Assessment of Breast Cancer Prevention Practices among Women Attending Primary Health Care in Abha City, Aseer Region, Saudi Arabia

Cancer is a leading cause of death worldwide, with breast cancer being the most common (2.26 million new cases and 685,000 deaths). In Saudi Arabia, breast cancer ranked the first among females in 2014, accounting for 15.9% of all cancers reported among Saudi nationals and 28.7% of all cancers reported among females of all ages. Early detection of breast cancer could decrease the risks, have a better prognosis, and have better outcomes/more successful treatments. Prevalence of breast cancer reached more than 25% of all diagnosed cancer in the kingdom among women. Aim: This study aims to assess the knowledge and performance of women attending primary care centers about breast self-examination and mammogram screening for prevention and early detection of breast cancer in Abha city primary healthcare centers, Kingdom of Saudi Arabia. Research Method: cross sectional design was conducted by using questionnaire, which was distributed to primary care center nurses. The collected data was statistically analyzed using the Statistical Package for Social Sciences, version 25. Results: The study found that participants had poor awareness and knowledge about breast self-examination, risk factors for breast cancer, and trends and practices in early diagnosis of breast cancer. Conclusion and Recommendations: It recommends increasing awareness campaigns and providing educational programs to improve knowledge and practices.

Ozone Sterilizer for Treatment and Health Care

Ozone is a green broad-spectrum bactericidal disinfectant, and a trace amount of ozone in the atmosphere makes many viruses and bacteria lose their biochemical activity and infectivity. Nature produces trace amounts of ozone in the air through lightning to purify the ecological environment. The product of ozone decomposition is oxygen, without secondary pollution. Ozone sterilizer is widely used in the epidemic prevention and control of intensive breeding farms and achieved remarkable results. If the concentration and action time of ozone can be accurately controlled, then ozone can quickly eliminate pathogens, without harming the normal cells in the human body. How to use medical ozone for epidemic prevention, treatment and health care is a subject worthy of serious study, which should arouse the attention of the experts in the field.

Living alone, health and preventive care use among the elderly in Shanghai, China

Objective:The purpose of the study was to compare the preventive care use and health between the elderly living alone and living with other individuals and identify strategies to improve the preventive care use among the elderly living alone.Methods:A questionnaire including socioeconomic characteristics,preventive care use,health status and Social Support Rate Scale was administered to 240 elderly living alone and 244 elderly living with other individuals in Shanghai,China.Logistic regression analysis was used to examine the predictors of preventive care use.Results:The elderly living alone were more likely to be single(never married,divorced,separated and widowed),have lower social support and income,utilize less routine physical check-up and blood glucose screenings,have worse self-reported health and have limitations in IADL compared to the elderly living with other individuals.Women,old age,high education,income and social support and close to medical institutions were positively associated with routine physical check-up among the elderly.Conclusion:Living alone was associated with less preventive care use and worse health.It was important to provide more social support and economic support for the elderly living alone to increase their preventive health care service utilization and improve their health status.

Does community-based health insurance affect lifestyle and timing of treatment seeking behavior?Evidence from Ethiopia

Objectives This paper aims to investigate the effects of enrollment in the Ethiopian community-based health insurance(CBHI)scheme on household preventive care activities and the timing of treatment-seeking behavior for illness symptoms.There is growing concern about the financial sustainability of CBHI schemes in developing countries.However,few empirical studies have identified potential contributors,including ex-ante and ex-post moral hazards.Methods We implement a household fixed-effect panel data regression model,drawing on three rounds of household survey data collected face to face in districts where CBHI scheme is operational and in districts where it is not operational in Ethiopia.Results The findings show that enrolment in CBHI does not significantly influence household behaviour regarding preventive care activities such as water treatment before drinking and handwashing before meals.However,CBHI significantly increases delay in treatment-seeking behaviour for diseases symptoms.Particularly,on average,we estimate about 4-6 h delay for malaria symptoms,a little above 4 h for tetanus,and 10-11 h for tuberculosis among the insured households.Conclusions While there is evidence that CBHI improve the utilization of outpatient or primary care services,our study suggests that insured members may wait longer before visiting health facilities.This delay could be partly due to moral hazard problems,as insured households,particularly those from rural areas,may consider the opportunity costs associated with visiting health facilities for minor symptoms.Overall,it is essential to identify the primary causes of delays in seeking medical services and implement appropriate interventions to encourage insured individuals to seek early medical attention.

