Implementing the elderly-friendly hospital initiative in the intensive care unit with a review of policy and practice

Aging is an unavoidable part of life. Every human must go through the aging process. A decline in organ function is a part of the aging process that leads to various health-related challenges. These healthcare challenges may require critical care. The uniqueness of the aged population needs to be considered to provide adequate and satisfactory care befitting this subset of clients seeking critical care. Using the elder-friendly approach, improved care tailored to meet the demands of increased organ support can be achieved in the intensive care unit.

Relevance of the Health Extension Program to the current Health Needs and Evolving Demands of Rural Ethiopia: A Mixed-Method Analysi

BACKGROUND: Ethiopia has been implementing a health extension program (HEP) to respond to the high maternal and child mortality in rural communities. HEP has brought tremendous contributions to improved access and coverage of primary healthcare in the last 15 years. Despite its attributions, attention to HEP has declined in recent years due to several reasons. This study is designed to explore HEP's relevance to the current healthcare needs of the rural communities. METHODS: This study is a nested cross-sectional mixed method to the overall HEP's evaluation between March and May 2019. Descriptive statistics were used on qualitative and quantitative assessment. A literature review supplemented the assessment. A representative quantitative sample of 11,746 women, men, and young girls; a qualitative sample of 268 key informants from Kebele administrators, HEWs, program people in the health system and focus groups from community leaders, men and women from 185 Kebeles in 62 woredas were selected. A thematic approach was used for qualitative analysis. RESULTS: Rural communities and program managers asserted that HEP's service packages with the existing service delivery modalities were relevant. Eighty-two percent of men and women and 77% of young girls confirmed this relevance. Besides the existing packages, additional curative services for adults and children were recommended with emphasis on the pastoralist community. HEP's service uptake has declined as over 86% of targeted rural communities bypassed HPs due to unavailability of services and capacity problems of HEWs. CONCLUSION: The current HEP packages with the existing service delivery modalities are still relevant to the rural communities' health needs. However, on-going changes to address the evolving demands of the targeted rural communities are crucial

Profil des édentements partiels selon la classification de Kennedy-Applegate dans une structure de soins dentaires de Lomé (Togo) / Profile of partial edentulism according to the Kennedy-Applegate classification in a dental care structure in Lome (Togo)

Introduction. La documentation des édentements partiels est un indicateur de l'état buccodentaire et permet d'évaluer les besoins en soins prothétiques. L'objectif de ce travail était de décrire le profil des édentements partiels selon la classification de Kennedy-Applegate dans une structure de soins dentaires. Matériels et méthodes. Il Une étude transversale descriptive a été réalisée durant 3 mois dans le service d'odonto-stomatologie et de chirurgie maxillo-faciale du Centre Hospitalier Universitaire Sylvanus Olympio (CHU-SO) de Lomé (Togo). Les données sociodémographiques et cliniques des patients inclus ont été recueillies et analysées grâce au logiciel Jamovi® version 2.2.5. Résultats. L'échantillon comportait 82 sujets dont 50% de femmes. L'âge moyen était de 47,4 ± 15,1ans. Les édentements de classe III de Kennedy prédominaient avec 75,2% des arcades édentées. Les édentements de classe III étaient retrouvés à 82,1% dans la tranche d'âge 19-40 ans, les 61 ans et plus comptaient 20% des classes I et 24% des classes II. L'édentement était significativement associé à l'âge (p=0,046). Conclusion. Il apparait que la classe III de Kennedy est globalement la plus fréquente des édentements partiels et que l'étendue édentement augmenterait avec l'âge

Introduction. Documentation of partial edentulism is an indicator of oral health status and enables prosthetic care needs to be assessed. The aim of this study was to describe the pattern of partial edentulism according to the Kennedy-Applegate classification in a dental care facility. Materials and methods. This A descriptive cross-sectional study was conducted over a 3-month period in the Odonto-stomatology and maxillofacial surgery department of the Centre Hospitalier Universitaire Sylvanus Olympio (CHU-SO) in Lomé (Togo). The sociodemographic and clinical data of the included patients were collected and analysed using Jamovi® version 2.2.5 software. Results. The sample included 82 subjects, 50% of whom were women. The average age was 47.4 ± 15.1 years. Kennedy class III edentulism predominated with 75.2% of edentulousness arches. Class III edentulous was found at 82.1% in the 19-40 years age group, those aged 61 years and over had 20% of class I and 24% of class II. Edentulism was significantly associated with age (p=0.046). Conclusion. It appears that Kennedy class III is globally the most frequent of partial edentulism and that the extent of edentulism would increase with age.

