Pub Date : 2024-08-23DOI: 10.1101/2024.08.23.24312503
Rachel Umoren, Ime Asangansi, Dillon Afenir, Brian W. Bresnahan, Annabelle Kotler, Cailin White, Matt Cook, Casey Lowman, Sara Berkelhamer
The costs of participating in training programs that rely on video conferencing vary by mechanics of use and the specific platform. We proposed practical solutions to limiting costs in low resource settings with the use of video conferencing calls. Scenarios in which facilitators have their video on and expect learners to participate with continuous video result in the greatest data burden, while use of intermittent video by both facilitator and learners can significantly lower data use, and thus costs. The choice of a platform also impacts teleprogramming, with creative options for use of lower cost platforms to reduce participant and training organization costs. These might include sharing educational content or video via chat groups and limiting conference to audio alone. In the context of COVID-19 where virtual meetings have become prevalent, it is critical that data burden is considered by program directors and funders. Looking forward, hybrid training that includes virtual and in-person training will likely become the norm in global health settings, but achieving this model will still require thoughtful consideration of data costs. Further, our findings are relevant to many other fields and advocate for evaluation of costs and data burden along with the growing use of teleprogramming in these settings.
{"title":"The Data Burden of Digital Learning","authors":"Rachel Umoren, Ime Asangansi, Dillon Afenir, Brian W. Bresnahan, Annabelle Kotler, Cailin White, Matt Cook, Casey Lowman, Sara Berkelhamer","doi":"10.1101/2024.08.23.24312503","DOIUrl":"https://doi.org/10.1101/2024.08.23.24312503","url":null,"abstract":"The costs of participating in training programs that rely on video conferencing vary by mechanics of use and the specific platform. We proposed practical solutions to limiting costs in low resource settings with the use of video conferencing calls. Scenarios in which facilitators have their video on and expect learners to participate with continuous video result in the greatest data burden, while use of intermittent video by both facilitator and learners can significantly lower data use, and thus costs. The choice of a platform also impacts teleprogramming, with creative options for use of lower cost platforms to reduce participant and training organization costs. These might include sharing educational content or video via chat groups and limiting conference to audio alone. In the context of COVID-19 where virtual meetings have become prevalent, it is critical that data burden is considered by program directors and funders. Looking forward, hybrid training that includes virtual and in-person training will likely become the norm in global health settings, but achieving this model will still require thoughtful consideration of data costs. Further, our findings are relevant to many other fields and advocate for evaluation of costs and data burden along with the growing use of teleprogramming in these settings.","PeriodicalId":501556,"journal":{"name":"medRxiv - Health Systems and Quality Improvement","volume":"180 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142224140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-23DOI: 10.1101/2024.08.23.24310791
Janelle Ryan, Shanie Landen, Vincent R Harley
Subjects in medical research have predominantly been male (1). Women experience 50-75% more adverse drug responses (2) resulting in withdrawn medications (3). While sex differences in metabolism, disease and treatment response are increasingly recognised, sex-informed medicine is lagging. In 2016, USAs National Institutes of Health (NIH) formulated the Sex as a Biological Variable policy (4), stating that grant recipients must consider sex in experimental design, planning, analysis and reporting of their findings. Australian data is lacking on the inclusion of both males and females as well as appropriate analysis of sex differences. We analysed the 219 Medical Journal of Australia (MJA) research articles over 2019-2023 (Box 1). We tallied when; i) both males and females were included in the study, ii) sex differences were reported and/or considered, and iii) the analysis was appropriate to support sex-related claims. We found that articles published in MJA are including males and females, however testing of sex differences is uncommon and appropriate statistical analysis is lacking. We hope that this article will bring attention to this fundamental issue and improve future efforts to investigate sex differences.
