Public Primary Health Care Centers Research Articles

Examination of WHO/INRUD Core Drug Use Indicators at Public Primary Healthcare Centers in Kisii County, Kenya.

Background Irrational drug use is a global problem. However, the extent of the problem is higher in low-income countries. This study sets out to assess and characterize drug use at the public primary healthcare centers (PPHCCs) in a rural county in Kenya, using the World Health Organization/International Network for the Rational Use of Drugs (WHO/INRUD) core drug use indicators methodology. Methods Ten PPHCCs were randomly selected. From each PPHCC, ninety prescriptions from October to December 2018 were sampled and data extracted. Three hundred (30 per PPHCC) patients and ten (1 per PPHCC) dispensers were also observed and interviewed. The WHO/INRUD core drug use indicators were used to assess the patterns of drug use. Results The average number of drugs per prescription was 2.9 (SD 0.5) (recommended: 1.6–1.8), and the percentage of drugs prescribed by generic names was 27.7% (recommended: 100%); the percentage of prescriptions with an antibiotic was 84.8% (recommended: 20.0–26.8%), and with an injection prescribed was 24.9% (recommended: 13.4–24.1%). The percentage of prescribed drugs from the Kenya Essential Medicines List was 96.7% (recommended: 100%). The average consultation time was 4.1 min (SD 1.7) (recommended: ≥10 min), the average dispensing time was 131.5 sec (SD 41.5) (recommended: ≥90 sec), the percentage of drugs actually dispensed was 76.3% (recommended: 100%), the percentage of drugs adequately labeled was 22.6% (recommended: 100%), and the percentage of patients with correct knowledge of dispensed drugs was 54.7% (recommended: 100%). Only 20% of the PPHCCs had a copy of KEML available, and 80% of the selected essential drugs assessed were available. Conclusion The survey shows irrational drug use practices, particularly polypharmacy, nongeneric prescribing, overuse of antibiotics, short consultation time, and inadequacy of drug labeling. Effective programs and activities promoting the rational use of drugs are the key interventions suggested at all the health facilities.

Portraits of HIV: a pilot photovoice study of adolescent experiences with HIV treatment in South Africa

Background Adolescents are one of the fastest growing groups of people living with HIV (PLWH) in South Africa. They are also more likely than PLWH in other age groups to report poor adherence to antiretroviral therapy (ART). This trend is likely due to a confluence of factors including life stage and transition from child to adult care. Solutions are urgently needed to support adolescent adherence, since ART can improve the lives of PLWH and limit HIV transmission. We explored adolescents’ facilitators and barriers to ART adherence via photovoice, to pilot the method with South African youth and gain information to inform future interventions. Methods The pilot study included three Photovoice groups, with 10 adolescents, who were enrolled in ART at two urban public primary health care centres in the Western Cape province of South Africa. Groups were organized by age and sex (group 1: 10-14 years, girls; group 2: 15-19 years, girls; group 3: 15-19 years, boys). Participants were given cell phones with cameras, and instructed to take pictures representing their experiences with HIV and treatment. Results Youth’s pictures and discussions focused on four key themes related to treatment and ART adherence. These themes included motivations for taking medicine, forming an identity with HIV, managing disclosure and treatment, and relationships between living conditions and HIV treatment. Treatment motivation was informed by familial support. Themes shed light on participants’ challenges and resilience in the face of HIV. Conclusion Adolescents found expressing their views through photos ‘exciting’ and were encouraged to share personal meanings in discussion with peers and researchers. Older adolescents needed less direction and encouragement than younger adolescents, to fully participate in photo-taking and discussions. Findings pave the way for future, larger Photovoice studies. Themes reiterate the importance of personal motivation including aspects of positive identity with HIV in helping youth adhere to medicine, as well as the need to address relational (e.g. family, disclosure) and structural (e.g. living conditions) factors in adherence interventions for this age group. Despite challenges, youth also have strengths (e.g. desire to commit to treatment) that interventionists can capitalize on to support adolescent treatment outcomes.

Physical activity and sedentary behaviour of ambulatory older adults in a developed Asian community: a cross-sectional study.