Ecologia integral e trabalhadores imigrantes na pandemia de Covid-19 / Integral ecology and immigrant workers in the Covid-19 pandemic

No período da pandemia deCovid-19 um dos grupos mais vulneráveis é aquele composto por trabalhadores imigrantes. Longe de seus países, muitos deles não recebem assistência médica ao mesmo tempo que continuam trabalhando normalmente por desempenharem funções consideradas essenciais. Além disso, encontram-seseparados de suas famílias por conta das restrições de entrada em fronteiras internacionais. Neste trabalho, queremos apresentar os princípios da ecologia integral daIgreja Católica como uma maneira de atender às necessidades mais urgentes dos trabalhadores imigrantes neste tempo da pandemia. Vamos, primeiramente,tratar da situação dos trabalhadores imigrantes com base em alguns estudos recentes. Depois explicaremos os princípios da ecologia integral segundo a doutrina social da Igreja Católica. Por fim, com base naqueles princípios, vamos propor recomendações para policy makerscom relação ao cuidado dos trabalhadores imigrantes no contexto da pandemia

At the time of the Covid-19 pandemic one of the most vulnerable groups is that composed of migrant workers. Far from their home countries, many of them do not receive medical assistance while continuing to work as they do essential jobs. In addition, they are separated from their families due to entry restrictions at international borders. In this paper, we want to present the principles of the Catholic Church's integral ecology as a way to address the most urgent needs of migrant workers in this time of pandemic. We will first address the situation of migrant workers based on some recent studies. Then we will explain the principles of integral ecology according to the social doctrine of the Catholic Church. Finally, based on those principles, we will propose recommendations for policy makers regarding the care of immigrant workers in the context of the pandemic.

The impact of public health interventions in a developing nation: an overview

Introduction: Around 80% of factors that determine population health sit outside the control of health services. It is essential we influence these factors in addition to those within the remit of health services in order to improve and protect the health of population in a developing country. Public health functions encompass working across the domains that constitute population health systems with various partners. The objective of this article is to give an overview of public health interventions that can improve the health of the population of a developing nation. Method: A descriptive study, based on a review of the literature of key public health frameworks and interventions that are likely to have significant impacts on population health. Some selected public health interventions and case studies are highlighted to illustrate the importance of priority areas in developing countries. Results: Various public health frameworks recognise the importance of wider determinants of health (socio-economic factors), effective healthcare, healthy behaviours, working with communities as critical to securing population health. Another framework adopts a life-course model of intervention starting from public health interventions during preconception period and childhood, adolescence, working life and older age. For many developing countries, the author identified some examples of priority areas for interventions such as stopping and preventing wars; improving child health, including free school meals; achieving universal healthcare through integrated primary health care; addressing commercial determinants of health; embracing new technologies; and measuring and monitoring population health. Conclusion: In order to improve the health of a population in a developing country, attention needs to go beyond health services to influence the wider determinants of health, health behaviours and adopting the World Health Organisation's roadmap on essential public health functions.

Digital health and self-management of chronic diseases in sub-Saharan Africa: A scoping review

Background: With the rise of noncommunicable diseases (NCDs) in sub-Saharan Africa (SSA), the concept of digital self-management presents great opportunities for relieving some of the burdens healthcare systems face. However, for this to be realised, effective use of digital health in self-management and assessment is essential. Objective: The objective of this scoping review was to identify social determinants and cognitive factors with potential influence on digital health use in self-management of chronic medical conditions associated with NCDs in SSA. Method: The 5-stage scoping review framework was used to search, identify, and filter publications over a 10-year period from two major databases, Google Scholar and Pubmed. Based on the inclusion criteria, a total of 12 documents were chosen for analysis. Results: Findings reveal that social determinants such as cultural values and societal practices demand a rethinking of how digital health for self-management of chronic diseases are designed and developed for use in SSA, whereas a cognitive factor such as self-efficacy is central in digital health use in self-management of chronic conditions, particularly in areas like adherence to medication, diet and exercise programmes. Conclusion: Owing to the unique characteristics of digital health users in SSA, technologies and content (particularly those for self-management of chronic diseases) should be tailored to the diverse needs of the population. It is through this that the region can fully benefit from the potential of digital health use in self-management of chronic diseases associated with NCDs.

