scholarly journals The Jordanian primary healthcare practitioner in cancer control

2017 ◽  
Vol 18 (03) ◽  
pp. 261-269 ◽  
Author(s):  
Nour A. Obeidat ◽  
Feras I. Hawari ◽  
Malek A. Habashneh ◽  
Rawan A. Shihab
Keyword(s):  
Cancer Screening ◽  
Cancer Detection ◽  
Primary Healthcare ◽  
Cancer Control ◽  
Signs And Symptoms ◽  
Related Services ◽  
Cancer Early Detection ◽  
Health Clinics ◽  
Primary Health ◽  
Specialized Care

AimTo measure the knowledge, perceptions, and practices of Jordanian primary healthcare practitioners (PHCPs) (physicians, nurses, midwives, and nurse aids) employed in Jordanian Ministry of Health (MoH) primary health clinics with respect to counseling on cancer (cancer screening, the signs and symptoms of cancer, and referral for specialized care).BackgroundIntegration of oncology services within primary care is a means of enhancing cancer early detection, and requires involvement of skilled. In the Middle East, little is known about PHCPs’ potential to be providers of such services.MethodsA questionnaire measuring PHCP perceptions and practices related to counseling on cancer screening and diagnosis was distributed to PHCPs across MoH clinics covering the main regions of Jordan.FindingsA total of 322 practitioners responded (75.1% response). Across most activities involving cancer detection, no more than 30% reported performing activities. Roughly half of PHCPs expressed discomfort at providing cancer-related counseling and at least 43% of non-physicians expressed limited confidence in cancer-related counseling. Confidence was a consistent predictor of provision of counseling and confidence in turn was associated with having greater knowledge, having positive a valuation of counseling, and being a physician. Results reveal points where educational efforts can strengthen PHCPs’ provision of cancer control-related services.

scholarly journals The knowledge, understanding and perceptions of professional nurses, working in primary health care clinics, about autism spectrum disorder

2018 ◽  
Author(s):  
◽  
Neil Arnold Williams
Keyword(s):  
South Africa ◽  
Autism Spectrum Disorder ◽  
Sample Size ◽  
Primary Healthcare ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Health Clinics ◽  
Primary Health ◽  
Kwazulu Natal ◽  
Professional Nurses

Background Abstract The Centers for Disease Control and Prevention (CDC) in the United States has found that more children than ever before are being classified as having autism spectrum disorders (ASDs) (Chiri and Warfield 2011: 1081). According to Matenge (2014: 1), ASD is a pervasive developmental disorder characterised by two essential features: a combination of impairments in social interaction and social communication, and restricted, repetitive, and stereotyped patterns of behaviour, interests and activities. Malcolm-Smith et al. (2013: 4) report that data on the incidence, prevalence, and impact of ASD in South Africa are almost entirely lacking. No epidemiological studies of ASD have been conducted in the country (Malcolm- Smith et al. 2013: 4). Diagnostic and intervention services, particularly at state level, are scarce (Malcolm-Smith et al. 2013: 4). Hence, those that are in place are heavily overburdened. Of particular concern for South Africa are research findings indicating that ASD is under-identified in low socioeconomic status communities, so in these contexts ASD often goes undiagnosed, or is diagnosed late (Malcolm-Smith et al. 2013: 4). Matenge (2014: 19) argues that there is, therefore, a need to assess the level of knowledge, understanding and the experiences of South African nurses regarding autism, as they are usually the first professionals that families of children with autism contact. Research purpose The purpose of this research was to determine the knowledge, understanding and perceptions of professional nurses who work in primary health clinics in eThekwini Health District, KwaZulu-Natal, regarding ASD. Research design A quantitative, non-experimental, descriptive research survey design was utilised. A self-reporting questionnaire was used to collect data. Sampling and sample size Simple random sampling was used to determine which clinics in the eThekwini health district would be part of the study. The sample size for the clinics was thirty four, of those thirty were eThekwini municipality clinics and four KwaZulu-Natal Department of Health clinics. These clinics were utilised and provided the 275 professional nurses needed. The sample was calculated with a margin of error and an alpha value of 0.05; the researcher needed a minimum of 275 respondents. The researcher selected the respondents utilising non-probability, convenience sampling. Data analysis Data was analysed with the assistance of the statistician, using SPSS version 22. Descriptive statistics were used to explore differences between or among groups (Grove, Burns and Gray 2013: 217). Inferential statistics are used to draw conclusions regarding the differences between groups in the population from which the samples are drawn and the relationship between the variables in the population (Morgan et al. 2015: 84). Both descriptive and inferential statistics were used to analyse data in this study. Conclusion and findings It was found that the average professional nurse working in a primary healthcare clinic has 65.8% knowledge and understanding of ASD. Of particular concern is that the majority of respondents 51% (n=141) did not know or understand that the child with autism loves routine which is a key symptom in making a diagnosis of ASD, which may lead to late, or missed diagnosis. Eighty eight percent (n = 242) of respondents felt that they would benefit from further training on the identification and diagnosis of ASD. It was also found that respondents that have completed the Psychiatric Nursing Science course were more knowledgeable about ASD and confident in diagnosing ASD and counselling parents on ASD and available ASD services in the community. Recommendations The researcher recommended that: Autism spectrum disorder to be included in the curriculum for nurses training and that regular in-service training be done to keep the professional nurses up to date with on new information related to ASD. It was also recommended that all children should be screened for ASD at 18 and 24 months at all PHCs in eThekwini district and that posters on the signs and symptoms of ASD should be displayed at primary healthcare clinics in full view of patients, parents and staff

