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.

Review of Two Years of Surgical Activities of the General Surgery Department of the Reference Health Center of Commune I of Bamako Mali

The objectives of this work were to evaluate the surgical activities carried out in the general surgery department of the Reference Health Center of Commune I of Bamako, to describe the sociodemographic characteristics of the operated patients, to determine the main pathologies encountered and to evaluate qualitatively the result of the treatment. In order to improve performance, and the quality of care, and to identify common pathologies in the surgical department, we undertook a retrospective study on surgical activities from January 2009 to December 2010. At the end of this study, out of 474 men and 187 women (equal sex ratio 2.53);we were able to determine the frequency of surgical pathologies. Farmers, housewives and pupils/students were the most represented with 25.9% respectively;20% and 13.3%. The most frequently observed pathologies were wall hernia (44.8%), prostate adenoma (12%) and acute appendicitis (10.5%). The average length of hospitalization was 3.43 days. Infectious complications affected 25 patients (3.8% of cases) and a death rate of 0.45% (i.e. 3 patients). The average cost of care was 53,500 FCFA. Indeed, the reality of surgical practice in health centers was not the same because of the level of skills of practicing surgeons.

Assessment of Satisfaction in the Reception and Emergency Department of a Health Center

Introduction The main objective of any healthcare establishment must be to ensure the quality of patient care and customer satisfaction. It is necessary to regularly assess patient satisfaction. The aim of this study was to assess the level of satisfaction of customers aged over 18 years attending the emergency department of the health center. Methodology This was a descriptive and analytical cross-sectional study of patients aged 18 years and over, who attended the Samu Municipal emergency department between 02 and 30 May 2023. The satisfaction index was determined using the adapted 2009 SAPHORA-MCO questionnaire and the Likert satisfaction scale. Results A total of 400 patients were surveyed. The average age was 35 years, with a standard deviation of 14.7. Of those surveyed, 51% were women, 87% were educated, 50% lived in Grand Yoff and 59.5% were unemployed. Satisfaction levels linked to perception of the cost of care (72%), waiting time (64.3%), information given to patients (69.1%) and pain management (74 .5%) are fair. On the other hand, the levels of satisfaction linked to administrative procedures (82.5%), staff attitudes towards patients (84%), staff availability (86.4%), patient privacy (89.2%), general atmosphere (87.2%), staff competence (87.3%), and the effectiveness of care (89.4%) were satisfactory. The average waiting time was 38 minutes. However, 32% of patients waited less than 30 minutes and 92% less than an hour. The satisfaction index linked to administration and reception was 72.9% and 79.85%, respectively. The satisfaction index linked to the administration and technical quality of care is equal to 85.8% and 83.7%, respectively. The overall satisfaction index is equal to 80.6%;the level of satisfaction of users of the health structure is satisfactory. Conclusion Patient satisfaction is an essential part of quality care. Patient satisfaction must be based on effective communication from the healthcare team and the creation of a patient-caregiver relationship.

Observation of the Clinical Effects of Detailoriented Nursing in Health Checkups at a Health Management Center

Objective:To observe the clinical effects of detail-oriented nursing in health checkups at a health management center.Methods:A total of 240 individuals undergoing health checkups at the hospital’s health management center from June 2023 to June 2024 were enrolled and randomly divided into two groups according to a random number table method.The control group received routine nursing care,while the observation group received detail-oriented nursing care,with 120 cases in each group.Differences in checkup quality and nursing risk incidence were compared.Results:The form submission rate,project completion rate,and one-time checkup completion rate in the observation group were higher than those in the control group,while the checkup time was shorter(P<0.05).The incidence of nursing risks such as item loss,falls,and patient-nurse disputes was lower in the observation group compared to the control group(P<0.05).Conclusion:Applying detail-oriented nursing in health checkups at a health management center can effectively improve checkup quality and reduce the occurrence of nursing risks.

