Health Care Centers Research Articles

Perceptions of Nurses Working in Primary Health Centres on Factors Influencing Their Readiness to Manage Family Violence in Kaduna State, Nigeria

Background. Family violence (FV) is a serious public health issue in Nigeria and globally. Despite being a public health issue, there is no literature indicating that FV has ever been investigated in Sabon-Gari, Kaduna State, Nigeria. Aim: This study aimed to assess nurses' perceptions of factors influencing their readiness to manage family violence. Methods: A descriptive cross-sectional study design was employed to collect information from the respondents in the selected primary health care facilities of Sabon-Gari L.G.A, Kaduna state, Nigeria. The collected data were coded, entered, and analysed using SPSS software version 24. Twenty-four (24) registered nurses working in 24 different primary health care centres were purposively selected out of 31primary health care centres of Sabon-Gari local government of Kaduna State Results: The majority of the nurses have a positive perception and high knowledge level on management of family violence victims (aggregate mean=3.4). The highest perception of the nurses was that nurses should be considered as the key figure in the management of family violence patients (mean value= 3.8), and the lowest perception of nurses was “nurses status within health care hierarchy (mean value= 2.9). The study also revealed a poor level of nurses’ involvement in managing family violence victims (aggregate mean= 2.42). Conclusion: The study concluded that despite having a positive perception and high knowledge level of management of family violence victims, nurses have a poor level of involvement in managing family violence victims. Recommendations: It was recommended, among other things, that the government should empower healthcare providers to support victims of family violence beyond counselling and treatment of injuries, expand education and training opportunities about FV, and enforce mandatory reporting policies for nurses and other healthcare providers to involve law enforcement. Keywords: Knowledge, Perception, Family Violence, Nurses involvement, Primary Health Centre.

Burn pain management in a female patient with severe burn injuries in Nepal: a case study and review.

Burn injuries in low-resource settings like Nepal present significant public health challenges, leading to substantial morbidity, mortality and severe pain. This paper assesses burn pain management in Nepal, emphasizing the need for enhanced strategies. A case study of a female patient with severe burn injuries from a rural village in Western Nepal illustrates current challenges. Reviewing studies on burn pain management in Nepal shows limited access to specialized facilities, inadequate palliative care, medication shortages and insufficient healthcare professionals. Pharmacological interventions are impacted by financial constraints and a lack of protocols, while nonpharmacological approaches have not been explored and contextualized for the Nepalese context due to similar financial issues. Comprehensive burn pain management requires addressing resource constraints through collaborative health-aid partnerships.

Preservation and Security of Information Resources at the Federal University Otuoke Health Care Centre, Bayelsa State

Considering the importance and need for efficient preservation and security of medical records in the federal university Otuoke, it is imperative to employ the use of technology to achieve this purpose. The use of technology will save funds, time, and space and prevent health hazards. The lack of technology in this digital age will lead to poor management of health records, which will invariably lead to health hazards. It is on this premise that this study seeks to investigate the preservation and security of information in the digital age at the Federal University Otuoke Healthcare Centre. The study identifies the records generated and kept, examines the factors militating against effective preservation, and determines the strategies that could be employed in preserving medical records. A descriptive research method was adopted; total enumeration sampling techniques were used as the study population of 70 was not large. A questionnaire was used for data collection, and the data was analysed using frequency count and simple percentages. The study revealed that major records generated include observations and administration of drugs and therapies, test results, x-rays, and reports, among others. Factors militating against the preservation and security of medical records indicated by respondents include lack of ICT, poor power supply, and lack of skilled manpower, among others; strategies employed for the preservation of medical records, as revealed by respondents, include shelving, cabinets, drawl air conditioning, etc. The study recommends employing a professional librarian to effectively manage the electronic facilities used to deploy electronic records.

