Community Health Problems Research Articles

Head Lice Eradication Efforts in a Group Home Environment: Yayasan Griya Asih Orphanage – A Case Study

Children living in orphanages are generally vulnerable to close-contact transmission diseases, including head lice infestation. The clinical manifestation of head lice infestation was relatively mild, such as itchy scalp, and hence it is often overlooked as a community health issue. Education plays an essential role in preventing re-infection and eradicating head lice infestation. The treatment options include chemical treatment using pediculicides and physical management by shaving the head and manually removing the parasite. This community service activity aimed to eradicate head lice from Yayasan Griya Asih Orphanage. A series of three activities were conducted at Yayasan Griya Asih Orphanage in Central Jakarta. Each activity was done around one month apart to evaluate the effectiveness of treatment. Firstyear medical students were recruited to participate in these activities to familiarize them with real-world community health problems. Student volunteers helped applied pulse doses of Permethrin 1% shampoo and provided health education activity. Fiftyfive Yayasan Griya Asih Orphanage residents joined this activity from mid-October until December 2022. Residents were instructed not to share their personal items to prevent re-infection. Health education activities were done using one-to-many followed by a one-on-one format. In conclusion, head lice infestation screening is essential in crowded environments, and permethrin 1% pulsed dose followed by personalized health education activities and pest control effectively broke the disease transmission chain and eradicated the head lice infestation.

PSYCHOSOCIAL SUPPORT CHALLENGES IN MATARAM WEST NUSA TENGGARA

This study aims to identify challenges and obstacles in implementing psychosocial support programs by stakeholders in local communities in Mataram, West Nusa Tenggara (NTB). Qualitative research and purposive sampling were employed to select ten participants from three departments in Mataram. Interviews were conducted, data was observed and analyzed using ATLAS.ti. The study provides crucial insights into Mataram's context. The results showed that stakeholders face several challenges, including limited human resources in mental health, stigma against mental health, mismatch in program implementation, and lack of family support. The implications of this study are the importance of increasing the number and quality of human resources in mental health, involving families in patient care, improving coordination between relevant departments, and building collaboration between governments, non-governmental institutions, and communities. Recommendations based on the findings of this study are to increase public awareness about mental health, reduce stigma, allocate adequate funds, and develop consistent and sustainable psychosocial support programs. This research contributes to understanding the specific context in Mataram, NTB, and guides policies and practices addressing mental health problems in local communities.

Knowledge, attitude and practice of hepatitis C virus among waste handlers in Sidama, Ethiopia

Hepatitis C virus (HCV) is a worldwide community health problem that gives rise to liver cancer. Even though the prevalence of HCV is higher and waste handlers are at high risk for HCV, there is a paucity of information on knowledge, attitude and practice (KAP) concerning HCV among waste handlers. The aim of this study was to assess knowledge, attitude and practice of waste handlers in Sidama, Ethiopia. A quantitative cross-sectional study with simple random sampling was conducted from October 2021 to 30 July 2022 in different public hospitals of Sidama region of Ethiopia. Two hundred and eighty-two waste handlers were selected for the study which was aimed to evaluate their knowledge, attitudes, and practice on hepatitis C virus using a standardized structured questionnaire. Descriptive statistics and multivariate logistic regression were conducted using SPSS version 20 set at 95% CI. Spearman's rho correlation was used to evaluate the association between KAP with p-value ≤ 0.05 considered statistically significant. Mean scores for knowledge, attitude and practice were 22.24±8.15, 46.75±10 and 4.19±1.72, respectively. Educational level (OR = 2.427; 95%CI = [1.116 –37.89], P = 0.042), monthly income(OR = 1.001; 95%CI = [1.000–10.002], P = 0.029), use of media(OR = 2.461; 95%CI = [2.688–8.799], P = 0.006), marital status(OR = 22.961; 95%CI = [1.203–38.157], P = 0.037) and residence(OR = 6.332; 95%CI = [1.703–23.544], P = 0.006) contributed significantly to the prediction of knowledge. Spearman rank correlation revealed significant positive correlations between knowledge-attitude (r = 0.57, P< 0.037), knowledge-practice (r = 0.265, P = 0.00) and attitude-practice (r = 0.72, P = 0.02). Although the study highlighted optimal KAP regarding several aspects of HCV, educational campaigns should emphasize the necessity of continued education about HCV to improve attitudes, knowledge and practices of waste handlers.

