Antimicrobial Stewardship from Health Professionals’ Perspective: Awareness, Barriers, and Level of Implementation of the Program

This study aimed to evaluate health professionals’ perceptions regarding the level of implementation of the Antimicrobials Stewardship (AMS) programs in Jordanian tertiary hospitals and to assess the perceived barriers to its implementation. During this cross-sectional study, a total of 157 healthcare providers agreed to participate (response rate 96.3%). Participants were asked to complete an electronic survey after meeting them at their working sites. Only 43.9% of the healthcare providers (n = 69) reported having an AMS committee in their hospital settings. The results suggested that private hospitals have significantly better AMS implementation compared to public hospitals among four areas (p ≤ 0.05). Moreover, the results showed that the most widely available strategies to implement AMS were infectious disease/microbiology advice (n = 112, 71.3%), and treatment guidelines (n = 111, 70.7%). Additionally, the study revealed that the main barrier to AMS implementation was the lack of information technology support (n = 125, 79.6%). These findings could draw managers’ attention to the importance of AMS and support the health care provider’s practice of AMS in Jordanian tertiary hospitals by making the right decisions and the required modifications regarding the strategies needed for the implementation of AMS programs.

Professionals’ Digital Training for Child Maltreatment Prevention in the COVID-19 Era: A Pan-European Model

The responsiveness of professionals working with children and families is of key importance for child maltreatment early identification. However, this might be undermined when multifaceted circumstances, such as the COVID-19 pandemic, reduce interdisciplinary educational activities. Thanks to technological developments, digital platforms seem promising in dealing with new challenges for professionals’ training. We examined a digital approach to child maltreatment training through the ERICA project experience (Stopping Child Maltreatment through Pan-European Multiprofessional Training Programme). ERICA has been piloted during the pandemic in seven European centers involving interconnected sectors of professionals working with children and families. The training consisted of interactive modules embedded in a digital learning framework. Different aspects (technology, interaction, and organization) were evaluated and trainers’ feedback on digital features was sought. Technical issues were the main barrier, however, these did not significantly disrupt the training. The trainers perceived reduced interaction between participants, although distinct factors were uncovered as potential favorable mediators. Based on participants’ subjective experiences and perspectives, digital learning frameworks for professionals working with children and families (such as the ERICA model nested in its indispensable adaptation to an e-learning mode) can represent a novel interactive approach to empower trainers and trainees to tackle child maltreatment during critical times such as a pandemic, and as an alternative to more traditional learning frameworks.

Knowledge, attitudes, and practices of cardiopulmonary rehabilitation among physiotherapists in Lebanon

Background Insufficient physical activity is one of the leading mortality risks worldwide for cardiovascular and pulmonary diseases. Physiotherapists (PT) are core healthcare professionals who play a major role in the prevention of disease complications and in inspiring a healthy lifestyle. To identify challenges in the promotion of cardiopulmonary rehabilitation (CR) in Lebanon, a survey was conducted among PT and physiotherapy students. The aim was to assess the knowledge, attitudes, and practices of CR in Lebanon. Results The response rate was 46.1% (N = 322). Results show that 24.5% of respondents have good to excellent knowledge about CR. More than 60% of the respondents indicate possible barriers to starting a CR program, and one of two respondents identify the absence of skills as a main barrier. Findings highlight the importance of the role of PT as a mediator to increase a healthy lifestyle among patients and to promote the prevention of cardiovascular diseases and pulmonary diseases in the country. Conclusions and recommendations Our results support the evidence and clinical guidelines that PT play a major role by increasing the participation of patients in CR. A cost-effective CR program needs to be covered by the private and public system in Lebanon.

Dental Awareness and Barriers in Reducing the Risk of Medication-related Osteonecrosis of the Jaw (MRONJ) Among Non-head and Neck Cancer Patients

Objectives. The objectives of this study are to assess the dental awareness in reducing the risk of Medication-Related Osteonecrosis of the Jaw (MRONJ) among non-head and neck cancer patients and their barriers of attending pre-medication dental evaluation (PMDE). Methodology: This study was conducted in the Department of Oncology of the University of Malaya Medical Centre. Non-head and neck cancer patients who are currently or will be undergoing anti-resorptive and/or anti-angiogenic therapy were interviewed using a questionnaire that consist of questions on patient’s awareness, attitude, and barriers of receiving PMDE. Ethics approval was obtained. Results. In total, 17 patients were interviewed. Only 6 patients were informed by the medical doctors about the risk of MRONJ. Nine patients were advised by the medical doctors to have the PMDE prior to the therapy, and most of them in this group follow the instruction and already had their PMDE done prior to the therapy. The other 8 patients, who did not attend a PMDE, thought it was not important because their medical doctors neither inform them about MRONJ, nor refer them for PMDE. Conclusion. Patients’ awareness of MRONJ risks and preventive strategies are poor. The main barrier for PMDE is the lack of referral and information on MRONJ from the medical doctors. Patients’ attitudes were positive towards PMDE if they were referred by the medical doctors.

