General Health Care Services Research Articles

Evaluation of family physicians' knowledge, attitudes, and awareness on orthodontic treatments and oral health

Aims: This study aims to evaluate the knowledge, attitudes, and awareness of family physicians regarding orthodontic treatments and oral health, which are primary aspects of general healthcare services. Methods: This descriptive study was conducted in 2023 with the participation of 309 family physicians from Diyarbakır and surrounding provinces. A total of 20 questions, including 16 questions to assess knowledge of orthodontic treatments and oral health, and 4 sociodemographic questions, were administered online to the participating physicians. Results: Among the physicians who participated in the study, 69.58% had over six years of professional experience, and 65.05% examined more than 51 patients per day. It was observed that 33.01% of the physicians had knowledge about orthodontic treatments. Of the physicians in our study, 24.92% recommended an annual oral and dental examination, while 32.36% reported that they referred patients with observed dental crowding during clinical examinations to an orthodontist/specialist. A statistically significant relationship was found between professional experience and both orthodontic awareness and the likelihood of providing oral hygiene care recommendations to patients (p

BARRIERS TO ACCESS HEALTH AND MENTAL HEALTH SERVICES AMONG SOUTH ASIAN OLDER ADULTS

Abstract Research on older immigrants in Canada is in its infancy despite their growing numbers. In 2019, Covenant Health, one of the largest healthcare providers in Canada, in partnership with the Indo-Canadian Women’s Association, a non-government service organization for new immigrants, in Edmonton, conducted a community consultation with South Asian older adults to understand their health and mental care needs and barriers to their access. The consultation was based on anecdotal evidence that South Asian older adults make poor use of health care services in general and mental health care services in particular. Focus groups and individual interviews with older adults were used to gather information, and the data were analyzed using thematic analysis. The results showed that a significant number of South Asian older adults lead marginalized and isolated lives within their community. Lack of language skills, transportation difficulties, poor knowledge of health care services, financial dependence on sponsors, and adherence to traditional beliefs about health and mental health services are some of the barriers to accessing services. Based on these findings, several recommendations are suggested to improve healthcare access for older adults.

Oral and Systemic Health in Older Adults: The Imperative Role of Nurses and Dentists in Integrated Smoking Cessation Programs

Background: Oral health is a critical component of overall health, particularly in older adults who face increased risks of oral and systemic diseases. Despite the preventability of many oral disorders, significant disparities exist, exacerbated by factors such as age, socioeconomic status, and access to care. Smoking and other lifestyle choices further complicate these health challenges. Methods: This review synthesizes current literature on the integration of oral health into general healthcare systems for elderly populations. A comprehensive analysis of studies from databases such as PubMed and Google Scholar was conducted, focusing on the roles of dental and nursing professionals in smoking cessation programs and their impact on oral and systemic health. Results: Findings indicate that incorporating oral health into general healthcare services significantly improves health outcomes for older adults. Dental practitioners are essential in advocating for smoking cessation, which can mitigate risks of periodontal disease and other systemic conditions. The review highlights various strategies for integration, including multidisciplinary cooperation, patient education, and addressing common risk factors. Conclusion: The integration of oral health into overall healthcare is vital for enhancing the health of older individuals. By addressing shared risk factors and fostering collaboration among healthcare providers, it is possible to reduce the prevalence of oral disorders and improve quality of life. Policymakers and health organizations must prioritize these strategies to ensure effective healthcare delivery for aging populations

A Qualitative Analysis of Rural Community Vaccination Barriers During the COVID-19 Pandemic.

