Private Health Centers Research Articles

Confidence as a Buffer Against Covid-19 Stigma: Enhancing Employee Engagement Among Recovered Individuals

Quality of work life (QWL) is important for individual and organizational success. Post-pandemic times have brought the challenge of declined, yet continued Covid-19 cases among the working Pakistani population. Stigma due to Covid-19 and thus deteriorated QWL in such individuals is plausible. Hence, elucidating factors that enhance the possible damaged quality of work life among Covid-19 stigmatized individuals remains an essential question for managers and practitioners. Drawing on the Social Identity theory, we hypothesize that QWL is damaged in Covid-19 recovered, stigmatized working individuals through deterioration in self-esteem as such individuals are prone to influences from the societal groups that they psychologically identify with. We also argue that self-efficacy buffers this negative effect. Albeit several researches have probed into relations of QWL with stigma-related antecedents and moderation and mediation mechanisms that underlie these effect, but this study investigates self-esteem and self-efficacy as mediator and moderator, respectively, of the Covid-19 related stigma and quality of work life relationship through the lens of the Social Identity Theory. Employing a correlational framework using purposive sampling, we obtained data from 133 working individuals who had been tested positive with Covid-19 in public and private hospitals and health centers of Pakistan during November 2022 – November 2023, had completely recovered and joined their professional lives. Results confirmed study hypotheses, suggesting that stigma related to Covid-19 damages QWL, this relationship is mediated by self-esteem, while self-efficacy buffers the relationship between Covid-19 related stigma and self-esteem. Such individuals and their managers need to collaboratively work in order to reduce effects of this stigma, and undo its damaging effects on self-esteem and QWL. In this regard, boosting self-efficacy plays a supporting role as it acts as a coping mechanism in the inter-play between Covid-19 stigma, self-esteem, and QWL.

Effect of abusive supervision on emotional exhaustion and organizational citizenship behavior: a moderating role of workplace friendship

PurposeThis study uses the Conservation of Resource theory to examine the influence of abusive supervision on organizational citizenship behavior (OCB) via emotional exhaustion, using a moderated mediation framework.Design/methodology/approachA questionnaire was adapted to collect data from 212 full-time employees in 22 private health centers in Nineveh governorate in Iraq in two waves. Hypotheses were tested using hierarchical regression and bootstrapping analyses.FindingsThis study suggests that workplace friendship reduces the positive relationship between abusive supervision and emotional exhaustion of employees and reduces the negative indirect effect of abusive supervision on OCB.Originality/valueFirst, this study provides academicians with a better understanding of the moderating effect of workplace friendship on the relationship between abusive supervision and emotional exhaustion and then its impact on OCB. Second, the paper is one of the few studies that dealt with the abusive supervision in the health sector using data from the Middle East in Iraq, while most leadership research is conducted in the western part of the world.

Distress financing associated with out-of-pocket expenditure for non-communicable diseases in India

ABSTRACT Objective The objective of this study is to assess the coping mechanisms used by the households who incur out-of-pocket expenditure (OOPE) due to Non-communicable Diseases (NCDs). Also, it seeks to examine the underlying factors responsible for various coping strategy. Data and Methods Data from the 75th round of the National Sample Survey Office (NSSO) has been used for the study. Descriptive statistics, concentration index (CI), and multinomial logistic regression have been employed to do the analysis. Results Households having cancer patients have a higher rate (46.80%) of distress financing, followed by cardiovascular diseases (27.43%), chronic respiratory diseases (26.91%), and diabetes (24.77%). The result of multinomial logistic regression shows that households belonging to the other caste categories, availing healthcare at private health centre, lower economic status, lack of insurance coverage, and households with casual labour are more likely to depend upon distress financing for NCDs hospitalisation. Conclusion The issue of financing inpatient care for NCDs, specifically cancer and cardiovascular diseases, is a significant concern in India. Therefore, an increase in public expenditure and investment in public health facilities is essential to increase health seeking behaviour of people by reducing OOPE, particularly among the poor and marginalised groups.

