Health Care Centers Research Articles

Pediatric Dermatology eConsultation in Academic Centers: A Collaborative Model for Optimized Outpatient Care.

The demand for pediatric dermatology services in the U.S. is high, especially at large academic healthcare centers. eConsultation programs provide a solution to poor in-person access by offering diagnostic and management support to primary care providers (PCPs). To determine the real-world utility of eConsultation in pediatric dermatology within a closed system at a major academic center, we assessed the outcomes, diagnostic and management concordance, and predictors of eConsult completion of an asynchronous provider-to-provider pediatric dermatology eConsult program. Retrospective cohort study of 900 consecutive outpatient pediatric dermatology eConsult referrals from PCPs at a tertiary academic center from 2017 to 2021. Of 900 eConsult referrals, 621 (69%) were completed without the need for in-person dermatology follow-up. 46 (5%) were completed but required follow-up. 233 eConsult referrals (26%) were declined, primarily due to medical complexity. Thirty referrals (3%) were declined because of inadequate clinical photos. The PCP communicated eConsult recommendations to the patient/family on an average of 1.6 days (SD 3) after receiving the completed eConsult. eConsults for adolescents were less likely to be completed compared to infants (p = 0.03). Diagnostic and management concordance between PCP and dermatologist was 78% and 67%, respectively. Provider-to-provider eConsultation provides rapid speciality guidance to PCPs managing low-complexity skin conditions in pediatric outpatients. The lower rate of management plan concordance compared to diagnostic concordance suggests that eConsultation improves outpatient skin management by PCPs.

Asynchronous teledentistry program in two long-term care facilities: Iowa's virtual dental home pilot project.

Older adults living in long-term care facilities (LTCFs) often have poor oral health and difficulty accessing dental services. The aim was to implement a virtual dental home (VDH) program for residents in two LTCFs utilizing asynchronous teledentistry techniques and mobile dental equipment. This pilot project was a 6-month longitudinal cohort study in two LTCFs. Dental hygienists and dentists from a local community health care center utilized asynchronous teledentistry to provide diagnostic and preventive dental services onsite and to establish a dental home for additional comprehensive care services. Data were collected, including resident's demographics, oral health status, and dental services received. Descriptive data analyses, Wilcoxon signed rank, and McNemar tests were conducted. Thirty-four residents completed in-person baseline oral exams and 16 residents completed the recall exams. Ninety-two percent (n=23) of dentate residents (n=25) had untreated caries and 64% (n=16) of dentate residents had at least one sextant of severe gingival inflammation. The median number of teeth with active untreated caries (p=.01) significantly decreased and arrested caries (p=.02) significantly increased from baseline. Iowa's VDH pilot project was successful in establishing a dental home using asynchronous teledentistry for residents in two LTCFs and providing resident access to preventive and disease control dental services.

Circadian variation pattern of sudden cardiac arrest occurred in Chinese community

BackgroundThe circadian variation pattern of sudden cardiac arrest (SCA) occurred in Chinese community including both community healthcare centres and primary hospitals remains unknown. This study analysed the circadian variation of...

Considering Participant Observation Methods for Nursing Qualitative Research

Observation is used as a research technique and the selection of the appropriate type depends on the research question and the paradigm underlying each study. The degree of participation and involvement of a nurse researcher varies according to the nature of the setting and the research question. The objective is to reflect on the experience in applying observational techniques in nursing qualitative research. We report on the experience of using 14 observations of interactions between nurse-child-parents in a nursing appointment in a healthcare center. This data collection allowed identification of advantages and limitations in the nurse-child-parent interaction processes, in a healthcare center. We argue that advantages of observation can include overcoming the divergence between what participants say and what they do; capturing the emotional dimension cultivated within the natural environment; flexibility and non-intrusiveness if the researcher gives time to develop a relationship with the participants. Doing observations requires significant time in the natural context, through sustained presence, building trust, and becoming integrated into the context before the research begins. In interpretive and naturalistic qualitative research observational techniques continue to offer a method that can be used alone or conjugated with other data collection techniques.

