Public Health in Practice

BackgroundBlood donation and transfusion practices are very crucial for a health care system. This study aims to check the perceptions of Public about blood donation and transfusion practices in Allied Hospital, Faisalabad (Pakistan). Study Design and MethodsThe study used a qualitative exploratory design, conducting 20 semi-structured interviews with patients and attendees of the surgical and gynaecology unit at Allied Hospital, Faisalabad, from April to June 2023. Using Random sampling technique, data was collected from both donors and non-donors. Then, data was analysed using inductive thematic analysis, which involved identifying patterns and themes within the data. ResultsInitial analysis revealed various codes which were ultimately reduced to five main themes with their subthemes namely 1. Personal Factors with sub-themes (1a) Blood donation priorities, (1b) Family influence and Physical Attributes of donor, (1c) Socio economic status, (1d) Gender roles, 2. Consequences of transfusion and Donation; sub-themes (2a) Allergic reaction, (2b) Weight changes after Blood Donation, 3. Motivating Factors for Blood Donation; sub-themes (3a) Health Benefits, (3b) Humanitarian Factors, 4. Restriction Factors for Blood Donation; sub-themes (4a) Selling of Donated Blood, (4b) Substandard Blood Bank, (4c) Wasting of Donated Blood and 5. Awareness regarding blood donation. ConclusionThis study shows that religion, personal beliefs, family and friends, and socioeconomic status influence willingness of a person to donate. However, low understanding of benefits and risks is prevalent among Pakistanis, highlighting the need for counselling and health education activities.

iii.Background and ObjectivesThe "Pan-European Transfusion Research InfrAstructure" (PETRA) project was established to advance the use of donor, blood product, and patient datasets in Europe, aiming to benefit both patient and donor health. Here, the initial PETRA objective was to describe the landscape of existing donor and blood establishment (BE) databases. Materials and MethodsAn online survey was circulated to the European Blood Alliances BE members. The survey collected information on the feasibility of accessing donor data, and challenges and possibilities for linking these datasets with information on the associated blood products and transfusion recipients, and donors own health records. ResultsSeventeen BEs across 16 countries completed the survey. The majority could, in principle, link their donor data to product data (13 BEs (76%)) and recipient data (10 BEs (59%)), for research purposes. However, capabilities were limited and in only 29% of the BEs was the donor to recipients linkage an automated process. BEs reported significant challenges to achieve full vein-to-vein linkage, including legal constraints and lack of consent (11 BEs) and resources (10-14 BEs). IT and data issues as well as lack of knowledge and training were cited as obstacles by a minority of BEs. ConclusionWhilst the survey results suggest considerable interest in developing linkages between blood donors, their products, and recipients, many challenges remain due to a variety of obstacles. First steps in working towards a PETRA may be assistance to navigate legal frameworks as well as investing in resources and quality and harmonisation of data collections. iv. HighlightsO_LI17 blood establishments (BEs) in 16 countries responded to a survey on obstacles and opportunities for achieving vein-to-vein datasets. C_LIO_LIIn 59% of the BEs donor-to-recipient links can be established for research improving transfusion outcomes, but only in 29% this is an automated process. C_LIO_LIIn order to work towards a "Pan-European Transfusion Research InfrAstructure" (PETRA), legal frameworks, adequate donor consent and (financial and human) resources are the most common obstacles that require addressing. C_LI

ObjectivesTo know and explore from convalescent plasma donators voices the experience in the blood donation process at a Peruvian social security hospital. MethodsQualitative study with a phenomenological design. The investigation was carried out in 01 hospitals of the social security of Peru. Semi-structured interviews were carried out. ResultsEleven donors of convalescent plasma were interviewed. The main motivations for donating were being able to contribute to national research and supporting patients affected by COVID-19. Fears focus on the possible risk of contagion within the hospital. Donors emphasised the attention and support of health personnel alongside the donation procedure. The main expectations and suggestions point towards greater dissemination of donation campaigns with special emphasis on safety. Likewise, an improvement in the time of the donation procedure (from enrolment to the extraction of convalescent plasma), and the implementation of friendly spaces to encourage future blood donation campaigns were highlighted. ConclusionsThe experience of the convalescent plasma donors was positive. However, improvements must be made in terms of processes and infrastructure to ensure future successful blood donation campaigns.