Efektivitas ekstrak kunyit (Curcuma longa) sebagai bioinsektisida alami untuk menghalau lalat rumah (Musca domestica)

Background: Fly-borne diseases are still a health problem in urban and rural communities, such as diseases related to the gastrointestinal tract, such as abdominal typhus, cholera, typhoid fever, diarrhoea, dysentery, and others. The simplest and most common mode of transmission is mechanical. In this method, the vector spreads the parasite through contact with the host without the parasite breeding on the fly.Objectives: This study aimed to determine the effectiveness of turmeric extract (Curcuma longa) as a natural bioinsecticide to repel house flies (Musca domestica).Method: Quasi-experiment with only design with control design. The samples in this study were 20 houseflies in each of the two treatments and one control with three repetitions. The research was conducted at the Aceh Polytechnic Laboratory in 2022 and analyzed by ANOVA test at 95% CI.Result: It was found that the number of houseflies that rejected the administration of turmeric extract was 28, based on concentrations of 10gram/100ml, 15gram, 100ml and control (without adding extracts).At the concentration of control - 10gram/100ml (p= 0,005), 10gram/100ml - 15gram/100ml (p= 0,000), control - 15gram/100ml. There is a significant difference in each concentration (p = 0,000).Conclusion: Turmeric extract, as a natural bioinsecticide for house fly repellent, is most effective at a concentration of 15 grams/100 ml. It is suggested that the community can utilize turmeric extract can be recommended as a bio-insecticide and a house fly repellent in the household industry process.

Physicochemical as Well Biological Parameters of Waste Water of the Last Chamber of the Septic Tank is Advocacy to the Hypothesis - ‘A New Ecosystem of Aedes SP. Mosquito’: A Survey and Observations

Aedes sp. Mosquito a global life threatening insect,“it bred and develop in the clean and clear water”, is an widely accepted theory regarding the life cycle of this vector.&#x0D; To establish the Hypothesis: of the present Study, ‘A NEW ECOSYSTEM OF Aedes sp. MOSQUITO’, analysis of Physicochemical and Biological parameters of Septik Tank water have been carried out at different laboratories.Total 5 nos of waste water samples have been collected and analyzed accordingly. Significant and interesting results have come out like,pH:8- 8.5, Nitrate: Below Detection Level, DO:0.7 - 1.0 (mg/L) etc.&#x0D; *Besides, Light intensity (LUX) of the covered tank is 00 so it is an APHOTIC ZONE. &#x0D; There is no trace of light and Nitrate in the water, so no problem of Eutrophication, no algal flora have been reported.&#x0D; *It is highly helpful for easy movement for the larva and pupa of the mosquito.&#x0D; * Bacterial Floral load is excessive high [Total Coliform -255 x 102 CFU).&#x0D; * So the water is enriched with sufficient nutrition and food materials for their development.&#x0D; Only but the important factor i.e. D.O.: - 0.85 mg/L, is in danger and toxic level for a normal aquatic creature, but this HYPOXIC CONDITION is not at all any problem for larva and pupa of Mosquito (Aedes. Sp.). Because they consume aerial Oxygen from the upper surface of the water with their SIPHON and TRUMP as an adaptive measure of their life cycle.&#x0D; From the above survey and observations an inference can be drawn that highly adaptive Aedes sp. mosquitoes are successfully growing in the so called dirty but nutrition enriched water of Septic Tank&#x0D; There is a strong interaction between Aedes sp .and Septic Tank. Aedes sp. also performing the role of entomological vector silently and creating a severe community health problem all over the world.

Comprehensive Training of Community Diagnosis and the Community-Oriented Primary Health Care Model in Nursing Education: An Evidence-Based Project.

