Effect of adult day care centre attendance on hypertension management.

BACKGROUND:  Hypertension (HT) silently threatens one in three adults, especially older adults, who struggle with blood pressure (BP) control because of limited health access, poor adherence to medication and failure to make lifestyle changes. This increases their risk for heart disease, kidney failure and dementia. Fortunately, adult day care centres (ADCCs) offer hope. These community facilities provide daytime care, including health support services, social activities and exercise. This study investigated the perceived effect of adult daycare centre attendance on BP control and treatment adherence. METHODS:  A mainly descriptive study at MUCPP Community Health Centre (CHC) in Bloemfontein, South Africa, between July 2020 and September 2020, used questionnaires researchers completed during interviews. The researchers approached 372 hypertensive patients of a minimum of 60 years old and at least 2 years since being diagnosed. RESULTS:  Of the 90 who attended ADCCs, 71.1% had controlled hypertension compared to 51.4% of those who did not. While treatment adherence showed no difference, a positive association between ADCC attendance and BP control is evident. CONCLUSION:  The findings suggest a promising link between ADCC attendance and improved BP control in older adults with hypertension. Adult Day Care Centres warrant further exploration as it seems to be an encouraging support intervention for this vulnerable population.Contribution: This study highlights the positive impact ADCCs have on hypertension management in older adults, urging increased physician awareness and patient referrals.

Practicing With a Framework Mindset: A Closer Look at the Principle of Care Coordination.

This is the second in a series of articles highlighting the practice principles of the refreshed School Nursing Practice Framework™. The focus of each article is to provide an in-depth look at each of the principles and emphasize how school nurses can apply them to their daily practice through a Framework Mindset. This article will explore Care Coordination as a practice principle, reflect on how it relates to current practice, and identify examples that illustrate care coordination. With each subsequent article in the series, we will continue to build upon and explore the interconnections between the Framework principles.

Mental Health Modulates Associations between Institutional Belonging and Substance Use Risk.

OBJECTIVE: The present study aimed to characterize profiles of mental health, incorporating both indicators of psychopathology and well-being, among college students and determine whether institutional belonging differentially relates to past month substance use by mental health profile. METHOD: Students (N = 4018; 59.5% female, 74.7% white) completed a survey regarding mental health (i.e., anxiety symptoms, depressive symptoms, stress, flourishing, academic confidence), institutional belonging, and whether they had engaged in any binge drinking of alcohol and use of cannabis and nicotine products, including nicotine vaping, over the past month. RESULTS: Latent profile analyses indicated five profiles of mental health with differing levels of psychopathology and well-being. Greater institutional belonging was only related to higher odds of binge drinking among students in profiles characterized by average or high well-being, irrespective of psychopathology. Among students with overall poor mental health, higher institutional belonging was related to higher odds of nicotine use. Results were generally invariant to campus and year at college. CONCLUSIONS: Our findings highlight that both positive and negative aspects of mental health should be considered when assessing college students' substance use. Greater institutional belonging may incur risk for substance use differentially by mental health, with respect to binge drinking for those with high levels of positive well-being and non-vaping nicotine use for those with overall poor mental health. Because associations emerged between belonging and substance use risk, institutions could consider implementing or raising awareness of alcohol-free, inclusive activities to ensure that students can feel a sense of belonging while abstaining from drinking.

Effectiveness of a Systems-Wide Initiative to Address Motivation and Expectations for Treatment on Initial Session Attendance to Outpatient Gambling Treatment.

This brief report expands the results of a prior efficacy study that examined the effect of a letter addressing prospective clients' motivation and expectations for outpatient gambling disorder treatment on initial session attendance. The results of that efficacy study indicated more clients attended the initial session when receiving the letter (77%) compared to receiving a reminder telephone call (51%). The present study examines the effectiveness of messages addressing prospective clients' motivation and expectations for outpatient gambling treatment across an entire treatment system. Messages were sent via letters, telephone, and in-person communication with all clinic staff. Participants were 54 clients with gambling disorder who were seeking outpatient psychological treatment. Results indicated that the percentage of clients attending the initial session was 85%, and no differences in attendance were found between in-person and telehealth sessions. These findings suggest that messages that address motivation and expectations persist under real-world conditions, and treatment systems can make meaningful changes that increase attendance to initial treatment sessions.

