World Academy of Science, Engineering and Technology

Authors: Patcharaporn Natsawang, Anongnart Pragobsuk

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Background: Drainage has been widely used when performing total knee arthroplasty. However, the benefits and disadvantages of this procedure remain no consensus in various studies. Objective: This study is a retrospective descriptive research project comparing adverse clinical outcomes after total knee arthroplasty between drainage and without drainage. Method: Data were collected from the medical records of patients who underwent elective total knee replacement at Ramathibodi Chakri Naruebodindra Hospital, along with electronic medical records, from January 1, 2021, to December 31, 2023. A total of 262 patients were included. Data were collected by recording forms, including personal data and adverse clinical outcomes. The data were analyzed using descriptive statistics and the Chi square test or Fisher’s exact test. Results: The drainage was not significantly different compared to without drainage. Wound complications, superficial wound infections, ecchymosis, swelling, and wound discharge were more common without drainage, but there was no difference between the two groups. Conclusion: No significant difference was observed in the two groups with respect to gender, age, body mass index, blood transfusion, Charson Comorbidity Index, blood loss, and operation time were not significantly different between drainage and without drainage. The findings of this study can guide hospitals in surgical planning and the development of care protocols to reduce adverse clinical outcomes in patients undergoing total knee replacement, ultimately enhancing patient safety.

Keywords: total knee arthroplasty, drainage and without drainage, wound complication, ecchymosis, swelling

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Authors: Aikaterini Roupa, Evridiki Patelarou

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Dehumanization is the tendency of individuals or groups to attribute less human characteristics to others (individuals or outgroups) or to themselves. Environments such as public hospitals favor the emergence of these latent forms of dehumanization due to their structure, organization, and the inherent demands associated with the profession. This qualitative study aims to capture the subjective perspectives of healthcare professionals regarding the phenomenon of hetero-dehumanization and self-dehumanization. Furthermore, through the interviews, an effort was made to highlight the causal factors contributing to the development of the phenomenon, as well as its impact on the quality of care provided within the framework of clinical practice and the well-being of healthcare workers. A qualitative interview study (focus group) was designed. A focus group consisting of nine members - physicians and nurses- was formed in September 2024. Data analysis was conducted following valid steps as proposed in the literature for qualitative studies. From the interviews, the following thematic units emerged: a) personality traits, b) empathy, c) hetero-dehumanization, d) self-dehumanization, e) professional quality of life, and f) evaluation and self-reporting of quality. The findings showed that healthcare professionals tend to mechanically dehumanize primarily patients but also themselves. The study revealed that dehumanization is a multifactorial phenomenon, with key causal factors being the lack of empathy and the degraded professional quality of life of healthcare workers. The final findings of the study are expected to highlight the extent and severity of the phenomenon of dehumanization. Through this research, programs are expected to be developed by the relevant authorities to implement interventions targeting a holistic approach to patient care, the improvement of care quality, and better professional quality of life for physicians and nurses.

Keywords: dehumanization, healthcare professionals, hospital, self-dehumanization

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Authors: Anongporn Poka, Kanyanat Ngamprasert, Nuttaya Pornmalairungruang

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This retrospective descriptive study aimed to determine the prevalence and associated factors of perineal wound infections among postpartum mothers who underwent vaginal delivery at Chakri Naruebodindra Medical Institute. Data were collected retrospectively from medical records of 294 postpartum mothers who delivered vaginally between January 1, 2021, and June 30, 2024. Perineal wound infections were identified in 7 cases, yielding a prevalence rate of 2.38%. Factors of interest included body mass index (BMI) > 30 kg/m² (prevalence 6.25%), third-degree perineal tears (prevalence 25%), estimated blood loss > 500 mL (prevalence 18.92%), and suturing time ≥ 40 minutes (prevalence 15.38%). Correlation analysis demonstrated that BMI, degree of perineal tear, episiotomy, and suturing duration were not significantly associated with perineal wound infection, while estimated blood loss ≤ 500 mL was significantly associated with wound infection (p-value = 0.00). The microorganisms isolated from the infected wounds included Klebsiella spp., Staphylococcus haemolyticus, Streptococcus agalactiae (GBS), Corynebacterium spp., Staphylococcus epidermidis, and Escherichia coli (E.coli). Treatment involved antibiotic therapy, wound opening, re-suturing, and warm sitz baths. The average wound healing time ranged from 18 to 20 days.

Keywords: perineal wound infection, postpartum mothers, vaginal delivery, associated factors

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Authors: Papatsara Khamsanam, Nisarat Pasanate, Janjira Pankaew

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Blood reservation for mothers in labor at the delivery room of Ramathibodi Chakri Naruebodindra Hospital is traditionally conducted using the Grouping & Crossmatching method, which involves detailed blood typing and compatibility testing between donor and recipient. This method consumes significant time, labor, and reagents, especially since the reserved blood is often unused. This retrospective comparative study aims to improve the blood reservation process for delivery procedures by comparing the Grouping & Crossmatching method with the Typing & Screening method. Data were collected from 400 deliveries between January 2023 and January 2024, divided into two groups: 200 cases using Grouping & Crossmatching and 200 cases using Typing & Screening. The study analyzed blood reservation records, actual blood usage, estimated blood loss, and related factors. Additionally, interviews were conducted with delivery room nurses to assess changes in workflow and evaluate the impact of transitioning from Grouping & Crossmatching to Typing & Screening on delivery procedures at Ramathibodi Chakri Naruebodindra Hospital.The results of the study found that the use of the Typing & Screening method in the delivery room increased from 0% to 86.5%. Nurses reported that the change reduced the time required to prepare blood and alleviated concerns about the expiration of reserved blood. The actual blood transfusion rate remained constant at 0.5% in both groups, indicating that the change in method did not compromise patient safety. Although the average blood loss increased from 290.9 mL to 339.3 mL, there was no statistically significant difference in the incidence of postpartum hemorrhage.

