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Innovative Surgical Sciences Mar 2024Since its introduction as a clinical technique, robotic surgery has been extended to different fields of surgery. However, the indications as well as the number of...
OBJECTIVES
Since its introduction as a clinical technique, robotic surgery has been extended to different fields of surgery. However, the indications as well as the number of robotic procedures varied in different institutions. The aim of this investigation was to evaluate the current use of robotic surgery in general and digestive surgery in Switzerland.
METHODS
All Swiss surgical departments that are recognized training institutes for postgraduate training in surgery by the Swiss Institute of Medical Education (SIWF) were queried with a detailed questionnaire regarding the use of robotic surgery techniques and were analyzed regarding hospital size and type of hospital.
RESULTS
Ninety-three departments were queried, and 67 % (n=63) answered the survey. Fifty-eight were public, and five were private institutions. Seventeen (26 %) of the queried departments used robotic surgery in digestive surgery. Four out of 17 (23 %) of the departments that performed robotic surgery were private hospitals, while 13 (77 %) were public institutions. In the majority of departments, robotic surgery of the rectum (n=12; 70.6 %) and colon (n=11; 64.7 %) was performed, followed by hernia procedures (n=8; 47.1 %) and fundoplication (n=7; 41.2 %). Less frequently, pancreatic resections (n=5; 29.4 %), cholecystectomy (n=4; 23.5 %), adrenalectomy (n=4; 23.5 %), gastric bypass (n=3; 17.7 %), gastric sleeve (n=3; 17.7 %), hepatic procedures (n=2; 11.7 %), or small bowel resections (n=1; 5.9 %) were performed as robotic procedures. More than 25 procedures per year per department were performed for hernia surgery (n=5 departments), gastric bypass (n=2 departments), cholecystectomy, fundoplication, and colon surgery (each n=1 department).
CONCLUSIONS
The number and range of robotic procedures performed in Switzerland varied widely. Higher accreditation for general surgery or subspecialization of visceral surgery of the department was positively associated with the use of robotic techniques, reflecting an unequal availability of robotic surgery.
PubMed: 38826632
DOI: 10.1515/iss-2023-0052 -
Midwifery May 2024The Baby-Friendly Hospital Initiative has yet to achieve widespread global implementation.
PROBLEM
The Baby-Friendly Hospital Initiative has yet to achieve widespread global implementation.
BACKGROUND
The implementation of the Baby-Friendly Hospital Initiative has been recognised as complex. The challenge has been to maintain accreditation.
AIM
To explore and gain a deeper understanding of the healthcare professionals' perceptions of the implementation process and the maintenance of the Baby-Friendly Hospital Initiative.
METHODS
A qualitative descriptive study with focus groups (n = 10) of the nurses, midwives and unit leaders (n = 43) perceptions of the implementation process were analysed using inductive thematic analysis.
FINDINGS
Analysis of the data revealed five main themes: groundwork for the baby-focused breastfeeding context, management support throughout the process, promoting baby-friendly practices, effective communication ensuring the right track, and supporting the maintenance of BFHI designation. The main themes describe the implementation as a journey of climbing a hill and after reaching the top trying to maintain their position.
DISCUSSION
The starting point for implementation was an optimal environment supporting baby-friendly breastfeeding practices. The support of the management of the organisation was an important way of moving the implementation forward. Commitment to the common goal strengthened the baby-friendly approach and with concrete and immediate feedback the right pathway on a journey was ensured.
CONCLUSION
Practical ways to support the implementation journey include regular update education on breastfeeding and continuous monitoring, as well as providing statistics to health professionals. Global guidelines on how to sustain change are needed. This will ensure that the work done is not wasted.
PubMed: 38824766
DOI: 10.1016/j.midw.2024.104029 -
American Journal of Pharmaceutical... May 2024Given the importance of developing student understanding and application of the Pharmacists' Patient Care Process (PPCP), programs may be able to use successful...
OBJECTIVE
Given the importance of developing student understanding and application of the Pharmacists' Patient Care Process (PPCP), programs may be able to use successful approaches from other institutions to enhance their curricular and experiential learning and assessment of student outcomes. The study objective was to explore successful methods of integrating the PPCP and outline areas of challenge.
METHODS
This study used a qualitative study design with semistructured interviews to gain insight from participants' lived experiences. Pharmacy faculty members participating in a national survey or who were authors of articles about PPCP initiatives were recruited to provide greater detail about building successful and innovative curricula. Thematic analysis identified commonalities and differences among the interviewed participants.
