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Sample records for attending public primary

  1. Comparison of obesity, overweight and elevated blood pressure in children attending public and private primary schools in Benin City, Nigeria.

    Science.gov (United States)

    Sadoh, W E; Israel-Aina, Y T; Sadoh, A E; Uduebor, J E; Shaibu, M; Ogonor, E; Enugwuna, F C

    2017-07-01

    Overweight and obesity in children, and adolescents is on the rise globally. Affected children are prone to cardio-metabolic problems later in life, especially hypertension. The prevalence of obesity/overweight may differ depending on school type. Private schools are attended mostly by children of the affluent, while public schools are attended predominantly by those in the low and middle socio-economic classes. To compare the prevalence of overweight, obesity and elevated blood pressure (BP) in pupils attending public and private primary schools in an urban community in Nigeria. In this cross sectional study, the BMI and BP of pupils in public and private primary schools, recruited by multistage sampling method, were measured. Their nutritional status was categorized using their BMI percentiles. Analysis was by SPSS. A total of 1466 pupils were recruited, 814(55.5%) were in public schools and 722(49.2%) were males. The prevalence of overweight and obesity was higher in private schools 11.8% and 11.7% compared to public schools 3.3% and 0.9%. The mean systolic BP of pupils in public schools 96.8 ± 12.5 mmHg was higher than that in private schools 95.5 ± 10.2 mmHg, p = 0.032. Distribution of pupils with prehypertension and hypertension between private and public schools was not significantly different. The prevalence of overweight and obesity is higher in pupils attending private schools compared to those in public school. Urgent measures are needed to stem this tide through education, weight reduction and physical activity programs, especially in pupils attending private schools.

  2. Potential prescription patterns and errors in elderly adult patients attending public primary health care centers in Mexico City

    Directory of Open Access Journals (Sweden)

    José Antonio Corona-Rojo

    2009-08-01

    Full Text Available José Antonio Corona-Rojo1, Marina Altagracia-Martínez1, Jaime Kravzov-Jinich1, Laura Vázquez-Cervantes1, Edilberto Pérez-Montoya2, Consuelo Rubio-Poo31Division of Biological Sciences and Health, Metropolitan Autonomous University, Campus Xochimilco (UAM-X, Xochimilco, México; 2National Polytechnical Institute (IPN, México DF; 3Faculty of Higher Studies – Zaragoza (FES-Zaragoza, National Autonomous University of México (UNAM, México City, MéxicoIntroduction: Six out of every 10 elderly persons live in developing countries.Objective: To analyze and assess the drug prescription patterns and errors in elderly outpatients attending public health care centers in Mexico City, Mexico.Materials and methods: A descriptive and retrospective study was conducted in 2007. Fourteen hundred prescriptions were analyzed. Prescriptions of ambulatory adults aged >70 years who were residents of Mexico City for at least two years were included. Prescription errors were divided into two groups: (1 administrative and legal, and (2 pharmacotherapeutic. In group 2, we analyzed drug dose strength, administration route, frequency of drug administration, treatment length, potential drug–drug interactions, and contraindications. Variables were classified as correct or incorrect based on clinical literature. Variables for each drug were dichotomized as correct (0 or incorrect (1. A Prescription Index (PI was calculated by considering each drug on the prescription. SPSS statistical software was used to process the collected data (95% confidence interval; p < 0.05.Results: The drug prescription pattern in elderly outpatients shows that 12 drugs account for 70.72% (2880 of prescribed drugs. The most prescribed drugs presented potential pharmacotherapeutic errors (as defined in the present study. Acetylsalicylic acid–captopril was the most common potential interaction (not clinically assessed. Potential prescription error was high (53% of total prescriptions. Most

  3. Reproductive tract infections among women attending primary ...

    African Journals Online (AJOL)

    Reproductive tract infections among women attending primary health care facilities in Moshi, Tanzania. ... Objectives: To determine the prevalence and risk factors for reproductive tract infections (RTIs), the requency of asymptomatic genital tract infections, the frequency of genitourinary symptoms and signs and to assess ...

  4. Awareness of Stomach and Colorectal Cancer Risk Factors, Symptoms and Time Taken to Seek Medical Help Among Public Attending Primary Care Setting in Muscat Governorate, Oman.

    Science.gov (United States)

    Al-Azri, Mohammed; Al-Kindi, Jamila; Al-Harthi, Thuraiya; Al-Dahri, Manal; Panchatcharam, Sathiya Murthi; Al-Maniri, Abdullah

    2017-08-07

    Colorectal and stomach cancers are the top ranking cancers in Oman. Most of the patients are diagnosed at advanced disease stages. The aim of this study is to explore the knowledge of risk factors, symptoms and the time needed to seek medical care for stomach cancer and colorectal cancer (CRC) among Omani participants attending 28 local health centres (LHCs) in the governorate of Muscat, the capital city of Oman. The Bowel Cancer/CRC Awareness Measure (CAM) questionnaire (translated into Arabic) was used to collect data from Omani adult participants (aged 18 years and above) who attended the LHCs during the study period. There was a total of 405 participants in the study out of the 500 who were invited (response rate = 81%). The most recognised risk factors were excessive drinking of alcohol (73.1%) and smoking (70.6%); the least recognised were doing less exercise (37.3%), eating food which was high in salt (26.8%) and a diagnosis of diabetes mellitus (24.9%). Multinomial logistic regression showed that young participants recognised more risk factors than older participants; highly educated participants recognised more risk factors than the less-educated and married participants recognised more risk factors than single participants. Participants with a high level of education were more likely to identify signs and symptoms of stomach cancer and CRC than less-educated participants. Multinomial logistic regression showed women were more likely than men to report barriers to seeking medical help (fear, difficulty in arranging transport, worried what the doctor might find). Also, participants with less education were more likely to report barriers than the highly educated (worried about wasting the doctor's time, difficulty in arranging transport, did not feel confident talking about symptoms, embarrassed, scared, worried what doctor might find). The majority of participants (93.6%) were not aware of any CRC screening programme or had undergone any screening (98

  5. Vaginal Trichomoniasis among Patients Attending Primary Health ...

    African Journals Online (AJOL)

    Trichomoniasis is widely distributed all over the world and remains a common infection among female patients attending sexually transmitted disease clinics. The aim of this study is to determine the prevalence of trichomonal infection in HIV/AIDS and non-HIV control groups of patients in a population of women.

  6. The prevalence of personality disorder among UK primary care attenders.

    Science.gov (United States)

    Moran, P; Jenkins, R; Tylee, A; Blizard, R; Mann, A

    2000-07-01

    To determine the prevalence rate of personality disorder among a consecutive sample of UK primary care attenders. Associations between a diagnosis of personality disorder, sociodemographic background and common mental disorder were examined. Three hundred and three consecutive primary care attenders were examined for the presence of ICD-10 and DSM-4 personality disorders using an informant-based interview. Personality disorder was diagnosed in 24% (95% CI: 19-29) of the sample. Personality-disordered subjects were more likely to have psychiatric morbidity as indicated by GHQ-12, to report previous psychological morbidity, to be single and to attend the surgery on an emergency basis. 'Cluster B' personality disorders were particularly associated with psychiatric morbidity. There is a high prevalence rate of personality disorders among primary care attenders. These disorders are associated with the presence of common mental disorder and unplanned surgery attendance. Personality disorders may represent a significant source of burden in primary care.

  7. Health profiles of foreigners attending primary care clinics in Malaysia

    National Research Council Canada - National Science Library

    Ab Rahman, Norazida; Sivasampu, Sheamini; Mohamad Noh, Kamaliah; Khoo, Ee Ming

    2016-01-01

    .... Little is known about the health profiles of foreign population in Malaysia. The aim of this study was to provide a detailed description of the health problems presented by foreigners attending primary care clinics in Malaysia...

  8. Health profiles of foreigners attending primary care clinics in Malaysia.

    Science.gov (United States)

    Ab Rahman, Norazida; Sivasampu, Sheamini; Mohamad Noh, Kamaliah; Khoo, Ee Ming

    2016-06-14

    The world population has become more globalised with increasing number of people residing in another country for work or other reasons. Little is known about the health profiles of foreign population in Malaysia. The aim of this study was to provide a detailed description of the health problems presented by foreigners attending primary care clinics in Malaysia. Data were derived from the 2012 National Medical Care Survey (NMCS), a cross sectional survey of primary care encounters from public and private primary care clinics sampled from five regions in Malaysia. Patients with foreign nationality were identified and analysed for demographic profiles, reasons for encounter (RFEs), diagnosis, and provision of care. Foreigners accounted for 7.7 % (10,830) of all patient encounters from NMCS. Most encounters were from private clinics (90.2 %). Median age was 28 years (IQR: 24.0, 34.8) and 69.9 % were male. Most visits to the primary care clinics were for symptom-based complaints (69.5 %), followed by procedures (23.0 %) and follow-up visit (7.4 %). The commonest diagnosis in public clinics was antenatal care (21.8 %), followed by high risk pregnancies (7.5 %) and upper respiratory tract infection (URTI) (6.8 %). Private clinics had more cases for general medical examination (13.5 %), URTI (13.1 %) and fever (3.9 %). Medications were prescribed to 76.5 % of these encounters. More foreigners were seeking primary medical care from private clinics and the encounters were for general medical examinations and acute minor ailments. Those who sought care from public clinics were for obstetric problems and chronic diseases. Medications were prescribed to two-thirds of the encounters while other interventions: laboratory investigations, medical procedures and follow-up appointment had lower rates in private clinics. Foreigners are generally of young working group and are expected to have mandatory medical checks. The preponderance of obstetrics seen in public

  9. A Study among Women Attending a Primary Healthcare Clinic

    African Journals Online (AJOL)

    Candidiasis: A Study among Women Attending a. Primary Healthcare Clinic in Kwazulu‑Natal, South Africa ... leading women to seek advice in primary healthcare facilities. Aim: The aim of this study is to describe the .... a 0.22 μm Costar Spin‑X cellulose acetate filter membranes. (Sigma). The filtered soluble fraction was ...

  10. Identification of dietary patterns of adolescents attending public schools

    OpenAIRE

    Lucinéia PINHO; Silveira, Marise Fagundes; Botelho,Ana Cristina de Carvalho; Caldeira,Antônio Prates

    2014-01-01

    OBJECTIVE: to identify the dietary patterns of adolescents attending public municipal schools in Northern Minas Gerais, Brazil, and to test the association between these patterns and socioeconomic variables and nutritional status of the adolescents. METHODS: this was an analytical, cross-sectional study with randomized sample of 474 adolescents of both genders, between 11 and 17 years of age, attending municipal public schools in the urban area of Montes Claros, MG, Brazil. The parents p...

  11. Knowledge, attitude and practice of patients attending primary care ...

    African Journals Online (AJOL)

    Background: Extracellular calcium is vital for the functioning of many metabolic processes and neuromuscular activities. Awareness and practice of patients with vitamin D deficiency are very important. Objective: To explore knowledge, attitude and practice of patients receiving vitamin D supplement and attending primary ...

  12. Prevalence of chronic pain in patients attending primary healthcare ...

    African Journals Online (AJOL)

    2012-02-18

    Feb 18, 2012 ... Original Research: Prevalence of chronic pain in patients attending primary healthcare facilities in south-west Tshwane. 85. Vol 55 No 1. S Afr Fam Pract 2013. Introduction. Chronic pain may have a significant bio-psychosocial impact on the health and quality of life of an individual. Chronic pain also has a ...

  13. Knowledge, attitude and practice of patients attending primary care ...

    African Journals Online (AJOL)

    Bassam A. Al Bathi

    2012-03-18

    Mar 18, 2012 ... processes and neuromuscular activities. Awareness and ... are oral vitamin D supplementation, increased exposure to. UV light ... a disease.13. The aim of the present study was to explore knowledge, attitude and practice of patients attending primary health care. (PHC) centers for vitamin D supplement. 2.

  14. Improving skilled attendants at birth: Experience in a primary health ...

    African Journals Online (AJOL)

    Background: Skilled attendance at birth has been identified as one of the most cost-effective methods of reducing maternal and neonatal mortality, but in spite of the efforts made to address the poor access in Nigeria, utilization in some communities is surprisingly poor. This study highlighted the experience of a primary ...

  15. Persistent frequent attenders in primary care: costs, reasons for attendance, organisation of care and potential for cognitive behavioural therapeutic intervention

    Directory of Open Access Journals (Sweden)

    Morriss Richard

    2012-07-01

    Full Text Available Abstract Background The top 3% of frequent attendance in primary care is associated with 15% of all appointments in primary care, a fivefold increase in hospital expenditure, and more mental disorder and functional somatic symptoms compared to normal attendance. Although often temporary if these rates of attendance last more than two years, they may become persistent (persistent frequent or regular attendance. However, there is no long-term study of the economic impact or clinical characteristics of regular attendance in primary care. Cognitive behaviour formulation and treatment (CBT for regular attendance as a motivated behaviour may offer an understanding of the development, maintenance and treatment of regular attendance in the context of their health problems, cognitive processes and social context. Methods/design A case control design will compare the clinical characteristics, patterns of health care use and economic costs over the last 10 years of 100 regular attenders (≥30 appointments with general practitioner [GP] over 2 years with 100 normal attenders (6–22 appointments with GP over 2 years, from purposefully selected primary care practices with differing organisation of care and patient demographics. Qualitative interviews with regular attending patients and practice staff will explore patient barriers, drivers and experiences of consultation, and organisation of care by practices with its challenges. Cognitive behaviour formulation analysed thematically will explore the development, maintenance and therapeutic opportunities for management in regular attenders. The feasibility, acceptability and utility of CBT for regular attendance will be examined. Discussion The health care costs, clinical needs, patient motivation for consultation and organisation of care for persistent frequent or regular attendance in primary care will be explored to develop training and policies for service providers. CBT for regular attendance will

  16. Abdominal obesity in adolescent girls attending a public secondary ...

    African Journals Online (AJOL)

    Background: Deposition of excess fat in the abdominal region is strongly associated with the metabolic disturbances thought to underlie many obesity related complications. Aim: To determine the prevalence of abdominal obesity using waist circumference inadolescents' girls attending a public secondary school in Port ...

  17. Barriers of Chinese primary care attenders to seeking help for psychological distress in Hong Kong.

    Science.gov (United States)

    Sun, Kai Sing; Lam, Tai Pong; Lam, Kwok Fai; Lo, Tak Lam; Chao, David Vai Kiong; Lam, Edmund Wing Wo

    2016-05-15

    Most of the previous studies on help seeking for psychological distress were derived from Western countries. This study investigated the barriers to help-seeking for psychological distress among Chinese primary care attenders in Hong Kong. Nine focus groups and 6 individual interviews were conducted among Chinese primary care attenders with/without known distress, patients' significant others and the general public. The identified barriers were investigated in a questionnaire survey with data from 1626 primary care attenders recruited from 13 private clinics and 6 public clinics. Worries about side effects of drugs (79.9%, 95% CI:(77.9%, 81.8%)) and drug dependency (74.7%, 95% CI:(72.5%, 76.8%)) were rated as the top barriers in the survey. Qualitative interviews found both worries and actual experience of the side effects of drugs, which weakened patients' trust in the treatment. Factor analysis on all barrier items suggested three factors: 1) worries of treatment, 2) uncertainties on primary care physicians' capacity, 3) public's limited knowledge on distress and sources of help. Distress level, education level and age were associated with factor 1, whereas distress level and healthcare setting were associated with the other two factors. Qualitative interviews revealed that not having a regular primary care physician in the public setting discouraged disclosure of psychological problems. The findings were based on self-reported data from the respondents. Hong Kong is influenced by a mixed Chinese and Western culture. Relevant public education in a Chinese context should target at reducing patients' worries of drug treatment and strengthening the image of primary care physicians as a feasible source of help. Copyright © 2016 Elsevier B.V. All rights reserved.

  18. [Frequent attendance in a Primary Health Care District].

    Science.gov (United States)

    Menéndez Granados, Nicolás; Vaquero Abellán, Manuel; Toledano Estepa, Manuel; Pérez Díaz, Manuel Modesto; Redondo Pedraza, Rosa

    2017-10-09

    To describe the distribution of frequent attenders (FA) through the different primary care practices in Cordoba-Guadalquivir Health District (Córdoba, Spain). An ecological study was performed, including data from 2011 to 2015. Defining FA as those subjects who made12 or more appointments per year; independently analysed for nursing, general practice and paediatrics. Prevalence of frequent attendance and FA/professional ratio were used as dependent variables. Demographic characteristics from district population, number of health professionals and use of general facilities were also examinated. Aiming to understand FA distribution, primary health settings were classified according to facility size and environmental location (urban, suburban and rural). The mean prevalence for FA was 10.86% (0.5 SE) for nursing; general practice 21.70% (0.7 SE) and for paediatrics 16.96% (0.7 SE). FA/professional ratios for the different professional categories were: 101.07 (5.0 SE) for nursing, 239.74 (9.0 SE) for general practice and 159.54 (9.8 SE) for paediatrics. A major part of primary health care users make a high number of consultations. From this group, women overuse nursing and general practitioner services more compared to men. A higher prevalence of FAs was observed in smaller settings, in rural areas. Although taking the FAs:professional ratio as the bar, medium-size practices are more highly overused. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  19. Abusive experiences and psychiatric morbidity in women primary care attenders.

    Science.gov (United States)

    Coid, Jeremy; Petruckevitch, Ann; Chung, Wai-Shan; Richardson, Jo; Moorey, Stirling; Feder, Gene

    2003-10-01

    Abusive experiences in childhood and adulthood increase risks of psychiatric morbidity in women and independently increase risks of further abuse over the lifetime. It is unclear which experiences are most damaging. To measure lifetime prevalence of abusive experiences and psychiatric morbidity, and to analyse associations in women primary care attenders. A cross-sectional, self-report survey of 1207 women attending 13 surgeries in the London borough of Hackney, UK. Independent associations between demographic measures, abusive experiences and psychiatric outcome were established using logistic regression. Childhood sexual abuse had few associations with adult mental health measures, in contrast to physical abuse. Sexual assault in adulthood was associated with substance misuse; rape with anxiety, depression and post-traumatic stress disorder but not substance misuse. Domestic violence showed strongest associations with most mental health measures, increased for experiences in the past year. Abuse in childhood and adulthood have differential effects on mental health; effects are increased by recency and severity. Women should be routinely questioned about ongoing and recent experiences as well as childhood.

  20. Identification of dietary patterns of adolescents attending public schools

    Directory of Open Access Journals (Sweden)

    Lucinéia de Pinho

    2014-06-01

    Full Text Available OBJECTIVE: to identify the dietary patterns of adolescents attending public municipal schools in Northern Minas Gerais, Brazil, and to test the association between these patterns and socioeconomic variables and nutritional status of the adolescents. METHODS: this was an analytical, cross-sectional study with randomized sample of 474 adolescents of both genders, between 11 and 17 years of age, attending municipal public schools in the urban area of Montes Claros, MG, Brazil. The parents provided demographic and economic data. The nutritional status (body mass index - BMI of the adolescents was determined at school, and their dietary habits were assessed though the administration of the Food Frequency Questionnaire for Adolescents (FFQA. Based on 26 categories extracted from FFQA, dietary patterns were determined using principal component analysis (PCA and associated to anthropometric and socioeconomic factors using multiple regression analysis. RESULTS: the three dietary patterns identified, "junk food," "healthy," and "traditional", explained 23.26%, 6.90%, and 5.24% of data variability, respectively. Adolescents with per capita family income exceeding half a minimum wage were more likely to consume the "junk food" pattern (OR = 1.66; 95% CI = 1.07-2.56, and overweight adolescents had lower chances of eating the "healthy" food pattern (OR = 0.56, 95% CI = 0.35-0.91. CONCLUSIONS: deviations from the "healthy" patterns were not associated to low income, but rather to bad eating habits in the studied population. Overweight adolescents did not adhere to the "healthy" dietary pattern, emphasizing the need for nutritional education among them.

  1. Identification of dietary patterns of adolescents attending public schools.

    Science.gov (United States)

    Pinho, Lucinéia de; Silveira, Marise Fagundes; Botelho, Ana Cristina de Carvalho; Caldeira, Antônio Prates

    2014-01-01

    to identify the dietary patterns of adolescents attending public municipal schools in Northern Minas Gerais, Brazil, and to test the association between these patterns and socioeconomic variables and nutritional status of the adolescents. this was an analytical, cross-sectional study with randomized sample of 474 adolescents of both genders, between 11 and 17 years of age, attending municipal public schools in the urban area of Montes Claros, MG, Brazil. The parents provided demographic and economic data. The nutritional status (body mass index - BMI) of the adolescents was determined at school, and their dietary habits were assessed though the administration of the Food Frequency Questionnaire for Adolescents (FFQA). Based on 26 categories extracted from FFQA, dietary patterns were determined using principal component analysis (PCA) and associated to anthropometric and socioeconomic factors using multiple regression analysis. the three dietary patterns identified, "junk food," "healthy," and "traditional", explained 23.26%, 6.90%, and 5.24% of data variability, respectively. Adolescents with per capita family income exceeding half a minimum wage were more likely to consume the "junk food" pattern (OR=1.66; 95% CI=1.07-2.56), and overweight adolescents had lower chances of eating the "healthy" food pattern (OR=0.56, 95% CI=0.35-0.91). deviations from the "healthy" patterns were not associated to low income, but rather to bad eating habits in the studied population. Overweight adolescents did not adhere to the "healthy" dietary pattern, emphasizing the need for nutritional education among them. Copyright © 2014 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  2. Interventions on frequent attenders in primary care. A systematic literature review

    NARCIS (Netherlands)

    Smits, Frans Th. M.; Wittkampf, Karin A.; Schene, Aart H.; Bindels, Patrick J. E.; van Weert, Henk C. P. M.

    2008-01-01

    Objective. To analyse which interventions are effective in influencing morbidity, quality of life, and healthcare utilization of frequently attending patients (FAs) in primary care. Methods. A systematic literature search was performed for articles describing interventions on FAs in primary care

  3. A qualitative study of the experiences of care and motivation for effective self-management among diabetic and hypertensive patients attending public sector primary health care services in South Africa.

    Science.gov (United States)

    Murphy, Katherine; Chuma, Thandie; Mathews, Catherine; Steyn, Krisela; Levitt, Naomi

    2015-08-01

    Diabetes and hypertension constitute a significant and growing burden of disease in South Africa. Presently, few patients are achieving adequate levels of control. In an effort to improve outcomes, the Department of Health is proposing a shift to a patient-centred model of chronic care, which empowers patients to play an active role in self-management by enhancing their knowledge, motivation and skills. The aim of this study was to explore patients' current experiences of chronic care, as well as their motivation and capacity for self-management and lifestyle change. The study involved 22 individual, qualitative interviews with a purposive sample of hypertensive and diabetic patients attending three public sector community health centres in Cape Town. Participants were a mix of Xhosa and Afrikaans speaking patients and were of low socio-economic status. The concepts of relatedness, competency and autonomy from Self Determination Theory proved valuable in exploring patients' perspectives on what a patient-centred model of care may mean and what they needed from their healthcare providers. Overall, the findings of this study indicate that patients experience multiple impediments to effective self-management and behaviour change, including poor health literacy, a lack of self-efficacy and perceived social support. With some exceptions, the majority of patients reported not having received adequate information; counselling or autonomy support from their healthcare providers. Their experiences suggests that the current approach to chronic care largely fails to meet patients' motivation needs, leaving many of them feeling anxious about their state of health and frustrated with the quality of their care. In accordance with other similar studies, most of the hypertensive and diabetic patients interviewed for this study were found to be ill equipped to play an active and empowered role in self-care. It was clear that patients desire greater assistance and support from their

  4. Public Staff Meetings – thank you for a large attendance

    CERN Multimedia

    Staff Association

    2013-01-01

    The public meetings of the Staff Association which took place recently were attended by about 500 staff, a large fraction of them young and on a limited duration (LD) contract. The audience mainly shared the worries of the Staff Association concerning the low number of IC post openings in this and the coming years. Moreover, after the meeting several LD contract holders contacted the Staff Association to express their point of view and to put forward their ideas to tackle this problem. As explained in those meetings, the Staff Association emphasizes that personnel policy should not be guided by self-imposed quota, even under pressure by the Member States. As we have repeated several times, CERN needs a total staff complement well beyond the baseline ceiling of 2250, the number agreed by Council, if it has to guarantee an efficient and excellence level of service to the ever-growing user community, which has almost doubled over the last decade. Moreover, the indefinite contract (IC) component should stan...

  5. Malaria among antenatal clients attending primary health care ...

    African Journals Online (AJOL)

    This study assessed the prevalence of fever, malarial parasitemia and anemia among pregnant women attending PHC facilities in Kano, northern Nigeria. Methods: A ... anemia. Intermittent Preventive Treatment (IPT) should be provided especially among primigravid, secondigravid and younger mothers at PHC centres.

  6. 77 FR 29634 - Notice of FERC Staff Attendance at the Louisiana Public Service Commission's Business and...

    Science.gov (United States)

    2012-05-18

    ... Attendance at the Louisiana Public Service Commission's Business and Executive Session Meeting The Federal... below. Their attendance is part of the Commission's ongoing outreach efforts. Louisiana Public Service... Services, Inc. Docket No. EL00-66 Louisiana Public Service Commission v. Entergy Services, Inc. Docket No...

  7. Quality of care offered to children attending primary health care ...

    African Journals Online (AJOL)

    antibiotic was prescribed in almost half (65/141) of the consultations, but antibiotic use was unwarranted in one-third of these cases. Health ... with clearly defined and monitored standard clinical practice routines and norms, is required to change the status quo. Primary .... Although both dosage and frequency of antibiotic ...

  8. Internet use among primary care patients attending a tertiary health ...

    African Journals Online (AJOL)

    Background: Global attention is being drawn to the use of internet resource because of its overwhelming benefits. Individuals, families, social groups, patients as well as research teams spend quality time on a daily basis exploring the internet. Objective: We carried out a study to determine internet use among primary care ...

  9. Prevalence of chronic pain in patients attending primary healthcare ...

    African Journals Online (AJOL)

    Objectives: Despite the significant biopsychosocial impact of chronic pain on the health and quality of life of an individual, as well as on healthcare utilisation, no published data are available on the prevalence of chronic pain in the South African primary healthcare context. The aim of this study was to investigate the ...

  10. Comparison of motor and cognitive performance of children attending public and private day care centers

    Directory of Open Access Journals (Sweden)

    Mariana M. Santos

    2013-12-01

    Full Text Available BACKGROUND: Given that environmental factors, such as the school environment, can influence child development, more attention should be paid to the development of children attending day care centers. OBJECTIVE: Todetermine whether there are differences in the gross motor, fine motor, or cognitive performances of children between 1 and3 years-old of similar socioeconomic status attending public and private day care centers full time. METHOD: Participants were divided into 2 groups, 1 of children attending public day care centers (69 children and another of children attending private day care centers (47 children. All children were healthy and regularly attended day care full time for over 4 months. To assess cognitive, gross and fine motor performance, the Bayley Scales of Infant and Toddler Development III was used. The Mann-Whitney test was used for comparative analyses between groups of children between 13 and 24 months, 25 and 41 months, and 13 and 41 months. RESULTS: Children in public day care centers exhibited lower scores on the cognitive development scale beginning at 13 months old. The fine and gross motor performance scores were lower in children over the age of 25 months attending public centers. Maternal education was not related to the performance of children in either group. CONCLUSION: The scores of cognitive performance as well as fine and gross motor performance of children of similar socioeconomic status who attend public day care centers are lower than children attending private daycare centers.

  11. Utilization of dental health services by Danish adolescents attending private or public dental health care systems

    DEFF Research Database (Denmark)

    Christensen, Lisa Bøge; Petersen, Poul Erik; Bastholm, Annelise

    2002-01-01

    systems. The study comprised 1,245 adolescents from 3 municipalities; the historical cohort study design was applied; and data were collected from dental records (public dental service) and dental claims (private practice). At age 16, 12% preferred being enrolled in the private practice system, while 88......% remained in the public dental care system. During the 2-year study period the attendance rate was 99% for the public system, while 90% attended the private practice system (P... that the economic barrier was eliminated a lower attendance rate was observed for patients transferred to the private practice system....

  12. Public outreach: Multitudes attend the Night of Science

    CERN Multimedia

    2006-01-01

    The Night of Science, which took place in the parc de la Perle du Lac in Geneva last weekend, was a great success, with 30000 visitors attending according to the organisers. Many curious people flocked to the stands and animations until late on Saturday night and all afternoon on Sunday. The CERN stand (photo) received a great amount of interest from participants. Both kids and adults discovered the activities of the Laboratory and the data-processing revolution initiated by CERN, from the Web to the Computing Grid. Hats off to the CERN collaborators in the Communication Group and IT Department who made this event a success.

  13. Communication and Computation Skills for Blind Students Attending Public Schools.

    Science.gov (United States)

    Suffolk County Board of Cooperative Educational Services 3, Dix Hills, NY.

    Outlined are evaluative and instructional procedures used by itinerant teachers of blind children in public schools to teach readiness for braille reading and writing, as well as braille reading and writing, signature writing, and the Nemeth Code of braille mathematics and scientific notation. Readiness for braille reading and writing is…

  14. [Professional competencies in primary health care for attending to older adults].

    Science.gov (United States)

    Witt, Regina Rigatto; Roos, Maclaine de Oliveira; Carvalho, Nilson Maestri; Silva, Andria Machado da; Rodrigues, Carla Daiane Silva; Santos, Mariana Timmers Dos

    2014-12-01

    To identify and analyze the necessary competencies in primary health care for attending to older adults. An exploratory, descriptive, and quali-quantitative study was developed. Three rounds of the Delphi Technique were conducted with participants from primary health care services and a multidisciplinary committee. The first questionnaire asked participants to indicate the competencies needed for attending to older adults in primary health care. They were compiled into a list and added to a Likert Scale (from 1 to 5) for the second and third questionnaires. A consensus criterion of 70% was adopted. Twenty eight competencies were reached by consensus and were classified into twelve domains. The competencies reflect Brazilian health care policy and constitute a reference for professional health practice and education when caring for the older adult in primary health care.

  15. Thank you for attending our public meeting on 22 September!

    CERN Multimedia

    Staff Association

    2016-01-01

    Many thanks to all of you who accepted the Staff Association’s invitation for Thursday, 22 September. Certainly, we would have appreciated reaching an even wider audience for the single public meeting. This would have surely been possible if certain meetings had been rescheduled in agreement with the management. After all, this has already been done in the past! Regardless, the feedback from our colleagues who were present at the meeting was very positive: the educational and fact-based approach of the presentation was very well received. Therefore, we encourage everyone who is interested to watch the video recording of this public meeting or to consult the presentation slides. This material should help to answer your questions, especially regarding the placement in grades and benchmark jobs. The first presentation of the new Executive Committee and Bureau of the Staff Association focused mainly on the implementation of the five-yearly review and on the impacts that this review can have on career...

  16. A Low-Effort, Clinic-Wide Intervention Improves Attendance for HIV Primary Care

    Science.gov (United States)

    Gardner, Lytt I.; Marks, Gary; Craw, Jason A.; Wilson, Tracey E.; Drainoni, Mari-Lynn; Moore, Richard D.; Mugavero, Michael J.; Rodriguez, Allan E.; Bradley-Springer, Lucy A.; Holman, Susan; Keruly, Jeanne C.; Sullivan, Meg; Skolnik, Paul R.; Malitz, Faye; Metsch, Lisa R.; Raper, James L.; Giordano, Thomas P.

    2012-01-01

    Background. Retention in care for human immunodeficiency virus (HIV)–infected patients is a National HIV/AIDS Strategy priority. We hypothesized that retention could be improved with coordinated messages to encourage patients' clinic attendance. We report here the results of the first phase of the Centers for Disease Control and Prevention/Health Resources and Services Administration Retention in Care project. Methods. Six HIV-specialty clinics participated in a cross-sectionally sampled pretest-posttest evaluation of brochures, posters, and messages that conveyed the importance of regular clinic attendance. 10 018 patients in 2008–2009 (preintervention period) and 11 039 patients in 2009–2010 (intervention period) were followed up for clinic attendance. Outcome variables were the percentage of patients who kept 2 consecutive primary care visits and the mean proportion of all primary care visits kept. Stratification variables were: new, reengaging, and active patients, HIV RNA viral load, CD4 cell count, age, sex, race or ethnicity, risk group, number of scheduled visits, and clinic site. Data were analyzed by multivariable log-binomial and linear models using generalized estimation equation methods. Results. Clinic attendance for primary care was significantly higher in the intervention versus preintervention year. Overall relative improvement was 7.0% for keeping 2 consecutive visits and 3.0% for the mean proportion of all visits kept (P < .0001). Larger relative improvement for both outcomes was observed for new or reengaging patients, young patients and patients with elevated viral loads. Improved attendance among the new or reengaging patients was consistent across the 6 clinics, and less consistent across clinics for active patients. Conclusion. Targeted messages on staying in care, which were delivered at minimal effort and cost, improved clinic attendance, especially for new or reengaging patients, young patients, and those with elevated

  17. Prevalence of depression among women attending a primary urban care clinic in Malaysia.

    Science.gov (United States)

    Sidik, Sherina Mohd; Arroll, Bruce; Goodyear-Smith, Felicity; Ahmad, Rozali

    2012-07-01

    Depression affects more women than men in Malaysia. The objective of this paper was to determine the prevalence of depression and its associated factors among women attending a government primary care clinic. A cross-sectional study was conducted in a government-funded primary care clinic in Malaysia. Consecutive adult female patients attending the clinic during the data collection period were invited to participate. The participants completed self-administered questionnaires (including the validated Patient Health Questionnaire [PHQ-9], which was translated into the Malay language). A total of 895 female patients participated in the study (response rate 87.5%). The prevalence of depression (PHQ-9 scores ≥ 10) was 12.1%. Based on multiple logistic regression analysis, certain stressful life events were found to be associated with depression (p Malaysia should be aware of this prevalence when making diagnoses in primary care.

  18. The onset of common mental disorders in primary care attenders in Harare, Zimbabwe.

    Science.gov (United States)

    Todd, C; Patel, V; Simunyu, E; Gwanzura, F; Acuda, W; Winston, M; Mann, A

    1999-01-01

    This study aimed to investigate the onset and predictors of common mental disorders (CMD) in primary-care attenders in Harare, Zimbabwe. Two (T1) and 12-month (T2) follow-up of a cohort of primary-care attenders without a common mental disorder (N = 197) as defined by the Shona Symposium Questionnaire (SSQ), recruited from primary health care clinics, traditional medical practitioner clinics and general practitioner surgeries. Outcome measure was caseness as determined by scores on the SSQ at follow-up. Follow-up rate was 86% at 2 months and 75% at 12 months. Onset of CMD was recorded in 16% at T1 and T2. Higher psychological morbidity scores at recruitment, death of a first-degree relative and disability predicted the presence of a CMD at both follow-up points. While female gender and economic difficulties predicted onset only in the short-term, belief in supernatural causation was strongly predictive of CMD at T2. Caseness at both follow-up points was associated with economic problems and disability at those follow-up points. Policy initiatives to reduce economic deprivation and targeting interventions to primary-care attenders who are subclinical cases and those who have been bereaved or who are disabled may reduce the onset of new cases of CMD. Closer collaboration between biomedical and traditional medical practitioners may provide avenues for developing methods of intervention for persons with supernatural illness models.

  19. Prevalence of problem alcohol use among patients attending primary care for methadone treatment

    LENUS (Irish Health Repository)

    Ryder, Niamh

    2009-06-11

    Abstract Background Problem alcohol use is associated with adverse health outcomes among current or former heroin users and primary care is providing methadone treatment for increasing numbers of this population. This study aimed todetermine the prevalence of problem alcohol use among current or former heroin users attending primary care for methadone treatment and to describe the socio-demographic characteristics and health service utilisation characteristics associated with problem alcohol uses. Methods We conducted a cross sectional survey of patients sampled from a national database of patients attending general practice for methadone treatment. Participants were recruited by their general practitioner and data was collected using an interviewer-administered questionnaire, which included the Alcohol Use Disorders Identification Test (\\'AUDIT\\'), with a score of >7 considered abnormal (ie \\'AUDIT positive cases\\') and socio-demographic, medical and substance use characteristics. Results We interviewed 196 patients (71% of those invited, 31% of those sampled, 11% of the national database). The median age was 32 years, 55% were hepatitis C positive, 79% had used illicit drugs in the previous month and 68% were male. Sixty-eight \\'AUDIT positive\\' cases were identified (prevalence of 35%, 95% CI = 28–41%) and these were more likely to have attended a local Emergency Department in the previous year (p < 0.05) and less likely to have attended a hospital clinic in the previous year (p < 0.05). Twenty-seven (14%) scored 20 or higher indicating possible alcohol dependence. Conclusion Problem alcohol use has a high prevalence among current or former heroin users attending primary care for methadone treatment and interventions that address this issue should be explored as a priority. Interventions that address problem alcohol use in this population should be considered as a priority, although the complex medical and psychological needs of this population may make

  20. Prevalence of problem alcohol use among patients attending primary care for methadone treatment.

    LENUS (Irish Health Repository)

    Ryder, Niamh

    2012-02-01

    BACKGROUND: Problem alcohol use is associated with adverse health outcomes among current or former heroin users and primary care is providing methadone treatment for increasing numbers of this population. This study aimed to determine the prevalence of problem alcohol use among current or former heroin users attending primary care for methadone treatment and to describe the socio-demographic characteristics and health service utilisation characteristics associated with problem alcohol uses. METHODS: We conducted a cross sectional survey of patients sampled from a national database of patients attending general practice for methadone treatment. Participants were recruited by their general practitioner and data was collected using an interviewer-administered questionnaire, which included the Alcohol Use Disorders Identification Test (\\'AUDIT\\'), with a score of >7 considered abnormal (ie \\'AUDIT positive cases\\') and socio-demographic, medical and substance use characteristics. RESULTS: We interviewed 196 patients (71% of those invited, 31% of those sampled, 11% of the national database). The median age was 32 years, 55% were hepatitis C positive, 79% had used illicit drugs in the previous month and 68% were male. Sixty-eight \\'AUDIT positive\\' cases were identified (prevalence of 35%, 95% CI = 28-41%) and these were more likely to have attended a local Emergency Department in the previous year (p < 0.05) and less likely to have attended a hospital clinic in the previous year (p < 0.05). Twenty-seven (14%) scored 20 or higher indicating possible alcohol dependence. CONCLUSION: Problem alcohol use has a high prevalence among current or former heroin users attending primary care for methadone treatment and interventions that address this issue should be explored as a priority. Interventions that address problem alcohol use in this population should be considered as a priority, although the complex medical and psychological needs of this population may make this

  1. Meet the Maximally Exposed Member of the Public: The Service Station Attendant for Spent Nuclear Fuel Going to Yucca Mountain

    Energy Technology Data Exchange (ETDEWEB)

    Collins, H. E.; Gathers, R.; Halstead, R. J.

    2002-02-28

    According to the 1999 Draft Environmental Impact Statement (DEIS) for the proposed Yucca Mountain repository site, members of the public along transportation routes by which spent nuclear fuel (SNF) and high-level radioactive waste (HLW) is shipped will receive annual radiation doses less than 100 mrem/yr, the international (ICRP) and national (Department of Energy, Nuclear Regulatory Commission) radiation limit for members of the public. For the ''Mostly Truck'' national transportation scenario, the DEIS specifically concludes that the maximally exposed member of the public, a service station attendant along the primary shipping route will receive no more than 100 mrem/yr, or 2.4 rem over 24 years. Based on the assumptions in the DEIS scenarios, however, it is highly likely that service station attendants along shipping routes will be called upon to fuel and service the rigs carrying SNF and HLW to Yucca Mountain. After reevaluating the DEIS, and making realistic alternative assumptions where necessary, the authors conclude that these attendants are likely to receive substantially more than 100 mrem/yr external dose, and perhaps several times that dose (up to 500 mrem/yr), unless mitigating measures are adopted. This is particularly true in Western states where refueling opportunities are limited, and the distances between fuel sources in rural areas may be up to 100 miles.

  2. Dietary habits and physical activity levels in Jordanian adolescents attending private versus public schools.

    Science.gov (United States)

    Tayyem, R F; Al-Hazzaa, H M; Abu-Mweis, S S; Bawadi, H A; Hammad, S S; Musaiger, A O

    2014-07-08

    The present study examined differences in dietary habits and physical activity levels between students attending private and public high schools in Jordan. A total of 386 secondary-school males and 349 females aged 14-18 years were randomly recruited using a multistage, stratified, cluster sampling technique. Dietary habits and physical activity level were self-reported in a validated questionnaire. The prevalence of obesity was significantly higher among adolescents in private (26.0%) than in public schools (16.7%). The frequency of breakfast intake was significantly higher among adolescents in private schools, whereas French fries and sweets intake was significantly higher in public schools. Television viewing showed a significant interaction with school type by sex. A higher rate of inactivity was found among students attending private schools. Despite a slightly better overall dietary profile for students in private schools, they had a higher rate of overweight and obesity compared with those in public schools.

  3. Utilization of dental health services by Danish adolescents attending private or public dental health care systems.

    Science.gov (United States)

    Christensen, Lisa Bøge; Petersen, Poul Erik; Bastholm, Annelise; Lone, Laurberg

    2002-03-01

    The objectives of the study were: 1) to describe the choice of dental care system among 16-year-olds, 2) to describe the utilization of dental services among 16-17-year-olds enrolled in either public or private dental care systems, and to compare the dental services provided by the alternative systems. The study comprised 1,245 adolescents from 3 municipalities; the historical cohort study design was applied; and data were collected from dental records (public dental service) and dental claims (private practice). At age 16, 12% preferred being enrolled in the private practice system, while 88% remained in the public dental care system. During the 2-year study period the attendance rate was 99% for the public system, while 90% attended the private practice system (Pdental services were provided more frequently by the public than the private system (P< 0.001). Despite the fact that the economic barrier was eliminated a lower attendance rate was observed for patients transferred to the private practice system.

  4. Prevalence of anxiety among women attending a primary care clinic in Malaysia.

    Science.gov (United States)

    Sidik, Sherina Mohd; Arroll, Bruce; Goodyear-Smith, Felicity

    2011-06-01

    This is the first study investigating anxiety among women attending a primary care clinic in Malaysia. The objective was to determine the factors associated with anxiety among these women. This cross-sectional study was conducted in a government-funded primary care clinic in Malaysia. Consecutive female patients attending the clinic during the data-collection period were invited to participate in the study. Participants were given self-administered questionnaires, which included the validated Generalised Anxiety Disorder-7 questionnaire (GAD-7) Malay version to detect anxiety. Of the 1023 patients who were invited, 895 agreed to participate (response rate 87.5%). The prevalence of anxiety in this study was 7.8%, based on the GAD-7 (score ≥8). Multiple logistic regression analysis found that certain stressful life events and the emotional aspect of domestic violence were significantly associated with anxiety (P<0.05). The prevalence of anxiety among women in this study is similar to that found in other countries. Factors found to be associated with anxiety, especially issues on domestic violence, need to be addressed and managed appropriately.

  5. The short-term outcome of depressive disorder in adolescents attending primary care: a cohort study.

    Science.gov (United States)

    Gledhill, Julia; Garralda, M Elena

    2011-10-01

    Depressive disorder is common amongst adolescents attending primary care, but little is known about its time course. To determine the 6-month outcome of depressive disorder in adolescent primary care attendees with regard to the time to recovery from (1) the date of index GP consultation and (2) the date of depressive episode onset, and to identify risk factors associated with time to recovery. A prospective cohort study of 13-18-year-olds attending a general practice in northwest London. Attendees were screened for depressive disorder at consultation: high scorers underwent a psychiatric research interview. Six months later, adolescents who were depressed at consultation were interviewed using a research psychiatric follow-up interview. Of the 274 young people who completed the baseline questionnaires, 26 had a depressive disorder at consultation; over 50% failed to recover by the 6-month follow-up. Median episode duration from illness onset was 13 months. Multivariate cox regression showed that fewer positive life events and more physical symptoms predicted a longer time to recovery from consultation. Younger age, fewer recent positive life events and more depressive symptoms predicted a longer time to recovery from illness onset. Adolescent depressive disorders in general practice attendees are persistent, highlighting the appropriateness of intervention.

  6. Toxocariasis in children attending a Public Health Service Pneumology Unit in Paraná State, Brazil

    Directory of Open Access Journals (Sweden)

    Edson V. Guilherme

    2013-06-01

    Full Text Available The enzyme-linked immunosorbent assay (ELISA is the most widely used tool to detect anti-Toxocara IgG antibodies for both serodiagnostic and seroepidemiological surveys on human toxocariasis. In the last eight years a high prevalence of toxocariasis (32.2-56.0% has been reported in children attending public health units from municipalities in the state of Paraná, Brazil. Therefore, the aim of this work was to compare the frequency found among the general child population with that of children attending a public pneumology service in Maringá, Paraná, Brazil and describe the laboratorial, clinical and epidemiological findings. The research was conducted at the Consórcio Público Intermunicipal de Saúde do Setentrião Paranaense (CISAMUSEP from July 2009 to July 2010 among children aged between one and 15 years. From a total of 167 children studied, only 4.2% (7/167 tested positive for anti-Toxocara spp. IgG antibodies and presented mild eosinophilia (2/7, increased serum IgE levels (6/7 and a positive allergy test for mites (5/7. The presence of pets (dogs or cats at home did not correlate with the seroprevalence. In conclusion, cases of toxocariasis involving the respiratory tract are rare in children attending a public health pneumology unit in the northwestern region of Paraná State, despite the high prevalence of this type of toxocariasis among the infantile population attending Basic Health Units in the same geographical area.

  7. Likelihood of Attending Treatment for Anxiety Among Veteran Primary Care Patients: Patient Preferences for Treatment Attributes.

    Science.gov (United States)

    Shepardson, Robyn L; Funderburk, Jennifer S

    2016-09-01

    Anxiety is common, but under-treated, in primary care. Behavioral health providers embedded in primary care can help address this treatment gap. Guidance on anxiety treatment preferences would help inform tailoring of clinical practice and new interventions to be more patient-centered and increase treatment engagement. We surveyed 144 non-treatment seeking Veteran primary care patients (82.6 % male, 85.4 % White, age M = 59.8 years, SD = 13.9) reporting current anxiety symptoms (M = 13.87, SD = 3.66, on the Generalized Anxiety Disorder-7 Questionnaire) on their likelihood of attending anxiety treatment featuring various levels of 11 attributes (modality, type, location, format, provider, visit frequency, visit length, treatment duration, type of psychotherapy, symptom focus, and topic/skill). Participants indicated clear preferences for individual, face-to-face treatment in primary care, occurring once a month for at least 30 min and lasting at least three sessions. They also tended to prefer a stress management approach focused on trouble sleeping or fatigue, but all topics/skills were rated equivalently. For most attributes, the highest rated options were consistent with characteristics of integrated care. Implications for research and practice are discussed.

  8. Public spirometry for primary prevention of COPD.

    Science.gov (United States)

    Zirlik, Sabine; Wich, Christina; Frieser, Markus; Hildner, Kai; Kleye, Christin; Neurath, Markus F; Fuchs, Florian S

    2014-02-01

    The most effective action for primary prevention of chronic obstructive lung disease is smoking cessation early enough. In secondary prevention, smokers with airway obstruction were more likely to quit smoking. The aim of this study was to evaluate the impact of a public spirometry on smoking habits in terms of primary prevention. Spirometry with its medical analysis was offered to visitors of a local public event called 'Lange Nacht der Wissenschaften' ('Long night of sciences'). The impact of results on smoking habits was evaluated in all smokers with an anonymized questionnaire afterwards. Two hundred fifty-seven people with the median age of 30 years (interquartile range 22-46) were examined. Out of 44 current smokers (17.1%), only two individuals showed a prebronchodilator FEV1/forced vital capacity-value spirometry result. These smokers were significantly younger (median age 28 vs. 40 years, P = 0.025) without differences in spirometry results or smoking habits. In an unselected population with a high amount of younger adults, normal spirometry did not show a short-term benefit for primary prevention of chronic obstructive lung disease in terms of increasing motivation to quit smoking. © 2013 John Wiley & Sons, Ltd.

  9. PREVALENCE OF ANAEMIA IN PREGNANT WOMEN ATTENDING A PRIMARY HEALTH CENTRE IN BARPETA DISTRICT, ASSAM

    Directory of Open Access Journals (Sweden)

    Dhritishna

    2016-05-01

    Full Text Available BACKGROUND Anaemia in pregnancy has serious adverse effects on the health of the mother and the developing foetus. OBJECTIVES The study aims to estimate the prevalence of anaemia in pregnant woman attending the Nagaon Primary Health Centre (PHC in Barpeta district, Assam. METHODS A cross-sectional study was carried out from 1 April, 2014 to 1 May, 2014. 100 pregnant women attending Nagaon PHC were interviewed using a predesigned and pretested interview schedule followed by a short clinical examination for pallor and laboratory estimation of haemoglobin. Sahli’s (Acid Haematin method was used for haemoglobin estimation. Haemoglobin level below the cut-off 11 g/dL was used to label a pregnant woman as anaemic and further classified as mild (10-10.9 g/dL, moderate anaemia (7-9.9 g/dL and severe anaemia (<7 g/dL. RESULTS 77% women were suffering from anaemia. Out of these, 57 %were mildly anaemic and 20% were moderately anaemic. Women of younger age groups, greater parity, a gap less than 3 years between subsequent pregnancies, less education and practising Hinduism had a greater prevalence of anaemia. CONCLUSION Awareness about the serious consequences that anaemia can lead to and advocacy of a proper iron-rich diet, regular intake of IFA tablets and purification of water to prevent infestation by parasites can help in reduction of anaemia.

  10. Estimating the Burden of Medically Attended Norovirus Gastroenteritis: Modeling Linked Primary Care and Hospitalization Datasets.

    Science.gov (United States)

    Verstraeten, Thomas; Cattaert, Tom; Harris, John; Lopman, Ben; Tam, Clarence C; Ferreira, Germano

    2017-11-15

    Norovirus is the leading cause of community-acquired and nosocomial acute gastroenteritis. Routine testing for norovirus is seldom undertaken, and diagnosis is mainly based on presenting symptoms. This makes understanding the burden of medically attended norovirus-attributable gastroenteritis (MA-NGE) and targeting care and prevention strategies challenging. We used linked population-based healthcare datasets (Clinical Practice Research Datalink General Practice OnLine Database linked with Hospital Episode Statistics Admitted Patient Care) to model the incidence of MA-NGE associated with primary care consultations or hospitalizations according to age groups in England in the period July 2007-June 2013. Mean annual incidence rates of MA-NGE were 4.9/1000 person-years and 0.7/1000 person-years for episodes involving primary care or hospitalizations, respectively. Incidence rates were highest in children aged norovirus-attributable gastroenteritis hospitalization rates were second highest in adults aged >65 years (1.7/1000 person-years). In this particular study, the burden of MA-NGE estimated from healthcare datasets was higher than previously estimated in small cohort studies in England. Routinely collected primary care and hospitalization datasets are useful resources to estimate and monitor the burden of MA-NGE in a population over time.

  11. Alcohol problems among patients attending five primary health care clinics in Harare city.

    Science.gov (United States)

    Chinyadza, E; Moyo, I M; Katsumbe, T M; Chisvo, D; Mahari, M; Cock, D E; Mbengeranwa, O L

    1993-02-01

    Modified versions of the CAGE and WHO AUDIT (Alcohol Use Disorders Identification Test) questionnaires were used to investigate drinking habits of patients attending primary care clinics in Harare in 1989. The questionnaires were administered to 483 consecutive patients of whom 63 pc were male and 37 pc female. The results showed that 41 pc of the patients were current drinkers, and over 60 pc of them were drinking to and beyond "safe limits". Thirty nine pc of the current drinkers drank at least three or more times per week. On an average drinking day 66 pc of the male drinkers consume 10 or more units of alcohol per day. On heavy drinking days 38.5 pc of the drinkers or 16 pc of the total sample consume more than 21 units per day. These sessions occurred around paydays. Thirteen (13.2 pc) of those who consume more than 10 units per heavy drinking session exceeded the recommended frequency levels i.e. not more than three times per week. Seventy five pc of drinkers stated that they drink to socialize or for recreational purposes. About 60 pc of the current drinkers had tried unsuccessfully to cut down or stop drinking. The main reason for such an attempt reported by 92 pc of them was health problems. More current drinkers presented with STD and work-related injuries compared to non-drinkers. None of the current drinkers were asked about their drinking habits by the health workers who attended to them at the clinic. No diagnosis of alcohol dependence or an alcohol problem was made by the Primary Health Care worker at the clinic.

  12. An Assesment of Emergency Contraception Knowledge of Women Attending the Primary Health Care Center in Umraniye

    Directory of Open Access Journals (Sweden)

    M. Fatih Onsuz

    2008-10-01

    Full Text Available BACKGROUND: The aim of the study was to determined the knowledge of women who were in reproductive age that were attending to a primary health care center which was having family planning service in Umraniye. METHODS: This descriptive research has been performed at a primary health care center in Umraniye, between 18-20 December 2006. In our study study sample isn’t selected and we include women of reproductive age who are attending to the primary health care with any cause in the study dates. Study has been performed at 241 women (89.9% that has been interwieved of 268. Study data has been collected by a three part questionnaire which has 33 question. The data has been evaluated by chi square and Fisher exact tests. RESULTS: The median age of the participants was 28 (25p-75p. Small part of participants have heard emergency contraception (13.7%. There was a significant relationship between hearing the method, being nullipar and high education level (p<0.05. The participants who were hearing the method just 60.6% of them also knew the aim of the method (8.3% of the all participants. In the same group of the participants only 36.4% knew correctly of taking time of the pills and 9.0% of them knew correctly of taking piece of tablet after an unprotected sexual intercourse. Only one of the women who were determining of hearing the method also ever used it. There was a statistically significant difference between young age and high education level and knowing correctly of the aim of the method. Also there was a statisticaly significant difference between high education level and knowing correctly of taking time of the method after an unprotected sexual intercourse (p<0.05. CONCLUSION: Although awareness of emergency contraception is at an apparent level the using rate of the method is at a very low level. Giving education about the aim, taking time and how taking of the method to the women who are living at the study area is providing of giving shape

  13. Utilization of Dental Services in Public Health Center: Dental Attendance, Awareness and Felt Needs.

    Science.gov (United States)

    Pewa, Preksha; Garla, Bharath K; Dagli, Rushabh; Bhateja, Geetika Arora; Solanki, Jitendra

    2015-10-01

    In rural India, dental diseases occur due to many factors, which includes inadequate or improper use of fluoride and a lack of knowledge regarding oral health and oral hygiene, which prevent proper screening and dental care of oral diseases. The objective of the study was to evaluate the dental attendance, awareness and utilization of dental services in public health center. A cross-sectional study was conducted among 251 study subjects who were visiting dental outpatient department (OPD) of public health centre (PHC), Guda Bishnoi, and Jodhpur using a pretested proforma from month of July 2014 to October 2014. A pretested questionnaire was used to collect the data regarding socioeconomic status and demographic factors affecting the utilization of dental services. Pearson's Chi-square test and step-wise logistic regression were applied for the analysis. Statistically significant results were found in relation to age, educational status, socioeconomic status and gender with dental attendance, dental awareness and felt needs. p-value dental services, thereby increasing the oral health status of the population.

  14. disparities in public and private pre-primary and primary schools ...

    African Journals Online (AJOL)

    1. To investigate the enrolment disparities existing between public and private pre-primary and primary schools. 2. To investigate how classroom accommodation in public pre-primary and primary schools compare with their private counterparts. 3. To investigate the gender disparities existing in the teaching staff of public.

  15. Psychological morbidity among young adults attending primary care: a retrospective study.

    Science.gov (United States)

    Hickey, Louise; Hannigan, Ailish; O'Regan, Andrew; Khalil, Sherif; Meagher, David; Cullen, Walter

    2015-10-15

    Currently, Ireland has the fourth highest rate of youth suicide in the European Union with psychological morbidity ranging from 21% to 27% in young adults. Primary care is ideally situated to address mental health problems and provide direction and support to young adults. This study investigates the prevalence and management of young adults aged 18-25 presenting to their general practitioner with a psychological problem as part of a larger study on all adults. A random sample of 100 patients aged 18 and over with a consultation in the previous 2 years was selected from the practice management systems of 40 general practices in Ireland. Clinical records of active patients (excluding temporary visitors to the practice) were examined using a standardized reporting tool to extract information on demographics, prevalence, diagnoses and treatments for psychological problems. Of the 3845 active patients sampled aged 18 and over, 479 were in the target age group of 18-25. Of the 479 young adults identified (51% female, 60% fee paying), 57 (12%, 95% CI: 9-15%) had a documented psychological problem within the previous 2 years. Those with psychological problems were more likely to be frequent attenders and eligible for free medical care. Depression (23%) and stress and anxiety (23%) were most commonly identified. The estimated prevalence rate is considerably lower than previous studies which may indicate reluctance among young adults in presenting to primary care or reflect under-identification of psychological problems. Given the high rate of prescribing, enhancing access to non-pharmacological treatments in primary care is a priority. © 2015 Wiley Publishing Asia Pty Ltd.

  16. Association of general psychological factors with frequent attendance in primary care: a population-based cross-sectional observational study.

    Science.gov (United States)

    Hajek, André; Bock, Jens-Oliver; König, Hans-Helmut

    2017-03-24

    Whereas several studies have examined the association between frequent attendance in primary care and illness-specific psychological factors, little is known about the relation between frequent attendance and general psychological factors. Thus, the aim of this study was to investigate the association between being a frequent attender in primary care and general psychological factors. Data were used from a large, population-based sample of community-dwelling individuals aged 40 and above in Germany in 2014 (n = 7,446). Positive and negative affect, life satisfaction, optimism, self-esteem, self-efficacy, and self-regulation were included as general psychological factors. The number of self-reported GP visits in the past twelve months was used to quantify frequency of attendance; individuals with more than 9 visits (highest decile) were defined as frequent attenders. Multiple logistic regressions showed that being a frequent attender was positively associated with less life satisfaction [OR: 0.79 (0.70-0.89)], higher negative affect [OR: 1.38 (1.17-1.62)], less self-efficacy [OR: 0.74 (0.63-0.86)], less self-esteem [OR: 0.65 (0.54-0.79)], less self-regulation [OR: 0.74 (0.60-0.91)], and higher perceived stress [OR: 1.46 (1.28-1.66)], after adjusting for sociodemographic factors, morbidity and lifestyle factors. However, frequent attendance was not significantly associated with positive affect and self-regulation. The present study highlights the association between general psychological factors and frequent attendance. As frequent GP visits produce high health care costs and are potentially associated with increased referrals and use of secondary health care services, this knowledge might help to address these individuals with high needs.

  17. Physicians′ therapeutic practice and compliance of diabetic patients attending rural primary health care units in Alexandria

    Directory of Open Access Journals (Sweden)

    Nahla Khamis R Ibrahim

    2010-01-01

    Full Text Available Objectives: The objectives of the study were to investigate physician′s therapeutic practice and the compliance of diabetic patients attending rural primary health units in Alexandria. Material and Methods: A cross-sectional study was conducted and a multistage stratified random sample method was used for the selection of 600 diabetic patients. Data were collected by means of an interviewing questionnaire, an observation checklist, review of prescriptions and laboratory investigations. A scoring system was made for a diabetic patient′s knowledge and skills, patient′s compliance, doctor-patient relationship, and glycemic control. Results: About 57% always took their medication as prescribed by doctor and on time, only 2.2% always complied with dietary regimen while no one reported regular compliance with exercise regimen. Complications of the regimen was the commonest cause (63.3% of noncompliance. A highly statistically significant difference was found between compliance with all regimens and patient′s knowledge of diabetes. The scores for doctor-patient relationship were all unsatisfactory. Results of glycosylated hemoglobin (HbA1c revealed that metabolic control of four-fifth of the patients was satisfactory, 12% had fair and 8% had poor metabolic control. Conclusions: Patient′s compliance with most of the diabetes regimen was low. Doctor-patient relationship and patient′s compliance should be improved by conducting educational and training programs.

  18. Knowledge, attitudes, and behavior concerning dental trauma among parents of children attending primary school.

    Science.gov (United States)

    Quaranta, A; De Giglio, O; Trerotoli, P; Vaccaro, S; Napoli, C; Montagna, M T; Caggiano, G

    2016-01-01

    Traumatic dental injuries occur frequently in children and adolescents. The purpose of the present study is to examine the levels of knowledge and behaviors regarding dental trauma among parents of children attending primary schools in the Apulia region of Italy. The study was carried out using an anonymous questionnaire with closed answers distributed to 2,775 parents who were enrolled based on the entire regional school population. Analyses were conducted using the PROC CORRESP (procedure to perform multiple correspondence analysis) and PROC FASTCLUS (procedure to perform cluster analysis). Statistical significance was set at p-value sports activities. The multivariate analysis showed that wrong knowledge are distributed among all kinds of subject. Parents with previous experience of dental trauma referred right behaviours, instead weak knowledge and wrong behaviours are associated with parents that easily worried for dental events. This study showed that most parents reported no experience of dental trauma in their children, and half of them did not know what to do in case of traumatic dental injury and they would intervene within 30 minutes, suggesting that dental trauma may trigger panic. However, they did not have the information needed to best assist the affected child. Motivating parents to assume a preventive approach towards dental trauma may produce positive changes that would result an increase of long-term health benefits among both parents and children.

  19. Lifestyle and Dietary Behaviors among Saudi Preschool Children Attending Primary Health Care Centers, Eastern Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Magdy A. Darwish

    2014-01-01

    Full Text Available Objective. To study life styles and dietary behaviors among Saudi preschool children (1–5 years attending primary health care centers (PHCCs in Dammam and Qatif areas, eastern province, Saudi Arabia. Material and Methods. Cross-sectional study. Data were collected using structured, interviewer-filled questionnaire. Children and their mothers were encountered during their well-baby clinic visits. A total number of 300 preschool children and their mothers were interviewed during study period. Results. Unsatisfactory areas include smoking fathers (32%, smoking in front of children (11.3%, overweight and obesity among mothers (60.3%, noncompliance using seat belts for both parents (56.3% and children (68%, children watching television (T.V more than 2 hours (50%, adherence to exclusive breast feeding (only 20.7%, and late solid food introduction (65.3%. Frequent intake of unhealthy food items was 26%, 25%, and 24% for pizza, burger, and soft drinks. Unfortunately frequent intake of the following unhealthy food items was high: biscuits, deserts/chocolates, and chips which was 78%, 67%, and 72%, respectively. Conclusion. This study provides benchmark about the current situation. It provides health care workers and decision makers with important information that may help to improve health services.

  20. Vaginal trichomoniasis among HIV patients attending primary health care centers of Jos, Nigeria

    Directory of Open Access Journals (Sweden)

    Nwadioha SI

    2012-10-01

    Full Text Available Objective: To determine the prevalence of trichomonal infection in HIV/AIDS and non-HIV control group of patients in a population of women with abnormal vaginal discharge. Methods: We conducted a simple cross-sectional study. Primary health care centers in Jos metropolis and Jos University Teaching Hospital, during December 2006 to December 2007. Seven hundred high vaginal swabs were collected; 350 from HIV positive and another 350 from HIV-negative control group of patients with abnormal vaginal discharge attending primary health care centers in Jos metropolis and analysed for microscopy and culture in Jos University Teaching Hospital. Data on epidemiologic indices from the patients, using structured interviewer-administered questionnaires were collected. Results: The rate of trichomoniasis among all participants in the study was 17% (n=120/700. The prevalence rate of trichomoniasis among persons with HIV was 24% while it was found to be 10.3% among HIV negative controls. The difference was statistically significant (氈 2 =23.172; df=1; P<0.05. The rate of co-infection of Trichomonas vaginalis (T. vaginalis in bacterial vaginosis was 42% (n=50/120, while it was 24% (n=29/120 in candidiasis. The singles had a 35% high rate of trichomonal infection. The infected women had a median age of 26 years, and a median number of 3 intra-vaginal sex partners per week. Conclusions: There was a significant statistical difference in prevalence of T. vaginalis between HIV/AIDS group and nonHIV(control group of patients in the study (P<0.05. Local HIV prevention strategies should target such women with trichomonal infection for intervention efforts, especially in HIV endemic area of sub-continent of Africa to further reduce the burden of HIV in the population.

  1. Degenerative mitral valve disease: Survival of dogs attending primary-care practice in England.

    Science.gov (United States)

    Mattin, M J; Boswood, A; Church, D B; McGreevy, P D; O'Neill, D G; Thomson, P C; Brodbelt, D C

    2015-12-01

    This study aimed to evaluate survival of dogs with degenerative mitral valve disease (DMVD). A retrospective cohort study of dogs with DMVD attending primary-care practices in England was undertaken. Cases of DMVD were identified within the electronic patient records (EPRs) of practices sharing data with VetCompass. Kaplan-Meier curves were used to explore survival and Cox regression models identified factors associated with hazard of death. The EPRs from 111,967 dogs, attending 93 veterinary practices between January 2010 and December 2011 identified 405 cases diagnosed with DMVD giving a prevalence of diagnosed DMVD of 0.36% (95% CI: 0.29-0.45%). A further 3557 dogs were classified as possible cases (heart murmurs consistent with DMVD). Overall, a total of 3962 dogs were classified as heart murmur cases (possible and diagnosed DMVD), giving a prevalence of 3.54% (95% CI: 3.26-3.84%). One hundred and sixteen (28.6%) of the diagnosed DMVD cases were incident, newly diagnosed with DMVD. The mean age at diagnosis was 9.52 years (95% CI: 8.98-10.14 years). Fifty-eight (50.0%) of the incident cases died during the study period. The median survival time (MST) for all-cause mortality was 25.4 months (95% CI: 20.4-34.4 months) after disease detection for DMVD cases. For possible cases, 121 (29.7%) from a random sample of 407 possible DMVD cases were incident cases (newly detected heart murmur consistent with DMVD during the study period). The mean age at which a heart murmur was first recorded in possible cases was 9.73 years (95% CI: 9.02-10.44 years). Forty-nine (40.5%) possible cases died during the study period. The MST for all-cause mortality was 33.8 months (95% CI: 23.7-43.1 months) after a heart murmur was initially detected. In the multivariable survival analysis for possible and diagnosed cases, Cavalier King Charles Spaniels (CKCSs) and other purebreds had higher hazards of death than crossbreds. Dogs weighing ≥20.0kg and older dogs had an increased hazard of

  2. Sociodemographic variables and social values: relationship with work-attendance problems in Brunei public- and private-sector employees.

    Science.gov (United States)

    Mundia, Lawrence; Mahalle, Salwa; Matzin, Rohani; Zakaria, Gamal Abdul Nasir; Abdullah, Nor Zaiham Midawati

    2017-01-01

    The study investigated the degree to which selected sociodemographic variables and social values were related to work-attendance problems in a random sample of 860 Brunei public- and private-sector employees and the nature of this relationship. This quantitative study used the field-survey approach to administer research instruments directly to participants. This enabled the researchers to help participants who needed assistance in completing the measures properly, so as to increase the number of usable returns. Two sociodemographic variables (seeking help from a counselor/psychologist and marital status) correlated significantly with work attendance. Private-sector employees were more likely to have work-attendance problems than government workers. Both single and married employees and the chief wage earner in the household were more likely to have work-attendance issues to deal with compared to their counterparts. However, employees who sought help from a counselor/psychologist were far less likely to have work-attendance problems compared to those who did not get such help. The most significant social-value correlates with work-attendance problems were interpersonal communication, employer-employee relationship, work-stress problems, self-presentation, self-regulation, self-direction, and interpersonal trust. Self-regulation, self-direction, and satisfaction with work-related achievements significantly predicted work-attendance problems positively, while interpersonal communication problems and work-stress problems predicted work-attendance problems negatively. Low scorers on self-regulation and self-direction, as well as on satisfaction with work-related achievements, were more likely to have work-attendance problems compared to high scorers. However, low scorers on interpersonal communication and work-stress problems were less likely to have work-attendance problems compared to high-scoring peers. Ample evidence from this study showed that sociodemographic

  3. Prevalence and risk factors for depression in non-demented primary care attenders aged 75 years and older.

    Science.gov (United States)

    Weyerer, Siegfried; Eifflaender-Gorfer, Sandra; Köhler, Leonore; Jessen, Frank; Maier, Wolfgang; Fuchs, Angela; Pentzek, Michael; Kaduszkiewicz, Hanna; Bachmann, Cadja; Angermeyer, Matthias C; Luppa, Melanie; Wiese, Birgitt; Mösch, Edelgard; Bickel, Horst

    2008-12-01

    Depression among the elderly is an important public health issue. The aims of this study were to report the prevalence of depression and to determine the impact of socio-demographic variables, functional impairment and medical diagnoses, lifestyle factors, and mild cognitive impairment on depression as part of the German Study on Ageing, Cognition and Dementia in Primary Care Patients (AgeCoDe Study). Included in the cross-sectional survey were 3327 non-demented subjects aged 75 and over attending general practitioners (GPs) (n=138) in an urban area of Germany. The GDS-15 Geriatric Depression Scale was used to measure depression with a threshold of full adjustment for confounding variables, odds ratios for depression were significantly higher only for functional impairment, smoking, and multi-domain mild cognitive impairment. Recruitment procedures might have led to an underestimation of current prevalence. The cross-sectional data did not allow us to analyze the temporal relationship between risk factors and depression. The prevalence of depression in the elderly is high and remains high into old age. In designing prevention programs, it is important to call more attention to the impact of functional and cognitive impairment on depression.

  4. Parental concerns in parents of children attending pre- and primary school: analysis of the Portuguese population by District

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    Susana Algarvio

    Full Text Available Objective: In this study, our aim was to assess and analyze parental concerns by Portuguese District. Methods: The participants were 3842 parents of children between 3 and 10 years old, attending preschool and primary school, from 820 public schools in 18 Portuguese Districts. Parents completed a sociodemographic questionnaire, and a Parental Concerns Scale, composed by 5 subscales, family and school problems; feeding, sleep and physical complaints; preparation; fears; and negative behaviors. Results: Portuguese parents concerned about all the dimensions considered in this study. The highest level of concern was obtained in family and school problems, and the lowest level of concern about their children’s fears. There were significant differences between Districts, parents from Porto and Bragança showed the highest levels of concern. Parents from Coimbra, Évora, Beja e Portalegre, presented the lowest levels of concern. Conclusion: Parental concerns are an aspect of general parenting and must be considered by health professionals to promote healthier parents-children relationships. Geographic differences should be further investigated.

  5. Effect Of Educational Services On The Quality Of Public Primary ...

    African Journals Online (AJOL)

    ... effect on the status and quality of public primary school products. This paper examines the effect of educational services on the quality of public primary school in Ogba/Egbema/Ndoni Local Government Area in Rivers State,. Keywords: primary education, challenges. Journal of Technology and Education in Nigeria Vol.

  6. A qualitative study of staff perspectives of patient non-attendance in a regional primary healthcare setting.

    Science.gov (United States)

    Akter, Shahinoor; Doran, Frances; Avila, Catharine; Nancarrow, Susan

    2014-01-01

    Non-attendance at health appointments reduces health service efficiency, is costly to services, and can risk patient health. Reminder systems are widely used to overcome forgetfulness, the most common reason for non-attendance; however, other factors, such as patient demographics and service accessibility, may also affect attendance rates. There is limited primary research on the reasons for patient non-attendance in the Australian healthcare setting, although the success of preventative health initiatives requires ongoing monitoring of patients. This study aims to improve our understanding of the Australian experience by examining staff perspectives. This qualitative study explored staff perspectives of the reasons for non-attendance in a large, regional general practice super clinic, which has a low socioeconomic catchment, and serves a large Aboriginal population. The practical barriers to attendance of travel, cost, and waiting times had largely been overcome with transport provision, free medical care and responsive appointment times, but paradoxically, these were seen to devalue allocated appointments and reinforce the expectations of "on-demand" health care. For Aboriginal patients specifically, a distrust of authority, combined with poor health literacy was perceived to impact negatively on the uptake of diagnostic tests, filling of prescriptions, health monitoring, and adherence to medication. The results suggest a complex interplay between poor health literacy and low patient self-worth; a funding system that encourages "five-minute medicine and prevents doctors getting to the root cause of patient problems or having the ability to provide health education.

  7. Consultation rates in cervical screening non-attenders: opportunities to increase screening uptake in GP primary care.