{"title":"Australian medical research that considered sex as a biological variable: a meta-analysis","authors":"Janelle Ryan, Shanie Landen, Vincent R Harley","doi":"10.1101/2024.08.23.24310791","DOIUrl":"https://doi.org/10.1101/2024.08.23.24310791","url":null,"abstract":"Subjects in medical research have predominantly been male (1). Women experience 50-75% more adverse drug responses (2) resulting in withdrawn medications (3). While sex differences in metabolism, disease and treatment response are increasingly recognised, sex-informed medicine is lagging. In 2016, USAs National Institutes of Health (NIH) formulated the Sex as a Biological Variable policy (4), stating that grant recipients must consider sex in experimental design, planning, analysis and reporting of their findings. Australian data is lacking on the inclusion of both males and females as well as appropriate analysis of sex differences. We analysed the 219 Medical Journal of Australia (MJA) research articles over 2019-2023 (Box 1). We tallied when; i) both males and females were included in the study, ii) sex differences were reported and/or considered, and iii) the analysis was appropriate to support sex-related claims. We found that articles published in MJA are including males and females, however testing of sex differences is uncommon and appropriate statistical analysis is lacking. We hope that this article will bring attention to this fundamental issue and improve future efforts to investigate sex differences.","PeriodicalId":501556,"journal":{"name":"medRxiv - Health Systems and Quality Improvement","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142185086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-21DOI: 10.1101/2024.08.21.24312377
Dinesh Kumar, Ingo Hauter, Felipe C. Canlas, Firli Yogiteten Sunaryoko, Gyanu Raja Maharjan, Md. Mazharul Anowar, Harjyot Khosa, Yi-Roe Tan, Peiling Yap
Citizen science (CS) promotes the inclusion of diverse stakeholders and offers a scientific in-depth understanding of community engagement to build trust, increase knowledge, and facilitate policymaking. Study aimed to understand concepts, practices, approaches, and sustainability issues of CS among citizens in five South and Southeast Asian countries. Qualitative study from October 2022 to March 2023 was carried in Nepal, Bangladesh, India, Philippines, and Indonesia. In each country, four focus group discussions were conducted with an overall total of 130 participants. Content analysis and coding were carried out for narrative responses of participants. Across all countries, the participants collectively comprehended the term "research" while referring to CS. Participants also related social responsibility and capacity building of citizens to CS. In terms of their contributions to pandemic response, participants stated compliance with government guidelines, helping to create awareness, and providing necessary support and assistance. Participants value personal achievement, satisfaction, happiness, and a chance to build social capital while participating in CS activities. Participants were ready to actively contribute to CS activities and share their opinions with stakeholders such as policymakers and researchers but felt that a lack of personal confidence, ineffective communication, and insufficient translation of their opinions to actions could deter them. Creation of an organization or network, provision of budget for activities, incentives to participants, and transportation assistance were considered as resources needed for the sustainability of CS. Participants expressed their readiness for CS activities considering personal and social factors, while systemic support is needed for sustained participation.
{"title":"Qualitative assessment of the citizen science approach to foster public partnerships for pandemic preparedness and response in South and Southeast Asian countries","authors":"Dinesh Kumar, Ingo Hauter, Felipe C. Canlas, Firli Yogiteten Sunaryoko, Gyanu Raja Maharjan, Md. Mazharul Anowar, Harjyot Khosa, Yi-Roe Tan, Peiling Yap","doi":"10.1101/2024.08.21.24312377","DOIUrl":"https://doi.org/10.1101/2024.08.21.24312377","url":null,"abstract":"Citizen science (CS) promotes the inclusion of diverse stakeholders and offers a scientific in-depth understanding of community engagement to build trust, increase knowledge, and facilitate policymaking. Study aimed to understand concepts, practices, approaches, and sustainability issues of CS among citizens in five South and Southeast Asian countries. Qualitative study from October 2022 to March 2023 was carried in Nepal, Bangladesh, India, Philippines, and Indonesia. In each country, four focus group discussions were conducted with an overall total of 130 participants. Content analysis and coding were carried out for narrative responses of participants. Across all countries, the participants collectively comprehended the term \"research\" while referring to CS. Participants also related social responsibility and capacity building of citizens to CS. In terms of their contributions to pandemic response, participants stated compliance with government guidelines, helping to create awareness, and providing necessary support and assistance. Participants value personal achievement, satisfaction, happiness, and a chance to build social capital while participating in CS activities. Participants were ready to actively contribute to CS activities and share their opinions with stakeholders such as policymakers and researchers but felt that a lack of personal confidence, ineffective communication, and insufficient translation of their opinions to actions could deter them. Creation of an organization or network, provision of budget for activities, incentives to participants, and transportation assistance were considered as resources needed for the sustainability of CS. Participants expressed their readiness for CS activities considering personal and social factors, while systemic support is needed for sustained participation.","PeriodicalId":501556,"journal":{"name":"medRxiv - Health Systems and Quality Improvement","volume":"53 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142227672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-20DOI: 10.1101/2024.08.19.24312251
Zoi Papalamprakopoulou, Sotirios Roussos, Elisavet Ntagianta, Vasiliki Triantafyllou, George Kalamitsis, Arpan Dharia, Vana Sypsa, Angelos Hatzakis, Andrew H. Talal
Background: Telehealth holds the potential to expand healthcare access for people who use drugs (PWUD). However, approaches to increase PWUDs' access to digital healthcare are not well understood. We studied digital healthcare accessibility among PWUD. Methods: We employed respondent-driven sampling to recruit 162 PWUD in Athens, Greece to collect data via a structured questionnaire. Participants were aged at least 18 years and had an injection drug use (IDU) history. We assessed current internet and computer access, and experience with telemedicine. We utilized logistic regression to evaluate sociodemographic associations. Results: Participants' mean (standard deviation) age was 45.9 (8.8) years, 84.0% were male, 90.1% Greek, 77.8% reported IDU within the past year, 85.2% were not linked to opioid treatment, and 50.0% were currently experiencing homelessness. Only 1.9% had experience and 46.3% had familiarity with telemedicine. Internet and computer access were reported by 66.0% and 31.5% of participants, respectively. Compared to participants with secure housing, those currently experiencing homelessness reported decreased internet (50.6% vs 81.5%, p<0.001) and computer access (11.1% vs 51.9%, p<0.001). Multivariable analyses revealed that older age (per 1-year increase: odds ratio [OR]=0.94, 95% confidence interval [CI] [0.89, 0.99], p=0.03), IDU within the past year (0.29 [0.10, 0.88], p=0.03), and homelessness (0.29, [0.13, 0.65], p=0.003) were associated with lower odds of internet access. Homelessness was associated with lower odds of computer access (0.17, [0.07, 0.41], p<0.001). Conclusions: Internet and infrastructure challenges, homelessness, and digital literacy gaps should be considered to bridge the digital divide and ensure equitable digital healthcare distribution for PWUD.
