In a developing country like the Philippines, it is critical to understand the important factors which lead college students to their current colleges and universities, especially during the COVID-19 pandemic. This study utilized the conjoint analysis approach with an orthogonal design for evaluating understudy's inclination in choosing a college with the various attributes such as the tuition fee, distance or location, employability, academic reputation, recommended by friends and peers, recommended by family or relatives, and the availability to transfer was assessed. A total of 518 Filipino students studying at public and state universities participated in answering the 16 combined attributions about university preference using purposive sampling approach. Based on the utilities estimate, the most important attribute was the tuition fee of the preferred university with an importance value of about 32.839%, followed by the employability rate of the university with about 6% gap difference. The mid-concerned attributes were the distance/location with an estimated of 11.139%, recommendation of friends or peers with approximately 11.689% tying together, and the academic reputation with an estimated of 10.638%. The two least important attributes were identified to be the availability to transfer, having with only about 2.713%, and the recommendation of parents with only 2% difference at approximately 4.453%. The outcomes of this study can aid college chairmen and enrolment specialists tweak their advertising procedures by giving significant data to the chief gatherings engaged with settling college decision choices. COVID-19; University preference; Conjoint analysis; College students; Tuition fee. ComputeOne of a student's major decisions that will determine the form and quality of their student life is choosing a university with money, effort, and time involved in the selection process . The uniConjoint analysis is a multivariate tool to measure people's preferences and understand a group's attributes based on an evaluation of the complete set-up  and has School leavers' key decision-making attributes include reputation, location, and content of the course. It was discovered course content was of prime significance in the beginning phases of the dynamic cycle with location becoming increasingly important as consumption process nears as well . In the The Philippine Commission on Higher Education (CHED) statistics data recorded the University of the Philippines (UP) as first in terms of enrollment with 57,387 enrolments and the Polytechnic University of the Philippines as 2nd with 56,928 enrollment as of October 8, 2020 . LearnerThis study incorporated the conjoint analysis approach with an orthogonal design for evaluating understudy's inclination in choosing a college with the various attributes such as the tuition fee, distance or location, employability, academic reputation, recommended by friends and peers, recommended by family or relatives, and the availability to transfer was assessed. The outcomes can help college chairmen and enrolment specialists tweak their advertising procedures by giving significant data to the chief gatherings engaged with settling on college decision choices.22.1This study was approved by Mapua University Research Ethics Committees. A purposive sampling was utilized to gather respondents with the use of an online platform such as Facebook and Messenger . Compute2.22.3The research design was adopted from the conjoint design model used by The first attribute Tuition has to do with to the money that learners would need to pay comprising of educational expenses, food, lease, and other expenses from the date of initiation of study until graduation. Since learners from lower-pay foundations prevent from going to college . TuitionSecond, distance or location is concerned with the separation from home including the time taken to get to college. Among understudies from lower-pay families felt far more the negative effect of distance, which supports the notion that an enormous piece of the motivation behind why distance is such a strong hindrance to going to college is financial costs . In the Third, employability refers to the scope of profession openings accessible to understudies subsequent to graduating. Employability is an attribute that employers will anticipate that is fundamental for the future compelling working of their organization . HoweverFourth, academic reputation denotes the total university's reputation such as ranking of the university status, achievement of the university, and accreditation as a result of the quality of education including learning experience and teaching quality experience. Most students viewed the university's academic reputation as very important to have a successful career . StudentFifth, the recommendation of friends and peers signify their experiences and knowledge (e.g. hear and read) that they choose a particular university. Being connected with other people influence their thoughts and emotions. They mostly liked and follow their friend's careers , which iSixth, recommendation by parents and relatives refers to the protection, and health of their children is the parents' responsibility. Their 3 bigger factors are social, economic, and cultural . On the Lastly, availability to transfer refers to offering the ability to receive and approve units from public to private universities . In fact2.4SPSS presents the minimum optimal orthogonal design available and has the option to add holdouts to determine internal consistency among the responses . In the 3Tables Pearson's R and Kendall's Tau insights are figured as synopsis proportions of decency of fit. They are accounted for as pointers of fit between the model and the acquired information . Table 74According to the different stimuli presented above, this conjoint study has shown results stating that most of the respondents consisting of mainly senior high school graduates and college students who accordingly chose combination 14 as the most favored preference in choosing a university amidst the Covid-19 pandemic. Particularly, universities with free tuition fee, close distance, good employability, strong academic reputation, recommended by friends and family, and offered availability to transfer were generally favored. The least preferred was combination 16 which denoted universities with high tuition fee, far distance, poor employability, yet strong academic reputation, recommended by friends but objected by the student's family, and does not give the option to transfer.Based on the utilities estimates, the most important attribute is the tuition fee of with an importance value of about 32.839% followed by the employability rate of the university with approximately a 6% gap difference. The mid-concerned attributes like distance or location obtained an importance value around 11.139%, recommendation of friends or peers with an estimated 11.689%, and academic reputation with an estimated 10.638%. The least important attribute decided by the respondents are Availability to Transfer with only 2.713% followed by the Recommendation of Parents with only 2% difference at an estimate of 4.453%.In accordance with the highest attribute, tuition fee is the most significant factor in students' university preference. In fact, previous studies stated that 1000 students who are aspiring for higher education revealed that a university's tuition fee decides their school enrollment. It deters them to choose their preferred university . In effeFree tuition fee is the most preferred level of the respondents. According to statistics , a publiDistance or Location is the second most preferred attributes that the respondents considered. With classes conducted remotely during the pandemic, location is one of the major factors to consider in choosing a suitable university which factors in the proximity of the school from home, budget to take public transportation, and ability to rent near the school. However, these aspects were discarded due to unavoidable circumstances to minimize the spread of the COVID-19 pandemic and the decision of the government to conduct all classes online in response to the needs of learners .Employability is the third most important among the attributes based on the results in the utility estimates. According to Academic reputation was found to be a mid-preference attribute. Recommendation by friends and peers was found to be the third preference by the respondents. In fact in other research, friends and peers are at the bottom . Pummel,This was followed by recommendation by parents and relatives. The desire of every parent of a happy and established life for their children gives them the motivation to choose a better career path for their children. Choosing a better career takes on a serious tone, especially throughout the application process . On the Lastly, availability to transfer refers to the privilege to leave their institutions to further expand their opportunities before they receive their degree. A student's retention and road to success is a critical matter in terms of federal levels, policy circles, and with employers included, at least on the higher levels it will come to be important. College or university transitions and successes are mainly focused on the studies and interventions aimed over at an individual student's academic completion . Many un4.1This is the first and complete study that breaks down the understudy's inclination in choosing a college and university school during the COVID-19 pandemic. From the results, students would tend to choose a school with a free tuition fee, strong academic reputation with a close distance to their home due to the pandemic. The result of this study can assist incoming college students to assess their criteria in choosing a school during the pandemic. By having a combination of factors in this matter, students will then make informed decision and focus in universities that meet their needs. Additionally, because students were found to value tuition fees and academic reputation, the school would be able to take note what factors are important in attracting students.4.2Based on the findings of this study, tuition fees and employability were the two most important attributes influencing Filipino students' preferences in choosing a university during the pandemic. This result implies that Filipino students preferred low-cost tuition to free of charge universities and colleges after the Philippine Commissions on higher education has announced a free tuition law that covers 111 state universities and colleges  includin4.3The investigation's huge commitments should be found with regard to certain constraints. The assortment of information and inclination estimation was done through an online review during the COVID-19 pandemic since there is an increasing amount of communicative activity that takes place through this new medium . This br5The university choice is a complex, profoundly elaborate choice interaction . In lineThe Conjoint Analysis uncovered that tuition fee was the most considered attribute influencing understudy's inclination. This is because free tuition lifts the financial burdens brought by higher education institutions to lower-income families and allow students to freely pursue their career goals. This was followed by employability, recommendation by friends and peers, distance or location, academic reputation, recommendation by family or relatives, and lastly by availability to transfer which is determined as the least considered attribute by the consumers. The outcomes can help academicians , collegeZachariah John A. Belmonte; Yogi Tri Prasetyo; Ardvin Kester S. Ong: Conceived and designed the experiments; Performed the experiments; Analyzed and interpreted the data; Contributed reagents, materials, analysis tools or data; Wrote the paper.Thanatorn Chuenyindee; Nattakit Yuduang; Poonyawat Kusonwattana; Reny Nadlifatin; Satria Fadil Persada; Thapanat Buaphiban: Analyzed and interpreted the data; Wrote the paper.This research was funded by Mapúa University Directed Research for Innovation and Value Enhancement (DRIVE).Data will be made available on request.The authors declare no conflict of interest.No additional information is available for this paper.