Novel Effects of Chlorhexidine Gluconate on Gram-Positive vs Gram-Negative Microorganisms

Abstract Introduction/Objective Chlorhexidine Gluconate (CHG) is a widely used antiseptic for the skin, oral areas, and cleansing oneself for surgery. Uses of CHG throughout healthcare centers have proven to reduce potential pathogens and lessen risks of central venous catheter blood infections. Gram-positive and gram-negative microorganisms can lead to major diseases such as prostatitis, candidiasis, endocarditis, and more. It is crucial to understand the effects that CHG has on these organisms so we can accurately apply it to treat these various illnesses. It also allows us to better understand the source of surgical site infections (SSIs) and prevent them. Methods/Case Report A minimum bactericidal concentration (MBC) was employed to see how various CHG concentrations (0% (control), 1%, 3%, 5%, 7%, and 9%) would affect the gram-positive (C. albicans and S. aureus) and gram-negative (P. aeruginosa and E. coli) microorganisms. First, a 1.0 McFarland suspension was created for each organism. Then, the various CHG concentration wells for each microorganism would be created within 96 well plates. In each well, there was always 300 μL of solution (containing the McFarland suspension and CHG liquid formula (HibiClensTM). After 4 minutes of CHG exposure in each well, an inoculating loop was used to streak a petri dish. One trial was completed after all concentrations were done for each microoganism. Each trial was incubated for 24 hours and there were a total of 6 trials. Results (if a Case Study enter NA) The substantial results challenged the previously assumed hypothesis that gram- negative microorganisms are more resistant to CHG. The separation between the two types of microorganisms became evident at even the 1% CHG concentration. C. albicans and S. aureus are thriving with averages of approximately 74,333 CFU/mL and 70,333.3 CFU/mL respectively for 1% CHG in comparison to the 1% CHG concentration for P. aeruginosa (2,500 CFU/mL) and E. coli (22,334.3 CFU/mL). Additionally. P. aeruginosa and E. coli had no colonies in any of the trials at 7% and 9% CHG, while C. albicans and S. aureus were present in numerous amounts. Conclusion Through numerous trials using an MBC as a new method, dose response curves for E. coli, P. aeruginosa, S. aureus, and C. albicans were deduced. The curves displayed how gram-positive microorganisms are more resistant to CHG than gram-negative microorganisms, defying what was previously assumed. In regards to various diseases and infections caused by these various bacteria, CHG may now be assesed for potential forms of treatment.

Dynamic Indicators of the Pulmonology Department of the National Center of Maternity and Child Health care for 2021-2023 Years

The article presents the materials of the reporting data on the therapeutic and diagnostic activities of the Department of pulmonology over the past 3-5 years. A comparative analysis of the department's work before and after the pandemic was carried out. The reasons for the increase in hospitalization in the Department of pulmonology over the past 3 years.

Experiences of Intensive Care Unit Patients as They Transition to the Ward: A Thematic Synthesis.

During the transfer of intensive care unit (ICU) patients to general wards, patients often experience transfer anxiety due to changes in the healthcare environment, staff and unfamiliarity with the new ward. However, the experiences of ICU patients during this transition period have received less attention. A systematic review and synthesis of the experiences of patients transitioning from the ICU to the ward. Thematic synthesis of qualitative studies. We searched the PubMed, Embase, CINAHL and Web of Science databases for qualitative research on the transition-to-ward experience of patients in ICUs for the year 2023 February. The quality of the literature was evaluated according to the qualitative research quality assessment criteria of the Joanna Briggs Institute, as outlined by the Australian Centre for Evidence-Based Healthcare. The data were then extracted from the studies, analysed and synthesised using a thematic synthesis approach. A total of 12 papers were included and the 32 findings were distilled and consolidated into three themes: emotional reactions; imperfections in the transition process; differences between wards and ICUs; and eight sub-themes: optimism; pessimism; emotionlessness; inadequate information; inadequate communication; physical condition; differences in care; differences in environment. The transfer from an ICU to a general ward is a major change of environment for the patient and can trigger upset and anxiety. Planning for turn-out, meeting patients' information needs and easing patients' emotions are critical in this process.