{"title":"Considerations for Equitable Distribution of Digital Healthcare for People Who Use Drugs","authors":"Zoi Papalamprakopoulou, Sotirios Roussos, Elisavet Ntagianta, Vasiliki Triantafyllou, George Kalamitsis, Arpan Dharia, Vana Sypsa, Angelos Hatzakis, Andrew H. Talal","doi":"10.1101/2024.08.19.24312251","DOIUrl":"https://doi.org/10.1101/2024.08.19.24312251","url":null,"abstract":"Background: Telehealth holds the potential to expand healthcare access for people who use drugs (PWUD). However, approaches to increase PWUDs' access to digital healthcare are not well understood. We studied digital healthcare accessibility among PWUD.\u0000Methods: We employed respondent-driven sampling to recruit 162 PWUD in Athens, Greece to collect data via a structured questionnaire. Participants were aged at least 18 years and had an injection drug use (IDU) history. We assessed current internet and computer access, and experience with telemedicine. We utilized logistic regression to evaluate sociodemographic associations.\u0000Results: Participants' mean (standard deviation) age was 45.9 (8.8) years, 84.0% were male, 90.1% Greek, 77.8% reported IDU within the past year, 85.2% were not linked to opioid treatment, and 50.0% were currently experiencing homelessness. Only 1.9% had experience and 46.3% had familiarity with telemedicine. Internet and computer access were reported by 66.0% and 31.5% of participants, respectively. Compared to participants with secure housing, those currently experiencing homelessness reported decreased internet (50.6% vs 81.5%, p<0.001) and computer access (11.1% vs 51.9%, p<0.001). Multivariable analyses revealed that older age (per 1-year increase: odds ratio [OR]=0.94, 95% confidence interval [CI] [0.89, 0.99], p=0.03), IDU within the past year (0.29 [0.10, 0.88], p=0.03), and homelessness (0.29, [0.13, 0.65], p=0.003) were associated with lower odds of internet access. Homelessness was associated with lower odds of computer access (0.17, [0.07, 0.41], p<0.001).\u0000Conclusions: Internet and infrastructure challenges, homelessness, and digital literacy gaps should be considered to bridge the digital divide and ensure equitable digital healthcare distribution for PWUD.","PeriodicalId":501556,"journal":{"name":"medRxiv - Health Systems and Quality Improvement","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142185104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-20DOI: 10.1101/2024.08.19.24312212
Stephanie Howard Wilsher, Julii Suzanne Brainard, Sarah Hanson, Duncan Peacock, Paul Everden
Objectives: To synthesise evidence about primary care clinicians treating patients in or adjacent to hospital emergency departments in the UK. Study design: Mixed methods narrative systematic review. Methods: Eligible studies were in English and described primary care services (general practitioners, GPs, or nurse practitioners) that treat patients within or adjacent to hospital Emergency Departments (ED). Searches were conducted on Medline, EMBASE, Cochrane Library and CINAHL databases. The search included extraction from an international review updated from 2020 to October 2022, and grey literature from inception to October 2022. The methods were informed by consultation with members of the public. Results: From 4189 studies screened, 20 met inclusion criteria. Four studies assessed typology and streaming of services. Seven studies reported patient and public involvement. Ten studies reported differences in clinical outcomes between primary care and emergency services, but not definitive benefit for either. Likewise, results were equivocal for economic evaluations. Diverse delivery formats complicate evaluation and may explain why clinicians had mixed opinions about the utility of such services. Patients were generally satisfied with the service they received, in either primary care or emergency services. Conclusion: Diversity of implementation complicate conclusions that can be drawn. Existing evaluations provide little evidence that primary care services in or near emergency departments offers any system advantages for clinical outcomes, or cost savings. Process evaluation in future evaluations is essential to understand what aspects of primary care at emergency departments are likely to improve system and patient care.
