal scale. The extracted data were summarized to calculate the pooled proportion of MRSA positives, with a 95% confidence interval (CI) based on the DerSimonian and Laird random-effects model. Results: A total of 1891 articles were retrieved from which 16 studies were selected for inclusion. Most of the studies were from high-income countries. The pooled proportion of MRSA carriage among 821 neonate mothers across four countries was found to be 2.1% (95% CI: 0.3-5.1; I2 = 76.6%, 95% CI: 36.1-91.5). The proportion of MRSA carriage among 909 HCWs in eight countries was determined to be 9.5% (95% CI: 3.1-18.4; I2 = 91.7%, 95% CI: 87.1-94.6). The proportion of MRSA carriage among HCWs was highest in the Western Pacific Region, at 50.00% (95% CI: 23.71-76.29). In environmental specimens from five countries, a pooled proportion of 16.6% (95% CI: 3.5-36.0; I2 = 97.7%, 95% CI: 96.6-98.4) was found to be MRSA-positive. Conclusion: With a significant heterogeneity, our systematic review found high MRSA carriage rates in neonate mothers, healthcare workers, and across various environmental surfaces in NICUs, posing a potential risk of nosocomial infections. Urgent interventions, including regular screening and decolonization of MRSA carriers, reinforcing infection control measures, and enhancing cleaning and disinfection procedures within NICUs, are crucial. This trial is registered with CRD42023407114.

Health-related quality of life and associated factors among health care providers in the northwest of Ethiopia: a multicenter cross-sectional study, 2023.

Background: The diminished quality of life among healthcare providers (HCPs) could impact both their personal well-being and their ability to effectively fulfill healthcare needs and provide necessary facilities to the public. Furthermore, this decline in quality of life may also significantly influence the overall health of HCPs, regardless of their professional training and duties. Objectives: The aim of this study was to assess the health-related quality of life (HRQoL) and associated factors among healthcare providers at comprehensive specialized hospitals in the Northwest Ethiopia. Method: A cross-sectional study was conducted among 412 healthcare providers at comprehensive specialized hospitals in Northwest Ethiopia from June to July 2023. Study participants were enrolled using simple random sampling. Health-related quality of life (HRQoL) was measured using the World Health Organization Quality of Life Scale-Bref Version. Data entry and analysis were performed using Epi-data version 4.6.1 and SPSS version 24, respectively. Binary logistic regression was employed to assess the association between quality of life and independent variables. Variables with a p-value <0.05 at a 95% confidence interval were considered statistically significant. Result: Out of the 422 study participants approached, 412 respondents were included in the final analysis. Poor quality of life was observed in 54.6% of participants. Factors such as working hours per day (AOR = 1.85, 95% CI: 1.12; 3.05), working experience (AOR = 1.95, 95% CI: 1.04; 3.65), and the presence of chronic disease (AOR = 2.11, 95% CI: 1.18; 3.75) were significantly associated with poor quality of life. Conclusion: This study revealed that more than half of the participants experienced poor quality of life. Specific attention is needed for healthcare providers working for more than 8 h per day, those with less work experience, and those with chronic illnesses in order to improve their quality of life.

The knowledge of primary health care professionals regarding mental health: diagnosis by mhGAP.

