Health Management Research Articles

Knowledge and personal hygiene behavior during menstruation among adolescent girls in various regions: A literature review

Personal hygiene is still a public health issue in Indonesia. Menstrual hygiene is the management of hygiene and health when women experience menstruation as part of a personal hygiene care routine with the concept of clean. Personal hygiene during menstruation plays an important role in a person's health status in avoiding functional disorders of the reproductive organs. Knowledge in Indonesia states that poor personal hygiene behavior during menstruation of adolescent girls is a major concern because it has a health impact. The method used was literature review by searching articles through Google Scholar and Pubmed databases. Selection stages were carried out to obtain articles that met the inclusion and exclusion criteria, and 6 articles were obtained that could be analyzed. The results showed that knowledge has a significant role in determining menstrual hygiene behavior in adolescent girls, there are also differences in knowledge and behavior when performing personal hygiene behavior during menstruation in urban and rural areas. To improve knowledge and behavior of personal hygiene during menstruation, especially in various regions, it can be done with various strategies such as promotion, education, collaboration, improving service quality, and increasing accessibility.

Awareness and practice regarding puerperal danger signs among postnatal mothers attending at rural tertiary care center of Nepal

Background: Global evidences show that all pregnancies are at risk and complications during pregnancy, childbirth, and the postnatal period are difficult to predict. Awareness regarding puerperal danger signs is essential for appropriate and timely health management so that maternal mortality and morbidity can be reduced. An objective of the study is to assess the awareness and practice regarding puerperal danger signs among postnatal mothers. Method: Descriptive cross-sectional study design was conducted among 139 postnatal mothers, who were attending at maternal and child health (MCH) clinic and postnatal ward of Karnali Academy of Health Sciences (KAHS), Jumla. Probability simple random sampling method was used. Data were collected by using semi-structured interview questionnaire. After collection of the data, coding was done. Coded data was entered into EXCEL and transformed in SPSS for analysis. Result: Out of 139 postnatal mothers, 60.4% had poor level of awareness regarding puerperal danger signs. Only 39.6% had good level of awareness regarding puerperal danger signs. Similarly, 85.6% of the respondents had poor practice on puerperal danger signs. Only 14.4% had good practice on puerperal danger signs. Conclusion: Health education & awareness program is needed to improve the mother’s knowledge and practice on puerperal danger signs.

Digital twin-enabled robust production scheduling for equipment in degraded state

Technological advancements are leading to a world where digital twins will become integral to manufacturing operations management. While wide-ranging applications of digital twins are being researched, robust production scheduling remains an enduring challenge, especially considering the numerous sources of uncertainty in a complex manufacturing system that can affect the validity of the obtained solution. Thus, the article proposes a Prognostics and Health Management (PHM)-enabled digital twin framework to perform job scheduling for a flow shop scheduling problem considering real-time equipment health state. The framework combines the adoption of a Genetic Algorithm optimizer with data-driven modelling leveraging algorithms like Principal Component Analysis and models like Discrete Event Simulation with the purpose to solve the engineering task of scheduling at hand. Building on such a technological blend, the framework incorporates the degradation and fault detection and diagnosis of failure modes across multiple components. The effect of degradation and faults on job processing times is learned as a distribution from the field data. The proposed framework is then validated in a laboratory environment where degradation is produced by inducing degradation and faults in the equipment. By means of various experiments, the optimized makespan is compared for the output schedules in different configurations. When equipment is degraded, production scheduling with PHM-enabled field-synchronized digital twin results in better makespan estimation, if compared to the digital twin without PHM. This shows the superiority of the framework in terms of more realistic makespan estimations, which finally corresponds to improved production schedule optimization, sensitive also to degraded states.

