Largest Age Group Research Articles

Clinical Characteristics and Outcomes of Hospitalized COVID-19 Patients with Different Variants of SARS-CoV-2 in a Tertiary Care Hospital, Thailand

The different strains of SARS-CoV-2 were detected and labeled in 2021. Each strain differs in both clinical symptoms and severity. Previous studies found different clinical symptoms and treatment outcomes between outbreak waves; however, data in Southeast Asia were limited. This study collected data of hospitalized COVID-19 patients from a Tertiary hospital in Thailand between January 2020 and December 2023 and analyzed patients’ data in each outbreak wave using Pearson’s chi-square. A total of 1084 inpatients were included for analysis. The median age was 64 (IQR, 0.4–100) years. The patients were hospitalized in predominantly Alpha (22.78%), Delta (21.68%), and Omicron (5.07%) periods of the virus outbreak. The largest age group was elderly (over 65 years old) in all three variant of concern (VOC) periods; 82.65% of the patients had comorbidities, including 58.5% hypertension, 46.5% dyslipidemia, and 42.0% diabetes mellitus (DM). The study found pneumonia at 67.53%, septic shock at 4.61%, acute respiratory distress syndrome (ARDS) at 2.86%, and congestive heart failure at 0.83% in all age groups with no significant difference between outbreak periods. The overall mortality rate was 16.14%. A total of 75% of deaths occurred in patients over 65 years old. The mortality rates in each VOC period were 20.0% Delta, 19.83% Alpha, and 13.23% Omicron. In the elderly group, the mortality rates were Delta 15.32%, Alpha 11.75%, and Omicron 10.88%. The Omicron VOC was less severe than other variants, particularly in the elderly (65 years). There were no significant differences in the younger (<65 years) age group. The elderly still had more severe symptoms and the highest mortality rates in every wave of outbreak.

Evaluating parental experiences in teaching children with learning disabilities in resource rooms of public schools in Amman

BackgroundThe education of children with learning disabilities in public schools’ resource rooms remains a vital area of concern, particularly in Amman, where diverse educational needs and varying levels of resource allocation pose significant challenges. Despite the establishment of resource rooms, there is a notable lack of comprehensive data on parental satisfaction with these services. Previous research has indicated that the effectiveness of such educational settings largely depends on the quality of instruction, the adequacy of educational resources, and the extent of parental involvement and satisfaction. However, there is a significant gap in understanding how these factors specifically impact parents’ perceptions in the context of Amman’s public schools.AimThis study aimed to address this gap by evaluating the perspectives of parents of students with learning disabilities in resource rooms within Amman’s public schools, focusing on their satisfaction with educational services, including instruction quality, resource adequacy, and facility accessibility.MethodsA cross-sectional study design was utilized, involving a structured questionnaire administered to 200 parents of children attending resource rooms in 33 public schools across Amman. The questionnaire included Likert-scale questions and demographic queries to assess parents’ perspectives on the educational services provided. Data were analyzed using SPSS version 27 to compute descriptive statistics, correlation coefficients, and hierarchical linear modeling (HLM) to account for clustering effects.ResultsThe majority of respondents were female (60%, n = 120), and the largest age group was 31–40 years (45%, n = 90). Most parents held a Bachelor’s degree (50%, n = 100) and were employed (75%, n = 150). The predominant age group of the children was 11–15 years (50%, n = 100), with dyslexia being the most common type of learning disability (40%, n = 80). Parents rated the quality of instruction at a mean of 3.5 (SD = 1.2), adequacy of educational materials at 3.3 (SD = 1.1), and overall satisfaction with the program at 3.6 (SD = 1.0). Accessibility of facilities was rated lower at 2.8 (SD = 1.3). This interpretation is based on the lower mean score, which indicates a less favorable perception of accessibility, and the relatively high standard deviation, which reflects variability in parental experiences. HLM analysis revealed significant positive relationships between quality of instruction (β = 0.75, SE = 0.05, t = 15.00, p < 0.01), adequacy of educational materials (β = 0.70, SE = 0.04, t = 17.50, p < 0.01), and accessibility of facilities (β = 0.65, SE = 0.06, t = 10.83, p < 0.01) with overall parental satisfaction.ConclusionThe study underscores the importance of high-quality instruction, sufficient educational materials, and improved facility accessibility in enhancing parental satisfaction with resource room programs in Amman. This conclusion is supported by the findings from both the hierarchical regression analysis and the descriptive statistics, demonstrating that these factors are crucial for the effective support of children with learning disabilities.