Association between medication complexity and follow-up care attendance: insights from a retrospective multicenter cohort study across 1,223 Chinese hospitals.

Background: Patients with Chronic Obstructive Pulmonary Disease (COPD) frequently face substantial medication burdens. Follow-up care on medication management is critical in achieving disease control. This study aimed to analyze the complexity of COPD-specific medication and determine how it impacted patients' attendance on follow-up care. Methods: This multicenter study includes patients with COPD from 1,223 hospitals across 29 provinces in China from January 2021 to November 2022. The medication Regimen Complexity Index (MRCI) score was used to measure COPD-specific medication complexity. The association between medication complexity and follow-up care attendance was evaluated using the Cox Proportional Hazard Model. Results: Among 16,684 patients, only 2,306 (13.8%) returned for follow-up medication management. 20.3% of the patients had high complex medication regimen (MRCI score >15.0). The analysis revealed that compared to those with less complex regimens, patients with more complex medication regimens were significantly less likely to attend the follow-up medication care, with a Hazard Ratio (HR) of 0.82 (95% Confidence Interval [CI], 0.74-0.91). Specifically, patients with more complex dosage forms were 51% less likely to attend the follow-up care (95% CI, 0.43-0.57). This pattern was especially marked among male patients, patients younger than 65 years, and those without comorbid conditions. Conclusion: Higher medication complexity was associated with a decreased likelihood of attending follow-up care. To promote care continuity in chronic disease management, individuals with complex medication regimens should be prioritized for enhanced education. Furthermore, pharmacists collaborating with respiratory physicians to deprescribe and simplify dosage forms should be considered in the disease management process.

Fathers' experiences, views and perspectives of childbirth attendance: A qualitative evidence synthesis protocol.

Background: The involvement of husbands and male partners in childbirth no longer ceases at conception and pregnancy, rather fathers wish to be more involved in supporting their partners during childbirth. This aligns with the World Health Organization's (WHO) call for promoting male participation in childbirth, emphasising the benefits of support and the positive impact attending childbirth has for husbands/partners, and their maternal partner. This knowledge has led to global initiatives promoting "humanised" birth and a family-approach. To gain in-depth insight and understanding of childbirth attendance from the perspectives of fathers, a qualitative evidence synthesis is proposed. Methods: To explore fathers' experiences, views, and perspectives of childbirth attendance. All studies that used qualitative methodologies to explore the phenomenon of interest will be included. MEDLINE, CINAHL, PsycINFO, MIDIRS, Web of Science, and Google Scholar will be systematically searched from their dates of inception to present, supplemented by a search for grey literature and a search of the reference list of included studies. Peer Review of Electronic Search Strategies (PRESS) will be used to ensure the comprehensiveness of the search strategy. Methodological quality assessment of included studies, using The Critical Appraisal Skills Programme assessment tool, and will be extracted from the included studies by two reviewers independently using a standard data extraction form. Thomas and Harden's three-stage approach will be used to thematically synthesise the data: coding of data, developing descriptive themes, and generation of analytical themes. The Grading of Recommendations Assessment, Development, and Evaluation-Confidence in the Evidence from Reviews of Qualitative research (GRADE-CERQual confidence in the synthesised findings Comprehensive insight and understanding of fathers' perspectives of childbirth attendance will be ascertained. PROSPERO Registration No: CRD42023470902.

Utilization of Dental Care and Oral Health Outcomes in the United States: Results from the National Health and Nutrition Examination Survey (2017-2020).

