Primary Health Services Research Articles

Measuring the healthcare spatial deprivation in multiple perspectives: a case study of Ningbo city

BackgroundEqualization of medical services is fundamental to the development of people-centered urbanization in Chinese-style modernization. In the past few decades, the achievements of the Chinese economy have remarkably increased the quantity and quality of healthcare services. Under rapid urbanization, large-scale population floating has led to a mismatch between supply and demand for healthcare services and raised the tension between spatial demographic reorganization and the relative stability of public healthcare service facilities. The current studies of healthcare spatial deprivation (HSD) mainly are focus on either supply, or demand, or accessibility based on census data. Therefore, it is necessary to build a multiple index that could give a physical result by using ordinary indices and mixing them together by relative methods to overcome this problem.MeasureWe chose Ningbo city, Zhejiang province, located in the eastern coastal region of China, as the study area. Moreover, from 2000 to 2020, the urbanization rate of Ningbo rapidly increased from 55.75 to 78.0%. In order to show the HSD in a rapidly urbanizing city, we first consider the subdistrict as the scale, innovatively absolve the medical accessibility to the IRD (Index of Relative Disadvantage), and construct the Index of Healthcare Relative Spatial Deprivation (IHRSD) framework. Based on the seventh national census data, we apply an IHRSD with Entropy Weight Method, 2SFCA (Two-step Floating Catchment Area Method) and GDM (Geographical Detector Model) to measure where and who are vulnerable to deprive in healthcare.ResultMeasured by IHRSD, (1) There is stronger healthcare spatial deprivation in peri-urban and developed-town in Ningbo; (2) Young childhood and fertile-women are vulnerable to healthcare spatial deprivation, in fact, they are spatially deprived in healthcare; (3) The socio-demographic attribute is a significant factor in healthcare spatial deprivation, especially the level of aging and population clustering; and (4) The relationship between healthcare spatial deprivation and accessibility shows an inverted U-shaped structure.ConclusionOur experiments show that the problems of HSD are mainly from the characteristics of the population, the layout of healthcare service institutions, the accessibility of the traffic system and the natural conditions. Although the constructions of equalization of primary medical and health services, hierarchical diagnosis, and treatment, and the “healthcare complex” are currently trying to reduce the phenomenon of HSD. Faced with groups and location, the acquisition of the accurately healthcare service supply is the key to realizing healthcare spatial equity.

Using simulation to enhance primary care sexual health services for breast cancer survivors: a feasibility study.

To evaluate the impact of a virtual simulation game (VSG) to improve primary care sexual health services for breast cancer survivors. We developed a VSG to help primary care providers (PCPs) address sexual health disturbances among breast cancer survivors. We used a pretest-posttest design with a series of validated tools to assess the feasibility and perceived impact of the VGS, including an open-ended question about participants' perceptions. Quantitative data was analyzed using descriptive and inferential statistics and qualitative data through an inductive content analysis approach. Of the 60 participants, the majority were nurse practitioner students (n = 26; 43.3%), female (n = 48; 80%), and worked full-time (n = 35; 58.3%). Participants perceived the VSG as feasible and potentially effective. The intervention elicited an improvement in PCPs' perception of knowledge between pretest and posttest surveys (z = - 1.998, p = 0.046). Professional background and previous exposure to sexual health training were predictors of knowledge perception. Participants described the intervention as an engaging educational strategy where they felt safe to make mistakes and learn from that. VSGs can be a potentially effective educational approach for PCPs. Our findings indicate that despite being an engaging interactive strategy, VSG interventions should be tailored for each professional group. This intervention has potential to improve the knowledge and practice of PCPs related to breast cancer follow-up care to support comprehensive care for survivors, resulting in a better quality of life and patient outcomes.

RANCANG BANGUN APLIKASI REKAM MEDIS ELEKTRONIK DI KLINIK MEDIKA LESTARI JAKARTA PUSAT

The implementation of Electronic Medical Records (RME) in all health service facilities is a digital transformation target in Indonesia. Clinics are health service facilities as the spearhead of primary level health services. However, there are still many clinics whose operations are still paper-based. The purpose of this study is to design an RME Clinical information system that produces precise and accurate data and information and uses RME variable guidelines and metadata to be ready to be integrated into the SATUSEHAT platform. The research design used in this research is qualitative. The system development method uses the System Development Life Cycle (SDLC) with the prototype method. The results of data collection found several problems in the implementation of medical records including paper-based, not standardized and structured diagnoses, medical record card storage was not efficient, report preparation was less effective. Based on this, a web-based clinical RME prototype was built. The resulting prototype makes clinical administration more efficient without a lot of paper/cards, standardized diagnostics, structured and safer data storage, and more effective report preparation because it is done through the system. Reports generated by the prototype can be used as a basis for clinical policies such as providing drug stock based on patient disease reports, as well as routine reports that are reported to the Puskesmas. This Clinical RME prototype can also be the forerunner of a clinical information system that wants to integrate RME with the SATUSEHAT platform.

