Rehabilitation services for persons affected by stroke in Jordan

The purpose of this study was to explore the perceptions stroke survivors have of the rehabilitation services received by them in the Jordanian community. A secondary aim was to explore the impact of culture on providing appropriate services for stroke survivors.Eighteen stroke survivors were recruited from an outpatient stroke rehabilitation programme. All 18 participants had been discharged from hospital for between one and six months. Semi-structured interviews were performed, either in the physiotherapy outpatient clinic where the affected person was attending a clinic or in their homes. Transcription of interviews carried out in Arabic and thematic analysis was also carried out in that language by transcribers who were fluent in Arabic and English, using a back-translation method. Necessary measures were taken to ensure the accuracy, reliability and validity of the data collection and analysis. Following thematic analysis, themes arising out of the data included physiotherapy and occupational therapy support in the community, out-patient rehabilitation clinic services, community clinic services and support from families, friends and neighbours. Participants expressed satisfaction with their therapists, but there were large areas of unmet rehabilitation need for stroke survivors in the Jordanian community such as a limited availability of occupational therapy services, insufficient amount of therapy services and poor medical support.   This study presents a unique contribution to knowledge relating to the experiences of stroke survivors in a developing country, and also shows how care systems are very dependent on cultural contexts, cultural beliefs and practises.DOI 10.5463/DCID.v22i1.18</p

“What’s happening in Syria even affects the rocks”: a qualitative study of the Syrian refugee experience accessing noncommunicable disease services in Jordan

Background Humanitarian actors and host-countries in the Middle East and North Africa region are challenged with meeting the health needs of Syrian refugees and adjusting the response to contemporary humanitarian conditions – urban-based refugees, stressed host-country health systems and high NCD prevalence. Although several studies have explored NCD prevalence, utilization of services and barriers to access, these analyses took place prior to dramatic shifts in Jordanian health policy and did not account for nuances in health seeking and utilization behaviors or operational barriers. Accordingly, we aimed to understand the depth and nuances of Syrian refugees’ experiences accessing NCD services in urban and semi-urban settings in Jordan. Methods A qualitative study was conducted to explore the healthcare experiences of Syrian refugees in Jordan. The study team conducted 68 in-depth interviews with Syrian refugees in urban and semi-urban locations in central and northern Jordan. Results The findings indicated four themes key to understanding the healthcare experience: (1) emotional distress is a central concern and is frequently highlighted as the trigger for a non-communicable disease or its exacerbation; (2) service provision across all sectors – government, NGO, private – is complex, inadequate, expensive and fragmented, making engagement with the health sector physically and financially burdensome; (3) given financial constraints, participants make harmful decisions that further damage their health in order to reduce financial burdens, and (4) host-community members actively exhibit solidarity with their refugee neighbors and specifically do so during emergency health episodes. The findings from this study can be used to inform program design for forcibly displaced persons with NCDs and identify points of entry for effective interventions. Conclusions Opportunities exist for humanitarian and host-country actors to provide more comprehensive NCD services and to improve the relevance and the quality of care provided to Syrian refugees in Jordan. Global and national funding will need to align with front-line realities and foster better coordination of services between host-country health systems, private actors and non-governmental organizations

Nationwide evaluation of the advanced clinical practitioner role in England: a cross-sectional survey

Copyright © Author(s) (or their employer(s)) 2022. Background and study objective In response to growing pressures on healthcare systems, the advanced clinical practice (ACP) role has been implemented widely in the UK and internationally. In England, ACP is a level of practice applicable across various healthcare professions, who exercise a level of autonomy across four domains, referred to as the four pillars of practice (education, leadership, research and clinical practice). A national framework for ACP was established in 2017 to ensure consistency across the ACP role, however current ACP governance, education and support is yet to be evaluated. This study aimed to analyse data from a national survey of the ACP role to inform the development and improvement of policies relating to ACP in the National Health Service (NHS) in England. Design A cross-sectional survey with free-text comments. Setting The survey was distributed across primary and secondary levels of care to three distinct groups in England, including individual ACPs, NHS provider organisations and Trusts and primary care settings. Participants A total of 4365 surveys were returned, from ACP staff (n=4013), NHS provider organisations and Trusts (n=166) and primary care organisations (n=186). Results Considerable variation was found in role titles, scope of practice, job descriptions and educational backgrounds of ACPs. Differing approaches to governance were noted, which led to inconsistent ACP frameworks in some organisations. A further challenge highlighted included committing time to work across the four pillars of advanced practice, particularly the research pillar. ACPs called for improvements in supervision and continuing professional development alongside further support in navigating career pathways. Conclusions A standardised approach may support ACP workforce development in England and enable ACPs to work across the four pillars of practice. Due to the wide uptake of ACP roles internationally, this study has relevance across professions for global healthcare workforce transformationHealth Education England (grant number ASA273 HKAUR-HEER)

