Primary Health Workers Research Articles

The Palliative Care Knowledge Questionnaire-Basic (PCKQ-B): Development and Validation of a Tool to Measure Knowledge of Health Professionals about Palliative Care in India.

Objectives:A well-educated and aware staff are the needed to overcome barriers to palliative care provision in the face of ever-increasing needs of palliative care in developing countries like India. Lack of a standardised and locally validated need assessment tool is felt as one of the important requirements for any successful educational program. This project is to develop and validate a basic palliative care knowledge needs assessment questionnaire.Materials and Methods:Development of Palliative Care Knowledge Questionnaire-Basic (PCKQ-B) for Indian nurses working in a tertiary care hospital in Delhi-NCR, India was undertaken with four basic processes, that is, item generation, content validity, pilot testing and field testing. Literature search helped us to find appropriate domains and items; content validity obtained with a panel of seven experts, pilot testing and finally field testing was done on 102 nurses working in 6 branches of Max Super Specialty Hospital, Delhi-NCR, India. The field study data were used to do item analyses including item difficulty, item discrimination and calculate reliability indicators including test-retest correlation and KR-20.Results:Content Validity index (CVI) of all the items was >0.78 (except 1 item) and Scale-CVI was 0.98 (excellent content validity). Items were selected on the basis of item difficulty index of 0.1 to 0.9 and an item discrimination index greater than 0.2. A total of 25 questions were selected that elicited KR-20 value of 0.65 and intra class correlation (test-retest reliability) of 0.52.Conclusion:Overall, PCKQ-B is a 25 item questionnaire with a moderate reliability. Although validated for nurses in tertiary care hospitals, this tool might find utility in education of primary health workers, community health workers, social workers, or physiotherapists in palliative care teams.

Barriers to managing elder abuse in primary care services: experiences of healthcare providers in Mexico City

ABSTRACT The purpose of this study was to analyze the barriers to managing elder abuse from the perspective of primary care health workers in Mexico City. We performed an ethnographic qualitative-descriptive study. Thirty semi-structured interviews were conducted with healthcare providers associated with three health centers located in areas with medium and high levels of poverty. A phenomenological approach was used to identify themes, subthemes and codes. Three main types of barriers were found: 1) institutional framework; 2) professional competency limitations and the dominance of a biomedical vision; and 3) the invisibilization of elder abuse. These barriers, described by healthcare workers, highlight the complexity involved in integrating the treatment of elder abuse into primary care health services. It is necessary to develop public educational and preventive public policies for elder abuse that are coordinated both with support services to treat such cases as well as with programs to strengthen healthcare providers professional competency.

Corona virus-19 preventive practices among primary health workers in Owo local government, Ondo state Nigeria

Background: Coronavirus disease 2019 (COVID-19) is an infectious disease with high mortality. Healthcare workers are at the frontline of COVID-19 response and are prone to infection. Therefore, healthcare workers’ preventive practices cannot be underestimated. The study aimed to determine the COVID-19 preventive practices among primary health workers in Owo, Local Government, Ondo state Nigeria.Methods: This was a descriptive cross-sectional study. Consenting staff of primary health centres completed a pretested self-administered questionnaire. The data were analysed using descriptive and inferential statistics.Results: A total of 400 respondents were recruited with 91 (22.8%) males and 309 (77.2%) females giving male to female ratio of 1:3.4. The age range of the respondents was 19-61 years with a mean age of 37.1 (8.1) years. More than half (58.0%) had tertiary level of education and most participant were community health extension workers (36.7%). Majority (99.8%) of the workers were aware of COVID-19 though 212 (53.0%) had good knowledge. The major source of information was the television (94.3%). About 351 (87.8%) had positive attitude despite 383 (95.7%) agreeing that COVID-19 is a problem in Nigeria. More than three-quarter (76.5%) had good practice. There was a significant relationship between knowledge (χ2=29.072, p<0.001), attitude (χ2=35.156, p<0.001) with practice. Educational level was the only factor associated with adherence to COVID-19 guideline (χ2=5.256; p=0.022). The predictors of good practice include knowledge (95% CI =2.296-6.269; p<0.001) and attitude (95% CI =3.079-10.767; p<0.001).Conclusions: The health workers had good knowledge, positive attitude and good preventive practices towards COVID-19.