Community-oriented primary health care is a health promotion model that includes community diagnosis of a targeted community. This educational project aimed to develop and implement an innovative approach of applying the principles of evidence-based practice in the teaching of community diagnosis, where the class of nursing students serves as an example of community. The method consisted of a lecture and an evidence-based simulation of community diagnosis based on data collection regarding the lifestyle and health behaviors of third-year nursing students from a 4-year academic nursing program (200 students; 90% response rate). The data analysis revealed insufficient consumption of fruits, vegetables, and unsweetened fluids; excessive consumption of red and processed meat; insufficient engagement in physical activity; high anxiety level; and sleep deprivation. This educational approach allowed an interactive presentation of community health diagnostic methodology as well as community health problem prioritization applying the principles of an evidence-based approach. The method also improves students' awareness of their health and makes them better ambassadors of promoting a healthy lifestyle.

Mixed-Use Building with Threshold Space Approach in Central Jakarta

This research aims to emphasize the relationship between the two functions of private and public space which can be achieved by applying the concept of a transitional space (threshold) with the integration of public open space in the middle of a mixed-use area. This phenomenon shows that overcoming mental health problems in urban communities with the integration of public open spaces with a perceptual research approach from the study of criteria and visual elements of public space. This research was conducted using quantitative methods with data revealed by explanative analysis. The research instrument used is in the form of a perceptual assessment survey regarding the transition space simulation that has been measured based on the threshold space and public space parameters. The needs for a mixed-use threshold space parameters that can become a new communal space for urban communities requires a design approach that supports the creation of sustainable architectural designs (eco-architecture planning) in terms of social aspects.

PENINGKATAN KADAR HEMOGLOBIN DENGAN EKSTRAK BIT MERAH (Beta vulgaris L) PADA TIKUS Rattus norvegicus BUNTING ANEMIA

Anemia is a major community health problem and is often found in communities and countries, especially in developing countries including Egypt and Saudi Arabia. norvegicus anemia. The study design was a pure experimental design with a pre-posttest control group design on 30 pregnant Rattus norvegicus white rats which were divided into 5 treatment groups randomly. There were 5 treatment groups, namely the negative control group, the positive control group was only induced into 5 treatment groups randomly. There were 5 treatment groups, namely the negative control group, the positive control was only induced, treatment I was induced by phenylhydrazine, treatment I was induced by phenylhydrazine with a dose of 0.04 mg/kg/BW + Red beet extract 150 mg/KgBW, treatment II was induced by phenylhydrazine. with a dose of 0.04 mg/kg/BW + red beet extract 300 mg/KgBW and treatment III was induced by phenylhydrazine at a dose of 0.04 mg/kg/BW + red beet extract was given 450 mg/KgBW. Samples were selected according to inclusion criteria, namely pregnant female white rats, female, 2-3 months old, body weight 120-200 grams, healthy and not anatomically deformed. Analysis of the data used is one-way ANOVA. there was a significant difference between data on hemoglobin levels of pregnant rats before and after treatment in the negative control group, treatment I and treatment II with p value &lt;0.05. Giving red beet extract to pregnant rats with anemia can increase hemoglobin levels.

Proyección social universitaria como eje para prevención de infestaciones parasitarias en comunidades marginales del Perú

Parasitic infestations are a public health problem in marginal communities, which can be combated with the contribution of professional knowledge that generates changes in human behavior that would help to prevent them. As an objective, it was proposed to determine the university social projection as an axis for the prevention of parasitic infestations in marginal communities of Peru. The study was descriptive-cross-sectional in the period February-August 2022, with a sample of 11 community promoters and 164 households from three communities in the Huánuco Province of Peru. As a data collection instrument, a pre-test and post-test was applied after the training on parasitic infestations. The data was stored in Microsfot Excel and processed through the statistical package to know frequencies (%) and confidence intervals. As a result, 36.36% of the promoters were 41-45 years old, 45.45% had higher education and 27.27% were housewives, 17.07% of the caregiver mothers were 31-35 years old, 75 00% were high school graduates and 32.32% were housewives, 63.64% of the promoters' capacities knew about pediculosis and 54.55% showed competence to promote deworming of animals, while the mothers who were caregivers 67, 07% in the prevention of it and 64.02% combed the girls' hair before taking them to school, in the post-test the changes were significant, raising the %. In conclusion, it is necessary to continue working on the application of health education programs, modifying human behaviors and habits to prevent parasitic infestation diseases.