Multidimensional health literacy profiles and health-related behaviors in the elderly:A cross-sectional survey

Objectives:To investigate health literacy profiles using a multidimensional tool in the elderly,analyze the factors related to health literacy,and explore the relationships between health literacy and health-related behaviors.Methods:A cross-sectional survey including 440 participants was conducted at a community health center and a village health center in Changsha,Hunan Province,between June 2020 and August 2020.We used the Health Literacy Questionnaire(HLQ)to assess the elderly’s health literacy.Sociodemographic data and health-related behaviors of them were surveyed with a self-designed questionnaire.Latent profile analysis,Pearson’s chi-squared and ordinal logistic regression were used to analyze the data.Results:The median age of the 440 respondents was 68 years.The participants had the lowest scores in the“appraisal of health information”subscale(2.22±0.52),followed by“navigating the healthcare system”subscale(2.89±0.81)of HLQ.Based on the analysis of three profiles,respondents who were 60 e74 years(OR=2.06,95%CI:1.23e3.42,P=0.006),living in urban areas(OR=3.28,95%CI:2.17e4.94,P<0.001),with secondary education or above(OR=2.86,95%CI:1.92e4.27,P<0.001),and having health insurance(OR=1.89,95%CI:1.02e3.51,P=0.042)were significantly associated with health literacy.Statistically significant associations were found between health literacy level and health-related behaviors,including medical service-seeking behavior(χ^(2)=25.14,P<0.001),exercising regularly(χ^(2)=34.08,P<0.001),and taking a medical examination in the past 12 months(χ^(2)=24.76,P<0.001).Conclusion:The multidimensional health literacy survey has identified the low health literacy level among the elderly in community settings.It revealed the relationships of sociodemographic character-istics,including age,education level and residence,with health literacy.These findings emphasized the importance of health literacy in promoting health behaviors,guiding a profound understanding of the Chinese elderly’s health needs and health literacy to develop community-based health promotion interventions.

Leveraging the Public Health Emergency Operation Center (PHEOC)for pandemic response: opportunities and challenges

Public Health Emergency Operation Center (PHEOC) was conceptualized and established for coordinatinginformation and resources towards goal-oriented response in large scale public health emergency. Yet, theactivities undertaken by PHEOCs and their intended goals have not been fully optimized in current scenario.This paper revisited the collective efforts invested in PHEOC conceptualization and development, identified theopportunities and challenges in compliance with standards and framework, demonstrated the accountabilityof PHEOC network, thereby promoted best practice guidance for global public health emergency preparednessand response. This review will help navigate emergency response complexities leveraging PHEOC partnershipsand advance the ability to detect and respond to public health emergencies in low resource settings. The reviewshows that the information on how to adapt best practice guidance to local circumstances could incentivizethe full implementation of prevention, early detection and response to outbreaks. Identifying and correctingdeficiencies in effectiveness evaluation will provide the basis for continuous PHEOC improvement. With thegradually reopening economies and public services in some countries, there is an urgent need to emphasize andvalidate the collective efforts undertaken by PHEOCs for tackling the COVID-19 pandemic.

How to allocate public health manpower in township health centers in China scientifically and reasonably

INTRODUCTION The global health issue is not a shortage of capital or technology, but a shortage of health manpower. Health human resource （HHR）, an important component of health resources, determines the quantity, quality and effectiveness of health service, thus greatly impacting on health service to the citizens.

Analysis of Inpatient Bed Allocation Equity and Utilization in the City Community Health Service Center of China

The objective of this study was to examine the inpatient bed （IB） allocation equity and utilization in Chinese city commtmity health service centers （CHSCs）. The data were derived from the Baseline Survey of National City Community Health Service System Building Project, which was conducted in 1917 CHSCs in 28 cities in 2007. The IB allocation was analyzed in terms oflB alloca- tion quantity and distribution equity, and the IB utilization was analyzed by the IB utilization rate and average length of stay of the CHSC inpatients. The results showed that 49.3% of the CHSCs were equipped with IB; averagely, there were 45 IBs per CHSC, 0.94 IBs per 1000 people, and 0.38 nurses and 0.57 doctors per IB; the IB Gini coefficient was 0.32; the IB utilization rate was 40.06%; and the average length of stay of inpatients was 12.24 days. The conclusions were that IB allocation among the population was equitable, but the number of nurse per IB was not up to the national standard; and the CHSC IB utilization was low as a whole, thus inpatient service was not the main health service for Chinese CHSCs.

