UNASSIGNED: Standard precautions are crucial for infection control in healthcare. Studies show public hospitals\' adherence, but data on private hospitals are scarce. Understanding this disparity is vital for safety, policy, and better patient outcomes. Hence, this study aimed to assess precautions and associated factors among healthcare workers at public and private hospitals in Northeast Ethiopia.
UNASSIGNED: A comparative cross-sectional study compared healthcare institutions. A total of 470 workers participated via stratified random sampling. Data collection used a pre-tested questionnaire and observation checklist. Epi data managed entry, while STATA analyzed. Binary logistic regression determined significance (P<0.05) for variables.
UNASSIGNED: The overall adherence to standard precautions was 51.6% (95% confidence interval (CI): 46.9-56.2). At public and private hospitals, it was 52.2% (95% CI: 45.6-58.6) and 60.4% (95% CI: 53.9-66.9), respectively. In public hospitals adherence was affected by female sex [adjusted odds ratio (AOR): 2.58; 95% CI: 1.32-5.02], availability of written guidelines [AOR: 3.10; 95% CI: 1.62-5.94], having good knowledge [AOR: 2.05; 95% CI: 1.03-4.11] and favorable attitude towards standard precautions [AOR: 2.21; 95% CI: 1.14-4.27]. In private hospitals, it was affected by the availability of running tape water [AOR: 2.36; 95% CI: 1.10-5.04], personal protective equipment (AOR: 2.22; 95% CI; 1.01-4.93), color-coded dust bins [AOR: 2.33; 95% CI: 1.04-5.21], having good knowledge [AOR: 2.10; 95% CI: 1.07-4.13] and favorable attitude [AOR: 2.63; 95% CI: 1.39-4.97].
UNASSIGNED: The adherence to standard precautions was higher among private than public hospital healthcare workers in Dessie City, Ethiopia. Thus, ensuring adequate availability of personal protective equipment, safety materials, and running tap water in working rooms, particularly in public hospitals is highly recommended. The initiatives aimed at promoting adherence to standard precautions should be designed and put into action for public hospitals.

OBJECTIVE: Undergoing surgery and adjuvant radiotherapy (aRT) at the same facility has been associated with higher overall survival (OS) in head and neck squamous cell carcinoma. Our study investigates whether undergoing surgery and aRT at the same academic facility is associated with higher OS in major salivary gland cancer (MSGC).
METHODS: The 2006-2018 National Cancer Database was queried for patients with MSGC undergoing surgery at an academic facility and then aRT. Multivariable binary logistic and Cox proportional hazards regression models were implemented.
RESULTS: Of 2801 patients satisfying inclusion criteria, 2130 (76.0%) underwent surgery and aRT at the same academic facility. Residence in a less populated area (adjusted odds ratio [aOR] 1.69, 95% confidence interval [CI] 1.16-2.45), treatment without adjuvant chemotherapy (aOR 1.97, 95% CI 1.41-2.76), and aRT duration (aOR 1.02, 95% CI 1.01-1.04) were associated with undergoing surgery and aRT at different facilities on multivariable logistic regression adjusting for patient demographics, clinicopathologic features, and adjuvant therapy (p < 0.01). Five-year OS was higher in patients undergoing surgery and aRT at the same academic facility (68.8% vs. 61.9%, p < 0.001). Undergoing surgery and aRT at different facilities remained associated with worse OS on multivariable Cox regression (aHR 1.41, 95% CI 1.10-1.81, p = 0.007).
CONCLUSIONS: Undergoing surgery and aRT at the same academic facility is associated with higher OS in MSGC. Although undergoing surgery and aRT at the same academic facility is impractical for all patients, academic physicians should consider same-facility treatment for complex patients who would most benefit from clear multidisciplinary communication.
METHODS: 4 Laryngoscope, 134:3620-3632, 2024.