    Science.gov (United States)

    Lim, Anita Wey Wey; Sasieni, Peter

    2015-06-01

    To estimate the proportion of cervical screening non-attenders presenting to general practice (GP) primary care over one year. 137 practices in East London, UK. Anonymous primary care records were downloaded using EMIS web (clinical software). Cervical screening nonattendance was defined as no recorded smear in the last 3.5 years (women aged 25-49) or 5.5 years (women aged 50-64). The last three consultation entries were used to estimate the proportion of non-attenders who consulted in GP over 3 months and 1 year using the Kaplan-Meier method. Newly registered women were assessed separately. Results were calculated for each practice and the median and interquartile range (IQR) across practices are presented. Heterogeneity was assessed using funnel plots. Of 261,810 women, 224,313 (86%) had been registered for >1 year. The proportion classified as non-attenders differed between those registered for >1 year (30%, IQR 27%--35%) and within the last year (49%, IQR 40%--57%), suggesting that screening records were less up-to-date in newly registered women. A median of 32% (IQR: 27%--37%) of non-attenders presented over 3 months, and 60% (IQR: 52%--67%) over 1 year. Funnel plots of the proportion of non-attenders presenting by the number of non-attenders showed substantial variation between practices. Over half of cervical screening non-attenders present to their GP at least once a year, in over 75% of practices. This represents a good opportunity for improving coverage by offering an alternative form of screening, such as self-sampling for human papillomavirus testing. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  8. Pilot nutrition and physical activity intervention for preschool children attending daycare centres (JUNJI): primary and secondary outcomes.

    Science.gov (United States)

    Salazar, Gabriela; Vasquez, Fabian; Concha, Fernando; Rodriguez, Maria Del Pilar; Berlanga, Maria Del Rocio; Rojas, Juanita; Muñoz, Alvaro; Andrade, Margarita

    2014-05-01

    A pilot intervention was conducted to promote physical activity and nutrition in public preschool education (near half a million children in Chile), in order to prevent obesity. To assess the primary (body fat) and secondary outcomes (physical activity and energy intake) of a nutrition and physical activity pilot intervention for preschool children, attending day care centres. A pilot intervention in six day care centres selected at random (n = 530), in 4-5 years old preschool children, Santiago, Chile intending to: provide nutritional and physical activity education to educators and health promotion activities for the family, which in turn, will affect the primary (body fat), and secondary outcomes (physical activity pattern and energy food intake) were measured in a representative subsample of 120 intervened and 145 controls children. In relation to secondary outcomes monitoring, moderate-vigorous activity was duplicated in the intervention group (+5.4% and +4.7%, respectively), in both obese and eutrophic children. Energy intake decreased in 11.7% in obese and 7.5% in eutrophic children. Dietary fat intake was reduced (-11 g in obese and -8.4 g in eutrophic children). Intervened obese children reduced body fat in 1.5%, meanwhile in control obese children, body fat increased 1.3% (p < 0.01). The pilot intervention demonstrated the feasibility to influence dietary risk factors and physical activity at the day care centres and families. Therefore, the implementation of the validated intervention program will be tested in different weather conditions, to prevent unhealthy habits in preschool children and their families. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  9. Characteristics of Chronic Pain Patients Attending a Primary Health Care Center in Oman

    Directory of Open Access Journals (Sweden)

    Nasrin Al-Zadjali

    2017-11-01

    Full Text Available Objectives: To determine the characteristics of patients presenting with chronic pain in a primary health care setting in Oman. Methods: A retrospective cross-sectional study was carried out including all patients aged ≥ 18 years who attended Sultan Qaboos University Health Center during 2010. Patients were identified to have chronic pain if they were prescribed an analgesic medication for at least three months. Patients were compared to a control group which consisted of age- and gender-matched patients with no chronic pain. Results: Out of 6 609 patients, 241 (3.6% were found to have chronic pain. The mean age of patients with chronic pain was 54.0±13.0 years. The majority of patients were female (n = 174; 72.1%, and most were Omani (n = 201; 83.4%. The prevalence of chronic pain was found to be significantly higher among females compared to males (4.5% vs. 2.5%; p < 0.001 and also among Omani nationals to non-nationals (83.4% vs. 70.1%; p < 0.001. Chronic pain was significantly associated with the following comorbidities; diabetes (33.1% vs. 20.7%; p < 0.001, obesity (35.2% vs. 26.5%; p = 0.001, and hypertension (51.0% vs. 38.5%; p = 0.002. Osteoarthritis was the most common pain condition (n = 104; 43.1%. Diclofenac was the most commonly prescribed drug (n = 168; 69.7%. Conclusions: The findings of our study point towards a higher prevalence of chronic pain in Omani females. These patients were also found to have a higher prevalence of other common comorbid conditions.

  10. Violence against young women attending primary care services in Spain: prevalence and health consequences.

    Science.gov (United States)

    Martín-Baena, David; Montero-Piñar, Isabel; Escribà-Agüir, Vicenta; Vives-Cases, Carmen

    2015-08-01

    There are a significant number of studies assessing the negative health consequences of violence against women. However, a limited number of studies analyse the health consequences of violence committed against young women by different types of aggressors. The goal of this study is to assess the prevalence of interpersonal violence against young women in Spain and analyse its impact on the physical and mental health of the victims. A total of 1076 women aged 18-25 years attending Spanish primary care services were selected. We estimated the prevalence of interpersonal violence and compared the health data and demographic characteristics of abused and non-abused young women, multi-logistic regression models were fitted. The Wald test was used to assess whether there were differences in the negative health consequences of intimate partner (IPV) versus non-IPV. As many as 27.6% young women reported a history of abuse, of whom 42.7% had been assaulted by their partner, 41.1% by someone other than their partner and 16.2% both by their partner and another person. The distribution of social and demographic characteristics was similar for IPV and non-IPV victims. Young abused women were three times more likely to suffer psychological distress and have somatic complaints, and they were four times more likely to use medication as compared to non-abused women. Our results suggest that all forms of violence compromise young women's health seriously. Including patients' history of abuse in their health record may help make more informed clinical decisions and provide a more integrated care. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  11. Poor availability of skilled birth attendants in Nigeria: a case study of enugu state primary health care system.

    Science.gov (United States)

    Nkwo, Peter O; Lawani, Lucky O; Ubesie, Agozie C; Onodugo, Vincent A; Obu, Herbert A; Chinawa, Josephat M

    2015-01-01

    The Government of Enugu State plans to offer free perinatal services at the primary health care (PHC) centers in order to improve perinatal outcomes in the state, but it was not clear whether there are skilled birth attendants (SBAs) at the PHC level to implement the program. To determine whether there are sufficient numbers of SBAs in the public PHC system in Enugu State of Nigeria. This cross-sectional survey involved enumeration of health workers who worked at each public PHC facility in Enugu State and included verification of the qualifications and trainings of each health worker. Data analysis was performed with the help of Stata statistical package version 13 and results were presented in tables and as simple proportions. There were 55 nurses and no midwife or doctor in the 152 PHC clinics studied. This number represents 0.36 nurses per health facility or about 9% (i.e., 55/608) of a minimum of 608 SBAs required for 24-h perinatal services at the 152 PHC clinics. There were 1233 junior community health extension worker/community health extension workers (JCHEW/CHEWs), averaging 8.1 JCHEW/CHEWs per PHC clinic. Enugu State has an acute shortage of SBAs. We recommend employment of qualified SBAs and in-service training of the JCHEW/CHEW and nurses to upgrade their midwifery skills. Incorporation of competency-based midwifery training into the pre-service training curricula of nurses and JCHEW/CHEW would provide a more sustainable supply of SBAs in Enugu state.

  12. Hydatid Disease in Yemeni Patients attending Public and Private Hospitals in Sana’a City, Yemen

    Directory of Open Access Journals (Sweden)

    Abdulbasit Alghoury

    2010-04-01

    Full Text Available Objectives: Hydatid disease is endemic and represents a major health problem in Yemen. The aim of this study is to determine the magnitude of the problem of hydatidosis in patients attending Public and Private Hospitals at Sana’a city, Yemen.Methods:66 patients with hydatid disease were identified during the period from August 2006 to February 2007. Complete medical history for all CE patients were collected and analyzed.Results: Among the 66 CE patients, 67% were females and 33% males. Liver was the most common involved organ. Single cyst was more frequently detected than multiple cysts and approximately 94% of the cysts were ≥5 cm. Moreover, Public hospitals were the main source of patients with CE disease.Conclusion: Hydatidosis is still an endemic disease and an important health problem in Yemen which needs to be studied further. Therefore, accurate information on the distribution of the disease is the first step for the control and prevention of the disease. Moreover, it is crucial to investigate the role of different intermediate hosts and genotypes of E. granulosus in humans and animals.

  13. Attendance of routine childcare visits in primary care for children of mothers with depression

    DEFF Research Database (Denmark)

    Lyngsøe, Bente Kjær; Vestergaard, Claus Høstrup; Rytter, Dorte

    2018-01-01

    .17) at the 5-year visit. Furthermore, the risk of missing at least four of the seven childcare visits was higher for children of females with maternal depression (RR = 1.16, 95% CI = 1.13 to 1.19). CONCLUSION: Maternal depression seems to compromise CCP attendance. These findings suggest a need for careful......BACKGROUND: Depression is a common and potentially debilitating illness worldwide. Attendance to routine childcare appointments is a key point of interest in the effort to improve the health and care for families facing depression. AIM: To evaluate the association between maternal depression...... and offspring non-attendance to the Danish childcare and vaccination programme (CCP) for children from 0-5 years of age. The CCP consists of seven separate visits and several vaccinations. To investigate if exposure to recent and previous depression may affect attendance differently. DESIGN AND SETTING...

  14. Sociodemographic variables and social values: relationship with work-attendance problems in Brunei public- and private-sector employees

    Directory of Open Access Journals (Sweden)

    Mundia L

    2017-08-01

    Full Text Available Lawrence Mundia, Salwa Mahalle, Rohani Matzin, Gamal Abdul Nasir Zakaria, Nor Zaiham Midawati AbdullahPsychological Studies and Human Development Academic Group, Sultan Hassanal Bolkiah Institute of Education, Universiti Brunei Darussalam, Bandar Seri Begawan, BruneiObjective: The study investigated the degree to which selected sociodemographic variables and social values were related to work-attendance problems in a random sample of 860 Brunei public- and private-sector employees and the nature of this relationship.Materials and methods: This quantitative study used the field-survey approach to administer research instruments directly to participants. This enabled the researchers to help participants who needed assistance in completing the measures properly, so as to increase the number of usable returns.Results: Two sociodemographic variables (seeking help from a counselor/psychologist and marital status correlated significantly with work attendance. Private-sector employees were more likely to have work-attendance problems than government workers. Both single and married employees and the chief wage earner in the household were more likely to have work-attendance issues to deal with compared to their counterparts. However, employees who sought help from a counselor/psychologist were far less likely to have work-attendance problems compared to those who did not get such help. The most significant social-value correlates with work-attendance problems were interpersonal communication, employer–employee relationship, work-stress problems, self-presentation, self-regulation, self-direction, and interpersonal trust. Self-regulation, self-direction, and satisfaction with work-related achievements significantly predicted work-attendance problems positively, while interpersonal communication problems and work-stress problems predicted work-attendance problems negatively. Low scorers on self-regulation and self-direction, as well as on satisfaction

  15. Correlates of Sexually Transmitted Infections among Adolescents Attending Public High Schools, Panama, 2015

    Science.gov (United States)

    Gabster, Amanda; Mohammed, Debbie Y.; Arteaga, Griselda B.; Castillero, Omar; Mojica, Nataly; Dyamond, José; Varela, Maria; Pascale, Juan Miguel

    2016-01-01

    Background Sexually transmitted infections (STIs) are common in adolescents worldwide. Vulnerability to STIs increases with risky sexual practices. This study described the sexual practices, estimated the prevalence of STIs, and identified correlates associated with STIs among participants, enrolled in public high schools, in the District of Panama, Panama. Methods A cross sectional study, using multistage cluster sampling, was conducted among participants, aged 14–18 years, enrolled in public high schools, in the District of Panama, Panama City, Panama, from August to November, 2015. Participants completed a self-administered questionnaire and provided biological samples. The samples of those reporting sexual activity (oral, vaginal, and/or anal intercourse) were tested for STIs. Odds ratios were used to identify correlates of STIs in this population. Results A total of 592 participants were included, of whom, 60.8% reported a history of sexual activity, and 24.4% tested positive for least one STI. STIs were more common in female participants, (33.5%). Compared to those without STIs, higher proportions of those with at least one STI reported ≥3 sexual partners in their lifetime (60.0%) and current sexual activity (76.3%). In the multivariable model, correlates of STI included female participants (Adjusted Odds Ratio (AOR) = 5.8, 95% Confidence Interval (CI) 2.3–14.6) and those who engaged in sexual intercourse with casual partners (AOR = 3.0, 95% CI: 1.2–7.5). Conclusions We report a high STI prevalence among adolescents attending public high schools, in the District of Panama. Reported risky sexual practices were common and correlated with STIs. Female participants and those reporting sexual intercourse with casual partners were more likely test positive for at least one STI. Our study identified a need for effective interventions to curb future infections in this population. PMID:27657700

  16. The epidemiology of patellar luxation in dogs attending primary-care veterinary practices in England.

    Science.gov (United States)

    O'Neill, Dan G; Meeson, Richard L; Sheridan, Adam; Church, David B; Brodbelt, Dave C

    2016-01-01

    Canine patellar luxation is one of the most common orthopaedic disorders of dogs and is a potential welfare concern because it can lead to lameness, osteoarthritis and pain. However, there are limited epidemiological data on the disorder relating to the general population of dogs in England. This study aimed to investigate the VetCompass Programme database of dogs attending primary-care veterinary practices in England to report on the prevalence, risk factors and clinical management of diagnosed patellar luxation cases. The study included all dogs with at least one electronic patient record in the VetCompass database from September 1(st), 2009 to August 31(st), 2014. Candidate patellar luxation cases were identified using free-text word searching of the clinical notes and VeNom diagnosis term fields. Univariable and multivariable binary logistic regression modelling was used for risk factor analysis. The overall dataset comprised 210,824 dogs attending 119 clinics in England. The prevalence of patellar luxation diagnosis in dogs was 1.30 % (95 % confidence interval (CI) 1.21-1.39). Of the 751 incident cases, 293 (39.0 %) received medical management, 99 (13.2 %) received surgical intervention and 28 (3.7 %) were referred for further management. Multivariable modelling documented 11 breeds with increased odds of patellar luxation compared with crossbred dogs, including the Pomeranian (odds ratio [OR]: 6.5, 95 % CI 4.0-10.7, P < 0.001), Chihuahua (OR: 5.9, 95 % CI 4.4-7.9, P < 0.001), Yorkshire Terrier (OR: 5.5, 95 % CI 4.3-7.1, P < 0.001) and French Bulldog (OR: 5.4, 95 % CI 3.1-9.3, P < 0.001). Dogs with bodyweight below their mean for breed and sex had a 1.4 times odds of diagnosis (95 % CI 1.2-1.6, P < 0.001). Dogs aged ≥ 12.0 years showed 0.4 times the odds (95 % CI 0.3-0.5, P < 0.001) compared with dogs aged < 3.0 years. Females had 1.3 times the odds (95 % CI 1.1-1.5, P < 0.001), neutered dogs had 2.4 times

  17. Prevalence of disorders recorded in dogs attending primary-care veterinary practices in England.

    Science.gov (United States)

    O Neill, Dan G; Church, David B; McGreevy, Paul D; Thomson, Peter C; Brodbelt, Dave C

    2014-01-01

    Purebred dog health is thought to be compromised by an increasing occurence of inherited diseases but inadequate prevalence data on common disorders have hampered efforts to prioritise health reforms. Analysis of primary veterinary practice clinical data has been proposed for reliable estimation of disorder prevalence in dogs. Electronic patient record (EPR) data were collected on 148,741 dogs attending 93 clinics across central and south-eastern England. Analysis in detail of a random sample of EPRs relating to 3,884 dogs from 89 clinics identified the most frequently recorded disorders as otitis externa (prevalence 10.2%, 95% CI: 9.1-11.3), periodontal disease (9.3%, 95% CI: 8.3-10.3) and anal sac impaction (7.1%, 95% CI: 6.1-8.1). Using syndromic classification, the most prevalent body location affected was the head-and-neck (32.8%, 95% CI: 30.7-34.9), the most prevalent organ system affected was the integument (36.3%, 95% CI: 33.9-38.6) and the most prevalent pathophysiologic process diagnosed was inflammation (32.1%, 95% CI: 29.8-34.3). Among the twenty most-frequently recorded disorders, purebred dogs had a significantly higher prevalence compared with crossbreds for three: otitis externa (P = 0.001), obesity (P = 0.006) and skin mass lesion (P = 0.033), and popular breeds differed significantly from each other in their prevalence for five: periodontal disease (P = 0.002), overgrown nails (P = 0.004), degenerative joint disease (P = 0.005), obesity (P = 0.001) and lipoma (P = 0.003). These results fill a crucial data gap in disorder prevalence information and assist with disorder prioritisation. The results suggest that, for maximal impact, breeding reforms should target commonly-diagnosed complex disorders that are amenable to genetic improvement and should place special focus on at-risk breeds. Future studies evaluating disorder severity and duration will augment the usefulness of the disorder prevalence information reported

  18. Prevalence of disorders recorded in dogs attending primary-care veterinary practices in England.

    Directory of Open Access Journals (Sweden)

    Dan G O Neill

    Full Text Available Purebred dog health is thought to be compromised by an increasing occurence of inherited diseases but inadequate prevalence data on common disorders have hampered efforts to prioritise health reforms. Analysis of primary veterinary practice clinical data has been proposed for reliable estimation of disorder prevalence in dogs. Electronic patient record (EPR data were collected on 148,741 dogs attending 93 clinics across central and south-eastern England. Analysis in detail of a random sample of EPRs relating to 3,884 dogs from 89 clinics identified the most frequently recorded disorders as otitis externa (prevalence 10.2%, 95% CI: 9.1-11.3, periodontal disease (9.3%, 95% CI: 8.3-10.3 and anal sac impaction (7.1%, 95% CI: 6.1-8.1. Using syndromic classification, the most prevalent body location affected was the head-and-neck (32.8%, 95% CI: 30.7-34.9, the most prevalent organ system affected was the integument (36.3%, 95% CI: 33.9-38.6 and the most prevalent pathophysiologic process diagnosed was inflammation (32.1%, 95% CI: 29.8-34.3. Among the twenty most-frequently recorded disorders, purebred dogs had a significantly higher prevalence compared with crossbreds for three: otitis externa (P = 0.001, obesity (P = 0.006 and skin mass lesion (P = 0.033, and popular breeds differed significantly from each other in their prevalence for five: periodontal disease (P = 0.002, overgrown nails (P = 0.004, degenerative joint disease (P = 0.005, obesity (P = 0.001 and lipoma (P = 0.003. These results fill a crucial data gap in disorder prevalence information and assist with disorder prioritisation. The results suggest that, for maximal impact, breeding reforms should target commonly-diagnosed complex disorders that are amenable to genetic improvement and should place special focus on at-risk breeds. Future studies evaluating disorder severity and duration will augment the usefulness of the disorder prevalence information

  19. Prevalence and causes of visual impairment among Saudi adults attending primary health care centers in northern Saudi Arabia

    OpenAIRE

    Al-Shaaln, Farhan Fayez; Bakrman, Marwan Abdurrahman; Ibrahim, Adel Mohammad; Aljoudi, Abdullah Srour

    2011-01-01

    BACKGROUND AND OBJECTIVES: Few studies have been conducted in Saudi Arabia to estimate the prevalence of visual impairment and its causes. The objective of this study was to estimate the prevalence of visual impairment, and identify its causes and associated factors among the adult population attending primary health care (PHC) centers in Aljouf province, in northern Saudi Arabia. DESIGN AND SETTING: A cross-sectional study during the year 2005 in PHC centers in Aljouf province in northern Sa...

  20. Preschool Attendance in Chicago Public Schools: Relationships with Learning Outcomes and Reasons for Absences

    Science.gov (United States)

    Ehrlich, Stacy B.; Gwynne, Julia A.; Stitziel Pareja, Amber; Allensworth, Elaine M.; Moore, Paul; Jagesic, Sanja; Sorice, Elizabeth

    2014-01-01

    Significant attention is currently focused on ensuring that children are enrolled in preschool. However, regular attendance is also critically important. Children with better preschool attendance have higher kindergarten readiness scores, this is especially true for students entering with low skills. Unfortunately, many preschool-aged children are…

  1. Sociodemographic variables and social values: relationship with work-attendance problems in Brunei public- and private-sector employees

    Science.gov (United States)

    Mundia, Lawrence; Mahalle, Salwa; Matzin, Rohani; Zakaria, Gamal Abdul Nasir; Abdullah, Nor Zaiham Midawati

    2017-01-01

    Objective The study investigated the degree to which selected sociodemographic variables and social values were related to work-attendance problems in a random sample of 860 Brunei public- and private-sector employees and the nature of this relationship. Materials and methods This quantitative study used the field-survey approach to administer research instruments directly to participants. This enabled the researchers to help participants who needed assistance in completing the measures properly, so as to increase the number of usable returns. Results Two sociodemographic variables (seeking help from a counselor/psychologist and marital status) correlated significantly with work attendance. Private-sector employees were more likely to have work-attendance problems than government workers. Both single and married employees and the chief wage earner in the household were more likely to have work-attendance issues to deal with compared to their counterparts. However, employees who sought help from a counselor/psychologist were far less likely to have work-attendance problems compared to those who did not get such help. The most significant social-value correlates with work-attendance problems were interpersonal communication, employer–employee relationship, work-stress problems, self-presentation, self-regulation, self-direction, and interpersonal trust. Self-regulation, self-direction, and satisfaction with work-related achievements significantly predicted work-attendance problems positively, while interpersonal communication problems and work-stress problems predicted work-attendance problems negatively. Low scorers on self-regulation and self-direction, as well as on satisfaction with work-related achievements, were more likely to have work-attendance problems compared to high scorers. However, low scorers on interpersonal communication and work-stress problems were less likely to have work-attendance problems compared to high-scoring peers. Conclusion Ample

  2. Danish Patients are positive towards fees for non-attendance in public hospitals

    DEFF Research Database (Denmark)

    Lou, Stina; Frumer, Michal; Olesen, Steen

    2016-01-01

    Introduction: Patients’ non-attendance is a significant problem in modern healthcare. Non-attendance delays treatment, reduces efficiency and increases healthcare costs. For several years, the introduction of financial incentives such as a non-attendance fee has been discussed in Denmark. Set...... in the context of a tax-financed, free-for-all healthcare system, the political hesitance to introduce fees relates to concerns that additional fees may be badly received by tax-paying citizens and may undermine the polit­ical priority of patient equity. The aim of this qualitative sub-study was to investigate...

  3. Toxocariasis: critical analysis of serology in patients attending a public referral center for ophthalmology in Brazil.

    Science.gov (United States)

    Rubinsky-Elefant, Guita; Yamamoto, Joyce H; Hirata, Carlos E; Prestes-Carneiro, Luiz E

    2018-01-01

    To analyze the contribution of IgG anti-Toxocara antibodies in the diagnosis of ocular toxocariasis (OT) in serum samples of patients attending a public referral center for ophthalmology in Brazil and to determine the most frequent ocular signs and symptoms. This was a retrospective descriptive study of a cohort of outpatients followed from December 1989 to May 2006. IgG anti-Toxocara antibody titers were determined by enzyme-linked immunosorbent assay. The results were correlated with the clinical and funduscopic findings. Of the diagnoses for the 126 patients, 42 were considered as probable OT, 48 as negative, and 36 as inconclusive. The median IgG anti-Toxocara antibody titers of the patients with probable OT were significantly higher than those of the patients in the negative or inconclusive groups (P = 0.0001). Higher titers were observed more frequently in patients in the probable OT group (P = 0.01) than in the negative group, in which titers were absent or lower in most patients (P < 0.0001). The right eye was affected more in the OT group than in the negative group (P = 0.01), and inflammation was located mostly in the intermediate and posterior poles. The mean age of the patients diagnosed with probable OT was significantly lower (mean, 8 years) than that of the negative patients (mean, 14.5 years) (P = 0.006). Higher levels of antibodies could help with the diagnosis of OT in patients with symptoms and clinical signs; however, negative results cannot exclude possible OT. Conversely, patients with negative serology or low titers make the diagnosis of OT less likely.

  4. Perceived benefits and barriers and self-efficacy affecting the attendance of health education programs among uninsured primary care patients.

    Science.gov (United States)

    Kamimura, Akiko; Nourian, Maziar M; Jess, Allison; Chernenko, Alla; Assasnik, Nushean; Ashby, Jeanie

    2016-12-01

    Lifestyle interventions have shown to be effective in improving health status, health behaviors, and self-efficacy. However, recruiting participants to health education programs and ensuring the continuity of health education for underserved populations is often challenging. The goals of this study are: to describe the attendance of health education programs; to identify stages of change to a healthy lifestyle; to determine cues to action; and to specify factors affecting perceived benefits and barriers to healthy food choices and physical activity among uninsured primary care patients. Uninsured primary care patients utilizing a free clinic (N=621) completed a self-administered survey from September to December of 2015. US born English speakers, non-US born English speakers, and Spanish speakers reported different kinds of cues to action in attending health education programs. While self-efficacy increases perceived benefits and decreases perceived barriers for physical activity, it increases both perceived benefits and perceived barriers for healthy food choices. The participants who had attended health education programs did not believe that there were benefits for healthy food choices and physical activity. This study adds to the body of literature on health education for underserved populations. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Sexual violence against adult women primary care attenders in east London.

    OpenAIRE

    Coid, Jeremy; Petruckevitch, Ann; Chung, Wai-Shan; Richardson, Jo; Moorey, Stirling; Cotter, Sarah; Feder, Gene S

    2003-01-01

    BACKGROUND: Sexual violence against women is common. The prevalence appears to be higher in north America than Europe. However, not all surveys have differentiated the experience of forced sex by a current or former partner. Few women are thought to report these experiences to their general practitioner (GP). AIM: To measure the prevalence of rape, sexual assault, and forced sexual intercourse by a partner among women attending general practices, to test the association between these experien...

  6. Early-stage primary school children attending a school in the Malawian School Feeding Program (SFP) have better reversal learning and lean muscle mass growth than those attending a non-SFP school.

    Science.gov (United States)

    Nkhoma, Owen W W; Duffy, Maresa E; Cory-Slechta, Deborah A; Davidson, Philip W; McSorley, Emeir M; Strain, J J; O'Brien, Gerard M

    2013-08-01

    In developing countries, schoolchildren encounter a number of challenges, including failure to complete school, poor health and nutrition, and poor academic performance. Implementation of school feeding programs (SFPs) in less developed countries is increasing and yet there is mixed evidence regarding their positive effects on nutrition, education, and cognition at the population level. This study evaluated cognitive and anthropometric outcomes in entry-level primary school children in Malawi with the aim of generating evidence for the ongoing debate about SFPs in Malawi and other developing countries. A total of 226 schoolchildren aged 6-8 y in 2 rural Malawian public primary schools were followed for one school year. Children attending one school (SFP school) received a daily ration of corn-soy blend porridge, while those attending the other (non-SFP school) did not. Baseline and post-baseline outcomes included the Cambridge Neurological Test Automated Battery cognitive tests of paired associate learning, rapid visual information processing and intra-extra dimensional shift, and anthropometric measurements of weight, height, and mid-upper arm circumference (MUAC). At follow-up, the SFP subcohort had a greater reduction than the non-SFP subcohort in the number of intra-extra predimensional shift errors made (mean 18.5 and 24.9, respectively; P-interaction = 0.02) and also showed an increase in MUAC (from 16.3 to 17.0; P-interaction school compared with children in the non-SFP school. These findings suggest that the Malawian SFP, if well managed and ration sizes are sustained, may have the potential to improve nutritional and cognitive indicators of the most disadvantaged children.

  7. Epidemiology of Diabetes Mellitus among 193,435 Cats Attending Primary-Care Veterinary Practices in England.

    Science.gov (United States)

    O'Neill, D G; Gostelow, R; Orme, C; Church, D B; Niessen, S J M; Verheyen, K; Brodbelt, D C

    2016-07-01

    Diabetes mellitus (DM) is a common endocrine disease of cats. The prevalence of DM in cats in England is not well-defined. To estimate the prevalence and identify risk factors for DM in a large population of cats attending primary-care practices. A cohort of 193,563 cats in the VetCompass Programme attending 118 primary-care practices in England. Cross-sectional analysis of cohort clinical data. Data were extracted covering September 1st 2009 and August 31st 2014. Period prevalence of DM was calculated. Associations between risk factors and DM were assessed using logistic regression modelling. Of 1,128 DM cases were identified among 194,563 cats (period prevalence 0.58%; 95% confidence interval [CI] 0.54-0.61). Multivariable modelling indicated that Tonkinese (OR 4.1; 95% CI 1.8-9.6; P = .001), Norwegian Forest (odds ratio [OR] 3.5; 95% CI 1.3-9.6; P = .001) and Burmese (OR 3.0; 95% CI 2.0-4.4; P Diabetes mellitus is an important component of the primary-care practice caseload with 1-in-200 cats affected. An increased risk of DM in certain cat breeds supports a genetic predisposition. These results can guide future research and preventative healthcare. Copyright © 2016 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

  8. Evaluation of school health instruction in public primary schools in ...

    African Journals Online (AJOL)

    Background: Effective school health instruction in primary schools is essential in addressing the health risks and needs of school age children and adolescents. This study sought to evaluate the status of school health instruction in public primary schools in Bonny Local Government Area. Method: This is a cross sectional ...

  9. Epidemiology of Cranial Cruciate Ligament Disease Diagnosis in Dogs Attending Primary-Care Veterinary Practices in England.

    Science.gov (United States)

    Taylor-Brown, Frances E; Meeson, Richard L; Brodbelt, Dave C; Church, David B; McGreevy, Paul D; Thomson, Peter C; O'Neill, Dan G

    2015-08-01

    To estimate the prevalence and risk factors for a diagnosis of cranial cruciate ligament (CCL) disease in dogs and to describe the management of such cases attending primary-care veterinary practices. Historical cohort with a nested case-control study. Nine hundred and fifty-three dogs diagnosed with CCL disease from 171,522 dogs attending 97 primary-care practices in England. Medical records of dogs attending practices participating in the VetCompass project that met selection criteria were assessed. Univariate and multivariate logistic regression methods were used to evaluate association of possible risk factors with diagnosis of CCL disease. The prevalence of CCL disease diagnosis was estimated at 0.56% (95% confidence interval 0.52-0.59). Compared with crossbred dogs, Rottweilers, West Highland White Terriers, Golden Retrievers, Yorkshire Terriers, and Staffordshire Bull Terriers showed increased odds of CCL disease diagnosis while Cocker Spaniels showed reduced odds. Increasing bodyweight within breeds was associated with increased odds of diagnosis. Dogs aged over 3 years had increased odds of diagnosis compared with dogs aged less than 3 years. Neutered females had 2.1 times the odds of diagnosis compared with entire females. Insured dogs had 4 times the odds of diagnosis compared with uninsured dogs. Two-thirds of cases were managed surgically, with insured and heavier dogs more frequently undergoing surgery. Overall, 21% of cases were referred, with referral more frequent in heavier and insured dogs. Referred dogs more frequently had surgery and an osteotomy procedure. Breed predispositions and demographic factors associated with diagnosis and case management of CCL disease in dogs identified in this study can be used to help direct future research and management strategies. © Copyright 2015 by The American College of Veterinary Surgeons.

  10. Why patients attend emergency departments for conditions potentially appropriate for primary care: reasons given by patients and clinicians differ.

    Science.gov (United States)

    Masso, Malcolm; Bezzina, Andrew J; Siminski, Peter; Middleton, Rebekkah; Eagar, Kathy

    2007-08-01

    To compare reasons identified by clinical staff for potential primary care attendances to the ED with those previously identified by patients. Survey of staff and primary care patients in five ED in New South Wales, Australia using questionnaire based on reasons identified in published studies. Clinicians in the survey identify a broader spectrum of reasons for potential primary care cases presenting to the ED than the patients themselves report. Doctors reported on average 4.1 very important reasons and nurses 4.8 compared with patients 2.4 very important reasons. The main reasons identified by both doctors and nurses were similar and quite different to those identified by patients. Clinicians were more likely to emphasize cost and access issues rather than acuity and complexity issues. There was no difference within the clinician group between doctors and nurses nor by varying levels of experience. Furthermore doctors with significant experience in both primary care and emergency medicine did not differ from the overall clinicians' pattern. These data confirm that clinician perspectives on reasons for potential primary care patients' use of ED differ quite markedly from the perspectives of patients themselves. Those differences do not necessarily represent a punitive or blaming philosophy but will stem from the very different paradigms from which the two protagonists approach the interactions, reflecting the standard tension in a provider - consumer relationship. If policy is to be developed to improve system use and access, it must take both perspectives into account with respect to redesign, expectations and education.

  11. Disparities in public and private pre-primary and primary schools ...

    African Journals Online (AJOL)

    School enrolment figures, number of classrooms and teachers are important statistical data essential for educational planning; their disparities in public and private pre-primary and primary schools should be equally reflected in the plan. Moreover, experience of educational sector and operational planning just concluded in ...

  12. Problem drinking among patients attending primary healthcare units in Kampala, Uganda.

    Science.gov (United States)

    Kullgren, G; Alibusa, S; Birabwa-Oketcho, H

    2009-02-01

    Previous studies have shown that a large a number of primary health care patients have alcohol related problems and very few are detected and treated. Few studies have been done in developing countries on this topic. This study sought to determine the prevalence and detection of alcohol related problems in a Primary Health Care setting (PHC). in Kampala Uganda. 768 consecutive PHC patients in two PHC centers in Kampala, Uganda, were screened in a two stage procedure. After being asked if they drink alcohol they were interviewed by means of the CAGE questionnaire and a quantity/frequency questionnaire. Those who scored positive on the CAGE were further diagnosed for alcohol dependence using the DSM- IV diagnostic criteria. Of all patients, 17.4% scored above cut-off on the CAGE, 28.5% had a high risk drinking pattern and 9.5% had alcohol dependence. Among drinkers, drinking beyond safe limit was more common among men. Males and those aged between 35 to 44 years, were more likely to be CAGE positive and to be diagnosed with alcohol dependence. Only 27 out of 366 drinkers were asked about alcohol by the PHC professional. Males and high risk drinkers were more likely to be asked. Prevalence of alcohol problems was high and detection rate of alcohol related problems was low in this Ugandan setting. Training of PHC professionals in diagnosing and treating alcohol related problems is required.

  13. Distribution of causes of infertility in patients attending primary fertility clinics in Israel.

    Science.gov (United States)

    Farhi, Jacob; Ben-Haroush, Avi

    2011-01-01

    Infertility is one of the most prevalent health disorders in young adults. To study the distribution of causes of infertility in couples referred to primary infertility clinics in Israel. Data for a 9 year period were derived from two clinics of major women's hospitals run by the country's largest health insurance fund. All patients were treated by one physician. Laparoscopy was not performed to rule out endometriosis. Of the 2515 couples identified, 1991 (79.2%) had a definitive diagnosis following complete workup (including hysterosalpingography). Mean age was 29.6 +/- 6.0 years; mean duration of infertility was 1.7 +/- 1.8 years. Primary infertility accounted for 65% of cases. Causes of infertility were male factor (45%), oligo-ovulation disorders (37%), and tubal damage (18%). Infertility factors were identified in the woman alone in 30.6% of cases and the man alone in 29.2%. Two combined infertility factors were found in 18% of patients, and three combined factors in 0.5%. The rate of unexplained infertility (which probably includes non-tubal endometriosis) was 20.7%. As male factor accounts for almost half of all cases of infertility in couples, sperm analysis is mandatory before any treatment.

  14. Behavioural profile of drug users attending public drug-treatment centres in Sicily: the role of social context

    Directory of Open Access Journals (Sweden)

    Francesco Vitale

    2007-12-01

    Full Text Available

    Objective: Investigations of injecting drug users (IDUs have suggested that the social context may influence high-risk behaviours in this population. The aim of this study was to describe knowledge, attitudes and behaviours of IDUs attending public drug-treatment centres in our area.

    Study design and methods: A cross-sectional survey was conducted between July 2002 and February 2004, enrolling 607 drug users attending four public drug-treatment centres in the Palermo area. Two of them were located inside the urban area, whereas the other two were in rural districts near the city. All participants answered an anonymous questionnaire concerning social and demographic characteristic and potential high-risk behaviours.

    Results: IDUs living in urban context have a higher educational level, higher number of sexual partners, as well as a lower prevalence of exchanging sex for drugs. Conversely, IDUs living in suburban/rural context are less likely to share syringes and more likely to have used light drugs in the past. Suburban/rural IDUs drink more alcohol but smoke less cigarettes/day, although both groups are strong smokers.

    Conclusions: The results suggest that public drug-treatment centres should take in consideration the adoption of specific programs targeting specific groups, in line with the profile and needs of the subjects in each context in order to promote approaches leading to risk reduction.

  15. Dental anxiety and the use of oral health services among people attending two HIV primary care clinics in Miami.

    Science.gov (United States)

    Singer, Richard; Cardenas, Gabriel; Xavier, Jessica; Jeanty, Yves; Pereyra, Margaret; Rodriguez, Allan; Metsch, Lisa R

    2012-05-01

    We examined factors associated with dental anxiety among a sample of HIV primary care patients and investigated the independent association of dental anxiety with oral health care. Cross-sectional data were collected in 2010 from 444 patients attending two HIV primary care clinics in Miami-Dade County, Florida. Corah Dental Anxiety Scores and use of oral health-care services were obtained from all HIV-positive patients in the survey. The prevalence of moderate to severe dental anxiety in this sample was 37.8%, while 7.9% of the sample was characterized with severe dental anxiety. The adjusted odds of having severe dental anxiety were 3.962 times greater for females than for males (95% confidence interval [CI] 1.688, 9.130). After controlling for age, ethnicity, gender, education, access to dental care, and HIV primary clinic experience, participants with severe dental anxiety had 69.3% lower adjusted odds of using oral health-care services within the past 12 months (vs. longer than 12 months ago) compared with participants with less-than-severe dental anxiety (adjusted odds ratio = 0.307, 95% CI 0.127, 0.742). A sizable number of patients living with HIV have anxiety associated with obtaining needed dental care. Routine screening for dental anxiety and counseling to reduce dental anxiety are supported by this study as a means of addressing the impact of dental anxiety on the use of oral health services among HIV-positive individuals.

  16. Prevalence of and risk factors for degenerative mitral valve disease in dogs attending primary-care veterinary practices in England.

    Science.gov (United States)

    Mattin, M J; Boswood, A; Church, D B; López-Alvarez, J; McGreevy, P D; O'Neill, D G; Thomson, P C; Brodbelt, D C

    2015-01-01

    To date, epidemiological studies on degenerative mitral valve disease (DMVD) in dogs have largely reported referral caseloads or been limited to predisposed breeds. Analysis of primary-care data to identify factors associated with DMVD would help clinicians identify high-risk individuals and improve understanding. To estimate the prevalence of and identify risk factors for DMVD in dogs attending primary-care veterinary practices in England. Cases were identified within the electronic patient records of 111,967 dogs attending 93 practices. Four hundred and 5 dogs were diagnosed with DMVD (diagnosed cases) and a further 3,557 dogs had a heart murmur (HM) consistent with DMVD (possible cases). Retrospective cross-sectional study design. Prevalence was adjusted for the sampling approach. Mixed effects logistic regression models identified factors associated with DMVD. Prevalence estimates of diagnosed DMVD and HMs consistent with DMVD (both diagnosed and possible cases) were 0.36% (95% confidence interval [CI]: 0.29-0.45) and 3.54% (95% CI: 3.26-3.84) respectively. In the multivariable analysis, males had higher odds of diagnosed DMVD than did females (odds ratio [OR] 1.40, 95% CI: 1.12-1.74). Insured dogs had increased odds of DMVD compared with noninsured dogs (OR 3.56, 95% CI: 2.79-4.55) and dogs ≥20 kg had approximately half the odds of DMVD diagnosis compared with dogs dogs. Knowledge of identified risk factors for DMVD could improve clinical diagnosis and direct future research. Copyright © 2015 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

  17. Unhappiness with the Fetal Gender is associated with Depression in Adult Pregnant Women Attending Prenatal Care in a Public Hospital in Durango, Mexico

    National Research Council Canada - National Science Library

    Alvarado-Esquivel, Cosme; Sifuentes-Alvarez, Antonio; Salas-Martinez, Carlos

    2016-01-01

    Depression during pregnancy has been scantily studied in Mexican women. We aimed to determine the prevalence and correlates of depression in adult pregnant women attending a public hospital in the northern Mexican city of Durango, Mexico...

  18. Equality of Educational Opportunities at Public Primary Schools in Argentina

    Science.gov (United States)

    Adrogue, Cecilia

    2013-01-01

    This paper assesses the degree of equality of educational opportunities across Argentina's public primary schools. The main finding is that there are inequalities between jurisdictions, but even greater inequalities within them, suggesting the existence of serious problems in the distribution of resources at the sub-national level. Following the…

  19. Motivation among Public Primary School Teachers in Mauritius

    Science.gov (United States)

    Seebaluck, Ashley Keshwar; Seegum, Trisha Devi

    2013-01-01

    Purpose: The purpose of this study was to critically analyse the factors that affect the motivation of public primary school teachers and also to investigate if there is any relationship between teacher motivation and job satisfaction in Mauritius. Design/methodology/approach: Simple random sampling method was used to collect data from 250 primary…

  20. Prevalence and pattern of co morbidity among type2 diabetics attending urban primary healthcare centers at Bhubaneswar (India.

    Directory of Open Access Journals (Sweden)

    Sandipana Pati

    Full Text Available India has the second largest diabetic population in the world. The chronic nature of the disease and high prevalence of co-existing chronic medical conditions or "co morbidities" makes diabetes management complex for the patient and for health care providers. Hence a strong need was felt to explore the problem of co morbidity among diabetics and its dimensions in primary health care practices.This cross sectional survey was carried out on 912 type 2 diabetes patients attending different urban primary health care facilities at Bhubaneswar. Data regarding existence of co morbidity and demographical details were elicited by a predesigned, pretested questionnaire"Diabetes Co morbidity Evaluation Tool in Primary Care (DCET- PC". Statistical analyses were done using STATA.Overall 84% had one ormore than one comorbid condition. The most frequent co morbid conditions were hypertension [62%], acid peptic disease [28%], chronic back ache [22%] and osteoarthritis [21%]. The median number of co morbid conditions among both males and females is 2[IQR = 2]. The range of the number of co morbid conditions was wider among males [0-14] than females [0-6]. The number of co morbidities was highest in the age group > = 60 across both sexes. Most of the male patients below 40 years of age had either single [53%] or three co morbidities [11%] whereas among female patients of the same age group single [40%] or two co morbidities [22%] were more predominantly present. Age was found to be a strong independent predictor for diabetes co morbidity. The odds of having co morbidity among people above poverty line and schedule caste were found to be[OR = 3.50; 95%CI 1.85-6.62]and [OR = 2.46; CI 95%1.16-5.25] respectively. Odds were increased for retired status [OR = 1.21; 95% CI 1.01-3.91] and obesity [OR = 3.96; 95%CI 1.01-15.76].The results show a high prevalence of co morbidities in patients with type 2 diabetes attending urban primary health care facilities. Hypertension

  1. Prevalence and pattern of co morbidity among type2 diabetics attending urban primary healthcare centers at Bhubaneswar (India).

    Science.gov (United States)

    Pati, Sandipana; Schellevis, F G

    2017-01-01

    India has the second largest diabetic population in the world. The chronic nature of the disease and high prevalence of co-existing chronic medical conditions or "co morbidities" makes diabetes management complex for the patient and for health care providers. Hence a strong need was felt to explore the problem of co morbidity among diabetics and its dimensions in primary health care practices. This cross sectional survey was carried out on 912 type 2 diabetes patients attending different urban primary health care facilities at Bhubaneswar. Data regarding existence of co morbidity and demographical details were elicited by a predesigned, pretested questionnaire"Diabetes Co morbidity Evaluation Tool in Primary Care (DCET- PC)". Statistical analyses were done using STATA. Overall 84% had one ormore than one comorbid condition. The most frequent co morbid conditions were hypertension [62%], acid peptic disease [28%], chronic back ache [22%] and osteoarthritis [21%]. The median number of co morbid conditions among both males and females is 2[IQR = 2]. The range of the number of co morbid conditions was wider among males [0-14] than females [0-6]. The number of co morbidities was highest in the age group > = 60 across both sexes. Most of the male patients below 40 years of age had either single [53%] or three co morbidities [11%] whereas among female patients of the same age group single [40%] or two co morbidities [22%] were more predominantly present. Age was found to be a strong independent predictor for diabetes co morbidity. The odds of having co morbidity among people above poverty line and schedule caste were found to be[OR = 3.50; 95%CI 1.85-6.62]and [OR = 2.46; CI 95%1.16-5.25] respectively. Odds were increased for retired status [OR = 1.21; 95% CI 1.01-3.91] and obesity [OR = 3.96; 95%CI 1.01-15.76]. The results show a high prevalence of co morbidities in patients with type 2 diabetes attending urban primary health care facilities. Hypertension, acid peptic

  2. Characterisation of antimicrobial usage in cats and dogs attending UK primary care companion animal veterinary practices.

    Science.gov (United States)

    Buckland, E L; O'Neill, D; Summers, J; Mateus, A; Church, D; Redmond, L; Brodbelt, D

    2016-11-12

    There is scant evidence describing antimicrobial (AM) usage in companion animal primary care veterinary practices in the UK. The use of AMs in dogs and cats was quantified using data extracted from 374 veterinary practices participating in VetCompass. The frequency and quantity of systemic antibiotic usage was described.Overall, 25 per cent of 963,463 dogs and 21 per cent of 594,812 cats seen at veterinary practices received at least one AM over a two-year period (2012-2014) and 42 per cent of these animals were given repeated AMs. The main agents used were aminopenicillin types and cephalosporins. Of the AM events, 60 per cent in dogs and 81 per cent in cats were AMs classified as critically important (CIAs) to human health by the World Health Organisation. CIAs of highest importance (fluoroquinolones, macrolides, third-generation cephalosporins) accounted for just over 6 per cent and 34 per cent of AMs in dogs and cats, respectively. The total quantity of AMs used within the study population was estimated to be 1473 kg for dogs and 58 kg for cats.This study has identified a high frequency of AM usage in companion animal practice and for certain agents classified as of critical importance in human medicine. The study highlights the usefulness of veterinary practice electronic health records for studying AM usage. British Veterinary Association.

  3. Common mental disorder symptoms among patients with malaria attending primary care in Ethiopia: a cross-sectional survey.

    Science.gov (United States)

    Tesfaye, Markos; Hanlon, Charlotte; Tessema, Fasil; Prince, Martin; Alem, Atalay

    2014-01-01

    Common Mental Disorders (CMDs) are frequent among patients attending primary care. In Africa, CMDs are often misdiagnosed as physical illnesses because many of the patients complain of somatic symptoms of mental distress. We explored whether there was difference in the levels of CMD symptoms between patients with thick film confirmed and clinical cases of malaria with negative thick film in primary care. A cross-sectional comparative study was conducted on 300 adults with a clinical diagnosis of malaria in primary care centres in Jimma, Ethiopia. Patients were recruited consecutively until 100 cases of 'malaria' with a negative thick film and 200 cases of malaria with a positive thick film consented to participate. The 20-item Self-Reporting Questionnaire (SRQ-20) was used to measure CMD. The non-parametric Wilcoxon rank-sum test was used to explore the association between thick film result and CMD. Participants had a mean age of 28.2 (S.D = 10.9) years and the majority (57.3%) were women. The prevalence of high CMD symptoms (six or more symptoms on the SRQ-20) was 24.5%. Suicidal ideation was reported by 13.8% of the participants. CMD symptoms were significantly higher in patients who had taken medication prior to visiting the primary care (p = 0.012) and in those whose symptoms had been present for seven days or more (p = 0.041). There was no statistically significant association between level of CMD symptoms and having a negative thick film result (OR 0.98; 95%CI 0.92, 1.04) or objective presence of fever (OR 1.04; 95%CI 0.93, 1.15). CMD symptoms among cases of malaria did not appear to be associated with a negative thick film result. The high levels of CMD symptoms, including suicidal ideation, calls for further studies to investigate the persistence and progression of these symptoms following resolution of the acute malarial episode.

  4. Behavioral and biological correlates of medicine use in type 2 diabetic patients attended by Brazilian public healthcare system

    Directory of Open Access Journals (Sweden)

    Jamile Sanches Codogno

    2013-01-01

    Full Text Available DOI: http://dx.doi.org/10.5007/1980-0037.2013v15n1p82 The relationship between physical activity and the use of medicines is not clear. The purpose of this study was to investigate this relationship between the level of physical activity and the use of medications by type 2 diabetic patients who were attended in the Brazilian public healthcare system. The sample was composed of 121 Brazilian diabetic patients, of both genders, attended by the public healthcare system. Body fat (estimated by anthropometry and bioelectrical impedance, physical activity (measured by Baecke’s questionnaire, and the participant’s use of medicines (during the 15 days before evaluation were assessed. There was a relationship between the use of medicines and: gender (r = 0.18; p = 0.045, body mass index (BMI (r = 0.22; p = 0.012, waist circumference (r = 0.19; p = 0.029, body fat percentage (r = 0.21; p = 0.016, age (r = 0.23; p = 0.009, and level of physical activity (r = -0.22; p = 0.012. Linear regression included in the multivariate model only age (β = 0.718; p = 0.057, BMI (β= 0.057; p = 0.022, and level of physical activity (β = -0.176; p = 0.044. In conclusion, physical activity decreases medicinal use independent of age or obesity.

  5. Prevalence of Trichomonas vaginalis by PCR in men attending a primary care urology clinic in South Korea.

    Science.gov (United States)

    Seo, Jun-Hyeok; Yang, Hye-Won; Joo, So-Young; Song, Su-Min; Lee, Yu-Ran; Ryu, Jae-Sook; Yoo, Eun Sang; Lee, Won Kee; Kong, Hyun-Hee; Lee, Sang-Eun; Lee, Won-Ja; Goo, Youn-Kyoung; Chung, Dong-Il; Hong, Yeonchul

    2014-10-01

    Trichomonas vaginalis, a causative agent of trichomoniasis, may trigger symptomatic or asymptomatic nongonococcal urethritis and chronic prostatitis in men. Despite the availability of highly sensitive diagnostic tests, such as nucleic acid amplification tests, including PCR, few prospective studies present data on male T. vaginalis infection in South Korea. In the present study, the prevalence of T. vaginalis and associated clinical conditions were evaluated in 201 male patients from a primary care urology clinic in South Korea. The prevalence of T. vaginalis infection in our cohort was 4% (8/201) by PCR. T. vaginalis infection was common in men older than 40 years (median age, 52 years). Among the 8 Trichomonas-positive patients, 87.5% (7/8) had prostatic diseases, such as prostatitis and benign prostatic hyperplasia, and 25.0% (2/8) and 12.5% (1/8) were coinfected with Chlamydia trachomatis and Mycoplasma genitalium, respectively. Our results suggest that T. vaginalis infection is not rare in men attending primary care urology clinics in South Korea, especially in those older than 40 years, in whom it may explain the presence of prostatic disease. The possibility of T. vaginalis infection should be routinely considered in older male patients with prostatic diseases in South Korea.

  6. Impact of collaborative care on survival time for dogs with congestive heart failure and revenue for attending primary care veterinarians.

    Science.gov (United States)

    Lefbom, Bonnie K; Peckens, Neal K

    2016-07-01

    OBJECTIVE To assess the effects of in-person collaborative care by primary care veterinarians (pcDVMs) and board-certified veterinary cardiologists (BCVCs) on survival time of dogs after onset of congestive heart failure (CHF) and on associated revenue for the attending pcDVMs. DESIGN Retrospective cohort study. ANIMALS 26 small-breed dogs treated for naturally occurring CHF secondary to myxomatous mitral valve disease at a multilocation primary care veterinary hospital between 2008 and 2013. PROCEDURES Electronic medical records were reviewed to identify dogs with confirmed CHF secondary to myxomatous mitral valve disease and collect information on patient care, survival time, and pcDVM revenue. Data were compared between dogs that received collaborative care from the pcDVM and a BCVC and dogs that received care from the pcDVM alone. RESULTS Dogs that received collaborative care had a longer median survival time (254 days) than did dogs that received care from the pcDVM alone (146 days). A significant positive correlation was identified between pcDVM revenue and survival time for dogs that received collaborative care (ie, the longer the dog survived, the greater the pcDVM revenue generated from caring for that patient). CONCLUSIONS AND CLINICAL RELEVANCE Findings suggested that collaborative care provided to small-breed dogs with CHF by a BCVC and pcDVM could result in survival benefits for affected dogs and increased revenue for pcDVMs, compared with care provided by a pcDVM alone.

  7. Prevalence of Trichomonas vaginalis by PCR in Men Attending a Primary Care Urology Clinic in South Korea

    Science.gov (United States)

    Seo, Jun-Hyeok; Yang, Hye-Won; Joo, So-Young; Song, Su-Min; Lee, Yu-Ran; Ryu, Jae-Sook; Yoo, Eun Sang; Lee, Won Kee; Kong, Hyun-Hee; Lee, Sang-Eun; Lee, Won-Ja; Goo, Youn-Kyoung; Chung, Dong-Il

    2014-01-01

    Trichomonas vaginalis, a causative agent of trichomoniasis, may trigger symptomatic or asymptomatic nongonococcal urethritis and chronic prostatitis in men. Despite the availability of highly sensitive diagnostic tests, such as nucleic acid amplification tests, including PCR, few prospective studies present data on male T. vaginalis infection in South Korea. In the present study, the prevalence of T. vaginalis and associated clinical conditions were evaluated in 201 male patients from a primary care urology clinic in South Korea. The prevalence of T. vaginalis infection in our cohort was 4% (8/201) by PCR. T. vaginalis infection was common in men older than 40 years (median age, 52 years). Among the 8 Trichomonas-positive patients, 87.5% (7/8) had prostatic diseases, such as prostatitis and benign prostatic hyperplasia, and 25.0% (2/8) and 12.5% (1/8) were coinfected with Chlamydia trachomatis and Mycoplasma genitalium, respectively. Our results suggest that T. vaginalis infection is not rare in men attending primary care urology clinics in South Korea, especially in those older than 40 years, in whom it may explain the presence of prostatic disease. The possibility of T. vaginalis infection should be routinely considered in older male patients with prostatic diseases in South Korea. PMID:25352707

  8. What happens to Palestine refugees with diabetes mellitus in a primary healthcare centre in Jordan who fail to attend a quarterly clinic appointment?

    Science.gov (United States)

    Khader, Ali; Ballout, Ghada; Shahin, Yousef; Hababeh, Majed; Farajallah, Loai; Zeidan, Wafaa; Abu-Zayed, Ishtaiwi; Kochi, Arata; Harries, Anthony D; Zachariah, Rony; Kapur, Anil; Shaikh, Irshad; Seita, Akihiro

    2014-03-01

    In a primary healthcare clinic in Jordan to determine: (i) treatment outcomes stratified by baseline characteristics of all patients with diabetes mellitus (DM) ever registered as of June 2012 and (ii) in those who failed to attend the clinic in the quarter (April-June 2012), the number who repeatedly did not attend in subsequent quarters up to 1 year later, again stratified by baseline characteristics. A retrospective cohort study with treatment outcome data collected and analysed using e-health and the cohort analysis approach in UNRWA Nuzha Primary Health Care Clinic for Palestine refugees, Amman, Jordan. As of June 2012, there were 2974 patients with DM ever registered, of whom 2246 (76%) attended the clinic, 279 (9%) did not attend, 81 (3%) died, 67 (2%) were transferred out and 301 (10%) were lost to follow-up. A higher proportion of males and patients with undetermined or poor disease control failed to attend the clinic compared with those who attended the clinic. Of the 279 patients who did not attend the clinic in quarter 2, 2012, 144 (52%) were never seen for four consecutive quarters and were therefore defined as lost to follow-up. There were a few differences between patients who were lost to follow-up and those who re-attended at another visit that included some variation in age and fewer disease-related complications amongst those who were lost to follow-up. This study endorses the value of e-health and cohort analysis for monitoring and managing patients with DM. Just over half of patients who fail to attend a scheduled quarterly appointment are declared lost to follow-up 1 year later, and systems need to be set up to identify and contact such patients so that those who are late for their appointments can be brought back to care and those who might have died or silently transferred out can be correctly recorded. © 2014 John Wiley & Sons Ltd.

  9. Algal eating habits of phycologists attending the ISAP Halifax Conference and members of the general public

    DEFF Research Database (Denmark)

    Edwards, Maeve D.; Holdt, Susan Løvstad; Hynes, Stephen

    2012-01-01

    A short questionnaire was devised during the 4th ISAP Conference in Halifax (2011) to gather some information on the algal eating habits of the participants. Responses were also collected from random members of the general public in Galway and Copenhagen. Most phycologists had eaten algae before...... the probability of eating algae regularly by 9% if the participant was male (at the 90% confidence limit). As hypothesised, being a conference attendee highly significantly increased the probability of eating algae by 22%, in comparison with non-conference attendees (i.e. the general public). The type...

  10. Thinking Locally: Attending to Social Context in Studies of Marketing and Public Education

    Science.gov (United States)

    Cucchiara, Maia

    2016-01-01

    A generation ago, billboards, flyers, or radio spots advertising a public school would have been unusual and surprising. Now they are an increasingly regular feature of the educational landscape. As schools compete for students and resources in the new educational marketplace, they increasingly look to market themselves to prospective parents (and…

  11. Assessing the Readability of College Textbooks in Public Speaking: Attending to Entry Level Instruction

    Science.gov (United States)

    Schneider, David E.

    2011-01-01

    More research is needed that examines textbooks intended for the entry level college classroom. This study offers valuable information to academics that adopt a public speaking textbook for instruction as well as objective feedback to the collective authors. Readability levels of 22 nationally published textbooks, based on McGlaughlin's (1969)…

  12. Dental Anxiety and the Use of Oral Health Services Among People Attending Two HIV Primary Care Clinics in Miami

    Science.gov (United States)

    Singer, Richard; Cardenas, Gabriel; Xavier, Jessica; Jeanty, Yves; Pereyra, Margaret; Rodriguez, Allan; Metsch, Lisa R.

    2012-01-01

    Objectives We examined factors associated with dental anxiety among a sample of HIV primary care patients and investigated the independent association of dental anxiety with oral health care. Methods Cross-sectional data were collected in 2010 from 444 patients attending two HIV primary care clinics in Miami-Dade County, Florida. Corah Dental Anxiety Scores and use of oral health-care services were obtained from all HIV-positive patients in the survey. Results The prevalence of moderate to severe dental anxiety in this sample was 37.8%, while 7.9% of the sample was characterized with severe dental anxiety. The adjusted odds of having severe dental anxiety were 3.962 times greater for females than for males (95% confidence interval [CI] 1.688, 9.130). After controlling for age, ethnicity, gender, education, access to dental care, and HIV primary clinic experience, participants with severe dental anxiety had 69.3% lower adjusted odds of using oral health-care services within the past 12 months (vs. longer than 12 months ago) compared with participants with less-than-severe dental anxiety (adjusted odds ratio = 0.307, 95% CI 0.127, 0.742). Conclusion A sizable number of patients living with HIV have anxiety associated with obtaining needed dental care. Routine screening for dental anxiety and counseling to reduce dental anxiety are supported by this study as a means of addressing the impact of dental anxiety on the use of oral health services among HIV-positive individuals. PMID:22547875

  13. Assessing prevalence of and barriers to medication adherence in patients with uncontrolled diabetes attending primary healthcare clinics in Qatar.

    Science.gov (United States)

    Jaam, Myriam; Mohamed Ibrahim, Mohamed Izham; Kheir, Nadir; Hadi, Muhammad Abdul; Diab, Mohammad Issam; Awaisu, Ahmed

    2017-11-20

    Studies conducted in Qatar have reported a high prevalence of diabetic nephropathy, retinopathy, and neuropathy. These complications are often associated with poor medication adherence and uncontrolled diabetes. The objectives of this study were to determine the rate of medication adherence among patients with uncontrolled diabetes, and to compare the characteristics and identified barriers between patients with good and those with poor medication adherence. A cross-sectional quantitative study was conducted among patients living in Qatar with uncontrolled diabetes attending primary healthcare clinics from October 2016 to January 2017. An interviewer-administered questionnaire comprising three sections was utilized in the study: patients' characteristics, Adherence to Refill and Medications Scale in Diabetes (ARMS-D), and barriers to medication adherence. ARMS-D is a validated tool that is used to identify adherence level among patients with diabetes. Descriptive and inferential statistics including regression analysis were used for data analysis. A total of 260 patients were included in the analysis. Overall, 73% (n=191) were nonadherent to their diabetes medications (ARMS-D score above 11). Nonadherent patients reported the majority of the pre-determined barriers to medication adherence with forgetfulness being the most commonly reported barrier. Multivariate linear regression analysis found age, ethnicity, education level, income level and HbA1c to be independent predictors of adherence. The findings of this study reaffirm the notion that non-adherence to medications among patients with uncontrolled diabetes within primary care setting is higher than the general diabetes population. This high prevalence is concerning and necessitates urgent interventions. Nonetheless, an in-depth understanding of barriers to medication adherence often requires qualitative research approach as these barriers are very complex and multifactorial in nature. Copyright © 2017 Primary

  14. Anticoagulation Control in Patients With Nonvalvular Atrial Fibrillation Attended at Primary Care Centers in Spain: The PAULA Study.

    Science.gov (United States)

    Barrios, Vivencio; Escobar, Carlos; Prieto, Luis; Osorio, Genoveva; Polo, José; Lobos, José María; Vargas, Diego; García, Nicolás

    2015-09-01

    To determine the current status of anticoagulation control in patients with nonvalvular atrial fibrillation treated with vitamin K antagonists in the primary care setting in Spain. The PAULA study was a multicenter cross-sectional/retrospective observational study conducted throughout Spain. The study included patients with nonvalvular atrial fibrillation who had been receiving vitamin K antagonist therapy during the past year and were attended at primary care centers. International normalized ratio (INR) values over the past 12 months were recorded. The degree of anticoagulation control was defined as the time the patient had remained within the therapeutic range and was determined by both the direct method (poor control < 60%) and by the Rosendaal method (poor control < 65%). The study assessed 1524 patients (mean age, 77.4 ± 8.7 years; 48.6% women; 64.2% in permanent atrial fibrillation; CHADS2 mean, 2.3 ± 1.2; CHA2DS2-VASc, 3.9 ± 1.5, and HAS-BLED, 1.6 ± 0.9). The mean number of INR readings recorded per patient was 14.4 ± 3.8. A total of 56.9% of patients had adequate INR control according to the direct method and 60.6% according to the Rosendaal method. The multivariate analysis identified the following predictors for poor INR control: female sex, dietary habits potentially affecting anticoagulation with vitamin K antagonists, multidrug therapy, and a history of labile INR. Approximately 40% of patients (43.1% by the direct method and 39.4% by the Rosendaal method) with nonvalvular atrial fibrillation who were receiving anticoagulation therapy with vitamin K antagonists in primary care in Spain had poor anticoagulation control during the previous 12 months. Copyright © 2015 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  15. Frequency and evaluation of the perceptions towards caesarean section among pregnant women attending public hospitals in Pakistan and the implications.

    Science.gov (United States)

    Ishaq, Rabia; Baloch, Nosheen Sikander; Iqbal, Qaiser; Saleem, Fahad; Hassali, Mohamed Azmi; Iqbal, Javeid; Ahmed, Fiaz Ud Din; Anwar, Mohammad; Haider, Sajjad; Godman, Brian

    2017-08-01

    There is increasing prevalence of caesarean sections (CS) worldwide; however, there are concerns about their rates in some countries, including potential fears among mothers. Consequently, we aimed to determine the frequency of CS, and explore patient's perception towards CS attending public hospitals in Pakistan, to provide future guidance. A two-phased study design (retrospective and cross sectional) was adopted. A retrospective study was conducted to assess the frequency of CS over one year among four public hospitals. A cross sectional study was subsequently conducted to determine patients' perception towards CS attending the four tertiary care public hospitals in Quetta city, Pakistan, which is where most births take place. Overall prevalence of CS was 13.1% across the four hospitals. 728 patients were approached and 717 responded to the survey. Although 78.8% perceived CS as dangerous, influenced by education (p = 0.004), locality (p = 0.001) and employment status (p = 0.001), 74.5% of patients were in agreement that this is the best approach to save mother's and baby's lives if needed. 62% of respondents reported they would like to avoid CS if they could due to post-operative pain, and 58.9% preferred a normal delivery. There was also a significant association with education (p = 0.001) and locality (p = 0.001) where respondents considered normal vaginal delivery as painful. The overall frequency of CS approximates to WHO recommendations, although there is appreciable variation among the four hospitals. When it comes to perception towards CS, women had limited information. There is a need to provide mothers with education during the antenatal period, especially those with limited education, to accept CS where needed.

  16. Public Health Amendment (Vaccination of Children Attending Child Care Facilities) Act 2013: its impact in the Northern Rivers, NSW.

    Science.gov (United States)

    Fraser, Alice C; Williams, Sarah E; Kong, Sarah X; Wells, Lucy E; Goodall, Louise S; Pit, Sabrina; Hansen, Vibeke; Trent, Marianne

    2016-04-15

    The objective of the study was to explore the impact of implementation of the Public Health Amendment (Vaccination of Children Attending Child Care Facilities) Act 2013 on child-care centres in the Northern Rivers region of New South Wales (NSW), from the perspective of child-care centre directors. Importance of study: Immunisation is an effective public health intervention, but more than 75 000 Australian children are not fully vaccinated. A recent amendment to the NSW Public Health Act 2010 asks child-care facilities to collect evidence of complete vaccination or approved exemption before allowing enrolment. Ten child-care centre directors participated in a semiscripted interview. Interviews were recorded, transcribed and analysed. Common themes included misinterpretation of the amendment before implementation, the importance of adequate notice for implementation, lack of understanding of assessment of compliance, increased administrative requirements, the importance of other public health efforts, and limited change in vaccination rates. Child-care centres differed in their experience of the resources provided by the government, interactions with Medicare, and ease of integration with existing record-keeping methods. Participants felt that the amendment was successfully implemented. The amendment was felt to have fulfilled its aim of prompting parents who had forgotten to vaccinate, but failed to significantly affect conscientious objectors. Overall, the amendment was perceived to be a positive step in improving vaccination rates, but its impact was largely complementary to other components of the multifaceted vaccination policy.

  17. Medication adherence and blood pressure control amongst adults with primary hypertension attending a tertiary hospital primary care clinic in Eastern Nigeria

    Directory of Open Access Journals (Sweden)

    Gabriel UP. Iloh

    2013-02-01

    Full Text Available Background: As the case detection rates of hypertension increase in adult Nigerians, achieving target blood pressure (BP control has become an important management challenge.Objectives: To describe medication adherence and BP control amongst adult Nigerians with primary hypertension attending a primary care clinic of a tertiary hospital in a resource-poor environment in Eastern Nigeria.Methods: A cross-sectional study was carried out in 140 adult patients with primary hypertension who have been on treatment for at least 6 months at the primary care clinic of Federal Medical Centre, Umuahia. A patient was said to have achieved goal BP control if the BP was < 140 per 90 mmHg. Adherence was assessed in the previous 30 days using a pretested researcher-administered questionnaire on 30 days of self-reported therapy. Adherence was graded using an ordinal scoring system of 0–4; an adherent patient was one who scored 4 points in the previous 30 days. Reasons for non-adherence were documented.Results: Adherence to medication and BP control rates were 42.9% and 35.0% respectively. BP control was significantly associated with medication adherence (p = 0.03, antihypertensive medication duration ≥3 years (p = 0.042, and taking ≥ one form of antihypertensive medication (p = 0.04. BP at the recruitment visit was significantly higher than at the end of the study (p = 0.036. The most common reason for non-adherence was forgetfulness (p = 0.046. Conclusion: The rate of BP control amongst the study population was low, which may be connected with low medication adherence. This study urges consideration of factors relating to adherence alongside other factors driving goal BP control.

  18. Reported intimate partner violence amongst women attending a public hospital in Botswana

    Directory of Open Access Journals (Sweden)

    Lindiwe I. Zungu

    2010-03-01

    Full Text Available Background: Intimate partner violence (IPV is common worldwide and occurs across social, economic, religious and cultural groups. This makes it an important public health issue for health care providers. In South Africa, the problem of violence against women is complex and it has social and public health consequences. The paucity of data on IPV is related to underreporting and a lack of screening of this form of violence in health care settings.Objectives: The aim of this study was to determine the prevalence of IPV and explore the risk factors associated with this type of violence against women who visited a public hospital in Botswana.Method: A descriptive, cross-sectional survey was conducted among randomly sampled adult women aged 21 years and older, during their hospital visits in 2007. Data were obtained by means of structured interviews, after obtaining written and signed, informed consent from each participant.Results: A total of 320 women participated in this study. Almost half (49.7% reported having had an experience of IPV in one form or another at some point in their lifetime, while 68 (21.2% reported a recent incident of abuse by their partners in the past year. Experiences of IPV were predominantly reported by women aged 21 – 30 years (122; 38%. Most of the allegedly abused participants were single (173; 54% and unemployed (140; 44%. Significant associations were found between alcohol use by participants’ male intimate partners (χ2 = 17.318; p = 0.001 and IPV, as well as cigarette smoking (χ2 = 17.318; p = 0.001 and IPV.Conclusion: The prevalence of alleged IPV in Botswana is relatively high (49.7%, especially among young adult women, but the prevalence of reported IPV is low (13.2%. It is essential that women are screened regularly in the country’s public and private health care settings for IPV.

  19. Linear growth of children attending public daycare centers in the municipality of Campina Grande, Paraíba, Brazil.

    Science.gov (United States)

    Pedraza, Dixis Figueroa

    2016-01-01

    To identify variables predictors of linear growth in preschool children attending public child day care centers of Campina Grande, Paraíba. A cross-sectional study on a probabilistic sample of 335 children attending child day care centers. Were obtained information about socioeconomic, maternal and children's characteristics. The height/age (Z-score) was analyzed as continuous dependent variable. Anthropometric data were obtained in compliance with the recommendations of the World Health Organization. The Multicentre Growth Reference Study was used as the reference population. The data were subjected to multiple linear regression analysis using the hierarchical model. Children who slept in rooms with at least two people, households without garbage collection, households with no refrigerator, rural zone, illiterate mothers, mothers of short stature, low birth weight and stay in child day care center at part time were the conditions associated with worse height/age of children. There is a clear difference in linear growth with multicausal characteristic in which the low birth weight, as an expression of adverse history, and the socioeconomic conditions, as an expression of health inequities, profiling the genetic potential of growth.

  20. Assessing the connection between health and education: identifying potential leverage points for public health to improve school attendance.

    Science.gov (United States)

    Gase, Lauren N; Kuo, Tony; Coller, Karen; Guerrero, Lourdes R; Wong, Mitchell D

    2014-09-01

    We examined multiple variables influencing school truancy to identify potential leverage points to improve school attendance. A cross-sectional observational design was used to analyze inner-city data collected in Los Angeles County, California, during 2010 to 2011. We constructed an ordinal logistic regression model with cluster robust standard errors to examine the association between truancy and various covariates. The sample was predominantly Hispanic (84.3%). Multivariable analysis revealed greater truancy among students (1) with mild (adjusted odds ratio [AOR] = 1.57; 95% confidence interval [CI] = 1.22, 2.01) and severe (AOR = 1.80; 95% CI = 1.04, 3.13) depression (referent: no depression), (2) whose parents were neglectful (AOR = 2.21; 95% CI = 1.21, 4.03) or indulgent (AOR = 1.71; 95% CI = 1.04, 2.82; referent: authoritative parents), (3) who perceived less support from classes, teachers, and other students regarding college preparation (AOR = 0.87; 95% CI = 0.81, 0.95), (4) who had low grade point averages (AOR = 2.34; 95% CI = 1.49, 4.38), and (5) who reported using alcohol (AOR = 3.47; 95% CI = 2.34, 5.14) or marijuana (AOR = 1.59; 95% CI = 1.06, 2.38) during the past month. Study findings suggest depression, substance use, and parental engagement as potential leverage points for public health to intervene to improve school attendance.

