Remote Monitoring of Patient- and Family-Generated Health Data in Pediatrics.

In this article, we provide an overview of remote monitoring of pediatric PGHD and family-generated health data, including its current uses, future opportunities, and implementation resources.

Neglected Parasitic Infections: What Family Physicians Need to Know-A CDC Update.

Chagas disease, cysticercosis, and toxoplasmosis affect millions of people in the United States and are considered neglected parasitic diseases. Few resources are devoted to their surveillance, prevention, and treatment. Chagas disease, transmitted by kissing bugs, primarily affects people who have lived in Mexico, Central America, and South America, and it can cause heart disease and death if not treated. Chagas disease is diagnosed by detecting the parasite in blood or by serology, depending on the phase of disease. Antiparasitic treatment is indicated for most patients with acute disease. Treatment for chronic disease is recommended for people younger than 18 years and generally recommended for adults younger than 50 years. Treatment decisions should be individualized for all other patients. Cysticercosis can manifest in muscles, the eyes, and most critically in the brain (neurocysticercosis). Neurocysticercosis accounts for 2.1% of all emergency department visits for seizures in the United States. Diagnosing neurocysticercosis involves serology and neuroimaging. Treatment includes symptom control and antiparasitic therapy. Toxoplasmosis is estimated to affect 11% of people older than six years in the United States. It can be acquired by ingesting food or water that has been contaminated by cat feces; it can also be acquired by eating undercooked, contaminated meat. Toxoplasma infection is usually asymptomatic; however, people who are immunosuppressed can develop more severe neurologic symptoms. Congenital infection can result in miscarriage or adverse fetal effects. Diagnosis is made with serologic testing, polymerase chain reaction testing, or parasite detection in tissue or fluid specimens. Treatment is recommended for people who are immunosuppressed, pregnant patients with recently acquired infection, and people who are immunocompetent with visceral disease or severe symptoms.

Innovative applications of informatics for families, systems, and health: Introduction to the special issue.

The articles included in this special issue of Families, Systems, & Health on informatics represent distinct elements of health informatics relevant to the implementation and provision of clinical services. Informatics is the collection, analysis, and application of data for direct care decisions in health care and an interdisciplinary field that brings medicine together with computer, cognitive, and social sciences. We frame the contributions of the included articles within the framework of the Quadruple Aim for health care: better outcomes, lower costs, improved patient satisfaction, and improved work life of health care providers. The examples provided aim to show how health informatics provides opportunities to improve care delivered to patients at individual and system levels while both identifying and closing gaps in research addressing the management and use of information generated in the course of delivering health care. The articles in this special issue reflect the cutting edge of health care, research and technology, where there is as much risk as there is promise of delivering stability to our dynamic health care system. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Development and feasibility of a Configurable Assessment Messaging Platform for Interventions (CAMPI).

INTRODUCTION: Short message service (SMS) is a widely accepted telecommunications approach used to support health informatics, including behavioral interventions, data collection, and patient-provider communication. However, SMS delivery platforms are not standardized and platforms are typically commercial "off-the-shelf" or developed "in-house." As a consequence of platform variability, implementing SMS-based interventions may be challenging for both providers and patients. Off-the-shelf SMS delivery platforms may require minimal development or technical resources from providers, but users are often limited in their functionality. Conversely, platforms that are developed in-house are often specified for individual projects, requiring specialized development and technical expertise. Patients are on the receiving end of programming and technical specification challenges; message delays or lagged data affect quality of SMS communications. To date, little work has been done to develop a generalizable SMS platform that can be scaled across health initiatives. OBJECTIVE: We propose the Configurable Assessment Messaging Platform for Interventions (CAMPI) to mitigate challenges associated with SMS intervention implementation (e.g., programming, data collection, message delivery). METHOD: CAMPI aims to optimize health data captured from a multitude of sources and enhance patient-provider communication through a technology that is simple and familiar to patients. Using representative examples from three behavioral intervention case studies implemented among diverse populations (pregnant women, young sexual minority men, and parents with young children), we describe CAMPI capabilities and feasibility. CONCLUSION: As a generalizable SMS platform, CAMPI can be scaled to meet the priorities of various health initiatives, while reducing unnecessary resource utilization and burden on providers and patients. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Reducing the Impact of Anti-Vaccine Propaganda on Family Health.

Emeritus Professor Alan Glasper from the University of Southampton discusses strategies to enhance Covid-19 and other vaccine uptake among some families and groups in society who are adversely influenced by so called anti-vaxxers.

COVID-19 threatens maternal mental health and infant development: possible paths from stress and isolation to adverse outcomes and a call for research and practice.