ObjectivesThis study will identify blood donor characteristics in Jordan. The study aims to investigate the extent of awareness and knowledge regarding blood donation among blood donors and to explore their attitudes towards blood donation in general. It also highlights various motivational factors and obstacles which impact the decision to donate blood among Jordanian donors. BackgroundRecruitment of low risk blood donors can be challenging. Efforts should be made to increase the level of awareness and positive attitude toward blood donation. An essential step to achieve this is obtaining comprehensive data about the current situation of awareness, knowledge, and attitudes of the population towards blood donation. Methods/MaterialsThe present study was conducted at two blood donation centers in Amman, Jordan, during 2021. A total of 535 whole blood donors were included. Data regarding their demographic characteristics, blood donation history as well as their knowledge and attitudes regarding blood donation was collected by a questionnaire. ResultsFour hundred ninety participants (91.6%) were males while 45 only (8.4%) were females. One hundred forty subjects (19.4%) were first time donors while 431 subjects (80.6%) had previous donations. The participants median score in the knowledge section was 19.0 points (range 5-25 points). There was no significant correlation between participants overall attitude score and their corresponding demographic characteristics or their overall knowledge score. ConclusionMeasures to improve knowledge and attitude toward blood donation should be implemented in order to meet the increasing demand for blood and blood components. Targeted campaigns, correction of some misconceptions, and using different motivations are suggested.

IntroductionDespite high injury mortality rates, Cameroon currently lacks a formal prehospital care system. In other sub-Saharan African low and middle-income countries, Lay First Responder (LFR) programs have trained non-medical professionals with high work-related exposure to injury in principles of basic trauma care. To develop a context-appropriate LFR program in Cameroon, we used trauma registry data to understand current layperson bystander involvement in prehospital care and explore associations between current non-formally trained bystander-provided prehospital care and clinical outcomes. MethodsThe Cameroon Trauma Registry (CTR) is a longitudinal, prospective, multisite trauma registry cohort capturing data on injured patients presenting to four hospitals in Cameroon. We assessed prevalence and patterns of prehospital scene care among all patients enrolled in a prospective, multisite trauma registry (Cameroon Trauma Registry (CTR)) in 2020. Associations between scene care, clinical status at presentation, and outcomes were tested using univariate and multivariate logistic regression. Injury severity was measured using the abbreviated injury score. Data were analyzed using Stata17. ResultsOf 2212 injured patients, 455 (21%) received prehospital care (PC) and 1699 (77%) did not receive care (NPC). Over 90% (424) of prehospital care was provided by persons without formal medical training. The most common prehospital interventions performed included bleeding control (370, 57%) and fracture immobilization (139, 21%). PC patients were more severely injured (p<0.001), had markers of increased socioeconomic status (p=0.01), and longer transport distances (p<0.001) compared to NPC patients. Despite increased severity of injury, patients who received PC were more likely to present with a palpable pulse (OR=6.2, p=0.02). Multivariate logistic regression adjusted for injury severity, socioeconomic status and travel distance found PC to be associated with reduced emergency department mortality (OR=0.14, p<0.0001). ConclusionsAlthough prehospital injury care in Cameroon is rarely performed and is provided almost entirely by persons without formal medical training, prehospital intervention is associated with increased early survival after injury. Implementation of LFR training to strengthen the frequency and quality of prehospital care has considerable potential to improve trauma survival. LFR training in Cameroon should target commercial drivers given high work-related exposure to the injured and emphasize bleeding control interventions.