Background: Horizon scanning aims to systematically identify upcoming health technologies and thus allows policy-makers to be better prepared for the entry of new medicines with possibly high price tags into the national health system. The aim of this study is to survey the existence of national and cross-national horizon scanning systems for medicines in European countries.Methods: Experts working in public authorities  in the WHO European region participated in surveys in 2014 and 2019 and informed about the status of horizon scanning in their country . Identified advanced horizon scanning systems as of 2019 were further investigated based on a literature review.Results: In 2019, six countries  reported systematic use of horizon scanning for some new medicines, and four countries  had some horizon scanning activities ongoing. No systematic use of horizon scanning was reported from the remaining 34 countries. The findings of the survey undertaken five years earlier were similar, with even fewer systems in place. A recent development is the establishment of cross-country initiatives of governments that aim, among others, to jointly perform horizon scanning; the International Horizon Scanning Initiative (IHSI) initiated by the Beneluxa collaboration is the most advanced undertaking in this respect. Countries with systematic use tend to have horizon scanning fully integrated in a system for the management of new medicines, and they use horizon scanning outcomes to inform decisions as to whether or not a Health Technology Assessment will be conducted and price negotiations be started. Differences between existing horizon scanning systems mainly concern the timings of scanning and reporting, the sources for the inputs and the accessibility of the findings.Conclusion: There appears to be a discrepancy between the perceived importance of horizon scanning based on some eye-opening examples in the past and its actual implementation in European health systems. The latter is likely attributable to horizon scanning being resource-intensive. The establishment of new national and international horizon scanning systems offers the opportunity to investigate their impact on sustainable access to affordable medicines from the start. Equitable patient access to affordable and effective medicines is a challenge in Europe and globally. Millions of people in low- and middle-income countries (LMIC) have ever since been struggling to afford medications for themselves and for people they care for, which resulted in catastrophic household spending , 2], , , 5], , , 8]..8].This is, to a major extent, attributable to the market entry of new medicines with (very) high price tags, for instance to treat cancers , 10], , . While sTo ensure the financial sustainability of publicly funded health care systems, governments have been applying pricing and reimbursement policies. They are supplemented by Health Technology Assessments (HTA) to help select and prioritise cost-effective treatments , 16], , , 18]. F. F18]. FIn this respect, a kind of a turning point was the hepatitis C medication sofosbuvir, which had come rather unexpectedly in 2014, with a very high price tag. Policy-makers openly admitted that they had not been prepared for this new treatment option . In respHorizon scanning is defined as “systematic identification of health technologies that are new, emerging or becoming obsolete and that have the potential to effect health, health services and/or society” . It is bPolicy-makers aim to be informed early enough before new medicines enter the market so that they have sufficient time to take evidence-based strategic decisions and prioritisation, and call for horizon scanning systems.While there is increasing debate on the need for horizon scanning, there is limited up-to-date knowledge on the current status of the establishment of horizon scanning systems for medicines in the pharmaceutical policy frameworks in European countries.Against this backdrop, this article surveys governments’ initiatives of national and cross-national horizon scanning and early alert systems for medicines with a view to exploring developments over years as well as similarities and differences between existing systems.The scope of the study is a system that allows policy-makers to be informed on upcoming medicines . Horizon scanning systems of interest could be national ones or cross-country initiatives. Horizon scanning for other health technologies  was not the focus of this research. The study was targeted at the World Health Organization (WHO) European region which comprises 53 countries .As in a horizon scanning process, the aim was to first scan a large number of countries and to identify horizon scanning systems, prioritise and select a few, based on defined criteria, and comparatively analyse them. To do so, a mixed methods approach was used Figure 1 .Surveys addressing officials in authorities responsible for pharmaceutical pricing and reimbursement in European countries were conducted at two points in time to learn whether or not (advanced) horizon scanning systems for medicines were in place. In 2014 and in 2019, members of the Pharmaceutical Pricing and Reimbursement Information (PPRI) network were addressed to participate in a survey. Both surveys were part of a larger questionnaire that studied further pricing and reimbursement policies for medicines. PPRI is a network of representatives of competent authorities for pharmaceutical pricing and reimbursement of medicines in mainly European countries . At the Systematically used national horizon scanning systems as of 2019 were selected as case studies if a sufficient level of information was available to allow for meaningful description.International horizon scanning systems in Europe were identified through a review of cross-country collaborations of European governments in pharmaceutical policy and subsequent contacts to the representatives of collaborations with horizon scanning activities (or plans) in summer 2018 and – to obtain updated information – again in autumn 2019.The description of national and cross-national horizon scanning systems is based on a review of published literature, including grey literature such as website information, presentations and technical reports.In 2019, six countries of the WHO European region  reported systematic use of horizon scanning for some new medicines. Four further countries  had ongoing horizon scanning activities, however not in a comprehensive, integrated manner in the health system, and this was also the case for the outpatient sector in Sweden. In the remaining 34 countries, no use of horizon scanning as part of the pharmaceutical policy framework was reported; however, Belgium informed on plans to introduce a national horizon scanning system.Five years earlier, two countries (Iceland and Norway) informed about an ongoing implementation of a national horizon scanning system, while Italy and UK already reported their up and running projects in 2014 .At cross-country level, some collaborations  plan to work jointly on horizon scanning. At the time of writing (Q2/2020), the sole cross-country system established is the International Horizon Scanning Initiative of the Beneluxa Initiative. Its members are, to some extent, countries  that already have a national horizon scanning system Table 1 .National horizon scanning systems of the countries that reported systematic use (except Iceland) are described in further detail in the following  in 2013 . It aimsSimilar to the processes in the Netherlands and Norway, horizon scanning in Sweden is integrated in the process of managed introduction of new medicines in hospitals. It aims to inform the regions who are the payers, by providing a basis for their decision on whether or not a “managed introduction” based on a full HTA or company collaboration is needed for a specific medicine. Horizon scanning is done by the four largest regions , through the Horizon Scanning working group (one representative of each of the four regions and a coordinator), as part of the “Collaboration Model” framework coordinated by the overarching Swedish Association of Local Authorities and Regions , 42]. T. T42]. TThe UK has a long history of horizon scanning, and UK’s countries have their own systems in place. In England, horizon scanning is the responsibility of the Horizon Scanning Research and Intelligence Centre of the National Institute for Health Research (NIHR HSRIC), which was called National Horizon Scanning Centre (NHSC) until 2012. Established as an independent research team at the University of Birmingham in 1998, it was incorporated as a research programme within the NIHR in 2006 . It provThe International Horizon Scanning Initiative (IHSI) was established in October 2019 as an independent legal entity that will provide outcomes to its member countries. It was initiated by the Beneluxa Initiative, a cross-national collaboration of five European countries , but as a separate area for collaboration independent from the status of being a Beneluxa member. The Beneluxa Initiative invited further countries to participate in collaborating in horizon scanning, without having to join the Beneluxa Initiative . IHSI stIn preparation for IHSI, the Belgian Health Care Knowledge Centre (KCE) was commissioned to develop a model for a joint horizon scanning system and to assess the feasibility of the proposed methodology for Belgium. KCE recommended to set up a central horizon scanning unit (either to be newly established or as an expansion of the horizon scanning activities of an existing unit), to provide sufficient resources, to pilot the proposed methodology and to perform an evaluation with subsequent adjustments .At the end of 2018, an open market consultation was conducted to inform market operators about an upcoming public procurement procedure for setting up an international horizon scanning system and to obtain market operators’ input on the viability of the procurement design and conditions .In Q1/2020, a tender was launched with the aim to select a third party provider tasked with building and implementing the IHSI Joint Horizon Scanning Database, which will consist of two key elements: the technical infrastructure to host the database, and a scientific component relating to the data collection exercise which is intended to continuously populate the database. At the time of writing (Q2/2020), the database was expected to be up and running by end of 2020, and first datasets were expected at the beginning of 2021 .To the author’s knowledge, this is the first survey on the existence of national and cross-national horizon scanning systems throughout the WHO European region. Previous studies – some of which were performed more than 15 years ago – only considered existing horizon scanning systems, usually with a focus on specific aspects, such as selection or search methodologies , 58], , . This stAt the same time, there appears to be high interest of numerous countries in an early alert of what is in the pipeline. One option to gain access to horizon scanning outcomes in the case of limited capacity and resources is through collaborative efforts: Several countries (members of the Beneluxa Initiative and beyond) joined the newly launched International Horizon Scanning Initiative. Further cross-country collaborations, which were established in recent years , are committed to work together on horizon scanning but have not yet started implementation; interestingly, some member countries of the mentioned cross-country collaborations also joined IHSI. Collaborative efforts help containing the costs, which may be substantial: in the 2017 feasibility study for a collaborative horizon scanning system of the Beneluxa Initiative, which then resulted in establishing the IHSI, an annual budget amounting to eight to ten full-time equivalents was established .Countries with advanced horizon scanning systems tend to establish them in an integrative manner in the respective pharmaceutical policy framework: As the country examples of this study show, horizon scanning is applied as a first, fundamental step in the system for managing the entry of new, possibly high-priced medicines in the national health service or social insurance system. The findings of systematic application of horizon scanning are used, frequently in a standardised way, to decide on the further path of identified medicines, i.e. whether or not a full HTA will be performed, price negotiations will be launched and/or managed-entry agreements will be concluded. It is obvious that budget impact considerations play a role, and this review confirmed that they are explicitly or implicitly used for the filtration and prioritisation process, in addition to other criteria.To contain the cost for the establishment and maintenance of horizon scanning systems, countries could limit their scope , or focThe study findings point to the importance of smooth coordination and well-functioning communication between technical experts and policy-makers if horizon scanning shall support the managed entry of new medicines. Some authors see an enhanced role of the HTA community to provide for a better bridging . FurtherBesides coordination and cooperation, Norway considers transparency as another success factor of their “New Methods” system . RegardiFinally, horizon scanning is usually targeted at identifying emerging new, possibly innovative health technologies, including medicines. However, for understanding the market, it is also important to know when (less expensive) alternatives will be launched and can contribute, due to competition, to savings in public budgets. Obtaining information on the date of the patent expiry is another challenge for governments. In this respect, the emergence of therapeutic equivalents could constitute an added value of horizon scanning systems. The English system, for instance, also scans for first biosimilar medicines of the indication .The study has some limitations. The PPRI surveys were focused on identifying the existence of horizon scanning systems, but did not investigate details of existing systems. Thus, further sources had to be consulted.The response rate to the respective question on the existence of a horizon scanning system was rather low in the 2014 survey, which overall limits the meaningfulness of this survey.Despite its systematic use, the Icelandic horizon scanning system could not be included in the more detailed comparative description due to lack of data.The WHO European region consists of 53 countries. Given the difficulties to obtain information from some smaller countries and Central Asian countries , the study was limited to the 44 PPRI countries in the European region .While the concept of a  horizon scanning system was defined in the surveys, it was up to the respondents to classify ongoing horizon scanning activities as a horizon scanning system. It is acknowledged that other respondents might have considered horizon scanning activities, such as those undertaken by the HTA institution in Denmark , as systThe study showed that, while horizon scanning is overall considered as an important policy tool, in particular with regard to contributing to ensuring patient access to new, possibly innovative medicines, only a few European countries actually have an advanced horizon scanning system in place. Systematic use of horizon scanning is resource-intensive, requires expertise in methods and access to data sources, and this may explain the lag in its implementation. Countries with a systematic use of horizon scanning started establishing their horizon scanning system in the last decade or even earlier, and most of them have integrated it into their national pharmaceutical pricing and reimbursement system, with the aim to use the outcomes strategically to inform the next steps such as assessment as well as pricing and reimbursement decisions.The analysis highlighted that existing horizon scanning systems differ between European countries. The design of the horizon scanning systems varies, among others, with regard to the methodology applied, confidentiality of the data sources and the dissemination strategy. This will, in return, impact the uptake of the findings by other stakeholders in the country and by other countries.With the establishment of new national horizon scanning systems and the use of the outcomes from cross-country collaborative systems such as the IHSI, it is advised to monitor their performance as well as to share experiences to allow lessons learning for the future. In particular, it is recommended studying the effects of different designs of horizon scanning systems on improving sustainable and equitable access to affordable medicines.Sincere thanks go to the members of the Pharmaceutical Pricing and Reimbursement Information (PPRI) network: experts working in public authorities in several countries who are not mentioned by name in compliance with the PPRI policy.Furthermore, I thank my colleague Nina Zimmermann for her involvement in the 2014 and 2019 surveys with the PPRI network and for reviewing an earlier draft of this article.The Austrian Federal Ministry of Social Affairs, Health, Care and Consumer Protection has been funding the work of the PPRI Secretariat to manage and maintain the PPRI network.The author declares that she has no competing interests.