scholarly journals Driving digital transformation of comprehensive primary health services at scale in India: an enterprise architecture framework

2021 ◽  
Vol 6 (Suppl 5) ◽  
pp. e005242
Author(s):  
Sunita Nadhamuni ◽  
Oommen John ◽  
Mallari Kulkarni ◽  
Eshan Nanda ◽  
Sethuraman Venkatraman ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Services ◽  
Primary Healthcare ◽  
Enterprise Architecture ◽  
Digital Health ◽  
Security And Privacy ◽  
Primary Health ◽  
Architecture Framework ◽  
Primary Health Services ◽  
Enterprise Architecture Framework

In its commitment towards Sustainable Development Goals, India envisages comprehensive primary health services as a key pillar in achieving universal health coverage. Embedded in siloed vertical programmes, their lack of interoperability and standardisation limits sustainability and hence their benefits have not been realised yet. We propose an enterprise architecture framework that overcomes these challenges and outline a robust futuristic digital health infrastructure for delivery of efficient and effective comprehensive primary healthcare. Core principles of an enterprise platform architecture covering four platform levers to facilitate seamless service delivery, monitor programmatic performance and facilitate research in the context of primary healthcare are listed. A federated architecture supports the custom needs of states and health programmes through standardisation and decentralisation techniques. Interoperability design principles enable integration between disparate information technology systems to ensure continuum of care across referral pathways. A responsive data architecture meets high volume and quality requirements of data accessibility in compliance with regulatory requirements. Security and privacy by design underscore the importance of building trust through role-based access, strong user authentication mechanisms, robust data management practices and consent. The proposed framework will empower programme managers with a ready reference toolkit for designing, implementing and evaluating primary care platforms for large-scale deployment. In the context of health and wellness centres, building a responsive, resilient and reliable enterprise architecture would be a fundamental path towards strengthening health systems leveraging digital health interventions. An enterprise architecture for primary care is the foundational building block for an efficient national digital health ecosystem. As citizens take ownership of their health, futuristic digital infrastructure at the primary care level will determine the health-seeking behaviour and utilisation trajectory of the nation.

scholarly journals Impact of Pharmacist Insulin Injection Re-Education on Glycemic Control Among Type II Diabetic Patients in Primary Health Clinics

2021 ◽  
Author(s):  
Selvakumari Selvadurai ◽  
Kit Yee Cheah ◽  
Min Wei Ching ◽  
Hanisah Kamaruddin ◽  
Xiao You Lee ◽  
...  
Keyword(s):  
Glycemic Control ◽  
Insulin Injection ◽  
Diabetic Patients ◽  
Type Ii ◽  
Health Clinics ◽  
Primary Health

scholarly journals Advancing engagement and capacity for rural cancer control: a mixed-methods case study of a Community-Academic Advisory Board in the Appalachia region of Southwest Virginia