OBJECTIVE: To analyze knowledge about priority topics in mental health care of strategic actors who work in regions where the Health Care Planning (PAS) methodology is used. METHODS: This is a quantitative, descriptive, cross-sectional, and observational study carried out with professionals from six health regions, distributed in three Brazilian states (Goiás, Rondônia and Maranhão) and linked to the project "Saúde mental na APS" (Mental health in PHC) of the Programa de Apoio ao Desenvolvimento Institucional do Sistema Único de Saúde (Proadi-SUS - Institutional Development Support Program of the Brazilian Unified Health System). The sample was made up of professionals who participated in the intervention guide multiplier training stage for mental, neurological and alcohol and other drug use disorders in the primary health care network, from July to September 2022. Data collection was through a self-administered instrument, in electronic format, consisting of a block with socioeconomic items and a structured questionnaire to assess participants' knowledge about priority topics in mental health. Descriptive analyses and comparison of proportions were conducted to analyze the data. RESULTS: A total of 354 health professionals participated in the study. Regarding the percentage of correct answers in the questionnaire on priority topics in mental health, the highest medians were identified in the "Depression" module. On the other hand, the content referring to the modules "Essential care and practices" and "Other important complaints" presented the lowest values. Furthermore, some participant characteristics were found to be associated with the percentage of correct answers in the questionnaire modules. CONCLUSIONS: The findings reveal opportunities for improvement, mainly in knowledge related to communication skills and the approach to emotional and physical distress without diagnostic criteria for a specific disease, offering support for planning actions aimed at intensifying the consideration of these themes during the operational stages of PAS.

Causal Selection of Covariates in Regression Calibration for Mismeasured Continuous Exposure.

Regression calibration as developed by Rosner, Spiegelman, and Willett is used to adjust the bias in effect estimates due to measurement error in continuous exposures. The method involves two models: a measurement error model relating the mismeasured exposure to the true (or gold-standard) exposure and an outcome model relating the mismeasured exposure to the outcome. However, no comprehensive guidance exists for determining which covariates should be included in each model. In this article, we investigate the selection of the minimal and most efficient covariate adjustment sets under a causal inference framework. We show that to address the measurement error, researchers must adjust for, in both measurement error and outcome models, any common causes (1) of true exposure and the outcome and (2) of measurement error and the outcome. We also show that adjusting for so-called prognostic variables that are independent of true exposure and measurement error in the outcome model, may increase efficiency, while adjusting for any covariates that are associated only with true exposure generally results in efficiency loss in realistic settings. We apply the proposed covariate selection approach to the Health Professional Follow-up Study dataset to study the effect of fiber intake on cardiovascular disease. Finally, we extend the originally proposed estimators to a nonparametric setting where effect modification by covariates is allowed.

Twitter Analysis of Health Care Workers' Sentiment and Discourse Regarding Post-COVID-19 Condition in Children and Young People: Mixed Methods Study.

BACKGROUND: The COVID-19 pandemic has had a significant global impact, with millions of cases and deaths. Research highlights the persistence of symptoms over time (post-COVID-19 condition), a situation of particular concern in children and young people with symptoms. Social media such as Twitter (subsequently rebranded as X) could provide valuable information on the impact of the post-COVID-19 condition on this demographic. OBJECTIVE: With a social media analysis of the discourse surrounding the prevalence of post-COVID-19 condition in children and young people, we aimed to explore the perceptions of health care workers (HCWs) concerning post-COVID-19 condition in children and young people in the United Kingdom between January 2021 and January 2022. This will allow us to contribute to the emerging knowledge on post-COVID-19 condition and identify critical areas and future directions for researchers and policy makers. METHODS: From a pragmatic paradigm, we used a mixed methods approach. Through discourse, keyword, sentiment, and image analyses, using Pulsar and InfraNodus, we analyzed the discourse about the experience of post-COVID-19 condition in children and young people in the United Kingdom shared on Twitter between January 1, 2021, and January 31, 2022, from a sample of HCWs with Twitter accounts whose biography identifies them as HCWs. RESULTS: We obtained 300,000 tweets, out of which (after filtering for relevant tweets) we performed an in-depth qualitative sample analysis of 2588 tweets. The HCWs were responsive to announcements issued by the authorities regarding the management of the COVID-19 pandemic in the United Kingdom. The most frequent sentiment expressed was negative. The main themes were uncertainty about the future, policies and regulations, managing and addressing the COVID-19 pandemic and post-COVID-19 condition in children and young people, vaccination, using Twitter to share scientific literature and management strategies, and clinical and personal experiences. CONCLUSIONS: The perceptions described on Twitter by HCWs concerning the presence of the post-COVID-19 condition in children and young people appear to be a relevant and timely issue and responsive to the declarations and guidelines issued by health authorities over time. We recommend further support and training strategies for health workers and school staff regarding the manifestations and treatment of children and young people with post-COVID-19 condition.