Case presentation of urinary tract infection by <i>StenotrophomonaS maltophilia</i>

Stenotrophomonas maltophilia is an emerging aerobic, non-fermentative, gram-negative multidrug-resistant global opportunistic bacillus. S. maltophilia causes a wide range of infections including respiratory tract infections, blood stream infections and, less commonly, biliary tract infections, skin and soft tissue infections, as well as bone and joint infections. It is increasingly being reported to cause urinary tract infections (UTIs). As for the case report, a 87-year-old male patient visited the Biopathology Laboratory of Nikea Primary Healthcare Center, Piraeus, Greece, for routine examination, being referred by the family doctor (GP). Patient history revealed diabetes mellitus type 2, arterial hypertension, hypercholesterolemia, hypertriglyceridemia, hyperuricemia, chronic obstructive pulmonary disease, diagnosed before 30 years prostate cancer Gleasongrade 6, operated before 15 years, followed by hormone therapy and radiation therapy. Patient history also revealed urinary tract stones with 3 episodes of obstructive pyelonephritis during the last 5 years, followed by hospital admissions and administration of intravenous antibiotic treatment. During the hospital admissions, he had a permanent bladder catheter and received special antimicrobial treatment, for various microorganisms detected in his urine samples, such as Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis and Enterococcus faecalis. Urinary incontinence has been a symptom for 15 years, after the prostate cancer surgery. Moreover, during the last 5 years, the patient faced many difficulties in his daily life because of the urinary incontinence. The situation was managed by bladder catheterisation, which further worsened his condition with recurrent UTIs and new episodes of pyelonephritis with subsequent hospitalization. Urinalysis showed proteinuria, intense pyuria, abundance of micro-organisms and abundance of red blood cells. The urine culture grew monomicrobial Stenotrophomonas maltophilia 105 CFU/ml. The bacterium was identified by the RapID™ REMEL ONE identification system (Thermo Fisher Scientific). Antimicrobial susceptibility testing revealed susceptibility to Trimethoprime/Sulfamethoxazole, Levofloxacin, Ceftriaxone and moderate susceptibility to Ciprofloxacin and Norfloxacin.The patient received treatment with Trimethoprime/Sulfamethoxazole.

Effectiveness of a novel artificial intelligence-assisted colonoscopy system for adenoma detection: a prospective, propensity score-matched, non-randomized controlled study in Korea.

The real-world effectiveness of computer-aided detection (CADe) systems during colonoscopies remains uncertain. We assessed the effectiveness of the novel CADe system, ENdoscopy as AI-powered Device (ENAD), in enhancing the adenoma detection rate (ADR) and other quality indicators in real-world clinical practice. We enrolled patients who underwent elective colonoscopies between May 2022 and October 2022 at a tertiary healthcare center. Standard colonoscopy (SC) was compared to ENAD-assisted colonoscopy. Eight experienced endoscopists performed the procedures in randomly assigned CADe- and non-CADe-assisted rooms. The primary outcome was a comparison of ADR between the ENAD and SC groups. A total of 1,758 sex- and age-matched patients were included and evenly distributed into two groups. The ENAD group had a significantly higher ADR (45.1% vs. 38.8%, p=0.010), higher sessile serrated lesion detection rate (SSLDR) (5.7% vs. 2.5%, p=0.001), higher mean number of adenomas per colonoscopy (APC) (0.78±1.17 vs. 0.61±0.99; incidence risk ratio, 1.27; 95% confidence interval, 1.13-1.42), and longer withdrawal time (9.0±3.4 vs. 8.3±3.1, p<0.001) than the SC group. However, the mean withdrawal times were not significantly different between the two groups in cases where no polyps were detected (6.9±1.7 vs. 6.7±1.7, p=0.058). ENAD-assisted colonoscopy significantly improved the ADR, APC, and SSLDR in real-world clinical practice, particularly for smaller and nonpolypoid adenomas.

Feasibility of an innovative medical dental integration program to provide overdue adolescent vaccinations in a federally qualified health center.

To determine the feasibility of a medical dental integration program to provide overdue vaccinations to adolescents ages 9-17 and evaluate the facilitators and barriers to the process. The program was developed and implemented at one dental clinic co-located within a medical clinic at a federally qualified healthcare center in Denver, Colorado. Utilizing a shared electronic health record, human papillomavirus, meningococcal, and/or tetanus-diphtheria-acellular pertussis vaccines were recommended by dental providers and then administered by the medical team. Plan-do-study-act cycles informed implementation. Descriptive analyses of eligible patients were performed and run charts were used track process implementation outcomes. One hundred and sixty eligible adolescents were identified during a 6-month period. Overall, 29 patients (18%) received 41 vaccines. Process facilitators included staff buy-in and individual provider feedback and barriers included staff shortages and family vaccine refusal/preference to receive vaccines in the medical home. Many adolescents see dental providers more than their primary care providers, creating an opportunity to vaccinate adolescents overdue for immunizations during dental visits. A medical dental integration program to provide adolescent vaccinations was feasible in a federally qualified health center with co-located medical and dental services. Expansion to diverse healthcare settings is necessary to further explore implementation outcomes.

