Objective: To assess the quality and performance of public hospitals in Erbil Governorate, Iraq. Methodology: This cross-sectional, multicenter mixed-methods study was conducted in all 13 public hospitals under the Directorate General of Health in Erbil Governorate, Kurdistan Region of Iraq, between the 1st of October 2023 and the 1st of October 2025. Hospital quality was evaluated using a psychometrically validated Iraqi-adapted Kayakalp checklist covering 6 domains, 53 criteria, and 300 compliances. Items were scored as 0 (non-compliant), 1 (partially compliant), or 2 (fully compliant), and converted to percentage scores. Results: Overall hospital performance ranged from 309/600 to 387/600, corresponding to 51.5–64.5%. The highest-performing hospitals were Rapareen (64.5%), Hawler (62.0%), Hareer (61.8%), and Maternity (61.5%), whereas Eye (51.5%), Perman (52.5%), Zeravani (52.8%), and Rizgary (53.2%) had the lowest scores. Domain performance varied markedly: hospital upkeep ranged from 46.9% to 77.7%, sanitation and hygiene from 47.3% to 72.0%, support services from 30.0% to 82.5%, waste management from 36.0% to 83.0%, infection control from 37.0% to 73.0%, and hygiene promotion from 8.7% to 26.2%. None of the hospitals achieved the 70% Kayakalp recognition threshold overall. Conclusion: Public hospitals in Erbil Governorate showed moderate overall quality performance with substantial inter-hospital variation. Infection control and hygiene promotion were consistently the weakest domain, indicating a priority area for improvement.
Objective: To adapt the Physical Activity Scale for the Elderly (PASE) and the Community Healthy Activities Model Program for Seniors (CHAMPS) for the Indonesian context and to evaluate their psychometric properties. Methodology: This cross-sectional study involved 60 older women (≥60 years) in Depok, Indonesia. Adaptation involved translation and expert review. Analyses included descriptive statistics, Cronbach’s alpha for internal consistency, and Multi-Group Confirmatory Factor Analysis (MGCFA). Results: The Indonesian PASE and CHAMPS demonstrated excellent internal consistency (Cronbach’s α=0.963 and 0.928, respectively) and satisfied configural, metric, and scalar invariance across age groups. PASE showed Comparative Fit Index (CFI) values of 0.955–0.964 (ΔCFI≤0.006), while CHAMPS showed CFI values of 0.945–0.952 (ΔCFI≤0.004), indicating stable measurement properties across younger-old and older-old participants. Conclusion: The Indonesian versions of PASE and CHAMPS demonstrated preliminary evidence of acceptable reliability, validity, and measurement invariance for assessing physical activity among older women in this study setting. Further validation with larger, more diverse populations is needed to confirm their broader applicability in Indonesia.
Objective: To explore lived experiences, family support, and educational needs shaping self-management among adolescents with thalassemia. Methodology: This descriptive phenomenological study was conducted in two public hospitals in Bekasi, Indonesia, from May 2024 to February 2025. Participants were purposively selected and included nine adolescents, eight parents or caregivers, and four nurses. Data were obtained through interviews, focus group discussions, observations, and field notes, and were then analyzed using inductive thematic analysis and team review. Results: Four themes were developed: negotiating self-management within lifelong treatment demands; preserving normal adolescence amid bodily and social disruption; family support as a scaffold for autonomy; and transforming education into shared family routines. Treatment fatigue, irregular transfusion scheduling, chelation difficulties, stigma, disrupted schooling, and medicine access shaped self-management. Families provided transport, reminders, monitoring, reassurance, and advocacy. Nurses emphasized structured, family-inclusive education. Conclusion: Adolescent thalassemia self-management is relational and service-dependent. Family-centered nursing that combines education, caregiver coaching, psychosocial screening, and coordinated follow-up may strengthen adherence, autonomy, and well-being.
Objective: To investigate the demographic, clinical, and antimicrobial resistance (AMR) profiles of E. coli from women with UTIs Urinary tract infections (UTIs). Methodology: This cross-sectional study was conducted from July 2023 to July 2024 at the Institute of Microbiology, Shah Abdul Latif University and Microbiology Laboratory, Dept. of Pathology, Chandka Medical College (CMC), Larkana. Employing convenience sampling and standard sample size formula, 576 midstream urine specimens were collected from women aged ≥18 years presenting with UTI symptoms. Specimens were cultured on MacConkey agar, with E. coli confirmed via Gram staining, biochemical profiling. Antimicrobial resistance was assessed using the Kirby-Bauer disk diffusion method following CLSI (2023) guidelines. Data were analyzed using SPSS 26. Results: Most of the women were illiterate (91.23%) and housewives (97.37%). The most affected age group was 20-30 years (85.09%), with pregnancy emerging as a significant risk factor (80.70% of cases), especially during the second trimester (34.21%) and among primigravida women (67.54%). Antimicrobial susceptibility testing revealed alarmingly high resistance rates against Ampiclox (92.98%), cefaclor (91.23%), fluoroquinolones (Ofloxacin: 87.72%; Norfloxacin: 79.82%) and third-generation cephalosporins (Ceftazidime: 58.77%). In contrast, amikacin (71.05% sensitivity) and chloramphenicol (63.16% sensitivity) demonstrated better efficacy. Conclusion: These findings underscore the urgent need for antimicrobial stewardship to curb empiric use of beta-lactams and fluoroquinolones.
Objective: To evaluate the effect of printing orientation on the dimensional accuracy, trueness, and 9-month stability of two 3D-printed dental resins. Methodology: In this in vitro study, 108 specimens of Model Resin Material (MRM) and Interim Prosthesis Material (IPM) were printed at 0°, 45°, and 90° (n=9/group). Specimens were scanned immediately and after nine months using a 3Shape lab scanner. Dimensional accuracy was assessed by linear measurements and trueness by RMS deviation using GOM Inspect. Data were analyzed with ANOVA (α=0.05). Results: Printing orientation had no significant effect on dimensional accuracy or trueness (p>0.05). All groups showed significant post printing shrinkage (p<0.05). IPM demonstrated better trueness (0.231±0.051 mm) than MRM (0.498±0.168 mm; p=0.001) and maintained superior dimensional stability after nine months (p=0.001). Conclusion: Printing orientation minimally affects accuracy. IPM shows better trueness and long term stability than MRM, and surface based analysis detects deviations not identified by linear measurements.
