WorldWideScience

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. Developing an assessment in dental public health for clinical undergraduates attending a primary dental care outreach programme.

    Science.gov (United States)

    Holmes, R D; Waterhouse, P J; Maguire, A; Hind, V; Lloyd, J; Tabari, D; Lowry, R J

    2011-02-01

    This paper describes the development and implementation of a Dental Public Health (DPH) assessment within the Primary Dental Care Outreach (PDCO) course at Newcastle University. The assessment was piloted alongside the delivery of the Bachelor of Dental Surgery (BDS) curriculum in accordance with established learning outcomes. To design and implement a pilot summative assessment, incorporating patients' social histories obtained by undergraduate students attending primary dental care outreach clinics. Undergraduates were tasked with obtaining a detailed social history from a patient seen during their two-year outreach attachment. Each student submitted a written account of their patient's social history and placed this in context by researching a number of demographic and social variables centred upon their patient's home residence. The final component involved writing a concise case feature for a nominated newspaper based upon the case history, where students were encouraged to identify one or more public health messages using language appropriate to a lay readership. Seventy one clinical undergraduates (98.6% of the year-group) subsequently submitted all components of the assessment. Eighty six per cent of the year-group was deemed to have passed the assessment with 9.9% achieving a 'Merit' grade and 76% a 'Satisfactory' grade. Following the assessment, students and clinical teachers were asked for their feedback through a focus group for staff, and a brief feedback form for students. Undergraduates subsequently reported greater awareness of the significance and importance of obtaining a detailed social history and its relevance when devising appropriate and realistic treatment plans. © 2011 John Wiley & Sons A/S.

  3. 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.

  4. 16 CFR 1012.4 - Public attendance at agency meetings.

    Science.gov (United States)

    2010-01-01

    ... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Public attendance at agency meetings. 1012.4 Section 1012.4 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION GENERAL MEETINGS POLICY-MEETINGS BETWEEN AGENCY PERSONNEL AND OUTSIDE PARTIES § 1012.4 Public attendance at agency meetings. (a) Any person...

  5. 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

  6. 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 ...

  7. 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 ...

  8. 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.

  9. [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.

  10. Utilization of skilled birth attendants in public and private sectors in Vietnam.

    Science.gov (United States)

    Do, Mai

    2009-05-01

    The private sector in health care in Vietnam has been increasingly competing with the government in primary health care services. However, little is known about the use of skilled birth attendance or about choice of public and private sectors among those who opt for skilled attendants. Using data from the Vietnam 2002 Demographic and Health Survey, this study examines factors related to women's decision-making of whether to have a skilled birth attendant at a recent childbirth, and if they did, whether it was a public or private sector provider. The study indicates that the use of the private sector for delivery services was significant. Women's household wealth, education, antenatal care and community's wealth were positively related to skilled birth attendance, while ethnicity and order of childbirth were negatively related. Order of childbirth was positively associated with skilled birth attendance in the private sector. Among service environment factors, increased access to public sector health centres was associated with an increased likelihood of skilled birth attendance in general, but a lowered chance of that in the private sector. Further studies are needed to assess the current situation in the private sector, the demand for delivery services in the private sector, and its readiness to provide quality services.

  11. 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 cross-sectional descriptive study was conducted among 360 ANCs attending PHC facilities in two Local Government Areas (LGAs) in Kano state. Data were ...

  12. Clinical characteristics of persistent frequent attenders in primary care: case–control study

    OpenAIRE

    Patel, Shireen; Kai, Joe; Atha, Christopher; Avery, Anthony; Guo, Boliang; James, Marilyn; Malins, Samuel; Sampson, Christopher James; Stubley, Michelle; Morriss, Richard K.

    2015-01-01

    Background. Most frequent attendance in primary care is temporary, but persistent frequent attendance is expensive and may be suitable for psychological intervention. To plan appropriate intervention and service delivery, there is a need for research involving standardized psychiatric interviews with assessment of physical health and health status.\\ud \\ud Objective. To compare the mental and physical health characteristics and health status of persistent frequent attenders (FAs) in primary ca...

  13. 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.

  14. Factors Affecting Non-Attendance in Irish Primary Schools and Reasons for Differences between Urban and Rural levels of Non-attendance

    OpenAIRE

    Gurhy, Anne Marie; Perry, Glen; Farrell, Mark

    2018-01-01

    This study will investigative the factors that influence school non-attendance, in designated disadvantaged Irish primary schools (DEIS1). Currently, no comprehensive data exists on the factors contributing to the levels and types of non-attendance within the Irish context. Since 2003/2004, the National Educational Welfare Board (NEWB, Appendix A) the agency with responsibility for school attendance, has collected specific data on attendance levels and the frequency of non-attendance across a...

  15. 45 CFR 702.16 - Attendance of news media at public sessions.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 3 2010-10-01 2010-10-01 false Attendance of news media at public sessions. 702... Attendance of news media at public sessions. Reasonable access for coverage of public sessions shall be provided to the various communications media, including newspapers, magazines, radio, newsreels, and...

  16. 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...

  17. 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 ...

  18. 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.

  19. 16 CFR 1013.4 - Public attendance at Commission meetings.

    Science.gov (United States)

    2010-01-01

    ... into account in all cases the relative advantages and disadvantages to the public of conducting the... concludes on balance, taking into account the relative advantages and disadvantages to the public of...

  20. An Evaluation of the Attendance Policy and Program and Its Perceived Effects on High School Attendance in Newport News Public Schools

    OpenAIRE

    Smith, Wayne Keith

    1998-01-01

    The purpose of this quantitative study is to determine the effects of the attendance policy and attendance program after one year of implementation in Newport News Public Schools with a total high school population of approximately 5,820 students. The school district recently implemented a new attendance policy and program to address high school student absenteeism. This multi-faceted study examined the effects of this new policy by conducting statistical analyses of attendance data, pro...

  1. 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.

  2. [Psychosocial aspects associated with excessive attendance in primary care paediatric clinics].

    Science.gov (United States)

    Martín Martín, Raquel; Sánchez Bayle, Marciano; Teruel de Francisco, Carmen

    2018-04-20

    Hyper-attendance is a significant problem in paediatric Primary Care clinics. The aim of our study was to analyse the level of attendance in these clinics and its relationship with certain psychosocial aspects of the families attending them. Observational descriptive study was conducted using questionnaires collected during a period of 6months, as well as recording the frequency of attendance in the previous 6months. A total of 346 questionnaires of children between 6months and 13years of age belonging to 2 urban Primary Care clinics in Madrid were completed. The raw data was analysed, and comparisons between groups and multivariate analysis were performed. The mean number of consultations in the last 6months, of the total included in the study, was 3.06 in the Primary Care centre, and 0.77 in the emergency services. It was considered over-frequent for those who had attended the Primary Care health centre 6 or more times in this period (>p90), of which there were 33 children (9.53%). In the multivariate analysis, the variables related to being frequent users of Primary Care clinics were: the presence of high level of anxiety in the parents (OR=5.50; 95%CI: 2.49-12.17, P<.0001), and the age of the children (OR=0.73; 95%CI: 0.58-0.91, P=.005). The model presented an area under the curve of 0.761 (95%CI: 0.678-0.945, P<.0001). The frequency of visits in paediatric Primary Care clinics is directly related to the high level of anxiety of the parents, and inversely to the age of the children. It would be advisable to detect and, if possible, intervene in cases of high parental anxiety in order to try to reduce the over-frequency in the paediatric primary health care. Copyright © 2018. Publicado por Elsevier España, S.L.U.

  3. 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...

  4. 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

  5. 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

  6. Information communication technology policy and public primary ...

    African Journals Online (AJOL)

    The main objective of this study was to correlate Information Communication Technology with public primary schools' efficiency in Rwanda. The study employed the descriptive survey and descriptive co-relational design. One hundred and forty-four primary teachers participated in the study. The level of ICT was poor (M ...

  7. Psychiatric disorders in children attending a Nigerian primary care unit: functional impairment and risk factors

    Directory of Open Access Journals (Sweden)

    Tunde-Ayinmode Mosunmola

    2012-07-01

    Full Text Available Abstract Background There is dearth of data on the level of functional impairment and risk factors for psychiatric morbidity in children attending primary care services in developing countries like Nigeria. The risk factors for psychiatric morbidity and functional impairment in children attending the primary care unit of a teaching hospital in Ilorin, Nigeria was therefore investigated to obtain data that could be used in improving service provision by primary care physicians. Methods A cross-sectional two-stage design was employed for the study. The first stage involved administration of the Child Behavior Questionnaire (CBQ to 350 children while the children’s version of the schedule for affective disorders and schizophrenia was used for the second stage involving 157 children, all high scorers on CBQ (score of ≥ 7 and 30% of low scorers (score  In addition, the Children Global Assessment Scale was used to assess the functional status of the children (score of ≤ 70 indicates functional impairment while the mothers’ mental health status was assessed with the 12-item version of the General Health Questionnaire, a score of 3 or more on this instrument indicate presence of mental morbidity. Results It was observed that 11.4% of the children had diagnosable psychiatric disorders and 7.1% were functionally impaired; and those with psychiatric disorders were more functionally impaired than those without. Thus, significant negative correlation was noted between CBQ scores and CGAS (r = 0.53; p  Conclusions Child psychiatric disorders are prevalent in the primary care unit studied. Many of the risk factors identified in the study population are modifiable. Collaborative efforts between psychiatrists and primary care physicians could therefore help to reduce level of risk and functional impairment and psychiatric morbidity among children attending the primary care unit studied. It could also help improve referral rates of

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

    International Nuclear Information System (INIS)

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

    2002-01-01

    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

  9. Preventing dehydration-related hospitalizations: a mixed-methods study of parents, inpatient attendings, and primary care physicians.

    Science.gov (United States)

    Shanley, Leticia; Mittal, Vineeta; Flores, Glenn

    2013-07-01

    The goal of this study was to identify the proportion of dehydration-related ambulatory care-sensitive condition hospitalizations, the reasons why these hospitalizations were preventable, and factors associated with preventability. A cross-sectional survey of primary care providers (PCPs), inpatient attending physicians, and parents was conducted in a consecutive series of children with ambulatory care-sensitive conditions admitted to an urban hospital over 14 months. Eighty-five children were diagnosed with dehydration. Their mean age was 1.6 years; most had public (74%) or no (17%) insurance, and were nonwhite (91%). The proportion of hospitalizations assessed as preventable varied from 12% for agreement among all 3 sources to 45% for any source. Parents identified inadequate prevention (50%), poor self-education (34%), and poor quality of care (38%) as key factors. PCPs identified parents providing insufficient home rehydration (33%), not visiting the clinic (25%), and not calling earlier (16%) as reasons. Inpatient attending physicians cited home rehydration (40%), delays in seeking care (40%), and lacking a PCP (20%) as contributors. Physicians (PCPs and inpatient attending physicians) were more likely than parents to describe the admission as inappropriate (75% vs 67% vs 0%; P dehydration-related hospitalizations may be preventable. Inadequate parental education by physicians, insufficient home rehydration, deferring clinic visits, insurance and cost barriers, inappropriate admissions, poor quality of care, and parental dissatisfaction with PCPs are the reasons that these hospitalizations might have been prevented.

  10. [Nutritional status in preschoolers attending a public day-care center in Valencia, Venezuela].

    Science.gov (United States)

    Real, Sara Irene del; Jaeger, Armando Sánchez; Barón, María Adela; Díaz, Nayka; Solano, Liseti; Velásquez, Emma; López, Jesús

    2007-09-01

    With the purpose of evaluating nutritional status in a group of preschoolers attending a public day care center in Valencia, Venezuela (2002), a research was made for social stratus, anthropometric variables; weight, height and arm circumference, hemoglobin, seric retinol, presence of parasitosis and food consumption, as well as the mother's educational level. The program SPSS 11.0 and the t Student, ANOVA Post Hoc from Bonferroni and Fisher (p education, while only 9.8% of the mothers in poverty had reached that level. According to the Z values (H/A, W/H and AC/H), high percentages under -1.00 were observed (27.3%, 25.6% and 24.5%, respectively). The W/H and AC/H of children of mothers studying in a university presented discrepancies when compared with children of mothers with a primary educational level. A 25.9% of anemia was presented, and there were differences between anemic and non-anemic groups for H/A and AC/H. Protozoaries were observed in 61.0%, helmintos in 16.9% and both in 22.1%. There was a 2.6 times higher risk of presenting nutritional deficiency for AC/H in the group found with parasites. An adequate consumption of energy and iron was found, with an excessive consumption of proteins and vitamin A. It is concluded that there exists a nutritional risk evaluated through hematologic parameters, the presence of parasitosis and social stratus.

  11. 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.

  12. 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 depression among participants in this study was clinically significant and corresponded with the findings of other international studies. Factors associated with depression need to be highlighted and addressed accordingly. Clinicians in Malaysia should be aware of this prevalence when making diagnoses in primary care.

  13. Poverty, violence and depression during pregnancy: a survey of mothers attending a public hospital in Brazil.

    Science.gov (United States)

    Lovisi, Giovanni Marcos; López, José Ramon R A; Coutinho, Evandro Silva Freire; Patel, Vikram

    2005-10-01

    Depression in women is associated with social deprivation and violence. We describe the prevalence and risk factors for depression during pregnancy, in particular the association with poverty and violence, in a Brazilian setting. A cross-sectional survey of women in the third trimester of pregnancy attending a public hospital maternity clinic from August 2003 to July 2004 in Rio de Janeiro. Participants were interviewed about their sociodemographic status, obstetric and medical conditions, substance use, stressful life events, and social support. Depression was diagnosed through the Composite International Diagnostic Interview (CIDI). A total of 230 of 240 eligible women consented to participate. The 12-month prevalence of depression was 19.1% (95% CI 14.4-24.9). On multivariate analyses, having been educated beyond primary school was protective (OR 0.5, 95% CI 0.2-0.9). Risk factors were: being divorced or widowed (OR 4.9, 95% CI 1.3-18.3); a history of depression before pregnancy (OR 7.9, 95% CI 3.1-20.5); loss of an intimate relationship (OR 8.4, 95% CI 3.3-21.4), experienced financial difficulties (OR 6.6, 95% CI 2.5-17.2) and having been exposed to violence in the previous year (OR 4.2, 95% CI 1.5-11.8). Depression is common during pregnancy and is associated with indicators of socio-economic deprivation, violence and the loss of an intimate relationship, and with a previous history of depression. Psychosocial interventions and appropriate social policies need to be implemented in this population to reduce the burden of maternal depression.

  14. Frequency and characteristics of individuals with seasonal pattern among depressive patients attending primary care in France.

    Science.gov (United States)

    Azorin, Jean-Michel; Adida, Marc; Belzeaux, Raoul

    2015-01-01

    High rates of bipolar disorder (BD) have been found among major depressives with seasonal pattern (SP) consulting in psychiatric departments, as well as among patients seeking primary care. As SP was reported to be common in the latter, the current study was designed to assess (a) the frequency and characteristics of SP among major depressives attending primary care and (b) the prevalence and aspects of BD in this population. Among 400 patients who consulted French general practitioners (GPs) for major depression between February and December 2010, 390 could be included in the study: 167 (42.8%) met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria for seasonal pattern [SP(+)], whereas 223 (57.2%) did not meet these criteria [SP(-)]. The two groups were compared on demographic, clinical, family history and temperamental characteristics. Compared to SP(-), SP(+) patients were more frequently female, married and with a later age at first depressive episode, and showed more atypical vegetative symptoms, comorbid bulimia and stimulant abuse. They also exhibited more lifetime depressive episodes, were more often diagnosed as having BD II and met more often bipolarity specifier criteria, with higher rates of bipolar temperaments and a higher BD family loading. Among SP(+) patients, 68.9% met the bipolarity specifier criteria, whereas 31.1% did not. Seasonality was not influenced by climatic conditions. The following independent variables were associated with SP: BD according to bipolarity specifier, female gender, comorbid bulimia nervosa, hypersomnia, number of depressive episodes and family history of substance abuse. Seasonal pattern is frequent among depressive patients attending primary care in France and may be indicative of hidden bipolarity. Given the risks associated with both SP and bipolarity, GPs are likely to have a major role in regard to prevention. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Characteristics of motorcyclists involved in road traffic accidents attended at public urgent and emergency services.

    Science.gov (United States)

    Mascarenhas, Márcio Dênis Medeiros; Souto, Rayone Moreira Costa Veloso; Malta, Deborah Carvalho; Silva, Marta Maria Alves da; Lima, Cheila Marina de; Montenegro, Marli de Mesquita Silva

    2016-12-01

    Injuries resulting from motorcycle road traffic accidents are an important public health issue in Brazil. This study aimed to describe the characteristics of motorcyclists involved in traffic accidents attended in public urgent and emergency services in the state capitals and the Federal District. This is a cross-sectional study based on data from the Violence and Accident Surveillance System (VIVA Survey) in 2014. Data were analyzed according to sociodemographic, event and attendance characteristics. Proportional differences between genders were analyzed by chi-square test (Rao-Scott) with 5% significance level. Motorcyclist-related attendances (n = 9,673) reported a prevalence of men (gender ratio = 3.2), young people aged 20-39 years (65.7%), black / brown (73.6%), paid work (76.4%). Helmet use was reported by 79.1% of the victims, 13.3% had consumed alcohol in the six hours prior to the accident, 41.4% of the events were related to the victim's work. Accidents were more frequent on weekends, in the morning and late afternoon. These characteristics can support the development of public accident prevention policies and health promotion.

  16. 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.

  17. Premenstrual symptoms and remedies practiced by Malaysian women attending a rural primary care clinic

    Directory of Open Access Journals (Sweden)

    Khairani Omar

    2009-06-01

    Method: This was a cross-sectional study conducted at a rural primary care clinic situated in Hulu Langat, Malaysia. All women of reproductive age (18 to 44 years old attending the clinic during the study period and who fit the selection criteria were included. Premenstrual symptoms and severity were assessed using a self-report questionnaire, the Shortened Premenstrual Assessment Form (SPAF. It consists of 10 items that measure changes in mood, behaviour and physical symptoms. The respondents were also asked if they had used any remedy to relieve their symptoms. Results: A total of 158 women were included in the study. The majority of the respondents were Malay (70.3%, followed by Indian (16.5% and Chinese (10.8% women. About 75% of the women experienced at least one of the premenstrual symptoms. Approximately 7% of them reported experiencing severe symptoms in all three subscales of the SPAF. The frequently reported symptoms were body ache (75.3%, abdominal pain (75.3%, irritable feeling (63.9% and breast discomfort (61.4%. The symptom score was higher among Malay women (p = 0.034, and those with a higher household income (p = 0.037 and higher educational level (p = 0.01. There was no significant association between premenstrual symptoms and age, marital status, menstrual cycle and age of menarche. The common remedies used were vitamins (19%, a healthy diet (15.8% and analgesics (13.3%. Approximately 60% of the women did not use any remedy to reduce their premenstrual symptoms. Conclusion: Premenstrual symptoms were common among women attending the clinic. The symptoms affect them significantly both physically and emotionally. Thus, it is essential for primary care providers to take an active role in identifying, educating and managing premenstrual symptoms among women.

  18. 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

  19. Bypassing Primary Care Facilities for Childbirth: Findings from a Multilevel Analysis of Skilled Birth Attendance Determinants in Afghanistan.

    Science.gov (United States)

    Tappis, Hannah; Koblinsky, Marge; Doocy, Shannon; Warren, Nicole; Peters, David H

    2016-01-01

    The objective of this study was to assess the association between health facility characteristics and other individual/household factors with a woman's likelihood of skilled birth attendance in north-central Afghanistan. Data from a 2010 household survey of 6879 households in 9 provinces of Afghanistan were linked to routine facility data. Hierarchical logistic regression models were used to assess determinants of skilled birth attendance. Women who reported having at least one antenatal visit with a skilled provider were 5.6 times more likely to give birth with a skilled attendant than those who did not. The odds of skilled birth attendance were 84% higher for literate women than those without literacy skills and 79% higher among women in the upper 2 wealth quintiles than women in the poorest quintile. This study did not show any direct linkages between facility characteristics and skilled birth attendance but provided insights into why studies assuming that women seek care at the nearest primary care facility may lead to misinterpretation of care-seeking patterns. Findings reveal a 36 percentage point gap between women who receive skilled antenatal care and those who received skilled birth care. Nearly 60% of women with a skilled attendant at their most recent birth bypassed the nearest primary care facility to give birth at a more distant primary care facility, hospital, or private clinic. Distance and transport barriers were reported as the most common reasons for home birth. Assumptions that women who give birth with a skilled attendant do so at the closest health facility may mask the importance of supply-side determinants of skilled birth attendance. More research based on actual utilization patterns, not assumed catchment areas, is needed to truly understand the factors influencing care-seeking decisions in both emergency and nonemergency situations and to adapt strategies to reduce preventable mortality and morbidity in Afghanistan. © 2016 by the American

  20. 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.

  1. 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.

  2. Orthodontic treatment need among young Saudis attending public versus private dental practices in Riyadh.

    Science.gov (United States)

    Al-Jobair, Asma M; Baidas, Laila F; Al-Hamid, Anfal A; Al-Qahtani, Sara G; Al-Najjar, Amani T; Al-Kawari, Huda M

    2016-01-01

    To assess and compare the severity of malocclusion and orthodontic treatment need among young Saudis receiving free treatment at public dental practices versus those paying for treatment at private practices. This retrospective study evaluated the records of 300 patients (179 females, 121 males; age 13-21 years) treated at orthodontic clinics from 2013 through 2015. The public sample was selected from orthodontic clinics at the College of Dentistry, King Saud University (KSU); the private sample was selected from five private orthodontic clinics in Riyadh, Saudi Arabia. The records were examined for the severity of malocclusion and for orthodontic treatment need using the Dental Health Component of the Index of Orthodontic Treatment Need. The prevalence of each occlusal discrepancy and the Dental Health Component grade were recorded. The severity of malocclusion and orthodontic treatment need were compared between practice types, age groups, and sexes with the chi-square test. Displacement, increased overjet, and Class II and III malocclusion were the most common orthodontic problems in this study. Patients attending public clinics at KSU generally had more severe malocclusion than the patients attending private clinics. Seventy-seven percent of orthodontically treated patients at KSU clinics were in great need of treatment, compared with 58.5% of patients treated at private clinics ( P =0.003). Among the patients with great treatment need, approximately 62% of male patients and 70% of patients ≤16 years of age were treated at KSU clinics, compared with 38% and 48%, respectively, treated at private clinics ( P orthodontic treatment at public clinics at KSU had more severe malocclusion with greater need of orthodontic treatment than the patients paying for treatment at private clinics.

  3. 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.

  4. Intestinal helminth infections and nutritional status of children attending primary schools in Wakiso District, Central Uganda.

    Science.gov (United States)

    Lwanga, Francis; Francis, Lwanga; Kirunda, Barbara Eva; Orach, Christopher Garimoi

    2012-08-01

    A cross-sectional study to assess the prevalence of intestinal helminth infections and nutritional status of primary school children was conducted in the Wakiso district in Central Uganda. A total of 432 primary school children aged 6-14 years were randomly selected from 23 schools. Anthropometric measurements of weight, height, MUAC were undertaken and analyzed using AnthroPlus software. Stool samples were examined using a Kato-Katz method. The prevalence of stunting, underweight and moderate acute malnutrition (MAM) was 22.5%, 5.3% and 18.5% respectively. Males had a threefold risk of being underweight (OR 3.2, 95% CI 1.17-9.4, p = 0.011) and 2 fold risk of suffering from MAM (OR 2.1, 95% CI 1.21-3.48, p = 0.004). Children aged 10-14 years had a 2.9 fold risk of stunting (OR 2.9, 95% CI 1.37-6.16, p = 0.002) and 1.9 risk of MAM (OR 1.9, 95% CI 1.07-3.44, p = 0.019). Attending urban slum schools had 1.7 fold risk of stunting (OR 1.7, 95% CI 1.03-2.75, p = 0.027). Rural schools presented a twofold risk of helminth infection (OR 1.95, 95% CI 1.12-3.32, p = 0.012). The prevalence of helminth infections was (10.9%), (3.1%), (1.9%), (0.2%) for hookworm, Trichuriatrichiura, Schistosomamansoni and Ascarislumbricoides, respectively. The study revealed that 26.6%, 46% and 10.3% of incidences of stunting, underweight and MAM respectively were attributable to helminth infections.

  5. Why do they keep coming back? Persistent frequent attenders in primary care

    NARCIS (Netherlands)

    Smits, F.T.M.

    2014-01-01

    The background of frequent attenders (FAs) of the General Practitioner (GP) often remains unclear. This thesis examines persistent frequent attendance, the relationship with (medical) conditions, methods to treat FAs, the impact of FAs on the GP’s workload and costs of healthcare, which medical file

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

    Directory of Open Access Journals (Sweden)

    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.

  7. Analysis of sexual activity without obstetric risk pregnant women attending public hospitals in Lima, Peru

    Directory of Open Access Journals (Sweden)

    Alex Guibovich Mesinas

    2015-09-01

    Full Text Available Objective: to know the characteristics of sexual activity in pregnant women without obstetric risk who attend public hospitals in Lima. Material and Methods: exploratory, multicenter, descriptive and cross-sectional study, conducted during the first half of 2014 in 9 public hospitals in Lima. The sample was made up of pregnant women without obstetric risk who attended the outpatient clinic of obstetric departments. A non-probabilistic model is used for convenience. An expert validated survey was conducted on patients who voluntarily agreed to participate and signed the informed consent. The information was analyzed using STATA 21 software. Results: 1991 pregnant women answered the survey, 924 (46.4% were between 15 and 25 years, most were married, and Catholic (81.8% and 1380 (69.3% were born in Lima. Most had several previous pregnancies (46.3%, with term pregnancy and 86.3% informed they had no pre-term infants. 1347 (67.6% had vaginal delivery. The frequency of sexual acts, sexual desire, the response pattern and the fear of exercising sexual intercourse decreased at higher gestational age. Fear of sex acts increased from 12.6% to 76.2% in the third quarter. Most informed of a lack of orgasm during intercourse (42.8%. The position for intercourse went from "him on her" in the first quarter to "sideways" during the third quarter, with statistical significance. Conclusion: sexual activity in pregnant women of Metropolitan Lima tend to decrease in frequency, desire, and response cycle. The "sideways" position was the most often used in the third trimester.

  8. Out-of-pocket costs, primary care frequent attendance and sample selection: Estimates from a longitudinal cohort design.

    Science.gov (United States)

    Pymont, Carly; McNamee, Paul; Butterworth, Peter

    2018-03-20

    This paper examines the effect of out-of-pocket costs on subsequent frequent attendance in primary care using data from the Personality and Total Health (PATH) Through Life Project, a representative community cohort study from Canberra, Australia. The analysis sample comprised 1197 respondents with two or more GP consultations, and uses survey data linked to administrative health service use (Medicare) data which provides data on the number of consultations and out-of-pocket costs. Respondents identified in the highest decile of GP use in a year were defined as Frequent Attenders (FAs). Logistic regression models that did not account for potential selection effects showed that out-of-pocket costs incurred during respondents' prior two consultations were significantly associated with subsequent FA status. Respondents who incurred higher costs ($15-$35; or >$35) were less likely to become FAs than those who incurred no or low (attenders. Copyright © 2018. Published by Elsevier B.V.

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

    African Journals Online (AJOL)

    Evaluation of school health instruction in public primary schools in Bonny Local Government Area, Rivers state. ... PROMOTING ACCESS TO AFRICAN RESEARCH ... Background: Effective school health instruction in primary schools is ...

  10. 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

  11. 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

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

    Science.gov (United States)

    Alghoury, Abdulbasit; El-Hamshary, Eman; Azazy, Ahmed; Hussein, Eman; Rayan, Hanan Z.

    2010-01-01

    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. PMID:22125707

  13. 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.

  14. Perception and utilization of traditional birth attendants by pregnant women attending primary health care clinics in a rural Local Government Area in Ogun State, Nigeria

    Directory of Open Access Journals (Sweden)

    Ebuehi OM

    2012-02-01

    Full Text Available Olufunke M Ebuehi, IA AkintujoyeReproductive and International Health Unit, Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, NigeriaBackground: In developing countries, most childbirth occurs at home and is not assisted by skilled attendants. This situation increases the risk of death for both mother and child and has severe maternal and neonatal health complications. The purpose of this study was to explore pregnant women’s perceptions and utilization of traditional birth attendant (TBA services in a rural Local Government Area (LGA in Ogun State, southwest Nigeria.Methods: A quantitative design was used to obtain information using a structured questionnaire from 250 pregnant women attending four randomly selected primary health care clinics in the LGA. Data were analyzed using Epi Info (v 3.5.1 statistical software.Results: Almost half (48.8% of the respondents were in the age group 26–35 years, with a mean age of 29.4 ± 7.33 years. About two-thirds (65.6% of the respondents had been pregnant 2–4 times before. TBA functions, as identified by respondents, were: “taking normal delivery” (56.7%, “providing antenatal services” (16.5%, “performing caesarean section” (13.0%, “providing family planning services” (8.2%, and “performing gynaecological surgeries” (5.6%. About 6/10 (61.0% respondents believed that TBAs have adequate knowledge and skills to care for them, however, approximately 7/10 (69.7% respondents acknowledged that complications could arise from TBA care. Services obtained from TBAs were: routine antenatal care (81.1%, normal delivery (36.1%, “special maternal bath to ward off evil spirits” (1.9%, “concoctions for mothers to drink to make baby strong” (15.1%, and family planning services (1.9%. Reasons for using TBA services were: “TBA services are cheaper” (50.9%, “TBA services are more culturally acceptable in my environment” (34.0%,

  15. Diabetic retinopathy and its risk factors in patients with type 2 diabetes attending rural primary healthcare facilities in Tamil Nadu.

    Science.gov (United States)

    Fredrick, Tony; Kaur, Prabhdeep; Murhekar, Manoj V; Jayaraman, Yuvaraj; Kolandaswamy, K; Rao, Sudha Ramachandra; David, Joseph K

    2016-01-01

    India has a high burden of diabetic retinopathy ranging from 12.2% to 20.4% among patients with type 2 diabetes mellitus (T2DM). A T2DM management programme was initiated in the public sector in Tamil Nadu. We estimated the prevalence of diabetic retinopathy and its associated risk factors. We did a cross-sectional survey among patients with T2DM attending two primary health centres for treatment and follow-up in Kancheepuram, Tamil Nadu in January- March 2013. We did a questionnaire-based survey, and measured blood pressure and biochemical parameters (serum creatinine, plasma glucose, etc.) of the patients. We examined their eyes by direct and indirect ophthalmoscopy and defined diabetic retinopathy using a modified classification by Klein et al. We calculated the proportion and 95% CI for the prevalence and adjusted odds ratio (AOR) for risk factors associated with diabetic retinopathy. Among the 270 patients, the mean (SD) age was 54.5 (10) years. The median duration of T2DM was 48 months. The prevalence of diabetic retinopathy was 29.6%. Overall, 65.9% of patients had hypertension, 14.4% had nephropathy (eGFR 5 years (AOR 6.5, 95% CI 3.6-11.7), poor glycaemic control (AOR 2.4, 95% CI 1.4-4.4), and nephropathy (AOR 2.3, 95% CI 1.1-4.6). There was a high burden of undetected retinopathy and other comorbid conditions among patients with T2DM. Early detection of comorbid conditions and glycaemic control can be improved by training care-providers and educating patients.

  16. The Diverse Risk Profiles of Persistently Absent Primary Students: Implications for Attendance Policies in Australia

    Science.gov (United States)

    Hancock, Kirsten J.; Mitrou, Francis; Taylor, Catherine L.; Zubrick, Stephen R.

    2018-01-01

    The risk factors associated with absenteeism are well known. However, children's exposure to combinations of risks and how these relate to absence patterns remains unclear. Understanding variations in risk profiles among persistently non-attending children will inform the development of absence interventions. Using a longitudinal sample of…

  17. Internet use, online information seeking and knowledge among third molar patients attending public dental services.

    Science.gov (United States)

    Hanna, K; Sambrook, P; Armfield, J M; Brennan, D S

    2017-09-01

    While Australians are searching the internet for third molar (TM) information, the usefulness of online sources may be questioned due to quality variation. This study explored: (i) internet use, online information-seeking behaviour among TM patients attending public dental services; and (ii) whether patients' TM knowledge scores are associated with the level of internet use and eHealth Literacy Scale (eHEALS) scores. Baseline survey data from the 'Engaging Patients in Decision-Making' study were used. Variables included: sociodemographics, internet access status, online information-seeking behaviour, eHEALS, the Control Preferences Scale (CPS) and TM knowledge. Participants (N = 165) were mainly female (73.8%), aged 19-25 years (42.4%) and had 'secondary school or less' education (58.4%). A majority (N = 79, 52.7%) had sought online dental information which was associated with active decisional control preference (odds ratio = 3.1, P = 0.034) and higher educational attainment (odds ratio = 2.7, P = 0.040). TM knowledge scores were not associated with either the level of internet use (F (2,152) = 2.1, P = 0.094, χ 2 = 0.0310) or the eHEALS scores (r = 0.147, P = 0.335). 'The internet-prepared patient' phenomena exists among public TM patients and was explained by preference for involvement in decision-making. However, internet use was not associated with better TM knowledge. Providing TM patients with internet guidance may be an opportunity to improve TM knowledge. © 2017 Australian Dental Association.

  18. 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.

  19. [Inclusion of traditional birth attendants in the public health care system in Brazil: reflecting on challenges].

    Science.gov (United States)

    Gusman, Christine Ranier; Viana, Ana Paula de Andrade Lima; Miranda, Margarida Araújo Barbosa; Pedrosa, Mayane Vilela; Villela, Wilza Vieira

    2015-05-01

    The present article describes an experience with traditional birth attendants carried out in the state of Tocantins, Brazil, between 2010 and 2014. The experience was part of a diagnostic project to survey home deliveries in the state of Tocantins and set up a registry of traditional birth attendants for the Health Ministry's Working with Traditional Birth Attendants Program (PTPT). The project aimed to articulate the home deliveries performed by traditional birth attendants to the local health care systems (SUS). Sixty-seven active traditional birth attendants were identified in the state of Tocantins, and 41 (39 indigenous) participated in workshops. During these workshops, they discussed their realities, difficulties, and solutions in the context of daily adversities. Birth attendants were also trained in the use of biomedical tools and neonatal resuscitation. Based on these experiences, the question came up regarding the true effectiveness of the strategy to include traditional birth attendants in the SUS. The present article discusses this theme with support from the relevant literature. The dearth of systematic studies focusing on the impact of PTPT actions on the routine of traditional birth attendants, including perinatal outcomes and remodeling of health practices in rural, riverfront, former slave, forest, and indigenous communities, translates into a major gap in terms of the knowledge regarding the effectiveness of such initiatives.

  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. 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...... patients’ attitudes towards a fee for non-attendance. Methods: Six semi-structured focus group interviews were conducted with a total of 44 patients who had been informed about being charged a fee for non-attendance. Data were transcribed verbatim and analysed using a qualitative content analysis. Results...

  2. Prevalence and determinants of antenatal depression among women attending primary health care centers in Western Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Jamala A. Bawahab

    2017-12-01

    Full Text Available Objectives: To measure the prevalence of antenatal depression among pregnant women attending the primary health care (PHC antenatal care clinics in Jeddah, Saudi Arabia and to determine associated factors. Methods: Following a cross-sectional study design, 320 pregnant women attending the antenatal care clinics in the Ministry of Health PHC Centers in Jeddah, Saudi Arabia between January 1st 2017 and February 15th 2017 were interviewed. A self-administered questionnaire used for data collection asked about socio-demographic variables and included the Edinburgh Postnatal Depression Scale. Results: The most common contributor was the harming herself (mean±SD, 2.7±0.60. Factors significantly associated with depression among participants were the number of daughters, previous diagnosis of depression, and financial problems. Conclusions: The prevalence of antepartum depression among pregnant women in Jeddah is 57.5%, and the greatest contributor is the thought of harming herself.

  3. 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

  4. 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 learning and catch-up growth in lean muscle mass in children in the SFP 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.

  5. Perception and utilization of traditional birth attendants by pregnant women attending primary health care clinics in a rural Local Government Area in Ogun State, Nigeria.

    Science.gov (United States)

    Ebuehi, Olufunke M; Akintujoye, Ia

    2012-01-01

    In developing countries, most childbirth occurs at home and is not assisted by skilled attendants. This situation increases the risk of death for both mother and child and has severe maternal and neonatal health complications. The purpose of this study was to explore pregnant women's perceptions and utilization of traditional birth attendant (TBA) services in a rural Local Government Area (LGA) in Ogun State, southwest Nigeria. A quantitative design was used to obtain information using a structured questionnaire from 250 pregnant women attending four randomly selected primary health care clinics in the LGA. Data were analyzed using Epi Info (v 3.5.1) statistical software. Almost half (48.8%) of the respondents were in the age group 26-35 years, with a mean age of 29.4 ± 7.33 years. About two-thirds (65.6%) of the respondents had been pregnant 2-4 times before. TBA functions, as identified by respondents, were: "taking normal delivery" (56.7%), "providing antenatal services" (16.5%), "performing caesarean section" (13.0%), "providing family planning services" (8.2%), and "performing gynaecological surgeries" (5.6%). About 6/10 (61.0%) respondents believed that TBAs have adequate knowledge and skills to care for them, however, approximately 7/10 (69.7%) respondents acknowledged that complications could arise from TBA care. Services obtained from TBAs were: routine antenatal care (81.1%), normal delivery (36.1%), "special maternal bath to ward off evil spirits" (1.9%), "concoctions for mothers to drink to make baby strong" (15.1%), and family planning services (1.9%). Reasons for using TBA services were: "TBA services are cheaper" (50.9%), "TBA services are more culturally acceptable in my environment" (34.0%), "TBA services are closer to my house than hospital services" (13.2%), "TBAs provide more compassionate care than orthodox health workers" (43.4%), and "TBA service is the only maternity service that I know" (1.9%). Approximately 8/10 (79.2%) of the users (past

  6. Herbal medicine use among hypertensive patients attending public and private health facilities in Freetown Sierra Leone.

    Science.gov (United States)

    James, Peter Bai; Kamara, Halimatu; Bah, Abdulai Jawo; Steel, Amie; Wardle, Jon

    2018-05-01

    This study aimed to determine the prevalence, determinants and pattern of herbal medicine use among hypertensive patients in Freetown. We conducted a cross-sectional study among hypertensive patients attending public and private health facilities in Freetown, Sierra Leone between August and October 2016. We analyzed the data using SPSS version 24. We used Chi-square, Fisher exact two-tailed test and regression analysis for data analysis. A p-value less than 0.05 was considered statistically significant. Out of 260 study participants, over half (n = 148, 56.9%) reported using herbal medicine for the treatment of hypertension alone or together with comorbid condition(s). The most commonly used herbal medicine among users were honey (n = 89, 33.3%), moringa (n = 80, 30.0%) and garlic (n = 73, 27.3%). No significant difference existed between users and non-users of herbal medicine with regards to socio-demographic and health-related factors. The majority (n = 241, 92.7%) of respondents considered herbal medicine beneficial if it was recommended by a healthcare provider yet 85.1% (n = 126) did not disclose their herbal medicine use to their health care provider. There is a high use of herbal medicines among hypertensive patients in Freetown, Sierra Leone. It is essential for healthcare providers to take heed of the findings of this study and routinely ask their patients about their herbal medicine use status. Such practice will provide the opportunity to discuss the benefits and risks of herbal medicine use with the aim of maximizing patient desired therapeutic outcomes. Copyright © 2018 Elsevier Ltd. All rights reserved.

