scholarly journals Multiple micronutrients in powder delivered through primary health care reduce iron and vitamin A deficiencies in young Amazonian children

2016 ◽  
Vol 19 (16) ◽  
pp. 3039-3047 ◽  
Author(s):  
Cristieli SM Oliveira ◽  
Patrícia Sampaio ◽  
Pascoal T Muniz ◽  
Marly A Cardoso ◽  

AbstractObjectiveWe evaluated the effect of home fortification with multiple micronutrient powder (MNP) on anaemia and micronutrient status of young Amazonian children.DesignA pragmatic controlled trial was performed. A control group (CG) of children aged 11–14 months was recruited in the routine of primary health-care centres for assessing anaemia and micronutrient status. At the same time, an intervention group (IG) of infants aged 6–8 months was recruited in the same health centres to receive MNP daily in complementary feeding for 2 months. The IG children were assessed 4–6 months after enrolment (n112) when they had reached the age of the CG participants (n128) for comparisons.SettingPrimary health centres in Rio Branco city, Brazilian Amazon.SubjectsA total of 240 children aged<2 years.ResultsIn the CG, the prevalence of anaemia (Hb<110 g/l), iron deficiency (ID; plasma ferritin <12 μg/l or soluble transferrin receptor >8·3 mg/l) and vitamin A deficiency (VAD; serum retinol <0·70 μmol/l) was 20·3 %, 72·4 % and 18·6 %, respectively. Among the IG participants (aged 11–14 months), the prevalence of anaemia, ID and VAD was 15·2 %, 25·2 % and 4·7 %, respectively. The IG had a lower likelihood of ID (prevalence ratio (95 % CI): 0·34 (0·24, 0·49)) and VAD (0·25 (0·09, 0·64)).ConclusionsHome fortification of complementary feeding delivered through primary health care was effective in reducing iron and vitamin A deficiencies among young Amazonian children.

2021 ◽  
Vol 6 (1) ◽  
pp. 1
Author(s):  
Vera Kurnia ◽  
Desti Nataria

Hypertension is one of the most common causes of morbidity and mortality  all over the world, also known as “the silent killer” because people with hypertension are without symptoms. West Sumatera Province reported that the prevalence of hypertension at the age 18 years has increased from 25,8% in 2013 to 31,7% in 2018. Successful strategies to manage the blood preasure depends on patients self-care management or the ability and willingness of the patient to change and maintain certain behavior.The purpose of this research is to determine the effect of self-education management of hypertension patients in the working area of primary health care in Bukittinggi.Design of this research is a quasi experimental design with pretest-posttest with control group. The sample which used were 62 respondents consist of 31 people in the intervention group and 31 people in the group control. Sampling was done by consecutive sampling technique. Data was analyzed Wilcoxon signed rank test and Mann Whitney test. The result of this research shows that there isn’t any effect of self education management to healthy behavior which includes exercise and healthy diet of the intervention group and the control group at community health center in Bukittinggi (mean rank after the intervention < 10; p> 0,05). Based on the result of this research it can be concluded that the habits of respondents who carry out light and medium activities every day and also education provided by primary health care  have given big impact to respondent’s habits where they always do exercise and healthy diet in their daily life.The result of this research can be used as an input for primary health care to maintain and improve education of healthy behavior for hypertension patients.


2020 ◽  
Vol 54 ◽  
pp. 103
Author(s):  
Marco Antonio Vieira da Silva ◽  
Thaís Moreira São-João ◽  
Marilia Estevam Cornelio ◽  
Fábio Luiz Mialhe

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.


2021 ◽  
Vol 32 (4) ◽  
pp. 577-582
Author(s):  
Mahacita Andanalusia ◽  
Yunita Nita ◽  
Umi Athiyah

Abstract Objectives Nonadherence to a long-term therapy, including diabetes mellitus, is one of the global problems that need to be overcome. This study aims to determine the effect of pillbox use and education by pharmacists toward medication adherence in patients with diabetes mellitus in a Primary Health Care Center in Mataram. Methods This research was an experimental research design with pretest-posttest with control group design. The study was conducted from October to December 2019 at Tanjung Karang Primary Health Care Center, Mataram. Measurement of adherence was done using the Adherence to Refill and Medication Scale questionnaire. The higher the score, the more nonadherence the patients. Patients were divided into three groups, which were the control group, educational intervention group, and pillbox and educational intervention group. Each group consisted of 11 patients. Results Patients’ medication adherence increased from 19.54 (SD 4.37) to 15.18 (SD 2.64) in the education and pillbox intervention group (p=0.004). Whereas, in the education and control group, the adherence did not provide a significant change (p>0.05). Based on the difference in adherence scores, it was known that what contributed to changes in compliance was refilling medicine and intentional nonadherence in taking medicine subscale (p=0.024). Conclusions Providing education and pillbox done by pharmacists at the Primary Health Care Center can increase adherence to the therapy of diabetes mellitus patients. Pharmacists at the Primary Health Care Center can use the intervention model to improve the level of adherence of patients with chronic illness.


