Improvements In Health Indicators Research Articles

The health impact of PM2.5 and O3 in Beijing modified by infiltration factors from 2014 to 2022.

PM2.5 and O3 are significant threats to the health of residents and modern residents spend more than 80% of their time indoors, so quantifying indoor exposure of residents has a positive influence on formulating policies and improving health indicators. Analysis of monitoring data shows a consistent decrease in the annual average concentration of outdoor PM2.5 in Beijing from 90.1 to 30.4μg/m3, and the equivalent human exposure concentration also declined from 55.2 to 18.6μg/m3 modified by infiltration factors from 2014 to 2022, while during the peak season, the average value of O3-8h concentration in Beijing has consistently remained between 159.3 and 225.3μg/m3; the equivalent human exposure concentration remained between 64.7 and 92.3μg/m3 modified by infiltration factors from 2014 to 2023. The equivalent exposure concentration is calculated by weighting the concentration of indoor and outdoor pollutants, the proportion of indoor and outdoor activity time of the population, and the permeability coefficient of outdoor pollutants into the room, so as to quantify the actual concentration of pollutants exposed to the human body in a certain time. Previous studies have primarily focused on the impact of annual changes in pollutant concentrations on health estimates, often neglecting indoor concentrations and behavior patterns. This limitation should be addressed. Therefore, this study utilized equivalent human exposure concentration and AirQ + , the authoritative software released by the World Health Organization (WHO), to evaluate quantitatively the impact of PM2.5 and O3 on the health of Beijing residents by combining pollutant concentration, annual population, and mortality of various diseases and other indicators to enhance the credibility of the study. The number of deaths related to PM2.5 has decreased from 28,182 people in 2014 to 10,250 people in 2022 (age ≥ 30). The number of premature deaths in 2022 was only 36.4 percent of that in 2014 and was decreasing by 1992 per year. The number of deaths related to O3 varies between 550 and 3358 people. Lowering PM2.5 and O3 concentrations can effectively reduce natural premature death as well as cardiovascular and respiratory diseases caused by air pollution. The government should persist in enhancing the regulation of PM2.5 and accord significance to the oversight of O3. Concurrently, there is a need to reinforce the cooperative regulation addressing both PM2.5 and O3.

The Effects of Subsidies for Healthy Foods on Food Purchasing Behaviors, Consumption Patterns, and Obesity/Overweight: A Systematic Review.

Taxing unhealthy foods and drinks is an essential measure against the double burden of malnutrition that affects every nation worldwide. In turn, subsidizing the consumption of healthy foods can also be a critical measure for changing the population's behavior and improving health indicators. A systematic review was conducted of food subsidies and their potential impact on food purchases, consumption, overweight/obesity, and changes in body mass index (BMI). The PubMed, Embase, LILAC, Scientific Electronic Library Online, and Google Scholar databases were searched to identify studies investigating the effects of subsidies on the amount of food purchased, food consumption, caloric intake, nutrient intake, and their impact on overweight, obesity, and BMI changes. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Two investigators independently performed data screening, extraction, and quality assessment. Of the 6135 studies screened, 149 were read in full and 18 were included in this systematic review. Most studies investigated the effects of subsidy scenarios on food purchases and observed increases in fruit and vegetable (F&V) purchases when these were subsidized. In randomized controlled studies, subsidized healthy foods were purchased more often. However, when the subsidy was suspended, F&V consumption decreased. Although quasi-experimental studies have demonstrated increased F&V consumption due to subsidies, some studies showed increased saturated fat and sodium intake. Only 2 studies evaluated the relationship between subsidies and obesity, yielding conflicting results. Although the subsidies appear to encourage purchase and consumption of healthier foods, enhancing the quality and diversity of dietary choices, the removal of subsidies can lead to a decline in the consumption of healthier foods. Additionally, their impact on obesity and BMI remains uncertain and requires further research. PROSPERO registration by the number CRD42023442122.