Barriers Faced by Australian and New Zealand Women When Sharing Experiences of Family Violence with Primary Healthcare Providers: A Scoping Review.

Despite the Australian Government's attempts to reduce domestic violence (DV) incidences, impediments within the social and health systems and current interventions designed to identify DV victims may be contributing to female victims' reluctance to disclose DV experiences to their primary healthcare providers. This scoping review aimed to provide the state of evidence regarding reluctance to disclose DV incidents, symptoms and comorbidities that patients present to healthcare providers, current detection systems and interventions in clinical settings, and recommendations to generate more effective responses to DV. Findings revealed that female victims are reluctant to disclose DV because they do not trust or believe that general practitioners can help them to solve their issues, and they do not acknowledge that they are in an abusive relationship, and are unaware that they are in one, or have been victims of DV. The most common symptoms and comorbidities victims present with are sleep difficulties, substance use and anxiety. Not all GPs are equipped with knowledge about comorbidities signalling cases of DV. These DV screening programs are the most prominent intervention types within Australian primary health services and are currently not sufficiently nuanced nor sensitive to screen with accuracy. Finally, this scoping review provides formative evidence that in order for more accurate and reliable data regarding disclosure in healthcare settings to be collected, gender power imbalances in the health workforce should be redressed, and advocacy of gender equality and the change of social structures in both Australia and New Zealand remain the focus for reducing DV in these countries.

Analysis of Business Strategy of Clinic X in Denpasar City

Clinic X in Denpasar City, Bali Province is the first level health facility in Bali that provides primary health services and a training center for health workers, requiring effective and efficient strategic tactics for the advancement and development of clinics so they can compete in this increasingly modern era. This research was conducted with the aim of conducting an analysis of the strategic plan for Clinic X in the city of Denpasar, Bali Province in dealing with competition in health services. The research method used is descriptive qualitative on primary data and secondary data. Research results are processed by SWOT analysis. The results showed that Clinic X had greater strengths than Weaknesses when viewed from the internal side. From the external side, Clinic X has a greater threat than opportunity. After analysis, X strong clinic has the opportunity to continue to progress and develop. Therefore it can be concluded that Clinic X can focus more on expanding cooperation with BPJS by increasing promotions to compete in the BPJS market and maintaining service quality by proposing monitoring and evaluation activities to be carried out regularly in accordance with indicators determined using a market penetration strategy. This strategy is translated into a more concrete strategy to be monitored and evaluated in assessing the achievement of the strategy.

Flexible and Innovative Connectivity Solution to Support National Decentralized Infectious Diseases Point-of-Care Testing Programs in Primary Health Services: Descriptive Evaluation Study.

Molecular point-of-care (POC) testing for Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Trichomonas vaginalis (TV) has been available in regional and remote primary health services in Australia as part of a decentralized POC testing program since 2016 and for SARS-CoV-2 from 2020. As there was no suitable existing connectivity infrastructure to capture and deliver POC test results to a range of end users, a new system needed to be established. The aim of the study is to design, implement, and optimize a connectivity system to meet clinical management, analytical quality management, and public health surveillance needs. We used commercially available e-messaging technology coupled with adapted proprietary software to integrate a decentralized molecular POC testing platform (GeneXpert) in primary health services and interface with end-user databases. This connectivity infrastructure was designed to overcome key barriers to the implementation, integration, and monitoring of these large multijurisdictional infectious disease POC testing networks. Test result messages were tailored to meet end-user needs. Using centrally captured deidentified data, we evaluated the time to receipt of test results and completeness of accompanying demographic data. From January 2016 to April 2020, we operationalized the system at 31 health services across 4 jurisdictions and integrated with 5 different patient management systems to support the real-time delivery of 29,356 CT/NG and TV test results to designated recipients (patient management system and local clinical and central program databases). In 2019, 12,105 CT/NG and TV results were delivered, and the median time to receipt of results was 3.2 (IQR 2.2-4.6) hours, inclusive of test runtime. From May 2020 to August 2022, we optimized the system to support rapid scale-up of SARS-CoV-2 testing (105 services; 6 jurisdictions; 71,823 tests) and additional sexually transmissible infection testing (16,232 tests), including the electronic disease-specific notifications to jurisdictional health departments and alerts for connectivity disruption and positive results. In 2022, 19,355 results were delivered with an overall median transmission time of 2.3 (IQR 1.4-3.1) hours, 2.2 (IQR 1.2-2.3) hours for SARS-CoV-2 (n=16,066), 3.0 (IQR 2.0-4.0) hours for CT/NG (n=1843), and 2.6 (IQR 1.5-3.8) hours for TV (n=1446). Demographic data (age, sex, and ethnicity) were completed for 99.5% of test results in 2022. This innovative connectivity system designed to meet end-user needs has proven to be sustainable, flexible, and scalable. It represents the first such system in Australia established independent of traditional pathology providers to support POC testing in geographically dispersed remote primary health services. The system has been optimized to deliver real-time test results and has proven critical for clinical, public health, and quality management. The system has significantly supported equitable access to rapid diagnostics for infectious diseases across Australia, and its design is suitable for onboarding other POC tests and testing platforms in the future.