Work ◽  
2021 ◽  
pp. 1-10
Author(s):  
Jenny Hultqvist ◽  
Pernilla Bjerkeli ◽  
Gunnel Hensing ◽  
Kristina Holmgren

BACKGROUND: Work-related stress (WRS) presents a risk for sick leave. However, effective methods to identify people at risk for sick leave due to WRS at an early stage are lacking in primary health care. OBJECTIVE: To evaluate whether a systematic early identification of WRS can prevent sick leave over 24 months after the intervention. METHODS: Study participants (n = 132 intervention; n = 139 control) were employed, non-sick-listed persons seeking care at primary health care centres. The intervention included early identification of WRS by a validated instrument, general practitioner (GP) awareness supported by a brief training session, patients’ self-reflection by instrument completion, GP giving the patient feedback at consultation and GP identifying preventive measures. The control group received treatment as usual. Outcome data were retrieved from the Swedish Social Insurance Agency. RESULTS: The intervention group had less registered median sick leave days (n = 56) than the control group (n = 65) but the difference was not statistically significant. CONCLUSIONS: The brief intervention was not proven effective in preventing sick leave in the following 24 months compared to treatment as usual. Further research on how to identify, advice and treat those at high risk for sick leave in primary health care is needed.


2020 ◽  
Vol 11 (3) ◽  
pp. 4603-4607
Author(s):  
Muhammad Faisal ◽  
Rahayu Indriasari ◽  
Meta Mahendradatta ◽  
Rukman Abdullah ◽  
Masrianih ◽  
...  

Aloe is a medicinal plant in Indonesia, which is often used as traditional medicine. The purpose of this study was to find out the influence of Aloe juice administration on changes in lipid profile (HDL, LDL, Triglycerides) in East Pontianak Primary Health Care Center. This study used quasi-experimental. This study used sampling on 36 people in 2 groups. In the treatment group, there was Aloe juice administration of 250 ml/day for 15 days while in the control group there was no Aloe juice administration. HDL level in the intervention group had an increase of 14.89 mg/ whereas in the control group had an increase of 1.22 mg/, where there was no significant difference between the intervention group and control group (p&gt; 0.05), LDL level in the intervention group had a decrease of 10.56 mg/ while the control group had a decrease of 5.94 mg/ where there was no significant difference between the intervention group and the control group (p&gt; 0.05) and triglyceride level in the intervention group had a decrease of 8.78 mg/ whereas in the control group had a decrease of 3.50 mg/ where there was no significant difference between the intervention group and the control group (p&gt; 0.05) which means intervention group and control group had no significant differences. The mean HDL level had an increase while the LDL level and triglyceride level had a decrease.


2021 ◽  
Vol 31 (Supplement_3) ◽  
Author(s):  
A-M Hultén ◽  
P Bjerkeli ◽  
K Holmgren

Abstract Background General practitioners (GPs) play an important role for early identification and prevention of sick leave among patients perceiving ill health due to work-relates stress. In order to fulfil the role, they need adequate methodologies and tools. This study aimed to evaluate the effectiveness of a brief intervention in primary health care including early identification of work-related stress combined with feedback at consultation on the number of self-reported sick leave days. Methods A randomised controlled trial was performed at seven primary health care centres in western Sweden. Self-reported sick leave data collected between November 2015 and January 2017 were analysed prospectively. The study included 271 employed, non-sick-listed patients aged 18-64 years seeking care for mental and/or physical health complaints. The intervention group received a brief intervention about work-related stress, including training for GPs, screening of patients' work-related stress, feedback to patients on screening results and discussion of measures at GP consultation. The control group received treatment as usual. Results At 6-month follow-up 59/105 (56%) in the intervention group and 61/115 (53%) in the control group reported no sick leave. At 12-month follow-up the corresponding numbers were 61/119 (51%) and 57/122 (47%) respectively. There were no statistically significant differences between the intervention group and the control group in the median number of self-reported sick leave days. Conclusions The brief intervention showed no effect on the numbers of self-reported sick leave days. However, using sick leave as an outcome measure was difficult, as sick leave is multifactorial and the data has a non-normal distribution. In addition, sick leave might be used as an indicator as well as a possible treatment of ill health. Other actions and interventions to address patients perceiving ill health due to work-related stress should be explored. Key messages Sick leave is used as an indicator and as a treatment of ill health, which can complicate the evaluation of studies. The complexity of primary health care trials calls for other evaluation methods.