Bridging the gap between healthcare sectors: Facilitating the transition from NICU to the municipality and home for families with premature infants.

PURPOSE: The transition from hospital to home can be challenging for parents of prematurely born infants. The aim of this ethnographic study was to describe a multidisciplinary and cross-sectoral discharge conference for families with premature infants transitioning from a neonatal intensive care unit to municipal healthcare services. DESIGN AND METHODS: An ethnographically/anthropologically inspired qualitative design was adopted. We conducted four participant observations of multidisciplinary and cross-sectoral discharge conferences and 12 semistructured interviews with four neonatologists, four nurses, and four health visitors who had attended one of the conferences. Salient themes were generated by two-part analysis consisting of a thematic analysis followed by Turner's ritual analysis. RESULTS: This study illustrated how multidisciplinary and cross-sectoral discharge conferences improved the quality of care for premature infants and their families in their transition process which was perceived as complex. These conferences contributed to promoting a sense of coherence and continuity of care. The healthcare professionals experienced that this event may be characterized as a ritual, which created structures that promoted cross-sectoral cooperation and communication while increasing interdisciplinary knowledge sharing. Thus, the conferences triggered a sense that the participants were building bridges to unite healthcare sectors, ensuring a holistic and coordinated approach to meet the unique needs of the infants and their families. IMPLICATIONS FOR PRACTICE: This study presented a unique holistic and family-centered approach to constructing multidisciplinary and cross-sectoral discharge conferences that seemed to underpin the quality of interdisciplinary and health-related knowledge sharing and establish a crucial starting point for early interventions, preventive measures, and health-promoting efforts. Hopefully, our findings will encourage others to rethink the discharge conference as a transitional ritual that may potentially bridge the gap between healthcare sectors. Specifically, our findings contribute to the mounting body of knowledge of family-centered care by showing how healthcare professionals may-in a meaningful and tangible manner-operate, develop, and implement this somewhat elusive theoretical foundation in their clinical practice.

User-Centered Development of a Patient Decision Aid for Choice of Early Abortion Method: Multi-Cycle Mixed Methods Study.

BACKGROUND: People seeking abortion in early pregnancy have the choice between medication and procedural options for care. The choice is preference-sensitive-there is no clinically superior option and the choice depends on what matters most to the individual patient. Patient decision aids (PtDAs) are shared decision-making tools that support people in making informed, values-aligned health care choices. OBJECTIVE: We aimed to develop and evaluate the usability of a web-based PtDA for the Canadian context, where abortion care is publicly funded and available without legal restriction. METHODS: We used a systematic, user-centered design approach guided by principles of integrated knowledge translation. We first developed a prototype using available evidence for abortion seekers' decisional needs and the risks, benefits, and consequences of each option. We then refined the prototype through think-aloud interviews with participants at risk of unintended pregnancy ("patient" participants). Interviews were audio-recorded and documented through field notes. Finally, we conducted a web-based survey of patients and health care professionals involved with abortion care, which included the System Usability Scale. We used content analysis to identify usability issues described in the field notes and open-ended survey questions, and descriptive statistics to summarize participant characteristics and close-ended survey responses. RESULTS: A total of 61 individuals participated in this study. Further, 11 patients participated in think-aloud interviews. Overall, the response to the PtDA was positive; however, the content analysis identified issues related to the design, language, and information about the process and experience of obtaining abortion care. In response, we adapted the PtDA into an interactive website and revised it to include consistent and plain language, additional information (eg, pain experience narratives), and links to additional resources on how to find an abortion health care professional. In total, 25 patients and 25 health care professionals completed the survey. The mean System Usability Scale score met the threshold for good usability among both patient and health care professional participants. Most participants felt that the PtDA was user-friendly (patients: n=25, 100%; health care professionals: n=22, 88%), was not missing information (patients: n=21, 84%; health care professionals: n=18, 72%), and that it was appropriate for patients to complete the PtDA before a consultation (patients: n=23, 92%; health care professionals: n=23, 92%). Open-ended responses focused on improving usability by reducing the length of the PtDA and making the website more mobile-friendly. CONCLUSIONS: We systematically designed the PtDA to address an unmet need to support informed, values-aligned decision-making about the method of abortion. The design process responded to a need identified by potential users and addressed unique sensitivities related to reproductive health decision-making.