Professional education and training of public health and preventive medicine specialists in Canada

Public health and preventive medicine (PHPM) specialist physicians focus on the population rather than individuals as their patients. These specialists assess the health status of a community and subsequently develop, implement and evaluate effective interventions at the population level to improve health. This work brings together their medical expertise, population health approach and management/ leadership skills. The Royal College of Physicians and Surgeons of Canada (RCPSC) states that ‘the Public Health and Preventive Medicine or community medicine (as called previously) specialist uses population health knowledge and skills to play leading and collaborative roles in the maintenance and improvement of the health and well-being of the community’. It is a broad speciality that requires strong generalist skills including in preventive medicine, management, epidemiology, emergency response, health promotion, and health protection.

Validating the indicator "maternal death review coverage" to improve maternal mortality data: A retrospective analysis of district, facility, and individual medical record data.

Understanding causes and contributors to maternal mortality is critical from a quality improvement perspective to inform decision making and monitor progress toward ending preventable maternal mortality. The indicator "maternal death review coverage" is defined as the percentage of maternal deaths occurring in a facility that are audited. Both the numerator and denominator of this indicator are subject to misclassification errors, underreporting, and bias. This study assessed the validity of the indicator by examining both its numerator-the number and quality of death reviews-and denominator-the number of facility-based maternal deaths and comparing estimates of the indicator obtained from facility- versus district-level data. We collected data on the number of maternal deaths and content of death reviews from all health facilities serving as birthing sites in 12 districts in three countries: Argentina, Ghana, and India. Additional data were extracted from health management information systems on the number and dates of maternal deaths and maternal death reviews reported from health facilities to the district-level. We tabulated the percentage of facility deaths with evidence of a review, the percentage of reviews that met the World Health Organization defined standard for maternal and perinatal death surveillance and response. Results were stratified by sociodemographic characteristics of women and facility location and type. We compared these estimates to that obtained using district-level data. and looked at evidence of the review at the district/provincial level. Study teams reviewed facility records at 34 facilities in Argentina, 51 facilities in Ghana, and 282 facilities in India. In total, we found 17 deaths in Argentina, 14 deaths in Ghana, and 58 deaths in India evidenced at facilities. Overall, >80% of deaths had evidence of a review at facilities. In India, a much lower percentage of deaths occurring at secondary-level facilities (61.1%) had evidence of a review compared to deaths in tertiary-level facilities (92.1%). In all three countries, only about half of deaths in each country had complete reviews: 58.8% (n = 10) in Argentina, 57.2% (n = 8) in Ghana, and 41.1% (n = 24) in India. Dramatic reductions in indicator value were seen in several subnational geographic areas, including Gonda and Meerut in India and Sunyani in Ghana. For example, in Gonda only three of the 18 reviews conducted at facilities met the definitional standard (16.7%), which caused the value of the indicator to decrease from 81.8% to 13.6%. Stratification by women's sociodemographic factors suggested systematic differences in completeness of reviews by women's age, place of residence, and timing of death. Our study assessed the validity of an important indicator for ending preventable deaths: the coverage of reviews of maternal deaths occurring in facilities in three study settings. We found discrepancies in deaths recorded at facilities and those reported to districts from facilities. Further, few maternal death reviews met global quality standards for completeness. The value of the calculated indicator masked inaccuracies in counts of both deaths and reviews and gave no indication of completeness, thus undermining the ultimate utility of the measure in achieving an accurate measure of coverage.

How to plan and provide general anesthesia for a troop of 98 hamadryas baboons (Papio hamadryas) for contraceptive and preventative health interventions.