To map the state of the existing literature to identify the optimal time frame between the arrival of refugees in a host country and psychosocial assessments. We conducted scoping review using the method of Arksey and O’Malley (2005). A systematic search of 5 databases including PubMed, Psycinfo (OVID), PsycINFO BD APA, Scopus and Web of Sciences) and grey literature identified 2698 references. Thirteen studies published between 2010 and 2021 were considered eligible. A data extraction grid was designed and tested by the research team. It is not so ease to identify the most appropriate time interval to assess the mental health of newly settled refugees. All the studies selected agree on the need to carry out an initial assessment when refugees arrive in their host country. Several authors agree on the need to carry out screening at least twice during the resettlement period. However, what is less clear is the best time to perform the second screening. This scoping review mainly helped in highlighting the lack of probing data on the mental health indicators focused on during the assessment and on the optimal timeline for the assessment of refugees. Further research is needed to determine whether developmental and psychological screening is beneficial, the right time to perform the screening, and the most appropriate collection instruments and interventions. The World Health Organization  argues tNumerous studies on access to primary health and social services support these observations and highlight the difficulties faced by migrant people in obtaining the necessary care, demonstrating that they receive fewer or poorer-quality services; are treated differently by caregivers; and receive treatment that does not meet their needs  between the arrival of refugees in a host country and psychosocial assessment. Exploring the Canadian and international literature on the topic will put into perspective the plan proposed by the MSSS for Quebec.We conducted a scoping review using the framework of Arksey and O’Malley . A scopiThe steps of selecting the keywords, validating the literature, and concluding the scoping review were conducted iteratively, with a view to optimizing the rigour of the process.What is the optimal time interval between the arrival of refugees and their first and follow-up mental health assessments? Then, the definitions of essential themes for the synthesis were suggested, discussed, and agreed upon within the same core research team members. These themes were “mental health assessment”, “optimal time frame” and “refugees”. This first step helped to clarify the scope of the synthesis and depth of the research . An overarching research question evolved after discussions as follows: The following steps made it possible to select the papers to be included in the scoping review.The identification of the relevant papers and documents were performed in two stages. First, we conducted an electronic search of five databases including PubMed, Psycinfo (OVID), PsycINFO BD APA, Scopus and Web of Sciences. These databases are selected because they list a wide range of scientific papers addressing the topics of interest. Two team members (AG and GMN) developed a search strategy, approved by LM. Consistent with the methodology of the scoping review, we used more sensitive than specific keywords to cover as many papers as possible , who independently read the titles and abstracts of 20% of the papers assigned to themAn iterative data extraction process was developed to address our research question. To extract the data, a grid was designed and tested by the team’s researchers and approved by LM. This grid includes the following data: paper references , research method, country of study, country of origin of refugees, categories of refugee, population categories , time interval of assessment , outcomes related to time interval and other factors influencing assessment . For each paper included, we extracted the above elements.The data extraction was carried out in three stages. In the first stage, each publication was categorized based on: type of study, year of publication, country of settlement Table . All papIn the second stage, data related to the origin of the refugees Tables  and 3 anMost of the selected articles concern refugees mainly from Iraq, Bhutan, and Burma Tables  and 3 anIn the third stage, the results of the selected papers were synthesized Tables  and 4. TOf the 13 publications included in the scoping review, 6 were categorized as quantitative research, 2 as mixed studies, 2 as transversal and/or prospective analysis, 2 as literature review and 1 as longitudinal study. All papers were written in English. The largest number of publications comes from the United States (6), followed by the United Kingdom (2) and Switzerland (2), then Norway (1), Australia (1) and Canada (1). The papers were published between 2010 and 2021, which can be considered an indicator of an emerging field of research or increased interest in the field. The studies targeted different population groups of refugees, immigrants, and asylum seekers: children and adolescents (accompanied or not), adults  and pregnant women. The countries of origin of the populations under study are very varied, but are mainly concentrated in the Middle East, Africa, and Asia. The countries of settlement of the population under study are mainly in the United States, but also in Sweden, Canada, Australia, Switzerland, and Germany .A few studies recommend performing the assessment more frequently and at specific intervals. The study of Chernet, Probst-Hensch, Sydow, Paris, and Labhardt  demonstrAmong the studies retained, only two carried out the evaluation at several intervals and over a long period. Green et al.  mention For her part, Vukovich  assessedThis section presents the results relating to the factors Table  that infThe personal factors identified concern cultural issues, traumas experienced and migration trajectories, as well as the literacy rate of populations under study. Regarding cultural issues, Woodland et al.  note thaRegarding migration trajectories, Hollifield, Toolson, Verbillis-Kolp, Beth Yamazaki, et al. 2021) point out that the type of distress trajectory during early resettlement varies by country of origin. Perceived self-efficacy at initial assessment would also protect against reporting initial distress, but other factors such as post-migration stress are more potent in creating distress over time (honeymoon period). Green et al. , researchers would overestimate the magnitude of mental health problems when the standard threshold recommended in the literature is used. For their part, Pottie et al.  point ou, researcWoodland et al.  interpreFurthermore, in addition to assessing mental health, screening tools should be able to assess factors related to the security and stability of newly arrived refugees, such as access to basic needs, English skills, job readiness and social support. These factors would explain the differences in distress levels during the first year of resettlement. Reliable and culturally appropriate screening tools that consider family and community impacts of trauma would be needed to inform planning and service delivery .Thus, it is important to train staff to use the questionnaire in culturally appropriate ways to introduce mental health screening, to provide psychoeducation to those who test positive, and to refer refugees to mental health facilities  or quantitative (X months). It is not so ease to identify the most appropriate time interval to assess the mental health of newly settled refugees. Indeed, several questions remain following the study of : “the optimal time to re-screen, identifying people who do not need re-screening, and the public health benefit of screening on health outcomes”. This is why they advocate the importance of early intervention by screening refugees for emotional distress at least twice during resettlement. Woodland et al.  at the first clinic visit and a second assessment six months after resettlement to allow the honeymoon period to pass. The program should provide a central entry point, access to trained interpreters, and the availability of community mental health services  is limitative, as it excludes the significant refugee movements of the 1970–1980 s and the 1990s . Fourth, some recommendations were related to macro-level contexts, and consequently were difficult to implement.Nonetheless, the results have helped in identifying several interesting research opportunities regarding mental health assessments for refugees and immigrants within optimal time frames and adapted to various trajectory contexts of refugees and of host countries.Through this study, we wanted to answer the question of what the optimal time interval between the arrival of refugees is and their first and follow-up mental health assessments. This scoping review mainly helped in highlighting the lack of probing data on the mental health indicators focused on during the assessment and on the optimal timeline for the assessment of refugees. This absence of data can be observed both in Canadian and international literature and confirms the need to deepen research in this area to develop better assessment and intervention strategies. Public and other authorities are responsible for making decisions on the time frames between the arrival in the host country, the initial consultation with the health and social service professionals as well as the continuity of services if needed. It is important to document the best practices collated in terms of assessment and optimal time frame with regard to such assessments for refugees. Woodland et al.  come to Our scoping review provides an unprecedented study of the issue of indicators and optimal time frames for initial mental health assessments for refugees upon arrival in their host countries. In addition to the issue of the time frame, this study also highlighted the other conditions that have an influence on the assessment. Furthermore, our scoping review has shown that there are many interesting research opportunities in connection with mental health assessments for refugees in optimal time frames and adapted to the various trajectories and contexts of refugees and of host countries.Nonetheless, some questions remain unanswered and should be given further attention. First of all, some authors raise concerns about potential adverse effects of screening. The studies do not question the relevance of screening. They also do not determine whether systematic screening and/or need-based follow-up is preferable. Then, some studies such as that of Polcher and Calloway  state thConsidering that this scoping review includes a wide range of assessment methods and suggests that refugee mental health assessments in optimal time frames could be improved by formal but flexible adaptation of services, future research could provide stronger evidence on more nuanced interventions and other types of outcomes. Future research should also take into consideration the post-pandemic context of COVID-19, which has, among other things, exacerbated economic and health inequalities and insecurities, mainly among refugee populations.


