Realization of Coronavirus Testing Kit Using a Combination of a Triangular Photonic Crystal (PhC) Structure and a 412 nm Laser Beam

The design of a Covid-19 testing kit is proposed in this research using a photonic crystal structure (PhC) and a violet laser beam. The basic principle of this structure relies on the phenomenon of absorbance reflectance and transmission at the signal of a 412 nm laser beam. Finally, the transmitted light energy through the PhC structure is the conclusive factor to detect the types of virus which is the function of the reflectance and absorbance. The reflected light energy is computed by plane wave expansion (PWE) whereas the absorbance of light energy is obtained through numerical computation. The notable advantages of this technique are that the virus related to Covid-19 can be recognized by observing the colour of transmitted energy through a photo energy meter. Finally, the outcomes of the research affirm that the sample could be Covid-19 if the output energy would be infrared (IR). Similarly, the sample could be a normal coronavirus, if the output energy would lie within the visible regime.

Realization of 20 Monochromatic Laser Beams Using a Photonic Crystal (PhC) Structure via the Principle of Filtering

The current work employs a Si-based one-dimensional (1-D) photonic struc-ture which delivers 20 different types of monochromatic laser beam via the filtering action. The I/P signals are essentially varying from visible to near infrared (NIR) range to justify the work. Though similar types of work related to filtering application are found in the literature, the present research deals with an output laser beam which could be deployed in different pur-poses vis-a-vis dentistry, dermatology, spectroscopy, printing, holography, barcode scanning, etc. The mechanism of this work incorporates 68 layers of SiO and Si-based 1-D optical waveguide along with their configuration where the plane wave expansion (PWE) method does fulfil the basics of the required mathematics to solve out electromagnetic wave equations. Reflec-tance and transmittance characteristics along with the absorbance are the critical parameters that substantiate the said application.

An Artificial Intelligence-Based Pharmacy in Rural Areas

Artificial intelligence is drastically changing the world. It has changed and impacted the world on multiple levels and its effects have now reached rural areas. More than half of India's population live in rural areas and 58% of people's livelihood are based only on agriculture. The major issue people face in rural areas is in the field of healthcare.Medical facilities in rural areas are in serious need of advancement due to a lack of workers and an optimal environment. People in rural areas have to travel to towns and cities for disease diagnosis. This causes additional strain on their existing poor financial condition. Online doctor assistance using AI can provide consultation with doctors using phones. Health workers can be trained to operate an AI-based diagnosis and sampling system which provides reports of patients. It can also assemble, store and trace clinical data of individual patients. AI can also be used by doctors to develop personalized assessments. Early detection of diseases can prevent lives. Prediction methodology and algorithms are advancing and providing precise output based on records of patients. During Covid-19, AI played a major role in tracking and predicting morbidity and mortality rate. It was also used for monitoring cases, predicting future outbreaks, and pattern recognition for studying disease trends.AI-based robots are used to help patients in hospitals during a pandemic. Artificial intelligence can help the advancement of healthcare facilities in rural areas.

An overview of Iran's actions in response to the COVID-19 pandemic and in building health system resilience.

This article is part of the Research Topic 'Health Systems Recovery in the Context of COVID-19 and Protracted Conflict'. The considerable human, social, and economic impacts of COVID-19 have demonstrated a global lack of health system resilience, highlighting gaps in health system capacities due to fragmented approaches to health system financing, planning, and implementation. One of the key actions for ensuring equitable essential health services in all countries in normal situations as well as emergencies is through strengthening the primary healthcare (PHC) system. In the context of the unfolding pandemic, the Iranian Ministry of Health and Medical Education (MoHME) undertook a variety of strategic actions to ensure the sustainability of health services during the current health emergency and to promote health system resilience against future shocks. Right after the Alma-Ata declaration in 1978, MoHME pursued the PHC philosophy incorporating the principles within the WHO health system framework and its six building blocks. In response to the evolving pandemic, MoHME put in place several interventions to ensure the maintenance of essential health services in addition to the provision of response. Some interventions were new, informed by global experience with COVID-19, while others leveraged existing strengths within the existing health system. Those were taking a whole-of-government approach; leveraging the PHC capacity; supporting the workforce; strengthening preparedness and response; improving access to medicines, vaccines, and health products; and leveraging the health information system into the pandemic response. Health system strengthening that promotes resilience is imperative for governments as health systems are fundamental to sustainable socioeconomic development. In recognition of this, the WHO Eastern Mediterranean Regional Office (EMRO) has recently outlined regional priorities for advancing universal health coverage (UHC) and ensuring health security. Iran's approach both prior to and during the pandemic is strongly aligned with those regional priorities, which are "primary health care-oriented models; enhancing health workforce; promoting equity; enabling environment for research; improving access to countermeasures; and fostering health system resilience."