Contraceptive Experiences of Women of Procreation Age Who Attended Two HealthCenters in the City of Abidjan (Cote d’Ivoire)

Introduction: Maternal mortality, which is estimated at 614 deaths per 100,000 births in C&#244;te d’Ivoire, is associated with a low national contraceptive prevalence rate of 13.9%. In this study, we are interested in the contraceptive experiences of women who attend health centers to estimate their rate of contraceptive use and to assess the factors involved in the use of modern contraceptive methods among women of childbearing age who are exposed to the risk of pregnancy. Method: A descriptive cross-sectional study was conducted from December 2018 to September 2019 among 423 women, who attended two health centers in Abidjan. A bivariate analysis identified factors associated with contraceptive use by these women. A descriptive analysis determined the means for the quantitative variables and the frequencies and percentages of qualitative variables. Interpretation of results was based on significance (α = 5%, 95% CI). Results: Contraceptive prevalence was 37%. There was a significant relationship between contraceptive use and the socio-demographic and reproductive characteristics of women (p Conclusion: Women who were over 35 years age, uneducated, primary school graduates, housewives, unemployed, in the informal sector, Muslims, nulliparous, and lacking information and decision-making power were less likely to use modern contraceptive methods. They are the target population for strategic interventions to improve contraceptive prevalence.

Nutrition Programs through Public Health Centers in Korea

In the peroid of confusion after the Korean War, there was an absolute shortage in the volume of food. The intake of energy and all other nutrients fell short of the recommended dietary intake. To solve the food shortage, there were many food assistant programs through the government channel. With the economic developments during past years, now, there are enough foods for everyone. Thus, food assistant program, which has been the only nutrition program in the government, is no longer needed except for low-income families.Currently, there are not enough nutrition programs in the government. In 1994, about 30 public health center start nutrition programs with the help of Korean Dietetic Association.In this study, kinds of nutrition programs, age, sex and number of participants, the content of programs are studied. The effects of nutrition programs are partially evaluated.Also, problems with current nutrition programs are discussed. Finally, future directions of nutrition programs in the public health centers are discussed

Intention to Leave and Associated Factors among Health Professionals in Jimma Zone Public Health Centers, Southwest Ethiopia

Background: Inadequate human resources are a major constraint to improving global health. The health sector is characterized by a high turnover coupled with internal as well as external brain drain but there is little information on intention to leave among health professionals in public health centers of Jimma Zone, Oromia Regional State. The aim of this study is to assess intention to leave and associated factors among health professionals in public health centers of Jimma Zone, southwest Ethiopia. Methods: A cross-sectional quantitative and qualitative study was conducted on seven randomly selected woredas (districts) which have 53 public health centers. All health professionals in sampled district public health centers were included (n = 505). Factor analysis was employed for all Likert scale instruments to extract factor(s) representing each of the scales using SPSS version 16.0. The qualitative data was analyzed by thematic analysis methods. Ethical approval was obtained from Jimma University. Results: Four hundred fifty five (90.1%) health professionals participated in the study;out of this, 290 (63.7%) had intention to leave. Among variables, job satisfaction (Beta = -0.298, (95% CI, -0.568 to -0.029), working environment (Beta = -0.612, (95% CI, -0.955 to -0.270), and organizational management (Beta = -0.552, (95% CI, 0.289 to 0.815) had statistically significant association with intention to leave among health professionals in public health centers of Jimma Zone. Conclusions: The overall intention to leave among health professionals was high. Level of job satisfaction, working environment, work pressure, and organizational management had statistically significant association with intention to leave. Thus, responsible bodies should aggressively work on the concerns identified, like, improvements in salary, promotion in terms of training/educational opportunity, improving working environment, and transfer of health professionals, and improvement of the leadership skills of managers.