BackgroundCollege campuses are a common setting for sexual violence prevention efforts. Those efforts are often focused solely on students, though implementation theory suggests that campus faculty and leaders must be engaged for successful implementation. This is especially true in low- and middle-income countries, where resources are scarce and norms may support sexual violence. Little research has examined knowledge attitudes and beliefs around sexual violence and implementation readiness. We present findings from a faculty survey at seven Universities across Vietnam which assessed knowledge, attitudes, and beliefs, along with the acceptability and feasibility of sexual violence prevention programming. Method2343 faculty (68% response rate) at seven Universities in Vietnam were surveyed preceding the implementation of the GlobalConsent intervention. Faculty reported on demographics; measures of knowledge, attitudes and beliefs (KAB) about sexual violence; and perceptions of the acceptability and feasibility for sexual violence implementation programming at their University. Analyses present descriptive data for key KAB measures, variation in KAB measures by key demographics, and regression models predicting implementation readiness. ResultsFaculty did not believe sexual violence was rare or problematic at their University, and while they tended not to endorse rape myths about victims, they tended to endorse rape myths about perpetrators, and beliefs supporting the need for sexual consent were moderate. Faculty did report positive campus climate for victims of sexual violence and believed sexual violence programming was acceptable and feasible. Female and younger faculty generally had more progressive mean scores for KAB measures. Several KAB measures related to the perceived feasibility and acceptability of sexual violence prevention programming, but the single strongest predictor of perceived feasibility and acceptability were perceptions of leader support for a positive campus climate around sexual violence. ConclusionFaculty perceived sexual violence prevention programming as both feasible and acceptable, and this was strongly related to university leaderships support for a positive campus climate around sexual violence. Cultivating visible and consistent leadership support appears to be crucial to fostering faculty buy-in and enhancing prevention efforts. Interventions should address faculty KAB and actively engage institutional leaders; this is key to creating a supportive climate for victims of sexual violence.

IntroductionThe ABO blood group system was the first human blood group system discovered by Austrian scientist Karl Landsteiner in 1901. The ABO blood group system is divided into four blood types on the basis of presence or absence of A and B surface antigens A and B antibodies presence in the plasma. Positive and Negative of the blood group determines by presence or absence of the D antigen.. ObjectivesThis study was carried out to determine the distribution pattern of blood groups among blood donors at a tertiary care hospital of Puducherry Materials and MethodsIt is a retrospective study done a period of 5 years from May 2017 to May 2022 that includes the 9062 blood donors. Blood group done as per the standard operative procedure. Data on the ABO and Rh blood group type of all blood donors was collected and analysed. ResultThe most common ABO blood group type was Group O (38%) followed by group B (33.5%), group A (21.6%) and group AB (6.9%) and one Bombay blood group. The distribution of Rh(D) blood group type revealed 92.5% as Rh-positive and 7.5% as Rh-negative. ConclusionThe most common ABO blood group type in our region (Puducherry) is Group O followed by B and A while, AB and Bombay groups are the least common type. Knowledge of the blood group distribution pattern is essential for the effective delivery of blood banking services.

BackgroundOn 26th, February 2020, first cases of COVID 19 were confirmed in Pakistan. Since then, surgeries were halted in a bid to prevent transmission. However, since such a long halt is infeasible, a general protocol of screening the carriers, especially asymptomatic carries, is a dire need of time. The objective of our study is to propose an economically feasible protocol of COVID 19 screening. Simple but effective screening strategies can help to restore the workings of hospital surgical departments. MethodsWe analyzed the clinical data of patients turning up for elective surgeries at the Rawal General Hospital (RGH), Islamabad from the 24th of March to the 15th of May, 2020. Asymptomatic patients with negative COVID 19 contact and travel histories were screened with COVID 19 Immunochromatography (ICT) IgM / IgG Ab Test. Complete blood count (CBC) was done and interpreted in conjunction with the ICT results. Results39 patients with a mean age of 49 years were studied. The result of ICT for COVID-19 was positive in 9 cases (23%). The entire positive ICT patients population expressed significantly lower lymphocyte count (p<0.01); 8 patients had high monocyte count (p<0.05) whereas only 4 patients had a combined high neutrophil and monocyte count (P<0.05). All of these four patients with high neutrophil count were females. The combined interpretation of CBC and ICT IgM / IgG Ab Test had a high accuracy in diagnosing asymptomatic COVID-19 carriers that were later confirmed by real-time reverse transcriptase-polymerase chain reaction (rRT-PCR). ConclusionWe propose that joint CBC-ICT interpretation should be adopted on a large scale to help in the diagnoses of asymptomatic carriers as both tests are simple and inexpensive and thus suit the developing countries limited health budget. Future research projects should be adopted in order to assess the accuracy of the proposed protocol on a large scale.

