Breastfeeding is known to provide health benefits for newborns and breastfeeding mothers. The World Health Organization and Health Canada recommend exclusive breastfeeding for the first six months of an infant’s life. However, the rates of exclusive breastfeeding practices among Arab immigrant mothers are lower when compared with rates for non-immigrant Canadian mothers and mothers in the immigrants’ countries of origin. Critical ethnography was used to explore the breastfeeding practices among immigrant Arab mothers in Alberta, Canada, and factors influencing their decision or ability to breastfeed exclusively. Face-to-face interviews were conducted with 10 participants, followed by thematic analysis of the qualitative narrative data. The results indicated that family and religion are the sociocultural factors that primarily influenced the mothers’ initiation and exclusive breastfeeding practices. The findings from this study can facilitate culturally safe and sensitive interventions to address Arab mothers’ breastfeeding needs and promote exclusive breastfeeding within this population in Canada.

The Ugandan military medical services work together with the civilian public health system to deliver quality healthcare. This Partnership is the mainstay of health service delivery in Uganda. The burden of needle stick injuries (NSIs) is increasing in Uganda’s larger health industry; however, data on needle stick injury in military and public health facilities is lacking. No published data exist on comparative studies for a mix of facilities both military and civilian health settings. This study represents the first time this issue has been studied in a military or public health hospital in Uganda. A hospital-based, cross-sectional study was conducted in July 2018 to September 2019 in Kakiri Military and SOS Hospitals in Uganda using a structured questionnaire. Respondents were purposively selected based on the objectives of study, occupation status and department (N = 310). The overall prevalence of NSIs among respondents was 27.2% and prevalence rates for the two facilities was nearly identical. The largest percentage of NSIs occurred during drawing venous blood samples (49.4%). Significant predictors of NSI were gender, occupational status, age, poor knowledge on prevention and post exposure of NSI, and less professional experience. Infection control practices were lacking in both selected health facilities. Over a quarter of HCWs in Uganda reported NSIs, which places them at significant health risk. Fostering the practice of universal precautions, best infection control practices and training of healthcare workers on bio-safety measures can reduce the prevalence of NSIs.

Objective: This paper assesses hospital costs associated with sinonasal cancer (SNC) in Italy and evaluates related time trends.
Methods: All Italian hospitalizations treating patients with a diagnosis of SNC (N = 29,355) were extracted from the National Hospital Discharge Registry. Data refer to patients discharged from public and private hospitals between 2001 and 2018. Hospitalization cost, admission rate, length of stay and other hospitalization-level variables were used as the main outcome variables. Information on the relative disease intensity per hospitalization was used to specifically allocate total hospitalization costs to SNC medical resources.
Results: Over the 2001-2018 period, Italian hospitals have treated 1,631 admissions with SNC every year, on average. The mean annual hospitalization cost across all hospitals was 5,502,909 €, or 3,374 € per admission, and 60.0% of these costs were attributable to SNC only. Patient age at discharge (from 62 to 63 years), percentage of surgical procedures (from 29.3% to 46.8%) and of urgent cases (from 13.5% to 16.5%) increased over time. The percentage of costs attributable to SNC followed an inverted U-shaped pattern reaching the minimum level in 2006; conversely, mortality rose until 2007 then decreased steadily.
Conclusions: Good progress has been made in SNC treatments. Endoscopic techniques represent one of the most important advances in this field, reducing morbidity and hospital length of stay while keeping similar survival rates. Policies aimed at monitoring workers most exposed to SNC risk and at standardizing hospital treatments could help Public Health Institutions to plan optimal prevention policies.

Exposure to environmental factors before conception or in the very early stage of the embryonic period, can cause permanent changes in an individual life that can result in the development of chronic illness later in life or be transferred to progeny and hence future generations. Diverse effects of poor diet, alcohol, tobacco consumption, infectious diseases, obesity, anxiety, and depression in pregnancy and fetal origin of adult diseases all are well documented and known. Many of these are preventable or can be modified or treated. The general provision of prepregnancy interventions, however, are neglected by current health system policy. According to the World Health Organization (WHO), 50% of pregnancies worldwide are unintentional. The consequences of this is that embryo exposure to the teratogens can occur weeks before the pregnancy has been detected. Most women modify their risky behavior, such as smoking cessation, reducing alcohol consumption and even alter their lifestyle to a healthier one, such as consuming folic acid and multivitamins, when they learn about their pregnancy, typically around 8-10 weeks of gestational age. By this time, however, women have missed the opportunity of providing a healthy uterine environment for their fetus through the critical stage of the embryonic period. Preconception care is a relatively new concept and provides a unique opportunity to improve maternal health and pregnancy outcomes before pregnancy, through pregnancy, and after birth. Despite the general acknowledgment of the potential valuable impact of preconception care, there are various impediments to implementation of preconception care as part of routine practice in the health system.

Objective: Previous healthcare informatics research identifies a critical need for information technologies to support the selfmanagement of chronic illness by patients and caregivers. However, little is known about their experiences and challenges in seeking health services.
Methods: We present a qualitative study with chronic stroke patients and their caregivers. Among them the 13 patients who participated in the study, 9 patients also participated together with a caregiver, who played a major role in helping the patients seek health services and the other 4 stroke patients, who dealt with stroke management independently, participated in the study by themselves. We used a grounded theory approach to analyze the interview data.
Results: Our findings revealed three main barriers that stroke patients and their caregivers faced in utilizing affordable, accessible, and satisfactory health services and the corresponding strategies they adopted to cope with these challenges.
Conclusions: We discussed that these strategies reflect patients’ creative appropriation in making services affordable and could inform technology design that builds around patients’ creation. In addition, patients’ collaborative and yet onerous strategies to access health services imply the opportunities of designing technologies that leverage local social resources. Moreover, to offer satisfactory health services, it is valuable to provide individualized treatment plans that consider patients’ treatment goals, symptoms, and home environment. The findings could apply to similar neurological diseases that require long-term rehabilitation.

Nigeria implemented a National Health Insurance Scheme (NHIS) in 2005, introducing monumental changes to the health care delivery system. This study assessed physicians’ understanding of the objectives of the NHIS as well as their perceptions of the scheme, to identify their level of acceptance and support of the health policy reform. A convenient sample of 134 physicians residing in South-East Nigeria were surveyed via a self-administered questionnaire. Descriptive statistics were used to summarize study data. Aggregate knowledge scores regarding health insurance and the NHIS objectives were assessed. Measures of consensus (Cns) of physicians’ perceptions of the health reform were also obtained. Study results show a high level of awareness and support for the NHIS among participants. However, there were deviations between awareness of the NHIS and knowledge of the program’s objectives. Aggregate knowledge scores differed significantly by age group, length of years of practice, place of employment and location. Further, consensus measures of physician’s perceptions of NHIS (Cns index = 0.69) and the introduction of Health Maintenance Organizations (HMOs) as intermediary operators of the scheme (Cns index = 0.68) were positive and considered strong while perceptions on associations between HMOs and corruption in the country was moderate (Cns index = 0.56) and slightly negative. This study demonstrates physicians’ support for the NHIS program in Nigeria and an acceptance of changes implemented with the health policy reform. Knowledge gaps were identified, highlighting the need for increased awareness of the reform and its objectives.