Direct Cost of Severe Malaria Treatment Borne by the Families of Children Aged 0 - 5 Years at the Fana Reference Health Centre, Mali

Introduction: Malaria is both a disease caused by poverty and a cause of poverty. Malaria is the leading cause of morbidity and mortality in Mali and is among the ten countries with the highest number of malaria cases and deaths. The objective was to estimate the direct economic cost borne by families in the treatment of severe malaria in children aged 0 - 5 years at the CSREF in Fana. Methodology: The study was cross-sectional, conducted from July 2017 to June 2018 with inclusion criteria and prospective data collection. The methodology was based on estimating the direct economic cost of severe malaria. Results: The sample consisted of 109 cases out of a total of 944 hospitalizations;59% of whom were boys and the 25 - 36 month age group was the most affected. The complications frequently encountered were severe anemia (50 cases) or 45.8%;convulsions (35 cases) or 32.1% and finally severe sepsis (8 cases) or 7.3%. The average direct cost was 25,324 Franc CFA (58.95 US Dollars) of which 66% represented the costs of medicines and consumables against 4% for the consultation. This cost was more than half the minimum wage in Mali. Conclusion: Despite the difficulties in estimating the cost in hospitals, the results obtained give us an estimate of the economic burden borne by families in the management of severe malaria cases among children in the district of Fana. Support is needed for parents in the fight against malaria in rural Mali.

Nurse Mentor Training Program to Improve Quality of Maternal and Newborn Care at Primary Health Centres: Process Evaluation

Quality of maternal and newborn care could be improved if health care providers’ knowledge and competencies as well as system level constraints are addressed. However, due to several barriers staff nurses who form the frontline of health care workforce have limited access to enhancing their clinical knowledge and competencies. To address this gap, a new cadre of nurse mentors (NMs) for the public health system were trained by specialists from a teaching hospital in a special 5-week training course. This included 54 hours of theory and 110 hours of practical in clinical obstetric and newborn care, apart from mentoring, quality improvement and health systems issues. The nurse mentors were assigned to support staff nurses in the primary health care centres (PHCs) in eight northern Karnataka districts. Each NM covered 6-8 PHCs monthly for 2 - 3 days and thus a total of 385 PHCs were reached. They received support in the field through supportive supervision visits done by the specialists who had trained them, as well as by refresher training and clinical postings to the district hospitals. This paper presents impact of the training program on change in immediate and long term knowledge and competency scores of nurse mentors. Their baseline knowledge scores changed from 44.3 ± 12.7 to 72.1 ± 13.8 immediately after the training in obstetric and from 18.2 ± 19.1 to 66.4 ± 14.9 in newborn (p p p > 0.05). Skills score soon after training increased from 62.2 ± 13.2 to 69.6 ± 12.5 in obstetric after a 1 year period and from 52.6 ± 9.3;63.5 ± 14.4 in newborn (p < 0.001) content areas respectively. These findings have implications for those interested in improving quality of maternal and child care through nurse-dependent health delivery systems.

The Performance of a Health System in Romania Ensures a Present for a Stable Healthy Population,Without Negative Influences of the Past

Regardless of the existing situations,economic crises,epidemics,or causes determined by the effects triggered in the foreign policy of the European Union states,health becomes a factor of maximum urgency in the state of a state,in order to have a healthy population.Ro mania now has both funding sources and revenues allocated to the establishment of the Single National Health Insurance Fund,major conditions for having an efficient health system.The National House of Health Insurance becomes the binder in the establishm ent and use of the Single National Health Fund,in the organization and coordination of projects for the development of the public and private health system,so that through the framework contract,legally constituted,we can look at the health system from needs up to the consumption of health services.No matter how much we analyze the health system in the country,it becomes efficient in the future,even if we have an aging population with pressing needs from a demographic point of view.Through a consist ent monitoring of the management in the health system and the attraction of medical personnel,after graduation,in hospital units,the balance of medical personnel vs.patient can become favorable.Family doctors must have the most important role in the h ealth system,in the existing conditions considering that the prevention and elimination of waiting time in hospitals are strictly related to the urgency of the medical services provided in time by them.Hospital units can reduce the degree of illness of t he population in the shortest possible time through monthly reporting of existing problems,including nosocomial infections.When there are well-established funding resources,the ways of their use and distribution are known,there are qualified medical pe rsonnel who can provide medical services to the population,upon returning to the country after specialization in other countries,we can clearly discuss that Romania has development levers of the public and private health system,in any condition.We must think that a transparent and prepared health system can therefore affect any country to have a healthy people,when the medical act is viewed through the lens of seriousness,humanity,professional values.