  7. Caring too much? Lack of public services to older people reduces attendance at work among their children.

    Science.gov (United States)

    Gautun, Heidi; Bratt, Christopher

    2017-06-01

    The need to provide care for older people can put a strain on their adult children, potentially interfering with their work attendance. We tested the hypothesis that public care for older people (nursing homes or home care services) would moderate the association between having an older parent in need of care and reduced work attendance among the adult children. The analysis used data from a survey of Norwegian employees aged 45-65 ( N  = 529). Institutional care for older people in need of care (i.e. nursing homes) was associated with improved work attendance among their children-their daughters in particular. Data also indicated a moderating effect: the link between the parents' reduced health and reduced work attendance among the children was weaker if the parent lived in a nursing home. However, the results were very different for home-based care: data indicated no positive effects on adult children's work attendance when parents received non-institutionalised care of this kind. Overall, the results suggest that extending public care service to older people can improve their children's ability to combine work with care for parents. However, this effect seems to require the high level of care commonly provided by nursing homes. Thus, the current trend towards de-institutionalising care in Europe (and Norway in particular) might hamper work attendance among care-giving adult children, women in particular. Home care services to older people probably need to be extended if they are intended as a real alternative to institutional care.

  8. Primary health care and public policy.

    Science.gov (United States)

    Mangelsdorf, K L; Luna, J; Smith, H L

    1988-01-01

    The health problems of Ecuador are similar to those in other developing countries where the standard of living is low, and housing and sanitation are inadequate. Women, children, and those living in rural areas are those most severely affected. National policy has been to attempt to increase access to health care in rural areas through the construction of new facilities and the appointment of highly paid medical staff. However, little attention was paid to sociocultural factors, which caused the peasantry to reject the medical care system, or to problems of internal efficiency which inhibited utilization. Since the 1970s various national and international organizations have attempted to implement primary health care (PHC) through the use of trained community health workers (CHWs). The primary problems faced by the CHWs were shortages of medicines and supplies, an almost total lack of supervision, and lack of transportation available to take staff to isolated villages. The poor supervision is blamed for the 17% drop out rate among CHWs since 1980. Independent PHC programs have also been established in Ecuador by voluntary organizations. These work best when coordinated with governmental programs, in order to allow monitoring and to avoid the duplication of services. Problems with the establishment of PHC programs in Ecuador will continue, as the government has no clear cut policy, and difficulties financing on a broad national scale. Other problems include the absence of effective supervision and logistical support for even small pilot programs, and inconsistencies in the training and role definition for CHWs. These problems need to be met in the implementation of a national PHC policy.

  9. The mental health of children of migrant workers in Beijing: the protective role of public school attendance.

    Science.gov (United States)

    Gao, Qin; Li, Hong; Zou, Hong; Cross, Wendi; Bian, Ran; Liu, Yan

    2015-08-01

    The present study aims to understand the mental health status of an understudied group of migrant children - children of migrant workers in China. A total of 1,466 children from Beijing participated in the study that compared migrant children (n = 1,019) to their local peers (n = 447) in public and private school settings. Results showed that overall, migrant children reported more internalizing and externalizing mental health problems and lower life satisfaction than local peers. However, public school attendance served as a protective factor for migrant children's mental health. The mental health status of migrant children attending public schools, including externalizing problems as well as friend and school satisfaction, was not different from local children. In addition, our data indicates that the protective effect of public school attendance for migrant children may be even more salient among girls than boys, and for younger children than older children. © 2015 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

  10. Premature ejaculation and its associated factors among men attending a primary healthcare clinic in Kelantan, Malaysia

    Directory of Open Access Journals (Sweden)

    Mohd Roslan Ahmad Zamree, MMed.

    2018-04-01

    لاحتمالات المعدلة (٩٥٪ فاصل ثقة: ٦.٠ (١.١٥، ٣١.٢٣] كانت مرتبطة ارتباطا ذا قيمة مع سرعة القذف.الاستنتاجات: سيتسبب تعزيز الوعي بسرعة القذف في المجتمع وبين مقدمي الرعاية الصحية، في زيادة معدل الكشف عن هذا الاضطراب. كما ستساعد هذه البيانات أيضا على تقديم خدمات صحية جنسية أفضل. ويوصى بإجراء البحوث على الأمراض المصاحبة لدى الرجال الذين يعانون من سرعة القذف بسبب تأثيرها السلبي على الصحة النفسية والاجتماعية وجودة الحياة. Abstract: Objectives: This study aimed to determine the prevalence of premature ejaculation and its associated factors among men attending a primary healthcare clinic in Kota Bharu, Kelantan, Malaysia. Methods: A cross-sectional study was conducted on 18- to 60-year-old sexually active men during at least the past 6 months. Patients with unstable psychiatric illnesses, mental retardation, and illiteracy were excluded. A questionnaire on sociodemographic factors, Malay version Premature Ejaculation Diagnostic Tool, and Malay version International Index Erectile Function-5 were distributed. Premature ejaculation was defined as a Premature Ejaculation Diagnostic Tool score of 9 and above. Descriptive analysis and simple and multiple logistic regression analyses were performed using SPSS version 22. Results: A total of 294 of 313 eligible men responded, with a response rate of 93.9%. The prevalence of premature ejaculation was 21.4% (n = 63. The multiple logistic regression analysis showed that mild [adj. OR (95% CI: 5.6 (1.89, 16.91; P = 0.002], mild-moderate [adj. OR (95% CI: 8.2 (2.72, 24.46; P < 0.001], and moderate-severe [adj. OR (95% CI: 6.0 (1.15, 31.23; P = 0.03] erectile dysfunctions were significantly associated with premature

  11. The Potential of the Traditional Birth Attendant. WHO Offset Publication No. 95.

    Science.gov (United States)

    Maglacas, A. Mangay, Ed.; Simons, John, Ed.

    In nine chapters, this book considers the extent to which training programs can be utilized to improve midwifery practice and reduce the risks surrounding childbirth in rural populations. The book opens with a chapter reviewing the question of whether the availability of trained birth attendants can be linked to a reduced incidence of neonatal…

  12. Primary birthing attendants and birth outcomes in remote Inuit communities—a natural “experiment” in Nunavik, Canada

    Science.gov (United States)

    Simonet, F; Wilkins, R; Labranche, E; Smylie, J; Heaman, M; Martens, P; Fraser, W D; Minich, K; Wu, Y; Carry, C; Luo, Z-C

    2010-01-01

    Background There is a lack of data on the safety of midwife-led maternity care in remote or indigenous communities. In a de facto natural “experiment”, birth outcomes were assessed by primary birthing attendant in two sets of remote Inuit communities. Methods A geocoding-based retrospective birth cohort study in 14 Inuit communities of Nunavik, Canada, 1989–2000: primary birth attendants were Inuit midwives in the Hudson Bay (1529 Inuit births) vs western physicians in Ungava Bay communities (1197 Inuit births). The primary outcome was perinatal death. Secondary outcomes included stillbirth, neonatal death, post-neonatal death, preterm, small-for-gestational-age and low birthweight birth. Multilevel logistic regression was used to obtain the adjusted odds ratios (aOR) controlling for maternal age, marital status, parity, education, infant sex and plurality, community size and community-level random effects. Results The aORs (95% confidence interval) for perinatal death comparing the Hudson Bay vs Ungava Bay communities were 1.29 (0.63 to 2.64) for all Inuit births and 1.13 (0.48 to 2.47) for Inuit births at ≥28 weeks of gestation. There were no statistically significant differences in the crude or adjusted risks of any of the outcomes examined. Conclusion Risks of perinatal death were somewhat but not significantly higher in the Hudson Bay communities with midwife-led maternity care compared with the Ungava Bay communities with physician-led maternity care. These findings are inconclusive, although the results excluding extremely preterm births are more reassuring concerning the safety of midwife-led maternity care in remote indigenous communities. PMID:19286689

  13. Breastfeeding practice and knowledge among women attending primary health-care centers in Riyadh 2016

    Directory of Open Access Journals (Sweden)

    Norah Faleh Al-Mutairi

    2017-01-01

    Full Text Available Introduction: Breast milk is the best natural essential nutrition to newborns and infants. However, the practice of breastfeeding (BF has declined in Saudi Arabia. Objective: The objective of this study was to assess the knowledge and practice of BF with their determinants among mothers in Riyadh. Materials and Methods: In this cross-sectional study, 252 mothers attending the well-baby clinics in Riyadh from March 2016 to May 2017 were selected randomly with their consent and studied by a standardized questionnaire. Results: Of the 252 women, 69.4% were 25–35 years of age and 56.7% with a bachelor degree or higher education. Nearly 75% mothers had education on BF before our study. Mixed feeding was the most preferred method (51.6% followed by artificial milk (29.4%. The most reported reason for discontinuing BF was breast milk insufficiency (37.3% and of breastfeed continuation was their perceived benefit (36.6%. Excellent knowledge was observed among 12.7%, good knowledge in 57.1%, and unsatisfactory level in 30.2% mothers. The regression model shows that high school education improved the knowledge by 10.9 points (P = 0.024 and undergraduate by 18.7 points (P value = 0.001 when compared to women who were literate. Women with parity> 5 improved knowledge score by 17.3 points (P < 0.001. Conclusion: We observed that majority (57.1% of Saudi mothers had a moderate level of knowledge on BF benefits and 19% had practiced exclusive BF. There is a need for better educational programs to increase awareness on its benefits for the health situation in the country on the long term.

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

    African Journals Online (AJOL)

    International Journal of Development and Management Review ... essential for educational planning; their disparities in public and private pre-primary and ... teaching as a career especially in the private schools where they constitute only 35.

  15. CLINICAL FEATURES OF ACUTE FEBRILE THROMBOCYTOPAENIA AMONG PATIENTS ATTENDING PRIMARY CARE CLINICS

    Directory of Open Access Journals (Sweden)

    Khairani Omar

    2006-01-01

    Full Text Available Introduction: Identifying clinical features that differentiate acute febrile thrombocytopaenia from acute febrile illness without thrombocytopaenia can help primary care physician to decide whether to order a full blood count (FBC. This is important because thrombocytopaenia in viral fever may signify more serious underlying aetiology like dengue infection.Objective: The aim of this study was to compare the clinical features of acute febrile patients with thrombocytopaenia and acute febrile patients without thrombocytopaenia.Methodology: This was a clinic-based cross-sectional study from May to November 2003. Consecutive patients presenting with undifferentiated fever of less than two weeks were selected from the Primary Care Centre of Hospital Universiti Kebangsaan Malaysia and Batu 9 Cheras Health Clinic. Clinical features of these patients were recorded and FBC examination was done for all patients. Thrombocytopaenia was defined as platelet count <150X109/L. The odds ratio of thrombocytopaenia for each presenting symptoms was calculated.Result: Seventy-three patients participated in this study. Among them, 45.2% had thrombocytopaenia. Myalgia and headache were common among all patients. However, nausea and vomiting occurred significantly more often among patients with thrombocytopaenia than in patients with normal platelet count (OR 2.2, 95% CI 1.1-4.5.Conclusion: Acute non-specific febrile patients presenting with symptoms of nausea and vomiting may have higher risk of thrombocytopaenia and should be seriously considered for FBC.

  16. Organizational factors influencing successful primary care and public health collaboration.

    Science.gov (United States)

    Valaitis, Ruta; Meagher-Stewart, Donna; Martin-Misener, Ruth; Wong, Sabrina T; MacDonald, Marjorie; O'Mara, Linda

    2018-06-07

    Public health and primary care are distinct sectors within western health care systems. Within each sector, work is carried out in the context of organizations, for example, public health units and primary care clinics. Building on a scoping literature review, our study aimed to identify the influencing factors within these organizations that affect the ability of these health care sectors to collaborate with one another in the Canadian context. Relationships between these factors were also explored. We conducted an interpretive descriptive qualitative study involving in-depth interviews with 74 key informants from three provinces, one each in western, central and eastern Canada, and others representing national organizations, government, or associations. The sample included policy makers, managers, and direct service providers in public health and primary care. Seven major organizational influencing factors on collaboration were identified: 1) Clear Mandates, Vision, and Goals; 2) Strategic Coordination and Communication Mechanisms between Partners; 3) Formal Organizational Leaders as Collaborative Champions; 4) Collaborative Organizational Culture; 5) Optimal Use of Resources; 6) Optimal Use of Human Resources; and 7) Collaborative Approaches to Programs and Services Delivery. While each influencing factor was distinct, the many interactions among these influences are indicative of the complex nature of public health and primary care collaboration. These results can be useful for those working to set up new or maintain existing collaborations with public health and primary care which may or may not include other organizations.

  17. Managing Mental Health Problems Among Immigrant Women Attending Primary Health Care Services.

    Science.gov (United States)

    Straiton, Melanie L; Powell, Kathryn; Reneflot, Anne; Diaz, Esperanza

    2016-01-01

    Researchers in Norway explore treatment options in primary care for immigrant women with mental health problems compared with nonimmigrant women. Three national registers were linked together for 2008. Immigrant women from Sweden, Poland, the Philippines, Thailand, Pakistan, and Russia were selected for analysis and compared with Norwegian women. Using logistic regression, we investigated whether treatment type varied by country of origin. Rates of sickness leave and psychiatric referrals were similar across all groups. Conversational therapy and use of antidepressants and anxiolytics were lower among Filipina, Thai, Pakistani, and Russian women than among Norwegians. Using the broad term "immigrants" masks important differences in treatment and health service use. By closely examining mental health treatment differences by country of origin, gaps in service provision and treatment uptake may be identified and addressed with more success.

  18. Satisfaction of Patients Attending in Primary Healthcare Centers in Riyadh, Saudi Arabia: A Random Cross-Sectional Study.

    Science.gov (United States)

    Almutairi, Khalid M

    2017-06-01

    This study aims to determine the level of satisfaction of patients who visit primary healthcare centers in Riyadh, Saudi Arabia. The investigation was a cross-sectional study conducted in twenty randomly selected primary healthcare centers in Riyadh, Saudi Arabia from October to December 2014. A descriptive data analysis was performed. Eligible participants had visited at least one of the selected primary healthcare centers within the past 12 months. A total of 1741 participants completed the survey, providing a response rate of 87 % (43 % male, 57 % female). The highest satisfaction rates were in the following areas: comprehensiveness and coordination 76.2 % (95 % CI 74.8 ± 77.5), communication 72.7 % (95 % CI 71.3 ± 74) and attitude of staff 73.4 % (95 % CI 72.1 ± 74.8) The areas of greatest concern expressed by the participants were the length of the wait and the quality of the facility 55.4 % (95 % CI 53.3 ± 57.5), 50.5 % (95 % CI 48.3 ± 52.7), respectively. The majority of the patients attending primary healthcare centers in Riyadh showed high levels of satisfaction; however, there are still some factors that need to be considered and improved upon. These include the accessibility of primary healthcare centers as well as waiting time of patients. The results of the current study showed relative improvement in other factors such as comprehensiveness and coordination, communication and attitude of staff. The level of satisfaction of patients and stakeholders shows the progress of the quality of care in healthcare facilities in Riyadh, Saudi Arabia.

  19. Knowledge, Attitudes and Practices of Yemeni Women Attending Primary Healthcare Centers in Sana’a City towards Family Planning

    Directory of Open Access Journals (Sweden)

    Essam H. AlSafadi

    2016-12-01

    Full Text Available Objective: To investigate the knowledge, attitudes and practices (KAPs of Yemeni women attending primary healthcare centers (PHCCs in Sana’a city towards family planning (FP. Methods: A descriptive, cross-sectional study was conducted among women attending three PHCCs in Sana'a city; namely, in Hadah, Al-Soneinah and Madhbah zones, between 21 November and 1 December 2011. The study included a sample of 281 married women, where data about socio-demographic characteristics and the KAPs towards FP were collected by interviewing women using a pre-designed, structured questionnaire and then analyzed using appropriate statistical tests. Results: Of the married women attending the PHCCs in Sana'a, the majority of respondents were from urban areas (96.4%; 271/281, aged between 25–29 years old (23.1% 65/281, employed (75.8%; 213/281 and with primary or secondary levels of education (60.9%; 171/281. In addition, the majority of women had a marriage length of 6–11 years (65.5%; 182/281 and 3–4 children (44.8%; 126/281. The majority of respondents (89.7% knew about FP, and 60.2% considered it as birth spacing. Moreover, most respondents (87.5% were aware of at least four methods of FP, and 53.6% heard of modern FP contraceptive methods. Of them, 85.9% and 74.0% heard of contraceptive pills and intrauterine contraceptive devices (ICDU, respectively; however, the least known contraceptive method was the use of male condoms (28.1%. Healthcare providers were the source of information on FP for the majority of respondents (60.5%. The majority of respondents believed that the optimum spacing between births should be two or three years, being 31.7% and 38.8%, respectively. In addition, most respondents (80.8% believed that both couples must share the decision-making on FP. Socio-cultural beliefs and values were thought to be the most common (57.3% barriers to the practice of FP. Conclusions: Although the majority of Yemeni women seeking healthcare after

  20. Primary School Teachers' Perceptions of Adequacy and Quality of Physical Facilities in Public Primary Schools under Free Primary Education

    Science.gov (United States)

    Muthima, Ndirangu Wahome; Udoto, Maurice O.; Anditi, Zephania O.

    2016-01-01

    The Free Primary Education (FPE) programme was commissioned in Kenya in January 2003 to provide basic education to all children of school going age and to ease the burden of cost sharing from the parents. However, even though the public primary school class teachers were to shoulder the greatest responsibility in the implementation of this…

  1. 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.

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

    OpenAIRE

    Alzahrani, Turki A.; Abaalkhail, Bahaa A.; Ramadan, Iman K.

    2016-01-01

    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 ad...

  3. 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.

  4. Depression among patients attending antiretroviral treatment program in public health facilities in Bahir Dar City, Ethiopia.

    Science.gov (United States)

    Tareke, Minale; Addisu, Fikir; Abate, Andargie

    2018-05-01

    The magnitude of depression is not well investigated among people living with HIV/AIDS. Thus, this research aimed to assess the magnitude of depression and its influencing factors among people living with HIV/AIDS attending government institutions in Bahir Dar City, North West, Ethiopia. institution based-cross-sectional study was done among randomly selected 415 people living with HIV/AIDS attending antiretroviral therapy program in Bahir Dar city, Ethiopia. Socio-demographic data and medical histories for all respondents were collected using interviewer-administered structured questionnaire. We assessed the odds of association of patient characteristics with depression was assessed using multiple logistic regression. The relative effect estimates of the respective factors were presented with odds ratio accompanied by their 95% uncertainty intervals. From 407 people living with HIV/AIDS interviewed, 198(48.6%) of them had depression. Social support, HIV clinical staging, total daily pill burden, treatment regimen and adherence to highly active antiretroviral therapy were significantly associated with depression. The magnitude of depression among people living with HIV/AIDS was found to be high. Early mental health screening should be done for people living with HIV/AIDS. Copyright © 2018 Elsevier B.V. All rights reserved.

  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. 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…

  7. Antibiotics use among Palestine refugees attending UNRWA primary health care centers in Jordan - A cross-sectional study.

    Science.gov (United States)

    Al Baz, Maysun; Law, Michael R; Saadeh, Rawan

    The irrational use of antibiotics is increasing in Jordanian refugee camps and consequently so too is bacterial resistance. About one-third of health expenditures at UNRWA health centers in Jordan are attributed to antibiotics. We studied knowledge, attitude and behaviour of Palestine refugees attending UNRWA health centers in Jordan regarding antibiotic use in order to plan public health interventions accordingly. A cross-sectional, interviewer-administered survey among 250 adult Palestine refugees at four different health centers was conducted. Irrational antibiotic use was widespread: 63% of patients share antibiotics at home, 38% use left-over antibiotics and 60% purchase antibiotics directly from the pharmacy without prescription (OTC) . 1 At the same time, knowledge about antibiotics side effects, resistance, and target agent was low. 90% of patients trust their doctor, however long waiting hours prevent them from seeking medical advice, which significantly increased self-medication. Our findings suggest a strong need for public education about antibiotics. In addition, health institutional level improvements such as shorter waiting hours and strict regulations prohibiting dispensing without prescription are necessary to combat growing bacterial resistance. Copyright © 2018 Elsevier Ltd. All rights reserved.

  8. 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.

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

    Science.gov (United States)

    Ofoedu, John N.; Njoku, Patrick U.; Amadi, Agwu N.; Godswill-Uko, Ezinne U.

    2013-01-01

    Abstract 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). Conclusions 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.

  10. 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.

  11. Risk factors for syphilis and hiv infection in pregnant women attending a tertiary care public sector hospital

    International Nuclear Information System (INIS)

    Batool, K.; Bano, K.A.; Sherwani, M.I.K.

    2010-01-01

    Background: Syphilis, a sexually transmitted disease which seemed to have disappeared or had been controlled over the years, has now been re-emerged as a major public health problem in many communities. It can complicate the pregnancies with serious consequences. Appropriate treatment of pregnant women often prevents such complications. Aims: To study the frequency of syphilis in pregnant women attending a tertiary care public sector hospital, and see the positivity for HIV/AIDS among syphilis positive women. Patients and Methods: This cross sectional and interventional study was conducted among pregnant women attending Sir Ganga Ram hospital for antenatal care at PMRC Research Centre, Fatima Jinnah Medical College, Lahore. Blood samples from 2000 women were collected after taking consent. The blood was tested for syphilis by Treponema Pallidum Haemagglutination. History of the subjects for risks factors was also taken. Syphilis positive women were further screened for human immunodeficiency virus positivity. Results: The treponemal antibodies were detected in less than one percent (9) pregnant women. The highest positivity was observed among age group of 21-26 years. Women in third trimester were significantly more infected with syphilis. Risk factors included husband's history with frequent traveling and drug abuse. All husbands of syphilis positive women were also positive. All syphilis positive women and their husbands were negative for Human immunodeficiency virus /Acquired immune deficiency syndrome. Conclusions: Less than 1% of pregnant women were infected with syphilis, and most of the spouses of these positive women were either travelers or drug addicts.(author)

  12. 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.

  13. Algal eating habits of phycologists attending the ISAP Halifax conference and members of the general public

    OpenAIRE

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

    2011-01-01

    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 (93%), but few participants ate it more regularly than per month. The general public responses were similar. A probability model tested the likelihood of a participant eating algae. Neither age nor na...

  14. 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.

  15. 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.

  16. Myths about diabetes mellitus among non-diabetic individuals attending primary health care centers of karachi suburbs

    International Nuclear Information System (INIS)

    Nisar, N.; Khan, I.A.; Qadri, M.H.; Sher, A.

    2007-01-01

    To determine the myths and misconception about diabetes mellitus among non-diabetics attending primary health care centers of Gadap town, Karachi. Data was collected from four primary health care centers, located at Gadap Town, Karachi, and about 198 non-diabetic patients, above 18 years of age, and resident of Gadap Town, coming consecutively during the month of July 2005, were interviewed after taking the informed consent by using a semi-structured pre-tested questionnaire regarding prevailing myths about diabetes mellitus. The data collected was entered and analyzed by using a statistical package SPSS 11.0. Myths are defined as stories shared by a group, as part of the cultural identity. There were 198 participants in the study. Mean age of study participants was 40 years with standard deviation of 13, while approximately two thirds, 62.6%, were females. About 39% had history of type II diabetes mellitus in family. Overall myths related to diabetes mellitus were common among the individuals, males reported myths pre-dominantly contagiousness of diabetes (p= <0.03), diabetics becoming more ill (p=<0.009) and belief in spiritual treatment for permanent cure of diabetes (p=<0.006). People having 5- 16 years of education were less misconceived as compared to illiterates. The variables that showed significant difference were overeating, causing diabetes (p= <0.006), diabetics falling ill more than others (p=<0.04), eating less starch (p=< 0.0006) and alternative treatment like spiritual treatment (p=<0.00001). Family history of diabetes was also found significantly associated with reporting myths. Frequency of reporting myths was significantly high in this study with preponderance of males, family history of diabetes mellitus and educational status. Education serves as protective factor, hence efforts should be made to promote education and health awareness regarding the disease, with more emphasis on addressing myths regarding diabetes mellitus. (author)

  17. 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)…

  18. 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

    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...

  19. 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…

  20. Documenting death: public access to government death records and attendant privacy concerns.

    Science.gov (United States)

    Boles, Jeffrey R

    2012-01-01

    This Article examines the contentious relationship between public rights to access government-held death records and privacy rights concerning the deceased, whose personal information is contained in those same records. This right of access dispute implicates core democratic principles and public policy interests. Open access to death records, such as death certificates and autopsy reports, serves the public interest by shedding light on government agency performance, uncovering potential government wrongdoing, providing data on public health trends, and aiding those investigating family history, for instance. Families of the deceased have challenged the release of these records on privacy grounds, as the records may contain sensitive and embarrassing information about the deceased. Legislatures and the courts addressing this dispute have collectively struggled to reconcile the competing open access and privacy principles. The Article demonstrates how a substantial portion of the resulting law in this area is haphazardly formed, significantly overbroad, and loaded with unintended consequences. The Article offers legal reforms to bring consistency and coherence to this currently disordered area of jurisprudence.

  1. A chart review of morbidity patterns among adult patients attending primary care setting in urban Odisha, India: An International Classification of Primary Care experience

    Directory of Open Access Journals (Sweden)

    Subhashisa Swain

    2017-01-01

    Full Text Available Introduction: Disease burden estimations based on sound epidemiological research provide the foundation for designing health services. Patients visiting a primary care often present with symptoms and signs. Understanding the burden is crucial for developing countries including India. The project aimed to record the reasons for encounter (RFE at primary care settings for estimating the burden at the health-care facility. Methodology: This cross-sectional study was undertaken at four urban health dispensaries of Bhubaneswar, Odisha, with the aim to explore the prevailing patterns of diseases among patients attending these facilities. Data collection spanned from May to October 2012. At each center, patients' information on age, sex, religion, and presenting illness was extracted from the outpatient records over these time period. Data were entered and analyzed in SPSS version 20, and the International Classification of Primary Care-2 was used for coding the illnesses. Results: In total, 2249 patient's records were extracted over 12 weeks. Out of them, 1241 (55.2% were male with mean age of 41.8 (±15.8 years vis-à -vis 38.2 (±14.1 years for females. Around 151 (6.7% had 2 or more symptoms or conditions. Overall, the most common categories were general and unspecified followed by digestive-related symptoms in both sexes. The most common symptoms among males were fever (11.4%, heart burn (8.1%, and vertigo or dizziness (3.6%. Similar pattern was seen among females. Respiratory (17.0% and cardiovascular (10.2% problems were the most common RFEs among males and females. The most common RFEs for acute care among males and females were fever, allergic rhinitis, upper respiratory tract infection, and acute bronchitis. Leading RFEs for chronic care among males were hypertension uncomplicated, heart burn, low back pain, whereas among females, hypertension and heartburn were mostly seen. Conclusion: Primary care settings are experiencing both communicable

  2. School choice : challenge to Sharpeville public primary school principals

    OpenAIRE

    2012-01-01

    M.Ed. This qualitative phenomenological study focuses on school choice as challenge to principals of Sharpeville public primary schools. Different aspects of these choices are explored. School choice is an important component of parental involvement in the education of their children. Parents and learners tend to be open about their right through the support of the Schools Act 84 of 1996. You may not discriminate on the basis of race trough the language policy at your school. This means th...

  3. 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

  4. 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.

  5. 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

    by ‘other’ (undefined) reasons, whereas the main reason for not eating algae in both groups was a ‘lack of availability’. Phycologists also ate algae for the perceived ‘health benefits’ (36%), whereas few members of the general public chose this option (13%). Consumption of red seaweeds was most popular (60...... of phycological research studied also had a significant effect. Researchers working with macroalgae were 22% more likely to eat algae, whereas microalgal researchers were 15% less likely to eat algae on a monthly or more regular basis. The main reasons for eating algae by both groups were ‘taste’, followed...

  6. 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.

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. Identification of Dyslipidemic Patients Attending Primary Care Clinics Using Electronic Medical Record (EMR) Data from the Canadian Primary Care Sentinel Surveillance Network (CPCSSN) Database.

    Science.gov (United States)

    Aref-Eshghi, Erfan; Oake, Justin; Godwin, Marshall; Aubrey-Bassler, Kris; Duke, Pauline; Mahdavian, Masoud; Asghari, Shabnam

    2017-03-01

    The objective of this study was to define the optimal algorithm to identify patients with dyslipidemia using electronic medical records (EMRs). EMRs of patients attending primary care clinics in St. John's, Newfoundland and Labrador (NL), Canada during 2009-2010, were studied to determine the best algorithm for identification of dyslipidemia. Six algorithms containing three components, dyslipidemia ICD coding, lipid lowering medication use, and abnormal laboratory lipid levels, were tested against a gold standard, defined as the existence of any of the three criteria. Linear discriminate analysis, and bootstrapping were performed following sensitivity/specificity testing and receiver's operating curve analysis. Two validating datasets, NL records of 2011-2014, and Canada-wide records of 2010-2012, were used to replicate the results. Relative to the gold standard, combining laboratory data together with lipid lowering medication consumption yielded the highest sensitivity (99.6%), NPV (98.1%), Kappa agreement (0.98), and area under the curve (AUC, 0.998). The linear discriminant analysis for this combination resulted in an error rate of 0.15 and an Eigenvalue of 1.99, and the bootstrapping led to AUC: 0.998, 95% confidence interval: 0.997-0.999, Kappa: 0.99. This algorithm in the first validating dataset yielded a sensitivity of 97%, Negative Predictive Value (NPV) = 83%, Kappa = 0.88, and AUC = 0.98. These figures for the second validating data set were 98%, 93%, 0.95, and 0.99, respectively. Combining laboratory data with lipid lowering medication consumption within the EMR is the best algorithm for detecting dyslipidemia. These results can generate standardized information systems for dyslipidemia and other chronic disease investigations using EMRs.

  12. 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

  13. The public health leadership certificate: a public health and primary care interprofessional training opportunity.

    Science.gov (United States)

    Matson, Christine C; Lake, Jeffrey L; Bradshaw, R Dana; Matson, David O

    2014-03-01

    This article describes a public health leadership certificate curriculum developed by the Commonwealth Public Health Training Center for employees in public health and medical trainees in primary care to share didactic and experiential learning. As part of the program, trainees are involved in improving the health of their communities and thus gain a blended perspective on the effectiveness of interprofessional teams in improving population health. The certificate curriculum includes eight one-credit-hour didactic courses offered through an MPH program and a two-credit-hour, community-based participatory research project conducted by teams of trainees under the mentorship of health district directors. Fiscal sustainability is achieved by sharing didactic courses with MPH degree students, thereby enabling trainees to take advantage of a reduced, continuing education tuition rate. Public health employee and primary care trainees jointly learn knowledge and skills required for community health improvement in interprofessional teams and gain an integrated perspective through opportunities to question assumptions and broaden disciplinary approaches. At the same time, the required community projects have benefited public health in Virginia.

  14. [Educational program had a positive effect on the intake of fat, fruits and vegetables and physical activity in students attending public elementary schools of Mexico].

    Science.gov (United States)

    Quizán-Plata, Trinidad; Villarreal Meneses, Liliana; Esparza Romero, Julián; Bolaños Villar, Adriana V; Díaz Zavala, R Giovanni

    2014-09-01

    Poor diet and lack of physical activity are the most important risk factors of mortality and burden of disease in Mexico and many other countries around the world. The purpose of this research was to analyze the effect of an educational intervention on The consumption of fruits, vegetables, fat, physical activity and inactivity in students attending public primary school of Sonora Mexico. The intervention consisted of educational workshops on nutrition and physical activity aimed to the students and educational talks on nutrition and physical activity aimed to parents. Anthropometric, 24 hours recall, nutrition-knowledge, and physical-activity questionnaires pre- and post-intervention were applied in order to evaluate changes in both groups. 126 of the initial 129 students (97.7%) were evaluated at the end of the intervention. the consumption of fruits and vegetables was significantly higher after the intervention (p=0.0032) and the consumption of total fat decreased (p=0.02) in the intervention schools. Moreover, intervention increased physical activity (p=0.04) and decreased sedentary activities (p=0.006). Intervention students obtained higher knowledge in nutrition (p=0.05) at the end of intervention. The intervention had a positive effect on improve fruits, vegetables and fat consumption, physical activity and nutrition knowledge. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  15. 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

    2016-07-01

    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, M age = 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.

  16. 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

  17. Obesity among children attending elementary public schools in São Paulo, Brazil: a case--control study.

    Science.gov (United States)

    Isabela da Costa, Ribeiro; Taddei, José Augusto A C; Colugnatti, Fernando

    2003-10-01

    To describe obesity among students of public schools in São Paulo and to identify risk factors for this nutritional and physical activity disorder. Case-control study of obese and non-obese schoolchildren to study risk factors for obesity. Anthropometric survey including 2519 children attending eight elementary public schools in São Paulo, Brazil. Schoolchildren aged 7-10 years, of whom 223 were obese (cases; weight-for-height greater than or equal to two standard deviations (>or=2SD) above the median of the National Center for Health Statistics (NCHS) reference population) and 223 were eutrophic (controls; weight-for-height +/-1SD from NCHS median). Parents or guardians of the 446 cases and controls were interviewed about the children's eating behaviours and habits. The prevalence of obesity (weight-for-height >or=2SD) in the surveyed population was 10.5%. A logistic regression model fitted to the case-control dataset showed that obesity was positively associated with the following factors: birth weight >or=3500 g (odds ratio (OR) 1.83, 95% confidence interval (CI) 1.21-2.78), child's appetite at meals (OR 3.81, 95% CI 2.49-5.83), watching television for 4 h per day or longer (OR 2.07, 95% CI 1.32-3.24), mother's schooling >4 years (OR 1.85, 95% CI 1.25-2.75) and parents' body mass index >or=30 kg x m(-2) (OR 2.50, 95% CI 1.43-4.37). The explanatory multivariate model points to preventive measures that would encourage knowledge of the children and their guardians in relation to a balanced diet and a less sedentary lifestyle, such as reducing television viewing. Schoolchildren with a birth weight of 3500 g or more or whose parents are obese should receive special attention in the prevention of obesity.

  18. 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

  19. Predictors of health related quality of life in older people with non-communicable diseases attending three primary care clinics in Malaysia.

    Science.gov (United States)

    Sazlina, S G; Zaiton, A; Nor Afiah, M Z; Hayati, K S

    2012-05-01

    To determine the health related quality of life and its predictive factors among older people with non-communicable diseases attending primary care clinics. Cross-sectional study. Three public primary care clinics in a district in Selangor, Malaysia. Registered patients aged 55 years and above. A face-to-face interview was conducted using a validated questionnaire of Medical Outcome Study 36-item short form health survey (SF-36). The outcome measure was the health related quality of life (HRQoL) and other factors measured were socio demography, physical activity, social support (Duke-UNC Functional Social Support Questionnaire), and presence of non-communicable diseases. A total of 347 participants had non-communicable diseases which included hypertension (41.8%), type 2 diabetes (33.7%), asthma (4.8%), hyperlipidaemia (1.7%), coronary heart disease (1.2%), and osteoarthritis (0.2%). Age ≥ 65 years old (OR =2.23; 95%CI=1.42, 3.50), single (OR=1.75; 95%CI=1.06,2.90), presence of co-morbid condition (OR=1.66; 95%CI=1.06, 2.61), and poorer social support (OR=2.11; 95%CI=1.27, 3.51; p=0.002) were significant predictors of poorer physical component of HRQoL . In predicting lower mental health component of HRQoL, the significant predictors were women (OR=2.28; 95%CI=1.44, 3.62), Indian ethnicity (OR=1.86; 95%CI=1.08, 3.21) and poorer social support (OR=2.71; 95%CI=1.63, 4.51). No interactions existed between these predictors. Older people with non-communicable diseases were susceptible to lower health related quality of life. Increasing age, single, presence of co-morbid conditions, and poorer social support were predictors of lower physical health component of HRQoL. While the older women, Indian ethnicity and poorer social support reported lower mental health component of HRQoL.

  20. Individual and contextual factors of influence on adherence to antiretrovirals among people attending public clinics in Rio de Janeiro, Brazil

    Science.gov (United States)

    2013-01-01

    Background There are inconsistencies in the determinants of adherence to antiretrovirals (ARVs) across settings as well as a lack of studies that take into consideration factors beyond the individual level. This makes it necessary to examine factors holistically in multiple settings and populations while taking into consideration the particularities of each context, in order to understand the patterns of ARV adherence. This research explored ARV adherence and individual, relational and environmental-structural factors. Methods A cross-sectional survey was conducted from August 2008 through July 2009 among participants currently on ARVs recruited from 6 public health clinics, selected to maximize diversity in terms of caseload and location, representing the range of clinics within Rio de Janeiro city, Brazil. Multivariate logistic regression analysis was used to assess the association between our multilevel factors with ARV adherence among participants with complete cases (n = 632). Results Eighty-four percent of respondents reported adherence to all of their ARV doses in the last 4 days. Of the socio-demographic variables, those who had one child were positively associated with adherence (AOR 2.29 CI [1.33-3.94]). On the relational level, those with high social support (AOR 2.85 CI [1.50-5.41]) were positively associated with adherence to ARVs. On the environmental-structural level, we found gender was significant with women negatively associated with adherence to ARVs (AOR 0.58 CI [0.38-0.88]) while those with a high asset index (AOR 2.47 CI [1.79-3.40]) were positively associated with adherence to ARVs. Conclusions This research highlights the importance of examining the multiple levels of influence on ARV adherence. Intervention research in lower and middle-income settings should address and evaluate the impact of attending to both gender and economic inequalities to improve ARV adherence, as well as relational areas such as the provision of social support. PMID

  1. From kitchen to classroom: Assessing the impact of cleaner burning biomass-fuelled cookstoves on primary school attendance in Karonga district, northern Malawi.

    Science.gov (United States)

    Kelly, Christine A; Crampin, Amelia C; Mortimer, Kevin; Dube, Albert; Malava, Jullita; Johnston, Deborah; Unterhalter, Elaine; Glynn, Judith R

    2018-01-01

    Household air pollution from burning solid fuels is responsible for an estimated 2.9 million premature deaths worldwide each year and 4.5% of global disability-adjusted life years, while cooking and fuel collection pose a considerable time burden, particularly for women and children. Cleaner burning biomass-fuelled cookstoves have the potential to lower exposure to household air pollution as well as reduce fuelwood demand by increasing the combustion efficiency of cooking fires, which may in turn yield ancillary benefits in other domains. The present paper capitalises on opportunities offered by the Cooking and Pneumonia Study (CAPS), the largest randomised trial of biomass-fuelled cookstoves on health outcomes conducted to date, the design of which allows for the evaluation of additional outcomes at scale. This mixed methods study assesses the impact of cookstoves on primary school absenteeism in Karonga district, northern Malawi, in particular by conferring health and time and resource gains on young people aged 5-18. The analysis combines quantitative data from 6168 primary school students with in-depth interviews and focus group discussions carried out among 48 students in the same catchment area in 2016. Negative binomial regression models find no evidence that the cookstoves affected primary school absenteeism overall [IRR 0.92 (0.71-1.18), p = 0.51]. Qualitative analysis suggests that the cookstoves did not sufficiently improve household health to influence school attendance, while the time and resource burdens associated with cooking activities-although reduced in intervention households-were considered to be compatible with school attendance in both trial arms. More research is needed to assess whether the cookstoves influenced educational outcomes not captured by the attendance measure available, such as timely arrival to school or hours spent on homework.