  1. Demographic and practice factors predicting repeated non-attendance in primary care: a national retrospective cohort analysis

    Directory of Open Access Journals (Sweden)

    David A Ellis, PhD

    2017-12-01

    in the adjusted model (1·05, 1·04–1·06. Practice factors also substantially affected attendance patterns, with urban practices in affluent areas that typically have appointment waiting times of 2–3 days the most likely to have patients who serially miss appointments. The combination of both patient and practice factors to predict appointments missed gave a higher pseudo R2 value (0·66 than models using either group of factors separately (patients only R2=0·54; practice only R2=0·63. Interpretation: The findings that both patient and practice characteristics contribute to non-attendance of general practice appointments raise important questions for both the management of patients who miss multiple appointments and the effectiveness of existing strategies that aim to increase attendance. Addressing these issues should lead to improvements in provision of services and public health. Funding: Scottish Government Chief Scientist Office and Data Sharing and Linkage Service of the Scottish Government.

  2. Reforming primary healthcare: from public policy to organizational change.

    Science.gov (United States)

    Gilbert, Frédéric; Denis, Jean-Louis; Lamothe, Lise; Beaulieu, Marie-Dominique; D'amour, Danielle; Goudreau, Johanne

    2015-01-01

    Governments everywhere are implementing reform to improve primary care. However, the existence of a high degree of professional autonomy makes large-scale change difficult to achieve. The purpose of this paper is to elucidate the change dynamics and the involvement of professionals in a primary healthcare reform initiative carried out in the Canadian province of Quebec. An empirical approach was used to investigate change processes from the inception of a public policy to the execution of changes in professional practices. The data were analysed from a multi-level, combined contextualist-processual perspective. Results are based on a longitudinal multiple-case study of five family medicine groups, which was informed by over 100 interviews, questionnaires, and documentary analysis. The results illustrate the multiple processes observed with the introduction of planned large-scale change in primary care services. The analysis of change content revealed that similar post-change states concealed variations between groups in the scale of their respective changes. The analysis also demonstrated more precisely how change evolved through the introduction of "intermediate change" and how cycles of prescribed and emergent mechanisms distinctively drove change process and change content, from the emergence of the public policy to the change in primary care service delivery. This research was conducted among a limited number of early policy adopters. However, given the international interest in turning to the medical profession to improve primary care, the results offer avenues for both policy development and implementation. The findings offer practical insights for those studying and managing large-scale transformations. They provide a better understanding of how deliberate reforms coexist with professional autonomy through an intertwining of change content and processes. This research is one of few studies to examine a primary care reform from emergence to implementation

  3. Primary prevention of type 2 diabetes: integrative public health and primary care opportunities, challenges and strategies.

    Science.gov (United States)

    Green, Lawrence W; Brancati, Frederick L; Albright, Ann

    2012-04-01

    Type 2 diabetes imposes a large and growing burden on the public's health. This burden, combined with the growing evidence for primary prevention from randomized controlled trials of structured lifestyle programs leads to recommendations to include caloric reduction, increased physical activity and specific assistance to patients in problem solving to achieve modest weight loss as well as pharmacotherapy. These recommendations demand exploration of new ways to implement such primary prevention strategies through more integrated community organization, medical practice and policy. The US experience with control of tobacco use and high blood pressure offers valuable lessons for policy, such as taxation on products, and for practice in a variety of settings, such as coordination of referrals for lifestyle supports. We acknowledge also some notable exceptions to their generalizability. This paper presents possible actions proposed by an expert panel, summarized in Table 1 as recommendations for immediate action, strategic action and research. The collaboration of primary care and public health systems will be required to make many of these recommendations a reality. This paper also provides information on the progress made in recent years by the Division of Diabetes Translation at the US Centers for Disease Control and Prevention (CDC) to implement or facilitate such integration of primary care and public health for primary prevention.

  4. Common mental disorder symptoms among patients with malaria attending primary care in Ethiopia: a cross-sectional survey.

    Directory of Open Access Journals (Sweden)

    Markos Tesfaye

    Full Text Available Common Mental Disorders (CMDs are frequent among patients attending primary care. In Africa, CMDs are often misdiagnosed as physical illnesses because many of the patients complain of somatic symptoms of mental distress. We explored whether there was difference in the levels of CMD symptoms between patients with thick film confirmed and clinical cases of malaria with negative thick film in primary care.A cross-sectional comparative study was conducted on 300 adults with a clinical diagnosis of malaria in primary care centres in Jimma, Ethiopia. Patients were recruited consecutively until 100 cases of 'malaria' with a negative thick film and 200 cases of malaria with a positive thick film consented to participate. The 20-item Self-Reporting Questionnaire (SRQ-20 was used to measure CMD. The non-parametric Wilcoxon rank-sum test was used to explore the association between thick film result and CMD.Participants had a mean age of 28.2 (S.D = 10.9 years and the majority (57.3% were women. The prevalence of high CMD symptoms (six or more symptoms on the SRQ-20 was 24.5%. Suicidal ideation was reported by 13.8% of the participants. CMD symptoms were significantly higher in patients who had taken medication prior to visiting the primary care (p = 0.012 and in those whose symptoms had been present for seven days or more (p = 0.041. There was no statistically significant association between level of CMD symptoms and having a negative thick film result (OR 0.98; 95%CI 0.92, 1.04 or objective presence of fever (OR 1.04; 95%CI 0.93, 1.15.CMD symptoms among cases of malaria did not appear to be associated with a negative thick film result. The high levels of CMD symptoms, including suicidal ideation, calls for further studies to investigate the persistence and progression of these symptoms following resolution of the acute malarial episode.

  5. Awareness and Use of Contraceptives Among Saudi Women Attending Primary Care Centers in Al-Qassim, Saudi Arabia

    Science.gov (United States)

    Al Sheeha, Mounira

    2010-01-01

    Background: The overall rapid change in the socio-demographic pattern of the Saudi Arabian community, especially the changes concerned with women’s education and work will be an important factor in changing fertility beliefs and behaviors with more tendencies to birth spacing and, consequently, the use of contraceptives. Objectives: The study aimed to identify the perception of Saudi women regarding the use of contraceptives Methods: A cross-sectional study was conducted among Saudi women attending primary care centers of Al-Qassim Region. A structured questionnaire was developed to cover the research objectives. The dependant variable was the utilization of contraceptive methods and the socioeconomic variables were the independent variables. Results: The results identified the low knowledge level of the participant women regarding the variety of contraceptive methods. Most participants and their husbands showed acceptance to the use of contraceptives for birth spacing. They preferred birth interval of 2–3 years. They intended to have from 5 to 10 children. There was a significant increase in contraceptive use among working women, 30 years and older, with a higher level of education, and those having a large number of children. Multiple regression models revealed that the significant determinants of the use of contraceptives were women’s working and education. The study recommended sustained efforts to increase awareness and motivation for proper contraceptive use. PMID:21475521

  6. A study on teenage pregnant mothers attending primary health centers of Kempegowda Institute of Medical Sciences, Bangalore.

    Science.gov (United States)

    Parasuramalu, B G; Shakila, N; Masthi, Ramesh N R

    2010-01-01

    Data were collected from 78 teenage pregnant mothers (15-19 years) out of 1446 pregnant mothers who attended the primary health centers situated in the field practice area of the rural health center, Kengeri of Kempegowda Institute of Medical Sciences, Bangalore, between May and July 2009 to study the factors associated with teenage pregnancies and awareness regarding family planning. This was a descriptive study. Out of 78 teenage pregnant mothers, 57 (73%) were Hindus and 45 (57.7%) belonged to joint families. 76 (97.4%) teenage pregnant mothers were housewives, i.e. 55 (70.5%) of the spouses of the teenage pregnant mothers were laborers, in majority, i.e. 40 (51.3%) teenage pregnant mothers' age at marriage and the age at first pregnancy were 18 years. The mean age at marriage increased significantly with an increase of the educational status of the teenage pregnant mothers (F value = 7.08%, Ppregnancy was also increased with an increase of the education status of both the teenage pregnant mothers and their spouse. The most common reason for early marriage and early pregnancy was traditional practices and family pressure among 50 (64%) and 45 (57.7%) teenage pregnant mothers, respectively. 49 (63%) teenage pregnant mothers were not aware of any family planning methods.

  7. Hepatitis C virus infection in patients and family members attending two primary care clinics in Puebla, Mexico.

    Science.gov (United States)

    López-Colombo, Aurelio; Meléndez-Mena, Daniel; Sedeño-Monge, Virginia; Camacho-Hernández, José R; Vázquez-Cruz, Eduardo; Morales-Hernández, Eduardo R; Sosa-Jurado, Francisca; Márquez-Domínguez, Luis; Santos-López, Gerardo

    2014-01-01

    Approximately 180 million persons (~2.8%) globally are estimated to be infected by hepatitis C virus (HCV). HCV prevalence in Mexico has been estimated to be between 1.2 and 1.4%. The aim of present work was to determine the prevalence of HCV infection in patients and family members attending two primary care clinics in Puebla, Mexico. Patients and their accompanying family members in two clinics were invited to participate in this study between May and September 2010. A total of 10,214 persons were included in the study; 120 (1.17%) persons were anti-HCV reactive. Of the reactive subjects, detection of viral RNA was determined in 114 subjects and 36 were positive (31%). The more frequent risk factors were having a family history of cirrhosis (33.1%) and having a blood transfusion prior to 1995 (29%). After a multiple logistic regression analysis only transfusion prior to 1995 resulted significant to HCV transmission (p = 0.004). The overall detected HCV genotypes were as follows: 1a (29%), 1b (48.5%), 2/2b (12.8%), and 3a (6.5%). The HCV prevalence in this population is in agreement with previous studies in other regions of Mexico.

  8. Comparison of asthma prevalence among African American teenage youth attending public high schools in rural Georgia and urban Detroit.

    Science.gov (United States)

    Ownby, Dennis R; Tingen, Martha S; Havstad, Suzanne; Waller, Jennifer L; Johnson, Christine C; Joseph, Christine L M

    2015-09-01

    The high prevalence of asthma among urban African American (AA) populations has attracted research attention, whereas the prevalence among rural AA populations is poorly documented. We sought to compare the prevalence of asthma among AA youth in rural Georgia and urban Detroit, Michigan. The prevalence of asthma was compared in population-based samples of 7297 youth attending Detroit public high schools and in 2523 youth attending public high schools in rural Georgia. Current asthma was defined as a physician diagnosis and symptoms in the previous 12 months. Undiagnosed asthma was defined as multiple respiratory symptoms in the previous 12 months without a physician diagnosis. In Detroit, 6994 (95.8%) youth were AA compared with 1514 (60.0%) in Georgia. Average population density in high school postal codes was 5628 people/mile(2) in Detroit and 45.1 people/mile(2) in Georgia. The percentages of poverty and of students qualifying for free or reduced lunches were similar in both areas. The prevalence of current diagnosed asthma among AA youth in Detroit and Georgia was similar: 15.0% (95% CI, 14.1-15.8) and 13.7% (95% CI, 12.0-17.1) (P = .22), respectively. The prevalence of undiagnosed asthma in AA youth was 8.0% in Detroit and 7.5% in Georgia (P = .56). Asthma symptoms were reported more frequently among those with diagnosed asthma in Detroit, whereas those with undiagnosed asthma in Georgia reported more symptoms. Among AA youth living in similar socioeconomic circumstances, asthma prevalence is as high in rural Georgia as it is in urban Detroit, suggesting that urban residence is not an asthma risk factor. Copyright © 2015 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  9. Is it just religious practice? Exploring patients’ reasons for choosing a faith-based primary health clinic over their local public sector primary health clinic

    Directory of Open Access Journals (Sweden)

    James D. Porter

    2017-01-01

    Full Text Available Background: Person-centred, re-engineered primary health care (PHC is a national and global priority. Faith-based health care is a significant provider of PHC in sub-Saharan Africa, but there is limited published data on the reasons for patient choice of faith-based health care, particularly in South Africa.Aim: The primary objective was to determine and explore the reasons for patient choice of a faith-based primary care clinic over their local public sector primary care clinic, and secondarily to determine to what extent these reasons were influenced by demography.Setting: The study was conducted at Jubilee Health Centre (JHC, a faith-based primary care clinic attached to Jubilee Community Church in Cape Town, South Africa.Methods: Focus groups, using the nominal group technique, were conducted with JHC patients and used to generate ranked reasons for attending the clinic. These were collated into the top 15 reasons and incorporated into a quantitative questionnaire which was administered to adult patients attending JHC.Results: A total of 164 patients were surveyed (a response rate of 92.4% of which 68.3% were female and 57.9% from the Democratic Republic of the Congo (DRC. Of patients surveyed, 98.2% chose to attend JHC because ‘the staff treat me with respect’, 96.3% because ‘the staff are friendly’ and 96.3% because ‘the staff take time to listen to me’. The reason ‘it is a Christian clinic’ was chosen by 70.1% of patients. ‘The staff speak my home language’ was given as a reason by 61.1% of DRC patients and 37.1% of South African patients. ‘The clinic is close to me’ was chosen by 66.6% of Muslims and 40.8% of Christians.Conclusion: Patients chose to attend JHC (a faith-based primary care clinic because of the quality of care received. They emphasised the staff–patient relationship and patient-centredness rather than the clinic’s religious practices (prayer with patients. These findings may be important in

  10. Is it just religious practice? Exploring patients' reasons for choosing a faith-based primary health clinic over their local public sector primary health clinic.

    Science.gov (United States)

    Porter, James D; Bresick, Graham

    2017-06-29

    Person-centred, re-engineered primary health care (PHC) is a national and global priority. Faith-based health care is a significant provider of PHC in sub-Saharan Africa, but there is limited published data on the reasons for patient choice of faith-based health care, particularly in South Africa. The primary objective was to determine and explore the reasons for patient choice of a faith-based primary care clinic over their local public sector primary care clinic, and secondarily to determine to what extent these reasons were influenced by demography. The study was conducted at Jubilee Health Centre (JHC), a faith-based primary care clinic attached to Jubilee Community Church in Cape Town, South Africa. Focus groups, using the nominal group technique, were conducted with JHC patients and used to generate ranked reasons for attending the clinic. These were collated into the top 15 reasons and incorporated into a quantitative questionnaire which was administered to adult patients attending JHC. A total of 164 patients were surveyed (a response rate of 92.4%) of which 68.3% were female and 57.9% from the Democratic Republic of the Congo (DRC). Of patients surveyed, 98.2% chose to attend JHC because 'the staff treat me with respect', 96.3% because 'the staff are friendly' and 96.3% because 'the staff take time to listen to me'. The reason 'it is a Christian clinic' was chosen by 70.1% of patients. 'The staff speak my home language' was given as a reason by 61.1% of DRC patients and 37.1% of South African patients. 'The clinic is close to me' was chosen by 66.6% of Muslims and 40.8% of Christians. Patients chose to attend JHC (a faith-based primary care clinic) because of the quality of care received. They emphasised the staff-patient relationship and patient-centredness rather than the clinic's religious practices (prayer with patients). These findings may be important in informing efforts to improve public sector primary care.

  11. Thank you for attending our public meetings on 5 and 6 October!

    CERN Multimedia

    Staff Association

    2017-01-01

    Many thanks to all of you, who accepted the Staff Association’s invitation and participated in our Public Meetings on Thursday 5 and Friday 6 October. It is important that the personnel as a whole stays informed and interacts with their representatives at the Staff Association on issues that affect us all. The presentation slides, in English, and the recordings of the meetings, in English and in French, are now available in Indico: https://indico.cern.ch/category/5482/. Keep informed! Consult your colleagues, and share and discuss with them the information provided by the Staff Association on topics such as: the CERN Health Insurance Scheme, the Pension Fund, the first MERIT exercise, promotions, the Kindergarten (EVEE), the Elections to the Staff Council. We would like to remind you that the Staff Association is the statutory body for the collective representation of all CERN personnel, whether they are Staff Members, Fellows, Associates, Users, etc.

  12. Primary prevention in public health: an analysis of basic assumptions.

    Science.gov (United States)

    Ratcliffe, J; Wallack, L

    1985-01-01

    The common definition of primary prevention is straightforward; but how it is transformed into a framework to guide action is based on personal and societal feelings and beliefs about the basis for social organization. This article focuses on the two contending primary prevention strategies of health promotion and health protection. The contention between the two strategies stems from a basic disagreement about disease causality in modern society. Health promotion is based on the "lifestyle" theory of disease causality, which sees individual health status linked ultimately to personal decisions about diet, stress, and drug habits. Primary prevention, from this perspective, entails persuading individuals to forgo their risk-taking, self-destructive behavior. Health protection, on the other hand, is based on the "social-structural" theory of disease causality. This theory sees the health status of populations linked ultimately to the unequal distribution of social resources, industrial pollution, occupational stress, and "anti-health promotion" marketing practices. Primary prevention, from this perspective, requires changing existing social and, particularly, economic policies and structures. In order to provide a basis for choosing between these contending strategies, the demonstrated (i.e., past) impact of each strategy on the health of the public is examined. Two conclusions are drawn. First, the health promotion strategy shows little potential for improving the public health, because it systematically ignores the risk-imposing, other-destructive behavior of influential actors (policy-makers and institutions) in society. And second, effective primary prevention efforts entail an "upstream" approach that results in far-reaching sociopolitical and economic change.

  13. Prevalence and causes of visual impairment among Saudi adults attending primary health care centers in northern Saudi Arabia.

    Science.gov (United States)

    Al-Shaaln, Farhan Fayez; Bakrman, Marwan Abdurrahman; Ibrahim, Adel Mohammad; Aljoudi, Abdullah Srour

    2011-01-01

    Few studies have been conducted in Saudi Arabia to estimate the prevalence of visual impairment and its causes. The objective of this study was to estimate the prevalence of visual impairment, and identify its causes and associated factors among the adult population attending primary health care (PHC) centers in Aljouf province, in northern Saudi Arabia. A cross-sectional study during the year 2005 in PHC centers in Aljouf province in northern Saudi Arabia. A sample of 620 Saudi adults, of age 18 years and older, from the catchment area of the Aljouf PHC centers, were randomly selected through a multistage random sampling technique. Data were collected using a questionnaire about socioeconomic and related information and a visual acuity test was performed using the Snellen chart (E). Diagnosis was established according to World Health Organization (WHO) criteria. Visual impairment was categorized into blindness for a visual acuity of less than 3/60 (20/400, 0.05) in the better eye with the best correction and low vision for a best corrected visual acuity of less than 6/18 (20/60, 0.3) but not less than 3/60 (20/400, 0.05) in the better eye. Regression analysis was used to identify the predictors of visual impairment. Of 617 adult Saudis interviewed and examined, 269 (43.6%) were females. The mean (SD) age was 38.6 (16.2) years. The overall prevalence of visual impairment was 13.9% (95% CI: 11.4%-16.9%). The main medical causes of visual impairments were refractive errors (36.0%) followed by cataract (29.1%) and diabetic retinopathy (20.9%), and the least leading cause was glaucoma (5.8%). The most prominent determinants of visual impairment were age (Pvisual impairment in the study population from the Aljouf area is high. It is recommended that regular checks of visual acuity be conducted for all Saudis of age 50+ years, who attend the PHC centers.

  14. A study on knowledge, attitude, and practice towards premarital carrier screening among adults attending primary healthcare centers in a region in Oman.

    Science.gov (United States)

    Al-Farsi, Omar A; Al-Farsi, Yahya M; Gupta, Ishita; Ouhtit, Allal; Al-Farsi, Khalil S; Al-Adawi, Samir

    2014-04-17

    Despite that hereditary diseases are widespread among the Arab population due to high rates of consanguineous marriages, research regarding community awareness towards premarital carrier screening in some countries such as Oman, is extremely scarce. This study aimed to investigate knowledge and attitude towards premarital carrier screening (PMCS) in Oman. A cross-sectional study was conducted using a self-administered questionnaire which was distributed to 400 Omani adults aged 20-35 who attended primary healthcare institutions at the South Batinah Governorate in Oman. The majority of the participants (84.5%) believed that PMCS was necessary, and about half of them (49.5%) supported the view of making PMCS compulsory. On the contrary, approximately one third (30.5%) of the participants reported that they were not in favor of taking the blood screening test. Overall, unwillingness to perform pre-marital testing was associated with female gender, younger age, being single, less education, and increased income. Despite the relatively high level of knowledge, about one third of the participants were still reluctant to carry out premarital testing. Such attitude calls for immediate need for community-based campaigns to encourage the public to do premarital testing.

  15. [Prevalence of postnatal depression in women attending public hospitals in Durango, Mexico].

    Science.gov (United States)

    Alvarado-Esquivel, Cosme; Sifuentes-Alvarez, Antonio; Estrada-Martínez, Sergio; Salas-Martínez, Carlos; Hernández-Alvarado, Ana Berthina; Ortiz-Rocha, Sara Guadalupe; García-López, Claudia Rosalba; Torres-Castorena, Alejandro; Sandoval-Herrera, Francisco

    2010-01-01

    To determine the prevalence of postnatal depression and associated epidemiological features in a population of women from Durango, Mexico. Applying a cross-sectional design in public hospitals from Durango, we studied 178 women during their 1 to 13 weeks postpartum. The Edinburg Postnatal Depression Scale was applied and depression was evaluated by using the DSM-IV criteria. In addition, socio-demographic, clinical, and psychosocial data from participants were obtained. Of the 178 women, 58 were depressed (32.6%). The prevalence of depression was significantly higher in women with low level of education, with more than 3 years of living with her partner, and in rural, non-insured women. Multivariate analysis showed that postnatal depression was significantly associated with previous depression, history of postnatal depression, depression, anxiety and stress during pregnancy, stress after pregnancy, trauma, bad relationship with partner, abandonment by partner, unwanted pregnancy, family problems, and living without partner. The prevalence of postnatal depression in women living in Durango, Mexico, is high. Several socio-demographic, clinical, and psychosocial factors appear to contribute to this condition.

  16. Prevalence and Risk Factors of Domestic Violence Against Women Attending a Primary Care Center in Riyadh, Saudi Arabia.

    Science.gov (United States)

    Barnawi, Fatima Hamza

    2015-05-27

    Domestic violence (DV) against women can negatively affect the physical, mental, sexual, and reproductive health of the women as well as the well-being of their children. The objective was to estimate among Saudi women the prevalence of different types of DV, to identify its associated risk factors, and to determine the immediate victims' reactions to such violence. A cross-sectional study was carried between March and July, 2011. Self-administrated questionnaire was administered to ever-married Saudi women attending Al-Wazarat primary health care center, in Riyadh, Saudi Arabia. Out of the 720 women studied, 144 (20%) reported exposure to DV over the last year. The most common DV types were emotional (69%), social (34%), economic (26%), physical (20%), and sexual violence (10%). In multivariate logistic regression analysis, the following characteristics were independently associated with DV: younger women age, longer duration of marriage, higher women education, lower husband education, working husbands, military occupation, fewer children, husbands with multiple wives, smoking husbands, aggressive husbands, presence of chronic disease in women or husbands, and non-sufficient family income. The most common impacts of DV on women were medical or behavioral problems (72%) and psychiatric problems (58%). The most common reactions to DV were seeking separation (56%) and doing nothing (41%). More than 90% of children of abused women suffered psychological or behavioral problems. In conclusion, DV against Saudi women is considerable and the response is generally passive. Promoting a culture non-tolerant to DV and providing accessible, effective, and trustful social services to abused women are critically needed. © The Author(s) 2015.

  17. Factors influencing reproductive choices of HIV positive individuals attending primary health care facilities in a South African health district.

    Science.gov (United States)

    Agbo, Samuel; Rispel, Laetitia C

    2017-06-02

    There is global recognition of the reproductive health rights of people living with HIV (PLHIV). The aim of this research study was to explore the reproductive choices, and the factors influencing these choices, of HIV positive patients attending primary health care (PHC) facilities in the Ekurhuleni health district of the Gauteng Province of South Africa. During 2013, a cross-sectional survey was conducted in the Ekurhuleni health district. At each of three randomly selected community health centres, a random sample of HIV positive patients was selected. After informed consent was obtained, trained fieldworkers administered a structured questionnaire that elicited information on socio-demographics, reproductive choices and knowledge of reproductive options. Survey data were analysed using STATA® 13. The majority of survey participants (n = 430) were female (70%) and unemployed (57%). The mean age of participants was 36.4 years (SD 8.6): 40.8 years (SD 8.7) for men and 34.5 years (SD7.8) for women. Among survey participants, 46% expressed a desire for children (95% CI: 41.4-50.9). In the multiple logistic regression analysis, predictors of desire for children were age less than 49 years, marriage or living together, and no biological children. The odds of wanting children was 16.48 [95% CI: 5.94-45.74] times higher for PLHIV without children, compared with those with two or more children, while for those less than 25 years, the odds of wanting children was 0.78 [95% CI: 0.23-2.59] compared with those older than 50 years. The PLHIV knowledge on the available reproductive options was limited, with the majority relying on the guidance of the health workers. Health care providers at PHC level should be educated to address the reproductive health needs of PLHIV. These aspects should be reflected in provincial and national health policies.

  18. [Dietary behaviour of children attending primary school in Italy found by the surveillance system "OKkio alla salute"].

    Science.gov (United States)

    Nardone, Paola; Lauria, Laura; Buoncristiano, Marta; Pizzi, Enrica; Galeone, Daniela; Spinelli, Angela

    2015-01-01

    to describe the dietary behaviour of children attending primary school and the school activities which promote healthy dietary habits. surveillance system with biannual prevalence studies. the fourth round of data collection of the surveillance system OKkio alla SALUTE took place in 2014, promoted and financed by the Ministry of Health and coordinated by the National Institute of Health in collaborations with all regions. 2,408 schools, 48,426 children and 50,638 parents participated. Stratified cluster sampling (with third grade classes as units) was used; information was collected using questionnaires completed by children, parents, teachers and head-teachers. consumption of breakfast, mid-morning snack, fruit and vegetables, sweetened and gassy drinks; school initiatives to promote healthy dietary habits. 31% of children have an adequate breakfast and 8% skip this meal; 52% consume an energy-dense mid-morning snack; 25% do not eat fruit and vegetables daily; 41% drink sweetened/gassy beverages daily. The unhealthy dietary habits are more common among children who have less educated parents or live in the South (more deprived area of the Country). Data show an improvement in the period 2008-2014, except in the consumption of fruit and vegetables. 74% of the schools include nutritional education in the curriculum, 66% have started initiatives of healthy dietary habits and 55% distribute healthy food; 35% involve parents in their initiatives. In the schools of the South nutritional education and involvement of parents are more frequent, while the distribution of healthy food and refectories are less common. the high frequency of unhealthy dietary behaviour and their geographic and social inequalities show that there is a great potential for improvement. Schools are very involved in initiatives of promotion, but they need more support from the institutions and involvement of the families.

  19. Family physician-patient relationship and frequent attendance of primary and specialist health care: Results from a German population-based cohort study.

    Science.gov (United States)

    Dinkel, Andreas; Schneider, Antonius; Schmutzer, Gabriele; Brähler, Elmar; Häuser, Winfried

    2016-07-01

    To investigate the association between the quality of the family physician-patient relationship and frequent attendance of primary and specialist health care. Cross-sectional survey of a representative German population sample (N=2.266). Family physician-patient relationship was assessed with the Patient Doctor Relationship Questionnaire (PDRQ-9). Determinants of frequent attendance were analyzed using logistic regression. Frequent attendance of family physicians was associated with lower income (OR 1.43, 95% CI 1.02-2.00), not being in paid work (OR 1.58, CI 1.08-2.30), psychological distress (OR 1.14, CI 1.07-1.22), somatic symptoms (OR 1.07, CI 1.04-1.11), and physical comorbidity (OR 1.54, CI 1.36-1.74) in the multivariate analysis. Frequent attendance of specialists was related to psychological distress (OR 1.12, CI 1.04-1.20), somatic symptoms (OR 1.08, CI 1.04-1.11), and physical comorbidity (OR 1.69, CI 1.48-1.93) in the multivariate analysis. Quality of the relationship was associated with frequent attendance only in the univariate analyses. A stronger relationship with the family physician was not associated with reduced contact with specialists. The quality of the family physician-patient relationship is not independently associated with frequent attendance. Family physicians should be aware that need factors, i.e. symptom burden and physical comorbidities, are main drivers of frequent attendance. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  20. Nurse-initiation and maintenance of patients on antiretroviral therapy: are nurses in primary care clinics initiating ART after attending NIMART training?

    Science.gov (United States)

    Cameron, David; Gerber, Amor; Mbatha, Melusi; Mutyabule, Judith; Swart, Helga

    2012-01-27

    To determine the percentage of nurses initiating new HIV-positive patients on therapy within 2 months of attending the Nurse Initiation and Maintenance of Antiretroviral Therapy(NIMART) course, and to identify possible barriers to nurse initiation. A brief telephonic interview using a structured questionnaire of a randomly selected sample (126/1736) of primary care nurses who had attended the NIMART course facilitated by the Foundation for Professional Development (FPD) between October 2010 and 31 March 2011 at primary care clinics in 7 provinces. Outcome measures were the number of nurses initiating ART within 2 months of attending the FPD-facilitated NIMART course. Of the nurses surveyed, 62% (79/126) had started initiating new adult patients on ART, but only 7% (9/126) were initiating ART in children. The main barrier to initiation was allocation to other tasks in the clinic as a result of staff shortages. Despite numerous challenges, many primary care nurses working in the 7 provinces surveyed have taken on the responsibility of sharing the task of initiating HIV-positive patients on ART. The barriers preventing more nurses initiating ART include the shortage of primary care nurses and the lack of sufficient consulting rooms. Expanding clinical mentoring and further training in clinical skills and pharmacology would assist in reaching the target of initiating a further 1.2 million HIV-positive patients on ART by 2012.

  1. Mediators of the Relation Between Community Violence and Sexual Risk Behavior Among Adults Attending a Public Sexually Transmitted Infection Clinic

    Science.gov (United States)

    Senn, Theresa E.; Walsh, Jennifer L.; Carey, Michael P.

    2016-01-01

    Prior research shows that violence is associated with sexual risk behavior, but little is known about the relation between community violence (i.e., violence that is witnessed or experienced in one's neighborhood) and sexual risk behavior. To better understand contextual influences on HIV risk behavior, we asked 508 adult patients attending a publicly-funded STI clinic in the U.S. (54% male, Mage = 27.93, 68% African American) who were participating in a larger trial to complete a survey assessing exposure to community violence, sexual risk behavior, and potential mediators of the community violence-sexual risk behavior relation (i.e., mental health, substance use, and experiencing intimate partner violence). A separate sample of participants from the same trial completed measures of sexual behavior norms, which were aggregated to create measures of census tract sexual behavior norms. Data analyses controlling for socioeconomic status revealed that higher levels of community violence were associated with more sexual partners for men and with more episodes of unprotected sex with non-steady partners for women. For both men and women, substance use and mental health mediated the community violence-sexual risk behavior relation; in addition, for men only, experiencing intimate partner violence also mediated this relation. These results confirm that, for individuals living in communities with high levels of violence, sexual risk reduction interventions need to address intimate partner violence, substance use, and mental health to be optimally effective. PMID:27000155

  2. Stillbirth history and Toxoplasma gondii infection in women attending public health centers in a northern Mexican City

    Science.gov (United States)

    Alvarado-Esquivel, C.; Pacheco-Vega, S. J.; Salcedo-Jaquez, M.; Sánchez-Anguiano, L. F.; Hernández-Tinoco, J.; Rábago-Sánchez, E.; Centeno-Tinoco, M. M.; Flores-Garcia, I. D.; Ramos-Nevarez, A.; Cerrillo-Soto, S. M.; Guido-Arreola, C. A.; Beristain-García, I.; Liesenfeld, O.; Berumen-Segovia, L. O.; Saenz-Soto, L.; Sifuentes-Álvarez, A.

    2015-01-01

    Through a cross-sectional study design, 150 women attending public health centers with a history of stillbirths were examined for anti-Toxoplasma gondii IgG and IgM antibodies in Durango City, Mexico. Bivariate and multivariate analyses were used to assess the association of T. gondii seropositivity with the characteristics of the women with stillbirth history. Of the 150 women (mean age: 32.09 ± 9.16 years) studied, 14 (9.3%) had anti-T. gondii IgG antibodies and six (42.9%) of them were also positive for anti-T. gondii IgM antibodies. Multivariate analysis showed that T. gondii seropositivity was associated with high frequency (4–7 days a week) of eating meat (OR = 5.52; 95% CI: 1.48–20.59; P = 0.01), history of lymphadenopathy (OR = 4.52; 95% CI: 1.14–17.82; P = 0.03), and history of surgery (OR = 8.68; 95% CI: 1.04–72.15; P = 0.04). This is the first study on the seroepidemiology of T. gondii infection in women with a history of stillbirths in Mexico. The association of T. gondii exposure with a history of surgery warrants for further research. Risk factors for T. gondii infection found in the present survey may help to design optimal educational programs to avoid T. gondii infection. PMID:26185685

  3. Prevalence of childhood and early adolescence mental disorders among children attending primary health care centers in Mosul, Iraq: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Al-Jawadi Asma A

    2007-10-01

    Full Text Available Abstract Background Children and adolescents are more vulnerable to the affects of war and violence than adults. At the time of initiation of this study, nothing was known about the prevalence of childhood and early adolescence mental disorders. The aim of the present study is to measure the point prevalence of mental disorders among children of 1–15 years age in the city of Mosul, Iraq. Methods A cross-sectional study design was adopted. Four primary health care centers were chosen consecutively as a study setting. The subjects of the present study were mothers who came to the primary health care center for vaccination of their children. The chosen mothers were included by systematic sampling randomization. All children (aged 1–15 that each mother had were considered in the interview and examination. Results Out of 3079 children assessed, 1152 have childhood mental disorders, giving a point prevalence of 37.4%, with a male to female ratio of to 1.22:1. The top 10 disorders among the examined children are post-traumatic stress disorder (10.5%, enuresis (6%, separation anxiety disorder (4.3%, specific phobia (3.3% stuttering and refusal to attend school (3.2% each, learning and conduct disorders (2.5% each, stereotypic movement (2.3% and feeding disorder in infancy or early childhood (2.0%. Overall, the highest prevalence of mental disorders was among children 10–15 years old (49.2% while the lowest was among 1–5 year olds (29.1%. Boys are more affected than girls (40.2% and 33.2%, respectively. Conclusion Childhood mental disorders are a common condition highly prevalent amongst the children and early adolescents in Mosul. Data from the present study mirrors the size of the problem in local community. Several points deserve attention, the most important of which include giving care at the community level, educating the public on mental health, involving communities and families, monitoring community mental health indicators, and

  4. Prevalence of herbal medicine use and associated factors among pregnant women attending antenatal care at public health facilities in Hossana Town, Southern Ethiopia: facility based cross sectional study.

    Science.gov (United States)

    Laelago, Tariku; Yohannes, Tadele; Lemango, Fiseha

    2016-01-01

    The use of herbal medicine has been on increase in many developing and industrialized countries. More pregnant women use herbal remedies to treat pregnancy related problems due to cost-effectiveness of therapy and easy access of these products. We sought to assess the prevalence of herbal medicine use and associated factors among pregnant women attending antenatal clinics of public health facilities. Facility based cross sectional study was conducted among 363 pregnant women attending antenatal clinics from May to June 2015 at public health facilities in Hossana town, Hadiya zone, Southern Ethiopia. Pretested structured questionnaire was used to collect data from each study subject. Bivariate logistic regression analysis was used to see significance of association between the outcome and independent variables. Odds ratios at 95 % CI were computed to measure the strength of the association between the outcome and the independent variables. P-value herbal medicine during current pregnancy . The herbal medicines commonly taken during current pregnancy were ginger (55.8 %), garlic (69.8 %), eucalyptus (11.6 %), tenaadam (rutachalenssis) (26.4 %), damakesse (ocimumlamiifolium) (22.8 %), feto (3.5 %) and omore (3.1 %). Being students (AOR: (5.68, 95 % CI: (1.53, 21.13), second trimester of pregnancy (AOR: 0.22, 95 % CI: (0.08, 0.76), sufficient knowledge on herbal medicine (AOR: 0.37, 95 % CI: (0.19, 0.79), no formal education (AOR: 4.41, 95 % CI: (1.11, 17.56), primary education (AOR: 4.15, 95 % CI: (1.51, 11.45) and secondary education (AOR: 2.55, 95 % CI: (1.08,6.03) were significantly associated with herbal medicine use. The findings of this study showed that herbal medicine use during pregnancy is a common experience. Commonly used herbal medicines during current pregnancy were garlic, ginger, tenaadam, damakasse and eucalyptus. Educational status, occupation, knowledge on herbal medicine and second trimester of pregnancy were the major factors

  5. Sexually transmitted infections and adverse pregnancy outcomes among women attending inner city public sexually transmitted diseases clinics.

    Science.gov (United States)

    Johnson, Hope L; Ghanem, Khalil G; Zenilman, Jonathan M; Erbelding, Emily J

    2011-03-01

    Studies in antenatal care clinics suggest that lower genital tract infections (LGTI) may be associated with adverse pregnancy outcomes (APO). We sought to characterize antenatal care patterns and determine whether LGTI are independently associated with preterm birth and/or low-birth weight among a high-risk public sexually transmitted diseases (STD) clinic population. Electronic STD clinic medical records and state birth records were matched for 730 pregnant women age 13 to 49 tested for 5 treatable LGTI (bacterial vaginosis, chlamydia, gonorrhea, early syphilis, and trichomoniasis) in a case-control analysis. Cases were women with preterm and/or low-birth weight newborns; controls were women without APO. The association between LGTI and APO was assessed using logistic regression. Although pregnant women attending STD clinics reported high risk behaviors and were found to have high rates of LGTI (55%), most of these women were engaged in antenatal care (85%). Of the pregnant women, 22% experienced an APO (7% preterm birth, 4% low birth weight, and 12% preterm birth and low birth weight). In multivariate analyses, chlamydia was associated with low-birth weight (adjusted odds ratio [aOR]: 2.07, 95% confidence interval [CI]: 1.01-4.24), and gonorrhea was associated with preterm birth (aOR: 2.01, 95% CI: 1.02-3.97), particularly when diagnosed during the first trimester (aOR: 2.95, 95% CI: 1.30-6.70). Our findings confirm the association of some LGTI with APO and suggest that timing of LGTI screening may affect outcomes. STD clinic visits represent a critical opportunity to target interventions aimed at improving pregnancy outcomes.

  6. Profile and prevalence of HBV among HIV affected individuals attending the largest public HIV care center in India.

    Science.gov (United States)

    Koli, Suneeta; Girish Kumar, C P; Selvaraj, V; Prabu, R; Chandrasekar, C; Valan, A S; Suria Kumar, J; Raja, K

    2016-09-01

    A large number of people living with HIV/AIDS residing in HBV endemic regions such as in India are highly susceptible to acquire co-infections like HBV but also transmit them to other due to their high risk behaviours. The present study aimed to estimate HBV prevalence and distribution of various HBV serological markers among HIV infected individuals. This cross sectional survey covered HIV infected individuals attending the largest HIV care center in India. Socio-demographic details and blood samples to screen for HBV seromarkers using commercial ELISA kits were collected. Among 1160 HIV infected patients, prevalence of HBcAb, HBsAb, HBsAg and HBeAg was 66, 29.4, 16.6 and 5.8 % respectively. Overall, 28.9 % individuals had no evidence of any of the four markers, indicating lack of previous exposure and future risk of acquiring HBV infection. Presence of anti-HBsAg in a mere 0.9 % of individuals reflected low levels HBV vaccine conferred immunity which could be due to poor HBV vaccine coverage in this high risk population. With high prevalence and evidence of exposure to HBV as well as considering the growing literature on increase in hepatic complications in HIV-HBV co-infected individuals, the need for mandatory HBV screening of all HIV infected individuals cannot be over-emphasised. The policy makers and HIV programme managers must consider HBV vaccination for newly detected HBV naive HIV infected individuals and also focus on creating public awareness on HBV and HIV prevention.

  7. Factors associated with the length of delay with tuberculosis diagnosis and treatment among adult tuberculosis patients attending at public health facilities in Gondar town, Northwest, Ethiopia.

    Science.gov (United States)

    Bogale, Selamsew; Diro, Ermias; Shiferaw, Atsede Mazengia; Yenit, Melaku Kindie

    2017-02-14

    Early diagnosis and prompt treatment is essential for an effective tuberculosis (TB) control program. However, significant proportion of cases remains undiagnosed and untreated. Delay in diagnosis and treatment increases transmission. Hence, the study assessed the length of delay and associated factors with tuberculosis diagnosis and treatment among adults attending public health facilities in Gondar town, Northwest Ethiopia. An institution based cross-sectional study was conducted from February to May, 2016. A total of 296 adults who came to health facilities for treatment for pulmonary TB from February to May, 2016, were included in the study. Data were collected using a structured questionnaire through interviewing and record review, cleaned, coded, and entered into Epi-info version 3.5.3, and transferred into SPSS version 20.0 for further statistical analysis. A p-value of less than 0.05 at multiple linear regression analysis was considered statistically significant. The mean duration of the total delay (in days) for tuberculosis diagnosis and initiation of treatment was 41.6 days (SD = 16.6). In this study, the mean duration of patient delay and the median health system delay were 33.9 days (SD = 14) and 5 days (IQR = 4-7), respectively. Total delay for TB diagnosis and treatment was shorter among HIV positive people (β:-12.62, 95% CI: -20.72,-4.53). Longer patient delay was noted among rural dwellers (β: 8.0, 95% CI: 5.26, 10.75); increased household income (β:-0.006, 95% CI: -0.008,-0.004) was associated with a shorter delay. Health system delay was positively associated with seeking care from more than one health care providers (β: 0.28, 95% CI: 0.23, 0.34) and seeking initial care from primary level health care facilities (β: 0.10, 95% CI: 0.07, 0.13). In this study, the majority of patients faced delayed in seeking health care and continued as sources of infection. Longer days of delay for TB diagnosis and treatment were noted among

  8. Determination of tobacco smoke exposure by plasma cotinine levels in infants and children attending urban public hospital clinics.

    Science.gov (United States)

    Dempsey, Delia A; Meyers, Matthew J; Oh, Sam S; Nguyen, Elizabeth A; Fuentes-Afflick, Elena; Wu, Alan H B; Jacob, Peyton; Benowitz, Neal L

    2012-09-01

    OBJECTIVE To determine the prevalence of secondhand smoke (SHS) exposure among infants and young children who received preventive care at pediatric preventative care clinics associated with an urban public hospital. Cotinine, a metabolite of nicotine, has been used to study SHS exposure in population-based studies of children 3 years of age or older. DESIGN Retrospective study using a convenience sample. SETTING Urban county pediatric primary care clinics in San Francisco, California. PARTICIPANTS A total of 496 infants and children (mean [SD] age, 2.4 [1.9] years). INTERVENTIONS Discarded plasma samples (which were routinely collected for lead screening) were tested, and medical records were reviewed, for SHS exposure. MAIN OUTCOME MEASURE Secondhand smoke exposure based on cotinine plasma level and history of exposure in the medical record. RESULTS Thirteen percent of parents reported that their child was exposed to SHS, yet biochemical testing detected cotinine in 55% of samples, at a geometric mean (SD) of 0.23 (3.55) ng/mL. There were no significant sex or age differences. African American children had much higher mean cotinine levels than did Latino children (multiplicative factor change in cotinine, 6.01 ng/ml [95% Cl, 4.49-8.05 ng/ml] [correction]. CONCLUSION In a city with a low smoking rate (12%) and public smoking bans, we documented 55% exposure among infants and young children, using a plasma biomarker, compared with 13% exposure reported by parents. Because SHS is associated with significant respiratory diseases and parents underreport exposure, routine biochemical screening should be considered as a tool to identify and reduce SHS exposure.

  9. Characteristics influencing attendance at a primary care health check for people with intellectual disability: An individual participant data meta-analysis.

    Science.gov (United States)

    Ware, Robert S; Lennox, Nicholas G

    2016-08-01

    Health checks benefit adolescents and adults with intellectual disability, however uptake is low despite government-funded incentives. To assess the characteristics of people with intellectual disability who, when offered a health check with their primary care physician at no cost, completed the health check. Data from three randomised controlled trials considering health checks in people with intellectual disability living in the community were included in an individual-patient data meta-analysis. The studies used the same health check and the participant characteristics investigated (age, sex, cause of disability, level of disability and socio-economic position) were defined identically, but participants were sourced from different settings: adults living in 24-h supported accommodation, adults living in private dwellings, and school-attending adolescents. In total 715 participants were offered health checks. Compared to participants with Down syndrome, participants with other known causes of disability were more likely not to attend their health check (odds ratio;95%CI)=(2.5;1.4-4.7), as were participants with no known cause of disability (2.3;1.2-4.3). These associations remained significant after adjusting for potentially confounding variables. Down syndrome was the only characteristic positively associated with health check attendance across all study settings. Future research should focus on strategies to increase health check uptake in this population. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Prevalence of disorders recorded in Cavalier King Charles Spaniels attending primary-care veterinary practices in England

    OpenAIRE

    Summers, J F; O'Neill, D G; Church, D B; Thomson, P.C.; McGreevy, P D; Brodbelt, D. C.

    2015-01-01

    Background Concerns have been raised over breed-related health issues in purebred dogs, but reliable prevalence estimates for disorders within specific breeds are sparse. Electronically stored patient health records from primary-care practice are emerging as a useful source of epidemiological data in companion animals. This study used large volumes of health data from UK primary-care practices participating in the VetCompass animal health surveillance project to evaluate in detail the disorde...

  11. 76 FR 54766 - Notice of FERC Staff Attendance at a Hearing Before the Arkansas Public Service Commission

    Science.gov (United States)

    2011-09-02

    ... efforts. The Arkansas Public Service Commission will hold an evidentiary hearing involving Entergy...-66 Louisiana Public Service Commission v. Entergy Services, Inc. Docket No. EL01-88 Louisiana Public Service Commission v. Entergy Services, Inc. Docket No. EL07-52 Louisiana Public Service Commission v...

  12. Socioeconomic inequalities in caries experience, care level and dental attendance in primary school children in Belgium: a cross-sectional survey.

    Science.gov (United States)

    Lambert, Martijn J; Vanobbergen, Jacques S N; Martens, Luc C; De Visschere, Luc M J

    2017-07-20

    Oral health inequality in children is a widespread and well-documented problem in oral healthcare. However, objective and reliable methods to determine these inequalities in all oral health aspects, including both dental attendance and oral health, are rather scarce. To explore oral health inequalities and to assess the impact of socioeconomic factors on oral health, oral health behaviour and dental compliance of primary school children. Data collection was executed in 2014 within a sample of 2216 children in 105 primary schools in Flanders, by means of an oral examination and a validated questionnaire. Intermutual Agency database was consulted to objectively determine individuals' social state and frequency of utilisation of oral healthcare services. Underprivileged children were compared with more fortunate children for their mean DMFt, DMFs, plaque index, care index (C, restorative index (RI), treatment index (TI), knowledge and attitude. Differences in proportions for dichotomous variables (RI100%, TI100% and being a regular dental attender) were analysed. The present study was approved by the Ethics Committee of the University Hospital Ghent (2010/061). All parents signed an informed consent form prior to data collection. All schools received information about the study protocol and agreed to participate. Children requiring dental treatment or periodic recall were referred to the local dentist. Underprivileged children had higher D1MFT (95% CI 0.87 to 1.36), D3MT (95% CI 0.30 to 0.64), plaque scores (95% CI 0.12 to 0.23) and lower care level (pchildren. Half of the low-income children could be considered as regular dental attenders, while 12.6% did not have any dental visit during a 5-year period. Oral health, oral hygiene, oral healthcare level and dental attendance patterns are negatively affected by children's social class, leading to oral health inequalities in Belgian primary school children. © Article author(s) (or their employer(s) unless otherwise

  13. Attendance and weight outcomes in 4754 adults referred over 6 months to a primary care/commercial weight management partnership scheme.

    Science.gov (United States)

    Stubbs, R J; Brogelli, D J; Pallister, C J; Whybrow, S; Avery, A J; Lavin, J H

    2012-02-01

    •  There is growing evidence of the effectiveness of commercial weight management programmes in the community. A recent randomized controlled trial has shown commercial providers to be more effective than NHS providers for weight management solutions in primary care. Some commercial weight management providers have established national slimming on referral schemes for weight management, which result on average in weight losses of 4-5% over a 12-week referral period. A recent randomized controlled trial of a similar scheme over 12 months yielded similar weight loses. Another RCT comparing commercial providers over 6 months showed average weight losses of ∼6.6% across providers. •  The present study shows that when local primary care practitioners target resources to where they, as health professionals, felt they would have the most beneficial effect in their local communities, greater weight losses can be achieved. •  Different NHS Trusts extended 12-week referrals by an additional 12 weeks in a total of 4754 patients. •  Mean weight losses of 8.6% were achieved suggesting that local targeting of primary care resources can maximize returns for NHS investments in commissioning the services of commercial weight management organizations. This project audited attendance and weight loss in a primary care/commercial weight management partnership scheme in patients who participated over 6 months. 4754 adult patients (575 men, 4179 women) were referred to Slimming World for 24 weekly sessions. Data were analysed using individual weekly weight records. Mean (standard deviation, SD) body mass index (BMI) change was -3.3 kg m(-2) (2.2), weight change -8.9 kg (6.0), percent weight change -8.6% (5.3) and number of sessions attended 21.3 (3.2) of 24. For patients attending at least 20 of 24 sessions (n = 3626 or 76.3%), mean (SD) BMI change was -3.6 kg m(-2) (2.2), weight change -9.6 kg (6.1), percent weight change -9.3% (5.3). Weight

  14. Screening for Bipolar Disorder Symptoms in Depressed Primary Care Attenders: Comparison between Mood Disorder Questionnaire and Hypomania Checklist (HCL-32

    Directory of Open Access Journals (Sweden)

    Anna Sasdelli

    2013-01-01

    Full Text Available Objective. To describe the prevalence of patients who screen positive for bipolar disorder (BD symptoms in primary care comparing two screening instruments: Mood Disorders Questionnaire (MDQ and Hypomania Checklist (HCL-32. Participants. Adult patients presenting to their primary care practitioners for any cause and reporting current depression symptoms or a depressive episode in the last 6 months. Methods. Subjects completed MDQ and HCL-32, and clinical diagnosis was assessed by a psychiatrist following DSM-IV criteria. Depressive symptoms were evaluated in a subgroup with the Patient Health Questionnaire (PHQ-9. Results. A total of 94 patients were approached to participate and 93 completed the survey. Among these, 8.9% screened positive with MDQ and 43.0% with HCL-32. MDQ positive had more likely features associated with BD: panic disorder and smoking habit (. The best test accuracy was performed by cut-off 5 for MDQ (sensitivity = .91; specificity = .67 and 15 for HCL-32 (sensitivity = .64; specificity = .57. Higher total score of PHQ-9 was related to higher total scores at the screening tests (. Conclusion. There is a significant prevalence of bipolar symptoms in primary care depressed patients. MDQ seems to have better accuracy and feasibility than HCL-32, features that fit well in the busy setting of primary care.

  15. Cardiac autonomic neuropathy: The hidden cardiovascular comorbidity in elderly patients with chronic obstructive pulmonary disease attending primary care settings.

    Science.gov (United States)

    Rasheedy, Doha; Taha, Hend M

    2016-03-01

    To quantify the prevalence of chronic comorbidities including cardiac autonomic neuropathy among elderly patients with chronic obstructive pulmonary disease (COPD). A cross-sectional study was carried out on 175 elderly male patients with COPD attending Ain Shams University Hospital, Cairo, Egypt. The comorbidities that might alter cardiac autonomic function in patients with COPD were identified. The patients without reported comorbidities underwent arterial blood gas analysis, pulmonary function tests and autonomic function assessment using cardiovascular reflexes. A total of 69.14% of the participants presented with comorbidities (group 1), whereas 30.85% of the participants reported no comorbidity (group 2). Among the participants, the most prevalent comorbid diseases were hypertension (34.20%), cor pulmonale (31.42%), ischemic heart disease (20.00%), diabetes (18.28%) and congestive heart failure (13.70%). In group 2, 29.60% and 22.20% of the patients had early and definite cardiac autonomic neuropathy (CAN) respectively. CAN occurred early in the course of the disease with 40.90% of mild COPD cases being affected. The patients with definite CAN had the highest resting heart rate. The presence of CAN was related to hypercapnia, but not hypoxemia or COPD severity. COPD has a complex spectrum of comorbidities. Cardiac autonomic neuropathy in elderly male patients with COPD correlated with hypercapnia, but not hypoxemia or the disease severity. © 2015 Japan Geriatrics Society.

  16. Public health governance and primary care delivery : a triangulated study.

    OpenAIRE

    Marks, L; Cave, S.; Hunter, D.J.; Mason, J M; S. Peckham; Wallace, A.; Mason, A; Weatherly, H; Melvin, K.

    2011-01-01

    The government is committed to improving health and well-being and tackling health inequalities. PCTs and other commissioners are charged with maximising health improvement for their local populations, working in partnership. However, the effectiveness of a local public health system in addressing these tasks is influenced by how far PCTs and other commissioners prioritise public health in the context of a complex web of incentives and governance arrangements, some of which may conflict. In c...

  17. Predictors of Medication Adherence and Blood Pressure Control among Saudi Hypertensive Patients Attending Primary Care Clinics: A Cross-Sectional Study.

    Directory of Open Access Journals (Sweden)

    Sarah M Khayyat

    Full Text Available To assess the level of medication adherence and to investigate predictors of medication adherence and blood pressure control among hypertensive patients attending primary healthcare clinics in Makkah, Saudi Arabia.Hypertensive patients meeting the eligibility criteria were recruited from eight primary care clinics between January and May 2016 for this study. The patients completed Arabic version of Morisky Medication Adherence Scale (MMAS-8, an eight-item validated, self-reported measure to assess medication adherence. A structured data collection form was used to record patients' sociodemographic, medical and medication data.Two hundred and four patients, of which 71.6% were females, participated in the study. Patients' mean age was 59.1 (SD 12.2. The mean number of medication used by patients was 4.4 (SD 1.89. More than half (110; 54% of the patients were non-adherent to their medications (MMAS score 65 years (OR 2.0 [95% CI: 1.0-4.2; P = 0.04], and being diabetic (OR 0.25 [95% CI: 0.1-0.6; P = 0.04] were found to be independent predictors of medication adherence.Medication adherence is alarmingly low among hypertensive patients attending primary care clinics in Saudi Arabia which may partly explain observed poor blood pressure control. There is a clear need to educate patients about the importance of medication adherence and its impact on improving clinical outcomes. Future research should identify barriers to medication adherence among Saudi hypertensive patients.

  18. Quality of social and emotional wellbeing services for families of young Indigenous children attending primary care centers; a cross sectional analysis.

    Science.gov (United States)

    Edmond, Karen M; McAuley, Kimberley; McAullay, Daniel; Matthews, Veronica; Strobel, Natalie; Marriott, Rhonda; Bailie, Ross

    2018-02-09

    The quality of social and emotional wellbeing services for Indigenous families of young children is not known, in many settings especially services provided by primary care centers. Our primary objective was to assess delivery of social and emotional wellbeing services to the families of young (3-11 months) and older (12-59 months) Indigenous children attending primary care centers. Our secondary objective was to assess if delivery differed by geographic location. Two thousand four hundred sixty-six client files from 109 primary care centers across Australia from 2012 to 2014 were analysed using logistic regression and generalised estimating equations. The proportion of families receiving social and emotional wellbeing services ranged from 10.6% (102) (food security) to 74.7% (1216) (assessment of parent child interaction). Seventy one percent (71%, 126) of families received follow up care. Families of children aged 3-11 months (39.5%, 225) were more likely to receive social and emotional wellbeing services (advice about domestic environment, social support, housing condition, child stimulation) than families of children aged 12-59 months (30.0%, 487) (adjusted odds ratio [aOR] 1.68 95% CI 1.33 to 2.13). Remote area families (32.6%, 622) received similar services to rural (29.4%, 68) and urban families (44.0%, 22) (aOR 0.64 95% CI 0.29, 1.44). The families of young Indigenous children appear to receive priority for social and emotional wellbeing care in Australian primary care centers, however many Indigenous families are not receiving services. Improvement in resourcing and support of social and emotional wellbeing services in primary care centers is needed.

  19. Developing primary health care and public health competencies in ...

    African Journals Online (AJOL)

    Stephen E Knight

    community-based programme within the undergraduate medical curriculum, which aims to develop primary health care (PHC) ... Methods: A cohort of 183 students concluded Selectives in 2015, and thereafter 70 (38%) completed a routine online evaluation ... educational imperatives, namely improving medical students'.

  20. Years Universal Basic Education Programme in Public Primary

    African Journals Online (AJOL)

    FIRST LADY

    2004-05-26

    into law by the then president Chief Olusegun Obasanjo on May 26, 2004. The UBE Act, 2004 provides for compulsory, free universal basic education for all children of primary and junior secondary school age in the Federal republic of Nigeria. Due to the imperative nature of the UBE Act, the junior secondary school has.

  1. Osteopathic Medicine and Primary Care completes first year of publication

    Science.gov (United States)

    Licciardone, John C; Cardarelli, Roberto

    2008-01-01

    Osteopathic Medicine and Primary Care affords authors the opportunity for rapid and universal dissemination of their work. We are keen to receive author manuscripts and reader comments on articles during 2008. A journal fund has been established to offset the cost of article processing charges for eligible authors who submit qualified manuscripts. PMID:18218102

  2. Teachers' reflections on distributive leadership in public primary ...

    African Journals Online (AJOL)

    The findings revealed that leadership in Soweto primary schools is rooted in classical leadership practices and that any potential for the practice of distributive leadership is hindered by autocratic styles of leadership, hierarchical structures, and non-participative decision-making. Keywords: Activity Theory, collective ...

  3. Knowledge, adherence and control among patients with hypertension attending a peri-urban primary health care clinic, KwaZulu-Natal.

    Science.gov (United States)

    Olowe, Olumuyiwa A; Ross, Andrew J

    2017-10-19

    Despite hypertension being a common condition among patients attending primary health care (PHC) clinics, blood pressure (BP) control is often poor. Greater insight into patient-related factors that influence the control of hypertension will assist in the development of an intervention to address the issues identified. The aim of the study was to assess patient-related variables associated with hypertension control among patients attending a peri-urban PHC clinic. The setting for this study was a peri-urban PHC clinic in KwaZulu-Natal. This was an observational, descriptive and cross-sectional study with 348 patients selected over a 1-month period. A validated questionnaire was used to collect data on patients' hypertension knowledge and self-reported adherence, and BP recordings from their medical record were recorded to ascertain control. Of the 348 participants, only 49% had good BP control and 44% (152/348) had concurrent diabetes mellitus. The majority of patients had moderate levels of knowledge on hypertension and exhibited moderate adherence. There was a significant relationship between knowledge and reported adherence, between reported adherence and control, but not between reported knowledge and control. Despite over 90% of the study population having moderate knowledge, and 62% with moderate reported adherence, BP was well controlled in only less than 50% of the study population. These findings suggest a need to emphasise adherence and explore new ways of approaching adherence.

  4. Prevalence of intimate partner violence and its associated risk factors among Saudi female patients attending the primary healthcare centers in Western Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Turki A. Alzahrani

    2016-01-01

    Full Text Available Objectives: To estimate the prevalence of intimate partner violence (IPV among female patients, age 18-60 years, attending primary health care centers (PHCCs and to measure its determinants, and reporting behavior. Methods: A cross-sectional study design using validated, translated, and self-administered questionnaire among 497 Saudi female patients attending PHCCs in Taif, Kingdom of Saudi Arabia (KSA from January to February 2015 was employed. A 2-stage probability sampling was adopted for selection of PHCCs in the first stage, and then participants in the second stage. Results: The estimated prevalence of IPV during the last year was 11.9%. Predictors of IPV related to abused women included divorced status and divorced parents; while those related to abusers (husbands included widowed parents, exposure to violence in childhood, and alcohol or drugs addiction. Most of the abused wives (56% talked regarding their IPV to their families, their husbands’ families (15.2%, or their friends (11.8%; while only a minority (3.3% complained to the police or to a judge, and no one reported this to a family physician, or to women protection agency. Conclusion: One out of 10 women is a victim of IPV in Taif, KSA. Intimate partner violence is significantly associated with a number of victim and abuser-related psychosocial factors, the detection of which might help screening for individuals at risk.

  5. Prevalence of disorders recorded in Cavalier King Charles Spaniels attending primary-care veterinary practices in England.

    Science.gov (United States)

    Summers, Jennifer F; O'Neill, Dan G; Church, David B; Thomson, Peter C; McGreevy, Paul D; Brodbelt, David C

    2015-01-01

    Concerns have been raised over breed-related health issues in purebred dogs, but reliable prevalence estimates for disorders within specific breeds are sparse. Electronically stored patient health records from primary-care practice are emerging as a useful source of epidemiological data in companion animals. This study used large volumes of health data from UK primary-care practices participating in the VetCompass animal health surveillance project to evaluate in detail the disorders diagnosed in a random selection of over 50% of dogs recorded as Cavalier King Charles Spaniels (CKCSs). Confirmation of breed using available microchip and Kennel Club (KC) registration data was attempted. In total, 3624 dogs were recorded as CKCSs within the VetCompass database of which 143 (3.9%) were confirmed as KC-registered via microchip identification linkage of VetCompass to the KC database. 1875 dogs (75 KC registered and 1800 of unknown KC status, 52% of both groups) were randomly sampled for detailed clinical review. Clinical data associated with veterinary care were recorded in 1749 (93.3%) of these dogs. The most common specific disorders recorded during the study period were heart murmur (541 dogs, representing 30.9% of study group), diarrhoea of unspecified cause (193 dogs, 11.0%), dental disease (166 dogs, 9.5%), otitis externa (161, 9.2%), conjunctivitis (131, 7.4%) and anal sac infection (129, 7.4%). The five most common disorder categories were cardiac (affecting 31.7% of dogs), dermatological (22.2%), ocular (20.6%), gastrointestinal (19.3%) and dental/periodontal disorders (15.2%). Study findings suggest that many of the disorders commonly affecting CKCSs are largely similar to those affecting the general dog population presented for primary veterinary care in the UK. However, cardiac disease (and MVD in particular) continues to be of particular concern in this breed. This work highlights the value of veterinary practice based breed-specific epidemiological studies

  6. Dogs attending primary-care practice in England with clinical signs suggestive of Chiari-like malformation/syringomyelia.

    Science.gov (United States)

    Sanchis-Mora, S; Pelligand, L; Thomas, C L; Volk, H A; Abeyesinghe, S M; Brodbelt, D C; Church, D B; Thomson, P C; McGreevy, P D; O'Neill, D G

    2016-10-29

    Chiari-like malformation/syringomyelia (CM/SM) in dogs describes a developmental disorder that can cause pain and reduced quality of life. This retrospective study aimed to report the period prevalence, clinical signs and risk factors for diagnosis of symptomatic CM/SM in the veterinary primary-care setting using a cross-sectional design. The study population included all dogs within the VetCompass Programme (September 1, 2009-June 13, 2014). Overall, the period prevalence of symptomatic CM/SM was 0.05 per cent (95 per cent CI 0.04 per cent to 0.06 per cent) for all breeds. The period prevalence in the Cavalier King Charles Spaniel (CKCS) was 1.6 per cent (95 per cent CI 1.2 to 2.06). Other breeds at increased odds included the King Charles Spaniel (KCS), Affenpinscher, Chihuahua and Pomeranian. Insured dogs had 4.6 times the odds (95 per cent CI 2.95 to 7.17) of having a diagnosis of CM/SM compared with uninsured dogs. Pain was the most commonly associated clinical sign (67 dogs, 72 per cent). Analgesics were prescribed to 72 (77.4 per cent) of the symptomatic dogs. Despite its low overall period prevalence, the high proportion of affected dogs identified with chronic pain suggests a significant welfare issue. Financial implications could impede the diagnostic process and lead to underestimation of the true prevalence. This study may help to inform clinicians about the clinical relevance and the need for improved awareness of clinical signs, particularly in high-risk breeds, to optimise the management of CM/SM in primary-care practice. British Veterinary Association.

  7. [Nasopharyngeal Hib Carriage Among Healthy Children Attending Daycare Centers in Yokohama After One Year of a Publicly Funded Vaccine Program].

    Science.gov (United States)

    Saito, Ayako; Sumita, Hiroko; Minohara, Yutaka; Fujita, Shinji; Yazaki, Shigeyoshi; Kitamura, Miyoshi; Kawai, Shigehiko; Kamata, Kazumi; Oota, Yoshimi; Yamada, Mikiko; Matsumoto, Yuko; Takeyasu, Nobuaki

    2015-01-01

    Yokohama city started a regular, free vaccine program for Haemophilus influenzae type b (Hib) from February of 2011. This study was completed to verify the effectiveness of the vaccine on the nasopharyngeal Hib carriage among healthy children attending daycare centers in the Isogo area. The research was conducted during the late spring (Jun--Jul) and fall (Oct-Nov) of 2012. There was a significant decrease in the Hib carriage rate (spring 8.8%, fall 1.6%). During this period there was no increase in the Hib vaccine coverage. The Hib carriage rate of each daycare center was 0-18.4% in spring and 0-4.9% in fall. There was no significant relationship between the rate of non immunized children and that of Hib carriage. This improvement in nasopharyngeal Hib carriage shows the impact of community immunity.

  8. Exacerbations and health care resource utilization in patients with airflow limitation diseases attending a primary care setting: the PUMA study

    Directory of Open Access Journals (Sweden)

    Montes de Oca M

    2016-12-01

    Full Text Available Maria Montes de Oca,1 Carlos Aguirre,2 Maria Victorina Lopez Varela,3 Maria E Laucho-Contreras,1 Alejandro Casas,2 Filip Surmont4 1Service of Pneumology, Hospital Universitario de Caracas, Facultad de Medicina, Universidad Central de Venezuela, Caracas, Venezuela; 2Colombian Pneumological Foundation, Bogotá, Colombia; 3Universidad de la República, Facultad de Medicina, Hospital Maciel, Montevideo, Uruguay; 4Medical Affairs, AstraZeneca Latin America, Coral Gables, FL, USA Background: COPD, asthma, and asthma–COPD overlap increase health care resource consumption, predominantly because of hospitalization for exacerbations and also increased visits to general practitioners (GPs or specialists. Little information is available regarding this in the primary care setting. Objectives: To describe the prevalence and number of GP and specialist visits for any cause or due to exacerbations in patients with COPD, asthma, and asthma–COPD overlap. Methods: COPD was defined as post-bronchodilator forced expiratory volume in 1 second/forced vital capacity (FEV1/FVC ratio <0.70; asthma was defined as prior medical diagnosis, wheezing in the last 12 months, or wheezing plus reversibility (post-bronchodilator FEV1 or FVC increase ≥200 mL and ≥12%; asthma–COPD overlap was defined as post-bronchodilator FEV1/FVC <0.70 plus prior asthma diagnosis. Health care utilization was evaluated as GP and/or specialist visits in the previous year. Results: Among the 1,743 individuals who completed the questionnaire, 1,540 performed acceptable spirometry. COPD patients had a higher prevalence of any medical visits to any physician versus those without COPD (37.2% vs 21.8%, respectively and exacerbations doubled the number of visits. The prevalence of any medical visits to any physician was also higher in asthma patients versus those without asthma (wheezing: 47.2% vs 22.7%; medical diagnosis: 54.6% vs 21.6%; wheezing plus reversibility: 46.2% vs 23.8%, respectively

  9. Prevalence, correlates, attitude and treatment seeking of erectile dysfunction among type 2 diabetic Chinese men attending primary care outpatient clinics

    Directory of Open Access Journals (Sweden)

    Wai Hon Lo

    2014-10-01

    Full Text Available To investigate the prevalence, correlates, attitude and treatment seeking behavior of erectile dysfunction (ED in type 2 diabetes mellitus (T2DM patients in the primary care setting, a multi-center cross-sectional survey using a structured anonymous self-administered questionnaire was performed in 10 general outpatient clinics. Of the 603 subjects (91% response rate, the prevalence of ED men, as defined by the International Index of Erectile Function, was 79.1%. Most subjects had mild ED (28.9%, followed by mild-to-moderate ED (27.9%, then moderate ED (13.4% and severe ED (9%. Nearly 55% of those with ED did not consider themselves as having ED. Less than 10% of them had ever sought medical treatment, although 76.1% of them wished to receive management from doctor(s should they be diagnosed with ED. They considered the most important management from doctors to be clinical assessment (41.7%, followed by management of potential underlying cause (37.8%, referral to specialist (27.5%, education (23.9%, prescription of phosphodiesterase type 5 inhibitors (16.9% and referral to counseling service (6.7%. The prevalence of ED was strongly associated with subjects who thought they had ED (odds ratio (OR = 90.49 (20.00-409.48, P< 0.001 and were from the older age group (OR = 1.043 (1.011-1.076, P= 0.008. In conclusion, ED is highly prevalent among T2DM men. The majority of them wanted management from doctors should they have ED, but only a minority would actually voice out the request. Screening of ED among T2DM men using structural questionnaire allowed the diagnosis of more than half of the ED cases, which otherwise would have gone undiagnosed.

  10. Prevalence and Determinants of Pre-Hypertension among Omani Adults Attending Non-Communicable Disease Screening Program in Primary Care Setting in Sohar City

    Directory of Open Access Journals (Sweden)

    Ali Abdullah Al-Maqbali

    2013-09-01

    Full Text Available Objectives: To estimate the prevalence of pre-hypertension and its association with some selected cardiovascular risk factors among the Omani adult population in the primary healthcare setting.Method: A cross-sectional study involving a sample taken from a National Screening Program of chronic non-communicable diseases in primary healthcare institutions, Sohar city, Sultanate of Oman (July 2006 - December 2007. Inclusion criteria included Omanis aged 40 years or above residents of Sohar city attending primary healthcare institutions not previously diagnosed with diabetes mellitus, hypertension, or chronic kidney diseases. Descriptive statistics were used to describe the demographic, physical and metabolic characteristics. Univariate analysis was used to identify the significant association between the characteristics and normal blood pressure, pre-hypertension and hypertension. Chi-squared test was used for categorical variables analysis and independent t-test was used for continuous variables analysis. In order to examine the strength of significant associations, the multinomial logistic regression analysis was used.Results: There were 1498 participants, 41% were males and 59% were females. Overall, pre-hypertension was observed in 45% of the total study population (95% CI: 0.422 - 0.473. There were more males affected than females (46% versus 44%. About 34% of the total study population was hypertensive. The multinomial logistic regression analysis revealed that an increase of one unit of age, body mass index, fasting blood glucose and total blood cholesterol, were significantly associated with higher risk in both pre-hypertension and hypertension. High odds ratio of pre-hypertension and hypertension was found with the total blood cholesterol.Conclusion: The prevalence of pre-hypertension was high among the Omani adult population. The determinants of pre-hypertension in this research age, body mass index, fasting blood glucose and total blood

  11. Prevalence and Determinants of Pre-Hypertension among Omani Adults Attending Non-Communicable Disease Screening Program in Primary Care Setting in Sohar City.

    Science.gov (United States)

    Al-Maqbali, Ali Abdullah; Temple-Smith, Meredith; Ferler, John; Blackberry, Irene

    2013-09-01

    To estimate the prevalence of pre-hypertension and its association with some selected cardiovascular risk factors among the Omani adult population in the primary healthcare setting. A cross-sectional study involving a sample taken from a National Screening Program of chronic non-communicable diseases in primary healthcare institutions, Sohar city, Sultanate of Oman (July 2006 - December 2007). Inclusion criteria included Omanis aged 40 years or above residents of Sohar city attending primary healthcare institutions not previously diagnosed with diabetes mellitus, hypertension, or chronic kidney diseases. Descriptive statistics were used to describe the demographic, physical and metabolic characteristics. Univariate analysis was used to identify the significant association between the characteristics and normal blood pressure, pre-hypertension and hypertension. Chi-squared test was used for categorical variables analysis and independent t-test was used for continuous variables analysis. In order to examine the strength of significant associations, the multinomial logistic regression analysis was used. There were 1498 participants, 41% were males and 59% were females. Overall, pre-hypertension was observed in 45% of the total study population (95% CI: 0.422 - 0.473). There were more males affected than females (46% versus 44%). About 34% of the total study population was hypertensive. The multinomial logistic regression analysis revealed that an increase of one unit of age, body mass index, fasting blood glucose and total blood cholesterol, were significantly associated with higher risk in both pre-hypertension and hypertension. High odds ratio of pre-hypertension and hypertension was found with the total blood cholesterol. The prevalence of pre-hypertension was high among the Omani adult population. The determinants of pre-hypertension in this research age, body mass index, fasting blood glucose and total blood cholesterol. A cost-effectiveness study about the

  12. Chagas disease among the Latin American adult population attending in a primary care center in Barcelona, Spain.

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    Carme Roca

    2011-04-01

    Full Text Available The epidemiology of Chagas disease, until recently confined to areas of continental Latin America, has undergone considerable changes in recent decades due to migration to other parts of the world, including Spain. We studied the prevalence of Chagas disease in Latin American patients treated at a health center in Barcelona and evaluated its clinical phase. We make some recommendations for screening for the disease.We performed an observational, cross-sectional prevalence study by means of an immunochromatographic test screening of all continental Latin American patients over the age of 14 years visiting the health centre from October 2007 to October 2009. The diagnosis was confirmed by serological methods: conventional in-house ELISA (cELISA, a commercial kit (rELISA and ELISA using T cruzi lysate (Ortho-Clinical Diagnostics (oELISA. Of 766 patients studied, 22 were diagnosed with T. cruzi infection, showing a prevalence of 2.87% (95% CI, 1.6-4.12%. Of the infected patients, 45.45% men and 54.55% women, 21 were from Bolivia, showing a prevalence in the Bolivian subgroup (n=127 of 16.53% (95% CI, 9.6-23.39%. ALL THE INFECTED PATIENTS WERE IN A CHRONIC PHASE OF CHAGAS DISEASE: 81% with the indeterminate form, 9.5% with the cardiac form and 9.5% with the cardiodigestive form. All patients infected with T. cruzi had heard of Chagas disease in their country of origin, 82% knew someone affected, and 77% had a significant history of living in adobe houses in rural areas.We found a high prevalence of T. cruzi infection in immigrants from Bolivia. Detection of T. cruzi-infected persons by screening programs in non-endemic countries would control non-vectorial transmission and would benefit the persons affected, public health and national health systems.

