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y and prioritising implementing one intervention well, provides more gains.

This study found that to improve the overall patient experience, more focus is needed on evidence-based interventions in dignity and respect and emotional support. Furthermore, the choice of interventions should be guided by evidence of their efficacy and prioritising implementing one intervention well, provides more gains.

Implementation ofevidence-based interventions often involvesstrategies to engage diverse populations while also attempting to maintain external validity. When using health IT tools to deliver patient-centered health messages, systems-level requirements are often at odds with 'on-the ground' tailoring approaches for patient-centered care or ensuring equity among linguistically diverse populations.

We conducted a fidelity and acceptability-focused evaluation of the STAR MAMA Program, a 5-month bilingual (English and Spanish) intervention for reducing diabetes risk factors among 181 post-partum women with recent gestational diabetes. The study's purpose was to explore fidelity to pre-determined 'core' (e.g. systems integration) and 'modifiable' equity components (e.g. health coaching responsiveness, and variation by language) using an adapted implementation fidelity framework. Participant-level surveys, systems-level databases of message delivery, call completion, and coaching notes were included.

96.6% ofween language groups and over time; and (3) examining the impact of engagement with language-concordant interventions on outcomes, including acceptability. Trial Registration National Clinical Trials registration number CT02240420 Registered September 15, 2014. ClinicalTrials.gov.

To gain in-depth knowledge of mothers' and fathers' experiences of the whole trajectory of an early in-home care programme supported by video consultations with a neonatal nurse.

A qualitative interview study.

Data were collected through dyadic semi-structured interviews with mothers and fathers participating in virtual early in-home care programmes and were subjected to inductive content analysis.

The mothers and fathers were anxious about mastering the care of their premature infants at the start of the early in-home care phase but gradually developed confidence by the completion of the early in-home care programme. Being at home during the early in-home care programme gave the mothers and fathers an opportunity to test their decision making concerning the care of the infant while having the ability to obtain support from nurses when needed.

Our findings indicate that the trajectory of early in-home care programmes combined with video consultations contributes to parents' increased confidence as mothers and fathers.

Clinical trial registration REG-113-2014 and SJ-431 .

Clinical trial registration REG-113-2014 and SJ-431 .

Correctional facilities are an underutilized venue for reaching young adults who have not vaccinated for human papillomavirus (HPV). The objective of this study was to identify factors that are associated with jail and local health department (LHD) interest in partnering to offer HPV vaccinations to young adults in jail.

Consolidated framework for implementation research (CFIR)-guided surveys were conducted with jail administrators in Iowa, Kansas, Missouri, and Nebraska, September 2017-October 2018. Jail survey data were analyzed using chi square distribution and relative risk regression. Using data from sister surveys conducted with LHD administrators in the same counties (results previously reported), we identified characteristics of counties in which both the jail and LHD indicated interest in collaborating to offer HPV vaccinations in the jail.

Jail survey response was 192/347 (55.3%). Surveys with LHDs yielded 237/344 (68.9%) responses. Eleven communities were identified where both the jail and LHD expressed interest. Only "any vaccines provided in jail" predicted shared interest (RR 5.36; CI 2.52-11.40; p < .01). For jail administrators, offering other vaccines was 3 times (CI1.49-6.01; p < .01) and employing a nurse 1.65 times more likely (CI 1.20-2.28; p < .01) to predict interest in collaborating to offer HPV vaccination. Open-ended responses indicated that managing linkages and stakeholder investment were areas of emphasis where collaborations to provide vaccinations in the jails had been previously implemented.

Interest in jail-LHD partnerships to provide HPV vaccinations in jails exists in the Midwest but will require building-out existing programs and linkages and identifying and strengthening shared values, goals, and benefits at all levels.

Interest in jail-LHD partnerships to provide HPV vaccinations in jails exists in the Midwest but will require building-out existing programs and linkages and identifying and strengthening shared values, goals, and benefits at all levels.

The use of prenatal dexamethasone remains controversial. Our recent studies found that prenatal dexamethasone exposure can induce maternal intrahepatic cholestasis and have a lasting adverse influence on bile acid (BA) metabolism in the offspring. The purpose of this study was to investigate the effects of dexamethasone on fetal-placental-maternal BA circulation during the intrauterine period, as well as its placental mechanism.

Clinical data and human placentas were collected and analyzed. Pregnant Wistar rats were injected subcutaneously with dexamethasone (0.2 mg/kg per day) from gestational day 9 to 20. The metabolomic spectra of BAs in maternal and fetal rat serum were determined by LC-MS. Human and rat placentas were collected for histological and gene expression analysis. BeWo human placental cell line was treated with dexamethasone (20-500 nM).