Primary Health Care Model for Non-Communicable Diseases Management during COVID-19 Pandemic in the Islamic Republic of Iran.

Background: Given the importance of appropriate response to prevent and manage Non-Communicable Diseases (NCDs), this study aimed to analyze the state of NCDs services at the level of the PHC system during the COVID-19 pandemic and to determine the main strategies. Methods: In this qualitative study, first, the circulars and guides in Iran's PHC system from the beginning of the pandemic to the end of September 2020 were retrieved manually and by searching the internal websites of the Ministry of Health. All documents about decision-making or governance and coordination mechanisms for the provision of NCDs services were enrolled and analyzed. In the second phase, the status of service delivery for major NCDs was presented in a model, and finally, SWOT analysis was used to analyze the situation and determine the main strategies. Results: 25 out of 199 circulars and guides were eligible and analyzed. In the crisis phase, most risk assessment, screening, and diagnosis services for NCDs have been suspended, and follow-up and care of patients with major NCDs were done by telephone. In the reopening phase, the general strategies and strategies to increase capacity and provide delayed care were adopted, and the PHC model of the provision of essential services for the major NCDs was developed in low-risk, intermediate and high-risk pandemic conditions. Finally, 16 main strategies were determined with the approach of integrating and focusing on essential services, considering vulnerable groups and the use of E-health technologies. Conclusion: The results indicate on interruption of NCDs services in the crisis phase while adopting strategies for responding to the pandemic. Revision of the COVID-19 guides with a particular focus on NCDs is recommended.

ICT Enabled Disease Diagnosis, Treatment and Management-A Holistic Cost-Effective Approach Through Data Management and Analysis in UAE and India.

This concept paper addresses specific challenges identified in the UN 2030 Agenda Sustainable Development Goals (SDG) as well as the National Health Policy of India (NHP-India) and the Ministry of Health Policy of UAE (MHP-UAE). This policy calls for a digital health technology ecosystem. SDG Goal 1 and its related objectives are conceptualized which serves as the foundation for Virtual Consultations, Tele-pharmacy, Virtual Storage, and Virtual Community (VCom). SDG Goals 2 and 3 are conceptualized as Data Management & Analytical (DMA) Architecture. Individual researchers and health care professionals in India and the UAE can use DMA to uncover and harness PHC and POC data into practical insights. In addition, the DMA would provide a set of core tools for cross-network initiatives, allowing researchers and other users to compare their data with DMA data. In rural, urban, and remote populations of the UAE and India, the concept augments the PHC system with ICT-based interventions. The ICT-based interventions may improve patient health outcomes. The open and flexible design allows users to access various digital materials. Extendable data/metadata format, scalable architecture for petabyte-scale federated discovery. The modular DMA is designed using existing technology and resources. Public health functions include population health assessment, policy development, and monitoring policy implementation. PHC and POC periodically conduct syndromic surveillance to identify population risk patterns. In addition, the PHC and POC deploy medical and non-medical preventive measures to prevent disease outbreaks. To assess the impact of social and economic factors on health, epidemiologists must first understand diseases. Improved health due to compliance with holistic disease treatment plans and access to scientific health information.