A Cross-Sectional Clinical Investigation of Organisms Causing Vaginal Discharge in Patients in Rural Tamil Nadu, India.

Background and aims Abnormal vaginal discharge is a prevailing gynecological problem among women in the reproductive age group. Vaginal discharges have multiple etiologies, and the present study was conducted with the objective of determining the prevalence of common organisms causing vaginal discharge and correlating with its various types of clinical presentations in those women attending a rural health centre of a medical college in Tamil Nadu, India. Materials and methods The study was a cross-sectional descriptive study, conducted in a rural health center of a teaching hospital in Tamil Nadu, India,from February 2022 to July 2022. All the patients clinically having the symptoms of vaginitis and with a discharge were included in this study, and postmenopausal women and pregnant women were excluded. Data was collected from a total of 175 patients. Results The mean (SD) age of the study population was 34.8 (6.9) years. Almost half, 91 (52%), of the study participants were in the age group of 31-40 years. Bacterial vaginosis was found in 74 (42.3%) and was themost common cause of abnormal vaginal discharge in our study participants, followed by vulvovaginal candidiasis, 34 (19.4%). There were significant associations between high-risk sexual behavior and the presence of co-morbidities with abnormal vaginal discharge. Conclusion The most common causes of abnormal vaginal discharge were found to be bacterial vaginosis followed by vulvovaginal candidiasis. The study results help to initiate early appropriate treatment for effective management of a community health problem.

Health in All Education: A Transdisciplinary Learning Outcomes Framework

Historical and recent population health issues necessitate the goal of educating and preparing a transdisciplinary workforce with population health knowledge and competence to be able to develop, implement, and evaluate innovative and feasible solutions that not only address multifaceted community health problems downstream but also to be able to predict and prevent those factors that contribute to an inequitable health burden upstream. To identify where population health education is already shared among multiple disciplines, the Centers for Disease Control and Prevention's Academic Partnerships to Improve Health program conceptualized the Health In All Education initiative that was implemented in partnership with the Association for Prevention Teaching and Research. The purpose of the initiative was to (1) show the importance of integrating population health principles into higher-education transdisciplinary practices; (2) discuss examples of Centers for Disease Control and Prevention collaboration with disciplines related to public health (i.e., economics, environmental engineering, health informatics, health law and policy, social work, liberal education in general education); and (3) explore opportunities to promote transdisciplinary learning to prepare for collaborative, interprofessional practice in population health. This article introduces the Health in All Education Learning Outcomes Framework, a set of shared population health concepts identified on the basis of discipline-representative consensus. The following domains were identified as having transdisciplinary applicability on the basis of established public health curricula, competency, and learning outcome models: determinants of health, evidence-based approaches, population health focus, interprofessional practice, community collaboration, environmental health, occupational health, global health, diversity/cultural competence, health systems, finance and budgeting, and health law and policy.

Job Satisfaction of Nurses Versus Other Mental Health Professionals Working in Psychosocial Rehabilitation Services.

The objectives of Psychiatric Reform were, on the one hand, psychiatric hospitals' shutting down and, on the other hand, the creation of Psychosocial Rehabilitation facilities, in order to provide appropriate care to individuals suffering from mental health problems in community. Therefore, mental health professionals' job satisfaction constitutes one of the fundamental factors leading either to success or failure of each reforming effort. The aim of this study was to investigate the level of professional satisfaction of nurses working in Psychosocial Rehabilitation facilities compared to other mental health professionals. Three hundred and sixty-seven mental health professionals, working in the field of psychosocial rehabilitation completed (a) a sociodemographic questionnaire, and (b) Spectοr's Job Satisfaction Survey (JSS). Moderate levels of total professional satisfaction were observed. Low satisfaction rates were recorded in "Pay," "Promotion," and "Fringe Benefits" subscale. High satisfaction rates were recorded in "Supervision," "Cooperation between colleagues," and "Nature of work," while moderate satisfaction rates were reported in "Contingent rewards," "Operating procedures," and "Communication" within facilities. It is noteworthy that nurses were statistically significant less satisfied with the "Contingent rewards" (p=0.028), the "Nature of work" (p=0.001), and the "Communication" (p=0.019), while they were statistically significant more satisfied with "Supervision" (p=0.007) compared to the other specialties of mental health professionals. The results can be used by those with administrative and scientific responsibilities in the field of mental health in order to recognize professionals' difficulties and solve their problems in psychosocial rehabilitation facilities. These interventions could improve their levels of job satisfaction, in order to achieve optimal therapeutic results for mentally ill and improve the quality of the services provided.