Women attending the sexual assault treatment unit services in the Republic of Ireland: A 7-year review.

Sexual assault is pervasive in today's society, with the numbers of those reporting it increasing. In Ireland, 50% of women will experience some form of sexual violence in their lifetime. We sought to describe the incident details of females presenting to the Sexual Assault Treatment Unit (SATU) network in the Republic of Ireland and to determine associations between incident characteristics and: (1) victim age, (2) presence of injury, (3) victim-perpetrator relationship, and (4) number of assailants. This was a retrospective cross-sectional study of all females who attended between 2017 and 2023. Descriptive bivariate analysis was performed. There were 5942 female attendances, with an average age of 26 years. The largest age group was women between 18 and 25 years (38.1%, n = 2263). Forensic examinations were performed in 76.6% (n = 4549). Assailants were male in 92% (n = 5469) of incidents, with multiple assailants disclosed in 7.3% (n = 435). Strangers or recent acquaintances were the assailant in 38.5% (n = 2290) of incidents, and close associates in 22.9% (n = 1359). Incidents occurred at the survivor's home in 22% (n = 1306) of incidents, and in the assailant's home in 22.6% (n = 1342). Drug use within 24 h was reported in 15.1% (n = 897) of cases, and alcohol use in 72% (n = 4276). Drug-facilitated assault was suspected by 16.1% (n = 955). Injuries (genital and extra-genital) occurred in 30.3% (n = 1800) of attendances and were more likely to be seen in those who disclosed ingesting alcohol (Relative risk [RR] 1.325, P < 0.001) or drugs (RR 1.111, P = 0.04) in the 24 h preceding the incident, in those who presented within 24 h (RR 1.646, P < 0.001), those aged 18 years or older (RR 1.07, P = 0.003), and those where the incident occurred outdoors (RR 1.24, P < 0.001). This study, one of the largest on female attendances to a national SATU network, offers detailed insights into demographics, incident details, and circumstances. Most were young women, mainly 18 years and older, many of whom were full-time students. Forensic examinations were the primary reason for attendance, underscoring the network's key role in evidence collection. The study also identified factors linked to a higher risk of injury detection, such as immediate post-incident attendance, being over 18, outdoor incidents, perpetration by a stranger, and prior alcohol or drug use.

The Role of a Biothesiometer in Early Detection and Management of Diabetic Neuropathy.

Diabetic foot ulcers (DFUs)have become a common and serious outcome of diabetes mellitus (DM). Diabetic peripheral neuropathy (DPN) is often underdiagnosed, which impairs the capacity to prevent foot ulceration. The clinical manifestations typically include sensory complaints, which leavepatients vulnerable to increased risk of injury without their awareness. The current study aims to assess the viability of VPT (vibration perception threshold) testing using a biothesiometer as an early diagnostic tool for detecting diabetic neuropathy and reducing the burden of diabetic foot disease. This prospective study was conducted in Dr. D. Y. Patil Medical College, Pimpri, Pune from August 2022 to July 2024 among 50 patients with DFUs. Ethical approval was taken from the Institutional Ethical Committee. An informed consent was obtained from all the study participants. VPT testing using a biothesiometer was done to assess the neurological status of the patient's limbs. A significant difference between the symptomatic and asymptomatic cases was also calculated to evaluate the co-relation of symptoms compared to VPT. The largest age group among those surveyed is 41-50 with a mean age of 50.72. Males form a slightly larger proportionthan females. A total of 22 (44%) ulcers are present over the plantar aspect of the foot. Out of the entire study, 37 (74%)individuals reported Grade II or III neuropathy, and 29 (58%)individuals reported no symptoms of diabetic neuropathy. The majority portion ofindividuals in the study had an HbA1c ranging from 6.5% to 8%. After an intervention, 44 (88%) patients did not experience a change in their VPT grading after six months. The chi-square test results suggest that the onset period of diabetes in years or the type of treatment history for diabetes does not significantly influence VPT grading among the surveyed individuals. However, individuals with higher HbA1c levels tend to exhibit more severe VPT impairments. Regular monitoring of VPT grading is crucial for early diagnosis of neuropathy, tracking disease progression, and assessing intervention effectiveness. Hence, we recommend all diabetic patientsregularly undergo biothesiometry as part of their routine diabetic check-ups to help prevent disease progressionand complications like amputations and improve their overall quality of life.

A Retrospective Study of the Profiles of Outpatients Attending the State Adolescent Friendly Health Resource Center, Andhra Pradesh, South India.

