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Our objective was to assess the feasibility of using the routine health information system data source, District Health Information System (DHIS2) to measure the effective coverage of selected health service indicators in Ethiopia and to explore stakeholder perceptions of those measures.
We conducted a mixed-methods study. We mapped the availability of data elements in DHIS2 between July 2022 and June 2023 for five indicators (four or more antenatal care visits (ANC4+), skilled birth attendance, postnatal care, sick child care and child nutrition care). We defined effective coverage cascade steps for each indicator, assessed data quality and analysed data using STATA V.17. Finally, qualitative interviews were conducted with 15 key stakeholders, and the data were analysed thematically for reflections on the DHIS2 output.
The data were captured from all public health facilities of 11 regions and 2 administrative cities in Ethiopia.
There was better availability of data elements for maternal healthcare than for child healthcare. It was possible to estimate the intervention-adjusted coverage of ANC4+ (16% nationally) and the process-quality-adjusted coverage of skilled birth attendance (19% nationally). Postnatal care, sick child care and child nutrition indicators lacked data across multiple cascade steps. The quality of data for effective coverage measurement differed by region. The key informants expressed concerns about the adequacy and appropriateness of DHIS2 data for this analysis. While all acknowledged its potential for decision-making, respondents emphasised the need for standardised methods and data sources to enhance comparability and acceptability of the findings.
The findings underscore the need for system-level improvement of data availability and quality, and adoption of a standardised approach to calculating effective coverage using DHIS2. There was a concern that the findings may not be accepted by policymakers; however, the local level granularity made possible through DHIS2 was appreciated.
To investigate adherence and non-adherence to treatment regimens among heart failure patients and to explore relationships with symptom burden and hospitalisation frequency.
The research employed a cross-sectional survey study design.
The online survey “Living with heart failure”, was conducted among patients attending the Cardiac outpatient clinic at a Swedish University Hospital over the course of a calendar year. Data analysis employed descriptive statistics using the statistical processing program SPSS.
The survey was made accessible to 1395 respondents; 479 individuals participated. The response rate was 34.3%. 73.6% were classified as non-adherent and 26.4% as adherent. Among the non-adherent, a statistically significantly higher symptom burden was observed. Lower hospitalisation frequency was associated with higher adherence and lower symptom burden. Frequent hospitalisations correlated with lower adherence and more severe symptoms.
This study underscores the prevalence of non-adherence in the heart failure population and emphasises the importance of addressing this issue.
Non-adherence to treatment regimens remains a global challenge, historically underestimated and challenging to quantify. Non-adherence to medical treatment in the heart failure population is about 50%; non-adherence from a wider perspective implicates a gap of knowledge. The principal discoveries from this study underscore the extensive non-adherence and its exacerbating effects on symptom burden and hospitalisation. The primary significance of this research will manifest among caregivers in multidisciplinary teams providing support to the heart failure population.
The Equator Guidelines Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) were adhered to.
No patient or public contribution.
The aim was to explore patients’ experiences of ward rounds in inpatient care.
An exploratory qualitative design was chosen, collecting data with one-to-one semistructured interviews, conducted from March to May 2023. An interview guide was used as a basis for the interviews. Data were analysed using reflexive thematic analysis.
A medical and a surgical ward at a medium-sized hospital in southern Sweden.
Purposeful sampling was used to recruit patients aged 18 years or older. 16 patients were recruited with an age range of 38–72 years.
The findings showed that patients’ experiences of ward rounds have a wide range of variation. The main theme was: ‘The ward round as a bridge between patients’ experiences and knowledge and healthcare professionals’. The main theme consisted of two subthemes, reflecting the variation in patients’ experiences: ‘Feeling of togetherness versus loneliness’ and ‘Getting answers or being left in limbo’. The subthemes also highlighted patients’ experiences of factors that enabled satisfactory interactions between patients and healthcare professionals during ward rounds, such as comprehensible detailed information and supportive atmosphere, as well as experiences of factors that obstructed such interactions and caused patients to feel uncertainty.
Ward rounds in inpatient care play an important role for patient care and health, functioning as a bridge between patients and healthcare professionals. It is important for healthcare practitioners and policy-makers to create a model for ward rounds that can contribute to an open and supportive atmosphere as well as sharing comprehensible and detailed information.
To explore implementation patterns and perceived value of the SEXIT (SEXual health Identification Tool) method in the school health care (SHC) setting in Sweden.
Mixed method survey using an online questionnaire with closed and free-text response options.
115 SHC professionals who had completed SEXIT training responded to an online questionnaire (response rate 26%), between March and May 2024. Closed questions were answered on a five-point Likert scale, and responses trichotomised. Quantitative data were analysed using descriptive statistics, qualitative data with a deductive qualitative content analysis. CROSS guideline was used.
70 of 115 SHC professionals used SEXIT in their work. Findings suggest that SEXIT is appropriate and useful, supporting communication about topics such as sexual health and violence that both pupils and professionals may avoid addressing. Implementation patterns showed that 61% of those who had completed training also used SEXIT. 63% of those used SEXIT during regular health dialogues, but some did not use it with all pupils. The perceived value was that most SHC professionals felt that SEXIT helped them get a better understanding of the pupil's situation, an objection that it was too time-consuming.
Most SHC professionals who had completed SEXIT training used the method regularly and perceived the method as valuable and facilitating discussions about sexual ill health and experiences of violence with pupils. There are indications that SHC services fail to identify particularly at-risk young people. Sexual health inequity persists, as some structurally marginalised and vulnerable youths are excluded from the SEXIT dialogues. A follow-up study will focus on pupils' experiences.
This study validates SEXIT in a new setting, SHC, and is relevant for the promotion of sexual and reproductive health for all, and for preventing violence and sexual ill health among young people.
Sepsis-related myocardial injury is common in sepsis patients and has been repeatedly associated with poor patient outcomes. While experimental animal studies suggest that direct and indirect myocardial damage occurs via a wide range of inflammatory mediators, including bacterial toxins, the extent of bacterial-driven myocardial injury in human sepsis remains unclear. This scoping review aims to map existing evidence, identify knowledge gaps and guide future research priorities.
This scoping review will follow the Joanna Briggs Institute methodology for scoping reviews. The review is anticipated to start on 12 December 2024 and be completed by 31 October 2025. A comprehensive search will be conducted in MEDLINE (PubMed), Web of Science and EMBASE. Two independent reviewers will screen titles and abstracts, followed by a full-text review of potentially eligible studies. Studies focusing on the role of bacteria and/or their toxins in myocardial injury in adult patients with sepsis will be included. Data will be independently extracted using predefined forms, and findings will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for Scoping Reviews guidelines.
Ethical approval is not required for this scoping review. On completion, findings will be submitted for publication in a peer-reviewed medical journal and presented at scientific conferences. The results will help identify and analyse knowledge gaps, providing valuable insights to inform future research in patients with sepsis.
Registered on Open Science Framework 3 March 2025.
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