Ethnic differences in SARS-CoV-2 vaccine hesitancy in United Kingdom healthcare workers: Results from the UK-REACH prospective nationwide cohort study

Background: In most countries, healthcare workers (HCWs) represent a priority group for vaccination against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) due to their elevated risk of COVID-19 and potential contribution to nosocomial SARS-CoV-2 transmission. Concerns have been raised that HCWs from ethnic minority groups are more likely to be vaccine hesitant (defined by the World Health Organisation as refusing or delaying a vaccination) than those of White ethnicity, but there are limited data on SARS-CoV-2 vaccine hesitancy and its predictors in UK HCWs. Methods: Nationwide prospective cohort study and qualitative study in a multi-ethnic cohort of clinical and non-clinical UK HCWs. We analysed ethnic differences in SARS-CoV-2 vaccine hesitancy adjusting for demographics, vaccine trust, and perceived risk of COVID-19. We explored reasons for hesitancy in qualitative data using a framework analysis. Findings: 11,584 HCWs were included in the cohort analysis. 23% (2704) reported vaccine hesitancy. Compared to White British HCWs (21.3% hesitant), HCWs from Black Caribbean (54.2%), Mixed White and Black Caribbean (38.1%), Black African (34.4%), Chinese (33.1%), Pakistani (30.4%), and White Other (28.7%) ethnic groups were significantly more likely to be hesitant. In adjusted analysis, Black Caribbean (aOR 3.37, 95% CI 2.11 - 5.37), Black African (aOR 2.05, 95% CI 1.49 - 2.82), White Other ethnic groups (aOR 1.48, 95% CI 1.19 - 1.84) were significantly more likely to be hesitant. Other independent predictors of hesitancy were younger age, female sex, higher score on a COVID-19 conspiracy beliefs scale, lower trust in employer, lack of influenza vaccine uptake in the previous season, previous COVID-19, and pregnancy. Qualitative data from 99 participants identified the following contributors to hesitancy: lack of trust in government and employers, safety concerns due to the speed of vaccine development, lack of ethnic diversity in vaccine studies, and confusing and conflicting information. Participants felt uptake in ethnic minority communities might be improved through inclusive communication, involving HCWs in the vaccine rollout, and promoting vaccination through trusted networks. Interpretation: Despite increased risk of COVID-19, HCWs from some ethnic minority groups are more likely to be vaccine hesitant than their White British colleagues. Strategies to build trust and dispel myths surrounding the COVID-19 vaccine in these communities are urgently required. Emphasis should be placed on the safety and benefit of SARS-CoV-2 vaccination in pregnancy and in those with previous COVID-19. Public health communications should be inclusive, non-stigmatising and utilise trusted networks

Caring for Those Who Take Care of Others: Developing Systemic and Sustainable Mental Health Support for the Diverse Healthcare Workforce in the United Kingdom

Pressures such as high workload, stretched resources, and financial stress are resulting in healthcare workers experiencing high rates of mental health conditions, high suicide rates, high rates of staff absences from work, and high vacancy rates for certain healthcare professions. All of these factors point to the fact that a systematic and sustainable approach to mental health support at different levels and in different ways is more important than ever. In response, we present a holistic analysis of the mental health and wellbeing needs of healthcare workers across the United Kingdom healthcare ecosystem. We recommend that healthcare organisations should consider the specific circumstances of these staff and develop strategies to counter the negative impact of these factors and help safeguard the mental health of their staff

Study of Some Blood Indicators for Non-infected with COVID-19 Virus and Those Vaccinated with Pfizer, AstraZeneca and Sinopharm in Babil Governorate

