Journal of Health Care and Research [ISSN: 2582-8967]

Anxiety is one of the most common psychological problems in older people and older people staying in geriatric centers are more vulnerable. This study aims to explore Anxiety and associated factors of older people staying in care facilities in Nepal.
This is a descriptive cross-sectional study. A total of 216 older people were recruited from geriatric centers of Kathmandu Valley, Nepal. Anxiety was assessed using Beck Anxiety Scale. Statistical software SPSS23.0 was used for data entry and analysis.
The mean of Anxiety was 13.23±6.84. The prevalence of anxiety disorder in the study population was 8.8 %, where 5.6 % of respondents had mild and 3.2% had moderate Anxiety. Results show gender, marital status, religion, type of previous family, chronic illness, stress, and type of living facilities were statistically significantly associated with anxiety. The difference was statistically significant (p<0.05). Depression and anxiety were also significantly positively correlated (r=0.232, p< 0.01).
Elderly people living in care facilities had slightly low levels of anxiety. Government and residential care facilities should be aware to provide appropriate support, care, and early psychological care during the intervention for the elderly so that it will help not to increase anxiety and other problems.

Objective: During the COVID-19 pandemic, screening mammography utilization declined nationally by nearly 65% compared to pre-pandemic volumes. This study assessed the impact of online screening mammography self-scheduling platform optimization on patient scheduling, rescheduling and cancellation rates during the COVID-19 pandemic.
Methods: A retrospective review of online SM scheduling utilization between October 1, 2019, and December 31, 2022 was performed. The electronic health record (EHR) was queried to extract the total number of SMs performed, online scheduling, rescheduling and cancellation rates during the busiest screening mammography months of October through December in 2019 and 2022.
Results: October to December online SM scheduling patient activity rose from 57 to 1481 patients when comparing 2019 and 2022 performance, representing a 26-fold increase in online platform utilization after EHR-tethered scheduling integration (p=0.013). This resulted in a concurrent 16x fold reduction in patient access specialist SM scheduling engagement. Concurrently, SM scheduling automation resulted in increases in appointment rescheduling and cancellation rates, from 14% to 22% (p=0.005) and 18% to 38% (p=0.000), respectively.
Discussion: Optimization of our online self-scheduling platform with EHR integration resulted in a 26-fold increase in online self-scheduling patient utilization and a 16x fold reduction in DI-PAS hands on SM scheduling engagement. The rates of OSS patient appointment rescheduling and cancellation also increased but the overall net gain in self-scheduling automation should not deter continued use and implementation of this program.

Background: With the proposal that people with undetectable serum viral loads of HIV cannot transmit, there is a large gap, either due to viral discordance or transcytosis, that would be explaining the persistent 4 to 7 percent vertical transmission of HIV to infants by Kenyan mothers.
Therefore, we looked for factors that predispose mothers with HIV to transmit the disease to their children so that policy can be generated for their screening to be conducted if they fit the specified criteria that identifies them as a high-risk group.
Methods: Through access to the National Database providing HIV treatment services country wide, we looked for the presence of the available factors from MTCT cases and assessed their association with increased risk of vertical transmission. The factors assessed were mother’s blood plasma viral load (BPVL), geographic location of the mother and child (associated with specific higher and lower socioeconomic status), gender of the baby being born, time age after birth with confirmation of Mother to Child Transmission (MTCT), method of feeding chosen by mothers, age of the mothers, and the regimen of Highly Active Anti Retro Viral treatment (HAART) that the mother and child had been given.
Results: Mixed breast feeding posed a much higher risk, mothers of a younger age posed a higher risk, residents of some areas were at higher risks, of note the town of Lamu in Kenya. The at birth stat administration of Niverapin with Zidovudin (NVP+AZT) to the baby was very effective against the transmission, in comparison to any of the other interventions, and having an UD BPVL led to a six-fold reduction the risk of MTCT.
Conclusion: There are factors that are associated with a higher risk of vertical transmission from pregnant and lactating UD BPVL mothers which warrant implementation of more stringent policy in their case to achieve Elimination of MTCT(EMTCT) in Kenya. Other factors that were not in the available records and the ones found to have an impact need to be investigated with more accuracy through a prospective study.