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Journal of Family Medicine and Primary... May 2024Family doctor contract service (FDCS) is a vital part of China's primary health care system. This study aims to explore whether contracting with FDCS affects residents'...
INTRODUCTION
Family doctor contract service (FDCS) is a vital part of China's primary health care system. This study aims to explore whether contracting with FDCS affects residents' utilization of and satisfaction with primary health care.
METHODS
A structured questionnaire was employed to collect data in January 2022. The questionnaire mainly included the following three parts: the social-demographic characteristics, health-related information, and utilization of and satisfaction with primary health care. Propensity score matching (PSM) was used to adjust for social-demographic differences between participants who contracted with a family doctor and those who did not. For the matched population, we used the Chi-square test to examine the differences in the utilization of and satisfaction with primary health care between contracted and non-contracted participants. Moreover, multiple logistic regression and linear regression were used to explore the influencing factors of the utilization of and satisfaction with primary health care.
RESULTS
A total of 10,850 people were investigated and 10,419 participants were incorporated into the data analysis. After matching, there were no significant differences in most of the matching variables between the contracted and non-contracted groups ( > 0.05). The utilization rate was significantly higher among the contracted population than of the non-contracted (96.3% vs 92.6%, < 0.001). The quality of services (e.g., good service attitude, high medical level, and a trusted family doctor) was more likely to be cited as the main reasons for the contracted people to utilize primary health care than for the non-contracted. The contracted people were also significantly more satisfied than the non-contracted in all terms of satisfaction. Moreover, people who contracted with a family doctor were more likely to use primary health care with OR = 1.979 (95% CI, 1.511-2.593).
CONCLUSION
The contracted people were more likely to utilize and be satisfied with primary health care than the non-contracted. In addition, the contracted people tended to use primary health care because of the quality of services rather than because of the close distance or short waiting time. Therefore, it is important to further promote the high quality of FDCS to ensure residents' sense of gain and improve their satisfaction.
PubMed: 38948628
DOI: 10.4103/jfmpc.jfmpc_1724_23 -
Journal of Family Medicine and Primary... May 2024Following the World Health Organization statement 'Health for all', family medicine is a specialty that provides continuing, comprehensive healthcare to individuals and...
BACKGROUND
Following the World Health Organization statement 'Health for all', family medicine is a specialty that provides continuing, comprehensive healthcare to individuals and their families. Despite that, it is still not yet utilized to its full potential by the developing Middle-Eastern community. The aim of our study is to assess the perception and utilization of family medicine services among Abu Dhabi Island's community.
METHODS
A cross-sectional study was conducted targeting Abu Dhabi Island's community. A representative sample with 95% confidence level and 5% margin of error was calculated taking into consideration the latest report by the Abu Dhabi Statistics Center. A total of 395 adult participants were included in the study, who were asked to fill in an electronic-based validated questionnaire. SPSS software was then used for data analysis.
RESULTS
Majority of participants were UAE nationals (81%) and married (71.1%), with almost equal male (50.4%) to female ratio (49.6%). Participants had positive experiences in primary healthcare (PHC) overall, regardless of their gender, nationality and marital status. Positive experience percentages dropped with higher age and educational level (-value <0.05). A better understanding was noticed among ≥50 years of age with the rightful destination for emergency symptoms (-value <0.05). Participants overall agreed on PHC being the preferred allocation for treatment of fever, body aches and sore throat.
CONCLUSION
Primary healthcare centres were chosen as preferred destinations for emergency and non-emergency cases, as the vast majority had positive experiences when attending them.
PubMed: 38948625
DOI: 10.4103/jfmpc.jfmpc_1736_23 -
Journal of Family Medicine and Primary... May 2024COVID-19 is a disease caused by the severe acute respiratory syndrome coronavirus 2 that has appeared as a global pandemic in recent times. Currently, the transmission...
INTRODUCTION
COVID-19 is a disease caused by the severe acute respiratory syndrome coronavirus 2 that has appeared as a global pandemic in recent times. Currently, the transmission rate has slowed down significantly, but the definite pathological reason behind this is still unknown. Therefore, the prevalence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody must be studied to establish the relation between the rate of transmission and antibody presence.