Adaptive feature fusion and disturbance correction for accurate remaining useful life prediction of rolling bearings

As a key component in the transmission system of high-speed trains, bearings need to withstand certain loads while rotating at high speeds. Once a failure occurs, it can directly affect the safety of train operations. Therefore, it is of great significance to establish a reliable remaining useful life model to ensure train operation safety. Addressing the problems of redundant features in the existing multi-feature fusion process, which affects diagnostic performance, and the spurious fluctuations in the fusion features, which cause inaccurate determination of the start fault time and lead to low prediction accuracy of remaining useful life, we propose a method based on adaptive feature fusion and the autoregressive integrated moving average model for rolling bearing prediction. Firstly, features from the time domain, frequency domain, and entropy are extracted. A feature selection mechanism with minimum redundancy is constructed to screen the optimal sensitive feature set. Secondly, based on adaptive feature fusion, the optimal sensitive feature set is dynamically fused, and the spurious fluctuations of the health index are corrected using linear regression and the 3σ principle. Next, a bottom-up time series segmentation method is employed to divide the health status of the Improved Health Indicators. Finally, a remaining useful life prediction model based on the autoregressive integrated moving average model is established. This study demonstrates that the proposed method effectively identifies features that are most sensitive to degradation trends, accurately determines the initial fault moment of bearings, and achieves effective prediction of the remaining useful life of bearings.

Effect of educational intervention based on the theory of planned behavior (TPB) on amount of salt intake in pregnant women with PreHypertension

BackgroundPrehypertension is one of the common disorders during pregnancy. Reducing salt intake is among the best cost-effective interventions to reduce the risk of hypertension. The present study aimed to explore the effect of an educational intervention based on the Theory of Planned Behavior (TPB) on amount of salt consumed by prehypertensive pregnant women.MethodsThe present quasi-experimental study was conducted in 2022 on 61 prehypertensive pregnant women visiting the Comprehensive Health Services Centers in Birjand, Iran. Pregnant women were selected through a convenience sampling method and randomly assigned to intervention and control groups. A blood pressure test and a 24-hour urine test were taken in 3 stages (before, immediately after, and one month after the intervention). A reliable and valid questionnaire based on the TPB was used to measure the cognitive variables. The intervention program included three training sessions based on the TPB held on an online platform (WhatsApp social network). Data were analyzed using repeated measures ANOVA and longitudinal marginal model with the GEE approach in SPSS19. The significance level for all statistical tests was set at p < 0 0.05.ResultsAfter intervention, the mean score of perceived behavioral control (p = 0.02), intention (p = 0.004), and salt consumption behavior (p = 0.03) increased significantly in the intervention group, and the mean score of systolic blood pressure (p < 0.001) and diastolic blood pressure (P < 0.01) decreased significantly in this group. In the control group, a statistically significant difference was observed in the systolic and diastolic blood pressure of the subjects (p < 0.01). However, the score of attitude, subjective norms, perceived behavioral control, intention, salt consumption behavior and the daily salt intake did not show a statistically significant difference over time (P < 0.05).ConclusionThe present findings showed that the perceived behavioral control, intention, behavior, systolic and diastolic blood pressure can be modifiable variables to improve the amount of salt consumed by pre-hypertensive pregnant women. Therefore, we recommend that the present model be used to develop interventions to improve health indicators in pregnant women as a highly susceptible group in society.

The impact of high-intensity interval training on women's health: A bibliometric and visualization analysis.