Using virtual patient to assess primary health workers' competence to detect postpartum depression in Hunan, China.

Primary health workers are the first fine to identify postpartum depression, which is important for patients with this disease to get early specialist diagnosis and treatment. The smartphone-based virtual patient is economical, convenient and effective, and has been applied extensively to evaluate the competency to detect postpartum depression, but there is no relevant application in China. This study aims to use virtual patient to assess the current status on the competency of detecting postpartum depression among primary maternal and child health workers in Hunan Province, and to explore potential influencing factors. A total of 222 primary maternal and child health workers from 3 regions with low, medium, and high economic levels in Hunan Province were enrolled, and smartphone-based virtual patients with postpartum depression were used for the assessment from May to July in 2018, and a self-designed questionnaire was used to investigate their demographic characteristics. The competency to detect postpartum depression was measured by 2 indicators: diagnostic accuracy and treatment accuracy. Descriptive statistical methods were used to describe the competency to detect postpartum depression among them and their demographic characteristics. A logistic regression analysis was used to explore the possible influencing factors for the diagnostic accuracy and treatment accuracy. The diagnostic accuracy rate was 64.0%. There was no significant difference between the demographic characteristics and diagnostic accuracy rate (P>0.05). The treatment accuracy rate was 50.9%. The workers from the middle economic level area were more likely to make the correct treatment than those from the low economic level area (OR= 3.229, 95% CI 1.478 to 7.014).Apart from postpartum depression, the 3 most frequently diagnosed items were bipolar disorder (22.1%, 49/222), secondary depression disorder (13.5%, 30/222), and neurasthenia (5.4%, 12/222). Among the correctly diagnosed health workers, the proportion for correct treatment was 29.6% (42/142), and there was no significant difference between the diagnostic accuracy and treatment accuracy (P>0.05). About half of the primary maternal and child health workers in Hunan Province, China have basic competency to detect postpartum depression, but the overall results are not satisfactory. The regional economic level is correlated with the competency of detecting postpartum depression, and the competency of detecting postpartum depression is stronger in more developed areas. Moreover, for the patients who have been identified as postpartum depression, the rate of correct treatment is low, which warrants particular attention in the follow-up training.

Case Study Analysis: The Utilization of Health Services by Citizens at Area of Tangerang Selatan, Indonesia

BACKGROUND: Citizens are people who have a high risk of exposure to diseases due to unhealthy environmental conditions. This requires citizens to take advantage of health services in order to get optimal examinations. AIM: The purpose of this study was to determine the description and relationship between the characteristics of citizens, the characteristics of health services and the utilization of health services by citizens in the area of Tangerang Selatan, Indonesia in 2020. METHODS: The quantitative research method with cross-sectional design used random sampling techniques. The number of samples was 150 families in the area of Tangerang Selatan, Indonesia. The riset measured data using a questionnaire and collected data by interviewing the respondents. Data analysis used Chi-square analysis and multiple logistic regression analysis. RESULTS: The results showed that the variables related to the utilization of health services were knowledge variable (p = 0.001), number of families (p = 0.021), perception of pain (p = 0.001), and family support (p = 0.030). And the variables that were not related to the utilization of health services were ownership of health insurance (p = 0.750), transportation (p = 0.297), distance (0.340), health information (p = 0.538), and attitudes of health workers (p = 1000). As well as the dominant variable related to the utilization of health services, that is knowledge (p = 0.000) with odds ratio 12.876. CONCLUSION: It is hope that primary healthcare and health workers can involve more communities around the area in their work programs, such as providing health information.