  2. A CROSS-SECTIONAL PROSPECTIVE STUDY ON CUTANEOUS DISEASES IN PAEDIATRIC PATIENTS BELONGING TO LOW INCOME GROUP FAMILIES ATTENDING PRIMARY HEALTH CENTRES AT BANGALORE RURAL, SOUTH

    Directory of Open Access Journals (Sweden)

    Megha Chandrashekar

    2017-12-01

    Full Text Available BACKGROUND The incidence and the spectrum of paediatric dermatological diseases vary from one part of the world to another.1 Skin diseases, though very common in many developing countries are not often regarded as a significant health problem.2 Majority of the skin diseases tend to occur in children under the age of 5 years. This high prevalence could be due to the lower immunity or higher frequency of hospital visits by infants due to greater parental care. The aim of the study is to compare the present spectrum of cutaneous disorders between two age groups of children less than 5 years and 5-14 years old and their correlation with socioeconomic status attending primary health centre, Bangalore rural, south. MATERIALS AND METHODS A prospective cross-sectional study was conducted from March 22 to November 22, 2017, in children with skin disorders under 14 years old who attended primary health centre at Bangarappanagar and Uttarahalli in Bangalore. RESULTS A total of 522 children with skin diseases, 486 children were included in the study and they were divided into two groups of those less than 5 years with the sex ratio (M:F 1.5:1 and 5-14 years old with the sex ratio (M:F 1.3:1. The most common dermatological disease among less than 5 years age group was infections, eczema, infestations and pigmentary disorders and the most common dermatological diseases between 5-14 years was infections, scabies, eczema and acne. CONCLUSION Skin problems mainly scabies, tinea, impetigo and eczema were common in children who attended the primary health centres at Bangalore rural. There is a high prevalence of communicable diseases among children belonging to parents of low socioeconomic status. Community health education regarding personal hygiene coupled with that of the surrounding environment can help in controlling these diseases in the long run.

  3. Free Primary Education Policy: Coping Strategies in Public Primary Schools in Kakamega South District, Kakamega County, Kenya

    Science.gov (United States)

    Mulinya, Lidoro Charles; Orodho, John Aluko

    2015-01-01

    This study examined the challenges of implementing free primary education and copping strategies in public primary schools in Kakamega South District, Kakamega County, Kenya. The study was premised on the demand and supply theory. A descriptive survey research design was adopted. The sample comprised 23 headteachers, 92 teachers and one Ministry…

  4. Mother Behavior Prefer Untrained Traditional Birth Attendant As Labor Support Person At Tembilahan Hulu Public Health Center Districts On 2016

    Directory of Open Access Journals (Sweden)

    alhidayati yati

    2018-03-01

    Full Text Available Background: Maternal Mortality Rate (MMR is one indicator of health development in Indonesia. Deliveries by health personnel to be very important in efforts to reduce maternal mortality. Coverage of births attended by skilled health personnel at health centers Tembilahan Hulu has yet to reach the target of 90%. Target Health Center Tembilahan Hulu is 80% but reached only 45%. The number of maternal deaths in health centers Hulu 2016 Tembilahan 1 case and the number of infant mortality as much as 5 case, one cause of death is handled by TBAs. Objective: to know the mother's behavior in selecting birth attendants in health centers working area Tembilahan Hulu. Design: Qualitative research, to obtain in-depth information about how the Mother Behavior in Choosing Auxiliary Power Delivery at Puskesmas Tembilahan Hulu 2016. Methods: This study used a qualitative descriptive method, which is an approach to research that revealed certain social situations to describe reality correctly, formed by words based on the techniques of collecting and analyzing relevant data obtained from the natural situation. Results and Discussion: Research shows that mothers choose birth attendants decision is closely linked to the knowledge, attitudes, social culture, access to health services, family support. Conclusions: The behavior of mothers in selecting birth attendant is still a lot to TBAs compared to the health worker / midwife.

  5. Strengthening primary health care through primary care and public health collaboration: the influence of intrapersonal and interpersonal factors.

    Science.gov (United States)

    Valaitis, Ruta K; O'Mara, Linda; Wong, Sabrina T; MacDonald, Marjorie; Murray, Nancy; Martin-Misener, Ruth; Meagher-Stewart, Donna

    2018-04-12

    AimThe aim of this paper is to examine Canadian key informants' perceptions of intrapersonal (within an individual) and interpersonal (among individuals) factors that influence successful primary care and public health collaboration. Primary health care systems can be strengthened by building stronger collaborations between primary care and public health. Although there is literature that explores interpersonal factors that can influence successful inter-organizational collaborations, a few of them have specifically explored primary care and public health collaboration. Furthermore, no papers were found that considered factors at the intrapersonal level. This paper aims to explore these gaps in a Canadian context. This interpretative descriptive study involved key informants (service providers, managers, directors, and policy makers) who participated in one h telephone interviews to explore their perceptions of influences on successful primary care and public health collaboration. Transcripts were analyzed using NVivo 9.FindingsA total of 74 participants [from the provinces of British Columbia (n=20); Ontario (n=19); Nova Scotia (n=21), and representatives from other provinces or national organizations (n=14)] participated. Five interpersonal factors were found that influenced public health and primary care collaborations including: (1) trusting and inclusive relationships; (2) shared values, beliefs and attitudes; (3) role clarity; (4) effective communication; and (5) decision processes. There were two influencing factors found at the intrapersonal level: (1) personal qualities, skills and knowledge; and (2) personal values, beliefs, and attitudes. A few differences were found across the three core provinces involved. There were several complex interactions identified among all inter and intra personal influencing factors: One key factor - effective communication - interacted with all of them. Results support and extend our understanding of what influences

  6. 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.

  7. Estimating primary care attendance rates for fever in infants after meningococcal B vaccination in England using national syndromic surveillance data.

    Science.gov (United States)

    Harcourt, Sally; Morbey, Roger A; Bates, Chris; Carter, Helen; Ladhani, Shamez N; de Lusignan, Simon; Smith, Gillian E; Elliot, Alex J

    2018-01-25

    In September 2015, the United Kingdom became the first country to introduce the multicomponent group B meningococcal vaccine (4CMenB) into a national infant immunisation programme. In early clinical trials 51-61% of infants developed a fever when 4CMenB was administered with other routine vaccines. Whilst administration of prophylactic paracetamol is advised, up to 3% of parents may seek medical advice for fever following vaccination. We used research-level general practitioner consultations to identify any increase in attendances for all-cause fever in vaccine-eligible infants following 4CMenB introduction in England. Consultations for infant all-cause fever in the year following the vaccine introduction were identified from The Phoenix Partnership (TPP) ResearchOne general practice database using Read (CTV3) codes. Average daily consultation rates and incidence rate ratios (IRRs) were calculated for vaccine-eligible age groups and compared to the two years preceding vaccine introduction. The difference between pre- and post-vaccine all-cause fever consultations was estimated. All-cause fever consultations in vaccine-eligible 7-10 week olds were 1.6-fold higher (IRR, 1.58; 95% CI, 1.22-2.05) compared to the two previous years and 1.5-fold higher (IRR 1.47; 95% CI, 1.17-1.86) in 15-18 week-olds. There were no significant differences in 0-6 or 11-14 week-olds. Applying the difference between pre- and post-vaccine consultation rates to the 4CMenB vaccine-eligible age groups across England estimated 1825 additional fever consultations in the year following 4CMenB introduction. We found a small but significant difference in all-cause fever consultation rates in vaccine-eligible infants who would have received 4CMenB with other vaccines. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  8. Comparative Study of Pupils' Academic Performance between Private and Public Primary Schools

    Science.gov (United States)

    Adeyemi, Sunday B.

    2014-01-01

    This paper compares pupils' academic performance between the private and public primary schools. The sample, made up of 240 pupils were randomly selected from the private and public primary schools in Ilesa East and West Local Government Council Areas of Osun State, Nigeria. Two instruments were used. A structured questionnaire and Pupils'…

  9. 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.

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

    Science.gov (United States)

    Alzahrani, Turki A; Abaalkhail, Bahaa A; Ramadan, Iman K

    2016-01-01

    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. 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. 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. One out of 10 women is a victim of IPV in Taif, KSA. Intimate partner violence is significantly associated with a number of victims and abuser-related psychosocial factors, the detection of which might help screening for individuals at risk.

  11. Еvaluation of health status of children attending primary schools with different organization of physical education lessons

    Science.gov (United States)

    Kondratiuk, Oleksandra S.; Korshun, Maria M.; Garkavyi, Serhii I.; Garkavyi, Serhii S.

    2018-01-01

    The mandatory swimming lesson in primary schools, equipped with swimming pools, was introduced without studying of its health-saving effectiveness. The purpose of this study was to evaluate the health status of pupils studying in schools with different organization of physical education lessons. Cross-sectional study was organized in two schools with different organization of physical education lessons. The experimental group (E) consisted of 408 children of 1‑4 year of study (210 girls and 198 boys) who during one of the lessons of physical education were engaged in swimming in the school basin. Control group (C) consisted of 279 primary school children (210 girls and 156 boys) from a neighboring educational institution where all physical education lessons were organized in the gym. The health status was evaluated using classical method of complex assessment of the state of health with the subsequent assignment of each child to one of the health groups. In result of evaluation of state of health there was established that among pupils from E group the proportion of boys with harmonious anthropometric parameters is higher (pprimary school has positive effect on health status of children.

  12. Primary health care quality and hospitalizations for ambulatory care sensitive conditions in the public health system in Porto Alegre, Brazil.

    Science.gov (United States)

    Gonçalves, Marcelo Rodrigues; Hauser, Lisiane; Prestes, Isaías Valente; Schmidt, Maria Inês; Duncan, Bruce Bartholow; Harzheim, Erno

    2016-06-01

    To investigate the relation of hospitalization for ambulatory care sensitive conditions (ACSC) with the quality of public primary care health services in Porto Alegre, Brazil. Cohort study constructed by probabilistic record linkage performed from August 2006 to December 2011 in a population ≥18 years of age that attended public primary care health services. The Primary Care Assessment Tool (PCATool-Brazil) was used for evaluation of primary care services. Of 1200 subjects followed, 84 were hospitalized for primary care sensitive conditions. The main causes of ACSC hospital admissions were cardiovascular (40.5%) and respiratory (16.2%) diseases. The PCATool average score was 5.3, a level considerably below that considered to represent quality care. After adjustment through Cox proportional hazard modelling for covariates, >60 years of age [hazard ratio (HR): 1.13; P = 0.001), lesser education (HR: 0.66; P = 0.02), ethnicity other than white (HR: 1.77; P = 0.01) and physical inactivity (HR: 1.65; P = 0.04) predicted hospitalization, but higher quality of primary health care did not. Better quality of health care services, in a setting of overwhelmingly low quality services not adapted to the care of chronic conditions, did not influence the rate of avoidable hospitalizations, while social and demographic characteristics, especially non-white ethnicity and lesser schooling, indicate that social inequities play a predominant role in health outcomes. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  13. Cardiovascular risk rate in hypertensive patients attended in primary health care units: the influence of pharmaceutical care

    Directory of Open Access Journals (Sweden)

    Paulo Yuri Milen Firmino

    2015-09-01

    Full Text Available Cardiovascular complications are relevant due to their frequency and severity on the hypertension scenario. Studies refer Pharmaceutical Care (PC as capable of decreasing cardiovascular risk rate (%CVR on hypertensive patients. This study aimed to investigate, through a randomized clinical assay, the influence of PC service on the %CVR of hypertensive patients assisted in a health primary care unit from Fortaleza-Ceará. Two study groups were formed: i. Intervention Group (IG, which received orientation about taking medicines, actions aiming to prevent/solve medicine interactions and adverse effects and non-pharmacological interventions for 9 months and, ii. Control Group (CG, which received traditional assistance of the unit and was monitored during the same period. It was observed a statistically significant reduction on %CVR (10.76 to 7.86; p=0.04 and systolic blood pressure levels (SBP (137.69 to 131.54; p<0.01 in the IG, while, in the CG, there was no significant alteration. 151 Drug Related Problem (DRP were identified and it was realized 124 pharmaceutical interventions, with 89.2% of them resulting on solution/prevention of the problem. Our findings indicated that the inclusion of the PC service in the hypertensive health assistance was more effective at the %CVR and the SBP reduction in comparison to the traditional assistance offered.

  14. 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 ... educational imperatives, namely improving medical students' ... Selectives is an innovative longitudinal, ... assessments of students in the Selectives module is the collective .... health and well-being of individuals,.

  15. 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 ...

  16. Do Local Contributions Affect the Efficacy of Public Primary Schools?

    Science.gov (United States)

    Jimenez, Emmanuel; Paqueo, Vicente

    1996-01-01

    Uses cost, financial sources, and student achievement data from Philippine primary schools (financed primarily from central sources) to discover if financial decentralization leads to more efficient schools. Schools that rely more heavily on local sources (contributions from local school boards, municipal government, parent-teacher associations,…

  17. 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.

  18. 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

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

    Directory of Open Access Journals (Sweden)

    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.

  20. 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

  1. 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

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

    Science.gov (United States)

    Alghafri, Thamra S; Alharthi, Saud M; Al-Farsi, Yahya; Bannerman, Elaine; Craigie, Angela M; Anderson, Annie S

    2017-08-01

    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. 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. 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/m 2 . 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 referrals to physical activity facilities (5

  3. IMPACT OF COMORBIDITY AND SOCIOECONOMIC STATUS ON QUALITY OF LIFE IN PATIENTS WITH CHRONIC DISEASES WHO ATTEND PRIMARY HEALTH CARE CENTRES.

    Science.gov (United States)

    Tüzün, Hakan; Aycan, Sefer; İlhan, Mustafa Necmi

    2015-09-01

    The aim of the study was to analyse the impact of chronic disease on the quality of life (QoL) and how QoL changes with comorbidity and socioeconomic status in persons who attend primary health care centres. The group of participants comprised 2,560 people who contacted six primary health care centres in Ankara. The level of QoL was determined by the World Health Organization Quality of Life Questionnaire Abbreviated Version (WHOQOL-BREF). Mental disorders and diabetes-hypertension comorbidity had the most negative effect on the QoL. In the physical domain of the WHOQOL-BREF, the effect of diabetes-hypertension comorbidity is greater than the additive effect of hypertension and diabetes individually. The co-occurrence of any disease with cardiovascular disease does not change QoL within any domain, except for the co-occurrence of any disease with musculoskeletal diseases which deteriorated QoL in the physical domain. The higher income and socioeconomic status corresponded to higher QoL. The effect of comorbidity on QoL can be different from the additive effects of the co-occurring diseases. Socioeconomic factors undoubtedly affect the relationship between chronic diseases and QoL, and this relationship points to health inequities among socioeconomic groups.

  4. Public health and primary care: struggling to "win friends and influence people".

    Science.gov (United States)

    Mayes, Rick; McKenna, Sean

    2011-01-01

    Why are the goals of public health and primary care less politically popular and financially supported than those of curative medicine? A major part of the answer to this question lies in the fact that humans often worry wrongly by assessing risk poorly. This reality is a significant obstacle to the adequate promotion of and investment in public health, primary care, and prevention. Also, public health's tendency to infringe on personal privacy-as well as to call for difficult behavioral change-often sparks intense controversy and interest group opposition that discourage broader political support. Finally, in contrast to curative medicine, both the cost-benefit structure of public health (costs now, benefits later) and the way in which the profession operates make it largely invisible to and, thus, underappreciated by the general public. When curative medicine works well, most everybody notices. When public health and primary care work well, virtually nobody notices.

  5. Examining physicians’ preparedness for tobacco cessation services in India: Findings from primary care public health facilities in two Indian states

    Directory of Open Access Journals (Sweden)

    Rajmohan Panda

    2013-03-01

    Full Text Available BackgroundA total of 275 million tobacco users live throughout India and are in need of tobacco cessation services. However, the preparation of physicians to deliver this service at primary care health facilities remains unknown.AimsThe study aimed to examine the primary care physicians’ preparedness to deliver tobacco cessation services in two Indian states.MethodResearchers surveyed physicians working in primary care public health facilities, primarily in rural areas using a semistructured interview schedule. Physicians’ preparedness was defined in the study as those possessing knowledge of tobacco cessation methods and exhibiting a positive attitude towards the benefits of tobacco cessation counselling as well as being willing to be part of tobacco prevention or cessation program.ResultsOverall only 17% of physicians demonstrated adequate preparation to provide tobacco cessation services at primary care health facilities in both the States. The findings revealed minimal tobacco cessation training during formal medical education (21.3% and on-the-job training (18.9%. Factors, like sex and age of service provider, type of health facility, location of health facility and number of patients attended by the service provider, failed to show significance during bivariate and regression analysis. Preparedness was significantly predicted by state health system.ConclusionThe study highlights a lack of preparedness of primary care physicians to deliver tobacco cessation services. Both the curriculum in medical school and on-the-job training require an addition of a learning component on tobacco cessation. The addition of this component will enable existing primary care facilities to deliver tobacco cessation services.

  6. 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.

  7. 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.

  8. 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.

  9. [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.

  10. 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

  11. Prevalence and public-health significance of HIV infection and anaemia among pregnant women attending antenatal clinics in south-eastern Nigeria.

    Science.gov (United States)

    Uneke, C J; Duhlinska, D D; Igbinedion, E B

    2007-09-01

    HIV infection and anaemia are major public-health problems in Africa and are important factors associated with an increased risk of adverse pregnancy outcomes. The objective of this study was to determine the prevalence of HIV infection and anaemia among pregnant women attending antenatal clinics in southeastern Nigeria. To achieve this, a cross-sectional survey was conducted during July 2005-June 2006 using standard techniques. Of 815 pregnant women studied, 31 (3.8%, 95% confidence interval [CI] 2.5-5.1) were HIV-positive. Maternal age and gestational age were not associated with HIV infection (p > 0.05). The prevalence of anaemia (Hb anaemia (Hb prevalence of anaemia was observed among individuals in their second pregnancy trimester (p anaemia are preventable, antenatal care services could serve as a pivotal entry point for simultaneous delivery of interventions for the prevention and control of HIV infection and anaemia in pregnant women.

  12. Correlations between attitude toward Christianity, prayer, and church attendance among 9- to 11-yr.-olds.

    Science.gov (United States)

    Robbins, Mandy; Babington, Peter; Francis, Leslie J

    2004-02-01

    Data provided by 150 9- to 11-yr.-old primary school pupils in England showed scores on the Francis Scale of Attitude toward Christianity more highly correlated with (personal) prayer (r = .57) than with (public) church attendance (r = .23), providing support for the view that attitude scales access a deeper level of religiosity less contaminated by those contextual and social factors which may influence public church attendance more than personal prayer.

  13. Association between postgraduate year 2 residency program characteristics and primary project publication.

    Science.gov (United States)

    Swanson, Joseph M; Shafeeq, Hira; Hammond, Drayton A; Li, Chenghui; Devlin, John W

    2018-03-15

    The association among residency program and research mentor characteristics, program director perceptions, and the publication of the primary research project for postgraduate year 2 (PGY2) graduates was assessed. Using a validated electronic survey, residency program directors (RPDs) of critical care PGY2 graduates were asked about primary research project publication success, program and research project mentor characteristics, and RPDs' perceptions surrounding project completion. All 55 RPDs surveyed responded; 44 (79%) reported being a research project mentor. PGY2 research project publications in 2011 and 2012 totaled 26 (37%) and 27 (35%), respectively. A significant relationship existed between research project publication and the number of residents in the program ( p project publication is important to their employer ( p projects versus no publications included the number of graduates in the PGY2 program (odds ratio [OR], 5.6; p project publication (OR, 10.2; p project versus no research projects was also independently associated with the RPD's perception that the employer valued research project publication (OR, 5.1; p = 0.04). A survey of RPDs of critical care PGY2 residents found that the number of PGY2 residents, the number of publications by the least experienced research mentor, and the perception that publishing the residents' research projects is important to the employer were independently associated with publication rates of residency research projects. Copyright © 2018 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    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

  15. 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

  16. 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.

  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. 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 schools. In contrast, the nine research-intensive public medical schools produced comparable proportions of graduates pursuing primary care 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.

  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. 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

  1. 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

  2. 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

  3. [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.

  4. The Delivery of Health Promotion and Environmental Health Services; Public Health or Primary Care Settings?

    Directory of Open Access Journals (Sweden)

    Lene Bjørn Jensen

    2018-05-01

    Full Text Available The WHO Regional Office for Europe developed a set of public health functions resulting in the ten Essential Public Health Operations (EPHO. Public health or primary care settings seem to be favorable to embrace all actions included into EPHOs. The presented paper aims to guide readers on how to assign individual health promotion and environmental health services to public health or primary care settings. Survey tools were developed based on EPHO 2, 3 and 4; there were six key informant surveys out of 18 contacted completed via e-mails by informants working in Denmark on health promotion and five face-to-face interviews were conducted in Australia (Melbourne and Victoria state with experts from environmental health, public health and a physician. Based on interviews, we developed a set of indicators to support the assignment process. Population or individual focus, a system approach or one-to-one approach, dealing with hazards or dealing with effects, being proactive or reactive were identified as main element of the decision tool. Assignment of public health services to one of two settings proved to be possible in some cases, whereas in many there is no clear distinction between the two settings. National context might be the one which guides delivery of public health services.

  5. The Delivery of Health Promotion and Environmental Health Services; Public Health or Primary Care Settings?

    Science.gov (United States)

    Bjørn Jensen, Lene; Lukic, Irena; Gulis, Gabriel

    2018-05-07

    The WHO Regional Office for Europe developed a set of public health functions resulting in the ten Essential Public Health Operations (EPHO). Public health or primary care settings seem to be favorable to embrace all actions included into EPHOs. The presented paper aims to guide readers on how to assign individual health promotion and environmental health services to public health or primary care settings. Survey tools were developed based on EPHO 2, 3 and 4; there were six key informant surveys out of 18 contacted completed via e-mails by informants working in Denmark on health promotion and five face-to-face interviews were conducted in Australia (Melbourne and Victoria state) with experts from environmental health, public health and a physician. Based on interviews, we developed a set of indicators to support the assignment process. Population or individual focus, a system approach or one-to-one approach, dealing with hazards or dealing with effects, being proactive or reactive were identified as main element of the decision tool. Assignment of public health services to one of two settings proved to be possible in some cases, whereas in many there is no clear distinction between the two settings. National context might be the one which guides delivery of public health services.

  6. Prevalence for Private Tuition among Parents, Teachers and Pupils in Public Primary Schools in Machakos County

    Science.gov (United States)

    Kirigwi, Lucy Wambui; Maithya, Redempta

    2016-01-01

    Private tuition refers to tutoring offered outside mainstream teaching. The study sought to establish the difference in prevalence for private tuition among parents, teachers and pupils in public primary schools in Machakos County. The study employed descriptive survey design. The target populations were all teachers, parents and pupils of public…

  7. Psychosocial Support for Orphans and Vulnerable Children in Public Primary Schools: Challenges and Intervention Strategies

    Science.gov (United States)

    Mwoma, Teresa; Pillay, Jace

    2015-01-01

    Much has been written about orphans and vulnerable children (OVC) with regard to their education and living. However, relatively few studies have documented the psychosocial support provided for OVC in public primary schools to enhance their psychosocial well-being. This study therefore contributes to the understanding of the challenges…

  8. 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…

  9. Comparison of patients' experiences in public and private primary care clinics in Malta.

    Science.gov (United States)

    Pullicino, Glorianne; Sciortino, Philip; Calleja, Neville; Schäfer, Willemijn; Boerma, Wienke; Groenewegen, Peter

    2015-06-01

    Demographic changes, technological developments and rising expectations require the analysis of public-private primary care (PC) service provision to inform policy makers. We conducted a descriptive, cross-sectional study using the dataset of the Maltese arm of the QUALICOPC Project to compare the PC patients' experiences provided by public-funded and private (independent) general practitioners in Malta. Seven hundred patients from 70 clinics completed a self-administered questionnaire. Direct logistic regression showed that patients visiting the private sector experienced better continuity of care with more difficulty in accessing out-of-hours care. Such findings help to improve (primary) healthcare service provision and resource allocation. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  10. Improving Attendance and Retention in Out-of-School Time Programs. Research-to-Results Practitioner Insights. Publication # 2007-17

    Science.gov (United States)

    Kennedy, Elena; Wilson, Brooke; Valladares, Sherylls; Bronte-Tinkew, Jacinta

    2007-01-01

    Regular participation in out-of-school time activities is associated with benefits for children. However, children cannot reap the benefits of program participation if they do not attend programs in the first place. This brief focuses on ways in which out-of-school time programs can improve the attendance and retention of children and youth in…

  11. Understanding case mix across three paediatric services: could integration of primary and secondary general paediatrics alter walk-in emergency attendances?

    Science.gov (United States)

    Steele, Lloyd; Coote, Nicky; Klaber, Robert; Watson, Mando; Coren, Michael

    2018-05-04

    To understand the case mix of three different paediatric services, reasons for using an acute paediatric service in a region of developing integrated care and where acute attendances could alternatively have been managed. Mixed methods service evaluation, including retrospective review of referrals to general paediatric outpatients (n=534) and a virtual integrated service (email advice line) (n=474), as well as a prospective survey of paediatric ambulatory unit (PAU) attendees (n=95) and review by a paediatric consultant/registrar to decide where these cases could alternatively have been managed. The case mix of outpatient referrals and the email advice line was similar, but the case mix for PAU was more acute.The most common parental reasons for attending PAU were referral by a community health professional (27.2%), not being able to get a general practitioner (GP) appointment when desired (21.7%), wanting to avoid accident and emergency (17.4%) and wanting specialist paediatric input (14.1%). More than half of PAU presentations were deemed most appropriate for community management by a GP or midwife. The proportion of cases suitable for community management varied by the reason for attendance, with it highestl for parents reporting not being able to get a GP appointment (85%), and lowest for those referred by community health professionals (29%). One in two attendances to acute paediatric services could have been managed in the community. Integration of paediatric services could help address parental reasons for attending acute services, as well as facilitating the community management of chronic conditions. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  12. 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.

  13. [The influence of the advertising in the medication use in a group of elderly attended in a primary health care unit in Aracaju (Sergipe, Brasil)].

    Science.gov (United States)

    de Lyra, Divaldo Pereira; Neves, Aline Souza; Cerqueira, Karine Santos; Marcellini, Paulo Sergio; Marques, Tatiane Cristina; de Barros, José Augusto Cabral

    2010-11-01

    The growth of the Brazilian elderly people has led to a trend to an increase in the medication use. The inadequate use of drugs can be induced by some factors, like advertisement, with the risk of damaging the user's health. The objective of the study was to evaluate the advertisement influence in medication use in a group of elderly patients in a primary health care unit in Aracaju, Sergipe, Brazil. 230 elderly aging over 60 years with both genders had been interviewed from April to June of 2007. The majority of the interviewees (73%) has at least a chronic health condition and 73.9% consumed regularly at least one medication. 17.8% of the sample informed to use medication motivated by publicity influence; 2.2% had considered that the medication never cause damages and 6.5% believed that always it makes well. In this study, correlations have been made and demonstrated that those who presented a higher level of consumption influenced by advertising also think that drugs used are always beneficial and vice versa (p= 0.04). The data showed that part of elderly suffered influence of advertisement to medication use, and are not conscious of risks involved.

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

    Directory of Open Access Journals (Sweden)

    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.

  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

    Directory of Open Access Journals (Sweden)

    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. 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

    Directory of Open Access Journals (Sweden)

    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.

  17. Knowledge and utilization of intermittent preventive treatment for malaria among pregnant women attending antenatal clinics in primary health care centers in rural southwest, Nigeria: a cross-sectional study.

    Science.gov (United States)

    Akinleye, Stella O; Falade, Catherine O; Ajayi, Ikeoluwapo O

    2009-07-09

    Intermittent preventive treatment for prevention of malaria in pregnancy (IPTp) is a key component of malaria control strategy in Nigeria and sulfadoxine-pyrimethamine (SP) is the drug of choice. Despite the evidence of the effectiveness of IPTp strategy using SP in reducing the adverse effects of malaria during pregnancy the uptake and coverage in Nigeria is low. This study set out to assess the use of IPTp among pregnant women attending primary health centres in the rural area and determine factors that influence the uptake. A cross-sectional study was carried out between July and August 2007 among 209 pregnant women selected by systematic random sampling from antenatal care attendees at primary health care in a rural Local Government Area of Ekiti State, Nigeria. Information on knowledge of IPT, delivery, adherence and acceptability was obtained using an interviewer administered questionnaire. Descriptive statistics such as means, range, proportions were used. Chi-square test was used to examine association between categorical variables. All analyses were performed at 5% level of significance. One hundred and nine of 209 (52.2%) respondents have heard about IPTp but only 26 (23.9%) were able to define it. Fifty seven (27.3%) reported to have received at least one dose of IPTp during the index pregnancy and all were among those who have heard of IPTp (52.3%). Twenty one of the 57 (36.8%) took the SP in the clinic. Only three of the twenty-one (14.3%) were supervised by a health worker. Twenty two of the 36 women (61.1%) who did not take their drugs in the clinic would have liked to do so if allowed to bring their own drinking cups. Almost half (43.9%) of those who had used IPTp during the index pregnancy expressed concern about possible adverse effect of SP on their pregnancies. Periodic shortages of SP in the clinics were also reported. In this study, IPTp use among pregnant women was very low and there was poor adherence to the Directly Observed Therapy (DOT

  18. Effectiveness and cost-effectiveness of fining non-attendance at public hospitals: a randomised controlled trial from Danish outpatient clinics.

    Science.gov (United States)

    Blæhr, Emely Ek; Væggemose, Ulla; Søgaard, Rikke

    2018-04-13

    Fines have been proposed as means for reducing non-attendance in healthcare. The empirical evidence of the effect of fines is however limited. The objective of this study is to investigate the effectiveness and cost-effectiveness of fining non-attendance at outpatient clinics. 1:1 randomised controlled trial of appointments for an outpatient clinic, posted to Danish addresses, between 1 May 2015 and 30 November 2015. Only first appointment for users was included. Healthcare professionals and investigators were masked. A fine of DKK250 (€34) was issued for non-attendance. Users were informed about the fine in case of non-attendance by the appointment letter, and were able to reschedule or cancel until the appointment. A central administration office administered the fine system. The main outcome measures were non-attendance of non-cancelled appointments, fine policy administration costs, net of productivity consequences and probability of fining non-attendance being cost-effective over no fining for a range of hypothetical values of reduced non-attendance. All of the 6746 appointments included were analysed. Of the 3333 appointments randomised to the fine policy, 130 (5%) of non-cancelled appointments were unattended, and of the 3413 appointments randomised to no-fine policy, 131 (5%) were unattended. The cost per appointment of non-attendance was estimated at DKK 56 (SE 5) in the fine group and DKK47 (SE 4) in the no-fine group, leading to a non-statistically significant difference of DKK10 (95% CI -9 to 22) per appointment attributable to the fine policy. The probability of cost-effectiveness remained around 50%, irrespective of increased values of reduced non-attendance or various alternative assumptions used for sensitivity analyses. At a baseline level of around 5%, fining non-attendance does not seem to further reduce non-attendance. Future studies should focus on other means for reduction of non-attendance such as nudging or negative reinforcement. ISRCTN

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

    Directory of Open Access Journals (Sweden)

    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. 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

  1. 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

    Directory of Open Access Journals (Sweden)

    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.

  2. The price of 'free'. Quantifying the costs incurred by rural residents attending publically funded outpatient clinics in rural and base hospitals.

    Science.gov (United States)

    Fearnley, David; Kerse, Ngaire; Nixon, Garry

    2016-09-01

    INTRODUCTION Rural living is associated with increased costs in many areas, including health care. However, there is very little local data to quantify these costs, and their unknown quantity means that costs are not always taken into account in health service planning and delivery. AIM The aim of this study was to calculate the average time and travel costs of attending rural and base hospital outpatient clinics for rural Central Otago residents. METHODS A survey of 51 people attending rural hospital outpatient clinics. Individual costs in terms of travel and time were quantified and an average cost of both rural and base hospital attendance was calculated. RESULTS The average travel and lost time cost of attending a rural outpatient clinic was NZ$182 and 61% of respondents reported this cost had a significant effect on their weekly budget. The average cost incurred by residents associated with a base hospital attendance in Dunedin was NZ$732. DISCUSSION This study data show that costs are substantial and probably higher than most people might expect for both rural and base hospital attendances. It seems likely that these costs are a potential barrier to service access. However, the full implications of the personal costs incurred by rural residents in accessing health services are largely unstudied and therefore remain unknown in New Zealand.

  3. Primary health care and public health: foundations of universal health systems.

    Science.gov (United States)

    White, Franklin

    2015-01-01

    The aim of this review is to advocate for more integrated and universally accessible health systems, built on a foundation of primary health care and public health. The perspective outlined identified health systems as the frame of reference, clarified terminology and examined complementary perspectives on health. It explored the prospects for universal and integrated health systems from a global perspective, the role of healthy public policy in achieving population health and the value of the social-ecological model in guiding how best to align the components of an integrated health service. The importance of an ethical private sector in partnership with the public sector is recognized. Most health systems around the world, still heavily focused on illness, are doing relatively little to optimize health and minimize illness burdens, especially for vulnerable groups. This failure to improve the underlying conditions for health is compounded by insufficient allocation of resources to address priority needs with equity (universality, accessibility and affordability). Finally, public health and primary health care are the cornerstones of sustainable health systems, and this should be reflected in the health policies and professional education systems of all nations wishing to achieve a health system that is effective, equitable, efficient and affordable. © 2015 S. Karger AG, Basel.

  4. Opportunities and Challenges for Public Primary School Head Teachers in the Implementation of Free Primary Education in Kisumu Municipality, Kenya: An Analytical Assessment

    Science.gov (United States)

    Akech, Benta Achieng' Opul; Simatwa, Enose M. W.

    2010-01-01

    This study investigated opportunities and challenges for public primary school head teachers in the implementation of Free Primary Education in Kisumu municipality. Being a descriptive research, the study population consisted of 114 head teachers, 17,100 class seven and eight pupils in the municipality. Out of this, a sample of 37 head teachers…

  5. 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

    2018-03-01

    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/.

  6. Metabolic control and chronic complications during a 3-year follow-up period in a cohort of type 2 diabetic patients attended in primary care in the Community of Madrid (Spain).

    Science.gov (United States)

    Arrieta, Francisco; Piñera, Marbella; Iglesias, Pedro; Nogales, Pedro; Salinero-Fort, Miguel Angel; Abanades, Juan Carlos; Botella-Carretero, José Ignacio; Calañas, Alfonso; Balsa, José Antonio; Zamarrón, Isabel; Rovira, Adela; Vázquez, Clotilde

    2014-01-01

    Our aim was to analyze both metabolic control and chronic complications of type 2 diabetes mellitus (T2D) patients regularly attended in primary care during a 3 years of follow-up in the Community of Madrid (Spain). From 2007 to 2010 we prospectively included 3268 patients with T2D attended by 153 primary care physicians from 51 family health centers. An prospective cohort study with annual evaluation over 3 years to the same population was performed. We measured the goals of control in diabetic patients and the incidence of chronic complications of diabetes during the study period. A significant decrease in serum glucose levels (143±42mg/dl vs 137±43mg/dl, p1.2% vs 7.02±1.2%, p191.4±38mg/dl vs 181.5±36mg/dl, p114.7±31mg/dl vs 105.5±30mg/dl, p144.5±93mg/dl vs 138±84mg/dl, p14mg/dl vs 49.9±16mg/dl, pdiabetic complications throughout the study period was low, with a incidence of coronary heart disease of 6.2%, peripheral arterial disease 3%, ischemic stroke 2.8%, diabetic foot 11.2%, nephropathy 5.9%, retinopathy 4.5%, and neuropathy 3%. Metabolic control in T2D patients attended in primary care in the Community of Madrid throughout 3 years is adequate and is accompanied by low percent of chronic diabetic complications during this period of follow-up. Copyright © 2013 SEEN. Published by Elsevier Espana. All rights reserved.

  7. 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.

  8. 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 (ppublic-sector clinics. Social workers without prior mental health experience can effectively provide CBT and manage depression care.

  9. 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

    2018-06-01

    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.

  10. 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.

  11. 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.

  12. 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.

  13. 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.

  14. 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

    2015-01-01

    Objective 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. Design Cross-sectional questionnaire-based study conducted between September 2010 and June 2011. Setting 16 general practices in the south west of England. Participants 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. Main outcome measures 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. Results 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. Conclusions 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. PMID:25991450

  15. School health services and its practice among public and private primary schools in Western Nigeria.

    Science.gov (United States)

    Kuponiyi, Olugbenga Temitope; Amoran, Olorunfemi Emmanuel; Kuponiyi, Opeyemi Temitola

    2016-04-06

    Globally the number of children reaching school age is estimated to be 1.2 billion children (18% of the world's population) and rising. This study was therefore designed to determine the school health services available and its practices in primary schools in Ogun state, Western Nigeria. The study was a comparative cross-sectional survey of private and public primary schools in Ogun state using a multi-stage sampling technique. Participants were interviewed using a structured, interviewer administered questionnaire and a checklist. Data collected was analyzed using the SPSS version 15.0. A total of 360 head teachers served as respondents for the study with the overall mean age of 45.7 ± 9.9 years. More than three quarters of the respondents in both groups could not correctly define the school health programme. There were no health personnel or a trained first aider in 86 (47.8%) public and 110 (61.1%) private schools but a nurse/midwife was present in 57 (31.7%) and 27 (15.0%) public and private schools. (χ(2) = 17.122, P = 0.002). In about 95% of the schools, the teacher carried out routine inspection of the pupils while periodic medical examination for staff and pupils was carried out in only 13 (7.2%) public and 31 (17.2%) private schools (χ(2) = 8.398, P = 0.004). A sick bay/clinic was present in 26 (14.4%) and 67 (37.2%) public and private schools respectively (χ(2) = 24.371, P = 0.001). The practice of school health programme was dependent on the age (χ(2) = 12.53, P = 0.006) and the ethnicity of the respondents (χ(2) = 6.330, P = 0.042). Using multivariate analysis only one variable (type of school) was found to be a predictor of school health programme. (OR 4.55, CI 1.918-10.79). The study concludes that the practice of the various components of school health services was poor but better in private primary schools in Nigeria. Routine inspection by teachers was the commonest form of health appraisal. This may suggest that more health personnel need to

  16. Factors associated with undernourishment among people 20 years old or over with HIV/AIDS, attending public health services in the São Paulo municipality, Brazil.

    Science.gov (United States)

    Bassichetto, Katia Cristina; Bergamaschi, Denise Pimentel; Garcia, Vania Regina Salles; Veras, Maria Amélia de Sousa Mascena

    2014-12-01

    The study evaluated the nutritional status of 629 people living with HIV/AIDS attended at 12 specialized services of São Paulo's Municipal Health Department, Brazil. Data were obtained from medical records and through interviews during nutritional consultation. We used the classification criteria established by World Health Organization to assess malnourished individuals, a BMI health care of individuals at nutritional risk.

  17. Traditional Birth Attendants: A Field Guide to Their Training, Evaluation, and Articulation with Health Services. World Health Organization Offset Publication No. 44.

    Science.gov (United States)

    World Health Organization, Geneva (Switzerland).

    Guidelines for the planning, implementation, and evaluation of nationwide programs for the training and utilization of traditional birth attendants (TBAs) are presented. The guide begins with a chart outlining the steps in the development and evaluation of TBA programs. The next section discusses the formulation of basic policies regarding the…

  18. 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 (passessed after the inclusion of 36 additional centers, maintaining the positive trend (61%, 87%, and 84% at the same time points; pquality of spirometry 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.