2021 ◽  
Vol 10 (13) ◽  
pp. e21101320382
Author(s):  
Camila Tomicki ◽  
Cassiano Ricardo Rech ◽  
Aline Mendes Gerage ◽  
Elizabeth Nappi Corrêa ◽  
Lisandra Maria Konrad ◽  
...  

This study aimed to investigate the effectiveness and maintenance of the behavior change program "VAMOS", version 2.0, on behavioral and health outcomes in Brazilian users (≥ 18 years) of Primary Health Care (PHC) in Florianópolis, state of Santa Catarina, southern Brazil. A pragmatic clinical trial was carried out between 2016 and 2019 in Basic Health Units, with 265 users allocated in the intervention group (n = 125) and the control group (n = 140). The intervention group participated for three months in the VAMOS to promote physical activity (PA) and a healthy diet. The control group received in a single meeting counseling about the importance of an active and healthy lifestyle. Variables of PA (daily minutes in light PA, moderate-to-vigorous PA, total PA, and sedentary behavior), eating behavior (weekly consumption of fruits, vegetables, and soda drinks), anthropometry (body mass, waist circumference (WC), and body mass index), and quality of life (QOL) (positive or negative perception), were evaluated, through interviews and objective measures, in the pre-intervention, post-intervention, and 12 months after the end of the intervention. The intervention group increased moderate-to-vigorous PA bouts, consumed of vegetables and, QOL, and decreased the consumption of soda drinks and WC (p<0.05). The intervention was sufficient to maintain the achieved benefits of moderate-to-vigorous PA bouts, soda drink consumption, and WC. VAMOS effectively promote an active and healthy lifestyle in PHC users and, its strategies proved to be adequate to maintain the gains acquired. VAMOS is a pioneer and a health innovation.


2018 ◽  
Vol 12 (3) ◽  
Author(s):  
Herta Masthalina ◽  
Zein Agustina

AbstractTo implement exclusive breastfeeding program, breastfeeding mothers should have a good knowledge. One way to gain knowledge is by providing nutritional counseling. This study aimed to determine the effect of nutrition counseling toward exclusive breastfeeding and nutritional status toward the knowledge and attitude of breastfeeding mothers in Lubuk Pakam Subdistrict Primary Health Care. This study was a quasi experimental with non-equivalent control group design. Samples of 60 mothers were divided into two groups that were 30 mothers who received intensive nutrition counseling at the intervention group inLubuk Pakam Primary Health Care work area and 30 mothers at control group in Tanjung Morawa Primary Health Care work area. The intervention group was given nutrition counseling intervention for three months provided in three sessions. The study was conducted in March-August 2016. The statistical analysis used t-test. The results showed that before intervention, knowledge and attitude in both groups did not differ consecutively with p value = 0.290 and p value = 0.658, after intervention both knowledge and behavior were significantly different p value = 0.000. While the average weight gain in infants in the first month was 1.25 kg in intervention group, 1.19 kg in control group , and in the second month was 1,44 kg in intervention group and 1 kg in control group. Paired tests show that there is effect of nutritional counseling toward knowledge and attitude in the intervention group.AbstrakUntuk dapat menjalankan program ASI eksklusif, ibu menyusui harus memiliki pengetahuan yang baik. Salah satu cara dalam menambah pengetahuan yaitu dengan memberikan konseling gizi. Penelitian ini bertujuan untuk mengetahui pengaruh konseling gizi tentang ASI eksklusif dan status gizi terhadap pengetahuan dan sikap ibu menyusui di wilayah Puskesmas Kecamatan Lubuk Pakam. Jenis penelitian ini adalah quasi experimental non-equivalent control group design. Sampel sejumlah 60 ibu dibagi ke dalam dua kelompok, yaitu 30 ibu yang diberikan konseling gizi intensif pada kelompok intervensi di wilayah kerja Puskesmas Lubuk Pakam dan 30 ibu pada kelompok kontrol di wilayah kerja Puskesmas Tanjung Morawa. Kelompok perlakuan diberikan intervensi konseling gizi selama tiga bulan yang diberikan sebanyak tiga sesi. Penelitian dilakukan pada bulan Maret-Agustus 2016. Hasil penelitian menunjukkan sebelum dilakukan intervensi pengetahuan dan sikap pada kedua kelompok tidak berbeda secara berturut-turut dengan p=0.290 dan p=0.658, sedangkan setelah intervensi baik pengetahuan maupun perilaku berbeda secara signifikan dengan nilai p=0.000. Rata-rata kenaikan berat badan bayi pada bulan pertama pada kelompok perlakuan sebesar 1,25 kg, kelompok kontrol sebesar 1,19 kg dan bulan kedua pada kelompok intervensi sebesar 1,44 dan kelompok kontrol 1 kg. Paired test yang dilakukan menunjukkan bahwa terdapat pengaruh konseling gizi terhadap pengetahuan dan sikap pada kelompok intervensi.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
P Bjerkeli ◽  
I M Skoglund ◽  
K Holmgren