Adolescents compose a significantly large age group, and attention to their health needs is lacking due to insufficient data and policy implementation globally and in India. India, having 268 million adolescents, faces the world's largest adolescent population, which highlights the importance of addressing their health requirements. The aim of this study was to describe the morbidity profiles of adolescent patients attending the State Adolescent Friendly Health Resource Centre at a tertiary-level healthcare institution in South India. A retrospective secondary data analysis was conducted at the State Adolescent Friendly Health Resource Center from 2022 to 2023. Data on adolescent health were collected from this center's OPD using a structured questionnaire, which included information on demographics, immunization status, chief complaints, and dietary intake. Diagnosis coding was done using the International Classification of Diseases, Tenth Revision (ICD-10), with estimated energy and protein intake. The study analyzed 4,000 adolescent patients, with a nearly equal gender distribution across physical OPD and telemedicine services. Adolescent females between 15 and 16 years had more visits for consultation. Most patients were within the normal BMI range, and telemedicine was popular among females with normal BMI. Obesity was more common in males, while overweight was prevalent in females. Energy and protein intake varied across BMI categories, with obese individuals having the highest intake. The morbidity profiles revealed significant gender differences in healthcare utilization and disease patterns. Gender differences in adolescent morbidity and the underutilization of telemedicine highlight the need for tailored healthcare interventions and further research based on socioeconomic factors.

Evaluation of Accidental and Intentional Pediatric Poisonings: Retrospective Analysis of Emergency Medical Service Interventions in Wroclaw, Poland.

Background/Objectives: Poisonings among children are a major cause of morbidity and mortality worldwide and present a significant challenge for emergency medical services (EMS). The aim of this study was to analyze the types of substances causing poisonings and the intention of poisonings in children, providing detailed information on the most common causes of poisonings in different age groups. Methods: A retrospective study was conducted analyzing medical records of pediatric patients under the care of emergency medical services (EMS) in Wroclaw, Poland, between 2015 and 2017. The study included all patients under 18 years old diagnosed with poisoning. Data collected included age, sex, cause of poisoning, location of the incident, neurological status (GCS), and the type of healthcare facility. Results: The study included 484 patients, with a mean age of 13 years. The largest age group was 16-18 years (44%), and the majority were female (58%). The most common causes of poisonings were alcohol (29.3%), medications (26%), and intoxicants (24.8%). Over half of the incidents occurred at home (52.5%). Intentional poisonings constituted 75% of cases, particularly involving alcohol (38.6%), intoxicants (32%), and medications (26.7%). Accidental poisonings were mainly due to household chemicals (28.7%) and carbon monoxide (27%). The differences in causes and locations of poisonings were statistically significant (p < 0.001). Conclusions: Our study showed that the most common causes of poisonings among children were alcohol, medications, and intoxicants. Poisonings most frequently occurred at home, especially with medications, while outside the home, alcohol and intoxicants were predominant. This study was not registered.

Analysis of Beer's Criteria 2019 and Patient Characteristics of Potentially Inappropriate Medication in Elderly Patients with Diabetes Mellitus

Background: Elderly patients with type 2 diabetes mellitus with polypharmacy and various comorbidities often have problems with Potentially Inappropriate Medications (PIMs). One of the methods commonly used to detect this event is Beer's Criteria 2019.Objectives: This study aims to: (1) identify the characteristics of elderly hospitalized patients with type 2 DM; (2) analyze the incidence of PIM in patients; and (3) analyze the relationship between characteristics (age, gender, comorbidities, length of stay, and number of drugs given) with the incidence of PIMs.Methods: The research was conducted at two type C hospitals in the city of Bengkulu, with a total of 105 patients using the purposive sampling method. This research is a cross-sectional study with data collection techniques in the form of medical record data from patients for the period January – December 2022 who received drug therapy. Data analysis consists of comparing data with Beer'’s Criteria, quantitative descriptive and Fisher'’s test.Results: The research results showed that: (1) the largest age group in Hospitals ) had comorbidities, the highest number of drugs given was more than 10 types of drugs, and the majority of patients were hospitalized for less than five days; (2) There was an incidence of PIMs of 98.65% (73 patients) in Hospital (3) Statistical tests show that there is no relationship between age, gender, comorbidities, number of medications and length of stay with the incidence of PIMs.Conclusion: There is still inappropriate use of drugs given to elderly DM patients. It is hoped that further researchers will be able to find out the reasons for giving these drugs to elderly patients.