High-intensity interval training (HIIT) can significantly improve health indicators such as cardiopulmonary function, metabolic efficiency, and muscle strength in a short period. However, due to significant physiological and metabolic differences between males and females, the effects of HIIT vary between genders. Therefore, exploring the specific impacts of HIIT on women's health is crucial. Although there is a considerable amount of individual research on the impact of HIIT on women's health, a systematic bibliometric analysis is still lacking. Publications related to HIIT in women's health were retrieved from the Web of Science Core Collection database, and tools like Microsoft Office Excel 2021, VOSviewer, and Citespace were used to create visualized tables and views. The study included 808 publications distributed across 1234 institutions in 61 countries, authored by 3789 researchers. The United States, Australia, and Canada lead in this domain. Researchers like Astorino TA and Gibala MJ are notably influential in this field. The research has been prominently published in specific academic journals and widely cited by high-impact journals. Highly cited and bursting documents primarily discuss the effects of HIIT on metabolic adaptation, muscle adaptation, cardiovascular health, insulin sensitivity, and exercise performance. Frequent keywords include "aerobic exercise," "sprint interval training," "resistance training," "obesity," "body composition," "aging," and "insulin resistance." Keyword burst analysis reveals that early studies focused primarily on basic concepts and training models, which then expanded to specific physiological responses, applications in particular populations, and impacts on specific diseases. This field has emerged as a research hotspot with international characteristics and extensive academic productivity. Journals and cited journals hold high academic influence, with highly cited and bursty references laying a solid theoretical and practical foundation for the field. In the rapid development of the past decade, research hotspots and frontier directions such as metabolic adaptation, muscle adaptation, cardiovascular health, exercise performance, and personalized training plans have been formed.

Brazil’s Unified Health System: the fight for a universal right in an unequal country

This article analyzes Brazil's Unified Health System (SUS), established by the 1988 Constitution. The article initially presents the previous trajectory of national health policy and the context of democratization in the 1980s, which favored health reform and created a public, universal, and comprehensive health system. It then explores the advances and contradictions recorded in more than three decades of implementation of the SUS. The main advances observed were the creation of institutional mechanisms compatible with the federative arrangement and social participation, political and administrative decentralization, the national expansion of access to health, changes in the health care model, including strengthening primary care, and improvements in health indicators. On the other hand, the persistence of structural problems and disputes between different health agendas, with differences between governments, led to contradictions in financing and public-private relations in health. Despite the differences between countries, the analysis of the Brazilian case provides lessons on the challenges in building universal health systems in Latin America.

Impact of Group Reality Therapy on Treatment Adherence and Health Indicators in Patients with Type 2 Diabetes Mellitus: A Randomized Controlled Trial

Background: The use of non-pharmacological therapies is important in reducing the complications and consequences of diabetes. Objectives: This study aimed to determine the effect of group reality therapy on adherence to treatment regimens and health indicators in patients with type 2 diabetes. Methods: This randomized controlled trial was performed on 60 patients with diabetes who were referred to Amir Al-Momenin Hospital in Ahvaz. Patients were randomly assigned to either the intervention group (N = 30) or the control group (N = 30). Both groups completed health indicator tests, questionnaires on demographic and clinical information, perceived adherence to the treatment regimen, and the Perceived Stress Scale. The intervention group received reality therapy training, which consisted of 10 sessions of 45 minutes each (one session per week) over 2 months, delivered through lectures and face-to-face training sessions. The control group received only routine hospital interventions. The collected data were then analyzed using a one-way t-test and one-way analysis of variance (ANOVA). Results: Twenty-seven patients in the intervention group and 27 in the control group completed the study. After analyzing the data, it was revealed that the mean age of the patients in the control group was 55.30 ± 7.95, while it was 51.96 ± 10.55 in the intervention group. Findings showed that scores for the dimensions of adherence to the treatment regimen in the intervention group significantly increased compared to the control group (P &lt; 0.001). Additionally, the mean health indicators in the intervention group showed a significant decrease compared to the control group (P &lt; 0.001). Moreover, the mean blood sugar level of patients in the intervention group decreased from 229.63 ± 98.76 to 123.59 ± 42.03. Likewise, the level of glycosylated hemoglobin and blood cholesterol significantly decreased from 8.19 ± 2.09 to 6.11 ± 1.86 and from 176.52 ± 51.53 to 146.22 ± 34.68, respectively. Conclusions: A reality therapy training program can be effectively used to increase treatment adherence and improve health indicators in patients with type 2 diabetes.