Exploration on the Implementation of the Integration of Medical and Preventive Model in China’s Primary Health Care Institutions

Objective To explore the different modes and approaches of medical and preventive integration in current primary health care institutions in China.Methods Through literature analysis,field research,telephone interviews,and other methods the implementation status was evaluated to systematically study the main experience and effect of implementing medical and preventive integration services in pilot areas.Results and Conclusion At present,there are three implementation modes of medical-prevention integration,namely,vertical mode based on the medical community,internal mode with optimized service process,and internal mode with great service capabilities.The three medical-prevention integration modes have their respective focuses,but they need to be further improved in terms of policy support,technical staffing,information system construction,and drug use.

Potential Legal Issues and Care Implications during Care-Prevention Gymnastic Exercises for the Elderly Using Pepper in Long Term Health Care Facilities

In Japan, the shortage of personnel is a problem in long-term care nursing and rehabilitative care prevention. Nevertheless, Japan has taken measures to compensate for these shortages by promoting medical and nursing care activities using robotic technologies, and employing human resources from overseas. The purpose of this study was to determine potential legal issues and subsequent implications for care during prevention gymnastic exercises for the elderly using Pepper in long-term health facilities. The application program of Care-Prevention Gymnastics Exercises for Pepper (Pepper with CPGE) was made by the Xing Company Japan. Currently, care workers become intermediaries for the safe use of Pepper with CPGE. However, it was realized that some legal issues may arise if Pepper with CPGE alone will carry out these preventive care programs for the elderly without the presence of care workers as intermediaries. In this situation, using Pepper with CPGE alone to conduct care prevention gymnastics will require safety measures to prevent these possible practice issues and anticipate implications for care. In this regard, determining detailed target levels of rehabilitation exercise demands and environmental setting safety become essential factors. The use of humanoid robots in healthcare is expected to influence more practice protocols in contemporary and futurist rehabilitative human care. The identification of possible safety issues in performance and environmental situations, and implications for care are critical to ensure safe and valuable rehabilitative health care practices for the elderly population.

Lifestyle, Biological Risk Markers, Morbidity and Mortality in a Cohort of Men 33 - 42 Years Old at Baseline, after 24-Year Follow-Up of a Primary Health Care Intervention

Objective: To study changes in lifestyle and biological risk markers in a 24-year follow-up study, and occurrences of cardiovascular diseases (CVD), cancer and total mortality from official registers. Design: A 24-year follow-up survey and register study of a cohort of men 33 - 42 years old, examined with a health profile at baseline. With the health profile based on lifestyle, biological risk markers, self-rated mental stress and mental health, the men were separated in different risk groups. Setting: Primary health care center of Habo in Sweden. Subjects: All 757 men, 33 - 42 years old, and living in the community of Habo in Sweden in 1985. Main Outcome Measures: Lifestyle, biological risk markers, morbidity from CVD and cancer, and total mortality. Results: Smoking and physical activity decreased during follow-up time while alcohol consumption increased. Biological risk markers, except diastolic blood pressure, deteriorated significantly with age. Based on three- lifestyle groups, 16 % of the men had a more favorable lifestyle and 19% had a less favorable life-style at follow-up compared with baseline. The men, who had been classified as high-risk, based on the health profile at baseline, had a significantly higher incidence of CVD and cancer in the register study compared to men in a low-risk group. The baseline non-participant group had a significantly higher incidence of CVD and a higher mortality compared to the low-risk group. Conclusion: A health profile with a combination of lifestyle factors and biological risk markers can already at the age of 33 - 42 years predict incidence of CVD and cancer on group level among men after 24 years.

Suicide Prevention in Mental Health Services—A Qualitative Study of a Web Based Program for Mental Health Care Staff

Background: Further strategies are needed to deal with the high losses to suicide. New modalities should be explored within the context of suicide prevention. Aim: The aim of the study was to evaluate participants’ experiences of a web based program for mental health care staff, including its potential clinical relevance. Methods: Nineteen participants participated in five focus groups. Data was analyzed using content analysis. Results: The analysis showed participants’ experiences of the program’s contents and format (“Web Based Modules”, “Discussion Groups”) and practical value (“Clinical Relevance and Use”, “Effects on Communication and Climate”). Conclusions: The program partly increased awareness about risk factors and the importance of inquiring about suicide ideation/plans and documenting suicide assessments. Experiences of the clinical value were varying and may be increased through potential enhancements.