Physical activity (PA) and sedentary behaviour (SB) independently influence the health outcomes of older adults. Both provide interventional opportunities for successful ageing. We aimed to determine levels of PA and SB in ambulatory older adults and their associated factors in a developed Asian population known for its longevity. We conducted a cross-sectional observational study in a Singapore public primary healthcare centre. Multi-ethnic Asian adults aged ≥ 60 years took an interviewer-administered questionnaire survey. PA and SB were assessed using the Physical Activity Scale for the Elderly (PASE; score range 0 to > 400) and the Sedentary Behaviour Questionnaire for the Elderly, respectively. Among 397 participants (50.9% female; 73.2% Chinese; 47.9% aged ≥ 70 years; 33.5% employed, including voluntary work), 58.7% had ≥ 3 chronic illnesses and 11.1% required walking aids. The median PASE score was 110.8 (interquartile range 73.8-171.6) and decreased significantly with increasing age. Higher PASE score was associated with higher educational level, employment, independent ambulation without aid, and fewer chronic illnesses (p < 0.01). Employment status significantly influenced PASE score (β = 84.9, 95% confidence interval [CI] 66.5-103.4; p < 0.01). 37.0% spent ≥ 8 hours daily on sedentary activity and were twice as likely to do so if they were employed (odds ratio 2.19, 95% CI 1.34-3.59; p < 0.01). The PA of the older adults decreased with increasing age and increased with employment. One-third of them were sedentary for ≥ 8 hours daily. Those who were employed were twice as likely to have SB.

¡Sí, Yo Puedo Vivir Sano con Diabetes! A Self-Management Randomized Controlled Pilot Trial for Low-Income Adults with Type 2 Diabetes in Mexico City.

BackgroundType 2 diabetes (T2D) is a worldwide epidemic and a leading cause of death in Mexico, with a prevalence of 15.9%, and >70% of diagnosed adults have poor glycemic control [glycated hemoglobin (HbA1c) >7.5%]. We developed a diabetes self-management education program contextualized to the study population, including dietary preferences, health literacy, and health system.ObjectivesWe aimed to evaluate the efficacy of a self-management + text message program (¡Sí, Yo Puedo Vivir Sano con Diabetes!) on primary (HbA1c), and secondary behavioral (self-management), clinical, and psychosocial outcomes in adults with T2D in Mexico City.MethodsParticipants were recruited at public primary healthcare centers (Seguro Popular), and randomly allocated to treatment (n = 26) or wait-list control groups (n = 21) with data collected at 3 and 6 mo. The program included 7 weekly sessions and 6 mo of daily text/picture messages. Descriptive statistics and a generalized linear mixed model with intent-to-treat analysis were calculated.ResultsParticipants were 55.5 ± 8.8 y of age (mean ± SD), 68% female, 88.6% overweight/obese, and 57% lived in food-insecure households. Mean ± SD T2D duration was 11.9 ± 7.8 y and HbA1c was 9.2% ± 1.5%. There was 89% attendance at sessions and 6.4% attrition across both groups at 6 mo. Group-by-time effects were seen in self-monitoring of blood glucose (P < 0.01) and diabetes self-efficacy (P < 0.04); and a trend for lower HbA1c was seen in the intervention group at 6 mo (P = 0.11). Significant improvements in dietary behavior (P < 0.01) were demonstrated in the intervention group over time, but this did not reach statistical significance compared with the control group.ConclusionsThe program was associated with clinically significant improvements in T2D self-management, self-efficacy, and HbA1c over time. Thus, T2D self-management skills, including diet, were improved in a vulnerable metropolitan population.This trial was registered at clinicaltrials.gov as NCT03159299.

Prevalence of Mood and Anxiety Disorders Among Adults Seeking Care in Primary Healthcare Centers in Cordoba, Argentina.