PURPOSE: This analysis aims to evaluate the association between the time since and reason for a patient's last dental appointment across clinical oral health outcomes. MATERIALS AND METHODS: We used data from the 2017-2020 National Health and Nutrition Examination Survey (NHANES), a cross-sectional, nationally-representative survey of noninstitutionalized US adults. The predictors were the time since and the reason for the last dental appointment (routine vs. urgent). We examined the presence and number of missing teeth and teeth with untreated coronal and root caries. Multivariable regression models with interaction were used to assess the association between the time since the last dental appointment and clinical oral health outcomes among routine and urgent users separately. RESULTS: Two-thirds of the US population had a dental appointment within a year, while nearly 44 million individuals did not visit a dentist for the last three years. The odds of having teeth with untreated coronal or root caries increased with the length of time since the last appointment, and urgent users had worse dental outcomes compared to routine users. Compared to those who had a dental appointment within a year, individuals who had their last dental appointment more than 3 years ago had 2.94 times the average number of teeth with untreated caries among routine users (95%CI=2.39, 3.62) and 1.60 times the average among urgent users (95%CI=1.05, 2.43). CONCLUSIONS: Recent, routine dental appointments are associated with improved oral health outcomes. The outcomes reiterate how social determinants of health impact access to oral health care and oral health outcomes.

Heightened mortality risk after a non-fatal opioid overdose: Risk factors for mortality in the week following emergency treatment.

AIMS: To measure all-cause mortality risk after an ambulance-attended non-fatal opioid overdose and associations with number of days following attendance, and individual and clinical characteristics. DESIGN: A prospective observational study. SETTING: Oslo, Norway. PARTICIPANTS: Patients treated with naloxone for opioid overdose by Oslo Emergency Services between 1 June 2014 and 31 December 2018. MEASUREMENTS: Medical records were linked to the national Cause of Death Registry (1 June 2014-31 December 2019). Crude mortality rates (CMR) and incidence risk ratios (IRR) with 95% confidence intervals (CI) were estimated for the time periods (0-7 days, 8-31 days, 32-91 days, 92-183 days, >183 days) using multivariate Poisson regression analysis. IRR were estimated for sex, age, Glasgow Coma Scale (GCS), respiration rate, place of attendance and non-transportation following treatment. Robust variance estimates applied due to multiple risk periods. Standardized Mortality Rates (SMR) were estimated. FINDINGS: Overall, 890 patients treated for 1764 overdoses contributed to a total time at risk of 3142 person-years (PY). Median number of attendances was 1 (range 1-27). The majority were male (75.5%) and the mean age was 37.7 years. In total, 112 (12.6%) died; 5.2% within 183 days and 2.2% between 184 and 365 days. Acute poisoning was the most common single cause of death (52.7%). The CMR was 3.6 (95% CI = 3.0-4.2) per 100-PY. The women had a SMR of 32 (95% CI = 15.8-57.9) and the men 24.9 (95% CI = 17.7-34.2). The CMR (22.2, 95% CI = 10.6-46.8) was particularly high in the first 7 days, and significantly higher than in the following periods. However, this finding was only valid for those with severe overdose symptoms (GCS score = 3/15 and/or respiratory rate ≤6/min). Except for increasing age, no other indicators were associated with the mortality risk. CONCLUSION: Patients treated by Oslo Emergency Services between June 2014 and December 2018 for a non-fatal opioid overdose with severe overdose symptoms at attendance had an overall high mortality risk compared with the general population, but particularly during the first 7 days after attendance.

Spatial variation of skilled birth attendance and associated factors among reproductive age women in Ethiopia, 2019; a spatial and multilevel analysis.

