Factors affecting neonatal birth weight in Sidotopo Wetan Health Centre: A cross-sectional study

Birth weight serves as an indicator of a newborn’s health status. It is associated with mortality rate in the first year, developmental problems in childhood and risk of various diseases in adulthood. Even in modern era, it continues to be a health concern globally, especially in developing countries. In Indonesia, the prevalence of low birth weight has increased from 2013 to 2018, swaying further from the national target. Low birth weight is often caused by insufficient nutrients supplied by the mother to the fetus. In Indonesia, chronic energy deficiency status is diagnosed in the first antenatal care visit by measuring maternal middle-upper arm circumference with a cut-off point of 23.5cm. Meanwhile, iron level is measured via assessing hemoglobin level will be measured in the first antenatal care visit and in trimester III. This study aims to describe the factors that may influence neonatal birth weight. It is a quantitative study with a cross sectional approach conducted at Sidotopo Wetan Public Health Centre. 97 samples are collected from medical records and analysed using bivariate correlative test. Result shows that maternal age (0.20), chronic energy deficiency status (0.026) and antenatal care visit minimal of 4 times (0.49) increase the risk of low-birth-weight incidence. On the other hand, educational level, maternal parity and anemia status does not acts as risks. In conclusion, maternal age, energy status and visits to antenatal care acts as risk factors in causing low birth weight.

Diabetes Self-Management Education and Association With Diabetes Self-Care and Clinical Preventive Care Practices

Purpose: The purpose of the study is to assess self-reported receipt of diabetes education among people with diabetes and its association with following recommended self-care and clinical preventive care practices. Methods: We analyzed data from the 2017 and 2018 Behavioral Risk Factor Surveillance System for 61 424 adults (≥18 years) with self-reported diabetes in 43 states and Washington, DC. Diabetes education was defined as ever taking a diabetes self-management class. The association of diabetes education with self-care practices (daily glucose testing, daily foot checks, smoking abstention, and engaging in leisure-time physical activity) and clinical practices (pneumococcal vaccination, biannual A1C test, and an annual dilated eye exam, influenza vaccination, health care visit for diabetes, and foot exam by a medical professional) was assessed. Multivariable logistic regression with predicted margins was used to predict the probability of following these practices, by diabetes education, controlling for sociodemographic factors. Results: Of adults with diabetes, only half reported receiving diabetes education. Results indicate that receipt of diabetes education is associated with following self-care and clinical preventive care practices. Those who did receive diabetes education had a higher predicted probability for following all 4 self-care practices (smoking abstention, daily glucose testing, daily foot check, and engaging in leisure-time physical activity) and all 6 clinical practices (pneumonia vaccination, biannual A1C test, and an annual eye exam, flu vaccination, health care visit, and medical foot exam). Conclusions: The prevalence of adults with diabetes receiving diabetes education remains low. Increasing receipt of diabetes education may improve diabetes-related preventive care.

Timing of the first antenatal care visit and associated risk factors in rural parts of Ethiopia

Early antenatal care visit promotes early detection and treatment of complications during pregnancy. The aim of this study was to assess the timing of the first antenatal care visit and associated factors in rural parts of Ethiopia. Only 3065 women from 2016 Ethiopian Demographic and Health Survey in rural area were included in this study. The descriptive and binary logistic regression analysis used to identify the determinants associated with the timing of the first antenatal care visit. This study revealed that 31% of women visited the first antenatal care within the first three months. Our study revealed that women education, maternal age, region, media access, women occupation, distance from health facility, wealth index, pregnancy complication and plan for pregnancy had significant effects on timing of the first antenatal care visit early. To initiate pregnant mothers to attend the first ANC visit timely, community-based services like media coverage, education, transportation and giving awareness about the necessity of having antenatal care service early is mandatory.