Systematic review of lean thinking in education institutions

The economy, culture, and social development of countries in the 21st century are directly related to the quality of education. For education to have expected quality and deliver the desired values to their client, many educational institutions are applying Lean management. Therefore, the paper aimed to explore the Lean implementation in education through a systematic review of papers from the past five years, in English and the Scopus and Web of Science databases. The methodology was developed using the PRISMA protocol and has been according to the type of approach, place of analysis, tools, facilitators, barriers, positive results, negative results, and the tendency of future work. The main results found were that 69.57% of the papers are analytical, LSS is the most discussed tool, the reduction is the main facilitator, the lack of Lean knowledge is the main barrier, and the attendance to the student obtained the best positive result.

The effectiveness of telepsychiatry: thematic review

Aims and method This review aims to clarify the evidence on the effectiveness of telepsychiatry following the COVID-19 pandemic. We conducted a literature review of three databases (Cochrane Library, PubMed and PsycINFO), using the terms virtual consultation/telepsychiatry/video consultation AND psychiatry/mental illness. Results We identified 325 eligible papers and conducted a thematic analysis resulting in five themes: patient and clinical satisfaction, diagnostic reliability, outcomes, technology and professional guidance. The most significant factors linked to effectiveness of telepsychiatry were patient and clinician satisfaction and adequate technology to facilitate examination of the patient. Clinical implications The consistent diagnostic reliability, satisfactory clinical outcomes and patient satisfaction linked to telepsychiatry favour its continued use once the pandemic ends. The main barrier is reluctance among clinicians and lack of professional guidance. We recommend education on the uses of telepsychiatry among clinicians, and the provision of professional guidance for its use from medical bodies and organisations.

Barriers to implementing adaptable housing: architects’ perceptions in Finland and Denmark

Adaptability is one key aspect in making housing more sustainable. One major approach to adaptability is internal transformability of buildings, i.e. the possibility to make modifications to the spaces and their equipment within the existing building envelope. This aspect is often taken into consideration in the design and implementation of office buildings. However, in housing the situation is different, and internal transformability is very seldom implemented in apartment buildings. There is a lack of studies for the reasons for this. In this article we take a look at the barriers to internal transformability of apartment buildings in two Nordic countries, Finland and Denmark. We compare the situations in both countries, and highlight their similarities and differences. The research is based on interviews of Finnish and Danish architects who have been involved in designing such buildings within the last 20 years. The interviews show that the disinterest of housing developers has been the main barrier to implementing internal transformability. Another important barrier is the developers’ cost-optimization. Secondary barriers were related to lack of solutions in building services that would support internal transformability. Additionally, secondary barriers were related to common construction techniques, regulations, and building conventions. Major barriers were similar in both countries. However, some differences in the secondary and other barriers between the two countries also exist.

Adapting Sanitation Needs to a Latrine Design (and Its Upgradable Models): A Mixed Method Study under Lower Middle-Income Rural Settings

Rural households have latrine preferences and unique sanitation needs. An assessment of how rural households adapt their sanitation needs to a nationally encouraged latrine design was done. A cross-sectional survey was conducted among 790 households in a rural district of Zimbabwe from November 2020 to May 2021. Data were analysed using logistic regression. Qualitative data were collected using focus groups and analysed using thematic analysis. Analyses were done in STATA 16 and considered significant at p < 0.05. There was low adoption of the Blair ventilated improved pit latrine and its upgradable models. Significant predictor variables of BVIP latrine adoption were mainly contextual and psychosocial at the individual and household levels. They included source and level of household income, residence period, nature of homestead, number of cattle owned, knowledge of sanitation options and perceived high latrine cost. The latrine design was considered not a pro-poor option as it was unaffordable by many rural households resulting in its non-completion, poor-quality designs, alternative options, sharing and open defaecation. Poverty appears the main barrier for latrine ownership. However, a window of opportunity to improve access to sanitation in rural Zimbabwe exists by considering alternative sanitation options and financial investment mechanisms.

Atlas of the HIV-1 Reservoir in Peripheral CD4 T Cells of Individuals on Successful Antiretroviral Therapy

The main barrier for HIV-1 cure is the presence of latently infected CD4 + T cells. Although various cell subpopulations have been identified as major HIV-1 reservoir cells, the relative contribution of infected CD4 subpopulations in the HIV-1 reservoir remains largely unknown.

Nanotherapeutics Overcoming the Blood-Brain Barrier for Glioblastoma Treatment

Glioblastoma (GBM) is the most common malignant primary brain tumor with a poor prognosis. The current standard treatment regimen represented by temozolomide/radiotherapy has an average survival time of 14.6 months, while the 5-year survival rate is still less than 5%. New therapeutics are still highly needed to improve the therapeutic outcome of GBM treatment. The blood-brain barrier (BBB) is the main barrier that prevents therapeutic drugs from reaching the brain. Nanotechnologies that enable drug delivery across the BBB hold great promise for the treatment of GBM. This review summarizes various drug delivery systems used to treat glioma and focuses on their approaches for overcoming the BBB to enhance the accumulation of small molecules, protein and gene drugs, etc. in the brain.