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Background:Colorectal cancer (CRC) is one of the leading causes of cancer incidence worldwide. In Saudi Arabia, it is ranked first most common cancer in males and second most common in females. CRC is an ideal for prevention because of the high incidence rate and the relative slow progression into an adenocarcinoma. Primary health care (PHC) setting is the ideal place where CRC screening should take place. This study was intended to evaluate awareness, knowledge and attitude towards CRC screening.Methods:A survey was performed among PHC physicians in Qassim province, Saudi Arabia. An electronic questionnaire adopted from the national cancer institute was formulated. Demographic data, specialty, qualifications, years of experience, knowledge and attitudes towards CRC screening, and perceived barriers regarding CRC screening were obtained.Results:A total of 94 physicians were recruited. 39.4% from the sample are females, and 60.6% are males. 99% of physicians agree that colorectal cancer screeningis needed when age appropriate. However, 68% were very compliant in CRC screening in clinical practice. Only 52% of physicians were familiar with national CRC cancer screening guidelines. 53% of physicians scored correct on the age appropriate to initiateCRC screening for average risk patients.Conclusions:More efforts should be given to improve knowledge of primary healthcare providers regarding CRC prevention. More funding and planning are needed to provide primary health care providers with the required tools and systems in order to make CRC prevention more efficient.
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Primary health care (PHC) center is the first point of contact between community and the medical officer at village level. The PHCs have been envisaged to provide an integrated curative and preventive health care to the rural population with emphasis on preventive and promotive aspects of health care. The PHCs are established and maintained by the State Governments under the minimum needs programme or basic minimum services programme. At present, a PHC is manned by a medical officer supported by paramedical and other staff. It acts as a referral unit for 4 to 6 sub centres. It has 6 beds for patients. The activities of PHC involve curative, preventive, promotive and family welfare services. There are 2080 PHCs functioning as on March, 2018 in the Rajasthan.
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Introduction: There are 15 million people worldwide who suffer a stroke each year. According to the World Health Organization,stroke is the second leading cause of death for people above the age of 60 years, and the fifth leading cause in people aged15–59 years old.Aim: This study aims to study the clinical profile of patients presenting with stroke in South Tamil Nadu.Materials and Methods: The cross-sectional study was conducted in the Department of Medicine at Kanyakumari GovernmentMedical College from September 2018 to June 2019. A total of 140 patients who presented with symptoms of stroke wereassessed, for the relative frequency of ischemic and hemorrhagic stroke separately.Results: The incidence of stroke is maximum in the age group of 51–60 years comprise 34.28% with a mean age of 56 years.Cerebral infarction was more than hemorrhage. Hypertension was among leading risk factors for both types comprise 48.5%.Hemiplegia was the most common presentation followed by speech involvement and facial palsy. In ischemic stroke, the mostcommon site was internal (20.71%) followed by parietal (9.28%). In hemorrhage, the most common site was capsuloganglionic(7.85%) followed by thalamus (5.0%).Conclusion: Developing countries like India are facing a double burden of communicable and non-communicable diseases.Stroke is one of the leading causes of death and disability in India.
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Background: Foodborne diseases are considered to be one of the emerging public health issues in the entire world. Poor standard of living is one of the main risk factors for the foodborne illness. The cases of foodborne diseases increase as a result of new emerging pathogens. It is evident that good knowledge of physicians helps in good diagnosis and treatment. Therefore, the objective of the current study is to evaluate the knowledge and attitude of public and private primary health care physicians and its association. Methods: This was a cross-sectional study conducted in the selected public and private primary health care centers in the city of Abha located in the southwestern region of Asir in the Kingdom of Saudi Arabia from October 2017 to March 2018. A total of 84 public and private healthcare centers were included in the study. A structured questionnaire was developed by using the existing literature. Results: Total of 125 physicians from both public and private primary health care centers participated in this study. No significant difference was found between the physicians operating in private and public primary health care centers in terms of knowledge and attitude. Results indicate that knowledge varies according to age, gender and years of experience. Conclusion: The knowledge and attitude of both public and private primary health care physicians are adequate but still there is a necessity to conduct training programs in a regular interval for enhancing the knowledge about the foodborne illness among physicians.