Bacteriocin production facilitates nosocomial emergence of vancomycin-resistant Enterococcus faecium.

Vancomycin-resistant Enterococcus faecium (VREfm) is a prevalent healthcare-acquired pathogen. Gastrointestinal colonization can lead to difficult-to-treat bloodstream infections with high mortality rates. Prior studies have investigated VREfm population structure within healthcare centers. However, little is known about how and why hospital-adapted VREfm populations change over time. We sequenced 710 healthcare-associated VREfm clinical isolates from 2017-2022 from a large tertiary care center as part of the Enhanced Detection System for Healthcare-Associated Transmission (EDS-HAT) program. Although the VREfm population in our center was polyclonal, 46% of isolates formed genetically related clusters, suggesting a high transmission rate. We compared our collection to 15,631 publicly available VREfm genomes spanning 20 years. Our findings describe a drastic shift in lineage replacement within nosocomial VREfm populations at both the local and global level. Functional and genomic analysis revealed, antimicrobial peptide, bacteriocin T8 may be a driving feature of strain emergence and persistence in the hospital setting.

Thymus assessments at birth in echocardiography: a preliminary cohort study

BackgroundEchocardiography is a tool used in neonatal period to screen for congenital heart defects and to assess the function of the cardiovascular system. It enables obtaining a three-vessel view (3VV) to show how the superior vena cava, the aorta and the pulmonary trunk relate to each other. A 3VV also provides a view of the thymus gland.MethodsIt is a preliminary study. Using the thymus measurements obtained in echocardiography of neonates delivered in one healthcare centre, a total of 1,331 thymus records were collected and statistically analysed. The study was conducted on group of 321 preterm neonates and 1,010 full-term neonates. The superior mediastinal view (three-vessel view, 3VV) was chosen for thymus measurements, with the parallel vascular system, including the superior vena cava, the aorta and the pulmonary trunk, with visible branching to the right and left pulmonary artery. Thymus width, depth and thymic 3VV index were measured. Thymic 3VV index (TI 3VV) is defined as a product of multipling the width and the depth of the thymus in three-vessel view projection.ResultsBased on a statistical analysis, a correlation was found of 3VV thymus dimensions and thymic 3VV index with body weight, gestational age and body surface area (BSA). These measurements led to the important finding that the TI 3VV value depends on thymus width and depth, more prominently the latter. The 3VV measurement of thymus depth alone can serve as a screening tool to assess the size of the gland.ConclusionsInclusion of thymic measurements in neonatal echocardiography protocol can be used as a screening tool to assess the size of thymus gland.

Child marriage and quality of marriage among young married women in a rural district, Lorestan Province, Iran

PurposeChild marriage remains a significant socio-cultural phenomenon with profound implications for the quality of marital relationships, particularly among young women. This study investigates the association between child marriage and the quality of marriage among young married women in Iran.MethodsThis study employed a population-based cross-sectional research design. A total of 70 young women, aged 18–20 years, who had married before reaching 18 years of age, were selected from four primary health care (PHC) centers in Papi District, Lorestan Province, Iran, employing a systematic random sampling approach. Subjects were categorized into women experiencing relationship distress and those without such distress using the Quality of Marriage Index (QMI). Concurrently, their level of sexual satisfaction was assessed utilizing the Hudson’s Index of Sexual Satisfaction (ISS). Furthermore, Social Support was evaluated using the Social Support Questionnaire (SSQ).ResultsThe mean age (SD) of women was 18.9 (0.7) years, and their mean age (SD) of marriage was 15.2 (2.1) years. Women experiencing distress showed significant differences in age of menarche (P = 0.006), education levels (P = 0.039), spouses’ education (P = 0.025), spouses’ occupations (P = 0.004), household income satisfaction (P = 0.041), and household structure (P = 0.045). Pearson’s correlation coefficient analysis revealed significant and positive correlations between sexual self-efficacy and social support with marital quality (r = 0.73, p < 0.001 and r = 0.55, p < 0.001, respectively). Conversely, there was a significant negative correlation between the score of indexes of sexual satisfaction and marital quality (r = -0.65, p < 0.001).ConclusionThese findings emphasize the complex factors affecting marital quality and underscore the urgent need for interventions to support young women in early marriages. It is essential to reinforce policies aimed at reducing child marriage to improve the quality of marriage among young married women.