Given the global prevalence of Non-Communicable Diseases (NCD) and the economic and clinical burden they impose, it is recommended that the management of essential medicines used to treat them be renovated and optimized through the application of predictive modeling such a RF model.in this study, a series of data pre-processing activities were used to select the top seventeen (17) NCD essential medicines most commonly used for treating common and frequent NCD. The study focused on machine learning (ML) applications, whereby a random forest (RF) model was applied to predict the demand using essential medicines consumption data from 2015 to 2019 for approximately 500 medical products.with a seventy-eight (78) percent accuracy rate for the training set and a 71 percent accuracy rate for the testing set, the RF model predicted the trend in demand for 17 NCD essential medicines. This was achieved by entering the month, year, district, and name of the NCD essential medicine. Based on historical consumption data, the RF model can thus be used to predict demand trends. Our findings showed that the RF model is talented to commendably perform as a predicting model.the study concluded that RF has the ability to optimize health supply chain planning and operational management by boosting the accuracy in predicting the demand trend for NCD essential medicines. The prediction of essential medicines demand is a critical component and a useful insight for foreseeing future health-care needs, according to today's health supply chain . The WorHealth supply chain experts and health-care providers can use predictive modeling and machine learning to optimize their mandate of providing the appropriate services at the right time. It also allows for the analysis of large amounts of data, which can be used to inform interventional procedures and data-driven decisions . The RF The benefits of the RF model stem from the fact that random forests produce the most accurate results of any popular data classification algorithm. The RF technique can also handle large datasets with a set of parameters . The RF Non-communicable diseases (NCDs) kill 41 million people worldwide each year, accounting for 71 percent of all deaths. The most frequent NCDs include cardiovascular illnesses, diabetes, cancer, and chronic respiratory diseases. Low- and middle-income nations account for 85 percent of NCD-related mortality . MoreoveNoncommunicable diseases (NCDs) are the leading cause of death and chronic disease in the world, killing more people than all other causes combined. NCDs, which include cardiovascular illnesses, diabetes, cancer, and chronic respiratory diseases, are the leading causes of death . To giveWhen it comes to health and well-being, the burden of noncommunicable diseases is one of the most pressing challenges, and according to World Health Organization (WHO) data, the availability of corresponding essential medicines is also a major concern for many people in developing countries . BecauseA study conducted in Kirehe District, Rwanda discovered that essential drugs needed to treat hypertension, diabetes, and asthma were frequently overstocked. In addition, the survey found that important drugs were delivered late and insufficiently in relation to the needs of health facilities. It suggested that routine tracking of NCD essential medicines supply levels be improved . As reveWhile the aim of this article is to demonstrate the results of determining future needs for NCD basic drugs based on reported utilization data, specifics objectives for this study were to: describe NCDs essential medicines historical consumption data, to train and test the dataset related to NCDs essential medicines consumption, to develop a RF model for prediction of essential medicines demand. The study is divided into five sections which include the current one as the first section, focusing on the foundational background relating to predictive modeling with machine learning and a brief on no communicable diseases. The section two focuses on the methodological approach, which includes a depiction of settings, sources, types, and exploration of data. The third section discusses data preprocessing and RF predictive modeling techniques, while the fourth section provides a summary of the experimental results and interpretation. Finally, the fifth section discusses the conclusion and recommendations for future research.Bureau des Formations Médicales Agréées du Rwanda) and an approved private medical store called MEDIASOL .Rwanda, also known as the Land of a Thousand Hills, is a landlocked country that has made universal healthcare access a priority. The country implemented a health development strategy based on decentralized management and district-level coordinated healthcare delivery . As statThe study is both descriptive and experimental. It used program data generated from after consulting the e-LMIS, an electronic digital tool used in the management of medical products in Rwanda. Data was collected and processed so that it could be used correctly during the predictive modeling process. In this study, the significant task accomplished through time series analysis was the prediction of NCD essential medicine demand . From 20As shown in According to As described in Machine learning is a game-changing topic in the field of business information technology. With advances in technology and a preference for computer-based business management, machine learning models can extract actionable insights from historical data and mimic the practical way of a human being to forecast various aspect and future business trend . This stResearch used historical program data from supply chain management and related datasets in Rwanda Health system such existing electronic data management tools such as e-LMIS (electronic Logistic Management Information System). The National Health Research Committee authorized the research (Ref No: NHRC/2020/PROT/015), and the Ministry of Health (Rwanda) provided a research collaborative notice.As indicated in In accordance to To learn its generalizability to new data, the model was trained on one set of observations and tested on a different set of observations using machine learning. The data was divided into two categories. The train was operational from January 2015 to June 2018, with test has taken the period from July 2018 to June 2019. We divided the data by year and month because we want to predict the amount of a particular NCD essential medicine on a monthly basis. Usually, the greater the degree of ambiguity in outlooks, the greater the level of discrepancy in time series prediction ,36. FollAccording to et al. on the integration of analytics and machine learning approaches for biomedical and healthcare data [et al. on the use of data mining approaches with spatial characteristics to improve medication demand forecasts [Our research article described a predictive modeling using machine learning in which the RF model was used to forecast the demand for essential medicines used in the management and treatment of essential medicines. The model construction process is comprised of the following steps, each of which clearly achieves the desired goal: First, the data was extracted from real-world data, specifically data related to the management of Rwanda´s health supply chain. The research used data covering a five-year period, and the data was clearly explained through visualization. The second task was to fix a training dataset containing data from January 2015 to June 2018, as well as a testing dataset containing data from July 2018 to June 2019. At this point, the distribution of data was recognized, as was a clear thoughtful of their description. Third, following the design and development of RF model, good results were observed, indicating an acceptable range of prediction accuracy. Our findings are consistent with and supported by evidence from other studies, such as one conducted by Dash are data , and anoorecasts . It has The RF model has been developed and tested with an R-square accuracy of 0.78 on a training set and 0.71 on a testing set and the experimental results pointed out the lowest error value upon developing the RF model. The research focused on flagging the evidence resulting from forecasting future needs for NCD essential medicines based on historical consumption data. Subsequently, the model fitness has been shown to optimize prediction because the difference between train and test prediction is only 5%, and we can conclude that it is generalizable to new datasets. Based on the observations from this study, it is undoubtedly recommended to extend future research to sustainably rationalize the use of machine learning applications in other supply chain activities such as manufacturing, packaging, distribution or transportation, inventory management, demand planning, warehousing, and customer service to name few. Furthermore, future study may look into the possibilities of using the RF model to promote inexpensive access to vital medicines in other contexts, such as infectious disease control and management.Machine learning has emerged as one of the most applied technologies in various fields due to its multiple capabilities that are absolutely essential to business and institutional success, such as making accurate forecasts and recognizing patterns;Random Forest is one of the Machine Learning models that has demonstrated potential use in predicting supply chain demand;Decision-makers can efficiently monitor logistics while avoiding supply disruptions such as shortages, out-of-stock, overstock, and expiries, to name few by adopting the application of machine learning techniques.As the supply of essential medicines is constantly evolving and shifting as a result of the technological revolution, the Random Forest model is regarded as useful and effective model for managing the digital health supply chain, notably for predicting essential medicines demand;There is thus a need to explore Random Forest, which is on of Machine Learning models for particularly predicting the demand of essential medicines, required for public health facilities to function properly and deal with the evolving challenge associated with non-communicable diseases;The Random Forest model is enabled to contribute for sightseeing more accuracy in demand prediction of non-communicable diseases related essential medicines.