Patterns of emergency department presentations for a youth mental health cohort: data-linkage cohort study.

Primary youth mental health services in Australia have increased access to care for young people, yet the longer-term outcomes and utilisation of other health services among these populations is unclear. To describe the emergency department presentation patterns of a help-seeking youth mental health cohort. Data linkage was performed to extract Emergency Department Data Collection registry data (i.e. emergency department presentations, pattern of re-presentations) for a transdiagnostic cohort of 7024 youths (aged 12-30 years) who presented to mental health services. Outcome measures were pattern of presentations and reason for presentations (i.e. mental illness; suicidal behaviours and self-harm; alcohol and substance use; accident and injury; physical illness; and other). During the follow-up period, 5372 (76.5%) had at least one emergency department presentation. The presentation rate was lower for males (IRR = 0.87, 95% CI 0.86-0.89) and highest among those aged 18 to 24 (IRR = 1.117, 95% CI 1.086-1.148). Almost one-third (31.12%) had an emergency department presentation that was directly associated with mental illness or substance use, and the most common reasons for presentation were for physical illness and accident or injury. Index visits for mental illness or substance use were associated with a higher rate of re-presentation. Most young people presenting to primary mental health services also utilised emergency services. The preventable and repeated nature of many presentations suggests that reducing the ongoing secondary risks of mental disorders (i.e. substance misuse, suicidality, physical illness) could substantially improve the mental and physical health outcomes of young people.

Antidepressants in pregnancy: applying causal epidemiological methods to understand service-use outcomes in women and long-term neurodevelopmental outcomes in exposed children.

Antidepressants are commonly prescribed during pregnancy, despite a lack of evidence from randomised trials on the benefits or risks. Some studies have reported associations of antidepressants during pregnancy with adverse offspring neurodevelopment, but whether or not such associations are causal is unclear. To study the associations of antidepressants for depression in pregnancy with outcomes using multiple methods to strengthen causal inference. This was an observational cohort design using multiple methods to strengthen causal inference, including multivariable regression, propensity score matching, instrumental variable analysis, negative control exposures, comparison across indications and exposure discordant pregnancies analysis. This took place in UK general practice. Participants were pregnant women with depression. The interventions were initiation of antidepressants in pregnancy compared with no initiation, and continuation of antidepressants in pregnancy compared with discontinuation. The maternal outcome measures were the use of primary care and secondary mental health services during pregnancy, and during four 6-month follow-up periods up to 24 months after pregnancy, and antidepressant prescription status 24 months following pregnancy. The child outcome measures were diagnosis of autism, diagnosis of attention deficit hyperactivity disorder and intellectual disability. UK Clinical Practice Research Datalink. Data on 80,103 pregnancies were used to study maternal primary care outcomes and were linked to 34,274 children with at least 4-year follow-up for neurodevelopmental outcomes. Women who initiated or continued antidepressants during pregnancy were more likely to have contact with primary and secondary health-care services during and after pregnancy and more likely to be prescribed an antidepressant 2 years following the end of pregnancy than women who did not initiate or continue antidepressants during pregnancy (odds ratioinitiation 2.16, 95% confidence interval 1.95 to 2.39; odds ratiocontinuation 2.40, 95% confidence interval 2.27 to 2.53). There was little evidence for any substantial association with autism (odds ratiomultivariableregression 1.10, 95% confidence interval 0.90 to 1.35; odds ratiopropensityscore 1.06, 95% confidence interval 0.84 to 1.32), attention deficit hyperactivity disorder (odds ratiomultivariableregression 1.02, 95% confidence interval 0.80 to 1.29; odds ratiopropensityscore 0.97, 95% confidence interval 0.75 to 1.25) or intellectual disability (odds ratiomultivariableregression 0.81, 95% confidence interval 0.55 to 1.19; odds ratiopropensityscore 0.89, 95% confidence interval 0.61 to 1.31) in children of women who continued antidepressants compared with those who discontinued antidepressants. There was inconsistent evidence of an association between initiation of antidepressants in pregnancy and diagnosis of autism in offspring (odds ratiomultivariableregression 1.23, 95% confidence interval 0.85 to 1.78; odds ratiopropensityscore 1.64, 95% confidence interval 1.01 to 2.66) but not attention deficit hyperactivity disorder or intellectual disability; however, but results were imprecise owing to smaller numbers. Several causal-inference analyses lacked precision owing to limited numbers. In addition, adherence to the prescribed treatment was not measured. Women prescribed antidepressants during pregnancy had greater service use during and after pregnancy than those not prescribed antidepressants. The evidence against any substantial association with autism, attention deficit hyperactivity disorder or intellectual disability in the children of women who continued compared with those who discontinued antidepressants in pregnancy is reassuring. Potential association of initiation of antidepressants during pregnancy with offspring autism needs further investigation. Further research on larger samples could increase the robustness and precision of these findings. These methods applied could be a template for future pharmaco-epidemiological investigation of other pregnancy-related prescribing safety concerns. This project was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (15/80/19) and will be published in full in Health Technology Assessment; Vol. 27, No. 15. See the NIHR Journals Library website for further project information.