Association of serum lipid profile and other systemic risk factors with retinal hard exudates in diabetic retinopathy

PurposeDiabetic macular edema is one of the leading causes of vision loss across the world. Hard exudates at the macula can lead to structural abnormalities in the retina leading to irreversible vision loss. Systemic dyslipidemia and other modifiable risk factors when identified and treated early may help prevent substantial vision loss. The purpose of this study was to study the association between serum lipid levels and other systemic risk factors like hemoglobin, HbA1c, and serum creatinine with hard exudates and macular edema in patients with diabetic retinopathy.MethodsIt is a prospective cross-sectional study conducted in a tertiary health care center in South India. 96 patients having diabetic retinopathy with hard exudates were included. Modified Airlie house classification was used to grade the hard exudates. Blood investigations including serum lipid profile, hemoglobin, HbA1c, and serum creatinine were carried out. Central subfield macular thickness was measured using optical coherence tomography.Results96 patients of type II DM with diabetic retinopathy were divided into three groups of hard exudates. A statistically significant correlation was observed between the severity of hard exudates and total cholesterol (p = 0.00), triglycerides (p = 0.00), LDL (p = 0.00), and VLDL (p = 0.00). HbA1c levels showed a statistically significant correlation with the severity of hard exudates (p = 0.09), no significant correlation was noted between hard exudates and hemoglobin levels (p = 0.27) and with serum creatinine (p = 0.612). A statistically significant association between CSMT and hard exudates (p = 0.00) was noted.ConclusionIn our study, we concluded that the severity of hard exudates is significantly associated with increasing levels of serum total cholesterol, triglycerides, LDL, VLDL, and HbA1c levels in type II DM patients presenting with diabetic retinopathy. The increasing duration of diabetes is significantly associated with increasing severity of hard exudates. Central subfield macular thickness increases with increasing severity of hard exudates in diabetic retinopathy.

Evaluating tuberculosis knowledge and awareness of effective control practices among health care workers in primary- and secondary-level medical institutions in Beijing, China

ObjectiveInadequate tuberculosis (TB) knowledge and awareness of proper TB control practices among health care workers (HCWs) may increase the risk of nosocomial TB transmission. This study aimed to assess HCWs’ TB-related knowledge and control practices to guide the development of more effective targeted TB health education and training programs.MethodsIn January 2023 a cross-sectional survey was administered to 323 HCWs employed by five primary health care centers and three secondary comprehensive medical institutions in Beijing, China. Survey data were collected using a standard questionnaire.ResultsAnalysis of survey responses revealed TB knowledge and practices awareness rates of 60.4% and 90.6%, respectively. The overall average awareness rate across all 19 TB knowledge- and practice-related questions was 70.0%. Intermediate- and senior-level HCW’s average TB knowledge score was respectively 2.225 and 8.175 times higher than that of primary-level HCWs, while the average TB knowledge score of HCWs in secondary comprehensive medical institutions was 3.052 times higher than that of HCWs in primary health care centers. Higher average TB knowledge score correlated with higher-level professional titles and higher level work units, but higher average TB control practices score correlated with employment at primary health care center rather than secondary comprehensive medical institution. Notably, 13.6% of HCWs had not received TB training during the past three years, while 86.1% expressed willingness to undergo online TB training.ConclusionThese findings highlight inadequate TB knowledge and awareness of proper TB control practices among HCWs in primary health care centers and secondary comprehensive medical institutions in Beijing, underscoring the urgent need for targeted educational and training initiatives to improve TB awareness and control efforts.

Source domain prior-assisted segment anything model for single domain generalization in medical image segmentation

Deep learning-based medical image segmentation models often suffer from performance degradation across domains due to domain discrepancies arising from data collected by various healthcare centers. Recent advancements, particularly the Segment Anything Model (SAM), have shown promising generalization abilities in this field, inspiring the development of several SAM-based approaches to address domain discrepancy issue. Nevertheless, these methods seldom exploit the full potential of the rich source domain knowledge to improve segmentation accuracy in unseen target domains. In this paper, we propose a source domain prior-assisted module for generalizable medical image segmentation based on SAM. Specifically, we store diverse features of the source domain data in a memory bank. When applying the model to the target domain, the features of the target domain first match with the features in the memory bank to obtain invaluable prior information. This strategy enables the model to utilize the prior information from the source domain to adapt to the target domain. We validate the proposed method on two widely used medical image segmentation tasks across multiple domains and achieve state-of-the-art performance.