Acceptability and Potential Effectiveness of eHealth Tools for Training Primary Health Workers From Nigeria at Scale: Mixed Methods, Uncontrolled Before-and-After Study

BackgroundThe in-service training of frontline health workers (FHWs) in primary health care facilities plays an important role in improving the standard of health care delivery. However, it is often expensive and requires FHWs to leave their posts in rural areas to attend courses in urban centers. This study reports the implementation of a digital health tool for providing video training (VTR) on maternal, newborn, and child health (MNCH) care to provide in-service training at scale without interrupting health services. The VTR intervention was supported by satellite communications technology and existing 3G mobile networks.ObjectiveThis study aims to determine the feasibility and acceptability of these digital health tools and their potential effectiveness in improving clinical knowledge, attitudes, and practices related to MNCH care.MethodsA mixed methods design, including an uncontrolled pre- and postquantitative evaluation, was adopted. From October 2017 to May 2018, a VTR mobile intervention was delivered to FHWs in 3 states of Nigeria. We examined changes in workers’ knowledge and confidence in delivering MNCH services through a pre- and posttest survey. Stakeholders’ experiences with the intervention were explored through semistructured interviews that drew on the technology acceptance model to frame contextual factors that shaped the intervention’s acceptability and usability in the work environment.ResultsIn total, 328 FHWs completed both pre- and posttests. FHWs achieved a mean pretest score of 51% (95% CI 48%-54%) and mean posttest score of 69% (95% CI 66%-72%), reflecting, after adjusting for key covariates, a mean increase between the pre- and posttest of 17 percentage points (95% CI 15-19; P<.001). Variation was identified in pre- and posttest scores by the sex and location of participants alongside topic-specific areas where scores were lowest. Stakeholder interviews suggested a wide acceptance of VTR Mobile (delivered via digital technology) as an important tool for enhancing the quality of training, reinforcing knowledge, and improving health outcomes.ConclusionsThis study found that VTR supported through a digital technology approach is a feasible and acceptable approach for supporting improvements in clinical knowledge, attitudes, and reported practices in MNCH. The determinants of technology acceptance included ease of use, perceived usefulness, access to technology and training contents, and the cost-effectiveness of VTR, whereas barriers to the adoption of VTR were poor electricity supply, poor internet connection, and FHWs’ workload. The evaluation also identified the mechanisms of the impact of delivering VTR Mobile at scale on the micro (individual), meso (organizational), and macro (policy) levels of the health system. Future research is required to explore the translation of this digital health approach for the VTR of FHWs and its impact across low-resource settings to ameliorate the financial and time costs of training and support high-quality MNCH care delivery.Trial RegistrationISRCTN Registry 32105372; https://www.isrctn.com/ISRCTN32105372

THE MANAGEMENT OF SNAKE BITE AND THEIR OUTCOME WITH DIFFERENT VARIABLES

Background: Snake Bite is a life-threatening medical emergency &amp; major public health issue throughout the world and especially in tropical countries like India. Snake bite which is a substantial cause of death in rural areas of developing countries, is a neglected public health problem.&#x0D; Methods: The study include the patient of snake bite who is admitted in department of medicine of M.D.M. Hospital attached to Dr S. N. Medical College Jodhpur during the period of one year January 01 2018 to December 31, 2018. Patients were enrolled after obtaining an informed consent and meeting inclusion criteria.&#x0D; Results: Maximum number of the cases did not receive any first aid and ASV&amp; Pain killer was the most common component of the first aid. Two third of the cases were bitten by Viper snakes while one third by Cobra and Krait collectively. ASV dose was given as per the case response and in ASV dose of 30-50 VIAL was injected in majority of the victims (38.56). 30-50 VIAL was injected in majority of the victims. At time of hospital admission WBCT is normal in 52 patients (33.09%) while 101 patients had WBCT more than 20 min.&#x0D; Conclusion: Snakebite, an important occupational hazard, though preventable in principle remains to be one of the common medical emergencies. Primary prevention by imparting information regarding quick transport, correct first aid measures and training of primary level health workers can drastically bring down the mortality of this neglected tropical disease.&#x0D; Keywords: Snake bite, ASV, Viper.

