<b>VIVENCIA DE DOS PERSONAS COSTARRICENSES DIAGNOSTICADAS COMO PORTADORAS DEL VIRUS DE INMUNODEFICIENCIA HUMANA (VIH) Y SUS DESAFÍOS EN EL ACCESO A LA SALUD </b>

Aim:To date, the available information regarding the quality of primary health care services in Albania is scarce. The aim of our study was to assess the quality of primary health care services in Albania based on physicians’ perceptions towards the quality of the services provided to the general population.Methods:A cross-sectional study was conducted in January-March 2013 including a representative sample of 132 physicians (59 men aged 41.3±6.9 years and 73 women aged 43.7±4.8 years; overall response rate: 132/150=88%) providing primary health care services in several polyclinics (health centers) of Tirana, the Albanian capital city. A structured self-administered and anonymous questionnaire was applied including physicians’ perceptions regarding different dimensions of the quality of primary health care. Binary logistic regression was used to assess the association of self-perceived quality of health care services with baseline characteristics of physicians.Results:Self-perceived adequate quality of health care services was positively related to the age of physicians, their working experience, female gender, a lower population served, and specialization in family medicine.Conclusion:Our findings provide useful evidence on the self-perceived quality of health services from primary health care physicians’ perspective in transitional Albania. Health authorities in Albania should implement suitable instruments to measure the quality of health care services at all levels.

تعد الرعاية الصحية الوقائية مطلبًا أساسيًا لدى جميع المواطنين الكبار والأطفال وخصوصَا لدى الأطفال لأنهم أكثر الفئات العمرية تعرضًا للأمراض, وأقل مقاومة للأمراض المعدية والمستوطنة, ومن هنا بدأ الاهتمام بنوعية جودة خدمات الرعاية الصحية وتطويرها لتحقيق رضي المستفيدين الذي يعتبر بدوره هدفًا اساسيًا تسعي المنظمات الصحية إلي بلوغه فهو انعكاس لمستوي هذه الخدمات ويولد ولاء لها, كما أن التوجه العالمي الحديث يعطي اهتماما متزايد بالخدمات الصحية ورعاية المريض, وأصبح إدراك مفهوم رضى المستفيدين عن جودة الخدمات الصحية الوقائية المقدمة في المنظمات الصحية مطلبًا أساسيًا لتحقيق النجاح في سياستيها الهادفة إلي تحقيق تطور مستمر من خلال زيادة القدرة التنافسية بينها, وقد دأبت المنظمات الصحية علي وضع ورسم الخطط والسياسات لمعالجة المعوقات التي تواجه عملها.فتسعى هذه الدراسة إلى رصد واقع التخطيط الاستراتيجي بوحدات الرعاية الصحية الوقائية, وكذلك تحديد مستوي جودة خدمات الرعاية الصحية الوقائية, تحديد العلاقة بين استخدام التخطيط الاستراتيجي وتحسين جودة خدمات الرعاية الصحية الوقائية, تحديد المعوقات التي تواجه استخدام التخطيط الاستراتيجي في تحسين جودة خدمات الرعاية الصحية الوقائية , وكذلك تحديد مقترحات تفعيل استخدام التخطيط الاستراتيجي في تحسين جودة خدمات الرعاية الصحية الوقائية, التوصل إلى صياغة استراتيجية مقترحة لحسين جودة خدمات الرعاية الصحية الوقائية. وتوصلت الدراسة إلى أنه توجد علاقة طردية إحصائيًا عند مستوى معنوية (0.01) بين استجابات الأمهات والمسئولين بالنسبة لتحديدهم لمستوى المعوقات التي تواجه استخدام التخطيط الاستراتيجي في تحسين جودة خدمات الرعاية الصحية الوقائية لصالح استجابات الأمهات , توجد أيضًا فروق جوهرية دالة إحصائياً عند مستوى معنوية (0.05) بين استجابات الأمهات والمسئولين بالنسبة لتحديدهم لمستوى مقترحات تفعيل استخدام التخطيط الاستراتيجي في تحسين جودة خدمات الرعاية الصحية الوقائية لصالح استجابات الأمهات, ود يرجع ذلك إلى وجود ارتباط طردي بين هذه الأبعاد وأنها جاءت معبرة عما تهدف الدراسة إلى تحقيقه.

Background: Quality of health-care services has grown in importance in both developed and developing countries' health-care systems over the years. This study aims to assess patients’ perception of quality of primary health care services in Osun State in order to improve healthcare outcomesMethods: This study employed the descriptive cross-sectional design to assess patients’ perception of quality of primary health care services in Osun State.Results: A greater proportion of respondents were motivated to utilize primary health care facilities as a result of accessibility to services/good attitude of health service providers compared to availability of services, affordability of health care services and quality of services. Sixty-two percent of 13 items measuring perception of quality of care by health care providers had above average response, only 25% of items measuring perception of quality of health care service delivery had above average response and only 16% of items measuring perception of quality of health facility had more than average responses. Physical accessibility, adequacy of cost and respectfulness of health workers were very important predictors of patient satisfaction with care.Conclusions: Overall quality of care is perceived to be of average quality. It is recommended that strategies be put in place to ensure sustenance of service areas with perceived good quality and continuous improvement of service areas with perceived poor quality especially recruitment of more health workers, provision of adequate medical equipment and improvement of payment arrangements at the facility.