RESULTS
A total of 10 interviews were conducted. The following 4 overarching themes arose from the data: discussions around intentional integration of the PPCP across multiple core courses may foster innovations in teaching strategies; intentional integration alone does not equate to PPCP integration across the curriculum; intentional integration may enhance program assessment; and PPCP data from experiential coursework may not be widely used in curricular continuous quality improvement.
CONCLUSION
Pharmacy programs will ideally involve the entire faculty, including experiential and basic and social/administrative science members, in weaving the PPCP throughout the curriculum. Rigorous assessment can better inform interventions related to student competency in various steps of the PPCP. Pharmacy programs should also clarify how data obtained from preceptors observing student performance in each of the PPCP steps are used to assess student mastery of this critical skill.
PubMed: 38823671
DOI: 10.1016/j.ajpe.2024.100726 -
Health Research Policy and Systems May 2024Research evidence has demonstrably improved health care practices and patient outcomes. However, systemic translation of evidence into practice is far from optimal. The...
BACKGROUND
Research evidence has demonstrably improved health care practices and patient outcomes. However, systemic translation of evidence into practice is far from optimal. The reasons are complex, but often because research is not well aligned with health service priorities. The aim of this study was to explore the experiences and perspectives of senior health service executives on two issues: (1) the alignment between local research activity and the needs and priorities of their health services, and (2) the extent to which research is or can be integrated as part of usual health care practice.
METHODS
In this qualitative study, semi-structured interviews were conducted with senior health leaders from four large health service organisations that are members of Sydney Health Partners (SHP), one of Australia's nationally accredited research translation centres committed to accelerating the translation of research findings into evidence-based health care. The interviews were conducted between November 2022 and January 2023, and were either audio-recorded and transcribed verbatim or recorded in the interviewer field notes. A thematic analysis of the interview data was conducted by two researchers, using the framework method to identify common themes.
RESULTS
Seventeen health executives were interviewed, including chief executives, directors of medical services, nursing, allied health, research, and others in executive leadership roles. Responses to issue (1) included themes on re-balancing curiosity- and priority-driven research; providing more support for research activity within health organisations; and helping health professionals and researchers discuss researchable priorities. Responses to issue (2) included identification of elements considered essential for embedding research in health care; and the need to break down silos between research and health care, as well as within health organisations.
CONCLUSIONS
Health service leaders value research but want more research that aligns with their needs and priorities. Discussions with researchers about those priorities may need some facilitation. Making research a more integrated part of health care will require strong and broad executive leadership, resources and infrastructure, and investing in capacity- and capability-building across health clinicians, managers and executive staff.
Topics: Humans; Qualitative Research; Health Services Research; Leadership; Australia; Translational Research, Biomedical; Evidence-Based Practice; Health Priorities; Interviews as Topic; Delivery of Health Care; Health Services; Administrative Personnel
PubMed: 38822374
DOI: 10.1186/s12961-024-01149-z -
BMC Nursing May 2024Expanding the quality and quantity of midwifery and nursing clinical preceptors is a critical need in many sub-Saharan educational settings to strengthen students'...
BACKGROUND
Expanding the quality and quantity of midwifery and nursing clinical preceptors is a critical need in many sub-Saharan educational settings to strengthen students' clinical learning outcomes, and ultimately to improve maternal and child mortality. Therefore, this study protocol was developed to establish a year-long, four step, precepting program to (1) improve partnership building and program development (2) provide an evidence-based course to expand competency and confidence in precepting students (3) select preceptors to become train the trainers and (4) secure accreditation for the program, ultimately to engage and support cohorts of preceptors and continue to monitor and evaluate the effectiveness of the program over five years.
METHODS
Qualitative and quantitative approaches will be used including evaluation of preceptors, faculty and leadership involved with the program, as well as students taught by preceptors. Data will include validated self-assessment scales, objective structured clinical examinations (OSCEs), satisfaction surveys, and direct clinical observation, in-depth interviews and/or focus group discussions (preceptors); feedback forms (students); process mapping and organizational readiness for implementing change surveys (faculty and leadership). Median change in scores will be the primary outcome for quantitative data. Content analysis within a deductive framework to identify key implementation and adoption themes will be used for qualitative data analysis.
DISCUSSION
This study aims to assess the readiness and early effectiveness for implementing a preceptor program for midwifery and nursing in Sierra Leone and Malawi. Determining the effectiveness of this program will guide future adaptations in order to strengthen the program for sustainability and potential scale-up.
PubMed: 38822288
DOI: 10.1186/s12912-024-02036-2 -
BMC Genomics Jun 2024Several single nucleotide polymorphism (SNP) pipelines exist, each offering its own advantages. Among them and described here is vSNP that has been developed over the...