Rural communities in the United States experience increased disparity of care for both general healthcare services and access to routine vaccines. Previous research has indicated a 40% lower vaccination rate in rural communities, as compared to urban counterparts. Having a better understanding regarding factors influencing lower vaccination rates in rural areas could help public health officials prepare for future vaccination efforts. This research sought to gather and evaluate the opinions of people who live and work in rural areas regarding barriers to COVID-19 vaccine uptake. A semi-structured qualitative key informant interview design was utilized by researchers to gather opinions from university Extension staff in Washington State. Interview transcripts were analyzed using the Theory of Planned Behavior (ToPB) framework to evaluate COVID-19 vaccination-related intentions and motivational factors that the Extension staff observed among rural populations in their communities. Twenty-one participants representing 34 out of the 40 Extension offices responded and were interviewed during fall 2023. Using the ToPB constructs, nine barriers were identified. Attitude-related barriers included the following: inherent social distancing in rural location negating vaccine necessity; lack of early vaccine availability in rural locales; concerns regarding ineffectiveness of the vaccine; and inadequate dissemination of vaccine information to non-English language speakers and those with limited access to technology. Subjective norm barriers included the following: perception of exclusion of rural populations' unique needs during design and implementation of vaccine mandates; exertion of social pressures on rural individuals' vaccine uptake decision; and highly visible breakdown in standard trust in core community institutions and leadership. Barriers related to loss of perceived behavioral control included vaccine mandates impacting self-perceived loss of autonomy and limitations in vaccine technology information impacting perception of vaccine safety. By identifying barriers to vaccination in rural communities during the COVID-19 pandemic, future outreach efforts can be designed to improve intention and lead to stronger vaccination uptake.

Association Between Unmet Needs in Health Care and Social Services and Exposure to Violence Among Parents.

Existing research has shown that parental exposure to violence has negative consequences on health outcomes, but the effect of such exposure on unmet health care and social service need is unknown. This study aims to investigate the association between unmet health care and social services and parental violence exposure among parents with children. This study used the data of 6289 parents aged 18-60 years who had at least one child under 18 years living in the same household. Parental violence exposure was measured. Unmet child and adult health care and social service need was operationalized through questions on the services needed, those that had not been received, and those that were considered inadequate. Parents who experienced any kind of violence had more unmet service need. There were more women among parents with violence experience (65.4%) than those with no violence experience (51.9%). Violence experience increased the odds of unmet need for general adult healthcare services (OR 2.02, CI 1.64-2.57), maternity and child health clinics (OR 2.52, CI 2.00-3.18), family guidance clinics and home help (OR 2.38, CI 1.60-3.54), mental health or child welfare services (OR 2.05, CI 1.52-2.75), and school health care (OR 1.99, 1.50-2.65). After adjusting for sociodemographic factors, the associations between exposure to violence experience and unmet needs for healthcare and social services remained statistically significant. Violence in close relationships profoundly impacts health and well-being. By addressing unmet health care needs and supporting parents, we can break the cycle of violence and promote better mental health outcomes. Preventive policies and early interventions are essential to mitigate the consequences of violence in families.

“They are trying their best”: incarcerated individuals’ assessment of general healthcare services in selected Ghanaian prisons

BackgroundThe World Health Organization (WHO) has indicated that the absence of prison health poses a threat to public health, making it important to safeguard access to quality healthcare for incarcerated populations. Although several studies have explored the quality of care in prisons, there is a dearth of empirical evidence on the perspectives of incarcerated individuals. This study investigated incarcerated individuals’ perspectives and opinions on the general healthcare services in Ghanaian prisons.MethodsUtilizing a qualitative approach, focus group discussions were conducted with 51 incarcerated individuals in five prisons sited in the Northern, Middle and Southern zones of Ghana. Thematic analysis following the tradition of Braun and Clarke was conducted. Four of the six constructs of the WHO Health Systems Framework – service delivery, health workforce, access to essential medicines, and leadership and guidance – were applied deductively to organise the data into themes and subthemes.ResultsFour themes were generated from the analysis: “Health service delivery”, “Health workforce in prisons”, “Access to essential medicines” and “Leadership; regulating healthcare services”. Participants rated health services in prisons as below average compared to those available to the general population. The use of nurses as prescribers in prison infirmaries, though consistent with Ghana Health Service policy, seems to negatively influence prisoners’ perceptions of the quality of the health workforce in prisons. Lack of basic equipment and essential medications at the infirmary for common endemic conditions such as malaria coupled with the bureaucratic processes required to access care outside of the prison also negatively affected incarcerated individuals’ perceptions of the quality of health care.ConclusionsIncarcerated individuals perceived that the quality of health services provided in prisons was inferior to that provided in the general population. Addressing challenges associated with the unavailability of essential drugs and equipment, improving the number of health staff, and addressing bottlenecks in accessing urgent care will enhance the experiences of incarcerated populations on the quality of care given.