Interest and practice of complementary and alternative medicine among the physicians working at primary health care centres of Qassim Province

Background: In the recent past, there is increase demand of alternative and complimentary medicine (CAM) use increased among the patients globally. During our regular practice at Primary health care centres (PHCC), some patients are requesting us to prescribe and discussing about certain products of CAM. This could be due to advertisements on the television and information from other sources. The present study was planned with the objective of opinions, interest and practice of physicians about CAM use for their patients. Methodology: A cross sectional study was conducted among the physicians working at the PHCC and all family medicine residents enrolled at Family Medicine academy. During COVID 19 pandemic, questionnaire distributed through google forms and 261 physicians responded. Data was analysed with statistical package for social sciences (SPSS). Necessary statistical tests were applied. Results: In the present study, female physicians were 85%. About 75% of PHC physicians up to the age of 30 years and mean age were 29 years. In the current study, about 61.7% were prescribing CAM to their patients at PHCC and also observed 40.6% were prescribed CAM for the self purpose. There was no significant association was observed with CAM practice with gender, qualification of physician, position of physician, marital status and nationality (P>0.05). Conclusions: There was increased use of CAM to their patients in the study. One of the limitations of the study was type of CAM product, duration and frequency such product details not taken. Need further studies are required to substantiate the present study findings.

Knowledge, Attitude and Practice toward COVID-19 among the Population attending primary healthcare centers in Makkah Al-Mukarramah Saudi Arabia 2022

Background: Since the World Health Organization (WHO) declared coronavirus disease 2019 (COVID-19) as a pandemic, it has become a major challenging public health problem worldwide. This pandemic has affected all aspects of Population life in almost all nations and among all socioeconomic groups. Population of all types are facing an unprecedented crisis with the rapid spread of COVID-19 and severity of the disease in many infected individuals. As such many healthcare systems have been overwhelmed and HCWs presented with work load . There is a potential shortage of physical resources, such as ventilators and intensive care unit beds, needed to care for surges of critically ill patients, however, additional medical supplies and beds will be of limited help unless there is an adequate medical workforce, as the Middle East respiratory syndrome coronavirus (MERS-CoV) continues to occur in small outbreaks in Saudi Arabia. Aim of the study: To assessment the Knowledge, Attitude and Practice toward COVID-19 among the Population attending primary healthcare centers in Makkah Al-Mukarramah Saudi Arabia 2022. Method(s): Cross sectional study, was conducted among Saudi Arabia population in primary health care center in Makkah Al-Mukarramah. The questionnaire collected socio-demographic characteristics, assessment of Knowledge, Attitude and Practice toward COVID-19 Our total participants were(200). Result(s): show the relation of participant to Attitude, knowledge, Practice score towards COVID-19 regarding the Attitude the most of participants high attitude were (78.0) heave a significant relation were P-value <0.001 and X2187.240, regarding the knowledge the most of participants high knowledge were (61.0%) P-value <0.001 and X270.360, the Practice the most of participants high Practice were (77.0%) a significant relation were P-value <0.001 and X2174.040. Conclusion(s): Study participants from KSA, not adequate knowledge, positive attitude, and acceptable practices towards COVID-19 Knowledge. Electronic and social media should be effectively utilized to spread awareness of COVID-19 among the public, the Population worry levels regarding transmitting for COVID-19 during the early stage of the COVID-19 pandemic, and subsequent awareness campaigns that were conducted were associated with increased knowledge, adherence to protective hygienic practices and reduction of anxiety toward the COVID-19 pandemic. Copyright © 2022 Ubiquity Press. All rights reserved.

Identification of Novel Coronavirus (n-CoV) Using a Two-Dimensional (2-D) Photonic Crystal (PhC) Structure and Finite Element Method (FEM) Via a Violet Laser Beam

Covid 19, a deadly virus is spreading exponentially across the globe that leads to loss of precious life. Recent data suggests that more than 4.6 million people have been died due to this, so it is requiring an ample precaution to stop it. Development of good vaccine along with rapid testing could reduce the mortality rate. Though recently few good vaccines have developed but adequate numbers of doses are not available for every individual due to lack of mass production. Not only are the production issues but also their prob-lems lie in transportation and distribution to huge population. In this sce-nario testing will play a vital role so that affected people could get a dose in priority basis. To meet the nitty-gritty of such problem. A violet laser beam interacted with a photonic crystal (PhC) structure having dimension of 600 x 600 nm2 to identify the novel coronavirus (n-CoV) know as SARS CoV-2. The device finds 16 squares which hold the samples of the swab collected from a patient where the signal of 412 nm (728 THz) incident to it. The principle of mechanism deals with the analysis of scattering parameters (S11 and S12) of the signals which is obtained through the finite element method (FEM). The S11 and S12 parameters deal with the transmittance and reflec-tance of the signal pertaining to the chosen structure. Further, the investiga-tion of transmittance identifies the nature of the virus;for example, the present research claims that blue and violet colours are two possible implica-tions at the output when the structure containing sample excited with a violet laser beam. The output with blue colour indicating the presence of just ordi-nary coronaviruses. On the other hand, if we receive violet colour then it is novel corona viruses (n-CoV)

Immunization programs to support primary health care and achieve universal health coverage.