The clinical environment: a facilitator of professional socialisation

Background: Competencies of health care workers, including nurses, often do not meet the health needs of populations. The clinical learning environment (CLE) is vital in socialising neophyte student nurses to display the desired competencies. Student nurses are however confronted with challenges, especially in the CLE, during this process. Aim: This article shares three validated guidelines to support professional nurses and nurse educators in facilitating appropriate professional socialisation of student nurses in the CLE. Setting: The study was conducted in an 832-bed academic hospital and nine nursing education institutions (NEIs) that offered the nursing programme concerned in a province in South Africa. Method: A sequential, exploratory, mixed-methods study was conducted and qualitative data were collected from two purposive samples, consisting of seven focus group interviews and field notes. Five themes that emerged from the integrated data guided the instrument design to collect data quantitatively from 277 educators. Experts validated 10 guidelines to a set of criteria, which was developed combining all data. Results: Qualitative and quantitative research evidenced that the CLE mostly did not support student nurses during professional socialisation. A few role models' behaviour was noteworthy, while student supervision was inadequate. The CLE was stressful, lacked in resources, marked by uncoordinated student placement, insufficient communication and inadequate preparation of student nurses. This evidence informed the development of the guidelines. Conclusions: The guidelines were (1) the empowerment of role models through reflective practice, (2) capacity building of professional nurses and nurse educators as clinical supervisors by means of intervention strategies and (3) adopting a multifaceted approach in the creation of a positive CLE. These guidelines could facilitate appropriate professional socialisation of student nurses

Information needs and information resources availability for nursing students in mission-Owned schools of nursing in Imo state

This study investigated the information needs and information resources availability for nursing students in mission-owned schools of nursing in Imo State. The study adopted the descriptive survey research design and five research questions guided the study. All the 416 second and third year nursing students were used for the study. Questionnaire on Information Needs of Nursing Students and a Checklist on Information Resources Availability were the instruments used to collect data. A total of 397 copies of the questionnaire were completed and returned for analysis representing 95.4% of the total population. All the head- librarian of the schools of nursing complied with the checklist. The findings showed that the students need varieties of information. It also showed that the students consulted different sources, mainly textbooks and internet to meet their information needs. Print information resources were available in the libraries and only few electronic information resources were available. The study recommended that the nursing school authorities should be updating their print resources since students were observed to rely more on textbooks. Also the libraries should upgrade to higher bandwidth so as to have easier and faster access to more e-books and e-journals.Keywords: Information, Information needs, Print and Electronic Information Resources Availability, Nursing Education

Impact of health education intervention on knowledge and utilization of postnatal care services among women in Edu local Government of Kwara State, Nigeria

Background: This study examined the impact of health education intervention (HEI) on the knowledge and utilization of postnatal care services among women in Edu, Nigeria.Methods: A quasi-experimental research design using pre-test and post-test control group to examine impact of HEI among women. Researchers-developed questionnaire was used for data collection.Intervention: One hundred and twenty women were exposed to ten weeks health education intervention; sixty (n=60) experimental group exposed to postnatal care services lectures and sixty (n=60) control group were exposed to HIV/AIDS prevention lectures. The results were analyzed using descriptive and inferential statistics to answer research question and test null hypothesis at 0.05 significant levels.Results: The findings showed an improvement from pre intervention mean scores of 64.26 to post intervention scores of 98.15 for the experimental group against 68.88 post intervention mean score of control group. While, the pre intervention mean score of utilization was 56.67 compared with post intervention mean scores of 92.91 for the experimental group and 61.04 for the control group utilization This showed positive impact of health education intervention on knowledge and willingness of women of childbearing age to utilize postnatal care services in Edu LGA.Conclusion: Study concluded that, health education intervention had positive impact on knowledge and willingness of WCA to utilize postnatal care, and the knowledge gained need to be sustained to improve WCA health seeking behaviour in the communities of Edu LGA