基于SHA 2011的天津基层医疗卫生机构基本公共卫生服务开展情况分析

[目的]强化经常性卫生费用核算数据政策分析,为基本公共卫生服务项目后续开展提供依据。[方法]以天津市2016-2019年基层医疗卫生机构预防服务费用核算结果为基础,分析基层医疗卫生机构基本公共卫生服务项目开展情况和存在问题。[结果]2016-2019年,天津市基层医疗卫生机构预防服务费用呈逐年增长趋势,由2016年的14.25亿元增加至2019年的18.04亿元。预防服务费用主要流向预防接种项目、慢性病管理和老年人健康管理项目;预防服务费用筹资来源仍以政府筹资方案为主,但家庭卫生支出占比呈快速增长趋势,主要是由于二类疫苗接种费用的快速增长所致。[结论]天津市基层医疗卫生机构预防服务费用流向与其基本公共卫生工作重点一致,但基层医疗卫生机构传染病防控投入程度与其职能不匹配。基层医疗卫生机构二类疫苗接种服务家庭卫生支出负担过重。

基于多维分析的对非外宣中医保健文本语际转换策略研究

中医保健文化是中医文化的重要组成部分。近年来,随着非洲各国人们对健康保健的日渐重视以及“文化走出去”战略的推进,对非中医保健外宣策略研究显得尤为重要。然而,针对非洲读者的中医外宣翻译研究乏善可陈,聚焦语言微观层面的研究更少。基于此,结合具体实例,应用多维文本分析法对高分译本的语体风格和语言特征进行了分析,总结出增译法、减译法和转译法等三种典型语际转换策略,以丰富相关研究。

妇幼保健体系子宫颈癌医防一体化管理与技术服务专家共识

子宫颈癌可防可控却仍严重威胁女性健康。人乳头瘤病毒(HPV)疫苗接种、子宫颈癌筛查和早诊早治的综合干预策略是实现全球消除子宫颈癌战略目标的重要路径。目前我国已建立比较完善的妇幼保健体系,承担人群子宫颈癌防控技术服务与管理的重要职能。在妇幼保健体系内建立子宫颈癌医防一体化服务管理模式与协同机制,整合健康教育、疫苗接种、筛查、诊断与治疗、随访管理,对提高防治服务可及性,加速消除子宫颈癌的目标实现具有重要的公共卫生意义。本共识在对我国妇幼保健体系充分调研和专家研讨基础上,系统梳理妇幼保健体系在子宫颈癌防控工作中的作用、服务模式和瓶颈因素,提出构建妇幼保健机构内医防服务一体化和妇幼保健机构间医防服务全流程闭环的双路径模式,以及实现医防一体化模式的关键要素和建设原则,为推动我国妇幼保健体系子宫颈癌防治服务向连续、整合、系统转型提供指导建议。

中医治未病思想及其现代应用探讨

中医治未病思想指导人们的养生保健及治疗,自提出以来一直被广泛应用。具有未病先防、欲病救萌、既病防变、瘥后防复的思想内涵。对人们的身体及心理健康都有很重要的指导意义。在现代社会,治未病思想旨在提高人们的健康观念、倡导新时代健康生活方式。广泛应用于亚健康状态的调节、慢性病的管理等方面,具有重要的现代应用价值。

社区导向的医防融合:理论基础和当代实施路径探析

本篇评论阐明了我国基层医疗卫生体系相对于国际初级卫生保健体系的两个独特特点:更狭窄的患者人群和业务范围,以及更薄弱的基本医疗能力。以此为基础,文章总结和对比了20世纪的两种最具代表性的,且在全球产生了广泛影响的两种与医防融合关系极为密切的整合基本医疗服务中的临床和公共卫生部分的理论-实践模式:“社区导向的基本医疗”模式和“赤脚医生”模式。在此基础上,本文进一步结合于2023年第四季度在上海市基层医疗卫生体系中观察到的多项实际案例,阐述了未来在我国的基层医疗卫生机构中,转化和实施这两种医防融合模式的可行路径和对外部条件的需求,并提出了在不同地区实施上述模式的原则性建议。