Inconsistent health hazard information across safety data sheets for substances in cleaning products used in healthcare centres

Safety Data Sheets (SDSs) are used to inform downstream users of any hazardous substances in chemical products and advise on how to manage the risks from using these products. It is therefore important that information on the SDS is accurate and consistent. This study investigates the accuracy and consistency of hazard information included in the SDSs of cleaning products used in the healthcare sector in England and Wales.Data on cleaning products used in the National Health Service (NHS) in England and Wales and their chemical composition and any hazard information (as H-statements) were collected from the products’ SDSs obtained from the NHS supply online catalogue. By each hazard, mainly respiratory hazards, the number of hazardous substances specified as hazardous in all SDSs was identified. Moreover, we investigated hazard characteristics of substances identified by only SDS (at least one SDS) or only through Harmonised Classifications and Labeling (CLH) or by SDS and through CLH simultaneously.In total, 229 unique chemical substances were found in 473 cleaning products’ SDSs. All 4 respiratory sensitisiers were identified in all SDSs and through CLH. However, only 14 of the 25 respiratory irritants (56.0 %) were consistently labelled across all SDSs. Although respiratory irritation characteristics of 3 substances were classified through CLH, it was not identified by any of the relevant SDSs.Substantially incorrect and inconsistent health hazard information for the same substances was identified across SDSs. Therefore, healthcare workers and their managers may not receive accurate information on the presence of and potential for exposure to hazardous substances in the cleaning products they are using.

Assessing patient satisfaction and healthcare delivery amidst the COVID-19 pandemic: insights from Jammu and Kashmir, India

IntroductionAmidst the challenges posed by Covid-19, assessing healthcare quality in India is crucial, particularly through patient satisfaction levels.MethodologyA cross-sectional survey of 277 participants in Jammu and Kashmir was conducted, utilizing a semi-structured questionnaire and PSQ-18. Data analysis was performed using SPSS (v25) including Chi-Square tests and Descriptive analysis.ResultsOut of 277 participants, 70.8% expressed high satisfaction with medical care. Majority (70%) agreed that doctors explained medical tests well. Additionally, 70% strongly agreed that their doctor’s office was well-equipped. Dissatisfaction factors were notably low. Significant associations were found between age and alcohol use (p = 0.041), gender and alcohol use (p = 0.007), gender and tobacco use (p = 0.032), and education level and vaccination (p = 0.001).ConclusionThe study highlights high patient satisfaction during the pandemic. Improving accessibility and quality of primary healthcare and community centres is essential to meet patient needs effectively.

Seasonal variations in psychiatry outpatient service utilization in a tertiary health care center in subtropical arid regions of northwestern India

Background: Research on climatic parameters contributing to psychiatric disorder seasonality is limited, particularly in subtropical, arid climates like Rajasthan, necessitating investigation into seasonal variations in psychiatric disorder incidence in the region. This study investigates seasonal variations in psychiatric disorder prevalence over 2 years at a Rajasthan tertiary healthcare center, aiming to uncover links with climatic factors. Aims: To investigate seasonal variations in the utilization of outpatient psychiatry services and elucidate potential determinants contributing to these temporal variations. Settings and Design: This is a hospital-based study. A retrospective chart review of all new patients who utilized psychiatry outpatient services from July 2021 to July 2023 was conducted. Methods and Material: Data were gathered from psychiatric outpatient records of adults (July 2021 to July 2023), diagnosed using ICD-10. Seasons were categorized: winter (November–January), spring (February–April), summer (May–July), and rainy (August–October). Meteorological data, temperature, and day length were obtained. Statistical analyses, including Pearson correlation and Chi-square fitness, assessed seasonal associations with psychiatric disorders. Results: A total of 29,164 patient records were observed. Depression correlated with temperature and photoperiod. Mania peaked in August, linked to day length. Schizophrenia showed seasonal variation without environmental correlation. Anxiety peaked in March with no statistical significance. Obsessive compulsive disorder cases spiked in June, moderately correlated with temperature and photoperiod. Alcohol-related disorders peaked in December, while opioid dependence remained steady. Cannabis-induced psychosis peaked in summer, strongly correlated with temperature and day length. Headaches surged in August, positively correlated with temperature and day length. Conclusions: This study reveals complex relationships between seasonality, environmental factors, and psychiatric disorders, emphasizing their importance in mental health research and practice.