  19. Collaboration across private and public sector primary health care services: benefits, costs and policy implications.

    Science.gov (United States)

    McDonald, Julie; Powell Davies, Gawaine; Jayasuriya, Rohan; Fort Harris, Mark

    2011-07-01

    Ongoing care for chronic conditions is best provided by interprofessional teams. There are challenges in achieving this where teams cross organisational boundaries. This article explores the influence of organisational factors on collaboration between private and public sector primary and community health services involved in diabetes care. It involved a case study using qualitative methods. Forty-five participants from 20 organisations were purposively recruited. Data were collected through semi-structured interviews and from content analysis of documents. Thematic analysis was used employing a two-level coding system and cross case comparisons. The patterns of collaborative patient care were influenced by a combination of factors relating to the benefits and costs of collaboration and the influence of support mechanisms. Benefits lay in achieving common or complementary health or organisational goals. Costs were incurred in bridging differences in organisational size, structure, complexity and culture. Collaboration was easier between private sector organisations than between private and public sectors. Financial incentives were not sufficient to overcome organisational barriers. To achieve more coordinated primary and community health care structural changes are also needed to better align funding mechanisms, priorities and accountabilities of the different organisations.

  20. 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.

  1. Attending to auditory memory.

    Science.gov (United States)

    Zimmermann, Jacqueline F; Moscovitch, Morris; Alain, Claude

    2016-06-01

    Attention to memory describes the process of attending to memory traces when the object is no longer present. It has been studied primarily for representations of visual stimuli with only few studies examining attention to sound object representations in short-term memory. Here, we review the interplay of attention and auditory memory with an emphasis on 1) attending to auditory memory in the absence of related external stimuli (i.e., reflective attention) and 2) effects of existing memory on guiding attention. Attention to auditory memory is discussed in the context of change deafness, and we argue that failures to detect changes in our auditory environments are most likely the result of a faulty comparison system of incoming and stored information. Also, objects are the primary building blocks of auditory attention, but attention can also be directed to individual features (e.g., pitch). We review short-term and long-term memory guided modulation of attention based on characteristic features, location, and/or semantic properties of auditory objects, and propose that auditory attention to memory pathways emerge after sensory memory. A neural model for auditory attention to memory is developed, which comprises two separate pathways in the parietal cortex, one involved in attention to higher-order features and the other involved in attention to sensory information. This article is part of a Special Issue entitled SI: Auditory working memory. Copyright © 2015 Elsevier B.V. All rights reserved.

  2. Domestic violence against women, public policies and community health workers in Brazilian Primary Health Care.

    Science.gov (United States)

    Signorelli, Marcos Claudio; Taft, Angela; Pereira, Pedro Paulo Gomes

    2018-01-01

    Domestic violence creates multiple harms for women's health and is a 'wicked problem' for health professionals and public health systems. Brazil recently approved public policies to manage and care for women victims of domestic violence. Facing these policies, this study aimed to explore how domestic violence against women is usually managed in Brazilian primary health care, by investigating a basic health unit and its family health strategy. We adopted qualitative ethnographic research methods with thematic analysis of emergent categories, interrogating data with gender theory and emergent Brazilian collective health theory. Field research was conducted in a local basic health unit and the territory for which it is responsible, in Southern Brazil. The study revealed: 1) a yawning gap between public health policies for domestic violence against women at the federal level and its practical application at local/decentralized levels, which can leave both professionals and women unsafe; 2) the key role of local community health workers, paraprofessional health promotion agents, who aim to promote dialogue between women experiencing violence, health care professionals and the health care system.

  3. 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…

  4. Effects of After-School Programs on Attendance and Externalizing Behaviors with Primary and Secondary School Students: A Systematic Review and Meta-Analysis

    Science.gov (United States)

    Maynard, Brandy R.; Kremer, Kristen P.; Polanin, Joshua R.; Vaughn, Michael G.; Sarteschi, Christine M.

    2015-01-01

    Over the past two decades, the number and types of after-school programs (ASPs) have increased substantially as a result of increased federal and private spending and because ASPs are perceived to provide wide-ranging and far-reaching benefits to students, families, schools and the public. The purpose of this systematic review and meta-analysis is…

  5. Exploring healthcare professionals experience and attitudes towards screening for and treatment of problem alcohol use among drug users attending primary care

    OpenAIRE

    Field, Catherine Anne; Klimas, Jan; Barry, Joe; Bury, Gerard; Keenan, Eamon; Lyons, Suzi; Smyth, Bobby P.; Cullen, Walter

    2011-01-01

    Problem alcohol use (PAU) is common among drug users (DUs) prevalence rates vary from 13-76%, in a recent Irish study of patients on methadone 35% had an AUDIT score indicating PAU. PAU is associated with adverse health outcomes including physical, psychological and social implications. Despite the crucial role of primary care in screening and treatment for problematic alcohol use and the importance of a stepped approach to alcohol treatment, supported by the evidence, little data reporting i...

  6. 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

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Legislative Changes to Primary Care Loan Program Authorized Under Title VII of the Public Health Service Act AGENCY... changes Section 723 of the Public Health Service Act (PHSA) regarding administration of the PCL program...

  7. Assessing the prevalence of depression in Punjabi and English primary care attenders: the role of culture, physical illness and somatic symptoms.

    Science.gov (United States)

    Bhui, Kamaldeep; Bhugra, Dinesh; Goldberg, David; Sauer, Justin; Tylee, Andre

    2004-09-01

    Previous studies exploring the prevalence of depression among South Asians reported inconsistent findings. Research artefacts due to sampling bias, measurements errors and a failure to include ethnographic methods may all explain this. We estimated the prevalence of depression, and variations of prevalence with culture, cultural adaptation, somatic symptoms and physical disability in a cross-sectional primary care survey of Punjabi and English attendees. We included a culture specific screening instrument, culturally adapted the instruments and offered bilingual interviews. We found that, compared with their English counterparts, depressive diagnoses were more common among Punjabis, Punjabi women, Punjabis with physical complaints and, contrary to expectation, even Punjabis with low scores for somatic symptoms.

  8. Prevalence of suicidal behaviour & associated factors among tuberculosis patients in public primary care in South Africa.

    Science.gov (United States)

    Peltzer, Karl; Louw, Julia

    2013-01-01

    In spite of the high prevalence of tuberculosis worldwide, there are only a few studies on its psychiatric complications such as suicidal behaviour. We undertook this study to assess the prevalence of suicidal behaviour and its associated factors among tuberculosis patients in public primary care in South Africa. In a cross-sectional survey conducted in three provinces of South Africa new TB and new re-treatment patients were assessed within one month of anti-tuberculosis treatment. The sample included 4900 (54.5% men and women 45.5%) consecutively selected tuberculosis patients from 42 public primary care clinics in three districts in South Africa. A total of 322 patients (9.0%) reported suicidal ideation and 131 (3.1%) had a history of a suicide attempt. In multivariate analysis female gender [Odds Ratio (OR)= 0.56, Confidence Interval (CI)= 0.43-0.74], psychological distress (OR=2.36, CI=1.04-2.29), post-traumatic stress disorders (PTSD) (OR=4.98, CI=3.76-6.59), harmful alcohol use (OR=1.97, CI=1.25-3.09) and being a TB re-treatment patient (OR=1.76, CI=1.32-2.34) were associated with suicidal ideation, and psychological distress (OR=3.27, CI=1.51-7.10), PTSD symptoms (OR=4.48, CI=3.04-6.61) and harmful alcohol use (OR=3.01, CI=1.83-4.95) were associated with a suicide attempt. Our findings suggest that co-morbid illnesses of psychological distress, PTSD and harmful alcohol use and HIV infection should be assessed in TB patients under TB control programmes to prevent suicidal behaviour. Clinicians should be aware about suicidality in tuberculosis patients to reduce mortality.

  9. Prevalence of suicidal behaviour & associated factors among tuberculosis patients in public primary care in South Africa

    Directory of Open Access Journals (Sweden)

    Karl Peltzer

    2013-01-01

    Full Text Available Background & objectives: In spite of the high prevalence of tuberculosis worldwide, there are only a few studies on its psychiatric complications such as suicidal behaviour. We undertook this study to assess the prevalence of suicidal behaviour and its associated factors among tuberculosis patients in public primary care in South Africa. Methods: In a cross-sectional survey conducted in three provinces of South Africa new TB and new re-treatment patients were assessed within one month of anti-tuberculosis treatment. The sample included 4900 (54.5% men and women 45.5% consecutively selected tuberculosis patients from 42 public primary care clinics in three districts in South Africa. Results: A total of 322 patients (9.0% reported suicidal ideation and 131 (3.1% had a history of a suicide attempt. In multivariate analysis female gender [Odds Ratio (OR= 0.56, Confidence Interval (CI= 0.43-0.74], psychological distress (OR=2.36, CI=1.04-2.29, post-traumatic stress disorders (PTSD (OR=4.98, CI=3.76-6.59, harmful alcohol use (OR=1.97, CI=1.25-3.09 and being a TB re-treatment patient (OR=1.76, CI=1.32-2.34 were associated with suicidal ideation, and psychological distress (OR=3.27, CI=1.51-7.10, PTSD symptoms (OR=4.48, CI=3.04-6.61 and harmful alcohol use (OR=3.01, CI=1.83-4.95 were associated with a suicide attempt. Interpretation & conclusions: Our findings suggest that co-morbid illnesses of psychological distress, PTSD and harmful alcohol use and HIV infection should be assessed in TB patients under TB control programmes to prevent suicidal behaviour. Clinicians should be aware about suicidality in tuberculosis patients to reduce mortality.

  10. [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.

  11. Patient and public involvement in primary care research - an example of ensuring its sustainability.

    Science.gov (United States)

    Jinks, Clare; Carter, Pam; Rhodes, Carol; Taylor, Robert; Beech, Roger; Dziedzic, Krysia; Blackburn, Steven; Hughes, Rhian; Ong, Bie Nio

    2016-01-01

    The international literature on patient and public involvement (PPI) in research covers a wide range of issues, including active lay involvement throughout the research cycle; roles that patients/public can play; assessing impact of PPI and recommendations for good PPI practice. One area of investigation that is less developed is the sustainability and impact of PPI beyond involvement in time-limited research projects. This paper focuses on the issues of sustainability, the importance of institutional leadership and the creation of a robust infrastructure in order to achieve long-term and wide-ranging PPI in research strategy and programmes. We use the case of a Primary Care Research Centre to provide a historical account of the evolution of PPI in the Centre and identified a number of key conceptual issues regarding infrastructure, resource allocation, working methods, roles and relationships. The paper concludes about the more general applicability of the Centre's model for the long-term sustainability of PPI in research.

  12. 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

  13. Selection of persons expressing opinions etc. and attendants in the public hearing concerning the alteration in reactor installations (addition of Unit 3 and 4) in the Genkai Nuclear Power Station of Kyushu Electric Power Co., Inc

    International Nuclear Information System (INIS)

    1984-01-01

    The Nuclear Safety Commission has selected 18 persons expressing opinions etc. and 255 (other) attendants for the public hearing on the alteration of reactor installations (addition of Unit 3 and 4) in Kyushu Electric's Genkai Nuclear Power Station to be held on June 18th, 1984. The order of expressing opinions etc., number of reception, names, addresses, ages and occupations are given of the persons expressing opinions etc. For both the groups, against the selected numbers there are given applicants etc. in number by towns and city. (Mori, K.)

  14. Patient-reported quality indicators for osteoarthritis: a patient and public generated self-report measure for primary care.

    Science.gov (United States)

    Blackburn, Steven; Higginbottom, Adele; Taylor, Robert; Bird, Jo; Østerås, Nina; Hagen, Kåre Birger; Edwards, John J; Jordan, Kelvin P; Jinks, Clare; Dziedzic, Krysia

    2016-01-01

    People with osteoarthritis desire high quality care, support and information. However, the quality of care for people with OA in general practice is not routinely collected. Quality Indicators can be used to benefit patients by measuring whether minimum standards of quality care are being met from a patient perspective. The aim of this study was to describe how a Research User Group (RUG) worked alongside researchers to co-produce a set of self-reported quality indicators for people with osteoarthritis when visiting their general practitioner or practice nurse (primary care). These were required in the MOSAICS study, which developed and evaluated a new model of supported self-management of OA to implement the NICE quality standards for OA. This article describes the public involvement in the MOSAICS study. This was 1) the co-development by RUG members and researchers of an Osteoarthritis Quality Indicators United Kingdom (OA QI (UK)) questionnaire for use in primary care, and 2) the comparison of the OA QI (UK) with a similar questionnaire developed in Norway. This study shows how important and effective a research user group can be in working with researchers in developing quality care indicators for osteoarthritis for use in a research study and, potentially, routine use in primary care. The questionnaire is intended to benefit patients by enabling the assessment of the quality of primary care for osteoarthritis from a patient's perspective. The OA QI (UK) has been used to examine differences in the quality of osteoarthritis care in four European countries. Background People with osteoarthritis (OA) desire high quality care, support and information about OA. However, the quality of care for people with OA in general practice is not routinely collected. Quality Indicators (QI) can be used to benefit patients by measuring whether minimum standards of quality care (e.g. NICE quality standards) are being met from a patient perspective. A Research User Group (RUG

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

    Directory of Open Access Journals (Sweden)

    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

  16. Factors associated with undernourishment among people 20 years old or over with HIV/AIDS, attending public health services in the São Paulo municipality, Brazil

    Directory of Open Access Journals (Sweden)

    Katia Cristina Bassichetto

    2014-12-01

    Full Text Available The study evaluated the nutritional status of 629 people living with HIV/AIDS attended at 12 specialized services of São Paulo's Municipal Health Department, Brazil. Data were obtained from medical records and through interviews during nutritional consultation. We used the classification criteria established by World Health Organization to assess malnourished individuals, a BMI < 18.5kg/m2. The prevalence of malnutrition in people with AIDS is 3.12 times that observed among people with HIV, and among people with co-infection it is 3.41 times that obtained among people without co-infection. This indicates how these conditions can harm the maintenance of the nutritional status, and shows that they demand a comprehensive understanding of the mechanisms involved in this phenomenon, as well as the development of strategies to improve the health care of individuals at nutritional risk.

  17. Tuberculosis non-communicable disease comorbidity and multimorbidity in public primary care patients in South Africa.

    Science.gov (United States)

    Peltzer, Karl

    2018-04-11

     Little is known about the prevalence of non-communicable disease (NCD) multimorbidity among tuberculosis (TB) patients in Africa.Aim and setting: The aim of this study was to assess the prevalence of NCD multimorbidity, its pattern and impact on adverse health outcomes among patients with TB in public primary care in three selected districts of South Africa.  In a cross-sectional survey, new TB and TB retreatment patients were interviewed, and medical records assessed in consecutive sampling within 1 month of anti-TB treatment. The sample included 4207 (54.5% men and 45.5% women) TB patients from 42 primary care clinics in three districts. Multimorbidity was measured as the simultaneous presence of two or more of 10 chronic conditions, including myocardial infarction or angina pectoris, arthritis, asthma, chronic lung disease, diabetes mellitus, hypertension, dyslipidaemia, malignant neoplasms, tobacco and alcohol-use disorder.  The prevalence of comorbidity (with one NCD) was 26.9% and multimorbidity (with two or more NCDs) was 25.3%. We identified three patterns of multimorbidity: (1) cardio-metabolic disorders; (2) respiratory disorders, arthritis and cancer; and (3) substance-use disorders. The likelihood of multimorbidity was higher in older age, among men, and was lower in those with higher education and socio-economic status. The prevalence of physical health decreased, and common mental disorders and post-traumatic stress disorder increased with an increase in the number of chronic conditions.  High NCD comorbidity and multimorbidity were found among TB patients predicted by socio-economic disparity.

  18. 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

  19. Public reporting influences antibiotic and injection prescription in primary care: a segmented regression analysis.

    Science.gov (United States)

    Liu, Chenxi; Zhang, Xinping; Wan, Jie

    2015-08-01

    Inappropriate use and overuse of antibiotics and injections are serious threats to the global population, particularly in developing countries. In recent decades, public reporting of health care performance (PRHCP) has been an instrument to improve the quality of care. However, existing evidence shows a mixed effect of PRHCP. This study evaluated the effect of PRHCP on physicians' prescribing practices in a sample of primary care institutions in China. Segmented regression analysis was used to produce convincing evidence for health policy and reform. The PRHCP intervention was implemented in Qian City that started on 1 October 2013. Performance data on prescription statistics were disclosed to patients and health workers monthly in 10 primary care institutions. A total of 326 655 valid outpatient prescriptions were collected. Monthly effective prescriptions were calculated as analytical units in the research (1st to 31st every month). This study involved multiple assessments of outcomes 13 months before and 11 months after PRHCP intervention (a total of 24 data points). Segmented regression models showed downward trends from baseline on antibiotics (coefficient = -0.64, P = 0.004), combined use of antibiotics (coefficient = -0.41, P < 0.001) and injections (coefficient = -0.5957, P = 0.001) after PRHCP intervention. The average expenditure of patients slightly increased monthly before the intervention (coefficient = 0.8643, P < 0.001); PRHCP intervention also led to a temporary increase in average expenditure of patients (coefficient = 2.20, P = 0.307) but slowed down the ascending trend (coefficient = -0.45, P = 0.033). The prescription rate of antibiotics and injections after intervention (about 50%) remained high. PRHCP showed positive effects on physicians' prescribing behaviour, considering the downward trends on the use of antibiotics and injections and average expenditure through the intervention. However, the effect

  20. Behavioral and biological correlates of medicine use in type 2 diabetic patients attended by Brazilian public healthcare system. http://dx.doi.org/10.5007/1980-0037.2013v15n1p82

    Directory of Open Access Journals (Sweden)

    Jamile Sanches Codogno

    2013-01-01

    Full Text Available 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.

  1. 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

    Directory of Open Access Journals (Sweden)

    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.

  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; 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

  3. Inconsistent condom use among public primary care patients with tuberculosis in South Africa.

    Science.gov (United States)

    Matseke, Gladys; Peltzer, Karl; Louw, Julia; Naidoo, Pamela; McHunu, Gugu; Tutshana, Bomkazi

    2012-01-01

    The high rate of HIV infections among tuberculosis (TB) patients in South Africa calls for urgent HIV reduction interventions in this subpopulation. While correct and consistent condom use is one of the effective means of HIV prevention among sexually active people, there is insufficient research on condom use among TB patients in South Africa. The aim of this paper was to determine the prevalence of inconsistent condom use among public primary care TB patients and its associated factors using a sample of 4900 TB patients from a cross-sectional survey in three health districts in South Africa. Results indicated that when asked about their consistency of condom use in the past 3 months, 63.5% of the participants reported that they did not always use condoms. In the multivariable analysis, being married (OR = 1.66; 95% CI 1.25-2.20) or cohabitating or separated, divorced, or widowed (OR = 3.67; 1.85-7.29), lower educational level (OR = 0.66; 0.46-0.94), greater poverty (OR = 1.60; 1.25-2.20), not having HIV status disclosed (OR = 0.34; 0.25-0.48), sexual partner on antiretroviral treatment (OR = 0.38; 0.23-0.60), and partner alcohol use before sex (OR = 1.56; 1.30-1.90) were significantly associated with inconsistent condom use in the past 3 months. The low proportion of consistent condom use among TB patients needs to be improved.

  4. 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.

  5. 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

  6. 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…

  7. Willingness to pay for private primary care services in Hong Kong: are elderly ready to move from the public sector?

    Science.gov (United States)

    Liu, Su; Yam, Carrie H K; Huang, Olivia H Y; Griffiths, Sian M

    2013-10-01

    How to provide better primary care and achieve the right level of public-private balance in doing so is at the centre of many healthcare reforms around the world. In a healthcare system like Hong Kong, where inpatient services are largely funded through general taxation and ambulatory services out of pocket, the family doctor model of primary care is underdeveloped. Since 2008, the Government has taken forward various initiatives to promote primary care and encourage more use of private services. However, little is known in Hong Kong or elsewhere about consumers' willingness to pay (WTP) for private services when care is available in the public sector. This study assessed willingness of the Hong Kong elderly to pay for specific primary care and preventive services in the private sector, through a cross-sectional in-person questionnaire survey and focus group discussions among respondents. The survey revealed that the WTP for private services in general was low among the elderly; particularly, reported WTP for chronic conditions and preventive care both fell below the current market prices. Sub-group analysis showed higher WTP among healthier and more affluent elderly. Among other things, concerns over affordability and uncertainty (of price and quality) in the private sector were associated with this low level of WTP. These results suggest that most elderly, who are heavy users of public health services but with limited income, may not use more private services without seeing significant reduction in price. Financial incentives for consumers alone may not be enough to promote primary care or public-private partnership. Public education on the value of prevention and primary care, as well as supply-side interventions should both be considered. Hong Kong's policy-making process of the initiative studied here may also provide lessons for other countries with ongoing healthcare reforms.

  8. Attendance as control

    OpenAIRE

    Beckton, Julian

    2013-01-01

    Student attendance in higher education, particularly at lectures, is a topic that researchers have largely neglected, other than in relatively small scale studies. This paper reviews university attendance policies based on documentary research in university web sites. While there are acknowledged methodological limitations to this approach, some universities are beginning to implement automated recording of student attendance in UK higher education and others are debating the merits of doing ...

  9. 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

  10. 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…

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

    Science.gov (United States)

    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,…

  12. 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…

  13. Teachers' Demographic Factors on Attitude towards Guidance and Counselling Services in Public Primary Schools of Kimilili Subcounty, Kenya

    Science.gov (United States)

    Nasilumbi, Wesonga Joanne; Jenniffer, Munyau K.; Prisca, Tarus

    2016-01-01

    The government of Kenya through the Ministry of education banned corporal punishment in schools. This necessitated strengthening of guidance and counseling (G&C) services in schools. This study aimed to: determine the teachers' attitude towards guidance and counseling services in public primary schools in Kimilili Sub-County and determine the…

  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.

    2010-01-01

    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…

  15. Inconsistent Condom Use among Public Primary Care Patients with Tuberculosis in South Africa

    Directory of Open Access Journals (Sweden)

    Gladys Matseke

    2012-01-01

    Full Text Available The high rate of HIV infections among tuberculosis (TB patients in South Africa calls for urgent HIV reduction interventions in this subpopulation. While correct and consistent condom use is one of the effective means of HIV prevention among sexually active people, there is insufficient research on condom use among TB patients in South Africa. The aim of this paper was to determine the prevalence of inconsistent condom use among public primary care TB patients and its associated factors using a sample of 4900 TB patients from a cross-sectional survey in three health districts in South Africa. Results indicated that when asked about their consistency of condom use in the past 3 months, 63.5% of the participants reported that they did not always use condoms. In the multivariable analysis, being married (OR=1.66; 95% CI 1.25–2.20 or cohabitating or separated, divorced, or widowed (OR=3.67; 1.85–7.29, lower educational level (OR=0.66; 0.46–0.94, greater poverty (OR=1.60; 1.25–2.20, not having HIV status disclosed (OR=0.34; 0.25–0.48, sexual partner on antiretroviral treatment (OR=0.38; 0.23–0.60, and partner alcohol use before sex (OR=1.56; 1.30–1.90 were significantly associated with inconsistent condom use in the past 3 months. The low proportion of consistent condom use among TB patients needs to be improved.

  16. 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.

  17. 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.

  18. Exploring “Speak-O-Rama” as a Public Speaking Module: A Pilot Study in an Islamic Integrated Primary School

    Directory of Open Access Journals (Sweden)

    Nurul Iman Ahmad Bukhari

    2017-01-01

    Full Text Available This paper describes the pilot study in implementing a public speaking module for a primary school level. The module development was structured according to ASSURE Model with the Communicative Language Teaching (CLT as the basis used in designing the module activities.  One group of Year 4 students from an Islamic integrated school was selected and the research method employed was the quasi-experimental research with pre and post-tests as well as interviews with the English teachers on the students’ performance and self-confidence.  Students were also interviewed to identify their self confidence level before and after the implementation of the public speaking module. This research project is hoped to increase students’ oral proficiency along with increasing self-confidence in public speaking at a young age, and to propose the implementation of this module as reference in primary education.

  19. 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

  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. The rate and factors associated with non-adherence to surgery, chemotherapy, radiotherapy and hormonal therapy among breast cancer patients attending public hospitals in Malaysia

    Directory of Open Access Journals (Sweden)

    Nur Aishah Taib

    2017-12-01

    Full Text Available Background: The role of breast cancer treatments in reducing recurrence and death has been established. However, the treatments side effects greatly impact on quality of life and little is known about the non-adherence rates. The purpose of this study was to determine the non-adherence rates to surgery, chemotherapy, radiotherapy and hormonal therapy, and factors that affect it in public hospitals in Malaysia. Methods: A multicentre cross-sectional study was conducted in six public hospitals involving all newly diagnosed breast cancer patients in 2012. Data were collected through medical record reviews and interview by using structured questionnaire. Non-adherence was categorized as any breast cancer patients refusing or discontinuing any treatment due to non-medical reasons. Univariable logistic regression and multiple logistic regressions were used for analysis. Results: A total of 340 breast cancer patients were included in the study. The proportion for non-adherence to surgery, chemotherapy, radiotherapy and hormonal therapy were 14%, 30.1%, 33.3% and 36.3% respectively. Factors associated with non-adherence to surgery were localities involving Kuala Lumpur (2 (OR: 3.41, Johor (OR: 8.38 and Kelantan (OR: 6.32, and those required mastectomy (OR: 5.66. No factors were found to be associated with non-adherence to chemotherapy, radiotherapy and hormonal therapy. These three treatment modalities were then combined as oncology therapy and the only independent factor associated with non-adherence to oncology therapy was Perak locality (OR: 1.42. Conclusion: Non-adherence to breast cancer treatments was high among breast cancer patients at public hospitals in Malaysia. Factors influencing non-adherence were locations and mastectomy implicating of socio-culture, body image issues, psychological disturbance and treatment navigation. Community educational programs focusing on correcting misconceptions, treatment outcomes and treatments’ side effects

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

    African Journals Online (AJOL)

    A quasi-experimental study was carried out to determine the effect of health education and training on the Knowledge,attitude and practices of patient referral by primary health care workers in Mushin and Surulere Local Government Areas of Lagos State of Nigeria. Material and method: A total sample of 170 primary health ...

  3. Challenges to creating primary care teams in a public health centre ...

    African Journals Online (AJOL)

    CNP) is essential to the provision of quality primary care in the South African context. The Worcester Community Health Centre (CHC) is situated in a large town and offers primary care to the rural Breede Valley Sub-District of the Western ...

  4. The Violence of Cultural Difference: Accommodation and Oppositional Practices of Muslim Pupils in a Public Primary School in Metro Manila

    Directory of Open Access Journals (Sweden)

    Gerry M. Lanuza

    2010-06-01

    Full Text Available Primary schools are supposed to provide a haven for young people to learn respect for individual differences and cultural diversity. However, schools often do not acknowledge cultural differences among their pupils or do not consciously consider the dynamics of these cultural differences in the school, which may lead to a simmering violence. This paper is an attempt to document the ways in which minority Muslim pupils in a primary public school develop different strategies of accommodation, assimilation, and resistance to the mainstream culture of the school.

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. 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

  10. tinal parasites among pupils of private and public primary schools in ...

    African Journals Online (AJOL)

    2017-03-10

    Mar 10, 2017 ... contamination of the soil, water, food and vegetables5,6 and the prevalent habit of ... dichotomisation of school system into private and public schools naturally ..... lation affirming the fact that intermittent use of anthelminthic ...

  11. [Technical efficiency assessment of public primary care providers in the Basque Country (Spain), 2010-2013].

    Science.gov (United States)

    Cordero, José Manuel; Nuño-Solinís, Roberto; Orueta, Juan F; Polo, Cristina; Del Río-Cámara, Mario; Alonso-Morán, Edurne

    2016-01-01

    To evaluate the technical efficiency of primary care units operating in the Basque Health Service during the period 2010-2013, corresponding to the implementation of a care integration strategy by health authorities. This study included 11 of the 12 primary care units in the Basque Health Service during the period 2010-2013. Data envelopment analysis (DEA) was used to assess the technical efficiency of the units. In particular, we applied the extension DEA windows to analyse all units as if they were in a single period (33 observations) as well as a conditional model, which allowed incorporation of the effect of the characteristics of the population covered. The outputs considered were a quality index based on fulfilment of different requirements related to primary care delivery and the rate of avoidable hospitalizations (treated as an undesirable output). The inputs used were the number of physicians, the number of nurses and the costs of prescriptions. The morbidity index was included as an exogenous variable. The results showed that the efficiency of all the units improved during the study period. However, this improvement was not greater in the units incorporated in the integrated healthcare organisation. In a context of global transformation of care delivery in the Basque country in the study period, primary care units increased their efficiency. However, this effect was not larger in vertically integrated primary care providers. Copyright © 2015 SESPAS. Published by Elsevier Espana. All rights reserved.

  12. Synthesizing diverse evidence: the use of primary qualitative data analysis methods and logic models in public health reviews.

    Science.gov (United States)

    Baxter, S; Killoran, A; Kelly, M P; Goyder, E

    2010-02-01

    The nature of public health evidence presents challenges for conventional systematic review processes, with increasing recognition of the need to include a broader range of work including observational studies and qualitative research, yet with methods to combine diverse sources remaining underdeveloped. The objective of this paper is to report the application of a new approach for review of evidence in the public health sphere. The method enables a diverse range of evidence types to be synthesized in order to examine potential relationships between a public health environment and outcomes. The study drew on previous work by the National Institute for Health and Clinical Excellence on conceptual frameworks. It applied and further extended this work to the synthesis of evidence relating to one particular public health area: the enhancement of employee mental well-being in the workplace. The approach utilized thematic analysis techniques from primary research, together with conceptual modelling, to explore potential relationships between factors and outcomes. The method enabled a logic framework to be built from a diverse document set that illustrates how elements and associations between elements may impact on the well-being of employees. Whilst recognizing potential criticisms of the approach, it is suggested that logic models can be a useful way of examining the complexity of relationships between factors and outcomes in public health, and of highlighting potential areas for interventions and further research. The use of techniques from primary qualitative research may also be helpful in synthesizing diverse document types. Copyright 2010 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  13. 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…

  14. 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

  15. Public Investment and the Goal of Providing Universal Access to Primary Education by 2015 in Kenya

    Science.gov (United States)

    Omwami, Edith Mukudi; Omwami, Raymond K.

    2010-01-01

    The authors use population census data to project school enrolment for Kenya. They also employ current education sector budget and national revenue base statistics to model the sector budget and to forecast the revenue base growth required to sustain universal primary education (UPE). The 2003 fiscal year unit cost of education is used as the base…

  16. 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…

  17. Comparison of patients’ experiences in public and private primary care clinics in Malta.

    NARCIS (Netherlands)

    Pullicino, G.; Sciortino, P.; Calleja, N.; Schäfer, W.; Boerma, W.; Groenewegen, P.

    2015-01-01

    Demographic changes, technological developments and rising expectations require the analysis of public–private primary care (PC) service provision to inform policy makers. We conducted a descriptive, cross-sectional study using the dataset of the Maltese arm of the QUALICOPC Project to compare the

  18. New public management in Iran's health complex: a management framework for primary health care system.

    Science.gov (United States)

    Tabrizi, Jafar Sadegh; HaghGoshayie, Elaheh; Doshmangir, Leila; Yousefi, Mahmood

    2018-05-01

    New public management (NPM) was developed as a management reform to improve the efficiency and effectiveness in public organizations, especially in health sector. Using the features of private sector management, the managers of health organizations may try to implement the elements of NPM with the hope to improve the performance of their systems.AimsOur aim in the present study was to identify the elements and infrastructures suitable for implementing NPM in the Iranian health complex. In this qualitative study with conventional content analysis approach, we tried to explore the NPM elements and infrastructures in Iranian public health sector. A series of semi-structured interviews (n=48) were conducted in 2016 with a managers in public and private health complex. Three focus group discussions with nine faculty members were also conducted. A data collection form was used to collect the demographic characteristics and perspectives of the participants.FindingsFrom the perspective of managers, managerialism, decentralization, using market mechanism, performance management, customer orientation and performance budgeting were the main elements of NPM in the Iranian context. The most important infrastructures for implementing this reform were as follows: education and training, information technology, the proper use of human resources, decision support systems, top management commitment, organizational culture, flexibility of rules, rehabilitating of the aging infrastructures, and expanding the coverage of services. The NPM was generally identified to be an effective replacement for the traditional administration method. These reforms may be helpful in strengthening the public health complex and the management capacity, as well. NPM also seems to be useful in interacting the public health sector with the private sector in terms of personnel and resources, performance, reward structure, and methods of doing business.

  19. Impact of Attendance Policies on Course Attendance among College Students

    Science.gov (United States)

    Chenneville, Tiffany; Jordan, Cary

    2008-01-01

    The purpose of this study was twofold: (a) to investigate whether having a graded attendance policy would have an effect on course attendance among college students, and (b) to examine beliefs about education and attendance policies among college students. Results support the utility of graded attendance policies for increasing class attendance…

  20. Food Insecurity, Nutritional Status, and Factors Associated with Malnutrition among People Living with HIV/AIDS Attending Antiretroviral Therapy at Public Health Facilities in West Shewa Zone, Central Ethiopia.

    Science.gov (United States)

    Gebremichael, Delelegn Yilma; Hadush, Kokeb Tesfamariam; Kebede, Ermiyas Mulu; Zegeye, Robel Tezera

    2018-01-01

    In resource limited settings, HIV/AIDS patients lack access to sufficient nutritious foods, which poses challenges to the success of antiretroviral therapy. HIV/AIDS and malnutrition are still major public health problems in Ethiopia. Though measuring nutritional status is an essential part of ART program, little evidence exists on food insecurity and nutritional status of HIV/AIDS patients in Ethiopia. Hence, the study aimed to determine food insecurity and nutritional status and contextual determinants of malnutrition among HIV/AIDS patients in West Shewa Zone, Ethiopia. Institution-based cross-sectional study was conducted among HIV/ADIS patients who have been attending antiretroviral therapy at public health facilities in West Shewa Zone from April to May 2016, Ethiopia. The sample size was 512 and study participants were selected from each facilities using systematic random sampling method. Data were collected using pretested questionnaire by trained data collectors. Data were entered to Epi-Info 3.5.1 for Windows and analyzed using SPSS version 22. Logistic regression analyses were conducted to determine independent factors associated with malnutrition. Prevalence of malnutrition was 23.6% (95% CI: 19.7%-27.4%) and prevalence of household food insecurity was 35.2% (95% CI: 31.1%-39.0%). Factors significantly associated with malnutrition among HIV/AIDS patients were unemployment (AOR = 3.4; 95% CI: 1.8-5.3), WHO clinical stages III/IV (AOR = 3.3; 95% CI: 1.8-6.5), CD4 count less than 350 cells/ μ l (AOR = 2.0; 95% CI: 1.8-4.2), tuberculosis (AOR = 2.3; 95% CI: 1.3-4.9), duration on antiretroviral therapy (AOR = 1.8; 95% CI: 1.2-2.9), and household food insecurity (AOR = 5.3; 95% CI: 2.5-8.3). The findings revealed high prevalence of malnutrition and household food insecurity among HIV/AIDS patients attended ART. The negative interactive effects of undernutrition, inadequate food consumption, and HIV infection demand effective cross-sectorial integrated

  1. Food Insecurity, Nutritional Status, and Factors Associated with Malnutrition among People Living with HIV/AIDS Attending Antiretroviral Therapy at Public Health Facilities in West Shewa Zone, Central Ethiopia

    Directory of Open Access Journals (Sweden)

    Delelegn Yilma Gebremichael

    2018-01-01

    Full Text Available Background. In resource limited settings, HIV/AIDS patients lack access to sufficient nutritious foods, which poses challenges to the success of antiretroviral therapy. HIV/AIDS and malnutrition are still major public health problems in Ethiopia. Though measuring nutritional status is an essential part of ART program, little evidence exists on food insecurity and nutritional status of HIV/AIDS patients in Ethiopia. Hence, the study aimed to determine food insecurity and nutritional status and contextual determinants of malnutrition among HIV/AIDS patients in West Shewa Zone, Ethiopia. Methods. Institution-based cross-sectional study was conducted among HIV/ADIS patients who have been attending antiretroviral therapy at public health facilities in West Shewa Zone from April to May 2016, Ethiopia. The sample size was 512 and study participants were selected from each facilities using systematic random sampling method. Data were collected using pretested questionnaire by trained data collectors. Data were entered to Epi-Info 3.5.1 for Windows and analyzed using SPSS version 22. Logistic regression analyses were conducted to determine independent factors associated with malnutrition. Results. Prevalence of malnutrition was 23.6% (95% CI: 19.7%–27.4% and prevalence of household food insecurity was 35.2% (95% CI: 31.1%–39.0%. Factors significantly associated with malnutrition among HIV/AIDS patients were unemployment (AOR = 3.4; 95% CI: 1.8–5.3, WHO clinical stages III/IV (AOR = 3.3; 95% CI: 1.8–6.5, CD4 count less than 350 cells/μl (AOR = 2.0; 95% CI: 1.8–4.2, tuberculosis (AOR = 2.3; 95% CI: 1.3–4.9, duration on antiretroviral therapy (AOR = 1.8; 95% CI: 1.2–2.9, and household food insecurity (AOR = 5.3; 95% CI: 2.5–8.3. Conclusions. The findings revealed high prevalence of malnutrition and household food insecurity among HIV/AIDS patients attended ART. The negative interactive effects of undernutrition, inadequate food

  2. Prevalence of anemia and associated factors among school children in Gondar town public primary schools, northwest Ethiopia: A school-based cross-sectional study.

    Science.gov (United States)

    Getaneh, Zegeye; Enawgaw, Bamlaku; Engidaye, Getabalew; Seyoum, Masresha; Berhane, Muruts; Abebe, Zegeye; Asrie, Fikir; Melku, Mulugeta

    2017-01-01

    Anemia is a global public health problem affecting 305 million school children (SC) worldwide. It has deleterious effects in SC, including lower school achievement due to impaired cognitive development and physical growth, fatigue and poor attention span, and increased morbidity because of reduced resistance to infection. Hence, the aim of this study was to assess the prevalence and associated factors of anemia among SC attending public primary schools in Gondar town, northwest Ethiopia. A school-based cross sectional study was conducted on a total of 523 SC aged from 6-14 years old. Multi-stage sampling followed by systematic random sampling techniques were employed to select study participants. Data on socio-demographic and socio-economic characteristics, and dietary status of children were collected using pre-tested structured questionnaire through face-to-face interview of children's caregivers. Anthropometric measurements were taken. Hemoglobin (Hb) concentration was determined by using HemoCue 301+analyser. Stool and blood samples were collected in the school premises, and examined for intestinal and hemoparasites, respectively. Data were entered into Epi Info version 3.5.3 and transferred to SPSS version 20 for analysis. Bivariate and multivariate binary logistic regression models were fitted to identify associated factors of anemia. P-value < 0.05 was considered as statistically significant. Of the total SC participated in the study, 269 (51.4%) were males. The median (inter quartile range (IQR)) age was 12 (10-13) years, and 332 (63.5%) of them were in the age group 11-14 years. About 81 (15.5%; 95%CI: 12.4%, 18.7%) of them were anemic: 56 (69.1%) and 25 (38.9%) of them were mildly and moderately anemic, respectively. Low maternal education (AOR = 2.30; 95%CI: 1.11, 4.78), stunting (AOR = 2.22; 95%CI: 1.30, 3.80), severe food insecurity (AOR = 5.11; 95%CI: 1.53, 17.13), and soil-transmitted helminthic (STH) infection (AOR = 7.13; 95%CI: 3.16, 16.86) were

  3. Prevalence of anemia and associated factors among school children in Gondar town public primary schools, northwest Ethiopia: A school-based cross-sectional study.