The COVID-19 pandemic exposed mothers to stress and social isolation during the pre- and post-natal periods. The deleterious effects of stress on both pregnant women and their infants are well documented, with research suggesting that effects are exacerbated by reduced social support. In this brief report, we summarize evidence linking stress and social isolation to negative outcomes for mothers and infants and present a conceptual model featuring inflammation as a driving mechanism. There is strong evidence that the coronavirus pandemic will affect mothers and infants through immune pathways that, in previous research, have been shown to link stress and social isolation during the pre- and post-natal periods with deficits in maternal mental health and infant well-being and development across developmental stages. We close with recommendations for novel research, policy changes, and integrated clinical care that can address these biological threats to infants and mothers while leveraging the anti-inflammatory effects of social support.

A parent-sibling dyadic interview to explore how an individual with Autism Spectrum Disorder can impact family dynamics.

BACKGROUND: Autism Spectrum Disorder (ASD) is a life-long condition which affects the individual and their family system. Little research understands the impact of an ASD upon families, how this may change over time and how COVID-19 has impacted these dynamics. AIMS: To explore the impact of an ASD on the lived experiences of parents and neurotypical adult siblings, including during the UK COVID-19 lockdown. METHODS: Eight parent-sibling dyads (16 individuals) completed semi-structured interviews discussing their family before, during and after receiving the ASD diagnosis, and in relation to the first UK lockdown. Interview transcripts were analysed using Interpretative Phenomenological Analysis. RESULTS: Three super-ordinate themes were identified: Dominated by ASD; Family Cohesion; and the Need for Support. CONCLUSIONS: The data suggested a closeness within the families and an adoration towards the individual with ASD (IWA). Dyads were, to an extent, consumed by the diagnosis both presently and in the future, implicating the need for a stretch in services to support parents and neurotypical siblings. In terms of the first UK lockdown, the IWA added an extra layer of difficulty to the dyads work-life balance yet there was an essence of family cohesion. Future research should consider longitudinal methods and explore the impact of ASD co-morbidities upon family dynamics.

Distance support and online intervention to blind and visually impaired children during the pandemic COVID-19.

The COVID-19 pandemic imposed dramatic changes to everyone's daily routines, but especially to children with developmental disabilities. The Robert Hollman Foundation decided not to interrupt its service to all the visually impaired children and initiated a Distance Support Project. It was an online process covering all aspects of support for the children and involving audio-video calls, videos and tailored-made multisensory material created specifically for each child. A questionnaire, carried out after the 5-month project duration, was created to collect feedback from parents and professionals to understand the impact this project had on everyone involved. Overall both parents and professionals indicated high levels of satisfaction, but in a significant number of questions parents reported consistently higher levels of satisfaction (p-value <0.001). It was shown that parents felt reassured at this otherwise very difficult time because their children were able to continue their treatment, even if in a very different way. This fact encourages us to consider enriching our existing programmes of support and care, integrating this online approach when necessary. At the same time, it seems clear that the responses of the professionals indicate their belief that the benefits of the traditional ways of working remain of unquestionable importance for children with sight deprivation.

Conicity index in people with hypertension followed in the Brazil's Family Health Strategy.

OBJECTIVES: to analyze the conicity index in people with hypertension followed in the Brazil's Family Health Strategy. METHODS: cross-sectional study conducted in a medium-sized municipality located in the state of Paraná. Data collection took place in the first semester of 2016. using an adapted and validated instrument. which addresses attributes of Primary Health Care. Sociodemographic and anthropometric variables and blood pressure were used in the study. The analysis of variance and linear regression was used to analyze the variables. RESULTS: a total of 417 people participated in the study. most were women. elderly. married. with less than eight years of education and retired. Conicity index was prevalent in most of the study population. being significantly associated with the group of people with inadequate blood pressure control and high anthropometric parameters. CONCLUSIONS: most of the study participants had altered conicity index. especially those with inadequate blood pressure control.

The quality of life of family health professionals: a systematic review and meta-synthesis.

OBJECTIVES: to perform a systematic review and meta-synthesis of qualitative studies about the work-related quality of life of Family Health Strategy professionals. METHODS: this systematic review was developed to answer the following PVO question: "Which factors (variables) are associated with the work-related quality of life (outcome) of Family Health Strategy professionals (population)?" The PubMed, Scopus, Embase, SciELO, Web of Science, LILACS, Science Direct, OpenThesis, OpenGrey, and OATD databases were selected. The meta-synthesis analyzed the main codes and secondary codes of all included studies. RESULTS: the database search resulted in 1,744 reports; six were considered eligible for the meta-synthesis. Four factors were considered for the quality of work life: working conditions; work processes; interpersonal relationships; and personal aspects. CONCLUSIONS: although this study confirms the adequacy of aspects commonly related to the quality of work life, other factors are important in the case of FHS professionals, especially work context.