The role of champions in the implementation of technology in healthcare services: a systematic mixed studies review.

BACKGROUND: Champions play a critical role in implementing technology within healthcare services. While prior studies have explored the presence and characteristics of champions, this review delves into the experiences of healthcare personnel holding champion roles, as well as the experiences of healthcare personnel interacting with them. By synthesizing existing knowledge, this review aims to inform decisions regarding the inclusion of champions as a strategy in technology implementation and guide healthcare personnel in these roles. METHODS: A systematic mixed studies review, covering qualitative, quantitative, or mixed designs, was conducted from September 2022 to March 2023. The search spanned Medline, Embase, CINAHL, and Scopus, focusing on studies published from 2012 onwards. The review centered on health personnel serving as champions in technology implementation within healthcare services. Quality assessments utilized the Mixed Methods Appraisal Tool (MMAT). RESULTS: From 1629 screened studies, 23 were included. The champion role was often examined within the broader context of technology implementation. Limited studies explicitly explored experiences related to the champion role from both champions' and health personnel's perspectives. Champions emerged as promoters of technology, supporting its adoption. Success factors included anchoring and selection processes, champions' expertise, and effective role performance. DISCUSSION: The specific tasks and responsibilities assigned to champions differed across reviewed studies, highlighting that the role of champion is a broad one, dependent on the technology being implemented and the site implementing it. Findings indicated a correlation between champion experiences and organizational characteristics. The role's firm anchoring within the organization is crucial. Limited evidence suggests that volunteering, hiring newly graduated health personnel, and having multiple champions can facilitate technology implementation. Existing studies predominantly focused on client health records and hospitals, emphasizing the need for broader research across healthcare services. CONCLUSIONS: With a clear mandate, dedicated time, and proper training, health personnel in champion roles can significantly contribute professional, technological, and personal competencies to facilitate technology adoption within healthcare services. The review finds that the concept of champions is a broad one and finds varied definitions of the champion role concept. This underscores the importance of describing organizational characteristics, and highlights areas for future research to enhance technology implementation strategies in different healthcare settings with support of a champion.

The impact of incentive scheme on rural healthcare workforce availability: a case study of Kazakhstan.

BACKGROUND: During the 1990-2000, Kazakhstan experienced a decline in the number of healthcare professionals working in rural areas. Since 2009, the national government has been implementing financial incentives to encourage healthcare professionals to relocate to rural areas. This study aims to investigate the temporal and spatial patterns in the distribution of the rural healthcare workforce and evaluate the impact of this incentive scheme. METHODS: Interrupted Time Series Analysis using ARIMA models and Difference in Differences analyzes were conducted to examine the impact of the incentive scheme on the density of different categories of the healthcare workforce in rural Kazakhstan in the period from 2009 to 2020. RESULTS: There was a significant increase in the number of rural healthcare professionals from 2009 to 2020 in comparison to the period from 1998 to 2008. However, this increase was less pronounced in per capita terms. Moreover, a decline in the density of internists and pediatricians was observed. There is substantial variation in the density of rural nurses and physicians across different regions of Kazakhstan. The incentive scheme introduced in 2009 by the government of Kazakhstan included a one-time allowance and housing incentive. This scheme was found to have contributed insignificantly to the observed increase in the number of rural healthcare professionals. CONCLUSION: Future research should be undertaken to examine the impact made by the incentive scheme on other medical subspecialties, particularly primary practitioners. Addressing the shortage of healthcare workers in rural areas is a complex issue that requires a multifaceted approach. Aside from financial incentives, other policies could be considered to increase relocation and improve the retention of healthcare professionals in rural areas.