Present an approach to the safe and efficient provision of anesthesia and birth control measures to a large group of primates. 98 hamadryas baboons (Papio hamadryas) held in a German zoological institution. A group of 12 veterinarians, 2 zookeepers, and 6 volunteers anesthetized all animals within 2 days. The baboons were orally premedicated with midazolam (0.1 to 0.5 mg/kg) and anesthetized with medetomidine (40 to 60 µg/kg, IM) and ketamine (2 to 4 mg/kg, IM); isoflurane at rates of 1.5% to 2% was used for maintaining anesthesia if necessary. All animals received a physical examination, prophylactic medication, and tuberculin testing. For population management, the animals received a contraceptive implant (adult females), orchiectomy (young males), or vasectomy (breeding males). Young males received intratesticular blocks with lidocaine. All animals received atipamezole (125 to 150 µg/kg) before recovery. Premedication resulted in anxiolysis, which facilitated separating and darting. Median time from darting to access to the animal was 10 minutes. Mean anesthetic times were 25 minutes for females and 55 minutes for males. The depth of anesthesia was appropriate for the procedures. No fatalities were recorded. One animal was injured by other baboons but recovered after treatment. Health management and birth control measures are necessary in baboon troops under human care. Anesthesia and/or contraception of individual animals often leads to intraspecific aggression. This case series describes how to provide anesthesia and contraception to an entire troop as an alternative approach that can be adopted to future similar interventions.

Wearable Sensors for Physiological Condition and Activity Monitoring

Rapid technological advancements have transformed the healthcare sector from traditional diagnosis and treatment to personalized health management. Biofluids such as teardrops, sweat, interstitial fluids, and exhaled breath condensate offer a rich source of metabolites that can be linked to the physiological status of an individual. More importantly, these biofluids contain biomarkers similar to those in the blood. Therefore, developing sensors for the noninvasive determination of biofluid‐based metabolites can overcome traditionally invasive and laborious blood‐test‐based diagnostics. In this context, wearable devices offer real‐time and continuous physiological conditions and activity monitoring. The first‐generation wearables included wristwatches capable of tracking heart rate variations, breathing rate, body temperature, stress responses, and sleeping patterns. However, wearable sensors that can accurately measure the metabolites are needed to achieve real‐time analysis of biomarkers. In this review, recent progresses in wearable sensors utilized to monitor metabolites in teardrops, breath condensate, sweat, and interstitial fluids are thoroughly analyzed. More importantly, how metabolites can be selectively detected, quantified, and monitored in real‐time is discussed. Furthermore, the review includes a discussion on the utility of, multifunctional sensors that combine metabolite sensing, human activity monitoring, and on‐demand drug delivery system for theranostic applications.

Gestational syphilis: a socioeconomic analysis of the increase in rates in Brazil

Syphilis is a sexually transmitted infection (STI) that has been known since the 15th century. This pathology, whose etiological agent is Treponema Pallidum, can be classified as: acquired, gestational or congenital, since transmission can be sexual or vertical, from mother to fetus. In recent years, gestational syphilis has seen a progressive and considerable increase in the number of cases detected in Brazil. Thus, knowing that this disease puts not only the pregnant woman's life at risk, but also that of the fetus, which can acquire the infection via transplacental transmission, it is extremely important to understand the factors involved in the increase in the number of detected cases of gestational syphilis, which is the main objective of this research. From a socio-economic perspective, the article discusses the correlation between the increase in cases and social inequality factors in areas of Brazil, understanding how the particularities of each region are reflected in health management, based on the incidence of the disease. As a methodology, we plan to carry out a bibliographical review based on books and catalogued scientific articles published in online indexed databases, such as Scientific Library Online (SciElo) and Pubmed. In addition, an analysis of data from the DATASUS platform will be carried out, also from the 2010 Census. As expected results, we believe that the increase in the rate of gestational syphilis is closely related to socioeconomic factors and access to adequate prenatal care.

Factors affecting the oral health of patients on maintenance hemodialysis and recommendations for standardized nursing care: a multicenter study.