    Directory of Open Access Journals (Sweden)

    Zegeye Getaneh

    Full Text Available Anemia is a global public health problem affecting 305 million school children (SC worldwide. It has deleterious effects in SC, including lower school achievement due to impaired cognitive development and physical growth, fatigue and poor attention span, and increased morbidity because of reduced resistance to infection. Hence, the aim of this study was to assess the prevalence and associated factors of anemia among SC attending public primary schools in Gondar town, northwest Ethiopia.A school-based cross sectional study was conducted on a total of 523 SC aged from 6-14 years old. Multi-stage sampling followed by systematic random sampling techniques were employed to select study participants. Data on socio-demographic and socio-economic characteristics, and dietary status of children were collected using pre-tested structured questionnaire through face-to-face interview of children's caregivers. Anthropometric measurements were taken. Hemoglobin (Hb concentration was determined by using HemoCue 301+analyser. Stool and blood samples were collected in the school premises, and examined for intestinal and hemoparasites, respectively. Data were entered into Epi Info version 3.5.3 and transferred to SPSS version 20 for analysis. Bivariate and multivariate binary logistic regression models were fitted to identify associated factors of anemia. P-value < 0.05 was considered as statistically significant.Of the total SC participated in the study, 269 (51.4% were males. The median (inter quartile range (IQR age was 12 (10-13 years, and 332 (63.5% of them were in the age group 11-14 years. About 81 (15.5%; 95%CI: 12.4%, 18.7% of them were anemic: 56 (69.1% and 25 (38.9% of them were mildly and moderately anemic, respectively. Low maternal education (AOR = 2.30; 95%CI: 1.11, 4.78, stunting (AOR = 2.22; 95%CI: 1.30, 3.80, severe food insecurity (AOR = 5.11; 95%CI: 1.53, 17.13, and soil-transmitted helminthic (STH infection (AOR = 7.13; 95%CI: 3.16, 16

  4. 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.

  5. Are primary care practitioners in Barbados following diabetes guidelines? - a chart audit with comparison between public and private care sectors

    Directory of Open Access Journals (Sweden)

    Carter Anne O

    2011-06-01

    Full Text Available Abstract Background Over 19% of the population ≥ 40 years of age in Barbados are diabetic. The quality of diabetes primary care is uncertain. Findings Charts of diabetic and hypertensive patients were randomly sampled at all public and 20 private sector primary care clinics. Charts of all diabetic patients ≥ 40 years of age were then selected. Processes of care, and quality targets for blood pressure (BP, fasting blood glucose (FBG and glycosylated haemoglobin (HbA1c were documented. 252 charts of diabetic patients (125 public and 127 private were audited. Patients had the following characteristics: mean age 64 years, female gender 61%, mean duration of diagnosis 9 years, and hypertension diagnosed 78%. Patients had an average of 4.7 clinic visits per year, 66% were prescribed metformin, 68% a sulphonylurea, 25% a statin, 21% insulin, 15% aspirin and 12% a glucosidase inhibitor. Public patients compared to private patients were more likely to be female (77% vs. 46%, p Conclusions Interventions such as body mass assessment, lifestyle advice, screening for retinopathy, monitoring blood glucose control, and achieving BP and glycaemic targets need improvement.

  6. 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…

  7. Relationship between Primary and Secondary Dental Care in Public Health Services in Brazil.

    Science.gov (United States)

    Martins, Renata Castro; Reis, Clarice Magalhães Rodrigues Dos; Matta Machado, Antonio Thomaz Gonzaga da; Amaral, João Henrique Lara do; Werneck, Marcos Azeredo Furquim; Abreu, Mauro Henrique Nogueira Guimarães de

    2016-01-01

    This cross-sectional study evaluated the relationship between primary and secondary oral health care in Brazil. For this purpose, data from the National Program for Improving Access and Quality of Primary Care were used. Dentists from 12,403 oral health teams (OHTs) answered a structured questionnaire in 2012. The data were analyzed descriptively and by cluster analysis. Of the 12,387 (99.9%) OHTs that answered all the questions, 62.2% reported the existence of Dental Specialties Centers (DSCs) to which they could refer patients. The specialties with the highest frequencies were endodontics (68.4%), minor oral surgery (65.8%), periodontics (63.0%), radiology (46.8%), oral medicine (40.2%), orthodontics (20.5%) and implantology (6.2%). In all percentiles, the shortest wait time for secondary care was for radiology, followed by oral medicine and the other specialties. In the 50th percentile, the wait for endodontics, periodontics, minor oral surgery and orthodontics was 30 days, while for implantology, the wait was 60 days. Finally, in the 75th percentile, the wait for endodontics, orthodontics and implantology was 90 days or more. Two clusters, with different frequencies of OHT access to specialties, were identified. Cluster 1 (n = 7,913) included the OHTs with lower frequencies in all specialties except orthodontics and implantology compared with Cluster 2 (n = 4,474). Of the Brazilian regions, the South and Southeast regions had the highest frequencies for Cluster 2, with better rates for the relationship between primary and secondary care. This study suggests certain difficulties in the relationship between primary and secondary care in specific specialties in oral health, with a great number of OHTs with limited access to DSCs, in addition to different performance in terms of OHT access to DSCs across Brazilian regions.

  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. 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

  10. HOBE+, a case study: a virtual community of practice to support innovation in primary care in Basque Public Health Service.

    Science.gov (United States)

    Abos Mendizabal, Galder; Nuño Solinís, Roberto; Zaballa González, Irune

    2013-11-05

    A virtual professional community of practice (VCoP), HOBE+, has been set up to foster and facilitate innovation in primary care. It is aimed at all primary care professionals of the Basque Public Health Service (Osakidetza) in the provinces of Biscay and Araba. HOBE + is a VCoP that incorporates innovation management from the generation of ideas to their implementation in primary care practice. We used a case study method, based on the data provided by the technology platform that supports the VCoP, and from a survey completed by HOBE + users. The target population was all primary care staff (including all professional categories) from Araba and Biscay provinces of the Basque Country (Spain), who represent the target users of the VCoP. From a total of 5190 professionals across all the professional categories invited to join, 1627 (31.3%) actually registered in the VCoP and, during the study period, 90 (5.5% of the registered users) participated actively in some way. The total number of ideas proposed by the registered users was 133. Of these, 23 ideas (17.2%) are being implemented. Finally, 80% of the users who answered the satisfaction survey about their experience with HOBE + considered the initiative useful in order to achieve continuous improvement and real innovation in clinical and managerial processes. The experience shows that it is possible to create a virtual CoP for innovation in primary care where professionals from different professional categories propose ideas for innovation that are ultimately implemented.This manuscript objectives are to assess the process of developing and implementing a VCoP open to all primary care professionals in Osakidetza, including the take-up, participation and use of this VCoP in the first 15 months after its launch in October 2011. In addition, the usefulness of the VCoP was assessed through a survey gathering the opinions of the professionals involved.

  11. 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.

  12. 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

  13. A Policy Analysis of Student Attendance Standards Related to State Education Policies

    Science.gov (United States)

    Guilliams, Mary Elizabeth

    2014-01-01

    This paper is a project report of a policy analysis of state attendance information available to public schools. Current state attendance information rarely expands beyond compulsory attendance law. It is vague, non-existent or difficult to find. Research provides strong links between student attendance and achievement. Informed school leaders…

  14. Molar incisor hypomineralization: proportion and severity in primary public school children in Graz, Austria.

    Science.gov (United States)

    Buchgraber, Barbara; Kqiku, Lumnije; Ebeleseder, Kurt A

    2018-03-01

    The aim of this study was to determine the proportion and severity of molar incisor hypomineralization (MIH) in primary school children in Graz (southeast of Austria). In 1111 children aged 6 to 12 years (mean age 9.0 ± 1.2), a wet examination of all teeth was performed by three trained examiners using a dental chair, optimal illumination, a dental mirror, and a dental explorer. All teeth with MIH lesions were registered so that different definitions of MIH were applicable. According to the European Academy of Pediatric Dentistry criteria that were considered valid at the time of the investigation, MIH was diagnosed when at least one first primary molar (FPM) was affected. MIH was present in 78 children (7.0%). In 64 children (5.8%), at least one molar and one incisor were affected (so-called M + IH). Additionally, in 9 children, only incisors were affected. In 7 affected children, teeth other than FPMs and incisors had MIH lesions. Almost an equal number of males (38) and females (40) were affected. The upper and lower molars were equally affected. The upper incisors were more frequently affected than the lower ones. Demarcated enamel opacities were the predominant types of defects. The proportion of MIH was 7.0% in Graz, which is similar to other comparable trials. This study has proven that MIH is an existing dental problem in Graz.

  15. [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.

  16. Traditional birth attendants in Malawi

    Directory of Open Access Journals (Sweden)

    J. J. M. Smit

    1994-03-01

    Full Text Available Traditional Birth Attendants (TBAs and traditional healers form an important link in the chain of health personnel providing primary health care in Malawi. In spite of the establishment of hospitals and health centres, it is to these traditional healers and TBAs that the majority of people turn in times of sickness and child-birth. Approximately 60 percent of all deliveries in Malawi occur in the villages. It is therefore important that due regard be paid to the activities of these traditional practitioners in order to ensure the achievement of the goal - "Health for all by the year 2000". The training of TBAs is seen as part of the Maternal and Child Health Services in the country.

  17. Traditional birth attendants in Malawi

    Directory of Open Access Journals (Sweden)

    J. J. M. Smit

    1994-05-01

    Full Text Available Traditional Birth Attendants (TBAs and traditional healers form an important link in the chain of health personnel providing primary health care in Malawi. In spite of the establishment of hospitals and health centres, it is to these traditional healers and TBAs that the majority of people turn in times of sickness and child-birth. Approximately 60 percent of all deliveries in Malawi occur in the villages. It is therefore important that due regard be paid to the activities of these traditional practitioners in order to ensure the achievement of the goal - "Health for all by the year 2000". The training of TBAs is seen as part of the Maternal and Child Health Services in the country.

  18. Effective Nutrition Intervention to Treat Children Under 5 Years Old Suffering MAM in Public Primary Health Care Services in El Salvador

    International Nuclear Information System (INIS)

    Sanchez, Ana

    2014-01-01

    Full text: Background: In El Salvador Moderate Acute Malnutrition (MAM) affects less than 1% of children under 5 years old. The importance of MAM has been neglected as a public health issue. Although moderate wasting is not a condition of medical urgency, it can easily deteriorate. If some of these undernourished children with moderate wasting do not receive adequate support, they may progress towards severe acute malnutrition (SAM), defined by the presence of severe wasting and/or bilateral pitting oedema, which is a life-threatening condition. Since 2010, a complementary feeding program for children from 6 to 59 months old was implemented at the primary health clinics for the management of moderate malnutrition. Program was implemented in 100 municipalities identified with the greatest levels of poverty at national level and it consists of a corn-soy fortified flour to be prepared at home as a poudrige given to children during the routine health controls. During the first months of program implementation, an acceptability test was conducted and it was determined that more than 85% of children had good acceptance of the product. The treatment consists of 45 grams per day of complementary food. Mothers were instructed on how to prepare the product and every month they would have to bring their children to the clinic to receive complementary food and control weight gain. If mothers did not attend the control, a health promotion worker would go visit the mother at their home and bring the complementary food to the child. Objective: Assess the results on nutritional status of children under 5 years old with MAM treated with complementary food during health controls at primary health facilities in El Salvador during January to October 2013. Methods: Transversal study. Inclusion criteria was children 6 to 59 months old attending health controls coming from prioritize municipalities, diagnose with MAM by a health professional without other disease or infections that

  19. The extent, quality and impact of patient and public involvement in primary care research: a mixed methods study.

    Science.gov (United States)

    Blackburn, Steven; McLachlan, Sarah; Jowett, Sue; Kinghorn, Philip; Gill, Paramjit; Higginbottom, Adele; Rhodes, Carol; Stevenson, Fiona; Jinks, Clare

    2018-01-01

    In the UK, more patients go to primary care than other parts of the health service. Therefore it is important for research into primary care to include the insights and views of people who receive these services. To explore the extent, quality and impact of patient and public involvement (PPI) in primary care research, we examined documents of 200 projects and surveyed 191 researchers.We found that about half of studies included PPI to develop research ideas and during the study itself. Common activities included designing study materials, advising on methods, and managing the research. Some studies did not undertake the PPI activities initially planned and funded for. PPI varied by study design, health condition and study population. We found pockets of good practice: having a PPI budget, supporting PPI contributors, and PPI informing recruitment issues. However, good practice was lacking in other areas. Few projects offered PPI contributors training, used PPI to develop information for participants about study progress and included PPI to advise on publishing findings.Researchers reported beneficial impacts of PPI. Most impact was reported when the approach to PPI included more indicators of good practice. The main cost of PPI for researchers was their time. Many reported difficulties providing information about PPI.In partnership with PPI contributors, we have used these findings to develop:a new Cost and Consequences Framework for PPI highlighting financial and non-financial costs, benefits and harms of PPIFifteen co-produced recommendations to improve the practice and delivery of PPI. Background: To improve the lives of patients in primary care requires the involvement of service users in primary care research. We aimed to explore the extent, quality and impact of patient and public involvement (PPI) in primary care research. Methods: We extracted information about PPI from grant applications, reports and an electronic survey of researchers of studies funded

  20. 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 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.

  1. Primary care pediatrics and public health: meeting the needs of today's children.

    Science.gov (United States)

    Kuo, Alice A; Etzel, Ruth A; Chilton, Lance A; Watson, Camille; Gorski, Peter A

    2012-12-01

    The proportion of children suffering from chronic illnesses--such as asthma and obesity, which have significant environmental components--is increasing. Chronic disease states previously seen only in adulthood are emerging during childhood, and health inequalities by social class are increasing. Advocacy to ensure environmental health and to protect from the biological embedding of toxic stress has become a fundamental part of pediatrics. We have presented the rationale for addressing environmental and social determinants of children's health, the epidemiology of issues facing children's health, recent innovations in pediatric medical education that have incorporated public health principles, and policy opportunities that have arisen with the passage of the 2010 Patient Protection and Affordable Care Act.

  2. Estimating the unit costs of public hospitals and primary healthcare centers.

    Science.gov (United States)

    Younis, Mustafa Z; Jaber, Samer; Mawson, Anthony R; Hartmann, Michael

    2013-01-01

    Many factors have affected the rise of health expenditures, such as high-cost medical technologies, changes in disease patterns and increasing demand for health services. All countries allocate a significant portion of resources to the health sector. In 2008, the gross domestic product of Palestine was estimated to be at $6.108bn (current price) or about $1697 per capita. Health expenditures are estimated at 15.6% of the gross domestic product, almost as much as those of Germany, Japan and other developed countries. The numbers of hospitals, hospital beds and primary healthcare centers in the country have all increased. The Ministry of Health (MOH) currently operates 27 of 76 hospitals, with a total of 3074 beds, which represent 61% of total beds of all hospitals in the Palestinian Authorities area. Also, the MOH is operating 453 of 706 Primary Health Care facilities. By 2007, about 40 000 people were employed in different sectors of the health system, with 33% employed by the MOH. This purpose of this study was to develop a financing strategy to help cover some or all of the costs involved in operating such institutions and to estimate the unit cost of primary and secondary programs and departments. A retrospective study was carried out on data from government hospitals and primary healthcare centers to identify and analyze the costs and output (patient-related services) and to estimate the unit cost of health services provided by hospitals and PHCs during the year 2008. All operating costs are assigned and allocated to the departments at MOH hospitals and primary health care centers (PPHCs) and are identified as overhead departments, intermediate-service and final-service departments. Intermediate-service departments provide procedures and services to patients in the final-service departments. The costs of the overhead departments are distributed to the intermediate-service and final-service departments through a step-down method, according to allocation

  3. Substance abuse in outpatients attending rural and urban health ...

    African Journals Online (AJOL)

    Substance abuse in outpatients attending rural and urban health centres in Kenya. ... Objectives: To estimate the prevalence and pattern of substance use among patients attending primary health centres in urban and rural areas of Kenya. Design: A ... Socio-cultural factors might be responsible for the differences noted.

  4. [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

  5. Validating the accuracy of GIS-based accessibility analysis in determining public primary health care demand in metropolitan areas: conference presentation

    CSIR Research Space (South Africa)

    Mokgalaka, H

    2014-07-01

    Full Text Available selected for the analysis are mainly those that offered public primary health care services and acted as first point of contact with the health service delivery system. Attached to the facility data are attribute data indicating the capacity...-Based Accessibility Analysis in Determining Public Primary Health Care Demand in Metropolitan Areas Hunadi Mokgalaka July 2014 Contents • Service access planning • GIS-based accessibility analysis • Key challenges to application • Methodology...

  6. Poor blood pressure control and its associated factors among older people with hypertension: A cross-sectional study in six public primary care clinics in Malaysia

    Directory of Open Access Journals (Sweden)

    Cheong Ai Theng

    2015-07-01

    Full Text Available Hypertension is highly prevalent in the older people. Chronic disease care is a major burden in the public primary care clinics in Malaysia. Good blood pressure (BP control is needed to reduce the morbidity and mortality of cardiovascular disease (CVD. This study aimed to determine the status of BP control and its associated factors among older people with hypertension in public primary care clinics.

  7. Publicity.

    Science.gov (United States)

    Chisholm, Joan

    Publicity for preschool cooperatives is described. Publicity helps produce financial support for preschool cooperatives. It may take the form of posters, brochures, newsletters, open house, newspaper coverage, and radio and television. Word of mouth and general good will in the community are the best avenues of publicity that a cooperative nursery…

  8. Junior Primary Greek School Pupils' Perceptions of the City's Public Open Spaces and Especially of the Urban Square: A Case Study

    Science.gov (United States)

    Papageorgiou, Nikoletta; Galani, Apostolia; Mavrikaki, Evangelia

    2016-01-01

    This work--part of a wider project aimed at engaging first year primary school pupils in public open-space design--explores the perceptions of junior primary school children as to the urban square. Data collection tools comprised semi-structured interviews, sketches and storytelling via puppet-animation. Our findings have shown that--according to…

  9. Preventive care delivered within Public Dental Service after caries risk assessment of young adults

    DEFF Research Database (Denmark)

    Hänsel Petersson, G; Ericson, E; Twetman, S

    2016-01-01

    OBJECTIVES: To study preventive care provided to young adults in relation to their estimated risk category over a 3-year period. METHODS: The amount and type of preventive treatment during 3 years was extracted from the digital dental records of 982 patients attending eight public dental clinics...... adults attending public dental service. Further research is needed how to reach those with the greatest need of primary and secondary prevention....

  10. 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 ...

  11. 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.

  12. Public Health England's Migrant Health Guide: an online resource for primary care practitioners.

    Science.gov (United States)

    Crawshaw, A F; Kirkbride, H

    2018-05-01

    Approximately 13% of the UK population in 2015 was born overseas. Most migrants have come to the UK to work or study although there has been a small increase in the number of asylum applications in the UK in recent years, reflective of the ongoing humanitarian situation across Europe. Migrants in the UK tend to be young and healthy, but some may face unique health needs as a result of their experiences before, during and after migration. For these needs to be appropriately recognised and addressed, evidence-based advice is needed for UK professionals. The Migrant Health Guide is a free online tool for healthcare professionals. It was launched in 2011 and is widely used in the UK and internationally. It has four sections: 1) Migrants and the NHS-information on access and entitlements to the National Health Service (NHS); 2) Assessing patients-includes a checklist for initial healthcare assessments and advice for patients travelling abroad to visit friends and relatives; 3) Countries-country-specific advice on infectious diseases, women's health and nutritional and metabolic concerns; and 4) Health topics-information about communicable and non-communicable diseases and other health issues. The guide has undergone an extensive update in 2017. In particular, the pages on mental health and human trafficking have been expanded. A formal evaluation will obtain feedback on the guide and measure changes in awareness, knowledge, opinions, attitudes and behaviour of end users. Findings will inform future revisions and updates to the guide. Public Health England's Migrant Health Guide is a valuable resource for healthcare professionals. The relaunched guide builds on the previous version in raising awareness of key issues and providing evidence-based advice to improve the health of migrants and refugees internationally and in the UK. Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.

  13. 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.

  14. 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.

  15. Where There Are (Few) Skilled Birth Attendants

    Science.gov (United States)

    Prata, Ndola; Rowen, Tami; Bell, Suzanne; Walsh, Julia; Potts, Malcolm

    2011-01-01

    Recent efforts to reduce maternal mortality in developing countries have focused primarily on two long-term aims: training and deploying skilled birth attendants and upgrading emergency obstetric care facilities. Given the future population-level benefits, strengthening of health systems makes excellent strategic sense but it does not address the immediate safe-delivery needs of the estimated 45 million women who are likely to deliver at home, without a skilled birth attendant. There are currently 28 countries from four major regions in which fewer than half of all births are attended by skilled birth attendants. Sixty-nine percent of maternal deaths in these four regions can be attributed to these 28 countries, despite the fact that these countries only constitute 34% of the total population in these regions. Trends documenting the change in the proportion of births accompanied by a skilled attendant in these 28 countries over the last 15-20 years offer no indication that adequate change is imminent. To rapidly reduce maternal mortality in regions where births in the home without skilled birth attendants are common, governments and community-based organizations could implement a cost-effective, complementary strategy involving health workers who are likely to be present when births in the home take place. Training community-based birth attendants in primary and secondary prevention technologies (e.g. misoprostol, family planning, measurement of blood loss, and postpartum care) will increase the chance that women in the lowest economic quintiles will also benefit from global safe motherhood efforts. PMID:21608417

  16. Cost of Delivering Health Care Services in Public Sector Primary and Community Health Centres in North India.

    Science.gov (United States)

    Prinja, Shankar; Gupta, Aditi; Verma, Ramesh; Bahuguna, Pankaj; Kumar, Dinesh; Kaur, Manmeet; Kumar, Rajesh

    2016-01-01

    With the commitment of the national government to provide universal healthcare at cheap and affordable prices in India, public healthcare services are being strengthened in India. However, there is dearth of cost data for provision of health services through public system like primary & community health centres. In this study, we aim to bridge this gap in evidence by assessing the total annual and per capita cost of delivering the package of health services at PHC and CHC level. Secondly, we determined the per capita cost of delivering specific health services like cost per antenatal care visit, per institutional delivery, per outpatient consultation, per bed-day hospitalization etc. We undertook economic costing of fourteen public health facilities (seven PHCs and CHCs each) in three North-Indian states viz., Haryana, Himachal Pradesh and Punjab. Bottom-up costing method was adopted for collection of data on all resources spent on delivery of health services in selected health facilities. Analysis was undertaken using a health system perspective. The joint costs like human resource, capital, and equipment were apportioned as per the time value spent on a particular service. Capital costs were discounted and annualized over the estimated life of the item. Mean annual costs and unit costs were estimated along with their 95% confidence intervals using bootstrap methodology. The overall annual cost of delivering services through public sector primary and community health facilities in three states of north India were INR 8.8 million (95% CI: 7,365,630-10,294,065) and INR 26.9 million (95% CI: 22,225,159.3-32,290,099.6), respectively. Human resources accounted for more than 50% of the overall costs at both the level of PHCs and CHCs. Per capita per year costs for provision of complete package of preventive, curative and promotive services at PHC and CHC were INR 170.8 (95% CI: 131.6-208.3) and INR162.1 (95% CI: 112-219.1), respectively. The study estimates can be used

  17. Overt Primary Hypothyroidism in an Industrial Area in São Paulo, Brazil: The Impact of Public Disclosure

    Directory of Open Access Journals (Sweden)

    Maria Angela Zaccarelli-Marino

    2016-11-01

    Full Text Available Background: Primary hypothyroidism (PH is the most common thyroid pathology. Purpose: to evaluate the impact of public disclosure of an unexpected number of PH cases on the frequency of patients seeking medical evaluation for endocrinological diseases. Methods: data on 6306 subjects (3356 living in the surroundings of a petrochemical complex and 2950 in a control region were collected over a 15-year time span. Thyroid function was determined by serum levels of triiodothyronine, thyroxine, free thyroxine and thyrotrophin. Antithyroglobulin and antithyroperoxidase antibodies and sonographic scans of the thyroid were performed in all patients. The data were analyzed via log-linear models to compute odds and odds ratios. Results: An increasing trend in the odds of PH was detected along the observation period with greater slope in the study region than in the control region. The odds of PH in the post-disclosure period (2002 to 2004 are greater than the corresponding ones in the pre-disclosure period (1989 to 2001. Conclusions: This study shows that living in the surroundings of a petrochemical complex may be an important risk factor for PH for both adults and children. Furthermore, public disclosure of such risk factor contributes to the awareness of the problem and to the possibility of an early diagnosis.

  18. Overt Primary Hypothyroidism in an Industrial Area in São Paulo, Brazil: The Impact of Public Disclosure.

    Science.gov (United States)

    Zaccarelli-Marino, Maria Angela; Saldiva André, Carmen Diva; Singer, Julio M

    2016-11-22

    Background : Primary hypothyroidism (PH) is the most common thyroid pathology. Purpose : to evaluate the impact of public disclosure of an unexpected number of PH cases on the frequency of patients seeking medical evaluation for endocrinological diseases. Methods : data on 6306 subjects (3356 living in the surroundings of a petrochemical complex and 2950 in a control region) were collected over a 15-year time span. Thyroid function was determined by serum levels of triiodothyronine, thyroxine, free thyroxine and thyrotrophin. Antithyroglobulin and antithyroperoxidase antibodies and sonographic scans of the thyroid were performed in all patients. The data were analyzed via log-linear models to compute odds and odds ratios. Results : An increasing trend in the odds of PH was detected along the observation period with greater slope in the study region than in the control region. The odds of PH in the post-disclosure period (2002 to 2004) are greater than the corresponding ones in the pre-disclosure period (1989 to 2001). Conclusions : This study shows that living in the surroundings of a petrochemical complex may be an important risk factor for PH for both adults and children. Furthermore, public disclosure of such risk factor contributes to the awareness of the problem and to the possibility of an early diagnosis.

  19. factors associated with late antenatal care attendance in selected

    African Journals Online (AJOL)

    Esem

    perception of no benefits derived from commencement of ... despite efforts to reverse the trend. ..... Table 4: Predictors of Late ANC attendance in Mpongwe and Ndola-logistic regression .... Institutional and Public Policy Factors Associated.

  20. Determinants of Healthcare Utilisation and Out-of-Pocket Payments in the Context of Free Public Primary Healthcare in Zambia

    Directory of Open Access Journals (Sweden)

    Felix Masiye

    2016-12-01

    Full Text Available Background Access to appropriate and affordable healthcare is needed to achieve better health outcomes in Africa. However, access to healthcare remains low, especially among the poor. In Zambia, poor access exists despite the policy by the government to remove user fees in all primary healthcare facilities in the public sector. The paper has two main objectives: (i to examine the factors associated with healthcare choices among sick people, and (ii to assess the determinants of the magnitude of out-of-pocket (OOP payments related to a visit to a health provider. Methods This paper employs a multilevel multinomial logistic regression to model the determinants of an individual’s choice of healthcare options following an illness. Further, the study analyses the drivers of the magnitude of OOP expenditure related to a visit to a health provider using a two-part generalised linear model. The analysis is based on a nationally representative healthcare utilisation and expenditure survey that was conducted in 2014. Results Household per capita consumption expenditure is significantly associated with increased odds of seeking formal care (odds ratio [OR] = 1.12, P = .000. Living in a household in which the head has a higher level of education is associated with increased odds of seeking formal healthcare (OR = 1.54, P = .000 and (OR = 1.55, P = .01, for secondary and tertiary education, respectively. Rural residence is associated with reduced odds of seeking formal care (OR = 0.706, P = .002. The magnitude of OOP expenditure during a visit is significantly dependent on household economic wellbeing, distance from a health facility, among other factors. A 10% increase in per capita consumption expenditure was associated with a 0.2% increase in OOP health expenditure while every kilometre travelled was associated with a K0.51 increase in OOP health expenditure. Conclusion Despite the removal of user fees on public primary healthcare in Zambia, access to

  1. 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

  2. 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 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.

  3. The impact of a lay counselor led collaborative care intervention for common mental disorders in public and private primary care: a qualitative evaluation nested in the MANAS trial in Goa, India.

    Science.gov (United States)

    Shinde, Sachin; Andrew, Gracy; Bangash, Omer; Cohen, Alex; Kirkwood, Betty; Patel, Vikram

    2013-07-01

    satisfaction with care in patients with CMD attending primary care clinics although the impact, compared with usual care, is greater in the public sector. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

  4. Scientific publications on primary biliary cirrhosis from 2000 through 2010: an 11-year survey of the literature.

    Directory of Open Access Journals (Sweden)

    Baodong Qin

    Full Text Available BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.

  5. 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.

  6. 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…

  7. Primary care and public health a natural alliance? The introduction of the guidelines for obesity and undernutrition of the Dutch College of General Practitioners.

    Science.gov (United States)

    van Avendonk, Mariëlle J P; Mensink, Paul A J S; Drenthen, A J M Ton; van Binsbergen, Jaap J

    2012-04-01

    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. But in the field of nutrition and other lifestyle-related interventions, there are many direct and indirect interfaces for over- as well as undernutrition. The Dutch College of General Practitioners (NHG) published the Practice Guideline Obesity in adults and children to lead GPs in this process and to bridge the gap with public health. The same applies for the recently published National Primary Care Cooperation Agreement Undernutrition on the collaboration of primary care workers to enhance awareness and early intervention in case of nutritional impairment. This article goes into the background as well as the content of these two NHG products and the implications for daily practice. An attempt is made to connect primary care and public health in this matter. Particularly in the case of obesity, a close relationship with public health is of vital importance.

  8. 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...

  9. Attitudes toward epilepsy among the primary and secondary school teachers in Malaysia, using the public attitudes toward epilepsy (PATE) scale.

    Science.gov (United States)

    Lim, Kheng Seang; Hills, Michael D; Choo, Wan Yuen; Wong, Mee Hoo; Wu, Cathie; Tan, Chong Tin

    2013-10-01

    There is a lack of study comparing the attitudes toward epilepsy between the teachers and general population, teachers and students, using a similar quantitative scale. This study was performed in one primary and one secondary school in Kuala Lumpur, Malaysia, using the Public Attitudes Toward Epilepsy (PATE) scale. A total of 186 teachers aged 39.6±10.4 years completed the questionnaire. The mean scores in both personal and general domains of PATE scale were significantly better in the teachers, comparing to the scores in the secondary and college students reported in previous study (Lim et al., 2013; pjob, rather than tertiary education generally. Subanalysis showed that the attitudes of teachers were significantly better than the general population and the students related to employment and social life, but were equally negative on issues directly related to education, such as placing children with epilepsy in regular classes. Teachers had more positive attitudes toward epilepsy as compared with the general population with tertiary education. Attitude to epilepsy may differ specific to types of work. Copyright © 2013 Elsevier B.V. All rights reserved.

  10. 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…

  11. 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…

  12. Depression during pregnancy: prevalence and risk factors among women attending a public health clinic in Rio de Janeiro, Brazil Depressão durante a gravidez: prevalência e fatores de risco em mulheres atendidas em uma unidade básica de saúde na cidade do Rio de Janeiro, Brasil

    Directory of Open Access Journals (Sweden)

    Priscila Krauss Pereira

    2009-12-01

    Full Text Available Depression is the most prevalent psychiatric disorder during pregnancy and is associated with psychosocial and clinical obstetric factors. Despite being an important public health issue, there are few studies about this issue in Brazil. A cross-sectional study was carried out, involving 331 pregnant women attending a public primary health service over a one-year period in Rio de Janeiro city, Brazil. Participants were interviewed about their socio-demographic status, obstetric/medical conditions, life events and violence during pregnancy. Depression was assessed using the Composite International Development Interview. The prevalence of depression during pregnancy was 14.2% (95%CI: 10.7-18.5 and associated factors included: previous history of depression and any psychiatric treatment, unplanned pregnancy, serious physical illness and casual jobs. These data emphasize the need for screening for depression and its risk factors during pregnancy in settings where care is available. Psychosocial interventions and social policies need to be devised for this population.A depressão é o transtorno mental de maior prevalência durante a gravidez e está associada a fatores psicossociais e clínicos/obstétricos. Apesar de ser uma importante questão de Saúde Pública, há poucos estudos sobre o tema no Brasil. Trata-se de um estudo seccional com 331 gestantes atendidas durante o período de um ano na cidade do Rio de Janeiro, Brasil. As participantes foram entrevistadas sobre características sócio-demográficas, condições médicas/obstétricas, eventos estressantes e violência durante a gravidez. A depressão foi avaliada através do Composite International Diagnostic Interview (CIDI. A prevalência da depressão na gravidez foi 14,2% (IC95%: 10,7-18,5, sendo os fatores associados: história anterior de depressão e de tratamento psiquiátrico, gravidez não-planejada, problema físico grave e trabalho informal. Os resultados reforçam a

  13. 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.

  14. Perfil do paciente com ceratopatia bolhosa pós-facectomia atendidos em hospital público Profile of patient with aphakic/pseudopfakic bullous keratopaty attended at public hospital

    Directory of Open Access Journals (Sweden)

    Marcony Rodrigues de Santhiago

    2009-08-01

    Full Text Available Objetivo: Identificar e analisar criticamente o perfil dos pacientes com ceratopatia bolhosa atendidos em um hospital municipal. Métodos: Foi realizada análise retrospectiva de 35 olhos de 35 pacientes em acompanhamento no setor de córnea e doenças externas do Hospital da Piedade, que apresentavam ceratopatia bolhosa pós-facectomia. Foram excluídos aqueles onde não se conseguiu determinar características pré e per-operatórias fundamentais em nossa pesquisa. Esta seleção de pacientes foi realizada durante o período de janeiro de 2007 a junho de 2007. Resultados: Como principais resultadosobservou-se que a ceratopatia bolhosa ocorreu em 22.86 % (8 olhos dos casos pós-facectomia extracapsular (FEC e 74.28 % (26 olhos pós- facoemulsificação. Em 25.71 % (9 olhos foi documentado rotura de cápsula posterior (RCP com perda vítrea. Em 94.29 % (33 olhos a lente intraocular se localizava na câmara posterior, e dois pacientes estavam afácicos. A acuidade visual de todos os pacientes era pior que 20/200. O tempo médio de evolução entre a facectomia e o diagnostico de ceratopatia bolhosa foi 11,93 meses (1 - 44 meses. Conclusão: A análise adequada do endotélio corneano é condição essencial para o sucesso da cirurgia de catarata com transparência corneal, e que a ceratopatia bolhosa parece estar mais associada à facoemulsificação. Esta informação deve ser interpretada com cautela, já que esta relação pode vir do maior numero de facoemulsificações realizadas no Hospital onde foi realizado o estudo e muitas destas por cirurgiões em treinamento.Objective: Analyze and identify critically the profile of patients with aphakic/pseudophakic bullous keratopathy attended at a public hospital. Methods: Retrospective analysis of 35 eyes of 35 patients with diagnosis of bullous keratopathy, which has been followed in the department of cornea and external diseases of Hospital da Piedade. The one whose pre and per operative data we

  15. What systemic factors contribute to collaboration between primary care and public health sectors? An interpretive descriptive study.

    Science.gov (United States)

    Wong, Sabrina T; MacDonald, Marjorie; Martin-Misener, Ruth; Meagher-Stewart, Donna; O'Mara, Linda; Valaitis, Ruta K

    2017-12-01

    Purposefully building stronger collaborations between primary care (PC) and public health (PH) is one approach to strengthening primary health care. The purpose of this paper is to report: 1) what systemic factors influence collaborations between PC and PH; and 2) how systemic factors interact and could influence collaboration. This interpretive descriptive study used purposive and snowball sampling to recruit and conduct interviews with PC and PH key informants in British Columbia (n = 20), Ontario (n = 19), and Nova Scotia (n = 21), Canada. Other participants (n = 14) were knowledgeable about collaborations and were located in various Canadian provinces or working at a national level. Data were organized into codes and thematic analysis was completed using NVivo. The frequency of "sources" (individual transcripts), "references" (quotes), and matrix queries were used to identify potential relationships between factors. We conducted a total of 70 in-depth interviews with 74 participants working in either PC (n = 33) or PH (n = 32), both PC and PH (n = 7), or neither sector (n = 2). Participant roles included direct service providers (n = 17), senior program managers (n = 14), executive officers (n = 11), and middle managers (n = 10). Seven systemic factors for collaboration were identified: 1) health service structures that promote collaboration; 2) funding models and financial incentives supporting collaboration; 3) governmental and regulatory policies and mandates for collaboration; 4) power relations; 5) harmonized information and communication infrastructure; 6) targeted professional education; and 7) formal systems leaders as collaborative champions. Most themes were discussed with equal frequency between PC and PH. An assessment of the system level context (i.e., provincial and regional organization and funding of PC and PH, history of government in successful implementation of health care reform, etc) along

  16. Dental pain and dental treatment of young children attending the general dental service.

    Science.gov (United States)

    Milsom, K M; Tickle, M; Blinkhorn, A S

    2002-03-09

    The objective was to examine the relationship between dental pain (and its sequelae), and the extent of restorative care provided for primary molars, amongst children who regularly attend a general dental practitioner. A retrospective review of the clinical case notes of 677 children with caries who attended 50 general dental practitioners on a regular basis. Analyses were performed at the subject level. Logistic regression models were fitted for the dependent variables whether or not pain, a dental extraction for pain or sepsis and a course of antibiotics was recorded, after taking into account the proportion of carious teeth that were restored, the total number of carious teeth, the age caries was first recorded, gender and the clustering of the subjects within dental practices. Almost half of the children in the study (48%) were recorded as having at least one episode of pain. Total decay experience in the primary molars was a significant predictor of pain, extraction due to pain or sepsis and prescription of antibiotics. There was no significant association between the proportion of carious teeth restored and each of the three dependent variables. For those children who regularly attend their general dental practitioner and who have decay in their primary molars, dental pain is a common finding. Total decay experience in primary molars is the principal predictor of pain, extraction due to pain and the need for antibiotics, whilst the level of restorative care in the primary dentition is less important. In order to reduce the incidence of dental pain in young children, effective methods of preventing caries at the individual and public health levels need to be expanded.

  17. 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…

  18. Parents, Quality, and School Choice: Why Parents in Nairobi Choose Low-Cost Private Schools over Public Schools in Kenya's Free Primary Education Era

    Science.gov (United States)

    Zuilkowski, Stephanie Simmons; Piper, Benjamin; Ong'ele, Salome; Kiminza, Onesmus

    2018-01-01

    Low-cost private schools (LCPS) are widespread in Kenya, particularly in urban areas. This study examines the reasons that parents send children to fee-charging schools in a context of free public primary education. Drawing on parent survey and interview data, as well as interviews with national policy makers, we found that parents who chose LCPS…

  19. 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

  20. 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

  1. 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

    OpenAIRE

    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

    2013-01-01

    Background:\\ud 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 considere...

  2. 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

  3. 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)

    2013-01-01

    Background 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. Methods/Design 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

  4. Influenza sentinel surveillance network: a public health-primary care collaborative action to assess influenza A(H1N1)pmd09 in Catalonia, Spain.