Awareness Regarding Screening Programs in General Population to Improve Health Indicators: Genetic Counselors as Facilitators

Public health screening programs are crucial for early disease detection, but limited awareness hinders their effectiveness in India, regardless of literacy. This study assessed awareness levels for key programs among 294 literate and illiterate individuals via an online survey. Results showed high awareness for antenatal care (96%). Newborn screening (NBS) and thalassemia screening awareness were higher in females, particularly regarding thalassemia's hereditary nature (73% vs 61% and 73% vs 57%). Cervical cancer awareness increased with education (83% for graduates). Interestingly, even those with no education displayed some awareness of breast cancer screening. Prostate cancer awareness was similar across genders, with limited knowledge even among highly educated individuals (66% for Ph.Ds). These findings highlight a critical gap in public health education. Genetic counselors can bridge this gap by implementing targeted campaigns, partnering with schools and communities, and collaborating with healthcare professionals. Empowering individuals with knowledge is essential for improved population health outcomes in India.

Exploring the shift in newborn care practices among mothers and grandmothers in rural Odisha, India — a qualitative study

BackgroundThis study delves into newborn care and infant-feeding practices in rural Odisha, specifically focusing on the rural KBK + region of Odisha (Kalahandi-Bolangir-Koraput region), inhabited predominantly by Schedule Tribes and Schedule Castes individuals. There has been an improvement in the health indicators in these areas in recent times. In the background of improved health indicators in these areas, this research explores the current and changing newborn care practices and attempts to gain insight into people’s perceptions of the factors that brought about the changes.MethodsThis qualitative study was conducted between February and July 2023 at Christian Hospital, Bissamcuttack in Odisha. The methodology involved focused group discussions with mothers and grandmothers.ResultsAnalysis revealed healthy practices like exclusive breastfeeding till six months of age, appropriate timing of the first bath, and prompt healthcare-seeking behavior for minor illnesses among the mothers. The use of cow ghee or breast milk in a baby’s eyes, the application of ash on the umbilical cord, and the use of herbal medicines for minor illnesses were practiced more by the grandmothers in the past and were not as popular among the mothers. It is noteworthy that the cultural practices to ward off the ‘evil eye’ were practiced by both mothers and grandmothers alike. Despite the influence of traditional cultural practices on the beliefs and norms of the community, the study identified a shift in health-seeking behavior, with increased reliance on healthcare providers and safe healthcare practices. The study identifies the pivotal role of Accredited Social Health Activists (ASHAs) as a bridge between the rural communities and the healthcare system.ConclusionsThis research provides valuable insights for healthcare providers aiming to enhance community-centric safe newborn care practices in rural settings. The emphasis is on the importance of understanding the current and changing local practices. This would help the healthcare providers to encourage healthy practices while eliminating the harmful practices related to newborn care through community workers like ASHA and Anganwadi workers.

Transparency interventions to improve health system outcomes in low and middle-income countries: a narrative systematic review

ObjectivesThis study aimed to identify the types of transparency interventions in the health systems of the low-income and middle-income countries and the outcomes of such interventions in those systems.MethodWe searched...

Engaging communities as partners in health crisis response: a realist-informed scoping review for research and policy

BackgroundHealth is increasingly affected by multiple types of crises. Community engagement is recognised as being a critical element in successful crisis response, and a number of conceptual frameworks and global guideline documents have been produced. However, little is known about the usefulness of such documents and whether they contain sufficient information to guide effective community engagement in crisis response. We undertake a scoping review to examine the usefulness of conceptual literature and official guidelines on community engagement in crisis response using a realist-informed analysis [exploring contexts, mechanisms, and outcomes(CMOs)]. Specifically, we assess the extent to which sufficient detail is provided on specific health crisis contexts, the range of mechanisms (actions) that are developed and employed to engage communities in crisis response and the outcomes achieved. We also consider the extent of analysis of interactions between the mechanisms and contexts which can explain whether successful outcomes are achieved or not.Scope and findingsWe retained 30 documents from a total of 10,780 initially identified. Our analysis found that available evidence on context, mechanism and outcomes on community engagement in crisis response, or some of their elements, was promising, but few documents provided details on all three and even fewer were able to show evidence of the interactions between these categories, thus leaving gaps in understanding how to successfully engage communities in crisis response to secure impactful outcomes. There is evidence that involving community members in all the steps of response increases community resilience and helps to build trust. Consistent communication with the communities in time of crisis is the key for effective responses and helps to improve health indicators by avoiding preventable deaths.ConclusionsOur analysis confirms the complexity of successful community engagement and the need for strategies that help to deal with this complexity to achieve good health outcomes. Further primary research is needed to answer questions of how and why specific mechanisms, in particular contexts, can lead to positive outcomes, including what works and what does not work and how to measure these processes.