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The Mother and Child Act is the most important law set up to maintain and improve maternal-child healthcare. This act was established in 1973 and was revised to improve maternal-child healthcare. This act includes the establishment and management of a maternal-child healthcare center in the district, a maternal-child regional healthcare center in the province, and a national maternal-child medical center. In the baby boom era, maternal-child healthcare centers provided maternity care and delivery services as well as emergency obstetrical management, but those centers stopped providing maternity care in the low birth-rate era. The last revised act included the establishment of a national maternal-child medical center to care for the increase in the number of high-risk pregnancies. This review briefly evaluates the goals and roles of a maternal-child healthcare center and a national maternal-child medical center according to the Mother and Child Act, and integrates high risk pregnancies with a neonatal care center to renovate the maternity healthcare system.
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Enfant , Humains , Grossesse , Prestations des soins de santé , Urgences , Jurisprudence , Mères , Croissance démographique , Grossesse à haut risqueRésumé
Objective To study the impact of essential medicine system on rational drug use in Community Health Care Center of Chun′an District .Methods Essential drug system in Community Health Care Center of Chun′an District in Zhejiang Province was taken as the intervention group ,and before implementation was taken as contrast group ,the essential medicin system was analyzed whether it was or not to promote the rational use of drugs by prescription surveys .Results Average num-ber of drugs per encounter was lower from 2 .68 to 2 .23(P< 0 .05) ,average expenditure per encounter was lower from 42 .11 yuan to 37 .75 yuan(P<0 .05) ,the use of essential medicines was riser from 79 .90% to 89 .81% (P<0 .05) ,the three in-dexes had significant difference ,the percentage of injections per encounter was lower from 37 .87% to 28 .50% (P>0 .05) ,the percentage of antibiotics per encounter was lower from 36 .52% to 24 .46% (P> 0 .05) ,the two indexes had no significant difference .Conclusion After execution of essential medicine system in Community Health Care Center of Chun′an District ,av-erage number of drugs and average expenditure per encounter were lower and the use of essential medicines was riser ,but the percentage of antibiotics and percentage of injections were not been improved ,belonged to irrational category ,although there had essential medicines manual ,but effective promoting measures still was deficient .
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Objetivo: analisar o cotidiano do trabalho de gerentes e o uso de instrumentos para o gerenciamento de unidades básicas de saúde (übs). Método: estudo qualitativo, de caráter compreensivo, cujos dados foram obtidos por meio de dois grupos focais com 12 gerentes de ubs de municípios de pequeno porte do Paraná - Brasil, realizados no mes de julho de 2011. Resultados: ressalta-se o caráter dialético das situacoes do cotidiano que interferem no trabalho gerencial, que ora facilitam ora dificultam o trabalho. Instrumentos mencionados na organizagao do trabalho: a epidemiologia para subsidiar o planejamento, pactuajao de metas e avaliajao das ajoes, e na gestão dos trabalhadores: reunioes com a equipe, supervisao e mediacao de conflitos. Conclusao: o gerente pode se constituir como elemento fundamental para a implementajao de mudanjas tendo em vista sua destacada atuajao, tanto na organizajao do trabalho como na gestao dos trabalhadores.
Objetivo: analizar el trabajo diario de los gerentes y el uso de instrumentos de gestión de las unidades básicas de salud (ubs). Método: estudio cualitativo, de carácter comprensivo, cuyos datos fueron obtenidos de dos grupos focales con doce gerentes de ubs de municípios de pequeño porte de Paraná, Brasil, realizados en el mes de julio del 2011. Resultados: se resalta el carácter dialético de las situaciones del cotidiano que interfieren en el trabajo gerencial, que a veces facilitan o dificultan el trabajo. Instrumentos mencionados en la organización del trabajo: la epidemiología para subsidiar la planificación, la negociación de metas, la evaluación de las acciones y la gestión de los trabajadores; reuniones con el equipo, supervisión y mediación de conflictos. Conclusión: el gerente puede ser el elemento fundamental para la implementación de cambios, con el fin de una destacada gestión tanto en la organización del trabajo como en la gestión de los trabajadores.
