Diagnosing leukaemia in a primary health care setting

2022 ◽  
pp. 175573802110657
Author(s):  
Emma Hyde-Nero ◽  
Sarah Smith ◽  
Charlotte Martin ◽  
Nick York
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Early Diagnosis ◽  
Care Setting ◽  
Current Knowledge ◽  
Blood Tests ◽  
Primary Health ◽  
The Common ◽  
Specific Symptoms

This article synthesises current knowledge about the presentation and diagnosis of leukaemia. It will also suggest strategies for early diagnosis of the disease in primary care. This article is to be used as a guide by GPs in their learning for when to initiate blood tests for possible cases of leukaemia and how to recognise the common and non-specific symptoms of leukaemia.

scholarly journals Physical activity promotion in the health care setting in Switzerland

2014 ◽  
Vol 62 (2) ◽  
Keyword(s):  
Physical Activity ◽  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Health Professionals ◽  
Care Setting ◽  
Physical Activity Promotion ◽  
Health Care Setting ◽  
Primary Health ◽  
Activity Promotion

The role of regular physical activity for population health has been clearly documented. Improvements in population levels of physical activity require long-term implementation of a combination of measures, including the evidence based approaches described in the “seven best investments for physical activity” (www.globalpa.org.uk): whole-of-school programmes, transport, urban planning, integration of physical activity promotion into primary health care systems, public education, community-wide programmes, sport for all. The health care setting has a particular role in this context, particularly in its access to physically inactive individuals. Switzerland has seen a number of successful research projects in this field, but there has been no wide adaptation of these approaches in the medical community. In recent years, a group of institutions including the Swiss College of Primary Care Medicine, the Policlinique Médicale Universitaire in Lausanne, the Ligue Vaudoise contre les Maladies Cardiovasculaires and the Institute of Social and Preventive Medicine of the University of Zurich have therefore focussed on the development of a physical activity counselling approach based on international evidence as well as on established tools, but streamlined to the specific demands of primary health care providers in Switzerland. PAPRICA (Physical Activity Promotion in Primary Care, www.paprica.ch) has been the result of these developments, and nearly 300 health professionals, most of them primary care physicians, have been successfully trained so far. PAPRICA is implemented together with the Swiss Society for Sports Medicine and a number of regional partners. The development of a national programme structure is currently under preparation. This will allow Switzerland to explore and better use the potential of physicians and other health professionals in the promotion of physical activity and in the fight against non-communicable diseases.

scholarly journals Body Mass Index Assessment of Health Care Professionals in a Primary Care Setting in Portugal: a Cross Sectional Study

2014 ◽  
Vol 27 (5) ◽  
pp. 609 ◽  
Author(s):  
Inês Campos-Matos ◽  
André Peralta-Santos ◽  
Bernardo Gomes ◽  
Gustavo Borges ◽  
Pedro Aguiar
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Body Mass Index ◽  
Primary Health Care ◽  
Body Mass ◽  
Health Care Professionals ◽  
Care Setting ◽  
Primary Care Setting ◽  
Cross Sectional ◽  
Primary Health

<p><strong>Introduction:</strong> Obesity is an important public health problem because it is a risk factor for numerous diseases and is associated with a higher death risk. Evidence concerning the prevalence of excess weight in health professionals is scarce and this group is often overlooked in weight interventions programs. This paper aims to estimate the prevalence of obesity and overweight among Portuguese primary health care professionals and to describe differences between occupational groups.<br /><strong>Material and Methods:</strong> This was a cross sectional study based on a primary care setting in Portugal in 2011. We collected data on occupation, age, sex and height of professionals from four primary care centers. We did a descriptive analysis of the main variables and an analysis of covariance to compare mean Body Mass Index.<br /><strong>Results:</strong> Our sample represented 52.8% of the total population of the four primary care centers, and 38.6% were overweight and 16.9% were obese. When adjusted for age and gender, health service personnel had the highest average Body Mass Index, followed by nurses, physicians, and superior technicians, in that order.<br /><strong>Discussion:</strong> Although we can’t ensure the generalisation of the results and cannot exclude the possibility of sampling bias, these results suggest high prevalence obesity and overweight in workers of primary health care in Portugal.<br /><strong>Conclusion:</strong> In this primary care setting more than half of the health care professionals were overweight or obese. Tailored interventions might be needed to tackle this issue.</p><p><br /><strong>Keywords:</strong> Body Mass Index; Health Personnel; Obesity; Portugal; Primary Health Care; Prevalence.</p>

