Socioeconomic Study of Climate Change and its Impacts on Livelihoods of People Living Around the Coastal Areas of the Gambia

The research aims to assess the effects of climate change on the livelihood of people living around the coastal areas and coping strategies used. The study uses a quantitative method with semi-structured interview questionnaire and convenient sampling method and conducts a survey of coastal community residents in Banjul, Barra, Bakau, Tanji, Sanyang, Gunjur, and Kartong and uses a descriptive analysis. Majority of respondents are self-employed as fishermen, and fish dryers, fish smokers, ship builders and boat riders. Most of the borrowing is done individually and the line of credit is mostly below D20,000 and more than 85% receive less than that amount. More than 60% of the respondents have no access to land and 4.71% stated that they do not have access to water. Most of the respondents rank their friends as their source of borrowing followed by families and banks. About 93% stated that it takes them less than 40 minutes to get to the nearest health facility. Adaptation strategies employed to deal with health problems during variable and extreme climate are going to hospital, cleanliness, eating healthy using herbal medicine. More than 85% of the respondents did not experience shortage of food in a year. But price of food has been increasing over the last 5 years. Finally, respondents favored adaptation strategy is saving followed by involving in other livelihood activities, government assistance, cleaning the environment, tree planting and protection of coastal areas.

Engaging Veterans in Identifying Key Elements of Environmental Cleaning: The Patient Perspective

Background: Contaminated surfaces in healthcare settings contribute to the transmission of pathogens. Environmental cleaning and disinfection are important for preventing pathogen transmission and reducing healthcare-associated infections (HAIs). Hospital cleanliness plays a large role in patient perception of the healthcare setting and, consequently, of patient satisfaction. However, patient perceptions of environmental cleaning remain unclear. To engage patients as part of achieving patient-centered care, we undertook a qualitative study to examine patient perspectives on environmental cleaning and disinfection in healthcare settings. Methods: We conducted semistructured qualitative interviews with 14 hospitalized patients at a large midwestern Veterans’ Administration hospital. Interviews were audio recorded, professionally transcribed verbatim, summarized in a “key domains” template developed by the research team, then coded for emerging themes. Results: Patients reported feeling satisfied with hospital cleanliness and especially the daily cleaning they observed while hospitalized. Cleaning activities highlighted included mopping and disinfecting high-touch surfaces, bathrooms, and floors. Despite this overall positive response, some patients expressed worries of being “in the way” or burdensome if they were in their rooms while staff were cleaning. One interviewee stated, “It’s easier for them if there isn’t a patient in [the room] … it’s hard to do any endeavor when you’ve got a complete stranger watching you.” Patients also acknowledged the importance of careful cleaning, especially during the COVID-19 crisis; “It’s got to be something you take seriously, especially during this pandemic.” Some patients spoke of the relationship which can develop between environmental services staff during daily hospital room cleaning. Conclusions: Patient perceptions of environmental cleaning are important to understand and incorporate into clinical practice. Overall, patients felt that their environments were clean, and they expressed confidence in the staff’s work. Interviewees additionally spoke of their own self-efficacy, saying they try to clean up after themselves and would feel comfortable speaking up if something needed to be cleaned. However, some patients acknowledged feeling burdensome to the environmental services staff if patients were present in rooms while staff cleaned. Cleaning activities may become more patient-centric if they are better planned (eg, while patient is out of the room) or based on patient preferences on time of day.Funding: NoDisclosures: None

Awareness on Kayakalp among health care workers in a tertiary care hospital, Imphal

Background: Kayakalp launched on May 15, 2015 by Government of India, is an initiative to improve cleanliness, hygiene and sanitation of public health facilities by awarding prizes. Awareness among HCWs of an institute can play a vital role in proper implementation of Kayakalp scheme. The study was aimed to assess the knowledge regarding Kayakalp among health care workers.Methods: A cross sectional study was conducted in a tertiary care hospital, Imphal. The study was conducted from September to October, 2019 among key health care workers. Data was collected using an interview schedule. Data were entered in IBM SPSS 21.0 and descriptive statistics were used.Results: Out of 103 participants, majority (64.2%) were nurses, 18.4% were doctors, and 17.4% were laboratory technicians and others. Majority participants (82%) were female and 56% of the participants had been oriented on hospital cleanliness in the past. Majority (91%) of the participants lacked awareness about Kayakalp and its guidelines.Conclusions: In spite of orientation, awareness about Kayakalp among health care workers were found to be inadequate. Periodic training or re-orientation among health care workers is recommended.

Coronavirus Disease 2019 (COVID-19) – An Overview

The coronavirus disease 2019 (COVID-19) is now a pandemic with a massive death toll across the world. The knowledge and understanding of this novel coronavirus transmission and pathogenesis are evolving. Although the landscape of vaccine and drug development is changing at an unprecedented pace, currently, there is no specific effective treatment. Proper and timely management of severe and critically ill COVID-19 patients is crucial to reduce deaths in the ongoing pandemic. Ramping up testing capacity alongside a test strategy in place, ensuring adequate resources, i.e., protective gear, O2 supply, ICU facilities are essential requirements in the fight against COVID-19. Infection prevention and control measures at a personal level (e.g., handwashing, wearing masks, proper donning and doffing of personal protective equipment), and at hospital settings (e.g., hospital cleanliness, safe handling, and disposal of waste) are extremely important to reduce the risk of infection. COVID-19 pandemic has caused a global crisis that requires a multidisciplinary response and concerted effort to ensure resilience in health systems. J Bangladesh Coll Phys Surg 2020; 38(0): 84-90