Keywords: typing&screening blood reservation, grouping&crossmatching blood reservation, blood transfusion, delivery room

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Authors: Wen-Chun Yu

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Background: The global trend of aging populations and increasing chronic diseases has challenged the conventional inpatient-centric model of care. Home-based care offers a critical solution by bridging acute care and community services, particularly for complex and elderly patients. Evidence-based interventions and interdisciplinary collaboration are essential to improving care quality and safety in home settings. Aim: To explore the application and outcomes of advanced home-based care strategies in three elderly patients with complex conditions, and to analyze the role of multidisciplinary teamwork in ensuring safe and effective home treatment. Method: We report three cases from an interdisciplinary home medical care program: Case 1: A 78-year-old male with vertebral osteomyelitis and renal insufficiency received 21 days of outpatient parenteral antibiotic therapy (OPAT) via PICC after discharge. Infection resolved without recurrence. Case 2: A 72-year-old female with short bowel syndrome received home parenteral nutrition (HPN) via Port-A catheter. Family caregivers were trained and capable of independent management. The patient showed gradual improvement in body weight and serum albumin. Case 3: A 91-year-old male with chronic respiratory failure used dual-mode home mechanical ventilation (HMV) for over three months after comprehensive team support and caregiver training, with no readmissions. Results: All three patients successfully received complex medical interventions at home, demonstrating clinical stability, high satisfaction, and no adverse events. Key success factors included pre-discharge care planning, family education, remote monitoring, and effective interdisciplinary coordination. Recent literature (2019–2024) supports the safety and efficacy of OPAT, HPN, and HMV in home settings, aligning with our findings. Conclusion: Patient-centered, evidence-based home care integrated with interdisciplinary collaboration can significantly enhance treatment outcomes, reduce hospital utilization, and improve quality of life in complex geriatric cases. We recommend health system support for structured home care programs, including caregiver training and telehealth integration, to meet growing demands in aging societies.

Keywords: home-based care, interdisciplinary collaboration, outpatient parenteral antibiotic therapy, home parenteral nutrition, home mechanical ventilation

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Authors: Wen-Chun Yu, Chiang-Yi Chen, Yi-Chin Pu, Yu-Feng Lin

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Background: Timely and accurate admission assessment plays a crucial role in guiding initial management and enhancing inpatient care outcomes. However, conventional methods often fail to detect critical conditions such as hypovolemia, urinary retention, or improper indwelling catheter placement, especially in high-risk patients. In response, our clinical nursing team initiated a practice-based project integrating point-of-care ultrasound (PoCUS) into routine admission evaluations, aiming to improve diagnostic accuracy, promote patient safety, and support timely interventions. Methods: This quality improvement initiative was conducted in a 42-bed general medical ward at a university-affiliated tertiary hospital in Taiwan. From January to April 2025, PoCUS was systematically implemented for newly admitted patients. The ultrasound assessments focused on inferior vena cava (IVC) collapsibility to evaluate volume status, bladder scanning to identify urinary retention, and real-time verification of indwelling urinary catheter tip positioning. Frontline nurses were trained and certified in basic PoCUS applications. Data were collected on the detection rates of abnormal findings, related clinical interventions, and feedback from interdisciplinary team members. Results: A total of 38 patients underwent admission PoCUS assessments during the implementation period. Among them, 12 cases (31.6%) showed IVC collapsibility suggestive of volume depletion and received timely fluid resuscitation; 7 cases (18.4%) had significant urinary retention requiring catheter reinsertion or bladder drainage; and 3 cases (7.9%) revealed improper catheter tip placement, prompting immediate repositioning. The integration of PoCUS enhanced communication among physicians, nurses, and allied health professionals, reduced assessment delays, and facilitated appropriate nursing and medical interventions. Conclusion: Incorporating PoCUS into admission evaluations by trained nursing staff effectively identifies high-risk conditions, augments clinical decision-making, and improves patient care quality. This nurse-led initiative highlights the growing role of PoCUS in advancing evidence-based, patient-centered nursing practice. We recommend broader implementation and ongoing training to support sustainable use of PoCUS across diverse clinical settings.

Keywords: point-of-care ultrasound, nursing assessment, admission evaluation, inpatient care, clinical nursing practice, patient safety

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Authors: Nutchanat Jongpean, Natcha Khetlikhitworagoon, Nuttaya Pornmalairungruang

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Cardiac catheterization via radial artery has increased popularity due to enhanced patient safety and comfort. However, improper wrist positioning remains a frequently encountered problem. This study aimed to develop an innovative radial artery puncture pillow to improve procedural efficiency and safety during cardiac catheterization. An innovative wrist support pillow was created with a semi-circular design measuring 10×15×5.5 cm, constructed with a foam core and synthetic leather covering. The device was tested with 39 patients and evaluated using three key indicators: preparation time, complication rates, and healthcare personnel satisfaction. After May 2567 B.E., the rate of patients requiring less than 5 minutes of preparation time increased to 100% (target >80%). Complication rates decreased to 0% (target <10%), and healthcare personnel satisfaction increased to 100% (target >80%). The innovative radial artery puncture pillow significantly improved procedural efficiency, reduced complications, and enhanced healthcare personnel satisfaction. This innovation can be implemented as a standard of care for patients undergoing cardiac catheterization via the radial artery approach.

Keywords: medical innovation, wrist support pillow, radial artery puncture, cardiac catheterization

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Authors: Natcha Khetlikhitworagoon, Nutchanat Jongpean, Nuttaya Pornmalairungruang

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Bronchoscopes are essential medical devices for diagnosing and treating respiratory diseases. However, they pose risks of pathogenic contamination without proper management. Water quality used in the reprocessing procedure is a critical factor affecting disinfection efficacy. The Bronchoscopy Unit at Ramathibodi Chakri Naruebodindra Hospital encountered problems with dust, sediment, and microbial growth contamination in the filtered water storage tank. The objectives of this study were to develop and evaluate the effectiveness of a filtered water storage system for bronchoscope reprocessing by comparing microbiological water quality before and after system development, studying contamination detection rates, and developing workflow guidelines for system maintenance. A research and development study combined with a quasi-experimental one-group pretest-posttest design was conducted over 12 months. The filtered water storage tank system was developed by implementing tight tank sealing, using opaque materials for the tank body, and establishing a 6-month tank cleaning schedule. Water samples for microbiological analysis were collected every 3 months (months 2, 5, 8, 11), totaling four samples, with monthly physical contamination assessments. Data analysis included descriptive statistics displaying frequency and percentage, pre-post system development comparison using Paired t-test or Wilcoxon Signed Rank Test, trend analysis for change patterns, and staff satisfaction evaluation using Repeated Measures ANOVA. The developed filtered water storage system is expected to reduce microbial and physical contamination, improve water quality for bronchoscope reprocessing, enhance patient safety standards, and provide guidelines applicable to other healthcare units.

