UNASSIGNED: Unpredictable events, such as the outbreak of infectious diseases and humanitarian crises, are putting a strain on health care systems. As a result, African countries will need to prepare themselves with appropriate strategies to withstand such occurrences. Therefore, the purpose of this scoping review was to map available evidence about what type and what components of health systems are needed to help countries cope with health emergencies and to foster health system resilience in the WHO African Region.
UNASSIGNED: A systematic search was performed independently in Scopus and PubMed electronic databases as well as grey literature. Studies were selected based on set eligibility criteria based on the Joanna Brigg\'s Institute (JBI) methodology for scoping reviews. The key findings were focused on health system resilience and were mapped based on the WHO\'s core health system components. Our data were tabulated, and a narrative synthesis was conducted.
UNASSIGNED: A total of 28 studies were included in this scoping review, mostly conducted in the WHO African Region and region of the Americas. Studies focused on a variety of strategies, such as the continuous delivery of essential services, the strengthening of the health workforce, including community health care workers, community engagement, the provision of protective mechanisms for the health workforce, and flexible leadership and governance measures.
UNASSIGNED: Our findings suggest that strategies to improve health system resilience must include all areas of the healthcare delivery process, including primary care. A resilient health system should be ready for a crisis and have adaptable policies in place to offer adequate response at all levels, as well as post-recovery planning. Such health systems should also seek for continuous improvement. More research is needed to assess the efficacy of initiatives for improving health system resilience, particularly in vulnerable African health systems.

OBJECTIVE: To explore the relationship between filial values (responsibility, reciprocity, and obligation) and caregiving preparedness in adult child carers of patients with chronic heart failure (CHF).
METHODS: A total of 339 adult child caregivers of CHF patients were recruited from six hospitals in China. Self-report questionnaires were used to measure caregivers\' filial values and their caregiving preparedness. Descriptive analysis, Spearman\'s correlation analysis, and hierarchical regression analysis were performed. The study adhered to the STROBE guidelines.
RESULTS: Filial values were positively correlated with caregiving preparedness. Hierarchical regression analysis revealed a positive relationship between the combined variables of care and respect with caregiver preparedness, jointly explaining 7.9 % of the variance.
CONCLUSIONS: Filial values promote caregiver preparedness, broadening the applicability of the Caregiver Empowerment Model.

BACKGROUND: Hospital adaptation and resiliency, required during public health emergencies to optimize outcomes, are understudied especially in resource-limited settings.
OBJECTIVE: What are the prepandemic and pandemic critical illness outcomes in a resource-limited setting and in the context of capacity strain?
METHODS: We performed a retrospective cohort study among patients admitted to ICUs at two public hospitals in the KwaZulu-Natal Department of Health in South Africa preceding and during the COVID-19 pandemic (2017-2022). We used multivariate logistic regression to analyze the association between three patient cohorts (prepandemic non-COVID-19, pandemic non-COVID-19, and pandemic COVID-19) and ICU capacity strain and the primary outcome of ICU mortality.
RESULTS: Three thousand two hundred twenty-one patients were admitted to the ICU during the prepandemic period and 2,539 patients were admitted to the ICU during the pandemic period (n = 375 [14.8%] with COVID-19 and n = 2,164 [85.2%] without COVID-19). The prepandemic and pandemic non-COVID-19 cohorts were similar. Compared with the non-COVID-19 cohorts, the pandemic COVID-19 cohort showed older age, higher rates of chronic cardiovascular disease and diabetes, less extrapulmonary organ dysfunction, and longer ICU length of stay. Compared with the prepandemic non-COVID-19 cohort, the pandemic non-COVID-19 cohort showed similar odds of ICU mortality (OR, 1.06; 95% CI, 0.90-1.25; P = .50) whereas the pandemic COVID-19 cohort showed significantly increased odds of ICU mortality (OR, 3.91; 95% CI, 3.03-5.05 P < .0005). ICU occupancy was not associated with ICU mortality in either the COVID-19 cohort (OR, 1.05 per 10% change in ICU occupancy; 95% CI, 0.96-1.14; P = .27) or the pooled non-COVID-19 cohort (OR, 1.01 per 10% change in ICU occupancy; 95% CI, 0.98-1.03; P = .52).
CONCLUSIONS: Patients admitted to the ICU before and during the pandemic without COVID-19 were broadly similar in clinical characteristics and outcomes, suggesting critical care resiliency, whereas patients admitted to the ICU with COVID-19 showed important clinical differences and significantly higher mortality.