    Science.gov (United States)

    Torner, Nuria; Baricot, Maretva; Martínez, Ana; Toledo, Diana; Godoy, Pere; Dominguez, Ángela

    2013-03-01

    The aim of this study was to evaluate the outcome of a collaborative action between Public Health services and Primary Care in the context of a case-control study on effectiveness of pharmaceutical and non-pharmaceutical measures to prevent hospitalization in a pandemic situation. To carry out this research the collaborative action of the primary care physicians members of the Influenza surveillance network was needed, they had to recall clinical information from influenza A(H1N1)pmd09 confirmed outpatient cases and negative outpatient controls matching their corresponding hospitalized confirmed case.   A survey questionnaire to assess involvement of Influenza Sentinel Surveillance Primary care physicians' Network of Catalonia (PIDIRAC) regarding the outpatient case and control outreach during the pandemic influenza season was performed. A total of 71,1% of completed surveys were received. Perception of pandemic activity was considered to be similar to seasonal influenza activity in 43.8% or higher but not unbearable in 37.5% of the replies. There was no nuisance reported from patients regarding neither the questions nor the surveyor. Collaborative research between Public Health services and Primary Care physicians enhances Public Health actions and research.

  5. Providing Family Planning Services at Primary Care Organizations after the Exclusion of Planned Parenthood from Publicly Funded Programs in Texas: Early Qualitative Evidence.

    Science.gov (United States)

    White, Kari; Hopkins, Kristine; Grossman, Daniel; Potter, Joseph E

    2017-10-20

    To explore organizations' experiences providing family planning during the first year of an expanded primary care program in Texas. Between November 2014 and February 2015, in-depth interviews were conducted with program administrators at 30 organizations: 7 women's health organizations, 13 established primary care contractors (e.g., community health centers, public health departments), and 10 new primary care contractors. Interviews addressed organizational capacities to expand family planning and integrate services with primary care. Interview transcripts were analyzed using a theme-based approach. Themes were compared across the three types of organizations. Established and new primary care contractors identified several challenges expanding family planning services, which were uncommon among women's health organizations. Clinicians often lacked training to provide intrauterine devices and contraceptive implants. Organizations often recruited existing clients into family planning services, rather than expanding their patient base, and new contractors found family planning difficult to integrate because of clients' other health needs. Primary care contractors frequently described contraceptive provision protocols that were not evidence-based. Many primary care organizations in Texas initially lacked the capacity to provide evidence-based family planning services that women's health organizations already provided. © Health Research and Educational Trust.

  6. The Zulu traditional birth attendant

    African Journals Online (AJOL)

    Some of the important practices of Zulu traditional birth attendants ... the people as regards pregnancy and labour. This article docu- .... into account previous perinatal deaths. ... They were either widows or married to husbands unable to work.

  7. A Case Study on Primary, Secondary and University Students' Environmentally Responsible Behaviors in Turkey

    Science.gov (United States)

    Kahyaoglu, Mustafa

    2013-01-01

    The purpose of the study is to prove the environmentally responsible behaviors of primary, secondary and university students in Turkey. The students', who attended the study as participants, environmentally political behaviors, consumer/economical behaviors, direct behaviors toward protecting the environment and individual and public persuasion…

  8. Commentary on "Finance, Management, and Costs of Public and Private Schools in Indonesia" and "Do Local Contributions Affect the Efficiency of Public Primary Schools?"

    Science.gov (United States)

    Berger, Mark C.

    1996-01-01

    Studies on Indonesia and the Philippines in this special issue examine how local financial control affects costs of providing primary schooling. In both countries, schools with greater financial decentralization operated more efficiently. These results have important implications for U.S. schools, where decentralization reforms in Kentucky and…

  9. 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.

  10. Primary care characteristics and their association with health screening in a low-socioeconomic status public rental-flat population in Singapore- a mixed methods study.

    Science.gov (United States)

    Wee, Liang En; Cher, Wen Qi; Sin, David; Li, Zong Chen; Koh, Gerald Choon-Huat

    2016-02-06

    In Singapore, subsidized primary care is provided by centralized polyclinics; since 2000, policies have allowed lower-income Singaporeans to utilize subsidies at private general-practitioner (GP) clinics. We sought to determine whether proximity to primary care, subsidised primary care, or having regular primary care associated with health screening participation in a low socioeconomic-status public rental-flat community in Singapore. From 2009-2014, residents in five public rental-flat enclaves (N = 936) and neighboring owner-occupied precincts (N = 1060) were assessed for participation in cardiovascular and cancer screening. We then evaluated whether proximity to primary care, subsidised primary care, or having regular primary care associated with improved adherence to health screening. We also investigated attitudes to health screening using qualitative methodology. In the rental flat population, for cardiovascular screening, regular primary care was independently associated with regular diabetes screening (adjusted odds ratio, aOR = 1.59, CI = 1.12-2.26, p = 0.009) and hyperlipidemia screening (aOR = 1.82, CI = 1.10-3.04, p = 0.023). In the owner-occupied flats, regular primary care was independently associated with regular hypertension screening (aOR = 9.34 (1.82-47.85, p = 0.007), while subsidized primary care was associated with regular diabetes screening (aOR = 2.94, CI = 1.04-8.31, p = 0.042). For cancer screening, in the rental flat population, proximity to primary care was associated with less participation in regular colorectal cancer screening (aOR = 0.42, CI = 0.17-0.99, p = 0.049) and breast cancer screening (aOR = 0.29, CI = 0.10-0.84, p = 0.023). In the owner-occupied flat population, for gynecological cancer screening, usage of subsidized primary care and proximity to primary care was associated with higher rates of breast cancer and cervical cancer screening; however

  11. How common is multiple general practice attendance in Australia?

    Science.gov (United States)

    Wright, Michael; Hall, Jane; van Gool, Kees; Haas, Marion

    2018-05-01

    Australians can seek general practice care from multiple general practitioners (GPs) in multiple locations. This provides high levels of patient choice but may reduce continuity of care. The aim of this study was to estimate the prevalence of attendance at multiple general practices in Australia, and identify patient characteristics associated with multiple practice attendances. A cross-sectional survey of 2477 Australian adults was conducted online in July 2013. Respondents reported whether they had attended more than one general practice in the past year, and whether they had a usual general practice and GP. Demographic information, health service use and practice characteristics were also obtained from the survey. Over one-quarter of the sample reported attending more than one practice in the previous year. Multiple practice attendance is less common with increasing age, and less likely for survey respondents from regional Australia, compared with respondents from metropolitan areas. Multiple practice attenders are just as likely as single practice attenders to have a usual GP. A significant proportion of general practice care is delivered away from usual practices. This may have implications for health policy, in terms of continuity and quality of primary care.

  12. 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…

  13. From primary care to public health: using Problem-based Learning and the ecological model to teach public health to first year medical students.

    Science.gov (United States)

    Hoover, Cora R; Wong, Candice C; Azzam, Amin

    2012-06-01

    We investigated whether a public health-oriented Problem-Based Learning case presented to first-year medical students conveyed 12 "Population Health Competencies for Medical Students," as recommended by the Association of American Medical Colleges and the Regional Medicine-Public Health Education Centers. A public health-oriented Problem-Based Learning case guided by the ecological model paradigm was developed and implemented among two groups of 8 students at the University of California, Berkeley-UCSF Joint Medical Program, in the Fall of 2010. Using directed content analysis, student-generated written reports were coded for the presence of the 12 population health content areas. Students generated a total of 29 reports, of which 20 (69%) contained information relevant to at least one of the 12 population health competencies. Each of the 12 content areas was addressed by at least one report. As physicians-in-training prepare to confront the challenges of integrating prevention and population health with clinical practice, Problem-Based Learning is a promising tool to enhance medical students' engagement with public health.

  14. A systematic tale of two differing reviews: evaluating the evidence on public and private sector quality of primary care in low and middle income countries.

    Science.gov (United States)

    Coarasa, Jorge; Das, Jishnu; Gummerson, Elizabeth; Bitton, Asaf

    2017-04-12

    Systematic reviews are powerful tools for summarizing vast amounts of data in controversial areas; but their utility is limited by methodological choices and assumptions. Two systematic reviews of literature on the quality of private sector primary care in low and middle income countries (LMIC), published in the same journal within a year, reached conflicting conclusions. The difference in findings reflects different review methodologies, but more importantly, a weak underlying body of literature. A detailed examination of the literature cited in both reviews shows that only one of the underlying studies met the gold standard for methodological robustness. Given the current policy momentum on universal health coverage and primary health care reform across the globe, there is an urgent need for high quality empirical evidence on the quality of private versus public sector primary health care in LMIC.

  15. 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.

  16. Longitudinal analysis of HIV risk behaviour patterns and their predictors among public primary care patients with tuberculosis in South Africa.

    Science.gov (United States)

    Peltzer, Karl

    2018-12-01

    The goal of this study was to identify various HIV risk behaviours among tuberculosis (TB) patients in a longitudinal study design in South Africa. In 42 public primary healthcare facilities in three districts in three provinces, adult new TB and TB retreatment patients with hazardous or harmful alcohol use were interviewed within 1 month of initiation of anti-TB treatment and were followed up at 6 months. The total sample with a complete 6-month follow-up assessment was 853. At the follow-up assessment, several HIV risk behaviours significantly reduced from baseline to follow-up. In multivariate Generalized Estimating Equations logistic regression analyses, high poverty (odds ratio (OR): 2.68, 95% confidence interval (CI): 1.56-4.62), Posttraumatic Stress Disorder (PTSD) symptoms (OR = 1.55, 95% CI = 1.03-2.36), and sexual partner on antiretroviral therapy (ART) (OR = 1.84, 95% CI = 1.09-3.10) were associated with a higher odds, and excellent/very good perceived health status (OR: 0.61, 95% CI: 0.37-0.98), severe psychological stress (OR = 0.51, 95% CI = 0.34-0.77), and HIV non-disclosure to most recent sexual partner (OR = 0.40, 95% CI = 0.25-0.65) were associated with a lower odds of inconsistent condom use. Being HIV positive (OR = 4.18, 95% CI = 2.68-6.53) and excellent/very subjective health status (OR = 2.98, 95% CI = 1.73-5.13) were associated with a higher odds, and having PTSD symptoms (OR = 0.60, 95% CI = 0.36-0.99), being on ART (OR = 0.48, 95% CI = 0.25-0.95), having a sexual partner on ART (OR = 0.41, 95% CI = 0.18-0.96), and HIV status non-disclosure (OR = 0.25, 95% CI = 0.15-0.41) were associated with a lower odds of having sex with an HIV-positive or HIV status unknown person. High poverty index (OR = 1.97, 95% CI = 1.19-3.25) and having a sexual partner on ART (OR = 4.37, 95% CI = 1.82-10.48) were associated with a higher odds, and having a partner with

  17. Flight Attendant Fatigue: A Quantitative Review of Flight Attendant Comments

    Science.gov (United States)

    2011-10-01

    Hellesoy, 1994; Hunt & Space, 1994; Nagda & Koontz , 2003; Nesthus et al., 2007; Rayman, 1997; Smolensky, Lee, Mott, & Colligan, 1982; Tashkin...www.boeing. com/commercial/cabinair/ventilation.pdf Nagda, N.L., & Koontz , M.D. (2003). Review of studies on flight attendant health and comfort in

  18. 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…

  19. 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…

  20. 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…

  1. 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…

  2. English Language Teaching in Public Primary Schools in Mexico: The Practices and Challenges of Implementing a National Language Education Program

    Science.gov (United States)

    Ramírez Romero, José Luis; Sayer, Peter; Pamplón Irigoyen, Elva Nora

    2014-01-01

    Over the past 15?years, many state governments in Mexico have initiated local programs to introduce English at the primary school level. In 2009, the Mexican Ministry of Education formalized the "Programa Nacional de Inglés en Educación Básica" (PNIEB) as part of the national curriculum, based on the argument that increasing the number…

  3. GIS-based accessibility analysis: An 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...

  4. 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...

  5. Church Attendance and Religious Experience

    Directory of Open Access Journals (Sweden)

    Marianne Nilsen Kvande

    2015-10-01

    Full Text Available Previous studies have shown that gender may moderate the relationship between religiousness and mental health in most countries, but few studies have been conducted in Norway and Denmark. This study examined gender differences in religious experiences and church attendance as predictors of existential well-being among 295 women and 233 men from the general Norwegian population. Analyses showed that the structural equation models for women and men did not differ significantly on the global level. The models for women and men, however, showed different patterns. Among men, church attendance and negative religious experiences predicted existential well-being; among women, positive and negative religious experiences were related to existential well-being, but church attendance was not. The present findings suggest that men may benefit more from active religiousness, whereas women may benefit more from affective religiousness. Comparing these results with research in other cultural contexts, we find that different operationalizations of church attendance yield the same types of patterns across cultural contexts. Consequently, the benefits of religiousness may be similar for women and men irrespective of cultural context.

  6. Attendance Policies and Student Grades

    Science.gov (United States)

    Risen, D. Michael

    2007-01-01

    The details described in this case study examine the issues related to attendance policies and how such policies might be legally used to affect student grades. Concepts discussed should cause graduate students in educational administration to reflect on the issues presented from various points of view when the students complete an analysis of the…

  7. 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.

  8. 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.

    Science.gov (United States)

    Weinreich, Stephanie S; de Lange-de Klerk, Elly Sm; Rijmen, Frank; Cornel, Martina C; de Kinderen, Marja; Plass, Anne Marie C

    2009-09-15

    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. 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. 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 Perceived behavioural control, i.e. the feeling that they could actually get tested if they wanted to, increased in the targeted age group of 18-45 years (N = 41; p ethnic groups was positive, yet they did not show strong intention to effectuate carrier testing of their patients on the basis of ethnicity. The main factor which explained their (lack of) intention was social norm, i.e. their perception of negative peer opinion (41% variance explained). The majority of primary health care providers felt that policy change was

  9. Kindergarten attendance may reduce developmental impairments in children: results from the Bavarian Pre-School Morbidity Survey.

    Science.gov (United States)

    Caniato, Riccardo N; Alvarenga, Marlies E; Stich, Heribert L; Jansen, Holger; Baune, Berhard T

    2010-08-01

    The relative risks and benefits of children attending kindergarten or pre-school remain uncertain and controversial. We used data from the Bavarian Pre-School Morbidity Survey (BPMS) to look at the prevalence of developmental impairments in pre-school children entering primary school and to assess if these were correlated with the duration of kindergarten attendance. We collected data from all school beginners in the district of Dingolfing, Bavaria from 2004 to 2007 (n = 4,005) and utilised a retrospective cross-sectional study design to review the information. The children were assessed for motor, cognitive, language and psychosocial impairments using a standardized medical assessment. Point prevalence of impairments of speech, cognition, motor functioning and psychosocial functioning were compared by chi(2)-test for the variable of time spent in kindergarten. We detected a high incidence of impairments, with boys showing higher rates than girls in all the areas assessed. Longer length of time spent in kindergarten was associated with reduced rates of motor, cognitive and psychosocial impairments. There was no clear correlation between length of kindergarten attendance and speech disorders. Kindergarten attendance may have a positive effect on a number of domains of development including motor, cognitive and psychosocial development, but no significant effect on speech impairments. Implications for public health policies are discussed.

  10. Validating the accuracy of GIS-based accessibility analysis in determining public primary health care demand in Metropolitan areas

    CSIR Research Space (South Africa)

    Mokgalaka, H

    2014-07-01

    Full Text Available dual system made up of private and public health care facilities. Private PHC is expensive and only affordable to affluent citizens or people with medical insurance, and does not form a part of this study. Two challenges regarding GIS...

  11. Stress Factors among Nurses at the Primary and Secondary Level of Public Sector Health Care: The Case of Slovenia

    OpenAIRE

    Jasmina Starc

    2018-01-01

    BACKGROUND: Working in nursing is mentally and physically demanding and is one of the most stressful professions. AIM: To determine the basic causes of stress and examine the symptoms of stress among healthcare professionals at the primary and secondary level of health care. MATERIAL AND METHODS: The research was based on the descriptive and causal non-experimental method of empirical research. The independent samples t-test was used. RESULTS: The survey results have shown that th...

  12. Toxoplasmosis among pregnant women attending antenatal clinic in ...

    African Journals Online (AJOL)

    Toxoplasmosis is a neglected tropical protozoan disease of public health importance. This study estimated the seroprevalence of toxoplasmosis and the associated risk factors among pregnant women attending the antenatal clinic in the University of Port Harcourt Teaching Hospital, Rivers State, Nigeria. Two hundred and ...

  13. Trauma unit attendance: Is there a relationship with weather ...

    African Journals Online (AJOL)

    Weather data, local soccer match locations and results, and information regarding public holidays and long weekends were obtained for the relevant shifts. Average daily attendances for IPV-related injuries and MVCs were compared across the various external factors described. Poisson regression models were fitted and ...

  14. The practice of exclusive breastfeeding among mothers attending a ...

    African Journals Online (AJOL)

    2012-08-08

    Aug 8, 2012 ... Original Research: The practice of exclusive breastfeeding among mothers ... programme for the PMTCT of HIV, which aims to reduce ... Setting and subjects: This study was conducted among women over the age of 18 years attending their first six weeks ..... publications/2009/9789241598873_eng.pdf. 3.

  15. 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 ...

  16. Syphilis and HIV infections among pregnant women attending ...

    African Journals Online (AJOL)

    Syphilis and HIV infections among pregnant women attending antenatal clinics in Republic of Congo. ... Introduction: HIV and syphilis during pregnancy remain a public health concern especially in developing countries. Pregnant women ... Marital status and sentinel site location were a risk factor associated with. HIV and ...

  17. Poor blood pressure control and its associated factors among older people with hypertension: A cross-sectional study in six public primary care clinics in Malaysia.

    Science.gov (United States)

    Cheong, A T; Sazlina, S G; Tong, S F; Azah, A S; Salmiah, S

    2015-01-01

    Hypertension is highly prevalent in the older people. Chronic disease care is a major burden in the public primary care clinics in Malaysia. Good blood pressure (BP) control is needed to reduce the morbidity and mortality of cardiovascular disease (CVD). This study aimed to determine the status of BP control and its associated factors among older people with hypertension in public primary care clinics. A cross-sectional study on hypertensive patients aged 18 years and above was conducted in six public primary care clinics in Federal Territory, Malaysia. A total of 1107 patients were selected via systematic random sampling. Data from 441 (39.8%) patients aged 60 years and more were used in this analysis. BP control was determined from the average of two BP readings measured twice at an interval of 5 min. For patients without diabetes, poor BP control was defined as BP of ≥140/90 mm Hg and ≥150/90 for the patients aged 80 years and more. For patients with diabetes, poor control was defined as BP of ≥140/80 mm Hg. A total of 51.7% (n = 228) of older patients had poor BP control. The factors associated with BP control were education level (p = 0.003), presence of comorbidities (p = 0.015), number of antihypertensive agents (p = 0.001) and number of total medications used (p = 0.002). Patients with lower education (less than secondary education) (OR = 1.7, p = 0.008) and the use of three or more antihypertensive agents (OR = 2.0, p = 0.020) were associated with poor BP control. Among older people with hypertension, those having lower education level, or using three or more antihypertensive agents would require more attention on their BP control.

  18. Analyzing the equity of public primary care provision in Kenya: variation in facility characteristics by local poverty level

    Directory of Open Access Journals (Sweden)

    Toda Mitsuru

    2012-12-01

    Full Text Available Abstract Introduction Equitable access to health care is a key health systems goal, and is a particular concern in low-income countries. In Kenya, public facilities are an important resource for the poor, but little is known on the equity of service provision. This paper assesses whether poorer areas have poorer health services by investigating associations between public facility characteristics and the poverty level of the area in which the facility is located. Methods Data on facility characteristics were collected from a nationally representative sample of public health centers and dispensaries across all 8 provinces in Kenya. A two-stage cluster randomized sampling process was used to select facilities. Univariate associations between facility characteristics and socioeconomic status (SES of the area in which the facility was located were assessed using chi-squared tests, equity ratios and concentration indices. Indirectly standardized concentration indices were used to assess the influence of SES on facility inputs and service availability while controlling for facility type, province, and remoteness. Results For most indicators, we found no indication of variation by SES. The clear exceptions were electricity and laboratory services which showed evidence of pro-rich inequalities, with equity ratios of 3.16 and 3.43, concentration indices of 0.09 (p Conclusions The paper shows how local area poverty data can be combined with national health facility surveys, providing a tool for policy makers to assess the equity of input and service availability. There was little evidence of inequalities for most inputs and services, with the clear exceptions of electricity and laboratory services. However, efforts are required to improve the availability of key inputs and services across public facilities in all areas, regardless of SES.

  19. The impact of daycare attendance on outdoor free play in young children.

    Science.gov (United States)

    Carsley, S; Liang, L Y; Chen, Y; Parkin, P; Maguire, J; Birken, C S

    2017-03-01

    Outdoor free play is important for healthy growth and development in early childhood. Recent studies suggest that the majority of time spent in daycare is sedentary. The objective of this study was to determine whether there was an association between daycare attendance and parent-reported outdoor free play. Healthy children aged 1-5 years recruited to The Applied Research Group for Kids! (TARGet Kids!), a primary care research network, were included. Parents reported daycare use, outdoor free play and potential confounding variables. Multivariable linear regression was used to determine the association between daycare attendance and outdoor free play, adjusted for age, sex, maternal ethnicity, maternal education, neighborhood income and season. There were 2810 children included in this study. Children aged 1 to <3 years (n = 1388) and ≥3 to 5 years (n = 1284) who attended daycare had 14.70 min less (95% CI -20.52, -8.87; P < 0.01) and 9.44 min less (95% CI -13.67, -5.20; P < 0.01) per day of outdoor free play compared with children who did not attend daycare, respectively. Children who spend more time in daycare have less parent-reported outdoor free play. Parents may be relying on daycare to provide opportunity for outdoor free play and interventions to promote increased active play opportunities outside of daycare are needed. © The Author 2016. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  20. 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.

  1. 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.

  2. 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.

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

    African Journals Online (AJOL)

    Caregivers experienced long waiting times (mean 135 (standard deviation 72) minutes). Many routine examination ... health needs meaningfully. A deliberate and radical restructuring of PHC for children, with clearly defined and monitored standard clinical practice routines and norms, is required to change the status quo.

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

    African Journals Online (AJOL)

    Bassam A. Al Bathi

    2012-03-18

    Mar 18, 2012 ... negative attitude toward vitamin D problems. Planning health ... Studies from Saudi Arabia, Kuwait, United Arab Emirates, and Iran reveal that .... Table 1 General characteristics of participants. Variables. Number. %. Gender. Male. 67. 33.5 .... and vitamin D status in Arab women of childbearing age. East.

  5. Practicing breast self-examination among women attending primary ...

    African Journals Online (AJOL)

    Saadoon F. Al-Azmy

    2012-09-24

    Sep 24, 2012 ... in the study and fill a self-administered questionnaire located on a table in the ... beliefs regarding a list of some warning symptoms and signs of. BC. ..... tial harms of BC, raise their awareness level about early warn- ing signs ...

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

    African Journals Online (AJOL)

    was seldom asked about or investigated, for the mother or for the child. Growth monitoring .... refrigerator, although vaccines were appropriately stored in. 11 clinics ..... simply reflects a 'can't be bothered' attitude, was outside the scope of this ...

  7. 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.

  8. 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

  9. Training of professionals in post-graduation courses in public health and primary healthcare in the municipality of Rio de Janeiro, Brazil.

    Science.gov (United States)

    Engstrom, Elyne Montenegro; Motta, José Inácio; Venâncio, Sandra Aparecida

    2016-05-01

    This paper examines post-graduation professional training and qualification courses in the fields of public health and primary healthcare. Its aim is to reflect on the construction and methodological proposal of two courses given by ENSP/Fiocruz in partnership with the Municipality of Rio de Janeiro, over the years 2010 to 2014: The Professional Master's Degree in Primary Healthcare (MPAPS), and Specialization in Public Health. Systematization of academic documents of the courses, with preparation of emerging analytical categories (theoretical management-interface history, field of pedagogy). Two classes of the MPAPS course (n=24 students per group) and five of the Specialization course (average 30 per group) were held in the period, with approval rates at the 90%-80% level, with curriculum structure adjusted to the local situation. As challenges that were implemented, we highlight: 1) On the epistemological level: development of competencies for professional training that would produce results coherent with health, as social/cultural production; 2) from the learning point of view: preparation of dynamics that give value to the students, their social-cultural context and experiences; 3) work environments and relationships, bringing their structured analysis into the learning environment.

  10. Social environment and frequent attendance in Danish general practice

    DEFF Research Database (Denmark)

    Vedsted, Peter; Olesen, Frede

    2005-01-01

    inequalities in health or whether social factors in themselves determine the use of general practice. AIM: To examine if social factors are associated with frequent attendance in general practice after adjusting for physical and psychological health variables. DESIGN OF STUDY: Population-based cross......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 social...... during the period November 1997-October 1998. A questionnaire about physical, psychological and social factors was sent to the patients. The associations between social factors and frequent attendance were adjusted for physical and psychological health and tendency towards somatisation. RESULTS: A total...

  11. 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.

  12. Satisfaction with Quality of Care Received by Patients without National Health Insurance Attending a Primary Care Clinic in a Resource-Poor Environment of a Tertiary Hospital in Eastern Nigeria in the Era of Scaling up the Nigerian Formal Sector Health Insurance Scheme

    Science.gov (United States)

    Iloh, GUP; Ofoedu, JN; Njoku, PU; Okafor, GOC; Amadi, AN; Godswill-Uko, EU

    2013-01-01

    Background: The increasing importance of the concept of patients’ satisfaction as a valuable tool for assessing quality of care is a current global healthcare concerns as regards consumer-oriented health services. Aim: This study assessed satisfaction with quality of care received by patients without national health insurance (NHI) attending a primary care clinic in a resource-poor environment of a tertiary hospital in South-Eastern Nigeria. Subject and Methods: This was a cross-sectional study carried out on 400 non-NHI patients from April 2011 to October 2011 at the primary care clinic of Federal Medical Centre, Umuahia, Nigeria. Adult patients seen within the study period were selected by systematic sampling using every second non-NHI patient that registered to see the physicians and who met the selection criteria. Data were collected using pretested, structured interviewer administered questionnaire designed on a five points Likert scale items with 1 and 5 indicating the lowest and highest levels of satisfaction respectively. Satisfaction was measured from the following domains: patient waiting time, patient–staff communication, patient-staff relationship, and cost of care, hospital bureaucracy and hospital environment. Operationally, patients who scored 3 points and above in the assessed domain were considered satisfied while those who scored less than 3 points were dissatisfied. Results: The overall satisfaction score of the respondents was 3.1. Specifically, the respondents expressed satisfaction with patient–staff relationship (3.9), patient–staff communication (3.8), and hospital environment (3.6) and dissatisfaction with patient waiting time (2.4), hospital bureaucracy (2.5), and cost of care (2.6). Conclusion: The overall non-NHI patient's satisfaction with the services provided was good. The hospital should set targets for quality improvement in the current domains of satisfaction while the cost of care has implications for government

  13. The household costs of health care in rural South Africa with free public primary care and hospital exemptions for the poor.

    Science.gov (United States)

    Goudge, Jane; Gilson, Lucy; Russell, Steve; Gumede, Tebogo; Mills, Anne

    2009-04-01

    To measure the direct cost burdens (health care expenditure as a percent of total household expenditure) for households in rural South Africa, and examine the expenditure and use patterns driving those burdens, in a setting with free public primary health care and hospital exemptions for the poor. Data on illness events, treatment patterns and health expenditure in the previous month were assessed from a cross-sectional survey of 280 households conducted in the Agincourt Health and Demographic Surveillance site, South Africa. On average, a household experiencing illness incurred a direct cost burden of 4.5% of total household expenditure. A visit to a public clinic generated a mean burden of 1.3%. Complex sequences of treatments led 20% of households to incur a burden over 10%, with transport costs generating 42% of this burden. An outpatient public hospital visit generated a burden of 8.2%, as only 58% of those eligible obtained an exemption; inpatient stays incurred a burden of 45%. Consultations with private providers incurred a mean burden of 9.5%. About 38% of individuals who reported illness did not take any treatment action, 55% of whom identified financial and perceived supply-side barriers as reasons. The low overall mean cost burden of 4.5% suggests that free primary care and hospital exemptions provided financial protection. However, transport costs, the difficulty of obtaining hospital exemptions, use of private providers, and complex treatment patterns meant state-provided protection had limitations. The significant non-use of care shows the need for other measures such as more outreach services and more exemptions in rural areas. The findings also imply that fee removal anywhere must be accompanied by wider measures to ensure improved access.

  14. Automated attendance management and alert system | Rahim ...

    African Journals Online (AJOL)

    Automated attendance management and alert system. ... Journal of Fundamental and Applied Sciences ... AAMAS provides various functions, from managing and recording students' attendance record, to sending automatic alerts to students ...

  15. 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, ...

  16. Cyber-Truancy: Addressing Issues of Attendance in the Digital Age

    Science.gov (United States)

    Archambault, Leanna; Kennedy, Kathryn; Bender, Stacy

    2013-01-01

    Although mandatory attendance is easily determined in a traditional, brick-and-mortar school, monitoring and enforcing attendance and truancy in an online environment is less obvious. Despite this challenge, virtual schools, especially those that are publicly funded, have a requirement to ensure that students who are enrolled are actually logging…

  17. 76 FR 61148 - Proposed Information Collection (Approval of School Attendance) Activity: Comment Request

    Science.gov (United States)

    2011-10-03

    ... marriages, a change in course of instruction and termination of school attendance. Affected Public... (Approval of School Attendance) Activity: Comment Request AGENCY: Veterans Benefits Administration... techniques or the use of other forms of information technology. Titles: a. Request for Approval of School...

  18. The Argument Is Not Compulsory Law, but How Attendance Is Recorded

    Science.gov (United States)

    Watson, Michael; Hemmer, Lynn

    2015-01-01

    This paper examines attendance accounting policies and practices for students enrolled in public schools in Texas and in alternative schools of choice (ASC) in particular. Technology advancement allows students to complete their coursework virtually anywhere they have internet access; however, conventional state attendance policies still require…

  19. Stress Factors among Nurses at the Primary and Secondary Level of Public Sector Health Care: The Case of Slovenia

    Directory of Open Access Journals (Sweden)

    Jasmina Starc

    2018-02-01

    Full Text Available BACKGROUND: Working in nursing is mentally and physically demanding and is one of the most stressful professions. AIM: To determine the basic causes of stress and examine the symptoms of stress among healthcare professionals at the primary and secondary level of health care. MATERIAL AND METHODS: The research was based on the descriptive and causal non-experimental method of empirical research. The independent samples t-test was used. RESULTS: The survey results have shown that those employed in nursing are exposed to stressful situations on a daily basis, most often involving psychological or physical violence in the workplace (M = 4.2, dealing with death (M = 3.9, lack of personnel (M = 3.9 and a high frequency of patients (M = 3.8. The following stress factors cause women greater stress than they do men: relationships among co-workers (t = 2.745; p = 0.006, psychological or physical violence in the workplace (t = 3.492; p = 0.001, and working with difficult patients (t = 2.427; p = 0.017. CONCLUSION: To manage risks, employees and employers must work together and establish a suitable safety and organisational culture, which would enable them to manage and reduce stress.

  20. Consumer health information technology in an adult public health primary care clinic: a heart health education feasibility study.

    Science.gov (United States)

    Gleason-Comstock, Julie A; Streater, Alicia; Jen, Kai-Lin Catherine; Artinian, Nancy T; Timmins, Jessica; Baker, Suzanne; Joshua, Bosede; Paranjpe, Aniruddha

    2013-12-01

    To explore the feasibility and short term outcomes of using an interactive kiosk integrated into office flow to deliver health information in a primary care clinic. Fifty-one adults with BMI ≥25 were randomly assigned to use a kiosk with attached devices to receive a six-week healthy eating/weight monitoring (intervention) or general health/BP monitoring (attention-control) program. Outcomes were measured at baseline, 8 weeks (post) and three month follow-up. Participants completed an average of 2.73 weekly sessions, with transportation and time given as limiting factors. They found the kiosk easy to use (97%), liked the touchscreen (94%), and would use the kiosk again (81%). Although there were no differences between groups, the 27 completing all assessments showed reduced weight (p=.02), and decreased systolic (p=.01) and diastolic BP (pinformation and self-monitoring. Multi-session educational content can provide beneficial short-term outcomes in overweight adults. A kiosk with attached peripherals in a clinic setting is a viable adjunct to provider education, particularly in medically underserved areas. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  1. Stress Factors among Nurses at the Primary and Secondary Level of Public Sector Health Care: The Case of Slovenia.

    Science.gov (United States)

    Starc, Jasmina

    2018-02-15

    Working in nursing is mentally and physically demanding and is one of the most stressful professions. To determine the basic causes of stress and examine the symptoms of stress among healthcare professionals at the primary and secondary level of health care. The research was based on the descriptive and causal non-experimental method of empirical research. The independent samples t-test was used. The survey results have shown that those employed in nursing are exposed to stressful situations on a daily basis, most often involving psychological or physical violence in the workplace (M = 4.2), dealing with death (M = 3.9), lack of personnel (M = 3.9) and a high frequency of patients (M = 3.8). The following stress factors cause women greater stress than they do men: relationships among co-workers (t = 2.745; p = 0.006), psychological or physical violence in the workplace (t = 3.492; p = 0.001), and working with difficult patients (t = 2.427; p = 0.017). To manage risks, employees and employers must work together and establish a suitable safety and organisational culture, which would enable them to manage and reduce stress.

  2. 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.

  3. Providing Telehealth Services to a Public Primary Care Network: The Experience of RedeNUTES in Pernambuco, Brazil.

    Science.gov (United States)

    Diniz, Paula Rejane Beserra; Ribeiro Sales, Fernando José; de Araújo Novaes, Magdala

    2016-08-01

    Information technologies have been applied in primary care domains to improve the delivery of health services. This article reports the telehealth network experience in Pernambuco, Brazil. Five different data sets were used, one by each service and the structural aspects of the network, collected from 2008 until August 2015. The data include solicited themes for educational activities, users' evaluation of services, numbers of sites, municipalities participating, participants in tele-education activities, teleconsultations, telediagnosis, and remote screenings. The analysis was done in absolute and percentage values using Microsoft Excel (version 2007). The indicators show high utilization of tele-education resources, followed by the teleconsultation service. The synchronous modality was the most used and the general clinical question was the most frequent type of question. Nurses are the professional category that most used the teleconsultation services (36%). Telediagnosis of electrocardiography has growth utilization, overcoming teleconsulting more recently. The satisfaction rate was 89%, and 68.5% of professionals changed their planning to patients' referrals to specialists. Telehealth has been considered effective since it avoids inappropriate referrals of the patient and provides continuous actualization to health professionals. Our results provide evidence of the feasibility and importance of using telehealth as a tool to ensure the universality, equality, and completeness in the health system.

  4. Attendance Control System based on RFID technology

    OpenAIRE

    Nurbek Saparkhojayev; Selim Guvercin

    2012-01-01

    In Kazakhstan, checking students' attendance is one of the important issues for universities, because many universities evaluate students attendance and while giving the final grade, professors consider their total number of appearances on classes during the whole semester. This brings to the idea of having some tool to control students attendance. Some universities prefer to use paper sheet for controlling attendance, whereas some universities prefer to use paper sheet for checking students'...

  5. 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.

  6. Utilization of Rural Primary Care Physicians' Visit Services for Diabetes Management of Public Health in Southwestern China: A Cross-Sectional Study from Patients' View.

    Science.gov (United States)

    Miao, Yudong; Ye, Ting; Qian, Dongfu; Li, Jinlong; Zhang, Liang

    2014-06-01

    Primary care physicians' visit services for diabetes management are now widely delivered in China's rural public health care. Current studies mainly focus on supply but risk factors from patients' view have not been previously explored. This study aims to present the utilization of rural primary care physicians' visit services for diabetes management in the last 12 months in southwestern China, and to explore risk factors from patients' view. This cross sectional study selected six towns at random and all 385 diabetics managed by primary care physicians were potential participants. Basing on the inclusion and exclusion criteria, 374 diabetics were taken as valid subjects and their survey responses formed the data resource of analyses. Descriptive indicators, χ2 contingency table analyses and Logistic regression were used. 54.8% respondents reported the utilization of visit services. According to the multivariate analysis, the positive factors mainly associated with utilization of visit services include disease duration (OR=1.654), use of diabetic drugs (OR=1.869), consulting diabetes care knowledge (OR=1.602), recognition of diabetic complications (OR=1.662), needs of visit services (OR=2.338). The utilization of rural primary care physicians' visit services still remains unsatisfactory. Mass rural health policy awareness, support, and emphasis are in urgent need and possible risk factors including disease duration, use of diabetic drugs, consulting diabetes care knowledge, recognition of diabetic complications and needs of visit services should be taken into account when making rural health policy of visit services for diabetes management in China and many other low- and middle-income countries.

  7. 29 CFR 785.28 - Involuntary attendance.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false Involuntary attendance. 785.28 Section 785.28 Labor... POLICY OR INTERPRETATION NOT DIRECTLY RELATED TO REGULATIONS HOURS WORKED Application of Principles Lectures, Meetings and Training Programs § 785.28 Involuntary attendance. Attendance is not voluntary, of...

  8. Successful Attendance Policies and Programs. Research Brief

    Science.gov (United States)

    Education Partnerships, Inc., 2012

    2012-01-01

    What steps can be taken to assure that High School students have the best attendance possible? It is commonly believed and well supported by research that students who attend school regularly are more successful than those who do not. The challenge for high schools is to design and implement attendance policies and programs that monitor,…

  9. 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.

  10. Effect of a reorganized after-hours family practice service on frequent attenders

    DEFF Research Database (Denmark)

    Vedsted, Peter; Olesen, Frede

    1999-01-01

    of this reorganization on the use of services by frequent attenders (FAs). METHODS: From 1990 to 1994, methods of contact and annual costs per attender were analyzed in an ecological time-trend study based on aggregated administrative data collected from the database of the Public Health Insurance, Aarhus County......, Denmark (600,000 inhabitants). The study only included attenders ages 18 and over. FAs were defined as the group that, within each calendar year (12 months), had 4 or more contacts with the after-hours family practice service. RESULTS: FAs made up 9.5% of the attenders and accounted for more than 40...

  11. Exploring the role of the public and private funded primary health care facilities for children in a pluralistic health care setting of Barbados: one of the English Caribbean countries

    Directory of Open Access Journals (Sweden)

    Alok Kumar

    2015-01-01

    Conclusions: The findings demonstrate the complimentary role of the public and the private sector in the primary health care of children in this country. While the private sector has a major role in the curative acute care of children, the public sector plays a pivotal role in the immunization services.

  12. Outcomes of treatment of drug-susceptible tuberculosis at public sector primary healthcare clinics in Johannesburg, South Africa: A retrospective cohort study.

    Science.gov (United States)

    Budgell, E P; Evans, D; Schnippel, K; Ive, P; Long, L; Rosen, S

    2016-09-05

    Despite the large number of tuberculosis (TB) patients treated in South Africa (SA), there are few descriptions in the published literature of drug-susceptible TB patient characteristics, mode of diagnosis or treatment outcomes in routine public sector treatment programmes. To enhance the evidence base for public sector TB treatment service delivery, we reported the characteristics of and outcomes for a retrospective cohort of adult TB patients at public sector clinics in the Johannesburg Metropolitan Municipality (JHB), SA. We collected medical record data for a retrospective cohort of adult (≥18 years) TB patients registered between 1 April 2011 and 31 March 2012 at three public sector clinics in JHB. Data were abstracted from National TB Programme clinic cards and the TB case registers routinely maintained at study sites. We report patient characteristics, mode of diagnosis, mode of treatment supervision, treatment characteristics, HIV status and treatment outcomes for this cohort. A total of 544 patients were enrolled in the cohort. Most (86%) were new TB cases, 81% had pulmonary TB, 58% were smear-positive at treatment initiation and 71% were HIV co-infected. Among 495 patients with treatment outcomes reported, 80% (n=394) had successful outcomes, 11% (n=55) were lost to follow-up, 8% (n=40) died and 1% (n=6) failed treatment. Primary healthcare clinics in JHB are achieving relatively high rates of success in treating drug-susceptible TB. Missing laboratory results were common, including follow-up smears, cultures and drug susceptibility tests, making it difficult to assess adherence to guidelines and leaving scope for substantial improvements in record-keeping at the clinics involved.