Keywords: filtered water storage system, bronchoscope, microbial contamination, quality improvement

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Authors: Deborah Chasco, Patricia Hoppes

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The Smart Hospital initiative and implementation represent a pioneering effort to revolutionize healthcare delivery through the integration of artificial intelligence (AI). This groundbreaking initiative aimed at transforming healthcare delivery through the integration of artificial intelligence (AI). By addressing critical challenges such as fall prevention, nursing shortages, and adherence to evidence-based practices, this study underscores the transformative potential of AI in reshaping hospital operations and improving patient care. The healthcare industry faces mounting challenges, including an aging population, increasing chronic disease prevalence, and rising operational costs. These issues strain hospital resources, leading to staff burnout, compromised patient safety, and inefficiencies in care delivery. How can artificial intelligence (AI) be effectively integrated into hospital operations to address critical challenges such as fall prevention, nursing shortages, and adherence to evidence-based practices, while ensuring sustainable improvements in patient care and workforce efficiency? This initiative employs a comprehensive, evidence-based framework that incorporates predictive analytics, virtual nursing models, AI-powered tissue analytics, and automated compliance tracking. Methodologies include pre- and post-survey evaluations, mixed-methods approaches combining quantitative data analysis with qualitative interviews, and longitudinal designs to assess sustained impacts. Comparative analyses with control groups validate the effectiveness of these solutions. Preliminary findings highlight significant advancements in hospital transformation, including enhanced patient safety, improved staff retention, and optimized workflow efficiency. Key results include 85% compliance with CMS eCQM requirements and a 50% reduction in patient falls during Phase 1. Reduction in nurse duress alongside a decrease in pressure injuries will be provided post Phase 2 implementation. Smart Hospital AI-powered system implementation further demonstrates measurable decreases in time spent by nurses completing patient admissions and discharges based on preliminary findings. Additionally, final results will include a significant return on investment (ROI) through cost savings from improved resource allocation with virtual nursing. The findings of the Smart Hospital initiative underscore the critical role of AI in addressing systemic challenges within healthcare. By demonstrating measurable improvements in patient safety, staff well-being, and operational efficiency, the initiative provides a scalable model for other institutions. The integration of AI technologies not only enhances immediate outcomes but also lays the groundwork for long-term sustainability and innovation in healthcare delivery. The Smart Hospital study exemplifies the transformative power of AI in healthcare, setting a new standard for innovation and excellence. Its findings not only address current challenges but also provide a roadmap for future advancements, ensuring sustainable improvements in hospital operations and patient outcomes. Ultimately, this study serves as a beacon for the future of healthcare, demonstrating how AI-driven innovation can lead to safer, more efficient, and patient-centered hospital environments.

Keywords: AI smart hospitals, nursing informatics, predictive analytics, virtual nursing

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Authors: Faten Ali Hassani

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The role of the school nurse has increasingly become more comprehensive in developed nations in order to meet the health care needs of students. The professional role of the school nurse, encompassing many aspects of care delivery, is underdeveloped in many schools in the Kingdom of Bahrain. In this study, a qualitative approach was used. A sample group of ten nurses was purposefully selected. Data was generated through semi-structured interviews and analyzed using Burnard's four-stage framework. Two major themes comprising of several subthemes emerged from the data: (1) The Role of Bahraini Secondary School Nurses, the need for nursing professional programs, and organizational structure. (2) Role conflicts of Bahraini Secondary School Nurses, lack of professional autonomy and collaboration, and the high ratio of students to Bahraini secondary school nurses. The implementation of a collaborative organizational structure between the two ministries (Ministry of Health and Ministry of Education) regarding school nurses’ roles, polices, and guidelines would facilitate and greatly enhance the current service, as would professional educational programs for the nurses who work in these school settings.

Keywords: school nurses, school nurses role, MoH, MoE

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Authors: Rnda I. Ashgar

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Introduction: Cardiovascular disease (CVD) is a leading cause of morbidity and mortality in women; negative psychological factors have been linked to an increased risk of CVD. Research indicates that these factors account for disparities in the prevalence and incidence of CVD among women; however, a comprehensive analysis of how these factors influence middle-aged women’s experiences is yet to be conducted. Aim: This study examined the literature on the influence of psychosocial factors on CVD experiences among middle-aged women. Method: The 2020 PRISMA guidelines were used to identify, screen, assess, and include articles on CVD among women. CINAHL, Psych-Info, and Web of Science databases were used to search for relevant studies. In total, 22 peer-reviewed English-language articles published between 2000 and 2024 were included. Results: The analysis revealed a consistent relationship between severe psychological conditions and symptoms and adverse cardiovascular outcomes, particularly in middle-aged women. Psychological conditions mediate the relationship between modifiable CVD risk factors (e.g., obesity, smoking) and CVD. Life stressors, including social support and perceived health, also influence CVD risk. Conclusion: The findings underscore the importance of integrating psychosocial health assessments with routine cardiovascular risk evaluations. Addressing psychosocial factors in clinical practice can help reduce CVD disparities among women and improve targeted interventions.

Keywords: cardiovascular disease, morbidity, mortality, psychosocial factors, women.

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Authors: Galgalo A. G., Nyakundi P. N., Várnagy A., Prémusz V.

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Background: Antenatal Care (ANC), is the leading indicators of improving maternal and child healthcare globally. This study investigated the effectiveness of a prototyped Global Position System (GPS) beaded bracelet intervention in enhancing maternal healthcare services uptake among nomadic communities. Methods: In this Randomized Control Trial (RCT), one hundred and seven pregnant women in their first trimester were randomly allocated to the intervention group (n=52) and control group (n=55). A GPS-beaded bracelet was given to the intervention group for the study duration of 16 months (6 months before delivery and 10 months after delivery). Meanwhile, the non-intervention group received routine antenatal care. The Pearson X2 test and multivariate logistic regression analysis were conducted using IBM SPSS version 27.0, following the Consolidated Standards of Reporting Trials (CONSORT) guidelines.The significance level was set at p<0.05. RCT was registered (ISRCTN15438206), and the GPS beaded bracelet was patented by Kenya Industrial Property Institutes (KIPI) NO: KE/UM/19/1211. Results: The majority of the participants in both the intervention 39 (75%) and control 31 (56.7%) groups were within the age group of 20-29 years, and over 40% walked over 15 kilometers to seek health care services. High illiteracy level was noted among intervention and control groups 48 (92.3 %) and 48 (87.3 %) respectively, with over 94 % of participants being multigravida. On their previous pregnancy history, the uptake of more than four antenatal care was 15 (28.8%). Women in the intervention group have nine-fold higher likelihood of having more than four ANC visits (AOR 9.13, 95% CI 1.75-47.54), compared to women in the control group. Other variables like age group, literacy level, and distance from health facility didn’t exhibit a statistically significant association. All three methods of model fit assessment indicated good model fit. Conclusion: The study result showed the effectiveness of GPS-beaded bracelets by significantly improving ANCattendance and reducing infant mortality. Future studies should focus on refining these technologies to explore the long-term impacts and scalability of such interventions across diverse nomadic populations to improve maternal and child healthcare.

