scholarly journals Prediabetes Screening with American Diabetes Association (ADA) Scoring in the Primary Health Care Yogyakarta (Development And Validation Of Scoring Systems)

2020 ◽  
Vol 3 (2) ◽  
pp. 22
Author(s):  
Yaltafit Abror Jeem ◽  
Hari Koesnanto ◽  
Muhammad Robikhul Ikhsan
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Sensitivity And Specificity ◽  
American Diabetes Association ◽  
Scoring Systems ◽  
Tolerance Test ◽  
Screening Methods ◽  
Oral Glucose ◽  
Scoring Method ◽  
Primary Health

Background: Numerous studies have shown  the increasing of prediabetes incidence from the time being. Some of the prediabetes screening methods that can be performed at primary health care were American Diabetes Association (ADA) scoring for prediabetes. However, there was no data that describes the validity and applicability of the ADA scoring on prediabetes patients in Indonesia. Objective: To discribe prediabetes screening and to find out the applicability of the ADA scoring method in Yogyakarta primary health care. Method: The diagnostic test by scoring system of the ADA questionnaire was compared with OGTT (oral glucose tolerance test) as the gold standard. The subjects were patients of primary health care in Yogyakarta who fulfill the inclusion and exclusion criteria. Result: The subjects were 279 respondents with 227 female  (81.4%) and 52 male patients (18.6%). The mean age of the study subjects was 50.4 years (SD 12.81). The sensitivity and specificity of the scoring method of ADA was 61% and 71%. This could be influenced by the difference in BMI standard as one of the scoring items. Conclusion: Prediabetes prevalence was 11.1% in the study population. The sensitivity and specificity of the scoring method of ADA is 61% and 71%. The scoring method of ADA could not be used in primary health care.

scholarly journals Academic Promotion of Physicians in Medical Schools: A Special Focus on Primary Health Care in Taiwan

2021 ◽  
Vol 18 (18) ◽  
pp. 9615
Author(s):  
Hsin Ma ◽  
Feng-Yuan Chu ◽  
Tzeng-Ji Chen ◽  
Shinn-Jang Hwang
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Impact Factor ◽  
Research Output ◽  
Scoring Systems ◽  
Medical Schools ◽  
Special Focus ◽  
Academic Promotion ◽  
Journal Citation Reports ◽  
Primary Health

The quality and quantity of papers published in journals play a crucial role in achieving an academic promotion in medical schools. Reports on the criteria for promotion and their impact on different specialties, especially on primary health care, which has low research output, are rare. We investigated the scoring systems generally adopted for academic promotion at most medical schools in Taiwan. The weighted scores were derived from the multiplication of weights from categories of paper, journal impact factor, or ranking in a certain category by impact factor, and author order. To determine the thresholds of papers required for different levels of promotion, we took papers in the highest- or lowest-ranked journals in the primary health care category in 2019 Journal Citation Reports as examples. Considering publications in the highest-ranked journals, a median of 4.6 first or corresponding author papers were required for a professorship, as well as 3.3 for an associate professorship, and 2.5 for an assistant professorship. In contrast, a median of 30, 20, and 13.5 papers in the lowest-ranked journals was required for the corresponding positions. Thus, academic promotions for primary health care educators in Taiwan are highly demanding. The detrimental effects of scoring systems deserve further research.

scholarly journals Improving primary health care workers’ knowledge of cervical cancer and visual inspection screening techniques through competency-based training: prospects for expanding coverage in developing countries

2020 ◽  
Vol 7 (5) ◽  
pp. 1637
Author(s):  
Ibiyemi J. Umuago ◽  
Irikefe P. Obiebi ◽  
Godson U. Eze ◽  
Nnamdi S. Moeteke
Keyword(s):  
Health Care ◽  
Cervical Cancer ◽  
Primary Health Care ◽  
Health Care Workers ◽  
Visual Inspection ◽  
Screening Methods ◽  
Screening Techniques ◽  
Primary Health ◽  
Care Workers ◽  
Competency Based

Background: Health workers in resource-poor settings have not demonstrated a comprehensive knowledge of visual staining procedures for cervical cancer screening. This study adopted competency-based training (CBT) to determine if it will improve their knowledge, and potentially expand screening coverage.Methods: A quasi-experimental (pretest-posttest) design was adopted in this study conducted among primary health care workers in Ethiope-West Local Government Area of Delta State, Southern Nigeria. The participants had a competency-based training following an initial assessment of their knowledge. Data were analysed using SPSS version 22. The main outcome measures were baseline knowledge of cervical cancer, its prevention, and visual inspection screening techniques, as well as the effect of CBT on knowledge.Results: Participants demonstrated correct knowledge of cervical anatomy/physiology and cervical cancer epidemiology/symptomatology to varying degrees, although their knowledge of visual inspection with acetic acid or Lugol’s iodine (VIA/VILI) was grossly inadequate as only half had adequate knowledge. Knowledge of prevention, performance of VIA and VILI, as well as overall knowledge, improved significantly to 100% post-intervention (p=0.002, p<0.001 and p=0.003 respectively). Mean knowledge scores drastically increased among the PHWs between pre-CBT and post-CBT. The lowest mean difference was recorded for knowledge of cervical anatomy/physiology: 17.58 (CI: 8.16 - 27.00); while the highest was for knowledge of VILI/VIA technique: 41.01 (CI: 29.40 - 52.62).Conclusions: CBT significantly improved knowledge of cervical cancer prevention and visual inspection screening methods (VIA and VILI), indicating a window of opportunity for expanding screening services at primary health care level.