INFORMASI, INTERAKTIFITAS, DAN RELEVANSI INSTAGRAM REELS ADS DAN DAMPAKNYA TERHADAP ADVERTISEMENT PERFORMANCE EXPECTANCY

The primary goal of this research was to explore the impact of information, interactivity, and relevance in Instagram Reels Ads, specifically focusing on their influence on ad performance expectations within the context of FitaminCylingCulture. The study takes a quantitative approach within the positivism paradigm. The target population consists of active users of social media who are followers of the Instagram account @FitaminCylingCulture. A total of 100 respondents were selected for the study based on the Lemeshow formula with a 10% margin of error. The sampling method employed was purposive, involving the selection of active followers of FitaminCyclingCulture who are also customers. Data analysis was conducted using partial least squares (PLS), which included testing the measurement model for validity and reliability, as well as assessing the statistical significance of the hypothesized relationships through structural model testing. The majority of respondents were located in the Jabodetabek region (94.2%), with the largest age group being 20-24 years old (63.5%). It was found that these three factors had a significant positive impact on advertisement performance expectations.

Methods for Measuring Sensitivity and Prevalence of Anti Microbial Resistance in Campylobacter Spp

Objective: The aim of this study is to examine the prevalence of antimicrobial resistance in thermophilic Campylobacter. Campylobacter has become the leading cause of infectious enteric zoonoses in developed and developing countries worldwide, with the aim of identifying key predictors to improve clinical outcomes and reduce food poisoning and infections, particularly in children, in line with the Sustainable Development Goals (SDGs)( good health and well-being). Theoretical framework: This theme presents the main concepts and theories underlying the research. The framework includes understanding the data on morphology, structure and percentages of each antibiotic, as well as means of phenotypic identification based on selective media for bacteria, the prevalence of resistance on a global scale and a clear message for public health that this is part of the Sustainable Development Goals (SDGs) for reducing the rate of antimicrobial resistance. The methodology adopted: for this search consisted of a systematic review of the literature. A comprehensive search was conducted in PubMed, SpringerLink, ScienceDirect, Neliti and Research Gate using the keywords "antimicrobial resistance Campylobacter ssp". The search yielded 203 articles, which were reviewed according to the inclusion criteria: published between 1980 and 2024, original articles, accessible full text, in English or Spanish, Brazilian, Chinese and relevant to mechanisms and percentages over time. A more in-depth review based on exclusion criteria, such as discrepancies in search titles, inaccessibility of articles and duplication, resulted in the selection of nine targeted articles that dealt solely with the bacterium Campylobacter ssp. Results and discussion: Antibiotic resistance has emerged in Campylobacter, mainly due to the use of antibiotics in animals entering the food chain. Resistance to the antibiotics mainly used in the treatment of infections, macrolides and fluoroquinolones, has become a clinical problem, and interventions aimed at reducing this resistance are recommended. Resistance to fluoroquinolones and macrolides is due to chromosomal mutations. Resistance to other usable antibiotics, which is due to the acquisition of resistance genes, has not yet spread. However, the fact that resistance genes come from both Gram-positive and Gram-negative bacterial species suggests the possibility of the emergence of acquired resistance in Campylobacter. Implications of the research: The practical and theoretical implications of this research are discussed, offering insight into how the results may be applied or influence practice in the field of public health and also for clinicians. These implications could include clinical practice guidelines, developing predictive tools and developing policies to reduce gastroenteritis infections, particularly in neonates and young children. Originality/value: this study provides information on a bacterium which has alerted public health through food poisoning, which increases resistance in silent mode and which affects a large age group between 0-14 years, which is more frequent and is linked to effective identification tools. Not forgetting the prevalence of the percentages of each antibiotic.

Investigation of Electrocardiographic Changes in Individuals with Three or More Cardiovascular Risk Factors on Santiago Island-The Cross-Sectional PrevCardio.CV Study.