Serological profile of voluntary blood donors in a blood bank of tertiary health care centre- An institution-based study

Background: The safe transfusion of blood facilities is an essential component of an efficient, excellent healthcare sector. Unsafe blood transfusions can be a cause of transfusion-transmitted infections and can be lethal. The present study was conducted to find out the seroprevalence of HBsAg, HCV, HIV, malarial parasites, and syphilis in voluntary blood donors in a tertiary care center. Materials and methods: This prospective study was conducted at the blood bank of the Shri Mahant Indiresh Hospital, Dehradun. 16413 samples from all blood donations were screened for HBsAg, HCV, HIV 1 and 2, malaria, and syphilis. Samples were collected in vacutainers at the time of blood donation and screened for HIV 1and2, HBsAg, and HCV using the fourth-generation enzyme-linked immunosorbent assay technique. Syphilis was tested by Treponema antibodies using the VITROS Syphilis TPA Reagent Pack. Malaria was tested by pan malaria card, monoclonal anti-pan specific parasite lactate dehydrogenase antibody conjugated to colloidal gold, and another monoclonal anti-pan specific parasite lactate dehydrogenase antibody immobilized on a nitrocellulose strip in a thin line. Results: Out of 16413 blood donors 342(2.1%) were found to be seropositive and 16071 (97.9%) were found to be seronegative. The total number of donors, who were found positive for HBsAg/Anti HCV was 1 (0.3%). Out of the seropositive cases, HBsAg, HCV, HIV, and Syphilis infections constituted 28.9%, 27.5, 14.6, and 28.7% cases respectively. Conclusions: There is a need for the development and implementation of stringent donor selection and sensitive screening tests to reduce the risk of acquiring transfusion-transmitted illnesses.

Experiences of Indonesian nurses as Hajj health personnel in caring for Hajj pilgrims: A qualitative study.

Investigating the experiences and roles of nurses during Hajj is vital due to the unique public health challenges posed by the mass gathering of diverse pilgrims. Nurses play a crucial role in disease surveillance, infection control, and managing emergencies like heat stroke and injuries. Their insights can improve emergency preparedness and public health management. This study aimed to explore the experiences of Indonesian nurses as Hajj health personnel caring for Hajj pilgrims during the 2023 Hajj season. This study employed a qualitative descriptive design and selected participants through purposive sampling from hospitals, public healthcare centers, and clinics in Yogyakarta, Indonesia. Nine nurses participated in the research, and data were collected through a focus group discussion in December 2023. Thematic analysis was used to analyze the data. Six themes emerged, including practicing ethical principles in providing health care during the hajj process, competency qualifications as a health worker, the health care process during Hajj, legal Requirements for Hajj, the importance of therapeutic communication skills to establish cooperation with various parties, and recognizing the role of duties and responsibilities during the hajj process. The study emphasizes the importance of competencies, ethics, communication, and strategic planning in Hajj healthcare. Effective online communication, especially via WhatsApp, was crucial for coordination. The findings emphasize the need for strategic workforce planning, resource allocation, and continuous training to enhance care quality for pilgrims, informing better planning and policy development for future Hajj seasons.

Bridging the gap: financing health promotion and disease prevention in Indonesia

BackgroundSpending on preventive care in low- and middle-income countries (LMICs), including Indonesia, is much lower than spending on curative care. There has been a pressing need to develop a clear pathway to increase spending on preventive care. This study aimed to assess the current financing landscape for health promotion and disease prevention in Indonesia and, subsequently, to develop a framework and recommendations for future health promotion financing in the country.MethodsWe adopted a mixed-method approach to gather information from all relevant stakeholders from December 2022 to June 2023. For the qualitative approach, we conducted (a) in-depth interviews (IDIs) and (b) focus group discussions (FGDs) with government officials at national and district levels, academics, professional organizations, healthcare workers in primary healthcare centres (PHCs), community health volunteers, non governmental organizations and private companies. For the quantitative approach, we applied a national online survey to healthcare workers involved in health promotion in PHCs. IDIs and FGDs were conducted with purposefully selected resource persons at the national level, five selected districts across Indonesia, and within 15 primary health offices and their communities. All qualitative data were recorded, transcribed, coded, interpreted, and then triangulated with national survey findings to develop the financing framework.ResultsWe identified gaps between the theory and practice of health promotion and disease prevention. These included the limited scope of health promotion initiatives, lack of direction and coordination between ministries, agencies and government levels, limited availability and capacity of health promoters, various yet uncoordinated funding resources and inflexibility in using the funds. To bridge the gap, the framework we developed suggests strengthening the legal and regulatory basis, strategically prioritizing financing arrangements, promoting evidence-based health promotion activities, developing the capacity of health promoters, enhancing the health financing information system and improving monitoring and evaluation.ConclusionsIdentified gaps and challenges in health promotion and disease prevention initiatives inform the development of our framework for future health promotion financing. This framework assists the national government in organizing national health promotion financing strategies and potentially serves as a valuable model for other LMICs.