  13. Gender difference in health related quality of life and associated factors among people living with HIV/AIDS attending anti-retroviral therapy at public health facilities, western Ethiopia: comparative cross sectional study.

    Science.gov (United States)

    Gebremichael, Delelegn Yilma; Hadush, Kokeb Tesfamariam; Kebede, Ermiyas Mulu; Zegeye, Robel Tezera

    2018-04-23

    Though HIV/AIDS has multidimensional consequences on quality of life, there is a gap in measuring and monitoring health related quality of life of HIV/AIDS patients. Hence, this study intended to measure health related quality of life domains and associated determinants among people living with HIV/AIDS in western Ethiopia. A comparative cross-sectional study was conducted among 520 HIV/AIDS patients on anti-retroviral therapy in public health facilities in West Shoa Zone, Western Ethiopia from April to May, 2016. Participants were selected using simple random sampling method. Quality of life was measured using WHOQOL-HIV BREF and depression was assessed using Beck Depression Inventory, Second Edition (BDI-II). Data were analyzed using SPSS version 22. An independent sample t-test was used to compare quality of life domains between men and women and logistic regression analysis was used to determine independent predictors. Females had significantly lower quality of life in physical, psychological, independence and environmental domains as compared with males except social relationship and spiritual domains. Depressed HIV patients had significantly lower quality of life in all domains as compared with HIV infected patients without depression in both genders. Malnutrition and anemia were significantly associated with poor physical, psychological, independence and environmental domains. Anemic women had 1.9 times lower independence quality of life compared with women who had no anemia (AOR = 1.9, 95%CI: 1.4, 3.5). Tuberculosis was also predictor of physical, psychological, independence and social domains in both genders. TB/HIV co-infected females had 2.0 times poorer environmental health compared to only HIV infected females (AOR = 2.0, 95%CI: 1.2, 3.5). Family support, education and occupation were also independent significant predictors of QOL domains in both genders. In females, residence was significantly associated with independence (AOR = 1.8, 95%CI

  14. The Effect Of School Feeding Programme On Primary School ...

    African Journals Online (AJOL)

    The Effect Of School Feeding Programme On Primary School Attendance In ... and SFP were significant variables which affect attendance of children in school. ... the school-feeding programme [SFP] succeeded in increasing parent's income.

  15. Effect of weather on football attendances

    Energy Technology Data Exchange (ETDEWEB)

    Cairns, J A

    1984-01-01

    On the premise that weather should have an effect on spectator attendance at sports events in outdoor settings (a topic which has received surprisingly little formalized study), the author examined the record of home attendances for three football teams in Scotland. In general, it was found that the greater the rainfall on the day of the match the lower the attendance. Dividing spectators into different groups, it was further found that an additional hour of sunshine was associated 162 more adults attending Aberdeen matches, while high temperatures appeared to increase juvenile attendance (by 57 for ever 1 deg. C. rise in temperature). Weather disruption of football games is attended by a number of costs, both direct and indirect. Quantifying the impact of weather can shed substantial light on the problem of scheduling for the season. For example, since certain periods are, on average, wetter than others, rescheduling to drier periods might encourage greater attendance.

  16. 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.

  17. 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

  18. Training traditional birth attendants on the WHO Essential Newborn Care reduces perinatal mortality.

    Science.gov (United States)

    Garcés, Ana; McClure, Elizabeth M; Hambidge, Michael; Krebs, Nancy F; Mazariegos, Manolo; Wright, Linda L; Moore, Janet; Carlo, Waldemar A

    2012-05-01

    To evaluate the impact of birth attendant training using the World Health Organization Essential Newborn Care (ENC) course among traditional birth attendants, with a particular emphasis on the effect of acquisition of skills on perinatal outcomes. Population-based, prospective, interventional pre-post design study. 11 rural clusters in Chimaltenango, Guatemala. Health care providers. This study analyzed the effect of training and implementation of the ENC health care provider training course between September 2005 and December 2006. The primary outcome measure was the rate of death from all causes in the first seven days after birth in fetuses/infants ≥1500g. Secondary outcome measures were overall rate of stillbirth, rate of perinatal death, which included stillbirths plus neonatal deaths in the first seven days in fetuses/infants ≥1500g. Perinatal mortality decreased from 39.5/1000 pre-ENC to 26.4 post-ENC (RR 0.72; 95%CI 0.54-0.97). This reduction was attributable almost entirely to a decrease in the stillbirth rate of 21.4/1000 pre-Essential Newborn Care to 7.9/1000 post-ENC (RR 0.40; 95%CI 0.25-0.64). Seven-day neonatal mortality did not decrease (18.3/1000 to 18.6/1000; RR 1.05; 95%CI 0.70-1.57). Essential Newborn Care training reduced stillbirths in a population-based controlled study with deliveries conducted almost exclusively by traditional birth attendants. Scale-up of this intervention in other settings might help assess reproducibility and sustainability. © Published [2012]. This article is a U.S. Government work and is in the public domain in the USA. Acta Obstetricia et Gynecologica Scandinavica© 2012 Nordic Federation of Societies of Obstetrics and Gynecology.

  19. Violência Sexual: integração saúde e segurança pública no atendimento imediato à vítima Sexual Violence: health and public security integration in immediate attending to the victim

    Directory of Open Access Journals (Sweden)

    Maria Angela Mirim Rosa e Campos

    2005-04-01

    Protocol to Care Victims of Sexual Violence, involving the Public Health and Public Security areas, at the Conjunto Hospitalar de Sorocaba. A research was undertaken with data from the epidemiological files, between April 2003 and March 2004, during six months in each period, analyzing the victim characteristics, relationship with the aggressor and the indication of medicinal prophylaxis. In 211 notifications, it was observed that the attending was four times higher after the implantation of this integrated action. Women younger than 18 years old were most of the victims, in both periods. The processes dealt by Police Station or Judiciary Councils, increased significantly in the second period, in which, the known aggressors showed to be the majority and the knowledge of their anti-HIV serology allowed victim anti-retroviral prophylaxis interruption. It was concluded that the integration among the Public Health and Public Security sectors is essential for sexual violence victims, to receive, as soon as possible, the assistance in the Public Health area, focusing on the prevention of the sequels that threaten their physical and emotional integrity. This integrated action allows the aggressor's identification sooner as possible and consequently to know their anti-HIV serology in order to reduce anti-retroviral chemoprophylaxis use to the victims.

  20. The return of the Traditional Birth Attendant

    Directory of Open Access Journals (Sweden)

    Karen Lane

    2016-12-01

    Full Text Available Sub–Saharan Africa and Southern Asia lag behind other regions in the provision of antenatal care and skilled attendance at birth (although typically attended by a family member or villager and over 32 million of the 40 million births not attended by skilled health personnel in 2012 occurred in rural areas. Overall, one–quarter of women in developing nations still birth alone or with a relative to assist them.

  1. Substance use and birth weight among mothers attending public ...

    African Journals Online (AJOL)

    unhcc

    recommend health professionals working in antenatal care service, be aware, on counseling of mothers for banning ... and recorded in a log book prepared for it. ... sample size assigned to the hospitals was distributed, .... refusal to participate.

  2. 29 CFR 2203.3 - Public attendance at Commission meetings.

    Science.gov (United States)

    2010-07-01

    ... action in a foreign court or international tribunal, or an arbitration, or the initiation, conduct... particular types of matters to be withheld; (4) Disclose trade secrets and commercial or financial...

  3. Psychosocial Profile of Gifted Adolescents Attending a Public High School

    Science.gov (United States)

    Ordaz-Villegas, Gabriela; Acle-Tomasini, Guadalupe

    2012-01-01

    Introduction: The current models in the study of giftedness such as the Triadic Interdependence define it as a favorable outcome of the interaction between intrinsic (intellectual capacity, creativity and motivation) and extrinsic (family, peers, and school) factors. Based on this, the purpose of this study was to identify and establish a profile…

  4. Identification of dietary patterns of adolescents attending public schools

    Directory of Open Access Journals (Sweden)

    Lucinéia de Pinho

    2014-05-01

    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.

  5. 39 CFR 3001.43 - Public attendance at Commission meetings.

    Science.gov (United States)

    2010-07-01

    ...) of this section) of the discussion of any item on the agenda, or of any item of the testimony of any... 13290, Mar. 10, 1977, as amended at 42 FR 25729, May 19, 1977; 58 FR 38976, July 21, 1993; 62 FR 45530...

  6. Investigating Level of Mathematics Knowledge for Students Attending Vocational Schools in Turkey

    Science.gov (United States)

    Colakoglu, Nurdan

    2013-01-01

    Students attend mathematics courses in Turkey for totally 11 years, throughout education life ranging from primary school to university, including eight years in primary education and three years in secondary education (four years based on new arrangement); however, level of mathematic knowledge of students is upsetting when they reach university…

  7. Community College Attendance and Socioeconomic Plans

    Science.gov (United States)

    Park, Sueuk; Pascarella, Ernest T.

    2010-01-01

    Using data from the National Education Longitudinal Study, 1988 (NELS: 88), this paper documents differences in the socioeconomic plans of students in two-year and four-year colleges. We found attendance at a two-year college led to a modest but statistically significant disadvantage in socioeconomic plans. However, the impact of attending a…

  8. A Study on Attendance and Academic Achievement

    DEFF Research Database (Denmark)

    Sund, Kristian J.; Bignoux, Stephane

    In this study we attempt to answer Romer’s (1993) question: “Should attendance be mandatory?” Contrary to many existing studies, we conclude that in the case of business and management programs the answer is ‘no’. In a study of over 900 undergraduate strategy students, spanning four academic years......, 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......-all degree classification, which we see as a proxy for academic ability. We suggest that attendance may simply be a reflection of student conscientiousness, engagement and motivation. We also challenge the assumptions about gender differences found in prior research on student attendance and student...

  9. 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.

  10. 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...

  11. Cesarianas: percepção de risco e sua indicação pelo obstetra em uma maternidade pública no Município do Rio de Janeiro Cesarean sections: risk perception and indication by attending obstetricians in a public maternity hospital in Rio de Janeiro

    Directory of Open Access Journals (Sweden)

    Marcos Augusto Bastos Dias

    2004-02-01

    Full Text Available A taxa de cesariana entre as maternidades públicas municipais da cidade do Rio de Janeiro no ano de 2000 foi de 30,1%. Com taxas tão elevadas, nossas hipóteses são que as indicações de cesarianas nestas unidades não estão restritas apenas às indicações clínicas. Este artigo tem como objetivo analisar as representações de médicos sobre os riscos inerentes da cesariana que influenciam a sua indicação. Neste estudo qualitativo, realizado com observação participante de plantões e entrevistas com obstetras, pudemos identificar que as indicações feitas pelos obstetras da unidade pública estudada sofrem influência de diversos fatores não obstétricos: a insegurança quanto às manobras obstétricas, a fragmentação do atendimento e o medo da responsabilização jurídica, entre outros. O artigo sugere que a banalização desta intervenção no serviço privado traz para o serviço público um desvio da prática obstétrica que compromete não apenas a qualidade da assistência pública, como pode colocar em risco a vida de mulheres e bebês.The cesarean section rate in municipal public maternity hospitals in the city of Rio de Janeiro in the year of 2000 was 30.1%. With such a high rate, our hypothesis is that attending obstetricians in these units are indicating cesarean sections for reasons not restricted to clinical factors. The article aims to analyze physicians' representations of the inherent risks in cesarean sections that influence the medical decision for their indication. In this qualitative study, conducted through participant observation during ward duty and interviews with obstetricians, we observed that C-section indications by obstetricians are influenced by various non-obstetric factors, including insecurity about performing obstetric maneuvers, fragmented care, and fear of legal liability. The paper suggests that the widespread use of this intervention in private maternity services has fostered a practice in

  12. 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

  13. 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

  14. Basic Education from Early Childhood: Impacts of Free Primary Education and Subsidized Secondary Education on Public ECDE Centers in Nyahururu District, Kenya

    Science.gov (United States)

    Mwangi, Peter Murage; Serem, T. D. K.

    2013-01-01

    Kenya must invest more in education to realize her vision 2030. The government commitment to Education for All's goal has been expressed through provision of basic education in pre-primary, primary and secondary school levels. To this end, the government introduced two kitties; Free Primary Education in 2003 and Subsidized Secondary Education in…

  15. Traditional Birth Attendants in Rural Northern Uganda: Policy, Practice, and Ethics.

    Science.gov (United States)

    Rudrum, Sarah

    2016-01-01

    The current emphasis on skilled attendants as a means to reduce maternal mortality contributes to a discouraging policy environment for traditional birth attendants (TBAs). They continue to attend a significant number of births, however, such that their role and the policies and practices affecting their work remain important to understanding maternity health care and maternal health in the global South. In this article, I examine the policies and practices governing community elders practicing as TBAs in rural northern Uganda. This discussion is relevant to health workers in developing countries and to scholars in fields such as women's studies, sociology, and public health.

  16. 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...

  17. "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

  18. 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.

  19. Indian public health standards in primary health centers and community health centers in Shimla District of Himachal Pradesh: A descriptive evaluation

    Directory of Open Access Journals (Sweden)

    Raman Chauhan

    2016-01-01

    Full Text Available Introduction: The health planners in India have visualized primary health centers (PHCs and community health centers (CHCs as the key healthcare delivery institutions in rural areas. These centers are supposed to have health manpower, infrastructure, and service delivery as per the Indian public health standards (IPHS guidelines (2010. Materials and Methods: A cross-sectional study was conducted in seven CHCs and 12 PHCs, randomly selected from eight blocks of Shimla District and evaluated in terms of health manpower, infrastructure, and services from September 2011 to August 2012. Data was collected from the selected units using structured data collection instruments designed by the IPHS. Results: The health centers were assessed according to IPHS guidelines. Outpatient department services and referral services were provided in all the centers studied. No specialist doctor was posted at any of CHCs against a sanctioned strength of at least four (surgeon, physician, obstetrician, and pediatrician per CHC. In 3 (42.8% CHCs and 8 (75% PHCs, no pharmacist was posted. Eight (75% PHCs did not have any staff nurse posted. Three (42.8% CHCs and 10 (83.3% PHCs did not have a laboratory technician. In CHCs, separate labor room was available in 6 (85.7% whereas a separate laboratory was available in all seven. Separate labor room and laboratory were available in four (25% PHCs. Conclusions: IPHS guidelines are not being followed at PHC and CHC levels of the district. Health manpower shortage is the key bottleneck in service delivery. Political advocacy is needed to ensure sufficient health manpower availability to deliver quality healthcare.

  20. 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...

  1. Metabolic Syndrome among Undergraduate Students Attending ...

    African Journals Online (AJOL)

    Methods: A total of 384 first-year students attending university medical clinics for obligatory medical ... Keywords: Metabolic syndrome, Obesity, Hypertension, Diabetes, Dyslipidemia, ..... requires the attention of all health professionals.

  2. Employee Lounge Attendant | IDRC - International Development ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Job Summary Under the direction of the Chief, Conference Management, the Employee Lounge Attendant is responsible to prepare coffee, beverages, and ... The incumbent also assists with food preparation for daily meals as well as ensure ...

  3. Physical Environmental Barriers to School Attendance among ...

    African Journals Online (AJOL)

    environment were the major barriers to school attendance. Conclusion: To ... Key words: Parents/caregivers, children with disabilities, barriers. Introduction .... It is not safe to walk ... feeling, learning, behaviour, and fits or convulsions. [19] The ...

  4. Neural responses to complex auditory rhythms: the role of attending

    Directory of Open Access Journals (Sweden)

    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.

  5. 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

  6. Attendance and Exam Performance at University

    OpenAIRE

    David O. Allen; Don J. Webber

    2006-01-01

    Marburger (2006) explored the link between absenteeism and exam performance by assessing the impact on absenteeism of removing a university wide policy of mandatory attendance for a single class. His results indicate that while an attendance policy has a strong impact on reducing absenteeism the link between absenteeism and exam performance is weak.This paper presents an alternative exploration into the link between absenteeism and exam performance by assessing the impact of implementing a mo...

  7. Factors influencing choice of skilled birth attendance at ANC: evidence from the Kenya demographic health survey.

    Science.gov (United States)

    Nyongesa, Caroline; Xu, Xiaoyue; Hall, John J; Macharia, William M; Yego, Faith; Hall, Brigid

    2018-04-10

    In Kenya, skilled attendance at delivery is well below the international target of 90% and the maternal mortality ratio is high at 362 (CI 254-471) per 100,000 live births despite various interventions. The preventative role of skilled attendance at delivery makes it a benchmark indicator for safe motherhood. Maternal health data from the Service Provision Assessment Survey, a subset of the 2010 Kenya Demographic Health Survey was analyzed. Logistic regression models were employed using likelihood ratio test to explore association between choice of skilled attendance and predictor variables. Overall, 94.8% of women are likely to seek skilled attendance at delivery. Cost, education level, number of antenatal visits and sex of provider were strongly associated with client's intention to deliver with a skilled birth attendant at delivery. Women who reported having enough money set aside for delivery were 4.34 (p < 0.002, 95% CI: 1.73; 10.87) times more likely to seek skilled attendance. Those with primary education and above were 6.6 times more likely to seek skilled attendance than those with no formal education (p < 0.001, 95% CI: 3.66; 11.95). Women with four or more antenatal visits were 5.95 (p < 0.018, 95% CI: 1.35; 26.18) times more likely to seek skilled attendance. Compared to men, female providers impacted more on the client's plan (OR = 2.02 (p < 0.014, 95% CI: 1.35; 3.53). Interventions aimed at improving skilled attendance at delivery should include promotion of formal education of women and financial preparation for delivery. Whenever circumstances permit, women should be allowed to choose gender of preferred professional attendant at delivery.

  8. 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

  9. 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.

  10. 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.

  11. 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

  12. Perda precoce de molares permanentes e fatores associados em escolares de 9, 12 e 15 anos da rede pública municipal de Campina Grande, Estado da Paraíba, Brasil = Early loss of permanent molars and associated factors in schoolchildren aged 9, 12 and 15 years attending public schools in Campina Grande, Paraíba State, Brazil

    Directory of Open Access Journals (Sweden)

    Francineide Guimarães Carneiro de Melo

    2011-01-01

    Full Text Available Este estudo avaliou a perda precoce de molares permanentes em escolares da rede pública de Campina Grande, Estado da Paraíba, com idades de nove, 12 e 15 anos. A amostra compreendeu 873 escolares, aleatoriamente selecionados. O instrumento de coleta consistiu de um questionário e de uma ficha clínica. As variáveis do estudo compreenderam os aspectos relativos à perda dentária (tipo de elemento dental, localização na arcada dentária e a região do arco, à prevenção e à autopercepção em saúde bucal. A análise estatística compreendeu a distribuição de frequências e os testes do Qui-quadrado e Exato de Fisher. Os resultados revelaram a prevalência de 17,2% de perda dentária, sem diferenças entre os sexos, frequência de escovação e palestra educativa (p > 0,05. Os elementos dentários 36 (42,5% e 46 (33,9% foram os mais frequentemente perdidos. Observou-se a associação positiva entre perda dentária e as variáveis idade, visita ao cirurgião-dentista (OR = 2,19; IC95%: 1,35-3,59, satisfação com o sorriso (OR = 0,40; IC95%: 0,24-0,65 e a dificuldade na mastigação (OR = 2,16; IC95%: 1,48- 3,16. Conclui-se que a prevalência da perda precoce de molares permanentes foi elevada, sendo necessária a imediata adoção de ações curativas a fim de reduzir a perda precoce desses elementos dentários.This study evaluate the early loss of permanent molars in schoolchildren aged 9, 12 and 15 years attending public schools in the city of Campina Grande, Paraíba State, Brazil. The sample was composed of 873 randomly selected schoolchildren. The instrument for data collection was a questionnaire and a clinical chart. The following variables were analyzed: tooth loss (tooth type, localization in the dental arch and region of the arch, prevention and selfperception of oral health. The statistical analysis was done by frequency distribution and the chisquare and fisher’s exact tests were used. The results showed a prevalence of

  13. 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

  14. 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

  15. [Variation in the pathology attended in out-patient Neurology Clinics: a demented future].

    Science.gov (United States)

    Morera-Guitart, J; Pedro Cano, M J

    2003-10-01

    We analyze the changes observed between 1996 and 2001 in the distribution of the pathology attended and the follow up model used by the out-patient Neurology Clinic in the Marina Alta area, in order to confirm possible variations that may have repercussions for Human Resource needs in the provision of adequate neurological care. We prospectively registered the attendance records for visits made to the Out-patient Neurology Clinic of Marina Alta in 1996. The variation coefficients between both series were calculated and compared. The average age of patients increased in 5 years. The number of patients attended increased 42.3%, new patients 40%, visits 13%, the "Review visit/First Visit" ratio reduced 29%. The attendance of patients with Cognitive Impairment (Cog. Imp.) doubled. There were no changes in the origins of the patients. Requests due to Cog. Imp. and parkinsonism increased significantly from Primary Care and Emergency Department. The delay to be attended increased 23%. Discharges increased 43.9%, highlighting an increase of 144% observed in the Cog. Imp. group. Changes have been observed in: the age of the population studied; the follow up of patients; the delay in attending them; and the pathology attended, with a significant increase in demand due to neurodegenerative pathology (especially Cog. Imp.). All this requires an increase in care needs that the Health Service has not been able to assume, creating an incongruous care model: we suggest a direct follow up model and offer a consultancy model.

  16. An investigation into why patients do not attend for out-patient radiology appointments

    International Nuclear Information System (INIS)

    Lyon, Rebecca; Reeves, Pauline J.

    2006-01-01

    Introduction: Patients who do not attend (DNA) for out-patient hospital appointments cause delays in the diagnosis and subsequent treatment of their own, and other patient's, illnesses, with potentially hazardous consequences. This also impacts upon waiting lists. Failure to attend is viewed as a specific type of non-compliance and social cognition theories have been applied to previous studies in an attempt to uncover the reasons why patients choose not to keep their appointments. Methods: A case-control study was conducted throughout the X-ray departments of a District General type of NHS Trust, using telephone interview questionnaires based on the Health Belief Model, in an attempt to identify any significant differences between attenders and non-attenders, so that likely non-attenders could be targeted. Results: Principal reasons for non-attendance were that the patient forgot or that they did not receive their appointment. The results differed from previous research, in that specific health beliefs were not the primary reasons for non-attendance. Departments that gave patients the opportunity to arrange their appointments for a mutually convenient time had exceptionally low DNA rates, as did those which had rigorous confirmation systems in place

  17. Mobile phones improve antenatal care attendance in Zanzibar

    DEFF Research Database (Denmark)

    Lund, Stine; Nielsen, Birgitte B; Hemed, Maryam

    2014-01-01

    BACKGROUND: Applying mobile phones in healthcare is increasingly prioritized to strengthen healthcare systems. Antenatal care has the potential to reduce maternal morbidity and improve newborns' survival but this benefit may not be realized in sub-Saharan Africa where the attendance and quality...... of care is declining. We evaluated the association between a mobile phone intervention and antenatal care in a resource-limited setting. We aimed to assess antenatal care in a comprehensive way taking into consideration utilisation of antenatal care as well as content and timing of interventions during...... included at their first antenatal care visit and followed until 42 days after delivery. 24 primary health care facilities in six districts were randomized to either mobile phone intervention or standard care. The intervention consisted of a mobile phone text-message and voucher component. Primary outcome...

  18. [Reasons for attending emergency departments. People speak out].

    Science.gov (United States)

    Pasarín, M Isabel; Fernández de Sanmamed, M José; Calafell, Joana; Borrell, Carme; Rodríguez, Dolors; Campasol, Salvador; Torné, Elvira; Torras, M Glòria; Guarga, Alex; Plasència, Antoni

    2006-01-01

    To ascertain why people attend hospital emergency departments (ED) for low complexity health problems. A phenomenological, interactionist, qualitative study was performed. A theoretical sample that selected one urban and one rural area from Catalonia (Spain) was designed. In each setting, persons (n = 36) who had used the ED or a primary care emergency service 1 month before the beginning of the study were chosen. Data were obtained through 8 focus groups. An interpretative content analysis was performed, and emergent categories were constructed through research triangulation. Five categories emerged: symptoms, whether or not self-diagnosis was involved, perception of needs, awareness of the health services available, and the overall context of the person. Symptoms generated feelings of failing health and thus initiated care seeking. Self-diagnosis determined perceived need and the type of care sought. People contrasted their self-perception of need with their own opinion about the health services available. The decision to go to one or other service was made as a result of this contrast, but the individual's family, work, and social situations also played a part. Informants were more familiar with the service provided by the ED than with that provided by primary care. Time consumption also figured heavily in decision making. The presence or absence of self-diagnosis is a determining factor in attendance at EDs. Other factors that influence demand are the level of awareness of the health services available, previous experiences, and the life situation of the individual.

  19. Antenatal care attendance, a surrogate for pregnancy outcome? The case of Kumasi, Ghana.

    Science.gov (United States)

    Asundep, Ntui N; Jolly, Pauline E; Carson, April; Turpin, Cornelius A; Zhang, Kui; Tameru, Berhanu

    2014-07-01

    Antenatal care (ANC) has been shown to influence infant and maternal outcomes. WHO recommends 4 ANC visits for uncomplicated pregnancies. However, pregnant women in Ghana are required to attend 8-13 antenatal visits. We investigated the association of ANC attendance with adverse pregnancy outcomes (defined as low infant birth weight, stillbirth, preterm delivery or small for gestational age). A quantitative cross-sectional study was conducted on 629 women, age 19-48 years who presented for delivery at two selected public hospitals and 16 traditional birth attendants from July to November 2011. Socio-demographic and antenatal information were collected using a structured questionnaire. ANC attendance, medical and obstetric/gynecological history were abstracted from maternal antenatal records. Data were analyzed using Chi square and logistic regression. Twenty-two percent of the women experienced an adverse outcome. Eleven percent of the women attended 5 children) was also associated with adverse birth outcomes. Women screened for syphilis or use of insecticide-treated bed nets had a 40 and 36% (p = 0.0447 and p = 0.0293) reduced likelihood of experiencing an adverse pregnancy outcome respectively. After adjusting for confounders, attending pregnancy outcome compared with ≥4 ANC visits (Adjusted OR 2.55; 95% CI 1.16-5.63; p = 0.0202). Attending pregnancy outcomes for uncomplicated pregnancies.

  20. Father Attendance in Nurse Home Visitation

    Science.gov (United States)

    Holmberg, John R.; Olds, David L.

    2015-01-01

    Our aim was to examine the rates and predictors of father attendance at nurse home visits in replication sites of the Nurse-Family Partnership (NFP). Early childhood programs can facilitate father involvement in the lives of their children, but program improvements require an understanding of factors that predict father involvement. The sample consisted of 29,109 low-income, first-time mothers who received services from 694 nurses from 80 sites. We conducted mixed-model multiple regression analyses to identify population, implementation, site, and nurse influences on father attendance. Predictors of father attendance included a count of maternal visits (B = 0.12, SE = 0.01, F = 3101.77), frequent contact between parents (B = 0.61, SE = 0.02, F = 708.02), cohabitation (B = 1.41, SE = 0.07, F = 631.51), White maternal race (B = 0.77, SE = 0.06, F = 190.12), and marriage (B = 0.42, SE = 0.08, F = 30.08). Random effects for sites and nurses predicted father-visit participation (2.7 & 6.7% of the variance, respectively), even after controlling for population sociodemographic characteristics. These findings suggest that factors operating at the levels of sites and nurses influence father attendance at home visits, even after controlling for differences in populations served. Further inquiry about these influences on father visit attendance is likely to inform program-improvement efforts. PMID:25521707

  1. An Analysis of Florida's School Districts' Attendance Policies and their Relationship to High School Attendance Rates

    Science.gov (United States)

    Reardon, Ryan Turner

    2008-01-01

    The purpose of this non-experimental correlational study was to determine the relationship between the type of attendance policies in the high schools of the 67 Florida school districts, the size of the school district (number of high school students), the socioeconomic status SES) of the school district, and the average daily attendance rate of…

  2. Does Attendance Matter? An Examination of Student Attitudes, Participation, Performance and Attendance

    Science.gov (United States)

    Massingham, Peter; Herrington, Tony

    2006-01-01

    Non attendance of lectures and tutorials appears to be a growing trend. The literature suggests many possible reasons including students' changing lifestyle, attitudes, teaching and technology. This paper looks at the reasons for non attendance of students in the Faculty of Commerce at the University of Wollongong and identifies relationships…

  3. 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

  4. RFID and IOT for Attendance Monitoring System

    Directory of Open Access Journals (Sweden)

    Dedy Irawan Joseph

    2018-01-01

    Full Text Available In recent years, RFID technology has been widely used in various sectors, such as in-education, transportation, agriculture, animal husbandry, store sales and other sectors. RFID utilization in education is student attendance monitoring system, by using Internet of Things (IoT and Cloud technology, it will produce a real time attendance monitoring system that can be accessed by various parties, such as lecturer, campus administration and parents. With this monitoring system if there are students who are not present can be immediately discovered and can be taken immediate action and the learning process can run smoothly.

  5. 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

  6. 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

  7. 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…

  8. Type of primary education is associated with condom use at sexual debut among Chilean adolescents.

    Science.gov (United States)

    Huneeus, Andrea; Deardorff, Julianna; Lahiff, Maureen; Guendelman, Sylvia

    2014-05-01

    Although condom use in adolescence is related to higher lifetime educational attainment, the association between primary education (from kindergarten to eighth grade) and adolescent sexual behavior is not well understood. This study examined the association between type of school in which primary education was completed-public, charter, or private-and condom use at sexual debut among Chilean adolescents. Drawing on the 2009 Chilean National Youth Survey, a population-based sample of general community youth aged 15 to 29 years, we conducted a study of the 4217 participants who reported onset of sexual activity during adolescence. Bivariate and multple logistic regression was used to examine the relationship between type of primary school attended (60.1% public, 30.3% charter, and 9.6% private) and condom use at sexual debut while controlling for sociodemographic characteristics and sexual behavior. Compared with students who completed their primary education in private or charter schools, students who completed their primary education in public schools had 1.85 (95% confidence interval, 1.12-3.04) and 1.67 (95% confidence interval, 1.26-2.23) higher odds, respectively, of not using condoms at sexual debut. Odds were similar for students living in urban settings, whereas there were too few students attending private schools in rural areas to allow meaningful estimates. Independent of household income, primary schooling is associated with sexual health behaviors among Chilean adolescents living in urban areas and can serve as a target for public health interventions designed to prevent sexually transmitted infections in adolescence.

  9. Swaziland's traditional birth attendants survey | Lech | African ...

    African Journals Online (AJOL)

    The Traditional Birth Attendants (TBAs) Survey in Swaziland was undertaken between March 27th 1996 and April 8th 1996. The objective of the survey was to generate reliable information regarding activities of TBAs in Swaziland. The survey was conducted in 25 Chiefdoms sampled out of a total of 206 Chiefdoms ...

  10. Differential campsite pricing and campground attendance

    Science.gov (United States)

    Wilbur F. LaPage; Paula L. Cormier; George T. Hamilton; Alan D. Cormier

    1975-01-01

    Several changes in the characteristics of campers' visits were discovered by comparing camping permit data before and after the start of differential campsite pricing at a New Hampshire state park campground in 1973. Differentials included a premium charge for waterfront sites and a preferential rate for New Hampshire residents. Attendance by state residents...

  11. Service Station Attendant. Performance Objectives. Basic Course.

    Science.gov (United States)

    Davis, John

    Several intermediate performance objectives and corresponding criterion measures are listed for each of 24 terminal objectives for a basic secondary level service station attendant course. The materials were developed for a two-semester course (2 and 3 hours daily). The specialized classroom and shop experiences are designed to enable the student…

  12. Electronic Attendance Application Using Raspberry Pi

    International Nuclear Information System (INIS)

    Mohd Dzul Aiman Aslan; Saaidi Ismail; Mohamad Safuan Sulaiman

    2016-01-01

    Raspberry Pi is a cheap mini-computer that officially runs on a Linux distribution Operating System (OS) such as Raspbian. It has many input and output mechanisms simulating a computer which make it useful replacement for a computer system. SimpleCV, an open source python-based image processing software and Telegram, a popular social application provide API that allow communication trough a device such as Raspberry Pi. Combining these two, an electronic attendance has been developed using open source basis, and the electronic attendance also provide enhancement of current system that is to record the person face and sending information through Telegram application. The methodology include gathering requirements on remaining system and test it on Linux which will discuss further. This project is serve as a prototype for enhancement of current Commersial Of The Shelf (COTS) electronic attendance that only record ID of the attendees. In the future, the electronic attendance can be enhanced with many features and should be make in-a-box for commercialization. (author)

  13. Attendance at NHS mandatory training sessions.

    Science.gov (United States)

    Brand, Darren

    2015-02-17

    To identify factors that affect NHS healthcare professionals' attendance at mandatory training sessions. A quantitative approach was used, with a questionnaire sent to 400 randomly selected participants. A total of 122 responses were received, providing a mix of qualitative and quantitative data. Quantitative data were analysed using statistical methods. Open-ended responses were reviewed using thematic analysis. Clinical staff value mandatory training sessions highly. They are aware of the requirement to keep practice up-to-date and ensure patient safety remains a priority. However, changes to the delivery format of mandatory training sessions are required to enable staff to participate more easily, as staff are often unable to attend. The delivery of mandatory training should move from classroom-based sessions into the clinical area to maximise participation. Delivery should be assisted by local 'experts' who are able to customise course content to meet local requirements and the requirements of different staff groups. Improved arrangements to provide staff cover, for those attending training, would enable more staff to attend training sessions.

  14. Psychological distress and symptoms among patients attending ...

    African Journals Online (AJOL)

    Background: The study was carried out to investigate the manifestations of psychological distress and symptoms among individuals receiving treatment for sexually transmitted diseases and to compare them with individuals who were not suffering from sexually transmitted diseases. Methods: Patients attending the sexually ...

  15. Malaria parasitemia amongst pregnant women attending selected ...

    African Journals Online (AJOL)

    A cross-sectional study to determine malaria parasitemia amongst 300 randomly selected pregnant women attending government and private healthcare facilities in Rivers State was carried out. Blood samples were obtained through venous procedure and the presence or absence of Plasmodium was determined ...

  16. The influence of a major sporting event upon emergency department attendances; A retrospective cross-national European study

    Science.gov (United States)

    Colón-González, Felipe J.; Fouillet, Anne; Elliot, Alex J.; Caserio-Schonemann, Céline; Hughes, Thomas C.; Gallagher, Naomh; Morbey, Roger A.; Smith, Gillian E.; Thomas, Daniel Rh.; Lake, Iain R.

    2018-01-01

    Major sporting events may influence attendance levels at hospital emergency departments (ED). Previous research has focussed on the impact of single games, or wins/losses for specific teams/countries, limiting wider generalisations. Here we explore the impact of the Euro 2016 football championships on ED attendances across four participating nations (England, France, Northern Ireland, Wales), using a single methodology. Match days were found to have no significant impact upon daily ED attendances levels. Focussing upon hourly attendances, ED attendances across all countries in the four hour pre-match period were statistically significantly lower than would be expected (OR 0.97, 95% CI 0.94–0.99) and further reduced during matches (OR 0.94, 95% CI 0.91–0.97). In the 4 hour post-match period there was no significant increase in attendances (OR 1.01, 95% CI 0.99–1.04). However, these impacts were highly variable between individual matches: for example in the 4 hour period following the final, involving France, the number of ED attendances in France increased significantly (OR 1.27, 95% CI 1.13–1.42). Overall our results indicate relatively small impacts of major sporting events upon ED attendances. The heterogeneity observed makes it difficult for health providers to predict how major sporting events may affect ED attendances but supports the future development of compatible systems in different countries to support cross-border public health surveillance. PMID:29898000

  17. The influence of a major sporting event upon emergency department attendances; A retrospective cross-national European study.

    Science.gov (United States)

    Hughes, Helen E; Colón-González, Felipe J; Fouillet, Anne; Elliot, Alex J; Caserio-Schonemann, Céline; Hughes, Thomas C; Gallagher, Naomh; Morbey, Roger A; Smith, Gillian E; Thomas, Daniel Rh; Lake, Iain R

    2018-01-01

    Major sporting events may influence attendance levels at hospital emergency departments (ED). Previous research has focussed on the impact of single games, or wins/losses for specific teams/countries, limiting wider generalisations. Here we explore the impact of the Euro 2016 football championships on ED attendances across four participating nations (England, France, Northern Ireland, Wales), using a single methodology. Match days were found to have no significant impact upon daily ED attendances levels. Focussing upon hourly attendances, ED attendances across all countries in the four hour pre-match period were statistically significantly lower than would be expected (OR 0.97, 95% CI 0.94-0.99) and further reduced during matches (OR 0.94, 95% CI 0.91-0.97). In the 4 hour post-match period there was no significant increase in attendances (OR 1.01, 95% CI 0.99-1.04). However, these impacts were highly variable between individual matches: for example in the 4 hour period following the final, involving France, the number of ED attendances in France increased significantly (OR 1.27, 95% CI 1.13-1.42). Overall our results indicate relatively small impacts of major sporting events upon ED attendances. The heterogeneity observed makes it difficult for health providers to predict how major sporting events may affect ED attendances but supports the future development of compatible systems in different countries to support cross-border public health surveillance.

  18. Seroprevalence of cytomegalovirus among pregnant women attending Murtala Mohammed Specialist Hospital Kano, Nigeria.

    Science.gov (United States)

    Hamid, K M; Onoja, A B; Tofa, U A; Garba, K N

    2014-03-01

    Primary Cytomegalovirus (CMV) infection during pregnancy is a frequent and serious threat to the fetus. As there is no vaccine alternative measures are needed to prevent congenital CMV infection. This study determined CMV Immunoglobulin G (IgG) antibody among pregnant women in order to ascertain the immune status of mothers to guide policy makers. A semi-structured questionnaire was initially administered to obtain information on demographic details, stage of pregnancy and risk factors. Blood was collected by venipuncture from 180 women attending the antenatal clinic in Murtala Mohammed Specialist Hospital Kano, Kano State, Nigeria. Sera samples were screened using CMV IgG ELISA kit (Dialab, Austria). Out of 180 pregnant women, 164 (91.1%) were seropositive. Based on stages of pregnancy 6/6(100%), 52/60(86.7%) and 106/114(93.0%) were seropositive among women in the first, second and third trimesters respectively. Seroprevalence of pregnant women to CMV Ig G is high, hence the need for CMV - IgM screening to know the extent of active infection. There is also need for public enlightenment on the methods of transmission, effective prevention and control strategies.