Relationship of Midwife's Knowledge Level about HIV/AIDS with Stigma to Pregnant Women with HIV/AIDS in Primary Health Service of Banyumas Regency

<p><strong>Background:</strong> The HIV/AIDS Situation Analysis conducted by the Banyumas Regency Health Office in September – October 2021 shows that HIV/AIDS cases are increasing rapidly. The high number of HIV/AIDS cases can lead to negative opinions or stigma attached to people living with HIV/AIDS (PLWHA). High knowledge of midwives can be a good behavior in preventing HIV transmission.. <strong>Objective</strong><a href="file:///D:/PUBLIKASI%20JURNAL/Revfix_4_2ndicmu_Wilda%20Salsabiela%20(English)%20Paper%20PLACENTUM%202022.docx#_msocom_1">[WU1]</a> <strong>:</strong> This research aims to analyze the correlation between the level of knowledge of midwives concerning HIV/AIDS and the stigma of pregnant women with HIV/AIDS in primary health care centers in Banyumas Regency. Independent variable in this study was the midwives' knowledge of HIV/AIDS and the dependent variable in this study is the stigma of midwives in pregnant women with HIV/AIDS <strong>Method</strong><a href="file:///D:/PUBLIKASI%20JURNAL/Revfix_4_2ndicmu_Wilda%20Salsabiela%20(English)%20Paper%20PLACENTUM%202022.docx#_msocom_2">[WU2]</a> <strong>:</strong> This study was descriptive analysis with cross-sectional research design. <a href="file:///D:/PUBLIKASI%20JURNAL/Revfix_4_2ndicmu_Wilda%20Salsabiela%20(English)%20Paper%20PLACENTUM%202022.docx#_msocom_3">[WU3]</a> The research subjects were midwives who had never attended HIV counselor training at the Medical Support Service Health Center in Banyumas Regency with a total of 61 respondents<a href="file:///D:/PUBLIKASI%20JURNAL/Revfix_4_2ndicmu_Wilda%20Salsabiela%20(English)%20Paper%20PLACENTUM%202022.docx#_msocom_4">[WU4]</a> which is obtained from the withdrawal sampling technique using cluster random sampling where according to Sugiyono's 2017 book that cluster random sampling is obtained by the formula for the number of respondents per cluster divided by the total number of respondents multiplied by the sample. The instrument used the HIV-KQ-18 questionnaire to measure the level of knowledge and the SHASS questionnaire to measure stigma attitudes. The analysis uses the Spearman rank correlation test. <strong>Results</strong> <strong>:</strong> A total of (14.80%) level of knowledge is sufficient and (1.60%) high stigma. There is no significant relationship between the level of knowledge of midwives and the stigma of pregnant women with HIV/AIDS in primary health services in Banyumas district. <strong>Conclusion</strong><a href="file:///D:/PUBLIKASI%20JURNAL/Revfix_4_2ndicmu_Wilda%20Salsabiela%20(English)%20Paper%20PLACENTUM%202022.docx#_msocom_6">[WU6]</a> <strong>:</strong> The knowledge of midwives about HIV/AIDS still needs to be improved. Efforts need to be made in relation to the stigma of midwives against PLWHA and educational institutions can add workshops with experts, Health Office, health services,<strong></strong></p><p><strong>Keywords:</strong>HIV, Midwife Stigma, Knowledge, Pregnant women</p><div><div><p> </p></div></div>

