1323. Implementation and Effectiveness of the Asia Pacific HIV Practice Course: Building Capacity of Healthcare Workers in the Region

Abstract Background Building the capacity of healthcare workers (HCW) can positively influence service quality and patient care. Given the limited HIV training opportunities in the Asia Pacific Region, the Asia Pacific HIV Practice Course (APHPC) aims to improve knowledge and skills and encourage patient-centered practice. Methods The APHPC is organized by an interprofessional organizing committee. The course was developed based on a needs assessment of HCWs in the region and is run over 4 days. Using didactic and interactive learning approaches, the course covers psychosocial, biomedical and service delivery topics. One hundred HCWs, predominantly nurses, social workers/counselors and, pharmacists have attended the course over 2 years (2016 and 2017). Participants have attended from Singapore, Sri Lanka, Indonesia, Malaysia, Philippines, Bangladesh, Papua New Guinea, Myanmar, and Vietnam. Pre- and post-course evaluations were completed, as well as daily session evaluations and a 3-month post-course evaluation. Participants rated their confidence from 1 to 5 (not confident–very confident). A paired-samples t-test was conducted to compare mean (M) confidence levels pre- and post-course in the various topics covered. Results There was significant improvement in mean confidence scores pre-course (M = 3.40, SD 0.27) and post-course (M = 4.09, SD = 0.13); t(11)= 13.1958, P < 0.0001. This was seen across all topics (figure) with the most marked improvement found in models of care and barriers to care, topics that are not routinely or explicitly covered in the same detail or frequency as HIV basics, testing, treatment and prevention. In the 3-month post-course survey, participants shared the changes they have made to their local practice since attending the APHPC. Changes include, additional staff training, revisions to counseling models and services and the implementation of monitoring and evaluation structures. Conclusion The APHPC has proven to be an impactful and highly evaluated course. To ensure the course continues to influence and improve practice, the content of the course can be expanded to cover nonstandard topics, and further interactive learning experiences can be incorporated. Disclosures All authors: No reported disclosures.

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An Asia-Pacific study on healthcare workers’ perceptions of, and willingness to receive, the COVID-19 vaccination

International Journal of Infectious Diseases ◽

10.1016/j.ijid.2021.03.069 ◽

2021 ◽

Vol 106 ◽

pp. 52-60

Author(s):

Nicholas W.S. Chew ◽

Clare Cheong ◽

Gwyneth Kong ◽

Kailun Phua ◽

Jinghao Nicholas Ngiam ◽

...

Keyword(s):

Healthcare Workers ◽

Asia Pacific ◽

To Receive

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Coronaviruses: A Scientist’s Race Against Time

10.51627/pghr.2020.04.00007 ◽

2020 ◽

Author(s):

Saloni Chaurasia ◽

Keyword(s):

Healthcare Workers ◽

Vaccine Development ◽

Drug Repurposing ◽

Alveolar Epithelial Cells ◽

Contact Tracing ◽

Medical Innovation ◽

Alveolar Epithelial ◽

Treatment And Prevention ◽

Scientific World ◽

Respiratory Droplets

As the clock ticks, more and more people are falling victim to COVID-19, and scientists are racing against time to find treatment and prevention strategies. But what’s stopping them? The answer comes from two primary problems. Firstly, coronaviruses (CoVs) are transmitted from person-to-person via respiratory droplets from an infected person’s coughs or sneezes, which makes them highly contagious (CDC, How COVID-19 Spreads, 2020). This can happen in minutes, and up to 25% of patients remain asymptomatic (Du, et al., 2020). This makes it difficult for healthcare workers and researchers to contain patients and establish contact tracing to isolate the infected population. Secondly, it is hard to target CoVs without damaging our cells. CoVs infect via spike protein, which binds to the ACE2 receptor located on the lung alveolar epithelial cells (Hoffmann, et al., 2020). Once they invade the cell, CoVs hijack the host cell’s mechanisms to replicate. Thus, it is hard to combat the virus without damaging the host cell. On the other hand, recent understanding of CoVs structure and mechanism of action enables the scientific world to create a cure or vaccine. The bad news is that these efforts will likely face the perennial hurdles of medical innovation and discovery, long timelines of clinical trials for drug repurposing, and vaccine development, sometimes fickle funding, and changing governmental priorities.