Effects of Virtual Education of Nutrition Programs in the Health System Evolution Plan on the Knowledge and Performance of Primary Health Workers (Behvarzes) in Mashhad, Iran Based on the Kirkpatrick Model in 2020

Background: In recent years, virtual education has emerged as one of the important applications of new information and communication technologies in the world. This study was conducted to determine the effect of the virtual training course of nutrition programs in the Health System Evolution Plan on the knowledge and practice of primary health workers in Mashhad, Iran based on the Kirkpatrick Model.Methods: This cross-sectional study was performed on 94 primary health workers in Health Center No. 1 in Mashhad. The sample size was calculated at 45 subjects and the samples were selected using a random number table. According to the staff training criteria, the training course with special conditions was held virtually based on the approved lesson plan. During the course, based on the Kirkptrick Model, a researcher-made questionnaire included four levels (reaction, learning, behavior, and results) was completed and scored based on a Likert scale. The data were analyzed in SPSS software (version 21).Results: The mean score of the content quality of the course was 4.61±0.45; it means that the participants were very satisfied with the quality of the course content. The mean score of the presentation of the course was 4.5±0.6 indicatings the presentation of the course was very good. The mean score obtained from the course exam was 85.9±10.3. Besides, the mean score of skills acquired by the subjects was 4.75±0.34 which is considered a very good level. The mean score of the job performance of subjects was 4.55±0.54 which is also a very good level.Conclusion: The in-service training course of nutrition programs in the Health System Evolution Plan was effective on the knowledge and performance of primary health workers in Mashhad.

Competency of health workers in detecting and managing gestational hypertension, pre-eclampsia, severe pre-eclampsia and eclampsia during antenatal check-ups in primary care health facilities in Bangladesh: a cross-sectional study

Study objectiveTo evaluate the competency of trained health workers in detecting and managing hypertensive disorders of pregnancy during routine antenatal check-ups (ANCs) at primary care facilities in Bangladesh.Study design and...

Prevalence of Severe Neurocognitive Impairment and Its Association with Socio-Demographics and Functionality Among Ugandan Older Persons: A Hospital-Based Study.

BackgroundThe prevalence of neurocognitive disorders, especially dementia, is rising due to an increase in longevity. Early detection and diagnosis of neurocognitive impairments are important for early interventions and appropriate management of reversible causes, especially by the primary health workers. However, this study aimed to determine the prevalence and associated factors of severe neurocognitive impairment among elderly persons attending a tertiary hospital in Uganda.MethodsThis cross-sectional survey was conducted in a Ugandan hospital setting, where older adults go for treatment for their chronic health problems. Following the inclusion criteria, interviews were conducted, where information about socio-demographics was collected, whereas neurocognitive impairment and functionality were assessed by Mini-Mental State Examination and Barthel Index, respectively. Chi-square test, Pearson correlation test, and logistic regression were performed to determine the factors associated with severe neurocognitive impairment.ResultsA total of 507 elderly persons aged 60 years and above were enrolled in this study (mean age 68.62 ±7.95 years), and the prevalence of severe neurocognitive impairment was 28.01%. Advanced age, female gender, lower education level, and functional dependency were significantly associated with severe neurocognitive impairment.ConclusionSevere neurocognitive impairment is prevalent among Ugandan hospital attending elderlies with functional dependency. This suggests a need to routinely screen cognitive disorders among older persons who visit the healthcare facilities with other physical complaints to enable early detection and treatment of reversible causes of neurocognitive impairment, such as depression and delirium to enable better functionality.

Determinants of safety climate at primary care level in Ghana, Malawi and Uganda: a cross-sectional study across 138 selected primary healthcare facilities