Cerebrocardiovascular diseases represent one of the greatest public health concerns globally. In Cabo Verde, non-communicable diseases, such as cerebrocardiovascular diseases, have become leading causes of morbidity and mortality. This study aimed to correlate risk factors with cardiac electrical changes in adult individuals residing on Santiago Island-Cabo Verde. A cross-sectional population-based study using simple random sampling was conducted in 2021 with individuals aged 18 and over, of both sexes, having authorization 35/2021 from the Cabo Verde Ethics Commission. The sample size was calculated based on Santiago Island's projected population for 2021, considering an estimated prevalence of 50%, a 95% confidence interval, and a standard error of 4%, resulting in a sample of 599 individuals. The data were collected through a questionnaire on risk factors and cerebrocardiovascular diseases, blood pressure measurement, capillary blood glucose evaluation, and a 12-lead electrocardiogram. The study sample was predominantly female (54.8%), with the largest age group being 18-27 years (21%). Among the sample, 9.3% had no risk factors, 27.5% had one risk factor, 36.2% had two risk factors, and 26.9% had three or more risk factors. Of those who underwent electrocardiography, 60.24% showed electrocardiographic changes, with the most prevalent being ventricular repolarization changes, nonspecific repolarization changes, and early repolarization. A relationship was observed between cerebrocardiovascular disease risk factors and the electrocardiographic changes found in the study participants.

Autism Spectrum Disorder and BRIEF-P: A Review and Meta-Analysis.

This research can facilitate the development of early detection tools for ASD by identifying specific patterns of deficits in executive functioning, validating the use of the BRIEF-P as a detection tool, and complementing information obtained from other evaluation instruments (Autism Diagnostic Interview-ADI-and Autism Diagnostic Observation Schedule-ADOS). To gain knowledge of the application and usefulness of the BRIEF-P in the evaluation of executive functions (EFs) in people with ASD in the early years of the life cycle. In order to systematically examine this hypothesis, a meta-analysis was conducted to identify the executive profile (strengths and weaknesses) of children with ASD. Out of a total of 161,773 potentially eligible published articles from different databases, 13 appropriate articles were revised and 4 articles were selected. Studies that were included evaluated samples involving individuals with ASD aged 2 to 8 years and were published in English or Spanish during the period of 2012-2022. The executive profile obtained from the application of the BRIEF-P in individuals with ASD was analyzed. It was identified that children with ASD, compared to typically developing children, show significantly clinical scores on the flexibility, inhibition, and global executive functioning scales. The results support the hypothesis of an executive deficit, with flexibility and inhibition being diagnostic markers for early and prompt identification of autism. The results confirm deficits in flexibility, although they are not conclusive. This may be due to aspects related to methodology, whereby the studies (i) include very large and heterogeneous age groups, (ii) do not discriminate based on the level of competence, and (iii) use instruments for evaluating executive functions that are not validated or adapted for people with ASD. Another reason is the lack of consensus in the very operational definition of the executive functions construct, with the studies focusing mainly on the cold dimension while ignoring the hot dimension. From the perspective of therapeutic and treatment implications, executive dysfunction can impact adaptive skills in daily life and consequently the person's autonomy.

Assessment of Patient Satisfaction Regarding Clinic Visits in Riyadh, Kingdom of Saudi Arabia: A Cross-Sectional Study.

Background Understanding patient experiences and opinions is crucial to improving the quality of treatment given as healthcare services in Riyadh continue to expand. This study attempts to evaluate various aspects of patient satisfaction with clinic visits. Objectives To assess and analyze patient satisfaction with clinic visits in Riyadh, Kingdom of Saudi Arabia, in order to identify areas for improvement and enhance the overall quality of healthcare services in the region. Methods This cross-sectional study collected data from 350 adults aged 18 and above in Riyadh, Kingdom of Saudi Arabia. A paper-based questionnaire was distributed using a snowball convenience sampling technique at various locations. The survey assessed different aspects of patient satisfaction, including demographics, accessibility, quality of care, and patient experience. Ethical approval was obtained, and informed consent was acquired from all participants. Results The study's demographic distribution revealed that the majority of participants were female (77.4%), with the largest age group being 24-35 years old (34.9%). Saudi nationals constituted the majority (72.6%). Regarding accessibility and convenience of healthcare services, a significant proportion of participants agreed that the distance between their residence and the health center was reasonable (73.4%). However, opinions were mixed regarding waiting times, with some considering it reasonable (47.4%) and others disagreeing (25.4%). Participants also had varying views on appointment availability, with a notable percentage finding it difficult (33.7%). In terms of continuity of care and communication, most participants agreed that the clinic proactively contacts them for appointments (67.4%), but there were mixed responses regarding the ease of transferring patients to a hospital (37.7% agreed, 13.1% disagreed). The agreement on seeing the same doctor at each visit was moderate (41.1%), and a majority agreed that doctors had easy access to medical records (74.9%). Regarding the quality of care and patient experience, most participants agreed that doctors treated them with respect (83.7%) and that nurses and staff members were respectful and cooperative (54.3%). The majority agreed that health centers provided services during emergencies (78%). In terms of evaluating the quality of medical services and facilities, most participants agreed that vital signs were checked during each visit (78.6%), while satisfaction with laboratory facilities was moderate (60.3%). When it came to doctor-patient communication and counseling, most participants agreed that doctors provided detailed information about their disease and medications (73.4%) and addressed patients' queries (74.9%). However, some participants said that doctors did not inform them well about their disease (23.4%). Most participants agreed that doctors showed empathy and friendliness (73.7%) and allocated adequate time during visits (71.7%). However, satisfaction with post-visit accessibility to the doctor was mixed (35.1% agreed it was easy). Conclusion The findings revealed that while participants expressed satisfaction with certain aspects of care, there were areas requiring improvement. These areas included reducing waiting times, enhancing appointment availability, improving transfer procedures, ensuring consistency in doctor-patient relationships, and enhancing communication and counselling.