Headache Disorders in VHA Primary Care: Prevalence, Psychiatric Comorbidity, and Health Care Utilization

Military veterans are at increased risk for headache disorders compared to the general population, yet the prevalence and burden associated with headache disorders among veterans is not yet well understood. In this electronic medical record study, we examined the prevalence of headache disorders among veterans seen in a northeastern network of Veterans Health Administration (VHA) primary care during 2017–2018. We also examined rates of psychiatric comorbidity and health care utilization of veterans with headache disorders for the year following the date of the first headache code in the medical record. Of the total population of veterans in the network, 1.3% had a headache disorder and another 3.5% had a possible headache disorder. Migraine and chronic migraine represented the majority of cases. Posttraumatic stress disorder was the most frequent psychiatric comorbidity. Having a headache disorder was associated with higher rates of primary care, neurology, pain clinic, and mental health service use but not higher rates of emergency department or Whole Health (e.g., patient-centered, holistic health services) use. Prevalence findings are comparable to those previously found among veterans, but a substantial proportion of veterans may have been misdiagnosed. Veterans with headache disorders have high rates of psychiatric comorbidity and use several types of health services at higher rates. Findings highlight the need for interdisciplinary care and further education and support for primary care providers. Primary care settings that integrate evidence-based behavioral and Whole Health services may be an optimal way of providing more holistic care for headache disorders.

A virtuous cycle of co-production: Reflections from a community priority-setting exercise.

Co-production is gaining increasing recognition as a good way of facilitating collaboration among different stakeholders, including members of the public. However, it remains an ambiguous concept as there is no definitive or universal model of co-production or clarity on what constitutes a good co-production approach. This paper draws on the reflections of the academic researchers, practitioners and public advisors involved in co-producing a priority-setting exercise. The exercise was conducted by the Primary and Community Health Services (PCHS) Theme of the National Institute for Health and Care Research Applied Research Collaboration for Kent, Surrey and Sussex (NIHR ARC KSS). We collected data through written and verbal reflections from seven collaborators involved in the PCHS priority-setting exercise. We used Gibbs' model of reflection to guide the data collection. We then analysed the data through an inductive, reflexive thematic analysis. A common thread through our reflections was the concept of 'sharing'. Although co-production is inherently shared, we used the virtuous cycle to illustrate a sequence of sharing concepts during the research cycle, which provides the underpinnings of positive co-production outcomes. We identified six themes to denote the iterative process of a shared approach within the virtuous cycle: shared values, shared understanding, shared power, shared responsibilities, shared ownershipand positive outcomes. Our results present a virtuous cycle of co-production, which furthers the conceptual underpinnings of co-production. Through our reflections, we propose that positive co-production outcomes require foundations of shared values and a shared understanding of co-production as a concept. These foundations facilitate a process of shared power, shared responsibilitiesand shared ownership. We argue that when these elements are present in a co-production exercise, there is a greater potential for implementable outcomes in the communities in which the research serves and the empowerment of collaborators involved in the co-production process. Three members of the public who are public advisors in the NIHR ARC KSS were involved in the priority-setting exercise that informed this paper. The public advisors were involved in the design of the priority-setting exercise and supported participants' recruitment. They also co-facilitated the focus groups during data collection and were involved in the data analysis, interpretation and preparation of the priority-setting report. For this current manuscript, two of them are co-authors. They provided reflections and contributed to the writing and reviewing of this manuscript.

The status and childcare management of overweight and obesity among preschool children in Hangzhou.