Risk factors for extended-spectrum beta-lactamase- and carbapenem- resistant Enterobacteriaceae in patients with urinary tract infection from a tertiary care hospital

Background: Urinary tract infection (UTI) is a common health problem in both community and nosocomial settings. However, the predisposing factors which are responsible for production of extended spectrum beta-lactamase (ESBL) and carbapenem-resistant Enterobacteriaceae makes the treatment option narrow and cause multidrug resistance. Aim and Objectives: This study demonstrate various risk factors associated with multidrug resistance in Enterobacteriaceae from UTI at tertiary care center in Gujarat. Material and Methods: A retrospective observational study was conducted at a tertiary-care hospital. Urine samples were received from various departments and outpatient department (OPD). Organisms from Enterobacteriaceae group were isolated and identified by various biochemical methods. ESBL and Carbapenemase producing organisms were then processed for Antibiotic susceptibility test as per CLSI guideline. Results: A total of 196 Enterobacteriaceae organisms were isolated from processed urine samples of tertiary care Hospitals. The most prevalent in people aged 45–65 years (36%) followed by those aged 17–30 (22%) years. UTI due to ESBL and Carbapenemase producer are more isolated in female (28%, 11%) as compare to male (16%, 6%). Indoor patients had higher prevalence of ESBL (29%) and carbapenemases (10%) isolation compare to OPD patient (ESBL-15%, Carbapenemases-7%) and among them most common ward was medicine department. The most common predisposing factor was catheterization followed by diabetes mellitus and obstructive uropathy. Discussion: High prevalence of ESBL and Carbapenemase producing Enterobacteriaceae is found in Indoor patients than OPD patients. Most of these patients are from Medicine department. Catheterization is the most common risk factor associated with ESBL and carbapenemase producing organism.

A descriptive study to assess knowledge related to hypertension and its impact upon exercises and sleep pattern among adults from communities of Uttarakhand.

Hypertension nowadays is a major community health problem. It is high prevalence, which becomes an important area of research which is also a major possibility for circulatory diseases and other complications. It is a silent killer, which does not show any warning sign until a severe medicinal crisis occurs. The study aims to assess the knowledge regarding hypertension and its effect on the amount of exercise and sleep among adults at risk of hypertension from both rural and urban communities of Uttarakhand. A descriptive cross-sectional research design with the total sample size was calculated as 542 adults at risk of hypertension. A purposive sampling method was used for sample selection in this study. A semi-structured questionnaire regarding knowledge related to hypertension and amount of exercise and sleep patterns was administered as tools for data collection. Analysis was done by using SPSS 23.0 version software, descriptive statistics with the use of frequency %, inferential statistics with Chi-square test, and P value ≤ 0.05 considered as significant. Majority (58%) of them were male, living with a nuclear family with very poor educational status. It showed that whenever they have free time, only then they were performing simple work without having any experience with regular exercise and yoga. Less than half of them (45%) were having good knowledge about increased blood pressure is a disease, medical management, and how to prevent it. Knowledge regarding hypertension showed significant association with less amount of exercise (use of a motored vehicle to going to job/work) (p value = 0.0001*) and satisfactory pattern of sleep among adults at risk of hypertension (p value = 0.001*). In this study, a lack of education and very poor knowledge regarding the management of hypertension found to be associated with less amount of exercise but satisfactory sleep among adults at risk of hypertension.