Timing of the First Antenatal Care Visit and Associated Risk Factors in Rural Parts of Ethiopia

Early antenatal care visit promotes early detection and treatment of complications during pregnancy. The aim of this study was to assess the timing of the first antenatal care visit and associated factors in rural parts of Ethiopia. Only 3065 women from 2016 Ethiopian Demographic and Health Survey in rural area were included in this study. The descriptive and binary logistic regression analysis used to identify the determinants associated with the timing of the first antenatal care visit. This study revealed that 31% of women visited the first antenatal care within the first three months. Our study revealed that women education, maternal age, region, media access, women occupation, distance from health facility, wealth index, pregnancy complication and plan for pregnancy had significant effects on timing of the first antenatal care visit early. To initiate pregnant mothers to attend the first ANC visit timely, community-based services like media coverage, education, transportation and giving awareness about the necessity of having antenatal care service early is mandatory.

Respiratory symptoms and radiologic findings in post-acute COVID-19 syndrome

RationaleThe characteristics of patients with respiratory complaints and/or lung radiologic abnormalities after hospitalisation for COVID-19 are unknown. The objectives were to determine their characteristics and the relationships between dyspnoea, radiologic abnormalities and functional impairment.MethodsIn the COMEBAC cohort study, 478 hospital survivors were evaluated by telephone 4 months after hospital discharge, and 177 who had been hospitalised in an intensive care unit (ICU) or presented relevant symptoms underwent an ambulatory evaluation. New-onset dyspnoea and cough were evaluated, and the results of pulmonary function tests, high-resolution computed tomography of the chest were collected.ResultsAmong the 478 patients, 78 (16.3%) reported new-onset dyspnoea, and 23 (4.8%) new-onset cough. The patients with new-onset dyspnoea were younger (56.1±12.3 versus 61.9±16.6 years), had more severe COVID-19 (ICU admission 56.4% versus 24.5%) and more frequent pulmonary embolism (18.0% versus 6.8%) (all p≤0.001) than patients without dyspnoea. Among the patients reassessed at the ambulatory care visit, the prevalence of fibrotic lung lesions was 19.3%, with extent <25% in 97% of the patients. The patients with fibrotic lesions were older (61±11 versus 56±14 years, p=0.03), more frequently managed in ICU (87.9 versus 47.4%, p<0.001), had lower total lung capacity (74.1±13.7 versus 84.9±14.8%pred, p<0.001) and diffusing lung capacity for carbon monoxide (DLCO) (73.3±17.9 versus 89.7±22.8%pred, p<0.001). The combination of new-onset dyspnoea, fibrotic lesions and DLCO <70%pred was observed in 8/478 patients.ConclusionsNew-onset dyspnoea and mild fibrotic lesions were frequent at 4 months, but the association of new-onset dyspnoea, fibrotic lesions and low DLCO was rare.

Maternity Care Services Utilization and Factors Associated with Institutional Delivery Among Postpartum Women in Dabat Demographic and Health Survey Site, Northwest Ethiopia: A Community Based Baseline Survey for MNCH Surveillance

Background Maternal continuum of care is identified to have a greatest impact on maternal and child survival. However, there is a wide variation in maternal health services utilization from place to place in Ethiopia. Therefore, knowing antenatal care, labor and delivery, and postnatal care uptake has paramount importance to take interventions. Methods A community-based cross-sectional survey was conducted among 1626 postpartum women. Descriptive statistics were done to characterize the study population and utilization of antenatal care, institutional delivery, and postnatal care services. Logistic regression analysis was employed to identify factors associated with institutional delivery. Results Nearly eighty percent, (79.7%, 95% CI: 77.7, 81.6), of women attended at least one antenatal care visit at any health facility. However, only less than one third (31.4%) used all the recommended antenatal care (ANC). About half, 820 (49.2%: 95% CI: 46.7, 51.8) women delivered their child in health institution. About half, 822 (50.6%, 95% CI: 48.2, 52.9) of postpartum women who participated in this study had at least one postnatal care (PNC) visit at health facilities. Being urban resident (AOR=8.18, 95%CI: 4.69, 14.26)), respondents of higher educational status (AOR= 4.99, 95%CI: 2.51, 9.90), being Orthodox Christian (AOR= 2.35, 95%CI: 1.15, 4.79), getting TT vaccination during pregnancy (AOR=1.54, 95%CI: 1.06, 2.23), and antenatal care utilization (AOR=2.97, 95%CI: 2.06, 4.27) were predictors for health facility/institutional delivery. Conclusions Though a significant proportion of the study participants initiated antenatal care, utilization of all the recommended antenatal care visits, facility delivery, and postnatal care services were low. Health professionals need to use the first antenatal care visit as a golden opportunity to attract and maintain pregnant women for the subsequent maternal health care services.