This study aims to investigate the prevalence of overweight and obesity in preschool children in Hangzhou and assess the impact of childcare management. By examining the characteristics and predicting the trends of overweight and obesity, we hope to emphasize the significance of childcare management in primary community health service centers and the use of Electronic Health-care System in kindergartens. This study also seeks to provide evidence for intervention measures and effective prevention and control management of childhood obesity. From 2020 to 2022, kindergarten children aged 3-6 years old were selected as the research objects in kindergartens in Hangzhou. The Electronic Health-care System will be utilized to facilitate the management of childhood obesity and provide guidance and training to pediatricians and Primary Care Physicians. The overall detection rates of overweight and obesity were 7.27 % and 3.55 %, respectively, among children aged 3-6 years in Hangzhou. The rates of simple obesity in Hangzhou preschool children aged 3-6 years were 4.25 , 3.42, and 3.04 % from 2020 to 2022, respectively; the overweight detection rates of children were 8.27 , 7.28, and 6.34 %, respectively, and the difference was statistically significant (p<0.05). The detection rates of overweight and obesity in 2022 were significantly lower than those in 2020 (p<0.05). The prevalence of obesity in children increased with age. Boys had a significantly higher incidence rate of obesity than girls (p<0.05). The proportion of children with moderate and severe obesity showed a downward trend. Intervention measures for childhood obesity in primary community health service centers and kindergartens are constantly being implemented. The prevalence of obesity in preschool children aged 3-6 years in Hangzhou exhibited a decreasing tendency. This research has identified that child care administration, particularly the implementation of the Electronic Health-care System, demonstrates effectiveness in handling overweight and obesity amongst children.

A reflection of the current status of the mental healthcare system in South Africa

In this paper we begin by highlighting the large treatment gap in South Africa for mental health conditions. We then describe the mental health services available, including the provision of evidence-based treatments in South Africa at each level of care, using the WHO's optimal mix of mental healthcare services as a framework. The optimal mix of services pyramid includes the following domains: informal services, which comprise self-care and informal community mental health care (including religious and traditional healers), primary care mental health services, psychiatric services provided at general hospitals, community mental health services, specialist services and long-stay facilities. In South Africa, mental healthcare services are concentrated at the apex of the pyramid within secondary hospital and specialist services, with fewer resources available at other levels of care, particularly at the community level. Barriers to access and delivery of evidence-based treatments at each level of care are discussed, including the current mental healthcare system resourcing and structure which drives the focus on the provision of medications and specialized services for patients with serious mental health conditions. The results of research conducted locally in collaboration with the Department of Health to address this gap, particularly regarding care for common mental health conditions in community settings, are described. Finally, we provide recommendations for the way forward to ensure that high-quality mental health services at all levels of care are delivered in an equitable, acceptable and effective manner.

Adherence of Primary Care Dentists to Infection Prevention and Control Guidelines at Oral Health Services in Semarang City

&lt;div&gt;&lt;table cellspacing="0" cellpadding="0" align="left"&gt;&lt;tbody&gt;&lt;tr&gt;&lt;td align="left" valign="top"&gt;&lt;p&gt;&lt;em&gt;Primary care dentists are the first destination for patients having dental and oral health problems. The primary dental health service also functions as a referral filter to advanced health facilities. Implementation of Infection Prevention and Control (IPC) in primary health care facilities has not been optimal, such as surveillance is not running well, data on infection incidence in primary health care has not been collected, and there is no supervision. This study aims to analyze the adherence of primary care dentists to the Infection Prevention and Control Guidelines at dental and oral health services. The research design was descriptive-analytic research with quantitative methods based on a cross-sectional study. Data collection was conducted from November to December 2022. The sampling technique used purposive sampling with a total sample of 102 primary care dentists who had been collected from a total population of 147 primary care dentists in Semarang City. The research was conducted by filling out a closed questionnaire.&lt;strong&gt; &lt;/strong&gt;Data were analyzed by Chi-Square test and logistic regression test.&lt;strong&gt; &lt;/strong&gt;There were significant relationships between perception (p=0.019), attitude (p=0.000), organizational support (p=0.011), clinic owner support (p=0.004), and dental facilities and &lt;/em&gt;&lt;em&gt;health &lt;/em&gt;&lt;em&gt;infrastructure (p=0.000) with adherence of primary care dentists to the Infection Prevention and Control Guidelines, whereas knowledge (p=0.748) had no relationship with the adherence of primary care dentists to the Infection Prevention and Control Guidelines. It concludes that primary care dentists in Semarang City have good adherence to Infection Prevention Control Guideline but that guidelines have not been implemented optimally.&lt;/em&gt;&lt;em&gt;&lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;em&gt; &lt;/em&gt;&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;/tbody&gt;&lt;/table&gt;&lt;/div&gt;&lt;p&gt;&lt;strong&gt;&lt;em&gt;Keywords: Adherence Dentist, Healthcare-Associated Infections, Infection Control&lt;/em&gt;&lt;/strong&gt;&lt;/p&gt;

Delivering Primary Health Care (PHC) Services for Controlling NCDs During the COVID-19 Pandemic: A Scoping Review.