MATERIALS AND METHODS
A clinical assessment was performed to evaluate the seroprevalence of SARS-CoV-2 Immunoglobulin G (IgG) antibodies among 299 healthy volunteers in the period of February to May 2021. Serum samples were analyzed using chemiluminescent microparticle immunoassay (CMIA) technology to detect the presence of IgG antibodies.
RESULT
It was observed that 21% of the participants were seropositive, and 78% of the population was seronegative across the different genders. This confirmed that the generation of antibodies is independent of gender. Simultaneously, a -test was performed that further suggested no statistical correlation between gender and seroprevalence. Moreover, a comprehensive analysis was performed to establish the relation between age and blood group with the seroprevalence. However, there was no statistical relationship found among these parameters.
CONCLUSION
This study assisted in examining the underlying causes of high or low seroprevalence among healthy volunteers.
PubMed: 38948624
DOI: 10.4103/jfmpc.jfmpc_780_23 -
Journal of Family Medicine and Primary... May 2024Systemic lupus erythematosus (SLE), the commonest type of lupus, is an autoimmune multisystemic disorder that can affect any organ system of the body, especially blood...
INTRODUCTION
Systemic lupus erythematosus (SLE), the commonest type of lupus, is an autoimmune multisystemic disorder that can affect any organ system of the body, especially blood vessels and connective tissues, causing widespread inflammation. Pediatric onset of SLE is a rare condition with more hematological involvement.
AIM
This study was undertaken to observe various hematological abnormalities and their association with various autoantibodies present in pediatric SLE in Eastern India.
METHODOLOGY
It was a single-centered, cross-sectional, observational, hospital-based study conducted in the Department of Pediatric Medicine in collaboration with the Department of Rheumatology in IPGME and R and SSKM Hospital, Kolkata. The duration of the study was 1.5 years, and a total of 30 children up to 12 years of age of either gender were enrolled. Study participants were evaluated for various parameters like demographic, hematological (anemia, neutropenia, leucopenia, lymphopenia, and thrombocytopenia), biochemical (CRP, Lactate dehydrogenase (LDH), and bilirubin), autoantibodies (anti-dsDNA, anti-Ro 52, and anti-Ribonucleoprotein [RNP]), and SLE related pathologies (Cutaneous, nephritis, serositis).
RESULTS
In the present study, most of the participants had arthritis, muscle pain (86.66%), and hematological involvement (80%). Among cytopenias, anemia was the commonest. dsDNA autoantibody was positive in most of the patients (83%), and about one-third suffered from autoimmune hemolytic anemia (AIHA). No association was observed between autoantibodies and various hematological manifestations.
CONCLUSION
It can be concluded from the present study that anemia is the most common cytopenia in pediatric SLE, but there is no association between autoantibodies and these cytopenias. However, study on larger population may give better results.
PubMed: 38948621
DOI: 10.4103/jfmpc.jfmpc_1583_23 -
Journal of Family Medicine and Primary... May 2024The 1978 Alma Ata Declaration established recommendations for health systems, which significantly impacted low-income countries. These guidelines marked improvements in...
UNLABELLED
The 1978 Alma Ata Declaration established recommendations for health systems, which significantly impacted low-income countries. These guidelines marked improvements in access to health, coverage and financial equity, especially in Latin American countries.
OBJECTIVES
This paper focuses on the role of the private sector (including for-profit and non-profit organizations) in achieving Universal Health Coverage (UHC). It examines their involvement in the management, service delivery, resource investment and financing of primary health care (PHC) within the sustainable development goals (SDGs).
METHODS
The study covers a review of health systems, emphasizing the influence of private institutions on public health, and evaluates how private sector experiences contribute to system functions and progress towards UHC.
RESULTS
The findings indicate the crucial role of the private sector in global health systems, notably expanded in several countries. Private actors are essential to improve access and coverage, particularly in countries with low health indicators. The article highlights the importance of primary care physicians understanding these dynamics since their management is vital in implementing public policies for UHC.