  19. Delay in Diagnosis and Treatment of Breast Cancer among Women Attending a Reference Service in Brazil

    Science.gov (United States)

    Romeiro Lopes, Tiara Cristina; Gravena, Angela Andréia França; Demitto, Marcela de Oliveira; Borghesan, Deise Helena Pelloso; Dell`Agnolo, Cátia Millene; Brischiliari, Sheila Cristina Rocha; Carvalho, Maria Dalva de Barros; Pelloso, Sandra Marisa

    2017-11-26

    Background: Cancer is a major public health problem. Early diagnosis and treatment are essential for reducing mortality. This study aimed to analyze factors associated with delay in breast cancer diagnosis and treatment among women attending a reference cancer service. Methods: This retrospective, cross-sectional study was performed with data collected from medical records and interviews conducted with women diagnosed with breast cancer and treated from October 2013 to October 2014 at a cancer reference hospital in Paraná, Southern Brazil. Results: A total of 82 participants were enrolled during the study period; their average age was 58.2 ± 11.5 years. The average time taken for final diagnosis of breast cancer was 102.5 ± 165.5 days. Treatment onset was delayed in the majority of cases, and the average time elapsing from diagnostic biopsy to onset of primary treatment was 72.3 ± 54.0 days. The odds of treatment delay were higher among the women with a low educational level. Conclusions: The results underline the need for proposals aimed at early detection, identification of risk factors and timely provision of treatment by health managers that focus on this group. Creative Commons Attribution License

  20. 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 recession in 2011 and by early 2013 it applied for an international bail-out agreement. This presupposed massive reforms in public governance. Health sector was considerably reformed and one of the measures was the introduction of co-payment for outpatient visits to public health care sector. The scope of this study is to assess the impact of financial crisis and co-payment to public outpatient visits in Nicosia urban and greater Nicosia region. An Interrupted time-series analysis. All outpatient visits to public health care family doctor/general practitioners in Nicosia urban and greater Nicosia region from January 2011 until May of 2014 were registered and analysed. Financial crisis did not alter outpatient visits. Introduction of co-payment led to a statistically significant decrease from the second month after its introduction (p = 0.048) (R(2) = 0.329, Q = 23.75, p = 0.137). This decrease was consistent until the end of the observational period and it did not level off. Financial crisis did not affect outpatient visits while co-payment can be considered as a potent cost containment measure during financial recession, by normalising utilisation of healthcare resources. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  1. Development of a Knowledge Management Model for the Development of a Quality Public Sector Management System for the Office of the Primary Educational Service Area

    Science.gov (United States)

    Khotbancha, Wijitra; Chantarasombat, Chalard; Sriampai, Anan

    2015-01-01

    The objectives of this research were: 1) to study the current situation and problem of Knowledge Management of the office of the primary education service area, 2) to develop a Knowledge Management model, 3) to study the success of the implementation of the Knowledge Management system. There were 25 persons in the target group. There were 2 kinds…

  2. 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.

    NARCIS (Netherlands)

    Assendelft, W.J.J.; Nielen, M.M.J.; Hettinga, D.M.; Meer, V. van der; Vliet, M. van; Drenthen, A.J.M.; Schellevis, F.G.; Oosterhout, M.J.W. van

    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

  3. Attendance at antenatal clinics in inner-city Johannesburg, South Africa and its associations with birth outcomes: analysis of data from birth registers at three facilities.

    Science.gov (United States)

    Gumede, Siphamandla; Black, Vivian; Naidoo, Nicolette; Chersich, Matthew F

    2017-07-04

    Antenatal care (ANC) clinics serve as key gateways to screening and treatment interventions that improve pregnancy outcomes, and are especially important for HIV-infected women. By disaggregating data on access to ANC, we aimed to identify variation in ANC attendance by level of care and across vulnerable groups in inner-city Johannesburg, and document the impact of non-attendance on birth outcomes. This record review of routine health service data involved manual extraction of 2 years of data from birth registers at a primary-, secondary- and tertiary-level facility within inner-city Johannesburg. Information was gathered on ANC attendance, HIV testing and status, pregnancy duration, delivery mode and birth outcomes. Women with an unknown attendance status were considered as not having attended clinic, but effects of this assumption were tested in sensitivity analyses. Multiple logistic regression was used to identify associations between ANC attendance and birth outcomes. Of 31,179 women who delivered, 88.7% (27,651) had attended ANC (95% CI = 88.3-89.0). Attendance was only 77% at primary care (5813/7543), compared to 89% at secondary (3661/4113) and 93% at tertiary level (18,177/19,523). Adolescents had lower ANC attendance than adults (85%, 1951/2295 versus 89%, 22,039/24,771). Only 37% of women not attending ANC had an HIV test (1308/3528), compared with 93% of ANC attenders (25,756/27,651). Caesarean section rates were considerably higher in women who had attended ANC (40%, 10,866/27,344) than non-attenders (13%, 422/3360). Compared to those who had attended ANC, non-attenders were 1.6 fold more likely to have a preterm delivery (95% CI adjusted odds ratio [aOR] = 1.4-1.8) and 1.4 fold more likely to have a stillbirth (aOR 95% CI = 1.1-1.9). Similar results were seen in analyses where missing data on ANC attendance was classified in different ways. Inner-city Johannesburg has an almost 5% lower ANC attendance rate than national levels. Attendance is

  4. Attendance at antenatal clinics in inner-city Johannesburg, South Africa and its associations with birth outcomes: analysis of data from birth registers at three facilities

    Directory of Open Access Journals (Sweden)

    Siphamandla Gumede

    2017-07-01

    Full Text Available Abstract Background Antenatal care (ANC clinics serve as key gateways to screening and treatment interventions that improve pregnancy outcomes, and are especially important for HIV-infected women. By disaggregating data on access to ANC, we aimed to identify variation in ANC attendance by level of care and across vulnerable groups in inner-city Johannesburg, and document the impact of non-attendance on birth outcomes. Methods This record review of routine health service data involved manual extraction of 2 years of data from birth registers at a primary-, secondary- and tertiary-level facility within inner-city Johannesburg. Information was gathered on ANC attendance, HIV testing and status, pregnancy duration, delivery mode and birth outcomes. Women with an unknown attendance status were considered as not having attended clinic, but effects of this assumption were tested in sensitivity analyses. Multiple logistic regression was used to identify associations between ANC attendance and birth outcomes. Results Of 31,179 women who delivered, 88.7% (27,651 had attended ANC (95% CI = 88.3–89.0. Attendance was only 77% at primary care (5813/7543, compared to 89% at secondary (3661/4113 and 93% at tertiary level (18,177/19,523. Adolescents had lower ANC attendance than adults (85%, 1951/2295 versus 89%, 22,039/24,771. Only 37% of women not attending ANC had an HIV test (1308/3528, compared with 93% of ANC attenders (25,756/27,651. Caesarean section rates were considerably higher in women who had attended ANC (40%, 10,866/27,344 than non-attenders (13%, 422/3360. Compared to those who had attended ANC, non-attenders were 1.6 fold more likely to have a preterm delivery (95% CI adjusted odds ratio [aOR] = 1.4–1.8 and 1.4 fold more likely to have a stillbirth (aOR 95% CI = 1.1–1.9. Similar results were seen in analyses where missing data on ANC attendance was classified in different ways. Conclusion Inner-city Johannesburg has an almost 5

  5. Lecture Attendance, Study Time, and Academic Performance: A Panel Data Study

    Science.gov (United States)

    Andrietti, Vincenzo; Velasco, Carlos

    2015-01-01

    The authors analyze matched administrative survey data on economics students enrolled in two econometrics courses offered in consecutive terms at a major public university in Spain to assess the impact of lecture attendance and study time on academic performance. Using proxy variables in a cross-sectional regression setting, they find a positive…

  6. Kindergarten Attendance and Readiness for Baltimore's Class of 2027. Policy Brief

    Science.gov (United States)

    Grigg, Jeffrey; Connolly, Faith; D'Souza, Stephanie; Mitchell, Charlie

    2016-01-01

    This brief examines kindergarten readiness and attendance in kindergarten for children enrolled in publicly provided early education programs as well as similar children who entered kindergarten without enrolling in these programs. Key findings detail the effects for children if they were enrolled for at least 90 calendar days as a three- or…

  7. Effect of Peer Attendance on College Students' Learning Outcomes in a Microeconomics Course

    Science.gov (United States)

    Chen, Jennjou; Lin, Tsui-Fang

    2015-01-01

    The authors' main purpose in this article is to examine whether peer presence, measured by overall class attendance rate, has any significant effect on college students' academic performance. They use a rich dataset from an intermediate microeconomics course from the fall of 2008 to the spring of 2013 at a public university in Taiwan. The…

  8. Fruit and Vegetable Intake and Dietary Patterns of Preadolescents Attending Schools in the Midwest

    Science.gov (United States)

    Nepper, Martha J.; Chai, Weiwen

    2015-01-01

    Objectives: The present study examined dietary intake of fruit and vegetables and dietary patterns of preadolescents attending schools in the Midwest. Methods: A total of 506 students (11.2 ± 1.3 years) from four public and private schools in Nebraska completed a validated 41-item Food Frequency Questionnaire to assess their dietary intake.…

  9. Social capital and frequent attenders in general practice: a register-based cohort study.

    Science.gov (United States)

    Pasgaard, Alexander A; Mæhlisen, Maiken H; Overgaard, Charlotte; Ejlskov, Linda; Torp-Pedersen, Christian; Bøggild, Henrik

    2018-03-02

    Frequent attendance to primary care constitutes a large use of resources for the health care system. The association between frequent attendance and illness-related factors has been examined in several studies, but little is known about the association between frequent attendance and individual social capital. The aim of this study is to explore this association. The analysis is conducted on responders to the North Denmark Region Health Profile 2010 (n = 23,384), individually linked with information from administrative registers. Social capital is operationalized at the individual level, and includes cognitive (interpersonal trust and norms of reciprocity) as well as structural (social network and civic engagement) dimensions. Frequent attendance is defined as the upper-quartile of the total number of measured consultations with a general practitioner over a period of 148 weeks. Using multiple logistic regression, we found that frequent attendance was associated with a lower score in interpersonal trust [OR 0.86 (0.79-0.94)] and social network [OR 0.88 (0.79-0.98)] for women, when adjusted for age, education, income and SF12 health scores. Norms of reciprocity and civic engagement were not significantly associated with frequent attendance for women [OR 1.05 (0.99-1.11) and OR 1.01 (0.92-1.11) respectively]. None of the associations were statistically significant for men. This study suggests that for women, some aspects of social capital are associated with frequent attendance in general practice, and the statistically significant dimensions belonged to both cognitive and structural aspects of social capital. This association was not seen for men. This indicates a multifaceted and heterogeneous relationship between social capital and frequent attendance among genders.

  10. Anemia e marcadores séricos da deficiência de ferro em grávidas atendidas na rede pública municipal de Manaus, Amazonas, Brasil Anemia and serum markers of iron deficiency in pregnant women attended by Public Health Service in Manaus, Amazonas, Brazil

    Directory of Open Access Journals (Sweden)

    Carolina Marinho da Costa

    2009-01-01

    Full Text Available O presente estudo teve como objetivo avaliar a anemia em grávidas, associando os resultados da dosagem de hemoglobina e hematócrito com a análise de marcadores do perfil sérico do ferro. Participaram do estudo 92 grávidas que estavam realizando pré-natal em unidades de atendimento à saúde no Município de Manaus, Amazonas, Brasil. Foi aplicado um formulário para obtenção dos dados antropométricos e informações sobre estilo de vida, além de serem realizadas dosagens dos níveis séricos de ferro, capacidade latente de ligação do ferro (CLLF, capacidade total de ligação do ferro (CTLF, índice de saturação da transferrina (IST, transferrina, ferritina e níveis sanguíneos de hemoglobina e hematócrito por metodologia automatizada utilizando kits comerciais disponíveis. Foram encontradas 26,1% de grávidas com níveis de hemoglobina abaixo de 11 g/dL. Observou-se que 17,4% das grávidas com níveis normais de hemoglobina apresentavam níveis inadequados de ferro sérico e 9,8% apresentavam níveis baixos de ferritina sérica. Os níveis de ferritina e de hemoglobina apresentaram diferença significativa entre os trimestres de gestação (p This study aimed to evaluate anemia in pregnant women, comparing results of hemoglobin and hemotocrit dosages with analysis of iron serum status markers. 92 pregnant women, in pre-natal attendance in Public Health Service of Manaus, Amazonas, Brazil, participated in this study. A questionnaire was used to access anthropometric data and life style information. Serum levels of iron, latent iron binding capacity (LIBC, total iron binding capacity (TIBC, transferrin saturation (TS, transferrin, ferritin, and blood levels of hemoglobin and hematocrit were measured by automated methods, using commercially available kits. The study showed that 26.1% of the pregnant women had hemoglobin levels below 11 g/dL. Also, of the pregnant women with normal levels of hemoglobin, 17.4% showed inadequate iron

  11. The Community College Effect Revisited: The Importance of Attending to Heterogeneity and Complex Counterfactuals*

    Science.gov (United States)

    Brand, Jennie E.; Pfeffer, Fabian T.; Goldrick-Rab, Sara

    2015-01-01

    Community colleges are controversial educational institutions, often said to simultaneously expand college opportunities and diminish baccalaureate attainment. We assess the seemingly contradictory functions of community colleges by attending to effect heterogeneity and to alternative counterfactual conditions. Using data on postsecondary outcomes of high school graduates of Chicago Public Schools, we find that enrolling at a community college penalizes more advantaged students who otherwise would have attended four-year colleges, particularly highly selective schools; however, these students represent a relatively small portion of the community college population, and these estimates are almost certainly biased. On the other hand, enrolling at a community college has a modest positive effect on bachelor's degree completion for disadvantaged students who otherwise would not have attended college; these students represent the majority of community college goers. We conclude that discussions among scholars, policymakers, and practitioners should move beyond considering the pros and cons of community college attendance for students in general to attending to the implications of community college attendance for targeted groups of students. PMID:25825705

  12. Iran's Experience of Health Cooperatives as a Public-Private Partnership Model in Primary Health Care: A Comparative Study in East Azerbaijan.

    Science.gov (United States)

    Farahbakhsh, Mostafa; Sadeghi-Bazargani, Homayoun; Nikniaz, Alireza; Tabrizi, Jafar Sadegh; Zakeri, Akram; Azami, Saber

    2012-01-01

    Iran started a new public-private partnership model in form of health coopera¬tives which is somehow different from other types of health cooperatives throughout the world. In this study we compared the performance and quality of health services in public health cen¬ters (PHCs) and cooperative health centers (CHCs). In this comparative study performance quality of two cohorts of public and coopera¬tive health centers were compared in several health service delivery programs over the time pe¬riod of 2001- 2002. Screening program: the rate of visited population during screening program was higher in CHCs. Maternal health care program: In some of studied programs CHCs had better results. Child health care: Most indicators were better or similar in CHCs. School health program and Health education: All indices were better or similar in CHCs. Environmental health: population based positive function was not significantly different for the population covered by CHCs compared to population covered by PHCs. Client and staff satisfaction as well as participation and attitudes of personnel towards management was better in CHCs. Mean annual cost per capita of the covered population by PHCs was higher. CHCs as a public private partnership model in Iran may deliver preventive health care services as effective as PHCs in many fields and even better in some areas.

  13. Smartphone use during inpatient attending rounds: prevalence, patterns and potential for distraction.

    Science.gov (United States)

    Katz-Sidlow, Rachel J; Ludwig, Allison; Miller, Scott; Sidlow, Robert

    2012-10-01

    While there are numerous benefits of smartphone use for physicians, little is known about the negative effects of using these devices in the context of patient care. To assess resident and faculty smartphone use during inpatient attending rounds and its potential as a source of distraction during transfer of clinical information. Cross-sectional survey. University-affiliated public teaching hospital. All housestaff and inpatient faculty in the departments of Medicine and Pediatrics. Participants were asked about smartphone ownership, usage patterns during attending rounds, and whether team members had ever missed important data during rounds due to distraction from smartphones. Attendings were asked whether policies should be established for smartphone use during rounds. The overall response rate was 73%. Device ownership was prevalent (89% residents, 98% faculty), as was use of smartphones during inpatient rounds (57% residents, 28% attendings). According to self-reports, smartphones were used during rounds for patient care (85% residents, 48% faculty), reading/responding to personal texts/e-mails (37% residents, 12% faculty), and other non-patient care uses (15% residents, 0% faculty). Nineteen percent of residents and 12% of attendings believed they had missed important information because of distraction from smartphones. Residents and faculty agreed that smartphones "can be a serious distraction during attending rounds," and nearly 80% of faculty believed that smartphone policies should be established. Smartphone use during attending rounds is prevalent and can distract users during important information transfer. Attendings strongly favored the institution of formal policies governing appropriate smartphone use during inpatient rounds. Copyright © 2012 Society of Hospital Medicine.

  14. Influência da propaganda na utilização de medicamentos em um grupo de idosos atendidos em uma unidade básica de saúde em Aracaju (SE, Brasil The influence of the advertising in the medication use in a group of elderly attended in a primary health care unit in Aracaju (Sergipe, Brasil

    Directory of Open Access Journals (Sweden)

    Divaldo Pereira de Lyra Jr

    2010-11-01

    Full Text Available O crescimento da população idosa brasileira tem levado a uma maior tendência ao uso de medicamentos. A sua utilização inadequada pode ser induzida por vários fatores, dentre eles a propaganda, podendo trazer danos à saúde do usuário. O objetivo do estudo foi avaliar a influência da propaganda no consumo de medicamentos por um grupo de idosos atendidos em unidade básica de saúde de Aracaju, Sergipe. No período de abril a junho de 2007, um grupo de 230 idosos, com idade acima de 60 anos, de ambos os gêneros, foi entrevistado. A maioria dos entrevistados (73% possuía pelo menos uma doença crônica e 73,9% consumiam pelo menos um medicamento regularmente. Do total de entrevistados, 17,8% da amostra relataram utilizar medicamentos por influência da propaganda; 2,2% consideraram que os medicamentos veiculados na mídia nunca fazem mal e 6,5% acreditavam que eles sempre fazem bem. No estudo, correlações foram feitas e demonstraram que quem mais consome medicamentos influenciados pela propaganda também considera que eles sempre fazem bem e vice-versa (p= 0,04. Os dados revelaram que parte dos idosos sofreu influência da propaganda no consumo de medicamentos, não levando em consideração os riscos que estes poderiam causar.The growth of the Brazilian elderly people has led to a trend to an increase in the medication use. The inadequate use of drugs can be induced by some factors, like advertisement, with the risk of damaging the user's health. The objective of the study was to evaluate the advertisement influence in medication use in a group of elderly patients in a primary health care unit in Aracaju, Sergipe, Brazil. 230 elderly aging over 60 years with both genders had been interviewed from April to June of 2007. The majority of the interviewees (73% has at least a chronic health condition and 73.9% consumed regularly at least one medication. 17.8% of the sample informed to use medication motivated by publicity influence; 2

  15. Beyond folding and gathering: museums attending to the new materiality

    Directory of Open Access Journals (Sweden)

    Kylie Budge

    2017-06-01

    Full Text Available Museums are attending to matters of technique in relation to objects and exhibitions suggesting a new or renewed interest in creative practice and how objects are made. This focus parallels practices and changes occurring in broader society. In this article I argue that a rise in attending to technique extends what various theorists have referred to as the ‘material turn’ in a dimension that underscores creative process and making. I do so by exploring two recent exhibitions, one in Israel and another in Australia, which have brought the notion of technique into focus through the context of textiles and other materials such as paper, porcelain, wood and metal. Through their emphasis on ‘gathering’ and ‘folding’, the construction of textiles and other forms are accentuated for public exploration, fostering new understandings of technique. Conclusions are drawn connecting museum contexts with that of broader society in reference to making, the role of the hand, and craft processes.

  16. How the integration of traditional birth attendants with formal health systems can increase skilled birth attendance.

    Science.gov (United States)

    Byrne, Abbey; Morgan, Alison

    2011-11-01

    Forty years of safe motherhood programming has demonstrated that isolated interventions will not reduce maternal mortality sufficiently to achieve MDG 5. Although skilled birth attendants (SBAs) can intervene to save lives, traditional birth attendants (TBAs) are often preferred by communities. Considering the value of both TBAs and SBAs, it is important to review strategies for maximizing their respective strengths. To describe mechanisms to integrate TBAs with the health system to increase skilled birth attendance and examine the components of successful integration. A systematic review of interventions linking TBAs and formal health workers, measuring outcomes of skilled birth attendance, referrals, and facility deliveries. Thirty-three articles met the selection criteria. Mechanisms used for integration included training and supervision of TBAs, collaboration skills for health workers, inclusion of TBAs at health facilities, communication systems, and clear definition of roles. Impact on skilled birth attendance depended on selection of TBAs, community participation, and addressing barriers to access. Successful approaches were context-specific. The integration of TBAs with formal health systems increases skilled birth attendance. The greatest impact is seen when TBA integration is combined with complementary actions to overcome context-specific barriers to contact among SBAs, TBAs, and women. Copyright © 2011 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  17. Mobile phones as a health communication tool to improve skilled attendance at delivery in Zanzibar

    DEFF Research Database (Denmark)

    Lund, S; Hemed, M; Nielsen, Bb

    2012-01-01

    Please cite this paper as: Lund S, Hemed M, Nielsen B, Said A, Said K, Makungu M, Rasch V. Mobile phones as a health communication tool to improve skilled attendance at delivery in Zanzibar: a cluster-randomised controlled trial. BJOG 2012; DOI: 10.1111/j.1471-0528.2012.03413.x. Objective......  To examine the association between a mobile phone intervention and skilled delivery attendance in a resource-limited setting. Design  Pragmatic cluster-randomised controlled trial with primary healthcare facilities as the unit of randomisation. Setting  Primary healthcare facilities in Zanzibar. Population...... for study participation. Methods  Twenty-four primary healthcare facilities in six districts in Zanzibar were allocated by simple randomisation to either mobile phone intervention (n = 12) or standard care (n = 12). The intervention consisted of a short messaging service (SMS) and mobile phone voucher...

  18. Effect of training traditional birth attendants on neonatal mortality (Lufwanyama Neonatal Survival Project): randomised controlled study.

    Science.gov (United States)

    Gill, Christopher J; Phiri-Mazala, Grace; Guerina, Nicholas G; Kasimba, Joshua; Mulenga, Charity; MacLeod, William B; Waitolo, Nelson; Knapp, Anna B; Mirochnick, Mark; Mazimba, Arthur; Fox, Matthew P; Sabin, Lora; Seidenberg, Philip; Simon, Jonathon L; Hamer, Davidson H

    2011-02-03

    To determine whether training traditional birth attendants to manage several common perinatal conditions could reduce neonatal mortality in the setting of a resource poor country with limited access to healthcare. Prospective, cluster randomised and controlled effectiveness study. Lufwanyama, an agrarian, poorly developed district located in the Copperbelt province, Zambia. All births carried out by study birth attendants occurred at mothers' homes, in rural village settings. 127 traditional birth attendants and mothers and their newborns (3559 infants delivered regardless of vital status) from Lufwanyama district. Using an unblinded design, birth attendants were cluster randomised to intervention or control groups. The intervention had two components: training in a modified version of the neonatal resuscitation protocol, and single dose amoxicillin coupled with facilitated referral of infants to a health centre. Control birth attendants continued their existing standard of care (basic obstetric skills and use of clean delivery kits). The primary outcome was the proportion of liveborn infants who died by day 28 after birth, with rate ratios statistically adjusted for clustering. Secondary outcomes were mortality at different time points; and comparison of causes of death based on verbal autopsy data. Among 3497 deliveries with reliable information, mortality at day 28 after birth was 45% lower among liveborn infants delivered by intervention birth attendants than control birth attendants (rate ratio 0.55, 95% confidence interval 0.33 to 0.90). The greatest reductions in mortality were in the first 24 hours after birth: 7.8 deaths per 1000 live births for infants delivered by intervention birth attendants compared with 19.9 per 1000 for infants delivered by control birth attendants (0.40, 0.19 to 0.83). Deaths due to birth asphyxia were reduced by 63% among infants delivered by intervention birth attendants (0.37, 0.17 to 0.81) and by 81% within the first two days

  19. Effect of training traditional birth attendants on neonatal mortality (Lufwanyama Neonatal Survival Project): randomised controlled study

    Science.gov (United States)

    Phiri-Mazala, Grace; Guerina, Nicholas G; Kasimba, Joshua; Mulenga, Charity; MacLeod, William B; Waitolo, Nelson; Knapp, Anna B; Mirochnick, Mark; Mazimba, Arthur; Fox, Matthew P; Sabin, Lora; Seidenberg, Philip; Simon, Jonathon L; Hamer, Davidson H

    2011-01-01

    Objective To determine whether training traditional birth attendants to manage several common perinatal conditions could reduce neonatal mortality in the setting of a resource poor country with limited access to healthcare. Design Prospective, cluster randomised and controlled effectiveness study. Setting Lufwanyama, an agrarian, poorly developed district located in the Copperbelt province, Zambia. All births carried out by study birth attendants occurred at mothers’ homes, in rural village settings. Participants 127 traditional birth attendants and mothers and their newborns (3559 infants delivered regardless of vital status) from Lufwanyama district. Interventions Using an unblinded design, birth attendants were cluster randomised to intervention or control groups. The intervention had two components: training in a modified version of the neonatal resuscitation protocol, and single dose amoxicillin coupled with facilitated referral of infants to a health centre. Control birth attendants continued their existing standard of care (basic obstetric skills and use of clean delivery kits). Main outcome measures The primary outcome was the proportion of liveborn infants who died by day 28 after birth, with rate ratios statistically adjusted for clustering. Secondary outcomes were mortality at different time points; and comparison of causes of death based on verbal autopsy data. Results Among 3497 deliveries with reliable information, mortality at day 28 after birth was 45% lower among liveborn infants delivered by intervention birth attendants than control birth attendants (rate ratio 0.55, 95% confidence interval 0.33 to 0.90). The greatest reductions in mortality were in the first 24 hours after birth: 7.8 deaths per 1000 live births for infants delivered by intervention birth attendants compared with 19.9 per 1000 for infants delivered by control birth attendants (0.40, 0.19 to 0.83). Deaths due to birth asphyxia were reduced by 63% among infants delivered by

  20. Emergency department attendance patterns during Ramadan.

    Science.gov (United States)

    Butt, Taimur; Khan, Hameed Ullah; Ahmed, Israr; Eldali, Abdelmoneim

    2016-01-01

    Patient attendance in the emergency department (ED) is inherently variable and unpredictable. Resources might be better allocated if use of the ER could be predicted during the month of fasting (Ramadan), healthy adult Muslims do not eat or drink from dawn to sunset and in the Middle East, social activities occur mostly during night. There is no published data that has reported changes in local ED attendance pattern during Ramadan. Determine if there are differences in tertiary care ed attendance during Ramadan compared to other times of the year. Retrospective, using data from the hospital integrated clinical information system. Tertiary care institution in Riyadh, Saudi Arabia. All ED visits during the Islamic calendar years of 1431-1434 (December 18, 2009-October 13, 2013) were analyzed. Patient volume, acuity, demographics and admission rate variability between Ramadan and other months. During the study period of 4 years, of 226075 ED patients, 129178 (57.14%) patients were seen during the day shift (07:00 to 18:59). During Ramadan, 10 293 (60%) patients presented during the night shift compared with the day shift (P many ED patients were actually fasting during the study period. This study was conducted in a tertiary care hospital and the patient population presenting to our ed is predominantly Muslim; therefore, the results may not be generalized to populations that are not predominantly Muslim.

  1. 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

  2. Journal article reporting standards for qualitative primary, qualitative meta-analytic, and mixed methods research in psychology: The APA Publications and Communications Board task force report

    OpenAIRE

    Levitt, H. M.; Bamberg, M.; Creswell, J. W.; Frost, D. M.; Josselson, R.; Suárez-Orozco, C.

    2018-01-01

    The American Psychological Association Publications and Communications Board Working Group on Journal Article Reporting Standards for Qualitative Research (JARS–Qual Working Group) was charged with examining the state of journal article reporting standards as they applied to qualitative research and with generating recommendations for standards that would be appropriate for a wide range of methods within the discipline of psychology. These standards describe what should be included in a resea...

  3. The choice of primary energy source including PV installation for providing electric energy to a public utility building - a case study

    Science.gov (United States)

    Radomski, Bartosz; Ćwiek, Barbara; Mróz, Tomasz M.

    2017-11-01

    The paper presents multicriteria decision aid analysis of the choice of PV installation providing electric energy to a public utility building. From the energy management point of view electricity obtained by solar radiation has become crucial renewable energy source. Application of PV installations may occur a profitable solution from energy, economic and ecologic point of view for both existing and newly erected buildings. Featured variants of PV installations have been assessed by multicriteria analysis based on ANP (Analytic Network Process) method. Technical, economical, energy and environmental criteria have been identified as main decision criteria. Defined set of decision criteria has an open character and can be modified in the dialog process between the decision-maker and the expert - in the present case, an expert in planning of development of energy supply systems. The proposed approach has been used to evaluate three variants of PV installation acceptable for existing educational building located in Poznań, Poland - the building of Faculty of Chemical Technology, Poznań University of Technology. Multi-criteria analysis based on ANP method and the calculation software Super Decisions has proven to be an effective tool for energy planning, leading to the indication of the recommended variant of PV installation in existing and newly erected public buildings. Achieved results show prospects and possibilities of rational renewable energy usage as complex solution to public utility buildings.

  4. Midwife-attended births in the United States, 1990-2012: results from revised birth certificate data.

    Science.gov (United States)

    Declercq, Eugene

    2015-01-01

    Data on attendance at birth by midwives in the United States have been available on the national level since 1989, allowing for the documentation of long-term trends. New items on payer source and prepregnancy body mass index (BMI) from a 2003 revision of the birth certificate provide an opportunity to examine additional aspects of US midwifery practice. The data in this report are based on records on birth attendant gathered as part of the US National Standard Certificate of Live Birth from a public use Web site, Vital Stats (http://www.cdc.gov/nchs/VitalStats.htm), which allows users to create and download specialized tables. Analysis of new items on prepregnancy BMI and birth payer source are limited to the 38 states (86% of US births) that adopted the revised birth certificate by 2012. Between 1989 and 2012, the proportion of all births attended by certified nurse-midwives (CNMs) increased from 3.3% to 7.9%. The proportion of vaginal births attended by CNMs reached an all-time high of 11.9%. Births attended by "other midwives" (typically certified professional midwives) rose to a peak of 28,343, or 0.7% of all US births. The distribution of payer source for CNM-attended births (44% Medicaid; 44% private insurance; 6% self-pay) is very similar to the national distribution, whereas the majority (53%) of births attended by other midwives are self-pay. Women whose births are attended by other midwives are less likely (13%) to have a prepregnancy BMI in the obese range than women attended by CNMs (19%) or overall (24%). The total number of births attended by CNMs and other midwives has remained steady or grown at a time when total US births have declined, resulting in the largest proportions of midwife-attended births in the quarter century that such data have been collected. © 2015 by the American College of Nurse-Midwives.

  5. The development of rhythmic attending in auditory sequences: attunement, referent period, focal attending.

    Science.gov (United States)

    Drake, C; Jones, M R; Baruch, C

    2000-12-15

    This paper is divided into three sections. The first section is theoretical; it extends Dynamic Attending Theory (Jones, M. R. Psychological Review 83 (1976) 323; Jones, M. R. Perception and Psychophysics 41(6) (1987) 631; Jones, M. R. Psychomusicology 9(2) (1990) 193; Jones, M. R., & Boltz, M. Psychological Review 96(3) (1989) 459) to developmental questions concerning tempo and time hierarchies. Generally Dynamic Attending Theory proposes that, when listening to a complex auditory sequence, listeners spontaneously focus on events occurring at an intermediate rate (the referent level), and they then may shift attention to events occurring over longer or shorter time spans, that is at lower (faster) or higher (slower) hierarchical levels (focal attending). The second section of the paper is experimental. It examines maturational changes of three dynamic attending activities involving referent period and level, attunement, and focal attending. Tasks involve both motor tapping (including spontaneous motor tempo and synchronization with simple sequences and music) and tempo discrimination. We compare performances by 4-, 6-, 8-, and 10-year-old children and adults, with or without musical training. Results indicate three changes with increased age and musical training: (1) a slowing of the mean spontaneous tapping rate (a reflection of the referent period) and mean synchronization rate (a reflection of the referent level), (2) enhanced ability to synchronize tapping and discriminate tempo (improved attunement), and (3) an enlarged range of tapping rates towards slower rates and higher hierarchical levels (improved focal attending). A final section considers results in light of the theory proposed here. It is suggested that growth trends can be expressed in terms of listeners' engagement of slower attending oscillators with age and experience, accompanied by the passage from the initial use of a single oscillator towards the coupling of multiple oscillators.

  6. Psychological distress as a predictor of frequent attendance in family practice: a cohort study

    DEFF Research Database (Denmark)

    Vedsted, Peter; Fink, Per; Olesen, Frede

    2001-01-01

    In cross-sectional studies, psychological distress has been associated with frequent health care utilization. However, there is a need for prospective studies to confirm these findings. This cohort study evaluated whether psychological distress predicted frequent attendance in family practice.......16 [0.99-1.36] for SCL and OR 1.31 [1.05-1.65] for Whiteley). Psychological distress involved an increased risk of future frequent attendance among adult patients consulting family practice in the daytime about an illness........ In 1990, 185 consecutive adults who consulted their primary care physician (PCP) about an illness were rated on two psychometric scales (Hopkins Symptom Check List [SCL-8] and Whiteley-7), and their annual number of face-to-face contacts with a family practice was followed until 1996. Frequent attenders...

  7. Communication between residents and attending doctors on call after hours.

    Science.gov (United States)

    Novoselsky Persky, Michal A; Yinnon, Amos M; Freier-Dror, Yossi; Henshke-Bar-Meir, Ruth

    2013-12-01

    Off-hours medical care in hospitals is provided by residents, while attendings on call are available for assistance. This study evaluated the gap between residents' expectations and professional guidelines' requirements of attendings on call and what actually occurs during night shifts, while comparing surgical and medical specialties. Two questionnaires based on professional guidelines were filled by residents. The first queried about residents' expectations of attendings on call, and the second asked about communication with the attendings during actual night shifts. While 91 (100%) of residents expected the attending on call to be available by phone during the shift, only 44 (48%) expected the attending to initiate contact, and only 17 (19%) expected the attending to visit the ward or emergency department (ED) without being requested to do so. In 127 shifts (84%), some form of communication occurred. Residents called their attendings during 105 shifts (70%). However, attendings initiated contact with residents at the beginning or during the shift in only 67 (44%) and 62 (41%) shifts, respectively, and initiated a visit to the ward/ED during the shift in only 41 cases (27%). Surgical attendings initiated contact in these three ways significantly more frequently than medical attendings [21 (28%) versus 46 (61%), 20 (26%) versus 42 (56%) and 4 (5%) versus 37 (50%), respectively; P communication during night shifts between residents and attendings occurs in most shifts, attendings initiate far less contact with residents than is required by the guidelines. © 2013 John Wiley & Sons Ltd.

  8. Student attendance and academic performance in undergraduate obstetrics/gynecology clinical rotations.

    Science.gov (United States)

    Deane, Richard P; Murphy, Deirdre J

    2013-12-04

    Student attendance is thought to be an important factor in the academic performance of medical students, in addition to having important regulatory, policy, and financial implications for medical educators. However, this relationship has not been well evaluated within clinical learning environments. To evaluate the relationship between student attendance and academic performance in a medical student obstetrics/gynecology clinical rotation. A prospective cohort study of student attendance at clinical and tutorial-based activities during a full academic year (September 2011 to June 2012) within a publicly funded university teaching hospital in Dublin, Ireland. Students were expected to attend 64 activities (26 clinical activities and 38 tutorial-based activities) but attendance was not mandatory. All 147 fourth-year medical students who completed an 8-week obstetrics/gynecology rotation were included. Student attendance at clinical and tutorial-based activities, recorded using a paper-based logbook. The overall examination score (out of a possible 200 points) was obtained using an 11-station objective structured clinical examination (40 points), an end-of-year written examination comprising 50 multiple-choice questions (40 points) and 6 short-answer questions (40 points), and an end-of-year long-case clinical/oral examination (80 points). Students were required to have an overall score of 100 points (50%) and a minimum of 40 points in the long-case clinical/oral examination (50%) to pass. The mean attendance rate was 89% (range, 39%-100% [SD, 11%], n = 57/64 activities). Male students (84% attendance, P = .001) and students who failed an end-of-year examination previously (84% attendance, P = .04) had significantly lower rates. There was a positive correlation between attendance and overall examination score (r = 0.59 [95% CI, 0.44-0.70]; P year examination, and the timing of the rotation during the academic year. Distinction grades (overall score

  9. Journal article reporting standards for qualitative primary, qualitative meta-analytic, and mixed methods research in psychology: The APA Publications and Communications Board task force report.

    Science.gov (United States)

    Levitt, Heidi M; Bamberg, Michael; Creswell, John W; Frost, David M; Josselson, Ruthellen; Suárez-Orozco, Carola

    2018-01-01

    The American Psychological Association Publications and Communications Board Working Group on Journal Article Reporting Standards for Qualitative Research (JARS-Qual Working Group) was charged with examining the state of journal article reporting standards as they applied to qualitative research and with generating recommendations for standards that would be appropriate for a wide range of methods within the discipline of psychology. These standards describe what should be included in a research report to enable and facilitate the review process. This publication marks a historical moment-the first inclusion of qualitative research in APA Style, which is the basis of both the Publication Manual of the American Psychological Association (APA, 2010) and APA Style CENTRAL, an online program to support APA Style. In addition to the general JARS-Qual guidelines, the Working Group has developed standards for both qualitative meta-analysis and mixed methods research. The reporting standards were developed for psychological qualitative research but may hold utility for a broad range of social sciences. They honor a range of qualitative traditions, methods, and reporting styles. The Working Group was composed of a group of researchers with backgrounds in varying methods, research topics, and approaches to inquiry. In this article, they present these standards and their rationale, and they detail the ways that the standards differ from the quantitative research reporting standards. They describe how the standards can be used by authors in the process of writing qualitative research for submission as well as by reviewers and editors in the process of reviewing research. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  10. Amenorrhea - primary

    Science.gov (United States)

    ... of periods - primary Images Primary amenorrhea Normal uterine anatomy (cut section) Absence of menstruation (amenorrhea) References Bulun SE. The physiology and pathology of the female reproductive axis. In: ...

  11. 38 CFR 21.374 - Authorization for travel of attendants.

    Science.gov (United States)

    2010-07-01

    ... severity of the veteran's disability. Attendants may only be used to enable a veteran to attend... or marriage is the veteran's (i) Spouse, (ii) Parent, (iii) Child, (iv) Brother, (v) Sister, (vi...

  12. Outreach at Washington State University: a case study in costs and attendance

    Science.gov (United States)

    Bernhardt, Elizabeth A.; Bollen, Viktor; Bersano, Thomas M.; Mossman, Sean M.

    2016-09-01

    Making effective and efficient use of outreach resources can be difficult for student groups in smaller rural communities. Washington State University's OSA/SPIE student chapter desires well attended yet cost-effective ways to educate and inform the public. We designed outreach activities focused on three different funding levels: low upfront cost, moderate continuing costs, and high upfront cost with low continuing costs. By featuring our activities at well attended events, such as a pre-football game event, or by advertising a headlining activity, such as a laser maze, we take advantage of large crowds to create a relaxed learning atmosphere. Moreover, participants enjoy casual learning while waiting for a main event. Choosing a particular funding level and associating with well-attended events makes outreach easier. While there are still many challenges to outreach, such as motivating volunteers or designing outreach programs, we hope overcoming two large obstacles will lead to future outreach success.

  13. Issue 7: Museum Attendance, Population Shifts, and Changing Tastes