A Comparative Analysis of Healthcare Facilities: With and Without 24/7 Interventions.

Background: Maternal and neonatal mortality remains disproportionately high in low and middle-income countries, particularly in remote areas with limited healthcare accessibility. The Tharparkar district of Sindh, Pakistan, exemplifies such challenges, with basic utilities and healthcare services notably lacking. Objective: This study aimed to assess the impact of 24/7 availability of Maternal, Newborn, and Child Health (MNCH) services on healthcare delivery and patient outcomes in government healthcare facilities in the Tharparkar district. Methods: This action research followed a cross-sectional study design. Data collection commenced after receiving ethical approval and written consent from the Government District Health Officer of Tharparkar. Longitudinal data were collected using District Health Information tools from six healthcare facilities, three of which operated 24/7 and the remaining three for six hours daily. Data included indicators such as general outpatient department (OPD) visits, non-vaginal deliveries (NVD), antenatal, postnatal care, family planning, immunization, neonatal deaths, stillbirths, and live births. Statistical analysis was conducted using SPSS version 25, and results were visualized using Tableau 2024. Results: Facilities operating 24/7 reported a significant increase in healthcare utilization: general OPD attendance increased by 118.5% at THQ Kheeme Jo Par, 168.2% at GD Jese Jo Par, and 150.5% at GD Mehrna Vero. There were also notable improvements in NVD, antenatal, postnatal care, and family planning services. Immunization rates improved, stillbirths decreased, and there were zero neonatal deaths reported in these facilities following the intervention. Conclusion: The implementation of 24/7 MNCH services in Tharparkar significantly enhanced healthcare service delivery and improved maternal and child health outcomes. Continuous healthcare availability is crucial for improving health indicators and achieving global health targets in underserved populations.

IJCM_249A: Assessment of availability of drugs &amp; logistics on Village Health Sanitation and Nutrition Day (VHSND) sessions of Raipur district, CG- A cross-sectional observational study