Background: The majority of maternal deaths were associated with a lack of access to skilled birth attendance. Because childbirth accounts for most maternal deaths, skilled birth attendance is crucial for reducing maternal mortality. The use of skilled birth attendance in Ethiopia is low, and it is crucial to identify factors that determine the use of skilled birth attendance. Hence, this study aimed to assess the spatial distribution, wealth-related inequality, and determinants for skilled birth attendance in Ethiopia. Methods: Secondary data analysis was done with a total weighted sample of 5,251 reproductive-aged women using the 2019 mini EDHS. The concentration index and graph were used to assess wealth-related inequalities. Spatial analysis was done to identify the spatial distribution and multilevel logistic regression analysis was used to identify predictors of skilled birth attendance in Ethiopia. Analysis was done using STATA version 14, ArcGIS, and SaTscan software. Results: The prevalence of skilled birth attendance was 50.04% (95% CI: 48.69%, 51.40%) in Ethiopia. Old age, being married, being educated, having television and radio, having ANC visits, being multiparous, having large household sizes, having a rich wealth index, living in rural residence, and living in a high level of community poverty and women's education were significant predictors of skilled birth attendance. Skilled birth attendance was disproportionately concentrated in rich households [C = 0.482; 95% CI: 0.436, 0.528]. High prevalence of unskilled birth attendance was found in Somalia, SNNP, Afar, and southern parts of the Amhara regions. Primary clusters of unskilled birth attendance Somalia and some parts of Oromia region of Ethiopia. Conclusion: Half of the women in Ethiopia did not utilize skilled birth attendants with significant spatial clustering. Age, marital status, educational status, ANC Visit, having television and radio, parity, household size, wealth index, residence, community level poverty, and community level of women's education were significant predictors of skilled birth attendance. Skilled birth attendance was unevenly concentrated in rich households. The regions of Somalia, SNNP, Afar, and southern Amhara were identified as having a high prevalence of using unskilled birth attendance. Public health interventions should target those women at high risk of using unskilled birth attendants.

Do school Water, Sanitation, and Hygiene facilities affect students' health status, attendance, and educational achievements? A qualitative study in Nepal.

Background and Aims: Access to safe and sufficient drinking Water, Sanitation, and good Hygiene (WASH) facilities in schools play a crucial role in preventing students from numerous Neglected Tropical Diseases, improving the learning environment in schools, and creating resilient communities living in a healthy environment. This study aims to explore the impact of combining WASH facilities on students' health status, school attendance, and educational achievements. Methods: Four schools, two with improved and two without improved WASH facilities, were selected purposively from Dhanusha and Chitwan districts of Nepal. A total of 24 participants, 16 students, and eight teachers were also purposively selected based on the Theory of Data Saturation. The participants were interviewed face-to-face using study guidelines; Key Informants Interview for teachers and In-depth Interview for students. The data were audio recorded and analyzed thematically using Dedoose 9.0.17 qualitative data management and analysis software. Results: School WASH facilities have a significant impact on students' health and well-being. Poor school-WASH facilities hindered students' school attendance, particularly for menstruating girls. School without separate toilets for girls, including menstruation hygiene facilities, lack of water and soap, sanitary pad, and secure toilet's door often have higher rates of absenteeism among girls. Poor teacher and students' relationships, students' low interest in education, household chores, and participation in social customs also contribute to students' absence from school and low educational performance. It is important to note that inadequate WASH facilities affect not only students, but also teachers in the same school. Conclusion: The lack of safe and sufficient drinking water, unimproved sanitation, and poor hygiene facilities were seen by students and teachers as reducing their health and well-being, school attendance, and academic performance. Thus, schools need prioritize and promote the provision of improved WASH facilities for the betterment of students' health, attendance, and educational proficiency.

Women with disabilities' use of maternal care services in sub-Saharan Africa.