Gains in immunization coverage and delivery of primary health care service have stagnated in recent years. Remaining gaps in service coverage reflect multiple underlying reasons that may be amenable to improved health system design. Immunization systems and other primary health care services can be mutually supportive, for improved service delivery and for strengthening of Universal Health Coverage. Improvements require that dynamic and multi-faceted barriers and risks be addressed. These include workforce availability, quality data systems and use, leadership and management that is innovative, flexible, data driven and responsive to local needs. Concurrently, improvements in procurement, supply chain, logistics and delivery systems, and integrated monitoring of vaccine coverage and epidemiological disease surveillance with laboratory systems, and vaccine safety will be needed to support community engagement and drive prioritized actions and communication. Finally, political will and sustained resource commitment with transparent accountability mechanisms are required. The experience of the impact of COVID-19 pandemic on essential PHC services and the challenges of vaccine roll-out affords an opportunity to apply lessons learned in order to enhance vaccine services integrated with strong primary health care services and universal health coverage across the life course.

Current status of prevention and treatment of respiratory diseases in primary care in China: a cross-sectional study.

BACKGROUND: China launched its new round of health care reform to develop primary care in 2009, establishing 954,390 primary care institutions that employed over 10 million staff by 2019. However, some studies have shown that the prevention and management of respiratory diseases is inadequate in these institutions. METHODS: We conducted a cross-sectional survey of grassroots institutions throughout China between September and December 2020 based on the standardized Prevention and Treatment System and Capacity Building Project of Respiratory Diseases in primary care settings. The operation of the respiratory department in primary health care institutions was evaluated in terms of facilities, drugs, personnel and management of chronic diseases by means of questionnaires. Descriptive analyses were performed to calculate percentages and frequencies of key parameters. RESULTS: A total of 144 primary health care institutions were surveyed, including 51 in the east, 82 in the west, 9 in the central and 2 in the northeast. Approximately 60% of institutions had spirometers and pulse oximeters. The majority had short-acting bronchodilators, theophylline, systemic corticosteroids, antibiotics, and traditional Chinese medicine. More than half had at least one respiratory physician and operator for spirometry. Half of the institutions carried out screening of chronic obstructive pulmonary disease within the jurisdiction. The institutions in the east were superior to those in the west regarding the equipment, common drugs, medical staff, and management of respiratory diseases. CONCLUSIONS: The study reveals that the overall operation of the respiratory department in primary care settings needs to be further strengthened. It is crucial to provide adequate essential equipment, medical professionals, and medicines for proper diagnosis and treatment of chronic respiratory diseases, as well as improving the management of diseases.

Community emergency medicine throughout the UK and Ireland: a comparison of current national activity.

BACKGROUND: Community emergency medicine (CEM) aims to bring highly skilled, expert medical care to the patient outside of the traditional ED setting. Currently, there are several different CEM models in existence within the UK and Ireland which confer multiple benefits including provision of a senior clinical decision-maker early in the patient's journey, frontloading of time-critical interventions, easing pressure on busy EDs and reducing inpatient bed days. This is achieved through increased community-based management supplemented by utilisation of alternative care pathways. This study aimed to undertake a national comparison of CEM services currently in operation. METHOD: A data collection tool was distributed to CEM services by the Pre-Hospital trainee Operated Research Network in October 2020 which aimed to establish current practice among services in the UK and Ireland. It focused on six key sections: service aims; staffing and training; job tasking and patient selection; funding and vehicles used; equipment and medication; data collection, governance and research activity. RESULTS: Seven services responded from across England, Wales and Ireland. Similarities were found with the aims of each service, staffing structures and operational times. There were large differences in equipment carried, categories of patient targeted and with governance and research activity. CONCLUSION: While some national variations in services are explained by funding and geographical location, this review process revealed several differences in practice under the umbrella term of CEM. A national definition of CEM and its aim, with guidance on scope of practice and measurable outcomes, should be generated to ensure high standard and cost-effective emergency care is delivered in the community.