  13. Correlates of physical activity and sitting time in adults with type 2 diabetes attending primary health care in Oman

    Directory of Open Access Journals (Sweden)

    Thamra S. Alghafri

    2017-08-01

    Full Text Available Abstract Background Despite evidence of the benefits of physical activity in the management of type 2 diabetes, it is poorly addressed in diabetes care. This study aimed to identify the prevalence and correlates of meeting ≥600MET-min/wk. (150 min/wk of physical activity and sitting time in adults with type 2 diabetes in Oman. Approaches to encourage physical activity in diabetes care were explored. Methods A cross-sectional study using the Global Physical Activity Questionnaire was conducted in 17 randomly selected primary health centres in Muscat. Clinical data including co-morbidities were extracted from the health information system. Questions on physical activity preferences and approaches were included. Patients were approached if they were ≥18 years, and had been registered in the diabetes clinic for >2 years. Results The questionnaire was completed by 305 people (females 57% and males 43%. Mean age (SD was 57 (10.8 years and mean BMI (SD was 31.0 (6.0 kg/m2. Duration of diabetes ranged from 2 to 25 (mean 7.6 years. Hypertension (71% and dyslipidaemia (62% were common comorbidities. Most (58.4% had an HbA1c ≥7% indicating poor glycaemic control (55% in males vs 61% in females. Physical activity recommendations were met by 21.6% of the participants, mainly through leisure activities. Odds of meeting the recommendations were significantly higher in males (OR 4.8, 95% CI 2.5–9.1, individuals ≤57 years (OR 3.0, 95% CI 1.6–5.9, those at active self-reported stages of change for physical activity (OR 2.2, 95% CI 1.2–4.1 and those reporting no barriers to performing physical activity (OR 2.7, 95% CI 1.4–4.9. Median (25th, 75th percentiles sitting time was 705 (600, 780 min/d. Older age (>57 years was associated with longer sitting time (>705 min/d (OR 2.8, 95% CI 1.7–4.6. Preferred methods to support physical activity in routine diabetes care were consultations (38%, structured physical activity sessions (13.4% and

  14. Feeding styles, parenting styles and snacking behaviour in children attending primary schools in multiethnic neighbourhoods: a cross-sectional study

    Science.gov (United States)

    Wang, Lu; van de Gaar, Vivian M; Jansen, Wilma; Mieloo, Cathelijne L; van Grieken, Amy; Raat, Hein

    2017-01-01

    Objective The aim of the present study was to investigate whether feeding styles and parenting styles are associated with children’s unhealthy snacking behaviour and whether the associations differ according to children’s ethnic background. Method Cross-sectional data from the population-based ‘Water Campaign’ study were used. Parents (n=644) of primary school children (6–13 years) completed a questionnaire covering sociodemographic characteristics, feeding style dimensions (‘control over eating’, ‘emotional feeding’, ‘encouragement to eat’ and ‘instrumental feeding’), parenting style dimensions (‘involvement’ and ‘strictness’) and children’s unhealthy snacking behaviour. Logistic regression analyses were performed to determine whether feeding styles and parenting styles were associated with children’s unhealthy snacking behaviour. Result Overall, children whose parents had a higher extent of ‘control over eating’ had a lower odds of eating unhealthy snacks more than once per day (OR, 0.57; 95% CI 0.42 to 0.76). Further stratified analysis showed that ‘control over eating’ was associated with less unhealthy snacking behaviour only in children with a Dutch (OR, 0.37; 95% CI 0.20 to 0.68) or a Moroccan/Turkish (OR, 0.44; 95% CI 0.25 to 0.77) ethnic background. ‘Encouragement to eat’ was associated with a lower odds of eating unhealthy snacks every day in children with a Dutch ethnic background only (OR, 0.48; 95% CI 0.25 to 0.90). ‘Instrumental feeding’ was associated with a higher odds of eating unhealthy snacks more than once a day in children with a Moroccan/Turkish ethnic background only (OR, 1.43; 95% CI 1.01 to 2.04). Conclusion Our results suggest that ‘control over eating’ may be associated with less unhealthy snack consumption in children. The associations of feeding styles and parenting styles with children’s unhealthy snacking behaviour differed between children with different ethnic

  15. Feeding styles, parenting styles and snacking behaviour in children attending primary schools in multiethnic neighbourhoods: a cross-sectional study.

    Science.gov (United States)

    Wang, Lu; van de Gaar, Vivian M; Jansen, Wilma; Mieloo, Cathelijne L; van Grieken, Amy; Raat, Hein

    2017-07-13

    The aim of the present study was to investigate whether feeding styles and parenting styles are associated with children's unhealthy snacking behaviour and whether the associations differ according to children's ethnic background. Cross-sectional data from the population-based 'Water Campaign' study were used. Parents (n=644) of primary school children (6-13 years) completed a questionnaire covering sociodemographic characteristics, feeding style dimensions ('control over eating', 'emotional feeding', 'encouragement to eat' and 'instrumental feeding'), parenting style dimensions ('involvement' and 'strictness') and children's unhealthy snacking behaviour. Logistic regression analyses were performed to determine whether feeding styles and parenting styles were associated with children's unhealthy snacking behaviour. Overall, children whose parents had a higher extent of 'control over eating' had a lower odds of eating unhealthy snacks more than once per day (OR, 0.57; 95% CI 0.42 to 0.76). Further stratified analysis showed that 'control over eating' was associated with less unhealthy snacking behaviour only in children with a Dutch (OR, 0.37; 95% CI 0.20 to 0.68) or a Moroccan/Turkish (OR, 0.44; 95% CI 0.25 to 0.77) ethnic background. 'Encouragement to eat' was associated with a lower odds of eating unhealthy snacks every day in children with a Dutch ethnic background only (OR, 0.48; 95% CI 0.25 to 0.90). 'Instrumental feeding' was associated with a higher odds of eating unhealthy snacks more than once a day in children with a Moroccan/Turkish ethnic background only (OR, 1.43; 95% CI 1.01 to 2.04). Our results suggest that 'control over eating' may be associated with less unhealthy snack consumption in children. The associations of feeding styles and parenting styles with children's unhealthy snacking behaviour differed between children with different ethnic backgrounds. © Article author(s) (or their employer(s) unless otherwise stated in the text of the

  16. Exacerbations and health care resource utilization in patients with airflow limitation diseases attending a primary care setting: the PUMA study

    Science.gov (United States)

    Montes de Oca, Maria; Aguirre, Carlos; Lopez Varela, Maria Victorina; Laucho-Contreras, Maria E; Casas, Alejandro; Surmont, Filip

    2016-01-01

    Background COPD, asthma, and asthma–COPD overlap increase health care resource consumption, predominantly because of hospitalization for exacerbations and also increased visits to general practitioners (GPs) or specialists. Little information is available regarding this in the primary care setting. Objectives To describe the prevalence and number of GP and specialist visits for any cause or due to exacerbations in patients with COPD, asthma, and asthma–COPD overlap. Methods COPD was defined as post-bronchodilator forced expiratory volume in 1 second/forced vital capacity (FEV1/FVC) ratio <0.70; asthma was defined as prior medical diagnosis, wheezing in the last 12 months, or wheezing plus reversibility (post-bronchodilator FEV1 or FVC increase ≥200 mL and ≥12%); asthma–COPD overlap was defined as post-bronchodilator FEV1/FVC <0.70 plus prior asthma diagnosis. Health care utilization was evaluated as GP and/or specialist visits in the previous year. Results Among the 1,743 individuals who completed the questionnaire, 1,540 performed acceptable spirometry. COPD patients had a higher prevalence of any medical visits to any physician versus those without COPD (37.2% vs 21.8%, respectively) and exacerbations doubled the number of visits. The prevalence of any medical visits to any physician was also higher in asthma patients versus those without asthma (wheezing: 47.2% vs 22.7%; medical diagnosis: 54.6% vs 21.6%; wheezing plus reversibility: 46.2% vs 23.8%, respectively). Asthma patients with exacerbations had twice the number of visits versus those without an exacerbation. The number of visits was higher (2.8 times) in asthma–COPD overlap, asthma (1.9 times), or COPD (1.4 times) patients versus those without these respiratory diseases; the number of visits due to exacerbation was also higher (4.9 times) in asthma–COPD overlap, asthma (3.5 times), and COPD (3.8 times) patients. Conclusion COPD, asthma, and asthma–COPD overlap increase the prevalence of

  17. Poor social support as a risk factor for antenatal depressive symptoms among women attending public antennal clinics in Penang, Malaysia.

    Science.gov (United States)

    Rashid, Abdul; Mohd, Rokiah

    2017-11-02

    Depression, a type of mental disorder which is portrayed by marked alterations in mood, is associated with distress and/or impaired functioning. Poor social support is an important risk factor for depression in pregnancy. An extensive literature search failed to show any published study conducted in Malaysia on antenatal depressive symptoms and the risk of poor social support on it. The aim of the study was to determine the risk of antenatal depressive symptoms due to poor social support. This cross sectional study was conducted among 3000 pregnant women attending antenatal clinics in Penang, Malaysia. Edinburgh Postnatal Depression Scale (EPDS) was used to screen for antenatal depressive symptoms and the Oslo-3 Social Support Scale (OSS-3) was used to measure social support. Odds ratio and adjusted odds ratio were used to quantify the risk of antenatal depressive symptoms due to poor social support. The prevalence of depressive symptoms was 20%. Using OSS-3 scale to gauge social support, most of the participants had moderate support (61.3%) followed by poor support (22%) and strong support (16.7%). Social support was found to be significantly associated with depressive symptoms in this study (OR 2.2, aOR 2.1, AR 45%). Considering that an expecting mother's psychological factors are important in the wellbeing of the mother and child, antenatal depression must be quickly identified. Screening pregnant women for social support can help identify women with higher risk of depression.

  18. Epidemiology of hyperadrenocorticism among 210,824 dogs attending primary-care veterinary practices in the UK from 2009 to 2014.

    Science.gov (United States)

    O'Neill, D G; Scudder, C; Faire, J M; Church, D B; McGreevy, P D; Thomson, P C; Brodbelt, D C

    2016-07-01

    To estimate prevalence and risk factors for diagnosis with hyperadrenocorticism in dogs attending primary-care veterinary practices in the UK from 2009 to 2014. Cases were identified by searching the de-identified electronic patient records from UK primary-care veterinary practices participating in the VetCompass Programme. The estimated prevalence for hyperadrenocorticism diagnosis in dogs was 0·28% (95% confidence interval: 0·25 to 0·31). Multivariable logistic regression analysis revealed four associated risk factors: breed, breed-relative bodyweight, age and insurance status. The bichon frise had 6·5 times the odds (95% CI: 3·5 to 12·1, PDogs weighing more than or equal to their breed mean had 1·7 times the odds (95% CI: 1·3 to 2·3, Pdogs weighing less than the breed mean. Dogs aged 12·0 years and above showed 5·7 times the odds (95% CI: 3·7 to 8·7, Pdogs aged 6·0 to 8·9 years. Insured dogs had 4·0 times the odds (95% CI: 2·8 to 5·6, Pdogs. This is the first epidemiological report of a non-referral hospital population of dogs diagnosed with hyperadrenocorticism in the UK and describes important breed, age and bodyweight associations with this disorder which may improve diagnosis and enhance understanding of the underlying pathophysiology. © 2016 British Small Animal Veterinary Association.

  19. Examining the Effects of Gender, Poverty, Attendance, and Ethnicity on Algebra, Geometry, and Trigonometry Performance in a Public High School

    Science.gov (United States)

    Shafiq, Hasan

    2013-01-01

    Over the last few decades school accountability for student performance has become an issue at the forefront of education. The federal No Child Left Behind Act of 2001 (NCLB) and various regulations by individual states have set standards for student performance at both the district and individual public and charter school levels, and certain…

  20. Information Communication Technology (ICT) Facilities Availability and Usage in Rivers State Public and Private Primary Schools

    OpenAIRE

    Asodike, Juliana; Jaja, Atuwokiki Sam

    2012-01-01

    This study examined the use of ICT facilities in Nigerian primary schools and its implications in enhancing the future of the Nigerian child. The study was conducted through survey drawn from 700 primary schools in Rivers State, Nigeria. It comprised 430 public and 270 private primary schools in the State. A 28-item self-constructed instrument with a reliability coefficient of .92 tagged ‘Primary School ICT Use Survey’ was used for data collection. The results showed that primary schools in R...

  1. Availability and type of human resource for health in public primary ...

    African Journals Online (AJOL)

    Background: Health human resource capacity is one of the major determinants of an effective health care delivery system. It is more importantly so in the Primary Health Care system, which is the key component of every health system. This study assessed the available and type of human resource for health in public primary ...

  2. Integration of Traditional Birth Attendants into Prevention of Mother-to-Child Transmission at Primary Health Facilities in Kaduna, North-West Nigeria.

    Science.gov (United States)

    Nsirim, Reward O; Iyongo, Joseph A; Adekugbe, Olayinka; Ugochuku, Maureen

    2015-03-31

    One of the fundamental challenges to implementing successful prevention of mother-to-child transmission (PMTCT) programs in Nigeria is the uptake of PMTCT services at health facilities. Several issues usually discourage many pregnant women from receiving antenatal care services at designated health facilities within their communities. The CRS Nigeria PMTCT Project funded by the Global Fund in its Round 9 Phase 1 in Nigeria, sought to increase demand for HIV counseling and testing services for pregnant women at 25 supported primary health centers (PHCs) in Kaduna State, North-West Nigeria by integrating traditional birth attendants (TBAs) across the communities where the PHCs were located into the project. Community dialogues were held with the TBAs, community leaders and women groups. These dialogues focused on modes of mother to child transmission of HIV and the need for TBAs to refer their clients to PHCs for testing. Subsequently, data on number of pregnant women who were counseled, tested and received results was collected on a monthly basis from the 25 facilities using the national HIV/AIDS tools. Prior to this integration, the average number of pregnant women that were counseled, tested and received results was 200 pregnant women across all the 25 health facilities monthly. After the integration of TBAs into the program, the number of pregnant women that were counseled, tested and received results kept increasing month after month up to an average of 1500 pregnant women per month across the 25 health facilities. TBAs can thus play a key role in improving service uptake and utilization for pregnant women at primary health centers in the community - especially in the context of HIV/AIDS. They thus need to be integrated, rather than alienated, from primary healthcare service delivery.

  3. Integration of traditional birth attendants into prevention of mother-to-child transmission at primary health facilities in Kaduna, North-West Nigeria

    Directory of Open Access Journals (Sweden)

    Reward O. Nsirim

    2016-05-01

    Full Text Available One of the fundamental challenges to implementing successful prevention of mother-tochild transmission (PMTCT programs in Nigeria is the uptake of PMTCT services at health facilities. Several issues usually discourage many pregnant women from receiving antenatal care services at designated health facilities within their communities. The CRS Nigeria PMTCT Project funded by the Global Fund in its Round 9 Phase 1 in Nigeria, sought to increase demand for HIV counseling and testing services for pregnant women at 25 supported primary health centers (PHCs in Kaduna State, North-West Nigeria by integrating traditional birth attendants (TBAs across the communities where the PHCs were located into the project. Community dialogues were held with the TBAs, community leaders and women groups. These dialogues focused on modes of mother to child transmission of HIV and the need for TBAs to refer their clients to PHCs for testing. Subsequently, data on number of pregnant women who were counseled, tested and received results was collected on a monthly basis from the 25 facilities using the national HIV/AIDS tools. Prior to this integration, the average number of pregnant women that were counseled, tested and received results was 200 pregnant women across all the 25 health facilities monthly. After the integration of TBAs into the program, the number of pregnant women that were counseled, tested and received results kept increasing month after month up to an average of 1500 pregnant women per month across the 25 health facilities. TBAs can thus play a key role in improving service uptake and utilization for pregnant women at primary health centers in the community – especially in the context of HIV/AIDS. They thus need to be integrated, rather than alienated, from primary healthcare service delivery.

  4. Assessment of Knowledge, Attitudes and Competencies of Health Professionals Attended an International Training Programme in Public Health

    Directory of Open Access Journals (Sweden)

    Despena Andrioti

    2013-01-01

    Full Text Available Background: Continuing education is a fundamental aspect of health personnel professional life. These enable health professionals improve patient-centred care, stay current and provide quality services.Objectives: To assess knowledge, attitudes and competencies from the interprofessional training programme in public health held in cooperation with WHO/EURO.Methods: A structured questioner for self-ratings on perceived seminar usefulness and implementation was placed on the internet followed by email notification to the 300 participants. We have received 128 completed questionnaires (42.5%.Programme effects were tested by categorical analysis using Pearson chi-Square or Fisher's exact test. Logistic regression was used to reveal correlation between implementation of competencies according to discipline and type of employer. All tests were considered to be significant at a 5% level. Analysis was carried out using SPSS 20.0. Findings: 85.9% (p = 0.021 <0.05 of the participants applied the knowledge they acquired in the seminar. The application of the competencies in public health services differed according to position (p<0.05. Supervisors achieved higher scores (81.4% in the administration and management than the officers (48.5%. Health professionals felt that their performance has been improved and consequently the quality of the services (75%. Conclusion: The international programme gave them confidence that the acquired knowledge and skills were equal to those of their European colleagues and that they are able to deal with public health issues and to provide the respective services.

  5. A retrospective study of community-acquired Salmonella infections in patients attending public hospitals in Lagos, Nigeria.

    Science.gov (United States)

    Akinyemi, Kabiru Olusegun; Oshundare, Yetunde O; Oyeyinka, Oladeji G; Coker, Akitoye Olusegun

    2012-05-14

    A retrospective cohort study on Salmonella-associated diseases (SADs) was conducted in 14 public hospitals across Lagos State, Nigeria, between 1999 and 2008. Medical records of clinically diagnosed patients with confirmed Salmonella infections were reviewed for the 10-year period. Laboratory diagnosis of typhoid fever cases in all the hospitals were first based on Widal agglutination tests then followed by culture, while non-typhoidal Salmonella infections were based on culture technique. A total of 85,187 confirmed cases of SADs were found, of which 880 deaths were recorded (case-fatality rate = 1.03% / 10 years). The mean incidence of SADs in Lagos State for the 10-year period was estimated at 45 cases per 100,000 persons/year, while that of typhoid fever alone was 16 cases per 100,000 persons/year. During the studied period, the number of deaths due to typhoid fever was significantly (P Salmonella-associated diseases were most prevalent in adults 21 to 30 years of age (49.49%). Cases of patients with invasive Salmonella-associated gastroenteritis were observed mainly in children under five years of age. The current surveillance data indicated high incidence of SADs in areas exposed to environmental contaminations. This study revealed that infections caused by Salmonella enterica serovars are endemic in our environment thus poses a serious threat to public health. Constant public health education is essential to avert undue epidemics.

  6. TORCH seroprevalence among patients attending Obstetric Care Clinic of Haydarpasa Training and Research Hospital affiliated to Association of Istanbul Northern Anatolia Public Hospitals.

    Science.gov (United States)

    Numan, Onur; Vural, Fisun; Aka, Nurettin; Alpay, Murat; Coskun, Ayse Deniz Erturk

    2015-01-01

    Toxoplasma gondii, Rubella, Cytomegalovirus and Herpes simplex viruses are microorganisms that cause congenital infections and they are called briefly as TORCH. There is an ongoing argument for the screening of reproductive age women due to the high cost of tests. For a test to be used in screening, prevalence of disease in this population should be known. The aim of this study was to investigate TORCH seroprevalence among women attending a teaching hospital in Istanbul. A total of 1101 patients attending outpatient clinic of Obstetric Care Clinic of Haydarpasa Training and Research Hospital affiliated to Association of Istanbul Northern Anatolia Public Hospitals between September 2013 to January 2015 and their laboratory data were evaluated retrospectively. We investigated Ig G and M seropositivity rates against TORCH. The age of the patients ranged between 17-47 years with a mean age of 30.3±5.8 years. Pregnant population had 99.5% anti-CMV Ig G (+), 94.2% anti-Rubella Ig G (+), 31% anti-Toxoplasma Ig G (+). Seroprevalence for Anti IgM was 0.5% for CMV, 0.2% for rubella. The screening for Toxoplasma gondii may be suggested since the prevalence is not high in our population. The screening of CMV is not meaningful, due to high seroprevalence. Although seroprevalence of rubella is also high, it may be suggested for preconception vaccination especially in women above 20 years of age born prior to National Vaccination Programme.

  7. Diagnostic accuracy and acceptability of rapid HIV oral testing among adults attending an urban public health facility in Kampala, Uganda.

    Directory of Open Access Journals (Sweden)

    Joanita Nangendo

    Full Text Available The prevalence of HIV in Uganda is 7.3%, and yet nearly 40% of people living with HIV are unaware of their status. The current HIV testing policy which is strictly blood-based poses several challenges including: a need for high level laboratory skills, stringent waste disposal needs, and painful sample collection. It is envisaged that introduction of a rapid, painless HIV oral fluid test as a potential alternative is likely to increase the number of people testing. The aim of this study was to determine the diagnostic accuracy and acceptability of rapid HIV oral testing among adults attending Kisenyi Health Centre IV in Kampala.We conducted a cross-sectional study among 440 adults recruited consecutively at Kisenyi Health Centre IV from January to March 2016. The diagnostic accuracy of the HIV oral test was assessed by comparing to the national HIV serial testing algorithm. We also assessed for acceptability among patients and health care workers (HCWs by triangulating responses from a structured questionnaire, three focus group discussions and seven key informant interviews. Acceptability was defined as willingness to take the test at the time of the study and intention for future use of the test if it was availed. The prevalence of HIV infection among study participants was 14.8%. The HIV oral fluid test was highly accurate with sensitivity of 100% (95% CI; 94.5-100.0, specificity of 100% (95% CI; 99.0-100.0, positive predictive value (PPV of 100% (95% CI; 94.5-100.0 and negative predictive value (NPV of 100% (95% CI; 99.0-100.0. Acceptability of HIV oral testing was also high at 87.0% (95% CI; 83.6-89.9. Participants preferred HIV oral testing because it was: pain free (91%, n = 399 and did not require blood draw (82%, n = 360.The HIV oral fluid test has high diagnostic accuracy and acceptability. HIV oral testing is a suitable addition to the national HIV testing strategies with the potential of increasing access to HIV testing services in

  8. Gender differences in partner influences and barriers to condom use among heterosexual adolescents attending a public sexually transmitted infection clinic in Singapore.

    Science.gov (United States)

    Wong, Mee-Lian; Chan, Roy K W; Tan, Hiok Hee; Sen, Priya; Chio, Martin; Koh, David

    2013-03-01

    To compare gender differences in the factors associated with condom use at most recent voluntary intercourse among heterosexual adolescents attending a public clinic for sexually transmitted infections (STIs). Between 2008 and 2011, we conducted a cross-sectional survey on 964 never-married adolescents between 14 and 19 years of age who reported having engaged in voluntary intercourse for most recent sexual encounter and were attending the only public STI clinic in Singapore for screening or treatment of STIs. Data were collected using a self-administered questionnaire. The response rate to the questionnaire was 85.2%. In multivariate analysis, condom use at last intercourse for both genders was negatively associated with Malay race and peer connectedness and was positively associated with confidence in the ability to use a condom correctly. Being employed was positively associated with condom use for female respondents only. For male respondents only, condom use showed a positive association with living in better housing, older age at first intercourse, and engaging in sexual intercourse with commercial sex partners. Almost all (90%) commercial sex partners suggested condom use and provided condoms compared with 8.1% of non-sex worker partners. Condom use showed a negative association with inconvenience in its use among male respondents but not female respondents. STI prevention programs for adolescents must promote condom use with nonpaying partners, address barriers to condom use, and develop condom application skills, taking into account gender differences. Future research should explore condom use within dating relationships. Copyright © 2013 Mosby, Inc. All rights reserved.

  9. Unhappiness with the Fetal Gender is associated with Depression in Adult Pregnant Women Attending Prenatal Care in a Public Hospital in Durango, Mexico

    Science.gov (United States)

    Alvarado-Esquivel, Cosme; Sifuentes-Alvarez, Antonio; Salas-Martinez, Carlos

    2016-01-01

    Depression during pregnancy has been scantily studied in Mexican women. We aimed to determine the prevalence and correlates of depression in adult pregnant women attending a public hospital in the northern Mexican city of Durango, Mexico. Through a cross-sectional study design, we assessed depression in 270 adult pregnant women attended for prenatal care in a public hospital using a validated Mexican version of the Edinburg Postnatal Depression Scale in pregnancy and further confirmation by a psychiatric evaluation using the DSM-IV criteria for depression. Prevalence association with socio-demographic, clinical and psychosocial characteristics of the pregnant women was also investigated. Of the 270 pregnant women studied, 101 (37.4%) had EPDS scores equal to or higher than nine. Depression was confirmed in 56 (20.7%) women. Of them, 42 suffered from minor depression and 14 from major depression. Multivariate analysis of socio-demographic, clinical and psychosocial characteristics of the women showed that depression was associated with depression before pregnancy (OR = 3.36; 95% CI: 1.20-9.40; P=0.02), anxiety during pregnancy (OR = 9.38; 95% CI: 1.87-46.96; P=0.006), smoking (OR = 25.05; 95% CI: 1.77-353.07; P=0.01), unhappy with the fetal sex (OR = 8.53; 95% CI: 2.46-29.48; P<0.001), and unintended pregnancy (OR = 2.90; 95% CI: 1.07-7.86; P=0.03). Results indicate that about one fifth of the pregnant women studied had confirmed depression. This is the first report of an association of prenatal depression with unhappiness with the fetal sex. Factors associated with prenatal depression found in this study may help for the optimal design of preventive measures against prenatal depression. PMID:27127452

  10. Comparison of patient perceived primary care quality in public clinics, public hospitals and private clinics in rural China.

    Science.gov (United States)

    Wang, Wenhua; Maitland, Elizabeth; Nicholas, Stephen; Loban, Ekaterina; Haggerty, Jeannie

    2017-10-03

    In rural China, patients have free choice of health facilities for outpatient services. Comparison studies exploring the attributes of different health facilities can help identify optimal primary care service models. Using a representative sample of Chinese provinces, this study aimed to compare patients' rating of three primary care service models used by rural residents (public clinics, public hospitals and private clinics) on a range of health care attributes related to responsiveness. This was a secondary analysis using the household survey data from World Health Organization (WHO) Study on global AGEing and adult health (SAGE). Using a multistage cluster sampling strategy, eight provinces were selected and finally 3435 overall respondents reporting they had visited public clinics, public hospitals or private clinics during the last year, were included in our analysis. Five items were used to measure patient perceived quality in five domains including prompt attention, communication and autonomy, dignity and confidentiality. ANOVA and Turkey's post hoc tests were used to conduct comparative analysis of five domains. Separate multivariate linear regression models were estimated to examine the association of primary care service models with each domain after controlling for patient characteristics. The distribution of last health facilities visited was: 29.5% public clinics; 31.2% public hospitals and; 39.3% private clinics. Public clinics perform best in all five domains: prompt attention (4.15), dignity (4.17), communication (4.07), autonomy (4.05) and confidentiality (4.02). Public hospitals perform better than private clinics in dignity (4.03 vs 3.94), communication (3.97 vs 3.82), autonomy (3.92 vs 3.74) and confidentiality (3.94 vs 3.73), but equivalently in prompt attention (3.92 vs 3.93). Rural residents who are older, wealthier, and with higher self-rated health status have significantly higher patient perceived quality of care in all domains. Rural

  11. Screening, detection and management of depression in elderly primary care attenders. II: Detection and fitness for treatment: a case record study.

    Science.gov (United States)

    Mullan, E; Katona, P; D'Ath, P; Katona, C

    1994-09-01

    Case note data were obtained for 186 elderly primary care attenders who also completed the 15 item Geriatric Depression Scale (GDS15). The presence or absence in the case notes of a current or past diagnosis of depression, of current treatment of depression, and of a number of clinical features of depression were noted. Case notes were also rated for the presence or absence of contraindications to the use of tricyclic antidepressants (TCAs) and to serotonin-specific reuptake inhibitors (SSRIs). Whereas 65 (35%) patients were rated as 'cases' of depression on the GDS15, only 28 (15%) had a current case note diagnosis of depression and 37 (20%) had one or more current symptoms of depression recorded in the case notes. Patients rated by their GP as having one or more current symptoms of depression scored higher on the GDS15 (P case (P = 0.05). There was no significant relationship between GDS caseness and a current case note diagnosis of depression. Seventy-three patients (39%) had a past history of depression and 53 (28.5%) patients had previously been treated with antidepressants. The former was significantly associated with GDS caseness (P caseness'.(ABSTRACT TRUNCATED AT 250 WORDS)

  12. [Non-randomised trial of an educational intervention based on cognitive-behavioural principles for patients with chronic low back pain attended in Primary Care Physiotherapy].

    Science.gov (United States)

    Díaz-Cerrillo, Juan Luis; Rondón-Ramos, Antonio; Pérez-González, Rita; Clavero-Cano, Susana

    2016-01-01

    To assess the influence of an educational intervention in reducing «fear-avoidance» (FA) and «pain catastrophising» (CAT) in a population with unspecific chronic low back pain (UCLBP), attending physiotherapy in Primary Health Care. A pragmatic quasi-experimental study was conducted in Health Centres of a Costa del Sol Health District. Quasi-experimental study. Primary Health Care physiotherapy Back Schools in Health Centres of a Costa del Sol Health District. The selection criteria were: UCLBP; 18-65years; understanding of the Spanish language; absence of parallel educational interventions; absence of red flags; not showing cognitive impairment or fibromyalgia; absence of thoracic-lumbar surgery, and exercise tolerance. The control group received the usual Back Schools program. The experimental group also received a written document for home reading, plus the subsequent sharing, clarifying doubts, and beliefs and goals restructuring during the development of the sessions. Both interventions lasted about 280minutes (7 sessions×40min). The main variables included FA and CAT. Pain and disability were also assessed. Some «demographic» and «related disorder» variables were considered in the analysis. Statistically significant differences were observed in the experimental group versus control, in the variation of FA -14 (-25.5; 0) vs -4 (-13; 0) (P=.009), and CAT -9 (-18; -4) vs -4,5 (-8.25; 0) (P=.000), were observed. Also differences in disability (P=.046), but not in pain (P=.280). These results should be considered in light of possible limits imposed by the study. Its pragmatic nature would allow a potential transfer to usual care. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  13. Molecular Genotyping of Giardia duodenalis Isolates from Symptomatic Individuals Attending Two Major Public Hospitals in Madrid, Spain.

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    Aida de Lucio

    Full Text Available The flagellate protozoan Giardia duodenalis is an enteric parasite causing human giardiasis, a major gastrointestinal disease of global distribution affecting both developing and industrialised countries. In Spain, sporadic cases of giardiasis have been regularly identified, particularly in pediatric and immigrant populations. However, there is limited information on the genetic variability of circulating G. duodenalis isolates in the country.In this longitudinal molecular epidemiological study we report the diversity and frequency of the G. duodenalis assemblages and sub-assemblages identified in 199 stool samples collected from 184 individual with symptoms compatible with giardiasis presenting to two major public hospitals in Madrid for the period December 2013-January 2015. G. duodenalis cysts were initially detected by conventional microscopy and/or immunochomatography on stool samples. Confirmation of the infection was performed by direct immunofluorescence and real-time PCR methods. G. duodenalis assemblages and sub-assemblages were determined by multi-locus genotyping of the glutamate dehydrogenase (GDH and β-giardin (BG genes of the parasite. Sociodemographic and clinical features of patients infected with G. duodenalis were also analysed.Of 188 confirmed positive samples from 178 giardiasis cases a total of 124 G. duodenalis isolates were successfully typed at the GDH and/or the BG loci, revealing the presence of sub-assemblages BIV (62.1%, AII (15.3%, BIII (4.0%, AI (0.8%, and AIII (0.8%. Additionally, 6.5% of the isolates were only characterised at the assemblage level, being all of them assigned to assemblage B. Discordant genotype results AII/AIII or BIII/BIV were also observed in 10.5% of DNA isolates. A large number of multi-locus genotypes were identified in G. duodenalis assemblage B, but not assemblage A, isolates at both the GDH and BG loci, confirming the high degree of genetic variability observed in other molecular surveys

  14. Public health nurses' primary health care practice: strategies for fostering citizen participation.

    Science.gov (United States)

    Aston, Megan; Meagher-Stewart, Donna; Edwards, Nancy; Young, Linda M

    2009-01-01

    Citizen participation is heralded as a critical element of community health programs that emphasize empowerment and health promotion strategies. Although there is a growing body of research on public health nurses' primary health care practice, few studies have described how public health nurses foster citizen participation. This article presents findings from an interpretive qualitative study of public health nurses' perceptions of their role in fostering citizen participation in an eastern Canadian province at a time of significant health care restructuring. The findings from this study clearly profile public health nurses as integral to the practice of fostering citizen participation.

  15. Introduction of soft drinks and processed juice in the diet of infants attending public day care centers

    Directory of Open Access Journals (Sweden)

    Giovana Longo-Silva

    2015-03-01

    Full Text Available OBJECTIVE: Identifying at what age infants enrolled in public day care centers are introduced to soft drinks and industrialized juice, as well as comparing the nutritional composition of these goods with natural fruit juice. METHODS: A cross-sectional study with the mothers of 636 children (aged 0 to 36 months from nurseries of day care centers, who were asked questions about the age of feeding introduction. This study evaluated the proximate composition of soft drinks and artificial juice, comparing them with those of natural fruit juice regarding energy, sugar, fiber, vitamin C, and sodium values. The chemical composition of fruit juice was obtained by consulting the Table of Food Composition and, for industrialized drinks, the average nutritional information on the labels of the five most consumed product brands. RESULTS: The artificial drinks were consumed before the first year of life by more than half of the children studied, however, approximately 10% consumed them before the age of 6 months. With regard to the comparison among the drinks, artificial fruit juice beverages and soft drinks proved to contain from nine to 13 times higher amounts of sodium, and 15 times less vitamin C than natural juices. CONCLUSIONS: The introduction of soft drinks and industrialized juice in the diet of infants was inopportune and premature.. When compared to natural fruit juice, these have inferior nutritional composition, which suggests the urgent need for measures based on strategies for food and nutrition education in order to promote awareness and the maintenance of healthy eating habits.

  16. Introduction of soft drinks and processed juice in the diet of infants attending public day care centers

    Science.gov (United States)

    Longo-Silva, Giovana; Toloni, Maysa Helena de Aguiar; de Menezes, Risia Cristina Egito; Asakura, Leiko; Oliveira, Maria Alice Araújo; Taddei, José Augusto de Aguiar Carrazedo

    2015-01-01

    OBJECTIVE: Identifying at what age infants enrolled in public day care centers are introduced to soft drinks and industrialized juice, as well as comparing the nutritional composition of these goods with natural fruit juice. METHODS: A cross-sectional study with the mothers of 636 children (aged 0 to 36 months) from nurseries of day care centers, who were asked questions about the age of feeding introduction. This study evaluated the proximate composition of soft drinks and artificial juice, comparing them with those of natural fruit juice regarding energy, sugar, fiber, vitamin C, and sodium values. The chemical composition of fruit juice was obtained by consulting the Table of Food Composition and, for industrialized drinks, the average nutritional information on the labels of the five most consumed product brands. RESULTS: The artificial drinks were consumed before the first year of life by more than half of the children studied, however, approximately 10% consumed them before the age of 6 months. With regard to the comparison among the drinks, artificial fruit juice beverages and soft drinks proved to contain from nine to 13 times higher amounts of sodium, and 15 times less vitamin C than natural juices. CONCLUSIONS: The introduction of soft drinks and industrialized juice in the diet of infants was inopportune and premature.. When compared to natural fruit juice, these have inferior nutritional composition, which suggests the urgent need for measures based on strategies for food and nutrition education in order to promote awareness and the maintenance of healthy eating habits. PMID:25662561

  17. [Introduction of soft drinks and processed juice in the diet of infants attending public day care centers].

    Science.gov (United States)

    Longo-Silva, Giovana; Toloni, Maysa Helena de Aguiar; de Menezes, Risia Cristina Egito; Asakura, Leiko; Oliveira, Maria Alice Araújo; Taddei, José Augusto de Aguiar Carrazedo

    2015-01-01

    Identifying at what age infants enrolled in public day care centers are introduced to soft drinks and industrialized juice, as well as comparing the nutritional composition of these goods with natural fruit juice. A cross-sectional study with the mothers of 636 children (aged 0 to 36 months) from nurseries of day care centers, who were asked questions about the age of feeding introduction. This study evaluated the proximate composition of soft drinks and artificial juice, comparing them with those of natural fruit juice regarding energy, sugar, fiber, vitamin C, and sodium values. The chemical composition of fruit juice was obtained by consulting the Table of Food Composition and, for industrialized drinks, the average nutritional information on the labels of the five most consumed product brands. The artificial drinks were consumed before the first year of life by more than half of the children studied, however, approximately 10% consumed them before the age of 6 months. With regard to the comparison among the drinks, artificial fruit juice beverages and soft drinks proved to contain from nine to 13 times higher amounts of sodium, and 15 times less vitamin C than natural juices. The introduction of soft drinks and industrialized juice in the diet of infants was inopportune and premature. When compared to natural fruit juice, these have inferior nutritional composition, which suggests the urgent need for measures based on strategies for food and nutrition education in order to promote awareness and the maintenance of healthy eating habits. Copyright © 2014 Associação de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

  18. [Clinical severity and functionality of acute stroke patients attended at the physiotherapy public services of Natal, Rio Grande do Norte State, Brazil].

    Science.gov (United States)

    da Costa, Fabrícia Azevêdo; da Silva, Diana Lídice Araújo; da Rocha, Vera Maria

    2011-01-01

    This article investigates the severity and functional independence of hemiplegics patients' post-acute stroke by means of a multidisciplinary clinical staff. It is a descriptive study composed by 40 hemiplegics attended at the four largest physiotherapy public services in Natal, Rio Grande do Norte State. The methods used were an evaluation form, Functional Independence Measure and NIHSS. The results showed a sample predominantly female (55%), stroke ischemic (90%), right brain hemisphere (52.5%) and Hypertension Risk Factor (90%). The mean of clinical severity and functional independence was 13.32±4.7 and 54.6±17.15 respectively. There was no significant difference between the mean of functionality about stroke side (pvalue = 0.66). There is a significant relation between clinical severity and functional independence (r = -0.45 pvalue=0.003). It can be concluded that the level of clinical severity and functional dependence of stroke patients that make use of public physiotherapy services is significant and show the necessity, beyond the classic treatment, to be encouraged preventive educational actions to improve knowledge of this population.

  19. Health literacy, health information seeking behaviors and internet use among patients attending a private and public clinic in the same geographic area.

    Science.gov (United States)

    Gutierrez, Natalia; Kindratt, Tiffany B; Pagels, Patti; Foster, Barbara; Gimpel, Nora E

    2014-02-01

    Despite the growing body of health information available online, patients with limited health literacy may lack either internet access or skills necessary to utilize this information. Nonetheless, patients at all health literacy levels may prefer other primary sources to obtain health information. We conducted a cross-sectional study to measure health literacy of patients attending two clinics in Dallas, TX and determine associations between health literacy, health information access and internet usage before and after controlling for confounders. Patients from both clinics (county N = 265; private N = 233) completed a brief survey which included sociodemographics, internet patterns, confidence in filling out medical forms and a self-administered Newest Vital Sign to measure health literacy. In the county clinic, most patients (61.5 %) were Hispanic, had low income (literacy (68.5 %). In the private clinic, participants were mostly black (40.4 %) or white (38.6 %), had higher incomes (≥$46,000), higher education (technical college or college) and adequate health literacy (75.1 %). The primary source of obtaining health information in both clinics was their health care professional (50.6 % county; 40.1 % private). In multivariate analyses to determine differences by health literacy level, there were no statistically significant differences between patients with limited and adequate health literacy and their primary information source. Regardless of health literacy, patients rely on their health care providers to obtain health information. These results showcase the importance of providers' effective communication with patients to make shared decisions about their health regardless of other factors.

  20. Developing tomorrow's integrated community health systems: a leadership challenge for public health and primary care.

    Science.gov (United States)

    Welton, W E; Kantner, T A; Katz, S M

    1997-01-01

    As the nation's health system moves away from earlier models to one grounded in population health and market-based systems of care, new challenges arise for public health professionals, primary care practitioners, health plan and institutional managers, and community leaders. Among the challenges are the need to develop creative concepts of organization and accountability and to assure that dynamic, system-oriented structures support the new kind of leadership that is required. Developing tomorrow's integrated community health systems will challenge the leadership skills and integrative abilities of public health professionals, primary care practitioners, and managers. These leaders and their new organizations must, in turn, assume increased accountability for improving community health.

  1. [Factors Related to the Disability Burden in People with Suicidal Attempts Attended in the Public Health Care Service Network of Santiago de Cali].

    Science.gov (United States)

    Alzate, Elvis Siprián Castro; Martínez, Alejandro Castillo

    2013-03-01

    According to the World Health Organization (WHO), the aftermaths of suicide attempts are the sixth leading cause of poor health and disability in the world. Establish the level of disability and related factors in terms of restrictions regarding participation and activity limitations in cases of suicidal attempts attended by the Public Service Network Health of Santiago de Cali, from September 2009 to June 2010. A cross-section, observational study was applied to 126 people between 15 and 65 who had attempted suicide and were treated at the Public Health Service in Santiago de Cali. A Spanish version of the Disability Assessment Scale of the World Health Organization 30 disability-adjusted life years (DALYs) were calculated together with a disability prevalence of 95.3%. 4.6% of the sample did not show disability while 41.27% had mild disability, 38.1%, moderate disability, and 15.87%, severe disability. Factors related with disability were: Age, occupation, presence of mental illness, current depressive symptoms, lethal methods, use of psychiatric drugs, activity limitations, participation restrictions and lack of religious practice. The prevalence of disability in people who have committed suicidal attempts treated at the public health services in Santiago de Cali, was 95.3%. The results are consistent with the study of global burden of disease that establishes a high score for mental disorders in suicidal attempts. The presence of a deficiency after the suicide attempt increases the burden of disability. Copyright © 2013 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  2. HIGH PREVALENCE OF Blastocystis spp. INFECTION IN CHILDREN AND STAFF MEMBERS ATTENDING PUBLIC URBAN SCHOOLS IN SÃO PAULO STATE, BRAZIL.

    Science.gov (United States)

    Rebolla, Mayra Frozoni; Silva, Eliete Maria; Gomes, Jancarlo Ferreira; Falcão, Alexandre Xavier; Rebolla, Maria Vicentina Frozoni; Franco, Regina Maura Bueno

    2016-01-01

    After a gastroenteritis outbreak of unknown etiology in the municipality of Sebastião da Grama, São Paulo, Brazil, we conducted a parasitological survey to establish the epidemiological profile of enteroparasitosis in children and staff members attending the public urban schools in operation in town. The cross-sectional study evaluated 172 children aged 11 months to 6 years old and 33 staff members aged 19 to 58 years old. Overall, 96 (55.81%) children and 20 (60.61%) staff members were mono-parasitized, while 58 (33.72%) children and 4 (12.12%) workers were poly-parasitized. Protozoa (88.37%; 72.73%) was more prevalent than helminthes (3.48%; 0%) in children and staff members respectively.Blastocystis spp. was the most prevalent parasite in children (86.63%) and staff members (66.67%). The age of 1 year old or less was found to be associated with increased prevalence of giardiasis [OR = 13.04; 95%CI 2.89-58.91; p = 0.00] and public garbage collection was identified as a protective factor against intestinal helminth infections [OR = 0.06; 95%CI 0.00-0.79; p = 0.03]. Although most of the children tested positive for Blastocystis spp. and also presented clinical signs/symptoms (62.2%), this association was not statistically significant [OR = 1.35; 95%CI 0.53-3.44; p = 0.51]. Intestinal parasites still represent a public health concern and this study underscores the importance of further investigations to better understand the pathogenic role of Blastocystis spp.

  3. HIGH PREVALENCE OF Blastocystis spp. INFECTION IN CHILDREN AND STAFF MEMBERS ATTENDING PUBLIC URBAN SCHOOLS IN SÃO PAULO STATE, BRAZIL

    Directory of Open Access Journals (Sweden)

    Mayra Frozoni REBOLLA

    2016-01-01

    Full Text Available After a gastroenteritis outbreak of unknown etiology in the municipality ofSebastião da Grama, SãoPaulo, Brazil, we conducted a parasitological survey to establish the epidemiological profile of enteroparasitosis in children and staff members attending the public urban schools in operation in town. The cross-sectional study evaluated 172 children aged 11 months to 6 years old and 33 staff members aged 19 to 58 years old. Overall, 96 (55.81% children and 20 (60.61% staff members were mono-parasitized, while 58 (33.72% children and 4 (12.12% workers were poly-parasitized. Protozoa (88.37%; 72.73% was more prevalent than helminthes (3.48%; 0% in children and staff members respectively.Blastocystis spp. was the most prevalent parasite in children (86.63% and staff members (66.67%. The age of 1 year old or less was found to be associated with increased prevalence of giardiasis [OR = 13.04; 95%CI 2.89-58.91; p = 0.00] and public garbage collection was identified as a protective factor against intestinal helminth infections [OR = 0.06; 95%CI 0.00-0.79; p = 0.03]. Although most of the children tested positive for Blastocystis spp. and also presented clinical signs/symptoms (62.2%, this association was not statistically significant [OR = 1.35; 95%CI 0.53-3.44; p = 0.51]. Intestinal parasites still represent a public health concern and this study underscores the importance of further investigations to better understand the pathogenic role ofBlastocystis spp.

  4. Determinants of pre-eclampsia/Eclampsia among women attending delivery Services in Selected Public Hospitals of Addis Ababa, Ethiopia: a case control study.

    Science.gov (United States)

    Grum, Teklit; Seifu, Abiy; Abay, Mebrahtu; Angesom, Teklit; Tsegay, Lidiya

    2017-09-15

    Pre-eclampsia is a pregnancy-specific hypertensive disorder usually occurs after 20 weeks of gestation. It is one of the leading causes of maternal and perinatal morbidity and mortality worldwide. In Ethiopia, the major direct obstetric complications including pre-eclampsia/eclampsia account for 85% of the maternal deaths. Unlike deaths due to other direct causes, pre-eclampsia/ eclampsia related deaths appear to be increasing and linked to multiple factors, making prevention of the disease a continuous challenge. The aim of this study is to assess determinants of pre-eclampsia/eclampsiaamong women attending delivery services in selected public hospitals in Addis Ababa, Ethiopia. Hospital based unmatched case control study design was employed. The study wasconducted in Addis Ababa among women attending delivery services in two public hospitals from December, 2015 G.C. to February, 2016 G.C. with sample size of 291 (97 cases and 194 controls). Women with pre-eclampsia/eclampsia were cases and women who had not diagnosed for pre-eclampsia/eclampsia were controls. Case-control incidence density sampling followed by interviewer administered was conducted using pretested questionnaire. The data was entered in Epi Info 7 software and exported to STATA 14 for cleaning and analysis. Descriptive statistics were used todisplay the data using tables compared between cases and controls. To compare categorical variables between cases and controls Chi-squared testwas used. Both bivariable and multivariable logistic regression analyses were computed to identify the determinants of pre-eclampsia/eclampsia. Factors that were found to have statistically significant association with pre-eclampsia or eclampsia were primigravida (AOR: 2.68, 95% CI: 1.38, 5.22), history of preeclampsia on prior pregnancy (AOR: 4.28, 95% CI: 1.61, 11.43), multiple pregnancy (AOR: 8.22, 95% CI: 2.97, 22.78), receiving nutritional counseling during pregnancy (AOR: 0.22, 95% CI: 0.1, 0.48) and drinking

  5. Protocol for Northern Ireland Caries Prevention in Practice Trial (NIC-PIP) trial: a randomised controlled trial to measure the effects and costs of a dental caries prevention regime for young children attending primary care dental services

    LENUS (Irish Health Repository)

    Tickle, Martin

    2011-10-10

    Abstract Background Dental caries is a persistent public health problem with little change in the prevalence in young children over the last 20 years. Once a child contracts the disease it has a significant impact on their quality of life. There is good evidence from Cochrane reviews including trials that fluoride varnish and regular use of fluoride toothpaste can prevent caries. The Northern Ireland Caries Prevention in Practice Trial (NIC-PIP) trial will compare the costs and effects of a caries preventive package (fluoride varnish, toothpaste, toothbrush and standardised dental health education) with dental health education alone in young children. Methods\\/Design A randomised controlled trial on children initially aged 2 and 3 years old who are regular attenders at the primary dental care services in Northern Ireland. Children will be recruited and randomised in dental practices. Children will be randomised to the prevention package of both fluoride varnish (twice per year for three years), fluoride toothpaste (1,450 ppm F) (supplied twice per year), a toothbrush (supplied twice a year) or not; both test and control groups receive standardised dental health education delivered by the dentist twice per year. Randomisation will be conducted by the Belfast Trust Clinical Research Support Centre ([CRSC] a Clinical Trials Unit). 1200 participants will be recruited from approximately 40 dental practices. Children will be examined for caries by independent dental examiners at baseline and will be excluded if they have caries. The independent dental examiners will examine the children again at 3 years blinded to study group. The primary end-point is whether the child develops caries (cavitation into dentine) or not over the three years. One secondary outcome is the number of carious surfaces in the primary dentition in children who experience caries. Other secondary outcomes are episodes of pain, extraction of primary teeth, other adverse events and costs which will

  6. Protocol for Northern Ireland Caries Prevention in Practice Trial (NIC-PIP) trial: a randomised controlled trial to measure the effects and costs of a dental caries prevention regime for young children attending primary care dental services

    Science.gov (United States)

    2011-01-01

    Background Dental caries is a persistent public health problem with little change in the prevalence in young children over the last 20 years. Once a child contracts the disease it has a significant impact on their quality of life. There is good evidence from Cochrane reviews including trials that fluoride varnish and regular use of fluoride toothpaste can prevent caries. The Northern Ireland Caries Prevention in Practice Trial (NIC-PIP) trial will compare the costs and effects of a caries preventive package (fluoride varnish, toothpaste, toothbrush and standardised dental health education) with dental health education alone in young children. Methods/Design A randomised controlled trial on children initially aged 2 and 3 years old who are regular attenders at the primary dental care services in Northern Ireland. Children will be recruited and randomised in dental practices. Children will be randomised to the prevention package of both fluoride varnish (twice per year for three years), fluoride toothpaste (1,450 ppm F) (supplied twice per year), a toothbrush (supplied twice a year) or not; both test and control groups receive standardised dental health education delivered by the dentist twice per year. Randomisation will be conducted by the Belfast Trust Clinical Research Support Centre ([CRSC] a Clinical Trials Unit). 1200 participants will be recruited from approximately 40 dental practices. Children will be examined for caries by independent dental examiners at baseline and will be excluded if they have caries. The independent dental examiners will examine the children again at 3 years blinded to study group. The primary end-point is whether the child develops caries (cavitation into dentine) or not over the three years. One secondary outcome is the number of carious surfaces in the primary dentition in children who experience caries. Other secondary outcomes are episodes of pain, extraction of primary teeth, other adverse events and costs which will be obtained

  7. Protocol for Northern Ireland Caries Prevention in Practice Trial (NIC-PIP trial: a randomised controlled trial to measure the effects and costs of a dental caries prevention regime for young children attending primary care dental services

    Directory of Open Access Journals (Sweden)

    Noble Solveig

    2011-10-01

    Full Text Available Abstract Background Dental caries is a persistent public health problem with little change in the prevalence in young children over the last 20 years. Once a child contracts the disease it has a significant impact on their quality of life. There is good evidence from Cochrane reviews including trials that fluoride varnish and regular use of fluoride toothpaste can prevent caries. The Northern Ireland Caries Prevention in Practice Trial (NIC-PIP trial will compare the costs and effects of a caries preventive package (fluoride varnish, toothpaste, toothbrush and standardised dental health education with dental health education alone in young children. Methods/Design A randomised controlled trial on children initially aged 2 and 3 years old who are regular attenders at the primary dental care services in Northern Ireland. Children will be recruited and randomised in dental practices. Children will be randomised to the prevention package of both fluoride varnish (twice per year for three years, fluoride toothpaste (1,450 ppm F (supplied twice per year, a toothbrush (supplied twice a year or not; both test and control groups receive standardised dental health education delivered by the dentist twice per year. Randomisation will be conducted by the Belfast Trust Clinical Research Support Centre ([CRSC] a Clinical Trials Unit. 1200 participants will be recruited from approximately 40 dental practices. Children will be examined for caries by independent dental examiners at baseline and will be excluded if they have caries. The independent dental examiners will examine the children again at 3 years blinded to study group. The primary end-point is whether the child develops caries (cavitation into dentine or not over the three years. One secondary outcome is the number of carious surfaces in the primary dentition in children who experience caries. Other secondary outcomes are episodes of pain, extraction of primary teeth, other adverse events and costs

  8. Protocol for Northern Ireland Caries Prevention in Practice Trial (NIC-PIP) trial: a randomised controlled trial to measure the effects and costs of a dental caries prevention regime for young children attending primary care dental services.

    Science.gov (United States)

    Tickle, Martin; Milsom, Keith M; Donaldson, Michael; Killough, Seamus; O'Neill, Ciaran; Crealey, Grainne; Sutton, Matthew; Noble, Solveig; Greer, Margaret; Worthington, Helen V

    2011-10-10

    Dental caries is a persistent public health problem with little change in the prevalence in young children over the last 20 years. Once a child contracts the disease it has a significant impact on their quality of life. There is good evidence from Cochrane reviews including trials that fluoride varnish and regular use of fluoride toothpaste can prevent caries. The Northern Ireland Caries Prevention in Practice Trial (NIC-PIP) trial will compare the costs and effects of a caries preventive package (fluoride varnish, toothpaste, toothbrush and standardised dental health education) with dental health education alone in young children. A randomised controlled trial on children initially aged 2 and 3 years old who are regular attenders at the primary dental care services in Northern Ireland. Children will be recruited and randomised in dental practices. Children will be randomised to the prevention package of both fluoride varnish (twice per year for three years), fluoride toothpaste (1,450 ppm F) (supplied twice per year), a toothbrush (supplied twice a year) or not; both test and control groups receive standardised dental health education delivered by the dentist twice per year. Randomisation will be conducted by the Belfast Trust Clinical Research Support Centre ([CRSC] a Clinical Trials Unit). 1200 participants will be recruited from approximately 40 dental practices. Children will be examined for caries by independent dental examiners at baseline and will be excluded if they have caries. The independent dental examiners will examine the children again at 3 years blinded to study group.The primary end-point is whether the child develops caries (cavitation into dentine) or not over the three years. One secondary outcome is the number of carious surfaces in the primary dentition in children who experience caries. Other secondary outcomes are episodes of pain, extraction of primary teeth, other adverse events and costs which will be obtained from parental

  9. Expanding Global Language Education in Public Primary Schools: The National English Programme in Mexico

    Science.gov (United States)

    Sayer, Peter

    2015-01-01

    The paper examines the recent national programme of English language instruction in the Mexican public primary schools, called the "Programa Nacional de Inglés en Educación Básica" (PNIEB). The programme, initiated in 2009 by the Ministry of Education as part of the national curriculum, represents the largest expansion of English…

  10. Screening and brief interventions for hazardous and harmful alcohol use among patients with active tuberculosis attending primary care clinics in South Africa: a cluster randomized controlled trial protocol

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    Naidoo Pamela P

    2011-05-01

    Full Text Available Abstract Background In 2008 the World Health Organization (WHO reported that South Africa had the highest tuberculosis (TB incidence in the world. This high incidence rate is linked to a number of factors, including HIV co-infection and alcohol use disorders. The diagnosis and treatment package for TB and HIV co-infection is relatively well established in South Africa. However, because alcohol use disorders may present more insidiously, making it difficult to diagnose, those patients with active TB and misusing alcohol are not easily cured from TB. With this in mind, the primary purpose of this cluster randomized controlled trial is to provide screening for alcohol misuse and to test the efficacy of brief interventions in reducing alcohol intake in those patients with active TB found to be misusing alcohol in primary health care clinics in three provinces in South Africa. Methods/Design Within each of the three selected health districts with the highest TB burden in South Africa, 14 primary health care clinics with the highest TB caseloads will be selected. Those agreeing to participate will be stratified according to TB treatment caseload and the type of facility (clinic or community health centre. Within strata from 14 primary care facilities, 7 will be randomly selected into intervention and 7 to control study clinics (42 clinics, 21 intervention clinics and 21 control clinics. At the clinic level systematic sampling will be used to recruit newly diagnosed TB patients. Those consenting will be screened for alcohol misuse using the AUDIT. Patients who screen positive for alcohol misuse over a 6-month period will be given either a brief intervention based on the Information-Motivation-Behavioural Skills (IMB Model or an alcohol use health education leaflet. A total sample size of 520 is expected. Discussion The trial will evaluate the impact of alcohol screening and brief interventions for patients with active TB in primary care settings in

  11. The Impact of Public Private Partnerships on Education: A Case Study of Sewell Group Plc and Victoria Dock Primary School

    Science.gov (United States)

    Gibson, Helen; Davies, Brent

    2008-01-01

    Purpose: The purpose of this paper is to examine the implications of Public Private Partnerships (PPPs) for education delivery, attainment, attitude, behaviour and attendance. Partnership success factors are identified, and transferable lessons extracted. Barriers to the success of the partnership are explored and suggestions for improvement are…

  12. The effect of a behaviour change intervention on the diets and physical activity levels of women attending Sure Start Children's Centres: results from a complex public health intervention.

    Science.gov (United States)

    Baird, Janis; Jarman, Megan; Lawrence, Wendy; Black, Christina; Davies, Jenny; Tinati, Tannaze; Begum, Rufia; Mortimore, Andrew; Robinson, Sian; Margetts, Barrie; Cooper, Cyrus; Barker, Mary; Inskip, Hazel

    2014-07-15

    The UK government's response to the obesity epidemic calls for action in communities to improve people's health behaviour. This study evaluated the effects of a community intervention on dietary quality and levels of physical activity of women from disadvantaged backgrounds. Non-randomised controlled evaluation of a complex public health intervention. 527 women attending Sure Start Children's Centres (SSCC) in Southampton (intervention) and 495 women attending SSCCs in Gosport and Havant (control). Training SSCC staff in behaviour change skills that would empower women to change their health behaviours. Main outcomes dietary quality and physical activity. Intermediate outcomes self-efficacy and sense of control. 1-year post-training, intervention staff used skills to support behaviour change significantly more than control staff. There were statistically significant reductions of 0.1 SD in the dietary quality of all women between baseline and follow-up and reductions in self-efficacy and sense of control. The decline in self-efficacy and control was significantly smaller in women in the intervention group than in women in the control group (adjusted differences in self-efficacy and control, respectively, 0.26 (95% CI 0.001 to 0.50) and 0.35 (0.05 to 0.65)). A lower decline in control was associated with higher levels of exposure in women in the intervention group. There was a statistically significant improvement in physical activity in the intervention group, with 22.9% of women reporting the highest level of physical activity compared with 12.4% at baseline, and a smaller improvement in the control group. The difference in change in physical activity level between the groups was not statistically significant (adjusted difference 1.02 (0.74 to 1.41)). While the intervention did not improve women's diets and physical activity levels, it had a protective effect on intermediate factors-control and self-efficacy-suggesting that a more prolonged exposure to the

  13. Knowledge of and attitude to foot care amongst Type 2 diabetes patients attending a university-based primary care clinic in Nigeria

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    Rabi I. Ekore

    2010-03-01

    Full Text Available Background: Individuals living with diabetes mellitus are at an increased risk of developing foot ulcers and cardiovascular complications or a neuropathy that may result in amputations. These complications have been shown to be already present in about 10% of diabetic patients at the time of diagnosis.Objectives: This study was carried out to determine the level of awareness and attitude to foot care among adult diabetic patients attending a university health centre (i.e. a primary care centre and to emphasise the ever-present need for health education and promotion and early complication detection (especially of foot problems among diabetic patients.Method: A descriptive cross-sectional, clinic-based study was carried out at the University of Ibadan Health Centre (Jaja Clinic. The study population consisted of consenting adult diabetic patients. Data were collected by the self-administration of structured questionnaires to eligible subjects and were analysed using the SPSS v.15software. Appropriate statistics were employed to analyse the collected data.Results: A total of 137 patients participated in the study and ranged in age from 37 to 75 years, with the mean ± SD age being 58.2 ± 9.2 years. Of the participants, 98 (71.5% were men and 39 (28.5%were women; all of the participants were married. The duration of illness ranged from 1 year to 20 years, with the median duration of illness being 3 ± 1.7 years. One hundred and twenty-six (92%patients had never received any education on foot care from their healthcare providers, while 11(8% had received some form of foot care education. Among those who had never received any foot care education, 92 (73% had been diabetic for 1–5 years, while the remaining 34 (27% had been diabetic for 6 – 20 years. Of the foot care measures that were known, 35 (25.5% patients knew to wash their feet daily and dry in between the toes thoroughly, 31 (22.6% knew not to go outdoors barefooted, 27 (19.7% checked

  14. Primary care careers among recent graduates of research-intensive private and public medical schools.

    Science.gov (United States)

    Choi, Phillip A; Xu, Shuai; Ayanian, John Z

    2013-06-01

    Despite a growing need for primary care physicians in the United States, the proportion of medical school graduates pursuing primary care careers has declined over the past decade. To assess the association of medical school research funding with graduates matching in family medicine residencies and practicing primary care. Observational study of United States medical schools. One hundred twenty-one allopathic medical schools. The primary outcomes included the proportion of each school's graduates from 1999 to 2001 who were primary care physicians in 2008, and the proportion of each school's graduates who entered family medicine residencies during 2007 through 2009. The 25 medical schools with the highest levels of research funding from the National Institutes of Health in 2010 were designated as "research-intensive." Among research-intensive medical schools, the 16 private medical schools produced significantly fewer practicing primary care physicians (median 24.1% vs. 33.4%, p careers (median 36.1% vs. 36.3%, p = 0.87) and matching in family medicine residencies (median 7.4% vs. 10.0%, p = 0.37) relative to the other 66 public medical schools. To meet the health care needs of the US population, research-intensive private medical schools should play a more active role in promoting primary care careers for their students and graduates.

  15. Drug use and antisocial behavior among adolescents attending public schools in Brazil Uso de drogas e comportamento antissocial entre adolescentes de escolas públicas no Brasil

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    Fernanda Lüdke Nardi

    2012-01-01

    Full Text Available INTRODUCTION: Drug use is a social and a public health problem that has been related with antisocial behavior. The aim of this study was to evaluate the relationship between drug use and antisocial behavior among adolescents attending public schools in Brazil. METHOD: A total of 7,176 adolescents from low-income neighborhoods and public schools aged 14 to 19 years were assessed in five geographical regions in Brazil. Data on biosociodemographic characteristics and on drug use and antisocial behavior were assessed from complete answers to a national survey on risk and protective factors among adolescents. RESULTS: Over 80% of the adolescents who used alcohol and cigarettes were between 14 and 17 years old. The percentage of participants with antisocial behaviors was significantly higher among users of marijuana, cocaine, or crack than among adolescents who were not drug users. CONCLUSIONS: Prevention programs aimed at reducing substance use might help to decrease antisocial behaviors.INTRODUÇÃO: O uso de drogas é um problema social e de saúde pública que tem sido relacionado a comportamentos antissociais. O objetivo deste estudo foi avaliar a relação entre uso de drogas e comportamento antissocial em adolescentes de escolas públicas no Brasil. MÉTODO: No total, 7.176 jovens com idades entre 14 e 19 anos estudantes de escolas públicas das cinco regiões geográficas do Brasil foram avaliados. Foram utilizados dados biossociodemográficos e sobre uso de drogas e comportamento antissocial obtidos na Pesquisa Nacional sobre Fatores de Risco e Proteção da Juventude Brasileira. RESULTADOS: Mais de 80% dos adolescentes que fizeram uso de bebidas alcoólicas e cigarro tinham entre 14 e 17 anos. O percentual de pacientes com comportamento antissocial foi significativamente maior entre usuários de maconha, cocaína ou crack do que entre adolescentes não usuários. CONCLUSÕES: Programas de prevenção direcionados à redução do uso de subst

  16. PRESCRIBING OF ANTIHYPERTENSIVE AGENTS IN PUBLIC PRIMARY CARE CLINICS – IS IT IN ACCORDANCE WITH CURRENT EVIDENCE?

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    SAJARI J

    2010-01-01

    Full Text Available Background: Large population surveys in Malaysia have consistently shown minimal improvement of blood pressure control rates over the last 10 years. Poor adherence to antihypertensive medication has been recognized as a major reason for poor control of hypertension. This study aimed to describe the prescribing pattern of antihypertensive agents in 2 public primary care clinics and assess its appropriateness in relation to current evidence and guidelines. Methods: A cross-sectional survey to describe the prescribing pattern of antihypertensive agents was carried out in 2 publicprimary care clinics in Selangor from May to June 2009. Hypertensive patients on pharmacological treatment for ≥1 year who attended the clinics within the study period of 7 weeks were selected. Appropriate use of antihypertensive agents was defined based on current evidence and the recommendations by the Malaysian Clinical Practice Guidelines (CPG on the Management of Hypertension, 2008. Data were obtained from patients’ medical records and were analysed using the SPSS software version 16.0. Results: A total of 400 hypertensive patients on treatment were included. Mean age was 59.5 years (SD ±10.9, range 28 to91 years, of which 52.8% were females and 47.2% were males. With regards to pharmacotherapy, 45.7% were on monotherapy,43.3% were on 2 agents and 11.0% were on ≥3 agents. Target blood pressure of <140/90mmHg was achieved in 51.4% of patients on monotherapy, and 33.2% of patients on combination of ≥2 agents. The commonest monotherapy agents being prescribed were β-blockers (atenolol or propranolol, followed by the short-acting calcium channel blocker (nifedipine. The commonest combination of 2-drug therapy prescribed was β-blockers and short-acting calcium channel blocker. Conclusion: This study shows that the prescribing pattern of antihypertensive agents in the 2 primary care clinics was not in accordance with current evidence and guidelines.

  17. Designing services for frequent attenders to the emergency department: a characterisation of this population to inform service design.

    Science.gov (United States)

    Jacob, Rebecca; Wong, Mai Luen; Hayhurst, Catherine; Watson, Peter; Morrison, Cecily

    2016-08-01

    Frequent attendance to the emergency department (ED) is a growing public health concern. Designing services for frequent attenders poses challenges, given the heterogeneous nature of this group. This was a two-part observational study identifying frequent attenders from ED records. The first stage studied trends and developed personas with emphasis on differentiating moderate frequent attenders (attending between 5 and 20 times per year) and extreme frequent attenders (attending more than 20 times). Stage 2 included a case note review of 100 consecutive frequent attenders. Results showed an increase in frequent attendance from 2.59% to 4.12% over 8 years. Moderate frequent attenders accounted for 97%. Of the 100 frequent attenders studied, 45% had medically unexplained symptoms (MUS), associated with younger age (p0.05). In conclusion, the ED is a useful hub for identifying frequent attenders with MUS, particularly among moderate frequent attenders; service design for this group should consider a 'whole-systems approach' with integration between primary and secondary care, including specialist liaison psychiatry services where appropriate. © 2016 Royal College of Physicians.

  18. Demand for long acting contraceptive methods among married HIV positive women attending care at public health facilities at Bahir Dar City, Northwest Ethiopia.

    Science.gov (United States)

    Gelagay, Abebaw Addis; Koye, Digsu Negese; Yeshita, Hedija Yenus

    2015-08-27

    The use of long acting contraceptive methods (LACMs) is one of the strategies for preventing mother-to-child transmission (MTCT) of HIV. Studies noted that significant proportion of unintended pregnancy among HIV positive women was due to contraceptive failure mainly of short term contraceptives. This highlights the need to use most effective types of modern contraception, long acting contraceptive. However, studies conducted on demand for long acting contraceptive methods in this particular group of people are scarce in Ethiopia. This study aimed to assess demand for long acting contraceptive methods and associated factors among married reproductive age women attending care at Antiretroviral treatment (ART) clinics in public health institutions at Bahir Dar City, Northwest Ethiopia. Institution-based cross-sectional study was conducted among 654 systematically selected women attending care in ART clinics in public health facilities at Bahir Dar city from March to April, 2014. A structured and pretested interviewer administered questionnaire was used to collect data. Data were entered using EPI info version 3.5.3 and then exported to SPSS version 16 for analysis. Descriptive statistics were used to describe the socio-demographic and economic characteristics of the study participants. Logistic regression analyses were employed to identify factors associated with demand for long acting contraceptive methods. Odds ratios with 95 % CI were used to assess the presence and strength of association. A total of 654 respondents have participated in the study (response rate 99. 09 %). The demand for long acting contraceptive methods was 36.7 % (95 % CI: 33.2 %, 40.6 %). The odds of demand for LACMs among HIV positive women who were living in urban were three times [AOR = 3.05, 95 % CI: 1.34, 6.89] higher than those who were living in rural. The odds of demand for LACMs among the respondents who were in elementary educational level were two times [AOR = 2.31, 95

  19. Desempenho motor de lactentes frequentadores de berçários em creches públicas Motor performance of infants attending the nurseries of public day care centers

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    Letícia Baltieri

    2010-09-01

    Full Text Available OBJETIVO: Analisar o desempenho motor axial, apendicular e global e sua correlação com as características neonatais, familiares e de tempo de exposição à creche em crianças com idade entre 12-24 meses, frequentadoras de creches públicas. MÉTODOS: Estudo transversal com 40 lactentes (idade média 14,3±2,4 meses frequentadores de creches públicas. Os participantes foram avaliados quanto ao desempenho motor com a Bayley Scales of Infant and Toddler Development-III, a qual possibilita análise do desempenho motor e comparação dos domínios motores axial e apendicular. Foram coletados dados neonatais, familiares e de exposição à creche e pesquisou-se a correlação destes fatores ao desempenho motor. Foi utilizado o teste t pareado para comparar médias e a correlação de Pearson. RESULTADOS: O desempenho motor do grupo esteve, em média, abaixo da referência, com 22,5% das crianças classificadas como suspeitas de atraso nos desempenhos axial e global, contrastando com nenhuma no domínio apendicular. A comparação axial e apendicular apontou diferença significativa, com desempenho axial aquém do apendicular, além de 35% do grupo ter apresentado discrepância significativa entre esses domínios. Não foi encontrada correlação linear entre os domínios motores avaliados e as variáveis neonatais, familiares e de exposição à creche. CONCLUSÕES: O desempenho motor global do grupo esteve abaixo da média de referência, com desempenho motor axial inferior ao apendicular e importante discrepância entre esses. Recomenda-se atenção às habilidades motoras axiais e às oportunidades de exploração que o ambiente em creches pode propiciar, especialmente no decorrer dos dois primeiros anos de vida.OBJECTIVE: To analyze gross, fine and global motor performance and its correlation with neonatal and familial variables and day care exposure among children between 12-24 months of age attending public day care centers. METHODS: This

  20. Antimicrobial susceptibility of Neisseria gonorrhoeae isolates from patients attending a public referral center for sexually transmitted diseases in Belo Horizonte, State of Minas Gerais, Brazil

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    Ligia Maria Bedeschi Costa

    2013-06-01

    Full Text Available Introduction The aim of this study was to determine the antimicrobial susceptibility of Neisseria gonorrhoeae isolates obtained from patients attending a public referral center for sexually transmitted diseases and specialized care services (STD/SCS in Belo Horizonte, Brazil. Methods Between March 2011 and February 2012, 201 specimens of Neisseria gonorrhoeae were consecutively obtained from men with symptoms of urethritis and women with symptons of cervicitis or were obtained during their initial consultation. The strains were tested using the disk diffusion method, and the minimum inhibitory concentrations of azithromycin, cefixime, ceftriaxone, ciprofloxacin, chloramphenicol, penicillin, tetracycline and spectinomycin were determined using the E-test. Results The specimens were 100% sensitive to cefixime, ceftriaxone and spectinomycin and exhibited resistances of 4.5% (9/201, 21.4% (43/201, 11.9% (24/201, 22.4% (45/201 and 32.3% (65/201 to azithromycin, ciprofloxacin, chloramphenicol, penicillin and tetracycline, respectively. Intermediate sensitivities of 17.9% (36/201, 4% (8/201, 16.9% (34/201, 71.1% (143/201 and 22.9% (46/201 were observed for azithromycin, ciprofloxacin, chloramphenicol, penicillin and tetracycline, respectively. The specimens had plasmid-mediated resistance to penicillin PPNG 14.5% (29/201 and tetracycline TRNG 11.5% (23/201. Conclusions The high percentage of detected resistance to penicillin, tetracycline, chloramphenicol and ciprofloxacin indicates that these antibiotics are not appropriate for gonorrhea treatment at the Health Clinic and possibly in Belo Horizonte. The resistance and intermediate sensitivity of these isolates indicates that caution is recommended in the use of azithromycin and emphasizes the need to establish mechanisms for the surveillance of antimicrobial resistance for the effective control of gonorrhea.