门急诊服务敏感疾病住院的管理策略研究

门急诊服务敏感疾病住院(ACSH)问题造成了我国每年至少千亿元卫生资源的浪费。实施精准干预措施以减少ACSH是卫生系统健康可持续发展的重要内容,有助于减缓疾病的发生发展,提升群众健康水平,降低经济负担。本研究旨在系统分析ACSH的影响因素,总结归纳减少ACSH的国际经验并探索适用于我国医疗卫生服务体系的ACSH管理策略。研究发现,ACSH受个体因素、卫生服务系统因素和社会因素的影响。国际上主要通过医疗卫生服务模式、服务提供和服务管理三方面举措减少ACSH。本研究结合国际经验和实际情况对我国ACSH管理工作提出如下建议:首先,将ACSH纳入医疗卫生服务评价体系,对门急诊服务敏感疾病(ACSCs)进行全面监测和综合管理,其次,提高医疗卫生服务能力,推动ACSCs管理的规范化与同质化,并基于循证理念改善管理水平;再次,应深入开展ACSCs本土化研究,促进高质量证据转化实施;最后,持续提高人口健康素养,强化患者和公众对减少ACSH的正确认识。

门急诊服务敏感疾病的研究进展:基于CiteSpace的文献计量分析

背景门急诊服务敏感疾病(ACSCs)指通过及时有效的门急诊服务可以避免住院的疾病。随着全球对提升医疗卫生服务质量与效率的日渐关注,深入了解ACSCs的发生发展和研究动态至关重要。目的分析近30年ACSCs研究领域的热点、前沿与趋势。方法2023年3月,检索并分析Web of Science数据库中与ACSCs相关的英文文献,使用CiteSpace 6.1.R6信息可视化软件进行数据汇总和分析,包括发表年份、作者、研究机构、关键词和参考文献。时间跨度设置为“1992-2023年”,时间分区设置为5年。网络节点关联强度选择“Cosine”算法。根据分析主题,选择“Author”“Institution”“Keyword”作为节点进行可视化分析,分别得到作者、机构、关键词共现的知识图谱。结果初检获得文献1701篇,经CiteSpace识别后,最终纳入分析1698篇。近年来关注ACSCs的研究数量总体呈现上升趋势,发文量排名前3位的机构分别是哈佛大学[81篇(4.77%)]、加利福尼亚大学[63篇(3.71%)]及密歇根大学[47篇(2.77%)]。关键词聚类图谱得到“nursing home”“public health”“primary care”“integrated care”“impact”“potentially avoidable hospitalizations”“management”“performance”8个聚类主题。引文分析显示,ACSCs领域高被引研究重点聚焦于可避免住院的现状与影响因素、可避免住院与医疗卫生服务的关系、减少可避免住院的措施三方面。结论近30年,ACSCs领域的研究迅速发展,目前已被世界主要发达国家广泛用于评估和改进医疗卫生服务。然而,研究者和机构之间缺乏跨区域合作,研究热点随时间演进不断变化,主题涵盖ACSCs及门急诊服务敏感疾病住院(ACSH)的研究意义与政策含义、影响因素、实践应用和政策启示四大类。国内对这些关键领域的探讨不足,未来需给予更多关注。

基于《黄帝内经》阴阳“五态人”理论浅析肺系疾病辨证保健

肺系疾病病种多、病位广,是现代医学治疗的难点及热点,结合中医“治未病”理念,可以降低肺系疾病的发生。辨证保健的目标是在疾病发生前开展精准的个性化保健,其兼具中医整体思维和辨证思维。肺系疾病的辨证保健关键点是对人的健康状态与发病趋势进行辨识,而阴阳“五态人”理论正是《黄帝内经》中对人健康状态和发病趋势的描述。运用阴阳“五态人”理论指导肺系疾病的辨证保健可提高肺系疾病保健的有效性,拓展疾病预防思路,为正确地选择保健措施提供保障,提高中医“治未病”在疾病预防中的优势地位,促进保健事业的发展,满足大众对健康的追求。