FROM AFRICA TO BRAZIL, A PARALLEL BETWEEN RELIGION AND TRADITIONAL YORUBA MEDICAL SYSTEMS

The Yoruba are one of the largest ethnolinguistic groups in West Africa. Among the Yoruba and their descendants, medicine and magic are given the same name, oogun, due to the similarity of their practices. From this point of view, Yoruba Traditional Medicine is interconnected with Yoruba Traditional Religion, including a series of religious and therapeutic practices employed in general health care and emotional well-being services. With their forced arrival in America, following Portuguese colonization, these people brought their rituals and their vision of medicine to Brazil, giving rise to the religion known as Candomblé. The objective of this work was to conduct a review study on Traditional Medicine employed by African people of Yoruba ethnicity in Nigeria, drawing a parallel with their descendants (direct and indirect) who practice Candomblé in Brazil, from an epistemological perspective, reflecting on the religiosity and health of these people and the challenges for its consolidation as a traditional medical system.

1.O. Scientific session: Trans & Gender-Diverse Individuals’ Mental & Behavioral Health Risks & Intervention Needs

Abstract Transgender and gender-diverse (TGD) individuals are at a greater risk for various poor mental and behavioral health outcomes than cisgender individuals, including higher rates of suicide, psychiatric diagnoses, and behavioral health problems. For example, research has documented a seven-fold increased risk for lifetime suicide attempts among young TGD people, compared with the general population. Less is known about the age of onset of such mental and behavioral health disparities and how these disparities may vary across other intersectional socio-demographic variables. It has been well-documented that trans and gender-diverse individuals often encounter discrimination and transphobia across various social, educational, professional, administrative, and healthcare settings. This discrimination, as highlighted in the literature, frequently poses obstacles to accessing both general and trans-specific healthcare services due to experiences of discrimination (e.g., misgendering, refusal of care, lack of adequate services). The right and ability to self-determine and the accessibility to gender-affirming care without discrimination are key to closing the gap in TGD individuals’ mental and behavioral health outcomes, and for them to live authentically and thrive. Tailored and affirming mental and behavioral health interventions to reduce these health inequities are pivotal for TGD individuals to achieve the highest attainable standard of physical and mental health: a key fundamental human right. Considerable gaps in the literature remain concerning the onset and determinants of gender identity-based health disparities and healthcare approaches that are respectful, inclusive, non-pathologizing, and grounded in human rights principles for TGD individuals. This workshop intends to address these knowledge gaps by delving into the mental and behavioral health needs of TGD individuals. The workshop seeks to further foster dialogue on strategies to overcome resistance to implementing approaches that uphold the human rights and well-being of these communities. Dr. Richard Bränström (Karolinska Institutet) will present a study that explores the age at which gender identity-based disparities in psychiatric diagnoses and treatment can be first identified. Dr. Gonzales (Vanderbilt University) will examine disparities in mental health and social determinants of health among TGD individuals with private insurance. Dr. Moleiro (Lisbon University Institute) will review TGD persons’ ways of identifying with the choices and trajectories in social, legal, and affirmative healthcare processes in Portugal. Dr. Lelutiu-Weinberger (Columbia University School of Nursing) will present findings from a study that assessed tobacco use and cessation attitudes, facilitators, and barriers to quitting, and intervention components and delivery modality acceptability among TGD individuals, as well as sexual minority individuals, in Romania to inform a tailored and affirming smoking cessation intervention. Key messages • Transgender and gender-diverse are at increased risk for a variety of poor mental and behavioral health compared with the general public. • There is a critical need to foster healthcare services for transgender and gender-diverse individuals that are tailored and affirming.

The RANZCP Workforce Report: Action is needed, now.

The RANZCP conducted an anonymous survey of 7200 members (trainees and psychiatrists) in December 2023, receiving 1269 responses, representing the views of roughly 1 in 6 members, and of the respondents, three quarters reported experiencing burnout in the last 3 years. We provide a commentary, citing evidence from relevant previous research, discussing the implications and proposing potential interventions. Members of the RANZCP reported worsening workforce shortages, with 9 in 10 respondents stating that these negatively impacted patient care, and 7 in 10 experiencing symptoms of burnout. Eighty per cent identified workforce shortages as the top contributing factor to such burnout. The aetiology of workforce shortages and burnout is likely due to operational and structural shortfalls in psychiatric services. However, public and private sector employment information was not included in the report. There are a range of strategic, evidence-based interventions to address the psychiatrist and trainee workforce challenges, comprising general healthcare service as well as specific initiatives. Based on the findings of the report, such interventions are needed, now.