{"title":"Primary care clinicians working in or near hospital emergency departments in the UK: A mixed methods systematic review","authors":"Stephanie Howard Wilsher, Julii Suzanne Brainard, Sarah Hanson, Duncan Peacock, Paul Everden","doi":"10.1101/2024.08.19.24312212","DOIUrl":"https://doi.org/10.1101/2024.08.19.24312212","url":null,"abstract":"Objectives: To synthesise evidence about primary care clinicians treating patients in or adjacent to hospital emergency departments in the UK. Study design: Mixed methods narrative systematic review.\u0000Methods: Eligible studies were in English and described primary care services (general practitioners, GPs, or nurse practitioners) that treat patients within or adjacent to hospital Emergency Departments (ED). Searches were conducted on Medline, EMBASE, Cochrane Library and CINAHL databases. The search included extraction from an international review updated from 2020 to October 2022, and grey literature from inception to October 2022. The methods were informed by consultation with members of the public.\u0000Results: From 4189 studies screened, 20 met inclusion criteria. Four studies assessed typology and streaming of services. Seven studies reported patient and public involvement. Ten studies reported differences in clinical outcomes between primary care and emergency services, but not definitive benefit for either. Likewise, results were equivocal for economic evaluations. Diverse delivery formats complicate evaluation and may explain why clinicians had mixed opinions about the utility of such services. Patients were generally satisfied with the service they received, in either primary care or emergency services. Conclusion: Diversity of implementation complicate conclusions that can be drawn. Existing evaluations provide little evidence that primary care services in or near emergency departments offers any system advantages for clinical outcomes, or cost savings. Process evaluation in future evaluations is essential to understand what aspects of primary care at emergency departments are likely to improve system and patient care.","PeriodicalId":501556,"journal":{"name":"medRxiv - Health Systems and Quality Improvement","volume":"72 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142185087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-19DOI: 10.1101/2024.08.17.24311962
SHARIFAH BALQIS SAYED ABDUL HAMID, ANIZA ISMAIL, SAPERI SULONG
Patient safety remains a global problem that affects both developed and developing countries. Healthcare organizations should focus on the need of assessing safety culture as that will provide basic understanding on safety related perceptions of their staffs. Objective : This study was aimed to assess baseline level and mean score of every domain of the patient safety attitude among doctors and nurses in public hospitals in Selangor and to identify the determinants associated with patient safety attitude in all domains : teamwork, safety climate, working condition, job satisfaction, stress recognition and perception of management. Method :This was a cross-sectional study utilizing the Safety Attitude Questionnaires (SAQ) involving 142 doctors and 231 nurses in three public hospitals in Selangor. The samples were selected through proportionate stratified random sampling. Data was analysed using descriptive, bivariate and multivariate analysis. Results: The response rate was 83% in which job satisfaction and perception of management received the highest and lowest mean score, respectively. The factors associated with positive patient safety attitude towards 1)teamwork were position (OR 1.99, p=0.03) and history of attending patient safety training (OR 3.228, p = 0.000); 2) safety climate were history of attending patient safety training (OR 7.283, p = 0.000); 3) job satisfaction were education level ( OR 35.709, p=0.000), position (OR 10.598, p=0.000) and history of attending patient safety training (OR 2.883, p = 0.000); 4) perception of management were age (OR 2.084,p=0.021) and work area (OR 2.461,p=0.012); 5) working condition were age (OR2.200,p 0.003) and history of attending patient safety training (OR1.738, p 0.032). Conclusion : Respondents with history of attending patient safety training have more positive attitude towards teamwork, safety climate, job satisfaction and working condition. Improving patient safety culture should be priorotized by the hospital management team to inculcate safety culture in healthcare providers.