The study included determining the extent of the effect of common vaccines for the Corona virus (COVID-19). Based on some blood tests of people not previously infected with the virus. From vaccinated and not vaccinated with Corona virus (COVID-19) vaccines, and of both sexes, a total number of 280 people. 70 samples of Pfizer vaccine, 70 Sinopharm, and 70 AstraZeneca. In addition to 70 samples for the control group for ages between (18-70) years, during the period from October 2021 to the end of April 2022. The highest value of blood count readings (WBC) was recorded for those vaccinated with AstraZeneca, which was (7.8), and the highest value was recorded The (RBC) for those vaccinated with Pfizer was [5.4], while the highest value for (Hb) was recorded for those vaccinated with Pfizer and it was (15.3). As for (PCV), the highest percentage of it was in the people vaccinated with AstraZeneca and Sinofam (43.8 and 43.0), and the highest percentage of (PLT) was for those vaccinated with Pfizer and Sinopharma (269.0 and 270.6), respectively.&nbsp

Liczebność bakterii E. coli i C. perfringens w odpadach drobiarskich oraz kolejnych fazach ich kompostowania

Rapidly growing commercial poultry production generates large amounts of waste. Waste that accumulates during the poultry slaughter process often remains unprocessed, becoming a serious threat to people’s health and the natural environment. Poultry production waste constitutes problems odour threat and dangerous sanitary threat. The aim of this study was to determine the population size of Escherichia coli and Clostridium perfringens in poultry waste and in successive stages of waste composting. Research material consisted of raw feathers collected immediately after the slaughter, samples of biological sludge from the centrifuge, mixture of straw, feathers and lime and processed compost. Microbiological analyses were conducted with the use of spread plate count method and the substrate was used in accordance with research standards. The size of population of microorganisms in the samples analyzed corresponded to the waste processing stage and group of microbes. The presence of C. perfringens strains was ascertained in all samples, whereas E. coli strains were identified only in raw feathers and centrifuge sludge, being most numerous in unprocessed material. A reverse trend was observed in case of C. perfringens with the highest population density in centrifuge sludge and least density in raw feathers.Intensywnie rozwijająca się produkcja drobiarska wiąże się z generowaniem dużej ilości odpadów. Powstające produkty uboczne podczas uboju pozostawione w stanie surowym stają się poważnym zagrożeniem dla środowiska naturalnego i zdrowia ludzi. Mogą stwarzać problemy odorotwórcze oraz istotnie groźne zanieczyszczenie sanitarne. Celem przeprowadzonych badań było określenie liczebności E. coli i C. perfringens w odpadach drobiarskich oraz kolejnych etapach ich kompostowania. Materiał badawczy stanowiły świeże pióra bezpośrednio po uboju, osad biologiczny z wirówki, mieszanina słomy, pierza i wapna oraz kompost przerobiony. Analizy mikrobiologiczne wykonano metodą płytkową, wykorzystując wybiórcze podłoża zgodne z normami. Liczebność mikroorganizmów w badanych próbach zależała od fazy przerobu odpadu i analizowanej grupy drobnoustrojów. Obecność bakterii C. perfringens stwierdzono we wszystkich próbach, natomiast bakterie E. coli tylko w piórach surowych i osadzie z wirówki, przy czym najliczniej występowały w materiale nieprzetworzonym. Odwrotną tendencję zaobserwowano w przypadku C. perfringens, które najliczniej zasiedlały osad z wirówki, natomiast ich mniejszą liczebność stwierdzono w piórach surowych

Study of Some Liver Functions for Non-infected with COVID-19 Virus and Those Vaccinated with Pfizer, AstraZeneca and Sinopharm in Babil Governorate

The study included determining the extent of the effect of common vaccines for the COVID-19 on the liver functions of people who were not previously infected with the virus. Whether vaccinated or not with Corona virus (COVID-19) vaccines, and of both sexes regardless, their total number was 280 people. 70 samples of Pfizer vaccine, 70 Sinopharm, and 70 AstraZeneca. In addition to 70 samples for the control group for ages between (18-70) years. During the period from October 2021 to the end of April 2022, The highest value of liver function readings (GOT, GPT) was recorded. Those vaccinated with Pfizer were (24.4 and 25.1). However, respectively, the lowest value was recorded for those vaccinated with Sinopharm, which was (22.9 and 23.9). Whilst the highest value for liver function readings (TSB and ALP) was recorded for those vaccinated with AstraZeneca which was (0.8 and 169.1). By comparing the results to the control group between the vaccinated and the non-vaccinated, as well as between the type of vaccine, there were no significant differences and high statistically significant effects that prevented the use of these vaccines against the Corona virus (COVID-19), which are safe and have no side effects on liver functions