Keywords: antenatal, pastoralist communities, global position system, pregnant women

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Authors: Enable Team, Emma Chademana, Linnea Stansert Katzen, Ondela Manjezi-Sokomani, Simthembile Lindani, Unarine Maluleke

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Background: The prevention of mother-to-child transmission (PMTCT) of HIV in South Africa has achieved significant progress. However, persistent challenges remain, particularly in remote rural areas such as the Eastern Cape, where late antenatal care presentation leads to delayed ART initiation and suboptimal adherence. Since 2016, One to One Africa has implemented the Enable Mentor Mother programme in these communities, aiming to eliminate vertical HIV transmission by ensuring that all pregnant and breastfeeding women know their HIV status and receive timely treatment and support. Structural barriers, including geographic isolation, limited healthcare infrastructure, and stigma, continue to hinder consistent access to essential PMTCT services in these regions. Methods: The programme deploys trained peer supporters, known as Mentor Mothers (MMs), who leverage mobile health (mHealth) technology to strengthen the PMTCT cascade. MMs enroll pregnant women, collect routine health data, provide adherence support, send appointment reminders, coordinate follow-up visits, refer clients to community nurses, and deliver health education. MMs also address psychosocial barriers to care by offering ongoing emotional support and building trust within their communities. Results: Between July 2023 and June 2024, the programme engaged 2,457 pregnant women, including 515 living with HIV. Of these, 97% (2,383) were aware of their HIV status, and 95% (487) of those living with HIV were on ART and adhering to treatment. Mental health screening using the PHQ-9 tool identified poor mental health in less than 1% (19) of participants. Notably, the programme achieved a 0% rate of mother-to-child HIV transmission during this period, highlighting the critical role of sustained support and early intervention. Conclusions: The Enable Mentor Mother programme demonstrates the effective integration of peer support to overcome barriers to timely antenatal care, ART initiation, and adherence in rural South Africa. By achieving high rates of HIV status awareness and ART coverage among pregnant women, and eliminating mother-to-child transmission in the target population, the programme makes a substantial contribution toward the elimination targets outlined in national PMTCT guidelines. These results underscore the importance of community-based interventions in closing persistent gaps in PMTCT services and advancing the goal of an HIV-free generation in South Africa. Replication and scale-up of this model may be vital in other underserved regions facing similar challenges.

Keywords: CHW, mentor mother, HIV/AIDS, PMTCT

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Authors: Aashvi Rauniar

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Beyond their role as primary care providers, physicians and health care service providers must assume leadership roles to positively influence staff engagement and patient outcomes during health care service delivery [5]. Aligning with the ‘practice and contextual’ leadership framework [1], research on the leadership process in the health care area warrants further investigation and validation. In leadership studies, authenticity means being true to oneself through actions and personal experiences [2]. AL, characterized by self-awareness, transparency, ethics, and relational integrity, encourages engagement [2] to provide high-quality care. Engaged health care staff, who feel supported and empowered [3], exhibit positive attitudes and compassionate care, leading to higher patient satisfaction rates (Shanafelt et al., 2015). According to [4], psychological meaningfulness (PM), safety (PS), and availability (PA) are three key drivers of employee engagement in the workplace. It is plausible that by fostering trust and promoting a supportive work environment in health care facilities, the AL style of the providers can enhance health care staff motivation and commitment, ultimately improving the quality of health care service delivery and patient experiences. Through a systematic literature review (SLR), this study aims to theorize and validate the relationship between the AL style of physicians and the three drivers of clinical staff engagement, i.e., PM, PS, and PA, and patient satisfaction. Using a multi-case study approach, the interview data would be analyzed using content analysis to validate the theoretical model of leadership, staff engagement, and patient satisfaction. Research on leadership in health care services and health care staff engagement is critical for improving patient care, as effective leadership fosters a motivated, cohesive team, leading to enhanced communication, higher service quality, and ultimately better patient outcomes.

Keywords: authentic leadership, health care staff, staff engagement, patient satisfaction

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Authors: Mardi Afrouz, Zare Maryam, Anbari Maryam, Nemati Ali, Shadman Atefeh

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Background: Infertility is a global health issue and multidimensional problem. Some of the factors influencing the prevalence and spread of infertility are malnutrition and inadequate nutrient intake, changes in lifestyle such as a sedentary lifestyle and consumption of fast foods, exposure to toxins, unhealthy eating habits, and obesity.The purpose of the study was to determine the rate of overweight and unhealthy nutrition in infertile women in Ardabil, Iran, 2023. Methods: A descriptive cross-sectional study was conducted on infertile women undergoing treatment at the infertility center in Ardabil. 304 eligible women were included in the study after obtaining written informed consent and using an convenience sampling method within a period of 9 months.The data collection tools consisted of a general characteristics questionnaire including demographic characteristics, height and weight, a food frequency questionnaire, and a 24-hour food recall questionnaire. Finally, food analysis was performed using Nutrition (N4) software. Results:The results of this study showed that the mean age of the infertile women was 30.62 ± 5.95, the highest frequency related to the level of education was high school diploma (77%), the BMI mean±SD was 26.06±4.77 and more than half of infertile women)59.86%( had an unhealthy diet. Conclusion:The results of the study indicated that the majority of infertile women had unhealthy diets and were overweight, which can have an undeniable impact on women's fertility status. Therefore, it is suggested that in addition to therapeutic interventions, special attention be paid to increasing awareness and making positive changes in the diet of infertile women.

Keywords: overweight, unhealthy nutrition, infertile, women, Ardabil, Iran

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Authors: Karen Coyne

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It is widely recognized that nursing is the most trusted, honest, and ethical profession. , . Therefore, it is hard to discern why patients report difficulty with nurses’ bias affecting their care. Perhaps this is due to the stigma surrounding certain medical conditions and vulnerable populations. Nurses, like everyone, have personal beliefs, values, and implicit biases that can affect their quality of care and thus their connectivity with their patients. Patient satisfaction can be improved by nurses’ simply recognizing their own beliefs, values, and biases that impact their nursing care. In the study, “Nurses Caring for Pregnant Women with Substance Use Disorder: Exploring Emotional Intelligence and Attitude”, Dr. Coyne(author) found a connection between emotional intelligence (EI) scores and implicit bias to medical conditions, specifically addiction. Additionally, there were definite correlations between EI, with variables such as loss in personal life from addiction, and how the nurse defined addiction as a choice, chronic condition, or both. The use of acronyms in education is not new, and the evidence suggests that it decreases time spent learning and improves performance. Utilizing this developed teaching strategy, an acronym was developed to address implicit bias before providing patient care. An intervention named PAUSE was developed and copyrighted by Dr. Coyne. The acronym PAUSE stands for P-pause before the encounter, A-assess and acknowledge your own values, beliefs, and biases, U-understand the medical condition, S-see the patient as an individual and E-encounter with empathy. This paper will explore the concept of utilizing an acronym to improve the EI of nursing students and nurses. The content of the PAUSE acronym will be validated by experts within nursing and education professions. Results are currently being collected and analyzed, and will be included in the final project.