scholarly journals Early diagnosis of neonatal sepsis in primary health care unit

2015 ◽  
Vol 14 (2) ◽  
pp. 169-172 ◽  
Author(s):  
Aditya Prasad Sarkar ◽  
Goutam Dhar ◽  
Munmun Das Sarkar ◽  
Tapan Kumar Ghosh ◽  
Sulekha Ghosh
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Sensitivity And Specificity ◽  
Neutrophil Count ◽  
Neonatal Sepsis ◽  
Comparison Group ◽  
Medical Science ◽  
Standard Test ◽  
Haematological Parameters ◽  
Primary Health

Aim: The aim of the study is to find out the role of common haematological parameters along with micro-ESR, I/T ratio in diagnosis of neonatal sepsis for initiating early management.Methods: This is a descriptive study consisting of 35 neonates admitted at a sophisticated institute with clinical suspicion of septicaemia along with 40 neonates as the comparison group. The neonatal haematological parameters including total leucocytes count, absolute neutrophil count, immature neutrophil count, I/T ratio, platelet count were measured in all the neonates. Micro-ESR was measured as a bed side test. CRP was also measured using slide agglutination method and the results were compared with turbidimetric method. Blood culture was done as a gold standard test for sepsis. Micro-ESR more than age of the patient in days +3 mm in 1st hour was considered significant for sepsis. I/T ratio more than or equal to 0.2 was considered positive for sepsis.Results: The study revealed that micro-ESR and I/T ratio were significantly higher (p<0.001) in suspected cases of septicaemia as compared to the neonates in the comparison group. Sensitivity and specificity of micro-ESR were 87.09% and 75.0% respectively. Sensitivity and specificity of I/T ratio were 93.54% and 95% respectively.Conclusion: Micro-ESR and I/T ratio can be used effectively as cheap and simple tests to screen for septicaemia in neonate which is possible even in a primary health care centre.Bangladesh Journal of Medical Science Vol.14(2) 2015 p.169-172

How to screen for diabetes mellitus

1983 ◽  
Vol 104 (4_Suppl) ◽  
pp. S37-S41
Author(s):  
Per-Olof Bitzén ◽  
Arne Melander ◽  
Bengt Scherstén
Keyword(s):  
Diabetes Mellitus ◽  
Health Care ◽  
Primary Health Care ◽  
Blood Glucose ◽  
Glucose Tolerance ◽  
Time Of Day ◽  
Glucose Measurement ◽  
Control Group ◽  
Screening Methods ◽  
Primary Health

ABSTRACT. In an attempt to compare and evaluate different screening methods for diabetes mellitus in primary health care, urine and blood samples from 1082 consequtive patients were collected without any relation to meal or time of day. Urine glucose was determined by strip tests and quantitatively by the hexokinase method. Venous blood glucose was analysed by the hexokinase method and semiquantitatively by Dextrostix-Eyetone reflectance meter. 89 patients fulfilling the criteria for a positive screen were subjected to further diagnostic examination. 38 patients were classified as diabetics and 13 as having impaired glucose tolerance. In a control group randomly selected from negatively screened patients, all 30 patients had a normal glucose tolerance. It was found that random blood glucose measurement using 7.0 mmol/l as screening level had significantly higher sensitivity than all other screening methods with comparable specificity. Key words: Screening, diabetes mellitus, primary health care, methods, validity.

scholarly journals A clinical algorithm for triaging patients with significant lymphadenopathy in primary health care settings in Sudan

2013 ◽  
Vol 5 (1) ◽  
Author(s):  
Eltahir A.G. Khalil ◽  
Imad A. El Hag ◽  
Kamal E. Elsiddig ◽  
Mohamed E.M.O. Elsafi ◽  
Mona E.E. Elfaki ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Lymph Node ◽  
Sensitivity And Specificity ◽  
Predictor Variables ◽  
Reduced Model ◽  
Node Number ◽  
Major Health Problem ◽  
Clinical Algorithm ◽  
Primary Health