  1. Prevalence and drug resistance profile of Mycobacterium tuberculosis isolated from pulmonary tuberculosis patients attending two public hospitals in East Gojjam zone, northwest Ethiopia.

    Science.gov (United States)

    Adane, Kelemework; Ameni, Gobena; Bekele, Shiferaw; Abebe, Markos; Aseffa, Abraham

    2015-06-20

    The spread of multidrug-resistant tuberculosis (MDR-TB) strains has become a challenge to the global TB control and prevention program. In Ethiopia, particularly in rural areas, information on drug-resistant TB is very limited. In this study, we determined the drug resistance patterns of Mycobacterium tuberculosis (M. tuberculosis) isolates from pulmonary TB patients attending two public hospitals in the East Gojjam zone of northwest Ethiopia. A cross-sectional study was conducted between May 2011 and January 2012 using Region of difference-9 (RD9) typing for the identification of species mycobacterium. Drug susceptibility testing (DST) of M. tuberculosis isolates to the first-line drugs: isoniazid, rifampicin, ethambutol and streptomycin was performed by the indirect proportion method on Middle brook 7H10 Agar media. Out of 385 pulmonary TB suspects studied, 124 (32.2%) were culture positive among which 120 were M. tuberculosis strains. Susceptibility testing was performed for 89 isolates. Resistance to at least one drug was 15.58% ([12/77], 95% CI: 7.48-23.68) among newly diagnosed and 50.0% ([6/12], 95% CI: 21.71-78.29) among previously treated cases. Resistance among newly diagnosed patients was most common for streptomycin 5.19% (4/77) and ethambutol 5.19% (4/77) followed by rifampicin 3.89% (3/77). Among retreatment cases, isoniazid resistance was most frequent in which 33.33% (4/12) of the isolates were resistant. MDR prevalence was 1.29% (1/77) for newly diagnosed and 16.67% (2/12) for retreatment cases. In a multivariate logistic regression analysis, age group of 25-34 years (adjusted OR = 4.24; 95% CI: 1.02-17.5; P = 0.046) and previous history of treatment (adjusted OR = 5.42; 95% CI: 1.56-27.49; P = 0.01) were independently associated with anti-TB drug resistance. In general, the magnitude of anti-TB drug resistance including MDR-TB was comparable to previous studies in other areas of Ethiopia. However, rifampicin resistance was high

  2. The knowledge and expectations of parents about the role of antibiotic treatment in upper respiratory tract infection – a survey among parents attending the primary physician with their sick child

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    Ron Adi

    2003-12-01

    Full Text Available Abstract Background Upper respiratory tract infections (URTI are common. The etiologic factor is usually viral, but many physicians prescribe antibiotics. We aimed to evaluate parents' expectations of and knowledge about the role of antibiotics in childhood URTI. Methods The study was conducted in thirteen primary care pediatric clinics. Parents of children aged 3 months to 6 years who attended with URTI symptoms were included when it was the first attendance in the current illness. Questionnaire about the current illness, reasons for attending and expectations from the visit, knowledge about URTI was filled before the visit. Results In 122 visits the average age was 2.8 ± 1.9 years. The main reasons for the visit were to avoid complications (81% and to be examined (78%. Expected treatment was: cough suppressants (64%, anti-congestants (57%, paracetamol (56%, natural remedies (53% and antibiotics (25%. In 28% the child had received antibiotics in past URTI. Only 37% thought that antibiotics would not help in URTI and 27% knew that URTI is a self-limited disease. 61% knew that URTI is a viral disease. Younger parental age and higher education were associated with lower expectations to receive antibiotics (p = 0.01, p Conclusions A quarter of the parents attending the physician with URTI are expecting to get antibiotics. Predictors were lower education, older parental age, receiving antibiotics in the past and the belief that antibiotics help in URTI.

  3. The knowledge and expectations of parents about the role of antibiotic treatment in upper respiratory tract infection--a survey among parents attending the primary physician with their sick child.

    Science.gov (United States)

    Shlomo, Vinker; Adi, Ron; Eliezer, Kitai

    2003-12-30

    Upper respiratory tract infections (URTI) are common. The etiologic factor is usually viral, but many physicians prescribe antibiotics. We aimed to evaluate parents' expectations of and knowledge about the role of antibiotics in childhood URTI. The study was conducted in thirteen primary care pediatric clinics. Parents of children aged 3 months to 6 years who attended with URTI symptoms were included when it was the first attendance in the current illness. Questionnaire about the current illness, reasons for attending and expectations from the visit, knowledge about URTI was filled before the visit. In 122 visits the average age was 2.8 +/- 1.9 years. The main reasons for the visit were to avoid complications (81%) and to be examined (78%). Expected treatment was: cough suppressants (64%), anti-congestants (57%), paracetamol (56%), natural remedies (53%) and antibiotics (25%). In 28% the child had received antibiotics in past URTI. Only 37% thought that antibiotics would not help in URTI and 27% knew that URTI is a self-limited disease. 61% knew that URTI is a viral disease. Younger parental age and higher education were associated with lower expectations to receive antibiotics (p = 0.01, p expectation for antibiotics. A quarter of the parents attending the physician with URTI are expecting to get antibiotics. Predictors were lower education, older parental age, receiving antibiotics in the past and the belief that antibiotics help in URTI.

  4. The Impact of Music Education on Academic Achievement, Attendance Rate, and Student Conduct on the 2006 Senior Class in One Southeast Virginia Public School Division

    OpenAIRE

    Waller, George Darryl

    2007-01-01

    For several decades music educators have proposed that the study of music has a significant impact on student academic achievement, attendance rates, and student conduct. In an era of higher student and teacher accountability, increasing budget cuts, the federal No Child Left Behind Act (NCLB), and stringent state standards of learning, a number of educators have argued that education in music can boost test scores, attendance, attitudes toward school, reduce discipline referrals, and increa...

  5. Market reforms in English primary medical care: medicine, habitus and the public sphere.

    Science.gov (United States)

    McDonald, Ruth

    2009-07-01

    Drawing on interviews with English primary care doctors (GPs), this paper examines GP responses to reforms intended to introduce a market in primary health care. GPs' reactions are conceptualised in terms of a GP habitus, which takes for granted the superiority of 'public' providers (i.e. GP partnerships) in the provision of care. GPs are actively involved in the defence of the public sphere, which is neither a neo-liberal minimalist market state, nor a wholly altruistic state, responding to consumers' wants. The public sphere they defend is one in which boundaries are drawn about entitlements and GPs are actively engaged in defining and policing these boundaries. The GP habitus can be seen as shaping responses in ways which serve GP interests. In the context of struggles involving various social actors (e.g. private providers, third-party payers, patients) with different stakes in the field of general medical practice; this public service orientation may enable GPs to reap cultural capital. At the same time, the habitus constrains action in a way which limits resistance to reforms threatening GPs' interests, with GPs responding by coping, rather than downing tools or engaging in active confrontation.

  6. Discrepancies in the primary PLATO trial publication and the FDA reviews.

    Science.gov (United States)

    Serebruany, Victor L

    2014-03-01

    The results of major indication seeking Phase 3 clinical trials are reported at international meetings, and simultaneously published In top medical journals. However, the data presented during such dual release do not disclose all the trial findings, suffer from overoptimistic interpretations heavily favoring the study sponsor. Ironically, after the New Drug Application is submitted for regulatory approval, and when the FDA secondary reviews become available for public, the benefit/risk assessment of a new drug is usually considered much less impressive. However, the community may ignore pivotal unreported findings later outlined in the government documents taking for granted the facts presented in the primary publication. The discrepancies between initial publication and the FDA files are not only confusing to the readership, but hold additional risks for patients. Indeed, if physicians are impressed with the initial interpretation of the trial, and do not have broad access to the FDA verified facts, chances are new agents will be prescribed based on exaggerated benefit and less safety concerns. The current pattern also hurts the reputation of the journal publishers, editors and reviewers challenging their trust and credibility. We here outline the disparity between the primary PLATO trial publication in the New England Journal of Medicine against the FDA verified numbers, and discuss how to avoid such mismatches in the future. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  7. Specialist public health capacity in England: working in the new primary care organizations.

    Science.gov (United States)

    Chapman, J; Shaw, S; Congdon, P; Carter, Y H; Abbott, S; Petchey, R

    2005-01-01

    To determine the capacity and development needs, in relation to key areas of competency and skills, of the specialist public health workforce based in primary care organizations following the 2001 restructuring of the UK National Health Service. Questionnaire survey to all consultants and specialists in public health (including directors of public health) based in primary care trusts (PCTs) and strategic health authorities (SHAs) in England. Participants reported a high degree of competency. However, skill gaps were evident in some areas of public health practice, most notably "developing quality and risk management" and in relation to media communication, computing, management and leadership. In general, medically qualified individuals were weaker on community development than non-medically qualified specialists, and non-medically qualified specialists were less able to perform tasks that require epidemiological or clinical expertise than medically qualified specialists. Less than 50% of specialists felt that their links to external organizations, including public health networks, were strong. Twenty-nine percent of respondents felt professionally isolated and 22% reported inadequate team working within their PCT or SHA. Approximately 21% of respondents expressed concerns that they did not have access to enough expertise to fulfil their tasks and that their skills were not being adequately utilized. Some important skill gaps are evident among the specialist public health workforce although, in general, a high degree of competency was reported. This suggests that the capacity deficit is a problem of numbers of specialists rather than an overall lack of appropriate skills. Professional isolation must be addressed by encouraging greater partnership working across teams.

  8. 75 FR 36099 - Legislative Changes to Primary Care Loan Program Authorized Under Title VII of the Public Health...

    Science.gov (United States)

    2010-06-24

    ... HUMAN SERVICES Health Resources and Services Administration Legislative Changes to Primary Care Loan... Care Act (ACA), Public Law 111-148. Section 5201 of the ACA changes the Primary Care Loan (PCL) program by: (1) Reducing the number of years for the primary health care service requirement; (2) lowering...

  9. Health-Related Quality of Life of Latin-American Immigrants and Spanish-Born Attended in Spanish Primary Health Care: Socio-Demographic and Psychosocial Factors

    Science.gov (United States)

    Salinero-Fort, Miguel Ángel; Gómez-Campelo, Paloma; Bragado-Alvárez, Carmen; Abánades-Herranz, Juan Carlos; Jiménez-García, Rodrigo; de Burgos-Lunar, Carmen

    2015-01-01

    Background This study compares the health-related quality of life of Spanish-born and Latin American-born individuals settled in Spain. Socio-demographic and psychosocial factors associated with health-related quality of life are analyzed. Methods A cross-sectional Primary Health Care multi center-based study of Latin American-born (n = 691) and Spanish-born (n = 903) outpatients from 15 Primary Health Care Centers (Madrid, Spain). The Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) was used to assess health-related quality of life. Socio-demographic, psychosocial, and specific migration data were also collected. Results Compared to Spanish-born participants, Latin American-born participants reported higher health-related quality of life in the physical functioning and vitality dimensions. Across the entire sample, Latin American-born participants, younger participants, men and those with high social support reported significantly higher levels of physical health. Men with higher social support and a higher income reported significantly higher mental health. When stratified by gender, data show that for men physical health was only positively associated with younger age. For women, in addition to age, social support and marital status were significantly related. Both men and women with higher social support and income had significantly better mental health. Finally, for immigrants, the physical and mental health components of health-related quality of life were not found to be significantly associated with any of the pre-migration factors or conditions of migration. Only the variable “exposure to political violence” was significantly associated with the mental health component (p = 0.014). Conclusions The key factors to understanding HRQoL among Latin American-born immigrants settled in Spain are age, sex and social support. Therefore, strategies to maintain optimal health outcomes in these immigrant communities should include public policies on

  10. Public primary and secondary skin cancer prevention, perceptions and knowledge: an international cross-sectional survey.

    Science.gov (United States)

    Seité, S; Del Marmol, V; Moyal, D; Friedman, A J

    2017-05-01

    The incidence of melanoma and non-melanoma skin cancer is continuing to increase worldwide, with sun exposure serving as the primary external aetiologic force in its development. Despite noticeable public health efforts, there continue to be gaps in public awareness and primary and secondary prevention mechanisms. This survey study sought to investigate preventative behaviours regarding sun exposure and skin cancer detection at an international scale. A questionnaire was submitted, both online and by telephone, to a representative sample (based on official demographic statistics on gender, age and region) of people aged from 15 to 65 originating from 23 countries. Questions dealt with demographics, sun exposure and protection, risk knowledge, self-examination, medical advice seeking. Data were then gathered and analysed at different levels. A total of 19 569 respondents were recruited. Overall, sunscreen and sunglasses were the most used measures for sun protection. There were however difference between countries and geographical areas. Some high-risk countries in terms of sun exposure (according to their location to Equator) exhibited higher rates of primary preventative behaviours, in particular Australia, Chile and Greece. There were also discrepancies between countries regarding secondary prevention through self-examination and medical advice seeking. Young people, men, individuals belonging to a lower socio-economic class or having a lower education level were all least likely to know or follow primary and secondary preventive measures. We found imperfections and geographical inequality both regarding primary and secondary prevention of skin cancer. Our study provides insights that could help to target populations more effectively through information campaigns embedded into the global needed endeavour aiming to reduce mid- and long-term development of skin cancer. © 2017 European Academy of Dermatology and Venereology.

  11. Feasibility of Implementing Chronic Care Model in the Malaysian Public Primary Care Setting.

    Science.gov (United States)

    Ariffin, F; Ramli, A S; Daud, M H; Haniff, J; Abdul-Razak, S; Selvarajah, S; Lee, V K; Tong, S F; Bujang, M A

    2017-04-01

    Non-communicable diseases (NCD) is a global health threat. the Chronic Care Model (CCM) was proven effective in improving NCD management and outcomes in developed countries. Evidence from developing countries including Malaysia is limited and feasibility of CCM implementation has not been assessed. this study intends to assess the feasibility of public primary health care clinics (PHC) in providing care according to the CCM. A cross-sectional survey was conducted to assess the public PHC ability to implement the components of CCM. All public PHC with Family Medicine Specialist in Selangor and Kuala Lumpur were invited to participate. A site feasibility questionnaire was distributed to collect site investigator and clinic information as well as delivery of care for diabetes and hypertension. there were a total of 34 public PHC invited to participate with a response rate of 100%. there were 20 urban and 14 suburban clinics. the average number of patients seen per day ranged between 250-1000 patients. the clinic has a good mix of multidisciplinary team members. All clinics had a diabetic registry and 73.5% had a hypertensive registry. 23.5% had a dedicated diabetes and 26.5% had a dedicated hypertension clinic with most clinic implementing integrated care of acute and NCD cases. the implementation of the essential components of CCM is feasible in public PHCs, despite various constraints. Although variations in delivery of care exists, majority of the clinics have adequate staff that were willing to be trained and are committed to improving patient care.

  12. Does public transportation improve the accessibility of primary dental care in São Paulo, Brazil?

    Science.gov (United States)

    Yuen, Aidan; Martins Rocha, Carla; Kruger, Estie; Tennant, Marc

    2018-01-29

    Advances in geospatial technologies have recognized the role of geographic distance as a barrier to healthcare accessibility. Frequent transportation is supposed to buffer issues with distance, while infrequent services impede the uptake of care. The role of public transportation on the accessibility of health care-including oral health care-is not well elucidated in the context of megacities, such as the municipality of São Paulo, Brazil. This study aimed to compare the supply of public transportation to primary dental clinics and the population between advantaged and disadvantaged areas in São Paulo city. A total of 4101 primary dental clinics in São Paulo city were identified and geocoded. Geographic coordinates were also retrieved for the 19 242 bus stops, 56 commuter rail stations and 64 rapid transit stations. Clinic locations and transport points were integrated with the city's 19 128 constituent census tracts-each containing sociodemographic data on the 11 252 204 residents-using Geographic Information Systems (GIS). Almost all clinics were located within 0.5 km of public transportation. Half of all clinics were within 0.5 km of high-frequency transport points, and three-quarters were within 1 km. Likewise, 99% of the population resided within 0.5 km of any public transportation. However, only 22% were within 0.5 km of high-frequency options, and half were within 1 km. Those within 0.5 km of high-frequency points had higher average monthly household incomes and lower illiteracy rates, with lower proportions of children and ethnic minorities, and higher proportions of older people. Clinics and populations in sociodemographically disadvantaged tracts have poorer public transportation links in São Paulo city. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. Effectiveness of Collaborative Care for Depression in Public-Sector Primary Care Clinics Serving Latinos.

    Science.gov (United States)

    Lagomasino, Isabel T; Dwight-Johnson, Megan; Green, Jennifer M; Tang, Lingqi; Zhang, Lily; Duan, Naihua; Miranda, Jeanne

    2017-04-01

    Quality improvement interventions for depression care have been shown to be effective for improving quality of care and depression outcomes in settings with primarily insured patients. The aim of this study was to determine the impact of a collaborative care intervention for depression that was tailored for low-income Latino patients seen in public-sector clinics. A total of 400 depressed patients from three public-sector primary care clinics were enrolled in a randomized controlled trial of a tailored collaborative care intervention versus enhanced usual care. Social workers without previous mental health experience served as depression care specialists for the intervention patients (N=196). Depending on patient preference, they delivered a cognitive-behavioral therapy (CBT) intervention or facilitated antidepressant medication given by primary care providers or both. In enhanced usual care, patients (N=204) received a pamphlet about depression, a letter for their primary care provider stating that they had a positive depression screen, and a list of local mental health resources. Intent-to-treat analyses examined clinical and process-of-care outcomes at 16 weeks. Compared with patients in the enhanced usual care group, patients in the intervention group had significantly improved depression, quality of life, and satisfaction outcomes (pclinics. Social workers without prior mental health experience can effectively provide CBT and manage depression care.

  14. Physical activity counseling in primary care: Insights from public health and behavioral economics.

    Science.gov (United States)

    Shuval, Kerem; Leonard, Tammy; Drope, Jeffrey; Katz, David L; Patel, Alpa V; Maitin-Shepard, Melissa; Amir, On; Grinstein, Amir

    2017-05-06

    Physical inactivity has reached epidemic proportions in modern society. Abundant evidence points to a causal link between physical inactivity and increased risk for numerous noncommunicable diseases, such as some types of cancer and heart disease, as well as premature mortality. Yet, despite this overwhelming evidence, many individuals do not meet the recommended amount of physical activity required to achieve maximum health benefits. Because primary care physicians' advice is highly regarded, clinicians have the unique opportunity to play an important role in enabling patients to modify their behavior at the point of care with the goal of guiding patients to adopt and maintain an active lifestyle. In the current study, the authors evaluate pertinent literature from the fields of medicine/public health and economics/psychology to suggest a comprehensive approach to physical activity counseling at the primary care level. They first examine the public health approach to physical activity counseling, and then proceed to offer insights from behavioral economics, an emerging field that combines principles from psychology and economics. The application of key behavioral economics tools (eg, precommitment contracts, framing) to physical activity counseling in primary care is elaborated. CA Cancer J Clin 2017;67:233-244. © 2017 American Cancer Society. © 2017 American Cancer Society.

  15. Prevalence and correlates of preterm labor among young parturient women attending public hospitals in Brazil Prevalencia y factores correlativos del parto prematuro en las jóvenes parturientas que acuden a los hospitales públicos del Brasil

    OpenAIRE

    Angélica E. Miranda; Valdir M. Pinto; Célia L. Szwarcwald; Elizabeth T. Golub

    2012-01-01

    OBJECTIVE: To determine the prevalence of and risk factors for preterm labor (< 37 weeks of gestation) among young pregnant women in Brazil. METHODS: A national cross-sectional study was conducted among parturient women aged 15-24 years attending Brazilian public maternities in 2009. Questionnaires were administered by interviewers during parturient admission to the maternity clinic (or soon after delivery, if survey participants were in too much pain to respond during labor). The questionnai...

  16. Cross-sectional study to evaluate Trichomonas vaginalis positivity in women tested for Neisseria gonorrhoeae and Chlamydia trachomatis, attending genitourinary medicine and primary care clinics in Bristol, South West England.

    Science.gov (United States)

    Nicholls, Jane E; Turner, Katy M E; North, Paul; Ferguson, Ralph; May, Margaret T; Gough, Karen; Macleod, John; Muir, Peter; Horner, Patrick J

    2017-08-10

    Highly sensitive, commercial nucleic acid amplification tests (NAAT) for Trichomonas vaginalis have only recently been recommended for use in the UK. While testing for T. vaginalis is routine in symptomatic women attending genitourinary medicine (GUM) clinics, it is rare in asymptomatic women or those attending primary care. The aim of this study was to evaluate the positivity of T. vaginalis using a commercial NAAT, in symptomatic and asymptomatic women undergoing testing for chlamydia and gonorrhoea in GUM and primary care settings. Samples from 9186 women undergoing chlamydia and gonorrhoea testing in South West England between May 2013 and Jan 2015 were also tested for T. vaginalis by NAAT alongside existing tests. T. vaginalis positivity using NAAT was as follows: in GUM 4.5% (24/530, symptomatic) and 1.7% (27/1584, asymptomatic); in primary care 2.7% (94/3499, symptomatic) and 1.2% (41/3573, asymptomatic). Multivariable regression found that in GUM older age, black ethnicity and deprivation were independent risk factors for T. vaginalis infection. Older age and deprivation were also risk factors in primary care. Testing women presenting with symptoms in GUM and primary care using TV NAATs is estimated to cost £260 per positive case diagnosed compared with £716 using current microbiological tests. Aptima TV outperforms existing testing methods used to identify T. vaginalis infection in this population. An NAAT should be used when testing for T. vaginalis in women who present for testing with symptoms in primary care and GUM, based on test performance and cost. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  17. Teachers' reflections on distributive leadership in public primary schools in Soweto

    Directory of Open Access Journals (Sweden)

    Suraiya R Naicker

    2013-01-01

    Full Text Available Schooling has become increasingly complex in purpose and structure and therefore requires appropriate forms of leadership to address this challenge. One current leadership approach that is receiving national and global attention is distributive leadership. A qualitative approach was employed to investigate teachers' experiences and perceptions of the practice of distributive leadership in public primary schools in Soweto. Soweto is a township in Johannesburg, South Africa, which comprises predominantly black African residents. The findings revealed that leadership in Soweto primary schools is rooted in classical leadership practices and that any potential for the practice of distributive leadership is hindered by autocratic styles of leadership, hierarchical structures, and non-participative decision-making.

  18. Job satisfaction of primary health-care providers (public sector in urban setting

    Directory of Open Access Journals (Sweden)

    Pawan Kumar

    2013-01-01

    Full Text Available Introduction: Job satisfaction is determined by a discrepancy between what one wants in a job and what one has in a job. The core components of information necessary for what satisfies and motivates the health work force in our country are missing at policy level. Therefore present study will help us to know the factors for job satisfaction among primary health care providers in public sector. Materials and Methods: Present study is descriptive in nature conducted in public sector dispensaries/primary urban health centers in Delhi among health care providers. Pretested structured questionnaire was administered to 227 health care providers. Data was analyzed using SPSS and relevant statistical test were applied. Results: Analysis of study reveals that ANMs are more satisfied than MOs, Pharmacist and Lab assistants/Lab technicians; and the difference is significant (P < 0.01. Age and education level of health care providers don′t show any significant difference in job satisfaction. All the health care providers are dissatisfied from the training policies and practices, salaries and opportunities for career growth in the organization. Majority of variables studied for job satisfaction have low scores. Five factor were identified concerned with job satisfaction in factor analysis. Conclusion: Job satisfaction is poor for all the four groups of health care providers in dispensaries/primary urban health centers and it is not possible to assign a single factor as a sole determinant of dissatisfaction in the job. Therefore it is recommended that appropriate changes are required at the policy as well as at the dispensary/PUHC level to keep the health work force motivated under public sector in Delhi.

  19. High prevalence of Staphylococcus aureus and methicillin-resistant S. aureus colonization among healthy children attending public daycare centers in informal settlements in a large urban center in Brazil.

    Science.gov (United States)

    Braga, Eneida Dias Vianna; Aguiar-Alves, Fábio; de Freitas, Maria de Fátima Nogueira; de e Silva, Monique Oliveira; Correa, Thami Valadares; Snyder, Robert E; de Araújo, Verônica Afonso; Marlow, Mariel Asbury; Riley, Lee W; Setúbal, Sérgio; Silva, Licínio Esmeraldo; Araújo Cardoso, Claudete Aparecida

    2014-10-06

    In the past decade methicillin-resistant Staphylococcus aureus (MRSA) has become increasingly prevalent in community settings. Attending a daycare center (DCC) is a known risk factor for colonization with MRSA. Brazil operates free, public DCCs for low-income families, some of which are located in census tracts defined by the Brazilian Census Bureau as informal settlements (aglomerados subnormais, AGSN). Physical and demographic characteristics of AGSNs suggest that S. aureus colonization prevalence would be higher, but little is known about the prevalence of MRSA in these settings. We conducted a cross-sectional study to assess risk factors for S. aureus and MRSA colonization among children attending DCCs located in AGSN vs non-AGSN. Nasal swabs were collected from children aged three months to six years in 23 public DCCs in Niterói, Brazil between August 2011 and October 2012. Of 500 children enrolled in the study, 240 (48%) were colonized with S. aureus and 31 (6.2%) were colonized with MRSA. Children attending DCCs in AGSNs were 2.32 times more likely to be colonized with S. aureus (95% CI: 1.32, 4.08), and 3.27 times more likely to be colonized with MRSA than children attending non-AGSN DCCs (95% CI: 1.52, 7.01), adjusted for confounding variables. S. aureus and MRSA colonization prevalence among children attending DCCs in informal settlement census tracts was higher than previously reported in healthy pre-school children in Latin America. Our data suggest that transmission may occur more frequently in DCCs rather than at home, highlighting the importance of DCCs in AGSNs as potential MRSA reservoirs. This finding underscores the importance of local epidemiologic surveillance in vulnerable AGSN communities.

  20. Genetics and Common Disorders: Implications for Primary Care and Public Health Providers

    Energy Technology Data Exchange (ETDEWEB)

    McInerney, Joseph D.; Greendale, Karen; Peay, Holly L.

    2005-06-01

    We developed this program for primary care providers (PCPs) and public health professionals (PHPs) who are interested in increasing their understanding of the genetics of common chronic diseases and of the implications of genetics and genomics for their fields. The program differs from virtually all previous educational efforts in genetics for health professionals in that it focuses on the genetics of common chronic disease and on the broad principles that emerge when one views disease from the perspectives of variation and individuality, which are at the heart of thinking genetically. The CD-ROM introduces users to content that will improve their understanding of topics such as: • A framework for genetics and common disease; • Basic information on genetics, genomics, genetic medicine, and public health genetics, all in the context of common chronic disease; • The status of research on genetic contributions to specific common diseases, including a review of research methods; • Genetic/environmental interaction as the new “central dogma” of public health genetics; • The importance of taking and analyzing a family history; • The likely impact of potential gene discovery and genetic testing on genetic counseling and risk assessment and on the practices of PCPs and PHPs; • Stratification of populations into low-, moderate-, and high-risk categories; • The potential role of PCPs and PHPs in identifying high-risk individuals and families, in providing limited genetics services, and in referring to clinical genetics specialists; the potential for standard referral algorithms; • Implications of genetic insights for diagnosis and treatment; • Ethical, legal, and social issues that arise from genetic testing for common chronic diseases; and • Specific prevention strategies based on understanding of genetics and genetic/ environmental interactions. The interactive content – developed by experts in genetics, primary care, and public health – is

  1. [Features and developments of Primary Care in a Public Health perspective].

    Science.gov (United States)

    Damiani, Gianfranco; Azzolini, Elena; Silvestrini, Giulia; Ricciardi, Walter

    2014-01-01

    . The second relates to decision-making mechanisms for the delivery of services. Some examples are given of the application of system governance for primary healthcare at the national level and of characteristics of aggregations of professionals and/or structures for PC delivery. Finally, ideas and proposals for the development of an integrated approach for the delivery of Primary Care and prevention services, in a Public Health perspective are presented.

  2. Telemedicine spirometry training and quality assurance program in primary care centers of a public health system.

    Science.gov (United States)

    Marina Malanda, Nuria; López de Santa María, Elena; Gutiérrez, Asunción; Bayón, Juan Carlos; Garcia, Larraitz; Gáldiz, Juan B

    2014-04-01

    Forced spirometry is essential for diagnosing respiratory diseases and is widely used across levels of care. However, several studies have shown that spirometry quality in primary care is not ideal, with risks of misdiagnosis. Our objective was to assess the feasibility and performance of a telemedicine-based training and quality assurance program for forced spirometry in primary care. The two phases included (1) a 9-month pilot study involving 15 centers, in which spirometry tests were assessed by the Basque Office for Health Technology Assessment, and (2) the introduction of the program to all centers in the Public Basque Health Service. Technicians first received 4 h of training, and, subsequently, they sent all tests to the reference laboratory using the program. Quality assessment was performed in accordance with clinical guidelines (A and B, good; C-F, poor). In the first phase, 1,894 spirometry tests were assessed, showing an improvement in quality: acceptable quality tests increased from 57% at the beginning to 78% after 6 months and 83% after 9 months (pspirometry tests were assessed after the inclusion of 36 additional centers, maintaining the positive trend (61%, 87%, and 84% at the same time points; pspirometry tests improved in all centers. (2) The program provides a tool for transferring data that allows monitoring of its quality and training of technicians who perform the tests. (3) This approach is useful for improving spirometry quality in the routine practice of a public health system.

  3. Growth surveillance in the context of the Primary Public Healthcare Service Network in Brazil: literature review

    Directory of Open Access Journals (Sweden)

    Dixis Figueroa Pedraza

    2016-03-01

    Full Text Available Abstract Objectives: to identify and analyze the scientific literature on child growth monitoring in the context of the primary public healthcare service network in Brazil, focusing on the main problems detected in studies. Methods: the review was based on searches ofSciELO, Lilacs and PubMed databases to identify articles published between 2006 and 2014. The articles were categorized according to the analytical categories of structure (items needed to carry out primary activities or work processes (set of activities and procedures used in the management of resources. Results: of the 16 articles included in this review, only six dealt with structure and, in these, thetraining of professionals and availability of protocols were the most frequently identified problems. Processes, addressed in 15 articles, highlighted the underutilization of Child Health Handbook to record growth measurements and the adoption of guidelines on the basis of notes taken. Conclusions: the difficulties found demonstrate the everyday circumstances of the public health service which have a detrimental effect on growth surveillance.

  4. Nutrition status and associated factors among children in public primary schools in Dagoretti, Nairobi, Kenya.

    Science.gov (United States)

    Mwaniki, E W; Makokha, A N

    2013-03-01

    Malnutrition among school-age children is due to inadequacies in one or more of the three main preconditions for good nutrition: food, care and health. Children stunted at school age are likely to have been exposed to poor nutrition since early childhood. Interventions for school age children can supplement efforts to reduce levels of stunting in the preschool years. To assess the nutrition status and associated risk factors of children in selected public primary schools in Dagoretti Division, Nairobi. Descriptive cross sectional design was used. 208 students aged 4-11years of both gender were randomly selected from four public primary schools in Dagoretti Division. Data was collected from school registers and directly questioning the students, parents /guardians. Among the children surveyed, 24.5% were stunted, 14.9% underweight and 9.7% were wasted. There were more boys than girls who were stunted. Breakfast contributed 10.2% of the daily energy intake. Few children consumed foods from more than four food groups. Incidence of diarrhea, colds/coughs increased the risk of stunting and underweight. Consumption of food which is inadequate in required calories and from less than four varieties of food groups by the children were important predictors of malnutrition.

  5. Factors Influencing Academic Performance Of Standard Eight Girls In National Examinations In Public Primary Schools A Case Of Matungu Division.

    OpenAIRE

    Oparanya Wamukoya Windrick; Kisiangani Benson Walela; Okiiya Andrew Sande

    2015-01-01

    ABSTARCT This study is designed to establish the factors influencing academic of standard eight girls in public primary schools in National exams in Matungu division. The researcher aimed at finding out why there is increased low performance of girls in public schools despite the fact that they are assessed through periodic performance tests do continuous assessment tests CATS midterm carry out tuition and the provision of free primary education which is aimed at improving academic performanc...

  6. Prevalence and Determinants of Pre-Hypertension among Omani Adults Attending Non-Communicable Disease Screening Program in Primary Care Setting in Sohar City

    OpenAIRE

    Ali Abdullah Al-Maqbali; Meredith Temple-Smith; John Ferler; Irene Blackberry

    2013-01-01

    Objectives: To estimate the prevalence of pre-hypertension and its association with some selected cardiovascular risk factors among the Omani adult population in the primary healthcare setting.Method: A cross-sectional study involving a sample taken from a National Screening Program of chronic non-communicable diseases in primary healthcare institutions, Sohar city, Sultanate of Oman (July 2006 - December 2007). Inclusion criteria included Omanis aged 40 years or above residents of Sohar city...

  7. Occurrence and impact of negative behaviour, including domestic violence and abuse, in men attending UK primary care health clinics: a cross-sectional survey.

    Science.gov (United States)

    Hester, M; Ferrari, G; Jones, S K; Williamson, E; Bacchus, L J; Peters, T J; Feder, G

    2015-05-19

    To measure the experience and perpetration of negative behaviour, including domestic violence and abuse (DVA), and investigate its associations with health conditions and behaviours in men attending general practice. Cross-sectional questionnaire-based study conducted between September 2010 and June 2011. 16 general practices in the south west of England. Male patients aged 18 or older, attending alone, who could read and write English. A total of 1403 of eligible patients (58%) participated in the survey and 1368 (56%) completed the questions relevant to this paper. 97% of respondents reported they were heterosexual. Lifetime occurrence of negative behaviour consistent with DVA, perceived health impact of negative behaviours, associations with anxiety and depression symptoms, and cannabis use in the past 12 months and binge drinking. 22.7% (95% CI 20.2% to 24.9%) of men reported ever experiencing negative behaviour (feeling frightened, physically hurt, forced sex, ask permission) from a partner. All negative behaviours were associated with a twofold to threefold increased odds of anxiety and depression symptoms in men experiencing or perpetrating negative behaviours or both. 34.9% (95% CI 28.7% to 41.7%) of men who reported experiencing negative behaviour from a partner, and 30.8% (95% CI 23.7% to 37.8%) of men who perpetrated negative behaviours said they had been in a domestically violent or abusive relationship. No associations with problematic drinking were found; there was a weak association with cannabis use. DVA is experienced or perpetrated by a large minority of men presenting to general practice, and these men were more likely to have current symptoms of depression and anxiety. Presentation of anxiety or depression to clinicians may be an indicator of male experience or perpetration of DVA victimisation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  8. Measuring Inviting School Climate: A Case Study of a Public Primary School in an Urban Low Socioeconomic Setting in Kenya

    Science.gov (United States)

    Okaya, Tom Mboya; Horne, Marj; Lamig, Madeleine; Smith, Kenneth H.

    2013-01-01

    The present study utilized the Inviting School Survey-Revised (ISS-R) (Smith, 2005b, 2013) based on Invitational Theory and Practice (Purkey & Novak, 2008) to examine the school climate of a public primary school in a low urban socio-economic setting in Kenya. School climate was defined as the perceptions of primary school teachers and pupils…

  9. Socio-Economic Factors Affecting Parents' Involvement in Homework: Practices and Perceptions from Eight Johannesburg Public Primary Schools

    Science.gov (United States)

    Ndebele, Misheck

    2015-01-01

    This paper examines socio-economic factors influencing parental involvement in homework at the Foundation Phase in eight Johannesburg public primary schools. The research was conducted among over 600 parents from schools in different geographical and socio-economic areas such as the inner city, suburban and township. Two primary schools were…

  10. Investigation of indoor molds and allergic diseases in public primary schools in Edirne city of Turkey.

    Science.gov (United States)

    Celtik, Coskun; Okten, Suzan; Okutan, Ozlem; Aydogdu, Halide; Bostancioglu, Musa; Ekuklu, Galip; Asan, Ahmet; Yazicioglu, Mehtap

    2011-03-01

    Studies evaluating the role of indoor molds in the development of allergic or respiratory symptoms in schools are few in childhood. This study aimed to investigate relation between indoor molds and allergic diseases or respiratory symptoms in primary school's children in Edirne, Turkey. Ten public primary schools were included into the study. A thorough assessment, using a questionnaire and inspection surveys was carried out. The concentration of culturable mold was assessed in the dust samples in the schools. Indoor temperature and humidity were measured. A total of 1374 students who completed valid questionnaires were included in the study, and dust-samples were collected from the schools. Cumulative and current prevalence rates of wheezing, asthma, allergic rhinitis, and atopic dermatitis were found as 31.4%, 9.3%, 16.2%, 6.0% and 13.4%, 11.9%, 15.1%, 2.1%, respectively. The most frequent mold-species detected in indoor dusts were Cladosporium, Penicillium, Alternaria and Aspergillus. Although the prevalence rates of allergic diseases and respiratory symptoms were high, indoor mold amounts were low in the schools in our region and no significant correlation was determined between indoor mold amount and the prevalence of these diseases in schools or classrooms. Even though allergic molds are present in schools, the mold-exposure may not be an important predisposing factor for development of allergic and respiratory diseases the schools in our region.

  11. [Psychosocial stress environment and health workers in public health: Differences between primary and hospital care].

    Science.gov (United States)

    García-Rodríguez, Antonio; Gutiérrez-Bedmar, Mario; Bellón-Saameño, Juan Ángel; Muñoz-Bravo, Carlos; Fernández-Crehuet Navajas, Joaquín

    2015-01-01

    To describe the psychosocial environment of health professionals in public health in primary and hospital care, and compare it with that of the general Spanish working population, as well as to evaluate the effect of psychosocial risk factors on symptoms related to perceived stress. Cross-sectional study with stratified random sampling. Health care workers in the province of Granada, distributed in 5 hospitals and 4 health districts. A total of 738 employees (medical and nursing staff) of the Andalusian Health Service (SAS) were invited to take part. CopSoQ/Istas21 questionnaire developed for the multidimensional analysis of the psychosocial work environment. Stress symptoms were measured with the Stress Profile questionnaire. The response rate was 67.5%. Compared with the Spanish workforce, our sample showed high cognitive, emotional, and sensory psychological demands, possibilities for development and sense of direction in their work. Primary care physicians were the group with a worse psychosocial work environment. All the groups studied showed high levels of stress symptoms. Multivariate analysis showed that variables associated with high levels of stress symptom were younger and with possibilities for social relations, role conflict, and higher emotional demands, and insecurity at work. Our findings support that the psychosocial work environment of health workers differs from that of the Spanish working population, being more unfavorable in general practitioners. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  12. Knowledge, awareness and practice of the importance of hand-washing amongst children attending state run primary schools in rural Malawi.

    Science.gov (United States)

    Grimason, Anthony Martin; Masangwi, Salule Joseph; Morse, Tracy Dawn; Jabu, George Christopher; Beattie, Tara Kate; Taulo, Steven Elias; Lungu, Kingsley

    2014-01-01

    A study was undertaken to determine the efficacy of hygiene practices in 2 primary schools in Malawi. The study determined: (1) presence of Escherichia coli on the hands of 126 primary school pupils, (2) knowledge, awareness and hygiene practices amongst pupils and teachers and (3) the school environment through observation. Pupil appreciation of hygiene issues was reasonable; however, the high percentage presence of E. coli on hands (71%) and the evidence of large-scale open defaecation in school grounds revealed that apparent knowledge was not put into practice. The standard of facilities for sanitation and hygiene did not significantly impact on the level of knowledge or percentage of school children's hands harbouring faecal bacteria. Evidence from pupils and teachers indicated a poor understanding of principles of disease transmission. Latrines and hand-washing facilities constructed were not child friendly. This study identifies a multidisciplinary approach to improve sanitation and hygiene practices within schools.

  13. Does screening for and intervening with multiple health compromising behaviours and mental health disorders amongst young people attending primary care improve health outcomes? A systematic review.

    Science.gov (United States)

    Webb, Marianne J; Kauer, Sylvia D; Ozer, Elizabeth M; Haller, Dagmar M; Sanci, Lena A

    2016-08-04

    Adolescence and young adulthood are important developmental periods. Screening for health compromising behaviours and mental health disorders during routine primary care visits has the potential to assist clinicians to identify areas of concern and provide appropriate interventions. The objective of this systematic review is to investigate whether screening and subsequent interventions for multiple health compromising behaviours and mental health disorders in primary care settings improves the health outcomes of young people. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, literature searches were conducted in Medline, PsycINFO, Scopus and Cochrane Library databases (Prospero registration number CRD42013005828) using search terms representing four thematic concepts: primary care, young people, screening, and mental health and health compromising behaviour. To be eligible for inclusion, studies had to: include a measure of health outcome; include at least 75 % of participants aged under 25 years; use a screening tool that assessed more than one health domain; and be conducted within a primary care setting. Risk of bias was assessed using the Quality Rating Scale. From 5051 articles identified, nine studies fulfilled the inclusion criteria and were reviewed: two randomised controlled trials (RCTs), one pilot RCT, two clustered RCTs, one randomised study with multiple intervention groups and no control group, one cluster RCT with two active arms, one longitudinal study and one pre-post study. Seven studies, including two RCTs and one clustered RCT, found positive changes in substance use, diet, sexual health or risky sexual behaviour, alcohol-related risky behaviour, social stress, stress management, helmet use, sleep and exercise. Of only two studies reporting on harms, one reported a negative health outcome of increased alcohol use. There is some evidence that the use of screening and intervention with young people

  14. School-based primary NCD risk reduction: education and public health perspectives.

    Science.gov (United States)

    Bay, Jacquie L; Hipkins, Rosemary; Siddiqi, Kamran; Huque, Rumana; Dixon, Robyn; Shirley, Debra; Tairea, Karen; Yaqona, Delaney; Mason-Jones, Amanda; Vickers, Mark H

    2017-04-01

    The rising global burden of noncommunicable diseases (NCDs) has heightened awareness of the necessity for primary risk prevention programmes. These aim to facilitate long-term behaviour changes in children and adolescents that can reduce NCD risk factors and disease onset in later-life. School-based programmes designed to improve childhood and adolescent health behaviours and wellbeing contribute to this; however, design and impact assessment of these is complex. These programmes should be multidisciplinary, utilizing both educational and health expertise. Health outcomes may not be evident in the short term, but may occur with learning-related behaviour modifications, highly effective when sustained over a lifetime. Thus assessment must analyse short-term learning and behaviour impacts as well as long-term capability, behaviour and health outcomes.The focus of assessment measures in the health and education sectors differs and often lacks depth in one or other area. Educators generally focus on identifying evidence of learning related to capability, attitude and/or behaviour changes, while public health practitioners typically focus on health measures (e.g. body mass index (BMI), mental health, or risk behaviours).We argue that multidisciplinary approaches incorporating education and health viewpoints clarify issues relating to the potential value of schools as a setting to facilitate primary NCD risk reduction. To demonstrate this, we need to: 1) build stronger understandings of the features of effective learning for behavioural change and the best way to evaluate these, and 2) convincingly correlate these measures with long-term metabolic health indicators by tracking learner behaviour and health over time. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  15. A scoping literature review of collaboration between primary care and public health.

    Science.gov (United States)

    Martin-Misener, Ruth; Valaitis, Ruta; Wong, Sabrina T; Macdonald, Marjorie; Meagher-Stewart, Donna; Kaczorowski, Janusz; O-Mara, Linda; Savage, Rachel; Austin, Patricia

    2012-10-01

    The purpose of this scoping literature review was to determine what is known about: 1) structures and processes required to build successful collaborations between primary care (PC) and public health (PH); 2) outcomes of such collaborations; and 3) markers of their success. Collaboration between PC and PH is believed to enable more effective individual and population services than what might be achieved by either alone. The study followed established methods for a scoping literature review and was guided by a framework that identifies systemic, organizational and interactional determinants for collaboration. The review was restricted to articles published between 1988 and 2008. Published quantitative and qualitative primary studies, evaluation research, systematic and other types of reviews, as well as descriptive accounts without an explicit research design, were included if they addressed either the structures or processes to build collaboration or the outcomes or markers of such collaboration, and were published in English. The combined search strategy yielded 6125 articles of which 114 were included. Systemic-level factors influencing collaboration included: government involvement, policy and fit with local needs; funding and resource factors, power and control issues; and education and training. Lack of a common agenda; knowledge and resource limitations; leadership, management and accountability issues; geographic proximity of partners; and shared protocols, tools and information sharing were influential at the organizational level. Interpersonal factors included having a shared purpose; philosophy and beliefs; clear roles and positive relationships; and effective communication and decision-making strategies. Reported benefits of collaboration included: improved chronic disease management; communicable disease control; and maternal child health. More research is needed to explore the conditions and contexts in which collaboration between PC and PH makes most

  16. Nutrition, mental health and violence: from pregnancy to postpartum Cohort of women attending primary care units in Southern Brazil - ECCAGE study

    Directory of Open Access Journals (Sweden)

    Nunes Maria A

    2010-08-01

    Full Text Available Abstract Background Woman's nutritional status, before and during pregnancy, is a strong determinant of health outcomes in the mother and newborn. Gestational weight gain and postpartum weight retention increases risk of overweight or obesity in the future and they depend on the pregestational nutritional status and on food consumption and eating behavior during pregnancy. Eating behavior during pregnancy may be the cause or consequence of mood changes during pregnancy, especially depression, which increases likelihood of postpartum depression. In Brazil, a study carried out in the immediate postpartum period found that one in three women experienced some type of violence during pregnancy. Violence and depression are strongly associated and both exposures during pregnancy are associated with increased maternal stress and subsequent harm to the infant. The main objectives of this study are: to identify food intake and eating behaviors patterns; to estimate the prevalence of common mental disorders and the experience of violence during and after pregnancy; and to estimate the association between these exposures and infant's health and development. Methods/Design This is a cohort study of 780 pregnant women receiving care in 18 primary care units in two cities in Southern Brazil. Pregnant women were first evaluated between the 16th and 36th week of pregnancy at a prenatal visit. Follow-up included immediate postpartum assessment and around the fifth month postpartum. Information was obtained on sociodemographic characteristics, living circumstances, food intake, eating behaviors, mental health and exposure to violence, and on infant's development and anthropometrics measurements. Discussion This project will bring relevant information for a better understanding of the relationship between exposures during pregnancy and how they might affect child development, which can be useful for a better planning of health actions aiming to enhance available

  17. Organizational scope of practice: assessing the primary care and public health activities of health centers and health departments in Iowa.

    Science.gov (United States)

    Wright, Brad; Ugwi, Patience; Nice, Andrew J

    2015-04-01

    The objective was to understand how Federally Qualified Health Centers (FQHCs) and local health departments (LHDs) address their shared mission of improving population health by determining the scope of primary care and public health activities each provides in their community. A brief mail survey was designed and fielded among executive directors at all 14 FQHCs in Iowa, and 13 LHDs in Iowa representing counties with and without an FQHC. This survey contained a mixture of questions adapted from previously validated primary care and public health survey instruments. Using survey responses, each FQHC and LHD was given 2 scores (each ranging from 0-100) measuring the extent of their primary care and public health activities, respectively. The overall response rate was 85.2%; the response rate was 78.6% within FQHCs and 91.7% within LHDs. Overall, FQHCs had higher scores (73.8%) compared to LHDs (27.3%) on total primary care services, while both LHDs (79.3%) and FQHCs (70.9%) performed particularly well on public health services. FQHCs and LHDs in Iowa address a variety of public health and primary care issues, including but not limited to screening for chronic diseases, nutrition counseling, immunizations, and behavioral health. However, FQHCs provide a higher amount of primary care services and nearly as many public health services when compared to LHDs. In a value-based health care delivery system, integrating to improve population health is a wise strategy to maximize efficiency, but this will require maximizing coordination and minimizing duplication of services across different types of safety net providers.

  18. HIV risk behaviour among public primary healthcare patients with tuberculosis in South Africa

    Directory of Open Access Journals (Sweden)

    Karl Peltzer

    2013-09-01

    Full Text Available Objective. To identify factors associated with HIV in tuberculosis (TB patients in a public primary healthcare (PHC setting in South Africa (SA.Method. Among 4 900 consecutively selected TB patients (54.5% men; women 45.5% from 42 public PHC clinics in 3 districts in SA, a cross-sectional survey was performed to assess new TB and new TB retreatment patients within one month of anti-TB treatment.Results. The sample comprised 76.6% new TB patients and 23.4% TB retreatment patients. Of those who had tested for HIV, 59.9% were HIV-positive; 9.6% had never tested for HIV. In multivariate analysis, older age (odds ratio (OR 5.86; confidence interval (CI 4.07 - 8.44, female gender (OR 0.47; CI 0.37 - 0.59, residing in an informal settlement (OR 1.55; CI 1.13 - 2.12, being a TB retreatment patient (OR 0.55; CI 0.42 - 0.72, occasions of sexual intercourse with condom use (OR 1.07; CI 1.02 - 1.13 and having a sexual partner receiving antiretroviral treatment (ART (OR 7.09, CI 4.35 - 11.57 were associated with an HIV-positive status in TB patients.Conclusion. This study revealed high HIV risk behaviour (e.g. unprotected last sexual intercourse and alcohol and drug use in the context of sexual intercourse among TB patients in SA. Various factors were associated with HIV risk behaviour. Condom use and substance use risk reduction need to be considered as HIV-prevention measures when planning such strategies for TB patients.

  19. Epidemiology of frequent attenders: a 3-year historic cohort study comparing attendance, morbidity and prescriptions of one-year and persistent frequent attenders

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    ter Riet Gerben

    2009-01-01

    Full Text Available Abstract Background General Practitioners spend a disproportionate amount of time on frequent attenders. So far, trials on the effect of interventions on frequent attenders have shown negative results. However, these trials were conducted in short-term frequent attenders. It would be more reasonable to target intervention at persistent frequent attenders. Typical characteristics of persistent frequent attenders, as opposed to 1-year frequent attenders and non-frequent attenders, may generate hypotheses regarding modifiable factors on which new randomized trials may be designed. Methods We used the data of all 28,860 adult patients from 5 primary healthcare centers. Frequent attenders were patients whose attendance rate ranked in the (age and sex adjusted top 10 percent during 1 year (1-year frequent attenders or 3 years (persistent frequent attenders. All other patients on the register over the 3-year period were referred to as non-frequent attenders. The lists of medical problems coded by the GP using the International Classification of Primary Care (ICPC were used to assess morbidity. First, we determined which proportion of 1-year frequent attenders was still a frequent attender during the next two consecutive years and calculated the GPs' workload for these patients. Second, we compared morbidity and number of prescriptions for non-frequent attenders, 1-year frequent attenders and persistent frequent attenders. Results Of all 1-year frequent attenders, 15.4% became a persistent frequent attender equal to 1.6% of all patients. The 1-year frequent attenders (3,045; 10.6% were responsible for 39% of the face-to-face consultations; the 470 patients who would become persistent frequent attenders (1.6% were responsible for 8% of all consultations in 2003. Persistent frequent attenders presented more social problems, more psychiatric problems and medically unexplained physical symptoms, but also more chronic somatic diseases (especially diabetes

  20. A Conceptual Framework for Evaluation of Public Health and Primary Care System Performance in Iran

    Science.gov (United States)

    Jahanmehr, Nader; Rashidian, Arash; Khosravi, Ardeshir; Farzadfar, Farshad; Shariati, Mohammad; Majdzadeh, Reza; Sari, Ali Akbari; Mesdaghinia, Alireza

    2015-01-01

    Introduction: The main objective of this study was to design a conceptual framework, according to the policies and priorities of the ministry of health to evaluate provincial public health and primary care performance and to assess their share in the overall health impacts of the community. Methods: We used several tools and techniques, including system thinking, literature review to identify relevant attributes of health system performance framework and interview with the key stakeholders. The PubMed, Scopus, web of science, Google Scholar and two specialized databases of Persian language literature (IranMedex and SID) were searched using main terms and keywords. Following decision-making and collective agreement among the different stakeholders, 51 core indicators were chosen from among 602 obtained indicators in a four stage process, for monitoring and evaluation of Health Deputies. Results: We proposed a conceptual framework by identifying the performance area for Health Deputies between other determinants of health, as well as introducing a chain of results, for performance, consisting of Input, Process, Output and Outcome indicators. We also proposed 5 dimensions for measuring the performance of Health Deputies, consisting of efficiency, effectiveness, equity, access and improvement of health status. Conclusion: The proposed Conceptual Framework illustrates clearly the Health Deputies success in achieving best results and consequences of health in the country. Having the relative commitment of the ministry of health and Health Deputies at the University of Medical Sciences is essential for full implementation of this framework and providing the annual performance report. PMID:25946937

  1. Teachers' Beliefs and Self-Reported Use of Inquiry in Science Education in Public Primary Schools

    Science.gov (United States)

    Lucero, Maria; Valcke, Martin; Schellens, Tammy

    2013-06-01

    This paper describes Ecuadorian in-service teachers and their science teaching practices in public primary schools. We wanted to find out to what extent teachers implement inquiry activities in science teaching, the level of support they provide, and what type of inquiry they implement. Four questionnaires applied to 173 teachers resulted in the identification of high context beliefs and moderately high self-efficacy beliefs. Teachers declared to implement activities mostly to develop understanding of the material, as contrast to actual manipulation of data and/or coming to conclusions. They adopt rather a strictly guided approach in contrast to giving autonomy to learners to work on their own. Finally, teachers keep control with regard to question formulation and choice in solution procedures, which constrains the development of real inquiry. When comparing teacher beliefs, we found that teachers' context beliefs make a difference in the level of support that teachers provide to their students. Teachers with lower context beliefs ask students to perform inquiry activities on their own to a lesser extent when compared with teachers with higher context beliefs. This implies that further research on the implementation of inquiry in science teaching should take into account teachers' differences in their context beliefs. We also found out that the use of high or low support in inquiry activities remained the same for teachers with either higher or lower self-efficacy beliefs.

  2. A conceptual framework for evaluation of public health and primary care system performance in iran.

    Science.gov (United States)

    Jahanmehr, Nader; Rashidian, Arash; Khosravi, Ardeshir; Farzadfar, Farshad; Shariati, Mohammad; Majdzadeh, Reza; Akbari Sari, Ali; Mesdaghinia, Alireza

    2015-01-26

    The main objective of this study was to design a conceptual framework, according to the policies and priorities of the ministry of health to evaluate provincial public health and primary care performance and to assess their share in the overall health impacts of the community. We used several tools and techniques, including system thinking, literature review to identify relevant attributes of health system performance framework and interview with the key stakeholders. The PubMed, Scopus, web of science, Google Scholar and two specialized databases of Persian language literature (IranMedex and SID) were searched using main terms and keywords. Following decision-making and collective agreement among the different stakeholders, 51 core indicators were chosen from among 602 obtained indicators in a four stage process, for monitoring and evaluation of Health Deputies. We proposed a conceptual framework by identifying the performance area for Health Deputies between other determinants of health, as well as introducing a chain of results, for performance, consisting of Input, Process, Output and Outcome indicators. We also proposed 5 dimensions for measuring the performance of Health Deputies, consisting of efficiency, effectiveness, equity, access and improvement of health status. The proposed Conceptual Framework illustrates clearly the Health Deputies success in achieving best results and consequences of health in the country. Having the relative commitment of the ministry of health and Health Deputies at the University of Medical Sciences is essential for full implementation of this framework and providing the annual performance report.

  3. A Comparative Study of the Influence of Head Teachers Management Styles on Pupils Performance in KCPE in Public and Private Primary Schools in Nakuru Municipality, Kenya

    Science.gov (United States)

    Shibo, Margaret Nekesa

    2016-01-01

    The purpose of this study was to compare the influence of management styles of head teacher's on pupils' performance in private and public primary schools in Nakuru municipality at Kenya Certificate of Primary Education level. The population comprised of teachers and head teachers in public primary schools. The study adopted the ex post facto…

  4. Effect of the Transcendental Meditation Program on Graduation, College Acceptance and Dropout Rates for Students Attending an Urban Public High School

    Science.gov (United States)

    Colbert, Robert D.

    2013-01-01

    High school graduation rates nationally have declined in recent years, despite public and private efforts. The purpose of the current study was to determine whether practice of the Quiet Time/Transcendental Meditation® program at a medium-size urban school results in higher school graduation rates compared to students who do not receive training…

  5. Antibiotic prescribing in public and private practice: a cross-sectional study in primary care clinics in Malaysia.

    Science.gov (United States)

    Ab Rahman, Norazida; Teng, Cheong Lieng; Sivasampu, Sheamini

    2016-05-17

    Antibiotic overuse is driving the emergence of antibiotic resistance worldwide. Good data on prescribing behaviours of healthcare providers are needed to support antimicrobial stewardship initiatives. This study examined the differences in antibiotic prescribing rates of public and private primary care clinics in Malaysia. We used data from the National Medical Care Survey (NMCS), a nationwide cluster sample of Malaysian public and private primary care clinics in 2014. NMCS contained demographic, diagnoses and prescribing from 129 public clinics and 416 private clinics. We identified all encounters who were prescribed antibiotic and analyse the prescribing rate, types of antibiotics, and diagnoses that resulted in antibiotic. Five thousand eight hundred ten encounters were prescribed antibiotics; antibiotic prescribing rate was 21.1 % (public clinics 6.8 %, private clinics 30.8 %). Antibiotic prescribing was higher in private clinics where they contributed almost 87 % of antibiotics prescribed in primary care. Upper respiratory tract infection (URTI) was the most frequent diagnosis in patients receiving antibiotic therapy and accounted for 49.2 % of prescriptions. Of the patients diagnosed with URTI, 46.2 % received antibiotic treatment (public 16.8 %, private 57.7 %). Penicillins, cephalosporins and macrolides were the most commonly prescribed antibiotics and accounted for 30.7, 23.6 and 16.0 % of all antibiotics, respectively. More recently available broad-spectrum antibiotics such as azithromycin and quinolones were more frequently prescribed in private clinics. Antibiotic prescribing rates are high in both public and private primary care settings in Malaysia, especially in the latter. This study provides evidence of excessive and inappropriate antibiotic prescribing for self-limiting conditions. These data highlights the needs for more concerted interventions targeting both prescribers and public. Improvement strategies should focus on reducing

  6. Malaria, Schistosomiasis and Soil Transmitted Helminth Burden and Their Correlation with Anemia in Children Attending Primary Schools in Kinshasa, Democratic Republic of Congo

    Science.gov (United States)

    Matangila, Junior R.; Doua, Joachim Yorokpa; Linsuke, Sylvie; Madinga, Joule; Inocêncio da Luz, Raquel; Van Geertruyden, Jean-Pierre; Lutumba, Pascal

    2014-01-01

    Background Anaemia reduces cognitive potential in school children, retards their growth and predisposes them to other diseases. As there is a paucity of data on the current burden of P. falciparum, S. mansoni and soil transmitted helminths (STH) infections and their correlation with schoolchildren’s anemia in the Democratic Republic of Congo (DRC), we collect these data. Methods This study reports baseline data collected from a randomized controlled trial investigating the impact of IPT with SP and SP-PQ on anemia and malaria morbidity in Congolese schoolchildren (Trial registration: NCT01722539; PACTR201211000449323). S. mansoni and STH infections were assessed using kato-katz technique. Malaria infection and hemoglobin concentration were assessed using Blood smear and Hemocontrol device, respectively. Results A total of 616 primary schoolchildren from 4 to 13 years old were enrolled in the study. The prevalence of Plasmodium spp. infection was 18.5% (95%CI:15.6–21.9). Amongst those infected, 24 (21%), 40 (35.1%), 40 (35.1%), 10 (8.8%), had light, moderate, heavy, very high malaria parasite density, respectively. Above 9 years of age (p = 0.02), male and history of fever (p = 0.04) were both associated with malaria infection. The overall prevalence of S. mansoni infection was 6.4% (95%CI:4.4–9.1). Girls were associated with S. mansoni infection (p = 0.04). T. trichiura was the most prevalent STH infection (26.3%), followed by A. lumbricoides (20.1%). Co-infection with malaria-S. mansoni and malaria-STH was, respectively, 1.5% (CI95%:0.7–3.3) and 6.4% (CI95% 4.4–9.1). The prevalence of anemia was found to be 41.6% (95%CI:37.7–45.6) and anemia was strongly related with Plasmodium ssp infection (aOR:4.1; CI95%:2.6–6.5;panemia in schoolchildren. Therefore, specific school-based interventions, such as intermittent preventive treatment or prophylaxis, LLITN distribution, anthelminthic mass treatment and micronutrient supplementation are needed

  7. Level ofnutrition and nutrition disorders as well as characteristics ofdietary habits and physical activity among 6–13-year-old children attending selected primary schools in Opole and Silesia Provinces in Poland

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    Paweł Jonczyk

    2016-06-01

    Full Text Available Aim of the study: Analysis of nutrition disorders, learning about eating habits and characterising physical activity among primary school children at the age of 6–13, living in the rural areas of Silesia and Opole Provinces in Poland. Material and methods: The study included the parents of children at the age 6–13 attending selected primary schools and living in rural areas of Silesia (Wielowieś, Boruszowice, Wojska, Potępa, Świerklaniec and Opole (Kielcza Provinces. The research group comprised 410 pupils: 217 boys (52.93% and 193 girls (47.07%. On the basis of obtained data, BMI index was calculated and a nutritional level was assessed. Moreover, the statistical analysis of dietary habits and physical activity of studied children was also performed. Results: Nearly 38% of studied children are overweight or obese. Furthermore, 17% are malnourished Every second child has a proper number of meals per day. Above 60% of pupils eat first and second breakfast every day. Merely 3.66% of children eat five or more portions of fruit and vegetables daily. Less than 62% of students declare to drink milk or eat dairy products. Over 83% of the respondents declare that their children eat meat several times a week. Over 28% of children have sweets or salty snacks every day. As for physical activity, about 59% of children prefer spending free time outdoors but approximately 22% of pupils practise sport regularly. Conclusion: This study revealed that students attending primary schools in selected rural areas are characterised by improper dietary habits. Their way of eating is not balanced in a right way – it is mainly based on meat and snacks like sweets. Furthermore, children eat few fruit and vegetables, highfibre products and drink little milk. Behaviours connected with physical activity are also inappropriate – children dedicate too little time to physical activity a week.

  8. How do public child healthcare professionals and primary school teachers identify and handle child abuse cases? A quilitative study

    NARCIS (Netherlands)

    Schols, M.W.A.; Ruiter, C. de; Ory, F.G.

    2013-01-01

    Background Public child healthcare doctors and nurses, and primary school teachers play a pivotal role in the detection and reporting of child abuse, because they encounter almost all children in the population during their daily work. However, they report relatively few cases of suspected child

  9. Impact of Discipline on Academic Performance of Pupils in Public Primary Schools in Muhoroni Sub-County, Kenya

    Science.gov (United States)

    Simba, Nicholas Odoyo; Agak, John Odwar; Kabuka, Eric K.

    2016-01-01

    In Muhoroni Sub-County, Kenya, pupils' academic performance has received little attention in relation to discipline. The objectives of this study were to determine the level of discipline and extent of impact of discipline on academic performance among class eight pupils in the sub-county's public primary schools. The study adopted descriptive…

  10. Accountability Practices in the History of Danish Primary Public Education from the 1660s to the Present

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    Ydesen, Christian; Andreasen, Karen E.

    2014-01-01

    This paper focuses on primary education accountability as a concept and as an organizational practice in the history of Danish public education. Contemporary studies of education policy often address questions of accountability, but the manifestations of school accountability differ significantly between different national settings. Furthermore,…

  11. Factors Influencing the Likelihood of Choice of Gaelic-Medium Primary Education in Scotland: Results from a National Public Survey

    Science.gov (United States)

    O'Hanlon, Fiona; Paterson, Lindsay

    2017-01-01

    This paper investigates the factors influencing the likelihood of choice of Gaelic-medium primary education in Scotland by means of the analysis of a national survey of public attitudes conducted in 2012. Binary logistic regression is used to investigate the association of five dimensions found in previous literature to be associated with the…

  12. The music of trees: the intergenerative tie between primary care and public health.

    Science.gov (United States)

    Whitehouse, Peter

    2016-01-01

    Stories help us frame and understand complex ideas and challenges. Metaphors are particularly powerful linguistic devices that guide and extend our thinking by bridging conceptual domains, for example to consider the brain as a digital computer. Trees are widely used as metaphors for broad concepts like evolution, history, society, and even life itself, i.e. 'the tree of life'. Tree-like diagrams of roots and branches are used to demonstrate historical and cultural relationships, for example, between different species or different languages. In this paper, we describe a theatrical character called a tree doctor which is a living metaphor. A human being, namely the author, lectures, acts or dances as a tree and offers lessons to Homo Sapiens about 'holistic' ideas of health. The character teaches us to not only see the value of our relationships to trees, but the importance of seeing forests as well the individual trees. The metaphorical statement that we should not 'miss the forest for the trees' means we should learn to think of health embedded in systems and communities. In medicine, we too often focus on individual molecules, pharmaceuticals, or even patients and miss the bigger picture of public and environmental health. In a time of great ecological system change, the tree doctor points to broad ethical responsibility for each other and future generations of humans and other living creatures. The character embraces arts and particularly music as a powerful way of infusing purpose and improving the qualities of our lives together, especially as we age. The tree doctor knows the value of intergenerational relationships. But it also points to intergenerative innovations across many cultural domains, disciplines and professions. The tree doctor supports primary care and empowers the value of intergenerational relationships, art and music in the recommendations doctors make to patients to improve their health and well-being.

  13. Relationship between health-related quality of life, perceived family support and unmet health needs in adult patients with multimorbidity attending primary care in Portugal: a multicentre cross-sectional study.

    Science.gov (United States)

    Prazeres, Filipe; Santiago, Luiz

    2016-11-11

    Multimorbidity has a high prevalence in the primary care context and it is frequently associated with worse health-related quality of life (HRQoL). Few studies evaluated the variables that could have a potential effect on HRQoL of primary care patients with multimorbidity. The purpose of this study, the first of its kind ever undertaken in Portugal, is to analyse the relationship between multimorbidity, health-related quality of life, perceived family support and unmet health needs in adult patients attending primary care. Multicentre, cross-sectional survey conducted among primary care patients with multimorbidity. It included 521 participants (64.1 % females) who met the inclusion criteria. HRQoL was evaluated using the Portuguese Short Form-12 Health Status Questionnaire. The Portuguese Family APGAR was used to measure the perceived family support. A patients' unmet health needs questionnaire was used. The unmet needs for medical, surgical and dental care; prescription medications; mental healthcare or counselling; and eyeglasses or other technical aid was assessed. Descriptive and multivariate analyses were performed. The sample had an overall average of 4.5 chronic health problems. Increased multimorbidity levels were linked to worse health-related quality of life, particularly the physical health. Some variables were confirmed as playing a role on health-related quality of life. Male patients with high monthly incomes and highly functional families had better physical and mental health. High levels of education and the presence of asthma were also associated with better physical health. Contrariwise, elderly patients with high levels of multimorbidity and with osteoarthritis had lower physical health. The majority of the patients did not have unmet health needs. When health needs were stated they were mostly for generalist medical care, dental care, and eyeglasses/other technical aid. Financial insufficiency was the primary reason for not fulfilling their

  14. Willingness to attend group visits for hypertension treatment.

    Science.gov (United States)

    Kawasaki, Lumie; Muntner, Paul; Hyre, Amanda D; Hampton, Kashley; DeSalvo, Karen N

    2007-05-01

    To determine the proportion and characteristics of patients willing to attend group medical visits. Cross-sectional survey. A telephone survey was administered to 296 patients with hypertension from an urban public hospital's primary care clinic between October 2004 and August 2005. Most respondents were female (79%) and African American (89%), with a monthly income of $1000 or less (75%) and a mean age of 56 years (age range, 29-81 years). After a brief description of the group medical visit, 68% of respondents indicated they were willing to attend the group visit. After offering 3 incentives (reduced wait to see their physician, more time with their physician, and parking or transportation subsidies), the total percentage of potential willing participants increased to 80%. Persons living with someone, reporting shorter wait times after appointment check-in, and desiring more time with their physician were more likely to be willing to attend group medical visits. Most of the surveyed patients in the study were willing to attend group medical visits. Although the effectiveness and cost savings need further investigation, group medical visits may prove to be a desirable chronic disease care approach for underserved populations.

  15. MRO's HiRISE Education and Public Outreach during the Primary Science Phase

    Science.gov (United States)

    Gulick, V. C.; Davatzes, A. K.; Deardorff, G.; Kanefsky, B.; Conrad, L. B.; HiRISE Team

    2008-12-01

    Looking back over one Mars year, we report on the accomplishments of the HiRISE EPO program during the primary science phase of MRO. A highlight has been our student image suggestion program, conducted in association with NASA Quest as HiRISE Image Challenges (http://quest.arc.nasa.gov/challenges/hirise/). During challenges, students, either individually or as part of a collaborative classroom or group, learn about Mars through our webcasts, web chats and our educational material. They use HiWeb, HiRISE's image suggestion facility, to submit image suggestions and include a short rationale for why their target is scientifically interesting. The HiRISE team gives priority to obtaining a sampling of these suggestions as quickly as possible so that the acquired images can be examined by the students. During the challenge, a special password-protected web site allows participants to view their returned images before they are released to the public (http://marsoweb.nas.nasa.gov/hirise/quest/). Students are encouraged to write captions for the returned images. Finished captions are then posted and highlighted on the HiRISE web site (http://hirise.lpl.arizona.edu) along with their class, teacher's name and the name of their school. Through these HiRISE challenges, students and teachers become virtual science team members, participating in the same process (selecting and justifying targets, analyzing and writing captions for acquired images), and using the same software tools as the HiRISE team. Such an experience is unique among planetary exploration EPO programs. To date, we have completed three HiRISE challenges and a fourth is currently ongoing. More than 200 image suggestions were submitted during the previous challenges and over 85 of these image requests have been acquired so far. Over 675 participants from 45 states and 42 countries have registered for the previous challenges. These participants represent over 8000 students in grades 2 through 14 and consist

  16. Integration of public health and primary care: A systematic review of the current literature in primary care physician mediated childhood obesity interventions.