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Investigating Psychological Differences between Nurses and Other Healthcare Workers from Asia-Pacific Region during the Early Phase of the Coronavirus Disease 2019 (COVID-19): A Machine Learning Approach (Preprint)

10.2196/preprints.32647 ◽

2021 ◽

Author(s):

YanHong Dong ◽

Mei Chun Yeo ◽

Rivan Danuaji ◽

Thang H Nguyen ◽

...

Keyword(s):

Machine Learning ◽

Psychological Distress ◽

Healthcare Workers ◽

Psychological Impact ◽

Asia Pacific ◽

Pacific Region ◽

Asia Pacific Region ◽

Psychological Outcome ◽

Psychological Differences ◽

Medical Healthcare

BACKGROUND As the pandemic evolves, frontline work challenges continue to impose significant psychological impact on nurses. However, there is a lack of data how nurses fared compared to other healthcare workers in Asia-Pacific region. OBJECTIVE This study aims to investigate 1) psychological differences between nurses, doctor and non-medical healthcare workers, and 2) psychological outcome characteristics of nurses from different Asia-Pacific countries. METHODS Decision-tree type machine learning models (LIghtGBM, Gradientboost, and RandomForest) were adopted to predict psychological impact on nurses. The SHAP (SHapley Additive exPlanations) values of these models were extracted to identify the distinctive psychological distress characteristic. RESULTS Nurses had relatively higher percentages of normal or no-change in psychological distress symptoms relative to other healthcare workers (86.3% - 96.8% vs 80.7% - 92.3%). Among those without psychological symptoms, nurses constituted a higher proportion than doctors and non-medical healthcare workers (40.8%, 25.8%, and 33.4%, respectively). CONCLUSIONS Different contexts, cultures, and points in pandemic curve may have contributed to differing patterns of psychological outcomes amongst nurses in various Asia-Pacific countries. It is important that all healthcare workers practise self-care and render peer support to bolster psychological resilience for effective coping. CLINICALTRIAL Not applicable

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Informatics for Medicines Management Systems in Resource-Limited Settings

Supply Chain Management ◽

10.4018/978-1-4666-2625-6.ch037 ◽

2012 ◽

pp. 634-645

Author(s):

Andy Stergachis ◽

Douglas Keene ◽

Shabir Somani

Keyword(s):

Information Technologies ◽

Care Delivery ◽

Monitoring And Evaluation ◽

Management Systems ◽

Medicines Management ◽

Resource Limited Settings ◽

Treatment And Prevention ◽

Resource Limited ◽

Key Stakeholders ◽

Potential Benefits

Improved access to information is necessary to ensure achievement of the potential benefits of medicines in resource-limited countries. The scaling up of treatment and prevention programs involving medicines in resource-limited regions with high disease burdens requires proper and urgent attention to the development and use of information technologies. Areas of need for medicines management systems informatics include prescribing, dispensing, pharmaceutical care, administration, patient monitoring, education and training, supply chain management, and monitoring and evaluation of program performance. Such information systems should strive to collect and manage data that are a standardized, compiled, and made easily accessible for use by key stakeholders, including ministries of health, medicines regulators, pharmaceutical industry, public health programs, academic researchers, donor organizations, the health care delivery sector, and ultimately the public and patients. A framework is described for medicines management systems informatics in resource-limited settings.