IntroOn August 14, a magnitude 7.2 earthquake occurred in the South of Haiti, killing over 2,200 people and leaving at least 12,000 injured. On August 17th, a joint task force coordinated the triage, treatment, and transport for patients arriving at the Port-au-Prince airport from the South. MethodsFrom August 17th-27th, approximately 243 patients were encountered at the Port-au-Prince airport. For the first three days of operations, written notes, reports, and various chat logs from WhatsApp were used to compile this data. Results243 patents were encountered at the airport Triage and Treatment from August 17 to August 27. Orthopedic injuries were the most common presenting injury with 20% of patients having a pelvis fracture (the most prevalent injury). Of the 174 with known transfer destinations, 118 (68%) were transported to one of three tertiary care hospitals, with 99 going via ground ambulance to the two in Port au Prince, and 19 going via HAA helicopter to Mirebalais. Once treatment operations were initiated, 106 patients received some form of treatment at the airport while awaiting transport. DiscussionInteragency coordination was the key to rapid scale up. To address the most prevalent patient issues, a treatment bundle was conceptualized a few days into operations that consisted of IV fluids, analgesia, IV antibiotics, wound debridement and cleaning, and tetanus prophylaxis.

BackgroundThe management of Covid-19 outbreaks presented particular challenges in the prison setting. In this study we describe the results from the implementation of a serial mass testing approach in two adult prisons in northern England. The overall aim was to examine the epidemiology of Covid-19 outbreaks in prisons and help inform public health policy and practice during the pandemic. MethodsRepeat mass testing was offered to all eligible staff and residents in a womens (nresidents=239; nstaff=246) and a mens (nresidents=703; nstaff=340) prison in February and March 2021 at days 0, 7 and 28 after Covid-19 outbreaks were declared. Positive swab samples were sent for viral whole genome sequencing by COG-UK. FindingsParticipation in at least one testing round ranged from a low of 67% of staff in the mens prison to a high of 98% of residents in the womens prison. The largest outbreak, in the mens prison (261 cases in residents and 37 cases in staff), continued to see new cases identified at the last testing round on day 28. Test positivity in residents of both prisons was significantly lower (p<0.05) at day 28 than on preceding test days, but no significant difference was observed for staff (p>0.05). Epidemiological data in conjunction with sequencing information provided evidence for multiple introductions of the SARS-CoV-2 virus from the local community into the prisons, with transmission identified both within wings and between wings among residents and staff. Two distinct SARS-CoV-2 lineages were identified in the womens and mens prisons, B.1.177 and B.1.17, respectively. ConclusionsDuring a Covid-19 outbreak, timely implementation of a whole prison testing regime can serve to inform a targeted approach to infection prevention and control by identifying the true extent of disease transmission in all (including asymptomatic) individuals. Staff, in particular, should be tested regularly and testing uptake should be as high as possible to minimise the risk of infection incursion. Ensuring high testing uptake across all testing rounds remains a challenge.

It is estimated that 81% of the 163 UK Higher Educational Institutes (HEIs) have more than a 50% chance of having at least one COVID-19 case arriving on campus when considering all staff and students. Across all HEIs it is estimated that there will be a total of approximately 700 COVID-19 cases (95% CI: 640 - 750) arriving on campus of which 380 are associated from UK students, 230 from international and 90 from staff. This assumes all students will return to campus and that student numbers and where they come from are similar to previous years. According to the current UK government guidance approximately 237,370 students arriving on campus will be required to quarantine because they come from countries outwith designated travel corridors. Assuming quarantining is 100% efficient this will potentially reduce the overall number of cases by approximately 20% to 540 (95% CI: 500 - 590). Universities must plan for COVID-19 cases to arrive on campus and facilitate mitigations to reduce the spread of disease. It is likely that the first two weeks will be crucial to stop spread of introduced cases. Following that, the risk of introduction of new cases onto campus will be from interactions between students, staff and the local community as well as students travelling off campus for personal, educational or recreational reasons.