Prevalence of and Factors Associated with Treatment Burden and Medication Adherence Among Primary Care Patients with Multimorbidity in Jeddah, Saudi Arabia: A Cross-Sectional Study.

Multimorbidity, the coexistence of multiple chronic conditions, presents significant challenges in treatment management and medication adherence. This study investigates the burden of multimorbidity and factors influencing treatment adherence among primary care patients in Jeddah, Saudi Arabia. A cross-sectional study was conducted from November to December 2023, including 422 participants selected via stratified random sampling from 12 primary healthcare centers in Jeddah. Participants were adults aged 18 years or older with two or more confirmed long-term medical conditions. The Multimorbidity Treatment Burden Questionnaire (MTBQ) and General Medication Adherence Scale (GMAS) were used to measure treatment burden and medication adherence, respectively. Demographic variables were assessed for their influence on these outcomes. High treatment burden was reported by 55% of participants, while 21% reported medium burden, 15% experienced low burden and 9% no burden. Medication adherence was partial in 69% of participants, with 13% reporting high adherence, 13% good adherence, and 5% poor adherence. Statistically significant differences in MTBQ scores were observed based on marital status, education level, residence, occupation, and income. GMAS scores varied statistically significantly with marital status, education level, residence, occupation, income, and previous self-care education session attendance and MTBQ scores, with those having high burden reporting the lowest adherence scores. Demographic factors, including marital status, education level, residence, occupation, and income, significantly influence multimorbidity treatment burden and medication adherence. A higher treatment burden was associated with lower adherence. Targeted interventions addressing these factors could improve treatment outcomes for patients with multiple chronic conditions.

Prevalence and Determinants of Exclusive Breastfeeding Among Mothers of Children Aged 6-24 Months in the Aseer Region.

Background Exclusive breastfeeding (EBF) is crucial for infant and maternal health, providing optimal nutrition and immune protection for infants while reducing maternal postpartum depression and cancer risk. However, global trends show an early cessation of breastfeeding and the introduction of other foods. This study aims to determine the prevalence and factors influencing EBF among mothers in the Aseer region of Saudi Arabia. Methodology A cross-sectional study using a multistage cluster sampling approach was conducted from January to March 2024 in primary healthcare centers across the Aseer region. Participants included mothers of children aged 6-24 months attending primary healthcare centers for immunizations or routine check-ups. A pretested structured questionnaire, developed after an extensive literature review and expert consultation, was used to interview consenting participants. The questionnaire covered sociodemographic data, obstetric and medical history, child data, EBF practices, maternal knowledge and perception of breastfeeding, counseling about breastfeeding, antenatal care, breastfeeding support, and barriers and motivators of EBF. Results A total of 1,008 eligible mothers were included. Only 131 (13%) fulfilled the World Health Organization criteria for EBF. Moreover, 257 (25.5%) mothers initiated breastfeeding within the first hour after delivery, and 387 (38.4%) exclusively breastfed for six months or more. EBF was less frequent among mothers with higher education (8%, n = 2) compared to those with lower education (23%, n = 23, p = 0.017). EBF was also less frequent among mothers who delivered via cesarean section (7.9%, n = 28) compared to those who had a vaginal delivery (15.8%, n = 103, p = 0.001). Conversely, EBF was more common among mothers with more than five pregnancies (15.8%, n = 45) compared to those with one to two pregnancies (9.4%, n = 37, p = 0.023). EBF was also more common among mothers who had breastfed more than four children (16.7%, n = 39) compared to those who had not (12.1%, n = 49, p = 0.048). Finally, EBF was more common among mothers without postpartum complications (13.4%, n = 131) or whose infants had no birth complications (13.4%, n = 128) compared to their respective counterparts (p = 0.029 and p = 0.048, respectively). Conclusions This study found a low prevalence of EBF in the Aseer region, despite high maternal knowledge and positive perceptions. Factors such as low education, medical barriers, unemployment, and high parity were associated with increased EBF rates. Interventions should focus on improving workplace support and increasing maternal awareness of EBF recommendations.