Perceived stress from social isolation or loneliness among clinical and non-clinical healthcare workers during COVID-19.

BACKGROUND: Workplace social isolation and loneliness have been found to result in a decline in job satisfaction and an increase in burnout among working individuals. The COVID-19 pandemic exacerbated feelings of loneliness and social isolation among healthcare workers. The majority of research on healthcare worker experiences is conducted in siloes which does not reflect the shared experiences of interprofessional teams. The purpose of this study is to understand stress from social isolation or loneliness across the entire clinical and non-clinical healthcare team over the course of the pandemic. METHODS: Data was acquired using a cross-sectional survey distributed to healthcare workers once a year at a large academic medical center in the Southeastern United States during the COVID-19 pandemic (2020-2022). Information pertaining to job role, work location, and demographic factors was collected. Participants were also asked to assess individual well-being and resilience, in addition to reporting stress derived from various sources including job demands and social isolation or loneliness. Descriptive statistics and bivariate analyses were conducted to assess the association between stress from social isolation or loneliness and individual characteristics. RESULTS: Stress from social isolation or loneliness was found to decrease over the survey period across all measured variables. Trainees and physician-scientists were found to report the highest rates of this stressor compared to other job roles, while Hospital-Based ICU and Non-ICU work locations reported the highest rates of loneliness and social isolation stress. Younger workers and individuals from marginalized gender and racial groups were at greater risk for stress from social isolation or loneliness. CONCLUSIONS: Given the importance of social connections for well-being and job performance, organizations have a responsibility to create conditions and mechanisms to foster social connections. This includes establishing and reinforcing norms of behavior, and developing connection mechanisms, particularly for groups at high risk of loneliness and social isolation.

Approaches to Engaging Men During Primary Healthcare Encounters: A scoping review.

Gender-responsive healthcare is critical to advancing men's health given that masculinities intersect with other social determinants to impact help-seeking, engagement with primary healthcare, and patient outcomes. A scoping review was undertaken with the aim to synthesize gender-responsive approaches used by healthcare providers (HCPs) to engage men with primary healthcare. MEDLINE, PubMed, CINAHL, and PsycINFO databases were searched for articles published between 2000 and February 2024. Titles and abstracts for 15,659 citations were reviewed, and 97 articles met the inclusion criteria. Data were extracted and analyzed thematically. Thirty-three approaches were synthesized from across counseling/psychology, general practice, social work, nursing, psychiatry, pharmacy, and unspecified primary healthcare settings. These were organized into three interrelated themes: (a) tailoring communication to reach men; (b) purposefully structuring treatment to meet men's health needs, and (c) centering the therapeutic alliance to retain men in care. Strength-based and asset-building approaches focused on reading and responding to a diversity of masculinities was reinforced across the three findings. While these approaches are recommended for the judicious integration into health practitioner education and practice, this review highlighted that the evidence remains underdeveloped, particularly for men who experience health inequities. Critical priorities for further research include intersectional considerations and operationalizing gender-responsive healthcare approaches for men and its outcomes, particularly at first point-of-contact encounters.

THYROID CANCER AS A PUBLIC HEALTH CHALLENGE IN GEORGIA.