Les impacts des déterminants sociaux de la santé sur la santé publique : Cas de la région sanitaire Est de l'Algérie

Cette recherche a pour objet de : mettre l'accent sur les déterminants sociaux de la santé comme ceux qui sont les plus prégnants pour la santé dans les sociétés pauvres ou modernes, comme : l'obésité, la sédentarité, la pratique du sport, l'alimentation, la dépendance, etc.Parmi les résultats de notre étude de cas sur les établissements publics de soins de proximité/EPSP des 7 wilayas de l'Est algérien, nous relevons des inégalités concernant les besoins de santé d'une part, et d'autre part, les moyens alloués pour couvrir ces besoins dans les communes d'une même wilaya et entre les wilayas elles-mêmes. Comme nous sommes arrivés à une certitude que la transition économique et sociale des années 90e, a engendré plus tard une transition épidémiologique vers des maladies chroniques (maladies cardiovasculaires, diabète, cholestérol, HTA …) à cause des nouvelles habitudes individuelles, collectives ou des politiques générales de l'Etat

Information needs, seeking behavior and work effectiveness of physicians in selected government hospitals in EDO state, Nigeria

Information behaviour and work effectiveness of physicians are vital elements in the day to day practice of physicians in selected government hospitals. This study was carried out to investigate the relationship of between information need, seeking behaviour and work effectiveness of physicians in six government hospitals in Edo State. The objectives of the study include the identification of various health information needs of physicians in government hospitals, finding out their information seeking patterns and examining the level of work effectiveness. The method adopted is the survey design. A structured questionnaire was used to gather data among the respondents. Out of the 620 questionnaire administered 516 (83.2%) were retrieved. The findings revealed that the major health information need of physicians in selected government hospitals in Edo State was information on treatment and tests of patients. The quality of work delivery in terms of commitment and individual care to patients as well as commitment to organization goals is less than satisfactory. There is a significant relationship between information needs and seeking behaviour of physicians and their work effectiveness (r =0.422; p<0.05 and r = 0.090; p<0.05), respectively. It is recommended that physicians in government hospitals in Edo State need to be more pro-active in updating themselves in general medical knowledge

Obstacles to HIV prevention, treatment and care in selected public universities in South Africa

South Africa; like the rest of Southern Africa; is ravaged by AIDS. Higher education in South Africa has a significant role to play in the fight against the spread of HIV and AIDS. This article reports the factors contributing to the spread of HIV and AIDS in three selected public universities in South Africa. To achieve the stated aim; the study answered the following research question: What are the factors contributing to the spread of HIV and AIDS in South African public universities? The problem in this study stems from South Africa's HIV and AIDS infection rate; one of the highest in the world; especially in KwaZulu-Natal. A qualitative approach was adopted by conducting focus group interviews with the students. The data were analysed using axial coding and open coding; where dominant themes from the discussions were identified and discussed in detail. The findings show that barriers to HIV and AIDS prevention; care and treatment exist in the tertiary institutions under study. Social and economic interventions are needed to stem the spread of HIV and AIDS at tertiary institutions. A range of recommendations for halting the spread of HIV and AIDS in these institutions is provided

Sexual; Reproductive Health Needs and Rights of Young People with Perinatally Acquired HIV in Uganda

Background: Numbers of young people with perinatally acquired HIV is growing significantly. With antiretroviral drugs; children who get infected at birth with HIV have an opportunity to graduate into adolescence and adulthood. This achievement notwithstanding; new challenges have emerged in their care and support needs. The most dynamic being; their sexual and reproductive health needs and rights (SRHR). Objectives: This paper aimed at establishing the gaps at policy; program and health systems level as far as addressing sexual and reproductive health needs of young people who have lived with HIV since infancy is concerned. Methods: This paper is based on a desk review of existing literature on sexual and reproductive health needs and rights of young positives. Results: The results indicate young positives are sexually active and are engaging in risky sexual encounters. Yet; existing policies; programs and services are inadequate in responding to their sexual and reproductive health needs and rights. Conclusion: Against these findings; it is important; that policies specifically targeting this subgroup are formulated and to make sure that such policies result in programs and services that are youth friendly. It is also important that integration of Sexual Reproductive Health (SRH) and HIV services is prioritized