IntroductionThe rates of request and use of blood concentrates are still poorly reported in the literature. This study aimed to analyze the rates of requests for blood concentrates and their use in patients undergoing emergency surgery in a teaching hospital. MethodsA retrospective, quantitative and descriptive study was conducted in 359 medical records of patients in urgent surgery scheduled with a request for a reserve of blood concentrate. The ratios between crossmatched and transfused units (C/T), transfusion index (TI), and probability (TP) were calculated, and the times between request and delivery at the transfusion agency (TA) and patient admission to the surgical center (SC). ResultsThe mean age was 58.5 {+/-} 22.2 years, with the majority being male (53.1%). There was an average of 27.5 monthly requests (min 12, max 44). Ninety-seven units of blood concentrates were transfused into 44 patients (C/T ratio 7.59; TI 0.27; TP 12.3%). Only seven patients had their requests made after admission to the OR. The median time between the request and arrival at the TA was 1h15min, while that between the request and the patients arrival at the SC was 5h23min. There was greater transfusion in major surgery (major 37, 14.8% vs. medium 7, 6.5%; p = 0.027) and non-orthopedic surgery (orthopedic 9, 4.0% vs. non-orthopedic 35, 26.9%; p < 0.001). Conclusionthere was a significant discrepancy between the number of requests for blood reservation and its real use and an increased time between reservation requests and their arrival at the TA.

BackgroundHealthcare authorities have generally advised against wearing glove by the general population. However, the use of gloves has become a common sight in public places raising the question of the necessity of glove wearing practice by the general population ObjectiveThis study aims to investigate the prevalence and types of glove used as well as the acceptance of the glove practice by individuals visiting the high-risk area during Covid-19 pandemic. SettingThis prospective observational study was conducted among individuals visiting a wet market and district specialist hospital During Covid-19 pandemic. The required data was recorded based on observation by trained data collectors who were stationed at the strategic entry point. MethodsIndividuals entering through dedicated entry point were observed for the type, category and practice of wearing personal protective equipment. Inclusion criteria for this study were any individuals entering the facilities from entry points without respiratory symptoms. Exclusion criteria for this study were individuals less than 2 years old, visiting the emergency department, facility staff, individuals who are suspected of multiple entry and individuals who are exiting the treatment facility entrance. Patients were categorized into two groups of acceptable and unacceptable glove practice. The Pearson chi-square was used to test for differences in investigated variables in the univariate setting. Main outcome measurePrevalence, acceptance of glove wearing practice. ResultsA total of 75 individuals (2.3%) compromising of 45 (60.0%) individuals from hospitals and 30 (40.0%) individuals from wet markets were seen wearing glove amongst 3322 individuals observed during the data collection period. A higher proportion of individuals visiting wet market (30.0%) were observed with unacceptable glove practice compared to individuals visiting the hospital (8.9%), {chi}2 (1) = 5.60, p = .018. Similarly, a Higher proportion of glove use among non-Malay (53.3%) compared to Malay (46.7%) was observed in hospital compared to a higher proportion of glove use among Malay compared to non-Malay (16.7%) visiting wet market, {chi}2 (1) = 10.20, p = .001. As for glove use, we found that male were using more medical-grade glove (78.8%) compared to non-medical grade glove (21.2%) while an equal amount of medical (50.0%) and non-medical grade glove (50.0%) was used among female, {chi}2 (1) = 6.546, p = .011. Besides, we found that higher proportion of individual using medical-grade glove was using medical grade facemask (68.3%) which was similar to the proportion of individuals using non-medical glove was using non-medical facemask (66.7%), {chi}2 (1) = 5.25, p = .022. ConclusionWe present the prevalence and characteristics of glove wearing practice in high-risk location during the current COVID-19 outbreak in Malaysia. Facing a worldwide public health emergency with limited effective clinical treatment, the role of glove-wearing in mitigating COVID-19 transmission is questionable. If needed, the compliance to proper glove-wearing could be improved through targeted public health education