Non-communicable diseases (NCDs) are the leading cause of death worldwide. NCDs also increase mortality from COVID-19 and primary health care (PHC) services are an important component in the prevention and control of long-term NCDs. The main goal of the present study was to review primary healthcare services for the NCDs patients via primary healthcare network during COVID-19 pandemic. In this scoping review, Search engines including PubMed, Scopus, and Science-direct up to 1st February 2022 were searched to identify studies regarding primary care services for NCDs patients via primary health care during COVID-19 pandemic. A total of 42 studies met the inclusion criteria and were included in our analysis. 24 studies were about the status and changes of primary health services for NCDs patients in PHC settings, while 18 studies focused on adaptive strategies used during COVID-19 in different countries including United States, Canada, United Kingdom, Portugal, Georgia, South Africa, Thailand, Mexico, India, Kenya, Guatemala and Saudi Arabia. These strategies included remote monitoring, follow up, consultation, empowerment and educational services as well as home visiting Disruption of NCDs services in PHC during the COVID-19 pandemic was observed in different countries, which highlights the urgency of attention of researchers and policy-makers to development of appropriate and adaptive policies to improve PHC service coverage and its quality during the pandemics.

Cervical sample-taking in the primary health service

In Norway, approximately 360000 cervical screening samples were taken in 2020, of which 11000 were registered as inadequate. We therefore wished to investigate doctors' knowledge of cervical sample-taking in the primary health service. An anonymous survey on cervical sample-taking was sent by email to around 4700 members of the Norwegian College of General Practice in September 2021. Of the 1039 doctors who responded to the survey, 820 (79%) reported that they always indicate the reason for taking the sample in the requisition form, and 898 (86%) reported that they avoid taking a sample during menstruation. Only one in three doctors (343) correctly indicated the location of the squamocolumnar junction in postmenopausal women. In response to a question aimed at users of the ThinPrep method, which is particularly sensitive to sampling errors, 426 out of 697 (61%) answered that they either avoid using a lubricant or use a water-based lubricant, while only 35% of the doctors responded that they stop taking the sample if bleeding occurs. The results show that although many doctors have satisfactory knowledge, a continuous focus on cervical sample-taking is essential. Correct sampling and knowledge of anatomical factors in postmenopausal women may be significant for reducing the number of inadequate samples.

A multidimensional approach for differentiating the clinical needs of young people presenting for primary mental health care

ObjectivesThere is an ongoing necessity to match clinical interventions with the multidimensional needs of young people. A key step toward better service planning and the design of optimal models of care is to use multidimensional assessment to understand the clinical needs of those presenting to primary mental health care. Methods1284 people aged 12–25 years presenting to primary youth mental health services completed an online assessment at service entry. Latent class analysis was conducted for seven scales assessing anxiety, depression, psychosis, mania, functioning (indexed by Work and Social Adjustment Scale), and suicidality. ResultsA three-class solution was identified as the optimal solution. Class 1 (n = 305, 23.75%), an early illness stage group, had low and mixed symptomatology with limited functional impairment, class 2 (n = 353, 27.49%) was made up of older persons with established depression and functional impairment, and class 3 (n = 626, 48.75%) had very high and complex needs, with functional impairment, suicidality, and at-risk mental states (psychosis or mania). Additional differentiating characteristics included psychological distress, circadian disturbances, social support, mental health history, eating disorder behaviours, and symptoms of post-traumatic stress disorder. ConclusionsA large proportion of help-seeking young people present with symptoms and functional impairment that may exceed the levels of care available from basic primary care or brief intervention services. These subgroups highlight the importance of multidimensional assessments to determine appropriate service pathways and care options.