THE AVAILABILITY AND QUALITY OF PALLIATIVE AND HOSPICE CARE ENSURING IN THE COVID-19 PANDEMIC CONTEXT.

OBJECTIVE: The aim: To study the availability, quality and features of outpatient palliative and hospice care (PHC) to the population, including the elderly, in the COVID-19 pandemic context in order to optimize the PHC-mobile-teams service. PATIENTS AND METHODS: Materials and methods: Domestic and foreign literary sources; sociological research results. The research methods: biblio-semantic, sociological (questionnaires), systemic approach and systemic analysis, conventional medical-statistical methods. RESULTS: Results: Based on the analysis of international regulatory documents, domestic and foreign literary sources, the socio-medical importance of PHC is shown. In Ukraine, as in other countries, the number of elderly people is constantly growing, which leads to an increase in the PHC need. The results of the sociological survey determine: PHC needs in terms of age showed that in Ukraine almost 78.86% of people in need of PHC were aged 60 and over; the most popular (86.0% of responses) were PHC-mobile-teams and home-based services; about 80% of respondents said that pain limited their ability to work and affected on their psycho-emotional state and their quality of life; 86.3% of respondents reported an pain increased after COVID-19. The results of an online survey showed the effectiveness of PHC-mobile-teams service by improving the availability of PHC. CONCLUSION: Conclusions: To ensure high-quality PHC availability it should be integrated at the Health and Social Care Systems. According to the experience of the Kyiv PHC-mobile-teams service, it significantly increases PHC availability, which is especially important in the COVID-19 pandemic context.

Vaccine Hesitancy among Parents and its Determinants in PHC in Al Madinah City 2020

Background: Vaccine hesitancy is caused by a variety of factors, which are complex and multifaceted. The perceived risks of vaccines, the relationship between parents and health-care providers, and the social norm of vaccination are all factors that influence vaccine decision making. Objective: This study aimed to conclude the prevalence of vaccine indecision amongst parents visiting PHC in Al-Madinah city, to identify socio-demographic determinants of vaccine hesitancy and to recognize agents and host-related factors, which leads to hesitancy. Methods: A cross-sectional research was implemented on parents who attended the PHC using a valid questionnaire filled by interviewing the parents. All data was confirmed manually then was implied and entered into SPSS software. Then the data were analyzed using the appropriate statistical test. Results: Vaccines can protect children from dangerous diseases, according to 98.1% of the 375 people who took part in our study. 88.5% of parents preferred to get their children vaccinated with all of the vaccines that are recommended. 69.9% of participants had ever been hesitant or unwilling to have their child vaccinated. 9.6% of parents were unable to get their child vaccinated due to distance, clinic timing, time needed to get the clinic or wait at the clinic, and/or the cost of getting to the clinic. Conclusion: Finally, our findings demonstrated that vaccine apprehension is a prominent issue among parents in Saudi Arabia. We discovered that vaccine fear is widespread, and that it spiked during the COVID-19 pandemic. [ FROM AUTHOR] Copyright of Egyptian Journal of Hospital Medicine is the property of Egyptian Journal of Hospital Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Egyptian perspectives on potential risk of paracetamol/acetaminophen-induced toxicities: Lessons learnt during COVID-19 pandemic.

Paracetamol/Acetaminophen was widely used as a first-line antipyretic and analgesic for COVID-19 patients without giving any attention to the potential risk of related toxicities. A survey was conducted on 176 Egyptians using an online survey portal to assess their knowledge, and attitude regarding potential risk of paracetamol toxicities and whether COVID-19 pandemic affected their practices regarding safe use of paracetamol. The self-administered questionnaire was developed by the researchers and was validated by expert opinions. A pilot testing of the questionnaire was done. Alpha Cronbach test used to assess the internal consistency reliability of the survey revealed good reliability. Overall percent-score revealed that only 24.4% of participants had good knowledge about paracetamol and its related potential toxicities. 62.5% of participants considered paracetamol safer than other medications of the same indications. 42.6% of participants could advise others to use paracetamol without prescription. According to the participants' responses, physicians were less concerned to give instructions about possibility of overdosage. Our results also revealed that participants' administration of paracetamol without physician prescription was more during COVID-19. Practice of paracetamol administration more than the allowed number of tablets/day was significantly more evident during the pandemic. We concluded that the unsupervised use of paracetamol is an alarming sign that should be addressed as this could lead to a high rate of accidental paracetamol toxicity. A lesson learnt from COVID-19 pandemic is the need to implement behavior change measures to mitigate the risk of accidental paracetamol toxicity.