Eye care is one of the most critical tasks of intensive care unit (ICU) nurses. Patients in this unit are exposed to potential ocular problems due to critical conditions. This study aimed to establish a new eye care protocol for preventing ocular surface disorders in patients admitted to ICU. This was a clinical trial study performed on patients admitted to ICU in 2019. The data gathering tools included the demographic questionnaire, the Schirmer test for dry eye, fluorescein staining and slit lamp manual for examining corneal ulcers, and slit lamp manual to check keratitis and conjunctivitis. A type of eye care protocol was performed on the patient's eyes. After five consecutive days of executing the protocol, the data were analyzed using SPSS software version 18. The use of eye care protocol reduced the risk of keratitis (P=0.027), conjunctivitis (P=0.012), eye dryness (P=0.001), and corneal ulcer (P=0.003) in patients admitted to ICU in the intervention group compared to the control group. Ophthalmology protocols reduced the incidence of keratitis, conjunctivitis, dry eye, and corneal ulcers in ICU patients. Therefore, using this method in ICU patients can improve nursing care. In healthy people, tears act as a mechanical lubricant, keeping the eye's surface moist and destroying microorganisms with their antimicrobial properties. In addition, the eyelids act as a physical barrier to prevent strike and dry eyes . A numbeEye injuries in Iran can be as mild as infection or as severe as corneal rupture and can even cause permanent damage and loss of vision. According to recent research, the rate of corneal injuries in hospitalized patients in intensive care units was 59.4% . Also, eet al. (2014) found that using a simple eye protocol could reduce the incidence of keratopathy in adults admitted to the ICU and exposed to critical keratopathy [Eye care is one of the most critical tasks of nurses in the intensive care unit; however, due to the critical situation and many treatment procedures done for patients admitted to the ICU, eye care could be done improperly. As the focus is on treating the main organs, eye care is considered a side issue . There hatopathy .Despite sporadic intervention studies in Iran, but probably because of the lack of proper and appropriate tools, eye care is not adequately performed; therefore, the rate of eye problems, including eye infections, is still high . EvaluatThis was a clinical trial study (#IRCT20190522043671N1) performed on patients admitted to the intensive care units of Imam Khomeini and Golestan Hospital at Ahvaz in 2019. Participants were selected from a research community who were eligible to participate. They were assigned to intervention and control groups randomly. The allocation of the type of intervention to the subjects in the study (nurses) was random and by the method of random blocks with block size 4 (using the table related to random replacements). A random list was prepared by a statistician. The type of intervention was assigned to each person who entered the study according to a random list and the corresponding codes. Inclusion criteria were age over 18 years and under 75, level of consciousness less than 8, patients with mechanical ventilation and impaired eyelid reflexes, no history of hospitalization in the intensive care unit for the last month, no history of eye problems (eye diseases), lack of use of ophthalmic medications such as corticosteroid eye drops, no allergy to eye lubricants, no eye trauma, no symptoms of increased intracranial pressure, healthy corneal surface at the initial examination and at least 24 hours after ICU hospitalization. Exit criteria were the return of the blinking reflex during the study period, discharge or transfer from the intensive care unit, and death before the end of the study period.Data collection tools in this study consisted of 4 sections. The first section included a demographic questionnaire that identified age, sex, hospitalization time, history of care in the intensive care unit over the past month, diagnosis, and use of suction. The second part was the use of Schirmer strips, which are used to check for dry eye, and the third part was the use of fluorescein staining and hand-held and portable slit lamps, which are used to examine corneal ulcers . The fouThe study looked at the effect of eye care, including keeping the eye closed with adhesive tape in patients whose eyelids were incompletely closed, as well as keeping the eye moist with 0.3% hypromellose tear drops on ocular surface disorders. The eye disorders were keratitis, conjunctivitis, corneal ulcers, and dry eyes. This care was performed on both eyes in the intervention group and compared with patients' eyes in the control group.Eye care protocol in eligible patients hospitalized in the ICU: in the first stage, the position of the eyelids was evaluated, and according to this assessment, patients were divided into three groups, and appropriate eye care was performed in each group.The first group consisted of patients with closed eyelids. In this group, one drop of hypromellose 0.3% was applied to both eyes every 2 hours and continued for 4 hours.In the second group, only the conjunctiva was visible. In this group, in addition to using three drops of hypromellose 0.3% every 2 hours that lasted for 6 hours, the adhesive tape was also used horizontally across the eye to keep the eyes closed .In the third group, the patient's cornea was exposed and these patients were at greater risk. In this group, three drops of hypromellose 0.3% were applied every 2 hours (for 8 hours), and the adhesive tape was used horizontally throughout the eye to keep the eyes closed.Eye care and its evaluation were performed by trained nurses on each shift. First, patients' eyes were washed with saline, and then eye care was provided. It should be noted that all patients in the control group received routine eye care every 2 hours (including washing the eyelid and surrounding skin using gas and sterile water). This eye care was performed for 5 days, and the ophthalmologist, without knowing the method of eye care, evaluated the patients before and after the intervention using fluorescein staining, Schirmer test, and slit lamp in terms of ocular surface disorders. The final evaluation was then performed by an ophthalmologist using a portable slit lamp, as well as the nurses' daily notes, ICU charts, and the occurrence of keratitis and conjunctivitis. The presence of white or yellow spots in the cornea was a sign of keratitis, and red conjunctiva with tearing and swelling of the eyelids indicated that conjunctivitis would develop. Patients with ocular surface disorders were treated by an ophthalmologist or ICU physician.Data analysis was conducted by SPSS 18 statistical software using the Chi-square test, independent t-test, and odds ratios. Significant levels were considered below 0.05.In the control group, two participants were dropped from the sample. One participant was excluded due to death and the other due to complete recovery of consciousness.According to According to et al., eye ointment in patients under mechanical ventilation and sterile eye gas in conscious patients were used daily, and their eyelids were cleaned. In the first stage, the incidence of keratopathy was generally 21%, with 56% reported in patients undergoing mechanical ventilation. In the second stage and after the protocol implementation, the incidence of keratopathy decreased. Finally, using a simple eye care protocol can reduce the prevalence of this complication and be easily used in clinical practice [et al. reported that rinsing the eyes of patients admitted to the intensive care unit with normal saline did not prevent keratopathy [et al. showed that using ophthalmic lubricants and contact lenses could limit keratopathy and improve its lesions in patients admitted to special wards [The present study showed that using eye care protocol reduced the incidence of keratitis in hospitalized patients in special wards in the intervention group compared to the control group. In the study of Kousha practice . Ehsani atopathy . Bendavial wards .Despite differences in the type of intervention in the above studies, similar results were obtained. According to previous studies, simple eye care protocols such as washing with normal saline should gradually be replaced by more effective interventions such as eye drops and ointments, but still, in many clinical settings, evidence-based interventions are not used. One of the reasons is the weakness of studies in introducing the best and most appropriate eye care solution. In fact, each study ultimately examines one or two interventions. On the other hand, systematic and meta-analysis studies sometimes cannot provide comprehensive results. It is because of the different research communities, sample size, and other variables such as different measurement tools and not considering distorting variables. Therefore, different interventions should be evaluated by researchers in the form of clinical trials.et al. [et al. reported that the use of adhesive on patients' eyelids reduced the rate of superficial eye