Background: Tuberculosis is a major health problem in developing countries. The distinction between tuberculous lymphadenitis, non-specific lymphadenitis and malignant lymph node enlargement has to be made at primary health care levels using easy, simple and cheap methods.Objective: To develop a reliable clinical algorithm for primary care settings to triage cases ofnon-specific, tuberculous and malignant lymphadenopathies.Methods: Calculation of the odd ratios (OR) of the chosen predictor variables was carried out using logistic regression. The numerical score values of the predictor variables were weighed against their respective OR. The performance of the score was evaluated by the ROC (ReceiverOperator Characteristic) curve.Results: Four predictor variables; Mantoux reading, erythrocytes sedimentation rate (ESR),nocturnal fever and discharging sinuses correlated significantly with TB diagnosis and were included in the reduced model to establish score A. For score B, the reduced model included Mantoux reading, ESR, lymph-node size and lymph-node number as predictor variables for malignant lymph nodes. Score A ranged 0 to 12 and a cut-off point of 6 gave a best sensitivity and specificity of 91% and 90% respectively, whilst score B ranged -3 to 8 and a cut-off point of3 gave a best sensitivity and specificity of 83% and 76% respectively. The calculated area underthe ROC curve was 0.964 (95% CI, 0.949 – 0.980) and -0.856 (95% CI, 0.787 ‑ 0.925) for scores Aand B respectively, indicating good performance.Conclusion: The developed algorithm can efficiently triage cases with tuberculous andmalignant lymphadenopathies for treatment or referral to specialised centres for furtherwork-up.

scholarly journals Awareness and utilization of cervical cancer screening services among primary health care providers in Zaria

2020 ◽  
Vol 2 (2) ◽  
Author(s):  
Anisah Yahya ◽  
Zubair Hadi Ismail ◽  
Umma Suleiman Bawa
Keyword(s):  
Health Care ◽  
Cervical Cancer ◽  
Primary Health Care ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Health Care Providers ◽  
Screening Methods ◽  
Care Providers ◽  
Primary Health ◽  
Primary Health Care Providers

Cervical cancer screening services have led to a significant decrease in the incidence of cervical cancer in countries were such services are implemented as population-based services. Cervical cancer still remains the most commonly diagnosed cancer in several countries in Sub-Saharan Africa and South Eastern Asia. This study explored the awareness, utilization and provision of cervical screening services among Primary Health Care providers in Zaria, Nigeria. A qualitative study was conducted among Primary Health Care providers in Zaria Local Government Area Kaduna State Nigeria. Five Primary Health Care centres were purposively selected for the study. Data was collected using Focus Group discussion method. The data from the discussion sessions were recorded on tape and transcribed verbatim to capture the exact messages. The transcripts were then analysed into themes. Majority of the participants were within 30-39-year age range, 75% were females, 64.3% were Community Health Extension Workers’ and 42.9% had >10 years working experience. The major themes were awareness of cervical cancer, awareness of cervical cancer screening methods, knowledge about cervical cancer screening methods and utilization. Many participants were not well informed about cervical cancer screening methods. Uptake among female participants was also low. In light of these findings, there is a need to train the health personnel in Primary Health Care centres on cervical cancer screening so that they can adequately educate women on cervical cancer screening.

Diabetology for primary health care – the use of metformin in the treatment of prediabetes, primary prevention and secondary prevention in type 2 diabetes

2021 ◽  
Vol 14 (4) ◽  
pp. 346-348
Author(s):  
Grzegorz Dzida
Keyword(s):  
Type 2 Diabetes ◽  
Health Care ◽  
Glucose Tolerance Test ◽  
Glycated Hemoglobin ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Oral Glucose Tolerance ◽  
Primary Health ◽  
New Criterion

The 2021 guidelines on the management of diabetes by the Polish Diabetes Association introduce the new criterion for the diagnosis of diabetes – percentage of glycated hemoglobin HbA1c > 6.5%. This is important, especially now, during the COVID-19 epidemic, for patients with diagnosed pre-diabetes who are already using metformin, as it allows to release the need for an oral glucose tolerance test. The article describes the principles of using metformin in the prevention of type 2 diabetes.

Non-Fatal Deliberate Self-Harm in Three Remote Indigenous Communities in Far North Queensland, Australia

Crisis ◽  
2019 ◽  
Vol 40 (6) ◽  
pp. 422-428 ◽  
Author(s):  
Chris Rouen ◽  
Alan R. Clough ◽  
Caryn West
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Care Center ◽  
Indigenous Communities ◽  
Indigenous Australians ◽  
Deliberate Self Harm ◽  
Health Care Center ◽  
Far North ◽  
Primary Health ◽  
Self Harm

Abstract. Background: Indigenous Australians experience a suicide rate over twice that of the general population. With nonfatal deliberate self-harm (DSH) being the single most important risk factor for suicide, characterizing the incidence and repetition of DSH in this population is essential. Aims: To investigate the incidence and repetition of DSH in three remote Indigenous communities in Far North Queensland, Australia. Method: DSH presentation data at a primary health-care center in each community were analyzed over a 6-year period from January 1, 2006 to December 31, 2011. Results: A DSH presentation rate of 1,638 per 100,000 population was found within the communities. Rates were higher in age groups 15–24 and 25–34, varied between communities, and were not significantly different between genders; 60% of DSH repetitions occurred within 6 months of an earlier episode. Of the 227 DSH presentations, 32% involved hanging. Limitations: This study was based on a subset of a larger dataset not specifically designed for DSH data collection and assesses the subset of the communities that presented to the primary health-care centers. Conclusion: A dedicated DSH monitoring study is required to provide a better understanding of DSH in these communities and to inform early intervention strategies.

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