BackgroundSafety climate is an essential component of achieving Universal Health Coverage, with several organisational, unit or team-level, and individual health worker factors identified as influencing safety climate. Few studies however, have investigated how these factors contribute to safety climate within health care settings in low- and middle-income countries (LMICs). The current study examines the relationship between key organisational, unit and individual-level factors and safety climate across primary health care centres in Ghana, Malawi and Uganda.MethodsA cross-sectional, self-administered survey was conducted across 138 primary health care facilities in nine districts across Uganda, Ghana and Malawi. In total, 760 primary health workers completed the questionnaire. The relationships between individual (sex, job satisfaction), unit (teamwork climate, supportive supervision), organisational-level (district managerial support) and safety climate were tested using structural equation modelling (SEM) procedures. Post hoc analyses were also carried out to explore these relationships within each country.ResultsOur model including all countries explained 55% of the variance in safety climate. In this model, safety climate was most strongly associated with teamwork (β = 0.56, p < 0.001), supportive supervision (β = 0.34, p < 0.001), and district managerial support (β = 0.29, p < 0.001). In Ghana, safety climate was positively associated with job satisfaction (β = 0.30, p < 0.05), teamwork (β = 0.46, p < 0.001), and supportive supervision (β = 0.21, p < 0.05), whereby the model explained 43% of the variance in safety climate. In Uganda, the total variance explained by the model was 64%, with teamwork (β = 0.56, p < 0.001), supportive supervision (β = 0.43, p < 0.001), and perceived district managerial support (β = 0.35, p < 0.001) all found to be positively associated with climate. In Malawi, the total variance explained by the model was 63%, with teamwork (β = 0.39, p = 0.005) and supportive supervision (β = 0.27, p = 0.023) significantly and positively associated with safety climate.Discussion/conclusionsOur findings highlight the importance of unit-level factors—and in specific, teamwork and supportive supervision—as particularly important contributors to perceptions of safety climate among primary health workers in LMICs. Implications for practice are discussed.

Effect of depression awareness and management training on the attitudes of rural primary health care workers.

To measure the effect of depression awareness and management training on the attitudes of rural primary health care workers. A repeated measures design in which participants acted as their own controls. The training program occurred in 6 locations across rural South Australia. The study enrolled primary care workers in general practitioner surgeries, Aboriginal Community Controlled Health Organisations, community health centres, public hospitals, regional health services and non-government organisations. A six-session training workshop that was informed by the National Institute for Health and Care Excellence guidelines for the treatment and care of people with depression. The 22-item Revised Depression Attitude Questionnaire comprised the main outcome measure. Participants were assessed 12weeks before the training, again on the day of commencement of the training and after the training. Seventy-two primary health workers completed the training program in depression awareness, building therapeutic relationships, working with ambivalence, and goal setting. Between the 2 pre-training assessments mean scores showed no significant difference. There were statistically significant improvements on the overall attitudes and the subscales therapeutic optimism and professional confidence between pre-training and post-training. Training rural primary health care workers in depression may improve their attitudes to working with people living with depression.

Filtering Inequality: Screening and Knowledge in Senegal's Topography of Hepatitis B Care.

Only a fraction of the estimated tenth or so of Senegalese who are chronically infected with hepatitis B virus (HBV) have been diagnosed. Of these, few have been assessed for their risk of progressing to potentially fatal liver disease (indicating need for treatment), and fewer still are taking antiviral drugs. A massive gap between those needing and getting treatment is widely acknowledged among experts. But given that HBV and its biomedical treatment options are largely invisible in bodies, health data, care practices, public messaging, or mass media, how can we observe, ethnographically, the effects of constraints on and inequalities in treatment? What are the stakes of access to drugs, when this access is not being sought out, claimed, or enacted? This article tackles these questions by examining how HBV is being enacted in Senegal, but not necessarily in relation to antiviral treatment. I first describe the emergence, over the past decade and a half, of an exclusionary topography of HBV diagnosis and treatment. I introduce the notion of “filtration” to describe the effects of this topography on the formation of potential “subjects of access.” The diagnostic therapies and expertise required to determine need for treatment are expensive, urban, and largely privatized. Moreover, knowledge about HBV and its possibilities of care circulates in narrow and sparsely distributed channels. Only a tiny minority of persons are effectively “filtered into” care, while issues of access remain largely outside of public debate. I then move onto small-scale efforts, led by rural primary health workers and community associations, to raise awareness of and expand screening for HBV. Those driving information and screening either do not reveal that effective drugs exist or locate these beyond the reach of most of their audiences or patients. Why then do they do it? I examine the logics and effects of their work to identify the forms of inclusion, care, efficacy, and explanation these open up. At the same time, I seek to discern the indirect effects of unequal access to knowledge and resources in the ambivalence, uncertainties, and contradictions that pervade these efforts to inform, diagnose, and advise.