To determine the oral health status of patients on maintenance hemodialysis (MHD) and to identify the factors influencing their oral health. This observational study included 1,186 patients with chronic kidney disease who received MHD across 33 hospitals in China. The patients were recruited for a questionnaire survey between April and August 2023 at Beijing Chaoyang Hospital using stratified sampling. Data collection tools included the General Information Questionnaire for Maintenance Hemodialysis Patients, the Oral Health Assessment Tool, the Pittsburgh Sleep Quality Index, and the Hospital Anxiety and Depression Scale. Spearman's rank correlation coefficients were used to assess the relationships between the oral health of patients on MHD and continuous variables such as sleep quality and emotional status. Multiple linear regression analysis was employed to explore the relationship between oral health and various variables. The oral health scores of the patients ranged from 8 to 22, with a mean score of 12.54 ± 2.63. The final model of the multiple linear regression analysis indicated a goodness of fit of 22.19%. Independent factors affecting the oral health of patients included smoking, the proportion of medical expenses, water consumption, sleep quality, and anxiety scores (all P < 0.05). High levels of smoking, substantial medical expenses, poor sleep quality, and elevated anxiety scores were risk factors for poor oral health (all P < 0.05). Adequate daily water intake served as a protective factor for oral health (P < 0.05). This study proposes targeted interventions to enhance the management and improvement of oral health in patients on hemodialysis, aiming to provide highly personalised and effective oral health care. These interventions are expected to improve oral health outcomes in future clinical practice.

Proactive behaviors and health care workers: A systematic review.

Proactive behaviors at work refer to discretionary actions among workers that are self-starting, change oriented, and future focused. Proactive behaviors reflect the idiosyncratic actions by individual workers that shape the delivery and experience of professional services, highlight a bottom-up perspective on workers' agency and motivation that can influence organizational practices, and are associated with a variety of employee and organizational outcomes. This systematic review aims to understand the various forms of proactive behaviors in health care workers that have been studied, and how these proactive behaviors are associated with employee-level outcomes and quality of care. Systematic review of articles published to date on proactive behaviors in health care workers. Based on the identification of 40 articles, we find that job crafting, active problem solving, voice, extra-role behaviors, and idiosyncratic deals have been investigated as proactive behaviors among health care workers. Among these, job crafting is the most commonly studied (35% of articles), and it has been conceptualized and measured in the most consistent way, including as individual- and group-level phenomena, and as organizational interventions. Studies on active problem solving, which refers to workers accepting responsibility, exercising control, and taking action around anticipated or experienced problems at work, have not been consistently investigated as a form of proactive behavior but represent 25% of the articles identified in this review. Overall, this review finds that proactive behaviors in health care is a burgeoning area of research, with the majority of studies being cross-sectional in design and published after 2010, and focused on workers' job satisfaction as the outcome. Health care workers and managers should consider the distinct influences and contributions of proactive behaviors as ways to improve employee-level outcomes and quality of care.

Physical work environment in an activity-based flex office: a longitudinal case study.

This study aimed to investigate and explore Occupational Health and Safety (OHS) management, office ergonomics, and musculoskeletal symptoms in a group of office workers relocating from cell offices to activity-based flex offices (AFOs). The analysis was based on qualitative interview data with 77 employees and longitudinal questionnaire data from 152 employees. Results indicate that there was a need to clarify roles and processes related to the management of OHS. Self-rated sit comfort, working posture, and availability of daylight deteriorated and symptoms in neck and shoulders increased after the relocation and seemed to be influenced by many factors, such as difficulties adjusting the workstations, the availability of suitable workplaces, and age, sex, and individual needs. Research on the long-term effects of physical work environments and management of (OHS) issues after implementing activity-based flex offices is sparse. This study demonstrates the importance of planning and organising OHS issue management when implementing an AFO, and to carefully implement office ergonomics among office workers.