"Landpartie 2.0" - Conceptual development and implementation of a longitudinal priority program to promote family medicine in rural areas.

Objective: This article reports on the conceptual development and subsequent implementation of a targeted and attractive general practice teaching program in a rural area for students of human medicine at the medical faculty of Goethe University, Frankfurt am Main. Project description: Since the 2016/2017 winter semester, usually up to 15 interested students a year have had the opportunity to participate in the longitudinal priority program "Landpartie 2.0". The program runs for six semesters during the clinical stage of medical studies and consists of regular internships during which the students receive one-to-one support in a family practice, and participate in a series of seminars and an annual one-day excursion. The aim is to enable students, early on in their studies and without any obligations, to gain uninterrupted experience of providing patient care, and to find out what it means to pursue a career in family medicine. Results: Since the beginning of the annual program, 62 students have been included in it. The initial results show that the different elements of the program fulfil the expectations and requirements of participants and that their overall level of satisfaction is high. Almost 95% of students reported that they felt their knowledge had increased as a result of the internships, and they rated them as a useful part of their medical education. Despite the rural focus of the program, around half of the participants were of urban origin. Conclusion: The "Landpartie 2.0" provides students with the opportunity to familiarize themselves with family health care in a rural area. Further studies should investigate to what extent the program encourages students to continue their training with a view to pursuing a career in family medicine.

Effects of a family diabetes self-management education intervention on the patients' supporters.

INTRODUCTION: Diabetes self-management education (DSME) programs that engage the families of patients with diabetes have shown to be effective in improving diabetes-related outcomes of the patients. The health effects of these "family models" of DSME on participating family members are rarely studied. Opportunity exists for the participating family members to benefit from the healthy lifestyle recommendations offered through such programs. METHOD: Using data from a randomized controlled trial to assess the effect of family DSME compared to standard DSME among Marshallese adults with Type 2 diabetes, this study examined baseline to 12-month changes in A1c, body mass index (BMI), food consumption, and physical activity among participating family members, comparing outcomes of family members based on attended at least 1 (n = 98) versus attended no (n = 44) DSME sessions. RESULTS: Overall, family member attendance was low. There were no differences in the level of change from baseline to 12 months for A1c, BMI, food consumption, and physical activity between groups. After controlling for attendance and sociodemographic measures, lowering of BMI was the only significant predictor of not having an A1c level indicative of diabetes at 12 months. DISCUSSION: Future research on family DSME should consider ways to improve family member attendance; have them set their own health improvement goals; and integrate healthy lifestyle education, such as healthy eating and being physically active, along with the DSME core content to create an added benefit of diabetes prevention for participating family members. The limitations of this study and recommendations for future research are provided. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

National Primary Health Care Policy: where are we headed to? / Política Nacional de Atenção Básica: para onde vamos?

This paper analyzes recent policies in the field of Primary Health Care (PHC) and their possible implications for the care model in the Unified Health System (SUS). Initially, some of the concepts that influenced the models of care in the Brazilian public system are revived, and we argue that the Family Health Strategy (ESF) bases for reorienting care practices in primary care are consistent with the principles of the SUS. Below, we analyze the central elements of new federal policies for PHC. We show that changes in the PHC care model threaten the teams' multidisciplinarity, prioritize acute illness care, focus in individual care, weaken the community territorial approach and establish coverage by registration, which evidence redirection of the health policy, harming the principles of universality, integrality, and equity in the SUS.

O artigo analisa políticas recentes no campo da Atenção Primária à Saúde (APS) e suas possíveis implicações para o modelo assistencial no Sistema Único de Saúde (SUS). Inicialmente resgatam-se algumas das concepções que influenciaram os modelos de atenção no sistema público brasileiro e argumenta-se que a Estratégia Saúde da Família (ESF) apresenta as bases para reorientação das práticas assistenciais na atenção básica coerentes com os princípios do SUS. A seguir, analisam-se elementos centrais de políticas federais recentes para a APS. Demonstra-se que as mudanças no modelo assistencial da APS com ameaças à multiprofissionalidade das equipes, prioridade ao pronto atendimento, centralidade no cuidado individual, enfraquecimento do enfoque territorial comunitário e cobertura por cadastramento, evidenciam redirecionamento da política de saúde, ferindo os princípios da universalidade, integralidade e equidade no SUS.

Política Nacional de Atenção Básica: para onde vamos? / National Primary Health Care Policy: where are we headed to?