Factors Influencing Self-Wound Care Adoption in Singaporean Communities: A Cross-Sectional Survey.

Managing wounds often requires frequent clinic visits, posing a burden on both patients and the healthcare system. Shared wound care, which encourages patients to manage dressings at home, has emerged as a potential solution. This study investigates factors influencing self-wound care adoption in Singapore. A cross-sectional survey involving 328 participants from six primary healthcare centers was conducted. The survey examined demographics, wound characteristics, and perceptions towards shared wound care using a locally validated questionnaire. Parametric tests and logistic regression were used to analyze the data. Unlike older participants, younger adults valued time saved through self-care and found clinic visits inconvenient. Participants in the younger age group, those in fixed-schedule employment, and students were more likely to opt for the self-wound care program and adopt self-wound care. Strong social support (p=0.034) and wound location on the head, neck, or face were the most significant factors (p=0.023) favoring self-care. Interestingly, participants with no formal education were significantly more likely to embrace self-wound care (p=0.006 to 0.012). Using individual attributes to select participants for self-wound care adoption may be more effective than relying on educational level. Strong social networks and encouragement from family and community can play a crucial role in promoting self-care practices. However, the generalizability of the findings may be limited, as the study was conducted solely within a Singaporean primary healthcare setting. All the same, while wound care practices may vary across countries, the foundational concepts of wound care are universal in the world. Insights about self-wound care can therefore be valuable and informative on a global scale, not just within Singapore.

Socio-demographic and obstetric characteristics of advanced maternal age in Abu Dhabi, United Arab Emirates

Purpose This study aims to better understand advanced maternal age (AMA) and its impact on maternal and perinatal health by investigating the prevalence, sociodemographic profiles and adverse pregnancy outcomes of AMA in Abu Dhabi, UAE. Design/methodology/approach This study is a part of a large multicenter cross-sectional study. The project aimed to improve maternal and early child health in Abu Dhabi, UAE. It was conducted at seven healthcare centers located in the urban, suburban and rural areas of Abu Dhabi. The project’s data included all mothers (i.e. Emirati and non-Emirati mothers) who came to the centers looking for healthcare follow-up. Findings From the total of 1,710 enrolled mothers with complete data, 379 were with AMA, having a prevalence of 22.2% (95% confidence interval [CI] = 20.2, 24.2). Among 379 advanced maternal age (AMA) mothers, 328(84.5%), and 51(15.5) mothers were between 35 and 39 years, and =40 years, respectively. The mean (SD) of maternal age was 30.0(5.2) years. No significant association was found between AMA, and parent’s education, family income, child gender, preterm birth and low birth weight. In multivariable logistic regression analysis, factors significantly associated with AMA were higher parity (adjusted odd ratio [AOR] = 2.24, 95%CI = 2.00, 2.50), p-value < 0.001, non-Arab mothers (AOR = 2.44, 95%CI = 1.83, 3.24), p-value < 0.001, maternal employment (AOR = 1.37, 95%CI = 1.05, 1.77), p-value = 0.019, and cesarean delivery (AOR = 2.44, 95% CI = 1.83, 3.24), p-value = 0.011, pre-pregnancy maternal overweight (AOR = 1.49, 95%CI = 1.12, 1.98), p-value = 0,006, and pre-pregnancy maternal obesity (AOR = 2.15, 95%CI = 1.35, 3.44), p-value = 0.001. Research limitations/implications First, unlike other studies, not all obstetrical outcomes (e.g. maternal and perinatal mortality and morbidity) were included as the current study data were part of a large project, and such limitations are expected; second, only quantitative method was used in the present study, it is clear from the literature AMA is a dilemma. Therefore, a qualitative study and mixed methods (both quantitative and qualitative) will provide a better explanation for such an understudied topic. Therefore, further research is recommended to overcome the abovementioned limitations aiming to explore the complexity of AMA, including studying its social determinants. Furthermore, it is worth emphasizing that future research involves more concerned parties, including health, culture and planning authorities, to better understand AMA issues. Originality/value The study provided valuable information regarding AMA issues in the UAE. Such information is of paramount importance to all involved parties, including policymakers, to take action regarding improving the health of mothers with advanced ages. Specific actions can be taken through thorough counseling of all expectant mothers with advanced ages before pregnancy, throughout pregnancy and delivery and beyond, by dealing with existing medical conditions and highlighting possible risks of AMA on pregnancy outcomes and how to overcome them in advance. In addition, further research is recommended to explore the social determinants of AMA.

