scholarly journals Large increase in opportunistic testing for chlamydia during a pilot project in a primary health organisation

2013 ◽  
Vol 5 (2) ◽  
pp. 141 ◽  
Author(s):  
Sunita Azariah ◽  
Stephen McKernon ◽  
Suzanne Werder
Keyword(s):  
New Zealand ◽  
Management System ◽  
Pilot Project ◽  
Chlamydia Screening ◽  
Age Group ◽  
Transmitted Infection ◽  
Chlamydia Testing ◽  
Primary Health ◽  
Significant Difference

INTRODUCTION: The Auckland chlamydia pilot project was one of three funded by the Ministry of Health to trial implementation of the 2008 Chlamydia Management Guidelines. Chlamydia is the most commonly notified sexually transmitted infection in New Zealand. AIM: To increase opportunistic testing in under-25-year-olds and to improve documentation of partner notification in primary care. METHODS: A four-month pilot was initiated in Total Healthcare Otara using a nurse-led approach. Laboratory testing data was analysed to assess whether the pilot had any impact on chlamydia testing volumes in the target age-group. Data entered in the practice management system was used to assess follow-up and management of chlamydia cases. RESULTS: During the pilot there was a 300% increase in the number of chlamydia tests in the target age-group from 812 to 2410 and the number of male tests increased by nearly 500%. Twenty-four percent of people tested were positive for chlamydia, with no significant difference in prevalence by ethnicity. The pilot resulted in better documentation of patient follow-up in the patient management system. DISCUSSION: There was a large increase in chlamydia testing during the pilot with a high prevalence found in the population tested. Chlamydia remains an important health problem in New Zealand. The cost benefit of increased chlamydia screening at a population level has yet to be established. KEYWORDS: Chlamydia; notification, partner; pilot project; prevalence; primary health care

scholarly journals Effect of implementation intention on walking in people with diabetes

2020 ◽  
Vol 54 ◽  
pp. 103
Author(s):  
Marco Antonio Vieira da Silva ◽  
Thaís Moreira São-João ◽  
Marilia Estevam Cornelio ◽  
Fábio Luiz Mialhe
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Leisure Time Physical Activity ◽  
Intervention Strategy ◽  
Intervention Group ◽  
Implementation Intention ◽  
Control Group ◽  
Primary Health ◽  
Significant Difference

OBJECTIVE: To evaluate the effect of implementation intentions as an intervention strategy to promote walking in adults with type 2 diabetes mellitus (T2DM). METHODS: We conducted a controlled and randomized trial, with 12 months of follow-up, involving 65 people with T2DM recruited from primary health care units and allocated them in the control group (CG, n = 32) and intervention group (IG, n = 33). The IG received the implementation intention strategy to promote walking and the CG remained in follow-up for conventional treatment in primary health care. The researchers were blinded by anthropometric measurements and the filling of the instruments. RESULTS: After twelve months of follow up, the IG presented a statistically significant increase in the leisure time physical activity when compared with the CG (p = 0.0413) and showed a significant decrease in waist circumference (p = 0.0061). No significant difference was observed regarding body mass index and glycated hemoglobin among groups. CONCLUSIONS: Implementation intention was effective in promoting walking and improving clinical indicators in adults with T2DM.

scholarly journals An Exploration of Current Primary Care Practice Regarding Osteoporosis Assessment Following a Low Trauma Wrist Fracture in people aged 50 years and above in Wellington, New Zealand: A Quantitative Survey

2021 ◽  
Author(s):  
◽  
Nikola Florance
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
New Zealand ◽  
Fragility Fractures ◽  
Wrist Fracture ◽  
Local Context ◽  
Osteoporosis Prevention ◽  
Primary Health ◽  
Study Results