Thyroid cancer (TC) is the most common endocrine cancer. The increase in thyroid cancer incidence has been observed in both developed and developing countries in different Geographical and climate areas The share of thyroid cancer drastically increased during the last decades in Georgia and ranked as the second most prevalent cause of cancer among women. Although for addressing the burden of cancer, important steps were taken by the State during the last decades, the burden of this disease is still significant. The presented paper aims to provide an overview of the current burden of thyroid cancer in Georgia, delving into its risk factors. To explore the opinion of key stakeholders about the factors causing the increased trend of thyroid cancer in Georgia in-depth interviews were used. The study was conducted from March to August 2023 in the capital of Georgia - Tbilisi. Women and men who had thyroid cancer and survived, women and men who are suffering from thyroid cancer along with healthcare providers, policymakers, and national professional bodies were the respondents in this study. The guides for the in-depth interviews were prepared based on the literature review. Stakeholders agreed that the number of thyroid cancer cases has increased during the last decades. The concern that the prevalence and incidence of thyroid cancer is the highest in the world in Georgia and it is the second leading cause of cancer among women was also expressed by respondents. According to study findings, new diagnostic methods revealed more cases of thyroid cancer. Other respondents stated that the development of the cancer registry, and the improvement of the reporting system existing cases of this disease. The issue of over-diagnosis was also mentioned by the stakeholders, Almost all study participant patients are challenged by the post-operational period. Some of them had not gotten information on how to deal with this period. Several patients mentioned financial problems due to fee-for-service or co-payments. According to the study participants, the recent sharp increase in the incidence and prevalence of thyroid cancer cases might be associated with overdiagnosis and the lack of monitoring and unified diagnostic and treatment methods.

Could retaining the dental recall interval save NHS dentistry?

The World Health Assembly in May 2021 was a watershed moment in oral health, with the landmark resolution that designated oral diseases as non-communicable diseases (NCDs). This was strongly supported by a host of other NCDs in recognition of the common risk factor principle and acknowledgement of the fact that oral diseases do not occur in isolation from other NCDs, but are commonly associated with cardiovascular disease, diabetes/obesity, respiratory diseases, metabolic syndrome, a range of other inflammatory disorders and cancers. Regular monitoring and early detection would potentially intercept these NCDs and this could form a central plank of a revamped holistic 'health'- as opposed to 'disease'-oriented health care system.Consultation with patients and dentists reveals strong support for maintaining regular recall intervals, which maintains trust and optimises motivation and compliance. In-person visits could be minimised by using technology, such as remote consultations and longitudinal monitoring systems, making it adaptable to different health care settings and equitable, affordable, cost-effective and sustainable.A new paradigm with dentists as oral health professionals, and the mainstreaming of oral health and population-level prevention, means the future of health care can be guided by integration and workforce modification producing a surveillance-based, early interceptive, preventive model of care.

World Health Organization World Hand Hygiene Day, 5 May 2024. SAVE LIVES: clean your hands campaign: promoting knowledge and capacity building on infection prevention and control, including hand hygiene, among health and care workers.

The World Health Organization's (WHO) World Hand Hygiene Day continues to "bring people together and accelerate hand hygiene action at the point of care in health care to contribute to a reduction in health care-associated infections and the achievement of safer, quality health care for all".

Introducing the i-Rainbow©: An Evidence-Based, Parent-Friendly Care Pathway Designed for Critically Ill Infants in the NICU Setting.

PURPOSE: This study investigated the feasibility and effectiveness of a novel, evidence-based developmental care pathway to be used by health care providers and parents in the neonatal intensive care unit (NICU) setting. The i-Rainbow is based on current evidence and responds to individual infant health status. It is not based on infant age. METHODS: After development and implementation of the i-Rainbow, pre- and postimplementation nurse and parent survey data were collected and pre- and post-developmental care rates were compared. RESULTS: After i-Rainbow implementation, disagreement among providers on appropriate developmental care interventions significantly decreased, total minutes of daily developmental care and swaddled holding increased significantly, and parents reported that they would recommend the tool. CONCLUSION: The i-Rainbow is a unique, parent-friendly, infant-based tool that guides sensory interventions in the NICU by staging infants based on cardiorespiratory status and physiologic maturity, not age. The i-Rainbow improved the delivery of developmental care activities in our unit and was well received by parents and nurses. VIDEO ABSTRACT: Supplemental Digital Content available at: http://links.lww.com/PPT/A516.