Exploring female frontline health workers' role and capacities in COVID-19 response in India.

Background: Sendai Framework for Disaster Risk Reduction emphasises building local capacities for disaster risk management. This article asks: What role did female frontline health workers (FFHWs) play in preparing, responding and managing health emergencies in India and how did information and communications technology (ICT) platforms hinder or facilitate their capacities? Methods: FFHWs' experiences in providing subnational and local health response to the COVID-19 pandemic in six states in India - Odisha, Bihar, Madhya Pradesh, Uttarakhand, Kerala and Maharashtra - was collected using semi-structured interviews. Data were thematically analysed, and studied within the government policies and guidelines to tackle the emerging concerns in COVID-19. Results: FFHWs were involved in planning, responding and managing COVID-19 cases, providing awareness and undertaking surveillance within their regions. Moreover they were also responsible to continue with essential health and nutrition service delivery to pregnant women and young infants. They relied on various information and communications technology (ICT) platforms in managing their tasks despite facing several challenges. Besides receiving training from hospitals and health officials, FFHWs received information on COVID-19 and prevention through different channels and modes: majority of them reported TV channels, news coverage, and videos sent on Whatsapp groups. Conclusions: There are underlying gender inequalities within the health system whereby limited resources and opportunities are available for the FFHWs, which extends to their use of ICT platforms in health emergencies. Using ICT in an equitable and just manner provides an opportunity to support local action for health resilience swiftly and promptly by building capacities and increasing representation of the frontline workers. This understanding can be further grounded around issues of equity, participation, representation in a gender-responsive health system.

Cost-Effectiveness of Portable Electrocardiogram for Screening Cardiovascular Diseases at a Primary Health Center in Ahmedabad District, India.

Background: District Health Authority in Ahmedabad, Gujarat has introduced Project Lifeline, 12-lead portable ECG devices across all primary health centers (PHC) in the district to screen cardiac abnormalities among high-risk and symptomatic adults for providing primary management and proper timely referral. The prime purpose of the study was to assess the cost-effectiveness of portable ECG for the screening of cardiovascular diseases (CVD) among high-risk and symptomatic adults at the PHC in Ahmedabad, Gujarat. Methods: Cost-effective analysis was conducted using a societal perspective. An incremental costing approach was adapted, and cost-effectiveness analysis was done using a decision-analytic model. We surveyed 73 patients who screened positive for cardiac abnormality, documented the type of ECG abnormalities, and diagnosed CVD. The program cost was obtained from the implementers. Transition probabilities were derived from primary data supported by expert opinion for the intervention arm, while a systematic search of the literature was undertaken to derive transition probabilities for the control arm. Results: The ECG screening at PHC saves 2.90 life years at an incremental cost of 89.97 USD (6657.47 INR), yielding a cost-effectiveness ratio of 31.07 USD (2,299.06 INR) per life-year saved, which is below the willingness to pay threshold. The budget impact analysis was also performed. Results are sensitive to the relative risk reduction associated with the non-participation and the cost of initial screening. Conclusion: Cost-effectiveness analysis clearly shows that the facility to screen cardiac abnormality at the PHC level is highly recommended for high-risk adults and symptomatic cases.

Prevention and control of COVID-19 by primary health care facilities in China: a field-survey-based qualitative study in three typical cities.