User experience and satisfaction with specialty consultations and surgical care in secondary and tertiary level hospitals in Mexico

Background To evaluate the association between user experience and satisfaction with specialty consultations and surgical care at the Mexican Institute of Social Security (IMSS) secondary and tertiary level hospitals. Methods We conducted secondary data analysis of the cross-sectional 2017 IMSS National Satisfaction Survey. The dependent variables were user satisfaction with outpatient consultation and with surgery. The study’s independent variables were user experience with these services. The Lancet Global Health Commission on High Quality Health Systems in the Sustainable Development Era framework was used to guide the analysis. For each dependent variable a double-weighted Poisson regression model with robust variance was performed and considered clustering of the observations within 111 secondary level and 25 tertiary level hospitals. Results The study included 6713 outpatient consultation users and 528 surgery users. 83% of users attending outpatient consultations and 86.6% of users who underwent inpatient surgery at IMSS hospitals were satisfied with the service received. The common patient negative experiences with specialty consultations and surgical care were long waiting time (40%) and lack of hospital cleanliness (20%). An additional concern was the lack of clinical examination during the consultation (25%). Shorter waiting times, health provider courtesy, good communication, clinical examination, and hospital cleanliness were associated with patient satisfaction with specialty consultations. Having the surgery without prior postponement(s) and without complications increased the probability of patient satisfaction. Conclusion Patient satisfaction with hospital outpatient consultations and surgical care may be raised by focusing on improvement strategies to enhance positive patient experiences with care.

“How Can the Patients Remain Safe, If We Are Not Safe and Protected from the Infections”? A Qualitative Exploration among Health-Care Workers about Challenges of Maintaining Hospital Cleanliness in a Resource Limited Tertiary Setting in Rural India

Background: Health care-associated infections (HAIs) result in treatment delays as well as failures and financial losses not only to patients but also to the treating hospital and overall health-care delivery system. Due to hospital-acquired infections, there are problems of increase in morbidity and mortality, additional diagnostic and therapeutic interventions and ultimately antimicrobial resistance. Proper understanding among health-care workers about the ill effects of HAIs is very important to address this issue. The present study is a qualitative exploration aimed at understanding various aspects of hospital environmental hygiene and Infection prevention control program, by exploring the staff perception regarding the challenges, facilitators and barriers as well as feasible measures towards improvement in a rural tertiary teaching hospital in central India. Method: A qualitative study was conducted using 10 focus group discussions (FGDs) among five different professional groups, which included hospital administrators, doctors, nurses, environmental cleaning staff, and undergraduate medical students. The FGD guide included the following topics: (1) opinion about the status of cleanliness, (2) concepts and actual practices prevailing of hospital environmental hygiene, (3) Barriers, constraints, and problems in maintaining hospital environmental hygiene, (4) Suggestions for improvements. The data were analyzed manually using the content (thematic) analysis method. Results: Two themes were identified: Theme 1: “Prevailing practices and problems related to hospital surface/object contamination and hospital infection control”. Theme 2: “Measures suggested for improving hospital cleanliness within the existing constraints”. The participants emphasized the influence of resource constraints and needed inputs. They brought up the consequent prevailing practices and problems related, on one hand, to various stakeholders (service consumers, hospital personnel including the management), on the other, to specific infection prevention and control processes. They also suggested various measures for improvement. Conclusions: The study has revealed prevailing practices, problems, and suggested measures related to hospital environmental hygiene, particularly hospital cleanliness and HAI prevention and control processes. These insights and assertions are important for developing future behavioral and structural interventions in resource-limited settings. This study recommends a nationwide reliable HAI surveillance system and a robust infection prevention and control program in each health-care institution.

Analysis of the quality of hospitalization based on the assessment of patients in Lublin, Poland

Introduction. The problem of health care affects every country. The structure and quality of hospitalization in Poland have changed over recent years. The state’s management of a balanced policy is possible prior to the collection of reports allowing to obtain data enabling assessment of changes in the health structure of the population, development of statistical data, as well as implementation and supervision of the National Health Program. Aim. The aim of the study was to evaluate the quality of hospitalization basing on the patients’ assessment of the availability, conditions, course of treatment and contact with hospital staff in the city of Lublin. Material and methods. The material for analysis was data collected from 254 patients. Respondents represented departments of diabetology, rehabilitation and internal diseases. The group consisted of 159 women and 95 men aged 19-84. The interview questionnaire was a research tool. Respondents were asked to assess: accessibility to hospital, efficiency of completing formalities when admitted to the hospital, cleanliness in the room, quality of the gastronomic services and contact with nursing and medical staff. Likert’s 5-point scale was used. Statistical analysis was performed using the software “STATISTICA 10.0”. Results. Most respondents assessed the quality of hospitalization as satisfactory. As many as 99% of respondents assessed contact with doctors as good or very good. Contact with nursing staff was rated as good by 88% of respondents. Conclusions. This study demonstrated good quality of health care in the examined hospital in Lublin. However, it is important to emphasize the need for further research aimed at collecting data on the presented problem.