The Level of Knowledge, Behaviors, and Attitudes on Rational Use of Drugs of Patients Who Applied to the Family Health Center in Istanbul, Türkiye: A Cross-Sectional Study

Background: This study, it was aimed to determine the level of knowledge, attitudes, and behaviors of patients who applied to a family health center about the rational use of drugs. Irrational use of drugs is a major problem worldwide. WHO reports that half of the patients do not use their drugs correctly. Methods: This cross-sectional study was conducted between 1 October 2017 and 30 November 2018 at Istanbul Fatih Family Health Center No 7. The sample size was determined as 301 people selected by systematic sampling method from patients aged 18 and older. Results: The mean age of the participants was 53.8% ± 16.8%, 59.8% were female, 62.5% were married, and 52.5% were primary school graduates. 63.9% of the participants knew the names of the drugs they used, and 79.9% of them knew the indication for use. 89% of individuals check the expiry date of the drugs before using them, and 83.1% read the drug prospectus. 84% of the participants support the prohibition of using over-the-counter drugs. Conclusion: The level of knowledge of the participants about the rational use of drugs is above the societal average. However, some issues need more awareness. The high level of rational use of drugs awareness of physicians and pharmacists will also strengthen the rational use of drugs and indirectly increase the awareness of the public.

Analysis of the Screening of Contact Subjects of People Living with HIV at the Antivenereal Health Center of the National Institute of Public Hygiene of Treichville, Abidjan/Côte d’Ivoire from January 2009 to December 2018

Introduction: In C?te d’Ivoire, people living with HIV are estimated to 460,000 with about 290,000 who know their HIV status. Index testing is a strategy for screening unidentified HIV carriers. This study aimed at analyzing the screening of contact subjects of people living with HIV at the anti-venereal health center of Treichville in Abidjan. Methods: We carried out a cross-sectional study from January 2009 to December 2018. The target population was index patients and their sexual partners. After giving their consent, index patients and their sexual partners were interviewed during their medical visit. Data were analyzed using Epi info 3.5.4. The khi2 test was performed at 5% significance level. Results: A total of 114 index patients have been included in the study. The majority of sexual partners were men (sex ratio M/F = 1.5) with an average age of 43 years (±9.77). 87.7% of index patients lived in pairs. The analysis showed that 87.7% of index patients had disclosed their HIV status to their sexual partners and 94.3% of index patients invited their sexual partners to be tested. 85.8% of sexual partners had been tested. 19.8% of sexual partners who have been tested were HIV positive. All the 8 children of female index patients were HIV negative. HIV test acceptability was statistically associated with living in pairs (P Conclusion: Screening sexual partners from index patients has been an effective way to detect HIV carriers who did not know their status.

我国相对贫困地区乡镇卫生院现况

目的分析我国相对贫困地区乡镇卫生院现况,以便发现问题并提出有针对性的改进建议。方法自行设计调查表,收集相对贫困地区乡镇卫生院的相关信息并进行描述性分析。结果相对贫困地区乡镇卫生院的各类卫生技术人员数低于全国平均水平,编制数低于规定标准且编外用工较多。注册全科医师、中医执业(助理)医师、公共卫生执业(助理)医师、妇产科执业医师、外科执业医师配备不足;中级及以上职称和大学本科及以上学历的执业助理医师及注册护士占比较低;设施设备配备量及服务量低于全国平均水平。结论相对贫困地区乡镇卫生院的人力资源数量和质量均有待进一步提升。应加大财政投入,确保编制人数达到相应标准,落实乡镇卫生院标准化建设。