Ambulatory complementary technologies in primary care for domestic healthcare

ABSTRACT. In recent years, the primary healthcare sector in our country has undergone significant development, driven by the implementation of tasks and the achievement of key indicators outlined in the National Healthcare Project. This growth has been supported by the countrys economic progress, leading to increased funding for the healthcare industry. Recently, a notable shift in focus has been toward preventive measures and outpatient care in medical facilities that provide primary health services. These measures include promoting a healthy lifestyle, assessing disease risks, and ensuring timely treatment and monitoring. The primary objective of all therapeutic and preventive measures is to enhance the lifespan and quality of life of our population. Since its establishment in 2020, the modernization of primary care, identified as a priority for healthcare development in the upcoming years, has made significant strides in improving accessibility and the quality of medical services. A key driver of this progress of healthcare in the Russian Federation is the extensive use of modern medical technologies, particularly in the provision of primary health care. This shift has also necessitated significant changes in professional terminology within the field. Consequently, an in-depth analysis of the potential integration and widespread use of modern medical technologies in medical facilities providing primary health care has led to the proposal of a new term: ambulatory complementary technologies. This term aims to enhance the conceptual framework of primary healthcare systems and eliminate discrepancies in medical professional terminology. This paper not only describes the reasons behind the emergence of the term ambulatory complementary technologies but also provides a clear definition and outlines prospects for its further development. By introducing this term, we aim to achieve a more accurate interpretation of the key indicators used to comprehensively assess primary healthcare across various regions of the Russian Federation. Ultimately, these efforts are geared toward enhancing the effectiveness of primary healthcare organizations.

Prevalence of Undiagnosed Hypertension and Associated Factors among Adults in Mizan-Aman Town, Bench Sheko Zone, Southwest Ethiopia: A Community-Based Cross-Sectional Study.

This study aimed to assess the prevalence of undiagnosed hypertension and associated factors among people aged 18 years and above in Mizan-Aman town of Bench Sheko Zone in Southwest Ethiopia. Study Design. A community-based cross-sectional study design was carried out among people aged 18 years old and above from April 1 to 30, 2021, in Mizan Aman town. A community-based cross-sectional study design was carried out among people aged 18 years old and above from April 1 to 30, 2021, in Mizan Aman town. Seven hundred fifty-nine subjects were selected by the multistage sampling technique. A structured pretested STEPwise questionnaire was used to interview the participants. Data entry and analysis were done using EpiData 3.1 and SPSS version 25 statistical software, respectively. Descriptive analysis was undertaken, and the results were presented using frequency tables, graphs, and statistical summaries. The dependent variable has a dichotomized response of yes and no, and hence binary logistic regression was used to predict a dependent variable based on independent variables, and predictors having p ≤ 0.25 on the bivariable analysis were considered as candidates for the multivariable analysis. Odds ratios with their 95% confidence intervals were calculated to measure the strength of association, and finally a p value <0.05 was considered statistically significant. The prevalence of undiagnosed hypertension was 14.8% with 95% CI [12.3-15.6]. Older age (AOR = 3.1, 95% CI [1.5-6.5]), male (AOR = 2.2, 95% CI [1.3-3.9]), low physical activity (AOR = 3.9, 95% CI [1.8-8.3]), low consumption of fruit and vegetable (AOR = 4.5, 95% CI [2.4-8.8]), and higher BMI (AOR = 2.7, 95% CI [1.6-4.6]) were significantly associated with undiagnosed hypertension. The current study outlined that the prevalence of undiagnosed hypertension was high in the study area. In addition, most of the risk factors identified were modifiable, and hence community-based preventive approaches like lifestyle modification, increasing awareness, and strengthening routine screening at primary health service facilities resulted in a substantial change in tackling the burden effectively.

Utilization Rate of Primary Health Services in the Diagnosis, Treatment, and Follow-Up of Patients Diagnosed with Rheumatic Disease

In this study, we aimed to investigate the utilization of primary health care in the diagnosis, treatment and follow-up of patients diagnosed with rheumatic disease. For this purpose, 350 patients with rheumatic disease were included in the survey and 26-question about the demographic information of the patients, utilization of primary health care during and afterwards the diagnosis process of the disease. The mean age of the participants was 48.67±13.26, and 73.7% (n=258) of them were female. The patients were diagnosed with rheumatic disease an average of 6.74±6.07 years ago. Joint pain was the most common complaint with a rate of 79.7%. 22% (n=77) of the patients were referred to first internal medicine outpatient department. First admission rate to a family physician was 12.3% (n=43) and 55.8% (n=24) of these patients were referred to higher care for diagnosis. 69.1% (n=242) of the patients were diagnosed in a tertiary healthcare institution. According to the analysis results, 47.7% of the patients had a prescription from their family physician for their rheumatic diseases, but only 6% (n=21) went to their primary care physician for check-ups for their rheumatic diseases. In our study, the rate of use of primary care services was high when patients' rheumatic disease symptoms first begin and were only prescribed prescription drugs after diagnosis. The tendency to prefer primary care for follow-up was low. Contributing to all processes of the rheumatic disease will reduce the workload of hospitals and contribute to a cost-effective approach. For this, the factors that will eliminate the negative perceptions of patients towards primary care can be reviewed and the rate of patients' preference for primary care can be increased.