Objective(s): To evaluate the family physicians' practices and to measure its impact upon the quality of familymedicine health care in Baghdad City model primary health care centers.Methodology: A descriptive study, using the evaluation approach, has evaluated the impact of family physicians'practices upon quality of healthcare in Baghdad's Model Primary Health Care Centers of Family Medicine. It iscarried out during 15th of May – 20th of August 2017. The study is conducted at five model primary health carecenters of family medicine from two districts; AL-Rusafa and AL-Kurkh. Sample size is calculated to be (76)family physicians. Convenient sample of (124) patients who are attending these primary health care centers to seekfamily health care services. Adopted structured self-administered questionnaire is used to collect data from theFamily physicians. The list of dual-forced items obtained through the Delphi process, which include "Do" or "Don'tdo". Inpatient care is clarified with (25) statements, urgent care and minor procedures tested in (27) statements andambulatory care includes (16) statements. The quality of health care questionnaire is developed for the purpose ofthe study. The overall number of items included in the questionnaire is (18) items. Internal consistency "split-half"reliability is obtained through computation of Cronbach's alpha correlation coefficient. Content validity of thequestionnaire is determined through panel of (10) experts. Data are collected through the utilization of thequestionnaire and the interview technique as means of data collection. Data of both stages is entered to computerusing Statistical Package of Social Science, Version (23.00) for windows(10) (SPSS-23) and are handled usingdescriptive statistical data analysis approach (frequencies, percentages, mean of scores, total scores and Cronbach'salpha correlation coefficient) and inferential statistical data analysis approach (simple linear regression).Results: The study reveals that the majority of the family physicians has performance experienced inadequate offamily health care practices. The quality of family medicine health care services in Baghdad's primary health carecenters of the patients' perspectives is poor (82.30%).The impact of family physicians' practices upon the quality offamily medicine health care services in Baghdad City model primary health care centers presents that familyphysicians' practices have not made noteworthy change on the quality of family medicine health care services.Recommendations: Family physicians can follow the family medicine practices' standards to provide quality offamily medicine health care services. The Ministry of Health Department of Primary Health Care can periodicallymonitor the implementation of family physicians' practices standards for the benefit of better quality of familymedicine health care services. The family medicine quality of health care services can be valued on a regular basefor the benefits of the patients who are attending the primary health care centers to seek such care

BackgroundDespite many initiatives made by the National Department of Health through the Minister of Health, the provision of quality health care services remains a serious challenge in South Africa, especially in public rural clinics.AimThe study aims to determine the perceptions of professional nurses on the factors affecting the provision of quality health care services at selected public primary health care clinics in rural areas of the Capricorn District, Limpopo Province.SettingThe study was conducted at selected public primary health care clinics in rural areas of the Capricorn District, Limpopo Province.MethodsThis study utilised a quantitative method, descriptive and a cross-sectional study conducted for three months at the selected public primary health care clinics. A structured self-administered questionnaire was used to collect data from 155 professional nurses who met the selection criteria. Data were analysed using Statistical Package for Social Sciences programme version 26.0.ResultsThe results of 155 professional nurses were only 116 (74%) and reported that the use of modern technology such as electronic blood pressure, sonar machines and pulse reading computers improves the quality of health care services. Also 129 (84%), 124 (77%) and 118 (76%) reported that they were overwhelmed by the workload, the staff attitude and cleanliness of the clinic, respectively, which all affect the quality of health care services rendered. Moreover, only about 29 (19%) were satisfied with the salary they earned.ConclusionDespite the effort and interventions put in place by the Department of Health with regard to the Ideal Clinic Realisation and Maintenance in response to the current deficiencies in the quality of primary health care services and to lay a strong foundation for the implementation of National Health Insurance. The quality of health care services is still hindered by several factors such as an overwhelming workload, the attitude of the staff and cleanliness in the work environment, poor infrastructure and the professional nurses perceive the environment as lacking equipment.

HIV Disease and Aging

Gastrointestinal Disease in Simian Immunodeficiency Virus-Infected Rhesus Macaques Is Characterized by Proinflammatory Dysregulation of the Interleukin-6-Janus Kinase/Signal Transducer and Activator of Transcription3 Pathway

Despite promotion by many stakeholders to improve maternal health outcome in many developing countries including Malawi, many analysts agree that the utmost success in maternal health will arise if maternal health care services are an unparallel led source for women’s health care solutions for any problem related to childbirth. Health advocates worldwide claim that even though maternal services are provided, women’s utilization of such services has not been ascertained. The objective of this study was to explore women’s perspectives on the quality of health care service delivery in Malawi. This article therefore investigates women’s perspectives on the quality of maternal health care services in Malawi. We used six focus group discussions in six health facilities that were selected across Malawi. We found that erratic availability of medical resources and unethical practices among health workers adversely affected quality of maternal health care service delivery. We concluded that the expensive routine operational audits of medical resources and service delivery across health facilities are imperative if women’s health outcomes are to be enhanced in Malawi.