    Science.gov (United States)

    Bhuyan, Soumitra S; Chandak, Aastha; Smith, Patti; Carlton, Erik L; Duncan, Kenric; Gentry, Daniel

    2015-01-01

    Childhood obesity, with its growing prevalence, detrimental effects on population health and economic burden, is an important public health issue in the United States and worldwide. There is need for expansion of the role of primary care physicians in obesity interventions. The primary aim of this review is to explore primary care physician (PCP) mediated interventions targeting childhood obesity and assess the roles played by physicians in the interventions. A systematic review of the literature published between January 2007 and October 2014 was conducted using a combination of keywords like "childhood obesity", "paediatric obesity", "childhood overweight", "paediatric overweight", "primary care physician", "primary care settings", "healthcare teams", and "community resources" from MEDLINE and CINAHL during November 2014. Author name(s), publication year, sample size, patient's age, study and follow-up duration, intervention components, role of PCP, members of the healthcare team, and outcomes were extracted for this review. Nine studies were included in the review. PCP-mediated interventions were composed of behavioural, education and technological interventions or a combination of these. Most interventions led to positive changes in Body Mass Index (BMI), healthier lifestyles and increased satisfaction among parents. PCPs participated in screening and diagnosing, making referrals for intervention, providing nutrition counselling, and promoting physical activity. PCPs, Dietitians and nurses were often part of the healthcare team. PCP-mediated interventions have the potential to effectively curb childhood obesity. However, there is a further need for training of PCPs, and explain new types of interventions such as the use of technology. Copyright © 2015 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

  17. A support programme for primary care leads to substantial improvements in the effectiveness of a public hepatitis C campaign.

    Science.gov (United States)

    Helsper, Charles W; van Essen, Gerrit A; Bonten, Marc J M; de Wit, Niek J

    2010-06-01

    Because of its lack of clinical signs, the detection of hepatitis C virus (HCV) infection in the Netherlands remains suboptimal. Therefore, the Dutch Health Council proposed an HCV campaign aimed to inform the general public and motivate people at risk to seek medical advice. Because knowledge and awareness of HCV infection is low among primary care workers, the implementation of a support programme for primary care complementary to a HCV campaign seems appropriate. To evaluate the added value of a support programme for primary care complementary to a public HCV campaign. We performed a non-randomized controlled intervention study. In two similar regions, a public HCV campaign was organized. In the intervention region, an additional support for primary care was provided by means of brochures, short courses and informative visits. In the intervention region, the proportional increase in anti-HCV tests was 3.02 (57-172 tests). In the control region, this increase was 1.36 (86-118 tests). In the intervention region, the increase in positive anti-HCV tests was 1.7% (95% confidence interval (CI): -0.2% to -3.7%). In the control region, this number decreased by 0.9% (95% CI: -4.1% to 2.3%). The addition of primary care practice support leads to considerable improvements in medical consciousness regarding HCV infection in primary care. Even though the positive effect on case finding cannot be indisputably demonstrated due to low prevalence, our results indicate such a positive effect. Therefore, future campaigns aimed at hepatitis C should invariably implement additional support for primary care to improve diagnostic uptake and optimize case finding.

  18. Assessing the Knowledge, Attitudes, and Practices on Antibiotics Among the General Public Attending the Outpatient Pharmacy Units of Hospitals in Bhutan: A Cross-Sectional Survey.

    Science.gov (United States)

    Tshokey, Tshokey; Adhikari, Deepika; Tshering, Thupten; Wangmo, Sangay; Wangdi, Kinley

    2017-10-01

    We assessed the level of knowledge, attitudes, and practices on antibiotics through a questionnaire-based cross-sectional survey among the general public in Bhutan. Of the 692 participants, 52.6% (364) were females with a mean age of 34.2 years. More than half of the respondents showed unsatisfactory knowledge varying significantly from 23.1% to 69.6%. Cotrimoxazole (septran) was the least known while amoxicillin was the most known antibiotics assessed. Two-thirds of the responsents (267) knew that inappropriate use of antibiotics could lead to antimicrobial resistance and 89% (319) were aware of the need to complete the antibiotic courses. In bivariate analysis, satisfactory knowledge was associated with the education level of graduate and higher as compared with no education. This study revealed unsatisfactory knowledge and attitude but satisfactory practices on antibiotics use among participants. Efforts are needed to improve public awareness on antibiotics. Enforcement of regulations on sale of antibiotics over the counter needs a revamp.

  19. Do Alcohol Misuse, Service Utilisation, and Demographic Characteristics Differ between UK Veterans and Members of the General Public Attending an NHS General Hospital?

    Directory of Open Access Journals (Sweden)

    Dominic Murphy

    2016-11-01

    Full Text Available The aim of this paper was to provide insights into alcohol misuse within UK veterans to inform as to whether their presentations differ from the general public. This was done by exploring differences in the severity of alcohol misuse between UK veterans and the general public admitted to a general NHS hospital over an 18 month period using retrospective data. All patients admitted to the hospital were screened for alcohol misuse. Those deemed as experiencing problems were referred for specialist nurse-led support. A total of 2331 individuals were referred for this supported and administered with a standardised assessment that included measures of the severity of alcohol difficulties (AUDIT, dependency levels (LDQ, and assessed for the presence of withdrawal symptoms (CIWA-Ar. In addition, information was collected on service utilisation, referral category (medical or mental health, other substance misuse, and demographic characteristics. No differences were found between the severity of reported alcohol difficulties between veterans and non-veterans. Evidence was found to suggest that veterans were more likely to be referred for support with alcohol difficulties at an older age and to be admitted to hospital for longer periods of time. This could have considerable cost implications for the NHS. It was more common for veterans to present at hospital with physical health difficulties prior to being referred for support for alcohol.

  20. Opportunities in the integration of primary care and public health nursing: Two case exemplars on physical activity and nutrition.

    Science.gov (United States)

    Evans-Agnew, Robin A; Mayer, Kala A; Miller, Lori L L

    2018-01-01

    The integration of primary care and public health nursing may provide new opportunities for transforming nursing practice that addresses population health. Effective programs emphasize multilevel approaches that include both downstream (education) and upstream (policy change) actions. The purpose of this article is to identify downstream and upstream nursing actions that integrate public health and primary care practice through two case exemplars concerning disparities in physical activity and nutrition. Describe two research case exemplars: (1) a secondary analysis of school physical activity policy for female adolescents in 36 public middle schools and (2) a focus group study of African American adults in a community kitchen program. In exemplar 1, school policies lacked population-based standards and presented structural disadvantages to African American girls who were already obese. In exemplar 2, participants found the community kitchen program to be more effective than the federally funded nutrition program. Integrating primary care and public health nursing could improve the tailoring of physical activity and nutrition programs to local populations by following core principles of community engagement, infrastructural sustainability, aligned leadership, and data sharing for population health improvement. © 2017 Wiley Periodicals, Inc.

  1. Obstetric fistula management and predictors of successful closure among women attending a public tertiary hospital in Rwanda: a retrospective review of records.

    Science.gov (United States)

    Egziabher, Tekle G; Eugene, Ngoga; Ben, Karenzi; Fredrick, Kateera

    2015-12-12

    Globally, 50,000-100,000 women develop obstetric fistula annually. At least 33,000 of these women live in Sub-Saharan Africa where limitations in quality obstetric care and fistula corrective repairs are prevalent. Among women with fistula seeking care at public health facilities in resource-limited settings, there is paucity of data on quality of care received. The aim of this study was to characterize obstetric fistula among Rwandan women managed at a public tertiary hospital and evaluate for predictors of successful fistula closures. A retrospective review of records for all obstetric fistula women managed at a public referral health facility between 2007 and 2013 was performed. Patient socio-demographics, obstetric characteristics and fistula repair outcomes data were reviewed. A multivariate logistic regression model was used to analyse for predictors of successful fistula repair outcomes. A total of 272 women aged between 16 to 78 years and with a mean age of 34.6 years were included. Of these, 93 (34.2 %), 48 (17.6 %), 65 (24 %) and 64 (23 %) women had vesico-vaginal fistula, recto-vaginal fistula, urethro-vaginal fistula and vesico-uteral fistula types, respectively. Successful fistula closure was achieved among 86.3 %. Women with fistula who reported being in labour for ≥3 days, having ≥1 previous fistula repair attempt, and having lived with the fistula for >1 year, had significantly lower odds of successful repair outcomes. Among 272 women with obstetric fistula managed in this study, 69.5 and 26.5 % of their fistula were causally associated with obstructed labour complications and iatrogenic factors, respectively. Successful fistula closure rates of about 89 % among women of index repair attempt were achieved. Conversely, reported histories of ≥3 days in labour, ≥1 previous failed attempts at repair and a fistula duration of >1 year, were significant determinants of failed fistula closures. To effectively mitigate obstetric fistula burden in

  2. Conjoint alcohol and tobacco use among tuberculosis patients in public primary healthcare in South Africa

    Directory of Open Access Journals (Sweden)

    Karl Peltzer

    2014-04-01

    Full Text Available Objective. To determine the prevalence of, and factors associated with conjoint alcohol and tobacco use among tuberculosis (TB patients in South Africa (SA. Methods. In a cross-sectional survey, 4 900 (54.5% men, 45.5% women consecutively selected TB patients (including new TB and new TB retreatment patients from 42 public primary care clinics in three districts in SA were assessed using various measures (including those for alcohol and tobacco use, within one month of anti-TB treatment. Results. Overall, 10.1% (15.5% among men; 3.4% among women were conjointly hazardous, harmful or dependent alcohol users and daily or almost-daily tobacco users. The proportion of daily or almost-daily tobacco users among hazardous, harmful or dependent alcohol users was 48.9%, (53.3% among men; 26.4% among women. Those with hazardous, harmful or dependent alcohol use had significantly higher odds of having anxiety and/or depression (odds ratio (OR 1.37; confidence interval (CI 1.13 - 1.65 and exhibiting daily or almost-daily tobacco use (OR 5.94; CI 4.33 - 5.87. The mean ± standard deviation alcohol use disorders identification test (AUDIT score among conjoint hazardous, harmful or dependent alcohol users and daily or almost-daily tobacco users was significantly higher (17.1±6.1 than among hazardous, harmful or dependent alcohol users who were not current tobacco users (15.4±5.6 (p<0.001. In multivariate analysis, male gender, coloured ethnicity, lower education and greater poverty, TB retreatment patient status and non-adherence to anti-TB medication were associated with a greater risk for conjoint alcohol and tobacco use. Conclusions. A high prevalence and several risk factors for conjoint alcohol and tobacco use were found among TB patients. The findings of this study call for dual-intervention approaches to alcohol and tobacco use.

  3. Overexpression of MMP-3 and uPA with Diminished PAI-1 Related to Metastasis in Ductal Breast Cancer Patients Attending a Public Hospital in Mexico City

    Directory of Open Access Journals (Sweden)

    Luis Miguel Barajas-Castañeda

    2016-01-01

    Full Text Available Extracellular matrix metalloproteases and the fibrinolytic system are important protease systems interacting with each other in charge of remodeling and recycling of tissues. Their role in tumor invasion and metastasis is often discussed. In this study several metalloproteases such as MMP-1, MMP-3, MMP-9, and TIMP-1 together with molecules from the fibrinolytic system like uPA, its receptor uPAR, and its inhibitor, PAI-1, were studied by immune-histochemistry to establish a comparison with and without metastasis. From the (118 primary tumors of Mexican patients with ductal breast cancer studied, 56% were grade II and 69% were size T2; the group with metastatic ganglia included 64 samples (54.3%. In patients with metastasis the estimated expression of MMP-3 and uPA (resp., 28% and 45% was higher than that from no metastatic tumors; it means there is higher expression of both markers in metastatic tumors (p<0.05. At the same time, metastatic tumors showed statistically significant lower signal of PAI-1 (24% than tumors without metastasis (p<0.05. We concluded that overexpression of MMP-3 and uPA, altogether with diminished expression of PAI-1 from metastatic tumors, might be a crucial step towards metastasis in ductal breast cancer. Nevertheless, additional studies in different populations are necessary to establish a pattern.

  4. Adherence to recommended lifestyle modifications and factors associated for hypertensive patients attending chronic follow-up units of selected public hospitals in Addis Ababa, Ethiopia

    Directory of Open Access Journals (Sweden)

    Tibebu A

    2017-02-01

    Full Text Available Abel Tibebu,1 Daniel Mengistu,2 Lemma Negesa1 1School of Nursing and Midwifery, Haramaya University College of Health and Medical Sciences, Harar, 2School of Nursing and Midwifery, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia Introduction: One of the most prevalent noncommunicable diseases is hypertension (HTN. The availability of effective antihypertensive medications does not result in the expected outcomes in terms of controlling blood pressure. The rationale for these and other findings of uncontrolled HTN points toward poor adherence. The most neglected causes of uncontrolled HTN are unhealthy lifestyles. Few studies have been conducted to show the gap and magnitude of self-management adherence.Objective: This study aimed to assess adherence to recommended lifestyle modifications of hypertensive patients undergoing follow-up at chronic follow-up units of public health hospitals in Addis Ababa, Ethiopia, 2016.Methods: Institutional-based cross-sectional study was conducted in four public health hospitals which were selected by drawing lots. Systematic random sampling was used to select study subjects. The results of the descriptive statistics were expressed as percentages and frequencies. Associations between lifestyle modification and independent variables were analyzed using bivariate and multivariate logistic regression analysis. The study was conducted from February 15, 2016 to April 15, 2016.Results: The study included 404 respondents with a 97% response rate; 210 (52% were male and the mean age was 54.00±10.77 years. The respondents’ adherence to lifestyle modifications was 23%. The lifestyle adherence was found to be better in females, patients who had comorbidities, and had been knowledgeable about the disease and was poor among young adult respondents.Conclusion: The rates of adherence to lifestyle changes were generally found to be low. Educational sessions that especially focus on lifestyle

  5. Quality of life in individuals living with HIV/AIDS attending a public sector antiretroviral service in Cape Town, South Africa.

    Science.gov (United States)

    Nglazi, Mweete D; West, Sacha J; Dave, Joel A; Levitt, Naomi S; Lambert, Estelle V

    2014-07-03

    Health related quality of life (HRQoL) is an important outcome helping to understand the impact of antiretroviral therapy (ART). We examined and compared the HRQoL in relation to ART status among HIV-infected patients in a public sector service in Cape Town, South Africa. In addition, we aimed to examine the relationship between ART status and HRQoL according to CD4 count strata. A cross sectional study sample of 903 HIV-infected patients who were categorized as not receiving ART (ART-naïve) or receiving first-line ART for > 6 months (ART). HRQoL outcomes were compared in the two groups. HRQoL was assessed using the EQ-5D (five domains) and Visual Analogue Scale (EQ-5D VAS). Of the total sample, 435 were categorised as ART naïve (76% women) and 468 were on ART (78% women). There were no significant associations between groups for most of the EQ-5D domains, however ART-naïve experienced a significantly greater problem with mobility than the ART group. Being ART-naïve (adjusted odds ratio (aOR) 3.08 95% confidence interval (CI) 1.63- 7.89) and obese 2.78 (95% CI 1.24- 6.22) were identified as predictors for increased mobility problems in multivariate analysis. In addition, receiving ART (5.61 difference; 95% CI 2.50 - 8.72) and having some source of income (4.76; 95% CI 1.63 -7.89) were identified as predictors for a higher EQ-5D VAS score. When grouped according to CD4 count strata, there were no significant difference between groups for most of the EQ-5D domains, however the ART-naïve group indicated having significantly greater problems under the CD4 count of >500 cells/μL in the anxiety/depression domain (22.4% vs 8.8%, p = 0.018) and significantly lower EQ-5D VAS scores under the CD4 counts of ≤ 200 cells/μL (median 80 (IQR 60-90) vs 90 (IQR 80-100), p = 0.0003) and 201-350 cells/μL (median 80 (IQR 70-90) vs 90 (80-100), p = 0.0004) compared to ART group. HRQoL (self-rated health state) was improved with ART use, including those with immunocompromised

  6. Prevalence of indeterminate human immunodeficiency virus western blot results in pregnant women attended at a public hospital in Presidente Prudente, Brazil.

    Science.gov (United States)

    Cremonezi, Denise; Mesquita, Paulo Eduardo de; Romão, Marisa Menezes; Prestes-Carneiro, Luiz Euribel

    2005-12-01

    The AIDS epidemic is spreading rapidly among women worldwide, offering increasing opportunities for vertical transmission of HIV. In Brazil, the prevalence of HIV infection among pregnant women is less than 1%. Therefore, the positive predictive value of an HIV EIA test tends to be lower than the more frequent indeterminate Western blot result. Pregnant women receiving antenatal care, from 2000 to 2004, at a public secondary hospital in the city of Presidente Prudente, São Paulo, Brazil, were systematically screened for HIV by means of two distinct EIA tests, in order to determine the prevalence of indeterminate Western blot results among pregnant women showing discordance in both HIV EIA tests and indirect immunofluorescence assay. Confirmatory indirect immunofluorescence was performed on material for all women with positive results in both EIA tests. Whenever there were positive results in EIA and IIA, the applicant was retested by the initial screening assay. Only those not showing concordance in results in EIA and IAA had a Western blot performed. The viral load was measured in pregnant women with positive or indeterminate Western blot results. Out of 9,786 sera, 105 (1.0%) were positive in the two HIV EIA screening tests, confirmed by indirect immunofluorescence. Among these women, Western blot was interpreted as indeterminate in 11 (0.1%) cases and their viral load was HIV indeterminate Western blots in pregnant women from Presidente Prudente and the surrounding region; none of these pregnant women had positive HIV viral loads.

  7. Longevity of 2- and 3-surface restorations in posterior teeth of 25- to 30-year-olds attending Public Dental Service-A 13-year observation.

    Science.gov (United States)

    Palotie, Ulla; Eronen, Anna K; Vehkalahti, Kimmo; Vehkalahti, Miira M

    2017-07-01

    The aim of this patient document-based retrospective study among 25- to 30-year-old Finnish adults was to evaluate longevity of 2- and 3-surface posterior restorations according to type of tooth, size of restoration, and restorative material used. Data were extracted from electronic patient files of the Helsinki City Public Dental Service (PDS), Finland. A total of 5542 2- and 3-surface posterior composite and amalgam restorations were followed indirectly from 2002 to 2015. Longevity of restorations was illustrated using Kaplan-Meier curves. Annual failure rates (AFRs) of the restorations were calculated separately by type of tooth, size, and material. Differences in longevity were statistically tested with log-rank tests. Composite restorations formed the majority (93%). The longest median survival times and the smallest failure rates were found for teeth in the upper jaw, for premolars, and for 2-surface restorations. Median survival time of all restorations was 9.9 years (95% CI 9.6, 10.2) and re-intervention of restorations occurred less often in the maxilla (AFR 4.0%) than in the mandible (AFR 4.7%). Median survival time of composite restorations was greater for 2-surface than for 3-surface restorations: in premolars 12.3 vs. 9.6 years (pmaterial choices for posterior multisurface restorations, composite and amalgam perform quite similarly in molars, 3-surface restoration being challenge for both materials. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Sexual practices of HIV-positive individuals attending antiretroviral treatment (ART) in Addis Ababa public hospitals: findings from in-depth interview.

    Science.gov (United States)

    Dessie, Yadeta; Deresa, Merga

    2012-01-01

    The rollout of Antiretroviral Treatment (ART) and improved health care services contributed in recuperating the quality of life and the functional status of HIV-positive people. These clinical effects of the treatment and cares are believed to bring a change on their sexual practices. The objective of this study was to explore the sexual practices of the HIV-positive people who were getting ART in selected Addis Ababa public hospitals. A qualitative in-depth interview was conducted. The interviews were made by trained nurse counselors of the same sex and were tape recorded. Verbatim transcription was made before the analysis. Thematic categorizations were made to present the findings. Most participants expressed regained sexual desires with initiation of ART while some others didn't appreciate the regains. Not using condoms or inconsistently using them was identified risky sexual practices. Sero-discordances and sero-status non-disclosure were common issues among the partners. Sero-status non-disclosure, non-use of condom and inconsistent using them were common sexual issues. These hinder the efforts that are being made to reduce new HIV infections and re-infections. Interventions against these problems can be made when clients come for their ART treatment and clinical care follow up.

  9. Assessment of urinary infection management during prenatal care in pregnant women attending public health care units in the city of Rio de Janeiro, Brazil.

    Science.gov (United States)

    Vettore, Marcelo Vianna; Dias, Marcos; Vettore, Mario Vianna; Leal, Maria do Carmo

    2013-06-01

    The aim of this study was to assess the sociodemographic risk factors for urinary tract infection and the inadequacy of antenatal care, according to the Kotelchuck index, in pregnant women in the city of Rio de Janeiro. A cross-sectional study was conducted with 1,091 pregnant women, 501 with urinary tract infection, in the public health antenatal care units in Rio de Janeiro, Brazil, in 2007-2008. Demographic and socioeconomic data, obstetric history and adequacy of antenatal care were collected by interviews and antenatal care card. Inadequacy management of urinary tract infection was evaluated by professional performance, health services and women dimensions. Chi-square and multivariate logistic regression were used to compare groups and to identify associated factors with management of urinary tract infection. Pregnant teenagers, anemic and diabetic pregnant women and quality of prenatal partially adequate or inadequate were those with higher odds of urinary tract infection. In the overall assessment, 72% had inadequate management of urinary tract infection. Inadequate management of urinary tract infection was associated with brown skin color compared to white skin color. In the assessment of health professional performance, inadequacy management of urinary tract infection was more common in pregnant women with low weight and overweight and obesity. According to pregnant women evaluation, primiparous women have lower odds of inadequacy management of urinary tract infection compared to those with one or more children.

  10. Adherence to prescribed antihypertensive medications and associated factors for hypertensive patients attending chronic follow-up units of selected public hospitals in Addis Ababa, Ethiopia.

    Science.gov (United States)

    Tibebu, Abel; Mengistu, Daniel; Bulto, Lemma Negesa

    2017-01-01

    The study was aimed at assessing adherence to prescribed antihypertensive medications and its associated factors. Institutional-based cross-sectional study was conducted in four public hospitals which were selected by lottery method. Systematic random sampling was used to select the study subjects. Data were checked, cleaned, and entered into Epidata software version 3.1 and were imported to SPSS version 21 software for analysis. The results of the descriptive statistics were expressed as percentages and frequencies. Associations between independent variables and dependent variable were analyzed using bivariate and multivariate analysis. The study was conducted from February 15 to April 15, 2016. The study included 404 respondents with 97% response rate. 210 (52%) were male and mean age was 54 ± 10.77 years. The respondents' adherence to antihypertensive medications was 66.8%. The medication-related adherences were found to be better in females, patients who had comorbidities and have been knowledgeable about the disease and was poor among young adult respondents. This study found out a 66.8% adherence to prescribed antihypertensive medications. This figures show that medication adherence (MA) rates are low. The factors impeding or enhancing the outcome variable was thoroughly analyzed. Sex, age, number of types of medications, and knowledge were associated with MA. Educational sessions that especially focus on MA and ongoing support for patients should be designed. Studies which assess all the components of self-management should be conducted for comparison among different subgroups.

  11. Comparison of direct fluorescent antibody, acridine orange, wet mount, and culture for detection of Trichomonas vaginalis in women attending a public sexually transmitted diseases clinic.

    Science.gov (United States)

    Bickley, L S; Krisher, K K; Punsalang, A; Trupei, M A; Reichman, R C; Menegus, M A

    1989-01-01

    To define the performance characteristics of two newer tests for Trichomonas vaginalis (TV), the authors compared direct fluorescent antibody (DFA) (mixed monoclonal antibody, Integrated Diagnostics, Inc, Berkeley, CA) and acridine orange (AO) tests to standard wet mount (WM) preparations and culture (modified Diamond medium) of vaginal wash specimens in consecutively examined women presenting to a public sexually transmitted diseases (STD) clinic. Cultures for Neisseria gonorrhoeae (GC), Chlamydia trachomatis (CT), and yeast were also performed on all patients. Of 104 women, 59 (57%) were infected with one or more pathogens. Trichomonas vaginalis was detected by WM and/or culture in 38 (37%) women and was the most prevalent infection. Of the 38 patients with TV, 95% were detected by culture, 83% by DFA, 66% by AO, and 66% by WM. An additional patient was DFA positive but negative for TV by all other methods. The sensitivity of DFA was superior to AO and WM in women with TV infection alone (96% compared to 67% and 53%, respectively). It was comparable to AO and WM in women with multiple infections (67% compared to 53% and 73%). Even in the presence of other pathogens, DFA appears to be a reasonable alternative to culture for detection of TV. In addition, DFA is rapid, easy to perform, and relatively inexpensive.

  12. Prevalence of indeterminate human immunodeficiency virus western blot results in pregnant women attended at a public hospital in Presidente Prudente, Brazil

    Directory of Open Access Journals (Sweden)

    Denise Cremonezi

    Full Text Available The AIDS epidemic is spreading rapidly among women worldwide, offering increasing opportunities for vertical transmission of HIV. In Brazil, the prevalence of HIV infection among pregnant women is less than 1%. Therefore, the positive predictive value of an HIV EIA test tends to be lower than the more frequent indeterminate Western blot result. Pregnant women receiving antenatal care, from 2000 to 2004, at a public secondary hospital in the city of Presidente Prudente, São Paulo, Brazil, were systematically screened for HIV by means of two distinct EIA tests, in order to determine the prevalence of indeterminate Western blot results among pregnant women showing discordance in both HIV EIA tests and indirect immunofluorescence assay. Confirmatory indirect immunofluorescence was performed on material for all women with positive results in both EIA tests. Whenever there were positive results in EIA and IIA, the applicant was retested by the initial screening assay. Only those not showing concordance in results in EIA and IAA had a Western blot performed. The viral load was measured in pregnant women with positive or indeterminate Western blot results. Out of 9,786 sera, 105 (1.0% were positive in the two HIV EIA screening tests, confirmed by indirect immunofluorescence. Among these women, Western blot was interpreted as indeterminate in 11 (0.1% cases and their viral load was <50 copies/mL. We found a prevalence of 0.1% HIV indeterminate Western blots in pregnant women from Presidente Prudente and the surrounding region; none of these pregnant women had positive HIV viral loads.

  13. The efect of the financial crisis on Croatia ’s primary budget deficit and public debt

    Directory of Open Access Journals (Sweden)

    Petar Sopek

    2009-09-01

    Full Text Available movements and sustainability of the public debt in the period up to 2013. It is shown that changes in the public debt come from the effect of the primary deficit created, stockflow adjustment, the real growth of the GDP and real interest rates. On the basis of results of the European Communities (2009 a statistical estimate is given of the trends in the primary deficit for EU-12, after which the model is adjusted to Croatian figures. The projection of stock-flow adjustment is undertaken from a projection of the primary deficit, due to the relatively strong negative correlation between those two variables in the past, whilst the projection of the real growth rate of the GDP and real interest rates is significantly simplified. The main hypothesis tested is that the ratio of the public debt in the GDP up to 2013 does not exceed the margin of sustainability prescribed in the Maastricht criterion of 60%, which is finally confirmed by this analysis.

  14. Public Funding and Budgetary Challenges To Providing Universal Access To Primary Education in Sub-Saharan Africa

    Science.gov (United States)

    Omwami, Edith Mukudi; Keller, Edmond J.

    2010-02-01

    Budgetary capacity that would allow for the public funding of the provision of universal access to primary education is lacking in many sub-Saharan economies. National revenues significantly lag behind the overall economic productivity measure of GDP. Analysis of data derived from UNESCO and UNDP for 2004 shows that governments in the region spend far less in US dollars per unit cost on primary education than do developed countries. Increasing the unit cost of education in order to enable a government to guarantee universal primary education would take away resources from other tiers of the education system in many countries in the region. The alternative is to universalise access, despite existing budget allocation constraints, and thereby further compound the problems of poor infrastructure and limited human resource capacity that continue to compromise education quality in sub-Saharan Africa.

  15. Improving the public health/primary care partnership: a perspective from NHS Hounslow

    OpenAIRE

    Saeed, Maha

    2012-01-01

    It is still not clear how the public health workforce will work with future clinical commissioning groups. Is it enough we are told that ‘Public Health England will ‘ensure appropriate population advice is available to the NHS’? Should we wait until we are invited? Should we wait until we are told what to do? The public health workforce should aspire to be central to population health, from prevention to care pathways through to establishing outcomes and evaluation measures, and to exert infl...

  16. Wolf homesite attendance patterns

    National Research Council Canada - National Science Library

    Potvin, Marcel J; Peterson, Rolf O; Vucetich, John A

    2004-01-01

    .... Pack size, number of pups, and prey density varied during the period of monitoring. Given the effect of prey density on wolf behavior, we predicted that wolf homesite attendance patterns would vary with prey density...

  17. [Work features of the psychologist in the primary health care centers of the public health care system in Chile].

    Science.gov (United States)

    Scharager Goldenberg, Judith; Molina Aguayo, María Loreto

    2007-09-01

    To define work characteristics of psychologists in public primary health care centers in Chile and the degree to which their functions conform to the standards set by the National Plan on Mental Health and Psychiatry (NPMHP). From December 2003 to November 2004, a cross-sectional, descriptive study was conducted employing a questionnaire sent to a nonrandom sample of 486 professionals working in public primary care centers of Chile's 29 health districts. The total response rate was 34.4% (167 completed questionnaires). The questionnaire gathered general information and demographics; frequency, distribution, and type of activities performed; the mental health issues treated; personal perspectives on the efficiency of care, factors affecting interventions, and the quality of work conditions; and competence level regarding diagnosis and treatment strategies, as well as the educational background needed to fulfill the role of psychologist at the primary health care centers. Descriptive statistics with 95% confidence intervals were calculated for the quantitative data. Content analysis techniques were applied to the responses to open-ended questions. Considerably more time is being devoted to individual consultations and interventions than to group and community promotion and prevention activities. Over 93% of the survey participants were satisfied with their work and valued their peers; however, more than half gave a negative rating to their work conditions and job security. The majority indicated that preparation for the role must include coursework on the health system, specifically the primary health care setting, and topics such as clinical and group psychology, public health policy, and primary health care management and specifics. Most critical to the work were a knowledge of diagnostic tools and classification systems, i.e., the International Classification of Diseases and the Diagnostic and Statistical Manual of Mental Disorders. Contrary to NPMHP

  18. Do Poverty Dynamics Explain the Shift to an Informal Private Schooling System in the Wake of Free Public Primary Education in Nairobi Slums?

    Science.gov (United States)

    Oketch, Moses; Mutisya, Maurice; Sagwe, Jackline

    2012-01-01

    With the introduction of free primary education (FPE) in Kenya in 2003, it was expected that the burden on poor households in financing primary education would be reduced substantially. This in turn would increase enrolment in public schools and lead to universal primary education. However, studies have shown that a considerable proportion of…

  19. Primary care-led commissioning and public involvement in the English National Health Service. Lessons from the past.

    Science.gov (United States)

    Petsoulas, Christina; Peckham, Stephen; Smiddy, Jane; Wilson, Patricia

    2015-05-01

    Patient and Public involvement (PPI) in health care occupies a central place in Western democracies. In England, this theme has been continuously prominent since the introduction of market reforms in the early 1990s. The health care reforms implemented by the current Coalition Government are making primary care practitioners the main commissioners of health care services in the National Health Service, and a duty is placed on them to involve the public in commissioning decisions and strategies. Since implementation of PPI initiatives in primary care commissioning is not new, we asked how likely it is that the new reforms will make a difference. We scanned the main literature related to primary care-led commissioning and found little evidence of effective PPI thus far. We suggest that unless the scope and intended objectives of PPI are clarified and appropriate resources are devoted to it, PPI will continue to remain empty rhetoric and box ticking. To examine the effect of previous PPI initiatives on health care commissioning and draw lessons for future development. We scanned the literature reporting on previous PPI initiatives in primary care-led commissioning since the introduction of the internal market in 1991. In particular, we looked for specific contexts, methods and outcomes of such initiatives. 1. PPI in commissioning has been constantly encouraged by policy makers in England. 2. Research shows limited evidence of effective methods and outcomes so far. 3. Constant reconfiguration of health care structures has had a negative impact on PPI. 4. The new structures look hardly better poised to bring about effective public and patient involvement.

  20. A randomised controlled trial to measure the effects and costs of a dental caries prevention regime for young children attending primary care dental services: the Northern Ireland Caries Prevention In Practice (NIC-PIP) trial.

    Science.gov (United States)

    Tickle, Martin; O'Neill, Ciaran; Donaldson, Michael; Birch, Stephen; Noble, Solveig; Killough, Seamus; Murphy, Lynn; Greer, Margaret; Brodison, Julie; Verghis, Rejina; Worthington, Helen V

    2016-09-01

    Dental caries is the most common disease of childhood. The NHS guidelines promote preventative care in dental practices, particularly for young children. However, the cost-effectiveness of this policy has not been established. To measure the effects and costs of a composite fluoride intervention designed to prevent caries in young children attending dental services. The study was a two-arm, parallel-group, randomised controlled trial, with an allocation ratio of 1 : 1. Randomisation was by clinical trials unit, using randomised permuted blocks. Children/families were not blinded; however, outcome assessment was blinded to group assessment. The study took place in 22 NHS dental practices in Northern Ireland, UK. The study participants were children aged 2-3 years, who were caries free at baseline. The intervention was composite in nature, comprising a varnish containing 22,600 parts per million (p.p.m.) fluoride, a toothbrush and a 50-ml tube of toothpaste containing 1450 p.p.m. fluoride; plus standardised, evidence-based prevention advice provided at 6-monthly intervals over 3 years. The control group received the prevention advice alone. The primary outcome measure was conversion from caries-free to caries-active states. Secondary outcome measures were the number of decayed, missing or filled tooth surfaces in primary dentition (dmfs) in caries-active children, the number of episodes of pain, the number of extracted teeth and the costs of care. Adverse reactions (ARs) were recorded. A total of 1248 children (624 randomised to each group) were recruited and 1096 (549 in the intervention group and 547 in the control group) were included in the final analyses. A total of 87% of the intervention children and 85% of control children attended every 6-month visit (p = 0.77). In total, 187 (34%) children in the intervention group converted to caries active, compared with 213 (39%) in the control group [odds ratio (OR) 0.81, 95% confidence interval (CI) 0.64 to

  1. Improving Student Performance in Public Primary Schools in Developing Countries: Evidence from Indonesia

    Science.gov (United States)

    Suryadarma, Daniel; Suryahadi, Asep; Sumarto, Sudarno; Rogers, F. Halsey

    2006-01-01

    This paper investigates the correlates of student performance in mathematics and dictation tests among schoolchildren in Indonesia. This is the first such study to use a new nationally representative sample of Indonesian primary-school students. Our dataset includes unique data on teacher absenteeism collected through direct observation, the first…

  2. Public perceptions of the causes and prevention of obesity among primary school children

    NARCIS (Netherlands)

    Hardus, P.M.; Vuuren, van C.L.; Crawford, D.; Worsley, A.

    2003-01-01

    OBJECTIVE: To investigate lay perceptions of the causes and prevention of obesity among primary school children. DESIGN: A cross-sectional survey of randomly selected sample of adults in a shopping centre. SUBJECTS: 315 adults in Melbourne, Australia. MEASUREMENTS: Subjects completed a

  3. Effect of education and training on patient referral by public primary ...

    African Journals Online (AJOL)

    Material and method: A total sample of 170 primary health care workers was involved in the study:85 in each of the Local Government Areas.The study involved three stages, the pre-intervention, the intervention phase,and a post intervention phase of the study. Analysis of the responses of the two groups showed that there ...

  4. The Governmentality of Childhood Obesity: Coca-Cola, Public Health and Primary Schools

    Science.gov (United States)

    Powell, Darren; Gard, Michael

    2015-01-01

    In this paper, we examine the emergence of what might seem an unexpected policy outcome--a large multinational corporation, frequently blamed for exacerbating childhood obesity, operating as an officially sanctioned driver of anti-obesity initiatives in primary schools across the globe. We draw on Foucault's notion of governmentality to examine…

  5. The Teaching of English in Public Primary Schools in Mexico: More Heat than Light?

    Science.gov (United States)

    Ramírez-Romero, José Luis; Sayer, Peter

    2016-01-01

    The national English program in Mexico was formally launched in 2009. The new program supplanted various state programs, and aimed to create a coherent, uniform curriculum that extended English instruction to all public school students across the country. The article describes the development, evolution, and changes as the program was piloted and…

  6. Factors Influencing Academic Performance Of Standard Eight Girls In National Examinations In Public Primary Schools A Case Of Matungu Division.

    Directory of Open Access Journals (Sweden)

    Oparanya Wamukoya Windrick

    2015-06-01

    Full Text Available ABSTARCT This study is designed to establish the factors influencing academic of standard eight girls in public primary schools in National exams in Matungu division. The researcher aimed at finding out why there is increased low performance of girls in public schools despite the fact that they are assessed through periodic performance tests do continuous assessment tests CATS midterm carry out tuition and the provision of free primary education which is aimed at improving academic performance. This study adapted a descriptive survey design as a major method of research where data was collected by the researcher members of a population under study. The target population comprised of Head teachers teachers pupils parents and parent schools representatives. Purposive sampling and simple random technique were used. Data was collected by use of questionnaires and interview guides. Data was analyzed by use of descriptive statistics constituting frequencies and percentages.The study established that girls were exposed to harsh school environmental conditions they walked long distances to school schools lacked facilities like toilets libraries and were exposed to male pest teachers. There were also teacher factors like training teacher shortage and motivation that affected girls performance.The study came up with recommendations for improvement of girls academic performance. More public schools should be build to reduce on distance and also overpopulation. The ministry of Education should monitor and evaluate the academic performance of girls in rural areas. The government should put up strict rules on pest teachers. The ministry should hire more teachers.

  7. Primary oral health care: a missing link in public health in Pakistan.

    Science.gov (United States)

    Basharat, S; Shaikh, B T

    2016-12-12

    In Pakistan, the limited availability of oral health care and the high level of unmet oral health care needs are well documented. The recorded prevalence of dental caries is 50-70% and that of oral cancer is among the highest in the world. Although oral health care has been declared to be part of the primary health care system, oral health disparities between rich and poor, and emerging problems of access to and use of appropriate care have never been addressed, reflecting a lack of awareness among both patients and health system decisionmakers. Oral cancer screening and atraumatic restorative treatment for tooth decay could be included in a basic package of oral care that does not require qualified dental surgeons. This article develops an argument, based on literature review and an analysis of the health system in Pakistan, for how a basic oral health programme could be an accessible, affordable and acceptable component of the primary health care system.

  8. Recognition of indigenous knowledges and identity construction in public primary education in Wayanad.

    OpenAIRE

    Aspelund, Ingrid

    2014-01-01

    Master i flerkulturell og internasjonal utdanning This thesis explores the recognition of indigenous knowledges in primary education in the Wayanad district in South India. India has made substantial progress in terms of providing free, compulsory education for all children, and in official rhetoric education is no longer a privilege for the wealthy minority, but should be accessible to everyone. Yet, inequality prevails. Even in the South Indian state of Kerala which is well-k...

  9. How integrating primary care and public health could improve population health outcomes: a view from Liverpool, UK.

    Science.gov (United States)

    Gosling, Rachael; Davies, Sandra M; Hussey, John A

    2016-01-28

    Although primary care is at the forefront of delivering healthcare to the population, its role in preventing poor health has varied throughout history. Faced with growing demand on healthcare services and a rise in noncommunicable diseases, some health systems are attempting to integrate healthcare delivery with broader population health and wellbeing interventions. Liverpool has a rich history of taking action to improve population health; this paper discusses a range of interventions that have taken place across the city. There is a renewed opportunity to systematise approaches to primary and secondary prevention, strengthened by the lead that general practitioners now have in commissioning health services and their accountability for improved population health outcomes through clinical commissioning groups. This is strongly articulated in the Healthy Liverpool program, a city-wide plan for health and care services. This paper suggests that four key enablers strengthen delivery of public health priorities through primary care: maximising opportunities to identify risk factors for preventable disease, fully exploiting the data collected in primary care to plan and design services, responding to community needs and assets through community engagement, and addressing wider determinants of health through strong partnerships.

  10. Evaluation of an HIV/STD sexual risk-reduction intervention for pregnant African American adolescents attending a prenatal clinic in an urban public hospital: preliminary evidence of efficacy.

    Science.gov (United States)

    DiClemente, R J; Wingood, G M; Rose, E; Sales, J M; Crosby, R A

    2010-02-01

    To evaluate an intervention to reduce HIV/STD-associated behaviors and enhance psychosocial mediators for pregnant African-American adolescents. A randomized controlled trial. Participants completed baseline and follow-up assessments. An urban public hospital in the Southeastern U.S. Pregnant African-American adolescents (N=170), 14-20 years of age, attending a prenatal clinic. Intervention participants received two 4-hr group sessions enhancing self-concept and self-worth, HIV/STD prevention skills, and safer sex practices. Participants in the comparison condition received a 2-hr session on healthy nutrition. Consistent condom use. Intervention participants reported greater condom use at last intercourse (adjusted odds ratio=3.9, P=0.05) and consistent condom use (AOR=7.9, P=0.05), higher sexual communication frequency, enhanced ethnic pride, higher self-efficacy to refuse risky sex, and were less likely to fear abandonment as a result of negotiating safer sex. Interventions for pregnant African-American adolescents can enhance condom use and psychosocial mediators. Copyright 2010 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  11. A qualitative study on why did the poorly-educated Chinese elderly fail to attend nurse-led case manager clinic and how to facilitate their attendance.

    Science.gov (United States)

    Hung, Susanna Lok Lam; Fu, Sau Nga; Lau, Po Shan; Wong, Samuel Yeung Shan

    2015-01-31

    This study explored the views, barriers and facilitators of the poorly-educated elderly who were non-attendee of the nurse-led case manager clinic. The case managers provide assessment for diabetes complication screening and can refer patients to the appropriate multidisciplinary team in public outpatient primary care setting. We adopted qualitative research method by individual semi-structured face to face interviews. Nineteen Chinese type 2 diabetes mellitus subjects aged ≥ 60 who failed to attend the nurse-led case manager clinic were interviewed. They all came from a socially deprived urban district in Hong Kong. Content and thematic analysis was performed. Seven men and twelve women aged 60 to 89 were interviewed. Nine of them received no formal education and ten of them attended up to primary school. The reasons for non-attendance included attitude and poor knowledge towards diabetes complication screening and confusion of the nurse-led clinic as an educational talk. Most respondents could not understand the reason for the screening of diabetic complications, the concept of multidisciplinary care and the procedure and outcomes of nurse assessment. Five respondents were unable to follow multiple appointments because they could not read. Other reasons included physical barriers and comorbidity, family and financial constraint. They either had a tight daily schedule because of the need to take care of family members, or the family members who brought them to clinic had difficulty in attending multiple appointments. Enhanced understanding of the importance and procedure of diabetes multidisciplinary management, a flexible appointment system and a single clear appointment sheet may facilitate their attendance. Poorly-educated Chinese elderly with DM and their care givers faced physical, social and psychological barriers when attending the nurse-led case manager clinic. Strategies targeting on their low literacy include effective communication and education

  12. Socioeconomic deprivation and accident and emergency attendances

    DEFF Research Database (Denmark)

    Scantlebury, Rachel; Rowlands, Gillian; Durbaba, Stevo

    2015-01-01

    BACKGROUND: Demand for England's accident and emergency (A&E) services is increasing and is particularly concentrated in areas of high deprivation. The extent to which primary care services, relative to population characteristics, can impact on A&E is not fully understood. AIM: To conduct...... a detailed analysis to identify population and primary care characteristics associated with A&E attendance rates, particularly those that may be amenable to change by primary care services. DESIGN AND SETTING: This study used a cross-sectional population-based design. The setting was general practices...... in England, in the year 2011-2012. METHOD: Multivariate linear regression analysis was used to create a model to explain the variability in practice A&E attendance rates. Predictor variables included population demographics, practice characteristics, and measures of patient experiences of primary care...

  13. Studying Absenteeism in Principles of Macroeconomics: Do Attendance Policies Make a Difference?

    Science.gov (United States)

    Self, Sharmistha

    2012-01-01

    The primary objective of this article is to see if and how attendance policy influences class attendance in undergraduate-level principles of macroeconomics classes. The second objective, which is related to the first, is to examine whether the nature of the attendance policy matters in terms of its impact on class attendance behavior. The results…

  14. Public-private partnerships to improve primary healthcare surgeries: clarifying assumptions about the role of private provider activities.

    Science.gov (United States)

    Mudyarabikwa, Oliver; Tobi, Patrick; Regmi, Krishna

    2017-07-01

    Aim To examine assumptions about public-private partnership (PPP) activities and their role in improving public procurement of primary healthcare surgeries. PPPs were developed to improve the quality of care and patient satisfaction. However, evidence of their effectiveness in delivering health benefits is limited. A qualitative study design was employed. A total of 25 interviews with public sector staff (n=23) and private sector managers (n=2) were conducted to understand their interpretations of assumptions in the activities of private investors and service contractors participating in Local Improvement Finance Trust (LIFT) partnerships. Realist evaluation principles were applied in the data analysis to interpret the findings. Six thematic areas of assumed health benefits were identified: (i) quality improvement; (ii) improved risk management; (iii) reduced procurement costs; (iv) increased efficiency; (v) community involvement; and (vi) sustainable investment. Primary Care Trusts that chose to procure their surgeries through LIFT were expected to support its implementation by providing an environment conducive for the private participants to achieve these benefits. Private participant activities were found to be based on a range of explicit and tacit assumptions perceived helpful in achieving government objectives for LIFT. The success of PPPs depended upon private participants' (i) capacity to assess how PPP assumptions added value to their activities, (ii) effectiveness in interpreting assumptions in their expected activities, and (iii) preparedness to align their business principles to government objectives for PPPs. They risked missing some of the expected benefits because of some factors constraining realization of the assumptions. The ways in which private participants preferred to carry out their activities also influenced the extent to which expected benefits were achieved. Giving more discretion to public than private participants over critical

  15. Predicting acute viral hepatitis serum markers (A and E) in patients with suspected acute viral hepatitis attending primary health care centers in Baghdad: a one year cross-sectional study.

    Science.gov (United States)

    Al-Naaimi, Ahmed Samir; Turky, Atallah Mekhlef; Khaleel, Hanan Abdulghafoor; Jalil, Rasha Waleed; Mekhlef, Olah A; Kareem, Susan Abdul; Hasan, Nadia Yousif; Dhadain, Azhar Abdulla

    2012-08-21

    Viral hepatitis is an important preventable infectious disease with various rates of occurrence in different areas of the world. The main objective of the present study was to evaluate the role of some risk factors in predicting a positive acute viral hepatitis marker among patients with suspected acute viral hepatitis in a primary health care setting in Baghdad. Besides, finding out the occurrence of jaundice, contribution of viruses A and E to the cases that have occurred in Baghdad province was also searched for. Over a period of 1 year a descriptive cross sectional study was carried out at the primary health care centers in Baghdad. A questionnaire form was used to collect data about demographic factors and the results of the investigations. Total serum bilirubin and bilirubin in urine were done at the primary health care center laboratory. The rest of the sera samples were sent to Hepatitis referral Lab at Central Public Health Laboratory (CPHL) to be tested for anti HAV IgM and anti HEV IgM using ELISA technique. A total of 7,576,372 consultations to primary health care centers were recorded in Baghdad. Among those a total of 2,692 cases (35.5 per 100,000 consultations) were labeled as acute viral hepatitis cases. A positive hepatitis viral marker (A, B, C and E) was found in 1,332 cases (17.6 per 100,000 consultations). More than two fifths (44.8%) of cases were positive for anti-HAV antibodies and another 1.6% had positive anti-HEV antibodies. During 1 year period, the rate of occurrence of suspected acute viral hepatitis cases was 35.5 per 100000 of consultations to the primary health care centers in Baghdad. Of the total suspected cases, only 17.6 per 100000 of the consultations were positive for one of the viral hepatitis markers. Those who tested positive for one of the viral hepatitis markers represent 49.5% of the suspected cases. Proportion of anti HAV IgM positive tests among suspected cases was 44.8%. Factors that were able to predict positive Anti

  16. Worldwide estimates and bibliography of net primary productivity derived from pre-1982 publications

    Energy Technology Data Exchange (ETDEWEB)

    Esser, G. [Justus-Liebig-Univ., Giessen (Germany). Inst. for Plant Ecology; Lieth, H.F.H. [Univ. of Osnabrueck (Germany). Systems Research Group; Scurlock, J.M.O.; Olson, R.J. [Oak Ridge National Lab., TN (United States)

    1997-10-01

    An extensive compilation of more than 700 field estimates of net primary productivity of natural and agricultural ecosystems worldwide was synthesized in Germany in the 1970s and early 1980s. Although the Osnabrueck data set has not been updated since the 1980s, it represents a wealth of information for use in model development and validation. This report documents the development of this data set, its contents, and its recent availability on the Internet from the Oak Ridge National Laboratory Distributed Active Archive Center for Biogeochemical Dynamics. Caution is advised in using these data, which necessarily include assumptions and conversions that may not be universally applicable to all sites.

  17. [Clinic management of public social protection policy in primary health care].

    Science.gov (United States)

    Arcos-Griffiths, Estela; Muñoz-González, Luz Angélica; Vollrath-Ramírez, Antonia; Sánchez-Segura, Ximena

    2016-01-01

    Knowing the effectiveness of clinical management of primary care health in the field of Integral Protection System for Children "Chile Crece Contigo" and "Red Protege". Observational, descriptive, with information available from secondary sources of Chile Crece Contigo system in the district of Pudahuel, Santiago de Chile. The population was 1,656 pregnant women assigned to Chile Crece Contigo system in 2009. Social vulnerability was measured with the Social Protection Record. Sociodemographic and Chile Crece Contigo system performance variables were selected. It featured a raw and refined database. Processing and analysis of data was performed using the statistical program Statistical Package for Social Sciences and Excel. Descriptive statistics for frequency, position and dispersion were calculated. Certification of Scientific Ethics Committee of the School of Nursing was granted. A 91.4% of institutional social vulnerability detected by screening social protection record was observed. Psychosocial risk was higher in women with social vulnerability (42.0 vs. 28.2%) more often recognized as inadequate family support, depressive symptoms, domestic violence, substance abuse and conflicts with motherhood. In the universal, specific and integrated performance it was not met with 100% access to benefits. The invisibility of the social vulnerability and low effectiveness of the transfer of benefits to socially vulnerable women/children deserves skills development of contextualized and integrated clinical management professionals in primary health care. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  18. Public purchasers contracting external primary care providers in Central America for better responsiveness, efficiency of health care and public governance: issues and challenges.

    Science.gov (United States)

    Macq, Jean; Martiny, Patrick; Villalobos, Luis Bernardo; Solis, Alejandro; Miranda, Jose; Mendez, Hilda Cecilia; Collins, Charles

    2008-09-01

    Several national health systems in Latin America initiated health reforms to counter widespread criticisms of low equity and efficiency. For public purchasing agencies, these reforms often consisted in contracting external providers for primary care provision. This paper intends to clarify both the complex and intertwined issues characterizing such contracting as well as health system performances within the context of four Central American countries. It results from a European Commission financed project lead between 2002 and 2005, involving participants from Costa Rica, Guatemala, Nicaragua, Salvador, United Kingdom, Netherlands and Belgium, whose aim was to promote exchanges between these participants. The findings presented in this paper are the results of a two stage process: (a) the design of an initial analytical framework, built upon findings from the literature, interlinking characteristics of contractual relation with health systems performances criteria and (b) the use of that framework in four case studies to identify cross-cutting issues. This paper reinforces two pivotal findings: (a) contracting requires not only technical, but also political choices and (b) it cannot be considered as a mechanical process. The unpredictability of its evolution requires a flexible and reactive approach. This should be better assimilated by national and international organizations involved in health services provision, so as to progressively come out of dogmatic approaches in deciding to initiate contractual relation with external providers for primary care provision.

  19. Perceived constraints to art museum attendance

    Science.gov (United States)

    Jinhee Jun; Gerard Kyle; Joseph T. O' Leary

    2007-01-01

    We explored selected socio-demographic factors that influence the perception of constraints to art museum attendance among a sample of interested individuals who were currently not enjoying art museum visitation. Data from the Survey of Public Participation in the Arts (SPPA), a nationwide survey were used for this study. Using multivariate analysis of variance, we...

  20. How do public child healthcare professionals and primary school teachers identify and handle child abuse cases? A qualitative study.

    Science.gov (United States)

    Schols, Manuela W A; de Ruiter, Corine; Öry, Ferko G

    2013-09-05

    Public child healthcare doctors and nurses, and primary school teachers play a pivotal role in the detection and reporting of child abuse, because they encounter almost all children in the population during their daily work. However, they report relatively few cases of suspected child abuse to child protective agencies. The aim of this qualitative study was to investigate Dutch frontline workers' child abuse detection and reporting behaviors. Focus group interviews were held among 16 primary school teachers and 17 public health nurses and physicians. The interviews were audio recorded, transcribed, and thematically analyzed according to factors of the Integrated Change model, such as knowledge, attitude, self-efficacy, skills, social influences and barriers influencing detection and reporting of child abuse. Findings showed that although both groups of professionals are aware of child abuse signs and risks, they are also lacking specific knowledge. The most salient differences between the two professional groups are related to attitude and (communication) skills. The results suggest that frontline workers are in need of supportive tools in the child abuse detection and reporting process. On the basis of our findings, directions for improvement of child abuse detection and reporting are discussed.

  1. Cross-sectional study of older adults with type 2 diabetes mellitus in two rural public primary healthcare facilities in Malaysia

    National Research Council Canada - National Science Library

    Ooi, C P; Loke, S C; Zaiton, A; Tengku-Aizan, H; Zaitun, Y

    2011-01-01

    .... A cross-sectional study in two rural public primary healthcare centres in Malaysia identified 170 actively engaged older patients with T2DM, with suboptimal glycaemic control and frequent hypoglycaemia...

  2. Social stratification, risk factor prevalence and cancer screening attendance.

    Science.gov (United States)

    Eisinger, François; Viguier, Jérôme; Touboul, Chantal; Coscas, Yvan; Pivot, Xavier; Blay, Jean-Yves; Lhomel, Christine; Morère, Jean-François

    2015-06-01

    This analysis aimed to assess the extent to which exposure to cancer risk factors and attendance of screening programmes are influenced by social characteristics. The validated Evaluation of deprivation and health inequalities in public health centres (EPICES) index was used to measure social deprivation. A sample of the general population (N=1603) was assessed to search for potential correlations between screening attendance, risk factors and any components of the EPICES score. In 2011, 33% of the population studied was classified as 'vulnerable'. Sex had no significant impact on this rating (32% men, 35% women), whereas occupational status did. Vulnerable individuals were more likely already to have cancer (10 vs. 7%; nonsignificant difference; odds ratio 1.43 [0.98-2.10]). The mean BMI was 26.0 kg/m (SD 4.9) for the vulnerable population versus 24.8 kg/m (SD 3.9) in the nonvulnerable population (P<0.01). The prevalence of current smoking was higher in the vulnerable group (38 vs. 23%, odds ratio 2.03 [1.61-2.56]). In contrast, no statistically significant difference was observed between attendance rates for nationwide organized cancer screening programmes (breast and colorectal; target age group 50-74 years) by the vulnerable and nonvulnerable groups. Social indicators of vulnerable populations are associated with increased rates of risk factors for cancer, but not with screening attendance. Our data support the previously reported marked impact of organized programmes that reduce or even remove inequalities in access to cancer screening. However, although the organized programmes have indeed enabled population-wide, nonselective access to screening, primary prevention as it stands today remains inadequate in the underserved population and further improvements are warranted.

  3. [Human ecology and interdisciplinary cooperation for primary prevention of environmental risk factors for public health].

    Science.gov (United States)

    Dobrowolski, Jan W

    2007-01-01

    training activity in ecologically-based primary prevention. Training in this important field is not adequate in medical, technological, and also natural subjects of studies. There is not enough opportunity for education of the students and graduates toward the application of integrated system approach of new achievements in different sciences and technologies. Interesting are experiences connected with long-term case studies in highly polluted regions in Poland, Japan, India, as well as exchange of methodological experiences during the series of International Summer Schools on the Human Environment from 1972, as well as during series of 11 International Conferences on Sustainable Development organized at AGH-UST from 1989 to 2006 and Polish Conferences in 2004 and 2007. It seems necessary not only to develop a training of experts that would be adequate to present needs, but also education of the whole society (including formal activities at all levels of education) as well as informal education (e.g. at Open Universities and Distance Education, based on the Internet) to achieve the integration of activity of scientists, practitioners and the whole society. It would be useful to focus this activity on crucial problems and selected regions. Let me propose as the top priority for inhabitants of Tarnow region as well as pilot projects for Poland; utilization of all possible achievements of science and technology for primary prevention of health hazard for inhabitants of Gmina Szczucin that is very polluted by asbestos, and also model management reducing risk factors for the natural environment and health of inhabitants in the regions of new motor-ways, as well as better primary prevention against flood accidents and connected with their effects (higher humidity of housing environment and its contamination by toxinogenic moulds) risk factors for health of communities living in rivers regions. For the purpose of optimisation of preventive action, it is necessary not only to

  4. Street-level diplomacy? Communicative and adaptive work at the front line of implementing public health policies in primary care.

    Science.gov (United States)

    Gale, Nicola; Dowswell, George; Greenfield, Sheila; Marshall, Tom

    2017-03-01

    Public services are increasingly operating through network governance, requiring those at all levels of the system to build collaborations and adapt their practice. Agent-focused implementation theories, such as 'street-level bureaucracy', tend to focus on decision-making and the potential of actors to subvert national policy at a local level. While it is acknowledged that network leaders need to be adaptable and to build trust, much less consideration has been given to the requirement for skills of 'diplomacy' needed by those at the front line of delivering public services. In this article, drawing on theoretical insights from international relations about the principles of 'multi-track diplomacy', we propose the concept of street level diplomacy, offer illustrative empirical evidence to support it in the context of the implementation of public health (preventative) policies within primary care (a traditionally responsive and curative service) in the English NHS and discuss the contribution and potential limitations of the new concept. The article draws on qualitative data from interviews conducted with those implementing case finding programmes for cardiovascular disease in the West Midlands. The importance of communication and adaptation in the everyday work of professionals, health workers and service managers emerged from the data. Using abductive reasoning, the theory of multi-track diplomacy was used to aid interpretation of the 'street-level' work that was being accomplished. Copyright © 2017. Published by Elsevier Ltd.

  5. Suicide survey in a London borough: primary care and public health perspectives.

    Science.gov (United States)

    Ougrin, Dennis; Banarsee, Reetoo; Dunn-Toroosian, Valentine; Majeed, Azeem

    2011-09-01

    In order to achieve the national target of 20% reduction in suicide in the UK, many primary care trusts have developed local suicide prevention action plans. However, there is concern about a lack of a whole-system approach in some localities. Suicide surveys are a necessary component of any suicide reduction strategy. All deaths by suicides and open verdicts of a multi-ethnic, socio-economically diverse London Borough's residents between February 2005 and February 2008 were identified (n = 54). Health records of the identified subjects were analysed by two researchers. The annual rate of suicide in the study period was 6.8 per 100 000 inhabitants. Of the 54 cases of suicide in the study period, 45% had a psychiatric diagnosis and 18% were in current contact with mental health services. Hanging was the most frequent mode of suicide. Twenty-four per cent were not registered with a GP, most of whom were immigrants. Twenty-five per cent had seen their GP within a month of suicide. The rate of suicide in those born in Ireland was 17.7 per 100 000. Suicide survey is a feasible method of monitoring suicide, sharing data between key stakeholders and learning from the trends uncovered.

  6. Prevalence and risk factors for Toxoplasma gondii infection among pregnant and postpartum women attended at public healthcare facilities in the City of Niterói, State of Rio de Janeiro, Brazil

    Directory of Open Access Journals (Sweden)

    Fernanda Loureiro de Moura

    2013-04-01

    Full Text Available Introduction To determine the prevalence of immunoglobulin G (IgG and immunoglobulin M (IgM anti-Toxoplasma gondii antibodies among pregnant and postpartum women attended within the public healthcare system in Niterói, State of Rio de Janeiro, and to detect possible exposure factors associated with T. gondii infection in this population. Methods IgM and IgG anti-T. gondii antibodies were investigated in 276 pregnant and 124 postpartum women by using the indirect immunofluorescence (IFAT and immunoenzymatic assay (ELISA techniques. The participants were selected by convenience sampling. All these 400 patients filled out a free and informed consent statement, answered an epidemiological questionnaire and were informed about the disease. Results Among the 400 samples analyzed, 234 (58.5% were reactive to IgG anti-T. gondii antibodies, according to the IFAT and/or ELISA assay. One pregnant woman was found to be reactive to IgM anti-T. gondii antibodies, with an intermediate IgG avidity test. Risk factor analysis showed that seropositivity was significantly associated (p<0.05 with age, contact with cats and presence of rodents at home. Through a logistic regression model, these associations were confirmed for age and contact with cats, while education at least of the high school level was found to be a protective factor. Conclusions The prevalence rate of IgG anti-T. gondii antibodies in the City of Niterói was high and the risk factors for infection detected after multivariate analysis were: age over 30 years, contact with cats and education levels lower than university graduate level.

  7. The breach in the dike : regime change and the standardization of public primary-school teacher training in Indonesia, 1893-1969

    NARCIS (Netherlands)

    Suwignyo, Agus

    2012-01-01

    The aim of the present study is to examine the transformation of teacher training in Indonesia from 1893 to 1969. Public teacher training altered over time to keep in step with the changing requirements in public primary school curricula which had been incurred by economic and political factors. In

  8. Primary care and public health a natural alliance? The introduction of the guidelines for obesity and undernutrition of the Dutch College of General Practitioners.

    NARCIS (Netherlands)

    Avendonk, M.J.P van; Mensink, P.A.J.S.; Drenthen, A.J.; Binsbergen, J.J. van

    2012-01-01

    The prevalence of obesity and overweight is increasing globally and forms a huge public health problem. On the other hand, the prevalence of malnutrition or undernutrition is substantial, especially in nursing homes or in the elderly at home. Primary care and public health are separate disciplines.

  9. Childhood obesity and academic achievement among male students in public primary schools in Kuwait.

    Science.gov (United States)

    Abdelalim, Ahmed; Ajaj, Nawras; Al-Tmimy, Abdulrahman; Alyousefi, Maytham; Al-Rashaidan, Sulaiman; Hammoud, Majeda S; Al-Taiar, Abdullah

    2012-01-01

    The aim of this study was to investigate the association between childhood obesity and student academic performance in the classroom setting. A multi-stage cluster random sampling was used to select a representative sample of 1,213 fifth-grade students in male public schools. Height and weight were measured using a standard protocol. Overweight was defined as BMI ≥85th but obesity as ≥95th BMI percentile, using growth charts provided by the Centre for Disease Control and Prevention (2000). Data on each student's academic performance and sociodemographic factors were extracted from school records. Of the 1,213 students, 147 were absent on the day the survey was conducted. Therefore, the analysis was based on 1,066 students. Of the 1,066 students, 67 did not have previous school records because they were new in the school; hence the association between school performance and obesity was based on 999 students. The prevalence of obesity was 186 (17.4%, 95% CI: 15.2-19.9%) while the prevalence of overweight was 232 (21.8%, 95% CI: 19.3-24.4%). There was no significant association between obesity and academic performance after adjusting for sociodemographic factors. Parental education was the most important predictor for high academic performance in the classroom setting. There is no association between obesity and academic performance in the classroom setting among boys in Kuwait. With the lack of evidence of a relationship between childhood obesity and academic performance, using high performance as a measure of success in prevention initiatives cannot be justified. Copyright © 2011 S. Karger AG, Basel.

  10. A review of injection and antibiotic use at primary health care (public and private centers in Africa

    Directory of Open Access Journals (Sweden)

    Richard Ofori-Asenso

    2015-01-01

    Full Text Available We conducted a review to study antibiotic and injections use at primary care centers (PHCs within the World Health Organization African region. This was part of a larger study on prescribing indicators at PHCs within the region. We analyzed antibiotic and injection use reported in studies published between 1993 and June 2013, which were identified through searches conducted in PubMed, Scopus, Web of science, Africa-Wide NiPAD, Africa Journals Online, Google Scholar, and International Network for Rational Use of Drugs bibliography databases. Sub-group analysis was carried out for private and public centers. Data were retrieved from 18 studies in 6 countries involving 21,283 patient encounters across 338 PHCs. The percentage of patient encounters with antibiotics prescribed was 51.5% (IQR 41.1-63.3%. The percentage of patient encounters which resulted in the prescription of an injection was 36.8% (IQR 20.7-57.6%. Injection use rate at private facilities was 38% (IQR 19.1-42.7 while that of the public was 32.3% (IQR 20.6-57.6. Rate of antibiotic prescribing at public centers was 49.7% (IQR 51.1-75.7 and that of private facilities 57.6 (IQR 39.0-69.5.The percentage use of injections and antibiotics is high in Africa. The excessive use of antibiotics and injections are particularly more problematic in private than public facilities. Further research is needed to understand fully the underlying factors for the observed patterns and ways of improving medicines use.

  11. Attitude of Primary Health Care Nurses in Kuwait Towards Domestic ...

    African Journals Online (AJOL)

    Background: Domestic violence against women is an important public health problem. Battered women attend primary health care centers seeking for both medical treatment and support. Nurses with a positive attitude play a key role to deal with victimized women. Objectives: The current study was formulated to reveal ...

  12. Schistosomiasis mansoni in school attenders and non-attenders in ...

    African Journals Online (AJOL)

    Background: Information on epidemiology of schistosomiasis in school age children and particularly non school attenders are scanty in northwestern Ethiopia. Objective: To assess the prevalence of Schistosoma mansoni in school attenders and non-attenders in Northwest Ethiopia. Methods: A parasitological survey was ...

  13. Knowledge about primary health care among medical students from public and private medical universities of Karachi, Pakistan.

    Science.gov (United States)

    Ehsan, Rubab; Hirani, Rahul; Bhesania, Nasha Homi; Zehra, Nosheen

    2017-10-01

    Primary health care (PHC) is the best approach to achieve health goals in a country. As medical students are a prominent part of future health care providers, it is important to assess their knowledge regarding basic concepts and functions of PHC. Total 400 medical students, 200 (50%) each from public and private medical universities responded in this study. Mean score was 15.21 ± 2.43 and 14.9 ± 2.89 respectively with no significant difference (P=0.370). On the basis of mean score the data is dichotomized into two groups i.e. above average and average (score > 15) and below average (score university fell in the average and above average category. This study shows challenges related to the knowledge and the medical students' level of understanding of the functioning of PHC system.

  14. Infecções genitais em mulheres atendidas em Unidade Básica de Saúde: prevalência e fatores de risco Genital infections in women attending a Primary Unit of Health: prevalence and risk behaviors

    Directory of Open Access Journals (Sweden)

    Mara Rejane Barroso Barcelos

    2008-07-01

    de medidas de prevenção, como o rastreamento de infecções sexualmente transmissíveis e programas de redução de risco em mulheres que procuram o serviço ginecológico de rotina.PURPOSE: to describe the prevalence and behavioral profile of genital infections in women attended at a Primary Health Unit in Vitoria, ES. METHODS: a transversal study including 14 to 49-year-old women attended by the Family Health Program (FHP. Exclusion criteria were: having been submitted to gynecological examination in less than one year before, and history of recent treatment (in the last three months for genital infections. An interview including socio-demographic, clinical and behavioral data was applied. Genital specimens were collected for cytology, GRAM bacterioscopy and culture, and urine sample for molecular biological test for Chlamydia trachomatis. RESULTS: two hundred and ninety-nine women took part in the study. The median age was 30.0 (interquartile interval: 24;38 years old; the average age of the first intercourse was 17.3 (sd=3.6 years old. The first pregnancy average age was 19.2 (3.9 years old. About 70% reported up to 8 years of schooling; 5% reported previous Sexually Transmitted Diseases (STD, and 8%, the use of illicit drugs. Only 23.7% reported consistent use of condoms. Clinical complaints were: genital ulcer (3%; dysuria (7.7%; vaginal discharge (46.6%: pruritus (20% and pelvic pain (18%. Prevalence rates were: Chlamydia trachomatis 7.4%; gonorrhea 2%; trichomoniasis 2%; bacterial vaginosis 21.3%; candidiasis 9.3%; and cytological changes suggestive of HPV 3.3%. In the final logistic regression model, the factors independently associated to genital infections were: abnormal cervical mucus, OR=9.7 (CI95%=5.6-13.7, previous HIV testing, OR=6.5 (CI95%=4.0-8.9, having more than one partner during the previous year, OR=3.9 (CI95%=2.7-5.0, and having more than one partner in life, OR=4.7 (CI95%=2.4-6.8. CONCLUSIONS: results show a high rate of genital infections

  15. Mobile phones improve antenatal care attendance in Zanzibar

    DEFF Research Database (Denmark)

    Lund, Stine; Nielsen, Birgitte B; Hemed, Maryam

    2014-01-01

    pregnancy. METHODS: This study was an open label pragmatic cluster-randomised controlled trial with primary healthcare facilities in Zanzibar as the unit of randomisation. 2550 pregnant women (1311 interventions and 1239 controls) who attended antenatal care at selected primary healthcare facilities were......, more women attending antenatal care late in pregnancy and more women with antepartum complications identified and referred. Mobile phone applications may contribute towards improved maternal and newborn health and should be considered by policy makers in resource-limited settings....

  16. Schools K-12 - MDC_ElementaryAttendanceBoundary

    Data.gov (United States)

    NSGIC Local Govt | GIS Inventory — Polygon feature class of Miami-Dade County, Public Schools attendance zones for Elementary schools (PK-5) and K-8 Centers (PK-8) schools. K-8 Centers are elementary...

  17. Estado nutricional relativo ao zinco de crianças que frequentam creches do estado da Paraíba Zinc nutritional status in children attending public daycare centers in the state of Paraíba, Brazil

    Directory of Open Access Journals (Sweden)

    Dixis Figueroa Pedraza

    2011-08-01

    Full Text Available OBJETIVO: Avaliar o estado nutricional relativo ao zinco de crianças assistidas em creches do Estado da Paraíba. MÉTODOS: O estado nutricional relativo ao zinco de 235 crianças pré-escolares foi avaliado através de sua concentração no soro, da ingestão dietética de zinco e da estatura para idade, como recomendado pelo International Zinc Consultative Group. As concentrações séricas de zinco foram determinadas por espectrofotometria de absorção atômica de chama, considerando deficiência de zinco valores OBJECTIVE: This study assessed the zinc levels of children attending public daycare centers in the state of Paraíba. Brazil. METHODS: The zinc levels of 235 preschool children were evaluated through serum zinc concentration, dietary zinc intake and height-for-age, as recommended by the International Zinc Nutrition Consultative Group. Baseline zinc levels in the serum were measured by flame atomic absorption spectrophotometry, considering values <65µmol/L indicative of zinc deficiency. The 24-hour recall method was used to record food consumption, considering the food consumption of the child the day before and in the daycare center. Zinc inadequacy was analyzed according to the estimated average zinc requirement by life stage and diet type recommended by the International Zinc Nutrition Consultative Group. The World Health Organization Growth Reference was used as the reference for the height-for-age indices. Children with indices two z-scores below the median value of the reference population were considered stunted. Statistical analysis was performed by the t-test or analysis of variance by the software Statistical Package for the Social Sciences -16.0. RESULTS: The prevalence of inadequate serum zinc concentration, inadequate zinc intakes and stunting were 16.2%, 16.6% and 7.7%, respectively. Mean serum zinc was lower in children of underweight mothers than in children of normal weight mothers. CONCLUSION: The studied children

  18. Psychosocial predictors of first attendance for organised mammography screening

    DEFF Research Database (Denmark)

    Aro, A R; de Koning, H J; Absetz, P

    1999-01-01

    of breast cancer risk as moderate were also predictive of attendance. Expectation of pain at mammography was predictive of non-attendance. CONCLUSION: Mammography screening organised as a public health service was well accepted. A recent mammogram, high reliance on self control of breast cancer......OBJECTIVE: To study psychosocial predictors of attendance at an organised breast cancer screening programme. SETTING: Finnish screening programme based on personal first round invitations in 1992-94, and with 90% attendance rate. METHODS: Attenders (n = 946) belonged to a 10% random sample (n...... = 1680 women, age 50, response rate 64%) of the target population (n = 16,886), non-attenders (n = 641, 38%) came from the whole target population. Predictors were measured one month before the screening invitation. Measures included items for social and behavioural factors, Breast Cancer Susceptibility...

  19. Library Adult Program Attendance

    Data.gov (United States)

    Town of Chapel Hill, North Carolina — A list of events put on by the Chapel Hill Library both on site and offsite with adults as the primary audience. This data also includes the list of partners used...

  20. The Microbiological@mind project: a public engagement initiative of Turin University bringing microbiology and health education into primary schools.