Background: Maternal and Child health remains one highly pervasive and damaging condition in low-middle-income countries. To improve the situation Govt. of India in 2007 initiated VHSND, as an effective platform for delivering healthcare services at the doorsteps of the unserved and underserved village population, improving awareness and access of the community for health services thereby leading to improvement in the health indicators.,(VHSND) are community-based health initiatives designed to bring essential healthcare services to the doorsteps of rural populations. These sessions serve as a crucial platform for promoting health, hygiene, and nutrition awareness within villages. Organized regularly, VHSNDs aim to address a spectrum of health issues, ranging from maternal and child health to sanitation and nutrition. The success of VHSNDs relies heavily on community participation. These sessions not only offer immediate health services but also empower communities by fostering a sense of ownership over their well-being. By engaging with local residents, VHSNDs contribute to the overall improvement of health indicators and the quality of life in rural areas. In summary, VHSNDs play a vital role in bridging the healthcare gap in rural communities, emphasizing preventive healthcare, and promoting a holistic approach to well-being. They embody the collaborative efforts of health professionals, community leaders, and residents to create healthier and more resilient villages. Objective: 1. To assess the status of logistic availability on VHSND sessions of Raipur District Methodology: A cross-sectional study was conducted to assess the status of logistic availability on 30 VHSND sessions of Raipur district during March- July 2023 in Chhattisgarh by observation and pre-tested pre-designed semi- structured questionnaires. Results: It was observed that out of 30 VHSND sessions site, 77 % were held as per the micro plan and from those 90% ANM, 97% ASHA, 84% Anganwadi workers, 57% Anganwadi helpers, and only 10% PRI members were present at the site of the session. Only 56% of session sites were supervised by supervisors, 28 (93.33%) session sites had drinking water facilities, 21 (70%) sites had toilet facilities, and only 25(83.33%) sites had electricity connectivity. BP Instrument, Stethoscope, Weighing scale, Hemoglobinometer, Glucometer, Disposable syringe 5ml, Disposable syringe 0.5 ml, Disposable syringe 0.1, MCP card, Examination table, were above (90%) present in most of the VHSND sessions. Out of 30 Sessions Stadiometer (19) Fetal Doppler (15), Curtains (21), Stepping stool for climbing on the examination table (17), and Referral slip (5) are present in the VHSND sessions. Nischaya kit, VDRL, HIV, and RDK for malaria kit were present in 74%,43%,97%, and 93% respectively. Iodized salt testing is not available in any sessions. All vaccines were available 100% except BCG, DPT, and Td, which were present in 87%,93%, and 90% sessions. AEFI Kit was available in 80% of sessions. Condom, OCPs, and Centchroman were present most of the site of the sessions but Inj. MPA, IUCD, and emergency contraceptive pills were available only in 14%,37%, and 14% of sessions respectively, 7.23 (77%) of the session sites have Information displayed about the day, time, and site of the VHSND session, Conclusion: Most of the session sites were held as per the micro plan, there is some lacuna in the availability of logistics although a majority of essential items were found at session sites special focus needs to be given to fetal doppler, HIV kit cold-chain maintenance, Iodized salt kit, Cotrimoxazole, Anti-malaria drugs, Td, and BCG vaccine. Satisfactory maternal and child health services were provided in many sessions.

INFLUENCE OF THE ENVIRONMENT ON HUMAN HEALTH AND QUALITY OF LIFE (ON THE EXAMPLE OF THE GREATER CAUCASUS OF THE REPUBLIC OF AZERBAIJAN)

Health occupies an important place in the system of indicators determining the quality of life. Issues of improving health indicators are especially relevant for the Greater Caucasus province, which plays an important role in the socio-economic development of the Azerbaijan Republic and has a high standard of living, demographic and labor potential. The territorial organization of health care in the Greater Caucasus province, environmental peculiarities and their impact on the quality of life have been studied. On the basis of statistical materials the indicators of disease spread among the population living in the region are studied. Atmospheric air pollution is mainly responsible for the spread of infectious diseases, so the relationship between them has been studied. The relationship between the human development index and the environment and its impact on the quality of life has been studied. It is found that the amount of waste from stationary sources in the region has decreased. Air pollution directly affects the health of the population. Thus, the low amount of waste emitted into the atmosphere corresponds to high values of the Human Development Index. More precisely, the correlation between them is negative, and the coefficient of determination is equal to 0.857, i.e. the dependence is determined at the level of 85%.

Colon and rectal cancer: An emergent public health problem.

Colorectal cancer ranks third globally, with a high mortality rate. In the United States, and different countries in Europe, organized population screenings exist and include people between 50 and 74 years of age. These screenings have allowed an early diagnosis and consequently an improvement in health indicators. Colon and rectal cancer (CRC) is a disease of particular interest due to the high global burden associated with it and the role attributed to prevention and early diagnosis in reducing morbidity and mortality. This study is a review of CRC pathology and includes the most recent scientific evidence regarding this pathology, as well as a diagnosis of the epidemiological situation of CRC. Finally, the recommendation from a public health perspective will be discussed in detail taking into account the context and the most current recommendations.