The emergence of SARS-CoV-2 has meant that pandemic preparedness has become a major focus of the global scientific community. Gathered in the historic St Edmund Hall college in Oxford, the one-day LPMHealthcare conference on emerging viruses (6 September 2023) sought to review and learn from past pandemics-the current SARS-CoV-2 pandemic and the Mpox outbreak-and then look towards potential future pandemics. This includes an emphasis on monitoring the \"traditional\" reservoirs of viruses with zoonotic potential, as well as possible new sources of spillover events, e.g., bats, which we are coming into closer contact with due to climate change and the impacts of human activities on habitats. Continued vigilance and investment into creative scientific solutions is required for issues including the long-term physical and psychological effects of COVID-19, i.e., long COVID. The evaluation of current systems, including environmental monitoring, communication (with the public, regulatory authorities, and governments), and training; assessment of the effectiveness of the technologies/assays we have in place currently; and lobbying of the government and the public to work with scientists are all required in order to build trust moving forward. Overall, the SARS-CoV-2 pandemic has shown how many sectors can work together to achieve a global impact in times of crisis.

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UNASSIGNED: Hospitals must maintain their effective operations during and after disasters. Due to the current increase in disasters, hospital resilience has drawn scholarly attention. This study aimed to review studies on the changes in the definition of hospital resilience after COVID-19, build a conceptual framework for careful measurement, and identify the main dimensions of hospital resilience emphasized during the COVID-19 pandemic.
UNASSIGNED: The initial phase of this study was a systematic review of articles published before the COVID-19 pandemic to extract the hospital resilience-related dimensions for the second phase. The second phase involved text-mining articles published both before and after the emergence of COVID-19.
UNASSIGNED: In the systematic review phase, 12 databases were searched from 2006 to January 2020, including Scopus, Web of Science, MEDLINE through PubMed, Embase, ERIC, ProQuest, the Cochrane Library, Emerald, Springer, Science Direct/ELSEVIER, Google Scholar, and SID (for Persian language papers). Then, after COVID-19, articles published in these databases between January 2020 and May 2022 were evaluated using text mining.
UNASSIGNED: During the systematic phase, 17 out of 1530 papers published before COVID-19 were synthesized to collect components of hospital disaster resilience. These identified components were the inputs for the text-mining phase. The text mining on pre-COVID papers resulted in six clusters, with the highest weight (0.65) belonging to general resilience and disaster preparedness, while in the post-COVID text mining phase, including 70 papers, 8 clusters have been identified, with the highest weight cluster (0.78) focusing on the mental and psychological aspects of resilience among healthcare workers.
UNASSIGNED: Following the COVID pandemic, scholarly attention has shifted to the more personal dimensions of hospital resilience, including psychological resiliency. It seems necessary for policymakers to focus more on the individual and psychological resilience of hospital staff.

OBJECTIVE: This study sought to examine the views of international graduates regarding how they perceived the Joint Medical Program Bachelor of Medicine (JMP BMed) undergraduate training prepared them to practice in a health system different from that in which they had studied. Eighteen international graduates of the JMP between 2010 and 2017 inclusive agreed to be interviewed face-to-face.
METHODS: JMP BMed international graduates were interviewed using 18 standardized questions to elicit perceptions of their preparedness to practice and reflections on their training experience. The interview data were qualitatively analyzed, and the main themes were identified and categorized.
RESULTS: Overall, the international graduates of the JMP BMed curriculum felt well-prepared for tasks associated with communication, self-directed learning, and approaching mental health issues. Conversely, they perceived the level of clinical exposure and experience as inadequate in preparing them for the expected level of medical knowledge and responsibility. They also felt underprepared for navigating a different health system.
CONCLUSIONS: The strengths and weaknesses identified in the JMP BMed program in its preparation of international graduates, particularly those who chose to practice in their country of origin, are of relevance for all medical schools that enrol international students. Greater awareness of the needs of international medical students returning home to practice may be of value for future curriculum planning purposes to ensure that medical schools optimally prepare their graduates to practice with confidence in a range of healthcare systems.