Standardized Management of Gout Based on Education of Patients and Primary Health Workers

Standardized Management of Gout Based on Education of Patients and Primary Health Workers

Effect of screening by clinical breast examination on breast cancer incidence and mortality after 20 years: prospective, cluster randomised controlled trial in Mumbai

ObjectiveTo test the efficacy of screening by clinical breast examination in downstaging breast cancer at diagnosis and in reducing mortality from the disease, when compared with no screening.DesignProspective, cluster randomised...

Prevalence estimates of dementia in older adults in rural Kilimanjaro 2009-2010 and 2018-2019: is there evidence of changing prevalence?

Although limited, existing epidemiological data on dementia in sub-Saharan Africa indicate that prevalence may be increasing; contrasting with recent decreases observed in high-income countries. We have previously reported the age-adjusted prevalence of dementia in rural Tanzania in 2009-2010 as 6.4% (95% confidence interval [CI] 4.9-7.9) in individuals aged ≥70 years. We aimed to repeat a community-based dementia prevalence study in the same setting to assess whether prevalence has changed. This was a two-phase door-to-door community-based cross-sectional survey in Kilimanjaro, Tanzania. In Phase I, trained primary health workers screened all consenting individuals aged ≥60 years from 12 villages using previously validated, locally developed, tools (IDEA cognitive screen and IDEA-Instrumental Activities of Daily Living questionnaire). Screening was conducted using a mobile digital application (app) on a hand-held tablet. In Phase II, a stratified sample of those identified in Phase I were clinically assessed using the DSM-5 criteria and diagnoses subsequently confirmed by consensus panel. Of 3011 people who consented, 424 screened positive for probable dementia and 227 for possible dementia. During clinical assessment in Phase II, 105 individuals met DSM-5 dementia criteria. The age-adjusted prevalence of dementia was 4.6% (95% CI 2.9-6.4) in those aged ≥60 years and 8.9% (95% CI 6.1-11.8) in those aged ≥70 years. Prevalence rates increased significantly with age. The prevalence of dementia in this rural Tanzanian population appears to have increased since 2010, although not significantly. Dementia is likely to become a significant health burden in this population as demographic transition continues.

How can we learn more about scabies worldwide?

British Journal of DermatologyVolume 184, Issue 2 p. e40-e40 Plain Language SummaryFree Access How can we learn more about scabies worldwide? First published: 05 February 2021 https://doi.org/10.1111/bjd.19731AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Abstract Scabies is very common throughout the world. It is caused by a parasitic mite, Sarcoptes scabiei var. hominis, which burrows into the skin and causes intense itching. It is spread by skin-to-skin contact. Children are especially affected. Severe itching can lead to sleep deprivation, impaired concentration, time off school or work, and economic hardship. In low income areas of the world, secondary bacterial infection with Staphylococcus aureus and Streptococcus pyogenes is common. This leads to boils and abscesses, and streptococcal infection can even lead to kidney failure and heart valve disease. The authors, based in the UK and Australia, reviewed what is known about the prevalence of scabies, how it is spread, and approaches to disease control. In 2012, the International Alliance for Control of Scabies (IACS) was established, with the aim of identifying priorities and supporting research into diagnosis and treatment. Scabies is generally diagnosed by healthcare practitioners in their clinics. Sometimes, but not always, the diagnosis can be confirmed by examining skin scrapings under the microscope, but this is time-consuming and taking skin samples can be distressing for children. Examination with a hand-held magnifier called a dermatoscope may be helpful, but dermatoscopes are expensive and not freely available in resource-poor areas. Other diagnostic aids being developed include low-cost means of magnification and a testing method called rapid antigen detection. Diagnosis can often be delayed because of a lack of clear diagnostic standards, meaning defined standards which will help healthcare workers evaluate if the symptoms are scabies. Researchers in several countries have devised algorithms to aid diagnosis by primary care health workers, but these have proved of limited value. IACS has led a discussion to improve diagnostic criteria, released in 2020. The global prevalence of scabies – meaning how many people have it – was estimated at 175 406 000 in 2017, but this may be an underestimate; however, little is known about its relative prevalence within vulnerable communities compared with more affluent populations in the same country. It is reported to be commoner in disadvantaged communities, for example among refugees. Severe systemic illness (meaning it affects other organs in the body) caused by streptococcal infection is common (estimated at around 18 million people) in resource-poor areas, but it is not clear how much is secondary to scabies. The World Health Organization has classified scabies as a neglected ttropical disease (NTD). Integration of epidemiology (which looks at things like patterns, causes and risk factors) and treatment programmes for scabies with other skin NTDs is proving successful in several parts of the world. This strengthens the case for increased funding of control programmes. Linked Article: Cox et al. Br J Dermatol 2021; 184:237–242. Volume184, Issue2February 2021Pages e40-e40 RelatedInformation