Sinus vein thrombosis conundrum: Persistent empty sella vs. flexible optic nerve sheath

IntroductionOur objective was to investigate the potential effect of thrombotic burden on pituitary gland height, bony sella and optic sheath width, taking into consideration the various venous sites and dominant drainage pattern. Patients and MethodsThis retrospective cohort study followed patients diagnosed with cerebral sinus vein thrombosis in a single primary healthcare center between the years 2000 and 2022. Data was collected from both CT/V and MR/V scans available on the local PACS system. Dural sinuses were divided into main anatomical sites and scored for patent, partially or totally blocked lumen. Dominant drainage flow was noted for each patient. For most scans, pituitary mid height, maximal depth and AP width of the bony sella and dorsum sella to tuberculum sella distance were assessed. Optic sheath width was measured for both sides at the maximal retrobulbar diameter. Regression methods, including linear mixed models, and non-parametric tests were used to analyze the data. Results90 patients (mean age, 44 years ±16.8, 54 women) were evaluated. Overall thrombus burden did not correlate with pituitary mid-height, however a relationship was observed between the change (from presentation) in the superficial thrombus score and the average width of the optic nerve sheath; the width of the optic sheath tended to decrease as thrombus burden improved and vice versa (p = 0.010). ConclusionsThrombus recanalization had a favorable effect on the optic nerve sheath diameter but did not appear to reverse the flattening of the pituitary gland, regardless of temporal improvement.

Adolescent mental health services in West Africa: a comparative analysis of Burkina Faso, Ghana, and Niger

BackgroundAdolescent mental health (AMH) is a critical issue worldwide, particularly in West Africa, where it is intensified by socio-economic, cultural, and security challenges. Insecurity and the presence of mining sites expose adolescents to hazardous environments, substance abuse, and adulterated alcohol, further aggravating their mental health. Despite these severe issues, research on AMH in this region remains limited. This study aims to analyze the provision of AMH services in Burkina Faso, Ghana, and Niger, highlighting the unique challenges these countries face within the broader West African healthcare context.MethodsThe study adopted a multi-stage, stratified sampling design to collect data from primary healthcare centers (PHCs) in the three countries. Using STATA.17, Descriptive analysis was conducted on the data related to availability of AMH services, types of mental health disorders treated, resources available, and OPD attendance rates. The analysis also incorporated factors such as the rural-urban divide and the presence of national guidelines for AMH services.ResultsThe findings reveal a significant shortfall in the provision of AMH services across the region, with less than 30% of PHCs across all the countries offering these services. The study also highlights a pronounced rural-urban disparity in AMH service availability, a general absence of national guidelines for AMH care, and low OPD attendance rates.ConclusionThe study highlights the urgent need for comprehensive policy reform and targeted interventions to enhance AMH services in West Africa. Key policy reforms should include the development and implementation of national guidelines for AMH care and integration of AMH services into primary healthcare. Additionally, efforts should focus on capacity building through the training of mental health professionals, increasing public awareness to reduce stigma, and ensuring equitable resource allocation across rural and urban areas. Improving AMH care is essential not only for the well-being of adolescents but also for driving broader socio-economic development in the region.

CT-Based Evaluation of Volumetric Posterior Pelvic Bone Density with Implications for the Percutaneous Screw Fixation of the Sacroiliac Joint.