ObjectiveTo estimate the prevalence of mood and anxiety disorders among adults seeking care in primary healthcare centers in Cordoba city, Argentina.MethodsCross-sectional analysis of a random sample of adults 18–69 years of age seeking care for general health problems in public (i.e., government-funded) primary healthcare centers in Cordoba city, Argentina in 2010–2011. Mood and anxiety disorders were assessed in the participants’ lifetime, and in the last 12 months and 30 days using the World Mental Health Composite International Diagnostic Interview 3.0, and defined following the International Classification of Diseases, tenth revision.ResultsOverall, 1,067 participants were included in the current analysis [mean age 35.6 (SD 13.2) years, 83.7% female]. The lifetime, 12-month and 30-day prevalence of any mood or anxiety disorder was 40.4% [95% confidence interval (95%CI) 37.4–43.4%], 20.1% (17.8–22.7%) and 7.8% (6.2–9.6%), respectively. The prevalence of anxiety disorders was higher compared to mood disorders when assessed in the participants’ lifetime [29.7% (95%CI 27.0–32.5%) versus 19.3% (17.0–21.8%)], and in the last 12 months [14.9% (12.8–17.2%) versus 8.7% (7.1–10.6%)] and 30 days [5.8% (4.5–7.4%) versus 2.3% (1.5–3.4%)]. Age and marital status-adjusted odds ratios for any mood or anxiety disorder in the participants’ lifetime and in the last 12 months and 30 days comparing women versus men were 1.19 (95%CI 0.85–1.67), 1.70 (1.07–2.69), and 2.26 (1.02–5.00), respectively.ConclusionThe prevalence of mood and anxiety disorders is high among adults seeking care in primary healthcare centers in Cordoba city, particularly among women. Integration of primary and mental health services is warranted.

Violence against Health-Care Workers in Governmental Health Facilities in Arar City, Saudi Arabia.

Background Violence against health-care workers (HCWs) showed increasing worldwide concern. No previous studies addressed violence against HCWs in the Northern region, Saudi Arabia. Objectives To determine the prevalence of violence against HCWs in public hospitals and primary health-care centers in Arar city, KSA, and to identify its associated factors. Methods A cross-sectional study was conducted on 352 HCWs in the Ministry of Health (MOH) facilities in Arar city from 1st October to 31st December 2018. Consented HCWs completed a structured self-administered questionnaire which was modified from the WHO questionnaire for violence. Results Out of 352 health-care workers, 171 (48.6%) reported exposure to violence during work in the past year. The verbal violence was the most common form experienced (83%). Physicians were the main exposed group (59%). Being non-Saudi HCWs, older with longer duration of experience, working in hospitals, working in the emergency room, and working in evening or night shifts were significantly associated with more exposure to violence. The unmet demand for the patient and deficient staff number were the leading reasons for aggression. Only 16.4% of assaulted HCWs reported the violent acts to the higher health affairs authority with the most frequent reasons for nonreporting were their perception that it was useless and their fear of negative consequences. Conclusions Violence against HCWs in Arar city, KSA, is a prevalent problem. Improving health security system and increasing staffing and their training on proper dealing with violence are highly recommended. Also, enforcing rules and regulations is an important demand to control and prevent violence against HCWs.

The pharmacy workforce in public primary healthcare centers: promoting access and information on medicines.

Background:Only few studies have analyzed the pharmaceutical workforce in primary healthcare centers, and a global recommendation calls for better understanding of the trends that shape workforce development and capacity.Objective:To analyze the distribution of the pharmaceutical workforce in primary healthcare centers in the national health system [Sistema Único de Saúde (SUS)] in Brazil.Methods:The study was conducted using data from the National Survey on Access, Use and Promotion of Rational Use of Medicines in Brazil. Secondary data referring to the socioeconomic indicators of each municipality were obtained from national public databases. Data stratification in geographic regions was considered, and data on workers in the management of the municipal pharmaceutical services and medicines dispensing centers were analyzed. Crude and adjusted prevalence ratios were calculated by Poisson regression in the study investigating the factors associated with low and high-density pharmacists per 10,000 inhabitants.Results:The results showed that most Brazilian municipalities have a rate of 1 or more pharmacist per 10,000 inhabitants in primary healthcare public facilities, with a higher concentration of pharmacists in small municipalities. Even in Brazilian municipalities with lower economic capacity, the conditions of access to medicines and pertinent information on medicines were directly related to the number of pharmacists available in these centers.Conclusions:This study showed a high number of pharmacists in the public health system. The higher density of pharmacists in primary healthcare public facilities correlated to increased access to medicines information and better municipal social development.

Is it possible to gain energy at work? A questionnaire study in primary health care.