BACKGROUND: During the coronavirus disease 2019 (COVID-19) containment, primary health care (PHC) facilities inChina played an important role in providing both healthcare and public care services to community populations. The tasks of COVID-19 containment facilitated by PHC facilities were different among different regions and during different periods of COVID-19 pandemic. We sought to investigate the gaps on task participation, explore existing problems and provide corresponding solutions. METHODS: Semi-structured face-to-face interviews with COVID-19 prevention and control management teams of PHC facilities were conducted. Purposive stratified sampling was used and 32 team members of 22 PHC facilities were selected from Wuhan (as high-risk city), Shanghai (as medium-risk city) and Zunyi (as low-risk city). Framework analysis was employed to analyze the transcribed recordings. RESULTS: The main tasks of PHC facilities during the early period of the pandemic included assisting in contact tracing and epidemiological investigation, screening of populations at high-risk at travel centers/internals, house-by-house, or pre-examination/triage within PHC facilities; at-home/ centralized quarantine management; the work of fever sentinel clinics. Further analyses revealed the existing problems and suggestions for improvement or resolutions. Regular medical supply reserves were recommended because of the medical supply shortage during the pre-outbreak period. Temporarily converted quarantine wards and centralized quarantine centers could be used to deal with pressures on patients' treatment and management of the febrile patients. Only after strict evaluation of nucleic acid testing (NAT) results and housing conditions, decision on quarantine at-home or centralized quarantine centers could be made. Settings of fever sentinel clinics at PHC facilities allowed fever patients with no COVID-19 infection risks for treatment without being transferred to fever clinics of the designed secondary hospitals. Psychological intervention was sometimes in need and really helped in addressing individuals' mental pressures. CONCLUSIONS: During the COVID-19 containment, PHC facilities in China were responsible for different tasks and several problems were encountered in the working process. Accordingly, specific and feasible suggestions were put forward for different problems. Our findings are highly beneficial for healthcare teams and governments in handling similar situations.

An integrative review of primary health care nurses' mental health knowledge gaps and learning needs.

Background: The global COVID-19 pandemic has escalated the prevalence of mental illness in the community. While specialist mental health nurses have advanced training and skills in mental health care, supporting mental health is a key role for all nurses. As front-line health care professionals, primary health care (PHC) nurses need to be prepared and confident in managing mental health issues. Aim: To critically analyse and synthesise international literature about the knowledge gaps and learning needs of PHC nurses in providing mental health care. Design and methods: An integrative review. The quality of papers was assessed using the Mixed Methods Appraisal Tool. Data were extracted into a summary table and analysed using narrative analysis. Data sources: CINAHL, Ovid MEDLINE, Web of Science and EBSCO electronic databases were searched between 1999 and 2019. Papers were included if they reported original research which explored mental health education/training of nurses working in PHC. Findings: Of the 652 papers identified, 13 met the inclusion criteria. Four themes were identified: preparedness; addressing knowledge gaps, education programs, and facilitators and barriers. Discussion: Despite increasing integration of physical and mental health management in PHC, there is limited evidence relating to knowledge gaps and skills development of PHC nurses or their preparedness to provide mental health care. Conclusion: Findings from this review, together with the global increase in mental illness in communities arising from COVID-19, highlight the need for PHC nurses to identify their mental health learning needs and engage in education to prepare them to meet rising service demands.

Preparedness of Primary Health Care Leaders During COVID-19 Outbreak, Riyadh, Saudi Arabia: A Qualitative Study.

PURPOSE: Our study aims to explore the preparedness of the frontline leaders of the primary health care (PHC) centres in dealing with the COVID-19 pandemic and to understand their experiences in implementing preventive interventions necessary to routinise health care service delivery. METHODS: A qualitative exploratory study was conducted using in-depth interviews with the participants in English. The interviews were transcribed verbatim, and inductive coding followed by thematic analysis was performed using NVivo version 12. PARTICIPANTS: Six participants in charge of managing their respective primary health care settings were included in the study. Purposive sampling was used to identify participants until saturation was reached. After agreement, the interviews were scheduled as per availability. RESULTS: The results were grouped into three major themes and nine subthemes. Most leaders reported that they were trained in pandemic preparedness, but there was a lack of focused readiness to handle a massive-scale, infectious disease outbreak or pandemic. The initial lack of guidelines specific to COVID-19 was a barrier in making decisions related to staff and patient care. Services were interrupted initially and there was lack of staff since many acquired COVID-19 and were isolated. The shortage of the staff was delt by repurposing staff from other departments to the essential care services. Fears related to pandemic was one of the main concerns reported among staff and patients. Several initiatives were taken to ensure staff safety and uninterrupted service delivery to patients. The use of technology was an effective mechanism in preparing for the pandemic. CONCLUSION: This qualitative study helped in understanding the experiences of primary health care leaders during the COVID-19 pandemic. The facilities lacked overall preparedness at the beginning of the pandemic; however, many initiatives were taken in course of time to ensure smooth operations and continued service delivery to the patients.