Nursing in one health, extension and research

Nursing plays a vital role in promoting One Health, integrating care for humans, animals and the environment. Here we focus on nursing's contribution to the One Health approach through outreach and research. Introduction: One Health recognizes the interconnection between human, animal and environmental health. Nursing plays a central role in this approach, as nursing professionals are positioned to understand and promote holistic well-being. Objectives: The objective of single health nursing is to improve overall health through collaborative interventions that address the needs of humans, animals, and the environment. This involves raising awareness about zoonotic diseases, the impact of environmental degradation on health, and promoting healthy practices in all areas. Methodology: Extension activity, through educational programs for communities, highlighting the importance of vaccination for both humans and animals, promoting environmental hygiene and providing information on healthy eating. In addition, blood samples were collected in the communities studied to evaluate zoonoses in order to induce treatment and prevention and for research, investigating the relationships between environmental exposure and human diseases, as well as the transmission of pathogens between humans and animals. Results: The results of the One Health Nursing approach are evident in the decreased spread of zoonotic diseases, improved health indicators in participating communities, and increased awareness of sustainable health practices. Research contributes to the knowledge base, informing public health policy and clinical practice.

Critical Success Factors for Deployment of Primary Health Care Networks and their Impact in Kenya

The Government of Kenya through the Bottom-up Economic Transformational Agenda (BETA) acknowledges Primary Health Care (PHC) as a cost-effective and efficient means to achieve Universal Health Coverage (UHC). The aim is to enhance equitable access to high-quality and affordable healthcare for all Kenyan citizens. Primary Health Care Networks (PCNs) are gaining traction as the main mode of achieving PHC in Low- and Middle-Income Countries, and Kenya is no exception. In Kenya, PCNs approach seeks to empower local communities at subcounty level through mobilizing resources and strengthening their decision-making authority to address context specific healthcare needs. The investment in PCNs is geared towards advancing equitable access to quality healthcare at the community level, mitigating fragmentation of health care services, strengthening preventive and promotive healthcare hence creating a more resilient and efficient healthcare system. The Ministry of Health in Kenya, in collaboration with County Governments and Development partners, initiated a Rapid Results Initiative (RRI) to deploy PCNs across the country in August, 2023. The goal was to establish 315 Primary Health Care Networks (PCN) across the 47 counties in Kenya. This was preceded by a Pilot phase in 3 Counties (Kisumu, Garissa, and Kwale) which was conducted in 2021. The pilot phase informed cost-effective approaches for the deployment and critical success factors for scale-up of PCNs countrywide. The nationwide deployment of PCNs followed a 10-step process of establishing PCNs as stipulated in Kenya PHC Guidelines. Data on experiences, progress in implementation and lessons learnt was abstracted from grey literature including reports from PCN establishment at County level, Stakeholder meetings through Accelerator and Sustainability taskforce and data from PCN observatory. The average time taken to establish a PCN was 3 weeks and costed approximately USD 34,000 for its full establishment. As at 20th December, 2023 (within 4 months of initiating the RRI), of the target of 315 PCNs, 93(30%) PCNs were fully established, 27(9%) PCNs were in progress and 195(62%) yet to start. Out of the 47 counties, 37(79%) counties have at least a fully established PCN, 4 Counties are in the process of establishing the first PCN and 6 are awaiting partner readiness. The eight main critical success factors for successful establishment included: County ownership and commitment, availability of Key Policy guidelines and strategies for reference, funding from development partners and donors, leveraging on existing National and County governance structures, multisectoral collaborations and partnerships, tracking of PCN establishment through National PCN observatory and Community engagement. Key process enablers to successful role out included: Meaningful engagement of development and implementing partners, Execution through County trained TOTs, Community engagement through Community Health Workforce and support from National Government. Over time, the Established PCNs in 3 pilot counties have demonstrated significant reduction in facility based maternal mortality, increased access to NCD screening services, coordinated health care workers through MDTs and improved forward and backward referrals. Additionally, incorporated innovation models within PCNs have improved access to medical supplies and specialized healthcare services at level 2 and 3 facilities. To achieve successful scale up of PCNs and sustainability for impact it is critical to contextualize PCNs to the County needs, establish sustainable primary health care financing mechanism for PCN activities, Strengthen PCN governance structures and utilise PCN observatory to continuously track PCN performance measurements and decision making. Adoption of a unified focus on PCN performance improvement including one PCN strategy, one action plan on how to optimally implement PCNs and one monitoring framework is critical. If implemented successfully, PCNs will contribute to long term social return on investments and improved health indicators for the Country

Improvement trend for individual health guidance intervention according to Japan clinical guidelines by public health nurses for type 2 diabetes mellitus who visited for medical checkups regularly: a case-control preliminary report.