<p>Osteoporosis remains a major health issue worldwide. The impact of the condition and the fractures that can occur, can have significant debilitating impact and also incur substantial financial costs to healthcare systems. The burden of osteoporosis and the rate of osteoporotic fractures in New Zealand is comparable to other countries such as Australia, the United States and Europe. There is global literature evidence dating back as far as 1960, indicating that a fracture sustained after a simple trip or fall can be an indicator of osteoporosis. There is a need to ensure that fracture patients with a potential osteoporosis diagnosis, receive follow up care for assessment to treat any underlying bone health issue to prevent future fragility fractures, particularly, hip fractures. Due to limited formal literature sources describing the associated New Zealand context, the aim of this research work was to explore current practice for osteoporosis assessment following a fragility wrist fracture in the general practitioner (GP) primary health care setting in Wellington, New Zealand.  A quantitative cross-sectional descriptive survey of Wellington GPs was undertaken for this purpose. The reporting of study results were guided by the recommendations detailed within the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement on reporting observational studies (Vandenbroucke et al., 2014). 35 out of 297 GPs from 60 practices in the Wellington region responded to the survey. When describing the local context in Wellington, New Zealand, study results showed that almost three quarters of Wellington GP survey respondents follow up patients who have sustained a potential fragility wrist fracture. The discharge summary was also shown to be a vital part of the communication process between the tertiary and primary health care sectors, acting as a prompt to the GP for further investigation. The single biggest barrier inhibiting processes to enable timely osteoporosis treatment as perceived by GP survey respondents, was lack of public funding, in particular to support availability of diagnostic Dual Energy X-ray Absorptiometry (DEXA) scanning.  Other barriers were identified by the GP survey respondents, such as anti-osteoporosis medication side effects, patient compliance to treatment plans and a lack of time within the scheduled consultation to screen patients for osteoporosis. The main educational resources that a large percentage of GP survey respondents independently accessed on a regular basis, were those that were readily available. These included GP guidelines published by “Osteoporosis New Zealand” and possibly other, and online resources such as “Health Pathways” (a best-practice, condition-specific guideline and information resource for primary health care practitioners - https://3d.healthpathways.org.nz). The results also highlighted that most GP survey respondents preferred to take the lead role in the care for patients needing to undergo osteoporosis investigation and treatment. In addition, the GP survey respondents demonstrated a high level of knowledge regarding osteoporosis risk factors.  In summary, this study has identified features of practice with regards to osteoporosis assessment following a fragility wrist fracture in the Wellington region. In addition, this study has also enabled identification of specific areas that could be better supported and resourced to assist GP’s in the prevention of secondary fragility fractures. These include highly visible public health campaigns to raise public awareness of osteoporosis and education to GP’s regarding the available screening tools. A significant finding was also that the GP respondents in this study indicated they considered that an important part of their role was responsibility for osteoporosis prevention and treatment. The study results also highlight that despite funding issues, GP survey respondents view osteoporosis prevention and treatment as best placed in the care of the primary health care sector.  This is the first New Zealand study that has identified and described the local context around current practice for fragility wrist fracture care within the Wellington GP community, establishing important reference points which can be used to support further development and research.</p>

scholarly journals Management of Edentulous Resorbed Mandibular Residual Ridge in Malaysian Geriatric Patients: 2-Year Clinical Study

2013 ◽  
Vol 3 (2) ◽  
pp. 83-86
Author(s):  
Ammar A Mustafa
Keyword(s):  
Clinical Study ◽  
Geriatric Patients ◽  
Complete Denture ◽  
Polished Surface ◽  
Neutral Zone ◽  
Age Group ◽  
Complete Dentures ◽  
Significant Difference ◽  
Improve Stability

ABSTRACT Objectives A combination of the neutral zone and the polished surface impression techniques is a useful method to reserve the functional and physiological forms of the underlying mandibular residual ridge by enhancing both retention and stability in Malaysian geriatric patients (2-year clinical study). Materials and methods A total of 25 Malaysian geriatric patients have participated in the current study. Two sets of dentures were served to the patients. The first set was constructed according the conventional method of complete denture construction whereas the second set was constructed by using neutral zone and polished surface impression techniques. Results The patients were followed up for 2 years and the obtained results showed that all patients have stopped using the conventional dentures and continued with the test dentures. The comparative analysis exhibited significant difference (p < 0.05) in favor of test dentures. Conclusion Combination of the neutral zone and the polished surface techniques can impart a physiological reservation to the underlying residual ridge without changes. Statement of problem It is common for completely edentulous geriatric patients to have resorbed mandibular residual ridge because of the process of aging. Some surgical interactions are contraindicated for this age group of patients, so, neutral zone technique and/or polished surface impression verified effective in improving stability for lower complete dentures. In spite of the fact that the above mentioned methods often used to enhance stability of complete denture, most of the studies were relying on only one of those methods to improve stability rather than retention. Researcher hypothesis stated that a combination of the neutral zone and the polished surface impression techniques should be performed together to enhance both stability and retention and henceforth reservation of the residual ridge under mandibular complete dentures issued to the patients with a constant follow-up for two consecutive years. How to cite this article Mustafa AA. Management of Edentulous Resorbed Mandibular Residual Ridge in Malaysian Geriatric Patients: 2-Year Clinical Study. Int J Prosthodont Restor Dent 2013;3(2):83-86.