Equity, diversity, and inclusion in oncology pharmacy practice: Everyone's business.

Equity, Diversity, and Inclusion (EDI) is gaining increased attention within all industries healthcare being no exception. The terminology Equity, Diversity, and Inclusion and its abbreviation EDI gained popularity in the early 2000's when varied socio-political factors prompted many organisations to examine EDI concepts and how to operationalise them. The growing diversity of our society requires cross-cultural inclusive approaches to increase equity and access to services. This unique research is community-led research supported by the British Oncology Pharmacy Association, in which the members of the BOPA community are equal partners to inform action on policies that address EDI. This research was a cross-sectional study involving an online survey of financial BOPA members. Demographic data was extracted, and the quotes were analysed for common themes. The majority of respondents were women, and the largest age group was between 34 and 44. The first cause of microaggressions identified by the respondents was of racial and ethnic origin, followed by marital status and religious nature. Participants described the lack of diversity in senior positions and the microaggressions experienced by those who hold leadership positions. Some participants described how some situations at work made them feel excluded or alienated. The impact of discrimination and bullying/microaggressions extended to patients was also reported. Despite strategic directions encompassing this aspect, this research underscores the pressing need for more evidence on the lack of EDI in healthcare institutions. Our findings, located in the pharmacy oncology specialty, have identified the problem and highlighted the potential benefits of addressing it. More needs to be done in training and professional development to address unconscious bias and change behaviours.

Current and future workforce of general internal medicine in Switzerland: a cross-sectional study.

General internal medicine is a crucial element in healthcare systems. Understanding how many people are and will be working in this field is important to maintain and improve quality for patients in healthcare systems. This can provide a basis for political decisions. We conducted a cross-sectional study to analyse the current and future workforce of generalists (general practitioners and internists in hospitals) in Switzerland. The Swiss Society of General Internal Medicine (SSGIM) distributed a survey to all members. Respondents were asked about their current average workload in 2023 and planned workload in 2033. The responses were used to calculate full-time equivalent (FTE) for the current and future workforce of generalists and to extrapolate FTE for all active SSGIM members. To model the demand by 2033, we derived different scenarios. Of all 6,232 active SSGIM members, 2,030 (33%) participated: 46% female, 25% (largest age group) 56-65 years old, 19% still in postgraduate training. The average workload in 2023 was 78% for female and 87% for male generalists; the FTE extrapolated to all active SSGIM members in 2023 was 5,246. By 2033, 1,935 FTEs (36%) will retire, 502 FTEs (10%) will reduce their workload, 116 FTEs (2%) will increase their workload and 2,800 FTEs (53%) will remain in the workforce with the same workload as in 2023. To maintain the same workforce as in 2023, 2,321 new FTEs (44%) will be needed by 2033. To fill this gap of 232 FTE new generalists per year, we modelled different scenarios with assumptions of interest, workload, migration and dropouts. Within only one decade, 44% of the current workforce of generalists will disappear, mainly due to retirement and decreased workload. To fill this gap, various scenarios need to be incorporated. Politicians are called upon to create the political framework to create attractive training and working conditions for generalists to address the future demand for healthcare services.

Assessing the Impact of Smartphone Use on Neck Pain and Related Symptoms Among Residents in Jeddah, Saudi Arabia: A Cross-Sectional Study.