    Science.gov (United States)

    Scalas, Daniela; Roana, Janira; Mandras, Narcisa; Cuccu, Sonia; Banche, Giuliana; Marra, Elisa Simona; Collino, Nicoletta; Piersigilli, Giorgia; Allizond, Valeria; Tullio, Vivian; Cuffini, Anna Maria

    2017-10-01

    Despite ongoing global efforts, antimicrobial resistance continues to threaten the treatment of an ever-increasing range of bacterial infections. There is substantial evidence that public education programs that foster microbial literacy amongst young school audiences may improve correct knowledge of specific health issues, such as prevention of microbial infections and responsible use of antibiotics. The aim of the Microbiological@mind project was to engage primary school students with the subject of microbiology, to promote both scientific interest and awareness towards correct behaviors that may ensure a safer lifestyle. Interactive workshops based on a full ''hands-on'' approach were carried out by an expert team from the University of Turin to over 1200 children aged 9-11 years at primary schools in Turin. A questionnaire (pre- and post-activity test) on the main topic (i.e. antibiotics) was used to assess project effectiveness. The workshops provided a useful means to strengthen the understanding of basic microbiology concepts amongst students. Students' baseline knowledge of antibiotics was quite low, as low percentages of correct answers on antibiotic action and use (5.0% and 12.1%, respectively) were found in the pre-activity tests. A significant increase (P <0.0001) in correct knowledge was observed in the post-activity tests, after implementation of the teaching activity. Our findings support the idea that microbial literacy in early childhood through hands-on educational programs is of great importance to foster children's interest in science learning, and to provide young people with information about general and specific health-related issues, such as prudent antibiotic use, for a more responsible citizenship. Copyright © 2017 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.

  1. Scientific publications on primary biliary cirrhosis from 2000 through 2010: an 11-year survey of the literature.

    Science.gov (United States)

    Qin, Baodong; Liang, Yan; Yang, Zaixing; Zhong, Renqian

    2012-01-01

    Primary biliary cirrhosis (PBC) is a chronic liver disease characterized by intrahepatic bile-duct destruction, cholestasis, and fibrosis. It can lead to cirrhosis and eventually liver failure. PBC also shows some regional differences with respect to incidence and prevalence that are becoming more pronounced each year. Recently, researchers have paid more attention to PBC. To evaluate the development of PBC research during the past 11 years, we determined the quantity and quality of articles on this subject. We also compared the contributions of scientists from the US, UK, Japan, Italy, Germany, and China. The English-language papers covering PBC published in journals from 2000 through 2010 were retrieved from the PubMed database. We recorded the number of papers published each year, analyzed the publication type, and calculated the accumulated, average impact factors (IFs) and citations from every country. The quantity and quality of articles on PBC were compared by country. We also contrasted the level of PBC research in China and other countries. The total number of articles did not significantly increase during the past 11 years. The number of articles from the US exceeded those from any other country; the publications from the US also had the highest IFs and the most citations. Four other countries showed complex trends with respect to the quantity and quality of articles about PBC. The researchers from the US have contributed the most to the development of PBC research. They currently represent the highest level of research. Some high-level studies, such as RCTs, meta-analyses, and in-depth basic studies should be launched. The gap between China and the advanced level is still enormous. Chinese investigators still have a long way to go.

  2. School Progress Report 2012. Montgomery County Public Schools

    Science.gov (United States)

    Montgomery County Public Schools, 2013

    2013-01-01

    The 2012 School Progress Report for Montgomery County Public Schools (MCPS) provides state, county, and individual school performance data, as well as information on student attendance, high school graduation rates, and the professional qualifications of teachers at the state, district, and school levels. Montgomery County primary schools are…

  3. Inequality, Preschool Education and Cognitive Development in Ethiopia: Implication for Public Investment in Pre-Primary Education

    Science.gov (United States)

    Woldehanna, Tassew

    2016-01-01

    This study used longitudinal data from the Young Lives Project in Ethiopia to examine the main factors relating to preschool access and their potential effects on cognitive performance of children aged five and eight years. The results show that only one quarter of the preschool-aged children have the opportunity to attend this vital stage of…

  4. Predictors of attendance at specialized survivor clinics in a population-based cohort of adult survivors of childhood cancer.

    Science.gov (United States)

    Nathan, Paul C; Agha, Mohammad; Pole, Jason D; Hodgson, David; Guttmann, Astrid; Sutradhar, Rinku; Greenberg, Mark L

    2016-08-01

    The purpose of the present study is to determine predictors of attendance at a network of publicly funded specialized survivor clinics by a population-based cohort of adult survivors of childhood cancer. We conducted a retrospective study linking data on eligible patients identified in a provincial pediatric cancer registry with health administrative databases to determine attendance at five specialized survivor clinics in the Canadian province of Ontario between 1999 and 2012. Eligible survivors were treated for cancer at ≤18 years between 1986 and 2005, had survived ≥5 years from their most recent pediatric cancer event, and contributed ≥1 year of follow-up after age 18 years. We assessed the impact of cancer type, treatment intensity, cumulative chemotherapy doses, radiation, socioeconomic status, distance to nearest clinic, and care from a primary care physician (PCP) on attendance using recurrent event multivariable regression. Of 7482 children and adolescents treated for cancer over the study period, 3972 were eligible for study inclusion, of which 3912 successfully linked to administrative health data. After a median of 7.8 years (range 0.2-14.0) of follow-up, 1695/3912 (43.3 %) had attended at least one adult survivor clinic visit. Significantly increased rates of attendance were associated with female gender, higher treatment intensity, radiation, higher alkylating agent exposure, higher socioeconomic status, and an annual exam by a PCP. Distance significantly impacted attendance with survivors living >50 km away less likely to attend than those living within 10 km (relative rate 0.77, p = 0.003). Despite free access to survivor clinics, the majority of adult survivors of childhood cancer do not attend. Alternate models of care need to be developed and assessed, particularly for survivors living far from a specialized clinic and those at lower risk of developing late effects.

  5. Toxoplasmose: soroprevalência em puérperas atendidas pelo Sistema Único de Saúde Toxoplasmosis: seroprevalence in postpartum women attended by SUS (Brazilian Public Health System

    Directory of Open Access Journals (Sweden)

    Paulo Roberto Dutra Leão

    2004-09-01

    postpartum women, attended in two hospitals of the Public Health System (SUS in Cuiabá, and its correlation with age, previous abortion and women's knowledge of the disease. METHODS: a cross-sectional study including 205 women with ages from 14 to 43 (mean 22.4 years old, attended in these hospitals for two months, in the first or second days postpartum. Each woman answered a short questionnaire and had peripheral blood sample collected. Blood samples were stored at 20°C until assay. The seroprevalence was determined by quantitative detection of specific IgG antibody against Toxoplasma gondii, using a microparticle enzyme immunoassay. All samples were assayed at the same time. RESULTS: The average number of pregnancies in the women included in this study was 2.2, and the majority of them was pregnant for the first time. The seroprevalence found was 70.7% (165 of 205 women. No statistical correlation was found between seroprevalence and age (p = 0.967 or previous abortion (p = 0.82. Most of the women in this study (78% did not know about toxoplasmosis and no statistical correlation was found between this condition and seroprevalence (p = 0.49. CONCLUSION: the high seroprevalence found in the present study is in accordance with surveys previously reported in our country and other developing countries. Among the women included in this study, an expressive number (29.3% is still under risk of contamination. The lack of statistical correlation between seroprevalence and women's age, lack of knowledge about the disease and report of previous abortion is in accordance with some previous studies and in disagreement with others.

  6. CBP Time and Attendance Management

    Data.gov (United States)

    Department of Homeland Security — The TAMS, supports time and attendance (payroll), overtime cap monitoring, overtime scheduling functions, budget reporting, staffing level reporting, and a variety...

  7. Attendance Policies, Student Attendance, and Instructor Verbal Aggressiveness

    Science.gov (United States)

    Snyder, Jason; Forbus, Robert; Cistulli, Mark

    2012-01-01

    The authors utilized an experimental design across six sections of a managerial communications course (N = 173) to test the impact of instructor verbal aggressiveness and class attendance policies on student class attendance. The experimental group received a policy based on the principle of social proof (R. B. Cialdini, 2001), which indicated…

  8. Quality Education for the Pastoralist in Public Primary Schools in Kajiado County, Kenya: Case Study of Dupoto-E-Maa Education Project in Kajiado Central District

    Science.gov (United States)

    Ouda, James Bill; Opiyo, Rose Atieno; Wambiya, Pascal

    2015-01-01

    Conditions of learning are critical in determining quality of education. There have been real concerns raised by stakeholders regarding the quality of education for pastoralists in public primary schools in Kajiado Central District in Kenya. Interventions have been put in place to address the issue of quality education. One such intervention is…

  9. Effects of Sand Harvesting on Environment and Educational Outcomes in Public Primary Schools in Kathiani Sub-County, Machakos County, Kenya

    Science.gov (United States)

    Nthambi, Mutiso Veronicah; Orodho, John Aluko

    2015-01-01

    The purpose of this study was to examine the effects of sand harvesting on environment and educational outcomes in public primary schools in Kathiani Sub-County, Machakos County, Kenya. This study was premised on treadmill theory of production proposed by Schnaiberg (1980). The study adopted a survey design. Combinations of purposive and…

  10. Methods, strategies and technologies used to conduct a scoping literature review of collaboration between primary care and public health.

    Science.gov (United States)

    Valaitis, Ruta; Martin-Misener, Ruth; Wong, Sabrina T; MacDonald, Marjorie; Meagher-Stewart, Donna; Austin, Patricia; Kaczorowski, Janusz; O-Mara, Linda; Savage, Rachel

    2012-07-01

    This paper describes the methods, strategies and technologies used to conduct a scoping literature review examining primary care (PC) and public health (PH) collaboration. It presents challenges encountered as well as recommendations and 'lessons learned' from conducting the review with a large geographically distributed team comprised of researchers and decision-makers using an integrated knowledge translation approach. Scoping studies comprehensively map literature in a specific area guided by general research questions. This methodology is especially useful in researching complex topics. Thus, their popularity is growing. Stakeholder consultations are an important strategy to enhance study results. Therefore, information about how best to involve stakeholders throughout the process is necessary to improve quality and uptake of reviews. This review followed Arksey and O'Malley's five stages: identifying research questions; identifying relevant studies; study selection; charting the data; and collating, summarizing and reporting results. Technological tools and strategies included: citation management software (Reference Manager®), qualitative data analysis software (NVivo 8), web conferencing (Elluminate Live!) and a PH portal (eHealthOntario), teleconferences, email and face-to-face meetings. Of 6125 papers identified, 114 were retained as relevant. Most papers originated in the United Kingdom (38%), the United States (34%) and Canada (19%). Of 80 papers that reported on specific collaborations, most were descriptive reports (51.3%). Research studies represented 34 papers: 31% were program evaluations, 9% were literature reviews and 9% were discussion papers. Key strategies to ensure rigor in conducting a scoping literature review while engaging a large geographically dispersed team are presented for each stage. The use of enabling technologies was essential to managing the process. Leadership in championing the use of technologies and a clear governance

  11. Attributes of patient-centered primary care associated with the public perception of good healthcare quality in Brazil, Colombia, Mexico and El Salvador.

    Science.gov (United States)

    Doubova, Svetlana V; Guanais, Frederico C; Pérez-Cuevas, Ricardo; Canning, David; Macinko, James; Reich, Michael R

    2016-09-01

    This study evaluated primary care attributes of patient-centered care associated with the public perception of good quality in Brazil, Colombia, Mexico and El Salvador. We conducted a secondary data analysis of a Latin American survey on public perceptions and experiences with healthcare systems. The primary care attributes examined were access, coordination, provider-patient communication, provision of health-related information and emotional support. A double-weighted multiple Poisson regression with robust variance model was performed. The study included between 1500 and 1503 adults in each country. The results identified four significant gaps in the provision of primary care: not all respondents had a regular place of care or a regular primary care doctor (Brazil 35.7%, Colombia 28.4%, Mexico 22% and El Salvador 45.4%). The communication with the primary care clinic was difficult (Brazil 44.2%, Colombia 41.3%, Mexico 45.1% and El Salvador 56.7%). There was a lack of coordination of care (Brazil 78.4%, Colombia 52.3%, Mexico 48% and El Salvador 55.9%). Also, there was a lack of information about healthy diet (Brazil 21.7%, Colombia 32.9%, Mexico 16.9% and El Salvador 20.8%). The public's perception of good quality was variable (Brazil 67%, Colombia 71.1%, Mexico 79.6% and El Salvador 79.5%). The primary care attributes associated with the perception of good quality were a primary care provider 'who knows relevant information about a patient's medical history', 'solves most of the health problems', 'spends enough time with the patient', 'coordinates healthcare' and a 'primary care clinic that is easy to communicate with'. In conclusion, the public has a positive perception of the quality of primary care, although it has unfulfilled expectations; further efforts are necessary to improve the provision of patient-centered primary care services in these four Latin American countries. © The Author 2016. Published by Oxford University Press. All rights reserved. For

  12. Public Stigma towards Older Adults with Depression: Findings from the São Paulo-Manaus Elderly in Primary Care Study

    Science.gov (United States)

    Kester, Rachel; Braga, Patrícia Emília; Peluso, Érica T. P.; Blay, Sérgio L.; R. Menezes, Paulo; E. Ribeiro, Euler

    2016-01-01

    This study investigates three domains of public stigma (perceived negative reactions, perceived discrimination, and dangerousness) against older adults with depression. The sample comprised of older adults registered with primary care clinics (n = 1,291) and primary health care professionals (n = 469) from São Paulo and Manaus, Brazil. Participants read a vignette describing a 70-year-old individual (Mary or John) with a depressive disorder and answered questions measuring stigma. The prevalence of the three stigma domains was between 30.2 and 37.6% among older participants from São Paulo and between 27.6 and 35.4% among older participants from Manaus. Older adults from both cities reported similar prevalence of perceived stigma. Key factors associated with stigmatizing beliefs among older participants were reporting depressive symptoms, having physical limitations, and identifying the case of the vignette as a case of mental disorder. Among health professionals, the prevalence of the three stigma domains was between 19.8 and 34.8% in São Paulo and 30.2 and 44.6% in Manaus. The key factor associated with stigma among primary health care professionals was city, with consistently higher risk in Manaus than in São Paulo. Findings confirm that public stigma against older adults in Brazil is common. It is important to educate the public and primary health care providers in Brazil on stigma related to mental illness in order to reduce barriers to adequate mental health treatment. PMID:27352293

  13. Public Stigma towards Older Adults with Depression: Findings from the São Paulo-Manaus Elderly in Primary Care Study.

    Directory of Open Access Journals (Sweden)

    Marcia Scazufca

    Full Text Available This study investigates three domains of public stigma (perceived negative reactions, perceived discrimination, and dangerousness against older adults with depression. The sample comprised of older adults registered with primary care clinics (n = 1,291 and primary health care professionals (n = 469 from São Paulo and Manaus, Brazil. Participants read a vignette describing a 70-year-old individual (Mary or John with a depressive disorder and answered questions measuring stigma. The prevalence of the three stigma domains was between 30.2 and 37.6% among older participants from São Paulo and between 27.6 and 35.4% among older participants from Manaus. Older adults from both cities reported similar prevalence of perceived stigma. Key factors associated with stigmatizing beliefs among older participants were reporting depressive symptoms, having physical limitations, and identifying the case of the vignette as a case of mental disorder. Among health professionals, the prevalence of the three stigma domains was between 19.8 and 34.8% in São Paulo and 30.2 and 44.6% in Manaus. The key factor associated with stigma among primary health care professionals was city, with consistently higher risk in Manaus than in São Paulo. Findings confirm that public stigma against older adults in Brazil is common. It is important to educate the public and primary health care providers in Brazil on stigma related to mental illness in order to reduce barriers to adequate mental health treatment.

  14. Public Stigma towards Older Adults with Depression: Findings from the São Paulo-Manaus Elderly in Primary Care Study.

    Science.gov (United States)

    Scazufca, Marcia; P de Paula Couto, Maria Clara; Huang, Hsiang; Kester, Rachel; Braga, Patrícia Emília; Peluso, Érica T P; Blay, Sérgio L; R Menezes, Paulo; E Ribeiro, Euler

    2016-01-01

    This study investigates three domains of public stigma (perceived negative reactions, perceived discrimination, and dangerousness) against older adults with depression. The sample comprised of older adults registered with primary care clinics (n = 1,291) and primary health care professionals (n = 469) from São Paulo and Manaus, Brazil. Participants read a vignette describing a 70-year-old individual (Mary or John) with a depressive disorder and answered questions measuring stigma. The prevalence of the three stigma domains was between 30.2 and 37.6% among older participants from São Paulo and between 27.6 and 35.4% among older participants from Manaus. Older adults from both cities reported similar prevalence of perceived stigma. Key factors associated with stigmatizing beliefs among older participants were reporting depressive symptoms, having physical limitations, and identifying the case of the vignette as a case of mental disorder. Among health professionals, the prevalence of the three stigma domains was between 19.8 and 34.8% in São Paulo and 30.2 and 44.6% in Manaus. The key factor associated with stigma among primary health care professionals was city, with consistently higher risk in Manaus than in São Paulo. Findings confirm that public stigma against older adults in Brazil is common. It is important to educate the public and primary health care providers in Brazil on stigma related to mental illness in order to reduce barriers to adequate mental health treatment.

  15. Comparison between pulpotomy with MTA (made in Iran and formocresol in primary molars of 3-6 years old children attending the department of pediatric dentistry, School of Dentistry, Medical Sciences/ University of Tehran in 2004

    Directory of Open Access Journals (Sweden)

    Kowsari A.

    2007-05-01

    Full Text Available Background and Aim: Formocresol (FC has been a popular pulpotomy medicament for primary dentition in recent decades. Concerns have been raised about the toxicity and potential carcinogenicity of FC, and alternatives have been proposed. Recently, the physical and biological properties of mineral trioxide aggregate (MTA have been described in many studies. The aim of this study was to compare the success rate of pulpotomy with MTA (made in Iran and FC in primary molars."nMaterials and Methods: In this clinical trial, 30 primary molars needing pulpotomy treatment were selected and randomly divided into two groups: (15 teeth in FC and 15 in MTA group. The teeth were then pulpotomized and restored. Clinical and radiographic results were recorded at 1-3-6-9 and 12 months and success rates of two groups were compared using Fisher’s exact test with p<0.05 as the level of significance. "nResults: After 12 months, there was no statistical significant difference between MTA group (85.8% and FC group (93.3% (P 1.0. The only observed radiographic failure was internal resorption. "nConclusion: Based on the results of this study, MTA can be used as an alternative to formocresol in primary teeth pulpotomy.

  16. Transit Employee Attendance Management Volume 1: Review of Attendance Programs

    Science.gov (United States)

    1986-06-01

    The objectives of this report are to: 1)provide background information on the : importance of improving employee attendance stressing the costs and associated : impacts of absenteeism; 2)summarize and review existing research and theories on : the ca...

  17. Kindergarten and Primary School Children's Implicit Theories of Learning to Write

    Science.gov (United States)

    Scheuer, Nora; de la Cruz, Montserrat; Pozo, Juan Ignacio; Echenique, Monica; Marquez, Maria Silvina

    2009-01-01

    This paper studies the process of learning to write from an insider perspective, by adopting the framework of implicit theories of learning. We interviewed 160 children attending kindergarten or primary education in public schools in Argentina (20 children from each of the eight grades from kindergarten to seventh grade). Main questions explored…

  18. IQuaD dental trial; improving the quality of dentistry: a multicentre randomised controlled trial comparing oral hygiene advice and periodontal instrumentation for the prevention and management of periodontal disease in dentate adults attending dental primary care.

    Science.gov (United States)

    Clarkson, Jan E; Ramsay, Craig R; Averley, Paul; Bonetti, Debbie; Boyers, Dwayne; Campbell, Louise; Chadwick, Graham R; Duncan, Anne; Elders, Andrew; Gouick, Jill; Hall, Andrew F; Heasman, Lynne; Heasman, Peter A; Hodge, Penny J; Jones, Clare; Laird, Marilyn; Lamont, Thomas J; Lovelock, Laura A; Madden, Isobel; McCombes, Wendy; McCracken, Giles I; McDonald, Alison M; McPherson, Gladys; Macpherson, Lorna E; Mitchell, Fiona E; Norrie, John Dt; Pitts, Nigel B; van der Pol, Marjon; Ricketts, David Nj; Ross, Margaret K; Steele, James G; Swan, Moira; Tickle, Martin; Watt, Pauline D; Worthington, Helen V; Young, Linda

    2013-10-26

    Periodontal disease is the most common oral disease affecting adults, and although it is largely preventable it remains the major cause of poor oral health worldwide. Accumulation of microbial dental plaque is the primary aetiological factor for both periodontal disease and caries. Effective self-care (tooth brushing and interdental aids) for plaque control and removal of risk factors such as calculus, which can only be removed by periodontal instrumentation (PI), are considered necessary to prevent and treat periodontal disease thereby maintaining periodontal health. Despite evidence of an association between sustained, good oral hygiene and a low incidence of periodontal disease and caries in adults there is a lack of strong and reliable evidence to inform clinicians of the relative effectiveness (if any) of different types of Oral Hygiene Advice (OHA). The evidence to inform clinicians of the effectiveness and optimal frequency of PI is also mixed. There is therefore an urgent need to assess the relative effectiveness of OHA and PI in a robust, sufficiently powered randomised controlled trial (RCT) in primary dental care. This is a 5 year multi-centre, randomised, open trial with blinded outcome evaluation based in dental primary care in Scotland and the North East of England. Practitioners will recruit 1860 adult patients, with periodontal health, gingivitis or moderate periodontitis (Basic Periodontal Examination Score 0-3). Dental practices will be cluster randomised to provide routine OHA or Personalised OHA. To test the effects of PI each individual patient participant will be randomised to one of three groups: no PI, 6 monthly PI (current practice), or 12 monthly PI.Baseline measures and outcome data (during a three year follow-up) will be assessed through clinical examination, patient questionnaires and NHS databases.The primary outcome measures at 3 year follow up are gingival inflammation/bleeding on probing at the gingival margin; oral hygiene self

  19. The Educational Benefits of Attending Higher Performing Schools: Evidence from Chicago High Schools

    Science.gov (United States)

    Allensworth, Elaine M.; Moore, Paul T.; Sartain, Lauren; de la Torre, Marisa

    2017-01-01

    Policymakers are implementing reforms with the assumption that students do better when attending high-achieving schools. In this article, we use longitudinal data from Chicago Public Schools to test that assumption. We find that the effects of attending a higher performing school depend on the school's performance level. At elite public schools…

  20. Raising awareness of carrier testing for hereditary haemoglobinopathies in high-risk ethnic groups in the Netherlands: a pilot study among the general public and primary care providers

    Directory of Open Access Journals (Sweden)

    Cornel Martina C

    2009-09-01

    Full Text Available Abstract Background In the Netherlands no formal recommendations exist concerning preconceptional or antenatal testing for carriership of hereditary haemoglobinopathies. Those at highest risk may be unaware of the possibility of carrier screening. While universal newborn screening has recently been introduced, neither preconceptional nor antenatal carrier testing is routinely offered by health care services to the general public. A municipal health service and a foundation for public information on medical genetics undertook a pilot project with the aim of increasing knowledge and encouraging informed choice. Two groups were targeted: members of the public from ethnic groups at increased risk, and primary health care providers. This study examines the effectiveness of culturally specific 'infotainment' to inform high-risk ethnic groups about their increased risk for haemoglobinopathies. In addition, the study explores attitudes and intentions of primary care providers towards haemoglobinopathy carrier testing of their patients from high-risk ethnic groups. Methods Informational sessions tailored to the public or professionals were organised in Amsterdam, and evaluated for their effect. Psychological parameters were measured using structured questionnaires based on the Theory of Planned Behaviour. Results The pre-test/post-test questionnaire showed that members of the public gained understanding of inheritance and carriership of haemoglobinopathies from the "infotainment" session (p Conclusion The "infotainment" programme may have a positive effect on people from high-risk groups, but informed general practitioners and midwives were reluctant to facilitate their patients' getting tested. Additional initiatives are needed to motivate primary care providers to facilitate haemoglobinopathy carrier testing for their patients from high-risk backgrounds.

  1. Applying discrete choice modelling in a priority setting: an investigation of public preferences for primary care models.

    Science.gov (United States)

    Seghieri, Chiara; Mengoni, Alessandro; Nuti, Sabina

    2014-09-01

    The shift toward more innovative and sustainable primary care models in Italy leads policy makers and clinicians to face difficult decisions between options that are all regarded as potentially beneficial. In this study, patient preferences for different primary care models in the Tuscany region of Italy were elicited. The relative importance of different attributes to the surveyed respondents was then examined, as well as the rate at which individuals trade between attributes and the relative value of different service configurations. A discrete choice experiment survey explored the following attributes in a stratified random sample of 6,970 adults: primary care provider, diagnostic facilities and waiting time for the visit. Respondents (3,263) were likely to prefer a consultation by their own general practitioner (GP) and a practice with many diagnostic facilities. The predicted utilities of different service configurations have shown that a "primary care centre" with many diagnostic facilities was preferable to a "solo GP" model or a "group general practice". The study demonstrated how a patient choice model could be used by decision makers for developing successful policies that takes into account different healthcare needs, balancing responsiveness with care continuity, equity and appropriateness. Considering that a primary care centre would perform better than a "solo GP", especially for younger respondents and for those with minor healthcare needs, for a more rapid diffusion of this model policymakers and managers could direct the care of primary care centres towards these targeted subgroups, at least in the first phase.

  2. Using Attendance Worksheets to Improve Student Attendance, Participation, and Learning

    Science.gov (United States)

    Rhoads, Edward

    2013-06-01

    As science instructors we are faced with two main barriers with respect to student learning. The first is motivating our students to attend class and the second is to make them active participants in the learning process once we have gotten them to class. As we head further into the internet age this problem only gets exacerbated as students have replaced newspapers with cell phones which can surf the web, check their emails, and play games. Quizzes can motivated the students to attend class but do not necessarily motivate them to pay attention. Active learning techniques work but we as instructors have been bombarded by the active learning message to the point that we either do it already or refuse to. I present another option which in my classroom has doubled the rate at which students learn my material. By using attendance worksheets instead of end of class quizzes I hold students accountable for not just their attendance but for when they show up and when they leave the class. In addition it makes the students an active participant in the class even without using active learning techniques as they are writing notes and answering the questions you have posed while the class is in progress. Therefore using attendance worksheets is an effective tool to use in order to guide student learning.

  3. Prevalence of psychological distress and associated factors in tuberculosis patients in public primary care clinics in South Africa

    Science.gov (United States)

    2012-01-01

    Background Psychological distress has been rarely investigated among tuberculosis patients in low-resource settings despite the fact that mental ill health has far-reaching consequences for the health outcome of tuberculosis (TB) patients. In this study, we assessed the prevalence and predictors of psychological distress as a proxy for common mental disorders among tuberculosis (TB) patients in South Africa, where over 60 % of the TB patients are co-infected with HIV. Methods We interviewed 4900 tuberculosis public primary care patients within one month of initiation of anti-tuberculosis treatment for the presence of psychological distress using the Kessler-10 item scale (K-10), and identified predictors of distress using multiple logistic regressions. The Kessler scale contains items associated with anxiety and depression. Data on socio-demographic variables, health status, alcohol and tobacco use and adherence to anti-TB drugs and anti-retroviral therapy (ART) were collected using a structured questionnaire. Results Using a cut off score of ≥28 and ≥16 on the K-10, 32.9 % and 81 % of tuberculosis patients had symptoms of distress, respectively. In multivariable analysis older age (OR = 1.52; 95 % CI = 1.24-1.85), lower formal education (OR = 0.77; 95 % CI = 0.65-0.91), poverty (OR = 1.90; 95 % CI = 1.57-2.31) and not married, separated, divorced or widowed (OR = 0.74; 95 % CI = 0.62-0.87) were associated with psychological distress (K-10 ≥28), and older age (OR = 1.30; 95 % CI = 1.00-1.69), lower formal education (OR = 0.55; 95 % CI = 0.42-0.71), poverty (OR = 2.02; 95 % CI = 1.50-2.70) and being HIV positive (OR = 1.44; 95 % CI = 1.19-1.74) were associated with psychological distress (K-10 ≥16). In the final model mental illness co-morbidity (hazardous or harmful alcohol use) and non-adherence to anti-TB medication and/or antiretroviral therapy were not associated with

  4. Faculty and medical student attitudes about preclinical classroom attendance.

    Science.gov (United States)

    Zazulia, Allyson R; Goldhoff, Patricia

    2014-01-01

    Technological advances have diminished reliance on classroom attendance for mastering preclinical medical school course content, but nonattendance may have unintended consequence on the learning environment. Perceptions among educators and students regarding the value of attendance and implications of nonattendance have not been systematically studied. The purpose of this study was to investigate differences in medical student and faculty attitudes regarding preclinical classroom attendance and the impact of nonattendance on educators and the learning environment. Using Internet-based surveys, we assessed attitudes about preclinical classroom attendance among medical students and teaching faculty at Washington University School of Medicine. Our primary hypothesis was that students would be less likely than faculty to place societal value on attendance and relate it to professionalism. A total of 382 (79%) of 484 eligible students and 248 (64%) of 387 eligible faculty completed the survey. Both groups recognized a negative impact of poor attendance on faculty enthusiasm for teaching (students 83%, faculty 75%), but faculty were significantly more likely to endorse a negative impact on effectiveness of lectures (75% vs. 42%, pclass for research and community service activities (70% vs. 14%, pclass-going primarily as a tool for learning factual material, whereas many faculty viewed it as serving important functions in the professional socialization process. In this single-center cohort, medical student and teaching faculty attitudes differed regarding the importance of classroom attendance and its relationship to professionalism, findings that were at least partially explained by differing expectations of the purpose of the preclinical classroom experience.

  5. The quality of outpatient primary care in public and private sectors in Sri Lanka--how well do patient perceptions match reality and what are the implications?

    Science.gov (United States)

    Rannan-Eliya, Ravindra P; Wijemanne, Nilmini; Liyanage, Isuru K; Jayanthan, Janaki; Dalpatadu, Shanti; Amarasinghe, Sarasi; Anuranga, Chamara

    2015-03-01

    To compare the quality of clinical care and patient satisfaction in public and private outpatient primary care services in Sri Lanka. A prospective, cross-sectional comparison was done by direct observation of patient encounters and exit interviews of outpatients in 10 public hospital general outpatient clinics and 66 private practitioner clinics in three districts of Sri Lanka. A total of 1027 public sector patients and 944 private sector patients were surveyed. Data were collected for 39 quality indicators covering diarrhoea, cough, hypertension, diabetes, asthma, upper respiratory tract infections (URTI) and five other conditions, along with prescribing indicators. The exit interviews collected data for 10 patient satisfaction indicators. The public sector performed better for some conditions (diarrhoea, cough and asthma) and the private sector performed better for others (hypertension, diabetes, URTI and tonsillitis). Overall quality was similar between the sectors in the domains of history taking, examination and investigations and management, but the private sector performed much better on patient education (57 vs 12%). Overall patient satisfaction was high in both sectors (98%), although the private sector performed much better in interpersonal satisfaction (94 vs 84%) and system-related indicators (95 vs 84%). Comparisons with studies from other countries suggest that both sectors perform considerably better than India, and similarly in many indicators to high-income countries. Quality of outpatient primary care in Sri Lanka is generally high for a lower-middle income developing country. The public and private sectors perform similarly, except that private sector patients have longer consultations, are more likely to receive education and advice, and obtain better interpersonal satisfaction. The public system, with its limited funding, is able to deliver care in diagnosis and management that is similar to the private sector, while private sector patients

  6. Bridging the gap between public health and primary care in prevention of cardiometabolic diseases; background of and experiences with the Prevention Consultation in The Netherlands

    Science.gov (United States)

    Assendelft, Willem J J; Nielen, Markus M J; Hettinga, Dries M; van der Meer, Victor; van Vliet, Mieke; Drenthen, Antonius J M; Schellevis, Francois G; van Oosterhout, Marianne J W

    2012-01-01

    Background. There is an increasing need for programmatic prevention of cardiometabolic diseases (cardiovascular disease, type 2 diabetes and chronic kidney disease). Therefore, in the Netherlands, a prevention programme linked to primary care has been developed. This initiative was supported by the national professional organizations of GPs and occupational physicians as well as three large health foundations. Objectives. To describe and discuss the content, structure of and first experiences with this initiative. Methods. Description of context, risk assessment tool, guideline, content of the Prevention Consultation and pilot studies. Results. Preceding surveys revealed a need for proactive disease prevention, linked to primary care. An evidence-based guideline was developed using a validated eight-question screening list. According to the guideline, high-risk participants were advised to attend two consultations at the general practice, for completing the risk assessment and for tailored advice. Three pilot studies revealed that the programme was feasible and that (sufficient) participants with a condition requiring treatment were detected. We learned that with a ‘passive’ recruitment (with only posters and brochures), screening uptake is limited. A more active approach with a personal invitation from the GP is more effective. Both an Internet as written questionnaire should be available and reminders are necessary. The need for a consultation with the GP practice after a high-risk test result should be emphasized. The first consultation can be performed by a practice nurse. Conclusions. A national systematic screening programme for cardiometabolic diseases linked to primary care is feasible. The cost-effectiveness still has to be established. PMID:22399541

  7. The attitudes of primary healthcare providers towards web-based training on public health services in rural China: a cross-sectional study.

    Science.gov (United States)

    Zhan, X X; Zhang, Z X; Sun, F; Peng, W J; Zhang, H; Yan, W R

    2016-12-01

    To explore the attitudes of primary healthcare workers, including township public health workers (TPHWs) and village doctors (ViDs), towards web-based training on basic public health services (BPHS) and to examine the factors influencing their attitudes. Cross-sectional study. Questionnaires addressing training status, needs, and attitudes towards web-based public health training were administered to 2768 primary healthcare workers from May to September 2013. Multivariate logistic regression models were used to identify the factors that were significantly associated with a positive attitude towards web-based public health training. Among the 2768 participants, 90.6% of the TPHWs and 86.9% of the ViDs expressed a positive attitude towards web-based BPHS training. TPHWs who had a positive attitude towards previous public health training (odds ratio [OR] = 2.75, 95% confidence interval [CI] = 1.28-5.93) and better computer skills (OR = 2.59, 95% CI = 1.03-6.48) were more likely to adopt web-based training on BPHS, as were ViDs who had better computer skills (OR = 2.54, 95% CI = 1.58-4.11) and better Internet speeds (neutral: OR = 2.81, 95% CI = 1.58-5.01; satisfied: OR = 2.53, 95% CI = 1.28-5.01). TPHWs who tended to read papers (OR = 0.24, 95% CI = 0.11-0.50) and were aged 50 years or older (OR = 0.34, 95% CI = 0.14-0.87), as were ViDs who tended to read papers (OR = 0.48, 95% CI = 0.29-0.77), expressed a more negative attitude towards web-based BPHS training. The findings indicated that most primary healthcare workers have a positive attitude towards web-based BPHS training. More priority measures, such as conducting computer training, improving Internet quality and integrating mobile technology, are recommended and will further improve the implementation of web-based public health training programs. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  8. An Exploration of Factors Influencing Career Progression of Tutors in Public Primary Teachers' Training Colleges in Kenya

    Science.gov (United States)

    Muchanje, Peter N.; Njuguna, Felicita W.; Kalai, Jeremiah M.; Bironga, Sophia M.

    2016-01-01

    The study sought to determine the influence of gender, Teachers Service Commission (TSC) adherence to career progression policy guidelines and tutors' exposure to professional development on career progression of tutors in primary teachers training colleges in Kenya. This study was a descriptive survey with 264 tutors randomly sampled from eight…

  9. GIS-based accessibility analysis- a mixed method approach to determine public primary health care demand in South Africa

    CSIR Research Space (South Africa)

    Mokgalaka, H

    2013-11-01

    Full Text Available The spatial realities and dynamics of a changing population with changing health care needs require regular and logical methods to evaluate and assist in primary health care (PHC) planning. Geographical access is an important aspect in the planning...

  10. Public and Private School Distinction, Regional Development Differences, and Other Factors Influencing the Success of Primary School Students in Turkey

    Science.gov (United States)

    Sulku, Seher Nur; Abdioglu, Zehra

    2015-01-01

    This study investigates the factors influencing the success of students in primary schools in Turkey. TIMSS 2011 data for Turkey, measuring the success of eighth-grade students in the field of mathematics, were used in an econometric analysis, performed using classical linear regression models. Two hundred thirty-nine schools participated in the…

  11. What about the Firewall? Creating Virtual Worlds in a Public Primary School Using Sim-on-a-Stick

    Science.gov (United States)

    Jacka, Lisa; Booth, Kate

    2012-01-01

    Virtual worlds are highly immersive, engaging and popular computer mediated environments being explored by children and adults. Why then aren't more teachers using virtual worlds in the classroom with primary and secondary school students? Reasons often cited are the learning required to master the technology, low-end graphics cards, poor…

  12. Acceptability of self-taken vaginal swabs and first-catch urine samples for the diagnosis of urogenital Chlamydia trachomatis and Neisseria gonorrhoeae with an amplified DNA assay in young women attending a public health sexually transmitted disease clinic

    NARCIS (Netherlands)

    Hoebe, Christian J. P. A.; Rademaker, Christiaan W.; Brouwers, Elfi E. H. G.; ter Waarbeek, Henriëtte L. G.; van Bergen, Jan E. A. M.

    2006-01-01

    Public health efforts are needed to encourage young women to get tested for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC). To assess the acceptability and feasibility of 2 noninvasive diagnostic approaches. Participants of this cross-sectional survey were 413 young women (age 16-35) who

  13. Public Broadcasting Service Participation in the NPACT Coverage of the Political Primaries and the Two and One Half National Conventions.

    Science.gov (United States)

    Stone, Robert R.

    Television coverage of the 1972 Presidential Conventions was a complicated, time consuming, exhausting and yet challenging task for the Public Broadcasting Service (PBS). Operating on limited funds and borrowed equipment, PBS had to literally throw together its operation in Miami Beach and still keep tabs on the candidates wandering around the…

  14. Concierge, Wellness, and Block Fee Models of Primary Care: Ethical and Regulatory Concerns at the Public-Private Boundary.

    Science.gov (United States)

    Reid, Lynette

    2017-06-01

    In bioethics and health policy, we often discuss the appropriate boundaries of public funding; how the interface of public and private purchasers and providers should be organized and regulated receives less attention. In this paper, I discuss ethical and regulatory issues raised at this interface by three medical practice models (concierge care, executive wellness clinics, and block fee charges) in which physicians provide insured services (whether publicly insured, privately insured, or privately insured by public mandate) while requiring or requesting that patients pay for services or for the non-insured services of the physicians themselves or their associates. This choice for such practice models is different from the decision to design an insurance plan to include or exclude user fees, co-payments and deductibles. I analyze the issues raised with regards to familiar health care values of equity and efficiency, while highlighting additional concerns about fair terms of access, provider integrity, and fair competition. I then analyze the common Canadian regulatory response to block fee models, considering their extension to wellness clinics, with regards to fiduciary standards governing the physician-patient relationship and the role of informed consent. I close by highlighting briefly issues that are of common concern across different fundamental normative frameworks for health policy.

  15. Prevalence and determinants of use of complementary and alternative medicine by hypertensive patients attending primary health care facilities in Kinshasa, Democratic Republic of the Congo: a cross-sectional study.

    Science.gov (United States)

    Lulebo, Aimée M; Mapatano, Mala A; Mutombo, Paulin B; Mafuta, Eric M; Samba, Gédéon; Coppieters, Yves

    2017-04-08

    In the Democratic Republic of the Congo the control of hypertension is poor, characterized by an increasing number of reported cases of hypertension related complications. Poor control of hypertension is associated with non-adherence to antihypertensive medication. It is well established that the use of complementary and alternative medicine is one of the main factors of non-adherence to antihypertensive medication. The aim of this study is to determine the prevalence and factors associated with the use of complementary and alternative medicine. A cross-sectional study was carried out at the Kinshasa Primary Health-care (KPHC) facilities network in November 2014. A structured interview questionnaire was administrated to a total of 280hypertensive patients. Complementary and alternative medicine were defined according to the National Institute of Health classification as a group of diverse medical and healthcare systems, practices, and products that are not presently considered to be part of conventional medicine. Data were summarized using proportion and mean (with standard deviation). The student's t test and χ2 test were used respectively for mean and proportion comparison. Logistic regression analysis identified determinants of the use of complementary and alternative medicine. The prevalence of use of complementary and alternative medicine was 26.1% (95% CI: 20.7% - 31.8%).Determinants of use of complementary and alternative medicine included misperception about hypertension curability (OR = 2.1; 95%CI: 1.1-3.7) and experience of medication side effects (OR = 2.9; 95%CI: 1.7-5.1). The use of CAM for hypertensive patients is a major problem; antihypertensives with fewer side effects must be emphasized. Religious leaders must become involved in the communication for behavioral change activities to improve the quality of life for hypertensive patients.

  16. Change in women's knowledge of general and personal preconception health risks following targeted brief counseling in publicly funded primary care settings.

    Science.gov (United States)

    Dunlop, Anne L; Logue, Kristi M; Thorne, Castalia; Badal, Hannah J

    2013-01-01

    To explore knowledge of general and personal preconception health risks among women in publicly funded clinics and whether brief counseling can improve knowledge. Interventional cohort study. Five publicly funded primary care clinics. Two cohorts of low-income, nonpregnant African-American and Hispanic women of reproductive age (300 in each cohort). Targeted brief counseling based upon risks identified via preconception health risk assessment. Correct responses on test of women's knowledge of general and personal preconception health risks pre-encounter vs. 3 to 6 months post-encounter. McNemar's test to compare proportion of women in each cohort who correctly answer questions of preconception health knowledge pre-encounter vs. 3 to 6 months post-encounter. Women in the intervention cohort experienced a significant increase in knowledge related to preconception health from baseline to 3 to 6 months post-encounter, including recognition of the importance of folic acid supplementation, seeking medical care for chronic conditions, and review of medication in the preconception period that was not observed for the comparison cohort. Among women with chronic medical conditions, those in the intervention cohort significantly increased their knowledge that the condition could lead to problems in pregnancy (+43%) relative to the lesser improvement in knowledge observed for those in the comparison cohort (+4%) (p preconception health risks improved following screening and brief counseling in publicly funded primary care clinics.

  17. Disparities in attendance at diabetes self-management education programs after diagnosis in Ontario, Canada: a cohort study.

    Science.gov (United States)

    Cauch-Dudek, Karen; Victor, J Charles; Sigmond, Marianne; Shah, Baiju R

    2013-01-30

    Patients newly-diagnosed with diabetes require self-management education to help them understand and manage the disease. The goals of the study were to determine the frequency of diabetes self-management education program utilization by newly-diagnosed patients, and to evaluate whether there were any demographic or clinical disparities in utilization. Using population-level health care data, all 46,553 adults who were diagnosed with any type of non-gestational diabetes in Ontario, Canada between January and June 2006 were identified. They were linked with a diabetes self-management education program registry to identify those who attended within 6 months of diagnosis. The demographic and clinical characteristics of attendees and non-attendees were compared. A total of 9,568 (20.6%) patients attended a diabetes self-management education program within 6 months of diagnosis. Younger age, increasing socioeconomic status, and the absence of mental health conditions or other medical comorbidity were associated with attendance. Patients living in rural areas, where access to physicians may be limited, were markedly more likely to attend. Recent immigrants were 40% less likely to attend self-management education programs than longer-term immigrants or nonimmigrants. Only one in five newly-diagnosed diabetes patients attended a diabetes self-management education program. Demographic and clinical disparities in utilization persisted despite a publicly-funded health care system where patients could access these services without direct charges. Primary care providers and education programs must ensure that more newly-diagnosed diabetes patients receive self-management education, particularly those who are older, poorer, sicker, or recent immigrants.

  18. Disparities in attendance at diabetes self-management education programs after diagnosis in Ontario, Canada: a cohort study

    Directory of Open Access Journals (Sweden)

    Cauch-Dudek Karen

    2013-01-01

    Full Text Available Abstract Background Patients newly-diagnosed with diabetes require self-management education to help them understand and manage the disease. The goals of the study were to determine the frequency of diabetes self-management education program utilization by newly-diagnosed patients, and to evaluate whether there were any demographic or clinical disparities in utilization. Methods Using population-level health care data, all 46,553 adults who were diagnosed with any type of non-gestational diabetes in Ontario, Canada between January and June 2006 were identified. They were linked with a diabetes self-management education program registry to identify those who attended within 6 months of diagnosis. The demographic and clinical characteristics of attendees and non-attendees were compared. Results A total of 9,568 (20.6% patients attended a diabetes self-management education program within 6 months of diagnosis. Younger age, increasing socioeconomic status, and the absence of mental health conditions or other medical comorbidity were associated with attendance. Patients living in rural areas, where access to physicians may be limited, were markedly more likely to attend. Recent immigrants were 40% less likely to attend self-management education programs than longer-term immigrants or nonimmigrants. Conclusion Only one in five newly-diagnosed diabetes patients attended a diabetes self-management education program. Demographic and clinical disparities in utilization persisted despite a publicly-funded health care system where patients could access these services without direct charges. Primary care providers and education programs must ensure that more newly-diagnosed diabetes patients receive self-management education, particularly those who are older, poorer, sicker, or recent immigrants.

  19. Utilizing community health workers as skilled birth attendants in rural ...

    African Journals Online (AJOL)

    Objective: The Nigerian Midwives Service Scheme (MSS) was designed to address the scarcity of skilled birth attendants at primary health care levels. Although, Nigeria has a rich population of trained Midwives, their deployment and retention at communities in critical need for their skills remains a huge challenge.

  20. Linking Teacher Quality, Student Attendance, and Student Achievement

    Science.gov (United States)

    Gershenson, Seth

    2016-01-01

    Research on the effectiveness of educational inputs, particularly research on teacher effectiveness, typically overlooks teachers' potential impact on behavioral outcomes, such as student attendance. Using longitudinal data on teachers and students in North Carolina I estimate teacher effects on primary school student absences in a value-added…

  1. Social environment and frequent attendance in Danish general practice

    DEFF Research Database (Denmark)

    Vedsted, Peter; Olesen, Frede

    2005-01-01

    BACKGROUND: A lack of social support is associated with increased morbidity and mortality and a decreased effect of prevention. Frequent attenders to primary care are characterised by poorer social conditions than other patients in general practice, but we do not know whether this is due to socia...

  2. Classroom Carbon Dioxide Concentration, School Attendance, and Educational Attainment

    Science.gov (United States)

    Gaihre, Santosh; Semple, Sean; Miller, Janice; Fielding, Shona; Turner, Steve

    2014-01-01

    Background: We tested the hypothesis that classroom carbon dioxide (CO[subscript 2]) concentration is inversely related to child school attendance and educational attainment. Methods: Concentrations of CO[subscript 2] were measured over a 3-5?day period in 60 naturally ventilated classrooms of primary school children in Scotland. Concentrations of…

  3. Mothers' and fathers' attendance in a community-based universally offered parenting program in Sweden.

    Science.gov (United States)

    Wells, Michael B; Sarkadi, Anna; Salari, Raziye

    2016-05-01

    Using a public health perspective, this study examined the characteristics of mothers and fathers who attended, compared to those who did not attend, a community-based practitioner-led universally offered parenting program. Mothers (141) and fathers (96) of 4- to 5-year-olds completed a set of questionnaires, including their demographic characteristics, their child's behavioral and emotional problems, and their own parenting behavior. They were all then given the opportunity to attend level 2 of the Triple P--Positive Parenting Program. During the first six months of the study, 33 mothers and 11 fathers opted to attend the program. The relation between program attendance and parental characteristics was similar for mothers and fathers. In general, fathers, non-native and lower educated parents were less likely to attend the program. Mothers, but not fathers, were more likely to attend if they reported more child behavior problems, while fathers, but not mothers, were observed at a trend level to attend if they perceived their child as having more emotional problems. In addition, parents in general were more likely to attend if they used more harsh parenting strategies. Although the universal offer did not reach parents universally, generally those parents who needed it were more likely to attend. Furthermore, this study shows that different factors may impact mothers' and fathers' attendance; therefore, parental data should be analyzed separately and different recruitment strategies should be used for mothers and fathers. © 2015 the Nordic Societies of Public Health.

  4. Classroom carbon dioxide concentration, school attendance, and educational attainment.

    Science.gov (United States)

    Gaihre, Santosh; Semple, Sean; Miller, Janice; Fielding, Shona; Turner, Steve

    2014-09-01

    We tested the hypothesis that classroom carbon dioxide (CO2 ) concentration is inversely related to child school attendance and educational attainment. Concentrations of CO2 were measured over a 3-5 day period in 60 naturally ventilated classrooms of primary school children in Scotland. Concentrations of CO2 were related to the class average annual attendance and proportions attaining a national standard for reading, writing, and numeracy, adjusted for socioeconomic status and class size. The median (interquartile range, IQR) CO2 concentration averaged over the school day was 1086 ppm (922, 1310). In the model, Time Weighted Average CO2 concentrations were inversely associated with school attendance but not academic attainments. An increase of 100 ppm CO2 was associated with a reduced annual attendance of 0.2% (0.04, 0.4) roughly equivalent to 1 half day of school per annum, assuming schools are open on 190 days per year. Indoor temperature and relative humidity were not related to attendance or academic attainment. Inadequate classroom ventilation, as evidenced by CO2 concentration exceeding 1000 ppm, is not uncommon and may be associated with reduced school attendance. A relationship between inadequate classroom ventilation and adverse health outcomes in children may be present and this needs to be explored. © 2014, American School Health Association.

  5. Translational study of obesity management using the Diabetes Prevention Program "Group Lifestyle Balance" in primary care clinics and public hospitals from Mexico: study protocol

    Directory of Open Access Journals (Sweden)

    Rolando Giovanni Díaz-Zavala

    2017-12-01

    Full Text Available Introduction: Obesity is the main modifiable risk factor for the development of chronic diseases in Mexico. Several randomized controlled trials have shown that intensive lifestyle programs are efficacious for the management of obesity. These programs include frequent sessions (14 or more contacts in the first 6 months focused on diet and physical activity and use a behavior change protocol. However, most Mexican primary care clinics and public hospitals apply traditional treatments for obesity management with limited results on weight loss. The purpose of the study is to evaluate the effectiveness of the Diabetes Prevention Program (DPP “Group Lifestyle Balance” for weight loss among adults with overweight and obesity from baseline to 6 months and from baseline to 12 months in primary care clinics and public hospitals from Sonora, Mexico. Material and Methods: This is a translational, multi-center, non-controlled, 6 and 12-month follow-up clinical study with a pre-test and post-test design. Healthcare providers from two primary care clinics, two hospitals and one university clinic will be trained with the DPP protocol to implement on their patients with overweight and obesity. Body weight, body mass index, waist circumference, systolic and diastolic blood pressure, depression, quality of life and stress scales will be measured in participants receiving the program at baseline, 6 and 12 months. Biochemical parameters will be measured at baseline and 12 months. The primary outcome is the change in body weight at 6 and 12 months. Discussion: This study will provide scientific evidence of the effectiveness of the DPP protocol as a model for obesity management in real world clinical practice among the adult Mexican population.

  6. Induced abortion among women attending antenatal clinics in ...

    African Journals Online (AJOL)

    Objectives: Unsafe abortion is a public health concern because of its impact on maternal morbidity and mortality. The objective of this study was to document on induced abortion in Yaounde, Cameroon. Design: Cross-sectional study. Setting: Six antenatal clinics in Yaounde, Cameroon. Methods: Women attending ...

  7. Visit Attendance Patterns in Nurse-Family Partnership Community Sites.

    Science.gov (United States)

    Holland, Margaret L; Olds, David L; Dozier, Ann M; Kitzman, Harriet J

    2017-08-15

    We examined visit attendance patterns of mothers enrolled in the Nurse-Family Partnership (NFP) home visitation program and associations between these patterns and characteristics of the families and sites, with the goal of increasing participant engagement. We utilized repeated measures latent class analysis to identify attendance patterns among 66,967 mothers in NFP sites across the USA. Mothers enrolled from 1996 to 2010. Data were collected by home visitors and aggregated by the NFP National Service Office. Five visit attendance patterns were identified. Consistent attenders (22%) remained engaged for the full program and attended 51.3 visits on average. Inconsistent attenders (9%) remained engaged but missed many visits, with an average of 36.4 visits. The remaining patterns were characterized by when participants left the program: early (28%; 6.7 visits), gradually (27%; 19.4 visits), or late (15%; 35.3 visits). Consistent and inconsistent attenders were less likely to use English as their primary language than other participants (R = 0.12; p < .001). Participants with more nurse changes per visit attended were more likely to drop out early (R = 0.11; p < .001). Sites with a higher percent of missing data had smaller portions of mothers who remained consistently engaged in the program over time (b = - 0.032; p < .01) and greater portions in the late (b = 0.007; p < .04) and gradual attrition classes (b = 0.018; p < .01). The large number of participants who dropped out early is concerning. Further exploration of this group may optimize use of resources by improving either retention or targeting of potential participants.

  8. Hazardous and Harmful Alcohol Use and Associated Factors in Tuberculosis Public Primary Care Patients in South Africa

    Directory of Open Access Journals (Sweden)

    Gladys Matseke

    2012-09-01

    Full Text Available The aim of this study was to assess the prevalence of hazardous and harmful alcohol use and associated factors among patients with tuberculosis in South Africa. In a cross-sectional survey new tuberculosis (TB and TB retreatment patients were consecutively screened using the Alcohol Use Disorder Identification Test (AUDIT within one month of anti-tuberculosis treatment. The sample included 4,900 (54.5% men and women 45.5% tuberculosis patients from 42 primary care clinics in three districts. Results indicate that, overall 23.2% of the patients were hazardous or harmful alcohol drinkers, 31.8% of men and 13.0% of women were found to be hazardous drinkers, and 9.3% of men and 3.4% of women meet criteria for probable alcohol dependence (harmful drinking as defined by the AUDIT. Men had significantly higher AUDIT scores than women. In multivariable analyses it was found that among men poor perceived health status, tobacco use, psychological distress, being a TB retreatment patient and not being on antiretroviral therapy (ART, and among women lower education, tobacco use and being a TB retreatment patient were associated with hazardous or harmful alcohol use. The study found a high prevalence of hazardous or harmful alcohol use among tuberculosis primary care patients. This calls for screening and brief intervention and a comprehensive alcohol treatment programme as a key component of TB management in South Africa.

  9. Public Reporting of Primary Care Clinic Quality: Accounting for Sociodemographic Factors in Risk Adjustment and Performance Comparison.

    Science.gov (United States)

    Wholey, Douglas R; Finch, Michael; Kreiger, Rob; Reeves, David

    2018-01-03

    Performance measurement and public reporting are increasingly being used to compare clinic performance. Intended consequences include quality improvement, value-based payment, and consumer choice. Unintended consequences include reducing access for riskier patients and inappropriately labeling some clinics as poor performers, resulting in tampering with stable care processes. Two analytic steps are used to maximize intended and minimize unintended consequences. First, risk adjustment is used to reduce the impact of factors outside providers' control. Second, performance categorization is used to compare clinic performance using risk-adjusted measures. This paper examines the effects of methodological choices, such as risk adjusting for sociodemographic factors in risk adjustment and accounting for patients clustering by clinics in performance categorization, on clinic performance comparison for diabetes care, vascular care, asthma, and colorectal cancer screening. The population includes all patients with commercial and public insurance served by clinics in Minnesota. Although risk adjusting for sociodemographic factors has a significant effect on quality, it does not explain much of the variation in quality. In contrast, taking into account the nesting of patients within clinics in performance categorization has a substantial effect on performance comparison.

  10. Linking primary care information systems and public health vertical programs in the Philippines: an open-source experience.

    Science.gov (United States)

    Herman, Tolentino; Marcelo, Alvin; Marcelo, Portia; Maramba, Inocencio

    2005-01-01

    Community-based primary care information systems are one of the building blocks for national health information systems. In the Philippines, after the devolution of health care to local governments, we observed "health information system islands" connected to national vertical programs being implemented in devolved health units. These structures lead to a huge amount of "information work" in the transformation of health information at the community level. This paper describes work done to develop and implement the open-source Community Based Health Information Tracking System (CHITS) Project, which was implemented to address this information management problem and its outcomes. Several lessons learned from the field as well as software development strategies are highlighted in building community level information systems that link to national level health information systems.

  11. Knowledge, attitudes, and practices of public sector primary health care physicians of rural north karnataka towards obesity management.

    Science.gov (United States)

    Somannavar, Manjunath S; Appajigol, Jayaprakash S

    2014-01-01

    Obesity is a risk factor for cardiovascular disease (CVD), diabetes mellitus (DM), and hypertension (HTN). In an era of rapidly growing prevalence of obesity, it is important to explore the current knowledge, attitude, and practices of primary care physicians. Study participants were medical officers (MOs) of primary health centers in three districts of North Karnataka. The questionnaire was developed by a review of literature in the field and validated with five participants for scope, length, and clarity. Of the 102 participants, only 15% were aware about the burden of obesity in India. HTN, DM, and CVD were indicated as comorbidities by 73, 78, and 60 participants, respectively. Only 25 and 12 participants indicated appropriate body mass index (BMI) cut-off values for overweight and obesity diagnosis. Of the 102 participants, 54 were not aware of the guidelines for obesity management. Practices and attitudes of the participants were encouraging. Nearly all of them felt that the adults with BMI within the healthy range should be encouraged to maintain their weight and, three-fourth of them agreed that most overweight persons should be treated for weight loss and small weight loss can achieve major medical benefit. However, nearly half of the participants' responses were stereotypical as they felt only obese and overweight with comorbidities should be treated for weight loss. Two-thirds of them use BMI to diagnose overweight/obese and nearly all of them advice their patients to increase physical activity and restrict fat. Most of the participants were advising their patients to restrict sugar intake, increase fruits and vegetable consumption, reduce red meat, and avoid alcohol consumption. Present study exposed the lack of knowledge regarding obesity. However, practices and attitudes of the participants were promising. There is a need of in-service training to MOs to further improve their knowledge and practices towards management of obesity.

  12. Knowledge, attitudes, and practices of public sector primary health care physicians of rural north karnataka towards obesity management

    Directory of Open Access Journals (Sweden)

    Manjunath S Somannavar

    2014-01-01

    Full Text Available Introduction: Obesity is a risk factor for cardiovascular disease (CVD, diabetes mellitus (DM, and hypertension (HTN. In an era of rapidly growing prevalence of obesity, it is important to explore the current knowledge, attitude, and practices of primary care physicians. Materials and Methods: Study participants were medical officers (MOs of primary health centers in three districts of North Karnataka. The questionnaire was developed by a review of literature in the field and validated with five participants for scope, length, and clarity. Results/Discussion: Of the 102 participants, only 15% were aware about the burden of obesity in India. HTN, DM, and CVD were indicated as comorbidities by 73, 78, and 60 participants, respectively. Only 25 and 12 participants indicated appropriate body mass index (BMI cut-off values for overweight and obesity diagnosis. Of the 102 participants, 54 were not aware of the guidelines for obesity management. Practices and attitudes of the participants were encouraging. Nearly all of them felt that the adults with BMI within the healthy range should be encouraged to maintain their weight and, three-fourth of them agreed that most overweight persons should be treated for weight loss and small weight loss can achieve major medical benefit. However, nearly half of the participants′ responses were stereotypical as they felt only obese and overweight with comorbidities should be treated for weight loss. Two-thirds of them use BMI to diagnose overweight/obese and nearly all of them advice their patients to increase physical activity and restrict fat. Most of the participants were advising their patients to restrict sugar intake, increase fruits and vegetable consumption, reduce red meat, and avoid alcohol consumption. Conclusion: Present study exposed the lack of knowledge regarding obesity. However, practices and attitudes of the participants were promising. There is a need of in-service training to MOs to further

  13. Encouraging School Enrollment and Attendance among Teenage Parents on Welfare: Early Impacts of Ohio's LEAP Program.

    Science.gov (United States)

    Wood, Robert G.; And Others

    1995-01-01

    Presents interim findings from an impact analysis of Ohio's Learning, Earning, and Parenting (LEAP) Program. LEAP is a statewide program designed to encourage school attendance among pregnant and parenting teens on welfare. Suggests that LEAP has succeeded in its primary short-term goal of increasing the school enrollment and attendance of teen…

  14. Speech-based Class Attendance

    Science.gov (United States)

    Faizel Amri, Umar; Nur Wahidah Nik Hashim, Nik; Hazrin Hany Mohamad Hanif, Noor

    2017-11-01

    In the department of engineering, students are required to fulfil at least 80 percent of class attendance. Conventional method requires student to sign his/her initial on the attendance sheet. However, this method is prone to cheating by having another student signing for their fellow classmate that is absent. We develop our hypothesis according to a verse in the Holy Qur’an (95:4), “We have created men in the best of mould”. Based on the verse, we believe each psychological characteristic of human being is unique and thus, their speech characteristic should be unique. In this paper we present the development of speech biometric-based attendance system. The system requires user’s voice to be installed in the system as trained data and it is saved in the system for registration of the user. The following voice of the user will be the test data in order to verify with the trained data stored in the system. The system uses PSD (Power Spectral Density) and Transition Parameter as the method for feature extraction of the voices. Euclidean and Mahalanobis distances are used in order to verified the user’s voice. For this research, ten subjects of five females and five males were chosen to be tested for the performance of the system. The system performance in term of recognition rate is found to be 60% correct identification of individuals.

  15. GIS as a Tool for Education Decision Support System: A Demonstration with Public Primary Schools in Zaria City Kaduna State Nigeria

    Directory of Open Access Journals (Sweden)

    U. Wali

    2015-07-01

    Full Text Available This paper aimed at demonstrating the use of GIS in the display of data about primary schools in the walled part of Zaria city, Kaduna State. It is hoped that the database and its graphic display in maps will guide decision making at the primary education level in the study area. Coordinates of the schools were obtained with a handheld GPS receiver, while their attribute data were obtained from the local education authority and triangulated with questionnaires administered to the headmasters of the schools. ArcGIS 9.2 version software was used for buffer zone (1 km. The result indicates that there are 31 public primary schools in the study area. The oldest was established in 1921 and the latest in 2007. Graphic displays of some attributes of the schools were produced. The buffer zones produced suggest no pupil walks more than a kilometer to reach school. It is recommended that in the future, GIS tools should be applied when managing school data. Capacities to achieve this should be developed.

  16. A Comparative Evaluation of Public Health Centers with Private Health Training Centers on Primary Healthcare Parameters in India: a Study by Data Envelopment Analysis Technique.

    Science.gov (United States)

    Davey, Sanjeev; Raghav, Santosh Kumar; Singh, Jai Vir; Davey, Anuradha; Singh, Nirankar

    2015-01-01

    The evaluation of primary healthcare services provided by health training centers of a private medical college has not been studied in comparison with government health facilities in Indian context. Data envelopment analysis (DEA) is one such technique of operations research, which can be used on health facilities for identifying efficient operating practices and strategies for relatively efficient or inefficient health centers by calculating their efficiency scores. This study was carried out by DEA technique by using basic radial models (constant ratio to scale (CRS)) in linear programming via DEAOS free online Software among four decision making units (DMUs; by comparing efficiency of two private health centers of a private medical college of India with two public health centers) in district Muzaffarnagar of state Uttar Pradesh. The input and output records of all these health facilities (two from private and two from Government); for 6 months duration from 1(st) Jan 2014 to 1(st) July 2014 was taken for deciding their efficiency scores. The efficiency scores of primary healthcare services in presence of doctors (100 vs 30%) and presence of health staff (100 vs 92%) were significantly better from government health facilities as compared to private health facilities (P healthcare services delivery by DEA technique reveals that the government health facilities group were more efficient in delivery of primary healthcare services as compared to private training health facilities group, which can be further clarified in by more in-depth studies in future.

  17. Toxocariasis in children attending a Public Health Service Pneumology Unit in Paraná State, Brazil Toxocaríase em crianças atendidas em Unidade de Pneumologia do Serviço de Saúde Pública, Paraná, Brasil

    Directory of Open Access Journals (Sweden)

    Edson V. Guilherme

    2013-06-01

    Full Text Available The enzyme-linked immunosorbent assay (ELISA is the most widely used tool to detect anti-Toxocara IgG antibodies for both serodiagnostic and seroepidemiological surveys on human toxocariasis. In the last eight years a high prevalence of toxocariasis (32.2-56.0% has been reported in children attending public health units from municipalities in the state of Paraná, Brazil. Therefore, the aim of this work was to compare the frequency found among the general child population with that of children attending a public pneumology service in Maringá, Paraná, Brazil and describe the laboratorial, clinical and epidemiological findings. The research was conducted at the Consórcio Público Intermunicipal de Saúde do Setentrião Paranaense (CISAMUSEP from July 2009 to July 2010 among children aged between one and 15 years. From a total of 167 children studied, only 4.2% (7/167 tested positive for anti-Toxocara spp. IgG antibodies and presented mild eosinophilia (2/7, increased serum IgE levels (6/7 and a positive allergy test for mites (5/7. The presence of pets (dogs or cats at home did not correlate with the seroprevalence. In conclusion, cases of toxocariasis involving the respiratory tract are rare in children attending a public health pneumology unit in the northwestern region of Paraná State, despite the high prevalence of this type of toxocariasis among the infantile population attending Basic Health Units in the same geographical area.O teste imunoenzimático (ELISA constitui a ferramenta mais utilizada no diagnóstico individual da toxocaríase humana e/ou em inquéritos soroepidemiológicos para pesquisa de anticorpos IgG anti-Toxocara spp. Tendo em vista a elevada freqüência da toxocaríase (32,2% e 56,0% observada em crianças atendidas em Unidades Básicas de Saúde de municípios do noroeste do Paraná, durante pesquisas realizadas ao longo dos últimos oito anos, o objetivo deste trabalho foi comparar estas frequências em crian

  18. Disinfection of an advanced primary effluent using peracetic acid or ultraviolet radiation for its reuse in public services.

    Science.gov (United States)

    Julio, Flores R; Hilario, Terres-Peña; Mabel, Vaca M; Raymundo, López C; Arturo, Lizardi-Ramos; Ma Neftalí, Rojas-Valencia

    2015-03-01

    The disinfection of a continuous flow of an effluent from an advanced primary treatment (coagulation-flocculation-sedimentation) with or without posterior filtration, using either peracetic acid (PAA) or ultraviolet (UV) radiation was studied. We aimed to obtain bacteriological quality to comply with the microbiological standard established in the Mexican regulations for treated wastewater reuse (NOM-003-SEMARNAT-1997), i.e., less than 240 MPN (most probable number) FC/100 mL. The concentrations of PAA were 10, 15, and 20 mg/L, with contact times of 10, and 15 min. Fecal coliforms (FC) inactivation ranged from 0.93 up to 6.4 log units, and in all cases it reached the limits set by the mentioned regulation. Water quality influenced the PAA disinfection effectiveness. An efficiency of 91% was achieved for the unfiltered effluent, as compared to 99% when wastewater was filtered. UV radiation was applied to wastewater flows of 21, 30 and 39 L/min, with dosages from 1 to 6 mJ/cm². This treatment did not achieve the bacteriological quality required for treated wastewater reuse, since the best inactivation of FC was 1.62 log units, for a flow of 21 L/min of filtered wastewater and a UV dosage of 5.6 mJ/cm².

  19. The associated markers and their limitations for the primary screening of HCV carriers in public health examination.

    Science.gov (United States)

    Miyazaki, Teruo; Honda, Akira; Ikegami, Tadashi; Hara, Takashi; Saitoh, Yoshifumi; Hirayama, Takeshi; Doy, Mikio; Matsuzaki, Yasushi

    2009-07-01

    Although the anti-hepatitis C virus (HCV) antibody test has been recommended to the whole Japanese population, most countries have not implemented it. The present study aims to re-evaluate the usefulness of markers examined in the general health examination for the initial screening of HCV carriers. Of the overall population, 25 142 individuals (8876 males, 16 266 females) participated in health examinations with HCV tests in 2005, and the most commonly associated markers for HCV-positive subjects were explored by multivariate analysis, based on blood biochemical, physical, sphygmomanometric and hematological parameters. Thereafter, the efficiencies of the markers were estimated from a total population of 85 013 individuals (29 502 males, 55 511 females) in 2003-2005. The most significantly associated markers for HCV positivity were aspartate aminotransferase (AST) and alanine aminotransferase (ALT). Optimal limits of ALT and AST by receiver-operator characteristic (ROC) analysis were 24 and 27 IU (male, 33 and 28 IU; female, 22 and 26 IU), respectively. However, one-quarter of HCV carriers were not found to be positive using the optimal limits of aminotransferases. The present study confirmed the limitation of serum aminotransferase levels as markers of HCV for primary screening. Therefore, at present, an anti-HCV antibody test is required for the efficient screening of HCV carriers in all health examinations.

  20. Early infection and asymptomatic spread of hepatitis A virus in a public child care center in Rio de Janeiro, Brazil: should attending children under two years of age be vaccinated?

    Directory of Open Access Journals (Sweden)

    Liliane M Morais

    2006-06-01

    Full Text Available A cross-sectional study was conducted in order to identify hepatitis A virus (HAV serological markers in 418 individuals (mean age, 16.4 years; range, 1 month-80 years at a public child care center in Rio de Janeiro, Brazil, as well as to analyze risk factors and determine circulating genotypes. Serum samples were tested using an enzyme immunoassay. Reverse transcription polymerase chain reaction (RT-PCR was used to detect and characterize HAV RNA, and sequencing was performed. Anti-HAV antibodies and IgM anti-HAV antibodies were detected, respectively, in 89.5% (374/418 and 10.5% (44/418 of the individuals tested. Acute HAV infection in children was independently correlated with crawling (p < 0.05. In 56.8% (25/44 of the IgM anti-HAV-positive individuals and in 33.3% (5/15 of the IgM anti-HAV-negative individuals presenting clinical symptoms, HAV RNA was detected. Phylogenetic analysis revealed co-circulation of subgenotypes IA and IB in 93.3% (28/30 of the amplified samples. In present study, we verify that 79% (30/38 of children IgM anti-HAV-positive were asymptomatic. In child care centers, this asymptomatic spread is a more serious problem, promoting the infection of young children, who rarely show signs of infection. Therefore, vaccinating children below the age of two might prevent the asymptomatic spread of hepatitis A.

  1. Early infection and asymptomatic spread of hepatitis A virus in a public child care center in Rio de Janeiro, Brazil: should attending children under two years of age be vaccinated?

    Science.gov (United States)

    Morais, Liliane M; de Paula, Vanessa S; Arantes, Milton R; Oliveira, Maria L A; Gaspar, Ana Maria C

    2006-06-01

    A cross-sectional study was conducted in order to identify hepatitis A virus (HAV) serological markers in 418 individuals (mean age, 16.4 years; range, 1 month-80 years) at a public child care center in Rio de Janeiro, Brazil, as well as to analyze risk factors and determine circulating genotypes. Serum samples were tested using an enzyme immunoassay. Reverse transcription polymerase chain reaction (RT-PCR) was used to detect and characterize HAV RNA, and sequencing was performed. Anti-HAV antibodies and IgM anti-HAV antibodies were detected, respectively, in 89.5% (374/418) and 10.5% (44/418) of the individuals tested. Acute HAV infection in children was independently correlated with crawling (p children IgM anti-HAV-positive were asymptomatic. In child care centers, this asymptomatic spread is a more serious problem, promoting the infection of young children, who rarely show signs of infection. Therefore, vaccinating children below the age of two might prevent the asymptomatic spread of hepatitis A.

  2. Malaria among antenatal clients attending primary health care ...

    African Journals Online (AJOL)

    anémie chez les femmes enceintes qui fréquentent les ... proportion plus élevée de primigravid et secondigravid clients (61 % VS 39 %) et les jeunes femmes enceintes (54,6 % ..... as teenage mothers than those with higher gravidity and older.

  3. Prevalence of obesity among women attending a Nigerian primary ...

    African Journals Online (AJOL)

    The objective was to determine the prevalence of obesity and associated risk factors among women in a Nigerian Out-Patient clinic. A pre-tested structured questionnaire was administered on women at the General Outpatients' Department (G.O.P.D.) of the University College Hospital (U.C.H.), Ibadan. The prevalence of ...

  4. Practicing breast self-examination among women attending primary ...

    African Journals Online (AJOL)

    Saadoon F. Al-Azmy

    2012-09-24

    Sep 24, 2012 ... studies dealing with the same topic as well as from our own experience.2–4,10 It included ... for data processing. Simple descriptive statistics .... discharge from nipple, breast mass, abnormal arm swelling, nipple retraction and ...

  5. Knowledge, attitude and practice of patients attending primary care ...

    African Journals Online (AJOL)

    Bassam A. Al Bathi

    2012-03-18

    Mar 18, 2012 ... Only 21.0% believed that they feel better regarding musculoskeletal symptoms after ... negative attitude toward vitamin D problems. Planning health .... on specific receptors on skeletal muscle or mediated by the effects of ...