disorders by 20.2%, and in patients who used eye ointment by 3.6%.This study showed that the use of eye care protocol reduced the incidence of corneal ulcers in patients admitted to special wards in the intervention group compared to the control group. In the study of Ehsani et al. , in addiet al. . The reset al. stated that polyethylene was more effective in corneal damage than hypromellose [et al. stated that using moisturizing ointment as a protective method for corneal abrasion could have positive effects in hospitalized patients [et al., moisturizing ointment as a protective method against dry eye had favorable effects in hospitalized patients [As a result, eye ointment was more effective than keeping the eye closed with an adhesive to prevent ocular surface disorders , which iomellose , which cpatients . This stpatients , correspet al. stated that opening the patient's eyelids increased the incidence of ocular surface disorders [et al. showed that keeping the eyelids closed without using an eye moisturizer like an ointment was not a complete and effective eye care method [et al. showed that using hypromellose lubricant was effective in patients with viral conjunctivitis. In this study, short-term use of dexamethasone was more effective than hypromellose in treating acute viral conjunctivitis [Attention to the dry eye has been one of the most important aspects of eye care. Güler isorders . Ahmadine method . Therefoctivitis , which iIn the mentioned studies, positive results were obtained from providing eye care strategies, but comparing these methods in different clinical trial studies is necessary to determine the best eye care method for each group of patients. Some studies used a small sample size, which makes generalization and comparison difficult, so future studies with reasonable sample sizes and comparison of different care methods are needed to provide a standard clinical guideline for nurses and caregivers in the ICU. One of the limitations of this study is the limited duration of the intervention, which suggests that the duration of care interventions be extended to provide a more reliable result within the clinical environment.This study showed that using eye care protocol reduced the incidence of keratitis, conjunctivitis, dry eye, and corneal ulcers in patients admitted to special wards. Therefore, this method applied to patients admitted to the intensive care unit can effectively improve eye care and prevent vision impairment after recovery.


Proper targeted cancer prophylaxis reduces the incidence of cancer in all forms; this includes cancers with significant progression potential and poor prognosis. Based on the assumption that one of the risk factors of cervical cancer is the avoidance of screening tests, we analyzed the current scenario of cervical cancer (CC) screening and recommendations in Poland (country with a well-off socioeconomic status). Based on the comprehensive literature review concerning documents of guidelines and recommendations of various bodies, including national ones, data on the implementation of CC screening in Poland, and different models for medium-to-high-income countries, we proposed how the CC screening strategy could be improved. Finally, the new strategy was further developed for those who are prone to not being screened. The proposal on how to improve the Polish CC screening program is the following: refinement of the public education on CC risk factors, popularization of CC screening incentives amongst the public, and improvement of networking strategies between CC screening facilities , allowing screenings to be more efficient and rapid. We believe that, to enhance the future quality of life of those with rapid CC progression by catching the disease preemptively and limiting the sequelae of the disease, we have to improve education and access to medical services. Cervical cancer (CC) is the most prevalent gynecological malignancy worldwide . Three tMoreover, according to the International Agency for Research on Cancer (IARC), the age-standardized mortality rate  for Poland is 4.9, and the European average is 3.1. This value is comparable to Eastern European countries, with their widely considered worse access to medical care. According to the report, Poland is the seventh country in Europe with the highest mortality rate for CC ..17].The tertiary prevention has to do with CC patients and their access to, as well as quality and effectiveness of, care. For a tertiary prevention to be successful, the WHO has identified an effective referral system and good compliance with the treatment, as well as functioning palliative care, to be essential. Referral systems, as well as palliative care, are largely dependent on the resources and structure of the healthcare system in each region. Palliative care can be especially demanding of a system, as it requires a high degree of specialized personnel.Compliance with treatment is both a good predicting factor for good patient outcomes, as well as a complex problem to tackle. Social factors, such as access to treatment and social relievers , along with consistency regarding treatment facilities, were all positively correlated with increased compliance ,19. The Therapeutic vaccinations are a controversial yet promising treatment for recurrent HPV-related cancers. Currently, there are several clinical trials investigating the effect of vaccinations on disease progression. The theoretical background suggests that vaccinations can prevent recurrent cancer manifestations by increasing the cell-mediated immunity in an already infected patient, as opposed to preventing the initial infection. The ideal target for this type of therapy is those HPV-infected and those with preinvasive lesions, as progression to cancer proper can take several decades. It is worth noting that this use of HPV vaccinations is not, at the time of writing this article, approved by the US Food and Drug Administration or the European Medicines Agency, although several clinical trials are currently in progress .Apart from the systemic ideal situation described above, a significant reason for the ongoing high occurrence of CC is the avoidance of regular CC screening. The indicated psychosocial barriers, which prevent patients from participating in prophylaxis, can be classified into three categories: barriers related to facilities/environment, e.g., difficulties in making an appointment, long distance from home to the facility, and problem with transport; barriers related to the personal characteristics of patients, e.g., problems with the organization of time, additional costs, other priorities, lack of awareness of the significance of prophylaxis, and emotional barriers related to the results of the examination itself; and social barriers, e.g., negative experiences with healthcare professionals in the past and lack of support among family and friends .Access to a gynecologist in Poland is actually difficult. According to the NIK report  of 2016 , there wHowever, the most common reported barriers  were thoIt has been shown that personal invitations are an ineffective way of increasing participation in the CC prevention program; in Poland, in 2009, only 5.5% responded to personal invitation to an examination. Women living in rural areas and with lower education resigned more often than women living in cities with higher education; therefore, the information campaign should cover the first group in particular . Patients also often feel that this type of screening does not apply to them because of: the stability and length of the current relationships, the feeling that the disease affects elders or that, after menopause, these screening are less important than before, no symptoms, and no cases in the family . The aboAnalyzing data from global cancer incidence reports, CC is one of the most frequent cancers amongst the female sex population. Hence, regarding the worldwide statistics, CC is still a matter of concern. Currently, CC prophylaxis consists of three stages: primary prevention, risk factor management, i.e., vaccination against hrHPV; secondary, populational screening for the early-stage CC or precancer; and tertiary, providing timely follow-up visits in order to prevent further complications. The world’s incidence of CC reflects the immense frequency of HPV infection. Unfortunately, vaccination against HPV is not widely administered. The WHO recommends HPV screening as the most effective and simple secondary prophylactic measure .The following facts that are generally known to the authors are the limitations that significantly complicate the analysis of the starting point of the situation in Poland: patients perform tests outside the NHF program; therefore, reporting the % coverage of the population only with NHF data may differ from the actual screening level in Poland; there is a growing interest in other types of screening tests than a Pap smear, i.e., LBC and HPV tests, which are not included in reporting; low social awareness ; and a reluctance toward preventive examinations occurs in victims of sexual violence—mostly people with different gender orientations or those HIV-infected.These