Resumo O artigo analisa políticas recentes no campo da Atenção Primária à Saúde (APS) e suas possíveis implicações para o modelo assistencial no Sistema Único de Saúde (SUS). Inicialmente resgatam-se algumas das concepções que influenciaram os modelos de atenção no sistema público brasileiro e argumenta-se que a Estratégia Saúde da Família (ESF) apresenta as bases para reorientação das práticas assistenciais na atenção básica coerentes com os princípios do SUS. A seguir, analisam-se elementos centrais de políticas federais recentes para a APS. Demonstra-se que as mudanças no modelo assistencial da APS com ameaças à multiprofissionalidade das equipes, prioridade ao pronto atendimento, centralidade no cuidado individual, enfraquecimento do enfoque territorial comunitário e cobertura por cadastramento, evidenciam redirecionamento da política de saúde, ferindo os princípios da universalidade, integralidade e equidade no SUS.

Abstract This paper analyzes recent policies in the field of Primary Health Care (PHC) and their possible implications for the care model in the Unified Health System (SUS). Initially, some of the concepts that influenced the models of care in the Brazilian public system are revived, and we argue that the Family Health Strategy (ESF) bases for reorienting care practices in primary care are consistent with the principles of the SUS. Below, we analyze the central elements of new federal policies for PHC. We show that changes in the PHC care model threaten the teams' multidisciplinarity, prioritize acute illness care, focus in individual care, weaken the community territorial approach and establish coverage by registration, which evidence redirection of the health policy, harming the principles of universality, integrality, and equity in the SUS.

Child and family health nursing: A workforce profile.

AIMS AND OBJECTIVES: To develop a profile of registered nurses working in Child and Family Health services across the Northern Sydney Local Health District to inform workforce strategic planning. BACKGROUND: Child and family health nurses (CFHNs) are registered nurses holding recognized qualifications in child and family health. To date, information regarding Child and family health nurses has been very limited. METHODS: The survey was conducted using a self-administrated online questionnaire between March-June 2017. RESULTS: Just over 75% of the respondents were aged over 50 years. Job satisfaction and feeling valued are enablers for remaining in current positions and not feeling valued can contribute to leaving employment. Nearly, one-third of respondents are currently a carer. CONCLUSION: This study provides an insight into the demographics of Child and family health nurses in Northern Sydney Local Health District, including roles as carers. It also examines factors influencing Child and family health nurses to remain or leave current positions. IMPLICATION FOR NURSING MANAGEMENT: This survey has drawn attention to the need for managers to urgently develop strategies, for example succession planning, to ensure that shortages of these experienced Child and family health nurses do not occur. The inability to staff Child and Family Health could potentially impact on the ability to provide services and meet key performance indicators.

Conicity index in people with hypertension followed in the Brazil's Family Health Strategy / Índice de conicidad en personas con hipertensión en seguimiento con la Estrategia de Salud Familiar / Índice de conicidade em pessoas com hipertensão arterial acompanhadas pela Estratégia Saúde da Família

ABSTRACT Objectives: to analyze the conicity index in people with hypertension followed in the Brazil's Family Health Strategy. Methods: cross-sectional study conducted in a medium-sized municipality located in the state of Paraná. Data collection took place in the first semester of 2016. using an adapted and validated instrument. which addresses attributes of Primary Health Care. Sociodemographic and anthropometric variables and blood pressure were used in the study. The analysis of variance and linear regression was used to analyze the variables. Results: a total of 417 people participated in the study. most were women. elderly. married. with less than eight years of education and retired. Conicity index was prevalent in most of the study population. being significantly associated with the group of people with inadequate blood pressure control and high anthropometric parameters. Conclusions: most of the study participants had altered conicity index. especially those with inadequate blood pressure control.

RESUMEN Objetivos: analizar el índice de conicidad en personas con hipertensión en tratamiento de seguimiento con la Estrategia de Salud Familiar. Métodos: estudio transversal realizado en un municipio de tamaño medio ubicado en el estado de Paraná. Los datos se recopilaron en el primer semestre de 2016. utilizando un instrumento adaptado y validado. que aborda los atributos de la Atención Primaria de Salud. En este estudio. se utilizaron las variables sociodemográficas. antropométricas y las mediciones de la presión arterial. El análisis de varianza y regresión lineal se utilizó para tratar las variables. Resultados: participación de 417 personas en el estudio. la mayoría mujeres. ancianos. casados. con menos de ocho años de estudio y jubilados. El índice de conicidad prevaleció en la mayoría de la población de estudio. con una asociación significativa con el grupo de personas con control inadecuado de la presión arterial y parámetros antropométricos altos. Conclusiones: la mayoría de los participantes en el estudio tenían un índice de variación alterado. especialmente aquellos con un control inadecuado de la presión arterial.