scholarly journals Filling in the gaps: estimating numbers of chlamydia tests and diagnoses by age group and sex before and during the implementation of the English National Screening Programme, 2000 to 2012

2017 ◽  
Vol 22 (5) ◽  
Author(s):  
Nastassya L Chandra ◽  
Kate Soldan ◽  
Ciara Dangerfield ◽  
Bersabeh Sile ◽  
Stephen Duffell ◽  
...  
Keyword(s):  
Age Groups ◽  
Chlamydia Screening ◽  
Surveillance Systems ◽  
Age Group ◽  
Publicly Funded ◽  
Reference Dataset ◽  
Chlamydia Testing ◽  
Diagnosis Rate ◽  
Monitoring And Surveillance ◽  
The Impact

To inform mathematical modelling of the impact of chlamydia screening in England since 2000, a complete picture of chlamydia testing is needed. Monitoring and surveillance systems evolved between 2000 and 2012. Since 2012, data on publicly funded chlamydia tests and diagnoses have been collected nationally. However, gaps exist for earlier years. We collated available data on chlamydia testing and diagnosis rates among 15–44-year-olds by sex and age group for 2000–2012. Where data were unavailable, we applied data- and evidence-based assumptions to construct plausible minimum and maximum estimates and set bounds on uncertainty. There was a large range between estimates in years when datasets were less comprehensive (2000–2008); smaller ranges were seen hereafter. In 15–19-year-old women in 2000, the estimated diagnosis rate ranged between 891 and 2,489 diagnoses per 100,000 persons. Testing and diagnosis rates increased between 2000 and 2012 in women and men across all age groups using minimum or maximum estimates, with greatest increases seen among 15–24-year-olds. Our dataset can be used to parameterise and validate mathematical models and serve as a reference dataset to which trends in chlamydia-related complications can be compared. Our analysis highlights the complexities of combining monitoring and surveillance datasets.

scholarly journals The Relationship between General Aviation Pilot Age and Accident Rate

2020 ◽  
Vol 39 (3) ◽  
pp. 506-516
Author(s):  
Raja Muhammad Riaz ◽  
Khawar Naeem ◽  
Abdul Salam Khan ◽  
Muhammad Abas ◽  
Misbah Ullah
Keyword(s):  
Normal Distribution ◽  
Linear Relationship ◽  
Statistical Difference ◽  
General Aviation ◽  
Age Group ◽  
Accident Rate ◽  
Significant Difference ◽  
The Mean ◽  
The Relationship

The purpose of this study is to assess the relationship between the number of accidents and pilot’s age. The pilot considered for this study is General Aviation Pilot. Normal distribution of the accidents shows the mean pilot’s age <MEAN age> = 54.60 with S. Dage = 14.38. There is a non-linear relationship between pilot’s age and accident rate and there is a significant difference in accidents across the age intervals F(19, 234) = 9.3116, p < 0.0001. There is no statistical difference in the number of accidents between the interval 40-70 age group. Also, there is statistical difference in the number of accidents above and below 60-year age with respect to event severity and cause of accident (Wiki’s lemma= 0.36, F(26, 160) = 4.00, p < 0.0001). The follow up shows that the number of fatal and non-fatal accidents were statistically different for both above F(2, 92) = 4.58, p < 0.0127 and for below F(2,129) = 7.2, p < 0.0011 while the number of accidents with respect to its causes above 60 are not statistically different but there is statistical difference (F = (5, 126) = 8.74, p < 0.0001) in the number of accidents caused by pilot and caused by technical fault or weather/wind in the age group below 60.

scholarly journals COMPARATIVE EVALUATION OF THE EFFICACY OF 4% MANGOSTEEN GEL AND 1% CHLORHEXIDINE DIGLUCONATE GEL IN MANAGEMENT OF PATIENTS WITH CHRONIC GINGIVITIS: A RANDOMIZED CLINICAL TRIAL