Mpox and Vaccine Knowledge, Beliefs, and Sources of Trusted Information Among Gay, Bisexual, and Other Men Who Have Sex With Men in the U.S.

ObjectivesThis research aims to characterize disparities in mpox- and vaccine-related knowledge in gay, bisexual, and other men who have sex with men (GBMSM) in the U.S. MethodsWe conducted a study using the American Men's Internet Survey (AMIS), which includes 823 cisgender (defined as their gender identity matching their sex assigned at birth) males aged 15 and older from August 5 – 15, 2022. We evaluated sociodemographic and behavioral factors associated with mpox knowledge, including race/ethnicity, region, age group, and HIV pre-exposure prophylaxis (PrEP) use using chi-squared tests. ResultsWe identified knowledge gaps with many participants unsure about whether individuals need two doses of the vaccine (34.4%), and if the vaccine confers immediate protection (27.2%). We observed racial and regional disparities (p<0.01), with 24.4% of Non-Hispanic Black men and 18.1% of men living in the South reporting little to no mpox awareness. Among the 707 self-reported HIV-negative participants, people who used PrEP within the past year were more likely to exhibit high awareness about mpox compared to people who did not use PrEP. ConclusionsFindings suggest the potential to leverage existing networks (i.e., STI or general healthcare services with PrEP use) for future targeted health service programming or education campaigns for mpox vaccination amongst GBMSM.

Stigma, and factors associated with experiencing stigma, while visiting health-care services among samples of people who use illegal drugs in Australia.

People who inject drugs experience stigma across multiple settings, including when accessing health-care services, however, comparatively little is known about experiences of stigma towards other groups of people who use illegal drugs. This paper examines experience of, and factors associated with, stigma among two samples of people who use illegal drugs when visiting both specialist alcohol and other drug (AOD) and general health-care services. Australians who regularly (i.e., ≥monthly) inject drugs (n = 879; illicit drug reporting system [IDRS]) or use ecstasy and/or other illegal stimulants (n = 700; ecstasy and related drugs reporting system [EDRS]) were surveyed between April and July 2022 about past 6-month experience of stigma in the above services. Multi-variable regression analyses were performed to determine the socio-demographic, drug use and health factors associated with stigma. Experiences of stigma in general health-care services were more common among IDRS (40%) than EDRS (24%; p < 0.001) participants, however, experiences were comparable in specialist AOD health-care settings (22% and 20%, respectively; p = 0.687). Gender identity and experiencing high psychological distress were associated with experiencing stigma across both samples. Past-year overdose was associated with experiencing stigma among the IDRS sample, while unstable housing and incomplete high school education were associated with experiencing stigma in the EDRS sample. Experiences of stigma when accessing health-care services are relatively common across different populations of people who use illegal drugs. Our findings highlight the multiple and intersecting dimensions of stigma and provide further support for recent calls for a universal precautions approach to stigma in health care.

Mental health services in Gauteng, South Africa: A proxy evaluation using pharmaceutical data.

South African legislation advocates for equitable access to mental healthcare services integrated into general healthcare settings. Mental, neurological, and substance use (MNS) disorders are often comorbid. Pharmacoepidemiology provides indirect evidence of service provision for conditions amenable to medicine treatment. The study aims to evaluate medicine procurement for MNS disorders at different service levels in the health system. The Public health sector, Gauteng province formed the setting for the study. A secondary analysis of the Gauteng pharmaceutical database was conducted using Anatomic Therapeutic Chemical (ATC) and defined daily dose (DDD) methodology. Anatomic Therapeutic Chemical classes of medicines for MNS disorders were included. Defined daily doses and costs were calculated per 1000 population served by each facility and service level. Statistical comparisons were made using chi-square testing. General healthcare settings accounted for 90% (R118 638 248) and specialised hospitals for 10% (R13 685 032) of expenditure on medicines for MNS disorders, procuring 94% (n = 49 442 474) and 6% (n = 3 311 528) of DDDs, respectively. Although district clinics procured 60% of DDDs, they procured the least per 1000 population served, whereas district hospitals procured the most. For almost all ATC classes, procurement differed significantly between municipalities at every service level and between specialised hospitals. In Gauteng province, most medicines for MNS disorders are procured by general healthcare services, but access to care may not be equitable. While population coverage at district clinics appears low, district hospitals may experience the greatest care burden. Research regarding quality of care at each service level is recommended. This study provides insight into service provision for MNS disorders.