COMMUNITY EMPOWERMENT THROUGH TRAINING AND ASSISTANCE OF LOCAL MATERIAL APPLIED TECHNOLOGY AND ENTREPRENEURSHIP

Background : The problem of poverty is a complex matter involving various aspects such as the fulfillment of food, health, education, employment and so on. Data from the Central Statistics Agency in 2014 shows that poverty rates are still high in Indonesia, which is around 13.8% in rural areas and 8.2% in urban areas. Poverty has a relationship with community welfare and health problems, including problems with the nutritional status of children under five.According to data from the Basic Health Research (Riskesdas) of the Ministry of Health of the Republic of Indonesia in 2013, 19.6% of children under five in Indonesia suffer from malnutrition and malnutrition. One of the long-term indicators for chronic malnutrition in children is childhood stunting. In 2013 in Indonesia as many as 37.3% of children under five, which is about 9 million children under five are short and very short. The efforts made according to this approach are to encourage an entrepreneurial culture, and encourage the emergence of small businesses, as well as encourage individual participation so that they can optimally utilize the entrepreneurial culture and the created business climate. One of the entrepreneurship is the production of black sticky rice tape. The biggest producer of black sticky rice tape in West Java Province is West Bandung Regency. Black sticky rice tape is a food that contains anthocyanins and has antioxidant activity and fiber.&#x0D; Methods : Community service is carried out in West Bandung Regency, Cililin sub-district, Kidan Pananjung Village because it is the location of a large black glutinous tape producer center in West Java and in this location research has been carried out related to the consumption of black sticky rice tape in the prevention of non-communicable diseases, namely metabolic syndrome and One of the recommendations of the research results is community development.Based on the above, it is necessary to do community service, namely: Community Empowerment through Training and Assistance in Applied Technology of Local Materials and Entrepreneurship to Cadres in Cililin District, West Bandung Regency.&#x0D; Results : The data from the pretest-posttest results of the effect of technology training on processed glutinous rice products in an effort to increase entrepreneurial abilities in Kidang Pananjung Village, Cililin District, West Bandung.&#x0D; Conclusion : Community Empowerment through Training and Assistance in Applied Technology of Local Materials and Entrepreneurship to Cadres in Cililin District is necessary to aplly.

Intestinal Parasitic Infection Among Rural Schoolchildren in Taiz, Yemen: School-based Assessment of The Prevalence and Associated Risk Factors.

Yemen is an underdeveloped country plagued by poverty, disease, and social conflicts. Furthermore, most of the population lives in rural areas and is vulnerable to intestinal parasite infections (IPI). School-based cross-sectional studies were conducted between 1 February and 31 March 2019 among schoolchildren in rural communities in the Sabir Almawadim and Almawasit districts of Taiz, southwest Yemen. A structured questionnaire collected information regarding sociodemographic characteristics and risk factors. Wet mount and formol-ether concentration techniques were used to detect and identify intestinal parasites in stool specimens. The stool specimens were collected from each study participant using a clean, leak-proof, and adequately labeled stool cup. Statistical analysis of the data was performed using SPSS version 20. Of the 478 students screened for intestinal parasites, 245 (51.26 %) had at least one parasite. The prevalence of protozoa was higher than helminths (30.3 % versus 20.9 %, respectively). The percentages of single, double, and triple infections were 37.4 %, 4.4 %, and 1.7 %, respectively. Giardia lamblia was the most prevalent pathogen (15.5 %), followed by E. hisrolyrica/dispar (14.9 %), Schistosoma mansoni (13.3 %), Ascaris lumbricoides (3.8 %), Trichuris trichiura (2.9 %), and Enterobius vermicularis (1.3 %). Multivariate analysis confirmed that practicing unwashed hands before eating, open field defecation, unwashed fruits and vegetables, and dirty unclipped fingernails were the most significant predictors of high risk of IPIs (p <0.05). Regarding Schistosoma mansoni, multivariate analysis identified the behaviors of practicing swimming in the river/ponds and practicing open defecation, especially near water sources, as independent risk factors for Schistosoma mansoni infection among schoolchildren. The current study showed that rural areas in Taiz were significantly infected with IPIs, showing that IPIs remains a significant public health problem in low-income communities. Consequently, prevention efforts should focus on treating and deworming schoolchildren regularly, promoting health education in rural schools, conducting personal hygiene inspections for students, and ensuring that schools have sanitary facilities.