Mozambique implemented in 2021 a formative assessment in 22 prisons to identify the operational and logistical needs for the second round of the Biobehavioral Survey (BBS). We discussed barriers and facilitators that could be anticipated in conducting BBS in prisons, in preparation for implementation, structured interviews with key informants with directors and other staff were administered. The data were cleaned and analyzed in Microsoft Excel, and the categorical variables were summarized by means of simple frequencies and percentages. In most prisons the actual prison capacity far exceeds the theoretical capacity, 40.9% have a theoretical capacity of [&ge;] 50 inmates, 81.8% have inmates who exceed their theoretical capacity. In the country half of the prisons receive only male inmates, and only one female, 54.5% of the prisons visited have inmates under 18 years of age, 72.7% of the prisons had a private space available for the survey, the penitentiary establishments have the physical space for study; ensuring the safety of staff within the facilities; involvement of correctional officers and a clinical focal point. However, barriers such as time management due to prison opening hours, prison laws, restrictions, or permits for research may change without notice due to security, lockdowns, riots, or other situations that may hinder the implementation of research. Currently, little is known about the implementation of a BBS in a correctional environment and only a few barriers can be anticipated, for Mozambiques context, these challenges and obstacles can be overcome through clear communication and collaboration with officials at all levels.

BackgroundHuman trafficking is considered a hidden global threat with unsubstantiated numbers despite the estimation of the presence of around 40.3 million victims worldwide. Human trafficking results in severe detrimental impacts on both mental and physical health. Given the sensitivity and negative consequences of human trafficking on the global system and victims, and considering the scarce research in this area, our current study aimed at describing the (i) Sociodemographic profiles of anonymized victims, (ii) Means of control, and (iii) Purpose of trafficking, utilizing the largest anonymized and publicly available dataset on victims of human trafficking. MethodsThis is a retrospective secondary analysis of the Counter-Trafficking Data Collaborative (CTDC) data pool in the period from 2010 to 2020. The utilized dataset is called the k-anonymized global victim of trafficking dataset, and it is considered the largest global dataset on victims of human trafficking. Data from the k-anonymized data pool were extracted and exported to Statistical Package for Social Sciences, SPSS(R) version 27.0 for Windows (IBM Corp. Version 27.0.Armonk, NY) for quality check and analysis using descriptive statistics. ResultsA total of 87003 victims of human trafficking were identified in the period from 2010 to 2020. The most age category encountered among victims was 9-17 years with around 10326 victims (11.9%), followed by 30-38 years with 8562 victims (9.8%). Females comprised 70% of the sample with 60938 victims. The United States (n=51611), Russia (n=4570), and the Philippines (n=1988) comprised the most countries of exploitation/trafficking. Additionally, the year 2019 witnessed the greatest number of victims registered for assistance by anti-trafficking agencies with around 21312 victims (24.5%). Concerning means of control, threats, psychological abuse, restriction of the victims movement, taking the victims earnings, and physical abuse were the most reported means. Around 42685 victims (49.1%) reported sexual exploitation as the purpose of their trafficking, followed by forced labor with 18176 victims (20.9%). ConclusionVarious means and methods can be used by traffickers to control the victims to be trafficked for many purposes, with sexual exploitation and forced labor being the most common ones. Global anti-trafficking efforts should be brought together in solidarity through utilizing the paradigm of protection of victims, prosecution of traffickers, prevention of trafficking, and inter-sectoral partnerships. Despite being a global concern with various reports that tried to capture the number of trafficked victims worldwide, human trafficking still has many unseen aspects that impose a significant challenge and adds to the global burden in combatting this threat.