BACKGROUND
Several single nucleotide polymorphism (SNP) pipelines exist, each offering its own advantages. Among them and described here is vSNP that has been developed over the past decade and is specifically tailored to meet the needs of diagnostic laboratories. Laboratories that aim to provide rapid whole genome sequencing results during outbreak investigations face unique challenges. vSNP addresses these challenges by enabling users to verify and validate sequence accuracy with ease- having utility across various pathogens, being fully auditable, and presenting results that are easy to interpret and can be comprehended by individuals with diverse backgrounds.
RESULTS
vSNP has proven effective for real-time phylogenetic analysis of disease outbreaks and eradication efforts, including bovine tuberculosis, brucellosis, virulent Newcastle disease, SARS-CoV-2, African swine fever, and highly pathogenic avian influenza. The pipeline produces easy-to-read SNP matrices, sorted for convenience, as well as corresponding phylogenetic trees, making the output easily understandable. Essential data for verifying SNPs is included in the output, and the process has been divided into two steps for ease of use and faster processing times. vSNP requires minimal computational resources to run and can be run in a wide range of environments. Several utilities have been developed to make analysis more accessible for subject matter experts who may not have computational expertise.
CONCLUSION
The vSNP pipeline integrates seamlessly into a diagnostic workflow and meets the criteria for quality control accreditation programs, such as 17025 by the International Organization for Standardization. Its versatility and robustness make it suitable for use with a diverse range of organisms, providing detailed, reproducible, and transparent results, making it a valuable tool in various applications, including phylogenetic analysis performed in real time.
Topics: Polymorphism, Single Nucleotide; Phylogeny; Whole Genome Sequencing; Software; Animals; Humans; Computational Biology
PubMed: 38822271
DOI: 10.1186/s12864-024-10437-5 -
Cureus Apr 2024The implementation of hospital accreditation standards in healthcare systems in Yemen that ensure safe and high-quality healthcare services is hampered by specific...
INTRODUCTION
The implementation of hospital accreditation standards in healthcare systems in Yemen that ensure safe and high-quality healthcare services is hampered by specific challenges. Therefore, this study was purposed to explore the challenges and strategies for applying hospital accreditation standards among healthcare professionals in Yemen.
METHODS
A qualitative, phenomenological design was adopted to conduct this study. Semi-structured interviews were used to collect data during the period from January 1, 2022, to February 28, 2022.
RESULTS
Based on the content analysis, the study outcomes and lack of (i) funding, (ii) competent human resources, (iii) optimal infrastructure, and (iv) equipment and supplies deter the implementation of hospital accreditation standards. Also, this study highlighted the cultural and social barriers limiting the effectiveness of hospital accreditation standards, the need for increased investment in healthcare infrastructure and human resources, and cultural sensitivity training for healthcare professionals to enhance the implementation of and compliance with hospital accreditation standards.
CONCLUSIONS
Policymakers should engage global corporations and development partners for technical assistance and capacity building that support the local application of hospital accreditation standards.
PubMed: 38817454
DOI: 10.7759/cureus.59383 -
Frontiers in Public Health 2024In 1995, the World Health Organization launched its Global School Health Initiative to expand the Health Promoting School (HPS). The objective of this study was to...
INTRODUCTION
In 1995, the World Health Organization launched its Global School Health Initiative to expand the Health Promoting School (HPS). The objective of this study was to explore the perception of the school community in implementing nutrition-friendly school initiatives in preschool settings.
METHODS
This paper delineates the exploratory phase of a mixed-method study, which broadly aims to assess the adoption of the Nutrition Friendly School Initiative (NFSI) through a preschool preparedness intervention package in rural Sindh province, Pakistan. The study sites include three campuses of the Aga Khan School (Mirpur Sakro, Junior Campus Vur, and a community-based school in Sujawal). Participants were selected purposively from these campuses and constituted a committee named 'school community,' which was responsible for implementing all activities outlined in the intervention package. Data was gathered through in-depth interviews and consultative meeting with the school community. Thematic analysis was employed for data analysis.
RESULTS
The analysis established five major themes that represent the participants' perception of school-based nutrition interventions in preschool settings. These five themes include (i) Challenges in health and nutrition for pre-school age children, (ii) Clarity in roles and responsibilities for school-based nutrition intervention, (iii) Advancing school-based nutrition activities and interventions, (iv) Recognizing resources requirements, (v) Opportunities and challenges for the way forward in school-based nutrition. Findings also suggest sustainability and scalability measures that include the aligning School Nutrition Policy with the school handbook, ways to engage with parents, a nutrition theme corner, the inclusion of a parenting component in the nutrition manual, and capacity building of the school community.