2022 ◽  
Vol 12 (6) ◽  
pp. 6-11
Author(s):  
Vinayaka A.M. ◽  
Gayathri G.V. ◽  
Triveni M.G.
Keyword(s):  
Clinical Trial ◽  
Plaque Index ◽  
Age Group ◽  
Chlorhexidine Digluconate ◽  
Gingival Index ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B

To clinically evaluate & compare the efficacy of 4% Mangosteen Gel and 1% chlorhexidine digluconate gel in managing patients with chronic gingivitis. Materials and Methods: A total of 50 patients with an age group of 20-45 years diagnosed with generalized plaque-induced gingivitis were selected for this clinical trial once attaining their informed consent. A thorough case history was chronicled comprising plaque index (P.I.), gingival index (G.I.) and Sulcus bleeding index (SBI) at baseline; then full-mouth scaling and polishing (SAP) was performed by a solitary attuned examiner. Patients were then randomly assigned into two groups using a computer-generated random numbering sequence system. Patients in group A received 4% Mangosteen Gel, and group B received 1% chlorhexidine digluconate gel for home application. The post-treatment follow-up examination for P.I., G.I. and SBI changes were assessed after 14 days and 21 days and compared with baseline data. Results: In both the groups, the mean plaque index, gingival index and sulcus bleeding index scores were significantly decreased after the 14th and 21st day compared to baseline scores. There was no significant difference between the groups, but only in group B, there was a substantial difference in SBI scores observed on day 21. Conclusion: 4% Mangosteen Gel and 1% chlorhexidine digluconate gel were clinically effective when used as an adjunct to SAP in managing patients with gingivitis. Hence, 4% Mangosteen Gel can be considered an alternative to 1% chlorhexidine digluconate gel without any side effects in managing generalized plaque-induced gingivitis.

Chlamydia Screening

2008 ◽  
Vol 1 (11) ◽  
pp. 737-742 ◽  
Author(s):  
Chantal Simon
Keyword(s):  
Early Detection ◽  
Disease Transmission ◽  
Screening Programme ◽  
Asymptomatic Infection ◽  
Chlamydia Infection ◽  
Chlamydia Screening ◽  
Age Group ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
The Uk

Chlamydia is the most common sexually transmitted infection (STI) in the UK. It is asymptomatic in 70% of infected women and 50% of infected men and so often goes undiagnosed. Between 2000 and 2004, the rate of new diagnoses of chlamydia among people who attended Genito-urinary medicine clinics greatly increased from 116 to 175/100 000 ( Fig. 1 ), with the largest increases in chlamydia rates occurring in the under 16 age group. However, the highest rates of chlamydia infection are seen in females aged between 16 and 19 years (1339/100 000) and males aged 20–24 years (1034/100 000). The National Chlamydia Screening Programme (NCSP) in England was established in 2003 with the objective of controlling chlamydia through the early detection and treatment of asymptomatic infection, thus preventing the development of sequelae and reducing onward disease transmission. Similar programmes are underway in the rest of the UK.

scholarly journals Depressive symptoms among clients attending monk healers and primary care clinics in Thailand: a comparative follow-up study

2021 ◽  
Vol 22 ◽  
Author(s):  
Supa Pengpid ◽  
Karl Peltzer
Keyword(s):  
Primary Care ◽  
Depressive Symptoms ◽  
Baseline Assessment ◽  
Primary Care Clinics ◽  
Primary Health ◽  
Significant Difference ◽  
Health Centres ◽  
Mixed Modelling ◽  
Condition Interaction

Abstract Background: The aim of this study was to conduct a comparative follow-up assessment of clients with depressive symptoms attending monk healers or primary care clinics in Thailand. Methods: Consecutively attending clients of three monk healing and three primary care centres who screened positive (a score of 9 or more) on the Primary Health Questionnaire (PHQ)-9 at the study site were followed up at 3 months after baseline assessment. Results: In 3 monk healer sites, 448 clients agreed to be screened with the PHQ-9 for depression, and 94 screened positive, and in 3 health centres 582 clients agreed to be screened, and 92 screened positive for depressive symptoms on the PHQ-9. In 2 monk healing sites, 79 clients (84%) were followed up at 3 months, and in 3 health centres, 79 clients (85.9%) were followed up at 3 months. At 3-month follow-up, mixed modelling found significant interaction effects (a time-by-condition interaction, i.e., between-group changes) on depression scores (P = <0.001). Depressive symptoms significantly decreased over time, but there was no significant difference in decline between the two groups. Conclusion: Clients attending monk healers decreased more in depressive scores compared to clients attending primary care centres, though there was no group effect with respect to number of depressed clients.