BackgroundFresh frozen plasma is a critical substitute therapy in management of bleeding. Increased risk of venous thrombosis has been described to be associated with high plasma levels of several coagulation factors. MethodologyThis study was a longitudinal study involving time series analysis of fresh frozen plasma stored at -18{degrees}C for five weeks. A sample of 180 ml plasma was obtained from the blood centrifuged at 4000rpm which was aliquoted into three parts each containing 60ml. The first aliquot was used to assess the changes in coagulation factors in FFP at baseline during the first week of sample collection, the second aliquot was used to assess the changes in coagulation factors in FFP storage at -18{degrees}C temp after three weeks of storage, the third aliquot was used to assess the changes in coagulation factors in FFP storage at -18{degrees}C temp after five weeks of storage. Coagulation factor analysis was performed using Erba Mannheim ECL 105 coagulation analyzer, India factor results recorded. Thawing for subsequent coagulation factor analysis and serial testing of stored cryoprecipitate and fresh frozen plasma was done using Stericox Plasma Thawing Bath at 37{degrees}C, for 45 mins before before analyzing the samples. Standard storage conditions for the aliquots were monitored and maintained to ensure homogeneity. ResultsThe findings showed significant changes in the coagulation factors in FFP during storage at -18 for a period to five weeks with chi-square value of 216.000 and asymptomatic significance value (p-value) <0.0001* less than the standard alpha 0.05. ConclusionThere was a constant decrease of coagulation factors in fresh frozen plasma during storage at -18{degrees}C for 5 weeks at Kisii Teaching and Referral Hospital, Kisii County.

BackgroundVenous thromboembolism (VTE) is common and preventable disease among non-surgical hospitalized patients. Its incidence is high and alarming. Acute medical patients have VTE risk during and after hospitalization. Padua prediction score is a risk model created to identify high VTE risk patients among non-surgical hospitalized patients. MethodsWe performed a cross-sectional survey of 107 patients admitted in Internal Medicine wards that were assessed as acute ill patients at Emergency Department, in a period of 4 weeks. The demographic and clinical data were collected using a designed questionnaire. VTE risk was defined as having a Padua Prediction score of [&ge;]4 points. Statistical analysis was done to determine prevalence. The patients at high VTE risk received thromboprophylaxis. ResultsOf one hundred and seven eligible patients included. 84% were found with high VTE risk. Among physiologically unstable patients, 60% of the patients were classified in red color during the time of triage, this means, they were severely sick and needing resuscitation. Among leading diagnosis, severe pneumonia was predominant (29%). Severe pneumonia and uncontrolled DM showed significant association with high VTE risk. 11.1% of high VTE risk patients were taking anticoagulant thromboprophylaxis prior to the recruitment. ConclusionThis study demonstrated a high prevalence of VTE risk among acute ill medical patients and underuse of anticoagulants thromboprophylaxis in potential patients at Kigali University Teaching Hospital, CHUK. Padua prediction score should be implemented for early detection of patients at-risk of VTE in severely ill patients and start anticoagulant thromboprophylaxis on time for reducing mortality and morbidity.

ObjectiveThis study aimed to evaluate the impact of combined use of chemiluminescent immunoassay (CLIA) and nucleic acid amplification testing (NAAT) to improve transfusion transmitted Hepatitis B Virus (HBV), Hepatitis C virus (HCV) and Human Immunodeficiency Virus-1 (HIV-1) among blood donors in Pakistan. DesignRetrospective, single center observational. SettingRegional blood center at tertiary care hospital in urban Pakistan. ParticipantsAll adults of 18 years or above who were eligible to donate blood after meeting the pre-donation screening criteria during the study period (n = 26,778). Outcome MeasuresPrimary outcome measure was to estimate the incremental yield of HBV, HCV, and HIV-1 infections using combined CLIA+NAAT compared to CLIA-alone per 100,000 donations. Secondary outcome was to calculate inter-test agreement and discordance between CLIA and NAAT methods. ResultsAmong 26,778 donors, the combined CLIA+NAAT testing detected a total of 2,423.6 viral infections per 100,000 donations, NAAT alone contributed 739.7/100,000 of these. For HBV, NAAT uniquely detected 489/100,000 additional cases missed by CLIA; the combined detection rate was 1,561/100,000. For HCV, NAAT-only yield was lower (247/100,000), with total detection of 825.3/100,000. HIV-1 was rare in the donor pool; incremental NAAT yield was 3.7/100,000, with a combined detection rate of 37.3/100,000. Agreement between tests was substantial for HBV ({kappa} = 0.63) and moderate to fair for HCV ({kappa} = 0.47) and HIV-1 ({kappa} = 0.40). The discordant cases detected by NAAT alone for HBV, HCV and HIV-1 were 183, 431 and 37 respectively. McNemars test showed statistically significant differences (p < 0.001) across all markers, with large effect sizes for HIV-1 (0.92, 95% CI: 0.80-1.00) and HCV (0.69, 95% CI: 0.65-0.73). ConclusionIntegrating CLIA with NAAT enhanced the detection of HBV, including occult and window period infections, and refined estimates of active HCV and HIV-1 infections which significantly improved blood transfusion safety. STRENGTHS AND LIMITATIONS OF THIS STUDYO_LIThe selection bias was reduced by including all consecutive eligible blood donors during study period. C_LIO_LIThe information bias was minimized through uniform, fully automated, and validated protocols for combined CLIA and NAAT testing of blood donors. C_LIO_LIThe single center retrospective study design restricts generalizability and causal inference. C_LIO_LIThe false positives/negatives and genetic variability were not confirmed. C_LI