Repeated exposure to HIV does not necessarily result in infection and HIV infection does not inevitably lead to the development of the AIDS. Multiple immunological and genetic features can confer resistance to HIV acquisition and progression at different steps in viral infection; a full understanding of these mechanisms could result in the development of novel therapeutic and vaccine approaches for HIV infection. In this review, we focus on the genetic mechanisms associated with resistance to HIV infection and to the progression to AIDS.

The role of electronic medical records in improving the quality of health care services: Comparative study

<h3>Background</h3> Protection of human dignity, especially in case of terminal (incurable) illness, is among the main pre-requisites of a just society. Although everyone agrees that dignity is the core of human rights, there are many (mis-)conceptions of its meaning. It is important that healthcare providers recognize patient's needs that preserve his/her dignity most. The aim of this paper is to compare opinions of Lithuanian citizens and healthcare professionals on what may pose threat to human dignity in case of terminal illness at the end of life. <h3>Methods</h3> In 2021, a national representative survey of citizens (N=1110) and a survey of healthcare professionals who cared for terminally ill patients (snowball sampling; N=166) were organized in Lithuania. <h3>Results</h3> The findings revealed that higher proportions of healthcare professionals believed that 'Dependence on others' help' (78.9% vs 56.3%), 'Physiological problems' (68.7% vs 55.3%), and 'Reduction in or loss of privacy' (62.0% vs 26.1%) are the dominating threats to dignity of terminally ill patients. Meanwhile, more citizens believed that 'Difficulties in management of pain and unpleasant symptoms' (53.4% vs 27.1%), 'Knowledge that the illness is incurable' (43.3% vs 20.5%), 'Low quality of healthcare services' (28.4% vs 17.5%), 'Low accessibility to medicines and medicinal products' (24.4% vs 2.4%), and 'Difficulties in getting social support' (23.7% vs 13.9%) reduce human dignity. <h3>Conclusion</h3> While health professionals saw physiological and autonomy related issues as negatively affecting patients' dignity, the citizens believed that, besides the knowledge that the illness is incurable, accessibility and quality of health and social care services need to be tackled with empathetic commitment and patient-centered approach. Health and social care systems should focus not only on the quality of health and social care services but also care about the mode of delivery of services to terminally ill patients so they felt dignified until the last moments of life.

PurposeThis paper aims to measure the perception of patients towards quality of services in public health care centres in rural India.Design/methodology/approachA 23‐item scale that tested well for reliability and construct validity was employed for the study. Mixed sampling technique was employed to select the sample. A total of 500 respondents from Eastern, Western and Central regions of Uttar Pradesh were surveyed.FindingsThe survey instrument had an overall Cronbach's alpha value of 0.96 and was able to discern differences across various socio‐demographic characteristics of the respondents. The opinions of the respondents towards health care quality were not very favourable. Negative scores were obtained on items, “availability of adequate medical equipments” and “availability of doctors for women”. Education, gender and income were found to be significantly associated with user perception.Research limitations/implicationsThe current study was limited to measuring the perceived quality of health care services in public centres only. Moreover, as the study was confined to the state of Uttar Pradesh so caution has to be exercised in making generalisations for the entire nation.Practical implicationsValuable insights into the quality of services at public health care centres in rural India have been provided by the study.Originality/valueKnowledge about the patients' perception towards health care quality is one of the most important steps towards introducing reforms in the health care sector. Identification of areas that require immediate improvement in public health care centres provides valuable guidance to the policy makers who can devise suitable strategies to make these centres more sensitive and responsible to the needs of the rural population. This can lead to restoration of faith in public health care centres and subsequently their increased consumption.

The Fashion Production Association and Service Learning describes the planning of an event, such as the FPA fashion show but also coming out with a greater understanding of Service Learning....

Quality in primary health care services is a key component in reducing all-cause mortality and disability cases. Quality in primary health care services is associated with adequacy of the features of primary health care and provision of preventive and promotive services. The purpose of the current study is to summarise the quality of primary health care in Uttar Pradesh (UP) and to identify important barriers that hamper quality service achievement. This review study was carried out in the year 2014 by searching Science Direct, PubMed and JSTOR, official reports and books. The search was conducted using the keywords primary health care, quality of primary health care, health indicators and barriers in health care delivery along with the term Uttar Pradesh and India. Studies were included if they address these pre-defined aspects of primary health care and published after the introduction of National Rural Health Mission in India. Therefore, studies, conducted before 2005 and not covered the aspects of primary health care are excluded from this review study. A total of 27 articles met the inclusion criteria out of 176 searched studies. The study results indicate that the quality of primary health care services is abysmally poor in primary health care setting of UP. The state has some of the deplorable health outcomes among the Indian states as consequences of poor quality in health care services. There are numerous barriers that impede quality services achievement and service utilisation.

Idiopathic AIDS Enteropathy and Treatment of Gastrointestinal Opportunistic Pathogens