Keywords: emotional intelligence, improved patient outcomes, educational intervention, acronym

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Authors: Harison Lagat, Elizabeth Bukusi, Jillian Pintye

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Background: Unintended pregnancy remains a public health challenge for adolescent girls and young women (AGYW) worldwide. Among AGYW in Kenya, sexual and reproductive health (SRH) services are often accessed in retail pharmacies, including emergency contraception (EC) and other family planning methods. Understanding factors associated with purchasing EC among AGYW at retail pharmacies in Kenya could inform pharmacy-delivered SRH services for this population. Methods: We analyzed data from an ongoing cluster-randomized trial comparing pharmacy-based PrEP delivery models among AGYW at 20 retail pharmacies in Kisumu, Kenya (NCT05467306). All AGYW (15-24 years) purchasing contraception (EC, oral pills, injectables, implants, condoms) at retail pharmacies were eligible. Data on sociodemographic characteristics, sexual behaviors, and reproductive health knowledge, attitudes, and practices were ascertained by trained study staff. Intimate partner violence (IPV) was assessed using the Hurt, Insult, Threaten (HIT) scale (0-10 points), using scores >10 to indicate IPV. We used Chi-square tests to compare the characteristics of AGYW purchasing EC versus other contraceptive products. Results: As of October 2024, 1,453 AGYW were enrolled in the trial; the median age was 21 years (IQR 19-23), and 11% were <18 years. Most AGYW (83%) were unmarried, 31% reported ≥1 sexual partner, and 54% reported a prior pregnancy. Overall, 12% had ever experienced IPV. EC was the most frequently purchased contraceptive method (48%), followed by injectables (22%), oral pills (15%), and condoms (13%). Among AGYW purchasing EC, 95% knew about long-acting reversible contraceptives (LARC) methods, but only 72% were currently using any method of contraception to prevent pregnancy; 65% reported any prior EC use. There was no difference in frequency of EC purchase among AGYW who were <18 versus ≥18 years (48% vs. 48%, p=0.974) or who experienced versus did not experience IPV (43% vs. 48%, p=0.594). AGYW enrolled in school more frequently purchased EC compared to those not currently enrolled in school (60% vs. 40%, p<0.001), as did AGYW who reported no prior pregnancy compared to those who reported a prior pregnancy (61% vs. 34%, p=0.001) and those who were unemployed versus employed (50% vs. 42%, p=0.01). Conclusion: AGYW seeking contraception at retail pharmacies often purchase EC, especially those who were attending school, unemployed, and without prior pregnancy. Although LARC knowledge was high, AGYW purchasing EC commonly was not using any other form of contraception. Retail pharmacies have the potential to reach AGYW seeking EC with other SRH services, including counseling on LARC, to address unmet SRH needs among AGYW.

Keywords: contraception, emergency contraception, LARC, AGYW

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Authors: Binu Mathew, Alolika Dolai, Joyce Joseph, Aditya Somani

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A qualitative analysis was conducted on the Primary Caregiver’s Experiences in Caring for Schizophrenia Patients. The study explores the experiences of primary caregivers of schizophrenia patients using a descriptive phenomenological approach. It aims to understand the physical, psychological, and environmental challenges faced by caregivers. The data was collected through semi-structured interviews from 9 primary caregivers who were caring the Schizophrenia Patients for at least 1 year. The samples were selected through purposive sampling. Each interview was conducted for 30 to 45 minutes. Braun and Clarke’s thematic analysis using NVivo software was used for analysing the data. There were three major themes emerged – physical experience, psychosocial experience and environmental experience. Caregiver Burden, Treatment Compliance, Symptom Challenges, Positive Aspects like resilience, empathy, and a sense of fulfilment, Negative Aspects like Stigma, financial burden, emotional exhaustion, Need for Support and Coping Strategies were the subthemes that emerged during analysis. The study concludes that Caregivers experience both positive and negative emotions in their roles.

Keywords: qualitative, primary care givers, schizophrenia patients, caring experience

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Authors: Dahabo Adi Galgalo, Shalini Chauhan, Kiptulon Evans Kasmai, Girma Alemu Wami, Ákos Várnagy, Viktória Prémusz

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Background: Improving maternal healthcare services is crucial to achieving sustainable development goal (SDG) number 3.1, which aims to reduce maternal mortality and morbidity. This can be done by providing antenatal care (ANC). The main objective of this study is to investigate the usage and factors associated with antenatal care services among pastoralist women in the pastoralist community in Moyale Sub-County, Marsabit County, Kenya. Methods: A baseline cross-sectional survey was conducted among 198 pastoralist women across 10 mobile villages. Data from 198 women who had given birth in the past two years before the survey was conducted were collected and analyzed for four or more antenatal care visits (ANC4+). The research identified the factors associated with the dependent variables. Results: Of the 198 women who participated, 180 met all eligible criteria and participated in the study, the average age was 27.44± 5.13 years, and the majority were in the age group between 20-29, which consisted of 60%, 92% were illiterate, 93.9% married, of which 33.3% practice polygamous marriage. The median commuting distance to health facilities was 15.00 km (10-74), and 41.7% attended more than four. Those women residing close to a health facility displayed a 5-fold higher likelihood of attending ANC 4+ visits (OR 5.30, 95% CI: 2.27-12.40). Women with a mobile phone had a higher likelihood of having ANC 4+ visits (OR 33.99, 95% CI: 7.42-155.70). Conclusion: In conclusion, the uptake of essential maternal health services is low among pastoralist women in Marsabit County, Kenya. Geographical proximity, village of residence, and possession of mobile phones for communication were very critical in predicting the use of maternal health care. Therefore, it's recommended that the Ministry of Health and stakeholders take the initiative to bring this service close to the pastoralist community by providing mobile health outreach services and facilitating access to mobile phones for communication.