Risk Factors and Frequency of Foot Ulceration in Patients Receiving Chronic Hemodialysis Treatment.

To determine the prevalence and risk factors of foot ulceration in patients receiving hemodialysis treatment. A total of 180 patients who received hemodialysis treatment in two state hospitals and a private health center between April 2017 and September 2017 were included in the study. The researchers collected data using a patient information form and by conducting physical evaluation of the lower extremities. They used the diabetic foot risk assessment algorithm to classify risk according to the data obtained. Of the patients receiving hemodialysis treatment, 6.7% had foot ulceration, 19.4% had a history of foot ulceration, and 8.3% had a history of hospitalization associated with ulceration in a lower extremity. Infected foot ulceration was the most common (6.1%) cause of hospitalizations. In the group with current or past foot ulceration, diabetic nephropathy was the most common etiologic factor of end-stage kidney disease (48.6%); there was a significant between-group difference in diabetic nephropathy (P < .05). Etiologic factors had a significant effect on foot ulcerations: As determined by univariate logistic regression, diabetes (odds ratio [OR], 2.727; P < .05), presence of neuropathy (OR, 4.208; P < .05), low-density lipoprotein cholesterol (OR, 1.013; P < .05), and serum albumin (OR, 0.302; P < .036) all had a statistically significant effect on the presence of foot ulcerations. Patients receiving hemodialysis treatment are at high risk for foot ulceration. Therefore, patient awareness strategies should be expanded to include individuals with end-stage renal disease regardless of diabetes status. Clinical and dialysis nurses should educate these patients about foot ulcerations and foot health to prevent ulcer development.

Effects of Results-Based-Financing on the Availability of Primary Registers in Private Health Facilities in Koulikoro, Mali

Summary: Registries provide an infrastructure for data evaluation and management as well as aknowledge collection system (library). The register in the health field allows you to acquire knowledge relevant and actionable to find solutions to problems current. Objective: The aim is to assess the availability of primary registers in private health centers. Methods and Materials: We carried out a retrospective, prospective and comparative survey on the availability of registers in the third quarter of 2022 and the third quarter of 2023 in private health centers having signed a performance contract with the Koulikoro contracting and verification agency as part of results-based financing. A total of 14 private health centers participated in this study. Results: We note an evolution in the availability rate of registers between the two periods evaluated. The availability of home visit, malnutrition and minor surgery registers was 0% in the third quarter of 2022 and it became respectively 4%, 7% and 80% in the third quarter of 2023. Conclusion: This study revealed that the regular verification of primary data recorded in registers is a factor leading to the increase in the availability of registers in private health centers.

Measuring the Accessibility and Capacity Sufficiency of Private and Public Health Centers in the Istanbul Metropolitan Area

Measuring the Accessibility and Capacity Sufficiency of Private and Public Health Centers in the Istanbul Metropolitan Area

Capacity Building and Participation of Private Health Centers in Tuberculosis Case-Finding in Bangli Regency, Bali Province

The 2017-2019 Bangli District Health Office data shows that Tuberculosis (TB) case finding in Bangli District was below the national target. An evaluation of TB surveillance found that the participation of private health services in reporting and finding TB cases remained low in Bangli. Based on this finding, a workshop on in strengthening private health service networks in Bangli was conducted online. The topics delivered in the workshop included TB case finding through the public private mix, the role of private services in TB case finding and the results of the evaluation of the TB surveillance system in Bangli District. The workshop was attended by 47 participants from various private health services in Bangli. The workshop was evaluated using a questionnaire measuring knowledge of TB and TB surveillance. The result shows that most of the respondents had good knowledge of TB and TB surveillance systems; however, the low participation rate which was only 50% of the target, made it important to send a summary of workshop materials designed in the form of booklets. These booklets have been distributed to all private health services, especially those who did not participate in the workshop to increase knowledge and willingness to participate in TB case finding in Bangli District.

Antifungal susceptibility of Aspergillusgenus determined by the Etest® method: eleven years of experience at the Instituto Médico La Floresta. Caracas, Venezuela.