The Experience and Psychosocial Needs of Patients with Traumatic Fractures Treated for more than Six Months at Doctors on Call for Service Hospital; Goma; Democratic Republic of Congo

Background: Trauma-related consultations; admissions and complications are the leading problems at Doctors on Call for Service (DOCS) Hospital; Goma; Democratic Republic of Congo; and yet no studies have been carried out to document the experience of long-stay traumatic-fracture patients in this hospital. Aim: The aim of this study was to explore the experience and psychosocial needs of patients with traumatic fractures treated for more than six months at DOCS Hospital. Methods: Six free-attitude interviews were conducted with purposively selected patients. The interviews were recorded with a tape recorder and transcribed verbatim; and content analysis was used to identify themes from the interviews. Results: All patients could clearly connect the injury experience to severe pain that lingered on for weeks or months for some patients; accompanied by other symptoms such as insomnia; poor appetite and psychological symptoms. Most patients felt disabled; were abandoned by relatives or friends and experienced financial problems. Some benefited from the injury by way of strengthened marital links. Some patients complained of poor information about their illness and the management plan and did not appreciate the treatment from caregivers; while some disclosed their needs and expectations and appreciated the caregivers who showed interest in them. Conclusions: The experience of long-term trauma has negative effects on the whole person of the patient; including his or her work and family; and some patients continue to suffer from the effects of the traumatic event up to six months later. The needs of patients suffering from trauma include reassurance by physicians and nurses; more information and participation in the decision-making process; regular visits from friends and family; and better bedside manners from caregivers

The Health Care Needs of the Physically Disabled Patient in a Home-Based Care Environment: Implications for the Training of Ancillary Health Care Workers

According to existing literature; ancillary health care workers (AHCWs) often do not meet the health care needs of patients with physical disabilities (physically disabled patients) in a home-based environment; because of inadequate training programmes. The purpose of this research study was to explore the health care needs of physically disabled patients in long-term; home-based care in the northern suburbs of Johannesburg and; based on results; to offer recommendations for the training of AHCWs. Qualitative; exploratory; descriptive and contextual means were employed in data collection and analysis. The population consisted of eight physically disabled participants who employed an AHCW to assist them with their long-term home care. Purposive sampling was used with subsequent snowballing to identify further participants for the study. Individual interviews were conducted; where participants had to answer the questions (1)'What are your health care needs?' and (2) 'How should these be met?' Data saturation was ensured; after which Tesch's method of data analysis was followed. Three categories of health care needs were identified (1) physical health care needs; (2) interpersonal relationship needs and (3) social needs; and 12 themes were derived from these categories. These categories of health care needs should be addressed in the training of AHCWs. From the themes; recommendations were described for the training of AHCWs on the health care needs of the home-based physically disabled patients. The AHCW should assist in the adaptation of the environment to the patient's individual needs; and should use knowledge and critical thinking skills to ensure a patient-centred care setting

Delivering on a Gendered Definition of Health Needs in Local Government Budgeting: Experiences and Concepts

Background: Local governments are granted budgetary power in the Local Governments Act of the Republic of Uganda2; which allows for local-level participation and flexibility in the allocation of financial grants channelled annually from central to local governments. The act prescribes a legal mandate to allocate public resources based on local priorities including the health needs of women compared with men. This study investigated the responsiveness of local government budgeting to the health needs of women as compared to men.Methodology: A qualitative study was conducted in Mpigi district using a set of data collection methods including: a) three (3) focus group discussions with 8 female and 8 male respondents in each group; b) face-to-face interviews with a random sample of 120 households; 75of which were male-headed and 25female-headed ; c) key informant interviews with a sample of 10 administrative officers in Mpigi district ; and d) desk-review of the Mpigi district Budget Framework Paper 4. Results: Health needs consist of the daily requirements; which; arise out of common disease infections and the socio-economic constraints that affect the well-being of women and men. However; the primary concern of the district health sector is disease control measures; without emphasis on the differing socio-economic interests of women as compared to men. Local government budgeting; therefore; does not reflect the broad community-wide understanding of health needs. Conclusion: Local government budgeting should be informed by a two-fold framework for the gendered definition of health needs. The two-fold framework combines both disease-based health needs and socio-economic needs of women as compared to men