above-mentioned issues have never been addressed in the Polish literature, and it should be noted that a review that cannot refer to these data must be incomplete. We also realize that our review is not a systematic one; therefore, it is subjected to selection bias. Despite these issues, we tried to make a diagnosis of the current system and propose a change in the way of thinking to be more oriented towards Polish patients. Our diagnosis is that the patient was not medically educated and was in a socioeconomic environment that offered limited access to prophylactic health services for oncological diseases in the population of importance.Therefore, we see that there is a need to pay attention to the issues not addressed so far in this article on the type of review.First of all, we are far from countries such as Australia or our close neighbor—Sweden. Sypień and Zielonka et al. estimated Poland’s HPV vaccine coverage to be less than 10%, with a total of only 22,341 individuals having been vaccinated in 2018 .Australia, in 2023, is set to become the world’s first country where CC will be a rare disease defined by less than 6 cases out of 100,000 inhabitants. Moreover, by 2028, there will be less than 4 new cases out of 100,000 inhabitants (2021-35) . On 1 DeSweden has implemented a screening program for anyone assigned female at birth between the ages of 23 and 64, wherein patients are called to give regular cell samples. The cases of cervical cancers have halved since the introduction of the screening program in the 1960s. Furthermore, HPV vaccines for 5th grade girls were introduced to the public vaccination schedule in 2010  and have remained in use since. As of 2019, Swedish boys are also vaccinated in the same manner as part of a plan to eradicate HPV in Sweden within the next 3–5 years. Compliance rates for the screening was 80% of those called on. Sweden also has a high amount of vaccine compliance, with 77.6% of girls and 71.9% of boys born in 2009 in Sweden having been vaccinated with at least two doses of the HPV vaccine in 2022, according to Folkhälsomyndigheten  . It is, Among all the recommendations encountered, in the context of groups that avoid screening, one should start with the simplest: teaching teenagers about the route of transmission of HPV infection and the importance of regular visits to the gynecologist.−Vaccination calendar—HPV vaccination as recommended and free.−Promoting vaccination in schools.−Involvement of the media (including actors and influencers) in promoting HPV vaccination.−Offering vaccinations to mothers who accompany patients in gynecological offices.−SMS notifications about cytology sent.−Mobile cervical cancer screening units .When referring to larger groups, more generalizing is necessary to emphasize certain conclusions and solutions for which there is more evidence.The main and most frequent suggestion is replacing the conventional cytology with the DNA genotyping test for hrHPV types as the basic screening test. This is recommended by leading health agencies and expert groups—including the WHO, the American Society for Clinical Oncology (ASCO), and the American Society for Colposcopy and Cervical Pathology (ASCCP). HPV testing has a relatively high negative predictive value, which means that screening intervals can be safely extended for HPV-negative patients, which seems to be a more favorable solution for women who are screened for CC ,36,37.The use of an LBC, which makes it possible to perform several diagnostics tests from one swab, will reduce the number of necessary visits for patient to one in the qualification stage for possible colposcopy with a biopsy, which would be much less oppressive and time-consuming for patients and would improve cooperation with them .Disseminating the idea of “Self-sampling”, a self-collection of vaginal material by the patient using a dedicated brush and subsequent performance of the HPV genotyping tests, would be a good solution for patients who may have difficulties owing to cultural barriers such as exposing private genital areas to an unknown gynecologist, pain experienced during previous examinations, or past history of abuse ,40.The creation of a nationwide information system through which patients would receive notifications about upcoming gynecological appointments would reduce the number of patients who irregularly perform CC screening. Additionally, by using such a platform, which could work as an application on a smartphone, patients could receive the results of their latest cytology and collect all previous results in one place .Extending the participation of non-gynecologists  in educating the society about the benefits of secondary CC prevention and promoting the idea of self-collection methods is an effective alternative to material collection by medical personnel.Additionally, combining CC prevention with breast cancer prevention in a joint program of preventive examinations would be justified in Poland .On the basis of the patient’s case , we shouIn developing preventive programs, education and social activity are very important for socioeconomics, language barriers, and traditional understandings of health and disease. There should be equal access to preventive screening for all women, regardless of race or being foreign-born, uninsured, less educated, and socioeconomically disadvantaged. Important in this regard are free and generally available services. The campaign promoting screening among Haitian women living in South Florida shows that there is a need to disseminate knowledge among women who, for various reasons, do not have access to it. Such campaigns help to develop promising strategies for encouraging the uptake of cervical cancer prevention services .In 2019, the National Comprehensive Cancer Network (NCCN) collaborated with the Maria Sklodowska Curie National Research Institute (MSCNRIO) in Warsaw and Alliance for Innovation (AFI) to create a pilot project called the Polish Edition: The NCCN Guidelines for Cervical Cancer. The project was shepherded by Polish oncologists, including the Health Technology Assessment Agency, National Health Fund, Ministry of Health representatives, and Polish patient advocacy groups. The standards being developed are intended to improve global cancer care so that cancer patients have access to treatments at similar levels in their countries. The Polish edition of the guidelines is one of the first to have been developed by a group of international experts and that will be applicable outside the United States. However, this is a version adapted to Polish conditions  (v. 1.2021) . HoweverIn Poland, every woman between the ages of 25 and 59 who has not had a pap smear screening test in the last 3 years can have this test done in a gynecological office and also in an internal medicine office if it is performed by a midwife certified to perform this test. In the above cases, a referral is not needed . If thatThe only refunded HPV vaccine in Poland is Cervarix, and the patient has to cover 50% of the costs. Girls 9–15 are recommended to receive two doses at 5 and 13 months. For women aged 15 and over, three doses at 0, 1, and 6 months are recommended. An internal medicine doctor can qualify the patient for the vaccination. The vaccine is not obligatory . The proSupplements to European Guidelines for Quality Assurance in Cervical Cancer Screening, published in 2015. Many organizational, logistic, economic, clinical factors, and considerations should be considered before the introduction of HPV-based screening. In Poland, the recruitment of patients for the HPV-DNA test pilot study is currently underway, organized by the Central Coordination Center, Maria Sklodowska Curie National Research Institute as part of the National Oncological Strategy under an agreement with the Minister of Health [The implementation of screening based on HPV genotyping in Poland requires a huge organizational effort. This test is more sensitive but less specific compared to cytology, which may increase the risk of false-positive results and, thus, overtreatment, which is particularly undesirable in women with maternity plans. In order to prevent this, the national CC prevention program should be carefully and gradually modernized, which should be preceded by pilot studies with their appropriate analyses. The necessity of pilotage is mentioned in f Health .Ultimately, screening tasks should be elaborated and carefully counted. This is beyond the scope of this article. However, we must point out that the expert and advisory teams still focus on medical issues, disregarding psychocultural considerations at least to the extent that we indicated in this review .The current administration of CC screening and prevention is deemed inadequate. With the state implementing the improvements discussed earlier, a larger audience could potentially be reached and be provided with the necessary incentives for partaking in CC screenings. Along with such measures, better networking amongst cervical screening clinicals may contribute to the desired applicable results. In closing, such benefits can lead to the reduction of costs in tertiary prevention.