Abstract. This research aimed to determine the susceptibility of Aspergil-lus spp. to four antifungal agents using the Etest® method in several clinical samples (respiratory samples, soft tissue, otic tissue, and ocular tissue, among others) from a private health center in Venezuela. Thirty-three strains were evaluated: 11 Aspergillus section Flavi, eight Aspergillus section Fumigati, six Aspergillus section Nigri, four Aspergillus section Terrei, and four Aspergillus spp. A 0.5 McFarland standard suspension of a 5-day culture of each Aspergillusstrain was prepared on Potato Dextrose agar and then inoculated on Sabouraud agar plates with 2% glucose. Voriconazole (VCZ), amphotericin B (AMB), caspo-fungin (CAS), and posaconazole (PCZ) were tested. Minimal inhibitory concen-trations (MIC) in μg/mL were determined after 24 and 48 hours of incubation at 35 °C and th range (R), geometric mean (GM), MIC50, and MIC90 were calcu-lated. The results for the 33 Aspergillus spp. tested after 24 h were the follow-ing: VCZ (R = 0.031- 16; GM = 0.145; MIC50 = 0.125 and MIC90 = 0.5), AMB (R = 0.031-16; GM = 0.644; MIC50 = 0.5 and MIC90 = 8), CAS (R = 0.031-16; GM = 0.1076; MIC50 = 0.063 and MIC90 = 1), PCZ (R =0.031 - 0.5; GM = 0.0755; MIC50 = 0.063 and MIC90 = 0.25). This investigation allowed assessing the an-tifungal susceptibility profiles of Aspergillus spp. isolated from clinical samples by the Etest® method, which is practical, reproducible and easy to perform in microbiology laboratories.

Toxic leadership as a predictor of physical and psychological withdrawal behaviours in the healthcare sector

ABSTRACT The current study aims to examine how toxic management styles can lead to both psychological and physical withdrawal of employees in the healthcare sector. The quantitative approach was used in this research. Preliminary data was collected through online questionnaires from 413 employees working in private and public hospitals and health centers in France. Structural equation modeling was used to test the research hypotheses in the SmartPLS program. The research results indicate a direct positive effect of two styles of toxic leadership (unpredictability and authoritarian leadership) on physical withdrawal behaviors. The results also showed that self-promotion and unpredictability positively affect psychological withdrawal behaviors in hospitals and health centers. The results of the research can be useful for managing health centers to remove the behaviors of toxic leaders from the work environment and protect and support staff so that they can continue carrying out their duties.

Out of pocket expenditure and distress financing on cesarean delivery in India: evidence from NFHS-5

BackgroundThough over three-fourths of all births receive medical attention in India, the rate of cesarean delivery (22%) is twice higher than the WHO recommended level. Cesarean deliveries entail high costs and may lead to financial catastrophe for households. This paper examines the out-of-pocket expenditure (OOPE) and distress financing of cesarean deliveries in India.MethodsWe used data from the latest round of the National Family Health Survey conducted during 2019–21. The survey covered 636,699 households, and 724,115 women in the age group 15–49 years. We have used 159,643 births those delivered three years preceding the survey for whom the question on cost was canvassed. Descriptive analysis, bivariate analysis, concentration index (CI), and concentration curve (CC) were used in the analysis.ResultCesarean deliveries in India was estimated at 14.08%, in private health centres and 9.96% in public health centres. The prevalence of cesarean delivery increases with age, educational attainment, wealth quintile, BMI and high for those who had pregnancy complications, and previous birth as cesarean. The OOPE on cesarean births was US$133. It was US$498 in private health centres and US$99 in public health centres. The extent of distress financing of any cesarean delivery was 15.37%; 27% for those who delivered in private health centres compared to 16.61% for those who delivered in public health centres. The odds of financial distress arising due to OOPE on cesarean delivery increased with the increase of OOPE [AOR:10.00, 95% CI, 9.35–10.70]. Distress financing increased with birth order and was higher among those with low education and those who belonged to lower socioeconomic strata.ConclusionHigh OOPE on a cesarean delivery leads to distress financing in India. Timely monitoring of pregnancy and providing comprehensive pregnancy care, improving the quality of primary health centres to conduct cesarean deliveries, and regulating private health centres may reduce the high OOPE and financial distress due to cesarean deliveries in India.