The widespread adoption of smartphones has transformed global communication but raised health concerns like Text Neck Syndrome - a musculoskeletal condition arising from prolonged device use, causing discomfort in the cervical spine. This study investigates its prevalence and associated factors among smartphone users in Jeddah, Saudi Arabia, focusing on usage patterns, symptoms, and awareness. This cross-sectional online surveywas conducted from June 1 to June 30, 2024. Data on demographics, smartphone habits, symptoms, and Text Neck Syndrome awareness were collected using a structured questionnaire. Statistical analysis involved descriptive statistics and chi-square tests. The study included 421 participants, predominantly female (279, 66.3%) and Saudi nationals (397, 94.3%). The largest age group was 21-40 years (308, 73.2%), and most were single (251, 59.6%) with a college degree (236, 56.1%). Over 42.0% of participants used smartphones for more than five hours daily, with 39.4% adopting a 30-degree neck posture. The most prevalent symptoms reported were neck pain (272, 64.6%), headaches (203, 48.2%), and shoulder pain (178, 42.3%). Awareness of Text Neck Syndrome was reported by 197 participants (46.8%), but only 60 (14.3%) had been diagnosed. Concerns about long-term complications such as osteoporosis (105, 24.9%) and prolapsed intervertebral disc (120, 28.5%) were expressed. Despite these concerns, 97.9% of participants hesitated to reduce smartphone usage due to reported symptoms. This study highlights the significant musculoskeletal impact of smartphone use in Jeddah, underscoring the need for interventions promoting ergonomic practices and increasing awareness about associated risks. Public health strategies should focus on promoting ergonomic practices and educating users about preventive measures.

Pediatric respiratory infectious emergencies: clinical profiles and outcomes.

Infectious diseases are among the most frequent causes of hospital admission and a substantial contributor to morbidity and mortality. These diseases pose a persistent concern, particularly within the pediatric population, where delays or inappropriate management can result in serious harm. Additionally, infectious diseases contribute to overcrowding in pediatric emergency departments (EDs). This study aimed to explore the epidemiology, clinical presentation, diagnostics, outcome, and social and behavioral impacts of infectious diseases on child health. We conducted a retrospective, single-hospital study at a tertiary care center that is publicly funded and owned to serve the entire community. Pediatric patients with at least one or more chief complaints related to the respiratory system or infectious etiology were included. Data analysis was performed using SPSS to assess relationships between variables. A total of 15,106 patients were included, with a mean age of 3.80 years. The largest age group was toddlers (42.8%). Most cases (71.9%) were classified as urgent (Priority 3). Regarding patient outcomes, 76.1% were discharged after receiving appropriate treatment in the ED, and 22.9% required admission for further management. Nearly 38% of patients presented with a single complaint. Fever was the most frequent complaint across all groups. In summary, this study provides insights into the presentation of pediatric respiratory infectious diseases in the emergency room. The study revealed that toddlers were the most affected age group, with fever and cough being the common symptoms.

Hubungan Penerapan Perilaku Hidup Bersih dan Sehat (PHBS) Keluarga terhadap Kejadian Infeksi Saluran Pernapasan Akut (ISPA) pada Balita di Puskesmas Mandai Kabupaten Maros

This study aims to explore the relationship between the implementation of clean and healthy living behaviors (PHBS) in the family with the incidence of Acute Respiratory Infections (ARI) in toddlers at Puskesmas Mandai, Maros Regency. Using a quantitative approach with a correlation analytic method, this study involved 58 toddlers aged 0-5 years who were diagnosed with ARI. The results showed that 58.6% of respondents were male, with the largest age group 0-12 months (25.9%). 74.1% of the toddlers were not exclusively breastfed, and 80.9% were underweight. In addition, 75.7% of respondents did not have the habit of washing hands with soap, and 94.8% lived in an environment with active smokers. Bivariate analysis showed a significant association between the PHBS variables and the incidence of ARI, with P values less than 0.05 for all variables. These results suggest that the implementation of exclusive breastfeeding, routine weighing of toddlers, hand washing with soap, and not smoking in the house play an important role in reducing the incidence of ARI. Therefore, health centers are advised to increase the socialization of PHBS and education about the dangers of smoking, as well as encourage the community to apply clean living behavior in everyday life. This study is expected to be the basis for improving health programs at Puskesmas Mandai and increasing public awareness about the importance of PHBS in preventing ARI.