Human male neonates born after prenatal dexamethasone treatment showed an increased serum BA level while no significant change was observed in females. Mlation of OATP2B1, while FXR mediated dexamethasone-altered expression of BCRP and MRP4.

By affecting placental BA transporters, dexamethasone induces an imbalanced fetal-placental-maternal BA circulation, as showed by the increase of primary BA levels in the fetal serum. This study provides an important experimental and theoretical basis for elucidating the mechanism of dexamethasone-induced alteration of maternal and fetal BA metabolism and for exploring early prevention and treatment strategies.

By affecting placental BA transporters, dexamethasone induces an imbalanced fetal-placental-maternal BA circulation, as showed by the increase of primary BA levels in the fetal serum. This study provides an important experimental and theoretical basis for elucidating the mechanism of dexamethasone-induced alteration of maternal and fetal BA metabolism and for exploring early prevention and treatment strategies.

Most people spend their last year of life at home, with many wishing to die there, but patients may need access to care after hours. Out-of-hours palliative care is delivered by multi-disciplinary teams including Health Care Assistants (HCA). However, little is known about the role, contribution and impact Health Care Assistants have on out-of-hours palliative care services. The aim of this study is to examine the Health Care Assistant role, contribution and impact on service delivery and patient care in out-of-hours community palliative care provided by hospice organisations.

A mixed methods exploratory study consisting of four phases. Phase one involves a scoping review to systematically map and identify gaps in policy and literature on the HCA role in out-of-hours palliative care. In phase two, all United Kingdom hospices will be invited to participate in an online census to enable the development of a typology of out-of-hours services and the contribution of the Health Care Assistant. Gambogic During phase three organisational case studies representing different service types will collect information from Health Care Assistants, patients, caregivers and service managers to gather qualitative and quantitative data about out-of-hours service provision and the Health Care Assistant role. Finally, phase four will synthesize and refine results through online focus groups.

Ethical approval has been obtained for phase two through Ulster University Research Governance Filter Committee, Nursing and Health Research. Findings will be disseminated through practitioner and/or research journals, conferences, and social media.

Ethical approval has been obtained for phase two through Ulster University Research Governance Filter Committee, Nursing and Health Research. Findings will be disseminated through practitioner and/or research journals, conferences, and social media.

There are multiple educational programs for individuals to become registered nurses (RNs), and the transition from an associate degree or diploma to a Bachelor of Science in Nursing (BSN) degree is vital to healthcare. This study examined the factors contributing to delayed completion or withdrawal from online RN-BSN nursing programs from students' perspectives.

Thematic content analyses were conducted on qualitative data obtained from semi-structured interviews (N = 26).

Complex factors contributed to delayed completion of online RN-BSN programs, including student-, institutional-, and faculty-related factors.

This study validated and extends previous studies without delineating students in fully online programs from hybrid and face-to-face programs. link2 Students, faculty, and institutions all have a role to play in facilitating on-time program completion. Recognizing and mitigating the barriers that delay on-time program completion is required to foster nurses to obtain a BSN degree.

This study validated and extends previous studies without delineating students in fully online programs from hybrid and face-to-face programs. Students, faculty, and institutions all have a role to play in facilitating on-time program completion. Recognizing and mitigating the barriers that delay on-time program completion is required to foster nurses to obtain a BSN degree.

While international students form an increasing population of higher education students in Turkey, there is limited empirical evidence about their health services utilization. The study aim was to investigate healthcare access among a group of international students studying in Ankara city and identify potential barriers that affect full healthcare utilization.

A total of 535 international students from 83 countries completed an online-based questionnaire. The survey was conducted from September until October 2020. Variables between groups within the study sample were compared using ANOVA and Chi-square tests (with Fisher's exact test). Logistic regression analysis was used to evaluate the relationships between variables related to access to health services.

Of the study population, 80.6% accessed the general practitioner (GP), 40% accessed the student health centres, and 11.4% were admitted to the hospital at least once. link3 About 80% of international students reported changing their views to access healthcare more because of the COVID-19 pandemic.

Lack of awareness of healthcare support systems, perceived stigma associated with mental health services, and language barriers were the main barriers affecting healthcare access by international students.

Study findings indicate the need for education of international students on available healthcare, targeted health promotion, and training of health providers on effective communication.

Study findings indicate the need for education of international students on available healthcare, targeted health promotion, and training of health providers on effective communication.