Background: Operative treatment of fragility fractures of the pelvis has become a gold standard. Preoperative planning, including the assessment of the pathway for iliosacral screws, is crucial. The anchorage of the screw depends on the bone quality. Some recent studies have concentrated on assessing bone mineral density (BMD) with the use of Hounsfield unit (HU) values obtained from CT scans. The aim of the present study is to determine the best sacral levels of S1-S3 on the pathway of iliosacral screws for sacroiliac joint fixation. Methods: Patients admitted to the Independent Public Healthcare Center in Rypin between 1 of September and 1 of December in 2023, who had CT scans of the pelvis performed on them for different reasons, were included in this study. In total, 103 patients-56 men and 47 women-were enrolled in the study and consecutively separated into two groups of different ages: 18-60 years old (group A) and above 60 years old (group B). The volumetric bone density expressed in HU values was measured with sacral levels of S1, S2 and S3. Apart from the bodies of sacral vertebrae S1-S3, our measurements involved the ala of the ilium in the vicinity of the sacroiliac joint and the wing of the sacrum. All the measurements were performed on the pathway of presumptive iliosacral screws to stabilize the sacroiliac joint. Results: In group A (58 patients) the highest bone density in sacral bodies was found in S1 that gradually decreased to S3, while the opposite tendency was demonstrated in the ala of ilium. The HU values in the wing of the sacrum did not display statistical significance. In group B (45 patients), the highest bone density was also found in the sacral body S1 that decreased toward S3 but in the ala of ilium, the highest bone density was found with level S1 and lowest with level S2. In both groups, the highest bone density referred to the wing of the sacrum. Conclusion: While the perfect construct for posterior pelvic ring fixation remains unclear, our findings may imply that sacroiliac joint screws inserted into the wing of the sacrum of greater bone density could provide much more successful fixation in comparison to those anchored in the body of sacral vertebra of lesser bone density.

Examining Physicians' Approaches to Treating Relatives in Primary Health Care Centers: Insights from a Qualitative Study.

Introduction: Family medicine physicians take care of a diverse population of patients with a variety of acute and chronic diseases. These patients include family, friends, and acquaintances who may ask for direct medical care or help in accessing healthcare products and services within or outside of officially approved procedures. This is ethically challenging due to an ambiguous medical code of ethics, but it is commonly accepted as normal behavior by society. The aim of this study was to explore family medicine physicians' perspectives regarding the benefits, difficulties, and ethics of responding to medical care requests and/or favors from family, relatives, friends, and acquaintances and to make recommendations. Methods: The study sample consisted of junior and senior family medicine physicians working in primary healthcare centers affiliated with the Ministry of Health in Saudi Arabia. In-depth semi-structured interviews were conducted to collect data. Using social exchange theory, this qualitative study explores how family medicine physicians perceive and handle requests for medical favors from family members and others. Results: Semi-structured interviews were conducted with 19 family medicine physicians (six focus groups) with clinical experience ranging from 3 to 20 years. The data analysis identified three themes: perceived benefits and costs of cultural and social connectedness, shortcomings in patient management and healthcare systems, and recommendations to address challenges between physicians and patients who are relatives. Discussion and Conclusions: This study shows that treating others outside of normal access to healthcare services presents several ethical, moral, and professional challenges. Therefore, policy adaptation requires understanding this intricate dilemma and improving laws, system regulations, and guidelines for physicians and community members to improve access to care, reduce system abuse, empower providers, and enhance community awareness and compliance.

How Does Virtual Reality Technology Affect Suicidal Ideation in Society?

Mental health issues such as anxiety and depression are on the rise in communities. Ignoring severe mental health issues can lead to suicide, which is a global public health issue. The use of advanced tools and methods to prevent suicide can help save human lives. Visual tools and virtual technologies have multiple applications in the medical and educational fields. The aim of this study was to investigate the effect of using virtual reality (VR) technology on suicidal thoughts. A quasi-experimental study was conducted, in which 189 individuals who had a history of suicide were tested. These individuals were divided into three groups: one control group and two intervention groups that received traditional and VR-based training for 90 days. The Beck Scale for Suicide Ideation was used. The posttest results after the training period showed that conducting the training course had a statistically significant effect on individuals' suicidal behaviour and those who participated in the VR-based training course had better improvements in suicidal thoughts. Therefore, the use of 3D simulation and visualisation tools can have a significant impact on individuals' thoughts and perceptions. The results of this study have practical implications for hospital managers and counsellors in healthcare centres to use VR technology in counselling and training courses to improve the behaviour of individuals with a history of suicide.