The area of regenerative work is still close to unexplored. The aim was to explore the possibility for employees to gain energy at work. Questionnaire to all employees (n = 599) from different professions in public and private primary health care centers in one health care district in Sweden. The questionnaire, which had a salutogenic perspective, included information on self-rated health, psychosocial work environment and experiences, recovery, social climate, and energy. Having an energy-building experience was defined by a positive response to two combined questions regarding energy at work. Analyses were performed with bivariate correlation and multiple logistic regression. The response rate was 84%. Health and energy correlated positively (r = 0.54). In total, 44.5% of the employees reported having an energy-building experience. Predictors for having an energy-building experience were recovery [positive odds ratio (POR) = 2.78], autonomy (POR = 2.26), positive workplace characteristics (POR = 2.09), and internal work experiences (POR = 1.88). The results support the hypothesis that it is possible to gain energy at work, an area that is still close to unexplored. There is a high correlation between energy and health. Employees' energy-building experiences relate to well-being at work and correlates to recovery, autonomy, positive workplace characteristics, and positive internal work experiences. This knowledge can help in improving future work environment development.

Prevention of Dental Caries in Nigeria: A Narrative Review of Strategies and Recommendations from 1999 to 2019.

ABSTRACTObjectives:This narrative review aimed to show the approaches recommended for the prevention of dental caries in Nigeria by epidemiological surveys (P), primary preventive methods and strategies,( I) comparison preferred by experts (C) in the prevention of dental caries (O).Methods:An electronic literature search of some databases such as Pubmed, Pubmed Central, Google Scholar, African Journal Online (AJOL) and Medline was conducted using these keywords delimited by Boolean operators AND, OR and NOT: “dental caries” “prevention” “Nigeria. Epidemiological studies using WHO criteria published in English between 1999 and 2019 were included in this study.Results:All studies that met the inclusion criteria were epidemiological cross-sectional studies, non-clinic –based. The approaches recommended include need for continuous caries surveillance, preventive and restorative programmes, primary prevention, use fluorides, oral health education and atraumatic restorative treatment.Conclusions:The recommended approaches should include continuous caries monitoring, comprehensive preventive and restorative programmes, primary prevention, use fluorides, oral health education and atraumatic restorative treatments in public schools and primary health care (PHC) centres. It is necessary to augment these approaches with undergraduate cariology curriculum review of dental schools, public-private partnership and oral health policy implementation with emphasis on prevention.

An Assessment of Healthcare Workers Knowledge about COVID-19

Introduction: Coronavirus disease 2019 (COVID-19) is caused by a viral infection and considered the third coronavirus emerging among human beings over the past two decades. Healthcare Workers (HCWs) are at high risk of acquiring this serious infection during providing care to patients. Therefore, it’s crucial to assess the knowledge of the HCWs about COVID-19. Methods: A multicenter cross-sectional study was conducted on HCWs working at public hospitals and Primary Healthcare (PHC) centers in the Najran region, KSA to evaluate the staff’s knowledge toward COVID-19. The questionnaire consisted of two parts, the first part included the demographic data, and the second part involved questions related to the COVID-19. Results: 451 HCWs participated in this study and the median of overall knowledge score was 67%. Most HCWs properly identified symptoms (82.9%), mode of transmission (78.5%), the incubation period (96.4%), the way of preventing the infection (91.5%), the COVID-19 is not same as MERS-CoV (74.3%) and availability of a vaccine against the COVID-19 (82%). However, HCWs were less likely to identify the source of COVID-19 when it was discovered in China (22.5%), the mortality rate (44.6%), and the presence of treatment (32.1%). Overall knowledge score was statistically significantly associated with profession (P = 0.034), educational level (P = 0.033), and availability of the infection control in the workplace (P = 0.006). Conclusion: The findings of this study demonstrated an intermediate level of knowledge of HCWs about COVID-19. Intervention programs are urgently needed to raise the knowledge of HCWs about this global public health issue.

The impact of a nurse mentoring program on the quality of labour and delivery care at primary health care facilities in Bihar, India

IntroductionAlthough the number of women who deliver with a skilled birth attendant in India has almost doubled between 2006 and 2016, the country still has the second highest number of...