Background: Quality maternal health care is central to the Sustainable Development Goals efforts to reduce maternal mortality, yet there remain limited quantitative data on maternal care inequities for women with disabilities in sub-Saharan Africa. Objectives: This study aims to understand the differences in maternal care providers for women with and without disabilities. Method: We used Multiple Indicator Cluster Surveys from 13 sub-Saharan African countries conducted between 2017-2020. We used logistic and multinomial logistic regression to examine the relationship between disability (Washington Group definition) and antenatal care attendance and the type of care provider for antenatal care, skilled birth attendance, and postnatal and postpartum checks. All analyses were adjusted for age, wealth, country, and location. Results: The sample included 10 021 women, including 306 (3.1%) women with disabilities. There were small absolute and no relative differences in antenatal care attendance, qualified antenatal care provider, postnatal, and postpartum checks, for disabled and women without disabilities. Women with disabilities had some evidence of higher odds of having a doctor at their birth compared to women without disabilities (aOR = 1.52, 95% CI: 0.99-2.33). Conclusion: This study shows small absolute and no relative differences between women with and without disabilities for antenatal access and provider types for maternal care, though these findings are limited by a small sample and no data on care quality, acceptability, or outcomes. More research on care quality and outcomes is needed. Contribution: This study is the first quantitative, multi-country study in sub-Saharan Africa to examine maternal care seeking patterns, demonstrating important data on maternal health indicators for women with disabilities.

Trends and socioeconomic inequalities in the dental attendance of adult smokers in Scotland from 2009 to 2019, a repeated cross-sectional study.

BACKGROUND: Smoking continues to be the single largest cause of preventable disease and death and a major contributor to health inequalities. Dental professionals are well placed to offer behavioural support in combination with pharmacotherapy to increase smoking cessation rates across the population. We aimed to assess the trends and socioeconomic inequalities in the dental attendance of adult smokers in Scotland from 2009 to 2019 and examine the potential population reach of dental settings for smoking cessation interventions. METHODS: A secondary analysis was conducted of combined Scottish Health Surveys (SHeS) from 2009/11, 2013/15 and 2017/19. 'Recent' dental attendance (within the past two years) was the focus and descriptive analysis examined attendance of self-reported smokers compared to non-smokers and stratified by the area-based Scottish Index of Multiple Deprivation (SIMD) and individual socioeconomic measures (income, education, and occupation). Generalised linear models were used to model recent attendance in non-smokers relative to smokers adjusted by the socioeconomic measures, for each of the survey cohorts separately. Absolute differences and risk ratios were calculated with 95% Confidence Intervals (CI). RESULTS: Recent dental attendance was generally high and increased in both smokers (70-76%) and non-smokers (84-87%) from 2009/11 to 2017/19 and increased across all SIMD groups. After adjustment for sociodemographic variables, the adjusted Risk Difference (aRD) for recent attendance between non-smokers and smokers was 8.9% (95% CI 4.6%, 13.2%) by 2017/19. Within smokers, recent attendance was 7-9% lower in those living in the most deprived areas compared to those living in the least deprived areas over the three surveys. CONCLUSIONS: SHeS data from 2009 to 2019 demonstrated that a high and increasing proportion of smokers in the population attend the dentist, albeit slightly less frequently than non-smokers. There were large inequalities in the dental attendance of smokers, to a lesser extent in non-smokers, and these persisted over time. Dental settings provide a good potential opportunity to deliver population-level smoking cessation interventions, but smokers in the most deprived groups and older age groups may be harder to reach. Consideration should be given to ensure that these groups are given appropriate proportionate support to take up preventive interventions.

The relationship between 'school readiness' and later persistent absenteeism.

Post-pandemic school absence is an increasing concern for governments worldwide. Absence is associated with poor academic outcomes and long-term illness (physical and mental). Absenteeism increases the risk of financial difficulties in adulthood and involvement in the criminal justice system. We hypothesized that early childhood problems might be an antecedent of absenteeism. We tested this hypothesis by investigating the pre-pandemic association between school readiness and persistent absenteeism using a population-linked dataset. Analyses included 62,598 children aged 5-13 years from the Connected Bradford database (spanning academic years 2012/13 to 2019/20). Special educational needs status, English as an Additional Language status, socioeconomic status, sex and ethnicity were covariates significantly associated with persistent absenteeism. Children who were not 'school ready' had increased odds of being persistently absent later in their education journey after controlling for these covariates. School readiness was associated with even greater odds of being persistently absent over two or more years. These findings show (i) the seeds of absenteeism are sown early in childhood; (ii) absenteeism shows the hallmark of structural inequities; and (iii) the potential of 'school readiness' measures to identify children at risk of long-term disengagement from the education system.