Brazilian National Household Health Survey and PCAT: the case of Mato Grosso do Sul, Brazil

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L F Pinto ◽  
D Soranz ◽  
L J Santos ◽  
M S Paranhos ◽  
L S Malta ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Data Collection ◽  
Health Survey ◽  
Household Surveys ◽  
Mato Grosso ◽  
Primary Health ◽  
The World ◽  
Mato Grosso Do Sul

Abstract Brazil is divided into five administrative regions, 27 federation units and 5,570 municipalities. Mato Grosso do Sul is one of the states located in the Midwest region and has 1.6 million km2 and a resident population of 2.8 million inhabitants, that is, it has an even lower demographic density than its region - only 7.8 inhabitants/km2. Mato Grosso do Sul has part of the Pantanal, a biome considered the largest continuous floodplain in the world, rich in biodiversity. For this reason, displacements for data collection in household surveys combine roads and rivers. In 2019, the Brazilian National Institute of Geography and Statistics (Istituto Nazionale di Statistica del Brasile) in partnership with the Ministry of Health launched the world's largest household sample survey, the National Health Survey (PNS-2019), in which part of its questions included the use of Primary Care Assessment Tool (PCAT, adult version), created by professors Barbara Starfield and Leiyu Shi in the 2000s. IBGE interviewers visited more than 100,000 households across the country. In Mato Grosso do Sul, more than 3,000 households were surveyed. In this work, we present the data collection instrument used by IBGE and its multiple analysis possibilities in the scope of primary health care, crossing the variables from other questionnaire modules in order to compare the results from Brazil with the state of Mato Grosso do Sul and its capital, Campo Grande. Developing a baseline and measuring the attributes of primary health care in each of the Brazilian states is another step towards giving health policy accountability, towards strong primary care. IBGE's experience in household surveys and innovation in data collection in primary care is an example for the world that yes, it is possible to develop statistically representative national sample surveys and make them perennial in their regular household surveys, by the time World Health Organization (WHO) discusses universal health coverage. Key messages Evaluation of primary care using an internationally validated instrument is possible on national bases with random household sample surveys. A questionnaire elaborated academically can be used as an instrument of public policy to evaluate nationwide health services.

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 Using logic models to enhance the methodological quality of primary health-care interventions: guidance from an intervention to promote nutrition care by general practitioners and practice nurses

2017 ◽  
Vol 23 (1) ◽  
pp. 53 ◽  
Author(s):  
Lauren Ball ◽  
Dianne Ball ◽  
Michael Leveritt ◽  
Sumantra Ray ◽  
Clare Collins ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Care Setting ◽  
Logic Model ◽  
Practice Nurses ◽  
Nutrition Care ◽  
Health Care Interventions ◽  
Primary Health ◽  
Health Care Practitioners ◽  
Logic Models

The methodological designs underpinning many primary health-care interventions are not rigorous. Logic models can be used to support intervention planning, implementation and evaluation in the primary health-care setting. Logic models provide a systematic and visual way of facilitating shared understanding of the rationale for the intervention, the planned activities, expected outcomes, evaluation strategy and required resources. This article provides guidance for primary health-care practitioners and researchers on the use of logic models for enhancing methodological rigour of interventions. The article outlines the recommended steps in developing a logic model using the ‘NutriCare’ intervention as an example. The ‘NutriCare’ intervention is based in the Australian primary health-care setting and promotes nutrition care by general practitioners and practice nurses. The recommended approach involves canvassing the views of all stakeholders who have valuable and informed opinions about the planned project. The following four targeted, iterative steps are recommended: (1) confirm situation, intervention aim and target population; (2) document expected outcomes and outputs of the intervention; (3) identify and describe assumptions, external factors and inputs; and (4) confirm intervention components. Over a period of 2 months, three primary health-care researchers and one health-services consultant led the collaborative development of the ‘NutriCare’ logic model. Primary health-care practitioners and researchers are encouraged to develop a logic model when planning interventions to maximise the methodological rigour of studies, confirm that data required to answer the question are captured and ensure that the intervention meets the project goals.

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