PubMed: 38948620
DOI: 10.4103/jfmpc.jfmpc_1697_23 -
Journal of Family Medicine and Primary... May 2024Postpartum hemorrhage (PPH) is defined by the World Health Organization as blood loss of ≥500 mL within 24 h of delivery. Globally, hemorrhage accounts for 27.1% of...
BACKGROUND
Postpartum hemorrhage (PPH) is defined by the World Health Organization as blood loss of ≥500 mL within 24 h of delivery. Globally, hemorrhage accounts for 27.1% of maternal deaths, making it the leading direct cause of maternal death. PPH has been identified in more than two-thirds of reported hemorrhage-related deaths, causing 38% of maternal deaths in India. Tranexamic acid, an antifibrinolytic, has been used to control bleeding after PPH is identified.
MATERIALS AND METHODS
Antenatal women admitted for elective cesarean section were randomized into two arms: the case group (received one gram of tranexamic acid 20 min prior to skin incision) and the control group (received a placebo), each group consisting of 36 participants. Clinical Trials Registry - India (CTRI) registration number - CTRI/2021/02/031579.
RESULTS
The mean (±standard deviation [SD]) intraoperative blood loss in the case group was 241.25 (±67.83) mL, and in the control group, it was 344.92 (±146.67) mL ( = 0.001), while postoperative blood loss did not differ significantly between the groups ( = 0.1470). In terms of the difference in hemoglobin, there was a significant difference between the two groups ( = 0.001). No significant maternal or neonatal side effects were found.
CONCLUSION
Preoperative tranexamic acid, when given in elective cesarean section, significantly reduces intraoperative blood loss.
PubMed: 38948612
DOI: 10.4103/jfmpc.jfmpc_1541_23 -
Journal of Family Medicine and Primary... May 2024Pakistan is in dire need of trained family physicians to enhance the quality of primary health care. To build capacity, there is a need to train the trainers on a large...
AIM
Pakistan is in dire need of trained family physicians to enhance the quality of primary health care. To build capacity, there is a need to train the trainers on a large scale through a feasible and accessible program. Therefore, for the first time, a three-month online course was designed and piloted, in collaboration with national and international family medicine faculty. The aim of this study was to determine the gap between the pre-course expectations and the post-program perceptions of the participants for* a unique family medicine "Train the Trainers" course.
METHODS
A longitudinal-observational study was conducted at a private college of Karachi after approval from the Institutional Review Board. The expectations and perceptions of all (31) participants were recorded through a pre- and post-course questionnaire. Data were analyzed through descriptive and analytical statistics on SPSS-26. The responses to the open-ended questions were analyzed by content analytical approach.
RESULTS
Out of 20 quantitative items on the questionnaire, four were associated with a positive gap between the expectations and perceptions. One item showed a negative gap, while the rest did not show any significant difference. The majority of the participants expressed that they expected to see an improvement in their teaching skills because of the online course.
CONCLUSION
The online course was successful in meeting the participants' expectations. The course delivery can be revisited to further improve its quality according to the participant's feedback, including an opportunity to ask questions and incorporating some face-to-face sessions.
PubMed: 38948611
DOI: 10.4103/jfmpc.jfmpc_1796_23 -
Journal of Family Medicine and Primary... May 2024The COVID-19 pandemic changed people's lives. The majority had to adapt to working online including students. The shift to online learning caused serious sleep and...
BACKGROUND
The COVID-19 pandemic changed people's lives. The majority had to adapt to working online including students. The shift to online learning caused serious sleep and mental health issues among students. This study aimed to examine the variations between the prevalence of sleep and mental health problems among undergraduate students during the periods of online learning and on-campus learning.
METHOD
An online survey was distributed to medical students in Saudi Arabia.