Knowledge, attitudes, and practices towards urinary system stones among the Chengdu population

This cross-sectional study aimed to explore the knowledge, attitudes, and practices (KAP) regarding urinary system stones among the general public in Chengdu, China. Conducted between January and June 2023, this research targeted individuals undergoing physical examinations at the Health Management Center of Sichuan Provincial People's Hospital. Structured questionnaires were administered to collect demographic information and assess KAP related to urinary system stones. Following meticulous scrutiny, 1014 valid questionnaires were retained for analysis. The computed scores for knowledge, attitude, and practice were 9.36 ± 4.23 (possible score range 0–17), 37.75 ± 7.20 (possible score range 11–55), and 30.77 ± 4.00 (possible score range 10–50), respectively. These outcomes suggested insufficient knowledge and moderately positive attitudes and practices among the participants. Structural Equation Modeling (SEM) analysis revealed a direct impact of knowledge on attitude (β = 0.967, P < 0.001), with attitude subsequently exerting a direct influence on practice (β = 0.167, P < 0.001). This indicated an indirect impact of knowledge on practice. Additionally, there was a direct effect of knowledge on practice (β = 0.167, P < 0.001). In conclusion, the general populace in Chengdu exhibited insufficient knowledge and moderate attitudes and practices concerning urinary stones. These findings underscore the imperative for targeted educational interventions aimed at enhancing public awareness and fostering positive attitudes and practices toward urinary stone prevention and management.

A Wireless Noninvasive Blood Pressure Measurement System Using MAX30102 and Random Forest Regressor for Photoplethysmography Signals

Hypertension, often termed “the silent killer”, is associated with cardiovascular risk and requires regular blood pressure (BP) monitoring. However, existing methods are cumbersome and require medical expertise, which is worsened by the need for physical contact, particularly during situations such as the coronavirus pandemic that started in 2019 (COVID-19). This study aimed to develop a cuffless, continuous, and accurate BP measurement system using a photoplethysmography (PPG) sensor and a microcontroller via PPG signals. The system utilizes a MAX30102 sensor and ESP-WROOM-32 microcontroller to capture PPG signals that undergo noise reduction during preprocessing. Peak detection and feature extraction algorithms were introduced, and their output data were used to train a machine learning model for BP prediction. Tuning the model resulted in identifying the best-performing model when using a dataset from six subjects with a total of 114 records, thereby achieving a coefficient of determination of 0.37/0.46 and a mean absolute error value of 4.38/4.49 using the random forest algorithm. Integrating this model into a web-based graphical user interface enables its implementation. One probable limitation arises from the small sample size (six participants) of healthy young individuals under seated conditions, thereby potentially hindering the proposed model’s ability to learn and generalize patterns effectively. Increasing the number of participants with diverse ages and medical histories can enhance the accuracy of the proposed model. Nevertheless, this innovative device successfully addresses the need for convenient, remote BP monitoring, particularly during situations like the COVID-19 pandemic, thus making it a promising tool for cardiovascular health management.

SHEEP HOUSING AND HEALTH MANAGEMENT AT JOGLO FARM DRAMAGA BOGOR

The health of sheep is an important factor and can affect sheep production. Livestock health handlers include health handling, hoof cutting, cage disinfection, ectoparasite control, vaccine administration, and deworming. This activity aims to compare the knowledge gained in lectures and their application in the field related to housing management and sheep health. This activity was held at Joglo Farm for a month, from August 13, 2022, to September 13, 2022—observation and interview methods. This activity showed that sheep health management on the Joglo farm was quite good because the maintenance procedures were exceptionally complete and regular

Does a GP service package matter in addressing the absence of health management by the occupational population? A modelling study.