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Jamie M. Zoellner ◽  
Kathleen J. Porter ◽  
Donna-Jean P. Brock ◽  
Emma Mc Kim Mitchell ◽  
Howard Chapman ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Cancer Screening ◽  
Cancer Control ◽  
Value Added ◽  
Advisory Board ◽  
Comprehensive Cancer Control ◽  
Structured Interviews ◽  
Human Papillomavirus Vaccination ◽  
Time Points

Abstract Background The objectives are to: 1) describe engagement processes used to prioritize and address regional comprehensive cancer control needs among a Community-Academic Advisory Board (CAB) in the medically-underserved, rural Appalachian region, and 2) detail longitudinal CAB evaluation findings. Methods This three-year case study (2017–2020) used a convergent parallel, mixed-methods design. The approach was guided by community-based participatory research (CBPR) principles, the Comprehensive Participatory Planning and Evaluation process, and Nine Habits of Successful Comprehensive Cancer Control Coalitions. Meeting artifacts were tracked and evaluated. CAB members completed quantitative surveys at three time points and semi-structured interviews at two time points. Quantitative data were analyzed using analysis of variance tests. Interviews were audio recorded, transcribed, and analyzed via an inductive-deductive process. Results Through 13 meetings, Prevention and Early Detection Action Teams created causal models and prioritized four cancer control needs: human papillomavirus vaccination, tobacco control, colorectal cancer screening, and lung cancer screening. These sub-groups also began advancing into planning and intervention proposal development phases. As rated by 49 involved CAB members, all habits significantly improved from Time 1 to Time 2 (i.e., communication, priority work plans, roles/accountability, shared decision making, value-added collaboration, empowered leadership, diversified funding, trust, satisfaction; all p < .05), and most remained significantly higher at Time 3. CAB members also identified specific challenges (e.g., fully utilizing member expertise), strengths (e.g., diverse membership), and recommendations across habits. Conclusion This project’s equity-based CBPR approach used a CPPE process in conjunction with internal evaluation of cancer coalition best practices to advance CAB efforts to address cancer disparities in rural Appalachia. This approach encouraged CAB buy-in and identified key strengths, weaknesses, and opportunities that will lay the foundation for continued involvement in cancer control projects. These engagement processes may serve as a template for similar coalitions in rural, underserved areas.

scholarly journals Primary care organizational model mix and avoidable hospitalization: an ecological study in Portugal

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Pinto ◽  
J V Santos ◽  
M Lobo ◽  
J Viana ◽  
J Souza ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Primary Healthcare ◽  
Pay For Performance ◽  
Care Quality ◽  
Organizational Model ◽  
Avoidable Hospitalizations ◽  
Primary Health ◽  
Age And Sex

Abstract Background In Portugal, there are different organizational models in primary health care (PHC), mainly regarding the payment scheme. USF-B is the only type with financial incentives to the professional (pay-for-performance). Our goal was to assess the relationship between groups of primary healthcare centres (ACES) with higher proportion of patients within USF-B model and the rate of avoidable hospitalizations, as proxy of primary care quality. Methods We conducted a cross-sectional study considering the 55 ACES from mainland Portugal, in 2017. We used data from public hospitalizations to calculate the prevention quality indicator (avoidable hospitalizations) adjusted for age and sex, using direct standardization. The main independent variable was the proportion of patients in one ACES registered in the USF-B model. Unemployment rate, proportion of patients with family doctor and presence of Local Health Unit (different organization model) within ACES were also considered. The association was assessed by means of a linear regression model. Results Age-sex adjusted PQI value varied between 490 and 1715 hospitalizations per 100,000 inhabitants across ACES. We observed a significant effect of the proportion of patients within USF-B in the crude PQI rate (p = 0.001). However, using the age-sex adjusted PQI, there was not a statistical significant association (p = 0.504). This last model was also adjusted for confounding variables and the association remains non-significant (p = 0.865). Conclusions Our findings suggest that, when adjusting for age and sex, there is no evidence that ACES with more patients enrolled in a pay-for-performance model is associated with higher quality of PHC (using avoidable hospitalizations as proxy). Further studies addressing individual data should be performed. This work was financed by FEDER funds through the COMPETE 2020 - POCI, and by Portuguese funds through FCT in the framework of the project POCI-01-0145-FEDER-030766 “1st.IndiQare”. Key messages Adjusting PQI to sex and age seems to influence its value more than the type of organizational model of primary health care. Groups of primary healthcare centres with more units under the pay-for-performance scheme was not associated with different rate of avoidable hospitalizations.