RESUMO Objetivos: analisar o índice de conicidade em pessoas com hipertensão arterial acompanhadas pela Estratégia Saúde da Família. Métodos: estudo transversal, realizado em um município de médio porte localizado no estado do Paraná. Os dados foram coletados no primeiro semestre de 2016, utilizando instrumento adaptado e validado, que aborda atributos da Atenção Primária à Saúde. Neste estudo, foram utilizadas variáveis sociodemográficas, antropométricas e medidas de pressão arterial. Empregou-se a análise de variância e regressão linear para o tratamento das variáveis. Resultados: participação de 417 pessoas, a maioria mulheres, idosas, casadas, com menos de oito anos de estudo e aposentadas. O índice de conicidade foi prevalente na maior parte da população estudada, com significativa associação ao grupo de pessoas com controle pressórico inadequado e parâmetros antropométricos elevados. Conclusões: a maioria dos participantes do estudo apresentou índice de conicidade alterado, principalmente as pessoas com controle pressórico inadequado.

The quality of life of family health professionals: a systematic review and meta-synthesis / Calidad de vida de profesionales de Salud de la Familia: una revisión sistemática y metasíntesis / Qualidade de vida de profissionais da Saúde da Família: uma revisão sistemática e metassíntese

ABSTRACT Objectives: to perform a systematic review and meta-synthesis of qualitative studies about the work-related quality of life of Family Health Strategy professionals. Methods: this systematic review was developed to answer the following PVO question: "Which factors (variables) are associated with the work-related quality of life (outcome) of Family Health Strategy professionals (population)?" The PubMed, Scopus, Embase, SciELO, Web of Science, LILACS, Science Direct, OpenThesis, OpenGrey, and OATD databases were selected. The meta-synthesis analyzed the main codes and secondary codes of all included studies. Results: the database search resulted in 1,744 reports; six were considered eligible for the meta-synthesis. Four factors were considered for the quality of work life: working conditions; work processes; interpersonal relationships; and personal aspects. Conclusions: although this study confirms the adequacy of aspects commonly related to the quality of work life, other factors are important in the case of FHS professionals, especially work context.

RESUMEN Objetivos: desarrollar una revisión sistemática y metaanálisis de estudios cualitativos sobre la calidad de vida relacionada al trabajo de profesionales de Salud de la Familia. Métodos: la revisión sistemática se desarrolló para responder la siguiente pregunta pautada en metodología PVO: "¿Cuáles factores (variables) están asociados con la calidad de vida relacionada al trabajo (resultado) de profesionales de Estrategia Salud de la Familia (población)?". Fueron seleccionadas las bases PubMed, Scopus, Embase, SciELO, Web of Science, LILACS, Science Direct, OpenThesis, OpenGrey y OATD. La metasíntesis analizó las categorías principales y subcategorías de todos los estudios incluidos. Resultados: la búsqueda en bases halló 1.744 registros, seis de ellos fueron considerados elegibles para la calidad de vida relacionada al trabajo: condiciones laborales, proceso de trabajo, relaciones interpersonales y aspectos personales. Conclusiones: Aunque este estudio confirme que algunos aspectos habitualmente relacionados con la calidad de vida son adecuados, hay otros factores importantes para los profesionales de Salud de la Familia, particularmente el ámbito laboral.

RESUMO Objetivos: desenvolver uma revisão sistemática e metanálise de estudos qualitativos sobre a qualidade de vida relacionada ao trabalho de profissionais da Saúde da Família. Métodos: a revisão sistemática foi desenvolvida para responder à seguinte questão pautada no método PVO: "Quais fatores (variáveis) estão associados com a qualidade de vida relacionada ao trabalho (resultado) de profissionais da Estratégia Saúde da Família (população)?" As bases de dados PubMed, Scopus, Embase, SciELO, Web of Science, LILACS, Science Direct, OpenThesis, OpenGrey e OATD foram selecionadas. A metassíntese analisou as categorias principais e subcategorias de todos os estudos incluídos. Resultados: a busca na base de dados resultou em 1.744 registros, e seis deles foram considerados elegíveis para a metassíntese. Quatro fatores foram considerados para a qualidade de vida relacionada ao trabalho: condições de trabalho, processo de trabalho, relações interpessoais e aspectos pessoais. Conclus ões : embora este estudo confirme a adequação de aspectos comumente relacionados à qualidade de vida no trabalho, outros fatores são importantes no caso dos profissionais da Saúde da Família, especialmente o contexto de trabalho.