To assess the influence of supply and demand factors on the contract behavior of occupational populations with general practitioner (GP) teams. We employed a system dynamics approach to assess and predict the effect of the general practitioner service package (GPSP) and complementary incentive policies on the contract rate for 2015-2030. First, the GPSP is designed to address the unique needs of occupational populations, enhancing the attractiveness of GP contracting services, including three personalized service contents tailored to demand-side considerations: work-related disease prevention (WDP), health education & counseling (HEC), and health-care service (HCS). Second, the complementary incentive policies on the supply-side included income incentives (II), job title promotion (JTP), and education & training (ET). Considering the team collaboration, the income distribution ratio (IDR) was also incorporated into supply-side factors. The contract rate is predicted to increase to 57.8% by 2030 after the GPSP intervention, representing a 15.4% increase on the non-intervention scenario. WDP and HEC have a slightly higher (by 2%) impact on the contract rate than that from HCS. Regarding the supply-side policies, II have a more significant impact on the contract rate than JTP and ET by 3-5%. The maximum predicted contract rate of 75.2% is expected by 2030 when the IDR is 0.5, i.e., the GP receives 50% of the contract income and other members share 50%. The GP service package favorably increased the contract rate among occupational population, particularly after integrating the incentive policies. Specifically, for a given demand level, the targeted content of the package enhanced the attractiveness of contract services. On the supply side, the incentive policies boost GPs' motivation, and the income distribution motivated other team members.

Health and social care managers' self-assessed competence in knowledge management: A descriptive cross-sectional study.

To describe health and social care managers' self-assessed competence in knowledge management and the factors associated with management competence. It has been shown that the performance of an organization is as good as the competence of its managers, so health and social care managers' competence in knowledge management should be assessed to improve organizational performance. A descriptive cross-sectional design. A total of 116 managers participated from six Finnish public health and social care organizations. The data were collected in February and August 2022 using the managers' competence in knowledge management (MCKM) instrument and analysed using descriptive statistical methods. Health and social care managers rated their self-reported total competence in knowledge management as good. Among the dimensions of knowledge management competence, managing a culture of competence received the highest rating, while planning competence development and cooperation was perceived as the weakest dimension. The results indicate that background factors such as the healthcare setting, the number of units managed and the number of direct staff had a statistically significant association with the health and social care managers' self-assessed competence in planning competence development and cooperation. Even though the health and social care managers' total self-assessed competence level in knowledge management was rated as good, the results underscore the significance of continuous competence development among these managers in all dimensions of knowledge management. By enhancing and clarifying managers' tasks and competence in knowledge management, managers can increase staff retention, attractiveness and work well-being. The results can be utilized to identify managers' strengths and weaknesses in knowledge management and, thus, effectively target their limited competence development resources. The STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) checklist. There is no patient or public contribution.

Strengthening district health management and planning: an evaluation of a multi-country initiative in Eastern and Southern Africa

Background District health management and leadership capacity is increasingly recognised as critical to health system performance. District health managers play a central role in effective implementation and tailoring of national health policies, and they need adequate skills and support. The District Health System Strengthening Initiative (DHSSi) was implemented over 2019-22 in Malawi, Kenya, Tanzania and Uganda to strengthen sub-national capacity for evidence-based planning and a broader set of management competencies needed to operationalize district plans. To support learning and adaptation, a three-year evaluation was conducted to assess progress against outcomes and to inform ongoing implementation and future investment. Methods The evaluation used a mixed-methods theory-based approach. Evaluation questions were structured using criteria of relevance, coherence, efficiency, effectiveness, sustainability and impact, and corresponded to outputs, outcomes and impacts in the DHSSi Theory of Change. The evaluation was conducted over three annual rounds, and combined data from document review, observation, interviews and group discussions with cross-country, national and district stakeholders, and analysis of secondary quantitative data. Results Experience of DHSSi implementation indicated the relevance of supporting district management and planning, with gaps in current capacity, government interest, and indications of the potential to improve district practice. DHSSi experience also highlighted challenges to effective achievement of stronger capacity, and to translation of skills to improved management practice and, ultimately, to improved service delivery. A range of factors beyond skills affected district capacities, motivation and opportunities for effective planning and management, including areas such as funding, planning templates, health information systems, staff turnover, partner alignment and political structures. Conclusions Strengthening sub-national health management is an important agenda in efforts to expand high-quality primary health care. Future initiatives should prioritize detailed understanding of the range of influences on district management, and work to strengthen the enabling environment for effective district practice.