A questionnaire to assess women's perception of respectful maternity care (WP-RMC): Development and psychometric properties

ObjectiveTo develop and assess the psychometric properties of Women's Perspection-Respectful Maternity Care (WP-RMC) Questionnaire. DesignAn exploratory sequential mixed method study was carried out from March to August 2018 in Tehran, Iran. The questionaire items were generated from the literature review and qualitatatve study. The revised items of questionnaire were assessed for validity via testing for face, content and construct validity and relibility. SettingPublic and semi-public hospitals, and public primary health care centers. ParticipantsPostpartum women who had a low risk pregnancy, normal vaginal childbirth and gave birth to a healthy baby with normal birth weight. FindingsThe WP-RMC has 19 items that loaded in three factors: Providing comfort, Participatory care and Mistreatment. Exploratory factor analysis jointly accounted for 53.05% of observed variance. The CVI was 0.97 and the CVR in all items was more than 0.79. Cronbach's alpha for all items was 0.91 and ICC was 0.9. Key conclusions'The WP-RMCquestionnaire is a valid and reliable tool to measure women's experiences of Respectful Maternity Care. This questionnaire could assess subjective features of quality of childbirth care. It can be used in maternity services trying to evaluate and improve women's care experiences during labour and childbirth. The use of the translation of WP-RMC questionnaire in other countries is recommended.

Perspectives of Registered Nurses on refugee healthcare in Lebanon and Jordan (PROfILE): A multi-site cross-sectional study protocol.

This is a study protocol to investigate nurses' perspectives on refugee health care in two countries. The aims are to: (a) explore self-reported work environment factors, including work stressors, self-rated leadership, staffing and resources adequacy, and teamwork among Jordanian and Lebanese nurses caring for refugees; (b) investigate the relationship between nurse related outcomes (physical health; emotional exhaustion) and their psychosocial work environment; and (c) assess the association between nurses' perceived work environment factors and implicit rationing of care and quality of patient care. Globally, the care of refugees is achieving increased attention. Over 6.3 million people are internally displaced and 4.8 million recorded Syrian expatriates are residing in and receiving healthcare services in the neighbouring host countries. This is a cross-sectional, comparative study using a survey design. The study setting involves both private and public hospitals and primary healthcare centres that provide care to refugees on regular basis in Lebanon and Jordan. The estimated sample size includes 3,000 Registered Nurses from Lebanon and 2,500 nurses and midwives from Jordan. Workplace factors affecting quality of nursing care and psychosocial status of nurses caring for refugees will be identified. Potential findings will help leaders design interventions to support nurses who are serving refugees for safer care and better patient outcomes. Findings will assist in more efficient resource allocation and management. New knowledge on the impact of providing health care for refugees will be generated based on the structure of nursing care (e.g., work environment), on the nursing process (e.g., implicit rationing of care), and nurse outcomes (health) in two hosting communities. Moreover, factors enabling resilience in patients, providers, and systems will be identified and be of potential use in addressing the growing global problem of caring for displaced persons.

Job satisfaction, work commitment and intention to leave among pharmacists: a cross-sectional study

ObjectivesWe assessed job satisfaction, work commitment and intention to leave among pharmacists working in different healthcare settings in Saudi Arabia.DesignThis was a cross-sectional study utilising a previously validated questionnaire.SettingWe surveyed...

Cluster Randomized Trial for Hypertension Control: Effect on Lifestyles and Body Weight

Lifestyle modification, such as healthy diet habits, regular physical activity, and maintaining a normal body weight, must be prescribed to all hypertensive individuals. This study aims to test whether a multicomponent intervention is effective in improving lifestyle and body weight among low-income families. Cluster randomized trial conducted between June 2013 and October 2016. A total of 1,954 uninsured adult patients were recruited in the study within 18 public primary healthcare centers of Argentina. Components targeting the healthcare system, providers, and family groups were delivered by community health workers; tailored text messages were sent for 18 months. Changes in the proportion of behavioral risk factors and body weight from baseline to end of follow-up. Data were analyzed in 2017. Low fruit and vegetable consumption (fewer than 5 servings per day) decreased from 96.4% at baseline to 92.6% at 18 months in the intervention group, whereas in the control group it increased from 97.0% to 99.9% (p=0.0110). The proportion of low physical activity (<600 MET-minutes/week) decreased from 54.3% at baseline to 46.2% at 18 months in the intervention group and kept constant around 52% (p=0.0232) in the control group. The intervention had no effect on alcohol intake (p=0.7807), smoking (p=0.7607), addition of salt while cooking or at the table (p=0.7273), or body weight (p=0.4000). The multicomponent intervention was effective for increasing fruit and vegetable intake and physical activity with no effect on alcohol consumption, smoking, addition of salt, or body weight among low-income families in Argentina. This study is registered at www.clinicaltrials.gov NCT01834131.