Keywords: antenatal care, pastoralist women, pregnancy, Kenya

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Authors: Elena Dal Monte, Federica Cerana, Andreas Aceranti, Simonetta Vernocchi, Marco Colorato, Riccardo Dossena, Daniel Zaccariello, Massimo Colombo

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The study explores the concept of grief from a psychological, social, and behavioral perspective, analyzing its multiple aspects and its impact on individuals’ lives. The analysis begins with an understanding of the true meaning of grief, which is not limited to the loss of a loved one but represents a complex process involving emotions, perceptions, and subjective reactions. From a clinical perspective, grief is categorized as either normal (uncomplicated) or pathological (complicated), which is essential for understanding when pain follows a natural process of adaptation and when, instead, it becomes stuck in an emotional blockage. Diagnostic criteria for recognizing the different manifestations of pathological grief are explored, along with intervention strategies aimed at fostering a more functional elaboration of loss. Although theories outline universal stages of grief, this study questions their actual applicability, considering the variability of individual reactions. The social and cultural context plays a crucial role in shaping how grief is experienced and processed, influencing whether it is openly shared or confined to a private dimension. In an era where death is increasingly a taboo, the importance of grief education emerges, both for adults and children. Various intervention methods are analysed, including death education, support groups, and therapeutic techniques aimed at promoting greater awareness and acceptance of loss. Finally, the paper provides practical guidelines for those who wish to support a grieving person, emphasizing the importance of active listening, emotional validation, and empathetic presence. The ultimate goal is to contribute to a more conscious society, capable of embracing pain as an integral part of the human experience. The tools used in this study comes form the author personal experience gained from working closely with people in mourning and the various studies undertaken in recent years. The research was conducted with the aim of exploring the reality of living with grief, in order to raise awareness and support those who -still poorly informed about these topics- feel overwhelmed by social expectations.

Keywords: pathological grief, emotional adaptation, grief education, intervention strategies, social context of grief

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Authors: Claire Dosdale

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Introduction: Sexual assault is a form of sexual violence and abuse, it is a deeply violating experience for the survivor resulting in both immediate and long-term health implications. Sexual assault is a serious public health concern of epidemic proportions internationally, yet the number of people seeking support from healthcare remains low. Nurses’ roles are continually evolving, leading to increased responsibility, indicating nurses are significantly more likely to receive disclosures and/or support those who have experienced sexual assault; however, little is known whether the response and care received aid recovery for the survivor. This research addresses this gap in knowledge and gives an insight into the experiences of sexual assault disclosure to nurses through the perspectives of both survivors and nurses. Methods: A phenomenological approach was used to carry out this research, exploring the lived experience. Descriptive phenomenological methods were sought to capture the experience of both sets of participants. Seventeen participants taking part in this study (9 survivors/8 nurses) using non-dyadic interviews. Data was analysed using the descriptive phenomenological psychological method. Outcomes: Three phenomenological concepts are identified: authenticity, empathy, and embodiment. Survivors struggled to face their authentic selves, resulting in a lack of acceptance of the assault. Whilst all participants experienced empathy they were often not aligned, eg. survivors were searching for empathy at the same time the nurse turned away from their empathetic response (to compartmentalise). Facing the authentic self and the empathetic engagement resulted in an experience that embodied both sets of participants. Conclusion: This study demonstrated nurses must be trauma informed in their care and practice, only then will they be able to fully support survivors of sexual assault. Both sets of participants’ experiences are entrenched with underlying rape myth and victim blaming assumptions resulting in bias that impacts communication.

Keywords: sexual violence, sexual assault, gendered violence, phenomenology

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Authors: Nasra Abdelhadi, Gizell Green, Layalleh Masalha, Dvorah Cohen, Wesal Ghantous, Sarit Rashkovits, Nasra Idilbi

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Infant crying is a physiological response aiding adaptation, yet neonatal nurses face prolonged exposure to high levels of crying. The level of infant crying is a factor that has not been thoroughly studied to be best of the authors' knowledge. In this mixed-methods study, 210 nurses were surveyed using both quantitative measures and open-ended questions. The findings revealed that prolonged exposure to infant crying negatively impacts nurses' well-being and functioning, both during shifts and at home, leading to frustration, mental fatigue, and emotional distress. Ward design, including inadequate acoustics and procedural inefficiencies (e.g., workflow disruptions or noise levels), further intensified these negative effects. Policymakers must address these environmental and procedural factors to support the mental and emotional health of neonatal nursing staff, improving their performance and overall well-being.

Keywords: infant crying, neonatal departments, nurses, performance, psychological and emotional effects

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Authors: Pantouvaki Anna, Patelarou Evridiki, Zografakis-Sfakianakis Michael

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Hip fractures are the most common injury that occurs in 95% of falls in older people, causing reduced function and quality of life and are associated with significant morbidity, mortality, and increased healthcare costs. It is reported that 50% of patients do not regain their mobility prior to the fracture, while 40% of older people experience another fall within a year. Falls following a hip fracture can lead to more severe functional impairments, higher mortality rates and longer hospital stays. A lot of rehabilitation interventions are mentioned in the research field, aiming to regain mobility and patient independence and it seems that a multidisciplinary approach could be addressed for better functional outcomes. This study aims to highlight that fragility hip fracture rehabilitation is a multi-component issue and that rehabilitation management that includes exercise programmes and patient training could enhance muscle strength and functional outcomes, increase patient independence and reduce fear of falling. Thirty-two patients ≥ 65 years old, inpatients of the orthopedic department of a General hospital after a hip fracture surgery, participated in this randomized control trial. The intervention group received a supervised exercise programme and educational sessions two months after hip surgery, while the control group received only the usual care after hip surgery. A lot of standardized and reliable tools were used to assess muscle mass and strength, quality of life and fear of falling patients. The results showed that muscle strength, quality of life and fear of falling were statistically improved immediately after the application of the intervention programme, which is quite important for patient independence and safety as most of the secondary falls occur 6 months after hip surgery. More research must be held to design the gold standard rehabilitation management in hip fractures and prevention of secondary fall.