Which of the Anthropometric Parameters and Hormonal Variables in Prepubertal Children Are Correlated to True Micropenis?

Background: Most issues of micropenis boys include poor body image and quality of life. Objectives: The purpose of this assay was to survey the relationship of anthropometric measures, testosterone, estradiol, gonadotropins and prolactin with stretched penile length (SPL) and flaccid glans-pubis length (GPL) in pre-pubertal boys with true small penis. Methods: This was prospective a cross-sectional observational study that was conducted in Imam Reza Hospital, Tehran, Iran from February 2015 to May 2020. The pre-pubertal children 7 - 14 years who referred with small penis size were evaluated by a pediatrician and urologist and, if they had true micropenis, they were enrolled in the study (n = 236). The anthropometric and hormonal measurements, SPL, GPL, and relationship of these variables were evaluated. Results: Mean ages of children were 11.65 ± 1.59 years. Mean SPL and GPL were 2.95 ± 1.23 and 2.29 ± 1.06 cm, respectively. There was a significant relationship between SPL and GPL (r = 0.976, P = 0.000). SPL and GPL were not correlated with BMI (r = -0.182, P = 0.054; r = -0.161, P = 0.089, respectively). A significant correlation was found between SPL and GPL with height, FSH, LH, Testosterone and T/E ratio (P &lt; 0.01) but no correlation with weight, estradiol and prolactin (&gt; 0.05). Conclusions: According to the finding of present study, the flaccid measurement can be as helpful as stretched measurement if it is done from pubic bone to tip of glans. Retraining of primary health workers about age-related penile length may be reducing the misdiagnosis of micropenis and concerns of parents, especially in obese boys. The penile length in prepubertal children was not related to BMI and weight but was significantly related to height. Furthermore, Estradiol level is not related to penile length in children with micropenis.

Artificial intelligence in medicine and health sciences

Artificial intelligence (AI) is being used in almost all aspects of life. The AI can assist medical consultants, primary health workers, and hospital administrators to understand analyze and interpret the medical data. The concepts such as data mining, image and signal processing, computer graphics, and machine learning are being utilized or being tried to implement in different health science areas such as dermatology, radiology, anesthesiology, psychiatry, surgery, and medical records . This article throws lights on some of the AI-related works that were carried out, especially in dermatology and radiology. This review has discussed its utility in other fields and the advantages such as faster execution, reliable results, and advantage over the manual process in certain aspects of healthcare. There are challenges, but further research and advances in technology in AI are likely to enormously benefit mankind.

Health Status of Left-Behind Children and Parenting Behaviors of Caregivers in Poor Rural Areas - 6 Provinces, China, 2018.

Summary What is already known about this topic? China has a significant population of left-behind children, and their health and living environments remain a major public health challenge. Children under 6 years old are especially vulnerable to poor health knowledge and behaviors of their caregivers. What is added by this report? The prevalence of stunting, being underweight, and often sick were 13%, 3.4%, and 5%, respectively. Only 53.9% of left-behind children could eat meat often, and 59.5% could control their intake of sugary drinks. The proportions of children who had a safe home environment, a safe play environment, and no family violence were 22.5%, 75.3%, and 45.9%, respectively. The percentages of caregivers who ensured that they rarely left their children alone and were always in their sight are 76.1% and 92.4%, respectively. What are the implications for public health practice? The implementation of early home visits is necessary to improve the physical health and safety of the living environment of left-behind children. Primary health workers should pay attention to improving the health knowledge and behaviors of caregivers.