Following recent events involving racism and violence in policing, the current study sought to understand factors associated with support for related social movements and worries about personal, family, and peer safety. Data were from 78 currently incarcerated young people (M = 16.5 years; 31% Black) and 20 juvenile prison staff (M = 40.3 years; 72% Black) via online surveys. A comparable proportion of young people (47.3%) and staff (47.4%) reported participating in the Black Lives Matter movement. Among young people, prior experiences with police were significantly associated with support for social movements and worries about safety concerning racism and violence in policing. Among staff, race, ethnicity, sexual orientation, and racial and ethnic identity were significantly associated with social movement support and worries about safety. Civic education and interventions to promote racial and ethnic identity may promote support for systemic change and buffer against worries about racism and violence in policing.

BACKGROUND: Infection prevention and control (IPC) is a critical component of delivering safe, effective and high-quality healthcare services, and eliminating avoidable healthcare-associated infections (HAIs) in health facilities, predominantly in population-dense settings such as Bangladesh.
OBJECTIVE: Our study aimed to assess the effect of an integrated intervention package in improving the IPC level of the health facilities in Bangladesh.
METHODS: We conducted a pre-post intervention study in six district hospitals (DHs) and 13 Upazila Health Complexes (UHCs) in the six districts of Bangladesh. Baseline and endline assessments were conducted between March and December 2021 using the adapted World Health Organization Infection Prevention and Control Assessment Framework (WHO-IPCAF) tool. The IPCAF score, ranging from 0-800, was calculated by adding the scores of eight components, and the IPC promotion and practice level was categorized as Inadequate (0-200), Basic (201-400), Intermediate (401-600) and Advanced (601-800). The integrated intervention package including IPC committee formation, healthcare provider training, logistics provision, necessary guidelines distribution, triage/flu corners establishment, and infrastructure development was implemented in all facilities.
RESULTS: The average IPCAF score across all the facilities showed a significant increase from 16% (95% CI: 11.5-20.65%) to 54% (95% CI: 51.4-57.1%). Overall, the IPCAF score increased by 34 percentage points (P<0.001) in DHs and 40 percentage points (P<0.001) in UHCs. Following the intervention, 12 (three DHs, nine UHCs) of 19 facilities progressed from inadequate to intermediate, and another three DHs upgraded from basic to intermediate in terms of IPC level.
CONCLUSIONS: The integrated intervention package improved IPCAF score in all facilities.

Despite evidence showing the feasibility and acceptability of implementing the World Health Organization\'s guidelines on managing possible serious bacterial infection (PSBI) in Kenya, the initial implementation revealed sub-optimal community-facility referrals and follow-up of PSBI cases. This study explores facilitators and barriers of community-facility linkages in implementing PSBI guidelines in Busia and Migori counties, Kenya. We used an exploratory qualitative study design drawing on endline evaluation data from the \'COVID-19: Mitigating Neonatal Mortality\' project collected between June and July 2022. Data include case narratives with caregivers of sick young infants (0-59 days old) (18), focus group discussions with community health volunteers (CHVs) (6), and in-depth interviews with facility-based providers (18). Data were analysed using an inductive thematic analysis framework. Between August 2021 and July 2022, CHVs assessed 10 187 newborns, with 1176 (12%) identified with PSBI danger signs and referred to the nearest facility, of which 820 (70%) accepted referral. Analysis revealed several factors facilitating community-facility linkage for PSBI treatment, including CHVs\' relationship with community members and facilities, availability of a CHV desk and tools, use of mobile app, training and supportive supervision. However, challenges such as health system-related factors (inadequate providers, stockout of essential commodities and supplies, and lack of transport/ambulance) and individual-related factors (caregivers\' refusal to take referrals) hindered community-facility linkage. Addressing common barriers and fostering positive relationships between community health workers and facilities can enhance acceptance and access to PSBI services at the community level. Combining community health workers\' efforts with a mobile digital strategy can improve the efficiency of the identification, referral and tracking of PSBI cases in the community and facilitate linkage with primary healthcare facilities.