The Role of Physicians' Factors in Underdiagnosis of Celiac Disease in the Eastern Province of Saudi Arabia.

Background Celiac disease is an autoimmune disorder triggered by gluten and related prolamines, which can cause a variety of symptoms and complications if left untreated. Despite being a common lifelong disorder, it often goes undiagnosed for a long time, leading to negative impacts on patients' health and quality of life. The diagnosis of celiac disease requires the presence of celiac-specific autoantibodies and distinctive histological changes in the small intestinal mucosa. Lack of disease knowledge among healthcare professionals and patients' adherence to gluten-free diets may contribute to diagnostic delays. Objectives This study aims to assess the reasons for celiac disease underdiagnosis and identify the functional deficiencies of healthcare professionals in the diagnosis and treatment of celiac disease, particularly in the Saudi population. Materials and methods A cross-sectional, questionnaire-based study was conducted among physicians in the Eastern Province of Saudi Arabia during the year 2023, between May and July. Participants were asked to complete an online self-administered questionnaire that included questions about their demographic characteristics, professional experience, and knowledge and attitudes toward celiac disease. The study recruited gastroenterologists, gastroenterology fellows, internal and family medicine specialists, residents, and general practitioners working in private or public health centers in various cities of the Eastern Province. Results The data were collected from 180 physicians who fulfilled the inclusion criteria of the study, with most participants aged under 30 years and predominantly male. Family medicine and general practitioners were the most represented specialties. While 49.4% of physicians knew that adult celiac disease was rare, only 19.4% frequently recommended celiac disease serology to their patients. In terms of risk, most physicians knew that adult celiac disease was a moderately severe and disabling disease, but only 24.4% thought that the cancer risk in patients with celiac disease was moderate. About 75.6% of physicians had an overall poor knowledge level regarding celiac disease, with gastroenterologists and internal medicine specialists demonstrating better knowledge compared to other specialties (P = 0.001). Conclusion The study found that a majority of physicians in the Eastern Province of Saudi Arabia had poor knowledge about celiac disease. This lack of knowledge could have implications for patient care, as it could lead to delays in diagnosis, inadequate treatment, and increased risk of complications.

Nurses' perceptions of preceptorship of undergraduate students in clinical context.

Nurses' perceptions of preceptorships for undergraduate nursing students are crucial for designing effective and tailor-made strategies to improve nurses' involvement, motivation, commitment, and satisfaction in preceptorships. The aim of this study was to determine nurses' perceptions of preceptorships for nursing students in two hospitals located in northern Spain. This study was conducted in two highly specialized, medium-large, university tertiary care hospitals, including one public and one private hospital, located in northern Spain. The participants of this study were clinical nurses in private and public health centers who had been preceptors for at least one year. A descriptive cross-sectional study was carried out between October 2021 and April 2022, with a total sample of 307. The validated "Involvement, Motivation, Satisfaction, Obstacles and Commitment" (IMSOC) questionnaire was used. Descriptive statistics and bivariate analysis were carried out. The variables included sex, age, educational level, preceptorship training, professional experience, work sector, work setting, and type of contract. The mean global questionnaire score was 115.25±33.86 (95% CI: 111.62-123), with the highest score obtained for the "Involvement" dimension (29.96; SD: 9.23; 95% CI: 29.01-34.87). Age showed statistically significant negative correlations with the overall and dimension scores (p<0.05). Comparisons by work sector and type of contract reflected that nurses working in the private sector and those with permanent contracts had higher motivation and commitment scores. Preceptors had positive perceptions of their role in undergraduate nursing students' education. Age, work sector, type of contract and time allocation should be considered when designing strategies to enhance the involvement, motivation, commitment, and satisfaction of nurses in their experiences as preceptors for undergraduate nursing students. Improving the preceptorship experience will benefit both nurses and students by improving preparation, satisfaction, and retention.