{"title":"ASSESSMENT OF PATIENT SAFETY ATTITUDE AMONG DOCTORS AND NURSES AT PUBLIC SPECIALIST HOSPITALS IN MALAYSIA","authors":"SHARIFAH BALQIS SAYED ABDUL HAMID, ANIZA ISMAIL, SAPERI SULONG","doi":"10.1101/2024.08.17.24311962","DOIUrl":"https://doi.org/10.1101/2024.08.17.24311962","url":null,"abstract":"Patient safety remains a global problem that affects both developed and developing countries. Healthcare organizations should focus on the need of assessing safety culture as that will provide basic understanding on safety related perceptions of their staffs. Objective : This study was aimed to assess baseline level and mean score of every domain of the patient safety attitude among doctors and nurses in public hospitals in Selangor and to identify the determinants associated with patient safety attitude in all domains : teamwork, safety climate, working condition, job satisfaction, stress recognition and perception of management. Method :This was a cross-sectional study utilizing the Safety Attitude Questionnaires (SAQ) involving 142 doctors and 231 nurses in three public hospitals in Selangor. The samples were selected through proportionate stratified random sampling. Data was analysed using descriptive, bivariate and multivariate analysis. Results: The response rate was 83% in which job satisfaction and perception of management received the highest and lowest mean score, respectively. The factors associated with positive patient safety attitude towards 1)teamwork were position (OR 1.99, p=0.03) and history of attending patient safety training (OR 3.228, p = 0.000); 2) safety climate were history of attending patient safety training (OR 7.283, p = 0.000); 3) job satisfaction were education level ( OR 35.709, p=0.000), position (OR 10.598, p=0.000) and history of attending patient safety training (OR 2.883, p = 0.000); 4) perception of management were age (OR 2.084,p=0.021) and work area (OR 2.461,p=0.012); 5) working condition were age (OR2.200,p 0.003) and history of attending patient safety training (OR1.738, p 0.032). Conclusion : Respondents with history of attending patient safety training have more positive attitude towards teamwork, safety climate, job satisfaction and working condition. Improving patient safety culture should be priorotized by the hospital management team to inculcate safety culture in healthcare providers.","PeriodicalId":501556,"journal":{"name":"medRxiv - Health Systems and Quality Improvement","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142185105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-17DOI: 10.1101/2024.08.16.24311723
Lisa Jane Gould, Emma Lawrence, Richard Powell, Eleanor Angwin
Abstract Background: The National Health Service (NHS) is suffering from a workforce crisis of mental and physical sickness and attrition following the COVID19 pandemic. An in depth understanding of healthcare workers (HCWs) experiences during the pandemic is required to understand the impacts on their mental health in this challenging work environment. This qualitative study explores HCWs concerns during the COVID19 pandemic, expressed in real time during an active mental health crisis. Design: This study involved analysis of data from Shout, a text message-based, UK wide mental health support service which, during the pandemic, was advertised to HCWs specifically. Pseudo-random sampling of scripts of anonymised text message conversations between HCWs and Shout Volunteers from April 2020 to March 2021 was undertaken, with data fully anonymised by Shout before researchers accessed them on a secure purpose built platform. Following application of exclusion and inclusion criteria, 60 conversations were coded to develop a thematic framework and analysed using grounded theory, with subthemes triangulated to create final themes. Quotes extracted from this process were then synthesised for publication. Results: Three themes emerged from the data: 1) Poor mental health, subthemes: (a) overwhelming negative feelings or emotional distress experienced, and; (b) active crisis/resurgent symptoms. 2) Negative work experiences, sub-themes: (a) negative NHS work culture and expectations; (b) inadequate structures and arrangements for support; (c) trauma at work, and; (d) abuse at work. 3) The impact of the COVID19 pandemic, sub-themes: (a) additional work pressure, and; (b) isolation and risk. Conclusion: This study explores the challenges and mental health concerns in HCWs during an active crisis. Organisational stressors, mental health provision and additional resources for HCWs to recover from the pandemic remain a vital issue in current NHS service provision.
{"title":"Healthcare workers mental health during the COVID-19 pandemic: A qualitative analysis of a text message-based NHS workforce support line","authors":"Lisa Jane Gould, Emma Lawrence, Richard Powell, Eleanor Angwin","doi":"10.1101/2024.08.16.24311723","DOIUrl":"https://doi.org/10.1101/2024.08.16.24311723","url":null,"abstract":"Abstract\u0000Background: The National Health Service (NHS) is suffering from a workforce crisis of mental and physical sickness and attrition following the COVID19 pandemic. An in depth understanding of healthcare workers (HCWs) experiences during the pandemic is required to understand the impacts on their mental health in this challenging work environment. This qualitative study explores HCWs concerns during the COVID19 pandemic, expressed in real time during an active mental health crisis. Design: This study involved analysis of data from Shout, a text message-based, UK wide mental health support service which, during the pandemic, was advertised to HCWs specifically. Pseudo-random sampling of scripts of anonymised text message conversations between HCWs and Shout Volunteers from April 2020 to March 2021 was undertaken, with data fully anonymised by Shout before researchers accessed them on a secure purpose built platform. Following application of exclusion and inclusion criteria, 60 conversations were coded to develop a thematic framework and analysed using grounded theory, with subthemes triangulated to create final themes. Quotes extracted from this process were then synthesised for publication. Results: Three themes emerged from the data: 1) Poor mental health, subthemes: (a) overwhelming negative feelings or emotional distress experienced, and; (b) active crisis/resurgent symptoms. 