BACKGROUND: An outbreak of cholera was reported in the Middle East by the second half of 2022. Raising public awareness and vaccination against cholera represent critical factors in the preventive efforts. The current study aimed to assess the knowledge of cholera and attitude towards its vaccination among a sample of the general public residing in Jordan.
METHODS: An online self-administered questionnaire was distributed to the residents in Jordan using a snowball convenience-based sampling approach. The questionnaire based on previously published studies included items to evaluate sociodemographic variables, knowledge about cholera symptoms, transmission, and prevention and the willingness to accept cholera vaccination. Additionally, four items based on the validated 5 C scale in Arabic were included to assess the psychological factors influencing attitude to cholera vaccination.
RESULTS: The final study sample comprised 1339 respondents, of whom 1216 (90.8%) heard of cholera before the study. Among those who heard of cholera, and on a scale from 0 to 20, the overall mean cholera Knowledge score (K-score) was 12.9 ± 3.8. In multivariate analysis, being over 30 years old and occupation as healthcare workers or students in healthcare-related colleges were significantly associated with a higher K-score compared to younger individuals and students in non-healthcare-related colleges. Overall, the acceptance of cholera vaccination if cases are recorded in Jordan, and if the vaccine is safe, effective, and provided freely was reported among 842 participants (69.2%), while 253 participants were hesitant (20.8%) and 121 participants were resistant (10.0%). In linear regression, the significant predictors of cholera vaccine acceptance were solely the three psychological factors namely high confidence, low constraints, and high collective responsibility.
CONCLUSIONS: In this study, the identified gaps in cholera knowledge emphasize the need to enhance educational initiatives. Although cholera vaccine acceptance was relatively high, a significant minority of the respondents exhibited vaccination hesitancy or resistance. The evident correlation between the psychological determinants and attitudes toward cholera vaccination emphasizes the need to consider these factors upon designing public health campaigns aimed at cholera prevention. The insights of the current study highlight the importance of addressing both knowledge gaps and psychological barriers to optimize cholera control strategies.

OBJECTIVE: Inadequate preparedness of family caregivers contributes to adverse outcomes of patients with heart failure (HF). However, evidence on caregiver preparedness is limited. This study aims to examine the determinants and potential mechanisms of preparedness in family caregivers of patients with HF.
RESULTS: In the cross-sectional study, 298 HF patient-caregiver dyads were recruited from 4 tertiary hospitals in China. Preparedness, uncertainty in illness, family relational quality, social support, and positive aspects of caregiving (PAC) were assessed in family caregivers using self-reported questionnaires. In the path analysis model, uncertainty in illness had an indirect negative effect on preparedness via reduced PAC [indirect effect = -0.020; 95% confidence interval (CI) -0.050 to -0.002]. Whereas, family relational quality had direct (β = 0.266; P < 0.001) and indirect positive effects on preparedness through increased PAC (indirect effect = 0.027; 95% CI, 0.003-0.067). Similarly, social support also had direct (β = 0.184; P = 0.004) and indirect positive effects on preparedness through increased PAC (indirect effect = 0.027; 95% CI, 0.004-0.065).
CONCLUSIONS: This study highlights that diminishing uncertainty in illness may indirectly improve caregiver preparedness through the enhancement of PAC, while raising family relational quality and social support may improve caregiver preparedness both directly and indirectly by augmenting PAC. These findings provide insightful implications for healthcare professionals in developing tailored interventions to ameliorate preparedness in family caregivers of patients with HF.

UNASSIGNED: The primary aim of undergraduate dental education is to prepare dental students for independent dental practice and to enable them to provide safe and effective dental care. This study aimed to investigate the self-perceived preparedness of senior dental undergraduate students in Turkey.
UNASSIGNED: Purposive sampling was used to recruit final-year dental students from 10 dental institutions offering undergraduate dental programs in Turkey. Student preparedness was assessed using a previously validated dental preparedness assessment scale based on 50 items encompassing core clinical skills, cognitive attributes, and behavioral skills. The research instrument was then translated into Turkish. The R statistical environment for Windows was used for the data analysis.
UNASSIGNED: Responses were provided by 272 students (156 women and 116 men; 57% and 43%, respectively) across 10 different universities. The mean score of the participants was 75.68 with slightly higher scores for men compared to women (77.35 vs. 74.46 respectively). However, independent t-tests showed that the scores did not differ significantly between women and men.
UNASSIGNED: This study evaluated the self-perceived preparedness for dental practice of final-year students from 10 universities in Turkey. Although the results showed several areas of weakness, the scores of self-perceived preparedness of Turkish students were comparable to those reported in Europe and Asia. These findings can be used to inform future curriculum development to support students in consolidating their learning in perceived areas of weakness.