Health determinants among participants in targeted health dialogues offered to all 40-year-old individuals in a metropolitan region of 1.4 million people

Objective To examine cardiovascular risk factors in 40-year-old participants in the health screening program targeted health dialogues (THDs). Design Cross-sectional study. Setting 99 Swedish healthcare centers. Intervention Metabolic risk factors and health behaviors were assessed. THDs were provided. Subjects 1831 (62.3%) THD participants that consented to take part in the research project. Main outcome measures (1) Prevalence of metabolic risk factors (blood pressure, LDL cholesterol, fasting plasma glucose, BMI, waist-hip ratio) and unhealthy behaviors (tobacco, alcohol, diet, physical activity) by sex, education, and place of birth. (2) Associations between different health behaviors and between the number of unhealthy behaviors and prevalence of metabolic risk factors. (3) THD participation by sociodemographics compared to age-matched controls. Results Men had a higher prevalence of all metabolic risk factors, excessive alcohol use and tobacco use than women. Lower educated individuals had a higher prevalence of metabolic risk factors (except for LDL cholesterol) and tobacco use than highly educated. Participants born outside Sweden had a higher prevalence of obesity, high waist-hip ratio, and tobacco use. Participants with 3–4 unhealthy behaviors had significantly higher prevalence of each of the metabolic risk factors except BMI. Women, highly educated and Swedish-born participants were slightly over-represented in the THDs. Conclusion Considering the associations between unhealthy behaviors and metabolic risk factors, the THD method, covering lifestyle as well as objective health measures, may be an appropriate method for early identification of individuals at risk for future non-communicable diseases in the whole population with a specific focus on certain groups. ClinicalTrials.gov NCT04912739

Physical Activity Assessment of Physicians in Primary Healthcare Centers in Makkah, Saudi Arabia.

Physical inactivity is a significant global health concern and a major contributor to numerous non-communicable diseases. A focus on physical activity in healthcare services, particularly among healthcare professionals, is crucial. This study aims to explore physical activity levels and influencing factors among physicians in Primary Healthcare Centers in Makkah, Saudi Arabia. A cross-sectional study was conducted involving physicians from Primary Healthcare Centers in Makkah. An online questionnaire was used to collect data, which included demographic factors and the General Practice Physical Activity Questionnaire (GPPAQ). Data were analyzed using the SPSS, version 29.0 (IBM Corp., Armonk, NY, USA). Of the 194 physicians included in the study, 25.3% were found to be inactive, 24.1% moderately inactive, 25.3% moderately active, and 25.3% active. There was no significant association between the Physical Activity Index and age, gender, nationality, income, having children, or job classification. However, marital status, Body Mass Index (BMI), smoking status, and the presence of diabetes mellitus, hypertension, dyslipidemia, and depression were significantly associated with the Physical Activity Index (p<0.05). The study provides valuable insights into the physical activity levels among physicians in Makkah, Saudi Arabia. The findings suggest the need for strategies to increase physical activity among physicians, particularly those who are single, overweight or obese, smokers, and those with certain health conditions.

Autistic features in patients with intellectual disability attending the psychiatry outpatient department of a tertiary healthcare center

Background: Meta-syndromic groups with cognitive and relational impairment include both autism spectrum disorder (ASD) and intellectual disability (ID). When it comes to individuals with intellectual difficulties, autistic traits are often unexplored unless they reach the level of the syndrome. The presence of both autism and ID increases disability percentage. Aim: To study the presence of autistic symptoms in individuals with ID. Materials and Methods: This was a cross-sectional, observational study in which after informed consent from caretakers of patients with ID, clinical history and sociodemographic details were recorded. Further Indian Scale for Assessment of Autism (ISAA) was administered for evaluation of autistic features. Statistical analysis of the data was done using the Chi-square test and Spearman’s correlation. Results: Out of 150 subjects with ID, 18% (n = 27) were diagnosed with comorbid ASD. A statistically significant (P value = &lt;0.001) association was found between the severity of ID (intelligence quotient, [IQ]) and the severity of autism in patients. Various domains of autism like social relation and reciprocity, speech, language, communication, emotional responsiveness, etc., showed a statistically significant correlation with IQ. Conclusion: This study finding also highlights that lower IQ scores, i.e., severe ID have higher incidence and severity of autistic features. Improving assessment both clinically and on objective testing can help in planning rehabilitation for these patients.