2) Negative work experiences, sub-themes: (a) negative NHS work culture and expectations; (b) inadequate structures and arrangements for support; (c) trauma at work, and; (d) abuse at work. 3) The impact of the COVID19 pandemic, sub-themes: (a) additional work pressure, and; (b) isolation and risk. Conclusion: This study explores the challenges and mental health concerns in HCWs during an active crisis. Organisational stressors, mental health provision and additional resources for HCWs to recover from the pandemic remain a vital issue in current NHS service provision.","PeriodicalId":501556,"journal":{"name":"medRxiv - Health Systems and Quality Improvement","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142185106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-16DOI: 10.1101/2024.08.15.24312090
Pablo Amor Fernandez, Rachel Neill, Ruchika Bhatia, Jigyasa Sharma, Kathryn Andrews, Sven Neelsen, Etoile Pinder, Marifat Abdullaev, Firuza Safarova, Mutriba Latypova, Mirja Channa Sjoblom, Tashrik Ahmed, Michael A Peters, Ashley Sheffel, Tawab Hashemi, Peter Meredith Hansen, Gafur Muhsinzoda, Gil Shapira
Health facility assessments provide important data to measure the quality of health services delivered to populations. These assessments are comprehensive, resource intensive, and periodic to inform medium- to-longer-term policies. However, in absence of other reliable data sources, country decision makers often rely on outdated data to address service delivery challenges that change more frequently. High-frequency phone surveys are a potential option to improve the efficiency and timeliness of collecting time-sensitive service delivery indicators in-between comprehensive in-person assessments. The objectives of this study are to assess the reliability, concurrent criterion validity, and non-response rates in a rapid phone-based health facility assessment developed by the Global Financing Facility’s FASTR initiative compared to a comprehensive in-person health facility assessment developed by the World Bank’s Service Delivery Indicators Health Program. The in-person survey and corresponding in-person item verification will serve as the gold standard. Both surveys will be administered to an identical sample of 500 health facilities in Tajikistan using the same data collection entity. To assess reliability, percent agreement, Cohens Kappa, and prevalence and bias adjusted Kappa will be calculated. To assess concurrent criterion validity, sensitivity and specificity will be calculated, with a cut-off of .7 used for adequate validity. The study will further compare response rates and dropout rates of both surveys using simple t-tests and balance tests to identify if the characteristics of the phone-based and in-person survey samples are similar after accounting for any differences in survey response rates. The results of this study will provide important insights into the reliability and validity of phone-based data collection approaches for health facility assessments. This is critical as Ministries of Health seek to establish and sustain more continuous data collection, analysis, and use of health facility-level data to complement periodic in-person assessments to improve the quality of services provided to their populations.
{"title":"Comparison of the results of in-person and mobile phone surveys for a health facility assessment in Tajikistan: a validation study protocol","authors":"Pablo Amor Fernandez, Rachel Neill, Ruchika Bhatia, Jigyasa Sharma, Kathryn Andrews, Sven Neelsen, Etoile Pinder, Marifat Abdullaev, Firuza Safarova, Mutriba Latypova, Mirja Channa Sjoblom, Tashrik Ahmed, Michael A Peters, Ashley Sheffel, Tawab Hashemi, Peter Meredith Hansen, Gafur Muhsinzoda, Gil Shapira","doi":"10.1101/2024.08.15.24312090","DOIUrl":"https://doi.org/10.1101/2024.08.15.24312090","url":null,"abstract":"Health facility assessments provide important data to measure the quality of health services delivered to populations. These assessments are comprehensive, resource intensive, and periodic to inform medium- to-longer-term policies. However, in absence of other reliable data sources, country decision makers often rely on outdated data to address service delivery challenges that change more frequently. High-frequency phone surveys are a potential option to improve the efficiency and timeliness of collecting time-sensitive service delivery indicators in-between comprehensive in-person assessments. The objectives of this study are to assess the reliability, concurrent criterion validity, and non-response rates in a rapid phone-based health facility assessment developed by the Global Financing Facility’s FASTR initiative compared to a comprehensive in-person health facility assessment developed by the World Bank’s Service Delivery Indicators Health Program. The in-person survey and corresponding in-person item verification will serve as the gold standard. Both surveys will be administered to an identical sample of 500 health facilities in Tajikistan using the same data collection entity. To assess reliability, percent agreement, Cohens Kappa, and prevalence and bias adjusted Kappa will be calculated. To assess concurrent criterion validity, sensitivity and specificity will be calculated, with a cut-off of .7 used for adequate validity. The study will further compare response rates and dropout rates of both surveys using simple t-tests and balance tests to identify if the characteristics of the phone-based and in-person survey samples are similar after accounting for any differences in survey response rates. The results of this study will provide important insights into the reliability and validity of phone-based data collection approaches for health facility assessments. This is critical as Ministries of Health seek to establish and sustain more continuous data collection, analysis, and use of health facility-level data to complement periodic in-person assessments to improve the quality of services provided to their populations.","PeriodicalId":501556,"journal":{"name":"medRxiv - Health Systems and Quality Improvement","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142185108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-16DOI: 10.1101/2024.08.16.24312101