We conducted a retrospective case-control study to assess the efficacy of personalized health guidance interventions on individuals with type 2 diabetes mellitus and obesity. A selection was made of individuals in regular visits to the Takagi Hospital for medical checkups between January 2017, and October 2021. Totally, 108 subjects (cases) with health guidance were divided into 2 groups: one group without pharmacotherapy for diabetes mellitus in medical institutions (n = 92) and another group with pharmacotherapy (n = 116). Cases were provided with personalized health guidance interventions by public health nurses for 30 min, in accordance with the Japanese clinical guidelines for the prevention of lifestyle-related diseases. Sex- and age-matched controls were chosen from individuals with diabetes mellitus without health guidance. The intervention without pharmacotherapy resulted in improvements in health indicators, including body weight, waist circumference, diastolic blood pressure, triglyceride levels, and γ-glutamyl trans-peptidase. These positive effects were not observed in the control group without health guidance. The therapeutic effects of health guidance were observed in cases where pharmacotherapy was administered. In conclusion, the implementation of individual health guidance interventions may prove to be effective for individuals with type 2 diabetes mellitus and obesity who regularly attend medical checkups.

Psychological and pedagogical strategies for forming a healthy lifestyle in Uzbekistan

The study analyzes the influence of climatic conditions and socio-economic factors on the health of the population of Uzbekistan with the aim of developing and justifying a model of health-improving measures adapted to local conditions. The study used quantitative and qualitative methods, including surveying and interviewing 800 respondents, statistical data analysis, and modeling the long-term effects of health-improving measures. The results showed that regions with a moderate climate have better health indicators, and the level of physical activity and body mass index (BMI) differ significantly between urban and rural areas. The effectiveness of the developed programs, including physical exercises, dietary recommendations, and psychological support, was confirmed by improved health indicators in the experimental group. The main barriers include insufficient public awareness and limited access to medical services. Modeling showed that the integration of climatic factors and modern health improvement methods significantly improves health indicators. The novelty of the study lies in a comprehensive approach that takes into account regional characteristics and modern scientific achievements to improve public health.

Mortalidade perinatal: análise de necropsias médico-legais no período de 2018 a 2022

OBJECTIVES: characterize the sociodemographic profile of the study population; analyze the cause of death described in the report; identify the events that contributed to the death; evaluate the quality of the completion of the Death Certificate (DC) and verify the prenatal follow-up of these children. METHODS: cross-sectional study, using secondary data from necropsy reports performed at the Criciúma and Tubarãos Death Verification Services. Individuals with death between 22 weeks of gestation and the sixth day of life were included, excluding those with more than 50% of the report without completion. The information present in the DC, necropsy reports and complementary tests were evaluated. RESULTS: a total of 212 necropsy reports were evaluated. Among these, 51,4% corresponded to females and 87,7% were caucasians. The majority (85.5%) of the cases analyzed were fetal deaths, with complications of the placenta, umbilical cord and membranes (ICD P02) being the main cause with 73,1% of the cases. There was a lack of completion of intermediate causes in 84,4%, and significant conditions that contributed to death in 98,5% of the reports. Regarding prenatal care, 89.6% underwent follow-up. CONCLUSION: it is emphasized that perinatal mortality is a crucial indicator for prenatal evaluation and factors related to mother and pregnancy. This is because it will be through epidemiological information related to it that public resources will be distributed, in order to reduce the diseases and improve health indicators.