scholarly journals Increasing Chlamydia Testing Rates via Targeted Outreach

PRiMER ◽  
2019 ◽  
Vol 3 ◽  
Author(s):  
Deyze Badarane ◽  
Jordan Knox ◽  
Ana Camacho ◽  
Michael K. Magill ◽  
Sonja Van Hala ◽  
...  
Keyword(s):  
The United States ◽  
Chlamydia Screening ◽  
Clinical Settings ◽  
Screening Rate ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Chlamydia Testing ◽  
Maximum Test ◽  
Increased Risk ◽  
Patient Outreach

Background and Objectives: Chlamydia trachomatis is the most prevalent bacterial sexually transmitted infection (STI) in the United States. Annual chlamydia screening of asymptomatic, sexually active women age 16 to 24 years and of older women who are at increased risk for infection is recommended. This study built on prior work in which our university-based family medicine clinic implemented quality improvement (QI) interventions in 2016 and 2017 to increase our chlamydia screening rate. Our primary aim in the current study was to increase the screening rate by 10%. Our secondary aim was to determine the number of patient contacts that yielded maximum test rates. Methods: For the most recent QI cycle, we conducted a prospective cohort study from December 2017 through March 2018. Using the FOCUS-PDSA model, a resident-led, interdisciplinary QI team developed the aims and implemented an intervention to streamline patient outreach. We also retrospectively analyzed data from the previous QI cycle to determine the number of tests obtained after each patient contact. Results: Chlamydia testing increased from 54% to 56.3% between December 2017 and March 2018. The majority of tests were completed by four patient contacts; additional contacts yielded few additional tests. Conclusions: Persistent outreach increases chlamydia screening rates. This QI project could be replicated in other clinical settings to improve the screening of chlamydia or other diseases.

scholarly journals Establishment of Egyptian developmental screening chart for infants from birth up to 30 months

2020 ◽  
Author(s):  
Ali M. El Shafie ◽  
Zein A.L. Omar ◽  
Mai M. Bashir ◽  
sorour fayez mahmoud ◽  
El-sayedamr M. Basma ◽  
...  
Keyword(s):  
Early Detection ◽  
Developmental Delay ◽  
Screening Tool ◽  
Mental Development ◽  
Developmental Screening ◽  
Age Group ◽  
Culturally Appropriate ◽  
Z Score ◽  
Significant Difference

Abstract Background: Detecting developmental delay in infants is an ongoing world commitment, especially for those below three years old. Early detection prevents the adverse outcomes in this critical period of age. To accurately assess the development of children; a culturally appropriate screening tool must be used. Egypt lacks such tool and multiple studies have shown that western tools are not suitable in other cultures.Objectives: To establish sufficient easy, rapid, culturally appropriate and applicable screening chart for early detection of developmental delay among Egyptian infants from birth up to 30 months.Methods: A cross sectional study was carried out on 1503 Egyptian infants of both genders aged from birth up to 30 months assumed to have normal development according to the inclusion and exclusion criteria. They were selected from vaccination centers and well-baby clinics. Developmental milestones from Baroda development screening test (BDST) were applied on them. Egyptian infants' developmental millstones scores were analyzed and carefully prepared in tables and charts. 97% pass levels of developmental achievements of infants represent the threshold below which infants are considered delayed. A z-score chart for motor and mental development follow up was designed by calculating each age group achievement.Results: The designed Egyptian Developmental Screening Chart (EDSC) is represented in a chart format with two curves 50% and 97% pass level. Infants considered delayed when infant's score below 97% pass level. Results revealed a statistically significant difference between Egyptian and Baroda chart at 50% and 97%pass levels.Conclusions: Extensive revision of the BDST was needed in order to create a more culturally appropriate Egyptian screening chart. This is the first study to create an Egyptian-specific screening tool, to be rapid and easy to use in Egypt for early detection of developmental delay and enabling early intervention practices. A z-score curve is reliable for follow up motor and mental development by calculating each age group achievement.

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