  6. Problem drinking among patients attending primary healthoare units ...

    African Journals Online (AJOL)

    being asked if they drink alcohol they were interviewed by means of the CAGE questionnaire and a quantity/frequency questionnaire. .... below the age of 35 years with 74% females and 64% males in Results from the CAGE and the quantity-frequency .... legally married or had been staying with each other for a long time.

  7. Practicing breast self-examination among women attending primary ...

    African Journals Online (AJOL)

    Saadoon F. Al-Azmy

    2012-09-24

    examination (BSE), few women perform it ... factors associated with BSE, whereas practicing subjects (control) were compared with a randomly selected similar ... and discoloration of the breast were signs and symptoms of breast cancer.

  8. Quality of care offered to children attending primary health care ...

    African Journals Online (AJOL)

    Growth monitoring and nutritional counselling at well child visits was generally inadequate, with not one of 11 children who qualified for food supplementation receiving it. Conclusion. The poor quality of PHC offered to children in the richest city in Africa is a sad indictment of the inability of health service providers to address ...

  9. Social Exclusion and the Hidden Curriculum: The Schooling Experiences of Chinese Rural Migrant Children in an Urban Public School

    Science.gov (United States)

    Zhang, Donghui; Luo, Yun

    2016-01-01

    Since 2001, the Chinese government had passed a series of policies known as "the two primary responsibilities" to allow the rural migrant children to attend urban public schools. However, what the migrant children actually experienced in and after negotiating access to these schools deserves serious attention from educators, scholars and…

  10. A comparative evaluation of public health centers with private health training centers on primary healthcare parameters in India: a study by data envelopment analysis technique

    Directory of Open Access Journals (Sweden)

    Sanjeev Davey

    2015-01-01

    Full Text Available Background: The evaluation of primary healthcare services provided by health training centers of a private medical college has not been studied in comparison with government health facilities in Indian context. Data envelopment analysis (DEA is one such technique of operations research, which can be used on health facilities for identifying efficient operating practices and strategies for relatively efficient or inefficient health centers by calculating their efficiency scores. Materials and Methods: This study was carried out by DEA technique by using basic radial models (constant ratio to scale (CRS in linear programming via DEAOS free online Software among four decision making units (DMUs; by comparing efficiency of two private health centers of a private medical college of India with two public health centers in district Muzaffarnagar of state Uttar Pradesh. The input and output records of all these health facilities (two from private and two from Government; for 6 months duration from 1 st Jan 2014 to 1 st July 2014 was taken for deciding their efficiency scores. Results: The efficiency scores of primary healthcare services in presence of doctors (100 vs 30% and presence of health staff (100 vs 92% were significantly better from government health facilities as compared to private health facilities (P < 0.0001. Conclusions: The evaluation of primary healthcare services delivery by DEA technique reveals that the government health facilities group were more efficient in delivery of primary healthcare services as compared to private training health facilities group, which can be further clarified in by more in-depth studies in future.

  11. Frequent attenders in general practice: problem solving treatment (PST) provided by nurses

    NARCIS (Netherlands)

    Schreuder, B.; van Oppen, P.C.; van Marwijk, H.W.J.; Smit, J.H.; Stalman, W.A.B.

    2005-01-01

    Background: There is a need for assistance from primary care mental health workers in general practice in the Netherlands. General practitioners (GPs) experience an overload of frequent attenders suffering from psychological problems. Problem Solving Treatment (PST) is a brief psychological

  12. Frequent attenders in general practice: problem solving treatment provided by nurses [ISRCTN51021015

    NARCIS (Netherlands)

    Schreuders, B.; van Oppen, P.C.; van Marwijk, H.W.J.; Smit, J.H.; Stalman, W.A.B.

    2005-01-01

    Background: There is a need for assistance from primary care mental health workers in general practice in the Netherlands. General practitioners (GPs) experience an overload of frequent attenders suffering from psychological problems. Problem Solving Treatment (PST) is a brief psychological

  13. Frequent attenders in general practice: problem solving treatment provided by nurses [ISRCTN51021015

    NARCIS (Netherlands)

    Schreuders, B.; Oppen, van P.C.; Marwijk, van H.W.J.; Smit, J.H.; Stalman, W.A.B.

    2005-01-01

    BACKGROUND: There is a need for assistance from primary care mental health workers in general practice in the Netherlands. General practitioners (GPs) experience an overload of frequent attenders suffering from psychological problems. Problem Solving Treatment (PST) is a brief psychological

  14. Impact of conference attendance on librarians' leadership ...

    African Journals Online (AJOL)

    ... attendance to leadership developments hows approximately 0.370.m Conference attendance was highly recommended as a means of enhancing leadership development of academic librarians. Keywords: Experiential learning, self efficacy, attitude, Conference, Impact, Leadership, Teamwork, development, brainstorm, ...

  15. Breakfast habit and quality in students from two public primary schools in the city of Santa Fe.

    Science.gov (United States)

    Fugas, Valeria; Berta, Eugenia; Walz, Florencia; Fortino, Ma Alejandra; Martinelli, Marcela J

    2013-12-01

    Breakfast provides the necessary energy and nutrients to achieve an optimal physical and mental performance. OBJECTIVE. To find out breakfast frequency, factors that influence breakfast habit and skipping, breakfast quality and snack intake in children from public schools in the city of Santa Fe. POPULATION AND METHODS. Descriptive, cross-sectional study. A total of 637 students were assessed using a closed-ended question survey. RESULTS. Seventy five percent of children had breakfast on a daily basis; only 1.6% had a good quality breakfast. Eating breakfast every day or some days did not depend on having the company of a family member. In the case of first to fifth grade children, the weekly frequency depended on having a family member who made it (p= 0.04). The main cause for skipping breakfast was lack of time. Twenty-three percent of children in sixth and seventh grade indicated feeling unwell when having breakfast. More than 50% of children watched television while having breakfast. Most students in first to third grade had breakfast that could be improved (41%) and which was insufficient (41%). An insufficient quality breakfast was more common among fourth and fifth grade students (50%). A remarkable piece of information is the number of sixth and seventh grade children who had a poor quality breakfast (16%). Very few children had a snack that was appropriate to supplement the final quality of breakfast. CONCLUSIONS. Although a high percentage of school-aged children are used to having breakfast, most have an incomplete breakfast. Very few manage to supplement their breakfast with snacks at mid-morning.

  16. Folate, vitamin B12 and Homocysteine status in the post-folic acid fortification era in different subgroups of the Brazilian population attended to at a public health care center.

    Science.gov (United States)

    Barnabé, Aline; Aléssio, Ana Cláudia Morandi; Bittar, Luis Fernando; de Moraes Mazetto, Bruna; Bicudo, Angélica M; de Paula, Erich V; Höehr, Nelci Fenalti; Annichino-Bizzacchi, Joyce M

    2015-02-19

    Folate and vitamin B12 are essential nutrients, whose deficiencies are considerable public health problems worldwide, affecting all age groups. Low levels of these vitamins have been associated with high concentrations of homocysteine (Hcy) and can lead to health complications. Several genetic polymorphisms affect the metabolism of these vitamins. The aims of this study were to assess folate, vitamin B12 and homocysteine status in distinct Brazilian individuals after the initiation of folic acid fortification by Brazilian authorities and to investigate the effects of RFC1 A80G, GCPII C1561T and MTHFR C677T polymorphisms on folate, vitamin B12 and Hcy levels in these populations. A total of 719 individuals including the elderly, children, as well as pregnant and lactating women were recruited from our health care center. Folate, vitamin B12 and Hcy levels were measured by conventional methods. Genotype analyses of RFC1 A80G, GCPII C1561T and MTHFR C677T polymorphisms were performed by PCR-RFLP. The overall prevalence of folate and vitamin B12 deficiencies were 0.3% and 4.9%, respectively. Folate deficiency was observed only in the elderly (0.4%) and pregnant women (0.3%), whereas vitamin B12 deficiency was observed mainly in pregnant women (7.9%) and the elderly (4.2%). Plasma Hcy concentrations were significantly higher in the elderly (33.6%). Pregnant women carrying the MTHFR 677TT genotype showed lower serum folate levels (p = 0.042) and higher Hcy levels (p = 0.003). RFC1 A80G and GCPII C1561T polymorphisms did not affect folate and Hcy levels in the study group. After a multivariate analysis, Hcy levels were predicted by variables such as folate, vitamin B12, gender, age and RFC1 A80G polymorphism, according to the groups studied. Our results suggest that folate deficiency is practically nonexistent in the post-folic acid fortification era in the subgroups evaluated. However, screening for vitamin B12 deficiency may be particularly relevant in our

  17. School attendance and the perceived value of formal education: Evidence from Tanzania

    OpenAIRE

    Christopher R. Gustafson

    2015-01-01

    The benefits of universal primary education (UPE)—ranging from increased personal wellbeing to socially important outcomes such as lower population growth and improved maternal and child health—are widely documented, and donor organizations have invested significant amounts of money to reduce barriers to education. However, there are still many children—and girls, in particular—who do not attend school. Countries in sub-Saharan Africa (SSA) have not attained rates of primary school attendance...

  18. Flight Attendants. Aviation Careers Series. Revised.

    Science.gov (United States)

    Zaharevitz, Walter

    This booklet, one in a series on aviation careers, outlines the career opportunities of airline flight attendants. General information about airline hiring policies for flight attendants are discussed, and the following information about the flight attendant job classification is provided: nature of the work, working conditions, where the jobs…

  19. 14 CFR 125.269 - Flight attendants.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Flight attendants. 125.269 Section 125.269....269 Flight attendants. (a) Each certificate holder shall provide at least the following flight... passengers—one flight attendant. (2) For airplanes having more than 50 but less than 101 passengers—two...

  20. Laparoscopic Repair of Primary Inguinal Hernia Performed in Public Hospitals or Low-Volume Centers Have Increased Risk of Reoperation for Recurrence

    DEFF Research Database (Denmark)

    Andresen, Kristoffer; Friis-Andersen, Hans; Rosenberg, Jacob

    2016-01-01

    BACKGROUND: Inguinal hernia repair is traditionally carried out as either open or laparoscopic repair. Laparoscopic repair has been shown to be superior in terms of pain and discomfort, but has a higher risk of reoperation. Quality of inguinal hernia repair is related to factors such as method...... of care. METHODS: This study was based on data from the Danish Hernia Database covering the period from January 1, 1998, to December 31, 2013. Hernia repairs included in this study were laparoscopic repair of primary, inguinal hernias in the elective setting, performed on adult male patients. RESULTS...... reoperation rate compared with public centers: 5.36% versus 8.53%, P ≤ .0001. Type of center and center volume were both independent risk factors for reoperation in a Cox regression model. CONCLUSION: Hospital volume had an effect on the reoperation rate for recurrence after laparoscopic inguinal hernia...

  1. [Contributions and challenges associated with bodily practices and meditation for health promotion in the public primary care system in the city of São Paulo, Brazil].

    Science.gov (United States)

    Galvanese, Ana Tereza Costa; Barros, Nelson Filice de; d'Oliveira, Ana Flávia Pires Lucas

    2017-12-18

    The article presents an analysis of contributions and challenges associated with bodily practices and meditation for health promotion in the public primary care system. The qualitative study was developed in 16 healthcare units in the city of São Paulo, Brazil, using interviews with 29 health professionals and 36 practitioners of bodily practices and meditation, including participant observation of 31 practices such as Tai Chi, Lian Gong, Qigong, Yoga, Capoeira, Dance, Meditation, Relaxation, Mindfulness, and Body Awareness. There was an improvement in joint pain, mobility, balance, memory, depression, and anxiety, besides greater ease in coping with chronic conditions. Such contributions are related to favoring practitioners' autonomy, building health references through self-awareness; the combination of health promotion and therapeutic care in the approaches; and support for access to cultural goods and community spaces. The challenges identified here were precarious integration with the supply of other health services, lack of supervision and evaluation, and the predominance of a health-sector culture.

  2. Surfactant therapy of pulmonary conditions excluding those with primary surfactant deficiency and bronchoscopy as delivery method: an overview of Russian patents and publications.

    Science.gov (United States)

    Jargin, Sergei V

    2013-08-01

    Preparations of pulmonary surfactant are used for the treatment of respiratory distress syndrome in a newborn. Their applicability as a method of routine for lung diseases beyond the neonatal period is questionable. Some publications from the former Soviet Union (SU) have reported on successful surfactant therapy of ARDS in children and adults as well as for inhalation injuries, pneumonia, and tuberculosis. Bronchoscopy was used and recommended as a method of surfactant delivery for ARDS, some types of pneumonia and tuberculosis. Manufacturing processes of surfactant preparations from bovine lung and amniotic fluid, described by Russian patents, and bronchoscopy as a delivery mode are discussed here. A concluding point is that some reports from the former SU about administration of exogenous surfactant in pulmonary conditions, excluding those with primary surfactant deficiency, are only partly confirmed by the international literature.

  3. Cross-sectional study of older adults with type 2 diabetes mellitus in two rural public primary healthcare facilities in Malaysia.

    Science.gov (United States)

    Ooi, C P; Loke, S C; Zaiton, A; Tengku-Aizan, H; Zaitun, Y

    2011-06-01

    Knowledge of the characteristics of older adults with type 2 diabetes mellitus (T2DM) is indispensible for improvement of their care. A cross-sectional study in two rural public primary healthcare centres in Malaysia identified 170 actively engaged older patients with T2DM, with suboptimal glycaemic control and frequent hypoglycaemia. The prevalence of multiple co-morbidities, complications of T2DM, high cardiovascular risk, neurological, musculoskeletal and visual deficits suggested high risk of disabilities and dependency but not yet disabled. This short window for interventions presents as an opportunity for development of a more comprehensive approach extending beyond glycaemia control to risk management, preventing functional loss and continuity of social participation.

  4. A survey of the sociodemographic and educational characteristics of oral health technicians in public primary health care teams in Minas Gerais, Brazil.

    Science.gov (United States)

    Abreu, Mauro Henrique Nogueira Guimarães; Sanglard-Oliveira, Carla Aparecida; Jaruche, Abdul Rahman Mustafá; Mambrini, Juliana Vaz de Melo; Werneck, Marcos Azeredo Furquim; Lucas, Simone Dutra

    2013-12-23

    To describe some sociodemographic and educational characteristics of oral health technicians (OHTs) in public primary health care teams in the state of Minas Gerais, Brazil. A cross-sectional descriptive study was performed based on the telephone survey of a representative sample comprising 231 individuals. A pre-tested instrument was used for the data collection, including questions on gender, age in years, years of work as an OHT, years since graduation as an OHT, formal schooling, individual income in a month, and participation in continuing educational programmes. The descriptive statistic was developed and the formation of clusters, by the agglomerative hierarchy technique based on the furthest neighbour, was based on the age, years of work as an OHT, time since graduation as an OHT, formal schooling, individual income in a month, and participation in continuing educational programmes. Most interviewees (97.1%) were female. A monthly income of USD 300.00 to 600.00 was reported by 77.5% of the sample. Having educational qualifications in excess of their role was reported by approximately 20% of the participants. The median time since graduation was six years, and half of the sample had worked for four years as an OHT. Most interviewees (67.6%) reported having participated in professional continuing educational programmes. Two different clusters were identified based on the sociodemographic and educational characteristics of the sample. The Brazilian OHTs in public primary health care teams in the state of Minas Gerais are mostly female who have had little time since graduation, working experience, and formal schooling sufficient for professional practice.

  5. An assessment of equity in the distribution of non-financial health care inputs across public primary health care facilities in Tanzania.

    Science.gov (United States)

    Kuwawenaruwa, August; Borghi, Josephine; Remme, Michelle; Mtei, Gemini

    2017-07-11

    There is limited evidence on how health care inputs are distributed from the sub-national level down to health facilities and their potential influence on promoting health equity. To address this gap, this paper assesses equity in the distribution of health care inputs across public primary health facilities at the district level in Tanzania. This is a quantitative assessment of equity in the distribution of health care inputs (staff, drugs, medical supplies and equipment) from district to facility level. The study was carried out in three districts (Kinondoni, Singida Rural and Manyoni district) in Tanzania. These districts were selected because they were implementing primary care reforms. We administered 729 exit surveys with patients seeking out-patient care; and health facility surveys at 69 facilities in early 2014. A total of seventeen indices of input availability were constructed with the collected data. The distribution of inputs was considered in relation to (i) the wealth of patients accessing the facilities, which was taken as a proxy for the wealth of the population in the catchment area; and (ii) facility distance from the district headquarters. We assessed equity in the distribution of inputs through the use of equity ratios, concentration indices and curves. We found a significant pro-rich distribution of clinical staff and nurses per 1000 population. Facilities with the poorest patients (most remote facilities) have fewer staff per 1000 population than those with the least poor patients (least remote facilities): 0.6 staff per 1000 among the poorest, compared to 0.9 among the least poor; 0.7 staff per 1000 among the most remote facilities compared to 0.9 among the least remote. The negative concentration index for support staff suggests a pro-poor distribution of this cadre but the 45 degree dominated the concentration curve. The distribution of vaccines, antibiotics, anti-diarrhoeal, anti-malarials and medical supplies was approximately

  6. Factors influencing improved attendance in the UK fire service

    OpenAIRE

    Litchfield, I; Hinckley, P.

    2016-01-01

    Background Sickness absence rates in the UK continue to exceed those in much of the developed world, with an annual cost to employers of ?29 billion. Rates of sickness absence in the public sector are higher than those in the private sector, with the exception of the fire service where they are consistently lower. Aims To understand the influences that increase attendance among operational firefighters. Methods A series of semi-structured interviews undertaken with operational staff to explor...

  7. 16 CFR 1013.4 - Public attendance at Commission meetings.

    Science.gov (United States)

    2010-01-01

    ... obtained from a person and privileged or confidential; (5) Involve accusing any person of a crime, or... criminal investigation, or by an agency conducting a lawful national security intelligence investigation, confidential information furnished only by the confidential source, (v) Disclose investigative techniques and...

  8. 39 CFR 3001.43 - Public attendance at Commission meetings.

    Science.gov (United States)

    2010-07-01

    ... obtained from a person and privileged or confidential; (5) Involve accusing any person of a crime, or... criminal investigation, or by an agency conducting a lawful national security intelligence investigation, confidential information furnished only by the confidential source, (v) disclose investigative techniques and...

  9. 29 CFR 2203.3 - Public attendance at Commission meetings.

    Science.gov (United States)

    2010-07-01

    ... procedures, or (vi) Endanger the life or physical safety of law enforcement personnel; (8) Disclose... Commission's issuance of a subpoena or the Commission's participation in a civil action or proceeding, an action in a foreign court or international tribunal, or an arbitration, or the initiation, conduct...

  10. Atenção básica na agenda da saúde Primary care in the agenda of public health sector in Brazil

    Directory of Open Access Journals (Sweden)

    Regina Bodstein

    2002-01-01

    Full Text Available O artigo discute a política de reorganização da atenção básica a partir do processo recente de descentralização do SUS no Brasil. Enfatiza-se o papel indutor do governo central, que, através de um conjunto de medidas e programas específicos (PAB e PACS/PSF, principalmente, transfere para os municípios a responsabilidade com a atenção básica. Assim, é no nível municipal que ocorre o processo de implementação dessa política, gerando efeitos de difícil avaliação, dada a diversidade de contextos locais. A argumentação central enfatiza a importância de se avaliarem processos e resultados intermediários voltados para o desempenho institucional, que podem ser traduzidos em vontade política e compromisso público, capacidade de gestão e maior controle e participação social, mais do que exatamente efeitos ou impactos mais diretos sobre a oferta de serviços. A conclusão é de que apesar de todas as dificuldades e obstáculos o processo tem implicado o fortalecimento da capacidade de gestão municipal no que diz respeito à organização da atenção básica em saúde.The article discusses the policies of reorganization of the primary health care taking the recent process of decentralization of SUS in Brazil. The central government's paper as inducement is emphasized. This can be verified by several measures and specific programs (PAB and PACS/PSF, mainly that transfer for the municipal level the responsibility with the primary care. So it is in the municipal level that happens the process of implementation of that policies generating effects of difficult evaluation given the diversity of local contexts. The central argument emphasizes the importance of the evaluation process and intermediary results turned to the institutional performance that can be translated in accountability and public commitment, administration capacity and larger control and social participation - rather than final effects or more direct impacts on

  11. Physician Assistant Distribution in Texas-Mexico Border Counties: Public Health Implications

    Directory of Open Access Journals (Sweden)

    P. Eugene Jones

    2010-01-01

    Full Text Available Purpose. Texas Medical Board physician assistant (PA data were assessed to assist workforce education and planning strategies for PA programs in regions with high percentages of Hispanic populations. Methods. Data were assessed for gender, ethnicity, program attended and current employment addresses within the 14 Texas-Mexico border counties. Results. Of the 329 border county PAs, 227 self-reported as Hispanic (69%, and 53% were female. Remarkably, 72% of all Hispanic PAs attended two of the six public Texas PA Programs. Conclusions. The Sullivan Commission report of 2004 concluded that the primary cause of poor public health care for minorities resulted from unequal representation of minorities in the health care professions. Two public Texas PA programs have made substantial contributions to public health care access in poverty-stricken border areas by educating and placing Hispanic PAs within medically underserved communities.

  12. Prevalence and factors associated with tuberculosis treatment outcome among hazardous or harmful alcohol users in public primary health care in South Africa.

    Science.gov (United States)

    Peltzer, K; Louw, J S

    2014-03-01

    Tuberculosis (TB) remains a chronic infectious disease with high morbidity and mortality. The aim of this study was to assess the prevalence and associated factors of tuberculosis treatment failure, death and default among hazardous or harmful alcohol users. We conducted a prospective study with TB patients in 40 public health clinics in three districts in South Africa. All consecutively new tuberculosis and retreatment patients presenting at the 40 primary health care facilities with hazardous or harmful alcohol use were included in this study. Logistic regression was used to assess determinants of TB treatment failure, death and default. The findings of our study showed that 70% of TB patients were either cured or had completed their TB treatment by the end of 6 months. In multivariate analysis participants living in a shack or traditional housing (Odds Ratio=OR: 0.63, Confidence Interval=CI: 0.45-0.89), being a TB retreatment patient (OR: 1.61, CI: 1.15-2.26) and residing in the eThekwini district (OR: 1.82, CI: 1.27-2.58) were significant predictors of treatment failure, death and default. A high rate of treatment failure, death and default were found in the TB patients. Several factors were identified that can guide interventions for the prevention of treatment failure, death and default.

  13. How willing are the public to pay for anti-hypertensive drugs for primary prevention of cardiovascular disease: a survey in a Chinese city.

    Science.gov (United States)

    Tang, Jin-Ling; Wang, Wei-Zhong; An, Jian-Gang; Hu, Yong-Hua; Cheng, Shi-Hua; Griffiths, Sian

    2010-02-01

    Current recommendations on drug treatment of hypertension for primary prevention of cardiovascular disease are primarily determined by the evidence of effectiveness, disregard the resources available and values of people, and recommend a universally fixed risk cutoff for initiating drug treatment. The guidelines may have over-estimated the willingness of the public to accept and pay for these drugs and a fixed cutoff may not fit all populations. Moreover, the public may have been misinformed and are unable to make the right decision even if they are consulted. We conducted this study to address these issues and to describe the gap between current policy and what the public truly want. A cross-sectional survey with face-to-face interviews of rural and urban residents in northern China. Before providing any information, we asked the residents whether they would accept drug treatment if they had hypertension and also asked them to estimate the 5-year cardiovascular risk in untreated hypertension and the benefits from anti-hypertensive drugs. We then informed the participants of necessary information and asked them above what benefit they would be willing to pay the current cost, and how much they would be willing to pay for the actual benefit, for anti-hypertensive drugs out of pocket. Eight hundred and eighty-seven rural residents and 921 urban residents were interviewed with a response rate of 97%. Ninety-five percent [95% confidence interval (CI) 94-96%] of the residents said they would take anti-hypertensive drugs if they had hypertension, although 91% (95% CI 89-92%) said they did not have sufficient knowledge to make a decision. Seventy-eight percent (95% CI 76-80%) believed that anti-hypertensive drugs were primarily to lower blood pressure or relieve symptoms. They over-estimated the cardiovascular risk of untreated hypertension by approximately 12 times and the absolute benefit of drug treatment by 20 times. Given the actual absolute benefit of the drugs

  14. "Só de pensar em vir trabalhar, já fico de mau humor": atividade de atendimento ao público e prazer-sofrimento no trabalho "When I think of coming to work, I get into a bad mood": Public attendance and pleasure-suffering at the workplace

    Directory of Open Access Journals (Sweden)

    Mário César Ferreira

    2001-06-01

    Full Text Available O texto aborda a inter-relação entre atividade de atendimento ao público e vivências de prazer-sofrimento no trabalho. A perspectiva de investigação é interdisciplinar, a partir de um diálogo entre a ergonomia francófona e a psicodinâmica. Em ergonomia, são utilizadas as noções de serviço de atendimento ao público, atividade e carga de trabalho, enquanto que em psicodinâmica são utilizados conceitos que fundamentam o prazer-sofrimento no trabalho. A pesquisa realizou-se em uma instituição pública do Distrito Federal com 64 sujeitos. A metodologia articula técnicas de coleta e análise de dados qualitativa e quantitativa, utilizando Análise Ergonômica do Trabalho - AET e a Escala de Prazer-Sofrimento no Trabalho - EPST. Os resultados mostram que a atividade de trabalho constitui um dos elementos explicativos para a predominância de vivências de sofrimento dos atendentes. Trata-se de um estudo exploratório que avança na interface entre as duas disciplinas, estabelecendo algumas perspectivas para novos estudos.The paper approaches the interrelation between public costumer service activity and pleasure-suffering existences at work. Interdisciplinary perspective is used in this investigation, through a dialogue between Francophonic ergonomics and psychodynamics. Categories as public costumer service, activity, work load support ergonomic theoretical reference and pleasure-suffering psychodynamic. The research took place at a public institution of Distrito Federal with 64 subjects. The methodology articulates qualitative and quantitative techniques to collect and analize data, using Ergonomic Analysis at Work and the Pleasure-suffering at Work Scale. The results demonstrate that work activity constitutes one of explanatory elements for predominance of suffering of costumer service attendants. It is a exploratory study that seeks the interface between two disciplines, establishing some perspectives for new studies.

  15. ASCUE 2067: How We Will Attend Posthumously

    Science.gov (United States)

    Fulbright, Ron

    2017-01-01

    The ASCUE conference is celebrating its 50th anniversary this year making me wonder if we will be able to attend the 100th conference in 2067. By then, many of us may very well be biologically deceased. However, there is technology currently in development making it possible for a digital version of ourselves to attend not only the 2067 conference…

  16. A Study on Attendance and Academic Achievement

    DEFF Research Database (Denmark)

    Sund, Kristian J.; Bignoux, Stephane

    , we examine the link between attendance and exam results. Unlike prior research on this topic, our findings show that attendance is not the best determinant of student performance. We find instead that the best determinant of student performance for third year bachelor students is their over...

  17. Clinic Attendance Compliance Pattern of Adult Hypertensive ...

    African Journals Online (AJOL)

    Objective: A number of factors affect the clinic attendance compliance of the average adult Nigerian. The consequent default from treatment could affect the management outcome of such patients. This study was therefore, undertaken to evaluate the clinic attendance compliance pattern of adult hypertensive patients being ...

  18. Anthropometric measurements of children attending a vaccination ...

    African Journals Online (AJOL)

    Objectives: To have a synopsis of the nutritional status in apparently healthy children attending a vaccination clinic and show the importance of anthropometric measurements in routine child health care. Design: A retrospective study. Patients and Participants: 1351 children aged (6-24months), who attended the vaccination ...

  19. Automated attendance management and alert system | Rahim ...

    African Journals Online (AJOL)

    “Automated Attendance Management and Alert System (AAMAS)” was developed to help UiTM lecturers and Academic Affairs Department in monitoring students' absenteeism and improving the absenteeism record management. AAMAS provides various functions, from managing and recording students' attendance record ...

  20. Observational study identifies non-attendance characteristics in two hospital outpatient clinics

    DEFF Research Database (Denmark)

    Blæhr, Emely; Søgaard, Rikke; Kristensen, Thomas

    2016-01-01

    INTRODUCTION: Non-attended hospital appointments are receiving increasing attention in times when rapid access and efficient service delivery at public hospitals are on the agenda. The aim of this study was to investigate the extent of non-attendance in a Danish outpatient setting and its...... association with user-level and provider-level characteristics. METHODS: The study was based on appointments scheduled from June 2013 to March 2015 at an orthopaedic and a radiologic outpatient clinic. Data on outcomes of cancellation on the part of the user or the provider, and non-attendance without giving......-attendance and thereby to improve the efficiency of Danish outpatient services. Future studies should investigate the effect of initiatives such as nudging and fines targeting the appointments that have the highest non-attendance rates. FUNDING: Danish Regions, the Danish Ministry of Health and the Central Denmark...

  1. Factors associated with non-attendance, opportunistic attendance and reminded attendance to cervical screening in an organized screening program: a cross-sectional study of 12,058 Norwegian women

    Directory of Open Access Journals (Sweden)

    Eriksen Tormod

    2011-04-01

    likelihood of attendance in an organized screening program was higher among women who were aware of cervical screening, which suggests a potential for a higher attendance rate through improving the public knowledge of screening. Further, the lower awareness among opportunistic than reminded attendees suggests that physicians may inform their patients better when smears are taken at the physician's initiative.

  2. Effects of Improving Primary Health Care Workers' Knowledge About Public Health Services in Rural China: A Comparative Study of Blended Learning and Pure E-Learning.

    Science.gov (United States)

    Zhan, Xingxin; Zhang, Zhixia; Sun, Fang; Liu, Qian; Peng, Weijun; Zhang, Heng; Yan, Weirong

    2017-05-01

    Primary health care workers (PHCWs) are a major force in delivering basic public health services (BPHS) in rural China. It is necessary to take effective training approaches to improve PHCWs' competency on BPHS. Both electronic learning (e-learning) and blended learning have been widely used in the health workers' education. However, there is limited evidence on the effects of blended learning in comparison with pure e-learning. The aim of this study was to evaluate the effects of a blended-learning approach for rural PHCWs in improving their knowledge about BPHS as well as training satisfaction in comparison with a pure e-learning approach. The study was conducted among PHCWs in 6 rural counties of Hubei Province, China, between August 2013 and April 2014. Three counties were randomly allocated blended-learning courses (29 township centers or 612 PHCWs-the experimental group), and three counties were allocated pure e-learning courses (31 township centers or 625 PHCWs-the control group). Three course modules were administered for 5 weeks, with assessments at baseline and postcourse. Primary outcomes were score changes in courses' knowledge. Secondary outcome was participant satisfaction (5-point Likert scale anchored between 1 [strongly agree] and 5 [strongly disagree]). The experimental group had higher mean scores than the control group in knowledge achievement in three course modules: (1) module 1: 93.21 (95% CI 92.49-93.93) in experimental group versus 88.29 (95% CI 87.19-89.40) in the control group; adjusted difference, 4.92 (95% CI 2.61-7.24; Plearning group gave more positive responses with the four issues than control group participants: (1) the increase of interest in learning, 1.85 (95% CI 1.22-2.80; P=.003); (2) the increase of interaction with others, 1.77 (95% CI 1.20-2.60; P=.004); (3) the satisfaction with learning experience, 1.78 (95% CI 1.11-2.88; P=.02); and (4) achievement of learning objectives, 1.63 (95% CI 1.08-2.48; P=.02). Among PHCWs in

  3. Effects of Improving Primary Health Care Workers’ Knowledge About Public Health Services in Rural China: A Comparative Study of Blended Learning and Pure E-Learning

    Science.gov (United States)

    Zhan, Xingxin; Zhang, Zhixia; Sun, Fang; Liu, Qian; Peng, Weijun; Zhang, Heng

    2017-01-01

    Background Primary health care workers (PHCWs) are a major force in delivering basic public health services (BPHS) in rural China. It is necessary to take effective training approaches to improve PHCWs’ competency on BPHS. Both electronic learning (e-learning) and blended learning have been widely used in the health workers’ education. However, there is limited evidence on the effects of blended learning in comparison with pure e-learning. Objective The aim of this study was to evaluate the effects of a blended-learning approach for rural PHCWs in improving their knowledge about BPHS as well as training satisfaction in comparison with a pure e-learning approach. Methods The study was conducted among PHCWs in 6 rural counties of Hubei Province, China, between August 2013 and April 2014. Three counties were randomly allocated blended-learning courses (29 township centers or 612 PHCWs—the experimental group), and three counties were allocated pure e-learning courses (31 township centers or 625 PHCWs—the control group). Three course modules were administered for 5 weeks, with assessments at baseline and postcourse. Primary outcomes were score changes in courses’ knowledge. Secondary outcome was participant satisfaction (5-point Likert scale anchored between 1 [strongly agree] and 5 [strongly disagree]). Results The experimental group had higher mean scores than the control group in knowledge achievement in three course modules: (1) module 1: 93.21 (95% CI 92.49-93.93) in experimental group versus 88.29 (95% CI 87.19-89.40) in the control group; adjusted difference, 4.92 (95% CI 2.61-7.24; Plearning group gave more positive responses with the four issues than control group participants: (1) the increase of interest in learning, 1.85 (95% CI 1.22-2.80; P=.003); (2) the increase of interaction with others, 1.77 (95% CI 1.20-2.60; P=.004); (3) the satisfaction with learning experience, 1.78 (95% CI 1.11-2.88; P=.02); and (4) achievement of learning objectives, 1

  4. Can Provision of Free School Uniforms harm Attendance? Evidence from Ecuador

    OpenAIRE

    Diana Hidalgo; Mercedes Onofa; Hessel Oosterbeek; Juan Ponce

    2010-01-01

    This discussion paper resulted in an article in the Journal of Development Economics (2013). Volume 103, pages 43-51. To raise school attendance, many programs in developing countries eliminate orreduce private contributions to education. This paper documents an unintendednegative effect of such programs. Using data from a randomized experiment thatprovides free uniforms to primary school children in Ecuador, we find that the interventionhas a significantly negative impact on attendance. An e...

  5. Deficiência de ferro, prevalência de anemia e fatores associados em crianças de creches públicas do oeste do Paraná, Brasil Iron deficiency and prevalence of anemia and associated factors in children attending public daycare centers in western Paraná, Brazil

    Directory of Open Access Journals (Sweden)

    Valdete Carreira Rodrigues

    2011-06-01

    Full Text Available OBJETIVO: Avaliar o estado nutricional de ferro, a prevalência de anemia e fatores associados, em crianças de 6 a 24 meses frequentadoras de creche pública em Cascavel, Região Oeste do Paraná, Brasil. MÉTODOS: O estudo transversal foi realizado com amostra aleatória de 256 crianças. A coleta de dados (questionário, medidas antropométricas e amostras de sangue ocorreu de julho a setembro de 2007. A deficiência de ferro foi avaliada em termos de transferrina, hemoglobina, volume corpuscular médio, ferro sérico e eosinófilos. Na análise estatística dos dados foram obtidas as odds ratio bruta e ajustada (regressão logística, bem como os respectivos níveis de significância (p-valor. Para identificar diferenças significativas entre as medidas quantitativas, adotou-se a Análise de Variância e o teste de comparação múltipla de Tukey. RESULTADOS: A prevalência da anemia foi de 29,7%, sendo que 77,3% das amostras apresentaram baixa concentração de ferro. A antropometria não apontou deficiência de macronutrientes, porém mostrou obesidade acima dos índices médios. Os fatores associados à anemia e à deficiência de ferro foram: doenças frequentes na família (OR=10,02, condições de moradia (OR=5,05, tempo de creche (OR=3,05, número de moradores na residência (OR=2,83 e falta de saneamento (OR=2,20. CONCLUSÃO: A prevalência de anemia e a elevada deficiência de ferro detectada evidenciam um grave problema de saúde pública entre os pré-escolares do município de Cascavel, Paraná. Apesar da amplitude do problema, a anemia não está sendo reconhecida, prevenida e tratada adequadamente. Neste estudo são sugeridas algumas possíveis intervenções.OBJECTIVE: This study assessed the iron levels and prevalence of anemia and associated factors in children aged 6 to 24 months attending public daycare centers in Cascavel, Western Paraná, Brazil. METHODS: This cross-sectional study included 256 randomly sampled children

  6. "Land of Volcanoes" workshop: a first step in Earth Sciences for "L'Alzina" Public School primary students (4-5 years old)

    Science.gov (United States)

    Cortés, Jordi; Geyer, Adelina; Díaz, Mabel

    2017-04-01

    "Land of Volcanoes" is a scientific outreach workshop devised by Adelina Geyer, researcher of the Institute of Earth Sciences Jaume Almera, ICTJA-CSIC. The workshop proposes an approximation to the world of volcanology through the explanation of different concepts related to these geological phenomena: its origin and its characteristics, magma eruptions and their associated hazards, etc. Over the last years, Geyer has developed the workshop in the context of different outreach activities for an audience formed, not only but mainly, by secondary school students. At the beginning of 2016, as a result of different informal contacts between ICTJA-CSIC Communication Unit and Mabel Díaz, teacher of the "L'Alzina" public school (Molins de Rei), arose the idea of developing Geyer's workshop in front of 26 students aged 4-5 years old, primary students. Díaz explains that it is "in the age ranged between 0 and 6 years when observation and hands-on activities are important elements of the learning process", although she adds that " primary students are usually not seen as potential audiences of this type of outreach activities and workshops". Díaz says that "Science is simple: it is about observing, asking questions and finding answers, the same that children, even the smallest, do constantly." Adelina Geyer accepted the challenge of conducting the "Land of Volcanoes" workshop in front of 4-5 year old children, although it was necessary to adapt its format and content to the new audience. Meanwhile, students prepared the session following the same process used in the project work system employed at the school and that started from two questions: "What do we know about volcanoes? What we want to know about them?" On June 3rd 2016, Adelina Geyer conducted "Land of Volcanoes" workshop at l'Alzina public school in front of a classroom of 4-5 years old students. The activity was divided in two parts with a total duration of 45 minutes: 1) Brief introductory talk: this part

  7. The first association of a primary amebic meningoencephalitis death with culturable Naegleria fowleri in tap water from a US treated public drinking water system.

    Science.gov (United States)

    Cope, Jennifer R; Ratard, Raoult C; Hill, Vincent R; Sokol, Theresa; Causey, Jonathan Jake; Yoder, Jonathan S; Mirani, Gayatri; Mull, Bonnie; Mukerjee, Kimberly A; Narayanan, Jothikumar; Doucet, Meggie; Qvarnstrom, Yvonne; Poole, Charla N; Akingbola, Olugbenga A; Ritter, Jana M; Xiong, Zhenggang; da Silva, Alexandre J; Roellig, Dawn; Van Dyke, Russell B; Stern, Harlan; Xiao, Lihua; Beach, Michael J

    2015-04-15

    Naegleria fowleri is a climate-sensitive, thermophilic ameba found in warm, freshwater lakes and rivers. Primary amebic meningoencephalitis (PAM), which is almost universally fatal, occurs when N. fowleri-containing water enters the nose, typically during swimming, and migrates to the brain via the olfactory nerve. In August 2013, a 4-year-old boy died of meningoencephalitis of unknown etiology in a Louisiana hospital. Clinical and environmental testing and a case investigation were initiated to determine the cause of death and to identify potential exposures. Based on testing of cerebrospinal fluid and brain specimens, the child was diagnosed with PAM. His only reported water exposure was tap water; in particular, tap water that was used to supply water to a lawn water slide on which the child had played extensively prior to becoming ill. Water samples were collected from both the home and the water distribution system that supplied the home and tested; N. fowleri was identified in water samples from both the home and the water distribution system. This case is the first reported PAM death associated with culturable N. fowleri in tap water from a US treated drinking water system. This case occurred in the context of an expanding geographic range for PAM beyond southern states, with recent case reports from Minnesota, Kansas, and Indiana. This case also highlights the role of adequate disinfection throughout drinking water distribution systems and the importance of maintaining vigilance when operating drinking water systems using source waters with elevated temperatures. Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  8. Comparing the performance of the public, social security and private health subsystems in Argentina by core dimensions of primary health care.

    Science.gov (United States)

    Yavich, Natalia; Báscolo, Ernesto Pablo; Haggerty, Jeannie

    2016-06-01

    Most Latin American health systems are comprised of public (PubS), social security (SSS) and private (PrS) subsystems. These subsystems coexist, causing health care fragmentation and population segmentation. To estimate the extent of subsystem cross-coverage in a geographically bounded population (Rosario city) and to compare the subsystems' performance on primary health care (PHC) dimensions. Through a cross-sectional, interviewer-administered survey to a representative sample (n = 822) of the Rosario population, we measured the percentage of cross-coverage (people with usual source of care in one subsystem but also covered by another subsystem) and the health services' performance by core PHC dimensions, as reported by each subsystem's usual users. We compared the subsystems' performance using chi-square analysis and one-way analysis of variance testing. We analyzed whether the observed differences were coherent with the predominant institutional and organizational features of each subsystem. Overall, 39.3% of the population was affiliated with the PubS, 44.8% with the SSS and 15.9% with the PrS. Cross-coverage was reported by 40.6% of respondents. The performance of the PubS was weak on accessibility but strong on person-and-community-oriented care, the opposite of the PrS. The SSS combined the strengths of the other two subsystems. Rosario's health system has a high percentage of cross-coverage, contributing to issues of fragmentation, segmentation, financial inequity and inefficiency. The overall performance of the SSS was better than that of the PrS and PubS, though each subsystem had a particular performance pattern with areas of strength and weakness that were consistent with their institutional and organizational profiles. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  9. Public Lecture: Human Space Exploration

    CERN Multimedia

    CERN. Geneva

    2015-01-01

    Should you wish to attend to this lecture only (and not the full colloquium), please register here: https://indico.cern.ch/event/386996/registration/ Participants to the full colloquium are automatically registered to the public lectures.

  10. Public Knowledge, Attitudes, and Experience Regarding the Use of Antibiotics in Italy

    OpenAIRE

    Napolitano, Francesco; Izzo, Maria Teresa; Di Giuseppe, Gabriella; Angelillo, Italo F.

    2013-01-01

    BACKGROUND: The objectives of the study were to investigate the level of knowledge, attitudes, and behaviors regarding antibiotics of the general population in Italy, and to assess the correlates of these outcomes of interest. METHODS: A cross-sectional survey was conducted on a random sample of 630 parents of students attending nine randomly selected public primary and secondary schools. A self-administered questionnaire included questions on demographic characteristics, knowledge about anti...

  11. 41 CFR 301-74.16 - What must be included in any advertisement or application form relating to conference attendance?

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 4 2010-07-01 2010-07-01 false What must be included in any advertisement or application form relating to conference attendance? 301-74.16 Section 301-74.16... included in any advertisement or application form relating to conference attendance? (a) Any advertisement...

  12. Class attendance and cardiology examination performance: a study in problem-based medical curriculum

    Directory of Open Access Journals (Sweden)

    Bamuhair SS

    2016-02-01

    Full Text Available Samira S Bamuhair,1 Ali I Al Farhan,1,2 Alaa Althubaiti,1 Saeed ur Rahman,1,2 Hanan M Al-Kadri1,3 1College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, 2Department of Family Medicine and Primary Health Care, 3Department of Obstetrics and Gynecology, King Abdulaziz Medical City, Riyadh, Saudi Arabia Background and aims: Information on the effect of students' class attendance on examination performance in a problem-based learning medical curriculum is limited. This study investigates the impact of different educational activities on students' academic performance in a problem-based learning curriculum. Methods: This is a retrospective cohort study conducted on the cardiology block at the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. All students who undertook the cardiology block during the academic year 2011–2012 were included. The students' attendance was measured using their overall attendance percentage. This percentage is a product of their attendance of many activities throughout the block. The students' performance was assessed by the final mark obtained, which is a product of many assessment elements. Statistical correlation between students' attendance and performance was established. Results: A total of 127 students were included. The average lecture attendance rate for the medical students in this study was found to be 86%. A significant positive correlation was noted between the overall attendance and the accumulated students' block mark (r=0.52; P<0.001. Students' attendance to different education activities was correlated to their final mark. Lecture attendance was the most significant predictor (P<0.001, that is, 1.0% increase in lecture attendance has predicted a 0.27 increase in students' final block mark. Conclusion: Class attendance has a positive effect on students' academic performance with stronger effect for lecture attendance compared to

  13. Professional orientation of pupils attending special elementary school

    OpenAIRE

    Bělová, Iva

    2012-01-01

    This diploma thesis approaches the development of an idea that mentally challenged pupils form about their future employment and introduces aspects that are involved in such process. This is applied to all ages of students with mild mental disability who attend the Primary Special School in Chabařovice. Another goal is to cover the level and the rate of success of pre-vocational training at this school. The thesis is divided into two parts. The theoretical part deals with the explanation of t...

  14. Sociodemographic profile and predictors of outpatient clinic attendance among HIV-positive patients initiating antiretroviral therapy in Selangor, Malaysia

    Directory of Open Access Journals (Sweden)

    Abdulrahman SA

    2017-07-01

    Full Text Available Surajudeen Abiola Abdulrahman,1,2 Lekhraj Rampal,1 Norlijah Othman,3 Faisal Ibrahim,1 Kadir Shahar Hayati,1 Anuradha P Radhakrishnan4 1Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, 2Department of Public Health Medicine, Penang Medical College, George Town, Penang, 3Department of Paediatrics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, 4Infectious Disease Clinic, Hospital Sungai Buloh, Sungai Buloh, Selangor, MalaysiaBackground: Inconsistent literature evidence suggests that sociodemographic, economic, and system- and patient-related factors are associated with clinic attendance among the HIV-positive population receiving antiretroviral therapy (ART around the world. We examined the factors that predict outpatient clinic attendance among a cohort of HIV-positive patients initiating ART in Selangor, Malaysia.Patients and methods: This cross-sectional study analyzed secondary data on outpatient clinic attendance and sociodemographic, economic, psychosocial, and patient-related factors among 242 adult Malaysian patients initiating ART in Selangor, Malaysia. Study cohort was enrolled in a parent randomized controlled trial (RCT in Hospital Sungai Buloh Malaysia between January and December 2014, during which peer counseling, medication, and clinic appointment reminders were provided to the intervention group through short message service (SMS and telephone calls for 24 consecutive weeks. Data on outpatient clinic attendance were extracted from the hospital electronic medical records system, while other patient-level data were extracted from pre-validated Adult AIDS Clinical Trial Group (AACTG adherence questionnaires in which primary data were collected. Outpatient clinic attendance was categorized into binary outcome – regular attendee and defaulter categories – based on the number of missed scheduled outpatient clinic appointments within a 6-month

  15. Lycaenid Caterpillar Secretions Manipulate Attendant Ant Behavior

    National Research Council Canada - National Science Library

    Hojo, Masaru K; Pierce, Naomi E; Tsuji, Kazuki

    2015-01-01

    .... We show here novel effects of insect exocrine secretions produced by caterpillars in modulating the behavior of attendant ants in the food-for-defense interaction between lycaenid butterflies and ants...

  16. Introdução de alimentos industrializados e de alimentos de uso tradicional na dieta de crianças de creches públicas no município de São Paulo Introduction of processed and traditional foods to the diets of children attending public daycare centers in São Paulo, Brazil

    Directory of Open Access Journals (Sweden)

    Maysa Helena de Aguiar Toloni

    2011-02-01

    Full Text Available OBJETIVO: Descrever e discutir a introdução de alimentos industrializados na dieta de crianças frequentadoras de berçários em creches, considerando a recomendação do Ministério da Saúde para uma alimentação saudável. MÉTODOS: Estudo transversal com 270 crianças frequentadoras de berçários de 8 creches públicas e filantrópicas do município de São Paulo. Por meio de questionário estruturado e pré-codificado, foi avaliada a introdução de alimentos a partir de 11 perguntas. Para cada alimento analisado foi registrada a idade em meses de introdução e avaliada a concordância com o oitavo passo do Guia Alimentar. No estudo das associações, utilizou-se o teste Qui-quadrado, a partir das variáveis idade e escolaridade maternas, renda familiar e trabalho da mãe fora do lar. RESULTADOS: Os resultados mostram que para aproximadamente 2/3 das crianças foram oferecidos, antes dos 12 meses, alimentos com potencial obesogênico, como macarrão instantâneo, salgadinhos, bolacha recheada, suco artificial, refrigerante e bala/pirulito/chocolate. São os filhos de mães com baixa escolaridade, mais jovens e com menor renda, os mais susceptíveis ao erro alimentar de introdução precoce de alimentos industrializados. CONCLUSÃO: Diante desses resultados, medidas educativas e preventivas devem ser propostas para a formação de hábitos alimentares saudáveis desde a infância, além da criação de campanhas abrangentes e efetivas que estimulem o consumo de frutas e hortaliças, considerando-se os fatores culturais, comportamentais e afetivos envolvidos com a alimentação.OBJECTIVE: This study described and discussed the introduction of processed foods to the diets of children attending the nurseries of daycare centers, considering the recommendation of the Ministry of Health for a healthy diet. METHODS: This cross-sectional study included 270 children attending nurseries of eight public and not-for-profit daycare centers in S

  17. Neural responses to complex auditory rhythms: the role of attending

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    Heather L Chapin

    2010-12-01

    Full Text Available The aim of this study was to explore the role of attention in pulse and meter perception using complex rhythms. We used a selective attention paradigm in which participants attended to either a complex auditory rhythm or a visually presented word list. Performance on a reproduction task was used to gauge whether participants were attending to the appropriate stimulus. We hypothesized that attention to complex rhythms – which contain no energy at the pulse frequency – would lead to activations in motor areas involved in pulse perception. Moreover, because multiple repetitions of a complex rhythm are needed to perceive a pulse, activations in pulse related areas would be seen only after sufficient time had elapsed for pulse perception to develop. Selective attention was also expected to modulate activity in sensory areas specific to the modality. We found that selective attention to rhythms led to increased BOLD responses in basal ganglia, and basal ganglia activity was observed only after the rhythms had cycled enough times for a stable pulse percept to develop. These observations suggest that attention is needed to recruit motor activations associated with the perception of pulse in complex rhythms. Moreover, attention to the auditory stimulus enhanced activity in an attentional sensory network including primary auditory, insula, anterior cingulate, and prefrontal cortex, and suppressed activity in sensory areas associated with attending to the visual stimulus.

  18. Impact of a school-based intervention on nutritional education and physical activity in primary public schools in Chile (KIND programme study protocol: cluster randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Nelly Bustos

    2016-12-01

    Full Text Available Abstract Background Chile has suffered a fast increase in childhood obesity in the last 10 years. As a result, several school programmes have been implemented, however the effectiveness of these needs to be evaluated to identify and prioritize strategies to curve this trend. Methods Cluster randomized controlled trial. Twelve primary public schools chosen at random over three regions of the country will take part in this study. The sample size consisted of a total of 1,655 children. For each region one school will be selected for each of the three nutritional intervention modes and one school will be selected as the control group. The intervention modes consist of the following: Healthy Kiosk and nutritional education (KSEAN; Optimized physical activity (AFSO; Healthy Kiosk and nutritional education (KSEAN + optimized physical activity (AFSO; Control group. The effectiveness of each intervention will be evaluated by determining the nutritional condition of each child by measuring percentage of body fat, BMI and the z-score of the BMI. This study will also identify the eating behaviours, nutritional knowledge and fitness of each child, along with the effective time of moderate activity during physical education classes. Discussion A protocol to evaluate the effectiveness of a school based intervention to control and/or reduce the rates of childhood obesity for children between 6 and 10 years of age was developed. The protocol was developed in line with the Declaration of Helsinski, the Nüremberg Code and the University of Chile Guidelines for ethical committees, and was approved by the INTA, Universidad de Chile ethical committee on Wednesday 12 March 2014. There is consensus among researchers and health and education personnel that schools are a favourable environment for actions to prevent and/or control childhood obesity. However a lack of evidence on the effectiveness of interventions to date has led some to question the wisdom of

  19. Impact of a school-based intervention on nutritional education and physical activity in primary public schools in Chile (KIND) programme study protocol: cluster randomised controlled trial.

    Science.gov (United States)

    Bustos, Nelly; Olivares, Sonia; Leyton, Bárbara; Cano, Marcelo; Albala, Cecilia

    2016-12-03

    Chile has suffered a fast increase in childhood obesity in the last 10 years. As a result, several school programmes have been implemented, however the effectiveness of these needs to be evaluated to identify and prioritize strategies to curve this trend. Cluster randomized controlled trial. Twelve primary public schools chosen at random over three regions of the country will take part in this study. The sample size consisted of a total of 1,655 children. For each region one school will be selected for each of the three nutritional intervention modes and one school will be selected as the control group. The intervention modes consist of the following: Healthy Kiosk and nutritional education (KSEAN); Optimized physical activity (AFSO); Healthy Kiosk and nutritional education (KSEAN) + optimized physical activity (AFSO); Control group. The effectiveness of each intervention will be evaluated by determining the nutritional condition of each child by measuring percentage of body fat, BMI and the z-score of the BMI. This study will also identify the eating behaviours, nutritional knowledge and fitness of each child, along with the effective time of moderate activity during physical education classes. A protocol to evaluate the effectiveness of a school based intervention to control and/or reduce the rates of childhood obesity for children between 6 and 10 years of age was developed. The protocol was developed in line with the Declaration of Helsinski, the Nüremberg Code and the University of Chile Guidelines for ethical committees, and was approved by the INTA, Universidad de Chile ethical committee on Wednesday 12 March 2014. There is consensus among researchers and health and education personnel that schools are a favourable environment for actions to prevent and/or control childhood obesity. However a lack of evidence on the effectiveness of interventions to date has led some to question the wisdom of allocating resources to programmes. This is the first study

  20. Effects of a free school breakfast programme on school attendance, achievement, psychosocial function, and nutrition: a stepped wedge cluster randomised trial

    Directory of Open Access Journals (Sweden)

    Maddison Ralph

    2010-11-01

    Full Text Available Abstract Background Approximately 55,000 children in New Zealand do not eat breakfast on any given day. Regular breakfast skipping has been associated with poor diets, higher body mass index, and adverse effects on children's behaviour and academic performance. Research suggests that regular breakfast consumption can improve academic performance, nutrition and behaviour. This paper describes the protocol for a stepped wedge cluster randomised trial of a free school breakfast programme. The aim of the trial is to determine the effects of the breakfast intervention on school attendance, achievement, psychosocial function, dietary habits and food security. Methods/Design Sixteen primary schools in the North Island of New Zealand will be randomised in a sequential stepped wedge design to a free before-school breakfast programme consisting of non-sugar coated breakfast cereal, milk products, and/or toast and spreads. Four hundred children aged 5-13 years (approximately 25 per school will be recruited. Data collection will be undertaken once each school term over the 2010 school year (February to December. The primary trial outcome is school attendance, defined as the proportion of students achieving an attendance rate of 95% or higher. Secondary outcomes are academic achievement (literacy, numeracy, self-reported grades, sense of belonging at school, psychosocial function, dietary habits, and food security. A concurrent process evaluation seeks information on parents', schools' and providers' perspectives of the breakfast programme. Discussion This randomised controlled trial will provide robust evidence of the effects of a school breakfast programme on students' attendance, achievement and nutrition. Furthermore the study provides an excellent example of the feasibility and value of the stepped wedge trial design in evaluating pragmatic public health intervention programmes. Trial Registration Number Australian New Zealand Clinical Trials Registry

  1. Effects of a free school breakfast programme on school attendance, achievement, psychosocial function, and nutrition: a stepped wedge cluster randomised trial.

    Science.gov (United States)

    Ni Mhurchu, Cliona; Turley, Maria; Gorton, Delvina; Jiang, Yannan; Michie, Jo; Maddison, Ralph; Hattie, John

    2010-11-29

    Approximately 55,000 children in New Zealand do not eat breakfast on any given day. Regular breakfast skipping has been associated with poor diets, higher body mass index, and adverse effects on children's behaviour and academic performance. Research suggests that regular breakfast consumption can improve academic performance, nutrition and behaviour. This paper describes the protocol for a stepped wedge cluster randomised trial of a free school breakfast programme. The aim of the trial is to determine the effects of the breakfast intervention on school attendance, achievement, psychosocial function, dietary habits and food security. Sixteen primary schools in the North Island of New Zealand will be randomised in a sequential stepped wedge design to a free before-school breakfast programme consisting of non-sugar coated breakfast cereal, milk products, and/or toast and spreads. Four hundred children aged 5-13 years (approximately 25 per school) will be recruited. Data collection will be undertaken once each school term over the 2010 school year (February to December). The primary trial outcome is school attendance, defined as the proportion of students achieving an attendance rate of 95% or higher. Secondary outcomes are academic achievement (literacy, numeracy, self-reported grades), sense of belonging at school, psychosocial function, dietary habits, and food security. A concurrent process evaluation seeks information on parents', schools' and providers' perspectives of the breakfast programme. This randomised controlled trial will provide robust evidence of the effects of a school breakfast programme on students' attendance, achievement and nutrition. Furthermore the study provides an excellent example of the feasibility and value of the stepped wedge trial design in evaluating pragmatic public health intervention programmes. Australian New Zealand Clinical Trials Registry (ANZCTR) - ACTRN12609000854235.

  2. Analysis of the patients’ with minor injuries attendance to the Emergency Department

    Directory of Open Access Journals (Sweden)

    Katarzyna Szwamel

    2016-06-01

    Full Text Available Background . The lack of effective system solutions in the field of primary care, long waiting times for outpatient consultation in the framework of specialist care are the cause of those patient’s applications to ED who do not require the use of emergency procedures. The ability to quickly get to ED and unrestricted patient access to health care services financed from public funds increase the likelihood of reporting to ED by the patients in non-urgent cases. Objectives. Analysis of the patient’s attendance with minor injuries to ED. Material and methods . 155 patients of ED in Kędzierzyn-Koźle were examined by a diagnostic survey based on a copyright questionnaire. Results. Patients with minor injuries are generally people aged 11–40 years (66.7%; 100 self-referred to ED (92.7%; 139, with injuries of the extremities (72.7%; 109 that arise from falling, tripping, slipping, impaction (78.7%;118 during three hours of the onset of injury (57.3%; 87 with moderate symptoms. Respondents believe that the minor injuries require diagnostic radiology (38.7%; 58 and specialist consultations (34%; 51 and ED is the most appropriate place for their treatment (45.3%; 68. If these patients do not attend PHC (85.3%; 128 it does not mean that the patient does not trust in the possibility of treatment by a family physician (OR = 1.46, 95% CI [0.52; 4.55]; p = 0.49. Conclusions . It is important to educate patients about the role of ED in the health system, the possibility of dressing minor injuries in PHC, self-care in the field of minor injuries dressing and the harmful effects of excess X-rays on the human body.

  3. Intermittent attendance at breast cancer screening

    Directory of Open Access Journals (Sweden)

    Padraic Fleming

    2013-09-01

    Full Text Available Background. To determine why women skip rounds and factors influencing return of previous non attenders (PNAs to breast screening. Design and methods. Retrospective, quantitative, structured questionnaire posted to 2500 women. First PNAs did not attend their first screening appointment in 2007/2008 but then attended in 2010; First Controls first attended in 2010 without missed previous appointments. Women who attended screening in 2006 or earlier then skipped a round but returned in 2010 were Subsequent PNAs; Subsequent Controls attended all appointments.Results. More First Controls than First PNAs had family history of cancer (72.7% vs 63.2%; P=0.003; breast cancer (31.3% vs 24.8%; P=0.04. More PNAs lived rurally; more First PNAs had 3rd level education (33.2% vs 23.6%; P=0.002 and fewer had private insurance than First Controls (57.7% vs 64.8%; P=0.04. Excellent/good health was reported in First PNAs and First Controls (82.9% vs 83.2%, but fewer Subsequent PNAs than Subsequent Controls (72.7% vs 84.9%; P=0.000. Common considerations at time of missed appointment were had mammogram elsewhere (33% First PNA and postponed to next round (16% First PNA, 18.8% Subsequent PNA. Considerations when returning to screening were similar for First PNAs and Subsequent PNAs: I am older (35.4%, 29.6%, I made sure I remembered (29%, 23.6%, could reschedule (17.6%, 20.6%, illness of more concern (16.5%, 19%. More First PNAs stated my family/friends advised (22.3% vs 15.2% or my GP (12.6% vs 4.6% advised me to attend, heard good things about BreastCheck (28.8% vs 13.6%.Conclusions. Intermittent attenders do not fit socio-demographic patterns of non-attenders; GP recommendation and word of mouth were important in women’s return to screening. Fear and anxiety seem to act as a screening facilitator rather than an inhibitor.

  4. A Comparative Evaluation of Public Health Centers with Private Health Training Centers on Primary Healthcare Parameters in India: a Study by Data Envelopment Analysis Technique

    National Research Council Canada - National Science Library

    Davey, Sanjeev; Raghav, Santosh Kumar; Singh, Jai Vir; Davey, Anuradha; Singh, Nirankar

    2015-01-01

    The evaluation of primary healthcare services provided by health training centers of a private medical college has not been studied in comparison with government health facilities in Indian context...

  5. Physical activity and associated factors among students attending evening classes

    Directory of Open Access Journals (Sweden)

    Fabio Luis Ceschini

    2015-03-01

    Full Text Available The aim of this study was to describe the physical activity level and associated factors among students attending evening classes in public and private schools in a region of the city of São Paulo. The sample was composed of 1,844 adolescents of both sexes aged 15-20 years. Three public and private schools in the city of São Paulo were visited. Daily physical activity level was assessed through International Physical Activity Questionnaire that classifies physical activity level. Physical activity level was divided into insufficiently active (when subject reported less than 300 minutes of moderate to vigorous physical activities per week and physically active (when subject reported more than 300 minutes of moderate to vigorous physical activities per week. Information related to risk behavior such as smoking and alcohol consumption was collected. Data were analyzed using logistic regression with three levels of data input and p<.05 as significance level. The prevalence of physically active adolescents was 36.1%. Most active subjects were: A younger boys with low socioeconomic levels; B adolescents from private schools; C adolescents that do not smoke or drink alcoholic beverages; D those who do not attend formal exercise program; E those who go to school to perform physical activities on weekends. Adolescents attending evening classes tended to be insufficiently active. We believe that school structure, working hours, and distance from home and workplace to school and risk factor should explain these data. Intervention programs could significantly contribute to increase the physical activity level among adolescents.

  6. Severidade clínica e funcionalidade de pacientes hemiplégicos pós-AVC agudo atendidos nos serviços públicos de fisioterapia de Natal (RN Clinical severity and functionality of acute stroke patients attended at the physiotherapy public services of Natal, Rio Grande do Norte State, Brazil

    Directory of Open Access Journals (Sweden)

    Fabrícia Azevêdo da Costa

    2011-01-01

    Full Text Available O acidente vascular cerebral (AVC representa a terceira causa de morte em vários países do mundo e principal causa de incapacidade física. O objetivo deste estudo foi investigar por meio de uma equipe multidisciplinar a severidade clínica e a independência funcional de pacientes hemiplégicos pós-AVC. Trata-se de estudo descritivo composto por quarenta hemiplégicos atendidos nos quatro maiores serviços públicos de fisioterapia da cidade de Natal (RN. Foram utilizados uma ficha de avaliação, a medida de independência funcional e o NIHSS. A amostra é predominantemente feminina(55%, AVC isquêmico(90%, hemisfério cerebral direito(52,5% e fator de risco hipertensão(90%. A média da severidade clínica é 13,32±4,7 e da independência funcional, 54,6±17,15. Não houve diferença significativa entre as médias funcionais dos pacientes quanto ao lado do AVC (pvalor=0,66. Existiu relação significativa entre severidade clínica e independência funcional (r=-0,45 pvalor=0,003. A severidade clínica e a dependência funcional de pacientes com AVC, ao darem entrada na fisioterapia, são significativas e evidenciam a necessidade de, além do tratamento clássico, serem incentivadas condutas educacionais que visem à conscientização da população.This article investigates the severity and functional independence of hemiplegics patients' post-acute stroke by means of a multidisciplinary clinical staff. It is a descriptive study composed by 40 hemiplegics attended at the four largest physiotherapy public services in Natal, Rio Grande do Norte State. The methods used were an evaluation form, Functional Independence Measure and NIHSS. The results showed a sample predominantly female (55%, stroke ischemic (90%, right brain hemisphere (52.5% and Hypertension Risk Factor (90%. The mean of clinical severity and functional independence was 13.32±4.7 and 54.6±17.15 respectively. There was no significant difference between the mean of

  7. Frequency of toxocara infection in children attended by the health public service of Maringá, south Brazil Freqüência de infecção por Toxocara em crianças atendidas em serviço público de Maringá, sul do Brasil

    Directory of Open Access Journals (Sweden)

    Márcia L. Paludo

    2007-12-01

    Full Text Available The lack of specific laboratorial diagnosis methods and precise symptoms makes the toxocariasis a neglected disease in Public Health Services. This study aims to determine the frequency of Toxocara spp. infection in children attended by the Health Public Service of Hospital Municipal de Maringá, South Brazil. To evaluate the association of epidemiological and clinical data, an observational and cross-section study was carried out. From 14,690 attended children/year aged from seven month to 12 years old, 450 serum samples were randomly collected from September/2004 to September/2005. A questionnaire was used to evaluate epidemiological, clinical and hematological data. An ELISA using Toxocara canis larval excretory-secretory products as antigen detected 130 (28.8% positive sera, mainly between children from seven month to five years old (p = 0.0016. Significant correlation was observed between positive serology for Toxocara, and frequent playing in sandbox at school or daycare center (p = 0.011 and the presence of a cat at home (p = 0.056. From the families, 50% were dog owners which exposed soil backyards. Eosinophilia (p = 0.776, and signs and symptoms analyzed (fever p = 0.992, pneumonia p = 0.289, cold-like symptoms p = 0.277, cough p = 0.783, gastrointestinal problems p = 0.877, migraine p = 0.979, abdominal pain p = 0.965, joint pain p = 0.686 and skin rash p = 0.105 could not be related to the presence of anti-Toxocara antibodies. Therefore, two asthmatics children showed titles of 1:10,240 and accentuated eosinophilia (p = 0.0001. The authors emphasize the needs of prevention activities.A falta de métodos de diagnóstico laboratorial específico e sintomas específicos fazem da toxocaríase uma doença negligenciada nos serviços públicos de saúde. Este estudo teve por objetivo determinar a freqüência de infecção por Toxocara spp. em crianças atendidas no serviço público do Hospital Municipal de Maringá, sul do Brasil, e

  8. 'The Public Spectre'

    DEFF Research Database (Denmark)

    Jepsen, Kim Sune Karrasch; Bertilsson, Margareta; Delgado, Ana

    2016-01-01

    This paper is concerned with how forms of publics come into being in situations of technological innovation and change. The paper attends to sudden social formations which arise as responses to what is perceived of as threatening socio-technical inventions into the routine of everyday social life...

  9. Comparing resident cataract surgery outcomes under novice versus experienced attending supervision

    Directory of Open Access Journals (Sweden)

    Puri S

    2015-09-01

    Full Text Available Sidharth Puri,1 Amanda E Kiely,2 Jiangxia Wang,3 Alonzo S Woodfield,4 Saras Ramanathan,5 Shameema Sikder21Johns Hopkins School of Medicine, Baltimore, MD, 2Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, 3Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 4Kaiser Permanente South Sacramento Medical Center, Sacramento, 5San Francisco School of Medicine, University of California, San Francisco, CA, USAPurpose: To determine whether supervision by an attending new to surgical teaching or an experienced attending measurably influences intraoperative complications rates or outcomes in phacoemulsification performed by ophthalmology residents.Setting: Single tertiary hospital.Design: Retrospective cohort study. Methods: Resident-performed phacoemulsification cases supervised by one novice attending (N=189 and experienced attending (N=172 over 1 year were included. Data included: resident year, patient age, sex, preoperative risk factors (4+ dense/white/brunescent cataracts, Flomax, zonular dialysis, pseudoexfoliation, glaucoma risk, post-vitrectomy, intraoperative risk factors (Trypan blue, iris hooks, and intraoperative complications (capsule tears, vitreous loss, zonular dialysis, zonular dehiscence, burns, nuclear fragment loss, Descemet’s tear. Experienced attending data were compared against those of the novice attending.Results: Regarding preoperative risks, experienced attending cases more likely involved 4+ cataract (P=0.005, Flomax (P<0.001, or glaucoma risk (P=0.001. For intraoperative risks, novice attending cases more likely involved Trypan blue (P<0.001. Regarding complications, novice attending cases were associated with vitreous loss (P=0.002 and anterior capsule tears (P<0.001. When comparing total complications, the novice attending was more likely to have both increased number of cases with complications and total complications than the experienced attending. The novice

  10. 75 FR 54085 - Dairy Industry Advisory Committee; Public Meeting

    Science.gov (United States)

    2010-09-03

    ... for Attending the Meeting Space for attendance at the meeting is limited. Due to USDA headquarters security and space requirements, all persons wishing to attend the public meetings or provide oral comments.... Upon arrival at the USDA Whitten or South Buildings, registered persons must provide valid photo...

  11. Poor Availability of Skilled Birth Attendants in Nigeria: A Case Study ...

    African Journals Online (AJOL)

    postnatal period.[1] Availability of SBAs is pivotal to achieving the MDGs 4 and 5, and contributes substantially in achieving. MDG 6.[2] SBAs are midwives and ... Nkwo: Poor availability of skilled birth attendants in Nigeria: A Case Study of Enugu State Primary Health Care System. Annals of ..... [16] Evidence from India and.

  12. Kinvolved: Utilizing Technology to Communicate, Evaluate, and Advocate for Improved Attendance and Family and Community Engagement

    Science.gov (United States)

    Altman, Miriam; Meis, Alexandra

    2013-01-01

    The American K-12 grade education system is experiencing a truancy crisis. Nationally, 15%, or 7.5 million students, miss an entire month of school annually [1], with that rate frequently doubling or even tripling among students from underserved communities [2]. Research has identified attendance as one of three primary indicators of high school…

  13. Barriers to men who have sex with men attending HIV related health ...

    African Journals Online (AJOL)

    2014-04-22

    Apr 22, 2014 ... discrimination affect MSM attendance to HIV related health services; (ii) determine how health care worker's (HCW's) practices and .... Level of education. No formal education. 2. Primary. 15. Vocational training. 1. Secondary. 32. Employment. Unemployed. 19. Self-employed. 23. Employed. 8. Sexual.

  14. Can provision of free school uniforms harm attendance? Evidence from Ecuador

    NARCIS (Netherlands)

    Hidalgo, D.; Onofa, M.; Oosterbeek, H.; Ponce, J.

    2010-01-01

    To raise school enrollment and attendance, many programs in developing countries eliminate or reduce private contributions to education. This paper documents an unintended negative effect of such programs. Using data from a randomized experiment that provides free uniforms to primary school children

  15. Can provision of free school uniforms harm attendance? Evidence from Ecuador

    NARCIS (Netherlands)

    Hidalgo, D.; Onofa, M.; Oosterbeek, H.; Ponce, J.

    2010-01-01

    To raise school attendance, many programs in developing countries eliminate or reduce private contributions to education. This paper documents an unintended negative effect of such programs. Using data from a randomized experiment that provides free uniforms to primary school children in Ecuador, we

  16. The Effects of Gender and Attendance Period on Children's Adjustment to Nursery Classes.

    Science.gov (United States)

    Davies, Julie; Brember, Ivy

    1991-01-01

    Analyzes the effects of gender and time of attendance on children's adjustment to English nursery classes attached to primary schools. Results show boys were perceived as less well adjusted to school than are girls. Afternoon attendees were found to be less well adjusted than morning attendees. Discusses strategies to help those who are less well…

  17. Public meeting

    CERN Multimedia

    HR Department

    2010-01-01

    Dear Colleagues, I am pleased to invite you to a public meeting which will be held on Thursday 11 November 2010 at 2:30 p.m., in the Main Auditorium (welcome coffee from 2 p.m.) In this meeting Sigurd Lettow, Director for Administration and General Infrastructure will present the Management’s proposals towards restoring full funding of the Pension Fund. The meeting will follow discussions which took place with the Staff Association, at the Standing Concertation Committee (CCP) of 1 November 2010 and will be held with the Members States, at the Tripartite Employment Conditions Forum (TREF) of 4 November 2010. You will be able to attend this presentation in the Main Auditorium or via the webcast. The Management will also be available to reply to your questions on this subject. Best regards, Anne-Sylvie Catherin

  18. The Ariadne's thread in co-payment, primary health care usage and financial crisis: findings from Cyprus public health care sector.

    Science.gov (United States)

    Petrou, P

    2015-11-01

    Cyprus entered a prolonged financial r