Keywords: fall prevention, hip fracture, rehabilitation, functional outcomes

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Authors: S. P. Bilankulu, A. Sunnasy, W. O. Jacobs

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Sexually transmitted infections (STIs) are pathogens spread mainly by unprotected sexual intercourse. STIs can be transmitted during pregnancy, childbirth, breastfeeding, and through infected blood. Some STIs can present symptoms or show no symptoms, and if untreated, they can lead to long-term effects. Undergraduate students must have adequate knowledge of STIs and their long-term effects to practice healthy sexual behaviours and prevent the spread of STIs. Undergraduate students are often involved in risky sexual behaviours due to low self-consciousness, peer pressure, and knowledge. The purpose of the study was to establish undergraduate students’ knowledge of STIs and their long-term effects and make recommendations to HEIs’ healthcare providers presenting health education programmes to facilitate undergraduate students’ knowledge about STIs and their long-term effects on their reproductive health. The research is about the knowledge that undergraduate students have about STIs and the long-term effects of STIs. A quantitative, descriptive, non-experimental, and contextual design was used to determine undergraduate students’ knowledge of STIs and their long-term effects. A simple random sampling method was used to determine the population for the study, which was 379 respondents. After the undergraduate students were approached, 379 respondents willingly participated and signed written consent. The respondents completed a self-report questionnaire, which was the data collection tool. The collected data were captured on an Excel spreadsheet and presented as descriptive statistics and frequency distribution using tables and figures. The statistician used the IBM SPSS version 28 software program to analyse the data. Validity and Reliability were adhered to throughout the research. Ethical clearance was obtained from the university and the higher education institution before data collection commenced. The response rate was 100%. The study’s findings provided an insight into undergraduate students’ knowledge of STIs and their long-term effects at a higher education institution. It allowed the researcher to make recommendations to healthcare providers presenting health education programmes to facilitate undergraduate students’ knowledge about STIs and their long-term effects on their reproductive health. This study’s findings indicated that respondents had some knowledge regarding STIs. However, some respondents lacked knowledge of the long-term effects of STIs, especially infections like syphilis, HPV, hepatitis B, and herpes. Health education should be continuous and evolving as the world evolves. Since the internet is the most preferred source of information, it is recommended that HEIs’ campus health and wellness centers dedicate a website for educational materials, such as videos and posters focused on sexual and reproductive health.

Keywords: student, knowledge, effects, STI

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Authors: Lily Parm, Irma Nool Mare Tupits, Ivi Prits, Merilin Kuhi

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Background: The results of previous clinical satisfaction surveys show that nursing students who underwent internships in the pediatric ward had the lowest satisfaction compared to other wards, but the quality of students' practical training experience is an important determinant in nursing education. The aim of the research was to describe nursing students` assessment to the clinical learning environment and supervision in pediatric wards Method: The research is quantitative. All students who had practical training in pediatric ward, participated in the study (N = 39). For data collection Clinical Learning Environment, Supervision and Nurse Teacher (CLES + T) evaluation scale was used, where the scale was answered on a 5-point LIkert scale. In addition, 10 background variables were used in the questionnaire. IBM SPSS Statistics 28.0 was used for data analysis. Descriptive statistics and Spearmann correlation analysis was used to find correlatins between background variables and satisfaction with supervision. Permission to conduct the study (No 695) has been obtained by the Ethics Committee of the Institute for Health Development.Results: Of the respondents, 28 (71.8%) were first-year, 9 (23.1%) second-year and 2 (5.1%) fourth-year students. The largest share of the last practical trainig was in nursing, with 27 (69.2%) respondents. Mainly the mentors were nurses for 32 (82,1%) of students. Satisfaction with the mentoring (4.4 ± 0.83) and ward nurse manager`s leaderhio style (4.4 ± 0.7), rated the highest and the role of the nurse teacher was rated the lowest (3,7 ± 0.83. In Spearmann's correlation analysis, there was a statistically strong correlation between a positive attitude towards the supervisor's supervision and receiving feedback from the supervisor (r =0.755; p <0.001), student satisfaction with supervision (r = 0.742; p <0.001), supervision based on cooperation (r = 0.77) and instruction based on the principle of equality that promoted learning (r = 0.755; p <0.001). Conclusions: The results of the research showed high satisfaction with the supervision and the role of ward manager. Still better cooperation is needed between practical placement and nursing school to enhance the students`satisfaction with supervision.

Keywords: clinical learning environments, nursing students, departmnent of pediatrics, practice supervisor

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Authors: M. Tupits, V. Raudsepp

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Background: An escape room is a game where a team of individuals must "escape" from a room filled with various tasks and challenges within a set timeframe. Recently, this concept has been increasingly utilized in health education across multiple fields as a teaching approach. Escape rooms demonstrate positive effects in several areas, including the practical application of knowledge and skills, collaborative learning, and the simulation of different clinical scenarios. The escape room approach enhances student motivation and fosters greater participation in the learning process. Interest in escape room activities has been notable among students of all genders. Moreover, these games can also be conducted online, allowing students to participate no matter their location. Feedback from students who took part in online escape rooms was encouraging, indicating that this method can be presented in engaging and effective ways across various formats and contexts. Objective: The aim of the study was to describe the satisfaction of third-year nursing students with the escape room method in pediatric nursing. Methodology: The research method is quantitative and descriptive, conducted in the spring semester of the 2022/23 academic year with a sample of third-year undergraduate nursing students. To assess nursing students’ satisfaction with the escape room method, "The development and psychometric testing of the Satisfaction with Simulation Experience Scale" was used. The satisfaction scale questionnaire included nine closed questions rated on a 5-point Likert scale. Data were analyzed using IBM SPSS Statistics 30.0. Descriptive statistics were used in data analysis, highlighting mean values, standard deviation, and median. Results: A total of 73 nursing students participated in the study, comprising 5 men and 68 women. Analyzing the results related to clinical reasoning and learning can be interpreted positively. The results of the questionnaire analysis about satisfaction with the escape room game show that most students agreed that the escape room enhanced clinical skills, knowledge, and developed teamwork. The mean value ranged from 4.34±0.74. A large proportion of respondents found the escape room to be a valuable learning experience and necessary for teaching pediatric nursing (4.78±0.52). Conclusion: The use of the escape room method has helped improve students' communication skills, problem-solving abilities, critical thinking, and teamwork. To further enhance nursing students' clinical learning experiences using the escape method, high-tech mannequins can be utilized in the future.