Performance Assessment of Health Visitor and Family Medicine Units in Babylon's Main Health Care Centers

Background: The Ministry of Health (MoH) has developed a standardized package of basic health services for all primary healthcare (PHC) facilities to enhance service quality. This study evaluates service availability and facility needs in the family health units in Babylon. Methods: This cross-sectional study was conducted in three family healthcare sectors (the first Al-Hillah sector, Al-Musayyib sector, and Al-Hashemiyyah sector), which includes 6 out of 23 primary healthcare centers in the Babylon Governorate. The data collection started on March 3, 2022, and ended on August 27, 2022, and was randomly chosen from all sectors. Results: According to this study, the family health unit had a poor mean score of 48.03±17.97. Similarly, the health visitor indicators had an inadequate level of assessment, with a mean score of 46.87±14.09. In conclusion, this revealed a study that the primary health care centers evaluated had poor scores in all the final evaluation indicators for the family health unit and the health visitor unit.

Implementation of Youth Integrated Healthcare Center in the Prevention of Stunting Incidents in the Kekeran Village of Badung Regency, Indonesia

Objective: Youth posyandu is a youth empowerment activity that can reduce the prevalence of stunting through pre-marital care. At the time during the Covid 19 pandemic, youth posyandu was not carried out. The purpose of the research is to identify the input, process and output of the implementation of youth posyandu activities, and identify knowledge and nutritional status of the adolescent women. Methods: This research is a mixed method research. Six qualitative research informants, and 32 quantitative data respondents. Data were collected through in-depth interviews and questionnaires. Research data analysis is descriptive analysis and distribution of frequency data knowledge and nutritional status of adolescent daughters. Results: The results show that the input from the implementation of the program is sufficient, seen from the presence of the programme implementation guidelines and the use of the funds that have been verified, the support of means, resources. The output indicates that the activities are going as planned, but the coverage of the participants is still 80%. The knowledge of youth posyanduis partially good and the nutritional status of the teenage daughter is mostly normal. Conclusion: The program input is sufficient, the process is running well, has managed. Should be corrected during the Covid 19 pandemic and the output of the program implementation is largely in line with the plan. Knowledge is partly good and nutritional status is mostly normal.

Health impact of the COVID-19 in Spanish non-healthcare workers by gender: Use of sickness absence for surveillance.

At the beginning of the pandemic, the identification of transmission chains was biased towards more closely monitored sectors, such as healthcare and sociosanitary centers. The objective of our research is to describe the impact of the pandemic on the Spanish non-healthcare workers measured through health-related workplace absences. A descriptive study of the cases of COVID-19-related temporary disability (TD) between February 15th and September 17th, 2020, was carried out. TD quarantine/infection ratios were calculated for every economic sector of activity. Rates of COVID-19 TDs per 100,000 affiliated workers were obtained, by gender, age, economic activity of the company or occupation of the worker. A total of 1,126,755 TDs were recorded, 45.4% in women. The overall TD rates were 5,465 quarantines and 1,878 illnesses per 100,000 women, and 4,883 quarantines and 1,690 illnesses per 100,000 men. The highest incidence rates of TD due to illness were observed in younger age groups, under 30. The median TD quarantine/infection ratio was 2.6 (Interquartile range [IQR] 1.5-3.9), and Postal and Courier activities had the highest value: 4.7 quarantines per case (IQR: 3.75-6.12). The TD rates were higher in female workers in most sectors of activity and occupations compared to men in the same sectors and with the same occupations. The results show the uneven impact of COVID-19 by occupation, with a higher rates in less qualified occupations (unskilled workers and laborers) versus the first categories of the table (directors, managers, technicians, and professionals). The results confirmed the high impact of COVID-19 on Spanish non-healthcare workers and it's inequalities. They also confirmed the potential use of TDs as an alternative source for epidemiological, public health surveillance and early warning of new emerging infections.