Thomas Ssemakadde, NALUMAGA PAULINE PETRA, Jude Collins Busingye, Joel Bazira, Kabanda Taseera
Background: The emergence and re- emergence of zoonotic bacterial infections and the upsurge reflected in current trends of antimicrobial-resistant bacteria is a major global concern. Salmonella spp and Escherichia coli (E.coli) are the two most important food-borne pathogens of public health interest incriminated in poultry products worldwide hence necessitating constant monitoring of microbial food safety measures. The purpose of this study was to determine the prevalence, associated factors and antimicrobial susceptibility patterns of Salmonella and E. coli in poultry farms in Wakiso District to provide detailed information of extent of spread to guide plans that influence safer poultry keeping practices in this era. Methods: This study was a cross sectional study that used a total of two hundred sixteen (216) poultry samples from cloacae swabs and fecal swabs collected from broiler poultry farms and cultured on Chromagar TM Salmonella and Sorbitol MacConkey agar for pathogenic E. coli. Biochemical tests, minimum inhibitory concentration, and polymerase chain reaction were utilized. Assessment of the correlations between the resistance patterns of resistant and susceptible isolates was determined using mean, and multiple logistic regression. Results: A total of 40 (18.5%) Salmonella and 120 (55.6%) Pathogenic E. coli was isolated. In this investigation, extended beta lactamase (ESBL) production was detected in 18 isolates Salmonella and 57 pathogenic E. coli. Prevalence of blaTEM gene was expressed in 7/18 (39%) Salmonella isolates and 42/57 (73.8%) Pathogenic E. coli isolates The associated factors that predispose these farms to Salmonella and Pathogenic E. coli identified in this study include: contact of poultry and wild birds (p -value =0.000), movement from one pen to the other by farm-handlers (P-Value = 0.030), use of untreated water ( P-Value =0.005) and food contamination of commercial poultry feeds (P-Value= 0.0021) Conclusion: Salmonella spp and Escherichia coli remain the two most important food-borne pathogens of public health interest incriminated in the poultry field, and it is evident from this study that these bacteria have resistant genes associated with them.
{"title":"Prevalence, associated factors and antimicrobial susceptibility patterns of Salmonella species and pathogenic Escherichia coli isolated from broiler poultry farms in Wakiso district, Uganda.","authors":"Thomas Ssemakadde, NALUMAGA PAULINE PETRA, Jude Collins Busingye, Joel Bazira, Kabanda Taseera","doi":"10.1101/2024.08.16.24312101","DOIUrl":"https://doi.org/10.1101/2024.08.16.24312101","url":null,"abstract":"Background: The emergence and re- emergence of zoonotic bacterial infections and the upsurge reflected in current trends of antimicrobial-resistant bacteria is a major global concern. Salmonella spp and Escherichia coli (E.coli) are the two most important food-borne pathogens of public health interest incriminated in poultry products worldwide hence necessitating constant monitoring of microbial food safety measures. The purpose of this study was to determine the prevalence, associated factors and antimicrobial susceptibility patterns of Salmonella and E. coli in poultry farms in Wakiso District to provide detailed information of extent of spread to guide plans that influence safer poultry keeping practices in this era.\u0000Methods: This study was a cross sectional study that used a total of two hundred sixteen (216) poultry samples from cloacae swabs and fecal swabs collected from broiler poultry farms and cultured on Chromagar TM Salmonella and Sorbitol MacConkey agar for pathogenic E. coli. Biochemical tests, minimum inhibitory concentration, and polymerase chain reaction were utilized. Assessment of the correlations between the resistance patterns of resistant and susceptible isolates was determined using mean, and multiple logistic regression.\u0000Results: A total of 40 (18.5%) Salmonella and 120 (55.6%) Pathogenic E. coli was isolated. In this investigation, extended beta lactamase (ESBL) production was detected in 18 isolates Salmonella and 57 pathogenic E. coli. Prevalence of blaTEM gene was expressed in 7/18 (39%) Salmonella isolates and 42/57 (73.8%) Pathogenic E. coli isolates The associated factors that predispose these farms to Salmonella and Pathogenic E. coli identified in this study include: contact of poultry and wild birds (p -value =0.000), movement from one pen to the other by farm-handlers (P-Value = 0.030), use of untreated water ( P-Value =0.005) and food contamination of commercial poultry feeds (P-Value= 0.0021)\u0000Conclusion: Salmonella spp and Escherichia coli remain the two most important food-borne pathogens of public health interest incriminated in the poultry field, and it is evident from this study that these bacteria have resistant genes associated with them.","PeriodicalId":501556,"journal":{"name":"medRxiv - Health Systems and Quality Improvement","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142185107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-14DOI: 10.1101/2024.08.13.24311963
Kim Greaves, Amanda King, Zoltan Bourne, Jennifer Welsh, Mark Morgan, M. Ximena Tolosa, Trisha Johnston, Carissa Bonner, Tony Stanton, Rosemary Korda