Background and ObjectivesLiquid plasma (LQP) stands out as an alternative to thawed plasma (TP) for emergent transfusions due to longer shelf life. We aim to measure fibrinogen, Protein C, Protein S, FV, FVII, and FVIII activity in LQP, quantify how these factors levels change during storage, and characterize how they compare in LQP to TP. Materials and MethodsCoagulation factor activities were measured on Days 15, 26, and 27 for LQP (n=26) and Day 5 for TP (n=31). Bayesian statistics was used to compare coagulation factor activity and quantify changes in activity during storage. ResultsFibrinogen and Protein C activity in Day 26 LQP (LQP26) was comparable to Day 5 TP (TP5) with posterior mean activity of 257 mg/dL vs 246 mg/dL and 100.4% vs 108.7%, respectively. FV, FVII, and FVIII had lower activity in LQP26 vs TP5 with posterior mean activities of 42.6% vs 72.0%, 55.0% vs 59.7%, and 48.8% vs 59.2%, respectively. Protein S in LQP26 was low with posterior mean activity of 28.0%, which was less than half that of TP5 at 66.4%. From Day 15 to Day 26, FVII in LQP decreased at a rate of -3.49% per day whereas fibrinogen, Protein C, Protein S, FV, and FVIII activity in LQP remained relatively stable. ConclusionCompared to TP5, LQP26 has comparable activities of fibrinogen, Protein C, FVII, lower activities of FV and Protein S, and slightly lower activity of Factor VIII. LQP is a viable alternative for use in emergency transfusions and massive transfusion protocols. Highlights- Liquid plasma has comparable activities to thawed plasma for fibrinogen, Protein C, and Factor VII, which is advantageous for emergency use due to its extended shelf life. - Liquid plasma has adequate fibrinogen and Protein C levels on the last day of expiration. - Liquid plasma has [~]50% FV, FVII and FVIII activity levels on the last day of expiration, making it a sufficient replacement option to TP for active bleeding.

ObjectivesTo explore the delivery of the train the trainer (TtT) model for Making Every Contact Count (MECC) training in the North East and North Cumbria (NENC) region of England. DesignA qualitative study, utilising semi-structured interviews. MethodsInterviews were conducted with 21 participants, including MECC TtT trainees (n = 13), eligible non-trainees (n = 6), and principal trainers (n = 2). Data analysis utilised the Framework Method guided by the Theoretical Domains Framework (TDF), and meta-themes were generated that transcended individual TDF domains. ResultsFour meta-themes were identified; the need for psychological preparedness to deliver MECC training, successful cascade is influenced by the MECC training content, limited accessibility of the pedagogical approach to both MECC TtT and MECC training, and a need to shift the focus from quantity to quality of MECC training cascade. ConclusionsThe TtT model potentially provides unique value for delivering high quality MECC training at scale, providing trainers feel ownership over and able to deliver MECC training. A skills-based approach to MECC training and an experiential learning approach to MECC TtT training is recommended. The MECC TtT programme should provide clear expectations of cascade at sign up stage, allow trainers to adapt content, and evaluate success based on quality. Data availability statementFully anonymised transcripts were uploaded onto the UK data service, publicly accessible here: https://reshare.ukdataservice.ac.uk/857461/. The pre-registered protocol is available on Open Science Framework, publicly accessible here: https://osf.io/xz8au.