Service utilization among adolescents seeking trauma-related care: Differences by risk for suicide and ethnoracial background.

Adolescents from ethnoracially minoritized backgrounds increasingly report high rates of attempted suicide, trauma exposure, and limited access to mental healthcare services. However, less is known regarding their use of services across different youth-serving systems. This study examines the associations and interactions between self-injurious thoughts and behaviors (SITBs), race/ethnicity, and service sector utilization (mental healthcare, general healthcare, school, and social services) among a sample of trauma-exposed and treatment-seeking adolescents. Participants were treatment-seeking adolescents (N = 4406) ages 12-17 from the National Child Traumatic Stress Network Core Data Set who had available data for SITBs, race/ethnicity, services utilized, and other key variables. Mixed effects logistic regression was used to examine main and interactive effects for whether adolescents' race/ethnicity and SITBs were associated with service utilization in each of the identified service sectors. SITBs were associated with adolescents' utilization of mental healthcare (OR = 1.38 p < 0.001), general healthcare (OR = 2.30; p < 0.001), and school services (OR = 1.38 p < 0.001). NH Black adolescents reporting SITBs were less likely to use mental health services than other NH Black youths (OR = 0.53; p = 0.004). Hispanic adolescents reporting SITBs were more likely to utilize healthcare services than other Hispanic youths (OR = 1.51; p = 0.039). Trauma-exposed adolescents reporting SITBs are more likely to utilize mental healthcare, general healthcare, and school-based services than other trauma-exposed adolescents. However, NH Black adolescents experiencing SITBs may face additional barriers to utilizing mental healthcare services. Findings can be used to develop nursing practices and policies to address barriers faced by adolescents reporting SITBs.

Can the Emergency Medical Service (EMS) System Help in Improving the Healthcare Access - Evidence from Maharashtra EMS.

For many people in the remote regions of India, medical help is inaccessible as 66% of rural Indians do not have access to critical medicine and 31% of the population travel more than 30 km seeking health care in rural India. Timely non-availability of doctors in healthcare facilities, especially in primary health centers (PHCs), leads to more dependency on the private healthcare practitioners for the out-patient department services. This needs immediate attention. The healthcare authority in Maharashtra has allowed doctors in 108 emergency ambulances to provide consulting services. The current study is based on the total consultations managed by the doctors on-board on the 108 ambulances in the state of Maharashtra in the years 2020, 2021, and 2022. The data are procured from the state-run Emergency Response Centre, and the analysis is done by using the basic statistical technique in MS Excel and SPSS16.0. More than 9.35 lakh medical consultations were provided with an average 856 consultations per ambulance in the year 2022, showing a significant growth of 452% over the consultations in 2020. The base location of the 32% ambulance (298) in the PHCs has improved the round the clock accessibility in 16% of the total PHCs in the state of Maharashtra. The availability of the doctors in the state-run emergency ambulances for general healthcare services has improved the adherence of Indian Public Health Standards, and such practice must be examined for implementation in other states.

Experiences of transgender persons in accessing routine healthcare services in India: Findings from a participatory qualitative study.

Despite having a higher burden of health problems, transgender persons face challenges in accessing healthcare in India. Most studies on healthcare access of transgender persons in India focus only on HIV related care, mental healthcare, gender affirmative services or on the ethno-cultural communities or transgender women. This study fills this gap by focusing on diverse gender identities within the transgender community with a specific focus on experiences in accessing general or routine healthcare services. A qualitative descriptive approach was used in this study. 23 in-depth interviews and 6 focus group discussions were conducted virtually and in-person with a total of 63 transgender persons in different regions of India between May and September 2021. The study used a community-based participatory research approach and was informed by the intersectionality approach. Thematic analysis was conducted to analyze the data. Four key themes emerged: (i) intersectional challenges in accessing healthcare start outside of the health system, continue through cisgender-binary-normative health systems that exclude transgender persons; and at the interface with individuals such as health professionals, support staff and bystanders; (ii) the experiences negatively impact transgender persons at an individual level; (iii) in response, transgender persons navigate these challenges across each of the levels: individual, health system level and from outside of the health system. This is a first of its kind qualitative participatory study focusing on routine healthcare services of transgender persons in India. The findings indicate the need to move conversations on trans-inclusion in healthcare from HIV and gender affirmative services to routine comprehensive healthcare services considering the higher burden of health problems in the community and the impact of poor access on their lives and well-being.