Objective: To analyze the daily work of managers and the use of management instruments of basic health units (ubs). Method: A comprehensive-type qualitative study; the data for the study were obtained from two focus groups with twelve managers of ubs from small municipalities of Paraná, Brazil, performed in July, 2011. Results: The dialectic nature of the everyday situations that interfere with the management work needs to be highlighted. These situations sometimes make work easier or harder. Instruments mentioned in the organization of work: the epidemiology to subsidize planning; goal negotiation; assessment of actions and management of workers; team meetings; supervision and mediation of conflicts. Conclusion: The manager may be the key element for the implementation of changes aimed at a prominent management of work organization as well as management of workers.
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Background: Bronchial asthma is one of the most common chronic diseases in Saudi Arabia, affecting more than 2 million Saudis. Poor knowledge, fear of use of new drugs, and lack of awareness of the importance of control of the disease are common among primary care physicians caring for asthma patients in the Kingdom of Saudi Arabia. Aims & Objective: To estimate the difference in control levels (controlled, partially controlled, and uncontrolled) among asthmatic patients in Eskan and Kakiah PHC centers, in Makkah Al-Mukarramah, October, 2011. As well as to determine pertinent factors associated with control of bronchial asthma. Material and Methods: A Cross-sectional analytic study included all asthmatic patients attended asthma clinic at Eskan PHC center, and equal number of asthmatic patients attended general clinics at Kakiah PHC center, Makkah Al-Mukarramah during the study period (October, 2011). Both groups were asked to fill in a self-administered questionnaire to assess their symptoms and asthma attacks by using the Asthma Control Test (ACT). Data were collected by questionnaire consists of three parts: Demographic data (six items), associated factors (six items) and Asthma Control Test (valid in Arabic version); Adult ACT (five items) and Child ACT (seven items). Results: The study included 100 asthmatic patients (50 were recruited from Kakiah PHCC and 50 were recruited from Eskan PHCC). Slightly more than half of them were over 12 years old, 28 (56%), and 22 (44%) were 12 years old or less. More than half, 27 (54%), of the asthmatic patients recruited from Eskan PHCC compared to 17 (34%) of those recruited from Kakiah PHCC, were controlled. This difference was statistically significant (P=0.035). The difference between bronchial asthma control between Eskan and Kakiah PHCC was statistically significant among adults, while it was not statistically significant among children. Females were found to have significantly better control compared to males. Conclusion: Level of control of bronchial asthma was significantly better among patients attended asthma clinic than those attended general clinic, and females were found to have significantly better control compared to males.
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Elderly people comprise an increasing proportion of the population, and nutritional impairments may contribute to health problems among this group. This study was conducted to evaluate the nutritional status by Mini-Nutritional Assessment (MNA) and to identify relationships among anthropometric measurements, biochemical indicators, bone Mineral Density (BMD) and MNA results among older adults (> or =65 yrs, n=98, 66.7+/-2.5 yrs; M=52, F=46, BMI 24.5+/-2.8 kg/m2) at a Health Care Center. A dietitian administered MNA and collected anthropometric measurements (weight, height, waist circumference), biochemical indicators (albumin, hemoglobin, hematocrit, TLC, glucose, lipids) and the BMD (spine, femur, F=46). Subjects were grouped into a normal nutrition group (0~2 risk factors of malnutrition) and a high risk of malnutrition group (>=3 risk factors of malnutrition) based on their risk factor status for malnutrition. The risk factors for malnutrition include age > or =65 years, PIBW <90%, albumin <3.5 g/dl, TLC <1,500%, Hgb <14 g/dl (men), Hgb <10 g/dl (women), loss of appetite and weight loss 1~3 kg/last 3 months. In addition, subjects were grouped into a normal, osteopenia and osteoporosis group by BMD. We found that 12% of the subjects were at risk of malnutrition (MNA score, 21.4+/-2.1) and that 88% were well nourished (27.3+/-1.5) according to the MNA. Full-MNA scores were positively and significantly (p<0.05) associated with BMI, mid-arm circumference (MAC), calf circumference (CC), albumin and hemoglobin, respectively. The full-MNA score of the high risk of malnutrition group (23.0+/-3.8) was lower than that of the normal nutrition group (27.0+/-2.1) (p<0.05). In addition, the Full-MNA score was negatively associated with the risk factor of malnutrition (r=-0.35, p=0.0004). We found that 39.1% of the subjects had osteoporosis, 45.7% had osteopenia and 15.2% were normal according to their BMD. The MNA score of osteoporosis group (24.58+/-3.3) was lower than that of the normal (27.4+/-1.1) and osteopenia group (26.9+/-1.5) (p<0.05). These results suggested that MNA can be useful as a nutritional screening tool of older adults in Health Care Centers.