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Health sector responses to intiate partner violence: A literature review

African Journal of Primary Health Care & Family Medicine ◽

10.4102/phcfm.v6i1.712 ◽

2014 ◽

Vol 6 (1) ◽

Cited By ~ 11

Author(s):

Kate Rees ◽

Virginia Zweigenthal ◽

Kate Joyner

Keyword(s):

Health Services ◽

South African ◽

Partner Violence ◽

Healthcare Workers ◽

Healthcare Providers ◽

Health Sector ◽

Models Of Care ◽

Health Concern ◽

Current State ◽

Current Systems

Background: Intimate partner violence (IPV) is a common and serious public health concern, particularly in South Africa, but it is not well managed in primary care.Aim: This review aims to summarise the current state of knowledge regarding health sector-based interventions for IPV, their integration into health systems and services and the perspectives of service users and healthcare workers on IPV care, focusing on the South African context.Method: PubMed, CINAHL, PsycINFO and Google Scholar were searched betweenJanuary 2012 and May 2014. All types of study design were included, critically appraised and summarised.Results: Exposure to IPV leads to wide-ranging and serious health effects. There is suffiient evidence that intervening in IPV in primary care can improve outcomes. Women who have experienced IPV have described an appropriate response by healthcare providers to be non-judgmental, understanding and empathetic. IPV interventions that are complex, comprehensive and utilise systems-wide approaches have been most effective, but system- andsociety-level barriers hamper implementation. Gender inequities should not be overlooked when responding to IPV.Conclusion: Further evaluations of health sector responses to IPV are needed, in order to assist health services to determine the most appropriate models of care, how these can be integrated into current systems and how they can be supported in managing IPV. The need for this research should not prevent health services and healthcare providers from implementing IPV care, but rather should guide the development of rigorous contextually-appropriate evaluations.

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Asian-Pacific perspective on the psychological well-being of healthcare workers during the evolution of the COVID-19 pandemic

BJPsych Open ◽

10.1192/bjo.2020.98 ◽

2020 ◽

Vol 6 (6) ◽

Cited By ~ 1

Author(s):

Nicholas W. S. Chew ◽

Jinghao Nicholas Ngiam ◽

Benjamin Yong-Qiang Tan ◽

Sai-Meng Tham ◽

Celine Yan-Shan Tan ◽

...

Keyword(s):

Healthcare Workers ◽

Physical Symptoms ◽

Psychological Outcomes ◽

Asia Pacific ◽

Pacific Region ◽

Medical Conditions ◽

Asia Pacific Region ◽

Factors Associated ◽

Prevalence Of Depression ◽

The Impact

Background The coronavirus disease 2019 (COVID-19) pandemic has led to significant strain on front-line healthcare workers. Aims In this multicentre study, we compared the psychological outcomes during the COVID-19 pandemic in various countries in the Asia-Pacific region and identified factors associated with adverse psychological outcomes. Method From 29 April to 4 June 2020, the study recruited healthcare workers from major healthcare institutions in five countries in the Asia-Pacific region. A self-administrated survey that collected information on prior medical conditions, presence of symptoms, and scores on the Depression Anxiety Stress Scales and the Impact of Events Scale-Revised were used. The prevalence of depression, anxiety, stress and post-traumatic stress disorder (PTSD) relating to COVID-19 was compared, and multivariable logistic regression identified independent factors associated with adverse psychological outcomes within each country. Results A total of 1146 participants from India, Indonesia, Singapore, Malaysia and Vietnam were studied. Despite having the lowest volume of cases, Vietnam displayed the highest prevalence of PTSD. In contrast, Singapore reported the highest case volume, but had a lower prevalence of depression and anxiety. In the multivariable analysis, we found that non-medically trained personnel, the presence of physical symptoms and presence of prior medical conditions were independent predictors across the participating countries. Conclusions This study highlights that the varied prevalence of psychological adversity among healthcare workers is independent of the burden of COVID-19 cases within each country. Early psychological interventions may be beneficial for the vulnerable groups of healthcare workers with presence of physical symptoms, prior medical conditions and those who are not medically trained.

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How Can Operational Research Help to Eliminate Tuberculosis in the Asia Pacific Region?