Abstract Background The study is part of a randomised controlled trial with the overall aim to evaluate if use of the Work Stress Questionnaire (WSQ), combined with feedback at consultation, can be used by healthcare professionals in primary health care to prevent sickness absence. The specific aim of the present study was to investigate whether there were differences in pharmacy dispensing of prescription medications between the intervention group and the control group. Methods The study was a randomized controlled trial. Non-sick-listed employed women and men, aged 18 to 64 years, seeking care at primary health care were eligible participants. The intervention included general practitionerś (GP) training to use the WSQ, early identification of patientś work-related stress by the WSQ, and GPś feedback on the WSQ results during the consultation. Pharmacy dispensing data from the Swedish Prescription Drug Register for 12 months following the intervention were analysed using Mann Whitney U tests and chi-square tests. Primary outcomes were the number of different medications used, type of medication and number of prescribing clinics. Results The study population included 271 individuals (132 in the intervention group and 139 in the control group). The proportion of individuals who collected more than 10 different medications was higher in the control group than in the intervention group (15.8% versus 4.5%, p = 0.002). In addition, the proportion of individuals filling prescriptions issued from more than three different clinics was higher in the control group than in the intervention group (17.3% versus 6.8%, p = 0.007). The number of different medications used per individual did not differ significantly between the control group (median 4.0) and the intervention group (median 4.0, p-value 0.076). Conclusions Systematic use of the WSQ combined with training of GPs and feedback at consultation may affect certain aspects of pharmacological treatment in primary health care patients. Key messages Systematic use of the WSQ combined with training of GPs and feedback at consultation may affect certain aspects of pharmacological treatment in primary health care patients. Patients in the intervention group had less polypharmacy and filled prescriptions issued from a smaller number of different clinics than controls.


2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Pernilla J. Bjerkeli ◽  
Ingmarie Skoglund ◽  
Kristina Holmgren

Abstract Background The study is part of a randomised controlled trial with the overall aim to evaluate if use of the Work Stress Questionnaire (WSQ), combined with feedback at consultation, can be used by healthcare professionals in primary health care to prevent sickness absence. The specific aim of the present study was to investigate whether there were differences in pharmacy dispensing of prescription medications between the intervention group and the control group. Methods The study was a randomized controlled trial. Non-sick-listed employed women and men, aged 18 to 64 years, seeking care at primary health care centres (PHCCs) were eligible participants. The intervention included early identification of work-related stress by the WSQ, general practitioner (GP) training and GP feedback at consultation. Pharmacy dispensing data from the Swedish Prescription Drug Register for a period of 12 months following the intervention was used. Primary outcomes were the number of different medications used, type of medication and number of prescribing clinics. Data was analysed using Mann Whitney U tests and chi-square tests. Results The study population included 271 individuals (132 in the intervention group and 139 in the control group). The number of different medications used per individual did not differ significantly between the control group (median 4.0) and the intervention group (median 4.0, p-value 0.076). The proportion of individuals who collected more than 10 different medications was higher in the control group than in the intervention group (15.8% versus 4.5%, p = 0.002). In addition, the proportion of individuals filling prescriptions issued from more than three different clinics was higher in the control group than in the intervention group (17.3% versus 6.8%, p = 0.007). Conclusion Systematic use of the WSQ combined with training of GPs and feedback at consultation may affect certain aspects of pharmacological treatment in primary health care patients. In this randomised control trial, analysis of pharmacy dispensing data show that patients in the intervention group had less polypharmacy and filled prescriptions issued from a smaller number of different clinics. Trial registration ClinicalTrials.gov. Identifier: NCT02480855. Registered 20 May 2015.


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