Out-of-pocket expenditure and its correlates for institutional deliveries in private and public healthcare sectors in India: findings from NFHS 5

BackgroundIncreased coverage for institutional delivery (ID) is one of the essential factors for improved maternal and child health (MCH). Though, ID increased over time, out-of-pocket expenditure (OOPE) for the care-seeking families had been found to be growing, parallelly. Hence, we estimated OOPE in public and private health centres for ID, along with their sources and attributing factors and compared state and union territory-wise, so that financial risk protection can be improved for MCH related services.MethodsWe used women’s data from the National Family Health Survey, 2019–2021 (NFHS-5). Reproductive aged women (15–49 years) delivering one live child in last 5 years (n = 145,386) in any public or private institutions, were included. Descriptive statistics were presented as frequency and proportions. OOPE, was summarized as median and interquartile range (IQR). To estimate the extent for each covariate’s effect, linear regression model was conducted.ResultsOverall median OOPE for ID was Rs. 4066 (median OOPE: private hospitals: Rs.25600, public hospitals: Rs.2067). Health insurance was not sufficient to slash OOPE down at private facilities. Factors associated significantly to high OOPE were mothers’ education, elderly pregnancy, complicated delivery, birth order of the latest child etc.ConclusionA standard norm for ID should be implemented as a component of overseeing and controlling inequality. Aiding the needy is probably just one side of the solution, while the focus is required to be shifted towards reducing disparity among the health facilities, so that the beneficiaries do not need to spend on essential services or during emergencies.

P-380 Reproductive autonomy in Spain - reproduction as a negative right and the obligations of the State

Abstract Study question Even when considering the right to reproduction as a negative right are there actions to be taken in order achieve a better reproductive autonomy? Summary answer Specific actions become a necessary positivisation of the right to reproduction. Ensuring socio-economic stability and promoting specific education are key parameters for promoting fertility. What is known already The reproductive autonomy of individuals consists of being able to choose the number of children desired and the appropriate timing between deliveries. However, there are many factors that prevent reproductive autonomy from being fully developed in Spain, being the country with the second lowest fertility indicator in Europe. There are texts that argue that reproductive autonomy should be approached from a Human Rights perspective and urge governments to adopt positive measures in accordance. However, the European Court of Human Rights' rulings on this issue are far from this perspective. Nevertheless, states have obligations to enhance the reproductive autonomy of individuals. Study design, size, duration In order to stablish this position, we studied the Spanish demographic and fertility indicator data and examined the existing Spanish laws regarding assisted reproductive techniques (such as Law 14/2006), the European Court of Human Rights' ruling on this matter, United Nations consensus related to this field, the Guttmacher-Lancet commission and recommendations of scientific societies such as ESHRE. Participants/materials, setting, methods Bibliography was achieved using the European Court Human Rights' ruling HUDOC database, the Spanish State Official Newsletter and United Nations Library, between others. Socio-economic and demographic indexes were obtained with Eurostat and the Spanish National Statistics Office. Selected legal aspects were included in the revision and manuscript. Main results and the role of chance The Spanish socio-economic panorama is unfavorable for the emancipation of young people and the consequent formation of families with offspring, which aggravates the existing demographic crisis and generational turnover. Importantly, people are not being fully autonomous in their reproductive decisions, mainly due to a lack of information and foresight regarding real fertility and infertility expectations. States must ensure comprehensive sexual and reproductive health promotion, which includes reproductive autonomy. The wide range of rights that constitute the so-called reproductive rights is encompassed within the framework of human rights. However, the right to reproduction is not always considered as a positive right, although the legislator must ensure that people can fully exercise their autonomy. The fact that the full positivisation of the right to reproduction is not considered does not exempt the State from obligations to ensure the reproductive autonomy of its citizens. Therefore, the positivisation of the right to reproduction must ensure socio-economic stability and reproductive health education, thus preventing future infertility problems. Public and private clinics and health centers must be provided with the necessary means to diagnose possible reproductive pathologies. Education and economic stability are solutions to most of the problems related to population growth and infertility. Limitations, reasons for caution In this study we have interpreted international Law, soft-law and reccommendations according to the actual Spanish socio-economic and demographic context, which may not be adequate to extrapolate to other countries or populations. Wider implications of the findings To consider the right to reproduction as a positive right may mean converting the State into a provider of resources for this purpose. However, positivisation of the right to reproduction materializes in education and socio-economic stability, actions worth considering, such as creating public campaigns aimed at fertility education and awareness. Trial registration number Not applicable