防根面龋牙科材料的研究进展

根面龋是老年人口腔常见病和多发病,发病率和未治疗率高,治疗难度大,可迅速进展引起牙髓根尖周病或残冠根,是老年人失牙的重要原因,已成为严重影响老年人生活质量的常见口腔慢性病之一。因此,根面龋早期干预和防治非常重要。传统防根面龋牙科材料如氟化物、氯己定等在临床中广泛应用,但是其具有牙齿着色、再矿化及杀菌效率低下等缺点。近年来,一系列新兴防根面龋牙科材料如无机纳米材料、胶原交联剂等逐步成为研究热点,新兴材料具有促进深部牙体组织再矿化、作用时间延长、黏附力增强等优点。未来防龋材料应根据根面龋的特点及应用人群进行设计,朝着简便化、高效化、低毒性方面发展。本文对目前防根面龋牙科材料的研究及应用进行综述,以期能够为防根面龋牙科材料的研究提供理论基础,对促进根面龋的有效预防,改善老年人的口腔健康状况和生活质量具有重要意义。

中小学校医与保健教师近视防控核心胜任力评价量表的构建研究

目的构建中小学校医与保健教师近视防控核心胜任力评价量表,为评价校医与保健教师开展校园近视防控工作水平提供工具。方法通过文献分析与半结构化访谈,提取校医与保健教师近视防控核心胜任力评价框架与指标条目。邀请到14名专家,通过德尔菲咨询与层次分析法确定各级指标内容与相应权重,构建中小学校医与保健教师近视防控核心胜任力评价量表。结果经过两轮专家咨询,确定一级指标4个,二级指标8个,三级指标28个。一级指标按权重依次为视力健康服务能力(0.296)、个人职业品质(0.278)、近视防控专业知识与技能(0.233)、组织管理能力(0.193)。专家积极性、权威性与意见协调程度与一致性较好。结论本研究通过德尔菲法与层次分析法初步构建了中小学校医与保健教师近视防控核心胜任力评价量表,具有一定的科学性和可靠性,可为中小学校医与保健教师近视防控核心胜任力评价提供参考。

天津市基层慢病管理中心实施慢病管理服务模式的效果分析

目的梳理天津市基层慢病管理中心的建设模式及实施慢病管理服务模式后取得的效果,从而提出进一步改进建议。方法在天津市16个区中,选取市内城区、环城郊区、远郊区各1个区作为研究样本,采集实施慢病管理服务模式后,2023年1月—12月期间以区为单位的基层慢病管理中心糖尿病患者随访情况、规范管理率等过程和效果指标及其变化情况进行统计分析。结果基层慢病管理中心共运行47家,累计随访糖尿病患者8.1万余例次,开具8.8万张健康管理处方,完成6.8万例次糖尿病并发症筛查,3个区的糖尿病签约患者转诊率平均降幅为10.54%。规范管理率、糖化血红蛋白检测率、血脂检测率和并发症筛查率均有提升,3个区的并发症筛查率均在90%以上。血糖控制率、糖化血红蛋白达标率、血压和血脂达标率等健康结果指标均逐步提升。结论基层慢病管理中心对于提升基层医疗服务能力,推进医防融合建设具有一定效果。今后尚需进一步提升管理同质化水平,加强慢病管理中心团队建设,关注慢病管理中心服务团队的积极性,创新激励机制,促进慢病管理中心进一步发展完善。

健康教育在人类免疫缺陷病毒感染者预防保健和疾病控制中的应用效果

目的探究健康教育在艾滋病预防保健控制中的应用价值。方法将我院收治的85例人体免疫缺陷病毒感染者作为对象,以随机数字表法分组为对照组和观察组,各42例、43例,对照组行常规教育,观察组行全面健康教育,研究在2019年1月至2023年4月实施,观察知识掌握情况,评估疾病控制情况,比较心理状态,观察依从性。结果观察组知识掌握优良率、疾病控制率均高于对照组(均P<0.05);干预后,观察组SAS、SDS评分低于对照组(均P<0.05);观察组皮肤治疗、饮食、用药、口腔清洁、物品管理等方面的依从率高于对照组(均P<0.05)。结论全面健康教育落实可以增强艾滋病控制效果,提升感染者对艾滋病的认知,从多个角度规范人体免疫缺陷病毒感染者的行为,且有改善心态的作用。