Studying Community Health characteristics and problems of the Population at one region of Sultanate of Oman

دراسة الخصائص الصحية لمجتمع سلطنة عمان تهدف إلى التعرف على الممارسات الصحية التي يستخدمها العمانيون ، و تحديد المشاكل الصحية المبكرة بين السكان التي تساعد في العلاج ومنع مضاعفات المشاكل الصحية. تعليم السكان فيما يتعلق يمكن أن تساعد الصحة والمرض في تعزيز الصحة والحماية من الأمراض مثل وكذلك الوقاية من مضاعفات الأمراض ؛ سيتم اختبار هذه الفرضية في

Workplace-based Nutrition Intervention towards Nutrition for All

Workplace-based Nutrition Intervention towards Nutrition for All

The heterogeneity of public preferences for the first healthcare visit: A discrete choice experiment in the context of Vietnam.

Primary healthcare is critical in addressing the main health problems of communities. In Vietnam, the increasing healthcare demands cause major challenges, especially overcrowding. This study identified public preferences regarding the selection of healthcare facilities for first visit. A discrete choice online survey was generated from five attributes including visit duration, travel time, personal connection with medical staff, doctors' experience, and health insurance. A Dz -efficient design constructed 36 choice sets, divided into three blocks of 12 choice sets. Each block formed one version of the questionnaire, which was randomly distributed to the participants. Heterogeneity in participant preferences was analysed by a latent class model with socio demographic characteristics and experiences of the last visit. 822 participants valued doctors' experience for both minor and severe symptoms. Preference heterogeneity for minor symptoms was quick service provision, highly experienced doctors, and payment through health insurance for the first (44.18%), second (32.17%), and third classes (23.66%), respectively. Regarding severe symptoms, they favoured all five attributes, quick health service, and reduced travel time for the first, second, and third classes, respectively (heterogeneities of 58.16%, 27.79%, and 14.05%, respectively). Predictions of choice from the worst to optimal healthcare facility scenario were 8.91%-61.91% and 10.16%-69.83% for minor and severe symptoms, respectively. Knowledge regarding public preference heterogeneity supports policymakers increase public acceptance in choosing primary healthcare facilities. Visit duration and doctors' experience should be considered a priority in decision making.

Assessing Responsiveness of Elevated Serum Ferritin Levels for Treatment in Patients with Chronic Hepatitis C Infection

Background: The infection of HCV is recognized worldwide as an important community health problem. There is an optimistic correlation between accumulation of iron in hepatocytes and amplified serum levels of markers, counting ferritin and transferrin. Aim: The goal of this study is to determine the response of serum levels of ferritin after the patient’s treatment with HCV infection. Material and methods: The study included 140 HCV-infected patients. All subjects were evaluated for clinical topographies, including HCV viral load, status of serum iron levels and biochemical data. The obtained outcomes were calculated by means of Microsoft Excel 2013. Results: The results showed that treatment with antiviral drugs interfered significantly the iron deposition in hepatocytes and have association between iron accumulation and HCV treatment. The mean iron value was 20.02 µmol / L for the positive PCR patients; and for a negative PCR reaction, 25.11 µmol / L was the estimated value before treatment. Both values were lower the normal array of 9-31.3 µmol / L. It is estimated that the mean ferritin value for negative PCR (668.55 µmol / L) and positive PCR (913.14 µmol / L) is above normal range which is 221 to 641.35 µmol / L. Conclusions: Patients with chronic HCV are significantly related to serum iron levels. High levels of iron and ferritin were associated significantly with the disease, resulting progressive fibrosis in the liver. There is no considerable change in serum iron markers among subjects with increased or less severity of HCV infection. The severity of the disease can be evaluated easily by measuring the serum transferrin levels along with ferritin levels, which are linked with the progression of fibrosis of the liver and necro-inflammatory activity. Keywords: levels of serum ferritin; iron load; drug; liver cells and HCV infection.