Tropical Medicine and Infectious Disease ◽

10.3390/tropicalmed4010047 ◽

2019 ◽

Vol 4 (1) ◽

pp. 47 ◽

Cited By ~ 3

Author(s):

Anthony Harries ◽

Ajay Kumar ◽

Srinath Satyanarayana ◽

Pruthu Thekkur ◽

Yan Lin ◽

...

Keyword(s):

Operational Research ◽

Disease Burden ◽

Control Programme ◽

Asia Pacific ◽

Pacific Region ◽

Asia Pacific Region ◽

Programme Implementation ◽

Treatment And Prevention ◽

Implementation Gaps ◽

Disease Control Programme

Broad multi-sectoral action is required to end the tuberculosis (TB) epidemic by 2030 and this includes National TB Programmes (NTPs) fully delivering on quality-assured diagnostic, treatment and preventive services. Large implementation gaps currently exist in the delivery of these services, which can be addressed and closed through the discipline of operational research. This paper outlines the TB disease burden and disease-control programme implementation gaps in the Asia-Pacific region; discusses the key priority areas in diagnosis, treatment and prevention where operational research can be used to make a difference; and finally provides guidance about how best to embed operational research within a TB programme setting. Achieving internationally agreed milestones and targets for case finding and treatment requires the NTP to be streamlined and efficient in the delivery of its services, and operational research provides the necessary evidence-based knowledge and support to allow this to happen.

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Delegation Opportunities for Malnutrition Care Activities to Dietitian Assistants—Findings of a Multi-Site Survey

Healthcare ◽

10.3390/healthcare9040446 ◽

2021 ◽

Vol 9 (4) ◽

pp. 446

Author(s):

Alita Rushton ◽

Adrienne Young ◽

Heather Keller ◽

Judith Bauer ◽

Jack Bell

Keyword(s):

Care Delivery ◽

Monitoring And Evaluation ◽

Models Of Care ◽

Nutrient Delivery ◽

Evaluation Practice ◽

Attitudes And Practices ◽

Nutrition Care ◽

Site Survey ◽

Implementation Program ◽

Knowledge Attitudes And Practices

Approximately one-third of adult inpatients are malnourished with substantial associated healthcare burden. Delegation frameworks facilitate improved nutrition care delivery and high-value healthcare. This study aimed to explore knowledge, attitudes, and practices of dietitians and dietitian assistants regarding delegation of malnutrition care activities. This multi-site study was nested within a nutrition care implementation program, conducted across Queensland (Australia) hospitals. A quantitative questionnaire was conducted across eight sites; 87 dietitians and 37 dietitian assistants responded and descriptive analyses completed. Dietitians felt guidelines to support delegation were inadequate (agreement: <50% for assessment/diagnosis, care coordination, education, and monitoring and evaluation); dietitian assistants perceived knowledge and guidelines to undertake delegated tasks were adequate (agreement: >50% food and nutrient delivery, education, and monitoring and evaluation). Dietitians and dietitian assistants reported confidence to delegate/receive delegation (dietitian agreement: >50% across all care components; dietitian assistant agreement: >50% for assessment/diagnosis, food and nutrient delivery, education, monitoring and evaluation). Practice of select nutrition care activities were routinely performed by dietitians, rather than assistants (p < 0.001 across all nutrition care components). The process for care delegation needs to be improved. Clarity around barriers and enablers to delegation of care prior to implementing reforms to the current models of care is key.

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Community perspectives on scabies, impetigo and mass drug administration in Fiji: A qualitative study

PLoS Neglected Tropical Diseases ◽

10.1371/journal.pntd.0008825 ◽

2020 ◽

Vol 14 (12) ◽

pp. e0008825

Author(s):

Elke Mitchell ◽

Stephen Bell ◽

Li Jun Thean ◽

Aalisha Sahukhan ◽

Mike Kama ◽

...