Mental health treatment utilization patterns among 108,457 Afghanistan and Iraq veterans with depression.

People with depression often underutilize mental health care. This study was conceived as a first step toward a clinical decision support tool that helps identify patients who are at higher risk of underutilizing care. The primary goals were to (a) describe treatment utilization patterns, early termination, and return to care; (b) identify factors associated with early termination of treatment; and (c) evaluate the accuracy of regression models to predict early termination. These goals were evaluated in a retrospective cohort analysis of 108,457 U.S. veterans who received care from the Veterans Health Administration between 2001 and 2021. Our final sample was 16.5% female with an average age of 34.5. Veterans were included if they had a depression diagnosis, a positive depression screen, and received general health care services at least a year before and after their depression diagnosis. Using treatment quality guidelines, the threshold for treatment underutilization was defined as receiving fewer than four psychotherapy sessions or less than 84 days of antidepressants. Over one fifth of veterans (21.6%) received less than the minimally recommended care for depression. The odds of underutilizing treatment increased with lack of Veterans Administration benefits, male gender, racial/ethnic minority status, and having received mental health treatment in the past (adjusted OR > 1.1). Posttraumatic stress disorder comorbidity correlated with increased depression treatment utilization (adjusted OR < .9). Models with demographic and clinical information from medical records performed modestly in classifying patients who underutilized depression treatment (area under the curve = 0.595, 95% CI [0.588, 0.603]). Most veterans in this cohort received at least the minimum recommended treatment for depression. To improve the prediction of underutilization, patient factors associated with treatment underutilization likely need to be supplemented by additional clinical information. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Study of Prevalence of Oral Diseases in The Population of District Buner Khyber Pakhtunkhwa, Pakistan

Background: Oral diseases, prevalent globally, pose significant health challenges, especially in regions with limited healthcare resources. District Buner, in Khyber Pakhtunkhwa, Pakistan, is one such area where oral health has received minimal attention. The study of oral diseases in this region is crucial for understanding the health needs of its population and for implementing effective public health interventions. Objective: This study aimed to assess the prevalence and types of oral diseases in District Buner and to identify the major contributing factors to these conditions, thereby informing targeted healthcare strategies. Methods: A cross-sectional study was conducted from October 2019 to October 2020 in all tehsils of District Buner. Data collection was based on questionnaires administered to both dentists and patients. Approximately 20 to 25 dentists from various healthcare facilities, including government hospitals and private clinics, participated in the study. The questionnaires for dentists consisted of ten open-ended questions, while those for patients included fifteen close-ended questions. The sample size was 508 individuals, representing various age groups and genders. Data analysis involved descriptive and inferential statistical methods to determine prevalence rates and associations. Results: The study revealed that the most common oral diseases were dental caries (90%), gingivitis (63%), periodontitis (59%), pulpitis (43%), TMJ disorders (23%), and oral cancer (5%). Dental caries was notably prevalent across all age groups, with a higher incidence in children. Gingivitis was observed more in females, particularly during pregnancy. Periodontitis and gingivitis showed a greater prevalence in males, often associated with smoking. Pulpitis was more common in females, while TMJ disorders were evenly distributed among genders. Oral cancer was the least prevalent disease. Conclusion: The study underscores the critical need for improved oral health awareness and preventive care in District Buner. The high prevalence of various oral diseases, influenced by factors such as dietary habits, smoking, and gender-specific issues, calls for comprehensive public health strategies. These strategies should include education on oral hygiene, increased access to dental care, and integration of oral health into general healthcare services.