scholarly journals Use of primary health care and participation in colorectal cancer screening – a Danish national register-based study

2020 ◽  
Vol 59 (8) ◽  
pp. 1002-1006
Author(s):  
Rebecca Beatrix Clarke ◽  
Christina Therkildsen ◽  
Mie Agermose Gram ◽  
Klaus Kaae Andersen ◽  
Lina Steinrud Mørch ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Health Care ◽  
Primary Health Care ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
National Register ◽  
Primary Health

Development of extracellular vesicles-based classifier for detection of early-stage bladder, ovarian, and pancreatic cancer.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 3048-3048
Author(s):  
Juan Pablo Hinestrosa ◽  
Razelle Kurzrock ◽  
Jean Lewis ◽  
Nick Schork ◽  
Ashish M. Kamat ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Confidence Interval ◽  
Extracellular Vesicles ◽  
Metastatic Disease ◽  
Cancer Detection ◽  
Early Stage ◽  
Expression Patterns ◽  
Stepwise Logistic Regression ◽  
Liquid Biopsies ◽  
Cancer Early Detection

3048 Background: Many cancers are lethal because they present with metastatic disease. Because localized/resectable tumors produce vague symptoms, diagnosis is delayed. In pancreatic cancer, only ̃10% of patients survive five years, and it will soon become the second leading cause of cancer-related deaths in the USA. For patients with metastatic disease, the 2- and 5-year survival is < 10% and ̃3%, respectively. For the few patients with local disease, 5-year survival is ̃40%. Many other cancers have comparable differences between early- and late-stage disease. It is apparent a diagnostic assay for early-stage cancers would transform the field by minimizing the need for aggressive surgeries and other harsh interventions, and by its potential to increase survival. Identifying cancer-specific aberrations in blood-based “liquid” biopsies offers a prospect for a non-invasive cancer detection tool. In the bloodstream, there are extracellular vesicles (EVs) with cargoes including membrane and cytosolic proteins, as well as RNA and lipids derived from their parent cells. Methods: We used an alternating current electrokinetics (ACE) microarray to isolate EVs from the plasma of stage I and II bladder (N = 48), ovarian (N = 42), and pancreatic cancer patients (N = 44), and healthy volunteers (N = 110). EVs were analyzed using multiplex protein immunoassays for 54 cancer-related proteins. EV protein expression patterns were analyzed using stepwise logistic regression followed by a split between training and test sets (67%/33% respectively). This process enabled biomarker selection and generation of a classifier to discriminate between cancer and healthy donors. Results: The EV protein-based classifier had an overall area under curve (AUC) of 0.95 with a sensitivity of 71.2% (69.4% – 73.0%, at 95% confidence interval) at > 99% specificity. The classifier’s performance for the pancreatic cancer cohort was very strong, with overall sensitivity of 95.7% (94.6% – 96.9%, at 95% confidence interval) at > 99% specificity. Conclusions: EV-associated proteins may enable early cancer detection where surgical resection is most likely to improve outcomes. The classifier’s performance for the initial three cancers studied showed encouraging results. Future efforts will include examining additional cancer types and evaluating the classifier performance using samples from donors with related benign conditions with the aim of a pan-cancer early detection assay.

scholarly journals Novel Mapping Methods to Describe Utilization of Free Breast Cancer Screening from a State Program

2020 ◽  
Author(s):  
Kelly Hughes ◽  
David Haynes ◽  
Anne Joseph
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Adaptive Filters ◽  
Mapping Technique ◽  
Cancer Early Detection ◽  
Spatially Adaptive ◽  
National Breast ◽  
Detection Program ◽  
Early Detection Program

The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) of Minnesota, &ldquo;Sage&rdquo;, provides breast cancer screening to uninsured women. We introduce a novel mapping technique, spatially adaptive filters (SAFs), to estimate utilization of Sage screening in Minnesota. Sage screenings (N = 74,712) were geocoded. The eligible population was modeled with the RTI synthetic population dataset. Between 2011 and 2015, 36,979 women a year were Sage eligible. Utilization was highly variable across Minnesota (M = 37.2%, range 0% - 131%, SD = 18.7%). This replicable approach modeled utilization rates to the neighborhood-level, allowing Sage to prioritize locations and engage communities.

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