Background: The ATHENA COVID-19 (ACV19) study was set up to recruit a cohort of patients with linked health information willing to be re-contacted in future to participate in clinical trials, and also to investigate the outcomes of people with COVID-19 in Queensland, Australia, using consent. This report describes how patients were recruited, their primary care data extracted, proportions consenting, outcomes of using the recontact method to recruit to a study, and experiences interacting with general practices requested to release the primary care data. Methods: Patients diagnosed with COVID-19 from January 1, 2020, to December 31, 2020, were systematically approached to gain consent to have their primary healthcare data extracted from their general practice into a Queensland Health database and linked to other datasets for ethically approved research. Patients were also asked to consent to allow future recontact to discuss participation in clinical trials and other research studies. Patients who consented to recontact were later approached to recruit to a long-COVID study. Patients general practices were contacted to export the patient files. All patient and general practice interactions were recorded. Outcome measures were proportions of patients consenting to data extraction and research, permission to recontact, proportions of general practices agreeing to participate. A thematic analysis was conducted to assess attitudes regarding export of healthcare data, and the proportions consenting to participate in the long-COVID study also reported. Results: Out of 1212 patients with COVID-19, contact details were available for 1155; 995(86%) were successfully approached, and 842(85%) reached a consent decision. Of those who reached a decision, 581(69%), 615(73%) and 629(75%) patients consented to data extraction, recontact, and both, respectively. 382 general practices were contacted, of whom 347(91%) had an electronic medical record compatible for file export. Of these, 335(88%) practices agreed to participate, and 12(3%) declined. In total 526 patient files were exported. The majority of general practices supported the study and accepted electronic patient consent as legitimate. For the long COVID study, 376(90%) of those patients recontacted agreed to have their contact details passed onto the long COVID study team and 192(53%) consented to take part in their study. Conclusions: This report describes how primary care data was successfully extracted using consent, and that the majority of patients approached gave permission for their healthcare information to be used for research and be recontacted. The consent-to-recontact concept demonstrated its effectiveness to recruit to new research studies. The majority of general practices were willing to export identifiable patient healthcare data for linkage provided consent had been obtained.
{"title":"Consent to Recontact for Future Research Using Linked Primary Healthcare Data: Outcomes and General Practice Perceptions from the ATHENA COVID-19 Study","authors":"Kim Greaves, Amanda King, Zoltan Bourne, Jennifer Welsh, Mark Morgan, M. Ximena Tolosa, Trisha Johnston, Carissa Bonner, Tony Stanton, Rosemary Korda","doi":"10.1101/2024.08.13.24311963","DOIUrl":"https://doi.org/10.1101/2024.08.13.24311963","url":null,"abstract":"Background: The ATHENA COVID-19 (ACV19) study was set up to recruit a cohort of patients with linked health information willing to be re-contacted in future to participate in clinical trials, and also to investigate the outcomes of people with COVID-19 in Queensland, Australia, using consent. This report describes how patients were recruited, their primary care data extracted, proportions consenting, outcomes of using the recontact method to recruit to a study, and experiences interacting with general practices requested to release the primary care data.\u0000Methods: Patients diagnosed with COVID-19 from January 1, 2020, to December 31, 2020, were systematically approached to gain consent to have their primary healthcare data extracted from their general practice into a Queensland Health database and linked to other datasets for ethically approved research. Patients were also asked to consent to allow future recontact to discuss participation in clinical trials and other research studies. Patients who consented to recontact were later approached to recruit to a long-COVID study. Patients general practices were contacted to export the patient files. All patient and general practice interactions were recorded. Outcome measures were proportions of patients consenting to data extraction and research, permission to recontact, proportions of general practices agreeing to participate. A thematic analysis was conducted to assess attitudes regarding export of healthcare data, and the proportions consenting to participate in the long-COVID study also reported. Results: Out of 1212 patients with COVID-19, contact details were available for 1155; 995(86%) were successfully approached, and 842(85%) reached a consent decision. Of those who reached a decision, 581(69%), 615(73%) and 629(75%) patients consented to data extraction, recontact, and both, respectively. 382 general practices were contacted, of whom 347(91%) had an electronic medical record compatible for file export. Of these, 335(88%) practices agreed to participate, and 12(3%) declined. In total 526 patient files were exported. The majority of general practices supported the study and accepted electronic patient consent as legitimate. For the long COVID study, 376(90%) of those patients recontacted agreed to have their contact details passed onto the long COVID study team and 192(53%) consented to take part in their study.\u0000Conclusions: This report describes how primary care data was successfully extracted using consent, and that the majority of patients approached gave permission for their healthcare information to be used for research and be recontacted. The consent-to-recontact concept demonstrated its effectiveness to recruit to new research studies. The majority of general practices were willing to export identifiable patient healthcare data for linkage provided consent had been obtained.","PeriodicalId":501556,"journal":{"name":"medRxiv - Health Systems and Quality Improvement","volume":"71 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142185290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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