How to improve the capacity of general practitioners? – a Flemish approach

“Barely any region left with freely accessible primary health care in Flanders.” This is one of the many newspaper headlines that was recently published to emphasize the fact that more and more general practitioners refuse to take in new patients, because they run out of capacity to provide patients with proper health care. Where does it go wrong? &#x0D; Accessibilty to general practitioners is a hot topic for the Flemish policymakers. An aging population and an increase of mental health problems asks a lot from the general practitioners, as well as the shift of tasks from hospitals towards primary health care and the growing attention for prevention. However, is there a real shortage in general practitioners? Looking abroad learns that the number of general practitioners might not be the major cause of the capacity problem, but that the true bottleneck might lie in the way of organizing primary health care capacity and accessibility. Embedded in a landscape of health care where general practitioners mostly work on a self-employed base, and the fragmented governmental structure in Belgium as an extra obstacle makes this a major challenge for the near future.&#x0D; A dialogue between policy makers from all Belgian governments was opened to create a common approach: each government will take actions within their own authorities. The Flemish government worked out a plan to counter this massive challenge in primary health care through different initiatives, in cooperation with representatives of the general practitioners on the field, local authorities and umbrella organizations.&#x0D; Flanders commits itself by installing three major fundaments which can create change in the way general practitioners are organized: a first step is to create an accurate and up-to-date database of the current available general practitioners health care services compared with the local care need; in parallel the funding of general practitioners will be expanded in a way which stimulates interdisciplinary collaboration and optimizes health care capacity; on top of that the Flemish government is experimenting with new forms of primary care practices in which integrated care is the keystone and which are supported by local authorities and in close connection with welfare services. &#x0D; These projects described above are in full development. On the working field more and more general practitioners are willing to put their shoulders under these initiatives to create solid solutions for the future. &#x0D; The international audience of this lecture might recognize similar issues they encounter in their own countries and will be able to see similarities and differences compared to the Flemish context. By drawing these parallels one can have a broader view on the approach of improving health care capacity and accessibility. &#x0D; These Flemish projects will be brought together with the initiatives from the other Belgian governments at a roundtable discussion to align all the initiatives on primary health care capacity and create a future proof primary health care capacity in Belgium.

MEDICAL TEAM SUPPORT FOR TABLE TENNIS EVENT – LPTK CUP XXI UM 2023

Introduction: LPTK CUP strives to improve relationships and unity among LPTK (Lembaga Pendidikan Tenga Kependidikan) members. It achieves this by merging competitive elements with entertainment to promote a feeling of camaraderie and cooperation. Furthermore, LPTK CUP includes a range of sports competitions, including table tennis. Purpose: This study aims to comprehend the medical team's involvement in providing support during the table tennis event at LPTK CUP XII UM 2023. Method: The medical team is crucial in delivering general and specialized healthcare services (for sports injuries) throughout the table tennis competition at LPTK CUP XXI UM 2023. Additionally, various approaches are employed in this event, including 1) Acquiring Medical Equipment, 2) Collaborating with Relevant Entities, 3) Arranging the Placement of the Medical Team, 4) Conducting Screening and Medical Services, and 4occurredviding Health Education. Result: Most table tennis participants are less than 50 years old. Several injuries occur during the match, namely Abrasion, Shoulder Sprain, and Ankle Sprain. The injury management provided is based on the Rice Method for sports injuries.

Use of sentiment analysis for capturing hospitalized cancer patients' experience from free-text comments in the Persian language

PurposeToday, the Internet provides access to many patients' experiences, which is crucial in assessing the quality of healthcare services. This paper introduces a model for detecting cancer patients' opinions about healthcare services in the Persian language, both positive and negative.MethodTo achieve the objectives of this study, a combination of sentiment analysis (SA) and topic modeling approaches was employed. All pertinent comments made by cancer patients were collected from the patient feedback form of the Tehran University of Medical Science (TUMS) Cancer Institute (CI) in Iran, from March to October 2021. Conventional evaluation metrics such as accuracy, precision, recall, and F-measure were utilized to assess the performance of the proposed model.ResultThe experimental findings revealed that the proposed SA model achieved accuracies of 89.3%, 92.6%, and 90.8% in detecting patients' sentiments towards general services, healthcare services, and life expectancy, respectively. Based on the topic modeling results, the topic "Metastasis" exhibited lower sentiment scores compared to other topics. Additionally, cancer patients expressed dissatisfaction with the current appointment booking service, while topics such as "Good experience," "Affable staff", and "Chemotherapy" garnered higher sentiment scores.ConclusionThe combined use of SA and topic modeling offers valuable insights into healthcare services. Policymakers can utilize the knowledge obtained from these topics and associated sentiments to enhance patient satisfaction with cancer institution services.