Factors Associated with Nonreturn after Loss to Follow-Up from Glaucoma Care: An IRIS® Registry Retrospective Analysis.

PURPOSE: Loss to follow-up (LTFU) in primary open-angle glaucoma (POAG) can lead to undertreatment, disease progression, and irreversible vision loss. Patients who become LTFU either eventually re-establish glaucoma care after a lapse or never return to the clinic. The purpose of this study is to examine a large population of patients with POAG who became LTFU to determine the proportion that return to care and to identify demographic and clinical factors associated with nonreturn after LTFU. DESIGN: Retrospective longitudinal cohort study. PARTICIPANTS: Patients with a diagnosis of POAG with a clinical encounter in 2014 in the IRIS® Registry (Intelligent Research in Sight). METHODS: We examined follow-up patterns for 553 663 patients with POAG who had an encounter in the IRIS Registry in 2014 by following their documented clinic visits through 2019. LTFU was defined as exceeding 1 calendar year without an encounter. Within the LTFU group, patients were classified as returning after a lapse in care (return after LTFU) or not (nonreturn after LTFU). MAIN OUTCOME MEASURES: Proportion of patients with nonreturn after LTFU and baseline demographic and clinical characteristics associated with nonreturn among LTFU patients with POAG. RESULTS: Among 553 663 patients with POAG, 277 019 (50%) had at least 1 episode of LTFU over the 6-year study period. Within the LTFU group, 33% (92 471) returned to care and 67% (184 548) did not return to care. Compared to those who returned to care, LTFU patients with nonreturn were more likely to be older (age >80 years; relative risk [RR] = 1.48; 95% confidence interval [CI]: 1.47-1.50), to have unknown/missing insurance (RR = 1.31; 95% CI: 1.30-1.33), and to have severe-stage POAG (RR = 1.13; 95% CI: 1.11-1.15). Greater POAG severity and visual impairment were associated with nonreturn with a dose-dependent relationship in the adjusted model that accounted for demographic characteristics. Among those with return after LTFU, almost all returned within 2 years of last appointment (82 201; 89%) rather than 2 or more years later. CONCLUSIONS: Half of patients with POAG in the IRIS Registry had at least 1 period of LTFU, and two thirds of LTFU patients with POAG did not return to care. More effort is warranted to re-engage the vulnerable patients with POAG who become LTFU. FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Stay or go? Changing breeding conditions affect sexual difference in colony attendance strategies of Atlantic puffins Fratercula arctica.

Male and female birds have different roles in reproduction and, thereby in their reproductive investment, which in turn may increase negative effects of poorer breeding conditions caused by e.g., climate change or ecosystem regime shifts. By using a 33-year time series of resightings of Atlantic puffins Fratercula arctica individually colour-ringed as breeders in previous years, we showed that the difference in colony attendance of male and female birds depended on the environmental conditions for raising young, proxied by the average duration of the chick period and size of the herring Clupea harengus fed to the chicks in the colony each year. The longer the chick period, the more was the sex ratio of adults sitting visibly in the colony biased in favour of males. An increase in herring size, indicating better feeding conditions for raising chicks, led to more observations of both sexes. Additionally, we found that birds were observed less with age and females more so than males. We discuss the results in relation to general life-history theory on sexual differences in trade-offs between individual investment in breeding and own survival. Our results suggest that females are increasingly more willing than males to invest in provisioning for the chick the more and longer the chick needs such care.

Factors affecting antenatal care attendance in Soweto, Johannesburg: The three-delay model.