Antidepressant adherence among outpatients with major depressive disorder

Major Depressive Disorder (MDD) is a global mental health concern, with treatment often involving antidepressant (AD) medications. However, adherence to these medications remains a significant challenge. This study aims to investigate the factors influencing medication adherence among individuals with MDD in Erbil, Iraq. This study was conducted at Erbil Psychiatric Hospital, a leading mental healthcare facility in Erbil city. Participants aged 18 to 65, diagnosed with MDD as per the DSM-5 criteria, were treated with antidepressants. The recruitment of 106 participants was facilitated by their treating psychiatrists at the hospital. Data analysis was conducted using SPSS version 22, standard for social science research. Out of the 106 participants, 64.2% were females, and 35.8% were males. The largest age group was 35–45, comprising 33% of the sample. A vast majority (99.1%) were under regular follow-up, with only 0.9% experiencing relapse. The primary antidepressant used was selective serotonin reuptake inhibitors (SSRIs) (72.6%). Most participants (61.3%) reported very high medication adherence. The notable barriers included treatment duration (13.4%), forgetting to take antidepressants (11.9%), frequent medication refills (17.9%), cultural and religious beliefs (19.3%), stigma (19.3%), travelling issues (42.9%), and lack of hospitals and clinics (30.8%). Healthcare facilitators such as effectiveness of antidepressants (27.5%), patient-provider relationship such as trusting healthcare providers (50.7%), and reminders such as keeping pills in visible places (65.9%) were prominent facilitators aiding adherence. Future research should focus on culturally tailored interventions and collaborative efforts among stakeholders. By addressing socio-cultural nuances and enhancing mental health support, more effective strategies can be developed to tackle medication adherence challenges in Erbil’s unique context.

Characteristics of Corneal Ulcer Patients at Bali Mandara Eye Hospital in 2021-2022

Background: A corneal ulcer is a pathological discontinuity of corneal epithelium surface. The incidence in developing countries reached 1.5-2 million per year and one of the causes of blindness. Corneal ulcers can occur at any age and gender which is influenced by geographic conditions. The causes of corneal ulcers vary depend on the region, predisposing factors, and microorganisms in the particular community. Purpose: To know the characteristics of corneal ulcers particularly at the Bali Mandara Eye Hospital and as a basic data for further research. Methods: A total of 77 selected medical records at Bali Mandara Hospital from January 2021–May 2022 were used in this descriptive study using a retrospective method. Patient characteristics, etiology, clinical characteristics, management, and complications were identified in this study. Descriptive analysis was performed on all data and presented in frequency tabulation. Results: In this study, 52 cases (67.5%) were male and 25 cases (32.5%) were female. The largest age group was 24-64 years with 34 cases (44.2%). All cases with corneal ulcers (100%) complained of red eye symptoms. Trauma (61.0%) as the most common predisposing factors that was caused by plants (24.7%). The most common etiologies were bacteria (46.8%) followed by fungi (5.2%), and mixed (28.6%). Most of the cases were managed without treatment (66.2%) with the outcome of improvement (55.8%), without complications (53.2%), perforation (28.6%), and descemetocele (15.6%). Conclusion: Most patients with corneal ulcers at the Bali Mandara Eye Hospital are male than female with range of 24-64 years and trauma being the most common predisposing factor. This is because it is the range for productive age and the majority of the population in Indonesia, especially Bali, works as farmers. Most microorganisms that cause corneal ulcers are bacteria. Most patients receive non-surgical treatment with more than 50% of patients experiencing improvements in vision and no complications. Keywords: Corneal Ulcers, keratitis, ocular trauma, visual impairment

Analysis of Clinical Features of Pulmonary TB Patients at Dr. Hospital. P.P. Magretti Saumlaki in 2022

Background: Pulmonary Tuberculosis is the most common disease in 2022 at RSUD dr. P.P. Magretti Saumlaki Tanimbar Islands, Maluku. Purpose: This study aims to determine the clinical picture of patients according to the characteristics of person, place and time. The retrospective approach is presented in descriptive form. The sampling technique uses purposive sampling. Method: The sample was 51 pulmonary TB patients in the isolation room in 2022 with complete medical record files. Results: The research results showed that the largest age group was 19-44 years, 24 people (47.1%); the male gender was more numerous, numbering 28 people (54.9%); The most common clinical symptoms were shortness of breath, 15 people (29.4%); The highest number of supporting examinations with Ro Thorax was 36 people (70.6%); The most common diagnoses were pulmonary TB on OAT as many as 22 people (43.1%); More patients returned home and recovered, namely 17 people (33.3%); the longest length of stay was 21.6% (3 days). Conclusion: The conclusion of this study is that pulmonary TB patients in the isolation room at RSUD dr. P.P. More Magretti in 2022: male gender, age 19-44 years, clinical symptoms of shortness of breath, AP/PA Thorax X-ray examination, discharged home recovered, and 3 days of hospitalization.