Articles

<b>Background: </b>The rising prevalence of diabetes mellitus and its adverse effects on pregnancy outcomes have made pre-pregnancy care (PPC) a critical component of diabetes management among women of reproductive age. Diabetes poses significant risks during pregnancy, but PPC provides an opportunity to prevent complications. Despite these benefits, Nigerian women of childbearing-age living with diabetes still miss out on these advantages due to poorly defined and imperfect integration of PPC into the country’s healthcare system by Health Birth professionals (HBPs). Therefore, their understanding of PPC and the integration of PPC into routine diabetes management practices for childbearing women is essential. The study, therefore, aims to explore HBPs’ provision of PPC for women with pre-existing diabetes in Lagos, Nigeria. <b>Methodology: </b>A qualitative exploratory research design was conducted at two tertiary health institutions in Lagos. A total of 20 participants were purposively selected among doctors and nurse/midwives. The data collected through in-depth semi-structured interviews were transcribed verbatim and analyzed thematically. The trustworthiness of this study was established following the criteria of trustworthiness (credibility, dependability, transferability, and conformability), authenticity was added based on the research worldview. <b>Result:</b> Five themes and eleven subthemes emerged from the analysis. The main themes were clinical importance of PPC for women with diabetes, pregnancy-intention screening for diabetic women, PPC as standard care practice for women with diabetes, raising awareness of PPC, and the enablers of PPC provision. <b>Conclusion:</b> The study emphasized the clinical significance of PPC for women with diabetes; the need for pregnancy-intention screening among diabetic women; the need to make PPC a standard of care for women with diabetes; the importance of raising awareness; and the enablers of PPC. The study highlighted the significance of PPC and the factors that would facilitate its integration PPC into Nigeria's healthcare system. The provision of PPC for women of childbearing potential living with diabetes, as it is key to improving obstetric outcomes and reducing the risks associated with diabetes in pregnancy. It would also be beneficial for leaders at various levels of healthcare institutions to seek the necessary regulatory approvals from the Nigerian government to establish PPC.

<b>Background</b>: By rediscovering the medical field spiritual foundation, clinicians sought to balance their care and realize that spirituality is frequently associated with healthcare, thus one’s spiritual beliefs influence patients' decisions between aggressive care and complementary therapies in oncology care. <b>Aim:</b> This study investigates clinicians’ experiences and perceptions of spirituality in oncology care that clinicians can utilize to improve cancer and spiritual care provision. <b>Methods:</b> A thematic, qualitative synthesis. <b>Results:</b> Four main themes emerged from the synthesis of the 11 included studies that can steer future framework and policies to make clinicians more inept in providing care to address spiritual well-being of the patients and their family from a clinician's point of view of spirituality: “Maintaining Hope and Spiritual Wellness, Clinician’s Sensitivity to Cancer Patients, Provision of Culturally Respectful Spiritual Care, and Education in Providing Spiritual Care”. <b>Conclusion:</b> Cancer patients, cancer survivors, and clinicians’ quality of life is correlated with measures of spirituality and spiritual well-being. Spirituality also fulfill these oncologic patients has been linked to improved emotional and spiritual adjustment. <b>Implications:</b> Clinicians with different proficiencies, novice or expert, develop a strong spiritual belief can also be a strength when it comes to caring for those terminally ill patients, to be able to aid them in their sufferings. Amidst the challenges of spiritual care, these clinicians provide a patient strategy approach that is holistic to the care.

Architectural frameworks for large-scale Electronic Health Record (EHR) data platforms are described. Existing EHR data platform architectures often leverage multiple cloud-based solutions blended with institutional infrastructures to manage and analyze clinical data at scale. Key design principles governing the scale of existing EHR data architecture include model design, governance structure, data access management, data security/policy/protection, data-information-language-based standardization, and analytics tool alignment, among others. The rapidly evolving technology landscape and the unprecedented volume of incident and retrospective clinical data being collected and generated within healthcare organizations have led to the emergent need for a dedicated architectural framework to support large-scale computing in the health informatics domain. The application areas of large-scale computing in health informatics include real-time predictive analytics, risk stratification, patient cohort analytics, development of predictive models for specific institutions or population groups, and many more. The use of EHR data for a multitude of decision-making processes in both clinical and non-clinical settings has prompted the establishment of policies prescribing the conditions of access and use of EHR data for non-employed individuals in the organization. Consequently, the demand for accessing, using, and managing EHR data at scale has impacted the over.