UNASSIGNED: The Powered Mobility Device Autonomy Residential Screen (PoMoDARS) is a new tool to enable clinicians to screen resident capacity and performance skills for powered mobility device (PMD) use in residential aged care settings. The PoMoDARS is context specific, time efficient and promotes resident autonomy and safety.
UNASSIGNED: To (i) undertake initial face and content validation of the PoMoDARS, and (ii) use the research findings to make any modifications.
UNASSIGNED: A mixed-methods study design, underpinned by Classical Test Theory. Eight clinicians completed 20 PoMoDARS screens and provided both quantitative and qualitative feedback on item importance and ease of use within a formal interview.
UNASSIGNED: Initial face and content validity of the PoMoDARS were supported, with small modifications made to item descriptors and instructions.
UNASSIGNED: The PoMoDARS has been developed for use in residential aged care settings to screen resident PMD use. While initial validation has been undertaken, further studies to determine the reliability of the tool and continue the validation process are required.
UNASSIGNED: Older adults in residential aged care facilities benefit greatly from the autonomy gained through PMD use. The PoMoDARS promotes collaboration between occupational therapists, nurses, and the wider team to support residents and safe PMD use.

We recount our experiences of relocating an active mycobacteriology reference level service in Karachi, Pakistan, from an older accredited biosafety level-3 facility to a newly constructed and environmentally validated facility.
The service relocation planning, execution, and verification stages are described in detail.
Lessons learned from our experience include establishing a service transfer plan, including relevant service staff, obtaining their buy-in on the plan, arranging backup service facilities or liaisons for the execution phase, and ensuring viable backup arrangements for troubleshooting during the verification phase of services in the new facility. Careful planning and inclusion of all stakeholders are critical to avoid service interruptions.
This narrative is expected to support other laboratorians, scientists, and clinicians providing laboratory services to large population sectors who are looking to move their services to a new location while continuing to offer said services in a proficient and reliable manner.

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The aims are to explore the factors influencing Bangladeshi patients\' decision-making process and their satisfaction level toward medical tourism in India.
The study used a quantitative research approach with a cross-sectional survey. Data were collected from the patients or their relatives (N = 388) who would have decided to travel to India for medical and treatment purposes at the Chittagong Indian visa center (IVAC). Data were collected using a structured, pre-tested, and facilitator-administered questionnaire, which mainly included the social demographic characteristics, health status, medical tourism information and medical tourism index. Hierarchical regression analysis was performed to explore the factors influencing their satisfaction level toward medical tourism in India.
More than three-fourths of the participants had visited India for self-treatment. Of the participants, 14% were cardiology patients, and 13% suffered from cancer. The relatives were the key source of information regarding medical tourism for more than one-fourth of the respondents. India\'s availability of well-experienced doctors, hospital/medical facilities with high standards, well-trained doctors, reputable doctors, and quality treatments and medical materials were top-ranked items. Regression results depict that facility and services appeared as the strongest factor (β = 0.24, t = 4.71, p < 0.001) followed by tourism destination factor (β = 0.16, t = 3.11, p = 0.002), medical tourism costs factor (β = 0.16, t = 3.24, p = 0.001) and country environment factor (β = 0.15, t = 2.69, p = 0.007).
We found that the factor related to facility and services is one of the strongest predictors in our models. Therefore, home countries must strengthen the health care providers\' advanced professional training, including service attitudes. Moreover, it is important to lessen the language barrier, reduce the airfare for medical tourists, and make the treatment cost more affordable for patients.

The design of an acute mental health inpatient facility must enable the provision of safe and effective care in an environment that is therapeutic. To be able to do that, in addition to the fittings, light and general ambience, a future design of such a facility must consider how consumers are likely to access mental healthcare in the future, what aspects of care they are likely to find value-adding and how the inpatient aspect of their care is likely to be integrated within their care continuum.
The future design must anticipate how consumers are likely to access information, support, care and treatment, how workflows of staff are likely to change, how the diverse needs of mental health consumers will need to be accommodated and how the needs and expectations of staff will be met to enable them to provide support to mental health consumers. A future design of a mental health inpatient unit may have to be very different from the current thinking about the design of such facilities.