Periodontal Health and Its Relationship with Psychological Stress: A Cross-Sectional Study

Background: Studies suggest that chronic psychological stress can lead to oral health deterioration, alter the immune response, and possibly contribute to increased inflammation, which can impact the physiological healing of periodontal tissues. This cross-sectional study seeks to assess and improve clinical understanding regarding the relationship between perceived stress, mindfulness, and periodontal health. Methods: A total of 203 people were analyzed from December 2022 to June 2023. The Periodontal Screening and Recording (PSR) score and Gingival Bleeding Index (GBI), and Plaque Control Record (PCR) of every patient were registered. Subsequently, participants completed the Sheldon Cohen Perceived Stress Scale (PSS) and the Mindfulness Awareness Attention Scale (MAAS) questionnaires. The collected data underwent statistical analysis, encompassing the evaluation of correlations and dependencies. Applying Welch’s t-test to assess the relationship between MAAS and the variable indicating the presence or absence of periodontitis, a noteworthy p-value of 0.004265 was obtained. Results: This underscores a significant distinction in MAAS scores between patients affected by periodontitis and those unaffected by the condition. Additionally, Pearson correlations were computed for GBI and perceived stress, PCR and perceived stress, PCR and MAAS. The resulting p-values of 2.2–16, 3.925–8, and 2.468–8, respectively, indicate a statistically significant correlation in each instance. Conclusions: These findings contribute valuable insights into the interconnectedness of these variables, emphasizing the significance of their associations in the study context. Despite the limitations, the findings of this study suggest a significant relationship between psychological stress, mindfulness, and periodontal tissue health. Clinical trials are necessary to incorporate the assessment of a patient’s psychological status as a new valuable tool in the management of periodontal health.

Effectiveness of dental floss in the management of gingival health: A 6-month follow-up of a randomized controlled clinical trial.

To evaluate, (i) if subjects submitted to a structured oral hygiene training program (OHt) maintain adopted habits over 180 days without professional guidance; and (ii) in perspective whether flossing provides additional benefits to toothbrushing on gingival health. Seventy-five adult subjects showing approximately 40% proximal gingival bleeding were randomized to receive OHt (1 session weekly over 8 weeks) using toothbrush and dental floss or toothbrush alone. The subjects were then followed over 180 days without professional guidance. Primary outcomes were mean interproximal Gingival Index (GI) and GI = 2 (gingival bleeding). Mixed linear models were used for the comparison between groups (p < 0.05). 68 subjects received OHt, 48 subjects completed the 180-day follow-up. Subjects maintained adequate oral hygiene routines. Besides a reduction in gingival inflammation, no alterations in gingival status were observed among groups, subjects additionally instructed to use dental floss showing a mean interproximal GI = 2 of 12.8 ± 2.5 compared with 19.8 ± 2.2 for subjects limited to tooth brushing alone. OHt intensive training promotes gingival health and maintenance lasting at least 6 months without professional supervision reinforcing important principles: (i) dental health professionals should dedicate time training and motivating their patients to reach adequate self-performed plaque control; and (ii) the adjunctive use of dental floss appears essential to reduce interproximal gingival inflammation in subjects with intact interdental papillae. Dentists need to invest time in training/motivating/engage their patients to achieve adequate OH; adjunct flossing in subjects with papilla filling the interdental space appears essential to reach and maintain gingival health. GOV : (53831716.5.0000.5346). The protocol registration was filed May 9, 2018 (# 538,311,716.5.0000.5346) on ClinicalTrials.gov. An NCT number (NCT04909840) was generated upon completed registration.

Exploring Health Information And Management System Trends Among Healthcare Workers At Kenyatta National Hospital

Exploring Health Information And Management System Trends Among Healthcare Workers At Kenyatta National Hospital