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Adulte , Sujet âgé , Humains , Appétit , Densité osseuse , Maladies osseuses métaboliques , Prestations des soins de santé , Fémur , Glucose , Hématocrite , Hémoglobines , Malnutrition , Dépistage de masse , Évaluation de l'état nutritionnel , État nutritionnel , Ostéoporose , Facteurs de risque , Perte de poidsRésumé
The purpose of this study was to analyze womens' health problems using Green & Kreuter's 1991 PRECEDE model and to develop a model for a womens' health care center located in the community. The subjects were recruited from Wonju City. 1. The results showed that 23% of the sample population felt there was a need for a womens' health care center. The mean number of health problems was 3.1. The prevalence rate, was 44.4%, and the rate for an artificial abortion, was 36.4%. Also 30.5% did not have a health examination in the past year. Women using the hospital for medical care accounted for 45% of the sample, while 40% used the drugstore. The average score on the HPLP was 2.41, and this was influenced by self-efficacy, family support, sexual role, and health locus of control. There are a few educational programs in the city provided by the Wonju Health Center and by community health nurse practitioners. 2. The nursing center, as defined in North America, is a nurse-anchored system of primary health care delivery or neighborhood health center. Centers offer various services ranging from primary care to the more traditional such as education, health promotion, wellness screening, and coordination of services by advanced practice nurses. For examples in Sweden MCH centers provide total services for childbearing women and their families, sexual counseling and education for adolescents, and screening by midwives for cervical cancer. 3. The developed model combines purpose, target population, organization, and services, and is related to health resources. The purpose is primary health care and promotion of the quality of life. The target population can be grouped according to the life cycle, (premarriaged age group, the childbearing/child rearing age group, and middle aged and elderly women) and focuses on self-help. The organization of the center includes an advisory committee to plan and evaluate, and a health services team that will be multidisciplinary to provide health care, counseling education, and research. The model development suggested that a variety of women's health care centers are needed to insure adequate management of women's health. Follow-up research using PROCEED is needed to analyze health outcomes. Also a health nursing specialist system is required to develop health promotion, and improve the quality of life of women.
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Adolescent , Sujet âgé , Femelle , Humains , Adulte d'âge moyen , Comités consultatifs , Centres de santé communautaires , Assistance , Prestations des soins de santé , Éducation , Éducation pour la santé , Promotion de la santé , Ressources en santé , Services de santé , Besoins et demandes de services de santé , Contrôle interne-externe , Étapes du cycle de vie , Dépistage de masse , Profession de sage-femme , Amérique du Nord , Infirmières en santé communautaire , Soins , Prévalence , Soins de santé primaires , Qualité de vie , Spécialisation , Suède , Tumeurs du col de l'utérus , Santé des femmesRésumé
In order to evaluate the status of health information management for occupational health care center, we surveyed the computerized health information system using questionnaires form July 15 to August 31 in 1997. Among the 105 centers, 53 centers answered. The results were as follows; 1. Twenty nine centers(54.7%) had computerized information system. Most of them have operated this system for 5 years ago, and the users were administrators, doctors, nurses, and hygienists. The most of twenty nine centers which had introduced the health information system developed the software programs by themselves(41.4%) or with computer companies(58.6%). The main reasons that the centers introduced the computerized health information system were to do financial work and manage the occupational data; including medical examination, environmental evaluation, and other statistics. The problems in operation of computerized information system were low capacity level of memory, non-transferability to other programs and high cost. They demanded the more advanced level of functional diversity, continuity, and accuracy in data management. 2. Sixty nine percent of the centers which had the computerized health information system and forty six percent of the centers which had not it had plans to extend or introduce the system. They presumed that they would spend the 10-50 million Won to do that. 3. Necessary were the advanced computer program which included the comprehensive occupational health service, transferability to other programs, linkage with other occupational health care centers, worksites and government information system.