CONCLUSION
Qualitative findings have guided the refinement of the intervention package, proposing additional measures for sustainability and scalability across AKES, P. The school community is hopeful that the implementation of the refined intervention package will enhance preschool preparedness toward achieving nutrition-friendly school checklist items. This study holds strong potential for replication in a public school setting and presents an opportunity to launch a school accreditation program to certify schools as Nutrition-friendly.
Topics: Humans; Pakistan; Child, Preschool; Rural Population; School Health Services; Schools; Female; Male; Health Promotion; Food Services; Perception; Qualitative Research; Nutrition Policy
PubMed: 38813413
DOI: 10.3389/fpubh.2024.1379229 -
IJID Regions Jun 2024Evidence-based prescribing is essential to optimize patient outcomes in cystitis. This requires knowledge of local antibiotic resistance rates. Diagnostic and...
Regional variations in antimicrobial susceptibility of community-acquired uropathogenic in India: Findings of a multicentric study highlighting the importance of local antibiograms.
OBJECTIVES
Evidence-based prescribing is essential to optimize patient outcomes in cystitis. This requires knowledge of local antibiotic resistance rates. Diagnostic and Antimicrobial Stewardship (DASH) to Protect Antibiotics (https://dashuti.com/) is a multicentric mentorship program guiding centers in preparing, analyzing and disseminating local antibiograms to promote antimicrobial stewardship in community urinary tract infection. Here, we mapped the susceptibility profile of from 22 Indian centers.
METHODS
These centers spanned 10 Indian states and three union territories. Antibiograms for urinary from the outpatient departments were collated. Standardization was achieved by regional online training; anomalies were resolved via consultation with study experts. Data were collated and analyzed.
RESULTS
Nationally, fosfomycin, with 94% susceptibility (inter-center range 83-97%), and nitrofurantoin, with 85% susceptibility (61-97%), retained the widest activity. The susceptibility rates were lower for co-trimoxazole (49%), fluoroquinolones (31%), and oral cephalosporins (26%). The rates for third- and fourth-generation cephalosporins were 46% and 52%, respectively, with 54% (33-58%) extended-spectrum β-lactamase prevalence. Piperacillin-tazobactam (81%), amikacin (88%), and meropenem (88%) retained better activity; however, one center in Delhi recorded only 42% meropenem susceptibility. Susceptibility rates were mostly higher in South, West, and Northeast India; centers in the heavily populated Gangetic plains, across north and northwest India, had greater resistance. These findings highlight the importance of local antibiograms in guiding appropriate antimicrobial choices.
CONCLUSIONS
Fosfomycin and nitrofurantoin are the preferred oral empirical choices for uncomplicated cystitis in India, although elevated resistance in some areas is concerning. Empiric use of fluoroquinolones and third-generation cephalosporins is discouraged, whereas piperacillin/tazobactam and aminoglycosides remain carbapenem-sparing parenteral agents.
PubMed: 38812702
DOI: 10.1016/j.ijregi.2024.100370 -
American Journal of Pharmaceutical... May 2024To describe the literature on the connections between empathy and professional identity formation (PIF) in pharmacy and other health professions education. A... (Review)
Review
OBJECTIVE
To describe the literature on the connections between empathy and professional identity formation (PIF) in pharmacy and other health professions education. A PRISMA-Scoping Review methodology was used for this study. Searches were conducted in PubMed and CINAHL from 2010 to January 12, 2023, with English added as a limiter. Articles had to address empathy and PIF, whether implicitly or explicitly. "Theory talk" was modified and utilized with 6 levels of connectedness to assess article quality.
FINDINGS
A total of 419 articles were reviewed for inclusion into the study with a total of 45 articles being included. Seventeen (37.8 %) and 12 articles (26.7 %) included a definition for empathy and PIF, respectively. Thirty-eight articles (84.4 %) implicitly discussed a connection between PIF and empathy. Educational initiatives that fostered connections between empathy and PIF focused on classroom activities, clinical rotation activities, and assessments. Key elements to enhance empathy and PIF development across articles focused on mentorship, role models, and reflective practice, alongside intentional curricular integration. Similarly, barriers to empathy and PIF are multifaceted.
SUMMARY
Despite educational initiatives in the literature that attempt to foster connections between empathy and PIF in classroom activities, clinical rotation activities, and assessments, most connections are implicit, as opposed to explicit. This may be due to the multiple barriers, such as the hidden curriculum, which make the connection between empathy and PIF difficult. This area needs further research and development given the importance of empathy in all health care provider interactions.
PubMed: 38810953
DOI: 10.1016/j.ajpe.2024.100725