Keywords: game, escape room, learing, nursing education, nursing student

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Authors: Valentina Raudsepp, Mare Tupits

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Background— Reflective practice is crucial for advancing the skills of students and health care providers. The use of simulation accompanied by audio and video capabilities has the potential to redefine patient-centered care. This approach can be effectively integrated into the educational framework for nursing students and health care professionals. By reflecting on clinical experiences from the patient’s perspective repeatedly, knowledge can be more readily applied in hospital settings. Simulation as a technique in nursing education is a powerful learning strategy that enhances critical thinking and clinical judgment while fostering greater knowledge, selfefficacy, and confidence among students. Furthermore, incorporating gamification technology can increase student knowledge retention and boost engagement in the learning process. Objective—The goal is to create a simulation scenario, test it with a GoPro camera in basic nursing education, and describe student satisfaction with the learning experience. Methodology—The research method is quantitative and descriptive. The sample was made up of students of the third-year nursing curriculum of Tallinn Health Care College, who had studied Child Nursing in the fall semester 2021, a total of 38 students participated. A questionnaire was used to clarify the students' learning needs, and a scale (Simulation Satisfaction Experience Scale) was used to assess satisfaction. The scale consisted of sixteen questions, and the response options for the questions were structured on a Likert-type scale; the last one was an open-ended question. Statistical analysis IBM SPSS Statistics 26 Trial version was used to analyze the data. Results—Thirty-seven students responded to the questionnaire, representing 97.4% of the total sample. Among the respondents, 89.2% (n=33) were women, and 10.8% (n=4) were men.The results of the questionnaire analysis regarding satisfaction with the simulation scenario indicate that most students agreed that the simulation helped develop and assess their clinical skills and clinical judgment, enabled them to recognize patient deterioration, and allowed them to identify their strengths and weaknesses in a clinical situation (4.09 ± 0.75). Furthermore, most students found the simulation to be a valuable learning experience. They also approved the use of the GoPro camera during the simulation (4.45 ± 0.68). Conclusion—The GoPro camera increased student engagement and participation, as it had not been used in simulations before. All participating students were satisfied with the simulation scenario and recommended its continuation. In the future, new evidence-based simulation scenarios could be developed in collaboration with faculty members from different curricula. Additionally, in various modules, a GoPro camera could be used for simulations, as it allows the monitoring of the simulation process from the perspective of students in their respective roles. This provides a more detailed insight into the situation compared to the fixed cameras in the simulation center.

Keywords: GoPro camera, child with disability, scenario, simulation

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Authors: Ranjan Dhungana, Mala Chalise, Robert B. Clark

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Background: Global neonatal mortality necessitates access to immediate newborn care interventions. In Nepal, disparities persist in the readiness and availability of newborn care services within health facilities. Objective: This study aimed to assess this status and compare facilities that had implemented an intensive newborn resuscitation capacity building and retention programme in the past five years with those that had not. Methods: Our observational cross-sectional study involved 154 health facilities across Nepal. Through on-site inspections and maternal log reviews, we evaluated the immediate newborn care readiness and availability. Results: The mean immediate newborn care intervention availability score of 52.8% (SE = 21.5) and the readiness score averaged 79.6% (SE = 12.3). Encouragingly, 96% of facilities ensured newborns were dried and wrapped for warmth, and 69.9% provided newborn resuscitation. Practices such as delayed cord clamping (42.0%), skin-to-skin contact (28.6%), and early breastfeeding (63.5%) showed room for improvement. Only 16.1% of health facilities administered Vitamin K1 prophylaxis. Domain-specific scores demonstrated a high level of facility readiness in infrastructure (97.5%), medicine, equipment, and supplies (90.6%), and staff training (90.9%), but a lower score for neonatal resuscitation aids (28.8%). Disparities in readiness and availability were evident, with rural areas and the Madhesh province reporting lower scores. Variations among health facility types revealed provincial and private hospitals outperforming local-level facilities. A positive association was observed between the LDSC/SSN mentoring programme and both the readiness and availability of immediate newborn care services. Conclusion: This study highlights the gap between healthcare facility readiness and the actual availability of immediate newborn care interventions in Nepal. Addressing disparities and barriers, particularly in rural areas and local-level facilities, is crucial for improving neonatal survival. The positive link between the LDSC/SSN programme and service availability and facility readiness emphasises the significance of targeted training and mentorship programmes in enhancing newborn care across Nepal.

Keywords: newborn resuscitation, immediate newborn care, health facility readiness, neonatal morbidity, newborn care capacity

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Authors: Chung-min Fu, Tsui-ju Chen, Zhen-hua Dai, Tung-sheng Wu

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It has been the rising traction that TCMs (traditional & complementary medicines) have been resumed for home-caring scenario since the COVID suffering, and much sub-healthcare agenda becomes popular among ageing groups and even younger community, instead of visiting modern hospital, medical clinic or folk conditioning workshops, not mentioning more post-clinic self-treatments or follow-up practices at home. It is the best wish healthcare living styles, before the medical treatments, if the non-expertise, common people may also have the on-demand, cheaper, mobile and digital access to the related domains knowledge. In recent years, likely digital-twin healthcare platform (for example, basic skeleton model, acupoints as digital-twin database), approach and ecosystem could much ensure the home-caring practices, traceability, interactive communication, and even the tele-healthcare feasibility, for greater society impact.

Keywords: TCM, traditional & complementary medicine, healthcare, digital-twin, ecosystem, skeleton, acupoint, tele-healthcare

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Authors: Eunice Mutava

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Despite drug-resistant tuberculosis comprising 3% of the total caseload in South Africa, the disproportionate and prohibitive costs to manage it pose a threat to the stability of tuberculosis control programmes in South Africa, making the disease significant to public health. High costs may result in greater rationing of who gets treatment and for how long, to the extent that it may lead to policies that result in earlier termination of treatment than could have been the case with untreated cases re-entering the community. This study assessed the possible impact of enhanced ventilation provided by wind-powered roof turbines on the risk probability of tuberculosis transmission in a residential setting. For the study, eight houses were recruited, and using a paired technique, they were divided into intervention and control groups. Every intervention house had a wind turbine installed. The carbon dioxide (CO₂) tracer gas concentration decay technique was used. CO₂ levels were monitored using an infrared gas analyzer. The potential effect of wind-driven roof turbines on the transmission of tuberculosis was stochastically evaluated using the Wells-Riley mathematical model. While other factors, such as season and time of day, influenced CO₂ decay, the presence of the wind-driven roof turbine was the biggest predictor of its degradation, according to the mixed effects regression model. In comparison to control houses, the addition of a roof turbine doubled the absolute ventilation in intervention houses. Due to this, the Wells-Riley model predicted a twofold increase in the probability of infection in control houses, with 67–79% of susceptible individuals anticipated to become ill following an 8–hour exposure to an infected person compared to 42–53% in the intervention houses. To link designated inpatient health facilities where patients are first treated with home-based/community care when patients who are still infectious but have some chances of recovery are released, it is important to consider installing low-cost and low-maintenance wind-driven ventilation systems as an additional layer of protection in residential settings. This can help inform potential programs that allow for continued care and reduce infectious disease transmission.

Keywords: wind-driven roof turbine, carbon dioxide decay, Wells-Riley equation, tuberculosis, South Africa, resource-limited, residential, infection risk

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