Valtakunnallisten Kanta-palvelujen käyttöönotto apteekeissa ja kuntien julkisessa perusterveydenhuollossa vuosina 2010–2016

Tutkimuksessa selvitettiin valtakunnallisten Kanta-palvelujen (resepti-palvelu ja Potilastiedon arkisto) käyttöönottoa apteekkien ja terveyskeskusten käyttöönottojen päivämäärien aineistossa vuosina 2010–2016. Palvelujen käyttöönottoa tarkasteltiin valtakunnallisesti, erityisvastuualueittain (erva) ja sairaanhoitopiireittäin (shp) sekä sähköisten potilaskertomusten tuotemerkkien ja terveyskeskusten lukumäärän mukaan. Kaksi valtakunnallista Kanta-palvelua saatiin käyttöön 5,5 vuodessa (keskimäärin 4,6 vuodessa erva:lla ja 3,6 vuodessa shp:ssä). Resepti-palvelu saatiin käyttöön apteekeissa ja terveyskeskuksissa valtakunnallisesti 3,4 vuodessa (keskimäärin 2,3 vuodessa erva:lla ja 1,1 vuodessa shp:ssä). Ahvenanmaalla palvelu otettiin käyttöön 7.12.2016 viimeisenä julkisessa terveydenhuollossa. Resepti-palvelun saaminen käyttöön apteekeissa valtakunnallisesti kesti 2,4 vuotta (keskimäärin 1,3 vuotta erva:lla ja 0,6 vuotta shp:ssä) sekä 3,4 vuotta terveyskeskuksissa (keskimäärin 2,0 vuotta erva:lla ja 0,6 vuotta shp:ssä). Potilastiedon arkisto (PTA) on käytössä Manner-Suomessa, mutta ei Ahvenanmaalla. Valtakunnallisesti PTA saatiin käyttöön 2,0 vuodessa (keskimäärin 1,5 vuodessa erva:lla ja 0,6 vuodessa shp:ssä). Kuntien terveyskeskuksissa oli vuosina 2010–2016 käytössä viisi sähköisen potilaskertomuksen tuotemerkkiä. PTA:n valtakunnallinen käyttöönotto kesti sitä pitempään, mitä enemmän sähköisiä potilaskertomuksia käyttäviä kuntia (terveyskeskuksia) kuului käyttöönoton piiriin. Yleisesti mitä vähemmän shp:ssä oli käytössä sähköisten potilaskertomusten eri tuotemerkkejä, sitä lyhyempi oli käyttöönottojen kesto.

Care providers\u2019 perceptions towards challenges and opportunities for service improvement at diabetes management clinics in public primary health care in Muscat, Oman: a qualitative study

BackgroundThe literature has described several challenges related to the quality of diabetes management clinics in public primary health care centres in Oman. These clinics continue to face challenges due to the continuous growth of individuals diagnosed with type 2 diabetes. We sought to explore the challenges faced in these clinics and discuss opportunities for improvement in Oman.MethodsThis qualitative study was designed to include non-participant observations of diabetic patients and care providers during service provision at diabetes management clinics, as well as semi-structured interviews with care providers, at five purposively selected public primary health care centres. Care providers included physicians, nurses, dieticians, health educators, pharmacists, an assistant pharmacist, a psychologist, and a medical orderly. The data were analysed using qualitative content analysis.ResultsThe study disclosed three different models of service delivery at diabetes management clinics, which, to varying degrees, face challenges related to health centre infrastructure, technical and pharmaceutical support, and care providers’ interests, knowledge, and skills. Challenges related to the community were also found in terms of cultural beliefs, traditions, health awareness, and public transportation.ConclusionThe challenges encountered in diabetes management clinics fall within two contexts: health care centres and community. Although many challenges exist, opportunities for improvement are available. However, improvements in the quality of diabetic clinics in primary health care centres might take time and require extensive involvement, shared responsibilities, and implications from the government, health care centres, and community.