Knowledge, attitude, and practice of patients, visiting a private primary level health care facility towards family physicians.

To study the knowledge, perception, attitude, and practice of patients visiting a private primary health centre towards family physicians. A cross-sectional questionnaire-based study was planned. A total of 272 patients visiting the health centre were included in the study. Above 90% of the patients felt confident in the capabilities of family physicians in managing all kinds of health problems and the time/cost-effectiveness of this speciality. Timely referral and holistic care were other areas that boosted their confidence on family physicians. 96.7% knew that family physicians are trained specialists. Although only 50% of the study participants were already seeking the services of a family physician, 88% of them felt that a family physician would be their primary point of contact in their health care needs. The positive attitude, knowledge, and perception towards family medicine were not reflected on their treatment seeking practice in areas of care, such as childcare (66.2%) and pregnancy (81.6%), where they preferred the services of a specialist. Also, for diabetes (52%) and chest pain (66%) related issues, the patients favoured a specialist's care over that of a family physician. Patients visiting our primary health centre had good knowledge and positive perception about the family physicians. Preference for specialists over family physicians was seen for conditions such as chest pain, diabetes care, child care, and obstetrics issues.

Bacteriological Evaluation of Air, Surfaces of Critical Areas and Water, in Operating Rooms of Two Private Health Centers. Valencia, Carabobo 2018

Bacteriological Evaluation of Air, Surfaces of Critical Areas and Water, in Operating Rooms of Two Private Health Centers. Valencia, Carabobo 2018

Smartphone-based point-of-care anemia screening in rural Bihar in India

BackgroundThe high prevalence of anemia in resource-constrained settings calls for easy-to-use, inexpensive screening tools. The Sanguina Smartphone App, an innovative tool for non-invasive hemoglobin estimation via color-sensitive, algorithm-based analysis of fingernail bed images, was validated in the United States. This study evaluates the performance of the App in a population with different socio-economic, ethnic, demographic and cultural composition in rural Bihar, India.MethodsFor 272 mainly adult patients of a private health centre, hemoglobin measurement with the App is compared with the gold standard laboratory blood analysis. For a second sample of 179 children attending pre-schools, hemoglobin measurement with the App is compared to the results of the HemoCue Hb 301, a point-of-care device using a small blood sample, serving as the reference standard for field-based settings.ResultsThe App reaches ±4.43 g/dl accuracy and 0.38 g/dl bias of comparator values in the clinic-based sample, and ±3.54 g/dl and 1.30 g/dl, respectively in the pre-school sample. After retraining the algorithm with the collected data, the validity of the upgraded version is retested showing an improved performance (accuracy of ±2.25 g/dl, bias of 0.25 g/dl), corresponding to the results of the original validation study from the United States.ConclusionsThe initial version of the App does not achieve the accuracy needed for diagnosis or screening. After retraining the algorithm, it achieves an accuracy sufficient for screening. The improved version with the potential for further adaptions is a promising easy-to-use, inexpensive screening tool for anemia in resource-constrained point-of-care settings.