Audit of oral and maxillofacial surgical conditions seen at Port Harcourt, Nigeria

BACKGROUND:The worldwide pattern of oral and maxillofacial surgical conditions has been rarely reported despite its significance in head and neck medicine. The Niger Delta region comprises 9 of the 36 states in the Federal Republic of Nigeria. There are scanty reports on oral and maxillofacial surgical diseases from the region despite its 95% contribution to Nigeria's oil-revenue.METHODS:This retrospective survey of oral/maxillofacial surgical cases seen at a referral center in Port Harcourt, a city in the Niger delta region of Nigeria.RESULTS: Between 2000 and 2004, our center offered specialized maxillofacial surgical services to 86 patients coming from 5 states in the Niger delta region. These patients made up 20% of all patients seen at the department within the period. There were 110 indications for surgical interventions. Most were complaints of trauma (46.4%). The rest were tumors and allied lesions (39.0%) and cysts (12.7%). Ratio of male to female patients was 1.7:1 while patients were aged between 9 and 85 years (mean 31.2 years, standard deviation +/- 15.4). Most (n? = ?63, 73%) had surgical treatment while a significant proportion (19%) defaulted. Seventy-nine surgical procedures were performed (69 primary and 10 secondary). Primary procedures included maxillo-mandibular fixation (31.9%) and enucleation of tumor/cyst (17.4%). While our series of 86 cases over 4 years appears low, there is likelihood that oral and maxillofacial surgical conditions are as common in the Niger Delta region as in other parts of Nigeria. There is scarcity of skilled manpower and equipments for the management of oral maxillofacial surgical conditions in the region. Health promotion activities are needed to improve awareness for early diagnosis of these conditions. Also, poverty alleviation measures need to be effective as defaults were often due to inability to pay for treatment. CONCLUSION: In many parts of the Niger Delta region of Nigeria, oral and maxillofacial surgical diseases are not uncommon causes of morbidity. However, many parts of the region lack requisite manpower for prevention and curative health activities. Defaults from hospital treatment were due to preference for traditional (unorthodox) measures and financial inability. Poverty alleviation measures need to be stepped up while the state of medical infrastructure should be enhanced in the region

Health Promotion Needs of Hammanskraal Families with Adolescents Orphaned by HIV/AIDS

Health promotion is regarded as the cornerstone of good health. It is the action expected from individuals and families in order to better their own health situation. Health promotion is an art and science (Edelman et Mandle; 2002:16) that is integrated into the primary health care to reduce existing health problems. The purpose of the research on which this article is reporting; was to explore and describe the health promotion needs of families with adolescents orphaned by human immunodeficiency virus or acquired immune deficiency syndrome (HIV/AIDS). The research was located within a qualitative paradigm that is both exploratory and descriptive. Eight families who were purposely selected participated in the research process. Qualitative methods; such as group interviews and field notes were utilised to collect data. The health promotion needs of the families with adolescents orphaned by HIV/AIDS were explored and described. Tesch's analysis process; which entails a series of steps; was followed (Creswell; 2003:192). Themes; categories and subcategories that form the central focus of health promotion needs emerged during the data analysis. These themes;categories and subcategories are used to develop guidelines for health promotion

Guidelines to Facilitate the Nursing Accompaniment of Mothers with in a Neonatal Intensive Care Unit

To be the mother of a premature infant in a neonatal intensive care unit can sometimes be overwhelming. The hospital environment and the sound made by the life support apparatus in the unit may be terrifying for persons who are unfamiliar with this environment. An observation of the researcher; who practises in a neonatal intensive care unit; was that mothers were often very distressed after the admission of their infants. It also appeared as if health care practitioners were failing to provide for the needs of these mothers. The objectives of the research on which this article is based were: firstly; to acknowledge and describe the experiences of the mothers with regard to the hospitali- sation of their infants in the neonatal intensive care unit and secondly; to utilise the information obtained to develop guidelines to assist registered nurses accompanying mothers throughout their infants' stay in the neonatal intensive care unit. The conclusion was reached that mothers whose infants are admitted to the neonatal intensive care unit have a need for compassionate accompaniment by registered nurses during the period of hospitalisation of their infants