Assessing Physicians' Diagnostic Practices on Foodborne Illnesses in Saudi Arabia: A Cross Sectional Study

Background: Foodborne illnesses are significant public health issues given they contribute to increasing the global burden of diseases. Incidents of Food-borne diseases are increasing due to the presence of newly emerging pathogenesis. Appropriate diagnostic practices among physicians reduce the magnitude of the problem nationally. Therefore, the aim of the current study is to evaluate the diagnostic practices of Foodborne illnesses among public and private primary health care physicians in the Kingdom of Saudi Arabia. Methodology: A cross-sectional study was conducted in thirty public and private primary health care centers in the city of Abha during the period of October 2017 to March 2018. A structured questionnaire was developed based on the previously published literature and was used to collect the data related to the diagnostic practices among the physicians. Results: One hundred and twenty-five physicians participated in this study. Approximately 49% of the physicians had ‘adequate’ diagnostic practicing skills. No significant difference in diagnostic practice of food-borne illness between the public and private health care physicians. However, the study found a positive correlation between the level of clinical practice, age, gender, area of speciality, years of experience and the number of patients per week. Conclusion: Given that the diagnostic practice skills among physicians were ‘adequate’, there has been a recommendation for newly hired physicians to enroll in a diagnosis and management of Foodborne diseases training program to improve their diagnostic practices.

Nurses' job satisfaction: A multi-center study

Introduction: Nurses, including expatriates, comprise the majority of Saudi health-care providers. Therefore, the need to measure their satisfaction within the Saudi context is critical for improving patient outcomes and productivity within the health-care system. This study aims to measure nurse job satisfaction in several Ministry of Health (MOH) and Saudi Arabian organizations. Materials and Methods: A multi-center, cross-sectional study design was utilized to recruit nurses from public hospitals and primary health-care centers in five cities across Saudi Arabia. Data were collected from October 1 to November 15, 2016, through an electronic questionnaire. The study instrument was adapted from former MOH surveys. Descriptive and analytical analyses were utilized. Results: A total of 2418 nurses responded with a response rate of 69%. Overall satisfaction level was low to moderate. Only a small portion of the participants demonstrated overall satisfaction in all domains, and living conditions were significantly low. Predictors of satisfaction were studied based on location and job title. Conclusions: The study revealed a low-to-moderate level of job satisfaction with a need to improve nurses' living conditions. Comparisons among the study locations revealed areas in need of improvement. Further studies are needed to explore methods through which to enact these improvements.

Health related quality of life improvement in chronic non-specific neck pain: secondary analysis from a single blinded, randomized clinical trial

BackgroundChronic non-specific neck pain is related to limited cervical mobility, impaired function, neck muscles myofascial pain syndrome, and stress at work. The aforementioned factors are strongly related and may lead to a negative impact on health-related quality of life. There are some effective conservative Physical therapy interventions for treating chronic non-specific neck pain. Currently, Deep Dry Needling is emerging as an alternative for improving symptoms and consequently, the quality of life in patients with chronic non-specific neck pain. The purpose of the study was to examine the effectiveness of Deep Dry Needling of myofascial trigger points on health-related quality of life improvement, as a secondary analysis, in people with chronic non-specific neck pain.MethodsA randomized parallel-group blinded controlled clinical trial was conducted at a public Primary Health Care Centre in Madrid, Spain, from January 2011 to September 2014. One hundred thirty subjects with chronic non-specific neck pain and active myofascial trigger points in neck muscles were randomly allocated into two groups. Subjects in the intervention group (n = 65) were treated with Deep Dry Needling in active myofascial trigger points plus stretching in neck muscles; Control group (n = 65) received only stretching. Both interventions lasted 2 weeks, 2 sessions per week. Health-related quality of life was measured with Short Form-36 (SF-36), in 5 assessments: at baseline, after intervention period; and at 1, 3 and 6 months after intervention.ResultsFor both groups, SF-36 mean values increased in all dimensions in every assessment. Significant differences (p < 0.05) were found in favor of the intervention group for all dimensions at the last assessment. For some dimensions (physical function, physical role, social function and vitality), the evidence was more consistent from the beginning.ConclusionsDeep Dry Needling plus stretching is more effective than stretching alone for Health-related quality of life improvement, especially for physical function, physical role, social function and vitality dimensions, in people with non-specific neck pain.Trial registrationCurrent Controlled Trials ISRCTN22726482. Registered 9 October 2011.