Associations of At-Risk Drinking, Current Smoking, and Their Co-Occurrence With Primary Care Service Utilization

Purpose Smoking and at-risk drinking are each associated with lower primary care utilization, but the influence of their co-occurrence is not known. The current study compared associations of endorsement of one behavior vs endorsement of both with primary care utilization. Design Cross-sectional telephone survey. Setting All United States and Territories. Subjects 246 801 adults aged 18–64. Measures The outcome was endorsement of attending a past-year primary care visit. Predictor variables included drinking and smoking status examined individually and combined. Analysis Multivariable logistic regressions, adjusted for socio-demographics and number of chronic health conditions. Results The odds of attending a past-year primary care visit were 24% lower for persons who drank at risk levels compared to the odds of persons who did not drink and 36% lower for persons who smoked vs those who did not smoke. Among persons who endorsed at least one risk behavior, the odds of attending a past-year primary care visit were 25–35% lower for those who engaged in multiple behaviors compared to the odds of persons who engaged in one behavior. Conclusion Substance use screening and intervention services in primary care may not be reaching individuals with the greatest need for services. Proactive outreach and identification of primary care utilization barriers are needed, with special consideration of those with co-occurring substance use.

Implementing Behavioral Health Social Workers' Increased Mental Health Care Among Older Adults

Depression is underdiagnosed and undertreated among older adults. Health systems can screen patients to identify depression, but systemic linkages to treatment are required to ensure care. We used a retrospective stepped-wedge study to identify the impact of implementing behavioral health social workers (BHSWs) on receipt of treatment after a new depression diagnosis. We included adults over 65 years of age with a primary care visit between 2016 and 2019 at a large integrated health system. We excluded patients who were diagnosed with or treated for depression in 2015. Patients were categorized into control (diagnosed before implementation) and intervention (diagnosed after implementation) groups. From our electronic health record, we collected prescriptions for pharmacotherapy and behavioral health visits. Patients were considered treated if they received pharmacotherapy or had a behavioral health visit within 30 days of diagnosis. We used multilevel logistic regression models to identify the association between implementation period (pre versus post) and treatment, adjusted for demographic variables and clustering within site. Our population included 4,475 people. The percent of patients that received treatment increased from 47% to 54% after implementation and the percent of patients with ≥1 behavioral health visit within 30 days increased from 3% to 8% (p&lt;0.01, respectively). The adjusted odds ratio of receiving treatment (AOR: 4.13, 95%CI: 2.84-6.01) and having a behavioral health visit (AOR: 3.12, 95%CI: 2.31-4.24) was significantly higher in the post-implementation period. In conclusion, implementation of BHSWs was associated with increased treatment for older patients with depression.

COVID-19 and Its Impact on Older Adults’ Routine and Urgent Health Care Visits

Older adults have not only been disproportionately affected by the COVID-19 pandemic, but relatedly, are also more vulnerable to other health problems. Moreover, previous research on epidemics shows that health care services are often disrupted during health crises—leading to less access to and lower utilization of health services unrelated to the health crisis. The primary aim of this research is to examine the impact of the COVID-19 pandemic on both routine and urgent health care visits. Using data collected in December 2020 on adults ages 54 to 100 living in one of nine senior living communities (SLCs) in the state of Nebraska (n = 723), logistic regression models were used to investigate correlates of missed health care visits, adjusting for sociodemographic and health characteristics. The results show that 58% of older adults in SLCs skipped or postponed a routine health care visit due to the pandemic, whereas 8% of older adults missed an urgent health care visit. The results further reveal that older adults with better perceived health (p &lt; 0.05), higher life satisfaction (p &lt; 0.01), and higher resilience (p &lt; 0.05) all had lower odds of missing a routine health care visit due to the pandemic. In contrast, those who missed an urgent health care visit were more likely to have higher perceived financial strain (p &lt; 0.05). The findings from this study demonstrate the consequences of the COVID-19 pandemic on older adults’ health care utilization, which may have serious implications for their long-term health.