RESULTS
A total of 110 participated in the study (age = 21 ± 1.4 years). The on-campus anxiety (8.2 ± 6.3) was significantly higher than online anxiety (5.5 ± 5.1). On-campus daytime sleepiness (8.5 ± 4) was significantly higher when compared to online daytime sleepiness (6.7 ± 4.6). Although not significant, the on-campus stress (7.7 ± 5.7) and insomnia (12 ± 7.3) were higher than online stress (6.9 ± 5.5) and insomnia (11.5 ± 6). The online depression (6.6 ± 5.7) was higher than the mean on-campus depression (5.8 ± 5.4). A significant strong positive correlation was found between on-campus anxiety and on-campus stress. A significant moderate positive correlation was detected between on-campus anxiety and on-campus daytime sleepiness. A weak but significant correlation was found between on-campus anxiety and on-campus insomnia. On-campus anxiety was significantly predicted by the following model, which included on-campus stress, insomnia, and daytime sleepiness ( < .001).
CONCLUSION
Medical students reported lower anxiety, daytime sleepiness, stress, and insomnia during their online learning compared to on-campus learning. Only depression was higher during online learning compared to on-campus learning.
PubMed: 38948610
DOI: 10.4103/jfmpc.jfmpc_1790_23 -
Journal of Family Medicine and Primary... May 2024Human rights provide a universal foundation for pursuing justice in public health in order to achieve the dignity of all individuals. In spite of international attempts...
BACKGROUND
Human rights provide a universal foundation for pursuing justice in public health in order to achieve the dignity of all individuals. In spite of international attempts to promote human rights in the context of health, a significant portion of India's indigenous population continues to have a limited understanding of these rights.
OBJECTIVE
This study aims to analyze tribal people's attitudes towards human rights in health care. The population consists of tribal residents from Manbazar - I and Puncha Blocks in the Puruliya district of West Bengal, India. Tribal young adults between the ages of 18 and 35 were the subject of a cross-sectional study.
METHODS
A pretested questionnaire was used to collect data. MS Excel and SPSS 27 were used for analysis. A descriptive analysis was carried out.
RESULTS
The participants' mean scores for awareness, accessibility and communication, autonomy and sexual and reproductive health and sexual and reproductive health rights (SRHR) were 8.06, 15.76, 7.35 and 32.52 revealing a moderate perception level among the young adult tribal population in the selected blocks.
CONCLUSION
A holistic focus of the governmental and other non-governmental organizations towards the tribals is required. Introducing various aspects of human rights in healthcare in the education curriculum along with community outreach would by all likelihood improve the perception of 'Human Rights' and thus help in better utilization of various services including health among tribal populations in India.
PubMed: 38948608
DOI: 10.4103/jfmpc.jfmpc_1098_23 -
Journal of Family Medicine and Primary... May 2024Cardiovascular diseases (CVDs) are a cluster of disorders of blood vessels and the heart. As a form of physical activity, yoga postures, and pranayama have been shown to...
INTRODUCTION
Cardiovascular diseases (CVDs) are a cluster of disorders of blood vessels and the heart. As a form of physical activity, yoga postures, and pranayama have been shown to be beneficial in various health conditions, i.e. hypertension, prediabetes, and diabetes among high-risk subjects. This study aimed to evaluate the impact of yoga and diet on the Framingham risk score (FRS) among high-risk cardiovascular subjects.
MATERIALS AND METHODS
The experimental interventional study was conducted at "RUHS College of Medical Sciences" and Associated Group of Hospitals", Jaipur among high-risk cardiovascular subjects. FRS was used as a measurement for the outcome of interest at baseline and six months of yoga diet intervention in the study and control groups.
RESULTS
Mean age of participants was 48.43 ± 6.4 years. Baseline values (mean ± SD) of FRS 24.59 ± 10.15 after six months of yogic lifestyle 15.1 ± 7.05. After six months of yogic lifestyle FRS scores and estimated 10-year cardiovascular risk were statistically significantly ( < 0.0001) decreased. Pearson correlation analysis results depict that FRS correlation. There was a strong positive correlation between the FRS score and total cholesterol ( = 0.787; < 0.001) and a negative strong correlation between the FRS score and high-density lipoprotein was observed ( =-0.621; < 0.002).
CONCLUSION
The findings of this study conclude that six months of yoga and diet lifestyle intervention significantly decreased FRS among high-risk CVD subjects compared to the control group.
PubMed: 38948605
DOI: 10.4103/jfmpc.jfmpc_1169_23