De 1864 à 1880 : Valentin Magnan (1835–1916), un anatomo-clinicien, expérimentateur, enseignant et fondateur d’une maison de santé privée à Suresnes fondée en 1875 avec Gustave Bouchereau (1835–1900) et Gustave Lolliot (1837–1882) ou l’histoire d’un évincement d’un aliéniste radical-socialiste à la chaire des maladies mentales et de l’encéphale en 1877 (Partie II)

The Orleans monarchist Ferdinand Duval (1827–1896) that was the prefect of the Seine issued a decree abolishing the teaching of mental illness following the Teulat affair and in the name of Moral Order politic, this is very different from the republican project. This decree inaugurated a lot of debates. The reading of these about the question of the creation of a chair for mental illnesses and the brain (1877) at the General Council of the Seine and the French National Assembly reflected the political oppositions between monarchist and republican. Magnan was discredited by his participation at the so-called exhibition of the insane and his creation of a private health center in Suresnes (1875) with Gustave Bouchereau (1835–1900) and Gustave Loliiot (1840–1882). That was said to oust Magnan as a candidate to hold the Chair Mental Illness Clinic. Auguste Voisin (1829–1898) was eliminated for this job because he was the brother of the police prefect Félix Voisin (1832–1915). We believe that Magnan was not selected because his attitude of allegiance to Georges Clémenceau (1841–1929); their relationship went beyond a simple friendship. Magnan’ political orientation was a radical socialist. He was not in favored on the one hand with the President of the Council Jules Simon (1814–1896) and on the other hand with the Minister of Public Education and Fine Arts William Henry Waddington (1826–1889). The latter was the signatory of Ball's appointment order and his installation to the Chair Mental Illness Clinic at Sainte-Anne Asylum. In fact, Ball has Britannic origin and was Protestant as W.-H. Waddington. Thus, he was the minister's favorite. At a time when an ambient anticlericalism existed, the appointment of a Protestant alienist reflected a desire to maintain religious influence on the hospital ground for the Protestant community. Therefore, Benjamin Ball (1833–1893) appointment as the first holder of the Chair Mental Illness Clinic at Sainte-Anne asylum has been based on political and religious background.

Mobile Application with AR as a Strategy to Improve the Marketing Process in a Dental Center

The post-pandemic period brought with it new challenges for both businesses and private health centers, many of which were affected by the loss of customers. In the case of dental centers, many were affected by the distrust of customers, since activities performed in the oral cavity exposed them to the contagion of Covid-19. This research work proposes the implementation of a mobile application with Augmented Reality (AR) as a strategy for digital marketing immersion, with the aim of achieving a dynamic approach to the services provided in the dental center to customers, this is through the use of this technology in conjunction with social networks, contributing to the improvement of the business and building trust with customers. The application was developed under the Mobile-D methodology with a layered system development architecture, having as indicators the time of elaboration of the advertisement, the cost of information material, the time to inform the services, and the level of customer satisfaction. Finally, the results revealed that the time of elaboration of the advertisement decreased from 25 hours to 14 hours, the cost of informative material was considered "low" since the implementation of the application turns out to be economic, and the time to inform the services in its marketing process went from 30 min to 19 min with the use of the application, finally, the customer satisfaction increased being considered in 87% between "Good" and "Excellent".

Perceptions of COVID-19 among frontline health workers in Burkina Faso.

In Burkina Faso, the first cases of COVID-19 were reported in March 2020. Health personnel are on the front line of COVID-19 control, and it is important to understand their perceptions and knowledge of the disease. The objective was to determine the knowledge and perceptions of healthcare personnel of COVID-19 in the city of Ouagadougou. The study was conducted in five plots in the city of Ouagadougou. A total of 20 health workers from public and private health centers in the city of Ouagadougou were selected during May 2020. In-depth individual interviews were conducted, and a thematic analysis was performed using NVIVO. The routes of transmission identified were promiscuity, respiratory tract, and physical contact. Various symptoms have been noted, such as fever, cough, and runny nose. However, they recognize that these symptoms are not sufficient to make a diagnosis of COVID-19. Similarly, the treatments mentioned are modern medicine and phytomedicine. The research has generated information on healthcare workers' knowledge and perceptions of COVID-19. Therefore, they are useful for decision-making regarding protective measures for health workers in the management of COVID-19.