BACKGROUND:  Antenatal care remains critical for identifying and managing complications contributing to maternal and infant mortality, yet attendance among women in South Africa persists as a challenge. AIM:  This study aimed to understand the challenges faced by women attending antenatal care in Soweto, Johannesburg, using the three-delay model. SETTING:  This study was conducted in Soweto, Johannesburg. METHODS:  An exploratory, descriptive and qualitative research design was used, and in-depth interviews were conducted with 10 pregnant women and four women who had recently given birth. RESULTS:  Findings indicate delays in seeking care due to factors such as pregnancy unawareness, waiting for visible signs, and fear of human immunodeficiency virus (HIV) testing. Challenges such as transportation difficulties, distance to clinics, and facility conditions further impeded the initiation of antenatal care. Late initiation often occurred to avoid long waits, inadequate facilities, language barriers and nurse mistreatment. CONCLUSION:  From this study, we learn that challenges such as unawareness of pregnancy, cultural notions of keeping pregnancy a secret, fear of HIV testing, long waiting lines, high cost of transportation fees, clinic demarcation, shortage of essential medicines, broken toilets and verbal abuse from nurses have delayed women from initiating antenatal care early in Soweto, Johannesburg.Contribution: Challenges of women with antenatal care attendance in South Africa must be addressed by implementing community-based health education interventions, institutionalising HIV psycho-social support services and improving quality of antenatal care services in public health facilities.

Measuring Pharmacy Student Engagement in a Pharmacotherapy Course With Required Attendance.

OBJECTIVE: This study aimed to evaluate student engagement in a pharmacotherapy course with required attendance, identify intervals where students were most and least likely to be engaged, and assess student perceptions of the importance of engagement. METHODS: In 2022, the pharmacotherapy course faculty implemented a graded attendance policy. A survey instrument was developed to gauge student engagement throughout in-class sessions and included 3 questions regarding engagement to determine whether students were on-task, off-task-related, or off-task-unrelated. Each week throughout the semester, students were randomly surveyed for a beginning, middle, and end time point. A second survey was utilized to collect perception data from students regarding attendance and engagement. The perception survey was released during the midpoint of the semester and at the end of the semester. RESULTS: The overall attendance rate was 91.1% (SD 4.64%) for the semester. Generally, students reported being on-task when surveyed. The average weekly tasks rates were 77.7% on-task, 15.8% off-task-related, and 6.5% off-task-unrelated. For the perception survey, both time points had a high response rate (82.8% midpoint survey, 77.1% end of semester). Most students had positive perceptions regarding mandatory attendance, engagement, and pre-class preparation. CONCLUSION: This study endorses high levels of student engagement in a pharmacotherapy course with required attendance. In addition, student perceptions were generally positive regarding required attendance. Future investigations need to be completed on the non-performance benefits of attending classes.

Determinants of clinic absenteeism in a chemotherapy service of a cancer center located at Rio de Janeiro, Brazil.

INTRODUCTION: Clinic absenteeism promotes higher waiting lists for medical procedures and public resources waste. OBJECTIVES: The present work aimed to identify the reasons for clinic absenteeism from each cycle of the antineoplastic chemotherapy treatment, as well as to determine the socio-demographic, clinical and treatment profiles of this population. METHODS: This observational prospective work evaluated pediatric and adult patients which missed their chemotherapy cycle between May and October 2023 in a Cancer Center located in Rio de Janeiro, Brazil. Clinic absenteeism rate was calculated, and socio-demographic profile was described. Reasons for absenteeism, treatment protocol and most used drugs were also identified. RESULTS: This work analyzed data from 69 patients, the majority above 60 years old. Approximately 60% were male, 33.3% had little to no education and 63.8% lived outside the center city. Absenteeism average monthly rate was 1.73% for adults and 0.87% for children. The most related non-attendance reasons were patient feeling too ill to attend their chemotherapy session, failure to remember the cycle day and lack of means of transportation. Most prevalent neoplasms were from the digestive tract (46%). Fluorouracil, irinotecan, oxaliplatin and gemcitabine were the most discarded drugs due to absenteeism. CONCLUSIONS: Older patients and the ones residing far away from the Center tend to miss the scheduled chemotherapy cycles. However, most reasons for absenteeism could be avoided by confirmation calls or text messages. These procedures implementation could lead to a lower absenteeism rate and less resource waste.