Keyword(s):

Drug Administration ◽

Mass Drug Administration ◽

Social Dynamics ◽

School Attendance ◽

Asia Pacific ◽

Local Health ◽

Prevention Measures ◽

Structured Interviews ◽

Community Based ◽

Treatment And Prevention

Scabies is endemic in Fiji and is a significant cause of morbidity. Little is known about the sociocultural beliefs and practices that affect the occurrence of scabies and impetigo, or community attitudes towards the strategy of mass drug administration that is emerging as a public health option for scabies and impetigo control in Fiji and other countries. Data were collected during semi-structured interviews with 33 community members in four locations in Fiji’s Northern Division. Thematic analysis examined participants’ lived experiences of scabies and impetigo; community knowledge and perceptions about scabies and impetigo aetiology and transmission; community-based treatment and prevention measures; and attitudes towards mass drug administration. Many indigenous Fijian (iTaukei) participants noted extensive and ongoing experience of scabies and impetigo among children in their families and communities, but only one participant of Indian descent (Indo-Fijian) identified personal childhood experience of scabies. Scabies and impetigo were perceived as diseases affecting children, impacting on school attendance and families’ quality of sleep. Awareness of scabies and impetigo was considerable, but there were major misconceptions around disease causation and transmission. Traditional remedies were preferred for scabies treatment, followed by biomedicines provided by local health centres and hospitals. Treatment of close household contacts was not prioritised. Attitudes towards mass drug administration to control scabies were mostly positive, although some concerns were noted about adverse effects and hesitation to participate in the planned scabies elimination programme. Findings from this first study to document perspectives and experiences related to scabies and impetigo and their management in the Asia Pacific region illustrate that a community-centred approach to scabies and impetigo is needed for the success of control efforts in Fiji, and most likely in other affected countries. This includes community-based health promotion messaging on the social dynamics of scabies transmission, and a campaign of education and community engagement prior to mass drug administration.

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THAI STUDENTS’ MOTIVATION TO SPEAK ENGLISH OUTSIDE THE CLASSROOM AT ASIA-PACIFIC INTERNATIONAL UNIVERSITY

Abstract Proceedings International Scholars Conference ◽

10.35974/isc.v7i1.992 ◽

2019 ◽

Vol 7 (1) ◽

pp. 1518-1538

Author(s):

Suwannee Lansri ◽

Josephine Esther Katenga

Keyword(s):

Intrinsic Motivation ◽

Extrinsic Motivation ◽

Asia Pacific ◽

Future Research ◽

Learning Approaches ◽

English Grammar ◽

Thai Students ◽

International University ◽

Undergraduate Programs ◽

The University

Introduction: The purposes of this study were to explore the factors that motivated and those that discouraged students from speaking English outside of the classroom at Asia-Pacific International University, Mauk Lek Campus. The university offers undergraduate programs in both English and Thai medium. The majority of Thai students who were enrolled in both programs notably lived in the University dormitories, which exposed them to students from 32 different countries, yet were still hesitant to speak English. Methods: Using the convenience sampling method, 197 students were selected to participate in this study. A descriptive quantitative method and a self-administered questionnaire were used to collect the data. Result: The findings reveal that motivation for speaking English outside the classroom was mainly for instrumental motivational reasons (M=4.17, SD=0.59), followed by integrative motivational reasons (M=3.74, SD=0.67). Less clear reasons were intrinsic motivation (M=3.41, SD=0.75) and extrinsic motivation (M=3.32, SD=0.82) motivations. The study also reported that factors such as inadequate vocabulary to speak effectively, insufficient knowledge of English grammar, and inability to speak English fluently and continuously, were perceived as hindering them from speaking English outside the classroom. Lastly, the study found statistically significant differences at the 0.05 level in instrumental motivation, intrinsic motivation, and extrinsic motivation when compared with gender, faculty, class status, program of study, and period of learning. Discussion: The recommendations for future research threefold: to study learning approaches to a variety of vocabularies which would enhance students’ communication outside of the classroom; to study participants from other nationalities; and to use a larger sample using other types of sampling and data collection methods.

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