Learning from socially driven frugal innovation to design the future of healthcare:A case of mobile Primary Health Center

Background and Aim:Despite their flaws,the low-cost but powerful economical solutions can ensure everyone has access to health.The main aim of this study is to extract characteristics of frugal innovation(FI)and social innovation(SI)for Primary Health Centers(PHCs)in low resource settings(LRS)for sustainable development.We will use the gained insights to design the mobile primary healthcare infrastructure using FI and SI strategies.There is a lack of methodology to design sustainable healthcare infrastructure for LRS.There is a gap in the literature about building sustainable infrastructure to provide basic healthcare facilities essential to the community.This article studies several factors necessary for designing sustainable infrastructure from the lens of FI,SI,and sustainability to develop a mobile healthcare infrastructure for last-mile people.Methods:Started with purposive sampled case studies to find out factors and criteria that most affect the success for an innovation to be frugal,social,and sustainable.The established criteria were used to design,develop,and deploy the mobile Primary Health Center(mPHC).Moving forward,we tested the system designed with stakeholders to gather insights.At this stage we found the feedback loop from the stakeholders and the role of interdisciplinary discussions between experts,medical officers,nurses,patient,and other staff of PHCs during the design,development,deployment,and test stage to be useful in taking design decisions efficiently.Results:The designed healthcare infrastructure of mPHC through the aspects of FI and SI proves to be efficient in providing key healthcare services to LRS.Conclusion:Focusing on essential capabilities and optimizing performance with technology,methodologies,and processes reduces costs in an innovation.Focus on socially inclusive and rebalancing power disparities,overcome societal challenges and improve human capabilities will create a sustainable and novel solution.

Associations between risk factors for cardiovascular diseases and frailty among community-dwelling older adults in Lanzhou,China

Objectives:To examine the relationship between cardiovascular disease risk factors and frailty in a sample of older Chinese adults.Methods:A total of 458 community-dwelling older adults(>65 years)in Lanzhou,Gansu Province of China participated in a cross-sectional survey.Their status was evaluated in terms of frailty phenotype(unintentional weight loss,exhaustion,low activity levels,slowness and weakness).Participants were categorized as not frail,prefrail or frail.Cardiovascular disease risk factors that were assessed included:blood pressure,body mass index,waist circumference,blood glucose,total cholesterol,triglycerides,lowdensity lipoproteins and high-density lipoproteins.Results:Individuals with obesity had an increased risk of prefrailty(OR:2.26;95%CI:1.05,4.84).Hypertension was inversely associated with frailtyamong the participants(OR:0.31;95%CI:0.11,0.87)after adjusting for covariates.Conclusions:The findings suggest that much more attention should be paid to weight control of the elderly in the community for preventing them from transition to prefrailty or frailty.Active prevention and control of cardiovascular diseases among the community-dwelling elder are still of great importance.

Partial Amputation of the Penis with Total Rupture of the Urethra: About a Case in the Urology Department of the Bonamoussadi District Medical Center

Penis amputations are rare, they are most often observed in a criminal context or in the context of self-mutilation. We present the case of a partial amputation of the shaft in the context of a domestic accident. This is a 53-year-old patient received in the emergency department for partial amputation of the penis occurred, whose mechanism of occurrence would be the fall of a sheet metal from the roof of his house, with reception on the proximal end of the shaft leading to a partial rupture of it—here, with total urethral section. He has no medical-surgical history. The physical examination finds a good general condition, a partial tearing of the ventral face of the penis associated with a total rupture of the urethra followed by a hemorrhage, the rest of the examination was without particularity. The emergency assessment carried out was without particularity. The treatment consisted initially of catheterizing the urethra by a urinary tube ch 20, then a urethral replacement, followed by a Peno plastie. The surgical suites were enamelled with parietal suppuration plus necrosis at J 14 post-operative. A more bidaily dressing debridement followed with a favorable evolution at 2 months. Subsequently, a penile graft was performed more urethrolastic, with removal of the flap on the inner side of the thigh, the surgical suites were favorable on the sexual plane gradual resumption of night erections.